International Journal of Nutrology
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Micronutrient supplementation among pregnant women: effects on maternal anemia and neonatal outcomes
Full text linkBackground: Synonymous with low- and middle-income countries (LMICs), micronutrient deficiencies during pregnancy is a serious public health issue. It is estimated that 38% of pregnant women around the world are anaemic and this is mainly due to iron deficiencies but other risks are posed by poor consumption of folate and vitamin B twelve. These shortcomings are a reason of poor maternal and neonatal outcomes, including preterm birth, low birth weight and fetal growth restriction. Multivitamin minerals (MMS) have been an attractive alternative to the conventional iron and folic acid (IFA) program. Objective: The purpose of this review is to examine barriers to implementation of supplementation programs, and to examine strategies including simulation frameworks, and real time data analytics, to enhance these interventions. Methods: Systematic literature review using scientific databases namely; PubMed, Scopus, and Google Scholar to identify studies targeting clinical subjects published between 2020 and 2025 was conducted. Qualitative thematic analysis approach was used for synthesizing the findings on maternal health, neonatal outcomes, as well as the program implementation challenges. The selected and included studies were based on the PRISMA framework. Results: MMS has been found to offer broader benefits than IFA in that it appears to reduce risks for preterm birth, low birth weight, and small-for-gestational-age, with the benefits accumulated when folate is also fortified. Although IFA continues to be an effective measure for tackling the problem of maternal anaemia and reducing neonatal mortality rates, as evidenced by its proven results in a host of observed cases, the nutritional support it provides is not comprehensive enough, unlike its counterpart MMS. The poor adherence, limited accessibility, socioeconomic barriers, and insufficient education were identified to be multiple barriers for implementation. We suggested strategies including SMS reminders, homebased support, and free provision of supplement. Cost benefit analyses also indicate that MMS would be a viable investment for maternal and child health programs. Conclusions: It is possible to reduce the possibility of improvement in maternal and neonatal health outcomes in LMICs with micronutrient supplementation, particularly with MMS. However, tailored interventions, better education, use of data driven approaches are what are needed to overcome the implementation barriers. The long term impacts and the best time and way of delivering the optimal gestational nutrition need to be studied or refined to achieve maternal and child health global targets.
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High cholesterol in a young woman with normal weight
Full text linkHypercholesterolemia is often associated with obesity and unhealthy lifestyle decisions. However, people with a normal body weight can also experience increased cholesterol levels, which emphasizes the need for routine lipid screening beyond conventional risk factors. This study presents a case of a 33-year-old woman with a BMI of 22.7, in which high cholesterol (total cholesterol: 301 mg/dL, LDL: 215 mg/dL) was diagnosed, although they have no knowncardiovascular risk factors. Instead of medication, she took a structured nutritional scheme that focused on increased fiber intake, reduced saturated fat consumption, and regular physical activity. Within 40 days, their total cholesterol level fell by 20%, and the LDL mirror fell by 25% and improved over six months. This case underlines the effectiveness of early dietary interventions in lipid management and underlines the boundaries of the BMI as the sole indicator ofcardiovascular risk. Regular lipid reviews and preventive nutritional strategies should be prioritized for individuals independently of body weight. Future research should examine the long-term effects of changes in nutrition on cardiovascular health and compliance with patients
Major clinical findings hormone replacement therapy and prevention of cardiovascular events: a systematic review
Full text linkIntroduction: Cardiovascular disease (CVD) is the leading cause of death in women. Low estrogen levels during menopause are associated with an increased risk of CVD. Therefore, hormone replacement therapy (HRT) can mitigate menopause-related diseases. Vasomotor symptoms affect about 60.0 to 80.0% of postmenopausal women and may have an incidence of 90.0% in perimenopausal women. The main studies in the last 20 years have investigated the effects of estrogen therapy on symptoms and women's health during menopause. Objective: This was to conduct a systematic review to better understand the main findings and discussions of international consensus on hormonal therapies in women regarding cardiovascular events. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from May to June 2025 in 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 130 articles were found. A total of 39 articles were fully evaluated, and 23 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 at high risk of bias and 25 studies that did not meet the GRADE and AMSTAR-2. It was concluded that hormone replacement therapy is a sex-specific and time-dependent primary cardiovascular disease prevention therapy that concomitantly reduces all-cause mortality as well as other aging-related diseases. Observational studies did not suggest an increased risk of myocardial infarction in postmenopausal women with diabetes prescribed HRT. Lipoprotein, LDL-C, and insulin resistance were lower with hormone therapy, and HDL-C levels were higher with hormone therapy compared to placebo. Thus, hormone therapy in women was shown to be important for improving organic functions and quality of life, as well as showing a bias in reducing cardiovascular events
Importance of nutrological management and gut microbiota in alzheimer's disease: a systematic review
Full text linkIntroduction: In the context of neurodegenerative diseases, Alzheimer's disease (AD) is the most common form of dementia. It is estimated that more than 46 million people are affected worldwide. Several factors contribute to the risk of developing late-onset Alzheimer's disease, including advanced age, genetic factors, family history, history of head trauma, hypertension in midlife, obesity, diabetes, and hypercholesterolemia. Studies have shown the important role of the gut microbiota in controlling this condition, together with adequate nutrition. Objective: It was to analyze the relationship between dietary patterns, gut microbiota, micro and macronutrients, and cognitive disorders in Alzheimer's disease. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from May to August 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: A total of 140 articles were found. 75 articles were fully assessed 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 15 studies with a high risk of bias and 25 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=89.5%>50%. It was concluded that several antioxidants found in a healthy natural diet can efficiently attenuate free radical attacks and neutralize dysregulated pro-oxidants, reducing oxidative stress and the induction of degenerative diseases such as Alzheimer's disease. Studies have found that plasma lipopolysaccharide levels in patients with Alzheimer's disease were three times higher than in healthy controls. Thus, increased concentrations of plasma lipopolysaccharide and fecal calprotectin indicate an altered intestinal barrier function and increased inflammation and intestinal permeability in patients with Alzheimer's disease
Action of probiotics and nutrients in the management of tregs cells in patients with obesity and cancer: a systematic review
Full text linkIntroduction: In the context of immunomodulation in patients with obesity and cancer, Bifidobacterium is one of the most commonly used probiotics and activates the anti-CTLA-4 antibody, a checkpoint inhibitor that frequently causes autoimmunity in humans undergoing cancer treatment. Immunotherapy enhances the host's immune system to produce antitumor effects, primarily by stimulating Treg cells. Objective: It was to highlight how probiotics and nutrients can stimulate regulatory T cells in patients with obesity and cancer, to immunomodulate and treat these patients. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from April to June 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: A total of 137 articles were found, and 39 articles were evaluated in full, and 31 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 25 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=68.9%>50%. It was concluded that oral administration of butyrate, propionate, and acetate, individually or in combination, led to an increase in the number of Treg cells in the colon. Also, all-trans retinoic acid (atRA), a bioactive form of vitamin A stimulates Treg cells in the human intestine. Probiotics, together with gut microbiota, have been increasingly proposed to improve immune checkpoint blockade treatments against cancer by activating Treg cells
Low-glycemic index dietary modulation and its impact on epigenetic aging markers in overweight adults: a prospective cohort study
Full text linkThis investigation examines how, among overweight adults, modest dietary lowering of the glycaemic index (GI) affects recognised molecular markers of epigenetic ageing. GI, the established framework for ranking foods according to their postprandial glucose effect, is increasingly understood as a dietary signal influencing underlying biological ageing processes. The central premise of the present work is that sustained low-GI intervention dampens the rate of epigenetic ageing—a contributor to biological and cognitive senescence—and thereby attenuates the onset of age-related morbidity. To evaluate this hypothesis, epigenetic ageing indicators, prominently including across-genome DNA methylation signatures, were ascertained at baseline and at the conclusion of a 12-week low-GI prescriptive programme. The analysis demonstrates pronounced modulation of epigenetic markers within the dietary intervention cohort in contrast to the control cohort, indicating that modulation of the glycaemic index in the diet may attenuate biological senescence. This manuscript elaborates the pathways by which a low-glycaemic-index dietary regime exerts epigenetic effects, therein suggesting that systemic nutritional alterations stand as a plausible strategy for the enhancement of healthspan. Concurrently, the data affirm the clinical utility of habitual low-glycaemic-index food consumption as a preventive measure against senescence-related morbidities. Recommended trajectories for continuing enquiry are outlined, prioritising prospective longitudinal cohorts and a more exhaustive dissection of the molecular mechanisms engaged
Main clinical evidence on nutrients, lifestyle and gut microbiota in the treatment of inflammatory bowel diseases: a concise systematic review
Full text linkIntroduction: The main risk factor for inflammatory bowel diseases (IBD) is a positive family history. The pathogenesis of IBD is linked to genetically susceptible individuals, dysregulated intestinal microbiota (dysbiosis), chronic inflammation and poor dietary patterns. Diet plays an important role in modulating the gut microbiota. Objective: It was to carry out a systematic review on the main interactions between nutrition, lifestyle changes, intestinal microbiota and inflammatory bowel diseases, in order to highlight the main clinical outcomes. Methods: The present study followed the international systematic review model (PRISMA). This study was carried out from January to March 2025. It included randomized controlled, prospective and retrospective studies. Common descriptive statistical analysis was performed. The Chi-Square (X2) and One-Way (ANOVA) tests were applied, adopting an α level lower than 0.05 (p<0.05) with statistical significance in the 95% confidence interval. The R-sq (X2) value using the Chi-Square test was analyzed to discover the inaccuracy or heterogeneity of the analyses, adopting the codes of low association ≤ 25%, medium association 25% <X<50% and high association ≥ 50%. The Cohen test was performed to calculate the effect size (Effect Size) and the inverse of the standard error (precision or sample size) for the risk of bias (Funnel Plot). Results: A total of 207 were found, 17 clinical studies on the modulation of diet to control IBD were included in this study. These studies showed reductions in persistent intestinal symptoms, improvement in the intestinal microbiota, reduction in markers of inflammation and improvement in quality of life, with statistical significance (p<0.05) (95% CI). The studies were homogeneous (X2 = 92.32%), which increases the reliability of clinical results on the importance of diet in modulating IBD. Conclusion: The important role of dietary modulation in controlling and even remitting IBD was evident
Catch-Up Growth or Catch-up Development? It's time to update the concept
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Investigation of clinical outcomes on the oral or injectable use of semaglutide and cardiovascular risks: a systematic review
Full text linkIntroduction: In the context of GLP-1 analogs and cardiovascular risks, both subcutaneous and oral formulations of semaglutide have undergone extensive phase 3 clinical trials. Objective: It was to analyze, through a systematic review, the main clinical findings of the oral or injectable use of semaglutide and its relationship with cardiovascular risks. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from November 2024 to January 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: 132 articles were found. A total of 35 articles were fully evaluated and 25 articles were included. According to the GRADE instrument, most of the studies presented homogeneity in their results, with X2 = 87.5%> 50%. It was concluded that subcutaneous injection is more likely to result in endocrine-related adverse events. Oral administration is more likely to induce gastrointestinal adverse events. Furthermore, it significantly accelerates the onset of adverse reactions. As one of the newer agents in the class, the safety of semaglutide in both subcutaneous and oral formulations has been examined in phase 3 and CVOT programs. However, no major safety concerns have emerged to date, although definitive conclusions for pancreatic cancer, thyroid cancer, and complications of polycystic kidney disease cannot be drawn at this time. Compared with the beneficial effects of these drugs on glucose metabolism, blood pressure, body weight, and cardiovascular (and potentially even renal) outcomes, these agents have an overall beneficial risk/benefit profile for treating patients with T2DM. GLP-1RAs are safe, well tolerated, and improve cardiovascular outcomes, largely independent of their antihyperglycemic properties, but they remain underutilized by cardiologists and require therapy management in patients with T2DM and established atherosclerotic cardiovascular disease or high risk for established atherosclerotic cardiovascular disease
Scientific evidence of teduglutide in parenteral support in patients with short bowel syndrome: a systematic review
Full text linkIntroduction: Short bowel syndrome (SBS) is a heterogeneous condition in which patients suffer from impaired intestinal absorption due to absolute loss of the intestine. Approximately 75% of SBS cases develop after a single massive bowel resection. Patients with SBS with intestinal failure (II) [SBS-II] experience decreased quality of life and increased morbidity and mortality due to their dependence on parenteral support (PS). Teduglutide is a degradation-resistant peptide 2 (GLP-2) analog that increases the functional and structural capacity of the intestine. Objective: To analyze the scientific evidence for teduglutide in parenteral support in patients with short bowel syndrome. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from June to August 2024 in the Web of Science, 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: A total of 91 articles were found. 29 articles were fully evaluated and 07 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=82.7%>50%. It was concluded that teduglutide can restore intestinal structural and functional integrity, promote mucosal growth, reduce gastric emptying and secretion, and increase nutrient absorption and enteral independence from parenteral nutrition. The 24-week treatment time with teduglutide was generally well tolerated in patients with short bowel syndrome with intestinal failure. The clinical studies showed that teduglutide treatment reduced the volumes and number of days of parenteral support for patients with short bowel syndrome with intestinal failure