Colorectal cancer therapy and nutrition: From ultra-processed consumption to metabolic reprogramming Rodrigo Soares Pereira Lima, Jheniffer da Silva Sousa, Maria Shelda de Oliveira Neres, Dallyla Jennifer Morais de Sousa, Jorddam Almondes Martins, et al. World Journal of Gastrointestinal Oncology, 2026 This narrative review examines the role of dietary patterns in colorectal cancer (CRC) development and management, with a focus on the diet-microbiome-metabolic reprogramming axis. CRC is one of the most prevalent and lethal malignancies worldwide, with pathogenesis shaped by genetic susceptibility, environmental exposures, and diet-related metabolic disturbances. High consumption of ultra-processed foods (UPFs), characterized by low fiber content and high levels of additives, has been associated with intestinal barrier dysfunction, dysbiosis, chronic inflammation, and oxidative stress, and a meta-analysis indicates that each 10% increase in UPF consumption corresponds to a 4% higher CRC risk. In contrast, metabolic dietary interventions, such as caloric restriction, fasting or fasting-mimicking diets, and ketogenic diets, have been primarily explored in preclinical models, demonstrating effects on tumor metabolism and inflammatory pathways. However, clinical evidence remains limited and heterogeneous, consisting mainly of small trials and observational studies with inconsistent protocols and variable adherence. This review critically synthesises current evidence by distinguishing between mechanistic insights and translational applicability. Well-designed clinical trials incorporating metabolic phenotyping and patient stratification are necessary to define the role of personalised nutrition as a potential adjunctive strategy in CRC prevention and treatment.
Caloric Restriction Enhances Chemotherapy Efficacy and Reshapes Stress Responses in Sarcoma Jorddam Almondes Martins, Irislene Costa Pereira, Thiago Sousa Reinaldo, Dallyla Jennifer Morais de Sousa, Isabelle Vasconcelos Rodrigues, et al. Cancers, 2026 Background: Oncological treatment remains a major clinical challenge. Despite therapeutic advances and the diversity of available approaches, many tumors continue to exhibit limited responsiveness to chemotherapy. In this context, nutrition has emerged as a promising complementary strategy to support cancer therapy. In particular, interventions based on nutritional deprivation have gained prominence due to their ability to modulate tumor metabolism, inducing alterations that may increase the sensitivity of cancer cells to conventional treatments. Accordingly, the present study aimed to evaluate the safety and efficacy of caloric restriction combined with chemotherapy in a Sarcoma-180 model, investigating its effects on immunological and hematological parameters, antioxidant activity, oxidative stress, and tumor and liver morphology, as well as DNA damage. Methods: Mice bearing Sarcoma-180 were randomly assigned to four groups: Ad Libitum (AL), Ad Libitum + Doxorubicin (ALDOX), Caloric Restriction (CR), and Caloric Restriction + Doxorubicin (CRDOX). Assessment included tumor weight and volume, food and caloric intake, hematotoxicity, lipid metabolism, oxidative stress and antioxidant markers, genotoxicity, morphological alterations in the tumor and liver, and overall survival. Results: The data obtained demonstrate that caloric restriction combined with doxorubicin is both safe and feasible, as it preserves body weight and does not induce metabolic disturbances. Importantly, this combined strategy produced a marked reduction in tumor volume and mass while also mitigating the hematotoxicity typically associated with doxorubicin. In peripheral blood, the regimen decreased chemotherapy-induced DNA damage, supporting a systemic protective effect. Consistently, the combination reduced oxidative stress markers (NOx and MDA) and enhanced antioxidant activity within the tumor. Histological analyses further confirmed these outcomes, showing tumor cell death with features compatible with apoptosis and reduced local invasion. Together, these data indicate that caloric restriction enhances the antitumor efficacy of doxorubicin while simultaneously improving treatment tolerance. Conclusions: This study demonstrates that caloric restriction, combined with doxorubicin, is safe, well-tolerated, and enhances the antitumor response in the Sarcoma-180 model.
Role of physical exercise, vagal nerve stimulation, and vagotomy in inflammatory bowel disease Alda Cassia Alves da Silva, Juliana Soares Severo, Brenda Lois Barros dos Santos, Heron Silva Soares, Jorddam Almondes Martins, et al. World Journal of Gastroenterology, 2025 Inflammatory bowel disease (IBD), comprising Crohn’s disease and ulcerative colitis, represents the two predominant clinical entities within this spectrum of gastrointestinal disorders. Current evidence indicates that the etiology of IBD is multifactorial, involving a complex interplay between host genetic susceptibility and environmental determinants. In recent years, non-pharmacological strategies such as physical exercise and vagus nerve stimulation have gained increasing attention as adjunctive therapeutic approaches. Vagus nerve stimulation has emerged as a promising therapeutic modality, particularly in conditions characterized by autonomic dysfunction and diminished vagal tone. Conversely, vagotomy, by disrupting vagal control, abolishes parasympathetic reflexes and may potentiate inflammatory responses and exacerbate IBD symptomatology under stress conditions. Physical exercise has likewise been investigated as a non-pharmacological intervention in Crohn’s disease and ulcerative colitis. Although the precise mechanisms remain to be fully elucidated, accumulating evidence suggests that skeletal muscle contractions promote the secretion of myokines, with recognized anti-inflammatory properties. These myokines act on the intestinal microenvironment, conferring protection against malignant transformation and modulating the composition and function of the gut microbiota. In this review, we critically examine the interplay between physical exercise, vagus nerve stimulation, and vagotomy in the pathophysiology and management of IBD, with particular emphasis on their immunomodulatory and therapeutic potential.
Development of a 24-Hour Movement Behavior Questionnaire: Reliability and Validity Testing in College Students From Low-Income Regions Marcus Vinicius Nascimento-Ferreira, Kliver Antonio Marin, Lorrane Cristine Conceição da Silva, Alaiana Marinho Franco, Francisco Leonardo Torres-Leal, et al. Sage Open, 2025 In this study, we aimed to develop and test the psychometric properties of an online 24-hr movement behavior questionnaire (24 hr-MBQ). We recruited a sample of 195 undergraduate students. We developed a questionnaire based on 19 items extracted from previously validated questionnaires. We conducted reliability and construct validity assessment by classical test theory and structural validity assessment using unsupervised machine learning. In the classic test, we identified seven factors where the explained variance was 66.80% in the exploratory factor analysis, with no item excluded. We identified three clusters using unsupervised machine learning and this structure was able to distinguish differences in physical activity (physically active vs. long sleeper), sedentary behavior (all cluster comparison), and sleep time duration (all cluster comparison). Our findings suggest that the online 24 hr-MBQ is a reliable and structured construct for assessing 24-hr movement behaviors in college students.
Supplementation Containing Bromelain on the Side Effects of Oncological Treatment: Systematic Review Irislene Costa Pereira, Raquel Barros Passos, Camila de Meneses Caetano Viana, Isabele Frazão Mascarenhas, Glauto Tuquarre de Melo Nascimento, et al. Journal of Medicinal Food, 2025 Systemic therapies for the treatment of cancer collaborate to reduce cancer progression and have been used for decades. However, despite the clinical benefits, its long-term use is associated with toxicity, promoting important side effects that can compromise the quality of life. Enzyme supplementation has been pointed out as a therapeutic potential in several diseases. Bromelain is an enzyme complex that regulates pathways associated with inflammation. This review aims to evaluate the use of bromelain-containing supplements to improve the side effects of cancer treatment. This systematic review was developed in PubMed, Web of Science, and Cochrane Library, using the terms: Cancer AND Bromelain. 239 studies were retrieved, and only three met our objective. In general, it was possible to observe that supplementation was able to reduce side effects of adjuvant hormone therapy and chemotherapy, such as mucosal dryness, arthralgia, and peripheral neuropathy induced by chemotherapy.
Probiotics in sports and physical exercise Juliana Soares Severo, Alda Cássia Alves da Silva, Irislene Costa Pereira, Francisco Leonardo Torres-Leal, Moisés Tolentino Bento da Silva Probiotics for Human Nutrition in Health and Disease, 2022
Modulation and Consequences of Sleep Duration in Child Obesity Marcus Vinicius Nascimento-Ferreira, Augusto César Ferreira De Moraes, Francisco Leonardo Torres-Leal, Heráclito Barbosa Carvalho Neurological Modulation of Sleep Mechanisms and Function of Sleep Health, 2020
Influence of magnesium on insulin resistance in obese women Kyria Jayanne Clímaco Cruz, Ana Raquel Soares de Oliveira, Denise Pereira Pinto, Jennifer Beatriz Silva Morais, Fabiana da Silva Lima, et al. Biological Trace Element Research, 2014
Protein synthesis regulation by leucine Daiana Vianna, Gabriela Fullin Resende Teodoro, Francisco Leonardo Torres-Leal, Julio Tirapegui Brazilian Journal of Pharmaceutical Sciences, 2010
Colorectal cancer therapy and nutrition: From ultra-processed consumption to metabolic reprogramming RSP Lima, JDS Sousa, MSO Neres, DJM de Sousa, JA Martins, ... World Journal of Gastrointestinal Oncology 18 (4) , 2026 2026
The Influence of Exercise on the Endocrine System: Impacts on Adolescent Growth and Development JS Severo, RSP Lima, AM de Oliveira, TS Reinaldo, FL Torres-Leal, ... Enhancing Adolescent Health: The Contribution of Exercise to Growth and … , 2026 2026
Fasting-mimicking diets as a strategy to reprogram tumor metabolism: a systematic review IC Pereira, JA Martins, DJM de Sousa, MS de Oliveira Neres, RSP Lima, ... European Journal of Nutrition 65 (2), 44 , 2026 2026 Citations: 1
Behavioral standardization and validation of a new model of cancer-induced depression in sarcoma-bearing mice RWR de Sousa, IL Dos Santos, DC do Nascimento Rodrigues, ... Physiology & Behavior 304, 115153 , 2026 2026
Caloric Restriction Enhances Chemotherapy Efficacy and Reshapes Stress Responses in Sarcoma JA Martins, IC Pereira, TS Reinaldo, DJM Sousa, IV Rodrigues, ... Cancers 18 (1), 110 , 2025 2025
Cellular toxicity of organotellurans: a systematic review of pre-clinical studies MLLB do Nascimento, IR de Sá Guimarães Nolêto, FL Torres-Leal, ... Naunyn-Schmiedeberg's Archives of Pharmacology 398 (11), 14589-14601 , 2025 2025
Role of physical exercise, vagal nerve stimulation, and vagotomy in inflammatory bowel disease ACA da Silva, JS Severo, BLB Dos Santos, HS Soares, JA Martins, ... World Journal of Gastroenterology 31 (38), 111252 , 2025 2025 Citations: 3
Can Pembrolizumab or Nivolumab be efficiently used against colorectal cancers with defective mismatch repair and high index of microsatellite instability? GTM do Nascimento, IC Pereira, KGF de Oliveira, ÁMCP Santos, ... Medical Oncology 42 (8), 306 , 2025 2025 Citations: 2
Development of a 24-Hour Movement Behavior Questionnaire: Reliability and Validity Testing in College Students From Low-Income Regions MV Nascimento-Ferreira, KA Marin, LCC da Silva, AM Franco, ... SAGE Open 15 (2), 21582440251338337 , 2025 2025
Supplementation Containing Bromelain on the Side Effects of Oncological Treatment: Systematic Review IC Pereira, RB Passos, CMC Viana, IF Mascarenhas, GTM Nascimento, ... Journal of Medicinal Food 28 (6), 513-518 , 2025 2025 Citations: 1
Buthionine sulfoximine acts synergistically with doxorubicin as a sensitizer molecule on different tumor cell lines JC Pereira, RWR de Sousa, MLP Conceição, MLLB do Nascimento, ... Journal of Toxicology and Environmental Health, Part A 88 (10), 409-431 , 2025 2025 Citations: 3
Bromelain and liver health: A comprehensive systematic review of preclinical studies IC Pereira, ÁMC Pedrosa-Santos, JA Martins, AA de Sousa, TA Nobre, ... Clinical nutrition ESPEN 66, 437-445 , 2025 2025 Citations: 2
Physical exercise alleviates oxidative stress and autonomic dysregulation in a rat model of inflammatory bowel disease BLB Dos Santos, ACA da Silva, JS Severo, B de Sousa Barbosa, ... Antioxidants 14 (3), 328 , 2025 2025 Citations: 1
Bromelain as a natural anti-inflammatory drug: a systematic review T Alves Nobre, AA de Sousa, IC Pereira, ÁM Carvalho Pedrosa-Santos, ... Natural product research 39 (5), 1258-1271 , 2025 2025 Citations: 19
Physical exercise as a therapeutic approach in gastrointestinal diseases JS Severo, ACA Silva, BLB Santos, TS Reinaldo, AM Oliveira, RSP Lima, ... Journal of Clinical Medicine 14 (5), 1708 , 2025 2025 Citations: 27
Brain Perception of Different Oils on Appetite Regulation: An Anorectic Gene Expression Pattern in the Hypothalamus Dependent on the Vagus Nerve GCA Lopes, BCR Miranda, JOPF Lima, JA Martins, AA de Sousa, ... Nutrients 16 (15), 2397 , 2024 2024 Citations: 1
Exercise physiology and gastrointestinal disorders MTB Silva, D Moreira-Gonçalves, FL Torres-Leal, AA Santos Frontiers in Sports and Active Living 6, 1404388 , 2024 2024 Citations: 1
Dietary restriction and hepatic cancer: Systematic review and meta-analysis of animal studies DJM de Sousa, KGF de Oliveira, IC Pereira, GTM do Nascimento, ... Critical Reviews in Oncology/Hematology 196, 104264 , 2024 2024 Citations: 6
Treadmill Exercise reverses the adverse effects of intermittent fasting on behavior and cortical spreading depression in young rats AF Braz, ML Figueira de Oliveira, DHS Costa, FL Torres-Leal, ... Brain Sciences 13 (12), 1726 , 2023 2023 Citations: 9
Physical exercise alleviates oxidative stress in brown adipose tissue and causes changes in body composition and nutritional behavior in rats with polycystic ovary syndrome WLL Santos, C da Silva Pinheiro, R de Oliveira Santos, ACA da Silva, ... Life sciences 325, 121754 , 2023 2023 Citations: 14
MOST CITED SCHOLAR PUBLICATIONS
Thyroid function in human obesity: underlying mechanisms LC Fontenelle, MM Feitosa, JS Severo, TEC Freitas, JBS Morais, ... Hormone and Metabolic Research 48 (12), 787-794 , 2016 2016 Citations: 187
Pequi (Caryocar brasiliense Camb.) almond oil attenuates carbon tetrachloride-induced acute hepatic injury in rats: Antioxidant and anti-inflammatory effects LRO Torres, FC de Santana, FL Torres-Leal, ILP de Melo, LT Yoshime, ... Food and Chemical Toxicology 97, 205-216 , 2016 2016 Citations: 112
The role of inflamed adipose tissue in the insulin resistance FL Torres‐Leal, MH Fonseca‐Alaniz, MM Rogero, J Tirapegui Cell biochemistry and function 28 (8), 623-631 , 2010 2010 Citations: 107
Palmitoleic acid (n-7) increases white adipocyte lipolysis and lipase content in a PPARα-dependent manner A Bolsoni-Lopes, WT Festuccia, TSM Farias, P Chimin, FL Torres-Leal, ... American Journal of Physiology-Endocrinology and Metabolism 305 (9), E1093-E1102 , 2013 2013 Citations: 100
Palmitoleic acid (n-7) increases white adipocytes GLUT4 content and glucose uptake in association with AMPK activation A Bolsoni-Lopes, WT Festuccia, P Chimin, TSM Farias, FL Torres-Leal, ... Lipids in Health and Disease 13 (1), 199 , 2014 2014 Citations: 99
The lipid accumulation product is a powerful tool to predict metabolic syndrome in undiagnosed Brazilian adults MV Nascimento-Ferreira, T Rendo-Urteaga, RC Vilanova-Campelo, ... Clinical nutrition 36 (6), 1693-1700 , 2017 2017 Citations: 92
Leucine supplementation improves adiponectin and total cholesterol concentrations despite the lack of changes in adiposity or glucose homeostasis in rats previously exposed to … FL Torres-Leal, MH Fonseca-Alaniz, GFR Teodoro, MD de Capitani, ... Nutrition & Metabolism 8 (1), 62 , 2011 2011 Citations: 80
Pinealectomy interferes with the circadian clock genes expression in white adipose tissue TSM de Farias, AC de Oliveira, S Andreotti, FG do Amaral, P Chimin, ... Journal of pineal research 58 (3), 251-261 , 2015 2015 Citations: 76
Leucine is essential for attenuating fetal growth restriction caused by a protein-restricted diet in rats GFR Teodoro, D Vianna, FL Torres-Leal, LC Pantaleao, EM Matos-Neto, ... The Journal of nutrition 142 (5), 924-930 , 2012 2012 Citations: 74
Chronic glucocorticoid treatment enhances lipogenic activity in visceral adipocytes of male Wistar rats P Chimin, TSM Farias, FL Torres‐Leal, A Bolsoni‐Lopes, AB Campaña, ... Acta Physiologica 211 (2), 409-420 , 2014 2014 Citations: 72
Metabolic disorders and adipose tissue insulin responsiveness in neonatally STZ-induced diabetic rats are improved by long-term melatonin treatment AC de Oliveira, S Andreotti, TSM Farias, FL Torres-Leal, ARG de Proença, ... Endocrinology 153 (5), 2178-2188 , 2012 2012 Citations: 70
p53 in AgRP neurons is required for protection against diet-induced obesity via JNK1 M Quinones, O Al-Massadi, C Folgueira, S Bremser, R Gallego, ... Nature communications 9 (1), 3432 , 2018 2018 Citations: 69
Influence of magnesium on insulin resistance in obese women. K Cruz, A Oliveira, D Pinto, J Morais, F Silva Lima, C Colli, F Torres-Leal, ... Biological trace element research 160 (3) , 2014 2014 Citations: 63
Long-term leucine supplementation reduces fat mass gain without changing body protein status of aging rats D Vianna, GFT Resende, FL Torres-Leal, LC Pantaleão, J Donato Jr, ... Nutrition 28 (2), 182-189 , 2012 2012 Citations: 59
Is self-reported physical fitness useful for estimating fitness levels in children and adolescents? A reliability and validity study ACF De Moraes, RC Vilanova-Campelo, FL Torres-Leal, HB Carvalho Medicina 55 (6), 286 , 2019 2019 Citations: 55
Obesity, inflammation, and insulin resistance LM Martins, ARS Oliveira, KJC Cruz, FL Torres-Leal, DN Marreiro Brazilian Journal of Pharmaceutical Sciences 50 (4), 677-692 , 2014 2014 Citations: 49
Design and objectives of the south American youth/child cardiovascular and environmental (SAYCARE) study HB Carvalho, LA Moreno, AM Silva, G Berg, A Estrada‐Restrepo, ... Obesity 26, S5-S13 , 2018 2018 Citations: 44
Protein synthesis regulation by leucine D Vianna, GFR Teodoro, FL Torres-Leal, J Tirapegui Brazilian Journal of Pharmaceutical Sciences 46, 29-36 , 2010 2010 Citations: 43
Magnesium status and its relationship with C-reactive protein in obese women ARS de Oliveira, KJC Cruz, JBS Morais, JS Severo, TEC Freitas, ... Biological trace element research 168 (2), 296-302 , 2015 2015 Citations: 40
Effects of administering testosterone undecanoate in rats subjected to physical exercise: effects on the estrous cycle, motor behavior and morphology of the liver and kidney MT Bento-Silva, MCC Martins, FL Torres-Leal, TL Barros, ILNF Carvalho, ... Brazilian Journal of Pharmaceutical Sciences 46 (1), 79-89 , 2010 2010 Citations: 35