Dietary Protocol Research Articles

Molecular mechanisms underlying the beneficial effects of exercise and dietary interventions in the prevention of cardiometabolic diseases.

Cardiometabolic diseases still represent a major cause of mortality worldwide. In addition to pharmacological approaches, lifestyle interventions can also be adopted for the prevention of these morbid conditions. Lifestyle changes include exercise and dietary restriction protocols, such as calorie restriction and intermittent fasting, which were shown to delay cardiovascular ageing and elicit health-promoting effects in preclinical models of cardiometabolic diseases. Beneficial effects are mediated by the restoration of multiple molecular mechanisms in heart and vessels that are compromised by metabolic stress. Exercise and dietary restriction rescue mitochondrial dysfunction, oxidative stress and inflammation. They also improve autophagy. The result of these effects is a marked improvement of vascular and heart function. In this review, we provide a comprehensive overview of the molecular mechanisms involved in the beneficial effects of exercise and dietary restriction in models of diabetes and obesity. We also discuss clinical studies and gap in animal-to-human translation.

High and low temperature processing: Effective tool reducing pesticides in/on apple used in a risk assessment of dietary intake protocol

Apples play an important role in everyone's diet and may contain pesticide residues that can pose a significant health problem for consumers. Various technological processes are promising methods for minimizing pesticide concentrations in fruit. Therefore, the subject of this comprehensive study was to investigate the effects of high-temperature (baking) and low-temperature (freeze-drying) processes on the change in the levels of nine fungicides in apples with skin and peeled. The investigated compounds belong to the chemical groups of benzimidazole (thiophanate methyl and carbendazim), phtalimide (captan and their metabolite tetrahydrophtalimid (THPI)), strobilurin (pyraclostrobin, trifloxystrobin) and triazole (difenoconazole, tebuconazole, tetraconazole). Processing factors (PF) were calculated for each pesticide-process-product combination. The results show that baking and freeze-drying generally reduced pesticide concentrations, with PFs ranging from 0.31 to 0.81 and 0.26 to 0.68, respectively. Apart from freeze-drying for carbendazim and baking for captan, PFs were above 1. Only for thiophanate-methyl, a complete reduction was observed, which resulted from complete degradation to carbendazim. The study also aimed to assess human risk according to the new strategy for different sub-populations with conversion using the 36 PFs obtained. The highest acute exposure (expressed as %ARfD) was obtained for tebuconazole in raw apples (initial concentration of 1.42 mg/kg; 400% ARfD) for Dutch toddlers. After food processing, this decreased to 284% (0.74 mg/kg, baking) and to 137% (0.37 mg/kg, freeze-drying), but was still above the safety limit. Similarly, for adults and the general French population for tebuconazole, the %ARfD was high as it reached the values of 104% (initial concentration of 0.89 mg/kg) in unprocessed apples, 73.9% after baking (0.73 mg/kg) and 35.6% after freeze-drying (0.35 mg/kg). The results indicate that food processing techniques can potentially be used to minimize the hazardous effects of pesticide residues on human health.

Validation of a dietary advice protocol for adults with obesity in primary health care according to the Brazilian Dietary Guidelines.

Obesity is a non-communicable chronic disease which carries a high cost for the Brazilian Unified Health System. Standardized protocols can help primary health care (PHC) professionals manage the disease. To describe the validation process of a protocol concerning dietary guidelines for adults with obesity in PHC by non-nutrition professionals. A validation study of a dietary advice protocol consisting of 6 recommendations was conducted according to Brazilian Dietary Guidelines. The topics incorporated into the recommendations were submitted to a panel of judges for content validity and achieved a Scale Content Validity Index (S-CVI) score >0.80. Subsequently, an online workshop was held and consisted of guiding questions to adequately improve current protocols. Face validity was assessed in a mediation workshop conducted with PHC non-nutrition professionals. Following the validation process, necessary adjustments were made to the eating protocol. The validation process was conducted by a panel of 20 judges and 10 PHC professionals. The content was validated using a 0.98 S-CVI. The online workshop expert panel agreed the instrument provides a trustworthy foundation for appropriate dietary guidelines. Moreover, the judges suggested changes to the flowchart designed to support the professionals' decisions, discussed the absence of quantitative prescription guidelines, and offered additional suggestions to strengthen equity and encourage autonomy in non-nutrition healthcare professionals in PHC. This study describes the validation process of a dietary advice protocol for people with obesity, as well as the importance of its integration into PHC.

A review of the diet, nutrients, and supplementation potential for the outcome augmentation in surgical treatment of peripheral nerve injuries.

Although the studies have shown the beneficial effects of diet, nutrition, and supplementation as an independent treatment modality, their roles are underestimated in the treatment of peripheral nerve injuries. This is in great part due to the development of efficient nerve repair techniques, combined with physical treatment and stimulation. To achieve the best possible functional recovery diet, nutrition, and supplementation should be implemented within a multidisciplinary approach. The aim of the study is to provide insight into the potentially beneficial effects of diet, nutrients, and supplementation, in the limitation of nerve damage and augmentation of the functional recovery after surgery in a review of human and animal studies. The data relating to the diet, nutrients, and supplementation effects on peripheral nerve injuries and their treatment was extracted from the previously published literature. General balanced diet as well as obesity influence the initial nerve features prior to the injury. In the period following the injury, neuroprotective agents demonstrated beneficial effects prior to surgery, and immediately after the injury, while those potentiating nerve regeneration may be used after the surgical repair to complement the physical treatment and stimulation for improved functional recovery. Standardized diet, nutrition, and supplementation recommendations and protocols may be of great importance for better nerve regeneration and functional recovery as a part of the multidisciplinary approach to achieve the best possible results in surgically treated patients with peripheral nerve injuries in the future.

Postoperative Poor Oral Intake After Distal Pancreatectomy.

Poor oral intake (POI) without an identifiable cause is frequently observed after distal pancreatectomy (DP). This study was designed to investigate the incidence and risk factors of POI after DP, and its impact on the length of hospital stay. The prospectively collected data of patients who received DP were retrospectively reviewed. A diet protocol after DP was followed, and POI after DP was defined as the oral intake being less than 50% of the daily requirement and parenteral calorie supply being required on postoperative day 7. Of the 157 patients, 21.7% (34) experienced POI after DP. The multivariate analysis revealed that the remnant pancreatic margin (head; hazard ratio, 7.837; 95% confidence interval, 2.111-29.087; P = 0.002) and postoperative hyperglycemia >200 mg/dL (hazard ratio, 5.643; 95% confidence interval, 1.482-21.494; P = 0.011) were independent risk factors for POI after DP. The length of hospital stay (median [range]) of the POI group was significantly longer than that of the normal diet group (17 [9-44] vs 10 [5-44] days; P < 0.001). Patients undergoing pancreatic resection at pancreatic head portion should follow a postoperative diet, and postoperative glucose levels should be strictly regulated.

OR20-3 Characterization of the Pathophysiologic Spectrum of Subclinical Primary Aldosteronism in Normotension

Abstract Context Accumulating evidence suggests that primary aldosteronism can manifest across a broad phenotypic spectrum and that its origins can at times be detected among normotensive individuals. Herein, we conducted deep-phenotyping studies to interrogate the pathophysiologic continuum of the primary aldosteronism phenotype among normotensive participants. Methods Normotensive participants with obesity, metabolic syndrome, and/or high-normal untreated blood pressure underwent dietary sodium loading and restriction protocols (to maximally suppress and stimulate angiotensin II-mediated aldosterone production), dexamethasone suppression and cosyntropin stimulation protocols (to maximally suppress and stimulate ACTH-mediated aldosterone production), and 24h ambulatory blood pressure monitoring. Measurement of aldosterone and 18-hybrid steroids via LC-MS/MS was conducted to quantify the degree of dysregulated CYP11B2 expression. Urinary extracellular vesicles (uEV) were isolated to measure renal tubular protein content associated with mineralocorticoid receptor activation. In order to characterize parameters across the severity spectrum of non-suppressible and renin-independent aldosterone production, participants with suppressed renin activity were categorized by tertile of 24h urinary aldosterone production following oral sodium suppression testing. Repeated measures linear mixed models were used to analyze trends for each parameter across tertiles of autonomous aldosterone production; for ease of presentation, the mean [SD] of the first vs. third tertile are presented for selected parameters. Results Following oral sodium loading, greater non-suppressible renin-independent aldosterone production was associated with greater kaliuresis, higher daytime ambulatory systolic blood pressure within the normal range, and a progressive impairment in the ability to suppress production of serum aldosterone (P-trend=0.009), 18-hydroxycorticosterone (9.3 [5.0] vs. 19.6 [6.5] ng/dL, P-trend=0.004), 18-hydroxycortisol (45.0 [25.4] vs. 70.9 [29.9] ng/dL, P-trend=0.03), and 18-oxocortisol (1.2 [0.03] vs. 3.4 [7.2], P-trend=0.01). Similarly, following dexamethasone suppression testing, there was a progressive inability to suppress 18-hydroxycorticosterone (8.3 [5.0] vs. 15.4 [8.2] ng/dL, P-trend=0.004), 18-hydroxycortisol (6.6 [3.8] vs. 10.2 [3.6] ng/dL, P-trend=0.03), and 18-oxocortisol (1.2 [0.01] vs. 1.4 [0.6] ng/dL, P-trend=0.01) in parallel with greater renin-independent aldosterone production. In contrast, following stimulation with cosyntropin, greater non-suppressible and renin-independent aldosterone production was associated with progressively enhanced production of 18-hydroxycorticosterone (77.6 [25.4] vs. 121.1 [31.1] ng/dL, P-trend=0.004), 18-hydroxycortisol (68.5 [28.4] vs. 86.2 [26.3] ng/dL, P-trend=0.03), and 18-oxocortisol (3.2 [2.8] vs. 7.3 [3.5] ng/dL, P-trend=0.01). Excretion of uEV's of pendrin (P=0.002) and aquaporin 2 (P=0.002) all increased with greater non-suppressible aldosterone production. Conclusions Dynamic phenotyping studies in normotensive individuals demonstrate a continuum of non-suppressible and renin-independent aldosterone production that parallels higher blood pressure, greater kaliuresis, increased 18-hybrid steroid production indicative of dysregulated CYP11B2 expression, and increased uEV excretion indicative of renal mineralocorticoid receptor activation. This pathophysiologic continuum of normotensive primary aldosteronism provides phenotypic support for histopathology studies showing ectopic CYP11B2 expression within adrenal glands of normotensive humans, and for epidemiologic studies demonstrating renin-independent aldosterone production in normotensive populations increases risk for developing hypertension. Presentation: Monday, June 13, 2022 11:30 a.m. - 11:45 a.m.

Are the Modern Diets for the Treatment of Obesity Better than the Classical Ones?

Conventional hypocaloric diets, providing continuous energy restriction, are considered to be the cornerstone of dietary management of obesity. Although energy-restricted diets are overall safe, healthy, and modestly effective, their long-term adherence is difficult to accomplish. Intermittent fasting and ketogenic diets have emerged as attractive alternative dietary options for weight loss and improvement in cardiometabolic risk. Intermittent fasting is a unique dietary pattern characterized by periods of eating alternated with periods of fasting. Ketogenic diets are very low in carbohydrate, modest in protein, and high in fat. Several systematic reviews and meta-analyses of randomized controlled trials (RCTs) have reported beneficial but short-lived effects of intermittent fasting and ketogenic diets on various obesity-related health outcomes. Although for both diets, the current evidence is promising and steadily evolving, whether they are better than traditional calorie-restricted diets, whether they can safely lead to sustained weight loss and overall health benefits, and their effects on body composition, weight loss maintenance, energy intake and expenditure, diet quality, and cardiometabolic risk factors are still not unequivocally proven. The aim of the present review is to summarize the current state of evidence regarding the effects of these two popular modern diets, namely intermittent fasting and ketogenic diets. We describe the rationale and characteristics of different dietary protocols, we analyze the major mechanisms explaining their weight loss and cardiometabolic effects, and we provide a concise update on their effects on body weight and cardiometabolic risk factors, focusing on meta-analyses of RCTs. We also discuss knowledge gaps in the field of these diets, and we indicate directions for future research.

Duodenojejunal Omega Switch Surgery Reduces Oxidative Stress Induced by Cafeteria Diet in Sprague-Dawley Rats.

Over-nutrition with cafeteria diet leads to glycemic control failure and subsequent obesity. Bariatric surgery remains the ultimate treatment option, and when complemented with specific dietary protocol, it may mitigate the effects of oxidative stress induced by a cafeteria diet. The study measured antioxidant marker activity: superoxidase dismutase (SOD) and ceruloplasmin (CER), total antioxidant capacity (TAC), and lipid peroxidation marker concentrations: lipofuscin (LS) and malondialdehyde (MDA), in the plasma of 56 Sprague-Dawley rats fed with a cafeteria (HFS) or a control (CD) diet and subjected to duodenojejunal omega switch (DJOS) or control (SHAM) surgery. The diet change after the surgery (CD/HFS or HFS/CD) strongly influenced SOD activity in DJOS- and SHAM-operated rats, but SOD activity was always higher in SHAM-operated rats. Every dietary protocol used in the study increased CER activity, except for the CD/CD combination. Cafeteria diet consumed before or after either of surgeries led to decrease in TAC levels. DJOS and no change in diet reduced MDA levels. DJOS reduced LS levels, but its beneficial effect was deteriorated by selected dietary protocols. The cafeteria diet negatively affected the positive impact of DJOS surgery, but SOD, CER, MDA, and LS were significantly lower in rats that underwent DJOS, suggesting that eight weeks of dietary treatment before and after the surgery did not totally dilapidate the effects of the bariatric treatment.

The effect of acute manipulation of carbohydrate availability on high intensity running performance, running economy, critical speed, and substrate metabolism in trained Male runners

ABSTRACT Completing selected training sessions with reduced glycogen availability is associated with greater signalling and improved muscle oxidative capacity, although it may impact the overall quality of the session. We examined the effects of low carbohydrate availability on high intensity exercise performance, running economy, critical speed, and substrate metabolism. On two occasions, nine male runners (V̇O2peak 60.3 ± 3.3 mL.kg−1.min−1) completed a glycogen depletion protocol involving 90-min at 75%vV̇O2peak followed by 10 × 1-min at 110% vV̇O2peak. This was followed either by high (HIGH) or low (LOW) carbohydrate intake (>6 g.kg−1.day−1 and <50 g.day−1, respectively) until completion of a performance protocol on day 2 consisting of a series of time-trials (TT) (50m to 3000m) and physiological assessments. There were no differences between LOW and HIGH for any TT distance (mean TT performance times for LOW and HIGH were: 3000m TT 651.7 ± 52.8s and 646.4 ± 52.5s, 1500 m TT 304.0 ± 20.2s and 304.2 ± 22.1s, 400 m TT 67.64 ± 4.2s and 67.3 ± 3.8s, 50 m TT 7.27 ± 0.44s and 7.25 ± 0.45s, respectively, P > 0.05), though some athletes performed better in LOW (n = 5). While fat oxidation in LOW was significantly greater than HIGH (Δ0.32 ± 0.14 g.min−1; P < 0.001 at 14 km.h−1 and Δ0.34 ± 0.12 g.min−1 at 16 km.h−1; P < 0.01), running economy did not differ between trials (P > 0.05). Acute manipulation of carbohydrate availability showed immediate effects on substrate metabolism evidenced by greater fat oxidation without changes in RE. Acute low carbohydrate availability did not affect high intensity running performance across a range of distances. Highlights Acute manipulation of muscle glycogen availability using an exercise and dietary manipulation protocol did not affect subsequent high intensity running performance across a range of running distances. Reduced muscle glycogen resulted in a marked increase in fat oxidation in low glycogen condition but no changes in running economy or critical speed. Individual factors should be considered when prescribing high intensity sessions with restricted carbohydrate availability.

Feed withdrawal coupled with classical conditioning modifies the behavioral, physiological, and productive traits in Japanese quail (Coturnix Coturnix japonica)

This study was conducted to investigate the influence of different feed withdrawal (FW) and ad libitum dietary protocols on the behavioral, physiological, and productive traits in Japanese quail (Coturnix Coturnix japonica). A total of 192 chicks were randomly allocated to 4 treatment groups (Control, 8-hrs fasting, 12-hrs fasting, and 16-hrs fasting) from the 3rd to the 5th weeks of age. Three replicates were performed for each treatment, with 16 chicks per replicate. Birds were conditioned to the FW-related hunger by introducing an alarm cue. A simple ethogram was created, and the treatment group, model and time of observation were used as fixed factors. The temporal conditioning by adding an alarm cue improved the behavioral responses of birds prior to the start of the FW. In addition, quails reared in the FW groups exhibited significantly lower physiological indicators of stress, i.e., lower corticosterone serum levels and heterophil/lymphocyte ratio, than the control group. Histological degenerations were prominent in the 12- and 16-hrs fasting groups. Both body weight (BW) and feed conversion ratio (FCR) in quails did not significantly differ between treatment groups (p = 1.00 and p = 0.55, respectively) at the end of the rearing period, but those in the 12- and 16-hrs fasting groups showed lower carcass weight. Quails in the different FW groups showed an improvement in meat quality parameters than those in the control group. Overall, FW either for 8 or 12 hrs. a day could be used as a promising dietary strategy in Japanese quails.

Ketogenic Diet for Preoperative Weight Reduction in Bariatric Surgery: A Narrative Review.

Bariatric surgery (BS) is the most effective treatment in reducing weight and the burden of comorbidities in patients with severe obesity. Despite the overall low mortality rate, intra- and post-operative complications remains quite common. Weight loss before BS reduces surgical risk, but studies are inconclusive regarding which is the best approach to apply. In this review, we summarize the current evidence on the effect of a ketogenic diet (KD) before BS. All studies agree that KD leads to considerable weight loss and important improvements in terms of surgical risk, but populations, interventions and outcomes are very heterogeneous. KD appears to be a safe and effective approach to induce weight loss before BS. However, randomized controlled trials with better-defined dietary protocols and homogeneous outcomes are necessary in order to draw firm conclusions.

Twelve-month outcomes in overweight/obese users with mental disorders following a multi-element treatment including diet, physical activity, and positive thinking: The real-world "An Apple a Day" controlled trial.

The present study aimed to evaluate the 12-month effectiveness of a real-world weight loss transdiagnostic intervention in overweight/obese participants affected by mental disorders under psychopharmacological treatment. We conducted a real-world, controlled, pragmatic outpatient trial. We allocated 58 overweight/obese adults under psychopharmacological treatment from a mental health outpatient unit and 48 overweight/obese adults from a cardiovascular prevention outpatient unit, and assigned them to an intervention or treatment usual as condition (TAU) enriched by life-style advice. Participants in both intervention groups took part in a diet programme (the modified OMNIHeart dietary protocol) and monitoring of regular aerobic activity. A brief group programme (“An Apple a Day” Metacognitive Training, Apple-MCT) was added in the intervention group of participants affected by mental disorders. The primary outcome was weight loss. Secondary outcomes included anthropometric, clinical, and metabolic variables. Psychopathology and health-related quality of life were also evaluated in the psychiatric sample. At 12 months, both intervention groups showed a more marked mean decrease in weight (6.7 kg, SD: 3.57) than the TAU group (0.32 kg, SD: 1.96), and a statistically significant improvement in metabolic variables compared with the control groups. Furthermore, the participants affected by mental disorders included in the intervention group reported improved health-related quality of life. Our findings suggest the need to implement integrated interventions based on a dietary protocol, physical activity, and modification of cognitive style in overweight/obese users with mental disorders.

Irisin improves adiposity and exercise tolerance in a rat model of postmenopausal obesity through enhancing adipo-myocyte thermogenesis

The prevalence of obesity and its associated metabolic disorders, along with their healthcare costs, is rising exponentially. Irisin, an adipomyokine, may serve as a critical cross-organ messenger, linking skeletal muscle with adipose tissue and the liver to integrate the energy homeostasis under diet-induced obesity. We aimed to explore the putative role of irisin in the protection against obesity in a postmenopausal rat model by modulating energy expenditure (EE). Bilateral ovariectomy (OVX) was performed. After 3 weeks of recovery, the OVX rats were classified according to their dietary protocol into rats maintained on normal diets (ND) (OVX) or high-fat diet (HFD) groups. The HFD-fed animals were equally divided into OVX/HFD, or irisin-treated OVX/HFD groups. Sham rats, maintained on ND, were selected as the control group. We evaluated anthropometric, EE, and molecular biomarkers of browning and thermogenesis in inguinal white adipose tissue and skeletal muscle, and the activity of the proteins related to mitochondrial long chain fatty acid transport, oxidation, and glycolysis. HFD of OVX further deteriorated the disturbed glucose homeostasis, lipid profile, and the reduced irisin, thermogenic parameters in adipose tissue and skeletal muscle, and EE. Irisin treatment improved the lipid profile and insulin resistance. That was associated with reduced hepatic gluconeogenic enzyme activities and restored hepatic glycogen content. Irisin reduced ectopic lipid infiltration. Irisin augmented EE by activating non-shivering thermogenesis in muscle and adipose tissues and decreasing metabolic efficiency. Our experimental evidence suggests irisin’s use as a potential thermogenic agent, therapeutically targeting obesity in postmenopausal patients.Graphical abstractIrisin modulates the non-shivering thermogenesis in skeletal muscle and adipose tissue in postmenopausal model

Dietary Standardisation in a Nutrient plus Exercise Intervention: Derivation, Implementation, and Evaluation

The objective was to devise and implement a dietary standardisation protocol for use in nutrient plus exercise intervention studies, and to report participant adherence to, and acceptability of same. The context was a nutrient plus exercise intervention study undertaken by resistance-trained men (18 to 35y). Participants’ habitual, seven-day, weighed dietary intake records informed the dietary standardisation protocol. Participants received a six-day meal plan that was prescribed relative to their body mass and provided 35 kcal∙kg-1∙d-1 comprising 2.0 g∙kg-1∙d-1 protein (including 0.33 g∙kg-1 of dietary protein supplement), 4.5 g∙kg-1∙d-1 carbohydrate, and 1.0 g∙kg-1∙d-1 fat. Apportioning of total protein intake was evenly distributed across six eating occasions (EOs), at three-hour intervals during waking hours. Median (25th-75th percentile) participant adherence to the prescribed meal plan was 100 (99-100)% for energy, carbohydrate and fat intakes, 100 (100–100)% for protein intake and frequency of EOs consumed, and 97 (93–100)% for distribution of EOs consumed. On study completion, 10 participants (45%) expressed that the standardised diet was easy to follow. Ten participants (45%) indicated activities of daily living as the primary challenge to adherence. The offered dietary standardisation (i.e. a protocol introduced 72 hours before the intervention study and a standardised diet) was effective in minimising the variability of dietary intake among participants undertaking a nutrient plus exercise intervention. The dietary standardisation resulted in high participant adherence and was well accepted.

Multi-Tissue Time-Domain NMR Metabolomics Investigation of Time-Restricted Feeding in Male and Female Nile Grass Rats.

Metabolic disease resulting from overnutrition is prevalent and rapidly increasing in incidence in modern society. Time restricted feeding (TRF) dietary regimens have recently shown promise in attenuating some of the negative metabolic effects associated with chronic nutrient stress. The purpose of this study is to utilize a multi-tissue metabolomics approach using nuclear magnetic resonance (NMR) spectroscopy to investigate TRF and sex-specific effects of high-fat diet in a diurnal Nile grass rat model. Animals followed a six-week dietary protocol on one of four diets: chow ad libitum, high-fat ad libitum (HF-AD), high-fat early TRF (HF-AM), or high-fat late TRF (HF-PM), and their liver, heart, and white adipose tissues were harvested at the end of the study and were analyzed by NMR. Time-domain complete reduction to amplitude–frequency table (CRAFT) was used to semi-automate and systematically quantify metabolites in liver, heart, and adipose tissues while minimizing operator bias. Metabolite profiling and statistical analysis revealed lipid remodeling in all three tissues and ectopic accumulation of cardiac and hepatic lipids for HF-AD feeding compared to a standard chow diet. Animals on TRF high-fat diet had lower lipid levels in the heart and liver compared to the ad libitum group; however, no significant differences were noted for adipose tissue. Regardless of diet, females exhibited greater amounts of hepatic lipids compared to males, while no consistent differences were shown in adipose and heart. In conclusion, this study demonstrates the feasibility of performing systematic and time-efficient multi-tissue NMR metabolomics to elucidate metabolites involved in the crosstalk between different metabolic tissues and provides a more holistic approach to better understand the etiology of metabolic disease and the effects of TRF on metabolic profiles.

Review of Diet Protocols Following Orthognathic Surgery and Analysis of Postoperative Weight Loss.

Orthognathic surgery is routinely practiced, yet little comparative data exists to evaluate post-orthognathic surgery diet protocols. To evaluate which postoperative diet protocols are recommended and to quantify post-orthognathic surgery weight changes in our institutional cohort. An internet search was carried out on Google for "orthognathic surgery diet" and the postoperative diet recommendations from centers worldwide were quantified. Additionally, a retrospective analysis of patients that underwent orthognathic surgery at our institution was performed, and their preoperative and postoperative weights were recorded. The internet search yielded 58 centers that met our inclusion criteria. Most centers were in the United States (n = 37, 63.8%) and were oral and maxillofacial surgeon (OMFS)-led centers (n = 39, 67.2%). Postoperative diets were categorized into 7 distinct protocols, ranging from most to least restrictive-the most popular was liquid diet for 2 to 4 weeks followed by soft diet for 2 to 6 weeks. There were no significant patterns observed across different geographical regions or specialties.In our institution, 135 patients were identified. Overall, there was an average maximum weight loss of 4.1 kg by week 4, followed by a gradual increase in weight. Linear regression analysis showed that patients with greater preoperative body mass index (BMI) lost more weight postoperatively than patients with lower BMI (R2 = 0.25, P < .001). There is a significant variability in recommended postoperative diets following orthognathic surgery. Following a moderately restrictive diet at our institution, patients returned to their preoperative weight after approximately 4 months.

Alternate-day fasting, a high-sucrose/caloric diet and praziquantel treatment influence biochemical and behavioral parameters during Schistosoma mansoni infection in male BALB/c mice

Schistosoma mansoni-induced granulomas result in severe damage to the host's liver, as well as neurological and metabolic disorders. We evaluated the biochemical and behavioral changes during schistosomiasis under three diet protocols: ad libitum (AL), alternate-day fasting (ADF) and a high-sucrose/caloric diet (HSD). Healthy male BALB/c mice were divided into noninfected, matched infected and infected/treated [praziquantel (PZQ)] groups. Caloric intake and energy efficiency coefficients associated with diets were measured. Behavioral (exploratory and locomotor) and biochemical (glucose, triglycerides, total cholesterol, AST, ALT, ALP, and γ-GT) tests and histological analysis were performed. Fifteen weeks postinfection, HSD and PZQ promoted weight gain, with higher caloric consumption than ADF (p < 0.05), reflecting serum glucose levels and lipid profiles. HSD and PZQ prevented liver dysfunction (AST and ALT) and significantly prevented increases in granuloma area (p < 0.05). HSD and PZQ also significantly improved mouse physical performance in exploratory and locomotor behavior (p < 0.05), reversing the impaired motivation caused by infection. These findings showed that ADF worsened the course of S. mansoni infection, while HSD and PZQ, even with synergistic effects, prevented and/or attenuated biochemical and behavioral impairment from infection.

Dietary interventions and molecular mechanisms for healthy musculoskeletal aging.

Over the past decade, extensive efforts have focused on understanding age-associated diseases and how to prolong a healthy lifespan. The induction of dietary protocols such as caloric restriction (CR) and protein restriction (PR) has positively affected a healthy lifespan. These intervention ideas (nutritional protocols) have been the subject of human cohort studies and clinical trials to evaluate their effectiveness in alleviating age-related diseases (such as type II diabetes, cardiovascular disease, obesity, and musculoskeletal fragility) and promoting human longevity. This study summarizes the literature on the nutritional protocols, emphasizing their impacts on bone and muscle biology. In addition, we analyzed several CR studies using Gene Expression Omnibus (GEO) database and identified common transcriptome changes to understand the signaling pathway involved in musculoskeletal tissue. We identified nine novel common genes, out of which five were upregulated (Emc3, Fam134b, Fbxo30, Pip5k1a, and Retsat), and four were downregulated (Gstm2, Per2, Fam78a, and Sel1l3) with CR in muscles. Gene Ontology enrichment analysis revealed that CR regulates several signaling pathways (e.g., circadian gene regulation and rhythm, energy reserve metabolic process, thermogenesis) involved in energy metabolism. In conclusion, this study summarizes the beneficiary role of CR and identifies novel genes and signaling pathways involved in musculoskeletal biology.

Ketogenic and Modified Mediterranean Diet as a Tool to Counteract Neuroinflammation in Multiple Sclerosis: Nutritional Suggestions.

Ketogenic Diet is a nutritional pattern often used as dietotherapy in inflammatory diseases, including neurological disorders. Applied on epileptic children since 1920, in recent years it has been taken into account again as a tool to both reduce inflammatory burdens and ameliorate the nutritional status of patients affected by different pathologies. Multiple sclerosis (MS) is considered an immune-mediated neuro-inflammatory disease and diet is a possible factor in its pathogenesis. The aim of this work is to investigate the main potential targets of MS-related impairments, in particular the cognitive deficits, focusing on the alteration of biomarkers such as the Brain Derived-Neurotrophic Factor and the Tryptophan/Kynurenine ratio that could play a role on neuroprotection and thus on MS progression. Furthermore, we here propose nutritional suggestions which are useful in the development of a ketogenic diet protocol that takes advantage of the anti-inflammatory properties of low-carbohydrate foods from the Mediterranean diet to be applied to subjects with MS. In conclusion, this approach will allow one to develop the ketogenic diet combined with a modified Mediterranean diet as a possible tool to improve neuroinflammation in multiple sclerosis.

7-DAYS HIGH-SALT DIET AFFECTS NO-MEDIATED MICROVASCULAR ENDOTHELIAL VASODILATION IN YOUNG HEALTHY INDIVIDUALS

Objective: We have previously reported that short-term (7-days) high-salt (HS) loading impairs microvascular endothelial function in young healthy individuals, independently of blood pressure (BP) or body composition and fluid status changes. This study aimed to functionally assess specifically nitric-oxide (NO) mediated endothelial vasodilation of skin microcirculation in response to 7-day HS diet in healthy salt-resistant individuals. Design and method: 20 young healthy individuals (10 women and 10 men), age ranged between 19–24 years, participated in the present study. All subjects adhered to a 7-day low-salt (LS) diet (3.5 g salt/day) followed by a 7-day high-salt (HS) diet (∼14.7 g salt/day) protocol. To confirm that subjects conformed to the diet protocol, daily salt intake based on 24-h urinary sodium excretion was calculated using appropriate formula before and after HS diet protocol. Blood pressure (BP) was measured before and after respective diet protocols and salt resistance was defined as a &lt; 5 mmHg change in mean arterial pressure (MAP) determined on LS versus HS diet. NO-mediated microvascular endothelial vasodilation in response to local heating (42°C) was functionally assessed using laser Doppler Flowmetry (LDF) (moorVMS-LDF, Moor Instruments, UK) and skin heater controller (moorVMS-HEAT, Moor Instruments, UK). Results: 24-hour sodium excretion significantly increased following HS diet compared to LS conditions (salt/g LS 6.6 ± 2.6 vs. HS 14.3 ± 2.5, P &lt; 0.001). Salt resistance was confirmed in all subjects undergoing study (MAP/mmHg LS 87 ± 7 vs. HS 86 ± 9, P = 0.829). 7-day HS diet significantly reduced skin microvascular flow increase in response to local heating compared to LS conditions (LDF HEAT LS 14.16 ± 6.01 vs. HS 10.67 ± 3.27, P = 0.006). Conclusions: Results of the present study have functionally demonstrated that 7-days HS diet alters specifically NO-mediated endothelium-dependent of skin microcirculation in salt-resistant young healthy individuals.