Anti-Inflammatory Nutrients and Obesity-Associated Metabolic-Inflammation: State of the Art and Future Direction

Associations of breakfast habits and breakfast quality with depression symptoms: A cross-sectional study based on NHANES 2007-2018

BACKGROUND

Breakfast, often considered the most important meal of the day, affects both physical and mental health. While most studies focused on the effects of skipping breakfast on depression, few explored the roles of breakfast quality and breakfast time. The study aimed to investigate the association of breakfast habits and breakfast quality with depression symptoms.

METHODS

This study included 23,839 participants aged 20 and older from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). Breakfast habits were assessed using two 24-h dietary recalls, capturing both whether and when breakfast was consumed. Breakfast quality was assessed by calculating the Breakfast Quality Score (BQS). Depression symptoms was diagnosed using the Patient Health Questionnaire (PHQ-9). Binary logistic regression was used to explore the associations.

RESULTS

Compared to participants who did not report breakfast, the ORs of participants who reported breakfast on both one recall and both recalls were 0.737(0.591,0.919) and 0.766(0.624,0.939) for depression symptoms. Compared to participants in the BQS T1 subgroup, the ORs of participants in the T2 subgroup and T3 subgroup were 0.895(0.723,1.108) and 0.716(0.564,0.908) for depression symptoms (P for trend = 0.013). Compared to participants who had breakfast before 8:00 AM, the ORs for depression symptoms were 1.104 (95 % CI: 0.888, 1.371) for those who had breakfast between 8:00-9:00 AM and 1.278 (95 % CI: 1.030, 1.587) for those who had breakfast after 9:00 AM.

CONCLUSIONS

Skipping breakfast, low breakfast quality, and late breakfast are independently associated with depression symptoms.

Advances in Leaf Plant Bioactive Compounds: Modulation of Chronic Inflammation Related to Obesity

Over the years, there has been a tendency for an increase in global obesity. The World Health Organization's (WHO) 2024 report states that in 2019, more than one billion people were obese, and this condition was responsible for five million deaths, being that obesity is more prevalent among adults compared to adolescents and children. Obesity is a chronic disease characterized by alterations in adipose tissue. When excessive food is consumed and energy expenditure is low, adipose tissue undergoes hypertrophy and hyperplasia. This process activates B cells and induces the transition of anti-inflammatory M2-like macrophages into pro-inflammatory M1-like macrophages. B cells, acting as inflammatory mediators, stimulate pro-inflammatory CD8+ T cells, and promote macrophage infiltration into tissues. This condition triggers inflammation, increases oxidative stress, and ultimately leads to cellular death. During inflammation, an increase of pro-inflammatory cytokines occurs along with a decrease of anti-inflammatory cytokines. By contrast, the increase of oxidative stress is related to an increase of reactive oxygen species (ROS), oxidation of biomolecules, and a decrease in antioxidants. This mechanism for obesity can be mitigated through several healthy lifestyle changes, primarily including regular physical activity and healthy eating. These factors help reduce pro-inflammatory mediators and ROS, lowering inflammation and oxidative stress. Therefore, this review article focuses on studying the bioactive compounds present in the edible leaves of Annona cherimola Mill., Ipomoea batata (L.) Poir., Colocasia esculenta (L.) Schott, Eriobotrya japonica, Cymbopogon citratus, Psidium guajava (L.), and Smallanthus sonchifolius to evaluate their effects on the mechanisms involved in obesity.

Methods, practices, and complications related to the use of artificial penile nodules within the French Guiana penitentiary

Background

Artificial penile nodules (APNs) are small, handmade objects inserted under the penile skin, a practice deeply rooted in the prison environment of French Guiana, raising significant concerns related to sexual health, including complications and an increased risk of sexually transmitted infections (STIs).

Aim

The primary objective of the current study was to investigate APN practices, methods, and complications in prison and to identify risk factors for complications among APN users and their sexual partners.

Methods

This cross-sectional study was conducted among adult male detainees in June 2023 at the French Guiana Penitentiary (FGP). Eligible participants completed an anonymous 47-question survey addressing sociodemographic data, APN practices, and sexual health. Facilitators played a critical role in distributing and collecting the questionnaires, which were available in five languages to accommodate the prison's population ethnogeographic diversity. Data analysis was conducted using logistic regression to identify risk factors associated with complications.

Outcomes

Outcomes included the prevalence of APN use among detainees, the proportion of individuals experiencing complications, the association between APN characteristics (number and placement) and partner-related complications, as well as the rates of condom breakage and self-reported STI history.

Results

Among 779 eligible detainees, 132 participated (17%). The majority were under 35 years old (67%), and 69% reported having APNs, with a median of 5.2 nodules per user (range: 1-22). The main motivation for APN use was enhancing partner satisfaction (60%), while 5% cited intent to harm. Complications were reported by 25%, including pain (52%), bleeding (41%), and infections (35%). Partner-related complications (pain or bleeding) were significantly associated with having five or more APNs and placement in the foreskin of the penis.

Clinical Implications

Given the high prevalence of APNs in the prison setting and their associated health risks, targeted health education and harm reduction strategies are essential to mitigate complications and promote informed decision-making among detainees.

Strengths and Limitations

The main limitation of this study was its reliance on self-reported questionnaires completed in cells, which may have affected confidentiality, response accuracy, and participation due to prison dynamics and literacy barriers. However, the approach provided valuable insight into a stigmatized topic, and collaboration with facilitators and staff helped achieve meaningful participation.

Conclusion

APNs are deeply rooted in prison culture in French Guiana but pose significant health risks. Findings underscore the need for targeted health education to address these risks, particularly focusing on reducing partner-related complications and promoting informed decision-making about APN practices.

Highlights

Despite their widespread use, APNs pose significant health risks, including pain, infections, and complications for sexual partners, with nearly half of users reporting partner-related issues.This study underscores the need for targeted health education interventions to address these risks and promote safer practices within the penitentiary system.Nearly 70% of detainees reported having artificial penile nodules, with a median of 5.2 nodules per user, highlighting the prevalence of this practice in French Guiana's prisons.A significant link was found between having five or more nodules and partner complications, such as pain or bleeding, emphasizing the impact on sexual health.

Prospective association of changes in (poly)phenol intake, body weight and physical activity with inflammatory profile

BACKGROUNDS AND AIM

To prospectively evaluate the associations between changes in (poly)phenol intake, body weight(BW), and physical activity(PA) with changes in an inflammatory score after 1-year.

METHODS AND RESULTS

This is a prospective observational analysis involving 484 participants from the PREDIMED-Plus with available inflammatory measurements. (Poly)phenol intake was estimated using a validated semi-quantitative food frequency questionnaire and the Phenol-Explorer database. An inflammatory score was calculated based on 8 blood biomarkers (IL-6, IL-8, IL-18, MCP-1, C-peptide, hs-CRP, leptin, and RANTES). The association between BW, PA, (poly)phenol intake and inflammatory score was evaluated using structural equations. Mediation analyses were performed to assess the relationship between change in (poly)phenol intake and inflammatory score was mediated by the change in BW. A higher increase in total (poly)phenol intake was related to a decrease in the inflammatory score (β = -0.005mg/1000 Kcal; CI95 % = -0.100,0.000) along with a decrease in BW (β = -0.006mg/1000 Kcal; CI95 % = -0.010,-0.003). Increased PA was associated with a lower inflammatory score (β = -0.129MET-min/d; CI95 % = -0.238,-0.021) and BW (β = -0.248MET-min/d; CI95 % = -0.343,-0.152). Finally, a decrease in BW was associated with a decrease in the inflammatory score (β = 0.240 kg; CI95 % = 0.155,0.325). Mediation analyses revealed that changes in BW explained 22 % of the overall association between changes in (poly)phenol intake and inflammatory score.

CONCLUSIONS

An inverse association between changes in (poly)phenol intake and inflammatory status was observed, with BW playing a significant mediating role, emphasising the impact of BW reduction on inflammation reduction.

Risk Factors of Primary Dysmenorrhea in Female Adolescent Basketball Players Related to Dietary, Hormonal, and Immuno-Metabolic Factors and Disordered Eating Attitudes

Background/Objectives: Primary dysmenorrhea (PD) is a condition characterized by painful pelvic cramps onsetting shortly before menses and lasting for 3 days, negatively impacting the quality of life of young females. Further, menstrual cycle disorders are common in athletes. This study investigated differences in dietary habits, hormonal and immuno-metabolic parameters, and susceptibility to disordered eating attitudes (DEAs) between dysmenorrheic (D group) and non-dysmenorrheic (no-D group) young female basketball players. It also aimed to identify risk factors for PD, focusing on nutrition, anthropometric parameters, and biochemical markers. Materials and Methods: The study included 25 female basketball players (mean age: 16 years), categorized into D and no-D groups. Blood samples were analyzed for hormonal, metabolic, and inflammatory markers, including follicle-stimulating hormone, luteinizing hormone, total testosterone, androstenedione, dehydroepiandrosterone sulfate, estradiol, sex hormone-binding globulin, cortisol, prolactin, fasting glucose, fasting insulin, C-reactive protein, lipid profile, and 25-hydroxyvitamin D3. Dietary intake was assessed via a three-day food record, and DEA susceptibility was evaluated using the Eating Attitudes Test (EAT-26). Logistic regression identified independent PD risk factors. Results: The D group had significantly higher EAT-26 scores and prolactin and cortisol levels than the no-D group (p = 0.0284, p = 0.0108, p = 0.0035, respectively). Elevated prolactin, cortisol, and EAT-26 scores were associated with increased PD risk (OR = 1.75; OR = 1.02; OR = 1.14). Conclusions: Female basketball players with PD show higher prolactin and cortisol levels and greater DEA susceptibility. These factors may contribute to PD risk, warranting further research.

Targeting Cytokine Dysregulation in Psoriasis: The Role of Dietary Interventions in Modulating the Immune Response

Psoriasis is a chronic immune-mediated skin disease characterized by cytokine dysregulation. Pro-inflammatory mediators, including tumor necrosis factor-alpha (TNF-α), interleukin (IL)-17, and IL-23, play pivotal roles in the pathogenesis of psoriasis. Emerging evidence suggests that dietary interventions can modulate cytokine activity, providing a complementary approach to standard therapies. This narrative review examines the impact of various dietary strategies, including a Mediterranean diet, ketogenic diet, gluten-free diet, and fasting-mimicking diet, on cytokine profiles and clinical outcomes in psoriasis. Research insights reveal that dietary components such as omega-3 fatty acids, polyphenols, and short-chain fatty acids influence immune signaling pathways. These pathways include nuclear factor-kappa B (NF-κB) and Signal Transducer and Activator of Transcription 3 (STAT3). Additionally, these dietary components promote anti-inflammatory effects mediated by gut microbiota. Clinical studies demonstrate significant reductions in psoriasis severity, improved quality of life, and modulation of key cytokines associated with disease activity. Despite these advancements, significant challenges persist in effectively integrating these findings into clinical practice. These challenges include variability in patient responses, adherence issues, and the need for robust biomarkers to monitor efficacy. Future directions emphasize the potential of personalized nutrition and precision medicine approaches to optimize dietary interventions tailored to individual cytokine profiles and genetic predispositions. Integrating these strategies into psoriasis care could transform treatment paradigms by simultaneously addressing both systemic inflammation and comorbid conditions.

Reduced Serum PD-L1 and Markers of Inflammation in Response to Alternate Day Fasting With a Low-Carbohydrate Intervention: A Secondary Analysis of a Single-Arm Trial

This secondary analysis aimed to examine the effect of a single-arm alternate day fasting intervention with a 30% low-carbohydrate diet on biomarkers of inflammation and immune activation in adults with obesity. A 12-week weight-loss period was followed by a 12-week weight maintenance period. Anthropometrics and blood samples were collected at baseline and weeks 12 and 24. Multiplex assay was used to measure serum biomarkers including programmed death ligand 1 (PD-L1), interleukin 8 (IL-8), IL-1 receptor antagonist (IL-1ra), chemokine ligand (CCL)2, CCL4, interferon gamma (IFnγ), IFNγ-induced protein 10 (IP-10), and cluster of differentiation 40 ligand (CD40-L). In 28 participants, body weight and fat mass decreased during the weight-loss period but stabilized during the weight maintenance period. Serum PD-L1 decreased from baseline to week 12 (P = 0.005) but not at week 24. Moreover, IL-1ra and CCL4 concentrations decreased from baseline to week 24 (P < 0.001 and P < 0.008, respectively). Changes were not significant for in CCL2, IL-8, CD40-L, IFNγ, or IP-10. In conclusion, alternate day fasting-low carbohydrate modulates circulating immune biomarkers, which may be relevant to diabetes, cancer, and autoimmunity. This trial was registered at clinicaltrials.gov as NCT03528317 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6934424/).

The Anti-obesity Effects of Lotus (Nelumbo nucifera Gaertn.) Seed Red Skin (Testa) Catechins by Regulating Lipoprotein Lipase Expression and Activity

Lipoprotein lipase (LPL) participates in the development of obesity by regulating triglyceride hydrolysis and fat storage or oxidation. In this study, the anti-obesity effects of lotus seed skin catechins and its mechanisms associated with LPL modulation were demonstrated. In vivo, catechins reduced body weight in high-fat diet-induced obese mice, improved lipid metabolism and antioxidant indices, and modulated LPL activity in adipose and skeletal muscle tissues. The expression of peroxisome proliferator-activated receptor γ (PPARγ) and (angiopoietin-like 4 proteins) ANGPTL4 mRNA and protein was significantly upregulated in epididymal fat depot but downregulated in skeletal muscle tissue. In vitro cell experiments and chromatin immunoprecipitation (ChIP) assays further revealed that the binding sites of PPARγ protein in the ANGPTL4 promoter region were enriched in adipocytes or reduced in skeletal muscle cells in response to catechin treatment. Therefore, lotus seed skin catechins exhibit anti-obesity activity in vivo and in vitro by specifically regulating the activity and expression of LPL in target tissues.

Preventing and Managing Pre- and Postoperative Micronutrient Deficiencies: A Vital Component of Long-Term Success in Bariatric Surgery

Bariatric surgery (BS) is an effective treatment for severe obesity and its related comorbidities, such as type 2 diabetes and hypertension. However, the anatomical and physiological changes associated with these procedures significantly increase the risk of preoperative and postoperative micronutrient deficiencies, which can lead to severe complications such as anemia, osteoporosis, and neurological disorders. This narrative review examines the prevalence and clinical implications of micronutrient deficiencies in BS patients, as well as evidence-based strategies for their prevention and management. The most common deficiencies include iron, vitamin B12, folate, calcium, vitamin D, and fat-soluble vitamins (A, E, and K). Procedures with a hypoabsorptive component, such as Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion with duodenal switch (BPD/DS), pose higher risks of deficiencies compared to restrictive procedures like sleeve gastrectomy (SG). Effective strategies involve the preoperative correction of deficiencies, continuous monitoring, and tailored supplementation. However, long-term adherence to supplementation tends to decrease over time, influenced by behavioral and socioeconomic factors. Hence, preventing and managing micronutrient deficiencies are crucial for the long-term success of BS. While current guidelines provide valuable recommendations, many are based on low-certainty evidence, underscoring the need for more robust studies. A multidisciplinary approach, combined with innovative strategies, such as telemedicine, can enhance adherence and achieve sustainable clinical outcomes.

Optimizing Nutritional Management Before and After Bariatric Surgery: A Comprehensive Guide for Sustained Weight Loss and Metabolic Health

Obesity is associated with multiple comorbidities that contribute to increased mortality among affected individuals. There are multiple treatments for this condition, including nutritional interventions, pharmacological therapies, and surgical procedures. Within these, bariatric surgery is an effective treatment option that requires a multidisciplinary approach, both before and after surgery. Nutritional management prior to surgery aims to achieve metabolic control and reduce comorbidities associated with the procedure. Postoperative nutritional management focuses on preventing complications, ensuring adequate nourishment, and providing necessary supplementation for optimal recovery and long-term success. This narrative review examines all these critical aspects of nutritional management in bariatric surgery, including preoperative nutrition, postoperative nutrition and physical activity recommendation, different nutritional aspects according to the type of bariatric surgery, and future directions for investigation.

(Poly)phenols and Multiple Sclerosis: Results from an Observational Cross-Sectional Study

(Poly)phenols are a wide and heterogeneous class of substances with several potential health benefits. Their role in neuroprotection and cognition is still questionable. This study's scope is to examine the possible association between total and individual (poly)phenol intake, major dietary sources, and the severity of multiple sclerosis (MS) in a cohort of MS patients. Participants' demographics, physical activity, smoking, and dietary information were collected, alongside clinical parameters including the Expanded Disability Status Score (EDSS), Multiple Sclerosis Severity Score (MSSS), MS phenotype, and current therapy. A validated 110-item food frequency questionnaire (FFQ) was used to assess participants' habits. The (poly)phenol content of foods was estimated using the Phenol-Explorer database. Data from 106 participants were analyzed. A high intake of vegetables was associated with a 4.6-fold higher probability of mild MS (95% CI: 1.49, 14.28), whereas no association was found for other food and beverage sources. Hydroxycinnamic acids were significantly related to MSSS (OR: 6.55, 95% CI: 2.15, 19.92). Although coffee intake differed significantly between patients with mild and severe MS (90.5 ± 53.9 vs. 59.4 ± 40.8 mL/d, respectively), linear regression analysis did not confirm an association with MSSS. A higher intake of hydroxycinnamic acids and vegetables may impact MS severity. Coffee's role remains unclear and needs to be further investigated.

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.

Preoperative Nutrition in Bariatric Surgery: A Narrative Review on Enhancing Surgical Success and Patient Outcomes

Bariatric surgery has become the preferred treatment for individuals with morbid obesity. Nutrition is key in optimizing surgical outcomes by reducing risks and enhancing recovery. Preoperative strategies, such as reducing body fat, decreasing liver size, and improving metabolic profiles, have been shown to facilitate safer surgical procedures with fewer complications. This narrative review aims to provide an analysis of the fundamental role of preoperative nutritional management in improving bariatric surgery outcomes, emphasizing the importance of addressing specific nutritional challenges to enhance surgical safety, recovery, and overall health. Preoperative nutritional interventions focus on correcting comorbidities and nutritional deficiencies, particularly hypovitaminosis and micronutrient imbalances, through a multidisciplinary approach involving nutritionists and other healthcare professionals. These interventions not only prepare patients for the physiological demands of surgery but also initiate a period of adaptation to new dietary habits, aiming to improve long-term compliance and mitigate risks such as postoperative weight regain and dumping syndrome. Adopting dietary changes, such as very low-calorie or ketogenic diets 6-12 weeks before surgery, enhances adherence to postoperative restrictions and overall surgical success. Future research should focus on developing comprehensive guidelines for preoperative nutritional care to improve patient outcomes globally.

Green guaje (Leucaena leucocephala) and pigmented guaje (Leucaena esculenta) as sources of antioxidant and immunomodulatory peptides

In recent years, there has been a growing interest in plant-based diets, particularly legumes, as a sustainable and healthy dietary choice. This study breaks new ground by investigating the effects of simulated gastrointestinal digestion on green (Leucaena leucocephala) and pigmented (Leucaena esculenta) guaje proteins. We evaluated the antioxidant and immunomodulatory properties of ultrafiltered fractions resulting from digestion in a macrophage model. Both fractions showed promising potential as radical scavengers. The fraction <5 kDa from pigmented guaje, even at the lowest doses tested, significantly (p < 0.05) inhibited the release of pro-inflammatory cytokines TNF-α and IL-6, and demonstrated an immunomodulatory effect by reducing the levels of ROS and NO. These findings suggest that green and pigmented guaje could be a valuable source of bioactive peptides, potentially used as a coadjutant for treating and preventing oxidative stress and inflammation-associated non-communicable diseases through the utilization of underutilized legumes.

Lymphocyte to High-density Lipoprotein Cholesterol Ratio is Positively Associated with Pre-diabetes, Metabolic Syndrome, and Non-traditional Cardiometabolic Risk Markers: A Cross-sectional Study at Secondary Health Care

High scores of lymphocyte-to-high-density lipoprotein cholesterol ratio (lymphocyte-to-HDL-c) may be a new indicator of inflammation and metabolic syndrome. Here, we investigated the associations of the lymphocyte-to-HDL-c with traditional and non-traditional cardiometabolic risk markers in subjects at high cardiovascular risk. This study is a cross-sectional analysis with subjects assisted in a Secondary Health Care (n = 581, age = 63.06 ± 13.86 years; 52.3% women). Lymphocyte-to-HDL-c ratio were assessed by routine laboratory tests. Anthropometric and/or biochemical variables were used to calculate traditional (body mass index - BMI, and waist-to-height ratio - WHtR) and non-traditional (lipid accumulation product index-LAP, visceral adiposity index-VAI, deep-abdominal-adipose-tissue index-DAAT, atherogenic index of plasma-AIP, and waist-hypertriglyceridemic phenotype-HTGW) cardiometabolic risk markers. Furthermore, anthropometric measurement waist circumference (WC), blood pressure, metabolic syndrome (MS), and biochemical markers (lipid and glycemic profile) were considered traditional markers of cardiometabolic risk. Pearson's chi-square test, Poisson regression with robust variance, or multinomial logistic regression were performed (α = 0.05). Individuals with a high lymphocyte-HDL-c ratio (> 0.84, 3rd tertile) were associated with the HTGW phenotype, high VAI, high LAP, hypertriglyceridemia, high AIP, high very low-density lipoprotein-cholesterol (VLDL-c), pre-diabetes, and 3 and 4 MS components compared with individuals in the first tertile, independent of confounders. Our findings supported the lymphocyte-to-HDL-c ratio as a potential biomarker during the screening of subjects at high cardiovascular risk.

Dietary Inflammatory Score (DIS)'s and Lifestyle Inflammatory Score (LIS)'s Impact on Multiple Sclerosis Severity

Background/Objectives: Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the central nervous system with variable degrees of inflammation and gliosis. Diet and lifestyle factors could influence MS development and also contribute to inflammation. The current study aims to evaluate the relationship between dietary and lifestyle inflammatory potential and multiple sclerosis severity. Methods: A cross-sectional study design was employed. Data collection included demographic, neurological, and nutritional information. The Dietary Inflammatory Score (DIS) and Lifestyle Inflammatory Score (LIS) were calculated based on the reference protocol. Results: One hundred and seven participants (69.2% female; mean age, 50.6 ± 11.6 years) completed the study. The anti-inflammatory LIS group had significantly higher proportions of normal-weight (p = 0.000) and physically active (p = 0.022) participants. A greater proportion of women exhibited an anti-inflammatory lifestyle compared to men (80% vs. 20%; p = 0.023). No relation was retrieved between the DIS, LIS, and MS Severity Score (MSSS). When analyzing the single DIS components, leafy greens were associated with MS severity (OR 1.67; 95% CI, 1.50-18.74; p = 0.009). Among the LIS components, "high physical activity" (OR 5.51; 95% CI, 1.66-18.30; p = 0.005) and "heavy drinking" (OR 5.61; 95% CI, 1.19-26.47; p = 0.029) were related to lower MS severity. Conclusions: Although no differences were found in the total Dietary and Lifestyle Inflammatory Scores, some of their components might be connected with MS severity. Further intervention studies are needed to validate these findings.

Nut Consumption Is Associated with Cognitive Status in Southern Italian Adults

BACKGROUND

Nut consumption has been considered a potential protective factor against cognitive decline. The aim of this study was to test whether higher total and specific nut intake was associated with better cognitive status in a sample of older Italian adults.

METHODS

A cross-sectional analysis on 883 older adults (>50 y) was conducted. A 110-item food frequency questionnaire was used to collect information on the consumption of various types of nuts. The Short Portable Mental Status Questionnaire was used to assess cognitive status. Multivariate logistic regression analyses were performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between nut intake and cognitive status after adjusting for potential confounding factors.

RESULTS

The median intake of total nuts was 11.7 g/day and served as a cut-off to categorize low and high consumers (mean intake 4.3 g/day vs. 39.7 g/day, respectively). Higher total nut intake was significantly associated with a lower prevalence of impaired cognitive status among older individuals (OR = 0.35, CI 95%: 0.15, 0.84) after adjusting for potential confounding factors. Notably, this association remained significant after additional adjustment for adherence to the Mediterranean dietary pattern as an indicator of diet quality, (OR = 0.32, CI 95%: 0.13, 0.77). No significant associations were found between cognitive status and specific types of nuts.

CONCLUSIONS

Habitual nut intake is associated with better cognitive status in older adults.

The Dietary Inflammatory Index and Sarcopenia in Older Adults in Four Chinese Provinces: A Cross-Sectional Study

Background: Sarcopenia associated with aging severely affects the quality of life of the elderly; diets have been shown to elicit an inflammatory response in the body, and diets that promote inflammation may lead to damage to muscles. The Dietary Inflammatory Index (DII) has been developed to quantify the inflammatory potential of individual diets. Therefore, this study aimed to investigate the association between the DII, sarcopenia and its components in elderly Chinese people. Methods: In this study, data were obtained from the China Nutrition Improvement Strategies and Applications for the Elderly Research Programme. An assessment of sarcopenia was carried out according to the Asian Working Group on Sarcopenia's (AWGS2019) criteria. The DII was calculated using food intake data obtained using the FFQ method, and then the quartile method was used to categorize the subjects into four groups. Multifactor logistic regression was conducted to examine the associations between DII, sarcopenia and its components. Results: This study included 993 subjects over the age of 65, and the prevalence of sarcopenia was 20.2%. The mean DII score of the study population was 0.99 ± 0.1. After adjusting for the confounders age, gender, marital status, and educational level, the risk of sarcopenia was 1.66 times higher in group Q4 than in group Q1 (p-trend < 0.05). However, this relationship is not statistically significant when other more confounding factors are added. Nevertheless, when further analyzing the relationship between DII and sarcopenia components, it was found that after adjusting the model, a higher DII was associated with a risk of muscle strength loss (OR = 1.65, p-trend < 0.05). Conclusions: Higher DII scores increase the risk of muscle strength loss in older adults. By guiding older adults to adopt a more anti-inflammatory diet, muscle health can be improved in terms of increased muscle strength. Further cohort or interventional studies are necessary to validate our findings.

Nutritional Strategies for Battling Obesity-Linked Liver Disease: the Role of Medical Nutritional Therapy in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Management

PURPOSE OF REVIEW

This narrative review explores the role of Medical Nutritional Therapy (MNT) in managing Metabolic-Associated Steatotic Liver Disease (MASLD), previously known as nonalcoholic fatty liver disease. It aims to examine the effectiveness of specific nutritional strategies in preventing and treating this obesity-linked liver disease.

RECENT FINDINGS

Emerging evidence underscores the benefits of the Mediterranean diet, low-carbohydrate diets, and intermittent fasting in reducing liver fat, improving insulin sensitivity, and mitigating inflammation. Supplementing with vitamin E, omega-3 fatty acids, and silymarin can potentially reduce liver fibrosis and promote liver health. MNT is a key intervention for MASLD management, emphasizing dietary patterns, caloric restriction, and nutraceutical supplementation. Integrating these strategies with lifestyle modifications, including regular physical activity, offers a comprehensive approach to improving metabolic and liver outcomes in patients with MASLD. Further research is needed to refine and personalize these therapeutic interventions.

The relationship between dietary inflammatory index and all-cause and cardiovascular disease-related mortality in adults with metabolic syndrome: a cohort study of NHANES

Objective

This study aims to investigate the correlation between dietary inflammatory index (DII) and mortality resulting from all-cause and cardiovascular diseases (CVD) in adults affected by metabolic syndrome (MetS).

Methods

The focus of this study was to analyze the information of 13,751 adults who had been diagnosed with MetS. DII scores were computed based on a 24-hour dietary intake at the start of the study. By implementing both the Cox regression analysis and restricted cubic spline(RCS) analysis, we examined the correlation between DII score and mortality.

Results

After a mean follow-up duration of 114 months, a total of 2,343 individuals (representing 13.45% of the sample) died, with 639 fatalities attributed to CVD. The degrees of dietary inflammation were classified into three groups based on DII scores: low, medium, and high-grade. The mortality rates for each tertile of DII were 11.55%, 13.96%, and 15.05%, respectively. In comparison to participants with T1, the multivariate-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for participants with T3 were 1.16 (95% CI: 1.01-1.34) regarding mortality caused by any reason, and 1.26 (95% CI: 0.95-1.68) for mortality related to CVD. Through the use of the Kaplan-Meier survival curve and RCS, it was observed that individuals in the high DII tertile had an increased likelihood of death compared to those in the low DII tertile.

Conclusion

Our findings provide validation of the theory that diets high in inflammatory substances contribute to elevated mortality rates for all causes and CVD-related deaths in individuals diagnosed with MetS.

The Impact of Diet and Nutrition on the Oral Microbiome

At present, it is well known that oral health is essential for the well-being of the body as a whole, thanks to the increasing awareness of how various oral diseases, including periodontal disease, oral carcinomas, and other conditions, have a close connection with various systemic disorders. In recent decades, studies on the oral microbiome have increasingly emphasized how the balance between the host and the microbial species that coexist there is essential for oral health at all stages of life. However, there are many factors capable of interfering with that balance, and diet is precisely one of them. The real influence of diet on the oral microbiota, and consequently on oral health, has been much debated. In this context, the observation of two key periods in human history, the Neolithic and the Industrial Revolution, has proved to be diriment. The foods and processing techniques that emerged in these two historical periods, in association with changes in customs and habits, significantly altered the central constituents of the human diet, including macronutrient proportions, glycemic load, fatty acid composition, sodium and potassium levels, micronutrient levels, dietary pH, and fiber content taken in by human beings. The introduction of these foods into the daily human routine has been linked to a decline in oral health and an increase of several other diseases, including cardiovascular diseases, inflammatory bowel disease, rheumatic diseases, many cancers, and obesity. The aim of this chapter is to update the current knowledge and further discuss the role of diet and nutrition on oral health.

The association of ultra-processed food intake with neurodegenerative disorders: a systematic review and dose-response meta-analysis of large-scale cohorts

OBJECTIVES

Our systematic review and meta-analysis aimed to uncover the relationship between UPFs intake and neurodegenerative disorders, including multiple sclerosis (MS), Parkinson's disease (PD), Alzheimer's disease (AD), cognitive impairment, and dementia.

SETTING

A systematic search was conducted using the Scopus, PubMed/MEDLINE, and ISI Web of Science databases without any limitation until June 24, 2023. Relative risk (RR) and 95% confidence interval (CI) were pooled by using a random-effects model, while validated methods examined quality and publication bias via Newcastle-Ottawa Scale, Egger's regression asymmetry, and Begg's rank correlation tests, respectively.

RESULTS

Analysis from 28 studies indicated that a higher UPFs intake was significantly related to an enhanced risk of MS (RR = 1.15; 95% CI: 1.00, 1.33; I2 = 37.5%; p = 0.050; n = 14), PD (RR = 1.56; 95% CI: 1.21, 2.02; I2 = 64.1%; p = 0.001; n = 15), and cognitive impairment (RR = 1.17; 95% CI: 1.06, 1.30; I2 = 74.1%; p = 0.003; n = 17), although not AD or dementia. We observed that a 25 g increment in UPFs intake was related to a 4% higher risk of MS (RR = 1.04; 95% CI: 1.01, 1.06; I2 = 0.0%; p = 0.013; n = 7), but not PD. The non-linear dose-response relationship indicated a positive non-linear association between UPF intake and the risk of MS (Pnonlinearity = 0.031, Pdose-response = 0.002). This association was not observed for the risk of PD (Pnonlinearity = 0.431, Pdose-response = 0.231).

CONCLUSION

These findings indicate that persistent overconsumption of UPFs may have an adverse impact on neurodegenerative conditions, potentially leading to a decline in quality of life and reduced independence as individuals age.

Association between prognostic nutritional index and stroke: A nationally representative cross-sectional study from NHANES

BACKGROUND

The correlation between the prognostic nutritional index (PNI) and the risk of stroke has become a hot spot within the medical research community. The available evidence from a large sample regarding the correlation between PNI and stroke is inadequate. There is also a need for more research analysis from national surveys.

OBJECTIVE

The principal goal of this research is to improve our understanding of the relationship between PNI and the risk of stroke. This study also intends to investigate the potential synergistic influence of PNI on stroke in combination with other interacting variables.

METHODS

A cross-sectional study was conducted with 35,549 participants selected from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 cycle. Information was gathered from all participants regarding the following: lymphocyte count, albumin levels, stroke occurrence, age, sex, race/ethnicity, education level, poverty income ratio (PIR), marital status, body mass index (BMI), smoking habits, drinking status, physical activity measured in total metabolic equivalents (PA_total_MET), diabetes status, glycohemoglobin levels, total cholesterol, direct high-density lipoprotein cholesterol(direct HDL-cholesterol), hypertension, and coronary heart disease. Curve fitting, subgroup analysis, and multifactor weighted logistic regression analysis were used to examine the relationship between PNI and stroke.

RESULTS

The overall prevalence of stroke was found to be 3.9%, PNI quartile 4(Q4) had an increased prevalence of stroke than quartile 1, 2, and 3(Q1,2,3). Our research suggested a negative association between PNI and the risk of stroke, as indicated by the odds ratio (OR=0.98) with a 95% confidence interval (CI=0.97∼0.99) and a p-value <0.05 (P=0.005), even after adjusting for all confounders. Subsequent subgroup analysis indicated a significant difference in the impact of PNI on stroke between individuals with different body mass index(BMI) levels (p for interaction = 0.02).

CONCLUSION

Our findings underscore that lower PNI in US adults is associated with an increased stroke risk, shedding light on a potential interrelationship between nutrition, inflammatory parameters, and stroke.

Intake of S-Methylmethionine Alters Glucose Metabolism and Hepatic Gene Expression in C57BL/6J High-Fat-Fed Mice

A diet containing foods that are sources of S-methylmethionine (SMM), and its use as a dietary supplement, have demonstrated beneficial health effects. Thus, the objective of this work was to evaluate the inclusion of SMM as a dietary supplement in C57BL/6J high-fat-fed mice to verify whether this compound alone would be responsible for these positive effects. Mice were divided into three groups: LF (low-fat diet), HF (high-fat diet), and HF+SMM (high-fat diet plus SMM), and maintained for 10 weeks with water and food provided ad libitum. Body weight and food intake were measured weekly, and food efficiency was calculated. In addition, at week 9, fasting glucose was measured and, after necropsy, at week 10, liver, inguinal adipose, and kidney weights were measured; triglycerides, histology, liver gene expression, serum insulin, and MCP-1 levels were also determined. Final body weight, average weight gain, and the liver/body weight of the SMM group showed a significant difference with the LF group. HF+SMM-fed mice show improved regulation in glucose metabolism, demonstrated by the assessment of fasting glucose, insulin concentration, and HOMA-IR, compared with the HF-fed group. Liver triglycerides and MCP-1 levels showed no significant differences between fed groups. By the positive gene regulation of Sult1e1, Phlda1, and Ciart, we hypothesized that SMM administration to mice may have regulated xenobiotic, glucose, and circadian rhythm pathways.

Lifestyle Factors Associated with Children's and Adolescents' Adherence to the Mediterranean Diet Living in Mediterranean Countries: The DELICIOUS Project

Background/Objectives. Traditional dietary patterns are being abandoned in Mediterranean countries, especially among younger generations. This study aimed to investigate the potential lifestyle determinants that can increase adherence to the Mediterranean diet in children and adolescents. Methods. This study is a cross-sectional analysis of data from five Mediterranean countries (Italy, Spain, Portugal, Egypt, and Lebanon) within the context of the EU-funded project DELICIOUS (UnDErstanding consumer food choices & promotion of healthy and sustainable Mediterranean Diet and LIfestyle in Children and adolescents through behavIOUral change actionS). This study comprised information on 2011 children and adolescents aged 6-17 years old collected during 2023. The main background characteristics of both children and parents, including age, sex, education, and family situation, were collected. Children's eating (i.e., breakfast, place of eating, etc.) and lifestyle habits (i.e., physical activity level, sleep, and screen time) were also investigated. The level of adherence to the Mediterranean diet was assessed using the KIDMED index. Logistic regression analyses were performed to test for likelihood of higher adherence to the Mediterranean diet. Results. Major determinants of higher adherence to the Mediterranean diet were younger age, higher physical activity level, adequate sleep duration, and, among dietary habits, having breakfast and eating with family members and at school. Parents' younger age and higher education were also determinants of higher adherence. Multivariate adjusted analyses showed that an overall healthier lifestyle and parents' education were the factors independently associated with higher adherence to the Mediterranean diet. Conclusions. Higher adherence to the Mediterranean diet in children and adolescents living in the Mediterranean area is part of an overall healthy lifestyle possibly depending on parents' cultural background.

The Role of Maternal and Early-Life Diet in Inflammatory Bowel Disease

BACKGROUND/OBJECTIVES

Inflammatory bowel disease (IBD) is a chronic gastrointestinal disorder with debilitating symptoms and multifactorial etiology. Nutritional factors during adult life have been implicated in IBD pathogenesis. In addition, there is growing evidence that maternal and early-life diet may be associated with intestinal inflammation and colitis severity. The aim of the current review was to detect and critically appraise all evidence regarding the role of maternal and early-life diet on intestinal inflammation.

METHODS

We performed a thorough search of the literature across two databases (Pubmed, ScienceDirect) using a variety of relevant terms.

RESULTS

A total of 23 studies, 16 experimental and 7 clinical, met inclusion criteria and were included in this review. Experimental studies reveal that high-fat and high-protein diets during gestation and neonatal life induce gut dysbiosis, amplify intestinal inflammation, and exacerbate colitis. In addition, a variety of nutritional factors included in maternal diets may affect offspring's microbiota composition and intestinal health. Human studies concluded that maternal diet quality and the intake of fish and vegetables and of food fortified with vitamin D during gestation and early infancy significantly decreased IBD risk. However, human data are limited, and larger investigations are needed to further clarify the complex associations between specific nutritional compounds and intestinal inflammation.

CONCLUSIONS

Dietary factors during pregnancy and early-life are involved in IBD pathogenesis, exerting either an exacerbating or protective effect. Improving pregnant women's dietary habits could be a cost-effective strategy to reduce future IBD burden.

Malnutrition in patients with obesity: An overview perspective

Malnutrition in patients with obesity presents a complex and often overlooked clinical challenge. Although obesity is traditionally associated with overnutrition and excessive caloric intake, it can also coincide with varying degrees of malnutrition. The etiopathogenesis of obesity is multifaceted and may arise from several factors such as poor diet quality, nutrient deficiencies despite excess calorie consumption, genetics, and metabolic abnormalities affecting nutrient absorption and utilization. Moreover, a chronic low-grade inflammatory state resulting from excess adipose tissue, commonly observed in obesity, can further exacerbate malnutrition by altering nutrient metabolism and increasing metabolic demands. The dual burden of obesity and malnutrition poses significant risks, including immune dysfunction, delayed wound healing, anemia, metabolic disturbances, and deficiencies in micronutrients such as vitamin D, iron, magnesium, and zinc, among others. Malnutrition is often neglected or not given enough attention in individuals with obesity undergoing rapid weight loss through aggressive caloric restriction, pharmacological therapies, and/or surgical interventions. These factors often exacerbate vulnerability to nutrition deficiencies. We advocate for healthcare practitioners to prioritize nutrition assessment and initiate medical intervention strategies tailored to address both excessive caloric intake and insufficient consumption of essential nutrients. Raising awareness among healthcare professionals and the general population about the critical role of adequate nutrition in caring for patients with obesity is vital for mitigating the adverse health effects associated with malnutrition in this population.

Rutin ameliorates HCD-induced cholesterol metabolism disorder in zebrafish larvae revealed by transcriptome and metabolome analysis

Changes in modern lifestyles have led to an increase in obesity rates. Excessive lipid accumulation leads to abnormal cholesterol metabolism, and maintaining a balanced cholesterol metabolism is essential for the normal functioning of cells and the body. Rutin belongs to the group of flavonoids with hypolipidemic, anti-inflammatory and antioxidant effects. The aim of this study was to investigate the role of rutin in cholesterol metabolism disorders induced by a high cholesterol diet in zebrafish larvae. The trial was divided into five groups: Normal diet (ND), 5 % high cholesterol diet (HCD), 5 % high cholesterol diet with 80 μg/g ezetimibe diet (EZE), 5 % high cholesterol diet with 5 % rutin diet (RL-HCD), and 5 % high cholesterol diet with 10 % rutin diet (RH-HCD). Zebrafish larvae at 5 dpf were randomly divided into five groups and continuously fed different diets for 10 days, after 10 days zebrafish samples were collected for subsequent experiments. Body length, body width, oil red O, and Nile red staining were measured to detect biochemical indexes, analyze inflammatory response and lipid accumulation. Vascular endothelial injury was assessed by stereofluorescence microscopy and ELISA. In order to study the protective effect of rutin in zebrafish with cholesterol metabolism disorder induced by HCD, RNA-seq and LC-MS/MS nontargeted metabolomics were employed. The results indicate that HCD led to an increase in the body length and width of zebrafish. The HCD group induced an increase in body length and width, lipid accumulation, and exacerbated inflammation. Additionally, vascular damage and abnormal expression of endothelial cell markers were observed. Rutin lowered lipid levels in zebrafish fed an HCD, reduced inflammation, and protected endothelial cells. The RNA-seq and metabolomic analysis combined demonstrated that rutin effectively ameliorates the disorder of cholesterol metabolism in vivo by reducing cholesterol synthesis and promoting cholesterol transport.

Associations between breast radiation dermatitis and post-mastectomy pain syndrome in patients with breast cancer: A multicenter retrospective study

Objective

This study explores the relationship between breast radiation dermatitis (BRD) and post-mastectomy pain syndrome (PMPS) among patients with breast cancer. Both BRD and PMPS significantly impact quality of life, yet their correlation and risk factors require further investigation.

Methods

We conducted a multicenter retrospective analysis of 784 patients with breast cancer who underwent postoperative radiotherapy between 2017 and 2023. Clinical data on BRD and PMPS were collected through patient questionnaires and hospital records, examining risk factors and evaluating the prevalence of PMPS among those with BRD.

Results

BRD affected 81.25% of patients, with higher incidence among older and obese individuals. PMPS was observed in 23.4% of the BRD group versus 13.6% in non-BRD patients (P=0.009). Early BRD onset during radiotherapy (P=0.004) and larger dermatitis areas (P=0.000) were strongly associated with increased PMPS risk.

Conclusions

This study highlights the significant relationship between BRD and PMPS, underscoring the need for early interventions to manage BRD and reduce chronic pain risk. Tailored care strategies could improve outcomes for high-risk patients.

Addressing Inflammaging and Disease-Related Malnutrition: Adequacy of Oral Nutritional Supplements in Clinical Care

BACKGROUND

Disease-related malnutrition, with or without inflammation, in older adults is currently emerging as a public health priority. The use of Foods for Special Medical Purposes, including Oral Nutritional Supplements, and supplements is crucial to support patients in achieving their nutritional needs. Therefore, this article aims to comprehensively provide an analysis of the adequacy of FSMPs in meeting the nutritional requirements of different age-related diseases and takes into account the emerging role of inflammation. Moreover, it provides an identikit of the ideal products, following the pathology-specific guidelines.

METHODS

Data on 132 products were gathered through face-to-face meetings with companies' consultants. Specifically, information on energy, macronutrient, and micronutrient contents were collected, as well as on texture and flavors, osmolarity, cost, and packaging.

RESULTS

Most FSMPs met the daily recommendations for energy and protein intake. Nonetheless, few products contained β-hydroxy-β-methylbutyrate, optimal Branched-Chain Amino Acids ratios, arginine, glutamine, and omega-3 fatty acids. Furthermore, a marked predominance of FSMPs with a high osmolarity (85.7%), sweet taste (72%), and only animal protein content (79.5%) was observed. Cost analysis of FSMPs revealed a mean cost of EUR 5.35/portion. Products were mostly adequate for cancer, neurodegenerative diseases, diabetes, inflammatory bowel disease, end-stage kidney disease, dysphagiam and chronic obstructive pulmonary disease. However, gaps have been found for sarcopenia and abdominal surgery.

CONCLUSION

In light of the current market landscape, there is a need for a comprehensive regulation that indicates the optimal composition of FSMPs and the production of such products to tackle disease-related malnutrition.

Methylphenidate can help reduce weight, appetite, and food intake-a narrative review of adults' anthropometric changes and feeding behaviors

Introduction

Obesity constitutes a complex global health that carries several comorbidities that include cardiovascular disease, diabetes, and cancer. Current treatments, such as lifestyle modifications and bariatric surgery, are often difficult to implement or carry risks, creating a need for alternative approaches. Methylphenidate (MPH), a drug commonly used to treat Attention Deficit and Hyperactivity Disorder (ADHD), has shown potential in regulating dopamine levels to modulate appetite and feeding behaviors.

Methods

This narrative review evaluated the effect of MPH in reducing food intake, body weight, and anthropometric indicators in adults with obesity or overweight. Using the PICO method, 39 studies were selected, including 14 randomized controlled trials and 3 observational studies.

Results

MPH canblead to modest weight loss of 1-2% and significant appetite suppression, with stronger effects observed in women, who reported greater reductions in appetite and food cravings. Studies could remain underpowered to detect consistent effects in men.

Discussion

Even if these results suggest MPH could be an option for treating obesity, concerns regarding its safety profile and long-term efficacy persist. This review underscores the need for further investigation to confirm MPH's therapeutic potential, particularly through studies that address gender-specific responses and evaluate its sustainability as a weight management tool.

Youth Healthy Eating Index (YHEI) and Diet Adequacy in Relation to Country-Specific National Dietary Recommendations in Children and Adolescents in Five Mediterranean Countries from the DELICIOUS Project

BACKGROUND/OBJECTIVES

The diet quality of younger individuals is decreasing globally, with alarming trends also in the Mediterranean region. The aim of this study was to assess diet quality and adequacy in relation to country-specific dietary recommendations for children and adolescents living in the Mediterranean area.

METHODS

A cross-sectional survey was conducted of 2011 parents of the target population participating in the DELICIOUS EU-PRIMA project. Dietary data and cross-references with food-based recommendations and the application of the youth healthy eating index (YHEI) was assessed through 24 h recalls and food frequency questionnaires.

RESULTS

Adherence to recommendations on plant-based foods was low (less than ∼20%), including fruit and vegetables adequacy in all countries, legume adequacy in all countries except for Italy, and cereal adequacy in all countries except for Portugal. For animal products and dietary fats, the adequacy in relation to the national food-based dietary recommendations was slightly better (∼40% on average) in most countries, although the Eastern countries reported worse rates. Higher scores on the YHEI predicted adequacy in relation to vegetables (except Egypt), fruit (except Lebanon), cereals (except Spain), and legumes (except Spain) in most countries. Younger children (p < 0.005) reporting having 8-10 h adequate sleep duration (p < 0.001), <2 h/day screen time (p < 0.001), and a medium/high physical activity level (p < 0.001) displayed a better diet quality. Moreover, older respondents (p < 0.001) with a medium/high educational level (p = 0.001) and living with a partner (p = 0.003) reported that their children had a better diet quality.

CONCLUSIONS

Plant-based food groups, including fruit, vegetables, legumes, and even (whole-grain) cereals are underrepresented in the diets of Mediterranean children and adolescents. Moreover, the adequate consumption of other important dietary components, such as milk and dairy products, is rather disregarded, leading to substantially suboptimal diets and poor adequacy in relation to dietary guidelines.

Overview of anti-inflammatory diets and their promising effects on non-communicable diseases

An anti-inflammatory diet is characterised by incorporating foods with potential anti-inflammatory properties, including fruits, vegetables, whole grains, nuts, legumes, spices, herbs and plant-based protein. Concurrently, pro-inflammatory red and processed meat, refined carbohydrates and saturated fats are limited. This article explores the effects of an anti-inflammatory diet on non-communicable diseases (NCD), concentrating on the underlying mechanisms that connect systemic chronic inflammation, dietary choices and disease outcomes. Chronic inflammation is a pivotal contributor to the initiation and progression of NCD. This review provides an overview of the intricate pathways through which chronic inflammation influences the pathogenesis of conditions including obesity, type II diabetes mellitus, CVD, autoinflammatory diseases, cancer and cognitive disorders. Through a comprehensive synthesis of existing research, we aim to identify some bioactive compounds present in foods deemed anti-inflammatory, explore their capacity to modulate inflammatory pathways and, consequently, to prevent or manage NCD. The findings demonstrated herein contribute to an understanding of the interplay between nutrition, inflammation and chronic diseases, paving a way for future dietary recommendations and research regarding preventive or therapeutic strategies.

Simvastatin-Loaded Polymeric Nanoparticles: Targeting Inflammatory Macrophages for Local Adipose Tissue Browning in Obesity Treatment

Obesity is defined as chronic, low-grade inflammation within specific tissues. Given the escalating prevalence of obesity among individuals of all ages, obesity has reached epidemic proportions, posing an important public health challenge. Despite significant advancements in treating obesity, conventional approaches remain largely ineffective or involve severe side effects, thus underscoring the pressing need to explore and develop treatment approaches. Targeted and local immunomodulation using nanoparticles (NPs) can influence fat production and utilization processes. Statins, known for their anti-inflammatory properties, show the potential for mitigating obesity-related inflammation. A localized delivery option offers several advantages over oral and parenteral delivery methods. Here, we developed simvastatin (Sim) encapsulated within PLGA NPs (Sim-NP) for localized delivery of Sim to adipose tissues (ATs) for immunomodulation to treat obesity. In vitro experiments revealed the strong anti-inflammatory effects of Sim-NPs, which resulted in enhanced modulation of macrophage (MΦ) polarization and induction of AT browning. We then extended our investigation to an in vivo mouse model of high-fat-diet (HFD)-induced obesity. Sim-NP administration led to the controlled release of Sim within AT, directly impacting MΦ activity and inducing AT browning while inducing weight loss. Our findings demonstrated that Sim-NP administration effectively inhibited the progression of obesity-related inflammation, controlled white fat production, and enhanced AT modulation. These results highlight the potential of Sim-NP as a potent nanotherapy for treating obesity by modulating the immune system.

Lifestyle Intervention to Promote an Adequate Gestational Weight Gain and Improve Perinatal Outcomes in a Cohort of Obese Women

OBJECTIVE

This study aims to evaluate the correlation of gestational weight gain (GWG) with pregnancy and perinatal outcomes in a cohort of obese women class I-III receiving standard care (SC) or lifestyle intervention (LI).

METHODS

This is a prospective cohort study including singleton obese women (body mass index, BMI ≥ 30) who delivered between 2016 and 2020. Women exposed to a LI were referred to an obesity weight management ad hoc clinic. Women followed by family centers or private settings represented the SC group. The LI started between the 9 and 12th week, consisting of a low-calorie diet and physical activity program. Pregnancy and perinatal outcomes were prospectively collected. Women included in the SC group were followed, simply checking their pregnancy and health status, providing general recommendations on a healthy lifestyle in pregnancy. GWG was categorized as insufficient, adequate, or excessive according to the Institute of Medicine (IOM).

RESULTS

A total of 1874 obese singleton women delivered in the study period. Among them, 565 (30.1%) were included in the LI while 1309 received SC. Women in SC showed a higher rate of GWG out of the IOM recommendations (excessive/insufficient), while women in the LI group showed higher adequate GWG. The small-for-gestational-age (SGA) rate resulted to be higher in the SC group. Once adjusting for age, BMI, country of origin, provider, and gestational hypertension, the risk for SGA was increased by insufficient GWG (OR = 1.25; 95%CI: 1.03-1.59), while it was reduced by LI (OR = 0.67, 95%CI: 0.42-0.98).

CONCLUSIONS

In a cohort of obese women, the exposure to an LI was associated with more adequate GWG, reduced insufficient weight gain, and a decreased risk of SGA infants.

Does tinnitus amplify the effects of healthy eating patterns and physical activity on the sleep disturbance or sleep insufficiency, based on the case study of NHANES survey in the United States

Objective

Exploring whether the presence of tinnitus amplifies the effects of an individual's dietary patterns and physical activity on sleep disturbance or sleep insufficiency.

Study design

This study extracted data from the five National Health and Nutrition Examination Surveys (NHANES) between 2009 and 2018, including individuals who had undergone complete questionnaires on tinnitus, dietary habits, physical activity, and sleep. Multivariate logistic regression, restricted cubic spline (RCS) and subgroup analyses were conducted to explore the associations of dietary habits, physical activity, and tinnitus with sleep disturbance and sleep insufficiency.

Results

A total of 7,440 participants were enrolled in this study, of whom 1,795 participants were evaluated as sleep disturbance (24.13%), and 2,281 were sleep insufficiency (30.66%). With adjusting confounding factors of demographic and socioeconomic variables, among overall population, participants with tinnitus showed a significantly increased risk of sleep disturbance [adjusted odds ratio (aOR) = 2.08, 95% confidence interval (CI): 1.83-2.36), and sleep insufficiency (aOR = 1.31, 95% CI: 1.15-1.49). Poor dietary habits also increased the risk of sleep disturbance (aOR = 1.08, 95% CI: 1.04-1.12), as does lack of physical activity (aOR = 1.14, 95% CI: 1.03-1.27); but neither exposure factors significantly increased the risk of sleep insufficiency. The non-linear trend analyses of RCS found that the influence of exposure factors on sleep disturbance experiencing a steady or small decline trend after rising. In addition, the results of the subgroup analysis showed that in tinnitus patients, poor dietary habits and lack of physical activity both significantly increased the risk of sleep disturbance, and poor dietary habits also increased the risk of sleep insufficiency remarkable, but lack of physical activity did not. In healthy participants, poor dietary habits were only significantly associated the sleep disturbance, while lack of physical inactivity even had a protective effect against sleep insufficiency.

Conclusion

Compared to the general population, tinnitus significantly amplified the effects of poor dietary patterns and physical inactivity on sleep disturbance and sleep insufficiency. For tinnitus patients, adjusting a healthy diet and increasing exercise could more effectively promote their sleep health.

Health and income inequality: a comparative analysis of USA and Italy

Introduction

Socio-economic background is often an important determinant for health with low income households having higher exposure to risk factors and diminished access to healthcare and prevention, in a way that is specific to each country.

Methods

Here, we perform a comparative analysis of the relations between health and income inequality in two developed countries, USA and Italy, using longitudinal and cross-sectional data from surveys.

Results and discussion

We show that the income class determines the incidence of chronic pathologies, associated risk-factors and psychiatric conditions, but find striking differences in health inequality between the two countries. We then focus our attention on a fraction of very disadvantaged households in the USA whose income in persistently at the bottom of the distribution over a span of 20 years and which is shown to display particularly dire health conditions. Low income people in the USA also display comorbidity patterns that are not found in higher income people, while in Italy income appears to be less relevant for comorbidity. Taken together our findings illustrate how differences in lifestyle and the healthcare systems affect health inequality.

Obesity and periodontitis: a comprehensive review of their interconnected pathophysiology and clinical implications

Obesity and periodontitis are significant health problems with a complex bidirectional relationship. Excess body fat is linked to systemic diseases and can lead to persistent inflammation, potentially harming periodontal health. Periodontitis, a chronic inflammatory condition affecting the supporting structures of teeth, poses substantial health risks. Both conditions share pathological processes such as inflammation and oxidative stress, which aggravate health status and make treatment more challenging. Understanding this interaction is crucial for developing effective management strategies for both diseases. This study explores the multifaceted aspects of obesity and periodontitis and their reciprocal relationship.

Flavan-3-ols and Vascular Health: Clinical Evidence and Mechanisms of Action

Cardiovascular diseases (CVDs) are one of the main causes of mortality and morbidity worldwide. A healthy diet rich in plant-derived compounds such as (poly)phenols appears to have a key role in improving cardiovascular health. Flavan-3-ols represent a subclass of (poly)phenols of great interest for their possible health benefits. In this review, we summarized the results of clinical studies on vascular outcomes of flavan-3-ol supplementation and we focused on the role of the microbiota in CVD. Clinical trials included in this review showed that supplementation with flavan-3-ols mostly derived from cocoa products significantly reduces blood pressure and improves endothelial function. Studies on catechins from green tea demonstrated better results when involving healthy individuals. From a mechanistic point of view, emerging evidence suggests that microbial metabolites may play a role in the observed effects. Their function extends beyond the previous belief of ROS scavenging activity and encompasses a direct impact on gene expression and protein function. Although flavan-3-ols appear to have effects on cardiovascular health, further studies are needed to clarify and confirm these potential benefits and the rising evidence of the potential involvement of the microbiota.

Individual and interaction effects of monounsaturated fatty acids on their associations with hypertension in Chinese residents

Currently, associations between dietary intakes of individual monounsaturated fatty acids (MUFAs) and hypertension were not well disclosed, and the interaction effects of MUFAs on their associations with hypertension were unknown. Obesity was correlated with both MUFAs and hypertension, while if anthropometric obesity indices performed mediating roles in associations between MUFAs and hypertension remained underdetermined. In our study, 8509 Chinese adults investigated from 2004 to 2011 were included. Dietary information collection and physical examinations were performed at baseline and each timepoint of follow-up. As we found, inverse associations of MUFA17, MUFA18 and MUFA20 with hypertension were statistically significant after adjustments, hazard ratios (HRs) were 0.87, 0.90 and 0.91, respectively. MUFA15 was positively associated with hypertension, with an HR of 1.07 (95% confidence interval: 1.01, 1.12). By performing principal component analysis (PCA) to estimate the joint effects of MUFAs on hypertension, the PCA score of MUFAs was only inversely associated with blood pressure. No joint effect was observed in g-computation analyses. Both linear and nonlinear interactions of MUFAs on their associations with hypertension were estimated using restricted cubic spline analysis. The association between MUFA15 and hypertension was interacted by MUFA17, and the association between MUFA20 and hypertension was interacted by MUFA18. The mediation effects of body mass index and waist circumference were found on associations of hypertension with MUFA15, MUFA17 and MUFA20. Our findings suggested that associations with hypertension were different among individual MUFAs, and mutual interactions existed, implying that the utility of individual MUFAs might be recommended for estimating relationships between MUFAs and diseases. Moreover, fat accumulation might potentially underlie associations between MUFAs and hypertension.

Cellular Senescence and Extracellular Vesicles in the Pathogenesis and Treatment of Obesity-A Narrative Review

This narrative review explores the pathophysiology of obesity, cellular senescence, and exosome release. When exposed to excessive nutrients, adipocytes develop mitochondrial dysfunction and generate reactive oxygen species with DNA damage. This triggers adipocyte hypertrophy and hypoxia, inhibition of adiponectin secretion and adipogenesis, increased endoplasmic reticulum stress and maladaptive unfolded protein response, metaflammation, and polarization of macrophages. Such feed-forward cycles are not resolved by antioxidant systems, heat shock response pathways, or DNA repair mechanisms, resulting in transmissible cellular senescence via autocrine, paracrine, and endocrine signaling. Senescence can thus affect preadipocytes, mature adipocytes, tissue macrophages and lymphocytes, hepatocytes, vascular endothelium, pancreatic β cells, myocytes, hypothalamic nuclei, and renal podocytes. The senescence-associated secretory phenotype is closely related to visceral adipose tissue expansion and metaflammation; inhibition of SIRT-1, adiponectin, and autophagy; and increased release of exosomes, exosomal micro-RNAs, pro-inflammatory adipokines, and saturated free fatty acids. The resulting hypernefemia, insulin resistance, and diminished fatty acid β-oxidation lead to lipotoxicity and progressive obesity, metabolic syndrome, and physical and cognitive functional decline. Weight cycling is related to continuing immunosenescence and exposure to palmitate. Cellular senescence, exosome release, and the transmissible senescence-associated secretory phenotype contribute to obesity and metabolic syndrome. Targeted therapies have interrelated and synergistic effects on cellular senescence, obesity, and premature aging.

Association between dietary (poly)phenol intake and the ATHLOS Healthy Ageing Scale in the Polish arm of the HAPIEE study

Inverse association between (poly)phenol intake and age-related disorders has been demonstrated; however, little is known whether they affect comprehensively assessed healthy aging. The aim of this study was to evaluate the associations between the intake of (poly)phenol (including selected classes and subclasses) and healthy aging scores related to biopsychosocial aspects of health and functioning. A cross-sectional study was performed using data on 9774 randomly selected citizens of Krakow (Poland) who were 45-69 years of age. Dietary (poly)phenol intake was evaluated using a food frequency questionnaire and matching food consumption data with the Phenol-Explorer database. The healthy aging scores were estimated from the ATHLOS Healthy Ageing Scale (HAS) developed by the Ageing Trajectories of Health-Longitudinal Opportunities and Synergies (ATHLOS) consortium. Beta coefficients were calculated using multivariable linear regression models. In multivariable adjusted models, there were significant positive associations between the ATHLOS HAS score and intake of total (poly)phenols (b per increase of 100 mg/day = 0.081; 95% CI, 0.050; 0.112) and among main classes of (poly)phenols with phenolic acids (b = 0.139; 95% CI, 0.098; 0.180). Intake of remaining classes of (poly)phenols (flavonoids, lignans, stilbenes, and others) was not related to the ATHLOS HAS score. Among individual classes studied, hydroxycinnamic acids, flavonols, flavones, and dihydrochalcones were associated with better healthy aging. The findings suggest the beneficial effect of total dietary (poly)phenol and some classes and subclasses of (poly)phenol intake in terms of healthy aging in Poland. These findings should be confirmed in other settings and with prospective data.

Lactobacillus rhamnosus 069 and Lactobacillus brevis 031: Unraveling Strain-Specific Pathways for Modulating Lipid Metabolism and Attenuating High-Fat-Diet-Induced Obesity in Mice

Obesity is a global health crisis, marked by excessive fat in tissues that function as immune organs, linked to microbiota dysregulation and adipose inflammation. Investigating the effects of Lactobacillus rhamnosus SG069 (LR069) and Lactobacillus brevis SG031 (LB031) on obesity and lipid metabolism, this research highlights adipose tissue's critical immune-metabolic role and the probiotics' potential against diet-induced obesity. Mice fed a high-fat diet were treated with either LR069 or LB031 for 12 weeks. Administration of LB031 boosted lipid metabolism, indicated by higher AMP-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC) phosphorylation, and increased the M2/M1 macrophage ratio, indicating LB031's anti-inflammatory effect. Meanwhile, LR069 administration not only led to significant weight loss by enhancing lipolysis which evidenced by increased phosphorylation of hormone-sensitive lipase (HSL) and adipose triglyceride lipase (ATGL) but also elevated Akkermansia and fecal acetic acid levels, showing the gut microbiota's pivotal role in its antiobesity effects. LR069 and LB031 exhibit distinct effects on lipid metabolism and obesity, underscoring their potential for precise interventions. This research elucidates the unique impacts of these strains on metabolic health and highlights the intricate relationship between gut microbiota and obesity, advancing our knowledge of probiotics' therapeutic potential.

Association of healthy lifestyle with self-reported sleep disordered breathing: A cross-sectional study

Some healthy lifestyle components have been linked with sleep disordered breathing (SDB), yet little is known about the relationship between comprehensive lifestyle factors and SDB. This study aimed to examine the healthy lifestyle with SDB in community-dwelling adults. We conducted a cross-sectional analysis of the Suzhou Food Consumption and Health Survey in China between 2018 and 2020. The healthy lifestyle index (HLI) was created by combining smoking, alcohol drinking, diet, physical activity, and body mass index (BMI). Its association with SDB was assessed by multiple logistic regression analysis. Subgroup analysis and sensitivity analysis were conducted to assess the robustness of our results. The final analysis included 3788 participants (2859 without SDB and 929 with SDB). In multivariable-adjusted analyses, non-smoking (OR: 0.58, 95 % CI: 0.47-0.71), non-drinking (OR: 0.55, 95 % CI: 0.45-0.68), healthy diet (OR: 0.79, 95 % CI: 0.65-0.95), and healthy BMI (OR: 0.72, 95 % CI: 0.6-0.86) were associated with SDB. Compared with participants with HLI score of 0-1, participants with HLI score of 2, 3, 4, and 5 had OR of 0.68 (95 % CI: 0.51-0.91), 0.49 (95 % CI: 0.37-0.64), 0.29 (95 % CI: 0.21-0.38), and 0.22 (95 % CI: 0.15-0.33), respectively, after adjustment for confounding factors (P-trend<0.001). An inverse dose-response relationship between HLI and SDB was also observed. The association was similar in subgroups stratified by sex, marital status, diabetes and dyslipidemia. A higher score of HLI was associated with reduced odds of SDB in Chinese adults. Our findings suggest the potential of addressing five modifiable lifestyle factors for the prevention of SDB.

Association of Chemotherapy-Induced Peripheral Neuropathy with Diet Quality Among Post-Treatment Cancer Survivors

Nutrition is essential for peripheral nerve function, yet dietary factors associated with chronic chemotherapy-induced peripheral neuropathy (CIPN) remain poorly characterized. The purpose of this cross-sectional study was to determine differences in diet quality and macronutrients for cancer survivors with and without CIPN. Cancer survivors (e.g., ≥3 months post platinum and/or taxane-based neurotoxic chemotherapy) with (i.e., ≥1/4 PRO-CTACE™ Numbness and Tingling Severity) and without CIPN completed the VioScreen Research Graphical Food Frequency Questionnaire. The association among diet (Healthy Eating Index [HEI]), macronutrient intake (average percent caloric intake), and CIPN severity were analyzed using generalized linear regression models, adjusting for caloric intake, body mass index, age, and sex. Results revealed that for each one-point increase in diet quality, PRO-CTCAE severity decreased by -0.06 (95% CI: -0.10, -0.02, P < 0.01). Participants without CIPN reported higher diet quality than those with CIPN (HEI mean: 70.11 vs 68.45) (OR = 0.94, P = 0.03, 95% CI: 0.89, 0.99). Participants with CIPN had significantly higher carbohydrate consumption than participants without CIPN (OR = 1.11, P = 0.04, 95% CI: 1.01, 1.22). There were no significant differences in consumption of proteins or fats between groups. Further research should be pursued to discover the potential benefits of dietary interventions for CIPN management among cancers survivors.

Obesity-associated inflammation countered by a Mediterranean diet: the role of gut-derived metabolites

The prevalence of obesity has increased dramatically worldwide and has become a critical public health priority. Obesity is associated with many co-morbid conditions, including hypertension, diabetes, and cardiovascular disease. Although the physiology of obesity is complex, a healthy diet and sufficient exercise are two elements known to be critical to combating this condition. Years of research on the Mediterranean diet, which is high in fresh fruits and vegetables, nuts, fish, and olive oil, have demonstrated a reduction in numerous non-communicable chronic diseases associated with this diet. There is strong evidence to support an anti-inflammatory effect of the diet, and inflammation is a key driver of obesity. Changes in diet alter the gut microbiota which are intricately intertwined with human physiology, as gut microbiota-derived metabolites play a key role in biological pathways throughout the body. This review will summarize recent published studies that examine the potential role of gut metabolites, including short-chain fatty acids, bile acids, trimethylamine-N-oxide, and lipopolysaccharide, in modulating inflammation after consumption of a Mediterranean-like diet. These metabolites modulate pathways of inflammation through the NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome, toll-like receptor 4 signaling, and macrophage driven effects in adipocytes, among other mechanisms.