ESPEN guideline on Clinical Nutrition in inflammatory bowel disease

Clinical Nutrition, Journal Year: 2023, Volume and Issue: 42(3), P. 352 - 379

Published: Jan. 13, 2023

Language: Английский

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ESPEN guideline on chronic intestinal failure in adults – Update 2023

Clinical Nutrition, Journal Year: 2023, Volume and Issue: 42(10), P. 1940 - 2021

Published: July 29, 2023

Language: Английский

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The importance of vitamin B12 for individuals choosing plant-based diets

European Journal of Nutrition, Journal Year: 2022, Volume and Issue: 62(3), P. 1551 - 1559

Published: Dec. 5, 2022

Vitamin B12 is an essential nutrient that not made by plants; consequently, unfortified plant-based foods are a reliable supply. Recent estimates suggest high rates of vitamin deficiency among the vegetarian and vegan populations, particularly in pregnant women or child-bearing age who, for ethical health reasons, shifting towards higher consumption ever-increasing numbers. plays crucial metabolic roles across life-course particular during pregnancy early development (first 1000 days life). Evidence now implicates with increased risk to range neuro, vascular, immune, inflammatory disorders. However, current UK recommended intake does adequately consider deficit those choosing diet, including vegetarianism veganism, representing hidden hunger. We provide cautionary note on importance preventing deficits individuals diet professionals advising them.

Language: Английский

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Personalized nutrition therapy in critical care: 10 expert recommendations

Critical Care, Journal Year: 2023, Volume and Issue: 27(1)

Published: July 4, 2023

Abstract Personalization of ICU nutrition is essential to future critical care. Recommendations from American/European guidelines and practice suggestions incorporating recent literature are presented. Low-dose enteral (EN) or parenteral (PN) can be started within 48 h admission. While EN preferred route delivery, new data highlight PN given safely without increased risk; thus, when early not feasible, provision isocaloric effective results in similar outcomes. Indirect calorimetry (IC) measurement energy expenditure (EE) recommended by both European/American after stabilization post-ICU Below-measured EE (~ 70%) targets should used during phase match later stay. protein delivery D1-2) (< 0.8 g/kg/d) progressed ≥ 1.2 g/kg/d as patients stabilize, with consideration avoiding higher unstable acute kidney injury on CRRT. Intermittent-feeding schedules hold promise for further research. Clinicians must aware delivered energy/protein what percentage represents. Computerized monitoring systems/platforms have become widely available. In at risk micronutrient/vitamin losses (i.e., CRRT), evaluation micronutrient levels considered days 5–7 repletion deficiencies where indicated. future, we hope use muscle monitors such ultrasound, CT scan, and/or BIA will utilized assess monitor response nutrition. Use specialized anabolic nutrients HMB, creatine, leucine improve strength/muscle mass promising other populations deserves study. setting, continued IC measures guide Research using rehabilitation interventions cardiopulmonary exercise testing (CPET) exercise/rehabilitation prescription agents testosterone/oxandrolone promote recovery needed.

Language: Английский

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Natural Ingredients to Improve Immunity

Pharmaceuticals, Journal Year: 2023, Volume and Issue: 16(4), P. 528 - 528

Published: April 1, 2023

The immune system protects the body from infectious agents such as bacteria, viruses, or fungi. Once encountered with pathogens antigens, innate and adaptive arms of trigger a strong response to eliminate them protect body. Thus, well-balanced immunity is pivotal for maintaining human health, an insufficient level defense leads infections tumors. In contrast, excessive functioning causes development autoimmune diseases allergies. Strong requires adequate nutrition, dietary interventions, sufficient intake certain vitamins (vitamin C, vitamin D, folic acid) minerals (magnesium, zinc, selenium). Therefore, nutritional micronutrient deficiencies lead compromised immunity. Several natural ingredients have shown potent immunomodulatory properties. immune-enhancing properties many plants fungi are due containing bioactive phytoconstituents polyphenols, terpenoids, β-glucans, vitamins, etc. Probiotics prebiotics can be used innovative tools reduce intestinal inflammation downregulate hypersensitivity reactions. Plant sources melatonin, multifunctional molecule proven anti-inflammatory properties, been discovered relatively recently. compounds augment by directly increasing cytotoxic activity killer cells, macrophages, neutrophils. Many prevent cell damage their powerful antimicrobial, antioxidant, present review attempts understand molecular mechanisms underlying some plants, fungi, animals, microorganisms, other sources.

Language: Английский

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ESPEN guideline on nutrition and hydration in dementia – Update 2024

Clinical Nutrition, Journal Year: 2024, Volume and Issue: 43(6), P. 1599 - 1626

Published: May 8, 2024

Background & aims Dementia is accompanied by a variety of changes that result in an increased risk malnutrition and low-intake dehydration. This guideline update to give evidence-based recommendations for nutritional care persons with dementia order prevent treat these syndromes. Methods The previous version was reviewed expanded accordance the standard operating procedure ESPEN guidelines. Based on systematic search three databases, strength evidence appropriate literature graded use SIGN system. original were reformulated, new added, which all then underwent consensus process. Results 40 older developed agreed, seven at institutional level 33 individual level. As prerequisite good care, organizations caring are recommended employ sufficient qualified staff offer attractive food drinks choice functional appealing environment. Nutritional should be based written concept standardized procedures. At level, routine screening dehydration, assessment close monitoring unquestionable. Oral nutrition may supported eliminating potential causes adequate social nursing support (including assistance, utensils, training oral care). supplements improve status but not correct cognitive impairment or decline. Routine dementia-specific ONS, ketogenic diet, omega-3 fatty acid supplementation appetite stimulating agents recommended. Enteral parenteral hydration temporary options patients mild moderate dementia, severe terminal phase life. In stages disease, supporting drink intake maintaining improving requires individualized, comprehensive approach. Due lack studies, most practice points. Conclusion integral part management. Numerous interventions available implemented daily practice. Future high-quality studies needed clarify evidence.

Language: Английский

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ESPEN practical short micronutrient guideline

Clinical Nutrition, Journal Year: 2024, Volume and Issue: 43(3), P. 825 - 857

Published: Jan. 30, 2024

BackgroundTrace elements and vitamins, named together micronutrients (MNs), are essential for human metabolism. The importance of MNs in common pathologies is recognized by recent research, with deficiencies significantly impacting the outcome.ObjectiveThis short version guideline aims to provide practical recommendations clinical practice.MethodsAn extensive search literature was conducted databases Medline, PubMed, Cochrane, Google Scholar, CINAHL initial guideline. focused on physiological data, historical evidence (for papers published before PubMed release 1996), observational and/or randomized trials. For each MN, main functions, optimal analytical methods, impact inflammation, potential toxicity, provision during enteral or parenteral nutrition were addressed. SOP wording applied strength recommendations.ResultsThe limited number interventional trials prevented meta-analysis led a low level most recommendations. underwent consensus process, which resulted percentage agreement (%): strong required >90 % votes. Altogether proposes 3 general specific 26 MNs. Monitoring management strategies proposed.ConclusionThis MN should facilitate handling at-risk diseases, whilst offering advice monitoring nutritional support.

Language: Английский

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Nutrition in the intensive care unit: from the acute phase to beyond

Intensive Care Medicine, Journal Year: 2024, Volume and Issue: 50(7), P. 1035 - 1048

Published: May 21, 2024

Recent randomized controlled trials (RCTs) have shown no benefit but dose-dependent harm by early full nutritional support in critically ill patients. Lack of may be explained anabolic resistance, suppression cellular repair processes, and aggravation hyperglycemia insulin needs. Also high amino acid doses did not provide benefit, instead associated with patients organ dysfunctions. However, most studies focused on interventions initiated during the first days after intensive care unit admission. Although intervention window some RCTs extended into post-acute phase critical illness, large studied beyond week. Hence, clear evidence-based guidance when how to initiate advance nutrition is lacking. Prolonged underfeeding will come at a price as there validated metabolic monitor that indicates readiness for medical therapy, an adequate response nutrition, which likely varies between micronutrient status cannot assessed reliably, inflammation can cause redistribution, so plasma concentrations are necessarily reflective total body stores. Moreover, individual micronutrients proven beneficial. Accordingly, current evidence provides strategies avoid, ideal regimen remains unclear. In this narrative review, we summarize findings recent studies, discuss possible mechanisms explaining results, point out pitfalls interpretation their effect clinical practice, formulate suggestions future research.

Language: Английский

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Malnutrition in Adults

New England Journal of Medicine, Journal Year: 2024, Volume and Issue: 391(2), P. 155 - 165

Published: July 10, 2024

Language: Английский

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Strategies for minimizing muscle loss during use of incretin‐mimetic drugs for treatment of obesity

Obesity Reviews, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 19, 2024

Summary The rapid and widespread clinical adoption of highly effective incretin‐mimetic drugs (IMDs), particularly semaglutide tirzepatide, for the treatment obesity has outpaced updating practice guidelines. Consequently, many patients may be at risk adverse effects uncertain long‐term outcomes related to use these drugs. Of emerging concern is loss skeletal muscle mass function that can accompany substantial weight reduction; such losses lead reduced functional metabolic health, cycling, compromised quality life, other outcomes. Available evidence suggests trial participants receiving IMDs lost 10% or more their during 68‐ 72‐week interventions, approximately equivalent 20 years age‐related loss. ability maintain caloric restriction‐induced reduction influenced by two key factors: nutrition physical exercise. Nutrition therapy should ensure adequate intake absorption high‐quality protein micronutrients, which require oral nutritional supplements. Additionally, concurrent activity, especially resistance training, been shown effectively minimize therapy. All participate in comprehensive programs emphasizing micronutrient intakes, as well preserve function, maximize benefit IMD therapy, potential risks.

Language: Английский

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