- Ready-to-use therapeutic food (RUTF) for home-based nutritional rehabilitation of severe acute malnutrition in children from six months to five years of age. [Review]
- CDCochrane Database Syst Rev 2019 May 15; 5:CD009000
- CONCLUSIONS: Compared to alternative dietary approaches, standard RUTF probably improves recovery and may increase rate of weight gain slightly, but the effects on relapse and mortality are unknown. Standard RUTF meeting total daily nutritional requirements may improve recovery and relapse compared to a similar RUTF given as a supplement to the usual diet, but the effects on mortality and rate of weight gain are not clear. When comparing RUTFs with different formulations, the current evidence does not favour a particular formulation, except for relapse, which is reduced with standard RUTF. Well-designed, adequately powered, pragmatic RCTs with standardised outcome measures, stratified by HIV status, and that include diarrhoea as an outcome, are needed.
- Nutrition in the acute phase of illness. [Journal Article]
- VLVnitr Lek 2019; 65(3):219-226
- Recent research of nutrition in the acute phase has brought up important findings regarding high protein and energy administration in critical illness with suggested adverse outcomes in catabolic pat…
Recent research of nutrition in the acute phase has brought up important findings regarding high protein and energy administration in critical illness with suggested adverse outcomes in catabolic patients. On the other hand, refeeding hypophosphatemia and refeeding syndrome may also be common during acute illness especially in chronically malnourished patients. Moreover, enteral nutrition is no longer superior to parenteral nutrition in recent studies as signals of harm using the enteral route in shock have been suggested. A consensus scheme for diagnosing malnutrition in adults in clinical settings on a global scale has been proposed. Nutrition screening, assessment and intervention guidelines in intensive care and in chronic polymorbid internal patients has recently been published. These new findings and guidelines will probably change the practice of metabolic and nutrition therapy in acute illness and subsequent recovery.
- Criteria for classification of protein-energy wasting in dialysis patients: impact on prevalence. [Journal Article]
- BJBr J Nutr 2019 May 14; :1-8
- Malnutrition is highly prevalent in dialysis patients and associated with poor outcomes. In 2008, protein-energy wasting (PEW) was coined by the International Society of Renal Nutrition and Metabolis…
Malnutrition is highly prevalent in dialysis patients and associated with poor outcomes. In 2008, protein-energy wasting (PEW) was coined by the International Society of Renal Nutrition and Metabolism (ISRNM), as a single pathological condition in which undernourishment and hypercatabolism converge. In 2014, a new simplified score was described using serum creatinine adjusted for body surface area (sCr/BSA) to replace a reduction of muscle mass over time in the muscle wasting category. We have now compared PEW-ISRNM 2008 and PEW-score 2014 to evaluate the prevalence of PEW and the risk of death in 109 haemodialysis patients. This was a retrospective analysis of cross sectional data with a median prospective follow-up of 20 months. The prevalence of PEW was 41 % for PEW-ISRNM 2008 and 63 % for PEW-score 2014 (P<0·002). Using PEW-score 2014: twenty-nine patients (27 %) had severe malnutrition (PEW-score 2014 0-1) and forty (37 %) with moderate malnutrition (score 2). Additionally, thirty-three (30 %) patients had mild wasting and only seven patients (6 %) presented a normal nutritional status. sCr/BSA correlated with lean total mass (R 0·46. P<0·001). A diagnosis of PEW according to PEW-score 2014, but not according to PEW-ISRNM 2008, was significantly associated with short-term mortality (P=0·0349) in univariate but not in multivariate analysis (P=0·069). In conclusion, the new PEW-score 2014 incorporating sCr/BSA identifies a higher number of dialysis PEW patients than PEW-ISRNM 2008. Whereas PEW-score-2014 provides timelier and therefore more clinically relevant information, its association with early mortality needs to be confirmed in larger studies.
- The effects of intradialytic resistance training on muscle strength, psychological well-being, clinical outcomes and circulatory micro-ribonucleic acid profiles in haemodialysis patients: Protocol for a quasi-experimental study. [Journal Article]
- MMedicine (Baltimore) 2019; 98(19):e15570
- CONCLUSIONS: This quasi-experimental study can add in an important way to our understanding of the effects of resistance training on dialysis patients' muscle strength, quality of life and disease-specific outcomes.
- Nutritional status of older patients on hemodialysis: Which nutritional markers can best predict clinical outcomes? [Journal Article]
- NNutrition 2019 Mar 20; 65:113-119
- CONCLUSIONS: Among older MHD patients, the prevalence of nutritional markers indicating PEW varies substantially depending on methods applied. SGA, MIS, BMI, GNRI, calf circumference, and HGS predicted worse outcomes. SGA and MIS showed the strongest association with hospitalization and mortality risk in the adjusted models.
- Short-Term Effects of Branched-Chain Amino Acids-Enriched Dialysis Fluid on Branched-Chain Amino Acids Plasma Level and Mass Balance: A Randomized Cross-Over Study. [Journal Article]
- JRJ Ren Nutr 2019 May 08
- CONCLUSIONS: In conclusion, the addition of BCAAs at physiological concentration in the dialysis fluid contributes to restore physiological plasma concentrations for valine, isoleucine, and leucine at the end of a dialysis session. As BCAAs are essential to muscle balance, this could help to limit losses of BCAAs, restore physiological BCAAs concentrations, and decrease muscle catabolism observed during the HD treatment. Further outcome-based studies are needed to confirm this hypothesis on a larger scale and longer treatment time.
- Dietary Practice among the Patients with End Stage Renal Disease undergoing Maintenance Haemodialysis. [Journal Article]
- JJJNMA J Nepal Med Assoc 2018 Sep-Oct; 56(213):830-836
- CONCLUSIONS: Considerable limited knowledge (medium) and practices (low) scores were found. Had they have taken adequate dietician's support, they might have taken right kind and right amounts of foods and benefitted in controlling potassium, phosphate and protein at the recommended level. Plant-based diet could assist in end stage renal disease in a number of ways: an edge of protection against diet cost, reduce inter-related co-morbidities or complications (hypertension and diabetes).
- Effect of two different nutritional supplements on postprandial glucose response and energy- and protein intake in hospitalised patients with COPD: A randomised cross-over study. [Journal Article]
- CNClin Nutr 2019 Apr 25
- CONCLUSIONS: Lower postprandial glucose concentrations were associated with the snack compared to ONS when taken after a meal compared to either type directly after overnight fasting. The clinical relevance of higher postprandial blood glucose after consuming a liquid ONS after breakfast compared with a semi solid snack needs to be studied further.
- [Daily practices of protein energy wasting management in hemodialysis patients: A French national survey]. [Journal Article]
- NTNephrol Ther 2019 Apr 30
- Protein energy wasting (PEW) is frequent among hemodialysis patients. Published international recommendations in this field are sometimes difficult to implement in daily practices. We evaluated daily…
Protein energy wasting (PEW) is frequent among hemodialysis patients. Published international recommendations in this field are sometimes difficult to implement in daily practices. We evaluated daily practices of PEW screening and treatment in French hemodialysis centers using an online computerized questionnaire sent by email (1 answer required per center). Eighty-six centers returned the questionnaire filled by a nephrologist (43%), nurse (14%) or dietician (43%). The mean number of patients per center was 112±64 patients. PEW screening was performed at least once/month in 56% of centers, once/3 months in 36%, and less frequently in 8%. PEW screening frequency and tools were in agreement with recommendations. Regarding treatment, dietitian interviews were proposed in 98% of units. Hundred percent of units prescribed home oral nutrition supplements (ONS), and 90% ONS during hemodialysis. Ninety-seven percent of centers practiced intradialytic parenteral nutrition, 34% enteral nutrition with feeding tube and 41% with gastrostomy. 14% of centers had no dietician or only on call. A dietician was present≤1 day per week in 44% of centers, 1 to 2.5 days per week in 27%, and>2.5 days per week in 15%. After adjustment for the number of patients, private practice units had significantly less time of presence of the dietician than nonprofit associations or public healthcare centers. In all, 36% of centers offered physical activity during hemodialysis sessions - cycling in almost all centers - and only 12.8% proposed physical activity programs apart from dialysis sessions. In summary, in majority of French hemodialysis centers, PEW screening was consistent with recommendations but the dietician time was insufficient to screen for PEW causes and elaborate a treatment program. Only one third of centers perform enteral nutrition, the most recommended artificial nutrition therapy. Nutritional treatment could be improved in hemodialysis centers in France.
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- Preventive lipid-based nutrient supplements given with complementary foods to infants and young children 6 to 23 months of age for health, nutrition, and developmental outcomes. [Review]
- CDCochrane Database Syst Rev 2019 May 02; 5:CD012611
- CONCLUSIONS: The findings of this review suggest that LNS plus complementary feeding compared to no intervention is effective at improving growth outcomes and anaemia without adverse effects among children aged six to 23 months in low- and middle-income countries (LMIC) in Asia and Africa, and more effective if provided over a longer duration of time (over 12 months). Limited evidence also suggests that LNS plus complementary feeding is more effective than FBF and MNP at improving growth outcomes.