The collagen market and knowledge, attitudes, and practices of Brazilian consumers regarding collagen ingestion

Collagen is considered a nutraceutical, and its consumption has been expanding due to the increased life expectancy, rising per capita income, and increased consumer awareness of health care. This study aimed to evaluate consumers' perceptions, knowledge, attitudes, and practices about the consumption of collagen-based products by using an online questionnaire and to correlate them with socio-economic data. A market survey (pharmacy stores and online) was also conducted to evaluate the available products. In total, 275 participants answered the survey, 73.3% from the Southeast region, mostly female (84.0%). Most participants reported three months as the period of collagen intake (31.6%), and the consumption period was associated with the perception of the health benefits (p < 0.001). Furthermore, the participants' knowledge and perceptions regarding collagen intake are frequently associated with dermatological and orthopedic changes. Collagen-based products supplementation is a growing market with a broad target audience (genders, age groups, and socio-economic levels). The commercial presentation of collagen has been diversified over the years, and powder collagen is the most consumed (52.7%) and cheapest compared with capsules, pills, or gummies. The results of the present study demonstrate that most consumers of this type of supplement associate its benefits with aesthetic care such as skin, hair, and nails, although the scientific literature has shown its effects in treating osteoarticular diseases, for example. Undoubtedly, the correct dose prescription, treatment time, and choice of product presentation must be analyzed carefully, as they significantly impact treatment results.

Chlorella sp.-ameliorated undesirable microenvironment promotes diabetic wound healing

Chronic diabetic wound remains a critical challenge suffering from the complicated negative microenvironments, such as high-glucose, excessive reactive oxygen species (ROS), hypoxia and malnutrition. Unfortunately, few strategies have been developed to ameliorate the multiple microenvironments simultaneously. In this study, Chlorella sp. (Chlorella) hydrogels were prepared against diabetic wounds. In vitro experiments demonstrated that living Chlorella could produce dissolved oxygen by photosynthesis, actively consume glucose and deplete ROS with the inherent antioxidants, during the daytime. At night, Chlorella was inactivated in situ by chlorine dioxide with human-body harmless concentration to utilize its abundant contents. It was verified in vitro that the inactivated-Chlorella could supply nutrition, relieve inflammation and terminate the oxygen-consumption of Chlorella-respiration. The advantages of living Chlorella and its contents were integrated ingeniously. The abovementioned functions were proven to accelerate cell proliferation, migration and angiogenesis in vitro. Then, streptozotocin-induced diabetic mice were employed for further validation. The in vivo outcomes confirmed that Chlorella could ameliorate the undesirable microenvironments, including hypoxia, high-glucose, excessive-ROS and chronic inflammation, thereby synergistically promoting tissue regeneration. Given the results above, Chlorella is considered as a tailor-made therapeutic strategy for diabetic wound healing.

Tipping the scale: the role of a national nutritional supplementation programme for pregnant mothers in reducing low birth weight and neonatal mortality in India

With over 1·3 million Anganwadi centres (AWC) (meaning ‘courtyard shelter’), the Indian government runs a nationwide intervention providing nutrition supplement to pregnant mothers to improve the health of their children. Using two successive rounds of the nationally representative cross-sectional National Family Health Survey data (collected during 2005–2006 and 2015–2016) of India, we assessed whether nutrition supplements given to pregnant mothers through AWC were associated with select child health indicators – extremely low birth weight (ELBW), very low birth weight (VLBW), low birth weight (LBW) and neonatal mortality (death during day 0–27) stratified by death during day 0–1, day 2–6 and day 7–27. A total of 148 019 children and 205 593 children were eligible for analysing birth weight and neonatal mortality, respectively. OR with 95% CI, estimated from multivariate logistic regression models, suggest that receipt of nutrition supplements was associated with decreased risk of VLBW (OR: 0·73, 95% CI 0·63, 0·83, P < 0·001), LBW (OR: 0·92, 95% CI 0·88, 0·96, P < 0·001), but not ELBW (OR: 0·80, 95% CI 0·56, 1·15, P = 0·226). Women who always received nutrition supplements during their pregnancy saw lower risk of death of their neonates (OR: 0·67, 95% CI 0·61, 0·73, P < 0·001), including death on day 0–1 (OR: 0·66, 95% CI 0·58, 0·74, P < 0·001), day 2–6 (OR: 0·69, 95% CI 0·58, 0·82, P < 0·001) and day 7–27 (OR: 0·68, 95% CI 0·53, 0·87, P = 0·002). Therefore, nutritional supplementation to pregnant mothers appears to be helpful in deterring various stages of neonatal mortality, VLBW and LBW, though it might not be effective in mitigating ELBW. Findings were discussed considering possible limitations of the study.

Effects of oral nutrition supplements in persons with dementia: A systematic review

OBJECTIVE

Persons with dementia are at risk of malnutrition, evidenced by low dietary intake, which has consequences for nutritional status, activity of daily living and disease progression. The effects of oral nutrition supplements (ONS) on nutritional intake, nutritional status, and cognitive and physical outcomes in older persons with dementia were evaluated.

METHODS

PubMed, Medline, Embase, CINAHL and the Cochrane Central Register of Controlled Trials were searched in December 2017, and this was repeated in May 2019. The Preferred Reporting Items for Systematic Reviews and Analysis (PRISMA) checklist was used. Papers were considered if they presented experimental clinical trials using oral nutritional supplements to persons diagnosed with dementia, including Alzheimer's disease and mild cognitive impairment, and conducted in hospitals, nursing homes or homes.

RESULTS

We included ten articles reporting nine clinical trials. A total of 407 persons with dementia were included, of whom 228 used ONS for 7 to 180 days. Nutritional intake improved by 201 to 600 kcal/day. Energy intake from ordinary foods was not affected, thus ONS improved the persons daily intake of energy and protein. Body weight, muscle mass, and nutritional biomarkers in blood improved in the intervention groups compared with the control groups. No effects on cognition or physical outcomes were observed.

CONCLUSION

ONS increases the intake of energy and protein and improves nutritional status in persons with dementia; however, RCTs with longer intervention periods are needed to investigate the impact on cognitive and functional outcomes.

Effects of oral administration of β-hydroxy β-methylbutyrate on lean body mass in older adults: a systematic review and meta-analysis

OBJECTIVE

Beta-hydroxy beta-methylbutyrate (HMB), a metabolite of leucine, is currently widely used in athletes to increase muscle mass and strength and has also been used as a nutritional supplement in recent years to maintain muscle mass in muscular atrophic diseases of older people. However, the effects of HMB supplementation on muscle mass, muscle strength, and physical function in older people remain controversial. The purpose of this review was to explore the effects of HMB on body composition in older adults.

METHODS

The PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases were searched to obtain the randomized controlled trials needed as a basis for systematic review and meta-analysis.

RESULT

A total of 9 studies (448 participants) were eventually found eligible. The pooled results showed that HMB supplementation significantly increased fat-free mass in older people compared with the control group (effect size: 0.37; 95% Cl 0.16, 0.58; Z value = 3.47, P = 0.001; Fixed-effect model). But it had no effect on fat mass (effect size: - 0.04 95% CI - 0.26, 0.18; Z value = 0.36, P = 0.716, fixed-effect model). Subgroup analysis of HMB supplementation alone showed a significant improvement in fat-free mass in older people (effect size: 0.59; 95% CI 0.32, 0.87; Z = 4.24, P < 0.001; fixed-effect model), whereas HMB supplementation combined with exercise intervention showed no additional fat-free mass change (effect size: 0.06; 95% CI - 0.26, 0.38; Z = 0.38, P = 0.705; Fixed-effect model).

CONCLUSION

HMB supplementation is beneficial for improving body composition in older people. However, the effect of HMB supplementation combined with exercise therapy to improve muscle mass is not obvious. Exercise programs need to be designed according to the different physical health of older people.

Acute p-synephrine ingestion increases whole-body fat oxidation during 1-h of cycling at Fatmax

PURPOSE

p-Synephrine, the principal alkaloid of bitter orange (Citrus aurantium), is widely used in dietary supplements for weight loss due to its purported effect of increasing fat oxidation. However, there is a paucity of scientific information about its effectiveness in enhancing fat oxidation during exercise. The aim of this investigation was to determine the effect of an acute dose of p-synephrine on substrate oxidation during prolonged and constant intensity exercise.

METHODS

In a double-blind and randomized experiment, 14 healthy subjects performed two acute experimental trials after ingesting either p-synephrine (3 mg kg^-1) or a placebo (cellulose). Energy expenditure and fat oxidation rates were continuously measured by indirect calorimetry during 1 h of continuous cycling at Fatmax, the intensity that induces maximal fat oxidation rate.

RESULTS

In comparison to the placebo, energy expenditure during 1 h of cycling remained unchanged with p-synephrine (698 ± 129 vs. 686 ± 123 kcal, P = 0.08). However, p-synephrine increased whole-body fat oxidation (33.6 ± 10.4 vs. 37.3 ± 9.8 g, P < 0.01) while also reducing carbohydrate oxidation (99.5 ± 30.4 vs. 85.0 ± 28.4 g, P < 0.01). However, the magnitude of the shift on substrate oxidation induced by p-synephrine was small.

CONCLUSION

Acute ingestion of p-synephrine augments fat oxidation during prolonged and constant-intensity exercise.