Nutrients

Editorial

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4 pages, 176 KiB

Open AccessEditorial

Nutritional Pearls and Pitfalls of Gastrointestinal Diseases

by Massimo Bellini and Christian Lambiase

Nutrients 2023, 15(13), 2889; https://doi.org/10.3390/nu15132889 - 26 Jun 2023

Viewed by 1275

Abstract

Since ancient times, food has been considered a possible therapy for treating a wide range of diseases [...] Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

Research

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14 pages, 755 KiB

Open AccessArticle

Raising Children on a Vegan Diet: Parents’ Opinion on Problems in Everyday Life

by Daisy Bivi, Teresa Di Chio, Francesca Geri, Riccardo Morganti, Silvia Goggi, Luciana Baroni, Maria Gloria Mumolo, Nicola de Bortoli, Diego Giampietro Peroni, Santino Marchi and Massimo Bellini

Nutrients 2021, 13(6), 1796; https://doi.org/10.3390/nu13061796 - 25 May 2021

Cited by 19 | Viewed by 11887

Abstract

A growing number of Italian families are adopting a vegan diet (VD) for their offspring from infancy for various reasons, with health benefits and ethics being the most common reasons. Barriers to effective communication with primary care pediatricians (PCPs) are perceived by many [...] Read more.

A growing number of Italian families are adopting a vegan diet (VD) for their offspring from infancy for various reasons, with health benefits and ethics being the most common reasons. Barriers to effective communication with primary care pediatricians (PCPs) are perceived by many parents and, depending on the actors involved and the environment, a VD may affect social interactions in everyday life. A national cross-sectional survey was conducted between July and September 2020. Parents of children following a VD completed an online questionnaire. Data from 176 Italian parents were collected. About 72% (71.8%) of the children included in this study had been on a VD since weaning. Parents did not inform their primary care pediatricians (PCP) about the VD in 36.2% of the cases. In 70.8% of the cases, PCPs were perceived as skeptical or against a VD. About 70% (71.2%) of the parents relied on medical dietitians, and 28.2% on nutritionists/dietitians for dietary counseling. Parents administered an individual B12 supplement in 87.2% of the cases. To the best of our knowledge, this survey is the first which explores the relationship between vegan parents and their PCPs, the parental management of their children’s diet and problems regarding the implementation of a VD in everyday life. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

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11 pages, 264 KiB

Open AccessCommunication

Hydrogen Breath Tests: Are They Really Useful in the Nutritional Management of Digestive Disease?

by Paolo Usai-Satta, Francesco Oppia, Mariantonia Lai and Francesco Cabras

Nutrients 2021, 13(3), 974; https://doi.org/10.3390/nu13030974 - 17 Mar 2021

Cited by 11 | Viewed by 3499

Abstract

Background: Carbohydrate malabsorption is a frequent digestive problem associated with abdominal pain, bloating and diarrhea. Hydrogen breath testing (BT) represents the most reliable and validated diagnostic technique. The aim of this manuscript was to clarify the usefulness of BTs in the nutritional management [...] Read more.

Background: Carbohydrate malabsorption is a frequent digestive problem associated with abdominal pain, bloating and diarrhea. Hydrogen breath testing (BT) represents the most reliable and validated diagnostic technique. The aim of this manuscript was to clarify the usefulness of BTs in the nutritional management of these disorders. Methods: A literature search for BT related to carbohydrate malabsorption was carried out using the online databases of Pubmed, Medline and Cochrane. Results: Lactose BT showed good sensitivity and optimal specificity for lactose malabsorption. However, an accurate diagnosis of lactose intolerance should require blind lactose challenge although this method is difficult to utilize in clinical practice. Regarding dose-depending fructose and sorbitol malabsorption, BTs could not add diagnostic advantage compared with a direct dietary intervention. In addition, carbohydrates are fundamental components of fermentable oligo-, di- and monosaccharides and polyols (FODMAPs). Before starting a low FODMAP diet, lactose BT should be suggested in a population with low prevalence of hypolactasia. Conclusions: BTs represent a valid and noninvasive technique in many digestive conditions. Regarding the management of carbohydrate intolerance, lactose BT can be recommended with some limitations. No sufficient evidence is available about the usefulness of BTs for other sugars in clinical practice. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

12 pages, 271 KiB

Open AccessArticle

Perception of the Role of Food and Dietary Modifications in Patients with Inflammatory Bowel Disease: Impact on Lifestyle

by Laura Guida, Francesca Maria Di Giorgio, Anita Busacca, Lucio Carrozza, Stefania Ciminnisi, Piero Luigi Almasio, Vito Di Marco and Maria Cappello

Nutrients 2021, 13(3), 759; https://doi.org/10.3390/nu13030759 - 26 Feb 2021

Cited by 20 | Viewed by 4147

Abstract

Background: Diet has a relevant role in triggering symptoms in inflammatory bowel disease (IBD) from the patients’ perspective, but there is gap the between patients’ and doctors’ perceptions. Few studies have addressed this topic. The aim of this study was to evaluate food [...] Read more.

Background: Diet has a relevant role in triggering symptoms in inflammatory bowel disease (IBD) from the patients’ perspective, but there is gap the between patients’ and doctors’ perceptions. Few studies have addressed this topic. The aim of this study was to evaluate food habits and nutrition knowledge in a homogeneous cohort of patients with IBD from southern Italy. Methods: 167 consecutive patients with IBD were recruited. The survey was based on the administration of a semi-structured questionnaire assessing demographics, disease features, dietary behavior, and food intolerance. Results: The majority of patients did not consider food a cause of their disease. However more than 80% changed their diet after the diagnosis and most report an improvement in symptoms. Spiced and seasoned foods, dairy products, vegetables, and fruit were often avoided. A dairy-free diet was adopted by 33.7%. Food choices were based on self-experience and not on medical counselling. Dietary modifications deeply impact on lifestyle. Conclusions: Most of the patients with IBD set diet and lifestyle on self-experience and give up many foods. This has an impact on psychosocial functioning and can lead to nutritional deficiencies. High quality studies are warranted to assess evidence-based dietary strategies and develop patient-targeted dietary recommendations. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

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12 pages, 752 KiB

Open AccessArticle

A Low FODMAP Diet Is Nutritionally Adequate and Therapeutically Efficacious in Community Dwelling Older Adults with Chronic Diarrhoea

by Leigh O’Brien, Paula Skidmore, Catherine Wall, Tim Wilkinson, Jane Muir, Chris Frampton and Richard Gearry

Nutrients 2020, 12(10), 3002; https://doi.org/10.3390/nu12103002 - 30 Sep 2020

Cited by 14 | Viewed by 5439

Abstract

The low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP)diet has been extensively researched, but not in the management of older adults with functional gastrointestinal symptoms. This study determines the positive and negative impacts of this dietary treatment in older adults with chronic diarrhea. [...] Read more.

The low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP)diet has been extensively researched, but not in the management of older adults with functional gastrointestinal symptoms. This study determines the positive and negative impacts of this dietary treatment in older adults with chronic diarrhea. A non-blinded intervention study was conducted with adults over 65 years with chronic diarrhea referred for colonoscopy where no cause was found. Participants followed a dietitian-led low FODMAP diet for six weeks and completed a structured assessment of gastrointestinal symptoms, the Hospital Anxiety and Depression scale, and a four-day food diary before and after the intervention. Twenty participants, mean age 76 years, were recruited. Adherence to the low FODMAP diet was acceptable; mean daily FODMAP intake reduced from 20.82 g to 3.75 g (p < 0.001) during the intervention and no clinically significant changes in macro- or micronutrient intakes were observed. There were clinically significant improvements in total gastrointestinal symptoms (pre diet 21.15/88 (standard deviation SD = 10.99), post diet 9.8/88 (SD = 9.58), p < 0.001) including diarrhea (pre diet 9.85 (SD = 3.84), post diet 4.05 (SD = 3.86), p < 0.001) and significant reductions in anxiety (pre diet 6.11/21 (SD = 4.31), post diet 4.26/21 (SD = 3.38), p < 0.05). In older adults the low FODMAP diet is clinically effective and does not jeopardise nutritional intake when supervised by an experienced dietitian. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

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Review

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23 pages, 402 KiB

Open AccessReview

Nutrition and Healthy Aging: Prevention and Treatment of Gastrointestinal Diseases

by Neri Maria Cristina and d’Alba Lucia

Nutrients 2021, 13(12), 4337; https://doi.org/10.3390/nu13124337 - 30 Nov 2021

Cited by 24 | Viewed by 8687

Abstract

Nutritional well-being is a fundamental aspect for the health, autonomy and, therefore, the quality of life of all people, but especially of the elderly. It is estimated that at least half of non-institutionalized elderly people need nutritional intervention to improve their health and [...] Read more.

Nutritional well-being is a fundamental aspect for the health, autonomy and, therefore, the quality of life of all people, but especially of the elderly. It is estimated that at least half of non-institutionalized elderly people need nutritional intervention to improve their health and that 85% have one or more chronic diseases that could improve with correct nutrition. Although prevalence estimates are highly variable, depending on the population considered and the tool used for its assessment, malnutrition in the elderly has been reported up to 50%. Older patients are particularly at risk of malnutrition, due to multiple etiopathogenetic factors which can lead to a reduction or utilization in the intake of nutrients, a progressive loss of functional autonomy with dependence on food, and psychological problems related to economic or social isolation, e.g., linked to poverty or loneliness. Changes in the aging gut involve the mechanical disintegration of food, gastrointestinal motor function, food transit, intestinal wall function, and chemical digestion of food. These alterations progressively lead to the reduced ability to supply the body with adequate levels of nutrients, with the consequent development of malnutrition. Furthermore, studies have shown that the quality of life is impaired both in gastrointestinal diseases, but especially in malnutrition. A better understanding of the pathophysiology of malnutrition in elderly people is necessary to promote the knowledge of age-related changes in appetite, food intake, homeostasis, and body composition in order to better develop effective prevention and intervention strategies to achieve healthy aging. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

13 pages, 290 KiB

Open AccessReview

Chronic Constipation: Is a Nutritional Approach Reasonable?

by Massimo Bellini, Sara Tonarelli, Federico Barracca, Francesco Rettura, Andrea Pancetti, Linda Ceccarelli, Angelo Ricchiuti, Francesco Costa, Nicola de Bortoli, Santino Marchi and Alessandra Rossi

Nutrients 2021, 13(10), 3386; https://doi.org/10.3390/nu13103386 - 26 Sep 2021

Cited by 35 | Viewed by 24238

Abstract

Chronic constipation (CC) is one of the most common gastroenterological diagnoses in clinical practice. Treatment includes several steps, depending on the severity of symptoms. Lifestyle modifications and increased intake of fiber and water are suggested by most health professionals. Unfortunately, the recommendations in [...] Read more.

Chronic constipation (CC) is one of the most common gastroenterological diagnoses in clinical practice. Treatment includes several steps, depending on the severity of symptoms. Lifestyle modifications and increased intake of fiber and water are suggested by most health professionals. Unfortunately, the recommendations in this regard are the most varied, often conflicting with each other and not always based on solid scientific arguments. This paper aims to clarify this topic by providing practical indications for the management of these patients in every day clinical practice. The literature available on this topic is scarce, and dietary studies have important methodological biases. However, fiber, mainly by binding water and acting as bulking agents and/or as prebiotics for the intestinal microbiota, and mineral water, especially if rich in magnesium and/or bicarbonate, are useful tools. An adequate, well-designed diet should be a cornerstone of any effective treatment for chronic constipation. High-quality studies on larger samples are mandatory to give scientific validity to the role of the food in CC therapy and to enable professionals to choose the best approach for their patients, combining nutritional and pharmacological agents. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

23 pages, 1210 KiB

Open AccessReview

Nutritional Aspects of Pediatric Gastrointestinal Diseases

by Teresa Di Chio, Christiane Sokollik, Diego G. Peroni, Lara Hart, Giacomo Simonetti, Franziska Righini-Grunder and Osvaldo Borrelli

Nutrients 2021, 13(6), 2109; https://doi.org/10.3390/nu13062109 - 19 Jun 2021

Cited by 4 | Viewed by 6138

Abstract

In the last decade, the role of nutritional management in pediatric gastrointestinal diseases has gained increasing popularity. Disease-specific diets have been introduced as conventional treatments by international guidelines. Patients tend to more willingly accept food-based therapies than drugs because of their relatively “harmless” [...] Read more.

In the last decade, the role of nutritional management in pediatric gastrointestinal diseases has gained increasing popularity. Disease-specific diets have been introduced as conventional treatments by international guidelines. Patients tend to more willingly accept food-based therapies than drugs because of their relatively “harmless” nature. Apart from a diet’s therapeutic role, nutritional support is crucial in maintaining growth and improving clinical outcomes in pediatric patients. Despite the absence of classical “side effects”, however, it should be emphasized that any dietary modification might have negative consequences on children’s growth and development. Hence, expert supervision is always advised, in order to support adequate nutritional requirements. Unfortunately, the media provide an inaccurate perception of the role of diet for gastrointestinal diseases, leading to misconceptions by patients or their caregivers that tends to overestimate the beneficial role of diets and underestimate the potential adverse effects. Moreover, not only patients, but also healthcare professionals, have a number of misconceptions about the nutritional benefits of diet modification on gastrointestinal diseases. The aim of this review is to highlight the role of diet in pediatric gastrointestinal diseases, to detect misconceptions and to give a practical guide for physicians on the basis of current scientific evidence. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

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16 pages, 548 KiB

Open AccessReview

Perioperative Nutritional Aspects in Total Pancreatectomy: A Comprehensive Review of the Literature

by Niccolò Furbetta, Annalisa Comandatore, Desirée Gianardi, Matteo Palmeri, Gregorio Di Franco, Simone Guadagni, Giovanni Caprili, Matteo Bianchini, Lorenzo Maria Fatucchi, Martina Picchi, Luca Bastiani, Giandomenico Biancofiore, Giulio Di Candio and Luca Morelli

Nutrients 2021, 13(6), 1765; https://doi.org/10.3390/nu13061765 - 22 May 2021

Cited by 9 | Viewed by 4166

Abstract

Total pancreatectomy (TP) is a highly invasive procedure often performed in patients affected by anorexia, malabsorption, cachexia, and malnutrition, which are risk factors for bad surgical outcome and even may cause enhanced toxicity to chemo-radiotherapy. The role of nutritional therapies and the association [...] Read more.

Total pancreatectomy (TP) is a highly invasive procedure often performed in patients affected by anorexia, malabsorption, cachexia, and malnutrition, which are risk factors for bad surgical outcome and even may cause enhanced toxicity to chemo-radiotherapy. The role of nutritional therapies and the association between nutritional aspects and the outcome of patients who have undergone TP is described in some studies. The aim of this comprehensive review is to summarize the available recent evidence about the influence of nutritional factors in TP. Preoperative nutritional and metabolic assessment, but also intra-operative and post-operative nutritional therapies and their consequences, are analyzed in order to identify the aspects that can influence the outcome of patients undergoing TP. The results of this review show that preoperative nutritional status, sarcopenia, BMI and serum albumin are prognostic factors both in TP for pancreatic cancer to support chemotherapy, prevent recurrence and prolong survival, and in TP with islet auto-transplantation for chronic pancreatitis to improve postoperative glycemic control and obtain better outcomes. When it is possible, enteral nutrition is always preferable to parenteral nutrition, with the aim to prevent or reduce cachexia. Nowadays, the nutritional consequences of TP, including diabetes control, are improved and become more manageable. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

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35 pages, 2128 KiB

Open AccessReview

Food Allergy and Intolerance: A Narrative Review on Nutritional Concerns

by Domenico Gargano, Ramapraba Appanna, Antonella Santonicola, Fabio De Bartolomeis, Cristiana Stellato, Antonella Cianferoni, Vincenzo Casolaro and Paola Iovino

Nutrients 2021, 13(5), 1638; https://doi.org/10.3390/nu13051638 - 13 May 2021

Cited by 73 | Viewed by 22534

Abstract

Adverse food reactions include immune-mediated food allergies and non-immune-mediated intolerances. However, this distinction and the involvement of different pathogenetic mechanisms are often confused. Furthermore, there is a discrepancy between the perceived vs. actual prevalence of immune-mediated food allergies and non-immune reactions to food [...] Read more.

Adverse food reactions include immune-mediated food allergies and non-immune-mediated intolerances. However, this distinction and the involvement of different pathogenetic mechanisms are often confused. Furthermore, there is a discrepancy between the perceived vs. actual prevalence of immune-mediated food allergies and non-immune reactions to food that are extremely common. The risk of an inappropriate approach to their correct identification can lead to inappropriate diets with severe nutritional deficiencies. This narrative review provides an outline of the pathophysiologic and clinical features of immune and non-immune adverse reactions to food—along with general diagnostic and therapeutic strategies. Special emphasis is placed on specific nutritional concerns for each of these conditions from the combined point of view of gastroenterology and immunology, in an attempt to offer a useful tool to practicing physicians in discriminating these diverging disease entities and planning their correct management. We conclude that a correct diagnostic approach and dietary control of both immune- and non-immune-mediated food-induced diseases might minimize the nutritional gaps in these patients, thus helping to improve their quality of life and reduce the economic costs of their management. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

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14 pages, 657 KiB

Open AccessReview

Dietary Management of Eosinophilic Esophagitis: Tailoring the Approach

by Pierfrancesco Visaggi, Lucia Mariani, Veronica Pardi, Emma Maria Rosi, Camilla Pugno, Massimo Bellini, Fabiana Zingone, Matteo Ghisa, Elisa Marabotto, Edoardo G. Giannini, Vincenzo Savarino, Santino Marchi, Edoardo V. Savarino and Nicola de Bortoli

Nutrients 2021, 13(5), 1630; https://doi.org/10.3390/nu13051630 - 12 May 2021

Cited by 23 | Viewed by 6352

Abstract

Eosinophilic esophagitis (EoE) is a unique form of non-immunoglobulin E-mediated food allergy, restricted to the esophagus, characterized by esophageal eosinophil-predominant inflammation and dysfunction. The diagnosis requires an esophago-gastroduodenoscopy with esophageal biopsies demonstrating active eosinophilic inflammation with 15 or more eosinophils/high-power field, following the [...] Read more.

Eosinophilic esophagitis (EoE) is a unique form of non-immunoglobulin E-mediated food allergy, restricted to the esophagus, characterized by esophageal eosinophil-predominant inflammation and dysfunction. The diagnosis requires an esophago-gastroduodenoscopy with esophageal biopsies demonstrating active eosinophilic inflammation with 15 or more eosinophils/high-power field, following the exclusion of alternative causes of eosinophilia. Food allergens trigger the disease, withdairy/milk, wheat/gluten, egg, soy/legumes, and seafood the most common. Therapeutic strategies comprise dietary restrictions, proton pump inhibitors, topical corticosteroids, biologic agents, and esophageal dilation when strictures are present. However, avoidance of trigger foods remains the only option targeting the cause, and not the effect, of the disease. Because EoE relapses when treatment is withdrawn, dietary therapy offers a long-term, drug-free alternative to patients who wish to remain off drugs and still be in remission. There are currently multiple dietary management strategies to choose from, each having its specific efficacy, advantages, and disadvantages that both clinicians and patients should acknowledge. In addition, dietary regimens should be tailored around each individual patient to increase the chance of tolerability and long-term adherence. In general, liquid elemental diets devoid of antigens and elimination diets restricting causative foods are valuable options. Designing diets on the basis of food allergy skin tests results is not reliable and should be avoided. This review summarizes the most recent knowledge regarding the clinical use of dietary measures in EoE. We discussed endpoints, rationale, advantages and disadvantages, and tailoring of diets, as well as currently available dietary regimens for EoE. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

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21 pages, 867 KiB

Open AccessReview

What Are the Pearls and Pitfalls of the Dietary Management for Chronic Diarrhoea?

by Leigh O’Brien, Catherine L. Wall, Tim J. Wilkinson and Richard B. Gearry

Nutrients 2021, 13(5), 1393; https://doi.org/10.3390/nu13051393 - 21 Apr 2021

Cited by 9 | Viewed by 5300

Abstract

Chronic diarrhoea affects up to 14% of adults, it impacts on quality of life and its cause can be variable. Patients with chronic diarrhoea are presented with a plethora of dietary recommendations, often sought from the internet or provided by those who are [...] Read more.

Chronic diarrhoea affects up to 14% of adults, it impacts on quality of life and its cause can be variable. Patients with chronic diarrhoea are presented with a plethora of dietary recommendations, often sought from the internet or provided by those who are untrained or inexperienced. In this review, we summarise the possible causes of chronic diarrhoea that can be managed by diet, the symptom improvement and quality of life benefits but also the potential risks of such dietary treatments. Clinicians need to consider both the benefits and risks of dietary treatments before making dietary recommendations to manage chronic diarrhoea. The pivotal role that dietitians have in ensuring optimal symptom improvement without jeopardising nutritional and overall health is discussed. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

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19 pages, 1073 KiB

Open AccessReview

Inflammatory Bowel Diseases: Is There a Role for Nutritional Suggestions?

by Lorenzo Bertani, Davide Giuseppe Ribaldone, Massimo Bellini, Maria Gloria Mumolo and Francesco Costa

Nutrients 2021, 13(4), 1387; https://doi.org/10.3390/nu13041387 - 20 Apr 2021

Cited by 23 | Viewed by 8473

Abstract

Nutrition has an important impact on inflammatory bowel diseases (IBD). In particular, several studies have addressed its role in their pathogenesis, showing how the incidence of IBD significantly increased in recent years. Meanwhile, nutrition should be considered a component of the treatment of [...] Read more.

Nutrition has an important impact on inflammatory bowel diseases (IBD). In particular, several studies have addressed its role in their pathogenesis, showing how the incidence of IBD significantly increased in recent years. Meanwhile, nutrition should be considered a component of the treatment of the disease, both as a therapy itself, and especially in the perspective of correcting the various nutritional deficiencies shown by these patients. In this perspective, nutritional suggestions are very important even in the most severe forms of IBD, requiring hospitalization or surgical treatment. Although current knowledge about nutrition in IBD is increasing over time, nutritional suggestions are often underestimated by clinicians. This narrative review is an update summary of current knowledge on nutritional suggestions in IBD, in order to address the impact of nutrition on pathogenesis, micro- and macro-nutrients deficiencies (especially in the case of sarcopenia and obesity), as well as in hospitalized patients. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

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13 pages, 525 KiB

Open AccessReview

Food and Nutrition in the Pathogenesis of Liver Damage

by Andrea Mega, Luca Marzi, Michael Kob, Andrea Piccin and Annarosa Floreani

Nutrients 2021, 13(4), 1326; https://doi.org/10.3390/nu13041326 - 16 Apr 2021

Cited by 26 | Viewed by 5740

Abstract

The liver is an important organ and plays a key role in the regulation of metabolism and in the secretion, storage, and detoxification of endogenous and exogenous substances. The impact of food and nutrition on the pathophysiological mechanisms of liver injury represents a [...] Read more.

The liver is an important organ and plays a key role in the regulation of metabolism and in the secretion, storage, and detoxification of endogenous and exogenous substances. The impact of food and nutrition on the pathophysiological mechanisms of liver injury represents a great controversy. Several environmental factors including food and micronutrients are involved in the pathogenesis of liver damage. Conversely, some xenobiotics and micronutrients have been recognized to have a protective effect in several liver diseases. This paper offers an overview of the current knowledge on the role of xenobiotics and micronutrients in liver damage. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

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26 pages, 1218 KiB

Open AccessReview

Mechanisms of Food-Induced Symptom Induction and Dietary Management in Functional Dyspepsia

by Kerith Duncanson, Grace Burns, Jennifer Pryor, Simon Keely and Nicholas J. Talley

Nutrients 2021, 13(4), 1109; https://doi.org/10.3390/nu13041109 - 28 Mar 2021

Cited by 42 | Viewed by 11596

Abstract

Functional dyspepsia (FD) is a common disorder of gut-brain interaction, characterised by upper gastrointestinal symptom profiles that differentiate FD from the irritable bowel syndrome (IBS), although the two conditions often co-exist. Despite food and eating being implicated in FD symptom induction, evidence-based guidance [...] Read more.

Functional dyspepsia (FD) is a common disorder of gut-brain interaction, characterised by upper gastrointestinal symptom profiles that differentiate FD from the irritable bowel syndrome (IBS), although the two conditions often co-exist. Despite food and eating being implicated in FD symptom induction, evidence-based guidance for dietetic management of FD is limited. The aim of this narrative review is to collate the possible mechanisms for eating-induced and food-related symptoms of FD for stratification of dietetic management. Specific carbohydrates, proteins and fats, or foods high in these macronutrients have all been reported as influencing FD symptom induction, with removal of ‘trigger’ foods or nutrients shown to alleviate symptoms. Food additives and natural food chemicals have also been implicated, but there is a lack of convincing evidence. Emerging evidence suggests the gastrointestinal microbiota is the primary interface between food and symptom induction in FD, and is therefore a research direction that warrants substantial attention. Objective markers of FD, along with more sensitive and specific dietary assessment tools will contribute to progressing towards evidence-based dietetic management of FD. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

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19 pages, 1048 KiB

Open AccessReview

Impact of Diet on Symptoms of the Irritable Bowel Syndrome

by Robin Spiller

Nutrients 2021, 13(2), 575; https://doi.org/10.3390/nu13020575 - 9 Feb 2021

Cited by 41 | Viewed by 15957

Abstract

Irritable bowel syndrome (IBS), with its key features of abdominal pain and disturbed bowel habit, is thought by both patients and clinicians to be strongly influenced by diet. However, the complexities of diet have made identifying specific food intolerances difficult. Eating disorders can [...] Read more.

Irritable bowel syndrome (IBS), with its key features of abdominal pain and disturbed bowel habit, is thought by both patients and clinicians to be strongly influenced by diet. However, the complexities of diet have made identifying specific food intolerances difficult. Eating disorders can masquerade as IBS and may need specialist treatment. While typical food allergy is readily distinguished from IBS, the mechanisms of gut-specific adverse reactions to food are only just being defined. These may include gut-specific mast cell activation as well as non-specific activation by stressors and certain foods. Visceral hypersensitivity, in some cases mediated by mast cell activation, plays a key part in making otherwise innocuous gut stimuli painful. Rapidly fermented poorly absorbed carbohydrates produce gaseous distension as well as short-chain fatty acids and lowering of colonic pH which may cause symptoms in IBS patients. Limiting intake of these in low FODMAP and related diets has proven popular and apparently successful in many patients. Existing diet, colonic microbiota and their metabolic products may be helpful in predicting who will respond. Wheat intolerance may reflect the fact that wheat is often a major source of dietary FODMAPs. It may also be either a forme fruste of coeliac disease or non-specific immune activation. Wheat exclusion can be successful in some of these patients. More research is needed to fully understand the mechanisms of food intolerances and how to best ameliorate them in a personalised medicine approach to diet in IBS. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

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11 pages, 500 KiB

Open AccessSystematic Review

Role of Dietary Habits in the Prevention of Diverticular Disease Complications: A Systematic Review

by Marilia Carabotti, Francesca Falangone, Rosario Cuomo and Bruno Annibale

Nutrients 2021, 13(4), 1288; https://doi.org/10.3390/nu13041288 - 14 Apr 2021

Cited by 8 | Viewed by 10744

Abstract

Recent evidence showed that dietary habits play a role as risk factors for the development of diverticular complications. This systematic review aims to assess the effect of dietary habits in the prevention of diverticula complications (i.e., acute diverticulitis and diverticula bleeding) in patients [...] Read more.

Recent evidence showed that dietary habits play a role as risk factors for the development of diverticular complications. This systematic review aims to assess the effect of dietary habits in the prevention of diverticula complications (i.e., acute diverticulitis and diverticula bleeding) in patients with diverticula disease. PubMed and Scopus databases were searched up to 19 January 2021, 330 records were identified, and 8 articles met the eligibility criteria and were subjected to data extraction. The quality of the studies was evaluated by the Newcastle-Ottawa quality assessment form. No study meets the criteria for being a high-quality study. A high intake of fiber was associated to a decreased risk of diverticulitis or hospitalization due to diverticular disease, with a protective effect for fruits and cereal fiber, but not for vegetable fiber; whereas, a high red meat consumption and a generally Western dietary pattern were associated with an increased risk of diverticulitis. Alcohol use seemed to be associated to diverticular bleeding, but not to recurrent diverticulitis or diverticular complications. Further high-quality studies are needed to better define these associations. It is mandatory to ascertain the role of dietary habits for the development of recurrent acute diverticulitis and diverticular bleeding. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

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