BACKGROUND/AIMS: Few reports have described the long-term treatment outcomes of the anti-tumor necrosis factor-α antibody for Japanese Crohn’s disease (CD) patients. The aim of this study was to evaluate them and clarify the clinical factors that affect the long-term prognosis of the anti-tumor necrosis factor-α treatments. METHODS: This was a retrospective, observational, single-center cohort study. Japanese CD patients treated with either infliximab or adalimumab as a first-line therapy were analyzed. The cumulative retention rates of the biologics, relapse-free survival, and surgery-free survival were analyzed using Kaplan-Meier methods. The clinical factors associated with the long-term outcomes were estimated by both the log-rank test and Cox proportional hazard model. RESULTS: The cumulative retention rate was significantly higher in the group with a concomitant elemental diet of ≥900 kcal/day, baseline C-reactive protein (CRP) levels < 2.6 mg/dL, and baseline serum albumin levels ≥3.5 g/dL, respectively. The baseline serum albumin levels were also associated with both relapse-free and surgery-free survival. The lack of concomitant use of an elemental diet ≥900 kcal/day was identified as the only independent risk factor for the withdrawal of the biologics. CONCLUSIONS: Baseline CRP levels and serum albumin levels could affect the long-term outcomes in CD patients. Concomitant elemental diet of ≥900 kcal/day could have a positive influence on clinical treatment course.
Adalimumab ; Antibodies ; Asian Continental Ancestry Group ; Biological Products ; C-Reactive Protein ; Cohort Studies ; Crohn Disease ; Food, Formulated ; Humans ; Infliximab ; Necrosis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Serum Albumin

No abstract available.
Crohn Disease* ; Food, Formulated* ; Humans ; Infliximab*

OBJECTIVE: Currently, there are no established dietary guidelines for patients with swallowing difficulties in Korea. Therefore, this study was conducted to develop an organized set of dietary guidelines listing simple yet diverse ingredients that are safe for consumption and have high nutritional quality. METHOD: Ninety patients with swallowing and masticatory dysfunction admitted in hospitals A and B were enrolled in this study. The initial study phase encompassed a 6-month period at each site from May 2016 to June 2017. The patients fed according to the dietary guidelines developed in this study were observed. The before- and after-care variances were observed by measuring the patients' weight, and TLC as well as the levels of serum albumin and food intake. This observation was based on the classification of swallowing difficulty and masticatory dysfunction into four scales. RESULT: The before- and after-care weight measurements of the study patients revealed a shift from 48.60±10.17 to 49.32±10.23 kg, and a change in the BMI from 20.04±3.91 to 20.33±3.93. The variances were deemed statistically significant, indicating that the nutrition index of the administered diet was adequate. An analysis of the types of food intake of side dishes and snacks before- and after- dietary administration per study revealed 3.58±1.01 to 4.19±0.83 and 2.77±0.98 to 3.49±1.21, respectively. CONCLUSION: The food intake level and the weight and BMI of patients in both hospitals increased during the 1-year study period. Furthermore, increasing the dietary level from the third to the fourth tier on an institutional basis enabled a systematic configuration of dietary formulations for each stage of this disorder.
Classification ; Deglutition ; Deglutition Disorders ; Dementia ; Diet ; Eating ; Food, Formulated ; Humans ; Korea ; Methods ; Nutrition Assessment ; Nutrition Policy ; Nutritive Value ; Serum Albumin ; Snacks ; Weights and Measures

OBJECTIVETo explore the value of nutrition management in obese patients with type 2 diabetes mellitus(T2DM) after laparoscopic sleeve gastrectomy(LSG).

METHODSClinical data of 22 obese T2DM patients undergoing LSG from March 2013 to July 2015 in Fudan University Pudong Medical Center were collected. All the patients strictly followed the specialized instruction by nutritionists: diabetic and low calorie diet 3347.2 to 5020.8 kJ (800 to 1200 kcal) per day before the operation; low calorie liquid diet 2510.4 kJ(600 kcal) per day before operation for promoting gastric emptying; fasting diet before postoperative ventilation; clear liquid diet 1673.6 to 2510.4 kJ (400 to 600 kcal) per day after postoperative ventilation (liquid intake >2000 ml); low fat liquid diet 2928.8 to 3765.6 kJ (700 to 900 kcal) per day (protein 60 g per day at least, 2000 ml liquid) 2 weeks after the operation; semi-liquid diet 1 month after operation and gradually normal diet. All the 22 patients were followed up at 1 week, 1, 3, 6 months after operation on time. Changes of body weight, waist circumference, hip circumference, body mass index(BMI), blood glucose indexes induding fasting blood glucose(FBG), 2-hour postparandial blood glucose(PBG), fasting C-peptide, 2-hour postprandial C-peptide, fasting serum inculin(FINS), 2-hour postprandial inculin(INS), HbAlc, blood pressure and blood lipid indexes were observed and analyzed before and 1 week, 1, 3, 6 months after operation.

RESULTSThe average age of 22 patients (10 men and 12 women) was 38.6 years (18 to 66 years). The duration of diabetes varied from 1 month to 15 years. Comorbidity included 12 patients of high blood pressure, 14 of fatty liver, 1 of coronary heart disease, 1 of gout, 1 of chronic thyroiditis and 1 of menstrual disorder. LSG was performed successfully in all the patients and no severe complications and transference to laparotomy occurred. As compared to pre-operation, at 6 months after operation, the average body weight decreased from (103.9±20.2) kg to (80.9±12.6) kg (t=6.294, P=0.000), waist circumference from (118.6±13.8) cm to (96.4±8.0) cm (t=6.331, P=0.000), hip circumference from (116.9±12.6) cm to (104.0±7.7) cm (t=3.854, P=0.000), BMI from (36.2±5.9) kg/mto (27.9±3.5) kg/m(t=5.630, P=0.000), showing a decreasing trend over time. There was no underweight patient after 6 months follow-up. As compared to pre-operation, at 6 months after operation, the average FBG reduced from (7.4±1.4) mmol/L to (6.0±0.9) mmol/L (t=3.172, P=0.003), 2 h PBG from (14.1±4.9) mmol/L to (7.5±2.2) mmol/L (t=7.026, P=0.000), FINS from (160.0±71.9) mIU/L to (43.8±20.8) mIU/L (t=7.259, P=0.000), 2-hour postprandial INS from (437.6±261.4) mIU/L to (140.5±104.6) mIU/L (t=5.858, P=0.000), fasting C-peptide from (1.1±0.6) μg/L to (0.7±0.3) μg/L (t=3.560, P=0.000), 2-hour postprandial C-peptide from (2.5±0.9) μg/L to (1.5±0.7) μg/L (t=3.865, P=0.000), HbAlc from (8.0±1.6)% to (5.9±0.6)% (t=5.953, P=0.000), showing a decreasing trend over time except FBG, 2h postprandial C-peptide and HbAlc(all P<0.05). FBG and 2-hour PBG of 16 patients returned to normal 3 months after the operation. Blood pressure and trigly ceride decreased obviously 6 months after operation compared to pre-operation with significant difference(P<0.05). At 6 months after operation, blood pressure of 8 comorbidity patients with high blood pressure became normal (8/12, 66.7%) and of 4 patients improved(4/12, 33.3%); B ultrasound examination revealed normal in 11 comorbidity patients with fatty liver(11/14,78.6%) and improvement in 3 patients (3/14,15.4%). Blood uric acid of the gout patient and the menstruation of the menstrual disorder patient returned to normal 3 months and 1 month after the operation respectively.

CONCLUSIONAs for obese patients with T2DM undergoing LSG, reasonable nutrition management is helpful to decrease body weight, and to obtain an ideal improvement of blood glucose and blood lipid levels.

Adolescent ; Adult ; Aged ; Bariatric Surgery ; Blood Glucose ; physiology ; Body Weights and Measures ; C-Peptide ; blood ; physiology ; Caloric Restriction ; Combined Modality Therapy ; Comorbidity ; Coronary Disease ; complications ; Diabetes Mellitus, Type 2 ; complications ; therapy ; Diet Therapy ; methods ; Diet, Diabetic ; Endoscopy ; Fatty Liver ; complications ; surgery ; Female ; Food, Formulated ; Gastrectomy ; Glycated Hemoglobin A ; physiology ; Gout ; complications ; surgery ; Hashimoto Disease ; complications ; Humans ; Hypertension ; complications ; surgery ; Insulin ; blood ; physiology ; Lipids ; blood ; physiology ; Male ; Menstruation Disturbances ; complications ; surgery ; Middle Aged ; Obesity ; complications ; therapy ; Perioperative Care ; methods ; Thyroiditis ; complications ; Treatment Outcome ; Triglycerides ; blood ; physiology

BACKGROUND/AIMS: Enteral nutrition (EN) is recommended for the treatment of pediatric Crohn's disease (CD) in Japan. However, the indications and treatment protocols for EN vary among hospitals. In the present study, we aimed to determine how EN was administered to pediatric patients and whether physicians followed treatment guidelines in their practices. METHODS: Two types of questionnaires were administered to 32 physicians who were involved in the treatment of pediatric CD. The consensus questionnaire evaluated the physicians' attitudes towards EN, whereas the efficacy questionnaire collected data on patients with CD, aged <17 years, who had undergone induction therapy between 2006 and 2011. RESULTS: A total of 23 physicians responded to the questionnaires. The results of the consensus questionnaire indicated that 82% and 59% of study participants recommended EN treatment for all newly diagnosed pediatric patients with CD and all relapsed patients, respectively. Exclusive EN (EEN) and elemental formula were recommended by 84% and 85% of physicians, respectively. The efficacy questionnaire revealed that 57 of the 58 patients received EN. Elemental formula was used in 39 of 40 patients who were treated with EEN. Of these 40 patients, 27 were treated with EEN alone; of these, 22 (81%) achieved remission without any other treatment. The mean duration of EEN was 15.9 days. CONCLUSIONS: EN is widely recommended by physicians treating pediatric CD in Japan. In contrast to Western countries, clinicians used elemental formula more often and with a shorter EEN treatment duration.
Asian Continental Ancestry Group* ; Child ; Clinical Protocols ; Consensus ; Crohn Disease* ; Enteral Nutrition* ; Food, Formulated ; Humans ; Japan ; Surveys and Questionnaires

Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Enteral Nutrition ; methods ; Food, Formulated ; Gastroesophageal Reflux ; drug therapy ; surgery ; therapy ; Gastroscopy ; Gastrostomy ; methods ; Humans ; Infant ; Jejunostomy ; Male ; Malnutrition ; drug therapy ; therapy ; Pneumonia, Aspiration ; drug therapy ; surgery ; therapy ; Teaching ; methods

Yerba Mate, derived from the leaves of the tree, Ilex paraguariensis, is widely-used as a tea or as an ingredient in formulated foods. The aim of the present study was to evaluate the effects of Yerba Mate extract on weight loss, obesity-related biochemical parameters, and diabetes in high-fat diet-fed mice. To this end, by using in vivo animal models of dietary-induced obesity, we have made the interesting observations that Yerba Mate has the ability to decrease the differentiation of pre-adipocytes and to reduce the accumulation of lipids in adipocytes, both of which contribute to a lower growth rate of adipose tissue, lower body weight gain, and obesity. Our data from in vivo studies revealed that Yerba Mate treatment affects food intake, resulting in higher energy expenditure, likely as a result of higher basal metabolism in Yerba Mate-treated mice. Furthermore, in vivo effects of Yerba Mate on lipid metabolism included reductions in serum cholesterol, serum triglycerides, and glucose concentrations in mice that were fed a high fat diet. In conclusion, Yerba Mate can potentially be used to treat obesity and diabetes.
Adipocytes ; Adipose Tissue ; Animals ; Basal Metabolism ; Body Weight ; Cholesterol ; Diet, High-Fat ; Eating ; Energy Metabolism ; Food, Formulated ; Glucose ; Ilex paraguariensis ; Lipid Metabolism ; Mice ; Models, Animal ; Obesity ; Tea ; Trees ; Triglycerides ; Weight Loss

Natural products in Chonnam, Korea were screened via anti-angiogenesis experiments, and 1 candidate product was identified, Corni fructus, which exerted dose-dependent inhibitory effects against angiogenesis, adipogenesis, and cell adhesion. C. fructus extract (CFE) exhibits an angiogenesis inhibitory effect superior to that of the EGCG from green tea leaves. The expression level of angiogenesis and adipogenesis-related signal molecules in the western blotting was reduced by increasing the amount of added CFE. Moreover, a diet supplemented with CFE was deemed more effective in inducing weight loss in LB mice than a representative synthetic diet drug, orlistat, which incidently caused the side effect of denuding the mice of their hair. These results indicate that C. fructus may prove to be a useful anti-adipogenic compound, and these in vitro results may be reflected later under in vivo conditions.
Adipogenesis ; Animal Experimentation ; Animals ; Biological Agents ; Blotting, Western ; Cell Adhesion ; Cornus ; Diet ; Food, Formulated ; Hair ; Korea ; Lactones ; Mice ; Tea ; Weight Loss

Protein-energy malnutrition is regarded as one of the public health problems in developing countries as a result of poor feeding practices due to poverty. This study, therefore, aimed at evaluating nutritional quality of a potential weaning food formulated from locally available food materials. The cooking banana fruit (CB) and bambara groundnut seeds (BG) were purchased from local market in Akure, Ondo State, Nigeria. The CB and BG were processed into flours, mixed in ratios of 90:10, 80:20, 70:30 and 60:40 and subjected into proximate, sensory and biochemical analyses using standard procedures. Nutrend (a commercial formula) and ogi (corn gruel, a traditional weaning food) were used as control. The nutritient composition (g/100 g) of the food samples were ranged as follows: moisture 2.94-6.94, protein 7.02-16.0, ash 1.76-2.99, fat 0.76-8.45, fibre 1.52-3.75, carbohydrate 63.84-88.43 and energy 1569.8-1665.7 kcal. The biological value (BV), net protein retention (NPR), protein efficiency ratio (PER) and feed efficiency ratio (FER) of the experimental food samples were significantly (p<0.05) lower than nutrend, but higher than ogi. The haematological variables of rats fed with formulated food samples, commercial formula (nutrend) and traditional weaning food (ogi) were not significantly (p>0.05) influenced by the dietary treatment. However, the values obtained for red blood cell (RBC), white blood cell (WBC), pack cell volume (PCV) and erythrocyte sedimentation rate (ESR) were higher in the experimental food samples than the commercial food. The growth rate of animals fed with experimental food samples were lower than those fed with the nutrend, but higher than those fed with ogi. In conclusion, the nutritional quality of CB and fermented BG mix of 60:40 ratio was better than ogi; and comparable to the nutrend. This implies that it can be used to replace low quality traditional weaning food and the expensive commercial weaning formula.
Animals ; Blood Sedimentation ; Cell Size ; Cooking ; Developing Countries ; Erythrocytes ; Flour ; Food, Formulated ; Fruit ; Humans ; Infant ; Leukocytes ; Musa ; Nigeria ; Nutritive Value ; Poverty ; Protein-Energy Malnutrition ; Public Health ; Rats ; Retention (Psychology) ; Seeds ; Weaning

OBJECTIVETo observe the effect of overdose iodine on the expression of CCK gene in brains of rats and identify the possible mechanisms.

METHODSOne-month weaning Wistar rats were randomly divided into five groups which were fed with normal feedstuff and water supplemented with different concentrations of potassium iodide, named A group (iodine ration was about 6.15 microg per day), B group (iodine ration was about 30.75 microg per day), C group (iodine ration was about 61.5 microg per day), D group (iodine ration was about 307.5 microg per day) and E group (iodine ration was about 615 microg per day). Rats were sacrificed after being fed for three or six months. Then serum thyroid hormones were measured by radioimmunoassay and the mRNA level of CCK gene was studied by using RT-PCR technique.

RESULTSAt the end of three months, the values of thyroid hormones in E group [TT4 (45.2 +/- 13.7) nmol/L, TI'3 (0.65 +/- 0.20) nmol/L, FT3 (0.93 +/- 0.45) pmol/L, FT4 (7.07 +/- 2.43) pmol/L, rT3 (0.15 +/- 0.04) nmol/L] were all lower than those in A group [TT4 (76.0 +/- 18.8) nmol/L, TT3 (1.34 +/- 0.41) nmol/L, FT3 (2.45 +/- 0.62) pmol/L, FT4 (15.12 +/- 3.40) pmol/L, rT3 (0.24 +/- 0.04) nmol/L]. There were significant differences between E group and A group on the levels of serum TH (F values are 14.68, 16.03, 21.16, 20.25, 13.52 respectively, P < 0.01); FT3 levels in C and D groups were significantly decreased as compared to A and B groups (F = 21.16, P < 0.05). rT3 level in D group was significantly decreased compared with A,B and C groups (F = 13.52, P < 0.05). At the end of six months, the levels of serum TH in E group (TT4 (51.84 +/- 15.83) nmol/L, TT3 (0.77 +/- 0.22) nmol/L, FT4 (6.88 +/- 2.23) pmol/L, FT3 (0.74 +/- 0.28) pmol/L, rT3 (0.14 +/- 0.03) nmol/L) were lower than those in any other groups (F values were 6.05, 12.22, 11.25, 13.42, 5.89 respectively, P < 0.05). At the end of both three and six months, the mRNA levels of CCK gene in E group were lower than any other groups (F values were 4.04, 3.95 respectively, P < 0.01). The results of correlation analysis showed that serum FT4 had linear correlation with levels of CCK mRNA (r values were 0.990, 0.948 respectively; P < 0.05); However serum FT3 had no linear correlation with the levels of CCK mRNA (r values are 0.970, 0.932 respectively).

CONCLUSIONSExposure to overdose of iodine (iodine ration was 100-fold higher than that of A group) could decrease the mRNA level of CCK gene. Compared with FT3, FT4 might have more important role on the regulation of CCK mRNA induced by excess of iodine.

Animals ; Brain ; metabolism ; Cholecystokinin ; biosynthesis ; genetics ; Drug Overdose ; Female ; Food, Formulated ; Gene Expression ; Hyperphagia ; Iodine ; toxicity ; Male ; RNA, Messenger ; genetics ; Rats ; Rats, Wistar ; Thyroid Hormones ; blood ; Thyrotropin ; blood ; Thyroxine ; blood ; Triiodothyronine ; blood