International Journal of Nutrology
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Major clinical outcomes of the gut microbiota-skin axis through exosomes and probiotics: a systematic review
Full text linkIntroduction: Skin diseases have contributed significantly to the increasing burden of disease and injury in recent years, and the gut microbiota, probiotics, and exosomes contribute to reducing this burden. These vesicles have emerged as a focus of fundamental research in regenerative medicine. Exosomes participate in intercellular communication, tissue repair, and disease pathogenesis. Objective: The study analyzed the main scientific evidence on the relationship between gut microbiota and skin, emphasizing the importance of intestinal health through probiotics and exosomes for aesthetically healthy skin. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from May to July 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 122 articles were found, 52 of which were fully evaluated, and 23 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in seven studies with a high risk of bias and 20 studies that did not meet GRADE and AMSTAR-2 criteria. Most studies showed homogeneity in their results, with X2=88.9%>50%. It was concluded that exosomes and the gut microbiota directly impact skin regenerative processes. Despite the challenges, their complexity and versatility reinforce their potential in the development of personalized strategies for skin health. To establish aesthetically healthy skin, it is imperative to manipulate the gut microbiota to achieve balance. Therefore, treatments that elevate or repair the gut are essential as adjunctive therapy in the management of inflammatory skin diseases and may contribute to the effectiveness of standard dermatotherapy
Choline and betaine intake among brazilian picky-eater children: an observational cross-sectional study
Full text linkIntroduction: Choline is a phospholipid component, considered by the Institute of Medicine (IOM), since 1998, as an indispensable nutrient for human beings. After ingestion, free choline is absorbed by the intestinal epithelium by carrier-mediated transport and accumulates in all tissues. In children, low choline levels are related to impairments in synaptic transmission, synaptic plasticity and learning processes, damage to the neuronal membrane, communication and visual-motor deficits and lower academic performance. Objective: To evaluate choline and betaine intake in a sample of Brazilian picky eaters aged between 2 and 5 years. Methods: This an observational cross-sectional study included 62 children classified as picky eaters, assessed during their first visit to a pediatric clinic in Ribeirão Preto, Brazil. Dietary intake was evaluated using a 24-hour dietary recall. Choline and betaine intakes were analyzed using nutrition analysis software, supplemented with data from the USDA food composition database. Choline intake adequacy was determined based on the Dietary Reference Intakes. Results: Median choline intake was 177.2 mg/day (IQR: 116.7–261.2), while betaine intake reached a median of 18.5 mg/day (IQR: 10.9–36.1). Choline intake was below the Adequate Intake (AI) in 61.3% (n=38) of the participants. No dietary reference values are established for betaine intake. Anthropometric z-scores indicated a sample with preserved nutritional status. Conclusion: Brazilian picky eater children have reduced choline intake and this fact can lead to the consequences that have been observed by the deficiency of this nutrient, especially negative repercussions for neurodevelopm.
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Recommendations and guidance on Cobalamin (Vitamin B12) based on the Delphi method
Full text linkIntroduction: Vitamins are essential micronutrients for the body to function. Cobalamins (Cbls) are watersoluble compounds, acting as cofactors in enzymatic reactions. However, the use of Cbls in the clinical environment is still controversial. Objective: It was to discuss the topic and help guide different professionals, experts were brought together to discuss criteria concerning the diagnosis, indications, and use of cobalamin. Methods: The study was carried out using the Delphi method. Topics were initially created to direct the discussion and initial contributions. In the first meeting with the panelists, questions were formulated. The questions were distributed to all panelists. With the contributions, a text with the answers was created, and a third round to review the contributions and agree with the text was carried out. Results: The main topics related to the use of cobalamin were identified. Conclusion: The main topics related to this topic include risk groups of deficiency of ingestion or absorption by the gastrointestinal tract. The deficiency diagnosis must be made through laboratory tests, and early indication must be made when a significant cobalamin deficiency is identified, to avoid irreversible clinical conditions. A recommended practice is monitoring between 2 and 6 months after starting cobalamin replacement. Evidence Level:6
Clinical evidence on nutrological management and gut microbiota in inflammatory bowel diseases: a systematic review
Full text linkIntroduction: The main risk factor for inflammatory bowel disease (IBD) is a positive family history. Crohn's disease (CD) can affect individuals aged 15 to 40 and 50 to 80 years, with a higher percentage in women. Ulcerative colitis (UC) can start at any age. Metabolism encompasses the interactions between diet, the microbiome, and cellular enzymatic processes that generate the chemical pathways necessary to sustain life. Endogenous metabolites and dietary nutrients can directly influence epigenetic enzymes. Epigenetic modifications to DNA and histone proteins alter cell fate by controlling chromatin accessibility and downstream gene expression patterns. Objective: It was to highlight the main interactions between nutrition and gut microbiota in the treatment of inflammatory bowel diseases. Methods: The present study followed the international systematic review model (PRISMA). This study was carried out from July to September 2024. It included randomized controlled, prospective, and retrospective studies published from 2013 to 2023. The Cohen test was performed to calculate the Effect Size and the inverse error standard (precision or sample size) for the risk of bias (Funnel Plot). Results and Conclusion: A total of 30 articles were found, and 17 clinical studies on the modulation of diet to control IBD were included in this study. These studies have shown reductions in persistent gut symptoms, improved gut microbiota, reduced markers of inflammation, and improved quality of life. Diet has an important role in controlling and even remitting IBD. The studies were homogeneous in results, with X2 = 82.5%, which increases the reliability of clinical results on the importance of diet in modulating IBD
Major clinical studies on the relationship between testosterone levels and aging in men: a systematic review
Full text linkIntroduction: After 30 years of age, testosterone levels decline at a rate of 1-2% per year, which correlates with an increased incidence of late-onset hypogonadism diagnosed in middle-aged and elderly men. Testosterone replacement therapy (TRT) is emerging as a promising solution for aging-related problems. Objective: This study aimed to present the main clinical studies on the relationship between testosterone levels and aging in men, as well as an analysis of the reduction in physical and metabolic comorbidities. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted 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: A total of 86 articles were found. A total of 23 articles were fully evaluated, and 11 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 21 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=77.4%>50%. It was concluded that in the setting of aging in men, late-onset hypogonadism is the clinical entity characterized by low testosterone concentrations associated with clinical symptoms in the absence of organic disease in elderly men. It has been associated with metabolic syndrome, reduced bone mineral density, and increased risk of cardiovascular morbidity and mortality. Although testosterone replacement therapy reverses most of these conditions in young hypogonadal men, the risk/benefit ratio of testosterone replacement therapy in older men is debatable. In middle-aged and older men with hypogonadism and low libido, testosterone replacement therapy for 2 years improved sexual activity, hypogonadal symptoms, and sexual desire, but not erectile function. Furthermore, men with low testosterone, elevated luteinizing hormone, or deficient estradiol concentrations had increased all-cause mortality. Testosterone treatment aimed at achieving physiological concentrations in middle-aged and older men may improve lean body mass, while exercise training improves lean body mass, aerobic fitness, and strength
Basophils in allergy: immunological mechanisms, diagnostic innovations, and clinical implications in the context of meat allergy
Full text linkIntroduction: Allergic diseases remain a widespread clinical problem, affecting diverse populations and placing increasing demands on healthcare resources. Objective: This review set out to assess the modern research about the immunological functions of basophils in the context of allergic disorders and to evaluate their diagnostic and therapeutic relevance. Methods: A thorough literature review, which adhered to PRISMA 2020 guidelines, was performed utilising the PubMed, Scopus, and Web of Science databases. Research published from 2019 to 2024 was chosen according to certain keywords pertaining to basophil activation, α-gal syndrome, and the diagnostic uses of the basophil activation test (BAT). Results and Conclusion: The evidence compiled here demonstrates the pivotal contribution of basophils to both IgE-dependent and IgE-independent allergic processes. These cells release potent mediators such as histamine and interleukin-4 (IL-4), influencing T-helper 2 (Th2) cell differentiation and amplifying inflammatory cascades. Recent research highlights the usefulness of the BAT in detecting IgE-mediated hypersensitivities to foods, medications, and insect venoms, owing to its notable sensitivity and specificity. Studies further suggest that monitoring basophil responsiveness during allergen-specific immunotherapy or biological interventions may guide therapeutic decisions, as declining basophil reactivity correlates with improved allergen tolerance. Notably, emerging research on meat allergies, particularly α-gal syndrome, reveals that basophils are critical mediators in IgE-mediated reactions to mammalian meat allergens. BAT is proving instrumental in diagnosing meat allergies, helping to distinguish sensitized individuals from those with clinical manifestations. Despite promising developments, several obstacles hinder the wider integration of BAT into clinical protocols, including variations in basophil responsiveness, lack of standardized testing procedures, and insufficient large-scale population studies. These gaps underscore the importance of ongoing research aimed at refining diagnostic accuracy, developing targeted therapeutics, and clarifying the multifaceted interplay between basophils and other immune components
Advances in the Treatment of Obesity with GLP-1 and GIP Agonists: State of the Art at the Upcoming XXIX Brazilian Congress of Nutrology
Full text linkQuality assessment of common CARp (Cyprinus Carpio) products depending on method of processing and storage methods: an experimental research
Full text linkBackground: With global fish production exceeding 178 million tonnes and up to 35% lost to spoilage, improving processing and storage is vital to maintain quality. Freshwater species like carp, rich in moisture and unstable fats, rapidly deteriorate during storage, demanding precise preservation methods. Objective: The study aimed to determine the effect of processing methods and storage conditions on the organoleptic, physicochemical, and microbiological quality of carp products. The subject of the study was carp fillets that were subjected to freezing, hot and cold smoking, and traditional and optimised drying. Methods: After processing, the samples were stored in three types of packaging: vacuum, modified atmosphere (gas mixture), and traditional (polyethylene and paper). The organoleptic evaluation was conducted by qualified and certified sensory panellists following the international standard and additionally determined moisture content, peroxide number, malondialdehyde content, texture hardness and total microbial contamination. Results: The highest sensory scores (4.6-4.8 points) were achieved by meat processed by hot smoking or optimised drying and packaged in a vacuum or modified atmosphere. The frozen meat gradually lost its texture and flavour properties, and after six months in traditional packaging the sensory score dropped to 2.5-2.8 points. At the same time, the peroxide number increased by 68% on average and the malondialdehyde content by 57%. Conclusions: A strong positive correlation between the storage time and the level of lipid oxidation was recorded (correlation coefficient of 0.89 with a significance level of less than 0.01). The results of the study can be used to improve the technologies of processing and packaging freshwater fish in production conditions to extend the shelf life without loss of quality.
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Major outcomes of clinical studies and guidelines on nutrological therapy and palliative care in critically ill patients: a systematic review
Full text linkIntroduction: Adequate nutritional therapy is often a missing factor in the treatment of patients receiving end-of-life palliative care. The American Academy of Hospice and Palliative Care defined palliative care as comprehensive and specialized care. The main concerns are nutritional, pain, and symptom management, information sharing and advance care planning, psychosocial and spiritual support, and care coordination. Objective: It was to list the main outcomes of clinical studies and guidelines on enteral/parenteral nutritional therapy and palliative care in critically ill patients. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from June 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 93 articles were found. A total of 44 articles were evaluated in full and 16 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 13 studies with a high risk of bias and 27 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=85.9%>50%. It was concluded that palliative nutritional care plans for critically ill patients should be managed by a nutritionist together with patients and family members. The benefits and risks of artificial nutrition and hydration should be discussed with the patient and/or caregiver when palliative care is initiated. The main goal of palliative care is to preserve the patient's quality of life. This includes defending freedom of choice and allowing the patient to determine their level of nutritional intervention. The results suggest that providing nutritional support ( 12 g of protein, 300 kcal) daily prevents the loss of active tissue mass in palliative cancer patients. Based on these results, we recommend the inclusion of this simple nutritional support to prevent malnutrition in cancer patients in palliative care. Furthermore, severe malnutrition is a predictor of reduced survival in patients with advanced gastrointestinal cancer. Information on nutritional status should be considered to individualize the palliative care plan for these patients and, therefore, improve their quality of life. Using the modified Glasgow Prognostic Score to identify the existence and severity of cancer cachexia has the potential to aid clinical decision-making regarding the indication of enteral nutrition in patients with incurable cancer receiving palliative care
Clinical outcomes of intravenous laser irradiation of blood in reducing inflammatory processes in obesity: a systematic review
Full text linkIntroduction: In the setting of hematologic diseases, Intravenous Laser Irradiation of Blood (ILIB) at a wavelength of 630-640 nm was developed to treat several diseases. Studies have shown that ILIB acts directly on the parameters of all blood cells, the state of the plasma, and all structural components of the vascular wall. Furthermore, by acting on cells of the immune system, hormones, and exchange processes, ILIB can influence all other systems of an organism. Objective: This was to conduct a systematic review to present the main clinical outcomes of using ILIB in restoring blood fluidity and reducing inflammatory processes. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from April to May 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: Ninety-four articles were found. A total of 25 articles were evaluated and 08 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 35 studies with high risk of bias and 19 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X2 = 87.2% >50%. It was concluded that ILIB causes systemic effects, with improvements in blood rheological properties and microcirculation, as well as reduction in infarction area, cardiac arrhythmias and sudden death. ILIB can reduce low-density lipoprotein (LDL) and increase high-density lipoprotein (HDL), and is also effective in relieving oxidative stress and mitochondrial dysfunction in patients with comorbidities or injuries. ILIB has shown an important role in reducing and controlling blood pressure in humans. Furthermore, patients with stroke may benefit from ILIB. Pro-inflammatory cytokine levels can be reduced, as well as corrections of immune disorders have been achieved with the use of ILIB compared to drug therapy alone