Strict Diet Research Articles

One Year Follow-Up Assessment of Impact of Rigorous Diet Regimen and Adequate C-PAP Therapy on Obese Patients with Obstructive Sleep Apnea Syndrome: A Retrospective Study.

Background/Objectives: This study evaluated the impact of continuous positive airway pressure (C-PAP) therapy combined with a rigorous diet regimen on obese patients with obstructive sleep apnea syndrome (OSAS). Methods: Sixty obese patients (BMI ≥ 30) diagnosed with severe OSAS were recruited in order to establish the evaluation of CPAP therapy with different extents of adherence to a rigorous diet regimen. After one year, significant improvements were observed. Results: BMI reduced by 12.32%, apnea-hypopnea index (AHI) by 22.04%, oxygen desaturation index (ODI) by 15.87%, total sleep time with oxygen saturation below 90% (TST90%) by 25.2%, and Epworth Sleepiness Scale (ESS) scores by 21.74%. Patients were, then, divided into three groups, based on adherence to the restricted diet, as well as to the correct use of the nocturnal C-PAP, showing different reductions in BMI, AHI, ODI, TST90%, and ESS, according to their adherence, based on the sum of % reduction in BMI + AHI into three groups. Conclusions: These findings underscore the effectiveness of combining C-PAP therapy with a strict diet in improving OSAS symptoms and overall health in obese patients. Future studies with larger cohorts and longer follow-up periods are needed to confirm these results and explore the long-term benefits of this integrated approach.

Monitoring the Quality of Life and the Relationship between Quality of Life, Dietary Intervention, and Dietary Adherence in Patients with Coeliac Disease.

Inadequate adherence to a gluten-free diet in coeliac disease triggers autoimmune reactions and can reduce the quality of life. The strict diet requires constant vigilance, which can cause psychological distress. Our research aimed to assess the quality of life in adult patients with coeliac disease and to find a correlation between quality of life, dietary intervention, and adherence. The study included 51 adult patients with coeliac disease who completed a quality-of-life questionnaire. Adherence was assessed using serological tests and a dietary adherence test. The patients were divided into two groups: those on a gluten-free diet for at least three months (Group I) and newly diagnosed patients (Group II). Group I showed a significant decrease in the dysphoria subscale of the quality-of-life test between the first and last surveys. Poor quality of life was associated with worse adherence in Group II. A higher "Health concerns" quality of life subscale score was also associated with worse adherence in Group II. Our results suggest that dietetic care may be beneficial for patients with coeliac disease by reducing dysphoria. We recommend regular and long-term dietary monitoring from diagnosis to ensure adherence to a gluten-free diet and to maintain quality of life.

A Review On: Role of Pearl Millet Derived Gluten Free Product and Its Benefit in Treating Iron Deficiency Anaemia in Celiac Patients

Hidden hunger is a global issue and is coming up as a alarming problem for mankind. At the same time world’s most popular countries data showed the occurrence of Celiac Disease, mostly popular in India, Brazil, Russia also in US. 5-8 million people of India is expected to have celiac disease which is not a number can be ignored. The Strict Gluten Free Diet (GFD) is the only therapy intended for celiac patients, as a result most of the patient suffers from Iron Deficiency Anemia which is one of the most reported additional intestinal manifestations of celiac disease. Today’s market lacks the proper gluten free diet products. Most of them are either too costly or not nutrient dense. Millets being a Nutri cereal and old-style staple food of the dry land areas of the world can work as wonder in treating this problem. Among millets, Pearl millet is famous and important grain in the dry and semitropical areas of many developing countries. Proper fortification, enrichment and introducing millets in the plate of celiac patients are showing beneficial result in improving their health status. Our present study will review the part of pearl millet derived product and their efficacy, in treating iron deficiency anemia in celiac patients.

RELATIONSHIP BETWEEN KNOWLEDGE LEVELS AND EFFORTS TO PREVENT GASTRITIS RECURRENCE AMONG TEENAGERS IN RW 006 OF SEPANJANG JAYA, RAWALUMBU DISTRICT IN 2022

Gastritis is a disease that often triggers recurrence. One of the factors that cause recurrence is the patient's lifestyle as a result of lack of knowledge in preventing the recurrence of gastritis. Busy activities at school, dense social activities, and a strict diet to maintain appearance are common characteristics of lifestyle mistakes among teenagers. Lack of knowledge and understanding of unhealthy lifestyles causes gastritis in them. This research was conducted using a quantitative method. The design in this study used Analytical Observation with a Cross Sectional approach. The research sample consisted of 51 teenagers aged 14 -19 years in RW 006 who were selected using purposive sampling technique. Bivariate analysis was carried out through the Chi Square statistical test. A p-value of (0.000) < (0.05) was obtained. This shows that Ho is rejected and Ha is accepted. The results of the bivariate analysis showed 42 respondents had a good level of knowledge, with 34 respondents (66.7%) aware of relapse prevention efforts. Based on the results of the study, there is a significant relationship between the level of knowledge and efforts to prevent recurrence of gastritis among teenagers in RW 006 of Sepanjang Jaya, District Rawalumbu in 2022.

Trends in Plant-Based Diets and the Associated Health Characteristics among Canadians.

In Canada, unhealthy dietary patterns comprise diets with poor nutrient density and are associated with chronic conditions. Plant-based diets have gained popularity due to their ability to provide a nutritionally adequate healthy diet. This study aims to compare sociodemographic, socioeconomic, and health characteristics, and diet quality between Canadian adults following plant-based and omnivore diets as well as assess the extent to which key nutrient intakes are of public health concern among Canadians following plant-based diets. The study used nationally representative nutritional data from the 2015 Canadian Community Health Survey and descriptive statistics were computed. The analysis determined that Canadians following strict plant-based diets (1% of total population) were significantly more likely to be an immigrant to Canada, less likely to meet national physical activity guidelines, and less likely to be overweight, compared to Canadians following omnivore diets. Compared to omnivore diets, plant-based diets were nutritionally superior according to the Nutrient-Rich Food index. Continued knowledge translation on what comprises healthy plant-based diets, public guidance on the intersection between diet and health, and the completion of prospective cohort studies are needed. To conclude, the research suggests well-planned plant-based diets, in comparison to omnivore diets, offer a nutrient-dense diet.

The Experience of Phenylketonuria in Pregnancy and the Developing Maternal-Infant Relationship: A Qualitative Study.

Phenylketonuria (PKU) is a rare metabolic condition characterised by an inability to metabolise phenylalanine (Phe), found in many foods. When pregnant with PKU, women must adhere to a strict low-Phe diet. If they do not, foetal abnormalities or pregnancy loss can occur. Pregnancies are therefore closely clinically monitored and dominated by dietary management, leaving little "space" for women's emotional experience. This article explores the emotional impact of PKU during pregnancy and how this effects pre-natal bonding. Based on interviews with six women with PKU, conducted whilst they were pregnant, this article explores their unusual and previously undocumented experience. Image-making during interviews allowed women to uncover aspects of their experience that might otherwise have remained hidden. Interpretative phenomenological analysis of the transcripts and images generated five themes summarising the women's experiences. Some themes reiterated findings from previous studies, for example, the huge cognitive burden associated with PKU pregnancies and the importance of both expert and informal support to successful pregnancy management. However, new understanding also emerged, including rich description of the emotional load of these pregnancies and strategies that women use to manage this. Anxiety about baby safety was central to their experiences, and the effect of this on pre-natal bonding was explored. This article calls for increased formal and informal support for women with the emotional aspects of their PKU pregnancies, for example, the creation of "attachment-aware" services that support women with their anxiety, promoting strong pre-natal attachment and subsequently protecting maternal and infant mental health throughout pregnancy and beyond.

The Psychosocial Aspects of Vegetarian Diets: A Cross-Sectional Study of the Motivations, Risks, and Limitations in Daily Life.

The popularity of vegetarian and vegan diets is linked to various motivations, such as health, ethics, ecology, and social and religious influence. India has the highest proportion of vegetarians and vegans. The practise of these diets is linked to moral and health reasons and environmental concerns. Vegetarianism may also be associated with eating disorders such as orthorexia (ON). The main aim of this study was to determine the psychosocial aspects of vegetarian diets. Understanding these aspects is crucial for identifying potential risks and developing effective interventions. This study investigated the reasons for following vegetarian diets, the duration of dietary adherence, the occurrence of feelings of restriction in selected situations, and the risk of orthorexia and other eating disorders. A questionnaire survey was conducted among 186 individuals (82 vegetarians and 104 traditional dieters) between October 2023 and April 2024. The survey was administered via a Computer-Assisted Web Interview (CAWI) using Google Forms, distributed through social media, forums, and private messages. The inclusion criteria for the study group included consent, an age over 18, and a vegetarian diet, excluding those with eating disorders or diseases requiring strict diet therapy. The control group criteria were similar, excluding vegetarians and those requiring special diets. Four unreliable questionnaires were excluded from the analysis. The survey consisted of four sections: metric data, the ORTO-15 questionnaire, the EAT-26 questionnaire, and the TFEQ-13 questionnaire. The main motivations for following vegetarian diets were ethical and environmental (86.9%) and health (32.1%) reasons. Over half of the vegetarians had been following a plant-based diet for over five years. Vegetarians were more likely to feel restricted in restaurants and when grocery shopping. The ORTO-15 results indicate a higher risk of orthorexia among vegetarians (48.8% vs. 29.4% in the control group; p = 0.00673). The EAT-26 questionnaire showed a higher, but not statistically significant, risk of eating disorders among vegetarians (23.8% vs. 14.7%; p = 0.11391). The TFEQ-13 showed no significant differences between groups (Subscale 1: food restriction, p = 0.77279; Subscale 2: lack of control in overeating, p = 0.91935; Subscale 3: eating under the influence of emotions, p = 0.16612). This study concluded that ethical and environmental considerations and a belief in health benefits mainly drive vegetarians. An analysis of BMI revealed no significant differences between groups. The ORTO-15 results suggest a higher risk of orthorexia among vegetarians. The EAT-26 indicated a higher, but not statistically significant, risk of eating disorders among vegetarians and vegans. The TFEQ-13 showed no significant differences in restrictive eating, lack of control in overeating, and emotional eating. Vegetarians were likelier to encounter dietary difficulties in restaurants and shopping but less likely to feel socially excluded.

HUBUNGAN STATUS GIZI DAN STATUS MENSTRUASI DENGAN KEJADIAN ANEMIA PADA REMAJA PUTRI USIA 16-17 TAHUN DI PONDOK PESANTREN MAHFILUD DUROR II KABUPATEN JEMBER

Anemia can be caused by several factors, including nutritional status and the length of the menstrual cycle. Adolescent nutritional status is influenced by body image. so go on a strict diet. Blood loss every month (menstruation) too. impact on anemia. The aim of this study was to determine the relationship between nutritional status and menstrual status with the incidence of anemia in young women in. Mahfilud Islamic Boarding School. Duror II, Suger Kidul Village, Jelbuk District, Jember Regency, This research design uses a correlation method with a cross sectional approach. The population in this study were 104 young women at the Mahfilud Duror II Islamic Boarding School. The sample for this research was 82 young women. The sampling technique used was nonprobability sampling using purposive sampling. The instruments in this study were body scales, height measuring instruments, questionnaires, and easy touch GCHB. From the research it was found that nutritional status was normal (64.6%), normal menstrual status (53.7%), anemia status, no anemia (51.2%). The results of the Spearman's Rho statistical test with (a = 0.05) resulted in a p value of 0.139 so that H1 was rejected so H0 was accepted, which means there is no relationship between nutritional status and the incidence of anemia. The results of the second Spearman's Rho statistical test with (a = 0.05) resulted in a p value <0.001 so that H2 was accepted, which means there is a relationship between menstrual status and the incidence of anemia at the Mahfilud Duror II Islamic Boarding School, Suger Kidul Village, Jelbuk District, Jember Regency with the strength of the relationship strong (r = 0.610). The coefficient number above is positive, so the better the menstrual status, the lower the anemia.

THE RELATIONSHIP BETWEEN OXYGEN SATURATION WITH LEVELS ANOREXIA IN DIABETES MELLITUS PATIENTS IN JEMBER

Background: Diabetes mellitus is widely known as a disease that is closely related to food intake, such as carbohydrates / sugar, protein, fat, and excessive energy can be an early risk factor for DM. Common problems in DM patients will experience a strict diet, and are at risk of eating disorders or can be called anorexia. Objective: determine the relationship between oxygen saturation and anorexia levels in DM patients in the jasmine inpatient room of RSD Balung. Research method: the research design used is correlational research with a cross sectional approach. The population of this study is patients suffering from diabetes mellitus in the jasmine inpatient room of RSUD Balung. The research sample of 50 people was taken using non-probability sampling techniques with the Quota sampling method. Datacollection used pulse oximetry analyzers to measure oxygen saturation and SNAQ questionnaires to measure anorexia levels. Uji statistics using the Chi-square test. Results of the analysis: the results of the study of the relationship of oxygen saturation with anorexia levels in DM patients obtained p-values (0.028 α (0.05) with contingency coefficient tests (0.354). Conclusion: there is a low relationship between oxygen saturation and anorexia levels in DM patients in the jasmine inpatient room of RSD Balung. Lack of nutrients will result in the breakdown of oxygen in the blood into fatty acids resulting in diabetic ketoacidosis. Lack of oxygen can also lead to weight loss. The body will be difficult to concentrate because the metabolic process is disrupted due to lack of oxygen supply in the blood that will circulate food throughout the body.

Predictive Modelling for Diabetes and Insulin Dosage Using Machine Learning

Now a days diabetes has become a chronic disease and managing this requires strict regular diet and workout to avoid various health issues and high blood glucose levels. To keep blood glucose at normal level in human body, diabetic patients have to be suggested with proper insulin dosage. It becomes difficult to predict the right amount of insulin to diabetes patients. To do this, Machine Learning(ML) method is used for identifying weather a person is suffering from diabetic and if he/she is suffering, right amount of insulin should be suggested to that patient. k-nearest neighbors(KNN) technique is employed to predict weather a patient is diabetic or not and Random Forest Regression technique is utilized for suggesting appropriate quantity of insulin dosage for the diabetic patient. Results are generated using the above-mentioned techniques.

The multifactorial approach and the food allergen-specific substitutive diet as a tool to manage and ameliorate adverse reactions to foodstuffs in adulthood: study protocol for a randomized controlled trial—the ALASKA study

BackgroundAdverse reactions to foodstuffs (ARFS), specifically food allergy (FA) and food intolerance (FI), are increasing worldwide and represent a major public health concern. Thus, ARFS management, its identification, evaluation, and intervention, must provide a comprehensive solution.Objectives(a) To develop a multifactorial strategy for ARFS management in adults with FA and/or FI; (b) to describe the multiple influential variables in ARFS within the realm of ARFS management; and (c) to design a personalized food allergen-specific substitutive diet (FASSD), as a 6-month dietary treatment option for adults with ARFS and as a component of ARFS management.MethodsThe ALASKA study will consider the following main variables as part of the ARFS management: (1) demographics and clinical information; (2) symptomatology, food and beverages intake and physical activity; (3) hematobiochemical study; (4) immunology; (5) enzymatic activity; (6) anthropometry, body composition, and physical fitness; (7) QoL; (8) 6-month intervention; (9) end of the study; and (10) other assessments. The FASSD will be designed with special emphasis on the commonly lacking micronutrients in the ARFS population: niacin, Mg, K, P, Ca, Zn, B12, folate, Fe, and fiber.DiscussionThe ALASKA study protocol has been developed as a global strategy to manage and evaluate ARFS in Spanish adults older than 18 years of age. Approaching ARFS with multiple assessments, as influencing factors, will lead to a novel strategy for ARFS management. The FASSD has been designed as a personalized tool to avoid crucial micronutrient deficiencies that a current strict food allergen avoidance or elimination diet may provoke.Trial registrationThe protocol has been approved by the Ethics Committee of the UPM (REF.20200602) and registered on ClinicalTrials.gov (NCT05802017).

Nutritional safety and status following a 12-week strict low FODMAP diet in patients with irritable bowel syndrome.

A low FODMAP diet (LFD) is an established dietary treatment for patients with irritable bowel syndrome (IBS). However, knowledge on the extended effects of the restriction phase regarding nutrient intake, symptom severity, and quality of life (QoL) is sparse. Therefore, our objectives were to evaluate the safety of a dietitian-led 12-week strict LFD on measures of blood biochemistry, nutritional status, symptom severity, and QoL. In this open-label dietitian-led 12-week strict LFD intervention for IBS patients with predominantly diarrhea or mixed stool pattern (IBS-D/-M), we collected data on diet intake (3-day dietary record), overnight fasting routine blood samples, body weight, IBS symptoms (IBS Severity Scoring System (IBS-SSS)), and IBS-related QoL (IBS-QoL) at baseline and after 12 weeks. Thirty-six participants completed the 12-week follow-up (mean age: 37 years, 67% women, IBS-SSS: 242 (101)). All blood parameters measured were within established reference values at both time points. We found no change in intake of macro- or micronutrients, but several micronutrients were below the recommendations both before and after 12 weeks. BMI slightly decreased, primarily driven by participants with BMI >25 (p < 0.005). QoL improved among most subdomains (p ≤ 0.002), except food avoidance and social reaction. An extended dietitian-guided LFD (12 weeks) is not inferior to the participants' baseline diet, since no clinically meaningful changes in nutritionally related blood samples and no changes in macro- or micronutrient intake were observed. However, the intake of several nutrients was below the recommendations at both time points indicating low diet quality.

Bringing nutritional ketosis to the table as an option for healing the pediatric brain.

Our core premise is that personalized variations of a ketogenic diet are likely to benefit pediatric patients with neuropsychiatric symptoms across multiple domains. Although pediatric epilepsy is currently a well-accepted indication for a strict ketogenic diet, there is a dearth of knowledge and therefore clinical guidelines upon which to recommend nutritional ketosis for pervasive pediatric conditions such as autism spectrum disorder and ADHD, even when comorbid epilepsy is present. However, there are published cohort studies and current clinical trials implementing medical ketogenic therapies for cognitive impairment, psychiatric comorbidities, motor disability, and even neuroinflammation. As holistic practitioners, it is imperative that we consider the health of a child in its entirety - and additionally offer the ketogenic diet as a therapeutic option when it may be synergistic in treating extra-neurologic diseases such as obesity. While there are uniquely pediatric potential adverse side effects such as linear growth deceleration and micronutrient deficiencies, previous trials in epilepsy and our center's experience have already proven the ketogenic diet to be a low-risk intervention when optimized with appropriate patient monitoring and support.

Quality of Life for Adults with Prader-Willi Syndrome in Residential Group Homes.

Background: Strict regimens of restricted caloric intake and daily physical exercise are life-saving in Prader-Willi syndrome (PWS) but are extremely challenging in home environments. PWS-specialized hostels (SH) succeed in preventing morbid obesity and in coping with behavioral disorders; however, effects of restricted living environments on quality of life (QOL) have not been described. Evidence on QOL is critical for clinicians involved in placement decisions. Methods: We examined the impact of living in SH versus at home or in non-specialized hostels (H and NSH) on QOL, behavior, and health parameters. All 58 adults (26 males) followed-up in the National Multidisciplinary Clinic for PWS were included: 33 resided in SH, 18 lived at home, and 7 lived in NSH. Questionnaires were administered to primary caregivers to measure QOL, and data were obtained from the medical records. Results: The H and NSH group were compared with those for adults in SH. Despite strict diet and exercise regimens, QOL was similar for both groups. Eight-year follow-up showed that food-seeking behavior decreased in SH but increased in H and NSH. BMI, cholesterol, and triglyceride levels were lower in SH. Conclusion: Our results suggest that living in SH is associated with benefits for physical health and behavior without negatively affecting QOL.

A Literature Review on Holistic Well-Being and Dopamine Fasting: An Integrated Approach.

Popularly known as dopaminergic detox or dopamine fasting, it is a concept that aims at reducing dependence on instant satisfaction gratification and overstimulation to attain mental clarity, lessen anxiety, and be able to enjoy everyday events again. Digital detox has been a part of the dopamine fasting concept for several years now. However, some critics argue that this notion has no scientific proof behind it and may fail to deal with the problem of dopamine dysregulation. Some intense types of dopamine fasting which include extreme isolation or strict dieting can result in damage to mental health as well as physical fitness. The objective of the article is to understand what dopamine fasting means and see the literature and evidence available on the topic. Indexes like PubMed, Scopus, OVID, Embase, and Google Scholar were searched using the keywords to understand the existing knowledge about dopamine fasting. The literature review was then written to incorporate the understanding in a way that can be implemented practically. Recent studies have shown that individuals who engage in dopamine-fasting-like ideologies may experience reduced impulsive behaviors, increased focus on tasks, and reduced overwhelm. However, extreme forms of dopamine fasting can lead to feelings of loneliness, anxiety, and malnutrition, which can have detrimental effects on mental and physical health. Hence, the effects of dopamine fasting can vary greatly among individuals, and there is no one-size-fits-all approach. It is essential to consider individual needs and preferences when incorporating dopamine fasting into one's lifestyle and explore alternative practices that align with the principles of dopamine fasting. Understanding and respecting these differences is crucial in determining the most suitable strategies for maintaining a balanced dopamine response and overall psychological health. The benefits of dopamine fasting can be tremendous if done correctly but it depends on every individual to find the correct way and in the modern day, the practices can become tough to implement.

Clinical Management of Ksheena Shukra (Oligospermia) W.S.R. to Ashwagandhadi and Shatavaryadi Choorna – A Comparative Study

Introduction: Kama or sexuality is the root of procreation. Every married couple’s dream of getting their own progeny is initiated, mediated, and formulated through this Kama. This is possible when the anatomical structures and physiological functions of sex organs of both partners are intact. Otherwise, the whole intention becomes in vain. In nutshell, Kama affects in sexual gratification and better progeny to lead happy life, which is perturbed in the absence of the same. Kama is the third pursuit of the man (purushartha) also. The inability to procreate, i.e., infertility is such a condition, which severely affects the couple’s psychological harmony, sexual life, and social stigma and ultimately leads to separation from life partner and many a time to suicide. According to Ayurveda, Shukra should possess such a potency so as to conceive a lady. The impact of defective Shukra is infertility. Although, in Ayurveda, many effective remedies for this disease are mentioned without any known side effects, a major drawback attribute to these remedies is that they involve laborious treatment procedures such as Shodhana procedures, where the patient has to be hospitalized and they have to follow strict diet and regimen during these procedures and these procedures are more time consuming also. Materials and Methods: In the present study, the subjects were randomly selected according to the inclusion and exclusion criteria, specifically designed, and were randomly placed into two Groups, namely Group A and Group B containing 15 subjects each. Subjects of both Groups were given internally Hareetakyadi Choorna for Mala Shodhana and till the Nirama Lakshana was obtained. Later, the subjects of Group A and Group B were given Ashwagandhadi and Shatavaryadi Choorna, respectively, for 2 months along with Ksheera as Sahapana internally. The follow-up period for both the groups was 2 months. Results: The assessment was done before the treatment, soon after the completion of the course of the treatment and after the follow-up period, and thus, the total assessment was done based on the change in improvement observed, before and after the treatment. Conclusion: On seeing the comparative efficacy of Group A and Group B, it is found that Group A is much effective on parameters such as Dourbalya, Mukhashosha, Shrama, Sadana, Pandu, Sperm Count, Liquefication time, and sluggish sperms whereas Group B is more effective on parameters such as volume, motile sperms, and non-motile/dead sperms.

Diagnostic value of daily calciuria on a strict diet in patients with primary hyperparathyroidism

Diagnostic value of daily calciuria on a strict diet in patients with primary hyperparathyroidism

Unmet needs in phenylketonuria: an exploratory Italian survey among patients and caregivers

Objective Patients with phenylketonuria (PKU) require a strict diet to maintain phenylalanine (Phe) levels within the desired range. However, the diet can be onerous, resulting in poor adherence. We carried out the first online national survey in Italy to better understand the perceptions, knowledge, and experiences of both patients with PKU and caregivers with the goal of improving patient outcomes. Methods An online survey of 35 questions to patients and 36 questions to caregivers was distributed in September 2022 through physicians and relevant Italian associations. The information collected included knowledge and impact of PKU, unmet needs, knowledge of available drugs, and satisfaction with therapy. Results Overall, 241 questionnaires were completed by 85 patients and 156 caregivers (96.0% were parents). Knowledge of the pathogenic basis of PKU was generally high. The most common patient-reported symptoms were agitation/anxiety (48.8%), fatigue (41.1%), mood disorders (39.8%), and difficulty concentrating (33.4%). Different perspectives on adherence to a low-Phe diet were observed (22.9% of patients reported strict adherence vs. 47.0% of caregivers). Drugs that allow more freedom were needed by 49.4% of patients and 61.7% of caregivers, along with a wider range of choices of non-dietary treatments (48.2% and 60.0%, respectively). Unmet informational needs of patients included PKU and pregnancy, complications, travel, sports, and transition into adult care. Conclusions Our data showed that patients with PKU and their caregivers reported difficulties in adherence to diet therapy and indicated interest in new therapeutic approaches. Apparent differences between patient and caregiver perspectives were identified. More informational resources on PKU are needed.

Gluten Free Casein Free Diet for Children with Autism Spectrum Disorder – A Review

Autism Spectrum Disorder is a group of neurodevelopmental conditions characterized by social and repetitive behaviour. As per WHO it is estimated that worldwide 1 in 160 children has ASD. Based on epidemiological studies conducted over the past 50 years, the prevalence of ASD appears to be increasing globally. Delayed speech, frequent repetition of set words and phrases, no social interactions, sensory changes etc. are the main symptoms of ASD. There is no known cure for ASD, but many different approaches are used to treat the symptoms of the disorders, for example, visual aids are used to improve communication, social stories interventions are used to teach appropriate social behaviour, and medication is used to ameliorate specific symptoms like aggression. Dietary intervention as a tool for maintaining and improving physical health and wellbeing for ASD is a widely researched and discussed topic. Studies have depicted that there is a link between diet, gut epithelial changes and altered immune response in the spectrum disorders exhibited by children with Autism. A gluten-free casein-free diet is also known as the GFCF diet. It is one of several alternative treatments for children with autism. When following this strict elimination diet, all foods containing and casein are removed from the child's daily food intake. Foods that contained proteins such as gluten and casein causes hypersensitivity to children with ASD. The children cannot digest these proteins properly. This result to increase the level of urinary small peptides. These peptides bind to opioid receptors and become biologically active, which results excess of opioid and leads to an increase of the behavioural difficulties seen in the children. Dietary interventions with the exclusion of gluten, casein or both is thought to have a positive effect on behavioural symptoms because of the elevated levels of peptides seen in the urinary analyses. Since the chemical structure of gluten and casein are very similar to each other, it is very likely that having a sensitivity to one of them means having a sensitivity to both, even though one could be worse than the other. This paper provide an overview of the gluten free casein free diet and its positive and negative results of Gluten free Casein free diet on the basis of reviewing case studies.

Benefits of a prolonged-release amino acid mixture in four pregnant women with phenylketonuria.

Background: Maternal phenylketonuria (mPKU) is a pathologic condition occurring in the fetus of a mother with PKU that is caused by prolonged elevated intrauterine blood phenylalanine (Phe) levels, which can lead to congenital abnormalities and mental retardation of newborns. Management of PKU during pregnancy can be challenging as protein substitutes may exacerbate nausea, vomiting, and gastrointestinal symptoms. Aim: To report the successful management of four PKU pregnant women. Methods: The patients were administered with prolonged-release amino acid supplementation and were recommended to follow a strict diet. Blood Phe concentration, adherence to diet, and occurrence of adverse events were monitored. Results: All patients achieved safe levels of blood Phe concentration (120-360 µmol/L) since preconception and during pregnancy (mean Phe concentration values of 143.34 ± 137.59, 226.48 ± 194.57, 186.68 ± 133.67, and 187.47 ± 42.59 µmol/L). During the first trimester of pregnancy, all patients manifested gastrointestinal symptoms such as nausea, gastrointestinal reflux, and abdominal bloating, which were managed by either changing protein substitute or extending the time window between different meals and amino acid mixtures administration. The four women continued their pregnancies without experiencing further complications and delivered neonates with normal growth parameters and no malformations. Conclusion: Findings of this case series suggest that the intake of a prolonged-release amino acid mixture in granules is well tolerated by pregnant PKU patients, eventually leading to good metabolic control and fetal growth within normal ranges.