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1.
Pediatr Clin North Am ; 66(5): 955-965, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31466684

RESUMO

Eosinophilic esophagitis is a recently defined condition that has dramatically increased in prevalence in the last several decades. It may occur at any age, but the clinical presentation in young children is often more vague than the classic solid food dysphagia and food impacting that are the major presenting symptoms of eosinophilic esophagitis in adults and adolescents. Successful therapies exist, including medications and dietary modifications, but disease typically recurs when the intervention is discontinued.


Assuntos
Esofagite Eosinofílica/diagnóstico , Esofagite Eosinofílica/imunologia , Esofagite Eosinofílica/terapia , Administração Tópica , Produtos Biológicos/uso terapêutico , Criança , Transtornos de Deglutição/diagnóstico , Diagnóstico Diferencial , Esofagoscopia , Hipersensibilidade Alimentar/dietoterapia , Hipersensibilidade Alimentar/imunologia , Humanos , Esteroides/uso terapêutico
2.
Nutrients ; 11(7)2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31284450

RESUMO

This review discusses the personalised dietary approach with respect to inflammatory bowel disease (IBD). It identifies gene-nutrient interactions associated with the nutritional deficiencies that people with IBD commonly experience, and the role of the Western diet in influencing these. It also discusses food intolerances and how particular genotypes can affect these. It is well established that with respect to food there is no "one size fits all" diet for those with IBD. Gene-nutrient interactions may help explain this variability in response to food that is associated with IBD. Nutrigenomic research, which examines the effects of food and its constituents on gene expression, shows that-like a number of pharmaceutical products-food can have beneficial effects or have adverse (side) effects depending on a person's genotype. Pharmacogenetic research is identifying gene variants with adverse reactions to drugs, and this is modifying clinical practice and allowing individualised treatment. Nutrigenomic research could enable individualised treatment in persons with IBD and enable more accurate tailoring of food intake, to avoid exacerbating malnutrition and to counter some of the adverse effects of the Western diet. It may also help to establish the dietary pattern that is most protective against IBD.


Assuntos
Deficiências Nutricionais/dietoterapia , Dieta Ocidental/efeitos adversos , Hipersensibilidade Alimentar/dietoterapia , Doenças Inflamatórias Intestinais/dietoterapia , Nutrigenômica/métodos , Estado Nutricional , Medicina de Precisão/métodos , Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente , Adulto , Animais , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Deficiências Nutricionais/epidemiologia , Deficiências Nutricionais/genética , Deficiências Nutricionais/fisiopatologia , Comportamento Alimentar , Feminino , Hipersensibilidade Alimentar/epidemiologia , Hipersensibilidade Alimentar/genética , Hipersensibilidade Alimentar/fisiopatologia , Interação Gene-Ambiente , Humanos , Doenças Inflamatórias Intestinais/epidemiologia , Doenças Inflamatórias Intestinais/genética , Doenças Inflamatórias Intestinais/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estado Nutricional/genética , Valor Nutritivo , Fatores de Risco , Resultado do Tratamento , Adulto Jovem
3.
Gastroenterol Hepatol ; 42(7): 449-457, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31262542

RESUMO

Wheat is a common cereal in the Western diet and an important source of protein as well as fiber. However, some individuals develop adverse reactions to a wheat-containing diet. The best characterized is celiac disease which develops after intake of gluten in individuals with genetic predisposition. Other wheat-related conditions are less well defined in terms of diagnosis, specific trigger and underlying pathways. Despite this, the overall prevalence of wheat-related disorders has increased in the last decades and the role of microbial factors has been suggested. Several studies have described an altered intestinal microbiota in celiac patients compared to healthy subjects, but less information is available regarding other wheat-related disorders. Here, we discuss the importance of the intestinal microbiota in the metabolism of wheat proteins and the development of inflammatory or functional conditions. Understanding these interactions will open new directions for therapeutic development using bacteria with optimal wheat protein degrading capacity.


Assuntos
Microbioma Gastrointestinal , Proteínas de Plantas/metabolismo , Triticum , Imunidade Adaptativa , Bactérias/metabolismo , Doença Celíaca/dietoterapia , Doença Celíaca/metabolismo , Doença Celíaca/microbiologia , Dieta Livre de Glúten , Hipersensibilidade Alimentar/dietoterapia , Hipersensibilidade Alimentar/microbiologia , Hipersensibilidade Alimentar/prevenção & controle , Glutens/efeitos adversos , Humanos , Imunidade Inata , Proteínas de Plantas/imunologia , Linfócitos T/imunologia , Triticum/efeitos adversos , Triticum/imunologia , Inibidores da Tripsina/efeitos adversos , Inibidores da Tripsina/metabolismo , Aglutininas do Germe de Trigo/efeitos adversos , Aglutininas do Germe de Trigo/metabolismo
4.
Nutrients ; 11(8)2019 07 25.
Artigo em Inglês | MEDLINE | ID: mdl-31349704

RESUMO

Epidemiological studies identified raw cow's milk consumption as an important environmental exposure that prevents allergic diseases. In the present study, we investigated whether raw cow's milk has the capacity to induce tolerance to an unrelated, non-milk, food allergen. Histone acetylation of T cell genes was investigated to assess potential epigenetic regulation. Female C3H/HeOuJ mice were sensitized and challenged to ovalbumin. Prior to sensitization, the mice were treated with raw milk, processed milk, or phosphate-buffered saline for eight days. Allergic symptoms were assessed after challenge and histone modifications in T cell-related genes of splenocyte-derived CD4+ T cells and the mesenteric lymph nodes were analyzed after milk exposure and after challenge. Unlike processed milk, raw milk decreased allergic symptoms. After raw milk exposure, histone acetylation of Th1-, Th2-, and regulatory T cell-related genes of splenocyte-derived CD4+ T cells was higher than after processed milk exposure. After allergy induction, this general immune stimulation was resolved and histone acetylation of Th2 genes was lower when compared to processed milk. Raw milk reduces allergic symptoms to an unrelated, non-milk, food allergen in a murine model for food allergy. The activation of T cell-related genes could be responsible for the observed tolerance induction, which suggested that epigenetic modifications contribute to the allergy-protective effect of raw milk.


Assuntos
Montagem e Desmontagem da Cromatina , Epigênese Genética , Hipersensibilidade Alimentar/dietoterapia , Histonas/metabolismo , Tolerância Imunológica , Ativação Linfocitária , Leite/imunologia , Subpopulações de Linfócitos T/metabolismo , Acetilação , Animais , Células Cultivadas , Citocinas/imunologia , Citocinas/metabolismo , Modelos Animais de Doenças , Feminino , Hipersensibilidade Alimentar/genética , Hipersensibilidade Alimentar/imunologia , Hipersensibilidade Alimentar/metabolismo , Camundongos Endogâmicos C3H , Ovalbumina , Subpopulações de Linfócitos T/imunologia , Linfócitos T Reguladores/imunologia , Linfócitos T Reguladores/metabolismo , Células Th1/imunologia , Células Th1/metabolismo , Células Th2/imunologia , Células Th2/metabolismo
5.
J Med Invest ; 66(1.2): 201-204, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31064942

RESUMO

Eosinophilic gastrointestinal disorders are chronic inflammatory diseases in which eosinophils highly infiltrate into gastrointestinal tissue, resulting in gastrointestinal dysfunction. Here, we report a case of pediatric eosinophilic gastroenteritis (EGE). A 7-year-old boy with multiple food allergies (cow milk, hen's egg, fish,shellfish, and chicken) was admitted to our hospital because of continuous abdominal pain and vomiting. His soy allergy had been diagnosed to have oral tolerance based on an oral food challenge at the age of 6 years. He was diagnosed with EGE based on biopsy findings showing eosinophilic infiltration ( 20 eosinophils per high-power field) into the gastrointestinal mucosa. A diet eliminating soy, wheat, beef, pork, rice, and sesame in addition to the food that had already been eliminated and oral corticosteroids improved his symptoms and peripheral eosinophilia. A relapse of both abdominal pain and peripheral eosinophilia after the reintroduction of soy or pork identified them as foods causative of EGE. This report highlights the utility of elimination diets in improving EGE symptoms and the subsequent reintroduction of offending foods in identifying causative foods. Furthermore,EGE onset should be considered when introducing potentially allergic food in the management of food allergy. J. Med. Invest. 66 : 201-204, February, 2019.


Assuntos
Eosinofilia/dietoterapia , Hipersensibilidade Alimentar/dietoterapia , Gastroenterite/dietoterapia , Criança , Humanos , Masculino
7.
Dig Dis Sci ; 64(6): 1401-1408, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30927211

RESUMO

Eosinophilic esophagitis (EoE) is an immune-mediated disease triggered by food antigens for which dietary elimination treatment can induce and sustain histologic remission. Our review aims to describe the state of the art regarding dietary treatment of EoE, highlighting a number of areas of controversy related to dietary therapy in EoE, including novel modalities for determining food triggers, making the empiric dietary elimination process more efficient, issues of cross-contamination and "dosing" of how much food to avoid or add back, costs and effects on quality of life, long-term efficacy, and the risk of developing immediate IgE-type reactions after initial dietary elimination. Elemental formulas, empiric elimination diets, and targeted allergy test-directed elimination diets are well-described treatments for EoE. Although elemental diets are most efficacious, their clinical use is limited by cost and the palatability of an exclusively liquid diet. While empiric elimination is less effective than elemental formula-based diets, they are more easily implemented and often sustainable. Since the comparative effectiveness of elimination diets with proton-pump inhibitors and swallowed topical steroids remains unknown, there are multiple areas to address with future research.


Assuntos
Alérgenos/efeitos adversos , Esofagite Eosinofílica/dietoterapia , Hipersensibilidade Alimentar/dietoterapia , Alérgenos/imunologia , Animais , Reações Cruzadas , Esofagite Eosinofílica/imunologia , Hipersensibilidade Alimentar/imunologia , Humanos , Fatores de Risco , Resultado do Tratamento
8.
Pediatrics ; 143(4)2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30886111

RESUMO

This clinical report updates and replaces a 2008 clinical report from the American Academy of Pediatrics, which addressed the roles of maternal and early infant diet on the prevention of atopic disease, including atopic dermatitis, asthma, and food allergy. As with the previous report, the available data still limit the ability to draw firm conclusions about various aspects of atopy prevention through early dietary interventions. Current evidence does not support a role for maternal dietary restrictions during pregnancy or lactation. Although there is evidence that exclusive breastfeeding for 3 to 4 months decreases the incidence of eczema in the first 2 years of life, there are no short- or long-term advantages for exclusive breastfeeding beyond 3 to 4 months for prevention of atopic disease. The evidence now suggests that any duration of breastfeeding ≥3 to 4 months is protective against wheezing in the first 2 years of life, and some evidence suggests that longer duration of any breastfeeding protects against asthma even after 5 years of age. No conclusions can be made about the role of breastfeeding in either preventing or delaying the onset of specific food allergies. There is a lack of evidence that partially or extensively hydrolyzed formula prevents atopic disease. There is no evidence that delaying the introduction of allergenic foods, including peanuts, eggs, and fish, beyond 4 to 6 months prevents atopic disease. There is now evidence that early introduction of peanuts may prevent peanut allergy.


Assuntos
Dieta , Intervenção Médica Precoce/métodos , Hipersensibilidade Alimentar/dietoterapia , Hipersensibilidade Alimentar/prevenção & controle , Cuidado Pós-Natal/métodos , Aleitamento Materno/efeitos adversos , Aleitamento Materno/métodos , Criança , Pré-Escolar , Feminino , Alimentos Formulados , Humanos , Hipersensibilidade Imediata/dietoterapia , Hipersensibilidade Imediata/prevenção & controle , Lactente , Alimentos Infantis/efeitos adversos , Recém-Nascido , Masculino , Necessidades Nutricionais , Prognóstico , Medição de Risco , Fatores de Tempo
9.
Nutrients ; 11(2)2019 02 09.
Artigo em Inglês | MEDLINE | ID: mdl-30744105

RESUMO

The prevalence of food allergy appears to be steadily increasing in infants and young children. One of the major challenges of modern clinical nutrition is the implementation of individualized nutritional recommendations. The management of food allergy (FA) has seen major changes in recent years. While strict allergen avoidance is still the key treatment principle, it is increasingly clear that the avoidance diet should be tailored according to the patient FA phenotype. Furthermore, new insights into the gut microbiome and immune system explain the rising interest in tolerance induction and immunomodulation by microbiota-targeted dietary intervention. This review article focuses on the nutritional management of IgE mediated food allergy, mainly focusing on different aspects of the avoidance diet. A personalized approach to managing the food allergic individual is becoming more feasible as we are learning more about diagnostic modalities and allergic phenotypes. However, some unmet needs should be addressed to fully attain this goal.


Assuntos
Hipersensibilidade Alimentar/dietoterapia , Terapia Nutricional , Medicina de Precisão , Humanos
10.
Clin Rev Allergy Immunol ; 57(2): 166-178, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29766369

RESUMO

Diet and nutrition play an important role in the development and management of food allergy. The diet of expectant mothers can have an effect on their offspring in terms of allergic outcomes. A host of confounding factors may influence this, with a maternal diet rich in fruits and vegetables, fish, vitamin D-rich foods associated with a lower risk of allergic disease in their children. More surprisingly, the consumption of milk and butter has also been shown to have a protective effect, especially in a farm environment. Similarly, the diet of the infant can also be important, not only in terms of breast feeding, but also the timing of the introduction of complementary foods, the diversity of the diet and the effect of individual foods on the development of allergy. One factor which has clearly been shown not to influence the development of food allergy is allergen avoidance by expectant mothers. In the infant diet, the manipulation of the gut microbiome to prevent the development of atopic disease is clearly an area which promises much, although studies have yet to provide a breakthrough in the prevention of atopic dermatitis. More concrete evidence of the value of diet in prevention has come from studies evaluating infant eating patterns which may protect gut health, through the consumption of large amounts of home-processed fruits and vegetables. The consumption of fish during the first year of life has also been shown to be protective. The importance of nutritional issues in children and adults who have a food allergy has become much more accepted in recent years. The primary allergenic foods in infancy and childhood, milk, egg, wheat and soy are also ones which are present in many foods and thus their avoidance can be problematic from a nutritional perspective. Thus, children with a food allergy can have their growth compromised through avoidance, especially pre-diagnosis, when foods may be excluded without any expert nutritional input. The management of a food allergy largely remains the exclusion of the offending food(s), but it is now clear that in doing so, children in particular can be at nutritional risk if insufficient attention is paid to the rest of the diet. Adults with food allergy are often thought not to need nutritional counselling; however, many will exclude a wide range of foods due to anxiety about trace exposure, or similar foods causing reactions. The avoidance of staple foods such as milk and wheat are common, but substitute foods very often do not have comparable nutritional profiles. Adults may also be more susceptible to on-line promotion of extreme nutritional regimes which can be extremely harmful. All food allergic individuals, whatever their age, should have a nutrition review to ensure they are consuming a healthy, balanced diet, and are not avoiding food groups unnecessarily.


Assuntos
Dieta , Hipersensibilidade Alimentar/dietoterapia , Hipersensibilidade Alimentar/prevenção & controle , Nutrientes , Adulto , Alérgenos/imunologia , Aleitamento Materno , Criança , Pré-Escolar , Feminino , Alimentos/efeitos adversos , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez
11.
Eur J Clin Nutr ; 73(1): 102-104, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30022117

RESUMO

Diagnosis of histamine intolerance (HIT) has been based on low serum diamine oxidase (DAO) values, functional gastrointestinal disorders and improvement of symptoms with a histamine-reduced diet (HRD). In a retrospective analysis of outpatients' charts we identified 101 patients with HIT. After a median of 13 months, a questionnaire was distributed to the patients so that they could be classified into four diet-compliance groups. Calculated with all 101 patients we found an increase of serum DAO values due to a HRD. In the 63 patients that completed the questionnaire, we found that 50 patients had improvement of symptoms or no continuing symptoms. A significant increase of serum DAO levels was found in the patients with strict and occasional diet compliance. Therefore, we demonstrate that a HRD is not only improving symptoms in HIT, but is causing an increase in serum DAO values that correlates with the degree of diet compliance.


Assuntos
Amina Oxidase (contendo Cobre)/sangue , Dietoterapia/métodos , Hipersensibilidade Alimentar/dietoterapia , Histamina/efeitos adversos , Cooperação do Paciente/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hipersensibilidade Alimentar/sangue , Hipersensibilidade Alimentar/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
12.
Allergol Int ; 68(2): 178-184, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30253946

RESUMO

BACKGROUND: Non-IgE-mediated gastrointestinal food allergies (non-IgE-GI-FAs) are one type of food allergy found in neonates and infants. Few reports have defined the severity of non-IgE-GI-FAs in these populations. METHODS: Grading scales of the severity of non-IgE-GI-FAs according to extra-GI symptoms, such as poor weight gain, as well as systemic symptoms, including fever and shock, were developed and retrospectively applied to patients with non-IgE-GI-FAs. The relationship between the severity of non-IgE-GI-FAs and both clinical and laboratory findings were examined. RESULTS: Elevation of C-reactive protein levels and a decrease in total protein and albumin were observed in accordance with allergy severity. In an endoscopic examination, inflammatory findings were confirmed in large areas of the colonic mucosa in case of higher severity levels, and infiltration of inflammatory cells other than eosinophils was found in the severest grade. Extensively hydrolyzed milk or amino acid-based milk was required for all patients with the severest grade. In addition, the timing of acquiring tolerance tended to be late for this grade. CONCLUSIONS: Classification and determination of the severity of non-IgE-GI-FAs in neonates and infants may not only contribute to elucidation of the pathogenesis but may also be useful in the clinical setting.


Assuntos
Hipersensibilidade Alimentar/diagnóstico , Proteína C-Reativa/análise , Colo/patologia , Endoscopia , Feminino , Hipersensibilidade Alimentar/sangue , Hipersensibilidade Alimentar/dietoterapia , Hipersensibilidade Alimentar/patologia , Humanos , Imunoglobulina E/sangue , Lactente , Recém-Nascido , Mucosa Intestinal/patologia , Masculino , Índice de Gravidade de Doença
13.
Pediatr Allergy Immunol ; 30(1): 99-106, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30346637

RESUMO

BACKGROUND: Food allergies can substantially burden patients and families by negatively affecting finances, social relationships, and personal perceptions of health. This study was performed under the Finnish Allergy Programme aimed at reducing avoidance diets to foods in schoolchildren by 50%. The main goal of this study was to investigate how many children could be freed from diet restrictions in a Finnish school district through a diagnostic algorithm including component-resolved diagnostics and food challenge. The secondary aim was to provide a crude estimate of the burden of the elimination food diets in the region, and the savings associated with the proposed intervention. METHODS: A total of 205 children on a food avoidance diet according to the school register because of food allergy were invited into the study. One hundred and fifty-seven children were interviewed, tested for IgE to extracts and allergen components and food challenged in respective order. RESULTS: After two years, 12 children still had an avoidance diet and three of them were treated successfully with sOTI; the rest suspended their avoidance diet (n = 134) or dropped out of the study (n = 11). The cost of the elimination diets was estimated in 172 700€ per year at start and 13 200€ per year at the end of the study; total savings were 128 400€ yearly. CONCLUSIONS: The results demonstrate a 65% reduction of avoidance diets to foods in school-aged children, exceeding the 50% aim of the Finnish Allergy Programme. Therefore, it is possible to actively reduce the number of food allergy diagnoses that remain unmonitored in the society through a tailored diagnostic work-up.


Assuntos
Alérgenos/imunologia , Efeitos Psicossociais da Doença , Hipersensibilidade Alimentar/diagnóstico , Adolescente , Algoritmos , Criança , Feminino , Finlândia , Hipersensibilidade Alimentar/dietoterapia , Hipersensibilidade Alimentar/economia , Humanos , Imunoglobulina E/sangue , Masculino , Análise em Microsséries/métodos , Serviços de Saúde Escolar/economia , Serviços de Saúde Escolar/estatística & dados numéricos
14.
J Altern Complement Med ; 25(2): 241-248, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30265560

RESUMO

OBJECTIVES: The goal of this study was to assess changes in serum immunoglobulin G (IgG) food antibody titers and quality-of-life measurements following a targeted elimination diet in overweight/obese adults. METHODS: We performed a randomized control trial. Participants were randomized in a 2:1 ratio to either an intervention group or waitlist group for 3 months. Food IgG testing was performed on all participants. The intervention group was instructed to eliminate up to 10 foods, for which they had high titers of IgG and communicated with health coaches for nutritional counseling for meal planning and adherence. The waitlist group did not receive their IgG testing results or health coaching. Primary outcome was serum IgG titers for foods eliminated during the trial, compared with baseline concentrations. Secondary outcomes were health-related quality of life measured by Patient-Reported Outcomes Measurement Information System (PROMIS-29) and change in participant-identified symptom severity measured by Measure Yourself Medical Outcome Profile. Exploratory outcomes were changes in body weight and waist circumference. RESULTS: IgG antibody concentrations decreased in 83% of the targeted foods in the treatment group and in 60% of the foods in the waitlist group, but this was not found to be a statistically significant difference. The intervention group reported improvement in sleep during the trial compared with waitlist, which was the only statistically significant finding in the study. CONCLUSIONS: The findings are consistent with changes in IgG titer measurements following an elimination diet based on IgG testing. Future larger clinical trials are necessary to determine the degree to which these findings are generalizable.


Assuntos
Hipersensibilidade Alimentar/dietoterapia , Imunoglobulina G/sangue , Obesidade/dietoterapia , Sobrepeso/dietoterapia , Qualidade de Vida , Adulto , Dieta , Feminino , Hipersensibilidade Alimentar/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Sobrepeso/complicações
16.
Allergol. immunopatol ; 46(6): 607-611, nov.-dic. 2018. tab
Artigo em Inglês | IBECS | ID: ibc-177902

RESUMO

Food protein-induced enterocolitis syndrome (FPIES) is a non IgE-mediated gastrointestinal food allergic disorder. Some diagnostic criteria have been published for acute FPIES. Of course, they are not all the same, so the clinician must choose which ones to adopt for his/her clinical practice. We present here a brief review of these criteria and, through two clinical cases, show how the choice of one or the other can change the diagnostic destiny of a child with suspect FPIES


No disponible


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Alérgenos/imunologia , Proteínas Dietéticas do Ovo/imunologia , Proteínas de Peixes/imunologia , Hipersensibilidade Alimentar/diagnóstico , Trato Gastrointestinal/patologia , Doença Aguda , Dietoterapia , Enterocolite , Hipersensibilidade Alimentar/dietoterapia , Tolerância Imunológica , Síndrome
17.
Nutrients ; 10(10)2018 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-30287726

RESUMO

Gluten-related disorders (GRD) affect millions of people worldwide and have been related to the composition and metabolism of the gut microbiota. These disorders present differently in each patient and the only treatment available is a strict life-long gluten-free diet (GFD). Several studies have investigated the effect of a GFD on the gut microbiota of patients afflicted with GRD as well as healthy people. The purpose of this review is to persuade the biomedical community to think that, while useful, the results from the effect of GFD on health and the gut microbiota cannot be extrapolated from one population to others. This argument is primarily based on the highly individualized pattern of gut microbial composition and metabolic activity in each person, the variability of the gut microbiota over time and the plethora of factors associated with this variation. In addition, there is wide variation in the composition, economic viability, and possible deleterious effects to health among different GFD, both within and among countries. Overall, this paper encourages the conception of more collaborative efforts to study local populations in an effort to reach biologically and medically useful conclusions that truly contribute to improve health in patients afflicted with GRD.


Assuntos
Doença Celíaca/microbiologia , Dieta Livre de Glúten , Hipersensibilidade Alimentar/microbiologia , Intolerância Alimentar/microbiologia , Microbioma Gastrointestinal , Glutens , Doença Celíaca/dietoterapia , Hipersensibilidade Alimentar/dietoterapia , Intolerância Alimentar/dietoterapia , Glutens/farmacologia , Humanos , Saúde da População
18.
F1000Res ; 72018.
Artigo em Inglês | MEDLINE | ID: mdl-30363819

RESUMO

Non-celiac gluten sensitivity (NCGS) is a condition characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing foods in the absence of celiac disease and wheat allergy. The diagnosis is cumbersome and currently confirmed only by gluten withdrawal and double-blind placebo challenge protocols. There is great overlap in symptoms between NCGS and other functional gastrointestinal disorders, making a differential diagnosis difficult. The pathophysiology of NCGS is largely unclear, and there are contrasting data on the trigger of this condition. This review will highlight the state-of-the-art knowledge on NCGS and the key open questions.


Assuntos
Hipersensibilidade Alimentar/diagnóstico , Glutens/imunologia , Doença Celíaca , Diagnóstico Diferencial , Dieta Livre de Glúten , Hipersensibilidade Alimentar/dietoterapia , Hipersensibilidade a Trigo
19.
Nutr. hosp ; 35(n.extr.4): 130-135, sept. 2018. graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-181555

RESUMO

El objetivo de esta revisión es resumir los aspectos más relevantes de la atención a comensales con dieta específica en los servicios de restauración a colectividades. Las características del comensal-usuario final del servicio suelen condicionar tanto la variedad de dietas específicas a las que hay que dar servicio como su modelo organizativo. Existen dos modelos de servicio a colectividades diferenciados entre sí por el lugar en el que se realiza la elaboración y el servicio de las comidas preparadas: producción centralizada o servicio de comidas transportadas y producidas in situ. El dietista-nutricionista experto en alimentación a colectividades y el uso de las nuevas tecnologías juegan un papel esencial en el proceso. La gestión de dietas específicas en los servicios de restauración a colectividades forma parte intrínseca de la actividad. A pesar de la alta profesionalización del sector en este ámbito, es necesario una constante adaptación a las nuevas necesidades emergentes, sobre todo las relacionadas con alergias e intolerancias alimentarias y las situaciones de dependencia generadas por el aumento de la esperanza de vida de la población


The objective of this review is to summarize the most relevant aspects of the attention to diners with specific diet in the catering sector. The characteristics of the final consumer usually determine both the variety of specific diets to be served and the operative of the service. There are two models of catering services that are differentiated from each other by the place where the foods are prepared and delivered: centralized production and on-site production. The specialized work of Dieticians and the implementation of technological solutions that entail the optimization and a better control of the process are usual in the catering sector. The management of specifics diets in catering sector is intrinsic to its activity. Despite the high professionalism of the sector in this area, it is necessary a constant adaptation to the new emerging needs, especially those related to allergies and food intolerances and the situations of dependence generated by the increase of the life expectancy of the population


Assuntos
Humanos , Serviços de Dietética/organização & administração , Serviços de Alimentação/organização & administração , Dieta , Hipersensibilidade Alimentar/dietoterapia , Medicina de Precisão
20.
Nutr Hosp ; 35(Spec No4): 130-135, 2018 Jun 12.
Artigo em Espanhol | MEDLINE | ID: mdl-30070135

RESUMO

The objective of this review is to summarize the most relevant aspects of the attention to diners with specific diet in the catering sector. The characteristics of the final consumer usually determine both the variety of specific diets to be served and the operative of the service. There are two models of catering services that are differentiated from each other by the place where the foods are prepared and delivered: centralized production and on-site production. The specialized work of Dieticians and the implementation of technological solutions that entail the optimization and a better control of the process are usual in the catering sector. The management of specifics diets in catering sector is intrinsic to its activity. Despite the high professionalism of the sector in this area, it is necessary a constant adaptation to the new emerging needs, especially those related to allergies and food intolerances and the situations of dependence generated by the increase of the life expectancy of the population.


Assuntos
Serviços de Dietética/organização & administração , Serviços de Alimentação/organização & administração , Dieta , Hipersensibilidade Alimentar/dietoterapia , Humanos , Medicina de Precisão
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