Effect Of Nutritional Supplementation Research Articles

The Effect of Nutritional Lipid Supplementation on Serum Lipid Levels and Effectiveness of Antitubercular Chemotherapy

The effect of serum lipid levels on the incidence and management of tuberculosis has recently been brought to the fore. The aim was to see the effect of nutritional supplementation on susceptibility of organisms of the mycobacterium tuberculosis complex to some known antitubercular drugs via effect on serum lipid levels. Blood samples were collected for baseline estimation of serum lipids from 250 tuberculosis patients who were then allocated into four groups including: those taking drugs for tuberculosis(antitubercular drugs) treatment only, those on antitubercular drugs and one boiled egg daily, those on antitubercular drugs and fish oil (1000 IU/day), and those on antitubercular drugs and both egg and fish oil daily, all for a three month duration, at the end of which blood samples were collected for estimation of serum triglycerides, total cholesterol (TC), high density lipoprotein (HDL-C), low density lipoprotein cholesterol (LDL-C), very low density lipoprotein cholesterol (VLDL-C), and Phospholipids, using appropriate methods. Results shows that though treatment with antitubercular drugs and supplementation with fish oil led to increases in serum lipid levels which were ab initio lower in tuberculosis patients than Healthy controls, supplementation with boiled egg led to a higher increase in serum lipid levels. Supplementation with fish oil also led to the greatest decreases in antitubercular drug resistance. It is thus suggested that supplementation with lipid rich foods in tuberculosis treatment will decrease anti tuberculosis drug resistance and help the global campaign on tuberculosis eradication.

Nutritional Supplementation Increases Rifampin Exposure among Tuberculosis Patients Coinfected with HIV

Nutritional supplementation to tuberculosis (TB) patients has been associated with increased weight and reduced mortality, but its effect on the pharmacokinetics of first-line anti-TB drugs is unknown. A cohort of 100 TB patients (58 men; median age, 35 [interquartile range {IQR}, 29 to 40] years, and median body mass index [BMI], 18.8 [17.3 to 19.9] kg/m(2)) were randomized to receive nutritional supplementation during the intensive phase of TB treatment. Rifampin plasma concentrations were determined after 1 week and 2 months of treatment. The effects of nutritional supplementation, HIV, time on treatment, body weight, and SLCO1B1 rs4149032 genotype were examined using a population pharmacokinetic model. The model adjusted for body size via allometric scaling, accounted for clearance autoinduction, and detected an increase in bioavailability (+14%) for the patients in the continuation phase. HIV coinfection in patients not receiving the supplementation was found to decrease bioavailability by 21.8%, with a median maximum concentration of drug in serum (Cmax) and area under the concentration-time curve from 0 to 24 h (AUC0-24) of 5.6 μg/ml and 28.6 μg · h/ml, respectively. HIV-coinfected patients on nutritional supplementation achieved higher Cmax and AUC0-24 values of 6.4 μg/ml and 31.6 μg · h/ml, respectively, and only 13.3% bioavailability reduction. No effect of the SLCO1B1 rs4149032 genotype was observed. In conclusion, nutritional supplementation during the first 2 months of TB treatment reduces the decrease in rifampin exposure observed in HIV-coinfected patients but does not affect exposure in HIV-uninfected patients. If confirmed in other studies, the use of defined nutritional supplementation in HIV-coinfected TB patients should be considered in TB control programs. (This study has the controlled trial registration number ISRCTN 16552219.).

The Effect of Nutritional Supplements on Serum High-Density Lipoprotein Cholesterol and Apolipoprotein A-I

One of the factors contributing to the increased risk of developing premature atherosclerosis is low plasma concentrations of high-density lipoprotein (HDL) cholesterol. Multiple potential mechanisms account for the cardioprotective effects of HDL and its main protein apolipoprotein A-I (apo A-I). Diet has an important role in modulating HDL cholesterol level. The widespread use of nutritional supplements may also alter the biology of HDL. In this review, we discuss the effect of select nutritional supplements on serum HDL cholesterol and apo A-I levels. Some nutritional supplements, such as phytosterols, soy proteins, and black seed extracts, may increase HDL cholesterol levels, while others such as cholic acid and high doses of commonly used antioxidant vitamins may downregulate HDL cholesterol levels and reduce its cardioprotection. Multiple mechanisms are involved in the regulation of HDL levels, so changes in production and clearance of HDL may have different clinical implications. The clinical relevance of the changes in HDL and apo A-I caused by nutrient supplementation needs to be tested in controlled clinical trials.

Effects of Nutritional Supplement with α-Lipoic Acid in Patients with Recurrent Pterygium

Background: Pterygium is an ocular disease characterized by fibro-proliferative disarray of the corneal surface. Control of oxidative stress with effective antioxidant supplementation, like α-lipoic acid, could prevent recurrence following surgical resection.Materials and methods: This study was a randomized placebo-controlled, double-blind trial. Seventy patients with recurrent pterygium participated. Oral therapy with α-lipoic acid or placebo was administered. Pterygium tissue was collected for histological and immunohistochemical analysis.Results: Pterygium recurrence was similar in both groups. A significant increment of fibroelastic tissue was observed in the placebo compared with the α-lipoic acid group. Number and caliber of blood vessels, extracellular matrix content and presence of inflammatory infiltrated cells decreased in the α-lipoic acid group. Myofibroblasts were also localized and smaller.Conclusions: Treatment with α-lipoic acid improved clinical appearances through decreased fibroelastic tissue size. Recurrence was similar. Blood vessels, extracellular matrix content and inflammatory infiltrated cells reduced with α-lipoic acid.

The assessment and impact of sarcopenia in lung cancer: a systematic literature review

ObjectivesThere is growing awareness of the relationship between sarcopenia (loss of muscle mass and function), and outcomes in cancer, making it a potential target for future therapies. In order to...

Effects of Nutritional Supplementation during Pregnancy on Early Adult Disease Risk: Follow Up of Offspring of Participants in a Randomised Controlled Trial Investigating Effects of Supplementation on Infant Birth Weight

BackgroundObservational evidence suggests that improving fetal growth may improve adult health. Experimental evidence from nutritional supplementation trials undertaken amongst pregnant women in the less developed world does not show strong or consistent effects on adult disease risk and no trials from the more developed world have previously been reported. ObjectiveTo test the hypothesis that nutritional supplementation during pregnancy influences offspring disease risk in adulthood DesignClinical assessment of a range of established diseases risk markers in young adult offspring of 283 South Asian mothers who participated in two trials of nutritional supplementation during pregnancy (protein/energy/vitamins; energy/vitamins or vitamins only) at Sorrento Maternity Hospital in Birmingham UK either unselected or selected on the basis of nutritional status. Results236 (83%) offspring were traced and 118 (50%) of these were assessed in clinic. Protein/energy/vitamins supplementation amongst undernourished mothers was associated with increased infant birthweight. Nutritional supplementation showed no strong association with any one of a comprehensive range of markers of adult disease risk and no consistent pattern of association with risk across markers in offspring of either unselected or undernourished mothers. ConclusionsWe found no evidence that nutritional supplements given to pregnant women are an important influence on adult disease risk however our study lacked power to estimate small effects. Our findings do not provide support for a policy of nutritional supplementation for pregnant women as an effective means to improve adult health in more developed societies.

The effect of nutritional supplementation during pregnancy on placental transporter expression in placentas from Gambian women

The effect of nutritional supplementation during pregnancy on placental transporter expression in placentas from Gambian women

Pressure Ulcer Risk Assessment and Prevention

Pressure ulcers are associated with substantial health burdens but may be preventable. To review the clinical utility of pressure ulcer risk assessment instruments and the comparative effectiveness of preventive interventions in persons at higher risk. MEDLINE (1946 through November 2012), CINAHL, the Cochrane Library, grant databases, clinical trial registries, and reference lists. Randomized trials and observational studies on effects of using risk assessment on clinical outcomes and randomized trials of preventive interventions on clinical outcomes. Multiple investigators abstracted and checked study details and quality using predefined criteria. One good-quality trial found no evidence that use of a pressure ulcer risk assessment instrument, with or without a protocolized intervention strategy based on assessed risk, reduces risk for incident pressure ulcers compared with less standardized risk assessment based on nurses' clinical judgment. In higher-risk populations, 1 good-quality and 4 fair-quality randomized trials found that more advanced static support surfaces were associated with lower risk for pressure ulcers compared with standard mattresses (relative risk range, 0.20 to 0.60). Evidence on the effectiveness of low-air-loss and alternating-air mattresses was limited, with some trials showing no clear differences from advanced static support surfaces. Evidence on the effectiveness of nutritional supplementation, repositioning, and skin care interventions versus usual care was limited and had methodological shortcomings, precluding strong conclusions. Only English-language articles were included, publication bias could not be formally assessed, and most studies had methodological shortcomings. More advanced static support surfaces are more effective than standard mattresses for preventing ulcers in higher-risk populations. The effectiveness of formal risk assessment instruments and associated intervention protocols compared with less standardized assessment methods and the effectiveness of other preventive interventions compared with usual care have not been clearly established.

Exercise and nutritional supplements; effects of combined use in people over 65 years; a systematic review

To systematically review the evidence in the scientific literature about the influence and effects of nutritional supplements on muscle mass and strength when combined with exercise training in healthy elderly. Cross-sectional descriptive study. Was selected scientific literature databases: MEDLINE, EMBASE, ISI, CINAHL, Cochrane and LILACS Given an inclusion criterion only randomized clinical trials (RCT) and excluding documents not based their study in healthy elderly and did not implement a training program. Of the 8 articles selected for the review, some studies supplement combined with various forms of training and other supplements with different training resistance. The supplements were administered: Protein supplementation (drinkable), Creatine, Vitamin D and calcium. The resistance training was assigned with: weights, elastic bands, machines, balance, guidance exercises and aerobic exercise. - Combine exercise supplementation, regardless reinforces the effects each can have on improving strength, balance and speed. - The improvement of the musculoskeletal system enhances mobility, contributing to the prevention of Sarcopenia and prolongation of the independence and autonomy of older people. - The use of supplements should be subject to an analysis of daily nutritional intake, individual energy demands and the choice of a physical endurance exercise practiced and extended in time, to preserve the benefits.

Effectiveness of Nutritional Supplementation on Muscle Mass in Treatment of Sarcopenia in Old Age: A Systematic Review

Much interest has been focused on nutritional treatment of sarcopenia, loss of muscle mass and performance associated to aging; however, its benefits are unclear. To analyze the relevance of nutritional treatment of sarcopenia and assess the effects of supplementation on muscle mass and function within the aged population. We searched Medline and the Cochrane Library for controlled trials published between 1991 and 2012. We have assessed the quality, type of intervention, the cohort used, the way muscle mass was measured, and the outcomes of the various studies. We have included 17 studies, with a total of 1287 patients, aged between 65 and 85 on average. An improvement in muscle mass was proven, whether measured with bioelectrical impedance analysis or dual energy x-ray absorptiometry, and an improvement in strength was also proven. Nutritional supplementation is effective in the treatment of sarcopenia in old age, and its positive effects increase when associated with physical exercise. The main limitation of this treatment is lack of long-term adherence. A healthy diet associated with a physically active lifestyle and possibly with aerobic exercise are the basis of healthy aging, which is the aim of all doctors treating aged people must seek.

Influence of flushing and season of kidding on reproductive characteristics of Small East African goats (does) and growth performance of their kids in a semi arid area of Tanzania

A study was carried out to assess the effects of nutritional supplementation (flushing) and season of kidding on reproductive performance of Small East African (SEA) does and growth performance of their crossbred (Norwegian x SEA). Seasons of kidding were defined as season 1 (June- August) and 2 (September to November) which represented the early and late dry months of the year, respectively. A total of 90 grazing does were divided into three groups of 30 does each and monitored for two years. In each observational year, one group (control goats) received no concentrate supplementation while the remaining groups were subjected to 200 or 400 g of concentrate diet/doe/day for a period of 60 days (November to January) before mating. Does were then exposed to sexually active bucks from January through June in 2008 and 2009. Nutritional flushing and season of kidding had no effects (P>0.05) on fertility, prolificacy and fecundity. Nonetheless, the relative weight increase during gestation was 35.8 % in season 1 being higher (P<0.01) than 12.6% recorded in season 2. The proportion of weight loss of does kidding in season 1(6.1%) was, however, lower (P<0.05) than 8.9% in season 2. Kids born in season 1 grew at a faster rate than their counterparts born in season 2 (80 vs. 57 g/day, P<0.05). Consequently, the average weight of kids weaned per doe kidding was 2 kg in favour of season 1. It is concluded that nutritional flushing during peak-dry season may not be necessary for goats to conceive especially when raised on lightly grazed rangeland and that breeding activities of goats should preferably be restricted to January to March for kidding to take place during early dry season (June to August). Key words: Goats, nutritional flushing, seasonality, reproductive performance, growth rate.

Nutritional interventions for liver-transplanted patients

Malnutrition is a common problem for patients waiting for orthotopic liver transplantation and a risk factor for post-transplant morbidity. The decision to initiate enteral or parenteral nutrition, to which patients and at which time, is still debated. The effects of nutritional supplements given before or after liver transplantation, or both, still remains unclear. The aim of this review was to assess the beneficial and harmful effects of enteral and parenteral nutrition as well as oral nutritional supplements administered to patients before and after liver transplantation. We searched the Cochrane Hepato-Biliary Group Controlled Trials Register (March 2012), the Cochrane Central Register of Controlled Trials (Issue 2 of 12, 2012) in The Cochrane Library, MEDLINE (January 1946 to March 2012), EMBASE (January 1974 to March 2012), Science Citation Index Expanded (January 1900 to March 2012), Social Science Citation Index (January 1961 to October 2010), and reference lists of articles. Manufacturers and experts in the field have also been contacted and relevant journals and conference proceedings were handsearched (from 1997 to October 2010). Randomised clinical trials of parallel or cross-over design evaluating the beneficial or harmful effects of enteral or parenteral nutrition or oral nutritional supplements for patients before and after liver transplantation were eligible for inclusion. Two authors independently assessed the risk of bias of the trials and extracted data. Dichotomous data were reported as odds ratios (OR) and continuous data as mean differences (MD) along with their corresponding 95% confidence intervals (CI). Meta-analysis was not possible due to clinical heterogeneity of included interventions. Thirteen trials met the inclusion criteria. Four publications did not report outcomes pre-defined in the review protocol, or other clinically relevant outcomes and additional data could not be obtained. Nine trials could provide data for the review. Most of the 13 included trials were small and at high risk of bias. Meta-analyses were not possible due to clinical heterogeneity of the interventions.No interventions that were likely to be beneficial were identified.For interventions of unknown effectiveness,postoperative enteral nutrition compared with postoperative parenteral nutrition seemed to have no beneficial or harmful effects on clinical outcomes. Parenteral nutrition containing protein, fat, carbohydrates, and branched-chain amino acids with or without alanyl-glutamine seemed to have no beneficial effect on the outcomes of one and three years survival when compared with a solution of 5% dextrose and normal saline. Enteral immunonutrition with Supportan® seemed to have no effect on occurrence of immunological rejection when compared with enteral nutrition with Fresubin®.There is weak evidence that, compared with standard dietary advice, adding a nutritional supplement to usual diet for patients during the waiting time for liver transplantation had an effect on clinical outcomes after liver transplantation. The combination of enteral nutrition plus parenteral nutrition plus glutamine-dipeptide seemed to be beneficial in reducing length of hospital stay after liver transplantation compared with standard parenteral nutrition (mean difference (MD) -12.20 days; 95% CI -20.20 to -4.00). There is weak evidence that the use of parenteral nutrition plus branched-chain amino acids had an effect on clinical outcomes compared with standard parenteral nutrition, but each was beneficial in reducing length of stay in intensive care unit compared to a standard glucose solution (MD -2.40; 95% CI -4.29 to -0.51 and MD -2.20 days; 95% CI -3.79 to -0.61). There is weak evidence that adding omega-3 fish oil to parenteral nutrition reduced the length of hospital stay after liver transplantation (mean difference -7.1 days; 95% CI -13.02 to -1.18) and the length of stay in intensive care unit after liver transplantation (MD -1.9 days; 95% CI -1.9 to -0.22).For interventions unlikely to be beneficial, there is a significant increased risk in acute rejections in malnourished patients with a history of encephalopathy and treated with the nutritional supplement Ensure® compared with usual diet only (MD 0.70 events per patient; 95% CI 0.08 to 1.32). We were unable to identify nutritional interventions for liver transplanted patients that seemed to offer convincing benefits. Further randomised clinical trials with low risk of bias and powerful sample sizes are needed.

Krill oil to improve blood lipids status in advanced cancer patient with cachexia.

e19634 Background: Cancer patients with cachexia symptoms often show a lipid profile disorder, consisting in severe hypertriglyceridemia due to increased circulating free fatty acids and variable total cholesterol levels, decreased activity of lipoprotein lipase and increased lipolysis, which is correlated with proinflammatory cytokines levels, particularly IL-6 and TNFα. Recent evidence further confirms impairment of adipose tissue metabolism in inflammatory condition like cancer cachexia. The aim of this study was to assess the effect of nutritional supplementation with Omega 3 fatty acids (EPA and DHA) in the form of Krill Oil, on main parameters of blood lipid profile and on IL-6 and TNFα blood levels. Methods: In 2011, 34 IV stage cachectic patients (M/F 20/14; age range 55-85 y) with cancer at different sites were enrolled. 21 healthy subjects were studied as controls. All patients had high blood tryglicerides, low total cholesterol levels , high levels of blood IL-6 and TNFα compared to controls. Patients received 3 capsules (3 g/day) of krill oil (Superba™ Krill Oil, Aker Biomarine, Norway), which is an oil extract from the crustacean krill (Euphausia Superba) which contains Omega-3 series unsaturated fatty acids in phospholipidic form, of which 98 % are EPA and DHA mainly in phospholipid form. Treatment duration was 2 months. Results: A significant reduction of tryglicerides blood levels (148.23 ± 88.06 vs 114 ± 55.8 mg/dl) and a significant improvement of HDL cholesterol (42.5 ± 15.6 vs 60.9 ± 12.3 mg/dl) and Total Cholesterol (135.6 ± 46.3 vs 159 ± 41.1 mg/dl) was observed after treatment. Cytokines Il-6 and TNFα blood levels did not change significantly after treatment Conclusions: Nutritional supplementation with krill oil showed a positive activity in the regulation of blood lipid profile, involving different metabolic and inflammatory pathways, probably mainly affecting hormone-sensitive lipase activity. Our data suggest that krill oil could be useful in multi-targeted combined pharmaco-nutritional approaches to treat cancer-cachexia. Additional phase III clinical studies are warranted.

Effect of nutritional supplementation upon pregnancy rates of goats under semiarid rangelands and exposed to the male effect

The aim of this study was to evaluate possible effects of improved protein and energy diet upon reproductive outcomes of adult goats under marginal rangeland grazing conditions and exposed to the male effect during the anoestrous-dry season. Adult goats (Nubian × Criollo, nonpregnant, nonlactating, n = 160, 22° 50' N, 100° 59' W, 1,653 m) were randomly divided in two experimental groups: Control (CG; n = 80) and Supplemented (SG; n = 80). Both CG and SG goats were kept together during the day for ranging a semiarid rangeland while separated accordingly at night. SG goats were individually supplemented [400 g kg(-1) day(-1); 14% CP and 2.92 Mcal DE kg(-1)] during a 30-day period. Thereafter, both the CG [35.5 ± 0.94 kg LW, 1.95 ± 0.06 U, body condition score (BCS)] and the SG [39.5 ± 0.94 kg LW, 2.29 ± 0.06 BCS] were exposed to adult males (Nubian, n = 4, two per group) of proven libido and fertility and kept together at night (1700-0900) during a 42-day experimental breeding period. At the beginning of the breeding period, both LW (P < 0.001) and BCS (P < 0.001) were higher in the SG, which was also reflected in higher pregnancy rate (92.5 vs. 76.3%, P < 0.01). Nonetheless, both CG and SG depicted an increased abortion rate (52.5 vs. 41.9% P > 0.05), respectively. Results suggest that nutritional supplementation and the male effect were able to successfully invoke neurophysiological pathways to increase ovarian activity and to promote a uterine milieu prone to the establishment of pregnancy during the anoestrus season. However, the increased abortion rates observed in the study occurred irrespective of the nutritional regime offered during the premating stage. Therefore, there is a need to align the last third of gestation to the onset of the grazing season in order to increase reproductive and economic efficiency in those rangeland-based marginal goat production systems.

Vitamin, mineral, and specialty supplements and risk of hematologic malignancies in the prospective VITamins And Lifestyle (VITAL) study.

Increasing evidence suggests that nutrients from fruits and vegetables have chemoprotective effects on various cancers including hematologic malignancies, but the effects of nutritional supplements are poorly examined. Herein, we prospectively evaluated the association of vitamin, mineral, and specialty supplements with incident hematologic malignancies in 66,227 men and women aged 50 to 76 years from Washington State recruited from year 2000 to 2002 to the VITamins And Lifestyle (VITAL) cohort study. Hematologic malignancies cases (n = 588) were identified through December 2008 by linkage to the Surveillance, Epidemiology, and End Results (SEER) cancer registry. HRs and 95% CIs associated with supplement use were estimated with Cox proportional hazards models. After adjustment, high use of garlic supplements [≥4 days per week for ≥3 years; HR = 0.55 (95% CI = 0.34-0.87); P(trend) = 0.028] and ever use of grape seed supplements [HR = 0.57 (95% CI = 0.37-0.88)] were inversely associated with hematologic malignancies in our models. In addition, high use (8-10 pill-years) of multivitamins was suggestive of an inverse association [HR = 0.80 (95% CI = 0.64-1.01)]. In contrast, no associations were observed for the remaining supplements. These data indicate that the use of garlic and grape seed may be associated with reduced risk of hematologic malignancies. This is the first cohort study to suggest a possible role of these supplements in the chemoprevention of hematologic malignancies.

Mathematical model insights into arsenic detoxification

BackgroundArsenic in drinking water, a major health hazard to millions of people in South and East Asia and in other parts of the world, is ingested primarily as trivalent inorganic arsenic (iAs), which then undergoes hepatic methylation to methylarsonic acid (MMAs) and a second methylation to dimethylarsinic acid (DMAs). Although MMAs and DMAs are also known to be toxic, DMAs is more easily excreted in the urine and therefore methylation has generally been considered a detoxification pathway. A collaborative modeling project between epidemiologists, biologists, and mathematicians has the purpose of explaining existing data on methylation in human studies in Bangladesh and also testing, by mathematical modeling, effects of nutritional supplements that could increase As methylation.MethodsWe develop a whole body mathematical model of arsenic metabolism including arsenic absorption, storage, methylation, and excretion. The parameters for arsenic methylation in the liver were taken from the biochemical literature. The transport parameters between compartments are largely unknown, so we adjust them so that the model accurately predicts the urine excretion rates of time for the iAs, MMAs, and DMAs in single dose experiments on human subjects.ResultsWe test the model by showing that, with no changes in parameters, it predicts accurately the time courses of urinary excretion in mutiple dose experiments conducted on human subjects. Our main purpose is to use the model to study and interpret the data on the effects of folate supplementation on arsenic methylation and excretion in clinical trials in Bangladesh. Folate supplementation of folate-deficient individuals resulted in a 14% decrease in arsenicals in the blood. This is confirmed by the model and the model predicts that arsenicals in the liver will decrease by 19% and arsenicals in other body stores by 26% in these same individuals. In addition, the model predicts that arsenic methyltransferase has been upregulated by a factor of two in this population. Finally, we also show that a modification of the model gives excellent fits to the data on arsenic metabolism in human cultured hepatocytes.ConclusionsThe analysis of the Bangladesh data using the model suggests that folate supplementation may be more effective at reducing whole body arsenic than previously expected. There is almost no data on the upregulation of arsenic methyltransferase in populations chronically exposed to arsenic. Our model predicts upregulation by a factor of two in the Bangladesh population studied. This prediction should be verified since it could have important public health consequences both for treatment strategies and for setting appropriate limits on arsenic in drinking water. Our model has compartments for the binding of arsenicals to proteins inside of cells and we show that these comparments are necessary to obtain good fits to data. Protein-binding of arsenicals should be explored in future biochemical studies.

Effects of nutritional supplements in healing of laparotomic dehiscences in obese patients with metabolic syndrome: a randomized prospective controlled study

Background Chronic venous insufficiency, infection, diabetes mellitus, excess malnutrition, exposure to pressure and shear, all conditions included in obesity, prolong the healing process. Moreover, a growing body of evidence clearly indicates that dietary supplementation or intravenous administration of Arg is beneficial in facilitating wound healing, enhancing insulin sensitivity, and maintaining tissue integrity. Arginine produces physiologic effects via nitric oxide dependent and independent pathways. Nitric oxide is important for the modulation of vascular tone, inflammation, immune function, endothelial function, platelet and leukocyte adherence, and neurotransmission. Nitric oxide modulates many biochemical processes important for the response to sepsis. Arginine, independent of nitric oxide, is important for growth, wound healing, cardiovascular function, immune function, inflammatory responses, energy metabolism, urea cycle function, and other metabolic processes. Arginine supplementation improves outcomes in animals with sepsis, wounds, ischemia-reperfusion injury, and following thermal injury. Enteral administration of arginine improves endothelial function but has little effect upon hemodynamics during human sepsis. An analysis of clinical studies using enteral formulas with supplemental arginine suggests benefits upon outcome, with no evidence of significant detrimental effects. The aim of this study was to evaluate the healing effects of a normocaloric diet enriched in arginine, eicosapentanoic acid (EPA) and gamma-linolenic acid (GLA) and vitamins (vitamins A, C and E) on laparotomies wound dehiscence.

Serum antioxidant levels and nutritional status in early and advanced stage lung cancer patients

ObjectiveMalnutrition frequently occurs in lung cancer patients. We aimed to determine nutritional status and antioxidant and mineral levels in Thai patients with lung cancer. MethodsA prospective study with matched case-control was conducted. Nutritional status was assessed by body mass index (BMI) and subjective global assessment (SGA). Eastern Cooperative Oncology Group (ECOG) performance status was used to assess the performance. The serum antioxidant and mineral levels were determined. ResultsForty-nine patients with a mean age of 58.8 (range, 35-82) who were first diagnosed with lung cancer were enrolled. They were compared with 60 healthy controls, and levels of retinol, α-tocopherol, β-carotene, lycopene, β-cryptoxanthin, selenium, and zinc were lower (P < 0.05). However, peroxidase activity was higher (P = 0.002) in patients. Selenium levels were higher in early stage compared to advanced stage patients (P = 0.041). Overweight patients had higher selenium levels (0.04 mg/L) than normal BMI patients (β = 0.04, P = 0.035). Patients with SGA class C had lower selenium levels (0.03 mg/L) than those with class A (β = −0.03, P = 0.035). The poorer ECOG performance patients had significantly lower β-carotene (β = −0.192, P = 0.003) and selenium (β = −0.031, P = 0.011) levels compared with those with good ECOG performance status. ConclusionsSignificantly lower levels of antioxidants and selenium were found in lung cancer patients compared to healthy controls. Levels of some antioxidants and minerals differed among categories of BMI, SGA categories, or ECOG performance status. These findings may be helpful for further studies, such as the effect of nutritional supplementation on clinical outcomes.

Effect of Nutritional Supplementation on the IGF Axis in Soldiers Undertaking Arduous Military Training

Soldiers undertaking the arduous tactical phase of the Section Commanders Battle Course (TAC SCBC) are shown to be in energy deficit (Richmond et al., 2010, Med Sci Sports Exerc, 42, S287). An energy deficit of >1000 kcal·d-1 blunts the positive anabolic adaptations to heavy training by decreasing circulating insulin-like growth factor (IGF) -1 and IGF binding protein (IGF BP) -3 (Nindl et al., 2003, J Appl Physiol, 95, 1083-89). PURPOSE: To investigate the effect of a mixed nutritional supplement on the IGF axis in soldiers undergoing TAC SCBC. METHODS: Thirty males (age 25 ± 3 yr; body mass 80.9 ± 7.7 kg; body fat 15.4 ± 3.3 %) undertaking the 8-week TAC SCBC consumed a habitual diet alone (CON, n = 15) or received an additional food supplement (SUP, n = 15). All soldiers were given ∼3,550 kcal·d-1 during in-barrack feeding between wk 0 and 6, and 4,242 kcal·d-1 during a final 2-wk field exercise (Field EX). SUP were provided an additional 1,350 kcal·d-1 during wk 0-6 and 850 kcal·d-1 during Field EX. The macronutrient breakdown of the supplement was ∼45% carbohydrate, ∼40% fat and ∼15% protein. Measures of body composition (DEXA) and resting blood samples were collected at 0530h at baseline (wk 0) and at the end of TAC SCBC (wk 8). Physical activity was monitored by accelerometry (3DNX, Biotel) during Field EX. RESULTS: There were no between group differences in baseline demographics or physical activity during Field EX. The loss in body mass (CON 5.0 ± 2.3; SUP 1.6 ± 1.5 kg: P < 0.001), lean mass (CON 2.1 ± 1.5; SUP 0.7 ± 1.5 kg: P < 0.05) and fat mass (CON 3.0 ± 1.6; SUP 0.9 ± 1.8 kg: P < 0.01) over the 8 wk period was greater in CON. Training reduced circulating IGF-1 (28%), testosterone (19%) the testosterone: cortisol ratio (25%) and increased sex hormone binding globulin (38%) (P < 0.01) with no effect of SUP. However, there was a significant decrease in IGF BP-3 in CON (wk 0, 2.3 ± 0.3; wk 8, 1.8 ± 0.4 μg·ml-1; P < 0.05) that was abolished in SUP (wk 0, 2.2 ± 0.5; wk 8, 2.1 ± 0.4 μg·ml-1). There were no changes in circulating insulin, cortisol, IGF BP-1, triiodothyronine or thyroxine. CONCLUSION: A mixed nutritional supplement did not blunt the unfavourable decreases in IGF-1 or testosterone concentration during 8 wks of arduous military training, but did prevent the decrease in IGF BP-3 concentration. Sponsored by UK Ministry of Defence (Army).

Effect of Nutritional Supplementation on Physical Performance and Body Composition during Arduous Military Training

Effect of Nutritional Supplementation on Physical Performance and Body Composition during Arduous Military Training