Vitamin C: From nutrition to oxygen sensing and epigenetics

Efficacy of Vitamin C as Glucocorticoid Substitute for Reducing Pain and Inflammation After Total Hip Arthroplasty: A Randomized Controlled Trial

BACKGROUND

Vitamin C shows strong anti-inflammatory and analgesic effects, so we explored whether it can replace glucocorticoids in reducing pain and inflammation after total hip arthroplasty (THA).

METHODS

In this prospective trial, a consecutive series of 107 patients (43.0% men, 56.8 ± 10.1 years of age, 100% Han Chinese) who underwent THA due to end-stage hip disease at our medical center between January 2023 and January 2024 were randomized to receive vitamin C, dexamethasone, or neither dexamethasone nor vitamin C after surgery. The 3 groups were compared in terms of the primary outcomes of pain reported on a visual analogue scale (VAS), perioperative morphine use, and blood indices of inflammation and fibrinolysis as well as in terms of secondary outcomes of efficacy and safety.

RESULTS

Compared with patients in the control group, those who received vitamin C or dexamethasone reported a significantly lower VAS pain score on postoperative day 1, had significantly lower perioperative morphine consumption, and demonstrated significantly lower blood levels of C-reactive protein on days 1 and 2. The 2 groups also showed a significantly lower rate of rescue analgesia on postoperative day 1 and significantly higher Harris hip scores of joint function at 2 and 12 weeks after surgery, as well as significantly smaller thigh circumference and a lower rate of swelling on the first 2 days after surgery. Either treatment was associated with a significantly lower rate of postoperative nausea and vomiting. Dexamethasone was associated with greater blood glucose levels after surgery.

CONCLUSIONS

Vitamin C may be an effective substitute for glucocorticoids for reducing morphine use and the risk of nausea or vomiting and for improving joint function after THA without side effects causing blood glucose fluctuations.

LEVEL OF EVIDENCE

Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.

The role of Bromelain and Liposomal Vitamin C in the treatment of chronic venous disease

Chronic venous disease (CVD) is a prevalent condition leading to significant morbidity and affecting quality of life. Among conservative treatment strategies, venoactive drugs are often recommended by major guidelines for the management of CVD. Bromelain and vitamin C are now emerging as promising options in the management of several chronic diseases owing to their anti-inflammatory, immunoregulatory, and antioxidant properties, though evidence remains scarce in this setting. This systematic review of the literature, endorsed by the Italian Society of Angiology and Vascular Medicine (Societa Italiana di Angiologia e Patologia Vascolare, SIAPAV), aims to evaluate the efficacy and safety of these compounds in the treatment of CVD. A comprehensive search yielded nine studies, two on bromelain and seven on vitamin C. No studies have evaluated the effects of bromelain and vitamin C alone or in combination, whereas both molecules were administered in combination with other nutritional supplements. Overall, CVD-related symptoms and edema seem to improve with dietary supplement containing these two compounds, with no major safety issues reported. Bromelain and vitamin C may thus represent attractive options in the management of patients with symptomatic CVD and/or presence of venous edema, provided optimal conservative treatment is in place. Dedicated clinical studies are needed to clarify the efficacy and safety of a combination of these molecules in CVD management.

Antioxidant Supplementation in Childhood Obesity: A Path to Improved Metabolic Health?

Childhood obesity is linked to heightened oxidative stress, a key driver of endothelial dysfunction, inflammation, and metabolic complications. Antioxidants, including Vitamins C and E, are vital in neutralizing free radicals and mitigating oxidative damage. This non-systematic review examines the potential advantages of antioxidant supplementation in pediatric obesity, focusing on its effects on vascular health, insulin sensitivity, and inflammatory processes. Emerging data suggest that antioxidants may improve endothelial function, reduce blood pressure, and enhance metabolic homeostasis in obese children. However, the long-term efficacy and safety of antioxidant supplementation remain uncertain, necessitating further rigorous randomized controlled trials. A deeper understanding of antioxidants' role in pediatric obesity could unlock novel therapeutic approaches for managing obesity-related complications and improving children's overall health outcomes.

Vitamin C-Dependent Intergenerational Inheritance of Enhanced Endurance Performance Following Maternal Exercise

Declining levels of physical activity and fitness in children and youth are linked to negative health outcomes. This study investigates whether maternal exercise can enhance offspring's physical fitness. Our results demonstrate that maternal exercise improves offspring's endurance by changing muscle fiber composition and promoting mitochondrial biogenesis, with benefits lasting across generations. This improvement is associated with changes in DNA methylation, specifically the demethylation of the Slc23a2 gene, which codes for SVCT2, crucial for vitamin C (VC) transport, in F1 and F2 generations. Importantly, VC administration during pregnancy mimics the transgenerational benefits of exercise on offspring fitness, but these benefits are absent in genetic VC deficiency mice. VC supplementation increases TET2 expression in murine and human myogenic cells, regulating DNA methylation, promoting the development of oxidative fibers, and enhancing mitochondrial biogenesis. This study highlights the VC-TET2-SVCT2 pathway as a key mechanism for the transgenerational endurance benefits of maternal exercise, suggesting potential strategies to enhance maternal and child health.

Exploring the Ascorbate Requirement of the 2-Oxoglutarate-Dependent Dioxygenases

In humans, the 2-oxoglutarate-dependent dioxygenases (2-OGDDs) catalyze hydroxylation reactions involved in cell metabolism, the biosynthesis of small molecules, DNA and RNA demethylation, the hypoxic response and the formation of collagen. The reaction is catalyzed by a highly oxidizing ferryl-oxo species produced when the active site non-heme iron engages molecular oxygen. Enzyme activity is specifically stimulated by l-ascorbic acid (ascorbate, vitamin C), an effect not well mimicked by other reducing agents. In this perspective article we discuss the reliance of the 2-OGDDs on ascorbate availability. We draw upon findings from studies with different 2-OGDDs to piece together a comprehensive theory for the specific role of ascorbate in supporting enzyme activity. Our discussion centers on the capacity for ascorbate to act as an efficient radical scavenger and its propensity to reduce and chelate transition metals. In addition, we consider the evidence supporting stereospecific binding of ascorbate in the enzyme active site.

Vitamin C: From Self-Sufficiency to Dietary Dependence in the Framework of Its Biological Functions and Medical Implications

Vitamin C is an organic compound biosynthesized in plants and most vertebrates. Since its discovery, the benefits of vitamin C use in the cure and prevention of various pathologies have been frequently reported, including its anti-oxidant, anti-inflammatory, anticoagulant, and immune modulatory properties. Vitamin C plays an important role in collagen synthesis and subsequent scurvy prevention. It is also required in vivo as a cofactor for enzymes involved in carnitine and catecholamine norepinephrine biosynthesis, peptide amidation, and tyrosine catabolism. Moreover, as an enzymatic cofactor, vitamin C is involved in processes of gene transcription and epigenetic regulation. The absence of the synthesis of L-gulono-1,4-lactone oxidase, a key enzyme in the pathway of vitamin C synthesis, is an inborn metabolism error in some fishes and several bird and mammalian species, including humans and non-human primates; it is caused by various changes in the structure of the original GULO gene, making these affected species dependent on external sources of vitamin C. The evolutionary cause of GULO gene pseudogenization remains controversial, as either dietary supplementation or neutral selection is evoked. An evolutionary improvement in the control of redox homeostasis was also considered, as potentially toxic H2O2 is generated as a byproduct in the vitamin C biosynthesis pathway. The inactivation of the GULO gene and the subsequent reliance on dietary vitamin C may have broader implications for aging and age-related diseases, as one of the most important actions of vitamin C is as an anti-oxidant. Therefore, an important aim for medical professionals regarding human and animal health should be establishing vitamin C homeostasis in species that are unable to synthesize it themselves, preventing pathologies such as cardiovascular diseases, cognitive decline, and even cancer.

Vitamin C and suicidal ideation: A cross-sectional and Mendelian randomization study

BACKGROUND

Studies have shown that a history of suicide attempts is associated with low levels of antioxidant vitamins. However, the specific relationship between vitamin C and suicidal ideation remains poorly understood. The purpose of this study is to investigate the effect of vitamin C on the development of suicidal ideation and to explore further the causal relationship using Mendelian randomization (MR).

METHODS

Using the 2005-2018 National Health and Nutrition Examination Survey (NHANES) dataset, a comprehensive, cross-sectional, stratified survey of 28,623 participants aged 20 years and older was conducted. Suicidal ideation was assessed using item 9 of the Patient Health Questionnaire-9 (PHQ-9) item. The relationship between vitamin C and suicidal ideation was revealed by weighted multiple linear regression, smooth curve fitting, hierarchical analysis, and interaction test. To determine causality, MR was performed on vitamin C and suicidal ideation.

RESULTS

In cross-sectional studies, all models showed a negative association between vitamin C and suicidal ideation, with a 37 % reduction in the risk of suicidal ideation for each unit increase in vitamin C in the highest quartile in the fully adjusted model. The results of the subgroup analysis showed that the association between vitamin C and suicidal ideation was stable across gender, age, education, smoking status, and marital status. In the MR study, our bivariate model showed no significant causal relationship between vitamin C and the development of suicidal ideation.

CONCLUSIONS

Dietary vitamin C intake was negatively associated with the development of suicidal ideation. However, genetic evidence does not support causation of these associations.

Association between total vitamin C intake and hypothyroidism among Hashimoto thyroiditis: National Health and Nutrition Examination Survey, 2007-2012

Oxidative stress may be involved in the progression of hypothyroidism in patients with Hashimoto thyroiditis (HT). Vitamin C is a well-known powerful antioxidant. To our knowledge, whether vitamin C intake relates to hypothyroidism in patients with HT remains unclear. In this cross-sectional study based on the National Health and Nutrition Examination Survey, 2007-2012, we aimed to explore the relationship between total vitamin C intake and hypothyroidism in patients with HT, using multivariate logistic regression models and restricted cubic spline analyses. Our results showed a significant negative linear association between total vitamin C intake (log10-transformed data) and hypothyroidism in HT. Compared with those with the lowest quartile of total vitamin C intake (log10-transformed), participants with the highest quartile were at lower odds of having hypothyroidism (adjusted OR 0·40, 95 % CI: 0·18, 0·88, Ptrend = 0·027). This association was consistent in subgroups stratified by sex (Pfor interaction = 0·084) and age (≥ 60 years and < 60 years, Pfor interaction = 0·330). This study revealed that total vitamin C intake was inversely associated with hypothyroidism among individuals with HT, indicating that higher vitamin C intakes (4·57-1258·9 mg/d) may be associated with a lower likelihood of hypothyroidism among HT participants.

The sodium/ascorbic acid co-transporter SVCT2 distributes in a striated membrane-enriched domain at the M-band level in slow-twitch skeletal muscle fibers

BACKGROUND

Vitamin C plays key roles in cellular homeostasis, functioning as a potent antioxidant and a positive regulator of cell differentiation. In skeletal muscle, the vitamin C/sodium co-transporter SVCT2 is preferentially expressed in oxidative slow fibers. SVCT2 is up-regulated during the early fusion of primary myoblasts and decreases during initial myotube growth, indicating the relevance of vitamin C uptake via SVCT2 for early skeletal muscle differentiation and fiber-type definition. However, our understanding of SVCT2 expression and function in adult skeletal muscles is still limited.

RESULTS

In this study, we demonstrate that SVCT2 exhibits an intracellular distribution in chicken slow skeletal muscles, following a highly organized striated pattern. A similar distribution was observed in human muscle samples, chicken cultured myotubes, and isolated mouse myofibers. Immunohistochemical analyses, combined with biochemical cell fractionation experiments, reveal a strong co-localization of SVCT2 with intracellular detergent-soluble membrane fractions at the central sarcomeric M-band, where it co-solubilizes with sarcoplasmic reticulum proteins. Remarkably, electrical stimulation of cultured myofibers induces the redistribution of SVCT2 into a vesicular pattern.

CONCLUSIONS

Our results provide novel insights into the dynamic roles of SVCT2 in different intracellular compartments in response to functional demands.

Tailoring biomaterials for skin anti-aging

Skin aging is the phenomenon of degenerative changes in the structure and function of skin tissues over time and is manifested by a gradual loss of skin elasticity and firmness, an increased number of wrinkles, and hyperpigmentation. Skin anti-aging refers to a reduction in the skin aging phenomenon through medical cosmetic technologies. In recent years, new biomaterials have been continuously developed for improving the appearance of the skin through mechanical tissue filling, regulating collagen synthesis and degradation, inhibiting pigmentation, and repairing the skin barrier. This review summarizes the mechanisms associated with skin aging, describes the biomaterials that are commonly used in medical aesthetics and their possible modes of action, and discusses the application strategies of biomaterials in this area. Moreover, the synergistic effects of such biomaterials and other active ingredients, such as stem cells, exosomes, growth factors, and antioxidants, on tissue regeneration and anti-aging are evaluated. Finally, the possible challenges and development prospects of biomaterials in the field of anti-aging are discussed, and novel ideas for future innovations in this area are summarized.

Effects of Vitamin C on the Gonad Growth, Texture Traits, Collagen Content and Synthesis Related Gene Expression of Sea Urchin (Mesocentrotus nudus)

The market value of sea urchin gonads is determined by the specific characteristics associated with gonad size and texture. Formulated feeds can effectively promote the gonad growth of sea urchins but cannot assure essential gonad texture traits. The objective of this study was to investigate the impact of vitamin C (VC) on the gonad growth, texture, collagen content, and the expression of genes involved in the collagen synthesis of sea urchins (Mesocentrotus nudus). Graded amounts of VC (0, 3000 and 6000 mg/kg) were supplemented to make three formulated feeds. Fresh kelp (Saccharina japonica) was used as the control diet. Each diet was randomly distributed to three tanks of M. nudus. The results indicated that the gonadosomatic index (GSI) and texture traits of M. nudus fed C3000 were significantly greater than those fed C0 and C6000. Collagen type I (Col I) in the gonads of M. nudus fed C3000 showed significantly greater areas than those fed C0 and C6000. Consistently, the expression levels of collagen alpha-1 (colp1α) of M. nudus fed C3000 were significantly higher than those fed C0 and C6000. As for the transforming growth factor beta (tgf-β)/Smads pathway, the expression levels of collagen synthesis genes (tgf-β receptor 1 and 2, smad nuclear-interacting protein 1 (snip1) and prolyl 4-hydroxylase subunit beta (p4hβ)) in the C3000 group were significantly greater than those in the C0, C6000 and kelp groups. On the contrary, the expression levels of collagen degradation genes (lysyl oxidase-like 2 (loxl2) and matrix metalloproteinase 14 (mmp14)) in the C3000 group were significantly lower than those in the C0, C6000 and kelp groups. In conclusion, VC at an addition level of 3000 mg/kg significantly increased the gonad texture and collagen contents of M. nudus, which could be accomplished by increasing collagen synthesis and inhibiting collagen degradation through the tgf-β/Smads pathway. These results could contribute to better understanding the beneficial effects of VC addition on the gonad texture quality of M. nudus.

Foodomics uncovers functional and volatile metabolite dynamics in red raspberry chewable tablet optimized processing

Raspberries are known to contain valuable metabolites and possess a robust antioxidant capacity. However, the impact of different tablet processing stages on the nutritional content and flavor profile of raspberries remains unclear. The dynamic profile of functional and volatile metabolites was investigated through foodomics combined with UPLC-MS/MS-based widely targeted metabolomics and HS-SPME-GC-MS, and antioxidant capacities were assessed during tablet processing. 1336 functional metabolites and 645 volatile metabolites were identified. Results indicated tablets retained 34% ∼ 61% of the total volatile contents. In addition, the conversion intensity of functional metabolites was consistent with the order of "Tableting > Freeze-drying > Crushing". Compared to raspberry, tablets showed higher antioxidant activity, which was positively correlated with vitamin contents. This study elucidated that tablet formation demonstrated advantages in antioxidation and aroma retention, which may provide insights for enhancing quality during the tableting process.

Vitamin C inactivates c-Jun N-terminal kinase to stabilize heart and neural crest derivatives expressed 1 (Hand1) in regulating placentation and maintenance of pregnancy

Vitamin C (VC) serves as a pivotal nutrient for anti-oxidation process, metabolic responses, and stem cell differentiation. However, its precise contribution to placenta development and gestation remains obscure. Here, we demonstrated that physiological levels of VC act to stabilize Hand1, a key bHLH transcription factor vital for the development trajectory of trophoblast giant cell (TGC) lineages, thereby promoting the differentiation of trophoblast stem cells into TGC. Specifically, VC administration inactivated c-Jun N-terminal kinase (JNK) signaling, which directly phosphorylates Hand1 at Ser48, triggering the proteasomal degradation of Hand1. Conversely, a loss-of-function mutation at Ser48 on Hand1 not only significantly diminished both intrinsic and VC-induced stabilization of Hand1 but also underscored the indispensability of this residue. Noteworthy, the insufficiency of VC led to severe defects in the differentiation of diverse TGC subtypes and the formation of labyrinth's vascular network in rodent placentas, resulting in failure of maintenance of pregnancy. Importantly, VC deficiency, lentiviral knockdown of JNK or overexpression of Hand1 mutants in trophectoderm substantially affected the differentiation of primary and secondary TGC in E8.5 mouse placentas. Thus, these findings uncover the significance of JNK inactivation and consequential stabilization of Hand1 as a hitherto uncharacterized mechanism controlling VC-mediated placentation and perhaps maintenance of pregnancy.

Molecular Pharmacology of Vitamin C and Relevance to Health and Obesity-A Narrative Review

The role of food constituents as pharmacological agents is an important consideration in health and obesity. Vitamin C acts as a small molecule antioxidant but is also a co-factor for numerous transition metal-dependent enzymes involved in healthy weight and energy metabolism. Vitamin C cannot be manufactured by humans and is mainly obtained from the dietary intake of fresh fruit and vegetables. There is great variability between different nutritional guidelines in the recommended daily allowance of vitamin C. Vitamin C deficiency results from an inadequate intake of vitamin C-containing foods and also increased utilization by oxidative and carbonyl stress. Risk factors for vitamin C deficiency include cigarette smoking, malnutrition, obesity, type 2 diabetes mellitus, age, race, sex, social isolation, major surgery, and Western-type diets. Despite the common belief that vitamin C deficiency is rare in affluent countries, surveys of large populations and specific patient groups suggest otherwise. Patients with obesity typically consume highly processed, energy-dense foods which contain inadequate micronutrients. As obesity increases, larger amounts of oral vitamin C are required to achieve adequate plasma and tissue concentrations, as compared to persons with a healthy weight. This is important in the control of oxidative stress and the maintenance of homeostasis and organ function. In this narrative review, the dosage, absorption, distribution, excretion, and catabolism of vitamin C are reviewed, together with the latest findings on vitamin C pharmacology in patients with obesity.

Empowering γδ T-cell functionality with vitamin C

Vitamin C (ascorbic acid) is a potent antioxidant and a cofactor for various enzymes including histone demethylases and methylcytosine dioxygenases. Vitamin C also exerts direct cytotoxicity toward selected tumor cells including colorectal carcinoma. Moreover, vitamin C has been shown to impact immune cell differentiation at various levels including maturation and/or functionality of T cells and their progenitors, dendritic cells, B cells, and NK cells. γδ T cells have recently attracted great interest as effector cells for cell-based cancer immunotherapy, due to their HLA-independent recognition of a large variety of tumor cells. While γδ T cells can thus be also applied as an allogeneic off-the-shelf product, it is obvious that the effector function of γδ T cells needs to be optimized to ensure the best possible clinical efficacy. Here we review the immunomodulatory mechanisms of vitamin C with a special focus on how vitamin C enhances the effector function of γδ T cells. We also discuss future directions of how vitamin C can be used in the clinical setting to boost the efficacy of adoptive cell therapies.

Association of dietary vitamin C consumption with severe headache or migraine among adults: a cross-sectional study of NHANES 1999-2004

Background

An antioxidant-rich diet has been shown to protect against migraines in previous research. However, little has been discovered regarding the association between migraines and vitamin C (an essential dietary antioxidant). This study assessed the dietary vitamin C intake among adult migraineurs in the United States to determine if there is a correlation between migraine incidence and vitamin C consumption in adults.

Methods

This cross-sectional research encompassed adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004, providing detailed information on their dietary vitamin C intake as well as their history of severe headaches or migraines. The study used weighted multivariable and logistic regression analyses to find an independent connection between vitamin C consumption and severe headache or migraine. Tests of interactions and subgroup analysis were conducted.

Results

Among the 13,445 individuals in the sample, 20.42% had a severe headache or migraine. In fully adjusted models, dietary vitamin C consumption was substantially linked negatively with severe headache or migraine (odds ratio [OR] = 0.94, 95% confidence interval [CI] = 0.91-0.98, p = 0.0007). Compared to quartile 1, quartile 4 had 22% fewer odds of having a severe headache or migraine (OR = 0.78, 95% CI = 0.69-0.89, p = 0.0002). Subgroup analyses showed a significant difference between vitamin C intake and severe headaches or migraines by gender (p for interaction < 0.01).

Conclusion

Reduced risk of severe headaches or migraines may be associated with increased consumption of vitamin C.

Pulsed electric field technology as a promising pre-treatment for enhancing orange agro-industrial waste biorefinery

In the processing of orange juice, 50-70% of the fresh fruit weight is converted into organic waste. Orange processing waste (OPW) primarily consists of peels, seeds, and pulp. Improper disposal of this residue can lead to greenhouse gas emissions, environmental pollution, and the wastage of natural resources. To address this ecological issues, recent research has focused on developing innovative process designs to maximize the valorization of OPW through biorefinery strategies. However, the current challenge in implementing these methods for industrial waste management is their significant energy consumption. In response to these challenges, recent studies have explored the potential of employing pulsed electric field (PEF) technology as a pre-treatment to improve energy efficiency in biorefinery processes. This non-thermal and emerging technology can enhance the mass transfer of intracellular components via electroporation of cell walls, thereby resulting in shorter processing times, lower energy inputs, greater retention of thermosensitive components, and higher extraction yields. In this regard, this review offers a comprehensive discussion on the innovative biorefinery strategies to the valorization of OPW, with a specific focus on recent studies assessing the technical feasibility of methodologies for the extraction of phytochemical compounds, dehydration processes, and bioconversion methods. Recent studies that discussed the potential of PEF technology to reduce energy demand by increasing the mass transfer of biological tissues were emphasized.

Understanding mechanisms of antioxidant action in health and disease

Several different reactive oxygen species (ROS) are generated in vivo. They have roles in the development of certain human diseases whilst also performing physiological functions. ROS are counterbalanced by an antioxidant defence network, which functions to modulate ROS levels to allow their physiological roles whilst minimizing the oxidative damage they cause that can contribute to disease development. This Review describes the mechanisms of action of antioxidants synthesized in vivo, antioxidants derived from the human diet and synthetic antioxidants developed as therapeutic agents, with a focus on the gaps in our current knowledge and the approaches needed to close them. The Review also explores the reasons behind the successes and failures of antioxidants in treating or preventing human disease. Antioxidants may have special roles in the gastrointestinal tract, and many lifestyle features known to promote health (especially diet, exercise and the control of blood glucose and cholesterol levels) may be acting, at least in part, by antioxidant mechanisms. Certain reactive sulfur species may be important antioxidants but more accurate determinations of their concentrations in vivo are needed to help assess their contributions.

An opportunity for acerola pulp (Malpighia emarginata DC) valorization evaluating its performance during the block cryoconcentration by physicochemical, bioactive compounds, HPLC-ESI-MS/MS, and multi-elemental profile analysis

The present study evaluated the effect of cryoconcentration of pulp blocks of acerola (Malpighia emarginata DC). The study evaluated cryoconcentration in three stages. The cryoconcentrated samples, the ice fractions, and the initial pulp were evaluated for physicochemical composition, bioactive composition, and multielement profile. The cryoconcentrated sample obtained in the third stage of cryoconcentration showed the best results for the concentration factor, process efficiency, total soluble solids content, red color intensity, and increasing of the macro and micronutrients: Cu, Ca, S, Sr, K, Mn, Na, P, Mg, Fe. All stages presented good performance in the total soluble solids content, increase in the titratable acidity of the concentrates, and progressive increase in the intensity of the red color. Generally, higher levels of total phenolic and antioxidant activity were found for the 2nd and 3rd concentrates. The phenolic activity showed an increase of 166.90% in the 3rd stage concentrate compared to fresh pulp, and the antioxidant activity was 112.10% by the ABTS method and 131.60% by the DPPH method, both in the 3rd stage concentrate. The major individual polyphenols were Ferulic acid, Protocatechuic acid, and Taxifolin, with significant increases in the concentration of the compounds in the 2nd and 3rd stage concentrates. In addition, the contents of potentially toxic metals were below detection limits. During the cryoconcentration process, there was a decrease in the values ​​of vitamin C content, moisture content, density, and elements Cu, Sr, and Zn.

Nutrigenomics and redox regulation: Concepts relating to the Special Issue on nutrigenomics

During our whole lifespan, from conception to death, the epigenomes of all tissues and cell types of our body integrate signals from the environment. This includes signals derived from our diet and the uptake of macro- and micronutrients. In most cases, this leads only to transient changes, but some effects of this epigenome programming process are persistent and can even be transferred to the next generation. Both epigenetic programming and redox processes are affected by the individual choice of diet and other lifestyle decisions like physical activity. The nutrient-gene communication pathways have adapted during human evolution and are essential for maintaining health. However, when they are maladaptive, such as in long-term obesity, they significantly contribute to diseases like type 2 diabetes and cancer. The field of nutrigenomics investigates nutrition-related signal transduction pathways and their effect on gene expression involving interactions both with the genome and the epigenomes. Several of these diet-(epi)genome interactions and the involved signal transduction cascades are redox-regulated. Examples include the effects of the NAD+/NADH ratio, vitamin C levels and secondary metabolites of dietary molecules from plants on the acetylation and methylation state of the epigenome as well as on gene expression through redox-sensitive pathways via the transcription factors NFE2L2 and FOXO. In this review, we summarize and extend on these topics as well as those discussed in the articles of this Special Issue and take them into the context of redox biology.

Recommendations for Nutritional Supplementation in Pediatric Oncology: A Compilation of the Facts

BACKGROUND

As one of the few modifiable risk factors, the importance of dietary patterns for both disease prevention and treatment outcome in pediatric oncology has gained increasing popularity. Malnutrition is associated with lower survival rates, tolerance to treatment, and quality of life. Yet, especially in children with malignancies, nutritional deterioration is common, and pediatric cancer patients often present with inadequate intake of micro- and macronutrients alike. Despite the reported widespread use of dietary supplements, few empirical data provide a basis for clinical recommendations, and evidence for their efficacy is inconsistent. Current literature lacks a systematic approach as to how and which supplements should be recommended for specific patients, types of cancer, or during specific treatments. The aim of this review is to highlight the role of the most frequently used nutrients in pediatric malignant diseases and to give a practical guide based on current scientific evidence.

METHODS

A comprehensive literature search was conducted on PubMed through April 2023 to select meta-analyses, systematic reviews, observational studies, and individual randomized controlled trials (RCTs) of macro- and micronutrient supplementation in pediatric oncology. The search strategy included the following medical subject headings (MeSH) and keywords: "childhood cancer", "pediatric oncology", "nutritional status", "dietary supplements", "vitamins", "micronutrients", "calcium", "magnesium", "vitamin D", "zinc" "glutamine", "selen", and "omega-3 fatty acids". The reference lists of all relevant articles were screened to include potentially pertinent studies.

RESULTS

The present review provides a comprehensive and updated overview of the latest evidence about the role of nutrition and diet in pediatric oncology, also focusing on different nutritional interventions available for the management of the disease. We summarize evidence about the importance of adequate nutrition in childhood cancer and the role of several micronutrients and critically interpret the findings. Possible effects and benefits of supplementation during chemotherapy are discussed, as are strategies for primary and secondary prevention.

CONCLUSIONS

We here describe the obvious benefits of dietary supplementation for childhood cancer. Further large-scale clinical trials are required to verify the impacts of deficiencies and the possible benefits of supplementation and optimal dosages. (337 words).