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Siervo M, Hussin AM, Calella P, Ashor A, Shannon OM, Mendes I, Stephan BC, Zheng D, Hill T, Mathers JC. Associations between Aging and Vitamin D Status with Whole-Body Nitric Oxide Production and Markers of Endothelial Function. J Nutr 2024; 154:469-478. [PMID: 38048992 DOI: 10.1016/j.tjnut.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/23/2023] [Accepted: 12/01/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Aging and vitamin D deficiency have been associated with reduced nitric oxide (NO) synthesis and impaired endothelial function (EF) but the evidence in humans remains weak. OBJECTIVES Two independent cross-sectional studies were designed to evaluate the association between age, sex, and plasma vitamin D concentrations with physiological and biochemical biomarkers of NO synthesis and EF in young and older healthy participants (Study 1) and in overweight and obese postmenopausal females (Study 2). METHODS In Study 1, 40 young (20-49 y) and older (50-75 y) males and females (10 participants per age and sex group) were included. Resting blood pressure and ear-to-finger peripheral pulse wave velocity (PWV) were measured. A stable-isotopic method was used to determine whole-body NO production. Plasma 25-hydroxyvitamin D (25(OH)D), nitrate, nitrite, and asymmetric dimethylarginine (ADMA) concentrations were determined. In Study 2, 80 older overweight and obese females (age 61.2 ± 6.2 y, body mass index 29.5 ± 4.4 kg/m2) were recruited. Postocclusion reactive hyperemia (PORH) and peripheral PWV were measured. Plasma concentrations of 25(OH)D, nitrate, cyclic guanosine monophosphate, 3-nitrotyrosine (3-NT), endothelin-1, vascular endothelial growth factor, and ADMA were determined. RESULTS In Study 1, whole-body NO production was significantly greater in young compared with older participants (0.61 ± 0.30 μmol·h-1·kg-1 compared with 0.39 ± 0.10 μmol·h-1·kg-1, P = 0.01) but there was no evidence of a sex difference (P = 0.81). Plasma 25(OH)D concentration was not associated with PWV (r = 0.18, P = 0.28) or whole-body NO production (r = -0.20, P = 0.22). Plasma ADMA concentration was associated positively with age (r = 0.35, P = 0.03) and negatively with whole-body NO production (r = -0.33, P = 0.04). In Study 2, age was associated with lower PORH (r = -0.28, P = 0.02) and greater ADMA concentrations (r = 0.22, P = 0.04). Plasma 25(OH)D concentration was inversely associated with 3-NT concentrations (r = -0.31, P = 0.004). CONCLUSIONS Older age was associated with lower whole-body NO production. Plasma vitamin D concentrations were not associated with NO production or markers of EF but showed a weak, significant correlation with oxidative stress in postmenopausal overweight females.
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Affiliation(s)
- Mario Siervo
- School of Population Health, Curtin University, Perth, WA, Australia; Curtin Dementia Centre of Excellence, Enable Institute, Curtin University, Perth, WA, Australia.
| | - Azizah Mat Hussin
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom; Institute of Medical Science Technology-Universiti Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Patrizia Calella
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope," Naples, Italy
| | - Ammar Ashor
- Department of Internal Medicine, College of Medicine, University of Al-Mustansiriyah, Baghdad, Iraq
| | - Oliver M Shannon
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
| | - Ines Mendes
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
| | - Blossom Cm Stephan
- Curtin Dementia Centre of Excellence, Enable Institute, Curtin University, Perth, WA, Australia
| | - Dingchang Zheng
- Research Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Tom Hill
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
| | - John C Mathers
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
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Lbban E, Kwon K, Ashor A, Stephan B, Idris I, Tsintzas K, Siervo M. Vitamin C supplementation showed greater effects on systolic blood pressure in hypertensive and diabetic patients: an updated systematic review and meta-analysis of randomised clinical trials. Int J Food Sci Nutr 2023; 74:814-825. [PMID: 37791386 DOI: 10.1080/09637486.2023.2264549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 09/25/2023] [Indexed: 10/05/2023]
Abstract
Results from randomised controlled trials (RCTs) testing the effect of vitamin C supplementation on blood pressure (BP) have been inconsistent. This systematic review evaluated the effects of vitamin C supplementation on BP and included RCTs testing the effects of vitamin C supplementation alone, on systolic and diastolic BP in adult participants (≥18 years). Random-effect models were conducted to estimate the pooled effects of vitamin C supplementation on BP. A total of 20 studies with 890 participants were included. The median dose of vitamin C was 757.5 mg/d, the median duration was 6 weeks. Vitamin C supplementation was found to reduce systolic BP by -3.0 mmHg (95%CI: -4.7, -1.3 mmHg; p = 0.001). Subgroup analysis showed a more pronounced effect on systolic BP in patients with hypertension (-3.2 mmHg, 95%CI -5.2, -1.2 mmHg, p = 0.002) and diabetes (-4.6 mmHg, 95%CI -8.9, -0.3 mmHg, p = 0.03). Further research needs to evaluate the long-term effect of vitamin C on BP in populations with impaired cardio-metabolic health.
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Affiliation(s)
- Eazaz Lbban
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
- Department of Physiology, College of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Kee Kwon
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Ammar Ashor
- College of Medicine, University of Al-Mustansiriyah, Baghdad, Iraq
| | - Blossom Stephan
- Curtin Dementia Centre of Excellence, enAble Institute, Curtin University, Perth, Australia
| | - Iskandar Idris
- School of Medicine, The University of Nottingham Medical School, Derby Hospital, Nottingham, UK
| | - Kostas Tsintzas
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
- Curtin Dementia Centre of Excellence, enAble Institute, Curtin University, Perth, Australia
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Lbban E, Macey A, Rundle J, Ashor A, Idris I, Siervo M. Effects of dietary nitrate and vitamin C co-ingestion on blood pressure and hand-grip strength in young adults. INT J VITAM NUTR RES 2023. [PMID: 37938096 DOI: 10.1024/0300-9831/a000799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Background: Co-administration of vitamin C and inorganic nitrate ([Formula: see text]) may reduce oxidative stress, boost the conversion of nitrite ([Formula: see text]) into NO and elicit positive vascular effects. Aims: We aimed to test the effects of oral inorganic [Formula: see text] and vitamin C co-supplementation on vascular function, muscular strength, and on concentrations of urinary [Formula: see text], vitamin C, 8-isoprostanes and salivary [Formula: see text] in healthy young adults. Methods: Ten young healthy participants were enrolled in a randomised, double-blind (only for the [Formula: see text] intervention) crossover clinical trial. Participants consumed in random order: 1) nitrate-rich beetroot juice and vitamin C (N+VC), 2) nitrate-rich beetroot juice alone (N) or 3) nitrate-depleted beetroot juice alone (ND). Resting blood pressure (BP) was measured at the research centre and at home. Non-invasive, continuous measurements of BP and cardiac function parameters were performed using a Finometer device. Free-living physical activity and hand-grip strength were assessed. Salivary [Formula: see text] and [Formula: see text] and urinary [Formula: see text], 8-isoprostanes and vitamin C concentrations were measured. Results: There were no significant differences for any of the vascular outcomes between the three interventions groups. However, analyses of within-intervention changes showed a significant lower daily systolic BP in the [Formula: see text]+vitamin C (N+VC) group only (P=0.04). Urinary [Formula: see text] (P=0.002) and salivary [Formula: see text] (P=0.001) were significantly higher in the N+VC group compared to the N and ND groups. Conclusion: These preliminary findings suggest that combining dietary [Formula: see text] with vitamin C could have protective effects on vascular function in young adults and could represent an effective strategy for the maintenance of healthy cardiovascular trajectories.
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Affiliation(s)
- Eazaz Lbban
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
- Department of Physiology, College of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Alex Macey
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Joshua Rundle
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Ammar Ashor
- College of Medicine, University of Al-Mustansiriyah, Baghdad, Iraq
| | - Iskandar Idris
- School of Medicine, The University of Nottingham Medical School, Derby Hospital, UK
| | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
- School of Population Health, Curtin University, Perth, Australia
- Dementia Centre of Excellence, enAble Institute, Curtin University, Perth, Australia
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Kimble R, Gouinguenet P, Ashor A, Stewart C, Deighton K, Matu J, Griffiths A, Malcomson FC, Joel A, Houghton D, Stevenson E, Minihane AM, Siervo M, Shannon OM, Mathers JC. Effects of a mediterranean diet on the gut microbiota and microbial metabolites: A systematic review of randomized controlled trials and observational studies. Crit Rev Food Sci Nutr 2022; 63:8698-8719. [PMID: 35361035 DOI: 10.1080/10408398.2022.2057416] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Consumption of the Mediterranean dietary pattern (MedDiet) is associated with reduced risk of numerous non-communicable diseases. Modulation of the composition and metabolism of the gut microbiota represents a potential mechanism through which the MedDiet elicits these effects. We conducted a systematic literature search (Prospero registration: CRD42020168977) using PubMed, The Cochrane Library, MEDLINE, SPORTDiscuss, Scopus and CINAHL databases for randomized controlled trials (RCTs) and observational studies exploring the impact of a MedDiet on gut microbiota composition (i.e., relative abundance of bacteria or diversity metrics) and metabolites (e.g., short chain fatty acids). Seventeen RCTs and 17 observational studies were eligible for inclusion in this review. Risk of bias across the studies was mixed but mainly identified as low and unclear. Overall, RCTs and observational studies provided no clear evidence of a consistent effect of a MedDiet on composition or metabolism of the gut microbiota. These findings may be related to the diverse methods across studies (e.g., MedDiet classification and analytical techniques), cohort characteristics, and variable quality of studies. Further, well-designed studies are warranted to advance understanding of the potential effects of the MedDiet using more detailed examination of microbiota and microbial metabolites with reference to emerging characteristics of a healthy gut microbiome.
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Affiliation(s)
- Rachel Kimble
- Human Nutrition Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Phebee Gouinguenet
- Human Nutrition Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- Nutrition & Food Sciences, University of Bordeaux, Bordeaux, France
| | - Ammar Ashor
- Department of Pharmacology, College of Medicine, Al-Mustansiriyah University, Baghdad, Iraq
| | - Christopher Stewart
- Clinical and Translational Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Jamie Matu
- School of Clinical Applied Sciences, Leeds Beckett University, Leeds, UK
| | - Alex Griffiths
- Institute for Sport, Physical Activity & Leisure, Leeds Beckett University, Leeds, UK
| | - Fiona C Malcomson
- Human Nutrition Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Abraham Joel
- Human Nutrition Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - David Houghton
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Emma Stevenson
- Human Nutrition Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Anne Marie Minihane
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia (UEA), Norwich, UK
| | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Oliver M Shannon
- Human Nutrition Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - John C Mathers
- Human Nutrition Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Abusaib M, Ahmed M, Nwayyir HA, Alidrisi HA, Al-Abbood M, Al-Bayati A, Al-Ibrahimi S, Al-Kharasani A, Al-Rubaye H, Mahwi T, Ashor A, Howlett H, Shakir M, Al-Naqshbandi M, Mansour A. Iraqi Experts Consensus on the Management of Type 2 Diabetes/Prediabetes in Adults. Clin Med Insights Endocrinol Diabetes 2020; 13:1179551420942232. [PMID: 32884389 PMCID: PMC7440731 DOI: 10.1177/1179551420942232] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 06/23/2020] [Indexed: 12/17/2022]
Abstract
Type 2 diabetes mellitus (T2DM) management differs dramatically between Iraqi public and private sectors; this variability is due to treatment access discrepancy. The aim of this consensus is to put for the first-time uniform recommendation on how to manage patients with T2DM taking in consideration the local obstacles in Iraq. These consensuses were approved by a group of Iraqi Internist and diabetologist from all over the country. Up-to-date and latest level of evidence was used throughout the recommendation.
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Affiliation(s)
- Mohammed Abusaib
- Department of Medicine, College of Medicine, Najaf Health Directorate, University of Kufa, Kufa, Iraq
| | - Mazyar Ahmed
- Department of Medicine, Erbil Health Directorate, Erbil, Iraq
| | - Hussein Ali Nwayyir
- Department of Medicine, Basrah Health Directorate, University of Basrah, Basrah, Iraq
| | - Haider Ayad Alidrisi
- Department of Medicine, Basrah Health Directorate, University of Basrah, Basrah, Iraq.,Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah, Iraq.,Endocrine and Metabolism Division, Department of Medicine, College of Medicine, University of Basrah, Basrah, Iraq
| | - Majid Al-Abbood
- Department of Medicine, Basrah Health Directorate, University of Basrah, Basrah, Iraq
| | - Ali Al-Bayati
- Department of Medicine, College of Medicine, Babylon Health Directorate, University of Babylon, Hillah, Iraq
| | | | | | - Haidar Al-Rubaye
- National Center for Diabetes, University of Mustansiriya, Baghdad, Iraq
| | - Taha Mahwi
- Department of Medicine, University of Sulaimani, Sulaymaniyah, Iraq
| | - Ammar Ashor
- National Center for Diabetes, University of Mustansiriya, Baghdad, Iraq
| | | | - Mahmood Shakir
- Department of Medicine, Nahrain University, Baghdad, Iraq
| | | | - Abbas Mansour
- Department of Medicine, Basrah Health Directorate, University of Basrah, Basrah, Iraq.,Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah, Iraq.,Endocrine and Metabolism Division, Department of Medicine, College of Medicine, University of Basrah, Basrah, Iraq
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Clifford T, Babateen A, Shannon OM, Capper T, Ashor A, Stephan B, Robinson L, O'Hara JP, Mathers JC, Stevenson E, Siervo M. Effects of inorganic nitrate and nitrite consumption on cognitive function and cerebral blood flow: A systematic review and meta-analysis of randomized clinical trials. Crit Rev Food Sci Nutr 2018; 59:2400-2410. [PMID: 29617153 DOI: 10.1080/10408398.2018.1453779] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We conducted a systematic review and meta-analysis of randomized clinical trials examining the effect of inorganic nitrate or nitrite supplementation on cognitive function (CF) and cerebral blood flow (CBF). Two databases (PubMed, Embase) were searched for articles from inception until May 2017. Inclusion criteria were: randomized clinical trials; participants >18 years old; trials comparing a nitrate/nitrite intervention with a control. Thirteen and nine trials were included in the meta-analysis to assess CF and CBF, respectively. Random-effects models were used and the effect size described as standardized mean differences (SMDs). A total of 297 participants (median of 23 per trial) were included for CF; 163 participants (median of 16 per trial) were included for CBF. Nitrate/nitrite supplementation did not influence CF (SMD +0.06, 95% CI: -0.06, 0.18, P = 0.32) or CBF under resting (SMD +0.14, 95% CI: -0.13, 0.41, P = 0.31), or stimulated conditions (SMD + 0.23, 95% CI: -0.11, 0.56, P = 0.19). The meta-regression showed an inverse association between duration of the intervention and CBF (P = 0.02) but no influence of age, BMI or dose (P < 0.05). Nitrate and nitrite supplementation did not modify CBF or CF. Further trials employing larger samples sizes and interventions with longer duration are warranted.
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Affiliation(s)
- Tom Clifford
- a Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University , Newcastle on Tyne , UK
| | - Abrar Babateen
- a Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University , Newcastle on Tyne , UK.,b Faculty of Applied Medical Sciences, Clinical Nutrition Department, Umm Al-Qura University , Makkah , Saudi Arabia
| | - Oliver M Shannon
- a Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University , Newcastle on Tyne , UK.,c Research Institute for Sport, Physical Activity, and Leisure, Leeds Beckett University , Leeds , UK
| | - Tess Capper
- a Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University , Newcastle on Tyne , UK
| | - Ammar Ashor
- a Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University , Newcastle on Tyne , UK.,d College of Medicine, University of Al-Mustansiriyah , Baghdad , Iraq
| | - Blossom Stephan
- e Institute of Health and Society, Newcastle University , Newcastle upon Tyne , UK
| | - Louise Robinson
- e Institute of Health and Society, Newcastle University , Newcastle upon Tyne , UK
| | - John P O'Hara
- c Research Institute for Sport, Physical Activity, and Leisure, Leeds Beckett University , Leeds , UK
| | - John C Mathers
- a Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University , Newcastle on Tyne , UK
| | - Emma Stevenson
- a Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University , Newcastle on Tyne , UK
| | - Mario Siervo
- a Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University , Newcastle on Tyne , UK
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