Inflammatory Bowel Research Articles

Raman spectroscopy on dried blood plasma allows diagnosis and monitoring of colorectal cancer.

Colorectal cancer (CRC) remains challenging to diagnose, necessitating the identification of a noninvasive biomarker that can differentiate it from other conditions such as inflammatory bowel diseases (IBD) and diverticular disease (DD). Raman spectroscopy (RS) stands out as a promising technique for monitoring blood biochemical profiles, with the potential to identify distinct signatures identifying CRC subjects. We performed RS analysis on dried plasma from 120 subjects: 32 CRC patients, 37 IBD patients, 20 DD patients, and 31 healthy controls. We also conducted longitudinal studies of CRC patient's postsurgery to monitor the spectral changes over time. We identified six spectral features that showed significant differences between CRC and non-CRC patients, corresponding to tryptophan, tyrosine, phenylalanine, lipids, carotenoids, and disulfide bridges. These features enabled the classification of CRC patients with an accuracy of 87.5%. Moreover, longitudinal analysis revealed that the spectral differences normalized over 6 months after surgery, indicating their association with the presence of the disease. Our study demonstrates the potential of RS to identify specific biomolecular signatures related to CRC. These results suggest that RS could be a novel screening and monitoring tool, providing valuable insights for the development of noninvasive and accurate diagnostic methods for CRC.

Designing the Essential Informational Needs of a Smartphone Application for Self‐Management of Patients With Inflammatory Bowel Disease

ABSTRACTBackground and AimsInflammatory bowel disease (IBD) is a chronic digestive disease that has a detrimental effect on the quality of life of IBD patients. This study aims to identify the informational needs and design the essential informational needs for a smartphone application for the self‐management of IBD.MethodsThis study was conducted in two stages and the informational needs of the patients were extracted in a questionnaire designed in three separate sections and given to 120 patients with UC and 60 patients with CD.ResultsAfter a literature review and analysis of patient responses, it was found that Knowledge of the disease, Medication, Educational information, Complications, Diet & Nutrition, and Lifestyle habits are among the most important domains of informational needs of inflammatory bowel disease patients.ConclusionPatients with IBD have many informational needs, and in this study, identifying these needs, can help improve the quality of life of these patients and be of interest to healthcare providers, designers, and developers of applications.

Effect of Perilla frutescens polyphenols against tight junction alterations and intestinal inflammation: a Caco-2/macrophage co-culture model-based study integrated with network pharmacology

The intestinal barrier plays important roles in the uptake of nutrients and prevention of harmful pathogens. However, intestinal inflammation causes barrier dysfunction, which may contribute to inflammatory bowel disease (IBD). Polyphenols from Perilla frutescens (L.) Britt. exhibit various bioactivities, though their protective effect on the intestinal barrier remains unclear. To address this, the study investigated the effect of Perilla frutescens (L.) Britt. polyphenols (PFP) against tight junction alterations and intestinal inflammation using an intestinal-like Caco-2/macrophage co-culture model. LC-MS/MS analysis identified 15 polyphenols in the PFP extract. Furthermore, PFP were transported across the apical Caco-2 monolayer, with apigenin, genistin, syringic acid and cinnamic acid showing relatively high transport rates (> 70%). The lipopolysaccharide (LPS)-induced tight junction alterations, evaluated by trans-epithelial electrical resistance (TEER) analysis, qPCR, and immunofluorescence assay, were significantly restored by medium and high doses of PFP (P < 0.05). In addition, network pharmacology analysis demonstrated that the core targets of PFP for intestinal inflammation were mostly located in the MAPK and NF-κB signaling pathways. The expression levels of the key proteins in these pathways were further validated by qPCR and western blot analyses. Overall, PFP exhibits great potential as a novel functional food component for treating intestinal inflammation.

Subcutaneous versus intravenous infliximab therapy - a real-world study: toward higher drug concentrations.

Recently, a formula of subcutaneous infliximab (SC-IFX) has been approved for inflammatory bowel disease (IBD), demonstrating a better pharmacokinetic and immunogenic profiles, compared to intravenous infliximab (IV-IFX), with similar efficacy and safety. The aim of this study is to evaluate the clinical, biochemical, and pharmacological outcomes of IBD patients in clinical remission, who switched from IV-IFX to SC-IFX, with a follow-up period of 6 months. Retrospective cohort study, including IBD patients in clinical remission, previously medicated with IV-IFX, who switched to SC-IFX 120 mg every other week. Biochemical parameters were evaluated before the switch and 6 months after, namely infliximab serum concentrations, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and fecal calprotectin. Included 41 patients in clinical remission, 32 with Crohn's disease (78.0%) and 9 with ulcerative colitis (22.0%). All patients maintained clinical remission during the 6 months after the switch, with a treatment persistence rate of 100%, and no patients requiring corticosteroid therapy, switching back to IV-IFX, or IBD-related hospitalization. The mean infliximab serum concentrations were significantly higher after 6 months of SC-IFX (17.3 ± 6.6 vs. 9.1 ± 5.5 µg/ml, P < 0.001). However, there were no differences between values of ESR, CRP, and fecal calprotectin, before and after the switch ( P = 0.791, P = 0.246, and P = 0.639). Additionally, none of the patients developed antibodies to infliximab. Switching from IV-IFX to SC-IFX in IBD patients in clinical remission is effective and leads to higher infliximab serum concentrations, regardless of the combination with immunomodulatory therapy.

Leucine-Enriched Diet Reduces Fecal MPO but Does Not Protect Against DSS Colitis in a Mouse Model of Crohn's Disease-like Ileitis.

Understanding the complex link between inflammation, gut health, and dietary amino acids is becoming increasingly important in the pathophysiology of inflammatory bowel disease (IBD). This study tested the hypothesis that a leucine-rich diet could attenuate inflammation and improve gut health in a mouse model of IBD. Specifically, we investigated the effects of a leucine-rich diet on dextran sulfate sodium (DSS)-induced colitis in germ-free (GF) SAMP1/YitFC (SAMP) mice colonized with human gut microbiota (hGF-SAMP). hGF-SAMP mice were fed one of four different diets: standard mouse diet (CHOW), American diet (AD), leucine-rich AD (AD + AA), or leucine-rich CHOW diet (CH + AA). Body weight, myeloperoxidase (MPO) activity, gut permeability, colonoscopy scores, and histological analysis were measured. Mice on a leucine-rich CHOW diet showed a decrease in fecal MPO prior to DSS treatment as compared to those on a regular diet (p > 0.05); however, after week five, prior to DSS, this effect had diminished. Following DSS treatment, there was no significant difference in gut permeability, fecal MPO activity, or body weight changes between the leucine-supplemented and control groups. These findings suggest that while a leucine-rich diet may transiently affect fecal MPO levels in hGF-SAMP mice, it does not confer protection against DSS-induced colitis symptoms or mitigate inflammation in the long term.

3D Printed Personalized Colon-targeted Tablets: A Novel Approach in Ulcerative Colitis Management.

Ulcerative colitis (UC) and Crohn's disease (CD) are two types of idiopathic inflammatory bowel disease (IBD) that are increasing in frequency and incidence worldwide, particularly in highly industrialized countries. Conventional tablets struggle to effectively deliver anti-inflammatory drugs since the inflammation is localized in different areas of the colon in each patient. The goal of 3D printing technology in pharmaceutics is to create personalized drug delivery systems (DDS) that are tailored to each individual's specific needs. This review provides an overview of existing 3D printing processes, with a focus on extrusion-based technologies, which have received the most attention. Personalized pharmaceutical products offer numerous benefits to patients worldwide, and 3D printing technology is becoming more affordable every day. Custom manufacturing of 3D printed tablets provides innovative ideas for developing a tailored colon DDS. In the future, 3D printing could be used to manufacture personalized tablets for UC patients based on the location of inflammation in the colon, resulting in improved therapeutic outcomes and a better quality of life.

Tarm1 may affect colitis by regulating macrophage M1 polarization in a mouse colitis model.

In this study, we aimed to explore the role of Tarm1 in juvenile mice with dextran sulfate sodium (DSS)-induced colitis and elucidate the mechanisms that affect intestinal barrier function. A DSS-induced pediatric inflammatory bowel disease mouse model was established using 4-week-old juvenile mice. Disease activity index and histopathological damage scores were determined using hematoxylin and eosin (H&E) staining. Tarm1, F4/80, CD68, and CD86 levels were detected using qPCR, western blotting, and immunofluorescence. Trans epithelial electric resistance (TEER) was detected using the transwell assay. Results revealed that juvenile colitis mice fed 4% DSS drinking water had increased Tarm1 expression in the colon tissue, increased macrophage M1 polarization, higher expression of pro-inflammatory cytokines, and an impaired intestinal mucosal barrier, compared with the control group. Tarm1-knockdown RAW264.7 cells inhibited lipopolysaccharide (LPS)-induced M1 polarization and attenuated barrier damage in co-cultured intestinal epithelial cells. Tarm1 expression was increased in colonic tissues of juvenile mice with colitis, and LPS-induced M1 polarization and intestinal barrier damage were attenuated in Tarm1-knockdown RAW264.7 cells. This suggests that attenuation of Tarm1 expression is a potential target for pediatric inflammatory bowel disease therapy.

043. Multidiciplinary Management of Toxic Megacolon in Ulcerative Colitis: A Case Report and Review of Current Practice

Background: Toxic megacolon is a life-threatening condition characterized by extreme colonic dilation and systemic toxicity. It often results from underlying inflammatory bowel disease, such as ulcerative colitis, or infectious colitis. Early recognition and management are crucial to prevent complications such as colonic perforation or sepsis. Case: We present the case of a 42-year-old male with a history of ulcerative colitis based on histopathology examination who developed toxic megacolon. The patient presented with severe abdominal pain, distension, fever, and signs of systemic toxicity. Imaging studies revealed marked colonic dilation, and laboratory tests indicated elevated inflammatory markers. Initial management included broad-spectrum antibiotics, intravenous corticosteroids, and fluid resuscitation. Despite aggressive medical treatment, the patient’s condition worsened, necessitating surgical intervention. A total colectomy with ileostomy was performed, and the patient’s postoperative course was uncomplicated. Conclusion: This case underscores the importance of early diagnosis and intervention in toxic megacolon. A multidisciplinary approach involving gastroenterologists, surgeons, and intensivists is essential for optimizing patient outcomes. Future research should focus on improving early diagnostic markers and treatment protocols to better manage this critical condition.

Improved injection site reactions after switching from adalimumab reference to adalimumab biosimilar LBAL for ulcerative colitis: A case report.

Adalimumab (ADA) is an antitumor necrosis factor agent that is used for the treatment of inflammatory bowel disease. However, its cost has resulted in varying degrees of restricted access across global healthcare economies. Biosimilars are agents that contain a similar version of the active substance of an already approved original biologic agent and are intended to be used for the same indication as the reference product. In general, biosimilars follow the originator; therefore, information on its efficacy and safety had been few. Some studies have reported on replacement of the originator with a biosimilar of the same efficacy because of medical reasons. A 15-year-old girl with steroid-dependent ulcerative colitis that relapsed after vedolizumab was treated with ADA reference. Six weeks after starting ADA reference, her gastrointestinal symptoms had completely resolved, however, immediately after the eighth dose of ADA reference, redness, swelling, and pruritus were noted at the injection site on the left thigh. Allergic reaction caused by the ADA reference. ADA reference was changed to ADA biosimilar LBAL. ADA biosimilar LBAL was continued without any symptoms, such as local swelling, redness, or itching. In addition, there was no deterioration of gastrointestinal symptoms. We showed the efficacy and safety of ADA biosimilar LBAL as an alternative to ADA reference, which caused injection site reactions. Changing from ADA reference to ADA biosimilar because of adverse events may be an option that needs careful observation, considering that the originator and the biosimilar are not exactly the same.

Glycyrrhizic acid and patchouli alcohol in Huoxiang Zhengqi attenuate intestinal inflammation and barrier injury via regulating endogenous corticosterone metabolism mediated by 11β-HSD1

Ethnopharmacological relevanceUlcerative colitis (UC), a chronic inflammatory bowel disease, has become a significant public health challenge due to the limited effectiveness of available therapies. Huoxiang Zhengqi (HXZQ), a well-established traditional Chinese formula, shows potential in managing UC, as suggested by clinical and pharmacological studies. However, the active components and mechanisms responsible for its effects remain unclear. Aim of studyThis study aimed to identify the bioactive components of HXZQ responsible for its therapeutic effects on UC and to elucidate their underlying mechanisms. Materials and methodsThe effect of HXZQ against dextran sodium sulfate (DSS) -induced colitis was investigated. Ingredients in HXZQ were characterized and analyzed in colitic mice using liquid chromatography–mass spectrometry (LC-MS) and gas chromatography–mass spectrometry (GC-MS). In vitro, biological activity of compounds was assessed using lipopolysaccharide (LPS)-induced Ana-1 cells and bone marrow-derived macrophages (BMDMs), tumor necrosis factor-alpha-induced Caco-2 cells, and isolated intestinal crypts from colitic mice. These results were confirmed in vivo. The targets of the components were identified through bioinformatics analysis and validated via molecular docking, enzyme inhibition assays, and in vivo experiments. Hematoxylin and eosin (HE) staining, periodic acid-Schiff (PAS) staining, immunohistochemistry, enzyme-linked immunosorbent assay (ELISA), western blotting, and quantitative real-time polymerase chain reaction (qPCR) were employed to confirm the pharmaceutical effects. ResultsA clinical equivalent dose of HXZQ (2.5 mL/kg) effectively treated DSS-induced colitis. 113 compounds were identified in HXZQ, with 35 compounds detected in colitic mice. Glycyrrhizic acid (GA) and patchouli alcohol (PA) emerged as key contributors to the anti-colitic effects of HXZQ. Further investigation revealed that HXZQ and its active components decreased the levels of pro-inflammatory cytokines TNF-α, interleukin-1β (IL-1β), and interleukin-6 (IL-6) in colon, likely by inhibiting nuclear factor kappa-B (NF-κB) signaling pathway. This inhibition indirectly activated the intestinal farnesoid X receptor (FXR) signaling pathway, correcting bile acid imbalances caused by colitis. Additionally, these components significantly enhanced the expression of tight junction proteins ZO-1 and Occludin, as well as the adhesion protein E-cadherin, and reduced goblet cell loss, thereby repairing intestinal barrier injury. Mechanistically, GA and PA were found to inhibit 11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) activity, leading to increased local active corticosterone levels in the intestine to exert anti-inflammatory effects. Notably, the inhibition of 11β-HSD1 with the selective inhibitor BVT ameliorated colitis in mice. ConclusionsHXZQ exhibits therapeutic effects on UC, primarily through GA and PA inhibiting 11β-HSD1. This suggests new natural therapy approaches for UC and positions 11β-HSD1 as a potential target for colitis treatment.

High serum pesticide levels are associated with increased odds of inflammatory bowel disease in a nested case-control study.

High serum pesticide levels are associated with increased odds of inflammatory bowel disease in a nested case-control study.

Poria cocos polysaccharides alleviate dextran sulphate sodium-induced ulcerative colitis in mice by modulating intestinal inflammatory responses and microbial dysbiosis

Poria cocos polysaccharide (PCP), one of the main active components of P. cocos, is extensively used worldwide and exhibits strong pharmacological effects. However, whether PCP can attenuate inflammatory bowel disease remains unclear. In this study, we assessed the effects of PCP supplementation on dextran sulphate sodium (DSS)-induced ulcerative colitis (UC) in mice. We found that PCP supplementation mitigated UC symptoms in DSS-treated mice, as evidenced by reductions in body weight loss, colon length shortening and disease activity index score. Importantly, PCP supplementation enhanced colonic barrier integrity by increasing tight junction protein abundance and exerted anti-inflammatory effects by suppressing nuclear factor-κB (NF-κB) activation in DSS-treated mice. Furthermore, PCP supplementation reversed DSS-induced dysbiosis in colonic microbiota by increasing the colonic abundance of beneficial bacteria (e.g. Akkermansiaceae) and decreasing the colonic abundance of harmful bacteria (e.g. Erysipelotrichaceae) in DSS-treated mice. Although PCP supplementation failed to ameliorate DSS-induced UC in antibiotic-treated mice, faecal microbiota transplantation from PCP-administered mice ameliorated DSS-induced UC in antibiotic-treated mice. In summary, PCP alleviates UC in mice by attenuating intestinal inflammation via the inhibition of NF-κB activation and modulating the intestinal microbiota.

Dietary antioxidant capacity, genetic susceptibility and polymorphism, and inflammatory bowel disease risk in a prospective cohort

Dietary antioxidant capacity, genetic susceptibility and polymorphism, and inflammatory bowel disease risk in a prospective cohort

Self-Management and Relationships: Perspectives of Young Adults With Chronic Conditions and Their Peers.

Because their disease is largely managed in the private environment, people with chronic conditions perform "chronic homework." The environment with which self-management is coordinated forms a kind of "chronic care infrastructure" in dealing with the disease and, in the case of young adults with chronic conditions (YACCs), is essentially formed by peers. The article investigates how YACCs handle their illness in the context of their peer relationships and how peers see their own role in the context of the YACCs' self-management. What do chronic homework and chronic care infrastructures look like, if the chronic conditions concern young adults in comparatively unstable and non-committal relationships with their peers? Episodic interviews were conducted with 60 YACCs (with type 1 diabetes, cancer, chronic inflammatory bowel disease, and rare conditions) and 30 peers. The interviews were analyzed using thematic coding. The YACCs' statements were compared to the peer perspectives on a case-by-case basis. We found that peers differ in the extent to which they seek to monitor or control the YACCs' self-management. We identified three groups of YACCs: (a) those who focus on their health needs; (b) those who seek to balance their disease management with their need for sociability and belonging; and (c) those who deprioritize their illness in their everyday life in favor of peer acceptance. The multi-perspective approach to YACCs' and their peers' experiences with self-management on the one hand and referring to a range of chronic conditions on the other allows to analyze this issue in a complex and comprehensive way.

061. A Rare Finding; Severe Intra Abdominal Infection and Colonic Necrosis in Geriatric Crohn’s Disease Patient

Background: Crohn's disease (CD) is an immune-mediated inflammatory bowel disease (IBD) marked by segments of transmural inflammation in the gastrointestinal tract. Only 10% to 15% of IBD cases occur in those over 65. In a retrospective study of 281 surgeries, 43 were in colitis patients and 242 in Crohn's patients. The mortality rate was 5.7%, with 9 deaths due to sepsis, mainly linked to emergency procedures and corticosteroid use. CD symptoms include fatigue, prolonged diarrhea, weight loss, and fever, with or without bleeding. Case: A 69-year-old female with a 15-day history of abdominal pain. Patient referred to our hospital after laparotomy and ileostomy 15-days ago. Patient condition worsened, sepsis condition. Upon arrival, the patient exhibited mild hypotension, abdominal distension with midline incision, intra abdominal drain, and an active ileostomy on the right lumbal region. Laboratory tests shows anemia, electrolyte imbalances, and hypoglycemia. A CT scan abdomen revealed pneumoperitoneum and intestinal inflammation. During relaparotomy operation, ileal perforation was found near the stoma, with full-thickness necrosis of the ascending colon extending into part of the transverse colon, and colitis with mucosal necrosis from part of the transverse colon to the rectum. So, we performed a total colectomy, and ileostomy relocation. Pathology confirmed Crohn's disease with granulomatous inflammation. The patient received intravenous fluids and antibiotics. She was subsequently admitted to the intensive care unit for further management. Conclusion: Crohn's disease with severe intra abdominal infected ec perforated colon in patients over 65 is a rare case. Timely diagnosis through detailed anamnesis and examination is crucial. Surgical options should be taken if there are signs of peritonitis.

Problematic issues of the impact of microplastics on the human body and the environment: A review

Currently, the widespread use of plastic has become a serious problem for the environment and human health. Microplastics, being an artificial polymer created by man, are highly resistant to external influences and their decomposition requires a significant amount of time. The article provides information on the distribution of microplastics and their impact on the environment and the human body, issues of detecting microplastics in the blood, heart, lungs, placenta and meconium, in breast milk, hypothetical mechanisms by which microplastics penetrate into human tissues and the metabolism of plasticizers in children with autism spectrum disorder and attention deficit hyperactivity disorder. In the modern world, plastic has become an integral part of our daily lives, the presence of microplastics in plastic bags for storing breast milk, in baby formula and polypropylene bottles has been demonstrated, the relationship between microplastics and postpartum depression, the relationship between fecal microplastics and the status of inflammatory bowel diseases has been described. Making the decision to limit the use of plastic products in your home is an important step that can play a key role in reducing environmental pollution and protecting the health of future generations.

Idiopatické střevní záněty a autoimunitní pankreatitida

Autoimmune pancreatitis is a subtype of chronic pancreatitis. Currently, type 1 is known (LPSP – lymphoplasmacytic sclerosing pancreatitis), which is classified among the clinical forms of a group of diseases designated as IgG4-related disease. This form occurs in younger individuals and IgG4 levels are normal with a few exceptions. This type is accompanied in 20–30% via findings of inflammatory bowel diseases, mainly ulcerative colitis. Type 3 autoimmune pancreatitis has been described, but it is still debated. The number of persons with inflammatory bowel diseases and the finding of type 2 autoimmune pancreatitis is highest in persons with ulcerative colitis – up to 2/3 of all patients. In the Mayo Clinic study, 19 persons with inflammatory bowel disease were found in a group of 43 patients with type 2 AIP; similarly, a Japanese study found AIP in 11 cases in a group of 52 patients with inflammatory bowel disease. Other studies have shown similar results. Inflammatory bowel disease with autoimmune pancreatitis is diagnosed in 20% of cases and steroid therapy is usually successful.

Gut microbiome-targeted therapies as adjuvant treatments in inflammatory bowel diseases: a systematic review and network meta-analysis.

Gut microbiome-targeted therapies (MTTs), including prebiotics, probiotics, synbiotics, and fecal microbiota transplantation (FMT), have been widely used in inflammatory bowel diseases (IBD), but the best MTTs has not yet been confirmed. We performed a network meta-analysis (NMA) to examine this in ulcerative colitis (UC) and Crohn's disease (CD). We searched for randomized controlled trials (RCTs) on the efficacy and safety of MTTs as adjuvant therapies for IBD until December 10, 2023. Data were pooled using a random effects model, with efficacy reported as pooled relative risks with 95% CIs, and interventions ranked according to means of surfaces under cumulative ranking values. Thirty-eight RCTs met the inclusion criteria. Firstly, we compared the efficacy of MTTs in IBD patients. Only FMT and probiotics were superior to placebo in all outcomes, but FMT ranked best in improving clinical response rate and clinical and endoscopic remission rate, and probiotics ranked second in reducing clinical relapse rate showed significant efficacy, while prebiotics ranked first showed nonsignificant efficacy. Subsequently, we conducted NMA for specific MTT formulations in UC and CD separately, which revealed that FMT, especially combined FMT via colonoscopy and enema, showed significant efficacy and was superior in improving clinical response and remission rate of active UC patients. As for endoscopic remission and clinical relapse, multistrain probiotics based on specific genera of Lactobacillus and Bifidobacterium showed significant efficacy and ranked best in UC. In CD, we found that no MTTs were significantly better than placebo, but synbiotics comprising Bifidobacterium and fructo-oligosaccharide/inulin mix and Saccharomyces ranked best in improving clinical remission and reducing clinical relapse, respectively. Moreover, FMT was safe in both UC and CD. FMT and multistrain probiotics showed superior efficacy in UC. However, the efficacy of MTTs varies among different IBD subtypes and disease stages; thus, the personalized treatment strategies of MTTs are necessary.

Food Insecurity Is Common in Patients with Inflammatory Bowel Disease and Is Associated with Increased Ultra-Processed Food Intake.

Food insecurity (FI) is defined as the lack of consistent access to enough food for an active and healthy life. FI affects over 30 million Americans and is associated with poor clinical outcomes and impaired quality of life and drives significant health inequities. Despite the rising prevalence of FI and the federal focus on improving access to healthy food, there is a paucity of research on FI in patients with inflammatory bowel disease (IBD). Therefore, the goal of this study was to define FI in a cohort of IBD patients and determine whether FI was associated with changes in dietary patterns, including specifically an increase in ultra-processed food (UPF) consumption in this high-risk patient population. This was a single-center, retrospective cohort study of patients with a diagnosis of IBD who were 18 years of age or older and who were seen in a nutrition focused clinic. Patients were screened for FI using the Hunger Vital Sign™, a 2-question validated FI screening tool and underwent a 24-h dietary recall. The degree of food processing was assessed using the NOVA Food Classification System. Among 128 patients with IBD, we observed that FI is increasingly prevalent, with 45% of patients reporting difficulty with sufficient grocery access at least "sometimes" in the last 12 months and 10% reporting decreased food access "often" in the prior year. In addition, the patients at high-risk for FI were significantly more likely to eat NOVA 4 UPFs (54% vs. 27%, p = 0.001) and were significantly less likely to eat NOVA 1 unprocessed foods (32% vs. 61%, p = 0.001) as compared to those not at risk for FI. Finally, only a small percentage of those at highest risk for FI were enrolled in a federal food assistance program for grocery support. The prevalence of FI is increasing in patients with IBD and is associated with reduced dietary quality.

Mushroom and Kefir Functional Characterizations: Hypolipidemia and Gut Microbiota Modulations in Rat Models

ABSTRACTHyperlipidemia is a malnutrition disease associated with different lifestyle factors mainly high fat/cholesterol foods consumption and less physical activity. Consumption of high fiber foods (prebiotic sources) additionally to gut microbiota (GM; probiotics species) could overcome hyperlipidemia and its associated risks. Prebiotics and probiotics are known by protective effects in different diseases like diabetes, inflammatory bowel diseases, and cardiovascular diseases. Mushroom and kefir milk (KM) are known for their high pre/probiotic nutritional values depending on many factors, for example, eating levels and/or conditions. Therefore, this study aimed to measure the potential health benefits of dried powdered mushrooms (DPM) supplemented with KM between hyperlipidemia rats in association with lipid profile, atherogenic index (AI), and GM profile. Rats were randomly divided into main negative control healthy group (G1; −ve), positive control hyperlipidemia (G2; +ve) and three hyperlipidemia groups (G3:G5) fed DPM at 2.5%, 5%, and 10% of rats' diet additionally to 5% KM (DPM + 5% KM) each, respectively. The collected blood samples used for glucose, lipid profile (cholesterol, triglycerides, high‐density lipoprotein cholesterol, and low‐density lipoprotein cholesterol), and AI in addition to fecal sample for GM and short‐chain fatty acids (SCFAs). Collected data illustrated that body weight, blood glucose, lipid profile, GM (Bifidobacteria and Lactobacillus vs. Clostridium histolyticum), AI, and SCFAs were improved between hyperlipidemia fed 5% both PDM + KM (p ≤ 0.05) at the best levels. In conclusion, same DPM/KM levels have broad development as functional active foods that could lower hyperlipidemia incidence and promotes intestinal health; however, much more human studies are needed.