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19 pages, 1251 KiB

Open AccessArticle

A Starch- and Sucrose-Reduced Diet in Irritable Bowel Syndrome Leads to Lower Circulating Levels of PAI-1 and Visfatin: A Randomized Controlled Study

by Bodil Roth, Julia Myllyvainio, Mauro D’Amato, Ewa Larsson and Bodil Ohlsson

Nutrients 2022, 14(9), 1688; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14091688 - 19 Apr 2022

Cited by 3 | Viewed by 2235

Abstract

Irritable bowel syndrome (IBS) is characterized by gastrointestinal symptoms. Overweight and increased risk of metabolic syndromes/diabetes are observed in IBS, conditions associated with plasminogen activator inhibitor-1 (PAI-1) and visfatin. The aim of this study was to measure blood levels of AXIN1, cholecystokinin (CCK), [...] Read more.

Irritable bowel syndrome (IBS) is characterized by gastrointestinal symptoms. Overweight and increased risk of metabolic syndromes/diabetes are observed in IBS, conditions associated with plasminogen activator inhibitor-1 (PAI-1) and visfatin. The aim of this study was to measure blood levels of AXIN1, cholecystokinin (CCK), enkephalin, ghrelin, neuropeptide Y (NPY), PAI-1, and visfatin before and after a 4-week intervention with a starch- and sucrose-reduced diet (SSRD). A total of 105 IBS patients were randomized to either SSRD (n = 80) or ordinary diet (n = 25). Questionnaires were completed, and blood was analyzed for AXIN1 and hormones. AXIN1 (p = 0.001) and active ghrelin levels (p = 0.025) were lower in IBS than in healthy volunteers at baseline, whereas CCK and enkephalin levels were higher (p < 0.001). In the intervention group, total IBS-symptom severity score (IBS-SSS), specific gastrointestinal symptoms, psychological well-being, and the influence of intestinal symptoms on daily life were improved during the study, and weight decreased (p < 0.001 for all), whereas only constipation (p = 0.045) and bloating (p = 0.001) were improved in the control group. PAI-1 levels tended to be decreased in the intervention group (p = 0.066), with a difference in the decrease between groups (p = 0.022). Visfatin levels were decreased in the intervention group (p = 0.007). There were few correlations between hormonal levels and symptoms. Thus, this diet not only improves IBS symptoms but also seems to have a general health-promoting effect. Full article

(This article belongs to the Special Issue Gluten-Free Diet and Gastrointestinal Diseases)

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11 pages, 872 KiB

Open AccessArticle

Risk of Drop-Out from Follow-Up Evaluations for Celiac Disease: Is It Similar for All Patients?

by Francesco Tovoli, Chiara Faggiano, Alberto Raiteri, Alice Giamperoli, Teresa Catenaro, Vito Sansone, Dante Pio Pallotta and Alessandro Granito

Nutrients 2022, 14(6), 1223; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14061223 - 14 Mar 2022

Cited by 1 | Viewed by 1776

Abstract

Background: Celiac disease (CD) follow-up is a relatively underevaluated topic. However, correct adherence to follow-up procedures is central to the early recognition of complicated CD and other conditions typically associated with CD. Establishing whether patients at increased risk of complications follow clinicians’ recommendations [...] Read more.

Background: Celiac disease (CD) follow-up is a relatively underevaluated topic. However, correct adherence to follow-up procedures is central to the early recognition of complicated CD and other conditions typically associated with CD. Establishing whether patients at increased risk of complications follow clinicians’ recommendations has multiple repercussions. Methods: We retrospectively analyzed the records of patients consecutively diagnosed with CD in our outpatient clinic between January 2004 and October 2017 to investigate the factors associated with drop-out from follow-up procedures. Results: Among the 578 patients analyzed, 40 (6.9%) dropped out during the first six months and 272 (50.6%) during the observation period. The median time to drop-out was 7.4 years (95% confidence interval: 6.8–8.0). No factors were associated with early drop-out. Instead, age at diagnosis >40 years (40–59 years, p < 0.001; ≥60 years, p = 0.048) and classical clinical presentation (p = 0.016) were significantly associated with a lower risk of later drop-out. Conclusions: Patients at increased risk of complicated CD are more compliant with follow-up procedures than patients at lower risk, despite being prescribed the same controls. These results indirectly support the hypothesis of tailored follow-up strategies, differentiated according to the risk of complications. Full article

(This article belongs to the Special Issue Gluten-Free Diet and Gastrointestinal Diseases)

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11 pages, 275 KiB

Open AccessArticle

Clinical Manifestation and Diagnostic Process of Celiac Disease in Poland—Comparison of Pediatric and Adult Patients in Retrospective Study

by Emilia Majsiak, Magdalena Choina, Alastair M. Gray, Mariusz Wysokiński and Bożena Cukrowska

Nutrients 2022, 14(3), 491; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14030491 - 23 Jan 2022

Cited by 16 | Viewed by 3005

Abstract

The diagnosis of celiac disease (CD) may be delayed due to non-specific clinical symptoms. The aim of the study was to evaluate the clinical manifestation and diagnostic process of CD in Polish children and adults. Methods: The members of the Polish Coeliac Society [...] Read more.

The diagnosis of celiac disease (CD) may be delayed due to non-specific clinical symptoms. The aim of the study was to evaluate the clinical manifestation and diagnostic process of CD in Polish children and adults. Methods: The members of the Polish Coeliac Society (n = 2500) were asked to complete a questionnaire on socio-demographic factors, clinical and diagnostic aspects of CD. The analysis was based on 796 responses from patients with confirmed CD diagnosis, and included 224 (28.1%) children and 572 (71.9%) adults. Results: The mean duration of symptoms prior to CD diagnosis in children was significantly shorter than in adults (p < 0.001), and amounted to 3.1 and 9 years respectively. The most frequent symptoms before CD diagnosis were abdominal pain and bloating in children (70.4%), and chronic fatigue in adults (74.5%). Although almost all CD patients claimed to strictly avoid gluten after CD diagnosis, symptoms were still present in the majority of these respondents. No comorbid diseases were reported by 29.8% of children and by 11.7% of adults (p < 0.001). Conclusions: the results indicate that CD diagnosis is delayed in Poland, especially in adults, and clinicians should be aware of the diversity in CD presentation. Full article

(This article belongs to the Special Issue Gluten-Free Diet and Gastrointestinal Diseases)

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9 pages, 1569 KiB

Open AccessArticle

Could I-FABP Be an Early Marker of Celiac Disease in Children with Type 1 Diabetes? Retrospective Study from the Tertiary Reference Centre

by Agnieszka Ochocińska, Marta Wysocka-Mincewicz, Artur Groszek, Anna Rybak, Ewa Konopka, Joanna Beata Bierła, Ilona Trojanowska, Mieczysław Szalecki and Bożena Cukrowska

Nutrients 2022, 14(3), 414; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14030414 - 18 Jan 2022

Cited by 2 | Viewed by 1723

Abstract

Patients with type 1 diabetes (T1D) are at higher risk of celiac disease (CD). Recently, intestinal fatty acid binding protein (I-FABP) has been shown to be a serological biomarker of impaired intestinal barrier in CD. Thus, the aim of this study was to [...] Read more.

Patients with type 1 diabetes (T1D) are at higher risk of celiac disease (CD). Recently, intestinal fatty acid binding protein (I-FABP) has been shown to be a serological biomarker of impaired intestinal barrier in CD. Thus, the aim of this study was to verify whether I-FABP could be an early marker of CD in pediatric T1D patients. I-FABP was measured in sera of patients with T1D (n = 156), active CD (n = 38), T1D with active CD (T1D-CD, n= 51), and age-matched healthy children (n = 55). Additionally, I-FABP was determined in T1D patients with negative CD serology at least one year before CD diagnosis (T1D-CD-1, n = 22), in CD patients on a gluten-free diet (CD-GFD, n = 36), and T1D-CD patients on GFD (T1D-CD-GFD, n = 39). Sera were tested using immunoenzymatic assay. Significantly increased levels of I-FABP were found in the T1D, active CD, and T1D-CD groups (1153 ± 665, 1104 ± 916, and 1208 ± 878, respectively) in comparison to healthy with controls (485 ± 416, p < 0.05). GFD induced a significant decrease in I-FABP levels in CD and T1D-CD groups (510 ± 492 and 548 ± 439, respectively). Interestingly, in T1D-CD-1 and T1D, I-FABP levels were comparable (833 ± 369 vs. 1153 ± 665), and significantly increased in relation to healthy controls and T1D-CD values on GFD. The results indicate that the epithelial barrier is disrupted in T1D patients independently of CD development; therefore, I-FABP cannot serve as an early marker of CD in T1D patients. Although GFD can improve epithelial recovery, the question remains as to whether GFD could exert beneficial effects on the intestinal barrier in early stages of T1D. Full article

(This article belongs to the Special Issue Gluten-Free Diet and Gastrointestinal Diseases)

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21 pages, 2576 KiB

Open AccessArticle

A Novel Sprouted Oat Fermented Beverage: Evaluation of Safety and Health Benefits for Celiac Individuals

by Natalia Aparicio-García, Cristina Martínez-Villaluenga, Juana Frias, Laura Crespo Perez, Cristina Fernández Fernández, Claudio Alba, Juan Miguel Rodríguez and Elena Peñas

Nutrients 2021, 13(8), 2522; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13082522 - 23 Jul 2021

Cited by 8 | Viewed by 2668

Abstract

The safety and health effects for celiac people of a novel beverage (SOFB) developed from sprouted oat flour by fermentation with Lactobacillus plantarum was explored. In vitro reactivity against anti-gliadin antibodies (AGA) and antioxidant/anti-inflammatory potential of SOFB in RAW 264.7 macrophages and Caco-2 [...] Read more.

The safety and health effects for celiac people of a novel beverage (SOFB) developed from sprouted oat flour by fermentation with Lactobacillus plantarum was explored. In vitro reactivity against anti-gliadin antibodies (AGA) and antioxidant/anti-inflammatory potential of SOFB in RAW 264.7 macrophages and Caco-2 cells were evaluated. Immunoreactivity against AGA and antioxidant activity were not detected in SOFB, but it exhibited significant anti-inflammatory activity. The tolerability and impact of SOFB consumption for 6 months on nutritional status and intestinal microbiota composition were investigated in 10 celiac adults (five treated and five control). SOFB consumption did not adversely affect duodenal mucosa nor the total IgA or anti-tissue transglutaminase antibody (IgA-tTG) levels in celiac participants, but it significantly decreased total cholesterol levels at all sampling times and folic acid levels at the end of the study compared to the placebo beverage. SOFB administration also shifted gut microbiota, leading to a higher relative abundance of some beneficial bacteria including the genera Subdoligranulum, Ruminococcus and Lactobacillus in the SOFB group. This study provides supporting evidence of the safety of health benefits of a novel functional beverage produced from sprouted oat. Full article

(This article belongs to the Special Issue Gluten-Free Diet and Gastrointestinal Diseases)

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11 pages, 752 KiB

Open AccessArticle

Assessing Health-Related Quality of Life in Children with Coeliac Disease: The Italian Version of CDDUX

by Marco Crocco, Angela Calvi, Paolo Gandullia, Federica Malerba, Anthea Mariani, Sonia Di Profio, Barbara Tappino and Stefano Bonassi

Nutrients 2021, 13(2), 485; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13020485 - 02 Feb 2021

Cited by 6 | Viewed by 2838

Abstract

We aimed to assess Health-Related Quality of Life (HRQoL) of Italian children and their parents with coeliac disease (CD) using the Coeliac Disease Dutch Questionnaire (CDDUX). The CDDUX underwent a cross-cultural adaptation in a multi-step process, according to international guidelines. A total of [...] Read more.

We aimed to assess Health-Related Quality of Life (HRQoL) of Italian children and their parents with coeliac disease (CD) using the Coeliac Disease Dutch Questionnaire (CDDUX). The CDDUX underwent a cross-cultural adaptation in a multi-step process, according to international guidelines. A total of 224 children aged between 8–18 years and their parents were prospectively recruited. Cronbach α coefficient was determined as a measure of internal consistency of the questionnaire and inter-children/parent reliability by intraclass correlation coefficient. Univariate and bivariate regression models were used to evaluate correlations between clinical variables and children and parents subclasses of CDDUX and overall mean Paediatric Quality of Life Inventory (PedsQL). The Italian CDDUX proved to be valid and reliable, mean CDDUX total score revealing a neutral evaluation of the quality of life in children 52.6 ± 17.2 and parents 49.5 ± 17.9 (p = 0.07) with strong correlation with PedsQL. The only clinical variable which appeared to affect significantly quality of life both in children and parents was the lower age. A comparison with our results showed remarkable differences in the HRQoL of populations of various nationalities. The Italian version of the CDDUX questionnaire is a simple and reliable tool for assessing the HRQoL in children and adolescents with CD. Full article

(This article belongs to the Special Issue Gluten-Free Diet and Gastrointestinal Diseases)

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Review

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14 pages, 320 KiB

Open AccessEditor’s ChoiceReview

Nutrition in Patients with Inflammatory Bowel Diseases: A Narrative Review

by Leda Roncoroni, Rachele Gori, Luca Elli, Gian Eugenio Tontini, Luisa Doneda, Lorenzo Norsa, Marialaura Cuomo, Vincenza Lombardo, Alice Scricciolo, Flavio Caprioli, Andrea Costantino, Lucia Scaramella and Maurizio Vecchi

Nutrients 2022, 14(4), 751; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14040751 - 10 Feb 2022

Cited by 21 | Viewed by 7439

Abstract

Inflammatory bowel diseases (IBD) affect the gastrointestinal tract: they include Crohn’s disease (CD) and ulcerative colitis (UC). Each has a different phenotypic spectrum, characterized by gastrointestinal and extra-intestinal manifestations. People living with IBD are very interested in diet, but little is known about [...] Read more.

Inflammatory bowel diseases (IBD) affect the gastrointestinal tract: they include Crohn’s disease (CD) and ulcerative colitis (UC). Each has a different phenotypic spectrum, characterized by gastrointestinal and extra-intestinal manifestations. People living with IBD are very interested in diet, but little is known about the impact of diet on these patients; no guidelines are available yet. In this review, we analyze the dietary patterns of patients with IBD and the approach to the choices of foods both in adults and pediatric patients. Very often, IBD patients report an intentional avoidance of gluten to manage the disease; furthermore, a proportion of IBD patients believe that dairy products worsen their symptoms and that avoidance may help the disease. They have a low compliance with the Mediterranean Diet, which is considered to have potential benefits but is little used in practice. In conclusion, the review underscores the pivotal role of nutritional counselling in IBD patients, and the importance of future clinical studies to evaluate the beneficial effects of dietary recommendations in the management of IBD. Full article

(This article belongs to the Special Issue Gluten-Free Diet and Gastrointestinal Diseases)

13 pages, 610 KiB

Open AccessReview

Multidimensional Disadvantages of a Gluten-Free Diet in Celiac Disease: A Narrative Review

by Martyna Marciniak, Aleksandra Szymczak-Tomczak, Dagmara Mahadea, Piotr Eder, Agnieszka Dobrowolska and Iwona Krela-Kaźmierczak

Nutrients 2021, 13(2), 643; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13020643 - 16 Feb 2021

Cited by 10 | Viewed by 5218

Abstract

A gluten-free diet is the mainstay method of treatment and the prevention of celiac disease complications. However, an inadequately balanced gluten-free diet can increase the risk of obesity, negatively affect glucose and lipid metabolism, and increase the risk of the metabolic syndrome. Therefore, [...] Read more.

A gluten-free diet is the mainstay method of treatment and the prevention of celiac disease complications. However, an inadequately balanced gluten-free diet can increase the risk of obesity, negatively affect glucose and lipid metabolism, and increase the risk of the metabolic syndrome. Therefore, an adequate nutritional counselling is necessary for patients diagnosed with celiac disease in order to prevent and treat the components of the metabolic syndrome. Full article

(This article belongs to the Special Issue Gluten-Free Diet and Gastrointestinal Diseases)

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