Sarcopenia, an extremely common condition in cancer patients, is described as a progressive and generalized musculoskeletal disorder that is associated with an increased likelihood of adverse outcomes, including falls, fractures, physical disability, and mortality. By contrast, cachexia is defined as a syndrome characterized by weight loss with the concomitant loss of muscle and/or fat mass. Cancer cachexia leads to functional impairment, reduced physical performance, and decreased survival, and is often accompanied by cancer progression and reduced response to therapy. The literature states that cancer patients with cachexia or sarcopenia have many more complications than patients without these conditions. The interplay between physiologic sarcopenia and cancer cachexia is, in part, responsible for the complexity of studying wasting disorders in the cancer population, particularly in the geriatric population. For these reasons, a comprehensive assessment of the body composition and physical function of these patients is necessary. There are several modalities adapted to measure skeletal muscle mass, such as dual-energy X-ray absorptiometry (DEXA), bioelectrical impedance analysis (BIA), computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US). The gold standard for the measurement of quantitative and qualitative changes in body composition in patients with cancer is the analysis of tissue density using a CT scan. However, this technique remains poorly implemented in clinical practice because of the use of ionizing radiation. Similarly, DEXA, MRI, and US have been proposed, but their use is limited. In this review, we present and compare the imaging techniques that have been developed so far for the nutritional assessment of cancer patients.

Introduction and aim: Usually, adherence to the gluten-free diet (GFD) in celiac patients is indirectly assessed through serological analysis, questionnaires, or invasive methods such as intestinal biopsy. The detection of gluten immunogenic peptides in urine (urinary gluten immunogenic peptides—uGIP) is a novel technique that directly evaluates the ingestion of gluten. The aim of this study was to evaluate the clinical efficacy of uGIP in the follow-up of celiac disease (CD). Methods: From April 2019 to February 2020, CD patients reporting complete adherence to the GFD were prospectively enrolled but were unaware of the reason for the tests. Urinary GIP, the celiac dietary adherence test (CDAT), symptomatic visual analog scales (VAS), and tissue transglutaminase antibodies (tTGA) titres were evaluated. Duodenal histology and capsule endoscopy (CE) were performed when indicated. Results: A total of 280 patients were enrolled. Thirty-two (11.4%) had a positive uGIP test (uGIP+). uGIP+ patients did not show significant differences in demographic parameters, CDAT, or VAS scores. The tTGA+ titre was not related to the positivity of uGIP (14.4% vs. 10.9% in patients with tTGA+ and tTGA−). Regarding histology, 66.7% of the GIP+ patients had atrophy compared to 32.7% of the GIP patients (p-value 0.01). However, the presence of atrophy did not correlate with tTGA. Mucosal atrophy was detected in 29 (47.5%) out of 61 patients by CE. With this method, no noticeable dependence on uGIP results (24 GIP− vs. 5 GIP+) was observed. Conclusions: The single uGIP test was positive in 11% of CD cases referring a correct GFD adherence. Furthermore, uGIP results significantly correlated with the duodenal biopsy, formerly considered the gold standard for assessing CD activity.

Irritable bowel syndrome (IBS) is a gut–brain axis chronic disorder, characterized by recurrent abdominal pain and altered bowel habits in the absence of organic pathology. Nutrition plays a central role in symptom management, yet no single dietary strategy has demonstrated universal effectiveness. This narrative review critically evaluates current nutritional approaches to IBS. The low-Fermentable Oligo-, Di-, Mono-saccharides and Polyols (FODMAP) diet is the most extensively studied and provides short-term symptom relief, but its long-term effects on microbiota diversity remain concerning. The Mediterranean diet, due to its anti-inflammatory and prebiotic properties, offers a sustainable, microbiota-friendly option; however, it has specific limitations in the context of IBS, particularly due to the adverse effects of certain FODMAP-rich foods. A gluten-free diet may benefit individuals with suspected non-celiac gluten sensitivity, although improvements are often attributed to fructan restriction and placebo and nocebo effects. Lactose-free diets are effective in patients with documented lactose intolerance, while a high-soluble-fiber diet is beneficial for constipation-predominant IBS. IgG-based elimination diets are emerging but remain controversial and require further validation. In this review, we present the 10 dietary commandments for IBS, pragmatic and easily retained recommendations. It advocates a personalized, flexible, and multidisciplinary management approach, avoiding rigidity and standardized protocols, with the aim of optimizing adherence, symptom mitigation, and health-related quality of life. Future research should aim to evaluate, in real-world clinical settings, the impact and applicability of the 10 dietary commandments for IBS in terms of symptom improvement and quality of life

Background: Eosinophilic esophagitis (EoE) is a chronic, immune‐mediated disease in which elimination diets represent an effective therapeutic option. Although six‐food elimination diets (6‐FED) achieve high remission rates, their complexity often compromises adherence. Dairy‐free diet (DFD) has emerged as a simpler alternative, yet evidence in adult populations remains limited. Aims: To evaluate the clinical, endoscopic, and histological outcomes of a 12‐week DFD in adult patients with EoE and to explore potential predictors of histological remission and dietary adherence. Methods: We conducted a prospective, multicenter, open label, single‐arm interventional study across five Italian referral centers, enrolling 31 adults with active EoE. Participants followed a 12‐week DFD, after which clinical symptoms (EEsAI), disease severity (I‐SEE), endoscopic findings (EREFS), quality of life (EoE‐QOL‐A), and adherence (VAS scale) were assessed. Results: Twenty‐eight patients completed the 12‐week protocol. Histological remission was achieved in 53.6% of patients (intention‐to‐treat: 48.4%); among these, 86.7% also reached clinical remission. The median EEsAI improved from 35 to 18.5 ( p = 0.009) and the median I‐SEE score from 6.5 to 4 ( p < 0.0001). Quality of life improved (median EoE‐QoL‐A from 36.5 to 52, p = 0.02), and adherence was high (median VAS 8 [IQR 7–9.5]). Predictors of lower histological response included previous esophageal dilations and higher baseline exudate and eosinophil counts. Male sex and higher BMI predicted lower adherence. Conclusions: In this exploratory multicenter prospective study, DFD induced histological remission in more than half of patients and clinically meaningful improvements in symptoms, disease severity, endoscopy, and quality of life.