Objective and Subjective Appetite Assessment in Patients with Gynecological Cancer: A Pre- and Post-Operative Pilot Study.

Although appetite and its disorders have been implicated in disease progression and outcomes, ghrelin concentrations, an objective appetite measure, are rarely assessed in patients with gynecological malignancies. The present study aimed to assess changes in post-operative versus pre-operative appetite levels in patients with gynecological cancers scheduled for tumor removal surgery (N = 53). Acylated ghrelin concentrations were assessed as an objective appetite proxy, whereas the Council of Nutrition appetite questionnaire (CNAQ) was employed as a subjective appetite measure. Ghrelin concentrations were increased post-operatively (median: 12.1 pg/mL, IQR: 0.67 to 23.5, p-value = 0.001) but the perceived appetite of patients (CNAQ) remained unchanged (median: -1, IQR: -3 to 1). Tumor removal surgery decreased all anthropometric indices (body weight, body mass index, waist and hips circumferences, triceps skinfolds, body fat, fat mass and fat mass index, p-value ≤ 0.001 for all) and doubled the risk of malnutrition among patients. No difference was recorded in the change in participants' objective and subjective appetite when they were classified according to the tumor type. No correlation was observed between ghrelin concentrations and CNAQ score pre-operatively (Spearman's rho correlation coefficient = -0.181, p-value = 0.298) or post-operatively (Spearman's rho correlation coefficient = 0.071, p-value = 0.684). The observed post-operative rise in ghrelin concentrations is associated with body weight loss and consists of a possible defense mechanism of the human body, aiming to prolong survival.

A comparison for acid production, proteolysis, autolysis and inhibitory properties of lactic acid bacteria from fresh and mature Feta PDO Greek cheese, made at three different mountainous areas.

Isolates of NSLAB were obtained from fresh (58 isolates) and mature (38) Feta cheese made at household level in three different mountainous areas, in order to study the effect of the area of production on NSLAB composition and their technological characteristics. Results obtained by SDS-PAGE of whole-cell proteins indicated that the microflora of the fresh cheese was composed of either lactococci (areas 1, 2), or lactococci and enterococci (area 3). The NSLAB microflora of mature cheese was composed almost entirely of lactobacilli species, differing according to the area of production. Species allocation by the SDS-PAGE method was confirmed by sequencing representative strains. Lactococci of cheese made in area 1 exhibited a narrow spectrum of antibacterial activity compared to isolates from areas 2 and 3, while for lactobacilli from all three areas a similar spectrum was noticed. Lactococci from area 2 exhibited higher (P<0.05) mean acidifying activity than lactococci from area 1. The isolates from the three areas also differed in respect of their caseinolytic activity, with preferences towards ß-CN (areas 1 and 2) or αs-CN (area 3). Mean proteolytic activity of lactococci from area 1 was stronger (P<0.05) than that of lactococci from area 2 and the same was observed for their mean aminopeptidase activity, as well as their extent of autolysis at pH5.1. Mean acidifying activity of lactobacilli after 6h was for strains of area 3>2=1. The strains from areas 1 and 3 degraded preferentially αs-CN, while a clear preference towards ß-CN was noticed for strains of area 2; their mean proteolytic activity was for strains of area 1 higher (P<0.05) than strains from area 3. The above results suggest that cheeses from the three areas differ in species composition of NSLAB and their technological properties. Principal component analysis of results on acidifying and proteolytic activities as well as autolysis allowed the distinction of lactococci according to their derivation area enabling the selection of appropriate strains as starters for cheese production in each area.

Greek pregnant women demonstrate inadequate micronutrient intake despite supplement use.

BACKGROUND/AIM: Maternal diet is important in the outcome of pregnancy and the health of the children. The present cross-sectional study aimed to assess the use of dietary supplements during pregnancy and define the maternal characteristics associated with supplement use. METHODS: The diet of 100 childbearing women was recorded for three consecutive days and micronutrient supplementation was added to the dietary intake and the median values were used in the analyses. RESULTS: The majority of the participants (92%) consumed at least one supplement. Supplementation of folic acid (FA) was significantly lower during the third trimester compared to the second (p ≤ .007). Higher intake of Ca and Fe supplements was observed in the second trimester (p ≤ .001). The use of supplements contributed to an attenuated consumption of all reported micronutrients (Mg, Ca, FA, and Fe, p ≤ .001). The principal components analysis revealed that the most important factor contributing to supplementation was primiparity. CONCLUSIONS: Overall, a high prevalence of micronutrient supplementation during pregnancy was observed without ensuring adequacy in the micronutrient intake. The increased rates of supplement users might be the result of an act for balancing diet in unplanned pregnancies.

Asociación entre la calidad de la dieta, el estado de salud y las complicaciones diabéticas en pacientes con diabetes tipo 2 y con obesidad comórbida / Associations between diet quality, health status and diabetic complications in patients with type 2 diabetes and comorbid obesity

Objetivos Los pacientes con diabetes tipo 2 (DM2) muestran un bajo cumplimiento dietético y esto se agrava aún más con la obesidad comórbida. El objetivo de este estudio fue evaluar la calidad en la dieta de los pacientes con DM2 y obesidad comórbida en comparación con pacientes que solo padecen DM2, además de examinar la asociación entre las comorbilidades y la calidad de la dieta. Métodos La muestra consistió en 59 pacientes adultos con diabesidad (DM2 y obesidad comórbida) y 94 pacientes con solo DM2. Se registraron todas las comorbilidades y las complicaciones por diabetes, y se evaluó la calidad de la dieta con el Índice de Alimentación Saludable (IAS).Resultados La media bruta del IAS en las personas diabéticas y obesas fue del 81,9±7,1 y en aquellas que presentaban solo diabetes 80,2±6,9. Al ajustar por sexo, edad y peso, las personas con diabetes y obesidad simultánea presentaron un IAS más elevado. De las comorbilidades habituales, solo la nefropatía disminuyó el IAS. De acuerdo con el análisis de componentes principales de la muestra total, la calidad de una dieta adecuada viene explicada por las enfermedades cardiovasculares, el tabaquismo, el consumo de alcohol, la úlcera péptica, el sexo, la diabesidad y el síndrome del pie diabético. En las personas diabéticas obesas, un IAS adecuado venía explicado por el síndrome del pie diabético, el tabaquismo, consumo de alcohol y antecedentes familiares de diabetes. Conclusiones Los pacientes adultos con DM2 demostraron una calidad adecuada en su dieta. Existen diversos factores asociados con la adopción de una dieta de alta calidad entre las personas con diabetes y obesas, y aquellas con solo DM2(AU)

Objective Patients with type 2 diabetes (T2DM) demonstrate low dietary adherence and this is further aggravated with comorbid obesity. The aim of the present study was to assess diet quality in patients with T2DM and comorbid obesity compared to patients with T2DM alone and to examine the associations between comorbidities and diet quality. Methods The sample consisted of 59 adult patients with diabesity (T2DM and comorbid obesity) and 94 patients with T2DM alone. All diabetes comorbidities and complications were recorded and diet quality was assessed with the Healthy Eating Index (HEI).Results Mean raw HEI of the diabese subjects was 81.9±7.1 and the diabetic subjects was 80.2±6.9. When HEI was adjusted to the sex, age and weight status, the diabese demonstrated a higher HEI. Among comorbidities, only renal disease decreased HEI. According to the principal component analysis of the total sample, adequate diet quality was explained by cardiovascular disease, cigarette smoking, alcohol consumption, peptic ulcer, sex, diabesity and diabetic foot syndrome. In the diabese, adequate HEI was explained by diabetic foot syndrome, smoking, drinking alcohol and having a family history of diabetes. Conclusions Adult patients with T2DM demonstrate adequate diet quality. Different factors are associated with the adoption of a high quality diet between the diabese and the T2DM alone(AU)

Associations between diet quality, health status and diabetic complications in patients with type 2 diabetes and comorbid obesity.

OBJECTIVE: Patients with type 2 diabetes (T2DM) demonstrate low dietary adherence and this is further aggravated with comorbid obesity. The aim of the present study was to assess diet quality in patients with T2DM and comorbid obesity compared to patients with T2DM alone and to examine the associations between comorbidities and diet quality. METHODS: The sample consisted of 59 adult patients with diabesity (T2DM and comorbid obesity) and 94 patients with T2DM alone. All diabetes comorbidities and complications were recorded and diet quality was assessed with the Healthy Eating Index (HEI). RESULTS: Mean raw HEI of the diabese subjects was 81.9±7.1 and the diabetic subjects was 80.2±6.9. When HEI was adjusted to the sex, age and weight status, the diabese demonstrated a higher HEI. Among comorbidities, only renal disease decreased HEI. According to the principal component analysis of the total sample, adequate diet quality was explained by cardiovascular disease, cigarette smoking, alcohol consumption, peptic ulcer, sex, diabesity and diabetic foot syndrome. In the diabese, adequate HEI was explained by diabetic foot syndrome, smoking, drinking alcohol and having a family history of diabetes. CONCLUSIONS: Adult patients with T2DM demonstrate adequate diet quality. Different factors are associated with the adoption of a high quality diet between the diabese and the T2DM alone.

Healthy Eating Index during pregnancy according to pre-gravid and gravid weight status.

OBJECTIVE: To assess differences in the Healthy Eating Index (HEI) during pregnancy with the pre-gravid and gravid weight status of women. DESIGN: Cross-sectional. SETTING: Athens, Greece. SUBJECTS: One hundred pregnant women, inhabitants of Athens. RESULTS: The mean raw HEI score of the sample was 66·9 (sd 7·6) and the mean HEI adjusted for energy intake was 66·9 (sd 0·6). No difference was recorded between the adjusted HEI and different gravidities, the embryo's sex, different income categories or education. When HEI was categorised as low, average and adequate, living in an urban residence increased the odds for demonstrating low HEI score (OR = 10·231, 95 % CI 1·300, 80·487). HEI score during pregnancy was significantly higher in participants who were either pre-gravidly underweight or of normal body weight (BW). In relation to the gestational weight status, the highest HEI scores and protein intake were shown in the underweight and of normal BW participants compared with the obese. According to the simple correspondence analysis, adequate HEI was associated with rural residence and being underweight or having normal BW during pregnancy. Low HEI was associated with overweight and obesity during pregnancy, with obesity before pregnancy and living in an urban environment. HEI was negatively correlated to the pre-conceptional and gestational BMI (r = -0·298, P ≤ 0·003 and r = -0·345, P ≤ 0·001) and to the week of gestation (r = -0·285, P ≤ 0·004). CONCLUSIONS: Overall, the HEI of the sample was mediocre. Women who were underweight or of normal BW exhibited a better diet quality compared with obese women; thus the latter consist a population in greater need for supervised nutrition and dietary counselling during pregnancy.

Evaluation of adhesion capacity, cell surface traits and immunomodulatory activity of presumptive probiotic Lactobacillus strains.

Twelve lactobacilli previously isolated from newborn infants' gastrointestinal tract and Feta cheese were further characterized by pulse field gel eletrophoresis (PFGE). All strains exhibited distinct PFGE genotypic patterns with the exception of DC421 and DC423 strains possessing identical patterns. The strains DC421, 2035 and 2012 were found to posses certain cell surface traits such as hydrophobicity, autoaggregation and/or high adhesive capacity suggesting potential immunomodulatory activity. However, application of the dorsal mouse air pouch system revealed that only the DC421, DC429 and 2035 strains exhibited strong immunostimulatory activity such as increased chemotaxis of polymorphonuclear (PMN) cells in association with increased phagocytosis and cytokine production. The same strains also induced immunomodulatory activity in the gut associated lymphoid tissue in mice in the absence of any inflammatory response. All strains induced IgA production while reduced TNFalpha production by small intestine cells. The strains DC421 and DC429 exerted their effect on the intestine through Toll-like receptor TLR2/TLR4/TLR9 mediated signalling events leading to secretion of a certain profile of cytokines in which gamma interferon (IFN-gamma), interleukin (IL)-5, IL-6 and IL-10 are included. The strain 2035 induced similar cytokine profile through the synergy of TLR2/TLR4. This study further supports the eligibility of the air pouch model to discriminate presumptive probiotic Lactobacillus strains exhibiting immunostimulatory activity in the gut. Furthermore, evidence is provided that the cell surface traits examined may not be the only criteria but an alternative and important component of a complex mechanism that enables a microorganism to interact with the host gut to exert its immunoregulatory activity.

Molecular characterization of low-level vancomycin-resistant enterococci found in coastal water of Thermaikos Gulf, Northern Greece.

Enterococcus includes species that may pose emerging health risks and has been used as biomarkers for environmental contamination while little is known concerning their occurrence in marine water. Classification of enterococci in environmental samples can be problematic and requires polyphasic taxonomy. In this study, we investigated the presence of vancomycin-resistant enterococci (VRE) in the inner bay of Thermaikos Gulf in Northern Greece. Based on physiological and biochemical criteria, 121 presumptive enterococcal strains were identified. High-level VRE were undetectable in seawater and only 35 vancomycin gene-negative strains possessed low-level vancomycin resistance. Genotyping by pulsed field gel electrophoresis (PFGE) proved to be more reliable for marine enterococcal discrimination and revealed distinguished characteristics of the seawater enterococci, indicating high genetic diversity. Random amplified polymorphic DNA-PCR (RAPD-PCR) was unable to separate distinct species analyzed in this study. This study indicates the need of polyphasic taxonomy for seawater enterococcal species' identification and provides information for future biomonitoring programs of Thermaikos Gulf.