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Fractional Ca absorption from calcium-fortified soya milk (A) and fermented Ca-fortified soya milk (B) in twelve individual osteopenic postmenopausal women.
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Ageing women may choose to drink soya milk to reduce menopausal symptoms. As fermentation enriches soya milk with isoflavone aglycones, its beneficial qualities may improve. To reduce osteoporotic risk, however, soya milk must be Ca enriched, and it is not known how fermentation affects Ca bioavailability. A randomised crossover pilot study was und...
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Context 1
... 0·23), respectively. The mean fractional Ca absorption (a) of the fermented CFSM was approximately 10 % higher compared with that of CFSM, a difference not of statistical significance (P¼0·122). The individual differences in fractional Ca absorption between fortified soya milk and fermented fortified soya milk in the partici- pants are shown in Fig. ...
Context 2
... will hydrolyse phytic acid and IP6-generating myo-inositols with reduced numbers of phosphate groups (IP3 -IP5) (21,22) causing a beneficial effect on Ca bioavailability. In the present study, the CFSM was made from soya protein isolate rather than from a whole soya bean, and even before fermentation, it had minimal phytic acid content. Fig. 1 shows the individual fractional Ca absorption from CFSM to fermented CFSM. Four of the twelve post- menopausal women absorbed Ca from the fermented CFSM better than from the non-fermented CFSM (32, 28, 69 and 31 %, respectively). These women may have come from the approximate one-third of the population who are 'equol producers', a ...
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... On the other hand, Cheung et al. [20] reported a randomized crossover pilot in postmenopausal osteopenic women consuming calcium-fortified soymilk (CFSM). This intervention diet contains 4% soy protein isolate and is fortified with calcium phosphate to achieve a calcium content comparable to cow's milk (120 mg/100 ml). ...
Osteoporosis is the most common cause of morbidity and economic burden globally. Osteoporosis treatment and management may be lacking in current methods. Isoflavones are considered potential alternatives to bone loss and osteoporosis therapy. This review aimed to describe the effect of dietary isoflavones on bone health. The association of calcium bioavailability and gut microbiota was discussed in this paper. Daidzein, genistein, and their metabolites, namely equol, are essential isoflavones in bone formation. Isoflavones play a role in calcium homeostasis during the calcium uptake process by mobilizing bone calcium into the circulation. Isoflavones and equol increase bone mineral density in the gastrointestinal tract by stimulating bone formation. However, despite the fact that isoflavones promote bone health by regulating the bioavailability of calcium and gut microbiota, conflicting results have defined their effects. Therefore, further research on the effects of isoflavones on bone health is still required to confirm the link between calcium bioavailability and gut microbiota.
... SCFAs may also increase calcium-binding protein expression and paracellular calcium transport [72,73]. Moreover, higher levels of SCFAs following probiotic production can decrease the pH of the cecum and colon, enhancing calcium solubility and absorption [72,74]. The study by Narva et al. 2004 [16] suggests that L. helveticus could positively affect calcium metabolism by decreasing serum parathyroid hormone (PTH) and increasing serum calcium concentrations. ...
Micronutrient deficiencies are a worldwide public health concern. Emerging evidence supports the ability of probiotics to enhance micronutrient status, which could aid in the prevention of non-communicable disease-associated malnutrition. This systematic review evaluated evidence of the efficacy of probiotic supplementation to improve micronutrient status in healthy subjects. The authors searched for published English language peer-reviewed journal articles in PubMed, Scopus, Embase, and Google Scholar databases from inception to July 2020 using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of eligible studies was assessed using the Revised Cochrane Risk-of-Bias tool (RoB)2 and Risk of Bias in Non-Randomized Studies of Interventions tool (ROBINS-I tool). Fourteen original studies out of 2790 met the inclusion criteria. The results indicated that, despite varying degrees of efficacy, the intake of certain probiotics in healthy subjects was associated with a positive impact on the status of certain micronutrients (vitamin B12, calcium, folate, iron and zinc). A limitation was that studies were widely heterogeneous in terms of participant age, probiotic strain, species, dosage, intervention duration, and form of administration. Additional clinical trials are warranted to determine the most effective strains of probiotics, doses and durations of interventions.
... Many original studies have examined the effect of probiotics, prebiotics, or synbiotics on calcium level, BMD, or the parameters related to bone metabolism in children or adolescence or adults. However, the participants, the species, doses and duration of interventions, outcomes, and measurements varied among these studies (Adolphi et al., 2009;Asemi, Bahmani, Shakeri, Jamal, & Faraji, 2015;Cheung et al., 2011;Farhangi, Javid, & Dehghan, 2016;Jafarnejad et al., 2017;Laird et al., 2017;Narva, Karkkainen, Poussa, Lamberg-Allardt, & Korpela, 2003;Tu et al., 2015). Therefore, it was necessary to conduct a systematic review and meta-analysis of the beneficial effect of probiotics, prebiotics, or synbiotics in maintaining calcium homeostasis and preserving bone mass. ...
Background:
Calcium homeostasis and bone health are an increasing concern for middle-aged and older adults. Many studies have explored the positive effects of probiotics, prebiotics, or synbiotics on serum calcium and bone mineral density (BMD) or other parameters related to bone health. However, the participants, the species, doses and duration of interventions, outcomes, and measurements varied among these studies.
Aims:
To systematically evaluate the effect of probiotics, prebiotics, or synbiotics on maintaining calcium homeostasis and improving bone health in middle-aged and older adults.
Methods:
We identified studies in Cochrane Library, Embase, PubMed, Web of Science, CINAHL, China National Knowledge Infrastructure, and Wanfang and articles in English and Chinese published from inception up to January 10, 2019. Randomized controlled trials (RCTs) involving probiotics, prebiotics, or synbiotics for middle-aged or older adults were employed for meta-analysis by using RevMan 5.3, and heterogeneity and risk of bias assessment were performed.
Results:
A total of eight studies, involving 564 participants, were included. Probiotics, prebiotics, or synbiotics supplementation was able to significantly elevate serum calcium levels (0.52 mg/dl, 95% CI [0.38, 0.66]), heterogeneity: p = .13, I2 = 44%), while the results of meta-analysis failed to support the effects of this supplementation on the parameters related to bone health in middle-aged and older adults, including BMD, parathyroid hormone, osteocalcin, and alkaline phosphatase.
Linking evidence to action:
Probiotics, prebiotics, or synbiotics supplementation exerts a facilitating influence on the level of serum calcium, while the present study has not yet supported the beneficial effects of such interventions on bone health. Therefore, further studies with high-quality RCTs are required to determine the effects of probiotics, prebiotics, or synbiotics supplementation on middle-aged and older adults.
... The combination of an enzyme producing probiotics such as β-glucosidase producing probiotics with soy extract help to improve the symptoms of menopause via producing bioactive isoflavone aglycones [47]. A study reported that the fermentation of soy milk with L. acidophilus does not significantly increase the absorption of Ca in osteopenic post-menopausal women [48]. Some controversial reports stated that the supplementation of soyisoflavone does not influence the microbiota of menopausal women [49]. ...
Menopause (MP) is a natural physiological event of woman's life and is defined as the absence of menstrual periods for at least twelve months and loss of function of ovarian. The common symptoms of MP are irregular vaginal bleeding, hot flushes especially in head and chest, night sweats, insomnia, vaginal and urinary symptoms, cognitive dysfunction, increased cancer risk, osteopenia, high blood pressure, diabetes, and cardiovascular diseases. Microbiome has been associated with several health benefits. Probiotic supplementation helps to enhance the quality of microbiome thereby confers the health benefits to the host system. The microbiome, hormone (estrogen) changes, and probiotic intervention are related to the health status of the female reproductive system. The vaginal microbiome (VM) play a critical role in female reproductive health and MP, which can be greatly influenced by probiotics, and other medicine especially antibiotics and hormone therapy. The role of VM in supporting vaginal health is not clear and debatable. Understanding the role of vaginal Lactobacillus could expose the pathogenesis of vaginal dysbiosis, which helps to improve diagnostic and therapeutic strategies for several dysbiosis associated health issues and menopause-related symptoms. Recent studies suggested that the intervention of probiotic preparation with or without nutraceutical formulation (mostly with isoflavones) improve the health status of menopausal women. The mechanism of probiotics mediated health improvement in menopausal women is not yet described clearly. Several controversies are there on the link between probiotic, gut microbiota, vaginal microbiota, and estrogen deficit. The present review summarizes the influence of probiotic supplementation on climacteric symptoms in menopausal women. The literature search was made in Scopus, Google Scholar, PubMed using the keywords "probiotics" and "menopause". The documents were carefully checked for the relevance to the current manuscript, and the selection was made without any restriction in the year of publication.
... In agreement with our study, the consumption of probiotics (Ecologic 641, containing four Lactobacillus and two Bifidobacillus strains) for 3 months did not affect serum ALT, AST, and ALP in patients with primary sclerosing cholangitis [51]. In addition, no significant difference was observed following consumption of Lactobacilluscontaining soymilk on calcium absorption among postmenopausal women [52] and intake of synbiotic on blood pressure in male apo E-deficient mice [53]. The differences between our findings and those of previous reports may be explained by the type and dosage of probiotic and prebiotic used, duration of the intervention, or the study participants. ...
Objectives:
To our knowledge, no reports are available indicating the effects of synbiotic bread consumption on nitric oxide (NO), biomarkers of oxidative stress, and liver enzymes among patients with type 2 diabetes mellitus (T2DM). This study was performed to determine the effects of the daily consumption of synbiotic bread on NO, biomarkers of oxidative stress, and liver enzymes in patients with T2DM.
Methods:
This randomized, double-blind, placebo-controlled trial was performed among 81 patients with diabetes, aged 35-70 years old. After a 2-week run-in period, patients were randomly divided into 3 groups: group A (n = 27) received synbiotic bread containing viable and the heat-resistant probiotic Lactobacillus sporogenes (1 × 10(8) CFU) and 0.07 g inulin per 1 g, group B (n = 27) received probiotic bread containing Lactobacillus sporogenes (1 × 10(8) CFU), and group C (n = 27) received control bread for 8 weeks. Patients were asked to consume the synbiotic, probiotic, or control breads 3 times a day in 40 g packages for a total of 120 g/day. Fasting blood samples were taken at baseline and after an 8-week intervention for quantificationof related markers.
Results:
After 8 weeks, the consumption of synbiotic bread compared to the probiotic and control breads resulted in a significant rise in plasma NO (40.6 ± 34.4 vs 18.5 ± 36.2 and -0.8 ± 24.5 µmol/L, respectively, p < 0.001) and a significant reduction in malondialdehyde (MDA) levels (-0.7 ± 0.7 vs 0.6 ± 1.7 and 0.5 ± 1.5 µmol/L, respectively, p = 0.001). We did not find any significant effect of the synbiotic bread consumption on plasma total antioxidant capacity (TAC), plasma glutathione (GSH), catalase, serum liver enzymes, calcium, iron, magnesium levels, and blood pressure compared to the probiotic and control breads.
Conclusion:
In conclusion, consumption of the synbiotic bread for 8 weeks among patients with T2DM had beneficial effects on plasma NO and MDA levels; however, it did not affect plasma TAC, GSH, catalase levels, serum liver enzymes, calcium, iron, magnesium levels, and blood pressure.
... This fortifi cant has the best sensory characteristics, however, the calcium bioavailability is lower compared with cow's milk and other fortifi cants such as calcium carbonate. [24][25][26][27] Therefore, soy milk does not seem to be a good option as a rich source of bioavailable calcium, and recommendations for the intake of foods rich in calcium need to be part of the treatment for IBD patients if dairy product restriction is recommended for some reason. In addition, dairy products are poor sources of lactose and can be consumed by patients with lactose intolerance. ...
... Low dietary calcium intake is already common among the Brazilian population. 25 The mean daily dietary calcium intake among adults is 476.4 mg for females and 546.4 mg for males, and the prevalence of inadequacy among females and males is 90.7% and 83.8%, respectively. 28 The decrease in dietary calcium intake is clinically important in IBD patients, particularly those treated with steroids, postmenopausal women and the elderly because they have a higher risk of developing osteoporosis 29 and fractures. ...
Introduction:
Calcium deficiency is considered a risk factor for the development of osteoporosis in inflammatory bowel disease (IBD) patients. Various dietary restrictions, including milk products are reported by these patients.
Objective:
To evaluate dairy product and dietary calcium intake by IBD patients.
Methods:
This cross-sectional study enrolled 65 outpatients with IBD recruited from one reference center for IBD. A semi-structured questionnaire (to collect demographic, socioeconomic and clinical data) and a quantitative food frequency questionnaire were administered. With regard to clinical data, we evaluated the anthropometric nutritional status, the disease classification, the disease activity index and the presence of gastrointestinal symptoms. Self-reported modifications in the use of dairy products were evaluated.
Results:
The IBD patients' ages ranged from 20-75 years and 67.0% were diagnosed with ulcerative colitis. The majority (64.7%) reported restricting dairy products. The frequency of gastrointestinal symptoms was higher among the Crohn's disease patients who restricted dairy products than among those with no restrictions (100% vs 42.9%; p = 0.013); this result was not observed among the UC (ulcerative colitis) patients. Disease activity was also more frequent in the IBD patients who restricted dairy products than in those with no restrictions (23.8% vs 4.5%; p = 0.031), and among the UC patients, extensive disease was more common in the patients who restricted dairy products than in those with no restrictions (42.9% vs 20.0%; p = 0.03).
Conclusion:
Restricting dairy products is common among IBD patients, possibly due to disease activity, the presence of gastrointestinal symptoms and the extension of the disease.
... [22] Findings from other studies in this regard are conflicting. [20,[23][24][25][26] Probiotics might affect serum calcium and iron levels through their beneficial effects on increased intestinal absorption of these minerals. [24] Attenuated liver injury and reduced tissue tumor necrosis factor-alpha level by probiotics might explain their effects of liver enzymes. ...
... [20,[23][24][25][26] Probiotics might affect serum calcium and iron levels through their beneficial effects on increased intestinal absorption of these minerals. [24] Attenuated liver injury and reduced tissue tumor necrosis factor-alpha level by probiotics might explain their effects of liver enzymes. [27,28] Previous studies on the effect of probiotics on serum calcium and iron levels as well as liver enzymes have been mostly performed in animal models. ...
... Our finding on the effect of probiotics on serum calcium levels are in line with previous studies. [18,19,24,30] However, the majority of previous studies have been conducted in animal models. A probiotic preparation with multi-strains composition caused a significant increase of serum calcium levels in broiler chickens. ...
To reach fetal appropriate growth during the third trimester, the requirements for dietary calcium and iron intakes during the pregnancy increases. This study was carried out to determine the effects of daily consumption of probiotic yoghurt on serum calcium and iron levels and liver enzymes among Iranian healthy pregnant women.
In this controlled clinical trial, 70 primigravida pregnant women carrying singleton pregnancy at their third trimester were participated. Participants were randomly divided into two groups of consuming 200 g/d of conventional (n = 33) or probiotic yogurts (n = 37) for 9 weeks. The probiotic yogurt contained Lactobacillus acidophilus and Bifidobacterium lactis with a total of min 1 × 10(7) CFU. To measure serum calcium, iron, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, blood samples were drawn in a fasting state at baseline and after 9 weeks intervention.
Consumption of probiotic yogurt resulted in maintaining serum calcium levels compared with the conventional yogurt (P = 0.01). Within-group differences in the conventional yogurt group revealed a significant reduction of serum calcium levels (-1.7 mg/dL, P < 0.0001). No significant differences were found between the two yogurts in terms of their effects on serum iron, AST and ALT levels.
Consumption of probiotic yogurt among pregnant women resulted in maintaining serum calcium levels compared with the conventional yogurt; however, it could not affect serum iron, ALT and AST levels.
Dairy products are included in dietary guidelines worldwide, as milk, yoghurt, and cheese are good sources of calcium and protein, vital nutrients for bones and muscle mass maintenance. Bone growth and mineralization occur during infancy and childhood, peak bone mass being attained after early adulthood. A low peak bone mass has consequences later in life, including increased risk of osteoporosis and fractures. Currently, more than 200 million people worldwide suffer from osteoporosis, with approximately 9 million fractures yearly. This poses a tremendous economic burden on health care. Between 5% and 10% of the elderly suffer from sarcopenia, the loss of muscle mass and strength, further increasing the risk of fractures due to falls. Evidence from interventional and observational studies support that fermented dairy products in particular exert beneficial effects on bone growth and mineralization, attenuation of bone loss, and reduce fracture risk. The effect cannot be explained by single nutrients in dairy, which suggests that a combined or matrix effect may be responsible similar to the matrix effects of foods on cardiometabolic health. Recently, several plant-based beverages and products have become available and marketed as substitutes for dairy products, even though their nutrient content differs substantially from dairy. Some of these products have been fortified, in efforts to mimic the nutritional profile of milk, but it is unknown whether the additives have the same bioavailability and beneficial effect as dairy. We conclude that the dairy matrix exerts an effect on bone and muscle health that is more than the sum of its nutrients, and we suggest that whole foods, not only single nutrients, need to be assessed in future observational and intervention studies of health outcomes. Furthermore, the importance of the matrix effect on health outcomes argues in favor of making future dietary guidelines food based.
In recent years, the intestinal microbiota has emerged as a crucial regulator of health with dysbiosis linked to a number of pathological states such as inflammatory bowel disease. In addition to a local intestinal effect, emerging evidence has demonstrated the potential for the microbiota to modulate systemic bone health via a gut-bone axis. In the present chapter, we discuss how diet can affect the composition of the intestinal microbiota, through the intake of prebiotics, and how these are utilized by the bacteria to influence the immune system and bone. In addition, we detail the recent murine studies that investigate how probiotic supplementation can increase bone mineral density in “healthy” individuals and protect against the pathological bone loss associated with menopausal estrogen deficiency. Finally, we highlight the advances made in unearthing the mechanisms that potentially lead to these observed beneficial effects.
Osteoporosis is a major public health concern for men and women over the age of 50, characterized by structural deterioration and low bone mass (NOF 2011) leading to hip and spine fractures, as well as loss of function, independence, and increased risk of death with mortality rates between 20-24% one year after fracture (Leibson et al. 2002). This debilitating disease is highly influenced by genetic and environmental factors with diet as an especially important modifiable lifestyle factor that helps maximize and prolong skeletal health.
