Nutritional management of lactose intolerance : the importance of diet and food labelling

Worldwide, 70% of the adult population has limited expression of lactase enzyme with a wide variation among different regions and countries. Lactase deficiency may lead to lactose intolerance (LI). Depending both on the amount of lactose ingested and on the lactase activity, people who suffer from lactose malabsorption might experience numerous gastrointestinal and extra-intestinal symptoms and manifestations. Treatment of LI mainly consists of reducing or eliminating lactose from the diet until the symptoms disappear as well as supplementing lactase, and inducing colon microbiome adaptation by probiotics. Cow's milk is one of the major source of calcium and several other vitamins and minerals. Thus, a complete exclusion of dairy products may favor the development of bone diseases such as osteopenia and osteoporosis. Therefore, the dietetic approach has a crucial role in the management of LI patients. Additionally, the use of lactose and milk-derived products in non-dairy products (e.g., baked goods, breakfast cereals, drinks, and processed meat) has become widespread in the modern industry (the so-called "hidden lactose"). In this regard, a strict adherence to the lactose-free diet becomes challenging for LI patients, forced to continuous check of all products and food labels. In fact, lactose-free product labeling is still controversial. Considering that nowadays a specific cut-off value establishing "lactose-free" labeling policy is lacking and that there is no universal law regulating the production and commercialization of "delactosed" products, identification of specific safe and suitable products with a well-recognized lactose-free logo might help consumers. This narrative review aims to identify the dietary management for lactose intolerant people, avoiding symptoms and nutrients deficiencies, helped by the use of specific labelling to guide them to choose the safer product on the market

Association between worldwide dietary and lifestyle patterns with total cholesterol concentrations and DALYs for infectious and cardiovascular diseases: An ecological analysis

Global dietary and lifestyle trends are primary risk factors for communicable and non-communicable diseases. An ecological analysis was conducted to examine the association of global dietary and lifestyle patterns with total cholesterol concentrations. This study also investigated whether total cholesterol modified the association between dietary and lifestyle habits with disability-adjusted-life-years-lost (DALYs) for infectious and cardiovascular diseases (CVDs). Country-specific mean total cholesterol concentrations and DALYs for infectious and CVDs were obtained. Data were then matched to country-specific food and energy availability for consumption and information on obesity, physical inactivity, urbanization, gross domestic product (GDP), life expectancy and smoking. Stepwise multiple regression models were developed to identify significant predictors of total cholesterol concentrations and DALYs for infectious and CVDs. Life expectancy and egg and meat consumption were significantly associated with cholesterol concentrations. DALYs for infectious diseases were associated with smoking, life expectancy and per capita GDP. Smoking was the only predictor of DALYs for CVDs. The improvement of socio-demographic conditions and economic growth is likely to reduce the burden of communicable diseases in developing countries. A concurring increase in non-communicable diseases is expected, and these results have, yet again, identified smoking as a primary risk factor for CVDs

Comparative study of the relationship between multi-frequency impedance and body water compartments in two European populations

To investigate possible differences in the relationship between multi-frequency impedance and body-water compartments (total body water (TBW) and extracellular water (ECW)) measured by dilution techniques in two European populations, we studied forty Italian (twenty male and twenty female) and forty-three Dutch (twenty-three male and twenty female) healthy subjects aged 19-41 years. The main differences in body build between the two groups were height, trunk length and the two ratios TBW/height and ECW/height. Population-specific prediction formulas for ECW (at 1 kHz) and TBW (at 100 kHz) were developed. The prediction errors for ECW and TBW were about 0.6 and 1.5 kg respectively, (CV 4%) in both groups. Cross-validation analysis showed no significant error in the prediction of TBW but a slight error (range -4.9 to +2.8%) in the ECW prediction. The biases in both TBW and ECW were correlated with ECW/TBW (r -0.44, P < 0.0005 and r +0.52, P < 0.0005 respectively) in the two groups; the biases in ECW were also related to ECW/height (r 0.51, P < 0.001), TBW/height (r 0.25, P < 0.05), trunk length (r 0.36, P < 0.001) and Z1/Z100 (r 0.32, P < 0.01). In conclusion, the water distribution between the extra- and intracellular compartments emerged in the present study as the major cause of error in the prediction of body water, and in particular of ECW from impedance measurements with a population-specific equation. Moreover, body build, expressed as TBW/height and ECW/height, had an impact on the bias

Unique Thermal Properties of Clothing Materials.

Cloth wearing seems so natural that everyone is self-deemed knowledgeable and has some expert opinions about it. However, to clearly explain the physics involved, and hence to make predictions for clothing design or selection, it turns out to be quite challenging even for experts. Cloth is a multiphased, porous, and anisotropic material system and usually in multilayers. The human body acts as an internal heat source in a clothing situation, thus forming a temperature gradient between body and ambient. But unlike ordinary engineering heat transfer problems, the sign of this gradient often changes as the ambient temperature varies. The human body also perspires and the sweat evaporates, an effective body cooling process via phase change. To bring all the variables into analysis quickly escalates into a formidable task. This work attempts to unravel the problem from a physics perspective, focusing on a few rarely noticed yet critically important mechanisms involved so as to offer a clearer and more accurate depiction of the principles in clothing thermal comfort

The role of fetal, infant, and childhood nutrition in the timing of sexual maturation

Puberty is a crucial developmental stage in the life span, necessary to achieve reproductive and somatic maturity. Timing of puberty is modulated by and responds to central neurotransmitters, hormones, and environmental factors leading to hypothalamic-pituitary-gonadal axis maturation. The connection between hormones and nutrition during critical periods of growth, like fetal life or infancy, is fundamental for metabolic adaptation response and pubertal development control and prediction. Since birth weight is an important indicator of growth estimation during fetal life, restricted prenatal growth, such as intrauterine growth restriction (IUGR) and small for gestational age (SGA), may impact endocrine system, affecting pubertal development. Successively, lactation along with early life optimal nutrition during infancy and childhood may be important in order to set up timing of sexual maturation and provide successful reproduction at a later time. Sexual maturation and healthy growth are also influenced by nutrition requirements and diet composition. Early nutritional surveillance and monitoring of pubertal development is recommended in all children, particularly in those at risk, such as the ones born SGA and/or IUGR, as well as in the case of sudden weight gain during infancy. Adequate macro and micronutrient intake is essential for healthy growth and sexual maturity

Gender-based differences in the clustering of metabolic syndrome factors in children and adolescents

We depicted gender-differences in metabolic syndrome (MS) clustering before and after puberty in pediatrics, in order to develop gender specific preventive strategies for childhood obesity. We considered 1079 children and adolescents (529 females and 550 males; mean age 11.5 \ub1 2.8 year). According to body mass index (BMI) percentiles the subjects were classified as normal weight BMI &lt;75th, overweight BMI 75-95th and with obesity BMI &gt;95th. MS was diagnosed when three of the following criteria for age and sex percentiles were met: BMI &gt;95th, triglycerides (TGs) level &gt;95th, high-density lipoprotein-cholesterol (HDL-c) level &lt;5th, blood pressure (blood pressure) &gt;95th percentile, fasting blood glucose (FBG) &gt;100 mg/dL and/or homeostatic model assessment-insulin resistance (HOMA-IR) &gt;97.5th percentile. The prevalence of dismetabolic factors was similar in both genders, except for pathological BP, which was higher in males (p = 0.02). MS was detected only in patients with obesity, with a higher prevalence in pubertal than late/post-pubertal subjects (p &lt; 0.001), without any significant difference between gender. In pre-puberty, the most common MS combination was obesity (HBMI) + hypertension (HBP) + hyperglycemia/insulin resistance (HGLY/IR) followed by HBMI + low HDL-levels (LHDL) + HGLY/IR versus HBMI + HBP + HGLY/IR followed by HBMI + HBP + LHDL, respectively, in females and males. In the early and late/post-pubertal periods, the most prevalent combination remained similar to pre-puberty, additionally in both sexes other combinations, such as HBMI + HTG + HBP + HGLY/IR, HBMI + HBP + LHDL + HGLY/IR, HBMI + HTG + LHDL + HGLY/IR and HBMI + HTG + LHDL + HBP + HGLY/IR were also detected, differently distributed in males and females. We confirm that MS is an important consequence related to obesity, particularly in the post-puberty stage. Some gender-based differences should be considered early in order to identify specific preventive and treatment strategies

Nonparametric Information Geometry

The differential-geometric structure of the set of positive densities on a given measure space has raised the interest of many mathematicians after the discovery by C.R. Rao of the geometric meaning of the Fisher information. Most of the research is focused on parametric statistical models. In series of papers by author and coworkers a particular version of the nonparametric case has been discussed. It consists of a minimalistic structure modeled according the theory of exponential families: given a reference density other densities are represented by the centered log likelihood which is an element of an Orlicz space. This mappings give a system of charts of a Banach manifold. It has been observed that, while the construction is natural, the practical applicability is limited by the technical difficulty to deal with such a class of Banach spaces. It has been suggested recently to replace the exponential function with other functions with similar behavior but polynomial growth at infinity in order to obtain more tractable Banach spaces, e.g. Hilbert spaces. We give first a review of our theory with special emphasis on the specific issues of the infinite dimensional setting. In a second part we discuss two specific topics, differential equations and the metric connection. The position of this line of research with respect to other approaches is briefly discussed.Comment: Submitted for publication in the Proceedings od GSI2013 Aug 28-30 2013 Pari

Folate status in women of childbearing age with obesity: a review

Several studies have described a positive association between elevated BMI and birth defects risk. Data on plasma concentration of folate in pregnant women with obesity have shown values far below those recommended, regardless of diet, while folate levels should increase before pregnancy to reduce neural tube defects. We report a descriptive review of the most recent studies (from 2005 to 2015) to evaluate folate status through a population of women of childbearing age affected by obesity. The literature contains few studies, which present conflicting results regarding folate status in non-pregnant women of childbearing age affected by obesity, and it appears that there is a modification in folate metabolism, with a reduction in plasma folate levels and an increase in erythrocyte folate uptake. In conclusion, the folate status in women of childbearing age should be assessed by both plasma and erythrocyte levels to start a personalised and more adequate supplementation before conception. Further studies need to be conducted in a larger population, which take into account variables that can affect folate metabolism, such as dietary intake, lifestyle and genetic factors, oral contraceptives or other drug use, previous weight-loss programmes, or a history of bariatric surgery

Nutritional and Plasma Antioxidant Status Assessment in a Group of Old Alzheimer\u2019s Inpatients

This study was carried out to assess the nutritional and plasma antioxidant status of Alzheimer\u2019s inpatients compared to age-matched controls by means of anthropometric measurements, neuropsychological and nutritional tests and plasma biomarkers. Assessment of nutritional biomarkers of prooxidant/antioxidant balance in patients with AD as well as nutritional status and neuropsychological evaluation are important since many studies have demonstrated their association with cognitive impairment. This cross sectional study was carried out in 35 subjects recruited in a geriatric institution in Pavia, Northern Italy. Cases mean Body Mass Index (BMI) was lower than controls\u2019 one as well as mid arm circumference, triceps skinfold and arm muscle circumference. Both inpatients MNA and MMSE mean scores were lower than controls ones. Plasma levels of lutein plus zeaxanthin, beta-cryptoxanthin, lycopene, alfa tocopherol, ascorbic acid were significantly lower (p < 0.05) in AD in patients as well as superoxide desmutase and glutathione peroxidase concentrations, while all the other biochemical markers levels did not differ. Plasma antioxidant levels and activities were decreased in AD and could be biologically predictive of an early mild cognitive decline, suggesting early intervention on dietary antioxidant intake

Internet of medical things. Measurement of respiratory dynamics using wearable sensors in post-COVID-19 patients

Respiratory dynamics; Post-COVID-19 condition; Respiratory rateDinàmica respiratòria; Condició post-COVID-19; Freqüència respiratòriaDinámica respiratoria; Condición post-COVID-19; Frecuencia respiratoriaNowadays, the measurement of respiratory dynamics is underrated at clinical setting and in the daily life of a subject, still representing a challenge from a technical and medical point of view. In this article we propose a concept to measure some of its parameters, such as the respiratory rate (RR), using four inertial sensors. Two different experiments were performed to validate the concept. We analyzed the most suitable placement of each sensor to assess those features and studied the reliability of the system to measure abnormal parameters of respiration (tachypnea, bradypnea and breath holding). Finally, we measured post-COVID-19 patients, some of them with breath alterations after more than a year of the diagnosis. Experimental results showed that the proposed system could be potentially used to measure the respiratory dynamics at clinical setting. Moreover, while RR can be easily calculated by any sensor, other parameters need to be measured with a sensor in a particular position.Hoy en día la medición de la dinámica respiratoria está infravalorada en el ámbito clínico y en la vida diaria de un sujeto ,y sigue representando un reto desde el punto de vista técnico y médico. En este artículo proponemos un concepto para medir algunos de sus parámetros, como la frecuencia respiratoria (FR), utilizando cuatro sensore sinerciales. Se realizaron dos experimentos diferentes para validar el concepto. Analizamos la colocación más adecuada de cada sensor para evaluar esas características y estudiamos la fiabilidad del sistema para medir parámetros anormales de la respiración (taquipnea, bradipnea y retención de la respiración). Por último, realizamos mediciones en pacientes pos COVID-19, algunos de ellos con alteraciones respiratorias después de más de un año del diagnóstico. Los resultados experimentales mostraron que el sistema propuesto podría utilizarse potencialmente para medir la dinámica respiratoria en el ámbito clínico. Además, mientras que la FR puede calcularse fácilmente con cualquier sensor, otros parámetros deben medirse con un sensor en una posición determinada.This research was partially funding by RoboCity2030-DIHCM Madrid Robotics Digital Innovation Hub (“Robotica aplicada a la mejora de la calidad de vida de los ciudadanos, Fase IV”; S2018/NMT-4331), funded by “Programas de Actividades I+D en la Comunidad de Madrid” and cofunded by Structural Funds of the EU. J. Benito-Leon is supported by the National Institutes of ´ Health, Bethesda, MD, USA (NINDS # R01 NS39422), the European Commission (grant ICT-2011-287739, NeuroTREMOR), the Ministry of Economy and Competitiveness (grant RTC2015-3967-1, NetMD—platform for the tracking of movement disorder), and the Spanish Health Research Agency (grant FIS PI12/01602 and grant FIS PI16/00451)