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Iron deficiency induces a yellowing in the aerial part of plants, known as iron chlorosis, and reduces the growth, yield, and quality of the fruits. Understanding plant response to iron deficiency is essential for agronomic management. This study decoded the temporal response of tomato plants (Solanum lycopersicum L.) to iron deficiency by quantifying different vegetative parameters. Subapical root swelling in the first 2.0 mm and several shoot and root growth parameters were measured in plants grown in a nutrient solution with and without Fe, on different dates designated as days after transplantation (DAT). Correlations between the total chlorophyll concentration in young leaves and 22 morphological and physiological parameters were also calculated. The plants grown in the absence of Fe had a higher number of secondary roots at 3 DAT, compared to control plants. On the same date, subapical root swelling was also observed, particularly at 1.5 and 2.0 mm from the root tip. Those plants also had a lower chlorophyll content in young leaves and a higher ferric-chelate reductase activity (FCR; EC 1.16.1.17) in the roots. At 9 DAT, the overall vegetative performance (plant height, fresh weight of stems and leaves) was negatively affected. At the end of the experiment (14 DAT), significant correlations were found between chlorophyll and the studied parameters. In conclusion, tomato plants experienced a cascade of responses to Fe deficiency throughout nine days: firstly, root lateralization increased; later, root swelling was observed, and a decrease in leaf chlorophyll content was registered associated with an increase in root FCR. At the end, the biomass of tomato plants decreased.

Context: People with type 2 diabetes (T2D) have higher risks of cancer incidence and death., Objective: We aimed to evaluate the relationship between dietary and physical activity-based lifestyle intervention and cancer outcomes among prediabetes and T2D populations., Methods: We searched for randomized controlled trials with at least 24 months of lifestyle interventions in prediabetes or T2D populations. Data were extracted by pairs of reviewers and discrepancies were resolved by consensus. Descriptive syntheses were performed, and the risk of bias was assessed. Relative risks (RRs) and 95% CIs were estimated using a pairwise meta-analysis with both a random-effects model and a general linear mixed model (GLMM). Certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation framework, and trial sequential analysis (TSA) was conducted to assess if current information is enough for definitive conclusions. Subgroup analysis was performed by glycemic status., Results: Six clinical trials were included. Among 12 841 participants, the combined RR for cancer mortality comparing lifestyle interventions with usual care was 0.94 (95% CI, 0.81-1.10 using GLMM and 0.82-1.09 using random-effects model). Most studies had a low risk of bias, and the certainty of evidence was moderate. TSA showed that the cumulative Z curve reached futility boundary while total number did not reach detection boundary., Conclusion: Based on the limited data available, dietary and physical activity-based lifestyle interventions had no superiority to usual care on reducing cancer risk in populations with prediabetes and T2D. Lifestyle interventions focused on cancer outcomes should be tested to better explore their effects., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Recent data from meta-analyses of randomized clinical trials (RCTs) suggest that dietary intake of coconut oil, rich in saturated fatty acids, does not result in cardiometabolic benefits, nor in improvements in anthropometric, lipid, glycemic, and subclinical inflammation parameters. Nevertheless, its consumption has surged in recent years all over the world, a phenomenon which can possibly be explained by an increasing belief among health professionals that this oil is as healthy as, or perhaps even healthier than, other oils, in addition to social network misinformation spread. The objective of this review is to present nutritional and epidemiological aspects related to coconut oil, its relationship with metabolic and cardiovascular health, as well as possible hypotheses to explain its high rate of consumption, in spite of the most recent data regarding its actual effects.

Obesity is a chronic disease resulting from multifactorial causes mainly related to lifestyle (sedentary lifestyle, inadequate eating habits) and to other conditions such as genetic, hereditary, psychological, cultural, and ethnic factors. The weight loss process is slow and complex, and involves lifestyle changes with an emphasis on nutritional therapy, physical activity practice, psychological interventions, and pharmacological or surgical treatment. Because the management of obesity is a long-term process, it is essential that the nutritional treatment contributes to the maintenance of the individual's global health. The main diet-related causes associated with excess weight are the high consumption of ultraprocessed foods, which are high in fats, sugars, and have high energy density; increased portion sizes; and low intake of fruits, vegetables, and grains. In addition, some situations negatively interfere with the weight loss process, such as fad diets that involve the belief in superfoods, the use of teas and phytotherapics, or even the avoidance of certain food groups, as has currently been the case for foods that are sources of carbohydrates. Individuals with obesity are often exposed to fad diets and, on a recurring basis, adhere to proposals with promises of quick solutions, which are not supported by the scientific literature. The adoption of a dietary pattern combining foods such as grains, lean meats, low-fat dairy, fruits, and vegetables, associated with an energy deficit, is the nutritional treatment recommended by the main international guidelines. Moreover, an emphasis on behavioral aspects including motivational interviewing and the encouragement for the individual to develop skills will contribute to achieve and maintain a healthy weight. Therefore, this Position Statement was prepared based on the analysis of the main randomized controlled studies and meta-analyses that tested different nutrition interventions for weight loss. Topics in the frontier of knowledge such as gut microbiota, inflammation, and nutritional genomics, as well as the processes involved in weight regain, were included in this document. This Position Statement was prepared by the Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), with the collaboration of dietitians from research and clinical fields with an emphasis on strategies for weight loss., (© 2023. The Author(s).)

Objective: The aim of this study was to test the effects of repetitive active transcranial direct current stimulation (tDCS) over the right dorsolateral prefrontal cortex (rDLPFC) associated with a hypocaloric diet on glucose homeostasis in people with excessive weight., Methods: Adults with overweight or obesity were selected in a randomized, double-blind pilot study to complete 4 weeks (20 sessions) of fixed-dose tDCS (2 mA, 20 minutes) delivered over the rDLPFC and associated with a standard hypocaloric diet. Participants were randomly assigned (1:1) and stratified by sex to the active tDCS group (active) or the sham tDCS group (sham). Changes in glucose homeostasis were assessed in a 4-hour liquid meal tolerance test, performed before and after the intervention., Results: Twenty-eight participants were randomized (79% with obesity; mean [SD] age 37.6 [5.8] years). After the intervention, fasting plasma glucose (mean [95% CI], -7.8 mg/dL [-14.0 to -1.6]) and insulin levels (-7.7 μIU/mL [-13.9 to -1.6]) decreased in the active compared with the sham. Similarly, the Matsuda insulin sensitivity index increase in the active (4.7 pmol -1  × mmol -1 [1.6 to 7.8]) compared with the sham (0.6 pmol -1  × mmol -1 [-1.4 to 3.2])., Conclusions: Repetitive, active tDCS over the rDLPFC could be a promising noninvasive technique to improve glucose homeostasis in individuals with overweight or obesity on a low-calorie diet, highlighting the importance of investigating this intervention modality in individuals with type 2 diabetes mellitus., (© 2022 The Obesity Society.)

Background: Lifestyle interventions improve the metabolic control of individuals with hyperglycemia., Purpose: We aimed to determine the effect of lifestyle interventions on cardiovascular and all-cause mortality in this population., Data Sources: Searches were made through MEDLINE, Cochrane CENTRAL, Embase, and Web of Science (no date/language restriction, until 15 May 2022)., Study Selection: We included randomized clinical trials (RCTs) of subjects with prediabetes and type 2 diabetes, comparing intensive lifestyle interventions with usual care, with a minimum of 2 years of active intervention., Data Extraction: Data from the 11 RCTs selected were extracted in duplicate. A frequentist and arm-based meta-analysis was performed with random-effects models to estimate relative risk (RR) for mortality, and heterogeneity was assessed through I2 metrics. A generalized linear mixed model (GLMM) was used to confirm the findings., Data Synthesis: Lifestyle interventions were not superior to usual care in reducing cardiovascular (RR 0.99; 95% CI 0.79-1.23) or all-cause (RR 0.93; 95% CI 0.85-1.03) mortality. Subgroup, sensitivity, and meta-regression analyses showed no influence of type of intervention, mean follow-up, age, glycemic status, geographical location, risk of bias, or weight change. All of these results were confirmed with the GLMM. Most studies had a low risk of bias according to the RoB 2.0 tool and the certainty of evidence was moderate for both outcomes., Limitations: Most studies had a low risk of bias according to the RoB 2.0 tool, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach resulted in moderate certainty of evidence for both outcomes. Differences in lifestyle programs and in usual care between the studies should be considered in the interpretation of our results., Conclusions: Intensive lifestyle interventions implemented so far did not show superiority to usual care in reducing cardiovascular or all-cause mortality for subjects with prediabetes and type 2 diabetes., (© 2022 by the American Diabetes Association.)

The kallikrein-kinin system has been implicated in body weight and glucose homeostasis. Their major effectors act by binding to the kinin B2 and B1 receptors. It was assessed the role of the kinin B1 receptor in weight and glucose homeostasis in B1 receptor knockout mice (B1RKO) subjected to a cafeteria diet (CAF). Wild-type (WT) and B1RKO male mice (C57BL/6 background; 8 weeks old) were fed a standard diet (SD) or CAF for 14 weeks, ad libitum, and four groups were formed: WT-SD; B1RKO-SD; WT-CAF; B1RKO-CAF. Body weight and food intake were assessed weekly. It was performed glucose tolerance (GTT) and insulin tolerance tests (ITT), and HOMA-IR, HOMA-β and HOMA-β* 1/HOMA-IR were calculated. Islets from WT and B1RKO were isolated in order to measure the insulin secretion. Western blot was used to assess the hepatic AKT phosphorylation and qPCR to assess gene expression. CAF induced a higher body mass gain in B1RKO compared to WT mice. CAF diet increased epididymal fat depot mass, hepatic fat infiltration and hepatic AKT phosphorylation in both genotypes. However, B1RKO mice presented lower glycemic response during GTT when fed with CAF, and a lower glucose decrease in the ITT. This higher resistance was overcomed with higher insulin secretion when stimulated by high glucose, resulting in higher glucose uptake in the GTT when submitted to CAF, despite lower insulin sensitivity. Islets from B1RKO delivered 4 times more insulin in 3-month-old mice than islets from WT. The higher insulin disposition index and high insulin delivery of B1RKO can explain the decreased glucose excursion during GTT. In conclusion, CAF increased the β-cell function in B1RKO mice, compensated by the diet-induced insulin resistance and resulting in a healthier glycemic response despite the higher weight gain., Competing Interests: The authors have declared that no competing interests exist.

The genetic influence in obesity prevalence is well described, but the role of genetic markers related to athletic strength/ endurance performance remains controversial. We investigated associations between obesity and the genetic polymorphisms alpha-actinin-3 (ACTN3) R577X and angiotensin-converting enzyme (ACE) I/D in schoolchildren aged 4-13 years from Southern Brazil. We collected sociodemographic data from parents through a questionnaire and conducted an anthropometric assessment. DNA was extracted from buccal cells and genotyping was performed by PCR. We found that 1.9% of the individuals were classified as low weight-for-age, 57.6% as normal weight and 40.5% as overweight/ obesity. Regarding allelic distribution, we found that 52.5% of individuals were DD, 30.8% ID, and 16.7% II for ACE; and 38.8% of individuals were RR, 40.2% RX and 21.0% XX for ACTN3. When both polymorphisms were combined, we observed a clear association between the composed genetic profile of these alleles and severe obesity in schoolchildren. Our data suggest that the combined analysis of ACTN3 R577X and ACE I/D polymorphisms may serve as a predictor for the risk of severe obesity in children. These data can contribute to a better understanding of the relationship between these polymorphisms and the body weight development of school-age children.

This study aims to analyze the behaviour of cardiac autonomic modulation in adolescents with a family history of hypertension along with polymorphism of the ACE gene (rs1799752). The study involved 141 adolescents, with a mean age of 14.89, divided into the following six groups: offspring of normotensive parents (ONP): DD, DI and II; and offspring of hypertensive parents (OHP): DD, DI and II. Blood pressure, body composition, family history of hypertension, sleep disorder, and sexual maturation were assessed for the groups' characterization. Afterwards, an electrocardiogram was performed, and oral mucosal cells were collected to analyze heart rate variability and genotypic research of angiotensin-converting enzyme. The main finding of this study was the decrease of vagal action in group OHP (genotype DD) relative to group ONP (genotype II): LF (%), 54.25 ± 3.14 vs 39.33 ± 3.80; HF (%), 45.74 ± 3.14 vs 60.66 ± 3.80; LF/HF, 1.48 ± 0.23 vs 0.68 ± 0.19. The results also showed changes in the variable diastolic blood pressure (DBP) in OHP (genotype DI) to ONP (genotype II) groups: 72.99 ± 2.33 vs 63.27 ± 1.72; and OHP (genotype DI) to ONP (genotype DD) groups. Adolescents with genotype DD and a family history of arterial hypertension present chances in cardiac autonomic modulation, the cardiac parasympathetic modulation is lower in these adolescents in comparison to participants of ONP + II group., (© 2020 John Wiley & Sons Australia, Ltd.)

Objectives: The importance of preservation of the subvalvular apparatus (PSVA) during mitral valve replacement (MVR) in non-rheumatic mitral valves is well recognized. Our aim was to analyse the impact of PSVA in MVR for rheumatic valves on long-term survival., Methods: From January 1992 to December 2012, 605 consecutive patients with rheumatic mitral valve disease were submitted to MVR. PSVA (limited to the posterior leaflet) was achieved in 224 (37.7%) patients. Follow-up was 4259 patient-years, and complete for 97% of the patients. Propensity score analysis was introduced to reduce selection bias., Results: Patients with PSVA were slightly older (61.9 vs 59.8 years, P = 0.014), with lower incidence of calcification (54.9 vs 63.0%, P = 0.05), pure mitral stenosis (29.9 vs 38.9%, P = 0.014) and history of rheumatic fever (44.6 vs 53.9%, P = 0.028). Mechanical prostheses were more frequently implanted in the Non-PSVA group (75.1 vs 65.6%, P = 0.013). Thirty-day mortality was 1.1%. Late survival rates at 5, 10 and 18 years were 86.6 ± 2.0, 70.8 ± 3.2 and 48.0 ± 5.1%, respectively, with no difference between groups. Both groups had compromised late survival when compared with the general population (age and gender matched, P < 0.001). Only age, large left atrium, pulmonary hypertension and 'pure' MR appeared as independent predictors for late mortality. There was no difference regarding adverse valve-related events between groups., Conclusions: Patients submitted to MVR for rheumatic mitral valve disease have a poor prognosis, independently of having the subvalvular apparatus preserved. PSVA did not improve late survival in this setting., (© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Aim: The objective of the study was to evaluate the impact of dental lesions on the periodontium, in a canine model of mandibular osteodistraction., Material and Methods: In six adult male Beagle dogs, an osteotomy was made between the right second lateral incisor and canine, and a distraction device placed. The roots adjacent to the osteotomy were deliberately damaged by the reciprocating saw and chisel, with preservation of the attached gingiva. The osteodistraction protocol used was: latency of 7 days, rate of distraction 1mm per day, and rhythm once a day for 5 days. Vital staining was carried out with tetracycline, Xylenol Orange and Calcein Green. The dogs were sacrificed after 12 weeks of consolidation and the specimens were evaluated with light microscopy (native, polarized light, fluorescence, and after toluidin blue staining)., Results: The periodontal ligament (PDL) regeneration was observed in the 2500 slices examined. Cementum and dentine lesions were repaired by cellular cementum. Loose dentine and cementum-dentine fragments were embedded in regenerated PDL and their surface repaired by cementum. By means of light microscopic examination and within the limited observation time, no degenerative pulpal changes were found, when the pulp canal was not entered. Extensive pulp exposure and destruction resulted in ingrowth of the PDL and bone-like tissue. In that case, cellular cementum also lined the dentine surface of the pulp canal., Conclusion: Although there was an extensive reparative response to the para-pulpal lesions, none of the changes observed showed evidence of a loss of functional integrity of the periodontium at the distraction site. The fate of the tooth with exposed pulp canal remains uncertain.

Introduction: The aim of this retrospective observational case series study was to determine the morbidity of transmandibular Distraction Osteogenesis (DO) using a bone-borne distraction device to adapt the surgical protocol and improve hardware design., Patients and Methods: The treatment of 23 consecutive, non-syndromic patients who underwent transverse mandibular DO after a midline symphyseal osteotomy with the TransMandibular Distractor (TMD ) was evaluated. The follow-up period lasted at least 1 year after the end of the contention period. Treatments were analysed according to the morphological and functional Success Criteria (SC) for Craniofacial Distraction Osteogenesis (CFDO) for patients with developmental dentofacial malformations established by the steering group of European Collaboration on Cranial Facial Anomalies (EUROCRAN)., Results: Appropriate distraction was obtained in 22 of the 23 patients. One patient had irreversible dentition damage, consisting of an inadvertent apical section. All other SC for CFDO were fulfilled 100% at 1 year follow-up. Seven patients suffered from short-term local infections during different phases of treatment. Two patients suffered subluxation of a central incisor that healed uneventfully. Local discomfort due to delayed union (in three patients) and trauma to the lower lip (one patient) were also observed., Conclusion: The main problems were high local infection rates and damage to an apex that required a root filling, as well as patient discomfort due to delayed union and/or the bulkiness of the TMD device. Based on the results of this morbidity study, modifications are recommended for both the surgical protocol and the TMD device hardware.

Introduction: The aim of this paper was to study the effect of transmandibular distraction on the periodontal and dental structures, and the initial movements of the mandibular halves, when using an axial plane non-rigid bone-borne distractor (TMD)., Material and Methods: Fourteen patients undergoing bimaxillary transverse osteodistraction had their six lower anterior teeth assessed for mobility, sensitivity, and pocket depth. Recordings were made pre-operatively, post-distraction, post-consolidation and at 1-year follow-up. Selected landmarks on pre-operative and post-consolidation models were also digitised in three dimensions to study individual tooth movements, and positional changes of the mandibular halves., Results: Pockets depths around the incisor teeth increased during the consolidation period (probably due to reduced oral hygiene), but returned to normal by the 1-year post-operative consultation. Tooth mobility increased temporarily in the active phase (central incisors, lateral incisors) and in the consolidation phase (lateral incisors, canine teeth). Sensitivity to cold was temporarily lost in the incisor teeth, probably as a result of 'apical contusion'. One central incisor was inadvertently apically osteotomized and needed root canal treatment. The angle between the mandibular halves closed by 9.4 degrees., Conclusion: Periodontal and dental morbidity is transient and limited to the distraction and consolidation period, as long as the tooth apices are avoided when the osteotomy is performed. A step-design osteotomy may be preferable when the central incisor apices are close to each other. The transmandibular distractor (TMD) allows for rotation at the temporomandibular joints.