Specific Vitamin Research Articles

Picky eating and stunting in children aged 2 to 5 years in central Lampung, Indonesia

Background: The difficulty of feeding (picky eater) is the behavior of the child does not want to or refuses to eat, or have difficulty consuming food or drink with the type and quantity of suitable age physiologically (natural and unnatural), ranging from open his mouth without coercion, chew, swallow, until absorbed in digestion are good without coercion and without granting specific medications, vitamins and Picky eater able to be symptoms of child health detriment if the reply was not directly addressed. A picky eater can make a child's nutritional intake shortage that certainly further cause severe Stunting and is easily affected by the disease. Purpose : Knowing correlation between toddler's picky eater and stunting on toddler in Central Lampung- Indonesia. Methods : This study used a quantitative approach to the design of case- control. Sampling techniques using the formula slovin. Data analysis using the chi- square test. Results : The statistical tests for non-parametric bivariate obtained the value of p = 0.000 picky eater relationship with stunting which means there is a significant correlation. Conclusion: There is a relationship between picky eater with a stunting incident in Central Lampung Indonesia. Suggestion for government authority to be pay attention especially in compliance of the nutritional needs to toddler and health education to the parent about an essential nutrition for the toddler

Assessment of Dietary Intake, Body Composition and Sports Nutrition Knowledge of NCAA Division I Female Collegiate Volleyball Players

Abstract Objectives To assess nutritional intake, body composition and sports nutrition knowledge of NCAA Division I female volleyball players. Methods Nutritional intake was assessed using three-day food records. Daily average energy, carbohydrate, protein, fat, and specific vitamins and minerals intakes were analyzed using Food Processor 11.1. These values were compared to the recommendations from the American College of Sports Medicine (ACSM). Sports nutrition knowledge was assessed using an 87-question validated nutrition for sports knowledge questionnaire (NSKQ). Athletes were also asked to state their sources for nutrition knowledge. Body composition was assessed using bioelectrical impedance analysis. Descriptive data (mean ± SD) and Pearson correlation coefficients (r) were calculated using SPSS 26.0 with significance set at P ≤ 0.05. Results Fourteen female volleyball players (age: 19.6 ± 1.3 y, height: 174.9 ± 8.2 cm, weight: 73.2 ± 8.5 kg, BMI: 24.1 ± 2.5 kg/m2; body fat: 25.2 ± 3.4%) completed the study. Athletes’ mean energy intake was 24.7 ± 6.4 kcal/kg BW/day, while carbohydrate, protein and fat intake were 2.9 ± 0.92, 1.3 ± 0.44, and 0.88 ± 0.28 g/kg BW/day, respectively. Vitamin D intake was 137.1 ± 90.7 IU/day and calcium intake was 673.4 ± 352.5 mg/day. Energy and carbohydrate intake were lower than the ACSM recommendations (37–41 kcal/kg BW/day and 6–10 g/kg BW/day, respectively) while fat intake was higher. Protein intake fell within the recommended ranges (1.2–1.7 g/kg BW/day). Additionally, vitamin D and calcium were lower than the recommendations. The average NSKQ score was 45.4 ± 9.6% and was positively associated with weight (r = .738, P = 0.003) and vitamin D intake (r = .587, P = 0.027). Weight management score (51.8 ± 15.4%) was positively associated with weight (r = .676, P = 0.008). Four athletes included a registered dietitian nutritionist (RDN) as a source of nutrition information. In contrast, twelve athletes listed athletic trainers as a source. Conclusions The average NSKQ score suggests that NCAA Division I female volleyball players lack adequate sports nutrition knowledge which may be associated with inadequate energy and nutrient intakes. Athletes may benefit from nutrition education and counseling for improved performance and health from RDNs. Funding Sources There are no funding sources.

Process and Method for Implementation of Automated Nutrient Profiling Reporting for a Global Food and Beverage Portfolio

Abstract Objectives With the increasing need for dynamic and flexible nutrient profiling of foods and beverages, PepsiCo has expanded capabilities to report on global nutrition data for business guidance and reporting to regulatory and health agencies. Additional processes were established to integrate nutrition and finance information and influence the long-term data strategy needs of the organization. Methods A multidisciplinary team of nutrition science, finance and IT professionals was assembled to systematically collect and link nutritional and financial data. A controlled, centralized database was created with data from 2015 to present from multiple data sources. Data quality is reviewed quarterly. Dashboards, scorecards and other reporting outputs were created (Tableau software, 2019.02) with end-user input, to measure performance against country-specific regulations, Front-of-Pack (FOP) labeling requirements and internal nutritional guidelines. Results Nutrition data from > 40,000 products are captured annually and linked with sales volume data. There was a 2.5-fold increase in countries contributing data since 2015 (10 vs 26 markets), representing >80% of the company's annual food/beverage sales volumes. Current reports focus on analyzing nutrients-to-encourage (protein, fiber, specific vitamins and/or minerals), food-groups-to-encourage (fruits, vegetables, whole grains, fat-free/low-fat dairy and nuts/seeds/legume) and nutrients-to-limit (saturated fat, sodium, added sugars, trans-fat). Dashboards are currently utilized by 9 company functions, supporting several requests, including national nutrition regulations (n = 2 dashboards), FOP labeling systems (n = 2), retail store requirements (n = 1), internal sustainability goals (n = 3) and customized reports (n = 40). Across all iterations, dashboards have received >1000 views. Conclusions Automated nutrient profiling has been successfully implemented by a multidisciplinary team. Dashboards provide end-users with a timely and efficient tool to dynamically analyze PepsiCo's product portfolio guiding short- and long-term business decisions. Future work includes informing opportunities to improve the nutrient profile of PepsiCo's portfolio and increasing data availability and analysis. Funding Sources PepsiCo Inc.

Investigating the Level of Vitamin E, C and Superoxide Dismutase in Patients with Allergic Asthma and Allergic Asthma with Helminths Infection

The aim of this study was to investigate the relationship of antioxidant activity, vitamin E, vitamin C and superoxide dismutase with the severity of allergic asthma by estimating their level in the patients’ sera, as well as evaluating their association with the level of total and specific serum IgE in allergic asthmatics and allergic asthmatics with helminths infection. The study applied on 180 subjects divided into three groups, 100 patients with allergic asthma and 50 patients having allergic asthma with helminths infection. The group of patients included 50 males and 100 females age 15-60 years. The control group comprised of 30 healthy individuals, included 14 males and 16 females age range 16-60 years. For each participant, the medical history was considered; the total and specific IgE levels, vitamin E, vitamin C and superoxide dismutase levels were determined in the patient’s sera using ELISA technique. The present study has demonstrated an increased level in serum total IgE in the patients’ groups (allergic asthma group and allergic asthma with helminths) compare to the control group, mean 374.54 IU/mL; 472.24 IU/mL; 29.21 IU/mL respectively. The level differences among the three groups are highly significant when compared statistically

Current and emerging pharmacological options for the treatment of nonalcoholic steatohepatitis

Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent disease and important unmet medical need. Current guidelines recommend, under specific restrictions, pioglitazone or vitamin E in patients with NASH and significant fibrosis, but the use of both remains off-label. We summarize evidence on medications for the treatment of nonalcoholic steatohepatitis (NASH), since NASH has been mainly associated with higher morbidity and mortality. Some of these medications are currently in phase 3 clinical trials, including obeticholic acid (a farnesoid X receptor agonist), elafibranor (a peroxisome proliferator activated receptor [PPAR]-α/δ dual agonist), cenicriviroc (a CC chemokine receptor antagonist), MSDC-0602 K (a PPAR sparing modulator), selonsertib (an apoptosis signal-regulating kinase-1 inhibitor) and resmetirom (a thyroid hormone receptor agonist). A significant research effort is also targeting PPARs and selective PPAR modulators, including INT131 and pemafibrate, with the expectation that novel drugs may have beneficial effects similar to those of pioglitazone, but without the associated adverse effects. Whether these and other medications could offer tangible therapeutic benefits, alone or in combination, apparently on a background of lifestyle modification, i.e. exercise and a healthy dietary pattern (e.g. Mediterranean diet) remain to be proven. In conclusion, major advances are expected for the treatment of NASH.

Alcoholism and nutrition: a review of vitamin supplementation and treatment.

This is a review of the research on the effectiveness of vitamin supplementation for alcoholism and alcohol-related illnesses. The focus is on research, both clinical and basic on alcohol treatment and nutritional effectiveness of these vital nutrients. Most of the research involves basic experiments exploring the impact of vitamin depletion or deficits on physiological systems, especially liver and brain, in rodents. These often include behavioral measures that use cognitive, learning/memory and motivation experiments that model clinical studies. These provide support for hypotheses concerning the impact of such deficiencies in clinical populations. Clinical studies are rare and involve evaluation of the outcome of supplementation usually in the context of a treatment program. Specific vitamins, dosages and treatment programs vary. Deficiencies in retinoids (vitamin A), thiamine (B1) and niacin (B3) are the most frequently investigated. However, there is a greater need for further research on other vitamins, and for more uniform supplementation and treatment procedures. The literature is primarily basic research on specific vitamins. There are very significant findings with individual vitamin supplementation and combinations that show promise of our understanding of the role of vitamins in the disease of alcoholism and its treatment.

Future perspectives in addressing the global issue of vitamin D deficiency.

Vitamin D is a fundamentally critical nutrient that the human body requires to function properly. It plays an important role in musculoskeletal health due to its involvement in the regulation of calcium and phosphorus. Having a low level of vitamin D in the body may be detrimental for a wide range of health outcomes, including risk of osteoporotic and stress fractures, risk of CVD and some cancers, and lowering of the capability of the immune system. Vitamin D is an unusual nutrient; it is not a vitamin, in the true sense of the word but a pro-hormone. The main source of vitamin D is UV exposure, not dietary intake. Interestingly, there are two forms of vitamin D, vitamin D2 and vitamin D3, both of which are metabolised into 25-hydroxyvitamin D (25(OH)D) in the liver, the biomarker of vitamin D status. Vitamin D deficiency is a global public health problem, especially amongst older people and ethnic minority groups. The newest publication from the UK Government's Public Health England Department recommends that vitamin D intake should be 10 μg daily and this recommendation compares well (albeit lower) with other guidelines such as the Institute of Medicine recommendation of 15 μg for those aged 1-70 years and 20 μg for those 70 years or over. Few countries, however, have a specific vitamin D policy to prevent deficiency in populations. Finland leads the way, demonstrating impressive results in reducing population-level vitamin D deficiency through mandatory food fortification programmes. Collaboration between academia, government and industry, including countries from varying latitudes, is essential to identify long-term solutions to the global issue of vitamin D deficiency. This paper provides a narrative review of the evidence related to the role of vitamin D deficiency in health outcomes, outlines controversies regarding setting levels of adequacy, identifies the prevalence of vitamin D deficiency across the globe, and identifies population-level strategies adopted by countries to prevent vitamin D deficiency.

Effects of a plant-based fatty acid supplement and a powdered fruit, vegetable and berry juice concentrate on omega-3-indices and serum micronutrient concentrations in healthy subjects

The major aim of this controlled, randomised, open-labelled, parallel-grouped, clinical trial was to investigate whether supplementation with different dosages of omega-3 fatty acids (0.5 g/d and 1 g/d) from a plant-based fatty acid supplement affected omega-3-indices (O3I) in well-nourished, healthy people. In addition, the combined ingestion of the plant-based fatty acid supplement, together with an encapsulated fruit, vegetable and berry (FVB) juice powder concentrate, was applied in order to observe the absorption of certain micronutrients and to examine some aspects related to the safe consumption of the products. The data demonstrate that the intake of only 0.5 g/day of omega-3 fatty acids from of a vegan supplement was able to increase the O3I significantly after 8 and 16 weeks. The combined ingestion with the FVB supplement concurrently increased serum concentrations of specific vitamins and carotenoids without effects on hepatic, kidney and thyroid function or changes in blood lipids.

Vitamin D deficiency in western dwelling South Asian populations: an unrecognised epidemic.

Vitamin D deficiency (25-hydroxyvitamin D; 25(OH)D) is at epidemic proportions in western dwelling South Asian populations, including severe deficiency (<12⋅5 nmol/l) in 27-60% of individuals, depending on season. The paper aimed to review the literature concerning vitamin D concentrations in this population group. Research from the UK and Europe suggests a high prevalence of South Asians with 25(OH)D concentration <25 nmol/l, with most having a 25(OH)D concentration of <50 nmol/l. In Canada, South Asians appear to have a slightly higher 25(OH)D concentration. There are few studies from the United States, South Africa and Australasia. Reasons for vitamin D deficiency include low vitamin D intake, relatively high adiposity, sun exposure avoidance and wearing of a covered dress style for cultural reasons. Possible health effects of deficiency include bone diseases such as rickets and hypocalcaemia in children and osteomalacia in adults. Vitamin D deficiency may also increase the risk of other chronic diseases. Increased fortification of food items relevant to South Asian groups (e.g. chapatti flour), as well as increased use of vitamin D supplements may help reduce this epidemic. Introducing culturally acceptable ways of increasing skin exposure to the sun in South Asian women may also be beneficial but further research is needed to assess the effectiveness of different approaches. There may be a need for a South Asian specific vitamin D dietary intake guideline in western countries. To conclude, vitamin D deficiency is epidemic in South Asians living in western countries and there is a clear need for urgent public health action.

Recent progress in Helicobacter pylori treatment

The main challenge in the field of Helicobacter pylori (H. pylori) infection is antibiotic resistance, which influences the efficacy of eradication regimens. Bismuth-containing quadruple therapy has been confirmed as an effective regimen for eradicating H. pylori, especially in strains with antibiotic resistance. High-dose proton-pump inhibitor-amoxicillin dual therapy could decrease the use of unnecessary antibiotics, which is a promising alternative approach. Adjuvant therapy (specific probiotic or vitamin) also showed good results, although more evidence is needed. Novel anti-H. pylori drugs are needed, and the establishment of the H. pylori database is an effective way to acknowledge the real-time information of H. pylori management. This review provides the recent progress of H. pylori treatment, and further studies are needed to address the role of different regimens in improving H. pylori eradication rate, especially in strains with antibiotics resistance.

Infants' Vitamin D Nutritional Status in the First Year of Life in Northern Taiwan.

Vitamin D deficiency (VDD) and insufficiency (VDI) are common among exclusively breastfeeding infants. However, epidemiological evidence for the prevalence of VDD in infants during their first year of life in Taiwan has never been found. This trial determined the prevalence of VDD and VDI and the association between dietary vitamin D and vitamin D nutritional status in Northern Taiwan. A cross-sectional study was conducted on infants who returned to well-baby examinations from October 2012 to January 2014 in three hospitals: Shin Kong Wu Ho-Su Memorial Hospital, Taipei Medical University Hospital, and Shuang Ho Hospital. The specific vitamin D cut-off concentrations for VDD, VDI, and VDS are 25(OH)D3 levels ≤20, 21–29, and ≥30 (ng/mL). Overall, 481 infants’ parents completed a questionnaire comprising questions related to vitamin D nutritional status, including weekly time outdoors, breastfeeding status, anthropometric measurement, and assessment of dietary intake, including milk and complementary food. The results revealed that 197 (41%) and 212 (44%) of infants in their first year of life had VDI and VDD, respectively, by the Endocrine Society guidelines. Breastfed infants had a higher prevalence of VDI (86.1%) than did mixed-fed (51.9%) and formula-fed (38.5%) infants (p < 0.001). The prevalence of VDD was 55.4% in infants aged under six months but increased to 61.6% in infants aged over six months. Infants in the VDI and VDD groups had the same anthropometrics as those in the vitamin D sufficiency (VDS) group. Our results revealed that 25(OH)D3 had a negative correlation with the intact parathyroid hormone (iPTH) when the serum 25(OH)D3 level ≤20 ng/mL (r = −0.21, p = 0.001). The VDS group had a higher total vitamin D intake than did the VDI and VDD groups, which was mainly obtained from infant formula. Our data revealed that dietary vitamin D intake and birth season were major indicators in predicting VDD. Lower dietary vitamin D intake and born in winter and spring significantly increased the odds ratio (OR) for VDI by 1.15 (95% CI 1.09–1.20) and 2.02 (95% CI 1.10–3.70), respectively, and that for VDD by 1.23 (95% CI 1.16–1.31) and 2.37 (95% CI 1.35–4.17) without covariates adjustment, respectively. Furthermore, ORs for VDI and VDD significantly differed after adjustment for covariates. In conclusion, the prevalence of VDI and VDD were high in infants during the first year of life. Breastfeeding infants had difficulty in obtaining sufficient vitamin D from diet. In cases where the amount of sun exposure that is safe and sufficient to improve vitamin D status is unclear, breastfed infants aged below one year old are recommended to be supplemented with vitamin D.

Vitamin D Binding Protein: A Historic Overview.

Vitamin D and all its metabolites are bound to a specific vitamin D binding protein, DBP. This protein was originally first discovered by its worldwide polymorphism and called Group-specific Component (GC). We now know that DBP and GC are the same protein and appeared early in the evolution of vertebrates. DBP is genetically the oldest member of the albuminoid family (including albumin, α-fetoprotein and afamin, all involved in transport of fatty acids or hormones). DBP has a single binding site for all vitamin D metabolites and has a high affinity for 25OHD and 1,25(OH)2D, thereby creating a large pool of circulating 25OHD, which prevents rapid vitamin D deficiency. DBP of higher vertebrates (not amphibians or reptiles) binds with very high affinity actin, thereby preventing the formation of polymeric actin fibrils in the circulation after tissue damage. Megalin is a cargo receptor and is together with cubilin needed to reabsorb DBP or the DBP-25OHD complex, thereby preventing the urinary loss of these proteins and 25OHD. The total concentrations of 25OHD and 1,25(OH)2D in DBP null mice or humans are extremely low but calcium and bone homeostasis remain normal. This is the strongest argument for claiming that the “free hormone hypothesis” also applies to the vitamin D hormone, 1,25(OH)2D. DBP also transports fatty acids, and can play a role in the immune system. DBP is genetically very polymorphic with three frequent alleles (DBP/GC 1f, 1s, and 2) but in total more than 120 different variants but its health consequences, if any, are not understood. A standardization of DBP assays is essential to further explore the role of DBP in physiology and diseases.

Successful Treatment of Alopecia Totalis with Topical Calcipotriol: Serial Case Report and Review of the Literature

Background: Alopecia totalis (AT) often responds poorly to standard therapies. This disease is chronic and relapsing, no effective cure treatment has been established. Calcipotriol is a vitamin D analog and acts as a potent immunomodulatory agent can be used in the treatment of alopecia areata (AA) with promising results. The active form of vitamin D mediates its action by binding to specific vitamin D receptors (VDR) located in the nuclei of target cells. Expression of VDR in keratinocytes is necessary for maintenance of the normal hair cycle. Objective: Our study aims to show the effectiveness of topical calcipotriol in the treatment of Alopecia Totalis patient. Methods: Three patients diagnosed with AT, duration of disease 6 – 12 months, refractory to other treatments were selected and were started on topical calcipotriol and were followed up every 4 weeks for 12 weeks. The efficacy was measured by hair regrowth using photographic assessment, Severity of Alopecia Tool score (SALT), Hair Pull Test and physical examination. Patients will be followed up for 6 months after stopping treatment for assessing disease relapse. Results: The patients showed excellent response with complete regrowth of scalp hair after a single 12-week treatment course of topical calcipotriol and no hair loss relapse was observed over the next 6 months. Conclusion: In our patients, a novel treatment option topical calcipotriol was successfully used in the management of AT, in the absence of significant adverse side effects. We recommend that further controlled studies be required to establish safety, confirm efficacy, and disease remission protocol. To our knowledge, this is the first published case series of successful treatment for AT with single topical calcipotriol although the sample size was small.

Vitamin D receptor Fokl polymorphism is a determinant of both maternal and neonatal vitamin D concentrations at birth

Maternal vitamin D deficiency is considered to be the key determinant of the development of neonatal vitamin D deficiency at birth and during early infancy. Specific vitamin D receptor (VDR) gene polymorphisms have been associated with adverse pregnancy and offspring outcomes. The aim of this study was to evaluate the effect of maternal and neonatal VDR polymorphisms (ApaI, TaqI, BsmI, FokI, Tru9I) on maternal and neonatal vitamin D status. VDR polymorphisms were genotyped in 70 mother-neonate pairs of Greek origin, and classified according to international thresholds for Vitamin D status. Mean neonatal and maternal 25-hydroxy-vitamin D [25(OH)D] concentrations were 35 ± 20 and 47 ± 26 nmol/l, respectively. Neonatal VDR polymorphisms were not associated with neonatal 25(OH)D concentrations. In contrast, mothers with the Fokl FF polymorphism had a 70 % lower risk of vitamin D deficiency [25(OH)D <30 nmol/l] compared with ff ones, after adjustment for several confounders. They were also in 73 % and 88 % lower risk of giving birth to vitamin D deficient [25(OH)D <30 nmol/l] neonates compared with Ff and ff mothers, respectively. These results suggest a protective role of maternal Fokl FF genotype against both maternal and neonatal vitamin D deficiency. Further studies are needed to clarify the complex gene-gene and gene-environment interactions that determine vitamin D status at birth.

An encapsulated fruit, vegetable and berry juice powder concentrate increases plasma values of specific carotenoids and vitamins.

Vitamins and carotenoids are organic compounds that are important for vital functions of the human organism. Since the human body is not able to synthesize most of these micronutrients, they need to be supplied by the intake of food or supplements. The aim of this study was to analyze whether a whole food based, encapsulated fruit, berry, and vegetable juice powder concentrate provides bioavailable carotenoids and vitamins A (all-trans retinol), E and C. Eighteen healthy subjects received 6 capsules a day for 8 weeks, which provided 2.91mg β-carotene, 490 μg vitamin A, 18.7mg vitamin E, 159mg vitamin C, 6.1mg lutein and 1mg lycopene. Plasma concentrations of several carotenoids and vitamins before and after supplementation were measured. After 8 weeks of supplementation, the plasma concentration of the following carotenoids increased significantly: α-carotene increased from 59.6±22.4nmol/L to 85.7±24.2nmol/L (p=0.002), β-cryptoxanthin from 106.7±39.8nmol/L to 151.9±57.9nmol/L (p=0.017), and lycopene from 1.2±0.5μmol/L to 1.7±0.5μmol/L (p=0.005). Significant increases were also observed for plasma concentrations of vitamin C from 70±20μmol/L to 90±10μmol/L (p<0.001), all-trans retinol from 1.99±0.24μmol/L to 2.30±0.66μmol/L (p=0.015), and α-tocopherol from 27±6μmol/L to 32±6μmol/L (p=0.008). For those micronutrients with accepted plasma reference ranges, all observed increases levelled off around the upper limit of the individual reference range. The data demonstrate that the investigated supplement is able to increase plasma concentrations of certain carotenoids and vitamins of healthy subjects within 8 weeks.

Roles of vitamins in stem cells.

Stem cells can differentiate to diverse cell types in our body, and they hold great promises in both basic research and clinical therapies. For specific stem cell types, distinctive nutritional and signaling components are required to maintain the proliferation capacity and differentiation potential in cell culture. Various vitamins play essential roles in stem cell culture to modulate cell survival, proliferation and differentiation. Besides their common nutritional functions, specific vitamins are recently shown to modulate signal transduction and epigenetics. In this article, we will first review classical vitamin functions in both somatic and stem cell cultures. We will then focus on how stem cells could be modulated by vitamins beyond their nutritional roles. We believe that a better understanding of vitamin functions will significantly benefit stem cell research, and help realize their potentials in regenerative medicine.

Assessing the Need for a Structured Nutrition Curriculum in a Primary Care Residency Program

Background: Given the epidemic of diet-related illnesses, medical training regarding nutrition counseling is not fully known. Historically, there is a lack of formalized nutrition training in both medical school and residency programs.Objective: This study surveyed a group of family medicine residents to elicit previous nutrition education and outlook on nutrition counseling. A measure of resident attitudes toward nutrition education and comfort with relaying nutrition education to patients was conducted.Design: A validated, self-administered questionnaire was administered. The survey was composed of 32 questions with yes/no or Likert scale response.Participants and setting: Participants were 30 family medicine residents in the final quarter of their individual postgraduate year of training (PGY1-3). A total of 23 residents electively responded.Results: The majority surveyed conveyed nutrition education in routine care is important in a physician–patient relationship. Except in diabetes, the overwhelming majority reported they were not adequately trained to give nutrition education in specific disease states. The group was not familiar with types of diets, the role of fatty acids, or the impact of specific vitamins on health.Conclusions: The data from this survey indicate a need for formalized nutrition education in primary care training. From the survey data results, the next steps include building a nutrition curriculum to be implemented in the residency program and potentially set a standard for nutrition education in the North Carolina region and beyond.

Health Care for Mitochondrial Disorders in Canada: A Survey of Physicians.

An improved understanding of diagnostic and treatment practices for patients with rare primary mitochondrial disorders can support benchmarking against guidelines and establish priorities for evaluative research. We aimed to describe physician care for patients with mitochondrial diseases in Canada, including variation in care. We conducted a cross-sectional survey of Canadian physicians involved in the diagnosis and/or ongoing care of patients with mitochondrial diseases. We used snowball sampling to identify potentially eligible participants, who were contacted by mail up to five times and invited to complete a questionnaire by mail or internet. The questionnaire addressed: personal experience in providing care for mitochondrial disorders; diagnostic and treatment practices; challenges in accessing tests or treatments; and views regarding research priorities. We received 58 survey responses (52% response rate). Most respondents (83%) reported spending 20% or less of their clinical practice time caring for patients with mitochondrial disorders. We identified important variation in diagnostic care, although assessments frequently reported as diagnostically helpful (e.g., brain magnetic resonance imaging, MRI/MR spectroscopy) were also recommended in published guidelines. Approximately half (49%) of participants would recommend "mitochondrial cocktails" for all or most patients, but we identified variation in responses regarding specific vitamins and cofactors. A majority of physicians recommended studies on the development of effective therapies as the top research priority. While Canadian physicians' views about diagnostic care and disease management are aligned with published recommendations, important variations in care reflect persistent areas of uncertainty and a need for empirical evidence to support and update standard protocols.

Micronutrient Deficiencies in Children With Inflammatory Bowel Diseases.

Children with inflammatory bowel diseases (IBDs) are at risk of developing nutrition deficiencies, particularly because of reduced intake, restrictive diets, malabsorption, and excessive nutrient loss. In this study, we aimed to assess the status of trace elements, minerals, and vitamins in a large cohort of children with IBDs. Medical records of children diagnosed with IBDs during 2000-2016 were reviewed retrospectively. Retrieved data included demographics, disease characteristics, disease activity indices, anthropometric measures, and specific trace elements, minerals, and vitamins at diagnosis and during follow-up. Out of 359 children with IBD (158 [44%] females, median age at diagnosis 14.1 years, interquartile range [IQR] 12.0-16.0), 240 (67%) were diagnosed with Crohn's disease (CD) and 119 (33%) with ulcerative colitis (UC). Median follow-up time was 7 years (IQR 5-10). The prevalence of deficiencies in patients with CD at diagnosis and last follow-up, respectively, were iron (88% and 39.5%), zinc (53% and 11.5%), vitamin D (39% and 36%), and folic acid (10% and 13%). In patients with UC, frequencies were: iron (77% and 40%), vitamin D (49% and 33%), zinc (31% and 10%), and folic acid (3.8% and 9.7%). Magnesium and vitamin B12 deficiencies were rare. For both diseases, iron deficiency was associated with hypoalbuminemia. Deficiencies in iron and zinc were more common in patients with CD than those with UC. Deficiencies in iron, zinc, and vitamin D are common at pediatric IBD diagnosis with limited improvement during follow-up, whereas deficiencies in magnesium and vitamin B12 are rare.

MON-214 1α,25-DIHYDROXYVITAMIN D3 TARGETING OF NF-ΚB SUPPRESSES TNF-Α INDUCED ADHESION MOLECULE EXPRESSION IN HUMAN ENDOTHELIAL CELLS

Vitamin D and its analogues have been documented to be associated with endothelial dysfunction in various diseases. However, the underlying mechanism remains unknown. Here, we conducted an in vitro study to evaluate the effect of 1α,25-dihydroxyvitamin D3, the active form of vitamin D3, on adhesion molecule expression in human endothelial cells. The possible mechanism involved in this process was also explored. Human umbilical vein cells (HUVECs) were cultured and treated according to the experiment requirement. Western Blot and RT-PCR were used to evaluate the expression of vascular cell adhesion molecular-1 (VCAM-1) and E-selectin. ChIP assay, immunofluorescence, Western Blot and co-immunoprecipitation were used to assess the effect of 1α,25-dihydroxyvitamin D3 on NF-κB signaling. 1α,25-dihydroxyvitamin D3 inhibited VCAM-1 and E-selectin mRNA and protein expression after TNF-α stimulation. ChIP assay showed that TNF-α increased the p65 binding to the promoter of VCAM-1 and E-selectin, which was suppressed by 1α,25-dihydroxyvitamin D3. 1α,25-dihydroxyvitamin D3 affected TNF-α induced IκBα phosphorylation and p65 NF-κB activation, leading to an inhibition of p65 nuclear translocation. These effects were reversed by a specific vitamin D receptor siRNA (VDR-siRNA). Co-immunoprecipitation revealed that 1α,25-dihydroxyvitamin D3 induced an increased binding of VDR to p65, which inhibited the ability of p65 binding to target gene promoters. 1,25-dihydroxyvitamin D3 suppresses TNF-α induced adhesion molecule expression in human endothelial cells by blocking the NF-κB pathway, and this was VDR dependent.