A systematic review of the role of vitamin insufficiencies and supplementation in COPD

<p>Abstract</p> <p>Background</p> <p>Pulmonary inflammation, oxidants-antioxidants imbalance, as well as innate and adaptive immunity have been proposed as playing a key role in the development of COPD. The role of vitamins, as assessed either by food frequency questionnaires or measured in serum levels, have been reported to improve pulmonary function, reduce exacerbations and improve symptoms. Vitamin supplements have therefore been proposed to be a potentially useful additive to COPD therapy.</p> <p>Methods</p> <p>A systematic literature review was performed on the association of vitamins and COPD. The role of vitamin supplements in COPD was then evaluated.</p> <p>Conclusions</p> <p>The results of this review showed that various vitamins (vitamin C, D, E, A, beta and alpha carotene) are associated with improvement in features of COPD such as symptoms, exacerbations and pulmonary function. High vitamin intake would probably reduce the annual decline of FEV1. There were no studies that showed benefit from vitamin supplementation in improved symptoms, decreased hospitalization or pulmonary function.</p

Το μανιάτικο μοιρολόι: Ιστορικές και εθνομουσικολογικές διαστάσεις

Η παρούσα πτυχιακή εργασία έχει ως θέμα το μανιάτικο μοιρολόι ως προς τις ιστορικές και εθνομουσικολογικές του διαστάσεις του. Η Μάνη, περιοχή της νοτιοδυτικής Πελοποννήσου στην Ελλάδα, έχει μακραίωνη ιστορία, η οποία συνέβαλε καθοριστικά στην διαμόρφωση και άνθιση ενός ιδιαίτερου είδους μοιρολογιού, το οποίο είναι και σήμα κατατεθέν της περιοχής και των ανθρώπων της. Ο θάνατος αποτελεί θεμελιώδες υπαρξιακό γεγονός στην ανθρώπινη ζωή και προς τούτο από αρχαιοτάτων χρόνων και σε κάθε πολιτισμό υπάρχουν νεκρικές τελετουργίες. Οι αρχαίες ελληνικές νεκρικές τελετουργίες επιβίωσαν σε γενικές γραμμές μέχρι σήμερα, αναπόσπαστο στοιχείο τους δε υπήρξε ο θρήνος. Ο τελετουργικός θρήνος της αρχαίας Αθήνας εμφανίζει δομικές και μορφολογικές ομοιότητες με το μοιρολόγι. Ιδιαίτερα το μανιάτικο μοιρολόι εμφανίζει συγκεκριμένα μορφολογικά χαρακτηριστικά, τα οποία το διακρίνουν από τα λοιπά μοιρολόγια του ελλαδικού χώρου. Στο τελευταίο μέρος της εργασίας αυτής, παρατίθενται οι μουσικές καταγραφές και μουσικές αναλύσεις μανιάτικων μοιρολογιών, που συνελέγησαν ύστερα από επιτόπια έρευνα, τα ευρύτερα συμπεράσματα της οποίας είναι διασκορπισμένα σε όλα τα κεφάλαια της εργασίας.The present bachelor thesis has as a subject the Maniot moirologi regarding with its historical and enthnomusicological aspects. Mani, peninsula of the southern west Peloponnese region in Greece, has a long history through the times, which has exerted great influence to the evolution and advancement of a particular kind of moirologi, which is characteristic of the region and its people. The demise of a person consists a fundamental event of the hard core of the human existance and that is why there is from the ancient times in every single culture special death ritual. The ancient Greek death ritual is still alive and throughout the times it is including included the lament as integral part. The ritual lament of the ancient Athens has structural and morphological similarities with the moirologi. In particular, the Maniot moirologi has special morphological features, by which it is distinguished from other moirologia of the Greek territory. In the latter chapter of this bachelor thesis, there are musical transcriptions and analysis of the Maniot moirologia, which have been collected in the context of in situ survey, the wider conclusions of which are dispersed in every chapter of this thesis

Impact of dietary shift to higher-antioxidant foods in COPD: a randomised trial

Chronic obstructive pulmonary disease (COPD) is characterized by increased oxidative stress. Dietary factors such as ample consumption of foods rich in antioxidants such as fruits and vegetables, might have beneficial effects in COPD patients. We investigated the association between dietary shift to foods rich in antioxidants and lung function in COPD in a 3-year prospective study. 120 COPD patients were randomized either to follow a diet based on increased consumption of fresh fruits and vegetables (intervention group-IG), or to follow a free diet (control group-CG). The mean consumption of foods containing antioxidants was higher in IG than in CG throughout the study period (p<0.05); The relationship between consumption of foods rich in antioxidants and FEV1(%pred) was assessed by using a general linear model for repeated measures: the two groups overall were different in time (p=0.03) with IG showing a better outcome. In investigating the effect of several confounders (gender/age/smoking-status/comorbidities/exacerbation) in group response over time, non-significant interactions were found between confounders, group and time. Our findings suggest that a dietary shift to higher antioxidant foods intake may be associated with improvement in lung function and in this respect, dietary interventions might be considered in COPD management.Εισαγωγή Η Χρόνια Αποφρακτική Πνευμονοπάθεια (ΧΑΠ) σχετίζεται με το αυξημένο οξειδωτικό stress και είναι υπεύθυνο για τις παθολογικές μεταβολές των αεραγωγών και την συστηματική φλεγμονώδη αντίδραση. Μελέτες αποδεικνύουν ότι διαιτητικοί παράγοντες όπως η αυξημένη πρόσληψη αντιοξειδωτικών ενδέχεται να έχουν ευεργετική επίδραση στην πνευμονική λειτουργία. Στόχος αυτής της εργασίας ήταν η διερεύνηση της σχέσης μεταξύ της αυξημένης πρόσληψης αντιοξειδωτικών και της πνευμονικής λειτουργίας ασθενών με ΧΑΠ. Μέθοδος Πρόκειται για μία 3ετή προοπτική μελέτη με προγραμματισμένο 6μηνο επανέλεγχο εξωτερικών ασθενών. Τον πληθυσμό μελέτης αποτέλεσαν 120 ασθενής με ΧΑΠ που πληρούσαν τα κριτήρια. Κατά την έναρξη και σε κάθε 6μηνο επανέλεγχο εξετάζονταν τα αναπνευστικά συμπτώματα, οι διαιτητικές συνήθειες, η φαρμακευτική αγωγή και η πνευμονική λειτουργία. Οι ασθενείς τυχαία επιλέχθηκαν είτε σε μια διατροφή με αυξημένη πρόσληψη αντιοξειδωτικών, πειραματική ομάδα (ΠΟ) είτε σε μια ελεύθερη διατροφή, ομάδα ελέγχου (ΟΕ). Αποτελέσματα Η μέση κατανάλωση αντιοξειδωτικών τροφών ήταν σημαντικά αυξημένη στην ΠΟ σε σχέση με την ΟΕ (ρ<0,05). Οι σπιρομετρικές μετρήσεις στην ΠΟ ( n=60), (FEV­1, FVC, FEV1/FVC) βρέθηκαν σημαντικά αυξημένες στη ΠΟ από την ΟΕ. Η μέση ετήσια μεταβολή του FEV1 [DFEV1%pred/year] ήταν 2,6 (0,4) και -2,0 (0,5) αντίστοιχα στην ΠΟ και στην ΟΕ. Συμπέρασμα Τα αποτελέσματα μας εισηγούνται ότι μια διατροφή πλούσια σε αντιοξειδωτικά πιθανών συνδέεται με βελτίωση της πνευμονικής λειτουργίας ασθενών με ΧΑΠ και η διαιτητική παρέμβαση μπορεί να ληφθεί σημαντικά υπόψη στη διαχείριση της νόσου

Impact of dietary shift to higher-antioxidant foods in COPD: a randomised trial

Chronic obstructive pulmonary disease (COPD) is characterised by increased oxidative stress. Dietary factors, such as ample consumption of foods rich in antioxidants, such as fruit and vegetables, might have beneficial effects in COPD patients. The association between dietary shift to foods rich in antioxidants and lung function in COPD was investigated in a 3-yr prospective study. A total of 120 COPD patients were randomised to follow either a diet based on increased consumption of fresh fruit and vegetables (intervention group (IG)) or a free diet (control group (CG)). The mean consumption of foods containing antioxidants was higher in the IG than in the CG throughout the study period (p < 0.05). The relationship between consumption of foods rich in antioxidants and percentage predicted forced expiratory volume in 1 s was assessed using a general linear model for repeated measures; the two groups overall were different in time (p=0.03), with the IG showing a better outcome. In investigating the effect of several confounders (sex, age, smoking status, comorbid conditions and exacerbation) of group response over time, nonsignificant interactions were found between confounders, group and time. These findings suggest that a dietary shift to higher-antioxidant food intake may be associated with improvement in lung function, and, in this respect, dietary interventions might be considered in COPD management

Nutrition support in pulmonary and cardiac disease

Chronic Obstructive Pulmonary Disease (COPD) is a lung disease characterised by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response [1]. Across the European region an estimated 66 million people live with the disease and it is predicted to rise to the third leading cause of mortality globally by 2020. In the UK, COPD is a major cause of morbidity and mortality with around 30,000 deaths per year and an estimated 3.7 million individuals with the disease [2]. The symptoms of COPD include shortness of breath (dyspnoea), chronic cough and chronic sputum production, and these are known to negatively impact on an individual’s ability to meet their nutritional requirements. In addition, the disease is characterised by stable periods punctuated by episodes of acute worsening of these symptoms or exacerbations. These exacerbations are often inflammatory in nature and further compromise nutritional intake

Nutrition support in pulmonary and cardiac disease

Nutrition support is effective at treating undernutrition in chronic obstructive pulmonary disease (COPD), resulting in improvements in functional capacity and quality of life. The symptoms of COPD include shortness of breath (dyspnoea), chronic cough and chronic sputum production, and these are known to negatively impact on an individual's ability to meet their nutritional requirements. Nutritional intake in COPD patients has been found to be severely impaired prior to hospitalisation, remaining low during the first few days of admission and only returning to the habitual level on discharge. Chronic heart failure (CHF) is also a leading cause of morbidity and mortality, affecting an estimated 26 million people worldwide. Whilst the aetiology of undernutrition in cardiopulmonary diseases is complex, its development in COPD and CHF shares several key similarities. The relationship between weight loss and COPD has been reported for over 100 years