Pub Date : 2024-09-01Epub Date: 2024-06-07DOI: 10.1097/MCO.0000000000001050
Ann Von Holle
Purpose of review: Iron is an essential trace element in human health that can be harmful at abnormal levels such as iron overload or deficiency. Measured iron status in the body can depend on health outcomes experienced by the individual and this can complicate its accurate assessment. This review will highlight recent research on iron assessment in the literature.
Recent findings: Research on iron assessment within the past 18 months included some common themes spanning new methods and biomarkers, as well as existing problems in assessing iron deficiency and overload. Heterogeneity in associations between inflammation and iron levels are reflected across different inflammatory biomarkers. New methods relevant to low- and high-resource settings may improve assessment in tissues with iron deficiency and overload. Consensus papers outlined best practices when using MRI to assess iron status. Outside of newer methods, traditional serum markers are the subject of a call for updated guidance when assessing iron status.
Summary: Research continues on the topic of iron assessment, underlying its complex metabolism in the body and resulting challenges in assessment. Current literature underscores progress to make iron assessment more accessible, improve existing methods, and update current assessment methods so they correspond with recent research to improve human health.
{"title":"Assessment of iron status.","authors":"Ann Von Holle","doi":"10.1097/MCO.0000000000001050","DOIUrl":"10.1097/MCO.0000000000001050","url":null,"abstract":"<p><strong>Purpose of review: </strong>Iron is an essential trace element in human health that can be harmful at abnormal levels such as iron overload or deficiency. Measured iron status in the body can depend on health outcomes experienced by the individual and this can complicate its accurate assessment. This review will highlight recent research on iron assessment in the literature.</p><p><strong>Recent findings: </strong>Research on iron assessment within the past 18 months included some common themes spanning new methods and biomarkers, as well as existing problems in assessing iron deficiency and overload. Heterogeneity in associations between inflammation and iron levels are reflected across different inflammatory biomarkers. New methods relevant to low- and high-resource settings may improve assessment in tissues with iron deficiency and overload. Consensus papers outlined best practices when using MRI to assess iron status. Outside of newer methods, traditional serum markers are the subject of a call for updated guidance when assessing iron status.</p><p><strong>Summary: </strong>Research continues on the topic of iron assessment, underlying its complex metabolism in the body and resulting challenges in assessment. Current literature underscores progress to make iron assessment more accessible, improve existing methods, and update current assessment methods so they correspond with recent research to improve human health.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-06-05DOI: 10.1097/MCO.0000000000001051
Harriët Jager-Wittenaar, Martine Sealy, Elke Naumann, Marian de van der Schueren
Purpose of review: With the shifts in society, healthcare and the profile of the malnourished individual, a re-consideration of the goal of nutritional risk screening is needed: screening for malnutrition, or screening for risk of malnutrition? In this review article, we reflect on the role of nutritional risk screening in relation to prevention and treatment of malnutrition.
Recent findings: Within the Global Leadership Initiative on Malnutrition (GLIM) Initiative, modified Delphi studies are currently being conducted to reach global consensus on the conceptual definition and operationalization of 'risk of malnutrition'. This is necessary because various studies have demonstrated that different nutritional screening tools identify different individuals, due to variability in screening tool criteria, which influences GLIM outcomes. Upon screening, three different situations can be distinguished: having risk factors for malnutrition without clear signs of presence of malnutrition, having mild signs of malnutrition (malnutrition in progress), or having obvious signs of malnutrition.
Summary: The outcomes of the studies on 'risk of malnutrition' will guide the screening step within the GLIM process, and will help professionals to make informed choices regarding screening policy and screening tool(s).
{"title":"Nutritional risk screening: a need to guide Alice in Nutritionland.","authors":"Harriët Jager-Wittenaar, Martine Sealy, Elke Naumann, Marian de van der Schueren","doi":"10.1097/MCO.0000000000001051","DOIUrl":"10.1097/MCO.0000000000001051","url":null,"abstract":"<p><strong>Purpose of review: </strong>With the shifts in society, healthcare and the profile of the malnourished individual, a re-consideration of the goal of nutritional risk screening is needed: screening for malnutrition, or screening for risk of malnutrition? In this review article, we reflect on the role of nutritional risk screening in relation to prevention and treatment of malnutrition.</p><p><strong>Recent findings: </strong>Within the Global Leadership Initiative on Malnutrition (GLIM) Initiative, modified Delphi studies are currently being conducted to reach global consensus on the conceptual definition and operationalization of 'risk of malnutrition'. This is necessary because various studies have demonstrated that different nutritional screening tools identify different individuals, due to variability in screening tool criteria, which influences GLIM outcomes. Upon screening, three different situations can be distinguished: having risk factors for malnutrition without clear signs of presence of malnutrition, having mild signs of malnutrition (malnutrition in progress), or having obvious signs of malnutrition.</p><p><strong>Summary: </strong>The outcomes of the studies on 'risk of malnutrition' will guide the screening step within the GLIM process, and will help professionals to make informed choices regarding screening policy and screening tool(s).</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-05-21DOI: 10.1097/MCO.0000000000001046
Amelia Faradina, Alexey A Tinkov, Anatoly V Skalny, Jung-Su Chang
Purpose of review: Deficiencies in micronutrients persist as widespread global challenges, where supplementation remains a crucial therapeutic approach. This review aims to elucidate the intricate relationships between micronutrient supplementation - specifically iron, selenium (Se), and vitamin D (Vit D) - and gut microbiota composition, investigating their collective impact on host health and disease susceptibility.
Recent findings: Maintaining balanced iron levels is essential for gut microbiota equilibrium and host health, as both iron deficiency and excess disrupt gut bacterial balance, affecting colon health. Se supplementation can restore and improve the gut microbial balance, influencing health outcomes not only in the gut but also in areas such as neuroprotection in the brain, testicular health, and metabolic syndrome. Clinical and experimental models demonstrate that Vit D modulates the gut microbiome, enhancing anti-inflammatory effects, supporting metabolic health, and potentially reducing the risk of gut-related behavioral changes and diseases.
Summary: Findings of this review emphasize that balanced iron levels are essential for maintaining a healthy gut microbiota composition and underscore the beneficial effects of Se and Vit D in modulating the gut microbiome. The interactions between micronutrients and the gut microbiome are complex but may have a broad spectrum of health outcomes.
综述的目的:微量营养素缺乏一直是全球普遍面临的挑战,补充微量营养素仍然是一种重要的治疗方法。本综述旨在阐明微量营养素补充(特别是铁、硒(Se)和维生素 D(Vit D))与肠道微生物群组成之间错综复杂的关系,研究它们对宿主健康和疾病易感性的共同影响:维持平衡的铁含量对肠道微生物群平衡和宿主健康至关重要,因为缺铁和过量都会破坏肠道细菌平衡,影响结肠健康。补充 Se 可以恢复和改善肠道微生物平衡,不仅影响肠道健康,还影响大脑神经保护、睾丸健康和代谢综合征等领域的健康。临床和实验模型表明,维生素 D 可调节肠道微生物群,增强抗炎作用,支持代谢健康,并可能降低肠道相关行为变化和疾病的风险:本综述的研究结果强调,平衡的铁水平对维持健康的肠道微生物群组成至关重要,并强调了 Se 和维生素 D 在调节肠道微生物群方面的有益作用。微量营养素与肠道微生物群之间的相互作用非常复杂,但可能对健康产生广泛的影响。
{"title":"Micronutrient (iron, selenium, vitamin D) supplementation and the gut microbiome.","authors":"Amelia Faradina, Alexey A Tinkov, Anatoly V Skalny, Jung-Su Chang","doi":"10.1097/MCO.0000000000001046","DOIUrl":"10.1097/MCO.0000000000001046","url":null,"abstract":"<p><strong>Purpose of review: </strong>Deficiencies in micronutrients persist as widespread global challenges, where supplementation remains a crucial therapeutic approach. This review aims to elucidate the intricate relationships between micronutrient supplementation - specifically iron, selenium (Se), and vitamin D (Vit D) - and gut microbiota composition, investigating their collective impact on host health and disease susceptibility.</p><p><strong>Recent findings: </strong>Maintaining balanced iron levels is essential for gut microbiota equilibrium and host health, as both iron deficiency and excess disrupt gut bacterial balance, affecting colon health. Se supplementation can restore and improve the gut microbial balance, influencing health outcomes not only in the gut but also in areas such as neuroprotection in the brain, testicular health, and metabolic syndrome. Clinical and experimental models demonstrate that Vit D modulates the gut microbiome, enhancing anti-inflammatory effects, supporting metabolic health, and potentially reducing the risk of gut-related behavioral changes and diseases.</p><p><strong>Summary: </strong>Findings of this review emphasize that balanced iron levels are essential for maintaining a healthy gut microbiota composition and underscore the beneficial effects of Se and Vit D in modulating the gut microbiome. The interactions between micronutrients and the gut microbiome are complex but may have a broad spectrum of health outcomes.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-08-08DOI: 10.1097/MCO.0000000000001052
Josh McGovern, Richard J E Skipworth, Barry J A Laird, Donald C McMillan
Purpose of review: The following article examines the rationale for an inflammation-first approach for diagnosing cachexia and how the current Global Leadership Initiative on Malnutrition (GLIM) framework may be adapted to facilitate this.
Recent findings: Recently, the GLIM have published guidance on the measurement of inflammation in the context of cachexia, advocating that C-reactive protein (CRP) should be utilized for quantification. The inclusion of a systemic inflammatory biomarker for the diagnosis of cachexia questions whether it may be more aptly considered a systemic inflammatory syndrome.
Summary: The current consensus of the GLIM is that cachexia is 'disease-related malnutrition with inflammation'. In line with this definition, the GLIM proposed a two-step diagnostic framework: screening for malnutrition using validated screening tools and then confirming the presence of disease-related malnutrition with phenotypic (nonvolitional weight loss, low BMI, and reduced muscle mass) and aetiologic criterion reduced food intake/assimilation, and inflammation or disease burden). The GLIM are to be commended for guidance on the measurement of systemic inflammation in their current proposal, given the relative importance to clinical outcomes in patients with cancer. However, the use of CRP is somewhat rudimentary and contrasts other cancer cachexia guidelines and contemporary clinical cancer research.
综述的目的:以下文章探讨了以炎症为先的方法诊断恶病质的基本原理,以及如何调整当前的全球领导营养不良倡议(GLIM)框架以促进这一诊断:最近,全球营养不良领导倡议组织发布了恶病质炎症测量指南,主张使用 C 反应蛋白 (CRP) 进行量化。将全身性炎症生物标志物纳入恶病质的诊断中,是否更适合将恶病质视为全身性炎症综合征呢?根据这一定义,GLIM 提出了一个两步诊断框架:使用有效的筛查工具筛查营养不良,然后根据表型(非波动性体重减轻、低体重指数和肌肉量减少)和病因标准(食物摄入/同化减少、炎症或疾病负担)确认是否存在疾病相关营养不良。鉴于全身性炎症对癌症患者临床预后的相对重要性,GLIM 在其当前建议中对全身性炎症的测量进行了指导,这一点值得称赞。然而,CRP 的使用略显粗糙,与其他癌症恶病质指南和当代临床癌症研究形成鲜明对比。
{"title":"Global Leadership Initiative on Malnutrition cachexia: an inflammation-first approach for the diagnosis of disease-related malnutrition.","authors":"Josh McGovern, Richard J E Skipworth, Barry J A Laird, Donald C McMillan","doi":"10.1097/MCO.0000000000001052","DOIUrl":"https://doi.org/10.1097/MCO.0000000000001052","url":null,"abstract":"<p><strong>Purpose of review: </strong>The following article examines the rationale for an inflammation-first approach for diagnosing cachexia and how the current Global Leadership Initiative on Malnutrition (GLIM) framework may be adapted to facilitate this.</p><p><strong>Recent findings: </strong>Recently, the GLIM have published guidance on the measurement of inflammation in the context of cachexia, advocating that C-reactive protein (CRP) should be utilized for quantification. The inclusion of a systemic inflammatory biomarker for the diagnosis of cachexia questions whether it may be more aptly considered a systemic inflammatory syndrome.</p><p><strong>Summary: </strong>The current consensus of the GLIM is that cachexia is 'disease-related malnutrition with inflammation'. In line with this definition, the GLIM proposed a two-step diagnostic framework: screening for malnutrition using validated screening tools and then confirming the presence of disease-related malnutrition with phenotypic (nonvolitional weight loss, low BMI, and reduced muscle mass) and aetiologic criterion reduced food intake/assimilation, and inflammation or disease burden). The GLIM are to be commended for guidance on the measurement of systemic inflammation in their current proposal, given the relative importance to clinical outcomes in patients with cancer. However, the use of CRP is somewhat rudimentary and contrasts other cancer cachexia guidelines and contemporary clinical cancer research.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-06DOI: 10.1097/MCO.0000000000001064
Noémie Beauregard, Kurt McInnis, Gary S Goldfield, Éric Doucet
Purpose of review: With obesity affecting over one billion people globally, understanding and managing this complex condition is more crucial than ever. This review explores the emerging role of GLP-1 receptor agonists (GLP-1RA) in weight management, focusing on their impact on energy balance. It highlights the necessity of this investigation due to the limited knowledge on both the short-term and long-term implications of GLP-1RA on energy expenditure (EE) and energy intake (EI).
Recent findings: GLP-1RA, such as liraglutide and semaglutide, have shown significant efficacy in promoting weight loss by reducing appetite, cravings and consequently, EI. Newer medications such as tirzepatide have demonstrated even greater weight loss success. Emerging evidence also suggests potential effects on EE, which could explain the greater weight loss success achieved with GLP-1 RA rather than typical lifestyle changes. However, comprehensive data on the total impact of these drugs on energy balance remain limited.
Summary: The findings underscore the promising role of GLP-1RA in obesity management, particularly through mechanisms influencing both EI and EE. Future research should focus on systematically measuring all components of energy balance to fully elucidate the mechanisms of GLP-1RA and optimize their therapeutic use for personalized medicine.
审查目的:全球有超过 10 亿人受到肥胖症的影响,因此了解和管理这一复杂的疾病比以往任何时候都更为重要。本综述探讨了 GLP-1 受体激动剂(GLP-1RA)在体重管理中的新作用,重点关注其对能量平衡的影响。由于对 GLP-1RA 对能量消耗(EE)和能量摄入(EI)的短期和长期影响了解有限,本综述强调了这一研究的必要性:最近的研究结果:GLP-1RA(如利拉鲁肽和司马鲁肽)通过降低食欲、欲望,进而降低能量摄入,在促进减肥方面显示出显著疗效。较新的药物,如替泽帕肽,在减轻体重方面取得了更大的成功。新的证据还表明,GLP-1 RA 对 EE 有潜在的影响,这也可以解释为什么使用 GLP-1 RA 比改变一般的生活方式能取得更大的减肥效果。小结:研究结果表明,GLP-1RA 在肥胖控制中的作用前景广阔,尤其是通过影响 EI 和 EE 的机制。未来的研究应侧重于系统测量能量平衡的所有组成部分,以全面阐明 GLP-1RA 的作用机制,并优化其在个性化医疗中的治疗应用。
{"title":"Energy balance and obesity: the emerging role of glucagon like peptide-1 receptor agonists.","authors":"Noémie Beauregard, Kurt McInnis, Gary S Goldfield, Éric Doucet","doi":"10.1097/MCO.0000000000001064","DOIUrl":"https://doi.org/10.1097/MCO.0000000000001064","url":null,"abstract":"<p><strong>Purpose of review: </strong>With obesity affecting over one billion people globally, understanding and managing this complex condition is more crucial than ever. This review explores the emerging role of GLP-1 receptor agonists (GLP-1RA) in weight management, focusing on their impact on energy balance. It highlights the necessity of this investigation due to the limited knowledge on both the short-term and long-term implications of GLP-1RA on energy expenditure (EE) and energy intake (EI).</p><p><strong>Recent findings: </strong>GLP-1RA, such as liraglutide and semaglutide, have shown significant efficacy in promoting weight loss by reducing appetite, cravings and consequently, EI. Newer medications such as tirzepatide have demonstrated even greater weight loss success. Emerging evidence also suggests potential effects on EE, which could explain the greater weight loss success achieved with GLP-1 RA rather than typical lifestyle changes. However, comprehensive data on the total impact of these drugs on energy balance remain limited.</p><p><strong>Summary: </strong>The findings underscore the promising role of GLP-1RA in obesity management, particularly through mechanisms influencing both EI and EE. Future research should focus on systematically measuring all components of energy balance to fully elucidate the mechanisms of GLP-1RA and optimize their therapeutic use for personalized medicine.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-06DOI: 10.1097/MCO.0000000000001065
Oliver Hayman, Emilie Combet, Oliver C Witard, Stuart R Gray
Purpose of review: This review aims to explore the latest research investigating the effects of marine-derived long-chain n-3 polyunsaturated fatty acid (LCn-3 PUFA) supplementation on neuromuscular function in older adults.
Recent findings: Ageing results in a decline in skeletal muscle strength and mass. There is growing evidence that LCn-3 PUFA supplementation increases muscle strength and mass in healthy older adults, yet the mechanisms underlying these effects remain elusive. Recent studies investigating LCn-3 PUFA supplementation have demonstrated effects on neuromuscular function such as increases in the compound muscle action potential (M-wave) amplitude and surface electromyography alongside increases in muscular strength. Therefore, evidence suggests that LCn-3 PUFA may elicit a beneficial effect at the neuromuscular junction and possess neuroprotective properties in older adults.
Summary: LCn-3 PUFA supplementation may increase or maintain neuromuscular function throughout the ageing process. Further research is warranted to investigate the long-term effects LCn-3 PUFA supplementation on neuromuscular outcomes such as single motor unit properties and cortical/supraspinal networks, utilizing state-of-the-art techniques in neuromuscular physiology.
{"title":"Long-chain n-3 polyunsaturated fatty acid supplementation and neuromuscular function in older adults.","authors":"Oliver Hayman, Emilie Combet, Oliver C Witard, Stuart R Gray","doi":"10.1097/MCO.0000000000001065","DOIUrl":"https://doi.org/10.1097/MCO.0000000000001065","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to explore the latest research investigating the effects of marine-derived long-chain n-3 polyunsaturated fatty acid (LCn-3 PUFA) supplementation on neuromuscular function in older adults.</p><p><strong>Recent findings: </strong>Ageing results in a decline in skeletal muscle strength and mass. There is growing evidence that LCn-3 PUFA supplementation increases muscle strength and mass in healthy older adults, yet the mechanisms underlying these effects remain elusive. Recent studies investigating LCn-3 PUFA supplementation have demonstrated effects on neuromuscular function such as increases in the compound muscle action potential (M-wave) amplitude and surface electromyography alongside increases in muscular strength. Therefore, evidence suggests that LCn-3 PUFA may elicit a beneficial effect at the neuromuscular junction and possess neuroprotective properties in older adults.</p><p><strong>Summary: </strong>LCn-3 PUFA supplementation may increase or maintain neuromuscular function throughout the ageing process. Further research is warranted to investigate the long-term effects LCn-3 PUFA supplementation on neuromuscular outcomes such as single motor unit properties and cortical/supraspinal networks, utilizing state-of-the-art techniques in neuromuscular physiology.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-05DOI: 10.1097/MCO.0000000000001067
Taylor J McColl, David C Clarke
Purpose of review: Amino acids are critical to health, serving both as constituents of proteins and in signaling and metabolism. Amino acids are consumed as nutrients, supplements, and nutraceuticals. Much remains to be learned about amino acid function. Physiologically based pharmacokinetic and pharmacodynamic (PBPK-PD) modeling is an emerging tool for studying their complex biology. This review highlights recent PBPK-PD models developed to study amino acid physiology and metabolism and discusses their potential for addressing unresolved questions in the field.
Recent findings: PBPK-PD models provided several insights. They revealed the interplay between the mechanisms by which leucine governs skeletal muscle protein metabolism in healthy adults. The models also identified optimal dosing regimens of amino acid supplementation to treat sickle-cell disease and recurrent hypoglycemia, and to minimize drug side effects in seizure disorders. Additionally, they characterized the effects of novel anticancer drugs that seek to deprive cancer cells of amino acids. Future models may inform treatment strategies for sarcopenia, characterize distinctions between animal- and plant-based nutrition, and inform nutrient-drug interactions in Parkinson's disease.
Summary: PBPK-PD models are powerful tools for studying amino acid physiology and metabolism, with applications to nutrition, pharmacology, and their interplay.
{"title":"Progress in physiologically based pharmacokinetic-pharmacodynamic models of amino acids in humans.","authors":"Taylor J McColl, David C Clarke","doi":"10.1097/MCO.0000000000001067","DOIUrl":"https://doi.org/10.1097/MCO.0000000000001067","url":null,"abstract":"<p><strong>Purpose of review: </strong>Amino acids are critical to health, serving both as constituents of proteins and in signaling and metabolism. Amino acids are consumed as nutrients, supplements, and nutraceuticals. Much remains to be learned about amino acid function. Physiologically based pharmacokinetic and pharmacodynamic (PBPK-PD) modeling is an emerging tool for studying their complex biology. This review highlights recent PBPK-PD models developed to study amino acid physiology and metabolism and discusses their potential for addressing unresolved questions in the field.</p><p><strong>Recent findings: </strong>PBPK-PD models provided several insights. They revealed the interplay between the mechanisms by which leucine governs skeletal muscle protein metabolism in healthy adults. The models also identified optimal dosing regimens of amino acid supplementation to treat sickle-cell disease and recurrent hypoglycemia, and to minimize drug side effects in seizure disorders. Additionally, they characterized the effects of novel anticancer drugs that seek to deprive cancer cells of amino acids. Future models may inform treatment strategies for sarcopenia, characterize distinctions between animal- and plant-based nutrition, and inform nutrient-drug interactions in Parkinson's disease.</p><p><strong>Summary: </strong>PBPK-PD models are powerful tools for studying amino acid physiology and metabolism, with applications to nutrition, pharmacology, and their interplay.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-02DOI: 10.1097/MCO.0000000000001066
Danielle E Bear, Matthew J Summers, Lee-Anne S Chapple
Purpose of review: Critical care nutrition guidelines recommend provision of higher protein doses than recommended in health. These recommendations have been predominately based on lower quality evidence and physiological rationale that greater protein doses may attenuate the significant muscle loss observed in critically ill patients. This review discusses the mechanistic action of protein in the critically ill, details results from recent trials on health outcomes, discusses considerations for interpretation of trial results, and provides an overview of future directions.
Recent findings: Two recent large clinical trials have investigated different protein doses and the effect on clinical outcome. Important findings revealed potential harm in certain sub-groups of patients. This harm must be balanced with the potential for beneficial effects on muscle mass and physical function given that two recent systematic reviews with meta-analyses demonstrated attenuation of muscle loss with higher protein doses. Utilizing biological markers such as urea: creatinine ratio or urea levels may prove useful in monitoring harm from higher protein doses.
Summary: Future research should focus on prospectively investigating biological signatures of harm as well as taking into the consideration elements that will likely enhance the effectiveness of protein dose.
{"title":"Dietary protein in the ICU in relation to health outcomes.","authors":"Danielle E Bear, Matthew J Summers, Lee-Anne S Chapple","doi":"10.1097/MCO.0000000000001066","DOIUrl":"https://doi.org/10.1097/MCO.0000000000001066","url":null,"abstract":"<p><strong>Purpose of review: </strong>Critical care nutrition guidelines recommend provision of higher protein doses than recommended in health. These recommendations have been predominately based on lower quality evidence and physiological rationale that greater protein doses may attenuate the significant muscle loss observed in critically ill patients. This review discusses the mechanistic action of protein in the critically ill, details results from recent trials on health outcomes, discusses considerations for interpretation of trial results, and provides an overview of future directions.</p><p><strong>Recent findings: </strong>Two recent large clinical trials have investigated different protein doses and the effect on clinical outcome. Important findings revealed potential harm in certain sub-groups of patients. This harm must be balanced with the potential for beneficial effects on muscle mass and physical function given that two recent systematic reviews with meta-analyses demonstrated attenuation of muscle loss with higher protein doses. Utilizing biological markers such as urea: creatinine ratio or urea levels may prove useful in monitoring harm from higher protein doses.</p><p><strong>Summary: </strong>Future research should focus on prospectively investigating biological signatures of harm as well as taking into the consideration elements that will likely enhance the effectiveness of protein dose.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-05-16DOI: 10.1097/MCO.0000000000001047
Christina C Dahm, Fie Langmann, Anne Østergaard Nannsen, Daniel B Ibsen
Purpose of review: This review highlights recent developments in understanding the role of dietary fibre and specific fibre types on risk and management of cardiometabolic disease with a focus on the causal pathways leading to cardiometabolic diseases, namely weight management, glycaemic control, and lipid levels, as well as the latest findings for cardiovascular disease outcomes such as coronary heart disease, stroke, and mortality. Evidence for mechanisms through gut microbiota are also briefly reviewed.
Recent findings: Dietary fibre intake is associated with improved weight management, the extent of which may depend on the subtype of dietary fibre. Overall dietary fibre intake reduces blood glucose and HbA1c, however soluble fibres may be particularly effective in reducing HbA1c, fasting blood glucose and blood lipids. Individual meta-analyses and umbrella reviews of observational studies on dietary fibre, as well as major fibre types, observed inverse associations with incident coronary heart disease, stroke, and mortality due to cardiovascular disease. As different types of fibres exerted different health benefits, fibre diversity (i.e. combinations of fibres) should be further investigated.
Summary: Dietary fibres improve both short-term and long-term cardiometabolic disease risk factors and outcomes, and thus should be on every menu.
{"title":"Role of dietary fibres in cardiometabolic diseases.","authors":"Christina C Dahm, Fie Langmann, Anne Østergaard Nannsen, Daniel B Ibsen","doi":"10.1097/MCO.0000000000001047","DOIUrl":"10.1097/MCO.0000000000001047","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review highlights recent developments in understanding the role of dietary fibre and specific fibre types on risk and management of cardiometabolic disease with a focus on the causal pathways leading to cardiometabolic diseases, namely weight management, glycaemic control, and lipid levels, as well as the latest findings for cardiovascular disease outcomes such as coronary heart disease, stroke, and mortality. Evidence for mechanisms through gut microbiota are also briefly reviewed.</p><p><strong>Recent findings: </strong>Dietary fibre intake is associated with improved weight management, the extent of which may depend on the subtype of dietary fibre. Overall dietary fibre intake reduces blood glucose and HbA1c, however soluble fibres may be particularly effective in reducing HbA1c, fasting blood glucose and blood lipids. Individual meta-analyses and umbrella reviews of observational studies on dietary fibre, as well as major fibre types, observed inverse associations with incident coronary heart disease, stroke, and mortality due to cardiovascular disease. As different types of fibres exerted different health benefits, fibre diversity (i.e. combinations of fibres) should be further investigated.</p><p><strong>Summary: </strong>Dietary fibres improve both short-term and long-term cardiometabolic disease risk factors and outcomes, and thus should be on every menu.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-06-06DOI: 10.1097/MCO.0000000000001040
Anastasia Z Kalea, Dorothy Klimis-Zacas
{"title":"Editorial: unravelling the trifecta: obesity, cancer, and DNA damage.","authors":"Anastasia Z Kalea, Dorothy Klimis-Zacas","doi":"10.1097/MCO.0000000000001040","DOIUrl":"10.1097/MCO.0000000000001040","url":null,"abstract":"","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}