Challenging periods like the COVID-19 pandemic require fast and efficient adaptations of the healthcare system. It is vital that every patient has access to nutritional care as a part of primary ...healthcare services, even if social distancing measures are adopted. Therefore, we propose a simple remote nutritional screening tool and practical guidance for nutritional care in primary practice, and their implementation into telemedicine processes and digital platforms suitable for healthcare providers. The acronym for the tool is R-MAPP, as for Remote – Malnutrition APP, while the tool will be available also as an app. This protocol consists of two simple validated clinical tools for identifying nutritional risk and loss of muscle mass and function –Malnutrition Universal Screening Tool (‘MUST’) and SARC-F (5-item questionnaire: Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls) - and additional practical guidance on nutritional interventions for family physicians.
Osteoarthritis (OA) is nowadays the most common musculoskeletal progressive condition. In recent decades, incidence and prevalence of OA have increased significantly. It is estimated that the ...prevalence of OA among adults older than 60 is 12%, affecting about 240 million people globally. The cause has not been fully elucidated, and therefore, there is no cure at the moment. It is a multifactorial degenerative disease with an inflammatory component mediated by numerous proinflammatory and anti-inflammatory cytokines, chemokines, and growth factors. OA is not yet fully understood; therefore, therapeutic interventions are aimed primarily at reducing symptoms and slowing the progression of joint destruction. Of the therapeutic options available, the most often prescribed are nonsteroidal antirheumatic drugs, which have numerous side effects. Therefore, a need for a safe, effective substance is differentiated, which will be used in adjuvant treatment, but also in disease prevention, and which will comparatively have no or fewer side effects. One such substance is curcumin, a hydrophobic polyphenol that forms the active component of the rhizome of the Curcuma longa plant. Several studies have shown its potent antioxidant and anti-inflammatory effect, non-toxicity, and safety at high daily doses. In addition to blocking chondrocyte apoptosis, curcumin also blocks the expression of cyclooxygenase, prostaglandin E-2 and proinflammatory cytokines in chondrocytes, potentially alleviating symptomatic diseases. Although there are significant variations in quality, methodology, and research results conducted on curcumin efficiency in OA treatment, curcumin is primarily recommended as systematic short-term and medium-term adjuvant therapy that reduces inflammatory biochemical factors. Reducing inflammation leads to better pain regulation and improved joint function, significantly reducing standard prescribed doses of drugs. The most researched daily doses of curcumin intake are 1000–2000 mg/day, which would also be the doses that most of the authors recommend. Further research is needed to determine the preventive role of curcumin in the pathogenesis of OA, the effects of long-term usage of curcumin in preventive purposes and treatment of osteoarthritis, as well as to determine optimal therapeutic dosages.
The information on microbiota composition in the human gastrointestinal tract predominantly originates from the analyses of human faeces by application of next generation sequencing (NGS). However, ...the detected composition of the faecal bacterial community can be affected by various factors including experimental design and procedures. This study evaluated the performance of different protocols for collection and storage of faecal samples (native and OMNIgene.GUT system) and bacterial DNA extraction (MP Biomedicals, QIAGEN and MO BIO kits), using two NGS platforms for 16S rRNA gene sequencing (Ilumina MiSeq and Ion Torrent PGM). OMNIgene.GUT proved as a reliable and convenient system for collection and storage of faecal samples although favouring Sutterella genus. MP provided superior DNA yield and quality, MO BIO depleted Gram positive organisms while using QIAGEN with OMNIgene.GUT resulted in greatest variability compared to other two kits. MiSeq and IT platforms in their supplier recommended setups provided comparable reproducibility of donor faecal microbiota. The differences included higher diversity observed with MiSeq and increased capacity of MiSeq to detect Akkermansia muciniphila, Odoribacteraceae, Erysipelotrichaceae and Ruminococcaceae (primarily Faecalibacterium prausnitzii). The results of our study could assist the investigators using NGS technologies to make informed decisions on appropriate tools for their experimental pipelines.
Trudnoća je vrlo osjetljivo razdoblje u životu žene, osobito kada se uz trudnoću veže dijagnoza kronične bolesti. Upalne bolesti crijeva su kronične autoimune bolesti koje nastaju kao rezultat ...interakcija između genetskih i okolišnih čimbenika. Upalne bolesti crijeva obuhvaćaju ulcerozni kolitis, Crohnovu bolest, mikroskopski kolitis i neklasificiranu upalnu bolest crijeva. Vršak incidencije upalnih bolesti crijeva javlja se između 15. i 30. godine života. Kod velikog broja žena bolest se javlja upravo u generativnoj dobi, što može značajno utjecati na odluku o ostvarivanju trudnoće. Osobe oboljele od upalnih bolesti crijeva nakon postavljanja dijagnoze i u razdoblju pogoršanja kliničke slike vrlo često isključuju pojedine namirnice ili skupine namirnica iz prehrane kako bi ublažili simptome bolesti, pa nedostatak nutrijenata nije rijetkost. Razdoblje pripreme za trudnoću, sama trudnoća i dojenje razdoblja su u životu žene koja su povezana s povećanim potrebama za energijom i određenim nutrijentima koji se smatraju ključnima za rast i razvoj djeteta te za zdravlje majke. Cilj ovog rada bio je ispitati kakvoću prehrane trudnica i žena koje planiraju trudnoću s dijagnozom upalnih bolesti crijeva u Republici Hrvatskoj, kako bi se utvrdila učestalost provođenja eliminacijskih dijeta koje mogu rezultirati narušavanjem nutritivnog statusa. Informacije o učestalosti konzumiranja različitih skupina namirnica, korištenju dodataka prehrani, provođenju eliminacijskih dijeta, te karakteristikama trudnoće prikupljene su putem anketnog upitnika. U istraživanju je sudjelovalo 15 ispitanica oboljelih od upalnih bolesti crijeva u dobi od 21 do 39 godina. Prema rezultatima, više od polovice ispitanica (53,3 %) iz svoje prehrane isključuje određene namirnice, najviše iz skupine povrća, mlijeka i mliječnih proizvoda, mesa, te voća. Također, vidljivo je kako dijagnoza rezultira značajnijim prehrambenim promjenama kod većine ispitanica (60 %). Uočen je nedovoljan unos folne kiseline, kako kod žena koje planiraju trudnoću, tako i kod trudnica tijekom prvih 12 tjedana trudnoće. Ovakvi rezultati ukazuju da važnost pravilne prehrane i unos folne kiseline prije začeća i tijekom trudnoće u Republici Hrvatskoj još uvijek nisu dovoljno prepoznati.
Pregnancy is a very sensitive period in a woman’s life, especially when it is associated with a diagnosis of a chronic disease. Inflammatory bowel diseases are chronic autoimmune disorders that result from the interplay of genetic and environmental factors, including ulcerative colitis, Crohn’s disease, microscopic colitis and unclassified inflammatory bowel disease. The peak incidence of inflammatory bowel diseases occurs between the ages of 15 and 30. Many women are diagnosed with the disease during their reproductive years, which can significantly impact their decision to become pregnant. Individuals with inflammatory bowel diseases often exclude certain foods or food groups from their diet to alleviate symptoms, particularly after diagnosis or during periods of active disease, leading to nutrient deficiencies. The period of preparing for pregnancy, pregnancy itself, and breastfeeding are phases in a woman’s life associated with increased energy and specific nutrient requirements crucial for the growth and development of the child as well as the mother’s health. Therefore, the aim of this study was to examine the dietary quality of pregnant women and women planning pregnancy with a diagnosis of inflammatory bowel diseases in the Republic of Croatia, to determine the frequency of elimination diets that may compromise nutritional status. Information on the frequency of consuming different food groups, the use of dietary supplements, implementation of elimination diets, and pregnancy characteristics were collected through a questionnaire. The study included 15 female participants with inflammatory bowel diseases aged 21 to 39 years. According to the results, more than half of the participants (53.3%) exclude certain foods from their diet, mainly from the vegetable, dairy, meat, and fruit groups. Additionally, the diagnosis leads to significant dietary changes for the majority of participants (60%). Insufficient folic acid intake was observed among women planning pregnancy as well as during the first 12 weeks of pregnancy. These results indicate that the importance of proper nutrition and folic acid intake before conception and during pregnancy in the Republic of Croatia is still not adequately recognized.
Pravilna prehrana iznimno je važna u prevenciji šećerne bolesti i regulaciji glikemije. Šećerna bolest ubraja se u kategoriju bolesti koje se uspješno mogu prevenirati, dobro liječiti te im se može ...spriječiti ili odgoditi razvoj kroničnih komplikacija. Edukacija o pravilnoj prehrani treba biti individualno prilagođena, pri čemu treba obratiti pozornost na dob bolesnika, način života, socioekonomski status, tjelesnu aktivnost i komplikacije vezane uz šećernu bolest. Kod šećerne bolesti promjena životnih navika, što uključuje pravilnu prehranu, redovitu tjelesnu aktivnost i regulaciju tjelesne mase, može uvelike pridonijeti regulaciji glikemije, a u tipu 2 u nekim slučajevima može dovesti i do njene remisije. Smjernice su rezultat suradnje zdravstvenih stručnjaka koji sudjeluju u liječenju i edukaciji osoba koje boluju od šećerne bolesti. Utemeljene su na dokazima, prema metodologiji GRADE (engl. grading of recommendations, assessment, development and evaluation) koja uz snagu dokaza opisuje i razinu preporuke. Temeljni zaključci ovih smjernica odnose se na procjenu nutritivnih potreba te primjenu medicinske nutritivne terapije, individualno prilagođene osobama sa šećernom bolešću kao i onima koji imaju i neke od
vezanih komorbiditeta.
The aging process dictates the daily energy needs of the elderly (aged 65 years and older) and their food intake, which depends on basic physiological needs, physical activity, individual needs of ...the elderly and many other factors, where monitoring of gerontological public health indicators is extremely important for health protection. This is precisely why this work is focused on reviewing the role and compliance of positive health behavior related to healthy diet of the elderly, geronto-tropometric characteristics of nutritional assessment, assessment of nutritional status via the NRS 2002 web service, assessment of energy needs of the elderly in relation to age, physical activity, morbidity, ratio of intake of macronutrients and micronutrients and the importance of the eight dietary rules for the elderly population. The main causes of mortality in the population aged 65 and over were singled out, and the main dietary norms from the manual “Nutritional-gerontological norms/menus in homes for the elderly and gerontological centers of institutional and non-institutional gerontological care” were singled out. The results state the adequacy of the quality of the menus (according the health status), as well as the importance of compliance with the energy and nutritional needs of the elderly, which will result in a healthy body mass (normal body mass index). Such achievements require an interdisciplinary approach that mainly contributes to the preservation of functional ability, disease prevention and improvement of health and quality of life in old age.
sindrom (RFS) je ozbiljna i potencijalno fatalna komplikacija koja se javlja u bolesnika s ozbiljnom pothranjenosti različite etiologije nakon ponovnog, nekontroliranog uvođenja prehrane, osobito ...ugljikohidrata. Nastanak komplikacija RFS-a, koje mogu zahvatiti bilo koji organski sustav ili više njih uslijed ozbiljnog elektrolitskog disbalansa, uvjetovan je brzim metaboličkim promjenama koje nastaju prilikom prelaska organizma iz katabolizma u anabolizam te unutarstaničnom deplecijom fosfora, kalija, magnezija te vitamina i mineralnih tvari. Najčešće komplikacije RFS-a vezane uz nedostatak vitamina odnose se na nedostatak tiamina. Zbog svoje ključne koenzimske uloge u metabolizmu ugljikohidrata i aminokiselina razgranatih lanaca, tiamin je važan čimbenik za održavanje normalne funkcije prije svega cerebralnog metabolizma. Razumijevanje temeljnih biokemijskih procesa tijekom gladovanja te posljedično mehanizama i čimbenika koji utječu na metaboličke promjene tijekom RFS-a važno je radi pravovremenog prepoznavanja bolesnika u riziku i prevencije RFS-a te brojnih kliničkih komplikacija koje nosi bez obzira na modalitet nutritivne potpore.
The healthy intestine represents a remarkable interface where sterile host tissues come in contact with gut microbiota, in a balanced state of homeostasis. The imbalance of gut homeostasis is ...associated with the onset of many severe pathological conditions, such as inflammatory bowel disease (IBD), a chronic gastrointestinal disorder increasing in incidence and severely influencing affected individuals. Despite the recent development of next generation sequencing and bioinformatics, the current scientific knowledge of specific triggers and diagnostic markers to improve interventional approaches in IBD is still scarce. In this review we present and discuss currently available and emerging therapeutic options in modulating composition and metabolic activity of gut microbiota in patients affected by IBD. Therapeutic approaches at the microbiota level, such as dietary interventions alone or with probiotics, prebiotics and synbiotics, administration of antibiotics, performing fecal microbiota transplantation (FMT) and the use of nematodes, all represent a promising opportunities towards establishing and maintaining of well-being as well as improving underlying IBD symptoms.
The Mediterranean diet (MD) and the Nordic diet (ND) share more similarities than differences. Both diets are based on typical local and seasonal foods, share similar nutritional recommendations ...based on plant-based dietary principles, and are both now orienting toward environmental protection and sustainability. The main difference between the two diets is the primary fat source. Olive oil is the synonym for MD while the ND uses more rapeseed/canola oil. While longitudinal epidemiological studies support adherence to MD as a way to prevent chronic diseases, ND still needs more such studies because the current results are discrepant. Notably, studies that assessed the association between both diets and lower risks of chronic diseases, disability, and mortality from specific and all causes, implied that ND could also have an advantageous effect as MD. Hopefully, there will be more longitudinal and large prospective studies in the future that will provide more evidence-based recommendations.
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