Nutritional Components in Western Diet Versus Mediterranean Diet at the Gut Microbiota-Immune System Interplay. Implications for Health and Disease

The link between ultra-processed food consumption, fecal microbiota, and metabolomic profiles in older mediterranean adults at high cardiovascular risk

BACKGROUND

Ultra-processed food (UPF) consumption has been linked to adverse metabolic outcomes, potentially mediated by alterations in gut microbiota and metabolite production.

OBJECTIVE

This study aims to explore the cross-sectional and longitudinal associations between NOVA-classified UPF consumption, fecal microbiota, and fecal metabolome in a population of Mediterranean older adults at high cardiovascular risk.

METHODS

A total of 385 individuals, aged between 55 and 75 years, were included in the study. Dietary and lifestyle information, anthropometric measurements, and stool samples were collected at baseline and after 1-year follow-up. Fecal microbiota and metabolome were assessed using 16 S rRNA sequencing and liquid chromatography-tandem mass spectrometry, respectively.

RESULTS

At baseline, higher UPF consumption was associated with lower abundance of Ruminococcaceae incertae sedis (β = - 0.275, P = 0.047) and lower concentrations of the metabolites propionylcarnitine (β = - 0.0003, P = 0.013) and pipecolic acid (β = - 0.0003, P = 0.040) in feces. Longitudinally, increased UPF consumption was linked to reduced abundance of Parabacteroides spp. after a 1-year follow-up (β = - 0.278, P = 0.002).

CONCLUSIONS

High UPF consumption was associated with less favorable gut microbiota and metabolite profiles, suggesting a possible link to reduced short-chain fatty acid (SCFA) production, altered mitochondrial energy metabolism, and impaired amino acid metabolism. These findings support the reduction of UPF consumption and the promotion of dietary patterns rich in fiber for better gut health. Further research is needed to confirm these associations and clarify the underlying mechanisms.

TRIAL REGISTRATION

ISRCTN89898870 ( https://doi.org/10.1186/ISRCTN89898870 ).

Astaxanthin obtained from freshwater crustaceans mitigates visceral adiposity by modulating adipose tissue lipogenesis and ameliorates dyslipidemia in high-sucrose diet fed rats

The incidence of overweight and obesity continues to grow at alarming rates around the world. The search for foods with potential benefits in the prevention/treatment of overweight/obesity and related disorders has great relevance. The aim of this study was to evaluate the effect of astaxanthin (ASTX) from freshwater crustaceans (crabs) upon visceral adiposity, adipose tissue lipid metabolism disorders and dyslipidemia present in a Metabolic Syndrome rodent model. Male Wistar rats were fed for 90 days with 1 of 4 experimental diets: a-Reference group (RD) received a standard commercial rodent diet, b- High-sucrose diet (HSD) group received a HSD, c- RD+ASTX group received a standard commercial rodent diet plus ASTX, d- HSD+ASTX group received a HSD plus ASTX. The rats were given orally either ASTX (10 mg/kg body weight/day in sunflower oil) or only sunflower oil. Compared with HSD-fed rats, HSD+ASTX group had lower body weight gain (19%) and both reduced abdominal circumference (5%) and visceral adiposity index (5%). Energy intake was 24% lower at the middle of the experimental period. Epididymal adipocytes size and triglyceride (TG) content was reduced by 14%. Besides, fatty acid synthase, malic enzyme and glucose-6-phosphate dehydrogenase activities in epididymal adipose tissue were 43%, 28% and 38% lower respectively. These changes were accompanied by lower TG (25%) and cholesterol (27%) serum levels, atherogenic index (31%) and reduced Systolic (12%) and Diastolic (15%) blood pressure. The results show that ASTX could be a potential strategy to prevent/attenuate the incidence of metabolic risk factors such as overweight/adiposity and dyslipidemia.

Mediterranean dietary pattern and risk of neurodegenerative diseases in a cohort of Swedish women

Mediterranean dietary patterns (MDP) may be neuroprotective. Using a large population-based cohort of 42,582 Swedish women, this study examined the association between MDP adherence and the risk of Parkinson's disease (PD), Alzheimer's disease (AD), and amyotrophic lateral sclerosis (ALS). During 1991-1992, women in the Women's Lifestyle and Health Study reported dietary intake, and MDP adherence was calculated. Incident neurodegenerative diseases were identified using the Swedish National Patient Register through 2022. Women who reported high MDP adherence had a lower risk of PD (HR: 0.69, 95% CI: 0.49-0.95), primarily over age 60 (HR: 0.68, 95% CI: 0.47-0.97). A moderate-high MDP adherence was associated with a lower risk of ALS before age 60 (HR: 0.44, 95% CI: 0.19-0.99), but not overall. We observed no association between MDP adherence and AD. Our findings suggest higher adherence to a MDP may be protective against PD above age 60, and ALS before age 60.

Food for thought: The relationship between poor eating habits, delay discounting, and quality of life in substance use recovery

BACKGROUND

Research on poor eating habits among individuals recovering from substance use disorders (SUD) is limited. This study examines the relationship between poor eating habits, delay discounting (DD), quality of life (QOL), and remission status, in addition to examining DD as a mediator of the relationship between poor eating and QOL.

METHODS

Participants (n = 257) in recovery from SUD, completed the Health Behaviors Questionnaire (poor eating was measured using the food domain), a DD task, the World Health Organization QOL questionnaire, demographics, and SUD-related questions. Multivariate linear regression was used to test associations between poor eating and DD, as well as each QOL domain. Mediation analyses were conducted to evaluate the role of DD in the relationship between poor eating and QOL. A binary logistic regression was used to test associations between poor eating and remission status, as well as DD and remission status.

RESULTS

Poor eating habits were significantly associated with higher rates of DD (β = 0.08, p < .001) and lower QOL across psychological (β = -0.88, p < .001, only for those in remission), physical (β = -0.58, p < .001), and environmental (β = -0.75, p < .001) domains. Additionally, DD significantly mediated the relationship between poor eating habits and reduced QOL in these domains (ꞵs < -0.08, ps < 0.003). Poor eating (ꞵ = 0.05, p = .014; OR = 1.05, p = .012) and high DD rates (ꞵ = 0.12, p = .049; OR = 1.12, p = .038) were associated with a lower likelihood of remission from SUD.

CONCLUSIONS

Our findings highlight the integral role of dietary habits in the recovery trajectory of individuals with SUD. The study supports the need for holistic treatment approaches that consider the impacts of nutrition on both psychological and physiological aspects of recovery.

Association between dietary index of gut microbiota and constipation in a female population: a cross-sectional study

Objective

To examine the potential association between dietary index of gut microbiota (DI-GM) scores and constipation in adult women in the United States.

Methods

This cross-sectional study used data from adult participants in the 2005-2010 US National Health Survey (NHANES). The missing values in the covariables were filled by multiple interpolation. Multivariate logistic regression models were used to determine the odds ratios (OR) and 95% confidence intervals (CI) for the association between DI-GM and constipation. Subgroup analyses were also performed to examine the possible interactions between DI-GM and constipation.

Results

Of the 7,325 subjects, 887 reported constipations, with a prevalence of 12.1%. After adjustment for multivariate modeling, the DI-GM score was significantly associated with constipation (0.92 [95% CI 0.87-0.96]; p = 0.001). Similar results were found for the association of beneficial gut microbiota score with constipation (OR 0.89 [95% CI 0.84 to 0.95]; p = 0. 001). Subgroup analyses revealed that the relationship between DI-GM scores and constipation remained stable (p > 0.05).

Conclusion

DI-GM was negatively associated with the incidence of constipation in the female population. Clinicians should consider the influence of dietary structure on the treatment of constipation in women. Dietary intervention can be an important strategy for the comprehensive treatment of constipation.

Role of gut microbiota in thalassemia: a review of therapeutic prospects

In recent years, the study of gut microbiota has gradually become a research hotspot in the field of medicine, as gut microbiota dysbiosis is closely related to various diseases. Thalassemia, as a hereditary hemoglobinopathy, has a complex pathophysiological mechanism, and traditional treatment methods show limited efficacy. With a deeper understanding of the gut microbiome, researchers have begun to focus on its role in the pathogenesis of thalassemia and its therapeutic effects. This article aims to review the role of gut microbiota in thalassemia and its potential therapeutic prospects, analyze the latest research findings, and explore the impact and mechanisms of gut microbiota on patients with thalassemia, with the goal of providing new ideas and directions for future research and clinical treatment of thalassemia.

Intervention and research progress of gut microbiota-immune-nervous system in autism spectrum disorders among students

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social interaction and communication, repetitive and stereotyped behaviors, restricted interests, and sensory abnormalities. Its etiology is influenced by both genetic and environmental factors, with no definitive cause identified and no specific pharmacological treatments available, posing a significant burden on patients' families and society. In recent years, research has discovered that gut microbiota dysbiosis plays a crucial role in the pathogenesis of ASD. The gut microbiota can influence brain function and behavior through the gut-brain axis via the nervous system, immune system, and metabolic pathways. On the one hand, specific gut microbes such as Clostridium and Prevotella species are found to be abnormal in ASD patients, and their metabolic products, like short-chain fatty acids, serotonin, and GABA, are also involved in the pathological process of ASD. On the other hand, ASD patients exhibit immune system dysfunction, with gut immune cells and related cytokines affecting neural activities in the brain. Currently, intervention methods targeting the gut microbiota, such as probiotics, prebiotics, and fecal microbiota transplantation, have shown some potential in improving ASD symptoms. However, more studies are needed to explore their long-term effects and optimal treatment protocols. This paper reviews the mechanisms and interrelationships among gut microbiota, immune system, and nervous system in ASD and discusses the challenges and future directions of existing research, aiming to provide new insights for the prevention and treatment of ASD.

The association between the Mediterranean Diet and the prime diet quality score and new-diagnosed irritable bowel syndrome: a matched case-control study

Background

Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder with multifactorial etiology. Dietary patterns, including the Mediterranean Diet (Med-Diet) and the Prime Diet Quality Score (PDQS), may play a role in IBS risk. This study examined the association between adherence to the Med-Diet and PDQS and new-diagnosed IBS in an Iranian population.

Methods

A matched case-control study was conducted on 170 newly diagnosed IBS patients and 340 age- and sex-matched controls recruited from outpatient clinics in Zanjan, Iran. Dietary intake was assessed using a semiquantitative food frequency questionnaire. The Med-Diet score and PDQS were calculated, with higher scores indicating better diet quality. Conditional logistic regression was used to determine the odds of IBS across quartiles of Med-Diet and PDQS, adjusting for sociodemographic and clinical factors.

Results

Higher adherence to the Med-Diet was associated with 51% lower odds of IBS (OR: 0.49; 95% CI: 0.30-0.73, P < 0.001) in the highest quartile compared to the lowest. Similarly, participants in the highest PDQS quartile showed a significantly 59% lower odds of IBS (OR: 0.41; 95% CI: 0.26-0.51, P < 0.001) compared to the lowest quartile. Both associations remained significant after adjusting for potential confounders, including total energy intake. These findings highlight the potential clinical relevance of dietary quality in IBS prevention.

Conclusion

Higher adherence to the Med-Diet and a higher PDQS were both inversely associated with IBS risk. Specifically, individuals with higher Med-Diet scores and higher PDQS scores had a lower risk of developing IBS compared to those with lower adherence or scores. These findings suggest a potential role of these dietary patterns in modulating IBS risk, although causal relationships cannot be established from this study.

Rosa roxburghii Fermentation Broths Attenuate Bleomycin-Induced Pulmonary Fibrosis by Activating the Nrf2/HO-1/NQO1 Signaling Pathway and Modulating Gut Microbiota

Pulmonary fibrosis (PF) is a chronic and progressive lung disease, and oxidative stress plays a critical role in its pathogenesis. Rosa roxburghii Tratt, known for its anti-inflammatory and antioxidant properties, has been shown to alleviate fibrosis. This study aimed to explore whether two Rosa roxburghii fermentation broths (RRFBs) (with different proportions) could attenuate bleomycin (BLM)-induced PF in mice and to elucidate the molecular mechanisms. The results revealed that RRFBs reduced structural lung damage, collagen deposition, and lung inflammation. RRFBs also suppressed fibrotic markers (Collagen I, Vimentin, and α-SMA) while enhancing epithelial marker E-cadherin expression. Additionally, RRFBs alleviated BLM-induced oxidative stress and apoptosis by activating the Nrf2/HO-1/NQO1 signaling pathway and facilitating Nrf2 nuclear translocation. Furthermore, RRFBs attenuated the BLM-induced changes in the gut microbiota; in particular, they decreased the abundance of the pathogenic bacterium Proteus and increased the abundance of the probiotics Ileibacterium and Dubosiella. Spearman correlation analysis revealed a strong association between oxidative stress inhibition and gut microbiota composition. These results indicated that RRFBs could exert lung-protective effects by inhibiting oxidative stress and alleviating intestinal disturbances.

Gut microbiota and breast cancer: systematic review and meta-analysis

BACKGROUND

The gastrointestinal microbiota can modulate systemic estrogens, potentially influencing estrogen-induced breast neoplasia development. This study aimed to assess alterations in the gut microbiota in breast cancer patients.

METHODS

A search strategy was developed using the terms: "Microbiota," "Gastrointestinal Microbiome," "Breast Cancer," and synonyms. Ten observational studies were included.

RESULTS

The total sample was 1730 women (929 cases and 801 controls). The meta-analysis of alpha diversity, assessed by the Shannon index, displayed that in the breast cancer group, the diversity of the gut microbiota was reduced compared to controls, with a standardized mean difference (SMD) of - 0.34 (95% CI - 0.59, - 0.10, I2 = 68%, p = 0.007). Regarding the premenopausal population, there was a significant reduction in the breast cancer group (SMD - 0.67, 95% CI - 1.06, - 0.28, I2 = 77%, p = 0.0009). In women with a body mass index (BMI) between overweight or obesity, no statistically significant difference was observed (SMD - 0.20; 95% CI - 0.51, 0.11; I2 52%, p = 0.20). However, in women with a BMI greater than or equal to 18.5 and less than 25.0, there was lower diversity in women with breast cancer compared to controls (SMD - 0.49, 95% CI - 0.94, - 0.04; I2 78%, p = 0.03).

CONCLUSIONS

The study found a significant difference in gut microbiota diversity between women with breast cancer and controls, supporting the growing evidence that the gut microbiota may play a role in mammary carcinogenesis.

The Detrimental Impact of Ultra-Processed Foods on the Human Gut Microbiome and Gut Barrier

Ultra-processed foods (UPFs) have become a widely consumed food category in modern diets. However, their impact on gut health is raising increasing concerns. This review investigates how UPFs impact the gut microbiome and gut barrier, emphasizing gut dysbiosis and increased gut permeability. UPFs, characterized by a high content of synthetic additives and emulsifiers, and low fiber content, are associated with a decrease in microbial diversity, lower levels of beneficial bacteria like Akkermansia muciniphila and Faecalibacterium prausnitzii, and an increase in pro-inflammatory microorganisms. These alterations in the microbial community contribute to persistent inflammation, which is associated with various chronic disorders including metabolic syndrome, irritable bowel syndrome, type 2 diabetes, and colorectal cancer. In addition, UPFs may alter the gut-brain axis, potentially affecting cognitive function and mental health. Dietary modifications incorporating fiber, fermented foods, and probiotics can help mitigate the effects of UPFs. Furthermore, the public needs stricter regulations for banning UPFs, along with well-defined food labels. Further studies are necessary to elucidate the mechanisms connecting UPFs to gut dysbiosis and systemic illnesses, thereby informing evidence-based dietary guidelines.

Associations Between Dietary Patterns and the Occurrence of Hospitalization and Gastrointestinal Disorders-A Retrospective Study of COVID-19 Patients

During the COVID-19 pandemic, dietary habits in the population changed and sometimes deviated from healthy eating patterns, such as the Mediterranean diet. Based on reports on the quality of the diet of respondents to studies conducted at the beginning of the pandemic, it could be concluded that these new dietary habits are unfavorable for a good prognosis and the course of any disease and its severity of symptoms. This study decided to confront these assumptions with the results of people who had COVID-19. Background/Objectives: This study aimed to assess the associations between dietary patterns and the occurrence of hospitalization and gastrointestinal disorders among patients diagnosed with COVID-19. Methods: This study included 550 respondents who completed a survey up to 8 months after being diagnosed with COVID-19. The survey included 62 items from the FFQ-6®, GSRS, PAC-SYM and FACT-G7 standardized questionnaires. Results: Two dietary patterns (DPs) were identified: 'Processed high fat/sugar/salt/meat/dairy/potatoes' and 'Semi-vegetarian'. Higher adherence to the 'Processed' DP was associated with higher odds of hospitalization due to COVID-19, a more severe course of the disease, and the highest intensity of gastrointestinal symptoms. Higher adherence to the 'Semi-vegetarian' DP was associated with lower odds of hospitalization due to COVID-19, a less severe course of the disease, and the lowest intensity of gastrointestinal symptoms. Conclusions: This study showed a strong harmful effect of high adherence to a processed dietary pattern on an increased incidence of hospitalization and gastrointestinal disorders among northwestern Polish adults during the COVID-19 pandemic, emphasizing the importance of a healthy diet.

High-salt diet decreases FOLFOX efficacy via gut bacterial tryptophan metabolism in colorectal cancer

BACKGROUND

FOLFOX is the recommended chemotherapy regimen for colorectal cancer (CRC), but its response rate remains low. Our previous studies have established a close relationship between gut microbiota and the anti-CRC effect of FOLFOX, though the underlying mechanisms remain unclear. Diet has been confirmed as a key factor influencing gut microbiota, and high-salt diets, representative of western dietary habits, has been shown to affect gut microbiota, immune function, and the risk of developing CRC. However, the impact of high-salt diets on the anti-CRC efficacy of FOLFOX remains unstudied. Therefore, we aimed to investigate the effect and mechanism of high-salt diets on the anti-CRC effect of FOLFOX.

METHODS

We performed 16 S rRNA sequencing and T500 targeted metabolomics analysis on fecal samples from CRC patients and healthy adults. A CRC orthotopic xenograft mouse model was used to study the effect of a high-salt diet on FOLFOX's anti-CRC efficacy. 16 S rRNA sequencing and non-targeted metabolomics were conducted on mouse fecal samples. Flow cytometry was used to assess immune cell infiltration in tumor and paracancerous tissues. A mouse macrophage conditioned medium system, with tryptophan metabolites, was employed to annotate the functional metabolites, followed by in vivo verification using the orthotopic xenograft mouse model.

RESULTS

The structure and metabolic profiles of gut microbiota are significantly different between 9 healthy adults and 6 CRC patients. A high-salt diet significantly reduced the efficacy of FOLFOX in mice, with notable changes in gut microbiota and related metabolites. Correlation analysis revealed a significant relationship between gut microbiota, tryptophan metabolites and FOLFOX efficacy. Flow cytometry indicated that a high-salt diet altered macrophage infiltration (CD45+F4/80+) in both the tumor and paracancerous tissues. In vitro experiments confirmed that the tryptophan metabolite SK reduced FOLFOX efficacy, while IPA enhanced it through macrophage-conditioned medium. In vivo, we verified that under a high-salt diet, SK inhibited the efficacy of FOLFOX, while IPA promoted it.

CONCLUSION

A high-salt diet reduces the anti-CRC efficacy of FOLFOX through gut bacterial tryptophan metabolism mediated macrophage immunomodulation.

Mediterranean Diet and Quality of Life in Adults: A Systematic Review

BACKGROUND/OBJECTIVES

With the increasing life expectancy and, as a result, the aging of the global population, there has been a rise in the prevalence of chronic conditions, which can significantly impact individuals' health-related quality of life, a multidimensional concept that comprises an individual's physical, mental, and social wellbeing. While a balanced, nutrient-dense diet, such as Mediterranean diet, is widely recognized for its role in chronic disease prevention, particularly in reducing the risk of cardiovascular diseases and certain cancers, its potential benefits extend beyond these well-known effects, showing promise in improving physical and mental wellbeing, and promoting health-related quality of life.

METHODS

A systematic search of the scientific literature in electronic databases (Pubmed/Medline) was performed to identify potentially eligible studies reporting on the relation between adherence to the Mediterranean diet and health-related quality of life, published up to December 2024.

RESULTS

A total of 28 studies were included in this systematic review, comprising 13 studies conducted among the general population and 15 studies involving various types of patients. Overall, most studies showed a significant association between adherence to the Mediterranean diet and HRQoL, with the most significant results retrieved for physical domains of quality of life, suggesting that diet seems to play a relevant role in both the general population and people affected by chronic conditions with an inflammatory basis.

CONCLUSIONS

Adherence to the Mediterranean diet provides significant benefits in preventing and managing various chronic diseases commonly associated with aging populations. Furthermore, it enhances the overall health and quality of life of aging individuals, ultimately supporting more effective and less invasive treatment approaches for chronic diseases.

Omnivore, vegan and vegetarian diet quality associations with depressive symptoms: A comparative cross-sectional analysis of the Australian Longitudinal Study on Women's Health

BACKGROUND

Depressive symptoms are experienced by >350 million people globally. Research suggests that a diet rich in plant foods could be protective against depressive symptoms, but vegans and vegetarians who eat a predominant plant-based diet are known to have higher depressive symptoms than omnivores.

METHODS

This study aims to explore a secondary analysis of the association between diet quality and depressive symptoms in women born between 1973 and 1978 who follow vegan, vegetarian, and omnivore diets from the Australian Longitudinal Study of Women's Health at baseline (1996) and at three time points (2000, 2003 and 2009).

RESULTS

After controlling for covarying factors, there was a significant association between diet quality and depressive symptoms in both the plant-based and omnivore groups at both time points F(9, 4851) = 106.90, p < .001. There was no significant difference between diet quality and depressive symptoms between diet type.

CONCLUSIONS

Despite diet type (plant-based or omnivore), adhering to a high-quality diet may decrease depressive symptoms and a low-quality diet may increase depressive symptoms in Australian women.

LIMITATIONS

Caution should be exercised when interpreting these results due to the small sample sizes and small resulting coefficients, there is uncertainty that coefficients this small can be associated with any meaningful change in an individual being treated for depressive symptoms in a clinical setting.

Targeted microbiota dysbiosis repair: An important approach to health management after spinal cord injury

Current research primarily focuses on the pathological mechanisms of spinal cord injury (SCI), seeking to promote spinal cord repair and restore motorial and sensory functions by elucidating mechanisms of cell death or axonal regeneration. However, SCI is almost irreversible, and patients often struggle to regain mobility or self-care abilities after injuries. Consequently, there has been significant interest in modulating systemic symptoms following SCI to improve patients' quality of life. Neuron axonal disconnection and substantial apoptotic events following SCI result in signal transmission loss, profoundly impacting various organ and systems, including the gastrointestinal tract. Dysbiosis can lead to severe bowel dysfunction in patients, substantially lowering their quality of life and significantly reducing life expectancy of them. Therefore, researches focusing on the restoration of the gut microbiota hold promise for potential therapeutic strategies aimed at rehabilitation after SCI. In this paper, we explore the regulatory roles that dietary fiber, short-chain fatty acids (SCFAs), probiotics, and microbiota transplantation play in patients with SCI, summarize the potential mechanisms of post-SCI dysbiosis, and discuss possible strategies to enhance long-term survival of SCI patients. We aim to provide potential insights for future research aimed at ameliorating dysbiosis in SCI patients.

Dietary Lipid Profile in Spanish Children with Overweight or Obesity: A Longitudinal Study on the Impact of Children's Eating Behavior and Sedentary Habits

BACKGROUND

Dietary lipids, sedentary habits, and eating behaviors influence childhood obesity, but their interrelations remain unclear.

AIM

To assess the relationships between young children's dietary lipid profile and children's eating behavior, as well as their sedentary habits, providing evidence-based insights that can help mitigate obesity risk in this vulnerable population.

DESIGN

A longitudinal randomized controlled trial conducted over 9 months, involving 90 children aged 2-6 years with overweight or obesity who were followed under a program that promoted healthy lifestyle habits for all participants and regularly monitored their parameters.

METHODS

The dietary lipid profile, eating behavior, and sedentary habits were assessed at baseline and after 9 months using validated tools, including 24 h recalls, the child eating behavior questionnaire (CEBQ), and screen time questionnaires.

RESULTS

Reductions in screen/sedentary time were significantly associated with decreased total fat (-11.1 g/day) and saturated fat (-4.3 g/day) intake, compared to smaller reductions in unchanged screen hours and increases with prolonged screen use. A positive correlation was observed between changes in dietary fat and the CEBQ domain "Desire to drink" (r = 0.528, p < 0.001), with regression analysis confirming a direct relationship.

CONCLUSIONS

Managing screen time and eating behavior is crucial for improving dietary lipid profile and reducing childhood obesity risk. Strategies should include reducing sedentary behaviors, limiting sugary drinks, and promoting water as the main beverage, alongside effective nutrition education for families.

Specific Composition Diets and Improvement of Symptoms of Immune-Mediated Inflammatory Diseases in Adulthood-Could the Comparison Between Diets Be Improved?

Diet is considered a possible cofactor, which affects the immune system and potentially causes dysregulation of intestinal homeostasis and inflammation. This study aimed to review the quality of evidence on the effects of specific diet composition on symptoms of immune-mediated inflammatory diseases (IMIDs), including rheumatoid arthritis (RA), spondyloarthritis, multiple sclerosis (MS), inflammatory bowel disease (IBD) [remission maintenance of Crohn's disease and ulcerative colitis], psoriasis and psoriatic arthritis in adult patients. We conducted a review of meta-analyses and Cochrane systematic reviews using PubMed and EMBASE, from inception to September 2024, and Google Scholar. The methodological quality of the meta-analyses was assessed using the AMSTAR 2 rating system. Three Cochrane systematic reviews and eight meta-analyses were evaluated. Some specific composition diets have been shown to reduce the symptoms of RA, IBD, and MS and improve activity parameters in IBD and RA, with critically low or low levels of evidence. The reduction in inflammatory biomarker levels is unclear. This review summarizes the global evidence for specific dietary interventions, mostly with anti-inflammatory properties due to their components, to improve IMID symptoms, clarifying the weaknesses of clinical trials and dietary meta-analyses with critically low or low levels of evidence; and shows the need to use indices such as the Dietary Inflammatory Index, which allows diets to be classified by their pro-inflammatory or anti-inflammatory food content, to better compare diet groups in clinical trials. The difficulty of obtaining high-level evidence from dietary studies is apparent and may delay the application of the results. Clinicians should be aware of the role of diets with anti-inflammatory properties as a complement to pharmacological treatments in IMIDs.

From Evidence to Practice: A Narrative Framework for Integrating the Mediterranean Diet into Inflammatory Bowel Disease Management

Emerging evidence underscores the pivotal role of diet in preventing and managing inflammatory bowel disease (IBD). As our comprehension of the microbiome's role in IBD expands, dietary modifications are increasingly recognized as potential adjuncts or primary therapeutic strategies. Key components of the Mediterranean diet (MD)-including microbiota-accessible carbohydrates, omega-3 fatty acids, polyphenols, and antioxidants-have demonstrated promise in enhancing gut microbiota diversity and reducing intestinal inflammation, making it a practical approach for managing IBD. Moreover, the MD offers additional benefits considering the rising prevalence of comorbid chronic inflammatory conditions such as diabetes, cardiovascular disease, and obesity in IBD patients. The purpose of this narrative review was to provide an overview of the feasibility and clinical outcomes of the MD and offer evidence-based guidance for researchers and practitioners on how to adapt the MD to patients with IBD. According to several cross-sectional and interventional studies, the MD is feasible for patients with IBD and confers several benefits, such as reduced inflammation, improved disease activity, and enhanced quality of life, with a strong adherence rate and minimal adverse effects. To facilitate knowledge translation, we provide a practical framework for integrating the MD as a nutritional therapy for IBD, including specific recommendations and messaging that researchers, practitioners, and patients can use. By synthesizing current evidence and offering actionable insights, the aim is to facilitate the integration of the MD into IBD management, with the potential to improve patient outcomes.

Grasping Posttraumatic Stress Disorder From the Perspective of Psychoneuroimmunoendocrinology: Etiopathogenic Mechanisms and Relevance for Integrative Management

Posttraumatic stress disorder (PTSD) is a debilitating condition caused by exposure to traumatic events that affects 5% to 10% of the population, with increased prevalence among women and individuals in war zones. Beyond psychological symptoms, PTSD induces significant physiological changes across systems. Psychoneuroimmunoendocrinology (PNIE) offers a framework to explore these complex interactions between the psyche and the nervous, immune, and endocrine systems. Studies have revealed that PTSD entails disruptions in the central and autonomic nervous, immune, and endocrine systems, including gut microbiota imbalances, which impair organ function. Integrative pathways that connect these parts include the microbiota-gut-brain axis, heart-brain axis, neuroinflammation, and hypothalamic-pituitary dysregulation, highlighting bidirectional links between mental and physical health. Viewing PTSD as an entity comprising both psychological and physiological challenges underscores the importance of integrative care strategies that combine pharmacological treatments, psychotherapy, and lifestyle interventions. These approaches are consistent with PNIE principles, which may help identify biomarkers for treatment efficacy. In this review, we discuss the pathophysiology of PTSD through a PNIE lens and its implications for improving patient care, advocating for personalized, multidisciplinary interventions in mental health.

Concussion and the Autonomic, Immune, and Endocrine Systems: An Introduction to the Field and a Treatment Framework for Persisting Symptoms

A significant proportion of patients who sustain a concussion/mild traumatic brain injury endorse persisting, lingering symptoms. The symptoms associated with concussion are nonspecific, and many other medical conditions present with similar symptoms. Medical conditions that overlap symptomatically with concussion include anxiety, depression, insomnia, chronic pain, chronic fatigue, fibromyalgia, and cervical strain injuries. One of the factors that may account for these similarities is that these conditions all present with disturbances in the optimal functioning of the autonomic nervous system and its intricate interactions with the endocrine system and immune system-the three primary regulatory systems in the body. When clinicians are working with patients presenting with persisting symptoms after concussion, evidence-based treatment options drawn from the literature are limited. We present a framework for the assessment and treatment of persisting symptoms following concussion based on the available evidence (treatment trials), neuroanatomical principles (research into the physiology of concussion), and clinical judgment. We review the research supporting the premise that behavioral interventions designed to stabilize and optimize regulatory systems in the body following injury have the potential to reduce symptoms and improve functioning in patients. Foundational concussion rehabilitation strategies in the areas of sleep stabilization, fatigue management, physical exercise, nutrition, relaxation protocols, and behavioral activation are outlined along with practical strategies for implementing intervention modules with patients.

Critical Review of the Cross-Links Between Dietary Components, the Gut Microbiome, and Depression

The complex relationship between diet, the gut microbiota, and mental health, particularly depression, has become a focal point of contemporary research. This critical review examines how specific dietary components, such as fiber, proteins, fats, vitamins, minerals, and bioactive compounds, shape the gut microbiome and influence microbial metabolism in order to regulate depressive outcomes. These dietary-induced changes in the gut microbiota can modulate the production of microbial metabolites, which play vital roles in gut-brain communication. The gut-brain axis facilitates this communication through neural, immune, and endocrine pathways. Alterations in microbial metabolites can influence central nervous system (CNS) functions by impacting neuroplasticity, inflammatory responses, and neurotransmitter levels-all of which are linked to the onset and course of depression. This review highlights recent findings linking dietary components with beneficial changes in gut microbiota composition and reduced depressive symptoms. We also explore the challenges of individual variability in responses to dietary interventions and the long-term sustainability of these strategies. The review underscores the necessity for further longitudinal and mechanistic studies to elucidate the precise mechanisms through which diet and gut microbiota interactions can be leveraged to mitigate depression, paving the way for personalized nutritional therapies.

Gender and sex differences in adherence to a Mediterranean diet and associated factors during the COVID-19 pandemic: a systematic review

Background

The COVID-19 pandemic has led to significant lifestyle changes, including alterations in dietary habits and increases in sedentary behavior. The Mediterranean diet (MD) has been associated with various health benefits, which are especially important given the health challenges posed by the pandemic. During the pandemic, an overall shift towards consuming more highly processed foods has been observed.

Methods

This systematic review investigated adherence to MD during the COVID-19 pandemic, focusing on gender differences and factors influencing adherence to MD in the general public. The literature search focused on papers published between January 1, 2019, and July 8, 2024, across various databases such as Web of Science (WOS), Scopus, PubMed MEDLINE, and PsycINFO.

Results

Following the PRISMA guidelines, this search identified 14,347 references, of which 5,734 were duplicates. After a thorough multi-level screening process, 29 studies, encompassing 55,242 participants, met the inclusion criteria. While seven studies reported that men adhered to a MD more than women during the COVID-19 pandemic, 12 studies also indicated that women had higher adherence to a MD compared to men. Nine studies, however, found no significant gender differences in MD adherence. Additionally, older age, higher education levels, higher socioeconomic status, and increased physical activity were linked to greater adherence to a MD in the pandemic context.

Conclusion

Gender-specific differences in dietary behavior are influenced by factors such as socioeconomic status, gender roles, and pandemic phases as well as biases in sample composition and methodological weaknesses. Significant gaps in the evidence, particularly concerning sexual and gender minorities, are highlighted.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=421727.

The neurotoxicity of acrylamide in ultra-processed foods: interventions of polysaccharides through the microbiota-gut-brain axis

Ultra-processed foods (UPFs) have become popular in recent years, however, the detrimental effects of their excessive consumption have also become evident. Acrylamide (AA), a processing hazard present in UPFs, can further aggravate the harmful effects of UPFs. AA can cause significant damage to both the intestinal barrier and gut microbiota, thereby affecting the nervous system through the microbiota-gut-brain (MGB) axis. Natural polysaccharides have demonstrated the capacity to significantly alleviate the oxidative stress and inflammatory response associated with AA exposure. In addition, they exhibit neuroprotective properties that may be mediated through the MGB axis. This paper reviews literature on the presence of AA in certain UPFs and its potential to inflict serious harm on the human gut microbiota and brain. Moreover, the possibility of utilizing polysaccharides as a preventative measure against AA-induced neurotoxicity was also proposed. These findings provide new insights into the safety risks associated with the overconsumption of UPFs and highlight the potential of polysaccharides to counteract the neurodegeneration induced by AA.

Exploring the gut-heart axis: A prospective analysis of microbiota in cardiovascular health

The relationship between gut microbiota composition and the development of cardiovascular disease, with a potential role of microbial metabolites in inflammatory and metabolic pathways is of interest. We analyzed gut microbiota and markers of cardiovascular health in a cohort of 100 participants for three years to search for microbial signatures correlated with increased CVD risk. Our results show several correlations between specific microbial taxa, lipid metabolism and systemic inflammation, whereby a higher Firmicutes/Bacteroides ratio is associated with a greater incidence of CVD. These results suggest that intervention targeting the microbiome has the potential to reduce risk for CVD and point towards a role for gut microbiota in cardiovascular health.

Type 2 Diabetes Mellitus in Inflammatory Bowel Disease Patients: A Case-Control Study Through a Long Follow-Up Period

Background/Objectives: The characterization of patients with inflammatory bowel disease (IBD) and type 2 diabetes mellitus (T2DM) as a new group has not been well detailed. This study aimed to evaluate the impact of T2DM on IBD progression and analyze the prevalence of steatotic liver disease and liver damage in these patients. Methods: Through a retrospective case-control study, we compared severe IBD occurrence in patients with both IBD-T2DM (cases) versus those with IBD alone (controls). Among 1047 medical records, 79 IBD-T2DM patients were selected and compared to 308 controls in a 1:4 ratio. Severe IBD was defined by variables such as surgery, target therapy, corticosteroid use, and hospitalization. Liver damage was assessed using Fib-4 (>1.3), and hepatic steatosis was evaluated by imaging. Results: There was no significant difference in severe disease rates (59.5% vs. 59.7%; p = 0.97). IBD-T2DM patients had higher rates of hepatic steatosis (62.9% vs. 27.2%; p < 0.0001) and liver damage (55.4% vs. 26.6%; p < 0.0001). IBD-T2DM patients used more corticosteroids (p < 0.0001) and fewer anti-TNF-alpha drugs (p = 0.007). The median age at diagnosis was higher in IBD-T2DM patients (48 vs. 32; p < 0.0001). In Crohn's disease, 24.3% of IBD-T2DM patients had exclusive colonic involvement compared to 5% in the IBD-only group (p = 0.003). Conclusions: T2DM was not associated with worse IBD progression, but was linked to increased liver steatosis and damage. Differences such as age of onset, colonic involvement, and liver damage suggest that IBD-T2DM patients could configure a special population worthy of further studies.

Ultra-Processed Food and Gut Microbiota: Do Additives Affect Eubiosis? A Narrative Review

The gut microbiota plays a key role in health and disease, but it could be affected by various factors (diet, lifestyle, environment, genetics, etc.). Focusing on diet, while the role of the different styles and choices (Mediterranean vs. Western diet, vegan or vegetarian diets) has been extensively studied, there are a few comprehensive papers on the effects of additives and food processing. Therefore, the main goal of this manuscript is to propose an overview of the link between ultra-processed foods and the gut microbiota based on papers and data available in the literature. The literature search was performed on PubMed and Clinicaltrials.gov, and after the selection of the most relevant articles, the paper proposes a synopsis of the effects of some classes of additives (sweeteners, preservatives, emulsifiers, glutamate, etc.), as well as of some treatments, on the gut microbiota and some pathological conditions.

Evaluation of dietary quality in patients with functional gastrointestinal symptoms: a Norwegian single centre study

Background

Poor dietary quality has been described as a contributor to symptoms in subjects with functional gastrointestinal (GI) symptoms. Hitherto, the focus in dietary evaluation and treatment in this patient group has mainly been on avoiding individual nutrient deficiencies, and less attention has been given to the dietary pattern and the overall food quality. Hence, we aim to describe and evaluate the dietary quality in patients with functional GI symptoms.

Methods

Patients with GI symptoms and a diagnosis of irritable bowel syndrome or inflammatory bowel disease in remission, consecutively referred to a clinical dietitian for nutritional guidance, were included. All participants completed a 7-day weighed food record. The intake of foods, energy, macro- and micronutrients was computed. Dietary quality was evaluated by intake frequencies based on a predefined food index, combined with assessing achievement of nutrient intake recommendations.

Results

A total of 35 patients were included. Intake frequencies of red meat, cheese and sweets were high, whereas intake frequencies of green leafy vegetables, berries, nuts, whole grain and legumes were low. The total intake of vegetables, fruit, berries, fish and nuts was lower than current recommendations, and the intake corresponded to intake below recommendations for several micronutrients, including vitamins D, C and A; iodine; folate; potassium; and selenium.

Conclusion

The group of patients with GI symptoms had overall inadequate dietary quality. Low intake of nutrient-dense food groups considered as beneficial for health corresponded with insufficient intake of several micronutrients. We recommend that dietary evaluation should focus on the intake of food groups, rather than nutrients, in the treatment of patients with functional GI symptoms, to ensure a better evaluation of dietary quality.

Understanding immune system dysfunction and its context in mood disorders: psychoneuroimmunoendocrinology and clinical interventions

Mood disorders include a set of psychiatric manifestations of increasing prevalence in our society, being mainly represented by major depressive disorder (MDD) and bipolar disorder (BD). The etiopathogenesis of mood disorders is extremely complex, with a wide spectrum of biological, psychological, and sociocultural factors being responsible for their appearance and development. In this sense, immune system dysfunction represents a key mechanism in the onset and pathophysiology of mood disorders, worsening mainly the central nervous system (neuroinflammation) and the periphery of the body (systemic inflammation). However, these alterations cannot be understood separately, but as part of a complex picture in which different factors and systems interact with each other. Psychoneuroimmunoendocrinology (PNIE) is the area responsible for studying the relationship between these elements and the impact of mind-body integration, placing the immune system as part of a whole. Thus, the dysfunction of the immune system is capable of influencing and activating different mechanisms that promote disruption of the psyche, damage to the nervous system, alterations to the endocrine and metabolic systems, and disruption of the microbiota and intestinal ecosystem, as well as of other organs and, in turn, all these mechanisms are responsible for inducing and enhancing the immune dysfunction. Similarly, the clinical approach to these patients is usually multidisciplinary, and the therapeutic arsenal includes different pharmacological (for example, antidepressants, antipsychotics, and lithium) and non-pharmacological (i.e., psychotherapy, lifestyle, and electroconvulsive therapy) treatments. These interventions also modulate the immune system and other elements of the PNIE in these patients, which may be interesting to understand the therapeutic success or failure of these approaches. In this sense, this review aims to delve into the relationship between immune dysfunction and mood disorders and their integration in the complex context of PNIE. Likewise, an attempt will be made to explore the effects on the immune system of different strategies available in the clinical approach to these patients, in order to identify the mechanisms described and their possible uses as biomarkers.

Food additives and their implication in inflammatory bowel disease and metabolic syndrome

Over the past half a century the Western diet (WD) has become saturated with food additives. During the same time, there has been an increase in Western diseases, such as inflammatory bowel disease (IBD) and metabolic syndrome (MetS). Emerging research has shown that food additives may be implicated in these diseases. However, critics have suggested that some of this research is problematic and may cause unnecessary fear amongst consumers. Here we review the emerging research concerning food additives and their implication in IBD and MetS, and criticisms thereof. To make the review more relevant to the WD, we only included common food additives, selected using supermarket data. Over a dozen common food additives from four categories were identified for their potential role in directly promoting these diseases. A consistent limitation of the research was the use of unrealistic human exposure conditions, such as high doses and modes of administration, as well as a lack of human trials. Another limitation was the absence of studies investigating the potential synergetic effect of consuming multiple food additives, as is common in the WD. Despite the limitations, there is some evidence that common food additives may be contributing to these additives, especially via their dysbiotic effect on the gut microbiota.

Gut microbiota and healthy longevity

Recent progress on the underlying biological mechanisms of healthy longevity has propelled the field from elucidating genetic modification of healthy longevity hallmarks to defining mechanisms of gut microbiota influencing it. Importantly, the role of gut microbiota in the healthy longevity of the host may provide unprecedented opportunities to decipher the plasticity of lifespan on a natural evolutionary scale and shed light on using microbiota-targeted strategies to promote healthy aging and combat age-related diseases. This review investigates how gut microbiota affects healthy longevity, focusing on the mechanisms through which gut microbiota modulates it. Specifically, we focused on the ability of gut microbiota to enhance the intestinal barrier integrity, provide protection from inflammaging, ameliorate nutrientsensing pathways, optimize mitochondrial function, and improve defense against age-related diseases, thus participating in enhancing longevity and healthspan.

Chronic Obstructive Pulmonary Disease: The Role of Healthy and Unhealthy Dietary Patterns-A Comprehensive Review

Chronic obstructive pulmonary disease (COPD) is a progressive and irreversible disease affecting many people worldwide. Recent evidence suggests that diet and lifestyle play a vital role in COPD progression. We aimed to provide a comprehensive review of the effect of healthy and unhealthy dietary patterns on preventing and treating COPD. For this reason, Scopus, EMBASE, Web of Science, and PubMed were searched. Based on our findings, it appears that adhering to a healthy dietary pattern rich in vegetables, legumes, fruit, nuts, and whole grains may have advantageous impacts on preventing and treating COPD while following an unhealthy dietary pattern rich in red and processed meat, saturated fats, sweets, and sugary drinks affect COPD negatively. Adhering to Mediterranean, dietary approaches to stop hypertension (DASH), Prudent, Ketogenic, and High-protein diet may be related to a lower risk of COPD and improved pulmonary function. Conversely, Western and Ramadan Intermittent Fasting diets may elevate the prevalence of COPD. Proposing a nutritious diet that enhances pulmonary function could potentially be an effective approach to preventing and managing COPD. A comprehensive knowledge of the relationship between dietary factors and COPD can provide healthcare professionals with properly supported approaches to advise patients and empower individuals to make informed lifestyle decisions that are beneficial to improve their pulmonary health.

Relationship Between Dietary Nutrient Intake and Autophagy-Related Genes in Obese Humans: A Narrative Review

Obesity is one of the world's major public health challenges. Its pathogenesis and comorbid metabolic disorders share common mechanisms, such as mitochondrial or endoplasmic reticulum dysfunction or oxidative stress, gut dysbiosis, chronic inflammation and altered autophagy. Numerous pro-autophagy dietary interventions are being investigated for their potential obesity-preventing or therapeutic effects. We summarize current data on the relationship between autophagy and obesity, and discuss various dietary interventions as regulators of autophagy-related genes in the prevention and ultimate treatment of obesity in humans, as available in scientific databases and published through July 2024. Lifestyle modifications (such as calorie restriction, intermittent fasting, physical exercise), including following a diet rich in flavonoids, antioxidants, specific fatty acids, specific amino acids and others, have shown a beneficial role in the induction of this process. The activation of autophagy through various nutritional interventions tends to elicit a consistent response, characterized by the induction of certain kinases (including AMPK, IKK, JNK1, TAK1, ULK1, and VPS34) or the suppression of others (like mTORC1), the deacetylation of proteins, and the alleviation of inhibitory interactions between BECN1 and members of the Bcl-2 family. Significant health/translational properties of many nutrients (nutraceuticals) can affect chronic disease risk through various mechanisms that include the activation or inhibition of autophagy. The role of nutritional intervention in the regulation of autophagy in obesity and its comorbidities is not yet clear, especially in obese individuals.

The role of diet as adjuvant treatment in FAP patients

BACKGROUND

The management of individuals with familial adenomatous polyposis (FAP) includes invasive prophylactic surgery and intensive endoscopic surveillance to reduce their risk of colorectal cancer. FAP patients frequently ask for dietary recommendations to alleviate bowel disturbances after prophylactic colectomy, and to prevent the formation and growth of new adenomas. We have enriched the multidisciplinary outpatient clinic for FAP with nutritional support. This paper presents the results of the first six months of this nutritional activity.

METHODS

Sixty-eight individuals with FAP, >18 years of age, who underwent a prophylactic total colectomy, entered in this observational study. At the baseline visit, participants underwent anthropometric measurements, answered the Mediterranean Diet Adherence Screener (MEDAS), the Faecal Incontinence Quality of Life (FIQL) questionnaire, and reported the number of their diarrhoeal discharges per day. They received dietary recommendations including specific information about the inflammatory food to reduce (red/processed meat, sugar, sweets), and the Mediterranean food to increase (vegetables, fruits, whole grain cereal in cream and legumes' hummus).

RESULTS

After six months, participants repeated the same baseline measurements. Fifty-three individuals with FAP completed the six-month follow-up. The before-after analysis showed significant improvements in patients' body composition measurements and MEDAS score. Participants significantly reduced the number of diarrhoeal discharges per day. FIQL results showed improvements in lifestyle, behaviour, and depression scores.

CONCLUSIONS

These results suggest that targeted low-inflammatory Mediterranean dietary recommendations are effective in improving anthropometric parameters, diet quality, and various aspects of quality of life related to bowel function in individuals with FAP.

Blood circulation effect of fermented citrus bioconversion product (FCBP) in EA.hy926 endothelial cells and high-fat diet-fed mouse model

Background

The escalating global burden of cardiovascular diseases, largely driven by unhealthy lifestyle choices and dietary patterns, has intensified the search for effective and safe interventions. With current treatments often marred by significant side effects, the exploration of natural compounds such as flavonoids presents a compelling alternative.

Objective

This study investigated the effects of fermented citrus bioconversion product (FCBP), a fermented citrus bioflavonoid, on various markers of cardiovascular health in the context of a high-fat diet.

Design

In vivo, a high-fat diet-induced mouse model was used to assess the effects of FCBP on body weight, serum nitric oxide (NO) levels, activated partial thromboplastin time (aPTT), phosphatidylserine (PS) exposure on red blood cells, and the expression of inflammatory markers Intercellular Adhesion Molecule (ICAM)-1 and Vascular Cell Adhesion Molecule (VCAM)-1 in the thoracic aorta. In vitro, EA.hy926 endothelial cells were used to evaluate the compound's effects on cell viability, NO production, endothelial nitric oxide synthase (eNOS) expression, and cell adhesion molecule (CAM) levels to further understand the mechanisms behind the in vivo findings.

Results

In vivo, FCBP supplementation led to a dose-dependent reduction in weight gain, a significant decrease in serum NO levels at 10 mg/kg, and reduced ICAM-1 and VCAM-1 expressions in the thoracic aorta, indicating anti-inflammatory properties. PS exposure on red blood cells was also reduced, suggesting decreased procoagulant activity, while aPTT remained unchanged. In vitro, FCBP was non-cytotoxic to endothelial cells, showed a trend toward increased NO production and eNOS expression, and reduced the expression of ICAM-1 and VCAM-1, supporting its potential anti-inflammatory effects.

Conclusions

FCBP demonstrates potential as a bioactive compound for managing cardiovascular health by reducing inflammation, mitigating weight gain, and influencing blood circulation-related parameters under high-fat diet conditions. Further studies, including diverse models and human trials, are warranted to elucidate its mechanisms and compare its efficacy with established cardiovascular therapeutics.

The role of gut microbiome and its metabolites in pancreatitis

Gut microbiome plays a vital role in the intestinal ecosystem and has close association with metabolites. Due to the development of metabolomics and microbiomics, recent studies have observed that alteration of either the gut microbiome or metabolites may have effects on the progression of pancreatitis. Several new treatments based on the gut microbiome or metabolites have been studied extensively in recent years. Gut microbes, such as Bifidobacterium, Akkermansia, and Lactobacillus, and metabolites, such as short-chain fatty acids, bile acids, vitamin, hydrogen sulfide, and alcohol, have different effects on pancreatitis. Some preliminary studies about new intervention measures were based on the gut microbiome and metabolites such as diet, prebiotic, herbal medicine, and fecal microbiota transplantation. This review aims to summarize the recent advances about the gut microbiome, metabolites, and pancreatitis in order to determine the potential beneficial role of the gut microbiome and metabolites in pancreatitis.

Gestational diabetes exacerbates intrauterine microbial exposure induced intestinal microbiota change in offspring contributing to increased immune response

BACKGROUND

maternal health during pregnancy can affect the intestinal microbial community of offspring, but currently the impact of intrauterine environmental changes resulting from gestational diabetes mellitus (GDM) on the microbiota of offspring as well as its interaction with the immune system remains unclear.

AIMS

to explore the impact of intrauterine microbial exposure during pregnancy of gestational diabetes mellitus on the development of neonate's intestinal microbiota and activation of immune responses.

METHODS

Levels of lipopolysaccharides in cord blood from GDM and expression of microbial recognition-related proteins in the placenta were measured. To evaluate embryonic intestinal colonization, pregnant mice with GDM were administered with labeled Escherichia coli or Lactobacillus. The intestinal colonization of pups was analyzed through 16S rRNA gene sequencing and labeled microbial culture. Additionally, memory T lymphocyte and dendritic cell co-culture experiments were conducted to elucidate the immune memory of intestinal microbes during the embryonic stages.

RESULT

Gestational diabetes mellitus led to elevated umbilical cord blood LPS level and increased GFP labeled Escherichia coli in the offspring's intestine after gestational microbial exposure. The mouse model of GDM exhibited increased immune markers including TLR4, TLR5, IL-22 and IL-23 in the placenta and a recall response from memory T cells in offspring's intestines, with similar observations found in human experiments. Furthermore, reduced intestinal microbiome diversity and an increased ratio of Firmicutes/Bacteroidetes was found in GDM progeny, with the stability of bacterial colonization been interfered.

CONCLUSIONS

Our investigation has revealed a noteworthy correlation between gestational diabetes and intrauterine microbial exposure, as well as alterations in the neonatal microbiota and activation of immune responses. These findings highlight the gestational diabetes's role on offspring's gut microbiota and immune system interactions with early-life pathogen exposure.

An unbiased, sustainable, evidence-informed Universal Food Guide: a timely template for national food guides

BACKGROUND

Although national food guides are designed, ostensibly, to translate scientific evidence with respect to food, dietary patterns, and health, their development has increasingly become a corporate/political process as well as scientific one; often with corporate/political influences overriding science. Our aim was to construct an unbiased, sustainable, evidence-informed Universal Food Guide to serve as a template for countries to develop their unique guides, thereby, provide a valid resource for health professionals, health authorities, and the public.

METHODS

To address our aim, we conducted an integrative review of multiple evidence-informed sources (e.g., established databases, evidence syntheses, scholarly treatises, and policy documents) related to four areas: 1. Food guides' utility and conflicts of interest; 2. The evidence-based healthiest diet; 3. Constituents of the Universal Food Guide template; and 4. Implications for population health; regulation/governance; environment/climate/planetary health; and ethics.

RESULTS

The eating pattern that is healthiest for humans (i.e., most natural, and associated with maximal health across the life cycle; reduced non-communicable disease (NCD) risk; and minimal end-of-life illness) is whole food, low fat, plant-based, especially vegan, with the absence of ultra-processed food. Disparities in national food guide recommendations can be explained by factors other than science, specifically, corporate/political interests reflected in heavily government-subsidized, animal-sourced products; and trends toward dominance of daily consumption of processed/ultra-processed foods. Both trends have well-documented adverse consequences, i.e., NCDs and endangered environmental/planetary health. Commitment to an evidence-informed plant-based eating pattern, particularly vegan, will reduce risks/manifestations of NCDs; inform healthy food and nutrition policy regulation/governance; support sustainable environment/climate and planetary health; and is ethical with respect to 'best' evidence-based practice, and human and animal welfare.

CONCLUSION

The Universal Food Guide that serves as a template for national food guides is both urgent and timely given the well-documented health-harming influences that corporate stakeholders/politicians and advisory committees with conflicts of interest, exert on national food guides. Such influence contributes to the largely-preventable NCDs and environmental issues. Policy makers, health professionals, and the public need unbiased, scientific evidence as informed by the Universal Food Guide, to inform their recommendations and choices.

High fat intake aggravates hyperlipidemia and suppresses fatty liver symptoms induced by a high-sucrose diet in rats

Overconsumption of sucrose or fat is widely acknowledged as a prominent feature of unhealthy dietary patterns. Both factors commonly co-occur and are recognized as hallmarks of the Western diet, which is an important contributor to non-communicative diseases. In this study, we investigated the hazards of high sucrose or fat intake, either alone or in combination. Wistar rats were divided into four groups and fed a control starch diet, high-sucrose diet, high-fat diet, or high-sucrose/fat diet for 30 days. High fat intake increased body weight and visceral and subcutaneous adipose tissue weights. Both high-sucrose and -fat diets were associated with increased plasma triglyceride and glucose levels, and high sucrose also elevated plasma cholesterol levels. The combination of high sucrose and fat synergistically elevated plasma triglyceride levels. The high-sucrose diet increased liver weight and hepatic total lipid and triglyceride levels, whereas this increase was suppressed by the high-fat diet. The high sucrose increased the mRNA levels of hepatic genes involved in fatty acid synthesis and transport (ACLY, ACACA, FAS, ELOVL6, SCD1, SREBP1, and CD36), whereas the high fat suppressed the high sucrose-induced expression of these genes. We observed that high sucrose and fat contents differently exerted their effects on hyperlipidemia and fatty liver. Furthermore, high fat aggravated hyperlipidemia and suppressed fatty liver induced by high sucrose.

Gut-Brain Axis and Neuroinflammation: The Role of Gut Permeability and the Kynurenine Pathway in Neurological Disorders

The increasing prevalence of neurological disorders such as Alzheimer's, Parkinson's, and multiple sclerosis presents a significant global health challenge. Despite extensive research, the precise mechanisms underlying these conditions remain elusive, with current treatments primarily addressing symptoms rather than root causes. Emerging evidence suggests that gut permeability and the kynurenine pathway are involved in the pathogenesis of these neurological conditions, offering promising targets for novel therapeutic and preventive strategies. Gut permeability refers to the intestinal lining's ability to selectively allow essential nutrients into the bloodstream while blocking harmful substances. Various factors, including poor diet, stress, infections, and genetic predispositions, can compromise gut integrity, leading to increased permeability. This condition facilitates the translocation of toxins and bacteria into systemic circulation, triggering widespread inflammation that impacts neurological health via the gut-brain axis. The gut-brain axis (GBA) is a complex communication network between the gut and the central nervous system. Dysbiosis, an imbalance in the gut microbiota, can increase gut permeability and systemic inflammation, exacerbating neuroinflammation-a key factor in neurological disorders. The kynurenine pathway, the primary route for tryptophan metabolism, is significantly implicated in this process. Dysregulation of the kynurenine pathway in the context of inflammation leads to the production of neurotoxic metabolites, such as quinolinic acid, which contribute to neuronal damage and the progression of neurological disorders. This narrative review highlights the potential and progress in understanding these mechanisms. Interventions targeting the kynurenine pathway and maintaining a balanced gut microbiota through diet, probiotics, and lifestyle modifications show promise in reducing neuroinflammation and supporting brain health. In addition, pharmacological approaches aimed at modulating the kynurenine pathway directly, such as inhibitors of indoleamine 2,3-dioxygenase, offer potential avenues for new treatments. Understanding and targeting these interconnected pathways are crucial for developing effective strategies to prevent and manage neurological disorders.

HLA diversity unveils susceptibility and organ-specific occurrence of second primary cancers: a prospective cohort study

BACKGROUND

Up to 17% of cancer survivors have been reported to develop second primary cancers (SPC), which cause significant physical and economic distress and often complicate clinical decision-making. However, understanding of SPC remains limited and superficial. Human leukocyte antigen (HLA) is characterized by its polymorphism and has been associated with various diseases. This study aims to explore the role of HLA diversity in SPC incidence.

METHODS

We analyzed a cohort of 47,550 cancer patients from the UK Biobank. SNP-derived HLA alleles were used and SPC-related HLA alleles were identified using logistic regression, followed by stepwise filtering based on the Akaike information criterion (AIC) and permutation tests. Additionally, we examined the association between extragenetic factors and the risk of SPC in patients carrying hazardous HLA alleles.

RESULTS

During a median follow-up of 3.11 years, a total of 2894 (6.09%) participants developed SPC. We identified three protective HLA alleles (DRB1*04:03 and DPA1*02:02 for males and DRB5*01:01 for females) and two hazardous alleles (A*26:01 for males and DPB1*11:01 for females) about SPC. The presence of the protective alleles was associated with a reduced SPC risk (males: hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.59-0.89; females: HR 0.81, 95% CI 0.70-0.93), while the hazardous alleles were linked to an increased risk (males: HR 1.27, 95% CI 1.03-1.56; females: HR 1.35, 95% CI 1.07-1.70). The hazardous allele A*26:01 indicated skin-lung organ-specific SPC occurrence in males. Animal fat and vitamin C were associated with SPC risk in males carrying the hazardous alleles, while free sugar and vegetable fat were linked to SPC risk in females.

CONCLUSIONS

These results suggest that HLA alleles may serve as biomarkers for the susceptibility and organ-specific occurrence of SPC, while dietary modulation may mitigate hazardous alleles-related SPC risk, potentially aiding in the early prediction and prevention of SPC.

Fluctuations in Mediterranean Diet Adherence Pre- and Post-Pandemic: A Study of Portuguese Cohorts 2019-2024

BACKGROUND/OBJECTIVES

The Mediterranean Diet (MD) is a lifestyle offering numerous health benefits. Nevertheless, the adherence to the MD is moderate even in Mediterranean countries. While sociodemographic factors influence MD adherence, additional impacts occurred due to the COVID-19 pandemic. This cross-sectional longitudinal study with three cohorts of Portuguese adults analyzes MD adherence before, during, and after the COVID-19 pandemic, and explores the effect of sociodemographic variables.

METHODS

Sociodemographic factors, lifestyle habits, and MD adherence were assessed in the years 2019, 2021, and 2024 with an online self-filled questionnaire. MD adherence was measured with the Mediterranean Diet Adherence Screener (MEDAS).

RESULTS

MEDAS score increased significantly (p < 0.05) from 2019 to 2021 (6.2 ± 0.7 to 7.7 ± 0.1), followed by a significant (p < 0.05) decrease in 2024 (7.2 ± 0.1) relative to 2019, which was more pronounced in participants with higher income. Accordingly, a trend in healthier food choices was observed followed by a decline in 2024. Of note is the significant increase in red meat consumption (p < 0.05) in 2024 relative to 2021. Respondents who consumed more red meat were mostly men, employed, or in a stable relationship. Most respondents practiced sport "Never or occasionally" in 2019 and 2021 (59.4 and 55.2%, respectively); in 2024, this category was significantly (p < 0.05) reduced (40.9%); men or higher-income participants were more likely to meet the recommended activity levels.

CONCLUSIONS

This study reveals that the improvements in MD lifestyle during the pandemic were not sustained in 2024, as healthier habits formed during confinement were not fully integrated into long-term behavior. These findings strengthen the need for targeted public health interventions to promote the MD.

Low-carbohydrate diet as a nutritional intervention in a major depression disorder: focus on relapse prevention

OBJECTIVES

Mood disorders are trending to be among the leading causes of years lived with disability. Despite multiple treatment options, around 30% patients with major depressive disorder (MDD) develop treatment resistant depression (TRD) and fail to respond to current pharmacological therapies. This study aimed to explore the potential benefits of nutritional treatment strategies, along with their molecular mechanisms of action, focusing especially on low-carbohydrate diet (LCHD), ketogenic diet (KD) and other strategies based on carbohydrates intake reduction.

METHODS

A comprehensive literature review was conducted to determine the impact of LCHD on alleviating depressive symptoms in patients with MDD, along with an explanation of its mode of action.

RESULTS

The study revealed significant impact of nutritional interventions based on restriction in carbohydrate intake such as LCHD, KD or sugar-sweetened beverages (SSB) exclusion on anxiety or depression symptoms reduction, mood improvement and lower risk of cognitive impairment or depression. The efficacy of these approaches is further substantiated by their underlying molecular mechanisms, mainly brain-derived neurotrophic factor (BDNF) which is a potential key target of sugar restriction diets in terms of neuroplasticity.

DISCUSSION

Healthcare professionals may consider implementing LCHD strategies for MDD and TRD patients to modify the disease process, maintain euthymia, and prevent depressive episode relapses. Ranging from the exclusion of SSB to the adherence to rigorous LCHD regimens, these nutritional approaches are safe, straightforward to implement, and may confer benefits for well-being and relapse prevention in this specific patient population.

Caloric restriction impacts skin barrier function and attenuates the development of hyperplasia skin disease

Caloric restriction (CR) stands out as one of the most potent interventions that prolong lifespan and mitigate age-associated diseases. Despite its well-established systemic effects, the impact of CR on skin physiological function remains poorly understood, and whether the intervention can alleviate the progression of inflammatory skin diseases remains uncertain. Here, we investigated the effects of CR on mouse skin barrier function and inflammatory response. Our results revealed that CR led to dramatic atrophy in the skin subcutaneous layer. The expression of barrier proteins and trans-epidermal water loss remain largely unchanged. Intriguingly, skin from CR mice exhibited reduced expression of inflammatory cytokines under steady conditions. In an imiquimod (IMQ)-induced mouse model of psoriasis, CR treatment attenuated the pathogenesis of psoriasis phenotypes, accompanied by a reduced activation of mTOR signaling in the psoriatic skin. Taken together, our findings shed light on the complex interplay between metabolic interventions and skin health, suggesting that CR has the potential to serve as a modulator of inflammatory responses in the skin.

The Effect of Dietary Types on Gut Microbiota Composition and Development of Non-Communicable Diseases: A Narrative Review

INTRODUCTION

The importance of diet in shaping the gut microbiota is well established and may help improve an individual's overall health. Many other factors, such as genetics, age, exercise, antibiotic therapy, or tobacco use, also play a role in influencing gut microbiota.

AIM

This narrative review summarizes how three distinct dietary types (plant-based, Mediterranean, and Western) affect the composition of gut microbiota and the development of non-communicable diseases (NCDs).

METHODS

A comprehensive literature search was conducted using the PubMed, Web of Science, and Scopus databases, focusing on the keywords "dietary pattern", "gut microbiota" and "dysbiosis".

RESULTS

Both plant-based and Mediterranean diets have been shown to promote the production of beneficial bacterial metabolites, such as short-chain fatty acids (SCFAs), while simultaneously lowering concentrations of trimethylamine-N-oxide (TMAO), a molecule associated with negative health outcomes. Additionally, they have a positive impact on microbial diversity and therefore are generally considered healthy dietary types. On the other hand, the Western diet is a typical example of an unhealthy nutritional approach leading to an overgrowth of pathogenic bacteria, where TMAO levels rise and SCFA production drops due to gut dysbiosis.

CONCLUSION

The current scientific literature consistently highlights the superiority of plant-based and Mediterranean dietary types over the Western diet in promoting gut health and preventing NCDs. Understanding the influence of diet on gut microbiota modulation may pave the way for novel therapeutic strategies.

Assessing the impact of dietary choices on fiber deficiency: insights from the 2017-2020 Polish national adult nutrition survey

Introduction

Dietary fiber is a key component of a healthy diet, associated with a reduced risk of cardiovascular disease, obesity, type 2 diabetes, certain cancers, chronic inflammation, or depression. The aim of the study was to perform an in-depth analysis of dietary fiber intake in the Polish population, taking account of the consumption of groups of products that are fiber sources and identify any age-related differences in the dietary fiber intake of the subjects.

Methods

We analyzed data obtained from two representative cross-sectional studies on the diet and nutritional status of adult Polish residents including the total of 4,000 individuals aged 19 years and more. Two 24-h recalls were used per individual to assess the diet using the computer-assisted personal interview (CAPI) technique. Total fiber content and fiber contained in cereal products, vegetables, fruits, legumes, nuts and seeds were calculated. Fiber intake was compared to the recommendations: 25 g/d for adults up to 65 years of age and 20 g/d for those aged 66 years and older. All statistical analyses, including the Pearson's chi-squared test, the Student's t-test, and the Analysis of Variance (ANOVA), were conducted using STATISTICA™ version 13.3, with the results being adjusted for demographic distribution biases to enhance the representativeness.

Results

The average daily fiber intake was 17.83 ± 0.14 g/day (78% of the recommended intake), with 20.5% of respondents meeting the requirement. More men than women (27.05% vs. 14.3%;) met the requirement and men were characterized by a higher average intake (19.34 ± 0.20 g/day) than women (16.43 ± 0.19 g/day). The main fiber sources were cereals (44.1%), vegetables (23.6%), and fruits (16.0%). As regards men, the sources included refined bread (25.8%), vegetables (23.1%), and fruits (10.2%) and for women, they were vegetables (24.0%), fruits (17.2%), and refined bread (16.3%). Although refined bread is not recommended as a primary fiber source due to its lower fiber content compared to whole grain bread, its high consumption significantly contributed to the total fiber intake.

Conclusion

The prevalence of widespread dietary fiber deficiency calls for the intensification of educational efforts that address the health advantages and sources of dietary fiber, as well as methods for its inclusion in daily meals.

Gut microbiome and metabolic dysfunction-associated steatotic liver disease: Pathogenic role and potential for therapeutics

Gut microbiota plays key functions in the human body, and its alteration is associated with several human disorders. Moreover, its manipulation is being investigated as a potential therapeutic strategy. In this narrative review we will dissect the involvement of the gut microbiota and of the gut-liver axis on metabolic dysfunction-associated steatotic liver disease (MASLD). Additionally, we will review the effects of lifestyle interventions commonly used for MASLD (i.e. Mediterranean diet and physical exercise) on gut microbiome, to understand if their beneficial effect can be microbially mediated. Finally, we will discuss the role and the available evidence of therapeutic microbiome modulators, including prebiotics, probiotics, symbiotics, and fecal microbiota transplantation (FMT), in the management of MASLD.

Improvement of starvation resistance via periodic fasting is genetically variable in Drosophila melanogaster

Organisms subjected to periodic nutrient limitation early in life exhibit improvements in aspects of survival, including resistance to some environmental stressors. Recent findings indicate that forms of periodic fasting such as intermittent fasting and time restricted feeding can improve starvation resistance. However, it remains unclear to what extent this survival improvement persists across different genetic backgrounds. In this study, we examine fasting-induced starvation resistance across a broad survey of wild-derived lineages and document genetic variation within this trait. We adopt a standard dietary intervention and show improvement to starvation resistance within a common laboratory lineage, replicating previous results. Next, we examine fasting-induced starvation resistance across isofemale lines collected across latitudes and in different seasons, and among inbred lines derived from flies collected on different continents. We discover genetic variation of fasting-induced starvation resistance, and show that fasting improved starvation resistance as often as it worsened starvation resistance. Fasted flies generally showed reduced fat concentration, and their starvation survival varied with sex, season of collection, and geographic origin. While specific lineages common to the laboratory can show a specific fasting-induced phenotype, we show that this result is not consistent across genetic backgrounds, reinforcing the idea that phenotypes observed in historic laboratory strains may not be conserved across a species.

The microbiome-driven impact of western diet in the development of noncommunicable chronic disorders

Noncommunicable chronic disorders (NCDs) are multifactorial disorders that share a state of chronic, low-grade inflammation together with an imbalance of gut microbiota. NCDs are becoming increasingly prevalent worldwide, and mainly in Western countries, with a significant impact on global health. Societal changes, together with the widespread diffusion of modern agricultural methods and food processing, have led to a significant shift in dietary habits over the past century, with an increased diffusion of the Western diet (WD). WD includes foods high in saturated fat, refined sugars, salt, sweeteners, and low in fiber, and is characterized by overeating, frequent snacking, and a prolonged postprandial state. An increasing body of evidence supports the association between the diffusion of WD and the rising prevalence of NCDs. WD also negatively affects both gut microbiota and the immune system by driving to microbial alterations, gut barrier dysfunction, increased intestinal permeability, and leakage of harmful bacterial metabolites into the bloodstream, with consequent contribution to the development of systemic low-grade inflammation. In this review article we aim to dissect the role of gut microbiota imbalance and gut barrier impairment in mediating the detrimental effects of WD on the development of NCDs, and to identify potential therapeutic strategies.

High-Salt Diet and Intestinal Microbiota: Influence on Cardiovascular Disease and Inflammatory Bowel Disease

Salt, or sodium chloride, is an essential component of the human diet. Recent studies have demonstrated that dietary patterns characterized by a high intake of salt can influence the abundance and diversity of the gut microbiota, and may play a pivotal role in the etiology and exacerbation of certain diseases, including inflammatory bowel disease and cardiovascular disease. The objective of this review is to synthesize the effects of elevated salt consumption on the gut microbiota, including its influence on gut microbial metabolites and the gut immune system. Additionally, this review will investigate the potential implications of these effects for the development of cardiovascular disease and inflammatory bowel disease. The findings of this study offer novel insights and avenues for the management of two common conditions with significant clinical implications.