Effect of vitamin D supplementation on blood pressure:a systematic review and meta-analysis incorporating individual patient data

D-PRESSURE Collaboration: et al.[Importance]: Low levels of vitamin D are associated with elevated blood pressure (BP) and future cardiovascular events. Whether vitamin D supplementation reduces BP and which patient characteristics predict a response remain unclear.[Objective]: To systematically review whether supplementation with vitamin D or its analogues reduce BP.[Data Sources]: We searched MEDLINE, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, and http://www.ClinicalTrials.com augmented by a hand search of references from the included articles and previous reviews. Google was searched for gray literature (ie, material not published in recognized scientific journals). No language restrictions were applied. The search period spanned January 1, 1966, through March 31, 2014.[Study Selection]: We included randomized placebo-controlled clinical trials that used vitamin D supplementation for a minimum of 4 weeks for any indication and reported BP data. Studies were included if they used active or inactive forms of vitamin D or vitamin D analogues. Cointerventions were permitted if identical in all treatment arms.[Data Extraction and Synthesis]: We extracted data on baseline demographics, 25-hydroxyvitamin D levels, systolic and diastolic BP (SBP and DBP), and change in BP from baseline to the final follow-up. Individual patient data on age, sex, medication use, diabetes mellitus, baseline and follow-up BP, and 25-hydroxyvitamin D levels were requested from the authors of the included studies. For trial-level data, between-group differences in BP change were combined in a random-effects model. For individual patient data, between-group differences in BP at the final follow up, adjusted for baseline BP, were calculated before combining in a random-effects model.[Main Outcomes and Measures]: Difference in SBP and DBP measured in an office setting.[Results]: We included 46 trials (4541 participants) in the trial-level meta-analysis. Individual patient data were obtained for 27 trials (3092 participants). At the trial level, no effect of vitamin D supplementation was seen on SBP (effect size, 0.0 [95% CI, −0.8 to 0.8] mm Hg; P = .97; I2 = 21%) or DBP (effect size, −0.1 [95% CI, −0.6 to 0.5] mm Hg; P = .84; I2 = 20%). Similar results were found analyzing individual patient data for SBP (effect size, −0.5 [95% CI, −1.3 to 0.4] mm Hg; P = .27; I2 = 0%) and DBP (effect size, 0.2 [95% CI, −0.3 to 0.7] mm Hg; P = .38; I2 = 0%). Subgroup analysis did not reveal any baseline factor predictive of a better response to therapy.[Conclusions and Relevance]: Vitamin D supplementation is ineffective as an agent for lowering BP and thus should not be used as an antihypertensive agent.Peer reviewe

Chronic iron deficiency as an emerging risk factor for osteoporosis: A hypothesis

© 2015, by the authors; licensee MDPI, Basel, Switzerland. Iron is essential in oxygen transport and participates in many enzymatic systems in the body, with important roles in collagen synthesis and vitamin D metabolism. The relationship between iron and bone health comes from clinical observations in iron overload patients who suffered bone loss. The opposite scenario—whether iron deficiency, with or without anemia, affects bone metabolism—has not been fully addressed. This is of great interest, as this nutrient deficiency is a worldwide public health problem and at the same time osteoporosis and bone alterations are highly prevalent. This review presents current knowledge on nutritional iron deficiency and bone remodeling, the biomarkers to evaluate iron status and bone formation and resorption, and the link between iron and bone metabolism. Finally, it is hypothesized that chronic iron deficiency induces bone resorption and risk of osteoporosis, thus complete recovery from anemia and its prevention should be promoted in order to improve quality of life including bone health. Several mechanisms are suggested; hence, further investigation on the possible impact of chronic iron deficiency on the development of osteoporosis is needed.This review is part of the Spanish project AGL2009-11437.We acknowledge support by the CSIC Open Access Publication Initiative through its Unit of Information Resources for Research (URICI).Peer Reviewe

Relación entre el estado del hierro y el remodelado óseo y efectos metabólicos del consumo de un alimento fortificado con hierro y vitamina D en mujeres con predisposición a anemia

Tesis inédita de la Universidad Complutense de Madrid, Facultad de Farmacia, Departamento de Nutrición y Bromatología I (Nutrición), leída el 28-02-2014Depto. de Nutrición y Ciencia de los AlimentosFac. de FarmaciaTRUEunpu

Nutrición y anemia

© 2012 Kellogg Company.El texto está disponible para cualquiera que se registre previamente en http://www.katedrakelloggs.comPeer Reviewe

The influence of the native teachers’ intercultural communicative competence in the EFL students’ learning process

"The present investigation attempts to identify how native teachers' intercultural communicative competence influences students' learning process when students learn English as a foreign language. There are two main purposes in this quantitative investigation. The first research purpose is to identify how intercultural communicative competence interferes with students’ learning process. The second is to distinguish the abilities that intercultural communicative competence promotes within this learning process, and how teachers take advantage of those abilities to guide students to become intercultural speakers. The results show that teachers integrate skills and sub-skills that are part of intercultural communicative competence. However, there are only a few skills and sub-skills integrated into their classes. Also, there are not enough follow-up activities to tighten students’ skills up and develop intercultural communicative competence. In addition, results indicate strategic and pragmatic teachers' competencies do not ensure that students will improve language skills such as reading and listening, but the correct use of authentic material will be beneficial. This investigation concludes by remarking on the importance of integrating intercultural competence in the classroom and the implementation of authentic materials to decipher cultural aspects"

Agua en la prevención del síndrome de resistencia a la insulina

Se sabe que el contenido de agua y su distribución en el organismo está regulada hormonalmente, pero existen pocos estudios científicos de intervención enhumanos en los que se haya controlado la ingesta de un agua cuya composición se conozca totalmente y los efectos en la sensibilidad a la insulina. En este capítulo se presentan brevemente las funciones de la insulina y el cálculo de la resistencia a la insulina, para continuar con la relación entre insulina, aldosterona y equilibrio hidrosalino, como introducción a los efectos del consumo de diferentes aguas minerales en la sensibilidad a la insulina. Se ha descrito que los minerales calcio y magnesio ejercen un papel en la secreción de la insulina. Sin embargo, se desconoce si las aguas ricas en estos elementos pueden contribuir o no a un efecto protector frente a la diabetes o síndrome metabólico. Nuestro grupo de investigación tiene amplia experiencia en los efectos del consumo de un agua mineral bicarbonatada sódica en la reducción del riesgo cardiovascular y ha encontrado que la ingesta de dicho agua junto con una comida estándar, en comparación con un agua control de baja mineralización, modifica las concentraciones de insulina y aldosterona, en el sentido de una mayor protección frente a la resistencia a la insulina, la hipertensión y el síndrome metabólico.Peer Reviewe

Agua mineral bicarbonatada sódica en la reducción del riesgo cardiovascular

Peer Reviewe

Aldosterone changes after consumption of a sodium-bicarbonated mineral water in humans. A four-way randomized controlled trial

Abnormally high aldosterone levels are associated to hypertension and cardiovascular disease. A sodium-rich mineral water was previously shown to reduce several markers of cardiovascular risk and did not increase blood pressure in healthy adults. We aimed to study the effects of consuming the same mineral water compared to a control water on aldosterone levels, and if the effects vary due to the presence of meal in healthy adults. The design was a four-way randomized controlled crossover 120-min-postprandial trial. Twenty-one healthy men and women participated in the study. Exclusion criteria are diabetes, hypertension, and being a usual consumer of carbonic mineral water. Two different mineral waters, high-sodium and bicarbonate mineral water (BW, sodium, 1 g/L; bicarbonate, 2 g/L) and low-mineral content control water (CW), were consumed with or without a standard meal (500 mL per meal). Statistical analysis was performed by repeated measures ANOVA. The results are as follows: serum sodium did not vary, and serum potassium decreased throughout the assay (p = 0.01) without water influence. Consumption of BW significantly decreased aldosterone levels at 30 (p = 0.046), 60 (p = 0.009), and 120 (p = 0.025) min when consumed alone, and at 120 min (p = 0.019) when consumed with meal, compared to CW. Moreover, the effect of BW on aldosterone levels was significant in women but not in men. In conclusion, consumption of a sodium-bicarbonated mineral water, in presence or absence of meal, induces aldosterone inhibition in healthy women, which is suggested to be a physiological response that protects them against hypertension. This trial is registered at clinicaltrial.gov as NCT01334840.This work was supported by Vichy Catalán, S.L.Peer Reviewe

Agua en la prevención del síndrome de resistencia a la insulina

Publicación patrocinada por Grupo Vichy Catalán.-Capítulo 5. Agua en la prevención del síndrome de resistencia a la insulinaPublicación patrocinada por Grupo Vichy Catalán.Peer reviewe