Effects of Dietary Linoleic Acid on Blood Lipid Profiles: A Systematic Review and Meta-Analysis of 40 Randomized Controlled Trials

Th aim of this meta-analysis was to elucidate whether dietary linoleic acid (LA) supplementation affected blood lipid profiles, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), compared with other fatty acids. Embase, PubMed, Web of Science and the Cochrane Library databases, updated to December 2022, were searched. The present study employed weighted mean difference (WMD) and a 95% confidence interval (CI) to examine the efficacy of the intervention. Out of the 3700 studies identified, a total of 40 randomized controlled trials (RCTs), comprising 2175 participants, met the eligibility criteria. Compared with the control group, the dietary intake of LA significantly decreased the concentrations of LDL-C (WMD: -3.26 mg/dL, 95% CI: -5.78, -0.74, I² = 68.8%, p = 0.01), and HDL-C (WMD: -0.64 mg/dL, 95% CI: -1.23, -0.06, I² = 30.3%, p = 0.03). There was no significant change in the TG and TC concentrations. Subgroup analysis showed that the LA intake was significantly reduced in blood lipid profiles compared with saturated fatty acids. The effect of LA on lipids was not found to be dependent on the timing of supplementation. LA supplementation in an excess of 20 g/d could be an effective dose for lowering lipid profiles. The research results provide further evidence that LA intake may play a role in reducing LDL-C and HDL-C, but not TG and TC.

Botanical Origin Influence on Some Honey Physicochemical Characteristics and Antioxidant Properties

Five types of honey (multifloral, sunflower, linden, rapeseed, and acacia), from Southern Romania, were classified using chemometrics methods coupled with IR spectroscopy. The botanical origin's effect on the physicochemical characteristics of honey was studied to highlight the most valuable plant source of honey. Except for antioxidant activity, the moisture, ash, electrical conductivity (EC), pH, free acidity (FA), total sugar content (TSC), hydroxymethylfurfural (HMF), total phenolic (TPC), tannin (TTC), and flavonoid content (TFC) were significantly influenced by the botanical origin of the honey. The results showed that sunflower honey had the highest moisture (15.53%), free acidity (16.67 mEq kg^-1), electrical conductivity (483.92 µS cm^-1), phenolics (167.59 mg GAE 100 g^-1), and flavonoids (19.00 mg CE 100 g^-1), whereas multifloral honey presented the highest total sugar content (69.64 g Glu 100 g^-1). The highest HMF content was found in linden honey (33.94 mg kg^-1). The HMF contents of all tested honey were within the standard recommended limit, and they confirmed that the tested honey was free of any heat treatment. All five types of tested honey presented a safe moisture content for storage and consumption (12.21-18.74%). The honey's free acidity was in the range of 4.00 to 25.00 mEq kg^-1; this indicated the freshness of the samples and the absence of any fermentation processes in the tested honey. Honey with a total sugar content over 60% (except for linden honey, with 58.05 g glucose 100 g^-1) showed the characteristic of nectar-derived honey. The elevated antioxidant activity of honey was correlated with its high moisture, flavonoids, and HMF, whereas the tannins and HMF were positively correlated with ash and electrical conductivity. The higher content of phenolics, flavonoids, and tannins was correlated with higher free acidity. The chemometric method, coupled with ATR-FTIR spectra, revealed a clear separation between linden honey from acacia, multifloral, and sunflower honey.

Lifestyle Changes during the SARS-CoV-2 Pandemic as Predictors of BMI Changes among Men and Women in Poland

BACKGROUND

Social isolation during the SARS-CoV-2 pandemic affected people's body weight, therefore, this study was designed to evaluate the association between lifestyle elements and the change in BMI during lockdown.

METHODS

This retrospective observational study involved 290 questionnaires completed by adult participants divided into three groups according to BMI change during isolation. The structured questionnaire included a general description of the study objective and collected data regarding sociodemographics, anthropometrics, physical activity, sedentary behaviour, sleep duration, and food intake pre- and during COVID-19 lockdown.

RESULTS

A decrease or increase in BMI was found in 23.6% and 47.8% of women and 18.5% and 42.6% of men, respectively. Among those who lost weight, 46.5% of women and 40% of men followed a diet of their own choice, 30.2% of women and 25% of men changed their product mix and reduced their intake, 40% of men stopped eating outside the home. An increase in BMI was associated with increased food intake (32.2% of women and 28.3% of men), increased sleep duration on weekdays (49.2% of women and 43.5% of men) and, in more than 50% of subjects, decreased physical activity. In women, increased BMI was associated with the highest frequency of snacking (p = 0.0003), the highest intake of sweets (p = 0.0021), and in men with the highest intake of alcohol (p = 0.0017).

CONCLUSIONS

The observed changes in BMI during social isolation were the result of lifestyle modifications including dietary behaviour and differed by gender.

Characterization of anthocyanin accumulation, nutritional properties, and postharvest attributes of transgenic purple tomato

Anthocyanins are natural pigments with diverse physiological roles and protective effects, but most tomatoes produce little. In this study, the anthocyanin characteristics, nutritional properties, and postharvest attributes of purple tomato (SlMYB75-OE) obtained by overexpression of SlMYB75 gene were first analyzed. Compared to wild-type (WT), eight monomeric anthocyanins were newly produced by overexpression of SlMYB75, and further study demonstrated the expression of dihydroflavonol-4-reductase (SlDFR) and two UDP-glycosyltransferase (SlUGTs) genes was activated by SlMYB75. The contents of sugars (sucrose, glucose, and fructose) and citric acid content in SlMYB75-OE were higher and lower, respectively, than in WT. In addition, FRAP and DPPH assays indicated SlMYB75-OE had higher antioxidant capacity, when compared to WT. Moreover, SlMYB75-OE exhibited a longer shelf life and stronger resistance to Botrytis cinerea than WT, and this characteristic was positively correlated with anthocyanin content. These results help to clarify the function of SlMYB75 and provide a reference for tomato breeding.

Exploring Consumers' Preferences and Attitudes to Honey: Generation Approach in Slovakia

Honey is popular among consumers for its composition and healing properties. The aim of the paper is to study the differences in honey preferences across various age generations in Slovakia. The study is based on primary data obtained by conducting an online questionnaire survey on a sample of 1850 Slovak consumers of honey in 2022. Multiple correspondence analyses and non-parametric tests were applied to study the differences in preferences across selected age cohorts (Generation Z, Generation Y, Generation X and Silver Generation). The results show that Silver Generation tends to consume honey due to its nutritional values and prefers to consume monofloral honey of a dark colour, while Generation Z does not use honey in cosmetics or consume it due to its nutritional values and are inclined to prefer polyfloral honey. The utilisation of honey in cosmetics was associated mostly with Generation X. Younger consumers (Generation Z and Generation Y) have a very low awareness of creamed honey and honey with additions in comparison to Silver Generation or Generation X. In addition, the results reveal that propolis, royal jelly and bee pollen were the most attractive additions for honey across all age cohorts in Slovakia, while spirulina and chilli were the least attractive additions.

Psyllium is a natural nonfermented gel-forming fiber that is effective for weight loss: A comprehensive review and meta-analysis

BACKGROUND

Psyllium is a natural, predominantly soluble fiber that forms a viscous gel when hydrated and is not digested or fermented. In the small intestine, psyllium gel increases chyme viscosity, slowing the degradation and absorption of nutrients. Psyllium has a significant effect in patients with metabolic syndrome and type-2 diabetes on glycemic control, while lowering serum cholesterol in hypercholesterolemic patients. Some randomized controlled studies have shown that psyllium also facilitates weight loss in overweight and obese participants.

OBJECTIVES

A comprehensive review and meta-analysis assessing psyllium's impact on body weight, body mass index (BMI), and waist circumference in overweight and obese participants.

DATA SOURCES

A comprehensive search was performed (Medline, Scopus, Cochrane Database) through March 21, 2022, using search terms to identify randomized, controlled, clinical studies designed to assess weight loss in overweight and obese participants over at least 2 months. Data were analyzed using the inverse variance method with random effects models.

CONCLUSIONS

Six studies meeting inclusion criteria were identified (total n = 354). The meta-analysis showed that psyllium, dosed just before meals (mean dose 10.8 g/day, mean duration 4.8 months), was effective for decreasing body weight (MD = -2.1 kg [95% confidence interval [CI]: -2.6 to -1.6]; p < .001), BMI (MD = -0.8 kg/m2 [95% CI: -1.0 to -0.6]; p < .001) and waist circumference (MD = -2.2 cm [95% CI: -2.9 to -1.4]; p < .001) in overweight and obese populations.

IMPLICATIONS FOR PRACTICE

Gel-forming nonfermented psyllium fiber, dosed just before meals, is effective in facilitating weight loss in overweight and obese participants.

Nutrition as prevention for improved cancer health outcomes: a systematic literature review

BACKGROUND

Among adults with cancer, malnutrition is associated with decreased treatment completion, more treatment harms and use of health care, and worse short-term survival. To inform the National Institutes of Health Pathways to Prevention workshop, "Nutrition as Prevention for Improved Cancer Health Outcomes," this systematic review examined the evidence for the effectiveness of providing nutrition interventions before or during cancer therapy to improve outcomes of cancer treatment.

METHODS

We identified randomized controlled trials enrolling at least 50 participants published from 2000 through July 2022. We provide a detailed evidence map for included studies and grouped studies by broad intervention and cancer types. We conducted risk of bias (RoB) and qualitative descriptions of outcomes for intervention and cancer types with a larger volume of literature.

RESULTS

From 9798 unique references, 206 randomized controlled trials from 219 publications met the inclusion criteria. Studies primarily focused on nonvitamin or mineral dietary supplements, nutrition support, and route or timing of inpatient nutrition interventions for gastrointestinal or head and neck cancers. Most studies evaluated changes in body weight or composition, adverse events from cancer treatment, length of hospital stay, or quality of life. Few studies were conducted within the United States. Among intervention and cancer types with a high volume of literature (n = 114), 49% (n = 56) were assessed as high RoB. Higher-quality studies (low or medium RoB) reported mixed results on the effect of nutrition interventions across cancer and treatment-related outcomes.

CONCLUSIONS

Methodological limitations of nutrition intervention studies surrounding cancer treatment impair translation of findings into clinical practice or guidelines.

The effects of melissa officinalis on depression and anxiety in type 2 diabetes patients with depression: a randomized double-blinded placebo-controlled clinical trial

BACKGROUND

Depression is more common in diabetic patients, with a 1.5-fold increased risk of death.Melissa officinalis (M. officinalis) have anti-diabetic and anti-depression activities. The study aimed to determine the efficacy of M. officinalis extract on depression, anxiety, and sleep quality in patients with type 2 diabetes with depressive symptoms.

METHODS

In this double-blind clinical trial, 60 volunteer patients (age range 20-65 years) with type 2 diabetes mellitus with symptoms of depression were randomized into the intervention (received 700 mg/day hydroalcoholic extract; n = 30) or control group (received 700 mg/day toasted flour; n = 30). Dietary intake, physical activity, anthropometric indices, FBS (Fasting blood sugar), hs-CRP(High-sensitivity C-reactiveprotein), depression, anxiety, and sleep quality were determined at the beginning and end of the study. Depression and anxiety were assessed by Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI), respectively; sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI).

RESULTS

Sixty participants received M. officinalis extract or placebo, of which 44 patients completed the 12-week double-blind clinical trial. After 12-week the mean change of depression and anxiety scores were statistically significant between the two groups (p < 0.001 and p = 0.04, respectively), but no significant differences were observed in FBS, hs-CRP, anthropometric indices, sleep quality, and blood pressure.In the intervention group, there was a significant decrease in depression and anxiety severity(p < 0.001 and p = 0.01, respectively) at the end of the study compared to the baseline.

TRIAL REGISTRATION

All protocols in this study were followed in accordance with the Helsinki Declaration (1989 revision). Ethical approval for this study was obtained from the Iran University of Medical Sciences Ethics committee (IR.IUMS.FMD.REC 1396.9413468004; research.iums.ac.ir). The study was registered at the Iranian Registry of Clinical Trials (IRCT201709239472N16); Registration date: 09/10/2017.

The effects of melissa officinalis on depression and anxiety in type 2 diabetes patients with depression: a randomized double-blinded placebo-controlled clinical trial

BACKGROUND

Depression is more common in diabetic patients, with a 1.5-fold increased risk of death.Melissa officinalis (M. officinalis) have anti-diabetic and anti-depression activities. The study aimed to determine the efficacy of M. officinalis extract on depression, anxiety, and sleep quality in patients with type 2 diabetes with depressive symptoms.

METHODS

In this double-blind clinical trial, 60 volunteer patients (age range 20-65 years) with type 2 diabetes mellitus with symptoms of depression were randomized into the intervention (received 700 mg/day hydroalcoholic extract; n = 30) or control group (received 700 mg/day toasted flour; n = 30). Dietary intake, physical activity, anthropometric indices, FBS (Fasting blood sugar), hs-CRP(High-sensitivity C-reactiveprotein), depression, anxiety, and sleep quality were determined at the beginning and end of the study. Depression and anxiety were assessed by Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI), respectively; sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI).

RESULTS

Sixty participants received M. officinalis extract or placebo, of which 44 patients completed the 12-week double-blind clinical trial. After 12-week the mean change of depression and anxiety scores were statistically significant between the two groups (p < 0.001 and p = 0.04, respectively), but no significant differences were observed in FBS, hs-CRP, anthropometric indices, sleep quality, and blood pressure.In the intervention group, there was a significant decrease in depression and anxiety severity(p < 0.001 and p = 0.01, respectively) at the end of the study compared to the baseline.

TRIAL REGISTRATION

All protocols in this study were followed in accordance with the Helsinki Declaration (1989 revision). Ethical approval for this study was obtained from the Iran University of Medical Sciences Ethics committee (IR.IUMS.FMD.REC 1396.9413468004; research.iums.ac.ir). The study was registered at the Iranian Registry of Clinical Trials (IRCT201709239472N16); Registration date: 09/10/2017.

Hazard characterisation for significant mycotoxins in food

This review updates the current status of activities related to hazard characterisation for mycotoxins, with special reference to regulatory work accomplished within the European Union. Because the relevant information on these topics is widely scattered in the scientific literature, this review intends to provide a condensed overview on the most pertinent aspects. Human health risk assessment is a procedure to estimate the nature and potential for harmful effects of mycotoxins on human health due to exposure to them via contaminated food. This assessment involves hazard identification, hazard characterisation, exposure assessment, and risk characterisation. Mycotoxins covered in this review are aflatoxins, ochratoxin A, cyclopiazonic acid, citrinin, trichothecenes (deoxynivalenol, nivalenol, T-2, and HT-2 toxins), fumonisins, zearalenone, patulin, and ergot alkaloids. For mycotoxins with clear genotoxic/carcinogenic properties, the focus is on the margin of exposure approach. One of its goals is to document predictive characterisation of the human hazard, based on studies in animals using conditions of low exposure. For the other, non-genotoxic toxins, individual 'no adverse effect levels' have been established, but structural analogues or modified forms may still complicate assessment. During the process of hazard characterisation, each identified effect is assessed for human relevance. The estimation of a 'safe dose' is the hazard characterisation endpoint. The final aim of all of these activities is to establish a system, which is able to minimise and control the risk for the consumer from mycotoxins in food. Ongoing research on mycotoxins constantly comes up with new findings, which may have to be implemented into this system.

Healthier Oils: A New Scope in the Development of Functional Meat and Dairy Products: A Review

In the present day, it has been widely established that a high intake of animal fat that contains a high content of saturated fatty acids may cause several life-threatening diseases, including obesity, diabetes-type 2, cardiovascular diseases, as well as several types of cancer. In this context, a great number of health organizations and government agencies have launched campaigns to reduce the saturated fat content in foods, which has prompted the food industry, which is no stranger to this problem, to start working to develop foods with a lower fat content or with a different fatty acid profile. Nevertheless, this is not an easy task due to the fact that saturated fat plays a very important role in food processing and in the sensorial perception of foods. Actually, the best way to replace saturated fat is with the use of structured vegetable or marine oils. The main strategies for structuring oils include pre-emulsification, microencapsulation, the development of gelled emulsions, and the development of oleogels. This review will examine the current literature on the different (i) healthier oils and (ii) strategies that will be potentially used by the food industry to reduce or replace the fat content in several food products.

Adherence to the Mediterranean Diet in Women and Reproductive Health across the Lifespan: A Narrative Review

The Mediterranean diet (MD) has been previously proven to have various health-related benefits; however, its effect on women's reproductive health over a lifespan is yet to be summarized. This study aimed to summarize the evidence-based knowledge regarding the association between the MD and selected reproductive health outcomes. By searching PubMed, ScienceDirect, and Google Scholar databases, as well as reference lists, 21 studies were included in this narrative review. The available evidence was very limited; however, there is some suggestion that higher adherence to the MD may be positively associated with a lower risk of early age menarche (1 study) and shorter menstrual cycles (1 study), but is unrelated to dysmenorrhea (1 study). Moreover, no study to date has examined the relationship between the MD and the onset age of natural menopause. Considering reproductive health diseases, there was limited evidence that a higher adherence to the MD was associated with a lower risk of premenstrual syndrome (1 study), an improvement in sexual health and a lower prevalence of sexual dysfunction (3 studies), and an improvement in the general condition of with endometriosis and the pain they can experience (1 study). The largest number of studies were found for polycystic ovarian syndrome (PCOS; 7 studies) and infertility (6 studies). Results showed that a higher adherence to the MD was associated with a lower risk of infertility, while results for PCOS were unclear, but mostly indicated a beneficial trend. Further investigations are necessary to establish the role of adherence to the MD in reproductive health maintenance and its possible role in the prevention and treatment of reproductive health diseases in women.

Polyphenols in twenty cultivars of blue honeysuckle (Lonicera caerulea L.): Profiling, antioxidant capacity, and α-amylase inhibitory activity

The polyphenols extracted from 20 blue honeysuckle cultivars were comprehensively characterized and quantified by HPLC-DAD and HPLC-ESI-QTOF-MS² analyses and evaluated for antioxidant capacity (ABTS, DPPH, FRAP) and α-amylase inhibitory activity. The 17 anthocyanins and 59 non-anthocyanin phenolics were characterized. Among them, cyanidin-3-glucoside, quercetin-3-galactoside, myricetin-3-galactoside, and 3-caffeoylquinic acid were the major polyphenols. These polyphenols not only contributed to the antioxidant capacity, but were also good α-amylase inhibitors. 'Lanjingling' showed the strongest antioxidant capacity evaluated by FRAP, while 'CBS-2' and '14-13-1' showed the strongest antioxidant capacity evaluated by ABTS and DPPH. All the twenty cultivars showed α-amylase inhibitory activity, and the IC₅₀ values ranged from 0.12 ± 0.01 to 0.69 ± 0.02 mg/mL. 'Lanjingling' showed the most potent α-amylase inhibitory activity. Additionally, principal component analysis indicated that Lonicera. caerulea subsp. emkuyedao bred in Japan differed markedly in phenolics and bioactivity compared to the other four subspecies bred in China and Russia.

Influence of different lactic acid bacteria strains and milling process on the solid-state fermented green and red lentils (Lens culinaris L.) properties including gamma-aminobutyric acid formation

The aim of this study was to evaluate the influence of lactic acid bacteria (LAB) strains (Lactiplantibacillus plantarum No.122 and Lacticaseibacillus casei No.210) and milling process on the solid-state fermented (for 24 h, at 30°C) green and red lentils (Lens culinaris L.) properties, chiefly pH, LAB viable counts, color coordinates, free amino acid (FAA) profile, γ-aminobutyric acid (GABA) and biogenic amine (BA) concentrations, fatty acid (FA) and volatile compound (VC) profiles. Results showed that both of the tested LAB strains are suitable for the fermentation of lentils: pH of fermented lentils was <4.5 and LAB viable counts >8.0 log10 colony-forming units (CFU)/g. A very strong negative correlation was found (r = -0.973, p ≤ 0.0001) between LAB counts and pH of the samples. Also, fermentation and milling process were significant factors toward color coordinates of the lentils. In most of the cases, solid-state fermentation (SSF) increased essential FAA content in lentils; however, some of the non-essential FAA content was reduced. SSF significantly increased GABA concentration in lentils and milling process was a significant factor on GABA content of the samples (p ≤ 0.05). The main BA in lentils was spermidine, and SSF decreased their total BA content (34.8% on average in red lentils and 39.9% on average in green lentils). The main FA in lentils were linoleic and oleic. The main VC in lentils were hexanal, 1-hexanol, hexanoic acid, D-limonene and (E)-2-nonen-1-ol. Furthermore, most of the VC showed significant correlations with pH of lentil samples, LAB counts and FA content. Finally, the LAB strain used for fermentation and the milling process of lentils are significant factors for most of the analyzed parameters in lentil. Moreover, despite the higher GABA concentration found in green non-milled SSF lentils, application of combined milling and SSF is recommended because they showed the lowest BA content in addition to higher essential FAA and GABA concentrations.

The Importance of Natural Antioxidants in Female Reproduction

Oxidative stress (OS) has an important role in female reproduction, whether it is ovulation, endometrium decidualization, menstruation, oocyte fertilization, or development andimplantation of an embryo in the uterus. The menstrual cycle is regulated by the physiological concentration of reactive forms of oxygen and nitrogen as redox signal molecules, which trigger and regulate the length of individual phases of the menstrual cycle. It has been suggested that the decline in female fertility is modulated by pathological OS. The pathological excess of OS compared to antioxidants triggers many disorders of female reproduction which could lead to gynecological diseases and to infertility. Therefore, antioxidants are crucial for proper female reproductive function. They play a part in the metabolism of oocytes; in endometrium maturation via the activation of antioxidant signaling pathways Nrf2 and NF-κB; and in the hormonal regulation of vascular action. Antioxidants can directly scavenge radicals and act as a cofactor of highly valuable enzymes of cell differentiation and development, or enhance the activity of antioxidant enzymes. Compensation for low levels of antioxidants through their supplementation can improve fertility. This review considers the role of selected vitamins, flavonoids, peptides, and trace elements with antioxidant effects in female reproduction mechanisms.

Use of the Single Cell Gel Electrophoresis Assay for the Detection of DNA-protective Dietary Factors: Results of Human Intervention Studies

The single cell gel electrophoresis technique is based on the measurement of DNA migration in an electric field and enables to investigate via determination of DNA-damage the impact of foods and their constituents on the genetic stability. DNA-damage leads to adverse effects including cancer, neurodegenerative disorders and infertility. In the last 25 years approximately 90 human intervention trials have been published in which DNA-damage, formation of oxidized bases, alterations of the sensitivity towards reactive oxygen species and chemicals and of repair functions were investigated with this technique. In approximately 50% of the studies protective effects were observed. Pronounced protection was found with certain plant foods (spinach, kiwi fruits, onions), coffee, green tea, honey and olive oil. Also diets with increased contents of vegetables caused positive effects. Small amounts of certain phenolics (gallic acid, xanthohumol) prevented oxidative damage of DNA; with antioxidant vitamins and cholecalciferol protective effects were only detected after intake of doses that exceed the recommended daily uptake values. The evaluation of the quality of the studies showed that many have methodological shortcomings (lack of controls, no calibration of repair enzymes, inadequate control of the compliance and statistical analyses) which should be avoided in future investigations.

The Impact of the ENDORSE Digital Weight Management Program on the Metabolic Profile of Children and Adolescents with Overweight and Obesity and on Food Parenting Practices

Childhood obesity is a serious public health problem worldwide. The ENDORSE platform is an innovative software ecosystem based on Artificial Intelligence which consists of mobile applications for parents and health professionals, activity trackers, and mobile games for children. This study explores the impact of the ENDORSE platform on metabolic parameters associated with pediatric obesity and on the food parenting practices of the participating mothers. Therefore, the metabolic parameters of the 45 children (mean age: 10.42 years, 53% girls, 58% pubertal, mean baseline BMI z-score 2.83) who completed the ENDORSE study were evaluated. The Comprehensive Feeding Practices Questionnaire was used for the assessment of food parenting practices. Furthermore, regression analysis was used to investigate possible associations between BMI z-score changes and changes in metabolic parameters and food parenting practices. Overall, there was a statistically significant reduction in glycated hemoglobin (mean change = −0.10, p = 0.013), SGOT (mean change = −1.84, p = 0.011), and SGPT (mean change = −2.95, p = 0.022). Emotional feeding/food as reward decreased (mean change −0.21, p = 0.007) and healthy eating guidance increased (mean change = 0.11, p = 0.051). Linear regression analysis revealed that BMI z-score change had a robust and significant correlation with important metabolic parameters: HOMA-IR change (beta coefficient = 3.60, p-value = 0.046), SGPT change (beta coefficient = 11.90, p-value = 0.037), and cortisol change (beta coefficient = 9.96, p-value = 0.008). Furthermore, healthy eating guidance change had a robust negative relationship with BMI z-score change (beta coefficient = −0.29, p-value = 0.007). Conclusions: The Endorse digital weight management program improved several metabolic parameters and food parenting practices.

Synbiotics as Supplemental Therapy for the Alleviation of Chemotherapy-Associated Symptoms in Patients with Solid Tumours

Chemotherapy is still the first line of treatment for most cancer patients. Patients receiving chemotherapy are generally prone to infections, which result in complications, such as sepsis, mucositis, colitis, and diarrhoea. Several nutritional approaches have been trialled to counter the chemotherapy-associated side effects in cancer patients, but none have yet been approved for routine clinical use. One of the approaches to reduce or avoid chemotherapy-associated complications is to restore the gut microbiota. Gut microbiota is essential for the healthy functioning of the immune system, metabolism, and the regulation of other molecular responses in the body. Chemotherapy erodes the mucosal layer of the gastrointestinal tract and results in the loss of gut microbiota. One of the ways to restore the gut microbiota is through the use of probiotics. Probiotics are the ‘good’ bacteria that may provide health benefits if consumed in appropriate amounts. Some studies have highlighted that the consumption of probiotics in combination with prebiotics, known as synbiotics, may provide better health benefits when compared to probiotics alone. This review discusses the different nutritional approaches that have been studied in an attempt to combat chemotherapy-associated side effects in cancer patients with a particular focus on the use of pre-, pro- and synbiotics.

Recent Innovations in Non-dairy Prebiotics and Probiotics: Physiological Potential, Applications, and Characterization

Non-dairy sources of prebiotics and probiotics impart various physiological functions in the prevention and management of chronic metabolic disorders, therefore nutraceuticals emerged as a potential industry. Extraction of prebiotics from non-dairy sources is economical and easily implemented. Waste products during food processing, including fruit peels and fruit skins, can be utilized as a promising source of prebiotics and considered "Generally Recognized As Safe" for human consumption. Prebiotics from non-dairy sources have a significant impact on gut microbiota and reduce the population of pathogenic bacteria. Similarly, next-generation probiotics could also be isolated from non-dairy sources. These sources have considerable potential and can give novel strains of probiotics, which can be the replacement for dairy sources. Such strains isolated from non-dairy sources have good probiotic properties and can be used as therapeutic. This review will elaborate on the potential non-dairy sources of prebiotics and probiotics, their characterization, and significant physiological potential.

Prevalence and economic cost of malnutrition in Italy: A systematic review and metanalysis from the Italian Society of Artificial Nutrition and Metabolism (SINPE)

OBJECTIVES

Disease-related malnutrition (DRM) is a major public health issue with dramatic consequences on outcomes. However, in Italy a comprehensive and updated overview on national prevalence, in both the adult and pediatric populations, and its burden on the health care environment, is missing. The aim of this systematic literature review and meta-analysis was to identify and summarize the available evidence regarding the prevalence of DRM in Italy from pediatric to adult and older ages, and to project its global costs on the health care system.

METHODS

We performed a systematic literature search for articles on epidemiology of DRM in Italy published up to June 2021. Studies reporting data on the prevalence of DRM in community-dwelling individuals with chronic diseases, nursing home patients, and hospitalized patients (medical, surgery, and oncology patients), were selected for inclusion. Methodological quality of the studies was assessed by two independent reviewers using published criteria. An epidemiologic meta-analysis to obtain an aggregate estimate of prevalence of DRM was performed and a model for estimating the cost of illness, based on the application of epidemiologic results to official national hospitalization data, and attribution of relevant unit costs in the national context was constructed.

RESULTS

Sixty-seven studies reporting on the prevalence of DRM in Italian populations were included in the final selection; meta-analytical pooling yields mean prevalence estimates of about 50% and 30% in adult and pediatric hospitalized populations, respectively, with even higher findings for residents of long-term care facilities. Modeled projections of DRM-attributable yearly economic effects on the Italian health care system exceed 10 billion € in base case analysis, with the most optimistic estimate still exceeding 2.5 billion €.

CONCLUSION

Although comparable in magnitude to data from previous studies in analogous international settings, the diffusion and effects of DRM in the Italian setting is impressive. Increased awareness of these data and proactive fostering of clinical nutrition services are warranted, as prompt identification and treatment of malnutrition have been shown to effectively improve clinical and economic results.

The effects of guar gum supplementation on glycemic control, body mass and blood pressure in adults: A GRADE-assessed systematic review and meta-analysis of randomized clinical trials

BACKGROUND

This systematic review and meta-analysis sought to evaluate the effects ofguar gum supplementation on glycemic control, blood pressure, and body mass in adults.

METHODS

Relevant studies were obtained by searching the PubMed, SCOPUS, Embase, and Web of Science databases (from inception to January 2022). Weighted mean differences (WMD) and 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity, sensitivity analysis, and publication bias were reported using standard methods.

RESULTS

Pooled analysis of 14 randomized controlled trials (RCTs) revealed that guar gum supplementation led to significant reductions in hemoglobin A1c (HbA1c) (WMD: -0.47 mg/dL, 95% CI: -0.75, -0.18, p = 0.001). However, there was no effect on fasting blood sugar (FBS), systolic and diastolic blood pressure, and body mass among adults in comparison with the control group. A subgroup analysis demonstrated that intervention in patients with type 2 diabetes (T2DM), and high supplementation dosages (>15 g/d) significantly decreased FBS concentrations, but not in other subgroups.

CONCLUSION

Guar gum supplementation may yield a beneficial effect on glycemic control in T2DM patients. However, the extant clinical trials, thus far, are not sufficient enough to form guidelines for clinical practice.

Clinical Impact of Enteral Protein Nutritional Therapy on Patients with Obesity Scheduled for Bariatric Surgery: A Focus on Safety, Efficacy, and Pathophysiological Changes

BACKGROUND

Ketogenic diet-induced weight loss before bariatric surgery (BS) has beneficial effects on the reduction in the liver volume, metabolic profile, and intra- and post-operative complications. However, these beneficial effects can be limited by poor dietary adherence. A potential solution in patients showing a poor adherence in following the prescribed diet could be represented by enteral nutrition strategies. To date, no studies describe the protocol to use for the efficacy and the safety of pre-operative enteral ketogenic nutrition-based dietary protocols in terms of weight reduction, metabolic efficacy, and safety in patients with obesity scheduled for BS.

AIMS AND SCOPE

To assess the clinical impact, efficacy, and safety of ketogenic nutrition enteral protein (NEP) vs. nutritional enteral hypocaloric (NEI) protocols on patients with obesity candidate to BS.

PATIENTS AND METHODS

31 NEP were compared to 29 NEI patients through a 1:1 randomization. The body weight (BW), body mass index (BMI), waist circumference (WC), hip circumference (HC), and neck circumference (NC) were assessed at the baseline and at the 4-week follow-up. Furthermore, clinical parameters were assessed by blood tests, and patients were asked daily to report any side effects, using a self-administered questionnaire.

RESULTS

Compared to the baseline, the BW, BMI, WC, HC, and NC were significantly reduced in both groups studied (p < 0.001). However, we did not find any significative difference between the NEP and NEI groups in terms of weight loss (p = 0.559), BMI (p= 0.383), WC (p = 0.779), and HC (p = 0.559), while a statistically significant difference was found in terms of the NC (NEP, -7.1% vs. NEI, -4%, p = 0.011). Furthermore, we found a significant amelioration of the general clinical status in both groups. However, a statistically significant difference was found in terms of glycemia (NEP, -16% vs. NEI, -8.5%, p < 0.001), insulin (NEP, -49.6% vs. NEI, -17.8%, p < 0.0028), HOMA index (NEP, -57.7% vs. NEI, -24.9%, p < 0.001), total cholesterol (NEP, -24.3% vs. NEI, -2.8%, p < 0.001), low-density lipoprotein (NEP, -30.9% vs. NEI, 1.96%, p < 0.001), apolipoprotein A1 (NEP, -24.2% vs. NEI, -7%, p < 0.001), and apolipoprotein B (NEP, -23.1% vs. NEI, -2.3%, p < 0.001), whereas we did not find any significative difference between the NEP and NEI groups in terms of aortomesenteric fat thickness (p = 0.332), triglyceride levels (p = 0.534), degree of steatosis (p = 0.616), and left hepatic lobe volume (p = 0.264). Furthermore, the NEP and NEI treatments were well tolerated, and no major side effects were registered.

CONCLUSIONS

Enteral feeding is an effective and safe treatment before BS, with NEP leading to better clinical results than NEI on the glycemic and lipid profiles. Further and larger randomized clinical trials are needed to confirm these preliminary data.

The ENDORSE Feasibility Study: Exploring the Use of M-Health, Artificial Intelligence and Serious Games for the Management of Childhood Obesity

Childhood obesity constitutes a major risk factor for future adverse health conditions. Multicomponent parent-child interventions are considered effective in controlling weight. Τhe ENDORSE platform utilizes m-health technologies, Artificial Intelligence (AI), and serious games (SG) toward the creation of an innovative software ecosystem connecting healthcare professionals, children, and their parents in order to deliver coordinated services to combat childhood obesity. It consists of activity trackers, a mobile SG for children, and mobile apps for parents and healthcare professionals. The heterogeneous dataset gathered through the interaction of the end-users with the platform composes the unique user profile. Part of it feeds an AI-based model that enables personalized messages. A feasibility pilot trial was conducted involving 50 overweight and obese children (mean age 10.5 years, 52% girls, 58% pubertal, median baseline BMI z-score 2.85) in a 3-month intervention. Adherence was measured by means of frequency of usage based on the data records. Overall, a clinically and statistically significant BMI z-score reduction was achieved (mean BMI z-score reduction -0.21 ± 0.26, p-value < 0.001). A statistically significant correlation was revealed between the level of activity tracker usage and the improvement of BMI z-score (-0.355, p = 0.017), highlighting the potential of the ENDORSE platform.

The Role of Dietary Antioxidants and Their Potential Mechanisms in Alzheimer’s Disease Treatment

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder associated with cognitive decline and characterized by amyloid-β plaques and neurofibrillary tau tangles. Although AD’s exact pathophysiology remains unclear, oxidative stress is known to play a role in the neurodegenerative process. Since no curative treatment exists, antioxidants represent a potential treatment for AD due to their ability to modulate oxidative stress. Therefore, this review aims to examine the impact of antioxidant supplementation and its potential mechanisms on cognitive function. The review primarily discusses research articles published between 2012 and 2022 reporting the results of clinical trials involving antioxidant supplementation on cognitive function in individuals with AD. Antioxidant supplementation included probiotics, selenium, melatonin, resveratrol, rosmarinic acid, carotenoids, curcumin, vitamin E, and coenzyme Q. While the studies included in this review did not provide much evidence for the beneficial role of antioxidant supplements on cognitive function in AD, the results varied from antioxidant to antioxidant and among trials examining the same antioxidant. Furthermore, many of the studies’ findings face several limitations, including short trial durations, small sample sizes, and a lack of diversity among study participants. As a result, more research is required to examine the impact of antioxidant supplementation on cognitive function in AD.

Going Vegan for the Gain: A Cross-Sectional Study of Vegan Diets in Bodybuilders during Different Preparation Phases

Numerous athletes compete at a high level without consuming animal products; although a well-planned vegan diet might be appropriate for all stages of the life cycle, a few elements need to be addressed to build a balanced plant-based diet for an athlete, particularly in bodybuilding, in which muscle growth should be maximised, as athletes are judged on their aesthetics. In this observational study, nutritional intakes were compared in a cohort of natural omnivorous and vegan bodybuilders, during two different phases of preparation. To this end, 18 male and female bodybuilders (8 vegans and 10 omnivores) completed a food diary for 5 days during the bulking and cutting phases of their preparation. A mixed-model analysis was used to compare macro- and micronutrient intakes between the groups in the two phases. Both vegans and omnivores behaved similarly regarding energy, carbohydrate, and fat intakes, but vegans decreased their protein intake during the cutting phase. Our results suggest that vegan bodybuilders may find difficulties in reaching protein needs while undergoing a caloric deficit, and they might benefit from nutritional professionals' assistance to bridge the gap between the assumed proteins and those needed to maintain muscle mass through better nutrition and supplementation planning.

Nutritional literacy levels of university academic and administrative staff: A cross-sectional study from Turkey

AIM

This study aimed to evaluate the nutritional literacy levels of university academic and administrative staff.

METHODS

Data were collected with a questionnaire including sociodemographic variables, some eating habits, and the Nutritional Literacy Assessment Tool of Adults. A total of 413 individuals, 211 women (51.1%) and 202 men (48.9%), aged 23-64 (mean: 37.41 ± 10.04 years), were included in the study. The data obtained were evaluated with the SPSS 25.0 statistical package program.

RESULTS

It was found that the nutritional literacy level of 18.15% of the participants is at the borderline, 81.85 are sufficient. Women's nutrition literacy scores are significantly higher than men's (p = 0.034). A significant relationship was found between nutritional literacy, socioeconomic status, and some eating habits (p < 0.05). The average daily water consumption of individuals with sufficient nutritional literacy is statistically significantly higher than those with borderline nutritional literacy (p < 0.001). It was determined that individuals with borderline nutritional literacy skipped meals more frequently (p < 0.05).

CONCLUSION

The present study suggests that nutritional literacy may be effective in developing healthy eating behaviors. The study's results can guide the determination of methods that will improve nutritional literacy and increase awareness in the future.

Association of diet quality indices with serum and metabolic biomarkers in participants of the ORISCAV-LUX-2 study

PURPOSE

Diet quality is a critical modifiable factor related to health, including the risk of cardiometabolic complications. Rather than assessing the intake of individual food items, it is more meaningful to examine overall dietary patterns. This study investigated the adherence to common dietary indices and their association with serum/metabolic parameters of disease risk.

METHODS

Dietary intakes of the general adult population (n = 1404, 25-79 years) were assessed by a validated food-frequency questionnaire (174 items). The French ANSES-Ciqual food composition database was used to compute nutrient intakes. Seven indicators were calculated to investigate participants' diet quality: the Alternative Healthy Eating Index (AHEI), Dietary Approaches to Stop Hypertension Score (DASH-S), Mediterranean Diet Score (MDS), Diet Quality Index-International (DQI-I), Dietary Inflammatory Index (DII), Dietary Antioxidant Index (DAI), and Naturally Nutrient-Rich Score (NNRS). Various serum/metabolic parameters were used in the validity and association analyses, including markers of inflammation, blood glucose, and blood lipid status.

RESULTS

Following linear regression models adjusted for confounders, the DASH-S was significantly associated with most metabolic parameters (14, e.g., inversely with blood pressure, triglycerides, urinary sodium, uric acid, and positively with serum vitamin D), followed by the DQI-I (13, e.g., total cholesterol, apo-A/B, uric acid, and blood pressure) and the AHEI (11, e.g., apo-A, uric acid, serum vitamin D, diastolic blood pressure and vascular age).

CONCLUSION

Food-group-based indices, including DASH-S, DQI-I, and AHEI, were good predictors for serum/metabolic parameters, while nutrient-based indices, such as the DAI or NNRS, were less related to biological markers and, thus, less suitable to reflect diet quality in a general population.

Risk Factors of Non-alcoholic Fatty Liver Disease in the Iranian Adult Population: A Systematic Review and Meta-analysis

Context: Non-alcoholic fatty liver disease (NAFLD) is progressing considerably worldwide. Identifying the risk factors of NAFLD is a critical step in preventing its progression. Methods: In November 2022, two independent researchers studied seven databases, including PubMed, ISI/WoS, ProQuest, Scopus, SID, Magiran, and Google Scholar, and reference list of relevant articles, searching studies that assessed NAFLD risk factors in the Iranian adult population. Heterogeneity between studies was assessed by Cochran’s test and its composition using I2 statistics. A random-effects model was used when heterogeneity was observed; otherwise, a fixed-effects model was applied. Egger’s regression test and Trim-and-Fill analysis were used to assess publication bias. Comprehensive Meta-analysis software (version 3) was used for the analyses of the present study. Results: The results of this study showed significant associations between NAFLD with age [n = 15, odds ratio (OR) = 2.12, 95% CI: 1.79 - 2.51], body mass index (n = 46, OR = 5.00, 95% CI: 3.34 - 7.49), waist circumference (n = 20, OR = 6.37, 95% CI: 3.25 - 12.48), waist-to-hip ratio (n = 17, OR = 4.72, 95% CI: 3.93 - 5.66), total cholesterol (n = 39, OR = 1.80, 95% CI: 1.52 - 2.13), high-density lipoprotein (n = 37, OR = 0.53, 95% CI: 0.44 - 0.65), low-density lipoprotein (n = 31, OR = 1.68, 95% CI: 1.38 - 2.05), triglyceride (n = 31, OR = 3.21, 95% CI: 2.67 - 3.87), alanine aminotransferase (n = 26, OR = 4.06, 95% CI: 2.94 - 5.62), aspartate aminotransferase (n = 27, OR = 2.16, 95% CI: 1.50 - 3.12), hypertension (n = 13, OR = 2.53, 95% CI: 2.32 - 2.77), systolic blood pressure (n = 13, OR = 1.83, 95% CI: 1.53 - 2.18), diastolic blood pressure (n = 14, OR = 1.80, 95% CI: 1.48 - 2.20), fasting blood sugar (n = 31,OR = 2.91, 95% CI: 2.11- 4.01), homeostatic model assessment for insulin resistance (n = 5, OR = 1.92, 95% CI: 1.48 - 2.59), diabetes mellitus (n = 15, OR = 3.04, 95% CI: 2.46 - 3.75), metabolic syndrome (n = 10, OR = 3.56, 95% CI: 2.79 - 4.55), and physical activity (n = 11, OR = 0.32, 95% CI: 0.24 - 0.43) (P < 0.05). Conclusions: In conclusion, several factors are significantly associated with NAFLD. However, anthropometric indices had the strongest relationship with NAFLD in the Iranian adult population.

Combined Effects of Domestication and Extraction Technique on Essential Oil Yield, Chemical Profiling, and Antioxidant and Antimicrobial Activities of Rosemary (Rosmarinus officinalis L.)

We aimed at comparing the effects of domestication and extraction technique on the chemical profiling and antioxidant and antimicrobial activities of Rosmarinus officinalis essential oil (ROEO). This was isolated from wild (WR) and cultivated rosemary (CR) using microwave-assisted extraction (ME) and Clevenger hydrodistillation (CH). Domestication was the main variability source in ROEO constituents, while yield was equally determined by domestication and extraction techniques. Our results revealed important variations, owing to domestication and isolation technique, in terms of ROEO yield (1.10–2.85%), major compounds: α-pinene (14.07–42.03%), camphene (2.26–8.19%), β-pinene (0.35–3.76%), α-terpinene (0.55–2.92%), p-cymene (1.22–4.18%), limonene (0.64–2.79%), 1,8-cineole (31.73–40.72%), β-myrcene (2.09–3.2%), linalool (0.22–1.94%), camphor (12.12–19.66%), borneol (0.53–1.67%), and α-terpineol (1.46–7.45%) as well as minimal inhibitory concentration (MIC, 6.17–15.50 μg/mL), and antioxidant activity (IC50, 2.61–8.58 mg/mL). WR performed better in terms of yield, limonene, cineole, camphor, MIC, and IC50, while the remaining compounds were better expressed in CR. ME displayed high records of ROEO traits except for limonene, camphor, and verbenone (better expressed in CH). Principal component analysis confirmed the obtained findings via the separation of WR, CR, and techniques through the first two components (over 93% of data variability). In conclusion, R. officinalis domestication results in differentiated effects on ROEO traits, fostering a better accumulation of some compounds but reducing yield of other compounds and therefore antioxidant along with antimicrobial activity. ME could be recommended as a green method for ROEO isolation since it was more efficient in terms of the investigated ROEO traits.

Associations between the human immune system and gut microbiome with neurodevelopment in the first 5 years of life: A systematic scoping review

The aim of this review was to map the literature assessing associations between maternal or infant immune or gut microbiome biomarkers and child neurodevelopmental outcomes within the first 5 years of life. We conducted a PRISMA-ScR compliant review of peer-reviewed, English-language journal articles. Studies reporting gut microbiome or immune system biomarkers and child neurodevelopmental outcomes prior to 5 years were eligible. Sixty-nine of 23,495 retrieved studies were included. Of these, 18 reported on the maternal immune system, 40 on the infant immune system, and 13 on the infant gut microbiome. No studies examined the maternal microbiome, and only one study examined biomarkers from both the immune system and the gut microbiome. Additionally, only one study included both maternal and infant biomarkers. Neurodevelopmental outcomes were assessed from 6 days to 5 years. Associations between biomarkers and neurodevelopmental outcomes were largely nonsignificant and small in effect size. While the immune system and gut microbiome are thought to have interactive impacts on the developing brain, there remains a paucity of published studies that report biomarkers from both systems and associations with child development outcomes. Heterogeneity of research designs and methodologies may also contribute to inconsistent findings. Future studies should integrate data across biological systems to generate novel insights into the biological underpinnings of early development.

Role of Probiotics and Synbiotics in Preventing Chemoradiotherapy-Associated Toxicity in Colorectal Cancer Patients: A Systematic Review

Background

Previous studies found that the use of probiotics may have a protective effect on chemotherapy-associated toxicity in cancer patients. A systematic review was conducted to evaluate the effect of probiotics and synbiotics on chemoradiotherapy-associated toxicity in colorectal cancer (CRC) patients.

Methods

A systematic review of randomized controlled trials (RCTs) was performed to assess the effect of probiotics and synbiotics in CRC patients undergoing chemotherapy. All RCTs in English, up to January 2021, were included through a literature search in Scopus, Google Scholar, PubMed (PMC Central, MEDLINE), ClinicalTrials.gov, and ProQuest databases. The impact of probiotics and synbiotics on the side effects associated with chemotherapy, radiotherapy, and chemoradiotherapy in CRC patients was evaluated. The quality of the RTCs was independently assessed by two reviewers. EndNote X8 software was used to manage the search results.

Results

Of the 904 identified articles, three studies finally met the inclusion criteria and were systematically reviewed. Two studies reported that patients who received probiotics had less abdominal discomfort and required less bowel toxicity-related hospital care. Although probiotic supplementation lowered radiation-associated diarrhea, it had no significant effect when anti-diarrheal drugs were used. Another study reported that synbiotic supplementation improved quality of life and marginally reduced diarrhea and serum levels of high-sensitivity C-reactive protein (hs-CRP) and matrix metalloproteinase (MMP-2 and MMP-9).

Conclusion

Probiotics and synbiotics do not have a significant effect on reducing chemotherapy-associated toxicity and diarrhea in CRC patients. These findings should be substantiated by further RCTs with rigorous placebo-controlled studies.

Mediators of dietary diversity score (DDS) on NAFLD in Iranian adults: a structural equation modeling study

BACKGROUND

The current study examines the association between the Dietary Diversity Score (DDS) and nonalcoholic fatty liver disease (NAFLD) in Iranian adults using structural equation modeling (SEM).

METHODS

A sample of 3220 adults from the Amol Cohort Study was recruited for this cross-sectional study. Dietary acid load (DAL) and DDS were calculated using the data obtained from a validated food frequency questionnaire. Anthropometric parameters, blood pressure, biochemical measurements, and liver ultrasonography were evaluated according to standard protocols.

RESULTS

DDS was neither directly nor indirectly associated with a greater prevalence of NAFLD. In the second model (DDS sub-scores model), the association of DAL with NAFLD was fully mediated through waist circumference (WC) (of DAL to WC: β = 0.14, P < 0.0001, and of WC to NAFLD: β = 0.50, P < 0.001). Vegetable and fruit diversity scores had a significant negative indirect relationship with NAFLD prevalence through DAL (β = -0.06, P = 0.001, β = -0.10, P < 0.001, respectively). Meat diversity score was positively associated with NAFLD prevalence in a full mediational process through DAL (β = 0.12, P < 0.001). The SEM fit indices suggested a reasonably adequate fit of the data to the DDS model (Χ2/df = 4.76, GFI = 0.98, AGFI = 0.97, IFI = 0.97, CFI = 0.97, RMSEA = 0.03, and SRMR = 0.02) and its sub-scores model (Χ²/df = 4.72, GFI = 0.98, AGFI = 0.97, IFI = 0.95, CFI = 0.95, RMSEA = 0.03, and SRMR = 0.02).

CONCLUSION

Meat diversity and lack of vegetable and fruit diversity were indirectly associated with NAFLD prevalence through DAL and WC mediators. Interventions for NAFLD may be more successful if they target a lower intake of animal protein sources and dietary diversity, particularly vegetable and fruit diversity.

Chemical profiles and pharmacological attributes of Apis cerana indica beehives using combined experimental and computer-aided studies

The current study sought to determine the anxiolytic, antidepressant, and anti-inflammatory properties of distilled water-soluble extract of beehive (WSE-BH). Gas chromatography-mass spectrometry (GC-MS) studies were used to characterize the chemical compositions obtained from beehives extracted in water and methanol (also fractions). The GC-MS analysis identified 19 compounds in WSE-BH, including high total phenol and flavonoid contents, compared with the methanol extract (21 compounds), ethyl acetate fraction (9 compounds), and CCl₄ fraction (27 compounds). The oral administration of WSE-BH (50 and 150 mg/kg) showed significant anxiolytic activities assessed by time spent in (30.80% and 39.47%, respectively) and entry into (47.49% and 55.93%, respectively) the open arms of the elevated plus-maze (EPM). Only the 150 mg/kg dose resulted in a significant effect on the number of head-dipping events in the hole-board test (HBT) (40.2 ± 2.33; p < 0.01) vs. diazepam (64.33 ± 3.16; p < 0.001). Both the 50 and 150 mg/kg doses resulted in significant (p < 0.001) decreases in immobility in the forced swim test (FST) and tail suspensions test (TST), corresponding to the effect of fluoxetine. WSE-BH inhibited histamine-induced paw edema significantly beginning at 60 min, with the 150 mg/kg dose having the highest effect at 180 min. The current findings suggested that WSE-BH had anxiolytic, antidepressant, and anti-inflammatory properties.

A Comprehensive Review of Herbal Supplements Used for Persistent Symptoms Attributed to Lyme Disease

Context

Lyme disease is the most common, tick-borne disease in the USA. While most patients successfully recover with antibiotics, some patients experience persistent symptoms for months to years. Patients who attribute chronic symptoms to Lyme disease commonly use herbal supplements. The complexity, variability in dose and formulation, and lack of data for these herbal compounds make it difficult to assess their efficacy and safety.

Objective

This review examines the evidence for the antimicrobial activity, safety, and drug-drug interactions of 18 herbal supplements that patients commonly use for treatment of persistent symptoms attributed to Lyme disease.

Design

The research team performed a narrative review by searching the PubMed, Embase, Scopus, Natural Medicines databases, and NCCIH website. The search used the keywords for 18 herbal compounds: (1) andrographis (Andrographis paniculate), (2) astragalus (Astragalus propinquus), (3) berberine, (4) cat's claw bark (Uncaria tomentosa), (5) cordyceps (Cordyceps sinensis), (6) cryptolepis (Cryptolepis sanguinolenta), (7) Chinese skullcap (Scutellaria baicalensis), (8) garlic (Allium sativum), (9) Japanese knotwood (Polygonum cuspidatum), (10) reishi mushrooms (Ganoderma lucidum), (11) sarsaparilla (Smilax medica), (12) Siberian ginseng (Eleutherococcus senticosus), (13) sweet wormwood (Artemisia annua), (14) teasle root (Dipsacus fullonum), (15) lemon balm (Melissa officinalis), (16) oil of oregano (Origanum vulgare), (17) peppermint (Mentha x piperita), and (18) thyme (Thymus vulgaris). The team also searched for terms related to protocols, including Dr. Rawls' protocol and the Buhner protocol.

Setting

University of Maryland Medical Center, Baltimore MD.

Results

Seven of the 18 herbs reviewed had evidence for in-vitro activity against B. burgdorferi. These compounds included: (1) cat's claw (2) cryptolepis, (3) Chinese skullcap, (4) Japanese knotweed, (5) sweet wormwood, (6) thyme, and (7) oil of oregano. With the exception of oil of oregano these compounds also have anti-inflammatory activity. In vivo data and clinical trials are lacking. Clinicians should be cautious as many of the identified compounds have drug interactions and additive effects that could lead to increased risks for bleeding, hypotension, and hypoglycemia.

Conclusions

Many of the herbs that alternative and integrative practitioners use to treat Lyme disease have anti-inflammatory effects that may contribute to patients' perceptions of symptomatic improvement. Some herbs have limited demonstrated anti-borrelial activity in vitro, but in-vivo data and clinical trial data is lacking. Further research is required to determine the efficacy, safety and appropriate use of these herbs for this patient population.

Comparative Study on Chemical Composition of Green and Black Table Olives Brines of the Endemic ''Sigoise'' Cultivar: Recovery of high-Added Values Compounds

The effluents derived from the processing of table olives stand for a serious environmental problem. The study aims to valorize the brine water of table olives at different stages of ripening (green and black) of the Algerian variety Sigoise of Bejaia (East) and Mascara (West). The physico-chemical characterization revealed that these samples display have a high acid pH and salinity. The comparative study of phenolic levels exhibited showed very significant differences between the brine waters of green olives from Bejaia and Mascara, while the brines of black olives presented showed comparable levels. A high strong antioxidant potential was confirmed by DPPH (CI₅₀ =0.35 μg/100 ml-0.50 μg/100 ml) and FRAP (CI₅₀ =626.89 μg/100 ml-875.54 μg/100 ml) tests. Chemical screening by HPLC-DAD of the four samples identified high concentrations of hydroxytyrosol (HT) (390.4 mg/100 ml-360.8 mg/100 ml) and tyrosol (202.2 mg/100 ml-101.4 mg/100 ml). This study provided a deeper insight into the phenolic profile and the antioxidant potential of these brines.

Cross-Sectional Analysis of Family Factors Associated with Lifestyle Habits in a Sample of Italian Primary School Children: The I-MOVE Project

The acquisition of healthy dietary and exercise habits during childhood is essential for maintaining these behaviors during adulthood. In early childhood, parents have a profound influence on a child's lifestyle pursuits, serving as both role models and decision-makers. The present study examines family factors as potential contributors to healthy lifestyle habits and their child's overall diet quality among a sample of primary school children. A secondary aim is to evaluate several aspects of diet quality using the Mediterranean adaptation of the Diet Quality Index-International (DQI-I). This cross-sectional study involved 106 children enrolled in a primary school located in Imola, Italy. Data were collected from October to December 2019 using an interactive tool used to assess parent characteristics, children's lifestyle, food frequency (ZOOM-8 questionnaire), and actigraph accelerometers to capture children's physical activity and sedentary behavior. Adherence to the Mediterranean Diet (expressed by KIDMED Index) was positively associated with fathers' educational level, parental sport participation, and the parent's overall nutritional knowledge. Higher mothers' educational level was inversely associated with children's leisure screen time. Parents' nutritional knowledge was positively related to children's average daily minutes of organized sport activities. The better score for DQI-I was for consumption adequacy, followed by variety and moderation. The lowest score was for overall balance. The present study reinforces the importance of family factors in young children's lifestyle choices, particularly their dietary, leisure time, and exercise habits.

Dietary Fatty Acids and Inflammation: Focus on the n-6 Series

Among the polyunsaturated fatty acids (PUFAs), those belonging to the n-3 (or ω3) series, i.e., alpha-linolenic (ALA), eicosapentaenoic (EPA), and docosahexaenoic (DHA) acids have been studied for decades from a pharma-nutritional viewpoint, namely in relation to cardiovascular health. More recent research is focusing on n-6 PUFAs, e.g., linoleic acid (LA), whose levels of consumption are much higher than those of n-3 and that cannot be used "pharmacologically". Perhaps because of this, the biological actions of n-6 PUFAs have not been investigated in details as those of their n-3 counterparts. However, an increasing body of evidence underscores their healthful actions on the cardiovascular system. Among the critiques to n-6 PUFAs and, particularly, LA there is the fact that they are precursors of pro-inflammatory eicosanoids. Hence, the hypothesis posits that we should reduce their intakes precisely to avoid increasing systemic, low-grade inflammation, i.e., one of the major etiological agents in degenerative diseases. In this narrative review, we address the issue of whether n-6 PUFAs are indeed pro-inflammatory, we discuss the most recent evidence of their role(s) in human health and prognosis, and we conclude that adequate intakes of n-6 fatty acids are associated with better cardiovascular health and child development.

Honey: A Promising Therapeutic Supplement for the Prevention and Management of Osteoporosis and Breast Cancer

Osteoporosis and breast cancer are serious diseases that have become a significant socioeconomic burden. There are biochemical associations between the two disorders in terms of the amended function of estrogen, receptor activator of nuclear factor kappa beta ligand, oxidative stress, inflammation, and lipid accumulation. Honey as a functional food with high antioxidant and anti-inflammatory properties can contribute to the prevention of various diseases. Its health benefits are mainly related to the content of polyphenols. This review aims to summarize the current knowledge from in vitro, animal, and human studies on the use of honey as a potential therapeutic agent for osteoporosis and breast cancer. Preclinical studies have revealed a beneficial impact of honey on both bone health (microstructure, strength, oxidative stress) and breast tissue health (breast cancer cell proliferation and apoptosis, tumor growth rate, and volume). The limited number of clinical trials, especially in osteoporosis, indicates the need for further research to evaluate the potential benefits of honey in the treatment. Clinical studies related to breast cancer have revealed that honey is effective in increasing blood cell counts, interleukin-3 levels, and quality of life. In summary, honey may serve as a prospective therapeutic supplement for bone and breast tissue health.

Demographic and Socioeconomic Factors Associated to Fruits and Vegetables Consumption in Elderly Europeans: A Systematic Review

Several epidemiological studies stress the association between a diet based on high fruits and vegetables intake and a better health condition. However, elderly Europeans cannot manage the recommended fruits and vegetables consumption. This systematic review aims to explore the main factors related to fruits and vegetables consumption in elderly Europeans. We conducted literature searches on Medline, Scopus, and Web of Science from inception to May 2022. Published articles including data related to certain fruits and vegetables consumption among elderly Europeans were selected. The New Castle-Ottawa Scale and National Heart, Lung, and Blood Institute tools were used for methodological quality assessment by two authors independently. A total of 60 articles were retrieved, and data from twenty-one high-quality cross-sectional studies and five moderate-to-high-quality cohort studies, including a total of 109,516 participants, were synthesized. Associated factors mostly analyzed were those relating to demographic and socioeconomic status, such as sex, age, marital status, educational level, and income. However, the findings show a high discrepancy. Some evidence suggests a possible positive association, while other evidence shows an inverse or no association at all. The relationship between demographic and socioeconomic factors with fruits and vegetables consumption is not at all clear. More epidemiological studies with an appropriate design and corresponding statistical methods are required.

Metabolomics-Based Profiling via a Chemometric Approach to Investigate the Antidiabetic Property of Different Parts and Origins of Pistacia lentiscus L

Pistacia lentiscus L. is a medicinal plant that grows spontaneously throughout the Mediterranean basin and is traditionally used to treat diseases, including diabetes. The aim of this work consists of the evaluation of the α-glucosidase inhibitory effect (i.e., antidiabetic activity in vitro) of different extracts from the leaves, stem barks and fruits of P. lentiscus harvested on mountains and the littoral of Tizi-Ouzou in Algeria. Metabolomic profiling combined with a chemometric approach highlighted the variation of the antidiabetic properties of P. lentiscus according to the plant's part and origin. A multiblock OPLS analysis showed that the metabolites most involved in α-glucosidase inhibition activity were mainly found in the stem bark extracts. The highest inhibitory activity was found for the stem bark extracts, with averaged inhibition percentage values of 84.7% and 69.9% for the harvested samples from the littoral and mountain, respectively. On the other hand, the fruit extracts showed a lower effect (13.6%) at both locations. The UHPLC-ESI-HRMS characterization of the metabolites most likely responsible for the α-glucosidase-inhibitory activity allowed the identification of six compounds: epigallocatechin(4a>8)epigallocatechin (two isomers), (epi)gallocatechin-3'-O-galloyl-(epi)gallocatechin (two isomers), 3,5-O-digalloylquinic acid and dihydroxy benzoic acid pentoside.

A Novel Symbiotic Formulation Reduces Obesity and Concomitant Metabolic Syndrome in Rats by Raising the Relative Abundance of Blautia

Obesity is regarded as an abnormal or excessive buildup of fat that may be bad for health and is influenced by a combination of intestinal flora, genetic background, physical activity level and environment. Symbiotic supplementation may be a realistic and easy therapy for the reversal of obesity and associated metabolic problems. In this study, we chose two Bifidobacterium species, three Lactobacilli species and four prebiotics to make a new symbiotic formulation. High or low doses of the symbiotic were administered to rats, and biochemical indicators were recorded to assess the biological effects in a high-fat-diet-induced rat model. The underlying mechanisms were explored by integrating 16S rRNA sequencing with an extensively targeted metabolome. High-dose symbiotic supplementation was effective in reducing obesity and concomitant metabolic syndrome. The high-dose symbiotic also significantly increased the abundance of Blautia, which was negatively correlated with taurocholic acid and the main differential metabolites involved in amino acid and bile acid metabolism. While the low-dose symbiotic had some therapeutic effects, they were not as strong as those at the high dose, demonstrating that the effects were dose-dependent. Overall, our novel symbiotic combination improved plasma glucose and lipid levels, shrunk adipocyte size, restored liver function, increased the abundance of Blautia and adjusted bile acid and amino acid metabolism.

Risk of obesity during a gluten-free diet in pediatric and adult patients with celiac disease: a systematic review with meta-analysis

CONTEXT

Obesity is a significant risk factor for many pathological conditions. Whether a gluten-free diet (GFD) is a risk factor for overweight or obesity remains controversial.

OBJECTIVE

The primary aim of this study was to assess the prevalence of body mass index (BMI) categories at disease presentation and the variation in BMI category from underweight/normal to overweight/obese and vice versa during a GFD.

DATA SOURCES

PubMed, Scopus, and Web of Science databases were searched through February 2021 for retrospective, cross-sectional, and prospective studies reporting BMI categories at disease diagnosis and during a GFD.

DATA EXTRACTION

Data were extracted by 2 reviewers independently. Disagreements were resolved by consensus; a third reviewer was consulted, if necessary. Risk of bias was assessed with the Cochrane ROBINS-I tool.

DATA ANALYSIS

Subgroup analysis based on age (pediatric/adult patients), study design (prospective, cross-sectional, retrospective), and duration of GFD was performed.. Forty-five studies were selected (7959 patients with celiac disease and 20 524 healthy controls). The mean BMI of celiac patients at presentation was significantly lower than that of controls (P < 0.001). During a GFD, the mean BMI increased significantly (mean difference = 1.14 kg/m2 [95%CI, 0.68-1.60 kg/m2]; I2 = 82.8%; P < 0.001), but only 9% of patients (95%CI, 7%-12%; I2 = 80.0%) changed from the underweight/normal BMI category to the overweight/obese category, while 20% (95%CI, 11%-29%; I2 = 85.8%) moved into a lower BMI category.

CONCLUSION

Most celiac patients had a normal BMI at presentation, although the mean BMI was significantly lower than that of controls. A GFD does not increase the risk of becoming overweight/obese, especially in children. The quality of several studies was suboptimal, with moderate or high overall risk of bias and heterogeneity.

In Vivo Anti-Alzheimer and Antioxidant Properties of Avocado (Persea americana Mill.) Honey from Southern Spain

There is growing evidence that Alzheimer's disease (AD) can be prevented by reducing risk factors involved in its pathophysiology. Food-derived bioactive molecules can help in the prevention and reduction of the progression of AD. Honey, a good source of antioxidants and bioactive molecules, has been tied to many health benefits, including those from neurological origin. Monofloral avocado honey (AH) has recently been characterized but its biomedical properties are still unknown. The aim of this study is to further its characterization, focusing on the phenolic profile. Moreover, its antioxidant capacity was assayed both in vitro and in vivo. Finally, a deep analysis on the pathophysiological features of AD such as oxidative stress, amyloid-β aggregation, and protein-tau-induced neurotoxicity were evaluated by using the experimental model C. elegans. AH exerted a high antioxidant capacity in vitro and in vivo. No toxicity was found in C. elegans at the dosages used. AH prevented ROS accumulation under AAPH-induced oxidative stress. Additionally, AH exerted a great anti-amyloidogenic capacity, which is relevant from the point of view of AD prevention. AH exacerbated the locomotive impairment in a C. elegans model of tauopathy, although the real contribution of AH remains unclear. The mechanisms under the observed effects might be attributed to an upregulation of daf-16 as well as to a strong ROS scavenging activity. These results increase the interest to study the biomedical applications of AH; however, more research is needed to deepen the mechanisms under the observed effects.

Perceived barriers, benefits, facilitators, and attitudes of health professionals towards type 2 diabetes management in Oujda, Morocco: a qualitative focus group study

BACKGROUND

In Morocco, the treatment of type 2 diabetes (T2D) is mainly focused on medication and only 2% of patients are coached towards a healthier lifestyle. In Oujda, Eastern Morocco the prevalence of T2D is 10.2%, and the current trend is alarming, especially for women. Therefore, the aim of this study is to explore healthcare professionals (HCP) views on the perceived barriers and benefits of an integrated care approach in primary healthcare centers (PHCCs) to T2D management in Oujda.

METHODS

A qualitative descriptive study using focus groups in 8 PHCCs. This resulted in a sample of 5 doctors and 25 nurses caring for diabetes patients. The transcripts of all conversations were coded to allow for thematic analysis.

RESULTS

The participants mentioned different barriers to an integrated approach to DM management:: excessive workload; poor reimbursement policy; lack of staff and equipment; interrupted drug supply; poor working environment; limited referral; gap in the knowledge of general practitioners; health beliefs; poverty; advanced age; gender; the use of psychotropic drugs. An integrated approach could be facilitated by simplified electronic records and referrals; uninterrupted free care; staff recruitment; continuous professional development; internships.

BENEFITS

structured care; promotion of care in PHCCs; empowerment of self-management.

CONCLUSION

HCP views reflect the urge to strengthen the management of T2D in PHCCs. There is a need for HCP with expertise in physical activity and nutrition to solve the current gap in the multidisciplinary integrated care approach. The specific local context in this Eastern Moroccan region, with limited resources and remote hard-to-reach rural areas, can contribute to patients' reluctance to change their lifestyles, and is a challenge to provide care in an efficient and sustainable manner. More research is needed to see how a patient-centered multidisciplinary approach to T2D management can help motivate patients in Morocco to change to a healthier lifestyle.

Global Dietary and Herbal Supplement Use during COVID-19-A Scoping Review

During the first year of the COVID-19 pandemic, the lack of cure and the intensity of the global spread raised a common awareness of health. The aim of this scoping review is to summarize dietary supplement use globally during first two years of the COVID-19 pandemic. A systematic search was conducted in December 2021 following PRISMA guidelines. PubMed, ERIC, and Scopus databases were searched, and 956 results were screened for eligibility. Fourteen cross-sectional studies from 11 countries and 3 continents were examined. All studies were large population surveys investigating healthy eating and supplement use during COVID-19. Vitamin C, vitamin D, zinc and multivitamins were the most widely reported, as well as natural/herbal products such as ginger and honey. The most common reason cited for supplements use was to strengthen immune system and to prevent infection of COVID-19. These studies reported that populations are relying on healthcare providers, family, friends, and social media to learn about supplement use. Future studies on the treatment of COVID-19 should include more evidence for supplement use.

The effect of gum consumption on blood pressure as a risk factor for coronary heart disease: A meta-analysis of controlled trials

Guar gum has been used in the management of hypercholesterolemia, constipation, weight loss, type 2 diabetes mellitus and hypertension. Our aim was to verify the hypothesis that Guar gum can be used as an alternative to pharmacological agents in the treatment of mild hypertension. Thus, we conducted a systematic review and meta-analysis to evaluate the effectiveness of Guar gum in reducing blood pressure. We searched the Cochrane Library, PubMed/Medline, Scopus and Google Scholar databases for studies published in the English language up to June 2020 which evaluated the effects of gum consumption on systolic blood pressure (SBP) and diastolic blood pressure (DBP). Nine randomized clinical trials with suitable comparison groups (placebo/control) reported SBP and DBP as outcome measures. These trials involved in total 640 participants. The overall results indicated that the consumption of gum resulted in a significant change in SBP (WMD: -1.190 mmHg, 95% CI: -2.011, -0.370) and DBP (WMD: -1.101 mmHg, 95% CI: -1.597, -0.605). Moreover, the greatest reduction in blood pressure was seen in patients with type 2 diabetes mellitus and metabolic syndrome who consumed Guar gum (WMD: -3.375 mmHg). In addition, there was a significant decrease in SBP if the gum dosage was > 15 g (WMD: -6.637 mmHg) and if the intervention duration was > 12 weeks (WMD: -1.668 mmHg). The results of the present dose-response meta-analysis support the employment of gum consumption in the reduction of SBP and DBP. Based on the sub-group analyses, we highlight that the greatest decrease in SBP was experienced if the gum dosage was > 15 g and when the intervention lasted > 12 weeks.

Mediterranean diet, physical activity, and family characteristics associated with cognitive performance in Italian primary school children: analysis of the I-MOVE project

Working memory (WM) is a multicomponent system that supports cognitive functioning. It has been linked to a wide variety of outcomes including academic success and general well-being. The present study examined the relations between adherence to the Mediterranean diet (MD) and WM among Italian children, adjusting for important parent characteristics and children's lifestyle habits. Data for this study was obtained from 106 children attending primary school in Imola (Italy) who were part of the I-MOVE study emphasizing school-based physical activity. Children's adherence to the MD was calculated using the KIDMED index (KI) based on the ZOOM-8 questionnaire. Physical activity (PA) levels were assessed using an actigraph accelerometer and WM using the backward digit span test. Univariate regression was used to select significant child-level and family measures associated with WM, which were then tested in a single multivariate regression model. Older age is positively associated with higher WM (β = 0.36; 95% CI 0.25, 0.47). Dietary adherence (KI) (β = 0.07; 95% CI 0.01, 0.14) and engagement in organized PA outside school hours (β = 0.58; 95% CI 0.09, 1.10) are positively related to WM. Among the family measures, father's education was positively associated with WM for high school education and for university vs. middle school or lower, respectively.

CONCLUSION

Adherence to the MD was associated with better WM capacity in primary school children. These findings can be used to guide policymakers in designing health promotion programs and instituting policies emphasizing healthy nutrition to improve physical health and boost cognitive functioning.

WHAT IS KNOWN

• The development of working memory involves the entire childhood with a rapid spurt between 2 and 8 years of age. • Working memory plays a critical role in children's learning and academic performance and underlies higher-order cognitive abilities.

WHAT IS NEW

• Adherence to the Mediterranean Diet was associated with higher working memory capacity in primary school children. • Health promotion interventions based on PA and sound nutrition involving children benefit not only physical and mental health, but also cognitive health.

Novel Signposts on the Road from Natural Sources to Pharmaceutical Applications: A Combinative Approach between LC-DAD-MS and Offline LC-NMR for the Biochemical Characterization of Two Hypericum Species (H. montbretii and H. origanifolium)

The members of the genus Hypericum have great potential to develop functional uses in nutraceutical and pharmaceutical applications. With this in mind, we aimed to determine the chemical profiling and biological properties of different extracts (ethyl acetate, methanol and water) from two Hypericum species (H. montbretii and H. origanifolium). We combined two approaches (LC-DAD-MS and LC-NMR) to identify and quantify chemical compounds of the extracts. Antioxidant properties (free radical quenching, reducing power and metal chelating) and enzyme inhibitory effects (cholinesterase, tyrosinase, amylase and glucosidase) were determined as biological properties. The tested extracts were rich in caffeic acid derivatives and flavonoids, and among them, 3-caffeoyl quinic acid and myricetin-3-O-rhamnoside were found to be the main compounds. The total phenolic and flavonoid levels were determined to be 50.97-134.99 mg GAE/g and 9.87-82.63 mg RE/g, respectively. With the exception of metal chelating, the methanol and water extracts showed stronger antioxidant properties than the ethyl acetate extracts. However, different results were obtained for each enzyme inhibition assay, and in general, the ethyl acetate extracts present more enzyme-inhibiting properties than the water or methanol extracts. Results from chemical and biological analyses were combined using multivariate analysis, which allowed establishing relationships between composition and observed effects of the Hypericum extracts based on the extraction solvents. To gain more insights between chemical compounds and enzyme-inhibiting effects, we performed molecular docking analysis. We observed favorable interactions between certain compounds and the tested enzymes during our analysis, confirming the data obtained from the multivariate approach. In conclusion, the obtained results may shed light on the road from natural sources to functional applications, and the tested Hypericum species may be considered potential raw materials, with promising chemical constituents and biological activities.