The role of intermittent fasting and the ketogenic diet in cancer disease: can they replace the Mediterranean diet?

The prevalence of cancer is rising globally, and it is the second leading cause of death. Nutrition has an important influence on the risk of developing cancer. Moreover, changes in the gut microbiota are connected to the risk of developing cancer and are critical for sustaining immunity. Various studies have shown that intermittent fasting, ketogenic diet, and the Mediterranean diet are effective therapies in changing the intestinal microbiota, the prevention of cancer, and the improvement of tolerance to treatment in cancer patients. Although there is not enough evidence to show that the ketogenic diet is effective in changing the intestinal microbiota in a manner that could prevent cancer, intermittent fasting and the Mediterranean diet could positively affect composition of intestinal microbiota against cancer. In addition, the ketogenic diet, intermittent fasting, and the Mediterranean diet have the potential to stimulate anticarcinogenic pathways, and they might increase cancer patients' quality of life according to scientific evidence. In this review, we represent and argue recent scientific data on relationship between intermittent fasting, the ketogenic diet, and the Mediterranean diet, intestinal microbiota, cancer prevention and cancer treatment.

The association of free testosterone levels with coronavirus disease 2019.

BACKGROUND: Angiotensin-converting enzyme 2 and transmembrane protease serine 2 are critical factors of virus transmission. Expression of angiotensin-converting enzyme 2 is highest in testes, and testicular function and testosterone levels were affected by coronavirus disease 2019. Low testosterone levels are related to infections, especially respiratory tract infections, and could worsen clinical conditions by exacerbating cytokine storms and increasing pro-inflammatory cytokines. OBJECTIVES: We aimed to evaluate the acute and chronic effects of coronavirus disease 2019 on gonadal functions. Our second aim was to detect the relationship between free testosterone levels and disease prognosis and determine the impact of low-free testosterone on admission to the intensive care unit. METHODS: Eighty-one patients with reverse-transcription polymerase chain reaction-confirmed coronavirus disease 2019 were enrolled. Twenty-nine patients were assessed again for 6 months post-coronavirus disease 2019 follow-up, and seven of them had a semen analysis. Serum follicle-stimulating hormone, luteinizing hormone, sex hormone-binding globulin, and total testosterone levels were measured. RESULTS: In this observational study, 71.6% (n = 58) of patients had low free testosterone levels at baseline, in which 69% were considered secondary hypogonadism. A longer length of hospitalization and increased inflammatory markers (d-dimer, high-sensitive C-reactive protein, and procalcitonin) were detected in the low-free testosterone group. Follicle-stimulating hormone, total, free, and bioavailable testosterone levels were lower in patients who required admission to the intensive care unit. Free testosterone levels were inversely correlated with the length of hospitalization and prognostic disease factors. Oligozoospermia and impaired progressive motility were present in 42.8% (3/7) of the patients. In 6 months post-coronavirus disease 2019 follow-up, out of 29 patients, 48.2% still had low testosterone levels. CONCLUSION: A high rate of hypogonadism (71.6%) was found, especially secondary hypogonadism, and about half of the patients had hypogonadism in the sixth months' follow-up. Low free testosterone levels were correlated with inflammatory parameters, and it is related to the intensive care unit admission. Studies with long-term follow-up data in larger groups are needed to determine persistent hypogonadism and impaired spermatogenesis.

PAH levels in a furniture-manufacturing city atmosphere.

In this study, in order to determine atmospheric PAH concentrations in Inegol/Turkey, ambient air samples were collected from two different sites representing industrial and uncontrolled furniture manufacturers regions. Sampling campaign took place between December 2017 and November 2018. Air samples were collected using high volume air samplers (HVAS) and PAH concentrations were determined in both gas and particulate phases. The mean of the atmospheric PAH concentrations obtained in the gas phase in the furniture workshops (FW) and industrial district (ID) regions were 697.82 ±â€¯637 ng/m3 and 772.92 ±â€¯864.23 ng/m3, respectively. The concentrations in the particulate phase in the regions were 413.52 ±â€¯430.23 ng/m3 and 342.40 ±â€¯527.48 ng/m3, respectively. The average total (gas + particlulate phases) concentration of ∑16PAH determined in the site of FW was 1111.34 ±â€¯1045.24 ng/m3 while that was 772.92 ±â€¯864.23 ng/m3 in ID. These values are over the ambient levels reported for urban sites wherein big industries exist around the world. Additionally, the average of particle phase percentage was 30% because of nearby combustion sources. The determination of possible sources of PAHs in the regions was performed using principal component analysis (PCA). PCA results showed that the main sources of pollutants of the regions are intertwined (combustion, traffic, industries). However, the most effective source is thought to be uncontrolled combustion of furniture wastes as fuel for residential heating. Health risks for the citizens were calculated for both regions and were found not to be at high-class risk.