Nutrition Clinique et Metabolisme最新文献

Health prevention includes an adequate dietary intake of macronutrients (carbohydrates, lipids, proteins) and micronutrients (vitamins, trace elements). Micronutrients play an essential role as co-factors or reducing agents in almost all of the biochemical reactions of cellular metabolism. The objective of this review is to provide an update of knowledge of the metabolism of the main micronutrients such as water-soluble (B1, B6, B9, B12, C) and fat-soluble (A, E, D) vitamins and trace elements (iron, zinc, copper, selenium) with a particular attention to their impact of inflammation. The aim of the review is also to define the status of micronutrients in groups at risk of emerging deficiency (inflammation bowel disease, bariatric surgery, bowel resection, COVID) and to draw out the main messages for putting them into practice. Biomarkers of micronutrient excess are generally less well characterized than those of deficiency, particularly in terms of links to functional or clinical symptoms of toxicity. The prevention of deficiencies in the absence of pathology, is based on a diet varied and balanced that easily covers all needs. Prevention by micronutritional supplements may be justified on a temporary or prolonged basis in particular pathophysiological situations (special diets, drug interactions, pathologies).

Introduction and objective

The finger-food (FF) technique is intended to allow people with neuropsychiatric, visual or motor disabilities to eat by taking food by hand. Data from the use of this technique are scarce. The objective of the study was to specify the modes of use of FF in medico-social establishments in the New-Aquitaine region.

Method

A simple secure questionnaire was sent electronically to the 2625 medico-social establishments. Data were collected automatically and answers were presented descriptively.

Results

In all, 3% of establishments contacted responded (n = 80, 82% from nursing homes, 15% from establishments for disabled adults and 2% from establishments for disabled children). FF concerned 24 establishments and 2% of residents. The presentation of food in FF was in 42% of cases in the form of bites, 30% of toasts and 20% of hydration cubes. The basic materials for FF were scarce. The FF diet was mainly offered at lunch and dinner. The perceived advantages of FF were the maintenance of the residents’ autonomy and pleasure of eating and the fight against undernutrition. On the side of the disadvantages felt, the main ones were the increase in working time, the excessively technical nature of the method and possible hygiene problems.

Conclusion

The FF technique seemed to have advantages, but raised problems which could probably be improved, thanks to an increase in the available staff time, the training of professionals, the acquisition of basic materials and the more frequent application of FF during breakfast and snacks. The interest of FF in terms of costs deserved to be explored.

Introduction

The new diagnostic criteria of the french health authority (HAS) for undernutrition suggest assessing patients’ muscle strength and/or mass. The methods are less available in practice. Albumin levels are now considered as a criterion for the severity of undernutrition. Our aim was to assess the impact of these changes in recommendations on the practices of professionals involved in screening for and diagnosing undernutrition.

Materials and methods

The Scientific Advisory Board of the french speaking society for clinical nutrition and metabolism (SFNCM) used google forms® to conduct an e-mail survey of the society's members.

Results

We obtained 363 responses. Eighty-seven percent and 77% of respondents respectively stated that they rarely or never assess muscle mass or strength. A minority of professionals said they were equipped to carry out these assessments (38% had a dynamometer, 23% an impedancemeter). However, even those had access to them did not use them regularly. With regard to albuminemia, almost half of those questioned said they used it to diagnose malnutrition.

Conclusion

Few of the professionals responsible for diagnosing undernutrition are able to assess muscle mass and strength, due to a lack of muscle mass and strength due to a lack of access to techniques. The use of albumin levels as a marker of the severity of undernutrition seems ambiguous to some. The training of teams and funding for equipment would therefore seem to be prerequisites for the successful implementation of these recommendations.

Diet is suspected to play a key role in IBD natural history. IBD patients often believe that diet is associated with symptoms and flares, leading to restrictive diets avoiding dietary components considered as potentially harmful. The risk factors of this restrictive eating disorder are now reported and result from disease activity, from patients’ psychological health and from confusing dietary advice. These restrictive diets are at risk of undernutrition, nutritional deficiencies and of mixed anxiety-depressive disorders. Epidemiological studies have highlighted the role of dietary factors in IBD risk. Mediterranean diets tend to reduce the risk of developing IBD. Conversely, the “Western” diet (high intakes of fat, sugar, salt, animal protein and ultra-processed foods) increases the risk of developing IBD. Experimental studies demonstrate the ability of nutrients to modulate the intestinal inflammatory response by influencing the composition of the intestinal microbiota, the function of the intestinal barrier or various actors of immunity. The level of scientific evidence is currently insufficient to propose an anti-inflammatory diet for IBD patients. Nevertheless, promising avenues of clinical research deserve to be investigated in the future through randomised interventional studies. As recommended by ESPEN statements with a strong consensus, every patient should benefit from dietary follow-up by a health professional as part of a multidisciplinary approach.

Objective

Parkinson's disease (PD) is associated with inflammation and lipid profile abnormalities. Considering the effects of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) on inflammation and lipid metabolism, the present study aimed to investigate the effects of ω-3 PUFAs supplementation on the pro- and anti-inflammatory cytokines and lipid profile in PD.

Material and methods

In this study, 44 patients with PD were selected and divided into two groups. The intervention group received two capsules of ω-3 PUFAs daily, each capsule containing 120 mg eicosapentaenoic acid and 180 mg docosahexaenoic acid, and the placebo group received two soft capsules of soybean oil daily for eight weeks. Weight, height, lipid profile (TG, HDL-c, LDL-c, total cholesterol [TC]), and pro- and anti-inflammatory cytokines (IL-6, TNF-α, and IL-10) were assessed at the beginning and at the end of the study.

Results

Body mass index (P = 0.02), weight (P = 0.04), HDL-c (P = 0.01), LDL-c (P = 0.03), and IL-6 (P = 0.02) levels increased, while TG (P = 0.01), TNF-α (P = 0.01), and IL-10 (P = 0.01) decreased significantly in the ω-3 PUFAs group. Between-group comparisons revealed the changes not to be significant after adjustments for baseline values and confounders. Moreover, the changes in TC were not significant in either within- or between-group comparisons.

Conclusion

Based on the results of the study, 600 mg ω-3 PUFAs supplementation for eight weeks has no significant effect on the assessed pro- and anti-inflammatory cytokines and lipid profiles in patients with PD. Further studies with higher doses are needed to better clarify the role of ω-3 PUFAs in the biochemical and clinical outcomes of PD patients.

Aim

To determine the status of 25(OH)D and parathyroid hormone (PTH) levels in patients with severe obesity who undergo and not undergo gastric bypass (GB); and analyzed their correlation with the degree of obesity and fat mass.

Methods

Cross-sectional study in 34 patients, analyzed in two groups: a) patients who not undergo GB and b) patients who did undergo GB. Height, weight, BMI, body composition, % excess weight loss (EWL) and % total weight loss (TWL) were determinate. 25(OH)D level was categorized according to the Endocrine Society criteria.

Results

Mean age was of 37.24 ± 5.83 vs 40.82 ± 9.03 years (P = 0.021) and BMI of 44.92 ± 8.63 vs 31.28 ± 5.60 kg/m² (P = 0.001) in patients who did not undergo GB and underwent GB respectively. Patients who underwent GB showed decreased levels of 25(OH)D: 14.04 ± 10.42 ng/mL vs patients without surgery 31.95 ± 31.00 ng/mL (P < 0.001). Vitamin D deficiency was identified in 70% patients having GB vs 59% patients without surgery (P < 0.05). Of all patients with GB, 35% were diagnosed with hyperparathyroidism vs 29% of those without GB (P = 0.492). Serum 25(OH)D concentrations were disclosed a significant inverse relationship with the % TWL after surgery, but not with weight, BMI and fat mass.

Conclusions

Vitamin D deficiency is prevalent in patients with severe obesity and patients who did undergo GB. The major determinant of low levels of 25(OH)D was % TWL after surgery. Hyperparathyroidism did not indicate vitamin D deficiency.

Objectives

Heterozygous familial hypercholesterolemia is a common genetic disease responsible for premature atherosclerosis. Therefore, early diagnosis and treatment are recommended to reduce cardiovascular risk. Usually, the screening is based on high plasma LDL-cholesterol. In children, blood testing is often an obstacle for screening. This study aims to evaluate the relevance of a salivary non-invasive LDL dosage in heterozygous familial hypercholesterolemia in a pediatric population.

Materials and methods

Prospective, case control, monocentric study comparaing the salivary cholesterol of 30 heterozygous familial hypercholesterolemia pediatric patients and 30 healthy age-matched controls with two different enzymatic kits (Amplite™ kit - AAT Bioquest® and Total Cholesterol Assay kit - CELL BIOLABS®, Inc).

Results

While the median serum total-cholesterol was significantly different in control and heterozygous familial hypercholesterolemia patients as expected, the median salivary cholesterol concentration was similar between the two groups and 1000 times lower than in serum. No correlation was found between salivary and serum cholesterol concentrations.

Conclusion

Although cholesterol is detectable in saliva, our study suggests that the low salivary cholesterol concentrations result mostly from variable gingival bleeding, precluding any reliable use for Heterozygous Familial Hypercholesterolemia screening in children.