Multivitamin (Senior)

Update of doi: 10.1002/14651858.CD015464. RATIONALE: Higher blood pressure is strongly related to an increased risk of cardiovascular disease. There has been interest in riboflavin (vitamin B2) as a potential intervention to lower blood pressure, particularly for those with a common genetic polymorphism in the methylene tetrahydrofolate reductase enzyme (MTHFR). OBJECTIVES: To assess the benefits and harms of riboflavin supplements compared to placebo or no additional treatment for lowering systolic and diastolic blood pressure. SEARCH METHODS: We searched the Cochrane Hypertension Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Ovid Embase, Clarivate Web of Science, Clarivate Food Science & Technology Abstracts and two clinical trials registries. There were no restrictions on language, publication year, or publication status. The latest search date was 24 October 2024. We also handsearched the reference lists of included studies. ELIGIBILITY CRITERIA: We included randomised controlled trials (RCTs) conducted in adults that evaluated oral riboflavin supplements compared with an inactive control (e.g. placebo or no additional treatment) and measured at least one of the critical outcomes. We did not include trials that evaluated multivitamins containing riboflavin. Participants in both the intervention and control groups were able to receive standard medical therapy for hypertension prior to and during the trial. OUTCOMES: The critical outcomes were systolic blood pressure and diastolic blood pressure. The important outcomes were antihypertensive medication, adverse events and biomarkers of riboflavin status. RISK OF BIAS: We used the Cochrane RoB 2 tool to assess the risk of bias in included studies for the following outcomes: systolic blood pressure, diastolic blood pressure, antihypertensive medication and adverse events. SYNTHESIS METHODS: We used standard Cochrane methods. For the critical outcomes, which were continuous, we calculated mean differences (MD) and 95% confidence intervals (CIs). We used a fixed-effect meta-analysis to pool data for each outcome where possible. We conducted subgroup analyses, inc

This study assessed possible dietary supplement-medication interactions of 62 older adults recruited from 8 senior congregate sites in Bexar County, Texas. Dietary supplement and medication use were collected by paper questionnaire and potential supplement-medication interactions were assessed using online databases. The majority of participants reported dietary supplements (77%), non-prescription medication (50%), and prescription medication (73%) use. Fifty percent of participants who reported dietary supplement and medication use were at-risk for a potential supplement-medication interaction, ranging from one to eight potential interactions. Calcium and multivitamin-mineral supplements were the most common dietary supplements with potential medication interactions. Surveyed older adults reported dietary supplements should be reported to a physician (97%), but over 20% believe herbal products are pure (38%) and dietary supplements are risk free (34%) and will not cause harm (22%). In conclusion, regular education and screening of dietary supplement and medication use among older adults is recommended.

62. J Acad Nutr Diet. 2015 Mar;115(3):406-418. doi: 10.1016/j.jand.2014.10.023. Epub 2015 Jan 6. Vitamin D supplementation and health-related quality of life: a systematic review of the literature. Hoffmann MR, Senior PA, Mager DR. Vitamin D deficiency and insufficiency are highly prevalent worldwide and thought to potentiate a variety of chronic disease states, including diabetes, cancer, and depression. Routine vitamin D supplementation is often needed to meet vitamin D requirements. Little is known regarding the effect of vitamin D supplementation on quality of life. The purpose of this article was to systematically review the literature regarding quality-of-life outcomes from vitamin D supplementation in healthy and clinical populations. Clinical trials of vitamin D supplementation, where quality-of-life outcomes were reported, were selected from Medline and Web of Science databases. Inclusion criteria were English language articles available online (published between 1950 and May 2014), primary research articles, studies conducted on human beings, and treatment/supplementation with vitamin D. Articles were excluded if they involved topical vitamin D application or implicit cotreatment with other vitamins (eg, multivitamins). Articles selected for review were examined for process and methodologic quality using validated methodologies. A total of 15 articles met the inclusion criteria for review. Interventions were highly variable in terms of study population (eg, healthy/diseased, children/elderly, and baseline vitamin D status) vitamin D dose, and duration of follow-up. Vitamin D supplementation ranged from 400 IU/day for an average of 7.1 years, to a single 300, 000 IU dose. The main tools used to capture quality of life were adaptations of validated, questionnaires (Medical Outcomes Study Short Form 36-item questionnaire and EuroQOL five dimension questionnaire). Vitamin D supplementation was not associated with significant changes in quality of life. Studies that reported changes in quality of life as a result of vitamin D supplementation were in clinical populations on short-term vitamin D. Most articles reviewed displayed poor methodologic quality (

Poor physical performance is associated with a higher risk of falls, fractures, and premature death among older adults. We determined whether supplementation with cocoa extract vs placebo or multivitamin/multimineral (MVM) vs placebo for 2 yr benefited physical performance measures. The COcoa Supplement and Multivitamin Outcomes Study was a double-blinded, placebo-controlled randomized trial of supplemental cocoa extract and/or MVM vs placebo for the primary prevention of cardiovascular disease and cancer in 21 442 US adults. This ancillary study was completed in a New England sub-cohort that underwent physical performance measurements, including grip strength, walking speed, standing balance, repeated chair stands, and timed-up and go (TUG) test, at baseline and 2-yr follow-up. In the clinic sub-cohort (n = 603) with a mean (±SD) age of 69.7 ± 5.5 yr and 49.3% women, supplemental cocoa extract, compared to cocoa-extract placebo, did not affect 2-yr changes in our primary pre-specified, co-equal outcomes of grip strength, walking speed, and the Short Physical Performance Battery (composite of walking speed, standing balance, and chair stands) or in secondary outcomes of standing balance, chair stands, or TUG tests. No effect modification by baseline characteristics of age, sex, body mass index, or randomization to MVM supplementation was observed. In parallel analyses, MVM, compared to MVM placebo, also did not affect physical performance measures. Supplementation with cocoa extract did not prevent age-related declines in physical performance measures in older ambulatory US men and women. © The Author(s) 2026. Published by Oxford University Press on behalf of the American Society for Bone and Mineral Research.

Despite widespread use in the USA, little is known about the impact of multivitamin-multimineral (MVM) supplementation on metabolomic profiles and how this may translate to biological aging and long-term risk of age-related chronic diseases. The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a 2 × 2 factorial, placebo-controlled, double-blinded, randomized clinical trial testing daily MVM (Centrum Silver®) in US older adults. In 399 participants with metabolomics profiles quantified using the Nightingale Health nuclear magnetic resonance platform at baseline, year 1, and year 2 (70.3 ± 5.7 years; 50.1% female), we evaluate the effects of MVM versus placebo on 168 metabolites, 7 metabolomics clocks of biological aging, and 24 metabolomic risk scores (MRS) for chronic diseases. Compared with placebo, 2-year daily MVM supplementation increased the concentrations of docosahexaenoic acid (Cohen's d for between-group differences in changes from baseline to 2 years, 0.212 [95% CI, 0.02 to 0.404]) and omega-3 fatty acids (0.193 [0.003 to 0.382]) as well as delayed the increase in concentrations of creatinine (-0.222 [-0.424 to -0.019]). MVM also reduced MRS for 16 chronic diseases, including major cardiovascular events, renal disease, all-cause dementia, asthma, cataracts, glaucoma, liver disease, non-melanoma skin cancer, and prostate cancer (Cohen's d range, -0.206 to -0.277). However, all these effects were only significant at nominal levels, not after multiple-testing correction (p < 0.05; FDR > 0.05). Additionally, MVM led to a non-significant decrease across all metabolomic aging clocks, ranging from 0.496 to 1.054 years. Despite the limited sample size, COSMOS provides preliminary evidence that daily MVM supplementation may modestly improve metabolomic profiles in older adults. Further expansion within COSMOS is still warranted to confirm whether these alterations contribute to the benefits of MVM supplementation for healthy aging. Trial registration number: NCT02422745. © 2026. The Author(s), under exclusive licence to American Aging Association.

BACKGROUND: Caloric restriction (CR) is a promising nutritional intervention for improving metabolic and age-related health outcomes, but its long-term effects on hematologic health remain unclear. Clarifying how prolonged CR affects anemia risk and iron status is essential for evaluating its long-term safety and clinical relevance. OBJECTIVES: To determine the effects of a 2-y CR intervention on markers of anemia, iron status, and hepcidin in females and males enrolled in the Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy (CALERIE) Phase 2 trial. METHODS: Participants in CALERIE Phase 2 (n = 220) were randomly assigned to 25% CR or ad libitum (AL) control. AL continued their habitual diet, whereas CR received an intensive intervention to promote CR over 2 y. All participants received a multivitamin/mineral supplement containing 18 mg iron. Fasted blood was collected at baseline (BL) and 12 (M12) and 24 (M24) mo and indicators of iron status (ferritin, soluble transferrin receptor, and serum iron), anemia (hemoglobin and hematocrit), and regulators of iron status (hepcidin, C-reactive protein, and IL-6) were measured. Six-day diet diaries were collected twice at BL and once each at M12 and M24. An anemia surveillance protocol monitored hemoglobin, hematocrit, red blood cell (RBC) count, and serum iron throughout the intervention, with medical evaluation and temporary/permanent CR discontinuation as needed. Linear mixed-effects models were used to evaluate the effect of treatment (CR compared with AL), time (BL, M12, and M24), and their interaction (treatment × time). RESULTS: Participants (n = 218) were mostly female (70%) with an mean age (±SD) of 38.1 ± 7.2 y and a mean BMI of 25.2 ± 1.7 kg/m2. At baseline, ferritin (105.5 ± 126.9 μg/L), hepcidin (8.6 ± 5.8 ng/mL), and dietary iron intake (16.1 ± 5.5 mg/d) were similar between groups (P > 0.05). There were no group × time interactions for markers of anemia, indicators of iron status, or hepcidin (P > 0.05). Despite the anemia surveillance protocol, anemia prevalence remained >5% in both groups across all timepoints. Low RBC count was the most common trigger, and participants who tri

Large-scale randomized trials have found that multivitamin-multimineral (MVM) supplements and cocoa flavanols may benefit several age-related chronic conditions among older adults, but it remains unclear whether these two supplements directly slow the biological aging process. This prespecified ancillary study evaluated the 2-year effect of a daily MVM (Centrum Silver) and cocoa extract (500 mg cocoa flavanols per day, including 80 mg (-)-epicatechin) on five DNA methylation measures of biological aging (PCHannum, PCHorvath, PCPhenoAge, PCGrimAge and DunedinPACE) among 958 participants (482 women and 476 men) in the COcoa Supplement and Multivitamin Outcomes Study (COSMOS). Compared with placebo, daily MVM supplementation modestly reduced the rate of increase of second-generation epigenetic clocks, with a between-group difference in yearly change of -0.113 years (95% confidence interval (CI) -0.205 to -0.020; P = 0.017) for PCGrimAge and -0.214 years (-0.410 to -0.019; P = 0.032) for PCPhenoAge. MVM had a stronger effect on PCGrimAge among those with accelerated biological aging at baseline (-0.236 [-0.380 to -0.091]) compared with those with normal or decelerated biological aging (-0.013 [-0.130 to 0.104]; P = 0.018 for interaction). Cocoa extract did not have an effect on the five epigenetic clocks tested. Although the statistically significant but small effects of daily MVM supplementation on slowing biological aging are encouraging, additional studies are needed to determine the clinical relevance of daily MVM supplementation on epigenetic clocks and whether such effects can help explain the beneficial effects of MVM supplementation on aging-related chronic conditions. © 2026. The Author(s), under exclusive licence to Springer Nature America, Inc.

BACKGROUND: Adequate intake of carotenoids and vitamin E supports healthy aging, yet evidence is limited on whether multivitamin-multimineral (MVM) supplementation changes serum concentrations over time. OBJECTIVE: The aim of this investigation was to evaluate the effect of daily MVM supplementation among older adults on serum carotenoid and vitamin E concentrations over a 2-year period. DESIGN: The COcoa Supplement and Multivitamin Outcomes Study is a large-scale, randomized, placebo-controlled, 2 × 2 factorial trial, designed to test the effects of daily MVM and cocoa extract supplementation for chronic disease prevention. Participants completed semiannual questionnaires and provided optional biospecimen samples at baseline, 1-year, and 2-year follow-up. PARTICIPANTS AND SETTING: Between 2015 and 2020, US adults (women aged 65 years and older, men aged 60 years and older) without major cardiovascular disease or recent cancer were enrolled in the COcoa Supplement and Multivitamin Outcomes Study. This analysis included biospecimen substudy participants with blood samples provided at baseline and ≥1 follow-up timepoint (n = 400; 1 excluded due to unusable sample; final N = 399). INTERVENTION: Participants were randomized to receive daily MVM supplementation or a placebo, with or without cocoa extract. MAIN OUTCOME MEASURES: Changes in serum carotenoids and α-tocopherol concentrations were evaluated over the 2-year follow-up. STATISTICAL ANALYSES: Multivariable linear mixed models estimated changes in serum biomarker concentrations, comparing MVM with placebo, adjusting for covariates (age, sex, and cocoa extract intervention). RESULTS: Increases in serum carotenoids and α-tocopherol levels with MVM supplementation emerged at year 1 and persisted through year 2. MVM supplementation led to significantly higher serum concentrations of total carotenoids (percent change: 15.5%; 95% CI, 8.72 to 22.70), lutein (percent change: 17.17%; 95% CI, 7.53 to 27.66), beta carotene (percent change: 46.96%; 95% CI, 35.10 to 59.85), and α-tocopherol (percent change: 29.50%; 95% CI, 22.88 to 36.47) over 2 years compared with placebo. No significant differences were observed for lyco

BACKGROUND AND OBJECTIVES: Vitamin deficiencies are closely associated with the development of chronic diseases. Therefore, effective and safe intervention strategies are critical to improving vitamin nutritional status. This study aimed to assess the effectiveness and differential impacts of nutrition education and multi-vitamin supplementation, providing a basis for selecting safer intervention strategies. METHODS AND STUDY DESIGN: A 4-week, double-blind, randomized controlled trial was conducted among 155 adults (aged 18-65 years) with confirmed deficiencies in fat-soluble vitamins (A, D, or E). Participants were randomly assigned to receive either nutrition education with a multivitamin supplement or nutrition education with placebo. The concentrations of fat-soluble vitamins (A, D, or E), as well as their deficiency rates, were compared before and after the intervention. RESULTS: A total of 155 participants completed the study. There were no significant differences in demographic characteristics between the two groups. In both groups, the concentration of vitamins (A, D, or E) significantly increased (all p < 0.001), and the deficiency rates for all three vitamins significantly decreased (all p < 0.001). However, there were no significant differences in the concentrations or deficiency rates of vitamins (A, D, or E) between the two groups after intervention (all p > 0.05). CONCLUSIONS: Multivitamin supplements are not superior to nutrition education. Nutrition education alone may be a safer and effective approach to addressing deficiencies in vitamins A, D, and E, while reducing the risks as-sociated with unnecessary vitamin supplementation in the general population.

To assess the feasibility of a randomized controlled trial (RCT) comparing 5-methyltetrahydrofolate (5-MTHF) and folic acid (FA) in couples with recurrent pregnancy loss. Pregnancy loss affects up to 15% of pregnancies, with over half of cases remaining unexplained. Emerging evidence suggests that folate metabolism, particularly in individuals carrying methylenetetrahydrofolate reductase polymorphisms such as C677T and A1298C variants, may influence reproductive outcomes. A double-blind, RCT feasibility trial was conducted in Australia with 22 reproductive dyads randomized to receive either 5-MTHF or FA prenatal multivitamins. Participants adhered to dietary restrictions, abstained from conception for two cycles, and completed regular assessments. Primary outcomes included feasibility, adherence, acceptability, and preliminary efficacy based on biochemical markers and pregnancy outcomes. The trial demonstrated high acceptability (86% in arm A [MTHF-A] and 94% in arm B [FA-B]) and adherence rates for supplement use over 78% in each arm. Unmetabolized FA concentration decreased in the 5-MTHF group but rose significantly in the FA group. A critical finding was the degradation of 5-MTHF in retained samples, highlighting formulation instability as a confounder. A fully online RCT comparing 5-MTHF and FA is feasible. Future trials should address formulation stability and expand sample size to evaluate clinical efficacy and personalized folate strategies.

OBJECTIVE: To explore the effects of multivitamin combined with magnesium sulfate on placental hemodynamics, coagulation function, and maternal and infant outcomes in preeclampsia patients. METHODS: A randomized controlled study was conducted among 194 pregnant women diagnosed with preeclampsia between April 2022 and April 2023. Participants were randomly assigned to either the control group (n = 97), receiving intravenous magnesium sulfate alone, or the observation group (n = 97), receiving magnesium sulfate combined with multivitamin supplementation. Magnesium sulfate was administered with a loading dose of 2.5-5 g via rapid IV infusion and a maintenance dose of 5-20 g by continuous drip. The observation group additionally received one oral multivitamin tablet (Bayer S.A., 30 tablets/box) once daily in the morning. The treatment duration for both groups was two weeks. Blood pressure, 24-hour urinary protein, placental Doppler indices (RI, PI, S/D), coagulation markers (PT, APTT, FIB, TT), and maternal-infant outcomes were measured and compared. RESULTS: After treatment, both groups showed significant reductions in systolic and diastolic blood pressure, but there was no significant difference between them. However, the observation group had significantly lower 24-hour urinary protein levels (0.71 ± 0.31 g vs. 0.92 ± 0.28 g, P < 0.001). Coagulation function improved in both groups, with the observation group showing greater improvements: longer PT, APTT, and TT times, and lower FIB levels (P < 0.01). Placental hemodynamics also improved more in the observation group, with lower resistance indices and S/D ratios in both the umbilical and spiral arteries (P < 0.001). The observation group had better maternal and neonatal outcomes, including fewer cases of postpartum hemorrhage (10 vs. 22, P = 0.020), low birth weight (10 vs. 23, P = 0.013), and NICU admissions (9 vs. 21, P = 0.018). Eclampsia occurred only in the control group (3 cases), though this was not statistically significant (P = 0.081). Other outcomes, such as uterine inertia and neonatal asphyxia, were similar between groups. Subgroup analysis showed that patients with severe preeclampsia in the observat

BACKGROUND: Male infertility is influenced by a variety of etiologies, including quantitative and qualitative impairments in spermatogenesis. Antioxidants scavenge reactive oxygen species (ROS), which reduce sperm motility, cause damage to DNA, and lead to subsequent apoptosis in sperm cells. This trial aimed to evaluate the effect of oral Synbiotic and a multivitamin-mineral supplement for men helping to improve male fertility (SperiGen), as an antioxidant agent, on the spermatogram in idiopathic Oligoasthenoteratozoospermia (iOAT). MATERIALS AND METHODS: This double-blind randomized clinical trial was conducted on infertile males with iOAT. Totally, 73 patients with iOAT were blindly randomized into two groups; one group received SperiGen as an antioxidant agent in addition to placebo. In the next group, in addition to SperiGen, the patients received 500 mg Synbiotic (FamiLact) on a daily basis. They continued their treatments for 3 months. Semen parameters were measured before and after the intervention. RESULTS: Supplementations with a combination of Synbiotic and SperiGen compared with SperiGen and placebo significantly increased the average change of sperm progressive motility (p = 0.001), DNA fragmentation (p = 0.001), and diminished the levels of non-motile sperm (p = 0.018). Eventually, within-group analysis indicated that all parameters were significantly improved in both groups, except for non-progressive motility in the SperiGen and placebo group. CONCLUSION: The combination of Synbiotic and SperiGen (an antioxidant supplement) appears to be much more effective than using an antioxidant alone in improving the DNA fragmentation, concentration, and progressive motility of sperm. TRIAL REGISTRATION: IRCT20190810044500N6, 2020-09-05. https://irct.behdasht.gov.ir/trial/46773. https://trial.medpath.com/clinical-trial/7ad7a7af5cba37f3/evaluating-symbiotic-therapy-male-infertility. © 2026 The Japanese Urological Association.

BACKGROUND: Multivitamin-multimineral (MVM) supplements have been associated with lower blood pressure (BP) in several small trials. We investigated the effects of a MVM on incident hypertension and BP in a secondary analysis of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS). METHODS: COSMOS is a 2×2 factorial, double-blinded RCT testing effects of cocoa extract and MVM supplementation among women aged ≥65 years and men aged ≥60 years. Among 8905 COSMOS participants free from hypertension, effects of MVM supplementation on incident hypertension were investigated. Hypertension diagnosis was ascertained through self-reports. Additionally, in two substudies with BP measurements (N = 529 at clinic by research staff and 994 at home by technician), we evaluated the effects on 2-year BP changes. RESULTS: Incident hypertension was observed in N = 1034 (22.9%) in MVM arm and N = 1039 (23.6%) in placebo arm over a median of 3.4 years (IQR: 3.0, 3.9) of follow-up, with hazard ratio (HR) 0.98 [95% CI: 0.90, 1.06]. Effects differed according to baseline diet quality, with HRs of incident hypertension 0.81 [0.70, 0.95] and 1.14 [1.01, 1.28] among participants with lower and higher Alternate Mediterranean Diet score, respectively (P-interaction = .001). There was no effect of MVM on 2-year changes in systolic BP (4.4 mmHg in MVM; 4.5 mmHg in placebo), while pronounced effects were observed for baseline normal BP (P-interaction = .004). CONCLUSIONS: MVM supplementation versus placebo did not reduce hypertension incidence or lower BP overall. Exploratory analyses showed greater reduction in hypertension risk and BP changes among those with lower dietary quality and normal BP at baseline, respectively. CLINICAL TRIAL REGISTRATION: NCT02422745. © The Author(s) 2025. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected]

Objective: The metabolite trimethylamine N-oxide (TMAO) is a biomarker influenced by diet and linked to atherosclerosis, thrombosis, and cardiovascular disease (CVD). Choline is a crucial nutrient involved in maintaining cell structure, promoting liver health, and neurotransmission. However, human evidence is limited whether cocoa extract (CE) changes TMAO and choline levels over time. The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a randomized, placebo-controlled, 2 × 2 factorial trial testing a CE supplement (containing 500 mg d-1 flavanols) and a daily multivitamin for chronic disease prevention in 21 442 older adults. We conducted a pilot study of the impact of CE on 1 year changes in TMAO and choline in COSMOS participants to facilitate sample size calculations for larger analyses of this trial in the future. In a pilot intention to treat analyses, linear mixed effect models were used to explore serum TMAO and choline trajectories in relation to CE assignment, adjusting for age, sex, and the other randomization arm. Methods: We randomly selected 40 COSMOS participants with blood samples at baseline and year 1. TMAO and choline were measured in plasma samples by liquid chromatography with stable isotope dilution tandem mass spectrometry. We excluded 3 of 40 participants due to extreme TMAO values ≥32.9 μM. Results: The mean age at baseline was 77 ± (5.5) years, and 18 (48.7%) were female. Randomization successfully distributed baseline demographic, clinical, behavioral, and dietary characteristics by treatment group. Among the 37 COSMOS participants, those assigned to take a CE supplement, as compared to placebo, had similar TMAO and choline levels at baseline but showed trends toward lower levels of TMAO (-0.60 [95% CI, (-3.76, 2.55)]) at 1 year. However, the between-group differences in the 1 year changes in TMAO (CE minus placebo) were not statistically significant (-1.16 [95% CI, (-5.81, 3.50)]; P = 0.62). In contrast, the group assigned CE showed trends toward higher levels of choline (0.84 (-1.57, 3.25)) at year 1, but the between-group differences in the 1 year changes in choline were again not statistically significant (2.23 [95% CI

OBJECTIVE: To examine the long-term effect of cocoa flavanols on inflammaging biomarkers in the COcoa Supplement and Multivitamin Outcomes Study (COSMOS). METHODS: COSMOS is a large, randomised, double-blind, placebo-controlled, 2 × 2 factorial trial testing the effects of a cocoa extract supplement (containing 500 mg cocoa flavanols/day, including 80 mg (-)-epicatechin) among women aged ≥65 years and men aged ≥60 years. This ancillary study measured five widely used serum inflammaging biomarkers, including three pro-inflammatory markers (high-sensitivity C-reactive protein [hsCRP], interleukin-6, tumour necrosis factor-α), one anti-inflammatory cytokine (interleukin-10) and one pleotropic cytokine (interferon-γ [IFN-γ]) in a random sample of 598 participants with biospecimens collected at baseline, Year 1, and Year 2. RESULTS: The mean age was 70.0 ± 5.6 years, and 49.8% were female. Cocoa extract supplementation significantly decreased hsCRP levels compared with placebo, with a between-group difference in yearly percentage change relative to baseline levels of -8.4% (95% CI, -14.1% to -2.3%; nominal P = .008; Holm-adjusted P value = .039). Moreover, cocoa extract increased IFN-γ with a 6.8% (95% CI, 1.5% to 12.2%, nominal P = .011; Holm-adjusted P value = .043) difference in yearly percentage change versus placebo. The effects of cocoa extract on other inflammatory markers were not significant (all adjusted P values >.05). CONCLUSION: Cocoa extract supplementation significantly decreased hsCRP, supporting a role in modulating the chronic inflammaging process as a potential mechanism underlying its cardio-protective effects, including a 27% reduction in cardiovascular disease death in the COSMOS trial. The biological effect of increased IFN-γ by cocoa extract warrants further exploration. © The Author(s) 2025. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further informatio

INTRODUCTION: Approximately one-third of the world's children have elevated blood lead levels (BLLs), which may lead to often-irreversible decreased intelligence, behavioral difficulties, and learning problems. Identification and removal of the source of lead, along with good nutrition, are the only advocated initial management, with chelation therapy for higher threshold BLLs. Probiotics have shown promising beneficial effects pre-clinically. Here, we investigated the safety and efficacy of the probiotic Lactiplantibacillus plantarum DSM 33464 in children with elevated blood lead levels. METHODS: Children aged 3-12 years with elevated BLLs (>3.5 μg/dL) were enrolled in a randomized double-blind placebo-controlled multi-centered study and received either probiotic (1 × 109) colony-forming units (CFUs) or placebo (control group), along with a multivitamin/mineral supplement in both groups daily for 12 weeks. RESULTS: Overall, 66 children were randomized, 54 received intervention (probiotic; n = 30 and control; n = 24). The probiotic was well-tolerated. Probiotics, combined with a multivitamin/mineral supplement, significantly reduced the BLLs in these children within 12 weeks of supplementation by 40%, similar to that of the control group, which received a placebo plus multivitamin/mineral supplement. A larger reduction in urine lead levels at 8 weeks was observed in the probiotic group, along with a reduction of abdominal pain and psychosomatic feelings at week 12. No depletion of essential minerals was observed in any of the groups. CONCLUSION: This study adds to previous findings suggesting that probiotic intervention may be a promising additional strategy to help reduce BLLs and their detrimental effects in children. Due to the preliminary nature of this study, larger studies investigating the effects of the strain alone, with a longer intervention period, are warranted to confirm the benefits observed. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov, identifier NCT04891666.

BACKGROUND: Obesity and iron deficiency (ID) are global health concerns in pregnancy, with serious consequences for mother and offspring. The inflammatory state associated with obesity and its potential contribution to ID/anemia is unclear. OBJECTIVES: This study aims to investigate the associations among maternal adiposity, the mediating role of inflammation, and iron status. We also aim to examine how adiposity affects the predictive accuracy of early pregnancy iron markers for late pregnancy ID risk. METHODS: This secondary analysis of a double-blind randomized controlled trial included singleton pregnancies supplemented with a multivitamin containing 17 mg/d of iron. Body mass index (BMI), body composition [12 gestational weeks (GW)], iron markers (12, 28, 36 GW), and hemoglobin/hematological indices (12, 28 GW, postpartum) were assessed. Proinflammatory cytokines were used to calculate an inflammation score and categorized as high/low inflammation. RESULTS: A total of 125 pregnant women were included: 43 normal weight, 44 overweight, and 38 with obesity. At 36 GW, ID was present in 50% of women with obesity, 40.9% of those overweight, and 30.2% with normal BMI. High BMI and fat mass index (FMI) at 12 GW predicted lower ferritin at 36 GW (BMI β = -0.253, P = 0.020; FMI β = -0.265, P = 0.010), and all adiposity measures predicted higher soluble transferrin receptor (sTfR). Transferrin saturation was lower in women with obesity at 12 and 28 GW (12 GW 23.9%, 24.5%, 30.3%, P = 0.016; 28 GW 13.2%, 17.7%, 17.2% P < 0.001, obesity, overweight, and normal weight, respectively). At 36 GW, pregnant women with obesity and higher inflammation score had lower ferritin than normal weight women (15.0 compared with 20.3 μg/L, P = 0.041). sTfR at 12 GW was the best predictor of ID at 36 GW [area under curve (AUC) = 0.738, P < 0.001], especially in overweight/obesity (AUC = 0.744, P < 0.001). CONCLUSIONS: High adiposity, mediated by inflammation, increases the risk of ID in the late third trimester. sTfR in early pregnancy emerges as an effective marker for predicting ID in late pregnancy.

CLINICAL CHARACTERISTICS: Hutchinson-Gilford progeria syndrome (HGPS) is characterized in the first year of life by growth deficiency, lagophthalmos, hair loss, delayed and incomplete primary tooth eruption, subcutaneous fat loss, and areas of abnormal skin (tightness, stippling, and/or small outpouchings over the abdomen and upper thighs). Motor and mental development is normal. Children have profound growth failure, subcutaneous lipodystrophy, total alopecia, high-pitched voice, nail dystrophy, horse-riding stance, coxa valga with possible hip dislocations, narrowed upper thorax, and progressive joint contractures. Characteristic facial features include disproportionately large head for the face, narrow nasal ridge, narrow nasal tip, thin vermilion of the lips, small mouth, retro- and micrognathia, delayed loss of primary teeth, and partial secondary tooth eruption. Additional features include low-frequency conductive hearing loss, dry eye with risk of exposure keratitis, and premature and accelerated atherosclerosis with cerebrovascular and cardiovascular disease. Without lonafarnib treatment death occurs at an average age of 14.5 years (range: 6-20 years). With lonafarnib treatment average life span is extended to approximately 18.7 years. DIAGNOSIS/TESTING: The diagnosis of classic or nonclassic genotype HGPS is established in a proband with characteristic clinical features and a heterozygous pathogenic variant in LMNA that results in production of progerin, the disease-causing abnormal lamin A protein, identified by molecular genetic testing. Individuals with classic genotype HGPS are heterozygous for pathogenic variant c.1824C>T (~90% of individuals). Individuals with nonclassic genotype HGPS are heterozygous for another LMNA pathogenic variant in exon 11 or intron 11 that results in production of progerin (~10% of individuals). MANAGEMENT: Targeted therapy: Lonafarnib results in increase in life span presumably due to slowed cardiovascular disease progression that includes improved arterial wall stiffness and carotid-femoral pulse wave velocity. The therapy also improves low-tone hearing and may decrease headache frequency. Side effects are primarily gas