Dietary Restriction Research Articles

Assessing Avoidant/Restrictive Food Intake Disorder (ARFID) Symptoms Using the Nine Item ARFID Screen in >9000 Swedish Adults With and Without Eating Disorders.

The Nine Item ARFID Scale (NIAS) is a widely used measure assessing symptoms of avoidant/restrictive food intake disorder (ARFID). Previous studies suggest that individuals with eating disorders driven by shape/weight concerns also have elevated scores on the NIAS. To further describe NIAS scores among individuals with diverse current and previous eating disorders, we characterized NIAS scores in a large sample of individuals with eating disorders and evaluated overlap in symptoms measured by the NIAS and the Eating Disorder Examination-Questionnaire (EDE-Q) version 6.0. Our sample comprised 9148 participants from the Eating Disorders Genetics Initiative Sweden (EDGI-SE), who completed surveys including NIAS and EDE-Q. NIAS scores were calculated and compared by eating disorder diagnostic group using descriptive statistics and linear models. Participants with current anorexia nervosa demonstrated the highest mean NIAS scores and had the greatest proportion (57.0%) of individuals scoring above a clinical cutoff on at least one of the NIAS subscales. Individuals with bulimia nervosa, binge-eating disorder, and other specified feeding or eating disorder also demonstrated elevated NIAS scores compared to individuals with no lifetime history of an eating disorder (ps < 0.05). All subscales of the NIAS showed small to moderate correlations with all subscales of the EDE-Q (rs = 0.26-0.40). Our results substantiate that individuals with eating disorders other than ARFID demonstrate elevated scores on the NIAS, suggesting that this tool is inadequate on its own for differentiating ARFID from shape/weight-motivated eating disorders. Further research is needed to inform clinical interventions addressing the co-occurrence of ARFID-related drivers and shape/weight-related motivation for dietary restriction.

4 vs 7 points self-monitoring blood glucose in gestational diabetes mellitus on diet modification: randomised clinical trial in a single tertiary centre in Malaysia.

There is no standardized best method on monitoring of patients with gestational diabetes on diet modification in the country. This study aims to investigate the optimum method of self-monitoring blood glucose. This is a randomized clinical trial in a single tertiary centre involving patients with gestational diabetes mellitus (GDM) diagnosed based on NICE guideline on diet modification. The patients are randomized in 1:1 ratio to 4 or 7 points self-monitoring blood glucose. The monitoring was required to be done monthly with ultrasound for fetal growth. Blood was taken at recruitment for measurement of serum HbA1c and fructosamine. A total of 200 patients were recruited. There were significantly more Malay patients in the 7 points group (88.9% vs 78.2%, p = 0.033). Multiparous patients were significantly more in the 4 points group (82.2% vs 68.7%, p = 0.033). Both groups were similar in clinical characteristics. There was no statistical difference in the neonatal outcome particularly fetal macrosomia and admission to neonatal intensive care unit. In patients with GDM on diet modification, self-blood glucose monitoring using either 4 or 7 points resulted in similar maternal and perinatal outcomes. The research was registered under ClinicalTrials.gov (NCT04101396) on 17/9/2019 ( https://register. gov/prs/app/action/SelectProtocol?sid=S00098EN&selectaction=Edit&uid=U0004RD4&ts=2&cx=-qlk1w2 ).

Impact of Dietary Counseling on Nutritional requirements and Mitigating Noncompliance behavior in Hemodialysis Patients: A Pilot Study

Abstract Introduction Hemodialysis is the most sought-after treatment modality in patients with end-stage renal disease. The success of hemodialysis depends on the patient's adherence to diet and fluid restrictions to a great extent. Nutritional health is a critical consideration, especially for hemodialysis patients. Nutritional education and counseling for renal disease patients significantly preserve renal function and overall well-being. Methods Quantitative research approach with a quasi-experimental crossover design to determine the effectiveness of dietary counseling on the nutritional requirement and noncompliance behavior of patients undergoing hemodialysis conducted at Mangala Kidney Hospital, Mangalore, Karnataka, India. Results The mean age among the participants was 46.07 + 9.67 years. Nearly half of the subjects, 11 (39.29%), had undergone dialysis for 1 to 5 years. Twenty-six (96.3%) had noncompliance behavior toward diet and fluid. Based on biochemical parameters, 20 (74.07%) were classified as low-risk noncompliance and 7 (25.92%) high-risk noncompliance behavior. A paired t-test showed that there is a significant difference in knowledge of nutritional requirements, t (26) = 6.30, p ≤ 0.001 at 5% level of significance, and noncompliance among the participants before and after the dietary counseling program as t (26) = –5.41, p ≤ 0.001 at 5% level of significance. Conclusion Implementing nurse-led counseling for hemodialysis patients can improve biochemical parameters and enhance understanding of dietary and fluid restrictions, positively impacting laboratory indicators.

Few chemoreceptor genes in the ambrosia beetle Trypodendron lineatum may reflect its specialized ecology

BackgroundChemoreception is crucial for insect fitness, underlying for instance food-, host-, and mate finding. Chemicals in the environment are detected by receptors from three divergent gene families: odorant receptors (ORs), gustatory receptors (GRs), and ionotropic receptors (IRs). However, how the chemoreceptor gene families evolve in parallel with ecological specializations remains poorly understood, especially in the order Coleoptera. Hence, we sequenced the genome and annotated the chemoreceptor genes of the specialised ambrosia beetle Trypodendron lineatum (Coleoptera, Curculionidae, Scolytinae) and compared its chemoreceptor gene repertoires with those of other scolytines with different ecological adaptations, as well as a polyphagous cerambycid species.ResultsWe identified 67 ORs, 38 GRs, and 44 IRs in T. lineatum (‘Tlin’). Across gene families, T. lineatum has fewer chemoreceptors compared to related scolytines, the coffee berry borer Hypothenemus hampei and the mountain pine beetle Dendroctonus ponderosae, and clearly fewer receptors than the polyphagous cerambycid Anoplophora glabripennis. The comparatively low number of chemoreceptors is largely explained by the scarcity of large receptor lineage radiations, especially among the bitter taste GRs and the ‘divergent’ IRs, and the absence of alternatively spliced GR genes. Only one non-fructose sugar receptor was found, suggesting several sugar receptors have been lost. Also, we found no orthologue in the ‘GR215 clade’, which is widely conserved across Coleoptera. Two TlinORs are orthologous to ORs that are functionally conserved across curculionids, responding to 2-phenylethanol (2-PE) and green leaf volatiles (GLVs), respectively.ConclusionsTrypodendron lineatum reproduces inside the xylem of decaying conifers where it feeds on its obligate fungal mutualist Phialophoropsis ferruginea. Like previous studies, our results suggest that stenophagy correlates with small chemoreceptor numbers in wood-boring beetles; indeed, the few GRs may be due to its restricted fungal diet. The presence of TlinORs orthologous to those detecting 2-PE and GLVs in other species suggests these compounds are important for T. lineatum. Future functional studies should test this prediction, and chemoreceptor annotations should be conducted on additional ambrosia beetle species to investigate whether few chemoreceptors is a general trait in this specialized group of beetles.

Modification of the Protein Amino Acid Content in Hen Eggs as a Consequence of Different Concentrations of Lupine and Soy in Feed

The effect of the diet modification (soybean and lupine addition) on the content of protein and amino acids (AA) in eggs was studied. Both the sampling day and the diet influenced the total protein content. In albumen, the lowest protein content (10.6%) was noted after administering a diet containing 25% lupine; in the same egg the yolk contained the most proteins (16.7%). In the content of nonessential AA (NAA) in egg yolks, differences were noted only for cysteine, with its the highest content in the yolks of the control group. The stable content of essential yolk amino acids (EAA) was observed only for isoleucine, leucine, tryptophan and phenylalanine. The highest contents of EAA and NAA were recorded in the yolks of the control group (~47 and ~53 g/100 g of protein, respectively) and in the group with 25% additions of lupine (~42 and ~51 g/100 g of protein, respectively). AA with constant content in the tested albumens were methionine, tryptophan and alanine. The highest content of EAA (&gt;~42 g/100 g of protein) and NAA (&gt;~62 g/100 g of protein) were determined in albumen of eggs determined in the group with at least 20% additions of lupine. The highest content of EAA for humans delivered eggs from groups 4–6 (with the addition of soy into the diet ≤5%). The protein sources used in the hen diet significantly influenced the content of protein and individual AA in the produced eggs.

Short-term starvation activates AMPK and restores mitochondrial inorganic polyphosphate, but fails to reverse associated neuronal senescence.

Neuronal senescence is a major risk factor for the development of many neurodegenerative disorders. The mechanisms that drive neurons to senescence remain largely elusive; however, dysregulated mitochondrial physiology seems to play a pivotal role in this process. Consequently, strategies aimed to preserve mitochondrial function may hold promise in mitigating neuronal senescence. For example, dietary restriction has shown to reduce senescence, via a mechanism that still remains far from being totally understood, but that could be at least partially mediated by mitochondria. Here, we address the role of mitochondrial inorganic polyphosphate (polyP) in the intersection between neuronal senescence and dietary restriction. PolyP is highly present in mammalian mitochondria; and its regulatory role in mammalian bioenergetics has already been described by us and others. Our data demonstrate that depletion of mitochondrial polyP exacerbates neuronal senescence, independently of whether dietary restriction is present. However, dietary restriction in polyP-depleted cells activates AMPK, and it restores some components of mitochondrial physiology, even if this is not sufficient to revert increased senescence. The effects of dietary restriction on polyP levels and AMPK activation are conserved in differentiated SH-SY5Y cells and brain tissue of male mice. Our results identify polyP as an important component in mitochondrial physiology at the intersection of dietary restriction and senescence, and they highlight the importance of the organelle in this intersection.

Pre-therapy Laparoscopic Jejunostomy Provides Safe, Reliable Nutrition for Trimodality GEJ Cancer Care

Background: Patients with locally advanced GEJ cancer may have severe obstruction and irreversible malnutrition requiring intervention such as TPN, stenting, or enteral access. Laparoscopic jejunostomy (LJ) is a reliable method of supplementing nutrition but is not widely used for fear of complications. At our institution we place LJ tubes preoperatively in such patients and aimed to evaluate their effectiveness. Methods: A retrospective review of patients undergoing neoadjuvant chemo-radiation and laparoscopic transhiatal esophagectomy (LTHE) from 2013 to 2022 was performed. Nutritional markers, weight, and height were recorded, LJ associated complications were recorded from placement time to removal. Thirty-day complications after LTHE were recorded using Clavien-Dindo classification. Results: Of 165 patients who underwent LTHE, twenty patients (12.1%) had LJ placement prior to neoadjuvant therapy due to obstructive symptoms and a median [IQR] weight loss of 13.6 kg [9.07, 16.74] despite dietary modification. LJs were placed a median [IQR] of 103.5 [93.3, 116.8] days prior to LTHE. Median [IQR] weight gain from LJ placement to LTHE was 2.09 kg [0.1, 5.03], P = .01. There were no major complications and 3 (15%) minor complications. There were no unplanned feeding interruptions greater than 48 hours or disruptions in neoadjuvant treatment. There was 1 (5%) 30-day complication after LTHE and there was no mortality. The median [IQR] hospital stay was 7 days [6.5, 9]. Conclusion: Jejunostomy feeding tube prior to neoadjuvant treatment consistently reverses weight loss with minor, manageable complications. Reliable pre-therapy nutrition in obstructed patients is associated with excellent esophagectomy results and should be considered the adjuvant nutritional treatment of choice.

Impact of a 12-Week Dietary Intervention on Adipose Tissue Metabolic Markers in Overweight Women of Reproductive Age

The prevalence of overweight and obesity in women of reproductive age leads to significant health risks, including adverse metabolic and reproductive outcomes. Effective dietary interventions are critical to improving health outcomes in this population. This study investigates the impact of a 12-week diet intervention on metabolic markers of adipose tissue in overweight women of reproductive age, determining whether calorie restriction or low-starch diets are more effective, while also accounting for salivary amylase activity. A total of 67 overweight women of reproductive age were enrolled in a randomized controlled trial (RCT). Participants were divided into high-salivary-amylase (HSA) and low-salivary-amylase (LSA) groups based on baseline salivary amylase activity measured using a spectrophotometric method. Each group was further subdivided into two dietary intervention groups: calorie restriction (CR) and low starch (LS), resulting in four subgroups (HSA-CR, HSA-LS, LSA-CR, LSA-LS), along with a control group (CTR) of normal-weight individuals (no intervention). Participants were assigned to a calorie-restricted diet or a low-starch diet for 12 weeks. Key metabolic markers of adipose tissue, including insulin sensitivity, adipokines, cytokines, and lipid profiles, were measured at baseline (T0), 30 min after consuming starch-containing muesli (T1), and 12 weeks after intervention (T2). Active GLP-1, glucagon, and C-peptide levels were assessed to clarify the hormonal mechanisms underlying the dietary effects. Salivary amylase activity was also measured to examine its role in modulating glucose and GLP-1 responses. Both diet interventions led to significant improvements in metabolic markers of adipose tissue, though different ones. Calorie restriction improved insulin sensitivity by effectively reducing visceral fat mass and enhancing insulin signaling pathways. In contrast, the low-starch diet was linked to a reduction in the coefficient of glucose variation influenced partly by changes in GLP-1 levels. Our findings highlight the importance of personalized diet strategies to optimize metabolic health in this demographic.

The association between visceral fat obesity and prefrailty in Chinese older adults: a cross-sectional study

BackgroundThe prevalence of obesity is escalating. Previous research has concentrated on the link between frailty and obesity; however, the association between prefrailty and obesity has been less studied. Prefrailty screening and intervention may prevent or postpone frailty in older persons.ObjectiveThe study was to investigate into the relationship between prefrailty and several obesity indicators in Chinese community-dwelling older individuals.MethodsThis research employed the Frailty Screening Index to investigate the frailty phenotype of people living in Shanghai. Bioelectrical impedance analysis was used for evaluating body composition.ResultsThere were 510 participants (39.0%) with high visceral adipose areas. Participants with a high visceral adipose area showed a higher risk of prefrailty (adjusted OR, 1.53; 95% CI, 1.19–1.96), according to multivariate models. When body mass index (BMI) and visceral fat area (VFA) were combined, it was discovered that having an overweight BMI with normal VFA was a protective factor for prefrailty (corrected OR, 0.62; 95% CI, 0.43–0.90), but having a normal weight but excess VFA increased the risk of prefrailty (corrected OR, 1.87; 95% CI, 1.15–3.03).ConclusionVisceral fat obesity is an independent risk factor for prefrailty in Chinese older adults. Implementing targeted interventions, such as dietary modifications, increased physical activity, and other lifestyle changes, could play a crucial role in reducing the risk of prefrailty and improving overall health outcomes in this population.

Effects of higher dietary acid load: a narrative review with special emphasis in children.

Metabolic effects of high diet acid load (DAL) have been studied for years in adults, although only recently in children. Contemporary diets, especially those of Western societies, owe their acidogenic effect to high animal-origin protein content and low contribution of base-forming elements, such as fruits and vegetables. This imbalance, where dietary acid precursors exceed the body's buffering capacity, results in an acid-retaining state known by terms such as "eubicarbonatemic metabolic acidosis," "low-grade metabolic acidosis," "subclinical acidosis," or "acid stress". Its consequences have been linked to chronic systemic inflammation, contributing to various noncommunicable diseases traditionally considered more common in adulthood, but now have been recognized to originate at much earlier ages. In children, effects of high DAL are not limited to growth impairment caused by alterations of bone and muscle metabolism, but also represent a risk factor for conditions such as obesity, insulin resistance, diabetes, hypertension, urolithiasis, and chronic kidney disease (CKD). The possibility that high DAL may be a cause of chronic acid-retaining states in children with growth impairment should alert pediatricians and pediatric nephrologists, since its causes have been attributed traditionally to inborn errors of metabolism and renal pathologies such as CKD and renal tubular acidosis. The interplay between DAL, overall diet quality, and its cascading effects on children's health necessitates comprehensive nutritional assessments and interventions. This narrative review explores the clinical relevance of diet-induced acid retention in children and highlights the potential for prevention through dietary modifications, particularly by increasing fruit and vegetable intake alongside appropriate protein consumption.

Trajectories of negative affect prior to and following disordered eating behaviors among women with eating disorder pathology: An examination of the role of state-interoception

ObjectiveAffect regulation theories of eating disorders (ED) posit that negative affect increases in the hours before and decreases following disordered eating behaviors (DEBs) in daily life, yet findings from studies assessing affective changes post-DEBs are mixed. This inconsistency may be due to the previously unassessed role of other transdiagnostic processes in these associations, such as interoception (the ability to sense and integrate information from bodily sensations). To address this research gap, the present study examined whether different interoception dimensions moderated negative affect trajectories surrounding DEBs in the natural environment. Method150 women with ED pathology (Mage = 21.0, SD = 4.1) completed 4 surveys targeting affect and DEBs each day for a 10-day ecological momentary assessment period. Polynomial multilevel models examined negative affect trajectories pre- and post-DEBs (dietary restriction, overeating, loss of control eating), and whether these trajectories varied based on daily interoception dimensions (not distracting, self-regulation, body listening and trust). ResultsNegative affect increased prior to loss of control eating—but not dietary restriction or overeating—and decreased following all DEBs. Further, the magnitude of the decrease in negative affect that emerged post-dietary restriction decreased in strength as daily “not distracting” interoception increased. The other interoception dimensions did not moderate negative affect trajectories surrounding DEBs. ConclusionsAllowing oneself to experience (vs. distract from) uncomfortable bodily sensations may weaken affect dysregulation processes that follow dietary restriction in daily life and are theorized to maintain DEBs. These results provide insight that may strengthen EDs theories, research, and inform interoception-focused interventions.

Different Strategies Targeting Gut Microbiota for the Management of Several Disorders: A Sustainable Approach.

A potential limelight is flashed on the Gut Microbiota (GM) in the human body, which confers additional psychological as well as physiological attributes to health. Other than just occupying a wide portion of the gastrointestinal tract, it also plays numerous functions in the systems of the body. Gut Microbiota is largely responsible for a considerably vast array of conditions such as obesity, diabetes ,other metabolic disorders, and cardiovascular disorders. Strategies targeting the gut microbiota have been proposed as a promising approach for the management of these disorders. This review aims to summarize the different strategies targeting the gut microbiota for the management of several disorders and to highlight the importance of a sustainable approach. A comprehensive literature search was conducted using various databases between 2008 and 2022 that focused on the use of prebiotics, probiotics, synbiotics, postbiotics, fecal microbiota transplantation, dietary interventions, and antibiotics. Different strategies targeting the gut microbiota for the management of several disorders were identified, including probiotics, prebiotics, synbiotics, postbiotics, fecal microbiota transplantation, and dietary interventions. Modification in diet and lifestyle, allowing favorable microbiota growth in the stomach, intake of prebiotics and probiotics, and fecal microbiota transplantation are amongst the widely accepted recent approaches allowing the application of GM in the field of treatment. Although considerable steps in enhancing and understanding the mechanism of treatment with the help of gut microbiota are under progress, much diversified and elaborate research must be conducted in order to enhance and implement the use of GM with high effectiveness.

Taste Disorders After Middle Ear Surgery: Chorda Tympani Nerve Injury and Quality of Life.

To evaluate taste disorders after middle ear surgery, their modifying factors especially chorda tympani nerve injury or underlying otologic disease. We investigated consequences of taste disorders on quality of life. Prospective cohort study. Monocentric study in tertiary care center. A total of 214 patients who underwent middle ear surgery were included. Data regarding taste disorders were collected by questionnaires over a 1-year follow-up period. Taste disorders were reported in 42.7% at 10 days, in 23.3% at 4 months, and in 9.2% 1 year postoperatively. When the chorda tympani nerve was initially healthy, taste disorders were more frequent after its transection throughout the follow-up period. When it was involved in a cholesteatoma or inflammatory process, postoperative taste disorders were more frequent after nerve stretching. Postoperative discomfort in daily life was rated on the Likert scale at 3.5 out of 10. Dietary modifications were reported by 25.8% of patients, and mood alterations by 15% of patients. Taste disorders are frequent after middle ear surgery although they mostly improve in the first months. When the CTN is healthy, cutting it leads to more taste disorders than stretching it, thus advocating its preservation to prevent these symptoms. However, in cases of pathological CTN, cutting this nerve, which is sometimes necessary to control the disease, is less likely to cause taste disorders than stretching it. These taste disorders are a source of discomfort and may present risks of dietary modifications and emotional impact.

Transiently restricting individual amino acids protects Drosophila melanogaster against multiple stressors.

Nutrition and resilience are linked, though it is not yet clear how diet confers stress resistance or the breadth of stressors that it can protect against. We have previously shown that transiently restricting an essential amino acid can protect Drosophila melanogaster against nicotine poisoning. Here, we sought to characterize the nature of this dietary-mediated protection and determine whether it was sex, amino acid and/or nicotine specific. When we compared between sexes, we found that isoleucine deprivation increases female, but not male, nicotine resistance. Surprisingly, we found that this protection afforded to females was not replicated by dietary protein restriction and was instead specific to individual amino acid restriction. To understand whether these beneficial effects of diet were specific to nicotine or were generalizable across stressors, we pre-treated flies with amino acid restriction diets and exposed them to other types of stress. We found that some of the diets that protected against nicotine also protected against oxidative and starvation stress, and improved survival following cold shock. Interestingly, we found that a diet lacking isoleucine was the only diet to protect against all these stressors. These data point to isoleucine as a critical determinant of robustness in the face of environmental challenges.

Different depths of food restriction and high-fat diet refeeding in mice impact host obesity and metabolic phenotypes with correlative changes in the gut microbiota.

Overweight and obesity affect almost 2 billion adults worldwide, and food restriction (FR) is commonly used to reduce body fat. Whether refeeding (Re) after FR at different ages and to different degrees leads to overweight and its possible mechanisms are uncertain. In this study, adult and young mice were both restricted to 15% and 40% of their casual food intake, and then were fed 60% high-fat chow (FR15%-Re, FR40%-Re), whereas the control groups(CON) consumed high-fat or normal food throughout, respectively. The results of the study suggest that mild FR-heavy feeding may lead to more significant abnormal fat accumulation, liver damage, and increased recruitment of intestinal inflammatory factors and immune cells in mice of different ages and involves multiple types of alterations in the gut microbiota. Further fecal transplantation experiments as well as serum and liver enzyme-linked immunosorbent assay experiments preliminarily suggest that the link between lipid metabolism and inflammatory responses and the gut microbiota may be related to the regulation of the gut and live by Lipopolysaccharides(LPS) and Peroxisome Proliferator-Activated Receptor-Alpha(PPAR-α). In addition, our study may also serve as a reference for studying obesity prevention and treatment programs at different ages.

Navigating the landscape of food allergies: Insights and perspectives from the AMCP Market Insights Program.

AMCP convened a panel of clinical and managed care experts to identify insights regarding the prevalence, clinical manifestations, and management approaches for immunoglobulin E-mediated food allergies. This article aims to summarize expert perspectives on health care system challenges and areas of agreement concerning the management of food allergies, and to advance payers' understanding of their role in supporting health care for patients with food allergies. Food allergy management requires dietary modification and is associated with significant patient and caregiver burdens. Emerging therapies provide hope for those living with food allergies but will likely lead to a rise in health plan pharmacy expenses. In considering the value of new treatments, it is important to consider the total cost of care and the value of preventing anaphylaxis and enhancing the patient's quality of life. Several challenges remain in identifying the appropriate patient population for treatment with newer agents and in optimizing treatment outcomes. Addressing health disparities will require standardized clinical protocols, better access to specialized allergy care, and management of comorbid conditions.

Associations of dietary inflammatory indices (DII and E-DII) with sperm parameters.

This study aimed to explore the ambiguous link between dietary inflammatory indices and sperm parameters. Specifically, it investigated the associations between the dietary inflammatory index (DII) and the energy-adjusted dietary inflammatory index (E-DII) with sperm motility, morphology, and count in men undergoing routine semen analysis. A cross-sectional study was conducted with 144 men enrolled, where semen samples were collected and evaluated according to the 2010 World Health Organization guidelines. Dietary data were gathered using a 147-item semi-quantitative food frequency questionnaire developed by the researchers. Pearson correlation analysis was employed to assess the relationships of the DII and E-DII with sperm parameters. The mean DII and E-DII scores were 1.23±1.1 and 0.49±0.43, respectively. The mean values for sperm motility, morphology, and count were 43.08%±19.30%, 78.03%±26.99%, and 48.12±44.41 million, respectively. Both motility (r=-0.353) and count (r=-0.348) were found to be inversely and significantly correlated with DII. Similarly, Pearson correlation tests revealed strong and significant inverse correlations of motility (r=-0.389) and count (r=-0.372) with E-DII. The findings suggest that a diet with a higher anti-inflammatory potential may be associated with increased sperm count and motility, but not with changes in morphology. Further research is necessary to confirm these findings, elucidate the underlying mechanisms, and identify dietary modifications that could improve male fertility.

Modifiable risk factors for weight loss after cancer treatment in Korean gastric cancer survivors.

Weight loss is a critical problem in gastric cancer survivor (GCS) associated with worse prognosis and quality of life. Nevertheless, modifiable factors related to weight loss of GCS seem limited. We investigated the factors with significant weight loss including dietary pattern change in GCS. In this cross-sectional study, Korean cancer survivors were recruited from two university-affiliated hospitals from 2014 to 2017. Overall, 591 GCSs were analyzed by preoperative body mass index levels. Significant and severe weight loss was defined as a weight reduction of more than 5% and 10%, respectively. Around 68.7% and 35.0% of GCS reported significant and severe weight loss, respectively. Age and surgery type were the important factors related to significant weight loss in total. In preoperative overweight or obese subjects, sex and surgery type were the risk factors for weight loss. Total food intake reduction was the only modifiable factor of significant weight loss (adjusted odds ratio (aOR) 1.78, 95% confidence interval (CI) 1.19-2.64), particularly in preoperative normal or underweight GCS (aOR 2.62, 95% CI 1.44-4.78). Increasing vegetable and salt reduction was found to be related to a lower risk of significant weight loss. The impact of reducing processed meat on weight loss differed by degree of weight loss and preoperative BMI level. Changing food consumption was the important modifiable factor related to significant weight loss which was more evident in preoperative underweight or normal GCS. Thus, further specific dietary recommendation is necessary for them to prevent significant weight loss. In order to prevent significant weight loss, dietary modification should be provided to GCS to ensure that total foodintake does not decrease.

Beliefs of Torajanese Pregnant Mother

Introduction: Various factors impact the health of pregnant women, including access to healthcare facilities and a nutritious diet. Cultural norms and beliefs prevalent in Indonesian society may influence food consumption patterns. This study explores dietary restrictions and preferred food choices during pregnancy among Toraja ethnic pregnant women.Methods: Employing a qualitative research methodology, specifically a descriptive phenomenological approach, this study was conducted within the jurisdiction of the Ge'tengan Community Health Center, Mengkendek District, Tana Toraja, Indonesia. The research adopted purposive sampling, involving eight pregnant women as participants. Data was collected through individual interviews, lasting 45 to 60 minutes for each participant.Results: The findings revealed three overarching themes: prohibited foods during pregnancy, reduced staple food intake, and the influence of elders on dietary practices and beliefs.Conclusion: Leveraging traditional wisdom regarding dietary recommendations can serve as valuable input in designing nutritional education programs tailored to meet the needs of Toraja ethnic pregnant women. Meanwhile, there are some foods that mothers need as support in fulfilling nutrition, and this is contrary to health. Therefore, it is very important to raise public awareness by disseminating accurate information about nutrition for pregnant women in the Toraja tribe by maintaining culture if it is not contrary to health, then helping people to adapt to cultures that benefit health called negotiation, and changing or replacing culture if the culture or habit is detrimental.

Exploring Multitargets Treatment for Diabetes

Diabetes Mellitus (DM) is a degenerative disease that modifies the body’s glucose metabolism. Although glucose is a vital energy source for body cells, individuals with diabetes can either not use insulin efficiently or do not create enough of this hormone, which controls blood sugar. This review aimed to explore the multi-target treatment for diabetes. This study investigates explicitly recent reports published in peer-reviewed journals indexed in various databases, including Web of Science, Scopus, PubMed, Google Scholar, and Science Direct. Individuals with diabetes are more likely to experience other health issues, such as elevated blood pressure and cholesterol. Environmental factors that can influence the onset of diabetes include air pollution, temperature and weather, and stress. With the shortage of diabetes specialists and healthcare experts coupled with an inefficient healthcare service in low- and middle-income nations, there is a need to introduce more creative approaches to treat diabetes. Although literature reveals that no one-size-fits-all method is available for managing diabetes because each person's reaction to the disease varies depending on several factors, such as the diabetes stage and the person’s susceptibility to complications, this study posits that there could be a headway in diabetes management by exploring multi-targets treatment. Introducing lifestyle change, diet modification and physical activity could reduce the risk of death due to diabetes. This study also highlights how diabetes can be managed in the rural and urban settings. Adopting telemedicine and web-based initiatives could impact diabetes treatment positively.