Introduction and purpose: Even though sweeteners’ popularity is increasing as they are approved by the Food and Drug Administration (FDA) and generally considered to be safe, their whole impact on the human body is still confusing. Polyols are among one of the most used sweeteners, therefore in this review we will focus on their impact on the gut microbiome as this community of various bacteria influences many aspects of overall health. Brief description of the state of knowledge: The current conclusions mostly present prebiotic benefits of polyols and their ability to increase the number of Bifidobacteria, there is research supporting the evidence of it conducted on isomalt, maltitol, lactitol and xylitol. It is possible, as most of them are able to reach the colon. We also investigate other ways sweeteners are shaping the gut microbiome such as multiplication of short chain fatty acids (SCFAs) or decreasing the numbers of Clostridium difficile. Conclusions: The impact of polyols on the gut microbiome has many knowledge gaps. More long-term studies are needed in order to consider the individual diversity of the participants’ gut microbiota. In order to conduct more valuable conclusions dietary and lifestyle habits should be taken into consideration. All things considered, there is not enough data to clearly determine polyols' role in modifying the gut microbiota.
Introduction and purpose: The aim of artificial sweeteners is to replace the sweetness of sugar without contributing to the higher energy consumption or unfavorable metabolic effects conventional sugar causes. Synthetic sweeteners - one of the most popular groups - are labeled as safe for use in foods and represented by acesulfame K, aspartame, neotame, saccharin, sucralose, cyclamate and advantame. Although they underwent safety procedures, their possible unbeneficial effects are still being evaluated. In this paper we focus on their impact on the gut microbiome. Brief description of the state of knowledge: For now, the advantage of search conducted on animals is observed. Those papers show the possibility of a relationship between artificial sweeteners and composition of the gut microbiota. Changes that were observed affected the gut microbiota in a negative way as they may be responsible for causing disbalance in the conglomerate of microorganisms. Studies on humans are limited. Long term consumption of acesulfame K and sucralose is linked with modulation of the composition of the microbiota. It has also been shown that synthetic sweeteners are able to increase the ability of bacteria to form a biofilm. Conclusions: Heretofore published paperworks about the impact of synthetic sweeteners on the gut microbiota are not sufficient to conduct valuable and unambiguous conclusions. Evidence collected until now is leading to a deduction that gut microbiota can be affected by the consumption of the sugar surrogates although more data is needed to clearly determine their possible role.
Introduction and purpose: Elevated FGF23 in X-linked hypophosphatemia (XLH) and tumor-induced osteomalacia (TIO) leads to systemic hypophosphatemia, several musculoskeletal manifestations and rickets in children. In this review we describe advances in the management of XLH and TIO using burosumab, which is a new therapeutic option approved both for adults and children. A search was conducted using PubMed and Google Scholarship databases. Brief description of the state of knowledge: Patients with XLH and TIO exhibit a similar clinical picture and way of treatment. Although in TIO surgery is the only definitive treatment, some tumors cannot be removed due to their location. In this case oral conventional therapy is used in treating both in TIO and XLH. Another approved treatment option is the use of burosumab, which is a fully humanised FGF23-antibody. This therapy led to normalisation of phosphate homoeostasis and resulted in improvement of bone turnover, fracture healing, subjective pain, and physical function. Compared to conventional, oral therapy burosumab has been shown to be superior for treatment of XLH and TIO.Conclusions: While burosumab appears to improve treatment outcomes, the effects of chronic or lifelong use have yet to be established. Long term follow-up studies would be necessary to assess especially the potential risk of nephrocalcinosis and cardiac calcification.
Introduction and purpose: Despite the fact that effective urate lowering therapy and anti-inflammatory drugs for the treatment of gout are commonly available, there is considerable interest in novel treatment approaches. Gouty patients often have a multitude of comorbidities, which lead to concern over drug–drug interactions and medication adverse events. Thus, diet modifications are examined as a way of nonpharmacological treatment of gout. In this review, we explore the potential impact of nutritional factors on hyperuricemia and clinical gout outcomes. A search was conducted using PubMed and Google Scholarship databases. Brief description of the state of knowledge: Management in patients with gout should be holistic. Incorrect nutrition may lead to hyperuricemia. Studies to date suggest that avoidance of certain foods and beverages can decrease the frequency of gout flares. Weight loss may be beneficial for prevention as well as treatment of gout and its comorbidities. The impact of various types of diet on the course of gout has been given particular attention and recent research suggests that vegetarian, mediterranean and dash diets may be beneficial for gouty patients. Also, some vitamins and omega-3 PUFA have favorable effects and the potential clinical use in gout treatment. Conclusions: We propose that simple dietary regimens may be beneficial to complement therapeutic management or contribute to the prevention of flares in gout patients. Although piecemeal modifications of various nutrients often provide incomplete dietary recommendations, understanding the role of nutritional factors in gout development would be helpful for patients in choosing their healthy diet.
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