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1.
Hipótesis sobre las conexiones entre COVID-19 severo en niños y nutrición: una revisión narrativa.
León-Lara, X, Vargas-Castillo, A, Ávila-Nava, A, Guevara-Cruz, M, Serralde Zúñiga, AE, Medina-Vera, I
Nutricion hospitalaria. 2021;(3):622-630
Abstract
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). Compared with adults, children with SARS-CoV-2 infection may have fewer and less severe symptoms. Gastrointestinal symptoms are commonly reported in children, sometimes as the only manifestation of the disease, and most often manifest as anorexia, diarrhea, nausea and vomiting, or abdominal pain. Although most children have asymptomatic or mild disease, 10 % of those infected may experience serious or critical disease, or even death. Multisystem inflammatory syndrome is a rare but serious condition recently reported in children with COVID-19. Studies indicate that children with obesity are at higher risk of developing severe COVID-19, and inflammation associated with obesity could be one of the factors that worsens COVID-19 symptoms due to an increased inflammatory response involving molecules such as interleukin 6, tumor necrosis factor alpha, and monocyte chemoattractant protein. On the other hand, evidence has been reported of a higher protein expression of ACE2 in the visceral adipose tissue of obese and malnourished humans, and this could be associated with complications and severity of COVID-19. Therefore, regulation of the intake of macronutrients or micronutrients could be used as a strategy to reduce the consequences of COVID-19. Diet in general and bioactive compounds could play an important role in the prevention of the inflammatory cascade. The micronutrients with the most evidence suggesting a role in immune support are vitamins C and D, zinc, and polyphenols.
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2.
Reviewing the recent advances in application of pectin for technical and health promotion purposes: From laboratory to market.
Moslemi, M
Carbohydrate polymers. 2021;:117324
Abstract
Pectin is natural biopolymer derived from various plant sources and its activity is driven by functional groups. Affinity of pectin and chemical interactions of the active sites to chemicals in media determines fate of adjuvant molecules. Pectin is appropriate co-polymer in modulation of drawbacks of other biopolymers such as low glass transition temperature, low water solubility, and susceptibility to human digestive tract. However, functionality of pectin is improved by its optimized complexation with other chemicals especially in food packaging and tissue engineering. In the last decade, several technical and health-related functions of pectin have been studied through which some products designed and marketed progressively. Pectin-based formulations were commercialized in food, medicine, and radioprotection sectors. It is also advised for alleviation of constipation symptoms. Cost-effectiveness of this multifunctional biopolymer compared to the others that are currently used, has introduced it as a potential alternative for the next years.
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3.
The effects of obesity on the human body part III: Cardiovascular, digestive, excretory, endocrine, and reproductive.
Dupont, G, Bordes, SJ, Lachkar, S, Wahl, L, Iwanaga, J, Loukas, M, Tubbs, RS
Clinical anatomy (New York, N.Y.). 2021;(2):307-311
Abstract
This third installment of The Effects of Obesity on the Human Body discusses the endocrine, digestive, reproductive, cardiovascular, and excretory systems. Obesity is known to upset hormonal balance, leading to widespread metabolic disorders involving organs such as the liver and pancreas. Furthermore, the hypersecretion of leptin from adipose tissue triggers various responses from the cardiovascular and gastrointestinal systems, with implications for energy and nutrient balance and uptake.
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4.
Factors Influencing Blood Alkalosis and Other Physiological Responses, Gastrointestinal Symptoms, and Exercise Performance Following Sodium Citrate Supplementation: A Review.
Urwin, CS, Snow, RJ, Condo, D, Snipe, R, Wadley, GD, Carr, AJ
International journal of sport nutrition and exercise metabolism. 2021;(2):168-186
Abstract
This review aimed to identify factors associated with (a) physiological responses, (b) gastrointestinal (GI) symptoms, and (c) exercise performance following sodium citrate supplementation. A literature search identified 33 articles. Observations of physiological responses and GI symptoms were categorized by dose (< 500, 500, and > 500 mg/kg body mass [BM]) and by timing of postingestion measurements (in minutes). Exercise performance following sodium citrate supplementation was compared with placebo using statistical significance, percentage change, and effect size. Performance observations were categorized by exercise duration (very short < 60 s, short ≥ 60 and ≤ 420 s, and longer > 420 s) and intensity (very high > 100% VO2max and high 90-100% VO2max). Ingestion of 500 mg/kg BM sodium citrate induced blood alkalosis more frequently than < 500 mg/kg BM, and with similar frequency to >500 mg/kg BM. The GI symptoms were minimized when a 500 mg/kg BM dose was ingested in capsules rather than in solution. Significant improvements in performance following sodium citrate supplementation were reported in all observations of short-duration and very high-intensity exercise with a 500 mg/kg BM dose. However, the efficacy of supplementation for short-duration, high-intensity exercise is less clear, given that only 25% of observations reported significant improvements in performance following sodium citrate supplementation. Based on the current literature, the authors recommend ingestion of 500 mg/kg BM sodium citrate in capsules to induce alkalosis and minimize GI symptoms. Supplementation was of most benefit to performance of short-duration exercise of very high intensity; further investigation is required to determine the importance of ingestion duration and timing.
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5.
Tripartite relationship between gut microbiota, intestinal mucus and dietary fibers: towards preventive strategies against enteric infections.
Sauvaitre, T, Etienne-Mesmin, L, Sivignon, A, Mosoni, P, Courtin, CM, Van de Wiele, T, Blanquet-Diot, S
FEMS microbiology reviews. 2021;(2)
Abstract
The human gut is inhabited by a large variety of microorganims involved in many physiological processes and collectively referred as to gut microbiota. Disrupted microbiome has been associated with negative health outcomes and especially could promote the onset of enteric infections. To sustain their growth and persistence within the human digestive tract, gut microbes and enteric pathogens rely on two main polysaccharide compartments, namely dietary fibers and mucus carbohydrates. Several evidences suggest that the three-way relationship between gut microbiota, dietary fibers and mucus layer could unravel the capacity of enteric pathogens to colonise the human digestive tract and ultimately lead to infection. The review starts by shedding light on similarities and differences between dietary fibers and mucus carbohydrates structures and functions. Next, we provide an overview of the interactions of these two components with the third partner, namely, the gut microbiota, under health and disease situations. The review will then provide insights into the relevance of using dietary fibers interventions to prevent enteric infections with a focus on gut microbial imbalance and impaired-mucus integrity. Facing the numerous challenges in studying microbiota-pathogen-dietary fiber-mucus interactions, we lastly describe the characteristics and potentialities of currently available in vitro models of the human gut.
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6.
Dietary Fat Effect on the Gut Microbiome, and Its Role in the Modulation of Gastrointestinal Disorders in Children with Autism Spectrum Disorder.
Kittana, M, Ahmadani, A, Al Marzooq, F, Attlee, A
Nutrients. 2021;(11)
Abstract
Children with autism spectrum disorder (ASD) report a higher frequency and severity of gastrointestinal disorders (GID) than typically developing (TD) children. GID-associated discomfort increases feelings of anxiety and frustration, contributing to the severity of ASD. Emerging evidence supports the biological intersection of neurodevelopment and microbiome, indicating the integral contribution of GM in the development and function of the nervous system, and mental health, and disease balance. Dysbiotic GM could be a contributing factor in the pathogenesis of GID in children with ASD. High-fat diets may modulate GM through accelerated growth of bile-tolerant bacteria, altered bacterial ratios, and reduced bacterial diversity, which may increase the risk of GID. Notably, saturated fatty acids are considered to have a pronounced effect on the increase of bile-tolerant bacteria and reduction in microbial diversity. Additionally, omega-3 exerts a favorable impact on GM and gut health due to its anti-inflammatory properties. Despite inconsistencies in the data elaborated in the review, the dietary fat composition, as part of an overall dietary intervention, plays a role in modulating GID, specifically in ASD, due to the altered microbiome profile. This review emphasizes the need to conduct future experimental studies investigating the effect of diets with varying fatty acid compositions on GID-specific microbiome profiles in children with ASD.
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7.
Clinical Implementation of Dual-Energy CT for Gastrointestinal Imaging.
Mileto, A, Ananthakrishnan, L, Morgan, DE, Yeh, BM, Marin, D, Kambadakone, AR
AJR. American journal of roentgenology. 2021;(3):651-663
Abstract
Dual-energy CT (DECT) overcomes several limitations of conventional single-energy CT (SECT) for the evaluation of gastrointestinal diseases. This article provides an overview of practical aspects of the DECT technology and acquisition protocols, reviews existing clinical applications, discusses current challenges, and describes future directions, with a focus on gastrointestinal imaging. A head-to-head comparison of technical specifications among DECT scanner implementations is provided. Energy- and material-specific DECT image reconstructions enable retrospective (i.e., after examination acquisition) image quality adjustments that are not possible using SECT. Such adjustments may, for example, correct insufficient contrast bolus or metal artifacts, thereby potentially avoiding patient recalls. A combination of low-energy monochromatic images, iodine maps, and virtual unenhanced images can be included in protocols to improve lesion detection and disease characterization. Relevant literature is reviewed regarding use of DECT for evaluation of the liver, gallbladder, pancreas, and bowel. Challenges involving cost, workflow, body habitus, and variability in DECT measurements are considered. Artificial intelligence and machine-learning image reconstruction algorithms, PACS integration, photon-counting hardware, and novel contrast agents are expected to expand the multienergy capability of DECT and further augment its value.
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8.
Appetite, the enteroendocrine system, gastrointestinal disease and obesity.
Crooks, B, Stamataki, NS, McLaughlin, JT
The Proceedings of the Nutrition Society. 2021;(1):50-58
Abstract
The enteroendocrine system is located in the gastrointestinal (GI) tract, and makes up the largest endocrine system in the human body. Despite that, its roles and functions remain incompletely understood. Gut regulatory peptides are the main products of enteroendocrine cells, and play an integral role in the digestion and absorption of nutrients through their effect on intestinal secretions and gut motility. Several peptides, such as cholecystokinin, polypeptide YY and glucagon-like peptide-1, have traditionally been reported to suppress appetite following food intake, so-called satiety hormones. In this review, we propose that, in the healthy individual, this system to regulate appetite does not play a dominant role in normal food intake regulation, and that there is insufficient evidence to wholly link postprandial endogenous gut peptides with appetite-related behaviours. Instead, or additionally, top-down, hedonic drive and neurocognitive factors may have more of an impact on food intake. In GI disease however, supraphysiological levels of these hormones may have more of an impact on appetite regulation as well as contributing to other unpleasant abdominal symptoms, potentially as part of an innate response to injury. Further work is required to better understand the mechanisms involved in appetite control and unlock the therapeutic potential offered by the enteroendocrine system in GI disease and obesity.
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9.
Oral Nutritional Supplements and Enteral Nutrition in Patients with Gastrointestinal Surgery.
Wobith, M, Weimann, A
Nutrients. 2021;(8)
Abstract
Nowadays, patients undergoing gastrointestinal surgery are following perioperative treatment in enhanced recovery after surgery (ERAS) protocols. Although oral feeding is supposed not to be stopped perioperatively with respect to ERAS, malnourished patients and inadequate calorie intake are common. Malnutrition, even in overweight or obese patients, is often underestimated. Patients at metabolic risk have to be identified early to confirm the indication for nutritional therapy. The monitoring of nutritional status postoperatively has to be considered in the hospital and after discharge, especially after surgery in the upper gastrointestinal tract, as normal oral food intake is decreased for several months. The article gives an overview of the current concepts of perioperative enteral nutrition in patients undergoing gastrointestinal surgery.
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10.
Herbal medicines in functional dyspepsia-Untapped opportunities not without risks.
Gwee, KA, Holtmann, G, Tack, J, Suzuki, H, Liu, J, Xiao, Y, Chen, MH, Hou, X, Wu, DC, Toh, C, et al
Neurogastroenterology and motility. 2021;(2):e14044
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Abstract
BACKGROUND Contemporary treatments for functional dyspepsia have limitations. Herbal medicine has been suggested as adjunctive treatment. With growing scientific recognition and public interests, an in-depth review of this is timely. AIMS/PURPOSE To evaluate the therapeutic potential and problems that may be associated with the adoption of herbal medicines in functional dyspepsia. METHODS We reviewed the treatment landscape of functional dyspepsia and assessed the scientific community's interest in herbal medicine. Preclinical pharmacological and clinical trial data were reviewed for several herbal medicines available in the market. Challenges associated with adoption of herbal medicine in mainstream medicine were critically evaluated. RESULTS We found that herbal medicines frequently comprise a combination of herbs with multiple reported pharmacological effects on gastrointestinal motility and secretory functions, as well as cytoprotective and psychotropic properties. We identified a number of commercially available herbal products that have undergone rigorous clinical trials, involving large numbers of well-defined subjects, reporting both efficacy and safety for functional dyspepsia. Persisting concerns include lack of rigorous assessments for majority of products, toxicity, consistency of ingredients, dose standardizations, and quality control. We provide a quality framework for its evaluation. CONCLUSIONS We commend herbal medicine as a viable future option in managing functional dyspepsia. An attractive appeal of herbal medicine is the prospect to simultaneously target multiple pathophysiological mechanisms. Wider adoption and acceptance of herbal medicines in treatment algorithms of functional dyspepsia will require the application of the scientific rigor expected of chemical therapies, to all stages of their development and evaluation.