Clinical nutrition ESPEN最新文献

{"title":"Skeletal muscle is independently associated with grade 3–4 toxicity in advanced stage pancreatic ductal adenocarcinoma patients receiving chemotherapy","authors":"Merel R. Aberle ,&nbsp;Mariëlle M.E. Coolsen ,&nbsp;Gilles Wenmaekers ,&nbsp;Leroy Volmer ,&nbsp;Ralph Brecheisen ,&nbsp;David van Dijk ,&nbsp;Leonard Wee ,&nbsp;Ronald M. Van Dam ,&nbsp;Judith de Vos-Geelen ,&nbsp;Sander S. Rensen ,&nbsp;Steven W.M. Olde Damink","doi":"10.1016/j.clnesp.2024.11.004","DOIUrl":"10.1016/j.clnesp.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Patients with advanced-stage pancreatic ductal adenocarcinoma (PDAC) are regularly treated with FOLFIRINOX, a chemotherapy regimen based on 5-fluorouracil, irinotecan and oxaliplatin, which is associated with high toxicity. Dosing of FOLFIRINOX is based on body surface area, risking under- or overdosing caused by altered pharmacokinetics due to interindividual differences in body composition. This study aimed to investigate the relationship between body composition and treatment toxicity in advanced stage PDAC patients treated with FOLFIRINOX.</div></div><div><h3>Methods</h3><div>Data from patients treated at the Maastricht University Medical Centre + between 2012 and 2020 were collected retrospectively (n = 65). Skeletal muscle-, visceral adipose tissue, subcutaneous adipose tissue-, (SM-Index, VAT-Index, SAT-Index resp.) and Skeletal Muscle Radiation Attenuation (SM-RA) were calculated after segmentation of computed tomography (CT) images at the third lumbar level using a validated deep learning method. Lean body mass (LBM) was estimated using SM-Index. Toxicities were scored and grade 3-4 adverse events were considered dose-limiting toxicities (DLTs).</div></div><div><h3>Results</h3><div>Sixty-seven DLTs were reported during the median follow-up of 51.4 (95%CI 39.2–63.7) weeks. Patients who experienced at least one DLT had significantly higher dose intensity per LBM for all separate cytotoxics of FOLFIRINOX. Independent prognostic factors for the number of DLTs per cycle were: sarcopenia (β = 0.292; 95%CI 0.013 to 0.065; <em>p</em> = 0.013), SM-Index change (% per 30 days, β = −0.045; 95%CI −0.079 to −0.011; <em>p</em> = 0.011), VAT-Index change (% per 30 days, β = −0.006; 95%CI −0.012 to 0.000; <em>p</em> = 0.040) between diagnosis and the first follow-up CT scan, and cumulative relative dose intensity &gt;80 % (β = −0.315; 95 % CI −0.543 to −0.087; <em>p</em> = 0.008).</div></div><div><h3>Conclusion</h3><div>Sarcopenia and early muscle and fat wasting during FOLFIRINOX treatment were associated with treatment-related toxicity, warranting exploration of body composition guided personalized dosing of chemotherapeutics to limit DLTs.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 134-143"},"PeriodicalIF":2.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of Omega-3 fatty acids and vitamin D supplementation on the quality of life and blood inflammation markers in newly diagnosed breast cancer women: An open-labelled randomised controlled trial","authors":"Heba F. Almassri ,&nbsp;Azidah Abdul Kadir ,&nbsp;Mohammed Srour ,&nbsp;Leng Huat Foo","doi":"10.1016/j.clnesp.2024.11.014","DOIUrl":"10.1016/j.clnesp.2024.11.014","url":null,"abstract":"<div><h3>Background and aims</h3><div>Nutritional intervention is one of the primary steps to improvement of health status and quality of life (QoL) in patients with cancer treated by chemotherapy. There is limited evidence on the potential nutritional intervention to complement active oncological treatment strategies in breast cancer (BC) patients in developing countries. The aim of the present study was to assess the effects of omega-3 fatty acids (ω3) and vitamin D₃ (VitD) supplementations on the QoL and blood inflammation markers of tumor necrosis factor-alpha (TNF-α) and high-sensitive C-reactive protein (hsCRP) assessed among women newly diagnosed with BC in the Gaza Strip, Palestine.</div></div><div><h3>Methods</h3><div>A total of 88 BC women were randomly assigned into one of four groups: i) omega-3 fatty acid (ω3) group; ii) vitamin D (VitD) group; iii) ω3+VitD group, and iv) the control. Participants were received either two 300 mg ω3 capsules daily, or one 50,000IU VitD tablet weekly, or both supplementation for 9-weeks. The QoL status was assessed by the European Organization for Research and Treatment of Cancer (EORTC) instruments of QLQ-C30 and QLQ-BR23 tools, while blood inflammatory markers of TNF-α hsCRP were used. All measurements were taken from baseline to the end of the intervention period. The detailed procedures of the present study were registered on ClinicalTrial.gov with the identifier NCT05331807.</div></div><div><h3>Results</h3><div>At the end of the trial, participants in the ω3+VitD group showed a significant increase in overall global health status (p &lt; 0.01) compared to other groups. Additionally, this group showed significantly higher functional scores (all p &lt; 0.05) and lower scores for fatigue (p &lt; 0.01), nausea and vomiting, pain, and appetite loss (all p &lt; 0.05) at the end of the trial compared to baseline. Furthermore, comparisons between the intervention groups revealed a significant difference in blood concentrations of TNF-α and hsCRP (p &lt; 0.05). These significant differences were identified in hsCRP between ω3 and control groups (p &lt; 0.01). The ω3+VitD group demonstrated a significant reduction in both hsCRP and TNF-α levels (both p &lt; 0.05) from baseline. No significant changes in blood inflammatory markers were observed within the ω3 or VitD groups alone.</div></div><div><h3>Conclusion</h3><div>Participants receiving daily ω3 and weekly VitD supplementation for 9 weeks showed a significant improved in QoL and blood inflammation markers among the newly diagnosed BC during their chemotherapy treatment.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 64-75"},"PeriodicalIF":2.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The associations between nutrition and circulating gut microbiota-derived uremic toxins in patients undergoing kidney replacement therapy: An observational, cross-sectional study","authors":"Sylwia Czaja-Stolc ,&nbsp;Marta Potrykus ,&nbsp;Jakub Ruszkowski ,&nbsp;Daniel Styburski ,&nbsp;Alicja Dębska-Ślizień ,&nbsp;Sylwia Małgorzewicz","doi":"10.1016/j.clnesp.2024.11.022","DOIUrl":"10.1016/j.clnesp.2024.11.022","url":null,"abstract":"<div><h3>Background</h3><div>Gut microbiota generates a series of bioactive metabolites that can be converted into uremic toxins such as trimethylamine-N-oxide (TMAO), p-cresyl sulfate (pCS), and indoxyl sulfate (IS). The aim of the study was to examine the association between diet and the concentrations of the mentioned gut microbiota-derived uremic toxins.</div></div><div><h3>Methods</h3><div>An observational cross-sectional study was conducted involving 210 participants: 84 hemodialysis (HD) patients, 44 peritoneal dialysis (PD) patients, 52 kidney transplant recipients (KTR), and 30 healthy controls. Dietary intake was assessed using a 3-day food diary and a food frequency questionnaire with 6 answers (FFQ-6). The alternate Mediterranean diet (aMED) score was calculated based on data obtained from the 3-day food diary and FFQ-6. Blood samples were analyzed for TMAO, pCS, and IS concentrations using liquid chromatography-mass spectrometry (LC-MS/MS).</div></div><div><h3>Results</h3><div>Significant differences in TMAO, pCS, and IS concentrations were observed among the study groups. HD and PD patients exhibited higher levels of these metabolites compared to KTR and healthy controls. The median aMED score was 4 (3−5) points in the HD group, 4.5 (4−6) points in the PD group, 5 (4−6) points in the KTRs, and 6 (5−7) points in the control group. Higher adherence to the Mediterranean diet (aMED score) was associated with lower pCS levels in dialysis patients. Vegetable intake several times a day was found to mitigate the effects of phenylalanine and tyrosine intake on pCS concentration among dialysis patients.</div></div><div><h3>Conclusions</h3><div>The diet of patients undergoing kidney replacement therapy (KRT) significantly affects the concentrations of gut microbiota-derived uremic toxins. These findings highlight the importance of dietary management in mitigating the adverse effects of these toxins in patients with chronic kidney disease (CKD).</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 105-114"},"PeriodicalIF":2.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal hormones and subjective ratings of appetite after low-carbohydrate vs low-fat low-energy diets in females with lipedema – A randomized controlled trial","authors":"Julianne Lundanes ,&nbsp;Gunnhild Eggen Storliløkken ,&nbsp;Marte Siwsdotter Solem ,&nbsp;Simon N. Dankel ,&nbsp;Randi J. Tangvik ,&nbsp;Rønnaug Ødegård ,&nbsp;Jens Juul Holst ,&nbsp;Jens Frederik Rehfeld ,&nbsp;Catia Martins ,&nbsp;Siren Nymo","doi":"10.1016/j.clnesp.2024.11.018","DOIUrl":"10.1016/j.clnesp.2024.11.018","url":null,"abstract":"<div><h3>Background</h3><div>Ketosis seems to attenuate, or prevent, the rise in both ghrelin concentrations and subjective hunger ratings that follow weight loss. However, most of the previous studies have employed very-low energy diets (VLED) and are therefore limited in terms of generalizability.</div></div><div><h3>Objectives</h3><div>To compare changes in ghrelin plasma concentrations after a low-carbohydrate (LCD) versus an isocaloric low-fat low energy diet (LED) in females with lipedema. Secondary objectives were to determine potential differences between diets in changes in satiety hormones, and subjective ratings of appetite.</div></div><div><h3>Methods</h3><div>Females with obesity and lipedema were randomized to either an LCD (75 g carbohydrates) or low-fat diet (180 g carbohydrates) for 8 weeks. Plasma concentrations of ghrelin, peptide YY, cholecystokinin (CCK), and glucagon-like peptide 1 (GLP-1), and subjective ratings of appetite were measured in the fasting and postprandial states, pre and post intervention.</div></div><div><h3>Results</h3><div>55 females (30 in LCD) were included (age 47.9 ± 11.3 years, BMI 36.8 ± 5.1 kg/m²). Both LCD and low-fat groups lost weight (10.3 %, P &lt; 0.001 and 7.3 %, P &lt; 0.001, respectively), but the LCD lost significantly more. No within or between groups differences were found for ghrelin in the fasting state. A reduction in postprandial (tAUC) ghrelin was seen only in the LCD group (P = 0.002), and this change was significantly different from the low-fat group (P = 0.046). The LCD group also reported an increase in postprandial (both iAUC and tAUC) fullness ratings (P = 0.035 and P = 0.005, respectively), but this was not significantly different from the low-fat group (P = 0.703 and P = 0.365, respectively), despite the latter experiencing no change (P = 0.127 and P = 0.152, respectively). Conversely, only the low-fat group reported increased hunger in fasting (P = 0.046), but changes were not significantly different from the LCD group (P = 0.711). A decrease in postprandial (both tAUC and iAUC) CCK was observed in both LCD and low-fat diet groups (P ≤ 0.005 for all).</div></div><div><h3>Conclusion</h3><div>Despite no changes in fasting ghrelin concentrations in either of the diet groups, a reduction in postprandial ghrelin and increased fullness was seen in the LCD group. These favorable changes in appetite in the LCD group might have contributed to the greater weight loss observed in this group.</div></div><div><h3>Clinical trial registration</h3><div>NCT04632810, Effect of Ketosis on Pain and Quality of Life in Patients With Lipedema (Lipodiet).</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 16-24"},"PeriodicalIF":2.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Six-month trajectory of phase angle after cardiovascular surgery and associated factors of the recovery during cardiac rehabilitation: A retrospective cohort study","authors":"Kenichi Shibata ,&nbsp;Masataka Kameshima ,&nbsp;Takuji Adachi ,&nbsp;Hisako Kito ,&nbsp;Chikako Tanaka ,&nbsp;Taisei Sano ,&nbsp;Mizuki Tanaka ,&nbsp;Masayuki Ida ,&nbsp;Yoriyasu Suzuki ,&nbsp;Hideki Kitamura","doi":"10.1016/j.clnesp.2024.11.017","DOIUrl":"10.1016/j.clnesp.2024.11.017","url":null,"abstract":"<div><h3>Background and aims</h3><div>Although the phase angle (PhA), a measure of frailty and sarcopenia, determined by bioelectrical impedance analysis has been reported as a prognostic factor after cardiovascular surgery, few studies have reported the trajectory of the PhA after discharge. In this study, we examined the trajectory of the PhA along with conventional physical function measures and explored the factors associated with recovery for 6 months after hospital discharge in patients who had undergone cardiovascular surgery.</div></div><div><h3>Methods</h3><div>We included 116 patients who underwent elective cardiovascular surgery and cardiac rehabilitation after discharge. The PhA, physical function measures (grip strength, knee extension isometric muscle strength [KEIS], and usual gait speed), and Geriatric Nutritional Risk Index (GNRI) were assessed preoperatively, at discharge, and 3 and 6 months. Correlations between the PhA recovery rates and physical function and nutritional indices were assessed using Spearman's correlation analysis. Multivariate linear regression analysis was performed to examine the factors associated with recoveries of PhA and physical function indices (grip strength, KEIS, gait speed) after discharge.</div></div><div><h3>Results</h3><div>Mean values of the PhA and physical function measurements and the GNRI score at discharge were lower than the preoperative values (PhA, −8.0 %; grip strength, −8.7 %; KEIS, −6.9 %; usual gait speed, −8.3 %; GNRI, −11 %). The grip strength, KEIS, and gait speed recovered to almost preoperative values 3 months after discharge. Values for the PhA and GNRI were still lower than preoperative values 3 months after discharge but had recovered to preoperative values at 6 months. The PhA was not significantly correlated with the recovery rates of the other indicators. Older age was negatively associated with PhA recovery rate, however, recovery rates decreased significantly with post-discharge physical activity.</div></div><div><h3>Conclusions</h3><div>In patients undergoing cardiovascular surgery, the PhA takes longer to recover than muscle strength or gait speed, requiring up to 6 months to recover to preoperative levels. Post-discharge interventions to increase daily physical activity may be an important method of speeding PhA recovery.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 1-8"},"PeriodicalIF":2.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The SARC-F score may indirectly reflect the extracellular water-to-total body water ratio","authors":"Akemi Hioka ,&nbsp;Naoki Akazawa ,&nbsp;Naomi Okawa ,&nbsp;Shinji Nagahiro","doi":"10.1016/j.clnesp.2024.11.015","DOIUrl":"10.1016/j.clnesp.2024.11.015","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>In the Asian Working Group for Sarcopenia 2019 guidelines, SARC-F is used to screen for sarcopenia. SARC-F is measured based on five components: strength, assistance with walking, rising from a chair, climbing stairs, and falling. However, it has been reported that SARC-F has high specificity but low sensitivity for sarcopenia screening. Considering that SARC-F is currently recommended for sarcopenia screening, indicating the utility of SARC-F not only in sarcopenia screening but also in other aspects is pivotal. This cross-sectional study aimed to clarify the relationship between the SARC-F score and the extracellular water-to-total body water ratio (ECW/TBW) in community-dwelling older people.</div></div><div><h3>Methods</h3><div>This study included 167 community-dwelling older people (aged ≥65) who were able to walk independently and used the SARC-F as a screening test for sarcopenia diagnosis. ECW/TBW and the skeletal muscle mass index (SMI) were measured using bioelectrical impedance analysis. The associations among the SARC-F score, ECW/TBW, and SMI were assessed using Spearman's correlation coefficient. Multiple linear regression analyses of the SARC-F score were conducted. Age, sex, number of medications, pain, medical history, ECW/TBW, and SMI were considered independent variables in multiple linear regression analysis.</div></div><div><h3>Results</h3><div>The analyses revealed a significant positive correlation between the SARC-F score and ECW/TBW (ρ = 0.473, p &lt; 0.001). SMI was significantly and negatively correlated with the SARC-F score (ρ = −0.233, p = 0.002). In the multiple linear regression analysis, ECW/TBW (β = 0.311, p &lt; 0.001) and prevalence of pain (β = 0.169, p = 0.023) were significantly and independently associated with the SARC-F score (R² = 0.260). SMI was not significantly associated with the SARC-F score (β = 0.002, p = 0.986).</div></div><div><h3>Conclusion</h3><div>This study revealed a positive correlation between SARC-F score and ECW/TBW in community-dwelling older people, and this relationship persisted even after adjusting for confounding factors. However, there was no correlation between the SARC-F score and SMI. Our study indicated that the SARC-F score may be considered an indirect indicator of ECW/TBW. The score might also be useful for discriminating high and low ECW/TBW. These findings highlight a new use for SARC-F.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 59-63"},"PeriodicalIF":2.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No sex differences in systemic metabolic responses to acute sprint interval training performed after an oral 75-g glucose load in adults with excess adiposity","authors":"Robinson Ramírez-Vélez ,&nbsp;Hugo Alejandro Carrillo-Arango ,&nbsp;Miguel Alejandro Atencio-Osorio ,&nbsp;Carlos Alejandro López-Álban ,&nbsp;Juan Carlos Calderon-González ,&nbsp;David Morales-Álamo ,&nbsp;Mikel Izquierdo ,&nbsp;María Correa-Rodríguez","doi":"10.1016/j.clnesp.2024.11.005","DOIUrl":"10.1016/j.clnesp.2024.11.005","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Research exploring sex-based variations in responses to acute sprint interval training (SIT) remains limited. This study aimed to examine the impact of biological sex on the systemic metabolic response to SIT. We hypothesized that acute metabolic responses to SIT would differ between males and females.</div></div><div><h3>Methods</h3><div>Sedentary adults (15 males; 14 females) with excess adiposity (defined as body fat &gt;30 %) were matched for age (32.8 ± 7.5 vs. 29.5 ± 6.5 years) and body fat mass (33.0 ± 2.9 vs. 33.2 ± 2.8 %). Following a 75-g glucose load, participants were randomly allocated to either a control (resting) or SIT trial (8 × 30 s of “all-out” cycling at a resistance of 0.075 % W kg⁻¹ of muscle mass, interspersed with 1 min of recovery). Parameters assessed included respiratory quotient (RQ), resting energy expenditure (REE), substrate utilization rates (fat and carbohydrate), total energy output, and blood lactate and glucose levels. These were collected during fasting and at 60, 120, and 240 min post-glucose load, with the area under the curve (AUC) calculated for both trials.</div></div><div><h3>Results</h3><div>An interaction was observed in time (<em>P</em> = 0.012) and trial (<em>P</em> &lt; 0.001) for RQ; however, there was no significant interaction between sex × trial (<em>P</em> = 0.818). Males exhibited higher mean REE values than females in both conditions. Nevertheless, AUC analysis showed no significant interaction between sex and trial (<em>P</em> = 0.562). A significant trial × time relationship was found for fat and carbohydrate percentage contributions (P &lt; 0.001). Post-SIT, AUCs for fat contribution (g min⁻¹ and mg kg⁻¹ min⁻¹) to energy expenditure increased in both sexes compared with resting (<em>P</em> &lt; 0.05), with differences noted among trials over time (P &lt; 0.001). Blood lactate levels also increased similarly post-SIT in both sexes (<em>P</em> &lt; 0.05), without a significant sex × trial interaction (AUC, <em>P</em> = 0.798).</div></div><div><h3>Conclusions</h3><div>These data demonstrate that exercise differed between the sexes and did not support the premise that acute metabolic responses to SIT would vary between males and females.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 25-35"},"PeriodicalIF":2.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and opportunities of Reformulated foods for improved nutritive values in African countries","authors":"Rebecca Oziohu Omosimua,&nbsp;Baskar Venkidasamy,&nbsp;Muthu Thiruvengadam","doi":"10.1016/j.clnesp.2024.11.012","DOIUrl":"10.1016/j.clnesp.2024.11.012","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 525-526"},"PeriodicalIF":2.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between caloric intake and clinical outcomes in critically ill patients: A retrospective study","authors":"You-Ru Lin ,&nbsp;Po-Chuan Chen ,&nbsp;Wei-Ting Li ,&nbsp;Min-Hsin Huang ,&nbsp;Shu-Fen Huang ,&nbsp;Chih-Jung Wang ,&nbsp;Yu-Wen Chien ,&nbsp;Ai-Wen Kao ,&nbsp;Yan-Shen Shan","doi":"10.1016/j.clnesp.2024.11.008","DOIUrl":"10.1016/j.clnesp.2024.11.008","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Despite ongoing research, the optimal nutritional support strategy in the first week of intensive care unit (ICU) stay remains unclear, given the complex interplay of the dynamic metabolic change and evolving nutritional requirements. In this study, we assessed the impact of calorie deficiency during this period on the nutritional care of critically ill patients.</div></div><div><h3>Methods</h3><div>In this retrospective study, we examined ICU admissions from January 2018 to September 2021, focusing on patients whose ICU stay exceeded 7 days. Data were collected from days 2–7 of ICU admission. The “average caloric intake (%)\" was calculated as the actual calorie intake divided by the calculated calorie requirement over 6 days. Cox proportional hazard models were employed for analyzing the 28-day mortality, supplemented by sensitivity and subgroup analyses.</div></div><div><h3>Results</h3><div>The analysis of 3544 patients revealed that those receiving less than 60 % of their target calories in the first ICU week experienced higher 28-day mortality (hazard ratio (HR): 1.41, 95 % confidence interval (CI): 1.19–1.67, p &lt; 0.0001). Daily caloric intake below 30 % of the goal from day 5 onward was associated with a gradual increase in mortality risk. Conversely, a significant reduction in 28-day mortality was noted in patients with a daily intake of &gt;80 % starting from day 6.</div></div><div><h3>Conclusion</h3><div>Our study underscores the correlation between caloric deficit (&lt;60 %) in the initial ICU week and heightened mortality risk. It suggests the potential benefits of aggressive nutritional intervention toward the end of the week. These insights offer valuable guidance for clinicians in critical care settings.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 9-15"},"PeriodicalIF":2.9,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimated protein intake and prognosis in hospitalised heart failure: A focus on patients with and without chronic kidney disease","authors":"Taishi Dotare ,&nbsp;Maeda Daichi ,&nbsp;Yuya Matsue ,&nbsp;Yudai Fujimoto ,&nbsp;Tsutomu Sunayama ,&nbsp;Takashi Iso ,&nbsp;Taisuke Nakade ,&nbsp;Shoichiro Yatsu ,&nbsp;Sayaki Ishiwata ,&nbsp;Yutaka Nakamura ,&nbsp;Yuka Akama ,&nbsp;Shoko Suda ,&nbsp;Takao Kato ,&nbsp;Masaru Hiki ,&nbsp;Takatoshi Kasai ,&nbsp;Tohru Minamino","doi":"10.1016/j.clnesp.2024.11.006","DOIUrl":"10.1016/j.clnesp.2024.11.006","url":null,"abstract":"<div><h3>Background and aims</h3><div>In patients with heart failure (HF), differences in the association between estimated protein intake (PI) and prognosis in those with and without chronic kidney disease (CKD) remain to be clarified. This study aimed to investigate whether the prognostic effects of the estimated PI differ between patients with HF with and without CKD.</div></div><div><h3>Methods</h3><div>We included patients who required hospitalisation owing to worsening HF between 2015 and 2019 and assessed the estimated PI based on the adjusted Maroni formula using the body mass index and urinary urea nitrogen level. Patients were stratified into the higher and lower estimated PI groups according to the median value of the estimated PI at the time of admission. The primary outcome was all-cause mortality.</div></div><div><h3>Results</h3><div>Among the 694 enrolled patients, 286 had CKD. A lower estimated PI was independently associated with a worse nutritional status. During a median follow-up period of 17.2 months, 175 all-cause deaths occurred, including 99 and 76 in the lower and higher estimated PI groups, respectively. In the Kaplan–Meier curves, the lower estimated PI group was associated with higher overall mortality. However, lower estimated PI was significantly associated with all-cause mortality in patients without CKD, but not in those with CKD, after adjustment for covariates. A significant interaction in terms of prognostic effect was observed between the presence or absence of CKD and estimated PI.</div></div><div><h3>Conclusions</h3><div>Among patients with HF, prognostic effect of the estimated PI may differ between patients with and without CKD.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 43-49"},"PeriodicalIF":2.9,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}