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Protein Consumption and Personalized Nutrition in CKD: A Comprehensive Review.
IF 5.1 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-17 DOI: 10.1017/S0954422425000022
Sami Alobaidi

Chronic Kidney Disease (CKD) poses a global health challenge, with dietary protein intake being a key factor in disease management. This review synthesizes evidence on the impact of different protein intake strategies, including low-protein diet (LPD), very low-protein diet (VLPD), high-protein diet (HPD), and plant-based diet (PBD), on CKD progression and patient outcomes. The review explores personalised nutrition strategies and identifies gaps in the literature. A systematic search of PubMed, Cochrane Library, Web of Science, and Scopus was conducted, covering studies published from 1982 to 2024, including randomized controlled trials (RCTs), observational studies, and meta-analyses involving adult CKD patients. The findings suggest that LPDs and VLPDs may slow CKD progression, particularly when supplemented with ketoanalogues, but adherence and long-term benefits remain uncertain. PBDs are associated with reduced renal burden and improved metabolic health, although achieving adequate protein intake from plant sources requires careful planning. HPDs, particularly those rich in animal protein, may exacerbate CKD progression, although recent research indicates that higher protein intake may benefit specific populations, such as older adults with mild to moderate CKD. In conclusion, managing protein intake in CKD is complex and necessitates a personalised approach. While LPD and PBD offer potential benefits, their long-term success is contingent upon patient adherence, individualized dietary management, and further research into their sustained effects. Future research should focus on long-term RCTs and the development of personalised nutrition strategies incorporating emerging technologies and multidisciplinary care to optimise CKD management.

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引用次数: 0
Digging deep for nutrients and metabolites derived from high dietary protein intake and their potential functions in metabolic health. 深入挖掘来自高膳食蛋白质摄入的营养素和代谢物及其在代谢健康中的潜在功能。
IF 5.1 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-12-13 DOI: 10.1017/S0954422424000374
Sarah Gilsenan, Dara Leong, Paul D Cotter, Lorraine Brennan, Kanishka N Nilaweera

Intake of high quantities of dietary proteins sourced from dairy, meat or plants can affect body weight and metabolic health in humans. To improve our understanding of how this may be achieved, we reviewed the data related to the availability of nutrients and metabolites in the faeces, circulation and urine. All protein sources (≥20% by energy) increased faecal levels of branched-chain fatty acids and ammonia and decreased the levels of butyrate. Some metabolites responded to dairy and meat proteins (branched-chain amino acids) as well as dairy and plant proteins (p-cresol), which were increased in faecal matter. Specific to dairy protein intake, the faecal levels of acetate, indole and phenol were increased, whereas plant protein intake specifically increased the levels of kynurenine and tyramine. Meat protein intake increased the faecal levels of methionine, cysteine and alanine and decreased the levels of propionate and acetate. The metabolite profile in the faecal matter following dairy protein intake mirrored availability in circulation or urine. These findings provide an understanding of the contrasting gut versus systemic effects of different dietary proteins, which we know to show different physiological effects. In this regard, we provide directions to determining the mechanisms for the effects of different dietary proteins.

从乳制品、肉类或植物中摄入大量的膳食蛋白质会影响人类的体重和代谢健康。为了更好地理解这是如何实现的,我们回顾了与粪便、循环和尿液中营养物质和代谢物的可用性相关的数据。所有蛋白质来源(按能量计≥20%)均提高了粪便中支链脂肪酸和氨的水平,降低了丁酸盐的水平。粪便中有对乳和肉蛋白(支链氨基酸)以及乳和植物蛋白(对甲酚)有响应的代谢产物,这些代谢产物在粪便中增加。乳蛋白摄入增加了粪便中乙酸、吲哚和苯酚的含量,而植物蛋白摄入增加了犬尿氨酸和酪胺的含量。肉类蛋白质的摄入增加了粪便中蛋氨酸、半胱氨酸和丙氨酸的水平,降低了丙酸和乙酸的水平。摄入乳蛋白后粪便中的代谢物反映了血液循环或尿液中的可利用性。这些发现提供了不同膳食蛋白质对肠道和系统的不同影响的理解,我们知道它们表现出不同的生理影响。在这方面,我们为确定不同膳食蛋白质的作用机制提供了方向。
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引用次数: 0
A scoping review of the impact of Food Policy Groups on local food systems in high-income countries. 对高收入国家粮食政策小组对当地粮食系统影响的范围审查。
IF 5.1 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-12-01 Epub Date: 2023-09-05 DOI: 10.1017/S0954422423000173
Stephanie Louise Godrich, Jess Doe, Sarah Goodwin, Laura Alston, Katherine Kent

This scoping review aimed to explore international evidence on the impact of Food Policy Groups (FPGs) on local food systems, in urban and rural regions of high-income countries. Peer-reviewed and grey literature were searched to identify thirty-one documents published between 2002 and 2022 providing evidence on the impact of FPGs. Activities spanned domains including increasing food equity (e.g. strengthening school meals programmes); increasing knowledge and/or demand for healthy food (e.g. food literacy programmes with children and adults); increasing food access (e.g. enhancing local food procurement); environmental sustainability (e.g. promoting low-waste food items on café menus); economic development (e.g. ensuring local businesses are not outperformed by large food distributors); and increasing food system resiliency (e.g. establishment of local produce schemes). Most FPGs reported conducting activities that positively influenced multiple food system domains and reported activities in urban areas, and to a lesser extent in rural areas. Our study highlighted a range of qualitative and quantitative evaluation strategies used to measure FPGs' impact on local food systems. Our recommendations focus on regular and systematic evaluation and research surrounding the impact of FPG activities, to build the evidence base of their impact. Ideally, evaluation would utilise comprehensive and established tools. We recommend exploring the establishment of FPGs across more regions of high-income countries, particularly rural areas, and forming partnerships between FPGs, local government and universities to maximise implementation and evaluation of activities.

这项范围界定审查旨在探索高收入国家城市和农村地区粮食政策小组对当地粮食系统影响的国际证据。对同行评审和灰色文献进行了检索,以确定2002年至2022年间发表的三十一份文件,这些文件提供了FPG影响的证据。活动涉及多个领域,包括提高粮食公平(例如加强学校供餐方案);增加对健康食品的知识和/或需求(例如针对儿童和成人的食品扫盲方案);增加粮食供应(例如加强当地粮食采购);环境可持续性(例如在咖啡馆菜单上推广低浪费食品);经济发展(例如,确保当地企业不会被大型食品分销商超越);以及提高粮食系统的弹性(例如建立当地生产计划)。大多数FPG报告称开展的活动对多个粮食系统领域产生了积极影响,并报告了城市地区的活动,农村地区的活动程度较低。我们的研究强调了一系列用于衡量FPG对当地粮食系统影响的定性和定量评估策略。我们的建议侧重于围绕FPG活动的影响进行定期和系统的评估和研究,以建立其影响的证据基础。理想情况下,评估将利用全面和既定的工具。我们建议探索在高收入国家的更多地区,特别是农村地区建立FPG,并在FPG、地方政府和大学之间建立伙伴关系,以最大限度地实施和评估活动。
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引用次数: 0
Bringing down barriers to children's healthy eating: a critical review of opportunities, within a complex food system. 降低儿童健康饮食的障碍:在复杂的食品系统中对机会的批判性审查。
IF 5.1 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-12-01 Epub Date: 2023-09-25 DOI: 10.1017/S0954422423000203
Paula Varela, Sofia De Rosso, Andreia Ferreira Moura, Martina Galler, Kaat Philippe, Abigail Pickard, Tija Rageliene, Julia Sick, Roselinde van Nee, Valérie L Almli, Gastón Ares, Alice Grønhøj, Sara Spinelli, Ellen van Kleef

This narrative review revises the scientific evidence of recent years on healthy eating in children and adolescents, making sense of promising avenues of action, from a food system perspective. A conceptual framework is provided to better understand how eating habits of children and adolescents are shaped to identify key multisectoral approaches that should be implemented to promote healthier diets. The following influencing factors are discussed: individual factors (physiological and psychological factors, food preferences and food literacy competencies), factors within the personal and socio-cultural food environments, external food environments, and the supply chain. In each section, the main barriers to healthy eating are briefly discussed focussing on how to overcome them. Finally, a discussion with recommendations of actions is provided, anchored in scientific knowledge, and transferable to the general public, industry, and policymakers. We highlight that multidisciplinary approaches are not enough, a systems approach, with a truly holistic view, is needed. Apart from introducing systemic changes, a variety of interventions can be implemented at different levels to foster healthier diets in children through fostering healthier and more sustainable food environments, facilitating pleasurable sensory experiences, increasing their food literacy, and enhancing their agency by empowering them to make better food related decisions. Acknowledging children as unique individuals is required, through interpersonal interactions, as well as their role in their environments. Actions should aim to enable children and adolescents as active participants within sustainable food systems, to support healthier dietary behaviours that can be sustained throughout life, impacting health at a societal level.

这篇叙述性综述从食品系统的角度,修订了近年来关于儿童和青少年健康饮食的科学证据,为有希望的行动途径提供了意义。提供了一个概念框架,以更好地了解儿童和青少年的饮食习惯是如何形成的,从而确定应采取的关键多部门方法,以促进更健康的饮食。讨论了以下影响因素:个人因素(生理和心理因素、食物偏好和食物识字能力)、个人和社会文化食物环境内的因素、外部食物环境和供应链。在每一节中,都简要讨论了健康饮食的主要障碍,重点是如何克服这些障碍。最后,提供了以科学知识为基础的讨论和行动建议,并可向公众、行业和政策制定者传播。我们强调,仅仅采用多学科的方法是不够的,需要一种具有真正整体观点的系统方法。除了引入系统性变革外,还可以在不同层面实施各种干预措施,通过培养更健康、更可持续的食物环境,促进愉悦的感官体验,提高他们的食物素养,并通过授权他们做出更好的食物相关决策来增强他们的能动性,从而促进儿童的健康饮食。需要通过人际互动以及儿童在环境中的作用,承认儿童是独特的个体。行动应旨在使儿童和青少年成为可持续粮食系统的积极参与者,支持可以在一生中持续的更健康的饮食行为,影响社会层面的健康。
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引用次数: 0
Exploring potential mechanisms for zinc deficiency to impact in autism spectrum disorder: a narrative review. 探索锌缺乏对自闭症谱系障碍影响的潜在机制:叙述性综述。
IF 5.1 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-12-01 Epub Date: 2023-09-20 DOI: 10.1017/S0954422423000215
M V Conti, S Santero, A Luzzi, H Cena

Autism spectrum disorder (ASD) is a heterogeneous and complex group of life-long neurodevelopmental disorders. How this clinical condition impacts an individual's intellectual, social and emotional capacities, contributing to alterations in the proprioceptive and sensory systems and increasing their selective attitude towards food, is well described in the literature. This complex condition or status exposes individuals with ASD to an increased risk of developing overweight, obesity and non-communicable diseases compared with the neurotypical population. Moreover, individuals with ASD are characterised by higher levels of inflammation, oxidative stress markers and intestinal dysbiosis. All these clinical features may also appear in zinc deficiency (ZD) condition. In fact, zinc is an essential micronutrient for human health, serving as a structural, catalytic and regulatory component in numerous physiological processes. The aim of this narrative review is to explore role of ZD in ASD. Factors affecting zinc absorption, excretion and dietary intake in this vulnerable population are taken into consideration. Starting from this manuscript, the authors encourage future research to investigate the role of ZD in ASD. The perspective is to potentially find another missing piece in the 'ASD clinical puzzle picture' to improve the health status of these individuals.

自闭症谱系障碍(ASD)是一组异质而复杂的终身神经发育障碍。这种临床状况如何影响个体的智力、社会和情感能力,导致本体感觉和感觉系统的改变,并增加他们对食物的选择性态度,在文献中有很好的描述。与神经正常人群相比,这种复杂的情况或状态使ASD患者患超重、肥胖和非传染性疾病的风险增加。此外,ASD患者的特征是炎症、氧化应激标志物和肠道微生态失调水平较高。所有这些临床特征也可能出现在缺锌(ZD)的情况下。事实上,锌是人类健康所必需的微量营养素,在许多生理过程中起着结构、催化和调节作用。这篇叙述性综述的目的是探讨ZD在ASD中的作用。考虑了影响这一弱势群体锌吸收、排泄和饮食摄入的因素。从这份手稿开始,作者鼓励未来的研究来调查ZD在ASD中的作用。从这个角度来看,有可能在“ASD临床拼图”中找到另一块缺失的东西,以改善这些人的健康状况。
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引用次数: 0
Nutritional practices to manage menstrual cycle related symptoms: a systematic review. 管理月经周期相关症状的营养实践:一项系统综述。
IF 8.3 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-12-01 Epub Date: 2023-09-25 DOI: 10.1017/S0954422423000227
Natalie Brown, Daniel Martin, Mark Waldron, Georgie Bruinvels, Lucy Farrant, Ruth Fairchild

Certain nutritional practices may reduce menstrual-related symptoms, but there is no current consensus on what foods/supplements are sufficiently evidenced to warrant promotion to reduce menstrual symptoms of naturally menstruating individuals. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two online databases were searched for published experimental studies that investigated the effects of foods/supplements on menstrual-related symptoms in eumenorrhoeic women. Extracted data and study characteristics were tabulated and grouped on the basis of food/supplement intervention and dosage compared with UK dietary reference values (DRV) and safe upper limits. In total, twenty-eight studies and twenty-one different foods/supplement interventions were included in the review. None of the studies reported a negative effect on symptoms, twenty-three reported a positive effect and five had no effect. Eighteen different ways of measuring menstrual-related symptoms were described across the studies. The results indicate a lack of consistency in studies to confidently provide information to eumenorrheic, naturally menstruating women regarding the use of foods/supplements to reduce menstrual symptoms. Determination of menstrual-related symptoms varied along with dose and duration of food or supplements provided. These data provide some evidence for the use of vitamin D, calcium, zinc and curcumin to reduce menstrual-related symptoms of non-hormonal contraceptive users, on an individual basis; however, further investigation is required prior to implementation with a focus on robust protocols to determine and measure changes in menstrual symptoms, with interventions adhering to DRV and safe upper limits.

某些营养实践可能会减少月经相关症状,但目前还没有达成共识,即哪些食物/补充剂有足够的证据证明有必要推广,以减少自然月经来潮者的月经症状。本综述遵循了系统评价和荟萃分析(PRISMA)指南的首选报告项目。在两个在线数据库中搜索了已发表的实验研究,这些研究调查了食物/补充剂对月经异常女性月经相关症状的影响。根据与英国饮食参考值(DRV)和安全上限相比的食品/补充剂干预和剂量,将提取的数据和研究特征制成表格并分组。共有28项研究和21种不同的食品/补充剂干预措施被纳入审查。没有一项研究报告对症状有负面影响,23项报告有正面影响,5项没有影响。研究中描述了18种不同的测量月经相关症状的方法。研究结果表明,研究缺乏一致性,无法自信地向月经正常、自然来潮的女性提供关于使用食物/补充剂来减轻月经症状的信息。月经相关症状的确定随着所提供食物或补充剂的剂量和持续时间而变化。这些数据为使用维生素D、钙、锌和姜黄素在个体基础上减少非激素避孕药使用者的月经相关症状提供了一些证据,但在实施之前需要进一步调查,重点是确定和测量月经症状变化的有力方案,干预措施应遵守DRV和安全上限。
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引用次数: 0
Moringa induces its beneficial effect via hormesis. 辣木通过刺激作用诱导其有益作用。
IF 5.1 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-12-01 Epub Date: 2023-09-04 DOI: 10.1017/S0954422423000161
Edward J Calabrese, Gaurav Dhawan, Rachna Kapoor, Evgenios Agathokleous, Vittorio Calabrese

Moringa oleifera, a traditional Indian herb, is widely known for its capacity to induce antioxidant, anti-inflammatory and other chemoprotective effects in a broad range of biomedical models. These perspectives have led to an extensive number of studies using various moringa extracts to evaluate its capacity to protect biological systems from oxidative stress and to explore whether it could be used to slow the onset of numerous age-related conditions and diseases. Moringa extracts have also been applied to prevent damage to plants from oxidative and saline stresses, following hormetic dose–response patterns. The present paper provides the first integrated and mechanistically based assessment showing that moringa extracts commonly induce hormetic dose responses and that many, perhaps most, of the beneficial effects of moringa are due to its capacity to act as an hormetic agent.

辣木是一种传统的印度草本植物,因其在广泛的生物医学模型中诱导抗氧化、抗炎和其他化学保护作用而广为人知。这些观点导致了大量使用各种辣木提取物的研究,以评估其保护生物系统免受氧化应激的能力,并探索其是否可用于减缓许多与年龄相关的疾病的发作。辣木提取物也被应用于防止氧化和生理盐水胁迫对植物的损害,遵循激素的剂量-反应模式。本论文提供了第一个基于机制的综合评估,表明辣木提取物通常会诱导刺激剂量反应,辣木的许多有益效果,也许是大多数,是由于其作为刺激剂的能力。
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引用次数: 0
Who consumes ultra-processed food? A systematic review of sociodemographic determinants of ultra-processed food consumption from nationally representative samples. 谁食用超加工食品?从具有全国代表性的样本中对超加工食品消费的社会人口决定因素进行系统审查。
IF 5.1 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-12-01 Epub Date: 2023-10-31 DOI: 10.1017/S0954422423000240
Samuel J Dicken, Sulmaaz Qamar, Rachel L Batterham

Ultra-processed food (UPF) intake is associated with increased non-communicable disease risks. However, systematic reports on sociodemographic predictors of UPF intake are lacking. This review aimed to understand UPF consumption based on sociodemographic factors, using nationally representative cohorts. The systematic review was pre-registered (PROSPERO:CRD42022360199), following PRISMA guidelines. PubMed/MEDLINE searches (‘ultra-processed/ultraprocessed’ and ‘ultra-processing/ultraprocessing’) until 7 September 2022 retrieved 1131 results. Inclusion criteria included: observational, nationally representative adult samples, in English, in peer-reviewed journals, assessing the association between sociodemographics and individual-level UPF intake defined by the NOVA classification. Exclusion criteria included: not nationally representative, no assessment of sociodemographics and individual-level UPF intake defined by NOVA. Risk of bias was assessed using the Newcastle–Ottawa Scale (NOS). Fifty-five papers were included, spanning thirty-two countries. All thirteen sociodemographic variables identified were significantly associated with UPF intake in one or more studies. Significant differences in UPF intake were seen across age, race/ethnicity, rural/urbanisation, food insecurity, income and region, with up to 10–20% differences in UPF intake (% total energy). Higher UPF intakes were associated with younger age, urbanisation and being unmarried, single, separated or divorced. Education, income and socioeconomic status showed varying associations, depending on country. Multivariate analyses indicated that associations were independent of other sociodemographics. Household status and gender were generally not associated with UPF intake. NOS averaged 5·7/10. Several characteristics are independently associated with high UPF intake, indicating large sociodemographic variation in non-communicable disease risk. These findings highlight significant public health inequalities associated with UPF intake, and the urgent need for policy action to minimise social injustice-related health inequalities.

超加工食品(UPF)的摄入与非传染性疾病风险的增加有关。然而,缺乏关于UPF摄入的社会人口学预测因素的系统报告。这篇综述旨在利用具有全国代表性的队列,了解基于社会人口因素的UPF消费。系统审查是按照PRISMA指南预先注册的(PROSPERO:CDR42022360199)。PubMed/MEDLINE搜索(“超处理/超处理”和“超处理”)至2022年9月7日检索到1131个结果。纳入标准包括:观察性的、具有全国代表性的成人样本,英文,发表在同行评审期刊上,评估社会人口统计学与NOVA分类定义的个人UPF摄入量之间的关系。排除标准包括:没有全国代表性,没有对NOVA定义的社会人口统计和个人水平UPF摄入量进行评估。使用纽卡斯尔-渥太华量表(NOS)评估偏倚风险。收录了55篇论文,涉及32个国家。在≥1项研究中,所有13个社会人口学变量均与UPF摄入量显著相关。UPF摄入量在年龄、种族/民族、农村/城市化、粮食不安全、收入和地区之间存在显著差异,UPF摄入量(%总能量)差异高达10-20%。UPF摄入量较高与年龄较小、城市化以及未婚、单身、分居或离婚有关。教育、收入和社会经济地位之间的关系因国家而异。多变量分析表明,这些关联与其他社会人口统计数据无关。家庭状况和性别通常与UPF的摄入无关。NOS平均5.7/10。几个特征与高UPF摄入量独立相关,表明非传染性疾病风险的社会人口统计学差异很大。这些发现突出了与UPF摄入相关的重大公共卫生不平等,以及迫切需要采取政策行动,最大限度地减少与社会不公正相关的健康不平等。
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引用次数: 0
The impact of botanical fermented foods on metabolic syndrome and type 2 diabetes: a systematic review of randomised controlled trials. 植物发酵食品对代谢综合征和2型糖尿病的影响:随机对照试验的系统综述。
IF 8.3 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-12-01 Epub Date: 2023-10-26 DOI: 10.1017/S0954422423000252
Miin Chan, Nadja Larsen, Helen Baxter, Lene Jespersen, Elif I Ekinci, Kate Howell

Our systematic review assessed the impact of botanical fermented food (BFF) consumption on glucose, lipid, anthropometric, inflammatory and gut microbiota parameters, in adults with metabolic syndrome (MetS), MetS components or type 2 diabetes mellitus (T2DM). Embase, MEDLINE, Cochrane CENTRAL and Google Scholar were searched with no language limits, from inception to 31 August 2022, for eligible randomised controlled trials (RCTs). Two independent reviewers screened 6873 abstracts and extracted relevant data. Risk of bias (ROB) was assessed using the Cochrane Collaboration's ROB2 tool. The final review included twenty-six RCTs, with thirty-one reports published between 2001 and 2022. Significant (p < 0·05) within-group and between-group changes in cardiometabolic outcome means were reported in twenty-three and nineteen studies, respectively. Gut microbiota composition was assessed in four studies, with two finding significant between-group differences. No significant difference between groups of any measured outcomes was observed in five studies. There were fourteen studies at low ROB; ten were of some concern; and two were at high ROB. In 73% of included studies, BFF consumption by participants with obesity, MetS or T2DM led to significant between-group improvements in discrete cardiometabolic outcomes, including fasting blood glucose, lipid profile, blood pressure, waist circumference, body fat percentage and C-reactive protein. BFF consumption increased the abundance of beneficial gut bacteria, such as Bifidobacterium and LAB, whilst reducing potential pathogens such as Bacteroides. To determine the clinical significance of BFFs as therapeutic dietary adjuncts, their safety, tolerability and affordability must be balanced with the limited power and magnitude of these preliminary findings.

我们的系统综述评估了食用植物发酵食品(BFF)对患有代谢综合征(MetS)、代谢综合征成分或2型糖尿病(T2DM)的成年人的葡萄糖、脂质、人体测量、炎症和肠道微生物群参数的影响。从开始到2022年8月31日,Embase、MEDLINE、Cochrane CENTRAL和Google Scholar在没有语言限制的情况下进行了搜索,以获得符合条件的随机对照试验(RCT)。两位独立评审员筛选了6873篇摘要,并提取了相关数据。使用Cochrane Collaboration的ROB2工具评估偏倚风险(ROB)。最终审查包括26项随机对照试验,2001年至2022年间发表了31份报告。显著(pBifidobacterium和LAB,同时减少拟杆菌等潜在病原体。为了确定BFFs作为治疗性膳食辅料的临床意义,必须将其安全性、耐受性和可负担性与这些初步发现的有限力量和规模相平衡。
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引用次数: 0
The role of diet in the management of psoriasis: a scoping review. 饮食在银屑病治疗中的作用:范围界定综述。
IF 5.1 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-12-01 Epub Date: 2023-09-20 DOI: 10.1017/S0954422423000185
Poppy Hawkins, Kate Earl, Thanasis G Tektonidis, Rosalind Fallaize

Psoriasis is a chronic, systemic, immune-mediated, inflammatory skin disease associated with significant comorbidities. Globally, there are an estimated 60 million people living with psoriasis (PLwP). There is a growing body of evidence on the role of diet in psoriasis management, and demand for dietary advice is high. However, there are no specific, evidence-based dietary guidelines. This scoping review summarises the literature on use and effectiveness of diet in the management of psoriasis to improve understanding of the evidence and assist PLwP and healthcare professionals (HCPs) to discuss diet. The findings were categorised into three themes: (1) dietary intakes of PLwP, (2) the perceived role of diet in psoriasis management and (3) dietary approaches to manage psoriasis symptoms. In cross-sectional studies PLwP were reported to have higher fat and lower fibre intakes compared with controls, and lower psoriasis severity was associated with higher fibre intake. However, research is limited. PLwP perceive diet to have an impact on symptoms and make dietary modifications which are often restrictive. Systematic reviews and RCTs found certain dietary approaches improved symptoms, but only in specific populations (e.g. PLwP with obesity and PLwP with coeliac disease), and evidence for supplement use is inconclusive. The grey literature provides limited guidance to PLwP; focusing on weight loss and associated comorbidities. Larger, controlled trials are required to determine dietary approaches for psoriasis management, especially in PLwP without obesity and non-coeliac PLwP. Further understanding of diet modification, information acquisition and experiences among PLwP will enhance holistic care for psoriasis management.

银屑病是一种慢性、全身性、免疫介导的炎症性皮肤病,伴有严重的合并症。在全球范围内,估计有6000万人患有银屑病(PLwP)。越来越多的证据表明饮食在银屑病管理中的作用,对饮食建议的需求也很高。然而,没有具体的、基于证据的饮食指南。本范围综述总结了有关银屑病治疗中饮食的使用和有效性的文献,以提高对证据的理解,并帮助PLwP和医疗保健专业人员(HCP)讨论饮食。研究结果分为三个主题:(1)PLwP的饮食摄入,(2)饮食在银屑病管理中的感知作用,以及(3)管理银屑病症状的饮食方法。在横断面研究中,据报道,与对照组相比,PLwP的脂肪和纤维摄入量较高,银屑病严重程度较低与纤维摄入量较高有关。然而,研究是有限的。PLwP认为饮食会对症状产生影响,并进行饮食调整,这通常是限制性的。系统综述和随机对照试验发现,某些饮食方法可以改善症状,但仅限于特定人群(例如,患有肥胖症的PLwP和患有腹腔疾病的PLwP),补充剂使用的证据尚不确定。灰色文献对PLwP提供了有限的指导;重点关注减肥和相关的合并症。需要更大规模的对照试验来确定银屑病治疗的饮食方法,特别是在没有肥胖和非腹腔PLwP的PLwP中。进一步了解PLwP的饮食调整、信息获取和经验将加强银屑病管理的整体护理。
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Nutrition Research Reviews
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