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The Effects of Extra Virgin Olive Oil on Alanine Aminotransferase, Aspartate Aminotransferase, and Ultrasonographic Indices of Hepatic Steatosis in Nonalcoholic Fatty Liver Disease Patients Undergoing Low Calorie Diet.
Shidfar, F, Bahrololumi, SS, Doaei, S, Mohammadzadeh, A, Gholamalizadeh, M, Mohammadimanesh, A
Canadian journal of gastroenterology & hepatology. 2018;2018:1053710
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Non-alcoholic fatty liver disease (NAFLD) is a risk factor for cardiovascular disease (CVD), which is the most common cause of death. The traditional Mediterranean diet has been shown to reduce the risk of NAFLD and CVD and this protective effect is thought to be in part due to the use of olive oil in this dietary pattern. The aim of this randomised, single-blind study was to evaluate the effect of virgin olive oil as part of a low-calorie diet on markers of NAFLD. 43 overweight or obese patients with NAFLD, characterised by increased liver enzymes (ALT and AST), were randomised to either a low calorie diet with normal fat or a low calorie diet with 20% of total energy intake from olive oil (overall percentage of fat 30% of total energy intake in both groups) for three months. Significant weight loss was observed in both groups, with no significant difference between groups. There was a reduction in liver enzymes in the olive oil group which was significantly greater than in the control group. The severity of liver steatosis (the accumulation of fat in the liver) did not change significantly in either group. The authors concluded that a low calorie diet with virgin olive oil led to slight weight loss and improvements in markers for NAFLD.
Abstract
Background: Coronary artery disease is the most common cause of death in the patients with nonalcoholic fatty liver disease (NAFLD). Studies have shown that there is a strong relation between the increase in the aminotransferase levels and fat accumulation in the liver with cardiovascular complications, independent of all aspects of the metabolic syndrome. This study aimed to examine the effect of virgin olive oil on alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and the severity of steatosis in the NAFLD patients undergoing a weight-loss diet. Methods: This clinical trial was carried out on 50 patients with nonalcoholic fatty liver (mean age of 45.91 ± 9.61 years, mean BMI of 29.7 ± 0.58 Kg/m2) and the subjects were randomly assigned to the olive oil group (receiving the equivalent of 20% of their total daily energy requirement from olive oil) or the control group (with normal consumption of oil) for 12 weeks. All the patients received a hypocaloric diet during the study. At the beginning and the end of the study, the serum levels of ALT and AST and liver steatosis were measured. Findings: A significant decrease in the level of ALT enzymes was observed in the control group at the end of the study (P = 0.004). In the olive oil group, both enzymes decreased compared to baseline measurements (P < 0.01). There were significant differences in the ALT and AST levels between the two groups (P < 0.02). The severity of liver steatosis did not change significantly during the study. Conclusion: The consumption of a low calorie diet enriched with olive oil, along with slight weight reduction, reinforces the desired effects of weight loss in improving the levels of the hepatic enzymes.
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Microbiological and clinical effects of probiotics and antibiotics on nonsurgical treatment of chronic periodontitis: a randomized placebo- controlled trial with 9-month follow-up.
Morales, A, Gandolfo, A, Bravo, J, Carvajal, P, Silva, N, Godoy, C, Garcia-Sesnich, J, Hoare, A, Diaz, P, Gamonal, J
Journal of applied oral science : revista FOB. 2018;26:e20170075
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Chronic periodontitis is an inflammatory disease affecting the gums caused by the accumulation of dental bacterial plaque. There has been evidence that certain bacteria, like Tannerella forsythia, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, are related to the development of chronic perdontitis. Research has shown that probiotic species such as Lactobacillus rhamnosus inhibit the growth of bacteria that cause gum disease. This parallel-arm, randomised, double-blinded, placebo-controlled clinical trial investigated the effects of Lactobacillus rhamnosus SP1 or Azithromycin tablets as an addition to non-surgical therapy on clinical and microbiological parameters of chronic periodontitis in healthy subjects. Participants in the intervention group consumed a probiotic sachet containing Lactobacillus rhamnosus SP1 and an antibiotic placebo daily for three months, whereas the placebo group consumed azithromycin 500 mg for five days and a probiotic placebo. At 6 weeks follow-up, both the probiotic group and the antibiotic group demonstrated improvements in clinical and microbiological parameters with a reduction in cultivable microbiota such as Tannerella forsythia, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans. The antibiotic group reduced the number of people with chronic periodontitis more effectively than the probiotic group, but there was no significant difference between the two. To identify the most effective probiotic therapy for chronic periodontitis, more robust studies are required. The results of this study can be used by healthcare professionals to learn about the effects of probiotic therapy in patients with chronic periodontitis.
Abstract
The aim of this double-blind, placebo-controlled and parallel- arm randomized clinical trial was to evaluate the effects of Lactobacillus rhamnosus SP1-containing probiotic sachet and azithromycin tablets as an adjunct to nonsurgical therapy in clinical parameters and in presence and levels of Tannerella forsythia, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. Forty-seven systemically healthy volunteers with chronic periodontitis were recruited and monitored clinically and microbiologically at baseline for 3, 6 and 9 months after therapy. Subgingival plaque samples were collected from four periodontal sites with clinical attachment level ≥1 mm, probing pocket depth ≥4 mm and bleeding on probing, one site in each quadrant. Samples were cultivated and processed using the PCR technique. Patients received nonsurgical therapy including scaling and root planing (SRP) and were randomly assigned to a probiotic (n=16), antibiotic (n = 16) or placebo (n = 15) group. L. rhamnosus SP1 was taken once a day for 3 months. Azithromycin 500mg was taken once a day for 5 days. All groups showed improvements in clinical and microbiological parameters at all time points evaluated. Probiotic and antibiotic groups showed greater reductions in cultivable microbiota compared with baseline. The placebo group showed greater reduction in number of subjects with P. gingivalis compared with baseline. However, there were no significant differences between groups. The adjunctive use of L. rhamnosus SP1 sachets and azithromycin during initial therapy resulted in similar clinical and microbiological improvements compared with the placebo group.
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Effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6 and 7 year olds: cluster randomised controlled trial (WAVES study).
Adab, P, Pallan, MJ, Lancashire, ER, Hemming, K, Frew, E, Barrett, T, Bhopal, R, Cade, JE, Canaway, A, Clarke, JL, et al
BMJ (Clinical research ed.). 2018;360:k211
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Excess weight in childhood is a global problem affecting around 41 million children under the age of 5 years. In addition to physical and psychosocial health consequences in these early years, childhood excess weight is an important predictor of obesity in adulthood. The aim of the study is to assess the effectiveness of a school and family based healthy lifestyle programme (WAVES intervention) compared with usual practice, in preventing childhood obesity. The primary outcome for clinical effectiveness was the difference in BMI z scores between arms at 15 and 30 months. The study was a school based, cluster randomised, controlled trial where 200 schools were randomly selected from all state run primary schools within 35miles of the study centre (n=980). 144 eligible schools were approached to achieve the target recruitment of 54 schools. The intervention components were delivered over a period of 12 months and targeted the home and school environment. The results show that there was no overall evidence of improvement in the primary outcomes of reduction in body mass index (BMI) z scores at 15 and 30 months after a childhood obesity prevention programme was delivered through schools and targeting 6 and 7-year olds. The intervention did not have any effects on secondary anthropometric, behavioural, or clinical outcomes. A clinically significant difference in BMI z score in favour of the intervention was seen in the first cohort of schools recruited. However, post hoc analysis suggested that this outcome may have been a cohort effect as no effect was seen in group 2 schools at any time point. Authors conclude that the study intervention did not result in a statistically significant difference in BMI z score overall, and there was no evidence of effect on measured diet or physical activity levels in children. However, the lower cost components of the intervention could be considered by schools to fulfil their mandated responsibilities for education on health and wellbeing.
Abstract
OBJECTIVE To assess the effectiveness of a school and family based healthy lifestyle programme (WAVES intervention) compared with usual practice, in preventing childhood obesity. DESIGN Cluster randomised controlled trial. SETTING UK primary schools from the West Midlands. PARTICIPANTS 200 schools were randomly selected from all state run primary schools within 35 miles of the study centre (n=980), oversampling those with high minority ethnic populations. These schools were randomly ordered and sequentially invited to participate. 144 eligible schools were approached to achieve the target recruitment of 54 schools. After baseline measurements 1467 year 1 pupils aged 5 and 6 years (control: 28 schools, 778 pupils) were randomised, using a blocked balancing algorithm. 53 schools remained in the trial and data on 1287 (87.7%) and 1169 (79.7%) pupils were available at first follow-up (15 month) and second follow-up (30 month), respectively. INTERVENTIONS The 12 month intervention encouraged healthy eating and physical activity, including a daily additional 30 minute school time physical activity opportunity, a six week interactive skill based programme in conjunction with Aston Villa football club, signposting of local family physical activity opportunities through mail-outs every six months, and termly school led family workshops on healthy cooking skills. MAIN OUTCOME MEASURES The protocol defined primary outcomes, assessed blind to allocation, were between arm difference in body mass index (BMI) z score at 15 and 30 months. Secondary outcomes were further anthropometric, dietary, physical activity, and psychological measurements, and difference in BMI z score at 39 months in a subset. RESULTS Data for primary outcome analyses were: baseline, 54 schools: 1392 pupils (732 controls); first follow-up (15 months post-baseline), 53 schools: 1249 pupils (675 controls); second follow-up (30 months post-baseline), 53 schools: 1145 pupils (621 controls). The mean BMI z score was non-significantly lower in the intervention arm compared with the control arm at 15 months (mean difference -0.075 (95% confidence interval -0.183 to 0.033, P=0.18) in the baseline adjusted models. At 30 months the mean difference was -0.027 (-0.137 to 0.083, P=0.63). There was no statistically significant difference between groups for other anthropometric, dietary, physical activity, or psychological measurements (including assessment of harm). CONCLUSIONS The primary analyses suggest that this experiential focused intervention had no statistically significant effect on BMI z score or on preventing childhood obesity. Schools are unlikely to impact on the childhood obesity epidemic by incorporating such interventions without wider support across multiple sectors and environments. TRIAL REGISTRATION Current Controlled Trials ISRCTN97000586.
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A poly-herbal blend (Herbagut®) on adults presenting with gastrointestinal complaints: a randomised, double-blind, placebo-controlled study.
Lopresti, AL, Gupta, H, Smith, SJ
BMC complementary and alternative medicine. 2018;18(1):98
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Functional gastrointestinal disorders are a group of conditions with no identifiable or diagnosable abnormality that commonly present as a range of symptoms including motility disturbance, pain and altered gut microbiota. Natural plant compounds show potential for restoring gastrointestinal health and reducing symptoms. Herbagut is a blend of 14 herbal extracts and according to unpublished studies, has exhibited antibacterial activity in the gut as well as improvements in constipation. The aim of this randomised controlled trial was to evaluate the efficacy and tolerability of Herbagut for the treatment of gastrointestinal symptoms in 50 adults with unsatisfactory bowel habits. Participants were randomly allocated to take Herbagut or a matching placebo for 28 days, and gastrointestinal changes and quality of life were measured through questionnaires. This study found Herbagut ingestion over a 28-day period resulted in improvements in several gastrointestinal symptoms, primarily constipation, as well as quality of life. Based on these results, the authors conclude that this poly-herbal blend be used for investigating larger samples and more diverse populations.
Abstract
BACKGROUND To evaluate the efficacy and tolerability of a poly-herbal formulation, Herbagut, for the treatment of gastrointestinal symptoms and its effect on quality of life parameters in patients presenting with self-reported, unsatisfactory bowel habits. METHODS This was a randomised, double-blind, placebo-controlled trial. Fifty adults with self-reported unsatisfactory bowel habits, primarily characterised by chronic constipation were randomly allocated to take Herbagut or a matching placebo for 28 days. Efficacy of gastrointestinal changes was measured by the completion of a patient daily diary evaluating changes in stool type (Bristol Stool Form Scale), ease of bowel movements, and feeling of complete evacuation; and the Gastrointestinal Symptom Rating Scale (GSRS). Changes in quality of life were also examined using the World Health Organization Quality of Life - abbreviated version (WHOQOL-BREF), and the Patient Assessment of Constipation-Quality of Life (PAC-QOL). RESULTS All participants completed the 28-day trial with no adverse events reported. Compared to the placebo, weekly bowel movements increased over time (p < .001), as did self-reported, normal bowel motions (76% vs 4%; p < .001). Self-reported incomplete evacuation was also lower in the Herbagut group compared to placebo (24% vs 76%; p = <.001). GSRS domain ratings for abdominal pain, constipation, diarrhoea, indigestion, and reflux also decreased significantly in people taking Herbagut compared to placebo (p < .001, for all domains). Moreover, quality of life significantly improved in the Herbagut group compared to placebo as indicated by significantly greater improvement in WHOQOL-BREF domain ratings for overall quality of life, social relations, environmental health, psychological health, and physical health (p < .001, for all domains); and PAC-QOL domain ratings for physical discomfort, psychosocial discomfort, worries and concerns, and life satisfaction (p < .001, for all domains). The changes were considered clinically meaningful as evidenced by their large effect sizes. CONCLUSION Herbagut ingestion over a 28-day period resulted in improvements in several gastrointestinal symptoms and overall quality of life. Further investigation utilising larger sample sizes and diverse clinical and cultural populations are needed. TRIAL REGISTRATION Clinical Trials Registry- India /2016/11/007479 . Registered 24 April 2015 (retrospectively registered).
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A randomized placebo-controlled clinical trial of a multi-strain probiotic formulation (Bio-Kult®) in the management of diarrhea-predominant irritable bowel syndrome.
Ishaque, SM, Khosruzzaman, SM, Ahmed, DS, Sah, MP
BMC gastroenterology. 2018;18(1):71
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Irritable bowel syndrome (IBS) is a common condition that has varied symptoms and affects an individual’s quality of life. Whilst there is no one clear factor known to cause IBS, growing evidence suggests that an imbalance of gut bacteria may contribute to IBS symptoms. In this randomised, double-blinded, placebo controlled trial, 400 patients with diarrhea-predominant IBS were assigned to 16 weeks of a multi-strain probiotic, Bio-Kult, or a placebo. Changes to the severity and frequency of abdominal pain, frequency and consistency of bowel movements and quality of life scores were monitored at intervals during the trial period and one month post-treatment. The treatment group receiving the probiotic therapy reported a 69% reduction in abdominal pain (placebo reported a 47% reduction). The number of bowel movements from month 2 of treatment was also significantly improved for the treatment group, as well as all dimensions of quality of life. This study was funded by Protexin, the manufacturers of Bio-Kult Probiotics.
Abstract
BACKGROUND Accumulating evidence supports the view that an imbalance of gut bacteria contributes to IBS, and that increasing the mass of beneficial species may reduce the numbers of pathogenic bacteria and help alleviate symptoms. METHODS In this double-blind trial 400 adult patients with moderate-to-severe symptomatic diarrhea-predominant IBS (IBS-D) were randomized to treatment with the multi-strain probiotic Bio-Kult® (14 different bacterial strains) or placebo for 16 weeks. The change in severity and frequency of abdominal pain was the primary outcome measure. RESULTS Probiotic treatment significantly improved the severity of abdominal pain in patients with IBS-D. A 69% reduction for probiotic versus 47% for placebo (p < 0.001) equates to a 145 point reduction on the IBS-severity scoring system (IBS-SSS). The proportion of patients who rated their symptoms as moderate-to-severe was reduced from 100% at baseline to 14% for the multi-strain probiotic at follow-up (month 5) versus 48% for placebo (p < 0.001). Also, the number of bowel motions per day from month 2 onwards was significantly reduced in the probiotic group compared with the placebo group (p < 0.05). In addition to relieving symptoms, the probiotic markedly improved all dimensions of quality of life in the 34-item IBS-Quality of Life (IBS-QoL) questionnaire. No serious adverse events were reported. CONCLUSIONS The multi-strain probiotic was associated with significant improvement in symptoms in patients with IBS-D and was well-tolerated. These results suggest that probiotics confer a benefit in IBS-D patients which deserves further investigation. TRIAL REGISTRATION [Clinicaltrials.gov NCT03251625 ; retrospectively registered on August 9, 2017].
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Comparison of two low-fat diets, differing in protein and carbohydrate, on psychological wellbeing in adults with obesity and type 2 diabetes: a randomised clinical trial.
Watson, NA, Dyer, KA, Buckley, JD, Brinkworth, GD, Coates, AM, Parfitt, G, Howe, PRC, Noakes, M, Murphy, KJ
Nutrition journal. 2018;17(1):62
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The psychological burden of living with type 2 diabetes (T2D) has far reaching effects, negatively impacting quality of life, physical health and emotional wellbeing. It has been suggested that health-related quality of life (HRQoL) changes in response to weight status however this has not yet been explored in individuals with T2D. The aim of this randomised controlled study was to compare the effects of high protein and high carbohydrate diets, combined with moderate intensity exercise, on psychological wellbeing and HRQoL in 61 overweight adults with T2D. Participants enrolled in a 12-week weight loss period followed by a 12-week weight maintenance phase and blood glucose levels and various quality of life factors were assessed. This trial found in overweight adults with T2D, improvements in several psychological wellbeing and HRQoL were seen in response to modest weight loss and improvements in blood sugar levels. Improvements were seen in both high protein and high carbohydrate group, though a high protein diet may be better for maintaining control of blood glucose levels thus improving feelings of vitality. Based on this study, the authors conclude that it is imperative to address and support the psychological aspects of patients managing T2D.
Abstract
BACKGROUND Although higher-protein diets (HP) can assist with weight loss and glycemic control, their effect on psychological wellbeing has not been established. The objective of this study was to compare the effects of a HP and a higher-carbohydrate diet (HC), combined with regular exercise, on psychological wellbeing both during weight loss (WL) and weight maintenance phases (WM). METHODS In a parallel RCT, 61 adults with T2D (mean ± SD: BMI 34.3 ± 5.1 kg/m2, aged 55 ± 8 years) consumed a HP diet (29% protein, 34% carbohydrate, 31% fat) or an isocaloric HC diet (21%:48%:24%), with moderate intensity exercise, for 12 weeks of WL and 12 weeks of WM. Secondary data evaluating psychological wellbeing was assessed using: Problems Areas in Diabetes (PAID); Diabetes-39 Quality of Life (D-39); Short Form Health Survey (SF-36); Perceived Stress Scale-10 (PSS-10) and the Leeds Sleep Evaluation Questionnaire (LSEQ) at Weeks 0, 12 and 24 and evaluated with mixed models analysis. RESULTS Independent of diet, improvements for PAID; D-39 diabetes control; D-39 severity of diabetes; SF-36 physical functioning and SF-36 general health were found following WL (d = 0.30 to 0.69, P ≤ 0.04 for all) which remained after 12 weeks of WM. SF-36 vitality improved more in the HP group (group x time interaction P = 0.03). Associations were seen between HbA1c and D-39 severity of diabetes rating (r = 0.30, P = 0.01) and SF-36 mental health (r = - 0.32, P = 0.003) and between weight loss and PAID (r = 0.30, P = 0.01). CONCLUSION Several improvements in diabetes-related and general psychological wellbeing were seen similarly for both diets following weight loss and a reduction in HbA1c with most of these improvements remaining when weight loss was sustained for 12 weeks. A HP diet may provide additional increases in vitality. TRIAL REGISTRATION The trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12613000008729 ) on 4 January 2013.
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The effects of fatty fish intake on adolescents' nutritional status and associations with attention performance: results from the FINS-TEENS randomized controlled trial.
Handeland, K, Skotheim, S, Baste, V, Graff, IE, Frøyland, L, Lie, Ø, Kjellevold, M, Markhus, MW, Stormark, KM, Øyen, J, et al
Nutrition journal. 2018;17(1):30
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The consumption of omega-3 rich oily fish is associated with good health and is included as a recommendation in dietary guidelines in many countries. In this randomised controlled trial, 415 Norwegian children were assigned to eat either a fish meal, a meat meal or take a fish oil supplement 3 times a week for 12 weeks, to see if this affected their blood status of fatty acids, Vitamin D and iron, and their urinary status of iodine. In addition, the study measured the effects of the trial intervention on attention performance (visual attention, processing speed and accuracy). The study found that participants were deficient in fatty acids, vitamin D, iron and iodine at baseline. After the intervention, the omega-3 status increased most in the fish oil supplement group, followed by the fish group and lastly the meat group. It was noted that there was a low compliance rate in the fish meal group which many account for the difference between the fish oil supplement and fish meal groups in change in omega-3 status. Vitamin D, iron and iodine increased in all groups, however no differences were noted between the groups, and there were no effects of the changed nutritional markers on attention performance. The authors note that a healthy dietary pattern and intake of oily fish was positively associated with attention performance at baseline.
Abstract
BACKGROUND Adolescence involves changes in dietary habits that may induce imbalances in the intake of different nutrients. Fish is an important dietary source of omega-3 (n-3) long-chain polyunsaturated fatty acids (LCPUFAs), vitamin D, several minerals and high-quality protein. By using secondary outcomes and exploratory analyses, the aims of this paper were to evaluate if nutritional biomarkers (red blood cell fatty acids, serum (s)-25(OH)D, s-ferritin and urinary iodine concentration (UIC)) were altered during a dietary intervention, and if they mediated previously reported changes in attention performance. In addition, to examine the status of the biomarkers and explore associations between dietary pattern, biomarkers and attention performance cross-sectionally at baseline. METHODS The Fish Intervention Studies-TEENS (FINS-TEENS) was a three-armed intervention trial, including adolescents from eight secondary schools (n = 415; age: 14-15y) in Bergen, Norway. Participants were individually randomized to receive either fish meals, meat meals or n-3 LCPUFA supplements, three times a week for a total of 12 weeks. Blood and urine samples were collected pre and post intervention and attention performance was assessed with the d2 test of attention. Analyses of covariance (ANCOVA) assessed differences between groups in changes of biomarkers and linear mixed models were applied in analyses of attention performance and biomarkers. The trial is registered in ClinicalTrials.gov (NCT02350322). RESULTS At baseline, the mean omega-3 index was 5.8 ± 1.3% and deficient status were identified for s-25(OH)D (54%), s-ferritin (10%) and UIC (40%). The intervention resulted in an increase in DHA and the omega-3 index which was larger in the supplement group compared to the fish and meat group (P < 0.01), and in the fish group compared to the meat group (P < 0.01). No differences between the groups were observed for changes in 25(OH)D, s-ferritin or UIC. None of the biomarkers mediated performance in the d2 test. The intake of fatty fish and a healthy dietary pattern was associated with scores in processing speed at baseline. CONCLUSIONS These results show that Norwegian adolescents have insufficient status of important nutrients, which may be improved with fatty fish consumption or n-3 LCPUFA supplements. However, nutritional status was not associated with scores in the d2 test of attention.
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Does additional support provided through e-mail or SMS in a Web-based Social Marketing program improve children's food consumption? A Randomized Controlled Trial.
Rangelov, N, Della Bella, S, Marques-Vidal, P, Suggs, LS
Nutrition journal. 2018;17(1):24
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Nutrition programmes designed for children are often difficult to implement and monitor as parents exert a powerful influence on eating habits. The World Health Organization has started to recommend Social Marketing as a way to promote a healthy diet and other lifestyle behaviours, however it is not currently clear to what extent text or email directed to parents can improve children’s eating behaviour. The aim of this randomised trial was to examine the effect of a Social Marketing healthy nutrition program on children’s food intake, while also considering whether additional support through text or email resulted in additional positive change in 608 children. Families were randomised to one of three groups, where the parent received intervention by Web, Web and email or Web and text, and children’s food consumption was assessed using a food diary. This study showed a Social Marketing tailored program for parents delivered through the Web and complemented with letters directed to children can improve children’s eating behaviours. The additional use of text and email did not significantly improve positive behaviour change.
Abstract
BACKGROUND The FAN Social Marketing program was developed to improve dietary and physical activity habits of families with children in Ticino, Switzerland. The aim of this study was to examine if the effects of the program on children's food intake differed by intervention group. METHODS Effects of the FAN program were tested through a Randomized Controlled Trial. The program lasted 8 weeks, during which participants received tailored communication about nutrition and physical activity. Families were randomly allocated to one of three groups, where the parent received the intervention by the Web (G1), Web + e-mail (G2) or Web + SMS (G3). Children in all groups received tailored print letters by post. Children's food consumption was assessed at baseline and immediate post intervention using a 7-day food diary. Generalized linear mixed models with child as a random effect and with time, treatment group, and the time by treatment interaction as fixed effects were used to test the impact of the intervention. RESULTS Analyses were conducted with a sample of 608 children. After participating in FAN the marginal means of daily consumption of fruit changed from 0.95 to 1.12 in G1, from 0.82 to 0.94 in G2, and from 0.93 to 1.18 in G3. The margins of the daily consumption of sweets decreased in each group (1.67 to 1.56 in G1, 1.71 to 1.49 in G2, and 1.72 to 1.62 in G3). The change in vegetable consumption observed from pre to post intervention in G3 (from 1.13 to 1.21) was significantly different from that observed in G1 (from 1.21 to 1.17). CONCLUSIONS A well-designed Web-based Social Marketing intervention complemented with print letters can help improve children's consumption of water, fruit, soft drinks, and sweets. The use of SMS to support greater behavior change, in addition to Web-based communication, resulted only in a small significant positive change for vegetables, while the use of e-mail in addition to Web did not result in any significant difference. TRIAL REGISTRATION The trial was retrospectively registered in the ISRCTN registry (ID ISRCTN48730279 ).
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High phosphorus intake and gut-related parameters - results of a randomized placebo-controlled human intervention study.
Trautvetter, U, Camarinha-Silva, A, Jahreis, G, Lorkowski, S, Glei, M
Nutrition journal. 2018;17(1):23
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It is known that calcium and phosphate form amorphous calcium phosphate in the small intestines, which can lead to various beneficial changes in the human gut. Currently it remains unclear whether dietary phosphorous influences serum phosphate concentrations. The aim of this study was to analyse the cytotoxicity and genotoxicity of faecal water and faecal concentrations of short chain fatty acids in 62 healthy subjects. All participants received placebo for two weeks, and afterwards an intervention for eight weeks according to the assigned group of either 1000 mg/d phosphorus, 1000 mg/d phosphorus and 500 mg/d calcium and 1000 mg/d phosphorus and 1000 mg/d calcium. Faecal collection took place after the placebo period and after the eight-week intervention period. This study found that the high phosphorus supplementation did not affect the toxicity of faecal water, nor the faecal fat concentrations, independent of calcium. Based on these results, the authors conclude that this study provides first hints for a potential phosphorus-induced modulation of the gut community.
Abstract
BACKGROUND In recent years, high phosphate intakes were discussed critically. In the small intestine, a part of the ingested phosphate and calcium precipitates to amorphous calcium phosphate (ACP), which in turn can precipitate other intestinal substances, thus leading to a beneficial modulation of the intestinal environment. Therefore, we analysed faecal samples obtained from a human intervention study regarding gut-related parameters. METHODS Sixty-two healthy subjects (men, n = 30; women, n = 32) completed the double-blind, placebo-controlled and parallel designed study (mean age: 29 ± 7 years; mean BMI: 24 ± 3 kg/m2). Supplements were monosodium phosphate and calcium carbonate. During the first 2 weeks, all groups consumed a placebo sherbet powder, and afterwards a sherbet powder for 8 weeks according to the intervention group: P1000/Ca0 (1000 mg/d phosphorus), P1000/Ca500 (1000 mg/d phosphorus and 500 mg/d calcium) and P1000/Ca1000 (1000 mg/d phosphorus and 1000 mg/d calcium). After the placebo period and after 8 weeks of intervention faecal collections took place. We determined in faeces: short-chain fatty acids (SCFA) and fat as well as the composition of the microbiome (subgroup) and cyto- and genotoxicity of faecal water (FW). By questionnaire evaluation we examined tolerability of the used phosphorus supplement. RESULTS Faecal fat concentrations did not change significantly due to the interventions. Concentrations of faecal total SCFA and acetate were significantly higher after 8 weeks of P1000/Ca500 supplementation compared to the P1000/Ca0 supplementation. In men, faecal total SCFA and acetate concentrations were significantly higher after 8 weeks in the P1000/Ca1000 group compared to the P1000/Ca0 one. None of the interventions markedly affected cyto- and genotoxic activity of FW. Men of the P1000/Ca1000 intervention had a significantly different gut microbial community compared to the men of the P1000/Ca0 and P1000/Ca500 ones. The genus Clostridium XVIII was significantly more abundant in men of the P1000/Ca1000 intervention group compared to the other groups. Supplementations did not cause increased intestinal distress. CONCLUSIONS The used high phosphorus diet did not influence cyto- and genotoxicity of FW and the concentrations of faecal fat independent of calcium intake. Our study provides first hints for a potential phosphorus-induced modulation of the gut community and the faecal total SCFA content. TRIAL REGISTRATION The trial is registered at ClinicalTrials.gov as NCT02095392 .
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Effect of Lactobacillus rhamnosus HN001 on carriage of Staphylococcus aureus: results of the impact of probiotics for reducing infections in veterans (IMPROVE) study.
Eggers, S, Barker, AK, Valentine, S, Hess, T, Duster, M, Safdar, N
BMC infectious diseases. 2018;18(1):129
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The bacteria Staphylococcus aureus (S. aureus) is found in the digestive tract, nostrils, mouth and armpits. Methicillin-resistant S. aureus (MRSA) is responsible for several difficult-to-treat infections in humans. Probiotics are emerging as an alternative to antibiotics in preventing or treating bacterial infections. This randomised controlled trial aimed to determine the ability of Lactobacillus rhamnosus (L. rhamnosus) HN001 to reduce S. aureus at several different body sites. Participants in the study were mostly male, with an average age of 64 years, and all carriers of S. aureus in one or more body sites. Participants were organised into groups depending on whether S. aureus was found within the gastrointestinal tract (GI) or in other body sites (extra-GI), and given either L. rhamnosus HN001 probiotic, or a placebo for four weeks. Subjects given the probiotic had 15% lower levels of S. aureus in their stool samples than those given the placebo at the end of the trial. They also had 73% reduced odds of methicillin-susceptible S. aureus (MSSA) presence, and 83% reduced odds of any S. aureus presence in the stool sample compared to the placebo group. No other sampling sites showed a significant difference in colonisation between the two groups. The authors concluded that use of daily oral L. rhamnosus HN001 reduced odds of carriage of S. aureus in the GI tract, however it did not eradicate S. aureus from other body sites. The results of the study support the use of this probiotic strain for reducing the population of S. aureus in the gut. Further studies are needed to assess the effectiveness of different probiotic strains and to compare probiotics with antibiotics in reducing S. aureus in other body sites.
Abstract
BACKGROUND Infection by Staphylococcus aureus (S. aureus) is a major cause of morbidity and mortality. Colonization by S. aureus increases the risk of infection. Little is known about decolonization strategies for S. aureus beyond antibiotics, however probiotics represent a promising alternative. A randomized controlled trial was conducted to determine the efficacy of Lactobacillus rhamnosus (L. rhamnosus) HN001 in reducing carriage of S. aureus at multiple body sites. METHODS One hundred thirteen subjects, positive for S. aureus carriage, were recruited from the William S. Middleton Memorial Medical Center, Madison, WI, USA, and randomized by initial site of colonization, either gastrointestinal (GI) or extra-GI, to 4-weeks of oral L. rhamnosus HN001 probiotic, or placebo. Nasal, oropharyngeal, and axillary/groin swabs were obtained, and serial blood and fecal samples were collected. Differences in prevalence of S. aureus carriage at the end of the 4-weeks of treatment were assessed. RESULTS The probiotic and placebo groups were similar in age, gender, and health history at baseline. S. aureus colonization within the stool samples of the extra-GI group was 15% lower in the probiotic than placebo group at the endpoint of the trial. Those in the probiotic group compared to the placebo group had 73% reduced odds (OR 0.27, 95% CI 0.07-0.98) of methicillin-susceptible S. aureus presence, and 83% reduced odds (OR 0.17, 95% CI 0.04-0.73) of any S. aureus presence in the stool sample at endpoint. CONCLUSION Use of daily oral L. rhamnosus HN001 reduced odds of carriage of S. aureus in the GI tract, however it did not eradicate S. aureus from other body sites. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01321606 . Registered March 21, 2011.