International Journal of Nutrology
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Systematic review of clinical outcomes of anorexigenic treatment of obesity
Full text linkIntroduction: Obesity and its comorbidities are a public health burden that currently affects more than 2.0 billion people, affecting approximately 19% of women and 14% of men worldwide. Anti-obesity medications modify the biological processes that affect appetite and significantly improve outcomes such as type 2 diabetes, hypertension, and dyslipidemia. Objective: This was to develop a systematic review to present the main clinical results of using anorectic drugs to treat obesity and its comorbidities. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from March to April 2025 in the Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 107 articles were found. A total of 42 articles were fully evaluated and 30 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 06 studies with a high risk of bias and 29 studies that did not meet GRADE and AMSTAR-2. Most studies presented homogeneity in their results, with X2=85.7%>50%. It was concluded, based on randomized clinical studies in recent years, that anorectic anti-obesity drugs associated with lifestyle change therapies are effective in weight loss and improvement of comorbidities. Furthermore, studies have shown that the combination of anti-obesity medicines and lifestyle intervention enables greater results in weight loss and maintenance of lost weight
Effects of dexmedetomidine and remifentanil on nutritional status in patients undergoing bariatric surgery: a systematic review
Full text linkIntroduction: In patients with obesity and mineral and vitamin deficiencies, the distribution of anesthetics occurs in the peripheral fat compartment, which is enlarged, delaying recovery from anesthesia. Based on this information, the choice of substances with faster recovery, lower production of active metabolites, and predictable elimination is recommended for anesthesia in bariatric surgery. Objective: This systematic review aimed to analyze the effects of dexmedetomidine and remifentanil on hemodynamics and renal function in patients undergoing bariatric surgery with vitamin and mineral deficiencies. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from September to October 2025 in the Scopus, PubMed, Science Direct, SciELO, and Google Scholar databases. The quality of the studies was assessed using the GRADE instrument, and the risk of bias was evaluated according to the Cochrane instrument. Results and Conclusion: 136 articles were found. A total of 52 articles were evaluated, and 31 were included in this systematic review. Considering the Cochrane risk of bias tool, the overall assessment resulted in 18 studies with high risk of bias and 25 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=87.9% >50%. It was concluded that in obese patients with mineral and vitamin deficiencies, total intravenous anesthesia with opioid restriction using dexmedetomidine reduces postoperative nausea, pain score, and the need for antiemetics and analgesics in the immediate postoperative period after bariatric surgery compared to the use of remifentanil. Furthermore, the better recovery profile after laparoscopic sleeve gastrectomy supports the use of intraoperative dexmedetomidine infusion as an anesthetic adjuvant versus remifentanil for this patient profile
Nutrological importance in bone loss recovery for the efficiency of dental implant process: a systematic review
Full text linkIntroduction: The global dental implant market generated approximately 13 billion dollars in 2023, with an annual growth of 6%. It is prioritized that the nutritional status significantly influences the osseointegration process. Objective: It was to conduct a systematic review to discuss the nutritional importance of optimizing the dental implant osseointegration process. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2024 to January 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 123 articles were found, 25 articles were evaluated in full and 22 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 27 studies with a high risk of bias and 32 studies that did not meet GRADE. Most studies did not show homogeneity in their results, with X2=81.2%>50%. It was concluded that a specific dietary regimen and micronutrients may play a key role in the different phases of dental implant osseointegration. Some micronutrient deficiencies increase oxidative stress and inflammation, in addition to affecting collagen structure and bone mineralization. However, data are lacking for many micronutrients that may modulate bone metabolism. There is evidence for the role of vitamin D as well as vitamin C supplementation in facilitating the success of dental implant surgery
Clinical outcomes and guidelines for nutrological therapy and palliative medicine in cancer patients: a systematic review
Full text linkIntroduction: Nutritional support for cancer patients in palliative care is still a controversial topic. Dietary counseling, providing nutritional support, and alleviating diet-related issues should be an essential components of a holistic approach to palliative and end-of-life care. Objective: It was to carry out a systematic review to explore and discuss the main approaches to nutritional therapy in palliative care in cancer patients. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from August to September 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 141 articles were found. A total of 46 articles were evaluated in full and 21 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 23 studies with a high risk of bias and 28 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=84.5%>50%. It was concluded that the use of the modified Glasgow Prognostic Score to identify the existence and severity of CC, which is associated with function, has the potential to assist in clinical decision-making regarding the indication of enteral nutrition in patients with incurable cancer undergoing palliative care. There are not enough quality studies that provide evidence of the improvement in health status and quality of life when using enteral nutrition through NGT in patients receiving palliative care. For this reason, decision-making in this field must be carried out on an individual basis, weighing up the benefits and harms that can be caused to patients' quality of life. The guidelines recommend that, if oral food intake remains inadequate despite counseling and oral nutritional supplements, enteral nutrition or, if this is not sufficient or feasible, parenteral nutrition (supplemental or total) should be considered
Nutrological, microbiological and extracellular vesicle evidence in the modulation and control of inflammatory bowel disease symptoms: a systematic review
Full text linkIntroduction: Inflammatory bowel diseases (IBD) have an increasing incidence and prevalence, such as Crohn's disease (CD) and ulcerative colitis (UC). Gut dysbiosis is affected by host genetics, nutrition, antibiotics, and inflammation, and is associated with the development of IBD, which can be attributed to impaired miRNA expression functions. Micro and macronutrient deficiencies and overabundance of calories and macronutrients trigger inflammatory processes and susceptibility to infections. Objective: To present the nutrological, microbiological, and extracellular vesicle (exosome-microRNAs) evidence in the modulation and control of symptoms of inflammatory bowel diseases. Methods: The systematic review rules of the PRISMA Platform were followed. The literary search process was carried out from March to May 2025 in the Web of Science, Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 189 articles were found. A total of 27 articles were fully evaluated and 21 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 21 studies with a high risk of bias and 29 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=85.7%>50%. It was concluded that miRNAs are important regulators of cellular function and homeostasis, and their abnormal activity has been demonstrated in several diseases, including IBD. Thus, new treatment options could be developed to alter imbalances in miRNA expression. miRNAs affect the intestinal barrier and inflammatory reactions through several pathological mechanisms. The use of miRNAs as biomarkers and therapeutic targets may help monitor IBD treatment and support the development of new, more individualized therapies that minimize common side effects. Extracellular vesicles may attenuate the inflammatory response by inhibiting the TLR4-NF-κB signaling pathway and activating the NLRP3 inflammasome. Dietary manipulation of microRNAs through prebiotics and probiotics may selectively manipulate the gut microbiota, with the bacterium Faecalibacterium prausnitzii being prevalent in healthy adults, being beneficial and producing short-chain fatty acids, such as butyrate, which serves as an energy source for intestinal epithelial cells and induces protective regulatory immune responses
Investigation of the gut microbiota and nutrients in regenerative processes in inflammatory bowel diseases: a systematic review
Full text linkIntroduction: Metabolism encompasses the interactions between diet, the microbiome, and cellular enzymatic processes that generate the chemical pathways necessary to sustain life. Epigenetic and nutritional mechanisms are of paramount importance, as approximately 80.0% of patients lose weight during inflammatory bowel diseases (IBD). Objective: It was to develop a systematic review of the main clinical studies on the impact of nutritional treatment on inflammatory bowel diseases. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from March to April 2025 in the Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 132 articles were found, and 20 articles were evaluated in full and 17 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 14 studies with a high risk of bias and 20 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=78.4%>50%. It was concluded that important randomized controlled clinical studies in recent years have highlighted the important role of diet modulation in the control and even remission of inflammatory bowel diseases. There was a reduction in persistent intestinal symptoms, balance of the gut microbiota, reduction of inflammatory markers, and improvement in quality of life
Control and treatment of obesity comorbidities by melatonin nutrological therapy: a systematic review
Full text linkIntroduction: There are more than 2.2 billion overweight and obese people worldwide. Sleep imbalance and the resulting reduction in melatonin (MEL) concentrations in the human body have a significant impact on health, particularly the development of obesity and comorbidities. Objective: This was to conduct a systematic review of the main approaches and clinical studies on melatonin regulation in the control and treatment of obesity and its comorbidities. Methods: The PRISMA rules for systematic review were followed. This study included review articles, systematic reviews/meta-analyses, prospective studies, retrospective studies, and randomized, double-blind, placebo-controlled trials in humans. Results and Conclusion: 27 of the 30 studies were selected to compose the results of this systematic review. Most studies presented homogeneity in their results, with X2=83.3%>50%. It was concluded that melatonin is an important participant in the regulation of energy metabolism, including body weight, insulin sensitivity, and glucose tolerance. Randomized placebo-controlled clinical studies have shown that daily melatonin consumption can be effective in controlling blood pressure, including systemic blood pressure, mean arterial pressure and pulse pressure, and reduces anthropometric indices of obesity in patients, as it increases the mass and activity of brown adipose tissue, functioning as an anti-obesogenic hormone. Melatonin can regulate adipose tissue and adipokines, such as adipocyte lipolysis and fat deposition. Furthermore, melatonin can interact with intracellular molecules, acting as an effective antioxidant. Several studies have indicated a higher risk of developing obesity in people who sleep less than six hours a day. Hormonal changes that occur during sleep deprivation may explain the increase in caloric intake and decrease in leptin, increase in ghrelin and peptide YY. Melatonin also regulates food intake by controlling the production and secretion of insulin, glucagon, and cortisol. Epidemiological studies have shown a link between sleep deprivation, insulin resistance, and T2DM
Exploring the Relationship Between Fatigue Severity and Clinical Parameters in Hemodialysis Patients Utilizing FACIT-F Scale: A Cross-sectional Study in West Bank Hospitals
Full text linkFatigue is one of the most common symptoms experienced by patients with End-Stage Renal Disease (ESRD) and it can be defined as weakness, exhaustion, incapacitating, and disorder. The purpose of this cross-sectional study is to determine the correlation between fatigue severity and key clinical parameters in hemodialysis patients in West Bank hospitals. 62 adult dialysis patients were evaluated for fatigue severity using the Functional Assessment of Chronic Illness Therapy - Fatigue Scale (FACIT-F). Demographic information, health behaviors, and clinical characteristics were gathered. The findings demonstrated a strong negative association between fatigue severity and hemoglobin levels (r=-0.319, p=0.023), emphasizing the role of low hemoglobin levels in increasing fatigue. There were no significant relationships between weariness and serum creatinine, phosphorus, or calcium levels. These findings emphasize the necessity of monitoring and treating hemoglobin levels in dialysis patients' tiredness management, pointing to further research and viable therapies
Epigenetic remodeling in response to intermittent fasting and its role in visceral fat reduction
Full text linkA compelling regimen that has recently gained popularity is intermittent fasting (IF), which aims to improve metabolic function and promote weight loss. Recent research suggests that IF has complex effects, influencing metabolic regulators like insulin sensitivity and lipolytic pathways as well as causing epigenetic changes, which are thought to be responsible for a significant portion of its therapeutic efficacy. Epigenetic remodeling controls inflammatory responses, fat deposition, and energy homeostasis by modifying chromatin structure and transcription dynamics in a way that is reversible and inheritable while leaving the nucleotide sequence unchanged. Metabolic abnormalities are characterized by an increase in visceral adipose tissue, which is a risk factor for obesity and type 2 diabetes. This review focuses on the inhibitory effect of IF on this expansion and how it leads to epigenetic changes. This sudy examines IF and its influence on certain epigenetic changes regulating ‘master’ genes and ‘core’ metabolic pathways parameters involved in fat storage, mitochondrial bioenergetics, and inflammation related to oxidative stress. In light of recent studies on targeted epigenomic remodeling and visceral fat loss, this text examines how time-restricted fasting may provide clinically relevant cardiometabolic benefits and explores personalized approaches to energy restriction based on epigenetic predictive factors. Such prediction may represent a selective point of relevance to offer therapeutic intervention in a day-to-day manner. This article ends with a set of prioritized suggestions for longitudinal studies that delineate the overlapping time frame of epigenetic fasting and its influence on the genome in the context of obesity and its associated cardiovascular components
Prevalence of vitamin D deficiency in patients with COVID-19 admitted to a tertiary hospital in Rio Grande do Sul
Full text linkBackground: Increasing data suggests a connection between vitamin D (vitD) and COVID-19. VitD may impact COVID-19 by affecting innate cellular immunity and exacerbating cytokine storms linked to severe respiratory syndrome from the virus. Objective: To assess the prevalence of vitD deficiency in COVID-19 patients hospitalized at Hospital Ernesto Dornelles and examine its links to in-hospital mortality, the need for Intensive Care Unit (ICU), patient demographics, and hospital stay duration. Methods: A cross-sectional study was performed, in which 3518 hospitalized patients with a confirmed diagnosis of COVID-19 were evaluated to obtain the prevalence of vitD deficiency, from March 2020 to August 2022. Data collection was performed using electronic medical records, excluding patients without serum levels of vitD measured during hospitalization, and including those with the exam in their medical records, which were later placed for statistical analysis. Results: 486 patients had their serum level of vitD measured, with a mean age of 68.3 years, 57.2% female, and 42.8% male. The prevalence of vitD deficiency was 60.1% (292 patients). There was no difference between the groups with and without vitD deficiency when comparing age, gender, and comorbidities. The median length of hospital stay, the need for ICU admission, and the outcome of death were significantly higher in the group with vitD deficiency (p<0.001; p=0.005; p=0.03). After adjusting for confounding factors, only the risk of ICU admission remained 1.38x higher in the group with vitD deficiency than in the group without (p=0.015), as well as age and CRF were factors with a higher risk for ICU admission. Conclusions: The prevalence of vitD deficiency in patients with COVID-19 was 60%, being associated with a higher risk of ICU admission, possibly presenting or not an association with higher mortality rates and length of stay. Therefore, further studies are needed to establish a cause-and-effect association