Effects of Mitoquinone (MitoQ) Supplementation on Aerobic Exercise Performance and Oxidative Damage: A Systematic Review and Meta-analysis

BACKGROUND

Contracting skeletal muscle produces reactive oxygen species (ROS) originating from both mitochondrial and cytosolic sources. The use of non-specific antioxidants, such as vitamins C and E, during exercise has produced inconsistent results in terms of exercise performance. Consequently, the effects of the mitochondrial-targeted coenzyme Q10, named Mitoquinone (MitoQ) on exercise responses are currently under investigation.

METHODS

In this study, we conducted a meta-analysis to quantitatively synthesize research assessing the impact of MitoQ on aerobic endurance performance and exercise-induced oxidative damage. PubMed, Web of Science, and SCOPUS databases were used to select articles from inception to January 16th of 2024. Inclusion criteria were MitoQ supplementation must be compared with a placebo group, showing acute exercise responses in both; for crossover designs, at least 14 d of washout was needed, and exercise training can be concomitant to MitoQ or placebo supplementation if the study meets the other inclusion criteria points. The risk of bias was evaluated through the Critical Appraisal Checklist (JBI).

RESULTS

We identified eight studies encompassing a total sample size of 188 subjects. Our findings indicate that MitoQ supplementation effectively reduces exercise-induced oxidative damage (SMD: -1.33; 95% CI: -2.24 to -0.43). Furthermore, our findings indicate that acute and/or chronic MitoQ supplementation does not improve endurance exercise performance (SMD: -0.50; 95% CI: -1.39 to 0.40) despite reducing exercise-induced oxidative stress. Notably, our sensitivity analysis reveals that MitoQ may benefit subjects with peripheral artery disease (PAD) in improving exercise tolerance.

CONCLUSION

While MitoQ effectively reduces exercise-induced oxidative damage, no evidence suggests that aerobic exercise performance is enhanced by either acute or chronic MitoQ supplementation. However, acute MitoQ supplementation may improve exercise tolerance in subjects with PAD. Future research should investigate whether MitoQ supplementation concurrent with exercise training (e.g., 4-16 weeks) alters adaptations induced by exercise alone and using different doses.

Vitamin E Does not Favor Recovery After Exercises: Systematic Review and Meta-analysis

This review aimed to verify the effects of vitamin E supplementation on oxidative stress, inflammatory response, muscle damage, soreness, and strength in healthy adults after exercise. We searched the MEDLINE, EMBASE, SPORTDiscus, Cochrane CENTRAL, and Web of Science from inception to August 2023, with no language restrictions. We included randomized placebo-controlled trials evaluating the supplementation of vitamin E on the abovementioned outcomes after a bout of physical exercise in healthy participants (no restriction for publication year or language). Meta-analyses were conducted to compare vitamin E and placebo supplementations to obtain a 95% confidence interval (95%IC). Twenty studies were included (n=298 participants). The effect of supplementation was assessed between 0 h and 96 h after the exercise. Compared to placebo, vitamin E had no effects on lipid (95%IC= -0.09 to 0.42), protein (-2.44 to 3.11), SOD (-1.05 to 0.23), interleukin-6 (-0.18 to 1.16), creatine kinase (-0.33 to 0.27), muscle soreness (-1.92 to 0.69), and muscle strength (-1.07 to 0.34). Heterogeneity for the analyses on carbonyls, interleukin-6 (1 h and 3 h), and muscle soreness ranged between 70 to 94%. Supplementing with vitamin E should not be recommended to support the recovery process in healthy individuals after exercise, given the lack of efficacy in the analyzed variables following an exercise session.

THE VITAMIN E CONSUMPTION EFFECT ON MUSCLE DAMAGE AND OXIDATIVE STRESS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

ABSTRACT Introduction: Vitamin E supplementation may protect against exercise-induced muscle damage (EIMD) through possible inhibition of free radical formation and cell membrane stabilization. However, there is no systematic review of this topic. This fact maintains academic stalemates that may have a resolution. Objective: This systematic review with meta-analysis aims to provide a comprehensive literature review on the hypothesis of the benefit of vitamin E supplementation on oxidative stress and muscle damage induced by aerobic exercise. Methods: A random-effects model was used, weighted mean difference (WMD) and 95% confidence interval (CI) were applied to estimate the overall effect. Results: The results revealed a significant effect of vitamin E supplementation on reducing creatine kinase (CK) and lactate dehydrogenase (LDH). In addition, a subgroup analysis resulted in a significant decrease in CK concentrations in trials with immediate and <24 hours post-exercise CK measurement; <1000 at daily vitamin E intake; ≤1 at weekly intake; 1 at six weeks and >6 weeks experimental duration, studies on aerobic exercise and training were part of the crossover study. Conclusion: Vitamin E can be seen as a priority agent for recovery from muscle damage. Evidence Level II; Therapeutic Studies – Investigating the results.

Can Low-Dose of Dietary Vitamin E Supplementation Reduce Exercise-Induced Muscle Damage and Oxidative Stress? A Meta-Analysis of Randomized Controlled Trials

Vitamin E plays an important role in attenuating muscle damage caused by oxidative stress and inflammation. Despites of beneficial effects from antioxidant supplementation, effects of antioxidants on exercise-induced muscle damage are still unclear. The aim of this meta-analysis was to investigate the effects of dietary vitamin E supplementation on exercise-induced muscle damage, oxidative stress, and inflammation in randomized controlled trials (RCTs). The literature search was conducted through PubMed, Medline, Science Direct, Scopus, SPORTDiscuss, EBSCO, Google Scholar database up to February 2022. A total of 44 RCTs were selected, quality was assessed according to the Cochrane collaboration risk of bias tool (CCRBT), and they were analyzed by Revman 5.3. Dietary vitamin E supplementation had a protective effect on muscle damage represented by creatine kinase (CK; SMD −1.00, 95% CI: −1.95, −0.06) and lactate dehydrogenase (SMD −1.80, 95% CI: −3.21, −0.39). Muscle damage was more reduced when CK was measured immediately after exercise (SMD −1.89, 95% CI: −3.39, −0.39) and subjects were athletes (SMD −5.15, 95% CI: −9.92, −0.39). Especially vitamin E supplementation lower than 500 IU had more beneficial effects on exercise-induced muscle damage as measured by CK (SMD −1.94, 95% CI: −2.99, −0.89). In conclusion, dietary vitamin E supplementation lower than 500 IU could prevent exercise-induced muscle damage and had greater impact on athletes

Effects of the combination of vitamins C and E supplementation on oxidative stress, inflammation, muscle soreness, and muscle strength following acute physical exercise: meta-analyses of randomized controlled trials

Background:The combined supplementation of vitamins C and E potentially can mitigate oxidative stress (OS) and accelerate recovery following exercise. However, there is little evidence and a lack of consensus on the effects of these vitamins for this purpose. The objective of this systematic review was to summarize the evidence on the effects of the combined supplementation of vitamins C and E in OS, inflammatory markers, muscle damage, muscle soreness, and musculoskeletal functionality following acute exercise. Methods: The search was carried out from inception until March 2021, on MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science, and SPORT Discus. We included placebo-controlled randomized clinical trials (RCTs) that evaluated the effects of combined supplementation of vitamins C and E in OS, inflammatory markers, muscle damage, muscle soreness, and muscle strength following a single bout of exercise. Random-effect meta-analyses were used to compare pre to post-exercise mean changes in subjects who received supplementation with vitamins C and E or placebo versus controls. Data are presented as standard mean difference (SMD) and 95% confidence interval (95% CI). Results: Eighteen RCTs, accounting for data from 322 individuals, were included. The use of vitamins attenuated lipid peroxidation (SMD= -0.703; 95% CI= -1.035 to -0.372; p < 0.001), IL-6 (SMD= -0.576; 95%CI= -1.036 to -0.117; p = 0.014), and cortisol levels (SMD= -0.918; 95%CI= -1.475 to -0.361; p = 0.001) immediately, and creatine kinase levels 48 h following exercise (SMD= -0.991; 95%CI= -1.611 to -0.372; p = 0.002). Supplementing the combination of vitamins had no effects on protein carbonyls, reduced/oxidized glutathione ratio, catalase, interleukin-1Ra, C-reactive protein, lactate dehydrogenase, muscle soreness, and muscle strength. Conclusion: Prior supplementation of the combination of vitamins C and E attenuates OS (lipid peroxidation), the inflammatory response (interleukin-6), cortisol levels, and muscle damage (creatine kinase) following a session of exercise.

Effect of omega-3 fatty acids supplementation on indirect blood markers of exercise-induced muscle damage: Systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Omega 3 fatty acids supplementation may have an attenuative effect on exercise-induced muscle damage (EIMD) through the cell membrane stabilization. The purpose of the present meta-analysis was to evaluate the effects of omega 3 fatty acids supplementation, on indirect blood markers of muscle damage following EIMD in trained and untrained individuals.

METHODS

Scopus, Medline, and Google scholar systematically searched up to January 2021. The Cochrane Collaboration tool was used for the quality of studies. Random-effects model, weighted mean difference (WMD), and 95% confidence interval (CI) were applied for the overall effect estimating. The heterogeneity between studies was evaluated applying the chi-squared and I2 statistic.

RESULTS

The outcomes showed a significant effect of omega 3 supplementation on reducing creatine kinase (CK), lactate dehydrogenase (LDH), and myoglobin (Mb) concentrations. In addition, a subgroup analysis indicated a significant reduction in CK, LDH, and Mb concentrations, based on follow-ups after exercise, studies duration, time of supplementation, and training status.

CONCLUSION

The current meta-analysis indicated an efficacy of omega 3 in reducing CK, LDH, and Mb serum concentration among healthy individuals, overall and in subgroups analysis. Thus, omega 3 should be considered as a priority EIMD recovery agent in interventions.

Micronutrients and athletic performance: A review

Optimising nutrition intake is a key component for supporting athletic performance and supporting adaption to training. Athletes often use micronutrient supplements in order to correct vitamin and mineral deficiencies, improve immune function, enhance recovery and or to optimise their performance. The aim of this review was to investigate the recent literature regarding micronutrients (specifically iron, vitamin C, vitamin E, vitamin D, calcium) and their effects on physical performance. Over the past ten years, several studies have investigated the impacts of these micronutrients on aspects of athletic performance, and several reviews have aimed to provide an overview of current use and effectiveness. Currently the balance of the literature suggests that micronutrient supplementation in well-nourished athletes does not enhance physical performance. Excessive intake of dietary supplements may impair the body's physiological responses to exercise that supports adaptation to training stress. In some cases, micronutrient supplementation is warranted, for example, with a diagnosed deficiency, when energy intake is compromised, or when training and competing at altitude, however these micronutrients should be prescribed by a medical professional. Athletes are encouraged to obtain adequate micronutrients from a wellbalanced and varied dietary intake.

An Overview of Physical Exercise and Antioxidant Supplementation Influences on Skeletal Muscle Oxidative Stress

One of the essential injuries caused by moderate to high-intensity and short-duration physical activities is the overproduction of reactive oxygen species (ROS), damaging various body tissues such as skeletal muscle (SM). However, ROS is easily controlled by antioxidant defense systems during low to moderate intensity and long-term exercises. In stressful situations, antioxidant supplements are recommended to prevent ROS damage. We examined the response of SM to ROS generation during exercise using an antioxidant supplement treatment strategy in this study. The findings of this review research are paradoxical due to variances in antioxidant supplements dose and duration, intensity, length, frequency, types of exercise activities, and, in general, the lack of a regular exercise and nutrition strategy. As such, further research in this area is still being felt.

Oxidative Stress and Abnormal Tendon Sonographic Features in Elite Soccer Players (A Pilot Study)

Objective  Sound experimental data suggest that oxidative stress plays an important role in the pathogenesis of tendinopathies. However, this hypothesis in humans remains speculative given that clinical data are lacking to confirm it. Recently, a new methodology has allowed to quantify the oxidative stress in vivo by measuring the concentration of hydroperoxides of organic compounds, which have been utilized as an oxidative stress-related marker in several pathologic and physiologic conditions. Given the reliability of this test and the lack of information in subjects with tendinopathies, the aim of the present study was to assess the oxidative stress status in elite professional soccer players with and without ultrasonographic features of tendon damage.

Methods  In 73 elite players, blood metabolic parameters were evaluated and oxidative stress was measured by means of a specific test (expressed as U-Carr units). Therefore, an ultrasonographic evaluation of the Achilles and patellar tendons was performed.

Results  No significant relationships were observed between metabolic parameters and oxidative stress biomarkers. The Achilles and patellar tendons showed a normal echographic pattern in 58 athletes, and sonographic abnormalities in 15. The athletes with ultrasonographic alterations, compared to those with normal US picture, showed significantly higher U-Carr levels ( p  = 0.000), body mass index (BMI) values ( p  = 0.03) and were older ( p  = 0.005). The difference in U-Carr values among the subjects remained significant also after adjustment for age and BMI.

Conclusion  The results of the present study support the hypothesis that oxidative substances, also increased at systemic and not only at local level, may favor tendon damage.

Level of Evidence  IV (pilot study).

Effects of Vitamin E and Coenzyme Q10 Supplementation on Oxidative Stress Parameters in Untrained Leisure Horses Subjected to Acute Moderate Exercise

The effects of antioxidant supplements on exercise-induced oxidative stress have not been investigated in untrained leisure horses. We investigated the effects of 14-day supplementation with vitamin E (1.8 IU/kg/day), coenzyme Q₁₀ (CoQ₁₀; ubiquinone; 800 mg/day), and a combination of both (the same doses as in mono-supplementation) on the blood levels of CoQ₁₀, vitamin E, and oxidative stress parameters in untrained leisure horses subjected to acute moderate exercise. Correlations between lipid peroxidation and muscle enzyme leakage were also determined. Forty client-owned horses were included in the study, with 10 horses in each of the antioxidant and placebo (paraffin oil) groups. Blood parameters were measured before supplementation, before and immediately after exercise, and after 24 h of rest. The differences in individual parameters between blood collection times and groups were analysed with linear mixed models (p ˂ 0.05). None of the supplemented antioxidants affected vitamin E and CoQ₁₀ concentrations, oxidative stress parameters, or serum muscle enzymes. Lipid peroxidation occurred in horses supplemented with placebo and CoQ₁₀ but not in horses supplemented with vitamin E or the combination of both antioxidants. These results suggest that vitamin E alone or in combination with CoQ₁₀ prevented lipid peroxidation in untrained leisure horses subjected to acute moderate exercise.

The lack of association between dietary antioxidant quality score with handgrip strength and handgrip endurance amongst Tehranian adults: A cross-sectional study from a Middle East country

OBJECTIVE

The association between dietary antioxidant quality score (DAQS) and handgrip strength (HS) and handgrip endurance (HE) is still unclear. We aimed to investigate whether adherence to dietary antioxidant quality score (DAQS) is associated with handgrip strength (HS) and handgrip endurance (HE) amongst adults in Tehran.

METHODS

This cross-sectional study was conducted on 270 (43.7% males, mean age 37 years and 56.3% females, mean age 35 years) apparently healthy adult subjects (53.2% were married) selected from different parts of Tehran, Iran. Dietary intake was assessed using a 168-item validated food frequency questionnaire. DAQS was calculated using antioxidant-nutrient intake. Body composition was measured using a body composition analyser. Handgrip strength and endurance were measured by a digital handgrip dynamometer. Relative muscle strength was expressed as the ratio of handgrip strength by body mass index (BMI).

RESULTS

The results showed that DAQs had no significant association with HS (P = .67, adjusted R2  = .60) and HE (P = .19, adjusted R2  = .08) after adjusting for potential confounders. However, a significant positive association was found between selenium intake and HE even after adjusting for potential confounders (P = .01, adjusted R2  = .10). After controlling for potential confounders no differences in the mean of HS (P = .29) and also HE (P = .61) amongst tertiles of DAQS was found. Positive linear association was found between vitamin C (P = .02, adjusted R2  = .53) and vitamin E (P = .03, adjusted R2  = .55) intake with relative muscle strength.

CONCLUSION

Our results revealed that no significant association between DAQS and HE and HS. It was found that more intake of selenium was positively linked to HE. Dietary intake of vitamin C and vitamin E are associated with higher relative muscle strength. It is evident that more prospective studies are needed to confirm the veracity of our results.

Effects of Dietary Strategies on Exercise-Induced Oxidative Stress: A Narrative Review of Human Studies

Exhaustive exercise can induce excessive generation of reactive oxygen species (ROS), which may enhance oxidative stress levels. Although physiological levels are crucial for optimal cell signaling and exercise adaptations, higher concentrations have been demonstrated to damage macromolecules and thus facilitate detrimental effects. Besides single dosages of antioxidants, whole diets rich in antioxidants are gaining more attention due to their practicality and multicomponent ingredients. The purpose of this narrative review is to summarize the current state of research on this topic and present recent advances regarding the antioxidant effects of whole dietary strategies on exercise-induced oxidative stress in humans. The following electronic databases were searched from inception to February 2021: PubMed, Scope and Web of Science. Twenty-eight studies were included in this narrative review and demonstrated the scavenging effects of exercise-induced ROS generation, oxidative stress markers, inflammatory markers and antioxidant capacity, with only one study not confirming such positive effects. Although the literature is still scarce about the effects of whole dietary strategies on exercise-induced oxidative stress, the majority of the studies demonstrated favorable effects. Nevertheless, the protocols are still very heterogeneous and further systematically designed studies are needed to strengthen the evidence.

The effect of curcumin supplementation on recovery following exercise-induced muscle damage and delayed-onset muscle soreness: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

curcumin consumption may have a protective effect against exercise-induced muscle damage (EIMD) through stabilization of the cell membrane via inhibition of free radical formation. Evidence supporting a protective role of curcumin after physical activity induced muscle injury in humans, however, it is inconsistent.

METHODS

Medline, Scopus, and Google scholar were systematically searched up to May 2020. The Cochrane Collaboration tool for assessing the risk of bias was used for assessing the quality of studies. Random effects model, weighted mean difference (WMD), and 95% confidence interval (CI) were used for estimating the overall effect. Between-study heterogeneity was assessed using the chi-squared and I² statistic.

RESULTS

The results revealed a significant effect of curcumin supplementation on reducing creatine kinase (CK) (weighted mean difference [WMD] = -48.54 IU.L^-1 ; 95% CI: -80.667, -16.420; p = .003) and muscle soreness index decrease (WMD = -0.476; 95% CI: -0.750, -0.202; p = .001). Moreover, a subgroup analysis resulted in a significant decrease in CK concentrations and muscle soreness index, according to follow-ups after exercise, dose of curcumin, duration of studies, exercise type, train status and study design.

CONCLUSIONS

The current evidence revealed a efficacy of curcumin in reducing CK serum levels and muscle soreness index among adults. Therefore, curcumin may be known as a priority EIMD recovery agent in interventions.

Nutrition and Sarcopenia-What Do We Know?

Muscle health is important for the functionality and independence of older adults, and certain nutrients as well as dietary patterns have been shown to offer protective effects against declines in strength and function associated with aging. In this paper, micronutrients, macronutrients, and food groups have been reviewed, along with their studied effects on the prevalence and incidence of sarcopenia, as well as their ability to preserve muscle mass and optimize physical performance. Randomized controlled trials appear to suggest a critical role for dietary intake of protein in preventing sarcopenia and muscle loss, although the optimal dose and type of protein is unknown. There are some promising data regarding the role of vitamin D and sarcopenia, but it is unclear whether the dose, frequency of dose, or length of treatment impacts the efficacy of vitamin D on improving muscle mass or function. Selenium, magnesium, and omega 3 fatty acids have been studied as supplements in clinical trials and in the diet, and they appear to demonstrate a potential association with physical activity and muscle performance in older individuals. Following the Mediterranean diet and higher consumption of fruits and vegetables have been associated with improved physical performance and protection against muscle wasting, sarcopenia, and frailty.

Nutritional strategies for maintaining muscle mass and strength from middle age to later life: A narrative review

Progressive age-related reductions in muscle mass and strength (sarcopenia) can cause substantial morbidity. This narrative review summarizes evidence of nutritional interventions for maintaining muscle mass and strength from midlife through old age. PubMed and Cochrane databases were searched to identify studies of dietary intake and nutritional interventions for sustaining muscle mass and strength. The benefits of progressive resistance training with and without dietary interventions are well documented. Protein and amino acid (particularly leucine) intake should be considered, and supplementation may be warranted for those not meeting recommended intakes. Vitamin D receptors are expressed in muscle tissue; meta-analyses have shown that vitamin D benefits muscle strength. Data suggest that milk and other dairy products containing different bioactive compounds (i.e. protein, leucine) can enhance muscle protein synthesis, particularly when combined with resistance exercise. Omega-3 s can improve muscle mass and strength by mediating cell signaling and inflammation-related oxidative damage; no studies were specifically conducted in sarcopenia. Low-dose antioxidants (e.g. vitamins C and E) can protect muscle tissue from oxidative damage, but relevant studies are limited. Magnesium is involved with muscle contraction processes, and data have shown benefits to muscle strength. Acidogenic diets increase muscle protein breakdown, which is exacerbated by aging. Alkalizing compounds (e.g. bicarbonates) can promote muscle strength. Small studies of probiotics and plant extracts have generated interest, but few large studies have been conducted. Based on available data, dietary and supplemental interventions may add to the benefits of exercise on muscle mass and strength; effects independent of exercise have not been consistently shown.

Effect of herbal antioxidant-rich formula on improvement of antioxidant defense system and heat shock protein-70 expression in recreational female athletes: A randomized controlled trial

Background:

The aim of the present study was to evaluate the effect of natural antioxidant formula (blend of herbs: ginger root, cinnamon bark and raw almond fruit powder, rosemary leaf powder, and honey) on oxidative status, antioxidant enzyme activity, and relative heat shock protein (HSP-70) expression in recreational female athletes.

Materials and Methods:

Eighteen female participants trained for 4 weeks and randomly received either antioxidant formula (FormEX) (n = 8) or placebo (PlcEX) (n = 10) in a randomized controlled trial. Blood samples were obtained 1-h before, 1 h and 24 h postexercise to measure malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD), glutathione peroxidases (GPx), and HSP70 mRNA expression. Data analysis was performed using 2 (treatment = grouping factor) ×6 (time = within-factor) repeated measurements analysis of variance or generalized estimating equations (GEE) test. We used the independent t-test to evaluate any significant differences for real-time polymerase chain reaction data.

Results:

Antioxidant formula increased the relative HSP-70 mRNA expression more than Plc-EX group in all time points (P = 0.001). The time main effect was significant with regard to TAC and SOD concentrations (P = 0.001 and 0.002, respectively). However, there were no statistically significant differences between groups for TAC, SOD, and MDA (P = 0.25, 0.06, and 0.38, respectively). Neither the time main effect for MDA nor time and intervention interaction was not statistically significant for MDA, TAC, and SOD (P = 0.19, 0.13, and 0.10, respectively). GEE results for GPx showed that there were no significant differences between the groups (P = 0.11).

Conclusion:

The results presented herein revealed that natural antioxidant rich formula had variable effects on oxidative status. However, in contrast to many antioxidant supplements, this formulation increases the HSP-70 mRNA expression which might improve the antioxidant ability of cells in the long-term period and exercise-induced adaptation.

Association of Healthy Eating Index and oxidative stress in adolescent volleyball athletes and non-athletes

OBJECTIVES

The objective of this study was to compare the relationship between the Healthy Eating Index and oxidative stress parameters in adolescent athletes and non-athletes.

METHODS

A cross-sectional study was carried out with 18 adolescent male and female volleyball athletes who were paired with 15 adolescent non-athletes. Body fat percentage, food intake, free radical production, antioxidant enzyme activity, and thiol and protein damage were measured.

RESULTS

In the Healthy Eating Index assessment, the food quality of 72.7% of the sample was classified as low, and no participant was found to have good food quality. The mean intake of vitamins A and E was below recommendations in both groups and sexes; however vitamin C intake was appropriate for the age group. Increased free radical production was observed in the athletes' erythrocytes (p<0.001), accompanied by lower levels of plasma reduced glutathione (p = 0.01), but there were no correlations between Healthy Eating Index and oxidative stress parameters or between body composition, vitamin A, C and E intake and oxidative stress.

CONCLUSIONS

The sample's diet quality was classified as low and, despite the fact that there was greater production of free radicals in the athletes' erythrocytes and plasma, in addition to lower levels of plasma reduced glutathione , there was no correlation between Healthy Eating Index and oxidative stress.

Vitamin E, Turmeric and Saffron in Treatment of Alzheimer's Disease

Alzheimer’s disease (AD) is a growing epidemic and currently there is no cure for the disease. The disease has a detrimental effect on families and will strain the economy and health care systems of countries worldwide. The paper provides a literature review on a few ongoing possible antioxidant therapy treatments for the disease. The paper highlights use of vitamin E, turmeric and saffron for an alternative antioxidant therapy approach. Clinical studies report their therapeutic abilities as protective agents for nerve cells against free radical damage, moderating acetylcholinesterase (AChE) activity and reducing neurodegeneration, which are found as key factors in Alzheimer’s. The paper suggests that future research, with more clinical trials focused on more natural approaches and their benefits for AD treatment could be worthwhile.

Control of antioxidant supplementation through interview is not appropriate in oxidative-stress sport studies: Analytical confirmation should be required

OBJECTIVE

Controlling antioxidant supplementation in athletes involved in studies related to oxidative stress and muscle damage is the key to ensure results. The aim of this study was to confirm through high-performance liquid chromatography (HPLC) analysis whether well-trained individuals lied during a personal interview when asked if they were taking supplements with antioxidants, and how this could affect oxidative stress, muscle damage, and antioxidant response.

METHODS

A total of 94 men, well trained in endurance sports, volunteered in this study. They denied taking any antioxidant supplementation at initial interview. After a HPLC analysis, abnormal α-tocopherol concentrations were detected, probably due to a hidden antioxidant supplementation. Participants were classified into two groups: no evidence of antioxidant supplementation (NS group = α-tocopherol values <80 nmol/mL; n = 75) and evidence of antioxidant supplementation (S group = α-tocopherol values >80 nmol/mL; n = 19). Lipid peroxidation, muscle damage, antioxidant enzyme activity, and nonenzymatic antioxidant content were analyzed according to this classification. Statistical comparisons were performed using Student's t test.

RESULTS

The α-tocopherol concentrations were significantly higher in the S group than in the NS group (MD = 725.01 ± 39.01 nmol/mL; P = 0.001). The S group showed a trend toward lower hydroperoxides than the NS group (MD = 1.19 ± 0.72 nmol/mL; P = 0.071). The S group showed significantly lower catalase activity than the NS group (MD = 0.10 ± 0.02-seg-1 mg-1; P < 0.01). Skeletal muscle damage markers did not differ between experimental groups.

CONCLUSIONS

Data from the present study reveal that 20% of participants lied in the exclusion criteria of antioxidant supplementation in a personal interview, as they showed high plasmatic α-tocopherol concentrations after HPLC verification. Catalase activity seems to be affected by high α-tocopherol plasma levels. Therefore, we strongly recommend the HPLC analysis as a necessary tool to verify the antioxidant intake and preserve results in studies linking oxidative stress and sport.

Vitamin E supplementation inhibits muscle damage and inflammation after moderate exercise in hypoxia

BACKGROUND

Exercise under hypoxic conditions represents an additional stress in relation to exercise in normoxia. Hypoxia induces oxidative stress and inflammation as mediated through tumour necrosis factor (TNF)-α release that might be exacerbated through exercise. In addition, vitamin E supplementation might attenuate oxidative stress and inflammation resulting from hypoxia during exercise. The present study aimed to evaluate the effects of vitamin E supplementation (250 mg) on inflammatory parameters and cellular damage after exercise under hypoxia simulating an altitude of 4200 m.

METHODS

Nine volunteers performed three sessions of 60 min of exercise (70% maximal oxygen uptake) interspersed for 1 week under normoxia, hypoxia and hypoxia after vitamin E supplementation 1 h before exercise. Blood was collected before, immediately after and at 1 h after exercise to measure inflammatory parameters and cell damage.

RESULTS

Percentage oxygen saturation of haemoglobin decreased after exercise and recovered 1 h later in the hypoxia + vitamin condition (P < 0.05). Supplementation decreased creatine kinase (CK)-TOTAL, CK-MB and lactate dehydrogenase 1 h after exercise (P < 0.05). The exercise in hypoxia increased interleukin (IL)-6, TNF-α, IL-1ra and IL-10 immediately after exercise (P < 0.05). Supplementation reversed the changes observed after exercise in hypoxia without supplementation (P < 0.05).

CONCLUSIONS

We conclude that 250 mg of vitamin E supplementation at 1 h before exercise reduces cell damage markers after exercise in hypoxia and changes the concentration of cytokines, suggesting a possible protective effect against inflammation induced by hypoxia during exercise.

Supplementation with vitamin A enhances oxidative stress in the lungs of rats submitted to aerobic exercise

Exercise training induces reactive oxygen species production and low levels of oxidative damage, which are required for induction of antioxidant defenses and tissue adaptation. This process is physiological and essential to improve physical conditioning and performance. During exercise, endogenous antioxidants are recruited to prevent excessive oxidative stress, demanding appropriate intake of antioxidants from diet or supplements; in this context, the search for vitamin supplements that enhance the antioxidant defenses and improve exercise performance has been continuously increasing. On the other hand, excess of antioxidants may hinder the pro-oxidant signals necessary for this process of adaptation. The aim of this study was to investigate the effects of vitamin A supplementation (2000 IU/kg, oral) upon oxidative stress and parameters of pro-inflammatory signaling in lungs of rats submitted to aerobic exercise (swimming protocol). When combined with exercise, vitamin A inhibited biochemical parameters of adaptation/conditioning by attenuating exercise-induced antioxidant enzymes (superoxide dismutase and glutathione peroxidase) and decreasing the content of the receptor for advanced glycation end-products. Increased oxidative damage to proteins (carbonylation) and lipids (lipoperoxidation) was also observed in these animals. In sedentary animals, vitamin A decreased superoxide dismutase and increased lipoperoxidation. Vitamin A also enhanced the levels of tumor necrosis factor alpha and decreased interleukin-10, effects partially reversed by aerobic training. Taken together, the results presented herein point to negative effects associated with vitamin A supplementation at the specific dose here used upon oxidative stress and pro-inflammatory cytokines in lung tissues of rats submitted to aerobic exercise.

Changes in Serum Free Amino Acids and Muscle Fatigue Experienced during a Half-Ironman Triathlon

The aim of this study was to investigate the relationship between changes in serum free amino acids, muscle fatigue and exercise-induced muscle damage during a half-ironman triathlon. Twenty-six experienced triathletes (age = 37.0 ± 6.8 yr; experience = 7.4 ± 3.0 yr) competed in a real half-ironman triathlon in which sector times and total race time were measured by means of chip timing. Before and after the race, a countermovement jump and a maximal isometric force test were performed, and blood samples were withdrawn to measure serum free amino acids concentrations, and serum creatine kinase levels as a blood marker of muscle damage. Total race time was 320 ± 37 min and jump height (-16.3 ± 15.2%, P < 0.001) and isometric force (-14.9 ± 9.8%; P = 0.007) were significantly reduced after the race in all participants. After the race, the serum concentration of creatine kinase increased by 368 ± 187% (P < 0.001). In contrast, the serum concentrations of essential (-27.1 ± 13.0%; P < 0.001) and non-essential amino acids (-24.4 ± 13.1%; P < 0.001) were significantly reduced after the race. The tryptophan/BCAA ratio increased by 42.7 ± 12.7% after the race. Pre-to-post changes in serum free amino acids did not correlate with muscle performance variables or post-race creatine kinase concentration. In summary, during a half-ironman triathlon, serum amino acids concentrations were reduced by > 20%. However, neither the changes in serum free amino acids nor the tryptophan/BCAA ratio were related muscle fatigue or muscle damage during the race.

Influence of vitamin C and vitamin E on redox signaling: Implications for exercise adaptations

The exogenous antioxidants vitamin C (ascorbate) and vitamin E (α-tocopherol) often blunt favorable cell signaling responses to exercise, suggesting that redox signaling contributes to exercise adaptations. Current theories posit that this antioxidant paradigm interferes with redox signaling by attenuating exercise-induced reactive oxygen species (ROS) and reactive nitrogen species (RNS) generation. The well-documented in vitro antioxidant actions of ascorbate and α-tocopherol and characterization of the type and source of the ROS/RNS produced during exercise theoretically enable identification of redox-dependent mechanisms responsible for the blunting of favorable cell signaling responses to exercise. This review aimed to apply this reasoning to determine how the aforementioned antioxidants might attenuate exercise-induced ROS/RNS production. The principal outcomes of this analysis are (1) neither antioxidant is likely to attenuate nitric oxide signaling either directly (reaction with nitric oxide) or indirectly (reaction with derivatives, e.g., peroxynitrite); (2) neither antioxidant reacts appreciably with hydrogen peroxide, a key effector of redox signaling; (3) ascorbate but not α-tocopherol has the capacity to attenuate exercise-induced superoxide generation; and (4) alternate mechanisms, namely pro-oxidant side reactions and/or reduction of bioactive oxidized macromolecule adducts, are unlikely to interfere with exercise-induced redox signaling. Out of all the possibilities considered, ascorbate-mediated suppression of superoxide generation with attendant implications for hydrogen peroxide signaling is arguably the most cogent explanation for blunting of favorable cell signaling responses to exercise. However, this mechanism is dependent on ascorbate accumulating at sites rich in NADPH oxidases, principal contributors to contraction-mediated superoxide generation, and outcompeting nitric oxide and superoxide dismutase isoforms. The major conclusions of this review are: (1) direct evidence for interference of ascorbate and α-tocopherol with exercise-induced ROS/RNS production is lacking; (2) theoretical analysis reveals that both antioxidants are unlikely to have a major impact on exercise-induced redox signaling; and (3) it is worth considering alternate redox-independent mechanisms.

Biomarkers of oxidative stress following continuous positive airway pressure withdrawal: data from two randomised trials

There is conflicting evidence whether intermittent hypoxia in obstructive sleep apnoea (OSA) influences oxidative stress. We hypothesised that withdrawal of continuous positive airway pressure (CPAP) from patients with OSA would raise markers of oxidative stress.59 patients with CPAP-treated moderate-to-severe OSA (oxygen desaturation index (ODI) >20 events·h(-1)) were randomised 1:1 to either stay on CPAP (n=30) or change to sham CPAP (n=29) for 2 weeks. Using samples from two similar studies at two sites, we measured early morning blood malondialdehyde (MDA, a primary outcome in one study and a secondary outcome in the other), lipid hydroperoxides, total antioxidant capacity, superoxide generation from mononuclear cells and urinary F2-isoprostane. We also measured superoxide dismutase as a marker of hypoxic preconditioning. "Treatment" effects (sham CPAP versus CPAP) were calculated via linear regression.Sham CPAP provoked moderate-to-severe OSA (mean ODI 46 events·h(-1)), but blood markers of oxidative stress did not change significantly (MDA "treatment" effect (95% CI) -0.02 (-0.23 to +0.19) μmol·L(-1)). Urinary F2-isoprostane fell significantly by ~30% (-0.26 (-0.42 to -0.10) ng·mL(-1)) and superoxide dismutase increased similarly (+0.17 (+0.02 to +0.30) ng·mL(-1)).We found no direct evidence of increased oxidative stress in patients experiencing a return of their moderate-to-severe OSA. The fall in urinary F2-isoprostane and rise in superoxide dismutase implies that hypoxic preconditioning may have reduced oxidative stress.

Exercise and oxidative stress: potential effects of antioxidant dietary strategies in sports

Free radicals are produced during aerobic cellular metabolism and have key roles as regulatory mediators in signaling processes. Oxidative stress reflects an imbalance between production of reactive oxygen species and an adequate antioxidant defense. This adverse condition may lead to cellular and tissue damage of components, and is involved in different physiopathological states, including aging, exercise, inflammatory, cardiovascular and neurodegenerative diseases, and cancer. In particular, the relationship between exercise and oxidative stress is extremely complex, depending on the mode, intensity, and duration of exercise. Regular moderate training appears beneficial for oxidative stress and health. Conversely, acute exercise leads to increased oxidative stress, although this same stimulus is necessary to allow an up-regulation in endogenous antioxidant defenses (hormesis). Supporting endogenous defenses with additional oral antioxidant supplementation may represent a suitable noninvasive tool for preventing or reducing oxidative stress during training. However, excess of exogenous antioxidants may have detrimental effects on health and performance. Whole foods, rather than capsules, contain antioxidants in natural ratios and proportions, which may act in synergy to optimize the antioxidant effect. Thus, an adequate intake of vitamins and minerals through a varied and balanced diet remains the best approach to maintain an optimal antioxidant status. Antioxidant supplementation may be warranted in particular conditions, when athletes are exposed to high oxidative stress or fail to meet dietary antioxidant requirements. Aim of this review is to discuss the evidence on the relationship between exercise and oxidative stress, and the potential effects of dietary strategies in athletes. The differences between diet and exogenous supplementation as well as available tools to estimate effectiveness of antioxidant intake are also reported. Finally, we advocate the need to adopt an individualized diet for each athlete performing a specific sport or in a specific period of training, clinically supervised with inclusion of blood analysis and physiological tests, in a comprehensive nutritional assessment.