Phenolic Compounds Profile and Antioxidant Capacity of Plant-Based Protein Supplements.

The study aimed to determine the phenolic content and antioxidant capacity of five protein supplements of plant origin. The content and profile of phenolics were determined using the UHPLC-DAD-MS method, while antioxidant capacity (ABTS and DPPH assays) and total phenolic content (TPC) were evaluated using spectrophotometric tests. In the analyzed proteins, twenty-five polyphenols were detected, including eleven phenolic acids, thirteen flavonoids, and one ellagitannin. Hemp protein revealed the highest individual phenolics content and TPC value (1620 µg/g and 1.79 mg GAE/g, respectively). Also, hemp protein showed the highest antioxidant activity determined via ABTS (9.37 µmol TE/g) and DPPH (9.01 µmol TE/g) assays. The contents of p-coumaric acid, m-coumaric acid, kaempferol, rutin, isorhamnetin-3-O-rutinoside, kaempferol-3-O-rutinoside, and TPC value were significantly correlated with antioxidant activity assays. Our findings indicate that plant-based protein supplements are a valuable source of phenols and can also be used in research related to precision medicine, nutrigenetics, and nutrigenomics. This will benefit future health promotion and personalized nutrition in the prevention of chronic diseases.

Antioxidant Activity and Profile of Phenolic Compounds in Selected Herbal Plants.

Herbs are characterized by a high content of biologically active substances that positively affect human health. Phenolic compounds are one of the main bioactive compounds in these plants with highly beneficial properties (e.g., anti-carcinogenic, cardioprotective, immune system support and antibacterial). Therefore, this study aimed to determine the composition of free and bound phenolic compounds and antioxidant activity in 10 different herbs (bogbean leaves, sage leaves, whole Indian hemp, whole heartsease, whole horsetail, whole blessed thistle, whole thyme, chamomile flower, corn silk and pine buds). Phenolic compounds were analyzed using the HPLC-TOF-MS/MS method, total phenolic (TP) and flavonoid (TF) contents were measured using spectrophotometric methods, while antioxidant activity was determined by ABTS and DPPH assays. The highest content of free TP was found in thyme, while sage was characterized by the highest range of these compounds released from ester and glycosidic derivatives by hydrolysis. In turn, the highest values of TF in non-hydrolyzed extracts were found in Indian hemp. The highest values of TF, including bound phenols were observed in extracts obtained from sage leaves. In the analyzed herbs thirty-three phenolic compounds were found, constituting 16 phenolic acids, 9 flavonoids and eight stilbenes. Moreover, the analyzed compounds appeared in the bound form than in the free form. The antioxidant activity of herb extracts differed significantly across varieties (P < 0.05). The research showed that each tested herb possesses its own fingerprint of phenolic compounds and antioxidant properties.

Sleep disturbance in adult dermatologic patients: A cross-sectional study on prevalence, burden, and associated factors.

BACKGROUND: Sleep disturbance remains insufficiently characterized in many dermatoses. OBJECTIVE: To investigate the prevalence, burden, and factors associated with sleep disturbance in dermatologic patients. METHODS: We recruited 800 patients and recorded pruritus characteristics and sociodemographic and clinical parameters. Validated questionnaires were used to assess sleep disturbance, psychological distress, health-related quality of life, and work productivity. RESULTS: Two thirds of patients met criteria of poor sleep, which was associated with psychological distress, diminished health-related quality of life, and lost work productivity. Patients with average and maximum pruritus on the visual analog scale exceeding 5 and 6.5 points, respectively, were at high risk of suffering pruritus-related sleep disturbance. Overall pruritus intensity and its nocturnal exacerbation contributed independently to sleep disturbance. Psychological distress was of even higher impact on sleep than pruritus and almost a third of the relationship between pruritus intensity and sleep was mediated by psychological distress. CONCLUSION: Sleep disturbance is prevalent in dermatologic patients and constitutes a considerable burden. CLINICAL IMPLICATION: Dermatologic patients with intense pruritus and psychological distress should be examined for sleep disorders. Adequate antipruritic therapy and complementary psychotherapy in affected patients may help them regain restorative sleep.

The characteristics and impact of pruritus in adult dermatology patients: A prospective, cross-sectional study.

BACKGROUND: Pruritus often accompanies chronic skin diseases, exerting considerable burden on many areas of patient functioning; this burden and the features of pruritus remain insufficiently characterized. OBJECTIVE: To investigate characteristics, including localization patterns, and burden of pruritus in patients with chronic dermatoses. METHODS: We recruited 800 patients with active chronic skin diseases. We assessed pruritus intensity, localization, and further characteristics. We used validated questionnaires to assess quality of life, work productivity and activity impairment, anxiety, depression, and sleep quality. RESULTS: Nine out of every 10 patients had experienced pruritus throughout their disease and 73% in the last 7 days. Pruritus often affected the entire body and was not restricted to skin lesions. Patients with moderate to severe pruritus reported significantly more impairment to their sleep quality and work productivity, and they were more depressed and anxious than control individuals and patients with mild or no pruritus. Suicidal ideations were highly prevalent in patients with chronic pruritus (18.5%) and atopic dermatitis (11.8%). CONCLUSIONS: Pruritus prevalence and intensity are very high across all dermatoses studied; intensity is linked to impairment in many areas of daily functioning. Effective treatment strategies are urgently required to treat pruritus and the underlying skin disease.

An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer.

PURPOSE: The aim of current systematic review was to update the body of evidence on associations between adherence to the Mediterranean diet (MedDiet) and risk of cancer mortality, site-specific cancer in the general population; all-cause, and cancer mortality as well as cancer reoccurrence among cancer survivors. METHODS: A literature search for randomized controlled trials (RCTs), case-control and cohort studies published up to April 2020 was performed using PubMed and Scopus. Study-specific risk estimates for the highest versus lowest adherence to the MedDiet category were pooled using random-effects meta-analyses. Certainty of evidence from cohort studies and RCTs was evaluated using the NutriGrade scoring system. RESULTS: The updated search revealed 44 studies not identified in the previous review. Altogether, 117 studies including 3,202,496 participants were enclosed for meta-analysis. The highest adherence to MedDiet was inversely associated with cancer mortality (RRcohort: 0.87, 95% CI 0.82, 0.92; N = 18 studies), all-cause mortality among cancer survivors (RRcohort: 0.75, 95% CI 0.66, 0.86; N = 8), breast (RRobservational: 0.94, 95% CI 0.90, 0.97; N = 23), colorectal (RRobservational: 0.83, 95% CI 0.76, 0.90; N = 17), head and neck (RRobservational: 0.56, 95% CI 0.44, 0.72; N = 9), respiratory (RRcohort: 0.84, 95% CI 0.76, 0.94; N = 5), gastric (RRobservational: 0.70, 95% CI 0.61, 0.80; N = 7), bladder (RRobservational: 0.87, 95% CI 0.76, 0.98; N = 4), and liver cancer (RRobservational: 0.64, 95% CI 0.54, 0.75; N = 4). Adhering to MedDiet did not modify risk of blood, esophageal, pancreatic and prostate cancer risk. CONCLUSION: In conclusion, our results suggest that highest adherence to the MedDiet was related to lower risk of cancer mortality in the general population, and all-cause mortality among cancer survivors as well as colorectal, head and neck, respiratory, gastric, liver and bladder cancer risks. Moderate certainty of evidence from cohort studies suggest an inverse association for cancer mortality and colorectal cancer, but most of the comparisons were rated as low or very low certainty of evidence.

Statement of the Committee of Human Nutrition Science of the Polish Academy of Sciences on the use of dietary supplements containing vitamins and minerals by adults.

The use of dietary supplements (supplementation) is the individual enrichment of the diet with ingredients naturally occurring in food. As a rule, dietary supplements should be used periodically. In nutritional practice, there are many indications for dietary supplementation, but the decision to take dietary supplements should be made by consumers wisely and only in justified situations, when there is a risk that the usual diet does not provide vitamins and minerals in an amount adequate to meet dietary recommendations. However, we should remember about the real dangers of taking too large doses of vitamins and minerals. Many people using dietary supplements, especially several types at the same time, may experience undesirable side effects and deterioration of health, and in addition, people taking medicines may seriously disrupt or weaken the effect of the drug, or even lack the therapeutic effect of the drug. The document presents 10 steps and rules for the use of dietary supplements available on the market, which are addressed to the general population.

Chocolate and risk of chronic disease: a systematic review and dose-response meta-analysis.

PURPOSE: Evidence for the association between chocolate intake and risk of chronic diseases is inconclusive. Therefore, we aimed to synthesize and evaluate the credibility of evidence on the dose-response association between chocolate consumption with risk of all-cause mortality, coronary heart disease (CHD), stroke, heart failure (HF), type 2 diabetes (T2D), colorectal cancer (CRC), and hypertension. METHODS: Prospective studies were searched until July 2018 in PubMed, Embase, and Web of Science. Random-effects meta-analyses comparing highest versus lowest intake categories, linear, and non-linear dose-response analyses were conducted. The credibility of evidence was evaluated with the NutriGrade scoring-system. RESULTS: Overall, 27 investigations were identified (n = 2 for all-cause mortality, n = 9 for CHD, n = 8 for stroke, n = 6 for HF, n = 6 for T2D, n = 2 for hypertension and CRC, respectively). No associations with HF (RR 0.99, 95% CI 0.94, 1.04) and T2D (RR 0.94, 95% CI 0.88, 1.01) per each 10 g/day increase in chocolate intake were observed in the linear dose-response meta-analyses. However, a small inverse association for each 10 g/daily increase could be shown for the risk of CHD (RR 0.96, 95% CI 0.93, 0.99), and stroke (RR 0.90, 95% CI 0.82, 0.98). The credibility of evidence was rated either very low (all-cause mortality, HF, T2D, CRC or hypertension) or low (CHD, stroke). CONCLUSION: Chocolate consumption is not related to risk for several chronic diseases, but could have a small inverse association with CHD and stroke. Our findings are limited by very low or low credibility of evidence, highlighting important uncertainty for chocolate-disease associations.

Low FODMAP Diet Is Not Effective in Children with Functional Abdominal Pain: A Randomized Controlled Trial.

INTRODUCTION: A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) has been shown to reduce symptoms among adult patients and children with irritable bowel syndrome. There are no studies investigating the effectiveness of the low FODMAP diet in pediatric patients with functional abdominal pain (FAP). OBJECTIVE: The study aimed to evaluate the effectiveness of the low FODMAP diet in reducing gastrointestinal symptoms in children with FAP in comparison to the control diet based on the National Institute for Health and Care Excellence (NICE) guidelines. METHODS: Twenty-seven children with diagnosed FAP were randomized to 2 groups. Each group received an intervention: the low FODMAP diet or the diet based on NICE. All food was prepared and delivered by a catering company. Data regarding gastrointestinal symptoms were recorded by participants during the 2-week baseline assessment and 4-week dietary intervention. The frequencies of abdominal pain and stools were reported as a number of events per day. The severity of abdominal pain was assessed using the Wong-Baker FACES Pain Rating Scale. The assessment of stool consistency was based on the Bristol Stool Form Scale. RESULTS: The tendency toward the improvement in abdominal symptoms was noted in the low FODMAP group but without statistical significance. No significant differences in stool consistency were observed in this group. The NICE group experienced significant reduction in abdominal pain intensity and frequency (p < 0.01) and improvement in stool consistency (93% reporting normal stool, p < 0.05). CONCLUSIONS: The results of this pilot study suggest that the low FODMAP diet is not effective in the reduction of symptoms in children with FAP.

A subjective dissatisfaction with body weight in young women: do eating behaviours play a role?

BACKGROUND: Food less frequently used to provide the necessary nutrients for the survival and the body begins to play a role, which it is not able to cope with, leading to a dysfunctional its use. In an era of obesity, excessive interest in his appearance and lean silhouette assigning too much significance relates to a growing number of young women. Young women due to a period of their procreative years are particularly vulnerable to the consequences of abnormal eating habits that threaten the health of women and their offspring. OBJECTIVES: In young women of reproductive age, to determine the emotional and habitual reasons behind binge eating and the effect that restriction diets can have for achieving desired body mass in relation to physical activity and the willingness to improve their weight. MATERIAL AND METHODS: Subjects surveyed were 372 women aged 18 to 27 years (mean 20.6 ± 1.4) who answered a questionnaire on dietary behaviour devised by Oginska-Bulik and Putynski [21] which had been extended to include body mass perception/image, adoption of slimming diets, levels of physical activity and place of residence. The women's actual body mass, height and body fat (adipose tissue content) were also measured. RESULTS: Most subjects (63.9%) were dissatisfied with their figures whilst 33.5% underwent slimming diets at least once. Those overweight, complained much more about their figures compared to normal weight women (97.9% vs. 65.1%, p<0.01), as well as being respectively more emotionally prone to overeating (4.5 ± 2.2 vs. 5.2 ± 2 points round, p<0.01), but less for adopting any dietary restriction (3.5 ± 2.7 vs. 4.8 ± 2.3, p<0.01). CONCLUSIONS: It seems necessary to create a prevention and educational programs on proper nutrition and the perception of one's own body as effective tools in reducing eating disorders in terms of the health of young women and multigenerational inheritance health of their offspring.

Anti-Hyperglycemic Effects of Bioactive Compounds in the Context of the Prevention of Diet-Related Diseases.

Diet-related diseases are health conditions primary caused by poor nutrition. These diseases encompass obesity, type 2 diabetes, cardiovascular diseases, osteoporosis, and certain types of cancer. Functional foods and nutraceuticals offer a promising dietary approach to addressing diet-related diseases across various clinical contexts. The bioactive compounds found in these foods are the subject of intensive studies aimed at discovering their anti-hyperglycemic effects, which are beneficial in alleviating chronic diseases and protecting human health. Hyperglycemia is a common risk factor for metabolic disease and mortality worldwide. Chronic hyperglycemic states can lead to many long-term complications, such as retinopathy, neuropathy, kidney disease, heart disease, cancer, and diabetes. This review explores the potential anti-hyperglycemic effects of bioactive compounds, specifically flavonoids and phenolic acids, and their proposed roles in mitigating chronic diseases and promoting human health. By thoroughly examining the existing literature, we investigated the potential anti-hyperglycemic effects of these bioactive compounds and their proposed roles in managing chronic diseases. The goal of this paper was to enhance our comprehension of how these compounds modulate glucose transporters, with the ultimate aim of identifying effective strategies for the prevention and treatment of diet-related diseases. Overall, this review investigated the use of bioactive compounds from functional foods as potential inhibitors of glucose transporters in the context of prevention/treatment of diet-related diseases.

Eating Habits and Disease Risk Factors.

Diet plays an inevitable role in human health and disease prevention [...].

The Effect of Low Doses of Zearalenone (ZEN) on the Bone Marrow Microenvironment and Haematological Parameters of Blood Plasma in Pre-Pubertal Gilts.

The aim of this study was to determine whether low doses of zearalenone (ZEN) influence the carry-over of ZEN and its metabolites to the bone marrow microenvironment and, consequently, haematological parameters. Pre-pubertal gilts (with a body weight of up to 14.5 kg) were exposed to daily ZEN doses of 5 µg/kg BW (group ZEN5, n = 15), 10 µg/kg BW (group ZEN10, n = 15), 15 µg/kg BW (group ZEN15, n = 15), or were administered a placebo (group C, n = 15) throughout the entire experiment. Bone marrow was sampled on three dates (exposure dates 7, 21, and 42-after slaughter) and blood for haematological analyses was sampled on 10 dates. Significant differences in the analysed haematological parameters (WBC White Blood Cells, MONO-Monocytes, NEUT-Neutrophils, LYMPH-Lymphocytes, LUC-Large Unstained Cells, RBC-Red Blood Cells, HGB-Haemoglobin, HCT-Haematocrit, MCH-Mean Corpuscular Volume, MCHC-Mean Corpuscular Haemoglobin Concentrations, PLT-Platelet Count and MPV-Mean Platelet Volume) were observed between groups. The results of the experiment suggest that exposure to low ZEN doses triggered compensatory and adaptive mechanisms, stimulated the local immune system, promoted eryptosis, intensified mycotoxin biotransformation processes in the liver, and produced negative correlations between mycotoxin concentrations and selected haematological parameters.

Association between Intake of Fermented Dairy Product and Diet Quality, Health Beliefs in a Representative Sample of Polish Population.

This study aimed to evaluate the association of diet quality and perception of consumption benefits with intake of fermented dairy products in a representative sample of the Polish population. The study was carried out in February 2020 and involved 2009 men and women randomly sampled from the representative Polish population stratified into two age groups (19-30 and 66-75 years). Dairy product intake was evaluated using a qualitative food frequency questionnaire. Diet quality was assessed by calculating the Mediterranean Diet Adherence Screener (MEDAS) score. The perceived health benefit of dairy product consumption was assessed by a literature-based questionnaire. The Health Concern Scale was used to measure participants' attitudes toward health. The median intake of fermented dairy products was 0.8 portion/day (IQR: 0.4-1.6). Intake of fermented dairy products was associated with a higher MEDAS score. We observed that people with the highest intake of fermented dairy products consumed more oils, vegetables, wine, legumes, fish and seafood, sweets and pastries, nuts, had a higher preference for white meat and were more likely to report their perceived benefits to maintain body weight, reduce cardiovascular risk, and improve immune and dental health. Moreover, a high intake of fermented dairy products was positively related to paying more attention to health. Our study identified patterns of health behaviors associated with the frequent consumption of fermented dairy products. We observed that the intake of fermented dairy products is associated with better diet quality, consumer self-consciousness, and a greater attitude toward personal health.

A Review of Colorectal Cancer in Terms of Epidemiology, Risk Factors, Development, Symptoms and Diagnosis.

This review article contains a concise consideration of genetic and environmental risk factors for colorectal cancer. Known risk factors associated with colorectal cancer include familial and hereditary factors and lifestyle-related and ecological factors. Lifestyle factors are significant because of the potential for improving our understanding of the disease. Physical inactivity, obesity, smoking and alcohol consumption can also be addressed through therapeutic interventions. We also made efforts to systematize available literature and data on epidemiology, diagnosis, type and nature of symptoms and disease stages. Further study of colorectal cancer and progress made globally is crucial to inform future strategies in controlling the disease's burden through population-based preventative initiatives.

Impact of different training modalities on anthropometric outcomes in patients with obesity: A systematic review and network meta-analysis.

Obesity management guidelines consistently advise aerobic training for weight loss, whereas recommendations for other training modalities are sparse. This systematic review and network meta-analysis (NMA) aimed to compare the long-term effects of different training modalities on anthropometric outcomes in patients with obesity. MEDLINE, Cochrane CENTRAL, and Web of Science were searched to identify the following: (1) randomized controlled trials (RCTs); (2) conducted in adults with a mean body mass index (BMI) ≥30 kg/m2 ; (3) comparing aerobic, resistance, combined, or high-intensity interval training head-to-head or to control for ≥6 months; and (4) reporting changes in body weight (BW), BMI, waist circumference (WC), fat mass (FM), or fat-free mass (FFM). Random-effects NMA models were fitted in a frequentist approach. GRADE framework was used to assess certainty of evidence. Thirty-two RCTs with 4774 participants with obesity were included in this review. Aerobic training was ranked as best for improving BW, BMI, and WC and combined training for improving FM, as well as equally with resistance training most effective for improving FFM. Low to moderate certainty of evidence supports use of aerobic training to improve anthropometric outcomes in obesity, and its combination with resistance training provides additional benefit for reducing FM and increasing FFM.

Correlations between Low Doses of Zearalenone, Its Carryover Factor and Estrogen Receptor Expression in Different Segments of the Intestines in Pre-Pubertal Gilts-A Study Protocol.

Plant materials can be contaminated with Fusarium mycotoxins and their derivatives, whose toxic effects on humans and animals may remain subclinical. Zearalenone (ZEN), a low-molecular-weight compound, is produced by molds in crop plants as a secondary metabolite. The objective of this study will be to analyze the in vivo correlations between very low monotonic doses of ZEN (5, 10, and 15 µg ZEN/kg body weight-BW for 42 days) and the carryover of this mycotoxin and its selected metabolites from the intestinal contents to the intestinal walls, the mRNA expression of estrogen receptor alfa (ERα) and estrogen receptor beta (ERß) genes, and the mRNA expression of genes modulating selected colon enzymes (CYP1A1 and GSTP1) in the intestinal mucosa of pre-pubertal gilts. An in vivo experiment will be performed on 60 clinically healthy animals with initial BW of 14.5 ± 2 kg. The gilts will be randomly divided into a control group (group C, n = 15) and three experimental groups (group ZEN5, group ZEN10, and group ZEN15; n = 15). Group ZEN5 will be administered per os 5 µg ZEN/kg BW (MABEL), group ZEN10-10 µg ZEN/kg BW (NOAEL), and group ZEN15-15 µg ZEN/kg BW (low LOAEL). In each group, five animals will be euthanized on analytical dates 1 (exposure day 7), 2 (exposure day 21), and 3 (exposure day 42). Samples for in vitro analyses will be collected from an intestinal segment resected from the following regions: the third (horizontal) part of the duodenum, jejunum, ileum, cecum, ascending colon, transverse colon, and descending colon. The experimental material will be collected under special conditions, and it will be transported to specialist laboratories where samples will be obtained for further analyses.

Occurrence of Zearalenone and Its Metabolites in the Blood of High-Yielding Dairy Cows at Selected Collection Sites in Various Disease States.

Zearalenone (ZEN) and its metabolites, alpha-zearalenol (α-ZEL) and beta-zearalenol (ß-ZEL), are ubiquitous in plant materials used as feed components in dairy cattle diets. The aim of this study was to confirm the occurrence of ZEN and its selected metabolites in blood samples collected from different sites in the hepatic portal system (posthepatic-external jugular vein EJV; prehepatic-abdominal subcutaneous vein ASV and median caudal vein MCV) of dairy cows diagnosed with mastitis, ovarian cysts and pyometra. The presence of mycotoxins in the blood plasma was determined with the use of combined separation methods involving immunoaffinity columns, a liquid chromatography system and a mass spectrometry system. The parent compound was detected in all samples collected from diseased cows, whereas α-ZEL and ß-ZEL were not identified in any samples, or their concentrations were below the limit of detection (LOD). Zearalenone levels were highest in cows with pyometra, where the percentage share of average ZEN concentrations reached 44%. Blood sampling sites were arranged in the following ascending order based on ZEN concentrations: EJV (10.53 pg/mL, 44.07% of the samples collected from this site), ASV (14.20 pg/mL, 49.59% of the samples) and MCV (26.67 pg/mL, 67.35% of the samples). The results of the study indicate that blood samples for toxicological analyses should be collected from the MCV (prehepatic vessel) of clinically healthy cows and/or cows with subclinical ZEN mycotoxicosis. This sampling site increases the probability of correct diagnosis of subclinical ZEN mycotoxicosis.

Pre-Competition Weight Loss Models in Taekwondo: Identification, Characteristics and Risk of Dehydration.

Athletes use different combinations of weight loss methods during competition preparation. The aim of this study was to identify and characterize pre-competition weight loss models, which describe these combinations. The second aim was to determine if any existing model pose a higher risk of severe dehydration and whether any of the models could be continued as a lower-risk option. The third aim was to explore whether athletes who used different weight management strategies could be differentiated based on age, sex, training experience or anthropometric parameters. Study participants were randomly selected from Olympic taekwondo competitors and 192 athletes were enrolled. Active (47% weight-reducing athletes), passive (31%) and extreme (22%) models have been described. In the extreme model, athletes combined the highest number of different weight loss methods (3.9 ± 0.9 methods vs. 2.4 ± 0.9 in active and 1.5 ± 0.6 in passive), reduced significantly more body mass than others (6.7 ± 3.5% body mass vs. 4.3 ± 1.9% and 4.5 ± 2.4%; p < 0.01) and all of them used methods with the highest risk of severe dehydration. The active and passive models could be continued as a lower-risk option, if athletes do not combine dehydrating methods and do not prolong the low energy availability phase. The extreme model carried the highest risk of severe dehydration. Every fifth weight-reducing taekwondo athlete may have been exposed to the adverse effects of acute weight loss. Taekwondo athletes, regardless of age, sex, training experience and anthropometric parameters, lose weight before the competition and those characteristics do not differentiate them between models.

The role of selected dietary and lifestyle factors in the occurrence of symptoms in children with functional abdominal pain - a pilot study.

BACKGROUND: Functional abdominal pain disorders (FAPDs) are a common health problem in the pediatric population. Research suggests that several environmental modifiable factors, such as physical activity, growth status and dietary habits, may determine the symptoms of the disease. The aim of this pilot study was to assess whether the frequency and severity of gastrointestinal symptoms are associated with dietary intake, physical activity level and BMI in children with functional abdominal pain (FAP). METHODS: The study enrolled 25 children (5-11 years old) with diagnosed FAP. Dietary intake data were collected using a 7-day food diary. Patients were asked about physical activity at school and during their free time. Participants collected information about gastrointestinal symptoms over a 2-week period. The frequencies of abdominal pain and stools were recorded as number of events per day; the severity of abdominal pain was assessed using the Wong-Baker FACES Pain Rating Scale, and stool consistency based on the Bristol Stool Form Scale. Differences between groups were verified with the Kruskal-Wallis test. RESULTS: In the group of children with insufficient intake of fiber, abdominal pain intensity was significantly higher (median: 1.75 points/day, IQR: 1.18-2.32) than among participants with adequate intake (median: 0.29 points/day, IQR: 0.08-0.57; p = 0.006). Stool frequency was significantly lower in children who reported moderate physical activity in their free time (median: 0.86 times/day, IQR: 0.64-1.14) than in children with high free time physical activity (median: 1.36 times/day, IQR: 1.29-1.50; p = 0.031). There was no significant association between other lifestyle factors and gastrointestinal symptoms. CONCLUSIONS: Our results suggest that simple recommendations relative to modifiable lifestyle factors, such as diet or physical activity, may reduce abdominal pain intensity and improve stool frequency in children with FAP.

Parental Opinion about the Low FODMAP Diet in Dietary Treatment of Children with Functional Abdominal Pain.

The aim of this study was primarily to evaluate differences between parental opinion about the diet and overall changes in children's symptoms of functional abdominal pain (FAP) during the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet and National Institute for Health and Care Excellence (NICE) diet. Secondly, this paper examined the agreement between parental perception of children's symptoms and children's self-assessment of symptoms during the diet in both treatment groups. Twenty-seven children with diagnosed functional abdominal pain (FAP) were randomized to one of two group, receiving the low FODMAP diet or the diet based on NICE guidelines. Children reported gastrointestinal symptoms at baseline and during the diet. At the end of the intervention, parents assessed their children's diet and symptoms changes, using Likert scales. The agreement between parental and children assessments of gastrointestinal symptoms was defined as the percentage of compatible answers. In the low FODMAP group a significantly lower percentage of parents (38%) declared that it was easy to follow the diet, compared to the NICE group (57%), (p = 0.017). A high percentage of parents in both groups reported improvement in all symptoms of children during dietary intervention. A high level of agreement was also observed between parental and children's self-assessment of abdominal pain intensity and frequency. Our research suggests that in parental opinion the low FODMAP diet is as effective as the diet based on NICE guidelines in children with FAP. However, the low FODMAP diet may seem more difficult to follow, and this may have had an impact on the effectiveness and acceptability of the FODMAP diet by children.