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Schistosomiasis and malnutrition are often overlapped in poor communities, resulting in disproportionately high mortality rates. Currently, fragmented data make it difficult to define the relationship between diet and schistosomiasis. Thus, we systematically review the preclinical evidence on the impact of diet in Schistosoma mansoni infection. From a structured search, we recovered 27 original articles. All studies used mice and most of them investigated hypoproteic (70.37%), hyperlipidic (22.22%) or vitamin-deficient (7.41%) diets. Diets based on carbohydrate, zinc or milk supplementation were investigated at a reduced frequency (3.70% each). Hypoproteic diets attenuated parasitic load and granulomatous inflammation, but also reduced host resistance to S. mansoni infection, determining higher mortality rates. By stimulating steatohepatitis, parasitic load and granulomatous inflammation, hyperlipidic diets increase organ damage and mortality in infected animals. Although a high-sugar diet and vitamin restriction potentiate and zinc supplementation attenuates S. mansoni infection, the current evidence for these diets remains inconclusive. Analysis of methodological quality indicated that the current evidence is at high risk of bias due to incomplete characterization of the experimental design, diet composition and treatment protocols. From the bias analysis, we report methodological limitations that should be considered to avoid systematic reproduction of inconsistent and poorly reproducible experimental designs.

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Type 1 diabetes mellit us (T1DM) is an autoimmune disease characterized by the destruction of beta cells and absolute insulin deficiency. T1DM usually appears in childhood and adolescence, but it can also be diagnosed in adulthood. For decades, American Diabetes Association (ADA) guidelines recommended consuming 50-60% of a diabetic's daily calories as carbohydrates. With these guidelines, the average number of patients with T1DM in the therapeutic goal (less than 7%) of glycated hemoglobin (HbA1c) in the world is no more than 10-15%, that is, we are not being effective in the treatment, either due to inadequate guidance, such as poor adherence due to difficulty in following the diet proposed by the ADA. Since 2019, the ADA recognized, albeit timidly, the low-carbohydrate diet (low-carb diet) as an acceptable approach, being the most studied, safe and effective strategy for the treatment of type 2 diabetes mellit us (T2DM). We recognize these advances, but we know that much remains to be elucidated, especially with regard to the treatment of T1DM. With that in mind, we developed a protocol [1], which aim a reduction in glycemic levels, a longer time on target with less hypoglycemia, a reduction in glycated hemoglobin and insulin doses, thus promoting an improvement in the patient's health and quality of life.

<p class="abstract"><strong>Background:</strong> Type 1 diabetes mellitus is an autoimmune disease characterized by the destruction of pancreatic beta cells and absolute insulin deficiency. After the discovery of insulin, guidelines recommended 50% to 60% of carbohydrate consumption in individuals with diabetes. However, this recommendation is ineffective, since carbohydrate is the macronutrient that causes the greatest increase in blood glucose. The aim of this research is to evaluate the efficacy of a low-carbohydrate diet in adults with type 1 diabetes mellitus.</p><p class="abstract"><strong>Methods:</strong> The study is a 26 weeks clinical trial. During the first 15 days, participants will receive approximately 130 g of daily carbohydrates, followed by a phase of 7 days, with the consumption of 90 g of daily carbohydrates, and finally, the consumption of 50 g of carbohydrates. The target audience is 20 participants diagnosed with type 1 diabetes mellitus, glycated hemoglobin (HbA1c) &gt;7.0% and aged between 21 and 50 years, in addition to the parameters defined in the established inclusion and exclusion criteria. The primary outcome is HbA1c. Glycemic variability, frequency of hypoglycemia, total daily insulin and improvement in quality of life will also be evaluated.</p><p class="abstract"><strong>Conclusions: </strong>Despite the evidence that low carbohydrate is effective for treating type 2 diabetes, there is low evidence for the recommendation in people with type 1 diabetes. In order to improve quality of life of this group and guidelines of clinical practice, and to promote development of health care professionals, further well-designed trials are needed.</p><p class="abstract"><strong>Trial registration:</strong> The trial was registered at https://ensaiosclinicos.gov.br/rg/RBR-107jk4tn.</p>