The purpose of this study is to present a concise and practical method of applying diet management in health and in some common diseases.

Research has documented that the dietary patterns of parents of typically developing (TD) children have an impact on their child's diets, including diet quality and intake of certain foods. This influence is thought to be a function of a combination of serving various foods to their child, modeling healthy eating behaviors, providing companionship during mealtime, and implementing various feeding styles and beliefs as their child develops. The extent to which parents of children with intellectual disabilities (ID) influence their children’s dietary intake is unknown. Children with ID experience aversions to certain sensory characteristics of food, food selectivity, and idiosyncratic mealtime behaviors, all of which may result in limited dietary variety. These factors may make children with ID less responsive to their parents’ dietary habits and patterns. Weak to moderate correlations have been found to exist between parents of TD children and their offspring in terms of dietary intake, however, studies examining the parent to child associations of fruit and vegetable intake in the ID population are lacking. We performed a secondary data analysis on a cohort of children and parents involved in the Children's Mealtime Study, a cross-sectional study conducted from 2013-2016 in order to examine factors associated with weight status in children with ID compared to TD children. The goal of our analysis was to determine whether correlations exist between fruit and vegetable variety and consumption frequency among children and mothers and whether these differ between children with ID and TD children. A modified food frequency questionnaire was used to assess variety and frequency of fruits and vegetables consumed by mothers and their children. Statistically significant positive correlations were observed for both fruit and vegetable variety score and consumption frequency among the entire sample. However, the strength of the correlations were weak overall. A significant positive relationship was shown to exist between child fruit consumption frequency for mothers of TD children and their children (p<0.01), but not between mothers and children with ID. The findings indicate that although children with ID may experience greater aversions to food during mealtime compared to TD children, they still appear to be responsive to dietary habits of their mothers for most measures of fruit and vegetable intake.

Indiana University-Purdue University Indianapolis (IUPUI) / People with depression are at elevated risk for future obesity; however, little is known about the potential mechanistic role of diet composition in this association. The aims of the present study were: (1) to examine depressive symptom severity as a predictor of 13-year change in seven diet composition factors over time, (2) to test 13-year change in diet composition factors as mediators of the association between depressive symptom severity and 13-year change in adiposity, and (3) to explore whether the Aim 2 mediation models are moderated by sex and race. Participants were 2,449 non-Hispanic Black and White adults who participated in the 1990, 1992, and 2005 years of the CARDIA study (mean baseline age = 35 years, 54% women, 56% non-Hispanic Black, mean baseline waist circumference = 84.0 cm, mean change in waist circumference = 8.3 cm). Depressive symptoms were assessed in 1990 using the Center for Epidemiologic Studies-Depression Scale (CES-D). Waist circumference and seven diet composition factors were assessed in 1992 and 2005. Diet composition factors included intake of total energy, saturated fatty acid, monounsaturated fatty acid, polyunsaturated fatty acid, fiber, sugar, and protein. PROCESS bootstrapping analyses were used to test for mediation and moderated mediation (see Figure 1 for the conceptual model). All models included adjustment for age; sex; race; education; prevalent and incident cardiovascular disease, diabetes, and cancer; incident pregnancy; and 13-year change in physical activity. Greater baseline CES-D Total predicted greater 13-year increases in waist circumference (path c β = 0.032, p = .006). In separate models, there was a trend for greater baseline depressive symptoms predicting 13-year increases in total energy intake (path a β = 0.040, p = .054), and greater baseline depressive symptoms predicted 13-year increases in protein intake (path a β = 0.059, p = .004) and fiber intake (path a β = 0.040, p = .0496). Depressive symptoms were unrelated to 13-year changes in intake of the other diet composition factors of saturated fatty acid, monounsaturated fatty acid, polyunsaturated fatty acid, and sugar (all ps ≥ .129). Mediation models revealed that 13-year change in total energy intake and protein intake partially mediated the association between baseline depressive symptoms and 13-year change in waist circumference (total energy intake indirect effect = 0.001, 95% CI=0.0001-0.004; protein intake indirect effect = 0.002, 95% CI=0.0004-0.005); mediation was not observed for the other diet composition factors. Exploratory moderated mediation models detected a significant interaction for CES-D Total by sex predicting 13-year change protein intake only (Index of moderated mediation=0.004, 95%CI=0.001-0.010). All other tests of moderated mediation were non-significant (95% CIs included zero). Analyses stratified by sex revealed that CES-D Total was more strongly associated with 13-year increases protein intake in men (β = 0.011, p=.004) than in women (β = 0.027, p = .246). Findings from this larger, longitudinal, epidemiologic study suggest that the prospective relationship between depression and future obesity risk may be explained, in part, by intake of certain diet composition factors. Advancing the understanding of the relationship between depression and diet changes will inform clinical efforts to prevent or manage depression-related obesity.

A dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Science in Medicine. / Introduction Despite the availability of several antifungal drugs, Candida infections remain a major health threat worldwide. The Candida infections problem has been amplified by the emergence of multidrug resistant Candida species towards the conventional antifungal drugs. In addition, activation of antioxidant defense system by Candida species has been known to be forefront mechanism to escape drug toxicity.This indicates an urgent need for the development of new therapeutic strategies and antifungal drugs. Natural products have served for centuries for the treatment of infectious diseases and are among the major sources for finding new antifungal drugs. Berberine (BER), an isoquinoline alkaloid found in a variety of plant species, has been shown to possess multiple biological and pharmacological properties including antimicrobial activity against C. albicans and other Candida species. However, the mechanism of action exerted by BER and its effect on Candida cells is not yet fully elucidated. Therefore, this study was conducted to evaluate the role of antioxidant enzymes in the susceptibility to fluconazole (FLC) in C. albicans. Another aspect was to determine the effect of BER on growth, antioxidant enzymes and their gene expression in C. albicans. Materials and methods Candida albicans clinical isolates (10 FLC susceptible and 10 FLC resistant) and one ATCC strain were obtained from the Department of Clinical Microbiology and Infectious Diseases, University of the Witwatersrand. Species identification was confirmed using API 20C AUX. Antifungal susceptibility was determined following CLSI M27-A3 guidelines. Gene expression of SOD1, SOD2, GPx2, GLR1, GTT11, and CAT1 in untreated and BER treated C. albicans cells was measured by RT-qPCR. The activity level of the corresponding enzymes in the presence of BER was determined using a spectrophotometer. Results Gene expression analysis showed an increase in mRNA expression level of SOD1, SOD2, GPx2, GLR1 and GTT11 genes in FLC resistant isolates than in the susceptible group. The most significantly expressed gene was SOD1 with 50.69-fold increase. The other genes showed moderate increase in the expression with fold change ranging from 1.2 to 4.2. The susceptibility test showed MICs ranging from 125 to 500 μg/ml with a significant difference in the activity of BER between FLC susceptible and resistant C. albicans. BER treatment induced upregulation in the mRNA expression and enzymatic activities of major antioxidants. In FLC resistant C. albicans, treatment with ½ MIC value of BER caused downregulation of the targeted antioxidant genes indicating that BER at this concentration induced an intense oxidative stress, therefore, surpassing the antioxidant capacity of the cells. Conclusion The findings in this study showed that drug resistance is not only caused by mutations in a particular gene but could also arise from proteomic modulations. The study . The study also demonstrated that C. albicans activates several antioxidant enzymes that form an integral component of the cell’s response against oxidative stress. Candida albicans showed efficient antioxidant response at lower concentrations of BER. However, BER at ½ MIC value induced robust oxidative stress, especially in FLC resistant C. albicans, surpassing the antioxidant capacity of the cells. This demonstrates that BER at sub-inhibitory concentrations is able to render C. albicans avirulent by suppressing its antioxidant defense response without compromising cell viability of the fungi. Therefore, BER has a potential to be developed into BER has a potential to be developed into a therapeutic agent a therapeutic agent for for the the treatment oftreatment of C. albicansC. albicans infections and other pathogenic fungi to infections and other pathogenic fungi to overcome drug resistance. overcome drug resistance. / E.K. 2019

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