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The purpose of this paper is to estimate the possible impact of the COVID-19 pandemic on the hospitalization and hospital mortality of the patients with gallstone disease and chronic liver diseases (CLD) in the worst pandemic period in Ukraine.

A retrospective comparative analysis of annual reports data of all economy subjects, which conducted economic activity in medical practice for 2019 and 2021. Data was accepted from the Ministry of Health of Ukraine, the National Security and Defense Council of Ukraine (NSDC) and the State Statistics Service of Ukraine (SSSU).

The total hospitalization rates for diffuse liver disease and cholelithiasis significantly decreased during the peak of the COVID-19 pandemic in Ukraine, compared to the values of 2019. At the same time, the rates of in-hospital mortality for these diseases have significantly grown. Also, various proportions of similar trends were described in other countries during the first wave of the pandemic.

This paper highlights the fact that regulatory restrictions and the fear of the population of referring to healthcare facilities considering the high risk of getting an infection had significant disruption to medical care for patients with gallstone disease and CLD. Improving the management of medical resources and strengthening all kinds of institutions in the healthcare system must be thought about if similar challenges appear in the future.

The purpose of this paper is to systematically review the functionalities, safety regulations and product applications of herb Stevia rebaudiana extract. This plant material is embedded with multiple functionalities such as antioxidant, antidiabetics, anti-inflammation and antimicrobial. The regulations released from global authorities are covered to ensure the safety premise of stevia. Besides, the product applications of the extract of aerial parts of the herb S. rebaudiana helps us to recognize its value from commercial side.

Relevant literatures are selected and obtained from main scientific databases such as Google Scholar, Web of Science, PubMed and trade magazines published between 2000 and 2023. The keywords and their possible combinations such as sweetening, antioxidant, antidiabetics, anti-inflammation, safety and product development were used to ensure the preciseness and completeness of literature searching. Major data such as sweetness, total phenolic content and dose together with latter critical conclusions from searched publications were appropriately used and discussed. In this review, approximately 150 scientific literatures were meticulously ordered and analyzed. In applications, it is the first time that sentiment analysis was used to obtain a market assessment of the stevia-containing products.

This review paper helps rearrange the scientific affairs of those stevia extract’s functions like sweetening, antioxidant, antidiabetics and inflammation. Sweetness indexes of steviol glycosides were summarized together for comparison while various in vitro and in vivo approaches were reviewed to quantify those functions’ capacities and to depict the related mechanism. The regulation of steviol glycoside compounds such as rebaudioside A was established by global authorities such as US Food and Drug Administration and Joint FAO/World Health Organization Expert Committee to ensure the safety endorsement before commercialization. Then, this study discussed about the market performance of stevia ingredients or products with the self-developed data analytics. This study also investigated the product development progress of stevia-containing food products in the categories of beverage, bakery, dairy and confectionery. Those stevia-containing food consumer goods can be acceptable by certain consumers.

This review paper precisely presents the evidential information about the stevia’s multiple functionalities with mechanisms and global regulation milestones. To the best of the authors’ knowledge, it is then the first time to probe the stevia-containing products’ market performance through data analytics.

This study aims to investigate the relationship between dietary polyamine levels, metabolic risk parameters and anthropometric measurements in postmenopausal women.

This cross-sectional study was conducted with 562 45–64-year-old postmenopausal women who presented to a Family Health Center. To collect the data, the Descriptive Information Form and Food Frequency Questionnaire were used. In the data analysis, numbers, percentages, mean, standard deviation and multiple linear regression analysis were used.

The multiple linear regression analysis demonstrated that dietary putrescine intake was negatively associated with systolic blood pressure (ß = −0.179, p < 0.001), dietary spermidine intake was positively associated with waist circumference (WC) (ß = 0.142, p = 0.013), systolic blood pressure (ß = 0.188, p = 0.001), diastolic blood pressure (ß = 0.218, p < 0.001), body mass index (BMI) (ß = 0.169, p = 0.003) and waist-to-height ratio (WHtR) (ß = 0.156, p = 0.006), and dietary spermine intake was negatively associated with WC (ß = −0.158, p = 0.003), systolic blood pressure (ß = −0.195, p < 0.001), BMI (ß = −0.107, p = 0.042) and WHtR (ß = −0.138, p = 0.009).

Owing to the study’s cross-sectional nature, the lack of succession in the cause–effect relationship, the use of self-report Food Frequency Questionnaire to determine dietary polyamine intake and the inability to analyze seasonal differences are among the limitations of the study.

In this study, an association was determined between dietary polyamines, metabolic risk parameters and anthropometric measurements. The findings suggest that dietary polyamines in human health should be further investigated owing to the increasing metabolic risk parameters.

The purpose of this study is to collect and assess the evidence available on the effect of non nutritive sweeteners on appetite, weight and glycemic regulation. As a replacement for sugars, non-nutritive sweeteners (NNSs) are widely being used in different food products with the assumption that these would lower calorie intake and help to manage weight and blood sugar levels better. However, studies using animal models have reported that chronic exposure to NNSs leads to increased food consumption, weight gain and insulin resistance.

Evidence was acquired from systematic reviews or meta-analyses (2016–2021) of relevant clinical studies, especially randomized control trials using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

The review showed NNSs exposure did not conclusively induce increased food intake or change in subjective appetite ratings. Appetite biomarkers like ghrelin, gastric inhibitory peptide, C-peptide levels and Peptide YY remained mostly unaffected by NNSs. Meta-analyses of human randomized control studies showed a reduced energy intake and body weight. No significant change was seen in blood glucose levels, post-prandial glycemic or insulin response after consumption of NNSs. Adequate evidence is not available to conclusively say that NNSs influence gut health at doses relevant to human use.

Most studies which are prospective cohort, observational and cross-sectional studies suggest that use of NNSs may promote obesity and metabolic syndrome in adults. Such studies are plagued by confounding variables and reverse causation. Mechanistic evidence is mostly based on in-vitro and in-vivo studies. The same causal pathways may not be operative or relevant in humans.

This review of available literature concludes that to achieve specific public health and clinical goals, the safe use of NNSs for the reduction of intakes of free sugars and energy should be explored. This would be possible by educating the consumer about energy compensation and understanding the nutritional content of artificially sweetened products in terms of calories coming from fat and complex carbohydrates used in the product.

This study was, thus, designed with the objective of examining the usefulness of NNSs in human population, especially with respect to insulin regulation, glycemic control and weight management. Well-designed randomized control trials which control for confounding variables are needed to generate high quality evidence.

This systematic review aims to gain the studies regarding the effect of Nigella Sativa (N. sativa) on adipokines including leptin, adiponectin and resistin.

Search was carried out using databases Scopus, Web of Science, PubMed and Google Scholar with no restriction on language or date until February 2023 and alert services were applied to identify any paper after the primary search.

Eighteen animal and human studies were eligible for the current systematic review. Leptin and resistin levels showed a downward tendency after consuming N. sativa and its ingredients [e.g. oil, thymoquinone (TQ) and thymol] as well as its extracts (e.g. water extract). Furthermore, considering 4 of 8 animal research studies and 2 of 5 human studies that evaluated adiponectin levels, a significant increase was observed after using N. sativa and its ingredients (e.g. oil, TQ and thymol).

The present paper collates evidence from animal and human studies regarding the effect of N. sativa on adipokines including leptin, adiponectin and resistin.

Nutrition labels provide a cost-effective method of conveying nutrition information to consumers. This study aimed to assess the use of nutrition facts panels, knowledge of traffic light labelling (TLL) and perceived healthiness of food items using TLL among consumers.

A web-based cross-sectional study was conducted among adults in the United Arab Emirates (UAE) (n = 1,322). TLL knowledge score was derived for each participant. Conjoint analysis was used to calculate the utilities and relative importance of the perceived healthiness scores for four attributes (fat, saturated fat, total sugar, salt) at the aggregate level.

Participants had a positive attitude towards TLL but were less familiar with TLL than the nutrition facts panel (47.4 vs 85.8%). The mean TLL knowledge score was 3.6 out of 7 (51.6%). Younger age, higher education, higher income, and health-related qualifications were associated with higher scores. Conjoint analysis showed that participants tend to choose products with greener labels, especially for sugars (80.1%) and avoid red labels for fats. Sugars had the highest percentage value of relative importance compared to the other attributes (27.1%).

The study outcomes offer valuable insights into the extent of consumer awareness, comprehension and utilization of nutrition facts panels in the UAE. These findings contribute essential knowledge for a deeper understanding of the impact of nutrition labels on consumer behaviour and decision-making in the region.

Depression is one of the most overlooked psychiatric disorders among middle-aged and elderly men. Saffron (Crocus sativus L.) stigmas are a favorite and common spice that is used as an antidepressant, an anti-inflammatory and a sexual stimulant. This systematic review aimed to provide a comprehensive survey of the effects of saffron on depression in middle-aged and elderly men.

The authors searched Web of Science, PubMed, ProQuest, Cochrane, Science Direct, Scopus and Google Scholar databases to gather any relevant studies published from 1980 to September 2022. This review included studies that examined the relationship between depression and testosterone concentration (four studies) or saffron’s effects on testosterone and depression (six studies).

Observational research showed an association between testosterone and depression in middle-aged and elderly men. Furthermore, animal studies have found that saffron increased testosterone levels and decreased depression in males. There is evidence that testosterone may contribute to the mood. Besides its antioxidant and anti-inflammatory properties, this study proposed scientific mechanisms that saffron may also play a protective role against depression through its influence on testosterone, in middle-aged and elderly men. The general use of saffron at high doses or for prolonged periods may cause side effects; therefore, it is important to consult a health-care professional before the recommended dosage and duration of saffron supplementation, especially if a person has any underlying health conditions or is taking medications.

This study provides researchers with an additional perspective for conducting clinical trials on the use of saffron to enhance the mood of elderly men with testosterone deficiency.

This chapter will identify readily accessible existing sources of public data. Thechallenges of using that data are considerable and require extensive time to ensure validity for reporting purposes. Summaries of data field selection and data wrangling requirements are presented in conjunction with data aggregation strategies.

This chapter more clearly identifies the distinction between Electronic Health Record (EHR) and Electronic Medical Record (EMR), and states their value in obtaining individual-level data. Synthetic medical records may be used as a surrogate for EHR data in order to ensure digital data privacy is maintained during the development of the LHS. Synthea is an open-source simulation tool available through GitHub.¹ Extensive descriptive analysis of synthesized data is provided as a foundation for the analysis in Chapter 7.

Background/Objectives: Protein-based meal replacements (MR) with viscous soluble fibre are known aids for weight loss. This study aims to compare the effects of new whey and vegan MR containing different amounts of PGX (PolyGlycopleX) on weight loss over 12 weeks, along with a calorie-restricted diet.

Subjects/Methods: Sixty-eight healthy adults of both sexes (53 women; 15 men; average age 47.1 years; BMI 31 ± 7.1 kg/m² and weight 85.05 ± 23.3 kg) were recruited. Participants consumed a whey or vegan MR twice/d (5–10 g/day PGX) with a low-energy diet (1,200 kcal/day), over 12 weeks. Weight, height, waist and hip circumference were recorded (four time periods).

Results: Forty-four participants completed the study. Results showed significant reductions in average body weight and at week 12, whey group was [−7.7 kg ± 0.9 (8.3%), p < 0.001] and vegan group was [−4.5 kg ± 0.8 (6.2%), p < 0.001)]. All participants (n = 44; BMI 27 to 33 kg/m²) achieved significant reductions in body measurements from baseline to week 12; p < 0.001. Conclusions: Supplementation of protein-based MR with PGX and a balanced, low-energy diet, appears to be an effective approach for short-term weight loss.

As the authors were evaluating if the MR as a whole (i.e. with PGX) caused weight loss from baseline over the 12 weeks, no comparators, i.e. just the MR without PGX, were used. Formulation of these new MRs resulted in a whey product with 5 g PGX and a vegan product with 2.5 g PGX. Only 2.5 g PGX could be formulated with the vegan protein due to taste and viscosity limitations. Study participants were not randomized and no control groups (e.g. no MR or MR without PGX but with energy restricted diet) were used. Furthermore, it is not clear whether the sort of protein alone or the combination with a higher amount of PGX (whey with 5 g PGX/serving vs vegan with 2.5 g PGX/serving) has contributed to these significant greater weight-loss effects. This was something the authors were testing, i.e. could only 2.5 g PGX/serving have an effect on weight loss for a vegan MR. These limitations would be somethings to evaluate in a subsequent randomized controlled study. Hence, the results of this study may serve as a good starting point for further sophisticated randomized controlled trials that can demonstrate causality – which the authors acknowledge as one of the fundamental limitations of an observational study design. Participants tracked their calories but adherence and compliance were self-assessed and they were encouraged to keep their exercise routine consistent throughout the study. Hence, these are further limitations. No control group was used in this study to observe the effect of the dietary intervention and/or physical activity on weight loss alone. However, a goal of the authors was to keep this study as close to a real-life situation as possible, where people would not be doing any of these measurements, to see if with minimal supervision or intervention, people can still lose weight and alter their body composition. Furthermore, differences in gender and the corresponding weight loss effects in response to MR-protein-based treatments could be evaluated in follow-up studies.

This study indicates that the consumption of protein-based (animal, whey or plant, pea protein) MR incorporating the highly soluble viscous PGX is beneficial for weight loss when combined with a healthy-balanced, calorie-restricted diet. MRs at either 2.5 g or 5 g per serving (RealEasy^TM with PGX) proved to be a highly effective as a short-term solution for weight loss. The observed results are encouraging, however, further long-term studies (i.e. randomized clinical trials RCT) are needed to confirm the clinical relevance. RCTs should focus on the individual effects of PGX and/or the different protein sources used in MRs, on weight loss and the maintenance of the reduced body weight, and should measure detailed blood parameters (lipid profiles, glucose etc.) as well as collect detailed exercise and food consumption diaries.

To the authors’ knowledge, this is the first study comparing a whey versus vegan, (as pea) protein-based MR that is supplemented with fibre PGX; thus, this work adds information to the already existing literature on fibre (such as PGX) and MRs regarding their combined weight loss effects. The purpose of this study was to observe if the novel protein-based (either whey or vegan versions) MR RealEasy^TM with PGX at 2.5 or 5 g in addition to a calorie-restricted diet (total of 1,200 kcal/day) would aid in weight loss in individuals over a 12-weeks period. Adding increasing amounts of whey protein and soluble fibre can help reduce subsequent ad libitum energy intake which could help adherence to energy restricted diets, but whether similar effects are seen with vegan protein is unclear – this study does aim to address this.