Diet for Functional Gastrointestinal Disorders/Disorders of Gut-Brain Interaction.

Dietary interventions may alleviate symptoms related to functional gastrointestinal disorders, now termed disorders of gut-brain interaction. We reviewed which interventions have high-quality data to support their use in gastroesophageal reflux disease (GERD), functional dyspepsia (FD), irritable bowel syndrome, and chronic idiopathic constipation.

Dietary Transitions and Health Outcomes in Four Populations - Systematic Review.

IMPORTANCE: Non-communicable chronic diseases (NCDs) such as obesity, type 2 diabetes, heart disease, and cancer were rare among non-western populations with traditional diets and lifestyles. As populations transitioned toward industrialized diets and lifestyles, NCDs developed. OBJECTIVE: We performed a systematic literature review to examine the effects of diet and lifestyle transitions on NCDs. EVIDENCE REVIEW: We identified 22 populations that underwent a nutrition transition, eleven of which had sufficient data. Of these, we chose four populations with diverse geographies, diets and lifestyles who underwent a dietary and lifestyle transition and explored the relationship between dietary changes and health outcomes. We excluded populations with features overlapping with selected populations or with complicating factors such as inadequate data, subgroups, and different study methodologies over different periods. The selected populations were Yemenite Jews, Tokelauans, Tanushimaru Japanese, and Maasai. We also review transition data from seven excluded populations (Pima, Navajo, Aboriginal Australians, South African Natal Indians and Zulu speakers, Inuit, and Hadza) to assess for bias. FINDINGS: The three groups that replaced saturated fats (SFA) from animal (Yemenite Jews, Maasai) or plants (Tokelau) with refined carbohydrates had negative health outcomes (e.g., increased obesity, diabetes, heart disease). Yemenites reduced SFA consumption by >40% post-transition but men's BMI increased 19% and diabetes increased ~40-fold. Tokelauans reduced fat, dramatically reduced SFA, and increased sugar intake: obesity and diabetes rose. The Tanushimaruans transitioned to more fats and less carbohydrates and used more anti-hypertensive medications; stroke and breast cancer declined while heart disease was stable. The Maasai transitioned to lower fat, SFA and higher carbohydrates and had increased BMI and diabetes. Similar patterns were observed in the seven other populations. CONCLUSION: The nutrient category most strongly associated with negative health outcomes - especially obesity and diabetes - was sugar (increased 600-650% in Yemenite Jews and Tokelauans) and refined carbohydrates (among Maasai, total carbohydrates increased 39% in men and 362% in women), while increased calories was less strongly associated with these disorders. Across 11 populations, NCDs were associated with increased refined carbohydrates more than increased calories, reduced activity or other factors, but cannot be attributed to SFA or total fat consumption.

Kluver-Bucy syndrome, hypersexuality, and the law.

A 51-year-old right-handed man developed hypersexuality after a second right temporal lobectomy to treat epilepsy. His hypersexuality started with increased marital intercourse and masturbation but he later downloaded child pornography. Hyperphagia and distractibility, other features of the Kluver-Bucy syndrome, also developed. Resection of the amygdala and/or temporal lobe neocortical areas that inhibit other limbic areas may contribute to the pathogenesis of hypersexuality. Neurological factors mitigate the criminal responsibility for hypersexual activity in patients with Kluver-Bucy syndrome. Most previously reported patients were never charged with a crime despite uninvited physical contact in some instances. Our patient was convicted and imprisoned.

Norman Geschwind's contribution to the understanding of behavioral changes in temporal lobe epilepsy: the February 1974 lecture.

Norman Geschwind catalyzed academic interest in the study of interictal behavioral changes in temporal lobe epilepsy. His contributions to this area comprise a series of 11 articles, chapters, editorials, and commentaries published between 1973 and 1984. This article summarizes, both chronologically and by behavioral topic, Geschwind's contributions and opinions on behavioral changes in temporal lobe epilepsy. A previously unpublished lecture (see article in this issue), "Personality Change in Temporal Lobe Epilepsy," from his course at Harvard Medical School on The Neurology of Behavior (1974), is also quoted to further illustrate his views on specific features of this syndrome. Notably, many of Geschwind's observations and formulations regarding this topic were highly developed in 1974, reflecting his long-standing interest in behavioral changes in epilepsy. Geschwind and his collaborators viewed temporal lobe epilepsy as an important model of behavioral change resulting from a stimulating lesion in the limbic system. This neurobiology accounted for the overarching increased interictal emotionality that underlay the increased religious interests, hypergraphia, increased aggression, increased moral and philosophical concerns, viscosity, and seriousness (lack of humor). Hyposexuality was the exception, although it was consistent with a discharging lesion altering this emotion-driven behavior. Geschwind provided a series of arguments to support the existence of this limbic syndrome and explain why alternative views (e.g., destructive lesion, psychological factors) and arguments against the syndrome's existence are inconsistent with the data.