BACKGROUND: Gestational diabetes mellitus (GDM), a temporary condition of pregnancy, identifies women at high risk of developing subsequent type 2 diabetes mellitus (T2D). Lifestyle interventions have been shown to reduce the risk of developing T2D after GDM. However, they often have low attendance and adherence rates. The Avoiding Diabetes After Pregnancy Trial in Moms (ADAPT-M) is a 24-week home-based postpartum program aimed at bridging the gap from prenatal care to T2D prevention for women with GDM. Our objective was to explore the experiences of participants who completed the ADAPT-M program, to elicit their perceived benefits and opportunities for improvement.
METHODS: This was a qualitative descriptive study wherein we conducted semi-structured interviews with 21 women with previous GDM who participated in the ADAPT-M program in Ontario, Canada. Transcripts were analyzed in NVivo using a conventional content analysis approach.
RESULTS: Two themes describing the experience of women who underwent the ADAPT-M lifestyle-based coaching program emerged: a) the benefits of a supportive relationship between coaches and participants, and b) a desire for more from the program, including peer support, more customization, and addressing emotional needs.
CONCLUSIONS: Our findings support the importance of fostering supportive healthcare relationships in T2D prevention programs for postpartum women with a history of GDM. Enhanced customization, emotional support, and opportunities for peer support should be considered in the development of future programming to better meet the needs of participants.

Major depressive disorder (MDD) is a leading cause of disability worldwide. While traditional pharmacological treatments are effective for many cases, a significant proportion of patients do not achieve full remission or experience side effects. Nutritional interventions hold promise as an alternative or adjunctive approach, especially for treatment-resistant depression. This review examines the potential role of nutrition in managing MDD through addressing biological deficits and modulating pathways relevant to its pathophysiology. Specifically, it explores the ketogenic diet and gut microbiome modulation through various methods, including probiotics, prebiotics, synbiotics, postbiotics, and fecal microbiota transplantation. Numerous studies link dietary inadequacies to increased MDD risk and deficiencies in nutrients like omega-3 s, vitamins D and B, magnesium, and zinc. These deficiencies impact neurotransmitters, inflammation, and other biological factors in MDD. The gut-brain axis also regulates mood, stress response, and immunity, and disruptions are implicated in MDD. While medications aid acute symptoms, nutritional strategies may improve long-term outcomes by preventing relapse and promoting sustained remission. This comprehensive review aims to provide insights into nutrition\'s multifaceted relationship with MDD and its potential for developing more effective integrated treatment approaches.

BACKGROUND: Breast cancer is a significant public health challenge, with 290 000 new cases annually and significant healthcare costs. Treatment advancements have led to improvements in survival, but common adverse effects include weight gain, fatigue, nausea, and taste changes, decreasing quality of life.
OBJECTIVE: This review aims to assess the impact of diet and lifestyle interventions during primary treatment for breast cancer and their effects on body weight, body composition, treatment-related adverse outcomes, and patient-reported quality of life.
METHODS: A search of PubMed, CINAHL, and EMBASE conducted through May 10, 2023, identified 31 publications describing 27 interventions including diet or diet plus exercise. The Cochrane Risk of Bias tool assessed the quality of publications.
METHODS: The findings suggest that whole foods, aerobic and strength-training exercises, and intermittent fasting during treatment may improve body weight and composition, treatment-related outcomes, and quality of life. Limitations include variation in study duration, small sample sizes, and limited sociodemographic data.
CONCLUSIONS: Improvements seen with increased diet quality and reduced caloric intake, with or without exercise, challenge current standard-of-care recommendations during treatment for breast cancer. While there is a need for additional research, healthcare teams can confidently promote healthy diets and exercise during primary treatment for breast cancer to manage weight and improve treatment-related side effects and quality of life.
BACKGROUND: PROSPERO registration no. 42023425613.

UNASSIGNED: The effectiveness of dietary therapy to induce remission of eosinophilic esophagitis (EoE) has been evaluated over the last decades and summarized in meta-analyses. Choosing the dietary modality, identifying the most suitable patients, and implementing specific prerequisites are essential to ensure long-term success.
UNASSIGNED: Impractical exclusive elemental diets provided the highest remission rates in EoE; however, they are not recommended due to their numerous disadvantages and detrimental effects on patient quality of life. Allergy testing-guided diets for EoE are limited; their insufficient effectiveness and low reproducibility are due to poor accuracy of skin or serum test results in identifying EoE food triggers. Initial experiences with a six-food elimination diet have provided evidence of high and predictive effectiveness rates and paved the way for less restrictive and more efficient step-up approaches, including four-food, two-food, and most recently, milk elimination diets. Dietary treatment for EoE is challenging for patients and families and requires certain skills to ensure success in the short and long term.
UNASSIGNED: The selection of appropriate patients is essential to ensure the success of and long-term adherence to dietary treatment of EoE. As normal triggers for EoE are commonly found in the staple diet, it is important to ensure adequate nutritional substitutes to avoid nutrient deficiency risks when long-lasting feeding difficulties or extensive restrictions are present. Specialized facilities in dietary therapy should adopt patient-centered and personalized approaches in order to provide timely monitoring and support for complex cases.

Obesity stands out as a primary risk factor for diabetes. Attaining healthy weight loss, especially reducing body fat, is important in managing prediabetes and preventing progression to full diabetes and its co-morbidities. This study examined the effects of personalized nutrition therapy (PNT) combined with continuous glucose monitoring (CGM) on body weight and composition in individuals with prediabetes. A total of 30 individuals with prediabetes who were overweight or obese were assigned randomly to either the treatment, observed CGM data plus PNT, or the control group which was blinded to their blood glucose results throughout the study. Both groups were provided with dietary recommendations for calorie intake and macronutrient distribution, coupled with personalized goal setting for glucose control and healthy eating, without any specific emphasis on weight reduction or changes in physical activity. Regular visits were scheduled every 10 days to perform measurements and replace CGMs. Data were analyzed using General Linear Model with repeated measures. Over the 30-day follow-up period, both groups experienced significant reductions in weight and fat mass. The treatment group exhibited two-fold greater reductions in both weight and fat mass, a significant decrease in carbohydrate intake, and a significant increase in time spent on physical activitycompared to the control group. In addition, compliance was notably higher in the treatment group. These findings indicate that overweight or obese individuals with prediabetes can achieve weight loss and improved body composition through personalized education for glucose control, without exclusively emphasizing weight loss as the primary objective. Additionally, the real-time feedback provided by CGM enhances these improvements.

Excess body weight in pediatric patients and the resulting dyslipidemia, if left untreated, are a serious risk factor for cardiovascular disease in young adults. Despite this, there is still no effective and validated nutritional strategy for the treatment of overweight/obesity and comorbid dyslipidemia in children and adolescents. A low-glycemic index (LGI) diet may be recommended, but evidence for its effectiveness in the pediatric population is limited. The aim of this study was to evaluate the effectiveness of nutritional intervention in children and adolescents with excess body weight and dyslipidemia. The study was conducted in patients aged 8-16 with overweight or obesity and lipid disorders (n = 64), of which 40 participants who completed the entire 8-week study were included in the analysis. Patients were randomly selected and allocated to one of the two dietary groups: the LGI diet or the standard therapy (ST) diet. Both diets were based on the principal recommendation of Cardiovascular Health Integrated Lifestyle Diet-2 (CHILD-2). This study showed that both LGI and ST diets were equally beneficial in reducing body weight, body fat, blood pressure, total cholesterol (TC), and triglyceride (TG) levels. The LGI diet, compared to the ST diet, was less effective in reducing blood TG levels but more effective in reducing diastolic blood pressure (DBP). Therefore, the choice of the type of diet in the treatment of children and adolescents with excess body weight and dyslipidemia may be individual. However, it should be based on the recommendation of CHILD-2. Further long-term, larger-scale studies are needed.

Crohn\'s disease is a type of inflammatory bowel disease (IBD) that typically presents in the second or third decade of life. There are various pharmaceutical therapies that have been developed to treat the disease\'s symptoms. However, some patients still do not find relief with these medications and turn to other therapies such as diet modification. The underlying cause of Crohn\'s disease involves multiple factors such as uncontrolled inflammation and several genetic variants. While most current medication therapies control the symptoms that occur due to this uncontrolled level of inflammation, an anti-inflammatory diet (AID) may actually lower the level of inflammation in the gut and therefore reduce the amount of disease symptoms in Crohn\'s disease. Some such diets include the IBD-AID, Crohn\'s disease exclusion diet, and the Groningen AID (GrAID). This report describes a case of treatment-resistant Crohn\'s disease in a patient who was given all categories of pharmaceutical therapies including prednisone, budesonide, sulfasalazine, olsalazine, 6-mercaptopurine, methotrexate, mesalamine, and adalimumab. These only gave temporary relief of symptoms and eventually failed for various reasons including allergic reaction, insufficient symptom control, and antibody formation against the medication. This prompted the patient to independently research AIDs instead. In conclusion, for patients whose disease is refractory to different treatments, or who develop antibodies to the medication, AIDs may offer a solution to reduce disease symptoms and progression. Education of healthcare professionals and patients alike is vital in order for Crohn\'s patients to gain the benefits from dietary therapy.

BACKGROUND: The aims of this study were to develop and evaluate a high/low-emulsifier diet and compare emulsifier content with preclinical studies that have associated Crohn\'s disease with emulsifiers.
METHODS: Supermarkets were audited with a seven-day high- (HED) and low-emulsifier diet (LED) meal plan developed. The emulsifier content of food was sought from food manufacturers, compared to acceptable daily intake (ADI), and doses were provided in trials. Nutritional composition analysis was completed. Healthy adults ate these diets for seven days in a randomized single-blinded cross-over feeding study to assess palatability, tolerability, satiety, food variety, dietary adherence, blinding and the ease of following the meal plan via visual analogue scale.
RESULTS: A database of 1680 foods was created. There was no difference in nutritional content between the HED and LED, except HED had a higher ultra-processed food content (p < 0.001). The HED contained 41 emulsifiers, with 53% of the products able to be quantified for emulsifiers (2.8 g/d), which did not exceed the ADI, was similar to that in observational studies, and was exceeded by doses used in experimental studies. In ten participants, diets were rated similarly in palatability-HED mean 62 (5% CI 37-86) mm vs. LED 68 (54-82) mm-in tolerability-HED 41 (20-61) mm vs. LED 55 (37-73) mm-and in satiety HED 57 (32-81) mm vs. LED 49 (24-73) mm. The combined diets were easy to follow (82 (67-97) mm) with good variety (65 (47-81)) and excellent adherence.
CONCLUSIONS: Nutritionally well-matched HED and LED were successfully developed, palatable and well tolerated.

BACKGROUND: Patients with dialysis-dependent kidney failure and treated for hyperphosphatemia receive a combination of dietary advice, phosphate binders and prolonged dialysis. However, research focusing on the challenges patients meet in everyday life addressing diet and medication is sparse.
OBJECTIVE: The objective of this study is to explore the everyday challenges patients meet when following treatment for hyperphosphatemia.
METHODS: Interpretive description was the methodological approach. Semistructured in-depth interviews were employed to study the challenges patients experienced. Data were analysed using Braun and Clarke\'s reflexive thematic analysis.
METHODS: Patients (n = 14) receiving haemodialysis and treated for hyperphosphatemia from two hospitals in Southern Denmark.
RESULTS: The analysis resulted in one over-arching theme; separation in social gatherings and two subthemes; a new social code, and my food and their food. Participants experienced difficulty integrating diet and medication in daily life, especially at social gatherings. They felt separated from others when special menus were provided for them or struggled when choosing between high and low phosphate-containing food. A new awareness of self and others arose, especially their position among families and friends, and how they presented themselves and their social identity to others. Likewise, a new social code manifested itself, which was difficult to accept. Most participants experienced that diet and medication were accompanied by a moral responsibility of whether to accept prepared food with high phosphorus content or not, which affected commensality.
CONCLUSIONS: Patients were often nonadherent to hyperphosphatemia treatment at social gatherings. Hyperphosphatemia treatment led to new social identities with new social codes, which patients found difficult to accept.

Many patients diagnosed with cancer adopt dietary changes and supplement use, and a growing body of evidence suggests that such modifications can affect outcomes to cancer therapy. We sought to assess the prevalence of these practices and the surrounding physician-patient dialogue among patients with metastatic renal cell carcinoma. An online survey was administered by Kidney Cancer Research Alliance (KCCure), interrogating dietary modification patterns, supplement usage, out-of-pocket expenditure related to supplements, and patients\' views toward alternative medicine practices. Patients with metastatic renal cell carcinoma receiving combination therapy were actively solicited. In total, 289 unique responses were collected. The most common first-line treatments were nivolumab/ipilimumab (32.4%) and axitinib/pembrolizumab (13.1%). Within the cohort, 147 (50.9%) started using supplements following diagnosis of renal cell carcinoma; the most utilized supplements were probiotics, cannabidiol (CBD) oil/marijuana, and Vitamin C, reported by 70 (47.6%), 61 (41.4%), and 54 (36.7%), respectively. Dietary modifications following cancer diagnosis were reported by 101 (34.9%) respondents, of which 19.8% followed the Mediterranean diet and 18.8% adopted a ketogenic diet. Most respondents (71.3%) noted that they consistently report supplement usage to their physicians. A substantial proportion of patients with metastatic renal cell carcinoma utilize dietary modification and supplements as an adjunct to antineoplastic therapy. Considering the widespread adoption of these practices and the reported effects on cancer treatment, it is crucial for healthcare providers to engage in discussions with patients regarding supplement use.