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PubMed | Medicine and Surgery, ; NUTRIM School for Nutrition, Grow Inc, Respiratory ; NUTRIM School for Nutrition and 2 more.
Type: Journal Article | Journal: Oncology reviews | Year: 2015

Until a few years ago, adult humans were not thought to have brown adipose tissue (BAT). Now, this is a rapidly evolving field of research with perspectives in metabolic syndromes such as obesity and new therapies targeting its bio-energetic pathways. White, brown and so-called brite adipose fat seem to be able to trans-differentiate into each other, emphasizing the dynamic nature of fat tissue for metabolism. Human and animal data in cancer cachexia to date provide some evidence for BAT activation, but its quantitative impact on energy expenditure and weight loss is controversial. Prospective clinical studies can address the potential role of BAT in cancer cachexia using (18)F-fluoro- deoxyglucose positron emission tomography-computed tomography scanning, with careful consideration of co-factors such as diet, exposure to the cold, physical activity and body mass index, that all seem to act on BAT recruitment and activity.


Oudhuis G.J.,NUTRIM School for Nutrition | Oudhuis G.J.,Erasmus Medical Center | Bergmans D.C.J.J.,Maastricht University | Verbon A.,NUTRIM School for Nutrition | Verbon A.,Erasmus Medical Center
Current Opinion in Critical Care | Year: 2011

PURPOSE OF REVIEW: In this era of increasing antimicrobial resistance, use of probiotics in infection prevention has brought new perspective. However, in 2008 the, until then considered, safe use of probiotics became an important topic after publication of a trial showing excess mortality in patients on probiotic prophylaxis. In this article, we review the concept of infection prevention by probiotics and the present knowledge of the efficacy of probiotics in prevention of infections among patients with abdominal diseases and in intensive care. Safety issues of probiotics will be discussed extensively. RECENT FINDINGS: Over 30 clinical trials with probiotics to prevent infections have been published, some of which were prematurely stopped recently. Studies with critically ill patients and patients with abdominal diseases showed conflicting results regarding the effects of probiotics on infection rates, as did meta-analyses. These studies are difficult to compare because different probiotics were used which all have different efficacy and safety profiles. SUMMARY: The efficacy of probiotics in infection prevention among critically ill patients is still not unequivocally determined. The safety profile differs per probiotic strain and should not be generalized towards other strains and patient populations. A well designed and well powered clinical trial with clear endpoints to demonstrate efficacy is warranted. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Vrolix R.,NUTRIM School for Nutrition | Vrolix R.,Top Institute of Food and Nutrition TIFN | Mensink R.P.,NUTRIM School for Nutrition | Mensink R.P.,Top Institute of Food and Nutrition TIFN
Contemporary Clinical Trials | Year: 2010

Background: Many studies on the health effects of the glycemic index (GI) are confounded by differences in the intakes of other macronutrients and fibre. Little data exist about the within- and between-subject variability of the GI. Objective: Our objectives were therefore (i) to calculate the GI of eight commonly used food products with similar macronutrient and fibre composition, but with different sources of carbohydrates, (ii) to examine the inter- and intra-individual variability of the incremental area under the curve (iAUC) after consuming the reference solution, and (iii) to compare the effect of three different methods on 2-h postprandial blood glucose responses. Design: Four groups of 10 healthy subjects consumed in random order the increased (iGI) and decreased GI (dGI) variants and twice a glucose solution. All products consisted of 25 g available carbohydrates (CHO). For the fruit drink, glucose values were simultaneously analyzed using venous and capillary blood samples, and by using a continuous glucose monitoring system (CGMS). Results: The GIs for increased and decreased variants were (mean ± standard error of the mean (SEM)) 69 ± 15 and 40 ± 4 for bread, 86 ± 14 and 48 ± 8 for a fruit drink, 51 ± 12 and 20 ± 4 for cake, and 63 ± 17 and 37 ± 10 for a cookie. The inter- and intra-individual coefficient of variation (CV) of the iAUCs of the reference solution was large and varied respectively between 13 and 38%, and between 33 and 80%. Conclusions: These data suggest that the GI is difficult to use at the individual level. © 2009 Elsevier Inc. All rights reserved.


Wijnands K.A.P.,Maastricht University | Vink H.,Maastricht University | Vink H.,CARIM Cardiovascular Research Institute of Maastricht | Briede J.J.,Maastricht University | And 5 more authors.
PLoS ONE | Year: 2012

Background: Impaired microcirculation during endotoxemia correlates with a disturbed arginine-nitric oxide (NO) metabolism and is associated with deteriorating organ function. Improving the organ perfusion in endotoxemia, as often seen in patients with severe infection or systemic inflammatory response syndrome (SIRS) is, therefore, an important therapeutic target. We hypothesized that supplementation of the arginine precursor citrulline rather than arginine would specifically increase eNOS-induced intracellular NO production and thereby improve the microcirculation during endotoxemia. Methodology/Principal Findings: To study the effects of L-Citrulline and L-Arginine supplementation on jejunal microcirculation, intracellular arginine availability and NO production in a non-lethal prolonged endotoxemia model in mice. C57/Bl6 mice received an 18 hrs intravenous infusion of endotoxin (LPS, 0.4 μg•g bodyweight-1•h-1), combined with either L-Citrulline (6.25 mg•h-1), L-Arginine (6.25 mg•h-1), or L-Alanine (isonitrogenous control; 12.5 mg•h-1) during the last 6 hrs. The control group received an 18 hrs sterile saline infusion combined with L-Alanine or L-Citrulline during the last 6 hrs. The microcirculation was evaluated at the end of the infusion period using sidestream dark-field imaging of jejunal villi. Plasma and jejunal tissue amino-acid concentrations were measured by HPLC, NO tissue concentrations by electron-spin resonance spectroscopy and NOS protein concentrations using Western blot. Conclusion/Significance: L-Citrulline supplementation during endotoxemia positively influenced the intestinal microvascular perfusion compared to L-Arginine-supplemented and control endotoxemic mice. L-Citrulline supplementation increased plasma and tissue concentrations of arginine and citrulline, and restored intracellular NO production in the intestine. L-Arginine supplementation did not increase the intracellular arginine availability. Jejunal tissues in the L-Citrulline-supplemented group showed, compared to the endotoxemic and L-Arginine-supplemented endotoxemic group, an increase in degree of phosphorylation of eNOS (Ser 1177) and a decrease in iNOS protein level. In conclusion, L-Citrulline supplementation during endotoxemia and not L-Arginine reduced intestinal microcirculatory dysfunction and increased intracellular NO production, likely via increased intracellular citrulline and arginine availability. © 2012 Wijnands et al.


Leenders M.,Top Institute Food and Nutrition | Verdijk L.B.,Top Institute Food and Nutrition | van der Hoeven L.,Top Institute Food and Nutrition | van Kranenburg J.,Top Institute Food and Nutrition | And 4 more authors.
Journal of Nutrition | Year: 2011

The loss of muscle mass with aging has been, at least partly, attributed to a blunted muscle protein synthetic response to food intake. Leucine coingestion has been reported to stimulate postprandial insulin release and augment postprandial muscle protein accretion. We assessed the clinical benefits of 6 mo of leucine supplementation in elderly, type 2 diabetes patients. Sixty elderly males with type 2 diabetes (age, 71 ± 1 y; BMI, 27.3 ± 0.4 kg/m2) were administered 2.5 g L-leucine (n = 30) or a placebo (n = 30) with each main meal during 6 mo of nutritional intervention (7.5 g/d leucine or placebo). Body composition, muscle fiber characteristics, muscle strength, glucose homeostasis, and basal plasma amino acid and lipid concentrations were assessed prior to, during, and after intervention. Lean tissue mass did not change or differ between groups and at 0, 3, and 6 mo were 61.9 ± 1.1, 62.2 ± 1.1, and 62.0 ± 1.0 kg, respectively, in the leucine group and 62.2 ± 1.3, 62.2 ± 1.3, and 62.2 ± 1.3 kg in the placebo group. There also were no changes in body fat percentage, muscle strength, and muscle fiber type characteristics. Blood glycosylated hemoglobin did not change or differ between groups and was 7.1 ± 0.1% in the leucine group and 7.2 ± 0.2% in the placebo group. Consistent with this, oral glucose insulin sensitivity and plasma lipid concentrations did not change or differ between groups. We conclude that prolonged leucine supplementation (7.5 g/d) does not modulate body composition, muscle mass, strength, glycemic control, and/or lipidemia in elderly, type 2 diabetes patients who habitually consume adequate dietary protein. © 2011 American Society for Nutrition.


Khalid-de Bakker C.A.,NUTRIM School for Nutrition | Khalid-de Bakker C.A.,Maastricht University | Jonkers D.M.,NUTRIM School for Nutrition | Hameeteman W.,NUTRIM School for Nutrition | And 3 more authors.
Netherlands Journal of Medicine | Year: 2011

Background: Large colorectal cancer screening studies using primary colonoscopy have reported a low risk of major complications. studies on diagnostic and therapeutic colonoscopy have pointed to a frequent occurrence of (minor) cardiopulmonary events, and with the steady increase of colonoscopy screening, it is important to investigate their occurrence in colonoscopy screening. Methods: this study describes the frequency of bradycardia (pulse rate <60 min-1), hypotension (systolic blood pressure (sbP) <90 mmHg), hypoxaemia (blood oxygenation, SaO2 <90%) and eCG changes during colonoscopy screening in an average-risk population (hospital personnel, n=214, mean age 54.0±3.8, 39.3% male), without signifcant comorbidity) and aims at identifying subject-related and/ or endoscopic factors associated with their occurrence. all data were collected prospectively. during 214 consecutive primary screening colonoscopies under conscious sedation (midazolam and pethidine), on top of pulse rate and SaO2, blood pressure and a three-channel eCG were recorded every fve minutes.results: no major complications or relevant eCG changes occurred. Hypoxaemia occurred in 119 (55.6%), hypotension in 19 (8.9%) and bradycardia in 12 subjects (5.6%). in multivariate analysis, the sedation level 3 increased the risk of hypoxaemia (or 4.8, Ci 1.7-13.7), and incomplete colonoscopy (or 5.3, Ci 1.6-18.1) was associated with hypotension. subjects with bradycardia had a longer mean procedure time (38±12 vs. 29±12 min, p<0.05), which did not turn out as a risk factor in a multivariate analysis. Conclusions: Mainly procedure-related and not subject-related factors were found to be associated withthe occurrence of cardiopulmonary events in primary colonoscopy screening in this relatively healthy screening population. © Van Zuiden Communications B.V. All rights reserved.


van Wijck K.,Top Institute Food and Nutrition | van Wijck K.,Maastricht University | Lenaerts K.,Top Institute Food and Nutrition | Lenaerts K.,Maastricht University | And 7 more authors.
PLoS ONE | Year: 2011

Background: Splanchnic hypoperfusion is common in various pathophysiological conditions and often considered to lead to gut dysfunction. While it is known that physiological situations such as physical exercise also result in splanchnic hypoperfusion, the consequences of flow redistribution at the expense of abdominal organs remained to be determined. This study focuses on the effects of splanchnic hypoperfusion on the gut, and the relationship between hypoperfusion, intestinal injury and permeability during physical exercise in healthy men. Methods and Findings: Healthy men cycled for 60 minutes at 70% of maximum workload capacity. Splanchnic hypoperfusion was assessed using gastric tonometry. Blood, sampled every 10 minutes, was analyzed for enterocyte damage parameters (intestinal fatty acid binding protein (I-FABP) and ileal bile acid binding protein (I-BABP)). Changes in intestinal permeability were assessed using sugar probes. Furthermore, liver and renal parameters were assessed. Splanchnic perfusion rapidly decreased during exercise, reflected by increased gap g-apCO 2 from -0.85±0.15 to 0.85±0.42 kPa (p<0.001). Hypoperfusion increased plasma I-FABP (615±118 vs. 309±46 pg/ml, p<0.001) and I-BABP (14.30±2.20 vs. 5.06±1.27 ng/ml, p<0.001), and hypoperfusion correlated significantly with this small intestinal damage (r S = 0.59; p<0.001). Last of all, plasma analysis revealed an increase in small intestinal permeability after exercise (p<0.001), which correlated with intestinal injury (r S = 0.50; p<0.001). Liver parameters, but not renal parameters were elevated. Conclusions: Exercise-induced splanchnic hypoperfusion results in quantifiable small intestinal injury. Importantly, the extent of intestinal injury correlates with transiently increased small intestinal permeability, indicating gut barrier dysfunction in healthy individuals. These physiological observations increase our knowledge of splanchnic hypoperfusion sequelae, and may help to understand and prevent these phenomena in patients. © 2011 van Wijck et al.


PubMed | Wageningen University, CARIM Cardiovascular Research Institute Maastricht, NUTRIM School for Nutrition, Maastricht University and Radboud University Nijmegen
Type: Journal Article | Journal: Obesity (Silver Spring, Md.) | Year: 2015

Parental high-fat feeding was proposed to negatively impact metabolic health in offspring. Here, the ectopic fat storage in heart and liver in offspring was investigated, and the effects on mitochondrial function, de novo lipogenesis, and postprandial lipid metabolism were explored in detail.Male and female mice received either a high-fat (HF) or standard chow (LF) diet during mating, gestation and lactation. All offspring animals received the HF diet.Abdominal visceral adipose tissue tended to be higher in HF/HF mice. Cardiac lipid content was also higher in the HF/HF mice (LF/HF vs.1.03%0.08% vs. 1.33%0.07% of water signal, P=0.01). In contrast, hepatic lipid content tended to be lower in HF/HF mice compared to LF/HF mice. A severely disturbed postprandial lipid clearance was revealed in HF/HF mice by the results from the triglyceride (TG) tolerance tests (LF/HF vs.6,7532,213 vs. 14,3671,978 mmoll(-1) min(-1) , P=0.01) and (13) C-fatty acid retention test (LF/HF vs.2.73%0.85% vs. 0.89%0.26% retention from bolus, P=0.04), which may underlie the lower hepatic lipid content.Here it is shown that HF diet negatively impacts postprandial TG clearance in offspring and results in an overall metabolic unfavorable phenotype and ectopic lipid deposition in the heart and in visceral storage sites.


PubMed | NUTRIM School for Nutrition and Maastricht University
Type: Journal Article | Journal: The journal of physiological sciences : JPS | Year: 2015

The gold standard for measuring brown adipose tissue (BAT) in humans is [(18)F]FDG-PET/CT-imaging. With this technique subjects are exposed to ionizing radiation and are therefore limited in the number of scans that can be performed. We investigated the relation between supraclavicular skin temperatures and BAT activity values using a strictly temperature-controlled air-cooling protocol. Data of 36 male subjects was analyzed. BAT activity was evaluated by [(18)F]FDG-PET/CT-imaging and skin temperature was measured by means of wireless temperature sensors. Supraclavicular skin temperature dropped less compared to skin temperatures at other sites (all P values <0.01). A significant positive correlation was found between the change in supraclavicular skin temperature with BAT activity (R (2) 0.23), and the change in supraclavicular skin temperature and non-shivering thermogenesis (R (2) 0.18, both P values <0.01). The correlations indicate that supraclavicular skin temperature (changes) can potentially be used as a qualitative measure of BAT activity and BAT thermogenesis.


PubMed | University of Bonn, NUTRIM School for Nutrition and Maastricht University
Type: Journal Article | Journal: The Journal of nutrition | Year: 2014

Dietary lutein intake is postulated to interfere with the development of age-related macular degeneration (AMD). Because egg yolk-derived lutein has a high bioavailability, long-term consumption of lutein-enriched eggs might be effective in preventing AMD development, but alternatively might increase cardiovascular disease risk. Here, we report the effect of 1-y daily consumption of a buttermilk drink containing 1.5 lutein-rich egg yolks on serum lipid and lipoprotein and plasma lutein concentrations. Additionally, subgroups that could potentially benefit the most from the intervention were identified. Men and women who had early signs of AMD in at least 1 eye, but were otherwise healthy, participated in a 1-y randomized, placebo-controlled parallel intervention trial. At the start of the study, 101 participants were included: 52 in the experimental (Egg) group and 49 in the control (Con) group. Final analyses were performed with 45 participants in the Egg group and 43 participants in the Con group. As expected, the increase in plasma lutein concentrations in the Egg group was 83% higher than that in the Con group (P < 0.001). Changes in serum total, HDL, and LDL cholesterol, as well as the ratio of total cholesterol to HDL cholesterol, were not different between the 2 groups. Interestingly, participants classified as cholesterol absorbers had higher serum HDL cholesterol concentrations than participants classified as cholesterol synthesizers or participants with average campesterol-to-lathosterol ratios (P < 0.05) at baseline. In addition, cholesterol absorbers had a 229% higher increase in plasma lutein concentrations than participants who were classified as having an average campesterol-to-lathosterol ratio upon consumption of the lutein-enriched egg yolk drink (P < 0.05). Moreover, the change in serum HDL cholesterol upon consumption was significantly different between these 3 groups (P < 0.05). We suggest that cholesterol absorbers particularly might benefit from the lutein-enriched buttermilk drink. This study was registered at clinicaltrials.gov as NCT00902408.

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