Adherence to Mediterranean diet and advanced glycation endproducts in patients with diabetes

BACKGROUND In recent years,American Diabetes Association started to strongly advocate the Mediterranean diet(MD)over other diets in patients with diabetes mellitus(DM)because of its beneficial effects on glycemic control and cardiovascular(CV)risk factors.Tissue levels of advanced glycation endproducts(AGEs)emerged as an indicator of CV risk in DM.Skin biopsy being invasive,the use of AGE Reader has been shown to reflect tissue AGEs reliably.AIM To examine the association between adherence to MD and AGEs in patients with DM type II.METHODS This cross-sectional study was conducted on 273 patients with DM type II.A survey questionnaire was composed of 3 separate sections.The first part of the questionnaire included general data and the habits of the participants.The second part aimed to assess the basic parameters of participants’diseases and associated conditions.The third part of the questionnaire was the Croatian version of the 14-item MD service score(MDSS).AGEs levels and associated CV risk were measured using AGE Reader(DiagnOptics Technologies BV,Groningen,The Netherlands).RESULTS A total of 27(9.9%)patients fulfilled criteria for adherence to MD,with a median score of 8.0(6.0-10.0).Patients with none/limited CV risk had significantly higher percentage of MD adherence in comparison to patients with increased/definite CV risk(15.2%vs 6.9%,P=0.028),as well as better adherence to guidelines for nuts(23.2%vs 12.6%,P=0.023)and legumes(40.4%vs 25.9%,P=0.013)consumption.Higher number of patients with glycated hemoglobin(HbA1c)<7%adhered to MD when compared to patients with HbA1c>7%(14.9%vs 7.3%,P=0.045).Moreover,those patients followed the MDSS guidelines for eggs(33.0%vs 46.8%,P=0.025)and wine(15.6%vs 29.8%,P=0.006)consumption more frequently.MDSS score had significant positive correlation with disease duration(r=0.179,P=0.003)and negative correlation with body mass index(BMI)values(r=-0.159,P=0.008).In the multiple linear regression model,BMI(β±SE,-0.09±0.04,P=0.037)and disease duration(β±SE,0.07±0.02,P<0.001)remained significant independent correlates of the MDSS score.Patients with HbA1c>7%think that educational programs on nutrition would be useful for patients in significantly more cases than patients with HbA1c<7%(98.9%vs 92.6%,P=0.009).CONCLUSION Although adherence to MD was very low among people with diabetes,we demonstrated that adherence to MD is greater in patients with lower CV risk,longer disease duration,and well-controlled glycaemia.

Physical Activity, Mediterranean Diet and Biomarkers-Assessed Risk of Alzheimer’s: A Multi-Modality Brain Imaging Study

Increased physical activity and higher adherence to a Mediterranean-type diet (MeDi) have been independently associated with reduced risk of Alzheimer’s disease (AD). Their association has not been investigated with the use of biomarkers. This study examines whether, among cognitively normal (NL) individuals, those who are less physically active and show lower MeDi adherence have brain biomarker abnormalities consistent with AD. Methods: Forty-five NL individuals (age 54 ± 11, 71% women) with complete leisure time physical activity (LTA), dietary information, and cross-sectional 3D T1-weigthed MRI, 11C-Pittsburgh Compound B (PiB) and 18F-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) scans were examined. Voxel-wise multivariate partial least square (PLS) regression was used to examine the effects of LTA, MeDi and their interaction on brain biomarkers. Age, gender, ethnicity, education, caloric intake, BMI, family history of AD, Apolipoprotein E (APOE) genotype, presence of hypertension and insulin resistance were examined as confounds. Subjects were dichotomized into more and less physically active (LTA+ vs. LTA-;n = 21 vs. 24), and into higher vs. lower MeDi adherence groups (n = 18 vs. 27) using published scoring methods. Spatial patterns of brain biomarkers that represented the optimal association between the images and the groups were generated for all modalities using voxel-wise multivariate Partial Least Squares (PLS) regression. Results: Groups were comparable for clinical and neuropsychological measures. Independent effects of LTA and MeDi factors were observed in AD-vulnerable brain regions for all modalities (p β load and lower glucose metabolism) were observed in LTA- compared to LTA+ subjects, and in MeDi- as compared to MeDi+ subjects. A gradient effect was observed for all modalities so that LTA+/MeDi+ subjects had the highest and LTA+/MeDi+ subjects had the lowest AD-burden (p < 0.001), although the LTA × MeDi interaction was significant only for FDG measures (p < 0.03). Adjusting for covariates did not attenuate these relationships. Conclusion: Lower physical activity and MeDi adherence were associated with increased brain AD-burden among NL individuals, in-dicating that lifestyle factors may modulate AD risk. Studies with larger samples and longitudinal evaluations are needed to determine the predictive power of the observed associations.

Role of Mediterranean diet in preventing platinum based gastrointestinal toxicity in gynecolocological malignancies: A single Institution experience

BACKGROUND Gynecological malignancies represent a major cause of death in women and are often treated with platinum-based regimens.Patients undergoing chemotherapy suffer from alterations in nutritional status which may worsen gastrointestinal(GI)toxicities,quality of life and affect the overall prognosis.Indeed,assuring a good nutritional status and limiting toxicities during treatment are still major goals for clinicians.AIM To assess the role of Mediterranean Diet(MD)in reducing GI toxicities in patients with gynecological cancers treated with platinum-based regimens.METHODS We conducted an observational study on 22 patients with gynecological tumors treated with a platinum-based chemotherapy at Candiolo Cancer Institute FPO/IRCCS between January 2018 and June 2018.The food and frequency(FFQ)and the Patient-Reported Outcomes Common Terminology Criteria For Adverse Events(PRO-CTCAE)questionnaires were administered at baseline and at every Day 1 of each cycle.To evaluate the differences in GI toxicities the study population was divided in two groups according to the currently validated Mediterranean Diet Serving Score(MDSS)at baseline.RESULTS Patients with high MDSS reported a trend toward lower GI toxicities according to PRO-CTCAE at each timepoint(first evaluation:P=0.7;second:P=0.52;third:P=0.01).In particular,difference in nausea frequency and gravity(P<0.001),stomach pain frequency and gravity(P=0.01 and P=0.02),abdomen bloating frequency and gravity(P=0.02 and P=0.03),and interference with daily activities(P=0.02)were highly statistically significant at the end of treatment.More than 60%of patients changed their food habits during chemotherapy mainly because of GI toxicities.A higher reduction of food intake,both in terms of caloric(P=0.29)and of single nutrients emerged in the group experiencing higher toxicity.CONCLUSION Our results show that adherence to MD possibly reduces GI toxicity and prevents nutritional status impairment during chemotherapy treatment.Bigger studies are needed to confirm our results.

Wine Consumption in the Mediterranean Diet: Old Concepts in a New Sight

The term “Mediterranean diet” is widely employed to indicate the typical diet of the Countries located on the Mediterranean sea coast. A growing body of scientific literature pointed out the healthy effects of this diet. In recent years we investigated about the protective effects of a regular and moderate wine consumption. As we know, alcoholic and non alcoholic wine constituents are responsible of different effects by means of molecular and cell mechanisms. Among the non alcoholic components, polyphenols (for example resveratrol and quercetin) were deeply investigated. The aim of this review is to underline the effects of a moderate and regular wine drinking in the context of the Mediterranean diet in light of the interactions between wine and important dietary factors such as olive oil, fruit and vegetables.

Role of Mediterranean diet, tropical vegetables rich in antioxidants, and sunlight exposure in blindness, cataract and glaucoma among African type 2 diabetics

AIM: To assess whether regular Mediterranean diet and regular intake of vegetables may reduce the risk of blindness, cataract, and glaucoma in these type 2 diabetics. · METHODS: A cross-sectional design was carried out among known black diabetics admitted at the diabetic clinics of Kinshasa, between October 2008 and March 2009. The Mediterranean-style dietary score (MSDPS) was used to characterize a Mediterranean-style dietary pattern in the study population using the Harvard semi quantitative FFQ adapted for Africa. · RESULTS: Five hundred Type 2 diabetic patients were included in this study (48% of males; 40% aged ≥60 years). There was a significant association between blindness, cataract and aging; between blindness (P <0.05), cataract (P<0.05), glaucoma (P <0.05), and physical inactivity; between blindness (P<0.05), cataract (P <0.0001), glaucoma (P <0.01) and high SES, and a very significant association between blindness (P <0.0001), cataract (P <0.0001), glaucoma (P <0.0001) and exposure to sunlight. There was also a significant association between blindness, glaucoma, and male sex. Regular intake of Mediterranean diet, Brassica Rapa, beans, Abelmoschus, Musa acuminata reduced significantly the risk of blindness, cataract and glaucoma. · CONCLUSION: Regular intake of Mediterranean diet, Brassica Rapa, beans, Abelmoschus, and Musa acuminata may significantly reduce the risk of blindness or its major causes among type 2 diabetes mellitus in Africa.

Effect of the Mediterranean Diet on BMI in Middle-Aged Hispanic Women with Pre-Obesity and Obesity Central Washington State

Background: Conclusive evidence has yet to emerge regarding the effectiveness and applicability of the Mediterranean diet on middle-aged Hispanic women, the largest female minority group in the United States who is at-risk of metabolic disorders. Objective: The aim of this study is to evaluate the effect of the Mediterranean diet (MED) on the BMI in middle-aged Hispanic women with pre-obesity and obesity in Central Washington State. Design: A prospective study was performed to determine the effect of Mediterranean diet on the BMI of 67 Hispanic women with pre-obesity and obesity between 45 to 65 years of age in Central Washington State. The study was carried out for eight weeks. Dietary adherence was monitored to ensure consistent results. Results: The proportion of Hispanic women who reported a reduction in BMI was 94%, with a decrease in mean BMI after eight weeks of 2.8 (95% CI: 2.5 to 3.0) and P = 0.02, with an odds ratio of 2.6. Multiple linear regression analysis was used to adjust for age, education, physical activity, and smoking. Conclusion: The reduction in BMI demonstrates that the Mediterranean diet can be a promising, culturally appropriate therapy to address the obesity epidemic that is prevalent among Hispanic women.

The Mediterranean Diet as a Factor in Environmental Education

The Mediterranean diet is an excellent nutritional model.Another feature of the Mediterranean diet is that it is a cultural model with common features for all peoples of the Mediterranean.But apart from health and culture,the Mediterranean diet,according to studies,also helps to protect the natural environment.As an environmental asset,therefore,the Mediterranean diet can be a teaching approach to environmental education.This study aims to raise awareness of the issue of the Mediterranean diet in the training and implementation of an environmental project at all levels of education.

Effects of adherence to the Mediterranean diet in children and adolescents with irritable bowel syndrome

BACKGROUND Irritable bowel syndrome(IBS)is a highly prevalent gastrointestinal disorder in children and adults,which increased over the past twenty years.The Mediterranean diet is a well-known diet full of antioxidants and anti-inflammatory ingredients.AIM To evaluate the safety,tolerability,and effects of adherence to the Mediterranean diet on disease patterns in children and adolescents with IBS.METHODS This prospective,cross-sectional case-controlled study included 100 consecutive IBS patients diagnosed according to Rome IV criteria,aged 12-18 years.Patients Group II on their regular diet for six months.Besides IBS scores(IBS-SSS,IBS-QoL,and total score),different clinical and laboratory parameters were evaluated at the start and end of the study.RESULTS The Mediterranean diet was safe and well-tolerated in IBS patients.IBS children and adolescents with good adherence to the Mediterranean diet(KIDMED Score≥8 points);group I showed significant improvement in IBS scores.IBS-SSS in the Mediterranean diet group was 237.2±65 at the beginning of the study and decreased to 163.2±33.8 at the end of the study(P<0.001).It did not show a significant improvement in the group with a regular diet(248.3±71.1 at the beginning of the study compared to 228.5±54.3 at the study end with P<0.05).The mean IBS-SSS in the Mediterranean diet group significantly improved compared with the group with a regular diet.Mean IBS-QoL in group I improved from 57.3±12.9 at the start of the study to 72.4±11.2 at the study end(P<0.001)and significantly improved when compared to its level in group II at the study end(59.2±12.7 with P<0.001),while group II showed no significant improvement in IBSQoL at the study end when compared to the beginning of the study(59.2±11.7 with P>0.05).The mean total IBS score in group I became 28.8±11.2 at the end of our study compared to 24.1±10.4 at the start(P<0.05)and significantly improved when compared to its level in group II at the end of the study(22.1±12.5 with P<0.05),while in group II,non-significant improvement in the total score at the end of our study compared to its mean level at the start of the study(22.8±13.5 with P>0.05).CONCLUSION The Mediterranean diet was safe and associated with significant improvement in IBS scores in children and adolescent patients with IBS.

Effect of a counseling-supported treatment with the Mediterranean diet and physical activity on the severity of the non-alcoholic fatty liver disease

AIM To determine the clinical effectiveness of nutritional counseling on reduction of non-alcoholic fatty liver disease(NAFLD) severity, weight loss, metabolic and anthropometric indexes and liver enzymes.METHODS Forty-six adults with NAFLD received a 6-mo clinical and a dietary intervention(based on Mediterranean diet) carried out respectively by a gastroenterologist and a nutritionist with counseling license. The counseling process consisted of monthly meeting(about 45 min each). The effect of the treatment was evaluated monitoring liver enzymes, metabolic parameters, cardiovascular risk indexes, NAFLD severity [assessed by ultrasound(US)] and related indexes. All parameters were assessed at baseline. Biochemistry was also assessed at mid-and end-interventions and US was repeated at end-intervention.RESULTS The percentage of patients with steatosis grade equal or higher than 2 was reduced from 93% to 48% and steatosis regressed in 9 patients(20%). At the end of the treatment the end-point concerning the weight(i.e., a 7% weight reduction or achievement/maintenance of normal weight) was accomplished by 25 out of 46 patients(i.e., 54.3%). As far as the liver enzymes is concerned, all three liver enzymes significantly decrease during the treatment the normalization was particularly evident for the ALT enzyme(altered values reduced from 67% down to 11%). Several parameters, i.e., BMI, waist circumference, waist-to-hip ratio, AST, ALT, GGT, HDL, serum glucose, Tot-Chol/HDL, LDL/HDL, TG/HDL, AIP, HOMA, FLI, Kotronen index, VAI, NAFLD liver fat score and LAP, showed a significant improvement(P < 0.01) between baseline and end-treatment.CONCLUSION Outcomes of this study further strengthen the hypothesis that Med Diet and more active lifestyle can be considered a safe therapeutic approach for reducing risk and severity of NAFLD and related disease states. The proposed approach may be proposed as a valid and recommended approach for improving the clinical profile of NAFLD patients.

Good adherence to mediterranean diet can prevent gastrointestinal symptoms:A survey from Southern Italy

AIM To evaluate how different levels of adherence to a mediterranean diet(MD) correlate with the onset of functional gastrointestinal disorders.METHODS As many as 1134 subjects(598 M and 536 F;age range 17-83 years) were prospectively investigated in relation to their dietary habits and the presence of functional gastrointestinal symptoms.Patients with relevant chronic organic disease were excluded from the study.The Mediterranean Diet Quality index for children and adolescents(KIDMED) and the Short Mediterranean Diet Questionnaire were administered.All subjects were grouped into five categories according to their ages:14-24 years;25-34;35-49;50-64;above 64.RESULTS On the basis of the Rome Ⅲ criteria,our population consisted of 719(63.4%) individuals who did not meet the criteria for any functional disorder and were classified as controls(CNT),172(13.3%) patients meetingcriteria for prevalent irritable bowel syndrome(IBS),and 243(23.3%) meeting criteria for prevalent functional dyspepsia(FD).A significantly lower adherence score in IBS(0.57 ± 0.23,P < 0.001) and FD(0.56 ± 0.24,P < 0.05) was found compared to CNT(0.62 ± 0.21).Females with FD and IBS exhibited significantly lower adherence scores(respectively 0.58 ± 0.24,P < 0.05 and 0.56 ± 0.22,P < 0.05) whereas males were significantly lower only for FD(0.53 ± 0.25,P < 0.05).Age cluster analyses showed a significantly lower score in the 17-24 years and 25-34 year categories for FD(17-24 years:0.44 ± 0.21,P < 0.001;25-34 years:0.48 ± 0.22,P < 0.05) and IBS(17-24 years:0.45 ± 0.20,P < 0.05;24-34 years:0.44 ± 0.21,P < 0.001) compared to CNT(17-24 years:0.56 ± 0.21;25-34 years:0.69 ± 0.20).CONCLUSION Low adherence to MD may trigger functional gastrointestinal symptoms,mainly in younger subjects.Moreover,with increasing age,patients tend to adopt dietary regimens closer to MD.

Plant-based dietary patterns and risk of esophageal cancer:A prospective cohort study spanning 17 years

Objective: Plant-based diets have multiple health benefits for cancers;however, little is known about the association between plant-based dietary patterns and esophageal cancer(EC).This study presents an investigation of the prospective associations among three predefined indices of plant-based dietary patterns and the risk of EC.Methods: We performed endoscopic screening for 15,709 participants aged 40-69 years from two high-risk areas of China from January 2005 to December 2009 and followed the cohort until December 31, 2022. The overall plant-based diet index(PDI), healthful plant-based diet index(h PDI), and unhealthful plant-based diet index(u PDI), were calculated using survey responses to assess dietary patterns. We applied Cox proportional hazard regression to estimate the multivariable hazard ratios(HRs) and 95% confidence intervals(95% CIs) of EC across 3plant-based diet indices and further stratified the analysis by subgroups.Results: The final study sample included 15,184 participants in the cohort. During a follow-up of 219,365person-years, 176 patients with EC were identified. When the highest quartile was compared with the lowest quartile, the pooled multivariable-adjusted HR of EC was 0.50(95% CI, 0.32-0.77) for h PDI. In addition, the HR per 10-point increase in the h PDI score was 0.42(95% CI, 0.27-0.66) for ECs. Conversely, u PDI was positively associated with the risk of EC, and the HR was 1.80(95% CI, 1.16-2.82). The HR per 10-point increase in the u PDI score was 1.90(95% CI, 1.26-2.88) for ECs. The associations between these scores and the risk of EC were consistent in most subgroups. These results remained robust in sensitivity analyses.Conclusions: A healthy plant-based dietary pattern was associated with a reduced risk of EC. Emphasizing the healthiness and quality of plant-based diets may be important for preventing the development of EC.

Methodologic quality of systematic reviews and meta-analyses on the Mediterranean diet and cognitive function： a review

背景与目的：近年来，很多系统评价与Meta分析研究了地中海式饮食与认知功能的关系，然而其方法学质量尚未被评估。同时，由于中国老龄化进程中相关护理需求量大，因此有必要对现有的系统评价与Meta分析进行总结，以便为中国老龄化管理与开展相关工作提供有力依据，并规范该领域的研究过程和方法。本研究通过使用公认的方法学质量评估量表AMSTAR评估有关地中海饮食与认知功能的系统评价／Meta分析的方法学质量，并为未来的研究与中国的系统评价／Meta分析提供参考。方法：使用AMSTAR量表评估现有系统评价／Meta分析的方法学质量。纳入的系统评价／Meta分析必须包含以下特征：1）使用系统评价／Meta分析的方法；2）地中海饮食独立干预。结果：AMSTAR评分5—9（7．35±1．27）分，质量高于平均水平，影响力较大的期刊刊载的文献质量评分更高。结论：研究表明目前有关地中海饮食对认知功能影响的系统评价／Meta分析并不完全符合方法学质量标准，因此需要加强该领域研究的方法学质量。为了更好地阐明地中海饮食和认知之间的关联，未来的系统评价和Meta分析不仅应该遵循方法学质量标准，还应包括更有效的结局指标。我们期待今后更高质量的随机对照试验的开展使研究结论更加真实可靠。

Food intolerance and the few-foods(or oligoantigenic)diet in children with attention-deficit hyperactivity disorder

The hypothesis that some children with attention-deficit hyperactivity disorder(ADHD)may show sensitivity or allergic reactions to various food items has led to the development of the the few-foods(or oligoantigenic)diet.The rationale of the diet is to eliminate certain foods from the diet in order to exclude potential allergens contained either naturally in food or in artificial ingredients with allergenic properties.The oligoantigenic diet attempts to identify individual foods to which a person might be sensitive.First,ADHD symptoms are monitored while multiple foods are excluded from the diet.Subsequently,if symptoms remit,foods are re-introduced,while observing the individual for the return of symptoms.An advantage of the oligoantigenic diet is that it can be tailored to the individual.A growing body of evidence suggests that behavioral symptoms of subgroups of children with ADHD may benefit from the elimination of certain foods.The effect sizes of an oligoantigenic diet regarding improvement of ADHD symptoms have been found to be medium to large.Available evidence suggests that the investigation of the role of food hypersensitivities in ADHD is a promising avenue worthy of further exploration.Further large-scale,randomized controlled studies including assessment of long-term outcome are therefore warranted.

Diet and monensin influence the temporal dynamics of the rumen microbiome in stocker and finishing cattle

Background Stocker cattle diet and management influence beef cattle performance during the finishing stage,but knowledge of the dynamics of the rumen microbiome associated with the host are lacking.A longitudinal study was conducted to determine how the feeding strategy from the stocker to the finishing stages of production affects the temporal dynamics of rumen microbiota.During the stocker phase,either dry hay or wheat pasture were provided,and three levels of monensin were administrated.All calves were then transported to a feedlot and received similar finishing diets with or without monensin.Rumen microbial samples were collected on d 0,28,85 during the stocker stage(S0,S28 and S85)and d 0,14,28,56,30 d before slaughter and the end of the trial during the finishing stage(F0,F14,F28,F56,Pre-Ba,and Final).The V4 region of the bacterial 16S rRNA gene of 263 rumen samples was sequenced.Results Higher alpha diversity,including the number of observed bacterial features and the Shannon index,was observed in the stocker phase compared to the finishing phase.The bacterial amplicon sequence variants(ASVs)differentiating different sampling time points were identified.Dietary treatments during the stocker stage temporally impact the dynamics of rumen microbiota.For example,shared bacteria,including Bacteroidales(ASV19)and Streptococcus infantarius(ASV94),were significantly higher in hay rumen on S28,S85,and F0,while Bacteroidaceae(ASV11)and Limivicinus(ASV15)were more abundant in wheat.Monensin affected rumen microbial composition at a specific time.Transportation to feedlot significantly influenced microbiome structure and diversity in hay-fed calves.Bacterial taxa associated with body weight were classified,and core microbiotas interacted with each other during the trial.Conclusions In summary,the temporal dynamics of the rumen microbiome in cattle at the stocker and finishing stage are influenced by multiple factors of the feeding strategy.Diet at the stocker phase may temporarily affect the microbial composition during this stage.Modulating the rumen microbiome in the steers at the stocker stage affects the microbial interactions and performance in the finishing stage.

Voluntary wheel running ameliorated the deleterious effects of high-fat diet on glucose metabolism,gut microbiota and microbial-associated metabolites

Exercise training is critical for the early prevention and treatment of obesity and diabetes mellitus.However,the mechanism with gut microbiota and fecal metabolites underlying the effects of voluntary wheel running on high-fat diet induced abnormal glucose metabolism has not been fully elaborated.C57BL/6 male mice were randomly assigned to 4 groups according to diets(fed with normal chow diet or high-fat diet)and running paradigm(housed in static cage or with voluntary running wheel).An integrative 16S rDNA sequencing and metabolites profiling was synchronously performed to characterize the effects of voluntary wheel running on gut microbiota and metabolites.It showed that voluntary wheel running prevented the detrimental effects of high-fat feeding on glucose metabolism 16S rDNA sequencing showed remarkable changes in Rikenella and Marvinbryantia genera.Metabolic profiling indicated multiple altered metabolites,which were enriched in secondary bile acid biosynthesis signaling.In conclusion,our study indicated that voluntary wheel running significantly improved glucose metabolism and counteracted the deleterious effects of high-fat feeding on body weight and glucose intolerance.We further found that voluntary wheel running could integratively program gut microbiota composition and fecal metabolites changes,and may regulate muricholic acid metabolism and secondary bile acid biosynthesis in high-fat fed mice.

Diet and physical activity influence the composition of gut microbiota,benefit on Alzheimer's disease

Alzheimer's disease is a neurodegenerative disease with complex etiology.Gut microbiota influences the gutbrain axis,which may affect pathways related to the pathogenesis of Alzheimer's disease.Additionally,diet and physical activity are likely to affect the pathology of Alzheimer's disease as well as the gut microbiota.This demonstrates that it may be possible to prevent or halt the progression of Alzheimer's disease by regulating the gut microbiota using diet and physical activity strategies.Therefore,the present study reviews the association between these two interventions and gut microbiota in the human body.It also summarizes how these two interventions benefit Alzheimer's disease.Furthermore,the primary limitations of these two interventions are discussed and promising strategies are proposed,which may be beneficial to further study and develop the intervening measure for the progression of Alzheimer's disease.

Effects of forsythin extract in Forsythia leaves on intestinal microbiota and short-chain fatty acids in rats fed a high-fat diet

Forsythia suspensa,belonging to the deciduous shrubs of the Luteaceae family,a traditional Chinese medicine,has effects of alleviating swelling,clearing heat,detoxification and promoting blood circulation.The leaves of F.suspensa contain multiple chemical components and have a long history of use in folk medicines and health foods.The purpose of this study was to explore the effects of forsythin extract from F.suspensa leaves on intestinal microbiota and short-chain fatty acid(SCFA)content in rats with obesity induced by a high-fat diet.Forsythin extract in F.suspensa leaves increased the abundance of the intestinal microbiota,ameliorated intestinal microbiota disorders and inhibited the increase in total SCFA content in the intestinal tract in rats with obesity induced by a high-fat diet.These results suggested that forsythin extract in F.suspensa leaves may slow the development of obesity induced by a high-fat diet;thus,its active components and efficacy are worthy of further study.

Interaction between diet and genetics in patients with inflammatory bowel disease

In this editorial,we comment on the article by Marangoni et al,published in the recent issue of the World Journal of Gastroenterology 2023;29:5618-5629,about“Diet as an epigenetic factor in inflammatory bowel disease”.The authors emphasized the role of diet,especially the interaction with genetics,in promoting the inflam-matory process in inflammatory bowel disease(IBD)patients,focusing on DNA methylation,histone modifications,and the influence of microRNAs.In this editorial,we explore the interaction between genetics,gut microbiota,and diet,in an only way.Furthermore,we provided dietary recommendations for patients with IBD.The Western diet,characterized by a low fiber content and deficiency the micronutrients,impacts short-chain fatty acids production and may be related to the pathogenesis of IBD.On the other hand,the consumption of the Mediter-ranean diet and dietary fibers are associated with reduced risk of IBD flares,particularly in Crohn’s disease(CD)patients.According to the dietary guidance from the International Organization for the Study of Inflammatory Bowel Diseases(IOIBD),the regular consumption of fruits and vegetables while reducing the consumption of saturated,trans,dairy fat,additives,processed foods rich in maltodextrins,and artificial sweeteners containing sucralose or saccharine is recommended to CD patients.For patients with ulcerative colitis,the IOIBD recommends the increased intake of natural sources of omega-3 fatty acids and follows the same restrictive recommendations aimed at CD patients,with the possible inclusion of red meats.In conclusion,IBD is a complex and hetero-geneous disease,and future studies are needed to elucidate the influence of epigenetics on diet and microbiota in IBD patients.