Nutritional Regimes Enriched with Antioxidants as an Efficient Adjuvant for IBD Patients under Infliximab Administration, a Pilot Study

Antioxidants are privileged candidates for the development of adjuvants able to improve the efficiency of pharmacological therapies, particularly for chronic inflammatory syndromes. During the last 20 years, anti-TNFα (tumor necrosis factor alpha) monoclonal antibodies infusion has been the biological therapy most frequently administered but there is still large space for improvement in disease remission rates and maintenance. In this context, nutritional bioactive compounds contained in dietary patterns or included as supplements, may act as adjuvants for the induction and maintenance of IBD (inflammatory bowel diseases) remission. To verify this possibility, a single-center preliminary study (SI-CURA, Soluzioni Innovative per la gestione del paziente e il follow up terapeutico della Colite UlceRosA) was designed and carried out to evaluate whether a daily administration of purple corn supplement could improve the response to Infliximab (IFX) infusion of IBD patients with both Crohn’s disease (CD) and ulcerative colitis (UC). A cohort of 47 patients was enrolled in the study. Biological samples were collected before the first and the third IFX infusion. All patients received nutritional guidelines, 27 of them received commercial red fruit tea with low anthocyanins content, while 20 received a purple corn supplement with a high anthocyanin content. Results show that the administration of an antioxidant-enriched purple corn supplement could improve IFX-mediated disease remission in terms of circulating inflammatory markers. Comparison between CD and UC patients revealed that, at this anthocyanin dosage, the purple corn extract administration improved the IFX response in CD but not in UC patients. Our results may pave the way for a new metacentric study of CD patients, recruiting a wider cohort and followed-up over a longer observational time.

Designing Just Transition Pathways: A Methodological Framework to Estimate the Impact of Future Scenarios on Employment in the French Dairy Sector

This paper proposes an innovative framework to describe sustainable transitions of food systems while considering simultaneously socio-economic and environmental issues, in a just transition perspective. This framework (i) describes the structural changes needed for a sustainable transition in food systems; (ii) assess their effects on employment at the farm and processing industry level; (iii) detect the political levers needed to make this transition a just one—that is, preserving jobs and livelihoods for communities. Using the decarbonation pathway for the agricultural sector issued from the French National Low-Carbon Strategy as reference, we developed two scenarios for the French dairy sector which have the same level of climate ambitious, but a different approach to reach the target. Aiming exclusively to achieve a greenhouse gases reduction, the first scenario relies only on supply side measures. This scenario has a negative impact in terms of employment loss at the farm level and in the agri-food sector. In contrast, a multifunctional scenario considering simultaneously climate, biodiversity, health, and employment issues, and playing with policy measures targeting supply, demand and market organisation can maintain jobs in the farm and agri-food sector, contributes to restore the agro-biodiversity and develops food products compatible with healthy nutritional guidelines.

Estimation of major nutrients in dry dog foods and their compliance with nutritional guidelines

The aim of this study was to estimate complete extruded dry food for adult dogs, with a particular focus on the nutritional value with respect to current nutritional guidelines for dogs, dietary fiber fractions, the division into breed size. Dog foods were subjected to chemical analyzes to determine the content of basic nutrients and dietary fiber fractions. The material for the research consisted of 15 maintenance foods for adult dogs (five for large breed dogs, five for small breed dogs and five for all breeds dogs). All analyzed feeds met the European Pet Food Industry Federation recommended minimum recommended levels of protein and fat. Individual tested foods were characterized by different levels of dietary fiber fractions, such as acid detergent fiber (ADF), cellulose (CEL), hemicellulose (HCEL). The group of foods for small breed dogs was characterized by the lowest mean of ME (391.23 kcal per 100 g DM). A higher level of ME (393.99 kcal per 100 g DM) was observed in the group of foods for dogs of large breeds, and the highest (397.05 kcal per 100 g DM) – in the group of foods for dogs of all breeds.

Medical Nutrition Therapy for Older Adults with Diabetes

Type 2 diabetes mellitus becomes increasingly more common with age. As such, older adults represent a very heterogeneous group in terms of functional ability and cognitive status. Older adults with diabetes are distinct from younger adults with diabetes, leading to differences in therapeutic approach. Some important goals of nutrition therapy in older adults with diabetes include minimizing hypoglycemia and hyperglycemia and meeting individualized glycemic goals. Nutrition therapy for older adults with diabetes should include meeting the nutritional needs for patients while considering their age, evaluating their fluid intake, avoiding significant weight loss, and being sensitive to individual preferences and long standing food habits while advocating good nutrition. However, there is little evidence for nutritional guidelines for older adults with diabetes, thus more research is needed.

Overweight and Cystic Fibrosis: An Unexpected Challenge

Achieving a healthy weight balance has been a central focus of care for people who have cystic fibrosis (CF). Over the years, the emphasis has primarily been on promoting weight gain in order to optimize pulmonary outcomes. With continued improvements in CF care, including highly effective CF modulator available for many people, the CF community is now experiencing a new challenge: addressing the concern that some people are gaining weight excessively. While at this time, we do not know to what extent overweight and obesity will affect health outcomes for people with CF, it is likely that excessive weight gain may have negative health impacts similar to those seen in the general population. In this paper, we review the history of nutritional guidelines for people with CF, as well as more recent trends toward overweight and obesity for some. A multidisciplinary approach is needed to collaboratively start the oftentimes difficult conversation regarding excessive weight gain, and to identify resources to help people achieve and maintain a healthy weight through diet, exercise, and behavioral modification.

The Modification of the Gut Microbiota via Selected Specific Diets in Patients with Crohn’s Disease

Gastrointestinal symptoms in Crohn’s disease (CD) are common and affect the quality of life of patients; consequently, a growing number of studies have been published on diet interventions in this group. The role of the gut microbiota in the pathogenesis and the progression of inflammatory bowel diseases (IBD), including CD, has been widely discussed. Mainly, a decreased abundance of Firmicutes, species of the Bifidobacterium genus, and the Faecalibacterium prausnitzii species as well as a reduced general diversity have been described. In this review article, we summarize available data on the influence of reduction diets on the microbiome of patients with CD. One of the most frequently used elimination diets in CD patients is the low-FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) diet. Although many papers show it may reduce abdominal pain, diarrhea, or bloating, it also reduces the intake of prebiotic substances, which can negatively affect the gut microbiota composition, decreasing the abundance of Bifidobacterium species and Faecalibacterium prausnitzii. Other elimination diets used by IBD patients, such as lactose-free or gluten-free diets, have also been shown to disturb the microbial diversity. On the other hand, CDED (Crohn’s disease exclusion diet) with partial enteral nutrition not only induces the remission of CD but also has a positive influence on the microbiota. The impact of diet interventions on the microbiota and, potentially, on the future course of the disease should be considered when nutritional guidelines for IBD patients are designed. Dietetic recommendations should be based not only on the regulation of the symptoms but also on the long-term development of the disease.