Role of Nutrition in Inflammatory Bowel Disease (IBD): New Therapeutic Approaches and Recent Outcomes

Inflammatory bowel disease (IBD) is the generic term given to a heterogeneous group of disorders of the gastrointestinal tract that are characterized by chronic inflammation. The major forms of IBD are Crohn's disease (CD) and ulcerative colitis (UC), which are increasing in incidence, prevalence and severity in many countries; these are characterized by intestinal inflammation and are believed to involve complex interactions between genetic, immunological and environmental factors. The incidence continues to rise, both in low and in high-incidence areas. Several dietary regimes may modify disease symptoms, in part through their actions on the host microbe. However, other dietary factors could affect the microbiotic or genetic expression in IBD patients in different ways. The purpose of this review is to discuss the most recent evidence from the literature on the use of nutritional therapy in the treatment of IBD and to review the role of environmental factors on the progressive increase of prevalence. The epidemiological data reveal an increasing incidence of IBD in recent years, which may be the result of increased intake of simple sugars and consumption disproportionate of fat (saturated and unsaturated). Intestinal permeability and inflammation could improve with proper diet in protein, probiotics and FA (n-3 and n-6). Diet and the host microbiota are likely to play important but as yet poorly defined roles therefore, is necessary to continue investigating to implement molecular findings in clinical treatments or adjunctive therapies

Oropharyngeal dysphagia spectrum in Wallenberg syndrome: a case report

Swallowing disorders are common clinical data in patients with Wallenberg syndrome, although with a broad clinical spectrum previously described. The objective of the study was to describe the characteristics of the spectrum of oropharyngeal dysphagia presentation in patients with Wallenberg syndrome. We performed a single-center, retrospective study in January 2016 and November 2020 with a series of cases and literature search. Data were collected from eight patients with ischemic spinal injury treated in the Phoniatrics Department of the General Hospital of Mexico. Eight cases were included, aged 28 and 74 years. In the first Fiber-optic Endoscopic Evaluation of Swallowing (FEES), the diagnosis was severe oropharyngeal dysphagia in 7 of the 8 patients (87.5%), compared to the second evaluation where mild oropharyngeal dysphagia was present in four patients, and severe oropharyngeal dysphagia on the other half. Oropharyngeal dysphagia can be found in 51-94% of patients with Wallenberg syndrome. In the first evaluation, difficulty with bolus propulsion of the oral phase in FEES was present in 62.5% of the patients. Still, in the second evaluation, the oral stage was reported with no alterations. Thus, patients could persist with severe dysphagia even passing the month of diagnosis. Wallenberg syndrome is a well-known condition that presents in a very variable way. Dysphagia could be severe, even passing the month after establishing the disease. The evaluation of dysphagia will allow their early rehabilitation and reduce the risk of complications

Dysphagia rehabilitation in post-COVID patients: Review of the literature

COVID-19 causes acute respiratory failure syndrome (SIRA), leading patients to require intubation in the intensive care unit (ICU). A common complication of this ventilatory support is dysphagia, which has a prevalence of up to 30%. This work aims to describe rehabilitation methods in patients with coronavirus infection based on levels of evidence according to the GRADE System, so a systematic review of the literature was carried out. The selected articles were divided into the following subtopics: diagnosis of dysphagia and rehabilitation in COVID patients. The gold standard for the diagnosis of dysphagia is the videofluoroscopic swallowing study (VFS). Fiberoptic Evaluation of Swallowing Assessment (FEES) has high sensitivity and specificity, although they have the disjunction of an aerosol-generating procedure (AGP); however, in a pandemic situation, the study of choice in the literature is VF. Once the diagnosis is made, it is necessary to initiate rehabilitation as soon as possible, even from hospitalization in patients who have hemodynamic stability to prevent long-term effects and promote normal swallowing even before discharge. In patients with COVID-19 infection dysphagia, the risk-benefit of assessment tools and therapy used for diagnosis should be decided to help to maintain social distancing. It becomes imperative to carry out clinical studies with high levels of evidence that allow us to generate Clinical Practice Guides for the benefit of our patients

Effects of increasing dietary concentrations of fish oil on lamb performance, ruminal fermentation, and leptin gene expression in perirenal fat

ABSTRACT The objective of this study was to evaluate the effects of four levels of fish oil on lamb performance, carcass yield, ruminal fermentation, and leptin gene expression in perirenal fat. Thirty-two lambs (24.10±2.15 kg, Katahdin × Pelibuey) were used in a completely randomized experimental design. The lambs were assigned to one of four dietary treatments (n = 8 lambs/treatment), expressed as g/kg DM basis: 0 fish oil and 300 corn; 10 fish oil and 250 corn; 20 fish oil and 205 corn; and 30 fish oil and 170 corn. The lambs were weighed on consecutive days at the beginning (days 0 and 1) and at the end (days 55 and 56) of the trial. Ruminal fluid samples were collected on day 56 to evaluate the ruminal fermentation pattern. The lambs were slaughtered on day 56; perirenal adipose tissue samples were collected and the carcass yields were recorded. Volatile fatty acids, ammonia N, and leptin mRNA expression were not affected by the dietary treatments. However, the dry matter intake, average daily gain, final body weight, and the hot carcass yield showed either increased linear or quadratic responses as the proportion of fish oil increased in the ration; the estimated optimal level obtained of fish oil levels for average daily gain was 11.2±0.21 g/kg and 12.8±4.67 g/kg for feed conversion. Additionally, feed efficiency and backfat thickness had an increment, showing quadratic response as the proportion of fish oil increased in the diet. Increasing the fish oil concentration in the diet does not affect leptin messenger ribonucleic acid expression. The lamb performance can be improved with 12 g/kg fish oil in diets of finishing lambs

High-Density Lipoprotein Reduction Differentially Modulates to Classical and Nonclassical Monocyte Subpopulations in Metabolic Syndrome Patients and in LPS-Stimulated Primary Human Monocytes In Vitro

The effect of metabolic syndrome on human monocyte subpopulations has not yet been studied. Our main goal was to examine monocyte subpopulations in metabolic syndrome patients, while also identifying the risk factors that could directly influence these cells. Eighty-six subjects were divided into metabolic syndrome patients and controls. Monocyte subpopulations were quantified by flow cytometry, and interleukin- (IL-) 1β secretion levels were measured by ELISA. Primary human monocytes were cultured in low or elevated concentrations of high-density lipoprotein (HDL) and stimulated with lipopolysaccharide (LPS). The nonclassical monocyte (NCM) percentage was significantly increased in metabolic syndrome patients as compared to controls, whereas classical monocytes (CM) were reduced. Among all metabolic syndrome risk factors, HDL reduction exhibited the most important correlation with monocyte subpopulations and then was studied in vitro. Low HDL concentration reduced the CM percentage, whereas it increased the NCM percentage and IL-1β secretion in LPS-treated monocytes. The LPS effect was abolished when monocytes were cultured in elevated HDL concentrations. Concurring with in vitro results, IL-1β serum values significantly increased in metabolic syndrome patients with low HDL levels as compared to metabolic syndrome patients without HDL reduction. Our data demonstrate that HDL directly modulates monocyte subpopulations in metabolic syndrome

Is a Non-Caloric Sweetener-Free Diet Good to Treat Functional Gastrointestinal Disorder Symptoms? A Randomized Controlled Trial

Background: A diet containing non-caloric sweeteners (NCS) could reduce calorie intake; conversely, some animal studies suggest that NCS consumption may increase functional gastrointestinal disorder symptoms (FGDs). This study aimed to compare the effect of consuming a diet containing NCS (c-NCS) versus a non-caloric sweetener-free diet (NCS-f) on FGDs. Methods: We conducted a randomized, controlled, parallel-group study using two different diets for five weeks: the c-NCS diet contained 50–100 mg/day NCS, whereas the NCS-f diet had less than 10 mg/day NCS. At the beginning of the study (PreTx) and at the end (PostTx), we assessed FGDs, dietary intake, and NCS consumption. Results: The percentage of participants with diarrhea (PreTx = 19% vs. PstTx = 56%; p = 0.02), post-prandial discomfort (PreTx = 9% vs. PstTx = 39%; p = 0.02), constipation (PreTx = 30% vs. PostTx = 56%; p < 0.01), and burning (PreTx = 13% vs. PostTx = 33%; p < 0.01) increased in the c-NCS diet group. Conversely, abdominal pain (PreTx = 15% vs. PostTx = 3%; p = 0.04), post-prandial discomfort (PreTx = 26% vs. PostTx = 6%; p = 0.02), burning (PreTx = 15% vs. PostTx = 0%; p = 0.02), early satiety (PreTx = 18% vs. PostTx = 3%; p < 0.01), and epigastric pain (PreTx = 38% vs. PostTx = 3%; p < 0.01) decreased in the NCS-f diet group. Conclusion: A c-NCS diet is associated with increased FGDs, including diarrhea, post-prandial discomfort, constipation, and burning or retrosternal pain. The NCS-f diet also decreased FGDs, as well as abdominal pain, post-prandial discomfort, burning or retrosternal pain, early satiety, and epigastric pain

A Single 48 mg Sucralose Sip Unbalances Monocyte Subpopulations and Stimulates Insulin Secretion in Healthy Young Adults

Sucralose is a noncaloric artificial sweetener that is widely consumed worldwide and has been associated with alteration in glucose and insulin homeostasis. Unbalance in monocyte subpopulations expressing CD11c and CD206 hallmarks metabolic dysfunction but has not yet been studied in response to sucralose. Our goal was to examine the effect of a single sucralose sip on serum insulin and blood glucose and the percentages of classical, intermediate, and nonclassical monocytes in healthy young adults subjected to an oral glucose tolerance test (OGTT). This study was a randomized, placebo-controlled clinical trial. Volunteers randomly received 60 mL water as placebo (n=20) or 48 mg sucralose dissolved in 60 mL water (n=25), fifteen minutes prior to an OGTT. Blood samples were individually drawn every 15 minutes for 180 minutes for quantifying glucose and insulin concentrations. Monocyte subsets expressing CD11c and CD206 were measured at -15 and 180 minutes by flow cytometry. As compared to controls, volunteers receiving sucralose exhibited significant increases in serum insulin at 30, 45, and 180 minutes, whereas blood glucose values showed no significant differences. Sucralose consumption caused a significant 7% increase in classical monocytes and 63% decrease in nonclassical monocytes with respect to placebo controls. Pearson’s correlation models revealed a strong association of insulin with sucralose-induced monocyte subpopulation unbalance whereas glucose values did not show significant correlations. Sucralose ingestion decreased CD11c expression in all monocyte subsets and reduced CD206 expression in nonclassical monocytes suggesting that sucralose does not only unbalance monocyte subpopulations but also alter their expression pattern of cell surface molecules. This work demonstrates for the first time that a 48 mg sucralose sip increases serum insulin and unbalances monocyte subpopulations expressing CD11c and CD206 in noninsulin-resistant healthy young adults subjected to an OGTT. The apparently innocuous consumption of sucralose should be reexamined in light of these results