The effect of casein glycomacropeptide versus free synthetic amino acids for early treatment of phenylketonuria in a mice model

Introduction Management of phenylketonuria (PKU) is mainly achieved through dietary control with limited intake of phenylalanine (Phe) from food, supplemented with low protein (LP) food and a mixture of free synthetic (FS) amino acids (AA) (FSAA). Casein glycomacropeptide (CGMP) is a natural peptide released in whey during cheese making by the action of the enzyme chymosin. Because CGMP in its pure form does not contain Phe, it is nutritionally suitable as a supplement in the diet for PKU when enriched with specific AAs. Lacprodan® CGMP-20 (= CGMP) used in this study contained only trace amounts of Phe due to minor presence of other proteins/peptides. Objective The aims were to address the following questions in a classical PKU mouse model: Study 1, off diet: Can pure CGMP or CGMP supplemented with Large Neutral Amino Acids (LNAA) as a supplement to normal diet significantly lower the content of Phe in the brain compared to a control group on normal diet, and does supplementation of selected LNAA results in significant lower brain Phe level?. Study 2, on diet: Does a combination of CGMP, essential (non-Phe) EAAs and LP diet, provide similar plasma and brain Phe levels, growth and behavioral skills as a formula which alone consist of FSAA, with a similar composition?. Material and methods 45 female mice homozygous for the Pahenu2 mutation were treated for 12 weeks in five different groups; G1(N-CGMP), fed on Normal (N) casein diet (75%) in combination with CGMP (25%); G2 (N-CGMP-LNAA), fed on Normal (N) casein diet (75%) in combination with CGMP (19,7%) and selected LNAA (5,3% Leu, Tyr and Trp); G3 (N), fed on normal casein diet (100%); G4 (CGMP-EAA-LP), fed on CGMP (70,4%) in combination with essential AA (19,6%) and LP diet; G5 (FSAA-LP), fed on FSAA (100%) and LP diet. The following parameters were measured during the treatment period: Plasma AA profiles including Phe and Tyr, growth, food and water intake and number of teeth cut. At the end of the treatment period, a body scan (fat and lean body mass) and a behavioral test (Barnes Maze) were performed. Finally, the brains were examined for content of Phe, Tyr, Trp, dopamine (DA), 3,4-dihydroxyphenylacetic acid (DOPAC), serotonin (5-HT) and 5-hydroxyindole-acetic acid (5-HIAA), and the bone density and bone mineral content were determined by dual-energy x-ray absorptiometry. Results Study 1: Mice off diet supplemented with CGMP (G1 (N-CGMP)) or supplemented with CGMP in combination with LNAA (G2 (N-CGMP-LNAA)) had significantly lower Phe in plasma and in the brain compared to mice fed only casein (G3 (N)). Extra LNAA (Tyr, Trp and Leu) to CGMP did not have any significant impact on Phe levels in the plasma and brain, but an increase in serotonin was measured in the brain of G2 mice compared to G1. Study 2: PKU mice fed with mixture of CGMP and EAA as supplement to LP diet (G4 (CGMP-EAA-LP)) demonstrated lower plasma-Phe levels but similar brain- Phe levels and growth as mice fed on an almost identical combination of FSAA (G5 (FSAA-LP)). Conclusion CGMP can be a relevant supplement for the treatment of PKU.

Effect of Flouride Varnish in Prevention of Dental Caries

Objective: To assess the effect of 5% sodium fluoride (NaF) varnish application in prevention of caries in mixed dentition rural Jamshoro school children over the course of 6 months. Methods: children with lower stage caries aged 7 to 10 years were included. Students were equally divided in two groups. In Group-A students, 5% fluoride varnish was applied. While in children of control group necessary instructions were given to the student about dietary control. After 3 months, varnish applied teeth on both group’s children were examined again and the rate of caries were documented by using DMFT. After 3 months fluoride varnish was applied to both groups using same method and same directives. Dental caries was examined using the DMFT score after six months of application of fluoride varnish in both groups. All the data was recorded in the proforma. Results: In this study total 108 children were studied, there was no significant difference according to age and brush frequency among both groups p-value 0.146 and 0.088 respectively. Most of the children were using brush among both groups. A starting of the trail mean of DMFT was 1.22+0.24 in group A and 1.39+0.56 in group B. After 3 months it was almost equal among both groups as, while on six months assessment DMFT was raised in control group in contrast to test group p-value 0.012 Conclusion: It was concluded there was significant preventive effect/impact of fluoride varnish on dental caries. DMFT was raised in control group during 6 months rather than test group. Keywords: Children, Dental caries, Fluoride varnish

Retention, Fasting Patterns, and Weight Loss With an Intermittent Fasting App: A Large-scale, 52-week Observational Study (Preprint)

BACKGROUND Intermittent Fasting (IF) is an increasingly popular approach to dietary control that focuses on the timing of eating rather than the quantity and content of caloric intake. IF practitioners typically seek to improve their weight and other health factors. Millions of practitioners have turned to purpose-built mobile applications to help them track and adhere to their fasts and monitor changes in their weight and other biometrics. OBJECTIVE This study aimed to quantify user retention, fasting patterns, and weight loss by users of two commonly used IF mobile apps. We aimed to describe starting BMI, amount of fasting, frequency of weight tracking, and other demographics as correlates of retention and weight change. METHODS We assembled height, weight, fasting and demographic data for adult users (age 18-100yo) of the LIFE Fasting Tracker and LIFE Extend apps from 2018-2020. Retention up to 52 weeks was quantified based on recorded fasts and correlated with user demographics. Users who provided height and at least two weights and whose first fast and weight records were contemporaneous were included in the weight loss analysis. Fasting was quantified as Extended Fasting Hours (hours beyond 12 in a fast) averaged per Day (EFH/Day). RESULTS 792,692 users were followed for retention based on 26 million recorded fasts. 132,775 (16.7%) of users were retained at 13 weeks, 54,881 (6.9%) at 26 weeks, and 16,478 (2.1%) at 52 weeks, allowing 4 consecutive weeks of inactivity. Weight loss in the qualifying cohort (n=161,346) was strongly correlated with starting BMI and EFH/Day. Users with BMI ≥ 40 lost 11.3% of their starting weight by 52 weeks versus a slight weight gain on average for users with starting BMI <23. Additionally, EFH/Day was an approximately linear predictor of weight loss for a given time point and starting BMI. By week 26, users lost over 1% of their starting weight per EFH/Day on average. Furthermore, users who recorded their weight monthly lost considerably more weight than those who did not (eg, 8.5% vs 3.7% weight loss at week 13 for users with BMI ≥25). By 26 weeks, 69.2% (2985/4313) of users with starting BMI ≥ 25 who recorded monthly weights lost at least 5% of their starting weight, and 39.9% (1722/4313) lost at least 10% body weight. CONCLUSIONS Intermittent Fasting with the LIFE mobile apps appears to be a sustainable approach to weight reduction in the overweight and obese population. Healthy weight and underweight individuals do not lose much weight on average, even with extensive fasting. Obese users lose substantial weight over time, with more weight loss in those who fast more and who record their weight more frequently.

If Mediterranean Diet Could Slow Atherosclerosis Progression, Could Specific Herbal Supplement Achieve the Same?

Dietary Control has been emphasized as an important means to prevent the development of atherosclerosis. It is a form belief without scientific evidence until the early report of the Study on Coronary Diet Intervention with olive oil and Cardiovascular Prevention (CODIOPREV Study on Mediterranean Diet). The current study is using Surrogate market IMT as the objective indicator, to compare the CORDIOPREV volunteers with known cardiovascular disease, which have demonstrated objective reduction in IMT thickness after 5 to 7 years of Mediterranean diet consumption. A study done in Hong Kong since 2003 using a simple twin herb formula for the prevention of progress of atherosclerosis in 4 different groups of patients with cardiovascular diseases, and using the same surrogate marker IMT as the objective indicator, showed comparable results within a much shorter period of 6-12 months. Extensive laboratory tests have also been completed to verify the bioactivities of the twin herb formula on anti-inflammation, anti-oxidation, endothelial protection and regenerative capacity related to atherosclerosis. It is suggested that before more potent therapeutic measures become available to slow atherosclerosis progression are available. The purpose of the paper is to compare the Mediterranean Diet for long term consumption and selective herbal preparations for shorter term or intermittent scheduled intake, and recommend to high-risk individuals.

CONTROLLING DIET EXPERIENCE OF DIABETIC PATIENTS IN BUKITTINGGI, INDONESIA

Background: In 2015, the International Diabetes Federation reported that there were 415 million adultsaged 20 to 79 with diabetes. Indonesia is among the 10 countries with the high number of diabetic patientsand is ranked 7th in the world with the number of patients reaching 10.2 million. Diabetes management canbe done through controlling blood sugar through 4 pillars, namely education, diet, exercise, andmedication. However, the current phenomena show that many diabetics have poor dietary control so theyfail maintain their blood sugar within its normal limits and are at greater risk for diabetes complications.However, we can still find diabetic patients who are able to improve their diet and control their blood sugar.Therefore, getting information from them, especially related to their experience in controlling their diet, isexpected to provide hope and motivation for others. Hence, this study aims to find out and expolore theexperience of diabetics with controlled blood sugar and dietMethods: This study uses a qualitative research method with a descriptive phenomenology approach. Theselection of participants was carried out by using a purposive sampling technique. The number ofparticipants in this study were 5 and data were processed through Colaizzi method.Result:.There are four themes obtained in this study namely: Self-commitment to discipline and dietarycompliance, Fruit as an alternative appetite suppresant, Controlling hunger as a habit, and Channellinghunger to activities. Controlling diet for participants has been succesfully done by created a new habitthrough controlling their hunger, so that they could keep their commitment dan disclipline for dietarycompliance, choosing fruits as alternative suppresant and doing activity for channeling the hunger.Therefore it is important for the nurses to educate the diabetic patients about how to deal with diet issuesthrough controlling a hunger as a habit

Controlling diet experience of diabetic patients in Bukittinggi, Indonesia

Background: In 2015, the International Diabetes Federation reported that there were 415 million adultsaged 20 to 79 with diabetes. Indonesia is among the 10 countries with the high number of diabetic patientsand is ranked 7th in the world with the number of patients reaching 10.2 million. Diabetes management canbe done through controlling blood sugar through 4 pillars, namely education, diet, exercise, andmedication. However, the current phenomena show that many diabetics have poor dietary control so theyfail maintain their blood sugar within its normal limits and are at greater risk for diabetes complications.However, we can still find diabetic patients who are able to improve their diet and control their blood sugar.Therefore, getting information from them, especially related to their experience in controlling their diet, isexpected to provide hope and motivation for others. Hence, this study aims to find out and expolore theexperience of diabetics with controlled blood sugar and dietMethods: This study uses a qualitative research method with a descriptive phenomenology approach. Theselection of participants was carried out by using a purposive sampling technique. The number ofparticipants in this study were 5 and data were processed through Colaizzi method.Result:.There are four themes obtained in this study namely: Self-commitment to discipline and dietarycompliance, Fruit as an alternative appetite suppresant, Controlling hunger as a habit, and Channellinghunger to activities. Controlling diet for participants has been succesfully done by created a new habitthrough controlling their hunger, so that they could keep their commitment dan disclipline for dietarycompliance, choosing fruits as alternative suppresant and doing activity for channeling the hunger.Therefore it is important for the nurses to educate the diabetic patients about how to deal with diet issuesthrough controlling a hunger as a habit

Lipid Profile in Relation to Body Mass Index among Medical College Students in Dhaka, Bangladesh.

Introduction: In Bangladesh, adolescents have unhygienic eating habits; often eating nutritionally unbalanced and junk & fast food diet that is low in dietary fibre and high in cholesterol, simple sugars, fats and additive. These types of dietary habit lead to obesity and dyslipidaemia. Obesity is a worldwide health problem and it is associated with dyslipidaemia and other metabolic syndrome. Objectives: To observe the relationship between Body Mass Index (BMI) and lipid profile among medical college students in Bangladesh. Materials & Methods: This cross sectional observational study was conducted in Department of Medicine, Sir Salimullah Medical College & Mitford Hospital, Dhaka, among the 100 undergraduate medical students. Detailed history, clinical examination and thorough investigations were done and the findings were recorded on a proforma. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Results: Maximum subjects (57.0%) were in the age group 21-23 years. Mean age was 23.42±4.5 years. The prevalence of the different abnormal lipid profile including hypercholesterolaemia, low level of HDL, high level of LDL and hypertriglyceridaemia were: 22.0%, 31.0%, 30.0% and 28.0% respectively. Hypercholesterolaemia and hypertriglyceridaemia levels were significantly associated with increasing body mass index. Conclusion: Overweight and obesity is common among the study subjects and those with higher BMI particularly the older ones tend to have abnormal lipid profile. Therefore adequate dietary control, food habit & life-style modification is needed for prevention of dyslipidemia at early life. Medicine Today 2021 Vol.33(2): 114-119

The best drug supplement for obesity treatment: a systematic review and network meta-analysis

Background Obesity is a complex disease with an increasing prevalence worldwide. There are different weight-management options for obesity treatment, including dietary control, exercise, surgery, and medication. Medications are always associated with different responses from different people. More safety and efficacy of drugs with fewer side effects are valuable for any clinical condition. In this systematic review and network meta-analysis, different anti-obesity drugs are compared to identify the most effective drug. Methods All relevant studies were extracted by searching national and international databases of SID, MagIran, ProQuest, PubMed, Science Direct, Scopus, Web of Science (WoS), and Google Scholar without time limit until October 2020. Finally, the meta-analysis was performed with the 11 remaining studies containing 14 different drug supplements. The standardized mean difference (SMD) was calculated at a 95% confidence interval (CI) to evaluate the effects of each treatment group compared with placebo. A random-effect model was used to evaluate the effect of individual studies on the final result. Heterogeneity and incompatibility of the network were assessed by Cochran’s Q and Higgins I2, and the Net Heat chart, respectively. Data analysis was performed using R software. Results Our results showed that there were significant mean effects in people intervened with Phentermine 15.0 mg + Topiramate 92.0 mg, Phentermine 7.5 mg + Topiramate 46.0 mg, Pramlintide, Naltrexone + Bupropion 32, and Liraglutide, with SMD effects size = − 9.1, − 7.4, − 6.5, − 5.9, − 5.35, respectively. Conclusion This study was performed to compare the effect of different drugs used for weight loss in obese patients. The most effective drugs for weight loss were phentermine and topiramate, pramlintide, naltrexone, bupropion, and liraglutide compared to placebo treatment, respectively. This study provides new insights into anti-obesity drugs and hopes to shed new light on future research to manage and treat obesity.

The influence of diet on polycystic ovary syndrome

Background: Polycystic ovary syndrome (PCOS) is a common endocrinopathy in women in reproductive age. It is estimated that it affects about 5-10% of women aged 18-44. This disease is associated with reproductive dysfunction and metabolic disorders. According to the American Society for Reproductive Medicine (ASRM) 2018 guidelines, the first line treatment for PCOS are lifestyle adjustments, including dietary control and exercise. Hence a lot of research on the diet that is most appropriate for this group of people. Material and methods: PubMed research base was searched using the following keywords: diet, pcos, policystic ovary syndrome in 2017-2021. Results: The diet of women with PCOS is poorly composed, and dietary errors may affect the metabolic disorders occurring in these patients. Women with PCOS tend to have insufficient intakes of vitamin D, fiber, and vitamin B9, as well as excessive sodium intake. Mediterranean, ketogenic, low-carbohydrate, low-glycemic, low-AGE and pod-based diets positively affect this disease in various ways. Conclusions: PCOS is a very diverse disease that affects a large number of women around the world. Changing your lifestyle, including diet and exercise, is the first line treatment. This is why creating the best diet for these patients is extremely important. Current discoveries are very promising and give hope to create a model of nutrition that will be the best for these women. Large, multicentre randomized trials are still needed to develop diets that are appropriate for different patients because the disease picture is heterogeneous.

Dietary Control of Inflammation and Resolution

The healing of any injury requires a dynamic balance of initiation and resolution of inflammation. This hypothesis-generating review presents an overview of the various nutrients that can act as signaling agents to modify the metabolic responses essential for the optimal healing of injury-induced inflammation. In this hypothesis-generating review, we describe a defined nutritional program consisting of an integrated interaction of a calorie-restricted anti-inflammatory diet coupled with adequate levels of omega-3 fatty acids and sufficient levels of dietary polyphenols that can be used in clinical trials to treat conditions associated with insulin resistance. Each dietary intervention works in an orchestrated systems-based approach to reduce, resolve, and repair the tissue damage caused by any inflammation-inducing injury. The orchestration of these specific nutrients and their signaling metabolites to facilitate healing is termed the Resolution Response. The final stage of the Resolution Response is the activation of intracellular 5' adenosine monophosphate-activated protein kinase (AMPK), which is necessary to repair tissue damaged by the initial injury-induced inflammation. The dietary optimization of the Resolution Response can be personalized to the individual by using standard blood markers. Once each of those markers is in their appropriate ranges, activation of intracellular AMPK will be facilitated. Finally, we outline how the resulting activation of AMPK will affect a diverse number of other intercellular signaling systems leading to an extended healthspan.