Micronutrients Dietary Supplementation Advices for Celiac Patients on Long-Term Gluten-Free Diet with Good Compliance: A Review.

Background and objective: Often micronutrient deficiencies cannot be detected when patient is already following a long-term gluten-free diet with good compliance (LTGFDWGC). The aim of this narrative review is to evaluate the most recent literature that considers blood micronutrient deficiencies in LTGFDWGC subjects, in order to prepare dietary supplementation advice (DSA). Materials and methods: A research strategy was planned on PubMed by defining the following keywords: celiac disease, vitamin B12, iron, folic acid, and vitamin D. Results: This review included 73 studies. The few studies on micronutrient circulating levels in long-term gluten-free diet (LTGFD) patients over 2 years with good compliance demonstrated that deficiency was detected in up to: 30% of subjects for vitamin B12 (DSA: 1000 mcg/day until level is normal, then 500 mcg), 40% for iron (325 mg/day), 20% for folic acid (1 mg/day for 3 months, followed by 400-800 mcg/day), 25% for vitamin D (1000 UI/day or more-based serum level or 50,000 UI/week if level is <20 ng/mL), 40% for zinc (25-40 mg/day), 3.6% of children for calcium (1000-1500 mg/day), 20% for magnesium (200-300 mg/day); no data is available in adults for magnesium. Conclusions: If integration with diet is not enough, starting with supplements may be the correct way, after evaluating the initial blood level to determine the right dosage of supplementation.

Silicon: A neglected micronutrient essential for bone health.

Bone matrix is predominantly made up of collagen, and in vitro and in animal models studies have shown that silicon is linked to glycosaminoglycans and plays an important role in the formation of cross-links between collagen and proteoglycans, determining the beneficial effects on strength, composition, and mechanical properties of bone. However, there are still no precise indications regarding a possible role of silicon on bone health in humans. Given this background, the aim of this narrative review was to consider the effectiveness of silicon dietary intake and silicon dietary supplementation (alone or with other micronutrients), in order to suggest a daily dosage of Si supplementation, on bone mineral density in humans. This review included eight eligible studies: four regarding dietary intake and four considering supplementation with silicon alone or with other nutrients. Despite the number of studies considered being low, the number of subjects studied is high (10012) and the results are interesting. Although to date the available scientific evidences are not considered valid enough to allow to establish an adequate level of Silicon intake, based on extrapolations from the data obtained with studies on animal and human models, it has been suggested that an adequate intake in order to promote beneficial effects for bone could be considered to be around 25 mg silicon/day. As for silicon dietary supplements, it has been shown that the combined treatment with orthosilicic acid (6 mg), calcium, and vitamin D has a potentially beneficial effect on femoral BMD compared to only use of calcium and vitamin D.

A favorable effect on nutritional status of 12-week tailored texture-modified sous-vide cooking meals in institutionalized elderly women with oropharyngeal dysphagia: an intervention study.

BACKGROUND: Dysphagic patients are not always able to meet their energy, micro and macronutrients needs for various causes and therefore are at high risk of malnutrition. The aim of the present study was to evaluate the effectiveness on satisfaction of the meal (by a 10-cm visuo-analogical scale), food intake (by visual estimation of food waste), nutritional status (anthropometric measures, mini nutritional assessment [MNA], vitamin D, B12, folic acid), functional (handgrip) and blood chemistry metabolic parameters of a tailored texture-modified sous-vide cooking meals (TTMSVC), well balanced in macro and micronutrients, in elderly women suffering from oropharyngeal dysphagia at long-term care facilities. METHODS: A 12-week intervention study was conducted on female elderly subjects affected by oropharyngeal dysphagia of level 3-5. The treated group received TTMSVC with the consistencies standardized using viscosimeter (5000-10000 mP/s). The control group maintained pureed hospital diet. RESULTS: 50 subjects, 25 in treatment group and 25 in control group, with mean±SD age 89.12±4.18 and mini mental state examination (MMSE) 20.58±1.63 were enrolled. The treatment and control groups were similar at baseline. The changes over time between the two groups showed significant differences for food intake, meal appreciation, Body Mass Index (BMI), calf circumference, arm circumference, MNA, prealbumin, albumin, folic acid, vitamin D, ionized calcium, C-Reactive Protein (CRP), Tumor Necrosis Factor (TNF-α), handgrip. Significant positive correlations were observed in the treatment group between the meal appreciation and prealbumin and vitamin D. CONCLUSIONS: This study demonstrated that elderly dysphagic women at long-term care facilities can eat better and increase nutritional status by eating 12-week tailored appealing TTMSVC.

A food pyramid, based on a review of the emerging literature, for subjects with inflammatory bowel disease.

Emerging literature suggests that diet plays an important modulatory role in inflammatory bowel disease (IBD) through the management of inflammation and oxidative stress. The aim of this narrative review is to evaluate the evidence collected up till now regarding optimum diet therapy for IBD and to design a food pyramid for these patients. The pyramid shows that carbohydrates should be consumed every day (3 portions), together with tolerated fruits and vegetables (5 portions), yogurt (125ml), and extra virgin olive oil; weekly, fish (4 portions), white meat (3 portions), eggs (3 portions), pureed legumes (2 portions), seasoned cheeses (2 portions), and red or processed meats (once a week). At the top of the pyramid, there are two pennants: the red one means that subjects with IBD need some personalized supplementation and the black one means that there are some foods that are banned. The food pyramid makes it easier for patients to decide what they should eat.

Effect of Polyglucosamine on Weight Loss and Metabolic Parameters in Overweight and Obesity: A Systemic Review and Meta-Analysis.

The use of dietary supplements for weight loss has gained significant momentum. Polyglucosamine, a chitosan derivative, is a dietary supplement increasingly used for weight loss. In this meta-analysis, we systematically summarized and quantified the key findings of four randomized, placebo-controlled clinical trials examining the effects of polyglucosamine supplementation and caloric restriction, and physical activity on body weight, body mass index (BMI), and waist circumference in subjects with overweight and obesity. The control group was set with a physical activity from 6-7 MET-h/week activity and up to 21 MET-h/week activity with caloric restriction. Compliance in the latter trials was reported via a follow-up questionnaire with the individual participants. The analysis included 399 subjects followed for a period ranging from 12 weeks to one year. Subjects' age ranged from 21-75 years, BMI from 26-45 kg/m2, and all were white European or Caucasian in ethnicity. The meta-analyzed mean differences for random effects showed that polyglucosamine supplementation improves weight loss by -1.78 kg [-2.78, -0.79], BMI by -1.52 kg/m2 [-3.58, 0.54], and improves waist circumference reduction by -1.45 cm [-2.77, -0.12]. In conclusion, the use of polyglucosamine supplementation in conjunction with lifestyle behavioral therapies can be effective for weight reduction. Further studies are needed to examine the long-term effects of polyglucosamine supplementation on weight loss and other metabolic parameters.

Effects of Hoodia Parviflora on satiety, abdominal obesity and weight in a group of overweight subjects: a randomized, blinded, placebo-controlled trial.

BACKGROUND: This study aimed to assess the effects of supplementation with Hoodia Parviflora (H. Parviflora) at 9 mg+200 mg of fructo-oligosaccharides on weight loss, body composition, hydration and satiety parameters. METHODS: A randomized blinded controlled trial was conducted in a sample of 30 overweight and obese patients (5 males and 25 females). Patients were randomly assigned in 2 groups: the intervention group, which received H. Parviflora twice a day for 4 weeks and the control group, which received a placebo. RESULTS: After a 4-week follow-up period, the study results showed an improvement of Δ=-1.632 kg (Confidence Interval [CI]95% -2.545; -0.719) and a statistically significant decrease in waist circumference (WC) compared with the placebo group -2.080 cm ([CI]95% -4.082; -0.078). The visual analogue scale reported an improvement of satiety sensation after day 5 (P=0.001). CONCLUSIONS: This study shows for the first time the simultaneous effect of H. Parviflora on weight loss, decreasing satiety, and improving fat mass, in particular Visceral Adipose Tissue (VAT).

Whey protein, amino acids, and vitamin D supplementation with physical activity increases fat-free mass and strength, functionality, and quality of life and decreases inflammation in sarcopenic elderly.

BACKGROUND: Interventions to attenuate the adverse effects of age-related loss of skeletal muscle and function include increased physical activity and nutritional supplementation. OBJECTIVE: This study tested the hypothesis that nutritional supplementation with whey protein (22 g), essential amino acids (10.9 g, including 4 g leucine), and vitamin D [2.5 µg (100 IU)] concurrent with regular, controlled physical activity would increase fat-free mass, strength, physical function, and quality of life, and reduce the risk of malnutrition in sarcopenic elderly persons. DESIGN: A total of 130 sarcopenic elderly people (53 men and 77 women; mean age: 80.3 y) participated in a 12-wk randomized, double-blind, placebo-controlled supplementation trial. All participants concurrently took part in a controlled physical activity program. We examined body composition with dual-energy X-ray absorptiometry, muscle strength with a handgrip dynamometer, and blood biochemical indexes of nutritional and health status, and evaluated global nutritional status, physical function, and quality of life before and after the 12 wk of intervention. RESULTS: Compared with physical activity and placebo, supplementation plus physical activity increased fat-free mass (1.7-kg gain, P < 0.001), relative skeletal muscle mass (P = 0.009), android distribution of fat (P = 0.021), handgrip strength (P = 0.001), standardized summary scores for physical components (P = 0.030), activities of daily living (P = 0.001), mini nutritional assessment (P = 0.003), and insulin-like growth factor I (P = 0.002), and lowered C-reactive protein (P = 0.038). CONCLUSION: Supplementation with whey protein, essential amino acids, and vitamin D, in conjunction with age-appropriate exercise, not only boosts fat-free mass and strength but also enhances other aspects that contribute to well-being in sarcopenic elderly. This trial was registered at clinicaltrials.gov as NCT02402608.

The Effect of Ginger (Zingiber officinalis) and Artichoke (Cynara cardunculus) Extract Supplementation on Functional Dyspepsia: A Randomised, Double-Blind, and Placebo-Controlled Clinical Trial.

Objective. Functional dyspepsia (FD) is a frequent clinical finding in western world. The aim of this study is to compare the efficacy of a ginger and artichoke supplementation versus placebo in the treatment of FD. Methods. A prospective multicentre, double blind, randomized, placebo controlled, parallel-group comparison of the supplement and placebo over a period of 4 weeks was performed. Two capsules/day were supplied (before lunch and dinner) to 126 FD patients (supplementation/placebo: 65/61). Results. After 14 days of treatment, only supplementation group (SG) showed a significant amelioration (SG: α S = +1.195 MCA score units (u), P = 0.017; placebo: α P = +0.347 u, P = 0.513). The intercept (α) resulted to be significantly higher in SG than in placebo (α S - α P = +0.848 u, P < 0.001). At the end of the study, the advantage of SG versus placebo persists without variation (ß S - ß P = +0.077 u, P = 0.542). In SG, a significant advantage is observed for nausea (ß S - ß P = -0.398 u, P < 0.001), epigastric fullness (ß S - ß P = -0.241, P < 0.001), epigastric pain (ß S - ß P = -0.173 u, P = 0.002), and bloating (ß S - ß P = -0.167 u, P = 0.017). Conclusions. The association between ginger and artichoke leaf extracts appears safe and efficacious in the treatment of FD and could represent a promising treatment for this disease.

A food pyramid, based on a review of the emerging literature, for subjects with inflammatory bowel disease / Pirámide de los alimentos derivado de la revisión de la literatura emergente para sujetos con enfermedad inflamatoria intestinal

Emerging literature suggests that diet plays an important modulatory role in inflammatory bowel disease (IBD) through the management of inflammation and oxidative stress. The aim of this narrative review is to evaluate the evidence collected up till now regarding optimum diet therapy for IBD and to design a food pyramid for these patients. The pyramid shows that carbohydrates should be consumed every day (3 portions), together with tolerated fruits and vegetables (5 portions), yogurt (125ml), and extra virgin olive oil; weekly, fish (4 portions), white meat (3 portions), eggs (3 portions), pureed legumes (2 portions), seasoned cheeses (2 portions), and red or processed meats (once a week). At the top of the pyramid, there are two pennants: the red one means that subjects with IBD need some personalized supplementation and the black one means that there are some foods that are banned. The food pyramid makes it easier for patients to decide what they should eat

La literatura emergente sugiere que la dieta resulta ser un importante papel modulador en la enfermedad inflamatoria intestinal (EII), a través del manejo de la inflamación y el estrés oxidativo. El objetivo de esta revisión narrativa es evaluar la evidencia hasta la fecha con respecto a la EII óptima de la terapia dietética, y construimos una pirámide de alimentos sobre este tema. La pirámide muestra que los hidratos de carbono deben consumirse todos los días (3 porciones), junto con las frutas y verduras toleradas (5 porciones), el yogur (125ml) y el aceite de oliva virgen extra; semanalmente, pescado (4 porciones), carne blanca (3 porciones), huevos (3 porciones), puré de legumbres (2 porciones), quesos condimentados (2 porciones) y carnes rojas o procesadas (una vez por semana). En la parte superior de la pirámide hay 2 banderines: uno rojo significa que los sujetos con IBD necesitan una suplementación personalizada y un negro significa que hay algunos alimentos que están prohibidos. La pirámide alimenticia permite a los pacientes descubrir fácilmente qué comer