Search Results (223)

Consumers increasingly demand dairy products with improved nutritional quality, particularly regarding their fatty acid (FA) composition, due to recognized implications for human health. This study aimed to evaluate the modification in the composition, FA profile, and sensory profile of cheeses elaborated with ewe milk, through the diet inclusion of crushed sunflower (Helianthus annuus) seeds and sunflower seed silage in corn silage-based diets. The study was conducted with six East-Friesian ewes in a double 3 × 3 Latin square design, including three 21-day periods. Three diets were based on ad libitum corn silage as follows: control (CTRL, without supplementation), sunflower seeds (SFS, supplemented with 86 g/kg crushed sunflower seeds), and sunflower seed silage (SFSS, supplemented with 137 g/kg sunflower seed silage). The composition and FA profile of milk and cheese, and the sensory properties of cheese, together with the sensory profile, were evaluated. Dietary feeding with SFS and SFSS did not affect milk production and milk fat percentage but increased protein percentage. SFS and/or SFSS increased C18:0, C18:1 trans-9, and C18:1 cis-9 compared to CTRL in milk and cheese. Cheeses from SFS ewes showed improved taste and total acceptability, while odor, color, and texture of cheese remained unaffected. Therefore, SFS and SFSS appeared as a viable strategy to increase the contribution of FA with beneficial effects for health in milk and cheeses. Full article

Dumping Syndrome (DS) is a significant complication following bariatric surgery, particularly Roux-en-Y gastric bypass (RYGB). This condition is characterised by gastrointestinal and vasomotor symptoms resulting from altered anatomy and hormonal dysregulation, notably accelerated gastric emptying and an exaggerated release of gut peptides. Based on the timing of symptom onset after food ingestion, DS is classified as early (EDS) or late (LDS). The critical roles of peptides such as GLP-1, GIP, insulin, and YY peptide are highlighted, along with the involvement of neuroendocrine pathways in symptom manifestation. Diagnosis relies on a combination of clinical evaluation and dynamic testing, with the oral glucose tolerance test (OGTT) often considered a key reference standard for diagnosis. Initial management involves dietary modifications, emphasising the glycaemic index of foods and meal distribution. In cases where nutritional interventions are insufficient, pharmacotherapy with agents such as acarbose, somatostatin analogues (octreotide and pasireotide), GLP-1 receptor agonists (liraglutide), calcium channel blockers (verapamil), and emerging therapies, including herbal medicine, may be considered. For refractory cases, surgical options like bypass reversal or partial pancreatectomy are reserved, although their efficacy can be variable. Despite advancements in understanding and treating DS, further large-scale, randomised controlled trials are essential to validate novel strategies and optimise long-term management. This review provides an updated and comprehensive overview of the aetiology, pathophysiological mechanisms, diagnostic approaches, and current management strategies for DS. Full article

Background: Bariatric surgery (BS) is the most effective long-term treatment for severe obesity, but many patients develop food intolerances that either reduce protein and micronutrient intake or shift consumption toward easily tolerated, calorie-dense “safe” foods (e.g., sweets, ice cream, sugar-sweetened beverages, refined-flour snacks), compromising nutrient adequacy and weight-loss maintenance. This narrative review summarizes evidence on the prevalence, mechanisms, and clinical impact of food intolerances after BS, focusing on red meat, dairy, water, cereal, and vegetables, and offers practical nutritional management strategies. Methods: A targeted literature search of PubMed and Cochrane Library from the past 10 years was conducted. Studies were selected based on relevance and quality. Results: Intolerance patterns vary by food type and surgical method. Red meat is the most frequently problematic food, with some patients symptomatic for years despite gradual improvement. Dairy products cause gastrointestinal discomfort in some cases, partly due to lactose intolerance. Cereal products may initially cause swallowing difficulties but are generally well tolerated two years postoperatively. Water intolerance mainly occurs shortly after sleeve gastrectomy (SG), linked to sleeve aperistalsis and edema, resolving within weeks. Cooked vegetables are overall well tolerated across procedures. Mechanisms behind intolerance include mechanical restriction, altered gastric emptying, exaggerated entero-hormonal responses, and new taste aversions. Conclusions: Food intolerances are a common, procedure-specific consequence of BS, requiring systematic assessment and personalized dietary management. Early management—modification of consistency, portion control, and supplementation—can improve product tolerance, prevent nutritional deficiencies, and support sustainable weight loss. However, further prospective studies on the mechanisms of food intolerances are needed. Full article

This review explores the maternal gut microbiome’s role in shaping neonatal neurodevelopmental outcomes following perinatal asphyxia (PA), a leading cause of infant mortality and disability with limited therapeutic options beyond hypothermia. We synthesized current evidence on microbiome-mediated neuroprotective mechanisms against hypoxic-ischemic brain injury. The maternal microbiome influences fetal development through bioactive metabolites (short-chain fatty acids, indole derivatives) that cross the placental barrier, bacterial antigen regulation, and infant microbiome colonization. These pathways activate multiple protective mechanisms: anti-inflammatory signaling via NF-κB suppression and regulatory T cell expansion; antioxidant defenses through Nrf2 activation; neural repair via BDNF upregulation and neurogenesis; and oxytocin system modulation. Animal models demonstrate that maternal dysbiosis from high-fat diet or antibiotics exacerbates PA-induced brain damage, increasing inflammatory markers and hippocampal injury. Conversely, probiotic supplementation, dietary fiber, and specific interventions (omega-3, resveratrol) reduce neuroinflammation and oxidative injury. Human studies link maternal dysbiosis-associated conditions (obesity, gestational diabetes) with adverse pregnancy outcomes, though direct clinical evidence for PA severity remains limited. Understanding the maternal microbiome-fetal brain axis opens therapeutic avenues, including prenatal probiotics, dietary modifications, and targeted metabolite supplementation to prevent or mitigate PA-related neurological sequelae, potentially complementing existing neuroprotective strategies. Full article

Metabolic illnesses such as obesity, type 2 diabetes and hyperuricemia are becoming more common, driving intensified research into nutritional interventions through targeted dietary modifications as a primary preventive strategy. The apparent fluctuation in blood glucose value is modulated by the digestive behavior of starch. Moreover, polyphenols—historically considered to be anti-nutrients due to their inhibition of digestive enzymes and sometimes astringent taste—can be used to significantly improve the functional properties of starch. This can be achieved primarily through α-amylase inhibition and the modulation of other enzyme activities, alongside the antioxidant and anti-inflammatory effects of polyphenols. Depending on their fine structure, starches are digested at different rates: rapidly digestible starch (RDS) spikes blood glucose; slowly digestible starch (SDS) smooths postprandial blood glucose peaks; resistant starch (RS) feeds gut microbes. The fine structure of starches, such as straight-chain starches, can form complexes with polyphenols through their ‘empty V-type’ structures under controlled processing conditions. Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD) and in vitro digestion modeling analyses have revealed that the formation of starch–polyphenol complexes primarily occurs due to certain interactions (hydrophobic interactions and hydrogen bonding) which lead to stabilized structures, including V-type encapsulation; this significantly increases the content of RSs and slows down enzymatic digestion rates. These complexes lower the GI values of foods via molecular barrier effects, while synergistically boosting antioxidant and anti-inflammatory activities; their anti-digestive capabilities were found to be superior even to those of ordinary starch–lipid compounds. However, limitations persist in the research and application of starch–polyphenol complexes: human bioavailability validation; incomplete mechanistic understanding of multicomponent interactions; industrial scalability challenges due to polyphenol instability. Full article

Celiac disease (CeD) is a chronic autoimmune enteropathy triggered by dietary gluten in genetically predisposed individuals. Along with other disorders such as non-celiac gluten/wheat sensitivity and gluten allergy, adherence to a strict gluten-free diet (GFD) is required as the only effective treatment for CeD. To this end, and partially due to the burdensome nature and limited efficacy in some patients of a GFD, significant research into alternative therapies has been catalyzed. This review gives a perspective on current and emerging treatment strategies targeting different aspects of CeD pathogenesis. These include gluten-degrading enzymes (e.g., AN-PEP, Latiglutenase, Zamaglutenase), gluten-sequestering agents (e.g., AGY-010, BL-7010), modulators of intestinal permeability (e.g., Larazotide acetate, IMU-856), immune-modulating agents (e.g., ZED1227, AMG 714, EQ102), and strategies for immune tolerization (e.g., TAK-101, KAN-101, Nexvax2). Newer approaches are also targeting probiotics to modulate the gut microbiota (e.g., VSL#3, Lactobacillus plantarum HEAL9), nutraceuticals (e.g., polyphenols, vitamins), or food modifications to remove the gluten from naturally gluten-containing foodstuffs (e.g., gluten transamidation, Gluten Friendly™ technology). Despite encouraging results in preclinical and clinical trials, no treatment has yet been conclusively proven to serve as an effective alternative to the GFD. Continued research is essential to validate efficacy, optimize dosing, and ensure safety in broader patient populations. Here, we provide a comprehensive overview of the therapeutic landscape for CeD, analyze the main strengths and limitations of each treatment and highlight promising directions for future management of CeD, altogether evidencing the urgent need to develop effective alternatives for these patients. Full article

Pediatric obesity represents a growing global health challenge, closely associated with increased cardiometabolic risk and long-term adverse outcomes. Although lifestyle modifications remain the cornerstone of treatment, sustained success is often limited. Emerging evidence suggests that the gut microbiota (GM) plays a pivotal role in the pathogenesis of obesity, influencing host metabolism, energy homeostasis, and systemic inflammation. This narrative review aims to provide a comprehensive and up-to-date overview of the complex interplay between GM and pediatric obesity, with a particular emphasis on microbiota-targeted interventions. These include probiotics, prebiotics, synbiotics, postbiotics, dietary modulation, and fecal microbiota transplantation (FMT). Findings from preclinical studies and early-phase clinical trials indicate that gut dysbiosis may contribute to obesity-related mechanisms, such as altered nutrient absorption, increased adiposity, and dysregulated appetite control. Interventions targeting the microbiota have shown promise in modulating inflammatory pathways and improving metabolic profiles. While preliminary findings underscore the potential of the GM as a novel adjunctive target in managing pediatric obesity, current evidence remains heterogeneous, and robust clinical pediatric data are limited. Further research is needed to clarify the therapeutic efficacy, safety, and long-term outcomes of microbiota-modulating strategies in children with obesity. Full article

Background/Objectives: Fatigue is the most common systemic manifestation of chronic liver diseases, including metabolic dysfunction-associated steatotic liver disease (MASLD). Fatigue not only adversely affects quality of life in MASLD patients but also complicates the attainment of therapeutic goals and contributes to a worse prognosis. This study aimed to analyze the relationship between clinically significant fatigue and laboratory parameters reflecting systemic inflammation, liver function, body composition, muscle strength, and blood pressure in patients with MASLD. Methods: A total of 154 patients with a confirmed diagnosis of MASLD were enrolled in this study. All participants underwent anthropometric assessment, laboratory testing, abdominal ultrasonography, and point shear-wave elastography. Muscle strength was evaluated using handgrip strength (GS) measurement and the Five Times Sit-to-Stand Test (5TSTS). Skeletal muscle mass (SMM) was quantified using dual-energy X-ray absorptiometry (DXA). Fatigue was evaluated using the Fatigue Assessment Scale (FAS), with scores ≥ 22 indicating clinically significant fatigue. Results: Patients with FAS scores ≥ 22 exhibited significantly lower hemoglobin levels (p = 0.004) and erythrocyte counts (p = 0.011), along with a significantly elevated erythrocyte sedimentation rate (ESR; p = 0.002) and C-reactive protein level (CRP; p = 0.007). Furthermore, MASLD patients with FAS scores ≥ 22 demonstrated significantly reduced relative grip strength (p = 0.012) and took longer to complete the 5TSTS (p = 0.011). Additionally, these patients had higher maximum systolic and diastolic blood pressure values compared to those with FAS scores < 22 (p = 0.028 and p = 0.019, respectively). Conclusions: These findings underscore the multifactorial nature of fatigue in MASLD and highlight the need for a comprehensive management strategy. Such a strategy should include dietary modification, increased physical activity, targeted treatment of systemic manifestations of MASLD, and appropriate management of comorbidities. Full article

Background/Objectives: To investigate the associations between educational attainment and 20-year cardiovascular disease (CVD) incidence, mortality, lifetime risk, and burden, and to explore the mediating role of healthy and sustainable dietary habits through a sex-specific lens. Methods: A total of 3042 CVD-free adults from the ATTICA Study were included at the 2001/2002 baseline. Educational level was treated as both continuous and ordinal variable. Adherence to the EAT–Lancet diet pattern (EAT-LDP) was assessed at baseline. Participants were followed for 20 years, with complete data on CVD outcomes available for 1988 individuals. Generalized structural equation and nested Cox regression models were used to estimate the direct and indirect effects between education attainment and 20-year CVD incidence. Moderation analysis was also conducted by incorporating interaction terms in Cox models. Results: An inverse educational gradient in CVD risk and burden was observed, particularly among females for lifetime risk estimates. Each additional year of education was associated with higher EAT-LDP adherence (β = 0.45, 95% CI: 0.40–0.50) and increased odds of physical activity (OR: 1.01, 95% CI: 1.00–1.01). These behaviors mediated part of the relationship between education and long-term CVD incidence. Among females, the cardioprotective role of EAT-LDP adherence was more evident at lower educational levels, suggesting potential effect modification. Conclusions: Educational disparities in long-term CVD outcomes are partly mediated by sustainable dietary habits. These findings highlight the need for gender-responsive and equity-focused strategies in cardiovascular prevention. Full article

In recent years, scientific interest in functional ingredients capable of replacing the non-therapeutic use of antibiotics in animal feed has intensified, fostering the exploration of novel additives such as Saccharomyces cerevisiae hydrolysate (SCH). This study investigated the effect of dietary SCH supplementation on growth performance, intestinal morphology, local immune response, and cecal microbiota composition in Ross 308 broiler chickens. A total of 300 one-day-old male chicks were randomly assigned to two experimental groups, receiving either a standard diet or a diet supplemented with SCH (500 mg/kg during the starter and grower phases; 250 mg/kg during the finisher phase). SCH supplementation significantly improved growth performance during the finisher phase, with increases in final body weight (p = 0.025), average daily gain (p = 0.049), and average daily feed intake (p = 0.027), without significant changes in feed conversion ratio (p > 0.05). Favourable intestinal morphological modifications were observed, with a significant increase in villus height to crypt depth ratio in both the jejunum and ileum at days 28 (p = 0.035 and 0.002, respectively) and 42 (p < 0.001). The expression of pro-inflammatory cytokine genes was significantly reduced, with lower levels of TNF-α, IL-1β, and IL-6, while tight junction protein genes ZO-1 and Occludin were significantly upregulated (p < 0.05). Microbiota profiling revealed higher alpha diversity and greater abundance of Prevotella. These findings highlight SCH as a promising dietary strategy to improve broiler performance, intestinal function, and sustainability in poultry production systems. Full article

Background/Objectives: Children with neurodevelopmental disorders (NDDs) frequently present with feeding challenges that can lead to inadequate fruit and vegetable consumption, which can increase their risk of nutritional deficiencies and related health issues. The aim of this scoping review was to describe the main interventions focused on promoting fruit and vegetable consumption in children with NDDs. Methods: Two authors carried out a search strategy in PubMed, Scopus, EMBASE, Web of Science, and PsycINFO using the following terms: “autism OR autistic OR asperger OR rett OR pervasive OR disintegrative OR ‘neurodevelopmental disorder’ OR ‘attention deficit disorder with hyperactivity’”; and the outcome (O): “fruit OR vegetable”. We included all randomized or non-randomized studies, published in English or Spanish, which assessed children’s fruit and vegetable consumption. Results: We included seven articles that applied different interventions, such as a mobile health and behavioral modification program (n = 1), repeated food exposure programs (n = 2), a play-based program with parental training (n = 1); the implementation of Dietary Approaches to Stop Hypertension diet (n = 1); an intensive interdisciplinary mealtime behavioral treatment (n = 1); and restrictive diets (n = 1). Conclusions: Parent-led behavior changes supported by multidisciplinary teams using play, positive reinforcement, and food modification strategies were the main interventions used to increase fruit and vegetable consumption in children with NDDs. This review supports designing evidence-based approaches to improve feeding challenges in this population. Full article

Heart failure readmissions remain a major challenge for healthcare systems, contributing significantly to morbidity, mortality, and increased healthcare costs. Despite advancements in medical and device-based therapies, rehospitalization rates remain high, particularly within the first 30 days of discharge. This review aims to evaluate the primary factors associated with HF readmissions and discuss evidence-based strategies to reduce these rates. The review examines the efficacy of pharmacological therapies and their impact on readmission rates, highlighting key interventions such as diuretics, beta-blockers, ACE inhibitors, ARBs, ARNIs, SGLT2 inhibitors, and intravenous iron supplementation. Additionally, device-based interventions, including CardioMEMS, LVADs, CRT-P/D, ICDs, Furoscix, and the ReDS vest, are critically evaluated for their role in the early detection and management of decompensation. Non-pharmacological strategies are also underscored, such as dietary modifications, exercise, cardiac rehabilitation, and structured follow-up programs. By synthesizing current evidence, this review provides a comprehensive analysis of heart failure readmission factors and proposes multidisciplinary, patient-centered strategies to improve outcomes and reduce hospitalizations. Full article

Obesity represents a global medical and social challenge characterized by pathological accumulation of adipose tissue as a result of complex interactions among genetic, environmental, and epigenetic factors. Recent studies have highlighted the pivotal role of epigenetic mechanisms in the pathogenesis of this condition, including abnormal DNA methylation of metabolic genes, dysregulation of microRNAs, and chromatin remodeling. These modifications are reversible and can be modulated by dietary, behavioral, and pharmacological interventions. This review provides a comprehensive analysis of tissue-specific epigenetic alterations identified not only in adipocytes and hepatocytes but also in peripheral blood cells, offering promising opportunities for the development of novel diagnostic biomarkers and targeted epigenetic therapeutic strategies. Full article

Breast cancer remains a critical global health challenge, with over 2.1 million new cases annually. This review systematically evaluates recent advancements (2022–2024) in machine and deep learning approaches for breast cancer detection and risk management. Our analysis demonstrates that deep learning models achieve 90–99% accuracy across imaging modalities, with convolutional neural networks showing particular promise in mammography (99.96% accuracy) and ultrasound (100% accuracy) applications. Tabular data models using XGBoost achieve comparable performance (99.12% accuracy) for risk prediction. The study confirms that lifestyle modifications (dietary changes, BMI management, and alcohol reduction) significantly mitigate breast cancer risk. Key findings include the following: (1) hybrid models combining imaging and clinical data enhance early detection, (2) thermal imaging achieves high diagnostic accuracy (97–100% in optimized models) while offering a cost-effective, less hazardous screening option, (3) challenges persist in data variability and model interpretability. These results highlight the need for integrated diagnostic systems combining technological innovations with preventive strategies. The review underscores AI’s transformative potential in breast cancer diagnosis while emphasizing the continued importance of risk factor management. Future research should prioritize multi-modal data integration and clinically interpretable models. Full article

Autonomic dysfunction of the stomach typically manifests as delayed gastric emptying or gastroparesis and is seen in individuals with both type 1 and 2 diabetes. However, impaired gastric motility is only modestly associated with the presence of upper gastrointestinal symptoms, and the diagnosis of gastroparesis essentially requires a formal measurement of gastric emptying, ideally employing a sensitive and precise technique such as scintigraphy. There is a bidirectional relationship between gastric emptying and glycemia: insulin-induced hypoglycemia accelerates, while acute elevations in blood glucose may delay gastric emptying. On the other hand, relatively more rapid emptying is associated with a higher initial rise in postprandial glucose. The management of gastroparesis requires an individualized approach, integrating dietary modifications, nutritional supplementation, pharmacological therapies, and, in severe cases, advanced interventions including gastrojejunostomy and gastric electrical stimulation. This review provides an overview of the pathophysiology and diagnosis of autonomic neuropathy of the diabetic stomach and discusses current clinical management strategies. Full article