Pregnancy as a window of opportunity for dementia prevention: a narrative review.

Dementia is a debilitating condition with a disproportionate impact on women. While sex differences in longevity contribute to the disparity, the role of the female sex as a biological variable in disease progression is not yet fully elucidated. Metabolic dysfunctions are drivers of dementia etiology, and cardiometabolic diseases are among the most influential modifiable risk factors. Pregnancy is a time of enhanced vulnerability for metabolic disorders. Many dementia risk factors, such as hypertension or blood glucose dysregulation, often emerge for the first time in pregnancy. While such cardiometabolic complications in pregnancy pose a risk to the health trajectory of a woman, increasing her odds of developing type 2 diabetes or chronic hypertension, it is not fully understood how this relates to her risk for dementia. Furthermore, structural and functional changes in the maternal brain have been reported during pregnancy suggesting it is a time of neuroplasticity for the mother. Therefore, pregnancy may be a window of opportunity to optimize metabolic health and support the maternal brain. Healthy dietary patterns are known to reduce the risk of cardiometabolic diseases and have been linked to dementia prevention, yet interventions targeting cognitive function in late life have largely been unsuccessful. Earlier interventions are needed to address the underlying metabolic dysfunctions and potentially reduce the risk of dementia, and pregnancy offers an ideal opportunity to intervene. This review discusses current evidence regarding maternal brain health and the potential window of opportunity in pregnancy to use diet to address neurological health disparities for women.

Regular use of fish oil supplements and course of cardiovascular diseases: prospective cohort study.

Objective: To examine the effects of fish oil supplements on the clinical course of cardiovascular disease, from a healthy state to atrial fibrillation, major adverse cardiovascular events, and subsequently death. Design: Prospective cohort study. Setting: UK Biobank study, 1 January 2006 to 31 December 2010, with follow-up to 31 March 2021 (median follow-up 11.9 years). Participants: 415 737 participants, aged 40-69 years, enrolled in the UK Biobank study. Main outcome measures: Incident cases of atrial fibrillation, major adverse cardiovascular events, and death, identified by linkage to hospital inpatient records and death registries. Role of fish oil supplements in different progressive stages of cardiovascular diseases, from healthy status (primary stage), to atrial fibrillation (secondary stage), major adverse cardiovascular events (tertiary stage), and death (end stage). Results: Among 415 737 participants free of cardiovascular diseases, 18 367 patients with incident atrial fibrillation, 22 636 with major adverse cardiovascular events, and 22 140 deaths during follow-up were identified. Regular use of fish oil supplements had different roles in the transitions from healthy status to atrial fibrillation, to major adverse cardiovascular events, and then to death. For people without cardiovascular disease, hazard ratios were 1.13 (95% confidence interval 1.10 to 1.17) for the transition from healthy status to atrial fibrillation and 1.05 (1.00 to 1.11) from healthy status to stroke. For participants with a diagnosis of a known cardiovascular disease, regular use of fish oil supplements was beneficial for transitions from atrial fibrillation to major adverse cardiovascular events (hazard ratio 0.92, 0.87 to 0.98), atrial fibrillation to myocardial infarction (0.85, 0.76 to 0.96), and heart failure to death (0.91, 0.84 to 0.99). Conclusions: Regular use of fish oil supplements might be a risk factor for atrial fibrillation and stroke among the general population but could be beneficial for progression of cardiovascular disease from atrial fibrillation to major adverse cardiovascular events, and from atrial fibrillation to death. Further studies are needed to determine the precise mechanisms for the development and prognosis of cardiovascular disease events with regular use of fish oil supplements.

Time-restricted feeding can increase food-related impulsivity: a randomized controlled trial.

OBJECTIVES: Although an increasing number of studies show that time-restricted feeding may improve metabolic health, studies examining the behavioral effects of this eating pattern are limited. This study examined the effect of time-restricted feeding on impulsivity in adults. METHODS: Thirty adults aged 25-41 years participated in this randomized controlled trial. The intervention group followed time-restricted feeding for 4 weeks and there was no energy restriction in the intervention group (n = 15) or control group (n = 15). Impulsivity was assessed before and after the intervention with the Barratt Impulsiveness Scale and the Go/NoGo task. RESULTS: The compliance rate (the percentage of days when participants had a feeding time of ≤ 8 hours/day) of the intervention group to the time-restricted feeding pattern was 92.38 ± 4.24%. The Barratt Impulsiveness Scale-11 total score of the intervention group increased from 55.53 ± 6.37 to 59.47 ± 7.67 (p = 0.02). During the Go/NoGo task, an indicator of inhibitory control, the reaction time to food and non-food stimuli was significantly shortened in the intervention group (respectively; p = 0.009, p = 0.01). In the control group, no significant change was detected in impulsivity determined by the BIS-11 or Go/NoGo task. DISCUSSION: This study showed that although time-restricted feeding may reduce body weight, it can lead to increased impulsivity and impaired inhibitory control.Trial registration: ClinicalTrials.gov identifier: NCT04960969.

Comparing dietary strategies to manage cardiovascular risk in primary care: a narrative review of systematic reviews.

BACKGROUND: Nutrition care in general practice is crucial for cardiovascular disease (CVD) prevention and management, although comparison between dietary strategies is lacking. AIM: To compare the best available (most recent, relevant, and high-quality) evidence for six dietary strategies that are effective for primary prevention/absolute risk reduction of CVD. DESIGN AND SETTING: A pragmatic narrative review of systematic reviews of randomised trials focused on primary prevention of cardiovascular events. METHOD: Studies about: 1) adults without a history of cardiovascular events; 2) target dietary strategies postulated to reduce CVD risk; and 3) direct cardiovascular or all-cause mortality outcomes were included. Six dietary strategies were examined: energy deficit, Mediterranean-like diet, sodium reduction (salt reduction and substitution), the Dietary Approaches to Stop Hypertension (DASH) diet, alcohol reduction, and fish/fish oil consumption. Reviews were selected based on quality, recency, and relevance. Quality and certainty of evidence was assessed using GRADE. RESULTS: Twenty-five reviews met inclusion criteria; eight were selected as the highest quality, recent, and relevant. Three dietary strategies showed modest, significant reductions in cardiovascular events: energy deficit (relative risk reduction [RRR] 30%, 95% confidence interval [CI] = 13 to 43), Mediterranean-like diet (RRR 40%, 95% CI = 20 to 55), and salt substitution (RRR 30%, 95% CI = 7 to 48). Still, some caveats remain on the effectiveness of these dietary strategies. Salt reduction, DASH diet, and alcohol reduction showed small, significant reductions in blood pressure, but no reduction in cardiovascular events. Fish/fish oil consumption showed little or no effect; supplementation of fish oil alone showed small reductions in CVD events. CONCLUSION: For primary prevention, energy deficit, Mediterranean-like diets, and sodium substitution have modest evidence for risk reduction of CVD events. Strategies incorporated into clinical nutrition care should ensure guidance is person centred and tailored to clinical circumstances.

Nature of the evidence base and approaches to guide nutrition interventions for individuals: a position paper from the Academy of Nutrition Sciences.

This Position Paper from the Academy of Nutrition Sciences is the third in a series which describe the nature of the scientific evidence and frameworks that underpin nutrition recommendations for health. This paper focuses on evidence which guides the application of dietary recommendations for individuals. In some situations, modified nutrient intake becomes essential to prevent deficiency, optimise development and health, or manage symptoms and disease progression. Disease and its treatment can also affect taste, appetite and ability to access and prepare foods, with associated financial impacts. Therefore, the practice of nutrition and dietetics must integrate and apply the sciences of food, nutrition, biology, physiology, behaviour, management, communication and society to achieve and maintain human health. Thus, there is huge complexity in delivering evidence-based nutrition interventions to individuals. This paper examines available frameworks for appraising the quality and certainty of nutrition research evidence, the development nutrition practice guidelines to support evidence implementation in practice and the influence of other sources of nutrition information and misinformation. The paper also considers major challenges in applying research evidence to an individual and suggests consensus recommendations to begin to address these challenges in the future. Our recommendations target three groups; those who deliver nutrition interventions to individuals, those funding, commissioning or undertaking research aimed at delivering evidence-based nutrition practice, and those disseminating nutritional information to individuals.

Factores que influyen en la adherencia al tratamiento nutricional en pacientes hipertensos, Paraguay 2021 / Factors that influence adherence to nutritional treatment in hypertensive patients, Paraguay 2021

Introducción: el tratamiento nutricional está afectado por la conducta de los sujetos para generar adherencia. Objetivo: determinar factores que influyen en la no adherencia al tratamiento nutricional en pacientes hipertensos que acuden al Hospital Regional de Coronel Oviedo, 2021. Metodología: estudio descriptivo transversal. La población estuvo comprendida por pacientes registrados en el Programa de hipertensión arterial/Departamento cardiovascular del Hospital Regional de Coronel Oviedo. Se estudiaron los datos sociodemográficos, los factores de tratamiento nutricional y el grado de adherencia al tratamiento nutricional. Resultados: participaron del estudio 206 sujetos, el 53,4 % poseía 55 años o menos y el 81,1 % fue del sexo femenino. Se pudo hallar que solo el 3,8 % de los pacientes se adhieren al tratamiento. La no adherencia al factor conocimiento estuvo relacionado con el bajo nivel educativo (p=0,032), al factor equipo de salud con provenir del área rural y tener un bajo nivel educativo (p=0,006, p=0,002), al factor paciente con provenir del área rural (p=0.002), ser de bajo nivel educativo (p=0,008) y poseer obesidad grado II y III (p=0,036). La no adherencia global estuvo relacionada a estar casado (p=0.001) y realizar trabajos domésticos (p=0,009). Conclusiones: la adherencia al tratamiento es baja en la población de estudio.

Introduction: nutritional treatment is affected by the behavior of the subjects to generate adherence. This study was carried out to determine factors that influence non-adherence to nutritional treatment in hypertensive patients who attend the Coronel Oviedo Regional Hospital, 2021. Methodology: this was a cross-sectional descriptive observational study. The population was comprised of patients registered in the hypertension department of the Coronel Oviedo Regional Hospital. Sociodemographic data, nutritional treatment factors and the degree of adherence to nutritional treatment were studied. Results: 206 subjects participated in the study, 53.4 % were 55 years old or younger and 81.1 % were female. We found that only 3.8 % of patients adhere to treatment. Non-adherence due to the knowledge factor was related to low educational level (p=0.032), to the health team factor with coming from a rural area and having a low educational level (p=0.006, p=0.002), to the patient factor with coming from a rural area (p=0.002), to have a low educational level (p=0.008) and to have obesity grade II and III (p=0.036). Global non-adherence was related to being married (p=0.001) and doing housework (p=0.009). Conclusions: adherence to treatment is low in the study population.

Variation observed in consensus judgments between pairs of reviewers when assessing the risk of bias due to missing evidence in a sample of published meta-analyses of nutrition research.

OBJECTIVES: To evaluate the risk of bias due to missing evidence in a sample of published meta-analyses of nutrition research using the Risk Of Bias due to Missing Evidence (ROB-ME) tool and determine inter-rater agreement in assessments. STUDY DESIGN AND SETTING: We assembled a random sample of 42 meta-analyses of nutrition research. Eight assessors were randomly assigned to one of four pairs. Each pair assessed 21 randomly assigned meta-analyses, and each meta-analysis was assessed by two pairs. We calculated raw percentage agreement and chance corrected agreement using Gwet's Agreement Coefficient (AC) in consensus judgments between pairs. RESULTS: Across the eight signaling questions in the ROB-ME tool, raw percentage agreement ranged from 52% to 100%, and Gwet's AC ranged from 0.39 to 0.76. For the risk-of-bias judgment, the raw percentage agreement was 76% (95% confidence interval 60% to 92%) and Gwet's AC was 0.47 (95% confidence interval 0.14 to 0.80). In seven (17%) meta-analyses, either one or both pairs judged the risk of bias due to missing evidence as "low risk". CONCLUSION: Our findings indicated substantial variation in assessments in consensus judgments between pairs for the signaling questions and overall risk-of-bias judgments. More tutorials and training are needed to help researchers apply the ROB-ME tool more consistently.

A pilot randomized controlled trial comparing nutritious meal kits and no-prep meals to improve food security and diet quality among food pantry clients.

BACKGROUND: Food pantry clients have high rates of food insecurity and greater risk for and prevalence of diet-related diseases. Many clients face time, resource, and physical constraints that limit their ability to prepare healthy meals using foods typically provided by pantries. We compared two novel approaches to alleviate those barriers and encourage healthier eating: meal kits, which bundle ingredients with a recipe on how to prepare a healthy meal, and nutritious no-prep meals, which can be eaten after thawing or microwaving. METHODS: Participants were adult pantry clients from a large food pantry in the Southern sector of Dallas, Texas. We conducted a repeated measures between-subjects study with 70 clients randomized to receive 14-days of meal kits (n = 35) or no-prep meals (n = 35). Participants completed questionnaires at baseline and two-week follow-up on demographics, hedonic liking of study meals, perceived dietary quality, and food security. Two-way repeated measures analysis of variance was used to examine group and time effects, and group by time interactions. We also describe feasibility and satisfaction outcomes to inform future implementation. RESULTS: Sixty-six participants completed the study (94%). Participants were predominantly Hispanic or Latino(a) (63%) and African American or Black (31%) women (90%). There was a significant interaction on hedonic liking of study meals (ηp²=0.16, F(1,64) = 11.78, p < .001), such that participants that received meal kits had greater improvements in hedonic liking over time than participants in the no-prep group. We observed significant improvements in perceived dietary quality (ηp²=0.36, F(1,64) = 36.38, p < .001) and food security (ηp²=0.36, F(1,64) = 36.38, p < .001) across both groups over time, but no between group differences or significant interactions indicating one intervention was more effective than the other. Program satisfaction was high across both groups, but higher among the meal kit group (ηp²=0.09, F(1,64) = 6.28, p = .015). CONCLUSIONS: Results suggest nutritious meal kits and no-prep meals may be desirable nutrition intervention strategies for pantry clients and have potential to increase food security and perceived dietary quality in the short-term. Our findings are limited by a small sample and short follow-up. Future studies should continue to test both interventions, and include longer follow-up, objective measures of dietary quality, and relevant clinical outcomes. TRIAL REGISTRATION: This trial was registered on 25/10/2022 on ClinicalTrials.gov, identifier: NCT05593510.

Diet in the management of type 2 diabetes: umbrella review of systematic reviews with meta-analyses of randomised controlled trials.

Objective: To systematically summarise and evaluate the existing evidence on the effect of diet on the management of type 2 diabetes and prevention of complications. Design: Umbrella review of systematic reviews with meta-analyses of randomised controlled trials. Data sources: PubMed, Embase, Epistemonikos, and Cochrane, from inception up to 5 June 2022. Eligibility criteria for selecting studies: Systematic reviews with meta-analyses of randomised controlled trials reporting summary effect estimates on the effect of diet on any health outcome in populations with type 2 diabetes were included in the review. Only meta-analyses with randomised controlled trials with the duration of at least 12 weeks were eligible for inclusion. Summary data were extracted by two investigators independently. Summary effect estimates with 95% confidence intervals were recalculated with a random effects model if the information provided was insufficient. Methodological quality was assessed with the A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 tool and the certainty of evidence with the Grading of Recommendations Assessment, Development, and Evaluations (GRADE) approach. Results: 88 publications with 312 meta-analyses of randomised controlled trials were included. Methodological quality was high to moderate in 23% and low to very low in 77% of the included publications. A high certainty of evidence was found for the beneficial effects of liquid meal replacement on reducing body weight (mean difference -2.37 kg, 95% confidence interval -3.30 to -1.44; n=9 randomised controlled trials included in the meta-analysis) and body mass index (-0.87, -1.32 to -0.43; n=8 randomised controlled trials), and of a low carbohydrate diet (<26% of total energy) on levels of haemoglobin A1c (-0.47%, -0.60% to -0.34%; n=17 randomised controlled trials) and triglycerides (-0.30 mmol/L, -0.43 to -0.17; n=19 randomised controlled trials). A moderate certainty of evidence was found for the beneficial effects of liquid meal replacement, plant based, Mediterranean, high protein, low glycaemic index, and low carbohydrate diets (<26% total energy) on various cardiometabolic measures. The remaining results had low to very low certainty of evidence. Conclusions: The evidence indicated that diet has a multifaceted role in the management of type 2 diabetes. An energy restricted diet can reduce body weight and improve cardiometabolic health. Beyond energy restriction, dietary approaches such as plant based, Mediterranean, low carbohydrate (<26% total energy), or high protein diets, and a higher intake of omega 3 fatty acids can be beneficial for cardiometabolic health in individuals with type 2 diabetes. Systematic review registration: PROSPERO CRD42021252309.

Genetic variant rs9939609 in FTO is associated with body composition and obesity risk in Korean females.

INTRODUCTION: The fat mass and obesity-associated (FTO) gene is a significant locus in obesity. However, the association between FTO genetic variants and body composition has not been fully elucidated. RESEARCH DESIGN AND METHODS: This observational study examined the associations of FTO rs9939609 T>A with obesity and body composition markers in Koreans. A total of 6474 participants from the Korean Genome and Epidemiology Study were analyzed for their general characteristics, body composition and FTO genotype with a sex-stratified approach. RESULTS: Females with the obesity risk A allele showed significantly greater body weight, hip circumference, and body mass index and were at a 1.28-fold higher risk of obesity (95% CI=1.088 to 1.507) than those with the TT genotype. Analyses of body composition also showed that females with the A allele had a greater body fat mass and percentage, abdominal fat percentage, and degree of obesity, and this association and FTO genetic variation and adiposity was observed in females, especially aged under 50 years. However, the effect of the variant allele on non-fat tissue markers was not evident in females and was not associated with any parameters examined in males. CONCLUSIONS: The FTO rs9939609 variant is associated with body composition in Koreans, especially body fat markers in females. These results support that the FTO rs9939609 variant is a genetic risk factor in the etiology of obesity.

Prevalence of iron-deficient but non-anemic university athletes in Japan: an observational cohort study.

BACKGROUND: Iron deficiency (ID) and iron deficiency anemia (IDA) are long-standing health problems in athletes, affecting both performance and health. ID prevalence in young athletes remains high and a matter of concern. ID and IDA can lead to fatigue, reduced endurance, and decreased oxygen transport, potentially compromising athletic performance. We hypothesized that ID would still be a major health concern in university athletes across sports clubs in Japan. PURPOSE: The study aimed to investigate the prevalence of ID and IDA in athletes participating in Kendo, badminton, baseball, and handball at the University of Tsukuba (Tsukuba, Ibaraki Prefecture, Japan). The study also examined the correlation between hypoferritinemia and other variables, such as previous use of iron supplements, body mass index (BMI), energy intake, and years of athletics. METHODS: Between January and December 2019, 126 university athletes, consisting of 79 males and 47 females, underwent physical measurements and blood tests. The blood test included complete blood count, levels of serum ferritin, serum iron, and total iron-binding capacity. The anemia was defined in accordance with the WHO criteria. Daily energy and iron intake were estimated with the food frequency questionnaire in Japanese (FFQg). Thirty-four female athletes responded to a survey about their menstruation and low-dose estrogen-progestin (LEP) usage. RESULTS: While none of the athletes had anemia, 22 (47%) female athletes exhibited serum ferritin levels of 30 ng/mL or less, defining them as hypoferritinemia. The multivariate logistic regression model revealed that a shorter duration of the athletic experience (adjusted odd ratio [95% confidence interval]: 0.62 [0.43-0.90]), lower energy intake (0.994 [0.989-0.999]), and higher dietary iron intake (4.40 [1.12-17.26]) were associated with hypoferritinemia. Seventeen (50%) female athletes reported a decline in subjective performance during menstruation, albeit two took LEP regularly. CONCLUSIONS: This study reveals that ID is a prevalent health concern among young female athletes across sports clubs. It underscores the need for their education on the importance of assessing ID status. Limitation includes the nature of single-site and observational study, the absence of hepcidin measurement, and an unspecified amount of exercise. Comprehensive investigations are needed to elucidate the causes and optimal treatments for ID in young athletes.

A pilot randomized controlled trial comparing nutritious meal kits and no-prep meals to improve food security and diet quality among food pantry clients.

Background: Food pantry clients have high rates of food insecurity and greater risk for and prevalence of diet-related diseases. Many clients face time, resource, and physical constraints that limit their ability to prepare healthy meals using foods typically provided by pantries. We compared two novel approaches to alleviate those barriers and encourage healthier eating: meal kits, which bundle ingredients with a recipe on how to prepare a healthy meal, and nutritious no-prep meals, which can be eaten after thawing or microwaving. Methods: Participants were adult pantry clients from a large food pantry in the Southern sector of Dallas, Texas. We conducted a repeated measures between-subjects study with 70 clients randomized to receive 14-days of meal kits (n=35) or no-prep meals (n=35). Participants completed questionnaires at baseline and twoweek follow-up on demographics, hedonic liking of study meals, perceived dietary quality, and food security. Two-way repeated measures analysis of variance was used to examine group and time effects, and group by time interactions. We also describe feasibility and satisfaction outcomes to inform future implementation. Results: Sixty-six participants completed the study (94%). Participants were predominantly Hispanic or Latino(a) (63%) and African American or Black (31%) women (90%). There was a significant interaction on hedonic liking of study meals (ηp2=0.16, F(1,64)=11.78, p<.001), such that participants that received meal kits had greater improvements in hedonic liking over time than participants in the no-prep group. We observed significant improvements in perceived dietary quality (ηp2=0.36, F(1,64)=36.38, p<.001) and food security (ηp2=0.36, F(1,64)=36.38, p<.001) across both groups over time, but no between group differences or significant interactions indicating one intervention was more effective than the other. Program satisfaction was high across both groups, but higher among the meal kit group (ηp2=0.09, F(1,64)=6.28, p=.015). Conclusions: Results suggest nutritious meal kits and no-prep meals may be desirable nutrition intervention strategies for pantry clients and have potential to increase food security and perceived dietary quality in the short-term. Our findings are limited by a small sample and short follow-up. Future studies should continue to test both interventions, and include longer follow-up, objective measures of dietary quality, and relevant clinical outcomes. Trial Registration: This trial was registered on 25/10/2022 on Clinicaltrials.gov, identifier: NCT05593510.

El etiquetado nutricional: su expresión en el contexto mexicano / Nutritional labeling: its expression in the Mexican context

Introduction: Food is a process that carries implicit socio-cultural elements in a specific historical moment. The changes in the diet caused an increase in problems of obesity and Chronic Non-Communicable Diseases in Mexico. Measures have been taken through public policies that seek to reduce the effects of the consumption of foods with high energy value, one of them is the nutritional labeling of foods. Development: As the first axis, a sociohistorical reconstruction is developed around food labeling in Mexico as an initiative that is part of an international public policy to present nutritional information for the selection and consumption of food. In a second moment, an analysis is carried out from a critical position on the implementation and exercise of decision-making for the consumption of said products, since it is subject to a complex network of sociocultural and individual factors that determine and are determinants of styles. and frequency of consumption of the products. Conclusions: The new labeling with nutritional information is an information tool for the selection in food consumption to face the problem of overweight and obesity in Mexico. However, eating habits and practices respond to sociocultural and economic elements that are above healthy lifestyles and a culture of prevention. It is necessary to build and promote community participation-action that promotes tools such as nutritional labeling to make its objectives effective.

Introducción: la alimentación es un proceso que implica elementos socioculturales en un momento histórico concreto. México se encuentra en un problema de salud generalizado de obesidad y enfermedades crónicas no transmisibles. Ante esto se han tomado medidas mediante políticas públicas que buscan disminuir los efectos del consumo de alimentos de alto valor energético, una de ellas es el etiquetado nutricional de los alimentos. Desarrollo: como primer eje se desarrolla una reconstrucción sociohistórica en torno al etiquetado de alimentos en México como iniciativa que forma parte de una política pública internacional para presentar información nutricional para la selección y consumo de los alimentos. En un segundo momento se realiza un análisis desde un posicionamiento crítico sobre la implementación y el ejercicio de las tomas de decisión del consumo de dichos productos, ya que está sujeta a una compleja red de factores socioculturales e individuales que determinan y son determinantes de los estilos y frecuencia de consumo de los productos. Conclusiones: el nuevo etiquetado con información nutricional es una herramienta de información para la selección en el consumo de alimentos para enfrentar el problema de sobrepeso y obesidad en México. Sin embargo, los hábitos y prácticas de alimentación responden a elementos socioculturales y económicos que están por arriba de los estilos de vida saludable y una cultura de prevención. Es necesario construir y promover una participación-acción comunitaria que potencie las herramientas como el etiquetado nutricional para hacer efectivos sus objetivos.

Revisión exploratoria sobre la evidencia de cultivos andinos con efecto hipoglucemiante y de sus componentes bioactivos / Exploratory review on the evidence of Andean crops with hypoglycemic effect and their bioactive components

RESUMEN La diabetes es una enfermedad crónica que afecta a varias personas en todo el mundo. Algunos cultivos domesticados y compartidos en el continente sudamericano se han reportado como una fuente prometedora de componentes bioactivos con posibles efectos hipoglucemiantes. En esta revisión se tuvo como objetivo explorar y sintetizar la evidencia existente en la literatura científica sobre el efecto hipoglucemiante de los cultivos andinos y sus componentes bioactivos. Se incluyó distintos tipos de estudios primarios de tres bases de datos (Scopus, Pubmed y Web of Science) durante junio de 2023, sin restricciones, por medio del lenguaje controlado y no controlado, según la estrategia PICO. Se encontró 30 estudios realizados entre 2005 y 2022 que demostraron tener efecto hipoglucemiante, mediante la inhibición enzimática en estudios in vitro y reducción significativa de la glucosa en estudios preclínicos y ensayos clínicos. Dicho efecto fue atribuido a diferentes componentes bioactivos que se identificaron con mecanismos independientes sobre la reducción de la glucosa e inhibición enzimática. Los cultivos más utilizados fueron Smallanthus sonchifolius (9/30), Lupinus mutabilis (5/30) y Solanum tuberosum (4/30). De los cuales se asignó el efecto hipoglucémico a los componentes bioactivos, como polifenoles, flavonoides, subclases de ácidos fenólicos, fructanos, alcaloides, hidrolizados, antocianinas y fibra dietética. A pesar de los resultados alentadores en distintos tipos de estudio, para que estos sean considerados como tratamientos seguros y efectivos, se requiere investigaciones adicionales que profundicen en los mecanismos de acción, comparen su eficacia con los tratamientos convencionales y evalúen su seguridad a largo plazo.

ABSTRACT Diabetes is a chronic disease that affects several people around the world. Some domesticated crops in South America have been reported to be a promising source of bioactive compounds with possible hypoglycemic effects. In this review we aimed to explore and synthesize the existing evidence in the scientific literature on the hypoglycemic effect of Andean crops and their bioactive components. We included different types of primary studies from three databases (Scopus, Pubmed and Web of Science) during June 2023, without restrictions, by means of controlled and uncontrolled language, according to the PICO strategy. We found 30 studies conducted between 2005 and 2022 that reported a hypoglycemic effect, through enzymatic inhibition in in vitro studies and significant glucose reduction in preclinical studies and clinical trials. This effect was attributed to different bioactive components that were identified with independent mechanisms related to glucose reduction and enzymatic inhibition. The most commonly used cultures were Smallanthus sonchifolius (9/30), Lupinus mutabilis (5/30) and Solanum tuberosum (4/30). The hypoglycemic effect was assigned to bioactive components such as polyphenols, flavonoids, phenolic acid subclasses, fructans, alkaloids, hydrolysates, anthocyanins and dietary fiber. Despite encouraging results from different types of studies, further research on their mechanisms of action, their efficacy compared to conventional treatments and their long-term safety is required for these to be considered safe and effective treatments.

Mapping the complexities of Relative Energy Deficiency in Sport (REDs): development of a physiological model by a subgroup of the International Olympic Committee (IOC) Consensus on REDs.

The 2023 International Olympic Committee (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) notes that exposure to low energy availability (LEA) exists on a continuum between adaptable and problematic LEA, with a range of potential effects on both health and performance. However, there is variability in the outcomes of LEA exposure between and among individuals as well as the specific manifestations of REDs. We outline a framework for a 'systems biology' examination of the effect of LEA on individual body systems, with the eventual goal of creating an integrated map of body system interactions. We provide a template that systematically identifies characteristics of LEA exposure (eg, magnitude, duration, origin) and a variety of moderating factors (eg, medical history, diet and training characteristics) that could exacerbate or attenuate the type and severity of impairments to health and performance faced by an individual athlete. The REDs Physiological Model may assist the diagnosis of underlying causes of problems associated with LEA, with a personalised and nuanced treatment plan promoting compliance and treatment efficacy. It could also be used in the strategic prevention of REDs by drawing attention to scenarios of LEA in which impairments of health and performance are most likely, based on knowledge of the characteristics of the LEA exposure or moderating factors that may increase the risk of harmful outcomes. We challenge researchers and practitioners to create a unifying and dynamic physiological model for each body system that can be continuously updated and mapped as knowledge is gained.

2023 International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs).

Relative Energy Deficiency in Sport (REDs) was first introduced in 2014 by the International Olympic Committee's expert writing panel, identifying a syndrome of deleterious health and performance outcomes experienced by female and male athletes exposed to low energy availability (LEA; inadequate energy intake in relation to exercise energy expenditure). Since the 2018 REDs consensus, there have been >170 original research publications advancing the field of REDs science, including emerging data demonstrating the growing role of low carbohydrate availability, further evidence of the interplay between mental health and REDs and more data elucidating the impact of LEA in males. Our knowledge of REDs signs and symptoms has resulted in updated Health and Performance Conceptual Models and the development of a novel Physiological Model. This Physiological Model is designed to demonstrate the complexity of either problematic or adaptable LEA exposure, coupled with individual moderating factors, leading to changes in health and performance outcomes. Guidelines for safe and effective body composition assessment to help prevent REDs are also outlined. A new REDs Clinical Assessment Tool-Version 2 is introduced to facilitate the detection and clinical diagnosis of REDs based on accumulated severity and risk stratification, with associated training and competition recommendations. Prevention and treatment principles of REDs are presented to encourage best practices for sports organisations and clinicians. Finally, methodological best practices for REDs research are outlined to stimulate future high-quality research to address important knowledge gaps.

Impact of Diet on Colorectal Cancer Progression and Prevention: From Nutrients to Neoplasms.

Colorectal cancer (CRC), one of the most common cancers worldwide, continues to increase in incidence and mortality rates. This trend is closely linked to changes in dietary habits, which are major risk factors for colorectal cancer. The increase in the incidence of CRC in countries previously considered low-risk and with low socioeconomic status is most likely due to lifestyle and dietary changes. Understanding the influence of dietary factors on the onset of colorectal cancer is essential for prevention and treatment. This review explores the complex interplay between dietary factors and colorectal cancer, focusing on the key nutrients and dietary habits that influence disease onset and progression. The impact of diet on colorectal microbiota and the influence of diet on early-onset colorectal cancer are also reviewed, reviewing recent research on how dietary interventions affect the treatment and recurrence of colorectal cancer. Finally, the future research directions for developing and applying effective dietary intervention strategies are discussed.

Nutritional intake in high-performance para athletes.

OBJECTIVE: This study aimed to describe the eating habits of para-athletes who attended a specialized training center in Brazil. METHODS: Participants were recruited from the Sports Training Center at the Universidade Federal de Minas Gerais, Brazil. Energy, macronutrient (expressed in absolute terms and relative to body weight), fiber, cholesterol, and micronutrient intakes were assessed via a food frequency questionnaire, based on intakes over the preceding 12 mo. Sociodemographic factors were assessed using a purpose-designed survey, which included self-reported weight and height. Differences in nutrient intake based on sex, age, body mass index, and sporting factors were evaluated. RESULTS: A total of 30 para-athletes (in para athletics, para-powerlifting, para-swimming, and para-taekwondo) were included in the study. The median total energy intake was 4089 (2855-5829) kcal. The median consumption of carbohydrates, proteins, and fats was 512.3 (358.7-853.5), 184.5 (118.5-246.4), and 137.1 (96.8-189.5) g/d, respectively. Adolescent athletes had higher protein intakes than adult athletes (P = 0.02). Para-athletes with a longer sports career had lower consumption of fiber (P = 0.01) and thiamine (P = 0.02). Participants with a higher body mass index had higher intake of alcohol (P = 0.04) and monounsaturated fats (P = 0.01). Higher consumption of alcohol was also reported by older para-athletes (P = 0.02). CONCLUSIONS: We identified a higher saturated fat intake in male than in female para-athletes as well as higher protein intake (g/kg) in younger compared with older athletes. In addition, sociodemographic characteristics influenced the dietary intake of some para-athletes, such as length of sports career, age, and income.