Reduction In Sodium Levels Research Articles

EFFECT OF MANNITOL ON ELECTROLYTES AND ITS RELATION WITH KIDNEY INJURY IN CARDIOPULMONARY BYPASS

The optimal composition of the priming solution used in cardiopulmonary bypass (CPB) during human cardiac surgery is still uncertain. Mannitol is a common component of CPB priming solutions, but its efficacy is debated. To clarify the effect of mannitol on CPB prime solutions, a prospective, randomized, double-blind trial was conducted on 40 patients with sound cardiac and renal functions who were undergoing coronary artery bypass grafting. The trial included two groups: one received Ringer's acetate-based prime (n = 20), and the other received a combination of Ringer's acetate and 200 mL mannitol as prime (n = 20). The study examined changes in renal-related parameters, electrolytes, osmolality, and acid-base balance. Interestingly, no significant differences in osmolality were observed between the Mannitol and Ringer's acetate groups. However, the Mannitol group showed a significant decrease in sodium levels from 138.7±2.8 mmol/L at the start of anesthesia to 133.9±2.6 mmol/L after the initiation of CPB (p <0.001). Renal parameters remained consistent across groups, except for a temporary effect of mannitol on post-surgery urine output (p = 0.003). In conclusion, this study found no significant differences in osmolality between Ringer's acetate-based prime and Mannitol-based prime in individuals with healthy cardiac and renal function. However, the addition of mannitol to the prime resulted in a significant, albeit short-term, reduction in sodium levels. These findings contribute to the ongoing discourse on optimizing CPB prime solutions, especially in cardiac surgical procedures involving mannitol inclusion.

Changes in sodium levels in Australian packaged foods between 2014 and 2019: an interrupted time series analysis of the impact of the Victorian Salt Reduction Partnership’s media advocacy strategy

BackgroundThe Victorian Salt Reduction Partnership (VSRP) implemented a media advocacy strategy (intervention) to stimulate food manufacturers to reduce sodium levels across targeted Australian packaged foods between 2017 and 2019. This study assessed changes in sodium levels of targeted and non-targeted packaged foods during the intervention (2017 to 2019) compared to before the intervention (2014 to 2016) in Australia.MethodsAnnually collected branded-food composition data from 2014 to 2019 were used. Interrupted time series analyses was conducted to compare the trend in sodium levels in packaged foods during the intervention (2017–2019) to the trend in the pre-intervention period (2014–2016). The difference between these trends was derived to estimate the effect of the intervention.ResultsA total of 90,807 products were included in the analysis, of which 14,743 were targeted by the intervention. The difference in before and during intervention trends between targeted and non-targeted food categories was 2.59 mg/100 g (95% CI: -13.88 to 19.06). There was a difference in the pre-intervention slope (2014, 2015, 2016) and intervention slope (2017, 2018, 2019) for four of 17 targeted food categories. There was a decrease in sodium levels (mg/100 g) in one food category: frozen ready meals (-13.47; 95% CI: -25.40 to -1.53), and an increase in three categories: flat bread (20.46; 95% CI: 9.11 to 31.81), plain dry biscuits (24.53; 95% CI: 5.87 to 43.19), and bacon (44.54; 95% CI: 6.36 to 82.72). For the other 13 targeted categories, the difference in slopes crossed the line of null effect.ConclusionsThe VSRP’s media advocacy strategy did not result in a meaningful reduction in sodium levels of targeted packaged food products during the intervention years compared to trends in sodium levels before the intervention. Our study suggests media advocacy activities highlighting the differences in sodium levels in packaged food products and industry meetings alone are not sufficient to lower average sodium levels in packaged foods in the absence of government leadership and measurable sodium targets.

Estimating Canadian sodium intakes and the health impact of meeting national and WHO recommended sodium intake levels: A macrosimulation modelling study.

Cardiovascular diseases (CVDs) are the second leading cause of total deaths in Canada. High blood pressure is the main metabolic risk factor for developing CVDs. It has been well established that excess consumption of sodium adversely affects blood pressure. Canadians' mean sodium intakes are well above recommended levels. Reducing dietary sodium intake through food reformulation has been identified as a cost-effective intervention, however, dietary sodium intake and the potential health impact of meeting recommended sodium intake levels due to food reformulation have not been determined in Canada. This study aimed to 1) obtain robust estimates of Canadians' usual sodium intakes, 2) model sodium intakes had foods been reformulated to align with Health Canada's sodium reduction targets, and 3) estimate the number of CVD deaths that could be averted or delayed if Canadian adults were to reduce their mean sodium intake to recommended levels under three scenarios: A) 2,300 mg/d-driven by a reduction of sodium levels in packaged foods to meet Health Canada targets (reformulation); B) 2,000 mg/d to meet the World Health Organization (WHO) recommendation; and C) 1,500 mg/d to meet the Adequate Intake recommendation. Foods in the University of Toronto's Food Label Information Program 2017, a Canadian branded food composition database, were linked to nationally representative food intake data from the 2015 Canadian Community Health Survey-Nutrition to estimate sodium intakes (and intakes had Health Canada's reformulation strategy been fully implemented). The Preventable Risk Integrated ModEl (PRIME) was used to estimate potential health impact. Overall, mean sodium intake was 2758 mg/day, varying by age and sex group. Based on 'reformulation' scenario A, mean sodium intakes were reduced by 459 mg/day, to 2299 mg/day. Reducing Canadians' sodium intake to recommended levels under scenarios A, B and C could have averted or delayed 2,176 (95% UI 869-3,687), 3,252 (95% UI 1,380-5,321), and 5,296 (95% UI 2,190-8,311) deaths due to CVDs, respectively, mainly from ischaemic heart disease, stroke, and hypertensive disease. This represents 3.7%, 5.6%, and 9.1%, respectively, of the total number of CVDs deaths observed in Canada in 2019. Results suggest that reducing sodium intake to recommended levels could prevent or postpone a substantial number of CVD deaths in Canada. Reduced sodium intakes could be achieved through reformulation of the Canadian food supply. However, it will require higher compliance from the food industry to achieve Health Canada's voluntary benchmark sodium reduction targets.

Early vasopressin infusion improves oxygenation in infants with congenital diaphragmatic hernia.

Congenital Diaphragmatic Hernia (CDH) is a complex disease including a diaphragmatic defect, lung hypoplasia, and pulmonary hypertension. Despite its increasing use in neonates, the literature on the use of vasopressin in neonates is limited. The aim of this work is to analyze the changes in clinical and hemodynamic variables in a cohort of CDH infants treated with vasopressin. Among CDH infants managed at the Neonatal Intensive Care Unit (NICU) of our hospital from May 2014 to January 2019, all infants who were treated with vasopressin, because of systemic hypotension and pulmonary hypertension, were enrolled in this retrospective study. The primary outcome was the change in oxygenation index (OI) after the start of the infusion of vasopressin. The secondary outcomes were the changes in cerebral andsplanchnic fractional tissue oxygen extraction (FTOEc and FTOEs) at near-infrared spectroscopy, to understand the balance between oxygen supply and tissue oxygen consumption after the start of vasopressin infusion. We also reported as secondary outcomes the changes in ratio of arterial oxygen partial pressure (PaO2) to fraction of inspired oxygen (FiO2), heart rate, mean arterial pressure, serum pH, and serum sodium. We included 27 patients with isolated CDH who received vasopressin administration. OI dramatically dropped when vasopressin infusion started, with a significant reduction according to ANOVA for repeated measures (p = 0.003). A global significant improvement in FTOEc and FTOEs was detected (p = 0.009 and p = 0.004, respectively) as a significant reduction in heart rate (p = 0.019). A global significant improvement in PaO2/FiO2 ratio was observed (p < 0.001) and also at all time points: at 6 h since infusion (p = 0.015), 12 h (p = 0.009), and 24 h (p = 0.006), respectively. A significant reduction in sodium levels was observed as expected side effect (p = 0.012). No significant changes were observed in the remaining outcomes. Our data suggest that starting early vasopressin infusion in CDH infants with pulmonary hypertension could improve oxygenation index and near-infrared spectroscopy after 12 and 24 h of infusion. These pilot data represent a background for planning future larger randomized trials to evaluate the efficacy and safety of vasopressin for the CDH population.

A Cross Sectional Study on Hypokalemia in Patients with Acute Myocardial Infarction

Introduction: Hypokalemia was found to be more common in women, those with hypertension, and those on chronic diuretic therapy.&#x0D; Objectives of the Study: The main objective of the study is to analyse the hypokalemia in patients with acute myocardial infarction.&#x0D; Materials and Methods: This cross sectional study was conducted in District Head Quarter Teaching Hospital Faisalabad during 2019 to 2020. The data was collected from 100 male and female patients with myocardial infarction. The effect of plasma potassium concentration on patient survival after a myocardial infarction is investigated. &#x0D; Results: The data was collected from 100 patients of MI. Mean age of male patients was found to be 64.12±12.34 and female patients was 46.21±10.24. There was statistically significant decrease in serum sodium and potassium levels in study group among both the ages compared to normal healthy control group. Serum sodium, potassium, chloride, calcium levels were significantly lower in the AMI patients and magnesium levels were slightly raised among cases than controls.&#x0D; Conclusion: It is concluded that reduction in sodium level was assessed only in patients with AMI as compared to healthy persons. Estimation of serum electrolyte is of utmost importance for diagnosis and prognosis of AMI.

Tempero à base de ervas como estratégia para redução da oferta de sódio para comensais de uma unidade de alimentação e nutrição

Objective : This study aimed to evaluate the use of a herbs-based seasoning in protein preparations as a strategy for reducing sodium intake by diners served at a Food and Nutrition Unit (FNU). Material and Methods : This was a cross-sectional study carried out in a FNU factory. The herbs-based seasoning was developed with the help of the unit's cooks. The proximate composition of protein preparations was determined with the aid of food composition tables. To assess the acceptance of the preparations, a sensory analysis was performed for two culinary preparations: chicken breast and beef chuck steak added with the herbs-based seasoning. The following attributes were considered for evaluating colour, texture, aroma, appearance and overall evaluation, on a 9-point hedonic scale ranging from “I disliked a lot” to “I liked a lot”. The acceptability index was also calculated for all attributes. Results: Forty-one consumer judges were recruited to perform the sensory analysis. There was an important reduction in sodium levels of 60.2% (from 939.2 mg to 375.3 mg) and 23.3% (from 709.7 mg to 544.0 mg) per 100g of chicken breast and beef chuck steak, respectively, and an increase in the fiber content of the preparations that received the herbs-based seasoning. The global acceptance index of seasoned chicken breast and beef chuck steak was 87.8% and 83.8%, respectively. Conclusion: The substitution of ultra-processed seasoning for herbs-based seasoning in protein preparations was well accepted among FNU diners.

Size-dependent enhancement in salt perception: Spraying approaches to reduce sodium content in foods

There is a rising need to come up with scalable approaches for reducing the salt content in foods. The product structure design is one of the mechanisms to reduce sodium content without impacting the taste of food. Here we report a new approach involving modification of the size and structure of common salt using two techniques: spray drying (SD) and electrohydrodynamic atomized drying (ED). We characterized the properties of the SD and ED produced salts; with size ranges of 1.21 μm and 520 nm, 2-fold and a 3-fold increase in saltiness were observed, indicative of around 58.67 and 65.34% reduction in sodium levels respectively, to achieve similar levels of saltiness for control salt. Finally, these findings were supported with time-intensity analysis and dissolution characteristics of these salts, demonstrating a promising approach for reducing sodium content in foods, particularly for surface-salting applications.

Effect of partial replacement of sodium chloride with potassium chloride on the characteristics of Minas Padrão cheese

Partial replacement of NaCl by KCl (25% and 50%) in Minas Padrão cheese was investigated for the physicochemical characteristics, sensory evaluation, fatty acid profile, and texture parameters. Salt replacement did not affect the moisture content, protein, fat, ash, water activity, chloride, pH, and proteolysis. A significant reduction in sodium levels was observed, ranging from 369.12 mg 100 g−1 to 210.05 mg 100 g−1, while the control treatment (100% NaCl) presented 608.67 mg 100 g−1. Proteolysis indexes increased throughout ripening. Hardness and chewiness increased, as a result of pH reduction and syneresis in cheese, which caused a decrease in moisture content. The fatty acid profile was affected by sodium reduction, with an increase in short chain, medium-chain, and polyunsaturated fatty acids. In relation to the acceptance test, no significant differences were observed for the cheese with a substitution of 25% sodium chloride with potassium chloride when compared with the control.

Uso del agua de coco (Cocos nucifera) como terapia electrolítica intravenosa en caninos deshidratados

El presente trabajo tuvo como objetivo evaluar el uso del agua de coco (AC) aplicada por vía intravenosa en perros. En una primera fase se evaluó la esterilidad e isotonicidad del AC. En una segunda fase se evaluaron los cambios hematológicos producidos 24 horas pos-aplicación del AC por vía intraperitoneal en ratas. En una tercera fase se evaluó la aplicación de AC vía intravenosa en perros con y sin actividad física (n=20, por grupo), donde se determinaron los valores hematológicos, pH y niveles de cloro y sodio antes y después de su aplicación, así como la frecuencia cardiaca, frecuencia respiratoria y temperatura al inicio, a los 15, 30, 45, 60 minutos de iniciada la aplicación y 30 minutos después de la aplicación del AC. Los resultados muestran que el AC es estéril e isotónico, no produjo alteraciones significativas en los valores hematológicos de las ratas ni en los perros sin actividad física. Sin embargo, los perros con actividad física mostraron una reducción del hematocrito a los 30 minutos pos-aplicación y una leve reducción de los niveles de sodio.

Evaluation of Australian soup manufacturer compliance with national sodium reduction targets.

Packaged foods dominate Australia's food supply and are important contributors to nutrition-related disease. To help address this problem, the Food and Health Dialogue (FHD) was launched in 2009, setting voluntary sodium reduction targets for various categories of packaged foods. The aim of this study was to examine the food industry's progress and compliance with the FHD sodium reduction targets for soup products. Nutritional information was collected from product labels of all soup products available from four major Australian supermarkets annually between 2011 and 2014. Products were assigned to categories in line with those in the FHD. The proportion of soup products meeting sodium reduction targets was examined by (i) soup category; (ii) FHD participant status; and (iii) manufacturer. A 6% reduction in sodium levels in soups overall was found from 2011 to 2014 (P = 0.002). Significant reductions were observed for FHD participants (P < 0.05 for all) but not for non-participants. In 2014, 67% dry soups and 76% of wet soups met national sodium reduction targets. Despite the majority of soup products meeting the sodium reduction targets specified by the FHD, re-evaluation of the targets may be required to further reduce sodium levels in soups. Manufacturers participating in the FHD are likely to be driving sodium reductions in the Australian soup market, further highlighting the need for continued government leadership in this area to ensure all manufacturers are actively involved in the process.

A Prospective Randomized Study Comparing Unipolar Versus Bipolar Hysteroscopic Myomectomy in Infertile Women.

Study Objective:To compare the operative and reproductive outcome of hysteroscopic myomectomy using unipolar resectoscope versus bipolar resectoscope in patients with infertility and menorrhagia.Design:Randomized, prospective, parallel, comparative, single-blinded study.Design Classification:Canadian Task Force classification I.Setting:Tertiary care institute.Patients:Sixty women with submucous myoma and infertility.Interventions:Hysteroscopic myomectomy performed with unipolar resectoscope or bipolar resectoscope.Measurements:Primary outcome measures were the pregnancy-related indicators. Secondary outcome measures were the operative parameters, harmful outcomes related to the procedure, and comparison of improvement levels in the menstrual pattern after surgery between the two groups.Main Results:A total of 60 patients were randomized into two groups of equal size. Baseline characteristics were not significantly different between the two groups. Reduction in sodium level from pre- to postsurgery was significantly (P = 0.001) higher in the unipolar group. Nine patients (30%) in the unipolar group had hyponatremia in the postoperative period compared to none in the bipolar group (P = 0.002). However, there was no significant difference in the other operative parameters between the two groups. In both the groups, a significant improvement in the menstrual symptoms was observed after myomectomy. Pregnancy-related outcomes were similar in both the groups.Conclusion:The use of bipolar resectoscope for hysteroscopic myomectomy is associated with lesser risk of hyponatremia compared to unipolar resectoscope. Bipolar resectoscopic myomectomy is found to be an effective and safer alternative to unipolar resectoscopy with similar reproductive outcome.

Reduction in sodium content of fresh, semihard Tzfat cheese using salt replacer mixtures: taste, texture and shelf life evaluation

Tzfat cheese is a semihard, fresh cheese commonly produced in Israel, with an average sodium content of 1000 mg/100 g cheese. Reduction in sodium levels by 30% and 50% (w/w) with and without salt replacer mixtures was assessed in terms of cheese physicochemical, microbiological and sensory properties. Cheese, containing 30% KCl and 70% NaCl had the closest taste profile to the control cheese, according to electronic tongue analysis. All cheeses underwent a similar increase in extent of proteolysis and microbial growth during shelf life. This study demonstrates the possibility of reducing the sodium content in fresh, semihard cheeses like Tzfat cheese by more than 30% using salt replacer mixtures, without significantly affecting quality.

Hyponatremia effect in patients with alcohol dependence on their physical and mental health status.

Hyponatremia, i.e. reduction of sodium level in the blood plasma below 135mmol/L, is one of the most common electrolyte disorders occurring in people addicted to alcohol. Numerous psychopathological symptoms may be significantly associated with its occurrence. Since sodium is one of the main bioelements, which is responsible for proper neuromuscular excitability maintenance and contributes in nerve impulses conduction, sodium balance disorders may be related to a risk to basic life functions. The tested group included 100 alcohol dependent patients (M=90, F=10). Sodium was determined using biochemical Indiko Plus analyzer. Analysis of sodium concentration demonstrated that 64% of people with alcohol dependence had low (<135mmol/L) plasma sodium level, of which: 7% had severe hyponatremia (<120mmol/L), 13% had moderate hyponatremia (120-130mmol/L) and 44% had mild hyponatremia (130-135mmol/L). The analysis showed an occurrence of significant differences in terms of: impulsivity, quality of life, clinical symptoms occurrence, maximum amount of alcohol consumed and general health state. The lower concentration of sodium in blood plasma in alcohol dependent people, the worse psychical and psychological quality of their life.

Effectiveness of a Communication for Behavioral Impact (COMBI) Intervention to Reduce Salt Intake in a Vietnamese Province Based on Estimations From Spot Urine Samples.

This study evaluated the effectiveness of the Communication for Behavioral Impact (COMBI)–Eat Less Salt intervention conducted in Viet Tri, Vietnam. The behavior change intervention was implemented in four wards and four communes for one year, which included mass media communication, school interventions, community programs, and focus on high‐risk groups. Mean sodium excretion was estimated from spot urine samples using different equations. A subsample provided 24‐hour urine to validate estimates from spot urine. Information about salt‐related knowledge and behaviors was also collected. There were 513 participants at both baseline and follow‐up. Mean sodium excretion estimated from spot urines fell significantly from 8.48 g/d at baseline to 8.05 g/d at follow‐up (P=.001). All spot equations demonstrated a significant reduction in sodium levels; however, the change was smaller than the measured 24‐hour urine. Participants showed improved knowledge and behaviors following the intervention. The COMBI intervention was effective in lowering average population salt intake and improving knowledge and behaviors.

Physicochemical properties of low sodium goat kafta

The effect of partial replacement (25 and 50%) of sodium chloride (NaCl) by potassium chloride (KCl) on physicochemical parameters of kafta prepared with goat meat was assessed. It was observed that the influence of sodium reduction on the physicochemical traits of goat kafta depends on the percentage of NaCl substitution. As expected, the partial substitution of NaCl by KCl in goat kafta formulations caused a reduction in sodium levels and increased potassium values. The percentage of NaCl substitution by KCl also had an influence (p < 0.05) on increased water activity, pH and shear-force of kafta samples. Although there was no modification in water-holding capacity between treatments (p < 0.05), it was observed an increasing trend of cooking loss with the percentage of NaCl substitution. Low-sodium samples showed low values of lightness and redness. Goat kafta prepared with 25% NaCl substitution had lower TBARs value compared to other treatments (p < 0.05). In conclusion, considering the occurrence of minor changes in the physicochemical characteristics of samples and the low sodium content, 25% substitution of NaCl by KCl in goat kafta formulations seems to be feasible.

Reduction of sodium content in spicy soups using monosodium glutamate

BackgroundExcessive dietary sodium intake causes several diseases, such as hypertension, cardiovascular and renal disease, etc. Hence, reducing sodium intake has been highly recommended. In this study the effect of monosodium glutamate (MSG), as an umami substance, on saltiness and sodium reduction was investigated.Methods and ResultsThe trained panellists were presented with basic spicy soups (curry chicken and chili chicken) containing different amounts of sodium chloride (NaCl) (0–1.2%) and MSG (0–1.2%). They tasted the optimum concentrations of NaCl and MSG for the two spicy soups and the overall acceptability were 0.8% and 0.7%, respectively. There was no significant effect of spiciness level on the saltiness and umami taste of both soups. The optimum levels of combined NaCl and MSG for overall acceptance in the chili and curry soups were 0.3% and 0.7%, respectively. The results showed that with the addition of MSG, it is possible to reduce sodium intake without changing the overall acceptability of the spicy soup. A 32.5% reduction in sodium level is made feasible by adding 0.7% MSG to the spicy soups.ConclusionsThis study suggests that low-sodium soups can be developed by the addition of appropriate amounts of MSG, while maintaining the acceptability of the spicy soups. It was also proven that it is feasible to reduce sodium intake by replacing NaCl with MSG.

Lithium as a coupling factor of mineral and glucose homeostasis disorders in malignant tumors of epithelial tissues

The impact of changes in orientation of the metabolism of carbohydrates and minerals in the cell malignancy has been demonstrated in several studies. The aim of this study was to analyze the molecular mechanisms and relationship of carbohydrate and mineral homeostasis with the processes of carcinogenesis. Parameters of carbohydrate and mineral metabolism of blood were defined in 73 patients with malignant tumors of epithelial tissues and 31 healthy subjects. In the presence of malignant tumors of epithelial tissues there was a statistically significant increase in the levels of glucose and glycated hemoglobin in the early stages of the disease and the absence of them at stage IV of the disease. There were no statistically significant differences in the levels of C-peptide and immunoreactive insulin in blood samples of cancer patients, although they tended to increase compared with the control group. Analysis of the composition of macroelements at the early stages of carcinogenesis revealed a statistically significant reduction of sodium level in plasma which wasn’t observed at the terminal stage of the disease. The concentrations of potassium and chlorine tend to increase in cancer patients, but the differences between these parameters were not statistically significant. Concentrations of calcium and magnesium significantly increased in the presence of malignant tumors. Analysis of microelements in the blood plasma showed a decrease in the concentration of cuprum and lithium (in 2.5-5 times) and the growth of strontium concentrations. Lithium has multiple effects on the life of cells, affecting a number of elements of messengers, as well as being the link between the carbohydrate metabolism and cell malignancy. Disorders of mineral homeostasis are important element in the disintegration of the metabolic processes in carcinogenesis

Health and economic impacts of eight different dietary salt reduction interventions.

BackgroundGiven the high importance of dietary sodium (salt) as a global disease risk factor, our objective was to compare the impact of eight sodium reduction interventions, including feasible and more theoretical ones, to assist prioritisation.MethodsEpidemiological modelling and cost-utility analysis were performed using a Markov macro-simulation model. The setting was New Zealand (NZ) (2.3 million citizens, aged 35+ years) which has detailed individual-level administrative cost data.ResultsOf the most feasible interventions, the largest health gains were from (in descending order): (i) mandatory 25% reduction in sodium levels in all processed foods; (ii) the package of interventions performed in the United Kingdom (UK); (iii) mandatory 25% reduction in sodium levels in bread, processed meats and sauces; (iv) media campaign (as per a previous UK one); (v) voluntary food labelling as currently used in NZ; (vi) dietary counselling as currently used in NZ. Even larger health gains came from the more theoretical options of a “sinking lid” on the amount of food salt released to the national market to achieve an average adult intake of 2300 mg sodium/day (211,000 QALYs gained, 95% uncertainty interval: 170,000 – 255,000), and from a salt tax. All the interventions produced net cost savings (except counselling – albeit still cost-effective). Cost savings were especially large with the sinking lid (NZ$ 1.1 billion, US$ 0.7 billion). Also the salt tax would raise revenue (up to NZ$ 452 million/year). Health gain per person was greater for Māori (indigenous population) men and women compared to non-Māori.ConclusionsThis study substantially expands on the range of previously modelled salt reduction interventions and suggests that some of these might achieve major health gains and major cost savings (particularly the regulatory interventions). They could also reduce ethnic inequalities in health.

Nilamadana, new fungal fermented cereal based food

The high therapeutic value of kodo millet (Paspalum scrobiculatum) due to an abundance of phytochemicals, particularly phenolic compounds having strong antioxidant properties, make this underutilized cereal an excellent substitute to rice or wheat. Solid state fermentation of kodo millet using Penicillium roqueforti showed an inhibition of 17% against pancreatic lipase and 55% towards the advanced glycation end products (AGEs) formation. The fermented product, Nilamadana, showed a 50% increase in fat content. Both soluble and reducing sugars were present in higher amounts in fermented product than in the control. In addition, a reduction in sodium level with increased levels of potassium and calcium was noted in the fermented product. HPLC analysis of the phenolic acids and flavonoids revealed that predominant phenolics in kodo millet were sinapic acid, caffeic acid and naringenin. Fermentation increased total flavonoid and chlorogenic acid contents. Nilamadana, up to 1 g per kg body weight, did not exhibit toxic effect or mortality in experimental rats till 14 days after administration. Nilamadana fed rats showed a 13% reduction in cholesterol levels than that of the control. Furthermore, histopathological examination of liver and kidney indicated that haematological and clinical parameters were within safe limits between the groups fed Nilamadana and the control diet. These results explain the bioactivities and functionalities of kodo millet-based fungal fermented functional food, Nilamadana and its potential use in the prevention of life style diseases.

Hypophosphatemia is a common complication in severely disabled individuals with neurological disorders and is caused by infection, refeeding and Fanconi syndrome

To describe the characteristics of hypophosphatemia in severely disabled individuals with neurological disorders and to identify its causative factors. We retrospectively reviewed clinical data from 82 individuals with motor skills classified as sitting, rollover or bedridden. Age, gender and body mass index were compared in individuals with (n=19) and without (n=63) a history of hypophosphatemia (serum phosphate levels <2.0 mg/dl). The clinical course of each patient with hypophosphatemia was reviewed and the cause identified. Laboratory data during hypophosphatemia was compared with that after recovery. The age, gender and body mass index did not differ significantly between the individuals with and without hypophosphatemia. Nineteen patients experienced 25 episodes of hypophosphatemia. The causes included febrile illnesses (n=17), refeeding syndrome (n=4) and Fanconi syndrome (n=3), but was unidentifiable in one episode. Significant elevations in C-reactive protein levels and reductions in sodium levels were observed during hypophosphatemia episodes. Hypophosphatemia is a common complication in severely disabled individuals with frequent bacterial infections, refeeding following malnutrition and valproate administration for epilepsy treatment. Because severe hypophosphatemia is life threatening, serum phosphate levels should be closely monitored in this population.