Therapeutic Diet Research Articles

Effects of a therapeutic weight loss diet on weight loss and metabolic health in overweight and obese dogs.

Obesity has become a major health issue in dogs. Obesity in dogs increases the risk of many chronic diseases and chronic low-grade inflammation. The objective of this study was to determine the effect of a therapeutic weight loss (TWL) diet on weight loss and metabolic health in overweight and obese dogs. Thirty overweight and obese dogs were randomized into two groups with 15 dogs per group based on key baseline (BSL) parameters and allotted to either a control or TWL diet for 6 mo. At the start of the study, the control group had six females and nine males with mean age of 9.12 ± 0.48 (mean ± SEM) yr; there were seven females and eight males with mean age of 9.73 ± 0.63 yr in the TWL group. The control group and the TWL group had comparable body weight (34.78 ± 0.76 and 34.63 ± 0.86 kg, respectively), % body fat (BF; 39.77 ± 1.18 and 39.89 ± 0.93, respectively), and body condition score (BCS; 7.80 ± 0.14 and 7.67 ± 0.16 on a 9-point BCS scale, respectively). The control (CTRL) diet was formulated based on the macronutrient ratio of a commercial metabolic diet, and the TWL diet was enriched with dietary protein, fish oil, and soy germ meal. Both diets were fortified with essential nutrients to account for caloric restriction during weight loss. Dogs were fed with 25% less than BSL maintenance energy requirement (MER) for the first 4 mo and if they did not reach a BCS of 5, they were fed 40% less than BSL MER for the last 2 mo. Body composition was determined by dual-energy x-ray absorptiometry. Postprandial glucose profiles were determined by continuous glucose monitoring devices. Serum samples were collected for analyses of blood parameters, hormones, and cytokines. All data were analyzed using SAS 9.3, with significance being P < 0.05. At the end of the study, the control group and the TWL group had comparable weight loss (-5.77 ± 0.31 and -6.14 ± 0.32 kg, respectively; P = 0.4080). But the TWL group lost significantly (P = 0.034) more BF (-13.27 ± 1.28%) than the control group (-9.90 ± 1.23%). In addition, the TWL diet completely prevented loss of lean body mass (LBM) in dogs compared with BSL. Dogs fed with the TWL diet had significantly lower fasting serum cholesterol, triglycerides, insulin, leptin, mean postprandial interstitial glucose, and pro-inflammatory cytokines compared with dogs fed with the CTRL diet. In summary, the TWL diet prevented loss of LBM, promoted weight loss and metabolic health, and reduced pro-inflammatory cytokines and chemokines in overweight and obese dogs during weight loss.

Effect of a Commercially Available Electrolyte Solution on Acute, Non-Specific Diarrhea in Dogs

Purpose: To determine if a commercially available electrolyte solution is safe and lessens the duration and severity of diarrhea in shelter dogs in stressful situations. Methods: In Experiment 1, six healthy beagles were administered the protocol-approved dose of the electrolyte solution to evaluate clinical, biochemical, or fecal microbiome changes. In Experiment 2, 22 dogs with small or large bowel diarrhea were randomized into one of three groups: the electrolyte solution and a prescription veterinary diet, a placebo and a prescription veterinary diet, or the electrolyte solution and a standard diet. A fecal score was assigned by trained, masked observers through Day 5 using the Purina 7-point fecal scoring system. All dogs were screened for enteric parasites by fecal flotation and the use of a fluorescence antibody assay for Giardia spp. cysts and Cryptosporidium spp. oocysts and all dogs that were parasitized were administered fenbendazole for five days. Results: In Experiment 1, all dogs tolerated the electrolyte solution with no vomiting or diarrhea noted and there was no evidence of negative effects on the gastrointestinal microbiome. In Experiment 2, 16 of the 22 dogs enrolled in the study had a normal stool the day after the first dose of the electrolyte solution, prescription diet, or placebo. All six dogs with the first day of normal stool detected after Day 1 were parasitized. When the days to normalcy were compared, the parasitized dogs had a significantly slower resolution (P = 0.018) than dogs with no parasites regardless of the other treatment group. Conclusions and Relevance: The results of the study suggest that this electrolyte solution is safe for use in dogs and that adding the electrolyte solution to a standard diet is equivalent to using a therapeutic diet alone or the electrolyte solution combined with a therapeutic diet.

Недостаточность питания у детей с муковисцидозом и возможность ее коррекции с помощью специализированной смеси

Objective. To determine the safety, tolerability, and clinical efficacy of the specialized dietary product “Clinutren Junior” in children with cystic fibrosis at the age of 1 to 10 years. Patients and methods. This study included 20 patients with cystic fibrosis (CF) aged 1 to 10 years who underwent treatment and rehabilitation at the Pulmonology Department of the National Medical Research Center for Children’s Health. According to the Shwachman index (SI), a severe course of CF (SI = 34.24 ± 1.97) was observed in 4 (20%) patients, a moderate course of CF (SI = 49.53 ± 1.76) in 12 (60%) patients, and a mild course of CF (SI = 61.5 ± 2.05) in 4 (20%) patients. All patients had malnutrition of varying severity. During dynamic observation, the children’s general health condition, nutritional status, including anthropometric and biochemical parameters, biological and nutritional value of the diet were evaluated. Results. Beneficial organoleptic properties of the formula and its good tolerability were noted. The analysis of the actual nutrition showed that the study product increased the protein quota and energy value of the age-differentiated standard sparing diet by 23-24%. Against the background of using the specialized formula, there was a tendency to improve the physical development of children, as evidenced by the complete elimination of mild malnutrition in 3 (3.8%) patients and a decrease in the number of patients with severe malnutrition. Conclusion. Inclusion of the specialized dietary product “Clinutren Junior” in the therapeutic diet for CF patients enhances and maintains their nutritional status at a satisfactory level, which in general provides a positive prognosis of the disease and improves the quality of life of patients and their families. Key words: cystic fibrosis, children, malnutrition, specialized food products

Current understanding of the pathogenesis of Dengue virus infection and therapeutic diet for controlling associated symptoms

Current understanding of the pathogenesis of Dengue virus infection and therapeutic diet for controlling associated symptoms

The impact of perception regarding therapeutic exercises and dietary changing adherence of subjects known with low back pain

Abstract: Debates regarding the role of therapeutic exercises and diet as modulators of an anti-inflammatory state occurred in the last years in the medical environment. The syner-gy between moderate-intensity exercise and a proper diet targeting decreasing IL-1 inhib-its the production of the pro-inflammatory cytokine TNF-α, the key regulator of local and systemic inflammation. One of the most important causes of short and long-term disabil-ity in all occupational groups is back pain, impacting the quality of life. Degeneration of the intervertebral disc (IVD) causes low back pain that intensifies with age. Assessment of the Oswestry Disability Index was applied on 23 subjects with low back pain to investigate the degree of disability. Nutrition of IVD, implying therapeutic exercises, and a customized diet may be crucial adjuvants for the rehabilitation process. The appropriate diet and therapeutic exercise approach are meant to evaluate the impact of awareness regarding the possibility of improving health outcomes. In this present study, women have a strong positive Pearson correlation (p&lt;0.05) with minimal (66-70 years) disability and moderate disability (r=1.000, CI =99%). Subjects with moderate disability conditions have “no” intention to implement diet changes and maintain therapeutic exercise adher-ence (r=0.902, CI = 95%). Men (71-75 years, r=0.995, CI =99%) registered a positive strong correlation with maximum deficiency (r=1.000, CI =99%) and “possible no” change in diet and exercise adherence will be applied (r=0.866, CI = 95%). Total disability responders an-swered with a “probable yes” option (r=0.884, CI=95%) but the dependence on their ca-reers is decisive. The education strategy is essential because diet change implementation can cause resistive behavior as well as adherence to exercise therapy. A key to effectively managing the inflammatory state due to different comorbidities is to use the cumulative effects of health professionals' prescriptions. The challenge is to ensure adherence to these actions for each patient. Keywords: anti-inflammatory, therapeutic exercises, rehabilitation, diet, Oswestry Disability In-dex (ODI), back pain, intervertebral disc, nutrition, perception, disability.

Rhamnose Displays an Anti-Obesity Effect Through Stimulation of Adipose Dopamine Receptors and Thermogenesis.

The imbalance between energy intake and energy expenditure leads to the prevalence of obesity worldwide. A strategy to simultaneously limit energy intake and promote energy expenditure would be an important new obesity treatment. Here, we identified rhamnose as a nonnutritive sweetener to promote adipose thermogenesis and energy expenditure. Rhamnose promotes cAMP production and PKA activation through dopamine receptor D1 in adipose tissue. As a result, rhamnose administration promotes UCP1-dependent thermogenesis and ameliorates obesity in mice. Thus, we have demonstrated a rhamnose-dopamine receptor D1-PKA axis critical for thermogenesis, and that rhamnose may have a role in therapeutic molecular diets against obesity.

TMET-24. MITOCHONDRIAL AND GENE EXPRESSION CHANGES IN BRAIN TUMOR CELLS GROWN IN Β-HYDROXYBUTYRATE

Abstract Malignant brain tumors are devastating diseases with poor outcomes. The search for more effective therapeutic combinations has led to investigation of the use of a therapeutic ketogenic diet (KD) as an adjuvant therapy based on the metabolic dysregulation that is a hallmark of cancer. KD sometimes results in extended survival, but like all cancer therapies the tumor eventually becomes resistant. Resistance can arise due to the “metabolic remodeling” of resistant cells due to limitations in nutrient availability and other signals from the tumor microenvironment. We are investigating the molecular and mitochondrial changes of tumor cells grown in β-hydroxybutyrate (BHB), the main ketone produced when following a therapeutic KD, to partially recapitulate the long-term effects of the KD on patients. Murine malignant glioma cells (GL261-luc2) were cultured long term in 2, 5 or 10mM BHB. The Agilent XFe96 Seahorse Analyzer was used to measure changes in cell metabolism. Epigenetic changes that occur in the mitochondria were interrogated using DNA methylation assays. Finally, we implanted BHB resistant glioma cells intracranially in mice and carried out RNAseq to determine the mechanisms by which these cells adapt. Seahorse analyses of GL261-luc2 cells grown in BHB demonstrated changes in several respiratory parameters including maximal respiration and reserve capacity. In addition, there is a statistically significant decrease in mitochondrial DNA methylation with increasing concentrations of BHB. RNAseq analysis of BHB resistant GL261 tumors showed changes in pathways related to mitochondrial translation and the electron transport chain. Our preliminary results show that the heterogeneity seen in these tumors is recapitulated in the various mitochondrial respiration parameters. Further, these may be altered as a consequence of BHB therapy. An understanding of the genetic and mitochondrial changes that occur when cells become resistant will lead to a more effective use of the KD as an adjuvant therapy.

The Role of Dietary Fibers in the Management of IBD Symptoms.

Inflammatory bowel diseases (IBDs) are chronic, progressive, immune-mediated diseases of the intestinal tract. The main subtypes of IBDs are Chron's disease (CD) and ulcerative colitis (UC). The etiology is still unclear, but there are genetic, environmental and host-related factors that contribute to the development of these diseases. Recent literature has shown that dietary therapy is the cornerstone of IBD treatment in terms of management of symptoms, relapse and care of the pathology. IBD patients show that microbiota dysbiosis and diet, especially dietary fiber, can modulate its composition. These patients are more at risk of energy protein malnutrition than the general population and are deficient in micronutrients. So far, no dietary component is considered responsible for IBD and there is not a specific therapeutic diet for it. The aim of this review is to evaluate the role of dietary fibers in CD and UC and help health professionals in the nutritional management of these pathologies. Further studies are necessary to determine the appropriate amount and type of fiber to suggest in the case of IBD to ameliorate psychosocial conditions and patients' quality of life.

Low-carbohydrate vegan diets in diabetes for weight loss and sustainability: a randomized controlled trial

Low-carbohydrate, high animal fat and protein diets have been promoted for weight loss and diabetes treatment. We therefore tested the effect of a low-carbohydrate vegan diet in diabetes as a potentially healthier and more ecologically sustainable low-carbohydrate option. We sought to compare the effectiveness of a low-carbohydrate vegan diet with a moderate-carbohydrate vegetarian diet on weight loss and metabolic measures in diabetes. One hundred and sixty-four male and female participants with type 2 diabetes were randomly assigned to advice on either a low-carbohydrate vegan diet, high in canola oil and plant proteins, or a vegetarian therapeutic diet, for 3 mo, with both diets recommended at 60% of calorie requirements. Body weight, fasting blood, blood pressure, and 7-d food records, to estimate potential greenhouse gas emissions, were obtained throughout the study with tests of cholesterol absorption undertaken at baseline and end of study on 50 participants. Both low-carbohydrate vegan and vegetarian diets similarly but markedly reduced body weight (-5.9 kg; 95% CI: -6.5, -5.28 kg; and -5.23 kg; 95% CI: -5.84, -4.62 kg), glycated hemoglobin (-0.99%; 95% CI: -1.07, -0.9%; and -0.88%; 95% CI: -0.97, -0.8%), systolic blood pressure (-4 mmHg; 95% CI: -7, -2 mmHg; and -6 mmHg; 95% CI: -8, -3 mmHg), and potential greenhouse gas emissions, but only for potential greenhouse gas emissions was there a significant treatment difference of -0.63 kgCO2/d (95% CI: -0.99, -0.27 kgCO2/d) favoring the low-carbohydrate vegan diet. Low-carbohydrate vegan and vegetarian diets reduced body weight, improved glycemic control and blood pressure, but the more plant-based diet had greater potential reduction in greenhouse gas emissions. clinicaltrials.gov identifier NCT02245399.

The Effect of Dietary Patterns on Inflammatory Biomarkers in Adults with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Some evidence supports the fact that chronic low-grade inflammation contributes to the physiopathology of type 2 diabetes mellitus (T2DM), and circulating markers of inflammation (e.g., C-reactive protein (CRP), pro- and anti-inflammatory biomarkers (e.g., adiponectin), and endothelial function markers could indicate an ongoing pathology. Following certain dietary patterns (DPs) may result in favorable changes in inflammatory biomarkers. The overarching aim of this systematic review and meta-analysis is to explore the inflammatory effect of healthy DPs on inflammatory biomarkers in adults with T2DM. A systematic search of the literature was conducted using the electronic databases MEDLINE, SCOPUS, and Cochrane Central Register of Controlled Trials. A total of 10 randomized controlled clinical trials (RCTs) were analyzed. In our linear meta-analysis, the random-effects model was applied to estimate standardized mean differences (SMD) to associate the effect of the interventions. Dietary Approaches to Stop Hypertension (DASH), Diabetes UK healthy eating, Mediterranean Diet (MD), Diabetes Prevention Program (DPP), and the American Heart Association’s Therapeutic Lifestyle Changes diet were associated with a significant reduction in CRP (SMD: −0.83, 99% CI −1.49, −0.17, p < 0.001; I2 94%), while plasma levels of adiponectin were significantly higher with the intake of MD, DPP, and Diabetes UK healthy eating (SMD: 0.81, 99% CI 0.06,1.56, p < 0.005; I2 96%), both of which indicate less inflammation. Sensitivity analyses were carried out, and potential publication bias was examined. In conclusion, low- moderate-quality evidence from RCTs suggests that, for the DPs evaluated, there are favorable changes in CRP and adiponectin.

Traditional, Vegetarian, or Low FODMAP Diets and Their Relation to Symptoms of Eating Disorders: A Cross-Sectional Study among Young Women in Poland.

Background: Eating disorders (EDs) are an ever-growing problem, seen most commonly among young women. People with EDs are particularly predisposed to restrictive eating patterns. Diet therapy for many diseases involves the elimination of certain food groups, and the use of restrictive diets in people with EDs may indirectly influence the recurrence of the disorder. The aim of this study was to assess the prevalence of the possible presence of EDs and orthorexia symptoms among young women following a traditional, alternative (vegetarian), or therapeutic (low FODMAP) diet. Methods: The analysis was based on 420 responses from female respondents aged 19 to 30 years. The research tool consisted of questionnaires to assess the possible presence of EDs (SCOFF), cognitive-behavioral aspects of eating (TFEQ-13), and the presence of orthorexia symptoms (ORTO-15). Results: Uncontrolled and emotional eating was least common in women on a vegetarian diet (5.6 ± 3.7; 3.5 ± 2.7; p < 0.05). Women on a low FODMAP diet were most prevalent with symptoms of orthorexia (n = 37, 47.4%; p < 0.05). Conclusions: It seems important to perform screening tests for eating disorders before recommending diet therapy in order to individually adjust the dietary regimen and refer patients to appropriate specialists.

Nutritional Support in Complex Treatment New Coronavirus Infection in COVID-19 Patients and Own Regional Observations (Analytical Review)

Monitoring and evaluation of the effectiveness of nutritional support for patients with post-COVID syndrome, and therapy and therapeutic diets for the new coronavirus infection COVID-19 were carried out. In each patient, before starting nutritional support, it is important to calculate the true energy requirement as a basal metabolic rate and corrections taking into account the patient's activity factor, risk factor, underweight and damage factor. The calculation of the need for energy and protein in patients with overweight was calculated on the recommended, and in patients with underweight — on the actual body weight. The diet was considered balanced when: proteins provide 10–15%, fats 20–30%, and carbohydrates 55–70% (10% simple carbohydrates) of calories.

A REVIEW ON YUSHA IN KAIYADEVA NIGHANTU

Ayurveda, the science of life, lays down all the preventative principles that are important in sustaining health. Ayurveda has described about the three pillars of life. They are ahara (diet), nidra (sleep), and brahmacharya (celibacy). Ahara (diet) is one of the most significant among them. It is noted that an individual can be disease free just by having a healthy diet. As a result, no medicine is equivalent to food. Kritanna varga is a group of processed food that comprises numerous food preparations such as manda (rice water), peya (thin gruel of rice), vilepi (thick gruel of rice), yavagu (gruels), yusha (soup of vegetables or pulses), ragah (sweet sour sauce), shadavah (confectionery), and so on. Yusha (soup of vegetables or pulses) is one of them, and it is well mentioned in Ayurvedic literatures and even in most of the conditions as a therapeutic diet. In Kaiyadeva nighantu- A treatise of ayurveda 22 yushas are mentioned in kritanna varga. Generally, yusha is prepared with one part of dhanya (rice) and eighteen parts of water. If saindhava lavana, sunthi (Zingiber officinale), pippali (Piper longum) etc. katu dravya’s (pungent substance) are taken and sneha (unctuousness) is added then it is called as krita (seasoned) yusha. Without katu dravyas (pungent substance) and sneha (unctuousness) it is akrita (unseasoned) yusha. Krita yusha is guru (heavy) due to sneha and akrita yusha is laghu (light). In all the yusha’s mentioned in treatise, mudga yusha is said to be best.

A 2022 Systematic Review and Meta-Analysis of Enriched Therapeutic Diets and Nutraceuticals in Canine and Feline Osteoarthritis

With osteoarthritis being the most common degenerative disease in pet animals, a very broad panel of natural health products is available on the market for its management. The aim of this systematic review and meta-analysis, registered on PROSPERO (CRD42021279368), was to test for the evidence of clinical analgesia efficacy of fortified foods and nutraceuticals administered in dogs and cats affected by osteoarthritis. In four electronic bibliographic databases, 1578 publications were retrieved plus 20 additional publications from internal sources. Fifty-seven articles were included, comprising 72 trials divided into nine different categories of natural health compound. The efficacy assessment, associated to the level of quality of each trial, presented an evident clinical analgesic efficacy for omega-3-enriched diets, omega-3 supplements and cannabidiol (to a lesser degree). Our analyses showed a weak efficacy of collagen and a very marked non-effect of chondroitin-glucosamine nutraceuticals, which leads us to recommend that the latter products should no longer be recommended for pain management in canine and feline osteoarthritis.

Inpatient’s Satisfaction of Therapeutic Diet at AL- Khor Hospital - Hamad Medical Corporation – State of Qatar

Background: A patient’s level of satisfaction is considered an essential determinant for quality hospital food services, as it has been linked with nutrient intake and optimum nutritional requirements which contribute significantly to the care and recovery of patients. Objectives: This hospital-based cross-sectional study aims to evaluate the inpatient’s level of satisfaction regarding their therapeutic diets in different wards at AL-Khor hospital - Hamad Medical Corporation (HMC) in the state of Qatar. Methods: The assessment of patients’ satisfaction regarding therapeutic diets of main meals was performed over six months (April-September) 2019, for each patient, on different types of therapeutic diets, was carried out through face-to-face interviews to evaluate his/her response regarding satisfaction dimensions. Satisfaction was measured as general satisfaction, per meal satisfaction, and per satisfaction dimensions. Results: The findings of the study show that most patients (88.6%) were satisfied with their therapeutic diet. Main meals satisfaction was (88.8%,89.4%,87.7%) for breakfast, lunch, and dinner respectively. The highest satisfaction dimension was meal timing (93.2%) while food choices were the lowest satisfied dimension (72.0%). The major issue for the dissatisfaction among patients was food choice and texture (72.0% &amp; 74.2%) respectively. Conclusion: Both patient satisfaction regarding therapeutic diet and the quality of food services at AL-Khor hospital – HMC- Qatar were extremely valuable. all satisfaction dimension’s on dinner meals had the lowest satisfaction compared with breakfast and lunch meals, affecting therapeutic diet overall patients’ satisfaction, which warrants improvement. Keywords : satisfaction level; food choice; food quality; texture, dimensions. DOI: 10.7176/FSQM/119-04 Publication date: September 30 th 2022

Effect of natural sources rich in calcium on treated rats induced osteoporosis

The present study aimed to treat female rats’ osteoporosis using natural sources rich in calcium (permeate with kiwi or fig). Thirty-two female rats weighting 150 ± 10 g were used in this experiment. After adaptation period (7 days), rats were divided to 8 groups (four in each group); first group worked as a control negative and other groups were injected with 1 mg Dex. /kg/bw glucocorticoid (dexamethasone) for 7 days to induce osteoporosis. Second group was considered as a positive group and other groups were treated with beverage (kiwi with permeate or fig with permeate) at different concentrations, i.e., 20, 30 and 40%. The DPPH test was recorded 69.19, 87.01, 68.95, and 44.88% for fresh kiwi, refrigerator kiwi beverage, fresh fig, and refrigerator fig beverage respectively. Meanwhile, using ABTS recorded of 32.6, 39.07, 36.66 and 41.99 Trolox/100 g for above mentioned treatments. In general, total phenol and total flavonoid values of fig treatments were high compared with kiwi treatments. The antimicrobial examination showed an increase in lactic acid bacteria due to refrigeration in both beverages and less total count. Mold, yeast, and coliform not detected. The biological assay resulted in decrease weight gain and feed intake while feed efficiency ratio slightly affected due to beverages. Ca and P content of osteoporotic femur have shown an increase more than the potassium content. Also, serum Ca, P, PTH, Vit. D and protein increased significantly as the result of beverage treatments. The X- ray showed an improved of bone in all treatments compared with (+) control. It could be concluded that permeate mixed with kiwi or fig can be used as a therapeutic diet for subjects, who suffered from osteoporosis.

The importance of human factors in therapeutic dietary errors of a hospital: A mixed-methods study.

An accurate therapeutic diet can help people improve their medical condition. Any discrepancy in this regard could jeopardize a patient's clinical condition. This study was aimed to determine prevalence of dietary errors among in-patients at an international private hospital's food department, and to explore causes of error to suggest strategies to reduce such errors in the future. Thus, a sequential explanatory mixed-methods study was carried out. For the quantitative part, secondary data were collected on a daily basis over one-month. For qualitative data, errors arising during the meal flow process were traced to the source on the same day of error followed by qualitative interviews with person responsible. Quantitative data were analyzed in SPSS v.25 as percentages. Qualitative data were analyzed by deductive-inductive thematic analysis. Out of a total of 7041 diets, we found that only 17 had errors. Of these, almost two-thirds were critical. Majority of these errors took place during diet card preparation (52.94%), by dietitians (70.59%), during weekdays (82.35%), breakfasts (47.06%), and in the cardiac care ward (47.06%). The causes identified through interviews were lack of backup or accessory food staff, and employee's personal and domestic issues. It was concluded that even though the prevalence of dietary errors was low in this study, critical errors formed majority of these errors. Adopting organizational behavior strategies in the hospital may not only reduce dietary errors, but improve patients' well-being, and employee satisfaction in a long run.

Adherence of Healthcare Professionals to Guidelines on Inpatient Management of Children with Severe Acute Malnutrition at the Upper East Regional Hospital in Ghana

Aim: To assess the adherence of health professionals to guidelines on inpatient management of children aged 6-59 months admitted with severe acute malnutrition (SAM)&#x0D; Study Design: Retrospective descriptive study&#x0D; Place and Duration of Study: Paediatric Unit of the Upper East Regional Hospital, Ghana. Records of children seen from 1st January, 2016 to 30th April, 2018 were reviewed.&#x0D; Methodology: Hospital records of 75 children discharged after treatment for SAM were assessed in the study. The records were selected using convenient sampling. Data analysis was done with SPSS version 20 and results presented using descriptive statistics.&#x0D; Results: Eighty-eight percent (88%) of the patients were treated for presumed infections. Of this, only 8% of the children received the recommended Ampicillin and Gentamycin therapy. Over 97% of patients were given therapeutic diets (F-75), and 90.7% of patients were assessed for dehydration. However, only one (1.3%) of the children had their blood glucose levels checked on admission. None 0(0%) of the children were given 10% IV glucose to prevent hypoglycaemia on admission and only 21.2% of patients with dehydration received the recommended ReSoMal&#x0D; Conclusion: There is inadequate adherence to the recommended guidelines for inpatient management of children with SAM. This requires exploring explanations to inform strategies that promote compliance.

The Mediating Role of Spiritual Health in Adherence to Treatment in Patients with Cancer

Background: Adherence to the treatment regimen is among the behaviors, which predict the successful control of the disease and decrease its intensity and negative consequences, which is influenced by several factors. The patient's beliefs and attitudes toward the disease are effective factors in disease management and adherence to treatment, and spiritual health is one of these influential variables. Objectives: The aim of this study was to determine the mediating role of spiritual health in adherence to treatment in patients with cancer. Methods: In this descriptive correlational study, the participants were 234 Iranian patients with cancer, who were selected through convenience sampling, admitted to the oncology wards of 9 selected teaching hospitals in the northern, southern, eastern, and western provinces of the country, as well as the capital in 2021. The research instruments included the Demographic and Clinical Information Questionnaire, Spiritual Well-Being Scale, and Morisky Medication Adherence Scale-8. The path analysis was done to determine the factors related to the degree of adherence to treatment, taking into account the mediating role of spiritual health. Results: The mean age of the participants in the study was 47.27 ± 15.36. The mean scores for spiritual health and adherence to treatment were 76.70 ± 13.75 and 6.47 ± 2.1, respectively. A positive and significant relationship was found between spiritual health and adherence to treatment (P-value &lt; 0.05). The variables of marital status, the time of diagnosis, and being a religious person had a direct effect on spiritual health, and the time of diagnosis indirectly affected treatment adherence. Conclusions: According to the results, the level of spiritual health and adherence to the treatment in patients with cancer was moderate. In addition, the variable of diagnostic time affected adherence to treatment indirectly. Besides, in examining the factors affecting spiritual health, the findings indicated the effect of the variables “being religious”, “marital status”, and “the time of diagnosis”. In addition to strengthening spiritual health, it is necessary to highlight the need to follow therapeutic diets in these patients. Therefore, it is suggested to consider a program to meet the patients with cancer spiritual needs along with the physical care program.

Orthorexia nervosa is a concern in gastroenterology: A scoping review.

There is concern that use of restrictive therapeutic diets, such as those used in disorders of the gut‐brain interaction (DGBI), may increase disordered eating. In this issue of Neurogastroenterology and Motility, Burton Murray et al. and Peters et al. both demonstrate a high prevalence of disordered eating in patients with gastrointestinal conditions, particularly those with DGBI. Given these findings, it is likely that orthorexia is common in this patient group, although this was not directly examined in these studies. Orthorexia nervosa is described as an obsessive and unsafe focus on eating foods perceived as healthy. This mini‐review therefore focuses on orthorexia by conducting a scoping review, as per the PRISMA extension for scoping reviews, aimed to assess the prevalence of orthorexia, and associations between orthorexia and restrictive eating practices. While a wide range of orthorexia prevalence has been reported (0%–97%) across the 57 studies included, no studies assessed prevalence specifically in gastrointestinal conditions. Four of eight studies describing diseases associated with specific dietary patterns suggested that participants who followed a diet for “digestive issues” or “food intolerances” were at higher orthorexia risk. These results suggest that dietary modifications may be a factor contributing to orthorexia. Additionally, we provide a commentary on the clinical implications of the findings for gastrointestinal conditions including a clinical flow chart. Clinicians should consider if a restrictive diet is appropriate for individuals with DGBI and include screening for disordered eating prior to implementation of dietary modifications. Future prospective studies should evaluate orthorexia within this patient group.