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Lifestyle interventions remain the cornerstone therapy for non-alcoholic fatty liver disease (NAFLD). This randomised controlled single-blind clinical trial investigated the effect of Mediterranean diet (MD) or Mediterranean lifestyle, along with weight loss, in NAFLD patients. In all, sixty-three overweight/obese patients (50 ( sd 11) years, BMI=31·8 ( sd 4·5) kg/m 2 , 68 % men) with ultrasonography-proven NAFLD (and elevated alanine aminotransferase (ALT) and/or γ-glutamyl transpeptidase (GGT) levels) were randomised to the following groups: (A) control group (CG), (B) Mediterranean diet group (MDG) or (C) Mediterranean lifestyle group (MLG). Participants of MDG and MLG attended seven 60-min group sessions for 6 months, aiming at weight loss and increasing adherence to MD. In the MLG, additional guidance for increasing physical activity and improving sleep habits were given. Patients in CG received only written information for a healthy lifestyle. At the end of 6 months, 88·8 % of participants completed the study. On the basis of intention-to-treat analysis, both MDG and MLG showed greater weight reduction and higher adherence to MD compared with the CG (all P <0·05) at the end of intervention. In addition, MLG increased vigorous exercise compared with the other two study groups ( P <0·001) and mid-day rest/naps compared with CG ( P =0·04). MLG showed significant improvements in ALT levels (i.e. ALT<40 U/l ( P =0·03) and 50 % reduction of ALT levels ( P =0·009)) and liver stiffness ( P =0·004) compared with CG after adjusting for % weight loss and baseline values. MDG improved only liver stiffness compared with CG ( P <0·001) after adjusting for the aforementioned variables. Small changes towards the Mediterranean lifestyle, along with weight loss, can be a treatment option for patients with NAFLD.

Hydrocolloids are important ingredients controlling the quality characteristics of the final bakery products. Hydrocolloids are frequently used in gluten-free (GF) recipes, mimicking some rheological properties of gluten, improving dough properties, delaying starch retrogradation and improving bread texture, appearance and stability. Hydrocolloids addition increases viscosity and incorporation of air into the GF dough/batter. Besides their advantages for the technological properties of the GF bread, hydrocolloids addition may impact the glycemic index (GI) of the final product, thus answering the demand of people requiring products with low GI. This review deals with the application of hydrocolloids in GF bread and pasta with a focus on their effect on dough rheology, bread hardness, specific volume, staling and GI.

Gluten-free products have come into the market in order to alleviate health problems such as celiac disease. In this review, recent advances in gluten-free bread are described along with plant-based gluten-free proteins. A comparison with animal-based gluten-free proteins is made reporting on different high protein sources of animal origin. Sea microorganisms- and insect-based proteins are also mentioned, and the optimization of the structure of gluten-free bread with added high protein sources is highlighted along with protein digestibility issues. The latter is an issue for consideration that can be manipulated by a careful design of the mixture in terms of phenolic compounds, soluble carbohydrates and fibres, but also the baking process itself. Additionally, the presence of enzymes and different hydrocolloids are key factors controlling quality features of the final product.

PurposeThe present review critically evaluates existing literature on the effects of short- and long-term low energy availability (EA) on bone metabolism and health in physically active individuals.MethodsWe reviewed the literature on the short-term effects of low EA on markers of bone metabolism and the long-term effects of low EA on outcomes relating to bone health (bone mass, microarchitecture and strength, bone metabolic markers and stress fracture injury risk) in physically active individuals.ResultsAvailable evidence indicates that short-term low EA may increase markers of bone resorption and decrease markers of bone formation in physically active women. Bone metabolic marker responses to low EA are less well known in physically active men. Cross-sectional studies investigating the effects of long-term low EA suggest that physically active individuals who have low EA present with lower bone mass, altered bone metabolism (favouring bone resorption), reduced bone strength and increased risk for stress fracture injuries.ConclusionsReduced EA has a negative influence on bone in both the short- and long-term, and every effort should be made to reduce its occurrence in physically active individuals. Future interventions are needed to explore the effects of long-term reduced EA on bone health outcomes, while short-term low EA studies are also required to give insight into the pathophysiology of bone alterations.

The paper focuses on the COVID-19 as a stress test to the Sino-Russian strategic partnership: has it driven Russia and China closer together, farther apart, or made no difference? Employing content analysis of official Russian discourse as expressed by the Kremlin, the Government, and the Ministry of Foreign Affairs (MFA), both via their official web pages (104 online publications) and Twitter accounts (260 tweets), this study focuses on the Russian twiplomacy as a more suitable mean to reflect the real-time changes of an evolving crisis. The analysis demonstrates that the Sino-Russian relationship extends beyond the “axis of convenience.” It does not, however, correspond to the support expected from a consolidated (comprehensive) strategic partnership, nor does it achieve the intensity of soft balancing (vis-à-vis the USA) in a particularly polarized and politicized international context.

Malnutrition risk screening in cirrhotic patients is crucial, as poor nutritional status negatively affects disease prognosis and survival. Given that a variety of malnutrition screening tools is usually used in routine clinical practice, the effectiveness of eight screening tools in detecting malnutrition risk in cirrhotic patients was sought. A total of 170 patients (57·1 % male, 59·4 ( sd 10·5) years, 50·6 % decompensated ones) with cirrhosis of various aetiologies were enrolled. Nutritional screening was performed using the Malnutrition Universal Screening Tool, Nutritional Risk Index, Malnutrition Screening Tool, Nutritional Risk Screening (NRS-2002), Birmingham Nutritional Risk Score, Short Nutritional Assessment Questionnaire, Royal Free Hospital Nutritional Prioritizing Tool (RFH-NPT) and Liver Disease Undernutrition Screening Tool (LDUST). Malnutrition diagnosis was defined using the Subjective Global Assessment (SGA). Data on 1-year survival were available for 145 patients. The prevalence of malnutrition risk varied according to the screening tools used, with a range of 13·5–54·1 %. RFH-NPT and LDUST were the most accurate in detecting malnutrition (AUC = 0·885 and 0·892, respectively) with a high sensitivity (97·4 and 94·9 %, respectively) and fair specificity (73·3 and 58 %, respectively). Malnutrition according to SGA was an independent prognostic factor of within 1-year mortality (relative risk was 2·17 (95 % CI 1·0, 4·7), P = 0·049) after adjustment for sex, age, disease aetiology and Model for End-stage Liver Disease score, whereas nutrition risk according to RFH-NPT, LDUST and NRS-2002 showed no association. RFH-NPT and LDUST were the only screening tools that proved to be accurate in detecting malnutrition in cirrhotic patients.

Early handling (EH), the brief separation of pups from their mother during early life, has been shown to exert beneficial effects. However, the impact of EH in a high anxiety background as well as the role of brain mitochondria in shaping EH-driven responses remain elusive. Here, we used a high (HAB) vs. normal (NAB) anxiety-related behavior mouse model to study how EH affects pup and dam behavior in divergent anxiety backgrounds. We also investigated EH-induced effects at the protein and mRNA levels in adult male HAB mice in the hypothalamus, the prefrontal cortex, and the hippocampus by examining the same mitochondrial/energy pathways and mitochondrial dynamics mechanisms (fission, fusion, biogenesis, and mitophagy) in all three brain regions. EH exerts anxiolytic effects in adult HAB but not NAB male mice and does not affect HAB or NAB maternal behavior, although basal HAB vs. NAB maternal behaviors differ. In adult HAB male mice, EH does not impact oxidative phosphorylation (OXPHOS) and oxidative stress in any of the brain regions studied but leads to increased protein expression of glycolysis enzymes and a correlation of anxiety-related behavior with Krebs cycle enzymes in HAB mice in the hypothalamus. Intriguingly, EH alters mitochondrial dynamics by increasing hypothalamic DRP1, OPA1, and PGC1a protein levels. At the mRNA level, we observe altered, EH-driven mitochondrial dynamics mRNA signatures which predominantly affect the prefrontal cortex. Taken together, our results show that EH exerts anxiolytic effects in adulthood in high anxiety and modulates mitochondrial dynamics pathways in a brain region-specific manner.

Cereal grains serve as the cornerstone of global nutrition, providing a significant portion of humanity’s caloric requirements. However, the presence of fungal genera, such Fusarium, Penicillium, Aspergillus, and Alternaria, known for their mycotoxin-producing abilities, presents a significant threat to human health due to the adverse effects of these toxins. The primary objective of this study was to identify the predominant fungal contaminants in cereal grains utilized in breadmaking, as well as in flour and bread. Moreover, a systematic review, including meta-analysis, was conducted on the occurrence and levels of mycotoxins in wheat flour from the years 2013 to 2023. The genera most frequently reported were Fusarium, followed by Penicillium, Aspergillus, and Alternaria. Among the published reports, the majority focused on the analysis of Deoxynivalenol (DON), which garnered twice as many reports compared to those focusing on Aflatoxins, Zearalenone, and Ochratoxin A. The concentration of these toxins, in most cases determined by HPLC-MS/MS or HPLC coupled with a fluorescence detector (FLD), was occasionally observed to exceed the maximum limits established by national and/or international authorities. The prevalence of mycotoxins in flour samples from the European Union (EU) and China, as well as in foods intended for infants, exhibited a significant reduction compared to other commercial flours assessed by a meta-analysis investigation.

Despite major progress in the understanding of the pathophysiology and therapeutic options for common ageing-related musculoskeletal conditions (i.e. osteoporosis and associated fractures, sarcopenia and osteoarthritis), there is still a considerable proportion of patients who respond sub optimally to available treatments or experience adverse effects. Emerging microbiome research suggests that perturbations in microbial composition, functional and metabolic capacity (i.e. dysbiosis) are associated with intestinal and extra-intestinal disorders including musculoskeletal diseases. Besides its contributions to disease pathogenesis, the role of the microbiome is further extended to shaping individuals’ responses to disease therapeutics (i.e. pharmacomicrobiomics). In this review, we focus on the reciprocal interactions between the microbiome and therapeutics for osteoporosis, sarcopenia and osteoarthritis. Specifically, we identify the effects of therapeutics on microbiome’s configurations, functions and metabolic output, intestinal integrity and immune function, but also the effects of the microbiome on the metabolism of these therapeutics, which in turn, may influence their bioavailability, efficacy and side-effect profile contributing to variable treatment responses in clinical practice. We further discuss emerging strategies for microbiota manipulation as preventive or therapeutic (alone or complementary to available treatments) approaches for improving outcomes of musculoskeletal health and disease.

Cereals have been one of the major food resources for human diets and animal feed for thousands of years, and a large quantity of by-products is generated throughout the entire processing food chain, from farm to fork. These by-products mostly consist of the germ and outer layers (bran) derived from dry and wet milling of the grains, of the brewers’ spent grain generated in the brewing industry, or comprise other types obtained from the breadmaking and starch production industries. Cereal processing by-products are an excellent low-cost source of various compounds such as dietary fibres, proteins, carbohydrates and sugars, minerals and antioxidants (such as polyphenols and vitamins), among others. Often, they are downgraded and end up as waste or, in the best case, are used as animal feed or fertilizers. With the increase in world population coupled with the growing awareness about environmental sustainability and healthy life-styles and well-being, the interest of the industry and the global market to provide novel, sustainable and innovative solutions for the management of cereal-based by-products is also growing rapidly. In that respect, these promising materials can be valorised by applying various biotechnological techniques, thus leading to numerous economic and environmental advantages as well as important opportunities towards new product development (NPD) in the food and feed industry and other types such as chemical, packaging, nutraceutical (dietary supplements and food additives), cosmetic and pharmaceutical industries. This review aims at giving a scientific overview of the potential and the latest advances on the valorisation of cereal-based by-products and wastes. We intended it to be a reference document for scientists, technicians and all those chasing new research topics and opportunities to explore cereal-based by-products through a circular economy approach.