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Hypoxic Pilates Intervention for Obesity: A Randomized Controlled Trial.
Jung, K, Kim, J, Park, HY, Jung, WS, Lim, K
International journal of environmental research and public health. 2020;17(19)
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Pilates is a commonly used form of exercise for the treatment of obesity. Hypoxic exercise, exercise performed under lower than normal oxygen concentrations mimicking training at higher altitudes, has been suggested to offer greater benefits in terms of metabolism, cardiovascular and pulmonary function. The aim of this Korean study was to evaluate the effect of Pilates under hypoxic conditions in women with obesity. 36 women with obesity were randomised to control group (no exercise), and Pilates under either normal (normoxic, 20.9% inspired oxygen fraction) or decreased (hypoxic, 14.5%) oxygen conditions, 3 times per week for 12 weeks. There were no significant differences between groups in body weight and composition and aerobic performance. However, the hypoxic Pilates group experienced significant improvements in diastolic blood pressure, total cholesterol and triglycerides, as well as in endothelial and blood flow functions compared to the control and normoxic groups, but not in other cardiometabolic risk factors, including blood glucose control. The authors discuss various possible biochemical mechanisms for these findings.
Abstract
This study examined the effect of Pilates training under hypoxia, a novel treatment method, for obesity. Thirty-two Korean women with obesity (age: 34-60 (47.5 ± 7.5) years) were randomly assigned to control (CON; n = 10), normoxic Pilates training (NPTG; n = 10), and hypoxic Pilates training groups (HPTG; n = 12). The NPTG and HPTG performed 50 min of Pilates training using a tubing band for 12 weeks (3 days/week) in their respective environmental conditions (NPTG: normoxic condition, inspired oxygen fraction (FiO2) = 20.9%; HPTG moderate hypoxic condition, FiO2 = 14.5%). The CON maintained their daily lifestyle without intervention. All subjects underwent body composition, blood pressure, arterial stiffness, vascular endothelial function, cardiometabolic biomarker, hemorheological function, and aerobic performance measurements before and after the intervention. The HPTG showed a significant improvement in diastolic blood pressure, total cholesterol and triglyceride concentrations, flow-mediated dilation, and erythrocyte deformability and aggregation (all p < 0.05) compared with the CON and NPTG. However, compared with the CON and NPTG, the HPTG did not show improvement in other parameters. Hypoxic Pilates intervention is a novel and successful method for promoting endothelial and hemorheological functions in women with obesity.
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A pilot, open labelled, randomised controlled trial of hypertonic saline nasal irrigation and gargling for the common cold.
Ramalingam, S, Graham, C, Dove, J, Morrice, L, Sheikh, A
Scientific reports. 2019;9(1):1015
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The common cold is a viral upper respiratory tract infection which affects adults and children worldwide, often multiple times a year. A large number of viruses cause these infections, making targeted antiviral treatment impractical. This small, randomised, controlled pilot trial (not blinded) of 68 adults aimed to assess the impact of salt-water nasal washing and throat gargling as many times as required (on average 3 times a day for 5 days) within 48 hours of symptom on-set on study recruitment and retention, as well as acceptability, symptom duration and viral shedding. The researchers found that nasal irrigation and gargling with a saline solution was acceptable to study participants. Illness duration was shortened by 1.9 days in the intervention arm, with significant reductions in the duration of runny nose, blocked nose, sneezing, cough and hoarseness of voice. The average quality of life score was also higher in the intervention arm, although this failed to reach significance. Viral shedding was higher in the intervention arm, with over the counter medication use 36% lower. There was also a lower rate of infection spread within households for the intervention arm. The authors call for a larger, placebo controlled trial to confirm these findings. Nutrition Practitioners supporting immunity in relation to the common cold virus may want to discuss the use of saline nasal irrigation with their clients as a simple measure to reduce symptoms and spread.
Abstract
There are no antivirals to treat viral upper respiratory tract infection (URTI). Since numerous viruses cause URTI, antiviral therapy is impractical. As we have evidence of chloride-ion dependent innate antiviral response in epithelial cells, we conducted a pilot, non-blinded, randomised controlled trial of hypertonic saline nasal irrigation and gargling (HSNIG) vs standard care on healthy adults within 48 hours of URTI onset to assess recruitment (primary outcome). Acceptability, symptom duration and viral shedding were secondary outcomes. Participants maintained a symptom diary until well for two days or a maximum of 14 days and collected 5 sequential mid-turbinate swabs to measure viral shedding. The intervention arm prepared hypertonic saline and performed HSNIG. We recruited 68 participants (2.6 participants/week; November 2014-March 2015). A participant declined after randomisation. Another was on antibiotics and hence removed (Intervention:32, Control:34). Follow up data was available from 61 (Intervention:30, Control:31). 87% found HSNIG acceptable, 93% thought HSNIG made a difference to their symptoms. In the intervention arm, duration of illness was lower by 1.9 days (p = 0.01), over-the-counter medications (OTCM) use by 36% (p = 0.004), transmission within household contacts by 35% (p = 0.006) and viral shedding by ≥0.5 log10/day (p = 0.04). We hence need a larger trial to confirm our findings.
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Influence of acute consumption of caffeine vs. placebo over Bia-derived measurements of body composition: a randomized, double-blind, crossover design.
Williamson, CM, Nickerson, BS, Bechke, EE, McLester, CN, Kliszczewicz, BM
Journal of the International Society of Sports Nutrition. 2018;15:7
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Bioelectrical analysis (BIA) is a commonly used method to assess body fat percentage and water values, by running a small electrical current through the body. Prior to testing using BIA, it is necessary to avoid exercise, fasting and caffeine consumption for accurate results. Caffeine’s role as a diuretic is well understood, however, its impact on measures of body water values when consumed prior to BIA testing has not been examined. The main aim of this study was to determine if the consumption of caffeine prior to BIA testing influences the cellular fluid balance and body fat percentage. Participants in the trial were measured on three separate occasions. The first visit worked as a control whilst the second and third visit were conducted using a double blind randomised crossover method. The total number of participants included in the trial were 20 physically active males who were habitual coffee drinkers. Participants were given either 200mg of caffeine or 200mg dextrose (control). The BIA measurements were taken at seven different time points after the preliminary measurements, separated by 15-min. The authors concluded that caffeine consumption in habitual users just prior to testing produced no significant changes in the BIA measurements. Therefore, the pre-testing guidelines for caffeine consumption may not be necessary in habitual caffeine consumers.
Abstract
BACKGROUND Bioelectrical impedance analysis (BIA) is often used to estimate total body water (TBW), intracellular body water (ICW), extracellular body water (ECW), and body fat percentage (BF%). A common restriction for BIA analysis is abstinence from caffeine 12-h prior to testing. However, research has yet to determine whether the consumption of caffeine influences BIA testing results. The purpose of this study was to determine if the consumption of caffeine influences BIA-derived BF% and body water values in habitual caffeine users. METHODS Twenty apparently healthy males (26.6 ± 4.1 years) identified as habitual caffeine consumers (≥ one 95 mg serving per day ≥ four days per week) participated in this study. Participants came to the lab on three occasions, the first visit serving as the control (CON) with no supplementation. The remaining two visits were performed in a randomized double-blind, cross-over fashion. Participants consumed 200 mg of dextrose (PLA) or caffeine (CAF) in capsule form. During each visit, seven multi-frequency BIA measurements were conducted before (PRE) and after (15-min, 30-min, 45-min, 60-min, 75-min, 90-min) consumption. RESULTS Repeated measures ANOVA revealed BF% for CAF was lower than the CON and PLA conditions at PRE and 15-min (p < 0.001, p = 0.004), but not statistically significant for the remaining time points (i.e., 30-, 45-, 60-, 75-, and 90-min). However, the effect size (ES) of the BF% differences were trivial. The CON, PLA, and CAF conditions had higher PRE ICW values than their associated post time points (i.e., 15-, 30-, 45-, 60-, 75-, and 90-min). Similar to BF%, ES of the mean differences for ICW were trivial. No other differences were observed. CONCLUSION Caffeine consumption in habitual users produced trivial changes in TBW, ECW, ICW, or BF%. Therefore, the pre-testing guidelines for caffeine consumption may not be necessary in habitual caffeine consumers.
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Emollient use alters skin barrier and microbes in infants at risk for developing atopic dermatitis.
Glatz, M, Jo, JH, Kennedy, EA, Polley, EC, Segre, JA, Simpson, EL, Kong, HH
PloS one. 2018;13(2):e0192443
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Atopic dermatitis (AD) is a type of eczema common in babies and young children. Poor function of the skin barrier is thought to lead to changes in the composition of bacteria found on the skin. This small study investigated the effects of daily use of an emollient, Cetaphil Moisturising Cream, on the barrier function and bacterial communities on the skin of infants at risk of developing AD. After 6 months, the emollient group had a lower skin pH than the control group. The group using the emollient had more diverse skin bacterial communities than the control group. The proportion of Streptococcus salivarius was higher in the emollient versus control groups. The authors concluded that lower skin pH and increased skin bacterial diversity after long-term emollient use may reduce inflammation and lower the risk of infants developing AD.
Abstract
BACKGROUND Emollients are a mainstay of treatment in atopic dermatitis (AD), a disease distinguished by skin bacterial dysbiosis. However, changes in skin microbiota when emollients are used as a potential AD preventative measure in infants remain incompletely characterized. RESULTS We compared skin barrier parameters, AD development, and bacterial 16S ribosomal RNA gene sequences of cheek, dorsal and volar forearm samples from 6-month-old infants with a family history of atopy randomized to receive emollients (n = 11) or no emollients (controls, n = 12). The emollient group had a lower skin pH than the control group. The number of bacterial taxa in the emollient group was higher than in the control group at all sites. The Streptococcus salivarius proportion was higher in the emollient versus control groups at all sites. S. salivarius proportion appeared higher in infants without AD compared to infants with AD. A decrease in S. salivarius abundance was further identified in a separate larger population of older children demonstrating an inverse correlation between AD severity at sampling sites and S. salivarius proportions. CONCLUSIONS The decreased skin pH and the increased proportion of S. salivarius after long-term emollient use in infants at risk for developing AD may contribute to the preventative effects of emollients in high-risk infants.
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Influence of a montmorency cherry juice blend on indices of exercise-induced stress and upper respiratory tract symptoms following marathon running--a pilot investigation.
Dimitriou, L, Hill, JA, Jehnali, A, Dunbar, J, Brouner, J, McHugh, MP, Howatson, G
Journal of the International Society of Sports Nutrition. 2015;12:22
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Prolonged exercise, such as marathon running, is associated with upper respiratory tract (URT) symptoms and airway inflammation. Tart Montmorency cherry juice, high in phytochemicals such as anthocyanins and quercetin, has been shown to have anti-inflammatory and anti-oxidative properties and therefore may help reduce inflammation and oxidative stress triggered by exercise. In this pilot study, twenty marathon runners were randomly assigned to receive two servings a day of either a placebo drink or cherry juice for eight days ─ prior, during and after a marathon run. Any URT symptoms were reported, and inflammatory markers were measured pre- and post-race and 24 and 48 hrs after the race, from saliva (immunoglobulins and cortisol) and serum (C-reactive protein, CRP). No differences in the effect on immunoglobulins and cortisol were found between the two groups. The increase in CRP was significantly lower in the cherry juice group compared to the placebo group. 50% of the runners in the placebo group developed URT symptoms, while none were reported in the cherry juice group. The authors conclude that Montmorency cherry juice may protect the URT from inflammatory symptoms triggered by exercise. They propose further studies with larger sample size of participants, suffering from various inflammatory respiratory conditions.
Abstract
BACKGROUND Prolonged exercise, such as marathon running, has been associated with an increase in respiratory mucosal inflammation. The aim of this pilot study was to examine the effects of Montmorency cherry juice on markers of stress, immunity and inflammation following a Marathon. METHODS Twenty recreational Marathon runners consumed either cherry juice (CJ) or placebo (PL) before and after a Marathon race. Markers of mucosal immunity secretory immunoglobulin A (sIgA), immunoglobulin G (IgG), salivary cortisol, inflammation (CRP) and self-reported incidence and severity of upper respiratory tract symptoms (URTS) were measured before and following the race. RESULTS All variables except secretory IgA and IgG concentrations in saliva showed a significant time effect (P <0.01). Serum CRP showed a significant interaction and treatment effect (P < 0.01). The CRP increase at 24 and 48 h post-Marathon was lower (P < 0.01) in the CJ group compared to PL group. Mucosal immunity and salivary cortisol showed no interaction effect or treatment effect. The incidence and severity of URTS was significantly greater than baseline at 24 h and 48 h following the race in the PL group and was also greater than the CJ group (P < 0.05). No URTS were reported in the CJ group whereas 50 % of runners in the PL group reported URTS at 24 h and 48 h post-Marathon. CONCLUSIONS This is the first study that provides encouraging evidence of the potential role of Montmorency cherries in reducing the development of URTS post-Marathon possibly caused by exercise-induced hyperventilation trauma, and/or other infectious and non-infectious factors.
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Effects of fasting and preoperative feeding in children.
Yurtcu, M, Gunel, E, Sahin, TK, Sivrikaya, A
World journal of gastroenterology. 2009;15(39):4919-22
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Preoperative fasting is usually carried out to prevent the risk of vomiting during anaesthesia. The study investigated whether children should have a long period of fasting before surgery. Eight groups of 10 children (aged 1-10 years) with disorders of groin and scrotum were orally fed normal liquid food (NLF) or a high calorie diet (HCD) in 2 divided doses at 6 hour intervals, then fasted for 2, 3, 4 or 5 hours prior to surgery. Four groups had NLF and 4 groups had HCD. All children had their glucose, prealbumin and cortisol levels measured twice, just after the oral feeding and just before surgery. Once anaesthesia was sufficient and stable, gastric liquid was collected and measured. Patients with disease that could delay gastric emptying, had high acid production or were on medication were excluded from the trial. The researchers found that there was no significant difference in blood prealbumin levels in all groups. There was significant increase in blood cortisol in 4 groups when fasted (NLF-2h fasted, HCD-2h fasted, NLF-3h fasted and HCD-5h fasted). Stomach aid residue liquids were at tolerable levels of 1-2ml in all children. Anaesthesia was uneventful, with no coughing, laryngospasm or vomiting reported, and outcomes of surgery and wound healing were not affected. The authors noted that drinking clear liquids up to 2 hours before surgery was unlikely to substantially affect the volume of gastric fluids, and did not appear to increase the risk of vomiting in normal, healthy children. Glucose and insulin infusions appeared to minimise endocrine stress response and normalised post-op insulin sensitivity. Additionally, there may be a psychological benefit for children as irritability appeared to decrease prior to surgery. The study concluded that there was no need for fasting longer than 2 hours prior to inguinoscrotal region surgery.
Abstract
AIM: To investigate whether children should undergo surgery without a long period of fasting after feeding. METHODS Eighty children with inguinoscrotal disorders (aged 1-10 years) were studied prospectively. They were divided into eight groups that each contained 10 children who were fed normal liquid food (NLF) and a high-calorie diet (HCD) 2, 3, 4 and 5 h before surgery, in two doses at 6-h intervals. NLF was given to four groups and HCD to the other four. In all groups, glucose, prealbumin and cortisol levels in the blood were measured twice: just after oral feeding and just before the operation. After the establishment of adequate anesthesia, gastric residue liquid was measured with a syringe. RESULTS Blood glucose levels in all patients fed NLF and HCD were high, except in patients in the HCD-4 group. There was no significant difference in the blood prealbumin levels. There was a significant increase in the blood cortisol levels in the NLF-2 (14.4 +/- 5.7), HCD-2 (13.2 +/- 6.0), NLF-3 (10.9 +/- 6.4), and HCD-5 (6.8 +/- 5.7) groups (P < 0.05). CONCLUSION The stress of surgery may be tolerated by children when they are fed up to 2 h before elective surgery.
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A randomized controlled study comparing elemental diet and steroid treatment in Crohn's disease.
Zoli, G, Carè, M, Parazza, M, Spanò, C, Biagi, PL, Bernardi, M, Gasbarrini, G
Alimentary pharmacology & therapeutics. 1997;11(4):735-40
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An elemental diet is considered an effective primary treatment for active Crohn's disease, usually given by a feeding tube. This RCT evaluated the affect of elemental diet administered orally on disease activity, intestinal permeability and nutritional status when compared to high-dose corticosteroids. 22 Crohn’s disease patients were enrolled of which 2 withdrew and 20 were randomised to oral elemental diet group (n-10) or corticosteroid plus normal diet group (n=10) for 2 weeks. After 2 weeks clinical disease activity improved significantly in both groups. Crohn’s disease activity and erythrocyte sedimentation rate improved in the diet group. Crohn's disease activity improved in the corticosteroid group. Disease remission rate was higher in the diet group (n=8) compared to the corticosteroid group (n=5). 12 months after the study there was no difference in disease relapse rate between groups. Intestinal permeability was significantly improved in the diet group only. However, at the start of the study, permeability levels were randomly lower in the corticosteroid group than the diet group so it is not possible to say that elemental diet was more effective than corticosteroids in promoting gut mucosal healing. Nutritional status improved in both groups but was more evident in the diet group. The authors conclude that an oral elemental diet is effective in promoting and maintaining remission of Crohn’s disease activity, in restoring intestinal permeability and improving nutritional status, and is generally well tolerated with a high degree of compliance.
Abstract
BACKGROUND Elemental diet is considered an effective primary treatment for active Crohn's disease, but it is usually given by a feeding tube. METHODS Twenty-two patients (12 males, median age 30 years, range 18-60) with moderately active Crohn's disease were enrolled in a randomized study in which the efficacy of an elemental diet administered orally was compared to high-dose corticosteroids in achieving clinical and laboratory remission. Ten patients were treated by oral elemental diet (Peptamen, Clintec, USA) and 10 received corticosteroids. Both treatment regimens lasted 2 weeks. The two groups did not differ with respect to age, sex, body weight, location of disease, treatment or disease activity prior to the study. In all patients studied, simple Crohn's disease activity index, nutritional status (expressed as body mass index), percentage of ideal body weight, fat mass, fat free mass, erythrocyte sedimentation rate, interleukin-6, intestinal permeability (expressed as permeability index), prealbumin, retinol binding protein and multiskin test were evaluated before and after treatment. RESULTS After 2 weeks of treatment, there were significant improvements in simple Crohn's disease activity index, erythrocyte sedimentation rate, permeability index, body mass index, prealbumin, retinol binding protein and multiskin test in the elemental diet group. There were significant improvements in simple Crohn's disease activity index and fat free mass in the corticosteroid group. CONCLUSIONS These data suggest that, in the short term, an oral elemental diet is at least as effective as steroids in inducing remission of mild-moderately active Crohn's disease, but it may be more effective in improving the nutritional status of these patients, probably through a more rapid restoration of normal intestinal permeability.