전해질 파우더

A randomized, controlled trial of oral sulfate solution versus polyethylene glycol for bowel preparation for colonoscopy.

1. BMC Gastroenterol. 2025 Apr 23;25(1):292. doi: 10.1186/s12876-025-03885-0. A randomized, controlled trial of oral sulfate solution versus polyethylene glycol for bowel preparation for colonoscopy. Xie DL(1), Fan JH(2), Fan CJ(1), Gao YH(1), Cheng JP(3). Author information: (1)Department of Ga

Efficacy of Polyethylene Glycol Electrolyte Powder Combined With Linaclotide for Colon Cleansing in Patients With Chronic Constipation Undergoing Colonoscopy: A Multicenter, Single-Blinded, Randomized Controlled Trial.

2. Clin Transl Gastroenterol. 2024 Jun 1;15(6):e1. doi: 10.14309/ctg.0000000000000708. Efficacy of Polyethylene Glycol Electrolyte Powder Combined With Linaclotide for Colon Cleansing in Patients With Chronic Constipation Undergoing Colonoscopy: A Multicenter, Single-Blinded, Randomized Controll

Lactulose vs Polyethylene Glycol for Bowel Preparation: A Single-Center, Prospective, Randomized Controlled Study Based on BMI.

3. Clin Transl Gastroenterol. 2024 Jan 1;15(1):e00652. doi: 10.14309/ctg.0000000000000652. Lactulose vs Polyethylene Glycol for Bowel Preparation: A Single-Center, Prospective, Randomized Controlled Study Based on BMI. Wenqi S(1), Bei Z, Yunrong W, Xinrong W, Yifan L, Weiwei W, Muhan N, Peng Y,

[Clinical efficacy of adaptive biofeedback training combined with oral administration of compound polyethylene glycol 4000-electrolyte powder in the treatment of children with outlet obstruction constipation: a prospective randomized controlled trial].

4. Zhongguo Dang Dai Er Ke Za Zhi. 2022 Apr 15;24(4):377-381. doi: 10.7499/j.issn.1008-8830.2112001. [Clinical efficacy of adaptive biofeedback training combined with oral administration of compound polyethylene glycol 4000-electrolyte powder in the treatment of children with outlet obstruction

The dose-response effects of nitrate-rich beetroot ingestion on cardiovascular and endothelial function: a randomised controlled trial.

1. Food Funct. 2026 Mar 9;17(5):2372-2383. doi: 10.1039/d5fo05298j. The dose-response effects of nitrate-rich beetroot ingestion on cardiovascular and endothelial function: a randomised controlled trial. McLellan AG(1)(2), Acton JP(1)(3), O'Donnell E(1), Rowland SN(1), Shepherd AI(4), Perissiou M(4), James LJ(1), Clifford T(1), Bailey SJ(1). Author information: (1)School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK. s.bailey2@lboro.ac.uk. (2)University of Oxford Medical Sciences Division, Oxford Cardiovascular Clinical Research Facility, Oxford, OX3 9DU, UK. (3)Department of Higher Education Sport, Loughborough College, Loughborough, LE11 3BT, UK. (4)School of Psychology, Sport and Health Sciences, University of Portsmouth, Portsmouth, PO1 2UP, UK. Dietary nitrate (NO3-) supplementation has been reported to improve cardiovascular health, but beyond its effects on brachial artery blood pressure (BP), dose-response effects on other cardiovascular variables are unclear. This study assessed the effects of three acute NO3- doses (200 mg, 400 mg, 800 mg NO3--rich beetroot powder) on brachial and aortic BP, arterial stiffness and macrovascular endothelial function, in a double-blind, randomised, crossover design. Cardiovascular variables and venous blood samples were measured prior to (control) and 2.5 h post supplement ingestion. Dietary NO3- supplementation increased plasma [NO3-] and plasma [nitrite] but had no effect on cyclic guanosine monophosphate (cGMP) concentration. Arterial stiffness markers improved following all NO3- doses, with no between-dose differences. However, endothelial function only improved following 400 mg (+3.07% compared to control) and aortic systolic BP only improved following 800 mg (-4 mmHg compared to control) dietary NO3- supplementation. Acute NO3- ingestion improved some cardiovascular risk factors, including arterial stiffness, macrovascular endothelial function and aortic systolic BP with different dose-response effects, but had no effect on brachial BP or plasma [cGMP]. These findings improve our understanding of NO3- supplementation and cardiovascular function in healthy adults. DOI: 10.1039/d5fo05298j PMID: 41704173 [Indexed for MEDLINE]

A Novel Honey Powder-Based Supplement Containing Carbohydrate and Protein Did Not Improve Endurance Performance in Recreationally Trained Cyclists.

2. Int J Sport Nutr Exerc Metab. 2025 Aug 14;35(6):520-529. doi: 10.1123/ijsnem.2025-0021. Print 2025 Nov 1. A Novel Honey Powder-Based Supplement Containing Carbohydrate and Protein Did Not Improve Endurance Performance in Recreationally Trained Cyclists. Toniazzo T(1)(2), Azevedo RA(3)(4), Oliveira TN(3)(4), de Souza RAS(3)(4), Marinho LSV(3)(4), Roschel H(3)(4), Gualano B(2)(3)(4), Saunders B(3)(4)(5), Tadini CC(1)(2). Author information: (1)Escola Politécnica, Department of Chemical Engineering, Universidade de São Paulo, São Paulo, SP, Brazil. (2)FoRC/NAPAN-Food Research Center, University of São Paulo, São Paulo, SP, Brazil. (3)Applied Physiology and Nutrition Research Group-School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil. (4)Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil. (5)Nutrology Academy, Rio de Janeiro, RJ, Brazil. Sports supplements composed of carbohydrate and protein are widely used by endurance athletes and recreational practitioners, mostly aimed at improving performance. This study investigated the effect of a novel carbohydrate + protein honey powder (HP) product on endurance cycling performance and physiological and perceptual responses using a double-blind, crossover, counterbalanced, placebo-controlled (PLA) design. Twelve male cyclists exercised for 100 min (i.e., 5 min at 1 W/kg of body mass, followed by three sets of 10-min stages at 1.5, 2.0, and 2.5 W/kg, followed by 5 min at 1 W/kg), followed by a 20-min self-paced time trial (20-min TT). Blood glucose, lactate, pH, bicarbonate, heart rate, ratings of perceived exertion, and side effects were analyzed throughout the 100-min cycling protocol and the 20-min TT. The 20-min TT performance was similar between HP and PLA (total work done: 294 ± 40 vs. 292 ± 44 kJ, p = .72; mean power output: 245 ± 33 vs. 243 ± 37 W, p = .61), as was blood glucose, lactate, pH, and ratings of perceived exertion either during the 100 or 20-min TT protocols (all p > .05). Blood bicarbonate was lower in HP compared with PLA throughout the 100-min protocol (p = .01), and heart rate was higher in HP compared with PLA during the 20-min TT (p = .01). Finally, HP supplementation did not elicit greater side effects compared with PLA, either during the 100 or the 20-min TT protocols (all p > .05). This novel HP supplement did not improve endurance performance in this study, though future research with higher doses is encouraged. DOI: 10.1123/ijsnem.2025-0021 PMID: 40812383 [Indexed for MEDLINE]

Clinical application of pre-rehabilitation concept on comfort colonoscopy in Chinese elderly patients: a randomised controlled trial.

3. BMC Gastroenterol. 2025 Jul 1;25(1):457. doi: 10.1186/s12876-025-04059-8. Clinical application of pre-rehabilitation concept on comfort colonoscopy in Chinese elderly patients: a randomised controlled trial. Zhang L(1), Lv X(2), Zhu Q(3), Zhou J(3), Huang H(3), Huang Y(4), Si C(5). Author information: (1)Department of Nutrition, Zhejiang Hospital, Hangzhou, Zhejiang, China. (2)Zhejiang Key Laboratory of Geriatrics and Geriatrics Institute of Zhejiang Province, Zhejiang Hospital, Hangzhou, Zhejiang, China. (3)Department of Digestion, Zhejiang Hospital, Hangzhou, Zhejiang, China. (4)Department of Anesthesia Surgery, Zhejiang Hospital, Hangzhou, Zhejiang, China. (5)Department of Nutrition, Zhejiang Hospital, Hangzhou, Zhejiang, China. sicaijuan0926@126.com. BACKGROUND: The concept of pre-rehabilitation has been clinically implemented across various surgical fields; however, studies investigating its application in colonoscopy remain limited. This study aimed to evaluate the effectiveness, safety, and patient satisfaction of the pre-rehabilitation concept in bowel preparation for comfort colonoscopy among elderly Chinese patients. METHODS: The enrolled patients were randomly allocated into the pre-rehabilitation and control groups. Prior to colonoscopy, patients in the pre-rehabilitation group received supplementary oral administration of ENSURE (Enteral Nutritional Powder) and psychological counseling provided by specialty nurses. The control group received only Polyethylene Glycol Electrolytes Powder. The primary outcome was the quality of bowel preparation, assessed using the Boston Bowel Preparation Scale. Secondary outcomes included the polyp detection rate, incidence of adverse effects, and patient satisfaction. RESULTS: A total of 485 patients who were admitted for colonoscopy during hospitalization were included in the analysis. There were no statistically significant differences between the two groups with respect to age, sex, and body mass index (BMI). The Boston total score in the pre-rehabilitation group was significantly higher than that in the control group (P < 0.001). The colon polyp detection rates in the two groups were 78.5% and 67.3%, respectively (P = 0.006). Patients in the pre-rehabilitation group reported higher satisfaction with colonoscopy procedures and experienced a lower incidence of hypoglycemic reactions. CONCLUSIONS: The combination of additional enteral nutrition supplements and psychological counseling can enhance the quality of bowel preparation, decrease the incidence of hypoglycemia, and improve patient satisfaction. This intervention measure is both feasible and worthy of clinical application and promotion. TRIAL REGISTRATION: This study was registered in the Chinese Clinical Trial Registry on 14/05/2025 (clinical trial registration number: ChiCTR2500102405). Retrospectively registered. © 2025. The Author(s). DOI: 10.1186/s12876-025-04059-8 PMCID: PMC12211789 PMID: 40597656 [Indexed for MEDLINE] Conflict of interest statement: Declarations. Ethics approval and consent to participate: This study was implemented after approval by Zhejiang Hospital Ethics Committee (Ethical Review Approval Number: 2020 Clinical Review No. 14 K). Informed consent was obtained from all individual participants included in the study. This study was registered in the Chinese Clinical Trial Registry (No: ChiCTR2500102405). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Short-Term Beetroot Juice Supplementation Enhances Strength, Reduces Fatigue, and Promotes Recovery in Physically Active Individuals: A Randomized, Double-Blind, Crossover Trial.

4. Nutrients. 2025 May 19;17(10):1720. doi: 10.3390/nu17101720. Short-Term Beetroot Juice Supplementation Enhances Strength, Reduces Fatigue, and Promotes Recovery in Physically Active Individuals: A Randomized, Double-Blind, Crossover Trial. Salem A(1)(2), Ammar A(1)(2)(3), Kerkeni M(1)(4), Boujelbane MA(1)(2), Uyar AM(2), Köbel LM(2), Selvaraj S(5), Zare R(6), Heinrich KM(7)(8), Jahrami H(9)(10), Tounsi S(11), Zmijewski P(12), Schöllhorn WI(2), Trabelsi K(1)(4)(13), Chtourou H(1)(14). Author information: (1)High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia. (2)Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, 55122 Mainz, Germany. (3)Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax, Sfax 3000, Tunisia. (4)Research Laboratory, Education, Motricity, Sport and Health, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia. (5)Department of Chemistry, Faculty of Applied Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Colombo 10250, Sri Lanka. (6)SRH Campus Hamburg, SRH University of Applied Sciences Heidelberg, 20095 Hamburg, Germany. (7)Department of Kinesiology, Kansas State University, Manhattan, KS 66506, USA. (8)Department of Research and Evaluation, The Phoenix, Denver, CO 80205, USA. (9)Government Hospitals, Manama P.O. Box 12, Bahrain. (10)Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain. (11)Laboratory of Biopesticides (LBPES), Center of Biotechnology of Sfax, University of Sfax, Sfax 3000, Tunisia. (12)Department of Biomedical Sciences, Jozef Pilsudski University of Physical Education in Warsaw, 00-809 Warsaw, Poland. (13)Department of Movement Sciences and Sports Training, School of Sport Science, The University of Jordan, Amman 11942, Jordan. (14)Research Unit, Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia. Background/Objectives: Beetroot juice (BJ), a natural source of dietary nitrate, has gained increasing attention for its potential to improve exercise performance and cardiovascular function. While its benefits are well documented in endurance contexts, less is known about its short-term effects on resistance training performance and recovery. Thus, this study investigated the effects of short-term BJ supplementation on strength performance, cardiovascular responses, muscle oxygenation, and post-exercise recovery in resistance-trained males. Methods: Twelve healthy men (age: 21.3 ± 1.9 years; body mass index: 21.42 ± 2.36 kg/m2) completed two supplementation protocols involving BJ, providing 450 mg of nitrate per day, and a nitrate-free placebo (PLA). Each protocol consisted of two laboratory visits, one to assess the acute ergogenic effects and another to evaluate recovery after 72 h, resulting in a total of four sessions over a two-week period. During the three consecutive days of supplementation, participants ingested a single 900 mL dose (15 g BJ powder/PLA) 2 h before the first session, followed by three daily 300 mL doses (5 g BJ each/PLA) over the next two days, and a final dose (15 g BJ powder/PLA) taken 2 h before the second session (72 h post-first session). Each testing session involved incremental back squat (BS) and bench press (BP) exercises at 60%, 70%, and 80% of the one-repetition maximum (1RM) performed to failure, with three-minute rest intervals between sets. Repetition to failure, movement velocity, peak power, peak heart rate (HR), and muscle oxygenation (SmO2) were recorded during BP and BS exercises. Heart rate variability (HRV) and blood lactate were assessed before and after each training session. Lower-limb strength (CMJ and SJ) and delayed-onset muscle soreness (DOMS) were assessed daily during the 3-day supplementation period. Results: BJ significantly increased repetitions completed at 80% 1RM during BP and BS (p < 0.05) compared to the PLA. Peak movement velocity improved across all intensities using BJ with higher values compared to the PLA at 60-80% 1RM (p < 0.05). SmO2 was higher in BJ at 70-80% 1RM) and further improved after 72 h of BJ supplementation (p < 0.05). Cardiovascular strain was reduced in BJ, evidenced by lower peak HRs and smaller post-exercise declines in HRV indices (p < 0.05). Post-exercise recovery favored BJ, with faster recovery in jump performance at 24 h and reduced upper-limb DOMS at 24-48 h (p < 0.05). Conclusions: Short-term BJ supplementation enhances high-intensity resistance performance, improves muscle oxygenation, attenuates cardiovascular strain, and accelerates neuromuscular recovery. These benefits highlight its potential as a practical strategy for athletes seeking to optimize training performance and recovery during periods of intense resistance training. DOI: 10.3390/nu17101720 PMCID: PMC12113839 PMID: 40431460 [Indexed for MEDLINE] Conflict of interest statement: The authors declare no conflicts of interest.

A randomized multi-arm open labelled comparative clinical trial report of Pankajakasthuri DiabetEaze powder, a novel polyherbal formulation on the nutritional management and glycemic control in type 2 diabetic and prediabetic patients.

5. Heliyon. 2025 Feb 13;11(4):e42631. doi: 10.1016/j.heliyon.2025.e42631. eCollection 2025 Feb 28. A randomized multi-arm open labelled comparative clinical trial report of Pankajakasthuri DiabetEaze powder, a novel polyherbal formulation on the nutritional management and glycemic control in type 2 diabetic and prediabetic patients. Sasidharan S(1)(2), Nair A K(3), R L(3), Nair AV(4), Sa S(5), Joseph SG(6), Chand Cp A(3), Satheesan S(7), Pratap A(3), Kumar S N(2), Paul J(8), Nair V V(9), R V(6), Nair J H(4). Author information: (1)HCEMM-SU Cardiovascular Comorbidities Research Group, Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1089, Budapest, Hungary. (2)Department of R&D, Pankajakasthuri Herbal Research Foundation, Pankajakasthuri Ayurveda Medical College Campus, Trivandrum, India. (3)Department of Kayachikitsa, Pankajakasthuri Ayurveda Medical College & PG Centre, Killy, Kattakada, Thiruvananthapuram, Kerala, India. (4)Pankajakasthuri Herbals India Pvt. Ltd., Poovachal, Trivandrum, India. (5)Department of Rasashastra & Bhaishajya Kalpana, Pankajakasthuri Ayurveda Medical College & P.G. Centre, Killy, Kattakada, Thiruvananthapuram, Kerala, India. (6)Department of Dravyagunavijnanam, Pankajakasthuri Ayurveda Medical College & P.G. Centre, Killy, Kattakada, Thiruvananthapuram, Kerala, India. (7)Department of Shalyatantra, Pankajakasthuri Ayurveda Medical College & PG Centre, Killy, Kattakada, Thiruvananthapuram, Kerala, India. (8)Department of Statistics, Vimala College (Autonomous), Thrissur, Kerala, 680009, India. (9)Neyyar Medicity, Killy, Kattakada, Thiruvananthapuram, Kerala, India. BACKGROUND AND AIMS: Recently Diabetes Mellitus (DM) has been associated with heightened susceptibility to malnutrition, suggesting that augmenting nutritional intake stands out as a potent therapeutic strategy for addressing malnutrition in individuals with DM. The aim of this clinical investigation was to evaluate the effect of DiabetEaze powder, a polyherbal nutritional formulation developed by us for nutritional management and glycaemic control, on patients with diabetic and prediabetic conditions. METHODS: A total of 143 type II diabetic (T2D) patients who were managing their diabetic condition through modern medicine, AYUSH medicine, lifestyle modification and 68 pre-diabetic patients, aged between 40 and 65 years, were randomly assigned into six groups: control, modern, AYUSH, lifestyle, prediabetic control and prediabetic trial. The treatment groups were administered 5 g of DiabetEaze powder two times a day after food for 6 months. Microminerals, vitamins, glycaemic parameters, Quality of Life (QoL), hematology, lipid profiles, Renal Function Test (RFT) and Liver Function Test (LFL) parameters, and electrolytes were evaluated at Day 0, Day 90, and Day 180. RESULTS: Out of 211 enrolled patients, 189 individuals successfully completed the entire 180-day duration of the study, indicating a retention rate of approximately 89.6 %. In our study, we observed a statistically significant elevation in the levels of vitamin D, B2, and B6 across all treatment groups. Besides, the treatment groups displayed a notable increase in zinc and manganese levels compared to the other minerals tested. Notably, the treatment groups demonstrated distinct mineral and vitamin profiles. In terms of metabolic markers, significant reductions in Fasting Blood Sugar (FBS)/Post Prandial Blood Sugar (PPBS) were observed across the modern, AYUSH, and lifestyle groups, while the modern group also showed a marked decrease in glycated haemoglobin (HbA1c) levels. Furthermore, overall QoL among the tested groups was also statistically significant. The consistent maintenance of normal LFT and RFT parameters and electrolyte levels across trial groups throughout the study duration indicates that the supplement does not induce liver toxicity or negatively impact hepatic function. CONCLUSION: In conclusion, the nutrients present in the DiabetEaze powder contribute to the effective management of nutritional status in diabetic people and thus effectively reduce sugar spikes by regulating PPBS and HbA1c levels, which is a critical aspect of its role in diabetes management. These properties benefit in managing diabetes-related outcomes and overall quality of life. CLINICAL TRIAL REGISTRY OF INDIA UNDER REGISTRATION NO: CTRI/2021/04/032956 on 20/04/2021. © 2025 The Authors. DOI: 10.1016/j.heliyon.2025.e42631 PMCID: PMC11903805 PMID: 40083990 Conflict of interest statement: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Dr. Shan Sasidharan reports financial support was provided by Department of Pharmacology and Pharmacotherapy, Semmelweis University & Pankajakasthuri Ayurveda Medical College & PG Centre, Killy, Kattakada, Thiruvananthapuram, Kerala, India. Dr. Shan Sasidharan reports a relationship with Department of Pharmacology and Pharmacotherapy, Semmelweis University & Pankajakasthuri Ayurveda Medical College & PG Centre, Killy, Kattakada, Thiruvananthapuram, Kerala, India that includes: employment. Dr. Shan Sasidharan has patent nil pending to nil. nil If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Investigation of the effect of nitrate and L-arginine intake on aerobic, anaerobic performance, balance, agility, and recovery in elite taekwondo athletes.

6. J Int Soc Sports Nutr. 2025 Dec;22(1):2445609. doi: 10.1080/15502783.2024.2445609. Epub 2024 Dec 23. Investigation of the effect of nitrate and L-arginine intake on aerobic, anaerobic performance, balance, agility, and recovery in elite taekwondo athletes. Kavcı Z(1), Ozan M(2), Buzdağlı Y(3), Savaş A(4), Uçar H(5). Author information: (1)Atatürk University, Graduate School of Winter Sports and Sport Sciences, Erzurum, Turkey. (2)Atatürk University, Department of Physical Education and Sports, Kazım Karabekir Faculty of Education, Erzurum, Turkey. (3)Erzurum Technical University, Department of Coaching Education, Faculty of Sport Sciences, Erzurum, Turkey. (4)Giresun University, Department of the Food Engineering, Giresun, Turkey. (5)İnönü University, Department of Physical Education and Sports, Faculty of Education, Malatya, Turkey. BACKGROUND: Taekwondo is a complex martial art that requires speed, balance, agility, and endurance. This study aims to examine the effects of nitrate and L-arginine supplementation on acute aerobic and anaerobic performance, balance, agility, and recovery in elite taekwondo athletes. METHOD: This study was conducted as a double-blind, randomized, crossover study with the participation of 15 experienced taekwondo athletes aged 19.06 ± 0.96 years and 8.93 ± 1.27 years of training experience. Participants visited the laboratory a total of nine times, including a practice session and anthropometric measurements. These visits consisted of eight experimental sessions conducted at 72-hour intervals. The experimental sessions were conducted with nitrate, L-arginine, and a combination of both supplements (NIT*L-ARG) and placebo. Nitrate supplementation was provided by homogenizing fresh spinach (837.40 mg/kg), while L-ARG was given as a single dose of 6 g in powder form three hours before exercise. RESULTS: NIT*L-ARG supplementation significantly improved the anaerobic performance of athletes in Wingate peak power and peak power (w/kg) compared to placebo and in mean power compared to NIT, L-ARG, and PLA. In addition, NIT*L-ARG supplementation significantly improved blood lactate levels and agility performance immediately after Wingate and Shuttle run tests. CONCLUSION: The combined intake of NIT*L-ARG was found to be effective in improving aerobic, anaerobic, and agility performances as well as fatigue levels of athletes. It was determined that taking NIT and L-ARG supplements alone contributed to the improvement of improving athletes' performance in Wingate mean power values and subsequent fatigue level compared to PLA. DOI: 10.1080/15502783.2024.2445609 PMCID: PMC11703352 PMID: 39714103 [Indexed for MEDLINE] Conflict of interest statement: No potential conflict of interest was reported by the author(s).

Efficacy of Probiotic Tablets in the Reduction of Halitosis: A Randomised, Single Blind, Controlled Clinical Trial.

7. Oral Health Prev Dent. 2024 Dec 3;22:639-646. doi: 10.3290/j.ohpd.b5866901. Efficacy of Probiotic Tablets in the Reduction of Halitosis: A Randomised, Single Blind, Controlled Clinical Trial. Huang G, Li N. PURPOSE: To evaluate the effect of a fresh-breath mild effervescent tablet on halitosis as an alternative to mouthwash. MATERIALS AND METHODS: Halitosis is the unpleasant and offensive odour emanating from the oral cavity (bad breath), which is linked to the presence of volatile sulphur compounds (VSCs). A randomised, single-blind, controlled clinical trial was conducted with 102 volunteers who had oral complaints (range 18-60 years). Breath samples were taken and analysed for the level of hydrogen sulphide (H2S), methyl mercaptan (CH3SH) and dimethyl sulphide (CH3SCH3). Sixty-one volunteers who met the halitosis criteria were enrolled and completed the clinical trial. Two groups were formed according to the test employed: the Immediate Effect Test (IET) (n = 31) and the Effective Duration Test (EDT) (n = 30). In the IET, subjects were divided into three subgroups: fresh-breath mild effervescent tablet (MT, n = 11), the fresh-breath lozenge tablet (LT, n = 10), and fresh-breath mouthwash (MW, n = 10). Halitosis was measured immediately after completely consuming the test tablet or gargling. In the EDT, subjects were also divided into three subgroups: fresh-breath mild effervescent tablet (MT, n = 10), probiotic powder (PP, n = 10) and probiotic tablet (PT, n = 10). Halitosis was measured at 0 h, 1 h, and 2 h after consuming the test substances. RESULTS: In the IET group, a statistically significant reduction in VSCs was obtained in all three subgroups compared with baseline (VSCs of MT group, p 0.01, VSCs of LT subgroup, p 0.05, VSCs of MT group, p 0.01). The fresh-breath mild effervescent tablet subgroup showed a statistically significantly greater reduction in VSCs compared to the fresh-breath lozenge subgroup (p 0.01). No statistically significant differences in VSC reduction were found between the fresh-breath mild effervescent tablet subgroup and the mouthwash group (p = 0.38). In the EDT group, the VSC level of the fresh-breath mild effervescent tablet group was still statistically significantly lower than the baseline 2 h after consumption (p 0.01). The two control groups which used commercial fresh-breath probiotic products did not show any statistically significant difference compared to baseline. The VSC level of these two groups gradually returned to the baseline level 2 h after consumption. CONCLUSION: Fresh-breath mild effervescent tablets have shown promising potential as an alternative, effective, and potentially safe choice for fresh breath in comparison to mouthwash. DOI: 10.3290/j.ohpd.b5866901 PMCID: PMC12094102 PMID: 39625350 [Indexed for MEDLINE]

No Difference between the Efficacy of High-Nitrate and Low-Nitrate Vegetable Supplementation on Blood Pressure after 16 Weeks in Individuals with Early-Stage Hypertension: An Exploratory, Double-Blinded, Randomized, Controlled Trial.

8. Nutrients. 2024 Sep 6;16(17):3018. doi: 10.3390/nu16173018. No Difference between the Efficacy of High-Nitrate and Low-Nitrate Vegetable Supplementation on Blood Pressure after 16 Weeks in Individuals with Early-Stage Hypertension: An Exploratory, Double-Blinded, Randomized, Controlled Trial. Li D(1)(2), Jovanovski E(1)(2), Zurbau A(1)(2), Sievenpiper J(1)(2), Milicic D(3), El-Sohemy A(1), Vuksan V(1)(2). Author information: (1)Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada. (2)Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1X1, Canada. (3)Department of Cardiovascular Diseases, School of Medicine, University of Zagreb, University Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia. Dietary inorganic nitrate lowers blood pressure (BP) in healthy individuals through improved nitric oxide (NO) bioavailability. However, there is limited evidence examining the long-term effects of dietary nitrate for managing hypertension. We aimed to determine whether the sustained intake of dietary nitrate improved BP and cardiovascular disease (CVD) risk factors in individuals with early-stage hypertension. The Dietary Nitrate (NO3) on BP and CVD Risk Factors (DINO3) Trial was a multi-center, double-blinded, parallel, randomized, controlled trial in participants with elevated BP. Participants were supplemented with high-nitrate (HN) (~400 mg nitrate) or low-nitrate (LN) vegetable powder (~50 mg nitrate) on top of their usual diets for 16 weeks. The primary outcome was office systolic BP at 16 weeks. The secondary outcomes were 24 h ambulatory BP, central BP, heart-rate-corrected augmentation index (AIx75), carotid-femoral pulse wave velocity (cf-PWV), lipids, and high-sensitivity C-reactive protein (hs-CRP). Sixty-six participants were randomized at baseline (39M:27F, age: 51.5 ± 10.8 years, BMI:27.9 ± 3.2 kg/m2). In an intention-to-treat analysis, no differences were observed between HN and LN groups in terms of office systolic BP at 16 weeks (3.91 ± 3.52 mmHg, p = 0.27) or secondary outcomes. In this exploratory study, sustained HN vegetable supplementation did not exhibit more favorable vascular effects than LN vegetable supplementation in individuals with elevated BP. DOI: 10.3390/nu16173018 PMCID: PMC11397180 PMID: 39275333 [Indexed for MEDLINE] Conflict of interest statement: V.V. previously held the Canadian (2 410 556) and American (7 326 404) patents on the medical use of viscous fiber blend for reducing blood glucose for treatment of diabetes, increasing insulin sensitivity, and reducing systolic blood pressure and blood lipids. J.S. has received research support from the Canadian Foundation for Innovation, Ontario Research Fund, Province of Ontario Ministry of Research and Innovation and Science, Canadian Institutes of health Research (CIHR), Diabetes Canada, American Society for Nutrition (ASN), International Nut and Dried Fruit Council (INC) Foundation, National Honey Board (U.S. Department of Agriculture [USDA] honey “Checkoff” program), Institute for the Advancement of Food and Nutrition Sciences (IAFNS; formerly ILSI North America), Pulse Canada, Quaker Oats Center of Excellence, The United Soybean Board (USDA soy “Checkoff” program), Protein Industries Canada (a Government of Canada Global Innovation Clusters), The Tate and Lyle Nutritional Research Fund at the University of Toronto, The Glycemic Control and Cardiovascular Disease in Type 2 Diabetes Fund at the University of Toronto (a fund established by the Alberta Pulse Growers), The Plant Protein Fund at the University of Toronto (a fund which has received contributions from IFF), and The Nutrition Trialists Network Research Fund at the University of Toronto (a fund which has received donations from the Calorie Control Council, Physicians Committee for Responsible Medicine, and vegan grants through the Karuna Foundation). He has received food donations to support randomized controlled trials from the Almond Board of California, California Walnut Commission, Peanut Institute, Barilla, Unilever/Upfield, Unico/Primo, Loblaw Companies, Quaker, Kellogg Canada, Danone, Nutrartis, Soylent, and Dairy Farmers of Canada. He has received travel support, speaker fees and/or honoraria from ASN, Danone, Dairy Farmers of Canada, FoodMinds LLC, Nestlé, Abbott, General Mills, Nutrition Communications, International Food Information Council (IFIC), Calorie Control Council, International Sweeteners Association, International Glutamate Technical Committee, Arab Beverages Association, and Phynova. He has or has had ad hoc consulting arrangements with Perkins Coie LLP, Tate & Lyle, Inquis Clinical Research, Ingredion, and Brightseed. He is a former member of the European Fruit Juice Association Scientific Expert Panel and former member of the Soy Nutrition Institute (SNI) Scientific Advisory Committee. He is on the Clinical Practice Guidelines Expert Committees of Diabetes Canada, European Association for the study of Diabetes (EASD), Canadian Cardiovascular Society (CCS), and Obesity Canada/Canadian Association of Bariatric Physicians and Surgeons. He serves as an unpaid member of the Board of Trustees of IAFNS and formerly served as an unpaid scientific advisor for the Carbohydrates Committee of IAFNS. He is a Director at Large of the Canadian Nutrition Society (CNS), founding member of the International Carbohydrate Quality Consortium (ICQC), Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the EASD, and Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. His spouse is an employee of AB InBev. A.E. is the founder and holds shares in Nutrigenomix Inc. A.Z. is a part time research associate at INQUIS Clinical Research, Ltd., a contract research organization. All other authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Dietary supplementation with a wheat polar lipid complex improves skin conditions in women with dry skin and mild-to-moderate skin aging.

9. J Cosmet Dermatol. 2024 Apr;23(4):1320-1330. doi: 10.1111/jocd.16130. Epub 2023 Dec 15. Dietary supplementation with a wheat polar lipid complex improves skin conditions in women with dry skin and mild-to-moderate skin aging. Kern C(1), Dudonné S(1), Garcia C(1). Author information: (1)Seppic Research and Innovation, La Garenne Colombes, France. BACKGROUND: Aging, menopause, and seasonal changes alter the lipid composition of the outermost skin layer, the stratum corneum, resulting in dry and itchy skin. AIMS: This clinical trial aimed at evaluating the effects of a wheat polar lipid complex (WPLC) on skin characteristics in women showing dry and wrinkled skin, investigating its effects in a subgroup of postmenopausal women, and assessing if benefits were maintained after supplementation. METHODS: Seventy-two women with dry and wrinkled skin were recruited in this double-blind, randomized, parallel-group study, and allocated to three groups of 24 subjects, each including at least 10 postmenopausal women. For 56 days, subjects consumed the WPLC supplement (oil or powder), or the placebo. Skin hydration, transepidermal water loss (TEWL), elasticity, and profilometry were evaluated at baseline, after 14, 28, and 56 days of supplementation, and 56 days after the end of supplementation. Additionally, a lipidomic analysis was performed to examine changes in superficial skin layers over 56 days. RESULTS: Dietary supplementation with WPLC rapidly improved all parameters. It increased skin hydration, smoothness, and elasticity while decreasing TEWL, roughness, and wrinkle depth after only 14 days of supplementation. These effects were also observed in the subpopulation of postmenopausal women and led to an improved self-perception of skin. For all the parameters, outcomes were not maintained after the supplementation was stopped. The lipidomic analysis revealed 10 compounds evolving over the 56 days of WPLC supplementation. CONCLUSION: WPLC supplementation improved skin hydration, smoothness, elasticity, and wrinkledness within 14 days and, as expected, did not last after supplementation was stopped. © 2023 SEPPIC. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC. DOI: 10.1111/jocd.16130 PMID: 38100124 [Indexed for MEDLINE]

Efficacy of Cordyceps cicadae (Ascomycota) Mycelium Supplementation for Amelioration of Dry Eye Symptoms: A Randomized, Double-Blind Clinical Pilot Study.

10. Int J Med Mushrooms. 2022;24(12):57-67. doi: 10.1615/IntJMedMushrooms.2022045307. Efficacy of Cordyceps cicadae (Ascomycota) Mycelium Supplementation for Amelioration of Dry Eye Symptoms: A Randomized, Double-Blind Clinical Pilot Study. Chang HH(1), Chang WJ(2), Jhou BY(3), Kuo SY(4), Hsu JH(3), Chen YL(3), Chen CC(5), Lin DP(6). Author information: (1)Department of Nutrition, Chung Shan Medical University, Taichung City 402, Taiwan; Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung City 402, Taiwan. (2)Department of Ophthalmology, Landseed International Hospital, Taoyuan City 320, Taiwan. (3)Biotech Research Institute, Grape King Bio Ltd., Taoyuan 325002, Taiwan. (4)Grape King Bio Ltd., Taoyuan City 320, Taiwan. (5)Grape King Bio Ltd., Taoyuan City 320, Taiwan; Department of Food Science, Nutrition, and Nutraceutical Biotechnology, Shih Chien University, Taipei City 104, Taiwan; Institute of Food Science and Technology, National Taiwan University, Taipei City 106, Taiwan; Department of Bioscience Technology, Chung Yuan Christian University, Taoyuan City 320, Taiwan. (6)Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung City 402, Taiwan; Department of Medical Laboratory and Biotechnology, Chung Shan Medical University, Taichung City 402, Taiwan. Dry eye disease (DED), a multifactorial inflammatory ocular surface disorder, affects up to 50% of individuals over 50 years old worldwide and is one of the most common reasons for seeking ophthalmologic care. Generally, topical eye drops or oral drugs are administered to treat DED; however, the use of preservatives in eye drops or the adverse effects of oral drugs are disadvantageous for long-term therapy. Cordyceps cicadae, a traditional Chinese medicinal fungus, possesses anti-inflammatory effects without evident toxicity and is obtainable at low price. Our previous study demonstrated that C. cicadae mycelium effectively ameliorates dry eye symptoms in the benzalkonium chloride (BAC)-induced mouse dry eye model by increasing tear volume and tear film breakup time (TBUT). However, the effects of C. cicadae mycelium for human dry eye amelioration remains unknown. Thus, the present study investigated the mitigation of dry eye conditions and related discomforts through oral supplementation of fermented C. cicadae mycelium. A total of 70 healthy individuals were recruited and randomly allocated to receive a daily oral dose of 1,050 mg preparation in sachet containing either freeze-dried C. cicadae mycelium powder with 0.3 mg of adenosine and 1.5 mg of HEA per gram or placebo for 90 days. The participants were subjected to anthropometric measurements, dry eye questionnaires (DEQ), Schirmer's tests, intraocular pressure (IOP) measurements, tear film breakup time (TBUT) tests, tear osmolality measurements, and tear electrolyte analysis prior to and right after completion of the study. The results showed a significantly increased TBUT as well as a significant decrease in tear osmolarity, in parallel with the decrease of tear electrolytes, especially Na+ and Cl ions. Although significant increase of tear volume was not observed, the increased TBUT suggests mitigation of dry eye through improvement of tear quality. Therefore, C. cicadae mycelium supplementation may be used for dry eye alleviation as a novel therapeutic intervention. DOI: 10.1615/IntJMedMushrooms.2022045307 PMID: 36374982 [Indexed for MEDLINE]

A Nutritionally Complete Oral Nutritional Supplement Powder Improved Nutritional Outcomes in Free-Living Adults at Risk of Malnutrition: A Randomized Controlled Trial.

11. Int J Environ Res Public Health. 2022 Sep 9;19(18):11354. doi: 10.3390/ijerph191811354. A Nutritionally Complete Oral Nutritional Supplement Powder Improved Nutritional Outcomes in Free-Living Adults at Risk of Malnutrition: A Randomized Controlled Trial. Yeung SSY(1), Lee JSW(1)(2)(3), Kwok T(1). Author information: (1)Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. (2)Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China. (3)Department of Medicine and Geriatrics, To Po Hospital, Hong Kong, China. BACKGROUND: This randomized controlled trial investigated the effectiveness of an oral nutritional supplement (ONS) on nutrition-related outcomes over 12 weeks in Chinese adults with or at risk of malnutrition. METHODS: 88 Chinese adults ≥18 years living independently in Hong Kong with Mini Nutritional Assessment-Short Form (MNA-SF) score ≤11 were randomly assigned to (1) 2 servings/day of nutritionally complete ONS powder made with water (Fresubin® Powder (Fresubin Kabi Deutschland GmbH, Bad Homburg, Germany), 600 kcal, 22.4 g protein) for 12 weeks (intervention group) or (2) no treatment (control group). The primary outcome was increase in body weight (BW) over 12 weeks. Secondary outcomes included improvement in body mass index (BMI), mid-arm circumference (MAC), calf circumference, MNA-SF score, quality of life, self-rated health, frailty, and diet quality. RESULTS: The intervention group showed a significantly higher mean increase in BW compared with the control group (1.381 kg, intervention vs control, p < 0.001). The intervention group also showed significantly higher mean increases in BMI, MAC, calf circumference, intake of energy, protein, vitamin D, and calcium compared with the control group. No group differences in the changes of other outcomes were observed. CONCLUSIONS: For Chinese free-living adults at risk of malnutrition, daily consumption of a nutritionally complete ONS powder improved nutritional outcomes compared with the control group. DOI: 10.3390/ijerph191811354 PMCID: PMC9517313 PMID: 36141627 [Indexed for MEDLINE] Conflict of interest statement: T.K. was provided with the funding and study products from Fresenius-Kabi Deutschland GmbH. S.S.Y.Y. and J.S.W.L. declare no conflicts of interest.

Efficacy of Calcium-Containing Eggshell Powder Supplementation on Urinary Fluoride and Fluorosis Symptoms in Women in the Ethiopian Rift Valley.

12. Nutrients. 2021 Mar 24;13(4):1052. doi: 10.3390/nu13041052. Efficacy of Calcium-Containing Eggshell Powder Supplementation on Urinary Fluoride and Fluorosis Symptoms in Women in the Ethiopian Rift Valley. Mulualem D(1), Hailu D(2), Tessema M(3), Whiting SJ(4). Author information: (1)School of Human Nutrition and Food Science, Hawassa University, P.O. Box 5 Hawassa, Ethiopia. (2)School of Public Health, Hawassa University, P.O. Box 5 Hawassa, Ethiopia. (3)Ethiopian Public Health Institute, P.O. Box 1242 Addis Ababa, Ethiopia. (4)College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada. Dietary calcium binds Fluoride (F), thus preventing excess F absorption. We aimed to assess the efficacy of supplementing calcium-containing Eggshell Powder (ESP) on F absorption using urine F excretion and on fluorosis symptoms. In total, 82 women (41 Intervention Group, IG; 41 Control Group, CG) were recruited; overall, 39 in each group completed the trial. Morning spot urine was collected before (baseline, BL) and after (endline, EL) the intervention that was 6-months daily supplementation with 2.4 g ESP (providing ~1000 mg of calcium). Dental, skeletal, and non-skeletal fluorosis assessments was carried out at BL and, except for dental, at EL. Relative risk (RR) and linear generalized estimating equation were used to compare outcomes between groups. At BL, urinary F excretion in the IG and CG groups was similar, ~10 mg/L. At EL, urinary F excretion in IG women was six-fold lower (β = -6.1 (95% CI: -7.1, -5.1)) compared to CG. The risk of developing skeletal and non-skeletal fluorosis were significantly (p < 0.001) reduced in the intervention group. A significant reduction in urinary F excretion and reduction in many fluorosis symptoms were observed among women supplemented with calcium-containing ESP, thus providing evidence for using this dietary calcium source for mitigation of fluorosis. Clinical trials registration: NCT03355222. DOI: 10.3390/nu13041052 PMCID: PMC8063921 PMID: 33804976 [Indexed for MEDLINE] Conflict of interest statement: The authors declare no conflict of interest.

Application of Molecular Hydrogen as an Antioxidant in Responses to Ventilatory and Ergogenic Adjustments during Incremental Exercise in Humans.

13. Nutrients. 2021 Jan 30;13(2):459. doi: 10.3390/nu13020459. Application of Molecular Hydrogen as an Antioxidant in Responses to Ventilatory and Ergogenic Adjustments during Incremental Exercise in Humans. Alharbi AAD(1), Ebine N(1), Nakae S(2), Hojo T(1), Fukuoka Y(1). Author information: (1)Graduate School of Health and Sports Science, Doshisha University, Kyoto 610-0394, Japan. (2)Division of Bioengineering, Graduate School of Engineering Science, Osaka University, Osaka 560-8531, Japan. We investigated effects of molecular hydrogen (H2) supplementation on acid-base status, pulmonary gas exchange responses, and local muscle oxygenation during incremental exercise. Eighteen healthy, trained subjects in a randomized, double-blind, crossover design received H2-rich calcium powder (HCP) (1500 mg/day, containing 2.544 µg/day of H2) or H2-depleted placebo (1500 mg/day) for three consecutive days. They performed cycling incremental exercise starting at 20-watt work rate, increasing by 20 watts/2 min until exhaustion. Breath-by-breath pulmonary ventilation (V˙E) and CO2 output (V˙CO2) were measured and muscle deoxygenation (deoxy[Hb + Mb]) was determined via time-resolved near-infrared spectroscopy in the vastus lateralis (VL) and rectus femoris (RF). Blood gases' pH, lactate, and bicarbonate (HCO3-) concentrations were measured at rest and 120-, 200-, and 240-watt work rates. At rest, the HCP group had significantly lower V˙E, V˙CO2, and higher HCO3-, partial pressures of CO2 (PCO2) versus placebo. During exercise, a significant pH decrease and greater HCO3- continued until 240-watt workload in HCP. The V˙E was significantly lower in HCP versus placebo, but HCP did not affect the gas exchange status of V˙CO2 or oxygen uptake (V˙O2). HCP increased absolute values of deoxy[Hb + Mb] at the RF but not VL. Thus, HCP-induced hypoventilation would lead to lower pH and secondarily impaired balance between O2 delivery and utilization in the local RF during exercise, suggesting that HCP supplementation, which increases the at-rest antioxidant potential, affects the lower ventilation and pH status during incremental exercise. HPC induced a significantly lower O2 delivery/utilization ratio in the RF but not the VL, which may be because these regions possess inherently different vascular/metabolic control properties, perhaps related to fiber-type composition. DOI: 10.3390/nu13020459 PMCID: PMC7911623 PMID: 33573133 [Indexed for MEDLINE] Conflict of interest statement: Author N.E. has received a research grant from ENAGEGATE Inc. We were provided with HCP supplements and a placebo by ENAGEGATE Inc. However, this company had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Ready-to-use therapeutic food (RUTF) for home-based nutritional rehabilitation of severe acute malnutrition in children from six months to five years of age.

14. Cochrane Database Syst Rev. 2019 May 15;5(5):CD009000. doi: 10.1002/14651858.CD009000.pub3. Ready-to-use therapeutic food (RUTF) for home-based nutritional rehabilitation of severe acute malnutrition in children from six months to five years of age. Schoonees A(1), Lombard MJ, Musekiwa A, Nel E, Volmink J. Author information: (1)Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Cape Town, Western Cape, South Africa, 7505. Update of Cochrane Database Syst Rev. 2013 Jun 06;(6):CD009000. doi: 10.1002/14651858.CD009000.pub2. BACKGROUND: Management of severe acute malnutrition (SAM) in children comprises two potential phases: stabilisation and rehabilitation. During the initial stabilisation phase, children receive treatment for dehydration, electrolyte imbalances, intercurrent infections and other complications. In the rehabilitation phase (applicable to children presenting with uncomplicated SAM or those with complicated SAM after complications have been resolved), catch-up growth is the main focus and the recommended energy and protein requirements are much higher. In-hospital rehabilitation of children with SAM is not always desirable or practical - especially in rural settings - and home-based care can offer a better solution. Ready-to-use therapeutic food (RUTF) is a widely used option for home-based rehabilitation, but the findings of our previous review were inconclusive. OBJECTIVES: To assess the effects of home-based RUTF used during the rehabilitation phase of SAM in children aged between six months and five years on recovery, relapse, mortality and rate of weight gain. SEARCH METHODS: We searched the following databases in October 2018: CENTRAL, MEDLINE, Embase, six other databases and three trials registers. We ran separate searches for cost-effectiveness studies, contacted researchers and healthcare professionals in the field, and checked bibliographies of included studies and relevant reviews. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs, where children aged between six months and five years with SAM were, during the rehabilitation phase, treated at home with RUTF compared to an alternative dietary approach, or with different regimens and formulations of RUTF compared to each other. We assessed recovery, deterioration or relapse and mortality as primary outcomes; and rate of weight gain, time to recovery, anthropometrical changes, cognitive development and function, adverse outcomes and acceptability as secondary outcomes. DATA COLLECTION AND ANALYSIS: We screened for eligible studies, extracted data and assessed risk of bias of those included, independently and in duplicate. Where data allowed, we performed a random-effects meta-analysis using Review Manager 5, and investigated substantial heterogeneity through subgroup and sensitivity analyses. For the main outcomes, we evaluated the quality of the evidence using GRADE, and presented results in a 'Summary of findings' table per comparison. MAIN RESULTS: We included 15 eligible studies (n = 7976; effective sample size = 6630), four of which were cluster trials. Eight studies were conducted in Malawi, four in India, and one apiece in Kenya, Zambia, and Cambodia. Six studies received funding or donations from industry whereas eight did not, and one study did not report the funding source.The overall risk of bias was high for six studies, unclear for three studies, and low for six studies. Among the 14 studies that contributed to meta-analyses, none (n = 5), some (n = 5) or all (n = 4) children were stabilised in hospital prior to commencement of the study. One small study included only children known to be HIV-infected, another study stratified the analysis for 'recovery' according to HIV status, while the remaining studies included HIV-uninfected or untested children. Across all studies, the intervention lasted between 8 and 16 weeks. Only five studies followed up children postintervention (maximum of six months), and generally reported on a limited number of outcomes.We found seven studies with 2261 children comparing home-based RUTF meeting the World Health Organization (WHO) recommendations for nutritional composition (referred to in this review as standard RUTF) with an alternative dietary approach (effective sample size = 1964). RUTF probably improves recovery (risk ratio (RR) 1.33; 95% confidence interval (CI) 1.16 to 1.54; 6 studies, 1852 children; moderate-quality evidence), and may increase the rate of weight gain slightly (mean difference (MD) 1.12 g/kg/day, 95% CI 0.27 to 1.96; 4 studies, 1450 children; low-quality evidence), but we do not know the effects on relapse (RR 0.55, 95% CI 0.30 to 1.01; 4 studies, 1505 children; very low-quality evidence) and mortality (RR 1.05, 95% CI 0.51 to 2.16; 4 studies, 1505 children; very low-quality evidence).Two quasi-randomised cluster trials compared standard, home-based RUTF meeting total daily nutritional requirements with a similar RUTF but given as a supplement to the usual diet (213 children; effective sample size = 210). Meta-analysis showed that standard RUTF meeting total daily nutritional requirements may improve recovery (RR 1.41, 95% CI 1.19 to 1.68; low-quality evidence) and reduce relapse (RR 0.11, 95% CI 0.01 to 0.85; low-quality evidence), but the effects are unknown for mortality (RR 1.36, 95% CI 0.46 to 4.04; very low-quality evidence) and rate of weight gain (MD 1.21 g/kg/day, 95% CI - 0.74 to 3.16; very low-quality evidence).Eight studies randomised 5502 children (effective sample size = 4456) and compared standard home-based RUTF with RUTFs of alternative formulations (e.g. using locally available ingredients, containing less or no milk powder, containing specific fatty acids, or with added pre- and probiotics). For recovery, it made little or no difference whether standard or alternative formulation RUTF was used (RR 1.03, 95% CI 0.99 to 1.08; 6 studies, 4188 children; high-quality evidence). Standard RUTF decreases relapse (RR 0.84, 95% CI 0.72 to 0.98; 6 studies, 4188 children; high-quality evidence). However, it probably makes little or no difference to mortality (RR 1.00, 95% CI 0.80 to 1.24; 7 studies, 4309 children; moderate-quality evidence) and may make little or no difference to the rate of weight gain (MD 0.11 g/kg/day, 95% CI -0.32 to 0.54; 6 studies, 3807 children; low-quality evidence) whether standard or alternative formulation RUTF is used. AUTHORS' CONCLUSIONS: Compared to alternative dietary approaches, standard RUTF probably improves recovery and may increase rate of weight gain slightly, but the effects on relapse and mortality are unknown. Standard RUTF meeting total daily nutritional requirements may improve recovery and relapse compared to a similar RUTF given as a supplement to the usual diet, but the effects on mortality and rate of weight gain are not clear. When comparing RUTFs with different formulations, the current evidence does not favour a particular formulation, except for relapse, which is reduced with standard RUTF. Well-designed, adequately powered, pragmatic RCTs with standardised outcome measures, stratified by HIV status, and that include diarrhoea as an outcome, are needed. DOI: 10.1002/14651858.CD009000.pub3 PMCID: PMC6537457 PMID: 31090070 [Indexed for MEDLINE] Conflict of interest statement: Anel Schoonees ‐ none known Martani Lombard ‐ none known Alfred Musekiwa ‐ none known Etienne Nel has received honoraria from the following organisations in 2018 for lectures given: AbbVie. Topic: Crohn’s Disease in Children: Nestle Nutrition Institute in Africa. Topic: Human Milk Oligosaccharides: Cipla. Topic: Constipation in Children. Jimmy Volmink ‐ none known

Effect of ascorbic acid rich, micro-nutrient fortified supplement on the iron bioavailability of ferric pyrophosphate from a milk based beverage in Indian school children.

15. Asia Pac J Clin Nutr. 2018;27(4):792-796. doi: 10.6133/apjcn.092017.07. Effect of ascorbic acid rich, micro-nutrient fortified supplement on the iron bioavailability of ferric pyrophosphate from a milk based beverage in Indian school children. Pauline M(1), Verghese ST(2), Srinivasu BY(3), Bose B(4), Thomas T(4), Mandal AK(3), Thankachan P(4), Kurpad AV(1)(4). Author information: (1)Department of Physiology, St John's Medical College, Bangalore, India. (2)Department of Physiology, St John's Medical College, Bangalore, India. sejil.tv@stjohns.in. (3)Clinical Proteomics Unit, Division of Molecular Medicine, St John's Research Institute, St John's National Academy of Health Sciences, Bangalore, India. (4)St John's Research Institute, St John's National Academy of Health Sciences, Bangalore, India. BACKGROUND AND OBJECTIVES: Nutritional anemia is a significant public health issue with 50-80% prevalence in Indian children. Fortification of food, specifically milk, with iron is a potential approach to increase dietary iron intake. Ferric pyrophosphate [Fe4(P2O7)3] is organoleptically neutral and is less soluble in acid medium and, further, has low bioavailability in milk. However, since ascorbic acid is a potent enhancer of iron absorption, the coadministration of ascorbic acid with Fe4(P2O7)3 might enhance the absorption of iron. We evaluated the effect of ascorbic acid on iron absorption from a Fe4(P2O7)3 and an ascorbic acid fortified milk beverage with respect to milk fortified with Fe4(P2O7)3 alone. METHODS AND STUDY DESIGN: A double-blind, two-way crossover, randomized study was conducted in 25 mildly anemic children. The test group received milk fortified with beverage powder containing 7 mg isotopically labeled iron (57Fe/58Fe) as Fe4(P2O7)3, equimolar proportions of ascorbic acid and 200 mg of calcium whereas control group received milk fortified with energy, calcium and iron equivalent beverage powder. Fractional iron absorption was measured by erythrocyte incorporation of stable isotopes of iron (57Fe/58Fe) in both the groups. RESULTS: The fractional iron absorption from the control drink was 0.80% (95% CI: 0.57, 1.12). Fortifying the milk with an equimolar amount of ascorbic acid increased the fractional iron absorption almost 2-fold to 1.58% (95% CI: 1.13, 2.22). CONCLUSIONS: The presence of ascorbic acid in an equimolar ratio with that of iron from Fe4(P2O7)3 salt in milk as a fortificant enhanced iron absorption when compared to milk fortified with only Fe4(P2O7)3. DOI: 10.6133/apjcn.092017.07 PMID: 30045423 [Indexed for MEDLINE]