RECENT RESEARCH available evidence . To date , little attention has been paid to evidence implementation in disciplines such as naturopathy . This study addresses this knowledge gap by examining the determinants of evidence implementation in Australian naturopathic practice .
Materials and methods : This crosssectional study was open to all Australian naturopaths who had internet access and were fluent in the English language . Participants were invited to complete the 84-item Evidence-Based practice Attitude and utilization Survey ( EBASE ) online between March and July 2020 .
Results : The survey was completed in full by 174 naturopaths ( 87.4 % female ; 31.6 % aged 40 – 59 years ). While participant attitudes were predominantly favourable of evidence implementation , engagement in evidence implementation activities was reported at a low to moderate level . Factors impacting participant engagement in such activities included a lack of clinical evidence in naturopathy , lack of time , and a moderate to moderately- high level of selfreported skill in evidence implementation . Enablers of evidence implementation were access to the internet , free online databases , full-text journal articles , and online education materials .
Conclusion : This study has provided valuable insights into the level of , and factors impacting evidence implementation among Australian naturopaths . Attitude did not pose a major barrier to evidence implementation ; rather , the barriers were largely structural and cognitive . This suggests that the obstacles to evidence implementation in naturopathy are most likely surmountable with the right means and concerted effort .
Maunder A , Arentz S , Armour M , Costello MF , Ee C . Effectiveness of adjunct naturopathy for improved pregnancy rates in women with diminished ovarian reserve : feasibility of a randomised controlled trial . Reproductive BioMedicine Online . doi : https :// doi . org / 10.1016 / j . rbmo . 2024.103844
Research question : Is it feasible to conduct a randomized control trial ( RCT ) to assess the effectiveness of whole-system naturopathy in improving pregnancy rates among women with diminished ovarian reserve ( DOR )?
Design : We conducted a two-arm , parallel group , assessor-blinded feasibility RCT . Australian women with DOR who were trying to conceive ( either naturally or with medically assisted reproductive treatments were randomly assigned to naturopathy plus usual care or usual care alone for 16 weeks ). Primary outcomes were feasibility ( recruitment , adherence , retention rates ), acceptability and safety . Secondary outcomes included ongoing pregnancy rates , live birth rates and health-related outcomes ( mental health , quality of life , diet , exercise , sleep , weight ). Statistical significance of the differences between the two groups ( pvalues ) were exploratory .
Results : One hundred and fifteen women completed the screening survey between March and November 2022 . Of these , 66 women were assessed for eligibility and 41 ( 62 %) consented . Recruitment resulted in seven enrolments each month . All 41 participants ( 100 %) adhered to the intervention , 38 ( 93 %) completed endpoint questionnaires , 32 ( 78 %) found study participation to be acceptable and 18 / 21 ( 86 %) from the intervention group would recommend a naturopathic intervention to other women with DOR . The naturopathic treatment was associated with only mild and temporary adverse events . There was no between group differences for pregnancy and live birth rates .
Conclusion : The evaluation of wholesystem naturopathy through a RCT was feasible and the treatment was acceptable and well-tolerated according to women with DOR . Outcomes from this study will help inform sample size calculations powered for fertility outcomes for future RCTs on this topic .
Nutrition
Shah A , Wondisford FE . Gluconeogenesis flux in metabolic disease . Annual Review of Nutrition . 2023 ; 43 , 153-177 . https :// doi . org / 10.1146 / annurev-nutr-061121-091507
Gluconeogenesis is a critical biosynthetic process that helps maintain whole-body glucose homeostasis and becomes altered in certain medical diseases . We review gluconeogenic flux in various medical diseases , including common metabolic disorders , hormonal imbalances , specific inborn genetic errors , and cancer . We discuss how the altered gluconeogenic activity contributes to disease pathogenesis using data from experiments using isotopic tracer and spectroscopy methodologies . These in vitro , animal , and human studies provide insights into the changes in circulating levels of available gluconeogenesis substrates and the efficiency of converting those substrates to glucose by gluconeogenic organs . We highlight ongoing knowledge gaps , discuss emerging research areas , and suggest future investigations . A better understanding of altered gluconeogenesis flux may ultimately identify novel and targeted treatment strategies for such diseases .
Bailey RL , Jun S , Cowan AE , Eicher-Miller HA , Gahche JJ , Dwyer JT , Hartman TJ , Mitchell DC , Seguin-Fowler RA , Carroll RJ , Tooze JA . Major Gaps in Understanding Dietary Supplement Use in Health and Disease . Ann Rev Nut . 2023 ; 43 , 179 – 197 . doi : 10.1146 / annurev-nutr-011923-020327 .
Precise dietary assessment is critical for accurate exposure classification in nutritional research , typically aimed at understanding how diet relates to health . Dietary supplement ( DS ) use is widespread and represents a considerable source of nutrients . However , few studies have compared the best methods to measure DSs . Our literature review on the relative validity and reproducibility of DS instruments in the United States [ e . g ., product inventories , questionnaires , and 24-h dietary recalls ( 24HR )] identified five studies that examined validity ( n = 5 ) and / or reproducibility ( n = 4 ). No gold standard reference method exists for validating DS use ; thus , each study ' s investigators chose the reference instrument used to measure validity . Self-administered questionnaires agreed well with 24HR and inventory methods when comparing the prevalence of commonly used DSs . The inventory method captured nutrient amounts more accurately than the other methods . Reproducibility ( over 3 months
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