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Dženita Salihefendić

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Background: In recent years, there has been a significant increase in the prevalence of insulin resistance (IR) which has become a global health problem. Obesity is the typical clinical presentation of IR. The connection between underweight and IR is less known. Objective: The study aimed to investigate the characteristics of eating habits in underweight and obese patients with IR. After the obtained results, propose suitable dietary instructions specific to 2 subject groups. The task was to determine the difference in the nutritional status of underweight and obese patients with proven IR. The questionnaire was designed to collect data on diet and eating habits. Methods: The research included 60 subjects of both sexes between the ages of 20 and 60. Inclusion criteria for entering the study were: proven obesity (BMI ≥ 30), underweight (BMI≤18,5) and confirmed IR by assessment of the homeostatic model for insulin resistance (HOMA IR-2). BMI, waist-to-hip ratio (WHR), and visceral fat area (VFA) were calculated using the bioelectrical impedance. Data on dietary habits was collected using a questionnaire that included general patient data, physical activity, lifestyle and eating habits. Descriptive statistical methods were used to process and analyse the obtained data. Results: The average BMI in obese subjects was 34.32 kg/m2, and in underweight subjects, 17.26 kg/m2. There are statistically significant differences between BMI, WHR and VFA. The mean value of HOMA-IR in the obese patients was 2.87 and in the underweight, 2.45. Underweight subjects have a statistically significant (p<0.05) tendency to lose weight, consume milk and milk products, prefer lean meat, and drink more alcohol. Obese subjects are significantly (p<0.05) less physically active, more prone to insomnia, tend to gain weight, enjoy food, consume fewer fruits and vegetables and more carbohydrate food, do not follow clinical nutritional guidelines, and mostly eat in a social setting. Both groups rarely practiced mindful eating. Consumption of highly processed food and sweets is common in both groups. Conclusion: There are statistically significant differences in the dietary and lifestyle habits of underweight and obese patients diagnosed with IR. It is necessary to educate healthcare workers and the general population about the importance of nutrition for preventing IR, regardless of body weight.

Background: Consuming a diet rich in natural foods that include oilseed products containing bioactive compounds and a diverse array of fatty acids is not just a dietary choice; it is a critical element of maintaining human health. Objective: This paper aims to review the current state of knowledge on minor bioactive compounds in vegetable cold pressed oils, these are substances that are found in small amounts in vegetable cold pressed oils. Methods: Intended as an indispensable resource, this review is designed to empower medical professionals in the fields of integrative medicine, nutrition, and dietetics. Results and Discussion: Cold-pressed oils extracted from various plant sources have emerged as vital allies in the battle against inflammation-related diseases, offering a versatile range of valuable compounds. These compounds contribute to the oils' multifaceted properties, which encompass potent anti-inflammatory, antioxidant, and anticancer effects, greatly enhancing their nutritional significance. This brief review delves deep into the intricate composition of cold-pressed oils, with a specific focus on the often overlooked but highly influential minor bioactive compounds, including phytosterols, phospholipids, tocols, phenols, squalene and pigments. Intended as an indispensable resource, this review is designed to empower medical professionals in the fields of integrative medicine, nutrition, and dietetics. It equips them with a wealth of knowledge to guide consumers in making informed choices when incorporating cold-pressed oils into their dietary plans, tailored to their individual health needs.. Conclusion: This paper highlights the importance of cold-pressed oils as a source of various minor bioactive compounds that have the potential to promote human health and prevent or manage a range of diseases. The findings presented in this paper serve as a valuable resource for medical professionals in the field of integrative medicine, nutrition, and dietetics, as well as for consumers looking to make informed choices about their dietary and health needs.

Background: Previous pandemic and catastrophic events significantly changed the life of every human being, bringing him/her into a state of stress and the need to quickly adapt to new ways of daily activity. COVID-19 has a negative impact on all elements of health: social, physical and mental. Pharmacotherapy, as well as protective measures (isolation, wearing masks and maintaining physical distance) did not give the expected results. Vaccination has not yet led to herd immunity, so it is still jeopardizing every aspect of human health (1, 2). Non-pharmacological methods, such as stress and sleep control, physical activity and contact with nature are of great importance since they can significantly contribute to staying healthy during a pandemic. Objectives: The aim of this paper is to evaluate the impact of non-pharmacological measures such as stress and sleep control (with different measures against the negative effects of anxiety and depression on mental state) and the possible positive impact of “forest bathing” on improving the immune response to the virus and its consequences. Methods: Available evidence-based studies on ways to com- bat stress and the effect of the proposed measures on human mental health and the im- mune system were analyzed. From the mentioned studies, recommended measures have been registered, which refer to stress and sleep control, diet and eating habits, contact with nature (“forest bathing”, gardening), virtual communication and meditation (mindfulness practice). Results and Discussion: The combined results of these studies indicate that COVID-19 has a chronic course and complications that significantly affect the physical, mental and emotional state of the patient. Proven positive effects of non-pharmacological measures can be applied in the daily practice of primary health care in the comprehensive fight against the COVID-19 pandemic. Conclusion: Non-pharmacological measures such as stress and sleep control, spending time in nature, healthy diet, and physical activity may improve the immune response to COVID-19. These measures, with their positive effects on all aspects of health, can make a major contribution to controlling and improving the quality of life during the COVID-19 pandemic.

Background: The corona virus is transmitted in three ways: by direct contact with an infected person, by droplets, and by air. Transmission control according to official guidelines can be prevented by keeping a distance, wearing a mask and washing hands. Sharing a space with several members of the immediate or extended family increases the risk of transmission in all three ways. In Traditional Bosnian families two or three generations live in one household. The family doctor is informed with living conditions of the residents and has the opportunity to monitor the rate of secondary transmission from the index case, and then recommend additional preventative and treatment measures. Objective: The aim of the study was to determine the first occurrence of the symptoms and to monitor possible intrafamilial transmission of the disease through clinical examinations and microbiological-serological tests. Methods: The study was conducted in a family medicine clinic in the region of northeastern Bosnia and Herzegovina from March to December 2020. Patients with symptoms that could indicate the presence of COVID-19 disease were registered. If COVID-19 was proven, the patient became an index case. The other members of the family would be monitored for the secondary transmission via laboratory (PCA SARS-CoV-2 and IgM and IgG antibodies) and clinical parameters. Results: Characteristics of 25 index cases were analyzed. All 25 of them were middle-aged men that worked outside the home. In 25 households, there was a total of 123 members that shared a home with the index patient. Secondary transmission developed in 76 out of 123 family members (61.8%). Only one patient had a severe form of the disease and was hospitalized. 2 patients died. Conclusion: Intrafamiliar transmission of Covid-19 in households of Bosnia and Herzegovina is high. The secondary attack rate of SARS- CoV-2 in households is 61,8%. In the surveyed households, family members use common rooms with an infected patient, and the customs of family gatherings are maintained, without the implementation of protective measures. The family medicine team has the opportunity to apply appropriate preventive action, education and early prehospital treatment as well as adequate selection for the hospital admission.

Background: Accurate human body composition assessment is becoming very important in clinical practice due to the possibility of early diagnosis and preventive interventions of metabolic disorders. Fats are one of the most important elements in maintaining normal body structure and different methods are used to determine its total amount and distribution. The amount and distribution of abdominal white adipose tissue, and especially the visceral type, provides important parameters in the development assessment of central obesity, insulin resistance, diabetes and other chronic non-infectious diseases. Objective: The aim of the study was to determine the amount of visceral adipose tissue in adults who are overweight and then estimate the probability of developing insulin resistance (IR) in those with higher amounts of visceral adipose tissue. Based on a comparison of the amount of visceral adipose tissue and the frequency of IR, evaluate the clinical significance of a routine procedure for body structure assessment in relation to the amount of visceral adipose tissue. Methods: Subjects were adults of both sexes aged 20 to 77 years, who were patients in two family medicine clinics. Including criteria for the study were: increased body weight (BMI≥25) and normal blood glucose values (4.0 – 5.4 mmol/L). All subjects underwent anthropometric measurements (BMI, waist circumference, waist-hip ratio) and body structure assessment with bioelectrical impedance. According to the values for the amount of visceral adipose tissue (below and above 110 cm2), the subjects were divided into two groups. All subjects underwent an IR test. We used the HOMA 1 value of 2 as a cut off for the risk of chronic non- infectious diseases in non-diabetic population. Results: The study included 80 patients. 14 patients did not complete the study, so the total number of subjects was 66 (39 women and 27 men). 36 subjects had elevated values of visceral adipose tissue (over 110 cm2). In this group, the presence of IR was registered in 30 patients or 81%. In the control group with a normal amount of visceral adipose tissue, IR was registered in 10 subjects or 33%, which is a statistically significant difference. Conclusion: Increased amount of visceral adipose tissue in overweight patients significantly affects the occurrence of IR. For the patients with an increased amount of visceral adipose tissue, it is necessary to introduce intensive preventive measures to stop the development of diabetes and other complications as a result of IR presence.

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