Cuantificación de metales en LECISAN®por espectrometría de emisión óptica con plasma acoplado inductivamente

Introducción: La contaminación resultante de la industrialización ha propiciado el aumento de la concentración de metales en diversos ambientes y su incorporación a materias primas y productos terminados, lo que repercute directamente en la salud humana. Objetivo: Cuantificar metales en la materia prima empleada en la fabricación de la tableta masticable LECISAN® y en la tableta, para establecer niveles de referencia de: aluminio, calcio, cadmio, cromo, cobre, hierro, magnesio, plomo, silicio, vanadio y zinc. Método: Se utilizó la espectrometría atómica de emisión óptica con plasma inductivamente acoplado (ICP OES) y se establecieron mediante métodos estadísticos los intervalos de confianza para la media de los valorescuantificados con una probabilidad del 95%. Resultados: Existen diferencias significativas entre las dos formas de presentación en cuanto a la cantidad de todos los metales, excepto aluminio (p<0,05). Los coeficientes de variación fueron bajos, el cromo obtuvo un valor cercano al 10% en la materia prima y el plomo resultó elevado (17,44 %). Los valores se encuentran dentro del rango reportado como permisibles según norma cubana (NC 493:2012) excepto para plomo y cobre. Se observaron mayores concentraciones de aquellos elementos con efectos favorables para la salud. Conclusiones: Los resultados encontrados deben ser considerados como referenciales para la evaluación del impacto que sobre la salud tendría el régimen de administración diaria del suplemento nutricionalLECISAN® yel análisis de factores relacionados con la presencia de metales en subproductos del refinado del aceite de soya para futura investigaciones.

Introduction: The pollution resulting from industrialization has led to an increase in the concentration of metals in various environments and their incorporation into raw materials and finished products, which has a direct impact on human health. Objective: To quantify metals in the raw material used in the manufacture of the LECISAN® chewable tablet and in the tablet, to establish reference levels of: aluminum, calcium, cadmium, chromium, copper, iron, magnesium, lead, silicon, vanadium and zinc. Method: Atomic optical emission spectrometry with inductively coupled plasma (ICP OES) was used and confidence intervals for the mean of the quantified values were established using statistical methods with a probability of 95%. Results: There are significant differences between the two presentation forms in terms of the amount of all metals, except aluminum (p<0.05). The variation coefficients were low, chromium obtained a value close to 10% in the raw material and lead was high (17.44%). The values are within the range reported as permissible according to Cuban standards (NC 493:2012) except for lead and copper. Higher concentrations of those elements with favorable health effects were observed. Conclusions: The results found should be considered as references for the evaluation of the impact that the daily administration regimen of the LECISAN® nutritional supplement would have on health and the analysis of factors related to the presence of metals in by-products of soybean oil refining for future research.

Introdução: A poluição decorrente da industrialização tem levado ao aumento da concentração de metais em diversos ambientes e à sua incorporação em matérias-primas e produtos acabados, o que tem impacto direto na saúde humana. Objetivo: Quantificar metais na matéria-prima utilizada na fabricação do comprimido mastigável LECISAN® e no comprimido, estabelecer teores de referência de: alumínio, cálcio, cádmio, cromo, cobre, ferro, magnésio, chumbo, silício, vanádio e zinco. Método: Foi utilizada espectrometria de emissão óptica atômica com plasma indutivamente acoplado (ICP OES) e os intervalos de confiança para a média dos valores quantificados foram estabelecidos por meio de métodos estatísticos com probabilidade de 95%. Resultados: Existem diferenças significativas entre as duas formas de apresentação quanto à quantidade de todos os metais, exceto alumínio (p<0,05). Os coeficientes de variação foram baixos, o cromo obteve valor próximo a 10% na matéria-prima e o chumbo foi alto (17,44%). Os valores estão dentro da faixa informada como permitida segundo as normas cubanas (NC 493:2012) exceto para chumbo e cobre. Foram observadas concentrações mais elevadas desses elementos com efeitos favoráveis à saúde. Conclusões: Os resultados encontrados devem ser considerados referências para a avaliação do impacto que o regime diário de administração do suplemento nutricional LECISAN® teria na saúde e a análise dos fatores relacionados à presença de metais em subprodutos do refino do óleo de soja para pesquisas futuras.

Morinda citrifolia L. (Noni) dietary supplementation ameliorates fluoride toxicity in the freshwater fish, Cyprinus carpio L

Fluoride is the organic and inorganic compound of the element fluorine, has detrimental effect to all animals including fish at higher concentration. Ground water with elevated concentration of fluoride is a major global problem including India. On the other hand, Morinda citrifolia (also called ‘Noni’ in Polynesia) is a medicinal plant, has antioxidative, anti-inflammatory and immunostimulatory properties. The ameliorating effect of M. citrifolia fruit extract dietary supplementation against fluoride induced toxicity on the growth performance, haematological parameters, and fluoride accumulation in the muscular tissue was investigated in the freshwater fish, Cyprinus carpio L. for 35 days in triplicate. One hundred and twenty acclimated C. carpio fingerlings were randomly allocated into five experimental groups (Groups I, II, III, IV and V) each with 24 fish divided into three replicates (eight fish/replicate). Group I (Control) and II (Toxic control or negative control) were provided with basal/control diet, whereas groups III, IV, and V were provided with 0.25% (2.5 g/kg), 0.50% (5.0 g/kg) and 0.75% (7.5 g/kg) M. citrifolia fruit extract supplemented diet respectively. All groups except for group I were exposed to 10% of the LC50 of fluoride. Selected growth and haematological parameters were estimated. The fluoride content in the muscular tissue of fish was also estimated following SPADNS method. Results revealed that exposure of sublethal concentration of fluoride significantly (P <0.05) reduced the growth performance and haematological parameters in Gr. II (toxic control) compared to the Gr. I (control). However, M. citrifolia dietary supplementation significantly (P <0.05) improved fluoride induced alteration of growth performance and haematological parameters of fish in the groups III, IV and V compared to Gr. II. Morinda citrifolia fruit extract dietary supplementation also significantly (P <0.05) decreased the accumulation fluoride in the muscular tissue of fish in groups III, IV and V compared to the Gr. II (toxic control). In conclusion, M. citrifolia dietary supplementation ameliorates the fluoride toxicity by preventing the accumulation of fluoride in the muscular tissue of the fish. The M. citrifolia dietary supplementation at 0.25% showed the best response, hence it is considered as the optimum dose.

Efeitos da cafeína no organismo humano / Effects of caffeine on the human body / Efectos de la cafeina en el cuerpo humano

A cafeína é uma substância presente em diversas bebidas e suplementos, que sua forma mais comum de ingestão é através do café. Devido a ampla procura pela substância e sua larga distribuição mundial, este trabalho apresenta uma revisão de literatura sobre a cafeína e seus efeitos no organismo humano. Ao longo do tempo, a cafeína teve seu consumo aumentado em diversas faixas etárias, além de estar presente em diferentes produtos. A ingestão da cafeína pode estimular a concentração e melhorar o desempenho físico, devido ao seu efeito estimulante do sistema nervoso central. O uso em suplementos está envolvido nos seus efeitos termogênicos, auxiliando no processo de lipólise e melhorando o rendimento nas atividades físicas. O consumo da cafeína é associado ainda com a redução do LDL-colesterol, porém, os efeitos sobre o colesterol plasmático ainda são controversos. Todavia, o uso excessivo da cafeína pode trazer malefícios ao sistema cardiovascular como a diminuição da frequência e pressão cardíaca, dilatação de vasos e redução da temperatura corporal. A sua ingestão quando associada a bebidas alcoólicas pode ocultar a sensação depressiva do álcool, podendo elevar as chances de intoxicação. Na gestação aconselha-se o uso limitado, pois não há estudos conclusivos sobre os efeitos da cafeína para o feto. A relação risco e benefício deve sempre ser avaliada de acordo com cada indivíduo, sendo o aconselhamento e acompanhamento do consumo da cafeína realizado por um profissional de saúde habilitado, como o farmacêutico, para assim se reduzir possíveis prejuízos que a cafeína pode trazer à saúde.

Caffeine is a substance present in several drinks and supplements, which its most common form of intake is through coffee. Due to the broad demand for the substance and its wide distribution worldwide, this work presents a literature review on caffeine and its effects on the human organism. Over time, caffeine has increased its consumption in several age groups, in addition to being present in different products. The intake of caffeine can stimulate concentration and improve physical performance, due to its central nervous system stimulating effect. The use in supplements is involved in its thermogenic effects, assisting in the process of lipolysis and improving the performance in physical activities. The consumption of caffeine is also associated with the reduction of LDL-cholesterol, but the effects on plasma cholesterol are still controversial. However, excessive use of caffeine can cause harm to the cardiovascular system, such as decreased heart rate and pressure, vessel dilation, and reduced body temperature. Ingestion of alcohol in association with alcohol may mask the depressive sensation of alcohol and may increase the chances of intoxication. In pregnancy, limited use is advised, as there are no conclusive studies on the effects of caffeine on the fetus. The risk-benefit ratio should always be evaluated according to each individual, and the advice and follow-up of caffeine consumption is carried out by a qualified health care professional, such as the pharmacist, in order to reduce possible damage that caffeine can bring to health.

la cafeína es una sustancia presente en varias bebidas y suplementos, que es la forma más común de ingestión a través del café. Debido a la amplia demanda de la sustancia y su amplia distribución a nivel mundial, este estudio presenta una revisión de la literatura sobre cafeína y sus efectos en el organismo humano. Con el tiempo, la cafeína aumentó su consumo en varios grupos de edad, además de estar presente en diferentes productos. La ingesta de cafeína puede estimular la concentración y mejorar el rendimiento físico debido a su efecto estimulante sobre el sistema nervioso central. El uso en suplementos participa en sus efectos termogénicos, ayudando al proceso de lipolisis y mejorando el rendimiento en actividades físicas. El consumo de cafeína también está asociado con la reducción del colesterol LDL, pero los efectos sobre el colesterol plasmático siguen siendo polémicos. Sin embargo, el uso excesivo de cafeína puede dañar el sistema cardiovascular, como una reducción de la frecuencia y la presión cardiaca, la dilatación de los vasos y una reducción de la temperatura corporal. La deglución combinada con alcohol puede enmascarar la sensación deprimida de alcohol y puede aumentar la posibilidad de intoxicación. En el embarazo se aconseja un uso limitado, ya que no hay estudios concluyentes sobre los efectos de la cafeína sobre el feto. La relación riesgo-beneficio debe evaluarse siempre de acuerdo con cada individuo, con el asesoramiento y el control del consumo de cafeína por parte de un profesional sanitario autorizado, como el farmacéutico, a fin de reducir el posible daño que la cafeína puede causar a la salud.

Dietary supplement intakes among adults living in Kota Kinabalu during the COVID-19 pandemic: A crosssectional study

@#Introduction: During the coronavirus 2019 (COVID-19) pandemic, the public may seek a non-pharmacological approach, such as dietary supplements, to prevent or manage COVID-19. Therefore, this study aimed to evaluate the use of dietary supplements during the COVID-19 pandemic among adults in Kota Kinabalu. Methods: This cross-sectional study recruited 213 adults living in Kota Kinabalu through convenient sampling from October 2021 to March 2022. A validated questionnaire was used to evaluate their perception on the use of dietary supplements, and the types of dietary supplements consumed before and during the COVID-19 pandemic. Results: One-hundred sixty-one (75.6%) adults reported that they were told to consume dietary supplements during the COVID-19 pandemic, primarily from close family members (64.0%) and social media (58.4%). One-hundred and thirty-two (62%) adults were consuming dietary supplements and 46 (34.8%) of them only started taking them during the COVID-19 pandemic. The reasons for taking dietary supplements during the COVID-19 pandemic included enhancing the immune system (83.6%) and for prevention of COVID-19 infection (64.4%). The most common dietary supplements consumed during the COVID-19 pandemic were vitamin C (90.2%), followed by multi-vitamin and mineral (32.6%), and fish oil (25.8%). After adjusting for age, sex, education level, and income level, KadazanDusun adults were most likely to consume dietary supplements (adjusted odds ratio = 2.369, 95% CI: 1.070 - 5.248, p=0.034). Conclusion: There was an increase in the number of adults consuming dietary supplements during the COVID-19 pandemic, which was likely driven by information sharing via family members and social media.

Research progress of platelet lysates in the field of regenerative medicine and cell therapy / 中国输血杂志

Human platelet lysates(HPL), as a new type of biomaterial, can promote tissue repair, cell proliferation and inflammation control. This paper introduced the development of HPL in the field of regenerative medicine and cell therapy and summarizes their application. The potential of HPL to promote cell proliferation was used as an entry point to show its advantages as a supplement of cell culture medium. Since there is currently no standard procedure for HPL preparation, this paper sorts out the standardization elements such as raw materials source, donor variability and preparation technology, in order to provide reference for the establishment of standards of relevant industry in the future.

The Prevalence of Online Natural Health Products Purchase: A Systematic Review

@#Aim and design: This systematic review aimed to estimate the prevalence of online natural health products (NHPs) purchases among consumers. Data Sources: Four databases (PubMed, Science Direct, Scopus and Web of Sciences) were searched for articles published up to July 1, 2021. Review Method: Studies included were those reporting the prevalence of online NHPs purchases, those excluded were case reports, commentaries, letters, editorials, review articles, theses and non-English studies. The risk of bias of selected studies was assessed using the Joanna Briggs Institute’s checklist, and the pooled prevalence of online NHPs purchases was generated using the random-effect model. Results: A total of 30 studies were included in the meta-analysis, representing a total of 40,535 respondents. The pooled prevalence of online NHPs purchases was estimated at 7.60% (95% CI: 5.49, 10.01). Prevalence was higher in studies conducted in recent years, among physically active populations and when sports nutrition was included within the scope of NHPs. More than half of the selected studies have a moderate risk of bias, and considerable heterogeneity was observed across the selected studies. Conclusion and Impact: Online purchases of NHPs are not common among consumers, but they have become more common in recent years. A wide range of NHPs were investigated across studies, which may have contributed to the considerable heterogeneity reported in this review. It is suggested that future studies investigating online NHPs purchases consider reporting individual prevalence statistics specific to each NHP type, to facilitate meaningful comparisons between studies.

Chlorella sp.-ameliorated undesirable microenvironment promotes diabetic wound healing

Chronic diabetic wound remains a critical challenge suffering from the complicated negative microenvironments, such as high-glucose, excessive reactive oxygen species (ROS), hypoxia and malnutrition. Unfortunately, few strategies have been developed to ameliorate the multiple microenvironments simultaneously. In this study, Chlorella sp. (Chlorella) hydrogels were prepared against diabetic wounds. In vitro experiments demonstrated that living Chlorella could produce dissolved oxygen by photosynthesis, actively consume glucose and deplete ROS with the inherent antioxidants, during the daytime. At night, Chlorella was inactivated in situ by chlorine dioxide with human-body harmless concentration to utilize its abundant contents. It was verified in vitro that the inactivated-Chlorella could supply nutrition, relieve inflammation and terminate the oxygen-consumption of Chlorella-respiration. The advantages of living Chlorella and its contents were integrated ingeniously. The abovementioned functions were proven to accelerate cell proliferation, migration and angiogenesis in vitro. Then, streptozotocin-induced diabetic mice were employed for further validation. The in vivo outcomes confirmed that Chlorella could ameliorate the undesirable microenvironments, including hypoxia, high-glucose, excessive-ROS and chronic inflammation, thereby synergistically promoting tissue regeneration. Given the results above, Chlorella is considered as a tailor-made therapeutic strategy for diabetic wound healing.

Clinical Application of Supplementing Essence and Boosting Marrow Method in the Treatment of Encephalopathy Based on the Marrow Sea Theory / 中医杂志

As the guiding theory for the diagnosis and treatment of encephalopathy in traditional Chinese medicine （TCM）， The marrow sea theory has important theoretical connotation and clinical value. This paper summarized the clinical research literature on the differentiation and treatment of common encephalopathy based on the marrow sea theory published in recent years， analyzed the treatment method and effects from eight aspects in terms of stroke， dizziness， insomnia， headache， constraint syndrome， dementia， tremor syndrome， and atrophy syndrome， and discussed the possible mechanism based on the relevant basic research. It is believed that marrow sea depletion is the common pathogenesis of encephalopathy in TCM. Guided by the method of supplementing essence and boosting marrow， the corresponding formulas and medicinals are recommended in accordance with differentiated syndromes， which can effectively improve the symptoms of the disease， delay the progression， increase the daily life ability of the patients， and improve the quality of life. Based on the marrow sea theory， the method of supplementing essence and boosting marrow， rectifying healthy qi and dispelling pathogen can be used to highlight the advantages of TCM and provide ideas for the diagnosis and treatment of encephalopathy in TCM.

Pharmacodynamic Material Basis of Astragali Radix and Angelicae Sinensis Radix Drug Pair in Supplementing Qi and Activating Blood Circulation / 中国实验方剂学杂志

ObjectiveTo evaluate the effect of Astragali Radix （AR）-Angelicae Sinensis Radix （ASR） drug pair on supplementing Qi and activating blood circulation in rats with Qi deficiency and blood stasis and provide a theoretical basis for clinical rational medication and identification and quality control of compound pharmacodynamic substances from the three aspects of characteristic map， identification of pharmacodynamic substances， and comparison of blood components. MethodHigh-performance liquid chromatography （HPLC） was employed to establish the fingerprint of AR∶ASR （3∶1）， and ultra-high performance liquid chromatography-Q-Exactive Orbitrap-mass spectrometry （UPLC-Q-Exactive Orbitrap-MS） was employed to analyze the ingredients of the decoction. Adult male Wistar rats with SPF grades were selected and randomly divided into a blank group， a model group， a 3∶1 group， and a 5∶1 group. The rat model of Qi deficiency and blood stasis syndrome was prepared by controlling food intake and swimming in cold water every day. In parallel， each group was given medicine （or water） once a day. The dose of drug groups was 10.2 g∙kg-1， and the model group and blank group were given the same amount of distilled water for 15 d. Animal behavior， body weight， whole blood and plasma viscosity， thymus index， spleen index， the levels of adenosine triphosphate （ATP）， adenosine diphosphate（ADP）， von willebrand factor （vWF）， and ATP/ADP value in serum of rats were recorded. The morphology of vascular endothelium was observed by hematoxylin-eosin （HE） staining and scanning electron microscopy. UPLC-Q-Exactive Orbitrap-MS was used to analyze prototype and metabolic components in serum. ResultThe fingerprint of AR-ASR drug pair （AR-ASR 3∶1） was established. UPLC-Q-Exactive Orbitrap MS identified 49 chemical components in vitro and preliminarily identified 11 prototype components absorbed into blood in vivo. As compared with the blank group， the body mass decreased significantly （P<0.01）， the whole blood （high shear， middle shear， and low shear） viscosity and plasma viscosity were significantly increased （P<0.05， P<0.01）， the thymus index and spleen index decreased significantly （P<0.05， P<0.01）， serum ATP content decreased significantly （P<0.01）， ADP content increased significantly （P<0.01）， ATP/ADP value decreased significantly （P<0.01）， and vWF content increased significantly （P<0.01）. The results of HE staining and scanning electron microscopy showed that the vessels were partially damaged， showing the structural disorder of the intima， the bulge， defect， and roughness of the endothelium， and the obvious cell adhesion and migration in the model group. As compared with the model group， the body mass also increased significantly （P<0.01）. The results of whole blood and plasma viscosity showed that the whole blood low shear viscosity was significantly decreased in the 3∶1 group （P<0.05）. The results of thymus index and spleen index showed that 5∶1 group significantly increased the thymus index of rats （P<0.05）. The results of serum ATP and ADP levels showed that the 5∶1 group had more significant effects on ATP and ADP levels （P<0.05）， and both groups significantly reduced ATP/ADP values （P<0.01）. The results of serum vWF level showed that the vWF content in the 3∶1 group decreased significantly （P<0.05）. The results of HE staining and scanning electronic microscopy showed that the damage of vascular endothelium was improved in the treatment group and the structure of intima was neat. ConclusionAR-ASR drug pair can improve the macro and micro indexes of rats with qi deficiency and blood stasis in the 3∶1 and 5∶1 groups. Overall， the 5∶1 ratio has a better effect on supplementing Qi but 3∶1 ratio has a better effect on promoting blood circulation.

Use of iron supplement to prevent anemia in children aged six to 59 months attended at the Family Health Strategy (ESF) units in a city in Minas Gerais, Brazil / Uso de suplemento de ferro para prevenção da anemia em crianças de seis a 59 meses atendidas pela Estratégia Saúde da Família de um município de Minas Gerais, Brasil

Abstract Objectives: to evaluate the use of iron supplementation and associated factors in children aged six to 59 months attended at the Family Health Strategy units in a city in Minas Gerais (MG). Methods: a cross-sectional, analytical-exploratory study, carried out with 252 children aged six to 59 months, attended at ten units, between 2014 and 2016. A structured questionnaire was used to collect data on socioeconomic conditions, maternal health, child's health and the knowledge of those responsible regarding anemia and iron supplementation, in addition to analysis of the child's medical records /booklet to collect test results. Descriptive statistics, bivariate association analysis and logistic regression for multivariate analysis were performed. Results: only 22.6% of the children aged between six and 24 months were receiving iron supplement at the time of the interview. Considering children aged six to 59 months, 13.1% were supplemented and breastfeeding time (p=0.006) and the participation in childcare (p=0.042), were positively associated with the use of supplementation. Conclusion: most children aged six to 24 months were not receiving supplementation as recommended by the Ministry of Health, demonstrating the need to implement prevention programs, such as the National Iron Supplementation Program and training of professionals on the importance of health education in preventing childhood anemia.

Resumo Objetivos: avaliar o uso do suplemento de ferro e fatores associados em crianças de seis a 59 meses atendidas em unidades Estratégia Saúde da Família em município de Minas Gerais (MG). Métodos: estudo transversal, analítico-exploratório, realizado com 252 crianças na faixa etária seis a 59 meses, atendidas em dez unidades, entre 2014 e 2016. Utilizou-se questionário estruturado para coleta de dados sobre condições socioeconômicas, saúde materna, saúde da criança e conhecimentos dos responsáveis acerca da anemia e suplementação com ferro, além de análise do prontuário / caderneta da criança para coleta de resultados de exames. Realizou-se análise estatística descritiva, análise de associação bivariada e regressão logística para análise multivariada. Resultados: apenas 22,6% das crianças com idade entre seis e 24 meses estavam recebendo o suplemento de ferro no momento da entrevista. Considerando as crianças de seis a 59 meses, 13,1% eram suplementadas e o tempo de amamentação (p=0,006) e a participação na puericultura (p=0,042) apresentaram associação com o uso de suplemento. Conclusão: a maioria das crianças de seis a 24 meses não recebia a suplementação, demonstrando a necessidade de implementação dos programas de prevenção, como o Programa Nacional de Suplementação de Ferro e capacitação dos profissionais sobre a importância da educação em saúde para prevenção da anemia infantil.

Iron Salts, High Levels of Hemoglobin and Ferritin in Pregnancy, and Development of Gestational Diabetes: A Systematic Review / Sais de ferro, níveis elevados de hemoglobina e ferritina na gravidez e o desenvolvimento de diabetes gestacional: Uma revisão sistemática

Abstract Objective The aim of this study was to systematically review literature on the use of iron supplements (not including iron derived from diet), increased levels of hemoglobin and/or ferritin, and the risk of developing gestational diabetes mellitus (GDM). Data source The following databases were searched, from the study's inception to April 2021: PUBMED, Cochrane, Web of Science, Scopus, Embase, Cinahl and Lilacs. Selection of studies A total of 6,956 titles and abstracts were reviewed, 9 of which met the final inclusion criteria, with 7,560 women in total. Data collection Data extraction was performed by two independent reviewers and disagreements were resolved by a third researcher. Data synthesis Methodological quality in controlled trials were assessed according to the Cochrane Collaboration tools (ROB-2 and ROBINS-1) and for the observational studies, the National Institutes of Health's (NIH) quality assessment tool was used. Among the 5 observational studies, women with a higher hemoglobin or ferritin level were more likely to develop GDM when compared with those with lower levels of these parameters. Among the 3 randomized clinical trials, none found a significant difference in the incidence of GDM among women in the intervention and control groups. However, we identified many risks of bias and great methodological differences among them. Conclusion Based on the studies included in this review, and due to the important methodological problems pointed out, more studies of good methodological quality are needed to better establish the association between iron supplementation and GDM.

Resumo Objetivo O objetivo deste estudo foi revisar sistematicamente a literatura sobre o uso de suplementos de ferro (não incluindo o ferro derivado da dieta), aumento dos níveis de hemoglobina e/ou ferritina e o risco de desenvolver diabetes mellitus gestacional (DMG). Fontes dos dados as bases de dados PUBMED, Cochrane, Web of Science, Scopus, Embase, Cinahl e Lilacs foram pesquisadas até abril de 2021. Seleção dos estudos Foram revisados 6.956 títulos e resumos, dos quais 9 preencheram os critérios finais de inclusão, totalizando 7.560 mulheres. Coleta de dados A extração de dados foi realizada por dois revisores independentes e as divergências foram resolvidas por um terceiro revisor. Síntese dos dados A qualidade metodológica dos ensaios controlados foi avaliada de acordo com as ferramentas da Colaboração Cochrane (ROB-2 e ROBINS-1) e para os estudos observacionais, foi utilizada a ferramenta de avaliação de qualidade do National Institutes of Health (NIH). Entre os 5 estudos observacionais, as mulheres com maiores níveis de hemoglobina ou ferritina apresentaram maior probabilidade de desenvolver DMG quando comparadas àquelas com níveis mais baixos nesses parâmetros. Entre os 3 ensaios clínicos randomizados, nenhum deles encontrou diferença significativa na incidência de DMG entre as mulheres dos grupos de intervenção e controle. No entanto, identificamos muitos riscos de viés e enormes diferenças metodológicas entre eles. Conclusão Com base nos estudos incluídos nesta revisão e devido aos importantes problemas metodológicos apontados, são necessários mais estudos de boa qualidade metodológica para melhor estabelecer a associação entre suplementação de ferro e DMG.

Supplemental nutrition for retinal health: Evidence based analysis of commercial preparations in India

Purpose: Antioxidants have been lately postulated as supportive and prophylactic supplements for various retinal disorders, especially age?related macular degeneration (AMD). Forty?eight brands of such supplements containing lutein and zeaxanthin are available in India. The aim of the study was to assess the market leaders in supplements for ophthalmology in view of AREDS recommendations. Methods: Descriptive review of top?selling supplements for eye health were compared to the contents of the AREDS?recommended levels. Results: None of the top 10 selling brands had exact or near similar composition as recommended in the AREDS?2 study, which is the most widely accepted level?1 evidence in AMD prevention. Conclusion: Physicians prescribing these antioxidants, especially for the prevention of advanced AMD, should be vigilant and aware of the contents of the prescribed brands.

Clinical Efficacy of Pancreatin Minimicrospheres Supplementation in Patients with Exocrine Pancreatic Insufficiency (EPI) : Real-world Evidence

Background : Exocrine pancreatic insufficiency (EPI), characterized by reduced secretion or activity of pancreatic enzymes, causes improper absorption of food, excessive fat excretion in the stool, and malnourishment. Methods : In this observational, real-world evidence study, patients with one or more of the following condition were enrolled: abdominal pain, acidity, diarrhea, nausea, or dyspepsia (as per ROME III criteria). Patients had either been diagnosed with gallstones, hypertriglyceridemia, alcohol consumption or undergone abdominal surgery. Patients were prescribed capsule EnzigestTM10000 (pancreatin minimicrospheres) for one month.The severity and frequency of various gastric symptoms was measured at day 0 and day 30. Results : 540 patients were enrolled with a mean age of 51.6 years. Enzigest significantly reduced the severity of functional dyspepsia by 88.67% (p<0.001) as per Rome III Criteria. There is significant improvement in frequency of symptoms (83.80%), abdominal pain severit(81.58%), epigastric pain (83.09%), nausea (84.35%) and vomiting by 89.62% (all P<0.001). The overall improvement in symptoms was significant (p<0.001). Enzigest was well tolerated.Conclusion : Enzigest improved abdominal pain, dyspepsia, and acidity in patients with exocrine pancreatic insufficiency due to alcohol consumption, gallstones, hypertriglyceridemia, diuretic (Furosemide or Thiazide) or abdominal surgery. Enzigest containing pancreatin minimicrospheres can be an easy therapeutic option to counteract EPI.

Fórmula artesanal a base de lactosuero: complemento alimenticio para niños preescolares / Artisanal whey-based formula: food supplement for preschool children

Resumen Se pretendió desarrollar una fórmula artesanal, a base de lactosuero, como complemento alimenticio para niños preescolares. Se realizó una investigación descriptiva ejecutada en tres fases: 1. Ensayos preliminares para la determinación del esquema tecnológico; 2. Evaluación fisicoquímica para la caracterización del producto y determinación de macronutrientes y 3. Evaluación sensorial donde se midió el nivel de agrado del producto final. Los datos obtenidos de los análisis se tabularon en cuatro repeticiones y se analizaron a través de estadísticas descriptivas de tendencia central y en frecuencias expresadas en tablas y gráficos mediante el programa estadístico SPSS versión 20.0. Se obtuvo que en el análisis proximal del requesón deshidratado, éste aportó por cada 100 gramos de producto: 480,28 kcal, 46,5% de proteínas, 22,36% de grasas y 23,26% de hidratos de carbono. La formulación final de la bebida constó de 2,9 g de requesón deshidratado, 3,6 g de arroz previamente cocido y 1,8 g de azúcar diluidos por cada onza preparada. Se determinó que es una fórmula hipocalórica-hiperproteica e isoosmolar, con una viscosidad de 275cP, un pH de 5,1 y con 0,291% de ácido láctico. La fórmula artesanal a base de lactosuero fue de agrado para 41 niños que participaron en el análisis sensorial. Se recomienda su uso en niños que se encuentren en condición de vulnerabilidad nutricional.

Abstract The main objective of this research was to develop an artisan formula based on whey as food supplement directed to preschool children. It was a descriptive study carried out in three phases: 1. Preliminary tests, for the determination of the technological scheme; 2. Physical-chemical evaluation, for the characterisation of the product and determination of nutrients and, 3. Sensory evaluation: the level of satisfaction of the final product measured. The data obtained from the analysis were tabulated in four repetitions and analysed through descriptive statistics of central tendency and in frequencies expressed in tables and graphs using the statistical program SPSS version 20.0. As a result, for each 100 grams of dehydrated cottage cheese this malnuprovides: 480.28 kcal, 46.5% protein; 22.36% fat and 23.26% carbohydrates. The final formulation of the drink consisted of 2.9 g of dehydrated cottage cheese, 3.6 g of previously cooked rice and 1.8 g of diluted sugar for each prepared ounce. It was determined as a hypocaloric-hyperproteic and isomolar formula, with a viscosity of 275cP, a pH of 5.1 and with 0.291% lactic acid. The artisan formula based on whey was liked by 41 children who participated in the sensory analysis. As a conclusion, it can be recommended as food supplement in children with nutritional vulnerability conditions.

Resumo O objetivo principal desta pesquisa foi desenvolver uma fórmula artesanal à base de soro de leite como suplemento alimentar direcionado a crianças pré-escolares. Foi realizado um estudo descritivo em três fases: 1. Ensaios preliminares, para determinação do esquema tecnológico; 2. Avaliação físico-química, para caracterização do produto e determinação de macronutrientes e 3. Avaliação sensorial: mediu-se o grau de satisfação do produto final. Os dados obtidos das análises foram tabulados em quatro repetições e analisados por meio de estatísticas descritivas de tendência central e em frequências expressas em tabelas e gráficos utilizando o programa estatístico SPSS versão 20.0. Como resultado da análise proximal, para cada 100 gramas de requeijão desidratado fornece: 480,28 kcal, 46,5% de proteína; 22,36% de gordura e 23,26% de carboidratos. A formulação final da bebida consistiu em 2,9 g de requeijão desidratado, 3,6 g de arroz previamente cozido e 1,8 g de açúcar diluído para cada onça preparada. O resultado concluiu que é uma fórmula hipocalórica-hiperproteica e isoosmolar, com viscosidade de 275cP, pH de 5,1 e com 0,291% de ácido lático. A fórmula artesanal à base de soro de leite foi apreciada por 41 crianças que participaram da análise sensorial. É recomendado seu uso em crianças que se encontrem em condições de vulnerabilidade nutricional.

Suplemento alimentar de vitamina C: fiscalização durante o período de adequação à nova legislação / Vitamin C dietary supplement: inspection during adequacy period of new legislation

Os suplementos à base de vitamina C são amplamente consumidos pela população, evidenciando a importância da fiscalização desses produtos. Em julho de 2018, a ANVISA (Agência Nacional de Vigilância Sanitária) publicou as novas regulamentações sobre suplementos alimentares, estabelecendo-se o prazo de 60 meses para as empresas se adequarem a essas normas. O presente trabalho teve como objetivo determinar os teores de vitamina C, comparar os valores analisados com os declarados na informação nutricional e avaliar os dizeres de rotulagem em produtos à base dessa vitamina. Os teores de vitamina C foram determinados por titulação potencio métrica e as análises de rotulagem foram realizadas com base nas legislações da ANVISA em doze amostras de suplementos colhidos pelas Vigilâncias Sanitárias do Estado de São Paulo. Os teores de vitamina C avaliados estavam de acordo com os declarados na informação nutricional do rótulo, com exceção de uma amostra que apresentou teor abaixo do valor declarado. Em relação aos dizeres de rotulagem, sete amostras (58%) apresentaram um ou mais itens em desacordo com a legislação, mostrando a necessidade de monitoramento constante desse tipo de produto. O trabalho representa um estudo preliminar de avaliação dos suplementos no período de adequação às novas regulamentações (AU).

Vitamin C-based supplements are widely consumed by the population, highlighting the importance of monitoring these products. In July 2018, the ANVISA (National Health Surveillance Agency) published new regulations for dietary supplements,setting a 60 months deadline for companies to comply with these standards.The objective of the present work was to evaluate the contents of vitamin C, and compare the analyzed/real values with those reported on the nutrition facts label, and to evaluate the labeling of vitamin supplements. Vitamin C contents were determined by potentiometric titration, and labeling analysis were performed based on ANVISA legislation in twelve samples of supplements collected by the Sanitary Surveillance of the State of São Paulo.The contents of vitamin C were in accordance with those declared in the nutritional information on the label, with the exception of one sample that presented content below the declared value. Regarding the labeling analysis, seven samples (58%) presented one or more items in disagreement with the legislation, showing the need for constant monitoring of this type of product.The work represents a preliminary study to evaluate the supplements in the adequacy period of new regulations (AU).

Consumo de suplementos dietarios en niños escolares de Bucaramanga, Colombia. Un estudio piloto / Dietary supplements consumption in school children from Bucaramanga, Colombia. A pilot study

Resumen Introducción: La obesidad infantil es un problema global de salud pública. Una de las causas subyacentes de este evento complejo y multicausal se relaciona con la alta ingesta de energía. El uso inadecuado de suplementos dietarios podría superar los requerimientos de energía y nutrientes y generar una ganancia excesiva de peso corporal en los niños. Objetivo: Describir el tipo, cantidad y frecuencia de consumo de suplementos dietarios ingeridos por niños y niñas durante la edad preescolar, y evaluar la correlación entre este consumo y la composición corporal de los mismos en la edad escolar. Metodología: Estudio de corte transversal analítico. Estudio piloto realizado en niños en edad escolar de Bucaramanga, Colombia. Variables dependientes: porcentaje de grasa corporal y masa músculo esquelética. Principal variable independiente: consumo de suplementos dietarios. La correlación entre variables fue evaluada usando el coeficiente de correlación de Spearman (rho). Resultados: La prevalencia del consumo de suplementos dietarios en algún momento, antes de los cinco años, fue de 51,11% (IC 95%, 0,35 a 0,66). Las formas de presentación usadas con mayor frecuencia fueron en polvo, granulado y líquido. Los tipos de suplementos utilizados correspondieron a fórmulas poliméricas (40,91%), seguidos por aceite de hígado de bacalao (36,36%). A mayor consumo de suplementos dietarios, se observó mayor porcentaje de grasa corporal (rho = 0,346) y menores valores de masa muscular esquelética (rho = -0,286). Sin embargo, estas correlaciones no fueron estadísticamente significativas (p = 0,114 y p = 0,286, respectivamente). Conclusión: Este estudio encontró una correlación débil y positiva entre el consumo de suplementos dietarios en la primera infancia y el porcentaje de grasa corporal y una correlación débil y negativa con la masa músculo esquelética; sin embargo, no hubo significancia estadística. Es necesario continuar investigando acerca de potenciales efectos no deseados del consumo inadecuado de suplementos durante la primera infancia.

Abstract Introduction: Childhood obesity is a global public health problem. One of the underlying causes of this complex and multicausal event is related to high energy intake. Inappropriate use of dietary supplements could exceed energy and nutrient requirements resulting in excessive body weight gain in children. Objective: To describe the type, quantity and frequency of consumption of dietary supplements ingested by boys and girls during preschool age and to evaluate the correlation between this consumption and their body composition at school age. Methods: Analytical cross-sectional study. Pilot study, carried out in school children from Bucaramanga, Colombia. Dependent variables: body fat percentage and skeletal muscle mass. Main independent variable: consumption of dietary supplements. The correlation between variables was evaluated using Spearman's correlation coefficient (rho). Results: The prevalence of consumption of dietary supplements at some point before the age of five was 51.11% (95% CI, 0.35 to 0.66). The most frequently used forms of presentation were powder, granules and liquid. The types of supplements used corresponded to polymeric formulas (40.91%), followed by cod liver oil (36.36%). A higher consumption of dietary supplements showed a higher percentage of body fat (rho=0.346) and lower values of skeletal muscle mass (rho= -0.286). However, these correlations were not statistically significant (p=0.114 and p=0.286, respectively). Conclusion: This study found a weak positive correlation between dietary supplement use in early childhood and body fat percentage and a weak negative correlation with skeletal muscle mass; however, there was no statistical significance. Further research is needed on the potential undesirable effects of inappropriate supplement use in early childhood.

How some biochemical indexes of apheresis platelet donors were affected by different calcium supplement methods at blood donation intervals / 中国输血杂志

【Objective】 To investigate the effect of two different oral calcium supplementation methods(method 1: bone health basic supplements in the interval plus routine calcium supplement; method 2: only routine calcium supplement on the day of donation)on platelet donors, to improve some biochemical indexes of the body caused by citrate anticoagulant. 【Methods】 A total of 252 long-term regular platelet donors in our station from January 2019 to December 2020 were selected and randomly divided into two groups: experimental group (n=126) were given 10% calcium gluconate oral solution 20 mL before platelet collection, orally. Oral caltrate D3 (containing 600 mg calcium carbonate and 125 international units of vitamin D3) was administered in the interval (20±2 days), 1 tablet per day. Oral alfacalcidol soft capsule (containing alfacalcidol 0.25 μg), 1 tablet per day; control group (n=126) were given routine administration of 10% calcium gluconate oral solution 20 mL before platelet collection. Serum PTH and serum concentrations of calcium, magnesium, phosphorus and 25 hydroxyvitamin D of the two groups were detected at 0 min after injection and 0 min after the end of the last circulation, respectively. Meanwhile, the occurrence of blood donation reactions was observed in the two groups. 【Results】 In the experimental group and control group, serum PTH concentration both increased significantly after donation, while serum calcium, inorganic phosphorus, magnesium and 25 hydroxyvitamin D decreased significantly(P<0.01). After donation, 4 donors in the experimental group and 8 in the control group showed citrate reaction, with the incidence of adverse reactions at 3.17%(4/126)and 6.34%(8/126), respectively. Before blood collection, serum calcium concentration in the experimental group was higher than that in the control group, while PTH concentration was lower than that in the control group (P<0.01), but no significant differences were noticed in serum magnesium, inorganic phosphorus and 25 hydroxyl vitamin D concentrations (P>0.05), and so was in the control group after blood collection. 【Conclusion】 Method 1 can further slow down the increase of serum PTH and the decrease of serum calcium, and can effectively reduce the citrate response of blood donors compared with method 2, which is of great significance to prevent osteoporosis in long-term regular blood donors.

Medical nutrition therapy in the context of value-based healthcare / 中华临床营养杂志

The purpose of value-based healthcare is to effectively control medical costs on the basis of comprehensively improved healthcare quality, which is the key focus of medical system reform in China. Improving information system framework, establishing scientific evaluation methods and transforming medical insurance payment methods are the impetus for value-based healthcare practice in China. "Screening, assessment and intervention" is the critical step in standardized medical nutrition management. In line with the connotation of value-based healthcare, nutritional risk screening aims to improve clinical outcomes. The diagnosis of malnutrition per the Global Leadership Initiative on Malnutrition (GLIM) criteria enables the inclusion into Diagnosis Related Groups (DRGs). Oral nutritional supplement is the preferred medical nutrition treatment for patients at nutritional risk or with malnutrition and insufficient food intake. Standardized application can reduce weight loss, improve clinical outcomes, save medical costs and improve the health and survival of malnourished elderly patients at a lower cost, exemplifying the value-based healthcare model.

Progress on the relationship between vitamin D and neonatal bronchopulmonary dysplasia / 国际儿科学杂志

Bronchopulmonary dysplasia is one of the most common complications of preterm infants.The main pathological feature is dysplasia of the alveoli and pulmonary microvessels.Vitamin D is a steroid hormone.By binding to vitamin D receptors, it can protect the barrier function of alveolar epithelium, promote pulmonary vascularization, inhibit pulmonary fibrosis, regulate immune function, and repair damaged lung epithelial cells.It is beneficial to lung development and the improvement of lung function in preterm infants.Therefore, monitoring the level of vitamin D in the perinatal period and supplementing with appropriate doses is expected to be one of the ways to reduce the occurrence of moderate and severe bronchopulmonary dysplasia and improve the lung development of preterm infants.