726 results on '"DIET therapy"'
Search Results
2. Naturally‐occurring dietary salicylates in the genesis of functional gastrointestinal symptoms in patients with irritable bowel syndrome: Pilot study
- Author
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Caroline J Tuck, Sreepurna Malakar, Jacqueline S Barrett, Jane G Muir, and Peter R Gibson
- Subjects
diet therapy ,irritable bowel syndrome ,salicylates ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract Background and Aim An elimination‐rechallenge dietary approach targeting naturally‐occurring bioactive chemicals has been proposed to alleviate functional gastrointestinal symptoms. A major focus of this approach is salicylates. This study aimed to address the potential role of dietary salicylates in the induction of symptoms in patients with irritable bowel syndrome (IBS). Methods A pilot, double‐blind, randomized, cross‐over trial of 2‐week low‐ versus high‐salicylate diets (6.6 and 27.9 g/day salicylate, respectively) was undertaken. All foods were provided containing minimal quantities of other potential food triggers. Gastrointestinal and extraintestinal symptoms were measured daily using a 100‐mm visual‐analogue‐scale. Results Ten participants with IBS completed the study, including one with known aspirin‐sensitivity. Overall, no differences in symptoms were observed (P = 0.625; Friedman test). However, clear symptom provocation was seen in the aspirin‐sensitive participant, with all abdominal symptoms and tiredness worsening during the high‐salicylate diet. A similar trend was seen in another participant, where abdominal symptoms gradually worsened during the high‐salicylate diet. Conclusions These results provide some evidence that food‐related salicylates may influence the genesis of symptoms in a subset of patients with IBS. A larger cohort is needed to determine the incidence of salicylate‐sensitivity and further evaluate the diet as a potential therapeutic target. The protocol was registered at www.anzctr.org.au (ACTRN12620001250921).
- Published
- 2021
- Full Text
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3. Nutrigenomics and Proteomics in Health and Disease : Towards a Systems-level Understanding of Gene-diet Interactions
- Author
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Martin Kussmann, Patrick J. Stover, Martin Kussmann, and Patrick J. Stover
- Subjects
- Intestines--Microbiology, Proteomics, Nutrition--Genetic aspects, Diet therapy
- Abstract
Now in a revised second edition, Nutrigenomics and Proteomics in Health and Disease brings together the very latest science based upon nutrigenomics and proteomics in food and health. Coverage includes many important nutraceuticals and their impact on gene interaction and health. Authored by an international team of multidisciplinary researchers, this book acquaints food and nutrition professionals with these new fields of nutrition research and conveys the state of the science to date. Thoroughly updated to reflect the most current developments in the field, the second edition includes six new chapters covering gut health and the personal microbiome; gut microbe-derived bioactive metabolites; proteomics and peptidomics in nutrition; gene selection for nutrigenomic studies; gene-nutrient network analysis, and nutrigenomics to nutritional systems biology. An additional five chapters have also been significantly remodelled. The new text includes a rethinking of in vitro and in vivo models with regard to their translatability into human phenotypes, and normative science methods and approaches have been complemented by more comprehensive systems biology-based investigations, deploying a multitude of omic platforms in an integrated fashion. Innovative tools and methods for statistical treatment and biological network analysis are also now included.
- Published
- 2017
4. Cooking for Special Diets
- Author
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Katherine Polenz, The Culinary Institute of America (CIA), Katherine Polenz, and The Culinary Institute of America (CIA)
- Subjects
- Cooking for the sick, Cooking, Diet therapy, Diet in disease
- Abstract
On-trend meal-away-from-home solutions for the growing number of diners on special diets The increasing prevalence of food allergies and dietary restrictions can make it difficult—or even impossible—for an ever-growing number of diners to enjoy foods prepared away from home. Many books deal with a single food issue, but for professional chefs who want to meet the demands of a skyrocketing customer base characterized by a diversity of special needs, Cooking for Special Diets is an indispensable resource. From cooking for gluten sensitivity, Celiac disease, and diabetes to crafting delicious, on-trend dishes void of nuts, shellfish, eggs, and other food allergens, this book provides comprehensive information on all of the most common dietary restrictions. This invaluable reference includes detailed instructions on choosing the right ingredients to address each type of diet, replacing and substituting for common allergens, and converting standardized recipes for cherished dishes to better suit every type of special dietary need. More than 225 recipes, organized by appetizers, soups, salads, entrées, side dishes, breads, and desserts Coverage includes creating meals for customers with food allergies as well as dietary restrictions related to heart disease, hypertension, high cholesterol, and cancer
- Published
- 2014
5. Cabbage ( Brassica oleracea var. capitata ): A food with functional properties aimed to type 2 diabetes prevention and management
- Author
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Maira Rubí Segura-Campos and Jonatan Jafet Uuh-Narvaez
- Subjects
endocrine system diseases ,biology ,business.industry ,Diet therapy ,nutritional and metabolic diseases ,Type 2 Diabetes Mellitus ,Brassica ,Type 2 diabetes ,biology.organism_classification ,medicine.disease ,Obesity ,Biotechnology ,Ingredient ,Diabetes Mellitus, Type 2 ,Functional food ,Functional Food ,Diabetes mellitus ,medicine ,Humans ,Brassica oleracea ,business ,Food Science - Abstract
Type 2 diabetes mellitus (T2DM) is increasing the prevalence worldwide at an alarming rate, becoming a serious public health problem that mainly affects developing countries. Functional food research is currently of great interest because it contributes to developing nutritional therapy strategies for T2DM prevention and treatment. Bioactive compounds identified in some plant foods contribute to human health by mechanisms of action that exert biological effects on metabolic pathways involved in the development of T2DM. Hence, vegetables with high bioactive compounds content may be a source of functional value for the control of T2DM. Cabbages varieties (Brassica oleracea var. capitata) such as green (GCB), white (WCB), and red (RCB) are foods consumed (raw or cooked) and cultivated in different regions of the world. Scientific evidence shows that cabbage has multi-target effects on glucose homeostatic regulation due to its high content of bioactive compounds. It has also been shown to decrease damage to organs affected by T2DM complications, such as the liver and kidney. Additionally, it could contribute as a preventive by attenuating problems underlying the development of T2DM as oxidative stress and obesity. This review highlights the functional properties of cabbage varieties involved in glucose regulation and the main mechanisms of the action exerted by their bioactive compounds. In conclusion, cabbage is a valuable food that can be employed as part of nutritional therapy or functional ingredient aimed at the prevention and treatment of T2DM.
- Published
- 2021
6. Modified Crohn's disease exclusion diet is equally effective as exclusive enteral nutrition: Real‐world data
- Author
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Zrinjka Mišak, Iva Hojsak, Sara Sila, Tena Niseteo, Ivana Trivić, and Sanja Kolaček
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Diet therapy ,Medicine (miscellaneous) ,Enteral Nutrition ,Crohn Disease ,Internal medicine ,medicine ,Humans ,Exclusion diet ,Medical nutrition therapy ,Child ,Retrospective Studies ,Crohn's disease ,Nutrition and Dietetics ,business.industry ,Remission Induction ,enteral nutrition ,malnutrition ,nutrition therapy ,remission ,medicine.disease ,Diet ,Parenteral nutrition ,Female ,medicine.symptom ,business ,Weight gain ,Real world data ,Body mass index - Abstract
Background: Data on the efficacy of the newly established dietetic treatment of Crohn's disease (CD), the CD exclusion diet (CDED), are scarce. The aim of this study was to provide real-world data on the efficacy of CDED in comparison with exclusive enteral nutrition (EEN) for remission induction. Methods: A retrospective analysis of children diagnosed with CD who were treated with CDED + partial EN (PEN) or with EEN was performed. Eighty percent of the children assigned to CDED + PEN underwent 1-2 weeks of EEN prior to CDED + PEN. For all children, data from the medical charts were extracted before the introduction of diet therapy and at the end of EEN or CDED + PEN phase 1. Results: A total of 61 patients (49.2% females ; median age, 14.4 years [minimum: 6.7, maximum: 17.9]) were included in the study ; 42 children (68.9%) achieved remission, 27 of 41 (65.9%) received EEN and 15 of 20 (75.0%) received CDED + PEN. There was no significant difference in the failure of nutrition therapy between the two groups (P = .469). Patients receiving CDED + PEN had significantly higher weight gain (P = .002) and increases in body mass index z- score (P = .001) compared with patients who received EEN alone. Conclusion: Treatment with CDED + PEN (with prior 1-2 weeks of EEN) has comparable efficacy to EEN therapy alone in inducing remission in children with CD, and it leads to better weight gain. Further studies are needed to confirm these results.
- Published
- 2021
7. Naturally‐occurring dietary salicylates in the genesis of functional gastrointestinal symptoms in patients with irritable bowel syndrome: Pilot study
- Author
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Sreepurna Malakar, Peter R. Gibson, Jane G. Muir, Caroline J Tuck, and Jacqueline Susanne Barrett
- Subjects
irritable bowel syndrome ,salicylates ,medicine.medical_specialty ,Hepatology ,Diet therapy ,business.industry ,Incidence (epidemiology) ,Gastroenterology ,Symptom provocation ,RC799-869 ,Original Articles ,Diseases of the digestive system. Gastroenterology ,medicine.disease ,diet therapy ,Internal medicine ,Cohort ,medicine ,Original Article ,In patient ,Abdominal symptoms ,business ,Irritable bowel syndrome ,Uncategorized - Abstract
Background and Aim An elimination‐rechallenge dietary approach targeting naturally‐occurring bioactive chemicals has been proposed to alleviate functional gastrointestinal symptoms. A major focus of this approach is salicylates. This study aimed to address the potential role of dietary salicylates in the induction of symptoms in patients with irritable bowel syndrome (IBS). Methods A pilot, double‐blind, randomized, cross‐over trial of 2‐week low‐ versus high‐salicylate diets (6.6 and 27.9 g/day salicylate, respectively) was undertaken. All foods were provided containing minimal quantities of other potential food triggers. Gastrointestinal and extraintestinal symptoms were measured daily using a 100‐mm visual‐analogue‐scale. Results Ten participants with IBS completed the study, including one with known aspirin‐sensitivity. Overall, no differences in symptoms were observed (P = 0.625; Friedman test). However, clear symptom provocation was seen in the aspirin‐sensitive participant, with all abdominal symptoms and tiredness worsening during the high‐salicylate diet. A similar trend was seen in another participant, where abdominal symptoms gradually worsened during the high‐salicylate diet. Conclusions These results provide some evidence that food‐related salicylates may influence the genesis of symptoms in a subset of patients with IBS. A larger cohort is needed to determine the incidence of salicylate‐sensitivity and further evaluate the diet as a potential therapeutic target. The protocol was registered at www.anzctr.org.au (ACTRN12620001250921)., This pilot randomised controlled trial (RCT) provides valuable data regarding the potential use of a diet low in naturally‐occurring dietary salicylates to reduce symptoms associated with common conditions such as irritable bowel syndrome.
- Published
- 2021
8. The Water Secret : The Cellular Breakthrough to Look and Feel 10 Years Younger
- Author
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Murad, Howard and Murad, Howard
- Subjects
- Skin--Care and hygiene, Beauty, Personal, Aging--Prevention, Diet therapy, Aging--Diet therapy
- Abstract
Description based on print version record.
- Published
- 2010
9. Dietary patterns and chronic kidney disease outcomes: A systematic review
- Author
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Geraldo Bezerra da Silva Junior, Juliana Gomes Ramalho de Oliveira, Antônio Augusto Ferreira Carioca, Simon D.S. Fraser, and Bárbara Cibelle Soares Farias Quintela
- Subjects
Adult ,medicine.medical_specialty ,Diet therapy ,Population ,030232 urology & nephrology ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,medicine ,Humans ,Medical nutrition therapy ,Renal Insufficiency, Chronic ,education ,Adverse effect ,education.field_of_study ,business.industry ,Public health ,General Medicine ,medicine.disease ,Diet ,Nephrology ,Disease Progression ,Life expectancy ,Observational study ,business ,Kidney disease - Abstract
Chronic kidney disease (CKD) is a serious public health problem and its prevalence is growing in many countries, often related to issues resulting from the lifestyle in growing economies and the population's life expectancy. Nutritional therapy is a beneficial but still neglected strategy for preventing CKD and delaying disease progression. The aim of this study was to assess the association of dietary patterns with CKD development and progression. Observational studies conducted in adult humans and the correlation between the adopted dietary pattern and prevalent and incident cases of CKD were assessed. A significant association was observed between unhealthy dietary patterns and an increased risk of developing or worsening CKD, as well as an adverse effect. Whereas healthy eating patterns characterized by the consumption of fruit, vegetables, and dietary fiber showed nephroprotective outcomes. This article is protected by copyright. All rights reserved.
- Published
- 2021
10. Exercise physiology in cirrhosis and the potential benefits of exercise interventions: A review
- Author
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Brooke Chapman, Jack West, Marie Sinclair, Paul J Gow, and Adam G Testro
- Subjects
Liver Cirrhosis ,Sarcopenia ,medicine.medical_specialty ,Cirrhosis ,End Stage Liver Disease ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,medicine ,Humans ,Muscle Strength ,Exercise physiology ,Intensive care medicine ,Exercise ,Aerobic capacity ,Exercise Tolerance ,Frailty ,Hepatology ,Mechanism (biology) ,business.industry ,Gastroenterology ,medicine.disease ,Exercise Therapy ,Review article ,Clinical research ,030220 oncology & carcinogenesis ,Body Composition ,Exercise Test ,Quality of Life ,030211 gastroenterology & hepatology ,business ,Diet Therapy - Abstract
Reduction in muscle mass is a highly prevalent phenomenon in cirrhosis and is now well-documented to be associated with significant morbidity and mortality. Research into muscle loss in cirrhosis remains limited by an ongoing poor understanding of its relationship with muscle function, physical activity, and aerobic capacity. Alterations in exercise physiology have been documented in studies of individuals with cirrhosis that provide important information on physical function that is not captured by simple quantification of muscle mass. Despite expert consensus recommending regular exercise in end-stage liver disease to maintain muscle mass and function, there is little evidence guiding clinicians as to which form of exercise or delivery mechanism is most effective. It also remains unproven whether any specific intervention can alter clinically relevant outcomes. This review article summarizes the available literature regarding the changes in exercise physiology observed in cirrhosis, the associated impact on physical capacity, and the results of existing trials that examine the potential benefits of exercise delivery in patients with cirrhosis, particularly pertaining to their impact on exercise physiology.
- Published
- 2021
11. Testing evolutionary explanations for the lifespan benefit of dietary restriction in fruit flies ( Drosophila melanogaster )
- Author
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Katy M. Monteith, Eevi Savola, Clara Montgomery, Fergal M Waldron, Pedro F. Vale, and Craig A. Walling
- Subjects
0106 biological sciences ,0301 basic medicine ,Calorie ,media_common.quotation_subject ,Longevity ,Zoology ,Biology ,Infections ,010603 evolutionary biology ,01 natural sciences ,03 medical and health sciences ,Stress, Physiological ,Pseudomonas ,Genetics ,medicine ,Animals ,bacteria ,Ecology, Evolution, Behavior and Systematics ,media_common ,Reproduction ,dietary restriction ,Original Articles ,Limiting ,Fecundity ,medicine.disease ,biology.organism_classification ,Biological Evolution ,infection ,Ageing ,Malnutrition ,Drosophila melanogaster ,030104 developmental biology ,ageing ,Wounds and Injuries ,Female ,Original Article ,diet ,General Agricultural and Biological Sciences ,Diet Therapy - Abstract
Dietary restriction (DR), limiting calories or specific nutrients without malnutrition, extends lifespan across diverse taxa. Traditionally, this lifespan extension has been explained as a result of diet-mediated changes in the trade-off between lifespan and reproduction, with survival favoured when resources are scarce. However, a recently proposed alternative suggests that the selective benefit of the response to DR is the maintenance of reproduction. This hypothesis predicts that lifespan extension is a side effect of benign laboratory conditions, and DR individuals would be frailer and unable to deal with additional stressors, and thus lifespan extension should disappear under more stressful conditions. We tested this by rearing outbred female fruit flies (Drosophila melanogaster) on 10 different protein:carbohydrate diets. Flies were either infected with a bacterial pathogen (Pseudomonas entomophila), injured with a sterile pinprick or unstressed. We monitored lifespan, fecundity and measures of ageing. DR extended lifespan and reduced reproduction irrespective of injury and infection. Infected flies on lower protein diets had particularly poor survival. Exposure to infection and injury did not substantially alter the relationship between diet and ageing patterns. These results do not provide support for lifespan extension under DR being a side effect of benign laboratory conditions. This article is protected by copyright. All rights reserved.
- Published
- 2021
12. Prescription for Drug Alternatives : All-natural Options for Better Health Without the Side Effects
- Author
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Balch, James F., Stengler, Mark, Young-Balch, Robin, Balch, James F., Stengler, Mark, and Young-Balch, Robin
- Subjects
- Drugs--Side effects--Prevention, Diet therapy, Naturopathy, Alternative medicine, Drugs--Side effects
- Abstract
The Ultimate Resource For Natural Alternatives To Prescription And Over-The-Counter Medications.'This book is essential reading for anyone who wants to take charge of his or her health. Read it to live long and well.'.?Hyla Cass, M.D., a.
- Published
- 2008
13. Management of gestational diabetes in women with a concurrent severe acute respiratory syndrome coronavirus 2 infection, experience of a single center in Northern Italy
- Author
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Ilma Floriana Carbone, Daniela Di Martino, Enrico Ferrazzi, Gabriele Rossi, Chiara Maria Soldavini, Francesco D'Ambrosi, Giulia Emily Cetera, Matteo Di Maso, and Valeria Maggi
- Subjects
Adult ,Pediatrics ,medicine.medical_specialty ,Diet therapy ,medicine.medical_treatment ,Asymptomatic ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Intensive care ,Obstetrics and Gynaecology ,Humans ,Hypoglycemic Agents ,Insulin ,Medicine ,Labor, Induced ,030212 general & internal medicine ,Pregnancy Complications, Infectious ,Retrospective Studies ,Mechanical ventilation ,030219 obstetrics & reproductive medicine ,Cesarean Section ,business.industry ,Infant, Newborn ,COVID-19 ,Obstetrics and Gynecology ,Retrospective cohort study ,General Medicine ,medicine.disease ,Gestational diabetes ,Diabetes, Gestational ,Italy ,Concomitant ,Asymptomatic Diseases ,Female ,medicine.symptom ,business - Abstract
OBJECTIVE: In this study we describe the management of women with gestational diabetes (GD) and an ongoing Sars-Cov-2 infection. The aim of the study is to evaluate whether the COVID-19 infection can further complicate pregnancies and thus if the protocol we usually use for GDM pregnancies is also applicable to patients who have contracted a Sars-Cov-2 infection. METHODS: This is a retrospective study analysing all pregnant women with gestational diabetes and a concomitant COVID-19 infection admitted to our Institution for antenatal care between March 1st and April 30th 2020. RESULTS: Among pregnant women with GD and a concomitant COVID-19 infection, the mean age was 32,9 (SD 5,6) years. Two patients (33%) were of Caucasian ethnicity while four (67%) were non-Caucasian. All patients were diagnosed with COVID-19 during the third trimester of pregnancy. Two women were asymptomatic while four were symptomatic. Only two patients (33,3%) received treatment with insulin. None of the patients required intensive care or mechanical ventilation. No complications were found among the newborns. CONCLUSION: the COVID-19 infection was not found to worsen the prognosis of GD patients or of their offspring. Glycaemic monitoring, diet therapy and insulin, when needed, are sufficient for a good metabolic control and a favourable maternal and fetal outcome.
- Published
- 2020
14. A mechanistic review: potential chronic disease‐preventive properties of sorghum
- Author
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Seong-Ho Lee, Dmitriy Smolensky, Wu-Joo Lee, Zhiyuan Lou, and Darshika Amarakoon
- Subjects
Reduced risk ,Research groups ,030309 nutrition & dietetics ,03 medical and health sciences ,0404 agricultural biotechnology ,Alcohol production ,medicine ,Animals ,Humans ,Sorghum ,0303 health sciences ,Nutrition and Dietetics ,biology ,business.industry ,food and beverages ,04 agricultural and veterinary sciences ,medicine.disease ,biology.organism_classification ,040401 food science ,Obesity ,Biotechnology ,Chronic disease ,Domestic animal ,Chronic Disease ,business ,Agronomy and Crop Science ,Diet Therapy ,Food Science - Abstract
Sorghum is one of the most widely cultivated crops, and is used in foods, domestic animal feedstuffs, alcohol production, and biofuels. Recently, many research groups have demonstrated that sorghum contains various components that are strongly associated with the prevention of major human chronic diseases such as obesity, diabetes, atherosclerosis, cancer, and inflammation. However, to use sorghum more widely as a food for the potential prevention and treatment of human chronic diseases, more studies will be required to elucidate the biological mechanisms. In this review paper, we highlight multiple findings to propose a mechanistic link between sorghum consumption and reduced risk of chronic diseases. © 2020 Society of Chemical Industry.
- Published
- 2020
15. Managing People with Diabetes Fasting for Ramadan During the COVID‐19 Pandemic: A South Asian Health Foundation Update
- Author
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Wasim Hanif, S Hanif, Mohamed Hassanein, Kamlesh Khunti, and S.N. Ali
- Subjects
Gerontology ,Endocrinology, Diabetes and Metabolism ,Review ,0302 clinical medicine ,Endocrinology ,Pandemic ,030212 general & internal medicine ,Disease management (health) ,Holidays ,Dehydration ,Diabetes ,Disease Management ,Fasting ,humanities ,Coronavirus Infections ,Diabetic ketoacidosis ,Diet therapy ,Pneumonia, Viral ,Reviews ,030209 endocrinology & metabolism ,Hypoglycemia ,Islam ,Risk Assessment ,Diabetic Ketoacidosis ,Betacoronavirus ,03 medical and health sciences ,COVID‐19 ,Diabetes mellitus ,Internal Medicine ,medicine ,Humans ,Hypoglycemic Agents ,Risk factor ,Pandemics ,Ramadan ,SARS-CoV-2 ,business.industry ,pandemic ,COVID-19 ,Ketosis ,medicine.disease ,United Kingdom ,Diabetes Mellitus, Type 1 ,Diabetes Mellitus, Type 2 ,Hyperglycemia ,Fluid Therapy ,Hyperglycemic Hyperosmolar Nonketotic Coma ,business ,Diet Therapy - Abstract
The month of Ramadan forms one of the five pillars of the Muslim faith. Adult Muslims are obligated to keep daily fasts from dawn to sunset, with exceptions. This year Ramadan is due to begin on 23 April 2020 and the longest fast in the UK will be approximately 18 hours in length. In addition, due to the often high‐calorie meals eaten to break the fast, Ramadan should be seen as a cycle of fasting and feasting. Ramadan fasting can impact those with diabetes, increasing the risk of hypoglycaemia, hyperglycaemia and dehydration. This year, Ramadan will occur during the global COVID‐19 pandemic. Reports show that diabetes appears to be a risk factor for more severe disease with COVID‐19. In addition, the UK experience has shown diabetes and COVID‐19 is associated with dehydration, starvation ketosis, diabetic ketoacidosis and hyperglycaemic hyperosmolar state. This makes fasting in Ramadan particularly challenging for those Muslims with diabetes. Here, we discuss the implications of fasting in Ramadan during the COVID‐19 pandemic and make recommendations for those with diabetes who wish to fast.
- Published
- 2020
16. The Role of Diet and Nutrition in Migraine Triggers and Treatment: A Systematic Literature Review
- Author
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Louise Lombard, Nada Hindiyeh, Sheena K. Aurora, Mallory Farrar, Pixy Banerjee, and Niushen Zhang
- Subjects
medicine.medical_specialty ,Migraine Disorders ,medicine.medical_treatment ,Psychological intervention ,MEDLINE ,Review Article ,triggers ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,medicine ,Humans ,migraine ,patterns ,030212 general & internal medicine ,Review Articles ,intervention ,business.industry ,Feeding Behavior ,Precipitating Factors ,medicine.disease ,Checklist ,Diet ,Systematic review ,Neurology ,Migraine ,Observational study ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Diet Therapy ,Ketogenic diet - Abstract
Background Migraine is a disabling primary headache disorder often associated with triggers. Diet-related triggers are a common cause of migraine and certain diets have been reported to decrease the frequency of migraine attacks if dietary triggers or patterns are adjusted. Objective The systematic literature review was conducted to qualitatively summarize evidence from the published literature regarding the role of diet patterns, diet-related triggers, and diet interventions in people with migraine. Methods A literature search was carried out on diet patterns, diet-related triggers, and diet interventions used to treat and/or prevent migraine attacks, using an a priori protocol. MEDLINE and EMBASE databases were searched to identify studies assessing the effect of diet, food, and nutrition in people with migraine aged ≥18 years. Only primary literature sources (randomized controlled trials or observational studies) were included and searches were conducted from January 2000 to March 2019. The NICE checklist was used to assess the quality of the included studies of randomized controlled trials and the Downs and Black checklist was used for the assessment of observational studies. Results A total of 43 studies were included in this review, of which 11 assessed diet patterns, 12 assessed diet interventions, and 20 assessed diet-related triggers. The overall quality of evidence was low, as most of the (68%) studies assessing diet patterns and diet-related triggers were cross-sectional studies or patient surveys. The studies regarding diet interventions assessed a variety of diets, such as ketogenic diet, elimination diets, and low-fat diets. Alcohol and caffeine uses were the most common diet patterns and diet-related triggers associated with increased frequency of migraine attacks. Most of the diet interventions, such as low-fat and elimination diets, were related to a decrease in the frequency of migraine attacks. Conclusions There is limited high-quality randomized controlled trial data on diet patterns or diet-related triggers. A few small randomized controlled trials have assessed diet interventions in preventing migraine attacks without strong results. Although many patients already reported avoiding personal diet-related triggers in their migraine management, high-quality research is needed to confirm the effect of diet in people with migraine.
- Published
- 2020
17. KCNT1‐related epilepsy: An international multicenter cohort of 27 pediatric cases
- Author
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Felippe Borlot, Sheffali Gulati, Kenneth A. Myers, Brahim Tabarki, Sangeetha Yoganathan, Tova Hershkovitz, Jitendra Kumar Sahu, Musaad Abukhalid, Elisabeth Simard-Tremblay, Ahmed Abushama, Vivek Jain, Shatha Shafi, Hesham Aldhalaan, Kollencheri Puthenveettil Vinayan, Leticia Pereira de Brito Sampaio, Ravindra Arya, Salleh N. Ehaideb, Hiroshi Otsubo, Robyn Whitney, Hanin S. Almuzaini, Maria Zak, Aimee F. Luat, Majid Alfadhel, Suvasini Sharma, Lokesh Lingappa, Nadine Morrison-Levy, Prateek Kumar Panda, Vykuntaraju K. Gowda, Priyanka Madaan, Ramesh Konanki, Maya Thomas, Puneet Jain, and Elizabeth J. Donner
- Subjects
Male ,0301 basic medicine ,Drug Resistant Epilepsy ,Pediatrics ,medicine.medical_specialty ,Microcephaly ,Diet therapy ,medicine.medical_treatment ,Nerve Tissue Proteins ,Potassium Channels, Sodium-Activated ,Cohort Studies ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Atrophy ,Humans ,Medicine ,Genetic Association Studies ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Focal tonic seizures ,Magnetic resonance imaging ,medicine.disease ,Quinidine ,Cross-Sectional Studies ,030104 developmental biology ,Neurology ,Child, Preschool ,Cohort ,Anticonvulsants ,Female ,Epilepsies, Partial ,Neurology (clinical) ,Diet, Ketogenic ,business ,030217 neurology & neurosurgery ,Ketogenic diet - Abstract
Objective Through international collaboration, we evaluated the phenotypic aspects of a multiethnic cohort of KCNT1-related epilepsy and explored genotype-phenotype correlations associated with frequently encountered variants. Methods A cross-sectional analysis of children harboring pathogenic or likely pathogenic KCNT1 variants was completed. Children with one of the two more common recurrent KCNT1 variants were compared with the rest of the cohort for the presence of particular characteristics. Results Twenty-seven children (15 males, mean age = 40.8 months) were included. Seizure onset ranged from 1 day to 6 months, and half (48.1%) exhibited developmental plateauing upon onset. Two-thirds had epilepsy of infancy with migrating focal seizures (EIMFS), and focal tonic seizures were common (48.1%). The most frequent recurrent KCNT1 variants were c.2800G>A; p.Ala934Thr (n = 5) and c.862G>A; p.Gly288Ser (n = 4). De novo variants were found in 96% of tested parents (23/24). Sixty percent had abnormal magnetic resonance imaging (MRI) findings. Delayed myelination, thin corpus callosum, and brain atrophy were the most common. One child had gray-white matter interface indistinctness, suggesting a malformation of cortical development. Several antiepileptic drugs (mean = 7.4/patient) were tried, with no consistent response to any one agent. Eleven tried quinidine; 45% had marked (>50% seizure reduction) or some improvement (25%-50% seizure reduction). Seven used cannabidiol; 71% experienced marked or some improvement. Fourteen tried diet therapies; 57% had marked or some improvement. When comparing the recurrent variants to the rest of the cohort with respect to developmental trajectory, presence of EIMFS, >500 seizures/mo, abnormal MRI, and treatment response, there were no statistically significant differences. Four patients died (15%), none of sudden unexpected death in epilepsy. Significance Our cohort reinforces common aspects of this highly pleiotropic entity. EIMFS manifesting with refractory tonic seizures was the most common. Cannabidiol, diet therapy, and quinidine seem to offer the best chances of seizure reduction, although evidence-based practice is still unavailable.
- Published
- 2020
18. Efficacy and safety of trelagliptin in Japanese patients with type 2 diabetes with severe renal impairment or end‐stage renal disease: Results from a randomized, phase 3 study
- Author
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Yuusuke Umeda, Kohei Kaku, Kazuyuki Ishida, Kohei Shimizu, and Meguru Achira
- Subjects
Male ,medicine.medical_specialty ,Chronic kidney failure ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,030232 urology & nephrology ,Renal function ,030209 endocrinology & metabolism ,Type 2 diabetes ,Placebo ,Gastroenterology ,Diseases of the endocrine glands. Clinical endocrinology ,End stage renal disease ,03 medical and health sciences ,0302 clinical medicine ,Trelagliptin ,Asian People ,Double-Blind Method ,Japan ,Internal medicine ,Diabetes mellitus ,Type 2 diabetes mellitus ,Internal Medicine ,medicine ,Humans ,Hypoglycemic Agents ,Renal Insufficiency ,Uracil ,Aged ,Glycated Hemoglobin ,Dipeptidyl-Peptidase IV Inhibitors ,business.industry ,Incidence (epidemiology) ,Type 2 Diabetes Mellitus ,General Medicine ,Articles ,Middle Aged ,medicine.disease ,RC648-665 ,Clinical Trial ,Exercise Therapy ,Clinical Science and Care ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,Kidney Failure, Chronic ,Female ,Hemodialysis ,business ,Diet Therapy - Abstract
Introduction To investigate the efficacy and safety of trelagliptin 25 mg in patients with type 2 diabetes mellitus with severe renal impairment or end‐stage renal disease. Materials and Methods This multicenter, randomized, phase 3 study comprised a 12‐week double‐blind phase followed by a 40‐week open‐label phase. Patients had type 2 diabetes mellitus with severe renal impairment (creatinine clearance, The efficacy and safety of trelagliptin 25 mg in patients with type 2 diabetes mellitus with severe renal impairment or end‐stage renal disease was investigated. Patients were randomized 1:1 to receive trelagliptin (A/A group, n = 55) or placebo (P/A group, n = 52) in a double‐blind manner (week 0 to the end of the double‐blind phase [week 12]); thereafter, both groups received trelagliptin in an open‐label manner until week 52. Once‐weekly trelagliptin 25 mg was efficacious, with no major safety concerns, and represents a meaningful treatment option in this patient population.
- Published
- 2020
19. Exploring the effectiveness of an 18‐month weight management intervention in adults with Down syndrome using propensity score matching
- Author
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Erik A. Willis, Joseph R. Sherman, Joseph E. Donnelly, David A. White, and Lauren T. Ptomey
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Calorie ,Developmental Disabilities ,Population ,Comorbidity ,Overweight ,Article ,Body Weight Maintenance ,Patient Education as Topic ,Arts and Humanities (miscellaneous) ,Weight loss ,Outcome Assessment, Health Care ,Weight management ,medicine ,Humans ,Obesity ,Propensity Score ,education ,education.field_of_study ,business.industry ,Rehabilitation ,medicine.disease ,Exercise Therapy ,Weight Reduction Programs ,Psychiatry and Mental health ,Neurology ,Propensity score matching ,Basal metabolic rate ,Female ,Neurology (clinical) ,Down Syndrome ,medicine.symptom ,business ,Diet Therapy - Abstract
Background Down syndrome (DS) is one of the most common birth defects in the USA associated with high levels of overweight and obesity. Unique characteristics of adults with DS that may contribute to the high levels of obesity are high rates of hypothyroidism, poor muscle tone, altered gait and lower resting metabolic rate. Due to these factors, it is unknown if the same weight management interventions that are effective in adults with intellectual or developmental disability (IDD) without DS are as effective in those with DS. Therefore, the purpose of this secondary analysis was to compare changes in weight, diet and physical activity between participants with DS-related and non-DS-related IDD participating in an 18-month weight management trial. Methods We used propensity score methods to adjust baseline variables of overweight/obese adults with and without DS participating in an 18-month effectiveness trial with 6 months weight loss and 12 months weight maintenance. Participants followed one of two reduced calorie diet plans, obtained 150 min of moderate-vigorous intensity physical activity (MVPA) per week, and logged dietary intake daily. A health educator held monthly at-home visits with participants and a caregiver to give feedback on intervention compliance. Results Out of the 124 participants that met the criteria for inclusion, 21 were diagnosed with DS and 103 with non-DS-related IDD. Twenty out of 21 participants with DS were successfully matched. Clinically significant weight loss was seen at 18 months in participants with DS (-5.2%) and non-DS-related IDD (-6.8%), with no difference between groups (P = 0.53). Significant reductions in energy intake were seen across the 18-month intervention in both DS and non-DS-related IDD groups with between-group differences at 12 months only (1119 vs. 1492 kcal/day, respectively; P = 0.003). Although MVPA did not increase in either group across the intervention, those with non-DS-related IDD had higher levels of MVPA compared with those with DS across 18 months. Conclusion Participants with DS lost a clinically significant amount of weight across the 18-month intervention. Compared with those with non-DS-related IDD, those with DS lost similar amounts of weight, had similar decreases in energy intake and participated in less MVPA across the 18-month intervention. Although individuals with DS have physiological factors that may contribute to obesity, weight management interventions designed for individuals with IDD may be equally effective in this population.
- Published
- 2020
20. In vivo efficacy of calcium phosphate‐based synthetic‐bone‐mineral on bone loss resulting from estrogen and mineral deficiencies
- Author
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Kritika Srinivasan, Denzil S. Zhang, Malvin N. Janal, Racquel Z. LeGeros, Dindo Q. Mijares, Yu Zhang, and Anupama Kulkarni Aranya
- Subjects
Calcium Phosphates ,0301 basic medicine ,medicine.medical_specialty ,Time Factors ,Materials science ,Bone density ,Normal diet ,Mineral deficiency ,Osteoporosis ,Biomedical Engineering ,Article ,Bone and Bones ,Rats, Sprague-Dawley ,Biomaterials ,03 medical and health sciences ,0302 clinical medicine ,Bone Density ,Internal medicine ,medicine ,Animals ,Humans ,Bone mineral ,Minerals ,030109 nutrition & dietetics ,Bone preservation ,Estrogens ,030206 dentistry ,medicine.disease ,Diet ,Rats ,Osteopenia ,Bone Diseases, Metabolic ,Endocrinology ,Mechanical Tests ,Ovariectomized rat ,Female ,Diet Therapy - Abstract
Osteopenia and osteoporosis affect over 40 million US adults 50 years and older. Both diseases are strongly influenced by estrogen and nutritional-mineral deficiencies. This study investigates the efficacy of orally delivered synthetic-bone-mineral (SBM), a newly developed calcium phosphate based biomaterial, on reversing bone loss induced by these two critical deficiencies. Thirty 3-month-old female rats were randomly allocated to either control-sham surgery on normal diet; or one of the four experimental groups: Sham surgery on a low mineral diet (LMD), ovariectomized (OVX) on LMD, OVX on LMD with SBM with/without fluoride (F). The rats were sacrificed after 6 months, at 9-month-old. After 6 months, although all groups lost bone mineral density relative to controls, the supplemented OVX rats showed higher bone mineral density than their unsupplemented counterparts. The 2 SBM supplemented groups improved bone loading capacity by 28.1 and 35.4% compared to the OVX LMD group. Bones from supplemented rats exhibited higher inorganic/organic ratios. The addition of F did not have a significant influence on bone loss. Our findings suggest that SBM supplement is effective in maintaining bone health and offsetting the deleterious effects of estrogen and/or mineral deficiencies on bone density, microarchitecture, and strength.
- Published
- 2019
21. Assessing the association between optimal energy intake and all‐cause mortality in older patients with diabetes mellitus using the Japanese Elderly Diabetes Intervention Trial
- Author
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Yukio Yoshimura, Takuya Omura, Hiroyuki Umegaki, Hideki Ito, Atsushi Araki, Chiemi Kamada, Takashi Sakurai, Takuya Yamaoka, Yasuo Ohashi, Yoshiaki Tamura, and Satoshi Iimuro
- Subjects
Male ,medicine.medical_specialty ,Diet therapy ,Population ,Body Mass Index ,Japan ,Internal medicine ,Diabetes mellitus ,Humans ,Medicine ,Prospective Studies ,education ,Original Article: Epidemiology, Clinical Practice and Health ,Exercise ,Aged ,Proportional Hazards Models ,education.field_of_study ,business.industry ,Proportional hazards model ,Mortality rate ,Body Weight ,Hazard ratio ,medicine.disease ,mortality ,Malnutrition ,diet therapy ,Diabetes Mellitus, Type 2 ,Quartile ,energy intake ,Regression Analysis ,Female ,elderly diabetes mellitus ,business ,bodyweight ,Follow-Up Studies - Abstract
Aim Selecting optimal energy intake during diet therapy for older patients with diabetes mellitus is difficult because of the large differences in physical function and comorbid diseases. In Japan, although requirements for total energy intake are calculated by multiplying a person's standard bodyweight (BW) by the amount of physical activity, evidence supporting the application of this method among older people is limited. Therefore, we aimed to assess optimal energy intake by evaluating the relationship between energy intake and mortality in older patients. Methods We evaluated data from a 6-year prospective follow up of 756 older patients with diabetes mellitus, and the association between baseline nutrient intake and mortality. Total energy intake and nutrients were evaluated, and energy intake per actual BW was categorized into quartiles (Q). Cox regression analysis was used for statistical analyses. Energy intake per standard BW or age-related target BW was statistically analyzed using the same protocol. Results Analysis of energy intake per actual BW showed that hazard ratios for mortality was significantly higher in Q1 and Q4. Similar associations were found for energy intake per standard or target BW. Subgroup analysis showed that mortality rate was the lowest in Q2 in the young-old population and in Q3 in the old-old population. Conclusions A U-shaped relationship was observed between energy intake per BW and mortality in older patients with diabetes mellitus, which suggests that the optimal energy intake per actual or target BW should encompass a wide range to prevent malnutrition and excessive nutrition in these patients. Geriatr Gerontol Int 2020; 20: 59-65.
- Published
- 2019
22. The Brain Wash : A Powerful, All-Natural Program to Protect Your Brain Against Alzheimer's, Chronic Fatigue Syndrome, Depression, Parkinson's, and Other Diseases
- Author
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Michelle Schoffro Cook and Michelle Schoffro Cook
- Subjects
- Diet therapy, Health behavior, Brain--Care and hygiene, Brain
- Abstract
A Powerful, All-Natural Program to Protect Your Brain Against Alzheimer's, Chronic Fatigue Syndrome, Depression, Parkinson's, and Other Brain Diseases. Scientists predict that within fifteen years brain disease will kill or disable more North Americans than cancer and heart disease combined. The Brain Wash is a powerful, holistic health plan based on the most cutting-edge brain, nutrition, and healing research. Combining thousands of scientific studies from around the globe, The Brain Wash offers a comprehensive, easy-to-follow approach proven to help protect your brain from damage. ••• The Ultimate Brain Health Plan ••• • Get individualized, proven prevention and treatment plans for Alzheimer's, depression, ALS (Lou Gehrig's Disease), Chronic Fatigue Syndrome, Attention Deficit Disorder, Multiple Chemical Sensitivities, Parkinson's, Multiple Sclerosis, and more. • Learn how everyday drugs, environmental pollutants, heavy metals, and pathogens cross the blood-brain barrier to wreak havoc on your brain. • Discover that your nutrition and lifestyle choices have been proven to be the key determinants in your brain's health--and what to do about it. Using brilliantly coloured foods and the most powerful natural medicines on earth, this book will show you how to strengthen your brain, prevent and treat disease, and enjoy your long life to its fullest.
- Published
- 2007
23. Comments on the Discussion Forum: Oromucosal immunomodulation as clinical spectrum mitigating factor in SARS‐CoV‐2 infection
- Author
-
Tej P. Singh, Sujata Sharma, and Michael L. Smith
- Subjects
viral < infections ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Immunology ,Iodine Compounds ,chemistry.chemical_element ,inflammation < processes ,Iodine ,Reference Daily Intake ,Virus ,Immunomodulation ,chemistry.chemical_compound ,Japan ,infection < diseases ,Immunity ,Pandemic ,Humans ,Medicine ,Lactoperoxidase ,SARS-CoV-2 ,Discussion Forum ,business.industry ,COVID-19 ,General Medicine ,Diet ,Hypoiodous acid ,lung < tissues ,chemistry ,human < subject ,business ,mucosa < tissues ,Diet Therapy - Abstract
The mammalian lactoperoxidase system, consisting of lactoperoxidase and the H2O2‐producing enzyme duox, is our first line of defence against airborne microbes. This system catalyses the production of hypoiodite and hypoiodous acid in the presence of sufficient iodine. These products are highly efficient at destroying the H1N1 virus and the respiratory syncytial virus (RSV). Japan has not been affected as much as other nations during the COVID‐19 pandemic (death rate about 10% of the United States), and we think this is due to a diet high in iodine. With this in mind, we suggest four actions to prevent SARS‐CoV‐2 infections. First, health professionals should study the preventative effect of increasing iodine in the diets of the aged, institutionalized, diabetics andsmokers. Second, the recommended daily intake (RDI) for iodine should be significantly increased, to at least double, the current RDI. Governments should encourage the use and distribution of cheap iodized salts, kelp and seaweed. Third, more research should be done around the physiology and the protective effects of the lactoperoxidase system. Finally, the degradation products of the SARS‐CoV‐2 viral particle by hypoiodite and hypoiodous acid should be characterized; portions of the damaged particle are likely to elicit stronger immunity and better vaccines.
- Published
- 2021
24. Development of a Family Support Scale for Diet Therapy for Male Workers with type 2 diabetes
- Author
-
Michiko Inagaki, Mizuyo Nagamune, Mai Kitagawa, Keiko Tasaki, Mayumi Okuwa, Yuya Asada, and Tomomi Horiguchi
- Subjects
Male ,Gerontology ,Psychometrics ,Research and Theory ,Diet therapy ,business.industry ,Family support ,Reproducibility of Results ,Type 2 diabetes ,medicine.disease ,Exploratory factor analysis ,Social support ,Cross-Sectional Studies ,Diabetes Mellitus, Type 2 ,Cronbach's alpha ,Surveys and Questionnaires ,Diabetes mellitus ,Scale (social sciences) ,medicine ,Humans ,Factor Analysis, Statistical ,business - Abstract
Aim Dietary self-care for patients with type 2 diabetes can be improved with family support. The purpose of this study was to develop a scale to assess family support for diet therapy for male workers with type 2 diabetes and to examine its reliability and validity. Methods In this cross-sectional study, we collected data from 110 Japanese male workers with type 2 diabetes. Data were analyzed using exploratory factor analysis, reliability testing, and validity testing. Results The resultant Family Support Scale for Diet Therapy for Male Workers (FSS-DMW) with type 2 diabetes consisted of 31 items and a six-factor structure. The six factors explained 72.9% of the variance, and Cronbach's alpha for the total scale was .964. The scale correlated as expected with the Social Support Scale for Chronic Illness and the dietary subscale of the Japanese version of the Summary of Diabetes Self-Care Activities Measure. Conclusion The FSS-DMW is a reliable and valid measure which can be used to assess family support for diet therapy for male workers with type 2 diabetes and has the potential to be used as a clinical instrument for family guidance.
- Published
- 2021
25. Laryngopharyngeal Reflux Disease is More Severe in Obese Patients: A Prospective Multicenter Study
- Author
-
Francois Bobin, Jerome R. Lechien, Sven Saussez, Stéphane Hans, and Vinciane Muls
- Subjects
Adult ,Male ,medicine.medical_specialty ,Esophageal pH Monitoring ,Alginates ,Disease ,Overweight ,Severity of Illness Index ,Gastroenterology ,Endoscopy, Gastrointestinal ,03 medical and health sciences ,Laryngopharyngeal reflux ,0302 clinical medicine ,Internal medicine ,Electric Impedance ,Laryngopharyngeal Reflux ,Prevalence ,medicine ,Humans ,Obesity ,Prospective Studies ,030223 otorhinolaryngology ,Aged ,business.industry ,Reflux ,Proton Pump Inhibitors ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Hypopharynx ,Otorhinolaryngology ,Multicenter study ,Research Design ,030220 oncology & carcinogenesis ,Gastroesophageal Reflux ,GERD ,Female ,medicine.symptom ,business ,Body mass index ,Diet Therapy - Abstract
Objectives/hypothesis To investigate whether there is an impact of obesity and overweight on the clinical findings and therapeutic responses of patients with laryngopharyngeal reflux (LPR). Study design Prospective uncontrolled. Methods Patients with LPR-related symptoms and positive LPR diagnosis at the hypopharyngeal-esophageal multichannel intraluminal impedance pH-monitoring (HEMII-pH) were recruited from December 2017 to December 2020. Patients were treated with a combination of diet, proton pump inhibitors, and alginate for 3 to 6 months. The following outcomes were studied according to the weight of patients: HEMII-pH, gastrointestinal endoscopy features, symptoms, findings, and therapeutic response. Results A total of 262 patients completed the study, accounting for 134, 85, and 43 patients with normal weight (body mass index [BMI] 30). Obese patients reported significant higher prevalence of gastroesophageal reflux disease (GERD), acid LPR, and a more severe LPR disease regarding the number of pharyngeal reflux events, reflux symptom score (RSS), and reflux sign assessment (RSA). RSS and RSA scores significantly improved from baseline to 3-month posttreatment irrespective of the patient weight group. Symptoms and signs continued to improve from 3 to 6-month posttreatment only in patients with a normal weight. Conclusion Obesity is associated with a more severe LPR disease and a higher proportion of GERD and acid LPR. Obese LPR patients may require more frequently PPI-therapy regarding the higher prevalence of GERD. Level of evidence 3 Laryngoscope, 131:E2742-E2748, 2021.
- Published
- 2021
26. Assessing the impact of diet, exercise and the combination of the two as a treatment for OSA: A systematic review and meta‐analysis
- Author
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Terry Haines, Alan Young, Helen Truby, Ai-Ming Wong, Claire C. Bristow, Bradley A. Edwards, Ladan Ghazi, Zoe E. Davidson, Garun S. Hamilton, and Denise M. O'Driscoll
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Psychological intervention ,Intervention group ,law.invention ,stomatognathic system ,Randomized controlled trial ,law ,Weight loss ,Intervention (counseling) ,Lifestyle intervention ,medicine ,Humans ,Randomized Controlled Trials as Topic ,Sleep Apnea, Obstructive ,business.industry ,Exercise Therapy ,nervous system diseases ,respiratory tract diseases ,Treatment Outcome ,Meta-analysis ,Physical therapy ,medicine.symptom ,business ,Risk Reduction Behavior ,Body mass index ,Diet Therapy - Abstract
This study aimed to provide an updated systematic review and meta-analysis of randomized controlled trials (RCT) investigating the effectiveness of lifestyle interventions on weight loss and the impact on the severity of obstructive sleep apnoea (OSA). A systematic search of five databases between 1980 and May 2018 was used to identify all RCT which employed a lifestyle intervention (i.e. diet-only, exercise-only or combination of the two) aiming to reduce the severity of OSA (assessed using the apnoea-hypopnoea index (AHI)). Random-effects meta-analyses followed by meta-regression were conducted. Ten RCT involving 702 participants (Intervention group: n = 354; Control group: n = 348) were assessed in two meta-analyses. The weighted mean difference in AHI (-8.09 events/h, 95% CI: -11.94 to -4.25) and body mass index (BMI, -2.41 kg/m(2), 95% CI: -4.09 to -0.73) both significantly favoured lifestyle interventions over control arms. Subgroup analyses demonstrated that all interventions were associated with reductions in the AHI, but only the diet-only interventions were associated with a significant reduction in BMI. No association was found between the reduction in AHI or BMI and the length of the intervention, or with baseline AHI and BMI levels. All lifestyle interventions investigated appear effective for improving OSA severity and should be an essential component of treatment for OSA. Future research should be directed towards identifying subgroups likely to reap greater treatment benefits as well as other therapeutic benefits provided by these interventions.
- Published
- 2019
27. Current therapies and therapeutic decision making for childhood‐onset movement disorders
- Author
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Shekeeb S. Mohammad, Russell C. Dale, and Simon P Paget
- Subjects
0301 basic medicine ,Movement disorders ,Deep Brain Stimulation ,Dopamine Agents ,Cell- and Tissue-Based Therapy ,Psychological intervention ,Disease ,0302 clinical medicine ,Botulinum Toxins, Type A ,Child ,Chelating Agents ,Dystonia ,Movement Disorders ,Parkinsonism ,Immunoglobulins, Intravenous ,Neuromuscular Agents ,Neurology ,Anticonvulsants ,medicine.symptom ,Adrenergic alpha-Agonists ,medicine.medical_specialty ,Monoamine Oxidase Inhibitors ,Tics ,GABA Agents ,Clinical Decision-Making ,Chenodeoxycholic Acid ,03 medical and health sciences ,Autoimmune Diseases of the Nervous System ,Organophosphorus Compounds ,Gastrointestinal Agents ,medicine ,Humans ,Immunologic Factors ,Enzyme Replacement Therapy ,Neurochemistry ,Intensive care medicine ,Glucocorticoids ,Cannabinoids ,business.industry ,Genetic Therapy ,medicine.disease ,Precision medicine ,Pterins ,030104 developmental biology ,Dietary Supplements ,Neurology (clinical) ,business ,Metabolism, Inborn Errors ,030217 neurology & neurosurgery ,Diet Therapy - Abstract
Movement disorders differ in children to adults. First, neurodevelopmental movement disorders such as tics and stereotypies are more prevalent than parkinsonism, and second, there is a genomic revolution which is now explaining many early-onset dystonic syndromes. We outline an approach to children with movement disorders starting with defining the movement phenomenology, determining the level of functional impairment due to abnormal movements, and screening for comorbid psychiatric conditions and cognitive impairments which often contribute more to disability than the movements themselves. The rapid improvement in our understanding of the etiology of movement disorders has resulted in an increasing focus on precision medicine, targeting treatable conditions and defining modifiable disease processes. We profile some of the key disease-modifying therapies in metabolic, neurotransmitter, inflammatory, and autoimmune conditions and the increasing focus on gene or cellular therapies. When no disease-modifying therapies are possible, symptomatic therapies are often all that is available. These classically target dopaminergic, cholinergic, alpha-adrenergic, or GABAergic neurochemistry. Increasing interest in neuromodulation has highlighted that some clinical syndromes respond better to DBS, and further highlights the importance of "disease-specific" therapies with a future focus on individualized therapies according to the genomic findings or disease pathways that are disrupted. We summarize some pragmatic applications of symptomatic therapies, neuromodulation techniques, and some rehabilitative interventions and provide a contemporary overview of treatment in childhood-onset movement disorders. © 2019 International Parkinson and Movement Disorder Society.
- Published
- 2019
28. An expert recommendation on salt intake and blood pressure management in Chinese patients with hypertension: A statement of the Chinese Medical Association Hypertension Professional Committee
- Author
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Ningling, Sun, Jianjun, Mu, Yuming, Li, and Zhiming, Zhu
- Subjects
Male ,China ,medicine.medical_specialty ,Potassium intake ,Endocrinology, Diabetes and Metabolism ,Sodium ,chemistry.chemical_element ,Blood Pressure ,Sodium Chloride ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Asian People ,Risk Factors ,Ventricular hypertrophy ,Internal medicine ,Guidelines on Sodium: China ,Prevalence ,Internal Medicine ,Humans ,Medicine ,In patient ,030212 general & internal medicine ,Sodium Chloride, Dietary ,Salt intake ,Randomized Controlled Trials as Topic ,Aged, 80 and over ,Blood pressure management ,Ventricular Remodeling ,business.industry ,Incidence (epidemiology) ,Blood Pressure Determination ,Feeding Behavior ,Hypertrophy ,medicine.disease ,Sodium salt ,Stroke ,chemistry ,Cardiovascular Diseases ,Hypertension ,Female ,Cardiology and Cardiovascular Medicine ,business ,Diet Therapy - Abstract
The occurrence of hypertension is influenced by combined actions of genetic and environmental factors. Among environmental factors, high salt intake is considered as one of the most important and critical dietary factors. High salt intake is closely related to the incidence and mortality of cardiac and cerebrovascular events, as well as ventricular hypertrophy, renal damage, and other target organ damages. The existing data show that the daily sodium salt intake of Chinese population is significantly higher than that of European and American populations, and it generally exceeds the standard. Therefore, sodium and potassium intake in patients with hypertension should be actively assessed to carry out targeted treatment, which is an important strategy in blood pressure management. According to the characteristics of high prevalence of hypertension, high sodium salt intake, and low blood pressure control rate in China, Chinese Medical Association Hypertension Professional Committee believes that it is necessary to promote salt restriction and formulate the assessment of salt intake and clinical process of blood pressure management according to the current status of sodium intake.
- Published
- 2019
29. Improving the effectiveness of lifestyle interventions for gestational diabetes prevention: a meta-analysis and meta-regression
- Author
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Jian-Zhong Sheng, Tiantian Yu, Ji Mx, Chen Xp, Xin-Mei Liu, He-Feng Huang, Guo Xy, Shu J, Fu Xh, and Lei Zhang
- Subjects
medicine.medical_specialty ,Population ,Psychological intervention ,Overweight ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Internal medicine ,medicine ,Humans ,Obesity ,education ,education.field_of_study ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics and Gynecology ,medicine.disease ,Exercise Therapy ,Pregnancy Complications ,Gestational diabetes ,Diabetes, Gestational ,Relative risk ,Meta-analysis ,Regression Analysis ,Female ,medicine.symptom ,business ,Body mass index ,Diet Therapy - Abstract
Background Diet and exercise during pregnancy have been used to prevent gestational diabetes mellitus (GDM) with some success. Objective To examine the effectiveness of lifestyle intervention on GDM prevention and to identify key effectiveness moderators to improve the prevention strategy. Search strategy Pubmed, Scopus, Cochrane, and cross-references were searched. Selection criteria Randomised controlled trials (RCTs) evaluating lifestyle interventions during pregnancy for GDM prevention. Data collection and analysis Two independent reviewers extracted data. A random-effects model was used to analyse the relative risk (RR) and 95% confidence interval (95% CI). Meta-regressions and subgroup analyses were used to investigate important moderators of effectiveness. Main results Forty-seven RCTs involving 15 745 participants showed that diet and exercise during pregnancy were preventive of GDM (RR 0.77, 95% CI 0.69-0.87). Four key aspects were identified to improve the preventive effect: targeting the high-risk population; an early initiation of the intervention; the correct intensity and frequency of exercise; and gestational weight gain management. Although 24 RCTs targeted women who were overweight or obese, body mass index (BMI) failed to predict the effectiveness of an intervention. Instead, interventions are most effective in high-incidence populations rather than simply in women who are overweight or obese. Furthermore, exercise of moderate intensity for 50-60 minutes twice a week could lead to an approximately 24% reduction in GDM. Conclusion The best strategy to prevent GDM is to target the high-risk population predicted by risk evaluation models and to control the gestational weight gain of women through intensified diet and exercise modifications early in their pregnancy. Tweetable abstract Four key effectiveness moderators of lifestyle interventions for GDM prevention.
- Published
- 2018
30. RNA sequencing identifies global transcriptional changes in peripheral CD4 + cells during active oesophagitis and following epicutaneous immunotherapy in eosinophilic oesophagitis
- Author
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Kathleen E. Sullivan, Kelly Maurer, Melanie A. Ruffner, Zhe Zhang, Amanda B. Muir, Jonathan M. Spergel, and Antonella Cianferoni
- Subjects
CD4‐positive lymphocytes ,eosinophilic oesophagitis ,food allergy ,medicine.diagnostic_test ,Diet therapy ,business.industry ,medicine.medical_treatment ,Immunology ,Antigen presentation ,RNA sequencing ,Immunotherapy ,RC581-607 ,Gene signature ,Allergic inflammation ,Downregulation and upregulation ,interferon response ,Gene expression ,Biopsy ,Immunology and Allergy ,Medicine ,immunotherapy ,Immunologic diseases. Allergy ,business ,General Nursing - Abstract
Objective There are no disease‐modifying therapies for the treatment of eosinophilic oesophagitis (EoE), which is driven by non‐IgE‐mediated allergic inflammation. A recent clinical trial of milk epicutaneous immunotherapy (EPIT) has shown initial promise, with 47% of treated EoE patients tolerating milk without recurrence of disease. Mechanisms of EPIT in EoE have not been studied in humans. Here, we identify transcriptional changes in the peripheral CD4+ T‐cell compartment during active EoE and following EPIT. Methods RNA isolation, sequencing and integrative data analysis were performed on peripheral CD4+ T cells isolated from 15 of 20 patients enrolled in a clinical trial of EPIT for EoE. Gene expression changes in peripheral CD4+ T cells were examined during diet therapy and following trial of milk antigen EPIT. Results We identify 244 differentially expressed genes in peripheral blood CD4+ cells of EoE patients consuming versus those eliminating milk, and 129 DEGs in CD4+ cells were isolated after EPIT versus after placebo (FDR ≤ 0.05). Gene set enrichment analysis identifies enrichment of hallmark interferon‐α and interferon‐γ response pathways in peripheral CD4+ T cells from EoE patients during active disease on a milk‐containing diet. We demonstrate overlap of this gene signature with the altered gene expression signature seen in EoE patient biopsy tissue. EPIT therapy response is associated with significant enrichment in pathways related to T‐cell receptor signalling (P = 1.16 × 10−14), antigen presentation and costimulation, and cytokine signalling (P = 1.11 × 10−16), as well as upregulation of genes associated with regulatory T‐cell function. Conclusions EoE is associated with distinct global transcriptional changes in CD4+ T cells, one feature of which is an IFN response signature. Clinically favorable response to EPIT is likely multifactorial but is associated with a distinct transcriptional profile in peripheral CD4+ cells supporting the hypothesis that EPIT alters peripheral CD4+ responses in EoE patients.
- Published
- 2021
31. Current and emerging therapies for managing hyperphagia and obesity in Prader‐Willi syndrome: A narrative review
- Author
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Hein M. Tun, Joan C. Han, Lucila Triador, Catherine J. Field, Timo D. Müller, Edward C. Deehan, Andrea M. Haqq, Qiming Tan, and Camila E. Orsso
- Subjects
Male ,Pediatric Obesity ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Potassium Channels ,Adolescent ,Acylation ,Endocrinology, Diabetes and Metabolism ,Bariatric Surgery ,030209 endocrinology & metabolism ,Hyperphagia ,Oxytocin ,Growth hormone ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Animals ,Humans ,Effective treatment ,In patient ,030212 general & internal medicine ,Early childhood ,Child ,Intensive care medicine ,Early onset ,Human Growth Hormone ,business.industry ,Public Health, Environmental and Occupational Health ,Infant ,nutritional and metabolic diseases ,medicine.disease ,Obesity ,Ghrelin ,nervous system diseases ,Clinical trial ,Child, Preschool ,Receptor, Melanocortin, Type 4 ,Female ,Narrative review ,business ,Prader-Willi Syndrome ,Diet Therapy - Abstract
In early childhood, individuals with Prader-Willi syndrome (PWS) experience excess weight gain and severe hyperphagia with food compulsivity, which often leads to early onset morbid obesity. Effective treatments for appetite suppression and weight control are currently unavailable for PWS. Our aim to further understand the pathogenesis of PWS led us to carry out a comprehensive search of the current and emerging therapies for managing hyperphagia and extreme weight gain in PWS. A literature search was performed using PubMed and the following keywords: "PWS" AND "therapy" OR "[drug name]"; reference lists, pharmaceutical websites, and the ClinicalTrials.gov registry were also reviewed. Articles presenting data from current standard treatments in PWS and also clinical trials of pharmacological agents in the pipeline were selected. Current standard treatments include dietary restriction/modifications, exercise, and growth hormone replacement, which appear to have limited efficacy for appetite and weight control in patients with PWS. The long-term safety and effectiveness of bariatric surgery in PWS remains unknown. However, many promising pharmacotherapies are in development and, if approved, will bring much needed choices into the PWS pharmacological armamentarium. With the progress that is currently being made in our understanding of PWS, an effective treatment may not be far off.
- Published
- 2020
32. Weight loss intervention through lifestyle modification or pharmacotherapy for obstructive sleep apnoea in adults
- Author
-
Torres-Castro R., Otto-Yáñez M., Resqueti V.R., Roqué i Figuls M., Kline C.E., Fregonezi G.A.F., and Vilaró J.
- Subjects
publication bias ,obesity ,treatment duration ,clinical effectiveness ,weight loss program ,Article ,body weight loss ,clinical trial protocol ,apnea hypopnea index ,sleep disordered breathing ,diet therapy ,priority journal ,quality of life ,lifestyle modification ,human ,kinesiotherapy ,outcome assessment ,continuous positive airway pressure - Abstract
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:. To assess the effectiveness of lifestyle modification or pharmacotherapy for weight loss for obstructive sleep apnoea in adults with overweight or obesity. Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
- Published
- 2020
33. The effects of gestational diabetes mellitus on fetal growth and neonatal birth measures in an African cohort
- Author
-
Richard J. Munthali, Shane A. Norris, Shelley Macaulay, and David B. Dunger
- Subjects
Adult ,Male ,medicine.medical_specialty ,endocrine system diseases ,Diet therapy ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Ultrasonography, Prenatal ,Fetal Macrosomia ,Cohort Studies ,Fetal Development ,South Africa ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Pregnancy ,Diabetes mellitus ,Internal Medicine ,medicine ,Birth Weight ,Humans ,Body Weights and Measures ,Fetus ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics ,Infant, Newborn ,nutritional and metabolic diseases ,Glucose Tolerance Test ,medicine.disease ,female genital diseases and pregnancy complications ,Gestational diabetes ,Diabetes, Gestational ,Cohort ,Gestation ,Female ,business ,Cohort study - Abstract
Aim Fetal exposure to gestational diabetes mellitus (GDM) is said to alter fetal growth and increase the risk of macrosomia. However, little research on GDM exists in African populations. This study aimed to assess longitudinal fetal growth and neonatal birth measures among Black African babies exposed to GDM. Methods Pregnant women (Soweto, South Africa) enrolled into a cohort study were followed up with repeated fetal ultrasounds. At 24-28 weeks' gestation a 2-h 75 g oral glucose tolerance test was performed and GDM was diagnosed using the World Health Organization's 2013 criteria. Neonatal birth measures were assessed. Results The study involved 741 women; 83 (11.2%) with GDM and 658 (88.8%) without. A total of 4040 fetal ultrasounds were performed. GDM exposure was associated with an increase in fetal growth measures, especially abdominal circumference, which was already seen at 16-18 weeks' gestation. Male fetuses in particular, showed a significant association between GDM exposure and increased abdominal circumference (P = 0.009). Most women with GDM (66.3%) received management; all received diet therapy and 32.7% were prescribed medication. There was no difference in birth measures between the GDM-exposed and unexposed neonates. Conclusion Repeated ultrasound measures identified the effects of GDM as early as 16-18 weeks' gestation, well before a diagnosis of GDM would usually be made. Sex differences in fetal growth were observed, with GDM-exposed male fetuses being more affected with larger abdominal circumferences than females. A low rate of macrosomia was observed compared with historical GDM populations.
- Published
- 2018
34. Successful implementation of diabetes audits in Australia: the Australian National Diabetes Information Audit and Benchmarking (ANDIAB) initiative
- Author
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Stephen Colagiuri, Angela S Lee, and Jeff R. Flack
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Databases, Factual ,Cross-sectional study ,Diet therapy ,Endocrinology, Diabetes and Metabolism ,MEDLINE ,Datasets as Topic ,Audit ,030204 cardiovascular system & hematology ,Diabetes Complications ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Health care ,Diabetes Mellitus ,Internal Medicine ,Humans ,Hypoglycemic Agents ,Medicine ,030212 general & internal medicine ,Antihypertensive Agents ,Aged ,Hypolipidemic Agents ,Quality of Health Care ,Aged, 80 and over ,Medical Audit ,business.industry ,Australia ,Benchmarking ,Middle Aged ,Health Planning ,Quality audit ,Cross-Sectional Studies ,Family medicine ,Female ,Information audit ,business ,Diet Therapy - Abstract
Aim We developed and implemented a national audit and benchmarking programme to describe the clinical status of people with diabetes attending specialist diabetes services in Australia. Methods The Australian National Diabetes Information Audit and Benchmarking (ANDIAB) initiative was established as a quality audit activity. De-identified data on demographic, clinical, biochemical and outcome items were collected from specialist diabetes services across Australia to provide cross-sectional data on people with diabetes attending specialist centres at least biennially during the years 1998 to 2011. Results In total, 38 155 sets of data were collected over the eight ANDIAB audits. Each ANDIAB audit achieved its primary objective to collect, collate, analyse, audit and report clinical diabetes data in Australia. Each audit resulted in the production of a pooled data report, as well as individual site reports allowing comparison and benchmarking against other participating sites. Conclusions The ANDIAB initiative resulted in the largest cross-sectional national de-identified dataset describing the clinical status of people with diabetes attending specialist diabetes services in Australia. ANDIAB showed that people treated by specialist services had a high burden of diabetes complications. This quality audit activity provided a framework to guide planning of healthcare services.
- Published
- 2018
35. Children with wheat allergy usually tolerate oats
- Author
-
Kaarina Kukkonen, Kati Palosuo, Janne Burman, Mika J. Mäkelä, and Anna S. Pelkonen
- Subjects
Male ,Adolescent ,Avena ,Edible Grain ,Diet therapy ,Immunology ,MEDLINE ,Wheat Hypersensitivity ,Immune tolerance ,03 medical and health sciences ,0302 clinical medicine ,Food allergy ,Immune Tolerance ,medicine ,Humans ,Immunology and Allergy ,030212 general & internal medicine ,Child ,Finland ,Triticum ,Sensitization ,business.industry ,Allergens ,medicine.disease ,Celiac Disease ,medicine.anatomical_structure ,030228 respiratory system ,Immunization ,Pediatrics, Perinatology and Child Health ,Female ,business ,Wheat allergy ,Diet Therapy - Published
- 2019
36. Consumption of orange fermented beverage improves antioxidant status and reduces peroxidation lipid and inflammatory markers in healthy humans
- Author
-
Daniele Del Rio, Isabel Cerrillo, Ángeles Ortega, Franz Martín, María-Soledad Fernández-Pachón, Hada C. Macher, Pedro Mena, Rocío Muñoz-Hernández, Blanca Escudero-López, María-Rosario Rodríguez-Griñolo, and Dámaso Hornero-Méndez
- Subjects
0301 basic medicine ,Orange juice ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Antioxidant ,Oxygen radical absorbance capacity ,business.industry ,Diet therapy ,Thiobarbituric acid ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Lipid peroxidation ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,chemistry ,TBARS ,Uric acid ,Medicine ,Food science ,business ,Agronomy and Crop Science ,Food Science ,Biotechnology - Abstract
BACKGROUND: Alcoholic fermentation of fruits has generated novel products with high concentrations of bioactive compounds and moderate alcohol content. The aim of this study was to evaluate the potential effect on cardiovascular risk factors of the regular consumption by healthy humans of a beverage obtained by alcoholic fermentation and pasteurization of orange juice. RESULTS: Thirty healthy volunteers were enrolled in a randomized controlled study. The experimental group (n = 15) drank 500 mL orange beverage (OB) per day for 2 weeks (intervention phase), followed by a 3-week washout phase. Blood samples were collected at baseline (E-T0) and at the end of the intervention (E-T1) and washout (E-T2) phases. Controls (n = 15) did not consume OB during a 2-week period. OB intake significantly increased oxygen radical absorbance capacity (43.9%) and reduced uric acid (−8.9%), catalase (CAT) (−23.2%), thiobarbituric acid reactive substances (TBARS) (−30.2%) and C-reactive protein (−2.1%) (E-T1 vs. E-T0). These effects may represent longer-term benefits, given the decreased uric acid (−8.9%), CAT (−34.6%), TBARS (−48.4%) and oxidized low-density lipoprotein (−23.9%) values recorded after the washout phase (E-T2 vs. E-T0). CONCLUSION: The regular consumption of OB improved antioxidant status and decreased inflammation state, lipid peroxidation and uric acid levels. Thus OB may protect the cardiovascular system in healthy humans and be considered a novel functional beverage. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry
- Published
- 2017
37. Evaluation of the natural history of patients who aspirate
- Author
-
Varun V. Varadarajan, Mary C. Brawley, Joel H. Blumin, and Jonathan M. Bock
- Subjects
medicine.medical_specialty ,Diet therapy ,business.industry ,Hazard ratio ,Retrospective cohort study ,Aspiration pneumonia ,medicine.disease ,Dysphagia ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Otorhinolaryngology ,Swallowing ,Internal medicine ,Esophageal dysphagia ,Cohort ,medicine ,medicine.symptom ,030223 otorhinolaryngology ,business ,030217 neurology & neurosurgery - Abstract
Objectives/Hypothesis The natural clinical progression of aspiration to eventual pulmonary compromise is not well understood. We hypothesized that dietary modification recommendations, Penetration-Aspiration Scale (PAS) score, and dysphagia etiology would be associated with changes in time to first pulmonary event and overall survival for patients with documented aspiration on radiologic testing. This study identified a cohort of patients with detectable unsensed penetration or aspiration on videofluoroscopic swallowing study (VFSS), and followed this cohort over time for development of pulmonary events and death. We then evaluated the association of aspiration severity and dietary modification recommendations on incidence of these endpoints. Study Design Retrospective chart review. Methods A total of 2,616 VFSS exam reports were reviewed from our institution performed between January 1, 2009 and December 31, 2010. Aspiration or unsensed penetration (PAS of 5 or greater) was detected in 564 (21.5%) of these patients, who were then included in the study cohort. Medical records were reviewed retrospectively for development of pulmonary events (pneumonia, pneumonitis, or other life-threatening pulmonary illness) and all-cause mortality for up to 54 months after initial VFSS. Univariate Kaplan-Meier analysis and multivariate Cox regression were performed for time to first pulmonary event and survival predicted by recommended diet, PAS score, and dysphagia etiology. Results Dysphagia etiology was highly associated with increased development of pulmonary events for some patients, especially those with generalized nonspecific dysphagia due to deconditioning or frailty (hazard ratio [HZ] vs. stroke 2.95, 95% confidence interval [CI]: 1.53-5.69, P = .001) and esophageal dysphagia (HZ: 2.66, 95% CI: 1.17-6.02, P = .019). Dysphagia etiology was also associated with increased mortality for patients with generalized nonspecific dysphagia due to deconditioning or frailty (HZ: 3.32, 95% CI: 2.0-5.52, P < .001), postsurgical patients (HZ: 1.73, 95% CI: 1.05-2.86, P = .032), and chronic neurologic disease (HZ: 1.87, 95% CI: 1.12-3.13, P = .017). Dietary modification recommendations at the time of VFSS (prohibition of oral intake or modification of food consistency) had no significant impact on time to first pulmonary event (P = .37) or survival (P = .17), whereas PAS score was associated with decreased time to first pulmonary event on univariate but not multivariate analysis (HZ for 1-point increase: 1.6, 95% CI: 0.99-1.36, P = .067). Kaplan-Meier estimate of overall 3-year mortality for this patient cohort was 39%. Conclusions Etiology of dysphagia is associated with a higher mortality rate and development of pulmonary events in patients with unsensed penetration or aspiration on VFSS, especially for those patients with generalized deconditioning and frailty or esophageal dysphagia. Severity of aspiration as defined by PAS was not associated with altered overall survival. Recommendations for dietary modification to a nothing by mouth status or modified food consistency had no statistically significant association with development of pulmonary events or survival in patients with detectable unsensed penetration or aspiration on VFSS compared to full-diet recommendation. Level of Evidence 4. Laryngoscope, 127:S1–S10, 2017
- Published
- 2017
38. PROP Nontaster Women Lose More Weight Following a Low-Carbohydrate Versus a Low-Fat Diet in a Randomized Controlled Trial
- Author
-
Hollie A. Raynor, Brenda Burgess, and Beverly J. Tepper
- Subjects
Supertaster ,medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,Diet therapy ,Endocrinology, Diabetes and Metabolism ,Medicine (miscellaneous) ,030209 endocrinology & metabolism ,Low fat diet ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Randomized controlled trial ,law ,Weight loss ,Internal medicine ,Medicine ,030212 general & internal medicine ,Taste-Blindness ,medicine.symptom ,Young adult ,business ,Low carbohydrate - Abstract
Objective Taste blindness to 6-n-propylthiouracil (PROP) associates with increased fat preference and intake. No studies have matched a diet to a woman's PROP phenotype to improve weight loss. This study investigated (1) whether PROP nontaster (NT) women would lose more weight following a low-carbohydrate (LC) diet than a low-fat (LF) diet, and (2) whether PROP supertaster (ST) women would lose more weight following a LF diet than a LC diet. Methods One hundred seven women (BMI = 34.8 ± 0.5 kg/m2), classified as PROP NTs (n = 47) and STs (n = 60), were randomized to a LC or LF diet within a 6-month lifestyle intervention. Assessments included 4-day dietary recalls and biobehavioral and psychosocial questionnaires. Results At 6 months, NTs lost more weight following the LC than the LF diet (−8.5 ± 0.5 kg vs. −6.6 ± 0.5 kg, P = 0.008); there was no difference between STs following either diet (−8.8 ± 0.4 vs. −8.9 ± 0.5, P = 0.35). Dietary self-reports were unrelated to weight loss, and prescription of a LC diet associated with greater self-efficacy. Conclusions NT women lost more weight following the LC diet compared to the LF diet. Screening for PROP phenotype may help personalize diet therapy for NT women to optimize their short-term weight loss.
- Published
- 2017
39. S1 guidelines: Lipedema
- Author
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Dirk Frank Richter, Manuel E. Cornely, Christian Ure, Gerd Lulay, Markus Stücker, Anya Miller, Stefan Rapprich, Klaus Schrader, Wolfgang Justus Brauer, Stefanie Reich-Schupke, Vivien Schacht, Gabriele Faerber, Malte Ludwig, and Wilfried Schmeller
- Subjects
medicine.medical_specialty ,Diet therapy ,business.industry ,medicine.medical_treatment ,Dermatology ,030204 cardiovascular system & hematology ,Easy Bruising ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Plastic surgery ,0302 clinical medicine ,Manual lymphatic drainage ,Liposuction ,Edema ,medicine ,Physical therapy ,Combined Modality Therapy ,Medical history ,medicine.symptom ,Intensive care medicine ,business - Abstract
Summary The present, revised guidelines on lipedema were developed under the auspices of and funded by the German Society of Phlebology (DGP). The recommendations are based on a systematic literature search and the consensus of eight medical societies and working groups. The guidelines contain recommendations with respect to diagnosis and management of lipedema. The diagnosis is established on the basis of medical history and clinical findings. Characteristically, there is a localized, symmetrical increase in subcutaneous adipose tissue in arms and legs that is in marked disproportion to the trunk. Other findings include edema, easy bruising, and increased tenderness. Further diagnostic tests are usually reserved for special cases that require additional workup. Lipedema is a chronic, progressive disorder marked by the individual variability and unpredictability of its clinical course. Treatment consists of four therapeutic mainstays that should be combined as necessary and address current clinical symptoms: complex physical therapy (manual lymphatic drainage, compression therapy, exercise therapy, and skin care), liposuction and plastic surgery, diet, and physical activity, as well as psychotherapy if necessary. Surgical procedures are indicated if – despite thorough conservative treatment – symptoms persist, or if there is progression of clinical findings and/or symptoms. If present, morbid obesity should be therapeutically addressed prior to liposuction.
- Published
- 2017
40. Dietetic intervention for inpatients on fluid-only diets helps to achieve nutritional requirements
- Author
-
Natalie Moran, Tilley Pain, Shonnel Rothery, Melissa Whiting, Sarah Deacon, Theophilus I. Emeto, Maree De Jonge, Kristina Ahnon, and Bonnie Laskey‐Gilboy
- Subjects
0301 basic medicine ,medicine.medical_specialty ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Diet therapy ,business.industry ,Public Health, Environmental and Occupational Health ,Psychological intervention ,Medicine (miscellaneous) ,medicine.disease ,Energy requirement ,Fluid diet ,Clinical Practice ,03 medical and health sciences ,Malnutrition ,0302 clinical medicine ,Intervention (counseling) ,Internal medicine ,medicine ,Physical therapy ,030212 general & internal medicine ,business ,Body mass index - Abstract
Aim The present study aimed to assess whether dietetic intervention helps patients on fluid-only diets to meet their energy and protein requirements. This topic has not been previously investigated. Methods A quasi-experimental study of 57 patients receiving fluid-only diets was conducted at The Townsville Hospital. The fluid consumption of participants was observed over 24 hours and was used to calculate total energy and protein intakes. The percentage of protein and energy requirements met was compared between patients receiving dietetic intervention and patients who were not. Results Patients receiving dietetic interventions met a higher percentage of their energy requirements (75.88) than the control group (18.10) based on median intakes (P
- Published
- 2017
41. BSACI guideline for the diagnosis and management of peanut and tree nut allergy
- Author
-
G. Stiefel, Pia A. J. Huber, Adam T. Fox, N. Brathwaite, April Clark, K. Anagnostou, S. J. Till, Pamela Ewan, David Luyt, Carina Venter, and Robert J. Boyle
- Subjects
Nut ,Emergency Medical Services ,medicine.medical_specialty ,Allergy ,Arachis ,Immunology ,Peanut allergy ,Context (language use) ,03 medical and health sciences ,0302 clinical medicine ,Cost of Illness ,Patient Education as Topic ,Oral allergy syndrome ,Antibody Specificity ,Risk Factors ,Anti-Allergic Agents ,Prevalence ,medicine ,Humans ,Nuts ,Immunology and Allergy ,Peanut Hypersensitivity ,030212 general & internal medicine ,Skin Tests ,business.industry ,digestive, oral, and skin physiology ,Disease Management ,food and beverages ,Allergens ,Immunoglobulin E ,medicine.disease ,Dermatology ,Biotechnology ,030228 respiratory system ,Egg allergy ,Quality of Life ,Tree nut allergy ,Hay fever ,Immunotherapy ,Nut Hypersensitivity ,Symptom Assessment ,business ,Diet Therapy - Abstract
Summary Peanut nut and tree nut allergy are characterised by IgE mediated reactions to nut proteins. Nut allergy is a global disease. Limited epidemiological data suggest varying prevalence in different geographical areas. Primary nut allergy affects over 2% of children and 0.5% of adults in the UK. Infants with severe eczema and/or egg allergy have a higher risk of peanut allergy. Primary nut allergy presents most commonly in the first five years of life, often after the first known ingestion with typical rapid onset IgE-mediated symptoms. The clinical diagnosis of primary nut allergy can be made by the combination of a typical clinical presentation and evidence of nut specifc IgE shown by a positive skin prick test (SPT) or specific IgE (sIgE) test. Pollen food syndrome is a distinct disorder, usually mild, with oral/pharyngeal symptoms, in the context of hay fever or pollen sensitisation, which can be triggered by nuts. It can usually be distinguish clinically from primary nut allergy. The magnitude of a SPT or sIgE relates to the probability of clinical allergy, but does not relate to clinical severity. SPT of ≥ 8 mm or sIgE ≥ 15 KU/L to peanut is highly predictive of clinical allergy. Cut off values are not available for tree nuts. Test results must be interpreted in the context of the clinical history. Diagnostic food challenges are usually not necessary but may be used to confirm or refute a conflicting history and test result. As nut allergy is likely to be a long-lived disease, nut avoidance advice is the cornerstone of management. Patients should be provided with a comprehensive management plan including avoidance advice, patient specific emergency medication and an emergency treatment plan and training in administration of emergency medication. Regular re-training is required.
- Published
- 2017
42. Retrospective evaluation of the impact of early enteral nutrition on clinical outcomes in dogs with pancreatitis: 34 cases (2010-2013)
- Author
-
Korinn E. Saker, Jessica P. Harris, Emily H. Griffith, and Nolie K. Parnell
- Subjects
medicine.medical_specialty ,General Veterinary ,medicine.diagnostic_test ,040301 veterinary sciences ,Diet therapy ,business.industry ,Physical examination ,04 agricultural and veterinary sciences ,medicine.disease ,Enteral administration ,Surgery ,0403 veterinary science ,03 medical and health sciences ,0302 clinical medicine ,Parenteral nutrition ,Internal medicine ,medicine ,Acute pancreatitis ,Pancreatitis ,030211 gastroenterology & hepatology ,Medical nutrition therapy ,Canine pancreatitis ,business - Abstract
Objective To evaluate the effect of early enteral nutritional therapy on time to return to voluntary intake, maximum food consumption, incidence of gastrointestinal intolerance (GI), and total hospitalization time for dogs with acute pancreatitis. Design and Setting Retrospective analysis of dogs with pancreatitis at a veterinary teaching hospital between 2010 and 2013. Animals Thirty-four client-owned dogs diagnosed with acute or acute-on-chronic pancreatitis. Procedures and Interventions Medical records of dogs evaluated for inappetence, anorexia, and GI for which a diagnosis of pancreatitis was recorded were reviewed. The time to initiation of food offerings since hospitalization were recorded in addition to signalment, historical medical conditions, chief complaint, physical examination findings, diagnostic results, treatments provided, timing of food offering (within 48 h of hospitalization, early feeding group (EFG) versus delayed feeding group (DFG), diet therapy (low fat versus high fat), caloric intake (% resting energy requirement), incidence of GI (%), and length of hospitalization (LOH) (days). A Clinical Severity Index Score (CSIS) was determined for each patient. Measurements and Main Results Dogs in the EFG demonstrated a decreased time to return of voluntary intake (2.1 days, EFG versus 2.7 days, DFG; P = 0.05) and time (days) to maximum intake (3, EFG versus 3.4 DFG) as compared to the DFG dogs. The DFG exhibited more GI versus EFG irrespective of CSIS grouping (60% versus 26%, P = 0.04). A CSIS ≥ 7 was associated with prolonged LOH (P = 0.004); however, time to initiation of feeding and diet selection did not impact LOH (P = 0.8). Conclusions and Clinical Relevance Results of the study suggested that feeding within 48 hours of hospitalization for canine pancreatitis has a positive impact on return to voluntary intake and decreases the frequency of GI in these patients, independent of CSIS. The traditional protocol of withholding food during hospitalization may not be necessary nor yield the most benefit for patient recovery; subsequently early enteral refeeding should be considered.
- Published
- 2017
43. Dietary sodium, dietary potassium, and systolic blood pressure in US adolescents
- Author
-
Jennifer Chmielewski and J. Bryan Carmody
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,National Health and Nutrition Examination Survey ,Diet therapy ,Endocrinology, Diabetes and Metabolism ,Sodium ,Potassium ,Population ,chemistry.chemical_element ,Blood Pressure ,030204 cardiovascular system & hematology ,Prehypertension ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Internal Medicine ,Humans ,Medicine ,030212 general & internal medicine ,Child ,education ,education.field_of_study ,business.industry ,Potassium, Dietary ,Blood Pressure Determination ,Sodium, Dietary ,Nutrition Surveys ,United States ,Dietary Potassium ,Cross-Sectional Studies ,Endocrinology ,Blood pressure ,chemistry ,Cardiovascular Diseases ,Dietary Sodium and Blood Pressure ,Hypertension ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Both high sodium and low potassium diets are associated with hypertension, but whether these risk factors are distinct or overlapping has not been thoroughly investigated. The authors evaluated the relationship between dietary sodium, potassium, and high systolic blood pressure among 4716 adolescents aged 12 to 14 years who participated in the National Health and Nutrition Examination Survey from 1999 to 2012. There was no association with blood pressure across most values of sodium or potassium intake. However, participants who reported sodium intake ≥7500 mg/d, potassium
- Published
- 2017
44. Eosinophilic esophagitis phenotypes: Ready for prime time?
- Author
-
Dan Atkins, Glenn T. Furuta, Jonathan M. Spergel, and Chris A. Liacouras
- Subjects
Adult ,medicine.medical_specialty ,Response to therapy ,Immunology ,Inflammatory bowel disease ,Article ,Diagnosis, Differential ,Feeding and Eating Disorders ,03 medical and health sciences ,Esophagus ,0302 clinical medicine ,Adrenal Cortex Hormones ,Prevalence ,medicine ,Animals ,Humans ,Immunology and Allergy ,In patient ,Child ,Eosinophilic esophagitis ,Asthma ,business.industry ,Eosinophilic Esophagitis ,Inflammatory Bowel Diseases ,medicine.disease ,Dysphagia ,Dermatology ,Phenotype ,030228 respiratory system ,Feeding problems ,Pediatrics, Perinatology and Child Health ,030211 gastroenterology & hepatology ,medicine.symptom ,Deglutition Disorders ,business ,Diet Therapy - Abstract
Eosinophilic esophagitis (EoE) is one of the most common causes of reflux-like symptoms and feeding problems in children and food impaction and dysphagia in adults with a prevalence of 1:2500. Therapeutic options include diet, use of swallowed corticosteroids, or dilation. In the last several years, recent clinical and translational researches have identified some common and distinctive features, for example, the varying response to diet and medications. As EoE shares some characteristics with both asthma and inflammatory bowel disease, the advances in these fields suggest that various phenotypes may also exist in patients with EoE. Here, we provide a rationale for EoE phenotypes and provide some suggestions for potential phenotypes based on histology, molecular signature, response to therapy or dietary therapy.
- Published
- 2017
45. Re-challenging FODMAPs: the low FODMAP diet phase two
- Author
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Caroline J Tuck and Jacqueline Susanne Barrett
- Subjects
0301 basic medicine ,chemistry.chemical_classification ,medicine.medical_specialty ,030109 nutrition & dietetics ,Hepatology ,Diet therapy ,business.industry ,Prebiotic ,medicine.medical_treatment ,Gastroenterology ,Dietary restrictions ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,chemistry ,Symptom improvement ,Low fodmap diet ,Good evidence ,medicine ,Physical therapy ,030211 gastroenterology & hepatology ,FODMAP ,business ,Irritable bowel syndrome - Abstract
The low fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet has good evidence for use in the treatment of patients with irritable bowel syndrome. Importantly, patients are encouraged not to remain on a strict low FODMAP diet long-term, and many patients maintain symptom improvement with a relaxed, moderate FODMAP restriction. The re-challenge phase is crucial to assist patients in identifying specific dietary triggers, reduce the level of dietary restriction required, and increase prebiotic intake. Limited evidence is available to guide best practice, but, in practice, beneficial outcomes can be seen through strategic food reintroductions. Here, we set out some practical recommendations based on clinical experience. Dietitians should tailor the challenge process to the individual patient and their needs. Food challenges should aim to improve dietary variety and nutritional adequacy while considering specific food preferences and usual dietary habits. Identifying FODMAP subgroups that are well tolerated is helpful, allowing the reintroduction of some moderate to high FODMAP foods back into the diet without symptom induction. FODMAP subtypes that are less well tolerated may also be reintroduced, but dosage and frequency of consumption need to be individualized. Additional challenges that face dietitians include consideration of patients with multiple dietary restrictions such as in vegetarians or patients with diabetes who are simultaneously following a low FODMAP diet. Ensuring nutritional adequacy is essential. The outcome of the re-challenge process aims to find a balance between good symptom control and expansion of the diet.
- Published
- 2017
46. Low sugar nutrition policies and dental caries: A study of primary schools in South Auckland
- Author
-
Gerhard Sundborn, Simon Thornley, Roger Marshall, Gary Reynolds, Grant Schofield, and Pauline I. Koopu
- Subjects
medicine.medical_specialty ,Diet therapy ,business.industry ,education ,Dentistry ,030206 dentistry ,Demographic profile ,Oral health ,Dental examinations ,Sugary food ,Confidence interval ,stomatognathic diseases ,03 medical and health sciences ,0302 clinical medicine ,Carious teeth ,Pediatrics, Perinatology and Child Health ,Epidemiology ,Medicine ,030212 general & internal medicine ,business ,Demography - Abstract
Aim The study assessed whether a healthy food policy implemented in one school, Yendarra Primary, situated in a socio-economically deprived area of South Auckland, had improved student oral health by comparing dental caries levels with students of similar schools in the same region with no such policy. Methods Records of caries of the primary and adult teeth were obtained between 2007 and 2014 for children attending Yendarra, and were compared to those of eight other public schools in the area, with a similar demographic profile. Children were selected between the ages of 8 and 11 years. Linear regression models were used to estimate the strength of association between attending Yendarra school and dental caries. Results During the study period, 3813 records were obtained of children who attended dental examinations and the schools of interest. In a linear model, mean number of carious primary and adult teeth were 0.37 lower (95% confidence interval: 0.09–0.65) in Yendarra school children, compared to those in other schools, after adjustment for confounders. Pacific students had higher numbers of carious teeth (adjusted β coefficient: 0.25; 95% confidence interval: 0.03–0.46) than Māori. Conclusion This nutrition policy, implemented in a school in the poorest region of South Auckland, which restricted sugary food and drink availability, was associated with a marked positive effect on the oral health of students, compared to students in surrounding schools. We recommend that such policies are a useful means of improving child oral health.
- Published
- 2017
47. Training Nonnursing Staff to Assist with Nutritional Care Delivery in Nursing Homes: A Cost-Effectiveness Analysis
- Author
-
Emmett B. Keeler, Matthew S. Shotwell, Xulei Liu, Ruopeng An, Sandra F. Simmons, Heidi J. Silver, Emily K. Hollingsworth, and Emily A. Long
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,Inservice Training ,Calorie ,Cost-Benefit Analysis ,Frail Elderly ,Article ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Randomized controlled trial ,Weight loss ,law ,Intervention (counseling) ,medicine ,Humans ,030212 general & internal medicine ,Nutritional care ,Aged, 80 and over ,030109 nutrition & dietetics ,business.industry ,Body Weight ,Malnutrition ,Cost-effectiveness analysis ,Nursing Homes ,Long-term care ,Physical therapy ,Female ,Geriatrics and Gerontology ,medicine.symptom ,Energy Intake ,Nursing homes ,business ,Diet Therapy ,Program Evaluation - Abstract
Objectives To determine the effect and cost-effectiveness of training nonnursing staff to provide feeding assistance for nutritionally at-risk nursing home (NH) residents. Design Randomized, controlled trial. Setting Five community NHs. Participants Long-stay NH residents with an order for caloric supplementation (N = 122). Intervention Research staff provided an 8-hour training curriculum to nonnursing staff. Trained staff were assigned to between-meal supplement or snack delivery for the intervention group; the control group received usual care. Measurements Research staff used standardized observations and weighed-intake methods to measure frequency of between-meal delivery, staff assistance time, and resident caloric intake. Results Fifty staff (mean 10 per site) completed training. The intervention had a significant effect on between-meal caloric intake (F = 56.29, P < .001), with the intervention group consuming, on average, 163.33 (95% CI = 120.19–206.47) calories per person per day more than the usual care control group. The intervention costs were $1.27 per person per day higher than usual care (P < .001). The incremental cost-effectiveness ratio for the intervention was 134 kcal per dollar. The increase in cost was due to the higher frequency and number of snack items given per person per day and the associated staff time to provide assistance. Conclusion It is cost effective to train nonnursing staff to provide caloric supplementation, and this practice has a positive effect on residents’ between-meal intake.
- Published
- 2016
48. Interactions and user-perceived helpfulness in diet information social questions & answers
- Author
-
Peilin Wang and Yin Zhang
- Subjects
Information Seeking Behavior ,Applied psychology ,Health Informatics ,Library and Information Sciences ,03 medical and health sciences ,Seekers ,0302 clinical medicine ,Information providers ,Health Information Management ,Process analysis ,Information system ,Humans ,Social media ,030212 general & internal medicine ,Internet ,05 social sciences ,Perspective (graphical) ,Social Support ,Satisfaction rating ,Data Accuracy ,Patient Satisfaction ,Helpfulness ,Perception ,0509 other social sciences ,050904 information & library sciences ,Psychology ,Social Media ,Social psychology ,Diet Therapy - Abstract
Background Online health information seeking using social questions and answers (Social Q&A) sites has been increasingly popular in recent years. It calls for better understanding of health information seeking behaviour and interactions between information seekers and information providers. Objectives The study investigates how diet information seekers interact with information providers on WebMD Answers, which is a Social Q&A site devoted to health-related topics, and examines the factors that constitute a ‘helpful’ answer from an information seeker's perspective. Methods Bales’ interaction process analysis was applied as the framework to analyse 568 diet-related Q&As from WebMD Answers to identify interaction patterns. Results Most diet information seekers post questions anonymously and without any detailed description. Individual experts or health organisations provide most answers. Overall, answers are positively received and had a high satisfaction rating. It was also found that information seeker-perceived helpfulness does not depend on who answered the question but to how an information seeker posted the question. Conclusions This study indicates that answers at WebMD Answers are helpful for diet information seekers. It sheds new light on the interactions during the Q&A process, preferred site functions and important factors that contribute to perceived helpful answers.
- Published
- 2016
49. Do more specific plans help you lose weight? Examining the relationship between plan specificity, weight loss goals, and plan content in the context of a weight management programme
- Author
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Stephan U Dombrowski, Yael Benyamini, David M. Steinberg, and Ronit Endevelt
- Subjects
implementation intentions ,Adult ,Male ,Gerontology ,Adolescent ,Population ,action plan ,Context (language use) ,Intention ,Plan (drawing) ,Body Mass Index ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Weight loss ,Weight management ,medicine ,Humans ,Obesity ,Prospective Studies ,030212 general & internal medicine ,education ,Exercise ,Applied Psychology ,Aged ,education.field_of_study ,030505 public health ,plan specificity ,General Medicine ,Middle Aged ,medicine.disease ,Weight Reduction Programs ,Planning ,weight management ,Action plan ,Linear Models ,Female ,medicine.symptom ,0305 other medical science ,Psychology ,Goals ,Body mass index ,Social psychology ,Diet Therapy - Abstract
Objectives The conditions under which planning for behaviour change is most effective are not fully understood. In the context of a weight management programme, we examined the interrelationship between plan specificity, type of behaviour planned (diet vs. exercise), and weight loss goals. Design Prospective design and content analysis of plans formed by participants of a 10-week weight management programme. Methods Participants (n = 239) formulated two plans, for dietary and exercise behaviours, respectively. Plans were rated for specificity by examining the number of plan components. Weight loss goals were assessed by asking how much weight participants intend to lose. Weight was measured objectively each of the 10 weeks. Changes in body mass index (BMI) over time and the interactions between plan specificity and weight loss goals, for all plans and separately for diet and exercise, were estimated using linear mixed models. Results Plan specificity was unrelated to weight loss, but interacted with weight loss goals in predicting linear change in BMI (t = −2.48): More specific plans were associated with higher decreases in weight in participants with high weight loss goals. Separate interaction tests for plans formulated for diet and exercise change showed that more specific dietary plans, but not exercise plans, were associated with higher decreases in weight in participants with high weight loss goals (t = −2.21). Conclusions Within a population that is highly motivated to lose weight, the combination of high weight loss goals and formulating detailed plans for changing dietary behaviours may be most effective in supporting weight loss. Statement of contribution What is already known on this subject? More specific plans are associated with increased performance of health-related behaviours. More motivated individuals form more specific plans. The interrelationship between plan specificity, plan content and behaviour-related goals in relation intervention effectiveness has not been explored to date. What does this study add? The effectiveness of forming specific plans may depend on the strength of behaviour-related goals as well as the behaviour selected for change. More detailed plans, in particular dietary plans, were related to greater weight loss, but only for participants with higher initial weight loss goals. Detailed exercise plans were not associated with weight loss, regardless of initial weight loss goals.
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- 2016
50. Clinical Practice Guidelines for the Management of Atopic Dermatitis 2016
- Author
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Hidehisa Saeki, Makoto Sugaya, Michiko Aihara, Yoko Kataoka, Akio Tanaka, Kenji Kabashima, Takeshi Nakahara, Norito Katoh, Tamotsu Ebihara, Takafumi Etoh, and Hiroyuki Murota
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Diet therapy ,Anti-Inflammatory Agents ,Histamine Antagonists ,Administration, Oral ,Dermatology ,Disease ,Administration, Cutaneous ,Severity of Illness Index ,Ultraviolet therapy ,Tacrolimus ,Dermatitis, Atopic ,Ointments ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Patient Education as Topic ,Severity of illness ,medicine ,Humans ,Glucocorticoids ,Evidence-Based Medicine ,business.industry ,Pruritus ,General Medicine ,Evidence-based medicine ,Atopic dermatitis ,medicine.disease ,030104 developmental biology ,Clinical research ,Quality of Life ,Patient Compliance ,Ultraviolet Therapy ,Dermatologic Agents ,business ,Immunosuppressive Agents ,Diet Therapy - Abstract
Atopic dermatitis (AD) is a disease characterized by relapsing eczema with pruritus as a primary lesion. Most patients have an atopic predisposition. The definitive diagnosis of AD requires the presence of all three features: (i) pruritus; (ii) typical morphology and distribution of the eczema; and (iii) chronic and chronically relapsing course. The current strategies to treat AD in Japan from the perspective of evidence-based medicine consist of three primary measures: (i) the use of topical corticosteroids and tacrolimus ointment as the main treatment for the inflammation; (ii) topical application of emollients to treat the cutaneous barrier dysfunction; and (iii) avoidance of apparent exacerbating factors, psychological counseling and advice about daily life. The guidelines present recommendations to review clinical research articles, evaluate the balance between the advantages and disadvantages of medical activities, and optimize medical activity-related patient outcomes with respect to several important points requiring decision-making in clinical practice.
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- 2016
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