The Molecular Link from Diet to Cancer Cell Metabolism.

Malignant cells remodel their metabolism to meet the demands of uncontrolled cell proliferation. These demands lead to differential requirements in energy, biosynthetic precursors, and signaling intermediates. Both genetic programs arising from oncogenic events and transcriptional programs and epigenomic events are important in providing the necessary metabolic network activity. Accumulating evidence has established that environmental factors play a major role in shaping cancer cell metabolism. For metabolism, diet and nutrition are the major environmental aspects and have emerged as key components in determining cancer cell metabolism. In this review, we discuss these emerging concepts in cancer metabolism and how diet and nutrition influence cancer cell metabolism.

Special Issue "Flavonoids and Their Disease Prevention and Treatment Potential": Recent Advances and Future Perspectives.

In recent years, the interest in flavonoids as dietary bioactives to prevent human diseases, as well as their candidacy as pharmaceutical leads, has exponentially expanded [...].

Concordance between modification of diet in renal disease, chronic kidney disease epidemiology collaboration and Cockcroft-Gault equations in patients with chronic kidney disease at St. Paul's hospital millennium medical college, Addis Ababa, Ethiopia.

BACKGROUND: The most commonly used glomerular filtration rate estimating equations for drug dosing are Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. However there is still a concern about whether to use MDRD and CKD-EPI interchangeably with CG for drug dosage adjustment. METHODS: The study was initiated to determine the concordance between MDRD, CKD-EPI and CG equations and associated factors in patients with chronic kidney disease at Saint Paul's Hospital Millennium Medical College (SPHMMC). This was a cross sectional study which involved patient chart review and physicians self-administered questionnaire. Serum creatinine level ≥ 1.2 mg/dL was used as a cutoff point in pre-selection of patients. The correctness of the drug dose prescribed for the level of renal function were compared to the drug database (Lexi-Comp) available through Up-to-date version 21.2. RESULTS: Among the total of 422 patients, 249 (59%) were males. Mean age of patients was 46.09 years. The use of MDRD equation for drug dose adjustment by physicians working in the renal clinic of SPHMMC was six out of nine physicians. The Pearson correlation coefficient between the CG with MDRD and CKD-EPI equations was r = 0.94, P < 0.001 and r = 0.95, P < 0.001, respectively. The concordance between the CG with MDRD and CKD-EPI equations for FDA assigned kidney function categories was 73.7%, Kappa = 0.644 and 74.9%, Kappa = 0.659, respectively. Concordance between the CG with MDRD and CKD-EPI equations for the drug dosing recommendation was 89.6%, kappa = 0.782 and 92%, kappa = 0.834, respectively. Age > 70 years was associated with discordance between CG and MDRD equations for drug dosing recommendation whereas serum creatinine 1.2-3.5 mg/dL, weight < 61 Kg and age > 70 years were associated with discordance between the CG with MDRD and CKD-EPI equations for FDA assigned kidney function categories. However, none of the factors associated with discordance between CG and CKD-EPI for drug dosing. CONCLUSION: MDRD equation can be used interchangeably with CG equation for drug dosing recommended in all adult patients between the age of 18 and 70 years. CKD-EPI can be used interchangeably with CG in all adult Ethiopian patients with CKD.

Resonance Raman spectroscopic evaluation of skin carotenoids as a biomarker of carotenoid status for human studies.

Resonance Raman spectroscopy (RRS) is a non-invasive method that has been developed to assess carotenoid status in human tissues including human skin in vivo. Skin carotenoid status has been suggested as a promising biomarker for human studies. This manuscript describes research done relevant to the development of this biomarker, including its reproducibility, validity, feasibility for use in field settings, and factors that affect the biomarker such as diet, smoking, and adiposity. Recent studies have evaluated the response of the biomarker to controlled carotenoid interventions, both supplement-based and dietary [e.g., provision of a high-carotenoid fruit and vegetable (F/V)-enriched diet], demonstrating consistent response to intervention. The totality of evidence supports the use of skin carotenoid status as an objective biomarker of F/V intake, although in the cross-sectional setting, diet explains only some of the variation in this biomarker. However, this limitation is also a strength in that skin carotenoids may effectively serve as an integrated biomarker of health, with higher status reflecting greater F/V intake, lack of smoking, and lack of adiposity. Thus, this biomarker holds promise as both a health biomarker and an objective indicator of F/V intake, supporting its further development and utilization for medical and public health purposes.

Current concepts and management approaches in nonalcoholic fatty liver disease.

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver dysfunction worldwide. NAFLD may progress to nonalcoholic steatohepatitis (NASH) and in turn cirrhosis. Importantly, hepatic cancer can occur in NASH in the absence of cirrhosis. The cardinal histologic feature of NAFLD is the presence of an excessive accumulation of triacylglycerols and diacylglycerols in hepatocytes. The presence of obesity and insulin resistance lead to an increased hepatic-free fatty acid (FFA) flux creating an environment appropriate for the development of NAFLD. The generation of toxic reactive oxygen species with the production of hepatic injury and inflammation as a consequence of FFA oxidation will ultimately lead to the initiation and progression of fibrosis. Lifestyle modifications specifically weight loss, physical exercise, and cognitive behavior therapy have been recommended as treatments for NASH. Dietary fructose is an independent risk factor for the development of NAFLD. Pioglitazone can be used to treat biopsy-proven NASH; however, its safety risks should be considered carefully. Greater consumption for coffee, independent of its caffeine component, has been associated with a significant reduced risk of advanced fibrosis in NASH. Additional data are needed before recommending bariatric surgery as an established option for the specific treatment of NASH.

[Sausage or carrot--spoilt for choice]. / Cervelat oder rüebli--die qual der wahl!

As far as healthy food is concerned, it cannot be categorized simply as "good" or "bad" since its effect on health depends mainly on the amount and method consumed. Today's recommendations include a diversified diet, a diet which targets energy-balance and provides all nutrients necessary. Living in an affluent society aggravates healthy choices because of a constantly available, large assortment of food items. In general, the way food is prepared these days has changed a lot: mainly, the energy content has constantly increased, while the fiber and natural micronutrient concentrations decreased. Food items with a high energy yield, containing a lot of fat and sugar, affects our energy balance, which may lead to diseases of affluence such as type 2 diabetes, cardiovascular diseases, and some kinds of tumors.

[Obesity in the general practice]. / Adipositas beim hausarzt.

In the western world, the prevalence of overweight and obesity has increased significantly since the early 1980s. The association between obesity and increased morbidity and mortality is well established, but the distribution of fat determines the individual metabolic risk. Sustainable success of therapy for weight loss can be achieved only through a long-term effective lifestyle changes by the patient, which requires a multimodal therapeutic approach in which different generalists and specialists including the patient itself collaborate. No matter which treatment success can be achieved in the long term at an obese patient, an overweight patient requires a long-term multi disciplinary follow-up.

[Features to improve health care in "dietology" profile in Voronezh Region].

Recent years, restructuring of the health care to the population, including a complex of measures to improve the human resources policy in health, spurring the practice of the disciplines to public health care, turning, organizing 3-tier health care system, including the profile "nutrition" is carried out in Voronezh region. Analysis of security by dietitians, dietary nurses and hi-tech medical equipment is carried out. Set of measures to developing interaction between health care institutions (accordingly Health Ministry order N 474 from 24.06.2010) was worked up. Implementation of order of medical care in "Dietology" profile, high-quality dietitians work at all stages of 3-tier system of organization of medical care will make an unconditional contribution to the overall development strategy of the national health care.

[Non-pharmacological and pharmacological treatment of arterial hypertension: current situation]. / Nichtmedikamentöse und medikamentöse Therapie bei arterieller Hypertonie: Aktueller Stand.

A permanent and successful treatment of high blood pressure is based on a combination of non-pharmacological treatment measures and pharmacological therapy. The most proven non-pharmacological measures are physical and sports activities, weight reduction, dietary adaption and reduction of salt intake as well as nicotine abstinence and moderate alcohol consumption. A blood pressure reducing effect of evidence grade A was demonstrated for these 4 pillars of non-pharmacological therapy in studies. For pharmacological treatment five main substance groups are available: thiazide diuretics, ACE inhibitors, AT1 blockers, calcium channel blockers and beta blockers. A very good blood pressure reducing effect with an advantageous side effect profile has been proven for all substances. The initial high blood pressure therapy can be carried out with monotherapy but therapy with several antihypertensives is often necessary for the very varied combination of compounds which are available in a meaningful combination and dosage of effective ingredients. For the treatment of comorbid hypertensive patients recommendations are available for an individualized pharmacological treatment corresponding to the specific cardiovascular risk and comorbidity. High blood pressure therapy must be continuously carried out over many years. For permanent success of the therapy good compliance is indispensible which can be encouraged by integration in the therapy and should be regularly controlled.

Central nervous system nutrient signaling: the regulation of energy balance and the future of dietary therapies.

The mammalian target of rapamycin (mTOR) pathway coordinates cell growth in response to nutrient availability. Increasing evidence points to a role for mTOR to also direct whole-body energy balance in response to micronutrient as well as hormonal cues. This positions mTOR as a key central integrator of acute and chronic changes in fuel status. Energy balance is affected by mTOR in several organ systems, including the hypothalamus, where the pathway can modulate feeding. We propose that a greater understanding of this nutrient-sensitive pathway may open the door to more intelligent, effective diet design based on the effects of micronutrients on specific signaling pathways.

[Dietary interventions and social care for treating obesity in children]. / Therapie der Adipositas aus sozialpädiatrischer, ernährungstherapeutischer und gesundheitswissenschaftlicher Sicht.

The prevalence of obesity and associated comorbidities among children and adolescents has risen worldwide throughout the past 3 decades. To break this trend, population-based activities in health promotion/prevention and health care are necessary. Studies showed that long-term eating behavior improvement with the cooperation of the patient's family together with child-friendly organization support both individual therapeutic improvements as well as a relevant reduction of obesity prevalence. A significant BMI reduction can be achieved with a normal varied diet, whose energetic value is 300-400 kcal/day below the patient's daily energetic needs, due to the lower consumption of fat and sugar. This requires, however, that the entire family be willing to change their unhealthy eating behaviors (e.g., soft drinks and fast food) and to introduce regular meals into their daily routine. Sensibly, most therapies combine diet therapy with increased physical activity and parental training. Controlled media consumption, active leisure-time behavior, and a structured daily routine are further conditions for successful weight reduction. The high-risk groups for pediatric obesity, i.e., families with migration background and/or low socioeconomic status, have been poorly reached by established programs.

[Options of adiposity treatment]. / Möglichkeiten der Adipositasbehandlung.

Due to its high prevalence in the population, obesity represents one of the central challenges to our healthcare system. An expanded body fat mass characteristic of the obese phenotype is associated with increased morbidity and mortality and causes an enormous disease burden to the society. At present, a broad spectrum of evidence-based treatment options to reduce body weight is available which has to be tailored to the individual situation. Basis of all intervention strategies is a long-term change in lifestyle comprising a lower calorie intake and an increase in physical activity. Other treatment options include very low calorie diets, weight-lowering drugs and behavioral therapy. In patients with morbid obesity, surgical techniques offer an effective intervention. The long-term treatment success depends on the one hand on the motivation and self-management abilities of the patient and on the other on the quality and continuity of health care. Furthermore, more efforts from the society are required for a primary prevention of obesity.

[Modern dietetics on the new step development of medicine (clinical essay)].

THE AIM OF REVIEW: To discuss some controversy moments in terminology. To show the possibility of modern dietetics in prophylacxis and treatment of deseases. ORIGINAL POSITIONS: Dietetics is an impotent part of modern treatment, that is considered on exemple of endoecology and gerontal diet. The authors offer necessary information to create an individual diet for concrete patient. CONCLUSION: In Russia it is not reasonable to change a term "dietetics" to a term "nutrition" or "clinical nutrition". It is necessary to improve a teaching of dietetics to doctors of different specializations.

Chronic Diseases and COVID-19: A Review.

The existence of a causal relationship between the rise of the death rate in COVID-19 infected patients and their sufferance from non-communicable pathophysiological conditions, particularly chronic diseases, was recently evidenced. In fact, in addition to the immunodeficiency generated by chronic disease conditions, COVID-19 also led to affect the immune system. Furthermore, the novel coronavirus attacks the lungs and other vital organs such as heart, kidneys, and brain. All these outcomes are accused of being involved in the increasing vulnerability and comorbidity in COVID-19- infected people with chronic diseases. Pharmacological, dietetic and natural approaches were suggested after deep bibliographic research for presenting preventive recommendations for this category of patients in order to avoid the fatal complications of this infection, and consequently limiting the risk of comorbidity. In this regard, some medications could enter into interaction with COVID-19 infection in patients with diabetes or hypertension and thereafter lead to fatal complications. Furthermore, regarding their nutritional values, some foods are more useful than others during this pandemic period because they are rich in vitamins, minerals, antioxidants and perhaps some bioactive phytochemicals, which are known to be effective in improving immune response, managing chronic diseases and/or having antiviral activities. In addition, vitamins, minerals, antioxidants, prebiotics and probiotics could be helpful in these conditions. Interestingly, in order to understand the mechanism of this causality and suggesting efficacious solutions, this review deserves considerable epidemiologic, clinical and experimental investigations.

State of the art in muscle glycogenoses.

The recognition of a series of metabolic/enzymatic dysfunctions in glycogenoses has allowed new therapeutic advances for their treatment due to the development of recombinant enzyme. A recent advance appears enzymatic replacement therapy (ERT) in glycogenosis type II in both infantile, juvenile and adult form. Targeted manipulation of diet has been tried both in glycogenosis type II (Pompe disease) and type V (Mc Ardle disease).

Eating during the Hemodialysis Session: A Practice Improving Nutritional Status or a Risk Factor for Intradialytic Hypotension and Reduced Dialysis Adequacy?

Historically, eating during the hemodialysis treatment has been associated with increased risk for adverse intradialytic symptoms and events, risks that have resulted in the implementation of restrictive in-center nutrition policies. Recent studies, however, have recorded a shift in clinical practice with a higher proportion of physicians following the view that administration of intradialytic meals and supplements represents a simple and effective approach to enhance caloric intake and improve nutritional status among patients on hemodialysis. This shift towards less restrictive in-center nutrition practices is mainly supported by evidence from observational studies associating intradialytic nutritional supplementation with improvements in protein-energy wasting, inflammatory state, and health-related quality of life. In sharp contrast, earlier and recent interventional studies have documented that feeding during the hemodialysis treatment provokes a rapid postprandial decline in blood pressure and raises the incidence of symptomatic intradialytic hypotension. Furthermore, other studies have shown that postprandial redistribution in intravascular volume and enhanced blood supply to the gastrointestinal circulation may interfere with the adequacy of the delivered hemodialysis. Those who defend the position that intradialytic nutritional support is beneficial do not dispute the physiology of postprandial hemodynamic response, but they argue against its clinical significance. In this article, we provide an overview of studies that explored the effect of eating during the hemodialysis treatment on intradialytic hemodynamic stability and adequacy of the delivered hemodialysis. We reason that these risks have important clinical implications that are not counteracted by anticipated benefits of this strategy on caloric intake and nutritional status.

Gastrointestinal taste receptors: could tastants become drugs?

PURPOSE OF REVIEW: Numerous studies have pointed to profound nongustatory roles of tastants and the corresponding taste receptors expressed in the alimentary canal in the modulation of digestive and metabolic functions. Already in early reports, the intriguing possibility to use tastants as drug-like effectors for the treatment of metabolic diseases was raised. With this review, focusing on the most recent literature, we intend to question how close we meanwhile came to the initial promise - the use of tastants as medicines. RECENT FINDINGS: Although the enormous complexity and experimental variability of studies investigating the effects of tastants on physiological functions still has not revealed a common fundament from which subsequent therapeutic measures could be designed, more and more evidence is mounting on an involvement of taste receptors and taste signaling molecules in the maintenance and fine regulation of gastrointestinal functions and immunity. SUMMARY: Although the initial goal - using tastants to treat metabolic disorders - has, by far, not been reached, numerous promising findings suggest that dietary interventions could be devised to support conventional therapies in the future.

[Role of alimentary factor in correction of the main features of the metabolic syndrome. Modern approaches to dietary].

In review the role of alimentary factors in the correction of main features of the metabolic syndrome is presented. The data on influence of body weight reduction, lifestyle changes on such as the features of metabolic syndrome insulin resistance, arterial hypertension, abnormalities of carbohydrate meabolism are discussed. Also in the article describes the basic approaches to the dietary therapy in metabolic syndrome.