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Effects of vitamin D, omega-3 and a simple strength exercise programme in cardiovascular disease prevention: The DO-HEALTH randomized controlled trial.
Gaengler, S, Sadlon, A, De Godoi Rezende Costa Molino, C, Willett, WC, Manson, JE, Vellas, B, Steinhagen-Thiessen, E, Von Eckardstein, A, Ruschitzka, F, Rizzoli, R, et al
The journal of nutrition, health & aging. 2024;28(2):100037
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There is an increased risk of developing cardiovascular disease in older adults with an increase in metabolic markers such as lipid levels and blood pressure in old age. Previous studies have shown that non-pharmaceutical interventions such as supplementation with marine omega-3 fatty acids and vitamin D and increasing physical activity may help reduce these metabolic marker levels. This DO-HEALTH double-blinded, randomised, placebo-controlled trial investigated the benefits of marine omega-3 fatty acids, vitamin D3 and a strength training home exercise programme (SHEP) in reducing the lipid levels, hypertension, and other cardiovascular biomarkers and reducing the risk of major cardiovascular events in active older adults. The interventions included supplementation of vitamin D3 2000 IU/day, 1 g omega-3 PUFA of marine origin (330 mg EPA: 660 mg DHA) and 30 minutes of strength training for three days a week. The Do-Health study ran for three years and 2157 active older adults enrolled into the study. This trial showed that omega-3 fatty acid supplementation decreased triglycerides and increased High-density lipoprotein levels. Omega 3 supplementation also showed a non-significant reduction in low-density lipoproteins, non-HDL and total cholesterol in older active adults. The intervention strategies did not show any benefits on hypertension or prevention of major cardiovascular events. Further robust studies using different dosages of supplements and different study durations are required to determine the efficacy of omega-3 fatty acid and vitamin D3 supplementation and strength training in reducing metabolic and cardiovascular biomarkers. However, healthcare professionals can use the results of this trial to understand the benefits of omega-3 fatty acid supplementation in older active adults.
Abstract
BACKGROUND The effects of non-pharmaceutical interventions in the prevention of cardiovascular diseases (CVD) in older adults remains unclear. Therefore, the aim was to investigate the effect of 2000 IU/day of vitamin D3, omega-3 fatty acids (1 g/day), and a simple home strength exercise program (SHEP) (3×/week) on lipid and CVD biomarkers plasma changes over 3 years, incident hypertension and major cardiovascular events (MACE). METHODS The risk of MACE (coronary heart event or intervention, heart failure, stroke) was an exploratory endpoint of DO-HEALTH, incident hypertension and change in biomarkers were secondary endpoints. DO-HEALTH is a completed multicentre, randomised, placebo-controlled, 2 × 2 × 2 factorial design trial enrolling 2157 Europeans aged ≥70 years. RESULTS Participants' median age was 74 [72, 77] years, 61.7% were women, 82.5% were at least moderately physically active, and 40.7% had 25(OH)D < 20 ng/mL at baseline. Compared to their controls, omega-3 increased HDL-cholesterol (difference in change over 3 years: 0.08 mmol/L, 95% CI 0.05-0.10), decreased triglycerides (-0.08 mmol/L, (95%CI -0.12 to -0.03), but increased total- (0.15 mmol/L, 95%CI 0.09; 0.2), LDL- (0.11 mmol/L, 0.06; 0.16), and non-HDL-cholesterol (0.07 mmol/L, 95%CI 0.02; 0.12). However, neither omega-3 (adjustedHR 1.00, 95%CI 0.64-1.56), nor vitamin D3 (aHR 1.37, 95%CI 0.88-2.14), nor SHEP (aHR 1.18, 95%CI 0.76-1.84) reduced risk of MACE or incident hypertension compared to control. CONCLUSION Among generally healthy, active, and largely vitamin D replete, older adults, treatment with omega-3, vitamin D3, and/or SHEP had no benefit on MACE prevention. Only omega-3 supplementation changed lipid biomarkers, but with mixed effects. TRIAL REGISTRATION CLINICALTRIALS. GOV IDENTIFIER NCT01745263.
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Regular use of fish oil supplements and course of cardiovascular diseases: prospective cohort study.
Chen, G, Qian, ZM, Zhang, J, Zhang, S, Zhang, Z, Vaughn, MG, Aaron, HE, Wang, C, Lip, GY, Lin, H
BMJ medicine. 2024;3(1):e000451
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Fish oil, a rich source of omega 3 fatty acids, containing eicosapentaenoic acid and docosahexaenoic acid, has been recommended as a dietary measure to prevent cardiovascular disease. The aim of this study was to examine the effects of fish oil supplements on the clinical course of cardiovascular disease, tracking the progression from a healthy state to conditions such as atrial fibrillation, major adverse cardiovascular events, and ultimately, death. This study was a prospective cohort study conducted using data from the UK Biobank study, which included participants aged 40-69 years. Results showed that among individuals without cardiovascular diseases, regular use of fish oil supplements was associated with a slight increase in the risk of developing atrial fibrillation and stroke. Conversely, for those with existing cardiovascular conditions, fish oil supplements appeared to be beneficial in reducing the risk of progression from atrial fibrillation to major adverse cardiovascular events and death. Authors concluded that although fish oil supplements might pose a risk for atrial fibrillation and stroke among the general population, they could offer benefits in slowing the progression of cardiovascular disease among those already diagnosed with such conditions. Thus, further research is needed to fully understand the mechanisms behind these effects.
Expert Review
Conflicts of interest:
None
Take Home Message:
Fish oil supplements may have different effects for different people and medications may modify their effects. Care should be taken around regular use, and preferably under the guidance of a registered nutrition practitioner.
Evidence Category:
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A: Meta-analyses, position-stands, randomized-controlled trials (RCTs)
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B: Systematic reviews including RCTs of limited number
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C: Non-randomized trials, observational studies, narrative reviews
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D: Case-reports, evidence-based clinical findings
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E: Opinion piece, other
Summary Review:
Introduction
The primary aim of this study was to assess associations between regular use of fish oil supplements and cardiovascular disease (CVD) outcomes and events in people with no known CVD. People at high risk of CVD were included. A secondary aim was to examine the modifying effects of fish oil supplements in people with known CVD for disease progression.
Methods
- Participants from the UK Biobank n=415,737 without known CVD, were followed up over a median period of 11.9 years. All participants were UK inhabitants aged 40-69 years at recruitment. N=130,365 (31.4%) self-reported as regular fish oil users at baseline.
- 6 transitional phases were monitored for disease progression from a healthy state to death including atrial fibrillation, myocardial infarction, stroke, heart failure, and major adverse cardiovascular events.
- Adjustments were made for the following covariates recorded at baseline; age, sex, ethnic group, obesity, hypertension, diabetes, use of specific medications, chronic pulmonary disease, chronic renal failure, and diet and fish consumption (oily and non-oily), alcohol intake and smoking status.
Results
- Use of fish oil supplements in people with no known CVD were associated with increased risk of stroke and atrial fibrillation.
- Risk of major adverse cardiovascular events was greater in women (hazard ratio 1.06, 95% CI 1.00 to 1.11, P value for interaction=0.0055) and non-smokers (1.06, 1.06 to 1.11, p=0.001).
- Regular use of fish oil supplements in people with diagnosed CVD was associated with a decreased risk of disease progression.
- The protective effect was greater in men (hazard ratio 0.93, 95% CI 0.89 to 0.98, P value for interaction=0.003) and older participants >65 (0.91, 0.86 to 0.96, p=0.002).
Conclusion
This study found associations between the use of fish oil supplements and an increased risk of atrial fibrillation and stroke. Conversely, a beneficial association was reported against the progression of CVD. It is not currently known why fish oil supplements may have differential roles. Further studies are needed to confirm these results along with identification of the exact mechanisms. No causal relationships can be drawn due to the observational nature of this study.
Clinical practice applications:
- Adverse effects may be linked to doses or formulations. This data was not available in this study.
- This study provided information on potential associations and not causal relationships.
- Covariates including use of prescription drugs may modify the effects of fish oil supplementation.
- Due to the uncertainty around CVD, caution should be used around the use of fish oil supplements for primary prevention of CVD.
- In relation to disease progression, fish oil supplementation may have anti-hypertriglyceridemia and anti-inflammatory effects, improve endothelial function, and contribute to a reduction in thrombosis. However, the effects may vary dependent on use of statins.
Considerations for future research:
- Observational studies provide information on potential associations only therefore further studies are needed to confirm any causal relationships and the exact mechanisms involved.
- Inconsistent results and conflicting findings between the results in this and other large studies may be due to differing dose and formulations.
- Results were based on hospital inpatient data and may be subject to additional confounding factors. In this study, 66.2% of participants were overweight or obese, 92.4% drank alcohol.
- A high proportion of the study population were white (94.2%) therefore the results may not be generalisable to other ethnic groups. Further studies are needed in a diverse range of populations.
- Future studies should also monitor behavioural changes over time.
Abstract
OBJECTIVE To examine the effects of fish oil supplements on the clinical course of cardiovascular disease, from a healthy state to atrial fibrillation, major adverse cardiovascular events, and subsequently death. DESIGN Prospective cohort study. SETTING UK Biobank study, 1 January 2006 to 31 December 2010, with follow-up to 31 March 2021 (median follow-up 11.9 years). PARTICIPANTS 415 737 participants, aged 40-69 years, enrolled in the UK Biobank study. MAIN OUTCOME MEASURES Incident cases of atrial fibrillation, major adverse cardiovascular events, and death, identified by linkage to hospital inpatient records and death registries. Role of fish oil supplements in different progressive stages of cardiovascular diseases, from healthy status (primary stage), to atrial fibrillation (secondary stage), major adverse cardiovascular events (tertiary stage), and death (end stage). RESULTS Among 415 737 participants free of cardiovascular diseases, 18 367 patients with incident atrial fibrillation, 22 636 with major adverse cardiovascular events, and 22 140 deaths during follow-up were identified. Regular use of fish oil supplements had different roles in the transitions from healthy status to atrial fibrillation, to major adverse cardiovascular events, and then to death. For people without cardiovascular disease, hazard ratios were 1.13 (95% confidence interval 1.10 to 1.17) for the transition from healthy status to atrial fibrillation and 1.05 (1.00 to 1.11) from healthy status to stroke. For participants with a diagnosis of a known cardiovascular disease, regular use of fish oil supplements was beneficial for transitions from atrial fibrillation to major adverse cardiovascular events (hazard ratio 0.92, 0.87 to 0.98), atrial fibrillation to myocardial infarction (0.85, 0.76 to 0.96), and heart failure to death (0.91, 0.84 to 0.99). CONCLUSIONS Regular use of fish oil supplements might be a risk factor for atrial fibrillation and stroke among the general population but could be beneficial for progression of cardiovascular disease from atrial fibrillation to major adverse cardiovascular events, and from atrial fibrillation to death. Further studies are needed to determine the precise mechanisms for the development and prognosis of cardiovascular disease events with regular use of fish oil supplements.
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Effects of Omega-3 fatty acids supplementation and resistance training on skeletal muscle.
Uchida, Y, Tsuji, K, Ochi, E
Clinical nutrition ESPEN. 2024;61:189-196
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The age-related decline in muscle strength and skeletal muscle mass can impede the daily lives of older adults and make independent living difficult. The study aimed to investigate the effects of omega-3 fatty acids supplementation and resistance training on muscle strength and mass. This study was a systematic review and meta-analysis of five studies. Results showed that: - omega-3 fatty acids supplementation, when combined with resistance training, significantly improved muscle strength compared to the placebo-controlled group. - no significant effects were observed in terms of muscle mass. Authors concluded that omega-3 fatty acids and strength training could be a potential strategy in preventing sarcopenia.
Abstract
BACKGROUND & AIMS The aim of this study was to investigate the omega-3 fatty acids supplementation, and resistance training on muscle strength and mass. METHODS A review was conducted by searching relevant randomized controlled trials investigating the effects of omega-3 fatty acids supplementation and resistance training on skeletal muscle strength and mass. Three experts independently performed a thorough examination of the literature database and conducted the systematic review and meta-analysis. RESULTS Four studies were ultimately included in the systematic review after screening. The results of the meta-analysis revealed that the supplementation of omega-3 fatty acids and resistance training significantly improved muscle strength compared to the placebo-controlled group. However, no significant effects were observed in the effect for muscle mass. CONCLUSIONS The interventions of omega-3 fatty acids supplementation and resistance training show promise as a countermeasure against muscular dysfunction. While further research is warranted to investigate its effects on skeletal muscle mass, the findings of this study hold implications for maintaining and/or improving the quality of life to elderly people.
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Thyroid Health - NED Infobite
Infobite 36_April 2023. Summaries of key research on thyroid health
2024
Abstract
Thyroid disease takes multiple forms and has far reaching effects on human health. This NED Infobite looks at different supplementation options, in particular focusing on synbitoics, Vitamin D, omega-3 fatty acids and selenium. BANT's scientific NED InfoBites are designed to provide key elements of the latest research using plain language. They provide quick overviews on particular health issues and nutrition topics for a speedy introduction to the science. Visually attractive and easily shareable with clients and social media followers.
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Novel Therapies for Ageing - NED Infobite
Infobite 54_June 2024. Summaries of key research on novel therapies for ageing
2024
Abstract
This NED Infobite features nutrition science on collagen peptides for various aspects of ageing, the effects of whey and soy proteins on inflammatory cytokines, the impacts of probiotics on muscle and muscle function, and the effects of omega-3 fatty acid supplementation on lipid profiles and blood pressure. BANT's scientific NED InfoBites are designed to provide key elements of the latest research using plain language. They provide quick overviews on particular health issues and nutrition topics for a speedy introduction to the science. Visually attractive and easily shareable with clients and social media followers.
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Are dietary intake and nutritional status of specific polyunsaturated fatty acids correlated with sarcopenia outcomes in community-dwelling older adults with sarcopenia? - Exploratory results from ENHANce.
Dupont, J, Wauters, E, Dedeyne, L, Vercauteren, L, Amini, N, Lapauw, L, Matthys, C, Verschueren, S, Tournoy, J, Koppo, K, et al
BMC geriatrics. 2023;23(1):272
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Diet plays an important role in the development and treatment of sarcopenia, the age-related loss of muscle mass and function. Besides protein intake, the intake of polyunsaturated fatty acids (PUFAs) is also suggested to influence muscle physiology and sarcopenia progression. The aim of this study was to assess the dietary intake of PUFAs and PUFAs status in a sample of well-defined sarcopenic older adults. This study was a secondary, exploratory, cross-sectional analysis of 29 older adults (aged 65 years or older) with sarcopenia. Results showed that omega-3 PUFAs intake was low in older adults with sarcopenia. Moreover, PUFAs intake and status did not correspond well in this population. Authors concluded that intake or status of omega-3 was positively associated with measures of sarcopenia, whereas intake of omega-6 was negatively associated.
Abstract
AIMS: To explore the relationship between dietary polyunsaturated fatty acids (PUFAs) intake, nutritional PUFAs status and sarcopenia outcomes in sarcopenic older adults. METHODS The Exercise and Nutrition for Healthy AgeiNg (ENHANce) is an ongoing 5-armed triple blinded randomized controlled trial, in sarcopenic older adults (> 65y) aiming to assess the effect of combined anabolic interventions (protein, omega-3 supplement and exercise) on physical performance in these adults, compared to single/placebo interventions. Baseline data were used for a secondary, exploratory, cross-sectional analysis. Dietary PUFAs intake was assessed with 4-day food records, status with RBC membrane fatty acids profiles. Spearman's rho(ρ) correlation coefficients were calculated to explore associations of PUFAs intake and status with sarcopenia-defining parameters (muscle strength, mass and physical performance), physical activity (step count) and quality of life (SF-36, SarQoL). RESULTS In total, 29 subjects (9♂/20♀, mean age 76.3 ± 5.4y) were included. Total omega-3 intake of participants (1.99 ± 0.99 g/d) was below the recommended intake (♂:2.8-5.6 g/d; ♀:2.2-4.4 g/d). Intake and status of PUFAs were not correlated. Regarding correlations with outcomes, α-linolenic acid status was inversely associated with appendicular lean mass (aLM) (ρ:-0.439; p = 0.017), whereas docosahexaenoic acid status was positively associated with aLM (ρ:0.388; p = 0.038). Some omega-3 PUFAs intake and status markers were positively associated with step count, SF-36 and SarQoL scores, whereas gamma-linolenic acid status was inversely associated with SF-36 physical component summary score (ρ = -0.426; p = 0.024). CONCLUSIONS Although intake of omega-3 and omega-6 was low, the present exploratory study generated new hypotheses for potential correlations of PUFAs intake and status with sarcopenia outcomes in older adults with sarcopenia.
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A combined DHA-rich fish oil and cocoa flavanols intervention does not improve cognition or brain structure in older adults with memory complaints: results from the CANN randomized, controlled parallel-design study.
Vauzour, D, Scholey, A, White, DJ, Cohen, NJ, Cassidy, A, Gillings, R, Irvine, MA, Kay, CD, Kim, M, King, R, et al
The American journal of clinical nutrition. 2023;118(2):369-381
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At a population level, interventions that delay the onset of dementia by 2 years are predicted to reduce the number of dementia patients by 20%. Prospective cohort studies have consistently reported cognitive and neurophysiological benefits of the fish-derived omega-3 long-chain polyunsaturated fatty acids (PUFAs), EPA, and DHA and plant-derived flavanols (FLAVs). This study hypothesised that 12-month administration of a combination of 500 mg cocoa FLAVs with 1.5g omega-3 long-chain PUFAs would improve cognitive function in a mixed subjective cognitive impairment and mild cognitive impairment cohort. This study is based on the results of the CANN randomised controlled trial. A total of 258 participants were recruited and randomised to control or test intervention. Following baseline measurements, 125 participants were randomised into the active OM3FLAV intervention group and 121 into the control group. Results showed that the 1-year intervention with EPA and DHA and cocoa FLAVs did not improve cognition or protect the brain against atrophy in older adults with evidence of memory deficits. Authors concluded that given the complexity of neuropathological processes underpinning cognitive decline and dementia risk, multidomain, multinutrient, or whole diet approaches may be needed to positively impact the cognitive trajectory in the medium term (months to 3 years).
Abstract
BACKGROUND There is evidence that both omega-3 long-chain polyunsaturated fatty acids (PUFAs) (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) and cocoa flavanols can improve cognitive performance in both healthy individuals and in those with memory complaints. However, their combined effect is unknown. OBJECTIVES To investigate the combined effect of EPA/DHA and cocoa flavanols (OM3FLAV) on cognitive performance and brain structures in older adults with memory complaints. METHODS A randomized placebo-controlled trial of DHA-rich fish oil (providing 1.1 g/d DHA and 0.4 g/d EPA) and a flavanol-rich dark chocolate (providing 500 mg/d flavan-3-ols) was conducted in 259 older adults with either subjective cognitive impairment or mild cognitive impairment. Participants underwent assessment at baseline, 3 mo, and 12 mo. The primary outcome was the number of false-positives on a picture recognition task from the Cognitive Drug Research computerized assessment battery. Secondary outcomes included other cognition and mood outcomes, plasma lipids, brain-derived neurotrophic factor (BDNF), and glucose levels. A subset of 110 participants underwent structural neuroimaging at baseline and at 12 mo. RESULTS 197 participants completed the study. The combined intervention had no significant effect on any cognitive outcomes, with the exception of reaction time variability (P = 0.007), alertness (P < 0.001), and executive function (P < 0.001), with a decline in function observed in the OM3FLAV group (118.6 [SD 25.3] at baseline versus 113.3 [SD 25.4] at 12 mo for executive function) relative to the control, and an associated decrease in cortical volume (P = 0.039). Compared with the control group, OM3FLAV increased plasma HDL, total cholesterol ratio (P < 0.001), and glucose (P = 0.008) and reduced TG concentrations (P < 0.001) by 3 mo, which were sustained to 12 mo, with no effect on BDNF. Changes in plasma EPA and DHA and urinary flavonoid metabolite concentrations confirmed compliance to the intervention. CONCLUSIONS These results suggest that cosupplementation with ω-3 PUFAs and cocoa flavanols for 12 mo does not improve cognitive outcomes in those with cognitive impairment. This trial was registered at clinicaltrials.gov as NCT02525198.
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Advancements in Nutritional Strategies for Gestational Diabetes Management: A Systematic Review of Recent Evidence.
Sánchez-García, JC, Saraceno López-Palop, I, Piqueras-Sola, B, Cortés-Martín, J, Mellado-García, E, Muñóz Sánchez, I, Rodríguez-Blanque, R
Journal of clinical medicine. 2023;13(1)
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Gestational Diabetes Mellitus (GDM) causes hyperglycaemia due to the deficit of insulin during pregnancy. Dietary and lifestyle management plays a vital role in maintaining glycaemic control in women with GDM to avoid health risks to the mother and baby. Therefore, this systematic review of fourteen randomised controlled trials evaluated the latest research advancements to identify effective nutritional strategies for managing hyperglycaemia in women with GDM. Among all the dietary strategies implemented in the included randomised controlled trials, probiotic supplementation and supplementation of probiotics and vitamin D were most effective in GDM. Further robust studies are required to evaluate the potential effectiveness of different nutritional strategies for managing GDM. Healthcare professionals can use the results of this systematic review to understand the latest evidence supporting nutritional strategy for women with GDM and the need for personalised support for managing hyperglycaemia in GDM.
Abstract
Gestational diabetes mellitus (GDM) is defined as hyperglycaemia first detected at any time during pregnancy with values lower than those determined by the WHO for diabetes diagnosis in adults. This pathology, with a worldwide prevalence of 13.4%, causes significant maternal and foetal risks. The first line of treatment consists of maintaining normo-glycaemia through an adequate diet and lifestyle changes. The aim is to synthesize the scientific evidence updating the nutritional recommendations for the effective management of GDM. A systematic review of the scientific literature was conducted following the PRISMA guidelines. Randomized clinical trials published within the last five years and providing information on nutritional recommendations to achieve an effective management of gestational diabetes were selected. The databases searched were PubMed, the WOS Core Collection, SCOPUS, and CINAHL, using the MeSH terms: "Diabetes, Gestational"; "Nutrition Assessment (nutrition*)"; "Diet"; "Eating"; and "Food"; with the Boolean operators "AND" and "OR". The PEDro scale (Physiotherapy Evidence Database) was used to assess the scientific quality of the studies, with a mean score of 8.9, indicating an average good scientific quality. Results: A total of 809 papers were collected, of which, after applying the inclusion and exclusion criteria, 14 randomized clinical trials were selected. Probiotic supplementation and co-supplementation with vitamin D have been found to be the most beneficial options for both mothers with GDM and neonates, but the most effective regimens are not known. Diets enriched with extra virgin olive oil (EVOO) and oat bran, as well as some recommendations focused on carbohydrates also seem effective, as well as diets designed for this group of women with GDM such as "CHOICE". Conclusions: Although there are numerous proposals that have been published in recent years focused on the diet of women with GDM in order to improve their results and those of their children, it is the supplementation with probiotics and the co-supplementation with vitamin D that is most agreed upon as beneficial; however, more research is needed into which protocols are most effective. Other proposals that could also be beneficial should be further studied.
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Effect of aerobic exercise alone or combined with Mediterranean diet on dry eye in obese hypertensive elderly.
Ismail, AMA, El-Azeim, ASA, Saif, HFAEA
Irish journal of medical science. 2023;192(6):3151-3161
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Tear deficiency or excessive evaporation is the main descriptive definition of the tear film disorder, dry eye (DE). DE can damage the interpalpebral ocular surface with subsequent symptoms of ocular discomfort. Considering DE a lifestyle disease, the application of caloric restrictive and exercise approaches is an advisable lifestyle for DE patients. The aim of this study was to investigate the effect of a 6-month high-intensity interval aerobic exercise (conducted 30 min, 3 times weekly) alone or combined with a caloric-restriction approach, the Mediterranean diet (MD), on DE parameters in obese hypertensive elderly. This study was a single-blinded randomised controlled trial of DE parameters. The participants were randomly selected obese hypertensive patients with DE and were assigned to one of the two groups. Results showed that exercise (high-intensity interval aerobic bicycling - HIIAB) can significantly relieve DE symptoms. DE relief can be also maximised by the additional effect of MD in obese hypertensive elderly with DE. Authors concluded that DE patients who maintained a 6-month energy-expenditure protocol (a 30-min HIIAB, 3 times per week) exhibited more significant improvements in subjective and objective DE parameters when this exercise protocol accompanied by a dietary restriction program, MD.
Abstract
BACKGROUND Lifestyle modification is a newly recommended complementary treatment for dry eye (DE) disorder. OBJECTIVE To investigate the effect of a 6-month high-intensity interval aerobic exercise (HIIAE) (conducted 30 min, 3 times weekly) alone or combined with a caloric-restriction approach, the Mediterranean diet (MD), on DE parameters in obese hypertensive elderly. THE DESIGN, SETTINGS, PARTICIPANTS, AND INTERVENTION This is a randomized controlled trial included sixty obese hypertensive elderly with DE based on university-based hospital recruitment. Elderly were randomly assigned to the experimental group (n = 30 elderly received HIIAE plus MD) and control group (n = 30 elderly received only HIIAE). Besides anthropometry (abdominal circumference, body weight, and body mass index) and blood pressure (measured in systole and diastole), DE parameters (tear film break-up time, DE scoring system, ocular surface disability index questionnaire, Schirmer's test, and Oxford grading system) were evaluated. RESULTS Significant improvements in anthropometry, blood pressure, and DE parameters were higher in the experimental group than in the control group. CONCLUSION Aging-related DE symptoms and signs can be prevented and/or treated with HIIAE alone or combined with MD in obese hypertensive elderly with DE disorder.
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The effect of fish oil supplementation on resistance training-induced adaptations.
Heileson, JL, Machek, SB, Harris, DR, Tomek, S, de Souza, LC, Kieffer, AJ, Barringer, ND, Gallucci, A, Forsse, JS, Funderburk, LK
Journal of the International Society of Sports Nutrition. 2023;20(1):2174704
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The preservation and promotion of skeletal muscle mass and strength is critical for physical performance and healthy physiology throughout the lifespan. Resistance exercise training (RET) may be one of the best- and well-established strategies to influence these parameters. The study aimed to investigate the impact of fish oil supplement (FOS) compared to placebo (PL) on RET-induced adaptations following a 10-week RET programme. This study was a randomised, single-blind, parallel-group design study. Twenty-eight young male (n = 12) and female (n = 16) adults were recruited and randomly assigned to one of the two groups. Results showed that: - Blood eicosapentaenoic acid + docosahexaenoic acid levels significantly increased in the FOS group (+109.7%) but remained unchanged in the PL group (+1.3%). - lean body mass, fat mass, and percentage body fat changes were similar between groups, although the effect size for fat mass favoured FOS (d = 0.84). - Absolute and relative 1RMBP (1 repetition maximum testing via bench press) strength were significantly higher in the FOS group compared to PL. - Absolute 1RMSQT (1 repetition maximum testing via the back squat) strength was similar between conditions. Authors concluded that FOS may be explored as a feasible and cost-effective nutritional strategy to influence general health and training adaptations, primarily for those with low blood or suboptimal dietary intake of long chain omega-3 polyunsaturated fatty acids.
Abstract
BACKGROUND Resistance exercise training (RET) is a common and well-established method to induce hypertrophy and improvement in strength. Interestingly, fish oil supplementation (FOS) may augment RET-induced adaptations. However, few studies have been conducted on young, healthy adults. METHODS A randomized, placebo-controlled design was used to determine the effect of FOS, a concentrated source of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), compared to placebo (PL) on RET-induced adaptations following a 10-week RET program (3 days·week-1). Body composition was measured by dual-energy x-ray absorptiometry (LBM, fat mass [FM], percent body fat [%BF]) and strength was measured by 1-repetition maximum barbell back squat (1RMSQT) and bench press (1RMBP) at PRE (week 0) and POST (10 weeks). Supplement compliance was assessed via self-report and bottle collection every two weeks and via fatty acid dried blood spot collection at PRE and POST. An a priori α-level of 0.05 was used to determine statistical significance and Cohen's d was used to quantify effect sizes (ES). RESULTS Twenty-one of 28 male and female participants (FOS, n = 10 [4 withdrawals]; PL, n = 11 [3 withdrawals]) completed the 10-week progressive RET program and PRE/POST measurements. After 10-weeks, blood EPA+DHA substantially increased in the FOS group (+109.7%, p< .001) and did not change in the PL group (+1.3%, p = .938). Similar between-group changes in LBM (FOS: +3.4%, PL: +2.4%, p = .457), FM (FOS: -5.2%, PL: 0.0%, p = .092), and %BF (FOS: -5.9%, PL: -2.5%, p = .136) were observed, although, the between-group ES was considered large for FM (d = 0.84). Absolute and relative (kg·kg [body mass]-1) 1RMBP was significantly higher in the FOS group compared to PL (FOS: +17.7% vs. PL: +9.7%, p = .047; FOS: +17.6% vs. PL: +7.3%, p = .011; respectively), whereas absolute 1RMSQT was similar between conditions (FOS: +28.8% vs. PL: +20.5%, p = .191). Relative 1RMSQT was higher in the FOS group (FOS: +29.3% vs. PL: +17.9%, p = .045). CONCLUSIONS When combined with RET, FOS improves absolute and relative 1RM upper-body and relative 1RM lower-body strength to a greater extent than that observed in the PL group of young, recreationally trained adults.