Advertising on complementary, alternative medicines and over the counter medicines (OTC) published in the printed journals for lay people from the view of Evidence Based Medicine Student: Schirlová. Z Tutor: Matoulková, P. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Czech Republic INTRODUCTION: Advertisements are important means of communicating information to public. The quality of the pharmaceutical advertising has been continuously discused. METHODS: The objective of the study was to assess availability of supporting scientific information for health claims stated in the food supplements and OTC (Over-the- Counter) medicines ads that were published during period September 2012 and June 2013 in the mostly read life style journals for women. For each advertisement, the emphasized claim/-s was compared to available scientific unbiased evidence. The literature search was conducted by using Pubmed database (mainly meta-analysis and randomized clinical trials). Further information was searched in the Scholar Google, Natural Medicines Comprehensive Database (Consumer version) and Micromedex. Different keywords and their appropriate combinations were used to identify relevant information. Frequency analysis was used to assess frequency...

1 ABSTRACT Opinions, knowledge, perception of risks and compliance of patients using non- prescription drugs and dietary supplements II. Author: Veronika Hrabcová1 Tutor: Josef Malý1 1 Department of Social and Clinical Pharmacy, Charles University in Pague, Faculty of Pharmacy in Hradec Králové Introduction: In recent years, the self-medication in the Czech Republic has become an important part of health care of citizens who are actively involved in this process. OTC drugs and dietary supplements are an integral part of it. With their increasing supply in pharmacies, the cooperation of patients and professionals in pharmacies has become more important. Objectives: The aim of the thesis was to investigate the current opinions, attitudes, awareness and knowledge of the Czech patients who come into contact with OTC drugs. Methods: The data were collected from September 2013 to February 2014. The directed interview was conducted according to a prepared questionnaire.The data were collected in two surgeries of general practitioners for adults in the town of Uherské Hradiště. The obtained data were transferred to an electronic form using Google and subsequently processed using Microsoft Excel 2010. In this program, the data were evaluated by means of the frequency analysis and converted into tables and graphs,...

Opinions, knowledge, perception of risks and compliance of patients using non-prescription drugs and dietary supplements I. Author: Hana Obrová1 Tutor: Josef Malý1 1 Department of Social and Clinical Pharmacy, Charles University in Pague, Faculty of Pharmacy in Hradec Králové Introduction: A part of the health knowledge everyone of us should be the self-medication. The assortment of OTC drugs and dietary supplements is still being spread in the Czech Republic. It carries benefits and risks. Objectives: The aim of the study was to investigate current opinions, attitudes and knowledge of patients from the Czech Republic about OTC drugs. Methods: The data were collected at the hospital in Svitavy and at the Department of occupational medicine in Svitavy. The interviews were performed in April and July 2013. The data were analysed and described by means of the frequency analysis in Microsoft Excel 2007. Results: The answers were obtained from 169 respondents (44,0 % women and 56,0 % men). The average age of the patients was 50 years. 54,0 % of the patients preferred self-medication before the visit of the doctor. 85,0 % of the patients used at least one OTC drug in the last year. 77,0 % of the patients agreed with the statement that the self-medication could have some risks. The...

M. Tech. (Hospitality and Tourism, Faculty of Human Sciences), Vaal University of Technology. / The primary objective of this study was to formulate a multi-mix, which could supply at least one-third of the daily requirements of primary school children, aged six to 13 years. The secondary objective was to ensure the adherence to the criteria of multi-mix formulation, which included affordability, convenient, palatability, culturally acceptable and cost effective, whilst providing high nutritional value for the specified target group. The nutritional criteria included the Index Nutrient Quality (INQ) and Energy Density (ED) requirements, for a specific target group. This study was conducted in Eatonside, an informal settlement situated in Gauteng. A situational analysis previously conducted in Eatonside (Napier 2003) showed that the children between the ages of six and 13 years, were 17% underweight (weight-for-age -2SD from the reference NCHS median), 12,7% were wasted (BMI-for-age -2SD) and 18% stunted (height-for-age -2SD). With the nutritional requirements of children and the most consumed food list, the multi-mix formulation began. Foods from the Top 20 list (Napier 2003), were combined with the ingredients most common within the households, and vegetable gardens already established . Estimated nutritional values were calculated using the food composition tables of South Africa. The ingredients were prepared and chemically analysed to determine the experimental nutritional value and to assess if the nutritional objectives were being achieved. The multi-mix was then combined with other commonly consumed ingredients to form recipes and sensory evaluated by professionals and the primary school children to assess the acceptability of the multi-mix and recipes. The multi-mix and recipe products were then sent for shelf life testing to assess its storage time at room temperature. The results from the nutritional analyses showed nutrient values to be above 30 percent of the Estimated Average Requirements (EAR). The INQ of the targeted nutrients was above 1,0 and the ED at 3,7kcal/g, which was within the 3,6-4,5 kcal/g requirements. The sensory evaluation for the multi-mix recipes had proved favourable response to snack items with preference for sweet products. The final evaluation session resulted in scores of 83.9 percent preference to the biscuit with the sweet muffin scoring 94.5 percent liking, whilst the savoury muffin at 73.1 percent. The average scores for all three recipes were above 80 percent. The multi-mix had a shelf life of minimum one-month, the biscuit, seven days and muffins, only 24 hours, at room temperature. The objectives of cultural acceptability had been achieved through the positive response from the use of ingredients within the community. The multi-mix had been cost effective as the final cost of R1.55, was within the R2.90 spent per person per day, for all three meals (Oidewage-Theron eta/. 2005). Further studies need to be conducted in order to implement the multi-mix into an intervention within the community to assess the effect on nutritional status. This study, aimed to reduce the underlying cause of malnutrition, food insecurity, by improving the nutritional status of children aged six to 13 years with the strengthening of food intake, through the combination of various scant ingredients, a multi-mix, providing maximum nutritional value with small quantities. An advantage of the multi-mix is a lower cost when compared with tablet supplementation on the market and versatility in relation to various recipes. / Vaal University of Technology National Research Foundation

A composição lipídica das lipoproteínas reflete o conteúdo de ácido graxo (AG) da dieta. A influência dos AG na lipemia e aterogênese varia conforme o grau de saturação, de oxidação e suas proporções na dieta. Vários estudos reportam os efeitos dos ácidos graxos saturados (AGS), monoinsaturados (AGM) e poliinsaturados (AGP) sobre a concentração das lipoproteínas plasmáticas. No entanto, são pouco explorados os efeitos dessa suplementação sobre as propriedades funcionais da lipoproteína de alta densidade (HDL). Desse modo, no presente estudo foi avaliada a transferência de fosfolípides (FL), colesterol livre (CL), ésteres de colesterol (EC) e triglicérides (TG) de uma nanoemulsão lipídica artificial para a HDL, bem como sua atividade antioxidante e a sua composição em ácidos graxos. Além disso, foram avaliadas as atividades das proteínas de transferência de ésteres de colesterol (CETP) e de fosfolípides (PLTP). Foram estudados 84 hamsters Golden Syrian, machos adultos, divididos em 3 grupos os quais receberam suplementação dietética de óleos ricos em AGS (n=28), AGM (n=29) ou AGP (n=27), por gavagem, durante 30 dias. Amostras de sangue foram coletadas, após jejum de 12 h, para determinação do perfil lipídico, atividade da CETP, da PLTP, da paroxonase 1 (PON1) e a composição em ácidos graxos do plasma total e da fração HDL por cromatografia gasosa, bem como a transferência de lípides da nanoemulsão lipídica artificial para a HDL. O método de transferência é baseado na troca de lípides ocorrida entre uma nanoemulsão lipídica artificial, semelhante à estrutura lipídica da LDL, marcada radioativamente com 14C-CL e 3H-TG ou 14C-FL e 3H-EC, usada como doadora de lípides. Após precipitação química da nanoemulsão e das demais lipoproteínas, a capacidade da HDL de receber lípides foi quantificada pela medida da radioatividade presente na lipoproteína. As concentrações de colesterol total, EC, TG e ácido graxo oléico foram menores no grupo AGP em relação aos grupos AGS e AGM (p=0,002, p=0,010, p=0,001, p<0,05, respectivamente). A atividade da PON1, a atividade da PLTP assim como a composição em ácidos graxos da HDL, não diferiu entre os grupos estudados. Por outro lado, a atividade da CETP foi maior no grupo AGM quando comparado aos grupos AGS e AGP (p<0,05). O grupo AGP apresentou maior transferência de EC e menor transferência de FL em comparação aos grupos AGS e AGM (p<0,05). A suplementação dietética de ácidos graxos é capaz de influenciar a funcionalidade da partícula HDL. Dessa forma, o presente estudo fornece subsídios para melhor compreensão do efeito da dieta nos mecanismos relacionados ao metabolismo lipídico nos hamsters / The lipid composition of the lipoproteins reflects the fatty acid (FA) content of the diet . The degree of saturation and oxidation as the dietary content of the FA differently affects the lipemia and the atherosclerosis development. Numerous studies have evaluated the effects of the saturated fatty acids (SFA), monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA) on the plasma lipoprotein concentrations. However, few studies explored the effects of the dietary supplementation of these FA on the functional properties of the high-density lipoprotein (HDL). Therefore, in this study, the transfer of phospholipids (PL), free cholesterol (FC), cholesteryl esters (CE) and triglycerides (TG) from an artificial lipidic nanoemulsion to HDL, as its antioxidant activity and total fatty acids composition were evaluated. Also, the cholesteryl ester transfer protein (CETP) and the phospholipid transfer protein (PLTP) activities were determined. We studied 84 adult male Golden Syrian hamsters divided into 3 groups that received dietary supplementation of 0.75 ml of SFA (n=28), MUFA (n=29) or PUFA (n=27) rich oils by gavage for thirty days. Blood samples were collected after 12 h fasting for determination of plasma lipids, CEPT, PLTP and paraoxonase-1 (PON-1) activities, the fatty acids composition of the total plasma and HDL fraction by gas-liquid chromatography and transfer of lipids from the artificial lipidic nanoemulsion to HDL. The later method is based on the lipid transfer between an artificial lipidic nanoemulsion labeled with 3H-TG and 14C-FC or 3H-CE and 14C-PL, structurally similar to the low-density lipoprotein (LDL), used as a radioactive lipid donator. After artificial nanoemulsion and other lipoprotein precipitation, the capacity of HDL to receive lipids was quantified by measuring the radioactivity present in the lipoprotein. Serum total cholesterol, CE, TG and oleic fatty acids concentrations were smaller in the PUFA group than in the SFA and MUFA groups (p=0.002, p=0.010, p=0.001 and p<0,05 respectively). The PON-1, the PLTP activities and fatty acids composition of the HDL fraction were similar between the groups. On the other hand, the CETP activity was greater in the MUFA group than in the SFA and PUFA groups (p<0.05). The PUFA group showed greater transfer of CE and smaller transfer of PL from the nanoemulsion to HDL compared with SFA and MUFA groups (p<0.05). The dietary supplementation of different FA can lead to alterations of the functionality of the HDL particles. Therefore, the present study contributes to a better understanding of the effects of different fatty acid -rich diets on the mechanisms involved in the lipid metabolism in hamsters

O consumo de suplementos dietéticos tem crescido para complementar a deficiência da ingestão de nutrientes essenciais, para melhorar o desempenho das atividades físicas nos atletas, prevenir doenças e para retardar os efeitos do envelhecimento. Além disso, estes produtos são facilmente acessíveis e de custo relativamente barato. Consequentemente, a avaliação da composição elementar dos suplementos dietéticos é de grande interesse para o controle da qualidade destes produtos e também para avaliar riscos à saúde humana com o seu consumo. O objetivo deste trabalho foi a avaliação da composição elementar de suplementos dietéticos multivitamínicos e proteicos, adquiridos na cidade de São Paulo. As concentrações de As, Br, Ca, Co, Cr, Cs, Fe, K, La, Na, Rb, Sb, Sc, Se e Zn foram determinadas nestes suplementos utilizando o procedimento do método de análise por ativação com nêutrons (NAA). O procedimento experimental consistiu em irradiar alíquotas dos suplementos e os padrões sintéticos dos elementos no reator IEA-R1, seguida de espectrometria de raios gama. O controle da qualidade analítica dos resultados foi realizado pela análise de materiais de referência certificados. A comparação entre os resultados obtidos nos suplementos com os valores declarados nos rótulos, indicou que os suplementos multivitamínicos contêm quantidades de elementos concordantes com os valores dos rótulos, ao contrário dos suplementos proteicos, que apresentaram quantidades para alguns elementos que não concordaram com os valores apresentados nos rótulos. Comparando a quantidade de elemento por dose do suplemento dietético com o percentil de valor diário de ingestão recomendado, foi possível verificar que todos os elementos estão abaixo de 100%, exceto para os elementos Cr em dois suplementos e Se em um suplemento. Os resultados da ingestão dos elementos calculada para a porção diária recomendada pelo fabricante, mostrou que para os suplementos analisados, nenhum elemento ultrapassou o limite superior tolerável. Nos suplementos analisados, os elementos tóxicos Cd e Hg não foram detectados e foram calculados os limites de detecção. Os resultados obtidos neste estudo demonstraram a viabilidade de aplicar NAA na avaliação da composição dos suplementos para diversos elementos. / Dietary supplement consumption has grown to complement deficiency of essential nutrient intake, to improve physical activity performance in athletes, to prevent diseases and to delay the effects of age. These products are readily accessible and relatively cheap. Consequently, the evaluation of the elemental composition of these supplements are of great interest for its quality control and to assess risks to human health. This study evaluated elemental composition of multivitamin and protein dietary supplements, acquired in São Paulo city. Concentrations of As, Br, Ca, Co, Cr, Cs, Fe, K, La, Na, Rb, Sb, Sc, Se and Zn were determined in these dietary supplements, using neutron activation analysis (NAA). The NAA procedure consisted of irradiating aliquots of supplement samples and synthetic element standards at the IEA-R1 nuclear research reactor, followed by gamma ray spectrometry. Analytical quality control of the results was evaluated by analyzing certified reference materials. Comparison between the results obtained in these dietary supplements and the values declared on their labels indicated that the multivitamin supplements contain element amounts according to the label values. On the other hand, protein supplements presented amounts of some elements that disagreed with those values presented on the labels. Comparing the element amount per dose of the dietary supplement with the recommended daily intake percentile, it was possible to verify that all elements are below 100%, except for Cr in two supplements and element Se in one supplement. Element intakes per daily portion calculated according to the supplement intake recommendations, showed element quantities do not exceed the tolerable upper intake levels. In the analyzed supplement samples, toxic elements such as Cd and Hg were not detected, and their detection limits were calculated. To assess the risks of dietary supplement intake, the elemental doses calculated were compared with the daily recommended and the upper limit intake values. The results obtained in this study demonstrated the feasibility of applying NAA to evaluate composition of dietary supplements for several elements.

Introdução: A ingestão de carboidrato (CHO) durante o exercício de resistência aeróbica de longa duração tem se mostrado capaz de otimizar o desempenho dos atletas. Alguns estudos recentes têm reportado também um efeito ergogênico quando a proteína (PTN) é adicionada a uma bebida carboidratada. Além disso, a coingestão tem sido relacionada com a atenuação do dano muscular, tido como fator limitante da recuperação muscular. No entanto, pouco se investigou sobre a influência dessas suplementações, comparadas a uma bebida placebo (PLA), no duatlo de distância olímpica. Objetivo: Comparar o efeito de três diferentes estratégias nutricionais de suplementação (CHO vs. CHO+PTN vs. PLA), durante um teste simulado de duatlo (TSD) olímpico, no desempenho e recuperação muscular de duatletas amadores. Métodos: Em um ensaio clínico, cruzado, randomizado e duplo-cego, treze atletas amadores do sexo masculino, com idade média de 29,7 ± 7,7 anos, participaram de três TSD consumindo: bebida carboidratada (CHO, 75 g); bebida isocalórica combinando carboidrato e proteína, na proporção 4:1 (CHO+PTN, 60,5 g CHO e 14,5 g PTN); e bebida placebo (PLA). Aos atletas informou-se apenas que o estudo visava investigar a influência de três diferentes tipos de suplementação. Após jejum de 8 h, sujeitos recebiam um café da manhã padrão, com 1,5 g/kg CHO e 45 min depois iniciavam o protocolo. As intensidades da primeira corrida (10 km) e da sessão de ciclismo (40 km) foram controladas, utilizando dados previamente coletados em testes preliminares, e a corrida final, de 5 km, foi tratada como um contrarrelógio (t5km). Coletas de sangue foram realizadas antes, imediatamente após e 24h após cada teste simulado, e analisou-se concentrações de glicose e creatina quinase (CK). Pico de torque (PT) isométrico foi mensurado no início do estudo e 24h após cada teste. Resultados: Os atletas completaram as distâncias totais do duatlo olímpico em ~1h 51min. Não houve diferença significativa no t5km entre as condições CHO (1270,3 ± 130,5 s) vs. CHO+PTN (1267,2 ± 138,9 s) vs. PLA (1275,4 ± 120 s); p = 0,87; TE ≤ 0,1. Os resultados de PT não demonstraram alterações significativas entre as condições basal (302,2 ± 52,8 N.m) vs. pós-24h CHO (300,1 ± 41,4 N.m) vs. pós-24h CHO+PTN (292,2 ± 49,4 N.m) vs. pós-24h PLA (282,1 ± 43,1 N.m); p = 0,24; TE ≤ 0,4. Embora, os resultados de CK tenham mostrado aumento significativo para todas as condições na comparação pré vs. pós-24h: CHO (300%; p < 0,01; TE = 0,93); CHO+PTN (82%; p < 0,01; TE = 0,73) e PLA (190%; p = 0,01; TE = 1,04), não foram encontradas diferenças entre as condições nos diferentes momentos - pré, imediatamente após e pós-24h (p = 0,32; TE = 0,3 – 1,04). Conclusão: Em uma prova simulada de duatlo olímpico, com refeição pré-teste contendo 1,5g/kg de carboidrato, as suplementações de CHO e de CHO+PTN não oferecem benefícios extras quando comparadas a uma bebida placebo no que diz respeito ao desempenho e recuperação muscular dos atletas. / Introduction: Carbohydrate (CHO) intake during long-term endurance exercise has been shown to optimize performance in athletes. Some recent studies have also reported an ergogenic effect when protein (PRO) is added to a carbohydrate drink. Furthermore, the coingestion has been related to the attenuation of muscle damage, seen as a limiting factor in muscle recovery. However, little has been investigated about the influence of such supplementation, compared to a placebo drink (PLA), in an Olympic-distance (OD) duathlon. Purpose: This study aimed to compare the effects of three different nutritional supplementation strategies (CHO vs. CHO+PRO vs. PLA) during a simulated OD duathlon, on performance and indices of muscle recovery of amateurs duathletes. Methods: In a crossover, randomized, double-blind clinical trial, thirteen male amateur athletes, mean age 29.7 ± 7.7 years, participated in three simulated OD duathlons consuming either a carbohydrate drink (CHO, 75 g); an isocaloric drink combining carbohydrate and protein in a 4:1 ratio (CHO+PRO, 60.5 g CHO and 14.5 g PRO); or a placebo (PLA) drink. The athletes were informed that the study aimed to investigate the influence of three different types of supplementation. After an 8 hours fast, subjects received a standard breakfast, with 1.5 g / kg CHO and 45 min later the protocol began. The intensities of the first running (10 km) and cycling session (40 km) were controlled using previously collected data, and the final running, 5 km, was treated as a time-trial (t5km). Blood samples were taken before, immediately after and 24 hours after each simulated duathlon and glucose and creatine kinase (CK) levels were analyzed. Isometric peak torque (PT) was measured at baseline and 24 hours after each test. Results: The athletes completed the OD duathlons in ~ 1h 51min. There was no significant difference in t5km between CHO (1270.3 ± 130.5 sec) vs. CHO+PRO (1267.2 ± 138.9 sec) vs. PLA (1275.4 ± 120 sec); p = 0.87; ES ≤ 0.1. The results of PT showed no significant changes between baseline conditions (302.2 ± 52.8 Nm) vs. 24h post-CHO (300.1 ± 41.4 Nm) vs. 24h post-CHO+PRO (292.2 ± 49.4 Nm) vs. 24h post-PLA (282.1 ± 43.1 Nm); p = 0.24; ES ≤ 0.4. Although CK results showed significant increase for all conditions when comparing pre vs. post 24h CHO (300%; p <0.01; ES = 0.93); CHO+PRO (82%; p <0.01; ES = 0.73) and PLA (190%, p = 0.01; ES = 1.04), no differences were found between the conditions in the different moments - pre, immediately after and after 24 hours (p = 0.32; ES = 0.3 – 1.04). Conclusion: In a simulated Olympic-distance duathlon, with pre-meal test containing 1.5g / kg of carbohydrate, the ingestion of CHO and CHO+PRO does not provide additional benefits when compared to a placebo drink regarding athletes’ performance and muscle recovery.

O consumo de suplementos dietéticos tem crescido para complementar a deficiência da ingestão de nutrientes essenciais, para melhorar o desempenho das atividades físicas nos atletas, prevenir doenças e para retardar os efeitos do envelhecimento. Além disso, estes produtos são facilmente acessíveis e de custo relativamente barato. Consequentemente, a avaliação da composição elementar dos suplementos dietéticos é de grande interesse para o controle da qualidade destes produtos e também para avaliar riscos à saúde humana com o seu consumo. O objetivo deste trabalho foi a avaliação da composição elementar de suplementos dietéticos multivitamínicos e proteicos, adquiridos na cidade de São Paulo. As concentrações de As, Br, Ca, Co, Cr, Cs, Fe, K, La, Na, Rb, Sb, Sc, Se e Zn foram determinadas nestes suplementos utilizando o procedimento do método de análise por ativação com nêutrons (NAA). O procedimento experimental consistiu em irradiar alíquotas dos suplementos e os padrões sintéticos dos elementos no reator IEA-R1, seguida de espectrometria de raios gama. O controle da qualidade analítica dos resultados foi realizado pela análise de materiais de referência certificados. A comparação entre os resultados obtidos nos suplementos com os valores declarados nos rótulos, indicou que os suplementos multivitamínicos contêm quantidades de elementos concordantes com os valores dos rótulos, ao contrário dos suplementos proteicos, que apresentaram quantidades para alguns elementos que não concordaram com os valores apresentados nos rótulos. Comparando a quantidade de elemento por dose do suplemento dietético com o percentil de valor diário de ingestão recomendado, foi possível verificar que todos os elementos estão abaixo de 100%, exceto para os elementos Cr em dois suplementos e Se em um suplemento. Os resultados da ingestão dos elementos calculada para a porção diária recomendada pelo fabricante, mostrou que para os suplementos analisados, nenhum elemento ultrapassou o limite superior tolerável. Nos suplementos analisados, os elementos tóxicos Cd e Hg não foram detectados e foram calculados os limites de detecção. Os resultados obtidos neste estudo demonstraram a viabilidade de aplicar NAA na avaliação da composição dos suplementos para diversos elementos. / Dietary supplement consumption has grown to complement deficiency of essential nutrient intake, to improve physical activity performance in athletes, to prevent diseases and to delay the effects of age. These products are readily accessible and relatively cheap. Consequently, the evaluation of the elemental composition of these supplements are of great interest for its quality control and to assess risks to human health. This study evaluated elemental composition of multivitamin and protein dietary supplements, acquired in São Paulo city. Concentrations of As, Br, Ca, Co, Cr, Cs, Fe, K, La, Na, Rb, Sb, Sc, Se and Zn were determined in these dietary supplements, using neutron activation analysis (NAA). The NAA procedure consisted of irradiating aliquots of supplement samples and synthetic element standards at the IEA-R1 nuclear research reactor, followed by gamma ray spectrometry. Analytical quality control of the results was evaluated by analyzing certified reference materials. Comparison between the results obtained in these dietary supplements and the values declared on their labels indicated that the multivitamin supplements contain element amounts according to the label values. On the other hand, protein supplements presented amounts of some elements that disagreed with those values presented on the labels. Comparing the element amount per dose of the dietary supplement with the recommended daily intake percentile, it was possible to verify that all elements are below 100%, except for Cr in two supplements and element Se in one supplement. Element intakes per daily portion calculated according to the supplement intake recommendations, showed element quantities do not exceed the tolerable upper intake levels. In the analyzed supplement samples, toxic elements such as Cd and Hg were not detected, and their detection limits were calculated. To assess the risks of dietary supplement intake, the elemental doses calculated were compared with the daily recommended and the upper limit intake values. The results obtained in this study demonstrated the feasibility of applying NAA to evaluate composition of dietary supplements for several elements.

Thesis (M.Tech.: Biotechnology)- Dept. of Biotechnology, Durban University of Technology, 2007 xv, 127 leaves / The human gut microbiota play a major role in host health, and attempts are being made to manipulate the composition of the gut microbiota-increase the composition of bacterial groups, such as lactobacilli and bifidobacteria that are perceived as exerting health promoting properties. These bacteria defined as food supplements (probiotics) beneficially affect the host by improving the intestinal microbial balance, and have been used to change the composition of the colonic microbiota. However, such changes may be transient, and the implantation of exogenous bacteria therefore becomes limited. In contrast, prebiotics are naturally occurring carbohydrates that are classified as non-digestible oligosaccharides present in edible plants. These carbohydrates enter the colon as intact compounds, elicit systemic physiological functions and act as fermentable substrates for colonic microflora-influencing the species composition and metabolic characteristics of intestinal microflora providing important health attributes. Currently, a widely marketed prebiotic, inulin is extracted from plants of the family Asteraceae. There are many unexploited plants that are regularly consumed and that may have a prebiotic effect or can have very high levels of inulin which could make them commercially viable. In this study, we investigated prebiotic compounds, especially inulin from locally growing, non-commercialised leafy plants. The aqueous extracts of 22 plants from the families Asparagaceae, Alliaceae, Asteraceae, Solanaceae, Cucurbitaceae, Amaranthaceae, Acanthaceae, Polygonaceae, Portulaceae, Fabaceae, Chenopodiaceae, Pedaliaceae and Apiaceae from Kwa-Zulu Natal were investigated for a prebiotic effect using a modified batch-culture technique with Lactobacillus bulgaricus, Lactobacillus lactis, Lactobacillus reuteri and Bifidobacterium longum, four common probiotics and the inulin content of the plants was determined using high performance liquid chromatography. Of the 22 plants studied, Solanum nigrum, Amaranthus spinosus, Amaranthus hybridus, Asystasia gangetica, Senna occidentalis, Cerathoteca triloba, Asparagus sprengeri, Tulbaghia violacea, Sonchus oleraceus and Taraxacum officinale exhibited a prebiotic effect. The prebiotic effect of the Taraxacum officinale, Sonchus oleraceus and Asparagus sprengeri extracts on L. lactis and L. reuteri was higher than or equivalent to inulin-a commercial prebiotic. In this study, Sonchus oleraceus exhibited the best prebiotic effect-was the only plant to stimulate all the probiotics including B. longum. Of all the plants analysed, Asparagus sprengeri tuber contained the highest amount of inulin (3.55%).

Dissertation submitted in partial compliance with the requirements for a Masters Degree in Tehcnology: Chiropractic, Durban University of Technology, 2009. / Background: The aim of this study was to determine the knowledge, perception and utilisation of vitamins and minerals, natural medicines and pharmacological agents as adjuncts to Chiropractic practice in South Africa. Method: This study was a population based cross sectional survey utilising a descriptive, quantitative questionnaire study design. The questionnaire was distributed to all practicing qualified Chiropractors (n=388) and masters Chiropractic students (n=102) in South Africa. Results: The results obtained (30.4% response rate), indicated that the majority of the respondents (62.8%) felt qualified to advise patients on vitamins and mineral supplements and had a positive view of the use of vitamins and minerals as part of Chiropractic patient management (86.6%). The majority of the practitioners were aware that topical substances are part of the scope of practice and males were nearly twice as likely as females to use them. The majority thought biopuncture should be available to Chiropractors (82%) and felt that Chiropractors should challenge the legislation to incorporate biopuncture as part of the scope of practice (77.5%). Most respondents agreed with the statement indicating that NSAIDS should be part of Chiropractic scope of practice and 71% of respondents felt that being able to use NSAIDS in non-emergency situations would enhance patient retention. This study revealed that amongst the student population the majority, if allowed, would consider administering pharmacological agents in practice (55.1%). Conclusion: A correlation exists between the perception, knowledge and utilisation of vitamins and minerals, natural medicines and pharmacological agents in the Chiropractic profession with respect to the demographic data and there is a significant difference in opinion between qualified Chiropractors and Chiropractic masters students regarding perception, knowledge and utilisation of these adjuncts to practice.