The incidence of inflammatory bowel disease (IBD) rapidly increases in Asia, and western dietary pattern is suspected to be the major risk factor. Despite this, there has been a lack of studies ...analyzing the relationship between dietary patterns and IBD in Taiwan. This study examines the dietary habits of Taiwanese individuals with and without IBD to inform clinical dietary recommendations for IBD patients.
We collected baseline characteristics and dietary habits from both IBD patients and healthy controls from February and August 2022 in Chang Gung memorial hospital using a structured and validated food frequency questionnaire. The dietary habits of IBD patients in this study were focused on the six months leading up to their IBD diagnosis.
Our study recruited 98 IBD patients and 184 healthy controls. In demographic characteristics, cigarette smoking is more common in IBD group. Besides, distinct dietary patterns were observed between groups. The healthy controls demonstrated a higher consumption of whole foods and antioxidants. By contrast, the IBD group consumed more western-style foods but the difference didn’t reach statistical significance.
Our study found that healthy controls in Taiwan embraced a dietary pattern rich in whole foods that may prevent IBD or reduce IBD disease activity. Nonetheless, a larger sample size is needed to further provide valuable dietary guidance for general population in Taiwan for IBD prevention or for patients with IBD for disease activity control.
Background
In pediatric Crohn's disease (CD), commercial formulas used as exclusive enteral nutrition (EEN) are effective at inducing remission. This study aims to assess the impact of a whole‐food ...blended smoothie as EEN on CD activity and the intestinal microbiome.
Methods
A 4‐week prospective trial assessed the impact of EEN with a whole‐food smoothie on newly diagnosed mild‐to‐moderate active pediatric CD. The smoothie with a multivitamin were developed to meet age‐appropriate nutritional requirements. Assessment over 4 weeks included Pediatric Crohn's Disease Activity Index (PCDAI), serum laboratories, fecal calprotectin (FCP), and stool collection for metagenomic shotgun sequencing and microbiota composition analysis. Clinical remission was defined as PCDAI ≤ 10 at week 4.
Results
Ten participants were enrolled with median age 14.5 years, and 8 completed the trial. Baseline mean PCDAI was 26.3 ± 9.1 and mean FCP 1149 ± 718 µg/g. At week 4, 80% of participants achieved clinical remission. FCP decreased by over half in 60% of participants, with FCP below 250 µg/g in 60% and below 100 µg/g in 40%. Microbiome analysis showed a significant increase in species richness over 4 weeks (p = 0.01). Compared to baseline, the relative abundance at week 2 and at week 4 was significantly increased for Bifidobacterium and Streptococcus and decreased for Blautia (p < 0.05 for all).
Conclusion
A whole‐food blended smoothie was effective for inducing clinical remission and decreasing FCP in pediatric CD similar to commercial EEN formulas. Further research may give insight into data‐driven whole‐food dietary approaches for CD management. ClinicalTrials.gov NCT03508193.
Brief Summary
Exclusive Enteral Nutrition (EEN) for Crohn's disease commonly employs commercial formula, but this study utilizes a specific home‐blended whole‐food recipe for EEN in a clinical trial over 4 weeks studying impact on inflammation and the gut microbiome.
What is Known
Exclusive enteral nutrition (EEN) is effective therapy for pediatric Crohn's disease.
EEN thus far has only been evaluated with commercial formulas.
Large interest exists in using restriction diets to treat Crohn's disease.
What is New
A whole‐food blended smoothie was able to induce clinical and biochemical remission of active Crohn's disease.
A whole‐food blended smoothie was associated with a significant increase in gut microbiome species richness.
Processed foods are typically praised/revered for their convenience, palatability, and novelty; however, their healthfulness has increasingly come under scrutiny. Classification systems that ...categorise foods according to their “level of processing” have been used to predict diet quality and health outcomes and inform dietary guidelines and product development. However, the classification criteria used are ambiguous, inconsistent and often give less weight to existing scientific evidence on nutrition and food processing effects; critical analysis of these criteria creates conflict amongst researchers.
We examine the underlying basis of food classification systems and provide a critical analysis of their purpose, scientific basis, and distinguishing features by thematic analysis of the category definitions.
These classification systems were mostly created to study the relationship between industrial products and health. There is no consensus on what factors determine the level of food processing. We identified four defining themes underlying the classification systems: 1. Extent of change (from natural state); 2. Nature of change (properties, adding ingredients); 3. Place of processing (where/by whom); and 4. Purpose of processing (why, essential/cosmetic). The classification systems embody socio-cultural elements and subjective terms, including home cooking and naturalness. Hence, “processing” is a chaotic conception, not only concerned with technical processes. Most classification systems do not include quantitative measures but, instead, imply correlation between “processing” and nutrition. The concept of “whole food” and the role of the food matrix in relation to healthy diets needs further clarification; the risk assessment/management of food additives also needs debate.
•Classifications were created to link processed foods to nutrition and health outcomes.•There is no consensus on what determines the level of food processing.•Classification includes the extent, nature of change, place and purpose of processing.•Processed food concepts relate to naturalness, additives, convenience, home cooking.•Food classifications embody social and cultural elements and subjective terms.
Over the past two decades, whole food supplementation strategies have been leveraged to target mental health. In addition, there has been increasing attention on the ability of gut microbes, so ...called psychobiotics, to positively impact behaviour though the microbiota-gut-brain axis. Fermented foods offer themselves as a combined whole food microbiota modulating intervention. Indeed, they contain potentially beneficial microbes, microbial metabolites and other bioactives, which are being harnessed to target the microbiota-gut-brain axis for positive benefits. This review highlights the diverse nature of fermented foods in terms of the raw materials used and type of fermentation employed, and summarises their potential to shape composition of the gut microbiota, the gut to brain communication pathways including the immune system and, ultimately, modulate the microbiota-gut-brain axis. Throughout, we identify knowledge gaps and challenges faced in designing human studies for investigating the mental health-promoting potential of individual fermented foods or components thereof. Importantly, we also suggest solutions that can advance understanding of the therapeutic merit of fermented foods to modulate the microbiota-gut-brain axis.
•Fermented foods offer an affordable dietary intervention strategy.•Fermented foods comprises of microbes and molecules with neuroactive potential.•Food substrate and environmental conditions shape fermented food microbiome.•Most preclinical and human studies lack accounting for appropriate controls.•Long term intervention with accurate measurement of fermented food intake is critical.
More than one third of global greenhouse gas emissions (GHG) can be attributed to our food system. Limiting global warming to 1.5° or 2 °C will not be possible without reducing GHG emissions from the ...food system. Dietary change at the meal level is of great importance as day-to-day consumption patterns drive the global food production system. The aim of this paper was to assess the life cycle environmental impact of a sample of meals from different cuisines (chilli, lasagne, curry and teriyaki meals) and their meat-based, vegetarian, vegan, and whole-food vegan recipe variations. The environmental impacts (global warming, freshwater eutrophication, terrestrial acidification and water depletion potential) of 13 meals, made with 33 different ingredients, were estimated from cradle to plate using Life Cycle Assessment (LCA). Results showed that irrespective of the type of cuisine, the plant-based version of meals (vegan and whole-food vegan) had substantially lower environmental impacts across all impact categories than their vegetarian and meat-based versions. On average, meat-based meals had 14 times higher environmental impact, while vegetarian meals had 3 times higher environmental impact than vegan meals. Substantial reductions in the environmental impacts of meals can be achieved when animal-based ingredients (e.g., beef, cheese, pork, chicken) are replaced with whole or minimally processed plant-based ingredients (i.e., vegetables, legumes) in recipes. Swapping animal-based meals for plant-based versions, and preferably transitioning to plant-based diets, present important opportunities for mitigating climate change and safeguarding environmental sustainability.
•Vegan meals consistently had the lowest environmental impact.•Meat-based meals had 14 times higher environmental impact than vegan meals.•Vegetarian meals had 3 times higher environmental impact than vegan meals.•Ingredient production stage was a hotspot in the meal life cycle.•Replacing animal-based ingredients is more effective than sourcing ingredients locally.
It is clearly understood that the economic disruption during the COVID-19 outbreak is causing people to lose their income and access to healthy food. Our study aims to investigate people's spending ...on food and how their daily expenses on cigarettes impact diet quality. We conducted a cross-sectional online survey in April, 2020 and interviews through social media. There were 180 subjects followed in this study. Analysis was conducted using chi-square. It is found that even though our subjects able to access food but their diet quality to have whole food of four food group daily is not adequate. There is significant association between food expenses on whole food and processed food to diet quality (p<0,001). While there is no significant association between smoking behaviours to diet quality (p=0,684) but the percentage of those who smoke 1 to 3 cigarettes and more than 3 cigarettes daily is larger to have poor diet quality rather than people who do not smoke at all. This study concluded household's expenses for cigarettes and food during the COVID-19 pandemic were able to explain whether diet quality is poor or good. The study suggests the government needs to impose smoking restrictions as part of COVID-19 prevention and reassure people's accessibility to nutritious food during this pandemic.
Display omitted
•WPE ameliorated HFD-induced abnormal body weight gain and blood metabolic factors.•WPE alleviated the severity of non-alcoholic fatty liver induced by HFD.•WPE modulated the hepatic ...genes involved in lipid and cholesterol metabolism.•WPE alleviated the HFD-induced gut microbiota dysbiosis.•WPE regulated the abundance of Akkermansia, Lactobacillus, and Bifidobacterium.
There is a growing interest in employing whole food-based strategies to prevent chronic diseases, owing to the potential synergistic interactions among various bioactive components found within whole foods. The current research aimed to determine inhibitory effects of the whole edible mushroom Pleurotus eryngii (WPE) on high-fat diet (HFD)-induced obesity in mice. Our results showed that dietary intake of WPE significantly inhibited the abnormal gain of body weight and adipose tissue weight, improved glucose tolerance, and ameliorated the serum biochemical parameters in HFD-fed mice. The histological analysis illustrated that the severity of non-alcoholic fatty liver induced by HFD was significantly reduced by WPE. Oral intake of WPE profoundly modulated the mRNA levels of hepatic genes involved in lipid metabolism and also increased the level of short-chain fatty acids in the mouse cecum. Moreover, WPE alleviated the HFD-induced gut microbiota dysbiosis, increasing the abundance of beneficial bacteria (Akkermansia, Lactobacillus, Bifidobacterium, and Sutteralla), and decreasing the harmful ones (rc4-4, Dorea, Coprococcus, Oscillospira, and Ruminococcus). These findings presented new evidence supporting that WPE could be used as a whole food-based strategy to protect against obesity and obesity-driven health problems.
Abstract
Context
The obesity epidemic is a main driver of the chronic disease epidemic; however, present treatment approaches have suboptimal efficacy.
Objectives
To assess the efficacy of ...plant-predominant (vegan, vegetarian, plant-based whole foods PBWFs) diets in treating obesity and its main cardiometabolic sequelae: hyperlipidemia (HLD); indices of insulin resistance, glycemic control, and diabetes mellitus type 2 (DM2); and cardiovascular disease (CVD), including hypertension (HTN).
Data Sources
A systematic search of multiple databases was conducted for articles published between November 2019 and February 2020; databases searched included: PubMed, Medline (Ovid), Cochrane, CENTRAL, and CINAHL.
Data Extraction and Analysis
All interventional trials (randomized controlled trials RCTs and trials of non-randomized experimental design) that met the inclusion criteria (English language, duration of at least 4 weeks, primary end point congruent with above objectives, no major flaws in research design that would prevent interpretation) were included in the review. A total of 3135 articles were scanned and 84 were selected. The articles were collated and summarized in 2 evidence tables. Risk of bias for RCTs was assessed using the Cochrane Risk-of-Bias tool 2 as a guide. For non-randomized trials, higher risk of bias was assumed, and the JBI Critical Appraisal tool was used as a guide to determine inclusion.
Results
Plant-based diets, in general, demonstrated improved weight control and cardiometabolic outcomes related to lipids, cardiovascular end points, blood pressure, insulin sensitivity, A1C, and fasting glucose, and a lower risk of diabetes compared with usual diets and in some cases standard health-oriented diets such as the American Heart Association (AHA), American Diabetic Association (ADA), and Mediterranean diets. Preliminary studies suggest plant-predominant diets practiced as part of healthy lifestyle interventions may stabilize or even reverse DM 2 and CVD. The acceptability and sustainability of plant-predominant diets where measured were generally similar to other health-oriented diets.
Conclusion
Plant-predominant diets can play a major role in reversing the obesity and chronic disease epidemics. In the setting of sustained lifestyle intervention programs, they may arrest or even reverse DM2 and CVD. Further higher-level RCTs are needed to confirm and expand on these findings.
Plant-sourced intrinsic dietary fiber (PIDF), mainly composed of nondigestible polysaccharides in a cell wall form, is often existed in plant tissue particles in which the physical structure of the ...particle size, density and spatial organization of food component as well as the intactness and porosity of cell wall are critical to its physicochemical properties and health functions. However, there is limited information of PIDF compared to isolated and purified DF that is a chemical entity without association with the food context.
The health benefit and physical structures of PIDF are emerging as a new research area in the field of DF although there is still limited information in the literature reports. In the current article, available information on the relationship between the physical structure and the physiological function as well as resulted health benefits of PIDF in a whole food context were reviewed in conjunction with food processing.
The physical structure of PIDF is a critical factor modulating the intestinal digestion and bioavailability of intracellular nutrients. PIDF can exert its health function through a physical structure-specific microbial fermentation and/or microbiota-independent pathways. A holistic approach to reveal the relationship between the physical structure and health function of PIDF will shed novel insight into the designing of PIDF enriched functional foods.
•Plant-sourced intrinsic dietary fiber (PIDF) is an physical entity presented as plant tissue particles•The physical structure is crucial for the functions of plant-sourced intrinsic dietary fiber (PIDF)•Encapsulation mechanism is involved in PIDF's impact on the metabolic fate of intracellular nutrients•The colonic fermentation-dependent and independent pathways are the basis for PIDF's health function