BACKGROUND Unhealthy maternal diet leads to heavy metal exposures from the consumption of ultra-processed foods that may impact gene behavior across generations,creating conditions for the neurodevelopmental disorders...BACKGROUND Unhealthy maternal diet leads to heavy metal exposures from the consumption of ultra-processed foods that may impact gene behavior across generations,creating conditions for the neurodevelopmental disorders known as autism and attention deficit/hyperactivity disorder(ADHD).Children with these disorders have difficulty metabolizing and excreting heavy metals from their bloodstream,and the severity of their symptoms correlates with the heavy metal levels measured in their blood.Psychiatrists may play a key role in helping parents reduce their ultra-processed food and dietary heavy metal intake by providing access to effective nutritional epigenetics education.AIM To test the efficacy of nutritional epigenetics instruction in reducing parental ultra-processed food intake.METHODS The study utilized a semi-randomized test and control group pretest-posttest pilot study design with participants recruited from parents having a learning-disabled child with autism or ADHD.Twenty-two parents who met the inclusion criteria were randomly selected to serve in the test(n=11)or control(n=11)group.The test group participated in the six-week online nutritional epigenetics tutorial,while the control group did not.The efficacy of the nutritional epigenetics instruction was determined by measuring changes in parent diet and attitude using data derived from an online diet survey administered to the participants during the pre and post intervention periods.Diet intake scores were derived for both ultra-processed and whole/organic foods.Paired sample t-tests were conducted to determine any differences in mean diet scores within each group.RESULTS There was a significant difference in the diet scores of the test group between the pre-and post-intervention periods.The parents in the test group significantly reduced their intake of ultra-processed foods with a preintervention diet score of 70(mean=5.385,SD=2.534)and a post-intervention diet score of 113(mean=8.692,SD=1.750)and the paired t-test analysis showing a significance of P<0.001.The test group also significantly increased their consumption of whole and/or organic foods with a pre-intervention diet score of 100(mean=5.882,SD=2.472)and post-intervention diet score of 121(mean=7.118,SD=2.390)and the paired t-test analysis showing a significance of P<0.05.CONCLUSION Here we show nutritional epigenetics education can be used to reduce ultra-processed food intake and improve attitude among parents having learning-disabled children with autism or ADHD.展开更多
Selective eating among toddlers is a well-known phenomenon which is characterized by varied factors including nutritional deficits and a unique and challenging sensory profile.Our clinical experience in a multidiscipl...Selective eating among toddlers is a well-known phenomenon which is characterized by varied factors including nutritional deficits and a unique and challenging sensory profile.Our clinical experience in a multidisciplinary feeding and eating clinic,in Hadassah Medical Center of Jerusalem binds specific feeding and eating patterns with high levels of parental stress ll.Parental stress is combined by three domains:parental general approach of satisfaction,the quality of interaction with child and child’s temperament,as perceived by parent.Our cross-sectional research includes 42 pairs of parents and their children,referring the clinic due to selective eating and suspected sensory integration disorder.Our study includes a broad nutritional assessment,questionnaires testing parental stress(PSI-4)and questionnaires testing sensory integration(Toddler Sensory Profile-2)and anthropometric indices.Our study’s results are relevant family physicians and pediatricians working in the community,who address diagnosis like autistic spectrum disorder,attention deficit hyperactive disorder,developmental delay,and learning disabilities that interface with domains of parental stress and experience of parenting interaction and child temperament,as well as sensory integration and limited eating and nutrition.Research results are significant in the field of locating babies and families needing early intervention and as a base of promoting intervention programs of prevention and treatment of toddlers and their parents.It is important to apply suitable intervention programs based on a reflective manner about dyadic and triadic eating and feeding relations,in the family unit,considering the cultural context.展开更多
AIM To investigate the effect of gastroenteric reconstruction on the nutritional status of patients with gastric cancer after total gastrectomy. METHODS From 1989 1994, nutritional status was studied in 24 patient...AIM To investigate the effect of gastroenteric reconstruction on the nutritional status of patients with gastric cancer after total gastrectomy. METHODS From 1989 1994, nutritional status was studied in 24 patients, including 12 patients with the gastric reservoir and pyloric sphincter reconstruction (GRPS), 7 with Braun′s esophago jejunostomy (EJ) and 5 with Lawrance′s Roux en Y reconstruction (RY). The ability of these patients to ingest and absorb the amount of nutrients was examined and compared, and metabolic balance test was performed to compare the efficiency of those patients to accumulate and use the absorbed nutrients. RESULTS In the controlled hospital situation, the amount of food ingested by all the patients was greater than that required for maintenance of ideal body weight. In direct contrast, food intake in most patients with EJ or RY reconstruction significantly decreased when the patients returned home and that in EJ patients it was the lowest. The overgrowth of anaerobic bacteria was found in the jejunum in the patients with EJ and RY, due mainly to food stasis in the duodenum or in the Roux limb, caused by the operative procedure itself. In patients with GRPS, because of restoring of the alimentary continuity according to the normal digestive physiologic characters, all the nutritional parameters could fall in the normal range. CONCLUSION The most common mechanism responsible for postoperative malnutrition was inadequate food intake. Having solved the problem of alkaline reflux esophagitis, it is imperative to preserve the duodenal food passage to reduce malabsorption and other complications after total gastrectomy.展开更多
Underweight and specific nutrient deficiencies are frequent in adult patients with inflammatory bowel disease(IBD).In addition,a significant number of children with IBD,especially Crohn's disease(CD) have impaired...Underweight and specific nutrient deficiencies are frequent in adult patients with inflammatory bowel disease(IBD).In addition,a significant number of children with IBD,especially Crohn's disease(CD) have impaired linear growth.Nutrition has an important role in the management of IBD.In adults with CD,enteral nutrition(EN) is effective in inducing clinical remission of IBD,although it is less efficient than corticosteroids.Exclusive EN is an established primary therapy for pediatric CD.Limited data suggests that EN is as efficient as corticosteroids for induction of remission.Additional advantages of nutritional therapy are control of inflammation,mucosal healing,positive benefits to growth and overall nutritional status with minimal adverse effects.The available evidence suggests that supplementary EN may be effective also for maintenance of remission in CD.More studies are needed to confirm these findings.However,EN supplementation could be considered as an alternative or as an adjunct to maintenance drug therapy in CD.EN does not have a primary therapeutic role in ulcerative colitis.Specific compositions of enteral dietselemental diets or diets containing specific components-were not shown to have any advantage over standard polymeric diets and their place in the treatment of CD or UC need further evaluation.Recent theories suggest that diet may be implicated in the etiology of IBD,however there are no proven dietary approaches to reduce the risk of developing IBD.展开更多
Schizophrenia is a mental health disorder that occurs worldwide,cutting across cultures,socioeconomic groups,and geographical barriers.Understanding the details of the neurochemical basis of schizophrenia,factors that...Schizophrenia is a mental health disorder that occurs worldwide,cutting across cultures,socioeconomic groups,and geographical barriers.Understanding the details of the neurochemical basis of schizophrenia,factors that contribute to it and possible measures for intervention are areas of ongoing research.However,what has become more evident is the fact that in targeting the neurochemical imbalances that may underlie schizophrenia,the type of response seen with currently available phamacotherapeutic agents does not provide all the answers that are needed.Therefore,the possible contribution of non-pharmacological approaches to schizophrenia management is worthy of consideration.In recent times,research is beginning to show nutrition may play a possibly significant role in schizophrenia,affecting its development,progression and management;however,while attempts had been made to examine this possible relationship from different angles,articles addressing it from a holistic point of view are not common.In this review,we examine existing scientific literature dealing with the possible relationship between nutrition and schizophrenia,with a view to elucidating the impact of diet,nutritional deficiencies and excesses on the aetiology,progression,management and outcome of schizophrenia.Secondly,the effect of nutritional supplements in prevention,as sole therapy,or adjuncts in schizophrenia management are examined.展开更多
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 repor...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.展开更多
目的总结孤独症谱系障碍(ASD)患者饮食管理的最佳证据,为开展具有针对性的饮食管理提供循证依据。方法按照循证检索资源的“6S”金字塔模型系统检索中英文相关指南和专家共识库:国际指南协作网(GIN)、美国国立指南库(NGC)、加拿大安大...目的总结孤独症谱系障碍(ASD)患者饮食管理的最佳证据,为开展具有针对性的饮食管理提供循证依据。方法按照循证检索资源的“6S”金字塔模型系统检索中英文相关指南和专家共识库:国际指南协作网(GIN)、美国国立指南库(NGC)、加拿大安大略注册护士协会(RNAO)官网、英国国家卫生与临床优化研究所(NICE)、苏格兰学院间指南网(SIGN)、中华医学期刊全文数据库、医脉通。检索循证资源数据库:Cochrane Library、Up To Date、JBI循证卫生保健中心数据库、中国生物医学(CBM)。检索原始研究数据库:PubMed、EMbase、Web of Science、中国知网、万方数据库、维普数据库中有关孤独症谱系障碍患者饮食管理的所有证据。检索时限为建库至2023年12月。由2名独立研究者对纳入的文献进行质量评价、证据提取和汇总。结果本研究共纳入15篇文献,其中包括指南10篇,专家共识2篇,系统评价2篇,Meta分析1篇,汇总涉及饮食管理流程、饮食管理团队建设、营养评估和监测、营养干预、健康管理5个方面共8条证据。结论本次研究共总结目前国内外关于ASD患者饮食管理的8条最佳证据,证据表明,医护人员在实行饮食管理前,应对孤独症谱系障碍患者进行全面的评估,根据营养筛查结果,结合国内医疗和科室环境,通过多学科协作制订孤独症谱系障碍患者个体化饮食管理方案,以便对ASD患者实行具有针对性的营养干预。展开更多
BACKGROUND Cyclic vomiting syndrome(CVS)is a chronic functional gastrointestinal disorder involving the gut–brain interaction that is characterized by recurring episodes of nausea,vomiting,abdominal pain,and interspe...BACKGROUND Cyclic vomiting syndrome(CVS)is a chronic functional gastrointestinal disorder involving the gut–brain interaction that is characterized by recurring episodes of nausea,vomiting,abdominal pain,and interspersed complete normal periods.Superior mesenteric artery(SMA)syndrome(SMAS)is a vascular condition in which the horizontal portion of the duodenum is compressed due to a reduced angle between the aorta and the SMA.This condition presents with symptoms similar to CVS,posing challenges in distinguishing between the two and often resulting in misdiagnosis or inappropriate treatment.CASE SUMMARY A 20-year-old female patient presented with recurrent episodes of vomiting and experienced a persistent fear of vomiting for the past 2 years.She adopted conscious dietary restrictions,which led to severe malnutrition.Initially,she was diagnosed with SMAS,as revealed by computed tomography angiography.Despite efforts to increase the angle between the aorta and the SMA through weight gain,her vomiting did not improve.Finally,she was diagnosed with comorbidities including CVS,SMAS and anxiety disorder.She underwent comprehensive interventions,including enteral and parenteral nutritional supplementation,administration of antiemetic and anti-anxiety agents,and participation in mindfulness-based cognitive therapy.The patient eventually experienced a notable improvement in both body weight and clinical symptoms.CONCLUSION We present a rare case of CVS in an adult complicated with SMAS and propose additional treatment with nutritional support,pharmacological intervention,and psychotherapy.展开更多
文摘BACKGROUND Unhealthy maternal diet leads to heavy metal exposures from the consumption of ultra-processed foods that may impact gene behavior across generations,creating conditions for the neurodevelopmental disorders known as autism and attention deficit/hyperactivity disorder(ADHD).Children with these disorders have difficulty metabolizing and excreting heavy metals from their bloodstream,and the severity of their symptoms correlates with the heavy metal levels measured in their blood.Psychiatrists may play a key role in helping parents reduce their ultra-processed food and dietary heavy metal intake by providing access to effective nutritional epigenetics education.AIM To test the efficacy of nutritional epigenetics instruction in reducing parental ultra-processed food intake.METHODS The study utilized a semi-randomized test and control group pretest-posttest pilot study design with participants recruited from parents having a learning-disabled child with autism or ADHD.Twenty-two parents who met the inclusion criteria were randomly selected to serve in the test(n=11)or control(n=11)group.The test group participated in the six-week online nutritional epigenetics tutorial,while the control group did not.The efficacy of the nutritional epigenetics instruction was determined by measuring changes in parent diet and attitude using data derived from an online diet survey administered to the participants during the pre and post intervention periods.Diet intake scores were derived for both ultra-processed and whole/organic foods.Paired sample t-tests were conducted to determine any differences in mean diet scores within each group.RESULTS There was a significant difference in the diet scores of the test group between the pre-and post-intervention periods.The parents in the test group significantly reduced their intake of ultra-processed foods with a preintervention diet score of 70(mean=5.385,SD=2.534)and a post-intervention diet score of 113(mean=8.692,SD=1.750)and the paired t-test analysis showing a significance of P<0.001.The test group also significantly increased their consumption of whole and/or organic foods with a pre-intervention diet score of 100(mean=5.882,SD=2.472)and post-intervention diet score of 121(mean=7.118,SD=2.390)and the paired t-test analysis showing a significance of P<0.05.CONCLUSION Here we show nutritional epigenetics education can be used to reduce ultra-processed food intake and improve attitude among parents having learning-disabled children with autism or ADHD.
文摘Selective eating among toddlers is a well-known phenomenon which is characterized by varied factors including nutritional deficits and a unique and challenging sensory profile.Our clinical experience in a multidisciplinary feeding and eating clinic,in Hadassah Medical Center of Jerusalem binds specific feeding and eating patterns with high levels of parental stress ll.Parental stress is combined by three domains:parental general approach of satisfaction,the quality of interaction with child and child’s temperament,as perceived by parent.Our cross-sectional research includes 42 pairs of parents and their children,referring the clinic due to selective eating and suspected sensory integration disorder.Our study includes a broad nutritional assessment,questionnaires testing parental stress(PSI-4)and questionnaires testing sensory integration(Toddler Sensory Profile-2)and anthropometric indices.Our study’s results are relevant family physicians and pediatricians working in the community,who address diagnosis like autistic spectrum disorder,attention deficit hyperactive disorder,developmental delay,and learning disabilities that interface with domains of parental stress and experience of parenting interaction and child temperament,as well as sensory integration and limited eating and nutrition.Research results are significant in the field of locating babies and families needing early intervention and as a base of promoting intervention programs of prevention and treatment of toddlers and their parents.It is important to apply suitable intervention programs based on a reflective manner about dyadic and triadic eating and feeding relations,in the family unit,considering the cultural context.
文摘AIM To investigate the effect of gastroenteric reconstruction on the nutritional status of patients with gastric cancer after total gastrectomy. METHODS From 1989 1994, nutritional status was studied in 24 patients, including 12 patients with the gastric reservoir and pyloric sphincter reconstruction (GRPS), 7 with Braun′s esophago jejunostomy (EJ) and 5 with Lawrance′s Roux en Y reconstruction (RY). The ability of these patients to ingest and absorb the amount of nutrients was examined and compared, and metabolic balance test was performed to compare the efficiency of those patients to accumulate and use the absorbed nutrients. RESULTS In the controlled hospital situation, the amount of food ingested by all the patients was greater than that required for maintenance of ideal body weight. In direct contrast, food intake in most patients with EJ or RY reconstruction significantly decreased when the patients returned home and that in EJ patients it was the lowest. The overgrowth of anaerobic bacteria was found in the jejunum in the patients with EJ and RY, due mainly to food stasis in the duodenum or in the Roux limb, caused by the operative procedure itself. In patients with GRPS, because of restoring of the alimentary continuity according to the normal digestive physiologic characters, all the nutritional parameters could fall in the normal range. CONCLUSION The most common mechanism responsible for postoperative malnutrition was inadequate food intake. Having solved the problem of alkaline reflux esophagitis, it is imperative to preserve the duodenal food passage to reduce malabsorption and other complications after total gastrectomy.
文摘Underweight and specific nutrient deficiencies are frequent in adult patients with inflammatory bowel disease(IBD).In addition,a significant number of children with IBD,especially Crohn's disease(CD) have impaired linear growth.Nutrition has an important role in the management of IBD.In adults with CD,enteral nutrition(EN) is effective in inducing clinical remission of IBD,although it is less efficient than corticosteroids.Exclusive EN is an established primary therapy for pediatric CD.Limited data suggests that EN is as efficient as corticosteroids for induction of remission.Additional advantages of nutritional therapy are control of inflammation,mucosal healing,positive benefits to growth and overall nutritional status with minimal adverse effects.The available evidence suggests that supplementary EN may be effective also for maintenance of remission in CD.More studies are needed to confirm these findings.However,EN supplementation could be considered as an alternative or as an adjunct to maintenance drug therapy in CD.EN does not have a primary therapeutic role in ulcerative colitis.Specific compositions of enteral dietselemental diets or diets containing specific components-were not shown to have any advantage over standard polymeric diets and their place in the treatment of CD or UC need further evaluation.Recent theories suggest that diet may be implicated in the etiology of IBD,however there are no proven dietary approaches to reduce the risk of developing IBD.
文摘Schizophrenia is a mental health disorder that occurs worldwide,cutting across cultures,socioeconomic groups,and geographical barriers.Understanding the details of the neurochemical basis of schizophrenia,factors that contribute to it and possible measures for intervention are areas of ongoing research.However,what has become more evident is the fact that in targeting the neurochemical imbalances that may underlie schizophrenia,the type of response seen with currently available phamacotherapeutic agents does not provide all the answers that are needed.Therefore,the possible contribution of non-pharmacological approaches to schizophrenia management is worthy of consideration.In recent times,research is beginning to show nutrition may play a possibly significant role in schizophrenia,affecting its development,progression and management;however,while attempts had been made to examine this possible relationship from different angles,articles addressing it from a holistic point of view are not common.In this review,we examine existing scientific literature dealing with the possible relationship between nutrition and schizophrenia,with a view to elucidating the impact of diet,nutritional deficiencies and excesses on the aetiology,progression,management and outcome of schizophrenia.Secondly,the effect of nutritional supplements in prevention,as sole therapy,or adjuncts in schizophrenia management are examined.
文摘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.
文摘目的总结孤独症谱系障碍(ASD)患者饮食管理的最佳证据,为开展具有针对性的饮食管理提供循证依据。方法按照循证检索资源的“6S”金字塔模型系统检索中英文相关指南和专家共识库:国际指南协作网(GIN)、美国国立指南库(NGC)、加拿大安大略注册护士协会(RNAO)官网、英国国家卫生与临床优化研究所(NICE)、苏格兰学院间指南网(SIGN)、中华医学期刊全文数据库、医脉通。检索循证资源数据库:Cochrane Library、Up To Date、JBI循证卫生保健中心数据库、中国生物医学(CBM)。检索原始研究数据库:PubMed、EMbase、Web of Science、中国知网、万方数据库、维普数据库中有关孤独症谱系障碍患者饮食管理的所有证据。检索时限为建库至2023年12月。由2名独立研究者对纳入的文献进行质量评价、证据提取和汇总。结果本研究共纳入15篇文献,其中包括指南10篇,专家共识2篇,系统评价2篇,Meta分析1篇,汇总涉及饮食管理流程、饮食管理团队建设、营养评估和监测、营养干预、健康管理5个方面共8条证据。结论本次研究共总结目前国内外关于ASD患者饮食管理的8条最佳证据,证据表明,医护人员在实行饮食管理前,应对孤独症谱系障碍患者进行全面的评估,根据营养筛查结果,结合国内医疗和科室环境,通过多学科协作制订孤独症谱系障碍患者个体化饮食管理方案,以便对ASD患者实行具有针对性的营养干预。
基金Supported by 1·3·5 Project for Disciplines of Excellence,West China Hospital,Sichuan University,No.ZYJC21004.
文摘BACKGROUND Cyclic vomiting syndrome(CVS)is a chronic functional gastrointestinal disorder involving the gut–brain interaction that is characterized by recurring episodes of nausea,vomiting,abdominal pain,and interspersed complete normal periods.Superior mesenteric artery(SMA)syndrome(SMAS)is a vascular condition in which the horizontal portion of the duodenum is compressed due to a reduced angle between the aorta and the SMA.This condition presents with symptoms similar to CVS,posing challenges in distinguishing between the two and often resulting in misdiagnosis or inappropriate treatment.CASE SUMMARY A 20-year-old female patient presented with recurrent episodes of vomiting and experienced a persistent fear of vomiting for the past 2 years.She adopted conscious dietary restrictions,which led to severe malnutrition.Initially,she was diagnosed with SMAS,as revealed by computed tomography angiography.Despite efforts to increase the angle between the aorta and the SMA through weight gain,her vomiting did not improve.Finally,she was diagnosed with comorbidities including CVS,SMAS and anxiety disorder.She underwent comprehensive interventions,including enteral and parenteral nutritional supplementation,administration of antiemetic and anti-anxiety agents,and participation in mindfulness-based cognitive therapy.The patient eventually experienced a notable improvement in both body weight and clinical symptoms.CONCLUSION We present a rare case of CVS in an adult complicated with SMAS and propose additional treatment with nutritional support,pharmacological intervention,and psychotherapy.
