Search Results (523)

Background/Objectives: Paediatric intestinal pseudo-obstruction (PIPO) is a disorder of gut motility in childhood, frequently leading to intestinal failure (IF). Consensus on optimum nutrition management (oral, enteral, intravenous feeding exclusively or in combination) is lacking. Our aim was to investigate the current approach to the nutrition support of children (<18 years) with PIPO managed in Gastroenterology centres in the United Kingdom (UK) and long-term mode of feeding. Methods: An electronic questionnaire was sent to the members of the British Society of paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN). The data collected (October–November 2023) included patient demographics, disease phenotype, age at symptom onset and mode/type of feeding. Results: A total of 36 patients fulfilled criteria for PIPO; 22/36 (61.1%) patients were female, and 25/36 (69.4%) were white British. A total of 15/36 (41.6%) became symptomatic during the neonatal period and 23/36 (63.8%) within the first year of life. A total of 5/36 (13.9%) was eating a normal solid diet: 2/36 (5.5%) of these never required artificial feeding, 2/36 (5.5%) were started on a normal diet after short-term parenteral nutrition (PN) in the first year of life, and 1/36 (2.8%) re-established oral eating after 10 years of total PN following small bowel transplantation. A total of 31/36 (86.1%) required permanent artificial feeding (enteral and/or parenteral) after an average time of symptoms of 14 months. A total of 2/36 (5.5%) was exclusively on enteral nutrition (EN), and 4/36 (11.1%) was on total PN. A total of 25/36 (69.4%) received a combination of PN and oral diet (normal, or bite and dissolve, or normal but minimal intake) and/or EN. Conclusions: The results show that how and with what children with PIPO are fed in the UK varies widely. Larger studies are needed to make evidence-based recommendations on the best nutrition approach. Full article

There are currently no published methods for the controlled introduction of microplastic particles into the European rabbit (Oryctolagus cuniculus) as an animal model. The aim of this pilot study was to establish a novel rabbit-based experimental model for assessing the impact of microplastic particles by evaluating the physiological and biochemical responses to an eight-day oral administration of polystyrene latex (1 and 5 mg/kg/b.w./day), providing a foundation for future studies. This study was also aimed at evaluating the possibility of using Raman spectroscopy and Fourier-transform infrared spectroscopy to analyze the distribution of microplastics in rabbit samples. We observed a dose-dependent decrease in water and food consumption in the high-dose (5 mg/kg) study group. In addition, a decrease in alanine aminotransferase and total calcium levels, along with an increase in phosphorus levels, was detected. The rabbit’s stomach was the only organ where polystyrene microparticles were identified, with the colon, kidneys, ovaries, and uterus not showing any evidence of polystyrene presence. The selected doses of microplastics did not lead to pronounced toxic effects in rabbits and may be used on larger animal samples. Physiological and biochemical data obtained indicate predominantly negative metabolic shifts associated with the intake of microplastics, which warrants further study. Full article

In response to the plastic pollution crisis, bioplastics emerged as a sustainable alternative. However, low degradation rate and abiotic decomposition generate micro- and nanoplastics. These particles enter the food chain, establishing oral intake as a key route of human exposure. This review gathered studies on the biotransformation of bioplastics in the gastrointestinal tract and on their toxicity in human cells and murine models. Most studies focused on polylactic acid particles due to widespread use in food packaging. Under simulated gastrointestinal conditions in vitro, particles were modulated, resulting in cavity and pore formation, fragmentation, lipase competition, protein corona formation, and alterations in the gut microbiota (including Selenomonadaceae, Bifidobacterium, and Prevotellaceae). Also, particle breakdown increases surface area, enhancing interactions with biomolecules and causing higher in vitro and in vivo toxicity. Indeed, pro-inflammatory cytokine secretion, oxidative stress induction, and redox imbalance were found in both models. In mice, alterations in gut microbiota involving Bacillales indirectly mediated hepatotoxicity, leading to uric acid and triglyceride accumulation. Furthermore, microbiota adaptation over time was suggested with an increase in microorganisms and the potential conversion of L-lactic into harmful D-lactic acid. Despite limited studies, this review highlighted that ingested bioplastic-derived micro- and nanoplastics can lead to toxic effects. Full article

Plant-derived sweet proteins are promising low-calorie natural sweeteners that may reduce dietary sugar intake and prevent non-communicable diseases. Although seven have been identified—thaumatin, miraculin, monellin, mabinlin, brazzein, pentadin, and curculin (neoculin)—only thaumatin is currently approved as a food additive. The development of others requires comprehensive safety assessments, particularly regarding allergenicity. This systematic review aims to investigate and synthesize allergenicity assessment methods (in silico, in vitro, in vivo, and clinical) applied to these seven sweet proteins. The literature searches were conducted following PRISMA guidelines across Scopus, PubMed, and Wiley Online Library databases, up to 30 November 2025, with no time restrictions. The risk of bias in selected studies was evaluated using GRADE. After the selection process, 14 out of 2634 studies met the inclusion criteria. Thaumatin, miraculin, monellin, and brazzein emerged as the most extensively studied proteins. In silico approaches (sequence and structural homology) and in vitro assays (digestibility and cell-based methods) were the most commonly employed methods. In contrast, in vivo studies (animal models) and clinical evaluations (skin prick tests, oral food challenges) were rarely reported. Allergenicity studies on pentadin, mabinlin, and curculin (neoculin) are limited, indicating a research gap that requires further study to support regulatory approval and consumer acceptance. Full article

Background: Diabetes mellitus is a metabolic disturbance characterized by chronic hyperglycemia, which stems from defective secretion and/or action of insulin. D-Limonene has been studied for the confirmation of its antidiabetic and antioxidant effects. This paper aims to investigate the antidiabetic and antioxidants effects of D-Limonene in an experimental model of DM1. Methods: Female Wistar rats (180–250g) received streptozotocin (STZ, 45 mg/kg) intraperitoneally. Animals with capillary glycemia ≥ 250 mg/dL were considered diabetic. D-Limonene at oral doses of 12.5 mg/kg, 25 mg/kg and 50 mg/kg was administered during 28-day treatment. Water and food intake, weight gain and capillary glycemia were evaluated. At the end of the treatment, the following biochemical parameters were assessed: serum glucose, HbA1c, urea, creatinine, AST, ALT, GGT, ALP and albumin. The oxidative stress markers were determined in plasma, erythrocytes, and aortic homogenates: malondialdehyde, nitrite, myeloperoxidase, superoxide dismutase and catalase. Results: D-Limonene (25 and 50 mg/kg) significantly reduced serum glucose, HbA1c, AST, ALT, GGT and ALP when compared to DC, as well as plasma MDA and nitrite concentrations. Interestingly, D-Limonene (25 and 50 mg/kg) decreased both plasma and aortic myeloperoxidase activities, as well as increased both erythrocytic and aortic catalase activities. Conclusions: These findings, besides a marked D-Limonene-induced hypoglycemic effect, pave the way for further studies comprising a multi-target treatment by providing benefits on hepatic and vascular complications related to the diabetic condition. Full article

Background/Objectives: Enteric drug forms are developed to delay drug release to avoid drug degradation in the acidic environment of the stomach or to prevent irritation of the stomach mucosa. The bioavailability of posaconazole (POS) after oral administration depends on stomach pH and food intake. Delayed-release tablets and unmodified oral suspension are the POS formulations currently available on the market. The oral suspension formulation is characterized by highly variable bioavailability, which may significantly affect therapy effectiveness. Methods: In this study, multi-unit drug forms with delayed and sustained POS release were designed. Polymeric microparticles consisting of sodium alginate (ALG), methacrylic acid–ethyl acrylate copolymer (EUD), or both, were prepared using the spray-drying technique. The formulations that met the pharmacopoeia enteric release standards in the in vitro dissolution test were subjected to further in vitro evaluation via swelling and mucoadhesion assays, an antifungal activity test, attenuated total reflectance–Fourier transform infrared spectroscopy (ATR-FTIR), and thermal analysis. Results: It was shown that EUD formulations at concentrations of 5% and 6% provided enteric release, whereas ALG at 1.5% concentration exhibited a sustained, although not delayed, POS release profile. The optimal blended formulations (EAP15–EAP18), comprising 4% EUD with 1.5–2.0% ALG and either 1% or 4% POS, met the pharmacopoeia criteria for enteric dosage forms. Furthermore, these blends demonstrated the most favorable sustained-release profiles in the buffer phase, ranging from 2 to 3 h. The microparticles exhibited beneficial swelling and mucoadhesive properties, which are essential for prolonging contact with the intestinal mucosa; combined with antifungal properties. Conclusions: Obtained carrier may provide a promising preliminary basis for developing a multi-unit, sustained-release enteric dosage form for POS and future in vivo investigations. Full article

Background/Objectives: Oral health is an essential component of general health, particularly in hospitalized pediatric patients undergoing surgery. Hospitalization may disrupt oral hygiene routines and dietary habits, increasing the risk of oral health deterioration. This prospective observational study aims to develop a standardized oral care protocol for pediatric patients hospitalized for surgical procedures by evaluating changes in oral health status, oral hygiene practices, and dietary habits between hospital admission and discharge. Methods: Children aged 0–17 years undergoing surgery and hospitalized for at least three nights were enrolled. Clinical oral examinations and caregiver-administered questionnaires were performed at admission and at discharge. Oral health status, plaque accumulation, gingival condition, oral pain, hygiene behaviors, and dietary habits were assessed. Results: In total, 118 patients were included. During hospitalization, plaque accumulation significantly increased and oral hygiene practices worsened. Dietary habits changed, with fewer daily meals and a slight reduction in cariogenic food and beverage intake. Oral hygiene instructions or dental examinations were documented in only 2.5% of patients. Based on these observations, a protocol was developed targeting hospitalized patients, their families, and healthcare staff, with the aim of improving oral health conditions during hospitalization. Conclusions: Pediatric surgical hospitalization is associated with a deterioration in oral hygiene behaviors and increased plaque accumulation. The implementation of standardized protocols and the dissemination of preventive oral health knowledge may transform hospitalization into an opportunity to improve oral health in children and adolescents. Full article

Dysphagia and age-related oral processing limitations are rising with population aging and the growing burden of neurological diseases. Texture-modified diets remain the most common non-pharmacological intervention, yet conventional pureeing and thickening often yield meals with low visual appeal, variable textures, and diluted nutrient density, which contribute to reduced intake and malnutrition risk. Extrusion-based three-dimensional food printing, especially when combined with gel-derived edible inks, offers a digital route to standardize geometry, portioning, and texture while enabling individualized nutrition and sensory design. In the past three years, the field has progressed from simple single-ingredient pastes to engineered soft-matter systems including emulsion gels, high-internal-phase emulsion gels, Pickering-stabilized gels, bigels, and multi-material constructs enabled by dual and coaxial printing. These advances are underpinned by improved rheological windowing, microstructure engineering, and post-print gelation strategies such as ionic crosslinking, thermal setting, enzymatic bridging, and pH-triggered network formation. Meanwhile, dysphagia-oriented product development has matured from “shape recovery” demonstrations toward clinically relevant texture targets, leveraging the IDDSI tests to anchor swallowability. This review synthesizes the recent literature across materials science, food engineering, and clinical nutrition to connect gel microstructure to extrusion performance, post-processing stability, and oral processing outcomes that are relevant to older adults and dysphagia patients. We propose design principles for gel network selection, phase structuring, and process control that simultaneously satisfy print fidelity and swallowing safety targets. Full article

Background: Gestational diabetes mellitus (GDM) affects many pregnancies worldwide and is associated with adverse maternal and fetal outcomes. Current screening at 24–28 weeks limits opportunities for early intervention. We evaluated whether machine learning (ML) models using first-trimester clinical and dietary data can predict GDM risk before the standard oral glucose tolerance test. Methods: We analyzed data from 797 pregnant women enrolled in the BORN2020 prospective cohort study (Thessaloniki, Greece). Ten ML algorithms were evaluated across five class-imbalance handling strategies using stratified 5-fold cross-validation, with final evaluation on an independent 20% held-out test set. Features included maternal demographics, obstetric history, lifestyle factors, and 22 dietary micronutrient intakes from the pre-pregnancy period assessed by Food Frequency Questionnaire. Results: The best-performing model (Logistic Regression without resampling) achieved an AUC-ROC of 0.664 (95% CI: 0.542–0.777), with sensitivity of 0.783 and NPV of 0.932 at the pre-specified threshold. The high NPV should be interpreted in the context of the low GDM prevalence (14.7%), as NPV is mathematically dependent on disease prevalence. A reduced nine-feature model using only routine clinical and demographic variables achieved a numerically higher AUC of 0.712 (95% CI: 0.589–0.825), with overlapping confidence intervals, indicating that detailed FFQ-derived micronutrient data did not improve prediction. Maternal age and pre-pregnancy BMI were the strongest individual predictors by SHAP analysis. No model reached the AUC >0.80 threshold for good discrimination. Substantial miscalibration was observed (slope: 0.56; intercept: −1.83), limiting use for absolute risk estimation. Conclusions: This exploratory study demonstrates that first-trimester ML models achieve modest discriminative ability for early GDM prediction, with routine clinical variables performing comparably to models incorporating detailed dietary assessment. These findings should be interpreted with caution, as no external validation cohort was available and the low events-per-variable ratio (~3.8) constrains the reliability of individual model estimates. Substantial miscalibration further limits use for absolute risk estimation. Accordingly, these models should be regarded as exploratory risk-ranking tools only and require external validation and recalibration before any clinical implementation. Full article

While various disturbances in organisms have been reported following long-term oral exposure to small plastic particles (microplastic particles, MPs), the effects of acute, short-term encounters remain underrepresented in scientific research. In this study, adult male Wistar rats were orally gavaged with MPs of three different sizes (~41 µm, 70 µm, or 106 µm; dose: 35 mg/kg), originating from poly(ethylene terephthalate) (PET) bottles. Twenty-four hours post-exposure, the impact on overall health indicators, including food and water intake, sensorimotor function and clinical signs of toxicity, in addition to serum biochemical markers related to organ function and oxidative stress, were assessed. Although no overt sensorimotor impairments or visible toxicity signs were observed in all MPs-treated groups, several investigated biochemical parameters were significantly altered. Water intake was also modified, whereas reduced food intake occurred only in the group treated with median-sized MPs, suggesting that acute exposure to MPs can lead to early physiological and biochemical responses. The obtained results, compared to the data extracted by using machine-learning (ML) tools and GPT-5 model within the available literature, highlighted the importance of investigating the acute effects of MPs, which may precede or contribute to long-term health consequences. Full article

This study investigates the systemic effects of amoxicillin and tetracycline on healthy Mus musculus (Swiss albino) mice, focusing on food intake, body weight, and hematological parameters. Over a 14-day oral treatment period, both antibiotics significantly reduced weight gain and food efficiency, with sex-specific variations: tetracycline had stronger metabolic effects in males, while amoxicillin was more impactful in females. To explore underlying mechanisms, molecular docking and MM-GBSA analyses were performed on PPAR-γ and TLR2–TIRAP complexes. Both antibiotics showed negligible binding to PPAR-γ, suggesting their metabolic effects are not receptor-mediated. In contrast, tetracycline exhibited strong and stable binding to TLR2 (ΔG_bind = −27.87 kcal/mol), supported by extensive hydrogen bonding, implying potential immunomodulatory action. These findings suggest that antibiotic-induced metabolic and immune alterations are more likely driven by microbiota disruption and innate immune signaling, rather than direct metabolic receptor engagement. Full article

Background/Objectives: Older adults living in long-term care facilities (LTCFs) are at high risk of undernutrition. This study evaluated the adequacy of planned energy intake (PEI) by comparing prescribed diets with individual requirements measured using indirect calorimetry (IC) and by modelling how different levels of food consumption affect energy adequacy. Methods: In this cross-sectional study, 169 adults aged ≥ 65 years living in LTCFs underwent anthropometric assessment and IC-based measurement of resting energy expenditure. Total energy expenditure (TEE) was derived using activity-specific PAL factors. PEI was calculated from 7-day menu records (oral diets) or enteral feeding prescriptions. Scenario analyses assumed intake levels from 100% to 50% of PEI and applied BMI-specific adequacy thresholds. Results: Mean TEE was 1447 ± 359 kcal/day (25 ± 6 kcal/kg), whereas mean PEI was 1999 ± 400 kcal/day, yielding an average surplus of 552 ± 496 kcal/day and a TEE/PEI ratio of 0.76. PEI did not differ across sex, BMI, or activity groups despite significant differences in measured TEE. Individuals receiving enteral nutrition demonstrated close agreement between intake and expenditure. Fewer than half of residents consumed > 75% of their served portion, about one third consumed 51–75%, and approximately one fifth consumed ≤ 50%, based on caregiver reports. Scenario modelling showed that the proportion of adults meeting adequacy criteria remained relatively stable at intake levels of 100–70% of PEI but declined significantly below 70%. Conclusions: Planned dietary energy provision exceeded measured requirements, yet underweight remained frequent, indicating a gap between prescribed and consumed energy. Monitoring actual intake and adjusting provision to individual needs are essential in LTCFs. Full article

Avoidant/restrictive food intake disorder (ARFID) is an eating disorder characterized by persistent restriction or avoidance of food intake leading to clinically significant nutritional, medical, and/or psychosocial consequences, without associated body-image disturbance. Although historically described in pediatric populations, ARFID is increasingly recognized in adults, particularly among patients with gastrointestinal (GI) disorders. Emerging data demonstrate a strong bidirectional relationship between ARFID and GI disease—especially disorders of gut–brain interaction—where fear of GI symptoms commonly drives restrictive eating, and chronic undernutrition may worsen GI motility, visceral sensitivity, and symptom severity, reinforcing a self-perpetuating cycle. Despite growing recognition of ARFID in adult gastroenterology patients, evidence guiding nutritional management and the use of nutrition support therapies in this population remains limited. This narrative review synthesizes the current literature on the epidemiology, clinical features, and nutritional consequences of ARFID in adults with GI disease, with a focus on screening and diagnostic considerations relevant to GI clinicians and principles of multidisciplinary management. Particular attention is given to the role of nutrition support therapies, including oral nutritional supplementation, enteral nutrition, and parenteral nutrition. While oral strategies are foundational to nutritional rehabilitation, available evidence supporting enteral or parenteral nutrition in adults with ARFID is sparse and largely extrapolated from pediatric or retrospective studies. Expert guidelines caution against routine or prolonged use of invasive nutrition support due to risks of reinforcing food avoidance, medical complications, and poor long-term outcomes, recommending their use only in carefully selected, medically necessary, and time-limited circumstances. Overall, ARFID represents an underrecognized but clinically significant contributor to malnutrition and symptom burden in adult patients with GI disorders, underscoring the need for routine screening, individualized multidisciplinary care, and high-quality prospective research to inform evidence-based treatment guidelines. Full article

Background: Rare sugar D-Allulose, a zero-calorie sweetener, markedly ameliorates obesity. It reportedly stimulates the release of endogenous glucagon-like peptide 1 (GLP-1) to activate vagal afferent and directly influences the neurons in hypothalamic arcuate nucleus (ARH), thus evoking vagal and central nervous routes. D-Allulose can now be produced substantially, being expected for diet therapy. Oral form GLP-1 receptor agonist (GLP-1RA), Oral semaglutide (O-Sema), without injection markedly ameliorates obesity. It evokes only central nervous route. Thus, these GLP-1-based substances utilize common/distinct routes, suggesting common/distinct effects on obesity and related disorders including sarcopenia. To address it, this study precisely compared their effects. Methods: O-Sema and D-Allulose were administered to diet-induced obese mice under identical conditions, equivalent doses, oral gavage, and food/water deprivation. Acute and sub-chronic effects on food intake, body weight and grip strength were measured. Results: Acutely, D-Allulose rapidly and O-Sema slowly reduced feeding. Sub-chronically, D-Allulose and O-Sema profoundly reduced food intake and weight in the early period (0–3 days) of treatment. The weight loss was diminished with O-Sema but maintained with D-Allulose in the late period (4–10 days) and after termination of treatment. D-Allulose and O-Sema increased muscle strength. Mechanistically, D-Allulose and semaglutide similarly activated anorexigenic leptin-responsive neurons while only D-Allulose significantly inhibited orexigenic ghrelin-responsive neurons in ARH. Conclusions: D-Allulose and O-Sema equally elicit weight reduction possibly via the central nervous route including ARH anorexigenic neuron activation. The weight loss is rebounded with O-Sema, while it is maintained with D-Allulose possibly via combined vagal afferent and central nervous routes including ARH orexigenic neuron inhibition. Their optimal use potentially provides precise control of obesity and related disorders. Full article

Background/Objectives: The consumption of ultra-processed foods (UPFs) has increased markedly in recent decades and has been associated with adverse health outcomes. In childhood, the family environment plays a central role in shaping dietary habits and oral health behaviors. This study investigated the association between UPF consumption by caregivers and children, its relationship with caregivers’ periodontal health-related quality of life, and described children’s dietary practices and oral hygiene habits. Methods: This cross-sectional study was conducted with caregivers of children participating in the Happy Smile Project in Birigui, São Paulo, Brazil. UPF consumption was assessed using a questionnaire based on the NOVA classification, and periodontal health-related quality of life was evaluated using the OHIP-14-PD. Results: A high frequency of UPF consumption was observed among both caregivers and children. Children whose caregivers had high UPF consumption were more likely to also present high consumption (OR = 9.96; 95% CI: 5.38–18.44; p < 0.001). Higher caregiver education was associated with lower odds of high UPF consumption among children. Children in the high-consumption group were older and showed higher consumption of sweetened milk beverages (p < 0.001). Risk behaviors for oral health, such as nighttime use of sweetened bottles and absence of toothbrushing afterward, were frequently reported. Regarding periodontal health-related quality of life, only the physical disability domain showed significantly higher scores among caregivers with high UPF consumption (p = 0.014). Conclusions: This study demonstrated that high consumption of ultra-processed foods by caregivers significantly increased the odds of children’s consumption and was associated with a greater negative impact on caregivers’ periodontal health-related quality of life, specifically in the physical disability domain. In addition, children exhibited a high frequency of oral health-damaging behaviors. These findings highlight the importance of family-centered strategies aimed at reducing the intake of ultra-processed foods and promoting healthier dietary and oral health behaviors. Full article