Dietary Changes Research Articles

Ileocecal intussusception in ileocecal intussusception in foals

Intussusception is a serious condition that can affect young animals (aged 3 to 12 months), characterized by the invagination of one part of the intestine into another, leading to lesions and intestinal necrosis. It can occur spontaneously or secondarily due to intestinal motility disorders. Enteritis is a predisposing factor, and in older foals, worm infestations, including ascarids, flatworms, Clostridium infections, and mesenteric arteritis, are risk factors. Other factors include sudden dietary changes and pedunculated masses. Clinical signs typically begin with abdominal discomfort, increased heart and respiratory rates, loss of appetite, and a distended abdomen on the right side, among other symptoms. Diagnosis is made through ultrasonography, and hematological tests may reveal toxemia due to rupture or necrosis of the intestinal loops. Prompt diagnosis and treatment improve the animal's prognosis.

Use of Technology in the Management and Treatment of Prediabetes, A New Era: A Case Report Series

Introduction: The escalating prevalence of prediabetes has positioned it as a silent precursor to a looming public health crisis, particularly as it paves the way for type 2 diabetes mellitus (T2DM). This case series report explores the transformative role of technology, specifically the Sugar Fit’s Diabetes Reversal and Management Program (SDRMP), in the treatment and management of prediabetic patients. Methods: The case series follows the progress of two patients aged 31-44 with prediabetes utilizing the SDRMP to prevent the progression to diabetes. The interventions for both patients involved continuous glucose monitoring, personalized nutrition plans, fitness strategies, and behavioral modifications. The patients also engaged in regular communication with their life coaches through the Sugar Fit application, ensuring ongoing support and adherence to the program. Results: The results revealed significant improvements in glycemic control, lipid profiles, and overall well-being. The first patient, a 44-year-old male, demonstrated a successful return to normal glycemic control in 177 days through a comprehensive approach involving dietary changes, exercise, and lifestyle modifications. The second patient, a 31-year-old male, achieved normal glycemic control in a comparable timeframe, showcasing the effectiveness of the SDRMP. Discussion and Conclusion: These cases demonstrate that patients were able to adhere to the goals of care, preventing the progression of prediabetes to diabetes and improving insulin resistance. The study also underscores the potential impact of technology on public health outcomes, bridging the gap between traditional interventions and the evolving needs of a tech-savvy population. The synergy between healthcare expertise and technological innovation not only arrests the progression of prediabetes but also contributes to a broader societal shift towards metabolic well-being, paving the way for a healthier future. Future monitoring is essential to ensure the maintenance of lifestyle modifications and continued success in preventing diabetes.

Metformin Use and Vitamin B12 Deficiency in People with Type 2 Diabetes. What Are the Risk Factors? A Mini-systematic Review.

Background and Aim: Metformin is recommended as the first-line agent for the management of type 2 diabetes following lifestyle and dietary changes. The long-term use of metformin has been associated with vitamin B12 deficiency. The aim of this review is to investigate the effect of metformin on vitamin B12 levels and identify any risk factors. Method: A literature search was conducted using MEDLINE, PubMed and ProQuest Central. Selected articles were peer-reviewed articles, written in English and published from 2015 and onwards. Excluded articles were case reports, reviews or meta-analyses, as well as those with no access to full text. Results: In total, 21 articles were included. There was a significant association between metformin use and vitamin B12 levels in 17 studies, while 4 studies found no such association. The risk factors examined were metformin dose, treatment duration, patient age and patient ethnicity. Conclusion: In summary, metformin use was associated with lower vitamin B12 concentrations, and higher doses and longer durations of treatment increase the risk of vitamin B12 deficiency. Routine vitamin B12 screening is recommended, prioritizing higher-risk patients. Further research is needed to identify when to initiate monitoring.

The association between dietary quality index- international and metabolic risk factors in RaNCD cohort study

BackgroundNon-communicable diseases (NCDs) are the leading cause of death around the world. The Dietary Quality Index-International (DQI-I) is one of the indicators that shows changes in diet and its association with NCDs. The aim of this study is to measure the association between the DQI-I and major metabolic risk factors.MethodsThis study is a cross-sectional study based on data collected in the first phase of the prospective cohort study on Ravansar non-communicable diseases (RaNCD). To perform clinical and biochemical tests such as lipid profile, blood glucose and liver enzymes, blood samples were collected using standard vacutainer blood collection techniques. Information from the food frequency questionnaire containing 118 food items was used to score each person’s DQI-I. Binary logistic regression was used to determine the association between the DQI-I tertile and the metabolic risk factors. Linear regression was also used for the association between subgroups of DQI-I score and the metabolic risk factors.ResultsThe total number of subjects in this study was 7,115, with a mean age of 47.14 ± 8.29 years. Dietary quality was generally poor, with 37.03% in the lowest tertile. Men had better dietary quality than women. Anthropometric measures, blood pressure, triglycerides and blood glucose were lower in the lowest tertile of dietary quality. A one-unit increase in the total DQI-I resulted in a 0.19 decrease in total cholesterol. Higher dietary quality was associated with a 22% increased risk of high triglycerides, a 19% increased risk of low high-density density lipoprotein, a 5% decreased risk of elevated low-density lipoprotein, a 42% increased risk of high blood pressure, and a 99% increased risk of high fasting blood glucose. Higher dietary quality was also associated with a 33% increased risk of overweight/obesity.ConclusionThe study found that participants had poor dietary quality, with some favorable metabolic outcomes in the lowest tertile, but concerning associations in the highest tertile, including increased risk for high triglycerides, blood pressure, and obesity. The complex associations suggest that balanced, multifaceted interventions are needed.

A detailed review on some effects of turmeric curcuminoids on inflammation in obese individuals

Turmeric, derived from Curcuma longa, contains curcuminoids, notably curcumin, renowned for its anti-inflammatory and antioxidant properties. This review explores turmeric curcuminoids, focusing on curcumin, as potential remedies for obesity-related inflammation and associated disorders. The urgency to address obesity-related health risks is emphasized, with elevated BMI correlating with increased morbidity and mortality. Current obesity management strategies involve dietary changes, physical activity, and, sometimes, pharmacotherapy. Research suggests curcumin's role in significant weight loss and lean tissue mass augmentation, inhibiting adipogenesis-related proteins and increasing basal metabolic rate. The intricate connection between obesity and type 2 diabetes is examined, highlighting curcumin's impact on glucose homeostasis, hepatic gluconeogenesis, and lipid metabolism. Additionally, curcumin's anti-inflammatory effects, including modulation of pro-inflammatory cytokines and the NFkB pathway, demonstrate therapeutic potential. Clinical studies indicate curcumin's positive effects in reducing inflammatory markers and rebalancing adipokines in overweight and obese individuals, showing promise for addressing obesity-related inflammation and associated health risks. This review aims to investigate the potential role of turmeric curcuminoids, particularly curcumin, as remedies for obesity-related inflammation and associated disorders in obese individuals.

A personalised nutrition intervention for adolescent depression: a mixed-methods feasibility pilot study.

Randomised controlled trials have demonstrated the benefit of diet modification to improve diet quality in the treatment of adult major depressive disorder (MDD). However, research examining nutritional interventions for adolescents with MDD is sparse. This pilot study examined the feasibility of a personalised nutrition intervention for adolescents with MDD. Ten adolescents with MDD and their parents recruited from a tertiary care setting participated in an 8-week, single-arm mixed-methods study. Feasibility was assessed using five criteria (demand, acceptability, implementation, adaptation and limited efficacy testing) alongside qualitative interviews. The intervention involved four bi-weekly virtual nutrition counselling sessions with a stepped approach to dietary change, menu planning, grocery delivery and educational eHealth messages. Study participants sought positive changes in diet, health and lifestyle for adolescents and family-wide benefits. Recruitment challenges included concerns about managing mood fluctuations, anticipated dietary restrictions and the potential time and effort required for diet adherence. Feedback based on interviews emphasised moderate to high acceptability, satisfaction with menu planning and counselling and recognition of the benefits of trying new foods and sustaining positive dietary changes beyond the study. Improvements in depression symptoms (Cohen's d = 0·36, 95 % CI (-0·24, 3·36)), parent food modeling (Cohen's d = 0·24, 95 % CI (-0·43, 1·16) and the family food environment (Cohen's d = 0·61, 95 % CI (-0·04, 2·61)) were observed. This nutrition intervention was feasible for adolescents with MDD and was acceptable to both parents and depressed adolescents. These preliminary data suggest that further examination of the intervention and its potential benefits on depression symptoms and family food dynamics are warranted.

Stable isotope of Mesolithic remains of Pila wernei of the Nile area, Sudan: A tool for palaeoenvironment reconstruction

The article deals with stable isotopes of oxygen and carbon on current and archaeological semi-aquatic gastropod shell of the Pila wernei from Sudan and reports some new 14C analyses on archaeological Pila specimens. This, with the aim of obtaining new information on climatic and environmental changes in the al-Khiday area during the first phase of Holocene. The Pila shells come from a well-preserved shell midden present at al-Khiday and dated 8700-7000 cal yr BP. The area of al-Khiday was inhabited since at least 10 ka. Pila wernei species has never been studied in detail; this study demonstrates that the O and C isotope composition of aragonite shell is able to record the environmental and diet changes during the gastropod life. The comparison between the isotope data obtained on present-day and archaeological shells show a prevalence of C4 plants and higher rainfall during the Mesolithic. Two climatic fluctuations have been recognised: the first one indicating wetter conditions from 8650-8400 to 8500-8050 cal yr BP (decrease of the δ18O values), the second one pointing less wetter conditions from 8500-8050 to 7850-7600 cal yr BP (increase of δ18O values). Despite the difficulties in studying semi-aquatic gastropods due to their lifestyle habit, the identification of climatic fluctuations in the Early Holocene confirms the reliability of this proxy for climatic reconstructions. Despite the high number of isotopic analyses (1556) used in this work, they were not sufficient to mirror the fast climate changes characterising the studied period and finally obtain a detailed reconstruction for nearly the two millennia considered. Nonetheless, future projects may benefit greatly from unveiling the shell-environment relationship of the species.

Favourable lifestyle changes 1 year after acute myocardial infarction

Abstract Background Acute myocardial infarction (AMI) is a life-threatening event that should be an excellent motivator to adopt a healthy lifestyle. We aimed to evaluate the proportion of patients with AMI who reported favourable lifestyle changes 1 year after AMI. Methods Harnessing a nationwide prospective cohort of patients with AMI in Switzerland, ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) patients enrolled in the AMIS Plus registry between 2012 and 2022 were followed-up 1 year after the event by telephone interview. Favourable lifestyle changes, often addressed in hospitals or rehabilitation programmes were defined as smoking cessation, weight reduction (for overweight patients at index presentation), dietary changes, increased physical activity and stress reduction. Self-reported lifestyle changes were stratified according to AMI type, sex, and age. Results From 7906 AMI patients, 7234 (91.5%) with follow-up data were included. Of these, 5627 (77.8%) were male, 1607 (22.2%) female, 4664 (64.5%) had a STEMI, and 2570 (35.5%) a NSTEMI. At a median follow-up of 397 (interquartile range 371 to 465) days, 861 (50.9%) smokers at the time of the AMI had quit smoking, 1297 (35.0%) overweight patients had lost weight, 2567 (44.8%) patients had implemented nutritional changes, 2415 (41.2%) had increased their physical activity, and 1729 (30.5%) had reduced their stress levels. Patients with STEMI were more likely to stop smoking (53.0% vs. 45.1%, p=0.005), change their diet (46.4% vs. 41.6%, p<0.001), increase their physical activity (43.5% vs. 36.8%, p<0.001), or reduce stress (31.4% vs. 28.7%, p=0.04) compared to NSTEMI patients. Male sex was associated with smoking cessation [52.5% vs. 44.4%; p=0.008; age-adjusted odds ratio (OR), 0.78; 95% confidence interval (CI), 0.61-0.99; p=0.043], dietary change (47.8% vs. 33.7%; p<0.001; age-adjusted OR, 0.67; 95% CI, 0.58-0.77; p<0.001), and an increase in physical activity (43.5% vs. 32.9%; p<0.001; age-adjusted OR, 0.77; 95% CI, 0.67-0.88; p<0.001). However, after adjusting for age, stress reduction was comparable between males and females (30.9% vs. 28.9%; p<0.001; age-adjusted OR, 1.09; 95% CI, 0.94-1.26; p=0.25). Conclusions A substantial proportion of patients with AMI in Switzerland reported favourable lifestyle changes within 1 year after the index event. In general, STEMI as well as male patients were more likely to report multiple favourable lifestyle changes. Nevertheless, there is still room for improvement in terms of secondary prevention measures.

Barriers to adopting a plant-based diet in various Finnish sociodemographic groups

Abstract Background According to nutrition recommendations, plant-based diets are favorable for both climate and health. However, the adoption of such diets varies between sociodemographic groups. Aims of this study are to examine how large proportions of the population have shifted towards plant-based diets to combat climate change, and to identify perceived barriers to dietary changes by gender, age, urbanization level, education, and household income. Methods The study is based on the Healthy Finland Survey conducted in 2022-2023, including 5390 participants (56% women) aged 20-74 years. Questions related to plant-based diet had pre-defined response options. Results Women reported that they had changed their diets to be more plant-based more often than men (46% vs. 31%). Women and men living in urban areas, having high education, or belonging to the highest income quartile had made changes more often than those in other sociodemographic groups. Women and men reported barriers in shifting to more plant-based diets, such as uncertainty about nutritional value (20% and 24%) and lacking skills to prepare tasty vegetarian food (30% and 28%). Disliking vegetarian foods (23%) or not being interested in the topic (28%) were also frequent issues in men, while women commonly cited the preferences of their close ones as preventing them from making vegetarian food (17%). These perceived barriers also differed between sociodemographic groups. For example, while uncertainty about nutritiousness of plant-based diets was most common in the oldest age group (29%), lack of skills to prepare tasty vegetarian food was most common in the youngest age group (35%). One third of men living in remote rural areas or with basic education reported not being interested in the topic. Conclusions Understanding barriers that prevent people in different sociodemographic groups from changing their diets to more plant-based is critical in tailoring more targeted and effective health promotion and policy. Key messages • Moving towards more plant-based diets to combat climate change and perceived barriers to dietary changes vary by gender, age, urbanization level, education, and household income. • Understanding barriers preventing people in different sociodemographic groups from changing their diets to more plant-based is critical in tailoring targeted and effective health promotion and policy.

SWITCHtoHEALTHY: Switching Mediterranean Consumers to Mediterranean Sustainable Healthy Dietary Patterns

Abstract In the Mediterranean countries profound changes in diet are taking place, largely due to cultural and socio-economic changes in lifestyle, which are leading to the erosion of the Mediterranean food cultures. The diet modernization process is noticeable; it has generated not only a modification of food choices in the direction of unhealthy foods, but also the habit of sedentary behaviours leading to an imbalance between energy intake and consumption. All of this has negative health impacts, as shown by the ever-increasing prevalence of overweight and obesity, as well as the rise of chronic diet-related diseases. The SWITCHtoHEALTHY project aims to generate an overall change of approach to the modern problem of eating behaviours, by strengthening the role of families towards the promotion of the sustainable Mediterranean food model. The main goal is to generate an actual switch to healthier dietary models, that are more consistent with the Mediterranean Diet. The project SWITCHtoHEALTHY aims to generate a dietary behaviour change in the direction of a greater adherence to the Mediterranean food model, by strengthening the role of families in the process of acquiring and maintaining healthy eating habits. The Mediterranean Diet (MD) is a healthy and sustainable food model, with an essentially plant-based dietary pattern (high consumption of fresh fruits and vegetables, cereals, and legumes). This goal will be reached by making available to families a combination of hands-on educational material and digital tools and complementing the dietary and lifestyle recommendations with easy-to-eat healthier snacking products.

Mediterranean-type diet trajectories and 20-year cardiovascular disease incidence: the ATTICA study (2002-2022)

Abstract Background/Introduction The protective effects of the Mediterranean-type diet (MTD) against cardiovascular disease (CVD) are well-known. However, based on a recent systematic review of 57 studies with 1,125,560 participants, MTD adherence has declined worldwide, even in the Mediterranean region, compared to the past, especially in the last decade. Moreover, studies evaluating changes in diet and CVD risk are scarce. Purpose The aim of this study was to longitudinally evaluate MTD adherence and changes in MTD adherence during 20-years of follow-up and its relation to 20-year CVD incidence. Methods Participants initially free-of-CVD from the ATTICA study were used (n=1,986). At 2002 and 2022, CVD events were assessed according to WHO-ICD-10 and MTD adherence was assessed via MedDietScore (range: 0-55). Hence, MTD trajectories were defined according to MTD adherence in 2002 and in 2022 as: low-low, low-high, high-low, high-high (i.e., high: MedDietScore >27/55). Results During the 20-year follow-up, 30.2% (n=600) of the participants were always away (i.e., low-low), 30.0% (n=596) went away (high-low), 21.4% (n=424) were always close (high-high) and 22% got closer (low-high) to the MTD. The 20-year CVD incidence was: 38.8% (n=233), 87.7% (n=321), 10.2% (n=61) and 24.3% (n=103) in those in the low-low, low-high, high-low and high-high trajectory, respectively (p-value<0.001). In multi-adjusted models, adjusted for socio-economic, clinical and lifestyle parameters, it was found that compared to those who were always away from the MTD, those who were always close had 68% lower CVD risk [Hazard Ratio-HR: 0.32, 95%Confidence Interval-CI: 0.14, 0.72], while those who went away during the 20-year follow-up had 47% lower CVD risk [HR: 0.53, 95%CI: 0.32, 0.86]. Conclusion Our study findings highlight the long-lasting effects of the MTD adherence early in the life-course. Public health measures to prevent CVD should focus on facilitating MTD adherence, as early in life as possible.

Smoking cessation after acute myocardial infarction: a Swiss-wide cohort study

Abstract Background Smoking is a major cardiovascular risk factor and of great importance in terms of both primary and secondary prevention. The present study aims to identify patient characteristics associated with smoking cessation within 1 year after acute myocardial infarction (AMI) to inform physician-patient interactions, secondary prevention measures, and public health planning. Methods ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) patients enrolled between 2012 and 2022 in the AMIS Plus registry who were active smokers at the time of the index event were included. At the 1-year follow-up, patients were questioned about their smoking behaviour via telephone interview and were further classified into those who had quit (stoppers) or continued (continuers) smoking. Patient characteristics were collected at the time of the index event and at follow-up and then compared using descriptive statistics. Results From a total of 4523 patients with AMI, 4242 (93.8%) provided information regarding their smoking status at a median follow-up of 395 days (interquartile range 370 to 469) after the index event. Of 1691 (39.9%) active smokers at the time of AMI, 861 (50.9%) reported quitting whereas 830 (49.1%) were still smoking at the 1-year follow-up. Stoppers were younger (57 vs. 58 years, p<0.001), more likely to be male (82.8% vs. 77.7%, p=0.008) and have presented with STEMI (77.0% vs. 71.0%, p=0.005), and less likely to have had a previous AMI (6.6% vs. 13.3%, p<0.001) than continuers. Smoking cessation was more common in patients with a more severe AMI characterised by a greater extent of myocardial injury (in-hospital median peak creatine kinase level 1291 IU/L vs. 1101 IU/L, p=0.012), at least one in-hospital complication (13.9% vs. 9.9%, p=0.01), and participation in a rehabilitation programme (83.7% vs. 68.8%, p<0.001). Stoppers more frequently implemented other favourable lifestyle changes, such as dietary changes (56.2% vs. 45.2%, p<0.001) and increased physical activity (54.6% vs. 37.7%, p<0.001) than continuers. Self-reported weight gain was more prevalent among those who quit smoking (44.0% vs. 19.7%, p<0.001). Conclusions In Switzerland, half of the patients with AMI who were active smokers at the time of AMI, reported to have stopped smoking 1 year after the index event. Smoking cessation was associated with participation in a rehabilitation programme and occurred more often in patients with larger AMI sizes, higher in-hospital complication rates and more frequent implementation of other favourable lifestyle changes after AMI. The significant weight gain after smoking cessation seems to represent a major issue that should specifically be addressed.

Diet Impact Assessment model: an interactive tool for analysing the health, environmental and affordability implications of diets

Abstract Global diets, environmental factors, and health require a holistic approach in public health discourse that takes into account the well-being of both humans and planetary health. Modeling tools have demonstrated being useful to estimate priorities and differences between countries and gain insight into future paths that depend on predetermined priorities. Modeling efforts that include environmental goals indicate the possibility of reducing environmental impacts while both improving food quality and overall health outcomes, especially in high-income settings. The aforementioned forecasts highlight the effectiveness of giving priority to dietary recommendations that lead to better, balanced patterns as the most effective approach to reducing mortality risks and environmental implications. The presentation will introduce the Diet Impact Assessment (DIA) model - a new interactive modelling tool for analysing the health, environmental and affordability implications of diets and dietary change. The tool enables countries to analyse user-specific scenarios of dietary change, and to estimate the health, environmental and cost burden of each scenario in terms of diet costs, avoidable deaths, changes in resource use and compatibility with global environmental targets, including those associated with food-related greenhouse gas emissions, land use, water use and fertilizer application. The tool was commissioned by the WHO Regional Office for Europe and is based on analytical frameworks developed by Marco Springmann and colleagues.

Can mobile apps facilitate more sustainable and healthier diets? A systematic review

Abstract Background One third of all greenhouse gas emissions come from the food system, and current diets are insufficient to meet environmental and public health goals. Digital health apps offer promise to change behaviour, but little is known about the effects of different types of apps. This systematic review assessed the effectiveness of mobile apps in facilitating dietary changes across adults from high-income countries. Methods Seven electronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, Global Health, GreenFILE, Web of Science), two trial registries (Cochrane Trials and Clinicaltrials.gov), and Google were systematically searched for intervention studies aiming to facilitate dietary change. Interventions were characterised by their use of messaging (e.g., motivational statements) and personalised features (e.g., tailored nutrition advice). Outcomes for three food groups were synthesised through meta-analysis. Results Of the 5261 identified records, 21 met the eligibility criteria and were included. Interventions, recruiting 73,973 participants in total, lasted from three days to six months. Overall positive changes were observed in daily servings of fruit and vegetables (0.59, 95% CI 0.20, 0.99), legumes (0.05, 95% CI 0.01, 0.08), and meat (-0.14, 95% CI -0.23, -0.05), remaining significant after removing non-randomised controlled trials. Changes in fruit and vegetable intake were more pronounced for users of apps with messaging components (0.75, 95% CI 0.18, 1.32) and personalisation (0.67, 95% CI 0.16, 1.19), and meat intake changes were larger for messaging-based apps (-0.21, 95% CI -0.27, -0.15) than apps without these features. Conclusions Our findings suggest to practitioners and policymakers that mobile apps could be a useful and innovative way to change behaviour. Within a wider behaviour change approach, apps could help facilitate diets that meet food-based dietary guidelines, are predominantly plant-based, and are protective of environmental and human health. Key messages • Overall, the results from 21 studies showed positive dietary changes towards more fruits, vegetables, and legumes and less meat consumption following the use of mobile apps. • Apps including messaging and personalised elements appeared most effective and may be important for driving changes in fruits, vegetables, and meat consumption.

Culinary medicine in type 2 diabetes management: co-designing the Cook2DIAbeat training program

Abstract Background Type 2 diabetes (hereinafter diabetes) stands among the top ten drivers of disease burden. Globally, more than 59 million adults are living with diabetes with a projection of 15% increase by 2045. The Cook2DIAbeat project aims to develop a tailor-made nutrition training program based on culinary medicine, for patients with diabetes to achieve lifelong dietary changes. The aim of the present work was to reveal potential drivers and barriers related to lifelong dietary modifications. Methods The study was implemented in February-July 2023 in Spain, Belgium, Greece, and Cyprus. A mixed-method co-design methodology was conducted: co-creation sessions with individuals with diabetes, family members, and healthcare professionals, and an online survey with patients with diabetes. Results In total, 23 health professionals and 25 patients and family members participated in the co-creation sessions, and 212 patients in the online survey. Patients and health professionals recognized the added value of the culinary approach for diabetes management. The main perceived barriers for changing dietary habits included difficulties accessing reliable and non-conflicting information, lack of time, emotional and psychological issues, and limited social support. Individuals at an advanced age and of low socioeconomic status seem to demand specific educational approaches addressing the actual challenges of their daily life. Conclusions The study indicated that training should provide reliable information and address psychosocial aspects. The translation of the dietary guidelines through the culinary medicine approach seems to be well-received by the target group. Last, the content needs to be tailored to suit the specific age group and socioeconomic background of the patients. Key messages • Reliability, practicability are three key characteristics of a nutrition training program in diabetes management. • Cultural and socioeconomic barriers needs to be taken into consideration.

Treatment of concomitant persistent chylothorax and superior vena cava syndrome through innominate vein-right atrial bypass.

Persistent chylothorax is a major challenge in paediatric patients. We present a case of a 6.5-kg, one-year-old boy with SVCS and persistent chylothorax, who underwent successful surgery without cardiopulmonary bypass. His medical history included multiple co-morbidities such as myeloproliferative disease, short bowel syndrome, and central vein catheterizations. The patient also had IV thrombosis, progressing to SVC, and was on anticoagulants. Despite dietary changes and somatostatin, his high-output chylous pleural effusion persisted. He was treated with innominate vein-to-right atrial bypass using a 6 mm Dacron graft. Postoperatively, there was a significant reduction in effusion and accelerated recovery. Somatostatin failure was likely due to mechanical obstruction of the thoracic duct.

A school-based intervention to foster adherence to the Mediterranean diet in adolescents: the PROMEDLIFE project

Abstract The need to maintain the production of local foods characterized by a high nutritional index, update traditional food production methodologies by developing attractive tech-based approaches, promote healthy eating habits that meet consumers’ preferences and acceptability, as well as reducing the complexity of supply chains (Farm to Fork) must be addressed to ensure food and nutrition security. This is especially true in Mediterranean countries undergoing dietary and nutritional changes that affect their inhabitants’ health while creating many socio-economic and environmental challenges. PROMEDLIFE aims to increase adherence to the Mediterranean diet through a multi-actor approach by encouraging the adoption of a healthy eating lifestyle while decreasing the environmental and economic impact of food production and processing. It also aims to attain optimal food communication and education through training programs that target primary and secondary students as well as their families, from children to older adults. A 4-week nutritional and sensory educational intervention in high school students involves frontal lessons, a web-app for families enrolled, and games on nutrients, food groups, balanced meals and various eating occasions, healthy and sustainable diets. In addition, adherence to the Mediterranean diet, nutritional knowledge, sociodemographic and lifestyle data, picky eating, and food neophobia are investigated. Including nutritional lectures in the school curriculum of high schools promotes knowledge acquisition about healthy diet. However, a period longer than 4 weeks may be necessary to translate this knowledge into improved eating habits. The project is still ongoing, and follow-up data collection will be performed. Final analysis, including data on picky eating and food neophobia, as well as overall eating behavior at follow-up, will allow an evaluation of possible long-term changes.

Effect of anti-inflammatory molecules from food on organoids derived from adenomatous polyps of FAP subjects.

Individuals with Familial Adenomatous Polyposis (FAP) or APC-associated polyposis, an autosomal dominant inherited condition, develop multiple adenomatous polyps and have an increased colorectal cancer (CRC) risk. A change in diet can help reduce cancer risk, and several dietary components have an antitumor effect. We aimed to evaluate the potential of the anti-inflammatory and anticancer substances quercetin (QER), epigallocatechin gallate (EGG) and fisetin (FIS) in decreasing the risk of CRC by reducing the growth of polyps in an organoid model. Patient-derived organoid (PDO) lines were generated from polyps obtained from patients with FAP undergoing prophylactic colectomy. PDOs were treated with QER, EGG, or FIS to determine their effect on cell growth. Changes in caspase 3/7 activity and expression of inflammation and apoptosis mediators were assessed by luminescent and colorimetric assays. Three PDO lines with different inactivating pathogenic variants in the APC gene were developed using a combinatorial approach. FIS was the most active of the three substances tested, presenting the lowest IC50 in all PDO lines (range: 42.6-9.2 uM). The IC50 was defined as the concentration required to halve the number of cells after 72 hours. All molecules tested induced apoptosis through activation of caspases 3/7. QER, EGG, and FIS can be easily taken from foods or dietary supplements, show toxicity on PDOs derived from adenomatous polyps, while they are known to be harmless on normal cells. Diets enriched with these substances could be potential supplemental treatments to reduce the risk of CRC in individuals with FAP.

Understanding barriers and facilitators to lifestyle management in people with polycystic ovary syndrome: A mixed method systematic review.

Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting 10-13% of reproductive-aged women. Lifestyle management through diet and physical activity changes can improve reproductive, metabolic, and psychological comorbidities. The aim of this systematic review is to understand the barriers and facilitators to lifestyle changes from the perspective of people with PCOS and health care professionals (HCP) using the theoretical domains framework and capability, opportunity, motivation, and behavior model. Six databases were systematically searched for qualitative, quantitative, and mixed-methods studies to 22nd September 2022. Quantitative outcomes from quantitative and mixed-methods studies were narratively synthesized and all studies were thematically analyzed. Sixty-eight papers met the eligibility criteria. HCP education on lifestyle management in PCOS was viewed by all to be inadequate, impacting the quality of care and health outcomes. Lifestyle advice delivered by a multidisciplinary team, including dietitians, was identified as a key component for change. All agreed that there was a need for individualized and PCOS-specific lifestyle advice. Weight stigma was identified as negatively impacting both those in larger and smaller bodies with PCOS, reducing the quality of care and affecting self-perception and mental health. People with PCOS perceived that lifestyle management was overly focused on weight loss and fertility, independent of their own personal motivations and goals. Systemic changes, including increasing HCP education on lifestyle management and multidisciplinary collaboration, focusing on lifestyle advice that meets individual needs, and reducing the use of weight-centric care are necessary for long-term sustainable changes and improvements in health outcomes in people with PCOS.

Alteration of the Intestinal Bacterial Community in Rainbow Trout (Oncorhynchus mykiss): The Role of Animal, Plant, and Microbial Diets

Intestinal bacterial community in rainbow trout (Oncorhynchus mykiss) is increasingly recognized as important for aquaculture and fish health. This review summarizes the current knowledge on how various feed components, including animal- and plant-derived ingredients, as well as other feed additives, influence the gut microbiota of rainbow trout. Studies using 16S rRNA gene profiling and metagenomics demonstrate how dietary changes affect the composition, diversity, and functionality of bacterial communities. The findings suggest that there is no single optimal alternative ingredient for fish feeds, but emphasize that the ratio of natural components plays a more significant role in shaping the intestinal bacterial community of trout. This balance is crucial for maintaining diversity, functionality, and overall fish health, thereby promoting growth and disease resistance, while enhancing aquaculture efficiency. The use of popular animal protein derived from the larva of Hermetia illucens increases the amount of Pseudomonadota, but the chitin they contain can prevent the absorption of nutrients. Thus, the development of optimal feed formulas requires careful selection and balancing of various natural ingredients to sustain a healthy microbiota and overall fish well-being.