Diet Therapy In Patients Research Articles

Role of Gluten-Free Diet on HbA1c Level in Children with Type 1 Diabetes Mellitus and Celiac Disease

Background: Due to autoimmune mechanisms, celiac disease (CD) may affect patients with type 1 diabetes mellitus (T1DM) more than the general population. Objectives: We evaluated the effect of a gluten-free diet (GFD) on HbA1c levels in patients with both type 1 diabetes and CD. Methods: In this cross-sectional study, biochemical and clinical information was gathered from 174 children with T1DM from January 2013 to January 2019. Results: We assessed 174 children with T1DM (93 girls and 81 boys). Celiac disease was diagnosed in 18 out of 174 cases (10.34%). Height and weight percentiles showed significant differences between children with CD and those without CD (P = 0.015 and P = 0.026, respectively). The average HbA1c in the celiac group was 8.61 ± 2.20 (95% CI: 5.1 - 12.1) prior to GFD therapy. HbA1c was assessed six and twelve months following the initiation of the GFD and was found to be 8.32 ± 1.46 (95% CI: 6 - 9.8) and 8.37 ± 1.67 (95% CI: 6.1 - 10.2), respectively. No significant change in HbA1c was observed before and after therapy (P = 0.501). Conclusions: Diabetic children with CD exhibit lower weight and height compared to those without CD. Gluten-free diet therapy in patients with CD did not affect HbA1c levels.

Algorithm for personalization of diet therapy in patients with atrial fibrillation and obesity based on metabolic status assessment

Aim: To develop an algorithm for personalizing the diet therapy of patients with obesity and atrial fibrillation (AF) based on the assessment of the metabolic status.Material and Methods. The study included 100 patients with grade III obesity and paroxysmal AF. All subjects had nonvalvular AF. Anthropometric parameters, actual nutrition, bioimedance analysis of body composition, basal metabolic rate (BMR) were assessed.Results. Changes in basal metabolism by gender were identified. In women – a decrease in the rate of carboydrate oxidation (CHO) (by 27 ± 12.2%, p < 0.05), an increase in fat oxidation (by 48,58 ± 14.6%, p < 0.01). In men – a decrease in BMR (by 26,23 ± 13.6%, p < 0.05), CHO (by 57,18 ± 18.1%, p < 0.01) and protein (by 28,06 ± 12.9%, p < 0.05), increased rate of fat oxidation (by 31,42 ± 10.0%, p <0.05). A hyperphagic pattern of actual nutrition has been established: excess daily energy intensity (by 16–44%), excess of daily intake of proteins (by 34–54%), fats (by 17% in women) and carbohydrates (by 57–72%, p < 0.05). An excessive amount of saturated fat, cholesterol, and added sugar was revealed in the diet. A deficiency in vitamin D intake was found (by 8–16%, p < 0.05). The maximum daily energy requirement for 95% of women is within 2250 kcal/day, for men – 2950 kcal/day.Conclusion. Metabolic status disorders serve as factors of hemodynamic overload, humoral and electrical dysfunction of the heart. Diet therapy is a powerful component in the treatment and prevention of AF. It is advisable to carry out an algorithm for individual correction of the chemical composition and energy value of diet therapy taking into account the optimal metabolic corridor of needs, enriching the diet with vitamin D, eliminating added sugar, cholesterol, sodium, phosphorus, and sources of vitamin K.

Long-term effectiveness and tolerability of ketogenic diet therapy in patients with genetic developmental and epileptic encephalopathy onset within the first 6 months of life.

To investigate the effectiveness and tolerability of ketogenic diet therapy (KDT) in patients with developmental and epileptic encephalopathy (DEE) associated with genetic etiology which onset within the first 6 months of life, and to explore the association between response to KDT and genotype/clinical parameters. We retrospectively reviewed data from patients with genetic DEE who started KDT at Beijing Children's Hospital between January 1, 2016, and December 31, 2021. A total of 32 patients were included, involving 14 pathogenic or likely pathogenic single genes, and 16 (50.0%) patients had sodium/potassium channel gene variants. The median age at onset of epilepsy was 1.0 (IQR: 0.1, 3.0) months. The median age at initiation of KDT was 10.0 (IQR: 5.3, 13.8) months and the median duration of maintenance was 14.0 (IQR: 7.0, 26.5) months, with a mean blood β-hydroxybutyrate of 2.49 ± 0.62 mmol/L. During the maintenance period of KDT, 26 (81.3%) patients had a ≥50% reduction of seizure frequency, of which 12 (37.5%) patients achieved seizure freedom. Better responses were observed in patients with STXBP1 variants, with four out of five patients achieving seizure freedom. There were no statistically differences in the age of onset, duration of epilepsy before KDT, blood ketone values, or the presence of ion channel gene variants between the seizure-free patients and the others. The most common adverse effects were gastrointestinal side effects, which occurred in 21 patients (65.6%), but all were mild and easily corrected. Only one patient discontinued KDT due to nephrolithiasis. KDT is effective in treating early onset genetic DEE, and no statistically significant relationship has been found between genotype and effectiveness in this study. KDT is well tolerated in most young patients, with mild and reversible gastrointestinal side effects being the most common, but usually not the reason to discontinue KDT. This study evaluated the response and side effects of ketogenic diet therapy (KDT) in patients who had seizures within the first 6 months of life, and were diagnosed with genetic developmental and epileptic encephalopathy (DEE), a type of severe epilepsy with developmental delay caused by gene variants. Thirty-two patients involving 14 gene variants who started KDT at Beijing Children's Hospital between were included. KDT was effective in treating early onset genetic DEE in this cohort, and patients with STXBP1 variants responded better; however, no statistically significant relationship was found between gene variant and response. Most young patients tolerated KDT well, with mild and reversible gastrointestinal side effects being the most common.

Assessment of tolerance of a new product (gluten-free grain snack) in children with food allergy to gluten

The development of a technological scheme for the production of cereal snacks based on the extrusion process with preliminary enzymatic treatment of wheat flour and the use of hydrolysate as a partial replacement for gluten-free raw materials is an urgent task. The use of gluten-free cereal snacks in the diet opens up new possibilities for dietary therapy in patients suffering from various manifestations of food allergy to gluten, making their diet more diverse and meeting their individual needs. The purpose of the research was to clinically evaluate the tolerance of gluten-free cereal snacks in children with PA to gluten. Material and methods. The study included 21 patients (male and female) aged 3 to 17 years with a diagnosed food allergy, including gluten. All children received gluten-free cereal snacks according to their age: children from 3 to 7 years old (n=11) received 50 g (176 kcal) daily, and children aged 8 to 17 years old (n=10) received 100 g (352 kcal) daily for 14 days, in addition to a non-specific hypoallergenic diet excluding highly allergenic foods. On the first day of the study, the patients or one of their parents evaluated the organoleptic properties of the presented product (taste, color, smell) using a 5-point scale (1 - very bad, 5 - excellent), according to a specially designed questionnaire. The assessment of clinical symptoms over time related to skin, gastrointestinal tract, and nervous system was conducted using a second questionnaire, where parents kept a daily «observation log» reflecting the child's well-being and condition, as well as adverse events associated with taking the product. Clinical safety parameters were assessed based on the dynamics of complete blood count and blood immunological parameters (total IgE, specific IgE, and IgG4 antibodies to the studied allergens) at the beginning and end of the consumption period. Results. Daily examinations and patient questionnaires revealed no adverse reactions to the product. No significant differences in body weight were observed at the end of the study (p>0.05). In the results of clinical and immunological blood analysis before and after consuming gluten-free cereal snacks, no significant deviations were observed in the form of an increase in eosinophil count, total IgE, allergen-specific IgE and IgG4 antibodies in peripheral blood. This suggests a favorable clinical safety profile of the proposed product. Conclusion. The study found that consumption of the new product (gluten-free cereal snacks) was well-tolerated by children aged 3 to 17 years with various manifestations of food allergy: no adverse effects of the product or exacerbations of the underlying disease were observed during the 14-day period of gluten-free cereal snack consumption. Therefore, the studied gluten-free cereal snacks can be recommended for children aged 3 to 17 years with various manifestations of gluten FA, in combination with a gluten free diet.

Development of the Enteral Mixtures Composition for the Protein-Energy Deficiency Correction

Protein-energy deficiency is widespread among patients with surgical, traumatological, burn and other profiles. The study aims at the enteral mixture composition development for patients with protein-energy deficiency. The authors analyzed composition, market presence and therapeutic orientation of enteral mixtures of Russian and foreign manufacturers; revealed insufficiency of oriented enteral mixtures of Russian production for patients with protein-energy deficiency. A man developed biomedical requirements for the enteral mixture composition for the protein-energy deficiency correction; justified the use of high-protein basic raw materials – whey protein concentrate and pea protein isolate; fats – medium-chain triglycerides and PUFA ω-3; carbohydrates – maltodextrin and sucrose mixtures. By the Etalon software, the researchers developed optimal formulation of the enteral mixture. The enteral mixture should be water-soluble in order to absorb nutrients into the gastrointestinal tract effectively, as well as suitable for self-consumption as a separate meal for people with disabilities or in conditions of limited access to food. The inclusion of enteral mixtures in the diet therapy of patients with protein-energy deficiency will improve their nutritional status, and treatment quality; accelerate rehabilitation; and reduce hospital costs for treatment and rehabilitation measures.

The relevance of the development of food products enriched with trace elements for diet therapy in cardiovascular diseases

Cardiovascular diseases (CVDs) remain to be the leading cause of death in the whole world. The structure of nutrition of the population and diet therapy are extremely important factors for prevention and treatment of CVDs. Results of the scientific research obtained over the last decade give new data on the role of certain micronutrients in the physiological processes and pathogenesis of these groups of diseases. The aim of this research was to study the current role of certain trace elements (magnesium, zinc and copper) in the pathogenesis of diseases, including assessment of the level of their intake in different countries. Furthermore, the review considers the necessity of creating new functional products to use in diet therapy for patients with cardiovascular diseases. It includes publications in Russian and English for the period of 2011 to 2022 from open databases PubMed, ScienceDirect, Scopus, CyberLeninka, eLIBRARY as well as from open Internet sources. The research work carried out during preparation of this review was directed to studying the sphere of CVD prevention, role and relevance of the development of functional foods enriched with micronutrients. The data on the dysfunctions of the human body caused by the deficiency of zinc, copper and magnesium intake are presented. The current physiological daily norms for intake of these trace elements in different countries are given, and the dynamics of changes in the norms of intake over the last twenty years is shown. The review summarizes new data on the correlation between the risk of emergence of certain CVD types and the specific features of assimilation of the above-mentioned trace elements. The regulatory conditions acting on the RF territory for introducing trace elements into food products are analyzed. Based on the obtained results, conclusions were made regarding the relevance of the further development of functional foods that do not require changes in the traditional food behavior model.

Gene-Diet Interactions: Viability of Lactoferrin-Fortified Yoghurt as an Element of Diet Therapy in Patients Predisposed to Overweight and Obesity.

Given the availability of molecular tools, population studies increasingly include the gen-diet interactions in their considerations. The use of these interactions allows for the obtaining of more uniform research groups. In practice, this translates into the possibility of reducing the size of the research group while maintaining the precision of the research. The research results obtained in this way can be used to select certain ingredients and foods in a dietary intervention with a higher degree of personalisation. In both prophylaxis and dietary therapy of overweight and obesity, the proper selection of bioactive ingredients best suited to the given group of consumers is of key importance. Hence, the aim of the presented study was to assess the effectiveness of a dietary intervention with the use of lactoferrin (LF)-fortified yoghurt, in terms of the ability to regulate body weight and carbohydrate metabolism in individuals whose genomes contained single nucleotide polymorphisms that predisposed them to increased accumulation of fatty tissue and consequently overweight or obesity. A group of 137 participants (98 women and 37 men) of Polish origin were screened for the presence of four single nucleotide polymorphisms (rs993960-FTO gene, rs7903146-TCF7L2 gene, rs10830963-MTNR1B gene, and rs1121980-FTO gene). Subsequently, a group of 19 participants diagnosed with the presence of risk factors within said SNPs underwent a 21-day dietary intervention (crossover study) with the use of yoghurt fortified with lactoferrin (200 mg/day). The results of the study revealed a genetic difference between the Polish population and the European average, in terms of the SNPs analysed. The dietary intervention showed a statistically significantly higher efficiency in terms of body mass reduction (p = 0.000) and lowering the glycated haemoglobin ratio (HbA1c) (p = 0.000) when consuming specially prepared yoghurt containing lactoferrin, as compared to results registered for unfortified yoghurt. Given the above, yoghurt fortified with LF should be considered as a viable element of diet therapy in overweight and obese patients diagnosed with risk factors within the analysed polymorphisms.

Factors Associated With Growth in Patients Treated With the Classic Ketogenic Diet for Drug-Resistant Epilepsy

BackgroundSuboptimal growth and malnutrition are often cited as complications of ketogenic diet therapy in patients with drug-resistant epilepsy; however, there is conflicting evidence on the factors that contribute to growth. MethodsThis is an observational, case-based study to evaluate growth in patients with drug-resistant epilepsy treated with the classic ketogenic diet for at least 12 months. Age, gender, height, weight, and body mass index (BMI) were collected at baseline and epilepsy clinic standard-of-care visits (one month, six months, and 12 months after diet initiation). Dietary intake and laboratory measures including glucose, bicarbonate, and beta-hydroxybutyrate were also collected. Results119 patients were included. After ketogenic diet initiation, there was a significant fall in height z score from baseline to 12 months (−0.15, P = 0.001) but no other significant changes in weight, weight-for-length/BMI, or height z scores were noted between any time points within the 12 months after diet initiation. When separated by age, height z score changes were limited to those aged zero to three years. This was accompanied by a significant decrease in energy intake 12 months after treatment in this age group. When separated by diet route, weight z scores at each time point were significantly lower in the group eating by mouth than tube. ConclusionsOur study provides further evidence that the classic ketogenic diet impacts growth. Our population demonstrated restriction in linear growth in those aged zero to three years, which correlated with declines in energy intake, and weight declines limited to patients fed by mouth.

Very Low-Calorie Ketogenic Diet (VLCKD) as Pre-Operative First-Line Dietary Therapy in Patients with Obesity Who Are Candidates for Bariatric Surgery.

Bariatric surgery is currently the most effective method for achieving long-term weight loss and reducing the risk of comorbidities and mortality in individuals with severe obesity. The pre-operative diet is an important factor in determining patients' suitability for surgery, as well as their post-operative outcomes and success in achieving weight loss. Therefore, the nutritional management of bariatric patients requires specialized expertise. Very low-calorie diets and intragastric balloon placement have already been studied and shown to be effective in promoting pre-operative weight loss. In addition, the very low-calorie ketogenic diet has a well-established role in the treatment of obesity and type 2 diabetes mellitus, but its potential role as a pre-operative dietary treatment prior to bariatric surgery has received less attention. Thus, this article will provide a brief overview of the current evidence on the very low-calorie ketogenic diet as a pre-operative dietary treatment in patients with obesity who are candidates for bariatric surgery.

Bringing dietary therapy for eosinophilic oesophagitis under scientific scrutiny

In The Lancet Gastroenterology & Hepatology, Kara L Kliewer and colleagues report results from the first major multicentre, randomised trial of dietary therapy in patients with eosinophilic oesophagitis. 1 Kliewer KL Gonsalves N Dellon ES et al. One-food versus six-food elimination diet therapy for the treatment of eosinophilic oesophagitis: a multicentre, randomised, open-label trial. Lancet Gastroentrol Hepatol. 2023; (published online Feb 27.)https://doi.org/10.1016/S2468-1253(23)00012-2 Google Scholar The detailed study of patient outcomes, along with the assessment of transcriptomic and other markers, give valuable insights into the benefits and limitations of dietary therapy. Their objective evidence shows that the value of dietary therapy, in particular the six-food elimination diet (6FED), might have been overestimated in previous studies. 2 Gonsalves N Yang GY Doerfler B Ritz S Ditto AM Hirano I Elimination diet effectively treats eosinophilic esophagitis in adults; food reintroduction identifies causative factors. Gastroenterology. 2012; 142: 1451-1459 Summary Full Text Full Text PDF PubMed Scopus (480) Google Scholar , 3 Lucendo AJ Arias A Gonzalez-Cervera J et al. Empiric 6-food elimination diet induced and maintained prolonged remission in patients with adult eosinophilic esophagitis: a prospective study on the food cause of the disease. J Allergy Clin Immunol. 2013; 131: 797-804 Summary Full Text Full Text PDF PubMed Scopus (305) Google Scholar , 4 Infante J Modolell I Alcedo J et al. Step-up empiric elimination diet for pediatric and adult eosinophilic esophagitis: the 2-4-6 study. J Allergy Clin Immunol. 2018; 141: 1365-1372 Summary Full Text Full Text PDF PubMed Scopus (140) Google Scholar In their study, histological remission to less than 15 eosinophils per high-power field (eos/hpf) occurred in only 23 (34%) of 67 patients on the one-food elimination diet (1FED; eliminating animal milk) and 25 (40%) of 62 patients on the 6FED at 6 weeks. Kliewer and colleagues also show that the margin between 1FED and 6FED is not significant in terms of both histological remission and symptom improvement. Given the complexity of life when trying to avoid six foods and the great difficulty in sustaining such an effort for more than a year, this evidence on the value of keeping dietary therapy simple is important. As well as being easier to comply with, a single-food elimination diet (or perhaps a two-food elimination diet avoiding milk and wheat 2 Gonsalves N Yang GY Doerfler B Ritz S Ditto AM Hirano I Elimination diet effectively treats eosinophilic esophagitis in adults; food reintroduction identifies causative factors. Gastroenterology. 2012; 142: 1451-1459 Summary Full Text Full Text PDF PubMed Scopus (480) Google Scholar ) requires fewer repeat endoscopies than the seven endoscopies needed to determine which foods are relevant in the multifood approach. One-food versus six-food elimination diet therapy for the treatment of eosinophilic oesophagitis: a multicentre, randomised, open-label trialHistological remission rates and improvements in histological and endoscopic features were similar after 1FED and 6FED in adults with eosinophilic oesophagitis. 6FED had efficacy in just less than half of 1FED non-responders and steroids had efficacy in most 6FED non-responders. Our findings indicate that eliminating animal milk alone is an acceptable initial dietary therapy for eosinophilic oesophagitis. Full-Text PDF

Levels Compliance to Medication and Diet Therapy of Patients with Hypertension

Levels Compliance to Medication and Diet Therapy of Patients with Hypertension

Concept of Food in Persian Medicine

In Persian Medicine (PM), food is considered as a basic concept, the proper understanding of which, will prove beneficial in nutrition of healthy individuals and diet therapy of patients. The objective of this article is to examine the defining attributes of the concept of food in PM. Concept analysis was performed using Walker & Avant's approach, comprising eight stages of 1) selecting a concept; 2) determining the objective of analysis; 3) identifying all uses of the concept; 4) determining the defining attributes of the concept; 5) constructing a model case; 6) constructing borderline, contrary and invented cases; 7) identifying antecedents and consequences; and 8) defining empirical referent. The results showed that, the defining attributes of the concept of food in PM are: 1) replacement of body tissues and organs; 2) resemblance to tissues and organs; 3) adding to body quantity; 4) prerequisites for childbirth; 5) delicious and sweet or tasteless or greasy flavors; and 6) production of blood humors, warmth and moisture. In order to clarify the concept, borderline, contrary and invented cases were also presented. The results of this study can provide an objective and understandable picture of the use of the concept of food for researchers and open new horizons in nutrition and diet therapy.

Evaluation of Geriatric Sarcopenia and Nutrition in the Case of Cachexia before Exitus: An Observational Study for Health Professionals.

It is important to assess the physical and nutritional status of the body using a bioelectrical impedance analyzer (BIA) in patients with cachexia; however, the correlation between cachexia and nutritional evaluations remains unclear. The objective of this study is to follow the effects of diet therapy in patients with cachexia/sarcopenia, using parameters measured by BIA, clinical parameters, and other nutrition-related assessments in patients with osteoporosis. This study aims to clarify the correlation between BIA-measured parameters, clinical parameters, and other nutrition-related assessments. Methods: Measurements of body composition, a clinical assessment of the sarcopenia/cachexia, and nutritional goal setting/a nutrition care process were performed. Results: The number of subjects was 200, of which 15 people (7.5%) were diagnosed with sarcopenia/cachexia. Univariate analyses showed that participants with a high body-fat mass tend to develop sarcopenic obesity (p = 0.029), those who lost a significant and progressive amount of muscle mass tend to develop sarcopenia (p = 0.001), as well as those with malnutrition (p < 0.001). The regression study shows not only the correlation but also the cause of the correlation, as is the case with obesity. As obesity increases, so does the sarcopenic index (this can explain sarcopenic obesity), and as fat mass decreases it leads to muscle mass loss, increasing the risk of cachexia with age. Conclusions: There was an improvement, but statistically insignificant, in cachexia and the nutritional objectives (p > 0.05); at the same time, correlations were established between the independent parameters (sex, age) and malnutrition parameters (hemoglobin and amylase) with the parameters of the research.

Potential adjunctive effects of diet therapy in patients with periodontitis under non-surgical periodontal treatment

Potential adjunctive effects of diet therapy in patients with periodontitis under non-surgical periodontal treatment

Effects of the ketogenic diet therapy in patients with STXBP1-related encephalopathy

ObjectiveWe aimed to investigate the effects of ketogenic diet (KD) and modified Atkins diet (MAD) in patients with epileptic encephalopathy, caused by the STXBP1 (syntaxin-binding protein 1) gene mutation. MethodsWe retrospectively evaluated the data of patients with STXBP1-related epileptic encephalopathy who were started on either KD or MAD between January 1, 2005, and June 30, 2021, in Severance Children’s Hospital. ResultsTwelve patients were examined. The median age of seizure onset was 1.5 months [interquartile range (IQR): 0–3] with a median age of dietary therapy initiation at 4.5 months (IQR: 3.0–9.3) and a median diet duration of 6.5 months (IQR: 2.8–13.3). The patients had various epilepsy syndromes: nine (75 %) patients had early infantile developmental and epileptic encephalopathy, two (16.7 %) had infantile epileptic spasms syndrome, and one (8.3 %) had developmental and epileptic encephalopathy. Three patients (25 %) were definite KD responders who achieved seizure freedom within the median of 2 months from KD initiation and remained seizure-free for a median of 36 months (IQR: 29.5–60.0). One patient (8.3 %) was a possible KD responder, seizure-free with KD initiation and steroid therapy while 8 were non-responders (66.7 %). The definite KD responders shared similar clinical characteristics as the rest, except that there were significantly more patients that had seizure onset at ≥ 6 months (p = 0.045) in the definite KD responder group. ConclusionWe demonstrated dietary therapy was highly effective for some patients with STXBP1-related epileptic encephalopathy, especially those with later onset.

Quantitative Three-Dimensional Gait Evaluation in Patients With Glucose Transporter 1 Deficiency Syndrome

BackgroundOf the patients with glucose transporter 1 deficiency syndrome (GLUT1-DS), 90% have a pathologic gait. Ataxic-spastic and ataxic gaits are seen in 35% of patients each. A ketogenic diet and modified Atkins diet (MAD) are effective therapy in GLUT1-DS in terms of both the seizures and movement disorder. A three-dimensional gait analysis (3DGA) system can be used to evaluate gait quantitatively using spatiotemporal data and gait kinematics. We performed 3DGA in three ambulatory patients with GLUT1-DS to evaluate the characteristics of their gait pathology, and we compared the gait variables before and after enhancing the MAD in one patient. MethodsAfter examination by pediatric neurologists and pediatric orthopedic surgeons, 3DGA was performed. We assessed walking speed, step length, step width, gait variability, Gait Deviation Index (GDI), Gait Profile Score (GPS), and Gait Variable Score (GVS). ResultsAll three patients had a low GDI and high GPS, comprehensive indices of gait pathology. The unstable gait pattern featured a wide step width in one patient and high gait variability in two patients. In the sagittal plane, the patients had increased GVSs in the knee and ankle joints due to excessive knee flexion or extension and excessive ankle plantarflexion. In the horizontal plane, the patients had increased GVSs in the pelvis, hips, and foot due to excessive rotation during walking. After enhancing the MAD, GDI, GPS, and GVSs improved. Conclusions3DGA has potential for quantifying the characteristics of gait pathology and its improvement with dietary therapy in patients with GLUT1-DS.

KETOgenic diet therapy in patients with HEPatocellular adenoma: study protocol of a matched interventional cohort study

IntroductionHepatocellular adenoma (HCA) is an uncommon, solid and benign liver lesion, mainly occurring in women using oral contraceptives. Patients are advised to stop using oral contraceptives (OC) and, as overweight...

From the Ketogenic Diet to the Mediterranean Diet: The Potential Dietary Therapy in Patients with Obesity after CoVID-19 Infection (Post CoVID Syndrome).

Purpose of reviewThis review primarily examines the evidence for areas of consensus and on-going uncertainty or controversy about diet and physical exercise approaches for in the post-CoVID. We propose an ideal dietary and physical activity approach that the patient with obesity should follow after CoVID-19 infection in order to reduce the clinical conditions associated with post-CoVID syndrome.Recent findingsThe CoVID-19 disease pandemic, caused by the severe acute respiratory syndrome coronavirus-2, has spread all over the globe, infecting hundreds of millions of individuals and causing millions of death. It is also known to be is associated with several medical and psychological complications, especially in patients with obesity and weight-related disorders who in general pose a significant global public health problem, and in specific affected individuals are on a greater risk of developing poorer CoVID-19 clinical outcomes and experience a higher rate of mortality. Little is still known about the best nutritional approach to be adopted in this disease especially in the patients post-CoVID syndrome.SummaryTo the best of our knowledge, no specific nutritional recommendations exist to manage in the patients post-CoVID syndrome. We report a presentation of nutritional therapeutic approach based on a ketogenic diet protocol followed by a transition to the Mediterranean diet in patients post-infection by CoVID, combined to a physical activity program to address conditions associated with post-CoVID syndrome.

Nutritional Therapy in Persons Suffering from Psoriasis.

Psoriasis is a chronic inflammatory skin disease. Immunological, genetic, and environmental factors, including diet, play a part in the pathogenesis of psoriasis. Metabolic syndrome or its components are frequent co-morbidities in persons with psoriasis. A change of eating habits can improve the quality of life of patients by relieving skin lesions and by reducing the risk of other diseases. A low-energy diet is recommended for patients with excess body weight. Persons suffering from psoriasis should limit the intake of saturated fatty acids and replace them with polyunsaturated fatty acids from the omega-3 family, which have an anti-inflammatory effect. In diet therapy for persons with psoriasis, the introduction of antioxidants such as vitamin A, vitamin C, vitamin E, carotenoids, flavonoids, and selenium is extremely important. Vitamin D supplementation is also recommended. Some authors suggest that alternative diets have a positive effect on the course of psoriasis. These diets include: a gluten-free diet, a vegetarian diet, and a Mediterranean diet. Diet therapy for patients with psoriasis should also be tailored to pharmacological treatment. For instance, folic acid supplementation is introduced in persons taking methotrexate. The purpose of this paper is to discuss in detail the nutritional recommendations for persons with psoriasis.

Diet therapy in patients with metabolically associated fatty liver disease: what is the choice for particular patient?

Metabolically associated fatty liver disease is a widespread disease (MAFLD).The main treatment strategy for MAFLD is the correction of metabolic factors, changes in lifestyle, normalization of body weight, which is achieved by the use of diet therapy and physical activity.The purpose of this review is to present the characteristics of diets that have been studied in the treatment of patients with MAFLD.Results. The greatest evidence base on the effectiveness of treatment of MAFLD and the safety profile is the use of the Mediterranean diet and the diet with a low glycemic index. Patients should be advised to reduce their sugar intake, reduce their intake of saturated fatty acids and trans fats, and increase their intake of dietary fiber. Eating a balanced, calorie-restricted diet can help to provide healthy lifestyle and healthy eating habits, which are essential for the prevention and treatment of MAFLD. Hereditary factors, the composition of the intestinal microbiota, comorbid pathology can affect the results of diet therapy, which emphasizes the urgent need for an individualized approach in the treatment of this disease.