Prescription, Compliance, and Burden Associated with Salt-Restricted Diets in Heart Failure Patients: Results from the French National OFICSel Observatory

(1) Background: There is much debate about the use of salt-restricted diet for managing heart failure (HF). Dietary guidelines are inconsistent and lack evidence. (2) Method: The OFICSel observatory collected data about adults hospitalised for HF. The data, collected using study-specific surveys, were used to describe HF management, including diets, from the cardiologists’ and patients’ perspectives. Cardiologists provided the patients’ clinical, biological, echocardiography, and treatment data, while the patients provided dietary, medical history, sociodemographic, morphometric, quality of life, and burden data (burden scale in restricted diets (BIRD) questionnaire). The differences between the diet recommended by the cardiologist, understood by the patient, and the estimated salt intake (by the patient) and diet burden were assessed. (3) Results: Between March and June 2017, 300 cardiologists enrolled 2822 patients. Most patients (90%) were recommended diets with <6 g of salt/day. Mean daily salt consumption was 4.7 g (standard deviation (SD): 2.4). Only 33% of patients complied with their recommended diet, 34% over-complied, and 19% under-complied (14% unknown). Dietary restrictions in HF patients were associated with increased burden (mean BIRD score of 8.1/48 [SD: 8.8]). (4) Conclusion: Healthcare professionals do not always follow dietary recommendations, and their patients do not always understand and comply with diets recommended. Restrictive diets in HF patients are associated with increased burden. An evidence-based approach to developing and recommending HF-specific diets is required.

An In Vitro Approach to Studying the Microbial Community and Impact of Pre and Probiotics under Anorexia Nervosa Related Dietary Restrictions

Individuals with anorexia nervosa (AN) often suffer psychological and gastrointestinal problems consistent with a dysregulated gut microbial community. Psychobiotics have been postulated to modify microbiota and improve mental well-being and gut symptoms, but there is currently a lack of evidence for such approaches in AN. The aim of this study was to use an in vitro colonic model to evaluate the impact of dietary restrictions associated with AN on the intestinal ecosystem and to assess the impact of pre and probiotic intervention. Bacteriology was quantified using flow cytometry combined with fluorescence in situ hybridisation and metabolic end products (including neurotransmitters) by gas chromatography and liquid chromatography mass spectrometry Consistent with previous research, the nutritional changes significantly reduced total microbiota and metabolites compared with healthy conditions. Pre and probiotic supplementation on restricted conditions enhanced the microbial community and modulated metabolic activity to resemble that of a healthy diet. The model system indicates that nutritional changes associated with AN can impact the microbial community, and that these changes can, at least in part, be restored through the use of pre and probiotic interventions.

FAKTOR RISIKO YANG MEMPENGARUHI KEJADIAN ANEMIA PADA IBU HAMIL DI WILAYAH KERJA PUSKESMAS NUSAWUNGU II CILACAP

Background: The prevalence of anemia in pregnant women in Indonesia is still high. Based on Riskesdas data from 2013-2018, the proportion of anemia in pregnant women increased from 37.1% to 48.9% while the 2019 RPJMN target was 28%. The Nusawungu II Health Center in Cilacap Regency ranks the highest in cases of anemia in pregnant women in 2020, which is 51.51%. The risk factors for anemia in pregnant women are quite diverse.Objective: This study aims to determine the risk factors that influence the incidence of anemia in pregnant women in the working area of the Nusawungu II Public Health Center, Cilacap.Methods: This type of research is an analytic observational study with a Case Control design. The sample set is 42 case groups and 42 control groups using purposive sampling technique. The collection of data on gestational age, nutritional status of pregnant women, diversity of food consumption, compliance with Fe tablet consumption, education level, economic status and dietary restrictions was carried out by distributing questionnaires and interviews. Data were analyzed using Chi Square test.Results: The results of the study showed that the risk factors associated with the incidence of anemia in pregnant women were gestational age (p 0.028; OR 2.667), diversity of food consumption (p 0.004; OR 3.758), economic status (p 0.028; OR 3.077) and dietary restrictions (p 0.015; OR 3.026) while the unrelated risk factors were nutritional status (p 0.786), adherence to Fe tablet consumption (p 0.811), and level of education (p 0.345).Conclusion: Gestational age, nutritional status of pregnant women, diversity of food consumption, compliance with Fe tablet consumption, education level, economic status and dietary restrictions are risk factors for anemia in pregnant women in the working area of Nusawungu II Public Health Center Cilacap.Keywords: Anemia; Pregnant mother; Diversity of Food Consumption; Food taboos.

High prevalence of food taboos and dietary restrictions in lactating mothers from coastal districts of a south Indian state: a hospital based study

Background: Adequate nutrition during pregnancy and lactation is pivotal for wellbeing of newborn infants. However, presence of traditional beliefs and taboos associated with food intake during pregnancy and lactation could interfere with nutritional needs of growing infants resulting in a variety of nutritional disorders. Our objective was to study the prevalence of dietary restrictions and food taboos practiced by lactating women from five costal districts of the state of Andhra Pradesh, India.Methods:It was a descriptive and observational study, conducted between November 2020 to January 2021 at the Children’s Heart Institute, Andhra Hospitals, Vijayawada, Andhra Pradesh. The study was conducted on mothers attending the out-patient clinic of pediatric cardiology department using convenient sampling technique. A pretested questionnaire was used to collect the data.Results: A total of 161 mothers have participated in the survey and, almost all of them (99.3%) have restricted one or more food item during lactation. Age of the mother, level of education and socio-economic status have no bearing on the prevalence of food restrictions and food taboos. Most commonly restricted food items include sweets, fruits, leafy vegetables, yogurt, some pulses, eggs and nuts. The concept of hot and cold food items is highly prevalent in the study population and lactating mothers have no knowledge of the nutritive value of the foods avoided/restricted.Conclusions:Food restrictions and taboos associated with food intake during post-partum period are widespread in our study population. Improving girl child education and campaigning through print and digital media are important tools in fighting against harmful traditional practices interfering with adequate nutrition during pregnancy and lactation.

Radioligands Targeting Fibroblast Activation Protein (FAP)

Targeting fibroblast activation protein (FAP) in cancer-associated fibroblasts (CAFs) has attracted significant attention in nuclear medicine. Since these cells are present in most cancerous tissues and FAP is rarely expressed in healthy tissues, anti-FAP tracers have a potential as pan-tumor agents. Compared to the standard tumor tracer [18F]FDG, these tracers show better tumor-to-background ratios (TBR) in many indications. Unlike [18F]FDG, FAP-targeted tracers do not require exhausting preparations, such as dietary restrictions on the part of the patient, and offer the possibility of radioligand therapy (RLT) in a theragnostic approach. Although a radiolabeled antibody was clinically investigated as early as the 1990s, the breakthrough event for FAP-targeting in nuclear medicine was the introduction and clinical application of the so-called FAPI-tracers in 2018. From then, the development and application of FAP-targeted tracers became hot topics for the radiopharmaceutical and nuclear medicine community, and attracted the interest of pharmaceutical companies. The aim of this review is to provide a comprehensive overview of the development of FAP-targeted radiopharmaceuticals and their application in nuclear medicine.

Management of Dietary Habits and Diarrhea in Fap Individuals: A Mediterranean Low-Inflammatory Dietary Intervention

Background: A total colectomy and a frequent life-long endoscopic surveillance are guaranteed to patients with Familial Adenomatous Polyposis (FAP) to reduce their risk of duodenal and rectal stump cancers. However, after surgery, individuals with FAP suffer from an increased number of diarrheal discharges that force them to dietary restrictions. A non-randomized pilot study was conducted to assess whether a three-month low-inflammatory Mediterranean dietary intervention reduces gastro-intestinal markers of inflammation in FAP individuals. The aim of the present work is to evaluate the participant’s adherence to the proposed dietary recommendations and the change in their number of diarrheal discharges. Methods: 26 FAP individuals aged >18 years, who underwent a total colectomy with ileo-rectal anastomosis and were involved in the surveillance program at the Fondazione IRCCS Istituto Nazionale Tumori of Milan, were included in the present analysis. Results: FAP individuals significantly reduced the Not recommended foods (p-value: 0.002) and increased the consumption of the Recommended ones (p-value: 0.075). The adherence to the proposed dietary recommendations was accompanied by a significant decrease in the number of diarrheal discharges (p-value: 0.008). Conclusions: This study suggests that adhering to a low-inflammatory Mediterranean diet has a potential protective effect on the number of diarrheal discharges in FAP individuals.

Non-pharmacological therapy for infantile colic

Infant colic is an inconsolable cry of unknown cause in healthy babies. Observed in about 20% of infants, the most common reason for seeking medical attention at an early age. Colic is associated with maternal stress and the most significant risk factor for shaken baby syndrome, and can also cause premature breastfeeding termination. Informing and supporting parents with crying babies is increasingly important, and some guidelines recommend it as a cornerstone of intervention in families with a baby with colic. Because of the high quality randomized trials, none of the behavioral, dietary, pharmacological, or alternative interventions can be recommended as the only effective treatment. Unfortunately, many mothers around the world associate their child’s anxiety with “dietary mistakes” in their diets, leading to further dietary restrictions as a preventative measure. At the same time, according to the recommendations of the experts of the IV Rome Criteria, dietary restrictions for infant colic in breastfeeding mothers can be recommended only if there is a suspicion of suspicion of tolerance of cow’s milk protein. It is also possible for any type of feeding to prescribe fennel and chamomile preparations, in particular, in the form of aqueous infusions, and when breastfeeding it is desirable to use a bottle and excessively large volumes, which can reduce the amount of milk in a woman. It is desirable to exclude unreasonable dietary restrictions in breastfeeding mothers by excluding the so-called “gas-forming products” and ineffective therapy, in particular simethicone preparations.

Impacts of mindfulness-based interventions in people undergoing hemodialysis: a systematic review

Introduction: Chronic kidney disease (CKD) is a serious public health problem worldwide, leading to a series of physical and psychological comorbidities, in addition to costly treatments, lifestyle and dietary restrictions. There is evidence that mindfulness-based interventions (MBIs) offer complementary treatment for people with chronic illnesses, including CKD, with the aim of improving overall health, reducing side effects and treatment costs. This review aims to investigate the MBIs impact on people with CKD undergoing hemodialysis, and to identify the methodological quality of the current literature in order to support future studies. Methods: We ran searches in five databases (MEDLINE via PubMed, PsycINFO, Embase, Web of Science and Scopus) in July 2020. The papers were selected and evaluated by two reviewers independently, using predefined criteria, including the Cochrane Group's risk of bias tool and its recommendations (CRD42020192936). Results: Of the 175 studies found, 6 randomized controlled trials met the inclusion criteria, and ranged from 2014 to 2019. There were significant improvements in symptoms of anxiety, depression, self-efficacy, sleep quality, and quality of life (n=3) in the groups submitted to the intervention, in addition to physical measures such as blood pressure, heart rate and respiratory rate (n=1). Conclusions: MBIs can offer a promising and safe complementary therapy for people with CKD undergoing hemodialysis, acting on quality of life and physical aspects of the disease.