A Narrative Review on Strategies for the Reversion of Prediabetes to Normoglycemia: Food Pyramid, Physical Activity, and Self-Monitoring Innovative Glucose Devices.

In 2019, "Nutrition Therapy for Adults with Diabetes or Prediabetes: A Consensus Report" was published. This consensus report, however, did not provide an easy way to illustrate to subjects with prediabetes (SwPs) how to follow a correct dietary approach. The purpose of this review is to evaluate current evidence on optimum dietary treatment of SwPs and to provide a food pyramid for this population. The pyramid built shows that everyday consumption should consist of: whole-grain bread or potatoes eaten with their skins (for fiber and magnesium) and low glycemic index carbohydrates (GI < 55%) (three portions); fruit and vegetables (5 portions), in particular, green leafy vegetables (for fiber, magnesium, and polyphenols); EVO oil (almost 8 g); nuts (30 g, in particular, pistachios and almonds); three portions of dairy products (milk/yogurt: 300-400 g/day); mineral water (almost 1, 5 L/day for calcium intake); one glass of wine (125 mL); and three cups of coffee. Weekly portions should include fish (four portions), white meat (two portions), protein plant-based food (four portions), eggs (egg portions), and red/processed meats (once/week). At the top of the pyramid, there are two pennants: a green one means that SwPs need some personalized supplementation (if daily requirements cannot be satisfied through diet, vitamin D, omega-3, and vitamin B supplements), and a red one means there are some foods and factors that are banned (simple sugar, refined carbohydrates, and a sedentary lifestyle). Three to four times a week of aerobic and resistance exercises must be performed for 30-40 min. Finally, self-monitoring innovative salivary glucose devices could contribute to the reversion of prediabetes to normoglycemia.

The Glycemic Index of Indica and Japonica Subspecies Parboiled Rice Grown in Italy and the Effect on Glycemic Index of Different Parboiling Processes.

Rice is generally considered a high-glycemic index (GI) food, but numerous studies show that parboiling reduces the GI. There are no studies on GI of Indica and Japonica subspecies parboiled rice grown in Italy. The aim of this study was (1) to evaluate GI in different varieties of parboiled rice (ribe, white and brown long B, basmati, black, red, roma, and arborio); (2) to evaluate GI of same variety of rice subjected to different rice parboiling processes (parboiled ribe and parboiled long B with two different methods: flora and conventional method); (3) to evaluate GI of two by-products of parboiled rice: white and brown rice cake. Participants were 10 healthy individuals (20-30 years old, body mass index 18.5-25 kg/m2). Proximate composition and GI were determined by using standard methods. All parboiled rice assessed is low-GI (brown long B 48.1 ± 6.4 by flora method, ribe 52.0 ± 1.8 GI by flora method, black rice 52.3 ± 7.6 by flora method, long B 52.4 ± 3.9 by flora method, long B 53.4 ± 5.1 by conventional method, ribe 54.4 ± 4.3 GI by conventional method, Roma 54.4 ± 7.9 GI by flora method, and arborio 54.4 ± 7.9 GI by flora method), except red rice that is of medium-GI (56.1 ± 7.0 GI), and both classic and brown cakes that are high-GI (respectively, 83.3 ± 8.9 GI and 102.2 ± 5.5 GI). Parboiled rice is low-GI and so is favorable for the dietary management of metabolic disorders and celiac disease. Clinicaltrials.gov (NCT05333081).

A food pyramid for adult patients with phenylketonuria and a systematic review on the current evidences regarding the optimal dietary treatment of adult patients with PKU.

Early dietary treatment is mind-saving in patients with phenylketonuria. A "diet-for-life" is advocated, aimed to prevent effects of chronic exposure to hyperphenylalaninemia. While adherence to diet is significant during childhood as patients are followed-up at specialized metabolic centers, during adolescence and adulthood percentage of patients discontinuing diet and/or lost at follow-up is still high. The process of passing skills and responsibilities from pediatric team to adult team is defined "transition". The goal of transition clinics is to set up specific multidisciplinary care pathways and guarantee continuity of care and compliance of patients to care. In 2017, "The complete European guidelines on phenylketonuria" were published. These guidelines, however, do not provide an easy way to illustrate to adult patients how to follow correct dietary approach. The purpose of this review is to evaluate current evidence on optimum dietary treatment of adults with phenylketonuria and to provide food pyramid for this population. The pyramid built shows that carbohydrates should be consumed every day (3 portions), together with fruits and vegetables (5 portions), extra virgin olive oil, and calcium water (almost 1 L/day); weekly portions can include 150 g potatoes walnuts and hazelnuts (20 g). At top of pyramid, there are two pennants. The green means that, based on individual metabolic phenotype and daily phenylalanine tolerance, patients need personalized supplementation (specific phenylalanine free amino acid mixtures, vitamins and omega 3 fatty acids); the one red indicates foods that are banned from diet (aspartame and protein foods exceeding individual dietary phenylalanine tolerance).

Vitamin D from UV-Irradiated Mushrooms as a Way for Vitamin D Supplementation: A Systematic Review on Classic and Nonclassic Effects in Human and Animal Models.

Recent literature has shown that vitamin D, in addition to its well-known activity on the skeleton, has many positive effects on health. Unfortunately, it is not easy to meet intake needs solely with food. Mushrooms could provide a valid way to achieve this goal, because they are one of the few sources of vitamin D. The aim of this systematic review was to summarize what has been reported in the literature on the treatment of animal and human models with irradiated commercial mushrooms, with particular attention paid to the effects on clinical outcomes associated with the classical and nonclassical vitamin D functions. A total of 18 articles were selected. Six studies were conducted on human samples, while twelve were focused on animal models. The six studies conducted in humans involved a large number of subjects (663), but the treatment period was relatively short (1-6 months). Furthermore, the treatment dosage was different in the various groups (600-3800 IU/day). Probably for this reason, the studies did not demonstrate clinical efficacy on the parameters evaluated (cognitive functions, muscle system/function, metabolic syndrome). Indeed, those studies demonstrated an efficacy in increasing the blood levels of 25(OH)D2, but not in increasing the levels of 25(OH)D total. In 9 of 12 studies conducted on the animal model, however, a clinical efficacy on bone metabolism, inflammation, and cognitive performance was demonstrated. The results of this systematic review indicate that the intake of vitamin D from irradiated mushrooms could possibly help to meet vitamin D needs, but the dosage and the time of treatment tested need to be evaluated. Therefore, studies conducted in humans for longer periods than the studies carried out up to now are necessary, with defined dosages, in order to also evaluate the clinical efficacy demonstrated in animal models both for the classical (bone metabolism) and nonclassical (muscle function, cognitive performance, anti-inflammatory, and antioxidant activities) effects of vitamin D.

Nutrition, Physical Activity, and Dietary Supplementation to Prevent Bone Mineral Density Loss: A Food Pyramid.

Bone is a nutritionally modulated tissue. Given this background, aim of this review is to evaluate the latest data regarding ideal dietary approach in order to reduce bone mineral density loss and to construct a food pyramid that allows osteopenia/osteoporosis patients to easily figure out what to eat. The pyramid shows that carbohydrates should be consumed every day (3 portions of whole grains), together with fruits and vegetables (5 portions; orange-colored fruits and vegetables and green leafy vegetables are to be preferred), light yogurt (125 mL), skim milk (200 mL,) extra virgin olive oil (almost 20 mg/day), and calcium water (almost 1 l/day); weekly portions should include fish (4 portions), white meat (3 portions), legumes (2 portions), eggs (2 portions), cheeses (2 portions), and red or processed meats (once/week). At the top of the pyramid, there are two pennants: one green means that osteopenia/osteoporosis subjects need some personalized supplementation (if daily requirements cannot be satisfied through diet, calcium, vitamin D, boron, omega 3, and isoflavones supplementation could be an effective strategy with a great benefit/cost ratio), and one red means that there are some foods that are banned (salt, sugar, inorganic phosphate additives). Finally, three to four times per week of 30-40 min of aerobic and resistance exercises must be performed.

Efficacy of gummy lozenges containing Erysimum as ancillary treatment in children with sore throat.

BACKGROUND: Sore throat frequently occurs in children aged between four and fifteen years and is often associated to inflammation of the upper respiratory tract mucosa. A reliable approach to limit the damage caused by inflammation and, therefore, to alleviate associated symptoms might be the protection of the mucosa. Aim of this study was to assess the efficacy and tolerability of a medical device, formulated as a gummy lozenge and containing a combination of natural functional components (Erysimum, aloe vera and Xilogel®) able to exert a barrier effect on the mucosa, as ancillary treatment in children with sore throat. METHODS: This was an observational, prospective, parallel-group, multiple-dose trial of a medical device given in association to standard pharmacological prescribed therapy with an open label comparison vs. standard pharmacological prescribed therapy alone. The outcome measures of the study were assessed at baseline and after three days of treatment. RESULTS: One hundred and twelve school children with sore throat symptoms were recruited for this study and 69 were assigned to the group taking the study product. At the end of the treatment a statistically higher reduction in Sore Throat Pain Intensity Score and Pharyngitis Symptom Score was observed in the group taking the medical device. Moreover, the treatment with the medical device is associated to a statistically significant higher improvement of Child's General Conditions. The pediatrician assessed the efficacy and tolerability of the product under study as good/very good in 91% and 94%, respectively, of treated children. The consumer satisfaction questionnaire revealed that most of the children taking the lozenge rated it very positively in regard to its flavor and easiness of administration. CONCLUSIONS: The medical device used in this study may represent a valid choice as an adjuvant treatment in children with sore throat associated to upper respiratory tract infection.

Polysaccharides from by-products of the Wonderful and Laffan pomegranate varieties: New insight into extraction and characterization.

The main crude polysaccharides (CPS), extracted from two widely cultivated pomegranate varieties, Laffan and Wonderful, were studied and characterized. We obtained the highest CPS extraction yield (approximatively 10% w/w on dried matter) by 1h of decoction (ratio 1/40w/v). The predominant polymers (75-80%) of the CPS samples showed a hydrodynamic volume close to 2000kDa by size exclusion chromatography and the exocarp and mesocarp profiles were very similar. The proton spectra (1H NMR), according to sugar composition and gelling ability, confirmed the main polysaccharide fractions were pectin with different acylation and methylation degree. The CPS from Laffan and Wonderful mesocarp showed prebiotic properties in vitro with Lactobacillus and Bifidobacterium strains. The composition of the decoction (12% ellagitannins and 10% of CPS) obtained by a green extraction process of pomegranate by-products, makes it a suitable component of functional food formulations.