Simultaneous Determination of Catechins and Caffeine in Green Tea-Based Beverages and Foods for Specified Health Uses

Catechins in green tea have various useful features including antioxidant activity and preventive effects on metabolic syndrome. Various beverages that are enriched with tea catechins are marketed as Foods for Specified Health Uses (FOSHU) in Japan. However, recent reports have indicated that excessive consumption of green tea extracts as a dietary supplement are associated with adverse health effects such as liver disorders. Various catechins and caffeine are constituents of FOSHU tea-based beverages. The amount of catechins in FOSHU products is displayed on labels as total catechin content, but the content of individual catechins are not provided. Although health hazards of FOSHU products have rarely been reported, precise information about the content and types of catechins in FOSHU products is needed to ensure safety. We used high-performance liquid chromatography with a photodiode array (HPLC/PDA) to simultaneously identify and quantify catechins and caffeine in green tea-based popular beverages and FOSHU beverages. This technique allowed simultaneous quantitation of five types of catechins and caffeine in green tea without complicated sample preparation. Epigallocatechin gallate (EGCG) and epigallocatechin EGC were the main catechins in various FOSHU beverages and the concentrations of almost all catechins were higher in FOSHU, than in popular green tea-based beverages. The concentrations of EGCG in green tea-based popular beverages and in FOSHU beverages were 5.4 - 7.3 and 10.2 - 41.9 mg/100mL, respectively, with the highest concentration being in a product named Healthya (approximately 147 mg/bottle). The simultaneous determination of compounds such as catechins and caffeine in FOSHU beverages can help to estimate beneficial and adverse effects to prevent deleterious effects on health and the excessive consumption of FOSHU beverages containing high concentrations of tea catechins should be avoided.

Restless legs syndrome is contributing to fatigue and low quality of life levels in hemodialysis patients

AIM To examine whether hemodialysis(HD) patients with restless legs syndrome(RLS) are subjects of greater fatigue and impaired quality of life(QoL) compared to HD patients without RLS.METHODS Eighty five stable HD patients participated in this study. According to their RLS status, the patients were dividedinto the RLS group(n = 23) and the non-RLS group(n = 62). QoL, fatigue, sleep quality, daily sleepiness and depression symptoms were assessed by using various questionnaires. Finally, biochemical parameters including iron, ferritin, hemoglobin, hematocrit and parathormone were assessed. RESULTS The HD patients with RLS scored worse in all the questionnaires used in the study(P < 0.05). The patients with RLS were more likely to receive the HD therapy on the morning shift, whilst 43.5% of the RLS patients reported to experience the RLS symptoms also during HD. The severity of RLS was correlated with fatigue, depression score and sleep quality(P < 0.05). CONCLUSION HD patients with RLS are subject to lower QoL related parameters and greater fatigue compared to HD patients without RLS. RLS should be successfully managed in order to improve the QoL of the sufferers.

Diagnosis and treatment of iron-deficiency anemia in gastrointestinal bleeding:A systematic review

BACKGROUND Anemia is considered a public health issue and is often caused by iron deficiency.Iron-deficiency anemia(IDA)often originates from blood loss from lesions in the gastrointestinal tract in men and postmenopausal women,and its prevalence among patients with gastrointestinal bleeding has been estimated to be 61%.However,few guidelines regarding the appropriate investigation of patients with IDA due to gastrointestinal bleeding have been published.AIM To review current evidence and guidelines concerning IDA management in gastrointestinal bleeding patients to develop recommendations for its diagnosis and therapy.METHODS Five gastroenterology experts formed the Digestive Bleeding and Anemia Workgroup and conducted a systematic literature search in PubMed and professional association websites.MEDLINE(via PubMed)searches combined medical subject headings(MeSH)terms and the keywords“gastrointestinal bleeding”with“iron-deficiency anemia”and“diagnosis”or“treatment”or“management”or“prognosis”or“prevalence”or“safety”or“iron”or“transfusion”or“quality of life”,or other terms to identify relevant articles reporting the management of IDA in patients over the age of 18 years with gastrointestinal bleeding;retrieved studies were published in English between January 2003 and April 2019.Worldwide professional association websites were searched for clinical practice guidelines.Reference lists from guidelines were reviewed to identify additional relevant articles.The recommendations were developed by consensus during two meetings and were supported by the published literature identified during the systematic search.RESULTS From 494 Literature citations found during the initial literature search,17 original articles,one meta-analysis,and 13 clinical practice guidelines were analyzed.Based on the published evidence and clinical experience,the workgroup developed the following ten recommendations for the management of IDA in patients with gastrointestinal bleeding:(1)Evaluation of hemoglobin and iron status;(2)Laboratory testing;(3)Target treatment population identification;(4)Indications for erythrocyte transfusion;(5)Treatment targets for erythrocyte transfusion;(6)Indications for intravenous iron;(7)Dosages;(8)Monitoring;(9)Indications for intravenous ferric carboxymaltose treatment;and(10)Treatment targets and monitoring of patients.The workgroup also proposed a summary algorithm for the diagnosis and treatment of IDA in patients with acute or chronic gastrointestinal bleeding,which should be implemented during the hospital stay and follow-up visits after patient discharge.CONCLUSION These recommendations may serve as a starting point for clinicians to better diagnose and treat IDA in patients with gastrointestinal bleeding,which ultimately may improve health outcomes in these patients.

Cold dialysis and its impact on renal patients' health:An evidence-based mini review

Chronic renal disease is associated with advanced age,diabetes,hypertension,obesity,musculoskeletal problems and cardiovascular disease,the latter being the main cause of mortality in patients receiving haemodialysis(HD).Cooled dialysate(35 ℃-36 ℃) is recently employed to reduce the incidence of intradialytic hypotension in patients on chronic HD.The studies to date that have evaluated cooled dialysate are limited,however,data suggest that cooled dialysate improves hemodynamic tolerability of dialysis,minimizes hypotension and exerts a protective effect over major organs including the heart and brain.The current evidence-based review is dealing with the protective effect of cold dialysis and the benefits of it in aspects affecting patients' quality of care and life.There is evidence to suggest that cold dialysis can reduce cardiovascular mortality.However,large multicentre randomized clinical trials are urgently needed to provide further supporting evidence in order to incorporate cold dialysis in routine clinical practice.

Effects of Fermented Rice Vinegar Kurozu and Its Sediment on Inflammation-Induced Plasminogen Activator Inhibitor 1 (PAI-1) Increase

Kurozu is a traditional black rice vinegar in Japan. Kurozu-moromi is the solid sediment that arises during the production of Kurozu. Kurozu is thought to have blood thinning and antithrombotic activities but a specific effect has not been proven. Plasma plasminogen activator inhibitor 1 (PAI-1) inhibits fibrinolysis and when elevated, it is a risk factor for the development of thrombotic diseases. Here, we examined the effects of a diet containing Kurozu and Kurozu-moromi on LPS (lipopolysaccharide)-induced increases in plasma PAI-1 levels in mice and on TNF-α (tumor necrosis factor α) increased PAI-1 production in the medium of a cultured endothelial cell line. Mice were fed with a diet containing 0.25% (w/w) concentrated Kurozu or 0.5% (w/w) Kurozu-moromi for four weeks, and then subcutaneously injected with 0.015 mg/kg of LPS in saline and sacrificed three hours later. Orally administered concentrated Kurozu and Kurozu-moromi significantly suppressed the LPS-induced increase in PAI-1 antigen and its activity in mouse plasma. The ethanol extract of Kurozu-moromi inhibited TNF-α induced increases of PAI-1 in the culture medium of the EA.hy926 endothelial cell line. The present findings showed that Kurozu and Kurozu-moromi contain natural products that decrease thrombotic tendencies by decreasing PAI-1 production in inflammatory states and have potential as antithrombotic foodstuffs.

Deconstructing athletes’sleep:A systematic review of the influence of age,sex,athletic expertise,sport type,and season on sleep characteristics

Purpose:This systematic review aimed to describe objective sleep parameters for athletes under different conditions and address potential sleep issues in this specific population.Methods:PubMed and Scopus were searched from inception to April 2019.Included studies measured sleep only via objective evaluation tools such as polysomnography or actigraphy.The modified version of the Newcastle-Ottawa Scale was used for the quality assessment of the studies.Results:Eighty-one studies were included,of which 56 were classified as medium quality,5 studies as low quality,and 20 studies as high quality.A total of 1830 athletes were monitored over 18,958 nights.Average values for sleep-related parameters were calculated for all athletes according to sex,age,athletic expertise level,training season,and type of sport.Athletes slept on average 7.2±1.1 h/night(mean±SD),with 86.3%±6.8%sleep efficiency(SE).In all datasets,the athletes’mean total sleep time was<8 h.SE was low for young athletes(80.3%±8.8%).Reduced SE was attributed to high wake after sleep onset rather than sleep onset latency.During heavy training periods,sleep duration and SE were on average 36 min and 0.8%less compared to pre-season and 42 min and 3.0%less compared to in-season training periods,respectively.Conclusion:Athletes’sleep duration was found to be short with low SE,in comparison to the general consensus for non-athlete healthy adults.Notable sleep issues were revealed in young athletes.Sleep quality and architecture tend to change across different training periods.

Role of diet on non-alcoholic fatty liver disease: An updated narrative review

The purpose of this article review is to update what is known about the role of diet on non-alcoholic fatty liver disease(NAFLD). NAFLD is the most common cause of chronic liver disease in the developed world and is considered to be a spectrum, ranging from fatty infiltration of the liver alone(steatosis), which may lead to fatty infiltration with inflammation known as non alcoholic steatohepatitis While the majority of individualswith risk factors like obesity and insulin resistance have steatosis, only few people may develop steatohepatitis. Current treatment relies on weight loss and exercise, although various insulin-sensitizing medications appear promising. Weight loss alone by dietary changes has been shown to lead to histological improvement in fatty liver making nutrition therapy to become a cornerstone of treatment for NAFLD. Supplementation of vitamin E, C and omega 3 fatty acids are under consideration with some conflicting data. Moreover, research has been showed that saturated fat, trans-fatty acid, carbohydrate, and simple sugars(fructose and sucrose) may play significant role in the intrahepatic fat accumulation. However, true associations with specific nutrients yet to be clarified.

An Updated Mini Review on Grapefruit: Interactions with Drugs, Obesity and Cardiovascular Risk Factors

The paper examines the effects of grapefruit consumption in relation to drugs, obesity and cardiovascular risk factors. The review includes the most updated studies found in Pub-Med. The grapefruit effect refers to the ability of grapefruit juice and supplements to interact with a wide variety of pharmaceuticals, either enhancing or limiting their systemic availability. Due to altering the active dosage of the pharmaceutical, Grapefruit juice is commonly not allowed to be used alongside with many drugs. Naringin is the most important one, which can inhibit absorption of some drugs but more commonly 6’7’-dihydroxybergamottin, which inhibits CYP3A4. Lately, grapefruit has been found both in rats and adults to reduce body weight, blood pressure, improve lipid and hepatic profile and decrease platelet aggregation. These promising results must be followed by additional studies in order to add to the importance of the role and effects of grapefruit as part of our diet.