Oral mucositis refers to erythematous and ulcerative lesions of oral mucosa during chemo/radiotherapy. Treatment modalities were directed towards reduction in severity of oral mucositis. Zinc plays an important role to retard oxidative processes and is considered as the critical component in wound healing. To compare the efficacy of zinc alone with improvised zinc preparation in reducing the severity of oral mucositis. Improvised zinc was a combination of zinc oxide, amla, tulsi and curcumin at 1% therapeutic concentrations. Seventy-five subjects undergoing chemo/radiotherapy were randomly divided into three groups: Group A (25 subjects) had received topical 5% zinc oxide paste trice daily application after food for entire treatment period, initiated 2 d prior to radiotherapy. Group B (25) received improvised zinc preparations (1%) and instructed to apply same as group A. Group C (25) received standard treatment offered by cancer hospital. All the groups were assessed for oral mucositis using WHO grading system at 7th, 14th, 21st, 28th, 35th day by the oncologist and results were tabulated for statistical analysis. Severity of oral mucositis reduced in zinc and improvised zinc group (p=0.096) when compared with controls with significant p value (0.037). Comparison of improvised zinc preparation (1%) group with only zinc group revealed that severity of overall mucositis though was not significant, was less in improvised zinc group with p value (0.029, 0.013) at 28 and 35 d respectively. Improvised zinc administration during radiation therapy was beneficial in reduction of oral mucositis during cancer treatment.

The aim of this study was to investigate the vitamin D status and related factors in community-dwelling Korean stroke survivors. Data of 23,872 individuals ≥20 y who participated in the Korea National Health and Nutrition Examination Surveys (KNHANES) were analyzed. Participants who had ever been diagnosed with stroke by a doctor were defined as stroke survivors (n=431). The serum 25-hydroxyvitamin D (25(OH)D) level was measured by radioimmunoassay, and vitamin D deficiency was defined as 25(OH)D<20 ng/mL. The association between vitamin D and stroke status was analyzed using multivariable general linear models and logistic regression models adjusted for sociodemographic and clinical covariates. The adjusted mean 25(OH)D level of stroke survivors was significantly lower than that of nonstroke controls; however, after adjustment for systolic blood pressure level and use of antihypertensive medication, the difference was no longer statistically significant. The burden of 25(OH)D deficiency was not higher in stroke survivors than in nonstroke controls (adjusted OR=1.14; 95% CI, 0.81-1.62). Current smoking was independently associated with 25(OH)D deficiency among stroke survivors (adjusted OR=3.17; 95% CI, 1.33-7.55). These findings indicated that treatment of high blood pressure and smoking cessation may be important measures to control vitamin D levels in stroke survivors.

Studies have shown that vitamin D status might be associated with dyslipidaemia, but results are conflicting and there might exist sex differences. The aim of our study was to explore the sex-specific association between vitamin D status and serum lipids and atherogenic index of plasma (AIP, a predictor for atherosclerosis) among Chinese middle-aged and elderly adults. A total of 4,021 middle-aged and elderly participants from a health management centre were included in this cross-sectional study. The individuals were classified into tertiles according to serum 25(OH)D. Linear and logistic regression models were used to estimate the association between vitamin D levels and serum lipids among the tertiles. The mean serum 25(OH)D level was 21.60 (16.60-27.20) ng/mL in all participants. After adjusting for potential confounders, a 10 ng/mL increase in 25(OH)D was associated with decreases of 1.156 mmol/L in triglycerides (TGs) and 0.068 in the AIP and an increase of 0.051 mmol/L in high-density lipoprotein cholesterol (HDL-C) in all subjects. In addition, 25(OH)D deficiency was associated with an increased prevalence of hypertriglyceridaemia (odds ratio (OR), 1.880; 95% confidence interval (CI), 1.351-2.615), hypoalphalipoproteinaemia/HDL (OR, 1.505; 95% CI, 1.146-1.977) and abnormal AIP (OR, 1.933; 95% CI, 1.474-2.534) in males, and 25(OH)D-deficient women had a 2.02-fold higher risk for hypoalphalipoproteinaemia/HDL than women with sufficient 25(OH)D levels (95% CI, 1.044-3.904; all p values <0.05). Vitamin D deficiency was positively associated with the prevalence of dyslipidaemia and abnormal AIP in the middle-aged and elderly Chinese population. And this association was stronger in men than in women.

To decrease body weight and insulin resistance, a calorie-restricted diet—with minimal caloric intake required for daily activities—is the primary treatment strategy for patients with type 2 diabetes (T2D) in Japan. However, many patients cannot continue with this diet for long, because calorie restriction is difficult and nutritional balance is hard to understand. Carbohydrate-restricted diets are easier for patients than conventional calorie-restricted diet. In this study we aimed to elucidate the effects of a moderate carbohydrate-restricted diet on glucose metabolism and renal function in patients with T2D on dipeptidyl peptidase-4 (DPP-4) inhibitors. Nineteen outpatients with T2D continued on a moderate carbohydrate-restricted diet (targeting 50% of calories) for 6 mo. Meanwhile, 10 other outpatients with T2D on DPP-4 inhibitors had the conventional calorie-restricted diet using the food exchange table. No change in prescription drugs occurred for both groups during the study period. After the intervention, the carbohydrate content in dietary intake was lowered significantly from 56.8±8.3 to 46.8±10.1%, while the lipid concentration, primarily n-6 polyunsaturated fatty acids, was significantly increased. There was no significant change in protein intake. Hemoglobin A1c (HbA1c) fell from 7.22±0.74% to 6.95±0.72% (mean±SD). Furthermore, salt intake decreased significantly from 6.8±2.5 g prior to the intervention, to 5.7±1.9 g after the intervention. The estimated glomerular filtration rates (eGFR) decreased slightly, while serum creatinine levels did not change. These findings suggest that a moderate carbohydrate-restricted diet (50%) is effective in patients with T2D, without affecting kidney function.

Few follow-up surveys have been conducted with regard to the changes in diet of mothers of children with food allergy. We examined changes in food and BMI over time in the mothers of children with food allergies. A total of 146 mothers completed a diet survey twice, with the first conducted in 2013-2016 and the second in 2018, and the dietary changes were examined. Furthermore, among the 120 mothers who eliminated eggs from their diet in the first survey, 98 continued to eliminate eggs and 22 reintroduced eggs during the second survey, and the change over time was examined. Additionally, factors related to BMI were analyzed. We observed a change in the amount of egg intake over time within each group. As the number of children who consumed eggs as the causative food declined, the amount of eggs consumed by the concerned mothers significantly increased (median: 7.8 g/1,000 kcal→12.7 g/1,000 kcal) (p<0.01), even in children who continued to not consume eggs. We found a negative correlation between BMI in mothers of children with FA and vegetable protein. The mothers indicated that their awareness on food allergy improved, which we believe led to increased consumption of foods that had been restricted thus far. BMI was believed to be related to synchronization with the elimination-substitution diet.

The present guidelines for sports nutrition recommend relatively higher doses of carbohydrates (CHO) for endurance exercise. There is a need for novel food products that are solid but easy to swallow and supply a large dose of CHO without gastrointestinal distress (ingesting a large amount of sugar solution may cause gastrointestinal distress because of its high osmolality). We prepared a modified rice cake (SPRC, sweet potato rice cake) and assessed its properties in swallowing and mastication; we also assessed the availability of this modified rice cake as a CHO source during endurance exercise. The number of chewing strokes with the SPRC tended to be lower compared to glutinous rice cakes. The exercise protocol consisted of 1 h at 80% VO_2max plus a continuous time trial. The subjects were administered a commercially available jelly drink (CHO gel) or SPRC at 0 and 30 min during exercise and immediately after completing the time trial. Heart rate, oxygen consumption, blood glucose elevation, and the rate of perceived exertion did not differ among the trials during exercise. However, the visual analog scale rating revealed that SPRC significantly suppressed hunger and sweetness ratings (p<0.05) and tended to suppress thirst ratings (p<0.10) during exercise. The palatability rating did not differ between the SPRC and CHO gel during exercise at 80% VO_2max and immediately after the time trial. In conclusion, pre- and during exercise ingestion of the SPRC suppressed sweetness, thirst, and hungry ratings without interfering with exercise performance.

The acute metabolic effect of low dosages of L-carnitine under fat-mobilizing conditions was investigated. Healthy subjects (Study 1: n=5; Study 2: n=6) were asked to fast overnight. Then, 30 min of aerobic exercise on a cycle ergometer was performed after supplementation, followed by a 3.5-h sedentary recovery phase. The following ingestion patterns were used: Study 1 (i) noningestion, (ii) 750 mg of L-carnitine (LC), and (iii) 750 mg of LC+50 g of carbohydrate (CHO); Study 2 (iv) noningestion, (v) 500 mg of LC, (vi) 30 mg of CoQ₁₀, and (vii) 500 mg of LC+30 mg of CoQ₁₀. The energy expenditure (EE) and nonprotein respiratory quotient (npRQ) were measured during the pre-exercise, postexercise, and recovery periods. Serum free carnitine, acetylcarnitine, total carnitine (Study 1 and 2), and ketone bodies (Study 2) were measured. The 750 mg LC treatment significantly facilitated fat oxidation during the recovery phases (p<0.05) without elevating EE. The higher fat oxidation associated with LC was completely suppressed by CHO. CoQ₁₀ affected neither npRQ nor EE. npRQ was significantly correlated with the serum total ketone bodies (R=−0.68, p<0.001) and acetylcarnitine (R=−0.61-−0.70, p<0.001). The highest correlation was found between acetylcarnitine and total ketone bodies immediately after exercise (R=0.85, p<0.001). In conclusion, LC enhanced liver fat utilization and ketogenesis in an acute manner without stimulating EE under fat-mobilizing conditions.

The main purpose of this study was to investigate the influence of pre-exercise glucose ingestion after a 2.5-h fast on the endurance capacity and blood glucose response in East Asian athletes who is expected to have genetically low insulin response. A total of 8 Japanese student athletes ingested 1.5 g/kg body mass of glucose (G trial) or 0.5 g/kg body mass of artificial sweetener dissolved in water (P trial) 30 min before exercise test after consuming a standardized breakfast. The exercise test comprised 40 min cycling exercise at 50% maximal oxygen uptake (VO_2max), immediately followed by cycling to exhaustion at 70% VO_2max. Before analyzing the data, we grouped the subjects into two groups depending on whether they showed rapid increase in blood glucose at the onset of exercise (increase rate in LOW group is <20% and HIGH group is ≥20%) to evaluate subject’s insulin response to glucose feeding. No subjects developed rebound hypoglycemia (<70 mg/dL) in the G trial of both group. Significantly higher blood glucose during exercise was recognized only in the G trial of LOW group. Although no significant difference was observed between the two trials of both group, cycling time to exhaustion in the LOW group tended to increase because of glucose ingestion. These results suggest that pre-exercise ingestion of glucose in East Asian student athletes does not induce rebound hypoglycemia regardless of difference in individual insulin responses. Furthermore, individuals with low insulin responses seem to improve endurance performance with glucose ingestion before exercise.

Calcium intake during a growth spurt may influence bone mineral acquisition. However, no population-based cohort studies have examined the relationship between calcium intake and whole-body bone mineral acquisition in Japanese children. The present study investigated the relationship between calcium intake and whole-body bone mineral acquisition in community-dwelling children in a northeast region of Japan using dual-energy X-ray absorptiometry. The source population for the baseline survey comprised all school children in 4th through 6th grades (275 children; age range, 10-12 y) in the Shiokawa area of Kitakata City, Fukushima. We obtained complete information from 220 children (100 girls and 120 boys), and analyzed total body less head (TBLH) bone mineral content (BMC), TBLH areal bone mineral density (aBMD), and bone mineral apparent density (BMAD) as an estimate of volumetric bone density. The Food Frequency Questionnaire for the Prevention and Management of Osteoporosis was validated in a previous study and used to estimate dietary nutrient intake. At baseline, mean calcium intake was 641 mg/d in girls and 660 mg/d in boys. Calcium intake in boys showed a significant (p<0.05) relationship with TBLH BMC and TBLH aBMD at follow-up, and with changes in TBLH BMC, TBLH aBMD, and TB BMAD from baseline to follow-up. After adjusting for potential confounding factors including body weight, we found no significant relationships between calcium intake and bone mineral parameters. Further studies are needed to clarify whether calcium intake affects bone mineral acquisition during pubertal growth spurts in the Japanese population.

A maternal low-protein diet increases the susceptibility of offspring to type 2 diabetes by inducing alterations in β cell mass and function. However, the mechanism of this pancreas injury remains poorly understood. The present study aimed to assess whether autophagy is altered in the pancreas of intrauterine growth restriction (IUGR). In addition, the autophagy associated mammalian target of rapamycin complex 1 (mTORC1) signaling and endoplasmic reticulum (ER) stress were further evaluated in the pancreas. The maternal protein restriction IUGR rat model was established as the IUGR group, and assessed alongside normal newborn rats (CON group). Then, the levels of autophagy markers were assessed by transmission electron microscopy, immunofluorescence, quantitative real-time PCR (qRT-PCR) and Western blot, respectively. In addition, mTORC1 signaling effectors were evaluated by Western blot; ER stress was quantitated by immunohistochemistry, qRT-PCR and Western blotting. Compared with the control group, the IUGR group showed increased levels of the autophagy markers LC3II and Beclin1, with decreased mTORC1 signaling activity. In addition, ER stress was confirmed in β cells of the IUGR group. These findings provided evidence that maternal protein restriction enhances autophagy in newborn pancreas, where ER stress was also induced in β cells, which might effect the pancreas development.

The aim of this study is to investigate the mechanism of anti-obesity effects of Aloe vera gel extract (AVGE) containing Aloe sterols. Previously, we reported that oral intake of Aloe vera components has an anti-diabetic and anti-obesity effect. This study was designed to assess the role of brown adipose tissue (BAT) in the anti-obesity effect of AVGE. Six-week-old male mice were divided into three groups; STD (standard diet), HFD (60% high fat diet) and AVGE (60% high fat diet with AVGE treatment). During 11 wk of AVGE administration, body weight has been monitored. Tissue samples were obtained to be measured the weight and evaluated the gene expressions. Mice treated with AVGE had suppressed body weight, and liver and fat weight gain. To investigate BAT activation, we measured the expression of mRNA related to BAT thermogenesis. Mice in the AVGE group had higher expression of Ucp1, Adrb3, and Cidea in BAT compared to HFD. Next, to investigate the possibility that AVGE induced hepatic FGF21, which is an important factor for nutrient and energy homeostasis including BAT regulation, in vitro study was conducted. HepG2 cell stimulated by AVGE were highly expressed FGF21. These results suggested that BAT activation partially contributes to mechanism of anti-obesity effect of Aloe sterols in diet-induced obesity (DIO) models. However, further study is needed to determine the predominant mechanism.

In Japan, Kombu (Laminaria japonica), which is a type of seaweed, is considered to be a foodstuff with health-promoting benefits, and Japanese people actively incorporate Kombu into their diets. Previously, we reported that the frequent intake of Kombu reduced the serum triglyceride levels of subjects with abnormally high serum triglyceride levels. In the current human study, we performed metabolomic analysis of serum lipids, and then the molecular species profiles of phosphatidylcholines (PC), phosphatidylethanolamines (PE), lysophosphatidylcholines (LPC), lysophosphatidylethanolamines (LPE), and free fatty acids (FFA) were evaluated. As a result, it was found that there were no marked differences between the lipid profiles obtained before and after the intake of Kombu for 4 wk in all subjects. In the subjects with abnormal serum triglyceride levels, the intake of Kombu improved the subjects’ molecular species profiles in terms of their serum levels of the diacyl and acyl forms of PC, PE, LPC, and LPE, and FFA. Furthermore, the intake of Kombu also tended to increase the serum levels of both the plasmanyl and plasmenyl forms of PC and PE in these subjects. The lipid alterations observed in our study might be related to the functionality of Kombu. Furthermore, it is important to evaluate the quality of lipids as well as the quantity of lipids in various types of research, including food functionality studies.

Obesity is one of the main causes of non-alcoholic steatohepatitis (NASH), which is associated with impaired liver functions including drug metabolism. Coleus forskohlii extract (CFE) is a popular ingredient of weight loss dietary supplements in Japan. In this study, we examined the effect of CFE on the treatment of NASH. C57BL/6 mice (male, 10-wk-old) were fed a NASH diet (high-fat, low-methionine, and choline-deficient diet) for 12 wk to establish NASH. Then, we examined the effect of 0.5% (w/w) CFE in diet during diet-treatment (change to control diet) and/or treadmill-exercise (45 min at 20 m/min, 5 d/wk) to improve NASH for 3 wk. After experimental period, lipids profiles and liver functional markers in the blood, and hepatic lipid content and major CYP subtype mRNA expression and activity in liver were measured. Diet-treatment, but not exercise decreased liver weight and hepatic lipid contents in NASH induced mice. CFE attenuated the effects of diet-treatment which reduced liver weight, even though body weight and adipose tissue weight were reduced. Further, CFE significantly increased liver microsomal CYP1A1, CYP1A2, CYP2C, and CYP3A activities in each condition, and CYP inductions were greater in diet-treatment group compared to those in exercise group. These results suggest that taking CFE should be avoided during diet-treatment of NASH, especially in patients under medication.

In the present study, we examined the effect of high fructose-induced metabolic syndrome (MetS) on tissue vitamin E and lipid peroxide (LPO) levels in rats. Feeding of a diet containing 60% fructose (HFD) to Wistar rats for 2, 4, and 6 wk caused week-dependent increases in HOMA-IR score and serum insulin, triglyceride, total cholesterol, and free fatty acid concentrations. Each week HFD feeding increased serum vitamin E concentration. Six-week HFD feeding reduced vitamin E status (the serum ratio of vitamin E/triglyceride+total cholesterol). Four- and 6-wk HFD feeding increased serum LPO concentration. Two-week HFD feeding increased liver, heart, kidney, and skeletal muscle (SM) vitamin E contents and decreased white adipose tissue (WAT) vitamin E content. Four- and 6-wk HFD feeding further reduced WAT vitamin E content without affecting the increased kidney and SM vitamin E contents. Six-week HFD feeding reduced the increased liver and heart vitamin E contents below the level of non-HFD feeding. Four-week HFD feeding increased heart and WAT LPO contents. Six-week HFD feeding increased liver LPO content and further increased heart and WAT LPO contents. Kidney and SM LPO contents remained unchanged. These results indicate that HFD-rats with early MetS have increased liver, kidney, heart, and SM vitamin E contents and decreased WAT vitamin E content under unchanged tissue LPO content and vitamin E status, while HFD-fed rats with progressed MetS have both decreased liver, heart, and WAT vitamin E contents under increased tissue LPO content and disrupted vitamin E status.

β-Carotene (BC) is a natural lipophilic carotenoid mainly present in vegetables and fruits. Although it has various beneficial pharmacological activities, its bioavailability is low owing to its low water solubility. Recently, we reported that BC solid dispersion prepared using hot-melt technology with polyvinylpyrrolidone and sucrose fatty acid esters was in an amorphous state and showed the highest solubility. We hypothesized that the absorption of BC solid dispersion would be better because of its increased water solubility. To verify this, we conducted a pharmacokinetic analysis of BC for application in functional foods. Crystalline or amorphous BC was orally administered to rats. Blood was collected at various time points, and the BC concentration in the plasma was measured by HPLC. Oral administration of amorphous BC showed increased absorption in rats compared with that of BC crystals. Using blood samples from rats that were intravenously injected with the plasma of rats that had been orally administered BC, pharmacokinetic parameters could be calculated without using organic solvents or surfactants. It was possible to calculate various pharmacokinetic parameters under physiological conditions according to amorphous BC characteristics. Thus, we were able to determine the bioavailability of BC after oral administration. This simple technology to improve BC solubility without the use of organic solvents can be applied not only in the pharmaceutical industry but also in the food industry, and it therefore has high utility value.