The legitimacy and safety of using alternative diets in cancer.

Alternative diets are used by cancer patients, especially among those who are not treated with conventional methods. Due to worrying data published by the World Health Organisation and its Agenda, the International Agency for Research on Cancer and the International Cancer Union, as well as epidemiological data from all over the world, it has been concluded that cancer will be the main cause of death in the world and that, therefore, the popularity of alternative diets among cancer patients may increase. The paper reviews the scientific literature and assesses the legitimacy and safety of selected alternative diets, as well as the description of research in terms of assumed anticancer efficacy in the following diets: ketogenic, Dr. Budwig and macrobiotic. The article also contains a summary of the analyzed scientific research and conclusions concerning the legitimacy of their use by cancer patients.

Special diets in modern America: Analysis of the 2012 National Health Interview Survey data.

BACKGROUND: Special diets are frequently used by the public but reasons for use and characteristics of users remain unclear. AIM: To determine prevalence of the use of special diets, the individual characteristics associated with their use and reasons for use. METHODS: The secondary analysis used data from the 2012 National Health Interview Survey (NHIS), a cross-sectional household interview survey of a nationally representative sample of non-hospitalized US adult populations ( n = 34,525). The dependent variables in this secondary analysis were the use of a special diet (vegetarian, macrobiotic, Atkins, Pritikin, and Ornish) ever and during the past 12 months. Independent variables included sociodemographic, clinical and behavioral variables. Prevalence of special diet use and reasons for use were analyzed descriptively. Associations between independent and dependent variables were analyzed using Chi-square tests and logistic regression. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. RESULTS: Lifetime and 12-month prevalence of using special diets were 7.5% (weighted n = 17.7 million) and 2.9% (weighted n = 6.9 million), respectively. Individuals using special diets in the past 12 months were more likely female (OR = 1.45; 95% CI = 1.21-1.74), not married (OR = 0.76; 95% CI = 0.63-0.91), college-educated (OR = 1.98; 95% CI = 1.25-3.11) and depressed (OR = 1.50; 95% CI = 1.14-1.98). They more likely also used herbal products (OR = 2.35; 95%CI = 1.84-2.99), non-vitamin (OR = 1.82; 95% CI = 1.45-2.27) and vitamin supplements (OR = 1.57; 95% CI = 1.24-1.99). Diets were mainly used to improve overall health (76.7%) or for general wellness/prevention (70.4%). CONCLUSIONS: Special diets are mainly used for unspecific health reasons by those who are females, have a college degree or with depression, and commonly used in conjunction with herbs and dietary supplements.

Gut microbiome response to short-term dietary interventions in reactive hypoglycemia subjects.

BACKGROUND: Reactive hypoglycemia is a metabolic disorder that provokes severe hypoglycemic episodes after meals. Over recent years, the gut microbiota has been recognized as potential target for the control of metabolic diseases, and the possibility to correct gut microbiota dysbioses through diet, favouring the recovery of metabolic homeostasis, has been considered. METHODS: We investigate the impact of 2 short-term (3-day) nutritional interventions, based on the macrobiotic Ma-Pi 2 diet and a control Mediterranean diet, on the structure and functionality of the gut microbiota in 12 patients affected by reactive hypoglycemia. The gut microbiota composition was characterized by next-generation sequencing of the V3 to V4 region of the 16S rRNA gene, and the ecosystem functionality was addressed by measuring the faecal concentration of short-chain fatty acids (SCFAs). In order to measure the short-term physiological gut microbiota fluctuation, the microbiomes of 7 healthy people were characterized before and after 3 days of constant diet. RESULTS: While no convergence of the gut microbiota compositional profiles was observed, a significant increase in SCFA faecal levels was induced only in the Ma-Pi 2 diet group, suggesting the potential of this diet to support a short-term functional convergence of the gut microbiota, regardless of the individual compositional layout. CONCLUSIONS: The Ma-Pi 2 diet, with its high fibre load, was effective in increasing the production of SCFAs by the gut microbiota. Because these metabolites are known for their ability to counterbalance the metabolic deregulation in persons with glucose impairment disorders, their increased bioavailability could be of some relevance in reactive hypoglycemia.

Treatment of reactive hypoglycemia with the macrobiotic Ma-pi 2 diet as assessed by continuous glucose monitoring: The MAHYP randomized crossover trial.

BACKGROUND AND AIMS: Nutritional therapy is recommended for management of reactive hypoglycemia (RH), a condition characterized by hypoglycemia that occurs within four hours after a meal. The macrobiotic Ma-Pi 2 diet improves glycemic control in subjects with type 2 diabetes. We explored the effect of this diet on outcomes in non-diabetic individuals with RH. MATERIALS AND METHODS: Twelve subjects with RH were randomized to the Ma-Pi 2 diet for three days and a control diet for three days in a randomized crossover design. Subjects received snacks on two days out of each three-day period only, and were monitored using continuous glucose monitoring. The 24-h period was divided into daytime (08:00-22:30h [subdivided into 'daytime without snacks' and 'daytime with snacks']) and night-time (22:31-07:59h). The effects of the two diets on the number of RH events (blood glucose <70mg/dL [3.9mmol/L]) and the percentage distribution of glucose readings within each of 16 glycemic intervals from <40mg/dL (2.2mmol/L) to >180mg/dL (4.4mmol/L) were determined. RESULTS: There were significantly fewer RH events on the Ma-Pi 2 diet than the control diet during daytime without snacks (-2.5 events; 95% CI: -7.5, 0.0; P=0.022) and daytime with snacks (-4.25 events; 95% CI: -7.5; -2.0; P=0.013) but no difference at night. The percentage of glucose readings in the interval 71-80mg/dL (3.9-4.4mmol/L) was significantly higher on the control diet during daytime with and without snacks (P=0.03 for both), while the percentage of glucose readings in the interval 91-100mg/dL (5.1-5.6mmol/L) was significantly higher on the Ma-Pi 2 diet during daytime without snacks (P=0.02). CONCLUSIONS: The macrobiotic Ma-Pi 2 diet reduced blood glucose excursions during the day, thereby facilitating glycemic control in subjects with RH. The Ma-Pi 2 diet represents an effective nutritional tool for management of RH.

A 6-month follow-up study of the randomized controlled Ma-Pi macrobiotic dietary intervention (MADIAB trial) in type 2 diabetes.

BACKGROUND: In the MADIAB trial (a 21-day randomized, controlled trial in patients with type 2 diabetes (T2D)), intervention with the Ma-Pi 2 macrobiotic diet resulted in significantly greater improvements in metabolic control compared with a standard recommended diet for patients with T2D. We report on a 6-month follow-up study, which investigated, whether these benefits extended beyond the 21-day intensive dietary intervention, in real-world conditions. SUBJECTS: At the end of the MADIAB trial (baseline of this follow-up study), all participants continued their assigned diet (Ma-Pi or control) for 6 months. The Ma-Pi 2 group followed the Ma-Pi 4 diet during this follow-up study. Forty of the original 51 subjects (78.4%) participated in the follow-up (body mass index, 27-45 kg m(-2); age, 40-75 years). Primary outcome was percentage change from baseline in HbA1c; secondary outcomes were anthropometric data and lipid panel. RESULTS: A significantly greater median percentage reduction was observed for HbA1c in the Ma-Pi group (-11.27% (95% confidence interval (CI): -10.17; -12.36)) compared with the control group (-5.88% (95% CI: -3.79; -7.98)) (P < 0.001). Total and low-density lipoprotein (LDL) cholesterol increased in both groups with no differences between groups (P=0.331 and P=0.082, respectively). After correcting for age and gender, the Ma-Pi diet was associated with a higher percentage reduction in HbA1c (95% CI: 2.56; 7.61) and body weight (95% CI: 0.40; 3.99), and a higher percentage increase in LDL cholesterol (95% CI: -1.52; -33.16). However, all participants' total and LDL cholesterol levels remained within recommended ranges (<200 mg dl(-1) and <100 mg dl(-1), respectively). The Ma-Pi diet group achieved the target median HbA1c value (<5.7% (39 mmol mol(-1))) at 6 months. CONCLUSIONS: Both the Ma-Pi and control diets maintained their benefits beyond the 21-day intensive monitored intervention over a 6-month follow-up in real-world conditions. The Ma-Pi diet resulted in greater improvement in glycemic control.

Modulation of gut microbiota dysbioses in type 2 diabetic patients by macrobiotic Ma-Pi 2 diet.

The gut microbiota exerts a role in type 2 diabetes (T2D), and deviations from a mutualistic ecosystem layout are considered a key environmental factor contributing to the disease. Thus, the possibility of improving metabolic control in T2D by correcting gut microbiome dysbioses through diet has been evaluated. Here, we explore the potential of two different energy-restricted dietary approaches - the fibre-rich macrobiotic Ma-Pi 2 diet or a control diet recommended by Italian professional societies for T2D treatment - to correct gut microbiota dysbioses in T2D patients. In a previous 21-d open-label MADIAB trial, fifty-six overweight T2D patients were randomised to the Ma-Pi 2 or the control diet. For the present study, stools were collected before and after intervention from a subset of forty MADIAB participants, allowing us to characterise the gut microbiota by 16S rRNA sequencing and imputed metagenomics. To highlight microbiota dysbioses in T2D, the gut microbiota of thirteen normal-weight healthy controls were characterised. According to our findings, both diets were effective in modulating gut microbiome dysbioses in T2D, resulting in an increase of the ecosystem diversity and supporting the recovery of a balanced community of health-promoting SCFA producers, such as Faecalibacterium, Roseburia, Lachnospira, Bacteroides and Akkermansia. The Ma-Pi 2 diet, but not the control diet, was also effective in counteracting the increase of possible pro-inflammatory groups, such as Collinsella and Streptococcus, in the gut ecosystem, showing the potential to reverse pro-inflammatory dysbioses in T2D, and possibly explaining the greater efficacy in improving the metabolic control.

Nutrient Composition and Anti-inflammatory Potential of a Prescribed Macrobiotic Diet.

Despite nutrient adequacy concerns, macrobiotic diets are practiced by many individuals with cancer and other life-threatening illnesses. This study compared the nutrient composition and inflammatory potential of a macrobiotic diet plan with national dietary recommendations and intakes from a nationally representative sample. Nutrient comparisons were made using the 1) macrobiotic diet plan outlined in the Kushi Institute's Way to Health; 2) recommended dietary allowances (RDA); and 3) National Health and Nutrition Examination Survey (NHANES) 2009-2010 data. Comparisons included application of the recently developed dietary inflammatory index (DII). Analyses focused on total calories, macronutrients, 28 micronutrients, and DII scores. Compared to NHANES data, the macrobiotic diet plan had a lower percentage of energy from fat, higher total dietary fiber, and higher amounts of most micronutrients. Nutrients often met or exceeded RDA recommendations, except for vitamin D, vitamin B12, and calcium. Based on DII scores, the macrobiotic diet was more anti-inflammatory compared to NHANES data (average scores of -1.88 and 1.00, respectively). Findings from this analysis of a macrobiotic diet plan indicate the potential for disease prevention and suggest the need for studies of real-world consumption as well as designing, implementing, and testing interventions based on the macrobiotic approach.

Nutrición como terapia complementaria o alternativa para cáncer / Nutrition as complementary or alternative therapy for cancer

Las terapias alternativas o complementarias (TAC) consisten en diversos sistemas médicos y de salud, prácticas y productos que no son considerados parte de la medicina convencional. Estas terapias se dividen en 2 subgrupos, de los cuales la terapia nutricional es considerada dentro de la categoría de productos naturales. Constantemente los pacientes con cáncer recurren a estas terapias en busca de mejorar su bienestar general. Debido a estudios poco conluyentes o sesgados, se conoce poco sobre la eficacia de este tipo de tratamiento, por esta razón en la medicina convencional son censuradas. Sin embargo se ha demostrado como las terapias alternativas y complementarias brindan motivación y esperanza a los pacientes con cáncer, lo que los ayuda a sobrellevar su enfermedad. La terapia de Gerson, la dieta macrobiótica y el régimen de González son tres ejemplos de como se ha utilizado la dieta como terapia ante el cáncer. La importancia radica en informarnos para ofrecer un tratamiento integral a nuestros pacientes y determinar como diferentes aspectos de estos tratamientos alternativos y complementarios pueden ayudarlos con su enfermedad.

Influence of diet on gut microbiota, inflammation and type 2 diabetes mellitus. First experience with macrobiotic Ma-Pi 2 diet.

Type 2 diabetes mellitus (T2DM) is a complex disorder influenced by both genetic and environmental factors. Recent studies have suggested that an imbalance of the intestinal microbiota may be involved in the development of several human diseases, including obesity and T2DM. The main regulators of the intestinal microbiota are age, ethnicity, the immune system and diet. A high-fat diet may induce dysbiosis, which can result in a low-grade inflammatory state, obesity and other metabolic disorders. Adding prebiotics to the diet may reduce inflammation, endotoxaemia and cytokine levels as well as improving insulin resistance and glucose tolerance. The administration of prebiotics such as fermentable dietary fibres, promotes glucagon-like peptide 1 and peptide YY (anorexigenic) and decreases ghrelin (orexigenic). In a recent 21-day, intervention study in patients with T2DM, the effect of using the macrobiotic Ma-Pi 2 diet was investigated. Results suggested that it could induce a significant improvement in fasting blood glucose, plasma lipid fractions, plasma insulin and homeostasis. It is therefore possible that a diet rich in prebiotics and probiotics can play a role in T2DM management, probably due to positive intestinal microbiota modulation. However, this must be demonstrated by larger studies including randomized controlled trials that measure indicators of inflammation.

Ma-Pi 2 macrobiotic diet and type 2 diabetes mellitus: pooled analysis of short-term intervention studies.

The macrobiotic, Ma-Pi 2 diet (12% protein, 18% fat and 70% carbohydrate), has shown benefit in adults with type 2 diabetes mellitus (T2DM). This pooled analysis aims to confirm results from four, 21-day intervention studies with the Ma-Pi 2 diet, carried out in Cuba, China, Ghana and Italy. Baseline and end of study biochemical, body composition and blood pressure data, were compared using multivariate statistical methods and assessment of the Cohen effect size (d). Results showed that all measured indicators demonstrated significant changes (p < 0.001); most of them with a very high (d ≥ 1.30), or high (d = 0.80-1.29) effect size. The global effect size of the diet was Italy (1.96), China (1.79), Cuba (1.38) and Ghana (0.98). The magnitude of the individual effect on each variable by country, and the global effect by country, was independent of the sample size (p > 0.05). Similarly, glycemia and glycemic profiles in all four studies were independent of the sample size (p = 0.237). The Ma-Pi diet 2 significantly reduced glycemia, serum lipids, uremia and cardiovascular risk in adults with T2DM. These results suggest that the Ma-Pi 2 diet could be a valid alternative treatment for patients with T2DM and point to the need for further clinical studies. Mechanisms related to its benefits as a functional diet are discussed.

Metales en algas comestibles: Evaluación y estudio comparativo / Metals in edible algae: evaluation and comparative study

Los contenidos de 4 macroelementos (Na, K, Ca, Mg), 13 elementos traza (B, Ba, Co, Cr, Cu, Fe, Mn, Mo, Li, Zn, Ni, Sr, V) y 3 metales tóxicos (Al, Cd, Pb) se determinaron por espectrometría de emisión atómica por plasma acoplado inductivamente (ICP-OES) en 27 muestras de 7 especies de algas comestibles deshidratadas (Porphyra spp., Chondrus crispus, Palmaria palmata, Laminaria spp., Undari pinnatífica, Hilmanthia elongata, Ulva lactuca), procedentes de dos orígenes diferentes (la costa asiática y la Unión Europea) y comercializadas en la isla de Tenerife (Islas Canarias, España). Las concentraciones medias (mg/kg) fueron: 4281 (Na), 7179 (K), 3222 (Ca), 2458 (Mg), 38,14 (B), 2,72 (Ba), 0,11 (Co), 0,26 (Cr), 1,98 (Cu), 106 (Fe), 8,21 (Mn), 0,11 (Mo), 2,33 (Li), 10,63 (Zn), 1,02 (Ni), 1,47 (Sr), 1,54 (V), 48,71 (Al), 0,30 (Cd) y 0,17 (Pb). El consumo de algas (4 g/día) podría contribuir a las ingestas dietéticas de metales esenciales y elementos traza principalmente Mg (4,13% de la IDR en mujeres adultas y 3,54% de la IDR en hombres adultos) y Fe (2,36% de la IDR en mujeres adultas y 4,71% de la IDR en hombres adultos). Las ingestas de metales tóxicos (195 μg Al/día 1,18 μg Cd/día y 0,68 μg Pb/día) derivada del consumo de 4 g/día de las algas analizadas no representan riesgo toxicológico para los consumidores (AU)

The content of 4 macroelements (Na, K, Ca, Mg), 13 trace elements (B, Ba, Co, Cr, Cu, Fe, Mn, Mo, Li, Zn, Ni, Sr, V) and 3 toxic metals (Al, Cd, Pb) were quantified by inductively coupled plasma optical emission spectrometry (ICP-OES) in 27 samples of 7 dehydrated edible seaweed species (Porphyra spp., Chondrus crispus, Palmaria palmata, Laminaria spp., Undari pinnatífica, Hilmanthia elongata, Ulva lactuca), from two different production origins (Asian coast and European Union) and purchased in Tenerife island (Canary Islands, Spain). Mean concentrations (mg/kg) were: 4281 (Na), 7179 (K), 3222 (Ca), 2458 (Mg), 38.14 (B), 2.72 (Ba), 0.10 (Co), 0.26 (Cr), 1.98 (Cu), 106 (Fe), 8.21 (Mn), 0.11 (Mo), 2.33 (Li), 10.63 (Zn), 1.02 (Ni), 1.47 (Sr),1.54 (V), 48.71 (Al), 0.30 (Cd) and 0.17 (Pb). Daily consumption of seaweed (4 g/day) contributes to the dietary intake of metals, mainly Mg (4.13% of the RDA for adult women, and 3.54% of the RDA for adult men) and Fe (2.36% of the RDA for adult women, and 4.71% of the RDA in adult men). The estimated intakes of toxic metals derived from a daily seaweed consumption of 4 g (195 μg Al/day, 1.18 μg Cd/day and 0.68 μg Pb/day) did not reveal toxicological risks for consumers (AU)

Preventing weight gain during adjuvant chemotherapy for breast cancer: a dietary intervention study.

Adjuvant chemotherapy significantly decreases recurrences and improves survival in women with early breast cancer (BC). However, the side effects of chemotherapy include weight gain, which is associated with poorer prognosis. We have previously demonstrated that by means of a comprehensive dietary modification which aims at lowering insulin levels it is possible to reduce body weight and decrease the bioavailability of insulin, sex hormones and the growth factors linked to BC risk and prognosis. We are now going to present a randomized controlled study of adjuvant diet in BC patients undergoing chemotherapy. The diet was designed to prevent weight gain during chemotherapy treatment. Women of any age, operated for invasive BC, scheduled for adjuvant chemotherapy and without evidence of distant metastases, were randomized into a dietary intervention group and a control group. The intervention implied changing their usual diet for the whole duration of chemotherapy, following cooking classes and having lunch or dinner at the study centre at least twice per week. 96 BC patients were included in the study. The women in the intervention group showed a significant reduction in their body weight (2.9 kg on average), compared with the controls. They also significantly reduced body fat mass, waist and hip circumferences, biceps, underscapular and suprailiac skinfolds, compared with the women in the control group. Our results support the hypothesis that dietary intervention during adjuvant chemotherapy for BC is feasible and may prevent weight gain.

Fuelling the athlete with type 1 diabetes.

People with type 1 diabetes (T1DM) want to enjoy the benefits of sport and exercise, but management of diabetes in this context is complex. An understanding of the physiology of exercise in health, and particularly the control of fuel mobilization and metabolism, gives an idea of problems which may arise in managing diabetes for sport and exercise. Athletes with diabetes need to be advised on appropriate diet to maximize performance and reduce fatigue. Exercise in diabetes is complicated both by hypoglycaemia and hyperglycaemia in particular circumstances and explanations are advanced which can provide a theoretical underpinning for possible management strategies. Management strategies are proposed to improve glycaemic control and performance.

The macrobiotic diet in chronic disease.

The macrobiotic diet is a low-fat, high-fiber, high-complex carbohydrate, mainly vegetarian diet. It is associated with a lifestyle system and a spiritual philosophy of life. Unlike many diets, the composition is not fixed and may be altered depending on a person's health status, among other considerations. Studies indicating lower serum lipid levels and blood pressure in people following a macrobiotic diet than in the general population suggest it to be an effective preventive strategy for cardiovascular disease. Many of its components suggest macrobiotics would be a valuable approach to cancer prevention. On the other hand, it has been the subject of controversy, especially with respect to its use in patients suffering from malignancies. Several remarkable anecdotal case reports have supported a therapeutic effect in patients with advanced cancers. However, to date, the few studies attempted have been inadequate to prove effectiveness and further research is warranted. Concerns include potential delay in conventional treatment for cancer, risks associated with nutrition deficiencies, and social limitations related to the complexities of strict adherence to this diet. Many aspects of currently popular dietary recommendations such as eating locally grown, in-season, fresh, organic foods are legacies of the macrobiotic lifestyle and diet.

Alimentación adecuada para mejorar la salud y evitar enfermedades crónicas / An appropriate feeding to improve the health and to avoid chronic diseases

La alimentación adecuada constituye un reto para muchas personas que prefieren disfrutar de los alimentos agradables pero riesgosos para la salud antes que cambiar sus hábitos erróneos y con ello mejorar su estado. Los antecedentes de la alimentación adecuada se encuentran en la Macrobiótica que se considera un arte y una ciencia de la salud y la longevidad. La educación nutricional es muy importante para lograr transformar la conducta alimentaria indebida, de ahí la intención de proporcionar conocimientos sobre la alimentación adecuada, sus características y relación con diferentes enfermedades crónicas. Se enfatiza el valor nutricional del arroz integral, la importancia del equilibrio entre los alimentos ácidos y alcalinos, con una mayor proporción de estos últimos y las formas de cocción de estos alimentos. Es recomendable que las personas ingieran alimentos que contengan fibra dietética como cereales integrales, legumbres, vegetales y frutas, con lo que pueden contribuir a reducir el riesgo de desarrollar el síndrome metabólico y enfermedades crónicas como el cáncer, las enfermedades cardiovasculares y la diabetes mellitus tipo 2

The appropriate feeding is a challenge for many people who prefer to enjoy of pleasant foods but riskier for health instead of to change its mistaken habits and thus to improve its status. The backgrounds of the appropriate feeding are in Macrobiotic feeding considered an art and a science of health and old age. The nutritional education is very important to achieve the transformation of a improper feeding behavior, thus, the intention to offer the necessary knowledges on a appropriate feeding, its features and relation to different chronic diseases. Authors emphasize the nutritional value of integral rice, the significance of balance among acid and alkaline foods with a greater proportion of this latter and the cooking ways of these foods. It is advisable that persons consume foods containing dietetic fibers as integral cereals, pod vegetables and fruits thus contributing to reduce the risk of to develop the metabolic syndrome and chronic diseases including the cancer, the cardiovascular diseases and the type 2 diabetes mellitus

Alimentación adecuada para mejorar la salud y evitar enfermedades crónicas / An appropriate feeding to improve the health and to avoid chronic diseases

La alimentación adecuada constituye un reto para muchas personas que prefieren disfrutar de los alimentos agradables pero riesgosos para la salud antes que cambiar sus hábitos erróneos y con ello mejorar su estado. Los antecedentes de la alimentación adecuada se encuentran en la Macrobiótica que se considera un arte y una ciencia de la salud y la longevidad. La educación nutricional es muy importante para lograr transformar la conducta alimentaria indebida, de ahí la intención de proporcionar conocimientos sobre la alimentación adecuada, sus características y relación con diferentes enfermedades crónicas. Se enfatiza el valor nutricional del arroz integral, la importancia del equilibrio entre los alimentos ácidos y alcalinos, con una mayor proporción de estos últimos y las formas de cocción de estos alimentos. Es recomendable que las personas ingieran alimentos que contengan fibra dietética como cereales integrales, legumbres, vegetales y frutas, con lo que pueden contribuir a reducir el riesgo de desarrollar el síndrome metabólico y enfermedades crónicas como el cáncer, las enfermedades cardiovasculares y la diabetes mellitus tipo 2(AU)

The appropriate feeding is a challenge for many people who prefer to enjoy of pleasant foods but riskier for health instead of to change its mistaken habits and thus to improve its status. The backgrounds of the appropriate feeding are in Macrobiotic feeding considered an art and a science of health and old age. The nutritional education is very important to achieve the transformation of a improper feeding behavior, thus, the intention to offer the necessary knowledges on a appropriate feeding, its features and relation to different chronic diseases. Authors emphasize the nutritional value of integral rice, the significance of balance among acid and alkaline foods with a greater proportion of this latter and the cooking ways of these foods. It is advisable that persons consume foods containing dietetic fibers as integral cereals, pod vegetables and fruits thus contributing to reduce the risk of to develop the metabolic syndrome and chronic diseases including the cancer, the cardiovascular diseases and the type 2 diabetes mellitus(AU)

Nutritional deficiencies in children on restricted diets.

Pediatric nutritional deficiencies are associated not only with poverty and developing countries, but also in children in the developed world who adhere to restricted diets. At times, these diets are medically necessary, such as the gluten-free diet for management of celiac disease or exclusion diets in children with food allergies. At other times, the diets are self-selected by children with behavioral disorders, or parent-selected because of nutrition misinformation, cultural preferences, alternative nutrition therapies, or misconceptions regarding food tolerance. Health care providers must be vigilant in monitoring both growth and feeding patterns to identify inappropriate dietary changes that may result in nutritional deficiencies.