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Livzan MA, Lyalyukova EA, Druk IV, Safronova SS, Khalashte AA, Martirosian KA, Petrosian VY, Galakhov YS. Obesity: current state of the problem, multidisciplinary approach. (based on the consensus of the World Gastroenterological Organization “Obesity 2023” and the European guideline on obesity care in patients with gastrointestinal and liver diseases, 2022). EXPERIMENTAL AND CLINICAL GASTROENTEROLOGY 2024:5-47. [DOI: 10.31146/1682-8658-ecg-218-10-5-47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2024]
Abstract
Obesity is the largest pandemic in the world, and its prevalence continues to increase. The purpose of the presented publication is to raise awareness of doctors about modern methods of diagnosing obesity and approaches to therapy, using an interdisciplinary team approach similar to that used in other chronic diseases, such as diabetes, heart disease and cancer. The article presents data from the World Gastroenterological Organization (2023) and the European Guidelines for the Treatment of Obesity in patients with diseases of the gastrointestinal tract and liver (2022). According to modern approaches, obesity should be considered as a chronic recurrent progressive disease, the treatment of which requires a comprehensive interdisciplinary approach involving psychologists and psychiatrists, nutritionists/nutritionists, therapists, endoscopists and surgeons, including lifestyle changes, a well-defined diet and exercise regimen, drug therapy, endoscopic or surgical methods of treatment. Conclusions. In order to stop the growing wave of obesity and its many complications and costs, doctors, insurance companies and health authorities should make systematic efforts to raise public awareness of both the adverse health risks associated with obesity and the potential reduction of risks through a comprehensive approach to therapy.
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Defeudis G, Massari MC, Terrana G, Coppola L, Napoli N, Migliaccio S. Gluten-Free Diet and Metabolic Syndrome: Could Be a Not Benevolent Encounter? Nutrients 2023; 15:nu15030627. [PMID: 36771334 PMCID: PMC9921299 DOI: 10.3390/nu15030627] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/19/2023] [Accepted: 01/21/2023] [Indexed: 01/28/2023] Open
Abstract
Celiac disease is a rising disorder and is becoming frequently diagnosed in recent years. To date, the only available treatment is the gluten-free diet (GFD). The role of gluten on components of metabolic syndrome and on related inflammatory response is still unclear due to controversial results. In recent years, scientific focus on this topic has been growing up, in particular regarding the role of the GFD on glycometabolic parameters and diabetes. In addition, studies on the remaining components showed discordant results, which was likely due to heterogeneous and large celiac disease populations and to the lack of prospective studies. Furthermore, knowledge about the role of the GFD on inflammatory cytokines and the relationship among vitamin D and celiac disease, metabolic syndrome (MS) and GFD is needed. In this narrative review, we provided evidence regarding the role of the GFD on glycometabolic parameters, cholesterol, triglycerides, waist circumference, blood pressure and inflammatory cascade, also evaluating the role of vitamin D, trying to summarize whether this nutritional pattern may be a value-added for subjects with dysmetabolic conditions. Finally, due to the limited findings and very low-certainty evidence, predominantly based on observational studies, the real effects of a GFD on different components of MS, however, are unclear; nevertheless, an improvement in HDL levels has been reported, although data on glycemic levels are discordant.
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Affiliation(s)
- Giuseppe Defeudis
- Department of Movement, Human and Health Sciences, University Foro Italico of Rome, 00135 Rome, Italy
- Correspondence: or (G.D.); (S.M.)
| | - Maria Chiara Massari
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Giovanni Terrana
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Lucia Coppola
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Nicola Napoli
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico of Rome, 00128 Rome, Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health Sciences, University Foro Italico of Rome, 00135 Rome, Italy
- Correspondence: or (G.D.); (S.M.)
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Dhruva V, Lawson C, Green C, Newberry C. "The Gluten-Free Diet and Its Relationship with Metabolic Syndrome: Dietary Friend or Foe?". Curr Nutr Rep 2021; 10:282-287. [PMID: 34510390 DOI: 10.1007/s13668-021-00371-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2021] [Indexed: 01/13/2023]
Abstract
PURPOSE OF REVIEW Celiac disease (CD) is a prevalent digestive illness as well as a budding area of research in the field of gastroenterology. While investigations are underway to find new and improved pharmacological therapies for CD, the gluten-free diet (GFD) remains the only option to effectively manage the condition. RECENT FINDINGS While the GFD is recommended for patients diagnosed with CD and other gluten-related conditions, studies show the number of individuals on the GFD surpasses the projected number of patients with these medical indications (1). The implications of widespread adoption of this dietary approach are still being determined, with many patients believing this diet will improve overall health and cardiovascular risk. This review analyzes the relationship between a GFD and metabolic syndrome in both non-celiac and celiac patients, concluding that although the diet may slightly improve overall cardiac risk factors, weight, and/or insulin resistance, its use in the absence of a gluten-related disorder is controversial.
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Affiliation(s)
- Vishal Dhruva
- Rutgers New Jersey Medical School, 65 Bergen Street, Newark, NJ, 07103, USA
| | - Christy Lawson
- Division of Trauma and Critical Care Surgery, University of Tennessee Medical Center, 1932 Alcoa Hwy Ste 270, Knoxville, TN, 37920, USA
| | - Caitlin Green
- Division of Gastroenterology, Medical University of South Carolina, 1600 Midtown Avenue, Mount Pleasant, SC, 29464, USA
| | - Carolyn Newberry
- Division of Gastroenterology, Weill Cornell Medical Center, 445 East 69th Street, 4th Floor, New York, NY, 10021, USA.
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Scientific evidence of diets for weight loss: Different macronutrient composition, intermittent fasting, and popular diets. Nutrition 2019; 69:110549. [PMID: 31525701 DOI: 10.1016/j.nut.2019.07.001] [Citation(s) in RCA: 138] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
New dietary strategies have been created to treat overweight and obesity and have become popular and widely adopted. Nonetheless, they are mainly based on personal impressions and reports published in books and magazines, rather than on scientific evidence. Animal models and human clinical trials have been employed to study changes in body composition and metabolic outcomes to determine the most effective diet. However, the studies present many limitations and should be carefully analyzed. The aim of this review was to discuss the scientific evidence of three categories of diets for weight loss. There is no one most effective diet to promote weight loss. In the short term, high-protein, low-carbohydrate diets and intermittent fasting are suggested to promote greater weight loss and could be adopted as a jumpstart. However, owing to adverse effects, caution is required. In the long term, current evidence indicates that different diets promoted similar weight loss and adherence to diets will predict their success. Finally, it is fundamental to adopt a diet that creates a negative energy balance and focuses on good food quality to promote health.
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Pilolli R, Gadaleta A, Mamone G, Nigro D, De Angelis E, Montemurro N, Monaci L. Scouting for Naturally Low-Toxicity Wheat Genotypes by a Multidisciplinary Approach. Sci Rep 2019; 9:1646. [PMID: 30733459 PMCID: PMC6367382 DOI: 10.1038/s41598-018-36845-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 11/29/2018] [Indexed: 12/23/2022] Open
Abstract
Over the last years, great efforts have been devoted to develop effective gluten detoxification strategies with a consequent detrimental alteration of the technological properties as well. Obtaining low-gluten products without affecting the rheological properties of wheat could still be considered a new challenge to face. In this investigation, we presented a comprehensive characterization of durum wheat genotypes aimed at identifying low gluten ones, which combine the potential lower toxicity/immunogenicity with conserved yield and rheological properties to encompass the perspective usability for bread or pasta making. A preliminary profiling of gluten proteins was accomplished by immunoassay-based quantification and liquid chromatography coupled to UV detection, focusing on the gliadin fraction as main responsible for immunoreactivity in celiac disease patients. In addition, data on grain protein content, grain yield per spike, dry gluten and gluten index were collected in order to provide complementary information about productivity-related traits and quali-quantitative characteristics related to wheat nutritional value and its technological properties. The whole pool of data was statistically evaluated driving to the selection of a preferred list of candidate low-toxicity genotypes that were subjected to in-vitro simulated gastroduodenal digestion and untargeted HR-MS/MS peptide identification. Finally, an in-silico risk assessment of potential toxicity for celiac disease patients was performed according to the most recent guidance provided by EFSA.
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Affiliation(s)
- Rosa Pilolli
- Institute of Sciences of Food Production, National Research Council of Italy (ISPA-CNR), via Giovanni Amendola, 122/O - 70126, Bari, Italy.
| | - Agata Gadaleta
- Institute of Sciences of Food Production, National Research Council of Italy (ISPA-CNR), via Giovanni Amendola, 122/O - 70126, Bari, Italy
- Department of Agricultural & Environmental Sciences, Università degli Studi di Bari Aldo Moro, via G. Amendola, 165/A - 70126, Bari, Italy
| | - Gianfranco Mamone
- Institute of Food Sciences, National Research Council of Italy (ISA-CNR), via Roma, 64 - 83100, Avellino, Italy
| | - Domenica Nigro
- Department of Soil, Plant & Food Sciences, Università degli Studi di Bari Aldo Moro, via G. Amendola 165/, A - 70126, Bari, Italy
| | - Elisabetta De Angelis
- Institute of Sciences of Food Production, National Research Council of Italy (ISPA-CNR), via Giovanni Amendola, 122/O - 70126, Bari, Italy
| | - Nicola Montemurro
- Institute of Sciences of Food Production, National Research Council of Italy (ISPA-CNR), via Giovanni Amendola, 122/O - 70126, Bari, Italy
| | - Linda Monaci
- Institute of Sciences of Food Production, National Research Council of Italy (ISPA-CNR), via Giovanni Amendola, 122/O - 70126, Bari, Italy
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Melini V, Melini F. Gluten-Free Diet: Gaps and Needs for a Healthier Diet. Nutrients 2019; 11:E170. [PMID: 30650530 PMCID: PMC6357014 DOI: 10.3390/nu11010170] [Citation(s) in RCA: 130] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/27/2018] [Accepted: 01/11/2019] [Indexed: 02/06/2023] Open
Abstract
The gluten-free diet (GFD) is currently the only effective treatment in remitting the symptoms of coeliac disease (CD), a chronic systemic autoimmune disorder caused by a permanent intolerance to gluten proteins in genetically susceptible individuals. The diet entails the substitution of gluten-containing products with gluten-free-rendered products. However, over recent decades the nutritional profile of gluten-free (GF) food products has been increasingly questioned within the scientific community. The aim of this paper is to review the nutritional profile of gluten-free-rendered products currently available on the market, and discuss the possible relationship thereof with the nutritional status of coeliac patients on a GFD. Key inadequacies of currently available GF products are low protein content and a high fat and salt content. More adequate levels of dietary fiber and sugar than in the past have been reported. Population studies confirmed the above mentioned inadequacies. Further efforts are required to conceive adoptable interventions for product development and reformulation in order to achieve compliance with nutritional recommendations.
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Affiliation(s)
- Valentina Melini
- CREA Research Centre for Food and Nutrition; Via Ardeatina 546, I-00178 Rome, Italy.
| | - Francesca Melini
- CREA Research Centre for Food and Nutrition; Via Ardeatina 546, I-00178 Rome, Italy.
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Vitaglione P, Zingone F, Virgilio N, Ciacci C. Appetite and Gastrointestinal Hormone Response to a Gluten-Free Meal in Patients with Coeliac Disease. Nutrients 2019; 11:nu11010082. [PMID: 30609862 PMCID: PMC6356816 DOI: 10.3390/nu11010082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 12/20/2018] [Accepted: 12/29/2018] [Indexed: 12/20/2022] Open
Abstract
Coeliac disease (CeD) is an immune-mediated inflammatory enteropathy triggered by the ingestion of gluten in genetically susceptible individuals. Gastrointestinal (GI) hormone response related to appetite and glucose metabolism is still under-investigated in patients with CeD. This study aimed at shedding light on the appetite sensations, glycaemia and hormone response induced by a complex meal in patients with coeliac disease. Twenty-two women with CeD, nine at the diagnosis (CeDD) and thirteen under a gluten-free diet (CeDGF), and ten healthy subjects (HS) were enrolled in a single day intervention study. All subjects consumed a test meal, recorded their appetite sensations, and blood was collected over three hours after meal consumption. The study found a lower decrease in hunger in CeDD compared to CeDGF and HS after meal intake. Data showed no difference of fullness and satiety between the groups. CeDD had lower insulin and glucose-dependent insulinotropic polypeptide (GIP) than CeDGF and HS. Both CeDD and CeDGF experienced a lower post-prandial response of glucose than HS. Data suggested that patients with CeD have an impaired glucose absorption after more than 12 months of gluten-free diet. Postprandial GIP may play a significant role in appetite cues and insulin response to a complex meal.
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Affiliation(s)
- Paola Vitaglione
- Department of Agricultural Sciences, University of Naples "Federico II", 80055 Portici, Italy.
| | - Fabiana Zingone
- Department of Surgery, Oncology, and Gastroenterology, University of Padua, 35100 Padua, Italy.
| | - Nicolina Virgilio
- Department of Agricultural Sciences, University of Naples "Federico II", 80055 Portici, Italy.
| | - Carolina Ciacci
- Department of Medicine, Surgery, and Dentistry, "Scuola Medica Salernitana" University of Salerno, 84084 Fisciano, Italy.
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Ehteshami M, Shakerhosseini R, Sedaghat F, Hedayati M, Eini-Zinab H, Hekmatdoost A. The Effect of Gluten Free Diet on Components of Metabolic Syndrome: A Randomized Clinical Trial. Asian Pac J Cancer Prev 2018; 19:2979-2984. [PMID: 30362336 PMCID: PMC6291063 DOI: 10.22034/apjcp.2018.19.10.2979] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: This study aimed to assess the effects of Gluten free diet (GFD) on components of metabolic syndrome (MES). Materials and Methods: In this randomized clinical trial, 50 subjects diagnosed with MES were randomly divided into two groups (n=25). The first group received a GFD and the second group continued their regular diet. Biochemical markers of MES and blood pressure were measured before and after 8-week intervention. Results: Forty five subjects completed the study. A post-hoc comparison of the groups showed no effects of the GFD and control diet on LDL cholesterol, total cholesterol, fasting insulin, HOMA-IR, systolic and diastolic blood pressure levels. The GFD reduced fasting blood glucose, waist circumference (WC) and serum triglyceride concentration significantly compared with the control diet (p<0.05). Conclusion: Short-term GFD reduced WC and improved glycemic control and Triglyceride level in subjects with the metabolic syndrome.
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Affiliation(s)
- Mehdi Ehteshami
- Department of Clinical Nutrition and Dietetics,, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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