The Guts and Bolts of the Diet and a Look into the Microbiome

Mounting evidence suggests that particular aspects of human health and disease may be attributable to the trillions of microbes that inhabit our gastrointestinal tract, collectively referred to as the gut microbiota. Evidence suggests that pathologic changes to the microbiota (termed “dysbiosis”) are associated with a wide variety of medical outcomes, and therefore therapeutic manipulation of the microbiota is a major area of research interest. As part of the mini-symposium entitled Manipulating the Gut Microbiome for Human Health, Dr. Olendzki presents on the Inflammatory Bowel Disease Anti-Inflammatory Diet (IBD-AID)

Assessment of Diet in Patients with Inflammatory Bowel Disease: A Collaboration of Behavioral and Basic Scientists

Introduction: Clinical research to develop treatment for inflammatory bowel disease (IBD) is focusing on a nutritional regimen restricting certain carbohydrates while incorporating the use of an optimal diet that includes pre- and probiotic foods. Current assessments are not able to measure elements of this nutritional regimen, thus we developed a food frequency questionnaire (FFQ). This FFQ will be utilized in a prospective study of IBD patients following an anti-inflammatory diet (IBD-AID) developed by us and used clinically at UMASS. We will track the bacterial communities inhabiting the microbiome of patients to determine diet-dependent changes, and their relation with patient wellbeing. Objectives: 1) Develop an FFQ capable of identifying dietary components important to IBD: prebiotics, probiotics, beneficial nutrient intake, and avoidance of certain foods. 2) Determine diet-dependent changes of the gut microbiome. Hypothesis: This study will show the microbiome of patients adopting the IBD-AID converge to one or more healthy \u27enterotype\u27 signatures, as compared to a non-IBD-AID control group. Experimental design: Patients record daily FFQ. Foods and food groups (270) are categorized and grouped according to criteria of interest. Each food has a referent by which the patient can compare their own consumption. A scoring system satisfying dietary guidelines and components of the IBD-AID will be utilized. Twice per week patients collect stool samples for microbiome analysis. Microbiome composition and ecological metrics are compared to identify components influenced by the IBD-AID, and to separate bacterial \u27enterotype\u27 signatures of patients before, during and after diet intervention. We are currently recruiting patients

Anti-Inflammatory Diet for Inflammatory Bowel Disease (IBD-AID)

Background: Inflammatory Bowel Disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are chronic, immune-mediated inflammatory conditions of the gastrointestinal tract, which have increasingly been linked to dysbiosis, or an imbalance in the gut microbiome. Standard of care for IBD involves an often-evolving combination of anti-inflammatory, antibiotic, and immunomodulatory medications; however, the pharmacological approach is never curative, and medications routinely become ineffective for individual patients. Partially fueled by the increasing inadequacy of pharmacologic treatment regimens, there is emerging interest from patients regarding diet and its role in the pathogenesis and treatment of inflammatory diseases, demanding more in-depth and substantiating research from the medical community. The Anti-Inflammatory Diet for IBD (IBD-AID), which is derived and augmented from The Specific Carbohydrate Diet (SCD), is a nutritional regimen that restricts the intake of pro-inflammatory carbohydrates such as refined sugar, lactose, and most grains, while maximizing anti-inflammatory foods including those with prebiotic and probiotic properties. We have previous results from a case series of 11 patients with IBD showing symptomatic improvement (by Harvey Bradshaw Index scores) and downscaling of medication regimens in all 11 patients after 4 weeks on the IBD-AID. Objectives: The purpose of this small prospective study was to further assess the efficacy and feasibility of the IBD-AID intervention for the treatment of CD, and to provide pilot data for a larger application. Methods: The sample included 17 patients with biopsy-confirmed Crohn’s disease. Participants were offered the treatment diet (IBD-AID) (n=12) or standard medical care alone (control) (n=5). Patients in the IBD-AID group were required to attend one individual nutrition counseling session and three IBD-AID-specific cooking classes at the University of Massachusetts Medical School’s Shaw Building teaching kitchen. The control group continued with usual care. For all participants, demographic, clinical, and symptom data were obtained from baseline and follow-up questionnaires; dietary composition was monitored by weekly dietary recalls and food journals. All participants continued to follow with their gastroenterologists throughout the study duration. Study duration was 2 months after 70% adherence to the diet for IBD-AID participants, and 2 months after baseline for control participants. Consistent with the goals for any treatment used for CD, efficacy measures included: 1) reduction in symptomology, as measured by the validated Harvey Bradshaw Index (HBI); 2) reduction in the need of immunomodulatory and anti-inflammatory medications; and 3) normalizing trend in circulating inflammatory markers (i.e., CRP and ESR), albumin, and hematocrit. Feasibility measures included participant retention, dietary compliance, and participants’ self-assessments of difficulty in maintaining the diet. Results: A total of 15 enrolled patients with confirmed diagnosis of Crohn’s Disease, 5 in observation arm, 10 in intervention arm. Significant trends in dietary composition included significant increases in prebiotic and favorable dietary components, and decrease in adverse foods for the group as a whole (paired t-test values 0.0016, 0.0344, 0.0085, and 0.0014, respectively). For those patients on medication at baseline and with complete follow-up (n=9), one-third were able to decrease doses of or discontinue these medications. In addition, lab values reflected symptomatic improvements in two of our intervention patients, with changes in CRP, ESR, and hematocrit levels of -55.9 and -1.4, -30.0 and -15.0, and +5.4 and +0.3, respectively, with corresponding symptomatic improvements (HBI scores 1à7 and 8à0, respectively). No significance can be assigned, however, due to low sample size and loss to follow-up. Feasibility measures include a significant loss to follow-up rate of 33.3%, as well as an average “difficulty score” of 3.1, reflecting participants’ views on the difficult nature of “sticking with” the IBD-AID (scored on scale of 1-5, very easy to very difficult). Conclusion: Despite the study’s limitations, as well as because of them, several conclusions can be drawn. The trends noticed in the participants’ dietary component reports, and supported by participants’ self-evaluation, reveal that it is relatively easy to eliminate problem foods from the diet, but adding unfamiliar foods, particularly from the probiotic category such as plain yogurt, kimchi, miso, sauerkraut, etc., is a huge barrier to maintaining compliance. This trend may be a partial reflection of the Western food and dieting culture in which our daily meals are relatively homogenous. We are also brought up from a young age learning that “dieting” and “healthy eating” means cutting out the bad, but not necessarily bringing in the good and/or new. Despite lack of statistical significance, the two patients who exhibited normalizing lab values, in combination with their improved HBI scores, suggest the possibility of a real and meaningful benefit from IBD-AID for those able to comply with the dietary and lifestyle changes. In terms of the diet’s feasibility, the considerable loss to follow-up in this study may reflect a variety of issues, one of which may be the well-established medical and psychosocial complexity of IBD patients. This element is important for clinicians to keep in mind, and reflects the need for additional support and close follow-up when it comes to facilitating lifestyle change in this population. It also has implications for the diet itself, which should be re-examined to simplify or reframe in order to maximize generalizability and access for a greater percentage of IBD patients. Overall, this small study highlights the need for larger-scale research to draft clinical nutrition guidelines and further legitimize the utility of preventive clinical nutrition in Western medicine

O que podem o riso e o jogo palhacesco contra o que (nos) mata?

O artigo, inicialmente, aborda a morte como tema de espetáculos palhacescos realizados pela autora e palhaça em sua pesquisa de doutorado, dentro de uma perspectiva entrelaçada com o pensamento trágico da afirmação da vida em Nietzsche. Diante do acirramento da crise sanitária e social eclodida na pandemia por covid-19 no país, o enfrentamento da morte por meio da poética cômica e palhacesca passa a ser considerado sob novos ângulos e questionamentos pela autora, tendo em vista a necropolítica (Mbembe, 2016) escancarada e imperante do governo de extrema-direita na presidência do Brasil no período. A partir desse contexto, são colocadas algumas questões para a criação artística sobre como enfrentar o que (nos) mata, entristece e oprime, através do jogo e da produção de humor na arte palhacesca, a favor da vida

Beverage Consumption Among Low-Income Hispanics with Uncontrolled Type 2 Diabetes

This study sought to describe beverage consumption, caloric contribution of beverages to total caloric intake, and associations between beverage consumption and metabolic factors among a sample of low-income Hispanics participating in a trial of a diabetes self-management intervention. Findings: Treatment strategies to improve glucose control and reduce diabetes complications among Hispanics are needed. There is a high consumption of calories from beverages, accounting for one-fifth of total caloric intake, among this high-risk Hispanic population. Milk, juices, fruit drinks and regular soda are particular sources of calories. Beverage consumption is associated with metabolic markers, including HbA1c, cholesterol, blood pressure, BMI and waist circumference, and may thus increase risk for diabetic and cardiovascular complications in this population. Beverage consumption among low-income Hispanics warrants further clinical and research attention, including development of interventions that target all liquid calories, not just sugar-sweetened beverages. Targeting beverage consumption through simple messages that are in line with the literacy challenges posed by this population may be feasible. The vast benefit of clarifying a single food group that can be modified to reduce risk factors of diabetes and obesity in this population cannot be overstated

Caracterização das interações de substâncias húmicas com a matéria inorgânica em solos de cultivo de arroz irrigado : contribuição à aquisição de dados essenciais para avaliação global do seqüestro de carbono no solo

Orientador: Antonio Salvio MangrichTese (doutorado) - Universidade Federal do Paraná, Setor de Ciências Exatas, Programa de Pós-Graduação em Química. Defesa: Curitiba, 2006Inclui bibliografi

Neighborhood Differences in the Availability of Healthy Foods in the City of Worcester

INTRODUCTION. Neighborhood food environment is important to healthy eating. The availability and proximity of healthy foods has been shown to affect dietary quality, obesity, and overall health. We surveyed food stores throughout City of Worcester to assess the variability of food availability in neighborhoods and inequalities in access to fresh produce, unprocessed foods, and other healthy food options by neighborhood socioeconomic status (N-SES). METHODS. Where permitted by the store manager, the Community Nutrition Environment Evaluation Data Systems (C-NEEDS) survey was completed inside the store by trained staff. Healthy Food Availability Index (HFAI; range 0-56) and Unhealthy Food Availability Index (UFAI; range 0-39) were calculated for each store. Higher HFAI indicates higher availability of healthy food items, and higher UFAI indicates high availability of unhealthy foods. Median household income and car ownership data were derived at the census tract level as measures of N-SES using the 2013 US Census American Community Surveys 5-Year estimates. RESULTS. Convenience stores (mean HFAI 7.9, UFAI 21.1) had lower availability of both healthy and unhealthy foods than grocery stores (HFAI 32.4, UFAI 29.8). However, convenience stores had a higher proportion of unhealthy foods to healthy foods. Neighborhoods with lower median income and car ownership had a greater density of convenience stores. Neighborhoods with higher SES and car ownership had less access to convenience stores. Grocery stores in higher SES neighborhoods had more healthy food options. DISCUSSION. These results demonstrate that residents in lower SES neighborhoods may be disadvantaged when it comes to availability of healthy foods. These neighborhoods have higher density of convenience stores that may promote an unhealthy eating environment. Residents in these neighborhoods may wish to make healthy choices, but without access to a car may be unable or unwilling to walk to the nearest store where healthy alternatives are available

Physician-Delivered Weight Management Counseling (PD-WMC)

Introduction: Individuals with excess weight have increased morbidity and mortality compared to those of normal weight, and there are differences in disease risk between overweight and obese men and women. However, limited information on how physicians counsel these groups and on patients’ experiences with weight management counseling (WMC) is available. The goals of this study are to describe specific WMC approaches provided to patients, reported benefit of these strategies, and study participants’ WMC preferences. Methods:103 participants, stratified by BMI (Overweight: 25.0 ≤ BMI ≤ 29.9; Obese: BMI ≥ 30.0) and gender, completed surveys. Survey questions focused on WMC approaches (e.g., discussions about diet, generation of specific weight loss goals) currently provided by physicians, reported benefit of these methods, and patients’ WMC preferences for future care. Frequency counts were used in analysis of all questions. Chi-square and Fisher’s exact test (p \u3c .05) were performed to assess significance between stratified groups. Results: Participants reported receiving a wide-range of WMC, from discussions about diet to surgery. Overweight participants and women reported less counseling compared to obese individuals and men, respectively. Compared to men, women reported fewer discussions in areas such as past weight loss attempts (p=0.014) and effects of weight on long-term health (p=0.008). In general, participants found scheduling follow-up appointments most beneficial (72.8%). There were no significant differences by BMI or gender. Overall, participants most preferred that physicians increase support in generating specific strategies to assist in weight loss (74.8%) and in helping them to develop specific weight loss goals (65.1%). By gender, men most preferred increased development of weight loss strategies (70.0%) by their physicians and desired more discussions about the effects of weight on long-term health (63.3%). Women most preferred increased development of specific weight loss strategies (79.2%) as well as increased generation of specific weight loss goals (67.9%) by their physicians. Both overweight and obese participants (68.6% and 80.7%, respectively) sought increased development of weight loss strategies. Conclusions: This appears to be the first cross-sectional study comparing patients’ WMC experiences and preferences, stratified by BMI and gender. Results demonstrate that regardless of BMI and gender, patients want more WMC, with preference for certain strategies. Differences were noted between stratified groups

Repensar-se, reescrever-se: das possibilidades de escritura da pesquisa em artes da cena na academia

Este artigo busca refletir sobre formas de escrever teses e dissertações na academia, como sendo correlatas com formas de pensar, conceber e produzir conhecimento. Desse modo, questiona e busca possibilidades de formas de escritura da pesquisa em artes da cena que possam ter maior correspondência com conteúdos, materialidades, processos e modos de expressão da área, tais como, o jogo, a fabulação e a performatividade. Para tal, partimos de estudos sobre a performatividade da linguagem (Austin), a crítica literária (Barthes), a filosofia (Nietzsche e Deleuze), abordando o processo de escritura da dissertação da autora

Position of the American Dietetic Association: total diet approach to communicating food and nutrition information

It is the position of the American Dietetic Association that the total diet or overall pattern of food eaten is the most important focus of a healthful eating style. All foods can fit within this pattern, if consumed in moderation with appropriate portion size and combined with regular physical activity. The American Dietetic Association strives to communicate healthful eating messages to the public that emphasize a balance of foods, rather than any one food or meal. Public policies that support the total diet approach include the Dietary Guidelines for Americans, MyPyramid, the DASH Diet (Dietary Approaches to Stop Hypertension), Dietary Reference Intakes, and nutrition labeling. The value of a food should be determined within the context of the total diet because classifying foods as good or bad may foster unhealthful eating behaviors. Alternative approaches may be necessary in some health conditions. Eating practices are dynamic and influenced by many factors, including taste and food preferences, weight concerns, physiology, lifestyle, time challenges, economics, environment, attitudes and beliefs, social/cultural influences, media, food technology, and food product safety. To increase the effectiveness of nutrition education in promoting sensible food choices, food and nutrition professionals should utilize appropriate behavioral theory and evidence-based strategies. A focus on moderation and proportionality in the context of a healthful lifestyle, rather than specific nutrients or foods, can help reduce consumer confusion. Proactive, empowering, and practical messages that emphasize the total diet approach promote positive lifestyle changes