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Military rations: Nutritional, sensorial and technological quality and their effects on military physical exercise in extreme environments. 军用口粮:营养、感官和技术质量及其对极端环境下军事体育锻炼的影响。
IF 5.1 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-09-26 DOI: 10.1017/S0954422424000246
Vitor Andre Silva Vidal, Ida-Johanne Jensen, Øyvind Sandbakk, Pål Haugnes, Martin Winge Austeen, Rune Gjeldnes, Birger Svihus, Jørgen Lerfall

In recent years, many countries have significantly increased military spending, mainly due to geopolitical instability in several regions and the potential risk of armed conflicts spreading worldwide. In this context, understanding the nutritional needs of soldiers in different climates (warm, cold and high altitude) is important and directly impacts the performance and health of soldiers, especially in extreme environments. The amount of liquids, calories, and macro- and micronutrients contained in military rations must be determined considering the type of exercise, duration and environment. Military rations, in addition to being nutritionally adequate, must be practical, sustainable and easy to consume at any temperature and situation. Given these considerations, this study aimed to review scientific knowledge regarding the convenience, sensory attributes and nutritional components of military rations. Furthermore, this review studied the factors influencing soldiers' appetite, gut microbiota and nutritional needs during training or combat in extreme environments (warm, cold and high altitude). This exploration further advances our understanding of contemporary nutritional strategies for military personnel, contributing to future research and highlighting areas that must be developed.

近年来,许多国家大幅增加了军费开支,这主要是由于一些地区地缘政治不稳定以及武装冲突蔓延全球的潜在风险。在这种情况下,了解士兵在不同气候(温暖、寒冷和高海拔)下的营养需求就显得非常重要,它直接影响到士兵的表现和健康,尤其是在极端环境下。必须根据运动类型、持续时间和环境来确定军用口粮中的液体、热量以及宏量和微量营养素的含量。军用口粮除了营养充足外,还必须实用、可持续,并且在任何温度和情况下都易于食用。鉴于这些考虑因素,本研究旨在回顾有关军用口粮的方便性、感官属性和营养成分的科学知识。此外,本综述还研究了在极端环境(温暖、寒冷和高海拔)下训练或作战期间影响士兵食欲、肠道微生物群和营养需求的因素。这一探索进一步加深了我们对当代军事人员营养战略的理解,有助于未来的研究,并突出了必须开发的领域。
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引用次数: 0
Nutrition and health effects of pectin: A systematic scoping review of human intervention studies. 果胶对营养和健康的影响:人类干预研究的系统性范围界定审查。
IF 5.1 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-09-26 DOI: 10.1017/S0954422424000180
Annika M Weber, Nélida Pascale, Fangjie Gu, Elizabeth P Ryan, Frederique Respondek

Pectin is composed of a group of complex polysaccharides that are naturally found in various plants and are associated with a range of beneficial health effects. Health outcomes from dietary pectin can vary depending on botanical origin, dietary dose and structure of pectin. The objective of this scoping review is to build a comprehensive overview of the current evidence available on intervention studies conducted in humans and to better understand the possible knowledge gaps in terms of structure-function relationships across the different health-related effects. PubMed and Embase databases were searched using PRISMA-ScR guidelines, yielding 141 references (from the initial 3704), representing 134 intervention studies performed between 1961 and 2022 that met inclusion criteria. Studies were divided into six categories, which included gut health, glycaemic response and appetite, fat metabolism, bioavailability of micronutrients, immune response and other topics. Review of these human intervention studies identified a variety of cohort characteristics and populations (life stage, health status, country), sources/types of pectin (i.e. citrus, sugarbeet, apple, other and non-defined), intervention timeframes (from one single intake to 168 d) and doses (0.1-50 g/d) that were tested for health outcomes in people. Gut health, post-prandial glucose regulation and maintenance of blood cholesterol represented the largest categories of studied outcomes. Further research to strengthen the structure-function relationships for pectin with health properties and associated outcomes is warranted and will benefit from a more precise description of physico-chemical characteristics and molecular compositions, such as degree of esterification, weight, degree of branching, viscosity, gel formation and solubility.

果胶由一组复杂的多糖组成,天然存在于各种植物中,具有一系列有益健康的作用。膳食果胶对健康的影响因植物来源、膳食剂量和果胶结构而异。本范围综述的目的是全面概述目前在人体中进行的干预研究的现有证据,并更好地了解在不同健康相关效应的结构-功能关系方面可能存在的知识差距。我们采用 PRISMA-ScR 指南对 PubMed 和 Embase 数据库进行了检索,从最初的 3704 篇参考文献中筛选出 141 篇,代表了 1961 年至 2022 年期间进行的 134 项符合纳入标准的干预研究。研究分为六类,包括肠道健康、血糖反应和食欲、脂肪代谢、微量营养素的生物利用率、免疫反应和其他主题。对这些人体干预研究的审查确定了各种队列特征和人群(生命阶段、健康状况、国家)、果胶来源/类型(即柑橘、甜菜、苹果、其他和未定义的果胶)、干预时间范围(从一次摄入到 168 天)和剂量(0.1-50 克/天),这些研究对人体健康结果进行了测试。肠道健康、餐后血糖调节和血液胆固醇的维持是研究结果的最大类别。有必要开展进一步研究,以加强果胶与健康特性和相关结果之间的结构-功能关系,更精确地描述酯化程度、重量、分支程度、粘度、凝胶形成和溶解度等理化特性和分子组成将对研究大有裨益。
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引用次数: 0
Selenium supplementation in chronic kidney disease patients undergoing haemodialysis: a systematic review of the effects on plasma selenium, antioxidant and inflammatory markers, immunological parameters and thyroid hormones. 接受血液透析的慢性肾病患者补硒:对血浆硒、抗氧化和炎症标志物、免疫学参数和甲状腺激素影响的系统综述。
IF 5.1 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-09-25 DOI: 10.1017/S0954422424000222
Pricilla de C Trigueira, Viviane de O Leal, Barbara R Cardoso, Denise Mafra, Marina C Araujo, Milena B Stockler-Pinto

Selenium (Se) is a mineral with several biological functions, and studies have shown that its deficiency can be linked to many complications in patients with chronic kidney disease (CKD). This study aims to systematically review the effects of Se supplementation in patients with CKD undergoing haemodialysis (HD). This systematic review was carried out according to the PRISMA statement. Clinical trials were searched in PubMed, Lilacs, Embase, Scopus and Cochrane Library databases from inception to July 2021 and updated in July 2024. The protocol was registered on PROSPERO (CRD42021231444). Two independent reviewers performed the study screening and data extraction, and the risk of bias was evaluated using the Cochrane Collaboration tool. Thirteen studies were included in this review. Only nine studies showed results on Se levels; in all, reduced Se levels were observed before supplementation. A positive effect of supplementation on plasma Se level was demonstrated. Of the ten studies analysed, six demonstrated positive effects on antioxidant and inflammatory markers. Only one study analysed immunological parameters, showing a positive impact. From two studies that analysed thyroid hormones, only one showed positive results. All studies were classified as high risk of bias. The findings suggest that Se supplementation significantly increases plasma Se levels in these patients; however, there are still not enough studies to clarify the effects of Se supplementation on the antioxidant and inflammatory markers, immune system and thyroid hormones. Further studies are needed to elucidate the effects of Se supplementation and to provide a recommendation for patients with CKD undergoing HD.

硒(Se)是一种具有多种生物功能的矿物质,研究表明,慢性肾脏病(CKD)患者缺乏硒与多种并发症有关。本研究旨在对接受血液透析(HD)的慢性肾脏病患者补充硒的效果进行系统回顾。本系统性综述根据 PRISMA 声明进行。在 PubMed、Lilacs、Embase、Scopus 和 Cochrane Library 数据库中检索了从开始到 2021 年 7 月的临床试验,并在 2024 年 7 月进行了更新。研究方案已在 PROSPERO(CRD42021231444)上注册。两名独立审稿人进行了研究筛选和数据提取,并使用 Cochrane 协作工具评估了偏倚风险。本综述共纳入 13 项研究。只有 9 项研究显示了 Se 水平的结果;在所有这些研究中,都观察到了补充前 Se 水平的降低。补充剂对血浆中的 Se 含量有积极影响。在分析的 10 项研究中,有 6 项研究显示了对抗氧化和炎症指标的积极影响。只有一项研究分析了免疫学参数,显示出积极影响。在对甲状腺激素进行分析的两项研究中,只有一项研究显示了积极效果。所有研究均被归类为高偏倚风险研究。研究结果表明,补充 Se 能显著提高这些患者的血浆 Se 水平;然而,目前仍没有足够的研究来阐明补充 Se 对抗氧化和炎症指标、免疫系统和甲状腺激素的影响。还需要进一步的研究来阐明补充 Se 的效果,并为接受 HD 治疗的慢性肾脏病患者提供建议。
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引用次数: 0
The influence of zinc levels on osteoarthritis: A comprehensive review. 锌水平对骨关节炎的影响:综述。
IF 5.1 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-09-23 DOI: 10.1017/S0954422424000234
İbrahim Tekeoğlu, Muhammed Zahid Şahin, Ayhan Kamanlı, Kemal Nas

Osteoarthritis (OA), a disease with a multifactorial aetiology and an enigmatic root cause, affects the quality of life of many elderly patients. Even though there are certain medications utilised to reduce the symptomatic effects, a reliable treatment method to reverse the disease is yet to be discovered. Zinc is a cofactor of over 3000 proteins and is the only metal found in all six classes of enzymes. We explored zinc’s effect on the immune system and the bones as OA affects both. We also discussed zinc-dependent enzymes, highlighting their significant role in the disease’s pathogenesis. It is important to note that both excessive and deficient zinc levels can negatively affect bone health and immune function, thereby exacerbating OA. The purpose of this review is to offer a better understanding of zinc’s impact on OA pathogenesis and to provide clarity regarding its beneficial and detrimental outcomes. We searched thoroughly systematic reviews, meta-analysis, review articles, research articles and randomised controlled trials to ensure a comprehensive review. In brief, using zinc supplementation in the treatment of OA may act as a doubled-edged sword, offering potential benefits but also posing risks.

骨关节炎(OA)是一种病因复杂、根源不明的疾病,影响着许多老年患者的生活质量。尽管有一些药物可减轻症状,但仍未找到一种可靠的治疗方法来逆转这种疾病。锌是 3000 多种蛋白质的辅助因子,也是唯一一种在所有六类酶中都能找到的金属。我们探讨了锌对免疫系统和骨骼的影响,因为 OA 对这两方面都有影响。我们还讨论了依赖锌的酶,强调了它们在疾病发病机制中的重要作用。值得注意的是,锌水平过高和过低都会对骨骼健康和免疫功能产生负面影响,从而加剧 OA。本综述的目的是更好地了解锌对 OA 发病机制的影响,并明确其有益和有害的结果。我们全面检索了系统综述、荟萃分析、综述文章、研究文章和随机对照试验,以确保综述的全面性。简而言之,使用锌补充剂治疗 OA 可能是一把双刃剑,既能带来潜在的益处,也会带来风险。
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引用次数: 0
What is the dietary intake and nutritional status of defence members: a systematic literature review 国防人员的膳食摄入量和营养状况如何:系统文献综述
IF 5.7 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-09-16 DOI: 10.1017/s0954422424000143
Jessica Bayes, Emily Burch, Romy Lauche, Jon Wardle
Optimal diet and nutrition is vital for military readiness, performance and recovery. Previous research on military diets has primarily focused on the nutritional composition of field/combat rations and dietary intake during deployment. There is accumulating research exploring the usual free-living dietary intake and nutritional status of defence members in garrison (i.e. military bases on which personnel are stationed). However, no comprehensive review has been conducted to assess the overall dietary quality of defence members internationally. Therefore, this review assessed the diets of military populations against national nutritional guidelines and Military Dietary Reference Intakes (MDRI). A systematic literature review of original research was conducted. CINAHL, Medline (EBSCO), Scopus (Elsevier), PubMed and AMED databases were searched up to the 20/02/2023. A total of thirty-six studies met the inclusion criteria. The overall quality of included studies was high, with a low risk of bias. The diet quality scores indicate poor to fair diet quality among defence members. Defence members display low intakes of fruits, vegetables, wholegrains, seafood, plant protein and nuts and high intakes of added sugars, trans fat and processed meat. Results also indicated suboptimal intake of fibre, essential fatty acids, vitamin A, vitamin E, folate, Mg, Zn and iodine. This may lead to reduced performance, increased risk of chronic diseases and mental health disorders. More research is needed to assess the long-term consequences of poor diet quality in defence members. These results require the attention of policymakers to ensure that military education and food environment is supportive of healthy eating.
最佳饮食和营养对军队的战备、表现和恢复至关重要。以往对军事饮食的研究主要集中在野战/战斗口粮的营养成分和部署期间的饮食摄入量。对驻军(即人员驻扎的军事基地)国防人员平时自由生活饮食摄入量和营养状况的探索研究也在不断积累。然而,目前还没有对国际上国防人员的整体饮食质量进行全面评估。因此,本综述根据国家营养指南和军用膳食参考摄入量 (MDRI) 对军人的膳食进行了评估。对原始研究进行了系统的文献综述。检索了截至 2023 年 2 月 20 日的 CINAHL、Medline (EBSCO)、Scopus (Elsevier)、PubMed 和 AMED 数据库。共有 36 项研究符合纳入标准。纳入研究的总体质量较高,偏倚风险较低。膳食质量评分表明,国防军成员的膳食质量从较差到一般不等。国防军成员的水果、蔬菜、全谷物、海鲜、植物蛋白和坚果摄入量较低,而添加糖、反式脂肪和加工肉类的摄入量较高。结果还表明,纤维、必需脂肪酸、维生素 A、维生素 E、叶酸、镁、锌和碘的摄入量不足。这可能会导致学习成绩下降、慢性疾病和精神疾病风险增加。需要进行更多的研究,以评估不良饮食质量对国防人员造成的长期后果。这些结果需要决策者的关注,以确保军事教育和饮食环境有利于健康饮食。
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引用次数: 0
Ceramides as the molecular link between impaired lipid metabolism, saturated fatty acid intake and insulin resistance: are all saturated fatty acids to be blamed for ceramide-mediated lipotoxicity? 神经酰胺是脂质代谢受损、饱和脂肪酸摄入量和胰岛素抵抗之间的分子联系:神经酰胺介导的脂肪毒性是否应归咎于所有饱和脂肪酸?
IF 5.7 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-09-12 DOI: 10.1017/s0954422424000179
Domenico Sergi, Enrico Zauli, Claudio Celeghini, Maurizio Previati, Giorgio Zauli
Type 2 diabetes mellitus (T2DM) is a metabolic disorder that has reached epidemic proportions worldwide, posing a huge treat on people’s health and quality of life. From a pathogenetic prospective, T2DM is driven by insulin resistance defined as a blunted response of tissues to insulin which leads to chronic hyperglycaemia. Mechanistically, lipotoxicity and particularly the intracellular accumulation of ceramides in the skeletal muscle and the liver, is a primary metabolic aberration underpinning insulin resistance. Indeed, intracellular ceramide accumulation can hamper insulin signal transduction pathway thereby promoting insulin resistance. This review will provide an updated overview of the metabolic defects underlaying ceramide buildup and the molecular mechanism by which ceramides imping upon insulin signalling. Additionally, the role of specific ceramide subspecies as potential biomarkers for T2DM and the role of both long- and medium-chain saturated fatty acids as a modulator of ceramide metabolism will be discussed.
2 型糖尿病(T2DM)是一种代谢紊乱疾病,在全球范围内已达到流行病的程度,对人们的健康和生活质量造成了巨大的影响。从病理角度看,T2DM 是由胰岛素抵抗驱动的,胰岛素抵抗被定义为组织对胰岛素的反应迟钝,从而导致慢性高血糖。从机理上讲,脂肪毒性,尤其是骨骼肌和肝脏中神经酰胺的细胞内蓄积,是胰岛素抵抗的主要代谢畸变基础。事实上,细胞内神经酰胺的积累会阻碍胰岛素信号转导途径,从而促进胰岛素抵抗。本综述将概述神经酰胺积累所导致的代谢缺陷,以及神经酰胺影响胰岛素信号传导的分子机制。此外,还将讨论特定神经酰胺亚种作为 T2DM 潜在生物标志物的作用,以及长链和中链饱和脂肪酸作为神经酰胺代谢调节剂的作用。
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引用次数: 0
The use of sentiment and emotion analysis and data science to assess the language of nutrition-, food- and cooking-related content on social media: a systematic scoping review. 使用情感和情绪分析以及数据科学评估社交媒体上与营养、食品和烹饪相关的内容语言:系统性范围审查。
IF 5.7 2区 医学 Q1 Nursing Pub Date : 2024-06-01 Epub Date: 2023-03-30 DOI: 10.1017/S0954422423000069
Annika Molenaar, Eva L Jenkins, Linda Brennan, Dickson Lukose, Tracy A McCaffrey

Social media data are rapidly evolving and accessible, which presents opportunities for research. Data science techniques, such as sentiment or emotion analysis which analyse textual emotion, provide an opportunity to gather insight from social media. This paper describes a systematic scoping review of interdisciplinary evidence to explore how sentiment or emotion analysis methods alongside other data science methods have been used to examine nutrition, food and cooking social media content. A PRISMA search strategy was used to search nine electronic databases in November 2020 and January 2022. Of 7325 studies identified, thirty-six studies were selected from seventeen countries, and content was analysed thematically and summarised in an evidence table. Studies were published between 2014 and 2022 and used data from seven different social media platforms (Twitter, YouTube, Instagram, Reddit, Pinterest, Sina Weibo and mixed platforms). Five themes of research were identified: dietary patterns, cooking and recipes, diet and health, public health and nutrition and food in general. Papers developed a sentiment or emotion analysis tool or used available open-source tools. Accuracy to predict sentiment ranged from 33·33% (open-source engine) to 98·53% (engine developed for the study). The average proportion of sentiment was 38·8% positive, 46·6% neutral and 28·0% negative. Additional data science techniques used included topic modelling and network analysis. Future research requires optimising data extraction processes from social media platforms, the use of interdisciplinary teams to develop suitable and accurate methods for the subject and the use of complementary methods to gather deeper insights into these complex data.

社交媒体数据发展迅速且易于获取,这为研究提供了机会。情感或情绪分析等分析文本情感的数据科学技术为从社交媒体中收集洞察力提供了机会。本文对跨学科证据进行了系统的范围界定,以探讨如何将情感或情绪分析方法与其他数据科学方法一起用于研究营养、食品和烹饪社交媒体内容。在 2020 年 11 月至 2022 年 1 月期间,采用 PRISMA 检索策略对九个电子数据库进行了检索。在已确定的 7325 项研究中,从 17 个国家选出了 36 项研究,对研究内容进行了专题分析,并在证据表中进行了总结。研究发表于 2014 年至 2022 年,使用了来自七个不同社交媒体平台(Twitter、YouTube、Instagram、Reddit、Pinterest、新浪微博和混合平台)的数据。研究确定了五个主题:饮食模式、烹饪与食谱、饮食与健康、公共卫生与营养以及一般食品。论文开发了情感或情绪分析工具,或使用了可用的开源工具。预测情感的准确率从 33-33%(开源引擎)到 98-53%(为本研究开发的引擎)不等。情感的平均比例为正面 38-8%,中性 46-6%,负面 28-0%。使用的其他数据科学技术包括主题建模和网络分析。未来的研究需要优化社交媒体平台的数据提取流程,使用跨学科团队开发适合该主题的准确方法,并使用补充方法收集对这些复杂数据的更深入见解。
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引用次数: 0
Scientific evidence of foods that improve the lifespan and healthspan of different organisms. 有科学证据表明,食物能改善不同生物的寿命和健康状况。
IF 5.7 2区 医学 Q1 Nursing Pub Date : 2024-06-01 Epub Date: 2023-07-20 DOI: 10.1017/S0954422423000136
So-Hyun Park, Da-Hye Lee, Dae-Hee Lee, Chang Hwa Jung

Age is a risk factor for numerous diseases. Although the development of modern medicine has greatly extended the human lifespan, the duration of relatively healthy old age, or 'healthspan', has not increased. Targeting the detrimental processes that can occur before the onset of age-related diseases can greatly improve health and lifespan. Healthspan is significantly affected by what, when and how much one eats. Dietary restriction, including calorie restriction, fasting or fasting-mimicking diets, to extend both lifespan and healthspan has recently attracted much attention. However, direct scientific evidence that consuming specific foods extends the lifespan and healthspan seems lacking. Here, we synthesized the results of recent studies on the lifespan and healthspan extension properties of foods and their phytochemicals in various organisms to confirm how far the scientific research on the effect of food on the lifespan has reached.

年龄是许多疾病的风险因素。虽然现代医学的发展大大延长了人类的寿命,但相对健康的老年期(或称 "健康期")并没有延长。针对老年相关疾病发病前可能出现的有害过程,可以大大改善健康和寿命。一个人吃什么、什么时候吃和吃多少对健康寿命有很大影响。通过限制饮食(包括限制卡路里摄入量、禁食或模拟禁食)来延长寿命和健康期限的做法近来备受关注。然而,似乎还缺乏直接的科学证据证明食用特定的食物可以延长寿命和延长健康寿命。在此,我们综合了近年来关于食物及其植物化学物质在不同生物体中延长寿命和健康寿命特性的研究结果,以证实食物对寿命影响的科学研究已达到何种程度。
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引用次数: 0
Culinary medicine and healthy ageing: a comprehensive review. 烹饪医学与健康老龄化:全面回顾。
IF 5.7 2区 医学 Q1 Nursing Pub Date : 2024-06-01 Epub Date: 2023-08-22 DOI: 10.1017/S0954422423000148
Jara Domper, Lucía Gayoso, Leticia Goni, Victor de la O, Usune Etxeberria, Miguel Ruiz-Canela

Culinary medicine (CM) represents a novel strategy to promote healthy ageing, as it improves adherence to healthy dietary patterns by providing nutritional education and training in cooking skills. We conducted a comprehensive review of the current scientific literature (2011-2022) concerning CM programmes implemented among participants over the age of 40. This review includes fourteen culinary-nutritional interventions. Each CM programme was analysed according to seven variables: health goal, study design, theoretical basis of the intervention, intervention duration, main outcomes, culinary intervention and the effectiveness of intervention. Although CM programmes showed low effectiveness in achieving positive results on psychosocial outcomes, they were successful in improving dietary intake and health-related outcomes. The interventions lasting for at least 5 months and employing study designs with two or more groups seemed to be important factors associated with achieving significant results. Significant results were observed regardless of the prevention phase defined as the health objective of the CM programme. The use of theoretical frameworks as an educational resource did not influence the effectiveness of the interventions. Other variables such as the inclusion of culinary outcomes, the optimisation of the culinary curriculum taught to the participants and the participation of a chef in the intervention are factors that should be taken into account. In addition, several educational components (cooking classes, hands-on cooking, free food delivery, individualized counselling) were promising for achieving health outcomes in ageing people. Our review has shown that CM programmes can be a powerful tool to improve the health status of ageing people.

烹饪医学(Culinary Medicine,CM)是促进健康老龄化的一种新策略,因为它通过提供营养教育和烹饪技能培训,提高了对健康饮食模式的坚持。我们对目前有关针对 40 岁以上参与者实施的烹饪医学计划的科学文献(2011-2022 年)进行了全面回顾。该综述包括 14 项烹饪营养干预措施。我们根据健康目标、研究设计、干预的理论基础、干预持续时间、主要结果、烹饪干预和干预效果等七个变量对每项烹饪干预计划进行了分析。虽然中餐方案在取得积极的社会心理成果方面效果不佳,但在改善饮食摄入量和健康相关成果方面却很成功。干预时间至少持续 5 个月以及采用两组或更多组的研究设计似乎是取得显著效果的重要因素。无论将预防阶段定义为 CM 计划的健康目标是什么,都能观察到显著的结果。使用理论框架作为教育资源并不影响干预措施的有效性。其他变量,如纳入烹饪成果、优化向参与者教授的烹饪课程以及厨师参与干预等,都是应该考虑的因素。此外,一些教育内容(烹饪课程、亲手烹饪、免费送餐、个性化咨询)也很有希望为老年人带来健康成果。我们的研究表明,中餐计划可以成为改善老年人健康状况的有力工具。
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引用次数: 0
Re-assessing the role of peri-operative nutritional therapy in patients with pancreatic cancer undergoing surgery: a narrative review. 术前营养治疗在癌症手术患者中的作用:叙述性综述。
IF 5.7 2区 医学 Q1 Nursing Pub Date : 2024-06-01 Epub Date: 2023-09-05 DOI: 10.1017/S0954422423000100
Zoi Bouloubasi, Dimitrios Karayiannis, Zoe Pafili, Avra Almperti, Konstantina Nikolakopoulou, Grigoris Lakiotis, George Stylianidis, Vasilios Vougas

Pancreatic cancer is the most common medical condition that requires pancreatic resection. Over the last three decades, significant improvements have been made in the conditions and procedures related to pancreatic surgery, resulting in mortality rates lower than 5%. However, it is important to note that the morbidity in pancreatic surgery remains r latively high, with a percentage range of 30-60%. Pre-operative malnutrition is considered to be an independent risk factor for post-operative complications in pancreatic surgery, such as impaired wound healing, higher infection rates, prolonged hospital stay, hospital readmission, poor prognosis, and increased morbidity and mortality. Regarding the post-operative period, it is crucial to provide the best possible management of gastrointestinal dysfunction and to handle the consequences of alterations in food digestion and nutrient absorption for those undergoing pancreatic surgery. The European Society for Clinical Nutrition and Metabolism (ESPEN) suggests that early oral feeding should be the preferred way to initiate nourishing surgical patients as it is associated with lower rates of complications. However, there is ongoing debate about the optimal post-operative feeding approach. Several studies have shown that enteral nutrition is associated with a shorter time to recovery, superior clinical outcomes and biomarkers. On the other hand, recent data suggest that nutritional goals are better achieved with parenteral feeding, either exclusively or as a supplement. The current review highlights recommendations from existing evidence, including nutritional screening and assessment and pre/post-operative nutrition support fundamentals to improve patient outcomes. Key areas for improvement and opportunities to enhance guideline implementation are also highlighted.

癌症是最常见的需要切除胰腺的疾病。在过去的三十年里,胰腺手术的相关条件和程序得到了显著改善,死亡率低于5%。然而,值得注意的是,胰腺手术的发病率仍然相对较高,其百分比范围为30-60%。术前营养不良被认为是胰腺手术术后并发症的独立风险因素,如伤口愈合受损、感染率升高、住院时间延长、再次入院、预后不良以及发病率和死亡率增加。关于术后时期,至关重要的是为接受胰腺手术的患者提供尽可能好的胃肠道功能障碍管理,并处理食物消化和营养吸收变化的后果。欧洲临床营养与代谢学会(ESPEN)建议,早期口服喂养应是启动营养手术患者的首选方式,因为这与较低的并发症发生率有关。然而,关于最佳术后喂养方法,目前仍存在争议。几项研究表明,肠内营养与较短的恢复时间、优越的临床结果和生物标志物有关。另一方面,最近的数据表明,胃肠外喂养可以更好地实现营养目标,无论是单独喂养还是作为补充。目前的综述强调了现有证据的建议,包括营养筛查和评估以及改善患者预后的术前/术后营养支持基础。还强调了需要改进的关键领域和加强准则执行的机会。
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Nutrition Research Reviews
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