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Low anterior resection syndrome (LARS) is a challenging complication following sphincter-preserving rectal surgery, characterized by bowel dysfunctions such as urgency, frequency, and incontinence. This case series investigates the potential role of lactose intolerance in exacerbating LARS symptoms. Three patients who developed LARS after rectal resections showed persistent symptoms despite conventional management with bulking agents, physiotherapy, and loperamide. However, all three experienced significant improvement in symptomatology, reflected by reductions in their LARS scores, after eliminating cow's milk from their diets. These findings suggest a potential link between lactose intolerance, including possible late-onset forms, and LARS symptoms. This study highlights the effectiveness of dietary modifications, particularly lactose elimination, as a simple and non-invasive strategy for managing LARS. The findings also support the need for dietary screening processes and recommendations for milk substitutes to enhance clinical care. Further research is necessary to validate these observations and refine therapeutic strategies. [ABSTRACT FROM AUTHOR]

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

Despite recent advancements in psoriasis treatment, challenges in management persist. Recently, there has been a rising interest amongst patients in complementary and alternative medicines (CAM), driven by the desire for more natural, holistic approaches and dissatisfaction with conventional treatments. Up to 41% of patients with psoriasis reported using alternative therapies and 39.5% use complementary therapies (Murphy EC, Nussbaum D, Prussick R, Friedman AJ (2019) Use of complementary and alternative medicine by patients with psoriasis. J Am Acad Dermatol 81:280–283). Despite their rapidly growing prevalence, literature on CAM therapies for psoriasis is lacking, making their recommendation difficult. Since the last systematic review on this topic published in 2018, evidence for new alternative therapies has emerged, promoting a further investigation of their efficacy (Gamret AC, Price A, Fertig RM, Lev-Tov H, Nichols AJ (2018) Complementary and Alternative Medicine Therapies for Psoriasis: A Systematic Review. JAMA Dermatol 154:1330–1337). This systematic review aims to compile recent literature on the most studied alternative therapies for psoriasis and further discuss their effectiveness in order to counsel clinicians in guiding patients on the use of these non-standard approaches. A literature search was conducted in the PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov databases for randomized controlled trials (RCT) on complementary and alternative therapies in psoriasis from March 2018 through April 2024, resulting in 12 studies being included in this review. The preliminary results for many treatments such as curcumin, dietary modification and additions, indigo naturalis, meditation, acupuncture, and balneotherapy showed positive clinical effects. However, additional well-designed randomized trials are needed to confirm the potential beneficial effects and to establish safety of use. [ABSTRACT FROM AUTHOR]

Cutaneous mastocytosis is a rare condition characterized by abnormal mast cell proliferation in the skin. We present the case of a 65-year-old man with recurrent urticaria-like rashes persisting for more than eight years. Despite multiple misdiagnoses as insect bites, examination and biopsy revealed mast cell infiltration. The patient's unique lifestyle, particularly his frequent seafood consumption, adds an intriguing dimension to the case. Treatment with systemic antihistamines and corticosteroids provided symptomatic relief, but long-term follow-up showed the persistence of clinical lesions, indicating that the treatment did not adequately address the underlying cause of the disease. A notable improvement in disease control was observed when the patient's diet was adjusted, suggesting a potential link between food and cutaneous mastocytosis. To our knowledge, this is the first documented case of maculopapular cutaneous mastocytosis in Syria.

Background: Lifestyle modification, particularly diet modification, has a significant impact on coronary artery disease (CAD) progression. Ayurveda, traditional Indian medical literature, provides a guide to a balanced lifestyle with detailed dietary instructions. Objective: This study was designed to evaluate the effect of the Ayurveda-based diet kit on components of atheroma plaque: calcified and soft plaque, individually. Methods: This prospective, single-arm, multicenter study was conducted in January 2021-December 2021. Patients were assessed for demographic and clinical characteristics and underwent routine 128-slice multi-detector coronary computed tomography angiography with plaque volumetric analysis for CAD diagnosis and to reflect the extent of plaque deposition at the time of recruitment (baseline) and posttherapy. Patients were prescribed appropriate Panchakarma therapy and a high protein, low carbohydrate diet plan provided with the reverse diet kit that is known to have a high oxidative radical absorption capacity (64,000 units per day). Results: Out of 280 known CAD patients, 246 patients (mean ± standard deviation: 57.63 ± 9.82 years) completed the study. The mean weight and body mass index significantly decreased poststudy intervention. The mean total cholesterol, mean serum triglycerides, and the mean low-density lipoprotein were noted to be significantly and substantially lowered. The fibrotic plaque volume, the fibrofatty plaque volume, and the overall soft plaque volume were also significantly lowered. The mean total atheroma volume (baseline: 541.33 mm3 vs. end of study: 469.57 mm3) was found to be significantly lowered. Conclusion: This study provides an objective world evidence of the effect of Ayurveda-based diet as assessed by the currently available high-end diagnostic tools. [ABSTRACT FROM AUTHOR]

Background: Dietary diversity is important for pregnant women since it has been associated with nutrient adequacy. It is very crucial to ensure optimal fetal health and development. There is no evidence at the community level on the magnitude of dietary diversity and its predictors among pregnant women in okra-producing areas of western Ethiopia. Objective: This study aimed to assess the level of dietary diversity and its associated factors among pregnant women. Design: A community-based cross-sectional study was employed among randomly selected 224 pregnant women in western Ethiopia. An interviewer-administered questionnaire was used to collect the data. The qualitative open 24-h recall was used to assess the level of dietary diversity. Ordinal logistic regression analyses were used by SPSS version 25. An adjusted proportional odds ratio along with a 95% confidence interval [CI] was computed to measure the strengths of the association at a P ≤ 0.05. Result: This study revealed that more than one-fourth, 64 (28.6%), of the respondents were found to have high dietary diversity scores. Antenatal Care [ANC] visits (Adjusted Odds Ratio [AOR] = 2.10, [95% CI: 1.13, 3.90], P = 0.01), changing food intake (AOR = 2.97, [95% CI: 1.16, 3.67], P = 0.002), and being food secure household (AOR = 2.63, [95% CI: 1.38, 5.00], P = 0.003) were significantly associated with a higher probability of having high dietary diversity score. However, lack of formal education (AOR = 0.34, [95% CI: 0.61, 0.89]) was inversely associated with the probability of having high dietary diversity. Conclusion: More than half of pregnant women in western Ethiopia were found to have low dietary diversity. Therefore, ANC follow-up, dietary modification, and promotion of frequent use of wild edible plants (okra) to maintain household food security were very crucial.

Background Previous research suggests that the Mediterranean diet (a diet high in fruits and vegetables, lean protein, legumes, whole grains, and olive oils) provides protective effects against colorectal cancer. However, there has been little research to determine how the Mediterranean diet could help prevent the recurrence of colorectal cancer following chemotherapy treatment. Objective This systematic review assesses the impact of the Mediterranean diet on the rate of recurrence following colorectal cancer treatment. Methods A systematic search on PubMed, UNE Library, and EMBASE was conducted to find all research studies assessing the Mediterranean diet and its effects on colorectal cancer and post-treatment effects. Article titles and abstracts were screened for relevance in addition to full article screening for eligibility and were quality rated based on ANDEAL criteria. Results Sixteen studies met the eligibility criteria and, as a result, were included. One study assessed lifestyle factors; three studies assessed the components of the Mediterranean diet and their effects on colorectal cancer; one study assessed the dietary inflammatory index and its impact on colorectal cancer; five studies assessed adherence to the Mediterranean diet; four studies assessed diet following cancer treatments; and two studies assessed long-term nutritional intervention on cancer recurrence. The results revealed that the Mediterranean diet has a positive impact on reducing the risk of colorectal cancer, with potential health benefits following treatment for colorectal cancer. Limitations in analyzing results include being a time-locked study, inability to access all articles on the topic, use of English-only articles, and limitation of search terms utilized. Conclusions While previous research reveals evidence that the Mediterranean diet reduces the risk of colorectal cancer, there is compelling data to suggest that adherence the Mediterranean diet, as a normal diet pattern following treatment for colorectal cancer, could reduce the rate of recurrence. Future research is needed to examine the effects of the Mediterranean diet following colorectal cancer treatment.

Insulin resistance (IR) is considered one of the most serious chronic conditions. Although IR usually starts silently (euglycemic state), it can seriously lead to impaired glucose tolerance and the development of diabetes mellitus (DM) with other debilitating complications. The current study was conducted for four months to test the application of healthy dietary modification and/or regular programmed exercise on 120 Egyptian male subjects with high blood glucose levels, high insulin levels, and high homeostatic model assessment of insulin resistance (HOMA-IR). They were assigned into 4 groups. The first group received no intervention (control). The second group received healthy dietary intervention. The third group received regular exercise program. The fourth group received both healthy dietary intervention and regular exercise program. Along with blood glucose and insulin levels; weight and triglycerides (TG) levels were also assessed. Compared to the control group, the results showed significant reduction (p<0.05) in both fasting and postprandial blood glucose and insulin levels as represented by HOMA-IR along with significant reduction (p<0.05) in the other metabolic parameters assessed during the study in both dietary intervention alone and exercise intervention alone groups. The reduction was more significant (p<0.05) in the group that received both healthy dietary and regular exercise intervention. In conclusion; IR could be avoided if either healthy dietary modification and/or regular programmed exercise are adopted. [ABSTRACT FROM AUTHOR]

Purpose: The current study sought to assess the synergistic effects of an eight-week nutrition education program (NEP) and controlled dietary modification (CDM) on the nutrition knowledge (NK), nutrition practice (NP), and daily dietary intake of nutrition counselling group (NCG) versus ad-libitum group (ALG), as well as to identify the dietary factors predicting athletes' NP. Methods: A total of 105 male players (14–18 years) from the sports disciplines-football, hockey, swimming, and athletics-were block randomized into the NCG and the ALG. The NCG underwent an 8-week nutritional intervention (NI) that included NEP and CDM, while ALG did not participate in the NI and followed ad-libitum dietary intake. Primary data on each subject's NK, NP, daily food intake, and anthropometric measurements were collected before and after the intervention period for paired and case-control analysis. Results: A strong association has been depicted between players’ NK and NP. Daily intake of carbohydrate, protein, calcium, and dietary fibre could be referred to as the significant positive predictors of NP, while fat intake is the negative predictor. The synergistic implementation of NEP and CDM reduced the energy deficits among the NCGby significantly increasing their daily calorie intake to an average of 97%. Protein intake was significantly increased, thus meeting 88% of the recommendation, while the increase in carbohydrate intake was insignificant, meeting 89% of the standards post-NI. Further, the NCG showed significant increases in intake of minerals like calcium, phosphorus, iron, zinc, and selenium, while the ALG had substantial reductions. The former also exhibited significant rises in vitamin A, B9, B12, C, and E intakes. The most significant spikes in macro and micronutrient intake were observed in the footballers and hockey players, who were also the groups with the largest increases in NK and NP scores. Conclusion: The equilibrium in macronutrient bifurcations and relative macronutrient and micronutrient intake post-intervention indicates the effectiveness of nutritional enactment through an 8-week controlled dietary modification and systematic nutrition education programme on the nutritional status of young athletes. Therefore, good nutrition knowledge may improve the dietary patterns and nutrition intake of athletes. Intervention studies should emphasize nutrition education, aiming for improved athletic performance.

Background: Diet is a critical component of healthy lifestyle, especially in cardiac rehabilitation. Psychological interventions, as well as mix‐treatment interventions, such as psychological components, appear promising approaches in the adoption and maintenance of a healthy diet in patients with cardiovascular disease (CVD). Given the variety of clinical intervention programmes available, we aimed to determine whether psychological interventions and interventions that incorporate psychological components provide better lifestyle outcomes than traditional care, specifically targeting dietary outcomes, and what types of psychological or mix‐treatment interventions are more likely to benefit patients with CVD. Methods: A systematic literature search was performed using MEDLINE (PubMed), Scopus, Cochrane Library and PsycINFO to identify interventional studies, published from 2012 to 2022, written in English, evaluating psychological and mix‐treatment intervention programmes for dietary outcomes in patients with CVD. In total, 33 intervention studies (n = 5644 patients) were retrieved and analysed using fixed and random effects models. Results: No significant effect of the psychological intervention was observed regarding fruit and vegetable intake (Hedge's g = +1.06, p = 0.766), whereas a significant reduction was observed in alcoholic beverage consumption in the intervention group, as compared to the control group (Hedge's g = −7.33, p < 0.001). However, based on both our qualitative and quantitative analyses, psychological and mix‐treatment interventions were more effective than traditional models in dietary modification. Also, the majority of effective interventions were psychological over mixed‐treatment interventions. Conclusions: Findings add to the growing evidence suggesting that specific psychological interventions may be effective approaches in dietary modification for patients with CVD, potentially forming part of public health agenda. Key points: Psychological interventions are a part of cardiac rehabilitation for addressing maladaptive lifestyle behaviours.Psychological and mix‐treatment interventions were more effective than traditional models in modifying dietary habits, dietary adherence and alcohol, salt and fat intake.The most commonly effective psychological interventions were based on social cognition and learning‐cognitive models.Further research is needed with well‐designed interventions, whereas better understanding the impact of contexts is also warranted. [ABSTRACT FROM AUTHOR]

Background:Meta-analyses of observational studies associate adherence to several dietary patterns with cognitive health. However, limited evidence from full scale, randomized controlled trials precludes causal inference regarding dietary effects on cognitive function. Methods:The Women's Health Initiative (WHI) Dietary Modification (DM) randomized trial, in 48,835 postmenopausal women, included a subset of 1,606 WHI Memory Study (WHIMS) participants >= 65 years old, to assess low-fat dietary pattern influence on global cognitive function, evaluated with annual screening (Modified Mini-Mental State Examinations [3MSE]). Participants were randomized by a computerized, permuted block algorithm, stratified by age group and center, to a dietary intervention (40%) to reduce fat intake to 20% of energy and increase fruit, vegetable and grain intake or usual diet comparison groups (60%). The study outcome was possible cognition impairment (failed cognitive function screening) through the 8.5 year (median) dietary intervention. Those failing screening received a comprehensive, multi-phase cognitive function assessment to classify as: no cognitive impairment, mild cognitive impairment, or probable dementia. Exploratory analyses examined the composite endpoint of death after possible cognitive impairment through 18.7 years (median) follow-up. The WHI trials are registered at ClinicalTrials.gov:NCT00000611. Findings:Among the 1,606 WHIMS participants, the dietary intervention statistically significantly reduced the incidence of possible cognitive impairment (n = 126; hazard ratio [HR] 0.59 95% confidence interval [CI] 0.38-0. 91, P = 0.01) with HR for dietary influence on subsequent mild cognitive impairment of 0.65 (95% CI 0.35-1.19) and HR of 0.63 (95% CI 0.19-2.10) for probable dementia (PD). Through 18.7 years, deaths from all-causes after possible cognitive impairment were non-significantly lower in the dietary intervention group (0.56% vs 0.77%, HR 0.83 95% CI 0.35 to 2.00, P = 0.16). Interpretation:Adoption of a low-fat eating pattern, representing dietary moderation, significantly reduced risk of possible cognitive impairment in postmenopausal women. Funding:Several Institutes of the US National Institutes of Health.

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

Mounting evidence shows that dietary intake of fruits with polyphenols is beneficial to improve impaired memory functions. This study explored the preventive as well as therapeutic effects of diet enriched with Morus alba fruits extract (DEMA) in streptozotocin (STZ) induced mouse model of memory impairment. The study consisted of two facets: one aspect consisted of pretreatment of animals with DEMA for two weeks followed by STZ (i.c.v) intervention and the second phase involved induction of dementia with STZ (i.c.v) followed by treatment with DEMA for 14 days. Cognitive functions of animals were measured by Morris Water Maze test and to delineate the associated mechanism of action, brain biochemical estimations (acetyl-cholinesterase activity, myeloperoxidase activity, thiobarbituric acid reactive species, superoxide dismutase activity, reduced glutathione and nitrite/nitrate) and histopathological studies (haematoxylin and eosin staining) were performed. Pre- and post- treatment with DEMA significantly prevented and attenuated, respectively, the detrimental effects of STZ on mice brain. The results demonstrated that dietary modification, by incorporation of M. alba fruits, reduces the incidence and aids in treatment of memory disorder in mice by reducing central cholinergic activity, decreasing oxidative stress and preventing neurodegeneration. [ABSTRACT FROM AUTHOR]

Adult Refsum disease (ARD) is a rare peroxisomal biogenesis disorder inherited in an autosomal recessive fashion and is often characterized by retinitis pigmentosa, cerebellar ataxia, and polyneuropathy. Many patients with ARD require diet modification, psychosocial support, and various specialist visits to manage their symptoms. In this study, we explored the quality of life in individuals with ARD by analyzing retrospective survey data collected by the Coordination of Rare Diseases at Sanford (CoRDS) Registry and Global Defeat Adult Refsum Everywhere (DARE) Foundation. Statistical tests used were frequencies, mean, and median. There were 32 respondents, ranging between 11 and 32 responses for each question. The mean age at diagnosis was 35.5 ± 14.5 years (range 6–64) with 36.4% male and 63.6% female respondents. The average age for retinitis pigmentosa diagnosis was 22.8 ± 15.7 years (range 2–61). Dieticians were the most frequently seen (41.7%) for management of low-phytanic-acid diets. Most participants exercise at least once per week (92.5%). Depression symptoms were reported in 86.2% of the participants. Early diagnosis of ARD is important for managing symptoms and preventing progression of visual impairment due to phytanic acid buildup. Interdisciplinary approach should be used for patients to address physical and psychosocial impairments of ARD. [ABSTRACT FROM AUTHOR]

Many cancers are associated with poor diet, lack of physical activity, and excess weight. Improving any of these three lifestyle factors would likely reduce cancer deaths. However, modifications to each of these—better nutrition, enhanced activity and fitness, and loss of extra body fat—have different effect sizes on cancer mortality. This review will highlight the relative benefit that each lifestyle change, enacted prior to a diagnosis of cancer, might impart on cancer-related deaths, as well as attempt to quantify the changes required to derive such a benefit. The review relies primarily on epidemiological data, with meta-analyses serving as the backbone for comparisons across interventions and individual studies within the larger meta-analyses providing the data necessary to form more quantitative conclusions. The reader can then use this information to better understand, recommend, and implement behaviors that might ultimately reduce cancer mortality. Of all the interventions, it seems clear that exercise, specifically improving cardiorespiratory fitness, is the best way to decrease the risk of dying from cancer. [ABSTRACT FROM AUTHOR]

The obesity epidemic is not only limited to high-income or urbanized societies, but has also become prevalent among rural communities, even in India. Approaches to modifiable behaviors, like unhealthy dietary habits or a sedentary lifestyle, could bring positive results among obese populations. This research aimed to assess the effectiveness of lifestyle intervention programs to prevent obesity and cardio-metabolic risks among Bengali obese adults (Body Mass Index of 25-30kg/m2). The population was selected from rural and urban communities of Hooghly district in west Bengal, India and included 121 participants (20-50 years), divided into four groups (rural male, rural female, urban male, and urban female) who underwent a 12-month intervention program. Anthropometric parameters, systolic and diastolic blood pressure, biochemical parameters (fasting blood glucose, fasting plasma insulin, Homeostatic Model Assessment for Insulin Resistance [HOMA-IR] and lipid profile), dietary habits, and physical activity profiles were assessed before the study (baseline), after 12 months of intervention (post-intervention), and after 24 months (follow-up), among all groups, to evaluate changes in data within and between the groups (rural vs. urban). The results showed a significant decline in anthropometric parameters and fasting blood glucose levels among all intervention groups, HOMA-IR in rural females, and serum triglyceride levels in urban groups. A significant improvement was noted regarding dietary habits and physical activity, even during follow-up. The impact of the intervention program did not show any rural-urban difference. The lifestyle intervention program was effective in reducing obesity and related health risks and promoting a healthy lifestyle among the target population. [ABSTRACT FROM AUTHOR]

ABSTRACT Background: The need to search for reliable process indicators for effectiveness of anti-diabetic therapy have been expressed in the literature. Process indicators have been described as important processes that contribute to the achievement of outcomes. Objective: This study seek to identify and propose evidence based process indicators for good outcome (effectiveness) of anti-diabetic therapy in a Nigerian University Teaching Hospital. Methods: A crossectional study using questionnaire about degree of subjects’ knowledge/practice of lifestyle/dietary modification based on set criteria was conducted. Glycemic control based on latest monitoring tests and physician’s remark were extracted from case note of each selected subject. Sample Size, n=1200. Subjects were selected by systematic random sampling (Sampling Interval=1). Results: Three Hundred and Thirteen (77.7%) out of 403 subjects who had good glycemic control were effects of exercise those who had excellent knowledge about signs and symptoms of hyperglycemia, beneficial effects of exercise, treatment and excellent practice of self monitoring. About 311 (77.2%) out of 403 subjects who had good glycemic control were those who had excellent knowledge about dietary modification. Almost 308 (76.4%) out of 403 subjects who had good glycemic control were those who had excellent knowledge about lifestyle modification. Three Hundred and Six (75.9%) out of 403 subjects who had good glycemic control were those who had excellent knowledge about complications of diabetes mellitus. Significant proportion of subjects who had excellent practice of lifestyle/dietary modification had good glycemic control. Conclusion: Evidence based process indicators for good outcome (effectiveness) of anti-diabetic therapy have been identified/proposed as degree of knowledge about signs and symptoms of hyperglycemia, complications of diabetes mellitus, beneficial effects of exercise, treatments, dietary modification and lifestyle modification. Other process indicators identified/proposed are degree of practice of self-monitoring, lifestyle and dietary modification.

Introduction: Observational studies demonstrated controversial effect of polyunsaturated fatty acids (PUFAs) on Parkinson's disease (PD) with limited causality evidence. Randomized control trials showed possible improvement in PD symptoms with PUFA supplement but had small study population and limited intervention time. Methods: A two-sample Mendelian randomization was designed to evaluate the causal relevance between PUFAs and PD, using genetic variants of PUFAs as instrumental variables and PD data from the largest genome-wide association study as outcome. Inverse variance weighted (IVW) method was applied to obtain the primary outcome. Mendelian randomization Egger regression, weighted median and weighted mode methods were exploited to assist result analyses. Strict Mendelian randomization and multivariable Mendelian randomization (MVMR) were used to estimate direct effects of PUFAs on PD, eliminating pleiotropic effect. Debiased inverse variance weighted estimator was implemented when weak instrument bias was introduced into the analysis. A variety of sensitivity analyses were utilized to assess validity of the results. Results: Our study included 33,674 PD cases and 449,056 controls. Higher plasma level of arachidonic acid (AA) was associated with a 3% increase of PD risk per 1-standard deviation (SD) increase of AA (IVW; Odds ratio (OR)=1.03 [95% confidence interval (CI) 1.01-1.04], P = 2.24E-04). After MVMR (IVW; OR=1.03 [95% CI 1.02-1.04], P =6.15E-08) and deletion of pleiotropic single-nucleotide polymorphisms overlapping with other lipids (IVW; OR=1.03 [95% CI 1.01-1.05], P =5.88E-04), result was still significant. Increased level of eicosapentaenoic acid (EPA) showed possible relevance with increased PD risk after adjustment of pleiotropy (MVMR; OR=1.05 [95% CI 1.01-1.08], P =5.40E-03). Linoleic acid (LA), docosahexaenoic acid (DHA), docosapentaenoic acid (DPA) and alpha-linolenic acid (ALA) were found not causally relevant to PD risk. Various sensitivity analyses verified the validity of our results. In conclusion, our findings from Mendelian randomization suggested that elevated levels of AA and possibly EPA might be linked to a higher risk of PD. No association between PD risk and LA, DHA, DPA, or ALA was found. Discussion: The odds ratio for plasma AA and PD risk was weak. It is important to approach our results with caution in clinical practice and to conduct additional studies on the relationship between PUFAs and PD risk. [ABSTRACT FROM AUTHOR]

Background and Objectives: Respiratory diseases account for 55.5% and 33.1% of all mortality rates in patients with Alzheimer's disease and vascular dementia, respectively. However, the widespread use of spirometers is often difficult due to challenges in performing the procedure. Therefore, the use of spirometers is usually unfeasible in patients with dementia and hinders the provision of preventive measures for aspiration pneumonia. The party horn is a common toy in many countries and can potentially be used as a novel tool. This study was conducted to analyze the usefulness of the party horn as an assessment tool for respiratory function, and to detect eating-related behavioral problems in patients with dementia. Materials and Methods: A total of 62 inpatient participants with dementia (34 males, 28 females; age, mean ± SD, 80.4 ± 7.59 years) were included in the study. The respiratory functions of patients were assessed using a party horn and a spirometer. Assessment items pertaining to cognitive function, mental and behavioral disorders, eating-related behavioral problems, and the required dietary modifications were evaluated to compare between patient groups stratified by respiratory function. Results: Significant differences between groups were noted in length of hospital stay, cognitive functions, mental and behavioral disorders, eating-related behavioral problems, and dietary modifications. Forced expiratory volume in 1 s, peak expiratory flow, and eating-related behavioral problems were significantly associated with the party-horn-integrated value (p < 0.05). Conclusions: Party-horn-based evaluation can facilitate the screening and evaluation of older dementia patients for eating-related behavioral problems and aspiration risk. [ABSTRACT FROM AUTHOR]

Background: Dietary diversity is important for pregnant women since it has been associated with nutrient adequacy. It is very crucial to ensure optimal fetal health and development. There is no evidence at the community level on the magnitude of dietary diversity and its predictors among pregnant women in okra-producing areas of western Ethiopia. Objective: This study aimed to assess the level of dietary diversity and its associated factors among pregnant women. Design: A community-based cross-sectional study was employed among randomly selected 224 pregnant women in western Ethiopia. An interviewer-administered questionnaire was used to collect the data. The qualitative open 24-h recall was used to assess the level of dietary diversity. Ordinal logistic regression analyses were used by SPSS version 25. An adjusted proportional odds ratio along with a 95% confidence interval [CI] was computed to measure the strengths of the association at a P ≤ 0.05. Result: This study revealed that more than one-fourth, 64 (28.6%), of the respondents were found to have high dietary diversity scores. Antenatal Care [ANC] visits (Adjusted Odds Ratio [AOR] = 2.10, [95% CI: 1.13, 3.90], P = 0.01), changing food intake (AOR = 2.97, [95% CI: 1.16, 3.67], P = 0.002), and being food secure household (AOR = 2.63, [95% CI: 1.38, 5.00], P = 0.003) were significantly associated with a higher probability of having high dietary diversity score. However, lack of formal education (AOR = 0.34, [95% CI: 0.61, 0.89]) was inversely associated with the probability of having high dietary diversity. Conclusion: More than half of pregnant women in western Ethiopia were found to have low dietary diversity. Therefore, ANC follow-up, dietary modification, and promotion of frequent use of wild edible plants (okra) to maintain household food security were very crucial. [ABSTRACT FROM AUTHOR]

Kidney disease is characterised by the improper functioning of the kidney as a result of kidney damage caused by hyperglycaemia-induced oxidative stress. The moderate hyperglycaemia seen in prediabetes can be treated using a combination of metformin and lifestyle interventions (low-calorie diets and exercising). However, patients have been reported to over-rely on pharmacological interventions, thus decreasing the efficacy of metformin, which leads to the development of type 2 diabetes mellitus (T2DM). In this study, we investigated the effects of a rhenium (V) compound in ameliorating renal dysfunction in both the presence and absence of dietary modification. Kidney function parameters, such as fluid intake and urine output, glomerular filtration rate (GFR), kidney injury molecule (KIM 1), creatinine, urea, albumin and electrolytes, were measured after 12 weeks of treatment. After treatment with the rhenium (V) compound, kidney function was restored, as evidenced by increased GRF and reduced KIM 1, podocin and aldosterone. The rhenium (V) compound ameliorated kidney function by preventing hyperglycaemia-induced oxidative stress in the kidney in both the presence and absence of dietary modification. [ABSTRACT FROM AUTHOR]

Background: Obesity is not only associated with cardiovascular diseases but also a primary cause of liver dysfunction and other related diseases. This study’s aim was to determine the impact of a combination of dietary modification and aerobic exercise on liver function in overweight and obese adult males. Methods: 45 overweight or obese men were randomly divided between the control group (n = 22) and intervention group (n = 23). Subjects in the intervention group were provided with dietary modification and aerobic exercise programmes. Dietary modification is a diet which restricts calorie intake and balances nutrients. Before and after 12 weeks of intervention, participants’ anthropometric characteristics and biochemical parameters relating to liver function including aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) were measured. Results: 12 weeks of aerobic exercise and dietary modification resulted in average weight loss of 10.6%, and body mass index, waist circumference and fat percentage decreased by 10.2%, 9.4% and 14.5% (p < 0.05). AST, ALT, GGT and ALP in the intervention group reduced by 20.6%, 18.1%, 37.7% and 6.1% (p < 0.05). Compared to the control group, AST, ALT, GGT and ALP in the intervention group were markedly lower (p < 0.05). Furthermore, there was a markedly positive relationship between the reduction rates of body weight and GGT (p < 0.05). Conclusion: 12 weeks of aerobic exercise and dietary modification caused significant weight, waist circumference and body fat percentage reduction in overweight and obese men and their liver function was improved. The findings can provide a scientific reference for the improvement of liver function and prevention of liver diseases among overweight and obese people.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder leading to chronic debilitating issues. A healthy diet plays an integral role in maintaining the gut microbiota equilibrium, thus promoting digestive health. The structure and function of gut microbiota are affected by genetics and environmental factors, such as altered dietary habits, gastroenteritis, stress, increased use of alcohol and drugs, and medication use. Whereas there are various management approaches cited in the literature to manage symptoms of IBS, the purpose of this article is to focus on dietary options that will restore the gut microbiome and help in managing IBS symptoms. Some of the diets that are discussed in this article include a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet, gluten-free/wheat-free diet, high-fiber diet, dietary and herbal supplements (psyllium, peppermint oil), and probiotics/prebiotics/synbiotics. The clinical practice guidelines recommended by the American College of Gastroenterology outlines evidence-based dietary recommendations for patients with IBS to manage symptoms. Recent advancements in the dietary management of IBS highlighting the use of a patient-centered, personalized nutrition approach along with lifestyle changes, pharmacological therapies, and psychosocial and behavioral interventions are also reviewed and discussed. [ABSTRACT FROM AUTHOR]

Micronutrient deficiencies, especially those of iron, vitamin A, zinc and iodine are most common around the world, particularly in children and adolescents. These deficiencies can be prevented through nutrition education and consumption of a healthy diet containing diverse foods, as well as food fortification and supplementation. Available evidence has suggested that instead of synthetic supplements, dietary diversification and modification by including micronutrient-rich foods with appropriate food preparation methods to increase bioavailability, is an effective strategy to treat deficiency state. Therefore, a literature search was conducted for studies i) developing nutritious food products and ii) evaluating food intervention effects. Twelve studies described formulation of snacks/recipes using micronutrientrich foods and proper cooking methods to enhance bioavailability. Twenty-four food-based intervention trials in children (6 months-16 years) reported increase in micronutrient intakes. Of these, 4 studies reported improvements in all growth parameters except one study showing no improvement in height z scores, 6 studies observed positive changes in bone and muscle development, whereas one study found no effect of dairy intervention on bone mass accrual, 6 studies noted increases in biochemical parameters and/or decrease in infections, whereas two showed no change in serum levels, 4 studies noticed improved cognitive/scholastic performance. Thus, available literature indicates that supplementing snacks or small meals with high bioavailable micronutrient contents significantly increases micronutrient intake and help improving growth and development of children. Further research is warranted to devise food-based strategies for improving micronutrient quality of diets to lower the associated health risks. [ABSTRACT FROM AUTHOR]

The continual growth of tumor cells requires considerable nutrient consumption. Methotrexate (MTX) is used to treat certain types of cancer by blocking the DNA and RNA productions through interfering one‐carbon metabolism and de novo purine and pyrimidine synthesis. However, treatment of MTX may cause many serious adverse effects, which hamper its clinical application. Herein, the authors synthesize ferrous ions, histidine, and MTX assembled nanoparticles (FHM) to deliver MTX at tumor site and enhance the sensitivity of tumor cells to MTX with histidine catabolism. Furthermore, fasting‐mimicking diet (FMD) is applied to intervene in the one‐carbon metabolism and enhance the cytotoxicity of MTX. Meanwhile, FMD treatment can significantly augment the cellular uptake and tumor accumulation of FHM nanoparticles. Due to the triple inhibitions of the one‐carbon metabolism, the proliferation of tumor cells is strongly disturbed, as which is highly replying on DNA and RNA production. Taken together, a 95% lower dose of MTX adopted in combined therapy significantly inhibits the growth of two types of murine tumors without evident systemic toxicity. This strategy may provide a promising nucleotide metabolism‐based nanomedicine for cancer therapy. [ABSTRACT FROM AUTHOR]

Aim: This scoping review aimed to explore the extent of the evidence of experimental studies evaluating the cost effectiveness of dietary interventions in individuals with mental disorders. Methods: Five databases (CINAHL, EMBASE, MEDLINE, PsycINFO and Scopus) were searched to October 2020 for cost‐analysis studies of interventions aiming to improve dietary intake in people with mental disorders. No restriction was placed on participant age, mental disorder type or intervention design. Results are presented narratively. Results: Of 2753 articles identified, 13 articles reporting on eight studies were included. Studies were RCTs (n = 5), cluster RCT (n = 1), cluster preference RCT (n = 1), and pre‐post test (n = 1). Seven studies were in community settings (eg, outpatient clinics), and one study in the community housing setting. All studies were in adults, seven included male and female participants, and one included only females. Defined mental disorder diagnoses included serious/severe mental disorders (n = 3), major depression (n = 2), schizophrenia, schizoaffective disorder or first‐episode psychosis (n = 1), any mental disorder (n = 1), and bulimia nervosa (n = 1). Five interventions were multi‐behaviour, two were diet only and one was eating disorder treatment. Cost analyses included cost‐utility (n = 3), cost‐effectiveness (n = 1), cost‐utility and cost‐effectiveness (n = 3), and a costing study (n = 1). Two studies (25%) reported positive results in favour of cost effectiveness, and four studies reported a mix of positive and neutral results. Conclusions: There is limited evidence evaluating the cost effectiveness of dietary interventions in individuals with mental disorders. Additional studies in various settings are needed to confirm cost effectiveness of different interventions. [ABSTRACT FROM AUTHOR]

Objectives: Cancer survivors are more related with healthy life-style including healthy diet after diagnosis. We evaluate inhere the dietary habit of Turkish breast or colon cancer patients after diagnosis in addition the changing dietary habit during follow-up period. Methods: Totally 228 breast or colorectal cancer patients were included. Dietary patterns were evaluated with food consumption frequency questionnaire. Any difference and related socioeconomical factors of patients with dietary changings were evealuated by logistic regression analysis. Results: Over two third of survivors had breast cancer with the median age of 57. The mean follow-up period of the patients was found to be 4.19±3.55 years. Most of patients (71.7%) reported the changing in food intake after the diagnosis. The most common changings were an increase of consuming fruit and vegetables, lower intake of red and processed meat, and sugar. Physical activities (p=0.003), presence of chronical illness (p=0.003) and adjuvant chemotherapy and radiotherapy (p=0.001) were correlated with changing dietary habit. Conclusion: The appropiate diet is important for management of cancer survivors. Our study shows the importance of adaptation of healthy dietary habits of cancer survivors that reflects Turkish population. [ABSTRACT FROM AUTHOR]

Abstract Aim To explore the experience of dealing with defecation dysfunction by changing the eating behaviours of people with rectal cancer following sphincter‐saving surgery. Design The descriptive qualitative design was applied. Methods Individual semi‐structured interviews were conducted with 36 purposively selected rectal cancer survivors who had experienced sphincter‐saving surgery. All interviews were recorded and transcribed verbatim. The thematic analysis was used to structure the data analysis. Results Three major themes, namely “have motivations to change diet”; “need strategies to change diet” and “face barriers to change diet” were generated along with 12 subthemes. Overall, needing to change one's dietary behaviour is the most important theme in addressing defecation dysfunction in patients following sphincter‐saving surgery. Future studies need to focus more on the specific relationship between different food types and the degree of defecation dysfunction. Systematic, scientific and continuous instructions on eating behaviour are in great need for patients after sphincter‐saving surgery.

Purpose: Metabolic syndrome (MetS) is a major risk factor for cardiovascular diseases and type-2 diabetes. The study aimed to establish the efficacy of a community-based lifestyle intervention on MetS in Kenyan adults using randomized control trial involving a 15-months follow up. Methods: A randomized controlled trial involving 352 (18–64 years old) adults with MetS spanning 15-months duration. Participants were recruited from a Nairobi based Mission-led outpatient clinic, randomly assigned equally into intervention and control groups. The intervention group was exposed to a community-based health education on lifestyle modification, while control group was subjected to hospital-led routine care involving treatment and general lifestyle advice. The study was structured into baseline, intervention and evaluation phases with inbuilt data collection in each phase. Physiologic, anthropometric, and clinical parameters as well lifestyle characteristics were measured at baseline, midline and end-line. The parameters were compared across the groups and between the time points during analyses using chi-square test, binary logistic, independent t-test and paired t-test. Results: Proportion of participants with MetS declined significantly (p < 0.001) with marked (p < 0.05) improvement in markers of MetS (elevated BP, raised sugars, cholesterols, central obesity) in intervention compared to control group. The rates of consumption of fruits, vegetables, legumes, nuts and uptake of physical activity significantly (p < 0.05) improved in the intervention group. However, the intake of processed/fast foods, salt, sugar, and alcohol significantly (p < 0.05) declined in the intervention compared to controls by the end-line. Conclusion: One in three adults under the community-based lifestyle intervention had improvement in physiologic, anthropometrics and clinical markers relevant to definition of MetS. Additionally, an improved adherence to the recommended dietary intake and increased uptake of physical activity in adults with MetS was observed. These findings underscore the feasibility, effectiveness and proof of concept for community-based lifestyle approach as a viable strategic intervention for addressing premorbid risk factors for cardiovascular CVDs and diabetes before evolving into full blown conditions in low-income settings. [ABSTRACT FROM AUTHOR]

Abstract Background The current paradigm for treating toddler’s diarrhea comprises dietary modification and fluid restriction. Previous studies show that probiotics and proton-pump inhibitors (PPIs) or H2 blockers could control diarrhea associated with functional gastrointestinal disorders (FGIDs). This study aims to determine and compare the efficacy of a short course of oral ranitidine and a probiotic in the treatment of toddler’s diarrhea. Methods This study was a parallel-group randomized controlled trial (RCT). We sequentially enrolled 40 patients who met the eligibility criteria. We randomly assigned 20 patients to the oral ranitidine group, ten patients to the probiotic group, and ten patients to the placebo group. In the oral ranitidine group, patients received oral ranitidine (3 mg/kg/day) once daily for 10 days; in the probiotic and placebo groups, they were administered 5 to 10 billion colony-forming units (CFUs) per day of lyophilized Lactobacillus rhamnosus and 50 mg of once-daily oral vitamin C tablet respectively for 10 days. Stool frequency and consistency on the 10th day of the interventions were recorded as the primary outcomes. We used the Student’s t-test to determine if there were significant differences in the mean daily stool frequencies in the three intervention groups. A p-value

Background: Tinnitus affects 10%-30% of the population. Recent evidence suggests that tinnitus is associated with spleen deficiency. However, compared with kidney deficiency-related tinnitus, less research has been conducted on the impact of spleen deficiency-related tinnitus., Aim: To investigate the clinical efficacy of using Guipi Wan and dietary and lifestyle modification based on traditional Chinese medicine for treatment of patients with spleen and stomach deficiency-related tinnitus., Methods: We enrolled 110 patients with spleen and stomach deficiency-related tinnitus who were distributed into treatment (58 cases) and control (52 cases) groups. Tinnitus severity, sleep quality and emotional state were assessed by questionnaires [Tinnitus Evaluation Questionnaire (TEQ); Pittsburgh Sleep Quality Index (PSQI); Depression-Anxiety-Stress Scale-21 (DASS-21)] that were used for analysis in the two groups during the initial and intervention and after. In the treatment group, patients were treated with oral administration of Guipi Wan and consulted for healthy dietary and lifestyle modification. In the control group, patients were only assessed and not treated., Results: At the end of the 6-months, TEQ scores decreased significantly in the treatment group ( P = 0.021) but not in the Control group. Significant effects in the treatment group were noted for PSQI total score ( P = 0.043) and several PSQI component scores in the treatment group ( P < 0.05). After treatment, the DASS-21 scores were significantly reduced in the treatment group ( P < 0.05)., Conclusion: Guipi Wan combined with dietary and lifestyle modification based on regulating the spleen and stomach can be considered core to the treatment of tinnitus related to spleen and stomach deficiency., Competing Interests: Conflict-of-interest statement: The authors have no conflicts of interest to declare., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Food is an important factor affecting the treatment of patients with early gastric cancer (EGC). We have established a hospital cohort to guide dietary patterns and observe the health status of patients with EGC after endoscopic submucosal dissection (ESD) after dietary modification. A total of 273 patients with EGC who underwent ESD were recruited to the cohort. They were given dietary instruction and education through a dietary manual and were followed up for 12 months. If the dietary pattern changed to the “traditional food” pattern (high consumption of vegetables, wheat products, and red meat) after the nutritional guidance, subjects were defined as the improvement diet group. Dietary patterns focused on “alcohol and fish” (drink a lot of wine and beer and eating freshwater and marine fish) or “coarse cereals” (mainly whole grains, beans and poultry) were the main ones in the unimproved diet group. The nutritional status, gastric mucosa, and gastrointestinal symptoms of the two groups of patients before and after the dietary instruction were compared. Compared with the unimproved diet group, the endoscopic performance score and the symptom score in the improved diet group were decreased by an average of 1.31 and 1.90, respectively. Except for lymphocyte count (P = 0.227), total protein (P < 0.000), albumin (P = 0.003), globulin (P = 0.014), red blood cell count (P < 0.000), and hemoglobin (P < 0.000) values were improved to varying degrees. After changing the diet, the intake of wheat products and vegetables in the improved diet group increased by 15.58 and 17.52%, respectively, while the intake of alcohol, fish, and pickled products was reduced by 43.36, 36.43, and 31.41%, respectively. After 1 year of dietary adjustment, the nutritional status, gastric mucosa, and gastrointestinal symptoms of patients with EGC after ESD eating the "traditional food" diet were all improved.

Background and Objectives: Respiratory diseases account for 55.5% and 33.1% of all mortality rates in patients with Alzheimer’s disease and vascular dementia, respectively. However, the widespread use of spirometers is often difficult due to challenges in performing the procedure. Therefore, the use of spirometers is usually unfeasible in patients with dementia and hinders the provision of preventive measures for aspiration pneumonia. The party horn is a common toy in many countries and can potentially be used as a novel tool. This study was conducted to analyze the usefulness of the party horn as an assessment tool for respiratory function, and to detect eating-related behavioral problems in patients with dementia. Materials and Methods: A total of 62 inpatient participants with dementia (34 males, 28 females; age, mean ± SD, 80.4 ± 7.59 years) were included in the study. The respiratory functions of patients were assessed using a party horn and a spirometer. Assessment items pertaining to cognitive function, mental and behavioral disorders, eating-related behavioral problems, and the required dietary modifications were evaluated to compare between patient groups stratified by respiratory function. Results: Significant differences between groups were noted in length of hospital stay, cognitive functions, mental and behavioral disorders, eating-related behavioral problems, and dietary modifications. Forced expiratory volume in 1 s, peak expiratory flow, and eating-related behavioral problems were significantly associated with the party-horn-integrated value (p < 0.05). Conclusions: Party-horn-based evaluation can facilitate the screening and evaluation of older dementia patients for eating-related behavioral problems and aspiration risk.

Eating and drinking are essential for maintenance of nutrition and hydration, but are also important for pleasure and social interactions. The ability to eat and drink hinges on a complex and coordinated system, resulting in significant potential for things to go wrong. The Royal College of Physicians (RCP) has published updated guidance on how to support people who have eating and drinking difficulties, particularly towards the end of life. Decisions about nutrition and hydration and when to start, continue or stop treatment are some of the most challenging to make in medical practice. The newly updated guidance aims to support healthcare professionals to work together with patients, their families and carers to make decisions around nutrition and hydration that are in the best interests of the patient. It covers the factors affecting our ability to eat and drink, strategies to support oral nutrition and hydration, techniques of clinically-assisted nutrition and hydration, and the legal and ethical framework to guide decisions about giving and withholding treatment, emphasising the two key concepts of capacity and best interests. This article aims to provide an executive summary of the guidance. [ABSTRACT FROM AUTHOR]

INTRODUCTION In December 2019, new coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) emerged in Wuhan, China causing pandemic all over the world which results in homestay order. Homestay lead to changes in lifestyle like sedentary life, sleeping habits and eating behavior. So, the objective is to assess dietary and life style modification among nursing students of Manipal College of Medical Sciences, Pokhara, Nepal. MATERIAL AND METHODS A descriptive cross-sectional online survey was conducted from August 1 to October 15, 2020. The setting of study (Manipal) was selected purposively in which enumerative sampling technique was used constituting total sample size of 216 nursing students. Data was collected through self-administer semi-structure questionnaire via online mode which was further analyzed using descriptive statistics SPSS 20.0 version. RESULTS There was slight modification in intake of food items like fruits, vegetable, protein, fats, commercialized items, carbonated/sweetened beverages and non-vegetarian diets (chicken and fish). During COVID-19, less than one-fifth (15%) wake up before 7 AM and 78.2% sleep duration was 7-9 hours. About 64.1% passed their leisure time watching TV/ facebook/ messenger/ youtube/ whatsapp/ instagram. Nearly 99.1% engaged in household activities during home stay. Although more than three-fourth (77.8%) of respondents were doing physical activity, 69.9% had weight gain. CONCLUSION Despite physical and household activities, some unhealthy practices like waking up late, increased sleep duration and use of screen was observed. There was less modification in dietary pattern. So it is recommended to follow healthy diet like Mediterranean diet having several health benefits like weight reduction, prevention from non-communicable diseases and boost immune system in period of pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Gastric cancer remains a significant public health issue despite declining incidence and mortality rates. Preventive strategies, including a healthy diet, could significantly reduce gastric cancer cases. On the other hand, some statistics show an uncontrolled increase in the use of salt in the diet. Early intervention and lifestyle modifications could prevent half of all gastric cancer events by 2031. Methods: This meta-analysis reviewed studies from PubMed, Web of Science, and Cochrane Library up to July 1, 2022, focusing on casecontrol studies with over 100 participants that assessed salty food intake and preference. The studies were evaluated for quality using the Newcastle-Ottawa scale and analyzed with STATA/SE 16., Results: Reducing salt and salted food intake, along with increasing fresh fruit and vegetable consumption, has contributed to the global decline in gastric cancer rates. This dietary modification is a practical strategy for preventing gastric cancer, especially in high-risk areas like Japan. A number of experimental studies supported the cocarcinogenic effect of salt through a synergistic effect with Helicobacter pylori infection, in addition to some independent effects such as increasing the rate of cell proliferation and endogenous mutations. Conclusions: Participants who always added salt to food had a 41% higher risk of gastric cancer than those who rarely did. This association was stronger after excluding early cases, suggesting reverse causality. Adding salt may be a proxy for habitual salt intake. [ABSTRACT FROM AUTHOR]

Objective: Individuals with a gastrointestinal (GI) disorder often alter their diet to manage GI symptoms, adding complexity to understanding the diverse motivations contributing to food avoidance/restriction. When a GI disorder is present, the DSM‐5 states that Avoidant/Restrictive Food Intake Disorder (ARFID) can be diagnosed only when eating disturbance exceeds that expected. There is limited guidance to make this determination. This study attempts to address this gap by characterizing the presentation of ARFID in adults with and without a self‐reported GI disorder. Method: Participants were 2,610 adults ages 18–44 who self‐identified as "picky eaters." Participants reported on motivations for food avoidance, affective experiences towards food, and perceived impairment. Responses were compared across four groups: GI issues and likely ARFID (L‐ARFID/GI), L‐ARFID‐only, GI‐only, and No‐ARFID/No‐GI. Results: Groups with a GI disorder (L‐ARFID/GI, GI‐only) reported more fear of aversive consequences of eating than those without a GI disorder, while groups with L‐ARFID (L‐ARFID, L‐ARFID/GI) evidenced significantly greater sensory aversion to food and indifference to food or eating, negative emotional reactions to food and overall disgust sensitivity, and eating related impairment. Discussion: Consideration of the interplay of a GI disorder with ARFID can add precision to case conceptualization. Food avoidance may be attempts to manage fears of aversive consequences that are augmented by a history of GI symptoms, while sensory aversions and negative emotional reactions towards foods may be more elevated in ARFID. These findings emphasize the need to consider an ARFID diagnosis in patients with GI disorders to optimize care. [ABSTRACT FROM AUTHOR]