Cow's milk protein allergy (CMPA) is one of the most common food allergies in infancy. Clinical food allergy guidelines recommend an extensively hydrolyzed formula (EHF) as the first-line treatment in nonbreastfed infants with CMPA. Designing and commercializing EHF poses both technical and regulatory challenges. Each manufacturing step, from sourcing of raw materials to release of the final product, needs to be managed in accordance with comprehensive quality systems. To avoid cross-contamination via externally sourced ingredients, suppliers should be carefully selected based on quality requirements. Strict zoning of the manufacturing areas according to contamination risk and air flow control are effective strategies to prevent accidental allergen contamination. Furthermore, dedicated manufacturing lines for hypoallergenic products are used to prevent potential cross-contamination from other products produced on the same line. The enzymatic hydrolysis, heat treatment and ultrafiltration used are specific to each manufacturer. https://www.selleckchem.com/ Consequently, EHF are a heterogenous group of products with differences in the molecular weight profile of peptides, content of residual immunogenic cow's milk allergens, and residual in-vitro allergenicity. These differences are likely to affect clinical efficacy and safety. As not all commercialized EHF products have undergone formal testing in the laboratory and clinical trials, there is a need to develop guidelines for minimum technical and regulatory requirements for EHF products, including validated assays for ongoing quality control. Clinical trials assessing new EHF products for their hypoallergenicity and ability to support normal growth remain the definitive proof of efficacy and safety in infants and young children with CMPA.Food allergy is a large and growing public health problem in many areas of the world. The prevalence of food allergy has increased in the last decades in a very significant way in many world regions, particularly in developed countries. In that respect, the research field of food allergy has experienced an extensive growth and very relevant progress has been made in recent years regarding the characterization of food allergens, the study of their immunological properties, and their detection in food sources. Furthermore, food labeling policies have also been improved decidedly in recent years. For that immense progress made, it is about time to review the latest progress in the field of food allergy. In this review, we intend to carry out an extensive and profound overview regarding the latest scientific advances and knowledge in the field of food allergen detection, characterization, and in the study of the effects of food processing on the physico-chemical properties of food allergens. The advances in food labeling policies, and methodologies for the characterization of food allergens are also thoroughly reviewed in the present overview.Freeze-drying, a drying unit operation frequently used in food, pharmaceutical, and biopharmaceutical industries to prolong the shelf life of labile products, is an energy-intensive, time-consuming, and expensive process. link2 Although all three steps (freezing, primary drying, and secondary drying) of freeze-drying are important, primary drying is the longest and most critical one. As sublimation during primary drying is mainly described in terms of heat and mass transfer, the present work provides extensive theoretical and experimental analyses of these processes. First, a detailed review of the current state-of-the art of freeze-drying, focusing on the drying stage, is given, which contributes to a fundamental understanding of the drying process. Second, a detailed experimental study of the drying section of the freeze-drying process is discussed, furnishing information on the relationship between input and output process parameters during the primary drying stage and thus aiding freeze-drying process design and optimization. In this regard, the influence of primary drying input parameters (i.e., shelf temperature and chamber pressure) and vial position on output parameters such as product temperature, sublimation rate, overall vial heat transfer coefficient, and resistance to mass transfer of the dried product are extensively discussed. For all combinations of shelf temperature and chamber pressure studied herein, the highest product temperature, sublimation rate, and overall vial heat transfer coefficient are observed in front edge vials, whereas the lowest values are observed in center vials. In general, the highest sublimation rate, at a given product temperature, is observed for low chamber pressure-high shelf temperature combinations.Around the world, the burden of malnutrition remains high despite significant efforts to thwart both undernutrition and overnutrition. The links between food security, dietary choices, and health outcomes pose a dilemma What can nutrition policymakers and health care professionals do to harness the benefits of nutrition to improve health outcomes for young and old? The Academy of Nutrition and Dietetics gathered a group of health care policymakers, physicians, and credentialed nutrition and dietetics practitioners from around the world for a Policy and Nutrition Forum that took place on August 31, 2019 in Krakow, Poland. Participants from countries in Asia, Europe, North America, and Latin America presented on nutrition and policy from their perspective and took part in discussions about the effects of nutrition policies on health and health care. To extend the conversation about food and nutrition and to build a healthier future for people worldwide, this report highlights information from the Forum.
Low-calorie sweetened beverages (LCSBs) are commonly used as a lower-calorie alternative to sugar-sweetened beverages (SSBs) by individuals with type 2 diabetes. However, little is known about how intake of LCSBs is related to dietary intake and cardiometabolic health, particularly among youth.

To test the hypothesis that having higher baseline LCSB intake and increasing LCSB intake over 2 years of follow-up are associated with poorer dietary intake and higher cardiometabolic risk factors among youth enrolled in the Treatment Option for Type 2 Diabetes in Adolescents and Youth (TODAY) study.

Secondary, exploratory, analysis of baseline and longitudinal data from the TODAY study, which was a randomized, multisite trial conducted from 2004 to 2012, to compare effects of 3 interventions (metformin alone, metformin+ rosiglitazone, and metformin+ intensive lifestyle intervention) on glycemic control in youth with type 2 diabetes.

The study included 476 children and adolescents (10-17 years, mean body mass es in sugar intake during follow-up, but further studies are needed to better understand this trend.
Computed tomography (CT)-defined sarcopenia is a demonstrated poor prognostic factor in patients with cancer; however, its influence on outcomes for patients with head and neck cancer (HNC) has not been established.

This review synthesizes current knowledge regarding the association between CT-defined sarcopenia and outcomes for adult patients undergoing radiotherapy with or without other treatment modalities of curative intent for HNC.

A systematic review of the literature published between January 2004 and June 2019 was conducted in Medline, Embase, Cumulative Index of Nursing and Allied Health Literature, Allied and Complementary Medicine Database, and PubMed. Empirical studies of CT-defined sarcopenia in adult patients (≥18 years) with HNC who had completed radiotherapy of curative intent with or without other treatment modalities were included. Outcomes reported included survival, prolonged radiotherapy breaks, and chemotherapy toxicity. Study quality was assessed using the American Academy of Nutrtion interventions and facilitating individualized care.
The effect of nonnutritive sweeteners on appetite is controversial. Some studies have found changes in certain appetite control hormones with sucralose intake that may be through interaction with sweet taste receptors located in the intestine.

The aim of this study was to evaluate whether sucralose consumption could produce changes in fasting plasma concentrations of appetite-regulating hormones, including glucagon-like peptide 1, ghrelin, peptide tyrosine tyrosine, and leptin, and secondarily in insulin resistance.

A 2-week parallel randomized clinical trial with an additional visit conducted 1 week after dosing termination.

Sixty healthy, normal-weight individuals, without habitual consumption of nonnutritive sweeteners were recruited from July 2015 to March 2017 in Mexico City.

Daily sucralose consumption at 15% of the acceptable daily intake by using commercial sachets added to food. The control group followed the same protocol without an intervention.

Fasting concentrations of appetite regula of glucagon-like peptide 1, ghrelin, peptide tyrosine tyrosine, or leptin. An increase in the homeostasis model assessment of insulin resistance observed only at 1 week postdosing is of unknown clinical significance, if any.
To evaluate the clinical accuracy of several estimated glomerular filtration rates (eGFR) using cystatin-C to measure renal function in Japanese renal donors.

In total, 61 healthy, potential renal donors were assessed. The average age was 42.7 years (range 27-67). We evaluated the GFR based on the 24-hour creatinine clearance (Ccr) using 24-hour urine collection, eGFR based on serum creatinine (eGFRcr), and cystatin-C (eGFRcys) levels using an equation developed by the Japanese Society of Nephrology, the average of the eGFRcr and eGFRcys (eGFRave) rates, and an eGFR based on a combination of serum creatinine and cystatin-C values using an equation developed by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). The association between Ccr and each eGFR was evaluated using Pearson's r and the Bland-Altman plot.

Pearson's correlation coefficient analysis revealed a significant correlation between the Ccr and the eGFRcr (r= 0.62, P< .0001), eGFRave (r= 45, P= .0003), and eGFRcr-cys (r= 0.451, P= .0014). The Bland-Altman study suggested that each eGFR had a low level of agreement with the Ccr because the latter was higher than each eGFR. On the other hand, the eGFRave had the highest level of agreement with CCr× 0.715.

The eGFRave may provide a simple and useful method of evaluating renal function in living renal transplant donors.
The eGFRave may provide a simple and useful method of evaluating renal function in living renal transplant donors.
Families of deceased potential donors often object to organ harvesting on religious grounds. The aim of this study was to learn the attitudes and opinions of Judaism followers regarding organ donation.

The study included 97 Judaism followers living in the northeastern part of Poland. The research used the diagnostic survey method.

A fairly large percentage (approximately 92%) of respondents accepted treatment using organ transplantation. The removal of organs for transplantation from a loved one after his death was accepted by about 90%. After his death, 14.43% expressed opposition to organ removal. About one-third of respondents did not talk to the family about their organ donation attitude. link3 The average age of people who talked to their family about their will to donate was 49.69 ± 13.95 years. In total, 91.75% of the respondents had a positive attitude toward organ transplantation, 6.19% negative, and 2.06% indifferent. According to respondents, the most common reasons for a family's refusal to collect organs from the deceased are death-related emotions (53.