Clinical nutrition最新文献

英文中文

Corrigendum to “ESPEN practical guideline on clinical nutrition in hospitalized patients with acute or chronic kidney disease” [Clin Nutr 43 (2024) 2238–2254]

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-09-16 DOI: 10.1016/j.clnu.2024.09.019

引用次数: 0

Effects of high-fat, low-carbohydrate enteral nutrition in critically ill patients: A systematic review with meta-analysis

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-09-12 DOI: 10.1016/j.clnu.2024.09.023

Background & aims

High-fat, low-carbohydrate enteral nutrition has gained attention, with expectations of an improved respiratory condition, fewer complications, and lower mortality. The present study performed a systematic review and meta-analysis of randomized controlled trials to examine the effects of high-fat, low-carbohydrate enteral nutrition in critically ill adult patients.

Methods

We searched MEDLINE via Pubmed, Cochrane Central Register of Controlled Trials (CENTRAL), and ICHUSHI for randomized controlled trials comparing high-fat, low-carbohydrate enteral nutrition to standard enteral nutrition in critically ill adult patients who received enteral nutrition. The primary outcome was mortality. Secondary outcomes included intensive care unit (ICU) mortality, length of ICU stay, length of mechanical ventilation, and adverse events of diarrhea and gastric residual volume. We examined the risk of bias using the Cochrane risk-of-bias tool for randomized trials version 2. We assessed the overall certainty of evidence based on the Grading of Recommendations Assessment, Development, and Evaluation methodology. Synthesis results were calculated with risk ratios and 95% confidence intervals using a Mantel-Haenszel random-effects model.

Results

Eight trials with 607 patients were included. The effects of high-fat, low-carbohydrate enteral nutrition on mortality did not significantly differ from those of standard enteral nutrition (62/280 [22.1%] vs. 39/207 [18.8%], risk ratios = 1.14, 95% confidence intervals 0.80 to 1.62, P = 0.47). No significant differences were observed in ICU mortality, ICU length of stay, diarrhea, or gastric residual volume between the two groups. However, high-fat, low-carbohydrate enteral nutrition was associated with a significantly shorter duration of mechanical ventilation (mean difference −1.72 days, 95% confidence intervals −2.93 to −0.50, P = 0.005).

Conclusion

High-fat, low-carbohydrate enteral nutrition may not affect mortality, but may decrease the duration of mechanical ventilation in critically ill adult patients. Limitations include the small number of studies and potential for bias. Further research is needed to confirm these results and investigate effects on other outcomes and in a subgroup of patients requiring mechanical ventilation.

背景& 目的高脂肪、低碳水化合物肠内营养受到关注，人们期望它能改善呼吸状况、减少并发症并降低死亡率。本研究对随机对照试验进行了系统回顾和荟萃分析，以研究高脂低碳水化合物肠内营养对重症成人患者的影响。方法我们通过 Pubmed、Cochrane Central Register of Controlled Trials (CENTRAL) 和 ICHUSHI 对 MEDLINE 进行了检索，以寻找在接受肠内营养的重症成人患者中比较高脂低碳水化合物肠内营养与标准肠内营养的随机对照试验。主要结果是死亡率。次要结果包括重症监护室（ICU）死亡率、重症监护室住院时间、机械通气时间以及腹泻和胃残渣量等不良事件。我们使用科克伦随机试验偏倚风险工具 2 版检查了偏倚风险。我们根据建议分级评估、制定和评价方法对证据的整体确定性进行了评估。采用 Mantel-Haenszel 随机效应模型计算综合结果的风险比和 95% 置信区间。高脂肪、低碳水化合物肠内营养对死亡率的影响与标准肠内营养没有显著差异（62/280 [22.1%] vs. 39/207 [18.8%]，风险比 = 1.14，95% 置信区间为 0.80 至 1.62，P = 0.47）。两组患者在重症监护室死亡率、重症监护室住院时间、腹泻或胃残渣量方面无明显差异。结论高脂肪、低碳水化合物肠内营养可能不会影响死亡率，但可缩短重症成人患者的机械通气时间。局限性包括研究数量少和可能存在偏倚。需要进一步的研究来证实这些结果，并调查对其他结果和需要机械通气的亚组患者的影响。

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引用次数: 0

Undernutrition, cognitive decline and dementia: The collaborative PROMED-COG pooled cohorts study 营养不良、认知能力下降和痴呆症：PROMED-COG 联合队列协作研究

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-09-10 DOI: 10.1016/j.clnu.2024.09.001

Background & aims

Undernutrition may negatively impact cognitive function, but evidence of this relationship is not yet consolidated. Under the “PROtein enriched MEDiterranean diet to combat undernutrition and promote healthy neuroCOGnitive ageing” (PROMED-COG) project, we evaluated the association between undernutrition, and cognitive decline and incident dementia in older adults.

Methods

Retrospective data harmonization was performed on three Italian population-based studies: the Italian Longitudinal Study of Ageing (ILSA), the Progetto Veneto Anziani (Pro.V.A.), and the Bollate Eye Study-Follow-Up (BEST-FU). The associations between undernutrition, operationalized using the Global Leadership Initiative on Malnutrition (GLIM) criteria, and decline on the Mini-Mental State Examination (MMSE) or dementia incidence follow-up were evaluated with Cox proportional hazard regression models.

Results

The pooled cohort comprised 9071 individuals (52% females) aged between 42 and 101 years. The prevalence of undernutrition at the baseline was 14.3%, significantly higher among females (15.4% vs 13%) and in older age, ranging from 3.5% in those aged <60 years to 28.8% in those 85+ years. Undernutrition was associated with both cognitive decline over a median 8.3-year follow-up (Hazard Ratio (HR) 1.20, 95% Confidence Interval (CI) 1.02–1.41, p = 0.028) and incidence of dementia over a median 8.6-year follow-up (HR = 1.57, 95%CI 1.01–2.43, p = 0.046). For cognitive decline, the association with undernutrition was more marked in males than females (HR = 1.36, 95%CI 1.05–1.77, p = 0.019 vs HR = 1.10, 95% CI 0.89–1.36, p = 0.375).

Conclusion

Undernutrition is prevalent among older people and is associated with an increased risk of experiencing cognitive decline and dementia. The prevention and early identification of undernutrition could be an important nonpharmacologic strategy to counteract neurodegeneration.

背景& 目的营养不良可能会对认知功能产生负面影响，但这种关系的证据尚未得到巩固。在 "PROtein富含地中海膳食，消除营养不良，促进神经健康老龄化"（PROMED-COG）项目中，我们评估了营养不良与老年人认知能力下降和痴呆症之间的关系。方法对三项基于意大利人口的研究进行了回顾性数据协调：意大利老龄化纵向研究（ILSA）、Progetto Veneto Anziani（Pro.V.A.）和Bollate Eye Study-Follow-Up（BEST-FU）。通过 Cox 比例危险回归模型评估了营养不良（采用全球营养不良领导倡议（GLIM）标准进行操作）与迷你精神状态检查（MMSE）下降或痴呆症发病率随访之间的关系。基线营养不良发生率为 14.3%，女性（15.4% 对 13%）和老年人显著较高，从 60 岁人群的 3.5% 到 85 岁以上人群的 28.8%。营养不良与中位随访8.3年的认知能力下降（危险比（HR）1.20，95%置信区间（CI）1.02-1.41，p = 0.028）和中位随访8.6年的痴呆症发病率（HR = 1.57，95%CI 1.01-2.43，p = 0.046）有关。就认知能力下降而言，男性与营养不良的关系比女性更为明显（HR = 1.36，95%CI 1.05-1.77，p = 0.019 vs HR = 1.10，95%CI 0.89-1.36，p = 0.375）。预防和早期识别营养不良可能是应对神经退行性病变的重要非药物策略。

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引用次数: 0

Association between maternal hemoglobin and iron status in early pregnancy and childhood cardiac outcome 孕早期母体血红蛋白和铁状况与儿童心脏预后的关系

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-09-07 DOI: 10.1016/j.clnu.2024.09.016

引用次数: 0

Enhancing methodological rigor in nutritional epidemiology: A critical review and recommendations for future research on dietary influences in type 2 diabetes management

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-09-07 DOI: 10.1016/j.clnu.2024.09.013

引用次数: 0

Comment on ‘Folic acid supplementation for stroke prevention: A systematic review and meta-analysis of 21 randomized clinical trials worldwide’ 关于 "补充叶酸预防中风：全球 21 项随机临床试验的系统回顾和荟萃分析

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-09-06 DOI: 10.1016/j.clnu.2024.09.015

引用次数: 0

Very-low calorie diet and Semaglutide: Synergy and long-term impact on type 2 diabetes management 极低热量饮食和赛马鲁肽：协同作用和对 2 型糖尿病管理的长期影响

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-09-06 DOI: 10.1016/j.clnu.2024.09.008

引用次数: 0

Letter to the editor: “Maternal prebiotic supplementation during pregnancy and lactation modifies the microbiome and short chain fatty acid profile of both mother and infant”

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-09-06 DOI: 10.1016/j.clnu.2024.09.009

引用次数: 0

Comment on:Effects of early enteral nutrition on persistent inflammation, immunosuppression, and catabolism syndrome in critically ill patients

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-09-06 DOI: 10.1016/j.clnu.2024.09.017

引用次数: 0

Addressing broader dietary patterns and physical activity in the study of dietary live microbe intake and sarcopenia 在膳食活微生物摄入量与肌肉疏松症的研究中关注更广泛的膳食模式和体育锻炼

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-09-06 DOI: 10.1016/j.clnu.2024.09.011

引用次数: 0

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