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Inflammatory bowel diseases (IBDs) are chronic, progressive, immune-mediated diseases of the intestinal tract. The main subtypes of IBDs are Chron's disease (CD) and ulcerative colitis (UC). The etiology is still unclear, but there are genetic, environmental and host-related factors that contribute to the development of these diseases. Recent literature has shown that dietary therapy is the cornerstone of IBD treatment in terms of management of symptoms, relapse and care of the pathology. IBD patients show that microbiota dysbiosis and diet, especially dietary fiber, can modulate its composition. These patients are more at risk of energy protein malnutrition than the general population and are deficient in micronutrients. So far, no dietary component is considered responsible for IBD and there is not a specific therapeutic diet for it. The aim of this review is to evaluate the role of dietary fibers in CD and UC and help health professionals in the nutritional management of these pathologies. Further studies are necessary to determine the appropriate amount and type of fiber to suggest in the case of IBD to ameliorate psychosocial conditions and patients' quality of life. [ABSTRACT FROM AUTHOR]

Background and Aims: The Mediterranean Diet (MD) represents a key player in cardiovascular disease prevention. Therefore, we aimed to assess the relationship between adherence to the MD and inflammatory, lipid and glycemic profile in patients affected by polyvascular atherosclerotic disease (PAD). We also investigated the incidence of long-term major adverse cardiovascular events (MACEs) according to MD adherence.Methods and Results: We enrolled 107 patients with PAD, defined as the simultaneous involvement of at least two vascular districts. Adherence to the MD was estimated through a 9-item simplified form of the Mediterranean Diet Score. Improved fasting glycemic and LDL-cholesterol levels were reported in the high-adherence group compared with the low-adherence group (p < 0.001 and p = 0.0049, respectively). Both C-reactive protein and platelet-to-lymphocyte ratio were significantly lower in high-adherence patients than those with poor adherence to the MD (p = 0.0045 and p = 0.008, respectively). During follow-up (mean 34 ± 11 months), fatal events happened exclusively in the low-adherence group (58%), with an event-free survival of 37% compared with 87% in the moderate-adherence group and 70% in the high-adherence group (log-rank p-value < 0.001). Low adherence to the MD was associated with a higher incidence of MACEs in the Cox regression model adjusted for atherosclerotic risk factors (HR 12.23, 95% CI 4.00-37.39).Conclusions: High adherence to Mediterranean dietary pattern seems to be associated with improving inflammatory and metabolic status in patients suffering from PAD, potentially translating into better long-term cardiovascular outcomes. These findings provide evidence regarding the relevance of MD as a secondary preventive tool in this high-risk population. [ABSTRACT FROM AUTHOR]

Group therapy is usually considered more effective in obtaining changes in patient nutritional behaviour. Members of the group can share experiences and common goals that strengthen relationships, help to be supportive of each other, thus increasing motivation to cope with the disease. The aim of this study was to evaluate in patients with type 2 diabetes the outcome in terms of metabolic control comparing Group versus Individual nutritional therapy. A total of 50 patients with type 2 diabetes were randomly assigned to either Group (n = 25) or Individual (n = 25) nutritional educational therapy. Four educational sessions took place every fortnight over a 2 month period; follow-up visits were scheduled every three months during one year follow-up. Fasting glucose, HbA1c, BMI and waist circumference were assessed during the first session and' at follow-up visits. Patients followed a structured program aimed at understanding and managing their disease, no written diet was provided but only information on the importance of a well-balanced diet, food composition, carbohydrate counting, and how to plan a healthy meal/snack. The importance of physical activity was also stressed encouraging subjects to exercise at least 150 minutes a week. No significant differences were observed between patients at entry. Patients enrolled in the Individual therapy underwent worsening of their anthropometric parameters, although these differences did not reach statistical significance compared to baseline values. A significant reduction in HbA[sub 1c] values was observed in the Group vs. Individual therapy (7.0% ± 1.1 at entry vs. 6.6% ± 0,9 at 1 year; 7.6% ± 1.3 at entry vs. 8.4% ± 1.8 at 1 year, respectively, p< 0.001), with a significant variation in delta SDS for Group vs. Individual therapy p< 0.5 ± 0.5 vs. + 0.8 ±1.6, respectively; p< 0,001). Group nutritional therapy was more effective than individual therapy in improving metabolic control in type 2 diabetes. We recommend its implementation in diabetes clinics. [ABSTRACT FROM AUTHOR]