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Relationship between Prenatal or Postnatal Exposure to Pesticides and Obesity: A Systematic Review.
Pinos, H, Carrillo, B, Merchán, A, Biosca-Brull, J, Pérez-Fernández, C, Colomina, MT, Sánchez-Santed, F, Martín-Sánchez, F, Collado, P, Arias, JL, et al
International journal of environmental research and public health. 2021;18(13)
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Obesity is a multifactorial disease with biological, psychosocial, and behavioural factors that include genetic, socioeconomic, and cultural influences. Exposure to pesticides can result in weight gain through different pathways. The aim of this study was to assess a possible association between prenatal and postnatal exposure to pesticides and obesity in offspring from human and animal studies. This study is a systematic review of 9 animal studies and 25 human studies (23 cohorts and 2 crossover experimental designs). Results show that there is still scarce evidence to support a clear relationship between exposure to pesticides and obesity in humans and experimental animals. In fact, the effects of pesticide exposure on body weight change are mostly inconclusive and report conflicting results. Authors conclude that further research is required to improve understanding of whether repeated exposures over time or just short-term exposures to pesticides during critical windows of development are related to obesity.
Abstract
In recent years, the worldwide prevalence of overweight and obesity among adults and children has dramatically increased. The conventional model regarding the onset of obesity is based on an imbalance between energy intake and expenditure. However, other possible environmental factors involved, such as the exposure to chemicals like pesticides, cannot be discarded. These compounds could act as endocrine-disrupting chemicals (EDC) that may interfere with hormone activity related to several mechanisms involved in body weight control. The main objective of this study was to systematically review the data provided in the scientific literature for a possible association between prenatal and postnatal exposure to pesticides and obesity in offspring. A total of 25 human and 9 animal studies were analyzed. The prenatal, perinatal, and postnatal exposure to organophosphate, organochlorine, pyrethroid, neonicotinoid, and carbamate, as well as a combined pesticide exposure was reviewed. This systematic review reveals that the effects of pesticide exposure on body weight are mostly inconclusive, finding conflicting results in both humans and experimental animals. The outcomes reviewed are dependent on many factors, including dosage and route of administration, species, sex, and treatment duration. More research is needed to effectively evaluate the impact of the combined effects of different pesticides on human health.
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The association between environmental exposures to chlordanes, adiposity and diabetes-related features: a systematic review and meta-analysis.
Mendes, V, Ribeiro, C, Delgado, I, Peleteiro, B, Aggerbeck, M, Distel, E, Annesi-Maesano, I, Sarigiannis, D, Ramos, E
Scientific reports. 2021;11(1):14546
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Chlordane is a synthetic organochlorine pesticide used for several decades in agriculture, but also in housing for pest control. Chlordane compounds are endocrine disrupting chemicals (EDCs), which means that they may affect the natural function of hormones by blocking, mimicking, displacing, or acting to subvert their roles. The aim of this study was to investigate whether exposure to chlordane compounds increases the risk of adiposity and diabetes in humans. This study is a systematic review and meta-analysis of 31 publications. Results demonstrate that there is no association between chlordane compounds and adiposity. However, there are higher odds of having diabetes-related features with increasing levels of all the chlordane compounds evaluated. Authors conclude that an international agreement on methods to measure both exposure and outcome variables and to conduct epidemiological studies could increase the knowledge on how adverse effects of exposure to various stressors (exposome) can influence human health.
Abstract
Chlordane compounds (CHLs) are components of technical chlordane listed in the Stockholm convention on persistent organic pollutants identified as endocrine disrupting chemicals (EDCs) and may interfere with hormone biosynthesis, metabolism or action resulting in an unbalanced hormonal function. There is increasing scientific evidence showing EDCs as risk factors in the pathogenesis and development of obesity and obesity-related metabolic syndromes such as type 2 diabetes, but there is no systematized information on the effect of CHLs in humans. Our aim is to identify the epidemiological data on the association between CHLs with adiposity and diabetes using a systematic approach to identify the available data and summarizing the results through meta-analysis. We searched PubMed and Web of Science from inception up to 15 February 2021, to retrieve original data on the association between chlordanes, and adiposity or diabetes. For adiposity, regression coefficients and Pearson or Spearman correlation coefficients were extracted and converted into standardized regression coefficients. Data were combined using fixed effects meta-analyses to compute summary regression coefficients and corresponding 95% confidence intervals (95% CI). For the association between chlordanes and diabetes, Odds ratios (ORs) were extracted and the DerSimonian and Laird method was used to compute summary estimates and respective 95% CI. For both, adjusted estimates were preferred, whenever available. Among 31 eligible studies, mostly using a cross-sectional approach, the meta-analysis for adiposity was possible only for oxychlordane and transchlordane, none of them were significantly associated with adiposity [(β = 0.04, 95% CI 0.00; 0.07, I2 = 89.7%)] and (β = 0.02, 95% CI - 0.01; 0.06), respectively. For diabetes, the estimates were positive for all compounds but statistically significant for oxychlordane [OR = 1.96 (95% CI 1.19; 3.23)]; for trans-nonachlor [OR = 2.43 (95% CI 1.64; 3.62)] and for heptachlor epoxide [OR = 1.88 (95% CI 1.42; 2.49)]. Our results support that among adults, the odds of having diabetes significantly increase with increasing levels of chlordanes. The data did not allow to reach a clear conclusion regarding the association with adiposity.
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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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Respiratory and Allergic Effects in Children Exposed to Pesticides-A Systematic Review.
Buralli, RJ, Dultra, AF, Ribeiro, H
International journal of environmental research and public health. 2020;17(8)
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Agricultural pesticides are harmful chemicals used to protect plants from pests and diseases. There has been previous research showing a link between pesticide usage and respiratory symptoms, asthma, allergies, and lung function irregularities in children. To evaluate the relationship between pesticide usage and allergic and respiratory effects in children, 21 studies were included in this systematic review. This systematic review reports an association between multiple sources of pesticide exposure during fetal and early development and respiratory symptoms and allergies among children. Compared to high-income countries, children in the middle- and low-income countries were exposed to multiple pesticide sources. As current scientific evidence is sparse, more research is needed to determine the causal relationship between pesticides and respiratory and allergic symptoms in children. Robust research in low- and middle-income countries is necessary. Healthcare professionals can use the results of this study to understand the harmful effects of pesticide exposure in children and to take clinical decisions to reduce the exposure and its effects.
Abstract
Pesticide exposure may affect children's respiratory and allergic health, although results from epidemiological studies have not reached consensus. This review aims to analyze the scientific evidence on respiratory and allergic effects of exposure to agricultural pesticides in children aged up to 12 years old. The databases PubMed, Web of Science, Scielo, and Lilacs were screened to select articles published in English, Spanish, or Portuguese, and 21 articles were included in this review. Most investigations were conducted in North America (mostly in the United States), while no studies conducted in Latin America or Africa were found, despite their intensive use of pesticides. Children are exposed to pesticides through multiple pathways from the prenatal period throughout later developmental stages and may experience several respiratory effects. Most studies (79%) found positive associations with pesticide exposure and children's respiratory and allergic effects such as asthma, wheezing, coughs, acute respiratory infections, hay fever, rhinitis, eczema, chronic phlegm, and lung function impairments. Contrastingly, 21% of the studies found no associations between pesticide exposure and children's respiratory health. The vast differences among the characteristics of the studies hamper any comparison of the results. Exposure to pesticides may have several impacts on childhood respiratory health. More studies must be conducted, especially in low- and middle-income countries, preferably with comparable research protocols adapted to local realities. Efforts should be made to develop comprehensive risk mitigation strategies and behavioral interventions to reduce children's exposure to pesticides used in agriculture and respiratory health effects, and to ensure healthy childhood growth.
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Fluoride exposure and kidney and liver function among adolescents in the United States: NHANES, 2013-2016.
Malin, AJ, Lesseur, C, Busgang, SA, Curtin, P, Wright, RO, Sanders, AP
Environment international. 2019;132:105012
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Fluoride is added to the water supply in some parts of the UK, US and Canada to help prevent tooth decay, but there is some concern that long-term exposure to fluoride could be harmful to health. Animal studies have indicated that fluoride may cause kidney and liver damage. This US study aimed to evaluate whether greater fluoride exposure is associated with altered kidney and liver function in adolescents. This cross-sectional study looked at data collected from the National Health and Nutrition Examination Survey (2013-2016). The average age of adolescents was 15 years. Fluoride levels were measured in blood and in household tap water. Higher levels of fluoride in the blood were associated with a lower estimated glomerular filtration rate, a higher blood uric acid concentration, and a lower blood urea nitrogen concentration. Higher levels of fluoride in tap water were associated with a lower blood urea nitrogen concentration. The researchers concluded that fluoride exposure may contribute to complex changes in kidney and liver function in US adolescents. However, researchers could not rule out the possibility that an altered kidney or liver function may impact the body’s ability to absorb or metabolise fluoride.
Abstract
BACKGROUND Hepato- and nephrotoxicity of fluoride have been demonstrated in animals, but few studies have examined potential effects in humans. This population-based study examines the relationship between chronic low-level fluoride exposure and kidney and liver function among United States (U.S.) adolescents. This study aimed to evaluate whether greater fluoride exposure is associated with altered kidney and liver parameters among U.S. youth. METHODS This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (2013-2016). We analyzed data from 1983 and 1742 adolescents who had plasma and water fluoride measures respectively and did not have kidney disease. Fluoride was measured in plasma and household tap water. Kidney parameters included estimated glomerular filtration rate (calculated by the original Schwartz formula), serum uric acid, and the urinary albumin to creatinine ratio. Liver parameters were assessed in serum and included alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, blood urea nitrogen, gamma-glutamyl transferase, and albumin. Survey-weighted linear regression examined relationships between fluoride exposure and kidney and liver parameters after covariate adjustment. A Holm-Bonferroni correction accounted for multiple comparisons. RESULTS The average age of adolescents was 15.4 years. Median water and plasma fluoride concentrations were 0.48 mg/L and 0.33 μmol/L respectively. A 1 μmol/L increase in plasma fluoride was associated with a 10.36 mL/min/1.73 m2 lower estimated glomerular filtration rate (95% CI: -17.50, -3.22; p = 0.05), a 0.29 mg/dL higher serum uric acid concentration (95% CI: 0.09, 0.50; p = 0.05), and a 1.29 mg/dL lower blood urea nitrogen concentration (95%CI: -1.87, -0.70; p < 0.001). A 1 mg/L increase in water fluoride was associated with a 0.93 mg/dL lower blood urea nitrogen concentration (95% CI: -1.44, -0.42; p = 0.007). CONCLUSIONS Fluoride exposure may contribute to complex changes in kidney and liver related parameters among U.S. adolescents. As the study is cross-sectional, reverse causality cannot be ruled out; therefore, altered kidney and/or liver function may impact bodily fluoride absorption and metabolic processes.
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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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Environmental Factors and the Risk of Brain Tumours in Young People: A Systematic Review.
Zumel-Marne, A, Castano-Vinyals, G, Kundi, M, Alguacil, J, Cardis, E
Neuroepidemiology. 2019;53(3-4):121-141
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Brain tumours (BT) are the second most common cancer type in children and young adults. The aim of this study was to review and summarize the scientific literature about exposure to environmental factors and BT risk. This study is a systematic review of 70 articles of which 69% (n = 49) had >200 cases recruited. Results indicate a possible association between exposure to heavy metals, passive smoking, water and air pollutants, use of pesticides and living on a farm with farm animals, meat consumption during preconception, pregnancy or early infancy and an increased risk of BT in children and young adults. Authors conclude that larger scale studies with better exposure assessment are needed to evaluate possible associations between environmental risk factors and BT in young people.
Abstract
BACKGROUND Brain tumours (BT) are one of the most frequent tumour types in young people, although little is known about their risk factors. OBJECTIVE The objective of the current work was to review and summarize the scientific literature concerning exposure to environmental factors and BT risk in young people (<25 years old). METHODS PUBMED, Embase, Cochrane Library, Scopus, IME-Biomedina (bibliographic database of Consejo Superior de Investigaciones Científicas) and Web of science databases were searched. A score to assess the quality of the methodological information was created. RESULTS Some possible associations between BT risk in young people were reported for cadmium, consumption of well water, presence of nitrate or nitrate-nitrogen in tap water, mother's passive smoking, air pollution, parental handling of pesticides at home and/or professional pesticide treatment within houses, living on a farm and/or with farm animals, some parental occupations and high amount of meat consumption. CONCLUSIONS Although many of the studies reviewed suggest associations between the environmental exposures and BT in children and young adults, at present no reliable conclusion can be drawn as most results are based on small number of cases and exposure assessment is limited. Large-scale studies with better exposure assessment are needed to shed light on these possible associations, especially on exposure to heavy metals, tab water consumption, pesticides and parental smoking.
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Swimming pool exposure is associated with autonomic changes and increased airway reactivity to a beta-2 agonist in school aged children: A cross-sectional survey.
Cavaleiro Rufo, J, Paciência, I, Silva, D, Martins, C, Madureira, J, Oliveira Fernandes, E, Padrão, P, Moreira, P, Delgado, L, Moreira, A
PloS one. 2018;13(3):e0193848
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Studies have shown an association between swimming in chemically-treated pools and a higher risk of asthma in children, although the mechanism is not fully understood. This study aimed to investigate how swimming pool attendance influences lung and nervous system function in school-aged children. Around 800 children were classified as current swimmers (CS), past swimmers (PS) or non-swimmers (NS). The children underwent several tests to determine their lung function and allergic response to common allergens. Parasympathetic nervous system function was tested by measuring the speed at which their pupils constricted in response to light. The current swimmers group had significantly lower pupil constriction speeds compared to PS and NS, suggesting a poorer functioning of the autonomic nervous system, possibly due to inflammation resulting from swimming pool chemical exposure. CS experienced greater constriction of the airways compared to NS. A non-significant trend for a higher risk of asthma, atopic eczema and rhinitis, was observed in swimmers. The authors concluded that swimming pool attendance appears to be associated with autonomic nervous system changes and increased baseline airway smooth muscle constriction even in children without asthma.
Abstract
BACKGROUND Endurance swimming exercises coupled to disinfection by-products exposure has been associated with increased airways dysfunction and neurogenic inflammation in elite swimmers. However, the impact of swimming pool exposure at a recreational level on autonomic activity has never been explored. Therefore, this study aimed to investigate how swimming pool attendance is influencing lung and autonomic function in school-aged children. METHODS A total of 858 children enrolled a cross sectional survey. Spirometry and airway reversibility to beta-2 agonist, skin-prick-tests and exhaled nitric oxide measurements were performed. Pupillometry was used to evaluate autonomic nervous function. Children were classified as current swimmers (CS), past swimmers (PS) and non-swimmers (NS), according to the amount of swimming practice. RESULTS Current swimmers group had significantly lower maximum and average pupil constriction velocities when compared to both PS and NS groups (3.8 and 5.1 vs 3.9 and 5.3 vs 4.0 and 5.4 mm/s, p = 0.03 and p = 0.01, respectively). Moreover, affinity to the beta-2 agonist and levels of exhaled nitric oxide were significantly higher in CS when compared to NS (70 vs 60 mL and 12 vs 10 ppb, p<0.01 and p = 0.03, respectively). A non-significant trend for a higher risk of asthma, atopic eczema and allergic rhinitis was found with more years of swimming practice, particularly in atopic individuals (β = 1.12, 1.40 and 1.31, respectively). After case-case analysis, it was possible to observe that results were not influenced by the inclusion of individuals with asthma. CONCLUSIONS Concluding, swimming pool attendance appears to be associated with autonomic changes and increased baseline airway smooth muscle constriction even in children without asthma.
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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.