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:

Physical activity in relation to irritable bowel syndrome among Iranian adults.

Irritable bowel syndrome (IBS) is the most prevalent functional gastrointestinal disorder worldwide. Physical activity in relation to IBS has been investigated in few studies and data in this regard are conflicting. To investigate the association between physical activity and IBS in a large sample of Iranian adults. This cross-sectional study was done on 4763 Iranian adults in the framework of SEPAHAN (The Study on the Epidemiology of Psycho-Alimentary Health and Nutrition) project. The physical activity of study participants was assessed using the General Practice Physical Activity Questionnaire (GPPAQ). Using a validated self-administered modified Rome III questionnaire, functional gastrointestinal disorders including irritable bowel syndrome was assessed. The mean age of study participants was 36.5 years. Irritable bowel syndrome was prevalent among 21.5% of participants. Compared with physically active individuals, those with sedentary physical activity had 1.27 times greater probability of suffering from IBS. However, this association was attenuated after adjusting for age, sex, cigarette smoking and medical history of colitis and diabetes. When the analysis was additionally adjusted for diet-related practices and body mass index (BMI), a non-significant association was found between sedentary physical activity and IBS. Gender-stratified analysis revealed similar findings in women either before or after controlling for covariates. In BMI-stratified analysis, a significant positive association was seen between sedentary physical activity and IBS among individuals with normal BMI. We found a significant positive association between sedentary physical activity and IBS, particularly among women and individuals of normal weight.

Irritable bowel syndrome: associations between FODMAPS intake, problematic foods, adiposity, and gastrointestinal symptoms.

This study investigated the association between fermentable oligo-di-mono-saccharides and polyols (FODMAPs) intake, problematic foods, body adiposity, and gastrointestinal symptoms in 44 women with irritable bowel syndrome (IBS). Around 84% reported to have excluded some food from their diet. Adiposity was not associated with the frequency of gastrointestinal symptoms and IBS severity. Controlling for BMI, there were significant correlations between number of problematic foods versus waist circumference and protein intake. The IBS severity correlated to the carbohydrate intake. Patients with diarrhea demonstrated statistical tendency to restrict the intake of fat, free fructose, and oligosaccharides. Patients with mucus in the stool had higher lactose intake. The number of food considered problematic was higher for patients who reported stomach burning. Associations among adiposity, gastrointestinal symptoms, problematic food, and FODMAPs were identified and reaffirm the role of individualized nutritional treatment in the management of IBS.

Timing of eating across ten European countries - results from the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study.

To examine timing of eating across ten European countries. Cross-sectional analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study using standardized 24 h diet recalls collected during 1995-2000. Eleven predefined food consumption occasions were assessed during the recall interview. We present time of consumption of meals and snacks as well as the later:earlier energy intake ratio, with earlier and later intakes defined as 06.00-14.00 and 15.00-24.00 hours, respectively. Type III tests were used to examine associations of sociodemographic, lifestyle and health variables with timing of energy intake. Ten Western European countries. In total, 22 985 women and 13 035 men aged 35-74 years. A south-north gradient was observed for timing of eating, with later consumption of meals and snacks in Mediterranean countries compared with Central and Northern European countries. However, the energy load was reversed, with the later:earlier energy intake ratio ranging from 0·68 (France) to 1·39 (Norway) among women, and from 0·71 (Greece) to 1·35 (the Netherlands) among men. Among women, country, age, education, marital status, smoking, day of recall and season were all independently associated with timing of energy intake. Among men, the corresponding variables were country, age, education, smoking, physical activity, BMI and day of recall. We found pronounced differences in timing of eating across Europe, with later meal timetables but greater energy load earlier during the day in Mediterranean countries compared with Central and Northern European countries.

KEYWORDS: 24 h diet recall, Chrono-nutrition, Diurnal eating, EPIC, Meal patterns, Meals, Snacks, Standardization

Clinical and neuropsychological outcomes for children with phenylketonuria in Upper Egypt; a single-center study over 5 years.

Phenylketonuria (PKU) is considered to be a rare inborn error of metabolism but one of the commonest causes of mental retardation if untreated. The present study was done to characterize the clinical patterns of PKU and analyze various neuropsychiatric outcomes in PKU children in Sohag Province, Egypt. A prospective cohort study was conducted on 113 PKU patients, diagnosed during the period from 2012 to 2017, at the Pediatric Neurology Clinic of Sohag University Hospital, Upper Egypt. One hundred and ten cases were diagnosed based on clinical suspicion combined with laboratory confirmation by measuring their plasma phenylalanine levels using amino acid analyzer, while 3 cases were detected during neonatal screening. With the exception of the 3 cases detected during neonatal screening, all patients were clinically diagnosed and treated late. Psychometric evaluations of PKU patients were done using intelligence quotient (IQ, Stanford- Binet V), Childhood Autism Rating Scale, and Children's Attention and Adjustment Survey. Dietetic management was applied. The results of neuroimaging (computed tomography or magnetic resonance imaging of the brain) and electroencephalography were included when available. The overall results showed that 15.9% had hyperphenylalaninemia, 35.4% had mild to moderate PKU, and classic PKU was diagnosed in 48.7%. Global developmental delay and delayed language were the most frequent presentations. Moderately impaired or delayed overall IQ was present in 77%. While, 83.2% had moderately impaired or delayed verbal IQ, autism was diagnosed in 50.4%. Super average and average probability of attention-deficit hyperactivity disorder was diagnosed in 88.5%. Abnormal neuroimaging (white matter abnormalities and brain atrophy) was the most important significant predictor for poor language and motor developmental outcome. PKU children had variable neuropsychological outcomes, mainly attention-deficit hyperactivity disorder and impaired verbal IQ, both of which were not related to the initial phenylalanine levels or to duration of dietary therapy, but were significantly related to early dietary intervention.

KEYWORDS: ADHD, CARS, IQ, Upper Egypt, autism, phenylketonuria

Breaking bread!

Humankind has existed for 2·5 million years but only in the past 10 000 years have we been exposed to wheat. Therefore, it could be considered that wheat (gluten) is a novel introduction to humankind's diet! Prior to 1939, the rationing system had already been devised. This led to an imperative to try to increase agricultural production. Thus, it was agreed in 1941 that there was a need to establish a Nutrition Society. The very roots of the Society were geared towards necessarily increasing the production of wheat. This goal was achieved and by the end of the 20th century, global wheat output had expanded by 5-fold. Perhaps, as a result, the epidemiology of coeliac disease (CD) or gluten sensitive enteropathy has changed. CD now affects 1 % or more of all adults. Despite this, delays in diagnosis are common, for every adult patient diagnosed approximately three-four cases are undetected. This review explores humankind's relationship with gluten, wheat chemistry, the rising prevalence of modern CD and the new entity of non-coeliac gluten or wheat sensitivity. The nutritional interventions of a low fermentable oligo-, di- and mono-saccharides and polyols diet and gluten-free diet (GFD) for irritable bowel syndrome and the evidence to support this approach (including our own published work) are also reviewed. There appears to be a rising interest in the GFD as a 'lifestyler', 'free from' or 'clean eater' choice, causing concern. Restrictive diets may lead to potential nutritional implications, with long-term effects requiring further exploration.

KEYWORDS: CD coeliac disease, FODMAP fermentable oligo-, GFD gluten-free diet, IBS irritable bowel syndrome, NGGS non-coeliac gluten sensitivity, di- and mono-saccharides and polyols, Coeliac disease, Gluten, Irritable bowel syndrome, Low FODMAP diet, Wheat

Gluten and Functional Abdominal Pain Disorders in Children.

In children, functional gastrointestinal disorders (FGIDs) are common at all ages. Consumption of certain foods, particularly gluten, is frequently associated with the development and persistence of FGIDs and functional abdominal pain disorders (FAPDs) in adults and children. However, this association is not well defined. Even without a diagnosis of celiac disease (CD), some people avoid gluten or wheat in their diet since it has been shown to trigger mostly gastrointestinal symptoms in certain individuals, especially in children. The incidence of conditions such as non-celiac gluten sensitivity (NCGS) is increasing, particularly in children. On the other hand, CD is a chronic, autoimmune small intestinal enteropathy with symptoms that can sometimes be mimicked by FAPD. It is still unclear if pediatric patients with irritable bowel syndrome (IBS) are more likely to have CD. Abdominal, pain-associated FGID in children with CD does not seem to improve on a gluten-free diet. The threshold for gluten tolerance in patients with NCGS is unknown and varies among subjects. Thus, it is challenging to clearly distinguish between gluten exclusion and improvement of symptoms related solely to functional disorders.

KEYWORDS: celiac disease, gluten, non-celiac gluten sensitivity, pediatric functional abdominal pain disorders, wheat

Use of dietary interventions for functional gastrointestinal disorders.

The role of food in the development of symptoms experienced within functional gastrointestinal disorders (FGIDs) is well recognised. This review aims to describe the evidence base for dietary interventions in the different functional esophageal, duodenal and bowel disorders. Randomised controlled trials are lacking for many of the FGIDs, with the exception of irritable bowel syndrome (IBS). Restricting rapidly fermentable, short-chain carbohydrates (FODMAPs) provides an evidence based dietary approach for the management of symptoms of IBS. Recent evidence shows the upper GI motility response varies between carbohydrates, which gives promise for the potential application of the low FODMAP diet in upper GI disorders. In addition to fine-tuning our FODMAP understanding, other observational data and smaller sized studies create an exciting and optimistic future for dietary management of all FGIDs.

Symptoms and dietary practices of irritable bowel syndrome patients compared to controls: results of a United States National survey.

Little is known regarding the dietary behaviors and epidemiology of irritable bowel syndrome (IBS) patients in the United States (US). This was an IRB-approved cross-sectional survey conducted via a secured online server (SurveyMonkey®). A representative sample of the US population were queried regarding demographics, gastrointestinal (GI) symptoms, treatments and dietary practices. Of 1,718 respondents, 161 reported IBS. These were compared to 1,116 subjects reporting no GI diagnosis (controls). Overall, 9% reported a diagnosis of IBS. When compared to controls, IBS patients were more likely over 45 years and female. IBS patients more frequently noted abdominal pain, constipation, diarrhea, gas/bloating and GERD/heartburn than controls. Regarding therapeutic measures, IBS patients were more likely to cite food avoidance, over-the-counter remedies, probiotics, consultation with doctor/dietitian, and prescriptions. However, they were less likely to believe their strategies were effective. While the majority of subjects believed food contributed to their symptoms, those with IBS listed more dietary triggers. IBS patients were more likely to follow a dietary 'plan' with 21% citing lactose-free, 17% gluten-free and 9% low-FODMAP. Nevertheless, 47% with IBS denied following any dietary plans. A minority,, of IBS patients was aware of the low- FODMAP diet. In this US survey, IBS was reported by 9% of the population, most often females over 45 years. IBS patients were more likely to implement therapeutic strategies and cite food triggers, yet few were aware of the low-FODMAP diet. Outreach programs could improve awareness of this substantiated intervention.

Updated review of current pharmacological and non-pharmacological management of irritable bowel syndrome.

Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract that is usually associated with chronic abdominal pain and altered bowel habits. The two spectra of the disease include constipation-predominant IBS and Diarrhea-predominant IBS. Earlier it was thought to be an unexplained brain-gut disorder, but of late, various underlying causes suggesting primary gut disturbance have been identified. The initial management primarily includes the non-pharmacological measures such as dietary modifications, increasing physical activity, and psychological therapy. Pharmacological management is adjunct to non-pharmacological management, and the drug is chosen based on the predominant symptom of bowel habit whether constipation or diarrhea. In this review, we aim to update the readers on the currently available management options in the treatment of IBS - both pharmacological and non-pharmacological options. Further, for the various pharmacological treatments, we summarize the clinical pharmacology, indications, contraindications, adverse effects and use in pregnancy.

KEYWORDS: Constipation, Diarrhea, Diet, IBS, IBS-C, IBS-D, Irritable bowel syndrome, Pathophysiology, Pharmacological agents

Diet Quality and High-Sensitivity C-Reactive Protein in Patients With Systemic Lupus Erythematosus.

C-reactive protein (CRP) is commonly used as a biomarker for inflammation. Mild elevations of CRP have been seen in chronic autoimmune diseases like systemic lupus erythematosus (SLE), and CRP has been linked to an increased risk of cardiovascular events. Diet quality and certain dietary factors seem to influence CRP levels in healthy subjects. To date, the effect of diet on serum CRP in SLE has not been studied. Our aim was to investigate the relationship between dietary nutrients, antioxidant intake, and serum CRP in SLE. A cross-sectional study was conducted among 91 patients with SLE. High-sensitivity hsCRP values were determined using an immuno-turbidimetry assay in a Beckman Coulter analyzer. Dietary intake of macro- and micronutrients was assessed through a 24-hr diet recall. Antioxidant nutrient intake was evaluated using the dietary antioxidant quality score (DAQs). Linear regression models were used to investigate the relationships between serum hsCRP levels, dietary nutrient intake, and DAQs. The mean serum hsCRP level observed was above the established normal range. However, participating SLE patients had low-quality diets, and we found no significant correlations between dietary intake of macro- or micronutrients or antioxidant nutrient intake (DAQs) and serum CRP levels. Our study reveals that participating SLE patients had a low-quality diet that did not influence inflammatory status measured using serum CRP levels. Further interventional studies with high-quality diets in this population are necessary to dissect the role of diet on CRP levels in SLE.

KEYWORDS: C-reactive protein, dietary antioxidant, inflammation, lupus, nutrition

Glutaric Aciduria Type 1 with Microcephaly: Masquerading as Spastic Cerebral Palsy.

Glutaric aciduria type 1 is an autosomal-recessive disorder caused by the deficiency of the mitochondrial enzyme glutaryl-CoA dehydrogenase. A 13-month-old boy presented with microcephaly, developmental delay, and progressive spasticity and was being treated as spastic cerebral palsy, later on had loss of developmental milestones after acute episode of illness at 12 months of age. The magnetic resonance imaging of brain revealed widened Sylvian fissure, hyperintensities in bilateral globus pallidus, and bilateral frontoparietal atrophy along with white matter loss. The urine examination by gas chromatography-mass spectroscopy revealed a marked excretion of glutaric acid and 3-hydroxyglutaric acid. The diagnosis of GA-1 was confirmed on the basis of characteristic neuroimaging, biochemical, and mutation studies. There are rare reports in the literature about association of GA-1 with microcephaly. The child was started on trihexyphenidyl, l -carnitine, and high-dose riboflavin, and dietary therapy in the form of low-protein diet was advised.

KEYWORDS: Developmental delay, metabolic disorders, neuroregression, organic aciduria

CA19-9 and Apolipoprotein-A2 isoforms as detection markers for pancreatic cancer - a prospective evaluation.

Recently, we identified unique processing patterns of apolipoprotein A2 in patients with pancreatic cancer. This study provides a first prospective evaluation of an ApoA2 isoform, alone and in combination with carbohydrate antigen 19-9, as an early detection biomarker for pancreatic cancer. We performed ELISA measurements of CA19-9 and ApoA2-ATQ/AT in 156 patients with pancreatic cancer and 217 matched controls within the European EPIC cohort, using plasma samples collected up to 60 months prior to diagnosis. The detection discrimination statistics were calculated for risk scores by strata of lag-time. For CA19-9, in univariate marker analyses, C-statistics to distinguish future pancreatic cancer patients from cancer-free individuals were 0.80 for plasma taken ≤6 months before diagnosis, and 0.71 for >6-18 months; for ApoA2-ATQ/AT, C-statistics were 0.62, and 0.65, respectively. Joint models based on ApoA2-ATQ/AT plus CA19-9 significantly improved discrimination within >6-18 months and ≤18 months. At 98% specificity, and for lag times of ≤6, >6-18 or ≤18 months, sensitivities were 57%, 36% and 43% for CA19-9 combined with ApoA2-ATQ/AT, respectively, vs. 50%, 29% and 36% for CA19-9 alone. Compared to CA19-9 alone, the combination of CA19-9 and ApoA2-ATQ/AT may improve detection of pancreatic cancer up to 18 months prior to diagnosis under usual care, and may provide a useful first measure for pancreatic cancer detection prior to imaging. This article is protected by copyright. All rights reserved.

KEYWORDS: Apolipoprotein A2, CA19-9, early detection, isoforms, pancreatic cancer, prospective study

Lacto-fermented sauerkraut improves symptoms in IBS patients independent of product pasteurisation - a pilot study.

Lacto-fermented sauerkraut contains a natural variety of lactic acid bacteria (LAB) and has not previously been studied in the treatment of irritable bowel syndrome (IBS) patients. The present study investigated the effect of a daily lacto-fermented sauerkraut supplement in relation to IBS patients' gastrointestinal symptoms and gut microbiota composition. A randomized double-blinded intervention was conducted with 34 Norwegian IBS patients. The patients were consuming either pasteurized sauerkraut or unpasteurized sauerkraut as a supplement to their daily diet for 6 weeks. The differences in change of symptoms were assessed using the questionnaire IBS-Symptom Severity Score (IBS-SSS) measured at the baseline, and at weeks 2, 4, 6 and 8 (follow-up). The gut microbiota composition was analysed using 16S rRNA gene amplicon sequencing of faecal samples from the baseline and week 6. The mean change in IBS-SSS was -38.57 ± 17.08 PS vs. -56.99 ± 16.92 UPS and was significantly improved in both groups, while the improvement in symptoms was not different between the intervention groups. The sauerkraut intervention (pasteurized or not) also led to significant gut microbiota compositional changes as determined by 16S rRNA gene amplicon sequencing. Sauerkraut related LAB in feces (Lactobacillus plantarum and Lactobacillus brevis) were significantly more often present in the UPS-group. In conclusion lacto-fermented sauerkraut had an effect on IBS patients' symptoms and gut microbiota even though the study was underpowered. Our results indicate that the observed effect to a larger extent can be attributed to the potential prebiotics in lacto-fermented sauerkraut rather than the viable LAB. Future studies with greater statistical power are needed to clarify the possible effects of LAB from lacto-fermented sauerkraut in the treatment of IBS patients.

Efficacy of glutamine in postinfection IBS.

KEYWORDS: abdominal pain, irritable bowel syndrome

[Nutritional aspects in Parkinson's disease: disease risk, dietary therapy and treatment of digestive tract dysfunction].

Epidemiological studies suggest an association of certain foods with the risk of Parkinson's disease. Also, a number of studies revaeled positive effects on disease progression by caffeine, higher uric acid and total cholesterol levels - especially in men. However, it is not yet clear whether a specific dietary concept or the effects of the intestinal microbiota on the human metabolism could play a role in the course of the disease. Given the lack of prospective nutrition studies, only general recommendations can be given: a "balanced" seasonal regional diet with emphasis on vegetables, fruits, nuts, fish, low amount of red meat, and non-processed foods with a low level of simple carbohydrates may be helpful. Especially for the elderly, a low-protein diet should be avoided. Rather, in order to prevent the development of sarcopenia and malnutrition, particular attention must be paid to adequate protein intake. The supply of vitamins B12 and D3 must be ensured - at the same time, the non-critical use of dietary supplements, especially micronutrients with presumed anti-oxidative properties, should be discouraged. Daten aus epidemiologischen Studien, die mögliche Assoziationen bestimmter Nahrungsmittel mit dem Risiko an der Parkinson’schen Krankheit zu erkranken untersucht haben, suggerieren, dass manche Nahrungsmittel, wie z. B. nikotinreiche Paprika, dieses modifizieren können. Auch scheinen nach der Analyse einer Reihe von Medikamenten-Zulassungsstudien positive Effekte auf den Krankheitsverlauf durch Coffein (Kaffee) und höhere Harnsäure-, sowie Gesamtcholesterinspiegel vor allem bei Männern vorhanden zu sein.Noch ist aber ungewiss, ob eine Diät oder besondere diätetische Konzepte und eventuell auch die Auswirkungen der Mikrobiota des Darmes auf den menschlichen Stoffwechsel, eine Rolle für den Krankheitsverlauf spielen könnten. Angesichts fehlender prospektiver Ernährungsstudien können nur allgemeine Empfehlungen gegeben werden: eine „ausgewogene“ saisonal-regional frische Ernährung mit Schwerpunkten auf Gemüse, Obst, Nüssen, Fisch, wenig rotem Fleisch und wenig hochverarbeiteter Nahrung mit nur einem geringen Anteil einfacher Kohlenhydrate könnte hilfreich sein. Speziell für ältere Menschen ist eine eiweißarme Diät nicht sinnvoll. Vielmehr muss, um der Entwicklung von Sarkopenie und Malnutrition im Alter vorzubeugen, besonders auf ausreichende Eiweißzufuhr geachtet werden. Die Versorgung mit den Vitaminen B12 und D3 muss sichergestellt werden – gleichzeitig muss von der unkritischen Anwendung von Nahrungsergänzungsmitteln, insbesondere von Mikronährstoffen mit vermuteten anti-oxidativen Eigenschaften, abgeraten werden.

Clinical application of dietary therapies in irritable bowel syndrome.

Diet appears to play a pivotal role in symptom generation in Irritable Bowel Syndrome (IBS). First line dietary therapy for IBS has focused on advice concerning healthy eating and lifestyle management. Research recently has focused on the role of a diet low in fermentable oligo-, di-, and mono-saccharides and polyols (FODMAPs), gluten free (GFD) and wheat free (WFD) diets for the relief of symptoms in IBS. A round table discussion with gastroenterologists and dietitians with a specialist interest in dietary therapies in IBS was held in Sheffield, United Kingdom in May 2017. Existing literature was reviewed. PubMed and EMBASE were searched with the MeSH terms irritable bowel syndrome/diet/diet therapy/gluten/low FODMAP in different combinations to identify relevant articles. A consensus on the application of these dietary therapies into day-to-day practice was developed. Fourteen randomized trials in IBS evaluating the low FODMAP diet, GFD and WFD were included in this review. The total number of patients recruited from randomized trials reviewed was: n=580 low FODMAP diet, n=203 GFD, n=276 WFD. There was no significant difference in the gender of patients recruited for both the low FODMAP and GFD randomized studies. The response rate in the literature to a low FODMAP diet ranged between 50-76%, and to GFD ranged between 34-71%. Percentage of IBS patients identified as wheat sensitive was reported as 30% in the literature. There are no head-to-head trials to date utilizing the low FODMAP diet, GFD and WFD for dietary treatment of IBS and still a number of concerns for diets, including nutritional inadequacy and alteration of the gut microbiota. The consensus suggests that there is evidence for the use of the low FODMAP diet, GFD and WFD as dietary therapies for IBS; the decision-making process for using each individual therapy should be directed by a detailed history by the dietitian, involving the patient in the process.

Nutritional quality of food as represented by the FSAm-NPS nutrient profiling system underlying the Nutri-Score label and cancer risk in Europe: Results from the EPIC prospective cohort study.

Helping consumers make healthier food choices is a key issue for the prevention of cancer and other diseases. In many countries, political authorities are considering the implementation of a simplified labelling system to reflect the nutritional quality of food products. The Nutri-Score, a five-colour nutrition label, is derived from the Nutrient Profiling System of the British Food Standards Agency (modified version) (FSAm-NPS). How the consumption of foods with high/low FSAm-NPS relates to cancer risk has been studied in national/regional cohorts but has not been characterized in diverse European populations. This prospective analysis included 471,495 adults from the European Prospective Investigation into Cancer and Nutrition, among whom there were 49,794 incident cancer cases. Usual food intakes were assessed with standardized country-specific diet assessment methods. The FSAm-NPS was calculated for each food/beverage using their 100-g content in energy, sugar, saturated fatty acid, sodium, fibres, proteins, and fruits/vegetables/legumes/nuts. The FSAm-NPS scores of all food items usually consumed by a participant were averaged to obtain the individual FSAm-NPS Dietary Index (DI) scores. Multi-adjusted Cox proportional hazards models were computed. A higher FSAm-NPS DI score, reflecting a lower nutritional quality of the food consumed, was associated with a higher risk of total cancer. Absolute cancer rates in those with high and low FSAm-NPS DI scores were 81.4 and 69.5 cases/10,000 person-years, respectively. Higher FSAm-NPS DI scores were specifically associated with higher risks of cancers of the colon-rectum, upper aerodigestive tract and stomach, lung for men, and liver and postmenopausal breast for women. The main study limitation is that it was based on an observational cohort using self-reported dietary data obtained through a single baseline food frequency questionnaire; thus, exposure misclassification and residual confounding cannot be ruled out. In this large multinational European cohort, the consumption of food products with a higher FSAm-NPS score (lower nutritional quality) was associated with a higher risk of cancer. This supports the relevance of the FSAm-NPS as underlying nutrient profiling system for front-of-pack nutrition labels, as well as for other public health nutritional measures.

Going gluten free in non-celiac autoimmune diseases: the missing ingredient.

KEYWORDS: Gluten, autoimmune disease, autoimmunity, dietary therapy, gluten-free diet, non-celiac autoimmune disease, nutrition, side effects

The first case of genetically confirmed sparganosis (Spirometra erinaceieuropaei) in European reptiles.

Sparganosis is a zoonosis caused by the spargana (larvae) of Spirometra sp. (Diphyllobothriidae). Reptiles are particularly important vectors for the transmission of this parasite in Asia; however, their role in sparganosis spread in European wildlife is unrecognized. We investigated the infection of reptiles with Spirometra sp. in NE Poland, where several mammalian hosts have been identified recently and in the past. Of the 59 dead reptiles, plerocercoids were found in two grass snakes (Natrix natrix) from the Białowieża Primeval Forest (BPF). The Spirometra erinaceieuropaei species was genetically confirmed using the evolutionary conserved nuclear 18S rRNA gene, and then compared to GenBank deposits. The sequences were identical to previously investigated Spirometra sp. found in Eurasian badger and wild boar from BPF. Our finding is the first genetically confirmed record of Spirometra sp. in reptiles in Europe. Since reptiles are often a component of mammalian diet, they can be a source of Spirometra tapeworm infection in European wildlife; however, further studies are needed to investigate the prevalence of infection in reptiles and other non-mammalian hosts.

KEYWORDS: DNA analyses, Natrix natrix, Non-mammalian host, Plerocercoid, Sparganum, Zoonosis

Applicability of Yeast Fermentation to Reduce Fructans and Other FODMAPs.

A diet low in fermentable oligosaccharides, disaccharides, monosaccharides and, polyols (FODMAPs) is recommended for people affected by irritable bowel syndrome (IBS) and non-coeliac wheat sensitivity (NCWS) in order to reduce symptoms. Therefore, the aim of this study was to evaluate the impact of 13 sourdough-related yeasts on FODMAP degradation, especially fructans. First, a model system containing a typical wheat carbohydrate profile was applied to evaluate the growth rate of each yeast strain. Additionally, changes in the sugar composition, for up to four days, were monitored by high-pressure anion-exchange chromatography (HPAEC). A more realistic approach with a wheat flour suspension was used to characterize CO₂ production according to the Einhorn method. The reduction of the total fructans was analyzed using an enzymatic method. Furthermore, a fingerprint of the present fructans with different degrees of polymerization was analyzed by HPAEC. The results revealed strong differences in the examined yeast strains' ability to degrade fructans, in both the model system and wheat flour. Overall, Saccharomyces cerevisiae isolated from Austrian traditional sourdough showed the highest degree of degradation of the total fructan content and the highest gas building capacity, followed by Torulaspora delbrueckii . Hence, this study provides novel knowledge about the FODMAP conversion of yeast strains.

KEYWORDS: FODMAPs, IBS, fermentation, fructan, sourdough, wheat, yeasts