Management of gestational diabetes mellitus via nutritional interventions:The relevance of gastric emptying

Gestational diabetes mellitus(GDM)represents one of the most common medical complications of pregnancy and is important to the well-being of both mothers and offspring in the short and long term.Lifestyle intervention remains the mainstay for the management of GDM.The efficacy of nutritional approaches(e.g.calorie restriction and small frequent meals)to improving the maternal-neonatal outcomes of GDM was attested to by Chinese population data,discussed in two articles in recent issues of this journal.However,a specific focus on the relevance of postprandial glycaemic control was lacking.Postprandial rather than fasting hyperglycaemia often represents the predominant manifestation of disordered glucose homeostasis in Chinese women with GDM.There is now increasing appreciation that the rate of gastric emptying,which controls the delivery of nutrients for digestion and absorption in the small intestine,is a key determinant of postprandial glycaemia in both health,type 1 and 2 diabetes.It remains to be established whether gastric emptying is abnormally rapid in GDM,particularly among Chinese women,thus contributing to a predisposition to postprandial hyperglycaemia,and if so,how this influences the therapeutic response to nutritional interventions.It is essential that we understand the role of gastric emptying in the regulation of postprandial glycaemia during pregnancy and the potential for its modulation by nutritional strategies in order to improve postprandial glycaemic control in GDM.

Effects and mechanisms of nutritional interventions on extradigestive complications in obese patients

BACKGROUND Obesity is associated with an increased risk of multiple extradigestive complic-ations.Thus,understanding the global epidemiology of obesity and its relation-ship with extradigestive complications,such as cardiovascular disease,type 2 diabetes mellitus,and non-alcoholic fatty liver disease is important.However,nutritional intervention can positively manage issues associated with obesity.Hence,the identification of the current high prevalence of extradigestive complica-tions among patients with obesity and the potential role of nutritional inter-ventions is also essential.AIM To determine the relationship between obesity and extradigestive complications and emphasize the importance of nutritional interventions in the management of patients with obesity.METHODS Overall,110 patients with obesity admitted to our hospital from February 2020 to November 2022 and 100 healthy individuals were included in the present study.Information of the study population,including demographic characteristics,such as age,sex,body mass index,indicators of extradigestive complications,dietary intake,and biomarkers was collected.The study design,participant selection,interventions,and development of the nutritional intervention program were described.The collected data were analyzed to assess the effect of nutritional inter-ventions on extradigestive complications.RESULTS As a part of nutritional intervention,the dietary structure was modified to decrease the saturated fatty acid and cholesterol intake and increase the dietary fiber and polyunsaturated fatty acid intake to improve the blood lipid levels and cardiovascular health.Mechanistic studies showed that these nutritional inter-ventions positively affected mechanisms that regulate lipid metabolism,improved inflammatory markers in the blood,and improved vascular functions.CONCLUSION The study discusses the consistency of the present results with previous findings to assess the clinical significance of the present findings.The study provides direction for future research on improving nutritional intervention strategies.

Surgical and nutritional interventions for endometrial receptivity:A case report and review of literature

BACKGROUND Polycystic ovary syndrome(PCOS)is an endocrine disease that combines metabolic,reproductive,and psychological dysfunctions.Ovulation disorders and impaired endometrial receptivity in PCOS can cause infertility.Insulin resistance(IR)is a pathological state of inadequate response to insulin that affects reproduction in PCOS,as damage caused by IR at the endometrial level becomes an obstacle for embryo implantation.Reversing IR resulted in spontaneous pregnancies in PCOS patients,indicating that metabolic corrections improve endometrial dysfunctions.Mesenchymal stem-cell treatment has also corrected endometrial quality and lead to pregnancies in patients with Asherman’s syndrome.We propose a combination of nutritional intervention with the surgical placement of stem cells to improve endometrial quality to achieve pregnancy in a PCOS patient undergoing in vitro fertilization(IVF)treatment.CASE SUMMARY After two failed IVF cycles,a metabolic intervention,consisting of a ketogenic diet with daily consumption of 50 g of carbohydrates(CH),was indicated until pregnancy.Metabolic Syndrome was assessed using the Harmonizing Definition(3 of 5 pathologies:Central obesity,hypertension,hyperglycemia,hypertriglyceridemia,and dyslipidemia),and the Homeostatic Model Assessment of IR(HOMA-IR)was used to measure the level of IR.Once IR improved,endometrial quality improved.However,two day 5-thawed embryos(euploid,donated oocyte–partner's sperm)failed to implant,suggesting endometrial quality improvement was insufficient.Therefore,transmyometrial implantation of mesenchymal stem cells from the stromal vascular fraction of adipose tissue was performed to enrich the endometrial stem cell niche.Minimal endometrial mean thickness for embryo transfer(6.9 mm)was achieved three months after stem cell treatment and continuous dietary control of IR.Two euploid-day 5-thawed embryos(donated oocyte–partner's sperm)were transferred,and embryo implantation was confirmed on day 14 byβ-hCG serum levels.Currently,a 37 wk baby girl is born.CONCLUSION In PCOS,endometrial quality can be improved by combining nutrient-based metabolic correction with endometrial stem cell niche enrichment.

The Effects of Nutritional Interventions on Energy Metabolism

Energy metabolism is vital to the body's metabolic processes.A key player in the production of ATP,mitochondria directly affect energy homeostasis.Mitochondrial dysfunction is the cause of many diseases.Many reports have suggested that nutritional interventions can play a protective role against the development of mitochondrial dysfunction or in ameliorating existing dysfunction,such as by improving energy metabolism.This review focuses on the impact of different nutritional interventions on energy metabolism.

Efficacy of a Nutritional Cream Intervention to Treat Depression in Rescuers:A Randomized Controlled Trial

Objective To explore the effectiveness of a nutritional intervention in rescuers who screened positive for depression.Methods A randomized controlled trial design was employed.From June to August,2022,4,460 rescuers were screened using the Self-Rating Depression Scale(SDS),and 1,615 positive cases were identified.Thirty-one volunteers were recruited and randomly divided into a nutritional intervention group and a control group.The intervention group received health education and nutritional intervention(a compound paste therapy primarily composed of red roses and Seville orange flowers),while the control group received psychological education.SDS scores were assessed before and after the intervention.Results There was a statistically significant decline in SDS scores in the nutritional intervention group after the intervention(P<0.05).Furthermore,the SDS scores of the intervention group were significantly lower than those of the control group,both before and after the intervention(P<0.05).No severe adverse reactions were observed during safety evaluation.Conclusion The nutritional intervention effectively reduced the depression scores in rescuers.Early nutritional intervention is recommended for rescuers who initially screen positive for depression.

Dietary Lipid Intervention in the Prevention of Brain Aging

As people live longer,the burden of aging-related brain diseases,especially dementia,is increasing.Brain aging increases the risk of cognitive impairment,which manifests as a progressive loss of neuron function caused by the impairment of synaptic plasticity via disrupting lipid homeostasis.Therefore,supplemental dietary lipids have the potential to prevent brain aging.This review summarizes the important roles of dietary lipids in brain function from both structure and mechanism perspectives.Epidemiological and animal studies have provided evidence of the functions of polyunsaturated fatty acids(PUFAs)in brain health.The results of interventions indicate that phospholipids—including phosphatidylcholine,phosphatidylserine,and plasmalogen—are efficient in alleviating cognitive impairment during aging,with plasmalogen exhibiting higher efficacy than phosphatidylserine.Plasmalogen is a recognized nutrient used in clinical trials due to its special vinyl ether bonds and abundance in the postsynaptic membrane of neurons.Future research should determine the dose-dependent effects of plasmalogen in alleviating brain-aging diseases and should develop extraction and storage procedures for its clinical application.

Effect of Individualized Nutrition Intervention Care Combined with Swallowing Training on Postoperative Nutritional Status in Patients with Laryngeal Cancer

Introduction: Laryngeal carcinoma accounts for 13.9% of head and neck tumors, and squamous cell carcinoma is the main pathological type. At present, the treatment of laryngeal cancer is mainly surgical treatment or postoperative radiotherapy. The surgery is delicate, complex, time-consuming and traumatic. Postoperative patients are prone to dysphagia, leading to an increase in the incidence of malnutrition. Malnutrition can cause a series of negative effects, including weight loss, increased incidence of infection, reduced tolerance of anti-tumor treatment, and extended length of hospital stay. Therefore, how to effectively improve the nutritional status of laryngeal cancer patients through nursing intervention has become an important topic of nursing research. Objective: Investigate the effect of individualized nutrition intervention care combined with swallowing training on postoperative nutritional status in patients with laryngeal cancer. Methods: A total of 120 consecutive patients who underwent laryngeal surgery at our hospital for the first time between May 2018 and May 2021 were selected for the study and equally divided into the control group and the study group by the random number table method, with 60 patients in each group. Patients in the control group were given swallowing function training and health counseling, and the study group adopted individualized nutrition intervention care based on the control group. The nutritional status, swallowing function, and quality of life (QOL) of the patients were assessed using the Patient-generated Subjective Global Assessment (PG-SGA), MD Anderson Dysphagia Inventory (MDADI), and Quality of Life Questionnaire-Core30 (QLQ-C30) before the intervention and three months after the intervention. Results: Before the intervention, the scores of MDADI, PG-SGA, and QLQ-C30 were not significantly different between the two groups (P > 0.05), and three months after the intervention, the scores of MDADI and QLQ-C30 increased and the score of PG-SGA decreased in the study group, with significant differences (P 0.05). At three months after the intervention, patients in the study group had higher scores on MDADI, QLQ-C30 and lower scores on PG-SGA than the control group, with significant differences (P Conclusion: Combining individualized nutrition intervention care with swallowing training improves the postoperative nutritional status, swallowing function, and QOL of patients with laryngeal cancer.

Effect of a Nutrition Education Intervention on Food Safety Knowledge, Attitudes and Practices of Mothers of Children under 5 Years in the Peri-Urban Areas of Bobo-Dioulasso: Before and after Study

Background: This study assessed the effect of a nutrition education intervention. This intervention aimed to improve the knowledge, attitudes, and practices of mothers on food safety in the peri-urban areas of Bobo-Dioulasso in Burkina Faso. Methods: A total of 243 mothers of children under 5 years in the peri-urban of Bobo-Dioulasso were administered the FAO questionnaire for food safety knowledge, attitudes, and practices assessment during two cross-sectional surveys, before and after the intervention, in January and October 2017. The intervention included two components consisting of a theoretical phase (counselling and discussion) and cooking demonstrations implemented for ten months. To account for the before-and-after design of the study, the McNemar’s test was used to assess the effect of the intervention on food safety KAP of mothers of children under 5 years. Results: The mean age of mothers was 29 ± 6.2 years and 50.6% of them were between 20 and 29 years old. One for knowledge (cooking thoroughly with, p-value = 0.0001) and another for attitudes (perceived benefits of reheating leftovers before eating them, p-value = 0.0001), significantly increased after the intervention. In terms of food safety practices, all the indicators (cleaning of dirty surfaces, plates and utensils and storage of perishable foods) significantly increased (all p = 0.0001 Conclusion: This study provided some evidence of an effective nutrition education intervention for improving maternal KAP on food safety for their child’s feeding.

Intestinal challenge with enterotoxigenic Escherichia coli in pigs,and nutritional intervention to prevent postweaning diarrhea

Gut health of nursery pigs immediately after weaning is tightly associated with their growth performance and economic values. Postweaning diarrhea(PWD) is one of the major concerns related to gut health of nursery pigs which often is caused by infections of enterotoxigenic Escherichia coli(ETEC),mainly including F4(K88)^+ and F18^+ E. coli. The main virulence factors of ETEC are adhesins(fimbriae or pili) and enterotoxins. The common types of fimbriae on ETEC from PWD pigs are F18^+ and F4^+. Typically, PWD in pigs is associated with both F18^+ and F4^+ ETEC infections whereas pre-weaning diarrhea in pigs is associated with F4+ ETEC infection. Enterotoxins including heat-labile enterotoxins(LT) and heatstable peptide toxins(ST) are associated with causing diarrhea in pigs. At least 109 to 1010 ETEC are required to induce diarrhea in nursery pigs typically lasting 1 to 5 days after ETEC infection. Antibiotics used to be the most effective way to prevent PWD, however, with the increased bacterial resistance to antibiotics, alternatives to the use of antibiotics are urgently needed to prevent PWD. Immunopropylaxis and nutritional intervention of antimicrobial minerals(such as zinc oxide and copper sulfate), organic acids, functional feedstuffs(such as blood plasma and egg yolk antibodies), direct fed microbials, phytobiotics, and bacteriophage can potentially prevent PWD associated with ETEC. Some other feed additives such as nucleotides, feed enzymes, prebiotic oligosaccharides, and clay minerals can enhance intestinal health and thus indirectly help with preventing PWD. Numerous papers show that nutritional intervention using selected feed additives can effectively prevent PWD.

Advance in Nutritional Status and Intervention after Spinal Cord Injury

Spinal cord injury(SCI)is a common disease in spinal surgery.SCI affects the metabolism of patients and changes their lifestyle.Nutritional problems may occur,which may be manifested as insufficient or overnutrition.Nutrition status is related to many complications and final outcome after SCI.In this paper,the nutritional status of patients with SCI and the progress of nutritional intervention were reviewed by comprehensive domestic and foreign literature.Medical staff should routinely screen and evaluate the nutrition of patients after SCI operation,and provide comprehensive nutritional intervention such as diet,exercise and dietary supplement.

Effect of individualized nutrition interventions on clinical outcomes of pregnant women with gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)can lead to excessive pregnancy weight gain(PWG),abnormal glucolipid metabolism,and delayed lactation.Therefore,it is necessary to provide appropriate and effective interventions for pregnant women with GDM.AIM To clarify the effects of individualized nutrition interventions on PWG,glucolipid metabolism,and lactation in pregnant women with GDM.METHODS The study population consisted of 410 pregnant women with GDM who received treatment at the Northern Jiangsu People's Hospital of Jiangsu Provinceand Yangzhou Maternal and Child Health Hospital between December 2020 and December 2022,including 200 who received routine in-terventions[control(Con)group]and 210 who received individualized nutrition interventions[research(Res)group].Data on PWG,glucolipid metabolism[total cholesterol,(TC);triglycerides(TGs);fasting blood glucose(FPG);glycosylated hemoglobin(HbA1c)],lactation time,perinatal complications(cesarean section,premature rupture of membranes,postpartum hemorrhage,and pregnancy-induced hypertension),and neonatal adverse events(premature infants,fetal macrosomia,hypo-glycemia,and respiratory distress syndrome)were collected for comparative analysis.RESULTS The data revealed markedly lower PWG in the Res group vs the Con group,as well as markedly reduced TG,TC,FPG and HbA1c levels after the intervention that were lower than those in the Con group.In addition,obviously earlier lactation and statistically lower incidences of perinatal complications and neonatal adverse events were observed in the Res group.CONCLUSION Individualized nutrition interventions can reduce PWG in pregnant women with GDM,improve their glucolipid metabolism,and promote early lactation,which deserves clinical promotion.

Effect of a Nutrition Education Intervention on Mothers’ Infant and Young Child Feeding Knowledge and Practices in the Peri-Urban Areas of Bobo-Dioulasso: Before and after Study

Background: This study assessed the effect of a nutrition education intervention aiming to improve the knowledge and practices of under 5 years children’s mothers on infant and young child feeding in peri urban areas of Bobo-Dioulasso in Burkina Faso. Methods: A total of 243 mothers of children under 5 years in the peri-urban of Bobo-Dioulasso were surveyed before and after the intervention using the FAO questionnaire for infant and young child feeding (IYCF) knowledge and practices assessment in January and October 2017. The intervention included two components consisting of a theoretical phase (counselling and discussion) and cooking demonstrations implemented for ten months. To account for the before-and-after design of the study, the McNemar’s test was used to assess the effect of the intervention on mothers’ infant and young child feeding knowledge and practices. Results: The mean age of mothers was 29 ± 6.2 years and 50.6% of the mothers were between 20 and 29 years old. All indicators used to assess the mothers’ knowledge of breastfeeding and complementary feeding significantly improved after the intervention (all p-values < 0.05). In terms of child feeding practices, half of the indicators (early breastfeeding initiation, age of complementary feeding initiation, and minimum meal frequency) significantly increased (all p = 0.001) while two indicators (minimum dietary diversity, and minimum acceptable diet) did not change (p = 0.06 and 0.67) after the intervention. Finally, continued breastfeeding, significantly declined after the intervention (73.3% vs 86.0% p = 0.001). Conclusion: The intervention improved the mothers’ knowledge on breastfeeding and complementary feeding and some child feeding practices. This study provided some evidence of an effective nutrition education intervention to increase maternal knowledge and practices.

Neurotransmitter-precursor-supplement Intervention for Detoxified Heroin Addicts

This study examined the effects of combined administration of tyrosine, lecithin, L-glutamine and L-5-hydroxytryptophan （5-HTP） on heroin withdrawal syndromes and mental symptoms in detoxified heroin addicts. In the cluster-randomized placebo-controlled trial, 83 detoxified heroin addicts were recruited from a detoxification treatment center in Wuhan, China. Patients in the intervention group （n=41） were given the combined treatment with tyrosine, lecithin, L-glutamine and 5-HTP and those in the control group （n=42） were administered the placebo. The sleep status and the withdrawal symptoms were observed daily throughout the study, and the mood states were monitored pre- and post-intervention. The results showed that the insomnia and withdrawal scores were significantly improved over time in participants in the intervention group as compared with those in the control group. A greater reduction in tension-anxiety, depression-dejection, anger-hostility, fatigue-inertia and total mood disturbance, and a greater increase in their vigor-activity symptoms were found at day 6 in the intervention group than in the control group （all P〈0.05）. It was concluded that the neurotransmitter-precursor-supplement intervention is effective in alleviating the withdrawal and mood symptoms and it may become a supplementary method for patients＇ recovery from heroin addiction.

Managing Cachexia and Improving Quality of Life in Cancer Patients Using Novel Nutritional Supplements: A PAN India Study

Cancer patients develop cachexia due to systemic inflammation, negative protein and energy balance. Esperer Onco Nutrition (EON) has come up with innovative nutritional supplements (EON Therapy) that help patients take the rigours of cancer therapy thereby improving prognosis and Quality of Life (QoL). This Post-marketing surveillance study was undertaken on 38 volunteers to assess the impact of EON therapy on cachexia and QoL of patients undergoing curative treatment. Body weight and biochemical parameters of the volunteers were recorded at each visit. Volunteers were assessed using ECOG Scale and Malnutrition Screening Tool (MST) to assess impact of nutritional supplements on QoL. Weight loss was observed in most of the patients for first two visits but the patients gained weight over subsequent visits and average weight at end of the study was higher than initial weight. At the end of study 22 of 38 volunteers gained weight and 7 volunteers maintained initial weight. The biochemical parameters either showed improvement or remained same. The QoL analysis indicated a marked improvement in physical wellness and nutritional status and no adverse effects were reported. In conclusion, the study underlines importance of research based on nutritional supplements for cancer patients for better disease management and prognosis.

EFFECTS OF EARLY NUTRITION INTERVENTION ON IGF1, IGFBP3,INTESTINAL DEVELOPMENT, AND CATCH-UP GROWTH OF INTRAUTERINE GROWTH RETARDATION RATS

To investigate the effects of early nutritional intervention on the serum insulin-like growth factor-1 (IGF1),insulin-like growth factor binding protein 3 (IGFBP3), intestinal development, and catch-up growth of intrauterine growth retardation (IUGR) rats by giving the IUGR new born rats different protein level diet. Methods IUGR rat model was built by starvation of pregnant female rats. Twenty-four IUGR pups and 8 normal pups were divided randomly into 4 groups: normal control group (C group); IUGR control group(S group), IUGR low-protein diet group (SL group), and IUGR high-protein diet group (SH group). Detected the serum IGF1, IGFBP3, body weight, body length, intestinal weight length, intestinal villi height (VH), crypt depth (CD), villi absorbing area (VSA), mucous thickness (MT), and disaccharidase at the 4th week. Results (1) The SH group showed the fastest catch-up growth, serum IGF1, IGFBP3, VH, and VSA were significantly higher than those of normal control group and IUGR control group. The intestinal weight and length, and the activities of lactase and saccharase of the SH group also reached the normal control group level. (2) The SL group kept on small size, the serum IGF1, IGFBP3, and most of intestinal histological indexes were all significantly lower than other groups. (3) IGF-1, IGFBP3 were positively correlated to intestinal VH, VSA, saccharase, body weight and length. Conclusions The serum IGF1 was a sensitive index to the catch-up growth. The early nutritional intervention of high-protein diet after birth is helpful for the catch-up growth of IUGR through promoting the intestinal development and the ab-sorption of nutrition

Maintenance of gut microbiome stability for optimum intestinal health in pigs——a review

Pigs are exposed to various challenges such as weaning,environmental stressors,unhealthy diet,diseases and infections during their lifetime which adversely affects the gut microbiome.The inability of the pig microbiome to return to the pre-challenge baseline may lead to dysbiosis resulting in the outbreak of diseases.Therefore,the maintenance of gut microbiome diversity,robustness and stability has been influential for optimum intestinal health after perturbations.Nowadays human and animal researches have focused on more holistic approaches to obtain a robust gut microbiota that provides protection against pathogens and improves the digestive physiology and the immune system.In this review,we present an overview of the swine gut microbiota,factors affecting the gut microbiome and the importance of microbial stability in promoting optimal intestinal health.Additionally,we discussed the current understanding of nutritional interventions using fibers and pre/probiotics supplementation as non-antibiotic alternatives to maintain microbiota resilience to replace diminished species.

Effect of early nutrition on intestine development of intrauterine growth retardation in rats and its correlation to leptin

AIM：To investigate the intestine and body development of intrauterine growth retardation（IUGR）rats under early different protein diet and to analyze the correlation between leptin and intestine and body development．METHODS：An IUGR rat model was established by food restriction of pregnant female rats．Fifty-six neonatal IUGR rats and 24 neonatal normal rats were randomly divided into normal control group（Cgroup），IUGR model group （scgroup），low protein diet IUGR group（SL group），and high protein diet IUGR group（SH group）．Eight rats were killed per group at wk 0，4，and 12．Serum leptin，body weight（BW），body length（BL），intestinal weight（IW），intestinal length（IL），andintestinal disaccharidase（including lactase，maltase，and saccharase） were detected．RESULTS：BW（4．50±0．41g），BL（5．96±0．40cm），IW（0．05±0．01g），and IL（15.9±2．8cm）in neonatal IUGR rats were much lower than those in Cgroup（6．01±0．55g，6．26±0．44cm，0．10±0．02g，21.8±2．7cm，P〈0．05），while intestinal lactase and maltase activities were higher than those in Cgroup．SH group showed the fastest catch up growth and their BW，BL，IW，and IL reached the Cgroup level at wk 4．SC group showed relatively slower catch up growth than SH group，and their BW，BL，IW did not reach the Cgroup level at wk 4．SL group did not show intestine and body catch up growth．Intestinal maltase [344±33μmol／（min·q）]and saccharase activities[138±32μmol／（min·g）]in SL group were both markedly lower than nose in C group [751±102，258±271μmol／（min·g），P〈0．05]．There were no significant difierences in lactase activities at wk 4 and disaccharidase activities at wk 12 among all groups（P〈0．05）．The leptin level in SL group（0．58±0．12ng／mL） was the highest in all groups，and much lower in SH group（0．21±0．03ng／mL） than that in any other IUGR groups at wk 4（P〈0．05）．Leptin was negatively related to BW （r=-0．556，P=0．001），IW（r=-0．692，P=0．001） and IL（r=-0．738，P=0．000）at wk 4，while no correlation was found at wk 12．CONCLUSION：High protein diet is a reasonable early nutritional mode to IUGR rats in promoting intestine and body catch up growth．

Early administration of branched-chain amino acid granules

The effect of malnutrition on survival in patients with decompensated liver cirrhosis has not been well defined. Nutritional intervention with branched-chain amino acid (BCAA) can increase serum albumin concentration in patients with decompensated cirrhosis but its effects on survival are unclear. The BCAA to tyrosine ratio (BTR) is a surrogate marker (the normal range of BTR is between 4.41 and 10.05, and a Fischer's ratio of 1.8 corresponds to a BTR of 3.5) in patients with decompensated liver cirrhosis, and BCAA inhibits hepatic carcinogenesis in patients with compensated cirrhosis. This review discusses data regarding the effect of early administration of BCAA granules based on the ratio of BCAA to BTR on prognosis in patients with cirrhosis.

The demands of the extra-time period of soccer:A systematic review

Background:Soccer match-play is typically contested over 90 min;however,in some cup and tournament scenarios,when matches are tied,they proceed to an additional 30 min,which is termed "extra-time^(ET).This systematic review sought to appraise the literature available on 120-min of soccer-specific exercise,with a view to identifying practical recommendations and future research opportunities.Methods:The review was conducted according to the PRISMA guidelines.Independent researchers performed a systematic search of PubMed,CINAHL,and PsycINFO in May 2019,with the following keywords entered in various combinations:"soccer","football","extra-time","extra time","extratime","120 minutes","120 min","additional 30 minutes",and "additional 30 min".Results:The search yielded an initial 73 articles.Following the screening process,11 articles were accepted for analyses.Articles were subsequently organized into the following 5 categories:movement demands of ET,performance responses to ET,physiological and neuromuscular response during ET,nutritional interventions,and recovery and ET.The results highlighted that during competitive match-play,players cover5%-12% less distance relative to match duration(i.e.,meters per minute) during ET compared to the preceding 90 min.Reductions in technical performance(i.e.,shot speed,number of passes and dribbles) were also observed during ET.Additionally,carbohydrate provision may attenuate and improve dribbling performance during ET.Moreover,objective and subjective measures of recovery may be further compromised following ET when compared to 90 min.Conclusion:Additional investigations are warranted to further substantiate these findings and identify interventions to improve performance during ET.

EON Therapy Ameliorates Cachexia and Quality of Life in Cancer Patients

Cancer induced cachexia, a gross loss of skeletal muscle with or without adipose tissue wasting, remains a clinical impasse resulting in poor prognosis and Quality of Life (QoL). It is characterized by an inflammation driven anorexia and aberrant energy and protein balance. Indubitably, nutritional rehabilitation is required to address various daunting challenges of this multifactorial syndrome. Esperer Onco Nutrition has come up with an optimal clinical nutrition formulation with promising anti-cachexia effects. Towards validating the efficacy and ensuring the safety of EON Therapy (Es-Invigour plus Es-Fortitude-Protect) under clinical settings, a phase IV post marketing surveillance (PMS) study with 63 patients from various hospitals across India was undertaken. This multi-nutrient and multi-targeted nutritional intervention, being concurrent with mainstream therapy, demonstrated potential to ameliorate the cachectic condition which was measured by body weight of the volunteers at each visit. Biochemical parameters improved or remained same. Overall QoL assessment was performed by using ECOG Scale and Malnutrition Screening Tool (MST) which showed significant improvement in physical wellness and nutritional status of the volunteers. No adverse effect was observed during the entire period. These observations reinforce the need of research based nutritional intervention for clinical use in cachectic cancer patients.