Magnesium and Intrauterine Growth Restriction

Background: The presence of intrauterine growth restriction (IUGR), could potentially lead to imbalances of Mg homeostasis, which have not yet been fully clarified.

Objective: To describe, in term newborn (NB) without IUGR, ionized magnesium (iMg) and total magnesium (TMg) concentrations in umbilical cord blood, on the third and seventh days of life and to compare these values with those of term NB with IUGR.

Methods: A prospective study was performed on 70 term NB divided into two groups: Group I—30 NB without IUGR and Group II—40 NB with IUGR. TMg concentrations were determined in sera by a classical colorimetric end point method (Cobas-Mira, Roche), and iMg was determined in whole blood by means of the Stat Profile-M analyzer (NOVA Biomedical).

Results: We found that in term NB without IUGR, TMg concentrations increased during the first week of life and were lower than those of NB with IUGR in cord blood (p < 0.05). NB without IUGR had decreased iMg concentrations in comparison to NB with IUGR in all sampling times, i.e., cord blood, third and seventh days of life (p < 0.001). iMg concentrations remained unchanged during the study period. We also found that all NB enrolled in the study presented with low iMg concentrations (reference interval 0.4–0.6 mmol/L).

Conclusion: The presence of IUGR may influence neonatal levels of magnesium, suggesting an effect on the modulation of this ion homeostasis, during the perinatal period.     

Feasibility of Intravenous Iron Isomaltoside to Improve Anemia and Quality of Life During Palliative Chemotherapy for Esophagogastric Adenocarcinoma

Background: Anemia is common with esophagogastric adenocarcinoma, increasing mortality, blood transfusions, and reducing quality of life (QOL). No clear evidence exists for safe and effective treatment.

Methods: Anemic patients (Hb <12?g/dl women, <13?g/dl men) with esophagogastric adenocarcinoma were recruited before initiation of palliative chemotherapy. Patients were randomized to standard care or single dose of intravenous iron isomaltoside (IVI) before chemotherapy. Post-chemotherapy changes in hemoglobin (Hb), ferritin, transferrin saturations (TSAT), blood transfusions, and QOL were recorded for three cycles of chemotherapy.

Results: Twenty-seven patients were randomized to standard care (n?=?13) or IVI (n?=?14). No significant change in Hb was seen (standard care MD –0.6?g/dl 95% CI –0.1–1.1?g/dl, P?=?0.336; IVI MD +0.5?g/dl 95% CI –0.1–1.1?g/dl, P?=?0.903). An increase in ferritin was seen with IVI after cycle one of chemotherapy (standard care 116?ng/ml; IVI 770?ng/ml, P?<?0.05). No difference in blood transfusions was seen between groups (P?=?0.851). IVI improved QOL with physical well-being, emotional well-being, anemia-specific QOL, trial outcome index, and total scores all exceeding minimum clinically important difference. No improvement was seen with standard care.

Conclusions: This feasibility study suggests IVI improves quality of life and ferritin. Larger adequately powered studies are required to definitively conclude if hemoglobin and blood transfusion changes with IVI.     

Vitamin and Mineral Intakes in Adults with Mood Disorders: Comparisons to Nutrition Standards and Associations with Sociodemographic and Clinical Variables

Objective: The purpose of this study was to investigate the nutrient intakes of people with mood disorders.

Method: A cross-sectional survey using 3-day food records was carried out in 97 adults with bipolar or major depressive disorder to compare nutrient intakes with Dietary Reference Intakes and British Columbia Nutrition Survey (BCNS) data. Blood levels of selected nutrients were compared to reference ranges. Bivariate and multivariate analyses examined the effects of sociodemographic and clinical variables on nutrient intakes.

Results: The average age of respondents was 46 (±13) years; most were women (n = 69) who had less than a university degree (n = 60) and whose incomes were in the government-defined lower range (n = 39). Compared with the BCNS, a larger proportion of the sample was below the estimated average requirement for thiamin (26% vs 8%), riboflavin (21% vs 4%), folate (64% vs 27%), phosphorous (12% vs 1%), and zinc (39% vs 15%; all P < 0.0001), as well as vitamin B₆ (25% vs 16%) and vitamin B₁₂ (27% vs 8%; both P < 0.05). Combined intakes of food and supplements helped reduce the prevalence of inadequacy; however, with supplementation, the proportion of participants exceeding the tolerable upper intake levels for niacin, vitamin B₆, folate, vitamin C, calcium, magnesium, iron, and zinc ranged from 1%–8%. Income, relationship status, age, gender, and caloric intake were associated with intakes of many nutrients. Types of medications were associated with nutrient intakes, as lower intakes of thiamin and phosphorous (P < 0.05) were found with antidepressant use, higher calcium and iron intakes (P < 0.05) were associated with antianxiety medication use, and magnesium intakes were increased with mood stabilizers (regression coefficient = 52.61, P < 0.05, 95% confidence interval = 0.74 to 104.48).

Conclusions: Adults with mood disorders are at risk for many nutrient inadequacies, as well as occasional excesses; social, demographic, and clinical factors may affect their nutrient intakes.     

Effect of Micronutrient-Fortified Milk on Zinc Intake and Plasma Concentration in Adolescent Girls

Objective: To assess the effect of dietary fortified milk with zinc and other micronutrients on zinc intake and plasma zinc content of adolescent girls.

Methods: The study included 108 schoolgirls (12–18 years old) from northwest Mexico, randomly assigned to either the control group (CG; n = 55) or the intervention group consuming a regular diet plus fortified milk (MG; n = 53). At the beginning of the study, age, weight, and height were measured. Food intake by the 24-hour recall method and plasma zinc levels assessed by absorption spectrophotometry were determined before and after 27 days of fortified milk intake.

Results: At baseline, no significant group-related differences were observed for energy, protein intake, zinc intake, and plasma zinc level (p > 0.05), and 35.2% of participant girls did not achieve their zinc requirement. After 27 days of treatment, there were no significant differences in energy and protein intake between groups (p > 0.05). Zinc intake was higher for MG than CG (16.7 ± 8.3 mg/d vs 10.5 ± 6.4 mg/d; p < 0.01), and there was a lower proportion of low zinc intake in MG than for CG (7 vs 16, respectively; p = 0.04). In addition, plasma zinc improved in the MG (116.6 ± 26.9 μg/dL, p < 0.01) compared with CG (98.5 ± 26.6 μg/dL), and it was mainly attributed to the fortified milk intake, as the main dietary zinc contributor.

Conclusion: Fortified milk intake is effective in increasing both intake and plasma zinc levels of adolescent Mexican girls; therefore, it could be an adequate strategy for zinc deficiency prevention or correction among adolescent girls.     

Maternal Nutrition and Birth Size among Urban Affluent and Rural Women in India

Background: Varying results of worldwide intervention programs to pregnant mothers necessitate the need to understand the relationship between maternal nutrition and birth size among well nourished and undernourished mothers.

Objective: To examine this relationship among urban affluent mothers and to compare the findings with those on rural Indian mothers.

Subjects: Data collected on urban affluent mothers (n = 236) was compared with rural mothers (n = 633).

Design: Mothers were contacted at 18 ± 2 and 28 ± 2 wk of gestation for anthropometry, dietary intakes [24-hr recall, Food Frequency Questionnaire (FFQ)] and after delivery for neonatal anthropometry.

Results: Despite large differences in nutritional status of urban and rural mothers ( pre-pregnant weight 55.9 ± 9.2 Vs 41.5 ± 5.2 kg, respectively) maternal fat intakes at 18 wk were associated with birth weight (p < 0.05), length (p < 0.01) and triceps skin fold thickness (p < 0.05) of the newborn in urban and rural mothers. Consumption of fruits was associated with birth length (p < 0.05) in urban (18wk) and with birth weight (p < 0.01) and length (p < 0.01) in rural (28wk) mothers, when their energy intakes were low. Maternal consumption of milk too, was associated with newborn's triceps (p < 0.01) in urban (28wk) while with birth weight (p < 0.05) and length (p < 0.05) in rural (18wk) mothers. The findings mainly underscore the importance of consumption of micronutrient rich foods, when energy intakes are limiting during pregnancy, for improving birth size.

Conclusions: Creating nutritional awareness and motivating rural mothers for consuming micronutrient rich foods like green leafy vegetables and seasonal fruits that are easily available in rural areas, will be a much affordable solution for combating the problem of low birth weight rather than waiting for improvement in the existing nationwide programs for pregnant women.     

Feeding Tolerance in Preterm Infants: Randomized Trial of Bolus and Continuous Feeding

Objective: To test the hypothesis that continuous gastric infusion (CGI) is better tolerated than intermittent gastric bolus (IGB) in small very low birth weight (VLBW) infants.

Design: Two-center, prospective, randomized, unmasked clinical trial.

Patients: 28 VLBW infants (birth weight <1250 g). A strict feeding protocol was followed.

Intervention: Patients were randomized to IGB or CGI.

Main outcome measures: Time to reach full feeds (160 cc/kg/d)(by design and real), daily weight, caloric intake, residual gastric volume and type of feeding (formula vs. human milk vs. both).

Results: Five infants failed to complete the study because of death (n = 4) or protocol violation (n = 1). The two groups did not differ by birth weight or gestational age; infants fed via IGB reached full feeds earlier (p = 0.03) and had less delay in reaching full feeds than infants fed via CGI.

Conclusion: Contrary to our hypothesis, gravity IGB is more effective than CGI in improving feeding tolerance in small VLBW infants.     

Prevalence and predictors of anemia in a population of North Indian children

ObjectiveAnemia is an important health concern worldwide, particularly in poor populations such as in India. The objective of this study was to determine the prevalence and predictors of anemia and iron status.MethodsOne thousand children ages 6 to 30 mo were included in a study undertaken in low- to middle-income neighborhoods in New Delhi, India. Children of Tigri and Dakshinpuri were identified through a community survey. Plasma concentrations of hemoglobin (Hb), soluble transferrin receptor (sTfR), folate, vitamin B₁₂, and total homocysteine (tHcy) were measured. Predictors for plasma Hb concentration were identified in multiple linear regression models and considered significant if P-value <0.05.ResultsThe prevalence of anemia (Hb concentration <11 g/dL) was 69.6% (n = 696) whereas the prevalence of iron deficiency (elevated sTfR i.e., >4.7 nmol/L) was 31% (n = 309). The main predictors for Hb concentration were plasma concentrations of sTfR (standardized beta coefficient [β], −0.49; P < 0.001), folate (β, 0.15; P < 0.001), vitamin B₁₂ (β, 0.10; P < 0.001), tHcy (β, −0.11; P < 0.001) among the biomarkers. Length-for-age Z score (β, 0.08; P = 0.002) and family income (β, 0.06; P = 0.027) also predicted Hb concentration.ConclusionAnemia was common in this population. Iron, folate, and vitamin B₁₂ status were important predictors for plasma Hb concentration. Improving the status of these nutrients might reduce the burden of childhood anemia in India.     

Zinc deficiency regulates hippocampal gene expression and impairs neuronal differentiation

Abstract

Objectives

Proliferating adult stem cells in the subgranular zone of the dentate gyrus have the capacity not only to divide, but also to differentiate into neurons and integrate into the hippocampal circuitry. The present study identifies several hippocampal genes putatively regulated by zinc and tests the hypothesis that zinc deficiency impairs neuronal stem cell differentiation.

Methods

Genes that regulate neurogenic processes were identified using microarray analysis of hippocampal mRNA isolated from adult rats fed zinc-adequate or zinc-deficient (ZD) diets. We directly tested our hypothesis with cultured human neuronal precursor cells (NT2), stimulated to differentiate into post-mitotic neurons by retinoic acid (RA), along with immunocytochemistry and western analysis.

Results

Microarray analysis revealed the regulation of genes involved in cellular proliferation. This analysis also identified a number of genes known to be involved in neuronal differentiation, including the nuclear RA receptor, retinoid X receptor (RXR), doublecortin, and a transforming growth factor-beta (TGF-β) binding protein (P < 0.05). Zinc deficiency significantly reduced RA-induced expression of the neuronal marker proteins doublecortin and β-tubulin type III (TuJ1) to 40% of control levels (P < 0.01). This impairment of differentiation may be partially mediated by alterations in TGF-β signaling. The TGF-β type II receptor, responsible for binding TGF-β during neuronal differentiation, was increased 14-fold in NT2 cells treated with RA (P < 0.001). However, this increase was decreased by 60% in ZD RA-treated cells (P < 0.001).

Discussion

This research identifies target genes that are involved in governing neurogenesis under ZD conditions and suggests an important role for TGF-β and the trace metal zinc in regulating neuronal differentiation.     

Impact of Weight Loss During Chemotherapy in Chinese Patients with Unresectable Pancreatic Cancer

Background: Weight loss is frequently observed in pancreatic cancer patients. We aimed to study the prognostic impacts of weight loss early during chemotherapy.

Methods: A total of 72 patients of Chinese ethnicity with unresectable pancreatic cancer who underwent chemotherapy were reviewed. Critical weight loss (CWL) was defined as weight loss ≥ 5% within one month after treatment. The prognostic impact of weight loss and CWL were analyzed.

Results: 47 patients (65.3%) had weight loss after one month of treatment, with 14 (19.4%) suffering from CWL. Baseline characteristics were similar between patients with and without CWL. The median OS and Time-to-treatment-failure (TTF) of patients with CWL were shorter than those without CWL (OS: 4.8?months [CWL] versus [vs.] OS 7.1?months [No CWL]; TTF 1.6?months [CWL] vs. 3.2?months [No CWL]; both P?<?0.01). CWL was an independent adverse prognosticator for OS (Hazard Ratio [HR]?=?2.50; P?=?0.01) and TTF (HR = 2.71; P?<?0.01). Other independent prognosticators for OS were serum albumin <35?mg/dl and CA19-9?≥?1000?IU/ml, while CWL was the only independent prognosticator for TTF (HR 2.71 [95% CI 1.33–5.52]; P?<?0.01).

Conclusions: Development of CWL in early course of chemotherapy was associated with worse prognosis in Chinese patients with unresectable pancreatic cancers.     

Iron status of pregnant Indian women from an area of active iron supplementation

ObjectiveThe aim of this study was to investigate the iron status of pregnant tribal women from Ramtek, Nagpur, Maharashtra, India using a combination of indices.MethodsA community-based observational study was conducted to assess iron status using a convenience sample of pregnant Indian tribal women from Ramtek. Pregnant women were recruited at 13 to 22 wk gestation (first visit; n = 211) and followed to 29 to 42 wk gestation (second visit; n = 177) of pregnancy. Sociodemographic and anthropometric data; iron supplement intake; and blood samples for estimating hemoglobin (Hb), serum ferritin (SF), soluble transferrin receptor (sTfR), and C-reactive protein (CRP) were obtained.ResultsThe mean (SD) Hb concentration at recruitment was 106 (15) g/L and 106 (14) g/L at the second visit; 41% of the women at recruitment and 55% at second visit were anemic (14% higher, P < 0.001). No women at recruitment and 3.7% at second visit had SF concentration < 15 ng/mL; and 3.3% at recruitment and 3.9% at the second visit had sTfR > 4.4 ng/mL (0.6% higher, P = 0.179). Almost 62% and 71% of pregnant women used iron supplements at both visits, respectively. Iron supplement intake > 7 d in the preceding month improved the Hb concentration by 3.23 g/L and reduced sTfR concentration by 13%; women who were breastfeeding at the time of recruitment had 11% higher SF concentration.ConclusionsThe iron indices suggest that pregnant tribal women of central India, although anemic, had good iron status. Use of iron supplements > 7 d in the preceding month improved iron status; however, non–iron-deficiency anemia persisted in this group.     

Randomized Placebo-Controlled Trial of Guava Juice as a Source of Ascorbic Acid to Reduce Iron Deficiency in Tarahumara Indigenous Schoolchildren of Northern Mexico

Objective: Assess the efficacy of a 10-week consumption of guava juice on the iron status of children with mild iron deficiency anemia.

Methods: Ninety-five boarding school children aged 6–9 years identified as anemic were randomly allocated to receive 300 mL of natural guava juice containing ～200 mg of ascorbic acid (AA) or placebo (guava-flavored juice free of AA) with the main meal (5 d/wk). Information about dietary intake was collected at weeks 3, 5, and 7 at school and household levels. Changes in hemoglobin (Hb) and plasma ferritin (PF) among the subsample iron deficient at baseline (n = 33) were the main outcomes.

Results: Iron and phytic acid intakes at school and at home did not differ between groups. Baseline Hb and PF were 11.9 ± 0.5 g/dL and 8.2 ± 3.6 ng/mL for the guava, and 11.4 ± 1.1 g/dL and 7.4 ± 4.6 ng/mL for the placebo group (Hb: p = 0.08; PF: p = 0.31); at week 10 of the study, corresponding values were 13.1 ± 0.9 g/dL and 17.9 ± 10.3 ng/mL (n = 16), and 12.3 ± 1.3 g/dL and 15.4 ± 5.8 ng/mL (n = 12) (Hb: p = 0.05; PF: p = 0.21). With analysis of variance (ANOVA) for repeated measures, the guava group had 0.64 g/dL higher Hb (CI₉₅, 0.18–1.11; p = 0.01) and 2.47 ng/mL higher PF (CI₉₅, ?1.04 to 5.98; p = 0.12) compared with the placebo group.

Conclusion: Guava juice providing 200 mg AA at one meal on each school day had a marginal effect on Hb and PF concentrations in children consuming high-phytate diets fortified with iron.     

Microbiota Diversity in Human Colorectal Cancer Tissues Is Associated with Clinicopathological Features

Aim: Few evidences are available regarding the link between microbiota composition in the human colorectal cancer (CRC) tissues and the patients’ clinicopathological features.

Methods: Microbiota diversity in CRC tissues (n?=?30) were profiled and compared by high-throughput sequencing with clinicopathological features, including tumor location, differentiation degree, metastasis, and CRC patients’ gender and age.

Results: Many bacteria with significant difference in abundance were identified associated with these clinicopathological features (P?<?0.05). There was a significant difference in microbial composition between right colon cancers (RCa) vs. left colon cancers (LCa), RCa vs. rectal cancers (P?<?0.05). The amount of Fusobacteria was significantly higher in LCa, moderately and poorly differentiated cancers (MPD), and young patients (<60?years), compared to RCa, well differentiated cancers (WD) and elder patients (>60?years), respectively (P?<?0.05). Helicobacter spp. in RCa and MPD patients was significantly higher than in LCa and WD patients (P?<?0.05). Firmicutes in non-lymph node metastasis (LNM) patients was significantly lower than in LNM patients (P?<?0.05).

Conclusion: The different microbiota composition in the CRCs was associated with patients’ clinicopathological features, which could be a consequence of microflora diversity.     

Dietary polydextrose and galactooligosaccharide increase exploratory behavior,improve recognition memory,and alter neurochemistry in the young pig

Objectives: Previous studies have shown that dietary prebiotics have the potential to improve memory, alter social behavior, and reduce anxiety-like behaviors in rodents. The present research sought to expand upon such results and describe the effects of feeding prebiotics early in life on cognition and neurochemistry using a translational piglet model.

Methods: Pigs were provided customized milk replacer containing 2?g/L each of polydextrose (PDX) and galactooligosaccharide (PDX/GOS) or 0?g/L (Control) from postnatal day (PND) 2-33. Beginning on PND 25, pigs were tested on the novel object recognition (NOR), novel location recognition (NLR), and backtest tasks to measure recognition memory and response to restraint stress. At study conclusion pigs were euthanized and intestine, blood, and brain tissues were collected and analyzed.

Results: PDX/GOS-fed pigs demonstrated recognition memory on the NOR task (P?<?0.001) whereas Control pigs did not (P?=?0.184). Additionally, PDX/GOS-fed pigs visited the novel and sample objects more frequently (all P?<?0.05) while spending less time per visit exploring the sample object (P?=?0.028) than Control pigs. Volatile fatty acids (VFAs) were decreased in the ascending colon (P?<?0.012), whereas butyrate tended to be higher in blood (P?=?0.080) and lower in the hippocampus (P?=?0.061) of PDX/GOS-fed pigs. PDX/GOS-fed pigs exhibited lower serotonin (P?=?0.016) in the hippocampus.

Conclusion: These findings suggest that early life consumption of PDX/GOS supports recognition memory as measured by NOR while modulating the concentrations of VFAs in the colon, blood, and brain, as well as hippocampal serotonin.     

Racial differences in hemoglobin and plasma volume variation: implications for muscle performance and recovery

Objective: To examine the effect of race differences on sprint performance, Hemoglobin (Hb), Hematocrit (Ht) and plasma volume (PV) variation in response to repeated sprint exercise.

Design: Thirty-six healthy, moderately trained men and women (20.8?±?0.2 year-old) volunteered to participate in this study. They were allocated to one of the four groups according to their gender and race: Black men’s group (BM, n?=?9), White men’s group (WM, n?=?9), Black women’s group (BW, n?=?9) and White women’s group (WW, n?=?9). All participants performed the running-based anaerobic sprint test (RAST), which consists of six?35-m sprints with 10 s of recovery in-between. Six venous blood samples were collected to determine Hb, Ht and PV levels at rest, after warm-up, immediately post- and at 5, 15 and 30 min post-RAST. Blood lactate is also sampled during the 3rd minutes of recovery.

Results: The best running time was significantly shorter (P?=?.002) in BW compared to WW. We have observed significantly higher Hb (P?=?.010) and Ht (P?=?.004) levels in BW compared to WW during the 5th minute of recovery. During RAST, the PV decreased significantly (P?=?.007) in WM only. Black groups had lower (P?<?.05) lactate levels compared to the white subjects. During recovery, PV increase was significantly (P?=?.003) higher in WW compared to BW during the 5th minute of recovery.

Conclusion: This study demonstrated that sprint and repeated sprint performances were different between white and black women. Differences in anaerobic performance between the groups were associated with racial differences in lactate levels and blood count among women’s group during recovery time. Hence, it is important to take into account this race-related difference in hematological parameters in responses to intense efforts.     

Relationship Between Serum Zinc Level and Metabolic Syndrome: A Meta-Analysis of Observational Studies

ABSTRACT

Objective: This research sought to summarize the evidence regarding the relationship between serum zinc level and metabolic syndrome (MetS).

Methods: The electronic databases of PubMed, Web of Science, and Embase were searched up to October 2017 for observational studies on the association between serum zinc level and MetS. The standard mean difference (SMD) and its corresponding 95% confidence interval (CI) of the serum zinc level for MetS versus control participants were calculated. In addition, the pooled odds ratio (OR) and relative risk (RR) of MetS for the highest versus lowest category of serum zinc level, as well as their corresponding 95% CI, were also calculated.

Results: A total of 11 observational studies (8 cross-sectional, 1 case-control, and 2 cohort studies) were included in this meta-analysis. The combined SMD demonstrated that the serum zinc level in MetS was higher than that in control participants (SMD = 0.11; 95% CI, 0.03–0.19; p = 0.009). Moreover, the overall multivariable-adjusted RR showed that the increased serum zinc level was associated with a higher risk of MetS (RR = 1.82; 95% CI, 1.33–2.50; p < 0.001). On the contrary, the overall multivariable-adjusted OR showed that there was no significant relationship between serum zinc level and MetS (OR = 1.00; 95% CI, 0.99–1.01; p = 0.841).

Conclusions: Although the serum zinc level in participants with MetS was significantly higher than that in control ones, the existing evidence was still insufficient to conclude a definite relationship between serum zinc level and MetS. More well-designed prospective cohort studies are needed to elaborate the concerned issues further.     

Effects of Preoperative Enteral Nutrition on Postoperative Recent Nutritional Status in Patients with Siewert II and III Adenocarcinoma of Esophagogastric Junction after Neoadjuvant Chemoradiotherapy

Objective: To study the effects of preoperative enteral nutrition (EN) on postoperative recent nutritional status (PRNS) in patients with Siewert II and III adenocarcinomas of esophagogastric junction (AEG) after neoadjuvant chemoradiotherapy (NCRT).

Methods: A total of 66 patients with resectable AEG (Siewert II and III) were randomly divided into two groups. The trial group accepted oral nutrition supplementation (ONS) for 7 days before surgery while the control not.

Results: Nutrition indexes were higher in trial group after surgery whereas the opposite was true for the diamine oxidase (DAO) and d-lactate (P?<?0.05). The rate of malnutrition and nutritional risk became lower in trial group on the 8th day after surgery (P?<?0.05). Injury levels of intestinal mucosa were more severe among control group. The recent prognosis was better in trial group. For patients with or without nutritional risks at admission, the PRNS and recent prognosis were improved by preoperative EN. Logistic regression analysis suggested that preoperative EN could be an independent protective factor of PRNS.

Conclusions: Preoperative EN may improve the PRNS and recent prognosis of patients with Siewert II and III AEG after NCRT.     

Zinc monotherapy increases serum brain-derived neurotrophic factor (BDNF) levels and decreases depressive symptoms in overweight or obese subjects: A double-blind,randomized, placebo-controlled trial

Abstract

Objective

Previous studies have shown a positive effect of zinc as an adjunctive therapy on reducing depressive symptoms. However, to our knowledge, no study has examined the effect of zinc monotherapy on mood. The aim of the present study was to determine the effects of zinc monotherapy on depressive symptoms and serum brain-derived neurotrophic factor (BDNF) levels in overweight or obese subjects.

Methods

Fifty overweight or obese subjects were randomly assigned into two groups and received either 30 mg zinc or placebo daily for 12 weeks. At baseline and post-intervention, depression severity was assessed using Beck depression inventory II (BDI II), and serum BDNF and zinc levels were determined by enzyme-linked immunosorbent assay and atomic absorption spectrophotometry, respectively.

Results

The trial was completed with 46 subjects. After a 12-week supplementation, serum zinc and BDNF levels increased significantly in the zinc-supplemented group compared with the placebo group. BDI scores declined in both the groups at the end of the study, but reduction in the zinc-supplemented group was significantly higher than the placebo group. More analysis revealed that following supplementation, BDI scores decreased in subgroup of subjects with depressive symptoms (BDI ≥ 10) (n = 30), but did not change in the subgroup of non-depressed subjects (BDI < 10) (n = 16). Moreover, a significant inverse correlation was observed between serum BDNF levels and depression severity in all participants. Interestingly, a significant positive correlation was found between serum BDNF and zinc levels at baseline.

Conclusion

Zinc monotherapy improves mood in overweight or obese subjects most likely through increasing BDNF levels.     

Individual,Social, and Environmental Correlates of Energy Drink Use Among Adolescents

ObjectiveTo investigate the correlates of adolescent energy drink (ED) use using a socioecological approach to inform future interventions.MethodsIn 2017–2018, 3,688 students attending 25 randomly selected Western Australian secondary schools completed a self-report survey. A backward stepwise logistic regression analysis was used to construct a model of the most significant individual (n = 12), social (n = 3), and environmental (n = 4) factors associated with being an ED user (ie, past month ED use).ResultsOverall, 18% of participants were ED users. The factors significantly associated with being an ED user included being male (P < 0.001), having a higher disposable income (P < 0.001), perceiving EDs as good for health (P = 0.009), perceiving EDs as safe for someone their age to drink (P < 0.001), having a sensation-seeking personality (P = 0.011), having friends who drink EDs (P < 0.001), having parents who would give them an ED if asked (P < 0.001), and having EDs available at home (P < 0.001).Conclusions and ImplicationsInitiatives to reduce ED intake among adolescents need to be multifaceted, addressing individual, social, and environmental factors. It is also important that educational interventions target both parents and adolescents.     

Methadone-maintained patients in primary care have higher rates of chronic disease and multimorbidity,and use health services more intensively than matched controls

Background: Methadone maintenance treatment in primary care is cost-effective and improves outcomes for opiate-dependent patients. A more developed understanding of the evolving needs of this important cohort will facilitate further improvements in their integrated care within the community.

Objectives: The aim of this study was to compare the burden of chronic disease, multi-morbidity and intensity of health-service use between methadone-maintained patients (MMPs) and matched controls in primary care.

Methods: This is a retrospective matched case-control design. Data on chronic disease and health service use was collected in 13 computerized GP surgeries on 414 patients (207 MMPs and 207 controls). Twelve months of records were examined. MMPs were compared with controls matched by gender, age, socio-economic status (SES) and GP surgery.

Results: MMPs suffered more chronic disease (OR = 9.1, 95% CI: 5.4–15.1, P < 0.001) and multi-morbidity (OR = 6.6, 95% CI: 4.3–10.2, P < 0.001). They had higher rates of respiratory, psychiatric and infectious disease. MMPs of lower SES had more chronic disease than their peers (OR = 7.2, 95% CI: 2.4–22.0, P < 0.001). MMPs attended the doctor more often with medical problems (OR = 15.4, 95% CI: 8.2–28.7, P < 0.001), with a frequent requirement to have medical issues addressed during methadone-management visits. Their care generated more telephone calls (OR = 4.4, 95% CI: 2.8–6.8, P < 0.001), investigations (OR = 1.8, 95% CI: 1.2–2.7, P = 0.003), referrals (2.6, 95% CI: 1.7–4.0, P < 0.001), emergency department visits (2.1, 95% CI: 1.3–3.6, P = 0.004), outpatient attendances (2.3, 95% CI: 1.51–1.43, P < 0.001) and hospital admissions (3.6, 95% CI: 1.6–8.1, P = 0.001).

Conclusion: Correcting for routine methadone care and drug-related illnesses, MMPs had a higher burden of chronic disease and used both primary and secondary health services more intensively than matched controls.