Nutrition Clinique et Metabolisme最新文献

Objective

This study aimed to identify the most effective nutritional risk screening tool for elderly patients with digestive system tumors.

Methods

Nutritional risk screening was performed using Nutritional Risk Screening 2002 (NRS2002), prognostic nutritional index (PNI) and Geriatric Nutritional Risk Index (GNRI) for elderly patients who underwent surgical resection of digestive tumor. Comparative analysis of each nutritional screening tool was conducted through Kappa test and ROC curve.

Results

Malnourished individuals diagnosed by the Global Leadership Initiative on Malnutrition (GLIM) criteria had lower levels of hematological parameters (serum albumin, pre-albumin, total protein and hemoglobin) and poorer body composition parameters (body mass index, body fat percentage, edema index, upper arm muscle circumference, skeletal muscle index, and phase angle; P < 0.05). NRS2002 demonstrated a sensitivity of 75.56% and specificity of 38.16% under the GLIM criteria, showing moderate agreement (Kappa = 0.346, P < 0.001). PNI had an average sensitivity of 71.11% and the highest specificity at 87.23%, but exhibited no consistency with GLIM (Kappa = 0.152, P = 0.062). GNRI showed the highest sensitivity at 91.11% and general specificity at 37.14%, aligning closely with GLIM criteria (Kappa = 0.711, P < 0.001). GNRI had the highest predictive value (AUC = 0.870, 95% CI: 0.801–0.939), followed by NRS2002 (AUC = 0.687, 95% CI: 0.589–0.785). Patients diagnosed with malnutrition via GNRI-GLIM exhibited higher rates of surgical site infection (χ² = 15.534, P < 0.001) and 3-month readmission (χ² = 4.499, P = 0.034).

Conclusion

GNRI and NRS2002 demonstrate good performance as GLIM criteria for nutritional screening in elderly patients with digestive tumors, with GNRI being potentially more suitable. Moreover, GNRI-GLIM can predict short-term prognosis in these patients.

Objectives

To examine the relationship between the energy-adjusted dietary inflammatory index (E-DII) and nutritional status, anthropometric measurements, subjective global evaluations (SGA) and biochemical parameters of chronic kidney disease patients.

Methods

Cross-sectional analyses were performed on data collected from individuals.

Participants/setting

Participants included 119 adults aged 19 years and older, who had data from at least three days of valid 24-hour dietary recall data. Main outcome measures nutritional status, anthropometric measurements, SGA and biochemical parameters were collected. Statistical analyses performed Mann–Whitney U test, ANOVA, Kruskal–Wallis and ANCOVA test was used.

Results

It was determined that 79.8% of the patients were well-nourished, 19.3% had moderate malnutrition, and 0.9% had severe malnutrition. The patients with severe malnutrition was in the last quartile. It was determined that macronutrients and all vitamin and mineral intakes decreased in the last quartile values compared to the first quartile values (P < 0.05). After adjustment for age, sex, energy intake and glomerular filtration rat, there was a significant differences in triceps skinfold thickness and body fat percentage among the four quartiles. There was an increase in the C reactive protein levels from the first quartile to the third quartile (P < 0.05).

Conclusions

This study shows that E-DII is a good tool for assessing the overall inflammatory potential of diet in chronic kidney disease patients.

Background

Omega-3 fatty acids supplementation may protect against exercise-induced muscle damage (EIMD) through its anti-inflammatory properties. The purpose of the present meta-analysis was to evaluate the effects of omega-3 fatty acid supplementation on inflammatory markers following EIMD in trained and untrained individuals.

Methods

Medline, Scopus, and Google Scholar databases were systematically searched up to April 2023. The Cochrane Collaboration tool was used to assess the risk of bias and evaluate the quality of the studies.

Results

Omega-3 supplementation significantly reduced interleukin (IL) 6, tumor necrosis factor (TNF)-ɑ, and C-reactive protein (CRP) concentrations.

Conclusion

The current meta-analysis indicated the efficacy of omega-3 in reducing the serum levels of inflammatory markers in healthy individuals, overall, and in subgroup analysis. Thus, omega-3 may be a priority EIMD recovery agent for interventions.

Flavonols got particular attention in the last few years. We hypothesized that the seasonal changes in the availability of their sources do not impact the general flavonols intake. Forty volunteers were enrolled in the study. The 3-day food interviews were performed in 3-month intervals for one year and compared with the FFQ dedicated to the yearlong assessment of flavonols intake. The analysis did not show significant differences for quercetin, kaempferol, isorhamnetin, and total flavonols throughout the year. Significant differences were observed only for myricetin (P = 0.003). At the same time, the detailed analysis of the categories of the consumed products showed significant differences in the seasonal structure of the intakes of fruits (P = 0.01), vegetables (P = 0.046), herbs and spices (P = 0.002), and tea and coffee (P = 0.01). The analysis of the correlation between the results of the one-year follow-up and the results of the FFQ showed significant correlations for total flavonols (R = 0.55; P = 0.001), kaempferol (R = 0.66; P < 0.001), quercetin (R = 0.48; P = 0.002), isorhamnetin (R = 0.41; P = 0.01), and myricetin (R = 0.49; P = 0.001) intakes. This study showed that despite the fluctuations in the selected product intake, the overall intake of quercetin, kaempferol, isorhamnetin, and total flavonols did not show significant differences throughout the year. The analysis showed good agreement between FFQ dedicated to the yearlong assessment of the flavonols intake and multiple food interviews, which proves the validity of the FFQ.

Malnutrition, a major public health issue that characterized by an altered energetic and nutritional balance, is associated with an increase of infectious complications and mortality risk. Indeed, an increase of infectious risk has been reported in malnourished subjects in many studies. Various mechanisms are involved in the increased risk of infections and encompass an altered immune response and disrupted barrier function particularly gut barrier function. In this brief review, we focus on thymic and spleen response in malnourished conditions, as well as on the role of energetic fuels, i.e. amino acids, glucose. The contribution of vitamins and trace-elements is also discussed, as well as the role of gut barrier function.

Objectives

The aim of this article was to study the quality of hospital-provided nutrition in Algeria, to understand possible deficiencies and weaknesses and then propose appropriate recommendations based on the recommendations of The ESPEN, the AFDN, and the SFNCM guidelines.

Materials and methods

The energetic and nutritional value of served meals throughout the week in four public hospitals in east Algeria was calculated. The menus proposed by the dietician of each hospital were used. Energy and nutrient values for each food item were calculated using “CIQUAL Table, 2016”.

Results

The energy average per day was 9759 ± 1111.6 kJ (2332 kcal), and the macronutrients averages per day were: 106 ± 9.2 g, 65 ± 20.5 g, and 326 ± 39.3 g for proteins, lipids and carbohydrates respectively. Results showed imbalance in macronutrients, severe deficiency in healthy fats and micronutrients. Several types of food are absent or insufficient, or proposed in inaccurate types and quantities in hospital menus. The absence and shortage of some types of food and the inaccuracy of types and quantities were the main reasons for the imbalance of the proposed menus in hospitals. We propose a series of evidence-based recommendations tailored to the Algerian healthcare context especially by offering multiple meal choices, addressing macronutrient proportions, and ensuring that diets are responsive to individual patient needs.

Conclusion

Nutrition approach in the hospitals concerned with the study is to reconsider, taking into account hospital menus and all the factors of reduced food intake, to prevent and treat hospital malnutrition and minimize its clinical and economic outcomes.

Objective

To systematically evaluate the effect of vitamin D supplementation on cardiac function in patients with chronic heart failure.

Methods

Search multiple databases to find randomized controlled trials of vitamin D for chronic heart failure from the self-built database until September 1, 2023. Meta-analysis was performed using RevMan5.3 and Stata15.0 software.

Results

Eighteen articles were included. Vitamin D supplementation has improved left ventricular ejection fraction [WMD = 3.18%, 95%CI (1.07, 5.3), P < 0.05] and 6-minute walking distance [MD = −11.54, 95%CI (−22,215, −0.871), P < 0.05], has decreased left ventricular end-diastolic diameter [MD = −1.67, 95%CI (−2.88, −0.46), P < 0.05], left ventricular end-diastolic volume [MD = −11.94, 95%CI (−20.59, −3.29), P < 0.05], N-terminal forebrain natriuretic peptide [WMD = −0.7, 95%CI (0.24, 1.16), P < 0.05].

Conclusion

Vitamin D supplementation can improve cardiac function, inhibit ventricular remodeling, and increase exercise endurance inpatients with chronic heart failure.

INPLASY registration number

202440032.

Background

Inflammation plays a great role in the pathogenesis of COVID-19 as a life-threatening epidemic. This study was conducted to investigate relationship between dietary inflammatory index (DII) and severity and symptoms of COVID-19.

Methods

In total, 683 patients recovered from COVID-19 were included. Dietary intakes of participants were assessed using a validated 168-item FFQ. Outcomes of interest were including severity of disease, symptoms, hospitalization, hypoxia, need to respiratory support, severe lung infection, disease duration, hospitalization, recovery after hospitalization and respiratory support as well as serum level of CRP and ESR.

Results

Participants at the highest quartile of DII score had higher risk of COVID-19 severity (OR: 1.80; 95% CI: 1.01, 3.20), duration of recovery (OR: 1.74; 95% CI: 1.01, 3.02), hypoxia (OR: 2.04, 95% CI: 1.08–3.83), needs to respiratory support (OR: 3.82; 95% CI: 2.08, 7.03), and long disease duration (OR: 2.63; 95% CI: 1.41, 4.89), and higher levels of CRP and ESR (P-value < 0.001). Moreover, risk of COVID-19 symptoms including dyspnea, cough, fever, chills, weakness, myalgia, chest pain, headache, vertigo, sore throat, nausea and vomiting and anorexia was higher among those patients; but no such an association was found for the risk of hospitalization, severe lung infection, hospital duration, duration of respiratory support, blood pressure, pulse rate and respiratory rate.

Conclusion

We found that high DII was associated with greater risk of severe disease, higher levels of serum inflammatory markers and lower life satisfaction in patients with COVID-19. Further, prospective studies are required to confirm our findings.