Search Results (312)

Irritable bowel syndrome (IBS) is a gut–brain axis chronic disorder, characterized by recurrent abdominal pain and altered bowel habits in the absence of organic pathology. Nutrition plays a central role in symptom management, yet no single dietary strategy has demonstrated universal effectiveness. This narrative review critically evaluates current nutritional approaches to IBS. The low-Fermentable Oligo-, Di-, Mono-saccharides and Polyols (FODMAP) diet is the most extensively studied and provides short-term symptom relief, but its long-term effects on microbiota diversity remain concerning. The Mediterranean diet, due to its anti-inflammatory and prebiotic properties, offers a sustainable, microbiota-friendly option; however, it has specific limitations in the context of IBS, particularly due to the adverse effects of certain FODMAP-rich foods. A gluten-free diet may benefit individuals with suspected non-celiac gluten sensitivity, although improvements are often attributed to fructan restriction and placebo and nocebo effects. Lactose-free diets are effective in patients with documented lactose intolerance, while a high-soluble-fiber diet is beneficial for constipation-predominant IBS. IgG-based elimination diets are emerging but remain controversial and require further validation. In this review, we present the 10 dietary commandments for IBS, pragmatic and easily retained recommendations. It advocates a personalized, flexible, and multidisciplinary management approach, avoiding rigidity and standardized protocols, with the aim of optimizing adherence, symptom mitigation, and health-related quality of life. Future research should aim to evaluate, in real-world clinical settings, the impact and applicability of the 10 dietary commandments for IBS in terms of symptom improvement and quality of life Full article

Patients with Inflammatory Bowel Disease (IBD) exhibit a dysregulated immune response that may be further exacerbated by bioactive compounds, such as histamine. Current dietary guidelines for IBD primarily focus on symptom management and flare-up prevention, yet targeted nutritional strategies addressing histamine metabolism remain largely unexplored. This narrative review aims to summarize the existing literature on the complex interplay between IBD and histamine metabolism and propose a novel dietary framework for managing IBD progression in patients with histamine intolerance (HIT). Relevant studies were identified through a comprehensive literature search of PubMed/MEDLINE, Google Scholar, ScienceDirect, Scopus, and Web of Science. The proposed low-histamine diet (LHD) aims to reduce the overall histamine burden in the body through two primary strategies: (1) minimizing exogenous intake by limiting high-histamine and histamine-releasing foods and (2) reducing endogenous histamine production by modulating gut microbiota composition, specifically targeting histamine-producing bacteria. In parallel, identifying individuals who are histamine-intolerant and understanding the role of histamine-degrading enzymes, such as diamine oxidase (DAO) and histamine-N-methyltransferase (HNMT), are emerging as important areas of focus. Despite growing interest in the role of histamine and mast cell activation in gut inflammation, no clinical trials have investigated the effects of a low-histamine diet in IBD populations. Therefore, future research should prioritize the implementation of LHD interventions in IBD patients to evaluate their generalizability and clinical applicability. Full article

Background: Bariatric surgeries, specifically laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), are a common intervention for morbid obesity, significantly affecting food tolerance and quality of eating. Understanding these changes is crucial for improving postoperative care and long-term success. Methods: This observational study at University Hospital Mannheim involved 91 patients, aged between 18 and 65 year, who underwent SG or RYGB between 2009 and 2019. Food tolerance was assessed between 25 days and 117 months after surgery using the validated score by Suter et al. (Food Tolerance Score, FTS) and an additional score evaluating tolerance to specific food groups and quality of life. Data on body composition were collected through Bioelectrical Impedance Analysis (BIA) at follow-up visits. Statistical analyses included linear mixed models to analyze the association of food tolerance with body composition changes. Results: The FTS indicated moderate or poor food tolerance in 62.6% of patients, with no significant differences between SG and RYGB. Considering the results of the additional score, food groups such as red meat, wheat products, raw vegetables, carbon dioxide, fatty foods, convenience food, and sweets were the most poorly tolerated food groups. A total of 57 of the participants had a baseline and follow-up BIA measurement. Postoperatively, a significant reduction in body weight and BMI as well as in BIA parameters (fat mass, lean mass, body cell mass, and phase angle) was found. Quality of life improved after bariatric surgery and 76.9% rated their nutritional status as good or excellent, despite possible food intolerances. Conclusions: Bariatric surgery significantly reduces weight and alters food tolerance. Despite moderate or poor food tolerance, patients reported high satisfaction with their nutritional status and quality of life. Detailed food tolerance assessments and personalized dietary follow-ups are essential for the early detection and management of postoperative malnutrition, ensuring sustained weight loss and improved health outcomes. Full article

Endometriosis is a chronic, estrogen-dependent inflammatory condition that affects multiple organ systems and significantly impairs the quality of life in women of reproductive age. While conventional hormonal therapies may alleviate symptoms of endometriosis, they are also frequently associated with intolerable side effects. As a result, there is growing interest in complementary, non-invasive strategies to support long-term disease management. This review explores the potential of plant-based diets and personalized nutrition as adjunctive approaches in endometriosis care. Plant-based dietary patterns, which are rich in antioxidants, phytochemicals, dietary fiber, and essential micronutrients, have been shown to reduce systemic inflammation, modulate estrogen activity, and alleviate pelvic pain. Additionally, the use of medicinal plants, such as curcumin and ginger, has demonstrated anti-inflammatory and anti-proliferative effects in preclinical studies. Moreover, identifying and addressing individual food sensitivities, particularly to gluten, dairy, or fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, may improve gastrointestinal and inflammatory symptoms in susceptible individuals. Future research should focus on high-quality clinical trials and integrative care models to evaluate the long-term efficacy, safety, and sustainability of these individualized nutritional interventions in the holistic management of endometriosis. Full article

IgG antibodies, particularly those of the IgG4 subclass, have generated significant debate regarding their role in immune tolerance versus food intolerance. This article comprehensively reviews the literature on the subject, exploring evidence from healthy individuals and patient populations with varied clinical conditions. On one hand, IgG—especially IgG4—is frequently detected in individuals without adverse food reactions and may represent a normal adaptive immune response to constant dietary antigen exposure, contributing to the development of regulatory T-cell–mediated tolerance. On the other hand, several studies have linked elevated food-specific IgG levels with conditions characterized by increased intestinal permeability and inflammation, including eosinophilic esophagitis, irritable bowel syndrome, inflammatory bowel disease, and autoimmune disorders. The review discusses multiple investigations where IgG-guided elimination diets have yielded symptomatic improvements, suggesting a potential benefit for targeted dietary interventions. However, these findings are tempered by the observation that IgG antibodies are commonly present in asymptomatic individuals, thereby questioning their specificity as markers of adverse food reactions. Current diagnostic guidelines from leading allergy and immunology organizations discourage routine IgG testing for food allergies and intolerances, highlighting that these antibodies might instead indicate exposure or underlying inflammation rather than an actual pathogenic mechanism. There is a need for well-controlled, large-scale studies to clearly define the clinical relevance of food-specific IgG responses. Until more substantial evidence is provided, clinicians are advised to interpret the IgG results cautiously and to consider them within the broader context of each patient’s clinical presentation before recommending restrictive dietary changes. Full article

Consumer demand for plant-based functional foods, especially probiotic beverages, has increased due to their health benefits and suitability as dairy-free alternatives. This study assessed, through a factorial combination, the stability of plant-based extracts (avocado, ginger, and tropical) individually inoculated with three commercial Lactobacillus strains (L. casei, L. plantarum, L. reuteri) and stored under refrigerated conditions during both primary (PSL) and secondary shelf life (SSL). Product shelf life was defined by probiotic viability, considering the functional threshold (≥6 log CFU/mL), which was maintained across all formulations throughout the storage period. Physicochemical parameters, including pH, titratable acidity, and colour, as well as volatile profile, remained stable, with only minor variations depending on the matrix and bacterial strain. Sensory evaluations (triangle and acceptability tests) confirmed that the probiotic juices were acceptable to consumers. Overall, the results demonstrate the feasibility of producing non-fermented, plant-based probiotic beverages that retain their functional properties and meet consumer sensory expectations, offering a promising alternative for vegan and lactose-intolerant individuals. Full article

Background: Based on the multitude of findings, nutrition is becoming increasingly important in the treatment of attention deficit/hyperactivity disorder (ADHD) in children. One promising approach is the so-called oligoantigenic diet (OD). This intervention involves avoiding certain foods that often trigger intolerances and allergies. Previous studies have shown that around 60% of patients experienced a significant reduction in ADHD symptoms after completing such a diet. The aim of the present study was to further confirm the efficacy of the OD within an analysis focusing on the symptom of impulsivity. Materials and Methods: In the present study, the Parent Rating of the Diagnostic System of Mental Disorders in Children and Adolescents (DISYPS-II FBB-ADHD) questionnaire was used to measure the severity of ADHD symptoms. Of 34 children and adolescents (between 7 and 18 years of age) screened and included in this study, 31 participants completed the 4-week OD diet. Results: The corresponding post-diet analysis showed significant short-term improvements for the DISYPS-II FBB-ADHD total score, compared to the start of the diet. This pattern of results also applied to the respective subscales of the DISYPS-II FBB-ADHD questionnaire. A follow-up evaluation conducted 3.5 years after the intervention with 21 participants suggested that the improvements in ADHD symptoms were maintained over time. Specifically, 66.7% of the participants continued to meet the responder criterion, with particularly notable and lasting reductions in impulsivity. Discussion: These results suggest that the beneficial effects of the oligoantigenic diet followed by identifying and avoiding individual intolerant foods may persist long term, and participants’ dietary habits may have also evolved over the years. Conclusion: The oligoantigenic diet may have long-term therapeutic potential for reducing ADHD symptoms, especially impulsivity, in children and adolescents. Full article

The purpose of this paper is to comprehensively review the research progress of nattokinase in lowering blood lipid, including its source, structure and physicochemical properties, mechanisms of functions, clinical research status, and safety considerations, so as to provide reference for further research on the application of nattokinase in the treatment of dyslipidemia. Natto is a traditional Japanese fermented food, which is made from soybeans fermented by Bacillus natto. During the fermentation process, natto will produce a variety of biologically active substances, including nattokinase. Nattokinase (NK) is a serine protease with stable enzyme activity and good freeze–thaw tolerance, which exerts lipid-lowering and anti-atherosclerotic effects by activating hormone-sensitive lipase (HSL), inhibiting hydroxymethylglutaryl monoacyl coenzyme A reductase (HMG-CoA reductase), and enhancing lipoprotein lipase (LPL) activity. Large-scale clinical trials have confirmed that nattokinase significantly improves the lipid profile and reduces the atherosclerotic plaque area and intima-media thickness with a favorable safety profile. Compared with traditional lipid-lowering drugs (e.g., statins and fibrates), nattokinase has a multifaceted lipid-lowering mechanism and lower risk of side effects, which makes it suitable for patients intolerant of traditional drugs; when combined with natural products such as statins, fibrates, red yeast, and lifestyle interventions, it can play a synergistic role and further reduce the risk of cardiovascular disease. There are various types of nattokinase preparations on the market, and consumers should choose regular products with high activity and purity, and pay attention to their safety and applicable population. Full article

Background/Objectives: Elimination diets targeting amines and salicylates have been used since the 1980s to diagnose pharmacological food intolerance in individuals with atopic dermatitis (eczema), yet supporting evidence regarding relevance is limited. To our knowledge, this systematic review with meta-analysis is the first to examine the prevalence and association between atopic dermatitis flares and amine intolerance (including histamine intolerance) and salicylate intolerance in individuals with atopic dermatitis. Methods: Following the PRISMA guidelines, searches of PubMed, Embase, CINAHL, and Cochrane were conducted. Included studies involved children and adults with atopic dermatitis who underwent dietary elimination and double-blind placebo-controlled challenges involving histamine, other amines, or salicylates. Risk of bias was assessed using the Joanna Briggs Institute Checklist for Prevalence Studies. Meta-analysis of the prevalence of atopic dermatitis flare by food chemical type was performed using a random effects model in Stata/MP, version 16.1 for Windows. Heterogeneity was assessed using the I² statistic and Cochrane’s Q test. Results: A total of 2323 titles and abstracts were screened, with 46 full-text articles evaluated independently by two reviewers, resulting in the inclusion of four prevalence studies involving 188 participants. Meta-analysis of two trials showed histamine intolerance prevalence at 31% [95% CI, 20–41%] with no heterogeneity (I² = 0.01%). Two trials showed amine intolerance prevalence at 32% [95% CI, 16–48%] with moderate heterogeneity (I² = 34.91%). Two trials showed salicylate intolerance prevalence at 53% [95% CI, 44–62%] with no heterogeneity (I² = 0.00%). Conclusions: This review suggests there may be low-certainty evidence linking intolerance to histamine, amines, and salicylates to atopic dermatitis flare in a substantial proportion of individuals with atopic dermatitis. Further, well-designed studies are needed to confirm these findings and clarify the role of pharmacological food intolerance in atopic dermatitis. Full article

Background/Objectives: Identifying and decomposing compound ingredients within meal plans presents meal customization and nutritional analysis challenges. It is essential for accurately identifying and replacing problematic ingredients linked to allergies or intolerances and helping nutritional evaluation. Methods: This study explored the effectiveness of three large language models (LLMs)—GPT-4o, Llama-3 (70B), and Mixtral (8x7B), in decomposing compound ingredients into basic ingredients within meal plans. GPT-4o was used to generate 15 structured meal plans, each containing compound ingredients. Each LLM then identified and decomposed these compound items into basic ingredients. The decomposed ingredients were matched to entries in a subset of the USDA FoodData Central repository using API-based search and mapping techniques. Nutritional values were retrieved and aggregated to evaluate accuracy of decomposition. Performance was assessed through manual review by nutritionists and quantified using accuracy and F1-score. Statistical significance was tested using paired t-tests or Wilcoxon signed-rank tests based on normality. Results: Results showed that large models—both Llama-3 (70B) and GPT-4o—outperformed Mixtral (8x7B), achieving average F1-scores of 0.894 (95% CI: 0.84–0.95) and 0.842 (95% CI: 0.79–0.89), respectively, compared to an F1-score of 0.690 (95% CI: 0.62–0.76) from Mixtral (8x7B). Conclusions: The open-source Llama-3 (70B) model achieved the best performance, outperforming the commercial GPT-4o model, showing its superior ability to consistently break down compound ingredients into precise quantities within meal plans and illustrating its potential to enhance meal customization and nutritional analysis. These findings underscore the potential role of advanced LLMs in precision nutrition and their application in promoting healthier dietary practices tailored to individual preferences and needs. Full article

Background/Objectives: Food hypersensitivity remains an understudied and overlooked subject globally. It is characterized by adverse reactions to dietary substances, potentially triggered by various mechanisms. Food allergy, a subset of food hypersensitivity, denotes an immune response to food proteins categorized into immunoglobulin IgE-mediated or non-IgE-mediated reactions. Conversely, food intolerance, another facet of food hypersensitivity, refers to non-immunological reactions, in which the human body cannot properly digest certain foods or components, leading to gastrointestinal discomfort and other non-immune-related symptoms. The main objective of this study was to determine and differentiate the differences, characteristics, and types of food hypersensitivity. Methods: This study involved a comprehensive review of key research from 1990 onward, including review articles, prospective studies, nested case–control studies, and meta-analyses. Results: Recognizing these differences is essential for healthcare professionals to ensure accurate diagnosis, effective management, and improved patient outcomes, while also aiding dietitians in providing optimal nutritional and dietary guidance. Conclusions: there are big differences between the main characteristics, such as symptoms, complications, and treatments between allergies, and food intolerances. Commonly reported trigger foods include cow milk, gluten, eggs, nuts, and seafood. Full article

Background/Objectives: Medicinal herbs produce valuable substances with therapeutic potential. The chemical structures of those substances are often converted by gut microbiota. Our previous studies showed that several kinds of bioactive molecules are newly generated in fermented medicinal herbal extract with plant-derived lactic acid bacteria (LABs). Methods: The fermented extract of Atractylodes Japonica Rhizoma (AJR), which is designated as “Byakujutsu” in Japan, with a plant-derived LAB strain IJH-SONE68 was prepared and whether the fermented extract could help reduce symptoms of food allergies, especially wheat intolerance, was confirmed using animal model. Results: It has been found that the fermented extract significantly ameliorates the anaphylaxis score (from 3.0 to 1.0, p = 0.003) of gliadin-induced allergic model mice (specific-pathogen-free, BALB/cJ) accompanied with the modulation of serum total immunoglobulin E (IgE) (from 778 to 518 ng/mL, p = 0.006), interferon (IFN)-γ (from 6.6 to 9.5 pg/mL, p < 0.001), and interleukin (IL)-4 (from 32.0 to 9.1 pg/mL, p < 0.001) levels. Conclusions: The fermented AJR extract may modulate the Th1/Th2 cell balance to alleviate the symptoms of gliadin-induced anaphylaxis in mice. The present study supports the view that the fermentation of medicinal herbal extract prepared using LABs may be a useful procedure for producing therapeutic potential compounds to maintain health. Full article

Production of plant-based products is still on the rise. There is a need for new plant-based dairy alternatives in the food market due to lactose intolerance, allergens to dairy and nuts and a rise in gluten-free products. Rice is a key source for these types of products because it is hypoallergenic. This study focused on the comparison storage stability and in vitro digestion of milk-based yogurt (MY) to yogurt alternatives (YA) made with four different rice flours. YAs and MY were prepared using L. delbrueckii and S. thermophilus for fermentation and L. rhamnosus (LGG) as a probiotic. Samples were stored refrigerated for up to 28 days and analyzed for titratable acidity, pH, color, syneresis, viscosity and bacterial counts every seven days. Probiotic survivability was tested under simulated gastric and intestinal conditions. YAs had lower syneresis than MY. There were few changes in color over time. Titratable acidity was lower in YAs (0.1 to 0.5%) than in MY (1%) while pH decreased in all samples during storage. Bacteria counts were stable throughout storage in all samples. MY had higher counts of LGG at the beginning of storage which significantly decreased during exposure to in vitro gastric conditions. Under in vitro intestinal conditions, both the white rice flour YAs and the MY retained the highest levels of LGG. This study indicated that it is possible for YAs made with rice flour to be stable overtime and with survivability of probiotic bacteria under gastric conditions. Full article

Milk is a highly complex food that contains all the nutrients necessary for the development of mammalian offspring. For millennia, humans have included milk and milk products as major components of their diet. However, the effect of the consumption of dairy products on health has been a concern in recent years in terms of myths and realities. This review briefly describes the composition of bovine milk, the positive and negative effects that have been related to dairy products, and those aspects where the scientific evidence is still inconclusive. In addition to being nutritional, dairy products are a source of bioactive peptides, prebiotics and probiotics, fatty acids such as CLA, and fat globule membranes or have a protective effect against certain diseases. Negative effects include milk protein allergy or lactose intolerance. The effects of dairy products on certain cancers, such as prostate cancer, and their role in type II diabetes mellitus or weight gain are still inconclusive. Although the role of dairy products in cardiovascular risk is still inconclusive, recent meta-analyses have shown that dairy products may have a protective effect. Full article