Relationship between Bone Mineral Density and Selected Parameters of Calcium-Phosphate Economy with Dietary Management and Metabolic Control in Polish Pediatric Patients with Classical Homocystinuria-A Preliminary Study.

BACKGROUND: Classical homocystinuria (HCU) is an inborn defect of methionine metabolism caused by a deficiency of the enzyme cystathionine ß-synthase (CBS). The main symptoms of classical homocystinuria are lens subluxation, bone lesions, vascular disease and developmental delay/intellectual disability. The treatment method for HCU is a methionine-poor diet supplemented with amino acid preparations. The aim of the study was to examine the relationship of dietary factors, metabolic compensation and selected skeletal parameters in patients with HCU. METHODS: Bone mineral density measurements (DXA) were performed in pediatric patients with HCU, and blood levels of selected amino acids, minerals and vitamins, as well as dietary nutritional value, were analyzed. RESULTS: A total of 11 patients with HCU whose median age was 9.3 years were enrolled in the study. The median DXA total body less head of HCU patients was -0.4 z-score, and the lumbar spine was -1.4 z-score. Despite supplementation, calcium intake was below the age norm. Average vitamin D3 intake was in line with recommendations, but 36% of patients had reduced blood levels. Bone mineral density depended on blood levels of 25-hydroxyvitamin D, homocysteine and methionine, as well as on BMI, age and intake of natural protein (R2 = 98.5%, p = 0.015; R2 = 86.7%, p = 0.0049) and protein from an amino acid preparation (r = 0.69, p = 0.026). CONCLUSION: The results of the study indicate the need for regular densitometry in patients with HCU and also the use of additional calcium and vitamin D3 supplementation. It is also necessary to perform a comprehensive analysis of the diet and metabolic controls.

Comparison of Glycemic Response to Carbohydrate Meals without or with a Plant-Based Formula of Kidney Bean Extract, White Mulberry Leaf Extract, and Green Coffee Extract in Individuals with Abdominal Obesity.

Due to the rising prevalence of obesity and type 2 diabetes, a strategy that can positively influence diet quality in a simple way is being explored, since a low glycemic index (GI) diet is advised in the dietoprophylaxis and diet therapy of diabetes. Methods: Twenty-three women with abdominal obesity participated in the study. The postprandial glycemic response and glycemic index were determined after three carbohydrate meals (noodle soup, white rice, strawberry sorbet) without or with the addition of a plant-base supplement (extracts of kidney bean, white mulberry leaf, and green coffee) with a potentially hypoglycemic effect. For two products (instant noodle soup and white rice), the addition of the plant supplement resulted in a reduction in glicemic iAUC values (respectively, by: 17.1%, p = 0.005 and 5.3%; p = 0.03; 40.6%, p = 0.004 and 5.3%, p = 0.019). However, this effect was not observed for strawberry sorbet. The blood glucose concentrations 30 min after the consumption of instant noodle soup and white rice with the plant-based formula addition significantly affected the GI value of tested meals (p = 0.0086, r = 0.53; p = 0.0096, r = 0.53), which may indicate the effect of this plant supplement on enterohormone and/or insulin secretion. Conclusion: A formula containing kidney bean, white mulberry leaves, and green coffee extracts may therefore be a notable factor in lowering postprandial glycemia and the GI of carbohydrate foods. However, further research is needed to determine for which food groups and meals its use may be most effective.

Assessment of the knowledge of nutritional recommendations and way of nutrition in vegetarians and vegans.

BACKGROUND: People following a vegetarian diet can obtain all the essential nutrients from a variety of foods. Among the nutrients, protein, iron, calcium, zinc, and vitamins B12 and D3 require special attention. OBJECTIVE: To assess the knowledge of dietary recommendations among different groups of vegetarians and the diet they follow. MATERIAL AND METHODS: The study involved a total of 390 subjects (360 women and 30 men), aged 18-60 years, who were following different vegetarian diets. The study was conducted in November 2020 via Facebook using the Computerassisted web interviewing (CAWI) method. Participation in the study was voluntary and anonymous, and sample selection was intentional (participants were members of groups for vegetarians in Facebook). Statistical analysis was carried out using the Chi2 test, using Statistica 13.3 (at p=0.05). RESULTS: To develop the results, the respondents were divided into 4 groups according to their diet: vegan, pescovegetarian, lactovegetarian, and people following other types of diets. The body mass index of nearly 2/3 of the respondents was within the normal range, and more than 80% of the respondents rated their health as good or very good. An analysis of the frequency of consumption of food products showed that, regardless of the type of vegetarian diet they followed, the participants adhered to the principles of proper nutrition. The respondents who rated their nutritional knowledge as very good were more likely to consume vegetables, fruits, legumes, and whole-grain cereals, and rarely consumed sweet and salty snacks, alcoholic and energizing drinks, or fast food. Vegans more frequently consumed fruits, vegetables, legumes, vegetable fats, and vegetable substitutes for meat and dairy products compared to other vegetarians. In addition to plant products, pesco- and lactovegetarians included selected animal-derived products in their food rations, thus skillfully diversifying the diet. More than 80% of the vegetarians used dietary supplements, mainly vitamins D and B12. CONCLUSIONS: Regardless of the type of vegetarian diet followed, the participants seemed to be aware of how to balance their diet and the ingredients that should be supplemented, even though a vast majority of them did not consult a diet specialist.

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.

Nutrition, supplementation and weight reduction in combat sports: a review.

Nutrition is the aspect closely connected to physical activity and may affect body composition, sports performance and post-workout regeneration. Using an appropriate diet plan is a proven method to optimize performance improvements in combat sports. In the majority of combat sports athletes are classified according to their body mass in order to minimize differences between competitors. Many athletes induce weight loss in order to gain an advantage over their opponents. The review was undertaken to provide safe, evidence-based protocols helping athletes in weight reduction without negative effects on sports performance. The nutritional requirements for combat sports athletes, sports supplements, gradual and rapid weight reduction strategies are discussed in this review.

Clinical Outcomes after Oat Beta-Glucans Dietary Treatment in Gastritis Patients.

The prevalence of gastritis in humans is constantly growing and a prediction of an increase in this health problem is observed in many countries. For this reason, effective dietary therapies are sought that can alleviate the course of this disease. The objective of this study was to determine the effect of chemically pure oat beta-glucan preparations with different molar masses, low or high, used for 30 days in patients with histologically diagnosed chronic gastritis. The study enrolled 48 people of both genders of different ages recruited from 129 patients with a gastritis diagnosis. Before and after the therapy, hematological, biochemical, immunological and redox balance parameters were determined in the blood and the number of lactic acid bacteria and SCFA concentrations in the feces. Our results demonstrated a beneficial effect of oat beta-glucans with high molar mass in chronic gastritis in humans, resulting in reduced mucosal damage and healthy changes in SCFA fecal concentration and peripheral blood serum glutathione metabolism and antioxidant defense parameters. This fraction of a highly purified oat beta-glucan is safe for humans. Its action is effective after 30 days of use, which sheds new light on the nutritional treatment of chronic gastritis.

Dietary recommendations during the Covid-19 pandemic. Statement of the Committee of Human Nutrition Science of the Polish Academy of Sciences.

During the COVID-19 pandemic, care for an adequate diet, well adapted to the body's needs and the current level of physical activity, becomes of particular importance. Many dietary compounds participate in the functioning of the immune system, while vitamins D, C, A (including beta-carotene), E, B6, B12, folic acid, zinc, copper, selenium, iron, amino acids, n-3 and n-6 polyunsaturated fatty acids and intestinal microbiota are crucial in various types of defence processes. There has been no evidence that consumed food and its compounds, including those with pro-/prebiotic properties, play a significant role in preventing SARS-CoV-2 infection or alleviating its course. However, in terms of the nutritional value of food and the prevention of dysbiosis, recommending a varied diet with a high proportion of plant-based foods and an adequate amount of animal-based foods has a sound scientific basis. Malnutrition, underweight and obesity are considered independent and prognostic risk factors of severe SARS-CoV-2 infection, which reduce a patient's chances of survival. Therefore, ensuring good nutritional status, including healthy body weight, is a reasonable approach in the prevention of viral infection SARS-CoV-2 or alleviating its course. The document is accompanied by two catalogues of practical nutritional recommendations during the COVID-19 pandemic, addressed to the general population and children.

Effectiveness of Personalized Low Salicylate Diet in the Management of Salicylates Hypersensitive Patients: Interventional Study.

Salicylic acid and its derivatives (including acetylsalicylic acid/aspirin) are popular in medicine. They also occur naturally in many food products. The aim of the study was to investigate the effect of the personalized low salicylate diet (PLSD) on the reduction of asthma, rhinosinusitis and urticaria symptoms in patients with hypersensitivity to aspirin (ASA) or nonsteroidal anti-inflammatory drugs (NSAIDs). To achieve the research goal, a prospective, nonrandomized, baseline-controlled intervention study was conducted. Thirty patients diagnosed with NSAIDs hypersensitivity, who despite pharmacotherapy had symptoms of hypersensitivity, were included in the study. The PLSD was recommended for all participants for a period of two to four weeks. The intensity of subjectively declared symptoms of asthma, rhinosinusitis and urticaria were measured before and after dietary intervention, using, respectively, the asthma control test (ACT), the sino-nasal outcome test (SNOT-22) and the four-item itch questionnaire (FIIQ). Diet adherence and salicylate intake were measured by a 3-day food record. The severity of symptoms improved significantly after the intervention. The median of the ACT score was 24 scores before and 25 after the dietary intervention (p < 0.002), the median of the SNOT-22 score was 25 before and 13 after a dietary intervention (p < 0.0002) and the median of the FIIQ score was 5 before and 0 after a dietary intervention (p < 0.0002). The intake of salicylates decreased from 0.79 mg/day (before intervention) to 0.15 mg/day (p < 0.001) (during intervention). Although the usefulness of a low salicylate diet in the treatment of salicylate hypersensitivity is controversial, the results of our study indicate that the PLSD may have a positive effect in reducing symptoms of salicylate hypersensitivity and could be an additional tool supporting the therapy of these patients.

Dissatisfaction with Body Weight among Polish Adolescents Is Related to Unhealthy Dietary Behaviors.

The aims of the study were to determine the socio-demographic factors that may affect body weight dissatisfaction and to analyze the relationship between eating habits and dissatisfaction with body weight among a national random sample of Polish adolescents aged 13-19 years. Data on gender, age, level of education, body weight status, screen time, body weight satisfaction and selected nutritional behaviors were collected using a questionnaire. Body mass status was assessed based on weight and height measurements. A total of 14,044 students from 207 schools participated in the study. A significant effect of gender, age, level of education, body weight status and screen time status on the participants' dissatisfaction with the body weight was observed. The greater prevalence of body weight satisfaction was observed among boys, younger subjects, secondary school students, adolescents with normal body weight status and those with screen time up to 2 h. Whereas girls, older study participants (17-19 years old), overweight/obese adolescents and subjects with screen time over 4 h were more often dissatisfied with body weight. Furthermore, it has been shown that participants dissatisfied with their body weight less often met dietary recommendations. These findings can help dietitians, nutritionists and healthcare professionals to provide age-specific and gender-specific nutrition strategies to promote healthy lifestyle among school-going adolescents.

Milk-free diet followed by breastfeeding women.

BACKGROUND: Breastfeeding is the most common way of feeding infants. Human milk contains nutrients which are necessary to provide proper growth of a child. Nowadays there aren't any recommendations to follow elimination diet in order to decrease the risk of allergy or baby colic. Only the occurrence of health problems such as lactose intolerance or cow's milk protein allergy in breastfeeding mother or infant should be a reason for eliminating dairy products from diet. It seems to be important to explore the reasons and the frequency of following milk-free diet by breastfeeding women. OBJECTIVES: The main purpose of the study was to find the reasons for following milk-free diet by breastfeeding women and making an assessment of their nutrition knowledge and food habits. MATERIAL AND METHODS: Thirty-three breastfeeding women following milk-free diet took part in the project. The women were interviewed by the Computer Assisted Web Interview (CAWI) method with an original questionnaire. The results were developed with Spearman's rank correlation, Chi2 test and the gamma coefficient. The statistical significance level for the p-value was <0.05. RESULTS: The main reason for following milk-free diet by the breastfeeding women was the occurrence of hypersensitivity reactions of the children's gastrointestinal system after consuming milk by mother (72% responses). After excluding milk from diet only 42% respondents declared consuming new food products or dietary supplements in order to refill the potential deficiency of nutrients. The majority of respondents also eliminated from diet highly processed food products, fast-food and the carbonated drinks. The most often declared source of information about lactation was Internet (85%). Only 12% respondents asked a nutritionist in order to get the information about breastfeeding. CONCLUSIONS: It's necessary to promote a specific nutritional advice about following milk-free diet in breastfeeding women group in order to decrease the health risk connected with low calcium diet.

Reduced Screen Time is Associated with Healthy Dietary Behaviors but Not Body Weight Status among Polish Adolescents. Report from the Wise Nutrition-Healthy Generation Project.

Screen time (ST) not only affects physical activity but can also be associated with dietary behaviors. Both of these factors determine the health and development of adolescents. The aims of the study were: 1. to analyze the relationship between ST and nutritional behaviors among adolescents; 2. to examine this association in relation to body weight status. Data on the ST duration and nutritional behaviors were collected using a questionnaire. Body mass status was assessed based on weight and height measurements. A total of 14,044 students aged 13-19 years old from 207 schools participated in the study. A significant relationship between ST and gender, age and type of school was observed, but not body weight status. The average ST duration increased with age (from 2.6 h among 13 years old to 3.2 h among 19 years old), and was significantly higher among boys in all age categories (2.7 h vs. 2.5 h in the youngest age group, and 3.5 h vs. 3.0 h in the oldest age group, respectively). The chance for meeting the recommendation for ST in a group of girls (regardless of age) was almost 50% higher compared to boys. Meeting ST recommendation (≤2 h) was associated with a greater odds ratio for favorable nutritional behaviors in the whole group, with exception of drinking milk or milk beverages, and significantly reduced the odds ratio of adverse dietary behaviors (drinking sweet beverages, consumption of sweets and fast food) in the whole group and by gender. More research is needed to clarify the possible cause-and-effect relationships between ST and dietary behaviors.

Nutritional Behaviors of Polish Adolescents: Results of the Wise Nutrition-Healthy Generation Project.

BACKGROUND: Recognition of the dominant dietary behaviors with respect to gender and specific age groups can be helpful in the development of targeted and effective nutritional education. The purpose of the study was to analyze the prevalence of the selected eating behaviors (favorable: Consuming breakfasts, fruit, vegetables, milk and milk beverages, whole grain bread and fish; adverse: Regular consumption of sweets, sugared soft drinks and fast-foods) among Polish adolescents. METHODS: Data on the nutritional behaviors were collected using a questionnaire. Body mass status was assessed based on weight and height measurements. RESULTS: 14,044 students aged 13-19 years old from 207 schools participated in the study. Significant differences were found in the nutritional behaviors depending on age, gender and nutritional status. Favorable nutritional behaviors corresponded with each other, the same relationship was observed for adverse behaviors. The frequency of the majority of healthy eating behaviors decreased with age, whereas the incidence of adverse dietary behaviors increased with age. Underweight adolescents more often consumed sugared soft drinks, sweets and fast food compared to their peers with normal and excessive body mass. CONCLUSIONS: A significant proportion of adolescents showed unhealthy nutritional behaviors. Showing changes in the incidence of nutritional behaviors depending on age, gender and body weight status, we provide data that can inform the development of dietary interventions tailored to promote specific food groups among adolescents on different stages of development to improve their diet quality.

Analysis of the Influence of Age, BMI, and WHtR on Body Mass Acceptance, Attitudes, and Motivation towards Body Mass Reduction in Overweight and Obese Caucasian Women.

The emotional consequences of excessive body mass, associated with body image and acceptance, have become a global public health challenge as they may decrease the general well-being and hinder weight loss in overweight and obese individuals. Therefore, this study aimed to analyze the influence of age, body mass index (BMI), and waist-to-height ratio (WHtR) on body mass acceptance, attitudes, and motivation toward body mass reduction in overweight and obese Caucasian women with excessive abdominal fat. The previously validated BodyMass⁻DRama (Body Mass⁻Dietary Restrictions: Acceptance, Motivation, Attitudes) questionnaire was applied in this study. The declared acceptance, attitudes and motivation towards body mass reduction were compared between subgroups based on age (20⁻40, 40⁻50, and 50⁻60 years), BMI (25.0⁻30.0, 30.0⁻35.0, and ≥35.0 kg/m²), and quartiles of WHtR. The age, BMI and WHtR were stated to be associated with declared acceptance, attitudes, and motivation towards body mass reduction. The different age groups indicated the following as the reasons for excessive body mass: young respondents-low physical activity and consumption of sweets; middle-aged ones-large/irregular meals; aging ones-large/irregular meals and low physical activity (p = 0.0161). While describing motivation toward body mass reduction, young respondents indicated the role of a physician or dietitian (p = 0.0012) or someone who can control them (p = 0.0044), as well as their expectation to be more successful at work after body mass reduction (p = 0.0045), while the aging ones indicated appreciation and plaudits from others (p = 0.0264) as a motivating factor. Respondents with the highest BMI declared having spending free time actively constricted (p = 0.0007); they declared more often than others of feeling exhausted (p = 0.0395) or tired all the time (p = 0.0445), but less often of feeling full of joy (p = 0.0457) or full of energy (p <0.0001). Respondents with moderate WHtR declared less often than others that they expect to enjoy socializing (p = 0.0376), but more often to be able to have a better vacation after body mass reduction (p = 0.0128), while those with the lowest WHtR expected to be more physically active (p = 0.0487). Women with the highest WHtR most commonly indicated external pressure from relatives or co-workers as a motivating factor for body mass reduction (p = 0.0435). Due to these differences between Caucasian women with excessive body mass, the approach of physicians and dietitians, as well as methods applied to motivate patients, need to be customized.

The Possibility of Applying the Vitamin D Brief Food Frequency Questionnaire as a Tool for a Country with No Vitamin D Data in Food Composition Tables.

Although the role of vitamin D is well known, the possibility of assessing its intake may be constricted in countries with no vitamin D data in food composition tables, as in the case of Croatia. The aim of the presented study was to adjust the VIDEO-FFQ (Vitamin D Estimation Only-Food Frequency Questionnaire), previously validated in Poland, to the Croatian population and to assess the validity and reproducibility of the adjusted Cro-VIDEO-FFQ (Croatian-VIDEO-FFQ). The study involved a group of Croatian women aged 20⁻30 and the Polish questionnaire was adjusted for a population due to similarities of the nutritional habits between countries. 106 individuals were recruited and 63 completed all the stages of the study. Participants conducted a 3-day dietary record and filled out the Cro-VIDEO-FFQ1 (first stage), as well as the same questionnaire (Cro-VIDEO-FFQ2) 6 weeks after (second stage). The following vitamin D intakes were observed in the studied group: 1.9 µg (0.2⁻8.0 µg) for 3-day dietary record, 3.3 µg (1.1⁻10.6 µg) for Cro-VIDEO-FFQ1, 3.6 µg (1.4⁻7.8 µg) for Cro-VIDEO-FFQ2. The Bland-Altman indexes in assessment of validity and reproducibility were 4.8% and 6.3%, respectively, with mean differences of 0.55 µg and 0.12 µg, as well as limits of agreement -0.91⁻2.01 µg and -0.44⁻0.69 µg. The kappa coefficient indicated a fair agreement for validity (0.21) and substantial for reproducibility (0.62), while correlations were significant (p = 0.0027, r = 0.37 for validity; p < 0.0001, r = 0.80 for reproducibility). It was observed that VIDEO-FFQ may be adjusted as a simple tool to assess vitamin D intake in a population with no vitamin D data in food composition tables, while Cro-VIDEO-FFQ may be a valid tool for nutritional assessment in Croatia.

A Polish Study on the Influence of Food Neophobia in Children (10-12 Years Old) on the Intake of Vegetables and Fruits.

Adhering to the recommended intake of fruits and vegetables is an important habit that should be inculcated in children, whereas food neophobia is indicated as one of the most important factors creating food preferences that may interfere. The aim of the presented study was to analyze the association between the food neophobia level and the intake of fruits and vegetables in children aged 10-12 years. The study was conducted among a group of 163 children (78 girls and 85 boys). The assessment of the food neophobia level was based on the Food Neophobia Scale (FNS) questionnaire and the assessment of the fruit and vegetable intake was based on the food frequency questionnaire. A negative correlation between the food neophobia level and the vegetable intake was observed both for girls (p = 0.032; R = -0.2432) and for boys (p = 0.004; R = -0.3071), whereas for girls differences in vegetable intake were observed also between various food neophobia categories (p = 0.0144). It may be concluded that children with higher food neophobia level are characterized by lower vegetable intake than children with lower food neophobia level. For fruits and juices of fruits and vegetables, associations with food neophobia level were not observed.

The effect of dairy products choice on calcium dietary intake in female university students of nutritional faculty.

BACKGROUND: Dairy products provide the most important source of calcium in a typical human diet, being of particular significance to women. OBJECTIVE: To determine dietary calcium intakes in a group of female students studying human nutrition at a Warsaw University of Life Sciences - SGGW through analysing the selections made of dairy products. MATERIALS AND METHODS: A food frequency questionnaire was used to assess average consumption of dairy products. Total daily calcium intakes were then estimated by adding the intakes obtained from such dairy products to an average non-dairy calcium value obtained from other foodstuffs and taken to be 250 mg. RESULTS: Varied choices were made of dairy foodstuffs, with most subjects consuming milk, milk beverages, cottage cheese and rennet cheese. Calcium intakes were thus dependent on the dietary assortment of such selected dairy products made. Whenever cheeses were avoided in the diet, then low calcium intakes became more common. CONCLUSIONS: When compared to dietary recommendations, calcium intakes in this group of young women were inadequately low especially for those not eating cheese and despite supposedly having sufficient knowledge through studying this subject area.

Possibility of pain reduction by dietary intervention in patients with advanced cancer.

Pain in advanced cancer can have many causes, and they are not necessarily associated with the presence of cancer. Invalid daily food rations in terms of energy, nutritional value, and cooking techniques used can significantly impair quality of life, increase patients' pain and other somatic symptoms and aggravate malnutrition and cachexia. Basic dietary factors affecting the quality of life and severity of somatic symptoms are the nutritional value of the diet, the frequency of meals and their consistency, the presence of fiber, fat, sugars, lactose, gluten and nutraceuticals. Extremely important is the role of a team of specialists, that offers professional nutritional advice to the patients and their carers.

[Self-acceptance motivation and expectations for loosing weight in obese women]. / Samoakceptacja, motywacja i oczekiwania zwiazane z redukcja masy ciala u otylych kobiet.

The objective of the study was to determine acceptance, motivation and expectations for loosing weight in obese women. The study included 189 under weight and obese women at the age of 22-65 years (44.3 +/- 10.4 years), with BMI from 25 to 46 kg/m2 (32.4 +/- 4.5 kg/m2), patients from Warsaw University of Life Science Dietary Counseling. Women divided by the degree of under weight and age. The acceptance, motivation and expectations for loosing weight was evaluated on the strength of ours questionnaire, witch was create especially for this aim. Age of obese women influenced on their self acceptance, women at the age of 30-50 years better approve their body weight than others. Degree of under weight influenced on self-confidence and their expectation of acceptance after loosing weight. The most important factors to loosing weight for women after 50 years old was health and the meetings with person who had the problem, but for women before 40 years old was more motivated by relatives.

[Oat products in gluten free diet]. / Przetwory owsiane w diecie bezglutenowej.

Diagnosis of celiac disease in patent in different age is increased, but gluten free diet is only way to treat this disease. Diet without gluten cereals: wheat, rye, barley and oats is often low in many minerals, vitamins and dietary fiber, but rich in fat and sugar. Gluten free diet witch is supplemented with oats products may contains more dietary fiber, minerals, thiamine, biotin, tokopherols, tokotrienos, and unsaturated fatty acids. The majority of researches show that inclusion 20-50g/d of oat products to gluten free diet is safe for children and adults with new diagnosed and also in remission state. Simultaneously, some patients with celiac disease may intolerance to avenin. The control and assessment of gluten (wheat, rye, barley) contamination in oat products and also long term introduction of oat products to gluten free diet for patient at different age.

[Assessment of tears secretion after refractive surgery]. / Ocena wydzielania lez u pacjentów po chirurgii refrakcyjnej.

PURPOSE: One of the complications of the corneal refractive surgery is a transient disturbance in tears secretion, which can lead to the dry eye syndrome. The aim of the study was to evaluate the tears secretion in patients after PRK, LASEK and LASIK surgery for myopia. MATERIAL AND METHODS: We examined 115 eyes of 69 patients (46 woman and 23 men), mean age 30.82, with myopia and myopic astigmatism, treated with three different refractive procedures. The patients included in this study were divided into three groups: Group I: 35 eyes of 22 patients (15 woman and 7 men) treated with PRK. The mean spherical equivalent of the refractive error was -4.18 dioptres (from -8.75 to -2.0). Group II: 41 eyes of 23 patients (13 woman and 10 men) treated with LASEK. The mean spherical equivalent of the refractive error was -5.73 dioptres (from -12.0 to -2.75). Group III: 39 eyes of 24 patients (18 woman and 6 men) treated with LASIK. The mean spherical equivalent of the refractive error was -7.49 dioptres (from -10.75 to -3.75). In this study the amount of tears secreted was analyzed on the base of Schirmer I test, performed before and after surgery. Test was always performed in the same room, in the morning hours (before noon), with constant temperature and air humidity values. RESULTS: In the PRK group the mean value of Schirmer I test was 20.91 mm before surgery. 14 days after surgery the mean value decreased to 14.09 mm, 1 month after surgery to 11.66 mm. Then increase in tears secretion was observed: 2 months after surgery the mean value of Schirmer I test was 13.94 mm, 3 months after surgery 15.23 mm, and 6 months after surgery 17.4 mm. In the LASEK group the mean value of Schirmer I test was 20.39 mm before surgery. 14 days after surgery the mean value decreased to 15.78 mm, 1 month after surgery to 13.05 mm. Two months after surgery the mean value of Schirmer I test was 15.24 mm, 3 months after surgery 16.17 mm, and 6 months after surgery 18.15 mm. In the LASIK group the mean value of Schirmer I test was 20.72 mm before surgery. 14 days after surgery the mean value decreased to 12.97 mm, 1 month after surgery to 5 mm. 2 months after surgery mean value of Schirmer I test was 12.79 mm, 3 months after surgery 15.05 mm, and 6 months after surgery 17.82 mm. CONCLUSIONS: Corneal refractive surgery causes transient reduction of tears secretion, especially during the first three postoperative months. The tears secretion was reduced most significantly in the LASIK group. In patients treated with PRK and LASEK tears secretion during the postoperative period was comparable with slightly better secretion in the LASEK patients.