RESUMO
Chronic wounds are characterized by prolonged non-healing, significantly affecting patients' quality of life. Oral formulas may enhance the wound healing process and contribute to cost reduction in care. This review aimed to evaluate the effects of oral nutritional supplementation on chronic wound healing and provide insights into formula characteristics. A comprehensive search across Cinahl, Embase, PubMed, and Web of Science databases yielded nine studies from the past decade involving 741 patients ages 52 to 81.7 across various care settings: hospitals, long-term care facilities, and home care. Primary wound types included pressure injuries (58%), diabetic foot ulcers (40%), and venous ulcers (2%). The intervention duration ranged from 2 to 16 wk, with sample sizes varying from 24 to 270 patients. Notably, four studies reported a reduction in wound area and an increased healing rate with a hypercaloric, hyperproteic formula enriched with zinc and vitamins A, C, and E. However, two studies found no significant differences compared with control groups. Two other studies investigated a combination of arginine, glutamine, and ß-hydroxy-ß-methylbutyrate; however, they did not yield significant results, and one study favored a hyperproteic formula instead of a hyperproteic formula with arginine. This review provides evidence supporting the potential of oral nutritional supplementation to enhance the healing process of chronic wounds. Based on our findings, a desirable formula should be characterized by a high calorie and protein content and the inclusion of antioxidant micronutrients, including, but not limited to, vitamins A, E, C, and zinc.
Assuntos
Suplementos Nutricionais , Úlcera por Pressão , Cicatrização , Humanos , Cicatrização/efeitos dos fármacos , Doença Crônica , Pé Diabético/terapia , Zinco/administração & dosagem , Úlcera Varicosa/dietoterapia , Úlcera Varicosa/terapia , Idoso , Arginina/administração & dosagem , Arginina/farmacologia , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Valeratos/administração & dosagem , Valeratos/farmacologia , Vitamina A/administração & dosagem , Glutamina/administração & dosagem , Vitamina E/administração & dosagem , Vitamina E/farmacologia , Ácido Ascórbico/administração & dosagem , Ácido Ascórbico/farmacologia , Feminino , Vitaminas/administração & dosagem , Masculino , Administração OralRESUMO
We investigated the bioavailability of the calcium salt (HMB-Ca) and the free acid (HMB-FA) forms of ß-hydroxy-ß-methylbutyrate (HMB). Sixteen young individuals received the following treatments on three different occasions in a counterbalanced crossover fashion: (1) HMB-FA in clear capsules; (2) HMB-Ca in gelatine capsules; (3) HMB-Ca dissolved in water. All treatments provided 1 g of HMB. Blood samples were taken before and on multiple time points following ingestion. The following parameters were calculated: peak plasma (Cmax), time to peak (Tmax), slope of HMB appearance in blood, area under the curve (AUC), half-life time (t1/2) and relative bioavailability (HMB-Ca in water set as reference). All treatments led to rapid and large increases in plasma HMB. HMB-Ca in capsules and in water showed similar plasma HMB values across time (p = 0.438). HMB-FA resulted in lower concentrations vs. the other treatments (both p < 0.001). AUC (HMB-Ca in capsules: 50,078 ± 10,507; HMB-Ca in water: 47,871 ± 10,783; HMB-FA: 29,130 ± 12,946 µmol L-1 × 720 min), Cmax (HMB-Ca in capsules: 229.2 ± 65.9; HMB-Ca in water: 249.7 ± 49.7; HMB-FA: 139.1 ± 67.2 µmol L-1) and relative bioavailability (HMB-Ca in capsules: 104.8 ± 14.9%; HMB-FA: 61.5 ± 17.0%) were lower in HMB-FA vs. HMB-Ca (all p < 0.001). HMB-Ca in water resulted in the fastest Tmax (43 ± 22 min) compared to HMB-Ca in capsules (79 ± 40 min) and HMB-FA (78 ± 21 min) (all p < 0.05), while t1/2 was similar between treatments. To conclude, HMB-Ca exhibited superior bioavailability compared to HMB-FA, with HMB-Ca in water showing faster absorption. Elimination kinetics were similar across all forms, suggesting that the pharmaceutical form of HMB affects the absorption rates, but not its distribution or elimination.
Assuntos
Cálcio , Valeratos , Água , Humanos , Disponibilidade Biológica , Preparações FarmacêuticasRESUMO
OBJECTIVE: Patients on the waiting list for liver transplantation (LTx) usually lose muscle mass. Supplementation with ß-hydroxy ß-methylbutyrate (HMB) may have a promising effect on this clinical condition. This study aimed to evaluate the effects of HMB on muscle mass, strength, functionality, and quality of life in patients on the LTx waiting list. METHODS: A double-blind, randomized study was conducted of 3g supplementation of HMB or 3g supplementation of maltodextrin (active control) with nutritional counselling for 12 wk in patients >18 y, evaluated at five points or timepoints. Body composition and anthropometric data (resistance, reactance, phase angle, weight, body mass index, arm circumference [AC], arm muscle area, and adductor pollicis muscle thickness) were collected, and muscle strength was assessed through dynamometry and muscle function by the frailty index (FI). Quality of life was assessed. RESULTS: A total of 47 patients were enrolled (HMB: 23 and active control: 24). There was a significant difference in both groups for AC (P = 0.03), dynamometry (P = 0.02), and FI (P = 0.01). There was an increase in dynamometry between weeks 0 and 12 in both groups (HMB [Δdynamometry: 10.1% ± 16.4%; P < 0.05] and active control [Δdynamometry: 23.0% ± 70.3%; P < 0.05]). The AC increased in both groups between weeks 0 and 4 (HMB [ΔAC: 0.9% ± 2.8%; P < 0.05] and active control [ΔAC: 1.6% ± 3.6%; P < 0.05]) and between weeks 0 and 12 (HMB [ΔAC: 3.2% ± 6.7%; P < 0.05] and active control [ΔAC: 2.1% ± 6.6%; P < 0.05]). The FI decreased in both groups, between weeks 0 and 4 (HMB [ΔFI: -4.2% ± 6.9%; P < 0.05) and active control [ΔFI: -3.2% ± 9.6%; P < 0.05]) and between weeks 0 and 12 (HMB ΔFI: -4.4% ± 11.2%; P < 0.05] and active control [ΔFI: -5.5% ± 11.3%; P < 0.05]). The other variables did not change (P > 0.05). CONCLUSIONS: Nutritional counselling with supplementation with HMB or active control in patients on the LTx waiting list improved AC, dynamometry, and the FI in both groups.
Assuntos
Transplante de Fígado , Humanos , Método Duplo-Cego , Qualidade de Vida , Listas de Espera , Suplementos Nutricionais , Valeratos/farmacologia , Força Muscular , Músculo Esquelético , Composição Corporal , AconselhamentoRESUMO
High amounts of grains in the equine diet led to high starch intake, causing gut alterations. Aimed at reducing harmful effects, Macleaya cordata extract (MCE) is a phytogenic additive that stands out for its antibiotic and anti-inflammatory effects proven in different species. However, there is no useful information for horses. The objective of this study was to evaluate the effects of different levels of the inclusion of commercial MCE on body weight (BW), body condition score (BCS), total apparent digestibility (AD) of nutrients, faecal pH and fermentative products, on ponies fed a high-starch diet. Eight healthy gelding Mini Horse ponies were used. The study design was contemporary double Latin-square 4 × 4 in the experimental unit, with the animal inside each experimental period (n = 8 experimental units per group). The experiment was conducted over four 20-d periods. Basal diet attended 1.75% BW dry matter daily and starch intake was 2.2 g/kg BW/meal. The experimental groups were as follows: control - without food additive; S1-1 mg/kg BW MCE; S1.5-1.5 mg/kg BW MCE and S2-2 mg/kg BW MCE. The data were analysed by PROC MIXED of SAS (p < 0.05). Tendency was considered when 0.05 < p < 0.1. Our results showed higher ether extract (EE) AD for S2 group (63.75%) when compared with the control (54.55%) (p = 0.0377). Lactate was lower (p = 0.0391) in S1 (3.27 mmol/l) and S2 (3.24 mmol/l) groups, although pH was not different between groups. Iso-valerate was greater in S1 group (2.29 mmol/l; p = 0.0289), and a tendency of higher butyrate values was found for S1 and S2 groups (p = 0.0980). We concluded that MCE supplementation probably positively influences equine resident microbiota, improving EE AD and increasing iso-valerate concentration. It can also minimise harmful high-starch impact. We recommend further studies using MCE in horses for a better understanding of its local activity and possible benefits.
Assuntos
Ração Animal , Dieta , Cavalos , Animais , Masculino , Dieta/veterinária , Ração Animal/análise , Digestão , Peso Corporal , Suplementos Nutricionais/análise , Extratos Vegetais/farmacologia , Valeratos/farmacologia , AmidoRESUMO
The main goal of this study was to assess the methane production in a biotrickling filter (BTF) using a synthetic gas mixture (H2/CO2: 60/40), evaluating the effect of the empty bed gas residence time (EBRT), pH, and temperature. The BTF was inoculated with acclimated granular anaerobic sludge. Three EBRT were tested: 11.6, 5.8, and 2.9 h. The decrease in EBRT (from 11.6 to 5.8 h) increased 1.3-fold the methane content (69 ± 3%) with H2 and CO2 removals of 100% and 24 ± 6%, respectively. The following reduction to 2.9 h showed no effect on CH4 content. The increment of the pH had no significant effect; however, the highest CH4 percentage (74%) was observed at a pH of 8.5. The system showed flexibility to adapt to changes in temperature without drastically diminishing CH4 concentration. In these stages, the principal hydrogenotrophic archaea detected was Methanobacterium flexile. Soluble microbial products such as butanol, caproate, and iso-valerate were detected in all the operating stages. This study demonstrates the potential of methane generation from a dark fermentation gaseous effluent.
Assuntos
Dióxido de Carbono , Metano , Anaerobiose , Reatores Biológicos/microbiologia , Butanóis , Caproatos , Fermentação , Hidrogênio , Esgotos/microbiologia , ValeratosRESUMO
The effect of beta-hydroxy-beta-methylbutyrate (HMB) supplementation associated with exercise training at different intensities and frequencies on skeletal muscle regeneration of muscle-injured rats was investigated. Male Wistar rats were divided into sedentary and trained groups. The sedentary groups were subdivided into non-injured (SED-Ct), non-injured supplemented with HMB (SED-Ct-HMB), injured (SED), and injured with HMB (SED-HMB), and the trained groups were injured, supplemented with HMB, and then divided into training three times a week without load (HT3) or with load (HT3L) and training five times a week without load (HT5) and with load (HT5L). The rats received a daily dose of HMB associated with 60 min of swimming with or without 5% body mass load for 14 days. On the 15th day, cryoinjury was performed in the right tibialis anterior muscle (TA), and 48 h later, supplementation and training continued for 15 days. After the last session, the TA was dissected and a cross-sectional area (CSA) of muscle fibers was used to determine the percentage of CSA fibers and connective tissue (%CT), as well as the total and phosphorylated protein contents. SED-HMB showed increased CSA and decreased %CT and TGF-ß when compared to SED. HT3 showed increased CSA and reduced %CT accompanied by increased IGF-1/Akt, myogenin, and MuRF1, and decreased TGF-ß. The CSA of HT5L also increased, but at the cost of a higher %CT compared to the other groups. Our results demonstrated that HMB associated with training without load and with lower frequency per week may be a valuable strategy for skeletal muscle regeneration.
Assuntos
Músculo Esquelético/crescimento & desenvolvimento , Condicionamento Físico Animal , Regeneração , Valeratos , Animais , Suplementos Nutricionais , Fator de Crescimento Insulin-Like I , Masculino , Proteínas Proto-Oncogênicas c-akt , Ratos , Ratos WistarRESUMO
Background: Most of the explanatory and prognostic models of COVID-19 lack of a comprehensive assessment of the wide COVID-19 spectrum of abnormalities. The aim of this study was to unveil novel biological features to explain COVID-19 severity and prognosis (death and disease progression). Methods: A predictive model for COVID-19 severity in 121 patients was constructed by ordinal logistic regression calculating odds ratio (OR) with 95% confidence intervals (95% CI) for a set of clinical, immunological, metabolomic, and other biological traits. The accuracy and calibration of the model was tested with the area under the curve (AUC), Somer's D, and calibration plot. Hazard ratios with 95% CI for adverse outcomes were calculated with a Cox proportional-hazards model. Results: The explanatory variables for COVID-19 severity were the body mass index (BMI), hemoglobin, albumin, 3-Hydroxyisovaleric acid, CD8+ effector memory T cells, Th1 cells, low-density granulocytes, monocyte chemoattractant protein-1, plasma TRIM63, and circulating neutrophil extracellular traps. The model showed an outstanding performance with an optimism-adjusted AUC of 0.999, and Somer's D of 0.999. The predictive variables for adverse outcomes in COVID-19 were severe and critical disease diagnosis, BMI, lactate dehydrogenase, Troponin I, neutrophil/lymphocyte ratio, serum levels of IP-10, malic acid, 3, 4 di-hydroxybutanoic acid, citric acid, myoinositol, and cystine. Conclusions: Herein, we unveil novel immunological and metabolomic features associated with COVID-19 severity and prognosis. Our models encompass the interplay among innate and adaptive immunity, inflammation-induced muscle atrophy and hypoxia as the main drivers of COVID-19 severity.
Assuntos
COVID-19 , SARS-CoV-2 , Índice de Gravidade de Doença , Adulto , Coagulação Sanguínea , Índice de Massa Corporal , COVID-19/sangue , COVID-19/imunologia , COVID-19/metabolismo , Citocinas/sangue , Armadilhas Extracelulares/imunologia , Feminino , Hemoglobinas/análise , Humanos , Masculino , Metaboloma , Pessoa de Meia-Idade , Atrofia Muscular , Neutrófilos/imunologia , Fenótipo , Prognóstico , Albumina Sérica Humana/análise , Linfócitos T/imunologia , Valeratos/sangueRESUMO
BACKGROUND: The aging process has great impact on body composition, such as the increase of adipose tissue in abdominal region, and the decrease of lean body mass, due to skeletal muscle loss. A reduction in muscle mass is associated to high risk of fractures and falls, loss of mobility, and increased number of hospitalizations. Beta-hydroxy-beta-methylbutyrate (HMB) is a biological substance derived from leucine metabolism, with anabolic and anticatabolic properties. Some HMB effects are tissue repair stimulation and protein anabolism. AIMS: We aimed to evaluate the effects of HMB supplementation on body composition and muscle strength in elderly, as well as to identify the efficient dosages to reach these effects. METHODS: This review included studies that evaluated muscle mass and muscle strength, associated or not with physical exercise and diet in elderly people. Only studies published from 2008 to 2019 were selected for analysis. RESULTS: Six articles were included in the review. The used doses varied from 1.5 to 3 g. In 5 studies, HMB supplementation was associated with calcium; only 1 study did not use the oral administration route. Two studies used 4 g of maltodextrin as a vehicle; 1 used HMB with a hypercaloric and hyperproteic supplement; 1 associated HMB with lysine and arginine; and 1 with arginine and glutamine. Supplementation of 3 g of HMB has shown to be most beneficial in improving strength and body composition in people over 65 years, especially in bed rest and untrained conditions. CONCLUSION: Our findings suggest that HMB has a positive effect on body composition and strength, especially in bedridden or sedentary elderly, due to its anticatabolic properties.
Assuntos
Composição Corporal/efeitos dos fármacos , Suplementos Nutricionais , Força Muscular/efeitos dos fármacos , Músculo Esquelético/efeitos dos fármacos , Valeratos/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Ensaios Clínicos como Assunto , Feminino , Humanos , Masculino , Sarcopenia/prevenção & controleRESUMO
ß-hydroxy-ß-methyl butyrate (HMB) is a bioactive metabolite derived from the amino acid leucine, usually applied for muscle mass increase during physical training, as well as for muscle mass maintenance in debilitating chronic diseases. The hypothesis of the present study is that HMB is a safe supplement for muscle mass gain by strength training. Based on this, the objective was to measure changes in body composition, glucose homeostasis and hepatic metabolism of HMB supplemented mice during strength training. Two of four groups of male mice (n = 6/group) underwent an 8-week training period session (climbing stairs) with or without HMB supplementation (190 mg/kgBW per day). We observed lower body mass gain (4.9 ± 0.43% versus 1.2 ± 0.43, p < 0.001) and increased liver mass (40.9 ± 0.9 mg/gBW versus 44.8 ± 1.3, p < 0.001) in the supplemented trained group compared with the non-supplemented groups. The supplemented trained group had an increase in relative adipose tissue mass (12.4 ± 0.63 mg/gBW versus 16.1 ± 0.88, P < 0.01) compared to the non-supplemented untrained group, and an increase in fasting blood glucose (111 ± 4.58 mg/dL versus 122 ± 3.70, P < 0.05) and insulin resistance (3.79 ± 0.19 % glucose decay/min versus 2.45 ± 0.28, P < 0.05) comparing with non-supplemented trained group. Adaptive heart hypertrophy was observed only in the non-supplemented trained group (4.82 ± 0.05 mg/gBW versus 5.12 ± 0.13, P < 0.05). There was a higher hepatic insulin-like growth factor-1 expression (P = 0.002) in supplemented untrained comparing with non-supplemented untrained group. Gene expression of gluconeogenesis regulatory factors was increased by training and reduced by HMB supplementation. These results confirm that HMB supplementation associated with intensive training protocol drives changes in glucose homeostasis and liver metabolism in mice.
Assuntos
Suplementos Nutricionais , Glucose/metabolismo , Homeostase/efeitos dos fármacos , Músculo Esquelético , Valeratos/metabolismo , Animais , Glucose/química , Humanos , Fígado , Masculino , Camundongos , Músculo Esquelético/anatomia & histologia , Músculo Esquelético/fisiologia , Valeratos/químicaRESUMO
This study is focussed on a biocatalysing chemical synthesis in order to produce a green apple flavour (ethyl valerate) using an immobilised lipase from Burkholderia cepacia. A strategy to improve the lipase stability during the esterification is used. In order to increase the ethyl valerate efficiency, an alternative method using the buffer pH to dissolve the lipase into alginate is proposed. Parameters of the immobilised lipase such as pH, temperature, activation energy and stirring speed are evaluated. The optimal condition using the substrate concentration and the lipase loading is provided. After 5 recyclability cycles, the immobilised lipase reveals a decreasing â¼25% in the ethyl valerate yield. An economical ester synthetising associated with the esterification efficiency is evidenced. This induces that a potential industrial application can be considered. This due to the demand for ethyl valerate in the flavour industry is required.