Vitamin D Supplementation and Sleep: A Systematic Review and Meta-Analysis of Intervention Studies

Background: Vitamin D deficiency is associated with sleep disorders and poor sleep quality. Whether vitamin D supplementation (VDS) helps resolve these problems remains unclear. Objective: To systematically review the effect of VDS on sleep quantity, quality, and disorders, and perform a meta-analysis of available data. Methods: The reporting of this review followed the PRISMA statement. VDS human interventions studies that reported on sleep quality, quantity, or disorders were included. Medline, CINAHL, EMBASE, PsycInfo, the Cochrane Library, Clinicaltrials.gov, and the ICTRP were searched, in addition to the references of the included articles and previous relevant reviews, without language or time restrictions. Included studies were critically appraised, findings were narratively synthesized, and a meta-analysis was conducted. Furthermore, the overall certainty of the evidence was assessed. Results: A total of 19 studies were included (13 randomized controlled trials (RCTs), 1 opportunistic addition to an RCT, 4 pre–post studies, and 1 pre–post study analyzed as a case series); 3 RCTs were meta-analyses. The risk of bias was generally low. Pre–post studies showed a significant improvement in sleep quality with VDS. Similarly, the results of the meta-analysis revealed a statistically significant decrease in the Pittsburgh Sleep Quality Index with VDS compared with placebo (mean difference, −2.33 (95% CI, −3.09, −1.57); p \u3c 0.001; I2 = 0%), with a moderate certainty of evidence. The results regarding the effect of VDS on sleep-related impairment, difficulty, and disorders, as well as sleepiness and restless legs syndrome, were not unanimous. Conclusions: VDS is promising in improving sleep quality; however, its effect on sleep quantity and disorders needs to be further investigated

Gut microbiome, probiotics and bone: An updated mini review

© 2019 Myriam Abboud, Dimitrios Papandreou. The gut microbiome is now considered as a large organ that has a direct effect on gastrointestinal tract, immune and endocrine system. There is no evidence that gut microbiota regulates the immune system and is responsible for bone formation and destruction. Probiotics have been shown through the gastrointestinal tract to have a positive effect on the management of the healthy bone. This article discusses the latest data available from PubMed and Scopus databases regarding gut microbiome, probiotics and bone briefly

Association between Serum Vitamin D and Metabolic Syndrome in a Sample of Adults in Lebanon

The evidence on the association between vitamin D and metabolic syndrome (MetS) is inconclusive. This was a cross-sectional study to explore the relationship between vitamin D serum levels and MetS in a sample of Lebanese adults (n = 230), free of diseases that affect vitamin D metabolism, recruited from an urban large university and neighboring community. MetS was diagnosed according to the International Diabetes Federation criteria. A logistic regression analysis was performed taking MetS as the dependent variable, and vitamin D was forced into the model as an independent variable. The covariates included sociodemographic, dietary, and lifestyle variables. The mean (SD) serum vitamin D was 17.53 (12.40) ng/mL, and the prevalence of MetS was 44.3%. Serum vitamin D was not associated with MetS (OR = 0.99 (95% CI: 0.96, 1.02), p \u3c 0.757), whereas the male sex, compared with the female sex and older age, was associated with higher odds of having MetS (OR = 5.92 (95% CI: 2.44, 14.33), p \u3c 0.001 and OR = 1.08 (95% CI: 1.04, 1.11), p \u3c 0.001, respectively). This result adds to the controversy in this field. Future interventional studies are warranted to better understand the relationship between vitamin D and MetS and metabolic abnormalities

The Health Effects of Vitamin D and Probiotic Co-Supplementation: A Systematic Review of Randomized Controlled Trials

Evidence of synergic health effects of co-supplementation with vitamin D and probiotics is emerging. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA statement, scientific databases and the grey literature were searched, and a narrative review and risk of bias assessment were conducted. Seven randomized controlled trials were included, which had low risk of bias. Six studies were double-blind, and once single-blind, extended over 6-12 weeks, and included 50-105 participants. Conditions explored included schizophrenia, gestational diabetes, type 2 diabetes and coronary heart disease, polycystic ovarian syndrome, osteopenia, irritable bowel syndrome (IBS), and infantile colic. Supplementation frequency was daily or bi-monthly, with mainly vitamin D3, and Lactobacillus, Bifidobacterium, and Streptococcus. Comparators were placebo, vitamin D, lower vitamin D dose, and probiotics and lower vitamin D dose. The co-supplementation yielded greater health benefits than its comparators did in all studies except in one assessing IBS. Beneficial effects included decreased disease severity, improved mental health, metabolic parameters, mainly insulin sensitivity, dyslipidemia, inflammation, and antioxidative capacity, and lower use of healthcare. Co-supplementation of vitamin D and probiotics generated greater health benefits than its comparators did. More studies in other diseases and various populations are needed to confirm these findings and to elucidate the optimal form, composition, and frequency of this co-supplementation

Effects of vitamin d supplementation on lipid profile in adults with the metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Background: Metabolic syndrome (MetS) increases the risk of cardiovascular disease, with atherogenic dyslipidemia being a major contributing factor. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to assess whether vitamin D supplementation (VDS) alleviates dyslipidemia in adults with MetS. Scientific databases (PUBMED, MEDLINE, CINAHL, EMBASE, Cochrane Library, ClinicalTrials.gov, International Clinical Trials Registry Platform) and the gray literature were searched for randomized controlled trials of VDS, reporting on blood lipids. A narrative review, meta-analyses, sensitivity analyses, and appraisal of the risk of bias and overall quality of evidence produced were conducted. Results: Seven studies were included, and four were meta-analyzed. The risk of bias was generally low, and the final quality of evidence was low or very low. VDS, whether in high or low dose, significantly increased endline vitamin D blood levels; did not affect total, low-density, high-density cholesterol levels, and novel lipid-related biomarkers; yet, significantly increased triglycerides (TG) levels compared with placebo (MD: 30.67 (95%CI: 4.89– 56.45) mg/dL; p = 0.02 for low-dose VDS; and MD: 27.33 (95%CI: 2.06–52.59) mg/dL; p = 0.03 for high-dose VDS). Pertaining heterogeneity was high (I2 = 86%; and I2 = 51%, respectively), and some included studies had significantly higher baseline TG in the intervention arm. The sensitivity analyses revealed robust results. Conclusion: VDS seems not to affect blood lipids in adults with MetS

Association between Serum Vitamin D and Irritable Bowel Syndrome Symptoms in a Sample of Adults

Vitamin D may be associated with irritable bowel syndrome (IBS) pathways. This cross-sectional study evaluated the associations between serum Vitamin D and IBS symptoms in a sample of Lebanese adults. Participants (n = 230; mean (SD) age: 43.36 (16.05) years, 62.9% females) were adults, free of diseases affecting Vitamin D metabolism, and recruited from a large university and the surrounding community. Serum Vitamin D (25-hydroxyvitamin D) was assessed using an automated chemiluminescence micro-particle immunoassay kit. The Birmingham IBS Symptom Questionnaire total scale, and pain, constipation, and diarrhea subscales were used to study IBS symptoms. Four linear regression analyses were performed, taking respectively the total scale and each of the subscales as the dependent variable. Vitamin D was forced into each model. Covariates included sociodemographic and medical variables, fluid intake, physical activity, sleep quality, stress, and adherence to the Mediterranean diet. Mean (SD) serum Vitamin D was 17.53 (12.40) ng/mL and mean (SD) Birmingham IBS Symptom Questionnaire was 16.98 (15.16) (pain: 20.75 (23.63), constipation: 25.06 (29.99), diarrhea: 9.88 (13.37)). Serum Vitamin D was not associated with the total score, nor with any of the subscales (p \u3e 0.05 for the four regression analyses). Serum Vitamin D was not associated with IBS symptoms in a sample of Lebanese adults, adding to the controversy in this field. Further understanding of the pathophysiological mechanisms involved in Vitamin D and IBS is warranted

Consumption of Raw Orange, 100% Fresh Orange Juice, and Nectar- Sweetened Orange Juice-Effects on Blood Glucose and Insulin Levels on Healthy Subjects

OBJECTIVE: The aim of this study is to investigate the effect of consumption of raw orange (RO), 100% fresh orange juice (FOJ), and nectar-sweetened orange juice (NSOJ) on postprandial glucose and insulin levels in non-diabetic young Emirati women. RESEARCH METHODS: This is a prospective, three-way, crossover study design. Blood records of thirteen normal weight and seven healthy obese university students were analyzed from Zayed University on three random days with the following three meal samples: 2 ROs, 100% FOJ, and NSOJ. Venous blood was collected at 0, 30, 60, 90, and 120 minutes after the respective meal consumption. Statistical analyses included repeated measures analysis of variance and calculations of the area under the glucose and insulin curves (AUC) for each one of the meal samples. RESULTS: Total fasting glucose and insulin levels did not differ by treatment in the normal versus obese group. All three meals had no significant effects on the plasma glucose levels. However, there was a significant change in plasma insulin concentrations at 120 min compared with that at 0 min for RO: -14 (-27.05, -0.90, P \u3c 0.001); 100% FOJ -13.7 (-28.80, 1.44, P \u3c 0.001); and NSOJ: -9.2 (-28.75, 10.30, P \u3c 0.001). CONCLUSIONS: This study shows that whole fresh fruit, 100% fruit juice, and sweetened fruit juice did not have a significant effect on the blood glucose levels in non-diabetic Emirati university students. However, a significant decrease in insulin response and HOMA-IR on all three sample meals was observed

Evaluation of Self-Assessed State of Health and Vitamin D Knowledge in Emirati and International Female Students in United Arab Emirates (UAE)

© Copyright © 2020 Abboud, Rizk, Papandreou, Hijazi, Al Emadi and Waszak. Introduction: Globally, vitamin D deficiency is one of the most common deficiencies, affecting nearly half the world’s population. The objective of this survey was to assess and compare the knowledge about vitamin D and the perceived state of health in Emirati and international tourist female students in Dubai, United Arab Emirates (UAE). Methods: This is a cross-sectional study that took place in universities in Dubai, United Arab Emirates. This survey consisted of 17 multiple choice questions and was adapted from a study recently conducted in Poland. The first part of the survey assessed levels of supplementation, diet and UV exposure. Another section evaluated the participants’ self-assessed state of health in terms of vitamin D testing, symptoms related to vitamin D deficiency and general welbeing. The collected data were statistically analyzed using SPSS statistics for windows version 26.0 (SPSS Inc., Chicago, IL, United States). Statistical significance was set at P \u3c 0.05. Results: 105 respondents were Emiratis and 65 were international students. The average age was 21, with an average BMI 23.3 kg/m2. Almost one-third of each group reported using Vitamin D supplements once weekly. The vast majority of both groups reported rarely getting tanned. Almost all participants in both groups reported regular consumption of Vitamin D rich foods. In both groups, more than half reported consuming milk and cheese regularly and up to one-third reported consuming fish in a regular manner. Although more than half of the students rated their health as good; more than two-thirds reported experiencing muscle pain; only half reported having their blood Vitamin D levels measured once; half reported experiencing problems with concentration and more than three-quarters reported experiencing bad mood in the past month. The prevalence of these symptoms was almost similar across different categories of vitamin D supplementation, tanning habits, dietary intake, or nationality. No statistically significant differences were noted between the Emirati and International tourist students regarding any of the studied variables. Conclusion: Notably, more Emirati students were aware of the association between vitamin D and osteoporosis than International tourist students (40% vs. 21.9%, respectively; p \u3c 0.05). On the other hand, both groups had lower knowledge about the relationship between vitamin D deficiency and depression, Rheumatoid Arthritis and Hypertension, and the optimal vitamin D level; however, no statistically significant differences were noted regarding this knowledge of Emiratis and international students

Oral Health of Children and Adolescents in the United Arab Emirates: A Systematic Review of the Past Decade

Oral diseases are a universal public health problem with serious health and economic burdens. These diseases are a major concern in the pediatric population specifically. In the United Arab Emirates (UAE), among all the diseases that affect children, oral diseases, particularly early childhood caries, are the most common despite improvement in the provision of oral health services. Enhancing oral health status is one of the key public health goals in the country. This current systematic review aims to summarize the available data on oral health among children and adolescents in the UAE over the past decade (2011–2021). The review was conducted following a predefined protocol and in concordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO, EMBASE via Ovid, the Cochrane Library, and the Index Medicus for the Eastern Mediterranean Region (IMEMR) databases, and the gray literature were searched for original studies reporting on oral health in the pediatric population in the UAE, without applying any language restriction. Twenty-nine studies were included reporting on a total of 43,916 participants; they were mostly cross-sectional, and emirate-based; they were mostly limited by their setting and convenient sampling. Among the general pediatric population, results showed a high prevalence of dental caries across different emirates. Nevertheless, it was difficult to provide a predictable profile of caries, as risk factors were not well-explored and inconsistent across studies. Suboptimal oral hygiene practices were also prevalent, in addition to a low utilization of dental services. Furthermore, included studies showed a high level of oral problems in children with different disease (down syndrome, cerebral palsy, thalassemia, autism…) and special conditions (children in prison nurseries); yet, in general, treatment indices were lower than their healthy counterparts. This review suggests that dental caries is a major pediatric health problem in the UAE. Risk factors included higher consumption of snacks, being in public schools, lower maternal education level, and socioeconomic status. Nevertheless, risk factors were not well-explored and inconsistent across studies. Suboptimal oral hygiene practices and a low utilization of dental services were also identified, in addition to a high level of oral problems in children with different disease coupled with lower treatment indices in comparison with their healthy counterparts. This systematic review provides crucial information for planning and evaluating effective oral health programs, identifies gaps in the recent research in this field, and paves the way for preventive and interventional studies targeting oral health in pediatrics in the UAE. Immediate oral health promotion strategies are needed to address this public health problem early in its course by creating conditions that promote oral health, and increasing uptake of dental services. Intensifying research to draw temporal trends, understand the profile of childhood caries in the UAE, and explore cost-effective national community prevention programs are also needed

Emirati Adults Have a Higher Overall Knowledge on Vitamin D Compared to Tourists

© Copyright © 2020 Saleh, Alhadhrami, Al Ramahi, Albloushi, Hijazi, Abboud and Papandreou. Objectives: In the last decade, vitamin D deficiency has become a major global issue. One of the main functions of vitamin D is the proper absorption of calcium in the gastrointestinal track. Optimal vitamin D levels are mandatory for adequate calcium absorption and bone health. The purpose of this study was to assess the level of knowledge of vitamin D, calcium, and physical activity among Emirati and tourist adults in Abu Dhabi. Methods: This is a cross-sectional study that took place in three different malls in Abu Dhabi and included Emirati and tourist adults. Participants were asked to fill in a questionnaire consisting of 32 questions. These included questions on vitamin D, calcium, supplement, and physical activity knowledge. Another section of the questionnaire included general information on age, sex, education, weight, and height. The collected data were statistically analyzed using descriptive statistics using IBM SPSS statistics for Windows version 26.0 (SPSS Inc., Chicago, IL, United States). Statistical significance was set at P \u3c 0.05. Results: Out of 147 adults, 113 were females and 34 males. The mean age, height, and weight were 27.9 ± 8.6 years, 162.7 ± 10.4 cm, and 66.5 ± 19.5 kg, respectively. Emiratis had statistically significant higher basic knowledge on vitamin D compared to tourists (44.9 vs 27.1%), respectively. More than 66% of the whole sample was aware that vitamin D deficiency can affect muscle strength, as well as that calcium may affect osteoporosis. In a multiple regression model to analyze the possible effects of other factors to knowledge, it was found that only age (Beta: 0.045, P \u3c 0.014) and nationality (Beta: 0.750, P \u3c 0.018) were independently and significantly associated to vitamin D. Conclusion: Emirati participants showed a higher overall vitamin D knowledge than their tourist counterparts. Both groups had low/medium level of knowledge when it comes to physical activity and calcium and vitamin D supplements