Plant Polyphenols in Obesity and Obesity-Associated Metabolic Disorders: A Narrative Review of Resveratrol and Flavonoids Upon the Molecular Basis of Inflammation

Background: The epidemic of obesity, metabolic syndrome, type 2 diabetes and non-alcoholic fatty liver disease is currently unsustainable for Public Health systems, and preventive and therapeutic approaches are urgently sought to improve health outcomes for affected individuals. Aim: In this study, we aim to further explore and synthetize available evidence on the effects of selected plant polyphenols (PP) upon molecular mechanisms associated with oxidative stress and inflammatory pathways. We also aim to briefly discuss PP supplementation as therapeutic tool for the prevention and management of prevalent obesity-associated metabolic disorders. Methods: This narrative review was performed in the PubMed database in June 2018 without restriction of publication period. Results: PP influence a broad range of cell signalling pathways; by modulating the activity of nuclear transcription factors, PP modulate gene expression and antioxidant responses, as well as inflammation and its resolution. Several interventional studies have investigated the effects of PP supplementation in a variety of sample populations, but no consensus has yet been reached regarding composition, dosage or course of treatment for therapeutic purposes. However, overall results tend to suggest a positive effect of PP in either improving metabolic profile or minimizing negative disease outcomes. Careful consideration on PP supplementation is paramount; adverse effects have already been described. Conclusion: The successful prevention and management or treatment of obesity-associated metabolic disorders may be achieved through an effective multidisciplinary approach to tackle their modifiable risk factors. A balanced diet, which includes naturally occurring sources of PP associated with lower consumption of ultra-processed foods, is a relevant approach for the positive health outcomes desired

ESPEN guideline: Clinical nutrition in surgery.

Early oral feeding is the preferred mode of nutrition for surgical patients. Avoidance of any nutritional therapy bears the risk of underfeeding during the postoperative course after major surgery. Considering that malnutrition and underfeeding are risk factors for postoperative complications, early enteral feeding is especially relevant for any surgical patient at nutritional risk, especially for those undergoing upper gastrointestinal surgery. The focus of this guideline is to cover nutritional aspects of the Enhanced Recovery After Surgery (ERAS) concept and the special nutritional needs of patients undergoing major surgery, e.g. for cancer, and of those developing severe complications despite best perioperative care. From a metabolic and nutritional point of view, the key aspects of perioperative care include: • integration of nutrition into the overall management of the patient • avoidance of long periods of preoperative fasting • re-establishment of oral feeding as early as possible after surgery • start of nutritional therapy early, as soon as a nutritional risk becomes apparent • metabolic control e.g. of blood glucose • reduction of factors which exacerbate stress-related catabolism or impair gastrointestinal function • minimized time on paralytic agents for ventilator management in the postoperative period • early mobilisation to facilitate protein synthesis and muscle function The guideline presents 37 recommendations for clinical practice

Gut morphology and gene expression in obesity: Short review and perspectives

Summary: Obesity, a multifactorial and polygenic condition, is considered one of the great global public health problems of our time. The intestinal microbiome should be considered as a set of genetic factors that, together with the host genotype and lifestyle (consumption and energy expenditure), contribute to the pathophysiology of obesity. Increasing evidence showed an increased proportion of bacterial phylum Firmicutes and reduced concentrations of Bacteroidetes in obese as compared to normal weight humans. Studies report that DNA methylation patterns in the blood are associated with intestinal microbiota profiles and suggest that the microbiota and its metabolites influence genomic reprogramming. Investigations of the intestinal microbiota and its impact on genomic changes and their relationship to the risk of developing obesity provide opportunities to establish the basis for incorporating biological individuality into recommendations with significant therapeutic potential

Effect of parenteral infusion of fish oil-based lipid emulsion on systemic inflammatory cytokines and lung eicosanoid levels in experimental acute pancreatitis

Aim: we evaluated the effect of short-term FOLE infusion before experimental induction of AP on systemic cytokine and lung eicosanoid profiles.Methods: Lewis rats (n = 72) received parenteral infusion of FOLE (FO group) or saline (SS group), or remained without parenteral infusion (CG group) for 48 h. Thereafter, AP was induced by retrograde injection of sodium taurocholate into the pancreatic duct. Animals were sacrificed after 2, 12 and 24 h. Blood and lung samples were collected to assess serum inflammatory cytokines (Luminex) and tissue eicosanoids (ELISA), respectively.Results: serum TNF-α increased over time and serum IL-10 decreased from 12 to 24 h in CG group. In SS group serum TNF-α increased from 12 to 24 h (p = 0.039) and serum IL-10 decreased over time. Both CG and SS groups exhibited increased IL-6/IL-10 ratio (p = 0.040). From 12 to 24 h animals from FO group showed decreased serum IL-1 (p < 0.001), IL-4 (p < 0.002) and IL-6 (p = 0.050), and a trend towards increased IL-10 (p = 0.060). All experimental groups showed a trend towards increased PGE2 and decreased LTB4 in the lung at 24 compared with 12 hConclusion: parenteral infusion of FOLE for 48 h before the induction of experimental AP appears to favorably influence the cytokine response without affecting lung eicosanoids at the time points measured. The use of FOLE to prevent and treat AP following major surgery needs to be further explore