Supplement Intake Research Articles

A clinical case of acute anabolic steroid-induced toxic hepatitis

Drug-induced liver injury (DILI) can be considered in cases of acute hepatitis by the exclusion of any disease-related causes. For several decades, anabolic steroids have been considered not only as drugs for treatment of diseases such as hypogonadism, sarcopenia, hypotrophy in cancer patients, aplastic anemia, etc., but also as risk factor for acute liver failure, that can lead to liver cancer, and even sudden death. Anabolic steroids are known to be increasingly used not only for legitimate medical uses, but also for enhance physical performance and promote muscle growth for ideal body shape. The article presents a clinical case of acute drug-induced hepatitis after 2 months of using stanozolol, a synthetic testosterone derivative, in a 25-year-old previously healthy man. Thorough etiological investigations ruled out other causes of DILI. The man was treated at the in-patient department and discharged with improvement, but it took several months for the disappearance of hepatic cytolytic and cholestatic changes. Clinicians should be aware of the risk for toxic drug-induced hepatitis in male bodybuilders and collect a thorough history of the patient’s intake of nutritional supplements that may contain androgen derivatives.

Vitamin D Status in Term Newborns and Their Mothers

The aim of this study is: 1) To evaluate vitamin D serum levels of fullterm newborns and its association with the maternal levels; 2) To evaluate the diet and the intake of multivitamin supplements of women; 3) To analyze seasonal dependence in serum levels of mother-baby pairs. The prospective study was carried out between July 2018 and February 2020 at the University Hospital of Obstetrics and Gynecology “Maichin dom”, Sofia. The study included 45 full-term newborns and their mothers. Data collected included maternal health, nutrition, vitamin intake, and anthropometric data of the newborns. The laboratory tests performed: maternal serum 25(OH)D levels taken in the third trimester of pregnancy and umbilical cord levels of 25(OH)D. The results show that the mean birth weight was 3234.22 ± 370.29 g and the mean gestational age was 38.13±0.89 weeks. A 25(OH)D sufficiency was found in 58% of mothers and 67% of newborns. A strong positive correlation between maternal and neonatal 25(OH)D concentrations (p = 0.007) was found. A relationship between maternal diet, vitamin supplementation and serum vitamin D levels was observed. The level of 25(OH)D in the umbilical cord in winter is lower than in summer (p = 0.002). Due to the essential role of vitamin D for the normal development of the fetus and the infant, a testing for serum levels of vitamin D during pregnancy is recommended.

Effect of Nutrition Therapy on Ferritin in Pregnant Women with Anemia at Gamping 2 Public Health Center

Cases of anemia in pregnant women in Indonesia are 48.9% and have the potential to endanger the safety of mother and child. Iron deficiency will cause a decrease in ferritin levels and will cause a decrease in hemoglobin levels below normal limits. Objective: to determine the effect of nutritional therapy for 2 months on serum hemoglobin and ferritin levels in anemic pregnant women in the second trimester. Experiment with a pretest-posttest control group design approach. A sample of 2nd trimester pregnant women with anemia at the Gamping II Health Center was 44 people. The sampling technique was Simple Random Sampling, divided into 2 groups, namely the case group 22 people received nutritional counseling therapy and Fe supplements and the control group 22 people received Fe supplement therapy. Both groups will compare the results of ferritin levels before and after receiving nutritional therapy for 2 months. Data collection used a ferritin test kit, sociodemographic data, obstetric history, nutritional counseling form, Fe supplement intake form. Analysis used the Independent t-test with STATA 13. Results the average ferritin of anemic pregnant women who were given nutritional counseling therapy and Fe supplements was 62.01 ng/mL, while anemic pregnant women who received Fe supplements obtained an average of 51. 4 ng/mL. The results of the statistical test obtained p value = 0.1131, which means that there was no significant difference between the ferritin levels of the intervention group and the control group.

Effects of cold water immersion and protein intake combined recovery after eccentric exercise on exercise performance in elite soccer players.

The purpose of this study is to analyze the effects of the combined recovery method of cold water immersion (CWI) and protein supplement intake after eccentric exercise that causes muscle fatigue in elite soccer players. Eleven semiprofessional soccer players participated in this study. Participants were divided into CWI group, combined protein and CWI group (PCWI), and passive resting group (CON). The participants completed the eccentric exercise for one hour and performed one of three recovery methods. The muscle strength of the quadriceps and hamstring muscles significantly decreased at 48-hr postexercise compared to before exercise in all recovery groups (P<0.05), with no significantly different between the recovery groups. The time required to sprint 40 m was significantly longer in all groups at 24 hr and 48 hr after exercise than before exercise (P<0.05). The vertical jump height was significantly decreased at 48 hr after exercise compared to before exercise in the CON and CWI groups (P<0.05). The muscle soreness values were higher at 6 hr, 24 hr, and 48 hr after exercise than before exercise in all groups (P<0.001). The perceived recovery quality was reduced after exercise in the PCWI (P<0.01) and CON groups (P<0.001) compared to before exercise; it was unchanged in the CWI group. The recovery quality decreased at 6 hr, 24 hr, and 48 hr after exercise in all recovery groups (P<0.01). In conclusion, the combined recovery method was less effective than CWI alone for the recovery of exercise performance.

Glycomacropeptide Impacts Amylin-Mediated Satiety, Postprandial Markers of Glucose Homeostasis, and the Fecal Microbiome in Obese Postmenopausal Women

BackgroundObesity with metabolic syndrome is highly prevalent and shortens lifespan. ObjectivesIn a dose-finding crossover study, we evaluated the effect of glycomacropeptide (GMP) on satiety, glucose homeostasis, amino acid concentrations, inflammation, and the fecal microbiome in 13 obese women. MethodsEligible women were ≤10 yr past menopause with a body mass index [BMI (in kg/m2)] of 28 to 35 and no underlying inflammatory condition affecting study outcomes. Participants consumed GMP supplements (15 g GMP + 10 g whey protein) twice daily for 1 wk and thrice daily for 1 wk, with a washout period between the 2 wk. Women completed a meal tolerance test (MTT) on day 1 (soy MTT) and day 7 (GMP MTT) of each week. During each test, subjects underwent measures of glucose homeostasis, satiety, cytokines, and the fecal microbiome compared with that of usual diet, and rated the acceptability of consuming GMP supplements. ResultsThe mean ± SE age of the 13 women was 57 ± 1 yr, with a median of 8 yr (range: 3–9 yr) past menopause and a BMI of 30 (IQR: 29–32). GMP was highly acceptable to participants, permitting high adherence. Metabolic effects were similar for twice or thrice daily GMP supplementation. Glucose, insulin, and cytokine concentrations were no different. The postprandial area under the curve (AUC) for glucagon concentrations was significantly lower, and the insulin-glucagon ratio was significantly higher with GMP than that with the soy MTT. Postprandial AUC amylin concentration was significantly higher with GMP than that with the soy MTT and correlated with C-peptide (P < 0.001; R2 = 0.52) and greater satiety. Ingestion of GMP supplements twice daily reduced members of the genus Streptococcus (P = 0.009) and thrice daily consumption reduced overall α diversity. ConclusionsGMP is shown to increase amylin concentrations, improve glucose homeostasis, and alter the fecal microbiome. GMP can be a helpful nutritional supplement in obese postmenopausal women at risk for metabolic syndrome. Further investigation is warranted.This trial was registered at clinicaltrials.gov as NCT05551091.

The Suppressive Effect of NF-kB Activation After Eicosapentaenoic Acid Intake Before Surgery.

To ascertain whether preoperative neo-adjuvant nutritional therapy (NANT) using eicosapentaenoic acid (EPA) supplementation can provoke a rise in blood levels of EPA capable of restricting NF-B nuclear translocation in resected specimens. Patients were allocated to two groups depending on individual preference: Patients in the treatment group received 2 g of EPA daily for two weeks prior to surgery (NANT group, n=18). Patients in the control group had a normal diet (CONT group, n=26). NF-B translocation rate, in specimens collected, was investigated by histopathology. Five hundred malignant cells were counted, and tissues with 10% or higher NF-B nuclear translocation were determined to be positive. The EPA blood concentration rose significantly in the NANT group (p<0.01). The positive rate of NF-B nuclear translocation in cancer cells was 11.1% in the NANT group compared with 50% in the CONT group. This difference was statistically significant (p<0.01). Increased blood concentrations of EPA after preoperative supplementation was associated with suppression of NF-B nuclear translocation in malignant cells. These results suggest that intake of EPA-containing supplements before surgery can control NF-B activation and by extension, cancer aggressiveness.

Effect of xanthophyll-rich food and supplement intake on visual outcomes in healthy adults and those with eye disease: a systematic review, meta-analysis, and meta-regression of randomized controlled trials

Xanthophyll intake is known to improve eye health; however, its benefits on visual outcomes have not been systematically studied, particularly in a population with eye diseases. A systematic review, meta-analysis, and meta-regression were conducted to investigate the effect of xanthophyll intake on visual outcomes, and further subgroup analysis was performed on the basis of eye disease status. The PubMed, Scopus, Embase, CINAHL, Cochrane, and Web of Science databases were searched, and relevant randomized controlled trials were identified. For systematic review, meta-analysis, and meta-regression, 43, 25, and 21 articles were selected, respectively. Xanthophyll intake enhanced macular pigment optical density (MPOD) for both heterochromatic flicker photometry (weighted mean difference [WMD], 0.05; 95% confidence interval [CI], 0.03-0.07) and autofluorescence imaging (WMD, 0.08; 95%CI, 0.05-0.11) measurements and decreased photostress recovery time (WMD, -2.35; 95%CI, -4.49 to -0.20). While enhancement in visual acuity logarithm of the minimum angle of resolution was observed in response to the xanthophyll-rich food and supplement intake only for patients with eye disease (WMD, -0.04; 95%CI, -0.07 to -0.01). Meta-regression showed a positive correlation between change in MPOD (heterochromatic flicker photometry) and the corresponding change in serum lutein levels (regression coefficient = 0.068; P = 0.00). Intake of xanthophyll-rich food or supplements can improve eye health. Additional improvement in visual acuity was observed in patients with eye disease. A positive association between MPOD and serum lutein level, while absent with dietary xanthophyll intake, suggests the importance of bioavailability when examining the effect of xanthophyll on eye health. PROSPERO registration no. CRD42021295337.

Development of an Instrument to Evaluate the Intake of Liquids, Food and Supplements in Endurance Competitions: Nutritional Intake Questionnaire for Endurance Competitions-NIQEC.

In the last few years endurance sports have experienced a great increase in the number of competitions and participants. Dietary-nutritional planning is key for performing well during such competitions. To date, there is no questionnaire expressly developed to be able to analyze the consumption of liquids, foods, and supplements, as well as gastrointestinal problems in these events. This study describes the development of the Nutritional Intake Questionnaire for Endurance Competitions (NIQEC). The study was composed in the following phases: (1) Bibliographic search for the most important nutrients, (2) focus groups (17 dietitian-nutritionists and 15 experienced athletes) and generation of items, (3) Delphi surveys, and (4) cognitive interviews. After an initial shaping of the questionnaire with the items that emerged in the focus groups, their relevance was evaluated by means of the Delphi survey, which showed more than 80% approval for most items. Finally, the cognitive interviews indicated that the questionnaire was simple and complete for its purpose. The final NIQEC (n = 50 items) was divided in 5 sections: Demographic data; sports data; consumption of liquids, food and supplements before, during, and after the competition; gastrointestinal complaints, and dietary-nutritional planning for the competition. The NICEQ is a useful tool that allows collecting information from participants on sociodemographic factors and gastrointestinal complaints, and estimating the intake of liquid, food, and supplements, for endurance competitions.

Individual and contextual-level factors associated with iron-folic acid supplement intake during pregnancy in Ethiopia: a multi-level analysis

BackgroundAnemia is still one of the major public health problems in many developing countries including Ethiopia. Thus, this study aimed to assess individual and contextual-level factors associated with iron-folic acid supplement intake during pregnancy in Ethiopia.MethodsA secondary analysis was done on the 2019 mini-Ethiopian Demographic and Health Survey (EDHS) dataset. A total of 3,927 pregnant women who gave birth five years before the survey were included in the analysis. Multi-level mixed-effect logistic regression analysis was done by STATA/SE version 14.0 to identify individual and contextual-level factors. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to show the strength and direction of the association. The level of statistical significance was declared at a P value less than 0.05.ResultsThose primary educated [AOR = 1.83, 95% CI: (1.24, 2.74)], secondary educated [AOR = 2.75, 95% CI: (1.57, 4.824)], women who had greater than 5 living children [AOR = 2.02, 95% CI: (1.25, 3.27)], women who had ANC visit [AOR = 21.26, 95% CI: (13.56, 33.32)] and women who lived in a cluster with high proportion of women had ANC visit [AOR = 1.72, 95% CI: (1.17, 2.54)] and women who lived in Somali [AOR = 0.44 0.73, 95% CI: (0.22, 0.87)] were significantly associated with iron-folic acid intake during pregnancy.ConclusionsBoth individual and contextual-level factors were significantly associated with iron-folic acid intake during pregnancy. From individual-level factors: education status of women, the total numbers of living children, and ANC follow-up are significant and from contextual-level factors: region and living in a high proportion of women who had ANC follow-up were found to have a statistically significant association. Promoting women’s education and maternal health services like ANC and intervention targeting the Somali region would be the recalled area of the government.

Can Iron and Polyunsaturated Fatty Acid Supplementation Induce Ferroptosis?

Ferroptosis is a regulated non-apoptotic cell death process triggered by excessive iron-induced lipid peroxidation. Excess intracellular iron promotes lipid peroxidation by increasing reactive oxygen species formation through the Fenton reaction. Thus, iron and polyunsaturated fatty acid intake may trigger ferroptosis under certain conditions. The aims of this review were to compile and examine evidence in the literature for the effects of iron and polyunsaturated fatty acid supplementation on ferroptosis. Omega-6 polyunsaturated fatty acids have relatively greater susceptibility to lipid peroxidation and could, therefore, participate in ferroptosis. By contrast, omega-3 polyunsaturated fatty acids promote intracellular antioxidants synthesis and reduce the formation of hydroperoxides that induce ferroptosis. As intestinal iron absorption is regulated by iron nutritional status, individuals with normal functioning of the hepcidin-ferroportin axis are at low risk of developing iron overload in response to ingestion of iron-rich foods. Therefore, iron supplementation is potentially toxic mainly for the intestinal epithelium and the microbiota. In animal models, iron-rich diets increased oxidative damage, lowered the glutathione concentration within hepatocytes, and downregulated desaturases that synthesize long-chain polyunsaturated fatty acids. These adverse effects of iron supplementation were prevented by omega-3 fatty acid co-supplementation. The impact of food and supplement intake on ferroptosis has seldom been investigated. Scientific evidence still does not allow us to know for sure whether iron and PUFA supplementation are capable of inducing ferroptosis. As the mechanisms that control ferroptosis can determine whether cells proliferate or die, future studies should directly investigate the effects of nutrient supplementation and food intake on the ferroptosis process in different types of cells and tissues.

Human Milk Composition and Nutritional Status of Omnivore Human Milk Donors Compared with Vegetarian/Vegan Lactating Mothers.

Women of childbearing age in Western societies are increasingly adopting vegetarian diets. These women are sometimes rejected as milk donors, but little about the composition of their milk is known. The present study aimed to compare the intake, nutritional status, and nutritional composition of human milk from omnivore human milk donors (Donors) and vegetarian/vegan lactating mothers (Veg). Milk, blood, and urine samples from 92 Donors and 20 Veg were used to determine their fatty acid profiles, as well as vitamins and minerals. In a representative sample of both groups, we also determined the lipid class profile as a distribution of neutral and polar lipids, the molecular species of triacylglycerols, and the relative composition of phospholipids in their milk. A dietary assessment was conducted with a five-day dietary record (while considering the intake of supplements). We highlight the following results, expressed as the mean (SE), for the Veg vs. Donors: (1) Their docosahexaenoic acid (DHA) intake was 0.11 (0.03) vs. 0.38 (0.03) g/day; the plasma DHA was 0.37 (0.07) vs. 0.83 (0.06)%; and the milk DHA was 0.15 (0.04) vs. 0.33 (0.02)%. (2) Their milk B12 levels were 545.69 (20.49) vs. 482.89 (4.11) pM; 85% of the Veg reported taking B12 supplements (mean dose: 312.1 mcg/day); and the Veg group showed no differences with Donors in terms of total daily intake or plasma B12. (3) Their milk phosphatidylcholine levels were 26.88 (0.67) vs. 30.55 (1.10)%. (4) Their milk iodine levels were 126.42 (13.37) vs. 159.22 (5.13) mcg/L. In conclusion, the Vegs' milk was shown to be different from the Donors' milk, mainly due to its low DHA content, which is concerning. However, raising awareness and ensuring proper supplementation could bridge this gap, as has already been achieved for cobalamin.

Effectiveness of Nutritional Supplements for Attenuating the Side Effects of SARS-CoV-2 Vaccines

Supplementation is known to enhance the immune response and reduce infection. Therefore, the association between immune nutrients and vaccine side effects needs to be investigated. Our aim was to analyze the relationship between vaccination side effects and supplement intake among the Italian population. The study included a questionnaire asking for personal data, anthropometric information, COVID-19 infection and immunity response, and COVID-19 vaccination and supplementation. The survey was conducted from 8 February to 15 June 2022. In the study, 776 respondents were included, aged between 18 and 86 (71.3% females). We observed a statistically significant correlation between supplement consumption and side effects at the end of the vaccination cycle (p = 0.000), which was also confirmed by logistic regression (p = 0.02). Significant associations were observed between supplement intake and side effects of diarrhea and nausea at the end of the vaccination cycle (p = 0.001; p = 0.04, respectively). Significant associations were observed between side effects and omega-3 and mineral supplementation at the start of the vaccination cycle (p = 0.02; p = 0.001, respectively), and between side effects and vitamin supplementation at the end of the vaccination cycle (p = 0.005). In conclusion, our study shows a positive impact of supplementation on vaccination response, increasing host immune defenses, and reducing side effects.

Micronutrient supplement intakes among collegiate and masters athletes: A cross-sectional study.

In our cross-sectional study, we evaluated micronutrient supplementation intake among Collegiate and Masters Athletes. We conducted a cross-sectional study to assess micronutrient supplementation consumption in Collegiate and Masters Athletes, comparing sex and sport classification within each respective group. Micronutrient supplement consumption data were measured using a Food Frequency Questionnaire. A two-way analysis of variance was used to explore the differences among Collegiate and Masters Athletes' supplement intakes of the following vitamins and minerals: vitamins A, B6, B12, C, E, D, and calcium, folate, iron, magnesium niacin, riboflavin, selenium, thiamine, and zinc. When significant differences were found, a Bonferroni post hoc test was performed to identify specific group differences. The significance level was set a priori at p < 0.05. A total of 198 athletes (105 females and 93 males) were included in the study. Participants were 36.16 ± 12.33 years of age. Collegiate male athletes had significantly greater vitamin A [1,090.51 ± 154.72 vs. 473.93 ± 233.18 mg retinol activity equivalents (RAE)/day] (p < 0.036), folate [337.14 ± 44.79 vs. 148.67 ± 67.50 mcg dietary folate equivalents (DFE)/day] (p < 0.027), and magnesium (65.35 ± 8.28 vs. 31.28 ± 12.48 mg/day) (p < 0.031) intakes compared to Collegiate female athletes. Collegiate CrossFit Athletes (940.71 ± 157.54 mg/day) had a significantly greater vitamin C intake compared to Collegiate General Athletes (156.34 ± 67.79 mg/day) (p < 0.005), Collegiate Triathletes (88.57 ± 148.53 mg/day) (p < 0.027), Collegiate Resistance Training Athletes (74.28 ± 143.81 mg/day) (p < 0.020), and Collegiate Powerlifters (175.71 ± 128.63 mg/day) (p < 0.044). Masters females had significantly greater calcium intakes compared to Masters males (494.09 ± 65.73 vs.187.89 ± 77.23 mg/day, respectively) (p < 0.002). Collegiate Runners (41.35 ± 6.53 mg/day) had a significantly greater iron intake compared to Collegiate Powerlifters (4.50 ± 6.53 mg/day) (p < 0.024). Masters Swimmers (61.43 ± 12.10 mg/day) had significantly greater iron intakes compared to Masters General Athletes (13.97 ± 3.56 mg/day) (p < 0.014), Masters Runners (17.74 ± 2.32 mg/day) (p < 0.03), Masters Triathletes (11.95 ± 3.73 mg/day) (p < 0.008), Masters CrossFit Athletes (15.93 ± 5.36 mg/day) (p < 0.043), Masters Rowers (9.10 ± 3.36 mg/day) (p < 0.003), and Masters Cyclists (1.71 ± 9.88 mg/day) (p < 0.011). Masters Powerlifters (47.14 ± 9.65 mg/day) had significantly greater zinc intakes compared to Masters General Athletes (9.57 ± 2.84 mg/day) (p < 0.015), Masters Runners (10.67 ± 1.85 mg/day) (p < 0.017), Masters Triathletes (10.24 ± 2.98 mg/day) (p < 0.020), Masters Rowers (9.33 ± 2.68 mg/day) (p < 0.013), and Masters Cyclists (1.43 ± 7.88 mg/day) (p < 0.019). There were no other significant differences among the other micronutrient supplement intakes between the sexes or among the sport classification. We reported significant differences among female and male Collegiate and Masters Athletes. Additionally, we reported significant differences among Collegiate and Masters Athletes sport classifications. Further research should examine both dietary and micronutrient supplement intake among Collegiate and Masters Athletes to examine the extent that athletes exceed the Recommended Dietary Allowances (RDA), and the potential effects on health and performance.

Changes in Food Consumption Trends among American Adults since the COVID-19 Pandemic.

The quality and quantity of food consumption have changed due to the COVID-19 pandemic. In this study, we examined how the COVID-19 pandemic has changed the consumption of different food groups in order to close the research gap by providing current evidence that reflects a later stage of the pandemic compared to other circulating research conducted at earlier stages. Data collection for this cross-sectional study was performed via an online Qualtrics survey from 10,050 adults aged 40-100 years. Nutritional status was measured using the 24-item short-form Dietary Screening Tool (DST) twice: before and since the COVID-19 pandemic. The DST questions were categorized based on MyPlate items, along with fat, sugar, and sweet items, as well as nutritional supplement intake. In addition, the total DST score was calculated for each participant, which categorized them into one of three groups: "at risk", "possible risk", and "not at risk". The results revealed that the consumption of grains, fruit, lean protein, and dairy decreased significantly, while the consumption of fat, sugar, and sweet items increased significantly due to COVID-19. The biggest decreases in consumption of food subcategories were related to whole grain bread and cereal, followed by fruit as a snack, in comparison with other types of grain and fruit. No changes in the consumption of vegetables, processed meat, or supplement intake were seen. The total DST score showed that, before and since COVID-19, the overall nutrition status of adult Americans has been at risk. In addition, of those participants who were not at risk before COVID-19, 28.5% were either at risk or at possible risk since COVID-19; moreover, of those participants who were at possible risk before COVID-19, 21% were at risk since COVID-19. As a good nutritional status can reduce the risk of severe illness or even mortality rate in times of crisis, the findings of this study can help policymakers and health educators to develop heath-protecting behavior sessions against future pandemics to manage crises.

Antenatal Care and Health Behavior of Pregnant Women-An Evaluation of the Survey of Neonates in Pomerania.

The German maternity guidelines require regular medical checkup (MC) during pregnancy as a measure of prevention. Socioeconomic factors such as education, profession, income and origin, but also age and parity may influence the preventive and health behavior of pregnant women. The aim was to investigate the influence of these factors on the participation rate in MC of pregnant women. The current analysis is based on the prospective population-based birth cohort study Survey of Neonates in Pomerania, which was conducted in Western Pomerania, Germany. The data of 4092 pregnant women from 2004 to 2008 were analyzed regarding the antenatal care and health behavior. Up to 12 MC were regularly offered; participation in 10 MC is defined as standard screening according to maternity guidelines. Women participated in the first preventive MC on average in the 10th (±3.8 SD) week of pregnancy. 1343 (34.2%) women participated in standard screening and 2039 (51.9%) took a screening above standard. 547 (13.92%) women participated in less than the 10 standard MCs. In addition, about one-third of the pregnancies investigated in this study were unplanned. Bivariate analyses showed an association between better antenatal care behavior and higher maternal age, stabile partnerships and mother born in Germany, p < 0.05. On the contrary antenatal care below standard were more often found by women with unplanned pregnancies, less educational women and women with lower equivalent income, p < 0.001. Health behaviors also influenced antenatal care. Whereas the risk of antenatal care below standard increased by smoking during pregnancy (RRR 1.64; 95% CI 1.25, 2.14) and alcohol consumption (RRR 1.31; 95% CI 1.01, 1.69), supplementation intake was associated with decreased risk (iodine-RRR 0.66; 95% CI 0.53, 0.81; folic acid-RRR 0.56; 95% CI 0.44, 0.72). The health behavior of pregnant women also differs according to their social status. Higher maternal income was negatively correlated with smoking during pregnancy (OR 0.2; 95% CI 0.15, 0.24), but positively associated with alcohol consumption during pregnancy (OR 1.3; 95% CI 1.15, 1.48) and lower pre-pregnancy BMI (Coef. = 0.083, p < 0.001). Lower maternal education was positively correlated with smoking during pregnancy (OR 59.0; 95% CI 28.68, 121.23). Prenatal care according to maternity guidelines is well established with a high participation rate in MC during pregnancy of more than 85%. However, targeted preventive measures may address younger age, socioeconomic status and health-damaging behaviors (smoking, drinking) of the pregnant women because these factors were associated with antenatal care below standard.

PD08-01 FINANCIAL TOXICITY IN NON-METASTATIC RENAL CELL CARCINOMA PATIENTS

You have accessJournal of UrologyCME1 Apr 2023PD08-01 FINANCIAL TOXICITY IN NON-METASTATIC RENAL CELL CARCINOMA PATIENTS Michael Staehler, Hedyeh Ebrahimi, Severin Rodler, Ulka Vaishampayan, Pavlos Msouel, Mark Ball, Ithaar Derweesh, and Dena Battle Michael StaehlerMichael Staehler More articles by this author , Hedyeh EbrahimiHedyeh Ebrahimi More articles by this author , Severin RodlerSeverin Rodler More articles by this author , Ulka VaishampayanUlka Vaishampayan More articles by this author , Pavlos MsouelPavlos Msouel More articles by this author , Mark BallMark Ball More articles by this author , Ithaar DerweeshIthaar Derweesh More articles by this author , and Dena BattleDena Battle More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003239.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Little is known about the financial impact of renal cell carcinoma (RCC). We sought to ascertain real world data on financial implications and how FT impacts quality of life in patients following surgery for localized RCC. METHODS: An online survey was conducted by the Kidney Cancer Research Alliance (KCCure), a non-profit patient advocacy organization, from 7/22 to 9/22. The survey included questions about costs and financial concerns related to the diagnosis of cancer, and the COST questionnaire. Pearson’s correlation (r) and Kendal’s tau test were used to analyze the COST questionnaire, financial burden and hardship. RESULTS: Out of 1062 responders 623 had initially localized RCC. Out of these patients 395 did not recure and 204 were willing to answer questions related to cost and financial hardship. Median age was 54 (range 19-84). Patients identified as white (89%), living in the US (84%) and had a bachelor's degree or beyond (53%). 15%, 59%, and 26% lived in urban, suburban, and rural locations. The approximate annual household income was <50.000US$ in 13%, <100,000US$ in 32% and >200,000US$ in 17%. 65% had private insurance, 13% are on Medicare, 3% on Medicaid and 0.5% were uninsured. 55% of patients work full time, 11% work part time, 4% are unemployed looking for work, 8% unemployed not looking for work, 18% are retired and 4% are on disability. 28% of patients reported that their medical diagnosis has not reduced their income at all and 26% report that their diagnosis has reduced their income very much. 31% of patients reported experiencing insurance denials for imaging scans, 30% faced delays in care due to pre-approval requirements, 45% reported facing high out-of-pocket costs for medical care, 18% reported being unable to go outside of a provider network. 25% reported spending over $100 a month on health-related products not covered by insurance. To cover medical costs 24% of patients reported taking a hardship withdrawal from a retirement account, 28% stopped funding or lowered contributions to an existing retirement account, 20% borrowed from friends or family. Median COST score was 32 (range 19-44)) and was significantly correlated to age, NCCN distress score, risk of recurrence and supplement intake (p<0.05). CONCLUSIONS: Patients diagnosed with localized RCC are impacted by financial hardship and financial toxicity, with more than a quarter of patients reporting that the diagnosis significantly reduced their income. More research is needed to characterize the full extent and root cause of financial implications to this group of patients. Financial counseling should be recommended as part of every cancer diagnosis regardless of stage. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e232 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Staehler More articles by this author Hedyeh Ebrahimi More articles by this author Severin Rodler More articles by this author Ulka Vaishampayan More articles by this author Pavlos Msouel More articles by this author Mark Ball More articles by this author Ithaar Derweesh More articles by this author Dena Battle More articles by this author Expand All Advertisement PDF downloadLoading ...

The association between vitamin D intake with inflammatory and biochemical indices and mortality in critically ill patients with COVID-19: A case-control study.

The coronavirus disease-2019 (COVID-19) has become a worldwide health issue with widespread hospitalization and dependence on the intensive care unit (ICU). Vitamin D has a key role in modulating immune cells and modulating the inflammatory responses. This study aimed to investigate the association of vitamin D supplementation with inflammatory, biochemical, and mortality indices in critically ill patients with COVID-19. This case-control study was conducted on critically ill COVID-19 patients hospitalized in the ICU including the survived >30 day patients as the case group and dead patients as the control group. The status of vitamin D supplementation and inflammatory and biochemical indices of the patients were retrieved from the medical records. Logistic regression method was used to assess the association between 30 days survival and vitamin D supplement intake. Compared to the group of COVID-19 patients who died in <30 day, the survived patients had a lower eosinophile level (2.2 ± 0.5 vs. 6 ± 0.0, p < .001) and higher vitamin D supplementation duration (9 ± 4.4 vs. 3.3 ± 1.9 day, p = .001). Vitamin D supplementation had a positive association with survival in COVID-19 patients (OR: 1.98, 95%CI:1.15-3.40, p < .05). The association remained significant after adjustments fot age, sex, underlying diseases,and smoking. Vitamin D supplementation in critically ill patients with COVID-19 has the potential to increase survivability within the first 30 days of hospitalization.

Sociodemographic Factors and Nutritional Knowledge Impacts on Overall Vitamin B12 Intake in Older Women

BACKGROUND: The older population is at high risk for vitamin B12 deficiency, leading to various significant and chronic health problems. AIM: This study aimed to determine the association between sociodemographic characteristics, nutritional knowledge and overall vitamin B12 intake among older persons. METHODS: An observational study with a cross-sectional design was directed to 69 older women aged &gt; 50 years. Data was collected from subject responses to various questions on the google platform, guided by professional assistance. RESULT: The study showed an inversed association between employment status (p&lt;0.05), income level (p&lt;0.001) and overall vitamin B12 intake, including dietary and supplement intake. The results provided new insights on monthly income level playing a crucial role in VB12 rich food consumption patterns in older persons, which were mostly unemployed. CONCLUSION: Efforts are needed to increase the coverage of VB12 supplementation, either peroral or intramuscular injection, as a solution to meet the needs of VB12 source that is affordable and effective for the older population.

COMPLIANCE TO IRON SUPPLEMENTATION AMONG PREGNANT WOMEN WITH IRON DEFICIENCY ANEMIA IN RIYADH, SAUDI ARABIA: DETERMINANTS AND BARRIERS

Background: iron deficiency anemia among mothers is a serious public health issue.Studies found a link between adverse events and iron supplementation compliance during pregnancy. Objectives: to assess the compliance to iron supplementation among pregnant women with iron deficiency anemia in Riyadh, Saudi Arabia, and its determinants and barriers. Methods: a cross-sectional study was done in Riyadh, Saudi Arabia on pregnant women with iron deficiency anemia who attended primary health care centers (PHCCs) in Riyadh, Saudi Arabia. An online questionnaire wasused to collect data about womens demographics, obstetric and gynecological history, prescribed iron supplements, womens awareness regarding iron deficiency anemia, compliance with iron/folate supplementation, and reasons for non-compliance. Results: 74.8% of females sometimes forget to take iron supplements, 54.1% reduced or stopped taking iron supplements without telling their doctor because they felt worse when taking them, and 63.5% sometimes forget to bring or take iron supplements when they leave home. The prevalence of low, medium and high compliance with iron supplement intake was 74.2%, 15.1%, and 10.7%, respectively, among the participants.Side effects (43.4%) and forgetting (32.1%) were the most common reasons for noncompliance. High compliance was significantly higher among participants over the age of 30, with a university education or higher, in the trimester, who had ≥ 5 antenatal visits, and who preferred iron supplements in tablet form. Conclusion: The low observed compliance among studied females emphasizes the importance of increasing communication for behavior change and counseling before or during antenatal care to improve adherence.

Nutritional Status of Patients with Facioscapulohumeral Muscular Dystrophy

In patients with facioscapulohumeral muscular dystrophy (FSHD), a rare genetic neuromuscular disease, reduced physical performance is associated with lower blood levels of vitamin C, zinc, selenium, and increased oxidative stress markers. Supplementation of vitamin C, vitamin E, zinc, and selenium improves the quadriceps' physical performance. Here, we compared the nutritional status of 74 women and 85 men with FSHD. Calorie intake was lower in women with FSHD than in men. Moreover, we assessed vitamin C, vitamin E, zinc, copper, and selenium intakes in diet and their concentrations in the plasma. Vitamin E, copper, and zinc intake were lower in women with FSHD than in men, whereas plasma vitamin C, copper levels, and copper/zinc ratio were higher in women with FSHD than in men. The dietary intake and plasma concentrations of the studied vitamins and minerals were not correlated in both sexes. A well-balanced and varied diet might not be enough in patients with FSHD to correct the observed vitamin/mineral deficiencies. A low energy intake is a risk factor for suboptimal intake of proteins, vitamins, and minerals that are important for protein synthesis and other metabolic pathways and that might contribute to progressive muscle mass loss. Antioxidant supplementation and higher protein intake seem necessary to confer protection against oxidative stress and skeletal muscle mass loss.