Low-fat Diet Research Articles

Association between improved erectile function and dietary patterns: a systematic review and meta-analysis.

Erectile dysfunction (ED) is prevalent among men, but its relationship with dietary habits is uncertain. The aim of our study was to assess whether dietary patterns enhance erectile function by reviewing the literature published before August 1, 2022, via PubMed, Web of Science, and EMBASE databases. The data compiled included author details; publication dates, countries, treatments, patient numbers, ages, follow-ups, and clinical trial outcomes, such as ED cases, odds ratios (ORs), confidence intervals (CIs), and International Index of Erectile Function-5 (IIEF-5) scores with means and standard deviations. An analysis of 14 studies with 27 389 participants revealed that plant-based diets (OR = 0.71, 95% CI: 0.66-0.75; P < 0.00001), low-fat diets (OR = 0.27, 95% CI: 0.13-0.53; P = 0.0002), and alternative diets such as intermittent fasting and organic diets (OR = 0.54, 95% CI: 0.36-0.80; P = 0.002) significantly reduced ED risk. High-protein low-fat diets (hazard ratio [HR] = 1.38, 95% CI: 1.12-1.64; P < 0.00001) and high-carb low-fat diets (HR = 0.79, 95% CI: 0.55-1.04; P < 0.00001) improved IIEF-5 scores. Combined diet and exercise interventions decreased the likelihood of ED (OR = 0.49, 95% CI: 0.28-0.85; P = 0.01) and increased the IIEF-5 score (OR = 3.40, 95% CI: 1.69-5.11; P < 0.0001). Diets abundant in fruits and vegetables (OR = 0.97, 95% CI: 0.96-0.98; P < 0.00001) and nuts (OR = 0.54, 95% CI: 0.37-0.80; P = 0.002) were also correlated with lower ED risk. Our meta-analysis underscores a strong dietary-ED association, suggesting that low-fat/Mediterranean diets rich in produce and nuts could benefit ED management.

Decreased neutrophils are associated with reduced risk of Type 2 Diabetes Incidence: Results from the CORDIOPREV study.

Numerous studies have reported an association between neutrophils and T2DM, although this relationship remains unclear. This study aims to investigate the interaction of neutrophils and a dietary intervention on T2DM incidence after 60 months of follow-up. A comprehensive analysis was conducted on the framework of the CORDIOPREV study, which included 462 patients without T2DM at the beginning of the study. They were randomly assigned to either a Mediterranean or a low-fat diet, of whom 107 developed T2DM. Absolute neutrophil counts and other related-ratio, were measured. Kaplan-Meier curves showed that the lowest tertile of basal neutrophils was associated with a reduced likelihood of T2DM incidence when compared to the middle [HR=0.499 (95%CI, 0.287-0.866)] and the highest tertiles [HR=0.442 (95%CI, 0.255-0.768)] in overall population, after adjusting for clinical variables. This association only remained significant in patients who follow a Mediterranean diet when compared the lowest to the middle [HR=0.423 (95% CI, 0.213-0.842)] and the highest tertiles [HR=0.371 (95% CI, 0.182-0.762)]. The predictive capacity yielded an AUC of 0.711 (95%CI: 0.652-0.769), being neutrophils the most important variable in the in the model. Decrease in neutrophils over the 60 months were associated with increased insulin sensitivity index (ISI) (R=-0.31; p=0.019), particularly in patients who followed the Mediterranean diet. These findings suggest that monitoring neutrophils can help prevent the development of T2DM, as a reduction in neutrophil counts could be associated with improved insulin sensitivity. Following a Mediterranean diet might be a potential strategy to reduce the incidence of T2DM by lowering neutrophil levels. Further research is necessary to gain a deeper understanding regarding this mechanism.

Short-term high-fat and high-carb diet effects on glucose metabolism and hedonic regulation in young healthy men.

Daily dietary intake of macronutrients and energy is closely associated with long-term metabolic health outcomes, but whether 24-h nutritional intervention under isocaloric conditions leads to changes in metabolism remains unclear. Moreover, the short-term effect of diets with different macronutrient composition on hedonic appetite regulation is less clear. This study examined the impact of an acute high-fat (F+) and high-carbohydrate (C+) diet on glucose metabolism and hedonic regulation of food intake in young healthy men under controlled conditions. Using a cross-over design, 19 male participants received a one-day isocaloric diet with different macronutrient composition (F+ = 11% carbohydrates, 74% fat; C+ = 79% carbohydrates, 6% fat) compared to a control diet (CON = 55% carbohydrates, 30% fat). Protein content was set at 15% of energy in all diets. The feeling of hunger, as well as "liking" and "wanting" for foods, was assessed through visual analog scales, and blood samples for glucose, insulin, and cortisol levels were assessed repeatedly during the experimental day. An intravenous glucose tolerance test was conducted the next morning. Postprandial glucose and insulin levels were lowest in F+ over the 24 h. Except for dinner, the CON diet showed the highest mean values in glucose. F+ diet improved insulin resistance, lowering Homeostatis Model Assessment Insulin Resistance (HOMA-IR) values. Changes in hedonic regulation of food intake were not observed during the intervention between the diets, except for higher feelings of satiety under the CON diet. An acute, isocaloric, high-fat diet improved insulin resistance even in healthy individuals but did not affect hedonic food intake regulation. Macronutrient composition modulate glucose metabolism even under short-term (24-h) and isocaloric diets, which should be considered for personalized preventive dietary treatments.

Determinants of adherence among patients with hypertension

Abstract Background Poor adherence to pharmacological treatment among patients with hypertension (HTN) is common. Approximately half of HTN patients do not use their medications as prescribed. Multiple barriers can influence adherence to antihypertensive medications. HTN patients may be characterized by the presence of frailty syndrome (FS) and cognitive impairment (CI). FS and CI may adversely affect the course of the disease and adherence to therapeutic recommendations. Purpose To assess the adherence and its determinants among patients with hypertension. Methods The study included 129 patients diagnosed with hypertension (81 men, 48 women; mean age M±SD=69.98±11.67) hospitalized in the Department of Occupational Diseases and Hypertension. Medical record analysis, the author's sociodemographic questionnaire, the Tilburg Frailty Idicator (TFI) to determine the presence of frailty syndrome, the Montreal Cognitive Assesment (MoCa) questionnaire to assess cognitive function, and the Adherence to Medication Scale (ARMS) to assess adherence were used. Results The majority of respondents were male (62.79%), living in large cities (31.78%), in a relationship (61.24%), with a high school education (68.22%), and retired (67.44%). Analysis of medical records among comorbidities showed diabetes (59.69%) and other cardiovascular diseases (58.91%) to be the most common. Hospitalizations due to hypertension within the past year in the range of 1-2 were reported in 72.09% of the subjects, 3-5 hospitalizations in 17.05%, and more than 5 hospitalizations in 10.85% subjects. The surveyed patients mostly kept self-monitoring diaries (61.24%), measured their blood pressure values 2-3 times a day (58.15%) with an upper arm blood pressure monitor (64.34%). In terms of self-care behaviors, respondents most often indicated following a diet with a restriction of unhealthy fats (52.71%), following a low-sodium diet (44.19%) and being physically active (33.33%). The mean blood pressure values in the study group were M±SD=139.73±16.73 mmHg for SBP and M±SD=81.48±13.25 mmHg for DBP, respectively. On the basis of the TFI, 99.22% of patients showed the presence of FS (M±SD =10.66±2.82), the MoCa questionnaire indicated abnormal values in cognitive function in 79.07% (M±SD =18.16±8.3). The average adherence ARMS score was M±SD 17,6±6,72 pcts. (higher the ARMS score the worse adherence). Univariate analysis as determinants of adherence showed unemployment (b=9.391;p=0.001), smoking (b=6.701;p=0.001), duration of illness (b=-0.153;p=0.003), 3-5 hospitalizations in the past year (b=3.891;p=0.014). Multivariate analysis among determinants of adherence showed unemployment (b=7.556;p=0.022), duration of illness (b=-0.167;p=0.002) and 3-5 hospitalizations (b=5.011;p=0.001). Conclusion Hypertensive patients are characterized by optimal adherence. Despite expectations, cognitive impairment and frailty syndrome did not determine adherence to medications.

Diets, ergogenic supplements, and microbiota in professional and non-professional athletes

Abstract Background Regular physical activity has significant health benefits and can help prevent and manage non-communicable diseases. Intense exercise during training requires diet modulation to support health and performance. Anaerobic sports require high-protein diets, while aerobic sports prefer high-carbohydrate diets. Two-thirds of adult athletes take dietary supplements, and non-professional athletes also use supplements to enhance their appearance. However, dietary stress and imbalanced use of supplements leads the body to different diseases like gastrointestinal diseases and even multifactorial diseases e.g. cancer, cardiovascular diseases, and neurodegenerative diseases. Depending on the specific nutritional intake, supplementations, types of exercises the microbiota can be influenced positively or negatively. A systematic review meta-analysis and a pilot study were conducted to investigate the role of diet and supplementation about the microbial composition of the gut, under different types and intensities of physical activities. Methods The systematic review and meta-analysis were conducted according to the PRISMA guidelines, and the protocol was registered in PROSPERO (Number CRD42024500826). In a pilot study gut microbiota (16S amplicon sequencing), anthropometric data, and information on diet and supplementation, physical activity and sport habits were collected in a sample including professional and non-professional athletes. Results Out of 1318 studies, only 9 met the criteria for inclusion in the meta-analysis. The pilot study’s meta-regression analysis and microbiota analysis highlight the role of physical activity type in changing the Bacillota/Bacteroidota ratio (p = 0.001). Conclusions As gut training becomes more popular among athletes, it is necessary to map interactions between microbiota and different personalized diets, physical activities, and the most popular ergogenic supplements to enhance performance and athletic wellness Key messages • The microbiome can be influenced positively or negatively by the specific dietary intake, types of physical activities and ergogenic supplementations. • To map interactions between microbiota and different diets, physical activities, and popular ergogenic supplements is needed to design new strategies to enhance performance and athletic wellness.

Acute hyperlipidemia has transient effects on large-scale bone regeneration in male mice

Excessive dietary fat intake increases plasma lipid levels and has been associated with reduced bone mineral density (BMD) and increased risk of osteoporotic fracture, especially in older postmenopausal women. The objective of this study was to investigate whether there are sex-related differences in lipid metabolism that could have an impact on large-scale bone regeneration. Because ribs provide a unique exception as the only bones capable of completely regenerating large-scale defects, we used a rib resection mouse model in which human features are recapitulated. After 10 days of exposure to a low-fat diet or high-fat diet (HFD), we performed large-scale rib resection surgeries on male and female mice (6–7 weeks old) with deletion of the low-density lipoprotein (LDL) receptor (Ldlr−/−) and age- and sex-matched wild-type (WT) mice were used as controls. Plasma analysis showed that short-term exposure to HFD significantly increases total cholesterol, LDL cholesterol, and triglycerides levels in Ldlr−/− mice but not in WT, with no differences between males and females. However, under HFD, callus bone volume was significantly reduced exclusively in male Ldlr−/− mice when compared to WT, although these differences were no longer apparent by 21 days after resection. Regardless of diet or genotype, BMD of regenerated ribs did not differ significantly between groups, although male mice typically had lower average BMD values. Together, these results suggest that short-term hyperlipidemia has transient effects on large-scale bone regeneration exclusively in male mice.

Time-Restricted Feeding Attenuates Adipose Tissue Inflammation and Fibrosis in Mice Under Chronic Light Exposure.

Time-restricted feeding (TRF) has emerged as a promising dietary approach for improving metabolic parameters associated with obesity. However, it remains largely unclear whether TRF offers benefits for obesity related to exposure to light at night. This study examined whether lean and obese mice under chronic light exposure could benefit from TRF intervention. Six-week-old C57BL/6 male mice were fed either a low-fat diet or a high-fat diet under a 12 h light/12 h dark cycle for 6 weeks. They were then divided into three subgroups: control light, chronic 24 h light, and chronic light with a daily 10 h TRF. Chronic light exposure led to increased weight gain and higher expression of inflammatory and fibrotic markers in the adipose tissue of both lean and obese mice. It also increased hepatic triglyceride content in mice, regardless of their weight status. TRF protected both lean and obese mice from weight gain, normalized inflammatory and fibrotic gene expression, and reduced adipose tissue collagen and liver triglyceride accumulation caused by light exposure alone or in combination with obesity. These results suggest that TRF could have clinical implications for preventing obesity associated with night shift work, regardless of current weight status.

Metaproteomics reveals diet-induced changes in gut microbiome function according to Crohn’s disease location

BackgroundCrohn’s disease (CD) is characterized by chronic intestinal inflammation. Diet is a key modifiable factor influencing the gut microbiome (GM) and a risk factor for CD. However, the impact of diet modulation on GM function in CD patients is understudied. Herein, we evaluated the effect of a high-fiber, low-fat diet (the Mi-IBD diet) on GM function in CD patients. All participants were instructed to follow the Mi-IBD diet for 8 weeks. One group of CD patients received one-time diet counseling only (Gr1); catered food was supplied for the other three groups, including CD patients (Gr2) and dyads of CD patients and healthy household controls (HHCs) residing within the same household (Gr3-HHC dyads). Stool samples were collected at baseline, week 8, and week 36, and analyzed by liquid chromatography-tandem mass spectrometry.ResultsAt baseline, the metaproteomic profiles of CD patients and HHCs differed. The Mi-IBD diet significantly increased carbohydrate and iron transport and metabolism. The predicted microbial composition underlying the metaproteomic changes differed between patients with ileal only disease (ICD) or colonic involvement: ICD was characterized by decreased Faecalibacterium abundance. Even on the Mi-IBD diet, the CD patient metaproteome displayed significant underrepresentation of carbohydrate and purine/pyrimidine synthesis pathways compared to that of HHCs. Human immune-related proteins were upregulated in CD patients compared to HHCs.ConclusionsThe Mi-IBD diet changed the microbial function of CD patients and enhanced carbohydrate metabolism. Our metaproteomic results highlight functional differences in the microbiome according to disease location. Notably, our dietary intervention yielded the most benefit for CD patients with colonic involvement compared to ileal-only disease.9orssYZV9GnhTtyZm1JCtCVideo

A Phase 1 Study to Assess the Pharmacokinetics, Food Effect, Safety, and Tolerability of Sepiapterin in Healthy Japanese and Non-Japanese Participants

Background: Sepiapterin is a natural precursor of tetrahydrobiopterin (BH4), a key cofactor for phenylalanine hydroxylase. It is being developed for the treatment of patients with phenylketonuria. In this study, the ethnic differences in pharmacokinetics and safety of sepiapterin in Japanese and non-Japanese participants and food effects were evaluated. Methods: Healthy participants (n = 60) received a single oral dose of sepiapterin at either 20, 40, or 60 mg/kg with a low-fat diet. The Japanese participants received two doses at 40 mg/kg, either under fasted conditions or with a low-fat diet with a 3-day washout period in between. Results: Sepiapterin was well tolerated in all participants, with no serious adverse events. Sepiapterin was quickly absorbed (Tmax 1.4–4.5 h) and rapidly and extensively converted to BH4 (Tmax ~4 h). Exposures to sepiapterin were &lt;1% of BH4. BH4 exposures were essentially dose-independent between 20 and 60 mg/kg. A low-fat diet increased BH4 exposures in Japanese participants by 1.7-fold compared with fasted conditions. Conclusions: BH4 exposures (Cmax and AUC0–last) in Japanese participants were 10–30% higher than in non-Japanese participants, which is deemed not clinically relevant; no dose adjustment is warranted. The slightly higher BH4 exposures in Japanese participants are likely due to the higher frequency of ABCG2 c.421C&gt;A mutation in the Japanese population.

Females have better metabolic flexibility in different metabolically challenging stimuli.

The first aim was to explore the difference in metabolic flexibility between sexes in response to changing exercise intensity under control conditions. The second aim was to evaluate metabolic flexibility between sexes in response to exercise intensity adding two different metabolically challenging stimuli (glycogen depletion and heat). Eleven males (22±3yrs, 176.2±4cm, 68.4±4.9kg and 60.2±4.1ml/kgFFM/min) and nine females (22±2yrs, 166.7±4.5cm, 61.9±2.9kg, 64.2±5.6 ml/kgFFM/min) performed a maximal incremental exercise test (30W every 3min) on a cycle ergometer under three conditions: control (24h high-carbohydrate diet followed by the incremental test), glycogen depletion (glycogen-depletion protocol followed by 24h low-carbohydrate diet and then the incremental test) and heat (24h high-carbohydrate diet followed by 30 min passive heating and then the incremental test in heat). In the last minute of each step, lactate was analysed, fat (FATox/FFM) and carbohydrate oxidation (CHox/FFM) and energy expenditure (EE/FFM) normalized to fat free mass was estimated by indirect calorimetry. Females presented a greater FATox/FFM as exercise intensity increases across conditions (control, glycogen depletion and heat) (p=0.006). In contrast, CHox/FFM was not significantly different between sexes at any specific intensity across conditions (p>0.05). Consequently, EE/FFM was higher in females throughout the different intensities across conditions (p=0.002). Finally, lactate concentration was not different between sexes at the same intensities across conditions (p=0.87). In conclusion, females present a greater metabolic flexibility, due to the higher FATox/FFM throughout the different intensities, regardless of whether the test is performed in a conditions emphasizing the oxidative pathway (glycogen depletion) or the glycolytic pathway (heat). Clinical trials:NCT05703100.

The impact of 3 different dietary interventions on overweight or obese adults: A network meta-analysis.

This network meta-analysis aims to investigate and compare the effectiveness of 3 dietary interventions - Mediterranean, ketogenic, and low-fat diet - on overweight and obese adults, with a comparison to traditional low-calorie diet. A systematic review was conducted in both Chinese and English databases, including the China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), SinoMed, PubMed, Web of Science, Cochrane Library and Embase to identify relevant randomized controlled trials (RCTs) up to January 31, 2024. Two researchers independently screened and extracted data from the identified literature. The quality of these studies was assessed using the Cochrane bias risk assessment tool. A random-effects network meta-analysis was performed using Review Manager 5.4.1 and Stata 16.0 software. A total of 17 randomized controlled trials involving 5802 subjects were included in this study. The network meta-analysis revealed a descending order of effectiveness for reducing body weight (BW), body mass index (BMI), and waist circumference (WC): ketogenic diet > low-fat diet > low-calorie diet > Mediterranean diet. The ketogenic diet was identified as the most effective intervention for reducing BW, BMI, and WC in the studied dietary comparisons. It consistently showed superior outcomes, ranking highest in effectiveness among the 4 evaluated dietary approaches. Nevertheless, additional high-quality randomized controlled trials are necessary to validate these findings.

Application of ultrasound-guided intranodal lymphangiography in the diagnosis and treatment of chylous ascites after abdominal surgery.

Chylous leakage is a serious and challenging postoperative complication. The purpose of this study was to explore the application of ultrasound-guided intranodal lymphangiography in the diagnosis and treatment of chylous ascites following abdominal surgery. Ten patients with chylous ascites after abdominal surgery after ineffective conservative treatment such as low-fat diet, parenteral nutrition, and negative pressure drainage were included in this single-center retrospective study. Of these 10 patients, 9 developed chylous ascites after liver surgery, and 1 after a radical gastrectomy. Lymphangiography was successfully performed in all 10 patients. The average dosage of lipiodol used was 4.5 ml (range 3.5-7.0 ml). No procedure-related complications were observed after excluding unrelated factors. During lymphangiography, lipiodol leakage was directly observed in 3 cases, and in the other 5 cases, it was detected through abdominal computed tomography post-lymphangiography. Chylous ascites resolved solely through lymphangiography in 6 patients without requiring additional surgical intervention. Lymphangiography may help identify leakage sites in patients with chylous ascites unresponsive to conservative treatment and could potentially be effective in treating chylous ascites following abdominal surgery.

RISE IN PLASMA BILE ACIDS FOLLOWING HYPOABSORPTIVE BARIATRIC SURGERIES PREDICT BENEFICIAL METABOLIC AND HOMEOSTATIC OUTCOMES IN MALE RATS.

The effects of three hypoabsorptive bariatric surgeries, Roux-en-Y gastric bypass (RYGB), biliopancreatic diversion with duodenal switch (BPD-DS) and single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S), on bile acids (BAs) were assessed including the changes in BA plasma levels associated with the metabolic and homeostatic effects of the surgeries. Male Wistar rats, etheir fed high- (HF) or a low-fat (LF) diets, were divided into seven groups: RYGB HF, BPD-DS HF, SADI-S HF, sleeve-gastrectomy (SG) HF, sham-operation (SHAM) HF, SHAM LF and SHAM HF-pair-weighed to BPD-DS (SHAM HF-PW). The rats were treated 56 days. The results demonstrate the ability of RYGB, BPD-DS and SADI-S to raise plasma levels of BAs, whose elevations, most notably those of the secondary BAs (deoxycholic acid, ursodooxycholic acid and lithocholic acid) associated negatively with body weight gain, fat gain and fasting insulin levels and positively with plasma peptide tyrosine-tyrosine (PYY). Plasma BAs also correlated positively with the fecal levels of Clostridium, Sutterella and Enterobacteriaceae and negatively with Clostridiales_f_g_2, Christensenellaceae, Ruminococcaceae_g_2, Oscillibacter and Oscillospira. Additionally, they associated positively with the short-chain fatty acid (SCFA) levels of propionate, butyrate, isobutyrate, valerate and isovalerate. Altogether, the present study emphasizes the ability of RYGB, BPD-DS and SADI-S to induce circulating BA elevations that predict the beneficial consequences of those hypoabsorptive bariatric surgeries on energy and glucose homeostasis and circulating levels of PYY. The present results also reveal close associations between plasma BAs and SCFAs, whose variations following hypoabsorptive surgeries are also linked to significant fat losses and metabolic health improvements.

Modulation of circulating levels of advanced glycation end products and its impact on intima-media thickness of both common carotid arteries: CORDIOPREV randomised controlled trial

BackgroundIncreasing evidence supports the role of advanced glycation end products (AGEs) in atherosclerosis in both diabetic and non-diabetic patients, suggesting that therapeutic strategies targeting AGEs may offer potential benefits in this population. The Mediterranean diet is associated with improved biomarkers and anthropometric measurements related with atherosclerosis in addition to its ability to modulate AGE metabolism. Our aim was to determine whether the reduction in atherosclerosis progression (measured by changes in intima-media thickness of both common carotid arteries (IMT-CC)), observed after consumption of a Mediterranean diet compared to a low-fat diet, is associated with a modulation of circulating AGE levels in patients with coronary heart disease (CHD).Methods1002 CHD patients were divided in: (1) Non-increased IMT-CC patients, whose IMT-CC was reduced or not changed after dietary intervention and (2) Increased IMT-CC patients, whose IMT-CC was increased after dietary intervention. Serum AGE levels (methylglyoxal–MG and Nε-Carboxymethyllysine-CML) and parameters related to AGE metabolism (AGER1 and GloxI mRNA and sRAGE levels) and reduced glutathione (GSH) levels were measured before and after 5-years of dietary intervention.ResultsThe Mediterranean diet did not affect MG levels, whereas the low-fat diet significantly increased them compared to baseline (p = 0.029), leading to lower MG levels following the Mediterranean diet than the low-fat diet (p < 0.001). The Mediterranean diet, but not the low-fat diet, produced an upregulation of AGE metabolism, with increased AGER1 and GloxI gene expression as well as increased GSH and sRAGE levels in Non-increased IMT-CC patients (all p < 0.05). Although the Mediterranean diet increased MG levels in Increased IMT-CC patients, this increment was lower compared to the low-fat diet (all p < 0.05).ConclusionsOur results suggest that an improvement in modulation of AGE metabolism, which facilitates better management of circulating AGE levels, may be one of the mechanisms through which the Mediterranean diet, compared to a low-fat diet, reduces the progression of atherosclerosis in patients with CHD.Trial registrationhttps://clinicaltrials.gov/ct2/show/NCT00924937, Clinicaltrials.gov number, NCT00924937.Graphical abstract

Late-onset chylothorax after lung cancer surgery: clinical characteristics, management, and prevention.

The clinical characteristics and management of late-onset chylothorax after lung cancer surgery remained unknown. Here we aimed to provide evidence on the management of late-onset chylothorax by analysis of several cases with the largest sample size. We retrospectively collected clinical data of patients who developed late-onset chylothorax after lung cancer surgery and were re-admitted by a single surgeon in our center from 2016 to 2022. The clinical characteristics and management for these patients were analysed. The role of Hem-o-lok clipping after lymphadenectomy in preventing late-onset chylothorax was further explored by comparing the surgical outcomes between treated group and control group. A total of six patients who were re-admitted for late-onset chylothorax after lung cancer surgery were included for analysis. The mean age of them was 60.7 years old. The symptom of late-onset chylothorax was mainly dyspnea and cough and the diagnosis was all made by Sudan III staining between postoperative day 17 to 42. All patients were firstly treated with thoracocentesis and low-fat diet with intravenous nutrition. Four patients were successfully managed with low-fat diet and thoracocentesis, while the other two patients were further managed with pleurodesis with 50% glucose fluid solution. We found a significantly decreased risk of late-onset chylothorax in the treated group with improved procedure of applying Hem-o-lok clipping after lymphadenectomy than in the control group (0% versus 2.6%, P < 0.01). Late-onset chylothorax after lung cancer surgery was a rare and negligible complication, which may usually be managed by non-surgical methods. Hem-o-lok clipping during lymphadenectomy seemed to be an effective method to prevent late-onset chylothorax after lung cancer surgery.

Prospective Outcomes of Standardized Non-operative Management of Pancreatic Trauma With Ductal Injury in Children: Less is More

BackgroundTraumatic pancreatic laceration with ductal injury in children can be managed non-operatively (NOM); however, variable management affects outcomes. We hypothesized that a standardized management approach with early feeding and limited resource utilization is safe and improves outcomes. MethodProspective, multicenter study of 13 pediatric trauma centers (2018–2022). Children with blunt pancreatic trauma with ductal injury were managed per a standard NOM pathway. Outcomes were compared to a historical NOM cohort with variable management. ResultsOf 22 patients, the median age was 7.5 years (range 1–14 years). Low-fat diet was started at median 4 days [IQR 2–7] and median hospital stay was 8 days [IQR 4–10]. One patient failed NOM and underwent distal pancreatectomy. Of the rest, most (17/21, 81%) had early recovery and discharged in median 6 days [IQR 4–8.25] while 4 (19%) had prolonged recovery (median stay 24 days, IQR 19.8–30.5) and higher peri-pancreatic cyst development (early 23.5% vs prolonged 75%,p = 0.05). Pancreatic ascites at presentation correlated with cyst development (p < 0.0001). Endoscopic stent (optional) was placed in 33% and did not prevent cyst development. Delayed exocrine pancreatic insufficiency was noted in 1 patient. Compared to the historic cohort (32 patients), TPN use was lower (pre-protocol 56% vs post 23%, p = 0.02), days to diet was shorter (pre-protocol 7 vs post 4; p = 0.03), and cyst development was lower (pre-protocol 81% vs post 33%, p < 0.001). ConclusionChildren with traumatic pancreatic ductal injury can be safely managed per the PTS NOM clinical pathway and most recover rapidly. Pancreatic ascites may predict pseudocyst formation. Levels of EvidenceIV. Study type: therapeutic, comparative.

Dietary bamboo charcoal powder ameliorates high-fat diet-induced hyperlipidemia by enhancing fecal lipid excretions in Sprague-Dawley rats.

Bamboo charcoal powder (BCP) is increasingly used as a food colorant. This study aims to evaluate the effects of BCP consumption on improving high-fat diet-induced hyperlipidemia. Fifty male SD rats were randomly assigned into five groups, with 10 rats in each group: the control group was fed a low-fat diet (LFD); the model control group was fed a high-fat diet (HFD); the low-BCP dose group was fed a HFD and given 2.81 g of BCP/kg of body weight (BCP-L) by gavage; the medium-BCP dose group was fed a HFD and given 5.62 g of BCP/kg of body weight (BCP-M) by gavage; the high-BCP dose group was fed a HFD and given 11.24 g of BCP/kg of body weight (BCP-H) by gavage. After 90 days, the consumption of BCP caused a decrease in body weight, plasma lipids (triglyceride, cholesterol, and low-density lipoprotein (LDL)), liver triglyceride, and cholesterol levels, and liver histopathological scores. BCP caused a significant increase in superoxide dismutase (SOD) activity and total antioxidant capacity (T-AOC) in liver tissues. BCP also led to an increase in 72-h fecal dry weight and crude fat in a rat metabolic cage. The analysis of fecal samples with liquid chromatography time-of-flight mass spectrometry (LC-Q-TOF-MS) showed that the biomarkers associated with BCP consumption were mainly related to fatty and amino acid metabolism. Notably, BCP treatment significantly promoted linoleic acid metabolism. These results suggest that BCP may have a preventive effect against diet-induced hyperlipidemia through the promotion of fecal fat excretion. BCP may potentially be used as an alternative functional food component for people with diet-induced hyperlipidemia.

The Evidence for Diet as a Treatment in Migraine-A Review.

Background/objectives: The connection between diet and migraine has gained increasing attention in migraine research due to its potential relevance as part of migraine treatment. This study reviewed the current evidence on the use of diets or specific foods in the prevention of migraine. Methods: A PubMed search was performed with the keywords "diet and migraine" OR "brain-gut-axis and migraine". One author (KVN) screened titles, abstracts, and full-text articles and excluded or included them based on eligibility criteria. Results: A ketogenic diet and a "Dietary Approaches to Stop Hypertension" diet reduced attack duration (p < 0.002), frequency (p < 0.05), and severity (p < 0.01). The ketogenic diet also reduced monthly medication intake (p ≤ 0.05). A low-fat vegan diet mixed with an elimination diet reduced the attack duration (p < 0.01), frequency (p < 0.05), severity (p < 0.0001), and percentage of medicated headaches (p < 0.001). Elimination diet reduced attack duration (p < 0.05), frequency (p < 0.02), severity (p < 0.01), and medication intake (p < 0.002). Elimination diet with IgG-positive foods reduced attack frequency (p < 0.001), and total medication intake (p < 0.01). Gluten-free diet reduced frequency (p = 0.02) and severity (p = 0.013). Conclusions: Certain diets and food items may trigger attacks in some migraine patients, though the overall evidence supporting this is limited. Modifying a diet may reduce symptoms such as attack duration, frequency, severity, and medication intake. However, the included studies' small populations and diverse study designs make the results difficult to apply in clinical practise. Further high-quality, double-blinded, randomised controlled trials are necessary to confirm the association between diet and migraine.

Obesity Human Soluble Prorenin Receptor Expressed in Adipose Tissue Improves Insulin Sensitivity and Endothelial Function in Obese Female Mice.

Soluble prorenin receptor (sPRR) is a component of the renin-angiotensin system (RAS) identified as a plasma biomarker for human metabolic disease. However, what tissue source of sPRR is implicated in the modulation of metabolic function remains unclear. This study investigated the contribution of human sPRR (HsPRR) produced in the adipose tissue (Adi) on the metabolic and cardiovascular function of lean and obese male and female mice. Adi-HsPRR mice, generated by crossing human sPRR-Myc-tag and Adiponectin/Cre mice, were fed a low-fat or high-fat diet (10% and 60% kCal from fat, respectively) for 20 weeks. Obese Adi-HsPRR mice showed elevated sPRR levels in adipose tissue without affecting adipocyte size or fat depot weight. Despite plasma sPRR being similar between obese Adi-HsPRR and control female mice, a positive correlation between plasma sPRR and adiposity was present only in controls. Obese Adi-HsPRR male mice showed elevated plasma sPRR compared with controls, but no correlation with adiposity was found in either group. Nevertheless, Adi-HsPRR expression improved insulin sensitivity and endothelial function, reduced adipogenic genes mRNA abundance (PPARg, SEBP1C and CD36), and increased plasma Angiotensin 1-7 levels only in obese HsPPR female mice. Taken together, elevated HsPRR in adipose tissue improved metabolic and vascular function in obese female mice despite normal circulating levels of sPRR, whereas increased local and circulating levels of HsPRR did not influence metabolic and cardiovascular function in obese male mice. Our data suggest that increased plasma sPRR associated with metabolic disease could be produced by other tissues rather than adipocytes.

The effect of probiotic supplementation on non-alcoholic fatty liver disease (NAFLD) fibrosis score in patients attending a tertiary hospital clinic in Cairo, Egypt.

Non-alcoholic fatty liver disease (NAFLD) is characterized by hepatic fat accumulation (> 5% of liver tissue) in the absence of alcohol abuse or other chronic liver diseases. NAFLD can progress to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). This study aimed to assess the efficacy of probiotic (lactobacillus) supplementation on NAFLD fibrosis score. A double-arm randomized controlled trial was conducted in the family medicine clinic of a tertiary hospital, enrolling patients with sonographic evidence of NAFLD. Fifty patients were divided into two groups: the Probiotic group received lifestyle modification instructions along with daily probiotic supplementation for twelve weeks, with regular monthly follow-up visits. The Standard Treatment group received low-fat diet and lifestyle modification instructions only. The mean age of participants was 46.10 years (SD 10.11), with 70% females and 30% males. The study found a statistically significant difference in liver enzymes (ALT and AST) and BMI in the probiotic group before and after intervention. However, there was no significant difference in NAFLD fibrosis score between the two groups. Short-term probiotic treatment resulted in improvements in ALT, AST, and BMI in the probiotic group, but did not significantly affect NAFLD fibrosis score. Further research with larger sample sizes and longer follow-up periods is warranted. The clinical trial was registered at Protocol Registration and Results System with number NCT06074094 (12/09/2021).