Pharmacist prescribers Linda Bryant and Leanne Te Karu discuss positive polypharmacy for heart failure. Current evidence shows the intensive implementation of four medications offers the greatest benefit to most patients with heart failure, with significant reductions in cardiovascular mortality, heart failure hospitalisations and all-cause mortality
Staying well over winter can be a challenge – develop protection from the inside out
Staying well over winter can be a challenge – develop protection from the inside out
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Many factors contribute to overall wellness – exercise, not smoking, managing stress and getting adequate sleep. We instinctively know that nutrition does too. Dietitian Leigh O’Brien explores the emerging evidence that our gut microbiome may also play a role
1. Dang AT, Marsland BJ. Microbes, metabolites, and the gut-lung axis. Mucosal Immunol 2019;12(4):843–50.
2. Bird L. High-fibre diet beats flu. Nat Rev Immunol 2018;18(7):420–21.
3. Hughes C, Davoodi-Semiromi Y, Colee JC, et al. Galactooligosaccharide supplementation reduces stress-induced gastrointestinal dysfunction and days of cold or flu: a randomized, double-blind, controlled trial in healthy university students. Am J Clin Nutr 2011;93(6):1305–11.
4. Wypych TP, Marsland BJ, Ubags NDJ. The impact of diet on immunity and respiratory diseases. Ann Am Thorac Soc 2017;14(Suppl 5):S339–47.
5. Van Puyenbroeck K, Hens N, Coenen S, et al. Efficacy of daily intake of Lactobacillus casei Shirota on respiratory symptoms and influenza vaccination immune response: a randomized, double-blind, placebo-controlled trial in healthy elderly nursing home residents. Am J Clin Nutr 2012;95(5):1165–71.
6. Jespersen L, Tarnow I, Eskesen D, et al. Effect of Lactobacillus paracasei subsp. paracasei, L. casei 431 on immune response to influenza vaccination and upper respiratory tract infections in healthy adult volunteers: a randomized, double-blind, placebo-controlled, parallel-group study. Am J Clin Nutr 2015;101(6):1188–96.
7. Baldeon A, Lovett J, Holscher H. Diet quality and the fecal microbiota in healthy adults in the American Gut Project. Curr Dev Nutr 2020;4(Suppl 2):1546.