Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature

Anxiety and stress plague populations worldwide. Voluntary regulated breathing practices offer a tool to address this epidemic. We examined peer-reviewed published literature to understand effective approaches to and implementation of these practices. PubMed and ScienceDirect were searched to identify clinical trials evaluating isolated breathing-based interventions with psychometric stress/anxiety outcomes. Two independent reviewers conducted all screening and data extraction. Of 2904 unique articles, 731 abstracts, and 181 full texts screened, 58 met the inclusion criteria. Fifty-four of the studies' 72 interventions were effective. Components of effective and ineffective interventions were evaluated to develop a conceptual framework of factors associated with stress/anxiety reduction effectiveness. Effective breath practices avoided fast-only breath paces and sessions <5 min, while including human-guided training, multiple sessions, and long-term practice. Population, other breath paces, session duration ≥5 min, and group versus individual or at-home practices were not associated with effectiveness. Analysis of interventions that did not fit this framework revealed that extensive standing, interruptions, involuntary diaphragmatic obstruction, and inadequate training for highly technical practices may render otherwise promising interventions ineffective. Following this evidence-based framework can help maximize the stress/anxiety reduction benefits of breathing practices. Future research is warranted to further refine this easily accessible intervention for stress/anxiety relief.

Effect of arginine supplementation on the morphology and function of intestinal epithelia, and serum concentrations of amino acids in pigs exposed to heat stress

The exposure of pigs to heat stress (HS) appears to damage their intestinal epithelia, affecting the absorption of amino acids (AA). Arg is involved in the restoration of intestinal epithelial cells but HS reduces Arg intake. The effect of dietary supplementation with Arg on morphology of intestinal epithelia, AA transporter gene expression, and serum concentration (SC) of free AA in HS pigs were analyzed. Twenty pigs (25.3 ± 2.4 kg BW) were randomly assigned to two dietary treatments: control (0.81% Arg), wheat-soybean meal diet supplemented with L-Lys, L-Thr, DL-Met and L-Trp, and the experimental diet where 0.16% free L-Arg was supplemented to a similar control diet (+Arg). All pigs were individually housed and exposed to HS, fed at libitum with full access to water. The ambient temperature, recorded at 15-min intervals during the 21-d trial, ranged on average from 29.6 to 39.4 °C within the same day. Blood samples were collected on d18 at 1600 h (ambient temperature peak); serum was separated by centrifugation. At the end of the trial, five pigs per treatment were sacrificed to collect samples of mucosa scratched from each small intestine segment. The expression of AA transporters in intestinal mucosa and the SC of AA were analyzed. Villi height was higher (P < 0.01) in duodenum, jejunum, and ileum but the crypt depth did not differ between the control and the +Arg pigs. Supplementation of L-Arg increased the mRNA coding for the synthesis of the cationic AA transporter b 0,+ (P < 0.01) and the neutral AA transporter B 0 (P < 0.05) in duodenum by approximately five-folds and three-folds, respectively, but no effect on mRNA abundance was observed in jejunum and ileum. The supplementation of L-Arg increased serum Arg, His, Met, Thr, Trp, and urea (P < 0.05); tended to increase Val (P < 0.10), but did not affect Ile, Lys, Leu, and Phe. These results indicate that supplementing 0.16% L-Arg to the control diet may help to improve the function of the small intestine epithelium, by increasing the villi height, the abundance of AA transporters, and the SC of most indispensable AA in pigs exposed to HS conditions. However, the lack of effect of supplemental Arg on both Lys SC and weight gain of pigs suggests that increasing the Lys content in the +Arg diet might be needed to improve the performance of HS pigs.

Effect of heat stress on the serum concentrations of free amino acids and some of their metabolites in growing pigs

Exposure to heat stress (HS) may affect the intestinal epithelia of pigs, resulting in impaired digestive and absorptive capacity. The serum concentration (SC) of free AA in pigs can be used as indicators of their availability. This study was conducted with 12 crossbred (Landrace × Hampshire × Duroc) pigs (29.0 ± 2.8 kg initial BW) distributed into 2 groups to analyze the SC of free AA and some AA metabolites in pigs exposed to HS conditions. The treatments were pigs housed under natural HS conditions in a room with no ambient temperature control (23.6 to 37.6°C, HS) and pigs housed at thermoneutral conditions (24 ± 2°C), feed restricted to a level similar to that of their HS counterparts. All pigs received a wheat-soybean meal diet. Blood samples were collected at both the absorptive (2.5 h after a meal) and postabsorptive (10.0 h after a meal) phase. At the absorptive phase, the SC of free Arg, Leu, Lys, Phe, Thr, and Trp were lower ( < 0.05) and the SC of His, Val, Ala, Pro, Ser, and Tyr tended to be lower ( < 0.10) in HS pigs. At the postabsorptive phase, the SC of free Arg, His, Met, Asn, Gln, and Tyr were higher ( < 0.05) but the SC of Ala was lower ( < 0.01) and the SC of Pro tended to be lower ( < 0.10) in HS pigs. The absorptive SC of carnosine, ornithine (Orn), and Tau were lower ( < 0.05) and of citrulline (Cit), cystathionine, and urea tended to be lower ( < 0.10) in HS pigs. The postabsorptive SC of 3-methyl-His, homo-Cys, OH-Lys, and OH-Pro increased ( = 0.05) and of Cit tended to increase ( = 0.10) but that of carnosine and sarcosine ( < 0.05) decreased in HS pigs. The results of this study show a marked and differential effect of HS on the SC of AA. These data indicate that HS negatively affects the digestive and absorptive capacity of pigs and that the metabolism of some AA is modified in pigs to counteract the negative effects of the HS.

Expression of genes coding for selected amino acid transporters in small intestine, liver, and skeletal muscle of pigs fed excess branched-chain amino acids

Excess Leu reduces the availability of Ile and Val in pigs likely by reducing absorption of the latter amino acids (AA). Twenty-four crossbred pigs were used to evaluate the effect of excess Leu alone or with surplus Ile and Val on the expression of cationic (b(0),(+)AT and CAT1) and neutral (B(0)AT1) AA transporters in the small intestine, liver, and skeletal muscle. Dietary treatments included: 1) basal diet; 2) basal plus 0.43% L-Leu (excess Leu); 3) basal plus 0.43% Leu, 0.20% L-Ile, and 0.25% L-Val (excess Leu, Ile, and Val). The basal diet contained 0.90% standardized ileal digestible Lys, as well as crystalline L-Lys, L-Thr, DL-Met, L-Trp, L-Leu, L-Ile, L-His, and L-Val. Diets 2 and 3 contained 52% more Leu and diet 3 contained 42% more Ile and Val compared with the basal diet. Excess Leu or excess Leu, Ile, and Val reduced b(0),(+)AT expression in the jejunum (P < 0.05) but had no effect in the ileum and liver. Excess Leu increased CAT1 expression in the ileum but reduced expression in the liver (P < 0.05). Excess Leu, Ile, and Val increased (P < 0.05) B(0)AT1 expression in the jejunum and tended to increase (P = 0.10) expression in the ileum. In general, b(0),(+)AT expression was higher but CAT1 expression was lower in the jejunum than in the ileum; B0AT1 was similarly expressed in the jejunum and ileum. Excess Leu or any branched-chain AA affects AA transporter expression, which may affect the absorption and availability of AA for animal growth.

Low-protein amino acid-supplemented diets for growing pigs: effect on expression of amino acid transporters, serum concentration, performance, and carcass composition

Pigs fed protein-bound AA appear to have a higher abundance of AA transporters for their absorption in the jejunum compared with the duodenum. However, there is limited data about the effect of dietary free AA, readily available in the duodenum, on the duodenal abundance of AA transporters and its impact on pig performance. Forty-eight pigs (24.3 kg initial BW) distributed in 4 treatments were used to evaluate the effect of the CP level and form (free vs. protein bound) in which AA are added to diets on the expression of AA transporters in the 3 small intestine segments, serum concentration of AA, and performance. Dietary treatments based on wheat and soybean meal (SBM) were 1) low-CP (14%) diet supplemented with L-Lys, L-Thr, DL-Met, L-Leu, L-Ile, L-Val, L-His, L-Trp, and L-Phe (LPAA); 2) as in the LPAA but with added L-Gly as a N source (LPAA+N); 3) intermediate CP content (16%) supplemented with L-Lys HCl, L-Thr, and DL-Met (MPAA); and 4) high-CP (22%) diet (HP) without free AA. At the end of the experiment, 8 pigs from LPAA and HP were sacrificed to collect intestinal mucosa and blood samples and to dissect the carcasses. There were no differences in ADG, ADFI, G:F, and weights of carcass components and some visceral organs between treatments. Weights of the large intestine and kidney were higher in HP pigs (P < 0.01). Expression of b(0,+) in the duodenum was higher in pigs fed the LPAA compared with the HP diet (P= 0.036) but there was no difference in the jejunum and ileum. In the ileum, y+ L expression tended to be higher in pigs fed the LPAA diet (P = 0.098). Expression of b(0,+) in LPAA pigs did not differ between the duodenum and the jejunum, but in HP pigs, the expression of all AA transporters was higher in the jejunum than in the duodenum or ileum (P < 0.05). The serum concentration of Arg, His, Ile, Leu, Phe, and Val was higher but serum Lys and Met were lower in pigs fed the HP diet (P < 0.05). These results indicate that LPAA can substitute up to 8 percentage units of protein in HP wheat-SBM diets without affecting pig performance; nonessential N does not seem to be limiting in very low-protein wheat-SBM diets for growing pigs. Also, the inclusion of free AA in the diet appears to affect their serum concentration and the expression of the AA transporter b0,+ in the duodenum of pigs.

Effect of L-lysine on expression of selected genes, serum concentration of amino acids, muscle growth and performance of growing pigs

Lysine (Lys) is the first limiting amino acid (AA) in most feed formulations for pigs and most abundant, along with leucine, in muscle proteins. An experiment was conducted with 17 pigs (17.7 ± 0.05 kg initial BW) to identify a role of dietary Lys in the control of protein synthesis in pigs. Fourteen pigs were randomly assigned to one of the two wheat-based dietary treatments: Lys-deficient, 3.0 g/kg (DEF) and Lys-adequate, 10.8 g/kg (ADE). Samples from jejunum mucosa, liver, Longissumus and Semitendinosus muscles, and blood were collected. The other three pigs were sacrificed at the beginning of the trial to measure basal carcass composition. Weight gain, gain:feed ratio, Lys intake and loin eye area were greater in ADE than in DEF pigs (p < 0.01). Muscle-related carcass characteristics were better, and myosin heavy chain IIb expression (MyHC IIb) in Semitendinosus was higher in ADE than in DEF pigs. Expression of AA transporters CAT-1 was lower (p < 0.05), serum Lys was higher and serum Val was lower in pigs fed the ADE diet. The higher muscularity, MyHC IIb expression in Semitendinosus muscle and Lys serum of pigs fed the ADE diet suggest that Lys increases growth rate not only by functioning as protein construction unit but also as potential control of the protein synthesis process.

Effect of L-valine supplementation to a wheat-based diet with leucine excess on performance, gene expression, and serum concentration of amino acids

Excess Leu in the diet reduces the expression of the cationic AA transporter b(0,+), absorption of Lys and Arg, feed intake, and ADG of pigs. Because Val competes with Leu for absorption, surplus Val may correct some of these effects. An experiment was conducted to analyze the effect of surplus Val in a basal wheat (Triticum aestivum) diet fortified with free Lys, Thr, and Met and containing excess Leu and Ile on performance, expression of genes encoding b(0,+), and serum concentrations of AA. Sixteen pigs (30.3 ± 2.1 kg BW) were used. Treatments were wheat based with excess Leu and Ile (T1) and T1 plus 0.44% L-Val (T2). At the end of the 21-d study, 12 pigs were euthanized; jugular blood was collected to analyze serum AA and jejunal mucosa to measure expression of b(0,+). Surplus Val increased (P < 0.05) ADG and G:F and serum Val, Lys, and Arg but did not affect (P > 0.10) b(0,+) expression. Although analyzed Val content in the basal diet was lower than calculated, the increased serum Lys and improved pig performance may suggest that excess Leu limits Val availability and that surplus Val could correct some of the negative effects of excess Leu.