Quality of life and nutritional status of a group of post-operative head and neck cancer patients.

Introduction: Introduction: scientific evidence on the appropriate nutritional support in the treatment of post-operative head and neck cancer (HNC) patients is still limited. Objectives: our aim was to evaluate nutritional status and quality of life in HNC patients in post-operative phase with different nutritional support. Methods: fifty-four HNC patients (26 with enteral nutrition [EN] via percutaneous endoscopic gastrostomy [PEG] and 28 with oral nutrition [ON]) were included. Nutritional status was evaluated with biochemical parameters and quality of life through the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Results: ON patients reported significantly (p < 0.05) lower levels of hemoglobin, lymphocytes, iron, folic acid, and vitamin D than EN patients, with greater percentage of ON patients found to be below the reference limits for hemoglobin (21.4 % vs 19.4 %), and significantly for serum iron (17.9 % vs 0 %) and vitamin D (78.6 % vs 30.8 %). Furthermore, EN patients had a better quality of life (63.8 ± 17.6) than ON (55.4 ± 20.3), although ON patients reported less symptoms related to dyspnea (-5.8 %), loss of appetite (-11.3 %) and vomiting (-23.1 %). Conclusions: these results suggest that the use of EN in post-operative HNC patients could have a positive effect on the nutritional status and quality of life of these patients. However, further research is needed to optimize the nutritional support in these patients in order to avoid malnutrition and improve their well-being.

Introducción: Introducción: la evidencia científica sobre el soporte nutricional más apropiado en pacientes con cáncer de cabeza y cuello (CCC) en el periodo postoperatorio es aún limitada. Objetivos: el objetivo de este estudio fue evaluar el estado nutricional y la calidad de vida en pacientes con CCC en el periodo postoperatorio. Métodos: se incluyeron 54 pacientes con CCC (26 con nutrición enteral [NE] mediante gastrostomía endoscópica percutánea [PEG] y 28 con nutrición oral NO]). El estado nutricional se evaluó mediante parámetros bioquímicos y la calidad de la vida, con el cuestionario European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Resultados: los pacientes con NO reportaron valores significativamente (p < 0,05) menores de hemoglobina, linfocitos, hierro sérico, ácido fólico y vitamina D respecto a los pacientes con NE, con un mayor porcentaje de pacientes con NO por debajo de los límites de referencia de hemoglobina (21,4 % vs. 19,4 %) y significativamente de hierro sérico (17,9 % vs. 0 %) y vitamina D (78,6 % vs. 30,8 %). Además, los pacientes con NE reportaron una mejor calidad de vida (63,8 ± 17,6) respecto los pacientes con NO (55,4 ± 20,3), aunque los pacientes con NO refirieron menos síntomas cómo disnea (-5,8 %), pérdida de apetito (-11,3 %) y vómitos (-23,1 %). Conclusión: estos resultados sugieren que el uso de NE en pacientes con HNC tras cirugía podría tener un efecto positivo sobre su estado nutricional y su calidad de vida. Sin embargo, es necesario seguir investigando para optimizar el soporte nutricional en estos pacientes a fin de evitar la desnutrición y mejorar su bienestar.

Effects of vegetarian versus Mediterranean diet on kidney function: Findings from the CARDIVEG study.

BACKGROUND: The aim of the present study was to assess the effects of a lacto-ovo-vegetarian diet (VD), compared to a Mediterranean diet (MD), on kidney function in a group of subjects with medium-to-low cardiovascular risk profile. METHODS: We analysed 107 subjects (82 women, 25 men; median age 52) who followed a VD (n = 54) and a MD (n = 53) for 3 months in the CARDIVEG study, a randomized, open, crossover trial that compared the effects of these 2 diets on cardiovascular disease risk. RESULTS: The effect of the two diets on kidney function markers was evaluated by conducting a general linear model for repeated measurements adjusted for possible confounding factors such as age, sex, physical activity, alcohol, smoking, hypertension, LDL cholesterol, glucose and body weight change. A significant reduction in creatinine (-5.3%; P < .001), urea nitrogen levels (-9%; P = .001), blood urea nitrogen (BUN) (-8.7%; P = .001) and BUN/creatinine ratio (-5.8%; P < .001), and an increase in estimated glomerular filtration rate (eGFR) (+3.5%; P = .001) was observed during the VD period. On the contrary, no significant changes were noted in the MD group. Variations obtained in the two dietary interventions were significantly different (P < .0001) for creatinine levels, BUN/creatinine and eGFR, for which opposite trends were observed in the VD and MD groups. CONCLUSIONS: In a selected group of subjects with medium-to-low cardiovascular risk profile, a 3 month VD period determined significant improvements in kidney function markers. Further trials are needed to confirm these results.

Effect of consumption of ancient grain bread leavened with sourdough or with baker's yeast on cardio-metabolic risk parameters: a dietary intervention trial.

The aim of this study was to compare the effect of consumption of ancient grain "Verna" bread obtained by two different leavening agents, sourdough (SD) and baker's yeast (BY), on inflammatory parameters and cardiometabolic risk factors. Seventeen clinically healthy subjects were included to consume SD or BY bread for 4 weeks each, and blood analyses were carried out. The consumption of "Verna" bread obtained with both leavening agents led to a significant improvement of LDL cholesterol. A reduction of -10.6% and -8.53% was observed after replacement with SD and BY bread, respectively. A significant increase in fasting blood glucose (+6%) was observed only after the intervention with BY bread. A 10.7% decrease of vascular endothelial growth factor was found after the SD bread replacement period. The consumption of "Verna" bread resulted significantly associated with an improvement in the cardiometabolic and inflammatory profile. However, only consumption of BY bread determined a significant increase in blood glucose levels.

Nutritional Interventions in the Management of Fibromyalgia Syndrome.

Fibromyalgia (FM) is a multifactorial syndrome of unknown etiology, characterized by widespread chronic pain and various somatic and psychological manifestations. The management of FM requires a multidisciplinary approach combining both pharmacological and nonpharmacological strategies. Among nonpharmacological strategies, growing evidence suggests a potential beneficial role for nutrition. This review summarizes the possible relationship between FM and nutrition, exploring the available evidence on the effect of dietary supplements and dietary interventions in these patients. Analysis of the literature has shown that the role of dietary supplements remains controversial, although clinical trials with vitamin D, magnesium, iron and probiotics' supplementation show promising results. With regard to dietary interventions, the administration of olive oil, the replacement diet with ancient grains, low-calorie diets, the low FODMAPs diet, the gluten-free diet, the monosodium glutamate and aspartame-free diet, vegetarian diets as well as the Mediterranean diet all appear to be effective in reducing the FM symptoms. These results may suggest that weight loss, together with the psychosomatic component of the disease, should be taken into account. Therefore, although dietary aspects appear to be a promising complementary approach to the treatment of FM, further research is needed to provide the most effective strategies for the management of FM.

A Khorasan Wheat-Based Replacement Diet Improves Risk Profile of Patients With Nonalcoholic Fatty Liver Disease (NAFLD): A Randomized Clinical Trial.

OBJECTIVE: KAMUT khorasan is an ancient grain with widely acclaimed health benefits. The aim of this study was to investigate the effects of a replacement diet with ancient khorasan wheat products in patients with NAFLD, in comparison to a similar replacement diet with control products made from organic semi-whole-grain modern wheat. METHODS: Forty NAFLD patients (12 M/28 F; age 55.2 ± 10.4 years) with mild to moderate liver steatosis were included. The experimental design was a randomized, double-blind, parallel-arm study with 20 participants assigned to consume either KAMUT khorasan or control wheat products (pasta, bread, crackers, biscuits) over a 3-month period. Anthropometric measurements, blood analyses, and ultrasonography examination were performed at both the beginning and end of each dietary intervention. RESULTS: After the implementation of a general linear model for repeated measurements adjusted for baseline demographic details, risk factors, and medication, alanine aminotransferase (ALT) was significantly reduced by 12%, aspartate aminotransferase (AST) by 14%, alkaline phosphatase (ALP) by 8%, and cholesterol by 6% only in the khorasan group (p < 0.05 for all). Similarly, significant reductions in circulating proinflammatory tumor necrosis factor-alpha by 50%, interleukin l-receptor antagonist-alpha by 37%, interleukin-8 by 24%, and interferon gamma by 24% were evident only in participants who consumed the khorasan products (p < 0.05 for all). Finally, significant improvements in the liver steatosis grading, Doppler perfusion index values, and reactive oxygen species (ROS) production were evident after consumption of both the khorasan and control products. CONCLUSIONS: This study suggests that a short-term replacement diet with ancient KAMUT khorasan products is most effective in reducing metabolic risk factors and ameliorating the liver profile in patients with NAFLD.

Ligation of the saphenofemoral junction tributaries as risk factor for groin recurrence.

OBJECTIVE: The aim of this study was to compare the recurrence rate after high ties performed with or without sparing of the saphenofemoral junction tributaries. METHODS: There were 867 lower limbs enrolled. All patients underwent a high tie with (group A) or without (group B) ligation of all the junctional tributaries for a great saphenous vein reflux (C2-5EpAsPr). A duplex ultrasound examination detected recurrences. RESULTS: Median follow-up was 5 years (interquartile range, 3-8 years). Group A had a higher recurrence rate than group B (odds ratio, 7.52; P < .001). Group A recurrences (7.4%), compared with group B (1.1%), presented with a more frequent direct stump reconnection (3.7% vs 0.2%; P < .001) or newly developed pelvic shunts (3% vs 0.5%; P < .001). No significant difference was reported between the two groups in newly incompetent perforating veins. CONCLUSIONS: Ligation of the junctional tributaries is associated with a higher recurrence risk. Further investigations are needed to determine the hemodynamic role of each single junctional tributary.

Effects of a 1-year dietary intervention with n-3 polyunsaturated fatty acid-enriched olive oil on non-alcoholic fatty liver disease patients: a preliminary study.

BACKGROUND AND AIMS: Non-alcoholic fatty liver disease (NAFLD) is a worldwide diffuse condition due to alimentary, environment and genetic factors. The aim of our preliminary study was to evaluate the effectiveness of long-term consumption of food enriched with n-3 polyunsaturated fatty acids (PUFA) in patients with NAFLD. METHODS: Eleven patients were enrolled; six (four males, two females) were planned for oral administration of 6.5 ml olive oil enriched with n-3 PUFA for 12 months, while five (four males, one female) were used as controls. RESULTS: Consumption of olive oil enriched with n-3 PUFA demonstrated a significant improvement of liver echo-texture and of the Doppler Perfusion Index after 12 months (after: 0.19 ± 0.02 vs. pre: 0.15 ± 0.03; P < 0.05), whereas no significant changes were seen at the end of follow-up in controls. Moreover, patients who consumed the olive oil enriched with n-3 PUFA showed a significant amelioration of liver enzymes, and of triglycerides (post: 132.8 ± 63.7 vs. pre: 164.5 ± 85.5 mg/dl; P = 0.04) in a general linear model adjusted for age and gender. Interestingly, patients reported to have a significant increase of adiponectin levels (post: 1,487.9 ± 96.7 vs. pre: 1,143 ± 24.8 µg/ml; P = 0.04). CONCLUSION: The results of this preliminary study showed that long-term consumption of olive oil enriched with n-3 PUFA in patients with NAFLD is able to decrease circulating liver enzymes and triglycerides, with a significant improvement of adiponectin levels.