Dissertation (PhD)--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: Activation of the NO-cGMP pathway is associated with myocardial protection against ischaemia/reperfusion injury. However, high-cholesterol diets alter function of this pathway and these alterations have been implicated in both ischaemic/reperfusion injury and the development of ischaemic heart disease. Little is known about the effects of supplements such as Red Palm Oil (RPO) on the myocardial NO-cGMP-signalling pathway. RPO consists of saturated, mono-unsaturated and poly-unsaturated fatty acids and is rich in antioxidants such as β-carotene and Vitamin E (tocopherols and tocotrienols). The aims of this study were: 1) to determine whether dietary RPO-supplemention protects against ischaemia/reperfusion injury in rats fed a standard rat chow (control) and cholesterol-enriched diets and 2) if so, to investigate possible mechanisms for this protection. Male Long-Evans rats were fed a standard rat chow or a standard rat chow plus cholesterol and/or RPO-supplementation for 6 weeks. Myocardial functional recovery was measured and hearts were freeze-clamped for determination of myocardial phospholipid, cAMP/cGMP concentrations, total myocardial nitric oxide concentrations, lipid hydroperoxide production and superoxide dismutase- and nitric oxide synthase activity in isolated rat hearts subjected to 25 minutes of normothermic total global ischaemia. In addition, the degree of phosphorylation of extracellular signal-regulated kinase (ERK), p38, c-Jun N-terminal protein kinase (JNK) and protein kinase B (PKB/Akt) was investigated. Furthermore, the effect of RPO-supplementation on caspase-3 activation and poly (ADP-ribose) polymerase (PARP)-cleavage in hearts subjected to ischaemia and reperfusion was also investigated. Our data show that dietary RPO-supplementation protects the hearts of rats on a standard rat chow (control) and hypercholesterolaemic diet against ischaemia/reperfusion injury as reflected by improved aortic output recovery. Increased intracellular cardiomyocyte NO concentrations as observed in control hearts supplemented with RPO after 120 minutes hypoxia may contribute to the elevated cGMP concentration and may confer some of the cardioprotection to the ischaemic/reperfused heart. Although improved functional recovery with RPO-supplementation of a high-cholesterol diet was also associated with an increase in intracellular cardiomyocyte NO production after hypoxia compared to the non-hypoxic conditions, it could not be linked to increased NO-cGMP signalling. These data are in agreement with other studies, which showed that high-cholesterol diet impairs NO-cGMP signalling and confirms our hypothesis that elevated cGMP concentrations may not be the only mechanism of protection. We have also shown that RPOsupplementation caused increased phosphorylation of p38 and PKB, reduced phosphorylation of JNK and attenuation of PARP cleavage, which may contribute to the protection of the cell against apoptosis. Based on our results we propose that the myocardial protection offered by RPO-supplementation of rats on a normal and hypercholesterolaemic diet may be associated with either its antioxidant characteristics and/or changes in the fatty acid composition of the myocardium during ischaemia/reperfusion. Furthermore, we demonstrated for the first time that RPO-supplementation protects the isolated perfused working rat heart during reperfusion from ischaemia/reperfusion-induced injury through a MAPK-dependent pathway. / AFRIKAANSE OPSOMMING: Aktivering van die NO-cGMP sein transduksie pad word geassosieer met miokardiale beskerming teen isgemie/herperfusie skade. Hoë cholesterol diëte verander egter die funksie van die pad en hierdie veranderings speel ‘n rol in beide isgemie/herperfusie besering en die ontwikkeling van isgemiese hartsiekte. Daar is egter min inligting beskikbaar oor die uitwerking van aanvullings soos rooi palm olie (RPO) op die miokardiale NO-cGMP sein transduksie pad. RPO bevat versadigde, mono-onversadigde en poli-onversadigde vetsure en is ryk aan anti-oksidante nl. β-karotene en vitamien E (tokoferole en tokotriënole). Die doelwitte van hierdie studie was: 1) om vas te stel of ‘n RPO-aanvulling beskerming bied teen isgemie/herperfusie besering in rotte wat gevoed is met ‘n standaard rotmengsel (kontrole) en cholesterol-verrykte dieet en 2) indien wel, om moontlike meganismes van beskerming te ondersoek. Long-Evans manlike rotte is vir 6 weke gevoer met ‘n standaard rotmengsel of ‘n standaard rotmengsel plus cholesterol en/of RPO-aanvulling. Miokardiale funksionele herstel is gemeet en harte is gevriesklamp vir die bepaling van miokardiale fosfolipied, cAMP/cGMP, totale stikstofoksied, lipied hidroperoksied, superoksied dismutase en stikstofoksied sintase in geïsoleerde rotharte wat vir 25 minute onderwerp was aan normotermiese totale globale isgemie. Hiermee saam is die graad van fosforilering van ekstrasellulêre sein gereguleerde kinase (ERK), p38 mitogeen-geaktiveerde proteïen kinase (p38 MAPK), c-Jun-N-terminale proteïenkinase (JNK) en proteïen kinase B (PKB/Akt) ondersoek, asook kaspase-3 aktivering en poli (ADP-ribose) polimerase (PARP) kliewing in harte blootgestel aan isgemie en herperfusie. Ons resultate toon dat RPO-aanvulling van rotte op ‘n normale en hipercholesterolemiese dieet die hart beskerm soos getoon deur verbeterde herstel van aortiese uitset. Verhoogde intrasellulêre miokardiale NO vlakke in kontrole harte met ‘n RPO-aanvulling wat blootgestel was aan 120 minute hipoksie, mag bygedra het tot die verhoogde cGMP vlakke en beskerming van die hart tydens isgemie en herperfusie. Alhoewel verbeterde funksionele herstel met RPO-aanvulling van ‘n hoë cholesterol dieet ook geassosieer is met ‘n toename in intrasellulêre miokardiale NO produksie ná hipoksiese toestande, kon dit nie verbind word met verhoogde aktivering van die NOcGMP sein transduksie pad nie. Hierdie resultate stem ooreen met ander studies wat aangetoon het dat hoë-cholesterol diëte die NO-cGMP seinpad onderdruk. Hierdie bevinding bevestig ons hipotese dat verhoogde cGMP vlakke moontlik nie die enigste beskermingsmeganisme is nie. Ons resultate het ook gewys dat RPO-aanvulling fosforilering van p38 en PKB/Akt verhoog, fosforilering van JNK verminder en PARP kliewing onderdruk. Dit dui op beskerming van die sel teen apoptose. Ons resultate dui aan dat die miokardiale beskerming wat RPO-dieet aanvulling bied moontlik geassosieer kan word met sy anti-oksidant eienskap en/of veranderinge in die vetsuur samestelling van die miokardium tydens isgemie/herperfusie. Ons het ook vir die eerste keer bewys dat RPO-aanvulling die geïsoleerde geperfuseerde werkende rothart gedurende herperfusie beskerm teen isgemie/herperfusie besering deur die aktivering en/of deaktivering van die MAPK afhanklike pad.

Background: The increasing consumption of dietary supplements (DS) has drawn the attention of regulatory agencies, researchers and healthcare professionals. The US Food and Drug Administration (FDA) does not require premarketing assessment of DS considering them safe unless proven otherwise. However, the reporting rate of DS adverse events (DS-AE) is low. Objective: To describe pharmacists’ attitudes and knowledge of DS and DS information resources, and to determine the importance of selected attributes in pharmacists’ decisions to report a DS-AE. Methods: A convenience sample of practicing pharmacists in Virginia was surveyed using a web-based self-administered questionnaire. A conjoint analysis exercise was developed using several scenarios based on a set of five attributes: patient’s age, initiation of DS, last modification in drug therapy, evidence supporting the AE, and outcome of the AE. Participants were asked to indicate their decision to report the AE in each scenario to prescriber, drug manufacturer, DS manufacturer and FDA on a 6-point ordered scale. Participants’ attitude, knowledge of DS, demographic information, and DS information resources were also requested. Linear regression models were used to determine the relative importance of the profile attributes on a pharmacist’s decision to report the AE. The effects of other characteristics on the importance of the attributes were assessed. Results: Participants’ overall attitudes were relatively positive for the clinical use of DS but negative for safe of DS. Formal training on DS was associated with better knowledge of DS regulation. The average knowledge score of DS identification was relatively good but was low for DS regulation. Lexi-Comp® was the most widely used and available information resource and the Natural Medicines Comprehensive Database was the most useful once. The most important attribute that a pharmacist considered in the decision to report a DS-AE to DS manufacturer, drug manufacturer and FDA was the outcome of the AE followed by the evidence supporting the AE. Ranking of these two factors was the reversed in reporting to prescriber. Conclusions: Outcome and evidence of the AE are the most important factors participants considered when reporting. Other characteristics do not have an impact on the relative importance of the attributes.

O zinco é um elemento-traço essencial que está envolvido em diferentes processos metabólicos. Possui função antioxidante, uma vez que faz parte da estrutura da enzima superóxido dismutase (CuZn-SOD), atua na restrição da produção endógena de radicais livres e, na estabilização da estrutura de membranas. Diabéticos geralmente apresentam deficiência de zinco, além de possuírem um grau aumentado de estresse oxidativo, que é gerado pela própria doença. Portanto o presente estudo teve como objetivo verificar se a suplementação com zinco em pacientes com diabetes mellitus do tipo 2 poderia melhorar as características indicativas de dano oxidativo. O estudo realizado foi duplo cego, sendo administrado zinco aminoquelado (20mg/dia) e placebo, durante 6 meses, sendo os parâmetros do estudo avaliados antes e depois da suplementação, para que fosse possível se observar as mudanças nos parâmetros indicativos do estresse oxidativo. Na avaliação antropométrica, se verificou peso, estatura, medidas da cintura e bioimpedância elétrica. Foi feita a avaliação dos parâmetros glicêmicos e lipídicos, do mineral zinco, bem como dos indicadores de estresse oxidativo, incluindo os óxidos de colesterol e os autoanticorpos anti-LDL eletronegativa. A avaliação alimentar foi realizada por meio do registro de consumo alimentar. Como resultados, podemos ressaltar alta prevalência de sobrepeso/obesidade. Após a suplementação, as concentrações do zinco no plasma e eritrócito tiveram um leve aumento, passando de 68±10 para 72,9±13µg/dL, e de 40,7±6,2 para 43±6,8µgZn/gHb, respectivamente, entretanto, este aumento não foi estatisticamente significativo. Também não foram encontradas diferenças significativas nas concentrações dos autoanticorpos anti-LDL eletronegativa e do total dos óxidos de colesterol, apesar de existir tendência de melhora destes parâmetros. / Zinc is an essential trace element that is involved with a variety of metabolic processes. It has an antioxidant function as it is part of the superoxidedismutase (CuZn-SOD) enzyme. It works in the restriction of the free-radicals endogenous production and in the membrane structure stabilization. Diabetic people often present zinc deficiency, besides of having an augmented degree of oxidative stress, which is generated by the own disease. Therefore, the present study had as objective to verify if the zinc supplementation would better the indicating characteristics of oxidative damage to type 2 diabetes mellitus patients. The study done was double-blind, with the administration of zinc chelate (20mg/day) and placebo, during 6 months. The study parameters were assessed both before and after the supplementation, in order to be possible for one to observe changes in the indicating oxidative stress parameters. In the antropometric evaluation, it was verified the weight, height, the measure of the waistline and the electric bioimpedance. It was evaluated the glicemic and fat parameters, zinc, as well as the oxidative stress indicators, which included the oxysterols and the electronegative anti-LDL autoantibody. The alimentary evaluation was done by means of the feed consumption registration. As a result, it could be highlighted the predomination of overweigh/obesity. After supplementation, the zinc concentrations in the plasma and erythrocyte showed a slight increase, from 68±10 to 72,9±13mg/dL, and from 40,7±6,2 to 43±6,8mgZn/gHb, respectively. However, this increase was not statically significative. Besides that, it was not found significative differences in the concentration of the electronegative anti-LDL autoantibody and of the oxysterols totals, despite of a trend in improvement of those parameters.

Após a realização de uma sessão de treinamento (ST) é comum a ocorrência do fenômeno denominado dano muscular induzido pelo exercício (DMIE), que se caracteriza por prejuizos a estrutura da fibra muscular, com ruptura de alguns sarcômeros, desordem miofibrilar e alargamento das linhas Z. Ainda em consequência ao DMIE, surgem alguns sintomas que são utilizados como marcadores indiretos: dor muscular de início tardio (DMIT), redução na produção de força, aumento de enzimas e proteínas na corrente sanguínea e inchaço. O presente estudo examinou os efeitos da suplementação nutricional a fim de minimizar os efeitos deletérios do DMIE em 3 experimentos. No 1° estudo, 36 indivíduos inexperientes em treinamento de força (TF) foram suplementados com: placebo (PLA, n=12, 50mg·kg-1 de carboidrato); leucina (LEU) baixa dose (LBD, n=12, 50mg·kg-1 de LEU + 50mg·kg-1 de carboidrato) e LEU alta dose (LAD, n=12, 250mg·kg-1 de LEU + 50mg·kg-1 de carboidrato) por 6 dias antecedentes a sessão de treinamento (ST), e nos 3 dias seguintes. Foi observada redução significante, p<0.05, na dor muscular de início tardio (DMIT) do peitoral por palpação, e alongamento nos momentos 48h, e 72h após a ST no grupo LBD comparado ao PLA. A redução no teste de 1 repetição máxima (1RM) apresentou significância no grupo PLA em todos momentos após ST. O aumento na atividade da creatina quinase (CK) foi significante no grupo PLA comparado ao LAD em 24h, 48h e 72h após a ST, enquanto o aumento da concentração de mioglobina (Mb) foi significante no grupo PLA comparado ao grupo LBD e LAD em 24h, 48h e 72h após a ST. O 2° estudo contou com a participação de 28 indivíduos com até 6 meses de experiência em TF. Os sujeitos foram suplementados com 3g de &beta;-hidroxi-&beta;-metilbutirato (HM) por 14 dias (H14, n=07); 7 dias (H07, n=07) e placebo por 14 dias (P14) ou 7 dias (P07, n=07) antecedentes a ST, e nos 3 dias seguintes. O aumento da DMIT por palpação e alongamento foi significante no grupo P14 comparado ao H14 em 24h (apenas alongamento), 48h e 72h após ST, ainda no momento 72h o grupo P07 era superior ao H07. A redução no teste de 1RM ocorreu nos 4 grupos imediatamente após, foi mantida em 24h após a ST nos grupos H14, H07 e P07, sem diferenças entre os grupos. O aumento na concentração de Mb foi significante no grupo P14 comparado ao grupo H14. No 3° estudo, 24 indivíduos experientes em TF foram suplementados com 7g de arginina (ARG, n=12) ou placebo (PLA, n=12, 7g carboidrato) 30 minutos pré-ST. O grupo PLA apresentou aumento significante na DMIT por palpação em 24h comparado ao grupo ARG. A redução no teste de 1RM alcançou significância apenas em 24h após a ST no grupo PLA, mas sem diferença entre os grupos. Os resultados do presente estudo permitem concluir que a suplementação nutricional implementada atenuou o comportamento de alguns marcadores indiretos DMIE, com maior efeito para a DMIT e parametros bioquímicos / After performing a training session (TS) is common the occurrence of the phenomenon called muscle damage induced by exercise (DMIE), which is characterized by damage to muscle fiber structure, breaking some sarcomeres, myofibrillar disorder and extension lines Z. As a consequence of DMIE, there are some symptoms that are measured as indirect markers: delayed onset muscle soreness (DOMS), reduction in strength production, increase of enzymes and proteins in the bloodstream, and swelling. The effect of nutritional interventions to minimize deleterious responses associated with exercise-induced muscle damage (EIMD) were investigated in 3 experiments. In study 1, 36 inexperienced subjects in resistance training (RT) were supplemented for 6 days prior to the training session (TS), and in the following 3 days with: placebo (PLA, n=12, 50mg·kg-1 of carbohydrate); leucine (LEU) low dose (LLD, n=12, 250mg·kg-1 LEU + 50mg·kg-1 + carbohydrate) and LEU high dose (LHD, n=12, 250mg·kg-1 LEU + 50mg·kg-1 + carbohydrate). There was a significant reduction (p <0.05) in delayed onset muscle soreness (DOMS), of the chest by palpation and stretching at 48h, after TS in the LLD group compared to PLA. A significant reduction in the one repetition maximum (1RM) test was observed in the PLA group at all times after TS. The increase in creatine kinase (CK) activity was significant in the PLA group compared to the LHD in 24h, 48h and 72h after TS, while the increase in myoglobin concentration (Mb) was significant in the PLA group compared to the LLD and LHD group in 24h, 48h, and 72h after TS. In study 2, 28 subjects with up to 6 months of RT experience were supplemented with 3g of &beta;-hydroxy-&beta;-methylbutyrate (HM&beta;) for 14 days (H14, n=7); for 7 days (H07, n=7), and placebo for 14 days (P14, n=7) or 7 days (P07, n=7) antecedent to ST, and in the next 3 days. The increase in DOMS by palpation and stretching was significant in the P14 group compared to H14 in 24h (stretching only), 48h and 72h after TS, yet at 72h the P07 group was higher than H07. The reduction in the 1RM test occurred in the 4 groups immediately after and maintained within 24h after TS in groups H14, H07 and P07, and there was no difference between groups. The increase in Mb concentration was significant in the P14 group compared to the H14 group. In study 3, 24 resistance-trained subjects were supplemented with 7g of arginine (ARG, n=12) or placebo (PLA, n=12, 7g of carbohydrate) 30 minutes pre- TS. The PLA group presented a significant increase in DOMS by palpation in 24h compared to the ARG group, and a significant reduction in the 1RM test only in 24h after ST in the PLA group, but without a significant difference between groups. The results of the present study suggest that the responses of indirect markers associated with EIMD were attenuated by nutritional interventions, with greater effect for DOMS and biochemical parameters

Made available in DSpace on 2014-07-29T15:25:16Z (GMT). No. of bitstreams: 1 Tese Ana Paula Perillo Ferreira Carvalho.pdf: 2730785 bytes, checksum: 1f68b9df4f7070c902674ee992b24c24 (MD5) Previous issue date: 2011-07-04 / Introduction: Heart failure is a progressive clinical syndrome in patients that generally, present alterations in their nutritional condition and loss in the functional capacity. objectives: Evaluating the effects of creatine supplementation on functional capacity and body composition of patients with heart failure. Methodology: Prospective, randomized, double-blind study performed at the Hospital das Clínicas of Federal University of Goiás, with 33 patients over 18 years old with heart failure. The selected patients were randomized in experimental group (CRE, n=17), supplemented with creatine monohydrate and placebo group (PLA, n=16), which received maltodextrin. For both groups, the instruction about taking the supplement or the placebo were 5 g dialy during the period of six months. The patients were submitted to evaluation of functional capacity by ergospirometry and the walking test per six minutes (6-MWT), anthropometry and the food consumption, before starting suplementation and at end of sixth month.The statistical model ANCOVA was used to analyze groups and treatment forms. Results: From the variables evaluated in the ergospirometry, the volume of the peak oxygen uptake (peak VO2 ), anaerobic threshold (AT), and the oxygen pulse (O2P) did not show significant differences between the groups (p>0,05). There was no significant difference in the distance travelled concerned to 6-MWT. The volunteers in the CRE groups presented average values of muscle circumference of the arm statistically superior from the PLA group (p=0,0413). The total of the body mass, lean body mass and the fat percentage did not present significant differences between groups. As for the total caloric value and macronutrients of the diet only medium amounts of lipids in the CRE group presented statistically lower (p=0.0120) than the PLA group. Conclusion: The creatine in patients with heart failure did not cause significant improvement in the functional capacity, in spite of the skeletal muscle enhancement in the CRE group, according to (MCA). / Introdução: A insuficiência cardíaca (IC) é uma síndrome clínica progressiva na qual os pacientes, em geral, apresentam alterações no seu estado nutricional e perda da capacidade funcional. Objetivo: Avaliar os efeitos da suplementação de creatina na capacidade funcional e composição corporal de pacientes com insuficiência cardíaca. Metodologia: estudo prospectivo, randomizado, duplo cego, realizado no Hospital das Clínicas da Universidade Federal de Goiás, com 33 pacientes maiores de 18 anos com insuficiência cardíaca. Os pacientes selecionados foram randomizados em grupo experimental (CRE, n =17), suplementado com creatina monoidratada e grupo placebo (PLA, n =16), que recebeu maltodextrina. Para ambos os grupos a instrução sobre a ingestão do suplemento ou do placebo foi de 5 g diárias durante o período de seis meses. Os pacientes foram submetidos à avaliação da capacidade funcional pela ergoespirometria e por teste de caminhada de seis minutos (TC6), antropometria e de consumo alimentar, antes de iniciarem a suplementação e ao final do sexto mês. O modelo estatístico Ancova foi utilizado na análise dos grupos e nas formas de tratamento. Resultados: Das variáveis avaliadas na ergoespirometria, o volume de oxigênio pico (VO2 pico), o limiar anaeróbico (LA) e o pulso de oxigênio (PO2) não apresentaram diferenças significativas entre os grupos (p>0,05). No TC6 não houve diferença significativa na distância percorrida. Os voluntários do grupo CRE apresentaram valores médios de circunferência muscular do braço (CMB) estatisticamente superiores aos do grupo PLA (p= 0,0413). A massa corporal total, a massa corporal magra e percentual de gordura não apresentaram diferenças significativas entre os grupos. Quanto ao valor calórico total e aos macronutrientes da dieta, apenas a quantidade média de lipídios no grupo CRE apresentou-se estatisticamente inferior (p = 0,0120) ao grupo PLA. Conclusão: A creatina em pacientes com insuficiência cardíaca não promoveu melhora significativa na capacidade funcional, apesar de ter ocorrido aumento da massa muscular esquelética no grupo CRE de acordo com a CMB.

University of Macau / Institute of Chinese Medical Sciences

University of Macau / Institute of Chinese Medical Sciences

University of Macau / Institute of Chinese Medical Sciences

University of Macau / Institute of Chinese Medical Sciences

Thesis (Msc Food Sc (Food Science))--Stellenbosch University, 2008. / The physical and mental development of underprivileged children, living in developing countries, is detrimentally affected by the exposure to poverty, malnutrition and poor health. The aim of the present study was to determine the possible risk of nutritional deficiencies of children (aged 5 – 6 years) in a low socio-economic community in the Grabouw area of the Western Cape, South Africa. The nutritional status of the children was evaluated by using anthropometric measurements (weight and height). Furthermore, the dietary intake provided by the meals offered at the schools they attended (Agapé 1 and Agapé 2), was assessed using the school menus. The latter were analysed using the FoodFinder3® computer programme (Medical Research Council of SA, Tygerberg, South Africa). Three supplementary food products (biscuit, health bar and soy milk-based drink) were subsequently developed to address possible nutritional deficiencies. The microbial stability of the products was determined, after which sensory acceptability of all three products was determined using a consumer panel consisting of children (n = 51; M:F = 27:24; 5 – 6 years) from the mentioned schools within the low socio-economic community. Anthropometric results were in agreement with those found by the National Food Consumption Survey (NFCS) (1999) and the South African Vitamin A Consultative Group (SAVACG) (1995), with stunting found to be most prevalent (16%). Only 5% of the children were found to be underweight and none were found to be wasted. The developed biscuit and health bar was found to be microbiologically safe when stored for at least 30 d at 25° and 35°C respectively, and the soy milk-based drink for 7 d if stored at refrigeration temperatures (5°C). Concerning the sensory preference, no significant difference was found between the preference for any of the developed products by the males and the females. For the specific products the preference for the biscuit did not differ significantly from the health bar, nor did the health bar differ significantly from the soy milk-based drink, but the biscuit did differ significantly (p = 0.006) from the soy milk-based drink for preference. The biscuit was found to be the most preferred of the three products and the soy milk-based drink the least. The majority of the juvenile consumer panel (95%) found all three developed food products acceptable and could, therefore, be considered possible supplementary foods in a school nutrition programme. The aim of nutritional supplementation is to supplement the existing diet and in doing so ensuring a more ideal nutrient intake closer to what is recommended by the recommended dietary allowance (RDA). It is proposed that nutritional deficiencies should, however, not only be addressed by means of nutritional supplementation, but should also be assisted by the nutrition education of the parent/guardian so as help them to make informed nutritional choices and in doing so providing their children with the nutrients necessary for optimal mental and physical development.