Search Results (154)

This review provides an updated and comprehensive assessment of the current literature on quinoa (Chenopodium quinoa Willd.) saponins, with particular emphasis on pharmacological effects. Quinoa (Chenopodium quinoa Willd.) is an annual plant native to South America. Quinoa seeds are characterized by high nutritional value and are rich in proteins, lipids, carbohydrates, minerals, and saponins. Saponins are found in quinoa seeds and impart a bitter taste, which is why they are typically removed before seed consumption. Saponins have been characterized as antinutritional agents, but in recent years they have been investigated for their pharmaceutical applications. Protocols have been developed for the extraction of saponins from seeds, such as conventional solid–liquid extraction (maceration), ultrasound-assisted extraction, microwave-assisted extraction, enzyme-assisted extraction, and pressurized liquid extraction. Ultrasound-assisted extraction and microwave-assisted extraction are considered the most suitable methods for quinoa saponins. Quinoa saponins have shown promise as vaccine adjuvants. Furthermore, they have demonstrated direct anticancer activity, inducing apoptosis and inhibiting the proliferation of breast and colon cancer cells. In general, saponins can induce hemolysis at high concentrations through membrane disruption, primarily via lipid solubilization or pore formation. However, hemolytic activity varies significantly among different saponins and depends on their chemical structure and concentration. In vivo, they have not recorded adverse side effects at doses below 50 mg/kg body weight per day. More than 40 triterpenoid saponins, mainly derived from oleanolic acid, ederagenin, phytolaccagenic acid, and sergianic acid, have been identified in quinoa. Overall, although quinoa saponins have traditionally been considered antinutritional compounds, accumulating evidence indicates that they possess promising pharmacological properties, particularly as anticancer agents. Full article

Background: Chronic inflammatory bowel diseases (IBDs), specifically Crohn’s disease and ulcerative colitis, present substantial clinical challenges characterized by a relapsing-remitting course. These conditions often lead to serious complications and significantly impair nutritional status, physical development, and overall quality of life. Methods: This unicentric, prospective, open-label, alternation-based comparative study investigated the efficacy of vitamin D₃ supplementation in adolescents with IBD. Patients aged 15–25 years were randomly assigned to receive either 1000 IU/day or 2000 IU/day of cholecalciferol for 6 months as an adjuvant to standard care. Eighty patients completed the study. Results: By month 6, remission was achieved in 52.5% of patients receiving 1000 IU/day (Group A) and 87.5% of those receiving 2000 IU/day (Group B). Significant differences were observed between groups regarding disease activity (p = 0.007), C-reactive protein levels (30.17 ± 15.74 mg/L vs. 62.82 ± 37.14 mg/L; p < 0.001), and fecal calprotectin levels. Conclusions: The machine learning models demonstrated consistent performance in assessing inflammatory indicators, with a weighted average recall exceeding 72% (Random Forest: 82.50%). No adverse effects were reported. Supplementation with 2000 IU/day of vitamin D₃ for 6 months was associated with more favorable clinical and biochemical outcomes than 1000 IU/day in this single-center open-label study as an adjunct to standard treatment in adolescents and young adults with IBD. The results suggest that higher doses of vitamin D may be beneficial in achieving remission and reducing systemic inflammation. Full article

Background/Objectives: Temporal muscle thickness (TMT) has been proposed as a practical surrogate marker for skeletal muscle mass, whereas the geriatric nutritional risk index (GNRI) reflects nutritional status. However, the independent and combined prognostic value of TMT and GNRI in surgically treated head and neck squamous cell carcinoma (HNSCC) remains unclear. Methods: We retrospectively analyzed 214 patients with HNSCC who underwent curative-intent surgery. Disease-free survival (DFS) and overall survival (OS) were evaluated using Cox proportional hazards models. In the primary analyses, TMT and GNRI were entered simultaneously as continuous variables and adjusted for age, sex, clinical stage, and postoperative adjuvant treatment. For clinical interpretability, Kaplan–Meier analyses were additionally performed using a composite TMT–GNRI score. Results: In the multivariable analyses, higher TMT was independently associated with longer DFS (hazard ratio [HR] 0.83 per 1 mm increase, 95% confidence interval [CI] 0.72–0.96, p = 0.014) and OS (HR 0.73, 95% CI 0.60–0.89, p = 0.002). GNRI was significantly associated with DFS and OS in the univariate analyses; after simultaneous adjustment for TMT and clinical covariates, it remained independently associated with OS (HR 0.98 per 1-point increase, 95% CI 0.96–0.99, p = 0.015) and showed a borderline association with DFS (HR 0.984, 95% CI 0.966–1.001, p = 0.068). Kaplan–Meier analyses using the composite TMT–GNRI score demonstrated clear risk stratification, with the poorest outcomes observed in patients with concomitantly low TMT and low GNRI. Conclusions: In surgically treated HNSCC, preoperative TMT was independently associated with both DFS and OS. GNRI may provide additional prognostic information, particularly for OS. Full article

Background: Recovery after major head-and-neck reconstruction extends beyond flap survival and wound closure, involving swallowing, psychological adaptation, body image, and overall quality of life. Integrated multidimensional assessments remain limited in routine reconstructive outcomes research. Aim: The aim of this study was to characterize and compare six-month multidimensional recovery—clinical, functional, nutritional, psychological, and body-image outcomes—between microvascular free-flap and regional pedicled-flap reconstruction and to identify factors that stratify risk for persistent functional and psychosocial impairment. Methods: We conducted a single-center prospective cohort study at the “Victor Babeș” University of Medicine and Pharmacy, Timișoara, Romania, enrolling 87 adults undergoing major reconstructive surgery after ablative treatment of head-and-neck defects (52 microvascular free flaps; 35 regional pedicled flaps). Patients were assessed at baseline and 6 months using the SF-36, WHOQOL-BREF, Body Image Scale (BIS), HADS, PHQ-9, GAD-7, Functional Oral Intake Scale (FOIS), speech intelligibility, and PEG/tracheostomy dependence. Results: At 6 months, most SF-36 and WHOQOL-BREF domains improved with moderate effect sizes (d = 0.3–0.7; all p ≤ 0.009), and body image distress decreased significantly (ΔBIS −2.9 ± 4.6; p < 0.001), whereas social functioning showed no robust gain (p = 0.098; not surviving false-discovery-rate correction). Pedicled reconstruction was associated with higher PEG dependence (37.1% vs. 9.6%; p = 0.005) and worse FOIS (4.7 ± 1.4 vs. 5.6 ± 1.2; p = 0.003). Major complications were linked to blunted or worsening psychological trajectories and a threefold higher rate of clinically significant depression (HADS-D ≥ 11: 66.7% vs. 18.7%; p = 0.001). In a reduced four-predictor multivariable model, pedicled flap (aOR 4.6), adjuvant radiotherapy (aOR 2.8), major complication (aOR 3.3), and lower baseline FOIS (aOR 0.5 per point) were independently associated with PEG dependence (optimism-corrected AUC 0.79). Clustering identified three recovery phenotypes—functional/emotional responders, psychological/body-image responders, and global slow recovery—with significantly different PEG rates (5.9%, 21.4%, 40.0%; p = 0.006). Exploratory mediation analysis suggested that the association between reconstruction technique and mental quality-of-life recovery was partly statistically accounted for by swallowing and body-image improvement. Conclusions: Recovery after major head-and-neck reconstruction is multidimensional and heterogeneous. Baseline swallowing function, reconstruction technique, radiotherapy, and major complications jointly stratify risk for persistent functional and psychosocial impairment, supporting risk-adapted multidisciplinary rehabilitation and early psycho-oncologic screening. Full article

Background and Objectives: Neoadjuvant chemotherapy (NAC) followed by radical cystectomy is the standard of care for eligible patients with locally advanced bladder cancer (LABC). However, adjuvant chemotherapy (AC) remains widely used in real-world practice. Host-related inflammatory and nutritional biomarkers may also influence survival outcomes. This study aimed to compare survival outcomes between NAC and AC and to identify independent prognostic factors for overall survival (OS) and progression-free survival (PFS), with particular emphasis on the Prognostic Nutritional Index (PNI). Methods: This multicenter retrospective study included 262 patients with locally advanced bladder cancer. The median age was 66 years, and 84% of patients were male. Patients were treated with neoadjuvant chemotherapy followed by radical cystectomy or adjuvant chemotherapy after surgery between August 2021 and March 2025. The Prognostic Nutritional Index (PNI) was calculated using pretreatment laboratory values. ROC analysis was used to determine the optimal PNI cut-off for predicting mortality, and the derived threshold (49.97) was applied for stratification in all survival analyses. Survival outcomes were evaluated using the Kaplan–Meier method and compared using the log-rank test. Multivariate Cox proportional hazards regression was used to identify independent prognostic factors. Results: Among 262 patients, 138 (52.7%) received NAC, and 124 (47.3%) received AC. Median follow-up was 33.6 months (95% CI: 29.4–37.8). No statistically significant differences in OS (p = 0.388) or PFS (p = 0.499) were observed between treatment groups. In univariate analyses, nodal stage, pathological complete response (pCR), and PNI were significantly associated with both OS and PFS. In multivariate analysis, low PNI (≤49.97) remained an independent predictor of mortality (HR 1.78, 95% CI 1.04–3.38; p = 0.044), while N3 nodal stage independently predicted disease progression (HR 5.92, 95% CI 1.06–32.84; p = 0.042). Conclusions: In this multicenter real-world cohort, nodal stage and systemic inflammatory-nutritional status were key determinants of prognosis in patients with locally advanced bladder cancer receiving perioperative chemotherapy. PNI emerged as an independent predictor of overall survival, suggesting that host-related biomarkers may improve prognostic stratification beyond traditional clinicopathological factors. Full article

Background: In chronic kidney disease (CKD) treatment, a holistic approach, which involves not only nephrologists but also nutritionists, sports physicians, and kinesiologists, is becoming increasingly important, characterized as including not only pharmacological therapy but also integrative treatments, i.e., nutritional therapies (like low protein diet-LPD) and adapted physical exercise (APE) programs. The aim of this study was to evaluate the potential adjuvant therapeutic role of an integrated APE + LPD program on CKD comorbidities, comparing its additional beneficial effects with those induced by the LPD alone. Methods: This clinical study is a randomized controlled trial, where 40 CKD patients (stage G3b-G5) were enrolled and divided into two homogeneous groups: an APE + LPD group, which performed an online APE protocol combined with LPD; and an LPD group, which received only LPD. All enrolled patients were evaluated at baseline (T₀) and after 12 weeks (T₁) for clinical and body composition parameters and for functional assessment and health-related quality of life (HRQoL). Results: Both groups showed a significant reduction in lipid and glucose metabolism parameters. Good adherence to the prescribed LPD led to significantly better control of systolic blood pressure and electrolytes, along with an increase in venous bicarbonate levels. Improvements in body composition and physical performance were also observed. In the APE + LPD group only we observed a significant increase in neutrophil count, serum iron levels, muscle strength, and patients’ HRQoL. Conclusions: Our results suggest that the integrated approach, rather than the LPD alone, is more effective for muscle-related outcomes, HRQoL, and in the positive modulation of the immune system. Full article

Background/Objectives: Obesity in young adults is a major public health concern and a key contributor to cardiometabolic risk. Vitamin K2 (VK2) has been proposed as a potential adjuvant therapy; however, evidence from randomized controlled trials remains limited. This study evaluated the effect of VK2 supplementation on cardiometabolic risk factors in young adults with overweight or obesity. Methods: In this 12-week randomized, double-blind, placebo-controlled trial (NCT05995522), men and women aged 18–35 years with overweight or obesity (BMI 25–40 kg/m²) were assigned to receive VK2 (menaquinone-4, 100 µg/day) or placebo. Both groups received standardized nutritional counseling. Body composition, blood pressure, glucose homeostasis, lipid profile, and vitamin K-dependent proteins were assessed at baseline and post-intervention. Between-group differences were analyzed using ANCOVA adjusted for baseline values. Results: Forty-six participants completed the study (placebo n = 24; VK2 n = 22). VK2 supplementation significantly reduced total cholesterol (−10.64 mg/dL, p = 0.038) and LDL cholesterol (−6.12 mg/dL, p = 0.005) compared with placebo. A reduction in systolic blood pressure showed a trend toward significance (−5.56 mm Hg, p = 0.067). No significant effects were observed on body composition, glucose metabolism, or vitamin K-dependent proteins. Conclusions: VK2 supplementation resulted in improvements in total and LDL cholesterol levels, with no significant changes in vitamin K-dependent proteins, and may represent a safe and potentially beneficial adjunct to nutritional strategies aimed at early cardiometabolic risk modulation. Full article

Despite advances in surgical technique and perioperative care, pancreatic ductal adenocarcinoma (PDAC) remains associated with poor survival. Sarcopenia is highly prevalent in PDAC and is consistently associated with inferior survival and reduced tolerance of systemic therapy. However, interventions primarily aimed at increasing muscle mass through nutritional supplementation and resistance-based exercise have yielded limited improvements in clinically meaningful postoperative outcomes. This has prompted increasing interest in sarcopenia as a marker of broader biological vulnerability rather than isolated physical deconditioning. Emerging clinical, translational, and experimental evidence demonstrates that skeletal muscle and adipose tissue function as active immunometabolic organs, and that cancer-associated inflammatory pathways drive early muscle loss, immune dysfunction, and impaired physiological recovery. Across multiple clinical cohorts, sarcopenia is reproducibly associated with worse overall survival and failure to complete adjuvant therapy, but not consistently with increased postoperative complications, suggesting that its prognostic relevance lies in impaired recovery and oncological fitness rather than immediate surgical risk. Translational studies further indicate that sarcopenia identifies patients with reduced antitumor immune competence, particularly in early-stage disease. This review synthesizes current evidence linking sarcopenia, immune dysfunction, and surgical outcomes in PDAC and examines implications for perioperative care. We propose that immunometabolic-informed prehabilitation, integrated with existing nutritional and exercise strategies, may represent a more effective approach to improving recovery, treatment tolerance, and durable oncological outcomes following PDAC resection. Full article

Background and objectives: Early recovery after major head-and-neck reconstruction is shaped by nutritional vulnerability and functional decline. We evaluated whether preoperative CT-defined low skeletal muscle mass—considered here as an imaging-derived muscle-depletion phenotype rather than the full consensus syndrome of sarcopenia—predicts swallowing milestones, weight trajectory, and patient-reported outcomes at 12 weeks. Methods: In a prospective longitudinal cohort of 74 adults undergoing oncologic resection with reconstruction, low skeletal muscle mass was derived from preoperative cervical CT-based skeletal muscle measurements and nutritional risk was screened with NRS-2002. Outcomes included FOIS, PEG dependence, percent weight loss, MDADI, and European Organisation for Research and Treatment of Cancer QLQ-C30/QLQ-H&N35 at 12 weeks. A multivariable logistic regression explored a composite poor-recovery endpoint (PEG at 12 weeks and/or FOIS ≤ 3 and/or MDADI < 55). Results: Low skeletal muscle mass (32/74, 43.2%) was associated with longer length of stay (13.4 ± 4.1 vs. 10.3 ± 3.3 days; p < 0.001) and more major complications (31.2% vs. 11.9%; p = 0.04). At 12 weeks, affected patients had greater weight loss (10.9 ± 3.4% vs. 8.6 ± 2.6%; p = 0.003), lower FOIS (3.9 ± 1.1 vs. 4.6 ± 1.1; p = 0.01), lower MDADI (57.1 ± 10.9 vs. 66.6 ± 11.9; p = 0.001), and higher PEG dependence (31.2% vs. 9.5%; p = 0.018). Low skeletal muscle mass remained associated with poor recovery after adjustment (aOR 5.4; 95% CI 1.4–24.0; p = 0.016); adjuvant radiotherapy was also associated (aOR 4.3; p = 0.049). Model discrimination was good (AUC 0.81). Conclusions: Preoperative CT-defined low skeletal muscle mass was associated with impaired early recovery after major head-and-neck reconstruction, particularly when adjuvant radiotherapy was anticipated; however, these findings should be interpreted as exploratory and hypothesis-generating. Full article

Type 2 diabetes mellitus (T2DM) has become a global metabolic disorder, and sprouted wheat (SW) exhibits potential for alleviating metabolic syndromes, although its mechanism remains unclear. This study aimed to investigate the effects and underlying mechanisms of SW on T2DM using a high−fat diet−induced T2DM mouse model. SW intervention significantly improved glycolipid metabolism disorders (p < 0.05), attenuated hepatic mitochondrial injury (p < 0.05) and maintained hepatic homeostasis. SW also reshaped the gut microbiota structure and inhibited the TLR4/NF−κB inflammatory pathway (p < 0.05). Untargeted metabolomics combined with network pharmacology identified five key functional metabolites and four core targets involved in the protective effects of SW. Germination optimized the nutritional composition of wheat, and SW regulated the microbe–liver axis through a multi−component, multi−target and multi-pathway mode. These results reveal the mechanism of SW in improving T2DM−related metabolic disorders and provide experimental support for its application. In the future, SW can be further developed as a dietary nutritional supplement for the prevention and adjuvant treatment of metabolic diseases. Full article

This study evaluates a non-invasive and feasible nutritional strategy as a realistic intervention to prevent or mitigate T2DM in one-year-old female Wistar rats. This strategy is based on replacing a commercial pâté (CP) with a functional one, either a silicon-enriched commercial pâté (Si-CP), a reduced-fat pâté formulated with a biopolymeric emulsion (BP), or a silicon-enriched and reduced-fat biopolymeric pâté (Si-BP). After consumption of a high-saturated fat high-cholesterol diet, CP rats exhibited elevated fecal excretion, fasting serum glucose, insulin, and LDL cholesterol, and altered islet morphology. Versus the CP group, the Si-CP consumption group exhibited significantly reduced fecal output (1.17 ± 0.02 vs. 2.09 ± 0.44) and serum insulin (12.06 ± 7.89 vs. 20.74 ± 7.44), triglycerides (47.51 ± 4.46 vs. 58.24 ± 9.97), LDL cholesterol (34.63 ± 5.14 vs. 42.20 ± 4.98), and ghrelin (32.49 ± 24.66 vs. 78.35 ± 22.85). Although BP rats also exhibited some positive effects, Si-BP animals presented the most promising results. Compared to the CP group, Si-BP consumption significantly reduced fecal excretion (1.44 ± 0.24) and serum glucose (129.1 ± 10.40 vs. 154.9 ± 15.76), insulin (9.49 ± 6.06), triglycerides (46.91 ± 5.13), and estradiol (528.2 ± 45.00 vs. 634.4 ± 98.87), preserved islet circularity (0.88 ± 0.02 vs. 0.82 ± 0.01), and significantly increased tibia length (4.09 ± 0.12 vs. 3.95 ± 0.09) and wet weight (0.65 ± 0.07 vs. 0.56 ± 0.06). This study demonstrates the antidiabetic effects of silicon from diatomaceous earth (4 mg Si/kg body/day) incorporated into pâté in middle-aged female rats. Replacing CP with a functional alternative improved the health status of diabetic female rats, supporting its potential as an effective nutritional adjuvant. Full article

Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome driven by systemic inflammation, persistent oxidative stress, endothelial dysfunction, and impaired mitochondrial bioenergetics. Despite recent therapeutic advances, the management of these specific pathophysiological mechanisms remains a challenge. Polyphenols, bioactive compounds found in plants, have emerged as potential modulators of these pathways. Objective: This review critically summarizes the pathophysiological and molecular evidence supporting the role of polyphenols—specifically phenolic acids, flavonoids, and lignans—in attenuating key pathways implicated in the progression of HFpEF, while also addressing the current limitations in clinical translation. Results: Preclinical evidence indicates that polyphenols regulate cellular homeostasis by activating the Keap1/Nrf2 antioxidant axis and AMPK/SIRT1 metabolic pathways, while inhibiting NF-κB-mediated pro-inflammatory signals and TGF-β fibrotic pathways. These molecular actions collectively preserve endothelial function via PI3K/Akt/eNOS, reduce interstitial fibrosis, and improve myocardial metabolic efficiency. Furthermore, the modulation of gut microbiota amplifies these systemic effects, particularly in obesity-related phenotypes. However, direct clinical application is currently hindered by low bioavailability and a scarcity of randomized trials specifically in HFpEF populations. Polyphenols represent a promising and biologically plausible nutritional therapeutic axis for the multidimensional management of HFpEF. While the molecular rationale is strong, future research should focus on improving bioavailability and conducting high-quality clinical trials to validate efficacy as an adjuvant therapy. Full article

A reassessment of the Trp requirements for brown laying hens using the Trp biomass source allows an update of the nutritional recommendation, in addition to assessing whether biomass has an adjuvant effect in the diet. This research was carried out with the aim of evaluating the efficiency utilization of Trp and determining the ideal Trp intake for aged brown laying hens using the L-Trp biomass 60%. A completely random design was used, with eight treatments and eleven replicates, totaling 264 hens. The diets were formulated by supplementation technique using one basal diet with 0.112% of digestible Trp, resulting in amino acid levels that ranged from 0.112 to 0.225% of digestible Trp. The variables analyzed were performance and egg quality. When the effect of Trp levels (p ≤ 0.05) was detected, the model’s linear–plateau (LP), quadratic–plateau (QP), and the first intercept of the QP in the plateau of LP were adjusted to determine the ideal Trp intake. The results obtained show an effect of the treatments (p < 0.05) only on the performance variables. The first intercept results obtained were 186.2, 174.7, 182.7, and 182.5 mg/hen per day for egg production, egg mass, feed conversion ratio, and feed efficiency, respectively. Dietary supplementation with L-Trp biomass 60% effectively meets the nutritional requirements of aged brown laying hens, supporting efficient nutrient utilization without impairing productive performance or egg quality. Full article

Background and Objectives: Nasopharyngeal carcinoma (NPC) is a distinct type of head and neck cancer with unique epidemiological and pathological characteristics. Inflammatory and nutritional markers have been increasingly recognized as prognostic indicators in cancer. In this study, we aim to evaluate the significance of the prognostic nutritional index (PNI) and C-reactive protein/albumin ratio (CRP/Alb) in the prognosis of patients with locally advanced nasopharyngeal carcinoma (NPC). Materials and Methods: We retrospectively analyzed a total of 78 patients diagnosed with locally advanced NPC who received chemoradiotherapy (CCRT) with or without induction or adjuvant chemotherapy between January 2010 and April 2024. Patient characteristics, treatment modalities, inflammatory and nutritional markers, overall survival (OS), and progression-free survival (PFS) were assessed. Kaplan–Meier survival analysis and Cox regression models were used to evaluate the prognostic impact of PNI and CRP/Alb. Results: A lower PNI (≤52.90) and lower CRP/Alb ratio (≤0.14) were significantly associated with higher mortality risk (p = 0.043 and 0.023, respectively). Tumor size (≥32.85 mm) was also found to be a significant prognostic factor (p = 0.041). Patients receiving CCRT alone or with adjuvant chemotherapy had a better OS and PFS compared to those who received induction chemotherapy plus CCRT (p = 0.028 and 0.002, respectively). Multivariate Cox regression analysis indicated that CCRT + AC (HR: 0.17, p = 0.029) and CCRT (HR: 0.25, p = 0.049) significantly reduced the risk of death. Conclusions: PNI and CRP/Alb ratio are independent prognostic markers in locally advanced NPC, providing valuable insights into patient stratification and treatment optimization. These findings support their integration into routine clinical practice for risk assessment. Future large-scale, multicenter studies are warranted to confirm these findings. Full article

Respiratory seasonal viral infections remain one of the most important issues in community medicine. The heterogeneity of etiological agents and the characteristics of the hosts airway antiviral defenses account for the complex management of these infections. The clinical consequence of this picture is that, despite the widespread use of vaccination as the primary prevention strategy, the rates of acute respiratory complications remain still high. In addition, they determine post-infectious fatigue and organ dysfunction. Inflammation and oxidative stress are the principal pathogenic mechanisms responsible for clinical complications during respiratory seasonal viral infections. Nowadays, a growing body of evidence indicates that adjunctive nutritional support can contribute to relieve the symptoms during the acute and subacute phases of respiratory viral infections. We assess the data in the literature regarding the combination of L-Arginine and Liposomal Vitamin C as adjuvant treatment for respiratory seasonal viral infections. The database of the National Library of Medicine (PubMed) was searched using the keywords “L-Arginine, Vitamin C, dietary supplements, seasonal respiratory viral infections”. The treatment of symptoms during acute and post-acute respiratory viral infections requires an integrated approach that includes vitamins and nutritional supplementation. The combination of L-Arginine and Liposomal Vitamin C seems to represent a nutritional support able to mitigate symptoms occurring during the acute or post-acute phase of infection. Full article