Impact of Intermittent Fasting and/or Caloric Restriction on Aging-Related Outcomes in Adults: A Scoping Review of Randomized Controlled Trials.

Intermittent fasting (IF) and caloric restriction (CR) are dietary strategies to prevent and attenuate obesity associated with conditions and aging-related outcomes. This scoping review examined the cardiometabolic, cancer, and neurocognitive outcome differences between IF and CR interventions among adults. We applied a systematic approach to scope published randomized controlled trials (databases: PubMed, CINAHL Plus, PsychInfo, Scopus, and Google Scholar) from inception through August 2023. The initial search provided 389 unique articles which were critically appraised. Thirty articles met the eligibility criteria for inclusion: 12 were IF, 10 were CR, and 8 were combined IF and CR interventions. IF and CR were associated with weight loss; however, IF studies tended to report greater adherence compared with CR. Overall, IF and CR were equivalently effective across cardiometabolic, cancer, and neurocognitive outcomes. Our findings suggest that IF has health benefits in a variety of conditions and may be better accepted and tolerated than CR, but more comparative research is required.

Human Milk Nutrient Composition Data is Critically Lacking in the United States and Canada: Results from a Systematic Scoping Review of 2017-2022.

Characterization of the nutrients in human milk is important to understand the dietary and developmental requirements of infants. The objective of this review was to summarize the state-of-the-science on the nutrient composition of human milk in the United States and Canada published from 2017 to 2022. Four databases were searched for randomized controlled studies and others given the scoping nature of this review. We limited type to mature milk collected 21 d postpartum and beyond from lactating individuals in the United States and Canada who gave birth at 37-wk gestation or later (full-term). Outcomes of interest included traditional macro- and micronutrients, including human milk oligosaccharides (HMOs), and milk volume. The publication date range was selected as January 1, 2017, to the day the literature search was performed. A total of 32 articles were included in the scoping review from primarily longitudinal cohort or cross-sectional designs. The most prevalent sample collection method was full-breast expression (n = 20) with most studies (n = 26) collecting samples from a single timepoint. Carbohydrates (HMOs [n = 12], glucose [n = 8], and lactose [n = 6]) and protein (n = 5) were the most frequently assessed nutrients in this body of work, with consensus among studies that glucose is present in limited concentrations compared to lactose (24-64 mg/dL compared with 6-7 g/dL) and that HMOs are influenced by temporality and secretor status. Included studies displayed an overall level of heterogeneity and sparsity paralleling previous reports and nutrient data in the USDA FoodData Central system. Much of the data extracted from retained articles generally provided analysis of a specific nutrient or group of nutrients. Moreover, many studies did not use the preferred analytical methods as outlined by the Human Milk Composition Initiative to increase measurement confidence. Up-to-date nutrient composition data of human milk is still greatly needed as it is paramount for the management of infant feeding, assessment of infant and maternal nutritional and health needs, and as a reference for infant formula development.

Gut microbiome diversity, variability, and latent community types compared with shifts in body weight during the freshman year of college in dormitory-housed adolescents.

Significant human gut microbiome changes during adolescence suggest that microbial community evolution occurs throughout important developmental periods including the transition to college, a typical life phase of weight gain. In this observational longitudinal study of 139 college freshmen living in on-campus dormitories, we tracked changes in the gut microbiome via 16S amplicon sequencing and body weight across a single academic year. Participants were grouped by weight change categories of gain (WG), loss (WL), and maintenance (WM). Upon assessment of the community structure, unweighted and weighted UniFrac metrics revealed significant shifts with substantial variation explained by individual effects within weight change categories. Genera that positively contributed to these associations with weight change included Bacteroides, Blautia, and Bifidobacterium in WG participants and Prevotella and Faecalibacterium in WL and WM participants. Moreover, the Prevotella/Bacteroides ratio was significantly different by weight change category, with WL participants displaying an increased ratio. Importantly, these genera did not display co-dominance nor ease of transition between Prevotella- and Bacteroides-dominated states. We further assessed the overall taxonomic variation, noting the increased stability of the WL compared to the WG microbiome. Finally, we found 30 latent community structures within the microbiome with significant associations with waist circumference, sleep, and dietary factors, with alcohol consumption chief among them. Our findings highlight the high level of individual variation and the importance of initial gut microbiome community structure in college students during a period of major lifestyle changes. Further work is needed to confirm these findings and explore mechanistic relationships between gut microbes and weight change in free-living individuals.

The freshman year of college is a transitional period that may provide insights into the relationship between the gut microbiome and body weight regulation due to the lifestyle changes that increase vulnerability to weight change. During this critical period many of the lifestyle factors that influence body weight formalize and have important bearing on health outcomes throughout an individual's life. In this college-aged population, shifts in community structure and variability of gut microbes were different by weight change trajectory. Genera that underpinned these shifts such as Bacteroides, Blautia, Bifidobacterium, Prevotella, and Faecalibacterium displayed varying degrees of inter-individual variability and, in some instances, resistance to alternative states. Accounting for these considerations in the context of body weight control in adolescents may prove useful for improving target outcomes in an intervention setting.

An Exploratory Study Investigating the Prevalence of Gastrointestinal Symptoms in Collegiate Division I American Football Athletes.

Gastrointestinal (GI) symptoms may limit performance, but their prevalence and impact among team sports athletes is not well-documented. The objective of this study was to examine the prevalence of GI symptoms in a small sample of collegiate DI American football athletes, using a survey including the Gastrointestinal Symptoms Ratings Scale (GSRS). Forty-six athletes responded to the survey and reported scores for the 15-question GSRS with additional questions about dietary habits and supplement use. A total of 44 athletes were included in the study (45% of the current roster, age: 20.7 ± 1.7 years, 50% Afro-American or black, 39% skill position, 18% NSAIDs use, and 41% reporting protein supplement use); approximately half of the athletes (52%) reported experiencing GI complaints during exercise. Two-thirds of the athletes (61%) reported at least one or more GI symptoms in general, and 50% reported at least four moderate complaints. Seven athletes (16%) reported ≥2 severe GI symptoms with 5-13 moderate complaints. The most reported symptom was stomach pain (39%, n = 17), followed by hunger pain (36%, n = 16). Athletes reporting the use of protein supplements reported a higher GSRS score (22.0 and interquartile range (IQR) 17.0-31.8) vs. athletes not reporting protein use (15.0 and IQR 15.0-19.3), p = 0.001. Most athletes surveyed reported experiencing GI symptoms. A small group of these athletes reported multiple, varied, and severe symptoms that were associated with self-reported protein supplement use. In conclusion, the number of complaints varied among athletes, confirming the value of integrating the GSRS for screening purposes, and the expected need for individual dietary treatment approaches.

Intermittent fasting and protein pacing are superior to caloric restriction for weight and visceral fat loss.

OBJECTIVE: This study compared intermittent fasting and protein pacing (IF-P) versus a heart-healthy caloric restriction (CR) diet, matched for energy intake and physical activity energy expenditure, on body weight, total and visceral fat mass, and cardiometabolic health outcomes in adults with obesity. METHODS: IF-P (n = 21) and CR (n = 20) were assessed pre- (week 0), mid- (week 5), and post- (week 9) intervention. RESULTS: Both groups reduced (p < 0.05) weight, total and visceral fat mass, blood pressure and lipids, and desire to eat food and increased proportion of fat-free mass. IF-P resulted in greater (p < 0.05) reductions in weight (-9% vs. -5%), total (-16% vs. -9%) and visceral (-33% vs. -14%) fat mass, and desire to eat (-17% vs. 1%) and increased fat-free mass percent (6% vs. 3%) compared with CR. These improvements were despite similar weekly total energy intake (IF-P, 9470 ± 550 vs. CR, 9095 ± 608 kcal/wk; p = 0.90) and physical activity energy expenditure (IF-P, 300 ± 150 vs. CR, 350 ± 200 kcal/d; p = 0.79). CONCLUSIONS: IF-P and CR optimize weight loss, body composition, cardiometabolic health, and hunger management, with IF-P providing greater benefits.

A systematic scoping review of study methodology for randomized controlled trials investigating probiotics in athletic and physically active populations.

BACKGROUND: The purported ergogenic and health effects of probiotics have been a topic of great intrigue among researchers, practitioners, and the lay public alike. There has also been an increased research focus within the realm of sports science and exercise medicine on the athletic gut microbiota. However, compared to other ergogenic aids and dietary supplements, probiotics present unique study challenges. The objectives of this systematic scoping review were to identify and characterize study methodologies of randomized controlled trials investigating supplementation with probiotics in athletes and physically active individuals. METHODS: Four databases (MEDLINE, CINAHL, Cochrane CENTRAL, and Cochrane Database of Systematic Reviews) were searched for randomized controlled studies involving healthy athletes or physically active individuals. An intervention with probiotics and inclusion of a control and/or placebo group were essential. Only peer-reviewed articles in English were considered, and there were no date restrictions. Results were extracted and presented in tabular form to detail study protocols, characteristics, and outcomes. Bias in randomized controlled trials was determined with the RoB 2.0 tool. RESULTS: A total of 45 studies were included in the review, with 35 using a parallel group design and 10 using a cross-over design. Approximately half the studies used a single probiotic and the other half a multi-strain preparation. The probiotic dose ranged from 2 × 108 to 1 × 1011 colony forming units daily, and the length of intervention was between 7 and 150 days. Fewer than half the studies directly assessed gastrointestinal symptoms, gut permeability, or the gut microbiota. The sex ratio of participants was heavily weighted toward males, and only 3 studies exclusively investigated females. Low-level adverse events were reported in only 2 studies, although the methodology of reporting varied widely. The risk of bias was generally low, although details on randomization were lacking in some studies. CONCLUSION: There is a substantial body of research on the effects of probiotic supplementation in healthy athletes and physically active individuals. Considerable heterogeneity in probiotic selection and dosage as well as outcome measures has made clinical and mechanistic interpretation challenging for both health care practitioners and researchers. Attention to issues of randomization of participants, treatments and interventions, selection of outcomes, demographics, and reporting of adverse events will facilitate more trustworthy interpretation of probiotic study results and inform evidence-based guidelines.

Exploratory analysis of one versus two-day intermittent fasting protocols on the gut microbiome and plasma metabolome in adults with overweight/obesity.

Nutritional interventions are a promising therapeutic option for addressing obesity and cardiometabolic dysfunction. One such option, intermittent fasting (IF), has emerged as a viable alternative to daily caloric restriction and may beneficially modulate body weight regulation and alter the gut microbiome (GM) and plasma metabolome. This secondary analysis of a larger, registered trial (ClinicalTrials.gov ID: NCT04327141) examined the effect of a four-week intervention comparing one vs. two-consecutive days of IF in combination with protein pacing (IF-P; 4-5 meals/day, >30% protein/day) on the GM, the plasma metabolome, and associated clinical outcomes in overweight and obese adults. Participants (n = 20) were randomly assigned to either a diet consisting of one fasting day (total of 36 h) and six low-calorie P days per week (IF1-P, n = 10) or two fasting days (60 h total) and five low-calorie P days per week (IF2-P, n = 10). The fecal microbiome, clinical outcomes, and plasma metabolome were analyzed at baseline (week 0) and after four weeks. There were no significant time or interaction effects for alpha diversity; however, baseline alpha diversity was negatively correlated with percent body fat change after the four-week intervention (p = 0.030). In addition, beta-diversity for both IF groups was altered significantly by time (p = 0.001), with no significant differences between groups. The IF1-P group had a significant increase in abundance of Ruminococcaceae Incertae Sedis and Eubacterium fissicatena group (q ≤ 0.007), while the IF2-P group had a significant increase in abundance of Ruminococcaceae Incertae Sedis and a decrease in Eubacterium ventriosum group (q ≤ 0.005). The plasma metabolite profile of IF2-P participants displayed significant increases in serine, trimethylamine oxide (TMAO), levulinic acid, 3-aminobutyric acid, citrate, isocitrate, and glucuronic acid (q ≤ 0.049) compared to IF1-P. Fecal short-chain fatty acid concentrations did not differ significantly by time or between groups (p ≥ 0.126). Interestingly, gastrointestinal symptoms were significantly reduced for the IF2-P group but not for the IF1-P group. Our results demonstrate that short-term IF modestly influenced the GM community structure and the plasma metabolome, suggesting these protocols could be viable for certain nutritional intervention strategies.

Association of food insecurity on gut microbiome and metabolome profiles in a diverse college-based sample.

Voluntary caloric restriction (e.g., eating disorders) often results in alterations in the gut microbiota composition and function. However, these findings may not translate to food insecurity, where an individual experiences inconsistent access to healthy food options. In this study we compared the fecal microbiome and metabolome of racially and ethnically diverse first year college students (n = 60) experiencing different levels of food access. Students were dichotomized into food secure (FS) and food insecure (FI) groups using a validated, 2-question screener assessing food security status over the previous 30 days. Fecal samples were collected up to 5 days post survey-completion. Gut microbiome and metabolome were established using 16S rRNA amplicon sequencing, targeted liquid chromatography-tandem mass spectrometry, and gas chromatography-mass spectrometry. FI students experienced significantly greater microbial diversity with increased abundance of Enterobacteriaceae and Eisenbergiella, while FS students had greater abundance of Megasphaera and Holdemanella. Metabolites related to energy transfer and gut-brain-axis communication (picolinic acid, phosphocreatine, 2-pyrrolidinone) were elevated in FI students (q < 0.05). These findings suggest that food insecurity is associated with differential gut microbial and metabolite composition for which the future implications are unknown. Further work is needed to elucidate the longitudinal metabolic effects of food insecurity and how gut microbes influence metabolic outcomes.

An urban diet differentially alters the gut microbiome and metabolomic profiles compared with a seed diet in mourning doves.

Urbanization influences food quality and availability for many avian species, with increased access to human refuse and food subsidies in built environments. In relation to such nutritional intakes and their presumed impact on microbes harbored in the intestinal tract and metabolic profiles of host physiological systems, our overall knowledge of the role of gut microbiome (GM) and metabolomic expression in the avian host lags far behind our understanding of mammals. Therefore, the objective of this investigation was to examine the potential differential effect of an urban modeled versus control (i.e., bird seed) diet on the GM, the metabolic profiles of plasma, liver, adipose, kidney, and muscle tissues, and circulating endotoxin and inflammatory factors in urban-caught mourning doves (Zenaida macroura). We hypothesized that the urban diet would differently impact the profiles of the GM and tissue metabolomes and increase plasma lipopolysaccharide (LPS) and proinflammatory factors compared with animals fed a seed diet. After a 4-wk-diet period, contents of the large intestine were sequenced to profile the microbiome, metabolomic analyses were performed on plasma and tissue homogenates, and circulating LPS and inflammatory markers were assessed. The composition of the GM was significantly dissimilar between diets, with greater abundance of Erysipelatoclostridiaceae, Sanguibacteraceae, Oribacterium, and Sanguibacter and decreased circulating LPS in the urban-fed birds. These differences were largely not reflected in the surveyed metabolomes and plasma inflammatory markers. This research supports the notion that the microbial composition in urban doves is impacted by diet, though may only weakly associate with host physiology.

Effectiveness of medical nutrition therapy in the management of adult dyslipidemia: A systematic review and meta-analysis.

Cardiovascular disease (CVD) is a leading cause of mortality in the United States. Many primary risk factors, such as dyslipidemia and blood pressure, are modifiable with diet and lifestyle interventions. Therefore, the objective of this systematic review and meta-analysis was to evaluate the effectiveness of medical nutrition therapy (MNT) interventions provided by registered dietitian nutritionists (RDN) or international equivalents, compared to usual care or no MNT, on lipid profile and blood pressure (secondary outcome) in adults with dyslipidemia. The databases MEDLINE, CINAHL, Cochrane CENTRAL, and Cochrane Database of Systematic Reviews were searched for randomized controlled trials (RCTs) published between January 2005 and July 2021. Meta-analyses were performed using a random-effects model for lipid outcomes (seven RCTs, n=838), systolic blood pressure (SBP) (three RCTs, n=308), and diastolic blood pressure (DBP) (two RCTs, n=109). Compared to usual care or no intervention, MNT provided by RDNs improved total cholesterol (total-C) [mean difference (95% CI): -20.84 mg/dL (-40.60, -1.07), P=0.04]; low-density lipoprotein cholesterol (LDL-C) [-11.56 mg/dL (-21.10, -2.03), P=0.02]; triglycerides (TG) [-32.55 mg/dL (-57.78, -7.32), P=0.01];; and SBP [ -8.76 mm Hg (-14.06 lower to -3.45) P<0.01].High-density lipoprotein cholesterol (HDL-C) [1.75 mg/dl (-1.43, 4.92), P=0.28] and DBP [-2.9 mm Hg (-7.89 to 2.09), P=0.25] were unchanged. Certainty of evidence was moderate for total-C, LDL-C, and TG, and low for HDL-C, SBP, and DBP. In conclusion, in adults with dyslipidemia, MNT interventions provided by RDNs are effective for improving serum lipids/lipoproteins and SBP levels.

Morning Exercise Reduces Abdominal Fat and Blood Pressure in Women; Evening Exercise Increases Muscular Performance in Women and Lowers Blood Pressure in Men.

The ideal exercise time of day (ETOD) remains elusive regarding simultaneous effects on health and performance outcomes, especially in women. Purpose: Given known sex differences in response to exercise training, this study quantified health and performance outcomes in separate cohorts of women and men adhering to different ETOD. Methods: Thirty exercise-trained women (BMI = 24 ± 3 kg/m2; 42 ± 8 years) and twenty-six men (BMI = 25.5 ± 3 kg/m2; 45 ± 8 years) were randomized to multimodal ETOD in the morning (0600-0800 h, AM) or evening (1830-2030 h, PM) for 12 weeks and analyzed as separate cohorts. Baseline (week 0) and post (week 12) muscular strength (1-RM bench/leg press), endurance (sit-ups/push-ups) and power (squat jumps, SJ; bench throws, BT), body composition (iDXA; fat mass, FM; abdominal fat, Abfat), systolic/diastolic blood pressure (BP), respiratory exchange ratio (RER), profile of mood states (POMS), and dietary intake were assessed. Results: Twenty-seven women and twenty men completed the 12-week intervention. No differences at baseline existed between groups (AM vs PM) for both women and men cohorts. In women, significant interactions (p < 0.05) existed for 1RM bench (8 ± 2 vs 12 ± 2, ∆kg), pushups (9 ± 1 vs 13 ± 2, ∆reps), BT (10 ± 6 vs 45 ± 28, ∆watts), SJ (135 ± 6 vs 39 ± 8, ∆watts), fat mass (-1.0 ± 0.2 vs -0.3 ± 0.2, ∆kg), Abfat (-2.6 ± 0.3 vs -0.9 ± 0.5, ∆kg), diastolic (-10 ± 1 vs-5 ± 5, ∆mmHg) and systolic (-12.5 ± 2.7 vs 2.3 ± 3, mmHg) BP, AM vs PM, respectively. In men, significant interactions (p < 0.05) existed for systolic BP (-3.5 ± 2.6 vs -14.9 ± 5.1, ∆mmHg), RER (-0.01 ± 0.01 vs -0.06 ± 0.01, ∆VCO2/VO2), and fatigue (-0.8 ± 2 vs -5.9 ± 2, ∆mm), AM vs PM, respectively. Macronutrient intake was similar among AM and PM groups. Conclusion: Morning exercise (AM) reduced abdominal fat and blood pressure and evening exercise (PM) enhanced muscular performance in the women cohort. In the men cohort, PM increased fat oxidation and reduced systolic BP and fatigue. Thus, ETOD may be important to optimize individual exercise-induced health and performance outcomes in physically active individuals and may be independent of macronutrient intake.

Intermittent fasting two days versus one day per week, matched for total energy intake and expenditure, increases weight loss in overweight/obese men and women.

BACKGROUND: Intermittent fasting (IF), consisting of either a one-day (IF1) or two consecutive days (IF2) per week, is commonly used for optimal body weight loss. Our laboratory has previously shown an IF1 diet combined with 6d/week of protein pacing (P; 4-5 meals/day evenly spaced, ~ 30% protein/day) significantly enhances weight loss, body composition, and cardiometabolic health in obese men and women. Whether an IF1-P or IF2-P, matched for weekly energy intake (EI) and expenditure (EE), is superior for weight loss, body composition, and cardiometabolic health is unknown. METHODS: This randomized control study directly compared an IF1-P (n = 10) versus an IF2-P (n = 10) diet on weight loss and body composition, cardiovascular (blood pressure and lipids), hormone, and hunger responses in 20 overweight men and women during a 4-week weight loss period. Participants received weekly dietary counseling and monitoring of compliance from a registered dietitian. All outcome variables were assessed pre (week 0) and post (week 5). RESULTS: Both groups significantly reduced body weight, waist circumference, percent body fat, fat mass, hunger, blood pressure, lipids, glucose, and increased percent fat-free mass (p < 0.05). However, IF2-P resulted in significantly greater reductions in body weight (-29%) and waist circumference (-38%) compared to IF1-P (p < 0.05), and showed a strong tendency for greater reductions in fat mass, glucose, and hunger levels (p < 0.10) despite similar weekly total EI (IF1-P, 9058 ± 692 vs. IF2-P, 8389 ± 438 kcals/week; p = 0.90), EE (~ 300 kcals/day; p = 0.79), and hormone responses (p > 0.10). CONCLUSIONS: These findings support short-term IF1-P and IF2-P to optimize weight loss and improve body composition, cardiometabolic health, and hunger management, with IF2-P providing enhanced benefits in overweight women and men. TRIAL REGISTRATION: This trial was registered March 03, 2020 at www. CLINICALTRIALS: gov as NCT04327141 .

Best Practices for Probiotic Research in Athletic and Physically Active Populations: Guidance for Future Randomized Controlled Trials.

Probiotic supplementation, traditionally used for the prevention or treatment of a variety of disease indications, is now recognized in a variety of population groups including athletes and those physically active for improving general health and performance. However, experimental and clinical trials with probiotics commonly suffer from design flaws and different outcome measures, making comparison and synthesis of conclusions difficult. Here we review current randomized controlled trials (RCTs) using probiotics for performance improvement, prevention of common illnesses, or general health, in a specific target population (athletes and those physically active). Future RCTs should address the key elements of (1) properly defining and characterizing a probiotic intervention, (2) study design factors, (3) study population characteristics, and (4) outcome measures, that will allow valid conclusions to be drawn. Careful evaluation and implementation of these elements should yield improved trials, which will better facilitate the generation of evidence-based probiotic supplementation recommendations for athletes and physically active individuals.

Lipopolysaccharide and the gut microbiota: considering structural variation.

Systemic inflammation is associated with chronic disease and is purported to be a main pathogenic mechanism underlying metabolic conditions. Microbes harbored in the host gastrointestinal tract release signaling byproducts from their cell wall, such as lipopolysaccharides (LPS), which can act locally and, after crossing the gut barrier and entering circulation, also systemically. Defined as metabolic endotoxemia, elevated concentrations of LPS in circulation are associated with metabolic conditions and chronic disease. As such, measurement of LPS is highly prevalent in animal and human research investigating these states. Indeed, LPS can be a potent stimulant of host immunity, but this response depends on the microbial species' origin, a parameter often overlooked in both preclinical and clinical investigations. Indeed, the lipid A portion of LPS is mutable and comprises the main virulence and endotoxic component, thus contributing to the structural and functional diversity among LPSs from microbial species. In this review, we discuss how such structural differences in LPS can induce differential immunological responses in the host.

Microbiome and metabolome profiles of high screen time in a cohort of healthy college students.

As screens are increasingly integrated into every facet of modern life, there is growing concern over the potential effects of high screen time. Previous studies have largely utilized self-report data on mood and behavioral aspects of screen time, and no molecular theory has yet been developed. In this study, we explored the fecal microbiome and metabolome of a diverse group of 60 college students, classified by high (≥ 75 min/day) or low (0-75 min/day) self-reported screen time using 16S rRNA amplicon sequencing, targeted liquid chromatography-tandem mass spectrometry, and targeted detection of short-chain fatty acids using gas chromatography-mass spectrometry. Several key taxa and metabolites were significantly altered between groups and found to be highly co-occurrent. Results of pathway and enzyme enrichment analyses were synthesized to articulate an integrated hypothesis indicating widespread mitochondrial dysfunction and aberrant amino acid metabolism. High screen time was also predicted to be significantly associated with type I diabetes, obesity, chronic fatigue syndrome, and various manifestations of inflammatory bowel. This is the first-ever study to report the effects of high screen time at the molecular level, and these results provide a data-driven hypothesis for future experimental research.

Effects of Probiotics on Allergic Rhinitis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

BACKGROUND: The prevalence of allergic rhinitis has been estimated to range from 10 to 30% in adults and up to 40% in children. Probiotics have been tested as for this condition, but no census on which probiotic types are most effective. OBJECTIVE: Our aim of this study was to provide probiotic strain-specific evaluation for the treatment of allergic rhinitis. METHODS: Databases (PubMed, Google Scholar, and ScienceDirect) were searched (from inception to October 2020) to identify randomized controlled trials (RCTs) of probiotic treatments in allergic rhinitis patients. A systematic review was done comparing types of reported outcomes, clinical and immunological parameters and safety data. A meta-analysis was done for probiotics with at least two RCTs per probiotic strain(s) and sharing a common outcome. RESULTS: A total of 13 randomized, double-blind, placebo-controlled trials (N = 1591 participants) were included in the systematic review. Overall, 8 of 9 probiotic types alleviated at least one clinical symptom of allergic rhinitis. The meta-analysis results showed that, neither L. paracasei Lp33 (SMD = -1.61, 95% CI -4.67, 1.45) nor L. rhamnosus GG (SMD = -1.00, 95% CI -3.01, 1.00) had significant efficacy for reducing nasal symptom scores. CONCLUSIONS: Our analysis showed probiotics produced a slight improvement in some clinical and immunological measurements on allergic rhinitis. Due to the diversity of outcome measurements and lack of sufficient trials for each probiotic strain, future trials are needed with similar study design and uniform outcomes to better compare the effect of probiotics on allergic rhinitis.

Short-term high fat diet alters genes associated with metabolic and vascular dysfunction during adolescence in rats: a pilot study.

BACKGROUND: Diet-induced metabolic dysfunction precedes multiple disease states including diabetes, heart disease, and vascular dysfunction. The critical role of the vasculature in disease progression is established, yet the details of how gene expression changes in early cardiovascular disease remain an enigma. The objective of the current pilot project was to evaluate whether a quantitative assessment of gene expression within the aorta of six-week old healthy male Sprague-Dawley rats compared to those exhibiting symptoms of metabolic dysfunction could reveal potential mediators of vascular dysfunction. METHODS: RNA was extracted from the aorta of eight rats from a larger experiment; four animals fed a high-fat diet (HFD) known to induce symptoms of metabolic dysfunction (hypertension, increased adiposity, fasting hyperglycemia) and four age-matched healthy animals fed a standard chow diet (CHOW). The bioinformatic workflow included Gene Ontology (GO) biological process enrichment and network analyses. RESULTS: The resulting network contained genes relevant to physiological processes including fat and protein metabolism, oxygen transport, hormone regulation, vascular regulation, thermoregulation, and circadian rhythm. The majority of differentially regulated genes were downregulated, including several associated with circadian clock function. In contrast, leptin and 3-hydroxy-3-methylglutaryl-CoA synthase 2 (Hmgcs2) were notably upregulated. Leptin is involved in several major energy balance signaling pathways and Hmgcs2 is a mitochondrial enzyme that catalyzes the first reaction of ketogenesis. CONCLUSION: Together, these data describe changes in gene expression within the aortic wall of HFD rats with early metabolic dysfunction and highlight potential pathways and signaling intermediates that may impact the development of early vascular dysfunction.

Resistant Starch Combined with Whey Protein Increases Postprandial Metabolism and Lowers Glucose and Insulin Responses in Healthy Adult Men.

Resistant starch (RS) and/or protein consumption favorably influence energy metabolism, substrate utilization, and weight management. The current study administered four different versions of a pancake breakfast containing waxy maize or RS with and without whey protein (WP) and measured postprandial thermogenesis (TEM), fuel utilization, and circulating satiation and appetite factors for 180 min in a group of healthy, adult men. On four separate visits to the laboratory, eight participants were administered four different pancake breakfast meal challenges using a single-blind, randomized crossover design: (1) waxy maize starch (WMS) control; (2) WMS and WP (WMS + WP); (3) RS; or (4) RS and WP (RS + WP). TEM (kcals/180 min) was significantly greater (p < 0.05) in RS + WP (45.11; confidence interval (CI), 33.81-56.41) compared to WMS (25.61; CI, 14.31-36.91), RS (29.44; CI, 18.14-40.74), and WMS + WP (24.64; CI, 13.34-35.94), respectively. Fat oxidation was enhanced (p < 0.05) after RS + WP compared to RS at 60 min (+23.10%), WMS at 120 min (+27.49%), and WMS and WMS + WP at 180 min (+35.76%; +17.31%, respectively), and RER was decreased with RS + WP versus the other three meals (mean differences: ≥-0.021). Insulin concentrations were decreased (p < 0.05) following RS + WP compared to WMS, whereas both RS (-46.19%) and RS + WP (-53.05%) insulin area under the curve (AUC) were greatly reduced (p < 0.01) compared to WMS. While limited by sample size, meals containing both RS and WP increased postprandial thermogenesis and fat oxidation, and lowered insulin response compared to isocaloric meals without this combination. Therefore, RS + WP may favorably impact energy metabolism and thus weight control and body composition under chronic feeding conditions.

Recent advances and health implications of dietary fasting regimens on the gut microbiome.

Calorie restriction is a primary dietary intervention demonstrated over many decades in cellular and animal models to modulate aging pathways, positively affect age-associated diseases and, in clinical studies, to promote beneficial health outcomes. Because long-term compliance with daily calorie restriction has proven problematic in humans several intermittent fasting regimens, including alternate day fasting and time-restricted feeding, have evolved revealing similar clinical benefits as calorie restriction. Despite significant research on the cellular and physiological mechanisms contributing to, and responsible for, these observed benefits, relatively little research has investigated the impact of these various fasting protocols on the gut microbiome (GM). Reduced external nutrient supply to the gut may beneficially alter the composition and function of a "fed" gut microflora. Indeed, the prevalent, obesogenic Western diet can promote deleterious changes in the GM, signaling intermediates involved in lipid and glucose metabolism, and immune responses in the gastrointestinal tract. This review describes recent preclinical and clinical effects of varying fasting regimens on GM composition and associated physiology. Although the number of preclinical and clinical interventions are limited, significant data thus far suggest fasting interventions impact GM composition and physiology. However, there are considerable heterogeneities of study design, methodological considerations, and practical implications. Ongoing research on the health impact of fasting regimens on GM modulation is warranted.

A four-week high fat diet does not alter plasma glucose or metabolic physiology in wild-caught mourning doves (Zenaida macroura).

The aim of this study was to determine the metabolic effects of a four-week 60% high-fat (HF) diet on mourning doves. Plasma glucose concentrations are, on average, 1.5-2 times higher in birds than in mammals of similar body mass, but birds have innate mechanisms that protect them from high blood glucose-associated pathologies normally developed in mammals. Elucidating these mechanisms may help develop therapeutics for treatment of human diabetes-related complications. A high fat (HF) diet is commonly used in rodents to investigate metabolic disease. We hypothesized that this diet in doves would elevate plasma glucose and alter metabolic physiology compared to the control (CON) diet. Following the four-week long diets, doves were euthanized, and we collected blood, liver, pectoralis muscles, and kidney samples. Contrary to the rodent-models, HF-fed birds did not have increased plasma glucose concentrations relative to CON-fed birds. Metabolomic analyses revealed no group differences in plasma, liver, pectoralis muscle, or kidney metabolites (FDR q-value>0.05 for all). Principal component analysis score plots of metabolites showed no separation between groups, and pathway analyses revealed no significantly altered metabolic pathways between groups (191 pathways across tissues, FDR q-value>0.05). Body mass, plasma uric acid, glucose, and insulin as well as liver and pectoralis muscle glycogen and triglycerides did not differ between groups (p > 0.05 for all). In conclusion, a four-week long high fat diet did not alter plasma glucose concentrations or metabolic physiology in mourning doves, indicating that these birds have mechanisms that allow them to avoid high fat diet-induced pathologies seen in mammals.