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Emerging literature suggests that diet plays an important modulatory role in inflammatory bowel disease (IBD) through the management of inflammation and oxidative stress. The aim of this narrative review is to evaluate the evidence collected up till now regarding optimum diet therapy for IBD and to design a food pyramid for these patients. The pyramid shows that carbohydrates should be consumed every day (3 portions), together with tolerated fruits and vegetables (5 portions), yogurt (125ml), and extra virgin olive oil; weekly, fish (4 portions), white meat (3 portions), eggs (3 portions), pureed legumes (2 portions), seasoned cheeses (2 portions), and red or processed meats (once a week). At the top of the pyramid, there are two pennants: the red one means that subjects with IBD need some personalized supplementation and the black one means that there are some foods that are banned. The food pyramid makes it easier for patients to decide what they should eat.

Nutritional problems are an important part of rehabilitation for chronic obstructive pulmonary disease (COPD) patients. COPD patients often present with malnutrition, sarcopenia, and osteoporosis with possible onset of cachexia, with an inadequate dietary intake and a poor quality of life. Moreover, diet plays a pivotal role in patients with COPD through three mechanisms: regulation of carbon dioxide produced/oxygen consumed, inflammation, and oxidative stress. A narrative review based on 99 eligible studies was performed to evaluate current evidence regarding optimum diet therapy for the management of COPD, and then a food pyramid was built accordingly. The food pyramid proposal will serve to guide energy and dietary intake in order to prevent and treat nutritionally related COPD complications and to manage progression and COPD-related symptoms. The nutrition pyramid described in our narrative review is hypothetical, even in light of several limitations of the present review; the main limitation is the fact that to date there are no randomized controlled trials in the literature clearly showing that improved nutrition, via the regulation of carbon dioxide produced/oxygen consumed, inflammation and oxidative stress, improves symptoms and/or progression of COPD. Even if this nutritional pyramid is hypothetical, we hope that it can serve the valuable purpose of helping researchers focus on the often-ignored possible connections between body composition, nutrition, and COPD.

Background: This study aimed to analyse the impact of des-acyl and acyl ghrelin (AG) on a wide range of muscular and metabolic markers and in order to discover the possible relationships and interactions of des-acylated ghrelin (DAG) on eating disorders.Materials & Methods: A total of 88 subjects (64 women and 24 men, with a mean age of 43 years and a mean body mass index (BMI) of 30.20 ± 3.27 kg/m2) were enrolled in the cross-sectional study.Results: The findings showed that for each unit of increase of free fat mass index (FFMI), levels of DAG decreased by -41.11 pg/mL (p < 0.05). Moreover, similar associations with DAG were found for insulin (β = -30.67; p < 0.001), leptin (β = -0.64; p < 0.05), body weight (β = -14.36; p < 0.001), and free fat mass (FFM) (β = -30.67; p < 0.001). In addition, associations were found between DAG and resting energy expenditure (REE) (β = -0.84; p = 0.05) and the binge eating scale (BES) in which a unit increase of the BES score Q3 (depression) correlated with a decrease of DAG levels (β = -9.98; p = 0.08). Further, a unit increase of AG/DAG ratio correspond with an increase in body weight (β = 12.20; p < 0.05), BMI (β = 4.70; p < 0.05) and fat mass (β = 7.30; p < 0.05). However, the AG/DAG ratio was not associated with FFMI (β = 2.61; p = 0.165) and FFML/BMI (β = -0,064; p = 0.625).Conclusion: This study suggests that higher levels of DAG at fasting are indices of poor muscle mass, insulin resistance and depression.

This research aimed to assess the effects of Ramadan intermittent fasting (RIF) on different dimensions, namely calorie intake, fullness and hunger sensations, mental health, body weight, waist circumference (WC), quality of sleep, body composition, hydration and nutritional status among female students at the University of Bahrain. A prospective single cohort study was conducted on 20 female students. The measurements were taken before Ramadan as well as the end of each week of Ramadan. From baseline to the end of Ramadan, there was a significant decrease in body weight (−0.779 kg, CI95% −1.287, −0.271), fat mass (FM) (−1.735 kg, CI95% −2.349, −1.122) and WC (−2.158 cm, CI95% −3.902, −0.414). In addition, the Hydragram® showed an increase at week 4 (0.288% CI95% 0.72, 0.504) and nutritional status with Nutrigram® increased during the time (Ptrend

Background This study aimed to assess the effects of supplementation with Hoodia Parviflora (H. Parviflora) at 9 mg+200 mg of fructo-oligosaccharides on weight loss, body composition, hydration and satiety parameters. Methods A randomized blinded controlled trial was conducted in a sample of 30 overweight and obese patients (5 males and 25 females). Patients were randomly assigned in 2 groups: the intervention group, which received H. Parviflora twice a day for 4 weeks and the control group, which received a placebo. Results After a 4-week follow-up period, the study results showed an improvement of Δ=-1.632 kg (Confidence Interval [CI]95% -2.545; -0.719) and a statistically significant decrease in waist circumference (WC) compared with the placebo group -2.080 cm ([CI]95% -4.082; -0.078). The visual analogue scale reported an improvement of satiety sensation after day 5 (P=0.001). Conclusions This study shows for the first time the simultaneous effect of H. Parviflora on weight loss, decreasing satiety, and improving fat mass, in particular Visceral Adipose Tissue (VAT).

Sarcopenic obesity combines the words sarcopenia and obesity. This definition of obesity should be better differentiated between visceral and subcutaneous fat phenotypes. For this reason, this review lays the foundation for defining the subcutaneous and the visceral fat into the context of sarcopenia. Thus, the review aims to explore the missing links on pathogenesis of visceral fat and its relationship on age: defining the peri-muscular fat as a new entity and the subcutaneous fat as a first factor that leads to the obesity paradox. Last but not least, this review underlines and motivates the mechanisms of the hormonal responses and anti-inflammatory adipokines responsible for the clinical implications of sarcopenic visceral obesity, describing factor by factor the multiple axis between the visceral fat-sarcopenia and all mortality outcomes linked to cancer, diabetes, cardiovascular diseases, cirrhosis, polycystic ovary, disability and postoperative complications.

Dates have a low glycemic index and are a source of antioxidants but, nevertheless, contain more than 70% sugar. This study aims to assess the effects of date consumption (three dates daily) on glycemic profile (HbA1c), body mass index (BMI), quality of life, and lipid profile, including total cholesterol, triglyceride, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) in terms of safety for type 2 diabetic mellitus (T2DM) subjects. A randomized controlled trial was conducted with a sample of 100 T2DM subjects (39 male and 61 female) randomly assigned in two groups. The first group received three dates daily for 16 weeks, and the control group avoided date consumption. After a 16-week follow-up period, the study results showed an improvement of lipid profile with a statistically significant decrease in total cholesterol of ∆ = &minus, 0.209 mmol/L (confidence interval (CI) 95% &minus, 0.358, &minus, 0.059, p &lt, 0.05) and in LDL of ∆ = &minus, 0.171 mmol/L (CI 95% &minus, 0.358, 0.016) in the group receiving three dates daily. Intra-group mean differences of BMI were not statistically different in both groups after 16 weeks of date consumption. Even HbA1c did not change, both within and between groups after date consumption (∆ = 0.087%, CI 95% &minus, 0.086, 0.261). Between groups, mean difference changes (intervention minus control) showed a statistically significant improvement of quality of life index of ∆ = &plusmn, 30.66 points (CI 95% 12.45, 48.23) due to the consequent improvement in mental health. Although the definitive effect of dose/intake response of date consumption on Hb1Ac, lipid profile, and BMI in T2DM subjects is still to be established, the study suggests that dates could potentially have a beneficial effect on lipid profile, especially in reducing total cholesterol and elevating HDL, because of its high polyphenolic content. In addition, a low&ndash, moderate consumption of dates did not impact glucose levels because of dates&rsquo, low glycemic index.

This study aims to assess the agreement between the appendicular skeletal muscle index (ASMI) and dual-energy X-ray absorptiometry (DXA) using a single frequency bioelectrical impedance analysis (BIA) to assess criteria. Moreover, we used the European working group on sarcopenia in older people 1 (EWGSOP1), EWGSOP2, and the Tengvall equation to estimate a low prevalence in ASMI (under the cutoff criteria). We examined a sample of 765 elderly individuals (27.8% male and 72.2% female, aged 82 &plusmn, 8.2 years). Based on the cutoff identified by Tengvall, EWGSOP1, and EWGSOP2, the results showed that the prevalence of low ASMI in females was 10.1%, 11.4%, and 9.2%, respectively, and 98.1%, 30.5%, and 23.5% in males, respectively. Moreover, low ASMI prevalence under each diagnostic criterion and body mass index (BMI) was calculated. For BMI &lt, 25 kg/m2, the ASMI prevalence was 39.9%, 25.9%, and 20.6%, as determined using Tengvall, EWGSOP1, and EWGSOP2, respectively, and for BMI &gt, 25 kg/m2, the ASMI prevalence was 29.0%, 6.6%, and 5.2%. The percentage of agreement and Cohen&rsquo, s Kappa with the corresponding p-value between Tengvall and EWGSOP1 was 70.1% (p &lt, 0.001). Between Tengvall and EWGSOP2, it was 69.4% (p &lt, 0.001). Between EWGSOP1 and EWGSOP2, it was 96.5% (p &lt, 0.001). Regarding gender, low ASMI prevalence in males was higher than in females. Moreover, in females, the prevalence was comparable among the three diagnostic criteria, while in males, it was significantly higher under Tengvall than the other two criteria. The application of the Tengvall formula with a single frequency BIA should be revised in terms of application for assessing low ASMI in elderly patients.

Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength and it is diagnosed by measurements of muscle mass, muscle strength, and physical performance. Sarcopenia affects quality of life and is associated with several adverse health effects. Muscle decline is aggravated by a sedentary lifestyle and can be prevented through proper nutrition, together with adequate physical activity. Fish contains biologically active compounds, such as omega-3 polyunsaturated fatty acids, proteins, vitamin D, magnesium, and carnitine, which are able to intervene positively on muscle metabolism. This narrative literature review was performed to evaluate evidence regarding the actual benefit of fish consumption in the prevention of sarcopenia and the positive action on the muscle mass of the biological compounds present in fish. The results demonstrated that fish consumption has a protective and anti-inflammatory function on skeletal muscle and that its biologically active compounds help to maintain good muscle performance, preventing sarcopenia. Considering the nutritional and health benefits, elderly with sarcopenia should consume at least three servings per week of fish in order to have a minimum intake of 4−4.59 g daily of omega 3, and reaching the 50% RDA in Vitamin E and D. High biological value of proteins in 150 g of fish and its high available magnesium (20% of RDA in 150 g of fish) are an added value that could suggest fish as a “functional food” in order to prevent and treat sarcopenia.

Background Traditional foods are an important part of Bahraini culture, identity, and heritage. The aim of this study was to document plant-based traditional foods and beverages consumed by local Bahrainis. Methods Traditional knowledge of plants used as food and beverage was obtained through 76 personal interviews of knowledgeable informants using a semi-structured questionnaire. Results A total of 52 common foods and beverages were reportedly documented by the respondents. Some traditional foods are not tied to specific seasons, but are consumed throughout the year, such as harees , momowash, sambosa, halwa, assidah, and legaimaat while others such as madquq bisr, mattaai, khabees, gurs al-taabi and khubez zinjibari are common at family celebrations or other specific holidays. Boiling and frying are the most popular traditional cooking methods employed in Bahrain. Conclusion The findings of this study could provide a knowledge basis for relating traditional food consumption and potential health status among Bahrainis.

The aim of this study is to characterise the rice germ from the nutritional point of view. The latest laboratory methods for evaluation of macronutrients and micronutrients have been used. Rice germ has a high protein content (18 g per 100 g of edible product) with considerable amounts of essential amino acids (mainly lysine, histidine and valine), fatty acids (mainly monounsaturated and polyunsaturated fatty acids), and fibre (7 g per 100 g). Regarding water-soluble vitamins, rice germ has high amounts of thiamine (B1) and vitamin B6, while vitamin E is the main fat-soluble vitamin present. Iron (77% of RDA) and magnesium (108% of RDA) are the two main minerals found in rice germ. Given its great nutritional value, it will be of interest in future studies to explore ways for rice germ to be incorporated into dietary supplements aimed at increasing nutrition intake for a specific population.

Despite advances in medicine and numerous agents that counteract pain, millions of patients continue to suffer. Attention has been given to identify novel botanical interventions that produce analgesia by interacting with nociceptive-transducing channels. The aim of this review is to provide an overview of the actual knowledge of Acmella oleracea (L.) and its activities, particularly those that are anti-inflammatory, anti-oxidant, and painkiller. These activities are attributed to numerous bioactive compounds, such as phytosterols, phenolic compounds and N-alkylamides (spilanthol, responsible for many activities, primarily anesthetic). This review includes 99 eligible studies to consider the anti-inflammatory, anti-oxidant, and painkiller of Acmella. Studies reported in this review confirmed anti-inflammatory and anti-oxidant activities of Acmella, postulating that transcription factors of the nuclear factor-κB family (NF-κB) trigger the transcription iNOS and COX-2 and several other pro-inflammatory mediators, such as IL-6, IL-1β, and TNF-α. The antinociceptive effects has been demonstrated and have been related to different processes, including inhibition of prostaglandin synthesis, activation of opioidergic, serotoninergic and GABAergic systems, and anesthetic activity through blockage of voltage-gated Na Channels. acmella oleracea represents a promise for pain management, particularly in chronic degenerative diseases, where pain is a significant critical issue.

Osteoarthritis (OA) is the most common form of arthritis in the world and is characterized by pain, various disabilities and loss of quality of life. Chondroitin sulfate (CS) is recommended as first-line therapy. CS of non-animal origin is of great interest for safety and sustainability reasons. This study aims to investigate the anti-inflammatory effects, anti-pain and ability-enhancement of a short-term supplementation with non-animal CS in overweight subjects with OA. In a randomized, double-blind, placebo-controlled pilot study, 60 overweight adults with symptomatic OA were allocated to consume 600 mg of non-animal CS (n = 30) or a placebo (n = 30) daily for 12 consecutive weeks. The assessment of knee-pain, quality of life, related inflammation markers and body composition was performed at 0, 4 and 12 weeks. The Tegner Lysholm Knee Scoring (TLKS) scale of the experimental group showed a statistically significant increase (+10.64 points, confidence interval (95% confidence interval (CI) 5.57, 15.70, p &lt, 0.01), while the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score decreased (&minus, 12.24 points, CI 95% &minus, 16.01, &minus, 8.38, 0.01). The results also showed a decrease in the C-reactive protein (CRP) level (&minus, 0.14 mg/dL, CI 95% &minus, 0.26, 0.04, 0.01) and erythrocyte sedimentation rate (ESR) level (&minus, 5.01 mm/h, CI 95% &minus, 9.18, 0.84, p &lt, 0.01) as well as the visual analogue scale (VAS) score in both knees. In conclusion, this pilot study demonstrates the effectiveness of non-animal CS supplementation in overweight subjects with knee OA in improving knee function, pain and inflammation markers.

Salmonellosis is one of the major public health concerns in Bahrain as it has increased rapidly during the past few years. This study aims to determine the prevalence of salmonellosis in children and the possible risk factors such as age, geographical area, nationality, gender, unsafe drinking water, infant born weight and gastrointestinal disease. The cases of salmonellosis in children reported by the Ministry of Health of Bahrain ranged from 21 to 26 per 100,000 population during the period 2012&ndash, 2016. Salmonellosis cases were geographically concentrated in the capital and northern regions. Statistical analysis showed a significant difference in the number of salmonellosis cases between Bahrainis and non-Bahrainis based on region, and gender (p &lt, 0.001). In the Bahraini cohort, there was an association between the increase of cases and the number of gastrointestinal disease-related deaths (p &lt, 0.05). In addition, unsafe water (over the level of 2.14%) and low-birth weight (&lt, 3.100 g) were associated, but not statistically significant (p = 0.086 and p = 0.126, respectively) with the increase of salmonellosis cases. Despite the decline in the number of cases, the results of this study contribute to the understanding of the epidemiology of Salmonella in humans and this, in turn, will help develop and implement preventative measures.

Background and objective: Often micronutrient deficiencies cannot be detected when patient is already following a long-term gluten-free diet with good compliance (LTGFDWGC). The aim of this narrative review is to evaluate the most recent literature that considers blood micronutrient deficiencies in LTGFDWGC subjects, in order to prepare dietary supplementation advice (DSA). Materials and methods: A research strategy was planned on PubMed by defining the following keywords: celiac disease, vitamin B12, iron, folic acid, and vitamin D. Results: This review included 73 studies. The few studies on micronutrient circulating levels in long-term gluten-free diet (LTGFD) patients over 2 years with good compliance demonstrated that deficiency was detected in up to: 30% of subjects for vitamin B12 (DSA: 1000 mcg/day until level is normal, then 500 mcg), 40% for iron (325 mg/day), 20% for folic acid (1 mg/day for 3 months, followed by 400−800 mcg/day), 25% for vitamin D (1000 UI/day or more-based serum level or 50,000 UI/week if level is Conclusions: If integration with diet is not enough, starting with supplements may be the correct way, after evaluating the initial blood level to determine the right dosage of supplementation.

Yogurt is a good source of probiotics, calcium, and proteins, but its content of vitamin D is low. Therefore, yogurt could be a good choice for vitamin D fortification to improve the positive health outcomes associated with its consumption. The primary aim of this systematic review and meta-analysis was to investigate the effect of vitamin D-fortified yogurt compared with plain yogurt on levels of serum 25-hydroxy vitamin D (25OHD). The secondary aim was to evaluate the effect of fortified yogurt on parathyroid hormone, anthropometric parameters, blood pressure, glucose metabolism, and lipid profile. We searched PubMed, Scopus, and Google Scholar for eligible studies; that is, randomized controlled trials (RCT) that compared vitamin D-fortified yogurt with control treatment without any additional supplement. Random-effects models were used to estimate pooled effect sizes and 95% confidence intervals. Findings from 9 RCT (n = 665 participants) that lasted from 8 to 16 wk are summarized in this review. The meta-analyzed mean differences for random effects showed that vitamin D-fortified yogurt (from 400 to 2,000 IU) increased serum 25OHD by 31.00 nmol/L. In addition, vitamin D-fortified yogurt decreased parathyroid hormone by 15.47 ng/L, body weight by 0.92 kg, waist circumference by 2.01 cm, HOMA-IR by 2.18 mass units, fasting serum glucose by 22.54 mg/dL, total cholesterol by 13.38 mg/dL, and triglycerides by 30.12 mg/dL compared with the controlled treatments. No publication bias was identified. Considerable between-study heterogeneity was observed for most outcomes. Vitamin D-fortified yogurt may be beneficial in improving serum 25OHD, lipid profile, glucose metabolism, and anthropometric parameters and decreasing parathyroid hormone level in pregnant women and adult and elderly subjects with or without diabetes, prediabetes, or metabolic syndrome.

Purpose. The purpose of this review was to identify the best solution for rapid and noninvasive diagnosis and long-term monitoring of patients affected by inflammatory gastrointestinal diseases, colon and gastric cancer, obesity in correlation to diet, and breast milk to evaluate exposure to VOCs in women and infants. Methods. This review included 20 previously published eligible studies. VOC analysis has allowed us to highlight differences in lifestyles, intestinal microbiota, and metabolism. New innovative methods have been described that allow the detection and quantification of a broad spectrum of metabolites present in exhaled breath even at very low levels, some of which have been shown to be indicators of pathological conditions. Results. Five studies were analyzed that involved VOC analysis in relation to type of diet. All of them showed that the type of diet can have an impact on metabolites excreted and therefore can be a useful tool in the nutritional studies related to metabolism and health and disease status. Two studies concerned VOC analysis in inflammatory bowel diseases, and the results showed that VOCs can distinguish active disease from remission; VOC profile is clearly different in patients. In particular, C15H30 1-pentadecene, 3-methyl-1-butanal, octane, acetic acid, alpha-pinene, and m-cymene are elevated in active ulcerative colitis. Four studies examined VOCs in gastric and colorectal tumors showing a change in metabolic biomarkers of cancer patients compared to the control group. Finally, the study of VOCs in breast milk has improved the understanding of the potential health risks of exposure of children to chemical pollutants. Conclusions. VOC analysis allowed to highlight differences in behavior, lifestyle, and metabolism of individuals. Analytical methods are continuously developed to allow for better detection and quantification of metabolites, thus enabling the detection of a broader spectrum of pathophysiology and disease biomarkers.

Musculoskeletal disorders in aging and pain are closely connected because of multiple mechanisms leading to loss of mobility and autonomy. Pain is predictive of diability and worsening frailty and the strength of this relationship increases with the severity of pain. This study presents a systematic review of randomized controlled trials, cross sectional studies, and observational studies based on treatment of pain in adults with musculoskeletal disorders using nutritional non-pharmacological (nutrients and antioxidants) interventions. The review found the efficiency of the following topics: (a) accession of the patient to a dietary counselling (e.g., daily recommended amount of protein—equivalent to at least of 1 g of protein per kilogram of body weight); (b) intake of glutamic acid-rich such as soy, egg, and cod and tryptophan-rich foods such as milk and peanuts—or taking quick-acting, free-form supplements; (c) supplementation of vitamin D and magnesium, if lacking; (d) weekly consumption of fish or supplements of omega-3 fatty acids; and (e) availability of botanicals, in particular curcumin and gingerol. These non-pharmacological interventions can help the pain therapist to create a personalized medicine (precision medicine), acting with the maximum efficacy and safety, and also reducing the dosage of analgesic drugs needed.

Medicinal plants have long been used by Bahrainis to combat a wide spectrum of diseases. To the best of the authors knowledge, this is the first quantitative ethnobotanical study of the country, aimed to quantify the ethnobotanical knowledge of ten native medicinal plants commonly used by herbalists for treating various common ailments in Bahrain. Ten species of native wild medicinal plants were selected based on their prevalence, frequency of use and medicinal properties. Semi-structured interviews and questionnaires, in combination with a checklist/inventory method, were conducted with 40 well-known traditional herbalists. A quantitative analysis approach resulting in different indexes including the informant consensus factor and use value was performed to evaluate the ethnobotanical knowledge and medicinal plant’s use. Herbal remedies were prepared using either fresh plant material (72%) or dried material (8%) and mostly administered orally or topically. The most important species according to use-diversity values are Suaeda aegyptiaca (Hasselq.) Zohary for gastrointestinal problems, Anastatica heirochuntica L. for facilitating labor and Ziziphus spina-christi (L.) Desf. as a shampoo/cleansing agent. On average, the level of informant consensus was relativity high (0.87) while total consensus (1.0) was noted for jaundice, fever, diarrhea, back pain, lactation and respiratory problems. The documented information provides basic data on indigenous medicinal plants from Bahrain which potentially appear promising in the treatment of various health problems. Thus, it is advisable that the safety and efficacy of these medicinal plants be confirmed through experimental and phytochemical studies, ultimately leading to the development of standardized herbal medicines.