John Eugene Lewis

• Doctor of Philosophy
• Voluntary Associate Professor at University of Miami

Introduction: Multiple sclerosis (MS) is a debilitating neurodegenerative disease affecting the central nervous system, causing disability and life-threatening complications. The interplay between immune cells and signaling pathways is a topic for investigating novel therapies. Past research has shown how the Th1/Th2 ratio plays a key role in the...

Background Alzheimer’s disease (AD) is a leading killer of Americans, imparting a tremendous societal toll. Relationships between immune function and inflammation with cognition are well-established in AD, but the Th1/Th2 ratio of immune function is unknown. Describing the Th1/Th2 ratio and its relationship with cognition may shed light on the dise...

Background and aim: Brain health is becoming more important to the average person as the number of people with cognitive impairments, such as Alzheimer's disease (AD), is rising significantly. The current Food and Drug Administration-approved pharmacotherapeutics for dementia neither cure nor halt cognitive decline; they just delay the worsening c...

Background and aim: Recently, optimal immune function has become a primary focus of worldwide attention not only in the prevention of chronic disease but also as one strategy to reduce the severity of acute illness. Inflammation, a process largely controlled by the immune system, has long been studied and recognized for its role in chronic disease...

The risk of developing Type 2 Diabetes Mellitus in people living with HIV (PLWH) can be four times greater and can occur at an earlier age and even without the presence of obesity compared to those without HIV. Therefore, the purpose of this analytical cross-sectional study was to determine the relationship between HIV duration and glucose metaboli...

Background. People living with HIV (PLWH) have increased risk of cardiovascular disease (CVD). Dietary behavior modification may assist in the treatment of CVD, but the optimal dose of nutrition education is unknown. The current aim was to determine if a weekly 1-hour nutrition education program would improve multiple outcomes among PLWH. Methods....

Background Physical exercise and cognitive training have been recommended to improve cognitive outcomes poststroke, but a multifaceted strategy including aerobic, resistance, and cognitive training to facilitate poststroke recovery has not been investigated. We aimed to assess the feasibility, adherence, and safety of a combined aerobic, resistance...

Background and aim: Given the ongoing problems of hypertension and endothelial dysfunction in the HIV population, the primary objective of the study was to assess the cardiovascular, endothelial function, and immune markers in response to rice bran arabinoxylan compound (RBAC) treatment in a sample of HIV+ adults on antiretroviral therapy (ART)....

The primary objective of the study was to evaluate the effect of a hydrolyzed polysaccharide, Rice Bran Arabinoxylan Compound (RBAC), on biomarkers in adults with nonalcoholic fatty liver disease (NAFLD). A 90-day randomized double-blind placebo-controlled trial examined the effect of RBAC on complete blood count, liver enzymes, lipids, oxidative s...

Background. People living with HIV (PLWH) have increased risk of cardiovascular disease (CVD). The Framingham Risk Score (FRS) predicts a 10-year CVD risk. Its relationships to physical fitness and C-reactive protein (CRP) are not well established. The current aim is to determine the links between FRS, physical fitness, and CRP in PLWH. Methods. Pa...

Background and aim: The objective of the present study was to investigate the relationships among pro-brain-derived neurotrophic factor (BDNF) and mature BDNF and immune functioning during aloe polymannose multinutrient complex (APMC) treatment in persons with moderate to severe Alzheimer's dementia (AD). Materials and methods: An open-label tri...

Human immunodeficiency virus (HIV) is a worldwide public health issue affecting millions of individuals, and people living with HIV (PLWH) are often affected by depression. However, evidence shows that exercise can prevent and treat depression among PLWH. The aim of the present study was to investigate the effect of a community-based exercise progr...

Multiple sclerosis (MS) is a progressive neurodegenerative disease that exerts a significant quality-of-life toll on patients. According to the literature, broad-spectrum dietary supplementation including a variety of nutrients, polysaccharides, and compounds may improve the quality of life, functionality, and symptom severity in people with MS. In...

Background Alcohol consumption is associated with poor health outcomes in women living with HIV (WLWH), but whether medication can help to reduce drinking in non–treatment‐seeking women or whether reduction in drinking improves HIV outcomes is unclear. We conducted a randomized clinical trial (RCT) of daily oral naltrexone (50 mg) versus placebo in...

The primary objective of the study was to evaluate the effects of a hydrolyzed polysaccharide, rice bran arabinoxylan compound (RBAC), on immune, hepatic, and renal function in HIV + individuals. A 6-month randomized double-blind placebo-controlled trial was utilized to conduct the intervention. Forty-seven HIV + individuals on stable antiretrovira...

Leukocyte telomere length (LTL), a biological marker of aging that is associated with age-related diseases, is longer in master endurance runners (ER) than age-matched controls, but the underlying mechanisms are poorly investigated. The LTL, nitric oxide (NO), and redox balance of ER master runners were analyzed and compared to untrained middle-age...

The primary objective of the study was to evaluate the effects of a hydrolyzed polysaccharide, rice bran arabinoxylan compound (RBAC), on immune, hepatic, and renal function in HIV + individuals. A six-month randomized double-blind placebo-controlled trial was utilized to conduct the intervention. Forty-seven HIV + participants on stable antiretrov...

Multiple sclerosis (MS) is a progressive neurodegenerative disease associated with increased infection rates, chronic inflammation, and premature death. Optimization of nutritional status via dietary supplementation may improve immune function in people suffering from MS and lead to decreased rates of infection. Fifteen individuals with a diagnosis...

The purpose of this study was to investigate the relationship between vitamin D status, measured as serum 25‐hydroxyvitamin D (25(OH)D), and markers of cardiac autonomic function, arterial stiffness and a composite cardio‐metabolic risk score (CMRS), using a novel non‐invasive system. The study enrolled 101 participants, and six were excluded due t...

Introduction: Physical activity has become less frequent since the 1980s, even among more active children. Objective: To analyze excess post-exercise oxygen consumption (EPOC) and total energy expenditure (TEE) in children during and after three different activities. Methods: Sixteen healthy children (9.6±0.1 yrs.) randomly underwent the following...

The primary objective of the study was to evaluate the effect of a hydrolyzed polysaccharide, Rice Bran Arabinoxylan Compound (RBAC), on biomarkers in adults with nonalcoholic fatty liver disease (NAFLD). A 90-day randomized double-blind placebo-controlled trial examined the effect of RBAC on complete blood count, liver enzymes, lipids, oxidative s...

Background Magnesium (Mg) deficiency contributes to the pathophysiology of numerous diseases. The therapeutic use of Mg has steadily increased over time. The increased in-hospital use of intravenous (IV) magnesium sulfate (MgSO4) warrants more extensive investigation regarding the safety of the therapy. The aim of this study was to determine the sa...

Background and aim: The objective of the present study was to investigate the effect of an aloe polymannose multinutrient complex (APMC) on pro brain-derived neurotrophic factor (BDNF) and mature BDNF in persons with moderate to severe Alzheimer's dementia. Methods: A 12-month open-label trial was utilized to evaluate the effect of the APMC on p...

The aim of this study was to analyze the acute responses of bradykinin, insulin, and glycemia to exercise performed above and below lactate threshold (LT) in individuals with type 2 diabetes mellitus (T2D). Eleven participants with a diagnosis of T2D randomly underwent three experimental sessions 72 h apart: 1) 20 min of exercise performed at 120%...

We have discovered in our clinical review that sexually abused girls have significantly better therapeutic outcomes than girls who have been victims of sex trafficking. Thus, we compared the mental health records of 25 adolescent female victims of commercial sexual exploitation with a group of 25 girls with a history of sexual abuse matched for age...

Background Diabetes-associated microvascular complications such as retinopathy and neuropathy often lead to end-organ and tissue damage. Impaired skin microcirculation often precedes the detection of other advanced diabetic complications. The ANS-1 system contains a redesigned sympathetic skin response (ANS-1 SSR) device that measures sudomotor fun...

Objective Physical activity (PA) following surgery for breast cancer may improve depressive symptoms and quality of life (QoL) via reduction in fatigue-related daily interference (FRDI). Less is known about how change in PA may relate to these psychosocial factors throughout the course of treatment. In a secondary analysis of a previous psychosocia...

Background Anthraquinones are a possible treatment option for oncological patients due to their anti-cancer properties. Cancer patients often exhaust a plethora of resources that ultimately fail to provide fully curative measures. Alternative treatments are subsequently sought in the hope of finding a therapeutic remedy. Po¬tential regimens include...

Background Physical activity has been associated with reduced oxidative stress (OS) in observational studies and clinical trials. Objective The purpose of this systematic review and meta-analysis of controlled trials was to determine the effect of physical exercise on OS parameters. Methods We conducted a systematic review of the literature up to M...

Background and Aim: Nutritional approaches that ameliorate cellular senescence may have the potential to counteract the effects of chronic disease. This study will investigate the effect of the Healthycell dietary supplement on markers of inflammation, oxidative stress, and DNA damage. Methods: Thirty adults between the ages of 18 and 55 were enrol...

Aim: Treatment-resistant depression patients are more likely to suffer from comorbid physical and mental disorders, experience marked and protracted functional impairment, and incur higher healthcare costs than non-affected individuals. Magnesium sulfate is a treatment option that may offer great potential for patients with treatment-resistant dep...

Background: Aerobic exercise is recommended for glycemic and weight control in type 2 diabetes (T2D), but exercise intensity that increase post-exercise fat oxidation has not been established yet. It is expected that high-intensity exercise induce higher absolute oxidations and rates of oxidation of CHO (during) and fat (after) in normoglycemic, bu...

Background: Worldwide, systemic arterial hypertension is a leading cause of death and non-communicable cardiovascular disease. A major factor contributing to this disease is a sedentary lifestyle. However, physical exercise, such as martial arts, may be an option for blood pressure (BP) control. The magnitude of post-exercise hypotension is associa...

Background: Aerobic exercise is recommended for glycemic and weight control in type 2 diabetes (T2D), but exercise intensity that increase post-exercise fat oxidation has not been established yet. It is expected that high-intensity exercise induce higher absolute oxidations and rates of oxidation of CHO (during) and fat (after) in normoglycemic, bu...

Objectives: The hypotheses of this systematic review were the following: 1) Prevalence of post-traumatic stress disorder (PTSD) will differ between various types of chronic pain (CP), and 2) there will be consistent evidence that CP is associated with PTSD. Methods: Of 477 studies, 40 fulfilled the inclusion/exclusion criteria of this review and...

The human immunodeficiency virus (HIV) pandemic remains a top national health priority. Chronic inflammation may be a critical component in the disease course of HIV as C-reactive protein (CRP) is elevated and associated with increased mortality. This study examined the effect of 3 months of combined aerobic and resistance exercise training among a...

Objective To evaluate the association of vitamin D status with age‐related changes in mobility and higher order cognitive function using a single and dual task physical performance test. Methods After consenting, participants completed the baseline assessments that included serum levels of vitamin D, vitals, anthropometrics and body composition, a...

The maximal lactate steady state is the gold standard for evaluating aerobic capacity; however, it is time-consuming. The lactate minimum protocol is an easier alternative, but is not feasible and still expensive. This study investigated whether the rating of perceived exertion of 13 is an accurate predictor of lactate minimum and maximal lactate s...

Background: Vitamin D deficiency has been associated with an increased risk of falls in older adults. Several studies have demonstrated an association between vitamin D deficiency and gait and cognitive impairments, which are two risk factors for falls in the elderly. There is lack of research about the role of vitamin D in cognitive function in t...

Objectives . Objectives were to determine at completion of a multidisciplinary pain program: 1) what percentage of chronic low back pain (CLBP) patients had improved at 30% or more (minimal clinically important difference [MCID]) and by 1.5 cm or more (minimal important change [MIC]) on the visual analog scale (VAS) and 2) whether that improvement...

Background: Exercise has been associated with improvements in adverse physiological and psychological effects of long-term antiretroviral therapy (ART) in people living with HIV (PLWH). Aim: To summarizes the findings on the effects of aerobic or resistance training alone or combined aerobic and resistance exercise training (CARET) on disease pr...

Type 2 diabetes mellitus (T2D) results in several metabolic and cardiovascular dysfunctions, clinically characterized by hyperglycaemia due to lower glucose uptake and oxidation. Physical exercise is an effective intervention for glycaemic control. However, the effects of exercising at different intensities have not yet been addressed. The present...

The perception of being a burden or self-perceived burden (SPB) is associated with suicide ideation in chronic pain patients (CPPs). The objective of this study was to determine if SPB is associated with five types of suicidality (wish to die, active suicide ideation, presence of suicide plan, history of suicide attempts, and preference for death o...

Background Exercise is effective in reducing glycemia, especially when it is performed in the postprandial period. However, no consensus exists in the literature about the effect of exercise on postprandial glucose control when it is performed before carbohydrate consumption. Aims The main aim was to determine whether 20 min of exercise performed...

Many chronic pain patients (CPPs) cannot be cured of their pain, but can learn to manage it. This has led to research on pain "acceptance" which is defined as a behavior pattern with awareness of pain but not directed at changing pain. CPPs who have accepted their pain generally acknowledge that a cure is unlikely. Time with pain may be necessary t...

Objectives: The belief in medical care entitlement has recently resulted in major changes in the medical system in the United States. The objectives of this study were the following: to compare endorsement of three medical entitlement beliefs (I deserve the best medical care no matter what the cost [BMC], I am entitled to all of the medical care I...

Stroke may cause physical or cognitive impairments. Approximately 50% to 75% of all stroke survivors have residual motor or cognitive disabilities that prevent them from living independently. Muscle weakness is considered a major cause of motor disability in stroke patients.1 Impaired walking occurs in as many as 80% of individuals immediately afte...

Objective The purpose of this study was to evaluate the prevalence of MetS characteristics, and factors associated with the presence of MetS, in 89 people living with HIV (PLWH) on ART enrolled in a community‐based exercise training and nutrition education program targeting individuals of low socioeconomic status. Results One in three PLWH met Adu...

Metabolic syndrome (MetS) is a constellation of symptoms used as a measure to identify patients at increased risk for cardiovascular disease, type 2 diabetes, and all-cause mortality. The results of prolonged life expectancy and cumulative toxic effects of antiretroviral therapy increase the chance that HIV can cause clinical abnormalities, includi...

Background: Persons living with HIV (PLWH) who also use crack cocaine may have stressful, chaotic lives and typically do not engage in standard medical care that addresses a multitude of extenuating life circumstances. Yoga/meditation (YM) improves quality of life (QOL) and biomarkers of stress, but the effect of this intervention is almost unknown...

To explore the association between cardiovascular fitness and metabolic syndrome across occupational groups using a nationally representative sample of the US population. Respondents aged 18 to 49 years from the 1999 to 2004 National Health and Nutrition Examination Survey were evaluated for cardiovascular fitness and classified with regard to meta...

This review wished to determine the reported prevalence of suffering in various patient diagnostic groups and examine the evidence for the association of pain and suffering. Twenty-four studies fulfilled inclusion-exclusion criteria. They were divided into the following groups: advanced cancer/terminal illness/hospice patients (AC/TI/H) (7 studies)...

Industrialized countries are currently experiencing an epidemic of high blood pressure (HBP) extending to people living with HIV (PLWH). Given the prevalence of hazardous alcohol use (HAU), this study examines the relationship between alcohol consumption and hypertension in PLWH. Including a gender analysis is critical, given the high rates of HAU...

Type 2 diabetes mellitus is frequently unrecognized until complications appear. Diabetic autonomic neuropathy is one of the early complications of type 2 diabetes mellitus, resulting in autonomic nervous system (ANS) dysfunction. The purpose of this study was to determine the validity of ANS function indicators to screen for type 2 diabetes mellitu...

Objective: To examine whether self-reported physical activity of a moderate/vigorous intensity influences risk markers for cardiovascular disease in persons with paraplegia due to spinal cord injury. Design: Descriptive, cross-sectional study. Subjects: A total of 134 wheelchair-dependent individuals (103 men, 31 women) with chronic (≥ 1 year)...

Objective: Given the emerging data suggesting the key role of brain-derived neurotrophic factor (BDNF) in the immune system, we assessed longitudinally whether BDNF depletions induced by hazardous alcohol use (HAU) would impact a response to antiretroviral therapy (ART). Methods: In a prospective single-site cohort, virological and immunological...

Objective The objective of this evidence-based structured review was to determine if there is consistent evidence that pain interferes with achieving antidepressant treatment response/remission of depression in patients with depression and pain.Methods After exclusion criteria were applied, of 2,801 studies/reports, 17 studies addressed this questi...

Objectives Somatic/psychiatric symptoms are frequently found in chronic pain patients (CPPs). The objectives of this study were to determine 1) which somatic/psychiatric symptoms are more commonly found in acute pain patients (APPs) and CPPs vs community nonpatients without pain (CNPWPs) and 2) if somatic/psychiatric symptom prevalence differs betw...

Objectives The objective of this narrative review was to examine recent evidence and, when necessary, past evidence on the association between pain and suicidality.DesignFifty-eight research reports were found on this topic, which had not previously been reviewed. These reports were divided into groups by whether they addressed suicide ideation (SI...

Introduction: The advent of combination antiretroviral therapy(cART) has lead to a significant reduction in morbidity and mortality among people living with HIV(PLWH). However, HIV-associated neurocognitive disorders (HAND) still remain a significant problem. One possible mechanism for the persistence of these disorders is through the effect of HI...

The leg extension (LE) is commonly used to strengthen the quadriceps muscles during training and rehabilitation. This study examined the effects of limb position (POS) and range of motion (ROM) on quadriceps electromyography (EMG) during 8 repetitions (REP) of LE. Twenty-four participants performed eight LE REP at their 8-repetition maximum with lo...

Background: Symptom clusters have not been previously explored in acute pain patients (APPs) and chronic pain patients (CPPs) with non-cancer pain. Objectives: The objectives of this study were to determine in CPPs and APPs which somatic and non-somatic symptoms cluster with each other, the number of clusters, and if cluster number and cluster s...

Background: Declining quality of life (QOL) is increasingly prevalent among the elderly. Certain nutrients may be effective at improving QOL. Objective: The purpose of this clinical trial was to evaluate (a) Ginkgo Synergy® and Choline and (b) OPC Synergy® and Catalyn,® compared to placebo, on QOL among healthy older adults. Design: Participants we...

The possibility that menthol cigarettes add to the deleterious cardiovascular effects of smoking has been barely discussed. Although cardiovascular diseases (CVD) are at the forefront of medical concerns of people living with HIV (PLWH), an important, yet unknown, issue for clinicians and public health authorities is whether use of menthol-flavored...

Declining cognitive function is relatively common and increasingly prevalent. Studies have shown that different nutrients (e.g., Ginkgo biloba and vitamin E) appear to be effective at improving memory and concentration, while less is known about their effect on immunity. This study investigated the effect of Ginkgo Synergy(R) plus Choline (n = 33)...

Purpose: Women undergoing surgery for breast cancer experience side effects, such as fatigue, reduced quality of life (QOL) and depression. Physical activity (PA) is associated with improved psychological adjustment during treatment and survivorship, yet little is known about how PA relates to fatigue, depression and QOL in the period following su...

The objectives of this evidence-based review were to review the evidence for whether neuropathic pain (NP) is associated with chronic low back pain (CLBP) and soft tissue syndromes (STS), and review the reported prevalence percentages for NP within these syndromes. Of 816 reports, 11 addressed the diagnosis of NP in CLBP and five of NP in STS. Stud...

Introduction In an expanding HAART era, obesity has become a health problem among persons living with HIV (PLWH). Whereas the rising level of obesity has been largely attributed to poor nutrition and exercise habits, differences in biological factors may explain why some individuals gain more weight than others. Thus, our main goal is to prospectiv...

To further explore the controversy as to whether childhood molestation is associated with chronic pain in adulthood. Community nonpatients without pain (CNPWP), community patients with pain (CPWP), acute pain patients (APPs), and chronic pain patients (CPPs) were compared for endorsement of affirmation of childhood molestation by chi-square. Logist...

Depression, the most common type of mental illness, is the second leading cause of disability and is increasing among Americans. The effect of improved nutrition, particularly with dietary supplements, on depression may provide an alternative to standard medical treatment. Some studies have shown that certain nutrients (e.g., inositol and S-adenosy...

The objectives of this study were to (1) compare the prevalence of smoking within chronic pain patients (CPPs) to community non-patients without pain (CNPWP), community patients with pain (CPWP), and acute pain patients (APPs); and (2) compare smokers to nonsmokers within CPPs, APPs, and CPWP for highest pain level. CNPWP, CPWP, APPs, and CPPs were...

The objective of this study was to determine whether self-reported visual analogue scale (VAS) low back pain (LBP) scores are valid against matched psychophysically induced pressure pain scores. Two hundred thirty-six chronic LBP patients (some with neck pain) reported their LBP and neck pain scores on a VAS immediately before psychophysical pressu...

Introduction: Previous studies have shown differences in cancer screening behavior by region, occupation, and race-ethnicity. We investigated differences in adherence to recommended cancer screening, comparing Florida to the rest of the United States. Methods: Following American Cancer Society guidelines, we measured rates of adherence to mammograp...

Background and Objective: Overall adherence to federal dietary guidelines among U.S. workers has not been evaluated. We calculated the Healthy Eating Index (HEI)-2005 total score by occupational group. Methods: We pooled employed adults from the 1999-2004 NHANES and calculated their HEI-2005 total scores (based on the intake of fruits, vegetables,...

Introduction: The water requirement for individuals is estimated using one of several formulas that are based either on kilocalories consumed or body weight. These formulas have never been validated. Given that total water intake (TWI) per the Dietary Reference Intakes can be used as a proxy for the water requirement, we sought to develop the best...

Background: The metabolic syndrome (MetS), comprised of an abnormal clustering of risk factors places an individual at high risk for coronary heart disease and type 2 diabetes mellitus. Weight loss can decrease these risks factors, but little is known about weight loss attempts among U.S. workers with MetS. Methods: We pooled data from the 1999-200...

Background: Dietary intake has been examined by various occupations however, little is known about the relationship between occupation and adherence to Adequate Intake (AI) recommendations for the nutrient water. We compared self-reported water intake to the AI (≥3.7 and ≥2.7 liters for males and females, respectively) by occupational groups. Metho...

Background: Young workers (≤24 years) are a large and relatively unstudied population in the US. Research suggests that among the young having a job can provide a variety of short- and long-term risks and/or benefits. The National Health Interview Survey (NHIS) provides a large and nationally-representative sample of all US civilian workers in whic...