Dietary management of celiac disease: revisiting the guidelines

Objective: Medical nutrition therapy (MNT), by lifelong compliance to a gluten free diet, is the only treatment of celiac disease (CD). Clinical practice guidelines (CPGs) regarding the management of CD emphasize on the role of MNT besides other treatment options. The aim of the present study was to review and critically appraise CD-specific MNT CPGs, and identify the areas in need of improvement for better adherence a¬¬nd outcomes. Research Methods & Procedures: A comprehensive search was performed at Pubmed, Guidelines International Network (GIN), Google Scholar and related websites for CPGs on the dietary management of CD, published in the English language. Results: A total of 12 CPGs were retrieved and critically appraised by three independent reviewers utilizing the AGREE II instrument. All CPGs were of low quality based on AGREE II tool. Among the 12 CPGs, the NICE ones achieved the highest score and was unanimously recommended without modifications by the three reviews, while AGA, AHS, BSPGHAN, CREST and FISPGHAN CPGs received the lowest score. Conclusions: The present study unveils the low quality of guidelines regarding the MNT of CD patients, indicating the need of updated and improved guidelines taking into consideration the proposed items of the AGREE II. Keywords: medical nutrition therapy; clinical practice; critical appraisal; gluten-free diet; autoimmune disease; nutrition intervention; evidence-based nutrition; gluten; CASP

INTA MOAT: a tool for governing the urban commons

In the historic city of Nicosia located on the island of Cyprus, the old city is enclosed by the Venetian walls. These were initially designed during the Venetian period on the island and later on, finished during the British Colonial period on Cyprus. Today the public space of the Moat and the Bastions are underused by citizens and visitors of the city. Most of the citizens of Nicosia nearly forgot the moat space due to the low public access and non-existence of social activities. Thus, lead to the leftover of the ‘bastions-moat-new city boundaries’ space as void. The INTA MOAT project proposes a platform to facilitate the use of the public space within the moat area at the old city’s Venetian walls, enabling a diverse set of activities and reconnection with this historical site

Moderators of Food Insecurity and Diet Quality in Pairs of Mothers and Their Children

Research has suggested that maternal diet and characteristics may influence the diet of offspring during childhood. The present cross-sectional study aimed to assess the influence of distinct maternal characteristics and the diet quality of mothers on the prevalence of household food insecurity (FI) and the diet quality of children. A total of 179 mother–child pairs were recruited from two primary schools in the metropolitan area of Thessaloniki. The children were aged between 10 and 12 years old. Diet quality was assessed as the level of adherence to the Mediterranean diet (MD), with the use of the KIDMED for the children and the MedDietScore for the mothers. The household FI and the social and demographic characteristics of the mothers were also recorded, and anthropometric measures of both the mothers and their children were collected. Approximately ¼ (26.3%) of the pairs reported some degree of FI, with a greater prevalence (64.7%) within single-mother families. Moreover, FI affected the level of maternal MD adherence (p = 0.011). On the other hand, FI was decreased in households with a greater maternal educational level (OR: 0.25; 95% CI: 0.10–0.63) and conjugal family status (OR: 0.15; 95% CI: 0.87–0.52). Maternal adherence to the MD was inversely related to the respective adherence of their offspring (OR: 0.93; 95% CI: 0.86–0.997), suggesting that during periods of financial constraints, maternal diet quality is compromised at the expense of affording a better diet for the minors in the family