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L’insuffisance rénale chronique (IRC) est en nette augmentation partout dans le monde. La prise en charge nutritionnelle demeure une question centrale qui fait l’objet de travaux permanents ayant pour but la prévention des complications métaboli-ques, endocriniennes et osseuses qui augmentent avec la réduction du débit de filtra-tion glomérulaire (DFG). Parmi les mesures diététiques préconisées pour préserver la fonction rénale, retarder le début du traitement de suppléance et maintenir les patients dans un état de santé satisfaisant: la restriction protidique de 0,5 à 0,28 g/kg/j selon le stade de l’IRC, une limitation du sodium, la prévention de l'hyperkaliémie, la correction de l'acidose, la lutte contre l'hyperparathyroïdie secondaire par une supplémentation calcique précoce et un régime pauvre en phosphore, traitement de l’anémie et la dyslipi-démie. Le dépistage de ces troubles doit être systématique. L’efficacité est assurée lors-qu’une bonne coopération existe entre le néphrologue et le diététicien. [Chronic kidney failure (CKF) is on the rise all over the world. Nutritional care remains a key issue and is the subject of ongoing work aimed at preventing metabolic, endocrine and bone complications that increase with the reduction in glomerular filtration rate (GFR). Among the dietary measures recommended to preserve kidney function, delay the start of replacement therapy, and maintain patients in a satisfactory health state: protein restriction of 0.5 to 0.28g/kg/d, depending on the CKF stage, sodium limitation, hyperkalaemia prevention, acidosis correction, fight against secondary hyperparathyroidism by early calcium supplementation and low phosphorus diet, treatment of anemia and dyslipidemia. Screening for these disorders should be syste-matic. Effectiveness is ensured when good cooperation exists between nephrologist and dietitian.]

Purpose: We aimed to explore student perspectives of the dietetics profession using a professional socialization lens. Methods: We conducted qualitative semi-structured interviews, virtually or by phone, with 25 dietetic undergraduate/graduate students or interns in 2020/21. Transcripts were thematically analyzed. Results: All participants identified as female, averaged 25 years old at the time of the interviews, and were in different stages of their education. Two themes captured their perspectives of the profession: dietitians have technical expertise and professional identities are evolving . Technical expertise was focused on scientific understandings of how individuals consume and utilize food, and how (mostly Western) food should be prepared for safety and maximum nutrition. Participants perceived dietetics as a white, feminized profession with dietitians' role to aid in weight loss; participants actively sought to resist these stereotypes, notably through social media. Conclusions: While holding technical expertise continues to be embedded as a key component of dietetics identity, student professional socialization is also being shaped by social media, racial justice, and body positivity movements. This socialization process is likely to influence changes to the profession as students enter practice.

Copyright of Revue du Monde Musulman et de la Méditerrannée is the property of Edisud and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The world's population will reach around 10 billion by 2050, and our global food demand is expected to increase by 60-110% by then. The current trend in food consumption which favors global greenhouse gas emissions from the agricultural sector is expected to increase by 32% by 2050. The EAT Lancet Commission has published a quantitative reference guide intended to help policy makers to achieve successful food transformation for a wider healthy audience and a sustainable planet. This diet is rich in fruits and vegetables, with protein and fat mainly from plant-based foods, unsaturated oils from fish, and carbohydrates from whole grains. More than 2000 years ago, the five-grain diet, first mentioned in Huangdi neijing, provided relevant and practical proposals on diet that were perfectly consistent with the framework of the EAT-Lancet guide. These traditional Chinese eating patterns, recommended for different food groups, can be easily adapted geographically and culturally. [ABSTRACT FROM AUTHOR]

La cystinurie est une maladie monogénique induisant une perte de fonction d'un transporteur d'acides aminés dibasiques impliqué dans la réabsorption de cystine au niveau des tubules rénaux proximaux. L'excrétion urinaire de cystine chez ces patients est augmentée d'un rapport 10 à 60 par rapport au sujet sain, responsable d'une sursaturation avec précipitation de cristaux de cystine dans les reins et de calculs dans les cavités excrétrices. La physiopathologie de la cystinurie est particulière : la concentration plasmatique de cystine est souvent normale alors que l'absorption intestinale est diminuée. Ce paradoxe est expliqué par une absorption intestinale préservée de cystéine et de méthionine qui sont deux acides aminés soufrés métabolisés notamment en cystine. Le principe du traitement consiste à empêcher la formation de cristaux de cystine dans les reins afin de prévenir la survenue d'une maladie lithiasique, mais aussi d'une authentique néphropathie cristalline responsable d'une insuffisance rénale chez plus de la moitié des patients. Le traitement médical des patients cystinuriques repose (1) sur une diminution de l'excrétion urinaire quotidienne de cystine qui est le reflet de l'absorption intestinale et donc des apports en méthionine ; (2) sur une augmentation du seuil de solubilité urinaire de la cystine afin de prévenir une précipitation cristalline intratubulaire et intracavitaire par une dilution et une alcalinisation des urines avec des valeurs cibles de 3 L et un pH urinaire aux alentour de 7,5. Le traitement par sulfhydryle dont le but est de dissocier les ponts disulfures des molécules de cystine avec un effet modeste sur la dissolution des calculs de cystine constitués ne devrait en toute logique être utilisé en dernier recours une fois les mesures diététiques et la cible de pH urinaire obtenue. Cystinuria is a dibasic amino acid transporter molecular defect preventing cystine reabsorption within renal proximal tubules. A 10 to 60 fold increase of urine cystine concentration compared to healthy subjects is responsible for pure cystine crystal onset within tubules and stones in the urinary tract leading to chronic renal failure in half cases. Plasma cystine concentration is usually reported in the normal range despite a decreased cystine intestinal absorption. This discrepancy is explained by a preserved intestinal absorption of cysteine and methionine, two sulphur amino acids which are partly metabolized into cystine. Monitoring and treatment is based on a pathophysiological approach aiming at decreasing both urine cystine excretion and concentration but also increasing urine cystine solubility (i.e. raising urine pH). Guidelines are thus based upon a methionine restricted diet, a water intake target of 3 liters/day and a urine pH target of 7.5. Sulfhydryl treatment (mainly tiopronin), frequently used in France in order to dissociate cystine disulfur bonds has a moderate effect on cystine stones solubilization and thus should be consider, to our view, only after diet and urine goal targets are reached. [ABSTRACT FROM AUTHOR]

For women with endometriosis, pain, fatigue and digestive problems affect the quality of their daily lives. Many professionals work to help them find a balance between the disease and their activities, expectations and needs., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Résumé: La dénutrition protéino-énergétique chez le sujet âgé est fréquente et grave. Sa prise en charge actuelle au sortir d'une hospitalisation est insatisfaisante. L'objectif de l'étude est d'évaluer la faisabilité et la satisfaction d'un nouveau programme collaboratif et participatif de lutte contre la dénutrition chez le sujet âgé en ville après une hospitalisation, entre patient, médecin généraliste et diététicien nutritionniste. Méthodes. Il s'agissait d'une étude interventionnelle non randomisée, prospective, réalisée de mai 2015 à février 2016 chez les sujets âgés de plus de 75 ans dénutris, avec un score MMSE > 20 et rentrant à domicile après un séjour à l'hôpital. À domicile, un diététicien de ville intervenait durant 3 mois, collaborant avec eux et leur médecin généraliste. La participation des patients et la satisfaction des 3 acteurs étaient évaluées. Résultats. Sur 67 patients approchés, 44 patients ont été inclus et 11,9 % (n = 8) ont bénéficié de la totalité du programme. Un entourage présent (p = 0,001), une éducation diététique à l'entourage (p = 0,003), un MMSE élevé (p = 0,04), avoir un ulcère (p = 0,0097) et un poids élevé en sortie d'hospitalisation (p = 0,03) favorisaient la participation des patients. Les patients (78,6 %) et les médecins généralistes (75 %) étaient satisfaits. Les patients reprochaient le peu d'implication du médecin généraliste et ces derniers estimaient n'avoir acquis aucune connaissance de diététique. Conclusion. La participation des patients et la collaboration entre les acteurs de ce nouveau programme de prise en charge de la dénutrition chez le sujet âgé étaient jugées faibles. Background. Malnutrition in the elderly people is frequent and serious. Management of malnutrition at home after hospitalization is unsatisfactory. The objective of the study is to evaluate the feasibility and participation of a new collaborative and participative program involving the patient, the general practitioner and the dietician nutritionist, to fight against malnutrition in the elderly people at home after hospitalization. Methods. This was a prospective and non-randomized study performed from May 2015 to February 2016, in subjects aged 75 and more, malnourished, with an MMSE score > 20 and returning homes after hospitalization. At home, a dietician worked with the patients and their general practitioner for 3 months. Patient participation and satisfaction of the 3 actors were assessed. Results. Forty-four patients were included and 11.9% (n=8) benefited from the entire program. Present entourage (p=0.001), dietary education to the entourage (p=0,003), a high MMSE score (p=0.04), having an ulcer (p=0.0097), and a high weight at discharge (p=0.03) increased patients' participation. Patients (78.6%) and general practitioners (75%) were satisfied with the program. Patients criticized the lack of involvement of the general practitioner. General practitioners felt they had not acquired any knowledge of dietetics. Conclusion. Patient participation and collaboration between actors of the program of management of malnutrition in elderly people were considered weak. [ABSTRACT FROM AUTHOR]

Résumé: Les maladies liées au gluten ont un double visage : la maladie cœliaque définie de façon robuste, la plus rare mais la plus grave car associée à des comorbidités somatiques (maladies lymphoprolifératives, fractures pathologiques, malabsorption, etc.) et les autres maladies qui répondent au moins partiellement au gluten (sensibilité au gluten non liée à la maladie cœliaque, syndrome de l'intestin irritable), entités nosologiques mal définies se recoupant fortement, non associées à des comorbidités somatiques. Le point commun de ces maladies est que tout ou partie de leur traitement repose sur le régime sans gluten. Les objectifs doivent être adaptés à la maladie : dans la maladie cœliaque, l'adhérence au régime doit être la meilleure possible, tout en ménageant une bonne qualité de vie. Ce régime est en effet difficile à maintenir dans la vie quotidienne, et peut être associé à des comorbidités psychiatriques (anxiété, dépression). Dans les autres maladies non cœliaques, l'approche doit être pragmatique puisque le respect parfait du régime sans gluten n'est pas recherché. Gluten-related diseases have a double face: Robustly defined celiac disease, the less diagnosed but the most serious because associated with somatic comorbidities (lymphoproliferative diseases, pathological fractures, etc.) and other diseases that respond at least partially to gluten (non celiac disease gluten sensitivity, irritable bowel syndrome). These last diseases are poorly defined and overlap strongly; they are not associated with somatic comorbidities. The common point of these diseases is that all or part of their treatment is based on the gluten-free diet. The objectives must be adapted to the pathology: in celiac disease adherence to the diet must be as perfect as possible, while providing a good quality of life. This diet is indeed difficult to maintain in everyday life, and may be associated with psychiatric comorbidities (anxiety, depression). In other non-celiac diseases, the approach must be pragmatic since the perfect respect of the gluten-free diet is not sought. [ABSTRACT FROM AUTHOR]

L'acidose métabolique est une complication fréquente de l'insuffisance rénale chronique. Bien qu'elle apparaisse classiquement à des stades avancés, de nombreuses études suggèrent un état de « rétention protonique global » dès les stades précoces de la maladie, responsables de lésions tissulaires, notamment musculo-squelettiques, d'altération du métabolisme protidique et endocrinien, favorisant la dénutrition et l'inflammation chronique, et enfin augmentant la mortalité globale. La plupart des recommandations internationales préconisent une supplémentation par substrats alcalins, notamment par bicarbonate de sodium, pour lutter contre cette complication. Une alternative intéressante pour corriger l'acidose métabolique consisterait à moduler la production endogène d'acides ou d'alcalins en jouant sur les apports alimentaires. Il a en effet été démontré que le métabolisme de certains aliments consomme ou produit des protons. Ainsi, les régimes hypoprotidiques et riches en fruits et légumes frais permettraient de corriger au moins aussi bien que la supplémentation par bicarbonate l'acidose métabolique, et de lutter contre ses complications, notamment en permettant de ralentir le déclin de la fonction rénale en diminuant les mécanismes adaptatifs délétères pro-fibrosants, comme en témoigne la diminution des marqueurs urinaires de souffrance tubulo-interstitielle. À condition d'être bien conduits, ces régimes ne semblent pas être pourvoyeurs de dénutrition protéino-énergétique ou d'hyperkaliémie. Ceux-ci apparaissent donc comme des alternatives séduisantes, efficaces et sûres, pour lutter contre l'acidose métabolique de l'insuffisance rénale chronique et ses complications. Metabolic acidosis is a frequent complication of chronic kidney disease. Although it is known to appear at advanced stages, many studies suggest a state of "global protonic retention" starting at early stages of the disease, responsible of tissue damage, particularly musculoskeletal, alteration of protidic metabolism and endocrine disorders, promoting malnutrition and chronic inflammation, and finally increasing mortality. The majority of international recommandations suggest of supplementation by alkali, most of the time by sodium bicarbonate, to struggle against this complication. An interesting alternative to correct acidosis would consist on the modulation of the endogenous production of acid by playing with the alimentary incomes. In fact, it has been demonstrated that some different types of food produce or consume protons during their metabolism. Low protein diet and rich fresh fruits and vegetables diet would manage to correct at least as well as the supplementation by sodium bicarbonate the metabolic acidosis, and to struggle against its complications, noteworthy by slowing the decline of glomerular filtration rate by limiting the toxic adaptative fibrotic mechanisms, demonstrated by the decrease of urinary tubulo-interstitial suffering markers. Of the condition of being well led, those diets do not seem to expose patients to an over-risk of malnutrition or hyperkaliemia. They therefore appear to be an attractive alternative, efficiency and safe, to fight against chronic kidney disease metabolic acidosis and its complications. [ABSTRACT FROM AUTHOR]

Many Canadian universities have committed to becoming more accountable to Indigenous Peoples by confronting the systemic, historical, and ongoing colonialism and anti-Indigenous racism that shape their campuses. In this Perspective in Practice piece, we invite the field of dietetics to consider how colonialism has shaped dietetics research, teaching, and practice. We also consider how we might transform the field of dietetics in ways that accept settler responsibility for interrupting racism and colonial harm; support the resurgence of Indigenous food and health practices; and recognise the connections between struggles to ensure that Indigenous Peoples can access culturally appropriate food and health care, and struggles for Indigenous sovereignty and self-determination. We do this by reviewing the history of the dietetics field, examining critical responses to existing Indigenisation and decolonisation efforts, and reflecting on recent changes to required dietetics competencies. We argue that curricula in dietetics programmes must teach the history of the colonial food system and equip students to identify and interrupt the individual and institutional colonial dynamics that contribute to the ongoing dispossession of Indigenous Peoples' lands and food sources and negatively impact Indigenous patients.

This scoping review mapped literature available on Canadian dietetics, nutrition, and foods students' and graduates' interaction(s) with simulation-based education (SBE) during undergraduate and/or practicum. One certified Librarian led the preliminary search (Summer, 2021), while three Joanna Briggs Institute-trained reviewers conducted the comprehensive search via MEDLINE (OVID), CINAHL (EBSCO), Academic Search Premier (EBSCO), Embase (Elsevier), Scopus (Elsevier), and Google (February 2022). A data extraction tool designed specifically for the study objectives and research inclusion criteria was used. We recorded 354 results and included 7. Seven types of SBE were recorded: ( i ) comprehensive care plan (n = 2); ( ii ) nutritional diagnosis/assessment (n = 2); ( iii ) body composition assessment (n = 1); ( iv ) introducing patient to dysphagia care (n = 1); ( v ) nutrition counselling session (n = 1); ( vi ) nutrition-focused physical examination (n = 1); and ( vii ) professional communications via social media (n = 1). Results indicate that Canadian dietitian-led SBE includes the use of simulated patients, nutritional diagnosis/assessment, and the creation of comprehensive care plans, among others. Students have been assessed for performance of trained tasks through exams, self-awareness surveys, and interviews, and SBE activities have been evaluated for effectiveness through questionnaires and interviews with users/students. Canadian literature is limited, and more can be learned by exploring the global context within and outside the profession.

Purpose: To investigate the experiences of dietetic students in a faculty-supervised, noncourse-based service-learning (NSL) opportunity called Nutrition Ignition! (NI!) to understand how NSL activities contribute to dietetic education. Methods: This study used focus group methodology. A convenience sample was recruited from current members of NI!. Participants completed a brief demographic questionnaire and then engaged in a focus group discussion led by a trained moderator who followed a semi-structured guide. Six focus group discussions were transcribed, and a common theme template was developed by researchers. Results: Out of 46 eligible members of NI!, 33 agreed to participate. The main reasons participants joined NI! were to develop professional skills and to help children in the community. Participants discussed many outcomes from their participation in NI!, including enhanced communication skills, especially in terms of knowledge translation; increased ability to be flexible and adapt to "real-world" situations; deeper awareness of the research process; and expanded world view. Conclusion: This study suggests that NSL is an effective way to build dietetic students' personal and professional skills and provide an additional opportunity in academic settings to prepare dietetic students for entry-level practice.

The morphological-compositional analysis of urinary stones allows distinguishing schematically several situations: dietary, digestive, metabolic/hormonal, infectious and genetic problems. Blood and urine testing are recommended in the first instance to identify risk factors of urinary stone disease in order to avoid recurrence or progression. The other objective is to detect a potential underlying pathology associated with high risk of urinary stone disease (e.g. primary hyperparathyroidism, primary or enteric hyperoxaluria, cystinuria, distal renal tubular acidosis) that may require specific management. Lifestyle-diet measures are the basis of the management of all stone types, but pharmacological treatments may be required. METHODOLOGY: These recommendations were developed using two methods: the Clinical Practice Recommendation (CPR) method and the ADAPTE method, depending on whether the question was considered in the European Association of Urology (EAU) recommendations (https://uroweb.org/guidelines/urolithiasis) [EAU 2022] and their adaptability to the French context., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Résumé Les patients dialysés sont considérés à haut risque d'effets indésirables médicamenteux. L'attention particulière qu'ils requièrent est d'autant plus justifiée qu'ils sont souvent âgés et fragiles. Dans cette population, les décès sont essentiellement d'origine cardiovasculaire, puis infectieuse. Par ailleurs, des progrès restent à faire dans la prise en charge diététique étant donné l'importance de l'hypoalbuminémie et du statut nutritionnel en tant que facteurs pronostiques de la mortalité en dialyse. C'est sur ces trois axes impliquant la survie que le pharmacien doit apporter sa contribution au néphrologue, en étant en particulier garant de la pertinence médicamenteuse. Summary The fact that these patients are often old and frail means that they require special attention. In this population, the main cause of mortality is cardiovascular disease followed by infection. Moreover, progress remains to be done in terms of the dietary management of these patients given that hypoalbuminaemia and nutritional status are significant prognostic factors of mortality with dialysis. It is in these three areas which have an impact on survival that the pharmacist can support the nephrologist, by assuring in particular drug compatibility. [ABSTRACT FROM AUTHOR]

Cystic fibrosis (CF) is a chronic condition requiring continued input from the CF dietitian as an integral part of the CF multidisciplinary team. In recent years, the longer life expectancy experienced by people with CF (PwCF) means that nutrition advice and therapy are evolving from a focus on nutrition support to prevention and management of comorbidities. Little has been reported regarding the perceived role of the CF dietitian amongst PwCF. We report the responses to 11 questions that were part of a larger international survey distributed to members of national CF charities in 2018-2019. These questions evaluated PwCFs' perspectives on ( i ) the importance of the CF diet, ( ii ) how often PwCF obtain dietary/nutritional advice from their dietitian, ( iii ) the perceived reliability of information given by the dietitian, ( iv ) other sources of CF information and their perceived reliability, and ( v ) how CF nutrition/diet, as well as CF-related diabetes, ranked as research priorities. There were 295 respondents from 13 countries. Almost half of the respondents (46.8%) contacted their CF dietitian on a frequent/more regular basis, compared to medical/scientific journals/medical/scientific search engines. The CF dietitian was considered a reliable source of information, as 84% of the respondents indicated that the information provided was very/generally reliable. At a time when CF care and expectations are changing rapidly, PwCF are in need of trusted and reliable information to make positive changes in lifestyle and habits. Dietitians working with PwCF should appreciate the pivotal and valued role they perform as purveyors of robust evidence-based information to this chronic disease population.

After the initial weekday hospital stay, a personalized, multidisciplinary care pathway is offered to each patient followed at the specialized obesity center (CSO). This article illustrates the support approach adopted by the CSO at Caen Normandy University Hospital., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

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Copyright of Fabula - LhT is the property of Fabula and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

While conducting nutrition/health research into weight changes during incarceration and related determinants, it became apparent that the correctional setting in Canada was unique and required study design modifications to ensure study success. Consequently, we made many methodological adjustments during recruitment and data collection because of unforeseen challenges in the correctional context. This paper provides an illustrative example and shares insights on the challenges faced when conducting nutrition/health research in Canadian correctional facilities. Guidance on how to adapt research methods to make them more conducive to this unique environment is provided. This paper also highlights the importance of conducting nutrition/health research in this setting, especially given the lack of this type of research and the need for more evidence-based data to guide health promotion and nutritional interventions in Canadian correctional facilities.

Gaps in communication training have been identified in Canadian and international academic and practicum dietetics programs. A workshop was developed to pilot supplementary media training to nutrition students/trainees studying in Nova Scotia. Students, interns, and faculty from two universities participated in the workshop. Data on perceived learning, media knowledge/skill use, and workshop feedback were collected immediately post-workshop using a mixed-form questionnaire. A modified questionnaire was administered eight months post-workshop to obtain information on utility of the perceived acquired knowledge/skills. Closed-ended responses underwent descriptive analysis, while open-ended responses underwent thematic analysis. Twenty-eight participants completed the questionnaire post-workshop, and six completed it at follow-up. All participants rated the workshop positively (7-point Likert scale) and reported learning something new (perceived). Perceived learning emphasized general media knowledge/skills and communication skills. Follow-up data suggested participants had applied perceived media knowledge/skills in message development and media and job interviews. These data suggest that nutrition students/trainees may benefit from supplementary communications and media training and provide a stimulus for ongoing curriculum review and discussion.

Résumé Du fait de l’amélioration de la survie, le cancer est aujourd’hui, dans bien des cas, une pathologie chronique. Une prise en charge nutritionnelle appropriée est nécessaire à tous les stades de la maladie. Pendant la phase de traitement curatif et de consolidation, elle vise à prévenir ou corriger une dénutrition afin de permettre la réalisation des traitements oncologiques les plus appropriés. Pendant la phase des traitements palliatifs, le maintien d’un bon état nutritionnel est le garant d’une meilleure qualité de vie, d’une moindre toxicité des traitements et probablement d’une survie plus prolongée. Après traitement, chez le patient guéri ou en rémission, de nombreux patients conservent des séquelles qui sont des facteurs de risque de dénutrition au long cours (troubles de la déglutition, sensoriels, de la vidange gastrique, séquelles de résection digestive, malabsorption…). De plus, les facteurs nutritionnels de risque de cancer (manque d’activité physique, mauvaise hygiène alimentaire, surpoids ou obésité, par exemple) persistent généralement après la guérison, voire se sont aggravés, et ils bénéficieraient d’une prise en charge qui est trop souvent négligée ; cette dernière vise alors à réduire le risque de récidive ou de second cancer et à diminuer le risque de comorbidité. Ce document dresse un état des lieux de l’existant et des besoins au regard des recommandations de pratique clinique existantes ; il émet des propositions pour une prise en charge rationnalisée dans les parcours de soins de cancérologie. Thanks to the increase of survival rate, cancer is now considered a chronic disease. All the efforts have to be put up in the establishment of nutritional care at every stage of the disease. During curative and consolidation treatments, nutritional care prevents or balances malnutrition to allow appropriate oncologic treatment to be carried out. During the palliative stages of the disease, nutrition care aims to keep patients in a better physical condition to face treatment toxicity and most likely to increase survival. At the end of the treatment, patients often keep sequela that could lead to long-term malnutrition. Moreover, cancer-associated nutritional risk factors (lifestyle with lack of physical activity and/or poor diet, overweight and obesity for instance) usually last after treatment and are eventually worsen. Patients could take advantage from a better care to reduce the risk of relapse or others comorbidities. This article summarizes the current situation and needs in relation to the existing clinical practice guidelines. Proposals are made for a more rational care along the oncological pathways of treatments. [ABSTRACT FROM AUTHOR]

The prevalence of type 2 diabetes (T2D) is constantly increasing, with an average increase of 5.4/year between 2001 and 2011 related to the increase in overweight and obesity cases, an aging population, the improvement of life expectancy of people treated for diabetes and intensified screening. There is limited evidence of the longterm effects on morbidity and health routine screening. Many intervention studies have shown a benefit/risk debatable for intensive treatment and therefore offer customized HbA1c targets taking into account age, and comorbidities. The implementation of lifestyle changes, including adherence to a Mediterranean diet, brings benefits in terms of weight loss, a decrease in drug consumption and improvement of biological constants. T2D is a typical example of the need for a patient-centered medicine, taking into account all aspects of the disease, the associated medical conditions, the patients characteristics, their expectations and needs. [ABSTRACT FROM AUTHOR]

Les allergies alimentaires sont de plus en plus fréquentes et il existe une grande diversité des formes cliniques de l'allergie (anaphylaxie, syndrome d'entérocolite induite par les protéines alimentaires – SEIPA –, syndrome d'allergie pollens-aliments...) et des allergènes incriminés (allergènes rares ou émergents dont certaines légumineuses). Il existe plusieurs phénotypes de patients allergiques alimentaires avec des profils de sévérité différents, des environnements familiaux et scolaires parfois très disparates. La prise en charge diététique est primordiale dans les allergies alimentaires, de l'éviction allergénique à l'immunothérapie orale. L'immunothérapie orale et/ou les biothérapies sont désormais des options thérapeutiques à discuter, tenant compte des recommandations, même si certaines questions restent non résolues. Ainsi, l'approche globale des patients avec une allergie alimentaire doit être adaptée et personnalisée en prenant en compte certains facteurs tels que la qualité de vie, les difficultés d'une éviction alimentaire à la maison ou dans le milieu extrafamilial, le contrôle des comorbidités associées (asthme, dermatite atopique...). Food allergies have increased in recent years in terms of prevalence and there is a great diversity of allergy clinical forms (anaphylaxis, FPIES, pollen food allergy syndrome, etc.) and agent of food allergy (emerging allergens like legumes) There are several food allergy phenotypes with different severity profiles. Sometimes, families and school environments are very disparate. The role of dietary management is essential, from strict food avoidance to oral immunotherapy. Oral immunotherapy and/or biotherapies are now therapeutic options that should be considered taking into account recommendations even if questions are still unresolved. Thus, the therapeutic approach of patients with a food allergy must be adapted and personalized, taking into account additional parameters such as the quality of life, the difficulties of food avoidance at home or in an extra-family environment and the control of associated comorbidities such as asthma or atopic dermatitis. [ABSTRACT FROM AUTHOR]

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Résumé Introduction Dans la prise en charge de l’obésité, de grandes études récentes ont précisé l’efficacité de différents régimes utilisables à long terme, dont celui modérément enrichi en protéines. Or ce régime augmente l’oxydation des lipides à l’exercice, ce qui pose la question d’une synergie amaigrissante de l’exercice ciblé sur l’oxydation des lipides et de l’enrichissement de la ration en protéines. Matériels et méthodes Afin de comprendre si l’activité physique en endurance à faible intensité agit en synergie avec l’enrichissement modéré de la ration en protéines, nous avons comparé les pertes de poids obtenues en soumettant une population de femmes obèses résistantes à l’amaigrissement, à trois stratégies différentes pendant un an : réentraînement ciblé sur l’oxydation des lipides, enrichissement en protéines purifiées de blanc d’œuf (lovamine) et association des deux démarches. Résultats Les sujets LIPOXmax ont perdu 3,93 ± 0,33 kg (3,57 % de leur poids initial) en moyenne et ceux qui prenaient seulement la supplémentation modérée en protéines ont perdu en moyenne 3,54 ± 0,17 kg, soit 4,92 % de leur poids initial. Cette différence n’est pas significative, les pertes de poids sous LIPOXmax seul ou enrichissement modéré en protéines seul sont similaires ( p = 0,05). Ceux associant LIPOXmax avec un supplément de protéines ont perdu 6,17 ± 0,34 kg, soit 8,18 % de leur poids initial en moyenne. La différence de perte de poids entre les sujets simplement réentraînés au LIPOXmax et les sujets réentraînés au LIPOXmax et recevant une supplémentation modérée en protéines est significative ( p = 0,026). Conclusion Ce travail montre que la supplémentation en protéines de blanc d’œuf semble être un complément intéressant à l’activité physique en endurance douce ciblée sur l’oxydation des lipides. Summary Purpose Both endurance exercise targeted on fat oxidation and moderate protein enrichment of diet have been demonstrated to be efficient weight-reducing procedures. In addition, protein enrichment has been shown to increase fat oxidation during exercise. We investigated whether these two strategies are synergistic for weight loss. We compared the weight loss profiles of obese women with diet-resistant obesity submitted to 3 weight-reducing strategies: exercise targeted at the level of maximal lipid oxidation (LIPOXmax), moderate protein enrichment of diet, or the association of both. Subjects trained at the LIPOXmax lost on the average 3.93 ± 0.33 kg (3.57% of their initial weight), and those who only received moderate protein supplements lost an average of 3.54 ± 0.17 kg or 4.92% of their initial weight. Weigh losses induced by only training at LIPOXmax or only protein enrichment were similar ( P = 0.05), while the association of the two methods resulted in an average loss of 6.17 ± 0.34 kg i.e. 8.18% of initial, which was significantly higher than the effect of either of the methods used individually ( P = 0.026). Conclusion Therefore, this preliminary study shows that supplementation with egg protein seems to be an attractive addition to physical activity targeted on endurance soft lipid oxidation. [ABSTRACT FROM AUTHOR]

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