Nutricion hospitalaria最新文献

Background: as chromium (Cr) is known to contaminate components of parenteral nutrition (PN), Cr-free PN is recommended for preterm infants. Exposure to Cr by PN in preterm infants is scarcely investigated.

Objective: to describe Cr levels in plasma (Crp) and urine (Cru) during the first month of life in premature newborns ≤ 1500 g of birthweight (BW) receiving PN, and to evaluate the impact on postnatal clinical parameters.

Methods: a prospective observational study. Cr-free PN was administered at day 1 of life and continued until full enteral feeding with fortified breastmilk began. Crp levels at day 15 and 30 and Cru at day 30 of life were assessed according to demographic factors, biochemical markers and postnatal morbidity.

Results: 97 infants had a median gestational age (GA) of 29.9 weeks, and a median BW of 1205 g. Median Crp remained at 1.0 µg/L at 15 and 30 days (IQR 0.7-1.4 and 0.7-1.3, respectively). Premature babies < 26 weeks had a significantly higher Crp at one month than the remainder (p = 0.043) and higher Cr elimination in the urine (p = 0.026). Crp increased with prolonged PN (p < 0.001), even after adjusting for gestational age (p = 0.001). Laboratory parameters were not influenced by Crp or Cru, nor was morbidity.

Conclusion: Crp increases with days of PN even when a trace mineral supplement without Cr is used, and the level reached persists during the first month of life with the introduction of Cr-supplemented breastmilk feeding. No relation to morbidity was observed.

Introduction and objectives: malnutrition and sarcopenia are prevalent in individuals with cirrhosis, but their diagnosis remains challenging due to limited access to suitable methods across different levels of healthcare. This study aimed to identify the most effective method for diagnosing sarcopenia in outpatients with liver cirrhosis and to evaluate the concordance between subjective and objective diagnostic methods.

Patients and methods: patients aged ≥ 18 years with a diagnosis of cirrhosis (regardless of etiology) under outpatient care were included. Exclusion criteria were: a) neoplasia, b) acute liver failure, c) pregnancy/lactation, d) HIV infection, e) special situations requiring liver transplantation, and f) history of organ failure. Nutritional and sarcopenia assessments used subjective methods, including the Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT), SARC-F, SARC-Calf, and RFH-Global Assessment (RFH-GA); and objective methods, including anthropometry, handgrip strength (HGS), the sit-and-stand test (15s), and appendicular skeletal muscle mass index (ASMI) by Dual-Energy X-ray Absorptiometry (DXA). Concordance between ASMI and traditional methods was analyzed. Significance was set at p < 0.05.

Results: a total of 45 patients were analyzed, with alcoholic liver disease being the most frequent etiology (44.4 %). The sit-and-stand test (15s) combined with muscle depletion by DXA diagnosed the most cases of sarcopenia (42.2 %). Moderate agreement was found between muscle depletion and isolated calf circumference (CC) (κ = 0.581; p < 0.001).

Conclusions: our study suggests excluding SARC-F and SARC-CalF from sarcopenia screening in outpatients with cirrhosis. While ASMI remains the most reliable diagnostic method, CC may serve as a feasible alternative when DXA is unavailable.

Objectives: diet quality indices (DQI) tend to relate positively to micronutrient intake. Our aim was to investigate the association between six DQIs and inadequate intake for 19 micronutrients in the SUN ("Seguimiento Universidad de Navarra") cohort.

Methods: we assessed 16,768 participants (59.3 % women, 37.8 years for mean age). Diet quality was evaluated using Dietary Approaches to Stop Hypertension (DASH); Mediterranean Diet Adherence Screener (MEDAS); Alternate Healthy Eating Index (AHEI-2010); Food-Based Global Diet Quality Score (GDQS); Alternative Mediterranean Diet Score (aMED) and Mediterranean Diet Score (MDS). Logistic regression analyses were conducted to estimate the probability of failing to meet Estimate Average Requirement (EAR) for either ≥ 3 or ≥ 6 micronutrients.

Results: overall, the lower and higher prevalence of inadequacy in fifth quintiles was for vitamins A, C, B1, B2, B3, B6, for Fe, P and Cr, and for vitamins E and D, respectively. In the multivariable adjusted model, the OR for failing to meet ≥ 3 DRI for the highest versus the lowest quintiles of DASH, MEDAS, AHEI-2010, GDQS, aMED and MDS were: 0.03 (95 % CI, 0.02 to 0.03), 0.06 (95 % CI, 0.05 to 0.07), 0.10 (95 % CI, 0.09 to 0.12), 0.05 (95 % CI, 0.04 to 0.06), 0.03 (95 % CI, 0.03 to 0.04), and 0.03 (95 % CI, 0.03 to 0.04), respectively.

Conclusions: adherence to six DQIs showed inverse associations with micronutrient inadequacy. Food-based DQIs could be a useful prevention tool. GDQS and MEDAS do not require deriving nutrient intake data, particularly MEDAS, which is even easier and quicker to fill out.