OBJECTIVES:This study aimed to develop and compare functional beverage powders based on seaweed (Kappaphycus alvarezii) formulated with dragon fruit peel (Hylocereus polyrhizus) and sweet orange (Citrus sinensis), focusing on physicochemical properties, phytochemical composition, antioxidant activity, sensory characteristics, heavy metal safety, and shelf-life stability. METHODS:Beverage powders were prepared from seaweed combined with dragon fruit peel or sweet orange at ratios of 3:1, 1:1, and 1:3 (w/w). The formulations were evaluated for solubility, moisture content, ash content, phytochemical composition, antioxidant activity using the DPPH radical scavenging assay, and sensory characteristics. Vitamin C and heavy metal analyses (Pb, Cu, and As) were conducted on F3 and F6, as these formulations exhibited the highest antioxidant activities within the seaweed-dragon fruit peel and seaweed-sweet orange formulation series, respectively. Shelf-life stability was predicted using the Accelerated Shelf-Life Testing (ASLT) method based on the Arrhenius model at 10, 27, and 35 °C. RESULTS:Increasing the fruit proportion improved antioxidant activity and sensory quality. Among the seaweed-dragon fruit peel formulations, F3 (1:3) exhibited the highest antioxidant activity, whereas F6 (seaweed-sweet orange, 1:3) showed the highest overall antioxidant activity and vitamin C content. In addition, F6 exhibited favorable sensory acceptance and heavy metal concentrations within the limits established by food safety standards. Shelf-life prediction using the Arrhenius model demonstrated that storage temperature significantly influenced product stability. CONCLUSION:The F6 formulation was identified as the optimal seaweed-based functional beverage powder, exhibiting enhanced antioxidant potential, acceptable quality characteristics, and compliance with food safety requirements. The developed formulation may serve as a potential functional beverage formulation; however, further preclinical and clinical studies are required to validate its biological relevance.
INTRODUCTION:Understanding of absolute and relative effect estimates, and determining effect size and certainty of evidence corresponding to effect estimates, represent fundamental evidence-based practice competencies that promote informed clinical decision-making. While research has been conducted in the medical profession, based on our literature review there is no published research on these competencies in the nutrition and dietetics profession. METHODS:Among registered dietitians, our main objectives were to assess (1) their understanding and perceived usefulness of three absolute and two relative effect estimate approaches to determine effect size, (2) their perceived usefulness of certainty of evidence, and (3) factors influencing their understanding and perceived usefulness. We conducted a web-based, cross-sectional survey by recruiting dietitians from the Academy of Nutrition and Dietetics (United States). Participants received effect estimates based on hypothetical dietary interventions vs. usual diet for reducing myocardial infarction risk. RESULTS:Of the 11,050 dietitians who received the survey link, 210 participated, and only completers (n = 114) were included in our analysis. Participants demonstrated a similar understanding of the relative (27.6%) and absolute (27.5%) effect estimates, with Risk Difference being the best understood approach and Number Needed to Treat being the least (30.7% vs. 24.6% correct responses). While perceived usefulness scores were similar between five approaches, they were highest when data was presented as Relative Risk [mean (SD): 4.82 (1.50)]. Dietitians rated the usefulness of certainty of evidence favorably [mean (SD): 5.07 (1.83), on a 7-point scale], and no factors were associated with correct understanding. CONCLUSION:Dietitians may have limited understanding of effect size thresholds presented in our survey, a finding mostly consistent with surveys of other health professionals. To optimize informed decision-making between dietitians and clients, dietetic programs and continuing education platforms should consider additional training on effect estimate approaches (relative and absolute), and determining effect sizes and certainty of evidence for effect estimates.
OBJECTIVE:This randomized, double-blind, placebo-controlled study investigated whether intensive periodized training combined with multi-strain probiotics affects training adaptation and exercise performance in amateur runners. METHODS:Thirty amateur runners were randomly assigned to receive either a multi-strain probiotic (PG, n = 15) or a placebo (CG, n = 15) during a four-week, intensive periodized training program. Two participants withdrew from the PG. Before and after the intervention, comprehensive laboratory, physical, and psychological assessments were conducted to evaluate training adaptation and exercise performance. RESULTS:Linear mixed-effects models indicated that intensive period training improved body composition, VO2peak, and Wpeak, accompanied by increased cortisol levels and a reduced testosterone-to-cortisol ratio. Probiotic supplementation alongside training attenuated biomarkers of exercise-induced muscle damage and endocrine disturbance, including Alanine aminotransferase levels, reduced athlete burnout scores, and modulated the fecal Firmicutes/Bacteroidetes ratio. Significant group × time interactions were observed for several key bacterial taxa. CONCLUSION:Intensive period training effectively enhances exercise performance and body composition. Probiotic supplementation might provide additional benefits related to training adaptation, gut microbiota modulation, and athlete burnout attenuation.
Lactose intolerance is a common digestive disorder found in many people around the world. It occurs when the body does not produce enough of the enzyme lactase needed to break down lactose, a type of sugar. Lactose is present in almost all mammal milk products, and for infants, this sugar is important for providing energy during their growth. There are many variations of adults with lactase persistence around the world; for example, in Nordic countries, more than 90% of adults produce lactase into adulthood, but in Southeast Asia, only around 10% of adults do so. Overall, about one-third of all adults can digest dairy products; however, many people believe that there will be negative side effects if they eat or drink dairy products. This leads to a restriction of dairy products that can hurt the body's ability to grow and get enough nutrients because dairy products contain many essential nutrient sources (protein, vitamins, minerals). About 68% of the world population is affected by lactose intolerance, but that figure has not changed much in the past decade. However, there are vast regional variations (5-28% in Europe and 70-98% in Asia and Africa). The therapeutic market, including enzyme supplements, probiotics, and dietary aids applicable in all of the severity stages of the condition, is estimated to be valued at $ 36.96 billion in 2026, which represents a 7.4% compound annual growth rate; to reach $ 49.13 billion in 2030 due to the creation of personalized interventions and dairy substitutes.
OBJECTIVE:The purpose of this study was to compare the glycemic/blood glucose (BG) and satiety responses of adding mango or sucrose to a high glycemic load (HGL) breakfast. METHODS:For this randomized, controlled trial (cross-over design), 18 healthy young adults consumed a breakfast of cornflakes and almond milk (Control), Control plus 34 gm added sucrose (ASug), or Control plus added mango (AMango) with 38 gm carbohydrate on 3 separate days. BG was determined at fasting, 15, 30, 60, 90, 120 min postprandial; satiety was rated with a visual analog scale at each time point. At 120 min, participants consumed a snack of hummus and crackers ad libitum and kcalorie intake was determined. RESULTS:BG spike was significantly higher in the ASug vs. the Control (p = 0.007); there was no difference in the spike between the AMango and Control. The glucose Area Under Curve (AUC) was significantly higher in the ASug and AMango group than the control (p < 0.02). At 15, 30, 60, and 120 min postprandial, satiety was rated significantly higher in the AMango group vs. the Control and ASug groups (p < 0.05). There were no differences in kcals of the snack consumed. CONCLUSIONS:Adding mango to a high glucose breakfast results in a more favorable glycemic response compared to an equivalent amount of carbohydrate as added sucrose. Although mango increased satiety, the snack kcal consumption was not significantly lower after the AMango vs. Control, indicating satiety did not influence consumption of a palatable snack.
BACKGROUND:Although shared understanding between consumers and experts, and within experts themselves, is essential for healthier food choices, no existing method systematically prioritizes foods based on the magnitude of health education gaps. OBJECTIVE:To develop and apply a quantitative belief-mapping methodology to identify commonly consumed foods that warrant prioritization for research and nutrition communication. METHODS:Based on survey data and a meta-nutrition profiling system that represents transparent and harmonized expert healthfulness ratings, consumer misalignment and misperception relative to experts, as well as expert-only uncertainty, were quantified across 20 commonly consumed carbohydrate-rich foods. Foods were then ranked by jointly considering misalignment, expert uncertainty, and national consumption prevalence. RESULTS:Among the 20 foods evaluated, 85% received a consumer-to-expert Alignment Grade of C or D, and 75% received an Uncertain expert-only healthfulness classification. Among consumers, the most negatively misperceived foods-those rated less healthy by consumers than by experts-included all surveyed potato based foods (French fries, chips, and baked potatoes) and unbuttered, air-popped popcorn. In contrast, honey was the most positively misperceived food, being rated as healthier by consumers than by experts. Most foods (70%) exhibited a mixture of negative and positive misperception (≥15/85%). When misalignment, expert uncertainty, and high U.S. consumption were considered jointly, white rice, white bread, corn tortilla, and fruit juice with vitamin C emerged as priority foods for future research and nutrition education. CONCLUSIONS:Substantial consumer-expert misalignment and expert uncertainty were observed across commonly consumed carbohydrate-containing foods. This scalable belief-mapping methodology prioritizes foods for future nutrition research, communication efforts, and policy.
OBJECTIVES:Fermented Papaya Preparation (FPP) is a supplement with antioxidant, anti-inflammatory, and immune-modulatory effects. This study investigated the effects of one-month continuous FPP intake on health parameters related to driving performance, the useful field of view (UFOV) and post-work fatigue recovery in active bus drivers and the effect of FPP on elite performance motor racing drivers and elite motor racing drivers. METHOD:This study examined the effects of one-month continuous intake of FPP on health outcomes, oxidative stress markers and useful field of view (UFOV) in active bus drivers and elite motor racing drivers. RESULT:Significant reductions were observed in oxidative stress markers (urinary 8-hydroxy-2'-deoxyguanosine [8-OHdG]) and reaction times within the UFOV. Subjective health measures related to driving performance-including concentration, vitality, fatigue, and sleep quality-also showed significant improvements. Participants with improved UFOV demonstrated concurrent reductions in urinary 8-OHdG. In the health-related quality of life assessment using the short form health survey SF-12®, significant improvements were detected in "general health perception" (p < 0.01), "vitality" (p < 0.05), and "mental health" (p < 0.01) after intervention. In the performance of elite drivers' assessment, the malondialdehyde (MDA) values in elite motor sport drivers were similar at the beginning of the race and at the 12 hr period, there were notable differences in the values at 24 hr following the endurance motor racing. The non-supplemented drivers had the highest level of MDA, and protein carbonyls with values of 1.26 µM and 0.411 µmoles/g protein respectively. The corresponding values for the FPP-supplemented drivers were 0.714 µM and 0.115 µmoles/g protein respectively. CONCLUSION:These findings suggest that FPP can be safely consumed by professional drivers and may serve as a complementary self-care strategy targeting fatigue recovery, thereby mitigating risk factors associated with driving accidents such as age-related decline in driving useful field of view, sleep quality, cognitive function, and accumulation. FPP may be applied as a "Driver Support Tool" contributing to fatigue reduction, health maintenance, and accident risk reduction in both professional and elderly drivers. FPP may hold significance in improving recovery and cognition in elite motor sports drivers and general auto drivers.
OBJECTIVE:Cell membrane capacitance (Cm) and characteristic frequency (fc) are two lesser-studied bioelectrical characteristics that may provide valuable insight into cell membrane integrity, yet reference data on these variables are scant. This study aimed to report normative data for Cm and fc among youth and adult populations. Secondary aims were to compare Cm and fc between subgroups, compare 50 kHz to fc, and explore relationships between fc and fat-free mass (FFM). METHOD:A secondary analysis was performed using data from the 1999-2000 U.S. National Health and Nutrition Examination Survey data set, including bioelectrical impedance spectroscopy data from male and female youth (8-17 years) and adults (18-49 years) to report reference data. Mann-Whitney U comparisons between sex and age subgroups and one-sample Wilcoxon rank test comparing fc to the common 50-kHz approximation were also conducted. RESULTS:Cm and fc ranged among youth (Cm = 0.43-4.57 nF; fc = 20.0-95.0 kHz) and adults (Cm = 0.65-4.68 nF; fc = 26.0-89.0 kHz). The youth group had significantly lower Cm (p < .001) and higher fc (p < .001) than the adults, while males had significantly higher Cm (p < .001) and lower fc (p < .001) than females. Compared to 50 kHz, fc was 9.0 kHz higher in youth (p < .001) and 7.0 kHz lower in adults (p < .001), while being 4.0 kHz lower with all ages combined (p < .001). CONCLUSIONS:Cm appears to mirror expected FFM differences between youths and adults and between males and females, while fc appears to have a largely inverse relationship with FFM, although the relationship is quadratic with a nadir near 35 to 40 kHz in adulthood. Cm and fc may have potential as noninvasive and clinically practical indicators of cell membrane functionality and maturation, although more research is needed to examine longitudinal validity of these measures alongside direct cellular observation.
OBJECTIVE:The role of overall macronutrient balance in gastric cancer (GC) risk remains unclear. This study investigated the associations of the Ketogenic Ratio (KR) and Simplified Ketogenic Ratio (sKR), as composite indicators of macronutrient composition, with GC risk, and examined potential modification by the ADIPOQ rs1501299 genotype. METHODS:A hospital-based case-control study was conducted among 376 GC cases and 752 controls. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Interactions between KR, sKR, the ADIPOQ rs1501299 polymorphism, and GC risk were evaluated using multiplicative terms in regression models. RESULTS:The ADIPOQ rs1501299 polymorphism alone was not associated with GC risk. Higher KR and sKR were significantly associated with reduced GC risk (KR: OR = 0.64; 95% CI = 0.44-0.93; sKR: OR = 0.59; 95% CI = 0.40-0.86). Notably, a significant gene-diet interaction was observed strictly for sKR, where this association was more pronounced among overweight/obese individuals carrying the ADIPOQ rs1501299 G/T or T/T genotypes (OR = 0.33, 95% CI: 0.16-0.66, P interaction = 0.038). In contrast, no significant interaction was found between KR and the ADIPOQ rs1501299 genotype. CONCLUSION:Higher KR and sKR are inversely associated with GC risk. The ADIPOQ rs1501299 genotype significantly modifies the association between sKR and GC risk, specifically among overweight/obese individuals. Future studies should focus on developing and validating standard measurements in nutritional epidemiology to elucidate biological pathways from gene-diet interactions.
BACKGROUND:Sarcopenia is characterized by a decline in muscle mass and quality and has emerged as a life-threatening aging-related syndrome. However, the association between adult weight trajectories and muscle health remains unclear. METHODS:Using data from 1,007 adults aged ≥50 years from the United States. National Health and Nutrition Examination Survey (NHANES) 2011-2014 cycles, a cross-sectional analysis of body mass index (BMI) trajectories across four adult life stages was conducted using growth mixture modeling. Dual-energy X-ray absorptiometry (DXA)-derived appendicular skeletal muscle mass index (ASMI) and muscle quality indices, including the appendicular muscle quality index (MQI.app) and total muscle quality index (MQI.total), calculated as grip strength per unit of muscle mass, were used to assess muscle health. Multivariate regression analysis was applied to evaluate the associations between BMI trajectories and muscle outcomes. RESULTS:Three BMI trajectories were identified: stable normal (38.5%), rapid increase (16.5%), and stable high (45.0%). The ASMI was greater, whereas the MQI was markedly lower in the rapid increase group than in the stable normal group, with odds ratios (ORs) of 11.38 (95% CI: 6.18-20.98) for the extremely low MQI.app category and 10.07 (95% CI: 5.85-17.11) for the extremely low MQI.total category. The stable high group also showed increased odds of lower MQI categories. CONCLUSIONS:BMI trajectory was heterogeneously associated with muscle phenotype. Static indicators such as BMI and the ASMI alone may not fully capture functional risk. These findings highlight the need for further research on muscle quality and long-term weight dynamics, and for prospective studies before any clinical screening or intervention implications can be considered.
OBJECTIVE:Sleep is crucial during infancy and supports health and development. Tryptophan is influential in the sleep/wake cycle, and studies have shown that increasing tryptophan intake can improve sleep outcomes. Consumption of alpha-lactalbumin increases ratios of tryptophan to large neutral amino acids (LNAA), an indicator of brain concentrations associated with sleep latency. The objective was to evaluate whether an infant formula with added alpha-lactalbumin improves sleep quality, indicated by nighttime feeding patterns. METHOD:Healthy infants born at full term were randomized to study formula (SF) with added alpha-lactalbumin or a formula with identical protein content without added alpha-lactalbumin (CF). Feeding patterns were assessed over 24 weeks and serum amino acids were measured at week 16. Groups were compared using repeated-measures mixed models and Wilcoxon rank-sum test, and the relationship between feeding and amino acid concentrations was assessed with correlation analysis. RESULTS:In 128 infants, mean time between nighttime feeds differed between the groups over time on study (p = 0.03) At 16 weeks, mean time between nighttime feeds was greater (+32 min; 95% confidence interval [CI], 5-60; p = 0.02), and mean number of nighttime feeds was lower (-0.3; 95% CI: -0.6 to 0.0; p = 0.04) in the SF group. Tryptophan concentrations (96 ± 15 μmol/L vs 86 ± 17 μmol/L, p = 0.019) and the ratio of tryptophan to LNAA (0.146 ± 0.026 vs 0.130 ± 0.018; p = 0.007) were higher in the SF subgroup. CONCLUSIONS:Clinically relevant longer duration between nighttime feeds was observed in infants in the SF group throughout most of the study, with an average of 32 additional minutes at 16 weeks. Concurrently, infants in the SF group had a higher tryptophan:LNAA ratio, supporting the hypothesis that the addition of alpha-lactalbumin may have positively impacted outcomes associated with sleep quality. TRIAL REGISTRATION:www.clinicaltrials.gov (NCT04218929 and NCT04389606 January 6, 2020, and May 15, 2020, respectively).
BACKGROUND:Perimenopause is often accompanied by changes in metabolism and body composition, including loss of lean soft tissue (LST). The purpose of this study was to compare measured resting energy expenditure (mREE) via indirect calorimetry to predicted REE from common equations in perimenopausal women. The secondary purpose was to examine the effect of LST on differences between mREE and metabolic equations. METHODS:REE was assessed using indirect calorimetry in 45 perimenopausal females. Estimated REE was calculated from Cunningham (C), De-Lorenzo (DL), Harris-Benedict (HB), Mifflin St. Jeor (MS), Molnar (M), and ten Haaf (TH) equations. LST (kg) was determined using dual energy x-ray absorptiometry. mREE vs estimated were compared using a mixed-model ANOVA. A linear regression was used to examine the effect of LST on predictive equations and mREE. RESULTS:Significant differences were seen between mREE vs estimated REE for C (mean difference ± standard error [mREE-C]: -157.8 ± 28.7 kcals, p = 0.001), DL ([mREE-DL]: -381.9 ± 32.8 kcals, p < 0.001), HB ([mREE-HB]: -100.5 ± 30.5 kcals, p = 0.033), and TH ([mREE-TH]: -142.2 ± 33.1 kcals, p = 0.003). MS ([mREE-MS]: -18.5 ± 31.7 kcals, p = 0.99) and M (29.9 ± 34.0 kcals, p = 0.99) equations most closely predicted REE. LST accounted for 1.1-2.2% range of variance in REE. CONCLUSIONS:Estimated REE significantly overestimated caloric expenditure compared to mREE by an average of ∼215 kcals/day, with some equations (MS, M) more accurately estimating REE in perimenopausal women. The MS equation may be most beneficial for REE estimates in midlife women. LST may not be driving differences between mREE and predictive equations.
Objective:Autoimmune disease (AD) has become a leading cause of illness in the twenty-first century, with autoimmune thyroid disease at the forefront of these conditions. Hashimoto's thyroiditis (HT) shares many features with other ADs, including associations with gastrointestinal symptoms linked to intestinal dysbiosis (ID). However, the pathogenesis of HT remains incompletely understood, particularly the role of specific T cell lymphocyte activity. The primary objective of this review was to investigate links between ID and HT pathogenesis, focusing on the relationship between a specific cluster of differentiation 4 (CD4) T cell subsets including T helper 17 (Th17) and regulatory T cells (Treg). A secondary aim was to explore whether vitamin D supplementation may serve as a viable intervention in managing HT, given existing research demonstrating links between Vitamin D status, HT pathogenesis and ID. Methods:A systematic literature search was conducted in PubMed using predefined inclusion/exclusion criteria across three tranches. A search of the review literature pertaining to thyroid autoimmunity, HT and the intestinal microbiome identified 21 papers for inclusion. A mechanistic literature search covering animal, in vitro and human studies on HT, autoimmunity, ID, intestinal microbiota, intestinal permeability (IP) and Th17 yielded 43 papers. A final search of human studies examining vitamin D status or supplementation in relation to ID, IP, Th17 and interleukin (IL)-17 identified 45 relevant papers. Accepted studies were critically appraised and synthesized in a narrative analysis.Results:Evidence across the included studies suggests an association between ID and pathogenesis of HT. Increased IP and alterations in Th17/Treg balance emerged as key contributing mechanisms. Vitamin D status was also associated with immune modulation, particularly involving Th17 activity, and was strongly linked to both ID and HT pathogenesis.Conclusions:ID may play a contributory role in HT pathogenesis through immune modulation involving CD4+ T cell subsets. Vitamin D supplementation demonstrates potential as an adjunctive strategy; however, further targeted human studies are required to clarify causality and therapeutic efficacy.
OBJECTIVE:This study aimed to identify consumer profiles based on their food choice motivations and their perceptions toward foods with nutrition claims (NCs). METHODS:The final sample consisted of 412 Brazilian consumers who answered to an online questionnaire. To measure food choice motives, The Eating Motivation Survey (TEMS) was used. The Three Factor Eating Questionnaire-R21 (TFEQ-R21) was employed to assess cognitive restraint, uncontrolled eating and emotional eating. Participants evaluated pairs of conventional foods and versions with nutrition claims (e.g. chocolate vs sugar-free chocolate, bread vs gluten-free bread, requeijão (cream-cheese) vs light requeijão, yogurt vs high-protein yogurt, milk vs lactose-free milk) in terms of perceived healthiness and likelihood of substitution in a weight-loss context. RESULTS AND DISCUSSION:Five clusters were identified, characterized by focus on: a) hedonic aspects, b) overall aspects, c) context, d) health and weight control, e) no concerns. Differences in perceived healthiness between clusters for NC foods were found only for high-protein yogurt and light cream-cheese. No differences were observed between clusters in the likelihood of substituting any conventional food with its NC version in a weight-loss diet context. It was noted that the positive effect of NCs on perceived healthiness influenced all consumer profiles in a similar way. CONCLUSION:These findings highlight the urgent need to improve public understanding of what NC actually mean and in which dietary contexts substituting conventional foods with claimed alternatives is appropriate. They also reinforce the importance of stricter regulation of NC on ultra-processed foods, so that these messages do not undermine healthy eating and weight-management efforts.
INTRODUCTION:This case report presents the methodology and the outcomes of a Personalized Nutrition intervention with a menopausal female over seven weeks and two online consultations. The report details the pathophysiological reasoning approach to the patient assessment and the recommendation of interventions with the supporting clinical evidence and learnings. CASE:A 47 year old working mother (Patient A) with maternal family history (FH) of osteoporosis (OP), a body mass index (BMI) of 24.2 kg/m2 and a waist-to-hip ratio (WHR) of 0.86. Patient A had seen her medical practitioner (MP) regarding fatigue, lack of concentration and low mood and was prescribed hormone replacement therapy (HRT). Patient A's sleep and mood remained unstable, and she presented with late afternoon fatigue, lower belly bloating and mild headaches. A chiropractor had diagnosed scoliosis. Patient A was seeking support for energy and bone health. Analysis of dietary recall and frequency data indicated that her current macronutrient intake was contributing to blood sugar imbalance, influencing energy levels and impacting hypothalamic-pituitary-adrenal (HPA) axis function, potentially exacerbated by a change in estrogen levels. A FH of OP encouraged the practitioner to promote bone health. Adjusted macronutrient intake was recommended to support blood sugar balance, increase and sustain energy and promote muscle synthesis. A supplementation plan with regular weight-bearing exercise aimed to support bone mineral density. Caffeine reduction, yoga and meditation to help rebalance the HPA axis. Patient A reported an increase in energy, a reduction in snacking and improved sleep. There was no change to her mood and bloating persisted. Her headaches worsened and the MP prescribed amitriptyline (10 mg) toward the end of the therapy period. Her bone health was not measured. CONCLUSIONS:This case provides observational evidence of the potential efficacy of personalized nutrition utilizing pathophysiological reasoning to assess health status, an evidence-based approach to support intervention decisions and coaching skills to embed dietary change.
OBJECTIVE:Osteoporosis is a growing public health burden. Trabecular bone score (TBS) from dual-energy X-ray absorptiometry (DXA) reflects trabecular microarchitecture and predicts fractures beyond bone mineral density (BMD). The relationship between Healthy Eating Index 2020 (HEI-2020) and TBS is unknown. METHODS:We modeled the HEI-2020 in relation to TBS in a cross-sectional sample from the National Health and Nutrition Examination Survey (NHANES) 2005-2008 (n = 7,007), using multivariable linear regression, restricted cubic splines for nonlinearity, stratified and interaction analyses for effect modification, and mixture and clustering analyses. RESULTS:Higher HEI-2020 scores were positively associated with TBS. Per 10-point increase: β = 0.0052 (95% CI 0.0026-0.0079). The highest versus lowest tertile had higher TBS (β = 0.0133, 95% CI 0.0063-0.0204; P for trend = 0.0242). The dose-response was linear. Associations were stronger in males and individuals with obesity, with significant interaction by sex (p = 0.0262) and body mass index (BMI; p < 0.0001). Mixture and clustering analyses supported positive dietary pattern effects, with the high-quality dietary cluster showing higher TBS (β = 0.0133, 95% CI 0.0053-0.0212). Sensitivity analyses confirmed robustness. CONCLUSION:Higher HEI-2020 scores were linearly associated with higher TBS, with effect modification by sex and BMI. While these cross-sectional findings suggest better diet quality may benefit trabecular bone microarchitecture, longitudinal studies are needed to establish causality.
BACKGROUND:Exogenous ketone supplementation acutely elevates circulating beta-hydroxybutyrate (R-BHB), but the impact of chronic repeated dosing on exercise performance, cognition, mood, and cardiometabolic health remains unclear. PURPOSE:To evaluate the effects of 31 days of thrice-daily ketone monoester (KME) supplementation (90 g/day; high-dose) on exercise performance, executive function, mood, metabolism, body composition, blood pressure, and tolerability in recreational runners. METHODS:In a single-blind, randomized-controlled trial, 18 runners consumed either (R)-3-hydroxybutyl (R)-3-hydroxybutyrate (KME; 30 g/dose; n = 9) or an isocaloric, flavor-matched placebo (PLA; 30 g/dose; n = 9) three times daily for 31 days. Outcomes included 5-km time trial (5KTT) performance, cognitive function, mood, body composition, blood pressure, and tolerability. Metabolism and substrate oxidation (rest and graded exercise) were performed after 31-d supplementation was completed to assess metabolic responses following 31 days of repeated exogenous ketone exposure. RESULTS:31-day KME did not alter 5KTT performance, but improved cognitive function, as evidenced by faster Stroop Incongruent (p = 0.015) and Switching task responses (p = 0.038). Mood and quality of life scores were unchanged. Metabolically, the KME reliably elevated post-ingestion R-BHB (∼3.0 mM; p < 0.001) and lowered glycemia by 15% (p < 0.001). After the 31-day KME supplementation stopped, KME-treatment preserved mean absolute VO2 during graded exercise testing (p = 0.029), without accompanying improvements in running performance. CONCLUSION:High-dose KME administration for 31-days did not alter running performance, but increased cognitive function and oxygen uptake during maximal graded exercise even after ketone administration stopped, indicating that selected physiological measures differed between groups when assessed after the supplementation period.
PURPOSE:Aging is associated with reduced protein intake, increasing the risk of infections by damping the pulmonary and systemic immune response. Although whey protein supplementation improves systemic immune response, its effects on the pulmonary immune response are unknown. METHODS:This clinical trial composed by two groups (Control; n = 38; Age 69.31 ± 6.13; Men = 9; Women = 27) and (Whey; n = 27;; Age 68.14 ± 5.72; Men = 12; Women = 31) investigated whether isolated whey protein supplementation (IWPS) (25 g/day; 7 days/week; 3 months) could impact the pulmonary immune response, as a primary outcome, and the lung function, systemic cellular and humoral immune response, respiratory muscle strength, functional capacity, peripheral muscle strength and body composition as secondary outcomes. RESULTS:Three months of IWPS improved the lung function, such as force expiratory volume (FEV1) (p < 0.048), forced expiratory volume in the first second/forced vital capacity ratio (FEV1/FVC) (forced vital capacity) (p < 0.003), forced expiratory volume 25-75% (FEF25-75%) (p < 0.048), and peak expiratory flow (PEF) (p < 0.002). IWPS reduced the fractional exhaled nitric oxide (FeNO) (p < 0.015), interleukin 6 (IL-6) (p < 0.001) and tumoral necrosis factor alpha (TNF-α) (p < 0.001) levels, while increased IL-10 (p < 0.001) and Klotho (p < 0.013) in breath condensate, displaying an anti-inflammatory and anti-aging effect. Furthermore, IWPS improved systemic immune response, as showed by reduction on blood total leukocytes (p < 0.017), neutrophils (p < 0.049), and eosinophils (p < 0.009), and plasma levels of pro-inflammatory IL-6 (p < 0.005) and TNF-α (p < 0.001) and increased levels of anti-inflammatory IL-10 (p < 0.00005) and anti-aging protein Klotho (p < 0.0436). The functional capacity (p < 0.0031), expiratory muscle (p < 0.0001) and peripheral muscle strength (p < 0.0028) was improved by IWPS. CONCLUSION:IWPS improved pulmonary and systemic immune response, lung function and functional capacity of older adults.
OBJECTIVE:Recent evidence suggests that gut microbial imbalance may contribute to the pathogenesis of obesity-related metabolic disorders, including cardiovascular diseases. Although the underlying mechanisms remain incompletely understood, numerous studies have investigated the modulation of gut microbiota through probiotic supplementation as a potential preventive or therapeutic approach. This randomized, prospective, triple-blind, placebo-controlled clinical trial aimed to evaluate the effects of Lactococcus lactis, a probiotic with anti-inflammatory properties, on cardiometabolic risk factors associated with obesity. METHOD:Fifty-two adults with elevated waist circumference and at least one additional metabolic alteration, such as elevated blood pressure, triglycerides, or glucose or reduced high-density lipoprotein cholesterol were recruited and randomly assigned to either a probiotic or placebo group (n = 26 each) for 90 days. During the study, 5 participants from the probiotic group withdrew, resulting in 21 participants for the probiotic group's endpoint analyses. Neither group received guidance regarding food intake. Participants underwent assessments of anthropometry, body composition, dietary intake, and a range of biochemical markers. RESULTS:No significant improvements were observed on cardiometabolic risk parameters following L lactis LMG 27352 supplementation. Dietary analysis further revealed a significant rise in carbohydrate intake in both groups. CONCLUSIONS:The findings of this study suggest limited clinical efficacy of L lactis LMG 27352 supplementation in metabolic disorders related to obesity under the conditions investigated. These results underscore the critical influence of dietary patterns, particularly sodium and carbohydrate intake, which may have modulated or counteracted any potential benefits of the probiotic strain.
OBJECTIVE:The probiotic properties of lactic acid bacteria (LAB) vary depending on the specific strain. This study aimed to evaluate the probiotic potential of LAB present in traditional dairy products using in vitro techniques. METHODS:Bacterial isolates from 63 artisanal dairy product samples, which included 6 kefir, 22 cheese, and 35 yogurt products, were analyzed. The isolates were subjected to tests for acid resistance, bile tolerance, antibiotic resistance, acidification capacity, hydrophobicity, exopolysaccharide (EPS) production, and antimicrobial activity. The isolates that gave positive results in these analyses were subsequently identified through 16S rRNA gene sequencing. RESULTS:The survival rates of the 93 isolates decreased significantly as the pH level lowered (p < 0.05), resulting in 76 isolates being classified as acid-resistant. The identical isolates also demonstrated tolerance to high concentrations of bile. Out of these, only 37 isolates were sensitive to all 12 antibiotics tested, while each isolate had varying levels of acidification capacity. Eight of these 37 isolates, which showed negative hydrophobicity ratios, were eliminated from further testing. All 29 remaining isolates exhibited EPS production, but only 17 showed an inhibitory effect against the selected pathogenic bacteria. Molecular identification of these 17 isolates revealed that 6 were Lactobacillus (Lact.) paracasei, 3 were Lact. crustorum, 2 were Lact. brevis, 2 were Lact. casei, 1 was Lact. plantarum, 1 was Lact. pentosus, 1 was Lact. helveticus, and 1 was Lact. rhamnosus. CONCLUSIONS:The findings indicated that LAB strains naturally present in traditional dairy products possess significant probiotic characteristics. The direct use of the isolated strains in the development of functional foods and supplements within the local industry could contribute to the conservation and enhancement of the country's biodiversity and regional economic value. It is recommended that further comprehensive research be conducted to explore their potential for production and use as dietary supplements for humans.
