Eating disorders related to image distortion and clinical outcomes of cannabidiol use: a systematic review

Introduction: In the context of eating disorders related to body image distortion, erroneous perception of body image is common in the general population and is also a central component of several serious diseases, including body dysmorphic disorder, anorexia nervosa, bulimia nervosa, and binge eating. Especially for the treatment of eating disorders, cannabidiol (CBD) was identified 50 years ago and has effects that can change mood, sensation, perception, tension, appetite, and pain. Objective: This was to analyze, through a systematic review, the main approaches to eating disorders related to body image distortion, as well as the clinical results of the use of cannabidiol for the treatment of this condition. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from April to May 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 123 articles were found. A total of 42 articles were assessed in full and 16 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 28 studies with a high risk of bias and 23 studies that did not meet GRADE and AMSTAR-2. Most studies presented homogeneity in their results, with X2=84.6%>50%. It was concluded that body image distortion can negatively alter the way someone thinks, feels, and behaves in their social or occupational lives; and is a proposed mechanism for the development of clinical and subclinical patterns of restricted eating or eating disorders. The eating disorders of anorexia nervosa and bulimia have reached epidemic proportions in our population today, especially among adolescent and adult women. Many times, these disorders are not diagnosed (and therefore not treated) because patients rarely disclose their symptoms to their doctor, therapist, or dietitian. There is growing evidence that cannabidiol acts as an antipsychotic, anxiolytic, and neuroprotective agent. Some studies show weight loss in people with anxiety and binge eating. However, new randomized controlled studies with larger numbers of participants are still needed

Nutrological management of meta-inflamation in patients with obesity: a systematic review

Introduction: Obesity stands out as a multifactorial disease that can cause several public health problems. There are more than 2.2 billion overweight and obese people in the world, and Brazil is in fifth place in the world ranking. A healthy nutritional status promotes immune function and can prevent the onset of a serious inflammatory process and severe infections. Objective: It was to highlight the main clinical considerations of nutritional and dietary regulation in obese patients with marked inflammatory processes and meta-inflammation through a systematic review. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from May to June 2025 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 127 articles were found. A total of 42 articles were fully evaluated and 29 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 32 studies at high risk of bias and 25 studies that did not meet the GRADE. Research has shown that unbalanced eating patterns, such as the Western diet, rich in simple sugars, refined carbohydrates, and saturated and trans fatty acids, lead to chronic inflammatory responses, increased adipose deposition, and future comorbidities associated with overweight and obesity. Calorie restriction decreased CRP in obese patients and diet administration over 12 weeks had a beneficial effect. Furthermore, obese patients with antioxidant supplementation had lower values of BMI, waist circumference, fasting blood glucose level, and assessment of the homeostasis model of insulin resistance when compared to the placebo group, as well as having lower levels of total cholesterol, triglycerides, LDL, malondialdehyde and tumor necrosis factor-alpha. n-3 PUFA supplementation can significantly reduce serum C-reactive protein (CRP), tumor necrosis factor α (TNFα), and interleukin 6 (IL-6) concentrations

Palliative medicine and nutritional therapy in critically ill oncological patients: a systematic review

Introduction: In nutritional therapies, appropriate or precise nutritional interventions are used in critically ill patients. Nutrition is considered a palliative treatment. Dietary counseling, provision of nutritional support, and alleviation of diet-related issues should be an essential component of a holistic approach to palliative and end-of-life care. Objective: This study aimed to highlight the main clinical outcomes and guidelines on nutritional therapies and palliative care in critically ill cancer patients. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from June to August 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 133 articles were found. A total of 44 articles were evaluated in full and 22 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 22 studies with a high risk of bias and 27 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=75.7%>50%. It was concluded that according to the ESPEN and ASPEN guidelines, no differences in clinical outcomes were identified between numerous nutritional interventions, including increased energy or protein intake, parenteral nutrition or isocaloric enteral nutrition, supplemental parenteral nutrition or different mixed oil lipid injectable emulsions. However, clinical judgment and close monitoring along with appropriate palliative care are required. Decisionmaking in this field must be carried out on an individual basis, weighing the benefits and harms that may cause to patients' quality of life. The guidelines recommend that, if oral food intake remains inadequate despite counseling and oral nutritional supplements, enteral nutrition or, if this is not sufficient or feasible, parenteral nutrition (supplemental or total) should be considered

Effects of supplementation of collagen types, vitamins, nutrients and exosome modulations for the rejuvenation of collagen fibers and improvement of skin aesthetics: a systematic review

Introduction: Collagen prevails in connective tissues, constituting 80% of the dry weight of human skin. Aging induces a decline in enzymes involved in the post-translational processing of collagen, reducing the number of fibroblasts that synthesize collagen and the vessels that irrigate the skin. Oral ingestion of hydrolyzed collagen together with vitamins and nutrients (especially apple exosomes/microRNAs) increases the levels of collagen-derived peptides in the bloodstream and improves skin properties. Objective: A systematic review was carried out to elucidate the main results of clinical studies and meta-analyses of clinical studies on the effects of supplementation of types of collagens, vitamins, nutrients and modulations of exosomes/microRNAs for the rejuvenation of collagen fibers and improvement of skin aesthetics. Methods: The search was carried out from November 2024 to January 2025 in the Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 122 articles were found, and 12 articles were evaluated in full, and 08 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with a high risk of bias and 26 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=62.4%>50%. Oral nutritional supplements containing collagen peptides can reduce skin vulnerability in the elderly and thus prevent conditions such as skin lesions. Thus, microRNA (miR-181b) may negatively regulate the proliferation of HEKs in psoriasis by targeting TLR4. The direct effects of collagen peptides on fibroblasts, M2-like macrophages, and mechanisms related to oral tolerance are the possible mechanisms for the beneficial effects of collagen supplementation. Special collagen peptides together with acerola extract, vitamin C, vitamin E, biotin, and zinc showed a significant improvement in the skin's collagen structure. The proven positive nutritional effect on collagen structure was fully consistent with the quality of healthy skin. Finally, apple-derived nanovesicles (exosomes) also reduce the degradation of the extracellular matrix, increasing collagen synthesis (COL3A1, COL1A2, COL8A1, and COL6A1) and negatively regulating the production of metalloproteinases

Nutrological and pharmacological therapy in patients with neoplasms and cachexia: a systematic review

Introduction: Cancer cachexia (CC) is a multifactorial syndrome that is generally characterized by continuous loss of skeletal muscle mass with or without fat loss, often accompanied by anorexia, weakness, and fatigue. Cancer cachexia is associated with low tolerance to antitumor treatments, reduced quality of life, and a negative impact on survival. Unintentional weight loss has been associated with a negative impact on multiple outcomes in cancer patients, including survival and quality of life. Objective: It was to present the main evidence of nutritional and pharmacological therapy for cachectic cancer patients through a systematic review. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from June to August 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 105 articles were found. 51 articles were assessed and 14 were included in this systematic review. Considering the Cochrane risk of bias tool, the overall assessment resulted in 11 studies with a high risk of bias and 22 studies that did not meet the GRADE criteria. It was concluded that the nutritional consequences of cancer treatments should be identified early with screening and assessment of nutritional status. Nutritional intervention includes screening and appropriate nutritional assessment, which should begin early in the course of the disease to reduce or delay negative effects on therapy and quality of life. Liquid nutritional supplements may be useful to help increase caloric intake. Numerous investigations have reported orexigenic activity associated with progestational agents, such as megestrol acetate and medroxyprogesterone. Megestrol acetate has received the most attention in randomized clinical trials of cancer patients. The use of corticosteroids and mirtazapine for weight gain and pain control was also highlighted. Enteral immunonutrition is an effective nutritional intervention that improves immune function in patients undergoing gastric cancer surgery

Major clinical outcomes of the action of the co-agonist tirzepatide to liraglutide and semaglutide in the treatment of obesity and type 2 diabetes mellitus: a systematic review

Introduction: Obesity is a chronic disease that affects a significant portion of the population. In Brazil, in surveillance research on risk and protective factors for diseases, more than half of the Brazilian population, 56% are overweight. In this scenario, liraglutide and semaglutide are medication for the treatment of type 2 diabetes mellitus (T2DM) and obesity. Tirzepatide is the first dual GLP1/GIP receptor co-agonist that has been approved for the treatment of T2DM and obesity. Objective: It was to present the major clinical outcomes of the action of the co-agonist tirzepatide to liraglutide and semaglutide in the treatment of obesity and type 2 diabetes mellitus. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from September to October 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 84 articles were found, and 52 articles were evaluated and 23 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 8 studies with a high risk of bias and 19 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X2 =79.8% >50%. It was concluded that in people without diabetes, 5 to 15 mg of tirzepatide once weekly for the treatment of obesity (SURMOUNT-1) resulted in substantial reductions in body weight (16.5% to 22.4%) over some time. 72 weeks. Furthermore, liraglutide (3.0 mg) as a medication for the treatment of obesity, in association with lifestyle changes, in patients with and without diabetes proved to be a good therapeutic option with a response about weight loss and maintenance, in addition to benefits secondary to clinical comorbidities associated with obesity

Analysis of the frequency of consumption of dairy foods as a source of calcium in women in the age group of 19 to 30 years: a prospective observational and cross-sectional study

Throughout a woman's life, the amount of calcium needed by her body changes, and in adulthood, this value is relatively lower than in adolescence and post-menopause. Even so, considering that bones are stores of calcium, consumption of the nutrient in adulthood is essential to avoid future problems such as osteoporosis and osteopenia. The objective of this study was to assess the frequency of consumption of dairy products rich in calcium, by adult women between 19 and 30 years old in the city of Catanduva, Brazil. A descriptive cross-sectional observational study was carried out with 114 volunteers. The frequency of consumption of milk and dairy products in the last 12 months was measured through an anonymous questionnaire via “google forms”. It was found that among the most consumed dairy foods are cheese, but most calcium-rich foods are never eaten by the women in the study. The low calcium intake can be explained by the increase in the financial cost of dairy products on the market and by the presence of women who are lactose intolerant. Therefore, the consumption of dairy foods must be encouraged among women, while alternatives must be thought of so that the consumption of calcium, of medicinal importance, is not affected by the prices of dairy products on the market or by the presence or absence of diseases related to lactose

Recommendations and guidance on Cobalamin (Vitamin B12) based on the Delphi method

Introduction: Vitamins are essential micronutrients for the body to function. Cobalamins (Cbls) are watersoluble compounds, acting as cofactors in enzymatic reactions. However, the use of Cbls in the clinical environment is still controversial. Objective: It was to discuss the topic and help guide different professionals, experts were brought together to discuss criteria concerning the diagnosis, indications, and use of cobalamin. Methods: The study was carried out using the Delphi method. Topics were initially created to direct the discussion and initial contributions. In the first meeting with the panelists, questions were formulated. The questions were distributed to all panelists. With the contributions, a text with the answers was created, and a third round to review the contributions and agree with the text was carried out. Results: The main topics related to the use of cobalamin were identified. Conclusion: The main topics related to this topic include risk groups of deficiency of ingestion or absorption by the gastrointestinal tract. The deficiency diagnosis must be made through laboratory tests, and early indication must be made when a significant cobalamin deficiency is identified, to avoid irreversible clinical conditions. A recommended practice is monitoring between 2 and 6 months after starting cobalamin replacement. Evidence Level:6

Tissue and metabolic regeneration in the light of stem cells, gut microbiota, microRNAs, and exosomes: a systematic review

Introduction: In the regenerative nutrology scenario, nutrients and energy balance stand out as triggers for the balanced functions (maintenance of quiescence) of adult tissue stem cells for tissue and metabolic regeneration. Objective: It was to develop a systematic review of clinical studies to explore the main nutrients and diets to favor tissue and metabolic regeneration, as well as to understand the functions of mesenchymal stem cells, gut microbiota, microRNAs, and exosomes in this process. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from February to April 2025 in the Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 133 articles were found. A total of 35 articles were evaluated in full and 23 were included and developed in the present systematic review study. Considering the Cochrane risk of bias tool, the overall assessment resulted in 26 studies with a high risk of bias and 21 studies that did not meet GRADE and AMASTAR-2. Most studies showed homogeneity in their results, with X2=81.2%>50%. It was concluded that signaling pathways, including mTORC, AMPK, MAPK, and others, are all sensitive to changes in nutrient levels. A healthy plant-based diet can reduce skin inflammation and improve overall skin health. Intermittent fasting regimens can inhibit hair follicle regeneration. Despite this, fasting-stimulated autophagy degrades unwanted components and plays a key role in muscle regeneration. Omega-3 fatty acids, magnesium, zinc, vitamins A, C, D, and resveratrol, together with probiotics, positively improve ulcer healing. Milk contains exosomes (extracellular vesicles) and microRNAs that influence the gut microbiota and aid in tissue regeneration. Supplementation with beta-hydroxy-beta-methylbutyrate, arginine, and glutamine promotes wound regeneration. Finally, studies have shown that patients with ulcers have deficient levels of vitamin C

Major considerations of immune strengthening and health longevity in the light of nutrology and lifestyle change: a systematic review

Introduction: In the scenario of nutritional impacts on quality of life, genetic, environmental, and lifestyle factors can determine the life expectancy of human beings. Nutrition is a key component that affects our health, and several studies show that nutrition also has the potential to increase life expectancy. Objective: A systematic review was developed to describe immune strengthening and healthy longevity in light of nutrology and lifestyle changes. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from March to April 2025 in the Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 134 articles were found, and 36 articles were evaluated, and 09 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 28 studies with a high risk of bias and 32 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X2=82.7%>50%. It was concluded that nutrients and natural substances from human physiology and biochemistry such as melatonin and coenzyme Q10 control the functions of the immune system. Many metabolic or chronic diseases have been implicated in poor diet and lifestyle. Improving diet quality is associated with reduced all-cause mortality, considering that multivitamin and multimineral supplements can improve life expectancy. Overall well-being is improved when sedentary but sufficiently physically active adults reduce the time spent sedentary and increase physical activity levels. The results of the pandemic indicate there have been a variety of lifestyle changes, physical inactivity, and psychological problems