Assessment of EN-RAGE, sRAGE, and its isoforms: cRAGE, esRAGE in obese patients treated by moderate caloric restriction combined with physical activity conducted in hospital condition.

BACKGROUND: AGEs, their receptor (RAGE), and the extracellular newly identified receptor for AGEs product-binding protein (EN-RAGE) are implicated in the pathogenesis of inflammation. AIM: We analyzed serum EN-RAGE, soluble RAGE (sRAGE), and their isoforms: endogenous secretory - esRAGE and cleaved - cRAGE concentrations in lean controls (n = 74) and in patients with obesity (n = 71) treated for three weeks with moderate calorie restriction (CR) combined with physical activity in a hospital condition. METHODS: Using the ELISA method, serum sRAGE, esRAGE, and EN-RAGE were measured before and after CR. RESULTS: The serum level of sRAGE and esRAGE in patients with obesity was lower than that in non-obese individuals, contrary to cRAGE. EN-RAGE concentration was about three times higher in obese patients. Gradually, a rise in BMI resulted in sRAGE, esRAGE reduction, and EN-RAGE increase. The sRAGE concentration was sex-dependent, indicating a higher value in lean men. A moderate negative correlation was observed between BMI and all RAGE isoforms, whereas EN-RAGE displays a positive correlation. CR resulted in an expected decrease in anthropometric, metabolic, and proinflammatory parameters and EN-RAGE, but no RAGE isoforms. The ratio EN-RAGE/sRAGE was higher in obese humans than in control and was not modified by CR. CONCLUSION: Obesity decreases sRAGE and esRAGE and increases EN-RAGE concentration. Moderate CR and physical activity by decreasing inflammation reduces EN-RAGE but is insufficient to increase sRAGE and esRAGE to the extent observed in lean patients. EN-RAGE instead of sRAGE could be helpful to indicate a better outcome of moderate dietary intervention in obese subjects.

The role of genetic risk factors, diet, and gut microbiota in type 1 diabetes mellitus, pancreas and pancreatic islet transplantation.

Despite advances in insulin delivery and glucose monitoring technology, prevention of the progression of secondary complications in patients with type 1 diabetes (T1DM) remains a challenge. Beta cell replacement therapy in the form of islet or pancreas transplantation can restore long-term normoglycaemia with sustained periods of insulin independence among T1DM patients. However, the same genetic, behavioural, or gut microbiota-related factors that promoted autoimmunity and primary islet destruction may also affect the function of transplanted islets and the ultimate results of transplant procedures. In such cases, identifying genetic risk factors and modifying behavioural factors and those related to gut microbiota may be beneficial for the outcomes of transplant procedures. Herein, we review related literature to the identified current gap in knowledge to be addressed in future clinical trials.

Are variants of the RBP4 gene associated with serum retinol-binding protein 4 concentrations and carotid intima-media thickness values in women with obesity?

INTRODUCTION: Several studies showed the correlation of retinol-binding protein 4 (RBP4) with increased cardiovascular risk - including higher values of carotid intima-media thickness (cIMT) - particularly in individuals with obesity. OBJECTIVES: Our study aimed to investigate the impact of rs10882273; rs3758538; rs3758539, and rs7094671 RBP4 gene variants on RBP4 serum concentrations as well as cIMT values (a marker of subclinical atherosclerosis) among female patients with obesity. PATIENTS AND METHODS: We recruited 74 women with obesity and 24 women without obesity as a study and control group, respectively. The genotypic and allelic frequencies of RBP4 gene variants were evaluated for associations with serum RBP4 and cIMT. RESULTS: The median serum RBP4 concentrations were 20.30 µg/mL and 19.80 µg/mL in the patients and control group, respectively (p = 0.740). No significant differences were seen in cIMT values between the two studied groups (0.60 [0.50-1.00] vs. 0.60 ± 0.10 in the patient and control group, respectively); however, the results were close to reaching significance (p = 0.071), similar as in observed association of the minor haplotype AA for rs7084671 and rs375839 with female obesity (p = 0.0559). The correlation analysis showed no significant differences between RBP4 gene variants with serum RBP4 and cIMT. CONCLUSIONS: According to our knowledge, this is the first study investigating the association between RBP4 gene variants and serum RBP4 and cIMT among Polish female patients with obesity. However, our results show that genetic variants rs10882273, rs3758538, rs3758539, and rs7094671 of the RBP4 gene are not associated with RBP4 serum concentrations or cIMT values among women with obesity.

Physical activity, quality of diet and bone mineral density in patients with inflammatory bowel disease.

BACKGROUND: The aim of this study was to find an association between moderate, vigorous and total physical activity (PA); diet quality; and bone mineral density (BMD) among patients suffering from inflammatory bowel disease (IBD). METHODS: We enrolled 54 IBD patients, including those with Crohn's disease (CD) and ulcerative colitis (UC), and 24 healthy adults. All subjects completed the Questionnaire of Eating Behaviour based on which prohealthy and nonhealthy diet indexes were calculated, and the questionnaire included questions from the International Physical Activity Questionnaire. Prohealthy and nonhealthy diet indexes were divided into low-, medium- and high scores. BMD and T- and Z-scores of the lumbar spine (L1-L4) and femoral neck (FN) were assessed using dual-energy X-ray absorptiometry method. RESULTS: BMD, T- and Z-scores of the FN and the Z-score of L1-L4 were significantly lower among patients with CD and UC than healthy controls. We did not find any differences in the time of PA among CD, UC and control groups (CG). The prohealthy diet index was higher among healthy subjects than the CD and UC groups. The nonhealthy diet index was lower among UC patients compared with the CG or CD patients. Prohealthy diet index positively correlated with BMD and T- and Z-scores of L1-L4 and FN in IBD. The prohealthy diet index correlated negatively with C-reactive protein and positively with body mass index. The prohealthy diet index correlated only with total PA in the CD group. CONCLUSION: A well-balanced diet and proper PA may decrease the risk of osteoporosis in IBD, so education of patients referring to nutrition and PA is needed.

Why Does Obesity as an Inflammatory Condition Predispose to Colorectal Cancer?

Obesity is a complex and multifactorial problem of global importance. Additionally, obesity causes chronic inflammation, upregulates cell growth, disturbs the immune system, and causes genomic instability, increasing the risk of carcinogenesis. Colorectal cancer is one of the most common cancers, and it has become a global problem. In 2018, there were around 1.8 million new cases and around 881,000 deaths worldwide. Another risk factor of colorectal cancer associated with obesity is poor diet. A Western diet, including a high intake of red and processed meat and a low consumption of whole grains, fruits, vegetables, and fiber, may increase the risk of both colorectal cancer and obesity. Moreover, the Western diet is associated with a proinflammatory profile diet, which may also affect chronic low-grade inflammation. In fact, people with obesity often present gut dysbiosis, increased inflammation, and risk of colorectal cancer. In this article, the association between obesity and colorectal cancer is discussed, including the most important mechanisms, such as low-grade chronic inflammation, gut dysbiosis, and poor diet.

Helicobacter pylori infection is associated with increased accumulation of advanced glycation end products in the skin in patients with type 1 diabetes: A preliminary study.

BACKGROUND: Helicobacter pylori infection (HPI) is more frequently diagnosed in patients with diabetes. Insulin resistance in patients with type 1 diabetes (DMT1) is associated with the accumulation of advanced glycation end products (AGEs) in the skin and progression of chronic complications. OBJECTIVES: Assessment of the relationship between the incidence of HPI and skin AGEs in patients with DMT1. MATERIAL AND METHODS: The study included 103 Caucasian patients with a DMT1 duration >5 years. A fast qualitative test was performed to detect the HP antigen in fecal samples (Hedrex). The content of AGEs in the skin was estimated using an AGE Reader device (DiagnOptics). RESULTS: The HP-positive (n = 31) and HP-negative (n = 72) groups did not differ in terms of age, gender, duration of diabetes, fat content, body mass index (BMI) and lipid profile, metabolic control, and inflammatory response markers. The studied groups differed in the amount of AGEs in the skin. The relationship between HPI and increased AGEs in the skin was confirmed in a multifactor regression model taking into account age, gender, DMT1 duration, glycated hemoglobin A1c (HbA1c), BMI, low-density lipoprotein cholesterol (LDL-C) and the presence of hypertension, and tobacco use. The studied groups also differed in serum levels of vitamin D. CONCLUSIONS: Increased accumulation of AGEs in the skin of patients with DMT1 with coexisting HPI suggests that eradication of HP may significantly improve DMT1 outcomes.

Effect of the one-day fasting on cortisol and DHEA daily rhythm regarding sex, chronotype, and age among obese adults.

Introduction: Physiological and biochemical processes in the human body occur in a specific order and show rhythmic variability. Time dependence characterizes the secretion of cortisol and dehydroepiandrosterone (DHEA). One-day fasting implies alternating fasting days and eating days. The study aimed to determine how 24-h fasting affects the daily rhythm of cortisol and DHEA levels in obese people while taking into account gender and chronotype. Methods: Forty-nine obese patients (BMI 32.2-67.1 kg/m2; 25 women and 24 men) underwent a 3-week hospital-controlled calorie restriction diet to reduce body weight. During hospitalization, patients fasted for 1 day, during which only water could be consumed. Samples of whole mixed unstimulated saliva were collected at 2-3-h intervals over a 64-h period and analyzed for cortisol and DHEA by immunoassays. The individual chronotypes were assessed by the morning and evening questionnaire, according to Horne and Östberg. Three components of daily rhythm were evaluated: amplitude, acrophase, and the so-called MESOR. Results: Cortisol rhythm showed differences in amplitude (p = 0.0127) and acrophase (p = 0.0005). The amplitude on the fasting day was 11% higher (p = 0.224) than the day after. The acrophase advanced on the day of fasting, 48 min earlier than the day before (p = 0.0064), and by 39 min to the day after fasting (p = 0.0005). In the rhythm of DHEA, differences were found in the MESOR (p = 0.0381). The MESOR on the fasting day increased. Discussion: Our results obtained during 64 consecutive hours of saliva sampling suggest that one-day fasting may affect three components of cortisol and DHEA daily rhythm. Additionally, no differences were found in the daily rhythm between the morning and evening chronotypes and between females and males. Although aging did not influence daily cortisol rhythm, DHEA amplitude, MESOR, and acrophase changed with age. To the best of our knowledge, this is the first presentation of changes in DHEA rhythm during one-day fasting.

Assessment of Oxidative Stress Indices and Total Phenolics Concentrations in Obese Adult Women-The Effect of Training with Supplemental Oxygen: A Randomized Controlled Trial.

Background: The aim of this study was to determine the effect of using an oxygen-enriched breathing mixture during controlled physical training on blood oxidative stress parameters and total phenolics (TP) concentrations in obese adult women. Methods: A prospective randomized controlled trial study included 60 women aged 19−68 with BMIs greater than 30 kg/m2. Patients were randomly assigned to the study group (n = 30), which received additional intervention in supplementing the breathing mixture with oxygen at the flow of 6 L/min during training sessions, and the control group (n = 30). At the beginning and at the end of the study, anthropometric assessments (height and weight and BMI) and blood tests (CRP, FRAP, TBARS, TP, BAC, and La) were performed. For each patient, an individual endurance training plan was established on a cycloergometer, including 12 training units, based on a cardiopulmonary exercise test (CPET). Results: A decrease in blood TBARS concentration was observed in each study group. For the control group, the change was more remarkable, and the difference between the groups was significant at (p < 0.05; ES: 0.583). Training with the oxygen breathing mixture increased blood concentrations of TP, while a decrease in TP in blood was observed in the group without oxygen supplementation during physical training. The difference in the responses between the groups was significant at (p < 0.05; ES: 0.657) Conclusions: Increasing the concentration of oxygen in the respiratory mixture under conditions of increased exercise was shown to be safe because it did not exacerbate oxidative stress in the obese group.

Impact of Folate Intake on Bone Mineral Density in Patients with Inflammatory Bowel Disease.

BACKGROUND: Decreased bone mineral density (BMD) is a common problem among patients with inflammatory bowel disease (IBD). We hypothesised that an insufficient intake of folate might affect BMD. METHODS: The study subjects included 26 with Crohn's disease-CD, 30 with ulcerative colitis-UC, and 31 healthy adults (control group-CG) aged 18-50 years. Participants were asked to follow their usual diet, and dietary intake was assessed by a 4-day, 24 h dietary recall. All the participants filled in a questionnaire referring to folic acid supplementation. The BMD, T-score, and Z-score of the lumbar spine (L1-L4) and femoral neck (FN) were assessed. RESULTS: We found significant differences in the body mass, BMI (body mass index), CRP (C-reactive protein), BMD, Z-score, and T-score of the L1-L4 and FN between groups. There were no differences in energy and folate intake or the percentage coverage of recommended dietary allowances (RDA) of folate in all groups. Moreover, 70% of patients with UC, 92% of patients with CD, and 77% of CG patients showed insufficient folate intake. Folic acid was supplemented with a similar frequency in patients covering and not covering the RDA of folate. The intake of folate per 1000 kcal correlated positively with the CD group's BMD and T-score of L1-L4. CONCLUSIONS: Insufficient folate intake is common in patients with IBD and healthy individuals. The impact of folate on BMD in IBD is not clear. We need more studies on the association between folate intake, folic acid concentration, and BMD in IBD.

Pleiotropic Effects of Vitamin D in Patients with Inflammatory Bowel Diseases.

The multifaceted activity of vitamin D in patients with inflammatory bowel disease (IBD) presents a challenge for further research in this area. Vitamin D is involved in the regulation of bone mineral metabolism, it participates in the regulation of the immune system, and it is an underlying factor in the pathogenesis of IBD. Additionally, vitamin D affects Th1 and Th2 lymphocytes, influencing the release of cytokines and inhibiting tumor necrosis factor (TNF) expression and the wnt/ß-catenin pathway. As far as IBDs are concerned, they are associated with microbiota dysbiosis, abnormal inflammatory response, and micronutrient deficiency, including vitamin D hypovitaminosis. In turn, the biological activity of active vitamin D is regulated by the vitamin D receptor (VDR) which is associated with several processes related to IBD. Therefore, in terms of research on vitamin D supplementation in IBD patients, it is essential to understand the metabolic pathways and genetic determinants of vitamin D, as well as to identify the environmental factors they are subject to, not only in view of osteoporosis prevention and therapy, but primarily concerning modulating the course and supplementation of IBD pharmacotherapy.

Accumulation of Advanced Glycation End-Products in the Body and Dietary Habits.

The formation of advanced glycation end-products (AGE) in tissues is a physiological process; however, excessive production and storage are pathological and lead to inflammation. A sedentary lifestyle, hypercaloric and high-fructose diet and increased intake of processed food elements contribute to excessive production of compounds, which are created in the non-enzymatic multi-stage glycation process. The AGE's sources can be endogenous and exogenous, mainly due to processing food at high temperatures and low moisture, including grilling, roasting, and frying. Accumulation of AGE increases oxidative stress and initiates various disorders, leading to the progression of atherosclerosis, cardiovascular disease, diabetes and their complications. Inborn defensive mechanisms, recovery systems, and exogenous antioxidants (including polyphenols) protect from excessive AGE accumulation. Additionally, numerous products have anti-glycation properties, occurring mainly in fruits, vegetables, herbs, and spices. It confirms the role of diet in the prevention of civilization diseases.

Treatment of Diabetes and Osteoporosis-A Reciprocal Risk?

Diabetes mellitus is a metabolic and systematic disorder that requires individualized therapy. The disease leads to various consequences, resulting in the destruction of tissues and organs. The aforementioned outcomes also include bone mineral disorders, caused by medications as well as diet therapy and physical activity. Some drugs may have a beneficial effect on both bone mineral density and the risk of fractures. Nevertheless, the impact of other medications remains unknown. Focusing on pharmacotherapy in diabetes may prevent bone mineral disorders and influence both the treatment and quality of life in patients suffering from diabetes mellitus. On the other hand, anti-osteoporosis drugs, such as antiresorptive or anabolic drugs, as well as drugs with a mixed mechanism of action, may affect carbohydrate metabolism, particularly in patients with diabetes. Therefore, the treatment of diabetes as well as osteoporosis prevention are vital for this group of patients.

Associations between vitamin D, bone mineral density, and the course of inflammatory bowel disease in Polish patients.

INTRODUCTION: There are various factors contributing to the pathogenesis of osteoporosis in inflammatory bowel disease (IBD), including steroid therapy, malnutrition, and vitamin D deficiency. OBJECTIVES: The study aimed to assess the vitamin D level among IBD patients and to investigate the relationship between vitamin D concentration and bone mineral density (BMD). PATIENTS AND METHODS: The study participants included 239 adult patients with IBD and a control group of 45 healthy adults. Densitometric measurements of the lumbar spine (L1-L4) and femoral neck (FN) were conducted using dual­energy X­ray absorptiometry. All patients completed a questionnaire referring to vitamin D supplementation. RESULTS: Significant differences were observed with regard to the body mass, body mass index, BMD, the Z­score, and the T­score of the FN and L1-L4. Only approximately 25% of all participants presented optimal or high concentrations of vitamin D. The research revealed no differences in vitamin D levels with regard to the disease extent and severity among the patients with ulcerative colitis. No differences were observed in terms of the disease localization, behavior, and the patient age at the time of diagnosis in the patients with Crohn disease. Furthermore, no differences were found in BMD, T­score, and Z­score of the FN and L1-L4 between the group of patients who supplemented and did not supplement vitamin D. CONCLUSIONS: Vitamin D may not be the only factor affecting BMD. Patients with IBD should supplement a higher dose of vitamin D than healthy adults.

Effect of Flaxseed (Linum usitatissimum L.) Supplementation on Vascular Endothelial Cell Morphology and Function in Patients with Dyslipidaemia-A Preliminary Observation.

CONTEXT: Flaxseed has a characteristic fatty acids composition and unique phytonutrient profile that may have health-promoting properties. OBJECTIVE: This study aimed to determine the effects of 10 weeks of supplementation with the flaxseed (28 g/day) on endothelial cells (EC) function, serum lipids and proinflammatory mediators in patients with mild and severe dyslipidaemia. MATERIALS AND METHODS: Eleven lean patients with severe dyslipidaemia treated with apheresis (group 1; 10 weeks treated in four phases: (i) ordinary diet, (ii) ordinary diet + flaxseed, (iii) ordinary diet (wash out), (iv) ordinary diet + placebo) and eleven obese patients with mild dyslipidaemia-not treated with apheresis (group 2; 10 weeks treated in two phases: (i) ordinary diet, (ii) low fat diet + flaxseed). Flaxseed was given blindly. Serum was collected at the end of each phase of the study. ECs were exposed in vitro to the medium supplemented with pooled serum taken from patients from both groups to detect their morphological changes using light and electron microscopy. ECs proliferation was also measured at the end of each study phase. RESULTS: Serum vascular endothelial growth factor was decreased after flaxseed supplementation but only in group 1. ECs proliferation was increased after flaxseed supplementation only in obese patients. ECs exposed to medium supplemented with obese patients' serum revealed the following cellular abnormalities: accumulation of lipid droplets, changes of rough endoplasmic reticulum and mitochondria, and flaxseed did not reverse observed changes. At the same time, flaxseed supplementation decreases total cholesterol in both tested groups, low-density lipoprotein cholesterol in group 1 and triglycerides in group 2. CONCLUSIONS: Our findings support the potential role of flaxseed in treating dyslipidaemia but indicate only a slight impact on endothelial cell function.

Where Do We Stand in the Behavioral Pathogenesis of Inflammatory Bowel Disease? The Western Dietary Pattern and Microbiota-A Narrative Review.

Despite the increasing knowledge with regard to IBD (inflammatory bowel disease), including ulcerative colitis (UC) and Crohn's disease (CD), the etiology of these conditions is still not fully understood. Apart from immunological, environmental and nutritional factors, which have already been well documented, it is worthwhile to look at the possible impact of genetic factors, as well as the composition of the microbiota in patients suffering from IBD. New technologies in biochemistry allow to obtain information that can add to the current state of knowledge in IBD etiology.

The effect of breathing an oxygen-enriched mixture on tissue saturation in obese women.

BACKGROUND: Physical activity undertaken in the treatment process additionally increases the oxygen demand of the working muscles. It seems interesting to see whether a delivery of an enriched respiratory mixture can have an impact on lower acidification of working muscles and oxygenation of tissues. OBJECTIVES: To assess tissue saturation and the level of acidification at rest and during exercise while breathing atmospheric air or an oxygen-enriched mixture. MATERIAL AND METHODS: Tissue saturation and lactate concentration at rest and during exercise were assessed in 18 females with an average body mass index (BMI) of 42 kg/m2. The study regimen was as follows: day 1 - cardiopulmonary exercise testing (CPET) - determination of the threshold load; day 2 - 20 min of physical effort on a cycloergometer (threshold load, breathing atmospheric air); day 3 - 20 min of physical effort on a cycloergometer (threshold load, breathing mixture enriched with oxygen). Saturation measurements were performed in 3 places on the patient's body by measuring absorbance via near-infrared spectroscopy (NIRS). RESULTS: A significant decrease in heart rate (HR) at rest was found when using the oxygen-enriched air mixture (Z = 2.1339, p = 0.0328 (effect size (ES) = 0.478)). During the exercise, a significant decrease in saturation was shown only for the midpoint of the quadriceps muscles (Z = 2.1572, p = 0.309 (ES = 0.600)). Medium effect sizes were shown by the difference in resting and exercising lactate concentration change between the experimental models studied (Z = 2.5041, p = 0.0122 (ES = 0.707)). In the experimental models studied, different medium effect sizes were demonstrated in the resting and exercising lactate concentration change. CONCLUSIONS: Oxygen-enriched air mixture contributes to reducing hypoxia in working muscles of obese people. Oxygen supplementation can result in higher physical fitness levels. The implementation of oxygen-enriched air mixture is a promising therapeutic strategy for obese patients who exhibit high lactate concentrations after exercise.

Why are western diet and western lifestyle pro-inflammatory risk factors of celiac disease?

The prevalence of celiac disease increased in recent years. In addition to the genetic and immunological factors, it appears that environmental determinants are also involved in the pathophysiology of celiac disease. Gastrointestinal infections impact the development of celiac disease. Current research does not directly confirm the protective effect of natural childbirth and breastfeeding on celiac disease. However, it seems that in genetically predisposed children, the amount of gluten introduced into the diet may have an impact on celiac disease development. Also western lifestyle, including western dietary patterns high in fat, sugar, and gliadin, potentially may increase the risk of celiac disease due to changes in intestinal microbiota, intestinal permeability, or mucosal inflammation. Further research is needed to expand the knowledge of the relationship between environmental factors and the development of celiac disease to define evidence-based preventive interventions against the development of celiac disease. The manuscript summarizes current knowledge on factors predisposing to the development of celiac disease including factors associated with the western lifestyle.

Iron Deficiency Anemia in Inflammatory Bowel Diseases-A Narrative Review.

Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, is characterized by chronic inflammation of the gastrointestinal tract. IBD has been associated with numerous symptoms and complications, with the most common being iron deficiency anemia (IDA). Iron deficiency in IBD is caused by inadequate intake, malabsorption (including duodenal involvement and surgical removal), and chronic blood loss by mucosal ulcerations. Therefore, an appropriate diet should be enforced. Iron deficiency and iron supplementation have been associated with alterations to gut microbiota. IBD-associated anemia, in particular iron deficiency anemia, is associated with a significant decrease in quality of life and with clinical symptoms such as chronic fatigue, headaches and dizziness, reduced exercise tolerance, pale skin, nails, conjunctiva, and fainting. However, despite these numerous adverse symptoms, IDA remains undertreated. The European Crohn's and Colitis Organisation (ECCO) guidelines state that patients should be monitored for anemia. Adequate treatment, whether oral or intravenous, should be implemented while taking into consideration C-reactive protein values (CRP), hemoglobin levels, and therapeutic response. It should be stressed that every case of anemia in IBD patients should be treated. Intravenous iron formulations, which are more superior compared to the oral form, should be used. There is a need to increase awareness and implementation of international guidelines on iron supplementation in patients with IBD.

Does Folic Acid Protect Patients with Inflammatory Bowel Disease from Complications?

Folic acid, referred to as vitamin B9, is a water-soluble substance, which participates in the synthesis of nucleic acids, amino acids, and proteins. Similarly to B12 and B6, vitamin B9 is involved in the metabolism of homocysteine, which is associated with the MTHFR gene. The human body is not able to synthesize folic acid; thus, it must be supplemented with diet. The most common consequence of folic acid deficiency is anemia; however, some studies have also demonstrated the correlation between low bone mineral density, hyperhomocysteinemia, and folic acid deficiency. Patients with inflammatory bowel disease (IBD) frequently suffer from malabsorption and avoid certain products, such as fresh fruits and vegetables, which constitute the main sources of vitamin B9. Additionally, the use of sulfasalazine by patients may result in folic acid deficiency. Therefore, IBD patients present a higher risk of folic acid deficiency and require particular supervision with regard to anemia and osteoporosis prevention, which are common consequences of IBD.

No Significant Effect of the Individual Chronotype on the Result of Moderate Calorie Restriction for Obesity-A Pilot Study.

BACKGROUND: Chronotype is the pattern of the circadian rhythm that allows an individual to optimize times of sleep and activity. It has been observed that chronotypes may associate with some conditions and diseases, including obesity. It is not known, however, whether chronotypes determine the effectiveness of weight loss regimens. Therefore, in the present study, we compared the outcomes of a 3-week moderate calorie restriction undertaken by individuals with obesity under the same controlled hospital conditions. METHODS: A total of 131 participants with obesity (median BMI 40.0) were studied. The subjects underwent the same dietary intervention over 3 weeks, with a 30% reduction in daily caloric intake. The individual chronotypes were assessed by the morning and evening questionnaire (MEQ) according to Horne and Östberg. Anthropometric and biochemical parameters were assessed by routine methods. RESULTS: Of all patients examined, 75% had the morning (lark) chronotype and 25% had the evening (owl) chronotype. These patient sub-groups did not differ in terms of demographic, anthropometric and biochemical characteristics at baseline. After 3 weeks of calorie restriction, both groups experienced a similar loss of weight and BMI (Body Mass Index) (3.4 ± 0.38% for larks vs. 4.1 ± 0.47% for owls, p = 0.45), with owls exhibiting a marginally greater loss of body fat (3.1 ± 0.79%) compared with larks (2.6 ± 0.64%), p = 0.02. On the other hand, the larks had a more discernable, but not statistically significant from owls, decrease in glycated haemoglobin and CRP (C Reactive Protein). CONCLUSIONS: The chronotype of individuals with obesity does not have a significant effect on the magnitude of the body weight loss, but there is a tendency observed towards the reduction in body fat content in owls through changing their meal and sleep timing to earlier hours, in response to moderate calorie restriction applied under the same controlled conditions.