Canned fish products enable long-term preservation of fish, a vital source of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Despite research on lipid composition, gaps remain in understanding the bidirectional fatty acid (FA) exchange between fish muscle and coating media during processing and storage. After a systematic literature search across five databases (PubMed, Scopus, Web of Science, Wiley Online Library, Cochrane Library), 20 studies were included examining FA profiles across fish species, filling media (vegetable oils, brine, tomato sauce), and storage durations (up to 5 years). Five studies showed that n-3 FAs migrate from fish to the filling medium, enhancing its nutritional value, while fish muscle absorbs FAs from the oil, increasingly resembling the filling medium. The use of n-6 FA-rich oils (sunflower, soybean) lowered the n-3/n-6 ratio in flesh. Conversely, aqueous media (brine) and tomato sauce maintained better ratios. EPA and DHA content generally decreased due to canning and storage, with retention varying by fish species, filling medium, and sterilization method. This review underscores significant FA exchange between fish and filling media, confirming bidirectional lipid interchange during processing. To optimize health benefits, aqueous packing media are recommended to preserve lipid profiles or to consume the covering oil to recover nutrients. Further research is needed on other factors altering FA content in canned fish such as environmental and geographical variables (including catching season), pre-canning preparation and sterilization steps (such as freezing, steaming, and frying), sterilization conditions (time, temperature, F0 value) and lipid oxidation induced by thermal processing.

BackgroundIn recent years, plant-based diets have gained popularity. The food industry has responded by introducing a range of alternative products that significantly differ from whole-food, plant-based diets in terms of their composition and processing levels. This study aimed to compare the fatty acid composition and fatty acid-based nutritional quality indices of ground beef-based foods with those of their plant-based counterparts available in the Hungarian market.MethodsThis study examined six plant-based and four beef hamburger patties, along with one plant-based and one beef minced meat product, each with three distinct expiration dates. Following homogenization and lipid extraction, the fatty acid composition was analyzed by gas chromatography. Based on the fatty acid values, several nutritional indices were calculated, including the unsaturation index (UI), atherogenicity index, thrombogenicity index, and hypocholesterolemic/hypercholesterolemic index (hHI).ResultsSignificant differences (p < 0.01) in fat content were observed between plant-based and animal-based products, based on both label information and gravimetric measurements (plant-based: 10.25% [8.60%; 14.87%], animal-based: 19.67% [16.16%; 26.68%], median [Q1; Q3]). Distinct fatty acid composition profiles were identified between and within the product groups for both animal- and plant-based products. Except for one product, plant-based alternatives exhibited higher UI and hHI (UI: 129.62 [96.84; 146.10]; hHI: 50.13 [45.69; 54.14]) than beef-based products (UI: 8.18 [3.13; 11.59]; hHI: 1.35 [1.23; 1.43]).ConclusionThe findings indicate that plant-based meat alternatives (except those containing coconut oil) have lower saturated and higher polyunsaturated fatty acid compositions than beef-based products, leading to more beneficial nutritional value. Further analytical and clinical studies are necessary to provide a more comprehensive understanding of the long-term health effects of these foods.

BACKGROUND:The aim of the present study is to investigate the presence of various factors in individuals diagnosed with chronic venous disease (CVD), as compared to a control group. These factors include both those that have been empirically validated and those that remain unproven or have received less study. The second objective was to ascertain the factors influencing disease severity among patients with CVD. METHODS:A questionnaire was employed to collect data on risk factors, anthropometrics, and medical history. The study involved 209 CVD patients and 194 controls. The Venous Clinical Severity Score and the Clinical, Etiologic, Anatomic and Pathophysiologic Classification were utilized to evaluate the severity of the disease. RESULTS:Regular exercise was more prevalent in the control group (p = 0.001), while prolonged sitting/standing (> 8 h) was more prevalent in the patient group (p < 0.001). Patients had higher levels of obesity and hypertension (p < 0.001). Female gender (p = 0.010) and family history of varicose veins (p = 0.002) contributed to mild venous disease. Prior deep vein thrombosis (p < 0.001), obesity (p = 0.031), extended sitting/standing (p = 0.035), inactivity (p = 0.001), and family history of varicose veins (p < 0.001) were associated with severe venous disease. Prior thrombosis was found to be associated with a more active utilization of compression therapy (p < 0.001). CONCLUSIONS:The findings emphasize that specific risk factors, including weight and physical inactivity, which are modifiable, correlate strongly with severe venous disease. Disease outcomes may improve through identification and modification of these factors.

Background: Wine production generates significant amounts of grape marc, which can serve as a potential source of bioactive compounds, including polyphenols. Objectives: In this study, we aimed to investigate the polyphenol content of skin and seeds separated from grape marc, and test their extracts against two significant bacteria, Listeria monocytogenes (LM) and Staphylococcus aureus (SA). Methods: A comprehensive analysis of the phenolic composition in the skin, seeds, and juice/wine derived from Cabernet Sauvignon grape berries was conducted over an 18-day fermentation period. High-performance liquid chromatography was performed to identify and quantify the main flavan-3-ols, flavonols, anthocyanins, and stilbenes. In addition, the total phenolic content (TPC) was determined by the Folin–Ciocalteu method. Results: The TPC of both seeds and skins significantly decreased over time. In parallel, the TPC in the wine gradually increased, indicating a release of phenolic compounds into the wine. We found that the TPC in seeds was consistently higher than in the skin at all examined time points. The main flavonoids in seeds were flavan-3-ols (catechin and epicatechin), while anthocyanins (delphinidin-, cyanidin-, petunidin-, peonidin-, and malvidin-3-O-glucoside) were the predominant ones in skins. Crude seed and skin extracts enriched in phenolics were prepared, of which only the crude seed extract was proven effective against LM and SA. Following the time-kill assay, our findings revealed that the minimal bactericidal concentration of the crude seed extract against LM was 5.02 mg/mL after 12 h incubation, demonstrating the eradication of the living bacterial cell number by ~6 log. A 24 h exposure time was required for complete inactivation of SA, but a lower concentration was sufficient (2.54 mg/mL). Conclusions: Grape waste remains a valuable source of polyphenols, with grape seeds, in particular, exhibiting significant antimicrobial activity against certain foodborne pathogens.

Cardiovascular diseases are among the leading causes of the death in Europe. Even though the prevalence of chronic coronary syndrome is increasing, the cardiovascular (CV) mortality is decreasing due to emerging effect of primary and secondary prevention. Not only the prevention and treatment of major risk factors like hypertension, diabetes and reduction of LDL-cholesterol level is principal, but physical training and microcirculation can play an important role. Our aim was to examine the impact of primary and secondary preventive measures on clinical and laboratory parameters in patients with chronic coronary syndrome (CCS) and those at high CV risk. We examined 89 patients, who attended at exercise ECG, divided them into two groups, 41 patients already diagnosed with CCS and 48 patients were at high CV risk (HR) without any former CV event. Body Mass Index (BMI), skeletal muscle mass and body fat mass were determined with bioimpedance analysis. Cardiovascular laboratory parameters (e.g. LDL cholesterol, HbA1c, GFR), as well as macro- (fibrinogen, haematocrit, whole blood and plasma viscosity) and microrheological markers (red blood cell aggregation and deformability) were measured. The metabolic equivalent (MET) was calculated via exercise ECG according to Bruce protocol. The data were evaluated with variance analysis (ANOVA) and chi-square test. The physical capacity of CCS patients lags significantly behind during stress ECG compared to HR patients (MET: 10,567±2,9324 vs 8,505±2,0478; p<0,000). BMI (29,18±4,41 vs 28,53±3,49; p=0,473) and skeletal muscle mass (SMM; 30,8±7,16 vs 30,89±6,28; p=0,999) did not differ between the groups. Even though the body fat did not differ significantly either, the CCS group had better body fat mass (28,63±10,16 vs 25,92±6,78; p=0,173) and visceral fat values (15,14±12,47 vs 12,51±3,79; p=0,222). CCS patients’ aggregation parameters, e.g. aggregation index (AI; 67,4815±5,85895 vs 64,2263±7,75453; p=0,033), aggregation halftime (t½; 1,7268±0,59808 vs 2,1333±0,79775; p=0,010) and disaggregation threshold (γ; 132,949±39,6692 vs 116,576±23,3890; p=0,021) were significantly worse than HR patients. LDL-cholesterol levels proved to be lower by the CCS group (2,2566±1,32451vs 3,0213±1,05406; p=0,003). CCS patients have worse metabolic state and due to microcirculatory impairment also decreased physical capacity. Even though BMI and SMM did not differ significantly, CCS patients have favourable body composition. Target levels for LDL-cholesterol were not reached in any of the groups. These findings underscore the need for more intensive secondary preventive measures, e.g. physical training-based CV rehabilitation and more strict monitoring strategies in both groups to reach target levels. Tailored prevention programs focused on clinical needs are essential to enhance quality of life and reduce cardiovascular risk in primary and secondary prevention.

Background/objectives: The COVID-19 pandemic affected cancer care globally. Our objective was to analyze the demographic and clinical characteristics of kidney cancer (KC) patients between the pre-COVID-19 and COVID-19 periods. We also aimed to assess how KC was discovered—incidentally or symptomatically—and identify factors predicting the mode of discovery and advanced-stage disease. Methods: This retrospective study analyzed data from 400 patients aged 18 years or older diagnosed with kidney cancer (KC) at a large regional Hungarian clinical center during two time periods: the pre-COVID-19 period (1 January 2019 to 15 March 2020) and the COVID-19 period (16 March 2020 to 13 May 2021). Demographic and clinical information, including the mode of cancer discovery, was collected for all patients. Results: During the pandemic, monthly kidney cancer diagnoses declined by 10.3%. The proportion of female patients rose significantly from 31.9% to 42.9% (p = 0.023). Incidental tumor detection decreased from 82.4% to 72.4% (p = 0.018), while symptomatic presentation increased from 14.2% to 19.4%, although not significantly (p = 0.166). Non-incidental detection was associated with a 3.42-fold increase in odds of advanced cancer pre-pandemic and a 2.03-fold increase during the pandemic. Symptomatic presentation raised these odds by 4.51 and 2.76 times, respectively. Conclusions: Our study revealed changes in kidney cancer detection during the pandemic, including a rise in the proportion of female patients and a decline in case numbers, likely due to reduced incidental findings. Non-incidental discovery and symptom presence remained predictors of advanced-stage disease, although the odds were lower. Various factors—such as changes in healthcare access and gender-related differences in health-seeking behavior—may possibly explain these changes. Our findings support the critical role of incidental detection in high-risk populations.

Fatty acids are essential in human physiology, serving as primary energy sources, forming membrane lipids, and acting as cellular signaling molecules, thereby playing a significant role in the etiology of metabolic syndrome [...]

Background/Objectives: Dietary guidelines recommend limiting trans fatty acid (TFA) intake to avoid adverse health effects. However, the impact of TFA intake in type 1 diabetes mellitus (T1DM) remains unclear. The aim of the present study was to investigate the levels of TFAs in plasma and erythrocyte membrane lipids of young diabetic patients and healthy controls. Methods: Data were re-analyzed from three case-control studies including diabetic children (n = 40, mean age: 12.0 years), diabetic young adults (n = 34, mean age: 21.8 years), and children with diabetic ketoacidosis (DKA, n = 9, mean age: 16.0 years). In these studies, TFA data were quantified by gas chromatography, but data have not yet been published. Results: Diabetic young adults and diabetic children had significantly lower TFAs in plasma lipids compared to healthy controls (sum of TFA in plasma sterol esters: 0.54 [0.34] versus 0.64 [0.37] and 0.51 [0.13] versus 0.65 [0.29], %, median [interquartile range], p < 0.05). However, children with DKA had significantly higher TFA levels in almost all plasma lipid fractions than the other two diabetic groups. Several negative correlations were observed between TFA and n-3 and n-6 long-chain polyunsaturated fatty acid levels in all groups, especially in the erythrocyte membrane lipid fractions. However, in the plasma fractions the correlation was less clear; both positive and negative correlations were found in each of the groups studied. Conclusions: Lower TFA values in young adults and children with diabetes may be associated with dietary patterns lower in TFAs, while elevated TFA values in DKA may be linked to challenges in adherence to dietary guidelines.

Hydroxyurea (HU) is a cytostatic drug used in oncotherapy. The drug has inhibitory effects on bone marrow and epithelial cells and causes minor side effects in the skin, including nail deformity, alopecia, and hyperpigmentation, and severe side effects, including skin tumors and nonhealing ulcers. Herein, we report the case of a patient who received HU therapy for polycythemia vera. The patient had type 2 diabetes and atherosclerosis. Onychodystrophy and a non-healing ulcer developed. Severe deep tissue infection and osteomyelitis, rare complications of a HU-related ulcer, were also diagnosed later. Diabetes and atherosclerosis made the condition more severe. Complex systemic and local therapy led to complete healing of the ulcer and osteomyelitis. Based on the literature and our own experience, a care protocol was proposed for the dermatological follow-up of patients under HU treatment. This recommendation may be particularly useful in the treatment of patients treated with hydroxyurea who suffer from atherosclerosis, diabetes, or leg ulcers and are therefore at increased risk of severe skin and deep tissue infections.

The receptive phase of the uterus is marked by structural and functional maturation of the endometrium. During this limited time span, the blastocyst competency is superimposed on the receptive endometrium. It is a well-known fact that lipid signalling in early-stage pregnancy has a crucial role in successful embryogenesis. In our study, CD-1 mouse uteri after normal and in vitro fertilization (IVF) were investigated at 6.5, 8.5, and 10.5 days of pregnancy. Matrix-assisted laser desorption/ionization time-of-flight imaging mass spectrometry and liquid chromatography coupled tandem mass spectrometry were used for identification of phosphatidylcholine (PC) lipid structures. In the embryonal tissues, PC 32:0 and PC 34:0 were increased, while in the antemesometrial (AM) decidua the two 20:4-containing PCs, PC 36:4 and PC 38:4 were increased. In transferred uterus samples, higher expressions of PC 34:0, PC 34:1, PC 34:2, PC 36:1, and PC 36:2 in mesometrial decidua were seen, whereas the two 20:4-containing PCs, PC 36:4 and PC 38:4 showed increased expression in the AM and lateral decidua. This paper shows a significant spatio-temporal change in lipid metabolism during IVF procedures for the first time.

The aim of our study was to compare the characteristics and time to initial physician contact in patients with head and neck squamous cell carcinoma (HNSCC) before and during the COVID-19 pandemic at a large Hungarian cancer center. This was a retrospective study of patients 18 years or older presenting at the regional cancer center of Pécs Clinical Center with HNSCC between 1 January 2017, and 15 March 2020 (the pre-COVID-19 period) and between 16 March 2020, and 13 May 2021 (the COVID-19 period). Demographic and clinical data were collected, and the time between initial symptom onset and initial physician contact (TTP) was determined. Descriptive and exploratory statistical analyses were performed. On average, the number of patients diagnosed with HNSCC per month during the pandemic decreased by 12.4% compared with the pre-COVID-19 period. There was a significant increase in stage I and stage II cancers (from 15.9% to 20.3% and from 12.2% to 13.8%, respectively; p < 0.001); a decrease in stage III and IVa,c cancers; and a significant increase in stage IVb cancers (from 6% to 19.9%; p < 0.001) during the pandemic. The median TTP increased during the pandemic from 43 to 61 days (p = 0.032). To our knowledge, this is the first study investigating the effect of COVID-19 on patients with HNSCC in the Central–Eastern European region. We found a bidirectional shift in cancer stages and increased TTP during the pandemic. Our findings highlight the necessity for more nuanced analyses of the effects of COVID-19.

It is well known that long chain polyunsaturated fatty acids (LCPUFAs) play an important role in neurodevelopment in the perinatal life. The most important source of these fatty acids is the diet, however, they can also be formed in the human body from their shorter chain precursors, the essential fatty acids. Since the WHO recommends exclusive breastfeeding for the first six months after birth, the exclusive source of these fatty acids for breastfed infants is human milk, which can be influenced by the mother’s diet. Unsaturated fatty acids can have either cis or trans configuration double bond in their chain with distinct physiological effects. Cis isomeric unsaturated fatty acids have several beneficial effects, while trans isomers are mostly detrimental, because of their similar structure to saturated fatty acids. Trans fatty acids (TFAs) can be further subdivided into industrial (iTFA) and ruminant-derived trans fatty acids (rTFA). However, the physiological effects of these two TFA subgroups may differ. In adults, dietary intake of iTFA has been linked to atherosclerosis, insulin resistance, obesity, chronic inflammation, and increased development of certain cancers, among other diseases. However, iTFAs can have a negative impact on health not only in adulthood but in childhood too. Results from previous studies have shown that iTFAs have a significant negative effect on LCPUFA levels in the blood of newborns and infants. In addition, iTFAs can affect the growth and development of infants, and animal studies suggest that they might even have lasting negative effects later in life. Since the only source of TFAs in the human body is the diet, the TFA content of breast milk may determine the TFA supply of breastfed infants and thus affect the levels of LCPUFAs important for neurodevelopment and the health of infants. In this review, we aim to provide an overview of the TFA content in human milk available in the literature and their potential effects on infant health and development.

IntroductionPatients with advanced cancer tend to utilize the services of the health care system, particularly emergency departments (EDs), more often, however EDs aren’t necessarily the most ideal environments for providing care to these patients. The objective of our study was to analyze the clinical and demographic characteristics of advanced patients with cancer receiving basic palliative care (BPC) or hospice care (HC), and to identify predictive factors of BPC and HC prior to their visit to the ED, in a large tertiary care center in Hungary.MethodsA retrospective, detailed analysis of patients receiving only BPC or HC, out of 1512 patients with cancer visiting the ED in 2018, was carried out. Sociodemographic and clinical data were collected via automated and manual chart review. Patients were followed up to determine length of survival. Descriptive and exploratory statistical analyses were performed.ResultsHospital admission, multiple (≥4x) ED visits, and respiratory cancer were independent risk factors for receiving only BPC (OR: 3.10, CI: 1.90-5.04; OR: 2.97, CI: 1.50-5.84; OR: 1.82, CI: 1.03-3.22, respectively), or HC (OR: 2.15, CI: 1.26-3.67; OR: 4.94, CI: 2.51-9.71; OR: 2.07, CI: 1.10-3.91). Visiting the ED only once was found to be a negative predictive factor for BPC (OR: 0.28, CI: 0.18-0.45) and HC (OR: 0.18, 0.10-0.31) among patients with cancer visiting the ED.ConclusionsOur study is the first from this European region to provide information regarding the characteristics of patients with cancer receiving BPC and HC who visited the ED, as well as to identify possible predictive factors of receiving BPC and HC. Our study may have relevant implications for health care planning strategies in practice.

Fatty acids (FAs) play important roles as membrane components and signal transduction molecules. Changes in short chain FA (SCFA) composition are associated with gut microbiota modifications. However, the effect of bacteria-driven changes on the detailed FA spectrum has not been explored yet. We investigated the effect of antibiotics (ABx) and/or probiotics, in four treatment groups on rat stool FA composition. Principal component analysis indicated that the chromatogram profiles of the treatment groups differ, which was also observed at different time points. Linear mixed effects models showed that in the parameters compared (sampling times, treatments. and their interactions), both the weight percentage and the concentration of FAs were affected by ABx and probiotic administration. This study found that the gut microbiome defines trans and branched saturated FAs, most saturated FAs, and unsaturated FAs with less carbon atoms. These results are among the first ones to demonstrate the restoring effects of a probiotic mixture on a substantial part of the altered total FA spectrum, and also revealed a previously unknown relationship between gut bacteria and a larger group of FAs. These findings suggest that intestinal bacteria produce not only SCFAs but also other FAs that may affect the host’s physiological processes.

Docosahexaenoic acid (DHA) is a novel mandatory constituent of breast-milk-substitute infant formula in Europe. The aim of the present narrative review was to summarize available data in connection with the background of the novel European mandatory dietary recommendation to add at least 20 mg/100 kcal (4.8 mg/100 kJ) DHA to infant formula. The literature search with the expression "docosahexaenoic acid with (infant or human milk or formula)" revealed nearly 2000 papers, including more than 400 randomized controlled trials (RCTs). DHA is a persistent constituent of human milk (HM) with a worldwide mean level of 0.37% (standard deviation: 0.11%) of all fatty acids in HM. RCTs on supplementing DHA to lactating women showed some indications, though no direct evidence of the beneficial effect of enhanced HM DHA on the development of breastfed infants. The most-recent Cochrane review of RCTs investigating the effect of DHA supplementation to infant formula for full-term infants reported no evidence for recommending supplementation. The controversy between the Cochrane view and the actual recommendation may be related to the numerous hurdles in organizing high-quality studies in this field. On the basis of the official food composition recommendation, today in Europe, DHA should be considered as a fatty acid essential for infants.

Somatostatin (SST) released from capsaicin-sensitive sensory nerves in response to stimulation exerts systemic anti-inflammatory, analgesic actions. Its elevation correlates with the extent of tissue injury. We measured plasma SST alterations during spine operations (scoliosis and herniated disc) to determine whether its release might be a general protective mechanism during painful conditions. Sampling timepoints were baseline (1), after: soft tissue retraction (2), osteotomy (3), skin closure (4), the following morning (5). Plasma SST-like immunoreactivity (SST-LI) determined by radioimmunoassay was correlated with pain intensity and the correction angle (Cobb angle). In scoliosis surgery, postoperative pain intensity (VAS 2.) 1 day after surgery significantly increased (from 1.44 SEM ± 0.68 to 6.77 SEM ± 0.82, p = 0.0028) and positively correlated with the Cobb angle (p = 0.0235). The baseline Cobb degree negatively correlated (p = 0.0459) with the preoperative SST-LI. The plasma SST-LI significantly increased in fraction 3 compared to the baseline (p < 0.05), and significantly decreased thereafter (p < 0.001). In contrast, in herniated disc operations no SST-LI changes were observed in either group. The VAS decreased after surgery both in the traditional (mean 6.83 to 2.29, p = 0.0005) and microdiscectomy groups (mean 7.22 to 2.11, p = 0.0009). More extensive and destructive scoliosis surgery might cause greater tissue damage with greater pain (inflammation), which results in a significant SST release into the plasma from the sensory nerves. SST is suggested to be involved in an endogenous postoperative analgesic (anti-inflammatory) mechanism.

Objectives To identify predictive factors of multiple emergency department (ED) visits, hospitalisation and potentially preventable ED visits made by patients with cancer in a Hungarian tertiary care centre. Design Observational, retrospective study. Setting A large, public tertiary hospital, in Somogy County, Hungary, with a level 3 emergency and trauma centre and a dedicated cancer centre. Participants Patients above 18 years with a cancer diagnosis (International Classification of Diseases, 10th Revision codes of C0000–C9670) who visited the ED in 2018, who had received their diagnosis of cancer within 5 years of their first ED visit in 2018 or received their diagnosis of cancer latest within the study year. Cases diagnosed with cancer at the ED (new cancer diagnosis-related ED visits) were also included, constituting 7.9% of visits. Primary outcome measures Demographic and clinical characteristics were collected and the predictors of multiple (≥2) ED visits within the study year, admission to inpatient care following the ED visit (hospitalisation), potentially preventable ED visits and death within 36 months were determined. Results 2383 ED visits made by 1512 patients with cancer were registered. Predictive factors of multiple (≥2) ED visits were residing in a nursing home (OR 3.09, 95% CI 1.88 to 5.07) and prior hospice care (OR 1.87, 95% CI 1.05 to 3.31). Predictive factors for hospitalisation following an ED visit included a new cancer diagnosis-related visit (OR 1.86, 95% CI 1.30 to 2.66) and complaint of dyspnoea (OR 1.61, 95% CI 1.22 to 2.12). Conclusions Being a resident of a nursing home and receiving prior hospice care significantly increased the odds of multiple ED visits, while new cancer-related ED visits independently increased the odds of hospitalisation of patients with cancer. This is the first study to report these associations from a Central-Eastern European country. Our study may shed light on the specific challenges of EDs in general and particularly faced by countries in the region.

This systematic review aims to assess whether edible vegetable oils and fats fortified with vitamin A and/or D are effective and safe in improving vitamin intake and ameliorating deficiency states in the general population. In November 2022, we systematically searched MEDLINE, Cochrane CENTRAL, Scopus, Global Index Medicus, ClinicalTrials.gov, and WHO ICTRP (International Clinical Trials Registry Platform) for randomized controlled trials (RCT) and non-randomized studies of interventions (NRSI) investigating the fortification of edible vegetable oils and fats with either vitamin A or vitamin D or both as compared to the same vegetable oils and/or fats without vitamin A and D fortification or no interventions, in the general population, without age restriction. We assessed the methodological quality of included RCTs using Cochrane’s risk of bias tool 2.0 and of NRSIs using ROBINS-I tool. We performed random-effects meta-analysis and assessed certainty of evidence using GRADE. We included eight studies. Available evidence showed no significant effect of fortification with vitamin A on serum retinol levels (RCTs: MD 0.35 µmol/L, 95% CI −0.43 to 1.12; two trials; 514 participants; low-certainty evidence; CCTs: MD 0.31 µmol/L, 95% CI −0.18 to 0.80; two trials; 205 participants; very low-certainty evidence) and on subclinical vitamin A deficiency. Low-certainty evidence showed no effect of vitamin D fortification on serum 25-hydroxy vitamin D concentration (MD 6.59 nmol/L, 95% CI −6.89 to 20.07; one trial; 62 participants). In conclusion, vitamin A-fortified vegetable oils and fats may result in little to no difference in serum retinol levels in general populations. The dose of vitamin A used in the trials may be safe but may not be sufficient to reduce subclinical vitamin A deficiency. Further, the evidence suggests that vitamin D fortification results in little to no difference in serum 25-hydroxy vitamin D concentration. Several aspects of providing fortified oils and fats to the general population as a public health intervention should be further investigated, including optimal fortification dose, effects on vitamin D deficiency and its clinical symptoms and potential adverse effects.

This article explores how Arab American comedians use humor and satire to challenge and subvert Hollywood’s negative stereotypes and portrayals of Arabs and Muslims. Drawing on the theory of Jack Shaheen, who analyzed and contested Arab and Muslim stereotypes in American media, the article uses qualitative content analysis to examine stand-up shows, films, and television series featuring Arab American comedians and other ethnic comedians in Hollywood. The article identifies common misconceptions and stereotypes, examines the techniques of humor and satire, and compares the impact of Arab American comedy with that of other ethnic comedies. The article argues that Arab American comedians successfully challenge Hollywood’s stereotypes and create alternative representations that celebrate their identity, culture, and diversity. The article contributes to existing literature on humor, satire, representation, stereotyping, resistance, empowerment, identity, culture, diversity, Arab Americans, Muslims, Hollywood, and the media.