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1.
Functional Dyspepsia and Food: Immune Overlap with Food Sensitivity Disorders.
Pryor, J, Burns, GL, Duncanson, K, Horvat, JC, Walker, MM, Talley, NJ, Keely, S
Current gastroenterology reports. 2020;(10):51
Abstract
PURPOSE OF REVIEW Functional dyspepsia (FD) is a chronic functional gastrointestinal disorder characterised by upper gastrointestinal symptoms. Here, we aimed to examine the evidence for immune responses to food in FD and overlap with food hypersensitivity conditions. RECENT FINDINGS A feature of FD in a subset of patients is an increase in mucosal eosinophils, mast cells, intraepithelial cytotoxic T cells and systemic gut-homing T cells in the duodenum, suggesting that immune dysfunction is characteristic of this disease. Rates of self-reported non-celiac wheat/gluten sensitivity (NCW/GS) are higher in FD patients. FD patients commonly report worsening symptoms following consumption of wheat, fermentable oligosaccharides, disaccharides, monosaccharides, or polyols (FODMAPs), high-fat foods and spicy foods containing capsaicin. Particularly, wheat proteins and fructan in wheat may drive symptoms. Immune mechanisms that drive responses to food in FD are still poorly characterised but share key effector cells to common food hypersensitivities including non-IgE-mediated food allergy and eosinophilic oesophagitis.
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The Effect of Food on the Single-Dose Bioavailability and Tolerability of the Highest Marketed Strength of Duloxetine.
Rizea-Savu, S, Duna, SN, Ghita, A, Iordachescu, A, Chirila, M
Clinical pharmacology in drug development. 2020;(7):797-804
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Abstract
Duloxetine is a combined serotonin and norepinephrine reuptake inhibitor indicated in adults for the treatment of major depressive disorder, diabetic peripheral neuropathic pain, and generalized anxiety disorder. The aim of these studies was to evaluate the effect of food on the pharmacokinetics and safety of duloxetine 60-mg gastroresistant hard capsules following single-dose administration. The data were obtained from 2 phase 1 bioequivalence studies, 1 in a fasting state and the other under fed conditions. Both studies have shown that, when administered as a single dose in the same prandial state, the test and reference duloxetine treatments were bioequivalent and exhibited similar safety profiles. The mean fed and fasting pharmacokinetic parameters and drug-related adverse events from the 2 studies were compared in order to assess the effect of food on the duloxetine bioavailability and respectively, tolerability. Administration of duloxetine in fed conditions increased peak plasma concentration by up to 30% and delayed mean time to peak concentration by an average of 1.15 hours while having an insignificant effect on extent of absorption (area under the plasma concentration-time curve in fed state within ±6% as compared with fasting conditions). Even though peak plasma levels were substantially higher in the fed state, there was no negative impact on the drug's safety profile. Actually, administration with food resulted in a lower average number of adverse events per single dose exposure. The negligible variation in overall systemic exposure suggests that efficacy remains unchanged irrespective of administration conditions; however, a better tolerability of the 60-mg dose is expected when the drug is taken with food.
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Estimating the potential effects of COVID-19 pandemic on food commodity prices and nutrition security in Nepal.
Singh, S, Nourozi, S, Acharya, L, Thapa, S
Journal of nutritional science. 2020;:e51
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Abstract
The objective of the paper is to analyse changes in food commodity prices and estimate the potential effects of food price change on nutrition security in Nepal in the context of COVID-19 contagion control measures. It presents a comparative intra-country observational study design looking at events before and during the pandemic (after implementation of contagion control measures). The study design includes three districts, enabling comparison between diverse agro-ecological zones and geographical contexts. The methodology consists of primary data collection, modelling and quantitative analysis. The analysis is based on actual school meal food baskets which represent culturally and nutritionally optimised food baskets, developed by the local community and notional typical household food baskets. End May/early June 2020 is the 'Post-COVID-19' reference point, the same time period in 2019 i.e. June 2019 is the 'Pre-COVID-19' reference point. The study finds a substantial increase in food commodity prices across food groups and districts with marked inter-district variation. For school meal basket, all micronutrients show large average declines ranging from 9⋅5 % for zinc to 11 % for vitamin-A. For household food baskets on average, vitamin-A reduced 37 % followed by iron at 19 %, reduction in zinc is low due to the high zinc content in whole grain cereals. COVID-19 control measures are likely to have contributed to substantial price inflation over the reference period with potentially damaging effects on nutrition security in Nepal with serious implications for vulnerable populations.
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Dietary therapy for eosinophilic esophagitis: chances and limitations in the clinical practice.
Lucendo, AJ, Molina-Infante, J
Expert review of gastroenterology & hepatology. 2020;(10):941-952
Abstract
INTRODUCTION Eosinophilic esophagitis (EoE) is a non-Immunoglobulin E-mediated food allergy that currently represents the main cause of dysphagia and food impaction in children and young adults. Diet remains the only therapy targeting the cause of the disease. Relevant advances in recent years allow novel approaches to dietary therapy in EoE. AREAS COVERED An up-to-date review on dietary therapy for EoE is provided, as a potential first-line anti-inflammatory therapy able to induce and maintain remission in a significant proportion of patients. Unpractical elemental diets and suboptimal food allergy testing-directed food restrictions paved the way for empiric elimination diets, which currently are to be considered as the most effective drug-free treatment for EoE. After largely restrictive empiric six-food elimination diets, most efficient step-up approaches now include four-food and two-food elimination diets. The potential of milk-elimination is also discussed. EXPERT COMMENTARY An empiric elimination diet step-up strategy should be currently considered as the initial approach for dietary treatment in EoE patients of all ages. Compared to a top-down strategy, step-up diets reduce the need for endoscopic procedures, shorten diagnostic process times, and avoid unnecessary restrictions. Furthermore, early identification of responders with few food triggers may select best candidates for maintenance dietary therapy.
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Effects of Food and Gender on Pharmacokinetics of Rosuvastatin in a Chinese Population Based on 4 Bioequivalence Studies.
Chen, J, Lou, H, Jiang, B, Shao, R, Yang, D, Hu, Y, Xu, Y, Ruan, Z
Clinical pharmacology in drug development. 2020;(2):235-245
Abstract
The effects of food and gender on the pharmacokinetics of rosuvastatin in healthy Chinese subjects were investigated from 4 bioequivalence studies. These studies were designed as randomized, open-label, and 2-period crossover in both fasting and fed states. A total of 204 subjects were enrolled, 134 men and 70 women. These subjects received a single oral 10-mg dose of rosuvastatin with a 7-day washout between 2 periods. The plasma concentrations were determined using a validated liquid chromatography tandem mass spectrometry method, and pharmacokinetic parameters were calculated by noncompartmental methods. Compared with the fasting condition, administration after a high-fat and high-calorie meal resulted in an approximately 40% reduction of rosuvastatin exposure and a near 50% decrease in absorption rate. Moreover, the apparent clearance was significantly greater in the fed state than that in the fasting state. It was noted that the adverse events incidence is increased by approximately 30% in the fasting state; however, no serious adverse events were observed. Additionally, small differences in pharmacokinetic characteristics were found between male and female subjects. Food effect might be considered for optimal effectiveness and safety of rosuvastatin therapy.
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Associations between nutritional factors and KRAS mutations in colorectal cancer: a systematic review.
El Asri, A, Zarrouq, B, El Kinany, K, Bouguenouch, L, Ouldim, K, El Rhazi, K
BMC cancer. 2020;(1):696
Abstract
BACKGROUND Between 30 and 50% of colon tumors have mutations in the Kirsten-ras (KRAS) gene, which have a large nutritional attributable risk. Despite its high frequency in colorectal cancer (CRC), data to support specific associations between KRAS mutations in CRC and diet are sparse. Here, we conducted a systematic review to summarize the current epidemiological evidence on the association between various dietary factors and KRAS mutations. METHODS PubMed, Science Direct, and Cochrane databases were searched for relevant studies published until December 31, 2019, using inclusion and exclusion criteria in accordance with PRISMA guidelines. We analyzed the studies to find associations between nutritional factors and CRC tumors with KRAS mutations in humans. RESULTS We identified 28 relevant studies to include in this systematic review. In-depth analyses showed unclear associations between nutritional factors and KRAS mutations in CRC. Most epidemiological studies in the same nutrient or food often reported conflicting and/or inconclusive findings, whereas for some dietary factors, the results were homogeneous. CONCLUSIONS Further research using a more robust prospective cohort study is needed to lend more credence to the epidemiological associations found between KRAS mutations and dietary factors.
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Endemic Kashin-Beck disease: A food-sourced osteoarthropathy.
Wang, K, Yu, J, Liu, H, Liu, Y, Liu, N, Cao, Y, Zhang, X, Sun, D
Seminars in arthritis and rheumatism. 2020;(2):366-372
Abstract
OBJECTIVE Kashin-Beck disease (KBD) is an endemic osteoarthropathy, which causes disability and heavy socioeconomic burdens. The preventive measures have been taken in the past few decades. However, recent KBD-epidemiological trend and comprehensive effect of its preventive measures need to be evaluated. METHODS By employing typical survey, cross-sectional survey, case-control study, intervention trial, and national surveillance, the present study summarizes comprehensive role of KBD-preventive measures. RESULTS The endemic KBD is distributed in a long and narrow area of the world. The latest epidemic began in the late 1950s and lasted until the end of 1980s. Epidemiology of the KBD was characterized by early-onset, gender equality, agricultural area, regional discrepancy, family aggregation, annual fluctuation, etc. Multivariate regression analysis suggested that etiology of the KBD was food-related factors such as fungal contamination of grains, selenium deficiency, imbalance of protein intake, etc. A series of intervention measures for KBD control had been implemented since 1990s, and involved more than 300 million residents. National incidences were 22.1% in 1990, 16.0% in 1995, 12.3% in 2000, 5.5% in 2005, 0.38% in 2010, and 0.18 in 2015, respectively. Although new patients were annually decreased, it still affected 22,567,600 inhabitants and there were 574,925 patients in 2016. CONCLUSIONS Etiology of the KBD is food-sourced. Its decreased incidence may attribute to an effective implementation of preventive measures. It is possible to eradicate KBD from the earth in the near future.
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The effects of nudging and pricing on healthy food purchasing behavior in a virtual supermarket setting: a randomized experiment.
Hoenink, JC, Mackenbach, JD, Waterlander, W, Lakerveld, J, van der Laan, N, Beulens, JWJ
The international journal of behavioral nutrition and physical activity. 2020;(1):98
Abstract
BACKGROUND Evidence on what strategies - or combination of strategies - are most effective and equitable in promoting healthier diets is needed. This study examined the efficacy of nudging and pricing strategies on increasing healthy food purchases and the potential differential effect by socio-economic position (SEP) among Dutch adults in a virtual supermarket. METHODS A randomized study design was conducted within a virtual supermarket (SN VirtuMart). Participants were exposed to five within-subject study conditions (control, nudging, pricing, price salience and price salience with nudging) and randomized to one of three between-subject study arms (a 25% price increase on unhealthy products, a 25% discount on healthy products, or a 25% price increase and discount). In total, 455 participants of low and high SEP (using either education or income as proxy) were randomized to conduct their weekly shopping in a virtual supermarket for five consecutive weeks. The primary outcome included the percentage of healthy purchases. Data were analyzed using linear mixed models. RESULTS In total, 346 (76%) adults completed all five shops within the SN VirtuMart. Median age was 32.5, 49.2% had high education and 32.8% had high income. Out of the 12 conditions, four conditions were statistically significantly different from the control condition. Nudging and non-salient pricing strategies alone did not statistically significantly increase healthy food purchases, whereas a combination of salient price increases and discounts led to an increase in the percentage of healthy food purchases (B 4.5, 95%CI 2.6; 6.4). Combining salient pricing and nudging strategies led to increases in the percentage of healthy products in all three pricing arms, with largest effects found in the combined price increase and discount arm (B = 4.0, 95%CI = 2.0; 6.0). Effects were not modified by SEP. CONCLUSIONS Combining health-related price increases and discounts and combining these salient pricing strategies with nudges in a supermarket setting seems to stimulate healthy food purchases for both low and high SEP populations. However, further research in real-world settings is needed. TRIAL REGISTRATION This randomized trial ( NTR7293 ) was registered in the Dutch trial registry ( www.trialregister.nl ).
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A review of the uses and reliability of food balance sheets in health research.
Thar, CM, Jackson, R, Swinburn, B, Mhurchu, CN
Nutrition reviews. 2020;(12):989-1000
Abstract
CONTEXT Food Balance Sheets (FBSs) are constructed by the Food and Agricultural Organization (FAO) and portray the food supply and utilization pattern of a country over time. OBJECTIVE To examine and analyse the uses of FAO-FBS data in international studies of health and nutrition, and to identify the reported strengths, limitations and reliability of FBS. DATA SOURCES PubMed, SCOPUS, EMBASE, Food Science and Technology Abstracts (FSTA) and Google Scholar. DATA EXTRACTION Data extracted were author, year of publication, country/countries of the study, aim, study design, analysis, data collected, data sources and outcomes. Additional relevant information (e.g. strengths and limitations of the FBS), were also included. The bibliographies of all included studies were further searched, and any potentially relevant studies retrieved and assessed. DATA ANALYSIS 119 eligible studies (all study designs) published from the earliest available to the end of April, 2016 were collated into five categories of use: within-country analysis of food availability, nutrient availability and/or dietary trends (n = 17); inter-country, regional or global comparison of food groups, nutrient availability and/or dietary trends (n = 45); comparison of FBS with other national sources of dietary data (n = 7); association between FBS dietary factors and mortality or health outcomes (n = 45); and modelling studies (n = 5). CONCLUSION Studies indicate that FBS are useful for international comparison and analysis of trends over time, as they are standardized and updated regularly. FBS data are more reliable when averaged over several years; when results are reported as nutrient densities, trends, and percentage of energy or ratios, rather than absolute values. Also, users should be aware that the quality of FBS data depends on the reliability of national input data. The FBS is a vital source of global food composition data and is valuable for epidemiological studies when reported and analysed appropriately.
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Development of a Food Frequency Questionnaire for Brazilian athletes.
Godois, ADM, Coelho-Ravagnani, CF, Raizel, R, Verly-Junior, E
Nutrition & dietetics: the journal of the Dietitians Association of Australia. 2020;(2):260-267
Abstract
AIM: Until recently most dietary survey methods have been developed for non-athletic populations. In this study, we aimed to develop a Food Frequency Questionnaire (FFQ) to assess the regular dietary intake of Brazilian athletes. METHODS We interviewed 141 athletes (23.36 ± 7.77 years old) for their dietary intake using 24-hour recalls. After grouping conceptually similar food items into 113 food items, percentage contribution analysis and stepwise regression models were used to highlight foods contributing to at least 90% of the between-person variability of key nutrients. RESULTS The developed FFQ contained 59 foods which were important predictors of the variance in nutrient intake. Vitamin C and pyridoxine had the lowest number of selected foods. Conversely, 13 food items were required to explain the between-person variation for energy, carbohydrate and magnesium intake. CONCLUSIONS Using a multiple regression analysis we developed a 59-food item questionnaire, which includes culturally specific food items and may represent an important dietary tool to analyse athletic populations. Reproducibility and validity of this FFQ will be verified in future research.