Multivitamin Research Articles

The impact of using bee pollen in poultry systems

The use of antibiotic growth promoters in poultry production has resulted in the development of drug resistance, and destruction of the normal beneficial intestinal flora. Therefore, the task of poultry industry is to find alternative solutions to ensure safe products. The aim of this review article was to understand the potential use of bee pollen in poultry production system regarding its impact on performance, carcass traits, immunity, bacterial community, and blood parameters. Bee products such as pollen have been used in traditional medicine and have recently appeared as possible feed additives. Bee pollen is considered the most important substance in the hive, as a basic feed for bees. It consists of a mixture of proteins, amino acids, fats, carbohydrates, and multiple vitamins, minerals, and enzymes. The chemical composition of bee pollen depends mainly on the plant species, geographic region, and season of collection. Bee pollen has many uses in human medicine and livestock production. It has been used to improve general health, and may also act as an antibacterial, antifungal, antioxidant, anti-radiation, anti-carcinogenic, anti-inflammatory, hepato- and cardio-protective, and antidiabetic. Dietary supplementation of bee pollen could increase performance parameters as a growth promotor, enhancing carcass quality. In addition, bee pollen can enhance the immune response, reduce the pathogenic bacterial count, and enhance important blood parameters.

Effect of Analytical Method on Vitamin C Tablet Levels Stored under Different Temperature Conditions

Vitamin C tablets are commonly consumed by the public as antioxidant supplements. Vitamin C is highly susceptible to oxidation, which is accelerated by factors such as heat, light, alkali, enzymes, oxidizers, and the presence of copper and iron catalysts. Oxidation will be inhibited if vitamin C is left in an acidic state or at low temperatures. However, many vitamin C tablets are not stored according to recommended conditions due to inadequate temperature control during storage or distribution, leading to changes in their vitamin C levels. Vitamin C levels can be analyzed using the Iodimetry method and UV-Vis spectrophotometry. This study aims to determine the effect of the analysis method on the content of vitamin C tablets stored at various temperature variations. This is an experimental research. The independent variable of this study is the analytical method of determining vitamin C content and the dependent variable of this research is the content of vitamin tablets stored at low temperature (2-6°C), room temperature (27-30°C), and high temperature (48°C). Quantitative analysis of vitamin C levels was conducted using both iodimetry and UV-Vis spectrophotometry methods. The highest vitamin C content was found in the analysis of levels using the UV-Vis spectrophotometry method. Statistical analysis shows significant differences, indicating that the method of analyzing the levels of vitamin C tablets stored under varying temperature conditions affects the levels of vitamin C tablets.

Causal relationships of familial hypercholesterolemia with the risk of multiple vitamin deficiencies: a Mendelian randomization study.

The causal relationship between familial hypercholesterolemia (FH) and various vitamin deficiencies has not yet been elucidated. Therefore, this study investigated the cause-and-effect relationship between FH and the risk of multiple vitamin deficiencies in humans. Mendelian randomization (MR) analysis was performed by extracting six datasets for FH, FH with ischemic heart disease (IHD), and vitamin deficiency (vitamin A, thiamine, other B-group vitamins, and vitamin D) from the FinnGen study, covering a total of 329,115; 316,290; 354,932; 354,949; 355,411 and 355,238 individuals, respectively. FH was suggestively associated with higher odds of thiamine deficiency [inverse variance weighted odds ratio (ORIVW) 95% confidence interval (CI): 1.62 (1.03, 2.55), P = 0.036] and vitamin D deficiencies [ORIVW CI: 1.35 (1.04, 1.75), P = 0.024], low-density lipoprotein receptor (LDLR) rs112898275 variant, rs11591147 and rs499883 in proprotein convertase subtilisin/kexin 9 (PCSK9), rs9644862 in cyclin-dependent kinase inhibitor 2 B antisense RNA1 (CDKN2B-AS1), and rs142834163 in dedicator of cytokinesis 6 (DOCK6) and rs115478735 in ABO blood group (ABO) strongly influenced the risk of thiamine deficiency, while the rs7412 variant in apolipoprotein E (APOE) mostly influenced the risk of vitamin D deficiency. FH with IHD was suggestively associated with higher odds of vitamin D deficiency (ORIVW, weighted median [WM][95%CI]: 1.31 [1.05, 1.64]; 1.47 [1.10, 1.97]) (P = 0.018; 0.010) without any single significant SNPs observed. FH was positively associated with increased risks of thiamine and vitamin D deficiencies, revealing a prospective and unfortunate complication of FH.

Maternal factors for neural tube defects in offspring: An umbrella review.

We conducted an umbrella review focusing on maternal risk factors during pregnancy associated with neural tube defects (NTDs). Our search was in databases PubMed, Scopus, and Web of Science. We specifically targeted meta-analyses examining maternal factors during pregnancy in relation to NTDs. The comparison involved assessing metrics such as odds ratio (OR) or related risk ratios reported in the included studies, as well as parameters like heterogeneity (I²), 95% prediction interval, small-study effects, excess significance biases, and sensitivity analysis. Three risk factors for fetal NTDs, namely hyperthermia with an OR of 1.92, obesity with an OR of 1.68, and passive smoking with an OR of 1.90, were classified as highly suggestive evidence (Class II). Influenza, with an OR of 3.33, was considered a risk factor with suggestive evidence (Class III). Multivitamin supplementation during pregnancy, with an OR of 0.76, and low maternal vitamin B12, with an OR of 2.41, were categorized as weak evidence (Class IV). We identified four risk factors including hyperthermia, influenza, obesity, and passive smoking as suggestive or highly suggestive evidence for NTDs. Low maternal vitamin B12 was identified as a risk factor for NTDs, supported by weak evidence.

Vitamin supplementation in the treatment of curled toe paralysis in 50 CHABRO chicks

AbstractChickens are much more susceptible to deficiency diseases, especially vitamin deficiencies, than other animals. Chicken being the monogastric animal, the gut flora of chicken does not synthesise any vitamins rather competes with the host for dietary vitamins. In this case report, some of the 50 Chabro chicks showed reduced feed intake, toe deformities, unable to walk properly, loose faeces and mortality. The chicks were reared under a backyard poultry farm. All the chicks were given commercial ration. On clinical examination, the chicks had curled toes, feed particles in the beak, soiled feathers and mucus in the eyes. The chicks were given Vitaplex Pro in drinking water for 15 days. The chicks were found fully recovered after 3 weeks of treatment. This case report revealed the possibility of rearing newly hatched chicks with immediate access to feed and water along with supplementation of multivitamins for optimum growth performance.

EAR CANKER IN A RABBIT – A CASE REPORT

A three-month-old female New Zealand White Rabbit, weighing about 1.4 kg was brought to the Veterinary Clinical Complex, Veterinary College and Research Institute, Tirunelveli with ahistory of intense pruritis and alopecia all over the body. Clinical observation revealed crusty lesions on the nose,ear margin and toes. Microscopic examination of the deep skin scraping revealed the presence of Psoroptes cuniculi mite. The rabbit was treated with an injection Ivermectin @ 0.4 mg/kg sub-cutaneous and an injection of Chlorpheniramine maleate @ 0.4 mg/kg intramuscular and further advised the owner to give HITEK® oral solution (Ivermectin) @ 0.4 mg/kg PO once a week and Benzyl benzoate I.P. solution topically daily for a continuous period of one month along with multivitamin supplementation (Multistar pet®) @ 2 ml PO BID. The rabbit recovered successfully without any drug side effects (Tandem usage of ivermectin and Benzyl Benzoate).

Improvements to mood, stress and loneliness following 12-week multivitamin supplementation in older adults: a randomised, placebo-controlled, trial.

Research has indicated the potential for multivitamin-mineral (MVM) supplementation to improve aspects of wellbeing and cognitive function in older adults via a range of biological mechanisms. However, outside of cognitive function and mood, this research rarely assesses other outcomes that are pertinent to the daily lives of older adults. The current study aimed to investigate the effectiveness of a MVM supplement on meaningful outcomes of everyday functioning in older adults. This randomised, double-blind, placebo-controlled, parallel groups trial investigated the effects of 12-week MVM supplementation on measures of wellbeing, mood, and memory; physical health and activity; and social interaction and loneliness. Outcomes were measured at baseline and after 12 weeks in a sample of 228 (124 female) older adults ( > 70 years). MVM supplementation had no effect on the primary outcome of wellbeing (p = 0.29 in males, p = 0.421 in females), but led to increased feelings of friendliness in females (p = 0.045). In males, following MVM, there were lower levels of prolonged stress reactivity (p = 0.007), lower overall stress reactivity (p = 0.019), and lower emotional loneliness (p = 0.042). This study provides novel evidence of increased friendliness and decreased stress reactivity and loneliness following MVM supplementation in older adults. These findings support the exploration of broader functions pertinent to aspects of daily living in older adults. Sex differences in response highlight the importance of exploring effects in men and women separately and support a recommendation for the inclusion of diverse samples in future research that are representative of the population.

Association of vitamin intake with health-related quality of life in hemodialysis patients.

It is still uncertain whether vitamin intake is associated with better quality of life in hemodialysis patients. This study aims to assess the association between the quantity of supplemented vitamins and health-related quality of life (HRQoL) in this population. This cross-sectional study included all patients on chronic hemodialysis from three units. Vitamins and micronutrients assessed were B1, B6, B12, C, D, folic acid, menaquinone, carnitine, zinc, and coenzyme Q10. Quality of life scores included the 8 domains of SF-36 and the 11 domains of the Kidney Disease Quality of Life (KDQOL). Bivariate analysis compared two groups of patients divided based on the median of vitamin intake. Spearman Rho test assessed the correlation between number of vitamins and different dimensions of HRQoL. A total of 183 patients were included. Median number of vitamins supplemented was 2 (1,3); 112 patients had an intake of ≤ 2 vitamins, and 71 patients were taking > 2 vitamins. There was a significant association between higher vitamin intake and the burden of kidney disease that remained significant in the multivariable analysis (p = 0.03), but no correlation between the number of vitamins (0 - 13) and different HRQoL scores. Sub-analyses of each category of vitamins showed no significant difference in HRQoL scores except for Vitamin B and staff encouragement (p = 0.01) and for multivitamins and quality of social interaction (p = 0.03). A higher number of vitamins in hemodialysis patients is associated with an increased perception of the burden of kidney disease. Interventional studies are needed to assess whether selective vitamin supplementation in case of deficiencies is associated with better quality of life.

Effect of high-dose multivitamin supplements on alanine aminotransferase elevations among adults living with HIV on antiretroviral therapy in Tanzania.

HIV infection can cause malabsorption and rapid utilization of nutrients. A randomized trial of multivitamin supplementation among people living with HIV/AIDS (PLWHA) initiating antiretroviral therapy (ART) in Tanzania was stopped early due to increased alanine aminotransferase (ALT) concentrations in the multiple recommended dietary allowances (RDA) multivitamin group. We conducted detailed analysis to assess the effect of multivitamins on ALT elevations and evaluate whether subgroups of PLWHA have greater hepatotoxicity risks associated with the use of high-dose multivitamins. We utilized data from a randomized, double-blind trial conducted in 2006-2009 that assessed the effect of high-dose multivitamins that contained vitamin B complex, vitamin C, and vitamin E at multiple RDA as compared to standard-dose multivitamins containing single RDAs among adults initiating ART in Tanzania. We evaluated the effect of high-dose multivitamins on incident mild/moderate ALT elevations > 40 IU/L, persistent ALT elevations > 40 IU/L (2 + clinic visits), and severe ALT elevations > 200IU/L using Cox proportional hazard models. We then evaluated effect modification by patient characteristics to determine if subgroups of PLWHA experienced different magnitudes of risk for ALT elevations associated with high-dose multivitamins. High-dose multivitamins increased the risk of incident mild/moderate ALT elevations > 40 IU/mL as compared to standard-dose multivitamins (hazard ratio (HR): 1.41; 95%CI: 1.26,1.58) as well as incident sustained mild/moderate ALT elevations (HR: 1.19; 95%CI: 1.04,1.36), but there was no overall effect on severe ALT elevations (HR: 1.44; 95% CI: 0.91,2.28). There was no evidence that the effect of high-dose multivitamins on any or sustained mild/moderate ALT elevations was modified by any patient characteristic. However, CD4 T-cell count was found to modify the effect of high-dose multivitamins on severe ALT elevations (p-value for interaction:0.01). Among participants with a baseline CD4 T-cell count ≤ 100 cells/µL, individuals receiving high-dose multivitamins had 3.74 times (95%CI: 1.52-9.17) the risk of incident severe ALT elevations compared to standard-dose multivitamins, while participants with CD4 T-cell counts > 100 cells/µL, appeared to have no effect of high-dose multivitamins on severe ALT elevations (HR:0.92; 95% CI: 0.50,1.67). High-dose RDA multivitamin supplementation increased the incidence of any mild to moderate ALT elevations among adults starting ART in Tanzania and the magnitude of the risk does not appear to differ by patient characteristics. However, immunocompromised PLWHA with CD4 T-cell counts < 100 cells/µL may experience greater risk of severe ALT elevations associated with the use of high-dose multivitamins. Although the study findings offer significant insights, it is essential to take into account limitations imposed by newer cART regimes.

Interaction and association between multiple vitamins and social adaptability and severity of autism: A large-scale retrospective study from China.

Since children with autism spectrum disorder (ASD) often exhibit selective eating behaviors, it is generally believed that they may have abnormal nutrient structure, leading to aberrant concentrations of some serum vitamins. However, previous studies on serum vitamins in individuals with ASD are mixed. Additionally, the interaction and association between multiple serum vitamin and ASD-related symptoms remain unclear. This study utilized a cross-sectional survey with a large sample size (n = 1235) from China to clarify previous mixed findings, and examine the interaction and association between multiple serum vitamins (including folic acid [FA], vitamin A [VA], vitamin E [VE], vitamin B12 [VB12], and vitamin D [VD]) and social adaptability and symptom severity in children with ASD. Findings found that symptom severity was negatively associated with concentrations of serum VA, VE, VB12, and VD; while, social adaptability was significantly associated with the natural log-transformed concentrations of FA and VB12. Finding also revealed the interaction of VA and VE on the association between both vitamins and severity of ASD symptoms, as well as the interaction of VB12 and FA on the association between both vitamins and social adaptability. In particular, the combination of low concentration of VA and high concentration of VE is associated with the lowest risk of being "severely autistic"; while, the combination of low concentration of FA and high concentration of VB12 is associated with the lowest risk of being "poor social adaptability". This study offers the evidence for the requirement of considering multiple vitamins comprehensively, as well as valuable references for revealing the association between vitamin disparities and food selectivity in children with ASD.

Simultaneous Identification of Vitamins B1, B3, B5, and B6 by an Engineered Nanopore.

Vitamin Bs, a group of water-soluble compounds, are essential nutrients for almost all living organisms. However, due to their structural heterogeneity, rapid and simultaneous analysis of multiple vitamin Bs is still challenging. In this paper, it is discovered that a hetero-octameric Mycobacterium smegmatis porin A (MspA) nanopore containing a sole nickel ion-bound nitrilotriacetic acid (NTA-Ni) adapter at its pore constriction is suitable for the simultaneous sensing of different vitamin Bs, including vitamin B1 (thiamine), vitamin B3 (nicotinic acid and nicotinamide), vitamin B5 (pantothenic acid), and vitamin B6 (pyridoxine, pyridoxal, and pyridoxamine). Assisted by a custom machine learning algorithm, all seven vitamin Bs can be fully distinguished, reporting a general accuracy of 99.9%. This method was further validated in the rapid analysis of commercial cosmetics and natural food, suggesting its potential uses in food and drug administration.

The Association Between Vitamin B12 Deficiency and Diabetic Foot Ulcer in Type 2 Diabetic Patients in Qassim Province, Saudi Arabia: A Case-Control Study.

Background Diabetic foot ulcer (DFU) is a major complication of diabetes with many identified risk factors. These include poor control of diabetes, cardiovascular disease, smoking, and end-stage kidney disease. This study aims to shed light on the micronutrient status of diabetic patients and its effect on DFU, particularly, the association between vitamin B12 deficiency and DFU. Methodology This retrospective case-control study included adults in Buraydah who were at least 18 years old and had type 2 diabetes mellitus. Data were obtained from the electronic files of the patients who visited the diabetes center from January 2018 to August 2023 and were analyzed using SPSS version 27.0.1 (IBM Corp., Armonk, NY, USA). Results The research involved 221 participants, with 114 controls (individuals with diabetes but no DFU), and 107 cases (individuals with diabetes affected by DFU). Vitamin B12 levels varied, with 79.2% falling within the normal range of 187-883 pg/mL. The average age of cases (58.5 years, SD = 11.3) was notably higher than that of controls (54.1 years, SD = 14.1).Glycated hemoglobin levels were significantly higher in cases (8.7, SD = 2.0) compared to controls (7.6, SD = 2.2) (p < 0.001). Regarding physical activity, cases showed a significantly higher percentage of inactivity (62.1%) compared to controls (39.1%) (p = 0.046). Neuropathy exhibited a significant association with ulcer development, with 59.1% of cases having neuropathy compared to 23.5% of controls (p < 0.001). Furthermore, complications such as dry foot and fissures (60.0% vs. 6.3%), Charcot joint (36.8% vs. 12.2%), and foot trauma (40.9% vs. 3.9%) were significantly more prevalent in cases compared to controls (p < 0.001 for all). Conclusions The significant associations observed with advanced age, uncontrolled diabetes, longer diabetes duration, neuropathy, and specific foot complications underscore the multifactorial nature of ulcer development. The normal levels of vitamin B12 in most patients reflect no positive impact of normalized vitamin B12 levels on DFU. However, further observational studies with multiple vitamin B12 readings over a longer period are needed to establish its association with DFU development.

407. MICRONUTRIENT INSUFFICIENCY AFTER SURGERY FOR OESOPHAGOGASTRIC NEOPLASMS: A PROSPECTIVE INTERVENTION STUDY CALLED THE VITAMIN STUDY

Abstract Background Oesophageal and gastric cancer have major impact on nutritional status and quality of life (QoL). Preoperative malnutrition is reported in 42–80%. However, studies investigating postoperative nutritional status are scarce and postoperative identification and treatment of micronutritional deficiencies are currently lacking in (inter-)national guidelines. The aim of this study is to identify micronutrient deficiencies after surgery for oesophagogastric neoplasms and target them by supplementation. Methods This is a recently closed multicenter trial in the Netherlands. Patients receive a tailormade multivitamin supplement which differs per group and a calcium supplement. Baseline measurements consist of blood withdrawal, faecal elastase-1 (FE-1) analysis, QoL questionnaires and dietary behaviour. After 6 (T=1), 12 (T=2) and 24 (T=3) months from baseline, measurements are repeated, and a supplement questionnaire is added. The primary objective is micronutrient deficiency (yes/no). Secondary objectives include occurrence and symptoms of exocrine pancreas insufficiency (EPI) and QoL. Results Inclusion spanned from December 2021 to December 2023. Preliminary results from 95 patients are available, whereby 68 patients underwent oesophagectomy and 27 gastrectomy. Of these, 55 patients received 6 months of supplementation (T=1). At T=0, 77.0% had at least one micronutrient deficiency. Identified deficiencies are shown in table 1. Deficiencies were more common in patients undergoing gastrectomy compared to those undergoing oesophagectomy (88.0% vs. 72.1%). Reduced FE-1 (&amp;lt;200 mg/kg) was found in 22.2% at baseline and 26.7% at T=1. 16.7% experienced EPI symptoms at baseline, which resolved at follow-up. Conclusion The most common micronutrient deficiencies decreased substantially after 6 months of supplementation. The follow-up extends until November 2024. Routine monitoring and supplementation could potentially be implemented in standard postoperative care for gastric and oesophageal cancer.

Do effervescent vitamin tablets affect the surface roughness, microhardness, and color of human enamel and contemporary composite resins?

To compare the impact of four effervescent vitamin tablets on the surface roughness, microhardness, and color of human enamel and contemporary composite resins. Sixty enamel and a total of 240 anterior (Gradia Direct Anterior), posterior (Gradia Direct Posterior), and universal composite resin (Filtek Ultimate) specimens (n = 60 per group) were fabricated. Each group was subdivided into five subgroups (n = 12, per subgroup). The specimens were subsequently immersed in YOUPLUS,Redoxon, Sunlife Immuvit, and Sambucol effervescent vitamin solutions for 2 min per day over 30 days. Distilled water was used as control. Subsequently, surface roughness (Ra) was detected using a profilometer, and microhardness (VHN) was measured using a microhardness tester. A spectrophotometer device was used to record the L,a,b color coordinates of the specimens after 24 h, 7 days, and 30 days, and the color changes (ΔE00) of the groups were calculated. The data were analyzed by ANOVA, two-way ANOVA, Kruskal-Wallis, Levene's, and Fisher's least significant difference (LSD) tests (p<0.05). SEM analysis was conducted on one randomly selected specimen per group (×1000). In terms of surface roughness, materialXvitamin interactions were found significant (p<0.05). The increase in Ra from 24 h to 30 days was found significant (p<0.05) except for Gradia Direct Anterior X Redoxon, Sunlife Immuvit and Sambucol, Filtek Ultimate X Sunlife Immuvit and Sambucol, and all control groups. Ra changes were also concluded by SEM. Regarding VHNs, material X vitamin interactions were significant (p<0.005), except for all Filtek Ultimate subgroups. The changes in VHNs of the groups from 24 h to 30 days were significant for all enamel and Gradia Direct Anterior X YOUPLUS, Gradia Posterior X YOUPLUS, Sunlife Immuvit, and Sambucol groups (p < 0.05). In terms of ΔE00, significant differences were observed between the 7 days and 30 days in the enamel (p = 0.047), Gradia Direct Anterior (p = 0.019), and Gradia Direct Posterior groups (p = 0.038). Daily consumption of effervescent vitamin tablets can increase surface roughness, decrease microhardness, and influence the color of human enamel and contemporary anterior, posterior, and universal composite resins after a 30-day period.

Vitamin Supplementation in Cardiovascular Disease Prevention: A Systematic Review

Background: Cardiovascular diseases (CVD) remain the leading cause of mortality worldwide, contributing to a significant public health burden. While pharmaceutical interventions like statins are effective, the increasing interest in non-pharmaceutical approaches has sparked debates on the role of vitamin supplementation in CVD prevention. Despite some studies suggesting benefits from vitamins with antioxidant properties, evidence remains inconclusive. This review aimed to evaluate the efficacy of various vitamins in reducing CVD risk using a network meta-analysis. Methods: A systematic review and network meta-analysis were conducted on clinical trials investigating vitamin supplementation for CVD prevention. Data were sourced from MEDLINE, Embase, Cochrane, and other databases. Studies were selected based on specific criteria, including randomized controlled trials with at least six months of follow-up and reported CVD outcomes. The primary outcomes included CVD mortality and risk of heart disease, while secondary outcomes focused on stroke and myocardial infarction. A random-effects model was employed to calculate risk ratios (RR), and meta-regression analyses explored the relationship between vitamin use and lipid levels. Discussion: The analysis revealed that vitamins B, D, and E were particularly effective in reducing CVD risk. However, there was no significant added benefit from combining multiple vitamins over using individual vitamins. While niacin showed potential benefits in reducing stroke and coronary artery disease in statin-intolerant populations, its overall impact on CVD mortality was not significant. Conclusion: This review provides valuable insights into the role of vitamins in CVD prevention, demonstrating that individual vitamins like B, D, and E are effective in reducing risk, while multivitamin combinations offer no additional advantage. The lack of correlation between HDL-C changes and CVD outcomes suggests that future research should focus on other mechanisms beyond lipid management.

Multivitamin Compliance Reduces Injuries of Female Recruits at Air Force Basic Training: A Randomized Controlled Cohort Study.

Department of the Air Force basic military training (BMT) is the 7.5-week initial entry training for all enlisting U.S. Air Force and Space Force recruits. Overuse musculoskeletal injuries (MSKI) during training threaten success in BMT, and trainees with nutritional deficiencies are at higher risk. Several efforts are made at BMT to mitigate these issues to help trainees graduate on time, such as the distribution of multivitamins (MVI) to female recruits. However, trainee compliance with the prescribed MVI has been reported to be low, calling into question the effectiveness of this intervention. This study evaluated the effect of briefing modality offered to these trainees at the time of distribution on educational effectiveness, MVI compliance, and injury rates. This was a randomized controlled cohort study of BMT female trainees. Subjects included all female trainees of a single iteration of BMT concurrently completing training within the same squadron. At the outset of training, cohorts were randomly educated in one of two ways regarding the provided MVI. The control cohort (n = 80) was presented with the standard educational video created by BMT-registered dietitians, while the test cohort (n = 79) was presented the video and then also briefed in-person by a group of subject matter experts. At the end of BMT, the trainees completed a questionnaire regarding their knowledge, confidence, and compliance with the MVI. Additionally, a routinely collected training database was queried and analyzed for differences in injuries and training outcomes using the chi-squared test with significance set to α ≤ 0.05. Although both cohorts found their educational presentation useful, the "in-person" cohort reported significantly higher compliance rates and were found to be diagnosed with MSKI and bone stress injuries at significantly lower rates (43% and 66% relative risk reductions, respectively). Education to female BMT trainees regarding the MVI, which included a face-to-face discussion with subject matter experts, resulted in greater compliance and reduced incidence of MSKI and bone stress injury, compared to a video prepared by registered dietitians alone. Such educational approaches should continue to be strived for in this and other military population health measures. This study's implication of MVI efficacy for injury risk reduction in female trainees should be further studied, verified, and improved upon in this and other populations.

Fat-soluble vitamins as biomarkers of nutritional status and their relation with complications in polytrauma patients.

This exploratory observational prospective study aimed to evaluate fat-soluble vitamin plasma levels during hospital admission and its relation with the development of malnutrition and complications in polytrauma patients, considering the protocolized multivitamin supplementation during intensive care unit (ICU) admission. In 49 well-nourished polytrauma (injury severity score ≥ 16) patients admitted to the ICU of two level-1 trauma centers, vitamin A, D, and E levels were assessed weekly during hospital stay. All patients received multivitamin supplementation during ICU stay. Linear mixed-effect models were used to assess a trend in vitamin levels over time during hospital stay. Mixed-effects logistic regression analysis was performed to relate vitamin concentrations with malnutrition, defined as a subjective global assessment score ≤5, and complications. Vitamin A levels increased 0.17 µmol/L per week (95% confidence interval 0.12-0.22, p < 0.001), vitamin D levels increased 1.49 nmol/L per week (95% confidence interval 0.64-2.33, p < 0.01), vitamin E levels increased 1.17 µmol/L per week (95% confidence interval 0.61-1.73, p < 0.001) during hospital stay (29 ± 17 days). Vitamin levels were not related to malnutrition or complications during hospital stay. Vitamin A, D, and E levels increased due to supplementation during hospital admission. Plasma levels of vitamins A, D, and E do not seem to be useful as biomarkers for the nutritional status of polytrauma patients during hospital stay. No correlation with complications could be demonstrated.

Nutrient Status and Supplement Use During Pregnancy Following Metabolic Bariatric Surgery: A Multicenter Observational Cohort Study

IntroductionPregnant women with a history of metabolic bariatric surgery (MBS) are at high risk of developing nutrient deficiencies, leading to greater challenges to reach nutritional requirements. This study compared nutrient status of women using specialized “weight loss surgery” multivitamin supplementation (WLS-MVS) to those using standard supplementation (sMVS) during pregnancy following MBS.MethodsMulticenter observational cohort study including 119 pregnant women at 41.0 (18.5–70.0) months after Roux-en-Y gastric bypass (RYGB, n = 80) or sleeve gastrectomy (SG, n = 39). Routine blood samples were analyzed every trimester (T1, T2, T3), and micronutrient serum levels were compared between WLS-MVS and sMVS users.ResultsDuring pregnancy after RYGB, WLS-MVS users demonstrated higher serum concentrations of hemoglobin (7.4 [7.2, 7.5] vs. 7.0 [6.8, 7.3] mmol/L), ferritin (23.2 [15.0, 35.7] vs. 13.7 [8.4, 22.4] µg/L), and folic acid (31.4 [28.7, 34.2] vs. 25.4 [21.3, 29.4] nmol/L) and lower serum vitamin B6 levels (T1: 90.6 [82.0, 99.8] vs. 132.1 [114.6, 152.4] nmol/L) compared to sMVS users. Iron deficiencies and elevated serum vitamin B6 levels were less prevalent in the WLS-MVS group. During pregnancy after SG, WLS-MVS users showed higher serum vitamin D concentrations (89.7 [77.6, 101.8] vs. 65.4 [53.3, 77.4] nmol/L) and lower serum vitamin B1 concentrations (T2: 137.4 [124.2, 150.6] vs. 161.6 [149.0, 174.1] nmol/L, T3: 133.9 [120.1, 147.7] vs. 154.7 [141.9, 167.5] nmol/L) compared to sMVS users.ConclusionLow maternal concentrations of micronutrients are highly prevalent during pregnancy after MBS. The use of specialized multivitamin supplementation generally resulted in higher serum levels during pregnancy compared to standard supplementation. Future research is needed to investigate how supplementation strategies can be optimized for this high-risk population.Graphical

Edetate Disodium–Based Chelation for Patients With a Previous Myocardial Infarction and Diabetes

In 2013, the Trial to Assess Chelation Therapy (TACT) reported that edetate disodium (EDTA)-based chelation significantly reduced cardiovascular disease (CVD) events by 18% in 1708 patients with a prior myocardial infarction (MI). To replicate the finding of TACT in individuals with diabetes and previous MI. A 2 × 2 factorial, double-masked, placebo-controlled, multicenter trial at 88 sites in the US and Canada, involving participants who were 50 years or older, had diabetes, and had experienced an MI at least 6 weeks before recruitment compared the effect of EDTA-based chelation vs placebo infusions on CVD events and compared the effect of high doses of oral multivitamins and minerals with oral placebo. This article reports on the chelation vs placebo infusion comparisons. Eligible participants were randomly assigned to 40 weekly infusions of an EDTA-based chelation solution or matching placebo and to twice daily oral, high-dose multivitamin and mineral supplements or matching placebo for 60 months. This article addresses the chelation study. The primary end point was the composite of all-cause mortality, MI, stroke, coronary revascularization, or hospitalization for unstable angina. Median follow-up was 48 months. Primary comparisons were made from patients who received at least 1 assigned infusion. Of the 959 participants (median age, 67 years [IQR, 60-72 years]; 27% females; 78% White, 10% Black, and 20% Hispanic), 483 received at least 1 chelation infusion and 476 at least 1 placebo infusion. A primary end point event occurred in 172 participants (35.6%) in the chelation group and in 170 (35.7%) in the placebo group (adjusted hazard ratio [HR], 0.93; 95% CI, 0.76-1.16; P = .53). The 5-year primary event cumulative incidence rates were 45.8% for the chelation group and 46.5% for the placebo group. CV death, MI, or stroke events occurred in 89 participants (18.4%) in the chelation group and in 94 (19.7%) in the placebo group (adjusted HR, 0.89; 95% CI, 0.66-1.19). Death from any cause occurred in 84 participants (17.4%) in the chelation group and in 84 (17.6%) in the placebo group (adjusted HR, 0.96; 95% CI, 0.71-1.30). Chelation reduced median blood lead levels from 9.03 μg/L at baseline to 3.46 μg/L at infusion 40 (P < .001). Corresponding levels in the placebo group were 9.3 μg/L and 8.7 μg/L, respectively. Despite effectively reducing blood lead levels, EDTA chelation was not effective in reducing cardiovascular events in stable patients with coronary artery disease who have diabetes and a history of MI. ClinicalTrials.gov Identifier: NCT02733185.

Relationship between minerals, vitamins and sports ability of dance athletes

Vitamins and minerals are essential for regulating metabolism. According to the nature of sports, athletes can take multi vitamin and mineral supplements to enhance some important metabolic processes and improve sports performance. The purpose of this study is to explore the effects of minerals and vitamins on the sports ability of dance athletes. In this study, 100 professional dancers were randomly divided into the experimental group and the control group by the control variable method. The sports diet and water of the experimental group were supplemented with certain vitamins and minerals. After that, the athletes were trained and tested, including 12 min running, strength test and dance training duration test. The results showed that the 12 min running distance of the experimental group was 420 m more than that of the control group, the balance time was 16 min longer, and the strength was increased by 25 N. In the overall energy comparison, the energy and endurance of the experimental group was two hours more than that of the control group. The conclusion is that minerals and vitamins play a role in promoting and subsidizing the physical fitness of athletes, which are more prominent in endurance and strength. This study provides a certain value for the effect of nutrients on athletes’ ability.