Discovering the Potential of Natural Antioxidants in Age-Related Macular Degeneration: A Review

Age-related macular degeneration (AMD) is a multifactorial disease associated with anatomical changes in the inner retina. Despite tremendous advances in clinical care, there is currently no cure for AMD. This review aims to evaluate the published literature on the therapeutic roles of natural antioxidants in AMD. A literature search of PubMed, Web of Science and Google Scholar for peer-reviewed articles published between 1 January 2011 and 31 October 2021 was undertaken. A total of 82 preclinical and 18 clinical studies were eligible for inclusion in this review. We identified active compounds, carotenoids, extracts and polysaccharides, flavonoids, formulations, vitamins and whole foods with potential therapeutic roles in AMD. We evaluated the integral cellular signaling pathways including the activation of antioxidant pathways and angiogenesis pathways orchestrating their mode of action. In conclusion, we examined the therapeutic roles of natural antioxidants in AMD which warrant further study for application in clinical practice. Our current understanding is that natural antioxidants have the potential to improve or halt the progression of AMD, and tailoring therapeutics to the specific disease stages may be the key to preventing irreversible vision loss.

Reversal of Graves’ Disease with a Whole Foods Plant Based Diet: A Case Report

The benefits of a whole-food, plant-based diet (WFPBD) include, but are not limited to, improvement of cardiovascular health, decreased inflammation, as well as enhanced endocrine system function. We present the case of a 51-year-old pre-diabetic female with a 22-year history of Graves’ disease who reversed her conditions following the ini- tial 28-week WFPBD period. In this time, she was able to reduce her thyroid stimu- lating immunoglobulin (TSI) and hemoglobin A1c (HbA1c) levels and discontinue methimazole and cetirizine intake. It was also found that maintaining vitamin D levels are beneficial for promoting a more balanced immune response to help lower thyroid antibodies.

A Mixture of Pure, Isolated Polyphenols Worsens the Insulin Resistance and Induces Kidney and Liver Fibrosis Markers in Diet-Induced Obese Mice

Obesity is a worldwide epidemic with severe metabolic consequences. Polyphenols are secondary metabolites in plants and the most abundant dietary antioxidants, which possess a wide range of health effects. The most relevant food sources are fruit and vegetables, red wine, black and green tea, coffee, virgin olive oil, and chocolate, as well as nuts, seeds, herbs, and spices. The aim of this work was to evaluate the ability of a pure, isolated polyphenol supplementation to counteract the pernicious metabolic effects of a high-fat diet (HFD). Our results indicated that the administration of pure, isolated polyphenols under HFD conditions for 26 weeks worsened the glucose metabolism in diet-induced obese mice. The data showed that the main target organ for these undesirable effects were the kidneys, where we observed fibrotic, oxidative, and kidney-disease markers. This work led us to conclude that the administration of pure polyphenols as a food supplement would not be advisable. Instead, the ingestion of complete “whole” foods would be the best way to get the health effects of bioactive compounds such as polyphenols.

Acceptability of Plant-Based Diets for People with Chronic Kidney Disease: Perspectives of Renal Dietitians

The purpose of this study was to explore the perspective of renal dietitians regarding plant-based diets for chronic kidney disease (CKD) management and evaluate the acceptability of a hypothetical plant-based dietary prescription aiming for the consumption of 30 unique plant foods per week. This study used an exploratory mixed methods design. Forty-six renal dietitians participated in either an online survey (n = 35) or an in-depth interview (n = 11). Dietitians perceived that plant-based diets could address multiple clinical concerns relevant to CKD. Forty percent of survey respondents reported the hypothetical dietary prescription was realistic for people with CKD, 34.3% were unsure, and 25.7% perceived it as unrealistic. Strengths of the hypothetical prescription included shifting the focus to whole foods and using practical resources like recipes. Limited staffing, time, and follow-up opportunities with patients, as well as differing nutrition philosophies were the most commonly reported challenges to implementation; while a supportive multidisciplinary team was identified as an important enabler. To increase patient acceptance of plant-based dietary approaches, education about plant food benefits was recommended, as was implementing small, incremental dietary changes. Successful implementation of plant-based diets is perceived to require frequent patient contact and ongoing education and support by a dietitian. Buy-in from the multidisciplinary team was also considered imperative.

Common proanthocyanidin-rich foods modulate gastrointestinal blooms of Akkermansia muciniphila in a diet-dependent manner

Developing methods to modulate growth of the mucin-degrading gut bacterium Akkermansia muciniphila could benefit patients with different health needs, as A. muciniphila has been associated with both positive metabolic health outcomes and detrimental neurodegenerative outcomes. Growth of A. muciniphila is sensitive to plant-derived polyphenols, and particularly proanthocyanidins (PACs), when administered in isolated form at supraphysiological doses. However, it remains unclear whether doses sufficient for these effects are achievable via diet. Here, we explore the extent to which nutritionally relevant doses of common polyphenol-rich foods - berries, wine, and coffee - influence A. muciniphila abundance in C57BL/6J mice under varying dietary conditions. By administering polyphenol-rich whole foods, comparing polyphenol-depleted and PAC-rich versus PAC-poor food supplements, and through gradient PAC-dosing experiments, we show that PAC-rich foods uniquely induce A. muciniphila growth at doses that are feasibly achieved through routine diet. Notably, the effects of PAC supplementation were detected against a high-fat diet but not a low-fat control diet background, highlighting the importance of habitual diet strategies in either amplifying or mitigating the prebiotic effects of PAC-rich food consumption. Ultimately, our work suggests that both PACs and diet influence A. muciniphila abundance with downstream impacts for human health.

Older Adults’ Knowledge and Perceptions of Whole Foods as an Exercise Recovery Strategy

Resistance exercise is a widely advocated treatment for improving muscle strength and performance in older adults. Maximizing the benefit of resistance exercise by ensuring optimal recovery is an important aim and studies are now seeking interventions to expedite exercise recovery in older people. A recovery strategy that has acquired considerable interest is the consumption of protein, and more recently, the consumption of protein-rich whole foods. This study aimed to understand the perspectives of community-dwelling older adults, and determine their knowledge of exercise recovery strategies, their preferences for recovery strategies, and their attitudes toward using whole foods, such as milk as a post-exercise recovery aid. Two hundred ninety-one older adults (74 ± 4 years) were recruited to complete a self-administered online survey. A mixed methods approach was used to gather in-depth data from the cohort. Participants were asked to complete a combination of free-text (open-ended) and multiple-choice questions. Content analysis was conducted on responses to open-ended questions through a systematic classification process of coding. The most common recovery strategies reported were heat treatment, rest, and massage. Nutrition was rarely cited as a recovery strategy. Less than 2% of respondents mentioned nutrition, of these, only half mentioned a protein source. Forty-nine percent expressed negative opinions toward recovery supplements (e.g., “waste of money”) compared to 7% expressing positive opinions. Whole foods such as milk, meat, fish, and fruit, were deemed to be a more acceptable recovery strategy than supplements by 80% of respondents. Those that found whole foods to be equally as acceptable (18%), cited efficacy as their main concern, and those that declared whole foods less acceptable (2%) had no common reason. Despite the high acceptability of whole foods, only 35% were aware that these foods could aid recovery. When asked about milk specifically, the majority of older adults (73%) said this would, or might, be an acceptable exercise recovery strategy. Those that found milk an unacceptable recovery strategy (27%) often cited disliking milk or an allergy/intolerance. In conclusion, whilst whole foods represented an acceptable recovery intervention for older adults, the majority were unaware of the potential benefits of nutrition for post-exercise recovery.

Chronic Kidney Disease: Role of Diet for a Reduction in the Severity of the Disease

Chronic kidney disease affects ~37 million adults in the US, and it is often undiagnosed due to a lack of apparent symptoms in early stages. Chronic kidney disease (CKD) interferes with the body’s physiological and biological mechanisms, such as fluid electrolyte and pH balance, blood pressure regulation, excretion of toxins and waste, vitamin D metabolism, and hormonal regulation. Many CKD patients are at risk of hyperkalemia, hyperphosphatemia, chronic metabolic acidosis, bone deterioration, blood pressure abnormalities, and edema. These risks may be minimized, and the disease’s progression may be slowed through careful monitoring of protein, phosphorus, potassium, sodium, and calcium, relieving symptoms experienced by CKD patients. In this review, the current Kidney Disease Outcomes Quality Initiative (KDOQI) recommendations are highlighted, reflecting the 2020 update, including explanations for the pathophysiology behind the recommendations. The Dietary Approaches to Stop Hypertension, the Mediterranean diet, and the whole foods plant-based diet are currently being examined for their potential role in delaying CKD progression. Biological explanations for why the whole foods plant-based diet may benefit CKD patients compared to diets that include animal products are examined. Strong evidence continues to support the importance of diet meeting the daily requirement in the prevention and progression of kidney disease, and medical nutrition therapy with a registered dietitian is a critical aspect in medical intervention for CKD.

Factors associated with the whole foods consumption by adults and elderly

Objectives: Evaluate associated factors to the consumption of whole foods by adults and elderly people. Methods: Cross-sectional study carried out in a municipality in the southwest of Paraná, in which an interview was conducted, comprising 41 objective questions, in adults and the elderly. The factors associated with the consumption of whole foods were evaluated using logistic regression models. Results: The sample consisted of 388 people, predominantly of women, white people, resident in the urban area, with more than 11 years of schooling belonging to socioeconomic class B2-C1. More than a half of the participants reported consuming whole foods (54.6%), however, 21.23% consumed them of irregular form. It was noticed that the female people (Odds Ratio: 2.24; CI 95%=1.38-3.65), physically actives (Odds Ratio: 3.33; CI 95%=1.89–5.87), and that had a greater knowledge about whole foods (Odds Ratio: 1.66; CI 95%=1.01–2.74) had greater chances of consuming them. Related to the regular consumption of these foods, overweight people (Odds Ratio: 0.45; CI 95%=0.21–0.96) presented less chances of ingestion, and the mean of communication and the health professional (Odds Ratio: 2.78; CI 95%=1.07–7.18) presented positive influence in regular consumption of whole foods. Conclusions: There is a need to increase the consumption of whole foods in specific audiences, such as men, sedentary, lower economic class, individuals who do not have knowledge about whole foods and those who are overweight.

Whole-Foods, Plant-Based Diet Perceptions of Medical Trainees Compared to Their Patients: A Cross-Sectional Pilot Study

Purpose: To evaluate medical trainees’ and patients’ perceptions of the utility of a whole-foods, plant-based (WFPB) diet for chronic disease management. Methods: A cross-sectional study using two original survey tools was implemented. Quantitative and qualitative data were collected from trainees and patients to evaluate perceived motivations and barriers to WFPB diet implementation. Results: Two hundred trainees and 52 patients responded to the surveys. Nearly half (48%) of patients were willing to try a WFPB diet, expressing a desire for additional information and help with its practical application. Over half (53%) of trainees were willing to recommend a WFPB diet to patients but expressed concern about its acceptability and feasibility. Patients perceived significantly more barriers related to personal enjoyment of animal products while trainees perceived more socioeconomic barriers. Conclusion: Poor diet has been identified as the United States’ leading risk factor for mortality from chronic diseases. Plant-predominant diets, such as a WFPB diet, are associated with improved health outcomes and may be an acceptable solution for many patients. WFPB dietary modification could be pursued with a motivational interviewing approach that targets patients’ individual goals. Medical providers should address their own assumptions regarding the dietary changes their patients are willing to make.