Electrolyte Powder

BACKGROUND: The quality of colonoscopy is significantly influenced by the effectiveness of bowel preparation. In this study, we aimed to evaluate the efficacy, safety, and tolerability of bowel cleansing between a new oral sulfate solution (OSS) and standard polyethylene glycol electrolyte powder (PEG). METHODS: This single center, randomized, superiority study recruited 679 outpatients who were assigned to either the new OSS group (Group A) or standard PEG group (Group B). The quality of bowel cleansing was evaluated using the Boston Bowel Preparation Scale (BBPS) and compared between the two groups. Furthermore, data pertaining to the duration of bowel preparation, patient tolerability, and the occurrence of adverse events were also analyzed. RESULTS: According to BBPS scores, group A demonstrated significantly higher bowel preparation cleanliness than group B. Additionally, group A achieved superior bowel cleansing, as evidenced by a greater proportion of patients with BBPS scores ≥ 8 compared to group B (75.3% vs. 55.2%, P < 0.05). No severe adverse events were reported during examinations in either group. CONCLUSIONS: The magnesium sulfate, sodium sulfate, and potassium sulfate concentrated oral solution is a novel, safe, and effective bowel preparation for colonoscopy. TRIAL REGISTRATION: This study was registered in the Chinese Clinical Trial Registry on 20/02/2024 (clinical trial registration number: ChiCTR2400081004). © 2025. The Author(s).

INTRODUCTION: Constipation is an independent risk factor for poor bowel preparation. This study aimed to evaluate the bowel cleansing efficacy and safety of polyethylene glycol (PEG) combined with linaclotide (lin) for colonoscopy in patients with chronic constipation (CC). METHODS: This single-blinded, randomized, controlled, and multicenter study was conducted from July 2021 to December 2022 at 7 hospitals. Patients with CC who underwent colonoscopies were enrolled and randomly assigned to 4 groups with split-PEG regimens: 4L-PEG group, 4L-PEG+1d-Lin group, 3L-PEG+1d-Lin group, and 3L-PEG+3d-Lin group. The primary outcome was rates of adequate bowel preparation, defined as a total BBPS score ≥6 and a score ≥2 for each segment. Secondary outcomes were adverse effects, sleep quality, willingness to repeat the colonoscopy, adenoma detection rate, and polyp detection rate. RESULTS: Five hundred two patients were enrolled. The rates of adequate bowel preparation (80.0% vs 60.3%, P < 0.001; 84.4% vs 60.3%, P < 0.001) and the total Boston Bowel Preparation Scale (BBPS) scores (6.90 ± 1.28 vs 6.00 ± 1.61, P < 0.001; 7.03 ± 1.24 vs 6.00 ± 1.61, P < 0.01) in the 4L-PEG+1d-Lin group and the 3L-PEG+3d-Lin group were superior to that in the 4L-PEG group. Compared with the 4L-PEG group, the 4L-PEG+1d-Lin group (66.7% vs 81.7%, P = 0.008) and the 3L-PEG+3d-Lin group (75.0% vs 81.7%, P = 0.224) had a lower percentage of mild adverse events. No statistically significant difference in willingness to repeat the colonoscopy, sleep quality, polyp detection rate, or adenoma detection rate was observed among groups. DISCUSSION: PEG combined with linaclotide might be an effective method for bowel preparation before colonoscopy in patients with CC.

INTRODUCTION: Colonoscopy is currently considered as one of the principal techniques to diagnose the colorectal diseases. Admittedly, qualified bowel preparation before colonoscopy is a premise for high-quality examination. Lower quality bowel preparation might seriously impede visualization of the intestinal mucosa, resulting in missed and misdiagnosed intestinal lesions. Therefore, it is necessary to choose the appropriate oral laxative based on the guarantee of safety and efficacy. METHODS: This prospective randomized controlled study was conducted to compare lactulose oral solution and polyethylene glycol (PEG) electrolyte powder for bowel preparation using the following indicators: Boston Bowel Preparation Scale, Bowel Bubble Score, detection rate of adenoma and lesion, patients' satisfaction, and adverse effects. Our study investigated the suitability of 2 bowel preparation reagents for patients with different body mass indices mainly based on body mass index (BMI). RESULTS: In the lactulose group, there was a significant improvement in the quality of bowel preparation compared with those in the PEG group ( P < 0.05), especially in people with normal BMI and higher BMI. Compared with the PEG group, individuals in the lactulose group had a significantly higher adenoma detection rate (50% vs 33.5%, P < 0.05) and taste scores (8.82 vs 6.69, P < 0.05), as well as significantly fewer adverse reactions (6.5% vs 32.5%, P < 0.05). DISCUSSION: Lactulose oral solution is superior to PEG in bowel preparation quality and taste, especially in normal BMI and higher BMI groups. It can be used clinically as a potential and promising bowel preparation agent in the future. Clinical Trial registration number: ChiCTR2100054318.

OBJECTIVES: To study the clinical efficacy, advantages, and disadvantages of adaptive biofeedback training combined with oral administration of compound polyethylene glycol 4000-electrolyte powder in the treatment of children with outlet obstruction constipation (OOC). METHODS: A total of 168 children with OOC were enrolled in this prospective study. All the subjects were randomly divided into a test group and a control group based on the order of visiting time, 84 in each group. The test group was treated with adaptive biofeedback training combined with oral administration of compound polyethylene glycol 4000-electrolyte powder, and the control group was treated with oral administration of compound polyethylene glycol 4000-electrolyte powder alone. Eleven children in the test group and two children in the control group withdrew from the study since they could not finish the whole treatment course. Finally, 73 children in the test group and 82 children in the control group were included in this analysis. As clinical outcomes, the total score of clinical symptoms and overall response rate were compared between the two groups at weeks 4 and 8 of treatment. RESULTS: There was no significant difference in the total score of clinical symptoms between the two groups at beginning of treatment and at week 4 (P>0.05), while the test group had a significantly lower total score of clinical symptoms than the control group at week 8 (P<0.05). At week 4, there was no significant difference in overall response rate between the two groups (P>0.05), while the test group had a significantly higher overall response rate than the control group at week 8 (P<0.05). CONCLUSIONS: Adaptive biofeedback training combined with oral administration of compound polyethylene glycol 4000-electrolyte powder is significantly associated with improvement of clinical outcomes in the treatment of children with OOC. Publisher: 目的: 探讨自适应式生物反馈疗法联合口服复方聚乙二醇4000电解质散在儿童出口梗阻型便秘治疗中的临床疗效，为出口梗阻型便秘患儿寻找合理而有效的治疗方法。方法: 前瞻性选取168例出口梗阻型便秘患儿为研究对象，按来院就诊次序随机分成试验组和对照组（n=84），试验组采用自适应式生物反馈疗法联合口服复方聚乙二醇4000电解质散治疗，对照组仅采用口服复方聚乙二醇4000电解质散治疗。最终因无法坚持治疗试验组退出11例，余73例；对照组退出2例，余82例。通过临床症状总积分和总有效率比较两组患儿治疗4周和8周时的疗效。结果: 治疗前和治疗4周时两组临床症状总

Dietary nitrate (NO3-) supplementation has been reported to improve cardiovascular health, but beyond its effects on brachial artery blood pressure (BP), dose-response effects on other cardiovascular variables are unclear. This study assessed the effects of three acute NO3- doses (200 mg, 400 mg, 800 mg NO3--rich beetroot powder) on brachial and aortic BP, arterial stiffness and macrovascular endothelial function, in a double-blind, randomised, crossover design. Cardiovascular variables and venous blood samples were measured prior to (control) and 2.5 h post supplement ingestion. Dietary NO3- supplementation increased plasma [NO3-] and plasma [nitrite] but had no effect on cyclic guanosine monophosphate (cGMP) concentration. Arterial stiffness markers improved following all NO3- doses, with no between-dose differences. However, endothelial function only improved following 400 mg (+3.07% compared to control) and aortic systolic BP only improved following 800 mg (-4 mmHg compared to control) dietary NO3- supplementation. Acute NO3- ingestion improved some cardiovascular risk factors, including arterial stiffness, macrovascular endothelial function and aortic systolic BP with different dose-response effects, but had no effect on brachial BP or plasma [cGMP]. These findings improve our understanding of NO3- supplementation and cardiovascular function in healthy adults.

Sports supplements composed of carbohydrate and protein are widely used by endurance athletes and recreational practitioners, mostly aimed at improving performance. This study investigated the effect of a novel carbohydrate + protein honey powder (HP) product on endurance cycling performance and physiological and perceptual responses using a double-blind, crossover, counterbalanced, placebo-controlled (PLA) design. Twelve male cyclists exercised for 100 min (i.e., 5 min at 1 W/kg of body mass, followed by three sets of 10-min stages at 1.5, 2.0, and 2.5 W/kg, followed by 5 min at 1 W/kg), followed by a 20-min self-paced time trial (20-min TT). Blood glucose, lactate, pH, bicarbonate, heart rate, ratings of perceived exertion, and side effects were analyzed throughout the 100-min cycling protocol and the 20-min TT. The 20-min TT performance was similar between HP and PLA (total work done: 294 ± 40 vs. 292 ± 44 kJ, p = .72; mean power output: 245 ± 33 vs. 243 ± 37 W, p = .61), as was blood glucose, lactate, pH, and ratings of perceived exertion either during the 100 or 20-min TT protocols (all p > .05). Blood bicarbonate was lower in HP compared with PLA throughout the 100-min protocol (p = .01), and heart rate was higher in HP compared with PLA during the 20-min TT (p = .01). Finally, HP supplementation did not elicit greater side effects compared with PLA, either during the 100 or the 20-min TT protocols (all p > .05). This novel HP supplement did not improve endurance performance in this study, though future research with higher doses is encouraged.

BACKGROUND: The concept of pre-rehabilitation has been clinically implemented across various surgical fields; however, studies investigating its application in colonoscopy remain limited. This study aimed to evaluate the effectiveness, safety, and patient satisfaction of the pre-rehabilitation concept in bowel preparation for comfort colonoscopy among elderly Chinese patients. METHODS: The enrolled patients were randomly allocated into the pre-rehabilitation and control groups. Prior to colonoscopy, patients in the pre-rehabilitation group received supplementary oral administration of ENSURE (Enteral Nutritional Powder) and psychological counseling provided by specialty nurses. The control group received only Polyethylene Glycol Electrolytes Powder. The primary outcome was the quality of bowel preparation, assessed using the Boston Bowel Preparation Scale. Secondary outcomes included the polyp detection rate, incidence of adverse effects, and patient satisfaction. RESULTS: A total of 485 patients who were admitted for colonoscopy during hospitalization were included in the analysis. There were no statistically significant differences between the two groups with respect to age, sex, and body mass index (BMI). The Boston total score in the pre-rehabilitation group was significantly higher than that in the control group (P < 0.001). The colon polyp detection rates in the two groups were 78.5% and 67.3%, respectively (P = 0.006). Patients in the pre-rehabilitation group reported higher satisfaction with colonoscopy procedures and experienced a lower incidence of hypoglycemic reactions. CONCLUSIONS: The combination of additional enteral nutrition supplements and psychological counseling can enhance the quality of bowel preparation, decrease the incidence of hypoglycemia, and improve patient satisfaction. This intervention measure is both feasible and worthy of clinical application and promotion. TRIAL REGISTRATION: This study was registered in the Chinese Clinical Trial Registry on 14/05/2025 (clinical trial registration number: ChiCTR2500102405). Retrospectively registered. © 2025. The Author(s).

Background/Objectives: Beetroot juice (BJ), a natural source of dietary nitrate, has gained increasing attention for its potential to improve exercise performance and cardiovascular function. While its benefits are well documented in endurance contexts, less is known about its short-term effects on resistance training performance and recovery. Thus, this study investigated the effects of short-term BJ supplementation on strength performance, cardiovascular responses, muscle oxygenation, and post-exercise recovery in resistance-trained males. Methods: Twelve healthy men (age: 21.3 ± 1.9 years; body mass index: 21.42 ± 2.36 kg/m2) completed two supplementation protocols involving BJ, providing 450 mg of nitrate per day, and a nitrate-free placebo (PLA). Each protocol consisted of two laboratory visits, one to assess the acute ergogenic effects and another to evaluate recovery after 72 h, resulting in a total of four sessions over a two-week period. During the three consecutive days of supplementation, participants ingested a single 900 mL dose (15 g BJ powder/PLA) 2 h before the first session, followed by three daily 300 mL doses (5 g BJ each/PLA) over the next two days, and a final dose (15 g BJ powder/PLA) taken 2 h before the second session (72 h post-first session). Each testing session involved incremental back squat (BS) and bench press (BP) exercises at 60%, 70%, and 80% of the one-repetition maximum (1RM) performed to failure, with three-minute rest intervals between sets. Repetition to failure, movement velocity, peak power, peak heart rate (HR), and muscle oxygenation (SmO2) were recorded during BP and BS exercises. Heart rate variability (HRV) and blood lactate were assessed before and after each training session. Lower-limb strength (CMJ and SJ) and delayed-onset muscle soreness (DOMS) were assessed daily during the 3-day supplementation period. Results: BJ significantly increased repetitions completed at 80% 1RM during BP and BS (p < 0.05) compared to the PLA. Peak movement velocity improved across all intensities using BJ with higher values compared to the PLA at 60-80% 1RM (p < 0.05). SmO2 was higher in BJ at 70-80% 1RM) and further improved after 7

BACKGROUND AND AIMS: Recently Diabetes Mellitus (DM) has been associated with heightened susceptibility to malnutrition, suggesting that augmenting nutritional intake stands out as a potent therapeutic strategy for addressing malnutrition in individuals with DM. The aim of this clinical investigation was to evaluate the effect of DiabetEaze powder, a polyherbal nutritional formulation developed by us for nutritional management and glycaemic control, on patients with diabetic and prediabetic conditions. METHODS: A total of 143 type II diabetic (T2D) patients who were managing their diabetic condition through modern medicine, AYUSH medicine, lifestyle modification and 68 pre-diabetic patients, aged between 40 and 65 years, were randomly assigned into six groups: control, modern, AYUSH, lifestyle, prediabetic control and prediabetic trial. The treatment groups were administered 5 g of DiabetEaze powder two times a day after food for 6 months. Microminerals, vitamins, glycaemic parameters, Quality of Life (QoL), hematology, lipid profiles, Renal Function Test (RFT) and Liver Function Test (LFL) parameters, and electrolytes were evaluated at Day 0, Day 90, and Day 180. RESULTS: Out of 211 enrolled patients, 189 individuals successfully completed the entire 180-day duration of the study, indicating a retention rate of approximately 89.6 %. In our study, we observed a statistically significant elevation in the levels of vitamin D, B2, and B6 across all treatment groups. Besides, the treatment groups displayed a notable increase in zinc and manganese levels compared to the other minerals tested. Notably, the treatment groups demonstrated distinct mineral and vitamin profiles. In terms of metabolic markers, significant reductions in Fasting Blood Sugar (FBS)/Post Prandial Blood Sugar (PPBS) were observed across the modern, AYUSH, and lifestyle groups, while the modern group also showed a marked decrease in glycated haemoglobin (HbA1c) levels. Furthermore, overall QoL among the tested groups was also statistically significant. The consistent maintenance of normal LFT and RFT parameters and electrolyte levels across trial groups throughout the study duration indicates that

BACKGROUND: Taekwondo is a complex martial art that requires speed, balance, agility, and endurance. This study aims to examine the effects of nitrate and L-arginine supplementation on acute aerobic and anaerobic performance, balance, agility, and recovery in elite taekwondo athletes. METHOD: This study was conducted as a double-blind, randomized, crossover study with the participation of 15 experienced taekwondo athletes aged 19.06 ± 0.96 years and 8.93 ± 1.27 years of training experience. Participants visited the laboratory a total of nine times, including a practice session and anthropometric measurements. These visits consisted of eight experimental sessions conducted at 72-hour intervals. The experimental sessions were conducted with nitrate, L-arginine, and a combination of both supplements (NIT*L-ARG) and placebo. Nitrate supplementation was provided by homogenizing fresh spinach (837.40 mg/kg), while L-ARG was given as a single dose of 6 g in powder form three hours before exercise. RESULTS: NIT*L-ARG supplementation significantly improved the anaerobic performance of athletes in Wingate peak power and peak power (w/kg) compared to placebo and in mean power compared to NIT, L-ARG, and PLA. In addition, NIT*L-ARG supplementation significantly improved blood lactate levels and agility performance immediately after Wingate and Shuttle run tests. CONCLUSION: The combined intake of NIT*L-ARG was found to be effective in improving aerobic, anaerobic, and agility performances as well as fatigue levels of athletes. It was determined that taking NIT and L-ARG supplements alone contributed to the improvement of improving athletes' performance in Wingate mean power values and subsequent fatigue level compared to PLA.

PURPOSE: To evaluate the effect of a fresh-breath mild effervescent tablet on halitosis as an alternative to mouthwash. MATERIALS AND METHODS: Halitosis is the unpleasant and offensive odour emanating from the oral cavity (bad breath), which is linked to the presence of volatile sulphur compounds (VSCs). A randomised, single-blind, controlled clinical trial was conducted with 102 volunteers who had oral complaints (range 18-60 years). Breath samples were taken and analysed for the level of hydrogen sulphide (H2S), methyl mercaptan (CH3SH) and dimethyl sulphide (CH3SCH3). Sixty-one volunteers who met the halitosis criteria were enrolled and completed the clinical trial. Two groups were formed according to the test employed: the Immediate Effect Test (IET) (n = 31) and the Effective Duration Test (EDT) (n = 30). In the IET, subjects were divided into three subgroups: fresh-breath mild effervescent tablet (MT, n = 11), the fresh-breath lozenge tablet (LT, n = 10), and fresh-breath mouthwash (MW, n = 10). Halitosis was measured immediately after completely consuming the test tablet or gargling. In the EDT, subjects were also divided into three subgroups: fresh-breath mild effervescent tablet (MT, n = 10), probiotic powder (PP, n = 10) and probiotic tablet (PT, n = 10). Halitosis was measured at 0 h, 1 h, and 2 h after consuming the test substances. RESULTS: In the IET group, a statistically significant reduction in VSCs was obtained in all three subgroups compared with baseline (VSCs of MT group, p 0.01, VSCs of LT subgroup, p 0.05, VSCs of MT group, p 0.01). The fresh-breath mild effervescent tablet subgroup showed a statistically significantly greater reduction in VSCs compared to the fresh-breath lozenge subgroup (p 0.01). No statistically significant differences in VSC reduction were found between the fresh-breath mild effervescent tablet subgroup and the mouthwash group (p = 0.38). In the EDT group, the VSC level of the fresh-breath mild effervescent tablet group was still statistically significantly lower than the baseline 2 h after consumption (p 0.01). The two control groups which used commercial fresh-breath probiotic products did not show any statistically

Dietary inorganic nitrate lowers blood pressure (BP) in healthy individuals through improved nitric oxide (NO) bioavailability. However, there is limited evidence examining the long-term effects of dietary nitrate for managing hypertension. We aimed to determine whether the sustained intake of dietary nitrate improved BP and cardiovascular disease (CVD) risk factors in individuals with early-stage hypertension. The Dietary Nitrate (NO3) on BP and CVD Risk Factors (DINO3) Trial was a multi-center, double-blinded, parallel, randomized, controlled trial in participants with elevated BP. Participants were supplemented with high-nitrate (HN) (~400 mg nitrate) or low-nitrate (LN) vegetable powder (~50 mg nitrate) on top of their usual diets for 16 weeks. The primary outcome was office systolic BP at 16 weeks. The secondary outcomes were 24 h ambulatory BP, central BP, heart-rate-corrected augmentation index (AIx75), carotid-femoral pulse wave velocity (cf-PWV), lipids, and high-sensitivity C-reactive protein (hs-CRP). Sixty-six participants were randomized at baseline (39M:27F, age: 51.5 ± 10.8 years, BMI:27.9 ± 3.2 kg/m2). In an intention-to-treat analysis, no differences were observed between HN and LN groups in terms of office systolic BP at 16 weeks (3.91 ± 3.52 mmHg, p = 0.27) or secondary outcomes. In this exploratory study, sustained HN vegetable supplementation did not exhibit more favorable vascular effects than LN vegetable supplementation in individuals with elevated BP.

BACKGROUND: Aging, menopause, and seasonal changes alter the lipid composition of the outermost skin layer, the stratum corneum, resulting in dry and itchy skin. AIMS: This clinical trial aimed at evaluating the effects of a wheat polar lipid complex (WPLC) on skin characteristics in women showing dry and wrinkled skin, investigating its effects in a subgroup of postmenopausal women, and assessing if benefits were maintained after supplementation. METHODS: Seventy-two women with dry and wrinkled skin were recruited in this double-blind, randomized, parallel-group study, and allocated to three groups of 24 subjects, each including at least 10 postmenopausal women. For 56 days, subjects consumed the WPLC supplement (oil or powder), or the placebo. Skin hydration, transepidermal water loss (TEWL), elasticity, and profilometry were evaluated at baseline, after 14, 28, and 56 days of supplementation, and 56 days after the end of supplementation. Additionally, a lipidomic analysis was performed to examine changes in superficial skin layers over 56 days. RESULTS: Dietary supplementation with WPLC rapidly improved all parameters. It increased skin hydration, smoothness, and elasticity while decreasing TEWL, roughness, and wrinkle depth after only 14 days of supplementation. These effects were also observed in the subpopulation of postmenopausal women and led to an improved self-perception of skin. For all the parameters, outcomes were not maintained after the supplementation was stopped. The lipidomic analysis revealed 10 compounds evolving over the 56 days of WPLC supplementation. CONCLUSION: WPLC supplementation improved skin hydration, smoothness, elasticity, and wrinkledness within 14 days and, as expected, did not last after supplementation was stopped. © 2023 SEPPIC. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.

Dry eye disease (DED), a multifactorial inflammatory ocular surface disorder, affects up to 50% of individuals over 50 years old worldwide and is one of the most common reasons for seeking ophthalmologic care. Generally, topical eye drops or oral drugs are administered to treat DED; however, the use of preservatives in eye drops or the adverse effects of oral drugs are disadvantageous for long-term therapy. Cordyceps cicadae, a traditional Chinese medicinal fungus, possesses anti-inflammatory effects without evident toxicity and is obtainable at low price. Our previous study demonstrated that C. cicadae mycelium effectively ameliorates dry eye symptoms in the benzalkonium chloride (BAC)-induced mouse dry eye model by increasing tear volume and tear film breakup time (TBUT). However, the effects of C. cicadae mycelium for human dry eye amelioration remains unknown. Thus, the present study investigated the mitigation of dry eye conditions and related discomforts through oral supplementation of fermented C. cicadae mycelium. A total of 70 healthy individuals were recruited and randomly allocated to receive a daily oral dose of 1,050 mg preparation in sachet containing either freeze-dried C. cicadae mycelium powder with 0.3 mg of adenosine and 1.5 mg of HEA per gram or placebo for 90 days. The participants were subjected to anthropometric measurements, dry eye questionnaires (DEQ), Schirmer's tests, intraocular pressure (IOP) measurements, tear film breakup time (TBUT) tests, tear osmolality measurements, and tear electrolyte analysis prior to and right after completion of the study. The results showed a significantly increased TBUT as well as a significant decrease in tear osmolarity, in parallel with the decrease of tear electrolytes, especially Na+ and Cl ions. Although significant increase of tear volume was not observed, the increased TBUT suggests mitigation of dry eye through improvement of tear quality. Therefore, C. cicadae mycelium supplementation may be used for dry eye alleviation as a novel therapeutic intervention.

BACKGROUND: This randomized controlled trial investigated the effectiveness of an oral nutritional supplement (ONS) on nutrition-related outcomes over 12 weeks in Chinese adults with or at risk of malnutrition. METHODS: 88 Chinese adults ≥18 years living independently in Hong Kong with Mini Nutritional Assessment-Short Form (MNA-SF) score ≤11 were randomly assigned to (1) 2 servings/day of nutritionally complete ONS powder made with water (Fresubin® Powder (Fresubin Kabi Deutschland GmbH, Bad Homburg, Germany), 600 kcal, 22.4 g protein) for 12 weeks (intervention group) or (2) no treatment (control group). The primary outcome was increase in body weight (BW) over 12 weeks. Secondary outcomes included improvement in body mass index (BMI), mid-arm circumference (MAC), calf circumference, MNA-SF score, quality of life, self-rated health, frailty, and diet quality. RESULTS: The intervention group showed a significantly higher mean increase in BW compared with the control group (1.381 kg, intervention vs control, p < 0.001). The intervention group also showed significantly higher mean increases in BMI, MAC, calf circumference, intake of energy, protein, vitamin D, and calcium compared with the control group. No group differences in the changes of other outcomes were observed. CONCLUSIONS: For Chinese free-living adults at risk of malnutrition, daily consumption of a nutritionally complete ONS powder improved nutritional outcomes compared with the control group.

Dietary calcium binds Fluoride (F), thus preventing excess F absorption. We aimed to assess the efficacy of supplementing calcium-containing Eggshell Powder (ESP) on F absorption using urine F excretion and on fluorosis symptoms. In total, 82 women (41 Intervention Group, IG; 41 Control Group, CG) were recruited; overall, 39 in each group completed the trial. Morning spot urine was collected before (baseline, BL) and after (endline, EL) the intervention that was 6-months daily supplementation with 2.4 g ESP (providing ~1000 mg of calcium). Dental, skeletal, and non-skeletal fluorosis assessments was carried out at BL and, except for dental, at EL. Relative risk (RR) and linear generalized estimating equation were used to compare outcomes between groups. At BL, urinary F excretion in the IG and CG groups was similar, ~10 mg/L. At EL, urinary F excretion in IG women was six-fold lower (β = -6.1 (95% CI: -7.1, -5.1)) compared to CG. The risk of developing skeletal and non-skeletal fluorosis were significantly (p < 0.001) reduced in the intervention group. A significant reduction in urinary F excretion and reduction in many fluorosis symptoms were observed among women supplemented with calcium-containing ESP, thus providing evidence for using this dietary calcium source for mitigation of fluorosis. Clinical trials registration: NCT03355222.

We investigated effects of molecular hydrogen (H2) supplementation on acid-base status, pulmonary gas exchange responses, and local muscle oxygenation during incremental exercise. Eighteen healthy, trained subjects in a randomized, double-blind, crossover design received H2-rich calcium powder (HCP) (1500 mg/day, containing 2.544 µg/day of H2) or H2-depleted placebo (1500 mg/day) for three consecutive days. They performed cycling incremental exercise starting at 20-watt work rate, increasing by 20 watts/2 min until exhaustion. Breath-by-breath pulmonary ventilation (V˙E) and CO2 output (V˙CO2) were measured and muscle deoxygenation (deoxy[Hb + Mb]) was determined via time-resolved near-infrared spectroscopy in the vastus lateralis (VL) and rectus femoris (RF). Blood gases' pH, lactate, and bicarbonate (HCO3-) concentrations were measured at rest and 120-, 200-, and 240-watt work rates. At rest, the HCP group had significantly lower V˙E, V˙CO2, and higher HCO3-, partial pressures of CO2 (PCO2) versus placebo. During exercise, a significant pH decrease and greater HCO3- continued until 240-watt workload in HCP. The V˙E was significantly lower in HCP versus placebo, but HCP did not affect the gas exchange status of V˙CO2 or oxygen uptake (V˙O2). HCP increased absolute values of deoxy[Hb + Mb] at the RF but not VL. Thus, HCP-induced hypoventilation would lead to lower pH and secondarily impaired balance between O2 delivery and utilization in the local RF during exercise, suggesting that HCP supplementation, which increases the at-rest antioxidant potential, affects the lower ventilation and pH status during incremental exercise. HPC induced a significantly lower O2 delivery/utilization ratio in the RF but not the VL, which may be because these regions possess inherently different vascular/metabolic control properties, perhaps related to fiber-type composition.

BACKGROUND: Management of severe acute malnutrition (SAM) in children comprises two potential phases: stabilisation and rehabilitation. During the initial stabilisation phase, children receive treatment for dehydration, electrolyte imbalances, intercurrent infections and other complications. In the rehabilitation phase (applicable to children presenting with uncomplicated SAM or those with complicated SAM after complications have been resolved), catch-up growth is the main focus and the recommended energy and protein requirements are much higher. In-hospital rehabilitation of children with SAM is not always desirable or practical - especially in rural settings - and home-based care can offer a better solution. Ready-to-use therapeutic food (RUTF) is a widely used option for home-based rehabilitation, but the findings of our previous review were inconclusive. OBJECTIVES: To assess the effects of home-based RUTF used during the rehabilitation phase of SAM in children aged between six months and five years on recovery, relapse, mortality and rate of weight gain. SEARCH METHODS: We searched the following databases in October 2018: CENTRAL, MEDLINE, Embase, six other databases and three trials registers. We ran separate searches for cost-effectiveness studies, contacted researchers and healthcare professionals in the field, and checked bibliographies of included studies and relevant reviews. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs, where children aged between six months and five years with SAM were, during the rehabilitation phase, treated at home with RUTF compared to an alternative dietary approach, or with different regimens and formulations of RUTF compared to each other. We assessed recovery, deterioration or relapse and mortality as primary outcomes; and rate of weight gain, time to recovery, anthropometrical changes, cognitive development and function, adverse outcomes and acceptability as secondary outcomes. DATA COLLECTION AND ANALYSIS: We screened for eligible studies, extracted data and assessed risk of bias of those included, independently and in duplicate. Where data allowed, we performed a random-effects meta-analysis usin

BACKGROUND AND OBJECTIVES: Nutritional anemia is a significant public health issue with 50-80% prevalence in Indian children. Fortification of food, specifically milk, with iron is a potential approach to increase dietary iron intake. Ferric pyrophosphate [Fe4(P2O7)3] is organoleptically neutral and is less soluble in acid medium and, further, has low bioavailability in milk. However, since ascorbic acid is a potent enhancer of iron absorption, the coadministration of ascorbic acid with Fe4(P2O7)3 might enhance the absorption of iron. We evaluated the effect of ascorbic acid on iron absorption from a Fe4(P2O7)3 and an ascorbic acid fortified milk beverage with respect to milk fortified with Fe4(P2O7)3 alone. METHODS AND STUDY DESIGN: A double-blind, two-way crossover, randomized study was conducted in 25 mildly anemic children. The test group received milk fortified with beverage powder containing 7 mg isotopically labeled iron (57Fe/58Fe) as Fe4(P2O7)3, equimolar proportions of ascorbic acid and 200 mg of calcium whereas control group received milk fortified with energy, calcium and iron equivalent beverage powder. Fractional iron absorption was measured by erythrocyte incorporation of stable isotopes of iron (57Fe/58Fe) in both the groups. RESULTS: The fractional iron absorption from the control drink was 0.80% (95% CI: 0.57, 1.12). Fortifying the milk with an equimolar amount of ascorbic acid increased the fractional iron absorption almost 2-fold to 1.58% (95% CI: 1.13, 2.22). CONCLUSIONS: The presence of ascorbic acid in an equimolar ratio with that of iron from Fe4(P2O7)3 salt in milk as a fortificant enhanced iron absorption when compared to milk fortified with only Fe4(P2O7)3.