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Evaluation of Lactocare® Synbiotic Administration on the Serum Electrolytes and Trace Elements Levels in Psoriasis Patients: a Randomized, Double-Blind, Placebo-Controlled Clinical Trial Study.
Akbarzadeh, A, Taheri, M, Ebrahimi, B, Alirezaei, P, Doosti-Irani, A, Soleimani, M, Nouri, F
Biological trace element research. 2022;200(10):4230-4237
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Psoriasis is an immune-mediated chronic inflammatory skin disorder characterised by plaques and lesions on the skin. While the etiopathogenesis of psoriasis is not completely understood, various mechanisms have been implicated, including changes in the composition of intestinal microbes, oxidative stress and changes in the levels of certain trace elements. Previous research has shown that fluctuations in trace minerals such as zinc and copper may contribute to the progression and progression of psoriasis. It is known that synbiotics, which are combinations of probiotics and prebiotics, have immune-modulating properties, and they may also enhance the absorption of trace minerals from food when consumed. This double-blind, randomised, placebo-controlled trial was conducted to randomly assign sixty-four patients with mild-to-moderate psoriasis to consume Lactocare, a symbiotic containing seven strains of probiotic bacteria and prebiotic fructooligosaccharide twice daily or a placebo for 12 weeks. Serum trace mineral levels were measured after 12 weeks of treatment, including Fe, K, Ca, Mg, P, Zn, Na, and Cu. A significant improvement in serum levels of zinc and calcium was observed in the symbiotic group after 12 weeks of treatment. Additionally, the symbiotic treatment significantly increased the levels of trace minerals such as Fe, Ca, Mg, P, Zn, and Na within the group compared to the baseline. Fe and Cu levels in the treatment group were affected by sex, with male participants showing significant differences. To evaluate the other benefits of symbiotic preparations in patients with psoriasis, further large-scale studies are required. Healthcare professionals can utilise the research to understand the immune-modulating and anti-inflammatory properties of symbiotic formulations such as Lactocare, as well as to understand how the consumption of Lactocare improves the absorption of trace minerals.
Abstract
BACKGROUND Despite the exact etiopathogenesis of psoriasis remains unknown, the increasing or decreasing of some trace elements and oxidative stress status are considered to play a role. In this study, the effect of Lactocare® synbiotic on the serum levels of trace elements including Zn, Cu, Mg, Na, Fe, P, Ca, and K in the patients with mild to moderate psoriasis was investigated. METHODS Sixty-four patients with mild to moderate psoriasis were included. Patients were randomly divided into treatment (n═32) and control (n═32) groups. The treatment group received Lactocare® and the control group received a placebo (two times daily for 12 weeks). Eight patients from the intervention group and 18 patients from the control group discontinued the study because of the recent COVID-19 condition. For routine trace element analysis, the blood samples were collected from all patients at the baseline as well as week 12 post-treatment. The serum was then isolated and the serum levels of trace elements including Fe, K, Ca, Mg, P, Zn, Na, and Cu were measured using an automatic electrolyte analyzer. For confirmation of the effect of Lactocare® on the alteration of serum levels of trace elements, intra-group analysis was performed at two interval times: baseline and week 12 post-treatment. RESULTS The serum levels of K, P, and Ca in the placebo group were significantly higher than that of the treatment group at baseline. Serum levels of Zn and Ca were significantly higher in the treatment group compared to the placebo group at week 12 post-treatment. Moreover, a significantly lower serum level of K, P, and Ca in the treatment group at the baseline compared to the placebo group was compensated on week 12 post-treatment. Intra-group analysis in the treatment group showed that the serum levels of Fe, Ca, Mg, P, Zn, and Na was significantly increased at week 12 post-treatment compared to baseline levels. Whereas, intra-group analysis in the control group showed only Ca has a significant difference between baseline and week 12 post-treatment. CONCLUSION The serum levels of Fe, Zn, P, Mg, Ca, and Na are increased significantly 12 weeks after oral administration of Lactocare® in psoriatic patients. The serum level of Fe and Cu is affected by sex at pre- and post-treatment. This study supports the concept that Lactocare® exerts beneficial effects in the gastrointestinal tract to improve mineral absorption in psoriatic patients.
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Intake and adequacy of the vegan diet. A systematic review of the evidence.
Bakaloudi, DR, Halloran, A, Rippin, HL, Oikonomidou, AC, Dardavesis, TI, Williams, J, Wickramasinghe, K, Breda, J, Chourdakis, M
Clinical nutrition (Edinburgh, Scotland). 2021;40(5):3503-3521
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This systematic review investigated vegan diets in the European populations and their adequacy of macro-and micronutrient intake, compared to the recommendations of the World Health Organization. Included were 48 studies and their outcomes regarding protein, carbohydrates, fats and micronutrients summarized. The overall results and their impact on health are discussed in the later sections of the paper. Adequate intake amongst vegans was seen with carbohydrates, fats, Vitamin A, B1, В6, C, E, iron, phosphorus, magnesium, copper and folate. Sodium exceeded recommended intake, whilst protein, Vitamin B2, B3, B12, D, iodine, zinc, calcium, potassium, selenium was of low consumption in a vegan diet. The bioavailability of some nutrients was also acknowledged. In summary, following a vegan diet appears to have positive and negative aspects. A vegan diet profile can contribute to disease prevention with lower incidence rates of obesity, Type 2 diabetes, and cardiovascular disease. Yet veganism appears to increase the risk for mental health conditions, bone fractures, immune system impairments, anaemias and deficiencies from low nutrient intake. This review yields a comprehensive overview of the positive and negative health consequences of a vegan diet. It may be a useful reference for those looking to support vegans or individuals considering adopting a vegan diet pattern.
Expert Review
Conflicts of interest:
None
Take Home Message:
- Vegan diets in European populations tend to be lower in protein intake, particularly amino acids lysine, methionine and tryptophan.
- Other micronutrients that tend to lower in vegan diets are Vitamin B12, zinc, calcium and selenium.
- Healthcare practitioners should be aware of these potential deficiencies when working with vegan clients.
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:
Vegan diets have become increasingly popular in the last ten years. This systematic review of 48 studies investigated the adequacy of vegan diets in European populations. It compared their macro- and micronutrient intakes compared to World Health Organization recommendations. It found that vegan diets tend to be lower in protein and in essential amino acids (lysine, methionine and tryptophan). They can also be lower in micronutrients especially vitamin B12, zinc, calcium and selenium. However, the lower intakes are not always associated with health impairments.
Clinical practice applications:
Practitioners should be aware of the potential deficiencies in a vegan diet.
Considerations for future research:
More research is needed to determine whether lower nutrient intakes in vegans correlated with poor health outcomes.
Abstract
BACKGROUND Vegan diets, where animal- and all their by-products are excluded from the diet, have gained popularity, especially in the last decade. However, the evaluation of this type of diet has not been well addressed in the scientific literature. This study aimed to investigate the adequacy of vegan diets in European populations and of their macro- and micronutrient intakes compared to World Health Organization recommendations. METHODS A systematic search in PubMed, Web of Science, IBSS, Cochrane library and Google Scholar was conducted and 48 studies (12 cohorts and 36 cross-sectional) were included. RESULTS Regarding macronutrients, vegan diets are lower in protein intake compared with all other diet types. Veganism is also associated with low intake of vitamins B2, Niacin (B3), B12, D, iodine, zinc, calcium, potassium, selenium. Vitamin B12 intake among vegans is significantly lower (0.24-0.49 μg, recommendations are 2.4 μg) and calcium intake in the majority of vegans was below recommendations (750 mg/d). No significant differences in fat intake were observed. Vegan diets are not related to deficiencies in vitamins A, B1, Β6, C, E, iron, phosphorus, magnesium, copper and folate and have a low glycemic load. CONCLUSIONS Following a vegan diet may result in deficiencies in micronutrients (vitamin B12, zinc, calcium and selenium) which should not be disregarded. However, low micro- and macronutrient intakes are not always associated with health impairments. Individuals who consume a vegan diet should be aware of the risk of potential dietary deficiencies.
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The Effect of a Multivitamin and Mineral Supplement on Immune Function in Healthy Older Adults: A Double-Blind, Randomized, Controlled Trial.
Fantacone, ML, Lowry, MB, Uesugi, SL, Michels, AJ, Choi, J, Leonard, SW, Gombart, SK, Gombart, JS, Bobe, G, Gombart, AF
Nutrients. 2020;12(8)
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Vitamins and minerals are essential for a healthy immune system. The prevalence of vitamin and mineral deficiencies increases with age, and this may contribute to age-related decline of the immune system. The aim of this study was to investigate whether a daily multivitamin and mineral (MVM) supplement could improve the immune function of older people. 42 healthy adults aged between 55 and 75 took part in this single-centre, two-armed, parallel, randomised, double-blinded study. Half of the group was given a MVM supplement called Redoxon Vita Immune (VI) containing the vitamins A, D, E, C, B6, B12 and folate plus iron, copper, zinc and selenium daily for 12 weeks, whilst the other half was given placebo tablets for 12 weeks. Participants were instructed to avoid certain foods high in vitamins and minerals such as oily fish, red meat, liver, and citrus fruits during the study period. Blood and saliva samples were taken from all participants at the beginning and end of the study period, to measure vitamin and mineral status and markers of immune function. Participants also kept a diary to record any illnesses or symptoms. At the end of the study, participants given the MVM supplement had increased their blood levels of vitamin C by 126% and zinc by 43%. There was no significant change in blood levels of vitamin D. There was no significant difference in the potential of blood to kill the introduced bacteria Staphylococcus aureus, or in neutrophil activity, nor were there any significant changes in blood levels of cytokines and chemokines. Participants taking the supplement did however report a shorter length, and lower severity of illnesses compared to those taking the placebo. The authors concluded that their findings support further research to test whether MVM supplementation can improve immune outcomes in older adults.
Abstract
Older adults are at increased risk for vitamin and mineral deficiencies that contribute to age-related immune system decline. Several lines of evidence suggest that taking a multi-vitamin and mineral supplement (MVM) could improve immune function in individuals 55 and older. To test this hypothesis, we provided healthy older adults with either an MVM supplement formulated to improve immune function (Redoxon® VI, Singapore) or an identical, inactive placebo control to take daily for 12 weeks. Prior to and after treatment, we measured (1) their blood mineral and vitamin status (i.e., vitamin C, zinc and vitamin D); (2) immune function (i.e., whole blood bacterial killing activity, neutrophil phagocytic activity, and reactive oxygen species production); (3) immune status (salivary IgA and plasma cytokine/chemokine levels); and (4) self-reported health status. MVM supplementation improved vitamin C and zinc status in blood and self-reported health-status without altering measures of immune function or status or vitamin D levels, suggesting that healthy older adults may benefit from MVM supplementation. Further development of functional assays and larger study populations should improve detection of specific changes in immune function after supplementation in healthy older adults. Clinical Trials Registration: ClinicalTrials.gov #NCT02876315.
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Selenium, antioxidants, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis of randomized controlled trials.
Jenkins, DJA, Kitts, D, Giovannucci, EL, Sahye-Pudaruth, S, Paquette, M, Blanco Mejia, S, Patel, D, Kavanagh, M, Tsirakis, T, Kendall, CWC, et al
The American journal of clinical nutrition. 2020;112(6):1642-1652
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Oxidative damage is a shared characteristic in chronic diseases such as cardiovascular disease (CVD), diabetes, cancer and ageing. Antioxidants mitigate the impact of oxidants and have been widely investigated in ageing and disease. However, the evidence for supplementary antioxidants has been mixed and some authorities have advised against the use of certain single nutrients for the prevention of CVD or cancer. This systematic review and meta-analysis focused on selenium due to its vital role in the antioxidant system and associations of low selenium blood levels with increased risk of CVD, cancers and death. The study included 43 randomised controlled trials (RCTs) evaluating the effect of supplemental selenium and antioxidants with or without selenium and their impact on CVD risk, cancer and all-cause mortality. Overall supplemental selenium or antioxidants alone did not seem to be associated with CVD outcomes, cancer, CVD and cancer mortality, or all-cause mortality. On close examination, a decreased risk was seen for CVD mortality when antioxidants were combined with selenium, whilst antioxidant mixtures without selenium demonstrated an increased risk in all-cause mortality. The findings did not seem to be influenced by dietary selenium intake. The authors suggested that inclusion of selenium as part of an antioxidant mix could be key for an antioxidant associated risk reduction. However, in the absence of further long term studies, a balanced antioxidant-rich diet was advocated as the safest approach. In clinical practice, where antioxidant support beyond diet is warranted, supplemental antioxidant use should be concurrent with adequate selenium supplementation, with dose benefits of 50-200mcg observed.
Abstract
BACKGROUND Antioxidants have been promoted for cardiovascular disease (CVD) risk reduction and for the prevention of cancer. Our preliminary analysis suggested that only when selenium was present were antioxidant mixtures associated with reduced all-cause mortality. OBJECTIVE We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the effect of selenium supplementation alone and of antioxidant mixtures with or without selenium on the risk of CVD, cancer, and mortality. METHODS We identified studies using the Cochrane Library, Medline, and Embase for potential CVD outcomes, cancer, and all-cause mortality following selenium supplementation alone or after antioxidant supplement mixtures with and without selenium up to June 5, 2020. RCTs of ≥24 wk were included and data were analyzed using random-effects models and classified by the Grading of Recommendations, Assessment, Development, and Evaluation approach. RESULTS The meta-analysis identified 9423 studies, of which 43 were used in the final analysis. Overall, no association of selenium alone or antioxidants was seen with CVD and all-cause mortality. However, a decreased risk with antioxidant mixtures was seen for CVD mortality when selenium was part of the mix (RR: 0.77; 95% CI: 0.62, 0.97; P = 0.02), with no association when selenium was absent. Similarly, when selenium was part of the antioxidant mixture, a decreased risk was seen for all-cause mortality (RR: 0.90; 95% CI: 0.82, 0.98; P = 0.02) as opposed to an increased risk when selenium was absent (RR: 1.09; 95% CI: 1.04, 1.13; P = 0.0002). CONCLUSION The addition of selenium should be considered for supplements containing antioxidant mixtures if they are to be associated with CVD and all-cause mortality risk reduction. This trial was registered at https://www.crd.york.ac.uk/PROSPERO/ as CRD42019138268.
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Partial purification and characterization of extrinsic pathway inhibitor (the factor Xa-dependent plasma inhibitor of factor VIIa/tissue factor).
Warn-Cramer, BJ, Maki, SL, Zivelin, A, Rapaport, SI
Thrombosis research. 1987;48(1):11-22
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Green tea (GT) consumption has been associated with the prevention and control of type 2 diabetes, cardiovascular and metabolic disease as well as having a positive effect on body weight and composition. However, the polyphenols in GT have been shown to interact with mineral distribution within the body and those minerals have been shown to be deficient in obesity. Studies to measure mineral status in obese subjects supplementing with GT have been inconclusive and this study aimed to measure the serum concentrations of minerals (calcium, copper, iron, zinc, magnesium), body mass index, total antioxidant status (TAS), lipid profile and glucose concentration. 46 obese patients were randomised into 2 groups, one group were supplemented with 279mg of green tea extract (GTE) and 208mg of the polyphenol epigallocatechin-3-gallate (EGCG) and the other group were issued with a placebo for 3 months. The study concluded that GTE improved Zn and Mg, however decreased levels of FE. The results confirmed a positive effect on body mass, lipid profile, glucose and TAS. It was concluded that more studies are required on a larger population over a longer period of time.
Abstract
We report a procedure to purify partially from plasma (approximately 1200 fold) the factor Xa-dependent inhibitor of factor VIIa/tissue factor (i.e., the extrinsic pathway inhibitor or EPI) and describe some of its properties. An assay for EPI was developed based upon inhibition of factor VIIa/tissue factor induced release of activation peptide from tritiated factor IX by a test sample in the presence but not in the absence of factor Xa. Approximately 50% of the total EPI activity in plasma was found in the lipoprotein fraction, which was used as the starting material for purification. Total lipoproteins (isolated by density ultracentrifugation) were delipidated and the urea soluble apoproteins gel filtered on Sephacryl S-200. The inhibitory activity co-eluted with the major protein peak, which primarily contained apoprotein A-I. Inhibitory activity was separated from apoprotein A-I by anion-exchange chromatography on Q-Sepharose and was further resolved from higher and lower molecular weight contaminating proteins by polypreparative disc gel electrophoresis in the presence of 0.1% SDS. Functional inhibitory activity eluted from the polypreparative disc gel in two discrete pools of different molecular weights (approximately 34,000 and approximately 43,000 D). Apoprotein E was identified by immunological techniques as the major protein present in both of these pools. However, incubation with a monospecific polyclonal antibody to human apoprotein E did not decrease EPI activity either in plasma or in the partially purified polypreparative disc gel fractions. A rabbit antiserum was prepared against material from the polypreparative disc gel. The IgG fraction neutralized approximately 95% of the total inhibitory activity present in plasma. Therefore, EPI in the lipoprotein fraction and in the non-lipoprotein fraction of plasma appears to be antigenically similar.