Some useful links

There is plenty of basic information on dietary therapy throughout the Internet. If you are interested in the latest medical findings you should consult the global database PUBMED of the medical publications. Below are examples of IBS-related studies:

Comorbidity of Migraine and Epilepsy in Pediatrics: A Review.

Migraine and epilepsy are classified as chronic paroxysmal neurologic disorders sharing many clinical features, as well as possible treatment options. This review highlights the similarities between migraine and epilepsy in pediatrics, focusing on epidemiologic, pathophysiological, genetic, clinical, and pharmacologic aspects. Despite the fact that several syndromes share symptoms of both migraine and epilepsy, further research is needed to clarify the pathophysiological and genetic basis of their comorbidity. Drugs used for prophylactic therapy of migraine and epilepsy have similar pharmacologic properties. The role of epileptic pharmacotherapy in the prophylaxis of migraine is assessed, including the use of conventional antiepileptic drugs, calcium channel blockers, and nonpharmacologic methods such as dietary therapy, supplements, and vagal nerve stimulation. Further randomized, controlled clinical trials assessing pharmacologic and nonpharmacologic methods for the treatment of both disorders are essential, in order to initiate new therapeutic approaches.

KEYWORDS: children, comorbidity, epilepsy, migraine

Outcome of hospital outpatient treatment of functional gastrointestinal disorders.

Functional gastrointestinal disorders (FGIDs), are the commonest conditions observed in gastrointestinal (GI) practice, yet the outcomes of their outpatient care are not known. We evaluated the outcome for patients with FGIDs attending a specialist GI clinic. Consecutive, newly referred patients with a FGID attending a specialist GI clinic in a tertiary hospital, over a one-year period were reviewed and then completed a phone survey to assess current symptoms. Of 102 patients 57% had IBS, 28% functional dyspepsia (FD) and 15% other functional disorders. At interview a median of 402 days after the last consultation 38% expressed symptom improvement, but 64% remained concerned about their condition despite 62% having been reassured. After treatment 50% of employed patients took time off work because of gut symptoms. FD patients were less likely to be symptomatically improved than other FGIDs. Patients given a low-FODMAP diet were more likely than others to achieve symptom improvement; PPI-treated patients were less likely to experience improvement; other treatments did not predict outcome. Number of visits, seniority of clinician, duration of care, and co-morbidities did not predict outcome. One year after attending a specialist GI clinic a minority of patients with FGIDs were symptomatically improved. Failure to benefit by many patients may relate to the nature of patients and conditions being treated or the limited nature and range of treatments offered. Different models of care, including more diverse multi-disciplinary models, should be explored. This article is protected by copyright. All rights reserved.

KEYWORDS: Functional gastrointestinal disorders, Hospital outpatient clinics, Irritable bowel syndrome

Therapeutic Approach for Irritable Bowel Syndrome: Old and New Strategies.

Irritable bowel syndrome (IBS) is the most frequently diagnosed functional gastrointestinal disorder. It is characterised by abdominal pain, bloating and changes in bowel habits that can have a serious impact on the patient's quality of life. Treatment strategies are based on the nature and severity of the symptoms, the degree of functional impairment of the bowel habits, and the presence of psychosocial disorders. The purpose of this review is to update our current knowledge of therapeutic approach of this disorder. A literature search for IBS therapy was carried out using the online databases of Pubmed, Medline and Cochrane. An ideal treatment begins by explaining this condition and providing reassurance to the patients. There is limited evidence for the efficacy, and tolerability of the therapies currently available for the treatment of IBS. There is also a limited availability of pharmacological agents licensed specifically for the treatment of IBS subtypes, although new agents have been recently proposed to this goal. Furthermore, patients often associate their complaints with the ingestion of foods containing FODMAPs (fermentable oligo-di-monosaccharides, and polyols) and gluten derivates and a personalized diet can be proposed. However, more severe symptoms can be associated with greater levels of psychosocial problems and a psychological approach and antidepressant drugs can be needed. The treatment of IBS remains focused on treating the patient's predominant, or most troublesome, symptoms. New promising treatments have recently become available for the treatment of IBS but long term studies are still needed.

KEYWORDS: Irritable bowel syndrome, constipation, diarrhea, diet, pain, pharmacological agents

Intact transferrin and total plasma glycoprofiling for diagnosis and therapy monitoring in phosphoglucomutase-I deficiency.

Phosphoglucomutase 1 deficiency results in a mixed phenotype of a Glycogen Storage Disorder and a Congenital Disorder of Glycosylation (CDG). Screening for abnormal glycosylation has identified more than 40 patients, manifesting with a broad clinical and biochemical spectrum which complicates diagnosis. Together with the availability of D-galactose as dietary therapy, there is an urgent need for specific glycomarkers for early diagnosis and treatment monitoring. We performed glycomics profiling by high-resolution QTOF mass spectrometry in a series of 19 PGM1-CDG patients, covering a broad range of biochemical and clinical severity. Bioinformatics and statistical analysis were used to select glycomarkers for diagnostics and define glycan-indexes for treatment monitoring. Using 3 transferrin glycobiomarkers, all PGM1-CDG patients were diagnosed with 100% specificity and sensitivity. Total plasma glycoprofiling showed an increase in high mannose glycans and fucosylation, while global galactosylation and sialylation were severely decreased. For treatment monitoring, we defined 3 glycan-indexes, reflecting normal glycosylation, a lack of complete glycans (LOCGI) and of galactose residues (LOGI). These indexes showed improved glycosylation upon D-galactose treatment with a fast and near-normalization of the galactose index (LOGI) in 6 out of 8 patients and a slower normalization of the LOCGI in all patients. Total plasma glycoprofiling showed improvement of the global high mannose glycans, fucosylation, sialylation, and galactosylation status on D-galactose treatment. Our study indicates specific glycomarkers for diagnosis of mildly and severely affected PGM1-CDG patients, and to monitor the glycan-specific effects of D-galactose therapy.

Research Progress on Non-Drug Treatment for Blood Glucose Control of Type 2 Diabetes Mellitus.

Type 2 diabetes mellitus is one of the common endocrinology diseases that greatly affects the health care sector and economy. Application of hypoglycemic drugs has its own drawbacks and the use of non-drug therapy on treating T2DM has drawn much attention recently. This paper reviewed the research development of the non-pharmacological interventions on T2DM in recent years, including dietary therapy, exercise therapy, psychotherapy, acupuncture and moxibustion therapies and so on. The authors mentioned the problems in the research of non-drug treatment for blood glucose control of T2DM and put forward new ideas for the research in the future. Further well-designed trials with large sample size and long-term follow-up are needed to confirm current conclusions.

KEYWORDS: blood glucose control, non-drug treatment, type 2 diabetes mellitus

A Systematic Review and Meta-Analysis Evaluating the Efficacy of a Gluten-Free Diet and a Low FODMAPs Diet in Treating Symptoms of Irritable Bowel Syndrome.

Dietary triggers such as gluten and highly fermentable oligo-, di- and monosaccharides and polyols (FODMAP)-containing foods have been associated with worsening irritable bowel syndrome (IBS) symptoms. However, the true impact of dietary restriction on IBS symptoms has remained unclear. The aim of this study was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) examining the efficacy of exclusion diets (we focused on low FODMAP and gluten-free diets (GFD)) in IBS. We conducted a search of the literature using the electronic databases MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews for RCTs of exclusion diets in IBS. Two independent reviewers screened citations and a third reviewer resolved disagreement. Two independent reviewers performed eligibility assessment and data abstraction. For inclusion, RCTs that evaluated an exclusion diet versus an alternative or usual diet and assessed improvement in either global IBS symptoms or abdominal pain were required. Data were synthesized as relative risk of symptoms remaining using a random effects model. Quality of evidence was assessed using GRADE methodology. A total of 1726 citations were identified. After full-text screening a total of nine studies were eligible for the systematic review. There were two RCTs of a GFD, involving 111 participants. Both selected patients who responded to a GFD and then randomized them to continue the diet or have the diet "spiked" with gluten. A GFD was associated with reduced global symptoms compared with a control diet, although this was not statistically significant. There were seven RCTs comparing a low FODMAP diet with various control interventions in 397 participants. A low FODMAP diet was associated with reduced global symptoms compared with control interventions. The three RCTS that compared low FODMAP diet with rigorous control diets had the least heterogeneity between studies, but also the least magnitude of effect. The overall quality of the data was "very low" according to GRADE criteria. There is insufficient evidence to recommend a GFD to reduce IBS symptoms. There is very low quality evidence that a low FODMAP diet is effective in reducing symptoms in IBS patients.

Long-term complications of glycogen storage disease type Ia in the canine model treated with gene replacement therapy.

Glycogen storage disease type Ia (GSD Ia) in dogs closely resembles human GSD Ia. Untreated patients with GSD Ia develop complications associated with glucose-6-phosphatase deficiency. Survival of human patients on intensive nutritional management has improved; however, long-term complications persist including renal failure, nephrolithiasis, hepatocellular adenomas (HCA), and a high risk for hepatocellular carcinoma (HCC). Affected dogs fail to thrive with dietary therapy alone. Treatment with gene replacement therapy using adeno-associated viral vectors (AAV) expressing G6Pase has greatly prolonged life and prevented hypoglycemia in affected dogs. However, long-term complications have not been described to date. Five GSD Ia-affected dogs treated with AAV-G6Pase were evaluated. Dogs were euthanized due to reaching humane endpoints related to liver and/or kidney involvement, at 4 to 8 years of life. Necropsies were performed and tissues were analyzed. Four dogs had liver tumors consistent with HCA and HCC. Three dogs developed renal failure, but all dogs exhibited progressive kidney disease histologically. Urolithiasis was detected in two dogs; uroliths were composed of calcium oxalate and calcium phosphate. One affected and one carrier dog had polycystic ovarian disease. Bone mineral density was not significantly affected. Here, we show that the canine GSD Ia model demonstrates similar long-term complications as GSD Ia patients in spite of gene replacement therapy. Further development of gene therapy is needed to develop a more effective treatment to prevent long-term complications of GSD Ia.

Low FODMAPs and gluten-free foods for irritable bowel syndrome treatment: Lights and shadows.

Irritable bowel syndrome (IBS) is a functional bowel disorder with a global prevalence of 10-20% and in which abdominal pain or discomfort is associated with defecation or a change in bowel habit. IBS strongly impairs quality of life, social function, work productivity, and brings substantial costs to health care services. The etiology of IBS remains poorly understood and the search for biomarkers is ongoing. Bloating, distension, and disordered defecation are commonly associated features. The role of dietary components in inducing IBS symptoms is difficult to explore. To date, foods are not generally considered a cause but rather symptom-triggering factors, and are a significant component of the management pathway for many individuals. The use of functional foods in the management of IBS has been limited to dairy products, with particular interest in the use of probiotics. Particular interest has been given to gluten-free and low fermentable oligosaccharides, disaccharides, monosaccharides, and polyol (FODMAP) approach to treatment of IBS. There is scope to modify some of the existing products in the cereal market, in such a way that they would then comply with the gluten-free/low FODMAP diet. This modification could then in turn, help individual patients to experience a beneficial reduction in the symptoms of IBS. This literature review is intended to provide a discussion on the diet disease link between IBS and gluten-free/low FODMAP diet, for the purpose of creating an academic foundation on which to develop functional foods, suitable for patients with IBS.

KEYWORDS: FODMAPs, Gluten-free, IBS, Probiotics

Frequency of food hypersensitivity in patients with Functional Gastrointestinal Disorders.

Food hypersensitivity (FH), irritable bowel syndrome (IBS) and functional dyspepsia (FD) have many overlapping symptoms, including abdominal discomfort, bloating, and altered bowel habits. We aimed to determine the frequency of FH in patients with IBS and functional FD. Adult patients of either gender diagnosed with IBS and/or FD as per the Rome III criteria were recruited. Patients underwent serological testing against 6 food allergens: beef, shrimp, egg white, milk, peanut, and soy-bean. Those testing positive were subjected to a food elimination diet for 4 weeks. Those showing improvement on elimination diet were subjected to re-challenge. Changes in symptoms were documented by the Global overall improvement scale (GOS) and Gastrointestinal symptom rating scale (GSRS). Two hundred patients were screened. Average age of the patients was 38.6, and 55 % were male. Nineteen patients tested positive, and were subjected to a food elimination diet. The most common food hypersensitivity was shrimp, followed by 4/21% for egg-white, and peanut. Off these, 8 showed improvement. They were re-challenged, and were evaluated 2 weeks later, when all suffered symptom relapse. These 8 patients were diagnosed with FH. There was a statistically significant difference in both GSRS (total and component) and GOS scores at baseline between patients testing (+) and. FH is present in 4 % of patients with a functional gastrointestinal disorder.

Dietary interventions for managing glucose abnormalities in cystic fibrosis: a systematic review protocol.

Glucose abnormalities in cystic fibrosis (CF) are common, but there is limited evidence to guide their dietary management. Progressive impaired glucose tolerance eventually leads to cystic fibrosis-related diabetes (CFRD), the most prevalent complication of CF, which is associated with increased morbidity and mortality. Optimising glycaemic control improves clinical status and reduces mortality; insulin therapy is the primary means of controlling glycaemia in CFRD, but its role in managing pre-diabetes is less clear. CF dietary therapy requires a high calorie diet due to increased energy expenditure and malabsorption, but this energy-dense diet is typically high in fat and sugar, and high sugar intakes often result in hyperglycaemia in individuals who have impaired glucose handling. Current guidelines for the dietary management of glucose abnormalities in CF are based on clinical consensus rather than empirical evidence. A systematic review conducted in 2012 on the effects of low glycaemic index dietary intervention in CF concluded that there is a dearth of evidence in this area. This review will update the systematic review by Balzer et al. in 2012 and will broaden the scope of their review to include any type of dietary intervention for managing glucose abnormalities in CF. Quantitative studies of dietary interventions to manage glucose abnormalities in individuals aged over 5 years with CF and glucose abnormalities will be reviewed. No limits will be placed on language or study design. The comparator will be standard CF dietary therapy (energy dense, high-fat diet) in addition to insulin therapy for individuals with CFRD. Electronic databases will be searched for completed quantitative studies published in peer-review journals that focus on dietary interventions for managing glucose abnormalities in CF. Searches will be conducted from 2000 up to the present day to reflect the evolving improvements in CF management. No restrictions will be placed on study design or language. Duration of the dietary intervention must be a minimum of 2 months and only interventions in out-patient or community settings will be included. Studies must report on dietary intervention, glycaemic control, anthropometry and lung function. Evidence will be assessed for heterogeneity and a narrative review or meta-analysis conducted as appropriate. This systematic review will elucidate current knowledge of the effects of dietary interventions for managing glucose abnormalities in the vulnerable CF clinical population. PROSPERO registration number: CRD42018085569 www.crd.york.ac.uk/prospero/.

KEYWORDS: Anthropometry, Body weight, Cystic fibrosis, Cystic fibrosis-related diabetes, Dietary intervention, Glycaemic control, Impaired glucose tolerance, Lung function

Ecological correlates of the spatial co-occurrence of sympatric mammalian carnivores worldwide.

The composition of local mammalian carnivore communities has far-reaching effects on terrestrial ecosystems worldwide. To better understand how carnivore communities are structured, we analysed camera trap data for 108 087 trap days across 12 countries spanning five continents. We estimate local probabilities of co-occurrence among 768 species pairs from the order Carnivora and evaluate how shared ecological traits correlate with probabilities of co-occurrence. Within individual study areas, species pairs co-occurred more frequently than expected at random. Co-occurrence probabilities were greatest for species pairs that shared ecological traits including similar body size, temporal activity pattern and diet. However, co-occurrence decreased as compared to other species pairs when the pair included a large-bodied carnivore. Our results suggest that a combination of shared traits and top-down regulation by large carnivores shape local carnivore communities globally.

KEYWORDS: Camera trap, ecological traits, global assessment, interspecific interactions, local community structure, spatial co-occurrence

Effect of mistimed eating patterns on breast and prostate cancer risk (MCC-Spain Study).

Modern life involves mistimed sleeping and eating patterns that in experimental studies are associated with adverse health effects. We assessed whether timing of meals is associated with breast and prostate cancer risk taking into account lifestyle and chronotype, a characteristic correlating with preference for morning or evening activity. We conducted a population-based case-control study in Spain, 2008-2013. In this analysis we included 621 cases of prostate and 1,205 of breast cancer and 872 male and 1,321 female population controls who had never worked night shift. Subjects were interviewed on timing of meals, sleep and chronotype and completed a Food Frequency Questionaire. Adherence to the World Cancer Research Fund/American Institute of Cancer Research recommendations for cancer prevention was examined. Compared with subjects sleeping immediately after supper, those sleeping two or more hours after supper had a 20% reduction in cancer risk for breast and prostate cancer combined and in each cancer individually. A similar protection was observed in subjects having supper before 9 pm compared with supper after 10 pm. The effect of longer supper-sleep interval was more pronounced among subjects adhering to cancer prevention recommendations and in morning types. Adherence to diurnal eating patterns and specifically a long interval between last meal and sleep are associated with a lower cancer risk, stressing the importance of evaluating timing in studies on diet and cancer.

KEYWORDS: breast cancer, circadian disruption, diet, prostate cancer

Post pancreatitis/cholecystectomy gluten intolerance.

This case report describes the journey of a patient who suffered from life-limiting gastrointestinal symptoms after an acute bout of pancreatitis following ERCP for cholelithiasis bile following a ductal stone, and subsequent cholecystectomy. She was diagnosed and treated for IBS with medication without significant improvement. On implementation of a simple gluten and lactose exclusion diet she recovered to her premorbid state, and trials of gluten challenge triggered flares of symptoms. This case report will go on to discuss current evidence for use of gluten and lactose exclusion diets in some gluten sensitive patients misdiagnosed with IBS.

KEYWORDS: Gluten sensitivity, Non-coeliac, Post-cholecystectomy gluten intolerance, Post-pancreatitis

An exploration into the motivation for gluten avoidance in the absence of coeliac disease.

To explore the motivation for gluten avoidance in the absence of coeliac disease (CD) and ascertain what symptoms are triggered by gluten and what beliefs/reasons influence this decision. Links between physical/psychological symptoms and gluten in CD are well known but less is known about those who self-select a gluten-free diet (GFD) in the absence of CD. An empirical study using responses to an anonymous on-line questionnaire. Closed questions were used as a screening tool to exclude participants who had CD, wheat allergy or were following a low FODMAP diet. Data from participants using a GFD in the absence of a medical diagnosis was then analysed using thematic analysis. 120 initial responses, 87 were completed in full. 23 respondents fulfilled the inclusion criteria for thematic analysis. 7 different themes emerged, including one for signs/symptoms. Other themes identified included difficulties of a GFD, health beliefs, feelings and influence on decision to follow a GFD. Responses indicate that the reasons for gluten avoidance are in the most part reasoned and logical and were based around participants' self-management of symptoms. Symptoms included those typical of irritable bowel syndrome (IBS), but also infertility, low mood/energy, immune function and weight management and visual and auditory hallucinations. It appears the majority of responses analysed thematically could fit into the spectrum of non-coeliac gluten sensitivity (NCGS). Findings also suggest more support at all levels of medical care may help patients establish if it is gluten, rather than wheat or FODMAPs particularly fructans that are contributing to signs/symptoms.

KEYWORDS: Coeliac disease, Gluten intolerance, Gluten-free, Non-celiac wheat sensitivity, Non-coeliac gluten sensitivity, Self-management of symptoms

Fermentable Sugar Ingestion, Gas Production, and Gastrointestinal and Central Nervous System Symptoms in Patients with Functional Disorders.

Functional gastrointestinal disorders (FGID) are defined by broad phenotypic descriptions and exclusion of recognizable disease. FGIDs cause multi-organ symptoms and abnormal results in a wide range of laboratory tests, indicating broad mechanisms of pathogenesis. Many patients with FGID develop symptoms following ingestion of fermentable sugars; we investigated the associations between symptoms and intestinal gas production following sugar provocation tests, to elucidate mechanisms of FGID. We performed fructose and lactose breath tests in 2042 patients with a diagnosis of FGID (based on Rome III criteria), referred to a gastroenterology practice from January 2008 through December 2011. Medical and diet histories were collected from all subjects. Breath samples were collected before and each hour after, for 5 hours, subjects ingested fructose and lactose dissolved in 300 ml water. Hydrogen and methane gas concentrations were measured and GI and non-GI symptoms were registered for 5 hours following sugar ingestion. Symptom and gas time profiles were compared, treelet transforms were used to derive data-related symptom clusters, and the symptom severity of the clusters were analyzed for their association with breath gas characteristics. We identified 11 GI and central nervous system (CNS) symptom profiles and hydrogen and methane breath concentrations that changed significantly with time following sugar ingestion. Treelet transform analysis identified 2 distinct clusters, based on GI and CNS symptoms. The severity scores for the GI and CNS symptoms correlated following ingestion of sugars. However, only the gastrointestinal symptoms associated with hydrogen and methane gas production. In an analysis of breath test results from more than 2000 patients with FGIDs, we identified clusters of GI and CNS symptoms in response to fructose of lactose ingestion. The association between specific symptoms and breath gas concentrations indicate distinct mechanisms of FGID pathogenesis, such as changes in the microbiome or mechanical and chemical sensitization. ClinTrials.gov no: NCT02085889.

KEYWORDS: FODMAP, IBS, Irritable Bowel Syndrome, functional dyspepsia

Non-coeliac gluten sensitivity and the spectrum of gluten-related disorders: an updated overview.

The spectrum of gluten-related disorders includes coeliac disease (CD), wheat allergy (WA) and the suggested entity of non-coeliac gluten sensitivity (NCGS). An increasing number of the world's population are avoiding gluten due to the assumption of health benefits and self-diagnosed gastrointestinal and/or extra-intestinal symptoms. Unlike CD and WA, NCGS is a relatively new entity with an unknown prevalence and mechanisms, complicated by recent literature suggesting that gluten is not the only food component that may trigger symptoms experienced by this group of patients. The term 'non-coeliac wheat sensitivity' has been proposed as a more accurate term, allowing inclusion of other non-gluten wheat components such as fructans and amylase-trypsin inhibitors. There is inconsistent evidence when evaluating the effects of a gluten challenge in patients with suspected NCGS and there is a need for a standardised procedure to confirm the diagnosis, ultimately enabling the optimisation of clinical care. The present review will give an overview of the different gluten-related disorders and discuss the most recent scientific evidence investigating NCGS.

KEYWORDS: ATI amylase–trypsin inhibitors, CD coeliac disease, DBPC double-blind placebo-controlled, FODMAPs fermentable oligo- di- monosaccharides and polyols, GFD gluten-free diet, HLA human leucocyte antigen, IBS irritable bowel syndrome, NCGS non-coeliac gluten sensitivity, WA wheat allergy, Coeliac disease, FODMAPs, Gastrointestinal symptoms, Gluten sensitivity, Wheat allergy

Gastrointestinal Manifestations of Hypereosinophilic Syndromes and Mast Cell Disorders: a Comprehensive Review.

Hypereosinophilic syndrome and mastocytosis are relatively rare proliferative diseases encountered in the general population. However, allergists frequently consider these disorders in the differential of patients presenting with gastrointestinal, pulmonary, cutaneous, and allergic symptoms. Gastrointestinal symptoms are some of the most frequent and/or debilitating aspects of both disease states and in many cases lead to poor quality of life and functional limitation for the patient. They are the third most common clinical manifestation in hypereosinophilic syndrome and have been found to be the most distressful aspect of the disorder in those with systemic mastocytosis. Both eosinophils and mast cells play integral parts in normal gut physiology, but when and how exactly their effector functionality translates into clinically significant disease remains unclear, and the available literature regarding their pathophysiology remains sparse. Eosinophils and mast cells even, in fact, may not necessarily function in isolation from each other but can participate in bidirectional crosstalk. Both are affected by similar mediators and can also influence one another in a paracrine fashion. Their interactions include both production of soluble mediators for specific eosinophil and mast cell receptors (for example, eosinophil recruitment and activation by mast cells releasing histamine and eotaxin) as well as direct physical contact. The mechanistic relationship between clonal forms of hypereosinophilia and systemic mastocytosis has also been explored. The nature of gastrointestinal symptomatology in the setting of both hypereosinophilic syndrome and mast cell disease is frequently manifold, heterogeneous, and the lack of better targeted therapy makes diagnosis and management challenging, especially when faced with a substantial differential. Currently, the management of these gastrointestinal symptoms relies on the treatment of the overall disease process. In hypereosinophilia patients, systemic corticosteroids are mainstay, although steroid-sparing agents such as hydroxyurea, IFN-α, methotrexate, cyclosporine, imatinib, and mepolizumab have been utilized with varying success. In mastocytosis patients, anti-mediator therapy with antihistamines and mast cell stabilization with cromolyn sodium can be considered treatments of choice, followed by other therapies yet to be thoroughly studied, including the role of the low-histamine diet, corticosteroids, and treatment of associated IBS symptoms. Given that both eosinophils and mast cells may have joint pathophysiologic roles, they have the potential to be a combined target for therapeutic intervention in disease states exhibiting eosinophil or mast cell involvement.

KEYWORDS: Eosinophil, Eosinophilic gastrointestinal diseases, Gastrointestinal, Hypereosinophilic syndrome, Mast cell, Systemic mastocytosis

Dietary intake and nutritional status in patients with systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease. Despite the influence of diet on inflammation, dietary habits in patients with systemic lupus erythematosus (SLE) are not well established. The study objective was to assess dietary intake and nutritional status in SLE patients. A cross-sectional study was conducted in 92 patients with SLE. Nutritional status was determined by body mass index (BMI) and energy/nutrient distribution of diet was analyzed and compared to a control group. Dietary reference intakes (DRIs) issued by the Spanish Societies of Nutrition, Feeding and Dietetics (FESNAD) and the Spanish Society of Community Nutrition (SENC) were used as reference. Body mass index was normal in 53.26% of patients, while 43.48% had excess weight. Energy, protein, and fat intake was significantly lower in the SLE group. Protein and fat contribution to total energy was higher, while that of carbohydrate and fiber was lower than recommended. Most patients did not reach the recommended intake for iron, calcium, iodine, potassium, magnesium, folate, and vitamins E and D, but exceeded the recommendations for sodium and phosphorus. Spanish SLE patients have an unbalanced diet characterized by low carbohydrate/fiber and high protein/fat intakes. Significant deficiencies were seen in micronutrient intake. Dietary counseling to improve nutrition would therefore be advisable in management of SLE.

KEYWORDS: Autoimmune, Autoinmune, Body weight, Dietary habits, Dietary intake, Estado nutricional, Hábitos dietéticos, Ingesta dietética, Lupus eritematoso sistémico, Nutrición, Nutrition, Nutritional status, Peso corporal, Systemic lupus erythematosus

Association study of dietary non-enzymatic antioxidant capacity (NEAC) and colorectal cancer risk in the Spanish Multicase-Control Cancer (MCC-Spain) study.

Studies attempting to link dietary non-enzymatic antioxidant activity (NEAC) and colorectal cancer (CRC) risk have reported mixed results. We examined this association in the Spanish Multicase-Control Study considering the likely influence of coffee and other dietary factors. 1718 CRC cases and 3312 matched-controls provided information about diet through a validated 140-item food frequency questionnaire. Dietary NEAC was estimated for three methods using published values of NEAC content in food, with and without coffee's NEAC. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated through unconditional logistic regression models adjusted for lifestyle and dietary factors. Overall dietary intake of NEAC was significantly lower in cases compared to controls and associated with a significantly reduced CRC risk, in both men and women, in multivariate models with and without the antioxidant contribution from coffee. The effect was similar for all the NEAC methods evaluated and for both colon and rectum. The association between dietary NEAC and CRC risk became non-significant when adjusting for fiber intake. However, intakes of NEAC and fiber were correlated. This study indicates that intake of an antioxidant-rich plant-based diet, both with and without NEAC from coffee, is associated with decreased CRC risk.

KEYWORDS: Antioxidants, Case–control study, Colorectal neoplasms, Diet, Risk factors

Coffee and tea consumption and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition.

The epidemiological evidence regarding the association of coffee and tea consumption with prostate cancer risk is inconclusive, and few cohort studies have assessed these associations by disease stage and grade. We examined the associations of coffee (total, caffeinated and decaffeinated) and tea intake with prostate cancer risk in the European Prospective Investigation into Cancer and Nutrition. Among 142,196 men, 7,036 incident prostate cancer cases were diagnosed over 14 years of follow-up. Data on coffee and tea consumption were collected through validated country-specific food questionnaires at baseline. We used Cox proportional hazards regression models to compute hazard ratios (HRs) and 95% confidence intervals (CI). Models were stratified by center and age, and adjusted for anthropometric, lifestyle and dietary factors. Median coffee and tea intake were 375 mL/day and 106 mL/day, respectively, but large variations existed by country. Comparing the highest versus lowest consumers of coffee and tea the HRs were 1.02 and 0.98 for risk of total prostate cancer, and 0.97 and 0.89 for risk of fatal disease, respectively. No evidence of association was seen for consumption of total, caffeinated or decaffeinated coffee or tea and risk of total prostate cancer or cancer by stage, grade or fatality in this large cohort. Further investigations are needed to clarify whether an association exists by different preparations or by concentrations and constituents of these beverages. This article is protected by copyright. All rights reserved.

KEYWORDS: Coffee, EPIC, caffeinated, decaffeinated, prostate cancer, tea