Search

Background: Child food neophobia, i.e., rejection or avoidance of novel foods at a young age, is a prevalent nutrition problem that affects the quality of children's diet and impedes the development of healthy food preferences. Sensory sensitivity can relate to the degree of food neophobia, but previous studies rarely focused on the olfactory component of this problem in children. Objective: We aimed to thoroughly examine the relationship between various aspects of olfactory sensitivity and food neophobia in children. Methods: 246 children aged between three and nine years took part in a food neophobia assessment as well as in a comprehensive, psychophysical olfactory testing. Results: We found that certain smell perception aspects such as lower odor liking, poorer odor identification ability as well as lower sensitivity to an unknown non-food odor all significantly predicted higher food neophobia in children. Among individual characteristics of either a child or a caregiver, only the child's age significantly and positively predicted food neophobia. The exploratory model looking into the role of family environment factors predicting self-reported food neophobia in children revealed that food neophobia was associated with lower control given to a child in this child's feeding process, as well as with a more frequent use of food as a reward in feeding. Conclusions: We suggest that suppressed olfactory perception and performance can play a unique role in child nutritional difficulties. The study inspires further considerations of olfaction-engaging interventions to counteract food-neophobia in children. [ABSTRACT FROM AUTHOR]

Background: Sleeve gastrectomy has become a gold standard in addressing medically refractory obesity. Robotic platforms are becoming more utilized, however, data on its cost-effectiveness compared to laparoscopy remain controversial (1–3). At NYU Langone Health, many of the bariatric surgeons adopted robotic surgery as part of their practices starting in 2021. We present a retrospective cost analysis of laparoscopic sleeve gastrectomy (LSG) vs. robotic sleeve gastrectomy (RSG) at New York University (NYU) Langone Health campuses. Methods: All adult patients ages 18–65 who underwent LSG or RSG from 202 to 2023 at NYU Langone Health campuses (Manhattan, Long Island, and Brooklyn) were evaluated via electronic medical records and MBSAQIP 30-day follow-up data. Patients with prior bariatric surgery were excluded. Complication-related ICD-10/CPT codes are collected and readmission costs will be estimated from ICD codes using the lower limit of CMS transparent NYU standard charges (3). Direct charge data for surgery and length of stay cost data were also obtained. Statistical T-test and chi-squared analysis were used to compare groups. Results: Direct operating cost data at NYU Health Campuses demonstrated RSG was associated with 4% higher total charges, due to higher OR charges, robotic-specific supplies, and more post-op ED visits. Conclusions: RSG was associated with higher overall hospital charges compared to LSG, though there are multiple contributing factors. More research is needed to identify cost saving measures. This study is retrospective in nature, and does not include indirect costs nor reimbursement. Direct operating costs, per contractual agreement with suppliers, are only given as percentages. Data are limited to 30-day follow-up. [ABSTRACT FROM AUTHOR]

Background: Despite increasing evidence of the potential inaccuracy and unwarranted practice of regular GRV measurement in critically in adults, this practice persists within the United Kingdom. Aim: To explore adult intensive care nurses' decision‐making around the practice of GRV measurement to guide enteral feeding. Study Design: A cross‐sectional 16 item electronic survey in four adult intensive care units (ICUs) in England and Wales. Results: Two hundred and seventy‐three responses were obtained across four ICUs with acceptable response rates for most [Unit 1 74 /127 = 58.2%; Unit 2 87/129 = 67.4%; Unit 3 77/120 = 64.1%; Unit 4 35/168 = 20.8%]. Most (243/273 (89%) reported measuring GRV 4–6 hourly, with most (223/273 82%) reporting that the main reason was to assess feed tolerance or intolerance and 37/273 (13.5%) saying their unit protocol required it. In terms of factors affecting decision‐making, volume obtained was the most important factor, followed by the condition of the patient, with aspirate colour and appearance less important. When asked how they would feel about not measuring GRV routinely, the majority (78.2%) of nurses felt worried (140/273 = 51.2%) or very worried (74/273 = 27%). Conclusions: Factors affecting the nurses' decision‐making around GRV were based largely on fear of risk (around vomiting and pulmonary aspiration) and compliance with unit protocols. Relevance to Clinical Practice: Despite increasing evidence suggesting it is unnecessary, nurses' beliefs around the value of this practice persist and it continues to be embedded into unit protocols around feeding. [ABSTRACT FROM AUTHOR]

Background: Ingestion of foreign bodies may be seen unconsciously or intentionally in patients with mental health problems. Most cases pass through the esophagus slowly; however, in some cases, the tumor may be located in narrower areas of the digestive tract that require endoscopic or surgical intervention. This study describes a rare case of successful removal of more than 450 pieces of metal objects from the stomach of a 36-year-old man via ingestion of foreign bodies at Imam Khomeini Hospital in Ahvaz. Case presentation: A 36-year-old male patient (Aryan race) presented with complaints of chronic abdominal pain, frequent vomiting, and intolerance to liquids and food. The patient's companions mentioned a history of gradual ingestion of small metal objects 3 months prior. The patient was conscious and had stable vital signs. In the patient's X-ray and endoscopy, multiple metal objects inside the patient's stomach were observed, causing gastric outlet obstruction. The patient underwent gastrostomy surgery, and 452 screws, nuts, keys, stones, and other metal parts weighing 2900 g were removed from the stomach. Five days after the operation, the patient was transferred to the psychiatric service in good general condition and was diagnosed with psychosis, and her condition returned to normal at follow-up. Conclusion: Successful removal of this foreign body is rare. In chronic abdominal pain, especially in the context of psychiatric disorders, attention should be given to the ingestion of foreign bodies. In swallowing large amounts of sharp and metallic foreign objects, surgical intervention is necessary, especially in cases of obstruction, and saves the patient's life. [ABSTRACT FROM AUTHOR]

This article discusses a study conducted on medical students in Turkey to examine the relationship between food neophobia (the fear of trying new flavors) and disgust sensitivity. The study found that females had higher levels of disgust sensitivity and food neophobia compared to males. There was also a positive correlation between disgust sensitivity and food neophobia. The study suggests that understanding the factors underlying food neophobia is important due to its potential impact on nutrition. Further research is needed to explore the relationship between food neophobia and health issues like malnutrition and obesity. Additionally, the article discusses the impact of geography, culinary culture, eating habits, and country conditions on food neophobia. It highlights that globalization has allowed people to access new tastes, but food neophobia can lead to a preference for less sustainable and ecological foods. The article also suggests that food neophobia may be a symptom of mental disorders, although research on this relationship is limited. The study has some limitations, such as a small sample size and lack of structured psychiatric interviews. The article concludes that more research is needed to understand the cultural, genetic, and neurobiological aspects of food neophobia and to develop interventions to address it. [Extracted from the article]

This study investigated the effects of oral feeding readiness assessments on nutraceutical therapies in infants admitted to neonatal intensive care units. Nutraceuticals are increasingly being used to promote newborn health. However, their effects on feeding transitions and developmental outcomes have not been thoroughly studied. Therefore, this study was conducted on 210 infants to explore the effect of nutraceutical therapies on the rate of successful eating transitions and the incidence of feeding-related problems. Data on age, gender, birth weight, delivery technique, and nutraceutical use were also collected. Successful transitions, delayed transitions, and complications such as aspiration and feeding intolerance were recorded. The findings indicated that infants who received nutraceutical therapies achieved a higher success rate in transitioning to feeding, with a statistically significant difference in outcomes compared to those who did not. Probiotics improved gastrointestinal well-being and decreased challenges during dietary changes. Omega-3 supplements and vitamin D exhibited favorable effects, aiding smooth transitions and reducing hospital readmissions. This study revealed that age and feeding technique significantly influenced the success of transitions. Incorporating nutraceuticals into feeding protocols can result in better outcomes in neonatal ICUs. [ABSTRACT FROM AUTHOR]

Background: Neurological impairment (NI) relates to disorders of the central nervous system. The specific aetiology of NI varies but includes genetic, congenital abnormalities or brain injury. In children with severe NI, feeding impairments can lead to undernutrition, and some children require a feeding tube. Although tube feeding improves overall nutritional status, it has also been associated with excess body fat. Commercially available enteral formulas that are low in energy, hydrolysed and nutritionally adequate for protein and micronutrients are available to mitigate gastrointestinal symptoms and obesity. Methods: This is a retrospective multicentre study of children who attended NI clinics between January 2022 and July 2023. Data were collected before and 1 month after receiving a low‐energy, partially hydrolysed enteral formula (0.6 kcal/mL) on demographic data (age, sex, ethnicity and NI diagnosis), anthropometric measurements (weight, height, weight‐for‐age Z‐score, height‐for‐age Z‐score, body mass index [BMI] Z‐score) and feed regimen (feed volume, total fluids and type of formula/supplements). Results: Dietitians collected data on 28 children, the median age was 7 years (interquartile range [IQR] 3, 8). The most frequently recorded NI was cerebral palsy, in 13 of 28 children (48%). Before the formula switch, the most frequently reported gastrointestinal symptom was constipation, in 13 of 28 children. Within 1 month of switching to a low‐energy, hydrolysed formula, 10 of the 13 (77%) children reported an improvement in constipation. Before the formula switch, all 28 children were experiencing excessive weight gain. After the formula was switched to low‐energy, hydrolysed formula, dietitians reported that 20 of the 28 (76%) children's weight either stabilised or reduced after 1 month. There was no statistically significant difference in weight‐for‐age Z‐score or BMI Z‐scores postswitch of formula (p‐value 0.1 and 0.09, respectively). Fibre intake increased significantly from 3.3 to 8.1 g/day (p‐value < 0.01) after formula switch. The number of children whose feed regimens were simplified after switching to a low‐energy, partially hydrolysed formula was 24 of 28 (91%). Conclusions: Children with an NI who have gastrointestinal symptoms may benefit from a low‐energy, hydrolysed enteral formula to maximise feed tolerance and promote healthy weight gain. In addition, changing to a low‐energy, hydrolysed formula may simplify feed regimens by eliminating the need for additional electrolytes, multivitamins and fluid boluses. Healthcare professionals should be knowledgeable about the effectiveness and availability of a low‐energy, hydrolysed formula. Highlights: A low‐energy, partially hydrolysed enteral formula may promote weight stabilisation and optimise feed tolerance in tube‐fed children with an NI.Switching to a low‐energy, partially hydrolysed enteral formula may simplify overly complicated feed regimens in tube‐fed children with an NI by excluding the need for additional multivitamins or electrolytes.Healthcare professionals should be knowledgeable about the availability of low‐energy, hydrolysed formulas. [ABSTRACT FROM AUTHOR]

While food is essential for survival, it can also cause a variety of harmful effects, ranging from intolerance to specific nutrients to celiac disease and food allergies. In addition to nutrients, foods contain myriads of substances that can have either beneficial or detrimental effects on the animals consuming them. Consequently, all animals evolved defense mechanisms that protect them from harmful food components. These "antitoxin" defenses have some parallels with antimicrobial defenses and operate at a cost to the animal's fitness. These costs outweigh benefits when defense responses are exaggerated or mistargeted, resulting in adverse reactions to foods. Additionally, pathological effects of foods can stem from insufficient defenses, due to unabated toxicity of harmful food components. We discuss the structure of antitoxin defenses and how their failures can lead to a variety of adverse food reactions. [ABSTRACT FROM AUTHOR]

Childhood is a critical period for immune system development, which is greatly influenced by the gut microbiome. Likewise, a number of factors affect the gut microbiome composition and diversity, including breastfeeding, formula feeding, and solid foods introduction. In this regard, several studies have previously demonstrated that breastfeeding promotes a favorable microbiome. In contrast, formula feeding and the early incorporation of certain solid foods may adversely affect microbiome development. Additionally, there is increasing evidence that disruptions in the early microbiome can lead to allergic conditions and food intolerances. Thus, developing strategies to promote optimal infant nutrition requires an understanding of the relationship between infant nutrition and long-term health. The present review aims to examine the relationship between infant feeding practices and the microbiome, as well as its implications on allergies and food intolerances in infants. Moreover, this study synthesizes existing evidence on how different eating habits influence the microbiome. It highlights their implications for the prevention of allergies and food intolerances. In conclusion, introducing allergenic solid foods before six months, alongside breastfeeding, may significantly reduce allergies and food intolerances risks, being also associated with variations in gut microbiome and related complications. [ABSTRACT FROM AUTHOR]

Background/Objectives: Quantification of diamine oxidase (DAO) concentrations in serum has been proposed as an adjunctive diagnostic modality for the evaluation of histamine intolerance (HIT). Limited empirical data exist concerning the influence of dietary patterns on DAO levels. Subjects/Methods: In the context of a prospective study employing a crossover design, 18 individuals diagnosed with HIT were randomized to initiate either a low histamine diet (LHD) or a conventional mixed diet (MXD). Serum DAO concentrations were measured at the commencement of the study and following each dietary phase. A control group underwent analogous DAO assessments without imposition of dietary constraints. Results: During the time when a diet restricted in histamine was implemented, noticeable differences in changes in DAO levels did not become apparent when compared to the changes observed during the mixed (MXD) phase. Specifically, among the group, 10 of the 18 patients exhibited elevated DAO values subsequent to the LHD regimen, while the remaining eight displayed either reduced or unchanging DAO levels. The prevalence of elevated DAO levels in the LHD group did not differ significantly from that observed in the control group during the MXD phase. Additionally, during the LHD phase, patients reported a significant reduction in gastrointestinal and cutaneous symptoms. Conclusions: This prospective investigation underscores the enduring utility of a histamine-restricted diet, coupled with structured dietary reintroduction, as an efficacious diagnostic approach for individuals presenting with suspected food-related histamine hypersensitivity. Notably, the measurement of DAO levels appears to furnish only a limited capacity to discern dietary-induced fluctuations. Notwithstanding, the dynamics of DAO alteration do not appear to exhibit a discernible association with specific dietary patterns, a finding consistent across both patient and control groups. [ABSTRACT FROM AUTHOR]

Background/Aims: Chronic inflammatory bowel diseases (IBDs), including Crohn's disease and ulcerative colitis are known for a combination of food intolerance, decreased oral intake, and malabsorption which all predispose patients to malnutrition and suboptimal dietary intake. The present study was conducted to 1) examine self-reported food intolerances and dietary supplement use 2) assess nutritional intake 3) assess the nutritional status and screen for malnutrition among patients with chronic inflammatory bowel disease (CIBD). Methods: 48 patients with CIBDs (28 Crohn's disease, 15 ulcerative colitis and 7 with atypical forms of IBD) took part in this cross-sectional study. Participants completed a food frequency questionnaire targeting dietary intakes and food trends over time. A questionnaire about food intolerance was also used. The nutritional status of patients with CIBDs was evaluated by a detailed history (medical diagnosis and medications and supplements administered) and by using the subjective global assessment (SGA) tool. Anthropometric data including height, weight, and BMI with body composition assessment using automated scales and stadiometer, while Bio-impedancemetry was used to measure body fat and visceral fat. Statistical analysis was conducted using SPSS 27, employing mean values, standard deviations, absolute and relative frequencies and Pearson's chi-square test, with significance set at p ≤ 0.05. Results: Food intolerance was equally common in all the types of CIBD specifically for dairy products, spicy foods, and high-fiber food items (beans and raw vegetables). Individuals with CIBD were also complaining about meat and chicken products (68%), followed by alcohol and soda (64%) and fish and sea foods (59%). 17% of the patients were malnourished. A significant percentage of malnourished patients with CIBD had to follow a diet outside the flare, had a nutritional follow up, were currently taking corticosteroids and had a severe form of the disease compared to patients who were well nourished. Conclusions: This study has contributed valuable insights into the understanding that some food items could be associated to periods of increased disease activity in CIBD patients and that awareness/intervention regarding nutrition must be provided by healthcare professionals (dietitians, physicians...) to decrease the need for second line therapy. In addition, this self-reported food intolerance paper gives an insight for patients on food items usually avoided by CIBD patients during flares. [ABSTRACT FROM AUTHOR]

Background: Adverse reactions to foodstuffs (ARFS), specifically food allergy (FA) and food intolerance (FI), are increasing worldwide and represent a major public health concern. Thus, ARFS management, its identification, evaluation, and intervention, must provide a comprehensive solution. Objectives: (a) To develop a multifactorial strategy for ARFS management in adults with FA and/or FI; (b) to describe the multiple influential variables in ARFS within the realm of ARFS management; and (c) to design a personalized food allergen-specific substitutive diet (FASSD), as a 6-month dietary treatment option for adults with ARFS and as a component of ARFS management. Methods: The ALASKA study will consider the following main variables as part of the ARFS management: (1) demographics and clinical information; (2) symptomatology, food and beverages intake and physical activity; (3) hematobiochemical study; (4) immunology; (5) enzymatic activity; (6) anthropometry, body composition, and physical fitness; (7) QoL; (8) 6-month intervention; (9) end of the study; and (10) other assessments. The FASSD will be designed with special emphasis on the commonly lacking micronutrients in the ARFS population: niacin, Mg, K, P, Ca, Zn, B12, folate, Fe, and fiber. Discussion: The ALASKA study protocol has been developed as a global strategy to manage and evaluate ARFS in Spanish adults older than 18 years of age. Approaching ARFS with multiple assessments, as influencing factors, will lead to a novel strategy for ARFS management. The FASSD has been designed as a personalized tool to avoid crucial micronutrient deficiencies that a current strict food allergen avoidance or elimination diet may provoke. Trial registration: The protocol has been approved by the Ethics Committee of the UPM (REF.20200602) and registered on ClinicalTrials.gov (NCT05802017). [ABSTRACT FROM AUTHOR]

Background: Irritable bowel syndrome (IBS) is a functional disorder commonly associated with extra‐intestinal symptoms. However, the prevalence of these symptoms according to IBS subtype is not well established. Aim: To compare the prevalence of extra‐intestinal symptoms among patients with different subtypes of IBS. Methods: A descriptive cross‐sectional study including patients with IBS according to Rome IV criteria was performed between July 2022 and April 2023. Patients were classified according their subtype of IBS: IBS‐D (diarrhea‐predominant), IBS‐C (constipation‐predominant), and IBS‐M (mixed bowel habits). Patients completed the IBS severity scoring system questionnaire (IBS‐SSS) to determine severity of IBS symptoms and patient health questionnaire‐ 9 (PHQ‐9) to define presence and severity of depressive symptoms. The prevalence of reported extra‐intestinal symptoms was also assessed and compared between groups. Key Results: A total of 4862 patients with IBS were included; 608 IBS‐D (12.5%), 1978 IBS‐C (40.7%), and 2276 IBS‐M (46.8%). Patients with IBS‐C had significantly lower IBS‐symptoms severity (mean IBS‐SSS 290 vs. 310 and 320 for IBS‐D and IBS‐M, respectively, p = 0.03). The prevalence of obesity was also significantly lower in these patients (17.1% vs. 30.9% IBS‐D and 27.9% IBS‐M, p = 0.0001). Patients with IBS‐D showed a significantly higher prevalence of food intolerance perception (9.5%, p = 0.03), history of cholecystectomy (17.8%, p = 0.03), and fecal incontinence (36.2%, p = 0.0001) as compared to the other groups. Patients with IBS‐M had significantly higher mean PHQ‐9 score (12.7 vs. 11.1 IBS‐D and 10.5 IBS‐C, p = 0.001) and prevalence of depressive symptoms (80.0%, p = 0.01). Patients with IBS‐M also had higher prevalence of extra‐intestinal symptoms such as arthralgia (62.4%, p = 0.0001), extremity numbness (64.5%, p = 0.0001), atopic dermatitis (28.2%, p = 0.02), and chronic cervicalgia (81.0%, p = 0.01). Conclusions & Inferences: The prevalence of most extra‐intestinal symptoms is higher among patients with IBS‐M. Further research is needed to better characterize IBS subtypes, which could potentially help refining tailored therapeutic strategies. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Abant Social Sciences / Abant Sosyal Bilimler Dergisi is the property of Journal of Abant Social Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Adverse reactions to foodstuffs (ARFS), specifically food allergy (FA) and food intolerance (FI), are increasing worldwide and represent a major public health concern. Thus, ARFS management, its identification, evaluation, and intervention, must provide a comprehensive solution. Objectives (a) To develop a multifactorial strategy for ARFS management in adults with FA and/or FI; (b) to describe the multiple influential variables in ARFS within the realm of ARFS management; and (c) to design a personalized food allergen-specific substitutive diet (FASSD), as a 6-month dietary treatment option for adults with ARFS and as a component of ARFS management. Methods The ALASKA study will consider the following main variables as part of the ARFS management: (1) demographics and clinical information; (2) symptomatology, food and beverages intake and physical activity; (3) hematobiochemical study; (4) immunology; (5) enzymatic activity; (6) anthropometry, body composition, and physical fitness; (7) QoL; (8) 6-month intervention; (9) end of the study; and (10) other assessments. The FASSD will be designed with special emphasis on the commonly lacking micronutrients in the ARFS population: niacin, Mg, K, P, Ca, Zn, B12, folate, Fe, and fiber. Discussion The ALASKA study protocol has been developed as a global strategy to manage and evaluate ARFS in Spanish adults older than 18 years of age. Approaching ARFS with multiple assessments, as influencing factors, will lead to a novel strategy for ARFS management. The FASSD has been designed as a personalized tool to avoid crucial micronutrient deficiencies that a current strict food allergen avoidance or elimination diet may provoke. Trial registration The protocol has been approved by the Ethics Committee of the UPM (REF.20200602) and registered on ClinicalTrials.gov (NCT05802017).

Abstract Background Food malabsorption and intolerance is implicated in gastrointestinal symptoms among patients with irritable bowel syndrome (IBS). Key triggers include fructose and fructan. Prior studies examined fructose and fructan malabsorption separately in IBS patients. None have concurrently assessed both within the same patient group. We aimed to investigate the association between fructose and fructan malabsorption in the same patients with IBS using hydrogen breath testing (HBT). Methods We retrospectively identified patients with IBS who underwent fructose and fructan HBTs and abstracted their results from the electronic medical record. Fructose and fructan HBTs were performed by administering a 25 g fructose solution or 10 g fructan solution, followed by breath hydrogen readings every 30 min for 3 h. Patients were positive for fructose or fructan malabsorption if breath hydrogen levels exceeded 20 ppm. Results Of 186 IBS patients, 71 (38.2%) were positive for fructose malabsorption and 91 (48.9%) were positive for fructan malabsorption. Of these patients, 42 (22.6%) were positive for fructose malabsorption and fructan malabsorption. Positive fructose HBT readings were significantly associated with positive fructan HBT readings (p = 0.0283). Patients positive for fructose malabsorption or fructan malabsorption had 1.951 times higher odds of testing positive for the other carbohydrate. Conclusions Our results reveal a clinically significant association between fructose malabsorption and fructan malabsorption in patients with IBS. Fructan malabsorption should be assessed in patients with fructose malabsorption, and vice versa. Further studies are required to identify the mechanisms underlying our findings.

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated food allergy presenting with delayed onset of projectile vomiting in the absence of cutaneous and respiratory symptoms. The pathophysiology of FPIES remains poorly characterized. The first international consensus guidelines for FPIES were published in 2017 and provided clinicians with parameters on the diagnosis and treatment of FPIES. The guidelines have served as a resource in the recognition and management of FPIES, contributing to an increased awareness of FPIES. Since then, new evidence has emerged, shedding light on adult-onset FPIES, the different phenotypes of FPIES, the recognition of new food triggers, center-specific food challenge protocols and management of acute FPIES. Emerging evidence indicates that FPIES impacts both pediatric and adult population. As a result, there is growing need to tailor the consensus guidelines to capture diagnoses in both patient groups. Furthermore, it is crucial to provide food challenge protocols that meet the needs of both pediatric and adult FPIES patients, as well as the subset of patients with atypical FPIES. This review highlights the evolving clinical evidence relating to FPIES diagnosis and management published since the 2017 International FPIES Guidelines. We will focus on areas where recent published evidence may support evolution or revision of the guidelines.

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Bothersome gastrointestinal (GI) signs/symptoms, including abdominal pain, distension, nausea, and flatulence, are common in children. A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) is frequently recommended for children with GI symptoms. Currently, there are no studies on the effect of FODMAPs in healthy schoolchildren. In this cross-sectional study, schoolchildren reported an association between FODMAPs and GI symptoms through a standardized questionnaire and images of 20 common staples known to be rich in FODMAPs. A total of 208 schoolchildren aged 8–18 years old participated. A proportion of 38.0% of children reported GI symptoms, with abdominal pain (33%) being the most common complaint followed by abdominal distension (24%) and nausea (23%). The majority of children who reported intolerances to FODMAP-containing foods were intolerant to less than two food groups (76%). While vegetables and legumes (26%), particularly black beans (11%) and onions (7%), emerged as the most common group of triggers, milk (12%) stood out as the single food most frequently associated with GI symptoms. In conclusion, there was a high prevalence of FODMAPs intolerance among schoolchildren. Larger studies are recommended to confirm these findings and to inform possible dietary interventions to reduce the effect of FODMAPs on schoolchildren. [ABSTRACT FROM AUTHOR]

Immunological illnesses related to wheat represent an epidemiologically relevant phenomenon at a pediatric age. The term "Wheat-related disorders" involves a spectrum of diseases: celiac disease, IgE-mediated wheat allergy, non-IgE mediated wheat allergy, wheat-related eosinophilic esophagitis, and non-celiac gluten sensitivity. Their pathogenesis is different. At the same time, wheat represents their common point. This article aims to the state-of-the-art and new clinical evidence in pediatric age. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Belatedly, gastroenterologists have begun to pay attention to the role of diet in the exacerbation of gastrointestinal symptoms in many digestive disorders—a recognition that has spurred both high‐quality clinical trials and translational research into this area. It has become clear that multiple mechanisms acting either in isolation or together can induce gut symptoms and that appropriate interventions can lead to significant relief. What this review will explore is not the role of diet in the production of certain symptoms or symptom clusters, but rather whether a dietary intervention can beneficially alter the natural history of a gastrointestinal disease—a much more demanding expectation. Yet there are examples of where a diet, if sustained, can have a long‐term impact on at least some of those affected by conditions such as eosinophilic esophagitis, celiac disease, food allergy, and constipation. [ABSTRACT FROM AUTHOR]

AbstractThe food matrix is a complex system encompassing all constituent elements in food production. It influences the digestibility of these elements through direct interactions and affects the digestive environment. Furthermore, the gastrointestinal system possesses precise mechanisms that efficiently process dietary components into essential nutrients, effectively preventing the onset of abnormal immune responses or dysfunctional host reactions in most instances. However, the incidence of adverse food reactions is constantly increasing, and evidence indicates that this process is environmental. Adverse reactions can be categorized as toxic or nontoxic. Toxic reactions are dose-dependent and can result from natural compounds, processing-induced substances, or contaminants. Nontoxic reactions like food intolerance and hypersensitivity depend on individual susceptibility and evoke specific pathological and physiological responses. This review aims to elucidate the mechanisms underlying the occurrence of immune- (food allergies and sensitivities) and non-immune-mediated (food intolerance) reactions, emphasizing the fundamental distinctions between these two categories. Enhanced comprehension and distinction of these mechanisms will significantly contribute to advancing preventive and therapeutic approaches and establishing guidelines for food labeling concerning immune-mediated reactions. [ABSTRACT FROM AUTHOR]

Background: Food malabsorption and intolerance is implicated in gastrointestinal symptoms among patients with irritable bowel syndrome (IBS). Key triggers include fructose and fructan. Prior studies examined fructose and fructan malabsorption separately in IBS patients. None have concurrently assessed both within the same patient group. We aimed to investigate the association between fructose and fructan malabsorption in the same patients with IBS using hydrogen breath testing (HBT). Methods: We retrospectively identified patients with IBS who underwent fructose and fructan HBTs and abstracted their results from the electronic medical record. Fructose and fructan HBTs were performed by administering a 25 g fructose solution or 10 g fructan solution, followed by breath hydrogen readings every 30 min for 3 h. Patients were positive for fructose or fructan malabsorption if breath hydrogen levels exceeded 20 ppm. Results: Of 186 IBS patients, 71 (38.2%) were positive for fructose malabsorption and 91 (48.9%) were positive for fructan malabsorption. Of these patients, 42 (22.6%) were positive for fructose malabsorption and fructan malabsorption. Positive fructose HBT readings were significantly associated with positive fructan HBT readings (p = 0.0283). Patients positive for fructose malabsorption or fructan malabsorption had 1.951 times higher odds of testing positive for the other carbohydrate. Conclusions: Our results reveal a clinically significant association between fructose malabsorption and fructan malabsorption in patients with IBS. Fructan malabsorption should be assessed in patients with fructose malabsorption, and vice versa. Further studies are required to identify the mechanisms underlying our findings. [ABSTRACT FROM AUTHOR]

Histamine intolerance is a condition characterized by the accumulation of histamine to a point that exceeds the body's capacity to eliminate it. Researchers have attributed several reasons to this condition, such as genetic factors, alcohol, and dietary deficiencies, among other elements. Symptoms of histamine intolerance have been found to extend beyond the gastrointestinal tract and to the whole body, with these symptoms being sporadic and non-specific. This review will explore various aspects related to histamine intolerance, such as its causes, symptoms, diagnosis, and information related to management. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 29-week gestation premature female with extremely low birth weight born to a primigravida mother. Topics include the pregnancy complications, the baby's birth conditions, development of Necrotizing Enterocolitis (NEC), surgical interventions, gastrointestinal issues, respiratory support, and eventual death due to respiratory failure and pulmonary hypertension.

The neonatal period is crucial for the development of postnatal adaptation and the formation of health and quality of life. Premature birth of a child in conditions of hypoxia and morphological and functional immaturity implies a high risk of adaptation disorders in the postnatal period, causing the formation of functional and chronic diseases in the later years of life. The course of the neonatal period can be characterized both by transient states due to the formation of physiological adaptation and the development of dysfunction of organ systems, in particular the digestive system, which is a consequence of pathological labor stress in the implementation of adverse factors during pregnancy and childbirth in the mother. Timely detection and correction of early manifestations of gastrointestinal dysfunction in perinatal pathology will improve approaches to the provision of medical care to newborns, especially premature infants, should be aimed at both stabilizing the child's condition and preventing the development of its long-term consequences. Aim of the study. To study the peculiarities of clinical and laboratory indicators of intestinal dysfunction in perinatal pathology in premature infants. Materials and methods. A comprehensive clinical and laboratory examination of premature infants of gestational age 34-36 weeks who had signs of disorders of the functional state of the gastrointestinal system in perinatal pathology in the early neonatal period was carried out. Group I consisted of 55 children with clinical signs of severe perinatal pathology; group II (control) consisted of 50 conditionally healthy children of the same gestational age. Exclusion criteria were newborns with diagnosed congenital malformations. The list of laboratory indicators of the functional state of the intestine included: the level of α1-antitrypsin (A1AT), secretory IgA (sIgA), fecal elastase 1 (FE-1), PMN elastase and albumin in the coprofiltrate of newborns in the first week of life. Methods of indicators determination: using enzyme-linked immunosorbent assay (ELISA) on the basis of Ukrainian-German laboratory «BUKINTERMED» (Chernivtsi, Ukraine). The scientific research was conducted in accordance with the provisions of GCP (1996), the Convention of the Council of Europe on Human Rights and Biomedicine (April 4, 1997), the Declaration of Helsinki of the World Medical Association for the Ethical Principles of Research Involving Human Subjects (1964-2008), the Order of the Ministry of Health of Ukraine No. 690 of September 23, 2009 (as amended by the Order of the Ministry of Health of Ukraine No. 523 of July 12, 2012). Protocol of the research study of the Biomedical Ethics Committee of BSMU dated 12.09.2015. Informed written consent was obtained from the parents of the patients before the study with an explanation of the purpose, objectives and methods of laboratory research. Statistical processing of the results was performed using STATISTICA software (StatSoft Inc., USA, version 10). Comparison of quantitative indicators with normal distribution was performed using Student's t-test, the probability of differences was considered statistically significant at p<0.05. The study was conducted within the framework of the scientific theme of the Department of Pediatrics, Neonatology and Perinatal Medicine of the Bukovinian State Medical University: Research work «Improvement of directions of prognostication, diagnosis and treatment of perinatal pathology in newborns and young children, optimization of schemes of catamenial observation and rehabilitation» (0115U002768, term of execution 01.2015-12.2019); Research work «Chronobiological and adaptive aspects and features of vegetative regulation in pathological conditions in children of different age groups» (0122U002245, term of execution 01.2020-12.2024). Research results and discussion. In premature infants with clinical forms of perinatal pathology, a significant incidence of autonomic dysfunction syndrome was noted, which was accompanied by disorders of the functional state of the gastrointestinal system. Clinical signs of dysfunction were: absence or decrease of sucking reflex, regurgitation, stasis, intestinal paresis, delayed passage of meconium, flatulence, hepatomegaly. Of the total number, 43.6 % of newborns had signs of multiple organ failure. Laboratory studies of coprofiltrate showed an increase in the level of A1AT, sIgA, PMN-elastase, albumin with a decrease in the level of FE-1, which are interdependent criteria that confirm the presence and in some way explain the pathophysiological mechanisms of digestive system dysfunction. In particular, a decrease in tolerance to enteral nutrition in newborns occurs against the background of insufficient activity of pancreatic proteolytic enzymes, activation of a local allergic reaction and increased permeability of the intestinal mucosa, which, against the background of local inflammation, entails the risk of increased translocation of microorganisms and toxins into the bloodstream, resulting in deepening of endotoxemia in severe forms of perinatal pathology. Conclusions. 1. Severe diseases of the perinatal period in premature infants with clinical signs of multiorgan dysfunction require timely diagnosis of disorders of the functional state of the digestive tract. 2. Non-invasive laboratory markers using coprofiltrate (A1AT, FE-1, sIgA, PMN-elastase, albumin), together with clinical signs, provide an opportunity to clarify gastrointestinal dysfunction, considering its pathophysiological mechanisms, which is aimed at appropriate correction of treatment measures. [ABSTRACT FROM AUTHOR]

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated food allergy presenting with delayed onset of projectile vomiting in the absence of cutaneous and respiratory symptoms. The pathophysiology of FPIES remains poorly characterized. The first international consensus guidelines for FPIES were published in 2017 and provided clinicians with parameters on the diagnosis and treatment of FPIES. The guidelines have served as a resource in the recognition and management of FPIES, contributing to an increased awareness of FPIES. Since then, new evidence has emerged, shedding light on adult-onset FPIES, the different phenotypes of FPIES, the recognition of new food triggers, center-specific food challenge protocols and management of acute FPIES. Emerging evidence indicates that FPIES impacts both pediatric and adult population. As a result, there is growing need to tailor the consensus guidelines to capture diagnoses in both patient groups. Furthermore, it is crucial to provide food challenge protocols that meet the needs of both pediatric and adult FPIES patients, as well as the subset of patients with atypical FPIES. This review highlights the evolving clinical evidence relating to FPIES diagnosis and management published since the 2017 International FPIES Guidelines. We will focus on areas where recent published evidence may support evolution or revision of the guidelines. [ABSTRACT FROM AUTHOR]

Copyright of Istanbul Gelisim University Journal of Health Sciences / İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi is the property of Istanbul Gelisim Universitesi Saglik Bilimleri Yuksekokulu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

It is crucial to accurately identify whether a patient's reaction to food is a result of a Food Allergy (FA) or Food Intolerance (FI), as this will determine the appropriate diagnosis and management plan. Medical practitioners should rely on verified diagnoses when discussing the prevalence of these conditions. Currently, obtaining a patient's clinical history, performing a skin prick test (SPT) or measuring serum specific IgE levels are typically the initial steps in diagnosing allergies. Additional methods, such as component-resolved diagnostics, basophil activation test (BAT) and oral food challenge (OFC) may be used, if available, to confirm the allergen causing symptoms when the results of first-line tests are equivocal or contradictory with history. Determining the prevalence of sensitization profiles to different allergens, considering geographical characteristics, is important for developing personalized therapeutic and preventive measures for children. Periodic reassessment of patients with FA through allergy tests and oral food challenges will allow for the possibility of reintroducing previously avoided foods if they develop tolerance over time and improve their quality of life.

Background and Aims: Dietary fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) contribute to gastrointestinal (GI) symptoms in individuals with FODMAP sensitivity and irritable bowel syndrome. Oral enzyme supplementation is a strategy to reduce dietary FODMAP exposure and limit FODMAP-associated GI distress. This clinical trial investigated the safety of dietary supplementation with a food-grade, microbial inulinase known to hydrolyze fructan-type or inulin-type FODMAPs and related fructo-oligosaccharides in vitro. Methods: A randomized, double-blind, placebo-controlled, parallel design trial was conducted in 60 healthy adult participants of both sexes. Following a 2-week run-in placebo phase, participants were randomized to consume inulinase or placebo capsules twice daily with meals for 4 weeks. The total daily dose of inulinase was 2000 inulinase activity units. Safety measures included blood clinical chemistry, hematology, lipid profile, high-sensitivity C-reactive protein, insulin, lactate, and uric acid. GI symptoms were recorded weekly using the 15-item Gastrointestinal Symptom Rating Scale. Results: Fifty-eight participants completed the study. There were no clinically meaningful between-group differences in blood biomarkers. During the 4-week intervention period, 5 (16.7%) of 30 participants reported 5 adverse events in the inulinase group, and 8 (26.7%) of 30 participants reported 13 adverse events in the placebo group. No statistically significant between-group differences were observed in the change from baseline to 1, 2, 3, or 4 weeks of supplementation with respect to the 15-item Gastrointestinal Symptom Rating Scale overall or domain scores. Conclusion: Microbial inulinase supplementation demonstrated a favorable safety profile in healthy adults. Further investigation in a dose-ranging study in individuals with dietary FODMAP, fructan, or inulin sensitivity or irritable bowel syndrome is warranted. ClinicalTrials.gov: NCT05744700.

Aim: To evaluate and summarize the evidence for prevention and management of enteral feeding intolerance in critically ill patients and provide reference for clinical practice. Design: This study was an evidence summary followed by the evidence summary reporting standard of Fudan University Center for Evidence‐based Nursing. Methods: Current literatures were systematically searched for the best evidence for prevention and management of enteral feeding intolerance in critically ill patients. Literature types included clinical guidelines, best practice information sheets, expert consensuses, systematic reviews, evidence summaries and cohort studies. Data Sources: UpToDate, BMJ Best Practice, Joanna Briggs Institute, Guidelines International Network, National Institute for Health and Care Excellence, Registered Nurses Association of Ontario, Scottish Intercollegiate Guidelines Network, the Cochrane Library, Embase, PubMed, Sinomed, Web of Science, Yi Maitong Guidelines Network, DynaMed, MEDLINE, CNKI, WanFang database, Chinese Medical Journal Full‐text Database, European Society for Clinical Nutrition and Metabolism website, the American Society for Parenteral and Enteral Nutrition website were searched from January 2012 to April 2023. Results: We finally identified 18 articles that had high‐quality results. We summarized the 24 pieces of best evidence from these articles, covering five aspects: screening and assessment of the risk of enteral nutritional tolerance; formulation of enteral nutrition preparations; enteral nutritional feeding implementation; feeding intolerance symptom prevention and management; and multidisciplinary management. Of these pieces of evidence, 19 were 'strong' and 5 were 'weak', 7 pieces of evidence were recommended in level one and 4 pieces of evidence were recommended in level two. Conclusion: The following 24 pieces of evidence for prevention and management of enteral feeding intolerance in critically ill patients were finally recommended. However, as these evidences came from different countries, relevant factors such as the clinical environment should be evaluated before application. Future studies should focus on more specific symptoms of feeding intolerance and more targeted prevention design applications. Implications for the profession and patient care: The clinical medical staffs are recommended to take evidence‐based recommendations for the implementation of standardized enteral nutrition to improve patient outcomes and decrease gastrointestinal intolerance in critically ill patients. Impact: The management of enteral nutrition feeding intolerance has always been a challenge and difficulty in critically ill patients. This study summarizes 24 pieces of the best evidence for prevention and management of enteral nutrition feeding intolerance in critically ill patients. Following and implementing these 24 pieces of evidence is beneficial to the prevention and management of feeding intolerance in clinical practice. The 24 pieces of evidence include five aspects, including screening and assessment of the risk of enteral nutritional tolerance, formulation of enteral nutrition preparations, enteral nutritional feeding implementation, feeding intolerance symptom prevention and management and multidisciplinary management. These five aspects constitute a good implementation process. Screening and assessment of enteral nutritional tolerance throughout intervention are important guarantees for developing a feasible nutrition program in critically ill patients. This study will be benefit to global medical workers in the nutritional management of critically ill patients. Reporting Method: This evidence summary followed the evidence summary reporting specifications of Fudan University Center for Evidence‐based Nursing, which were based on the methodological process for the summary of the evidence produced by the Joanna Briggs Institute (JBI). The reporting specifications include problem establishment, literature retrieval, literature screening, literature evaluation, the summary and grading of evidence and the formation of practical suggestions. This study was based on the evidence summary reporting specifications of the Fudan University Center for the Evidence‐based Nursing, the register name is 'Best evidence summary for prevention and management of enteral feeding intolerance in critically ill patients', the registration number is 'ES20231823'. [ABSTRACT FROM AUTHOR]

Copyright of Medicina Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Food hypersensitivity (FHS) management requires daily risk assessments of all food and drinks consumed to prevent unpleasant and potentially fatal adverse reactions. Most research has focussed on food allergy in children and families. Little is known about the impact on adults or those with other FHS, such as food intolerance or coeliac disease. This study assessed differences in practices and risk assessment behaviours when eating out for adults with FHS. Methods: Adult UK residents (N = 930; 820 females, 90 males; 95% White; mean age 50 years [±16.6SD]), with food allergy (18%), food intolerance (23%) coeliac disease (44%) or multiple FHS (15%) completed an online survey. Results: Adults checked information to identify foods causing a reaction always or most of the time when eating out. However, adults with food intolerance reported checking significantly less often than adults with other FHS (all ps < 0.001). Adults reporting more severe FHS, medical rather than self‐diagnosis of FHS, previous anaphylaxis, had called an ambulance or been in hospital due to a reaction checked information significantly more often (all ps < 0.001), but were also less confident in the information provided (all ps < 0.05). Adults with allergy, coeliac disease or multiple FHS were also less confident in written and verbal information provided than those with food intolerance (p < 0.01). The type of FHS, greater perceived severity of FHS and having a medical diagnosis consistently predicted risk assessment behaviours when eating out (all ps < 0.001). Conclusion: Clinicians, patients and the food industry should be aware that the type of FHS, patient‐perceived severity and past experience of reactions affect risk assessment behaviours when eating out. This should be considered when providing clinical advice and emergency plans. [ABSTRACT FROM AUTHOR]

The article discusses the systemic inequities in the U.S. highlighted by the infant formula shortage. It shows the impact of infant formula shortage on families in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) program and stresses the need for WIC optimization and modernization. It suggests pediatric providers to advocate for paid family leave, lactation accommodations in the workplace and public spaces, and health-care based lactation support.

Background: The role of food in managing bile acid diarrhoea (BAD) is poorly understood. The present study explored the prevalence of food intolerance amongst adults with BAD. Methods: The study comprised a cross‐sectional survey of adults with BAD determined by the 75selenium homotaurocholic acid test (SeHCAT) living in the UK. Participants anonymously completed an online questionnaire on 39 food items. Frequency of food in general affecting BAD symptoms, as well as frequencies of diarrhoea, abdominal pain, bloating, flatulence and consequential food avoidance after food item ingestion, were assessed. Food group avoidance was also assessed. Results: There were 434 participants who completed the questionnaire between April and May 2021 of whom 80% reported moderate to severe chronic diarrhoea. Food intolerances were reported by 88.0% (95% confidence interval [CI] = 84.6–90.9) of participants. Diarrhoea was reported most frequently after take‐away food, fish and chips, creamy sauces, cream and large quantities of fruit (range 41.0%–33.6%). Lowest frequencies were for potato, avocado, mango, watermelon and pear (range 3.7%–7.4%) for the foods listed in the questionnaire. Similar trends were found for abdominal pain, bloating, flatulence and consequential food avoidance. Symptom‐triggering within 30 min of ingestion was more prevalence than after 30 min for almost all foods. Food group avoidance was highest for fatty foods (81.2%; 95% CI = 77.8–85.3) followed by dairy (53.9%; 95% CI = 49.1–58.7). Conclusions: Perceived food intolerance amongst adults with BAD and persisting diarrhoeal symptoms is high. Important triggers were meals with a higher fat content and higher‐fat dairy products. Diets amongst those with persisting diarrhoeal symptoms may be overly restrictive. Key points: This cross‐sectional online study identified a very high prevalence of perceived food intolerance amongst 434 UK adults living with self‐reported 75selenium homotaurocholic acid test (SeHCAT)‐diagnosed bile acid diarrhoea.Out of 39 foods explored, take‐aways and fish and chips were most frequently blamed for provoking overall gut symptoms and diarrhoea.Potato, avocado, mango, watermelon and pear were perceived to be the least frequently provocative for onset of diarrhoea, abdominal pain, bloating and flatulence.These findings indicate that further studies are needed to better understand the tolerance to dietary fat in bile acid diarrhoea, supporting the inclusion of lower‐fat milk and dairy products, fruits and vegetables. [ABSTRACT FROM AUTHOR]

In contrast to taste sensitivity, the assessment of texture or tactile sensitivity has received relatively little attention in the food context. Texture plays an important role in food preferences and food intake, and individual differences make it important to understand physiological drivers of perception as tactile sensitivity. The multi‐dimensional and dynamic aspects of texture perception suggest there is not one single method that can explain individual differences. This scoping review aims to systematically map methods assessing tactile sensitivity, in the context of food, highlighting differences in approach and implementation. Eligibility criteria included papers describing methods to assess individual differences in tactile sensitivity, that involved human participants and the context was relevant to food behavior. Sources are peer‐reviewed publications of original research in English. In mapping the methods, we assessed how they relate to food texture parameters (mechanical, geometrical, and surface) and the dynamics of breaking down (touch with hand, first bite/sip, oral processing, residual or after‐swallowing sensations). We also review other parameters associated (oral processing, preference, diet and food intake behavior). The literature in this relatively young area is still very fragmented and it is difficult to have a clear picture regarding best practices or recommendations for the measurement of tactile sensitivity in the food context. Future studies should aim to methodological harmonization for application in the food behavior area, with a design of experiment combining different aspects of tactile sensitivity to food, focusing on the thresholds and perceived intensity of textural parameters as well as affective and behavioral responses, and covering the whole spectrum of tactile texture perception (mechanical, geometrics, and surface), including the dynamics of perception. [ABSTRACT FROM AUTHOR]

Background: Routine gastric residual volume monitoring remains common in nursing practice. However, current evidence supports using a focused nursing assessment to identify signs and symptoms of enteral feeding intolerance such as abdominal pain, abdominal distension, and vomiting. Local Problem: At the author's institution, nurses and other clinicians began reporting inconsistencies in gastric residual volume monitoring along with frequent interruptions in the delivery of enteral nutrition. Interventions: The quality improvement project included patients in the medical intensive care unit receiving enteral nutrition. Gastric residual volume monitoring was eliminated. Instead, enteral nutrition was suspended on the basis of signs and symptoms of enteral feeding intolerance. Multimodal education was provided to nurses, nurse practitioners, and physicians caring for these patients. Formative evaluation occurred via staff rounds, summative evaluation occurred through a staff survey, and nutritional adequacy was evaluated by tracking patient weight. Results: The 6-week project included 37 patients on the medical intensive care unit service. Of these patients, 28 gained weight; the mean change in weight was +6.2%. The practice change was well perceived by staff and is now an established part of care for any patient receiving enteral feedings at the study hospital. Conclusions: The deimplementation of routine gastric residual volume monitoring is supported by evidence. Use of a focused gastrointestinal nursing assessment to identify enteral feeding intolerance is safe, feasible, and effective and improves nutrition delivery and nurses' workflow. [ABSTRACT FROM AUTHOR]

Food intolerances are prevalent and often confused with food allergies. This article reviews the complex landscape of adverse reactions to food, distinguishing between immune-mediated responses (food allergies) and nonimmune reactions (food intolerances). It also explores specific food intolerances such as lactose intolerance, nonceliac gluten sensitivity, fructose intolerance, and salicylate sensitivity. [ABSTRACT FROM AUTHOR]

Food allergies are on the rise; the incidence and types of foods implicated have increased worldwide. While peanut allergies are the most well-known, allergies exist to almost all types of foods. This article discusses various types of food allergies along with the most recent prevention and treatment strategies. [ABSTRACT FROM AUTHOR]