Nutritional Approach Research Articles

Exploring Feed Efficiency in Beef Cattle: From Data Collection to Genetic and Nutritional Modeling

Increasing feed efficiency in beef cattle is critical for meeting the growing global demand for beef while managing rising feed costs and environmental impacts. Challenges in recording feed intake and combining genomic and nutritional models hinder improvements in feed efficiency for sustainable beef production. This review examines the progression from traditional data collection methods to modern genetic and nutritional approaches that enhance feed efficiency. We first discuss the technological advancements that allow precise measurement of individual feed intake and efficiency, providing valuable insights for research and industry. The role of genomic selection in identifying and breeding feed-efficient animals is then explored, emphasizing the benefits of combining data from multiple populations to enhance genomic prediction accuracy. Additionally, the paper highlights the importance of nutritional models that could be used synergistically with genomic selection. Together, these tools allow for optimized feed management in diverse production systems. Combining these approaches also provides a roadmap for reducing input costs and promoting a more sustainable beef industry.

Novel study designs and modelling approaches in nutrition research: application of advanced statistical modelling approaches and N-of-1 study designs.

Randomised controlled trials are the gold standard approach in nutrition research to show a causal relationship between a dietary intervention and clinically relevant outcomes at the population level. Here we review why different study designs are needed to establish the efficacy of dietary interventions at the individual level, and to better account for relevant factors that can also influence the outcomes. Over the past decade, precision nutrition approaches have been developed as a new way to measure the effectiveness of dietary interventions at the individual and population level. Precision nutrition aims to determine the individual factors that are associated with differences in responses to dietary interventions. This is complex, typically needing studies with a large number of participants, and using advanced statistical approaches and machine-learning algorithms to identify predictors that can explain why individuals do or do not respond to consuming specific foods, meals, or diets, for a given outcome. N-of-1 study designs, which are new to nutrition science, offer a robust alternative approach to assess how an intervention, and/or everyday behaviours, affect individual health outcomes. They utilise repeated measures within individuals, rather than baseline and end measures in a larger number of participants, to provide the statistical power required to determine an individuals responsiveness to an intervention. The adoption of new study designs and modelling approaches, particularly the N-of-1 approach, to examine responses to interventions within individuals, will help to further the understanding of the relationships between diet and health within individuals more effectively and accurately.

Guidance and position of RINN22 regarding precision nutrition and nutriomics.

Precision nutrition is based on the integration of individual´s phenotypical and biological characteristics including genetic variants, epigenetic marks, gut microbiota profiles and metabolites fingerprints as well as medical history, lifestyle practices, and environmental and cultural factors. Thus, nutriomics areas including Nutrigenomics, Nutrigenetics, Nutriepigenetics, Nutrimetabolomics, and Nutrimetagenomics have emerged to comprehensively understand the complex interactions between nutrients, diet, and the human body's molecular processes through precision nutrition. This document from the Ibero-American Network of Nutriomics and Precision Nutrition (RINN22; https://rinn22.com/) provides a comprehensive overview of the concepts of precision nutrition approaches to guide their application in clinical and public health as well as establish the position of RINN22 regarding the current and future state of precision nutrition. The progress and participation of nutriomics to precision nutrition is an essential pillar for addressing diet-related diseases and developing innovative managing strategies, which will be promoted by advances in bioinformatics, machine learning and integrative software as well as the description of specific novel biomarkers. In this context, synthesizing and critically evaluating the latest developments, potential applications and future needs in the field of nutrition is necessary with a holistic perspective, incorporating progress in omics technologies aimed at precision nutrition interventions. This approach must address and confront healthy, social, food security, physically active lifestyle, sanitation and sustainability challenges with preventive, participatory, and predictive strategies of personalized, population and planetary nutrition for a precision tailored health.

ABORDAGEM NUTRICIONAL EM ADULTOS COM INSULINOTERAPIA: UMA REVISÃO INTEGRATIVA

Introduction: Diabetes Mellitus (DM) is a chronic disease characterized by hyperglycemia due to severe deficiency in insulin secretion or resistance of the body to it. In 2021, it was estimated that 537 million people between the ages of 20 and 79 were living with diabetes, and that number could rise to 628.6 million by 2045. The ideal treatment is insulin therapy associated with a healthy and balanced diet, crucial for glycemic control and the prevention of complications. Objective: To describe current nutritional approaches for better management of care in adult patients on insulin therapy. Method: An integrative literature review was carried out, including publications from 2019 to 2024, in Portuguese and English, addressing MD I and/or MD II, covering review articles, scientific and technical notes, as well as guidelines from relevant institutions. Studies in other languages, articles that did not respond to the survey after reading the abstract, case reports, duplicates, not available in full, and those involving pregnant women and children were discarded. Results: The search in the databases resulted in 54 articles, reduced to 5 after applying the inclusion and exclusion criteria. All addressed individualized diets (100%), two highlighted the importance of physical activity (40%), and one article emphasized reducing carbohydrates and increasing fiber (20%). In addition, two articles (40%) mentioned the importance of decreasing sugars and refined foods, and increasing whole grains. Conclusion: The importance of a personalized nutritional approach in diabetes management, optimizing insulin use and improving glycemic control is highlighted. Continuing nutritional education by health professionals is essential for patients' autonomy and adherence to nutritional care.

Why protein-energy wasting leads to faster progression of chronic kidney disease.

Protein-energy wasting (PEW) is increasingly more prevalent as chronic kidney disease (CKD) progresses to more advanced stages. There is a global recognition of the importance of preventing and mitigating PEW in the CKD population not on dialysis given the goal of extending dialysis-free time and delaying dialysis initiation and growing evidence of the clinical consequences of PEW which include the risk of death, hospitalization and clinical conditions such as infections. We reviewed the association of PEW and the malnutrition characteristics indicative of PEW on CKD progression. Studies show the association between low serum albumin levels, low BMI, and diets with inadequate dietary energy and protein intake and CKD progression. Limited studies suggest low muscle mass impacts CKD progression. Optimizing nutrition by dietary management, including a moderately low protein (0.6-0.8 g/kg/day) and plant-based (>50% of protein source, known as PLADO) diet and as needed with supplementation [e.g. during acute kidney injury (AKI) event] administrated orally, enterally, or parenterally are the basis for the prevention and treatment of PEW in CKD and delaying CKD progression. Furthermore, other therapeutic methods such as treating or avoiding comorbidities and AKI, ensuring appropriate exercise and incremental transition to dialysis treatment may help ameliorate and prevent PEW development in CKD patients. Using tailored precision nutrition approaches and nutritional supplementation with or without other beneficial strategies may help prevent and treat PEW and its consequent occurrence of CKD progression.

Dumping syndrome: Update on pathophysiology, diagnosis, and management.

Dumping syndrome is a complex of gastrointestinal symptoms originally studied in peptic ulcer surgery patients. At present, it is most prevalent in patients who underwent bariatric, upper gastrointestinal cancer or anti-reflux surgery. The symptom pattern comprises early and late dumping symptoms. Several management options have been reported including nutritional, pharmacological and surgical approaches. In this study, we aimed to review the current evidence on dumping syndrome definition, diagnosis and treatment, including preliminary data from newer pharmacological studies. Current pathophysiological concepts and analyses of provocative tests has led to a clear definition of dumping syndrome, including both early and late dumping symptoms. The term postbariatric hypoglycemia represents a limited focus on late dumping only. The diagnosis relies on recognition of symptoms and signs in a patient with appropriate surgical history; and can be confirmed by provocative testing or registration of spontaneous hypoglycemia. The initial treatment focuses on dietary intervention, to which meal viscosity enhancers and/or the glycosidase inhibitor acarbose can be added. The most effective therapy is the use of short- or long-acting somatostatin analogues, which is however expensive and entails side effect issues. In case of refractory hypoglycemia, diazoxide or SGLT2 inhibitors can be considered, based on limited evidence. In refractory patients, continuous enteral feeding or (rarely) surgical reinterventions have been advocated, although not supported by solid evidence. Therapies under current evaluation include the broad-spectrum somatostatin analogue pasireotide, GLP-1 receptor antagonists, GLP-1 receptor agonists and administration of stable forms of glucagon are currently under study. Dumping syndrome is a well-defined but probably under-diagnosed complication of upper gastrointestinal, especially bariatric, and surgeries. Diagnosis is confirmed by a provocative test and incremental therapies starting with diet, adding meal viscosity enhancers or glycosidase inhibitors and adding somatostatin analogues in refractory cases. A number of emerging therapies targeting intestinal propulsion, peptide hormone effects and hypoglycemic events are under evaluation.

Improving diets and multimorbidity prevention.

In 2023, the UK government announced a Major Conditions Strategy, publishing 'The case for change and our strategic framework', which set out the focus on cancers, diabetes, dementia, mental ill health, musculoskeletal disorders, CVD and chronic respiratory diseases. Together, these conditions account for 60% of total disability-adjusted life years lost to early death or ill health in England, and one in four adults has at least two (multimorbidity). This review considers some of the key dietary risks for these major conditions and population policies that may improve diets and reduce risks. UK Government dietary recommendations, based on independent risk assessment and advice from the Scientific Advisory Committee on Nutrition, are encapsulated in the national food model, the Eatwell Guide. Based on key sources of dietary data - chiefly consumption data from the National Diet and Nutrition Survey and consumer purchase data from Kantar - most people do not meet dietary recommendations. This review considers how science and evidence inform health improvement policy. This includes policies that encourage healthier food choices, such as labelling and public procurement standards to those that minimise the impact of the less healthy choice such as sugar and salt reduction and reformulation. The review also considers nutritional approaches to managing some non-communicable diseases. Given the role nutrition and excess weight play in the onset, prognosis and quality of life for those living with one or more of the major conditions, there are huge potential gains from even small dietary improvements across population groups.

Protocol for a randomized comparative effectiveness trial comparing a very low-carbohydrate diet to DASH diet for polycystic ovary syndrome: the SUPER (Supporting Understanding of PCOS Education and Research) trial

BackgroundPolycystic ovary syndrome (PCOS), the most common endocrine disorder for women of reproductive age, is associated with increased risk for insulin resistance and type 2 diabetes. Current PCOS treatments insufficiently address the spectrum and severity of the disorder, and there is little evidence-based guidance available for lifestyle management of PCOS, especially through nutritional approaches. Some evidence shows that a very low-carbohydrate diet can improve glucose control compared to low-fat or moderate-carbohydrate diets, leading to improved glucose control and insulin levels that may help to treat symptoms of PCOS. This research investigates whether a very low-carbohydrate diet is more effective in improving glucose control and decreasing symptoms of PCOS in comparison to a DASH diet.MethodsThe SUPER study aims to address the gap in knowledge about nutritional advice for people with PCOS through a randomized, comparative effectiveness trial comparing two approaches to glucose control: the dietary approaches to stopping hypertension (DASH) diet, and a very low-carbohydrate (VLC) diet. We will randomize 184 women with PCOS with body mass indexes (BMIs) between 25 and 50 kg/m2 to a VLC or DASH diet. All participants will follow a 24-session, 12-month, online diet, and lifestyle intervention that teaches their assigned diet. Participants will receive nutritional education, support from diet coaches, and education about behavioral strategies to improve dietary adherence. The primary outcome measure is HbA1c, and secondary outcomes include glucose variance, lipid and hormone levels (including total and free testosterone), PCOS symptoms, inflammation (measured by high-sensitivity C-reactive protein), body composition and weight, psychological well-being, and intervention feasibility and acceptability.DiscussionThe SUPER study is a randomized comparative effectiveness trial that compares two promising approaches to glucose control in people with PCOS. The study also aims to assess the effects of each diet on PCOS symptoms. The research addresses an important gap in knowledge regarding nutritional advice for people with PCOS.Trial registrationClinicalTrials.gov NCT05452642. Registered 6 July 2022.

EPA and DHA inhibit LDL-induced upregulation of human adipose tissue NLRP3 inflammasome/IL-1β pathway and its association with diabetes risk factors

Elevated numbers of atherogenic lipoproteins (apoB) predict the incidence of type 2 diabetes (T2D). We reported that this may be mediated via the activation of the NLRP3 inflammasome, as low-density lipoproteins (LDL) induce interleukin-1 beta (IL-1β) secretion from human white adipose tissue (WAT) and macrophages. However, mitigating nutritional approaches remained unknown. We tested whether omega-3 eicosapentaenoic and docosahexaenoic acids (EPA and DHA) treat LDL-induced upregulation of WAT IL-1β-secretion and its relation to T2D risk factors. Twelve-week intervention with EPA and DHA (2.7 g/day, Webber Naturals) abolished baseline group-differences in WAT IL-1β-secretion between subjects with high-apoB (N = 17) and low-apoB (N = 16) separated around median plasma apoB. Post-intervention LDL failed to trigger IL-1β-secretion and inhibited it in lipopolysaccharide-stimulated WAT. Omega-3 supplementation also improved β-cell function and postprandial fat metabolism in association with higher blood EPA and mostly DHA. It also blunted the association of WAT NLRP3 and IL1B expression and IL-1β-secretion with multiple cardiometabolic risk factors including adiposity. Ex vivo, EPA and DHA inhibited WAT IL-1β-secretion in a dose-dependent manner. In conclusion, EPA and DHA treat LDL-induced upregulation of WAT NLRP3 inflammasome/IL-1β pathway and related T2D risk factors. This may aid in the prevention of T2D and related morbidities in subjects with high-apoB.Clinical Trail Registration ClinicalTrials.gov (NCT04496154): Omega-3 to Reduce Diabetes Risk in Subjects with High Number of Particles That Carry “Bad Cholesterol” in the Blood – Full Text View - ClinicalTrials.gov.

Time-restricted feeding prevents memory impairments induced by obesogenic diet consumption, via hippocampal thyroid hormone signaling

ObjectiveThe early consumption of calorie-rich diet disrupts circadian rhythms and has adverse effects on memory, yet the effects of time-restricted feeding (TRF) and the underlying molecular mechanisms are unknown. Here, we set out to identify the behavioral and molecular circadian rhythms disruptions generated by juvenile obesogenic diet consumption and their restoration by TRF in male mice. MethodsMetabolic rhythms were measured by indirect calorimetry and memory performances by behavioral tasks. Hippocampal translatome (pS6_TRAP), enrichment and co-regulated gene network analyses were conducted to identify the molecular pathways involved in memory impairments and their restoration by TRF. Differential exon usage analyses, mass spectrometry and pharmacological intervention were used to confirm thyroid hormone signaling involvement. ResultsWe show that four weeks of TRF restore the rhythmicity of metabolic parameters and prevents memory impairments in mice fed a high fat-high sucrose (HFS) diet since weaning, independently of body fat levels. Hippocampal translatome and differential exon usage analyses indicate that impaired memory of mice under ad libitum HFS diet is accompanied by reduced thyroid hormone signaling and altered expression of astrocytic genes regulating glutamate neurotransmission. TRF restored the diurnal expression variation of part of these genes and intra-hippocampal infusion of T3, the active form of thyroid hormone, rescues memory performances and astrocytic gene expression of ad libitum HFS diet-fed mice. ConclusionsThus, thyroid hormones contribute to the TRF positive effects on both metabolism and memory in mice fed an obesogenic diet, highlighting this nutritional approach as a powerful tool in addressing obesity brain comorbidities and paving the way for further mechanistic studies on hippocampal thyroid signaling.

Epigenetic modification of IGF2/H19 imprinting control region regulates PGC-1α/PI3K/AKT2 pathway in a rat model of intrauterine growth restriction.

Intrauterine growth restriction (IUGR) is associated with adverse metabolic outcomes during adulthood. Histone modifications and changes in DNA methylation-affected genes are important for fetal development. This study aimed to confirm the epigenetic mechanisms in IUGR. IUGR models were established in Sprague-Dawley rats using a maternal nutritional restriction approach during pregnancy. The abundance of insulin-like growth factor 2 (IGF2), phosphoinositide 3-kinase (PI3K), AKT serine/threonine kinase 2 (AKT2), and PPAR gamma coactivator 1 alpha (PGC-1α) was examined by real-time polymerase chain reaction (RT-PCR) and Western blotting analysis. Chromatin immunoprecipitation RT-PCR was employed to analyze histone modification in CCCTC-binding factor (CTCF)1-4 binding sites of the IGF2/H19 imprinting control region (ICR). The methylation states of CTCF1-4 binding sites were studied by pyrosequencing. The IUGR models were constructed successfully. IGF2 mRNA abundance in the placenta, fetal liver, and newborn liver was decreased in the IUGR group (P <0.01). Meanwhile, as compared with the control group, the expression levels of AKT2, PI3K, and PGC-1α were lower in newborn and 8-week-old livers in the IUGR group (P <0.05). In addition, knocking down IGF2 reduced the protein expression levels of AKT2-P and PGC-1α (P <0.05). In CTCF binding sites 1-4 of the IGF2/H19 ICR, AcH3 enrichment was significantly lower in CTCF1-3 in newborn and 8-week-old IUGR rats. H3K4me3 enrichment was significantly lower in the CTCF1-4 of newborn and 8-week-old IUGR groups (P <0.01). H3K9me2 enrichment was significantly higher in the IUGR group (P <0.01). The CpG dinucleotide methylation levels of CTCF1 and CTCF3, but not those of CTCF2 and CTCF4 binding sites in IUGR rat fetal, 4-week old, and 8-week-old livers decreased significantly (P <0.05). The methylation status and histone modification in the IGF2/H19 ICR are related to growth and lipid metabolism via the PGC-1α/PI3K/AKT2 pathway in IUGR rats.

Can Fasting Practices Improve Vitamin D Levels?

Vitamin D deficiency is emerging as a very serious public health problem. Numerous epidemiological studies link vitamin D deficiency to the pathophysiological process of several acute and chronic diseases. Sun exposure, vitamin D supplementation, and fortification of foods with vitamin D are the present strategies adopted to tackle this epidemic. While this can be effective, recent evidence suggests the need to consider the multifaceted causation of vitamin D deficiency such as impaired liver function, kidney function, hyperparathyroidism, and endocrine dysfunction. Therapeutic fasting, a popular nutritional approach has shown to have a positive association with vitamin D levels. This perspective attempts to provide an overview of literature discussing fasting and vitamin D, the possible mechanisms behind this association, and discusses the future possibilities of using fasting as a public/clinical tool in mitigating vitamin D deficiency.

Nutritional Approaches to Managing Pediatric Migraine

Nutritional Approaches to Managing Pediatric Migraine

Neuronutrition and Its Impact on Post-Stroke Neurorehabilitation: Modulating Plasticity Through Diet.

The recovery of neurological deficits after ischemic stroke largely depends on the brain's ability to reorganize its undamaged neuronal circuits and neuronal plasticity phenomena. The consolidated evidence highlights the involvement of the patient's impaired nutritional conditions in post-stroke recovery and unsatisfying rehabilitative outcomes. Standardized nutritional protocols usually applied in hospitalized patients in a rehabilitation setting aim mainly to improve the general health conditions of patients, do not consider the high inter-individual variability in neurorehabilitation outcomes, and are not sufficiently modifiable to provide neuroprotective and restorative dietary patterns that could promote neuronal plasticity and functional recovery during neurorehabilitation. Neuronutrition, an emergent scientific field of neuroscience, represents a valid model of a personalized nutritional approach, assuring, for each patient, nutrients having antioxidant and anti-inflammatory properties, ensuring a balanced microbiota composition, and providing adequate neurotrophic support, essential for improving neuronal plasticity, brain functional recovery, and rehabilitative outcomes. In the present narrative review, we provide an overview of the current knowledge on neuronutrition as an adjuvant strategy of a personalized nutritional approach potentially effective in improving post-stroke neuroplasticity and neurorehabilitation by counteracting or at least limiting post-stroke oxidative/nitrosative stress, neuroinflammation, and gut-brain axis disturbance.

Identification of the Active EPA/AA-Binding Ether-Type Phosphatidylcholine Derived from the Starfish Patiria pectinifera for C2C12 Myotube Growth.

Concerns about nutritional approaches for promoting skeletal muscle mass and function have increased. This study assessed the effects of starfish-derived glycerophospholipids (PLs) (SPL), characterized by unique ether-linked subclasses, alkylacyl (Alk)- and alkenylacyl (Pls)-PL, on skeletal muscle function, focusing on myotube formation in C2C12 myoblasts. SPL was prepared via chloroform/methanol extraction from Patiria pectinifera, followed by silica gel chromatography fractionation. Myoblasts were induced to differentiate with or without SPL treatment. On day 7 of differentiation, 50 μg/mL of SPL treatment increased myotube diameter. The phosphatidylcholine (PC) fraction (SPC) also enhanced myotube growth at 30 μg/mL. LC-MS/MS analysis indicated the most abundant PC molecular species in SPC were Alk- and Pls-PC with eicosapentaenoic acid and arachidonic acid. Treatment with 1-O-hexadecyl-2-arachidonoyl-PC, 1-1(Z)-hexadecenyl-2-arachidonoyl-PC or 1-O-hexadecyl-2-eicosapentaenoyl-PC increased myotube diameter and myokine Il-15 mRNA expression. These results demonstrate a novel functionality of SPC and highlight the role of ether-type PC molecules in muscle function.

The dynamic crosslinking between gut microbiota and inflammation during aging: reviewing the nutritional and hormetic approaches against dysbiosis and inflammaging.

The early-life gut microbiota (GM) is increasingly recognized for its contributions to human health and disease over time. Microbiota composition, influenced by factors like race, geography, lifestyle, and individual differences, is subject to change. The GM serves dual roles, defending against pathogens and shaping the host immune system. Disruptions in microbial composition can lead to immune dysregulation, impacting defense mechanisms. Additionally, GM aids digestion, releasing nutrients and influencing physiological systems like the liver, brain, and endocrine system through microbial metabolites. Dysbiosis disrupts intestinal homeostasis, contributing to age-related diseases. Recent studies are elucidating the bacterial species that characterize a healthy microbiota, defining what constitutes a 'healthy' colonic microbiota. The present review article focuses on the importance of microbiome composition for the development of homeostasis and the roles of GM during aging and the age-related diseases caused by the alteration in gut microbial communities. This article might also help the readers to find treatments targeting GM for the prevention of various diseases linked to it effectively.

Retinol intake and PCOS management: a plasma metabolite and protein analysis via Mendelian randomization and NHANES 2011-2016.

Polycystic Ovary Syndrome (PCOS) represents a complex endocrine disorder characterized by a significant interplay with metabolic dysfunction and obesity. This research endeavors to elucidate the causal dynamics among plasma metabolites, proteins, and PCOS, alongside Body Mass Index (BMI), to pinpoint prospective therapeutic interventions. This investigation employed Mendelian randomization (MR) analyses combined with data derived from the National Health and Nutrition Examination Survey (NHANES) to explore the relationships between 1,400 plasma metabolites and PCOS, factoring in BMI adjustments. Additionally, the study examined the influence of plasma proteins and performed a retrospective cross-sectional analysis focusing on retinol consumption and testosterone levels. MR analyses showed metabolite Glycosyl-N-(2-hydroxynervonoyl)-sphingosine (GNS) and protein Keratin 19 (KRT19) were identified as significant markers in the context of PCOS and BMI adjustments. A Phenome-Wide Association Study (PheWAS) underscored the linkage between KRT19 and BMI, while gene-drug interaction findings demonstrated a connection between KRT19 and retinol. Analysis for NHANES data disclosed a negative correlation between retinol intake and testosterone levels, particularly within normal weight and obese cohorts, suggesting the feasibility of dietary interventions for PCOS management. The study sheds light on the intricate interactions between plasma metabolites, proteins, and PCOS, considering BMI variations, and highlights KRT19 protein as a promising therapeutic target. The outcomes support the integration of retinol consumption into dietary strategies to regulate testosterone levels and potentially alleviate PCOS symptoms, underscoring the necessity for personalized nutritional and therapeutic approaches in the effective management of PCOS.

Loss of Bone Density in Patients with Anorexia Nervosa Food That Alone Will Not Cure.

Anorexia Nervosa is a highly lethal illness that is also associated with many medical complications. Food restriction and weight loss define this illness. Most of its physical complications are reversible with weight restoration, with the notable exception of the loss of bone density, which is commonly present in anorexia nervosa. A comprehensive scientific literature review was performed in order to explore bone disease in anorexia nervosa. The pathophysiology of the loss of bone mineral density in anorexia nervosa was elucidated, along with the diagnosis and treatment of osteoporosis in patients with anorexia nervosa, including the nutritional approach to weight restoration. Loss of bone mineral density in anorexia nervosa is very aggressive. Nutritional rehabilitation is a cornerstone to treating this, along with medicinal considerations.

Very Early-Onset Inflammatory Bowel Disease: Insights into Etiology, Diagnosis, and Treatment Strategies

Very early-onset inflammatory bowel disease: is a subtype of inflammatory bowel disease (IBD) and is defined by its onset in children younger than 6 years of age. The etiology includes the interplay of various factors such as genetic predisposition, environmental factors, gut microbiota and strong family history. The clinical presentation can present with both gastrointestinal symptoms such as bloody and/or mucus-containing diarrhea, recurrent vomiting, peri annal symptoms like fistulas, abscesses and perinatal skin tags and also present as extra-intestinal symptoms like intermittent fevers, arthritis, folliculitis, uveitis etc. In this article we discuss about various treatment methods used in Very early-onset inflammatory bowel disease (VEO IBD) including medical therapy, surgical therapy, hematopoietic stem cell transplantation and nutritional approach. In this systematic review, we have tried to summarized the current knowledge about Very early-onset inflammatory bowel disease

Nutrition and Training Recommendations for Transgender and Gender-Diverse Athletes Involved in Strength Sports and Resistance Training: A Case Series of Nine Athletes Assigned Female at Birth.

Transgender and gender diverse (TGGD) athletes have distinct nutrition and training considerations. Guidance for nutrition and sport professionals working with TGGD athletes is lacking, especially when addressing sex-specific data. The purpose of this case series was to depict nutrition and training assessment approaches and recommendations for TGGD athletes involved in strength sports or resistance training. Six types of data informed each case presentation, including: demographic, anthropometric, health history, and survey data (Eating Competence Scale, Exercise Benefits and Barriers Scale); a 3-day food and physical activity record; and an in-depth interview. Nine TGGD athletes assigned female at birth (AFAB) presented with a range of gender identities, experiences, sport involvement, and transition journeys. Most athletes consumed inadequate energy and fiber, adequate or marginally high levels of saturated fat and added sugars, and high levels of sodium. Most athletes scored low on the Eating Competence Scale and high on the Exercise Benefits and Barriers Scale. Nutrition and sports professionals can individualize the care they provide for TGGD athletes when addressing sex-specific data and help athletes ensure they are meeting their nutrient needs.