Dietary Changes Research Articles

Assessment of diet composition of Pakistani ethnic groups in the UK – does dietary pattern change between 1st and 2nd generations?

Dietary acculturation in immigrant groups can impact health and may increase the risk of conditions like diabetes and cardiovascular disease among East Asian immigrants as they adopt host-country eating patterns(1). Pakistani immigration to the UK has resulted in a dynamic cultural exchange, including modifications in culinary preferences and practices among Pakistani ethnic groups. Prior research indicates that second-generation adults exhibit more signs of acculturation in their choice of diets than their first-generation counterparts (2). There is limited understanding of the food habits or the effects of acculturation on this group. The primary purpose of this study was to investigate intergenerational disparities in food preferences among Pakistani immigrants and the impact of dietary acculturation.This cross-sectional study examined the food habits and acculturation experiences of 51 first (1G) and 51 second-generation (2G) participants of the Pakistani community living in London. Data was collected using survey questionnaires modified from previous studies (3,4). We compared traditional foods like paratha and samosa with Western options like fish and chips through a set of questions, from which a dietary score was calculated (Global scale) (5). We measured food acculturation using a 5-point scale, with higher scores indicating greater Western influence and lower scores indicating less Western acculturation. Scores ranged from 6 to 30 and were categorised as low, moderate, high, or very high. Data was analysed using SPSS (version 28.0). Chi-square and t-tests were applied to identify differences between groups with significance levels set to p<0.05.Most of the participants were male (67%) with 38.8% aged 36-45 years. Urdu ethnicity predominated in both generations (64.8%). Significant differences in dietary restrictions for health conditions (p =.008), language (p = .001), consumption frequency of traditional Pakistani cuisine (p = .001), desserts/sweets (p = .001), chai/lassi (p = .017), popular UK meals, fizzy drinks, and inclusion of rice/flatbread (p = .003) emerged between first and second generations. Health-related dietary behaviours differed in fruits/vegetables, dairy, and meat consumption (p =.001). ‘Traditional’ and ‘Western’ dietary scores were significantly different between generations (‘Traditional’: 1G: 17.15 ± 3.52 vs 2G: 13.68 ± 4.71, p = .001; ‘Western’: 1G: 16.29 ± 1.98 vs 2G: 18.21 ± 3.84, p = .001). The results demonstrated a preference for traditional eating patterns by 1G, whereas a nuanced move towards Western food preferences was observed among the 2G participants, falling into the high category of global scale. 1G Participants cited language acquisition, time constraints, and financial issues as factors affecting their dietary changes.This study found significant differences in dietary habits and preferences between first- and second- generation Pakistani immigrants in the United Kingdom. The second generation displayed a more significant shift towards Western food patterns, possibly because of socio-cultural variables, language fluency, and adaptability to the local environment.

Nanodrug delivery materials for digestive system diseases

Digestive system diseases, such as gastritis, gastric ulcers, chronic liver disease, inflammatory bowel disease (IBD), and colorectal cancer, represent a major group of diseases that have high morbidity and death rates worldwide. Their incidence continues to rise owing to factors such as dietary structure changes, accelerated lifestyles, increased environmental pollution, and population aging. Despite the rapid development of the medical technology, the treatment of digestive diseases still faces many challenges, such as addressing drug-resistant Helicobacter pylori infections, treating IBD, and improving the efficacy of advanced gastrointestinal tumor therapies. Fortunately, the emergence of drug-releasing materials has provided new insights that can be used in the treatment of digestive disorders. Drug-releasing materials are a category of specially designed carriers or systems capable of carrying drugs and controlling their release at specific time intervals on demand to achieve the desired therapeutic effect. This article reviews recent research progress of drug-releasing materials used to diagnose and treat digestive disorders. First, the limitations of traditional oral drug delivery methods, such as low bioavailability and nonspecific distribution, are discussed. Second, different types of drug-releasing materials, such as liposomes, dendritic polymers, micelles, nanogels, inorganic nanoparticles, and extracellular vesicles, along with their advantages in terms of improved drug stability, biocompatibility, targeting, and controlled release, are outlined. In addition, the application strategies and preclinical findings of various drug release materials for different digestive disorders are discussed in detail. This Review could help researchers explore more advanced nanomaterials for personalized treatment of drug delivery for digestive disorders.

Post bariatric surgery complications, nutritional and psychological status.

Bariatric surgery becomes the final option for managing severe obesity. This study aims to identify the complications, changes in anthropometry, adherence to dietary recommendations, and psychological well-being of post-bariatric surgery patients. An observational study was conducted on 63 post-bariatric surgery patients who had undergone bariatric surgery between two weeks and five years after surgery. The participants were assessed for the complications experienced, current comorbidities, anthropometric changes, dietary intake, and psychological well-being. A three-day, 24-hour diet recall was done to assess the dietary intake of the patients. The mean macronutrient and micronutrient intakes were compared to several available recommendations. The DASS-21 questionnaire was administered to determine the psychological well-being of the participants. The most common complications experienced by patients after bariatric surgery were hair loss (50.8%), gastroesophageal reflux disease (GERD) (49.2%), and vomiting (41.3%). There were significant differences in mean weight before (129.5 (33.0) kg/m2) and after (85.0 (32.0) kg/m2) bariatric surgery (p<0.001). The prevalence of clinically severe obesity declined by 55%. Overall, patients had insufficient intake of some nutrients such as protein, fat, calcium, and iron. Majority of the patients experienced a normal level of stress, anxiety, and depression, but some had mild (3.2%), moderate (4.8%), and severe anxiety (1.6%). There were drastic improvements in patients' weight following bariatric surgery. However, there were several complications including nutrient deficiencies. Due to the anatomical changes in the gastrointestinal tract, patients must comply with the dietary and lifestyle changes and follow up with the healthcare professional. A nutrition module will be helpful for patients to prepare for and adapt to the changes after bariatric surgery.

Nutraceuticals: New Perspective and Approach to Prevent Dysmenorrhea

Background: The words "nutrition" and "pharmaceutical" are combined to form the phrase "nutraceutical." Nutraceuticals are foods or dietary components that have an important role in regulating and sustaining normal physiological function in humans. For the treatment of dysmenorrhoea, a variety of pharmacological medications are available, however, they all have significant side effects. Dietary supplements and lifestyle management, on the other hand, were found to have a major influence on the occurrence and control of dysmenorrhea. Objective: The objective of this paper is to study a comprehensive review of the dietary and nutritional supplements with special emphasis on dysmenorrhea. This paper focuses on understanding and interpreting the details of menstrual pain and its effective nutritional diet that can be used as a treatment for avoiding menstrual discomfort. Methods: The selection of data has been done by studying a combination of various research and review papers from different databases like PubMed, NCBI, Science Direct, WHO, Cochrane Library, and Web of Science from the year 2000-2022. Results: Based on various papers and literature reviews, we have concluded about various dietary supplements and herbs that can be used to avoid pain during mensuration followed by its all-daily requirement of nutrition on different age groups and efficacy of treatments. Conclusion: According to current evidence, young women should be instructed in the proper use of dietary supplements, nutrition, and vitamins, as well as the inclusion of effective diet and lifestyle changes such as exercise and a well-balanced diet with adequate nutrition, as these are likely to reduce the negative effects of dysmenorrhea.

The impact of the COVID-19 pandemic on dietary behaviors among school-age children, adolescents, and young adults: a systematic review and meta-analysis.

The COVID-19 pandemic has had a global impact on food security and nutrition, both in the short and long term. The influence on school-age children, adolescents, and young adults may be particularly significant and long-lasting. This systematic review and meta-analysis aimed to quantify the impact of the COVID-19 pandemic on dietary habits among school-age children, adolescents, and young adults worldwide. PubMed, Web of Science, and Embase were searched from inception to October 5, 2023. We included observational studies published in English that reported dietary quality scores and dietary intake quantities during and before the COVID-19 pandemic among school-age children, adolescents, and young adults. We included a total of 22 cohort studies and 20 cross-sectional studies of high or moderate quality. We conducted a meta-analysis, expressing dietary quality scores and dietary intake quantities as standardized mean differences (SMD) with 95% confidence intervals (CIs). For studies with low heterogeneity, we used a fixed-effects model; otherwise, we applied a random-effects model. The Newcastle-Ottawa Scale was employed by 2 reviewers independently to evaluate methodological quality. The analysis indicated that, overall, juice intake increased (SMD = 0.12, 95% CI: 0.04 to 0.20), while alcohol consumption reduced during the COVID-19 pandemic (SMD = -0.28, 95% CI: -0.47 to -0.08). However, the age-stratified results varied. Among school-age children, intake of fruit, dairy products, sugar, and juice increased. Adolescents showed an increase in meal frequency and vegetable intake. Young adults showed reduced carbohydrate and alcohol intakes, while protein and dairy product intakes increased, based on limited included studies. Dietary changes in school-age children from before to during the pandemic were mixed, while dietary behavior changes in adolescents and young adults tended to be more positive. Considering the lasting effects of negative dietary behaviors, attention should be given to addressing the increased sugar and juice intakes. It is also crucial that caregivers and researchers monitor whether positive dietary behaviors will rebound after returning to normal study and life. PROSPERO registration no. CRD42023420923.

Stable isotope analysis evidences dietary changes in toxodontids (Mammalia, Notoungulata) across the Neogene-Quaternary from Argentina

Toxodontidae was an extinct family of South American notoungulates, widely studied systematically, but not so much from an ecological perspective. This work aims to improve the knowledge about variations in diet and habitats of different representatives of this group in the context of biotic and abiotic events throughout the last 20 My. The tooth enamel carbon isotope composition (δ13C) of 7 genera recorded in 11 localities of Central, West and Northeastern Argentina, from the Early Miocene to the Late Pleistocene, was analyzed. The diet of the toxodontids studied in this work range from mainly C3 resources during the Miocene, mixed C3-C4 in the Pliocene, to a significant consumption of C4 plants during the Pleistocene. Differences in diet during the Late Pleistocene were also recorded, associated with geographic (i.e., Northeastern vs. Central) and temporal (i.e., glacial vs. interglacial periods) variations, evidencing the adaptive capacity of the group under ecological and environmental pressures.

Farm-specific estimates of forage variability result in larger optimal control limits for forage quality monitoring

Variation in forage composition decreases the accuracy of diets delivered to dairy cows. However, variability of forages can be managed using a renewal reward model (RRM) and genetic algorithm (GA) to optimize sampling and monitoring practices for farm conditions. Specifically, use of quality-control-charts to monitor forage composition can identify changes in composition for which adjustment in the formulated diet will result in a better match of the nutrients delivered to cows. The objectives of this study were 1) assess the use of a clustering algorithm to estimate the mean time the process is stable or in-control (d) (TStable) and the magnitude of the change in forage composition between stable periods (ΔForage) for corn silage and alfalfa-grass silage which are input parameters for the RRM; 2) compare optimized farm-specific sampling practices (number of samples (n), sampling interval (TSample) and control limits (ΔLimit) using previously proposed defaults and our estimates for the TStable and ΔForage input parameters; and 3) conduct a simulation study to compare the number of recommended diet changes costs of quality control under the proposed sampling and monitoring protocols. We estimated the TStable and ΔForage parameters for corn silage NDF and starch and alfalfa-grass silage NDF and CP using a k-means clustering approach applied to forage samples collected from 8 farms, 3x/week during a 16-week period. We compared 4 sampling and monitoring protocols that resulted from the 2 methods for estimating TStable and ΔForage (default values and our proposed method) and either optimizing only the control limit (Optim1) or optimizing the control limits, the number of samples, and the number of days between sampling (Optim2). We simulated the outcomes of implementing the optimized monitoring protocols using a quality control chart for corn silage and alfalfa-grass silage of each farm. Estimates of T^Stable and Δ^Forage from the k-means clustering analysis were, respectively, shorter and larger than previously proposed default values. In the simulated quality control monitoring, larger Δ^Forage estimates increased the optimized ΔLimit resulting in fewer detected shifts in composition of forages and a lower frequency of false alarms and a lower quality control cost ($/d). Recommended diet reformulation intervals from the simulated quality control analysis were specific for the type of forage and farm management practices. The median of the diet reformulation intervals for all farms using our optimal protocols was 14 d (Q1 = 8, Q3 = 26) for corn silage and 16 d (Q1 = 8, Q3 = 26) for alfalfa-grass silage.

African food system and biodiversity mainly affected by urbanization via dietary shifts

The rapid urbanization in Africa profoundly affects local food and ecological systems. According to earlier research, urbanization may cause food production and biodiversity losses as agricultural or natural lands are absorbed by expanding cities. Land-use displacement effects may buffer agricultural production losses or may lead to additional biodiversity losses but are often overlooked. Moreover, impacts of dietary changes associated with urbanization are rarely considered. To address this, we combined spatially explicit projections of African urban area expansion with observed rice consumption shifts to inform a partial equilibrium model (the Global Biosphere Management Model). We demonstrate the importance of displacement effects to identify potential food production or biodiversity issues until 2050 and argue for their integration in land-use planning and policymaking across spatial scales. We identify that because of agricultural displacement, the impact of urban area expansion on food production losses is probably limited (<1%)—at the cost of additional losses of natural lands by 2050 (up to 2 Mt). We also show that considering dietary shifts associated with urbanization increases rice consumption, production (+8.0%), trade (up to +2 Mt of required import) and agricultural methane emissions (up to +12 MtCO2-equivalent yr–1), thereby underscoring the need for a systems approach in future sustainability studies.

Dynamic Changes in Gut Microbiota-Derived Metabolite Trimethylamine-N-Oxide and Risk of Type 2 Diabetes Mellitus: Potential for Dietary Changes in Diabetes Prevention.

A gut-microbial metabolite, trimethylamine N-oxide (TMAO), has been associated with type 2 diabetes mellitus (T2DM). Few previous prospective studies have addressed associations between the changes in TMAO and T2DM incidence. Data were derived from a longitudinal cohort conducted from 2019 to 2021 in rural areas of Fuxin County, Liaoning Province, China, and 1515 diabetes-free participants aged above 35 years were included. The concentrations of serum TMAO and its precursors were measured at two time points, namely in 2019 and 2021. TMAO and TMAO changes (ΔTMAO) were separately tested in a logistic regression model. For further examination, the odds ratios (ORs) for T2DM were calculated according to a combination of TMAO levels and ΔTMAO levels. During a median follow-up of 1.85 years, 81 incident cases of T2DM (5.35%) were identified. Baseline TMAO levels exhibited a nonlinear relationship, first decreasing and then increasing, and only at the highest quartile was it associated with the risk of T2DM. The OR for T2DM in the highest quartile of serum TMAO was 3.35 (95%CI: 1.55-7.26, p = 0.002), compared with the lowest quartile. As for its precursors, only choline level was associated with T2DM risk and the OR for T2DM in the Q3 and Q4 of serum choline was 3.37 (95%CI: 1.41-8.05, p = 0.006) and 4.72 (95%CI: 1.47-15.13, p = 0.009), respectively. When considering both baseline TMAO levels and ΔTMAO over time, participants with sustained high TMAO levels demonstrated a significantly increased risk of T2DM, with a multivariable-adjusted OR of 8.68 (95%CI: 1.97, 38.34). Both initial serum TMAO levels and long-term serum TMAO changes were collectively and significantly associated with the occurrence of subsequent T2DM events. Interventions aimed at normalizing TMAO levels, such as adopting a healthy dietary pattern, may be particularly beneficial in T2DM prevention.

Levothyroxine management in Hashimoto’s thyroiditis: A comprehensive revie

Hashimoto thyroiditis and hypothyroidism are related thyroid conditions with different aetiologies and clinical manifestations. Insufficient synthesis of thyroid hormones causes hypothyroidism, which may lead to systemic symptoms that impact energy, metabolism, and overall wellness. Thyroid tissue damage mediated by the immune system is the hallmark of the autoimmune thyroid condition known as Hashimoto thyroiditis, which is the most prevalent cause of hypothyroidism. A wide range of symptoms, such as fatigue, weight gain, cold sensitivity, constipation, dry skin, and cognitive impairment, are clinical indications of hypothyroidism and Hashimoto thyroiditis. Thyroid function tests, which measure serum levels of free thyroxine, thyroid-stimulating hormone, and thyroid autoantibodies, must be performed for the diagnosis. Imaging techniques, such ultrasonography, may aid with nodular changes detection and thyroid morphology assessment. The goals of management plans for Hashimoto thyroiditis and hypothyroidism are to stop complications, relieve symptoms, and return the body to normal. The cornerstone of treatment is levothyroxine-based thyroid hormone replacement medication, which is customized for each patient depending on their clinical presentation and thyroid function testing. Dietary restrictions, patient education, and lifestyle changes are essential components of illness management.

Remote Delivery of Partial Meal Replacement for Weight Loss in People Awaiting Arthroplasty.

Background: Obesity is linked to higher rates of complications; lower absolute recovery of mobility, pain, and function; and increased costs of care following total knee or hip arthroplasty (TKA, THA). The aim of this prospective cohort study was to evaluate the effectiveness of a 12-week partial meal replacement (PMR) weight loss program for people awaiting TKA or THA and living with obesity (body mass index (BMI) ≥ 30 kg/m2). Methods: The intervention was delivered remotely and included a 12-week PMR plan of 1200 calories/day, incorporating two meal replacement shakes/soups and a third suitable simple meal option. The intervention support was provided through online group education sessions, one-to-one teleconsultation with a dietitian, and access to a structured PMR App with functions for goal setting and providing educational content on diet, physical activity, and behaviour changes. Results: Of the 182 patients approached, 29 provided consent to participate, 26 participants commenced the program, and 22 participants completed the 12-week PMR plan. Completers exhibited statistically significant weight loss from baseline to 12 weeks, with a paired difference of 6.3 kg (95% CI: 4.8, 7.7; p < 0.001), with 15 out of 22 (68.2%) participants achieving at least 5% weight loss. Statistically significant reductions in HbA1c and low density lipoprotein (LDL) were observed at 12 weeks compared to baseline. Moreover, a significant increase in the proportion of participants in the action and maintenance phases of the readiness to change diet, physical activity, and weight were observed at 12 weeks. The majority of program completers (18 out of 22) expressed willingness to pay for the service if offered on a long-term basis following the arthroplasty. Conclusions: This study's findings demonstrated that significant weight loss is achievable for people living with obesity awaiting arthroplasty following a 12-week PMR weight loss program. The remote delivery of the intervention was feasible and well accepted by people awaiting TKA or THA.

Family support for healthy dietary changes in children with obesity: A systematic review

Background: The World Health Organization (WHO) defines overweight or obesity as a condition of abnormal or excessive fat accumulation that can affect a person's health. In Indonesia, children and adolescents have bad eating habits, namely consuming foods and drinks that are high in sugar, salt and fat, eating less vegetables and fruit. Purpose: To investigate the intervention of family support in dietary adjustments against healthy dietary changes in children with obesity. Method: The method applied in the article is a systematic review with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). This article analyses the results of different types of studies to provide a more complete and comprehensive picture. Information was collected from Proquest, Pubmed sources published between 2019 and 2023. Results: The review of 8 articles recommended that family support interventions on dietary regulation on changing healthy eating patterns in obese children as an effective intervention in changing healthy eating habits of obese children. Conclusion: Family support intervention on dietary regulation on healthy eating changes in obese children as an effective intervention in changing healthy eating habits of obese children.

Potential lethality of organochlorine pesticides: Inducing fatality through inflammatory responses in the organism

BackgroundOrganochlorine pesticides, with their environmental persistence and bioaccumulation potential, have gained significant attention. This study explores the impact of organochlorine pesticides on mortality and chronic diseases, investigates their link to inflammatory states, and examines the role of anti-inflammatory diets in mitigating adverse reactions to these pesticides. MethodsThis study, with 2,847 participants, used gas chromatography and mass spectrometry to measure organochlorine pesticide exposure in NHANES data. Conventional statistical methodologies, encompassing survival curves, Cox proportional hazards regression, regression analysis, and restricted quadratic spline analysis, were employed to investigate the association between pesticides and mortality, chronic ailments, and inflammation. Furthermore, machine learning techniques, comprising RF, AdaBoost, Extra-Trees, LightGBM, and BPNN, were leveraged to evaluate the impact of pesticides on chronic disease and mortality prognostication. ResultsOrganochlorine pesticides were significantly and positively correlated with increased mortality (p<0.05). Additionally, these pollutants were linked to the incidence of chronic diseases such as chronic kidney disease, diabetes, and hypertension (p< 0.05). Our study, utilizing various machine learning models, also showed a notable increase in the Area Under the Curve when incorporating organochlorine pesticide indicators into the model as opposed to excluding them. Furthermore, strong correlations were observed between serum c-reactive protein (CRP) and CRP to serum albumin ratio (CAR) concentrations with these substances, demonstrating their pro-inflammatory effects at specific concentrations. Interestingly, cutting down on dietary inflammation through changes in diet effectively reduced the risk of death at high organochlorine pesticide exposure levels, but the effect was less noticeable at low to moderate exposure levels. ConclusionsExposure to organochlorine pesticides was linked to a higher risk of mortality, likely due to an increased prevalence of chronic diseases. In this context, inflammation played a crucial role, and adopting an anti-inflammatory diet significantly reduced the mortality risk associated with these pesticides.

Особенности потребления продуктов питания в Республике Саха (Якутия)

Over the past decades, industrial development, urbanization, globalization, as well as economic development and socio-economic crises have caused rapid changes in diet and lifestyle of the population of Yakutia. According to existing international statistics, quality of diet has a significant impact on health and life expectancy of population. The article is concerned with specific features of food consumption patterns in Yakutia as a region, as well as with compliance of energy and nutritional value of the food consumed with the recommended standards. The study is based on a summary of state statistics data starting from the mid-1990s, which allowed to compare behavior and structure of food consumption with the key socio-economic indicators of living standards. Standard statistical methods were used for the analysis.

Understanding the Impact of Different Doses of Reducose® Mulberry Leaf Extract on Blood Glucose and Insulin Responses after Eating a Complex Meal: Results from a Double-Blind, Randomised, Crossover Trial.

Non-communicable diseases (NCDs) are becoming an increasingly important health concern due to a rapidly ageing global population. The fastest growing NCD, type 2 diabetes mellitus (T2DM), is responsible for over 2 million deaths annually. Lifestyle changes, including dietary changes to low glycemic response (GR) foods, have been shown to reduce the risk of developing T2DM. The aim of this study was to investigate whether three different doses of Reducose®, a mulberry leaf extract, could lower the GR and insulinemic responses (IR) to a full meal challenge in healthy individuals. A double-blind, randomised, placebo-controlled, repeat-measure, crossover design trial was conducted by the Oxford Brookes Centre for Nutrition and Health; 37 healthy individuals completed the study. Participants consumed capsules containing either 200 mg, 225 mg, 250 mg Reducose® or placebo before a test meal consisting of 150 g white bread and egg mayo filler. Capillary blood samples were collected at 15-min intervals in the first hour and at 30-min intervals over the second and third hours to determine glucose and plasma insulin levels. The consumption of all three doses of Reducose® resulted in significantly lower blood glucose and plasma insulin levels compared to placebo. All three doses of Reducose® (200 mg, 225 mg, 250 mg) significantly lowered glucose iAUC 120 by 30% (p = 0.003), 33% (p = 0.001) and 32% (p = 0.002), respectively, compared with placebo. All three doses of Reducose® (200 mg, 225 mg, 250 mg) significantly lowered the plasma insulin iAUC 120 by 31% (p = 0.024), 34% (p = 0.004) and 38% (p < 0.001), respectively. The study demonstrates that the recommended dose (250 mg) and two lower doses (200 mg, 225 mg) of Reducose® can be used to help lower the GR and IR of a full meal containing carbohydrates, fats and proteins.

Muco-Adhesive and Muco-Penetrative Formulations for the Oral Delivery of Insulin.

Insulin, a pivotal anabolic hormone, regulates glucose homeostasis by facilitating the conversion of blood glucose to energy or storage. Dysfunction in insulin activity, often associated with pancreatic β cells impairment, leads to hyperglycemia, a hallmark of diabetes. Type 1 diabetes (T1D) results from autoimmune destruction of β cells, while type 2 diabetes (T2D) stems from genetic, environmental, and lifestyle factors causing β cell dysfunction and insulin resistance. Currently, insulin therapy is used for most of the cases of T1D, while it is used only in a few persistent cases of T2D, often supplemented with dietary and lifestyle changes. The key challenge in oral insulin delivery lies in overcoming gastrointestinal (GI) barriers, including enzymatic degradation, low permeability, food interactions, low bioavailability, and long-term safety concerns. The muco-adhesive (MA) and muco-penetrative (MP) formulations aim to enhance oral insulin delivery by addressing these challenges. The mucus layer, a hydrogel matrix covering epithelial cells in the GI tract, poses significant barriers to oral insulin absorption. Its structure, composition, and turnover rate influence interactions with insulin and other drug carriers. Some of the few factors that influence mucoadhesion and mucopenetration are particle size, surface charge distribution, and surface modifications. This review discusses the challenges associated with oral insulin delivery, explores the properties of mucus, and evaluates the strategies for achieving excellent MA and MP formulations, focusing on nanotechnology-based approaches. The development of effective oral insulin formulations holds the potential to revolutionize diabetes management, providing patients with a more convenient and patient-friendly alternative to traditional insulin administration methods.

Higher Levels of Cytokines in Patients with Chronic Limb-Threatening Ischemia

ObjectiveInflammation is a key element in the initiation and progression of peripheral arterial disease (PAD). Understanding the impact of inflammatory molecules, as cytokines in PAD could help us to improve the prognosis of these patients. The main goal of this study was to compare the serum level of cytokines between patients with claudication to those with critical limb treating ischemia (CLTI). The second objective was to evaluate the relationship between the levels of cytokines and death or amputation rate. MethodsAn observational, single-centre and prospective study was conducted from January 2018 to July 2022. The study was approved by the ethical commission of the Local Hospital (75/2017). Patients with PAD, suggested by the clinical history and objective examination and, confirmed with ankle-brachial index (ABI) attending Vascular Surgery consultations of the first author were included. The following exclusion criteria were applied: i) bedridden individuals or subjects who refused to participate in the protocol; ii) diseases responsible for body composition changes or pro-inflammatory state; iii) recent diet change, iv) active malignancy, v) auto-immune disease, vi) active infection, vii) chronic renal failure (GFR <30 mL/min/1.73m2) or viii) heart failure in the past three months. This cohort was observed at admission, three, six and twelve months. A panel of 27 cytokines was determined with ELISA, at baseline. ResultsWe included 119 subjects (mean age: 67.58 ± 9.60 years-old; 79.80% males), 65 patients with claudication and 54 with CLTI. From the 27 cytokines analysed, patients with CLTI, when compared to those with claudication, had a higher serum level of 11 cytokines: IL1ra; IL-6; IL-8; IL12 p70; G-CSF; IP-10; MCP-1; MIP-1α; PDGF-β, RANTES, TNF-α. From the group of patients with CLTI those who underwent a major amputation had a higher serum level of FGF-basic [Median = 49.04; IQR = 37.03-52.49; versus Median = 33.04; IQR =28.60-38.98; p = 0.001]. ConclusionsPatients with CLTI have higher serum level of inflammatory cytokines, which may have role in the prognosis of these patients.

Complementary and alternative medicine use in migraine patients: results from a national patient e-survey.

This cross-sectional study aims to investigate migraineurs' preferred complementary and alternative medicine (CAM) types and the factors influencing their usage. An anonymous e-survey was distributed to Lithuanian Migraine Association members, and social media migraine support communities. The collected data consisted of demographic, migraine-related questions, personal qualities, CAM habits. 470 respondents were analyzed. 95.96% were women with a median age of 37 (IQR 31, 44). The median duration of migraine was 17.5 years (IQR 10, 25) and the median headache severity was rated 8 (IQR 7, 10) out of 10. 68.90% of participants had one or more headache days per week. 71.49% of respondents were triptan users, 27.66% used medical prophylaxis, and 17.87% used monoclonal antibodies. 52.55% of respondents used CAM in the past 12 months. Physical activity (36.17%), dietary changes/fasting (27.02%), relaxation/meditation (26.60%) were the most used CAM types. Reasons for CAM use included dissatisfaction with conventional treatment effectiveness (42.51%), concerns about safety (48.18%) and adverse effects (37.25%). Factors associated with the decision to explore CAM included longer headache duration (p = 0.017, Mann-Whitney U test), frequent sick leaves (p < 0.001, Mann-Whitney U test), current preventive medication use (p = 0.016, chi-square test), positive views on CAM safety/naturality (p = 0.001/ p < 0.001, Mann-Whitney U test), belief of having a healthy diet (p < 0.001, chi-square test), food-related worries (p = 0.011, Mann-Whitney U test) and Big-five personality trait of openness to experience (p = 0.049, chi-square test). After logistic regression, the frequent need to take sick leaves, having a healthy diet, food-associated fears maintained statistical significance. CAM use was not associated with non-adherence to conventional medicine. 48.99% of CAM consumers disclosed CAM use to their doctors. CAM is explored by a significant proportion of migraineurs, less than half communicate this to their doctors. In our sample, physical activity, dietary changes, and relaxation techniques were the most common. Many patients opted for CAM due to previously experienced side effects/ineffectiveness of conventional migraine treatment or the fear of potential harm from standard medication. Individual factors, such as openness of personality can be an important contributing factor.

Social impediments to meat-eaters’ adherence to critical calls for a meat-free diet: An experimental test of social norm and message source effects

Reducing meat consumption is highly effective for reducing personal carbon emissions, yet most people in Western nations still eat meat. We build on recent research highlighting that group boundaries may impede dietary change by (a) promoting pro-meat norms and (b) prohibiting critical calls for a veg* diet (vegetarian and vegan, i.e., meat-free). Past research relied on self-reports and behavioural measures of engagement, leaving open whether these effects extend to food consumption settings and ad-hoc meal choice. We conducted two pre-registered experiments in which meat-eaters read critical calls to adopt a veg* diet, either by a vegan (outgroup) or a meat-eater (ingroup). In Experiment 2, participants moreover read an article either highlighting a veg* or a meat-eating norm. We then assessed actual (Experiment 1) or hypothetical (Experiment 2) meal choice as dependent variables. As predicted, intergroup criticism (i.e., voiced by veg*s) consistently led to message rejection in comparison to the same criticism voiced by meat eaters, but we did not observe effects on meal choice. Norms neither had a main nor interaction effect on self-reports and behaviour. We discuss potential intermediary processes between engagement with and adoption of a vegan diet and derive evidence-based recommendations for constructive communication across group boundaries.

Multiple environmental and nutritional effects of changing food consumption in urban and rural China

Driven by urbanization and increasing income, dietary changes are dramatic in China. Food consumption directly links environmental and human health, and an in-depth understanding on environment–health nexus is necessary to achieve their co-benefits. Previous studies mostly examine health outcomes through disease risks and premature deaths, overlooking the hidden hunger resulting from inadequate nutrients intakes. Here, we evaluated multiple dietary environmental and nutritional impacts as well as their linkages in urban and rural China for the period 1990–2020. The results showed that daily per capita water, land and carbon footprints are 1.25–1.61 m3, 1.67–2.23 g2, and 1.47–1.84 kg CO2eq. Fat, fiber and Ca were key nutrients influencing dietary nutritional quality. Dietary changes in China increased environmental effects, and increased intakes of both beneficial and restricted-intake nutrients. More importantly, adoption of Chinese Dietary Guidelines, Mediterranean diet, EAT–Lancet, WHO recommendations, and DASH dietary scenarios would increase environmental footprints by 33% and 48% on average compared with current urban and rural diets. It would improve nutritional quality, but increase intakes of restricted-intake nutrients. The complex trade-offs between dietary environmental and nutritional effects emphasize the need for formulating comprehensive dietary guidelines, and food waste reduction is a possible strategy for addressing the environment–health dilemma effectively.