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  1. Ahmed IA, Mikail MA
    Nutrition, 2024 Mar;119:112350.
    PMID: 38232577 DOI: 10.1016/j.nut.2023.112350
    The skin protects humans from pathogens, ultraviolet light, chemicals, mechanical, thermal, and physical injuries as well as hazardous substances. Other important roles of the skin include the regulation of several important physiological processes of the body, sensing stimuli, synthesis of vitamin D, and immune surveillance. However, aging, diseases and environmental conditions significantly change the skin's behavior and functioning. The treatment and prevention strategies for various skin diseases especially photoaging usually include topical treatment with medical cosmetology, active ingredients and other physical means of photoprotection. In recent times, however, there is an increasing consciousness about the role of diet and nutrition in skin health with certain dietary components emerging as an adequate alternative approach to alleviate and prevent both endogenous and exogenous aging symptoms. Therefore, this narrative review uniquely discusses the basic structure of the skin and also addresses common dermatological signs of damaged skin, the impacts of unhealthy diet habits on the skin, and the beneficial effects of some healthy diet habits on skin health. The information and data were collated from various literature databases and resources such as Science Direct, PubMed, Wiley, Springer, Taylor and Francis, Inflibnet, Scopus, Google, and Google Scholar using relevant keywords Medical Subject Headings (MeSH). In conclusion, diet and nutrition play essential roles in the optimum functioning of the human body, including the skin. Thus, certain diet habits such as less water intake, high-fat diet, refined sugar, and certain food additives are unhealthy and harmful to the skin while alternative healthy diet habits such as adequate water intake; consumption of antioxidants and polyphenolic-rich fruits, vegetables, nuts, and legumes; a low glycemic index diet; probiotics; and phytoestrogens should be adopted to enhance skin health.
  2. Ali O
    Nutrition, 1995 Sep-Oct;11(5 Suppl):517-20.
    PMID: 8748212
    Iodine as a trace element is an essential nutrient for human growth and development. Its potential impact on manpower development in third world countries are of special concern, primarily due to iodine deficiency disorders (IDD) such as goiter, hypothyroidism, and cretinism. IDD of mild to moderate severity are still found in Malaysia. The prevalence ranges from almost zero in many developed urban areas to more than 90% in some rural parts of Malaysia, especially in Sabah and Sarawak. The endemias were associated with low urinary excretion of iodine among the population, indicating poor iodine intake and low iodine content in the environment. Water and salt iodination strategies are being planned to eradicate the disease by the year 2000.
  3. Bakhsh A, Mustapha NM, Mohamed S
    Nutrition, 2013 Apr;29(4):667-72.
    PMID: 23290096 DOI: 10.1016/j.nut.2012.09.005
    Postmenopausal estrogen deficiency often causes bone density loss and osteoporosis. This study evaluated the effects of an oral administration of oil palm leaf extract (OPL) on bone calcium content and structure, bone density, ash weights, and serum total alkaline phosphatase (T-ALP) of estrogen-deficient ovariectomized (OVX) rats.
  4. Cheng HS, Yaw HP, Ton SH, Choy SM, Kong JM, Abdul Kadir K
    Nutrition, 2016 Sep;32(9):995-1001.
    PMID: 27130470 DOI: 10.1016/j.nut.2016.02.002
    OBJECTIVE: To investigate the effects of glycyrrhizic acid supplementation on glucose and lipid metabolism in rodents consuming a high-fat, high-sucrose diet.

    METHODS: Twenty-four male, 8-week old Sprague Dawley rats with an initial weight of 160 to 200 g were randomised into three groups (n = 6 for each group): groups A (standard rat chow), B (high-fat, high-sucrose diet), and C (high-fat, high-sucrose diet + 100 mg/kg/d of glycyrrhizic acid via oral administration). The rats were treated accordingly for 4 wk. Glycaemic parameters, lipid profile, stress hormones, and adiponectin levels were measured after the treatment. Relative gene expressions of peroxisome proliferator-activated receptor α and γ, lipoprotein lipase as well as gluconeogenic enzymatic activities in different tissues were also determined.

    RESULTS: Consumption of high-fat, high-sucrose diet triggered hyperglycaemia, insulin resistance, and dyslipidemia, which were effectively attenuated by supplementation with glycyrrhizic acid. Glycyrrhizic acid supplementation also effectively reduced circulating adrenaline, alleviated gluconeogenic enzymes overactivity, and promoted the upregulation of lipoprotein lipase expression in the cardiomyocytes and skeletal muscles. A high calorie diet also triggered hypoadiponectinaemia and suppression of peroxisome proliferator-activated receptor γ expression, which did not improve with glycyrrhizic acid treatment.

    CONCLUSION: Supplementation with glycyrrhizic acid could alleviate high calorie diet-induced glucose and lipid metabolic dysregulations by reducing circulatory stress hormones, normalizing gluconeogenic enzyme activities, and elevating muscular lipid uptake. The beneficial effects of these bioactivities outweighed the adverse effects caused by diet-induced repression of peroxisome proliferator-activated receptor γ expression, resulting in the maintenance of lipid and glucose homeostasis.

  5. Cheng HS, Goh BH, Phang SCW, Amanullah MM, Ton SH, Palanisamy UD, et al.
    Nutrition, 2020 08 12;79-80:110973.
    PMID: 32916379 DOI: 10.1016/j.nut.2020.110973
    OBJECTIVES: Metabolic syndrome (MetS), a multiplex risk factor for cardiovascular disease and type 2 diabetes, is increasingly prevalent worldwide. Ellagitannin geraniin, a polyphenol found in the rind of rambutan (Nephelium lappaceum), has demonstrated therapeutic effects against metabolism dysfunction. The aim of this study was to characterize the metabolic effects and possible mechanism of geraniin in rats with MetS induced by a high-fat diet (HFD).

    METHODS: MetS was induced in Sprague Dawley rats on an HFD, followed by a daily oral gavage of geraniin (25 mg/kg) for 4 wk. The outcomes of geraniin-treated rats were compared with those of untreated rats on either a control diet or an HFD and with rats with MetS treated with metformin on a daily basis (200 mg/kg).

    RESULTS: The supplementation of geraniin ameliorated multiple metabolic abnormalities caused by HFD, including hypertension, impaired glucose and lipid metabolism, ectopic fat deposition in the visceral fat and liver, and disturbed antioxidant mechanism and inflammatory response. The benefits conferred by geraniin were comparable to metformin. Transcriptomic analysis revealed a profound influence of geraniin on the hepatic expression profiles. The lipid and steroid metabolic processes that were aberrantly activated by HFD were suppressed by geraniin. Based on the differential transcriptomes, geraniin also exerted a significant modulatory effect on the expression of mitochondrial genes, potentially influencing the mitochondrial activity and leading to the observed beneficial effects.

    CONCLUSION: Geraniin supplementation mitigated metabolic anomalies of MetS in rats, making it an attractive drug candidate for further investigation.

  6. Chin SF, Hamid NA, Latiff AA, Zakaria Z, Mazlan M, Yusof YA, et al.
    Nutrition, 2008 Jan;24(1):1-10.
    PMID: 17884341
    The free radical theory of aging (FRTA) suggests that free radicals are the leading cause of deteriorating physiologic function during senescence. Free radicals attack cellular structures or molecules such as DNA resulting in various modifications to the DNA structures. Accumulation of unrepaired DNA contributes to a variety of disorders associated with the aging process.
  7. Firouzi S, Haghighatdoost F
    Nutrition, 2018 02 06;51-52:104-113.
    PMID: 29626749 DOI: 10.1016/j.nut.2018.01.007
    OBJECTIVES: Recent studies have demonstrated promising results regarding possible improvements in renal function after prebiotic, probiotic, and synbiotic supplementation. The aim of this review was to demonstrate whether such supplementation will improve renal profile indexes including glomerular filtration rate (GFR), creatinine, blood urea nitrogen (BUN), uric acid (UA), and urea.

    METHOD: The meta-analysis included all studies that examined the effect of prebiotic, probiotic, and synbiotic supplements on one or more renal function parameters and had a control group. We searched July 1967 through to March 2016 MEDLINE, Scopus, and Google Scholar databases.

    RESULTS: Of 437 studies, 13 were eligible for inclusion in the meta-analysis. GFR levels tended to be reduced; whereas creatinine levels increased in the intervention group compared with the placebo group, both in a non-significant manner. The pooled effect on BUN demonstrated a significant decline compared with the placebo group (MD, -1.72 mmol/L; 95% confidence interval [CI], -2.93 to -0.51; P = 0.005). Urea significantly decreased after intervention (-0.46 mmol/L; 95% CI, -0.60 to -0.32; P <0.0001). The UA levels significantly increased in the intervention group compared with the placebo group (12.28 µmol/L; 95% CI, 0.85-23.71; P = 0.035).

    CONCLUSION: This study showed a significant increase in UA and a decrease in urea and BUN. The use of prebiotic, probiotic, and synbiotic supplements among those with compromised renal function or those at risk for renal failure should be limited until large-scale, well-designed randomized controlled trials prove the safety and efficacy of these supplements in improving renal function.

  8. Ho CY, Majid HA, Jamhuri N, Ahmad AF, Selvarajoo TA
    Nutrition, 2022 06 01;103-104:111758.
    PMID: 35843037 DOI: 10.1016/j.nut.2022.111758
    BACKGROUND: High stoma output is a significant complication after bowel surgery that causes dehydration, resulting in acute kidney injury, electrolyte imbalances, unintentional weight loss, and malnutrition. This study evaluates the postoperative ileostomy output among patients with colorectal cancer after being supplemented with partially hydrolyzed guar gum.

    METHODS: This cross-sectional study collected sociodemographic and clinical characteristics, stoma output, and dietary intake upon discharge, hospitalization, and readmission within 30 d of discharge.

    RESULTS: A total of 29 participants were recruited, with 72.4% having moderate malnutrition risk. Patients who received partially hydrolyzed guar gum (PHGG) fiber reported lower stoma output with firmer output consistency than patients who received standard care (SC) (P < 0.05 and P < 0.01). Patients who received PHGG achieved higher energy, protein, and soluble fiber intake than did the SC group (P < 0.01) upon discharge. There was a significant inverse association between soluble fiber (PHGG fiber + dietary soluble fiber) intake and ileostomy output (r, -0.494; P = 0.006).

    CONCLUSIONS: Partially hydrolyzed guar gum fiber acts as an agent to hold water, reduce the speed of gastrointestinal tract transit, increase effluent viscosity, and potentially decrease water losses. Supplementation with PHGG fiber appeared to minimize ileostomy output and improve clinical outcomes among postoperative ileostomy patients. This needs to be evaluated further with a randomized controlled trial to confirm this preliminary finding.

  9. Katoch OR
    Nutrition, 2021 Dec 11;96:111565.
    PMID: 35066367 DOI: 10.1016/j.nut.2021.111565
    OBJECTIVES: Child undernutrition is a major public health problem. Globally in 2020, 149 million children <5 y of age were estimated to be stunted (too short for age), 45 million to be wasted (too thin for height), and 38.9 million were overweight. The aim of this review was to examine previous studies to determine the factors associated with malnutrition and contribute to the existing body of evidence needed for the formulation of effective interventions.

    METHODS: This systematic review was conducted using the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The Google Scholar database was used to search the studies conducted between 2012 and 2021. The included studies were searched by using some combinations of keywords and saved in Mendeley Desktop for review and referencing.

    RESULTS: Of 2150 articles retrieved from the Google Scholar databases, 37 met our inclusion criteria. Of the 37 studies reviewed; 13 were conducted in India, 5 in Ethiopia, 3 in Bangladesh, 2 in Ghana, 2 in Nepal, 2 in developing countries, and 1 each in Bolira, Benin, Netherland, Columbia, Pakistan, Malaysia, Africa, Egypt, Ecuadorian, and Indonesia.

    CONCLUSION: The most consistent factors associated with child malnutrition were maternal education, household income, maternal nutritional status, age of the child, availability of sanitation facility at home, size of family, birth order in the family, and child's birth weight. Breastfeeding and caring practices, cooking area and the fuel used, sex, and socioeconomic status of the children also contribute toward child malnutrition.

  10. Khan MNA, Yunus RM
    Nutrition, 2023 Apr;108:111947.
    PMID: 36641887 DOI: 10.1016/j.nut.2022.111947
    BACKGROUND: The proper intake of nutrients is essential to the growth and maturation of youngsters. In sub-Saharan Africa, 1 in 7 children dies before age 5 y, and more than a third of these deaths are attributed to malnutrition. The main purpose of this study was to develop a majority voting-based hybrid ensemble (MVBHE) learning model to accelerate the prediction accuracy of malnutrition data of under-five children in sub-Saharan Africa.

    METHODS: This study used available under-five nutritional secondary data from the Demographic and Health Surveys performed in sub-Saharan African countries. The research used bagging, boosting, and voting algorithms, such as random forest, decision tree, eXtreme Gradient Boosting, and k-nearest neighbors machine learning methods, to generate the MVBHE model.

    RESULTS: We evaluated the model performances in contrast to each other using different measures, including accuracy, precision, recall, and the F1 score. The results of the experiment showed that the MVBHE model (96%) was better at predicting malnutrition than the random forest (81%), decision tree (60%), eXtreme Gradient Boosting (79%), and k-nearest neighbors (74%).

    CONCLUSIONS: The random forest algorithm demonstrated the highest prediction accuracy (81%) compared with the decision tree, eXtreme Gradient Boosting, and k-nearest neighbors algorithms. The accuracy was then enhanced to 96% using the MVBHE model. The MVBHE model is recommended by the present study as the best way to predict malnutrition in under-five children.

  11. Khor BH, Sahathevan S, Sualeheen A, Ali MSM, Narayanan SS, Chinna K, et al.
    Nutrition, 2019 01 15;63-64:14-21.
    PMID: 30927642 DOI: 10.1016/j.nut.2019.01.005
    OBJECTIVES: The aims of this study were threefold: first, to assess the dietary fatty acid (FA) intake and blood FA status in Malaysian patients on hemodialysis (HD); second, to examine the association between dietary FA intakes and blood FA profiles in patients on HD; and third, to determine whether blood FAs could serve as a biomarker of dietary fat intake quality in these patients.

    METHODS: Using 3 d of dietary records, FA intakes of 333 recruited patients were calculated using a food database built from laboratory analyses of commonly consumed Malaysian foods. Plasma triacylglycerol (TG) and erythrocyte FAs were determined by gas chromatography.

    RESULTS: High dietary saturated fatty acid (SFA) and monounsaturated fatty acid (MUFA) consumption trends were observed. Patients on HD also reported low dietary ω-3 and ω-6 polyunsaturated fatty acid (PUFA) consumptions and low levels of TG and erythrocyte FAs. TG and dietary FAs were significantly associated respective to total PUFA, total ω-6 PUFA, 18:2 ω-6, total ω-3 PUFA, 18:3 ω-3, 22:6 ω-3, and trans 18:2 isomers (P < 0.05). Contrarily, only dietary total ω-3 PUFA and 22:6 ω-3 were significantly associated with erythrocyte FAs (P < 0.01). The highest tertile of fish and shellfish consumption reflected a significantly higher proportion of TG 22:6 ω-3. Dietary SFAs were directly associated with TG and erythrocyte MUFA, whereas dietary PUFAs were not.

    CONCLUSION: TG and erythrocyte FAs serve as biomarkers of dietary PUFA intake in patients on HD. Elevation of circulating MUFA may be attributed to inadequate intake of PUFAs.

  12. Lee ZY, Ibrahim NA, Mohd-Yusof BN
    Nutrition, 2018 09;53:26-33.
    PMID: 29627715 DOI: 10.1016/j.nut.2017.11.014
    OBJECTIVES: Intensive care unit (ICU) enteral nutrition (EN) can involve frequent feeding interruption (FI). The prevalence, causes, and duration of such interruption were investigated.

    METHODS: Reasons for EN FI identified from extensive literature review were prospectively collected in adult mechanically ventilated critically ill patients. Results were reported by descriptive statistics. Baseline and nutritional characteristics between patients who died and those alive at day 60 were compared.

    RESULTS: A total of 148 patients receiving ≥1 day of EN for the full 12-day observational period were included in the analysis. About 332 episodes of EN FI were recorded and contributed to 12.8% (4190 hours) of the total 1367 evaluable nutrition days. For each patient, FI occurred for a median of 3 days and the total duration of FI for the entire ICU stay was 24.5 hours. Median energy and protein deficits per patient due to FI for the entire ICU stay were -1780.23 kcal and -100.58 g, respectively. Duration of FI, days with FI, and the amount of energy and protein deficits due to FI were not different between patients who had died and those who were still alive at day 60 (all P > 0.05). About 72% of the total duration of EN FI was due to procedural-related and potentially avoidable causes (primarily human factors), while only about 20% was due to feeding intolerances.

    CONCLUSIONS: EN FI occurred primarily due to human factors, which may be minimized by adherence to an evidence-based feeding protocol as determined by a nutrition support team.

  13. Logarajan RD, Nor NM, Ibrahim S, Said R
    Nutrition, 2023 Jul;111:112030.
    PMID: 37172456 DOI: 10.1016/j.nut.2023.112030
    OBJECTIVE: This study aims to assess social determinants of stunting among children aged <5 y within the Malay ethnicity in Malaysia.

    METHODS: This study used data from the National Health and Morbidity Survey 2016: Maternal and Child Health. It includes a sample of 10 686 children, ages 0 to 59 mo, of Malay ethnicity. Height-for-age z score was determined based on the World Health Organization Anthro software. A binary logistic regression model was used to examine the association between the selected social determinants and the occurrence of stunting.

    RESULTS: About 22.5% of children aged <5 y of Malay ethnicity were stunted. For those ages 0 to 23 mo, stunting is more prevalent in boys, in rural areas, and in those who have screen exposure, whereas a reduction of stunting was observed for those children whose mothers work in the private sector and in those who consume formula milk and meat. As for those ages 24 to 59 mo, there was a higher prevalence of stunting for those with self-employed mothers and reduced prevalence in children with hygienic waste disposal practices as well as those who play with toys.

    CONCLUSIONS: The prevalence of stunting among children of Malay ethnicity aged <5 in Malaysia necessitates immediate intervention. It is pertinent to facilitate early identification of those children at risk of stunting for additional care to promote healthy growth.

  14. Menon KC, Ferguson EL, Thomson CD, Gray AR, Zodpey S, Saraf A, et al.
    Nutrition, 2014 Mar;30(3):291-6.
    PMID: 24484679 DOI: 10.1016/j.nut.2013.08.015
    The aim of this study was to investigate the iron status of pregnant tribal women from Ramtek, Nagpur, Maharashtra, India using a combination of indices.
  15. Nadhiroh SR, Micheala F, Tung SEH, Kustiawan TC
    Nutrition, 2023 Nov;115:112094.
    PMID: 37572547 DOI: 10.1016/j.nut.2023.112094
    OBJECTIVES: Maternal anemia is a worldwide health issue and a common pregnancy complication. It leads to consequences including infant mortality, low birth weight, preterm birth, unrecoverable or partially reversible neurobehavioral and cognitive deficits, and short birth length. However, the relationship between maternal anemia and stunting in children is not well defined. This systematic literature review sought to determine whether maternal anemia was associated with height or length and stunting conditions in infants and children ages 0-60 mo in cohort, case-control, and cross-sectional studies carried out in several countries.

    METHODS: A systematic review was performed on articles published from 2014-2021 related to maternal anemia and stunting. The electronic databases used were ScienceDirect, PubMed, Scopus, ProQuest, Google Search, and AJOG (American Journal of Obstetrics and Gynecology). The literature search was performed up to December 7, 2021.

    RESULTS: Twelve studies were included. Nine studies examined the correlation between maternal anemia and length or weight in children. Seven of the nine studies showed an association between maternal anemia and stunting in children; the others showed an association between maternal anemia and birth length. Three studies found no association between maternal anemia and stunting in children under age 5 y.

    CONCLUSIONS: The current review emphasizes that stunting in children may be associated with maternal anemia, specifically in developing countries. This implies that it is crucial to prevent anemia in adolescent girls and women before and during pregnancy as a part of programs to eliminate stunting in children.

  16. Rahmat A, Ngah WZ, Shamaan NA, Gapor A, Abdul Kadir K
    Nutrition, 1993 May-Jun;9(3):229-32.
    PMID: 8102564
    The effects of long-term administration of tocotrienol on hepatocarcinogenesis in rats induced by diethylnitrosamine (DEN) and 2-acetylaminofluorene (AAF) were investigated by determining the activities of gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), glutathione S-transferases (GSTs), and glutathione (GSH) levels in blood and liver. Twenty-eight male 7- to 8-wk-old Rattus norwegicus rats, weighing 120-160 g, were used in this study. The rats were divided into four treatment groups: a control group on a basal diet, a group fed a basal diet supplemented with tocotrienol (30 mg/kg food), a group treated with DEN/AAF, and a group treated with DEN/AAF and fed a diet supplemented with tocotrienol (30 mg/kg food). Blood was collected monthly, and GGT, ALP, and GSH levels were determined. The rats were killed after 9 mo, and the livers were examined morphologically. Grayish white nodules (2/liver) were found in all the DEN/AAF-treated rats (n = 10), but only one of the rats treated with DEN/AAF and supplemented with tocotrienol (n = 6) had liver nodules. A significant increase in the level of blood and liver GSH, ALP, and GGT activities was observed in the DEN/AAF-treated rats. Liver GSTs were similarly increased with DEN/AAF treatment. Tocotrienol supplementation attenuated the impact of the carcinogens in the rats.
  17. Shalan NA, Mustapha NM, Mohamed S
    Nutrition, 2017 Jan;33:42-51.
    PMID: 27908549 DOI: 10.1016/j.nut.2016.08.006
    OBJECTIVE: Black tea and Nonileaf are among the dietary compounds that can benefit patients with bone resorption disorders. Their bone regeneration effects and their mechanisms were studied in estrogen-deficient rats.

    METHODS: Noni leaves (three doses) and black tea water extracts were fed to ovariectomized rats for 4 mo, and their effects (analyzed via mechanical measurements, micro-computed tomography scan, and reverse transcriptase polymerase chain reaction mRNA) were compared with Remifemin (a commercial phytoestrogen product from black cohosh).

    RESULTS: The water extracts (dose-dependently for noni leaves) increased bone regeneration biomarker (runt-related transcription factor 2, bone morphogenetic protein 2, osteoprotegerin, estrogen receptor 1 [ESR1], collagen type I alpha 1A) expressions and reduced the inflammatory biomarkers (interleukin-6, tumor necrosis factor-α, nuclear factor [NF]-κB, and receptor activator of NF-κB ligand) mRNA expressions/levels in the rats. The extracts also improved bone physical and mechanical properties. The extracts demonstrated bone regeneration through improving bone size and structure, bone mechanical properties (strength and flexibility), and bone mineralization and density.

    CONCLUSIONS: The catechin-rich extract favored bone regeneration and suppressed bone resorption. The mechanisms involved enhancing osteoblast generation and survival, inhibiting osteoclast growth and activities, suppressing inflammation, improving bone collagen synthesis and upregulating ESR1 expression to augment phytoestrogenic effects. Estrogen deficiency bone loss and all extracts studied (best effect from Morinda leaf at 300 mg/kg body weight) mitigated the loss, indicating benefits for the aged and menopausal women.

  18. Shamaan NA, Kadir KA, Rahmat A, Ngah WZ
    Nutrition, 1998 12 3;14(11-12):846-52.
    PMID: 9834927
    The effects of vitamin C and aloe vera gel extract supplementation on induced hepatocarcinogenesis in male Sprague-Dawley rats (120-150 g) by diethylnitrosamine (DEN) and 2-acetylaminofluorene (AAF) was investigated. The severity of the carcinogenesis process was determined by measuring gamma-glutamyl transpeptidase (GGT) and the placental form of glutathione S-transferase (GSTP) histochemically in situ and in plasma and liver fractions. In addition, plasma alkaline phosphatase (ALP) and liver microsomal uridine diphosphate glucuronyl transferase (UDPGT) activity were also determined. Administration of DEN/AAF caused an increase in the surface area and number of enzyme-positive foci (both GGT and GSTP) compared with control. Supplementation of vitamin C or aloe vera gel extract to the cancer-induced rats suppressed this increase significantly (P < 0.05; P < 0.001). Increases in liver UDPGT, GGT, and GSTP activities were also observed with cancer induction that were again suppressed with either vitamin C or aloe vera gel supplementation. Plasma GGT in the DEN/AAF rats were determined monthly for the duration of the experiment and found to be reduced as early as 1 mo with aloe vera gel supplementation and 2 mo with vitamin C supplementation. In conclusion, vitamin C and aloe vera gel extract supplementation were found to be able to reduce the severity of chemical hepatocarcinogenesis.
  19. Tripathi C, Girme A, Champaneri S, Patel RJ, Hingorani L
    Nutrition, 2020 06;74:110729.
    PMID: 32203878 DOI: 10.1016/j.nut.2020.110729
    In today's era of increased standards of lifestyle and life expectancy, there has been a constant demand for supplements by consumers. Nutraceuticals are among the supplements in demand. Although there is a big opportunity for the nutraceutical business, there are no uniform regulatory requirements in different regions. Nations are looking to the nutraceutical sector to help keep their populations healthy and safe by introducing certain rules and regulations. Generally, developed countries have regulations in place, but there are some countries, such as those in the Asia Pacific regions or in Association of Southeast Asian Nations (ASEAN) countries, that have not yet fine-tuned their regulations for nutraceutical products. The ASEAN countries involve highly commercialized markets such as Singapore, Thailand, Malaysia, and the Philippines. The overall nutraceutical market of ASEAN countries is growing at a compound annual growth rate of ∼8.4%. About 40% of the ASEAN population consumes nutraceuticals on a daily basis. ASEAN countries are forming harmonized regulations for dietary supplements. This could be a big opportunity for manufacturers to introduce their products into the ASEAN market. A special unit of the Traditional Medicine and Health Supplements Product Working Group (TMHA PWG) helps manufacturers understand the regulatory procedures of these countries. Despite countries' own special requirements, manufacturers can follow the standards and harmonized guidelines put forth by TMHA PWG. The aim of this review is to introduce the regulatory procedure and requirements for international business developers to launch any new nutraceutical products into the ASEAN market.
  20. Vandenplas Y, Latiff AHA, Fleischer DM, Gutiérrez-Castrellón P, Miqdady MS, Smith PK, et al.
    Nutrition, 2019 01;57:268-274.
    PMID: 30223233 DOI: 10.1016/j.nut.2018.05.018
    OBJECTIVES: Guidance and evidence supporting routine use of partially hydrolyzed formula (pHF) versus intact cows' milk protein (CMP) formula are limited in non-exclusively breastfed infants. The aim of this review was to better clarify issues of routine use of pHF in non-exclusively breastfed infants who are not at risk for allergic disease by using a systematic review and Delphi Panel consensus.

    METHODS: A systematic review and Delphi consensus panel (consisting of eight8 international pediatric allergists and gastroenterologists) was conducted to evaluate evidence supporting growth, tolerability, and effectiveness of pHF in non-exclusively breastfed infants.

    RESULTS: None of the studies reviewed identified potential harm of pHF use compared with CMP in non-exclusively breastfed infants. There was an expert consensus that pHF use is likely as safe as intact CMP formula, given studies suggesting these have comparable nutritional parameters. No high-quality studies were identified evaluating the use of pHF to prevent allergic disease in non-exclusively breastfed infants who are not at risk for allergic disease (e.g., lacking a parental history of allergy). Limited data suggest that pHF use in non-exclusively breastfed infants may be associated with improved gastric emptying, decreased colic incidence, and other common functional gastrointestinal symptoms compared with CMP. However, because the data are of insufficient quality, the findings from these studies have to be taken with caution. No studies were identified that directly compared the different types of pHF, but there was an expert consensus that growth, allergenicity, tolerability, effectiveness, and clinical role among such pHF products may differ.

    CONCLUSIONS: Limited data exist evaluating routine use of pHFs in non-exclusively breastfed infants, with no contraindications identified in the systematic review. An expert consensus considers pHFs for which data were available to be as safe as CMP formula as growth is normal. The preventive effect on allergy of pHF in infants who are not at risk for allergic disease has been poorly studied. Cost of pHF versus starter formula with intact protein differs from country to country. However, further studies in larger populations are needed to clinically confirm the benefits of routine use of pHF in non-exclusively breastfed infants. These studies should also address potential consumer preference bias.

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