Search

The etiology of hidradenitis suppurativa is not fully understood, complicating treatment strategies. Current pharmacological and surgical options are limited by patient acceptance, efficacy, safety, and cost. Integrative approaches aim to enhance standard care with safe and acceptable treatments, complementing rather than replacing therapies. This review highlights recent developments in integrative approaches including smoking cessation, dietary modifications, exercise, and psychosocial support for managing hidradenitis suppurativa effectively. [ABSTRACT FROM AUTHOR]

We tested whether dietary modification (DM) altered the risk for incident primary open-angle glaucoma (POAG). Secondary analysis of a randomized intervention trial. We linked Medicare claims data to 45 203 women in the Women's Health Initiative Dietary Modification Trial, of which 23 776 participants were enrolled in fee-for-service Medicare Part B and had physician claims. Women were randomized to follow either DM (a low-fat diet, with increased vegetable, fruit, and grain intake) or their usual diet without modification. Nine thousand three hundred forty women were randomized to the DM intervention, whereas 13 877 women were randomized to the control group. Our analyses were based on an intention-to-treat design, with a follow-up to the end of continuous Medicare coverage, death, or the last claims date (12/31/2018), whichever occurred first. Primary open-angle glaucoma was defined as the first claim with the International Classification of Diseases, Ninth or Tenth Revision, codes. Dietary data were assessed using a food frequency questionnaire. We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of POAG. Subgroup analyses were performed with P values for interaction. After exclusion of women with Medicare-derived glaucoma before randomization, the final analysis included 23 217 women (mean age, 64.4 ± 5.8 years). Baseline characteristics were balanced between the intervention and control groups. Primary open-angle glaucoma incidence was 11.1 per 1000 woman-years (mean follow-up, 11.6 ± 7.4 years; mean DM duration, 5.2 ± 3.2 years). We found no overall benefit of DM in reducing incident POAG (HR, 1.04; 95% CI, 0.96–1.12). Race and participant age did not modify this relation (P = 0.08 and P = 0.24 for interaction, respectively). In further analysis of baseline nutrient and food intake stratified by quartile groups, risk of open-angle glaucoma (OAG) in DM participants in the lowest quartile group for percentage calories (kilocalories) from total fat (33.8 or lower) was increased (HR, 1.22; 95% CI, 1.05–1.41; P = 0.007 for interaction). Analysis suggests that DM in participants in the lowest quartile group for percentage calories from total fat at baseline increased the risk of incident OAG among women regardless of age or race. Proprietary or commercial disclosure may be found after the references. [ABSTRACT FROM AUTHOR]

Gastrointestinal involvement in systemic sclerosis is common and a major cause of disease-related morbidity. Patients increasingly enquire about dietary modifications that may help with gastrointestinal symptoms. Many clinical practice reviews and treatment guidelines make specific reference to dietary modifications in the management of gastrointestinal involvement in systemic sclerosis. We report the findings of a systematic literature review designed to evaluate the evidence to support dietary modification in the management of gastrointestinal symptoms of systemic sclerosis. A systematic literature review protocol was developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered with the International prospective register of systematic reviews (CRD42018103549). Standardised searches of EMBASE and MEDLINE were undertaken to identify studies reporting the outcome of dietary modification in the management of gastrointestinal symptoms of systemic sclerosis. Wide heterogeneity in study design, interventions and study outcomes necessitated a qualitative data synthesis. Our standardised searches identified 1032 articles, of which 3 were deemed eligible for full data extraction. These studies were small (mean 19 subjects per study), single centre, short-term (mean 6 week duration) open-label non-randomised studies examining the role of probiotics, low-fermentable oligo-saccharides, disaccharides, monosaccharides, and polyol (low-FODMAP) diet and highly individualised medical nutrition therapy counselling, respectively. Improvements in patient-reported outcome assessment of gastrointestinal symptoms were reported after intervention with probiotic therapy and low-FODMAP diet but not following tailored dietary and nutritional counselling. The Risk of Bias Assessment Tool for Nonrandomized Studies identified high risk-of-bias for confounding variables and blinding of assessors in each of the three studies evaluated. The evidence-base to support dietary modification for gastrointestinal involvement in systemic sclerosis is currently limited and clinical practice guidelines should take a measured approach to such recommendations. The emergence of large patient registries could facilitate the capture of vital practice-based evidence regarding the efficacy of dietary modification in the management of gastrointestinal involvement in systemic sclerosis to inform future clinical practice guidelines. [ABSTRACT FROM AUTHOR]

Abstract Objective The aim of this study was to evaluate the effectiveness of an alternative treatment in a form of recommended diet modification during and after conventional treatment with antifungals in patients with a chronic form of intestinal Candida overgrowth (ICOG). Methods The study included patients with ICOG divided in two subgroups: patients treated with nystatin and recommended diet regime (study group-SG) and the patients treated only with nystatin (control group-CG). After treatment, the mycological control examination and follow-up were performed two times: the first one within ten days after the completion of antifungal treatment, and the second one three months after the treatment initialization. Results A total of 120 patients finished the study: 80 from the SG and 40 from the CG. At the first mycological control examination of SG patients stools, we noted satisfactory antifungal and symptomatic effect in 56 out of 80 (70.0%) patients and 29 out of 40 (72.5%) in CG, with no statistically significant difference. However, at the second control stool examination, significantly higher percent (85%) of cured patients was recorded after three months of the recommended diet comparing with CG–17 out of 40 (42.5%). Conclusion Results of this pilot study showed that patients who adhered to diet modification during and after treatment with nystatin had better outcomes of ICOG and strongly suggest the need for diet modification in these patients which recommendation could reduce excessive prescription of antifungals. [ABSTRACT FROM AUTHOR]

Obesity is considered a major influential factor of foot structure and function. It has been reported to result in detrimental alterations of foot structure indicators and a decrease in muscle strength, which can lower the quality of life and increase the morbidity of obesity. The purpose of the present study was to determine the effect of weight reduction on foot structure and the strength of the muscles that move the ankle in obese adults. A total of 33 obese Japanese participants (mean body mass index 28.49 ± 2.87 kg/m 2 ) without an exercise habit participated in a 12-week dietary modification program. Their foot structure indicators were measured using a 3-dimensional foot scanner, and the strength of the muscles that move the ankle was assessed using a dynamometer. After the dietary modification, the mean body weight reduction was 7.49 ± 4.10 kg (9.38%; 77.82 ± 13.26 kg before and 70.33 ± 11.37 kg after; p  <   .001). The wide foot indicators, including the forefoot girth, rearfoot width, and instep girth, had decreased significantly ( p  <   .05), and the decreases correlated positively with the weight reduction. Regarding the strength of the muscles that move the ankle, except for dorsiflexion, all the measured peak torque values per body weight had increased significantly ( p  <   .01). These results suggest that the weight reduction induced by a 12-week dietary modification results in thinner feet and increased strength of the muscles that move the ankle. [ABSTRACT FROM AUTHOR]

Engagement in one type of health behavior change may exert a "spillover" effect resulting in other behavior changes. Few studies have examined dietary intake following prolonged training, and none have evaluated spontaneous dietary changes beyond alterations in energy or macronutrient intake following initiation of strength/resistance training (RT). The purpose of this observational investigation was to determine if spontaneous dietary intake modifications occur in response to initiation of an RT program, among older adults. Previously sedentary adults with prediabetes (n=134, age=59±1 years) were enrolled in a supervised 12-week RT program. Participants were not given dietary advice or encouraged to change eating behaviors. Three non-consecutive 24-hour dietary recalls were collected at baseline and after 12 weeks of RT. Reductions in intake of energy (1914±40kcal vs. 1834±427kcal, p=0.010), carbohydrate (211.6±4.9g vs. 201.7±5.2g, p=0.015), total sugar (87.4±2.7g vs. 81.5±3.1g, p=0.030), glycemic load (113.4±3.0 vs. 108.1±3.2, p=0.031), fruits and vegetables (4.6±0.2 servings vs. 4.1±0.2 servings, p=0.018), and sweets and desserts (1.1±0.07 servings vs. 0.89±0.07 servings, p=0.023) were detected over time. No changes in other dietary intake variables were observed. Mode of exercise and disease state may be important factors in determining whether dietary modifications occur with exercise initiation, among previously sedentary adults. Successful initiation of RT may represent an opportunity for health care professionals to promote beneficial changes in dietary habits, among older adults with prediabetes. [ABSTRACT FROM AUTHOR]

Abstract: Iron deficiency remains one of the world’s greatest public health problems. Globally it is the greatest contributor to anaemia, affecting 47% of pre-school age children and 25% of school age children worldwide, and is a major contributor to both physical and neuro-developmental morbidity. Iron deficiency results from inadequate intake, excess turnover or excessive loss. Whilst inadequate intake is the commonest cause of deficiency in children in the industrialized world, impaired absorption through malabsorption syndromes like inflammatory bowel disease and coeliac disease should also be considered. Blood loss additionally causes iron deficiency, the three most common causes of which are cows’ milk enteropathy, menstruation and hook worm infection. Prevention of iron deficiency, though theoretically simple, is complex at a population level. Treatment requires appropriate management of the underlying cause as well as additional iron replacement. In the western world, the focus has been on preventing iron deficiency through public education and modification of iron availability in children’s diets. It is recommended that children should not receive whole cows’ milk during the first year of life, but should instead be given breast milk or iron fortified formula. Worldwide management strategies again focus on dietary improvements, as well as the control of hook worm and malaria infections to reduce levels of iron deficiency. [Copyright &y& Elsevier]

Numerous molecules, which are either excreted or metabolized by the kidney, accumulate in patients with chronic kidney disease (CKD). These uremic retention molecules (URMs), contributing to the syndrome of uremia, may be classified according to their site of origin, that is, endogenous metabolism, microbial metabolism, or exogenous intake. It is increasingly recognized that bacterial metabolites, such as phenols, indoles, and amines, may contribute to uremic toxicity. In vitro studies have implicated bacterial URMs in CKD progression, cardiovascular disease, and bone and mineral disorders. Furthermore, several observational studies have demonstrated a link between serum levels of bacterial URMs and clinical outcomes. Bacterial metabolism may therefore be an important therapeutic target in CKD. There is evidence that besides reduced renal clearance, increased colonic generation and absorption explain the high levels of bacterial URMs in CKD. Factors promoting URM generation and absorption include an increased ratio of dietary protein to carbohydrate due to insufficient intake of fiber and/or reduced intestinal protein assimilation, as well as prolonged colonic transit time. Two main strategies exist to reduce bacterial URM levels: interventions that modulate intestinal bacterial growth (e.g., probiotics, prebiotics, dietary modification) and adsorbent therapies that bind bacterial URMs in the intestines to reduce their absorption (e.g., AST-120, sevelamer). The efficacy and clinical benefit of these strategies are currently an active area of interest. [ABSTRACT FROM AUTHOR]