Obesity treatment in adolescents and adults in the era of personalized medicine.

In this multi-professional review, we will provide the in-depth knowledge required to work in the expanding field of obesity treatment. The prevalence of obesity has doubled in adults and quadrupled in children over the last three decades. The most common treatment offered has been lifestyle treatment, which has a modest or little long-term effect. Recently, several new treatment options-leading to improved weight loss-have become available. However, long-term care is not only about weight loss but also aims to improve health and wellbeing overall. In the era of personalized medicine, we have an obligation to tailor the treatment in close dialogue with our patients. The main focus of this review is new pharmacological treatments and modern metabolic surgery, with practical guidance on what to consider when selecting and guiding the patients and what to include in the follow-up care. Furthermore, we discuss common clinical challenges, such as patients with concurrent eating disorder or mental health problems, and treatment in the older adults. We also provide recommendations on how to deal with obesity in a non-stigmatizing way to diminish weight stigma during treatment. Finally, we present six microcases-obesity treatment for persons with neuropsychiatric disorders and/or intellectual disability; obesity treatment in the nonresponsive patient who has "tried everything"; and hypoglycemia, abdominal pain, and weight regain after metabolic surgery-to highlight common problems in weight-loss treatment and provide personalized treatment suggestions.

"A balancing act": parents' longitudinal perspectives of weight-related discussions with their children following obesity treatment.

Weight-related discussions during childhood may have long-lasting effects on children's body image and well-being. However, little is known about how parents frame these discussions with children who have undergone treatment for obesity. Our study aimed to explore how parents perceive weight-related discussions, several years after their children started obesity treatment. This qualitative study is part of the 4-year follow-up of the More and Less study, a randomized controlled trial examining the effectiveness of a parental support program as part of obesity treatment for preschool-aged children in Stockholm, Sweden. Semi-structured interviews were conducted with 33 parents (79% mothers, 48% with a university degree, 47% with foreign background) of 33 children (mean age 9.3 years (SD 0.7), 46% girls), transcribed and analyzed using realist informed thematic analysis. Three main themes, encompassing three subthemes were developed. Under the first theme, Parental attitudes and concerns, parents emphasized the importance of discussing weight and health behaviors with their children, yet found it challenging due to uncertainties about how to approach it safely and sensitively. A few parents found the conversation manageable, citing their own experiences of having overweight or their style of communication with the child as facilitating the conversation. Under the second theme, The significance of time and context, parents said they engaged in weight-related conversations with their children more frequently as the children matured, driven by their growing self-awareness. Parents also expressed how contextual factors, such as gender and the presence of others, shaped conversations. Parents perceived boys as more resilient, thus exposing them to more negative weight talk. The third theme, Navigating weight stigma, revealed how parents employed strategies such as nurturing their children's self-confidence, downplaying the significance of appearance and emphasizing health when discussing weight to shield their children from weight stigma. Taken together, we found that many parents need support to navigate weight-related discussions. Addressing weight stigma is part of children's obesity management process, as children may be bullied, teased, or experience discrimination in different social settings. More research is needed to explore how young children undergoing obesity treatment experience weight stigma and to understand gendered differences in these experiences.

The prevalence of overweight among 4-year-olds during and after the COVID-19 pandemic was associated with socioeconomic burden.

AIM: To assess the prevalence of overweight among Swedish 4 year olds in 2018, 2020 and 2022, taking socioeconomic variables into account. METHODS: Aggregated regional data on children's body mass index were collected. The socioeconomic Care Need Index (CNI), foreign background, low education, being a single parent, low income and childhood poverty, were assessed. The differences in overweight, including obesity, were tested for Sweden and for regions. RESULTS: Data were available for 303 843 children, representing 87% of children born in 2014, 2016 and 2018. Overweight or obesity were found in 11 177 (11.4%) of children in 2022, decreasing from 2020 (13.3%, p < 0.001) but at the same level as in 2018. Regional low CNI, low level of foreign background, education and income as well as being a single parent were associated with a higher prevalence of overweight or obesity in all cohorts (p < 0.001). In regions with high levels of childhood poverty, overweight or obesity were more prevalent during (p = 0.009) and after the pandemic (p < 0.001). CONCLUSION: Three national cohorts demonstrate that the increase in overweight during the COVID-19 pandemic has returned to pre-pandemic levels, but the inequalities in health associated with socioeconomic vulnerability of the regions remained.

Isolation of Bioactive Compounds (Carotenoids, Tocopherols, and Tocotrienols) from Calendula Officinalis L., and Their Interaction with Proteins and Oils in Nanoemulsion Formulation.

Calendula officinalis L. has numerous health-promoting properties due to the presence of a large number of lipophilic compounds. Their effective delivery to the body requires the use of an appropriate technique such as emulsification. So, the main purpose of this study was to understand how the profile of lipophilic compounds from pot marigold and the pro-health potential are shaped by different types of protein, oil, and drying techniques in o/w nanoemulsion. To obtain this, the profiles of carotenoid compounds and tocols were measured. Additionally, antioxidant potential and the ability to inhibit α-amylase and α-glucosidase were measured. Pea protein emulsion exhibited a higher final content of carotenoid compounds (23.72-39.74 mg/100 g), whereas those with whey protein had stronger α-amylase inhibition (487.70 mg/mL). The predominant compounds in the studied nanoemulsions were ß-carotene (between 19% and 40%), followed by α-tocopherol/γ-tocopherol. The type of proteins shaped the health-promoting properties and determined the content of health-promoting compounds.

Advantages of Spray Drying over Freeze Drying: A Comparative Analysis of Lonicera caerulea L. Juice Powders-Matrix Diversity and Bioactive Response.

The study investigated the impact of Lonicera caerulea L. juice matrix modification and drying techniques on powder characteristics. The evaluation encompassed phenolics (514.7-4388.7 mg/100 g dry matter), iridoids (up to 337.5 mg/100 g dry matter), antioxidant and antiglycation capacity, as well as anti-ageing properties of powders produced using maltodextrin, inulin, trehalose, and palatinose with a pioneering role as a carrier. Spray drying proved to be competitive with freeze drying for powder quality. Carrier application influenced the fruit powder properties. Trehalose protected the phenolics in the juice extract products, whereas maltodextrin showed protective effect in the juice powders. The concentrations of iridoids were influenced by the matrix type and drying technique. Antiglycation capacity was more affected by the carrier type in juice powders than in extract products. However, with carrier addition, the latter showed approximately 12-fold higher selectivity for acetylcholinesterase than other samples. Understanding the interplay between matrix composition, drying techniques, and powder properties provides insights for the development of plant-based products with tailored attributes, including potential health-linked properties.

A long-term follow-up of treatment for young children with obesity: a randomized controlled trial.

BACKGROUND: Early childhood obesity interventions supporting parents have the largest effects on child weight status. However, long-term follow-ups are lacking. OBJECTIVE: To examine weight status 48 months after obesity treatment initiation for 4- to 6-year-olds. METHODS: 177 families were recruited to the More and Less study, a 12-month randomized controlled trial (RCT) conducted in Sweden (2012-2017); 6 children were excluded due to medical diagnoses. Thus, 171 families (non-Swedish origin 59%, university degree 40%) were eligible for this 48-month follow-up with modified intention-to-treat (n = 114 had 48-month data, n = 34 dropped out, n = 23 lost to follow-up). The RCT compared 3 treatment approaches: a 10-week parent support program (1.5 h/w) with follow-up booster sessions (PGB) or without (PGNB), and standard outpatient treatment (ST). Treatment effects on primary outcome (BMI-SDS) and secondary outcomes (BMI, %IOTF25 i.e., the distance, in percent, above the cut-off for overweight) were assessed. Clinically significant reduction of BMI-SDS (≥0.5) was assessed with risk ratio. Sociodemographic factors and attendance were examined by three-way interactions. RESULTS: After 48 months (mean 50 months, range 38-67 months) mean (95% CI) BMI-SDS was reduced in all groups: PGB -0.45 (-0.18 to -0.73, p < 0.001), PGNB -0.34 (-0.13 to -0.55, p < 0.001), ST -0.25 (-0.10 to -0.40, p < 0.001), no significant difference between groups. A clinically significant reduction of BMI-SDS ≥ 0.5 was obtained in 53.7% of PGB which was twice as likely compared to ST, 33.0%, RR 2.03 (1.27 to 3.27, p = 0.003), with no difference to PGNB, 46.6% (p = 0.113). %IOTF25 was unchanged from baseline for PGB 4.50 (-1.64 to 10.63), and significantly lower compared to ST 11.92 (8.40 to 15.44) (p = 0.043). Sociodemographics or attendance had no effect. CONCLUSION: The intensive parent-support early childhood obesity intervention led to better weight status outcomes over time, though BMI-SDS alone did not reflect this. Further research should investigate how to assess weight changes in growing children. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov, NCT01792531 .

Cost-Effectiveness and Long-Term Savings of the Bright Bodies Intervention for Childhood Obesity.

OBJECTIVES: To estimate the cost and cost-effectiveness of Bright Bodies, a high-intensity, family-based intervention that has been demonstrated to improve body mass index (BMI) among children with obesity in a randomized controlled trial. METHODS: We developed a microsimulation model to project 10-year BMI trajectories of 8 to 16-year-old children with obesity, using data from the National Longitudinal Surveys and Centers for Disease Control and Prevention growth charts, and we validated the model using data from the Bright Bodies trial and a follow-up study. We used the trial data to estimate the average reduction in BMI per person-year over 10 years and the incremental costs of Bright Bodies, compared with the traditional clinical weight management (control), from a health system's perspective in 2020 US dollars. Using results from studies of Medical Expenditure Panel Survey data, we projected the long-term obesity-related medical expenditure. RESULTS: In the primary analysis, assuming depreciating effects postintervention, Bright Bodies is expected to reduce a participant's BMI by 1.67 kg/m2 (95% uncertainty interval 1.43-1.94) per year over 10 years as compared with control. The incremental intervention cost of Bright Bodies was $360 ($292-$421) per person compared with the clinical control. Nevertheless, savings in obesity-related healthcare expenditure offset these costs and the expected cost-savings of Bright Bodies is $1126 ($689-$1693) per person over 10-years. The projected time to achieve cost-savings compared with clinical control was 3.58 (2.63-5.17) years. CONCLUSIONS: Although resource-intensive, our findings suggest that Bright Bodies is cost-saving compared to the clinical control by averting future obesity-related healthcare costs among children with obesity.

National data showed an increased prevalence of overweight and obesity among four-year-old Swedish children during the first year of COVID-19.

AIM: This paper summarised national data on the prevalence of overweight and obesity among 4-year-old children in Sweden in 2020, the first year of the COVID-19 pandemic. It compares this with data from 2018. Differences between regions and sex were identified. METHODS: Comparative data from Swedish Child Health Services were available for 18/21 regions. Chi-square tests were used to compare data from 2018 and 2020 and to examine differences between the sexes. Sex and year were examined through interaction tests. RESULTS: In 2020, 13.3% of the 100 001 children had overweight or obesity: 15.1% of the girls and 11.6% of the boys (p < 0.001). In 2018, 11.4% of the 105 445 children had overweight or obesity: 13.2% of the girls and 9.4% of the boys. This was an overall increase of 16.6% (p = 0.000) in the national Swedish data from 2018 to 2020. The increase between the years was greater for obesity (31.8%, p = 0.000) than for overweight (13.3%, p = 0.000). CONCLUSION: The prevalence of overweight and obesity among 4-year-olds in Sweden increased during the COVID-19 pandemic and needs to be addressed. The prevalence needs to be followed as part of prevention programmes and to evaluate health interventions.

The Effect of Nonthermal Pretreatment on the Drying Kinetics and Quality of Black Garlic.

Black garlic is obtained from regular garlic (Allium sativum L.) through the aging process and consequently gains many health-promoting properties, including antidiabetic and antioxidant. However, the material is still prone to microbiological deterioration and requires a long time to dry due to its properties. Therefore, this study aimed to investigate the effect of various drying methods on the quality of black garlic as well as determine the influence of selected nonthermal pretreatments on the drying kinetics and quality of black garlic, which is especially important in the case of the materials that are difficult to dry. The Weibull model was chosen to describe drying kinetics. Additionally, color, water activity together with antioxidant activity, phenolic compounds, and antidiabetic potential were determined. This study found that the application of a pulsed electric field (PEF), a constant electric field (CEF) as well as a magnetic field (MF) significantly reduced the time of drying (by 32, 40, and 24 min for a PEF, a CEF, and a MF, respectively, compared to combined drying without the pretreatment), and resulted in high antidiabetic potential. However, the highest content of phenolic compounds (1123.54 and 1125.36 mg/100 g dm for VMD125 and CD3h-VMD, respectively) and antioxidant capacity (ABTS = 6.05 and 5.06 mmol Trolox/100 g dm for VMD500 and CD6h-VMD, respectively) were reported for black garlic treated by vacuum-microwave drying and combined convective pre-drying followed by vacuum-microwave drying. Overall, the nonthermal pretreatment decreased the time of drying and showed very good efficiency in maintaining the antidiabetic potential of black garlic, especially in the case of the materials pretreated by a constant electric field (IC50 = 99 and 56 mg/mL, for α-amylase and α-glucosidase, respectively).

Possibility to use the different sizes and colors of carrots for the production of juices - comparison of bioactive compounds, nutritional quality, pro-health properties, and sensory evaluation.

BACKGROUND: Carrot is a popular vegetable consumed by people of all age groups and is used in various food products because of its high nutritional content, especially vitamin A. RESULTS: In the present study, colorful fresh carrot juices of 12 carrot varieties were investigated for in vitro antidiabetic, anti-aging, and anti-obesity activities with antioxidant potential by ABTS (2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) and FRAP (ferric reducing ability of plasma) assays. The studied juices were also compared for physicochemical characteristics: titratable acidity, pH, pectin content, total soluble solids, dry mass, ash, viscosity, turbidity, osmolality, and color. The results of the study showed that normal purple carrot juice exhibited the best activities in all biological and antioxidant tests, except for anti-α-glucosidase activity. Normal purple carrot juice also had the highest total mineral content with elevated results for titratable acidity, pH, total soluble solids, dry mass, ash, viscosity, and osmolality. CONCLUSION: Purple carrot juices demonstrated elevated health-promoting activities and could be used in blended beverage recipes to attract children's attention. The results of sensorial characteristics (appearance, color, and taste) of juices, however, showed that people are more familiar with orange carrot products. © 2022 Society of Chemical Industry.

Children's experiences of meals after obesity treatment: a qualitative follow-up four years after a randomized controlled trial.

BACKGROUND: The practice of eating together, commensality, is rarely explored in the context of childhood obesity treatment. This is noteworthy given long-standing debates about the physical, psychosocial, and societal benefits of meals, especially family meals. Moreover, as children with obesity experience weight bias and stigma both within and outside the home, it is important to examine meals as a locus of social exchange around food and the body. Our study is based on the premises that eating together (i) matters and (ii) occurs in different environments with diverse social organization, where food-related interactions create varying arrangements of individuals, groups, their statuses, and their actions. METHOD: The study explores children's experiences of meals in different social contexts. Thirty-two children (age 8-10 years) living in Sweden were interviewed, 4 years after they entered an obesity intervention trial. Thematic analysis was applied to the data. RESULTS: We thematized three meal types, with each meal type having two subthemes: (i) "The family meal", with "Shared routines, rituals, and rules" and "Individual solutions and choices"; (ii) "The school meal", with "Rules and norms of the school" and "Strategies of the child"; and (iii) "The friend meal", with "Handling food that was disliked" and "Enjoyment of food". These three different meal types carried different experiences of and knowledge about how they were socially organized. CONCLUSIONS: While the children spoke about the family and school meals as meaningful, the friend meal stood out as particularly positive. Contrary to our expectations, the children did not express experiences of weight bias or obesity stigma around meals, nor did they speak negatively about parental control of their food intake. Our findings, especially regarding the friend meal, have implications for further research into commensality and social influences on eating among children with obesity, from early childhood into adolescence.

Associations of preschoolers' dietary patterns with eating behaviors and parental feeding practices at a 12-month follow-up of obesity treatment.

Although dietary patterns are key to the management of childhood obesity, they are rarely assessed and thus poorly understood. This study examines preschoolers' dietary patterns and correlates 12 months after the start of obesity treatment (n = 99, mean age 5.2 years, 52% girls). A food frequency questionnaire (FFQ), the Child Eating Behavior Questionnaire (CEBQ), Child Feeding Questionnaire (CFQ) and Lifestyle Behavior Checklist (LBC) were answered by parents to assess children's food intake, eating behaviors, parental feeding practices, and obesity-related behaviors, respectively. Principal component analysis identified dietary patterns based on FFQ data. Through multiple linear regressions we examined correlations between a healthy (HD) and a less healthy (LHD) dietary pattern and mean scores of the CEBQ, CFQ, LBC scales as well as BMI z-scores. The reported intake of items in the LHD decreased after treatment while no differences were found for the HD. Children's eating behaviors, in particular food fussiness, showed consistent associations with diet (b = -0.39, 95% CI -0.63, -0.14 for HD and b = 0.41, 95% CI 0.15, 0.66 for LHD). Feeding practices and obesity-related behaviours were weakly associated with the dietary patterns (HD and Monitoring: b = 0.36, 95% CI 0.09, 0.62; LHD and Screen time b = 0.08, 95% CI 0.01, 0.15). Among the measured variables, eating behaviors had the largest impact on children's dietary patterns. The LHD was associated with a higher BMI z-score but no associations were found between changes in LHD intake and changes in BMI z-scores. Our findings suggest that decreasing food fussiness in children with obesity is key to positive dietary changes. Assessment of children's eating behaviors can help tailor dietary advice and provide support for families of children with obesity.

Phytoprostanes, phytofurans, tocopherols, tocotrienols, carotenoids and free amino acids and biological potential of sea buckthorn juices.

BACKGROUND: Juices are currently a fast-growing segment in the fruit and vegetable industry sector. However, there are still no reports on the diversity of the phytochemical profile and health-promoting properties of commercial sea buckthorn (Hippophaë rhamnoides) juices. This study aimed to identify and quantify phytoprostanes, phytofurans by ultra high-performance liquid chromatography coupled with triple quadrupole mass spectrometry (UHPLC-QqQ-MS/MS), tocopherols, tocotrienols by ultra-performance liquid chromatography coupled with a fluorescence detector (UPLC-FL), carotenoids, and free amino acids by ultra-performance liquid chromatography coupled with a photodiode detector-quadrupole and tandem time-of-flight mass spectrometry (UPLC-PDA-Q/TOF-MS), and assess their anti-cholinergic, anti-diabetic, anti-obesity, anti-inflammatory, and antioxidant potential by in vitro assays of commercial sea buckthorn juices. RESULTS: Phytoprostanes (PhytoPs) and phytofurans (PhytoFs) in sea buckthorn juices were identified for the first time. Juices contained eight F1 -, D1 -, B1 - and L1 -phytoprostanes and one phytofuran (32.31-1523.51 ng and up to 101.47 µg/100 g dry weight (DW)), four tocopherol congeners (22.23-94.08 mg 100 g-1 DW) and three tocotrienols (5.93-25.34 mg 100 g-1 DW). Eighteen carotenoids were identified, including ten xanthophylls, seven carotenes and phytofluene, at a concentration of 133.65 to 839.89 mg 100 g-1 DW. Among the 20 amino acids (175.92-1822.60 mg 100 g-1 DW), asparagine was dominant, and essential and conditionally essential amino acids constituted 11 to 41% of the total. The anti-enzyme and antioxidant potential of juices correlated selectively with the composition. CONCLUSION: Sea buckthorn juice can be a valuable dietary source of vitamins E and A, oxylipins and amino acids, used in the prevention of metabolic syndrome, inflammation, and neurodegenerative processes. The differentiation of the composition and the bioactive potential of commercial juices indicate that, for the consumer, it should be important to choose juices from the declared berry cultivars and crops. © 2021 Society of Chemical Industry.

Childhood memories of food and eating in lower-income families in the United States: a qualitative study.

BACKGROUND: Childhood obesity prevention initiatives emphasize healthy eating within the family. However, family-focused initiatives may not benefit children whose families lack economic and/or social resources for home cooking and shared meals. The aim of this paper is to examine how adults talk about and make sense of childhood memories of food and eating, with particular attention to understandings of family life and socioeconomic conditions. METHODS: Semi-structured interviews with 49 adults in 16 families (22 parents and 27 grandparents of young children) were conducted in Oregon, United States. Most participants had experienced socioeconomically disadvantaged childhoods. The interviews were analyzed using thematic analysis, with a focus on the participants' memories of food provision, preparation, and consumption in their childhood homes. RESULTS: Two main themes were developed: (1) "Food and cohesion", with the subthemes "Care and nurturance" and "Virtue transmission through shared meals", and (2) "Food and adversity", with the subthemes "Lack and neglect" and "Restriction and dominance". The first theme captures idealized notions of food in the family, with participants recounting memories of care, nurturance, and culinary pleasure. The second theme captures how participants' recollections of neglectful or rigidly restrictive feeding, as well as food discipline tipping over into dominance, upend such idealized images. Notably, the participants alternately identified poverty as a source of lack and as an instigator of creative and caring, if not always nutritionally-ideal, feeding. Thus, they remembered food they deemed unhealthy as a symbol of both neglect and care, depending on the context in which it was provided. CONCLUSIONS: Childhood memories of food and eating may express both family cohesion and family adversity, and are deeply affected by experiences of socioeconomic disadvantage. The connection between memories of food the participants deemed unhealthy and memories of care suggests that, in the context of socioeconomic disadvantage, unhealthy feeding and eating may become a form of caregiving, with nutrition considered only one aspect of well-being. This has implications for public health initiatives directed at lower-income families.

Evaluation of Innovative Dried Purée from Jerusalem Artichoke-In Vitro Studies of Its Physicochemical and Health-Promoting Properties.

The present study aimed to evaluate the effect of Jerusalem artichoke processing methods and drying methods (freeze drying, sublimation drying, vacuum drying) on the basic physicochemical parameters, profiles and contents of sugars and polyphenolic compounds, and health-promoting properties (antioxidant activity, inhibition of the activities of α-amylase, α-glucosidase, and pancreatic lipase) of the produced purée. A total of 25 polyphenolic compounds belonging to hydroxycinnamic phenolic acids (LC-PDA-MS-QTof) were detected in Jerusalem artichoke purée. Their average content in the raw material was at 820 mg/100 g dm (UPLC-PDA-FL) and was 2.7 times higher than in the cooked material. The chemical composition and the health-promoting value of the purées were affected by the drying method, with the most beneficial values of the evaluated parameters obtained upon freeze drying. Vacuum drying could offer an alternative to freeze drying, as both methods ensured relatively comparable values of the assessed parameters.

Effect of Inoculated Lactic Acid Fermentation on the Fermentable Saccharides and Polyols, Polyphenols and Antioxidant Activity Changes in Wheat Sourdough.

Inoculation of sourdough allows the fermentation medium to be dominated by desired microorganisms, which enables determining the kinetics of the conversion of chemical compounds by individual microorganisms. This knowledge may allow the design of functional food products with health features dedicated to consumers with special needs. The aim of the study was to assess the dynamics of transformations of fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) compounds from wheat flour as well as their antioxidant activity during inoculated and spontaneous sourdough fermentation. The FODMAP content in grain products was determined by the fructan content with negligible amounts of sugars and polyols. To produce a low-FODMAP cereal product, the fermentation time is essential. The 72 h fermentation time of L. plantarum-inoculated sourdough reduced the FODMAP content by 91%. The sourdough fermentation time of at least 72 h also positively influenced the content of polyphenols and antioxidant activity, regardless of the type of fermentation. The inoculation of both L. plantarum and L. casei contributed to a similar degree to the reduction in FODMAP in sourdough compared to spontaneous fermentation.

Microalgae as a Potential Functional Ingredient: Evaluation of the Phytochemical Profile, Antioxidant Activity and In-Vitro Enzymatic Inhibitory Effect of Different Species.

The functional food market has been in a state of constant expansion due to the increasing awareness of the impact of the diet on human health. In the search for new natural resources that could act as a functional ingredient for the food industry, microalgae represent a promising alternative, considering their high nutritional value and biosynthesis of numerous bioactive compounds with reported biological properties. In the present work, the phytochemical profile, antioxidant activity, and enzymatic inhibitory effect aiming at different metabolic disorders (Alzheimer's disease, Type 2 diabetes, and obesity) were evaluated for the species Porphyridium purpureum, Chlorella vulgaris, Arthorspira platensis, and Nannochloropsis oculata. All the species presented bioactive diversity and important antioxidant activity, demonstrating the potential to be used as functional ingredients. Particularly, P. purpureum and N. oculata exhibited higher carotenoid and polyphenol content, which was reflected in their superior biological effects. Moreover, the species P. purpureum exhibited remarkable enzymatic inhibition for all the analyses.

Inhibition of enzymes associated with metabolic and neurological disorder by dried pomegranate sheets as a function of pomegranate cultivar and fruit puree.

BACKGROUND: Obesity and type 2 diabetes mellitus are the most extended current chronic diseases and also Alzheimer pathology which is a progressive degenerative neurological disorder. Therefore, finding effective enzyme inhibitors responsible for the development of these diseases are essential. Therefore, the aim of this study was to investigate the impact of fruit purée (Cydonia oblonga, Ziziphus jujube and Malus domestica) and pomegranate juice cultivar ('Mollar de Elche' and 'Wonderful') of dried pomegranate sheets (DS) on the inhibition of enzymes associated with metabolic (α-amylase, α-glucosidase, and pancreatic lipase activity), and neurological disorder (acetylcholinesterase and butyrylcholinesterase activity). Quality properties (colour coordinates, texture properties and sensory characteristics) of DS were also studied. In addition, it was researched the effect of storage conditions (4 months at 4 and 20 °C) on phenolic content. RESULTS: DS from jujube had the highest antioxidant capacity and were characterized by the highest storage stability with respect to phenolic compounds. The α-amylase and α-glucosidase half maximal inhibitory concentration (IC50 , in mg mL-1 ) inhibition of DS ranged from 107 to 216 and from 55.2 to values indicating no effect, respectively. The inhibition toward pancreatic lipase (IC50 < 5 mg mL-1 ), acetylcholinesterase (ranged 9.15-22.2%) and butyrylcholinesterase (ranged 20.6-48.6%) was increased with the presence of total flavonoids and hydroxycinnamic acids content (identifying mainly in DS from quinces). It is noteworthy that none of the samples presented off-flavour notes, supporting the high quality of the products. CONCLUSION: DS can be an innovative supplement to a diet as a snack used in the prevention of neurological changes and disorders of carbohydrate and lipid metabolism. © 2020 Society of Chemical Industry.

Epidemiological Analysis of the First 1389 Cases of COVID-19 in Poland: A Preliminary Report.

BACKGROUND The World Health Organization has declared COVID-19 a global pandemic. This paper presents an epidemiological analysis of the first phase of the COVID-19 epidemic in Poland. MATERIAL AND METHODS This cross-sectional study was carried out between 3 and 27 March 2020 on a sample of 1389 laboratory-confirmed COVID-19 cases in Poland. Data were obtained from epidemiological reports collected by the Chief Sanitary Inspectorate. Analysis includes the number of COVID-19 cases, number of deaths, number of hospitalizations, number of people quarantined, and number of laboratory tests performed. RESULTS The first case was confirmed on 4 March 2020. Over 24 days after the first case, the total number of confirmed infections rose to 1389 (34,000 laboratory tests were performed). The highest incidence rates (over 5 per 100,000) were observed in the 2 central administrative regions (Mazowieckie and Lódzkie) and in the south-western region of Dolnoslaskie, which borders the Czech Republic and Germany. Based on available data about age and sex, a clearly higher incidence was observed in the 20-29 years (4.0 per 100,000), 40-49 years (4.1 per 100,000), and 50-59 years (4.3 per 100,000) age groups. In the period analyzed (24 days), there were 16 confirmed deaths (average age 65.5 years; 81.2% males). CONCLUSIONS The proportion of women and men with confirmed COVID-19 infection was similar to the sex ratio in the general population. Infections were relatively less common in those aged under 20 years. The largest numbers of confirmed cases were detected in 3 of the 4 largest cities, each of which has an international airport.

Changes in parental feeding practices and preschoolers' food intake following a randomized controlled childhood obesity trial.

Childhood obesity treatment involving parents is most effective during the preschool age. However, the mechanisms of change are not known. The present study reports on secondary outcomes (changes in parental feeding practices and child food intake) of early obesity treatment. The More and Less study is a randomized controlled trial conducted in Stockholm County, Sweden. Children with obesity (n = 174, mean BMI SDS 3.0, mean age 5 years, 56% girls) and their parents (60% with foreign background, 40% with a university degree) were randomized to: 1) standard treatment focusing on lifestyle recommendations (ST), 2) a parent support program with boosters (PGB), and 3) a parent support program without boosters (PGNB). The Child Feeding Questionnaire (CFQ) was used to measure parental feeding practices. Child food intake was assessed with a Food Frequency Questionnaire (FFQ). We calculated the monthly changes in CFQ practices and FFQ items based on four measurements. We did not find any significant between-group differences in parental feeding practices and child food intake over time. However, general linear models showed that changes in certain feeding practices predicted changes in child food intake. When ST was compared to the parent support groups, some associations moved in opposite directions. For example, increasing maternal restriction predicted increased consumption of cookies/buns in PGNB (b = 2.3, p < 0.05) and decreased consumption of cookies/buns in ST (b = -2.1, p < 0.05). This is among the few studies to examine the effect of parental feeding practices on child food intake and weight status after obesity treatment among preschoolers. We found no evidence that changes in feeding practices or changes in child food intake mediated child weight loss. Future studies should consider other intermediary processes related to general parenting practices and parent-child interactions.