Zinc supplementation in the treatment of anorexia nervosa.
Revista da Associacao Medica Brasileira (1992). 2022;59(4):321-4
Nutrition in Menopausal Women: A Narrative Review.
Plain language summary
Anorexia nervosa (AN) is a disorder characterised by significant weight loss, restrictive diets, a search for thinness and a distortion of body image. Zinc is a key micronutrient that plays essential roles in the body including in gene transcription regulation and enzyme reactions. There is a similarity between symptoms of zinc deficiency and AN; namely weight loss, changes in appetite and sexual dysfunction. This review aims to provide healthcare professionals with insight into the nutritional recommendations for zinc in patients with AN. The review suggests that there are clinical studies demonstrating a strong association between AN and low levels of serum zinc and low levels of urinary zinc suggesting a micronutrient deficiency in these individuals. The severity of zinc deficiency is associated with greater weight deficits and longer AN duration. It is also associated with higher levels of anxiety and depression in AN individuals. Zinc is key in smell and taste perception and the brain regions associated with interpreting eating as pleasurable. Reduced food intake and practices like purging and low-zinc diets may exacerbate any low levels and impair zinc absorption. A controlled study showed that oral supplementation resulted in a higher rate of body mass index (BMI) increase and an improvement in neurotransmitters. The review recommends: 1. Check serum levels of zinc in AN patients as it may be low. Zinc status may contribute to eating behaviour including gaining pleasure from eating, smell and taste. 2. Zinc supplementation of 15mg/daily for preventative purposes and 15-20mg/daily if zinc deficiency is identified after testing. The review recommends supplementation for a minimum of 2 months.
Plain language summary
Menopause is the permanent cessation of menstrual cycles following the loss of ovarian follicular activity. It is associated with increased prevalence of obesity, metabolic syndrome, cardiovascular disease, and osteoporosis. The aim of this narrative review was to discuss the current evidence on the association between dietary patterns and clinical endpoints in postmenopausal women (body composition, bone mass, and risk markers for cardiovascular disease), and thereby providing novel insight into the establishment of optimal dietary guidelines for healthy postmenopausal period. Research shows that: - the changes in weight and fat distribution in women are associated with aging and mainly with the decrease in oestradiol levels during peri- and post-menopause. - calcium, vitamin D, vitamin K, selenium, magnesium, and beta-carotene adequate intake could be linked with better BMD in postmenopausal women. - diet is a major modifiable risk factor for cardiovascular disease and could be a powerful intervention to reduce cardiovascular risks in postmenopausal women. - the Mediterranean diet is composed of healthy foods that have anti-inflammatory and antioxidant properties. Authors indicate that future studies evaluating the effects of low-fat, plant-based diets on fat mass in post-menopausal women are needed.
Among the various aspects of health promotion and lifestyle adaptation to the postmenopausal period, nutritional habits are essential because they concern all women, can be modified, and impact both longevity and quality of life. In this narrative review, we discuss the current evidence on the association between dietary patterns and clinical endpoints in postmenopausal women, such as body composition, bone mass, and risk markers for cardiovascular disease. Current evidence suggests that low-fat, plant-based diets are associated with beneficial effects on body composition, but further studies are needed to confirm these results in postmenopausal women. The Mediterranean diet pattern along with other healthy habits may help the primary prevention of bone, metabolic, and cardiovascular diseases in the postmenopausal period. It consists on the use of healthy foods that have anti-inflammatory and antioxidant properties, and is associated with a small but significant decrease in blood pressure, reduction of fat mass, and improvement in cholesterol levels. These effects remain to be evaluated over a longer period of time, with the assessment of hard outcomes such as bone fractures, diabetes, and coronary ischemia.
Probiotics in Prevention and Treatment of COVID-19: Current Perspective and Future Prospects.
Archives of medical research. 2021
Plain language summary
The novel coronavirus pandemic of 2019 (COVID-19), an emerging infectious disease, is caused by multiple strains of Severe Acute Respiratory Syndrome Coronavirus-2. The main aim of this study was to outline the potential role of probiotics in fighting the COVID-19. This study focuses on recent evidence on the association between microbiota, probiotics, and COVID-19, the role of probiotics as an immune-modulator and antiviral agent. Findings support probiotics’ role in regulating the immune system, suggesting a definitive role for probiotics in viral infections. Thus, probiotics supplementation could reduce the severity of COVID-19 morbidity and mortality. Authors conclude that supplementation of probiotics in high risk and severely ill patients, and frontline health workers, may help to limit the infection and flatten the COVID-19 curve. However, further studies should be conducted for more conclusive evidence.
Saving lives and flattening the curve are the foremost priorities during the ongoing pandemic spread of SARS-CoV-2. Developing cutting-edge technology and collating available evidence would support frontline health teams. Nutritional adequacy improves general health and immunity to prevent and assuage infections. This review aims to outline the potential role of probiotics in fighting the COVID-19 by covering recent evidence on the association between microbiota, probiotics, and COVID-19, the role of probiotics as an immune-modulator and antiviral agent. The high basic reproduction number (R0) of SARS-CoV-2, absence of conclusive remedies, and the pleiotropic effect of probiotics in fighting influenza and other coronaviruses together favour probiotics supplements. However, further support from preclinical and clinical studies and reviews outlining the role of probiotics in COVID-19 are critical. Results are awaited from many ongoing clinical trials investigating the benefits of probiotics in COVID-19.
More Than 50 Long-Term Effects of COVID-19: A Systematic Review and Meta-Analysis.
Research square. 2021
Plain language summary
Symptoms, signs, or abnormal clinical parameters persisting two or more weeks after COVID-19 onset that do not return to a healthy baseline can potentially be considered long-term effects of the disease. The aim of this study was to estimate the incidence of all the symptoms, signs, or abnormal laboratory parameters extending beyond the acute phase of COVID-19 reported to date. This study is a systematic review and meta-analysis of 15 peer-reviewed studies that reported symptoms, signs, or laboratory parameters of patients at a post-COVID-19 stage (assessed two weeks or more after initial symptoms) in cohorts of COVID-19 patients. Results indicate that 80% (95% CI 65–92) of individuals with a confirmed COVID-19 diagnosis continued to have at least one overall effect beyond two weeks following acute infection. In total, 55 effects, including symptoms, signs, and laboratory parameters, were identified, with fatigue, anosmia [partial or complete loss of the sense of smell], lung dysfunction, abnormal chest X-ray/CT scan, and neurological disorders being the most common. Authors conclude that physicians should be aware of the symptoms, signs, and biomarkers present in patients previously affected by COVID-19 to promptly assess, identify and halt long COVID-19 progression, minimize the risk of chronic effects and help re-establish pre-COVID-19 health.
undefined: COVID-19, caused by SARS-CoV-2, can involve sequelae and other medical complications that last weeks to months after initial recovery, which has come to be called Long-COVID or COVID long-haulers. This systematic review and meta-analysis aims to identify studies assessing long-term effects of COVID-19 and estimates the prevalence of each symptom, sign, or laboratory parameter of patients at a post-COVID-19 stage. . LitCOVID (PubMed and Medline) and Embase were searched by two independent researchers. All articles with original data for detecting long-term COVID-19 published before 1 of January 2021 and with a minimum of 100 patients were included. For effects reported in two or more studies, meta-analyses using a random-effects model were performed using the MetaXL software to estimate the pooled prevalence with 95% CI. Heterogeneity was assessed using statistics. This systematic review followed Preferred Reporting Items for Systematic Reviewers and Meta-analysis (PRISMA) guidelines, although the study protocol was not registered. A total of 18,251 publications were identified, of which 15 met the inclusion criteria. The prevalence of 55 long-term effects was estimated, 21 meta-analyses were performed, and 47,910 patients were included. The follow-up time ranged from 14 to 110 days post-viral infection. The age of the study participants ranged between 17 and 87 years. It was estimated that 80% (95% CI 65-92) of the patients that were infected with SARS-CoV-2 developed one or more long-term symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). All meta-analyses showed medium (n=2) to high heterogeneity (n=13). . In order to have a better understanding, future studies need to stratify by sex, age, previous comorbidities, the severity of COVID-19 (ranging from asymptomatic to severe), and duration of each symptom. From the clinical perspective, multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID-19 care.
An algorithm for differentiating food antigen-related gastrointestinal symptoms.
Gastroenterology and hepatology from bed to bench. 2021;14(1):8-16
Plain language summary
Irritable bowel syndrome (IBS) is a collection of gastrointestinal symptoms. Due to multiple etiologies, the pathogenesis of IBS is poorly understood. The aim of this audit was to assess the outcomes achieved using a lactose and gluten-free diet clinical intervention in patients traditionally diagnosed with IBS. This study was an audit of outcomes from the records of 149 patients presenting with IBS symptoms at secondary and tertiary Gastroenterology outpatients in two UK hospitals. This audit has demonstrated that more than 70% of patients presenting with IBS symptoms improved by following a diet eliminating lactose and gluten containing grains (improvement for >30% in their symptoms). The success of the elimination diet did not seem to be correlated with the body mass index (BMI). The best outcome was recorded in patients with normal BMI and also in the overweight group. Patients with higher BMI >30 or low below 18 also responded well to nutrition therapy. In conclusion, multidisciplinary team management and implementation of detailed nutrition therapy using the audit algorithm might prove to be both cost effective and efficacious a treatment option in IBS.
Aim: The aim of this clinical audit was to assess patient-reported outcomes on the effect of dietary intervention, to enhance our understanding of possible treatment options in irritable bowel syndrome (IBS). Background: A large number of food-related gastro-intestinal disorders have been attributed to IBS for decades. Methods: Patient-reported outcomes from the records of 149 IBS patients treated at secondary and tertiary Gastroenterology outpatients in two UK hospitals between January 2014 and July 2016 were audited. Patients all presented with symptoms fulfilling Rome III-IV criteria for IBS had negative coeliac serology and did not have other gastrointestinal (GI) conditions. A modified version of a low FODMAP diet had been recommended (gluten and lactose free diet (G/LFD)) and was implemented for 6 weeks. Outcomes and dietary adherence were recorded during outpatient's consultations. Results: A total of 134 patients complied with the diet optimally. The majority had an improvement rate >70% and continued with the diet. Fifty-three percent became completely or almost asymptomatic, while 27.6% had a poor response to the diet (scoring < 30%) to G/LFD. The improvement was excellent in patients with normal BMI and good in overweight and obese and where BMI <18. Over 50% did not require any follow-up within 12 months. Conclusion: Although it is unclear whether symptoms are triggered by gluten, fructans or lactose, elimination of gluten and lactose proved to be an effective treatment in patients with IBS. Multidisciplinary team management and implementation of detailed nutrition therapy using the audit algorithm might prove to be both cost effective and efficacious a treatment option in IBS.
Do These Microbes Make Me Look Fat?
This article reflects upon the epidemic of obesity, analysing the role that socioeconomic factors, dietary patterns, lifestyle, environmental toxins, and genetics are playing in metabolic disorders development. Moreover, it presents us with some compelling food for thought regarding the impact that a healthy/unhealthy gut can play in obesity and cardiovascular disease development, and how microbiome research is showing promising results in the field.
Nutrition and Men's Health - NED Infobite
This NED Infobite focuses on some of the science related to men's health. It includes randomised controlled trials looking at time-restricted feeding, the impact of including apples in the daily diet and the outcomes of lower carbohydrate versus mixed carbohydrate diets on weight loss.
Obesity: tackling the causes of the causes
This article analyses the responsibility of society systems’ structures towards the obesity epidemic - and how strongly a shift in the government responses is required to tackle this issue. Our “obesogenic” environments hinder the population from accessing healthy lifestyle and dietary patterns, while portraying obesity as an individual’s lack of personal willpower. By challenging the current views on obesity, this article proposes that new policies must be created to eliminate inequalities and to provide long-term solutions to the root causes of obesity, deeply entrenched across all aspects of society.
Navigating Obesity in Immune Dysfunction
This blog post discusses the management of obesity in clinical practice. The benefits of using a personalised approach are highlighted while other factors are taken into consideration when supporting obese patients - too little versus too much physical activity, and their equal contribution to respiratory tract infection risk for example. The crucial role of weight loss is analysed and discussed, along with the importance of working with a team of different healthcare practitioners, who practice patient-lead healthcare.
Episode 27: Clinical Conversations: Behavioral Interventions in Lifestyle Change
In this podcast episode, OMA Clinical Education Director, Nicholas Pennings, interviews Ariana Chao, PhD, CRNP, about the role of behavioural interventions in obesity. The topics covered include: - the fundamental roles that health practitioners play when providing support with obesity; - how to address negative self-talk with patients; - the impact of intensive behavioural therapy and goal setting on the development of the disease; - the importance of group support when it comes to patients’ long-lasting commitment to lifestyle and dietary interventions.