Meal Schedule Research Articles

Impact of Food Intake and Sleep Disturbances on Gut Microbiota.

Lactobacilli andBifidobacteria are types ofmicrobiota that live in the gastrointestinal (GI) system, or gut microbiota, and are essential for both human well-being and disease. This review looks at the relationship between the composition of gut microbiota and function and two important lifestyle factors - dietary intake and sleep disorders. The diversity of the gut microbiota and metabolic processes is strongly influenced by food intake. Fiber-rich diets encourage the development of good bacteria that synthesize short-chain fatty acids (SCFA), while diets heavy in fat or sugar can negatively impact the microbial balance. Microbial communities are also impacted by regular meal schedules and probiotic and prebiotic use. Sleep disturbances cause stress reactions that alter gut microbiota and upset circadian rhythms. These include irregular sleep cycles and insomnia. These effects are driven by the immune system and gut-brain axis dysregulation, which affects microbial diversity and plays a role in GI and metabolic illnesses. The significance of comprehensive lifestyle treatments to improve gut health is highlighted by an understanding of these interconnections. It may be possible to modify the composition of gut microbiota and improve general health outcomes through the use of strategies that emphasize balanced meals, consistent eating schedules, and better sleep hygiene.

Kepatuhan Diet pada Penyandang Diabetes Mellitus di Puskesmas Simpang IV Sipin Kota Jambi

Diabetes mellitus has become a global health threat. Diabetes mellitus patients need to understand the importance of meal schedule consistency, food type, and caloric intake to prevent complications. Many factors influence dietary compliance in diabetes mellitus patients, including social support, information exposure, and comorbidities. This study aims to identify the factors associated with dietary compliance among diabetes mellitus patients. This is a quantitative study with a cross-sectional design. The population consisted of all diabetes mellitus patients visiting Simpang IV Sipin Health Center in 2021, totaling 1,543 patients. A sample of 91 respondents was selected using accidental sampling. The study was conducted from June 15 to July 12, 2023, at Simpang IV Sipin Health Center, Jambi City. Data were collected using questionnaires and analyzed univariately and bivariately using the chi-square statistical test. The univariate analysis results showed that most respondents had good social support, were exposed to information about diabetes mellitus diets, had comorbidities, and exhibited high dietary compliance. The bivariate analysis revealed a significant relationship between social support and comorbidities with dietary compliance, but no relationship was found between information exposure and dietary compliance in diabetes mellitus patients at Simpang IV Sipin Health Center, Jambi City.

Adult's Lived Experience Using the Insulin-Only Bionic Pancreas.

The purpose of this study was to assess adults' perspectives after using the insulin-only Bionic Pancreas (BP) during a 13-week pivotal trial. Automated insulin delivery (AID) systems show promise in improving glycemic outcomes and reducing disease burden for those with type 1 diabetes mellitus (T1D). Understanding the lived experience of those using the BP can help to inform education and uptake of AID devices. Adults ages 19 to 75 (n = 40) participated in age-specific focus groups (19-25, 26-40, 41-64, and 65+) exploring their experiences, thoughts, and feelings about using the BP. Three authors analyzed the focus group data using a hybrid thematic approach. Qualitative analysis of focus groups revealed 14 sub-themes falling into four major themes (diabetes burden, managing glucose levels, daily routine, and user experience). Although participants' overall experience was positive, some reported struggles related to managing out-of-range glucose levels and challenges with the system responding to unique meal schedules and exercise regimens. This study captures patient perspectives regarding their experiences with a new AID system. Patient voice can inform device development and educational approaches for people with T1D. Identifying which patients may benefit the most from wearing this system may facilitate patient/clinician discussions regarding insulin delivery systems that best meet their individualized needs and expectations that may support device uptake and continued use.

Comparative Analysis of Lifestyle Practices Between Diabetic Patients and Healthy Non-diabetic Individuals in the Saudi Population.

The burden of diabetes mellitus in Saudi Arabia is considerable, with high prevalence rates affecting the population's health and healthcare resources. This situation necessitates attention from healthcare policymakers. The study aims to compare lifestyle practices between diabetic and non-diabetic individuals in Saudi Arabia to inform targeted health interventions. The primary aim is to compare lifestyle practices, including dietary habits, physical activity levels, and smoking habits, between diabetic and non-diabetic individuals in Saudi Arabia. A 12-month cross-sectional study was conducted in Riyadh, Saudi Arabia. A total of 424 participants, evenly distributed across age, gender, and socioeconomic status, were enrolled. A total of 424 participants, balanced for age, gender, and socioeconomic status, were recruited. Data were collected via structured interviews employing a validated questionnaire. The King Fahad Medical City IRB approved the study. Informed consent was obtained from all participants. The study found that diabetic individuals were more likely to be older, male, and sedentary (p < 0.001). They were also at a higher likelihood of being current smokers (p = 0.002) and consuming whole grains regularly. Non-diabetic individuals consumed more fruits and fast food and had more flexible meal schedules (p < 0.001). Both groups had similar levels of regular vegetable consumption. A significantly lower proportion of diabetics (40 individuals; 20%) engaged in moderate physical activity three to four days a week compared to non-diabetics (80 individuals; 36%), which was highly significant (p < 0.001). The study identified critical differences in lifestyle practices between diabetic and non-diabetic individuals in Saudi Arabia. These findings underscore the need for tailored health interventions to address the rising diabetes rates and promote healthier lifestyle practices among the Saudi population.

Impact of Infancy Conditions on Physical Growth of Children Under-five

Children under five years old is the age group most vulnerable to several health problems. It is important to evaluate the impact of infancy condition on their physical growth. This research aimed to examine the impact of infancy condition on the physical growth of children under-five years old. The unmatched case-control study was conducted in Puskesmas Griya Antapani areas, Bandung from May to July, 2023. A total of 112 children aged under 5 years were included in this study (56 cases and 56 control). The analysis used multivariate logistic regression to determine adjusted odds ratios (OR). The results showed that the variables associated with the children growth are infection or illness in infancy (OR is 0,138 95 percent CI 0,51 until 0,375), feeding patterns in infancy (OR is 11,000 95 percent CI 4,566 until 26,503), birth weight (OR is 0,170 95 percent CI 0,036 until 0,818) and economic status (OR is 0,062 95 percent CI 0,14 until 0,280). Multivariate logistic regression showed that economic status was the most dominant factor for children physical growth (OR is 6.701 95 percent CI 1,323 until 33,944). Education for families is needed in choosing food that is rich in nutrition and economical by utilizing alternative sources of protein, the amount of food, and the schedule of meals according to the needs of children according to their age.

A STUDY OF ASSOCIATION AMONG BODY COMPOSITION AND KHAT CHEWING AMONG THE EMPLOYEES OF UNIVERSITY OF SCIENCE AND TECHNOLOGY, SANA’A, YEMEN

Catha edulis (khat) is a plant grown commonly in the Republic of Yemen. The leaves of small khat are chewed by the people for its stimulant action. Association between body composition, khat chewing is little known. We recruited 300 individuals 19-70 years of age from University of Science and Technology, Sana’a, Yemen. Demographic, body composition and physical activity data were collected using structured questionnaires and anthropometric measurements devices. Muscle mass (kg), body fat (kg), visceral fat (kg), waist circumference (cm) and body Mass index (kg/m2) were estimated. Participants in habit of khat chewing were 170 (56.7%) of Chewer and 130 (43.3%) of non-chewer. Participants’ mean ± SD of age was 38.7±9 years, 217 (72.3%) and 83 (27.7%) were males and females, respectively. Including 40 (13.3%) smokers and 260 (86.7%) non-smokers. Whereas 151 (88.8%) of the men and 19 (11.2%) of the women take khat, including 39 (22.9%) academics and 131 (77.1%) non-academics. In addition, 46 (27.1%) have low activity and 105 (61.8%) %) had moderate activity and 19 (11.2%) had high activity. Participants in daily khat chewing were 77 (45.3%) while 14 (8.2%), 43 (25.3%), 36 (21.2%) were 4-6 times/week, 2-3 times/week and Once/week, respectively. Participants spent an average of 4.5±2 hours per day in khat chewing sessions, with 52.9% spending 1-4 hours, 43.5% spending 5-8 hours, and 3.5% spending more than 8 hours. The majority of khat chewers reported spending around 2000 Yemeni Riyals (Y.R.) per day on khat. In terms of the impact on meal schedules, 38.8%. Khat chewers had higher muscle mass (33±6), lower body fat percentages (27.8±9), higher levels of visceral fat (9.3±4), larger waist circumferences (88.4±10) and slightly higher BMI values (25.9±4) compared with non-chewers were muscle mass (29.9±7), body fat percentages (31±12 levels of visceral fat (7.8±4), waist circumferences (82.6±11) and BMI values (24.9±4). In addition to, males khat chewers had higher muscle mass, higher visceral fat levels and higher waist circumferences values in compared with females where were muscle mass, visceral fat levels and waist circumferences low. There is no significant association between khat chewers’ status and excess body fat.

Budaya Makan pada Balita Stunting di Desa Rahia Kecamatan Gu Kabupaten Buton Tengah

Stunted toddlers are often not aware of it, and after two years it will be seen that the toddler is short. Chronic nutritional problems in toddlers are caused by insufficient dietary intake for quite a long time because parents or families do not know or are not aware of providing food according to their children’s nutritional needs. Based on data on the prevalence of nutritional status of children under five with indicators of height based on age (height/a) at the Central Buton Health Office. This study aimed to discover the eating culture of stunted toddlers and what causes stunting to occur in Rahia Village, Gu District, Central Buton Regency. This study uses ethnographic methods with observation participation and in-depth interviews. The results of this study indicate that the eating culture of stunting toddlers in Rahia Village, Gu District, Central Buton Regency is influenced by a lack of parental knowledge so that stunting is still difficult to overcome. The causes of stunting include the provision of MP-ASI too early, the quality of food is less nutritious, dietary restrictions for pregnant women, babies who do not receive immunizations, irregular meal schedules, low mother’s knowledge and lack of socialization regarding stunting education.

The Assessment of the Nutritional Status among the Young-Old and Old-Old Population with Alimentary-Dependent Diseases.

Background and Objectives: Unhealthy nutrition can contribute to the development or progression of various alimentary-dependent diseases, including obesity, type 2 diabetes mellitus, metabolic syndrome, anaemia, and arterial hypertension. Young-old and old-old individuals often have diets deficient in essential vitamins, minerals, and macronutrients, characterized by high consumption of carbohydrate-rich foods and insufficient intake of plant-based products like vegetables and fruits. This study aims to identify key parameters of nutritional status among the young-old (aged 60-74 years) and old-old (aged 75-90 years) populations in central Kazakhstan, particularly in relation to specific alimentary-dependent diseases. Materials and Methods: The study involved 300 participants aged 60-90 years. The study incorporated a dietary questionnaire, food consumption records (such as 24 h recalls), and measurements of anthropometric indicators including weight and skinfold measurements. Results: Residents in the surveyed regions typically consumed food 3-4 times daily, with breakfast, lunch, and dinner being eaten at consistent times. A significant proportion of individuals, especially older adults, followed this meal schedule. About one-third ate before bedtime, and more than half believed they adhere to a specific diet. The mean BMI for men aged 60-74 years was 28.3 (95% CI: 20.1-43.2) and, for those aged 75-90 years, it was 29.0 (95% CI: 22.1-40.8). Caloric intake among individuals aged 60-74 was higher compared to those aged 75-90, with males consuming an average of 2372.7 kcal and females consuming 2236.78 kcal versus 2101.5 kcal for males and 2099.9 kcal for females in the older age group. Conclusions: The dietary patterns observed among old-old individuals were marked by excessive calorie intakes and imbalances in macronutrient composition, with a predominant emphasis on high-carbohydrate foods at the expense of essential nutrients like proteins, fats, and key vitamins (such as C, E, B vitamins) and minerals (such as potassium, calcium, and iron).

Lifestyle Factors Associated With Frequent Recurrent Headaches in Children and Adolescents: A Canadian Population-Based Study.

Lifestyle behaviors have been postulated to affect headache frequency in youth and are often the primary target of self-management recommendations. Our study aimed to assess the association between various lifestyle factors and frequent recurrent headaches in children and youth. Children and adolescents aged 5-17 years were enrolled in a large cross-sectional Canadian population-based health survey, completed on January 31, 2019. Headache frequency was dichotomized into "approximately once/week or less" or ">once/week" (defined as frequent recurrent headaches). The association between frequent headaches and meal schedules, screen exposure, physical activity, chronotype, and frequent substance use/exposure (alcohol, cigarettes, electronic cigarettes, and cannabis) was assessed using both unadjusted logistic regression models and models adjusted for age/sex. Fully adjusted models examined the odds of frequent headaches according to all exposures. Survey design effects were accounted for using bootstrap replicate weighting. There were an estimated nweighted = 4,978,370 eligible participants in the population. The mean age was 10.9 years (95% CI 10.9-11.0); 48.8% were female; 6.1% had frequent headaches. Frequent headaches were associated with older age (odds ratio [OR] = 1.31, 95% CI 1.28-1.34, p < 0.001) and female sex (OR = 2.39, 95% CI 2.08-2.75, p < 0.001). In models adjusted for age/sex, the odds of frequent headaches decreased with meal regularity (adjusted OR [aOR] = 0.90, 95% CI 0.89-0.92, p < 0.001) and increased with later chronotype (aOR = 1.10, 95% CI 1.05-1.15, p < 0.001) and excess screen exposure (≥21 hours vs none in past week: aOR = 2.97, 95% CI 1.53-5.77, p = 0.001); there was no significant association with reported physical activity (aOR = 0.95, 95% CI 0.67-1.34, p = 0.77). In 12- to 17-year-olds, frequent headaches were associated with frequent alcohol use (≥1/wk vs never: aOR = 3.50, 95% CI 2.18-5.62, p < 0.001), binge drinking (≥5 times in past month vs never: aOR = 5.52, 95% CI 2.95-10.32, p < 0.001), smoking cigarettes (daily vs never: aOR = 3.81, 95% CI 1.91-7.62, p < 0.001), using e-cigarettes (daily vs never: aOR = 3.10, 95% CI 2.29-4.20, p < 0.001), and cannabis use (daily vs never: aOR = 3.59, 95% CI 2.0-6.45, p < 0.001). In the entire sample, daily exposure to smoking inside the house was associated with frequent headaches (aOR = 2.00, 95% CI 1.23-3.27, p = 0.005). Several lifestyle behaviors were associated with frequent headaches in children and youth, such as meal irregularity, late chronotype, prolonged screen exposure, and frequent substance use/exposure, suggesting that these are potential modifiable risk factors to target in this population.

Gut hormones and appetite regulation.

Various gut hormones interact with the brain through delicate communication, thereby influencing appetite and subsequent changes in body weight. This review summarizes the effects of gut hormones on appetite, with a focus on recent research. Ghrelin is known as an orexigenic hormone, whereas glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), cholecystokinin (CCK), postprandial peptide YY (PYY), and oxyntomodulin (OXM) are known as anorexigenic hormones. Recent human studies have revealed that gut hormones act differently in various systems, including adipose tissue, beyond appetite and energy intake, and even involve in high-order thinking. Environmental factors including meal schedule, food contents and quality, type of exercise, and sleep deprivation also play a role in the influence of gut hormone on appetite, weight change, and obesity. Recently published studies have shown that retatrutide, a triple-agonist of GLP-1, GIP, and glucagon receptor, and orforglipron, a GLP-1 receptor partial agonist, are effective in weight loss and improving various metabolic parameters associated with obesity. Various gut hormones influence appetite, and several drugs targeting these receptors have been reported to exert positive effects on weight loss in humans. Given that diverse dietary and environmental factors affect the actions of gut hormones and appetite, there is a need for integrated and largescale long-term studies in this field.

Риск распространения COVID-19 среди медицинских работников Самарской области в стационарах различного типа

The purpose of this study was to assess the epidemiological risk for medical workers in the pandemic spread of a new coronavirus infection in various types of medical organizations. Materials and methods. The results of epidemiological surveillance of the staff of the State Budgetary Healthcare Institution of the Samara region «Samara City Clinical Hospital № 2 named after N.A. Semashko» in the number of 631 people, according to the protocols of 132 commissions for the prevention of infections related to the provision of medical care for the period from January 2021 to December 2022. Information from 1318 reports No. 1035 «Monitoring on the number of cases of coronavirus infection, including community-acquired pneumonia, and deaths» in the Samara region from the Rospotrebnadzor information system from April 22, 2020 to December 31, 2022 in terms of the total number of COVID-19 patients per day, the number of infected medical workers per day, the number of infected people in medical organizations. The results of the analysis of 11 scientific articles on the topic of the characteristics of epidemic foci in the teams of medical workers. Results and discussions. The COVID-19 pandemic has demonstrated the importance of developing national bed resources and the human resources of medical workers, taking into account the need for rapid conversion of somatic hospitals. Doctors, mid-level and junior medical personnel are at higher risk of infection both through contact with patients if they do not follow the rules for using PPE, and when interacting with each other. Repurposed somatic hospitals (GBUZ SB «SOKB named after V.D. Seredavina», FGBI VO «Clinics of SamSMU»), in comparison with a specialized infectious diseases hospital (GBUZ SB «GBS № 6»), due to the peculiarities of construction and planning solutions, represent an environment with a higher risk of infection of medical personnel, which requires additional organizational preventive measures. In addition to the general requirements of biological safety in the repurposed red zone, a comprehensive formation of a safe working environment is required, including such components as: organization of rest rooms for staff separately from the residents, development and observance of a meal schedule to eliminate the intersection of personnel flows as much as possible, digitalization of medical documentation, time-limited reception of biomaterial in the laboratory, issuance of the results of research through an electronic information system. Keywords: COVID-19, nosocomial component, epidemic outbreak, medical personnel, PPE, risk of infection, organization of the working environment.

Ishrana radnika koji rade u noćnoj smeni - razlog ili izgovor za nepravilnu ishranu

The availability of artificial light and light-emitting devices has changed human life in relation to time, enabling 24-hour health care, trade, and production, as well as the expansion of social life around the clock. In Europe, about 21% of the labor force consists of shift workers. 10% of the employed population work evening shifts or the night shift, and 7% of employees in Europe regularly work the night shift. According to the Bureau of Labor Statistics, more than 15 million Americans work the night shift. Shift work, especially night-time work, seriously affects dietary habits. It is known that night-time work produces a conflict between the socially determined rhythm of eating and the circadian biological rhythms related to the feeling of hunger, satiety, as well as the metabolism itself. Night meals cause disorders of intestinal motility, affect digestion, absorption, but also the utilization of nutrients and possible medical therapy (if the individual has one). From the point of view of chronobiology, humans belong to diurnal species, which to a certain extent explains why night shift workers have a decreased appetite at night, when the human body is programmed for rest and fasting, as well as for endogenous mobilization of glucose. From the psychosocial aspect, shift workers usually experience a discrepancy between their daily routines (including the meal schedule) and those they have with family and friends, which further leads to even more severe disorders of dietary habits. However, it is difficult to give dietary recommendations regarding nutrition. Firstly, there are no clear views on whether night shift workers should eat during the night hours or not. Secondly, even if night eating is encouraged, definitive evidence is lacking on which types of food should be consumed and which should be avoided. Thirdly, the most nutritious foods may not be available at that time of night. Finally, eating at night certainly has an impact on the metabolism. With all the above in mind, we have tried to provide some useful guidelines regarding these issues.

GAMBARAN POLA MAKAN PADA PASIEN HIPERTENSI DI RUMAH SAKIT SANTA ELISABETH MEDAN TAHUN 2023

Diet is one of the efforts in overcoming hypertension sufferers so they can control their habits by adjusting the amount of food, type of food, meal schedule and balance nutritional intake. A balanced menu needs to be started and well known so that controllable eating habits will be formed. Hypertension is a non-communicable disease that can cause blood pressure to increase where systolic and diastolic are above normal limits. Factors that can cause hypertension are genetic factors (heredity), gender, age. The aim of the study is to find out the eating patterns of hypertensive patients. The research uses a quantitative method where data collection is carried out using a questionnaire of 25 questions so as to be able to dig deeper into the diet of hypertensive patients. The sampling technique uses random sampling of 53 respondents. The data analysis technique uses is descriptive. The results of the study are: eating patterns of hypertensive patients based on the amount of food in good category 45 respondents (84.9%). The eating pattern of hypertensive patients based on the type of food is in good category, 43 respondents (81.1%). The eating pattern of hypertensive patients based on the frequency of eating was in good category, 44 respondents (83.0%). Researcher's suggestion: It can be used as a recommendation for one of the non-pharmacological management of hypertensive patients by providing health education about diet, and used as information to maintain eating patterns in hypertensive patients.&#x0D;

Effects of Intermittent Fasting on Patients with Immune Thrombocytopenia (ITP) Receiving TPO-RA : Multicenter Mixed-Design Study

Introduction The thrombopoietin receptor agonists (TPO-RAs), such as Avatrombopag (AVA), Eltrombopag (ELT), and Romiplostim (ROM), have, in recent years, changed ITP treatment, showing that there is both increased platelet destruction and suboptimal platelet production in ITP. ELT and AVA are oral drugs, while ROM is subcutaneous, and studies have shown that absorption of ELT can be affected by meals. Thus, for optimum absorption, patients are counseled to take it on an empty stomach at least 1 hour before or 2 hours after a meal and at least 2 hours before and 4 hours after calcium-containing meals. However, in Muslim countries where the 16/8 type of intermittent fasting is practiced by religion, the scheduling of drug consumption can be affected. Objective The aim of this study is to evaluate the effect of fasting on patients with ITP receiving different Thrombopoietin receptor agonists (TPO-RAs) brands. Methods A Multicenter, mixed design study was performed in which we interviewed Muslim patients (n = 100) who were 18 years of age or older in Qatar, Kuwait, and Saudi Arabia and fasted Ramadan while receiving TPO-RA treatment between the years of 2015 and 2023. Clinical and biological parameters are recorded using using a standardized patient form. Fasting status was confirmed by a telephone call to each patient. Patients' responses were retrospectively evaluated before, during, and after Ramadan. A statistically significant result was identified with a P-value of &amp;lt; 0.05. Bleeding tendency was also evaluated as either no bleeding, minor cutaneous and mucosal bleeding, or life-threatening bleeding involving major organs (i.e., central nervous system, gastrointestinal, or genitourinary). Results A hundred patients were identified who matched our inclusion criteria for this study. Platelet responses were different among the 3 products, and statistical significance was attributed to the product's compromised efficacy due to disturbed meal schedules and decreased absorption. For patients on AVA, the drug efficacy was not directly affected by meal schedule and absorption but instead was affected by patient compliance. The mean platelet count before Ramadan was estimated at 146.11 ± 111.76, while during Ramadan it dropped to 131.7 ± 107.6. Whereas when comparing platelets before and after Ramadan, there was an insignificant difference 146.11 ± 111.76 vs. 134.17 ± 60.9. For patients on ELT, the mean platelet count before Ramadan was estimated at 120.02 ± 59.7, while during Ramadan it dropped to 100.8 ± 68.16. Whereas when comparing platelets before and after Ramadan, there was an insignificant difference 120.02 ± 59.7 vs. 136.04 ± 74.86. For patients on ROM, the mean platelet count before Ramadan was estimated at 122.68 ± 80.57, while during Ramadan it was 130.94 ± 84.96. Whereas when comparing platelets before and after Ramadan, there was an insignificant difference but an increase in platelet count 122.68 ± 80.57 vs 212.0 ± 113.72. Only 3% (3 patients on ELT) of the patients fasting during Ramadan experienced bleeding episodes. 2 of which experienced minor bleeding (ecchymosis and gingival bleeding), and 1 had major bleeding episodes (Lt. hemorrhagic infarction). 47% of the patients experienced a complete response (PLT&amp;gt;100x10 9) among the three products, and 17% experienced a partial response (PLT 51-100x10 9) 36.6% of the patients on AVA showed a complete response, 46.15% of patients on ELT, and 63.15% of patients on ROM. Conclusion TPO-RAs achieve target platelet counts in adult ITP patients. However, the absorption of ELT is highly affected by food consumption, and thus it is critical to adhere to the instructions given on how the dose should be adjusted and consumed on an empty stomach. AVA absorption didn't show compromise with food consumption, and its efficacy may depend only on patient's compliance. ROM showed better adherence to the medication schedule compared to ELT, contributing to its subcutaneous form and a tailored home visit program given weekly by trained nurses, enhancing patient compliance. The general tolerability and efficacy of TPO-RAs may be reflected on incidence of no major bleeding and the better efficacy of AVA and ROM, which are not affected by fasting.

Supporting patients in the transition to the revised pexidartinib dosing regimen: perspectives from the multidisciplinary clinical and allied health professional team

Pexidartinib is a colony-stimulating factor-1 receptor inhibitor approved in the United States for treatment of adult patients with symptomatic tenosynovial giant cell tumor (TGCT) associated with severe morbidity or functional limitations and not amenable to improvement with surgery. Because of the risk of severe and potentially fatal hepatotoxicity, pexidartinib is only available through a Risk Evaluation and Mitigation Strategy (REMS) program. Pexidartinib pharmacokinetics are influenced by the fat content of meals: compared with the fasted state, consuming a high-fat meal with pexidartinib increases pexidartinib absorption by 100%; a low-fat meal increases absorption by approximately 60%. Pexidartinib was initially authorized to be taken at 800 mg/day on an empty stomach; therefore, if this same dose of pexidartinib is taken with food, there is a risk of overexposure and potential toxicity. To reduce the risk of hepatotoxicity and improve patient compliance, pexidartinib has undergone a revised dosing regimen, from 800 mg/day (400 mg twice daily) fasted to 500 mg/day (250 mg twice daily) with a low-fat meal (approximately 11–14 g of total fat). The objective of this report is to educate clinical and allied health professionals on the revised dosing regimen and the importance of patient compliance with a low-fat meal. Healthcare professionals need to understand the rationale for the switch from pexidartinib dosing on an empty stomach to dosing with a low-fat meal and how meal composition and timing influence pharmacokinetics. Finally, we provide guidance for the healthcare team of prescribing providers, nurses, pharmacists, and dietitians who are caring for patients with TGCT on pexidartinib. It is important for healthcare providers to deliver consistent messaging on the low-fat meal requirement and help patients fit pexidartinib into their regular meal schedules. Consulting a dietitian may be helpful for patients, especially those with complex dietary needs. We provide an overview of the roles and responsibilities of each healthcare professional and outline steps to best support patients, including key questions and answers related to the revised dosing regimen. This report provides the information necessary to guide the multidisciplinary team caring for patients with TGCT and to support them through the pexidartinib dosing regimen change.

ANALYSIS OF THE RESULTS OF THE QUESTIONNAIRE OF CHILDREN WITH ORTHODONTIC PATHOLOGY REGARDING THEIR FOOD HABITS

Actuality. Harmful eating habits of children with orthodontic pathology in combination with increased consumption of carbohydrates worsens the hygienic condition of the oral cavity and increases the risk of dental caries and periodontal diseases.&#x0D; The aim of the research is to determine the peculiarities of the diet of children with orthodontic pathology by analyzing the results of their questionnaire.&#x0D; Materials and methods. A questionnaire regarding the peculiarities of the use of food products was conducted among 95 children aged 14 to 17 years who had orthodontic pathology. In the presence of their parents, the children independently filled out a specially designed questionnaire in a Google form, which contained 12 questions with a multiple-choice answer.&#x0D; Research results. According to the results of the questionnaire, it was established that a significant part of the children who answered the questions do not follow the recommended schedule of main meals, giving preference to quick "snacks". More than half of the children indicated that they finish the main meal with sweets, snacks or carbonated sugary drinks. Every day or several times a week, almost three quarters of the surveyed children use various sweet confectionery products. The vast majority of children like liquid or soft food, while eating solid food they "get tired" quickly or even immediately.&#x0D; Conclusion. The analysis of the results of the questionnaire shows that the majority of surveyed children with orthodontic pathology do not have a "healthy diet", there is almost no regular chewing activity, their diet is overloaded with sweets, which in conditions of difficult hygienic care of the oral cavity increases the risks of dental caries and periodontal disease.

Meal intake in an adult Moroccan population: determinants and implications for weight status.

In recent decades, the Moroccan population has changed its dietary practices, particularly those related to meal-taking. It is about irregular meal schedules, reduced frequency and shorter time of meal taking times, as well as a decrease in family meal-taking. All these factors are likely to influence its nutritional status. The aim is to study meal-taking practices, their determinants and their implications on weight status. In this study, meal-taking practices are defined by the regularity of the schedule, the frequency and the duration of the meals as well as the family commensality. This work data are part of a study conducted among 507 households in the region of Rabat-SaléKenitra in Morocco, with a validated conceptual and methodological framework. The questionnaire was completed with one member of each household and the body mass index (BMI) was determined by an impedance meter. The main results indicate that the majority of the surveyed population was aged 35 years (59%), female (52%), urban (70%), with a BMI ≥25 kg/m2 (51%), took usually three meals a day (89%), spent less than 90 minutes a day in meals and snacks (60%), had irregular meal schedule (69%), and usually eat at least two meals or snacks a day with family (49%). The univariate analysis showed that urban area was a factor favoring variations of meal times, the male sex was a factor favoring three meals a day, the level of higher education was a factor penalizing the daily duration of meals, and that marital status "married" was a factor favoring family commensality. In addition, variable meal times were revealed as a factor contributing to overweight/obesity, and meal times ≥90 min were revealed as a protective factor of overweight/obesity. The study identified factors associated with meal times, frequency and duration. The results obtained will serve as a basis for the development of educational actions for a change in behavior conducive to health.

Characteristics of Nutrition Intake in Diabetic Ulcer Patients at Hospital dr. Slamet Garut

Diabetes mellitus can lead to the development of ulcers on the extremities, which are typically caused by peripheral nerve disorders, infections, and blood flow disorders. Managing diabetes requires adhering to proper nutritional intake, including the frequency and duration of meals, as well as the types of foods consumed. In this study, we aimed to examine the nutritional intake characteristics of outpatients with diabetic ulcers at Dr. Slamet Garut, including their eating frequency, meal duration, and food choices. We used a quantitative descriptive research design and selected a sample of 49 diabetic ulcer patients through purposive sampling. Data was collected using a validated and reliable questionnaire. The results of our study indicated that the majority of patients (57.1%) did not eat frequently, had short meal durations (51.0%), and consumed low-calorie foods (61.2%). Diet planning is a major component of success in treating diabetic ulcers. The accuracy and regularity of the patient in setting the amount, type and schedule of meals aims to control glucose levels so that blood flow to the ulcer area becomes smooth and the ulcer healing process will run well. Overall, nutritional intake in patients with diabetic ulcers is largely inadequate during the wound healing process.

Lifestyle factors, substance use, and frequent recurrent headaches in youth: Data from a Canadian population-based observational study (S41.004)

<h3>Objective:</h3> To assess the association between lifestyle factors, substance use, and frequent recurrent headaches in youth. <h3>Background:</h3> We hypothesized that higher odds of frequent headaches would be associated with several lifestyle factors and frequent substance use in youth. <h3>Design/Methods:</h3> This was an observational study of youth aged 5–17 using data from a population-based health survey (2019 Canadian Health Survey on Children and Youth). Headache frequency was dichotomized as ‘about once a week or less’ or ‘&gt;once a week’ (defined as frequent recurrent headaches). Logistic regression was used to quantify the association between frequent headaches and meal schedules, prolonged screen exposure (≥21h in past week), physical activity (≥60 minutes/day), chronotype, frequent substance use (alcohol ≥1/week, binge drinking ≥5 times in past month, daily smoking, daily e-cigarettes, daily cannabis), and exposure to daily smoking in the household, unadjusted and adjusted for age and sex. Design effects were addressed using bootstrap replicate weighting. <h3>Results:</h3> There were 4,978,370 youth (weighted sample size) (mean age=10.9 years, 48.8% females) and 6.1% had frequent headaches. Age and female sex were associated with frequent headaches (OR=1.31, 95%CI=1.28–1.34, and 2.39, 95%CI=2.08–2.75, respectively). In models adjusted for age/sex, the odds of frequent headaches decreased with meal regularity (OR=0.90, 95%CI=0.89–0.92) and increased with later chronotype (OR=1.10, 95%CI=1.05–1.15) and excess screen exposure (OR=2.97, 95%CI=1.53–5.77); there was no significant association with physical activity. In adolescents 12–17 years old, frequent headaches were associated with alcohol use (OR=3.50, 95%CI=2.18–5.62), binge drinking (OR=5.52, 95%CI=2.95–10.32), smoking cigarettes (OR=3.81, 95%CI=1.91–7.62), using e-cigarettes (OR=3.10, 95%CI=2.29–4.20), and cannabis use (OR=3.59, 95%CI=2.0–6.45). Smoking inside the house was associated with higher odds of frequent headaches in youth of all ages (OR=2.00, 95%CI=1.23–3.27). <h3>Conclusions:</h3> Lifestyle factors (meal irregularity, late chronotype, and prolonged screen exposure) were significantly associated with frequent headaches in a large sample of Canadian youth. Frequent substance use was associated with frequent headaches in adolescents. <b>Disclosure:</b> The institution of Dr. Orr has received research support from Alberta Children’s Hospital Research Institute. The institution of Dr. Orr has received research support from Canadian Institutes of Health Research. Dr. Orr has received publishing royalties from a publication relating to health care. Dr. Orr has a non-compensated relationship as a Associate Editor with Headache: The Journal of Head and Face Pain that is relevant to AAN interests or activities. Dr. Orr has a non-compensated relationship as a Editorial Board with Neurology that is relevant to AAN interests or activities. Ms. Nilles has received research support from French Gilles de la Tourette Association. Ms. Nilles has received research support from Owerko Centre of Alberta Children’s Hospital Research Institute. Ms. Nilles has received research support from Assistance Publique - Hôpitaux de Paris. Dr. Patten has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Canadian Psychiatric Association. Dr. Patten has received publishing royalties from a publication relating to health care. Jeanne Williams has nothing to disclose. The institution of Dr. Pringsheim has received research support from Maternal Newborn Child and Youth Strategic Clinical Network. The institution of Dr. Pringsheim has received research support from Owerko Center of Alberta Children’s Hospital Research Institute. The institution of Dr. Pringsheim has received research support from Canadian Institutes of Health Research. The institution of Dr. Pringsheim has received research support from Public Health Agency of Canada.

Evolutionary algorithm for the optimization of meal intake and insulin administration in patients with type 2 diabetes.

The optimal management of type 2 diabetes (T2DM) is complex and involves an appropriate combination of diet, exercise, and different pharmacological treatments. Artificial intelligence-based tools have been shown to be very useful for the diagnosis and treatment of diverse pathologies, including diabetes. In the present study, we present a proof of concept of the potential of an evolutionary algorithm to optimize the meal size, timing and insulin dose for the control of glycemia. We found that an appropriate distribution of food intake throughout the day permits a reduction in the insulin dose required to maintain glycemia within the range recommended by the American Diabetes Association for patients with T2DM of a range of severities. Furthermore, the effects of restrictions to both the timing and amount of food ingested were assessed, and we found that an increase in the amount of insulin was required to control glycemia as dietary intake became more restricted. In the near future, the use of these computational tools should permit patients with T2DM to optimize their personal meal schedule and insulin dose, according to the severity of their diabetes.