WorldWideScience

Sample records for supplemental nutrition care

  1. The clinical content of preconception care: nutrition and dietary supplements.

    Science.gov (United States)

    Gardiner, Paula M; Nelson, Lauren; Shellhaas, Cynthia S; Dunlop, Anne L; Long, Richard; Andrist, Sara; Jack, Brian W

    2008-12-01

    Women of child-bearing age should achieve and maintain good nutritional status prior to conception to help minimize health risks to both mothers and infants. Many women may not be aware of the importance of preconception nutrition and supplementation or have access to nutrition information. Health care providers should be knowledgeable about preconception/pregnancy-related nutrition and take the initiative to discuss this information during preconception counseling. Women of reproductive age should be counseled to consume a well-balanced diet including fruits and vegetables, iron and calcium-rich foods, and protein-containing foods as well as 400 microg of folic acid daily. More research is critically needed on the efficacy and safety of dietary supplements and the role of obesity in birth outcomes. Preconception counseling is the perfect opportunity for the health care provider to discuss a healthy eating guideline, dietary supplement intake, and maintaining a healthy weight status.

  2. Stress, nutrition and parental care in a teleost fish: exploring mechanisms with supplemental feeding and cortisol manipulation.

    Science.gov (United States)

    Zolderdo, A J; Algera, D A; Lawrence, M J; Gilmour, K M; Fast, M D; Thuswaldner, J; Willmore, W G; Cooke, S J

    2016-04-15

    Parental care is an essential life-history component of reproduction for many animal species, and it entails a suite of behavioural and physiological investments to enhance offspring survival. These investments can incur costs to the parent, reducing their energetic and physiological condition, future reproductive capabilities and survival. In fishes, relatively few studies have focused on how these physiological costs are mediated. Male smallmouth bass provide parental care for developing offspring until the brood reaches independence. During this energetically demanding life stage, males cease active foraging as they vigorously defend their offspring. Experimental manipulation of cortisol levels (via implantation) and food (via supplemental feeding) in parental males was used to investigate the fitness consequences of parental care. Improving the nutritional condition of nest-guarding males increased their reproductive success by reducing premature nest abandonment. However, supplemental feeding and cortisol treatment had no effect on parental care behaviours. Cortisol treatment reduced plasma lymphocyte numbers, but increased neutrophil and monocyte concentrations, indicating a shift in immune function. Supplemental feeding improved the physiological condition of parental fish by reducing the accumulation of oxidative injury. Specifically, supplemental feeding reduced the formation of 8-hydroxy-2'-deoxyguanosine (8-OHdG) on DNA nucleotides. Increasing the nutritional condition of parental fish can reduce the physiological cost associated with intensive parental activity and improve overall reproductive success, illustrating the importance of nutritional condition as a key modulator of parental fitness. © 2016. Published by The Company of Biologists Ltd.

  3. Providing quality nutrition care in acute care hospitals: perspectives of nutrition care personnel.

    Science.gov (United States)

    Keller, H H; Vesnaver, E; Davidson, B; Allard, J; Laporte, M; Bernier, P; Payette, H; Jeejeebhoy, K; Duerksen, D; Gramlich, L

    2014-04-01

    Malnutrition is common in acute care hospitals worldwide and nutritional status can deteriorate during hospitalisation. The aim of the present qualitative study was to identify enablers and challenges and, specifically, the activities, processes and resources, from the perspective of nutrition care personnel, required to provide quality nutrition care. Eight hospitals participating in the Nutrition Care in Canadian Hospitals study provided focus group data (n = 8 focus groups; 91 participants; dietitians, dietetic interns, diet technicians and menu clerks), which were analysed thematically. Five themes emerged from the data: (i) developing a nutrition culture, where nutrition practice is considered important to recovery of patients and teams work together to achieve nutrition goals; (ii) using effective tools, such as screening, evidence-based protocols, quality, timely and accurate patient information, and appropriate and quality food; (iii) creating effective systems to support delivery of care, such as communications, food production and delivery; (iv) being responsive to care needs, via flexible food systems, appropriate menus and meal supplements, up to date clinical care and including patient and family in the care processes; and (v) uniting the right person with the right task, by delineating roles, training staff, providing sufficient time to undertake these important tasks and holding staff accountable for their care. The findings of the present study are consistent with other work and provide guidance towards improving the nutrition culture in hospitals. Further empirical work on how to support successful implementation of nutrition care processes is needed. © 2013 The British Dietetic Association Ltd.

  4. Weight Loss Nutritional Supplements

    Science.gov (United States)

    Eckerson, Joan M.

    Obesity has reached what may be considered epidemic proportions in the United States, not only for adults but for children. Because of the medical implications and health care costs associated with obesity, as well as the negative social and psychological impacts, many individuals turn to nonprescription nutritional weight loss supplements hoping for a quick fix, and the weight loss industry has responded by offering a variety of products that generates billions of dollars each year in sales. Most nutritional weight loss supplements are purported to work by increasing energy expenditure, modulating carbohydrate or fat metabolism, increasing satiety, inducing diuresis, or blocking fat absorption. To review the literally hundreds of nutritional weight loss supplements available on the market today is well beyond the scope of this chapter. Therefore, several of the most commonly used supplements were selected for critical review, and practical recommendations are provided based on the findings of well controlled, randomized clinical trials that examined their efficacy. In most cases, the nutritional supplements reviewed either elicited no meaningful effect or resulted in changes in body weight and composition that are similar to what occurs through a restricted diet and exercise program. Although there is some evidence to suggest that herbal forms of ephedrine, such as ma huang, combined with caffeine or caffeine and aspirin (i.e., ECA stack) is effective for inducing moderate weight loss in overweight adults, because of the recent ban on ephedra manufacturers must now use ephedra-free ingredients, such as bitter orange, which do not appear to be as effective. The dietary fiber, glucomannan, also appears to hold some promise as a possible treatment for weight loss, but other related forms of dietary fiber, including guar gum and psyllium, are ineffective.

  5. Nutritional supplements

    DEFF Research Database (Denmark)

    Petersen, Gry Bjerg; Andersen, Jens Rikardt

    2015-01-01

    Background: Several studies have indicated that cancer patients have significantly altered taste sensitivity without specifying the preferences. One of the related problems is low compliance to nutritional therapy with oral nutritional supplements (ONS) in patients suffering severe weight loss...

  6. Nutritional supplements for people being treated for active tuberculosis

    African Journals Online (AJOL)

    2018-01-17

    Jan 17, 2018 ... review assessing the effects of oral nutritional supplements in people with active tuberculosis who are receiving antituberculosis drug therapy. The review ... 2 Cochrane Nutrition, hosted jointly by the Centre for Evidence-Based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch. University ...

  7. Nutrition and Supplementation in Soccer

    Science.gov (United States)

    Oliveira, César Chaves; Ferreira, Diogo; Caetano, Carlos; Granja, Diana; Pinto, Ricardo; Mendes, Bruno; Sousa, Mónica

    2017-01-01

    Contemporary elite soccer features increased physical demands during match-play, as well as a larger number of matches per season. Now more than ever, aspects related to performance optimization are highly regarded by both players and soccer coaches. Here, nutrition takes a special role as most elite teams try to provide an adequate diet to guarantee maximum performance while ensuring a faster recovery from matches and training exertions. It is currently known that manipulation and periodization of macronutrients, as well as sound hydration practices, have the potential to interfere with training adaptation and recovery. A careful monitoring of micronutrient status is also relevant to prevent undue fatigue and immune impairment secondary to a deficiency status. Furthermore, the sensible use of evidence-based dietary supplements may also play a role in soccer performance optimization. In this sense, several nutritional recommendations have been issued. This detailed and comprehensive review addresses the most relevant and up-to-date nutritional recommendations for elite soccer players, covering from macro and micronutrients to hydration and selected supplements in different contexts (daily requirements, pre, peri and post training/match and competition). PMID:29910389

  8. Nutrition and Supplementation in Soccer.

    Science.gov (United States)

    Oliveira, César Chaves; Ferreira, Diogo; Caetano, Carlos; Granja, Diana; Pinto, Ricardo; Mendes, Bruno; Sousa, Mónica

    2017-05-12

    Contemporary elite soccer features increased physical demands during match-play, as well as a larger number of matches per season. Now more than ever, aspects related to performance optimization are highly regarded by both players and soccer coaches. Here, nutrition takes a special role as most elite teams try to provide an adequate diet to guarantee maximum performance while ensuring a faster recovery from matches and training exertions. It is currently known that manipulation and periodization of macronutrients, as well as sound hydration practices, have the potential to interfere with training adaptation and recovery. A careful monitoring of micronutrient status is also relevant to prevent undue fatigue and immune impairment secondary to a deficiency status. Furthermore, the sensible use of evidence-based dietary supplements may also play a role in soccer performance optimization. In this sense, several nutritional recommendations have been issued. This detailed and comprehensive review addresses the most relevant and up-to-date nutritional recommendations for elite soccer players, covering from macro and micronutrients to hydration and selected supplements in different contexts (daily requirements, pre, peri and post training/match and competition).

  9. [Oral nutritional supplementation in hematologic patients].

    Science.gov (United States)

    Peñalva, A; San Martín, A; Rosselló, J; Pérez-Portabella, C; Palacios, A; Julià, A; Planas, M

    2009-01-01

    Hematological patients often present anorexia which along with other secondary effects from the chemotherapy and/or radiotherapy treatments compromise their nutritional status. Oral supplementation can aid to fulfill the energy and protein requirements of these patients. Nevertheless, the use of commercial nutritional supplements normally available, is limited by its poor intake. To evaluate the degree of fulfillment of the prescribed supplements and fulfillment of energy requirements, as well as the development of nutritional status in hematological patients hospitalized for treatment with chemotherapy and/or radiotherapy. Prospective, randomized and open study of inpatients at the hematological ward. Patients were randomized sequentially and they were assigned into 3 different nutritional interventions providing: Group 1 (G1), a flavored supplement; Group 2 (G2): a non flavored (neutral) supplement and Group 3 (G3): "kitchen" foods as supplements. Need and amount of nutritional supplements were provided according to the oral intake previously analyzed. Nutritional assessment (at admission and discharge) was based in the Subjective Global Assessment test (SGA), Risk Nutritional Index (RNI) and percentage of lost weight. Both fulfillment of supplement intake and achievement of energetic requirements were analyzed. 125 patients of 51.3 +/- 16.8 years; 45% men and 55% women. 54% lymphoma, 33% leukemia, 8% myeloma and others 4%. Length of stay (LOS): 7.0 +/- 3.6 d. The nutritional assessment done by SGA showed significant negative changes in G2 and G3 (G1: 30% developed malnutrition and 28% improved their nutritional status, p = NS; G2: 50% developed malnutrition against 7% whom improved their nutritional status, p = 0.002; y G3: 37% developed malnutrition against 21% whom improved their nutritional status, p = 0.02). According to RNI, patients evolved negatively from their nutritional state but no significant differences were found within groups (G1, from 81% of

  10. Nutritional Supplements for Endurance Athletes

    Science.gov (United States)

    Rasmussen, Christopher J.

    Athletes engaged in heavy endurance training often seek additional nutritional strategies to help maximize performance. Specific nutritional supplements exist to combat certain factors that limit performance beginning with a sound everyday diet. Research has further demonstrated that safe, effective, legal supplements are in fact available for today's endurance athletes. Several of these supplements are marketed not only to aid performance but also to combat the immunosuppressive effects of intense endurance training. It is imperative for each athlete to research the legality of certain supplements for their specific sport or event. Once the legality has been established, it is often up to each individual athlete to decipher the ethics involved with ingesting nutritional supplements with the sole intent of improving performance.

  11. Glutamine Supplemented Parenteral Nutrition to Prevent Ventilator-Associated Pneumonia in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Meltem Türkay Aydoğmuş

    2012-12-01

    Full Text Available Objective: Ventilator-associated pneumonia (VAP is a form of nosocomial pneumonia that increases patient morbidity and mortality, length of hospital stay, and healthcare costs. Glutamine preserves the intestinal mucosal structure, increases immune function, and reduces harmful changes in gut permeability in patients receiving total parenteral nutrition (TPN. We hypothesized that TPN supplemented by glutamine might prevent the development of VAP in patients on mechanical ventilator support in the intensive care unit (ICU. Material and Methods: With the approval of the ethics committee and informed consent from relatives, 60 patients who were followed in the ICU with mechanical ventilator support were included in our study. Patients were divided into three groups. The first group received enteral nutrition (n=20, and the second was prescribed TPN (n=20 while the third group was given glutamine-supplemented TPN (n=20. C-reactive protein (CRP, sedimentation rate, body temperature, development of purulent secretions, increase in the amount of secretions, changes in the characteristics of secretions and an increase in requirement of deep tracheal aspiration were monitored for seven days by daily examination and radiographs. Results: No statistically significant difference was found among groups in terms of development of VAP (p=0.622. Conclusion: Although VAP developed at a lower rate in the glutamine-supplemented TPN group, no statistically significant difference was found among any of the groups. Glutamine-supplemented TPN may have no superiority over unsupplemented enteral and TPN in preventing VAP.

  12. Glutamine supplemented parenteral nutrition to prevent ventilator-associated pneumonia in the intensive care unit.

    Science.gov (United States)

    Aydoğmuş, Meltem Türkay; Tomak, Yakup; Tekin, Murat; Katı, Ismail; Hüseyinoğlu, Urfettin

    2012-12-01

    Ventilator-associated pneumonia (VAP) is a form of nosocomial pneumonia that increases patient morbidity and mortality, length of hospital stay, and healthcare costs. Glutamine preserves the intestinal mucosal structure, increases immune function, and reduces harmful changes in gut permeability in patients receiving total parenteral nutrition (TPN). We hypothesized that TPN supplemented by glutamine might prevent the development of VAP in patients on mechanical ventilator support in the intensive care unit (ICU). With the approval of the ethics committee and informed consent from relatives, 60 patients who were followed in the ICU with mechanical ventilator support were included in our study. Patients were divided into three groups. The first group received enteral nutrition (n=20), and the second was prescribed TPN (n=20) while the third group was given glutamine-supplemented TPN (n=20). C-reactive protein (CRP), sedimentation rate, body temperature, development of purulent secretions, increase in the amount of secretions, changes in the characteristics of secretions and an increase in requirement of deep tracheal aspiration were monitored for seven days by daily examination and radiographs. No statistically significant difference was found among groups in terms of development of VAP (p=0.622). Although VAP developed at a lower rate in the glutamine-supplemented TPN group, no statistically significant difference was found among any of the groups. Glutamine-supplemented TPN may have no superiority over unsupplemented enteral and TPN in preventing VAP.

  13. Supplemental parenteral nutrition in critically ill patients: a study protocol for a phase II randomised controlled trial.

    Science.gov (United States)

    Ridley, Emma J; Davies, Andrew R; Parke, Rachael; Bailey, Michael; McArthur, Colin; Gillanders, Lyn; Cooper, David J; McGuinness, Shay

    2015-12-24

    Nutrition is one of the fundamentals of care provided to critically ill adults. The volume of enteral nutrition received, however, is often much less than prescribed due to multiple functional and process issues. To deliver the prescribed volume and correct the energy deficit associated with enteral nutrition alone, parenteral nutrition can be used in combination (termed "supplemental parenteral nutrition"), but benefits of this method have not been firmly established. A multi-centre, randomised, clinical trial is currently underway to determine if prescribed energy requirements can be provided to critically ill patients by using a supplemental parenteral nutrition strategy in the critically ill. This prospective, multi-centre, randomised, stratified, parallel-group, controlled, phase II trial aims to determine whether a supplemental parenteral nutrition strategy will reliably and safely increase energy intake when compared to usual care. The study will be conducted for 100 critically ill adults with at least one organ system failure and evidence of insufficient enteral intake from six intensive care units in Australia and New Zealand. Enrolled patients will be allocated to either a supplemental parenteral nutrition strategy for 7 days post randomisation or to usual care with enteral nutrition. The primary outcome will be the average energy amount delivered from nutrition therapy over the first 7 days of the study period. Secondary outcomes include protein delivery for 7 days post randomisation; total energy and protein delivery, antibiotic use and organ failure rates (up to 28 days); duration of ventilation, length of intensive care unit and hospital stay. At both intensive care unit and hospital discharge strength and health-related quality of life assessments will be undertaken. Study participants will be followed up for health-related quality of life, resource utilisation and survival at 90 and 180 days post randomisation (unless death occurs first). This trial

  14. Nutritional supplementation for Alzheimer's disease?

    Science.gov (United States)

    Shea, Thomas B; Remington, Ruth

    2015-03-01

    Evidence for the benefit of nutrition in Alzheimer's disease continues to accumulate. Many studies with individual vitamins or supplements show marginal, if any, benefit. However, new findings with combinatorial formulations demonstrate improvement in cognitive performance and behavioral difficulties that accompany Alzheimer's disease. Herein, we review some of the most recent clinical advances and summarize supportive preclinical studies. We present novel positive effects on Alzheimer's disease derived from diet, trace elements, vitamins and supplements. We discuss the inherent difficulty in conducting nutritional studies because of the variance in participants' nutritional history, versus pharmacological interventions in which participants are naive to the intervention. We examine the evidence that epigenetics play a role in Alzheimer's disease and how nutritional intervention can modify the key epigenetic events to maintain or improve cognitive performance. Overall consideration of the most recent collective evidence suggests that the optimal approach for Alzheimer's disease would seem to combine early, multicomponent nutritional approaches (a Mediterranean-style diet, multivitamins and key combinatorial supplements), along with lifestyle modifications such as social activity and mental and physical exercise, with ultimate addition of pharmacological agents when warranted.

  15. Optimizing the electronic health record to standardize administration and documentation of nutritional supplements.

    Science.gov (United States)

    Citty, Sandra W; Kamel, Amir; Garvan, Cynthia; Marlowe, Lee; Westhoff, Lynn

    2017-01-01

    Malnutrition in hospitalized patients is a major cause for hospital re-admission, pressure ulcers and increased hospital costs. Methods to improve the administration and documentation of nutritional supplements for hospitalized patients are needed to improve patient care, outcomes and resource utilization. Staff at a medium-sized academic health science center hospital in the southeastern United States noted that nutritional supplements ordered for patients at high risk for malnutrition were not offered or administered to patients in a standardized manner and/or not documented clearly in the electronic health record as per prescription. This paper reports on a process improvement project that redesigned the ordering, administration and documentation process of oral nutritional supplements in the electronic health record. By adding nutritional products to the medication order sets and adding an electronic nutrition administration record (ENAR) tab, the multidisciplinary team sought to standardize nutritional supplement ordering, documentation and administration at prescribed intervals. This process improvement project used a triangulated approach to evaluating pre- and post-process change including: medical record reviews, patient interviews, and nutrition formula room log reports. Staff education and training was carried out prior to initiation of the system changes. This process change resulted in an average decrease in the return of unused nutritional formula from 76% returned at baseline to 54% post-process change. The process change resulted in 100% of nutritional supplement orders having documentation about nutritional medication administration and/or reason for non-administration. Documentation in the ENAR showed that 41% of ONS orders were given and 59% were not given. Significantly more patients reported being offered the ONS product (p=0.0001) after process redesign and more patients (5% before ENAR and 86% after ENAR reported being offered the correct

  16. Use of hormones and nutritional supplements among gyms' attendees in Riyadh

    Science.gov (United States)

    Alshammari, Sulaiman A.; AlShowair, Mishal A.; AlRuhaim, Abdulmalik

    2017-01-01

    BACKGROUND: Worldwide, studies have shown a high prevalence of hormones and nutritional supplement use by athletes and gym members. Many athletes consume unproven, potentially harmful or even banned supplements. OBJECTIVES: To assess the prevalence of the use of hormones and nutritional supplements by people who exercise in gyms in Riyadh, Saudi Arabia, and the types of supplements they most commonly use and to obtain a general view of the main reasons for using these enhancements. MATERIALS AND METHODS: A cross-sectional study using a self-administered questionnaire was conducted at gyms in Riyadh that were selected randomly from different sectors of the city. The sample size was estimated at 289, but the actual number of randomly selected participants in the study was 457. RESULTS: The number of gym members who participated in this study was 457. Approximately 47.9% of the sample reported an intake of nutritional supplements and 7.9% reported that they took hormones. Protein powder was consumed by 83.1% of the participants. Approximately 16.8% of supplement users had noticed some side effects, and 25.7% of those who took hormones had stopped taking them because of adverse effects. Only half of the hormone users (54.2%) reported that they had had medical checkups. The major source of information on supplement and hormone use was non-health professionals; friends being major source (40%) of information on the use of hormones. The use of nutritional supplements was significantly associated with BMI (OR = 1.89, CI = 1.06–3.39), duration of daily exercise (OR = 4.23, CI = 2.06–8.68), and following a special diet (OR = 8.42, CI = 5.37–13.2). There was a very strong association between nutritional supplement consumption and hormone use (P gyms took nutritional supplements, and most had received their information from nonhealth professionals. There was an association between the duration of exercise and the use of hormones and supplements. Fewer than half of

  17. Food and Nutrition Practices and Education Needs in Florida's Adult Family Care Homes

    Science.gov (United States)

    Dahl, Wendy J.; Ford, Amanda L.; Gal, Nancy J.

    2014-01-01

    A statewide survey was carried out to determine food and nutrition practices and education needs of Florida's adult family care homes (AFCHs). The 30-item survey included questions on food and nutrition education, supplement use, and menu planning. Infrequent use of menus and nutrition supplements was reported. A strong need was indicated for…

  18. Attitudes towards nutritional supplement use amongst adult ...

    African Journals Online (AJOL)

    Background: Nutritional supplements refer to a product ingested to increase the nutritional content of a normal diet, to fill a dietary need and/or presumed deficiency. The usage and popularity of nutritional supplements, however, raises concerns from a health benefit and risk perspective. In South Africa, there is currently no ...

  19. Nutritional Supplements for Strength Power Athletes

    Science.gov (United States)

    Wilborn, Colin

    Over the last decade research involving nutritional supplementation and sport performance has increased substantially. Strength and power athletes have specific needs to optimize their performance. Nutritional supplementation cannot be viewed as a replacement for a balanced diet but as an important addition to it. However, diet and supplementation are not mutually exclusive, nor does one depend on the other. Strength and power athletes have four general areas of supplementation needs. First, strength athletes need supplements that have a direct effect on performance. The second group of supplements includes those that promote recovery. The third group comprises the supplements that enhance immune function. The last group of supplements includes those that provide energy or have a direct effect on the workout. This chapter reviews the key supplements needed to optimize the performance and training of the strength athlete.

  20. Nutrition in Cancer Care (PDQ®)—Health Professional Version

    Science.gov (United States)

    Nutrition in cancer care can be affected by the tumor or by treatment and result in weight loss, malnutrition, anorexia, cachexia, and sarcopenia. Get information about strategies to screen, assess, and treat nutritional problems, including through diet and supplements, in this clinician summary.

  1. [When enteral nutrition is not possible in intensive care patients: whether to wait or use parenteral nutrition?

    Science.gov (United States)

    Habes, Q L M; Pickkers, P

    2016-01-01

    - Overfeeding of critically ill patients is associated with a higher incidence of infections and an increased length of ventilation. However, trophic nutrition or permissive underfeeding appears to have no negative effect on the patient and may even provide a survival benefit.- Initiation of enteral nutrition within 24-48 hours after Intensive Care Unit (ICU) admission may reduce the number of complications and increase the chance of survival.- Total parenteral nutrition is associated with a higher risk of infections than enteral nutrition. This seems to be related to the higher calorie intake with parenteral nutrition rather than the route of administration.- In previously well-nourished patients, in whom enteral nutrition is only partially successful, it is safe to wait for up to 8 days before initiating supplemental parenteral nutrition.- In critically ill children, it is also safe to start supplemental parenteral nutrition at a late (on the 8th day after admission) rather than an early stage (within 24 hours of admission). Late supplemental parenteral nutrition may even result in fewer infectious complications and shorter hospitalisation.

  2. Early goal-directed nutrition versus standard of care in adult intensive care patients

    DEFF Research Database (Denmark)

    Allingstrup, Matilde Jo; Kondrup, Jens; Wiis, Jørgen

    2017-01-01

    Purpose: We assessed the effects of early goal-directed nutrition (EGDN) vs. standard nutritional care in adult intensive care unit (ICU) patients. Methods: We randomised acutely admitted, mechanically ventilated ICU patients expected to stay longer than 3 days in the ICU. In the EGDN group we...... estimated nutritional requirements by indirect calorimetry and 24-h urinary urea aiming at covering 100% of requirements from the first full trial day using enteral and parenteral nutrition. In the standard of care group we aimed at providing 25 kcal/kg/day by enteral nutrition. If this was not met by day 7......, patients were supplemented with parenteral nutrition. The primary outcome was physical component summary (PCS) score of SF-36 at 6 months. We performed multiple imputation for data of the non-responders. Results: We randomised 203 patients and included 199 in the intention-to-treat analyses; baseline...

  3. Nutritional supplement intake knowledge among university active ...

    African Journals Online (AJOL)

    The purpose of this study is to examine the nutritional supplement intake knowledge among university athletes. Fifty-one university athletes volunteered to participate in this survey study. Results showed the nutritional supplement intake was significantly higher compared to the knowledge that they have about the ...

  4. Inadvertent doping through nutritional supplements is a reality

    African Journals Online (AJOL)

    Enrique

    In 1994 legislation was passed by the United States Food and Drug Administration ... resulting in contamination of nutritional supplements, which may be a possible ... Nutritional supplement manufacturing is not subject to the same stringent ...

  5. Use of nutritional supplements contaminated with banned doping substances by recreational adolescent athletes in Athens, Greece.

    Science.gov (United States)

    Tsarouhas, Konstantinos; Kioukia-Fougia, Nassia; Papalexis, Petros; Tsatsakis, Aristidis; Kouretas, Dimitrios; Bacopoulou, Flora; Tsitsimpikou, Christina

    2018-05-01

    Although the use of nutritional supplements by adult athletes has been extensively studied, information on supplements consumption by adolescent athletes is still limited. The present study reports on the use of nutritional supplements contaminated with banned doping substances among 170 recreational adolescent athletes from eleven, randomly selected, gym centres, in Athens, Greece. Nutritional supplements consumption was reported by almost 60% of the study population, with proteins/amino acids and vitamins being the most popular. Nine per cent of the users were found to consume nutritional supplements contaminated with anabolic steroids, prohormones, selective androgen receptor modulators (SARMs) and aromatase inhibitors, all pharmacological substances with endocrine modulating properties not stated on the label. None of these individuals had previously consulted a physician or a nutritionist. A representative sample (ca 15%) of the protein/aminoacids and creatine preparations used by the study population were also tested and found free from doping substances. The majority (63%) of adolescents purchased products from the internet. In conclusion, exercising adolescents can have easy access to contaminated nutritional supplements and "black market" products, which could constitute a risk for public health. Low level of awareness and low involvement of medical care professionals among recreational adolescent athletes is also observed. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Future Trends: Nutritional Supplements in Sports and Exercise

    Science.gov (United States)

    Spano, Marie; Antonio, Jose

    The field of sports nutrition is defined not only by dietary recommendations for various athletes, research and new supplements that are on store shelves but also by the direction of the industry itself. Consumer spending, media coverage, professional athlete endorsement of various supplements, lawsuits, regulations in governing bodies and clinical research all have an impact on the direction and growth of the sports nutrition industry. To date, no supplement has affected sports nutrition as much as creatine and the company that both funded most of the research supporting the ergogenic benefits of creatine and capitalized on such research. There is no current leader in the sports nutrition market. Instead, companies are vying among steady competition for space on store shelves and overall product sales.

  7. Key issues in nutrition. Supplementation through adulthood and old age.

    Science.gov (United States)

    Fahey, P J; Boltri, J M; Monk, J S

    1987-05-01

    A varied and balanced diet is usually adequate to meet the energy, protein, vitamin, and mineral requirements of adults and the elderly. However, some high-risk groups may require supplementation or special dietary recommendations. Some examples are persons on a weight-loss diet, alcoholics, premenopausal women, women taking oral contraceptives, postmenopausal women not taking estrogen, and patients with diminished immunity or cancer. An understanding of the nutritional needs of adult and elderly patients is vital if the primary care physician is to answer their questions and help them maintain good health through dietary adjustment or supplementation.

  8. Nutritional care of cancer patients: a survey on patients' needs and medical care in reality.

    Science.gov (United States)

    Maschke, J; Kruk, U; Kastrati, K; Kleeberg, J; Buchholz, D; Erickson, N; Huebner, J

    2017-02-01

    Cancer patients represent a patient group with a wide-range of nutrition related problems which are often under-recognized and undertreated. In order to assess the status quo of nutritional care in Germany, we conducted a survey among patients with different types of cancer. A standardized questionnaire was distributed online by two national umbrella organizations for self-help groups. 1335 participants completed the questionnaire. 69 % of the participants reported having received information on nutrition and/or specific nutrition-related symptoms. Most often this information was derived from print media (68.5 %) or from within self-help groups (58.7 %). 57.0 % of participants reported having had questions concerning nutrition and/or problems with food intake. most frequently named topics of interest were "healthy diet" (35.0 %) weakness/fatigue (24.3 %), dietary supplements (21.3 %) and taste changes (19.8 %). Nutrition information was most often provided by dietitians (38.7 %) followed by physicians (9.8 %). Women reported receiving nutrition counseling in the hospital nearly twice as often as men (12.5 % versus 5.7 %; p nutrition information more often reported using supplements (p Nutrition is an essential element in cancer care and patients report a high interest and need: Yet, many patients do not have access to high quality nutrition therapy during and after cancer therapy. With respect to survival and quality of life, increasing the availability and resources for provision of evidence based nutrition information seems mandatory.

  9. The Palatability of Cereal Based Nutritional Supplements in Cancer Patients

    Science.gov (United States)

    Baik, Hyun Wook; Lee, Yu Sun; Song, Min-Kyung

    2014-01-01

    Recently, it is reported that intervention of oral nutritional supplement improves the nutritional status of cancer patients, and the effectiveness is affected by the sensory preference of cancer patients on the oral nutritional supplement. However, the variety of oral nutritional supplement is extremely limited and the number of patient's benefits from using the products are restricted mostly due to sensory dislikes. The objective of this study was to provide sensory preference score of trial manufactured products with different accessory ingredients to maximize the use of oral nutritional supplements. Cancer patients (n = 30) and age, sex-matched healthy volunteers (n = 30) participated in the sensory assessments (taste, flavor, viscosity, color and overall preference) of three types of oral supplements (cereal base, cereal base+herb and cereal base+fruit) and a control supplement product with scorched cereal flavor, a top seller in current Korean market. Results indicate that the cancer patients' overall preference was significantly higher for the control supplement, and fruit added supplement was preferred over plain cereal and herb added products, although the difference was insignificant. However, there was no significant preference difference for the supplements among the control group for all sensory factors. These results suggest that cancer patients are more sensitive to sensory preferences compared to the control group, and the patients prefer the flavor of cooked cereal which is a staple food in Korea. PMID:24527420

  10. Association between oral nutritional supplementation and clinical outcomes among patients with ESRD.

    Science.gov (United States)

    Cheu, Christine; Pearson, Jeffrey; Dahlerus, Claudia; Lantz, Brett; Chowdhury, Tania; Sauer, Peter F; Farrell, Robert E; Port, Friedrich K; Ramirez, Sylvia P B

    2013-01-01

    Oral nutritional supplementation (ONS) was provided to ESRD patients with hypoalbuminemia as part of Fresenius Medical Care Health Plan's (FMCHP) disease management. This study evaluated the association between FMCHP's ONS program and clinical outcomes. Analyses included FMCHP patients with ONS indication (n=470) defined as 2-month mean albumin management setting.

  11. Consumption of nutritional supplements among adolescents: usage and perceived benefits.

    Science.gov (United States)

    O'Dea, Jennifer A

    2003-02-01

    The aim of the study was to obtain rich qualitative data about the type of nutritional supplements and drinks consumed by adolescents, and the reasons for their consumption, with particular emphasis on the perceived benefits of nutritional supplementation. Semi-structured focus group interviews (n = 16) were conducted among 78 adolescents aged 11-18 years from a co-educational government high school. Participants reported consuming sports drinks, vitamin and mineral supplements, energy drinks, herbal supplements, guarana, creatine, high protein milk supplements, and coenzyme Q10. Reasons for supplement use included perceived short-term health benefits, prevention of illness, improved immunity, parental supply of supplements, taste, energy boost, better sports performance and to rectify a poor diet. Results suggest that some adolescents consume nutritional supplements, sports drinks and energy drinks for their perceived physiological benefits, and that they may not be aware of any potential risks. Health educators should be aware that adolescents seek specific health benefits from nutritional supplements and drinks, which may be better achieved through appropriate consumption of a nutritious diet. Health education programmes should incorporate the perceptions, aspirations and motivations of young people into the planning of interventions and activities in order to make them most relevant and effective.

  12. Assessment of Nutritional Status in Children With Cancer and Effectiveness of Oral Nutritional Supplements.

    Science.gov (United States)

    Gürlek Gökçebay, Dilek; Emir, Suna; Bayhan, Turan; Demir, Hacı Ahmet; Gunduz, Mehmet; Tunc, Bahattin

    2015-01-01

    Malnutrition is a common consequence of cancer in children, but the most effective methods of nutrition intervention are under debate. We aimed to evaluate the nutritional status of children diagnosed with cancer, and to investigate the effect of oral nutritional supplements on anthropometric measurements, biochemical parameters, and outcome. A randomized clinical study of 45 newly diagnosed cancer patients was performed. Anthropometric and biochemical data and related factors were assessed at 0, 3, and 6 months after diagnosis. On initial anthropometric assessment, prevalence of malnutrition by weight or height was found to be lower as compared with body mass index (BMI), or weight for height (WFH), or arm anthropometry. Twenty-six of the patients (55%) received oral nutritional supplement. During the second 3 months after diagnosis, there was a statistically significant decrease in number of the patients with WFH Nutritional intervention is necessary to promote normal development and increase functional status as a child receives intensive treatment. Protein- and energy-dense oral nutritional supplements are effective for preventing weight loss in malnourished children.

  13. Nutritional supplementation increases Rifampin exposure among tuberculosis patients coinfected with HIV

    DEFF Research Database (Denmark)

    Jeremiah, Kidola; Denti, Paolo; Chigutsa, Emmanuel

    2014-01-01

    Nutritional supplementation to tuberculosis (TB) patients has been associated with increased weight and reduced mortality, but its effect on the pharmacokinetics of first-line anti-TB drugs is unknown. A cohort of 100 TB patients (58 men; median age, 35 [interquartile range {IQR}, 29 to 40] years......, and median body mass index [BMI], 18.8 [17.3 to 19.9] kg/m(2)) were randomized to receive nutritional supplementation during the intensive phase of TB treatment. Rifampin plasma concentrations were determined after 1 week and 2 months of treatment. The effects of nutritional supplementation, HIV, time...... on nutritional supplementation achieved higher Cmax and AUC0-24 values of 6.4 μg/ml and 31.6 μg · h/ml, respectively, and only 13.3% bioavailability reduction. No effect of the SLCO1B1 rs4149032 genotype was observed. In conclusion, nutritional supplementation during the first 2 months of TB treatment reduces...

  14. Evaluation of supplemental nutrition in elderly orthopaedic patients.

    OpenAIRE

    Driver, Lynn.

    1994-01-01

    A degree of malnutrition is evident in many elderly patients on admission to hospital. The increased metabolic demands of surgery, and low food intake during the post operative period, can cause a further deterioration in nutritional status, with adverse effects on clinical outcome. Sip feed supplements offer a simple and inexpensive method of providing nutrition support. 'The present study has evaluated the efficacy of, and compliance to, sip feed supplements in elderly patients undergoing e...

  15. Nutritional supplement for control of diabetes

    Directory of Open Access Journals (Sweden)

    Vladimir Vsevolodovich Sadovoy

    2017-06-01

    Full Text Available Analysis of diabetic patients’ dietary habits indicate that there is an imbalance of selected vitamins and minerals. A nutrient supplement composition; intended for prophylactic administration, was developed to correct this imbalance. It was composed of dried eggs and yeast component (60%, vitamin В1 (0.02% and nicotinamide (0.04%, chromium chelate (0.02%, “selen-active” (0.02% and lecithin (39.9%. The dried eggs and yeast component was prepared by homogenization of lysozyme rich chicken eggs and yeast followed by storage and drying at a pre-defined temperature and to a set water content respectively. The nutritional supplement was incorporated at 5% concentration into a cooked sausage recipe. An assessment of the safety and efficacy of the prophylactic nutritional supplement was performed in an alloxan induced diabetic rat model. The developed composition, as a part of feedstuff, improved metabolic processes, increased antioxidant activity, reduced lipid peroxidation, decreased blood cholesterol, and improved the carbohydrate metabolism.

  16. Enhanced Nutrition Education Instead of Consuming Supplements

    Science.gov (United States)

    Crowder, Todd; Kidd, Kellie; Jensen, Nancy; Jensen, Laura

    2008-01-01

    Fueled by the internet, instantaneous videos, and the emphasis to look "right" or always win athletic competitions, many students are seeking information on nutrition and dietary supplements. Classroom observations reveal student interest and discussions are among the highest when the topic is dietary supplements. Teachers and coaches provide an…

  17. Intake of Nutritional Supplements among People Exercising in Gyms in Beirut City

    Science.gov (United States)

    El Khoury, D.; Antoine-Jonville, S.

    2012-01-01

    The use of nutritional supplements among exercisers in gyms has been never investigated in the Middle East. The aim of the current study was to assess the prevalence intake of nutritional supplements and the potential influencing factors among people exercising in gyms in Beirut city. In this cross-sectional study, 512 exercisers, aged between 20 and 50 years, were randomly selected from gyms. The intake of nutritional supplements was reported among 36.3% (95% confidence interval 32.2–40.5) of participants, with a weak presence of medical supervision. Patterns of supplement use differed by gender and age. Men and younger exercisers were found to focus on supplements associated with performance enhancement and muscle building, while women and older exercisers were more concerned with health-promoting products such as vitamins, minerals, and herbal supplements. An appropriate dissemination of accurate and scientifically sound information regarding the benefits and side effects of nutritional supplements is highly recommended in the sports environment in Beirut city. PMID:22506105

  18. Intake of Nutritional Supplements among People Exercising in Gyms in Beirut City.

    Science.gov (United States)

    El Khoury, D; Antoine-Jonville, S

    2012-01-01

    The use of nutritional supplements among exercisers in gyms has been never investigated in the Middle East. The aim of the current study was to assess the prevalence intake of nutritional supplements and the potential influencing factors among people exercising in gyms in Beirut city. In this cross-sectional study, 512 exercisers, aged between 20 and 50 years, were randomly selected from gyms. The intake of nutritional supplements was reported among 36.3% (95% confidence interval 32.2-40.5) of participants, with a weak presence of medical supervision. Patterns of supplement use differed by gender and age. Men and younger exercisers were found to focus on supplements associated with performance enhancement and muscle building, while women and older exercisers were more concerned with health-promoting products such as vitamins, minerals, and herbal supplements. An appropriate dissemination of accurate and scientifically sound information regarding the benefits and side effects of nutritional supplements is highly recommended in the sports environment in Beirut city.

  19. Effectiveness of nutrition education, iron supplementation or both on iron status in children.

    Science.gov (United States)

    Kapur, D; Sharma, S; Agarwal, K N

    2003-12-01

    A community-based, randomized trial was designed to compare the effect of nutrition education and/or iron supplementation (weekly) on iron status of children in an urban slum in Delhi. Four hundred and fifty one children, 9-36 months of age and their caretakers (mothers), assigned to one of the following groups were included in the cohort. Group 1, nutrition education. Group 2, supplementation (with 20 mg elemental iron). Group 3, nutrition education with supplementation (with 20 mg elemental iron) and Group 4, control given placebo. The intervention program was of four months duration, with a treatment phase of 8 wk followed by 8 wk of no treatment. Post intervention, at 8 wk and at 16 wk, the hemoglobin change in the nutrition education, supplementation, nutrition education with supplementation and control groups was 2.9, 1.9, 3.8 and -5.9%, respectively and 2.1, -1.9, 0 and -9.3%, respectively (as compared to initial values). There was no significant effect of any of the intervention at 8 weeks. At 16 wk, there was significant positive effect of nutrition education group (p less than 0.05). The percent change in serum ferritin value at 16 wk in the nutrition education, supplementation, nutrition education with supplementation and control groups was 5.7, -2.3, -3.4 and -40%, respectively. Serum ferritin values were significantly higher for the nutrition education group (p nutrition education group mothers showed significantly higher nutrition knowledge and the dietary iron intake of children was significantly higher than their control group counterparts (p nutrition education did have a positive effect on the iron status possibly by improving the dietary iron intake.

  20. Effects of nutritional supplementation and genotype on milk ...

    African Journals Online (AJOL)

    Effects of nutritional supplementation and genotype on milk production and fertility of lactating dairy ... Bulletin of Animal Health and Production in Africa ... The objective of this study was to determine effects of nutrition on milk production and ...

  1. Nutritional supplements for people being treated for active tuberculosis: A technical summary.

    Science.gov (United States)

    Grobler, L; Durao, S; Van der Merwe, S M; Wessels, J; Naude, C E

    2017-12-13

    Tuberculosis and nutrition are intrinsically linked in a complex relationship. Altered metabolism and loss of appetite associated with tuberculosis may result in undernutrition, which in turn may worsen the disease or delay recovery. We highlight an updated Cochrane review assessing the effects of oral nutritional supplements in people with active tuberculosis who are receiving antituberculosis drug therapy. The review authors conducted a comprehensive search (February 2016) for all randomised controlled trials comparing any oral nutritional supplement, given for at least 4 weeks, with no nutritional intervention, placebo or dietary advice only in people receiving antituberculosis treatment. Of the 35 trials (N=8 283 participants) included, seven assessed the provision of free food or high-energy supplements, six assessed multi-micronutrient supplementation, and 21 assessed single- or dual-micronutrient supplementation. There is currently insufficient evidence to indicate whether routinely providing free food or high-energy supplements improves antituberculosis treatment outcomes (i.e. reduced death and increased cure rates at 6 and 12 months), but it probably improves weight gain in some settings. Plasma levels of zinc, vitamin D, vitamin E and selenium probably improve with supplementation, but currently no reliable evidence demonstrates that routine supplementation with multi-, single or dual micronutrients above the recommended daily intake has clinical benefits (i.e. reduced death, increased cure rate at 6 and 12 months, improved nutritional status) in patients receiving antituberculosis treatment. In South Africa, most provinces implement a supplementation protocol based on nutritional assessment and classification of individuals rather than on disease diagnosis or treatment status.

  2. [State of food and nutritional care in public hospitals of Ecuador].

    Science.gov (United States)

    Gallegos Espinosa, Sylvia; Nicolalde Cifuentes, Marcelo; Santana Porbén, Sergio

    2014-10-03

    The ELAN Ecuadorian Study of Hospital Malnutrition returned a malnutrition rate of 37.1% in public hospitals of Ecuador [Gallegos Espinosa S, Nicolalde Cifuentes M, Santana Porbén S; para el Grupo Ecuatoriano de Estudio de la Desnutrición Hospitalaria. State of malnutrition in hospitals of Ecuador. Nutr Hosp (España) 2014;30:425-35]. Hospital malnutrition could be the result of institutional cultural practices affecting the patient's nutritional status. To present the current state of food and nutritional care provided to patients assisted in public hospitals of Ecuador. The state of food and nutritional care provided to 5,355 patients assisted in 36 hospitals of 23 provinces of the country was documented by means of the Hospital Nutrition Survey (HNS), conducted as part of the ELAN Study. HNS recorded the completion of nutritional assessment exercises, the use of food-bymouth, fasting, use of oral nutritional supplements, and implementation and conduction of Artificial nutritional schemes (Enteral/Parenteral); respectively. Less than 0.1% of clinical charts had a diagnosis of malnutrition included in the list of the patient's health problems. Less than half of the patients had been measured and weighted on admission. Serum Albumin values and Total Lymphocytes Counts were annotated on admission in only 13.5% and 59.2% of the instances, respectively. Current weight value was registered in only 59.4% of the patients with length of stay ³ 15 days. An oral nutritional supplement was prescribed in just 3.5% of non-malnourished patients in which significant metabolic stress and/or reduced food intakes concurred. Although up to 10 different indications for use of Artificial nutrition were identified in the sample study, any of these techniques was administered to just 2.5% (median of observed percentages; range: 1.3 - 11.9%) of surveyed patients. Currently, nutritional status of hospitalized patient is not included within therapeutic goals, nutritional assessment

  3. Cost-effectiveness of food, supplement and environmental interventions to address malnutrition in residential aged care: a systematic review.

    Science.gov (United States)

    Hugo, Cherie; Isenring, Elisabeth; Miller, Michelle; Marshall, Skye

    2018-05-01

    observational studies have shown that nutritional strategies to manage malnutrition may be cost-effective in aged care; but more robust economic data is needed to support and encourage translation to practice. Therefore, the aim of this systematic review is to compare the cost-effectiveness of implementing nutrition interventions targeting malnutrition in aged care homes versus usual care. residential aged care homes. systematic literature review of studies published between January 2000 and August 2017 across 10 electronic databases. Cochrane Risk of Bias tool and GRADE were used to evaluate the quality of the studies. eight included studies (3,098 studies initially screened) reported on 11 intervention groups, evaluating the effect of modifications to dining environment (n = 1), supplements (n = 5) and food-based interventions (n = 5). Interventions had a low cost of implementation (<£2.30/resident/day) and provided clinical improvement for a range of outcomes including weight, nutritional status and dietary intake. Supplements and food-based interventions further demonstrated a low cost per quality adjusted life year or unit of physical function improvement. GRADE assessment revealed the quality of the body of evidence that introducing malnutrition interventions, whether they be environmental, supplements or food-based, are cost-effective in aged care homes was low. this review suggests supplements and food-based nutrition interventions in the aged care setting are clinically effective, have a low cost of implementation and may be cost-effective at improving clinical outcomes associated with malnutrition. More studies using well-defined frameworks for economic analysis, stronger study designs with improved quality, along with validated malnutrition measures are needed to confirm and increase confidence with these findings.

  4. Oral nutritional supplementation increases caloric and protein intake in peritoneal dialysis patients.

    Science.gov (United States)

    Boudville, Neil; Rangan, Anna; Moody, Harry

    2003-03-01

    Malnutrition is highly prevalent in peritoneal dialysis (PD) patients and is associated with a poor prognosis. Attempts to improve nutritional status with enteral supplements have yielded poor results. We performed a crossover-design trial on 13 PD patients to investigate whether these patients reduce their food intake after drinking oral nutritional supplements. Patients attended three visits in which they were administered a standard oral nutritional supplement either 2 hours or 30 minutes before lunch or a placebo drink 30 minutes before lunch. Lunch was provided as a self-select buffet-style meal, and food intake was measured. Total intake was calculated by adding the nutritional content of the oral supplement. Patients showed poor food intake, with mean values equaling only 18% of the recommended daily intake for calories and 34% for protein. Drinking the supplement 2 hours before lunch resulted in a significant increase compared with the placebo visit in total caloric (430 to 843 kcal; P lunch. These results indicate that oral nutritional supplements administered before a meal may significantly increase caloric and protein intakes of PD patients. Copyright 2003 by the National Kidney Foundation, Inc.

  5. High school athletes and nutritional supplements: a study of knowledge and use.

    Science.gov (United States)

    Massad, S J; Shier, N W; Koceja, D M; Ellis, N T

    1995-09-01

    Factors influencing nutritional supplement use by high school students were assessed. Comparisons were made between various groups of sports participants and non-sports participants. The Nutritional Supplement Use and Knowledge Scale was administered to 509 students. Mean supplement use score was 10.87 (SEM = 0.50, range 0-57). Mean knowledge score was 13.56 (SEM = 0.16, range 1-21). Significant relationships (p knowledge with use, and supplement use with gender. ANOVA found significant differences between supplement use by gender (p knowledge scores by sports category (p knowledge, supplement use, and subscores for protein, vitamins/minerals, knowledge, supplement use, and subscores for protein, vitamins/minerals, and carbohydrates were best discriminators of sport group membership. Greater knowledge about supplements was associated with less use; hence, education about supplements can be a deterrent to use. This study may help coaches, athletic trainers, athletic directors, teachers, physicians, and parents identify nutritional misconceptions held by adolescents.

  6. Protein-energy wasting and nutritional supplementation in patients with end-stage renal disease on hemodialysis.

    Science.gov (United States)

    Sabatino, A; Regolisti, G; Karupaiah, T; Sahathevan, S; Sadu Singh, B K; Khor, B H; Salhab, N; Karavetian, M; Cupisti, A; Fiaccadori, E

    2017-06-01

    Protein-Energy Wasting (PEW) is the depletion of protein/energy stores observed in the most advanced stages of Chronic Kidney Disease (CKD). PEW is highly prevalent among patients on chronic dialysis, and is associated with adverse clinical outcomes, high morbidity/mortality rates and increased healthcare costs. This narrative review was aimed at exploring the pathophysiology of PEW in end-stage renal disease (ESRD) on hemodialysis. The main aspects of nutritional status evaluation, intervention and monitoring in this clinical setting were described, as well as the current approaches for the prevention and treatment of ESRD-related PEW. An exhaustive literature search was performed, in order to identify the relevant studies describing the epidemiology, pathogenesis, nutritional intervention and outcome of PEW in ESRD on hemodialysis. The pathogenesis of PEW is multifactorial. Loss of appetite, reduced intake of nutrients and altered lean body mass anabolism/catabolism play a key role. Nutritional approach to PEW should be based on a careful and periodic assessment of nutritional status and on timely dietary counseling. When protein and energy intakes are reduced, nutritional supplementation by means of specific oral formulations administered during the hemodialysis session may be the first-step intervention, and represents a valid nutritional approach to PEW prevention and treatment since it is easy, effective and safe. Omega-3 fatty acids and fibers, now included in commercially available preparations for renal patients, could lend relevant added value to macronutrient supplementation. When oral supplementation fails, intradialytic parenteral nutrition can be implemented in selected patients. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  7. Effects of nutritional supplementation for HIV patients starting antiretroviral treatment

    DEFF Research Database (Denmark)

    Olsen, Mette Frahm; Abdissa, Alemseged; Kæstel, Pernille

    2014-01-01

    Objectives: To determine the effects of lipid based nutritional supplements with either whey or soy protein in patients with HIV during the first three months of antiretroviral treatment (ART) and to explore effects of timing by comparing supplementation at the start of ART and after three months....../µL (−2 to 53 cells/µL) were CD4. Effects of the soy containing supplement on immune recovery were not significant. The effects of the two supplements, however, were not significantly different in direct comparison. Exploratory analysis showed that relatively more lean body mass was gained by patients...... with undetectable viral load at three months. Patients receiving delayed supplementation had higher weight gain but lower gains in functional outcomes. Conclusions: Lipid based nutritional supplements improved gain of weight, lean body mass, and grip strength in patients with HIV starting ART. Supplements...

  8. Randomised trial of glutamine and selenium supplemented parenteral nutrition for critically ill patients. Protocol Version 9, 19 February 2007 known as SIGNET (Scottish Intensive care Glutamine or seleNium Evaluative Trial

    Directory of Open Access Journals (Sweden)

    Vale Luke D

    2007-09-01

    Full Text Available Abstract Background Mortality rates in the Intensive Care Unit and subsequent hospital mortality rates in the UK remain high. Infections in Intensive Care are associated with a 2–3 times increased risk of death. It is thought that under conditions of severe metabolic stress glutamine becomes "conditionally essential". Selenium is an essential trace element that has antioxidant and anti-inflammatory properties. Approximately 23% of patients in Intensive Care require parenteral nutrition and glutamine and selenium are either absent or present in low amounts. Both glutamine and selenium have the potential to influence the immune system through independent biochemical pathways. Systematic reviews suggest that supplementing parenteral nutrition in critical illness with glutamine or selenium may reduce infections and mortality. Pilot data has shown that more than 50% of participants developed infections, typically resistant organisms. We are powered to show definitively whether supplementation of PN with either glutamine or selenium is effective at reducing new infections in critically ill patients. Methods/design 2 × 2 factorial, pragmatic, multicentre, double-blind, randomised controlled trial. The trial has an enrolment target of 500 patients. Inclusion criteria include: expected to be in critical care for at least 48 hours, aged 16 years or over, patients who require parenteral nutrition and are expected to have at least half their daily nutritional requirements given by that route. Allocation is to one of four iso-caloric, iso-nitrogenous groups: glutamine, selenium, both glutamine & selenium or no additional glutamine or selenium. Trial supplementation is given for up to seven days on the Intensive Care Unit and subsequent wards if practicable. The primary outcomes are episodes of infection in the 14 days after starting trial nutrition and mortality. Secondary outcomes include antibiotic usage, length of hospital stay, quality of life and

  9. Randomised trial of glutamine and selenium supplemented parenteral nutrition for critically ill patients. Protocol Version 9, 19 February 2007 known as SIGNET (Scottish Intensive care Glutamine or seleNium Evaluative Trial).

    Science.gov (United States)

    Andrews, Peter J D; Avenell, Alison; Noble, David W; Campbell, Marion K; Battison, Claire G; Croal, Bernard L; Simpson, William G; Norrie, John; Vale, Luke D; Cook, Jonathon; de Verteuil, Robyn; Milne, Anne C

    2007-09-20

    Mortality rates in the Intensive Care Unit and subsequent hospital mortality rates in the UK remain high. Infections in Intensive Care are associated with a 2-3 times increased risk of death. It is thought that under conditions of severe metabolic stress glutamine becomes "conditionally essential". Selenium is an essential trace element that has antioxidant and anti-inflammatory properties. Approximately 23% of patients in Intensive Care require parenteral nutrition and glutamine and selenium are either absent or present in low amounts. Both glutamine and selenium have the potential to influence the immune system through independent biochemical pathways. Systematic reviews suggest that supplementing parenteral nutrition in critical illness with glutamine or selenium may reduce infections and mortality. Pilot data has shown that more than 50% of participants developed infections, typically resistant organisms. We are powered to show definitively whether supplementation of PN with either glutamine or selenium is effective at reducing new infections in critically ill patients. 2 x 2 factorial, pragmatic, multicentre, double-blind, randomised controlled trial. The trial has an enrollment target of 500 patients. Inclusion criteria include: expected to be in critical care for at least 48 hours, aged 16 years or over, patients who require parenteral nutrition and are expected to have at least half their daily nutritional requirements given by that route. Allocation is to one of four iso-caloric, iso-nitrogenous groups: glutamine, selenium, both glutamine & selenium or no additional glutamine or selenium. Trial supplementation is given for up to seven days on the Intensive Care Unit and subsequent wards if practicable. The primary outcomes are episodes of infection in the 14 days after starting trial nutrition and mortality. Secondary outcomes include antibiotic usage, length of hospital stay, quality of life and cost-effectiveness. To date more than 285 patients have been

  10. Effective Nutritional Supplement Combinations

    Science.gov (United States)

    Cooke, Matt; Cribb, Paul J.

    Few supplement combinations that are marketed to athletes are supported by scientific evidence of their effectiveness. Quite often, under the rigor of scientific investigation, the patented combination fails to provide any greater benefit than a group given the active (generic) ingredient. The focus of this chapter is supplement combinations and dosing strategies that are effective at promoting an acute physiological response that may improve/enhance exercise performance or influence chronic adaptations desired from training. In recent years, there has been a particular focus on two nutritional ergogenic aids—creatine monohydrate and protein/amino acids—in combination with specific nutrients in an effort to augment or add to their already established independent ergogenic effects. These combinations and others are discussed in this chapter.

  11. Androgen Bioassay for the Detection of Nonlabeled Androgenic Compounds in Nutritional Supplements.

    Science.gov (United States)

    Cooper, Elliot R; McGrath, Kristine C Y; Li, XiaoHong; Heather, Alison K

    2018-01-01

    Both athletes and the general population use nutritional supplements. Athletes often turn to supplements hoping that consuming the supplement will help them be more competitive and healthy, while the general population hopes to improve body image or vitality. While many supplements contain ingredients that may have useful properties, there are supplements that are contaminated with compounds that are banned for use in sport or have been deliberately adulterated to fortify a supplement with an ingredient that will produce the advertised effect. In the present study, we have used yeast cell and mammalian cell androgen bioassays to characterize the androgenic bioactivity of 112 sports supplements available from the Australian market, either over the counter or via the Internet. All 112 products did not declare an androgen on the label as an included ingredient. Our findings show that six out of 112 supplements had strong androgenic bioactivity in the yeast cell bioassay, indicating products spiked or contaminated with androgens. The mammalian cell bioassay confirmed the strong androgenic bioactivity of five out of six positive supplements. Supplement 6 was metabolized to weaker androgenic bioactivity in the mammalian cells. Further to this, Supplement 6 was positive in a yeast cell progestin bioassay. Together, these findings highlight that nutritional supplements, taken without medical supervision, could expose or predispose users to the adverse consequences of androgen abuse. The findings reinforce the need to increase awareness of the dangers of nutritional supplements and highlight the challenges that clinicians face in the fast-growing market of nutritional supplements.

  12. Intake of Nutritional Supplements among People Exercising in Gyms in Beirut City

    OpenAIRE

    El Khoury, D.; Antoine-Jonville, S.

    2012-01-01

    The use of nutritional supplements among exercisers in gyms has been never investigated in the Middle East. The aim of the current study was to assess the prevalence intake of nutritional supplements and the potential influencing factors among people exercising in gyms in Beirut city. In this cross-sectional study, 512 exercisers, aged between 20 and 50 years, were randomly selected from gyms. The intake of nutritional supplements was reported among 36.3% (95% confidence interval 32.2–40.5) o...

  13. Nutritional supplement practices of professional Ugandan athletes: a cross-sectional study.

    Science.gov (United States)

    Muwonge, Haruna; Zavuga, Robert; Kabenge, Peninnah Aligawesa; Makubuya, Timothy

    2017-01-01

    The use of nutritional supplements (NS) places athletes at great risk for inadvertent doping. Due to the paucity of data on supplement use, this study aimed to determine the proportion of Ugandan athletes using nutritional supplements and to investigate the athletes' motivation to use these supplements. A cross-sectional study was conducted in which an interviewer-administered questionnaire was used to collect data from 359 professional athletes participating in individual (boxing, cycling, athletics) and team (basketball, rugby, football, netball, and volleyball) sports. The data were categorized, and a Chi-square test was used for statistical analysis. Of the 359 athletes, 48 (13.4%) used nutritional supplements. Carbohydrate supplements, energy drinks, vitamin and mineral supplements, fish oils, and protein supplements were the most common supplements used by athletes. NS use was significantly more common among athletes who played rugby and basketball ( X 2 = 61.101, p sport for 5-10 years ( X 2 = 7.460, p = 0.024), and athletes who had attained a tertiary education ( X 2 = 33.377, p performance and health. Compared to NS use by athletes elsewhere, NS use among Ugandan athletes was low. However, determinants of athlete NS use in the current study (category of sport and duration of time spent playing the sport) are similar to those reported elsewhere.

  14. Encouraging appropriate, evidence-based use of oral nutritional supplements.

    Science.gov (United States)

    Stratton, Rebecca J; Elia, Marinos

    2010-11-01

    With the considerable cost of disease-related malnutrition to individuals and to society (estimated to be >£13×109 for the UK, 2007 prices), there is a need for effective and evidence-based ways of preventing and treating this condition. The wide range of oral nutritional supplements that may be prescribed for the dietary management of malnutrition and other conditions account for only about 1% (about £99×106, 2007 data) of the prescribing budget in England. Systematic reviews and meta-analyses consistently suggest that ready-made, multi-nutrient liquids which may be prescribed can improve energy and nutritional intake, body weight and have a variety of clinical and functional benefits in a number of patient groups. Meta-analyses have repeatedly shown that oral nutritional supplements produce significant reductions in complications (e.g. infections) and mortality, and a recent meta-analysis shows a reduction in hospital admissions (OR 0·56 (95% CI 0·41, 0·77), six randomised controlled trials). Such benefits suggest that the appropriate use of oral nutritional supplements should form an integral part of the management of malnutrition, particularly as there is currently a lack of evidence for alternative oral nutrition strategies (e.g. food fortification and counselling). As with all therapies, compliance to oral nutritional supplements needs to be maximised and the use monitored. To make sure that those at risk of malnutrition are identified and treated appropriately, there is a need to embed national and local policies into routine clinical practice. In doing so, the economic burden of this costly condition can be curtailed. As recently suggested by the National Institute for Health and Clinical Excellence, substantial cost savings could be made if screening and treatment of malnourished patients was undertaken.

  15. Review of nutritional supplements for the treatment of bipolar depression.

    Science.gov (United States)

    Rakofsky, Jeffrey J; Dunlop, Boadie W

    2014-05-01

    Many patients view psychotropics with skepticism and fear and view nutritional supplements as more consistent with their values and beliefs. The purpose of this review was to critically evaluate the evidence base for nutritional supplements in the treatment of bipolar depression (BD). A literature search for all randomized, controlled clinical trials using nutritional supplements in the treatment of BD was conducted via PubMed and Ovid MEDLINE computerized database. The studies were organized into essential nutrients/minerals, nonessential nutrients, and combinations of nutritional products. Among essential nutrients/minerals, omega-3-fatty acids (O3FAs) have the strongest evidence of efficacy for bipolar depression, although some studies failed to find positive effects from O3FAs. Weak evidence supports efficacy of vitamin C whereas no data support the usefulness of folic acid and choline. Among nonessential nutrients, cytidine is the least supported treatment. Studies of N-acetylcysteine have not resolved its efficacy in treating acute depressive episodes relative to placebo. However, one study demonstrates its potential to improve depressive symptoms over time and the other, though nonsignificant, suggests it has a prophylactic effect. Studies of inositol have been mostly negative, except for 1 study. Those that were negative were underpowered but demonstrated numerically positive effects for inositol. There is no evidence that citicholine is efficacious for uncomplicated BD depression, though it may have value for comorbid substance abuse among BD patients. Finally, combination O3FA-cytidine lacks evidence of efficacy. The findings of this review do not support the routine use of nutritional supplements in the treatment or prophylaxis of BD depression. Studies with more rigorous designs are required before definitive conclusions can be made. Despite the inadequacy of the existing data, clinicians should remain open to the value of nutritional supplements: after

  16. Meat quality in pigs fed diets with gradual ractopamine supplementation and nutritional adjustments

    Directory of Open Access Journals (Sweden)

    M. Amin

    2017-12-01

    Full Text Available This study evaluated the effects that gradual ractopamine supplementation in diets with nutritional adjustments on pig meat. Were used 80 finishing crossbred barrows in a randomized block design with a 2×5 factorial arrangement (two diets: with and without nutritional adjustment; five levels of ractopamine supplementation: 5-5, 10-10, 20-20, 5-10 and 10-20 ppm in the 14 initial and 14 final study days, four replicates with two animals by experimental unit. Higher shear force values (P<0.05 were obtained using the 5-5 and 10-20 ppm ractopamine supplementation plans in the diets without nutritional adjustment. With nutritionally adjusted diets, the 5-10 ppm of ractopamine supplementation plan yielded higher shear force values (P<0.05. Water retention capacity was higher (P<0.05 for animals fed adjusted diets and 5-5 and 10-20 ppm of actopamine plans. In the 10-20 ppm of ractopamine supplementation plan, meat pH was higher (P<0.05 for diets without nutritional adjustment, whereas in the 20-20 ppm of supplementation plan, pH was higher for adjusted diets.

  17. Chemical Properties And Toxicity of Chromium(III) Nutritional Supplements

    Energy Technology Data Exchange (ETDEWEB)

    Levina, A.; Lay, P.A.

    2009-05-19

    The status of Cr(III) as an essential micronutrient for humans is currently under question. No functional Cr(III)-containing biomolecules have been definitively described as yet, and accumulated experience in the use of Cr(III) nutritional supplements (such as [Cr(pic){sub 3}], where pic = 2-pyridinecarboxylato) has shown no measurable benefits for nondiabetic people. Although the use of large doses of Cr(III) supplements may lead to improvements in glucose metabolism for type 2 diabetics, there is a growing concern over the possible genotoxicity of these compounds, particularly of [Cr(pic){sub 3}]. The current perspective discusses chemical transformations of Cr(III) nutritional supplements in biological media, with implications for both beneficial and toxic actions of Cr(III) complexes, which are likely to arise from the same biochemical mechanisms, dependent on concentrations of the reactive species. These species include: (1) partial hydrolysis products of Cr(III) nutritional supplements, which are capable of binding to biological macromolecules and altering their functions; and (2) highly reactive Cr(VI/V/IV) species and organic radicals, formed in reactions of Cr(III) with biological oxidants. Low concentrations of these species are likely to cause alterations in cell signaling (including enhancement of insulin signaling) through interactions with the active centers of regulatory enzymes in the cell membrane or in the cytoplasm, while higher concentrations are likely to produce genotoxic DNA lesions in the cell nucleus. These data suggest that the potential for genotoxic side-effects of Cr(III) complexes may outweigh their possible benefits as insulin enhancers, and that recommendations for their use as either nutritional supplements or antidiabetic drugs need to be reconsidered in light of these recent findings.

  18. Nutritional Supplementation Increases Rifampin Exposure among Tuberculosis Patients Coinfected with HIV

    Science.gov (United States)

    Denti, Paolo; Chigutsa, Emmanuel; Faurholt-Jepsen, Daniel; PrayGod, George; Range, Nyagosya; Castel, Sandra; Wiesner, Lubbe; Hagen, Christian Munch; Christiansen, Michael; Changalucha, John; McIlleron, Helen; Friis, Henrik; Andersen, Aase Bengaard

    2014-01-01

    Nutritional supplementation to tuberculosis (TB) patients has been associated with increased weight and reduced mortality, but its effect on the pharmacokinetics of first-line anti-TB drugs is unknown. A cohort of 100 TB patients (58 men; median age, 35 [interquartile range {IQR}, 29 to 40] years, and median body mass index [BMI], 18.8 [17.3 to 19.9] kg/m2) were randomized to receive nutritional supplementation during the intensive phase of TB treatment. Rifampin plasma concentrations were determined after 1 week and 2 months of treatment. The effects of nutritional supplementation, HIV, time on treatment, body weight, and SLCO1B1 rs4149032 genotype were examined using a population pharmacokinetic model. The model adjusted for body size via allometric scaling, accounted for clearance autoinduction, and detected an increase in bioavailability (+14%) for the patients in the continuation phase. HIV coinfection in patients not receiving the supplementation was found to decrease bioavailability by 21.8%, with a median maximum concentration of drug in serum (Cmax) and area under the concentration-time curve from 0 to 24 h (AUC0–24) of 5.6 μg/ml and 28.6 μg · h/ml, respectively. HIV-coinfected patients on nutritional supplementation achieved higher Cmax and AUC0–24 values of 6.4 μg/ml and 31.6 μg · h/ml, respectively, and only 13.3% bioavailability reduction. No effect of the SLCO1B1 rs4149032 genotype was observed. In conclusion, nutritional supplementation during the first 2 months of TB treatment reduces the decrease in rifampin exposure observed in HIV-coinfected patients but does not affect exposure in HIV-uninfected patients. If confirmed in other studies, the use of defined nutritional supplementation in HIV-coinfected TB patients should be considered in TB control programs. (This study has the controlled trial registration number ISRCTN 16552219.) PMID:24709267

  19. Health care costs matter: a review of nutrition economics – is there a role for nutritional support to reduce the cost of medical health care?

    Directory of Open Access Journals (Sweden)

    Naberhuis JK

    2017-08-01

    Full Text Available Jane K Naberhuis,1 Vivienne N Hunt,2 Jvawnna D Bell,3 Jamie S Partridge,3 Scott Goates,3 Mark JC Nuijten4 1Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA; 2Abbott Nutrition, Research and Development, Singapore; 3Abbott Nutrition, Research and Development, Columbus, OH, USA; 4A2M (Ars Accessus Medica, Amsterdam, The Netherlands Background and aims: As policy-makers assess the value of money spent on health care, research in the field of health economics is expanding rapidly. This review covers a period of 10 years and seeks to characterize the publication of papers at the intersection of health economics and nutrition. Methods: Relevant publications on nutrition care were identified in the medical literature databases using predetermined search criteria. These included nutritional interventions linked to health economic terms with inclusion criteria requiring original research that included clinical outcomes and cost analyses, subjects’ ages ≥18 years, and publications in English between January 2004 and October 2014. Results: Of the 5,646 publications identified in first-round searches, 274 met the specified inclusion criteria. The number of publications linking nutrition to economic outcomes has increased markedly over the 10-year period, with a growing number of studies in both developed and developing countries. Most studies were undertaken in Europe (39% and the USA and Canada (28%. The most common study setting was hospital (62% followed by community/noninstitutional care (30%. Of all the studies, 12% involved the use of oral nutritional supplements, and 13% involved parenteral nutrition. The economic outcomes consistently measured were medical care costs (53% of the studies, hospital length of stay (48%, hospital readmission rates (9%, and mortality (25%. Conclusion: The number of publications focused on the economics of nutrition interventions has increased dramatically in recent years

  20. Nutritional supplements for people being treated for active tuberculosis

    Science.gov (United States)

    Grobler, Liesl; Nagpal, Sukrti; Sudarsanam, Thambu D; Sinclair, David

    2016-01-01

    Background Tuberculosis and malnutrition are linked in a complex relationship. Tuberculosis may cause undernutrition through increased metabolic demands and decreased intake, and nutritional deficiencies may worsen the disease, or delay recovery by depressing important immune functions. At present, there is no evidence-based nutritional guidance for adults and children being treated for tuberculosis. Objectives To assess the effects of oral nutritional supplements in people being treated with antituberculous drug therapy for active tuberculosis. Search methods We searched the Cochrane Infectious Disease Group Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL; Issue 1, 2016), MEDLINE (from 1946 to 4 February 2016), EMBASE (from 1980 to 4 February 2016), LILACS (from 1982 to 4 February 2016), the metaRegister of Controlled Trials (mRCT), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), and the Indian Journal of Tuberculosis up to 4 February 2016, and checked the reference lists of all included studies. Selection criteria Randomized controlled trials that compared any oral nutritional supplement given for at least four weeks with no nutritional intervention, placebo, or dietary advice only for people being treated for active tuberculosis. The primary outcomes of interest were all-cause death, and cure at six and 12 months. Data collection and analysis Two review authors independently selected trials for inclusion, and extracted data and assessed the risk of bias in the included trials. We presented the results as risk ratios (RR) for dichotomous variables, and mean differences (MD) for continuous variables, with 95% confidence intervals (CIs). Where appropriate, we pooled data from trials with similar interventions and outcomes. We assessed the quality of the evidence using the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. Main results Thirty-five trials

  1. The impact of nutritional supplement intake on diet behavior and obesity outcomes.

    Directory of Open Access Journals (Sweden)

    Sven Anders

    Full Text Available After decades-old efforts to nudge consumers towards healthier lifestyles through dietary guidelines, diet-related diseases are on the rise. In addition, a growing share of U.S. consumers proactively chooses nutritional supplements as an alternative preventative way of maintaining good health, a $25.5 billion industry in the United States. This paper investigates possible linkages between the economics of consumer supplement choices and the relationship to important dietary and health outcomes. We use National Health and Nutrition Examination Survey (NHANES data to estimate the impact of nutritional supplements intake on respondent's body weight outcomes, controlling for diet quality.: The focus of this article is to determine whether nutritional supplements takers differ from non-takers with regard to their health outcomes when controlling for differences in diet quality, based on individual Healthy Eating Index (HEI-2010 score. The analysis applies treatment effects estimators that account for the selection bias and endogeneity of self-reported behavior and diet-health outcomes. The analysis demonstrates a negative association between supplement intake and BMI but no significant effect on an individual's diet quality. Our findings suggest that individuals proactively invest into their health by taking nutritional supplements instead of improving diet quality through more nutritious food choices. Our results provide important contributions to the literature on a key food policy issue. Knowledge of the determinants of supplement demand in the context of strong diet-health trends should also be helpful to stakeholders in the U.S. produce sector in their competition over consumer market share.

  2. Progress in the study of multivitamins and minerals nutritional supplements for troops stationed in high altitude regions

    OpenAIRE

    Yan-qiang ZHONG; Ying LU

    2013-01-01

    Nutritional supplements are products intended to supplement and improve the diet, and they contain one or more dietary ingredients (including vitamins, minerals herbs or other botanicals, amino acids, protein and other substances) or their constituents. Supplement of vitamins and trace elements play an important role in the nutritional supplements. Supplements play a direct role in health by filling the nutritional gap and preventing diseases caused by nutritional deficiencies, especially for...

  3. Key Resources for Creating Online Nutrition Education for Those Participating in Supplemental Nutrition Assistance Program Education

    Science.gov (United States)

    Stosich, Marie C.; LeBlanc, Heidi; Kudin, Janette S.; Christofferson, Debra

    2016-01-01

    Internet-based nutrition education is becoming an important tool in serving the rural, low-income community, yet the task of creating such programming can be daunting. The authors describe the key resources used in developing an Internet-based nutrition education program for those participating in Supplemental Nutrition Assistance Program…

  4. Effectiveness of nutritional supplements on cognitive functioning in elderly persons: a systematic review.

    NARCIS (Netherlands)

    Manders, M.; Groot, de C.P.G.M.; Staveren, van W.A.; Wouters-Wesseling, W.; Mulders, A.J.M.J.; Schols, J.M.G.A.; Hoefnagels, W.H.L.

    2004-01-01

    Background. The effectiveness of nutritional supplementation in improving cognitive functioning is evaluated in elderly people. Methods. The authors systematically reviewed randomized controlled trials that compared nutritional supplementation with a placebo treatment. Trials were identified from a

  5. Effectiveness of nutritional supplements on cognitive functioning in elderly persons: a systematic review.

    NARCIS (Netherlands)

    Manders, M.; Groot, L.C.P.G.M. de; Staveren, W.A. van; Wouters-Wesseling, W.; Mulders, A.; Schols, J.M.G.A.; Hoefnagels, W.H.L.

    2004-01-01

    BACKGROUND: The effectiveness of nutritional supplementation in improving cognitive functioning is evaluated in elderly people. METHODS: The authors systematically reviewed randomized controlled trials that compared nutritional supplementation with a placebo treatment. Trials were identified from a

  6. [Sensory evaluation of enteral nutritional supplements].

    Science.gov (United States)

    Granell Vidal, Lina; Sánchez Juan, Carlos; Alfonso García, Antonio

    2014-07-01

    Enteral nutrition (EN) is indicated in patients who, although they may not eat enough food, maintain a sufficient function to receive, digest and absorb nutrients digestive system. Oral Nutritional Supplements (SON) are nutritionally complete or incomplete formulas (depending on whether or not provide all the nutrients needed to serve as the sole source of nutrients), which supplement inadequate oral diet. This study aims to evaluate the organoleptic characteristics of hyperproteic, normoproteic and fiber-enriched oral SON. SON test, carried out at the Department of Endocrinology and Nutrition Consortium Hospital General Universitario de Valencia from October 2012 to February 2013. 137 SON were evaluated in total, of which 47 were hyperproteic, 46 normoproteic and 44 enriched in fiber. Of the SON evaluated in the group of hyperproteic the following 3 SON obtained the best scores: Fresenius Prot Energy Drink® (21,27, vanilla flavor), Avant Standard Nut® (20.3 , strawberry flavor) and Resource® Protein (20.01, chocolate flavor) In the group of normoproteic SON the 3 best rated were: Ensure Plus® (22.3, banana flavor), Ensure Plus® (21.9, peach flavor) and Fresubin Energy Drink® (21, strawberry flavor) In the group of fiber-enriched the 3 SON most appreciated were: 2 Kcal Fresubin Fibre Drink® (23.78, vanilla flavor), Ensure Plus® TwoCal (22.9, banana flavor) and Fortimel Compact® (21.5, strawberry flavor) The study aims to guide clinicians on what SON may be more acceptable to the patient, so that the SON serve their purpose and restore or improve nutritional status, as the SON intervention is safe and cost - effective, since they improve both the functionality and quality of life. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  7. Randomized clinical trial of arginine-supplemented enteral nutrition versus standard enteral nutrition in patients undergoing gastric cancer surgery.

    Science.gov (United States)

    Zhao, Hongyan; Zhao, Hongying; Wang, Yu; Jing, Huang; Ding, Qian; Xue, Jun

    2013-09-01

    Significant malnutrition exists in a high percentage of patients with gastric cancer. It is, therefore, crucial to establish an effective means to provide nutrition for these patients. This prospective, randomized, double-blinded clinical trial aims to assess the long-term survival of arginine-supplementation enteral nutrition versus standard enteral nutrition in malnourished patients with gastric cancer. The control group (36 cases) received postoperative standard enteral nutrition. Meanwhile, the arginine-supplementation group (37 cases) adopted the same nutrition product but enriched with arginine (9.0 g/L). The primary study objective was overall survival (OS). Secondary endpoints were progression-free survival (PFS); serum parameters including total protein, albumin, proalbumin, and transferrin obtained on preoperative day 1, postoperative day 2, and day 12; CD4(+) and CD8(+) T cells, natural killer (NK) cells, immunoglobulin M (IgM), and immunoglobulin G (IgG) obtained on preoperative day 1 and postoperative day 7. No significant differences in baseline characteristics were observed between groups. The group receiving arginine-enriched nutrition had a significantly better OS (P = 0.03, 41 vs. 30.5 months) and better PFS (P = 0.02, 18 vs. 11.5 months). On postoperative day 7, CD4(+) T cells, NK cells, IgM and IgG levels of the arginine-supplemented group increased prominently and were significantly higher than those of the control group and those on preoperative day 1. There is no significant difference in the serum total protein, albumin, proalbumin, and transferrin levels between the two arms. Arginine-supplemented enteral nutrition significantly improves long-term survival and restores immunity in malnourished gastric cancer.

  8. Stable isotope aided evaluation of Community Nutrition Program: effect of food supplementation schemes on maternal and infant nutritional status

    International Nuclear Information System (INIS)

    Sarr Cisse, Aita; Dossou, Nicole; Ndiaye, Mamadou

    2002-01-01

    The supplementation program of the community nutrition project (PNC) launched by the Senegalese Government in order to protect the most vulnerable groups (children and women) was evaluated. Using a stable isotope (deuterium), we assessed the effect of the PNC on breastmilk output, mother's body composition, and baby's growth at three months of lactation. Breastmilk triglycerides, lactose, protein, and zinc were also determined. Mothers who were supplemented more than 60 days during pregnancy showed a significant increase in fot- free mass as compared to those who were supplemented for less than 30 days (p= .03). Breastmilk output was not influenced by the supplementation, but breastmilk lactose, total protein, and zinc contents increased significantly (p < .01) in the supplemented mothers. Growth of the babies of the supplemented mothers was better than that of those whose mothers were not supplemented. It was concluded that the food supplementation had beneficial effects on both mothers' and babies' nutritional status depending on the onset of the supplementation.

  9. Compliance with preoperative oral nutritional supplements in patients at nutritional risk--only a question of will?

    Science.gov (United States)

    Grass, F; Bertrand, P C; Schäfer, M; Ballabeni, P; Cerantola, Y; Demartines, N; Hübner, M

    2015-04-01

    Preoperative nutrition has been shown to reduce morbidity after major gastrointestinal (GI) surgery in selected patients at risk. In a randomized trial performed recently (NCT00512213), almost half of the patients, however, did not consume the recommended dose of nutritional intervention. The present study aimed to identify the risk factors for noncompliance. Demographic (n = 5) and nutritional (n = 21) parameters for this retrospective analysis were obtained from a prospectively maintained database. The outcome of interest was compliance with the allocated intervention (ingestion of ⩾ 11/15 preoperative oral nutritional supplement units). Uni- and multivariate analyses of potential risk factors for noncompliance were performed. The final analysis included 141 patients with complete data sets for the purpose of the study. Fifty-nine patients (42%) were considered noncompliant. Univariate analysis identified low C-reactive protein levels (P = 0.015), decreased recent food intake (P = 0.032) and, as a trend, low hemoglobin (P = 0.065) and low pre-albumin (P = 0.056) levels as risk factors for decreased compliance. However, none of them was retained as an independent risk factor after multivariate analysis. Interestingly, 17 potential explanatory parameters, such as upper GI cancer, weight loss, reduced appetite or co-morbidities, did not show any significant correlation with reduced intake of nutritional supplements. Reduced compliance with preoperative nutritional interventions remains a major issue because the expected benefit depends on the actual intake. Seemingly, obvious reasons could not be retained as valid explanations. Compliance seems thus to be primarily a question of will and information; the importance of nutritional supplementation needs to be emphasized by specific patients' education.

  10. Multifaceted nutritional intervention among nursing-home residents has a positive influence on nutrition and function

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Damkjær, Karin; Beyer, Nina

    2008-01-01

    intervention study with nutrition (chocolate and homemade oral supplements), group exercise twice a week (45-60 min, moderate intensity), and oral care intervention one to two times a week, with the aim of improving nutritional status and function in elderly nursing-home residents. A follow-up visit was made 4......-home residents by means of a multifaceted intervention consisting of chocolate, homemade supplements, group exercise, and oral care. (C) 2008 Elsevier Inc. All rights reserved....

  11. Study of nutritional supplements using neutron activation analysis

    International Nuclear Information System (INIS)

    Reis, Rogerio Alves de Sousa; Saiki, Mitiko

    2005-01-01

    The increasing consumption of nutritional supplements among the people mainly aiming at the replacement of nutrients and minerals in the organism has led the commercialization of a great number of brands of these products. Consequently the quality control of these products is of great interest to verify if their element contents agree the values presented in labels or in the instructions for their uses. In this study the elements Ca, Co, Cr, Cu, Fe, K, Na, Se and Zn were analyzed in multimineral supplements and vitamins samples using neutron activation analysis method. The results obtained compared with the values of the labels of nutritional supplements presented good agreement. For quality control of the analytical data, certified reference materials NIST 1400 Bone Ash and NIST 1633b Coal Fly Ash provided by National Institute of Standards and Technology were analysed. Accuracy and precision of the results were evaluated and Z score values obtained were lower than 2 indicating that the data found are within the certified values at 95% of significance level. (author)

  12. Stuck in tradition-A qualitative study on barriers for implementation of evidence-based nutritional care perceived by nursing staff.

    Science.gov (United States)

    O Connell, Malene Barfod; Jensen, Pia Søe; Andersen, Signe Lindgård; Fernbrant, Cecilia; Nørholm, Vibeke; Petersen, Helle Vendel

    2018-02-01

    To explore the barriers for nutritional care as perceived by nursing staff at an acute orthopaedic ward, aiming to implement evidence-based nutritional care. Previous studies indicate that nurses recognise nutritional care as important, but interventions are often lacking. These studies show that a range of barriers influence the attempt to optimise nutritional care. Before the implementation of evidence-based nutritional care, we examined barriers for nutritional care among the nursing staff. Qualitative study. Four focus groups with thirteen members of the nursing staff were interviewed between October 2013-June 2014. The interview guide was designed according to the Theoretical Domains Framework. The interviews were analysed using qualitative content analysis. Three main categories emerged: lacking common practice, failing to initiate treatment and struggling with existing resources. The nursing staff was lacking both knowledge and common practice regarding nutritional care. They felt they protected patient autonomy by accepting patient's reluctance to eat or getting a feeding tube. The lack of nutritional focus from doctors decreased the nursing staffs focus leading to nonoptimal nutritional treatment. Competing priorities, physical setting and limited nutritional supplements were believed to hinder nutritional care. The results suggest that nutritional care is in a transitional state from experience- to evidence-based practice. Barriers for nutritional care are grounded in lack of knowledge among nursing staff and insufficient collaboration between nursing staff and the doctors. There is a need for nutritional education for the nursing staff and better support from the organisation to help nursing staff provide evidence-based nutritional care. This study contributes with valuable knowledge before the implementation of evidence-based nutritional care. The study provides an understanding of barriers for nutritional care and presents explanations to why

  13. Importance of nutritional status in recovery from acute cholecystitis: benefit from enteral nutrition supplementation including medium chain triglycerides.

    Science.gov (United States)

    Nomura, Yukinobu; Inui, Kazuo; Yoshino, Junji; Wakabayashi, Takao; Okushima, Kazumu; Kobayashi, Takashi; Miyoshi, Hironao; Nakamura, Yuta

    2007-09-01

    This study was undertaken to clarify the importance of nutritional status in patients with acute cholecystitis, and also evaluate whether they benefited from enteral nutrition supplementation, including medium-chain triglycerides (MCT), during the convalescent stage. Patients with acute cholecystitis admitted to our hospital between April 1994 and March 2002 were classified into a poor nutrition group (n=40; total serum proteinnutrition group (n=71; >5.0 g/dl). Patients with poor nutrition were significantly more elderly than those with fair nutrition, and had significantly higher serum C-reactive protein (CRP) concentrations. The two groups did not differ significantly with respect to other laboratory data, gender distribution, or medical treatment. We supplemented ordinary meals with enteral nutrition including MCT in 16 patients during the convalescent stage (MCT group). We compared their length of hospital stay and days required to recovery to pre-admission functional status for activities of daily living (ADL) with the same intervals in 16 patients without supplementation (non-MCT group) selected to match for age, gender, and fair or poor nutritional status from among 111 patients. Hospitalizations were significantly longer in the poor nutrition group (43.0+/-2.2 days) than in the fair nutrition group (27.0+/-8.2 days). Significantly more days were required to recover ADL status in the poor nutrition group (12.0+/-7.2 days) than in the fair group (9.4+/-5.2 days). Hospitalizations were significantly shorter in the MCT group (20.1+/-15 days) than in the non-MCT group (35.4+/-12.8 days). Significantly fewer days were required to recover ADL status in the MCT group (10.9+/-7 days) than in the non-MCT group (13.1+/-6.8 days). Administration of enteral nutrition including MCT during convalescence from acute cholecystitis thus appears to promote functional recovery shorten hospital stay.

  14. A study of impact of cost-effective nutritional supplement in patients on maintenance hemodialysis

    Directory of Open Access Journals (Sweden)

    D Rangarajan

    2014-01-01

    Full Text Available Nutritional status in patients on hemodialysis is always of concern as malnutrition predisposes to excess morbidity and mortality. Most of the nutritional supplements available in the market are expensive. We explored the possibility of improving nutrition of the patients on maintenance hemodialysis by supplementation of calories and proteins that can be given in the form of a palatable and economical gruel in this prospectively designed, open labeled study. Patients who were on maintenance hemodialysis (twice a week for a period of at least 6 months were divided into two groups. The study group was given the gruel supplement and the control group was not given the gruel supplement. Nutritional status was assessed in the study group and controls at 0 and 3 months by the following parameters: percentage body fat, mid arm muscle circumference and serum albumin. Analysis of results revealed that there was a significant decline in the protein intake at the end of the 3 rd month in the control group (P = 0.01. Other parameters did not show significant change at the end of the study period in both groups. The nutritional supplement can be assumed to have helped at least in the maintenance of protein intake over this short period and could possibly in the long run contribute to improvement of nutritional parameters.

  15. Nutrition Knowledge and Supplement Use among Elite U.S. Army Soldiers

    National Research Council Canada - National Science Library

    Bovill, Maria E; Tharion, William J; Lieberman, Harris R

    2003-01-01

    A U.S. Army Special Forces (SF) unit was studied to determine the characteristics of those who were dietary supplement users, assess their nutrition knowledge, and identify the nutrition information sources they use. SF-qualified (n=119...

  16. Is there a place for nutritional supplements in the treatment of idiopathic male infertility?

    Directory of Open Access Journals (Sweden)

    Davide Arcaniolo

    2014-09-01

    Full Text Available Objective: Infertility affects 15% of couples in fertile age. Male factor is a cause of infertility in almost half of cases, mainly due to oligoasthenoteratozoospermia (OAT. The purpose of this study is to review the effects of nutritional supplements as medical treatment for idiopathic male infertility. Material and methods: A Pub Med and Medline review of the published studies utilizing nutritional supplements for the treatment of male infertility has been performed. Results: Clinical trials on Vitamin E, Vitamin A, Vitamin C. Arginine, Carnitine, N-Acetyl-Carnitine, Glutathione, Coenzyme Q10, Selenium and Zinc were reviewed. Although there is a wide variability in selected population, dose regimen and final outcomes, nutritional supplements both alone and in combination seems to be able to improve semen parameters (sperm count, sperm motility and morphology and pregnancy rate in infertile men. Conclusions: There are rising evidences from published randomized trials and systematic review suggesting that nutritional supplementation may improve semen parameters and the likelihood of pregnancy in men affected by OAT. This improvement, however, is not consistent and there is a wide variation in the treatment regimens used. Well designed and adequately powered RCTs are needed to better clarify the role of nutritional supplements as treatment for male infertility.

  17. The advertising of nutritional supplements in South African women's ...

    African Journals Online (AJOL)

    The advertising of nutritional supplements in South African women's magazines: a descriptive ... These types of products are increasingly advertised and the advertisements frequently contain health claims. ... AJOL African Journals Online.

  18. Nutritional supplement products: Does the label information influence purchasing decisions for the physically active?

    Science.gov (United States)

    Gabriels, Gary; Lambert, Mike

    2013-10-02

    The increase in sales of nutritional supplement globally can be attributed, in part, to aggressive marketing by manufacturers, rather than because the nutritional supplements have become more effective. Furthermore, the accuracy of the labelling often goes unchallenged. Therefore, any effects of the supplement, may be due to contaminants or adulterants in these products not reflected on the label. A self-administered questionnaire was used to determine how consumers of nutritional supplements acquired information to assist their decision-making processes, when purchasing a product. The study was approved by the University of Cape Town, Faculty of Health Sciences Human Research Ethics Committee. The questionnaire consisted of seven, closed and open-ended questions. The participants were asked to respond to the questions according to a defined list of statements. A total of 259 participants completed and returned questionnaires. The data and processing of the returned questionnaires was captured using Windows-based Microsoft® Office Excel 2003 SP 1 (Excel © 1985-2003 Microsoft Corporation). Statistica Version 10 (copyright © Stat Soft, Inc. 1984-2011) was used to calculate the descriptive statistics. The main finding of the study was that nearly 70% of the respondents who purchased supplements were strongly influenced by container label information that stipulated that the nutritional supplement product is free of banned substances. The second finding was that just over 50% of the respondents attached importance to the quality of the nutritional supplement product information on the container label. The third finding was that about 40% of the respondents were strongly influenced by the ingredients on the labels when they purchased nutritional supplements. This study, (i) identifies short-comings in current labelling information practices, (ii) provides opportunities to improve label and non-label information and communication, and, (iii) presents the case for

  19. The palatability of oral nutritional supplements : before, during, and after chemotherapy

    NARCIS (Netherlands)

    IJpma, Irene; Renken, Remco J.; ter Horst, Gert J.; Reyners, Anna K. L.

    2016-01-01

    Oral nutritional supplements (ONS) are commonly prescribed to malnourished patients to improve their nutritional status. Taste and smell changes in patients with cancer can affect the palatability of ONS. The present study investigated: (1) the palatability of six ONS in testicular cancer patients

  20. Prostate Cancer, Nutrition, and Dietary Supplements (PDQ®)—Health Professional Version

    Science.gov (United States)

    Nutrition methods and dietary supplements have been studied for prostate cancer prevention or treatment. Read about the history of research, laboratory, and human studies on various prostate supplements, such as calcium, green tea, lycopene, pomegranate, selenium, soy, and vitamin E in this expert-reviewed summary.

  1. Nutrition Care after Discharge from Hospital: An Exploratory Analysis from the More-2-Eat Study

    Directory of Open Access Journals (Sweden)

    Celia Laur

    2018-01-01

    Full Text Available Many patients leave hospital in poor nutritional states, yet little is known about the post-discharge nutrition care in which patients are engaged. This study describes the nutrition-care activities 30-days post-discharge reported by patients and what covariates are associated with these activities. Quasi-randomly selected patients recruited from 5 medical units across Canada (n = 513 consented to 30-days post-discharge data collection with 48.5% (n = 249 completing the telephone interview. Use of nutrition care post-discharge was reported and bivariate analysis completed with relevant covariates for the two most frequently reported activities, following recommendations post-discharge or use of oral nutritional supplements (ONS. A total of 42% (n = 110 received nutrition recommendations at hospital discharge, with 65% (n = 71/110 of these participants following those recommendations; 26.5% (n = 66 were taking ONS after hospitalization. Participants who followed recommendations were more likely to report following a special diet (p = 0.002, different from before their hospitalization (p = 0.008, compared to those who received recommendations, but reported not following them. Patients taking ONS were more likely to be at nutrition risk (p < 0.0001, malnourished (p = 0.0006, taking ONS in hospital (p = 0.01, had a lower HGS (p = 0.0013; males only, and less likely to believe they were eating enough to meet their body’s needs (p = 0.005. This analysis provides new insights on nutrition-care post-discharge.

  2. Supplementation with Eskimo Skin Care improves skin elasticity in women. A pilot study.

    Science.gov (United States)

    Segger, Dörte; Matthies, Andreas; Saldeen, Tom

    2008-01-01

    To investigate the question of whether supplementation with an oral oil formulation rich in natural stable fish oil can alter skin elasticity, transepidermal water loss (TEWL), and skin roughness in healthy women. Twenty-four healthy women aged 40-60 years participated in a single-blind randomized trial for testing the effect of a proprietary oral supplement for skin nutrition (Eskimo Skin Care) on skin elasticity, TEWL, and skin roughness. Skin elasticity was measured by an optical cutometer, TEWL by a water-loss module based upon the vapour gradient principle, and skin roughness with a three-dimensional microtopography imaging system. Skin elasticity increased by 10% after 3 months of treatment with the supplement, a statistically significant increase in comparison with the control group (p=0.0298). There was a trend, though not statistically significant, towards a positive influence on the skin's barrier function. No effect on the skin roughness was observed. Eskimo Skin Care, an oral preparation rich in natural stable fish oil, can improve skin elasticity.

  3. Combining pain therapy with lifestyle: the role of personalized nutrition and nutritional supplements according to the SIMPAR Feed Your Destiny approach

    Directory of Open Access Journals (Sweden)

    De Gregori M

    2016-12-01

    Full Text Available Manuela De Gregori,1–3 Carolina Muscoli,2,4,5 Michael E Schatman,2,6 Tiziana Stallone,2,7 Fabio Intelligente,2,8 Mariangela Rondanelli,2,9 Francesco Franceschi,2,10 Laura Isabel Arranz,2,11 Silvia Lorente-Cebrián,2,12 Maurizio Salamone,2,13,14 Sara Ilari,2,5 Inna Belfer,2,15 Massimo Allegri2,16,17 1Pain Therapy Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; 2Study in Multidisciplinary Pain Research Group, 3Young Against Pain Group, Parma, Italy; 4Department of Health Sciences, Institute of Research for Food Safety and Health, University “Magna Graecia” of Catanzaro, Parma, Italy; 5IRCCS San Raffaele Pisana, Roccelletta di Borgia, Catanzaro, Italy; 6US Pain Foundation, Bellevue, WA, USA; 7ENPAB, Rome, 8Chronic Pain Service Anestesia Day-Surgery, IRCCS Humanitas Research Hospital, Rozzano, 9Department of Public Health, Section of Human Nutrition and Dietetics, Azienda di Servizi alla Persona di Pavia, University of Pavia, Pavia, 10Institute of Internal Medicine, Catholic University of Rome, Rome, Italy; 11Department of Nutrition, Food Sciences and Gastronomy, University of Barcelona, Barcelona, 12Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain; 13Metagenics Italia srl, Milano, 14Italian Lifestyle Medicine Association, Bari, Italy; 15Faculty of Dentistry, McGill University, Montreal, QC, Canada; 16Department of Surgical Sciences, University of Parma, 17Anesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliero, Universitaria of Parma, Parma, Italy Abstract: Recently, attention to the lifestyle of patients has been rapidly increasing in the field of pain therapy, particularly with regard to the role of nutrition in pain development and its management. In this review, we summarize the latest findings on the role of nutrition and nutraceuticals, microbiome, obesity, soy, omega-3 fatty acids, and curcumin supplementation as key elements in

  4. Vitamin supplementation and related nutritional status in Thai children, aged 1-5 years.

    Science.gov (United States)

    Ratanachu-ek, Suntaree

    2014-06-01

    To evaluate the prevalence of vitamin supplementation in Thai children aged 1-5 years at Queen Sirikit National Institute of Child Health (QSNICH), parental knowledge of vitamins, practices, and related factors such as nutritional status in vitamin supplementation. A cross-sectional study was performed at the Well Child Clinic, QSNICH, from 1-31 May 2005. Five hundred parents of young children, aged 1-5 years were interviewed by using the questionnaire to obtain information regarding knowledge and practices of vitamin supplementation. Weight and length/height were measured and nutritional status was assessed using the Thai growth reference. The relationships among vitamin supplement, nutritional status, and other related factors were analyzed using Chi-square test. The p-value vitamin supplementation was 76%, including vitamin C 62%, multi-vitamin (MTV) 35%, and cod-liver oil 20%. Regarding parental knowledge of vitamins, 57% of them knew the health benefits but 74% did not know the toxic effects of vitamins. The reasons for vitamin supplementation were poor feeding 63%, under-weight 23% and unhealthy status 14%. Vitamins were obtained from over-the-counter 59%, health services 40%, and friends 1%. Vitamin supplementation was significantly higher in children over 2 years of age, whose parents knew the benefits of vitamins, and in those children with malnutrition. The prevalence of vitamin supplementation was high in malnourished children, over 2 years of age whose parents had knowledge about benefits of vitamins. Parents should be warned about the dangers of high dose of vitamin consumption.

  5. Nutrition and dementia care: developing an evidence-based model for nutritional care in nursing homes.

    Science.gov (United States)

    Murphy, Jane L; Holmes, Joanne; Brooks, Cindy

    2017-02-14

    There is a growing volume of research to offer improvements in nutritional care for people with dementia living in nursing homes. Whilst a number of interventions have been identified to support food and drink intake, there has been no systematic research to understand the factors for improving nutritional care from the perspectives of all those delivering care in nursing homes. The aim of this study was to develop a research informed model for understanding the complex nutritional problems associated with eating and drinking for people with dementia. We conducted nine focus groups and five semi-structured interviews with those involved or who have a level of responsibility for providing food and drink and nutritional care in nursing homes (nurses, care workers, catering assistants, dietitians, speech and language therapists) and family carers. The resulting conceptual model was developed by eliciting care-related processes, thus supporting credibility from the perspective of the end-users. The seven identified domain areas were person-centred nutritional care (the overarching theme); availability of food and drink; tools, resources and environment; relationship to others when eating and drinking; participation in activities; consistency of care and provision of information. This collaboratively developed, person-centred model can support the design of new education and training tools and be readily translated into existing programmes. Further research is needed to evaluate whether these evidence-informed approaches have been implemented successfully and adopted into practice and policy contexts and can demonstrate effectiveness for people living with dementia.

  6. Usage patterns, health, and nutritional status of long-term multiple dietary supplement users: a cross-sectional study

    OpenAIRE

    Wong Les G; Dalvi Tapashi B; Norkus Edward P; Jensen Christopher D; Block Gladys; McManus Jamie F; Hudes Mark L

    2007-01-01

    Abstract Background Dietary supplement use in the United States is prevalent and represents an important source of nutrition. However, little is known about individuals who routinely consume multiple dietary supplements. This study describes the dietary supplement usage patterns, health, and nutritional status of long-term multiple dietary supplement users, and where possible makes comparisons to non-users and multivitamin/mineral supplement users. Methods Using a cross-sectional study design...

  7. Nutritional Care in Iranian Intensive Care Units

    Science.gov (United States)

    2018-01-01

    Intensive care units (ICUs) provides intensive treatment medicine to avoid complications such as malnutrition, infection and even death. As very little is currently known about the nutritional practices in Iranian ICUs, this study attempted to assess the various aspects of current nutrition support practices in Iranian ICUs. We conducted a cross-sectional study on 150 critically ill patients at 18 ICUs in 12 hospitals located in 2 provinces of Iran from February 2015 to March 2016. Data were collected through interview with supervisors of ICUs, medical record reviews and direct observation of patients during feeding. Our study showed that hospital-prepared enteral tube feeding formulas are the main formulas used in Iranian hospitals. None of the dietitians worked exclusively an ICU and only 30% of patients received diet counselling. Regular monitoring of nutritional status, daily energy and protein intake were not recorded in any of the participating ICUs. Patients were not monitored for anthropometric measurements such as mid-arm circumference (MAC) and electrolyte status. The nasogastric tube was not switched to percutaneous endoscopic gastrostomy or jejunostomy (PEG/PEGJ) in approximately 85% of patients receiving long-term enteral nutrition (EN) support. Our findings demonstrated that the quality of nutritional care was inappropriate in Iranian ICUs and improvement of nutritional care services within Iranian ICUs is necessary. PMID:29713622

  8. Increased Plasmodium chabaudi malaria mortality in mice with nutritional iron deficiency can be reduced by short-term adjunctive iron supplementation

    DEFF Research Database (Denmark)

    Castberg, Filip C; Maretty, Lasse; Staalsoe, Trine

    2018-01-01

    infected mice had extramedullary splenic haematopoiesis, and iron-supplemented mice had visually detectable intracellular iron stores. CONCLUSIONS: Blood transfusions are the only currently available means to correct severe anaemia in children with malaria. The potential of carefully timed, short...... parts of the world. This has rendered interventions against iron deficiency in malaria-endemic areas controversial. METHODS: The effect of nutritional iron deficiency on the clinical outcome of Plasmodium chabaudi AS infection in A/J mice and the impact of intravenous iron supplementation with ferric...... deficiency was associated with increased mortality from P. chabaudi malaria. This increased mortality could be partially offset by carefully timed, short-duration adjunctive iron supplementation. Moribund animals were characterized by low levels of hepcidin and high levels of fibroblast growth factor 23. All...

  9. ["Care" and public nutrition].

    Science.gov (United States)

    Martin-Prével, Yves

    2002-01-01

    In 1990, the Unicef conceptual framework for nutrition recognised the role of care, along with household food security and health services and environment, as one of the three underlying factors of child survival, growth, and development. This model has been adopted at a policy level at the International Conference on Nutrition (Rome, 1992) and over the past ten years the concept of care has been refined through literature reviews, consultative meetings and empirical works. "Care is the provision in the household and the community of time, attention, and support to meet the physical, mental, and social needs of the growing child and other household members". Basically, care refers to the actions of caregivers (mainly, but not only mothers) that translate food and health resources into positive outcomes for the child's nutrition. Even under circumstances of poverty, enhanced caregiving can optimise the use of resources to promote good nutrition. Care practices have been grouped into six categories: care for women, breastfeeding and child feeding practices, psychosocial care, food preparation, hygiene practices, household health practices. They cover a wide range of behaviours, are often culturally specific and are daily, repetitive, and time-consuming activities. It must be underlined that the way care practices are performed (i.e., quality of care) is as important as the practices themselves. It has also been emphasised that children play a significant role in determining the quality of care that they receive, through an interactive process: an active child elicits more care from the caregiver, who is in turn more responsive. Care resources at household level have been described according to three categories: human (knowledge, beliefs, education, physical and mental health of the caregiver), economic (control on income, workload and time), and organisational (alternate caregivers, community support). But the availability of care also depends on support at the

  10. Clinical Evaluation of a Polyherbal Nutritional Supplement in Dyslipidemic Volunteers.

    Science.gov (United States)

    Suganya, Subramanian; Natarajan, Subapriya; Chamundeeswari, Duraipandian; Anbarasu, Anand; Balasubramanian, Kunissery A; Schneider, Lynn C; Nandagopal, Balaji

    2017-11-02

    Ten important plant parts routinely used in South Indian ethnic food preparation as spices and condiments were investigated for their potential antidyslipidemic properties. The aim of the study was to characterize the biochemical properties of the polyherbal formulation (nutritional supplement) and evaluate its use to control dyslipidemia in patients. Phytochemical evaluation, in vitro α-amylase inhibitory assay, and high performance thin layer chromatography (HPTLC) fingerprinting were carried out with alcoholic extracts of all 10 individual plants and with the nutritional supplement. Investigation in human volunteers was conducted to evaluate the effect on dyslipidemia as measured by serum lipid biomarkers. Sixty-five volunteers were recruited for this study. Biomarker values at baseline and at 6th visit (end of review, 8/9 months) were compared to assess the usefulness of the nutritional supplement in the normalization of lipid biomarkers. In the qualitative analysis of metabolites, the results revealed the presence of various bioactive primary and secondary metabolites that might be responsible for their medicinal attributes. In human volunteers, after supplement intake along with standard therapy, we observed significant decrease in serum cholesterol, triglyceride, low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) levels. High-density lipoprotein (HDL) level did not change in test patient volunteers. Reductions in hemoglobin A1C (HBA1C) and postprandial blood sugar levels were observed; the difference was not statistically significant. We believe that the polyherbal formulation of 10 medicinal plants has potent antidyslipidemic activity. Our results contribute for the first time toward documentation of augmented dyslipidemia control by use of the formulation.

  11. Information on nutritional supplement labels: time for legislation ...

    African Journals Online (AJOL)

    To assist this process, it is important to have specific knowledge and understanding of the claims made on labels of nutritional supplement products used for general, and more specifically, for sports consumers. The industry is not regulated, and therefore the claims that are made may not always be accurate. Method: The ...

  12. Nutrition and Supplements for Elite Open-Weight Rowing.

    Science.gov (United States)

    Boegman, Susan; Dziedzic, Christine E

    2016-01-01

    Competitive rowing events are raced over 2,000 m requiring athletes to have highly developed aerobic and anaerobic systems. Elite rowers therefore undertake training sessions focused on lactate tolerance, strength and power as well as aerobic and anaerobic capacity development, that can amount to a 24-h training week. The training stimuli and consequent metabolic demands of each session in a rowing training program differ depending on type, length, and intensity. Nutrition guidelines for endurance- and power-based sports should be drawn upon; however, individualized and flexible nutrition plans are critical to successfully meet the daily, weekly, and cyclic nutrient requirements of a rower. This review will provide an overview of key nutritional strategies to optimize training and enhance adaptation, and briefly discuss supplement strategies that may support health and enhance performance in elite rowing.

  13. Nutritional care of medical inpatients: a health technology assessment

    Directory of Open Access Journals (Sweden)

    Kruse Filip

    2006-02-01

    Full Text Available Abstract Background The inspiration for the present assessment of the nutritional care of medical patients is puzzlement about the divide that exists between the theoretical knowledge about the importance of the diet for ill persons, and the common failure to incorporate nutritional aspects in the treatment and care of the patients. The purpose is to clarify existing problems in the nutritional care of Danish medical inpatients, to elucidate how the nutritional care for these inpatients can be improved, and to analyse the costs of this improvement. Methods Qualitative and quantitative methods are deployed to outline how nutritional care of medical inpatients is performed at three Danish hospitals. The practices observed are compared with official recommendations for nutritional care of inpatients. Factors extraneous and counterproductive to optimal nutritional care are identified from the perspectives of patients and professional staff. A review of the literature illustrates the potential for optimal nutritional care. A health economic analysis is performed to elucidate the savings potential of improved nutritional care. Results The prospects for improvements in nutritional care are ameliorated if hospital management clearly identifies nutritional care as a priority area, and enjoys access to management tools for quality assurance. The prospects are also improved if a committed professional at the ward has the necessary time resources to perform nutritional care in practice, and if the care staff can requisition patient meals rich in nutrients 24 hours a day. At the kitchen production level prospects benefit from a facilitator contact between care and kitchen staff, and if the kitchen staff controls the whole food path from the kitchen to the patient. At the patient level, prospects are improved if patients receive information about the choice of food and drink, and have a better nutrition dialogue with the care staff. Better nutritional care of

  14. The self-reported clinical practice behaviors of Australian optometrists as related to smoking, diet and nutritional supplementation.

    Science.gov (United States)

    Downie, Laura Elizabeth; Keller, Peter Richard

    2015-01-01

    The primary aim of this study was to examine the self-reported, routine clinical practice behaviors of Australian optometrists with respect to advice regarding smoking, diet and nutritional supplementation. The study also sought to assess the potential influence of practitioner age, gender, practice location (major city versus regional), therapeutic-endorsement status and personal nutritional supplementation habits upon management practices in these areas. A survey was electronically distributed to Australian optometrists (n = 4,242). Respondents anonymously provided information about their personal demographics and lifestyle behaviors (i.e., age, gender, practice location, therapeutic-endorsement status, smoking status, nutritional supplement intake) and routine patient management practices with respect to advice across three domains: smoking, diet and nutritional supplementation. Multivariate logistic regression analyses were performed to assess for potential effects of the listed factors on practitioner behavior. A total of 283 completed surveys were received (completed survey response rate: 6.7%). Fewer than half of respondents indicated routinely asking their patients about smoking status. Younger practitioners were significantly (p smoking behaviors, but this did not extend to counseling for smoking cessation. Almost two-thirds of respondents indicated routinely counseling patients about diet. About half of practitioners specified routinely asking their patients about nutritional supplement intake; this form of questioning was significantly more likely if the respondent was female (p smoking status, diet and nutritional supplement behaviors, being key modifiable lifestyle risk factors with long-term implications for eye health.

  15. Phytotherapy and Nutritional Supplements on Breast Cancer

    Directory of Open Access Journals (Sweden)

    C. M. Lopes

    2017-01-01

    Full Text Available Breast cancer is the most frequent type of nonskin malignancy among women worldwide. In general, conventional cancer treatment options (i.e., surgery, radiotherapy, chemotherapy, biological therapy, and hormone therapy are not completely effective. Recurrence and other pathologic situations are still an issue in breast cancer patients due to side effects, toxicity of drugs in normal cells, and aggressive behaviour of the tumours. From this point of view, breast cancer therapy and adjuvant methods represent a promising and challenging field for researchers. In the last few years, the use of some types of complementary medicines by women with a history of breast cancer has significantly increased such as phytotherapeutic products and nutritional supplements. Despite this, the use of such approaches in oncologic processes may be problematic and patient’s health risks can arise such as interference with the efficacy of standard cancer treatment. The present review gives an overview of the most usual phytotherapeutic products and nutritional supplements with application in breast cancer patients as adjuvant approach. Regardless of the contradictory results of scientific evidence, we demonstrated the need to perform additional investigation, mainly well-designed clinical trials in order to establish correlations and allow for further validated outcomes concerning the efficacy, safety, and clinical evidence-based recommendation of these products.

  16. Gauging food and nutritional care quality in hospitals

    Directory of Open Access Journals (Sweden)

    Diez-Garcia Rosa

    2012-09-01

    Full Text Available Abstract Background Food and nutritional care quality must be assessed and scored, so as to improve health institution efficacy. This study aimed to detect and compare actions related to food and nutritional care quality in public and private hospitals. Methods Investigation of the Hospital Food and Nutrition Service (HFNS of 37 hospitals by means of structured interviews assessing two quality control corpora, namely nutritional care quality (NCQ and hospital food service quality (FSQ. HFNS was also evaluated with respect to human resources per hospital bed and per produced meal. Results Comparison between public and private institutions revealed that there was a statistically significant difference between the number of hospital beds per HFNS staff member (p = 0.02 and per dietitian (p  Conclusions Food and nutritional care in hospital is still incipient, and actions concerning both nutritional care and food service take place on an irregular basis. It is clear that the design of food and nutritional care in hospital indicators is mandatory, and that guidelines for the development of actions as well as qualification and assessment of nutritional care are urgent.

  17. A cluster-randomized, controlled trial of nutritional supplementation and promotion of responsive parenting in Madagascar: the MAHAY study design and rationale.

    Science.gov (United States)

    Fernald, Lia C H; Galasso, Emanuela; Qamruddin, Jumana; Ranaivoson, Christian; Ratsifandrihamanana, Lisy; Stewart, Christine P; Weber, Ann M

    2016-06-03

    Over half of the world's children suffer from poor nutrition, and as a consequence they experience delays in physical and mental health, and cognitive development. There is little data evaluating the effects of delivery of lipid-based, nutrition supplementation on growth and development during pregnancy and early childhood within the context of a scaled-up program. Furthermore, there is limited evidence on effects of scaled-up, home-visiting programs that focus on the promotion of child development within the context of an existing, national nutrition program. The MAHAY ("smart" in Malagasy) study uses a multi-arm randomized-controlled trial (RCT) to test the effects and cost-effectiveness of combined interventions to address chronic malnutrition and poor child development. The arms of the trial are: (T0) existing program with monthly growth monitoring and nutritional/hygiene education; (T1) is T0 + home visits for intensive nutrition counseling within a behavior change framework; (T2) is T1 + lipid-based supplementation (LNS) for children 6-18 months old; (T3) is T2 + LNS supplementation of pregnant/lactating women; and (T4) is T1 + intensive home visiting program to support child development. There are anticipated to be n = 25 communities in each arm (n = 1250 pregnant women, n = 1250 children 0-6 months old, and n = 1250 children 6-18 months old). Primary outcomes include growth (length/height-for-age z-scores) and child development (mental, motor and social development). Secondary outcomes include care-giver reported child morbidity, household food security and diet diversity, micro-nutrient status, maternal knowledge of child care and feeding practices, and home stimulation practices. We will estimate unadjusted and adjusted intention-to-treat effects. Study protocols have been reviewed and approved by the Malagasy Ethics Committee at the Ministry of Health in Madagascar and by the institutional review board at the University of

  18. The self-reported clinical practice behaviors of Australian optometrists as related to smoking, diet and nutritional supplementation.

    Directory of Open Access Journals (Sweden)

    Laura Elizabeth Downie

    Full Text Available The primary aim of this study was to examine the self-reported, routine clinical practice behaviors of Australian optometrists with respect to advice regarding smoking, diet and nutritional supplementation. The study also sought to assess the potential influence of practitioner age, gender, practice location (major city versus regional, therapeutic-endorsement status and personal nutritional supplementation habits upon management practices in these areas.A survey was electronically distributed to Australian optometrists (n = 4,242. Respondents anonymously provided information about their personal demographics and lifestyle behaviors (i.e., age, gender, practice location, therapeutic-endorsement status, smoking status, nutritional supplement intake and routine patient management practices with respect to advice across three domains: smoking, diet and nutritional supplementation. Multivariate logistic regression analyses were performed to assess for potential effects of the listed factors on practitioner behavior.A total of 283 completed surveys were received (completed survey response rate: 6.7%. Fewer than half of respondents indicated routinely asking their patients about smoking status. Younger practitioners were significantly (p < 0.05 less likely to enquire about patients' smoking behaviors, but this did not extend to counseling for smoking cessation. Almost two-thirds of respondents indicated routinely counseling patients about diet. About half of practitioners specified routinely asking their patients about nutritional supplement intake; this form of questioning was significantly more likely if the respondent was female (p < 0.05. Practitioners who recommended nutritional supplements most commonly did so for age-related macular degeneration (91.2% and dry eye disease (63.9%. The primary source of evidence used to guide practitioners' nutrition-related patient management was reported to be peer-reviewed publications.These findings

  19. The Evidence for Dietary Interventions and Nutritional Supplements as Treatment Options in Multiple Sclerosis: a Review.

    Science.gov (United States)

    Mische, Leah J; Mowry, Ellen M

    2018-03-17

    This review aims to critically evaluate published studies examining diets and nutritional supplements (excepting vitamin D) for the impact on prevention and prognosis of multiple sclerosis (MS). There is a negative relationship between the Mediterranean diet and vascular disease, and vascular co-morbidities are associated with a worse MS prognosis. Low-fat, fish-based diets, sodium-restricted diets, calorie restriction, the paleo diet, and gluten-free diets have been examined, mostly in observational studies; results are inconclusive. With regard to nutritional supplements, pilot data show a possible benefit of biotin with respect to disability worsening in people with progressive MS (PMS). The best designed randomized controlled trials (RCTs) for PUFA supplementation have not shown significant impact, but several weaker RCTs have. Many other nutritional supplements have been tested, including several anti-oxidants. While some early studies show positive results, no result has been definitive. Unfortunately, there is no strong evidence for a direct benefit of any given dietary intervention on MS risk or prognosis. However, due to its relationship with vascular co-morbidities, the Mediterranean diet has the strongest rationale for employment in PwMS. Higher-quality clinical trials are needed to ascertain the possible benefits of nutritional supplements.

  20. Intake of nutritional supplements among people exercising in gyms and influencing factors.

    Science.gov (United States)

    Goston, Janaina Lavalli; Correia, Maria Isabel Toulson Davisson

    2010-06-01

    To assess supplement intake in people who exercise regularly in gyms in the city of Belo Horizonte, Brazil, and discuss the influencing factors on its ingestion. A total of 1102 enrolled subjects who exercised in 50 gyms throughout the city were part of this cross-sectional study. Men and women were recruited and all subjects were at least 18 y old. Participants were asked to complete written questionnaires about their use of supplements. Data were collected over a period of 4 mo. Descriptive statistics and chi-square tests were performed. The intake of nutritional supplements was reported by 36.8% of participants. The highest intake was in men (44.6%). Five products were consumed almost daily: those rich in proteins and amino acids (58%), isotonic drinks (32%), those rich in carbohydrates (23%), natural/phytotherapeutic (20%), and multivitamin/mineral supplements (19%). Most people (55%) reported using nutritional supplements without any specialized professional guidance and based primarily on self-prescription. Individuals younger than 30 y, mainly men (odds ratio 3.28, 95% confidence interval 2.06-5.20, P gyms is high and is usually self-prescribed. We emphasize that the use of dietary supplements must be always done under the supervision of a specialist (physician or nutritionist). Copyright 2010 Elsevier Inc. All rights reserved.

  1. OUTCOME OF ZINC SUPPLEMENTATION ON NUTRITIONAL INTAKE OF CKD PATIENTS

    Directory of Open Access Journals (Sweden)

    N. Sahni

    2012-06-01

    Conclusion: Zn supplementation alone failed to improve dietary intake as it seemed patients were scared to eat more/wrong/kidney unfriendly food in absence of clear dietary guidelines, but favorable results were observed when Zn supplementation was coupled with parametric, individualized dietary counseling which shows that role of diet counseling in removing food misconceptions & lack of knowledge is important to make any therapy effective. So there is a critical need for implementation of effective nutritional management strategies.

  2. Will the new Consumer Protection Act prevent harm to nutritional supplement users?

    Science.gov (United States)

    Gabriels, Gary; Lambert, Mike; Smith, Pete; Hiss, Donavon

    2011-07-25

    BACKGROUND. There is no clear distinction between the regulation of food, supplements and medicines in South Africa. Consequently, grey areas exist in implementing the legislation, particularly in the supplement industry. The increase in supplement sales in South Africa can be attributed to aggressive marketing by manufacturers whose claims are not always supported by published peer-reviewed evidence. Such claims often go unchecked, resulting in consumers being mislead about the role of supplements. As a result of poor regulation, contaminants or adulterants in supplements may also cause insidious effects unrelated to the listed ingredients. AIM. To assess the regulations, legislation, and claims associated with nutritional supplement products in South Africa. METHOD. Peer-reviewed literature and the relevant South African statutes were consulted. RESULTS. The National Health Act incorporates the Medicine Control Council, which is charged with ensuring the safety, quality and effectiveness of medicines, and related matters, including complementary/alternative medicines. The South African Institute for Drug-Free Sport and Amendment Act provides for testing athletes for using banned substances, but currently does not concern itself with monitoring nutritional supplements for contaminants or adulterants that may cause a positive drug test, which has implications for sports participants and also the health of the general population. The implementation of the Consumer Protection Act 68 of 2008 (CPA) could protect consumer rights if it is administered and resourced appropriately. CONCLUSION. The CPA should promote greater levels of policy development, regulatory enforcement, and consumer education of South Africa's supplement industry.

  3. Nutrition and Supplementation Considerations to Limit Endotoxemia When Exercising in the Heat.

    Science.gov (United States)

    Guy, Joshua H; Vincent, Grace E

    2018-02-06

    Exercise-induced heat production is further elevated by exercise performed in hot conditions and this can subsequently impact inflammation, and gastrointestinal (GI) health. Implementing nutrition and supplementation strategies under these conditions may support the hyperthermic response, the systemic inflammatory response, GI permeability and integrity, and exercise performance. Therefore, the aim of this brief review is to explore athletes' inflammatory response of two key biomarkers, lipopolysaccharide (LPS), and interleukin-6 (IL-6), and provide nutrition and supplementation recommendations when exercising in hot conditions. There is emerging evidence that probiotics, glutamine, and vitamin C can preserve GI integrity, which may improve performance during exercise in the heat. Glucose rich food when consumed with water, before and during exercise in the heat, also appear to limit endotoxemia, preserve GI integrity, and reduce the incidence of GI disturbances compared with water alone. The use of non-steroidal anti-inflammatory drugs (NSAIDs) may compromise GI integrity and this may result in greater leakage of endotoxins during long duration exercise in the heat. Further work is required to elucidate the impact of nutrition and supplementation strategies, in particular the use of NSAIDs, when exercising in the heat.

  4. Nutrition and Supplementation Considerations to Limit Endotoxemia When Exercising in the Heat

    Directory of Open Access Journals (Sweden)

    Joshua H. Guy

    2018-02-01

    Full Text Available Exercise-induced heat production is further elevated by exercise performed in hot conditions and this can subsequently impact inflammation, and gastrointestinal (GI health. Implementing nutrition and supplementation strategies under these conditions may support the hyperthermic response, the systemic inflammatory response, GI permeability and integrity, and exercise performance. Therefore, the aim of this brief review is to explore athletes’ inflammatory response of two key biomarkers, lipopolysaccharide (LPS, and interleukin-6 (IL-6, and provide nutrition and supplementation recommendations when exercising in hot conditions. There is emerging evidence that probiotics, glutamine, and vitamin C can preserve GI integrity, which may improve performance during exercise in the heat. Glucose rich food when consumed with water, before and during exercise in the heat, also appear to limit endotoxemia, preserve GI integrity, and reduce the incidence of GI disturbances compared with water alone. The use of non-steroidal anti-inflammatory drugs (NSAIDs may compromise GI integrity and this may result in greater leakage of endotoxins during long duration exercise in the heat. Further work is required to elucidate the impact of nutrition and supplementation strategies, in particular the use of NSAIDs, when exercising in the heat.

  5. Is multi-level marketing of nutrition supplements a legal and an ethical practice?

    Science.gov (United States)

    Cardenas, Diana; Fuchs-Tarlovsky, Vanessa

    2018-06-01

    Multi-level marketing (MLM) of nutrition products has experienced dramatic growth in recent decades. 'Wellness' is the second most popular niche in the MLM industry and represents 35% of sales among all the products in 2016. This category includes dietary supplements, weight management and sports nutrition products. The aim of this paper is to analyse whether this practice is legal and ethical. An analysis of available documentary information about the legal aspects of Multi-level marketing business was performed. Ethical reflexion was based on the "principlism" approach. We argue that, while being a controversial business model, MLM is not fraudulent from a legal point of view. However, it is an unethical strategy obviating all the principles of beneficence, nonmaleficence and autonomy. What is at stake is the possible economic scam and the potential harm those products could cause due to unproven efficacy, exceeding daily nutrient requirements and potential toxicity. The sale of dietary and nutrition supplements products by physicians and dieticians presents a conflict of interests that can undermine the primary obligation of physicians to serve the interests of their patients before their own. While considering that MLM of dietary supplements and other nutrition products are a legal business strategy, we affirm that it is an unethical practice. MLM products that have nutritional value or promoted as remedies may be unnecessary and intended for conditions that are unsuitable for self-prescription as well. Copyright © 2018 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  6. Nutritional Supplement Use by Dutch Elite and Sub-Elite Athletes: Does Receiving Dietary Counselling Make a Difference?

    NARCIS (Netherlands)

    Wardenaar, F.C.; Ceelen, I.J.M.; Dijk, van J.W.; Hangelbroek, R.W.J.; Roy, van L.; Pouw, van der B.; Vries, de J.H.M.; Mensink, M.R.; Witkamp, R.F.

    2017-01-01

    The use of nutritional supplements is highly prevalent among athletes. In this cross-sectional study we assessed the prevalence of nutritional supplement use by a large group of Dutch competitive athletes in relation to dietary counselling. A total of 778 athletes (407 males and 371 females)

  7. [Nutritional care in the cardiac rehabilitation program].

    Science.gov (United States)

    da Vico, Letizia; Biffi, Barbara; Masini, Maria Luisa; Fattirolli, Francesco

    2007-06-01

    There is some evidence of the efficacy of nutritional care in modifying eating habits and behavior in patients undergoing cardiac rehabilitation: nutritional care has a relevant role in the secondary prevention of cardiovascular disease. The dietitian is the qualified sanitary professional for nutritional care. The aim of this study was to define the role of dietitians within a health care team in programs of cardiac rehabilitation. In this setting, nutritional care starts with a dietary assessment, which includes a measurement of the anthropometric parameters, and a survey of the patient knowledge and eating habits. If there is no need for change in the patient lifestyle, the patient is addressed to the normal cardiac rehabilitation program with no further nutritional intervention except one session of counseling. When lifestyle changes are needed, the dietitian defines, together with the patient, therapeutic aims and expected results. The following phase is represented by group session with patients and their relatives during which nutritional topics are discussed and nutritional education is provided Afterwards, self-monitoring sheets of eating habits are individually discussed in one visit; a last individual visit is used for a final assessment of nutritional knowledge, dietary habits, and anthropometric parameters. In case of unsatisfactory results, patients are invited to participate to three group session to be held biweekly, during which they interact with the dietitian and take part to exercises and group discussions. When the established targets are reached, the nutritional program includes individual follow up visits at six and twelve months for further assessment of medium term results.

  8. The Effect of Omega-3 Docosahexaenoic Acid Supplementation on Gestational Length: Randomized Trial of Supplementation Compared to Nutrition Education for Increasing n-3 Intake from Foods

    Directory of Open Access Journals (Sweden)

    Mary A. Harris

    2015-01-01

    Full Text Available Objective. DHA supplementation was compared to nutrition education to increase DHA consumption from fish and DHA fortified foods. Design. This two-part intervention included a randomized double-blind placebo controlled DHA supplementation arm and a nutrition education arm designed to increase intake of DHA from dietary sources by 300 mg per day. Setting. Denver Health Hospitals and Clinics, Denver, Colorado, USA. Population. 871 pregnant women aged 18–40 were recruited between16 and 20 weeks of gestation of whom 564 completed the study and complete delivery data was available in 505 women and infants. Methods. Subjects received either 300 or 600 mg DHA or olive oil placebo or nutrition education. Main Outcome Variable. Gestational length. Results. Gestational length was significantly increased by 4.0–4.5 days in women supplemented with 600 mg DHA per day or provided with nutrition education. Each 1% increase in RBC DHA at delivery was associated with a 1.6-day increase in gestational length. No significant effects on birth weight, birth length, or head circumference were demonstrated. The rate of early preterm birth (1.7% in those supplemented with DHA (combined 300 and 600 mg/day was significantly lower than in controls. Conclusion. Nutrition education or supplementation with DHA can be effective in increasing gestational length.

  9. [Assessment of nutritional education and iron supplement impact on prevention of pregnancy anemia].

    Science.gov (United States)

    Parra, Beatriz Elena; Manjarrés, Luz Mariela; Gómez, Alba Lucía; Alzate, Dora María; Jaramillo, María Clemencia

    2005-06-01

    Iron and folic acid deficiencies are the major causes of health problems among pregnant women and children, with a significant negative impact on economic and social development. From April 2002 to April 2003 at the Gilberto Mejía Mejía Hospital (Rionegro, Antioquia), the prenatal program was assessed for its impact on a cohort of pregnant women concerning knowledge of the following nutritional parameters: iron and folic acid functions, their source foods and bioavailability, supplement intake and tolerance, and globular indexes. A sample of 42 pregnant women was subjected to a nutritional education program along with the administration of a supplement consisting of 60 mg elemental iron, 400 microg folic acid, and 70 mg vitamin C. This formulation was prepared specifically for the study by Laboratorio Profesional Farmacéutico, LAPROFF. The effect of the educational program was measured by knowledge changes about how patient behaviours affect nutrient bioavailability via source foods intake, as well as recognition of the tolerance limits of supplements and potential effect of non-adherance. The physiological status of each patient was measured by three hematologic variables--hemoglobin, hematocrit, and ferritin. A positive understanding of how to improve nutritional practices was observed. With the supplements, 94.4% of women did not show anaemia at the end of pregnancy. These results agree with those in other, similar populations and indicate that implementation of prenatal control programs by educational and supplement administration is worthwhile.

  10. Nutritional issues and self-care measures adopted by cancer patients attending a university hospital in Turkey

    Directory of Open Access Journals (Sweden)

    Sevgisun Kapucu

    2016-01-01

    Full Text Available Objective: This study aimed to assess the nutritional status of cancer patients and the self-care measures they adopted as a response to nutritional problems. Methods: This descriptive study included seventy cancer patients staying in the oncology and internal disease clinics of a university hospital in Turkey. Data were collected using a questionnaire with 29 questions. Results: The mean age of participants was 40.2 ΁ 1.82 years. Approximately, 62.9% of the patients ate only half of the meals offered to them, 65.7% experienced weight loss, and 45.7% had difficulty eating their meals on their own. Moreover, 47.1% of the patients received nutritional support and nutritional problems were observed in 71.4% of the patients; 80% were unable to eat hospital food, 54.3% had an eating disorder related to a special diet, 30% suffered from loss of appetite, 27% had nausea, and 14.3% had difficulty swallowing. Furthermore, 48.5% of patients responded that they ate home-cooked food or ordered food from outside when questioned about the self-care measures taken to avoid the aforementioned nutritional problems. Conclusions: Most of the cancer patients had serious nutritional problems and ate home-cooked food and used nutritional supplements to overcome these problems. Oncology nurses are responsible for evaluating the nutritional status of cancer patients and eliminating nutritional problems.

  11. Support for Policies to Improve the Nutritional Impact of the Supplemental Nutrition Assistance Program in California.

    Science.gov (United States)

    Leung, Cindy W; Ryan-Ibarra, Suzanne; Linares, Amanda; Induni, Marta; Sugerman, Sharon; Long, Michael W; Rimm, Eric B; Willett, Walter C

    2015-08-01

    The Supplemental Nutrition Assistance Program (SNAP) provides a vital buffer against hunger and poverty for 47.6 million Americans. Using 2013 California Dietary Practices Survey data, we assessed support for policies to strengthen the nutritional influence of SNAP. Among SNAP participants, support ranged from 74% to 93% for providing monetary incentives for fruits and vegetables, restricting purchases of sugary beverages, and providing more total benefits. Nonparticipants expressed similar levels of support. These approaches may alleviate the burden of diet-related disease in low-income populations.

  12. Support for Policies to Improve the Nutritional Impact of the Supplemental Nutrition Assistance Program in California

    Science.gov (United States)

    Ryan-Ibarra, Suzanne; Linares, Amanda; Induni, Marta; Sugerman, Sharon; Long, Michael W.; Rimm, Eric B.; Willett, Walter C.

    2015-01-01

    The Supplemental Nutrition Assistance Program (SNAP) provides a vital buffer against hunger and poverty for 47.6 million Americans. Using 2013 California Dietary Practices Survey data, we assessed support for policies to strengthen the nutritional influence of SNAP. Among SNAP participants, support ranged from 74% to 93% for providing monetary incentives for fruits and vegetables, restricting purchases of sugary beverages, and providing more total benefits. Nonparticipants expressed similar levels of support. These approaches may alleviate the burden of diet-related disease in low-income populations. PMID:26066922

  13. Academy of Nutrition and Dietetics benchmarks for nutrition in child care 2011: are child-care providers across contexts meeting recommendations?

    Science.gov (United States)

    Dev, Dipti A; McBride, Brent A

    2013-10-01

    The Academy of Nutrition and Dietetics (Academy) recommends feeding practices for child-care providers to establish nutrition habits in early childhood to prevent obesity. With >12 million US children in child care, little is known about child-care providers' feeding practices. The purpose of this study was to examine child-care providers' feeding practices to assess whether providers met the Academy's benchmarks and whether attainment of benchmarks varied across child-care contexts (Head Start, Child and Adult Care Food Program [CACFP], and non-CACFP). Cross-sectional data was collected in 2011 and 2012 from 118 child-care providers who completed self-administered surveys regarding their feeding practices for 2- to 5-year-old children. χ(2) tests and analysis of variance were used to determine variation across contexts. Head Start providers sat more frequently with children during meals (P=0.01), ate the same foods as children (P=0.001), and served meals family style (Pchildren (P=0.01) received more nutrition-education opportunities compared with CACFP and non-CACFP. Head Start providers encouraged more balance and variety of foods (Pchildren about nutrition (PAcademy's benchmarks compared with CACFP and non-CACFP providers. Possible reasons for this compliance might be attributed to Head Start nutrition performance standards and increased nutrition-training opportunities for Head Start staff. Head Start programs can serve as a model in implementing the Academy's benchmarks. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  14. A cluster-randomized, controlled trial of nutritional supplementation and promotion of responsive parenting in Madagascar: the MAHAY study design and rationale

    Directory of Open Access Journals (Sweden)

    Lia C. H. Fernald

    2016-06-01

    Full Text Available Abstract Background Over half of the world’s children suffer from poor nutrition, and as a consequence they experience delays in physical and mental health, and cognitive development. There is little data evaluating the effects of delivery of lipid-based, nutrition supplementation on growth and development during pregnancy and early childhood within the context of a scaled-up program. Furthermore, there is limited evidence on effects of scaled-up, home-visiting programs that focus on the promotion of child development within the context of an existing, national nutrition program. Methods/Design The MAHAY ("smart" in Malagasy study uses a multi-arm randomized-controlled trial (RCT to test the effects and cost-effectiveness of combined interventions to address chronic malnutrition and poor child development. The arms of the trial are: (T0 existing program with monthly growth monitoring and nutritional/hygiene education; (T1 is T0 + home visits for intensive nutrition counseling within a behavior change framework; (T2 is T1 + lipid-based supplementation (LNS for children 6–18 months old; (T3 is T2 + LNS supplementation of pregnant/lactating women; and (T4 is T1 + intensive home visiting program to support child development. There are anticipated to be n = 25 communities in each arm (n = 1250 pregnant women, n = 1250 children 0–6 months old, and n = 1250 children 6–18 months old. Primary outcomes include growth (length/height-for-age z-scores and child development (mental, motor and social development. Secondary outcomes include care-giver reported child morbidity, household food security and diet diversity, micro-nutrient status, maternal knowledge of child care and feeding practices, and home stimulation practices. We will estimate unadjusted and adjusted intention-to-treat effects. Study protocols have been reviewed and approved by the Malagasy Ethics Committee at the Ministry of Health in Madagascar and by

  15. The age-gender-status profile of high performing athletes in the UK taking nutritional supplements: Lessons for the future

    Directory of Open Access Journals (Sweden)

    Naughton Declan P

    2008-01-01

    Full Text Available Abstract Background Owing to the mechanics of anti-doping regulation via the World Anti-Doping Agency's Prohibited List, nutritional supplement use received little attention in comparison to the prevalence of doping. The aims of this study were to investigate supplement use, identify groups of athletes with high levels of supplement use and the prevalence of concomitant use of supplements. Methods Survey data from 847 high-performing athletes in the UK were analysed using descriptive statistics. The survey, conducted by UK Sport, consisted of questions regarding knowledge of the prohibited substances, testing procedure, nutritional supplement use and perceptions of the doping problem. The proportion of supplement users and the relative use of each supplement were compared by age, gender and professional status. Results Among 874 high-performing athletes in the UK sample, 58.8% of them reported the use of at least one nutritional supplement. Among supplement users, 82.6% used more than one and 11.5% reported use of more than five nutritional supplements. Of the 9 supplements listed, multivitamins (72.6% and vitamin C (70.7% were used most, followed by creatine (36.1%, whey protein (31.7%, echinacea (30.9%, iron (29.9% and caffeine (23.7%. Less than 11% reported the use of magnesium or ginseng. Creatine use was typically associated with males regardless of status and across all ages, whereas iron was characteristically used by females. A 'typical' supplement user is male, between 24 and 29 years of age, involved in professional sport and using a combination of supplements. Male professional players between age 30 and 34 years, and female non-professional athletes between 24 and 29 years of age also represented a considerable proportion of supplement users. Athletes older than 40 years of age were practically non-users. Concomitant use of supplements is characteristic of male users more than females. Conclusion As supplement use has been previously

  16. Effects of nutritional supplementation on periodontal parameters, carotenoid antioxidant levels, and serum C-reactive protein.

    Science.gov (United States)

    Harpenau, Lisa A; Cheema, Abida T; Zingale, Joseph A; Chambers, David W; Lundergan, William P

    2011-05-01

    Few studies have focused on the role of nutrition in periodontal disease. The purpose of this trial was to determine the effect of a nutritional supplement on gingival inflammation, bleeding, probing depth, clinical attachment level, carotenoid antioxidant level, and C-reactive protein. The test supplement, consisting of a standard multivitamin formula, as well as several phytonutrients associated with antiinflammatory/antioxidant effects, provided modest benefits in reducing inflammation; however, further studies with larger populations and longer intervention are warranted.

  17. Nutritional supplement use by elite young UK athletes: fallacies of advice regarding efficacy

    Directory of Open Access Journals (Sweden)

    Bloodworth Andrew

    2008-12-01

    Full Text Available Abstract Background The objective was to study nutritional supplement use among young elite UK athletes to establish whether a rationale versus practice incongruence exists, and to investigate the sources of information. Survey data were analysed for association between supplements used and motives for using such substances among young athletes along with the sources of advice and literature precedents on supplement effects. Methods Participants were elite UK male and female athletes, within the age range between 12 and 21 (n = 403, mean age 17.66 ± 1.99. Associations between type of supplements and reasons for using supplements were tested by calculating Pearson's χ2 and the strength of these symmetric associations shown by phi (ϕ association coefficients. Results Single supplement use was reported by 48.1%, with energy drinks being the most popular, consumed by 41.7% of all athletes and 86.6% of the supplement users in the sample. No agreement was observed between athletes' rationale and behaviour in relation to nutritional supplements except for creatine. Among health professionals, nutritionists and physiotherapists, followed by coaches, were most frequently consulted. Answers regarding reasons and supplements used showed incongruence and suggest widespread misinformation regarding supplements and their effects is an issue for the young athlete. Conclusion Widespread supplement taking behaviour was evidenced in the young elite athlete population with the most notable congruence between rationale and practice among young athletes being performance-related. Young athletes in the present sample appear to be less 'health conscious' and more 'performance focused' than their adult counterparts. Further research, using a full list of supplements, is warranted to test the hypothesis that health consciousness is less dominant in supplement choice by young athletes.

  18. Nutritional practices in full-day-care pre-schools.

    LENUS (Irish Health Repository)

    Jennings, A

    2011-06-01

    Full-day-care pre-schools contribute significantly to the nutritional intake and acquisition of dietary habits of the pre-school child. The present study investigated nutritional practices in full-day-care pre-schools in Dublin, Ireland, aiming to determine the nutritional support that pre-school managers deem necessary, thereby facilitating the amelioration of existing pre-school nutritional training and practices.

  19. Consumer involvement in oral nutritional supplements purchasing behavior

    OpenAIRE

    Fitriyani, Dwi Meilia; Yuliati, Lilik Noor; Simanjuntak, Megawati

    2017-01-01

    The paper aimed to get insight of consumer involvement in purchasing behavior towards ONS (Oral Nutritional Supplements) for children. By implementing an online survey with sample size of 100, the research investigated the factors (motivation and stimulus factor) influencing consumer involvement and the causality between consumer involvement with the product knowledge as well as purchasing behavior. The research tool used was a 5-points Likert questionnaire in which respondents were asked to ...

  20. [Esthetic nutrition: body and beauty enhancement through nutritional care].

    Science.gov (United States)

    Witt, Juliana da Silveira Gonçalves Zanini; Schnider, Aline Petter

    2011-09-01

    Nowadays, there is an increasing quest for beauty and the models proposed by fashion goods and service segments, to achieve the perfect body. The standard of beauty corresponds to a thin body, without considering health aspects. The number of women who go on diets to control weight is increasing; and taking this into consideration the objective of this study is to conduct a bibliographical review and extract data on esthetics and body image to support the practice of nutritional care. Socio-cultural aspects, which motivate the quest for the perfect body, as well as body, beauty, esthetics, nutritional counseling and cognitive behavior therapy were examined in this survey. On the basis of this work, it is possible to conclude that the continuing obsession with the body may lead the person to go on diets and other drastic methods to control weight, such as surgical procedures. In this respect, nutritional care is far more than merely recommending a standard diet or giving information, as it represents providing an effective model for nutritional reeducation, prioritizing improvement in the style and quality of life. This article provides data about enhancing esthetics and beauty by means of appropriate nutrition.

  1. Use of Nutritional Supplements by High School Football and Volleyball Players

    Science.gov (United States)

    Mason, Melanie A; Giza, Matthew; Clayton, Lori; Lonning, Jim; Wilkerson, Rick D

    2001-01-01

    The known use of performance enhancing agents by athletes has occurred throughout history. In the 1960s and 1970s steroids and amphetamines were the supplements most often used. Now athletes are turning to supplements that are either natural or stimulate the release of natural hormones. The purpose of this study is to evaluate the prevalence of use of nutritional supplements among high school football and volleyball players. This study surveyed 495 male football players and 407 female volleyball players from 20 high schools in Northwest Iowa. These athletes completed anonymous surveys and returned them to their coaches. Results showed that 8% of the male athletes and 2% of the female athletes were using supplementation. Supplements used included creatine, androstiendione, HMB, amino acids, DHEA, phosphogen, weight gainer 1850, Tribulus, muscle plus, multivitamins, calcium, GABA, and Shaklee Vita Lea and Physique. PMID:11813950

  2. The effect of testosterone and a nutritional supplement on hospital admissions in under-nourished, older people

    Directory of Open Access Journals (Sweden)

    Cameron Ian D

    2011-10-01

    Full Text Available Abstract Background Weight loss and under-nutrition are relatively common in older people, and are associated with poor outcomes including increased rates of hospital admissions and death. In a pilot study of 49 undernourished older, community dwelling people we found that daily treatment for one year with a combination of testosterone tablets and a nutritional supplement produced a significant reduction in hospitalizations. We propose a larger, multicentre study to explore and hopefully confirm this exciting, potentially important finding (NHMRC project grant number 627178. Methods/Design One year randomized control trial where subjects are allocated to either oral testosterone undecanoate and high calorie oral nutritional supplement or placebo medication and low calorie oral nutritional supplementation. 200 older community-dwelling, undernourished people [Mini Nutritional Assessment score 2: 7.5% over 3 months]. Hospital admissions, quality-adjusted life years, functional status, nutritional health, muscle strength, body composition and other variables will be assessed. Discussion The pilot study showed that combined treatment with an oral testosterone and a supplement drink was well tolerated and safe, and reduced the number of people hospitalised and duration of hospital admissions in undernourished, community dwelling older people. This is an exciting finding, as it identifies a treatment which may be of substantial benefit to many older people in our community. We now propose to conduct a multi-centre study to test these findings in a substantially larger subject group, and to determine the cost effectiveness of this treatment. Trial registration Australian Clinical Trial Registry: ACTRN 12610000356066

  3. Selenium supplementation in pediatric patients using parenteral nutrition: Is it time to do something?

    Science.gov (United States)

    Freitas, Renata Germano Borges de Oliveira Nascimento; Nogueira, Roberto José Negrão; Hessel, Gabriel

    2018-03-01

    To analyze the nutritional status of selenium and verify the effect of its supplementation in pediatric patients during 14 days of parenteral nutrition (PN). This is a series of cases with patients followed for two weeks while using PN. Data collection was performed at the beginning (T0), in the 7th (T1) and 14th days of PN (T2). The supplemented group received 2 µg/kg/day of selenous acid. Weight and height were measured for nutritional status assessment. Tests requested: plasma selenium, albumin, pre-albumin, C-reactive protein (CRP), total cholesterol and HDL-cholesterol. Fourteen (14) patients with inflammatory process and with low or very low weight for their ages were evaluated. In both groups (with and without supplementation), all patients had low selenium levels. Median plasma selenium concentrations were 17.4 µg/L (T0), 23.0 µg/L (T1) and 20.7 µg/L (T2). Increase and reduction of selenium occurred both in patients with high CRP and in those presenting normalization of this parameter. Lower plasma selenium levels have been detected since the start of the research and supplementation (2 µg/kg/day of selenous acid) was not to enough to approach the reference values.

  4. Characterization of inorganic components in nutritional supplements by neutron activation analysis

    International Nuclear Information System (INIS)

    Reis, Rogerio Alves de Sousa

    2006-01-01

    The control of element composition in nutritional supplements is of great interest due to increasingly high consumption and a large diversity and brands of these products offered in market. Therefore, there is the necessity to evaluate the element contents in the supplements and to compare with those values declared on the labels. In this study neutron activation analysis (NAA) was applied to evaluate the element composition of 11 commercial nutritional supplement brands bought in natural product drugstores and pharmacies. These samples acquired in capsule or tablet forms were ground to a homogeneous powder. The samples were irradiated together with the elemental standards in the IEA-R1 nuclear research reactor. Irradiations of 8 h under a thermal neutron flux of 5 x 10 12 n cm -2 s -1 were carried out for Ca, Co, Cr, Fe, Se and Zn determinations. For Cu, K and Na determinations thermal neutron flux of 1 x 10 12 n cm -s-1 was used and, the exposure time was 1h. The induced gamma activities were measured using a hyper pure Ge detector coupled to a gamma ray spectrometer. The obtained results compared with the values of the labels of nutritional supplements presented good agreement for most of the elements. Toxic elements such as As, Cd, Hg and Sb were not detected in the samples. For quality control of the analytical data, certified reference materials NIST 1400 Bone Ash and NIST 1633b Coal Fly Ash provided by the National Institute of Standards and Technology were also analysed. Accuracy and precision of these results were evaluated. The obtained Z score values were lower than 2 indicating that the data are within the ranges of certified values at 95% confidence level (author)

  5. Effect of enzyme supplementation on the nutritive value of malted ...

    African Journals Online (AJOL)

    The composition of malted sorghum sprout (MSP) and its nutritive value when supplemented with an exogenous enzyme was investigated using weanling albino rats. A nitrogen free basal diet was formulated along with a soya bean meal (SBM) reference diet (10% CP) and two test diets each containing 10% CP supplied ...

  6. Usage patterns, health, and nutritional status of long-term multiple dietary supplement users: a cross-sectional study

    Science.gov (United States)

    Block, Gladys; Jensen, Christopher D; Norkus, Edward P; Dalvi, Tapashi B; Wong, Les G; McManus, Jamie F; Hudes, Mark L

    2007-01-01

    Background Dietary supplement use in the United States is prevalent and represents an important source of nutrition. However, little is known about individuals who routinely consume multiple dietary supplements. This study describes the dietary supplement usage patterns, health, and nutritional status of long-term multiple dietary supplement users, and where possible makes comparisons to non-users and multivitamin/mineral supplement users. Methods Using a cross-sectional study design, information was obtained by online questionnaires and physical examination (fasting blood, blood pressure, body weight) from a convenience sample of long-term users of multiple dietary supplements manufactured by Shaklee Corporation (Multiple Supp users, n = 278). Data for non-users (No Supp users, n = 602) and multivitamin/mineral supplement users (Single Supp users, n = 176) were obtained from the National Health and Nutrition Examination Survey (NHANES) 2001–2002 and NHANES III 1988–1994. Logistic regression methods were used to estimate odds ratios with 95% confidence intervals. Results Dietary supplements consumed on a daily basis by more than 50% of Multiple Supp users included a multivitamin/mineral, B-complex, vitamin C, carotenoids, vitamin E, calcium with vitamin D, omega-3 fatty acids, flavonoids, lecithin, alfalfa, coenzyme Q10 with resveratrol, glucosamine, and a herbal immune supplement. The majority of women also consumed gamma linolenic acid and a probiotic supplement, whereas men also consumed zinc, garlic, saw palmetto, and a soy protein supplement. Serum nutrient concentrations generally increased with increasing dietary supplement use. After adjustment for age, gender, income, education and body mass index, greater degree of supplement use was associated with more favorable concentrations of serum homocysteine, C-reactive protein, high-density lipoprotein cholesterol, and triglycerides, as well as lower risk of prevalent elevated blood pressure and diabetes

  7. Usage patterns, health, and nutritional status of long-term multiple dietary supplement users: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Wong Les G

    2007-10-01

    Full Text Available Abstract Background Dietary supplement use in the United States is prevalent and represents an important source of nutrition. However, little is known about individuals who routinely consume multiple dietary supplements. This study describes the dietary supplement usage patterns, health, and nutritional status of long-term multiple dietary supplement users, and where possible makes comparisons to non-users and multivitamin/mineral supplement users. Methods Using a cross-sectional study design, information was obtained by online questionnaires and physical examination (fasting blood, blood pressure, body weight from a convenience sample of long-term users of multiple dietary supplements manufactured by Shaklee Corporation (Multiple Supp users, n = 278. Data for non-users (No Supp users, n = 602 and multivitamin/mineral supplement users (Single Supp users, n = 176 were obtained from the National Health and Nutrition Examination Survey (NHANES 2001–2002 and NHANES III 1988–1994. Logistic regression methods were used to estimate odds ratios with 95% confidence intervals. Results Dietary supplements consumed on a daily basis by more than 50% of Multiple Supp users included a multivitamin/mineral, B-complex, vitamin C, carotenoids, vitamin E, calcium with vitamin D, omega-3 fatty acids, flavonoids, lecithin, alfalfa, coenzyme Q10 with resveratrol, glucosamine, and a herbal immune supplement. The majority of women also consumed gamma linolenic acid and a probiotic supplement, whereas men also consumed zinc, garlic, saw palmetto, and a soy protein supplement. Serum nutrient concentrations generally increased with increasing dietary supplement use. After adjustment for age, gender, income, education and body mass index, greater degree of supplement use was associated with more favorable concentrations of serum homocysteine, C-reactive protein, high-density lipoprotein cholesterol, and triglycerides, as well as lower risk of prevalent elevated blood

  8. Descriptive characteristics and health outcomes of the food by prescription nutrition supplementation program for adults living with HIV in Nyanza Province, Kenya.

    Science.gov (United States)

    Nagata, Jason M; Cohen, Craig R; Young, Sera L; Wamuyu, Catherine; Armes, Mary N; Otieno, Benard O; Leslie, Hannah H; Dandu, Madhavi; Stewart, Christopher C; Bukusi, Elizabeth A; Weiser, Sheri D

    2014-01-01

    The clinical effects and potential benefits of nutrition supplementation interventions for persons living with HIV remain largely unreported, despite awareness of the multifaceted relationship between HIV infection and nutrition. We therefore examined descriptive characteristics and nutritional outcomes of the Food by Prescription (FBP) nutrition supplementation program in Nyanza Province, Kenya. Demographic, health, and anthropometric data were gathered from a retrospective cohort of 1,017 non-pregnant adult patients who enrolled into the FBP program at a Family AIDS Care and Education Services (FACES) site in Nyanza Province between July 2009 and July 2011. Our primary outcome was FBP treatment success defined as attainment of BMI>20, and we used Cox proportional hazards to assess socio-demographic and clinical correlates of FBP treatment success. Mean body mass index was 16.4 upon enrollment into the FBP program. On average, FBP clients gained 2.01 kg in weight and 0.73 kg/m2 in BMI over follow-up (mean 100 days), with the greatest gains among the most severely undernourished (BMI 20, though 44.5% achieved a BMI increase ≥0.5. Greater BMI at baseline, younger age, male gender, and not requiring highly active antiretroviral therapy (HAART) were associated with a higher rate of attainment of BMI>20. This study reports significant gains in weight and BMI among patients enrolled in the FBP program, though only a minority of patients achieved stated programmatic goals of BMI>20. Future research should include well-designed prospective studies that examine retention, exit reasons, mortality outcomes, and long-term sustainability of nutrition supplementation programs for persons living with HIV.

  9. Problems of actuality in meal and nutrition care

    DEFF Research Database (Denmark)

    Krogh, Line Hesselvig; Beck, Anne Marie; Hansen, Mette Weinreich

    2018-01-01

    This study is based on an issue in nurses´ meal and nutrition care, relating to nurses´ perception of transfer of knowledge between different care settings. Through the notion ‘problems of actuality’, the aim is to identify how and why different methods in care, may complicate preventive effort...... related to undernutrition among older adults. It is a qualitative study that lends itself to ethnography and ethnomethodology, with data collected through the use of semi-structured interviews and insights into patients´ medical charts. Through explications of nurses’ methods in meal and nutrition care...... between social-bodily care work and text-based care work, there is a lack of transfer of knowledge, from which important parts of meal and nutrition care work become invisible. The study finds a need for noticing the disjuncture between social-bodily care and text-based care and for both methods of care...

  10. Patterns of Nutrition and Dietary Supplements Use in Young Egyptian Athletes: A Community-Based Cross-Sectional Survey

    Science.gov (United States)

    Tawfik, Safaa; El Koofy, Nehal; Moawad, Eman Mohamed Ibraheim

    2016-01-01

    The aim of this study was to investigate the pattern of basic and sport nutrition as well as perspectives of young Egyptian athletes. Structured interview survey measuring knowledge, attitudes, beliefs and behaviors about basic and sport nutrition was administered to adolescent athletes recruited from 4 sport clubs and 2 fitness centers in Greater Cairo governorate. A total of 358 participants aged 13–18 years completed questionnaires. Basic nutrition knowledge was reasonable in almost all domains except fast food. Fixed breakfast (78.5%), home meals (lunch, 70.7%), and healthy snacks (55.8%) were the most positive features of the basic dietary pattern. More than 70% perceived themselves as knowledgeable about sport nutrition. The prevalence rate of sport supplement intake was (48.9%, n = 175), predominantly sport drinks (66.9%) and creatine (54.3%). Coaches were the primary source of sport nutrition information. Forty-four percent of participants (n = 77/175) reported supplement consumption during competition seasons only. Better physical appearance and enhancement of athletic performance were the major motivations for supplement intake. These findings indicate the necessity of a comprehensive nutrition education program targeting not only athletes and parents, but also coaching staff, health trainers and all sport team officials. PMID:27529492

  11. Patterns of Nutrition and Dietary Supplements Use in Young Egyptian Athletes: A Community-Based Cross-Sectional Survey.

    Directory of Open Access Journals (Sweden)

    Safaa Tawfik

    Full Text Available The aim of this study was to investigate the pattern of basic and sport nutrition as well as perspectives of young Egyptian athletes. Structured interview survey measuring knowledge, attitudes, beliefs and behaviors about basic and sport nutrition was administered to adolescent athletes recruited from 4 sport clubs and 2 fitness centers in Greater Cairo governorate. A total of 358 participants aged 13-18 years completed questionnaires. Basic nutrition knowledge was reasonable in almost all domains except fast food. Fixed breakfast (78.5%, home meals (lunch, 70.7%, and healthy snacks (55.8% were the most positive features of the basic dietary pattern. More than 70% perceived themselves as knowledgeable about sport nutrition. The prevalence rate of sport supplement intake was (48.9%, n = 175, predominantly sport drinks (66.9% and creatine (54.3%. Coaches were the primary source of sport nutrition information. Forty-four percent of participants (n = 77/175 reported supplement consumption during competition seasons only. Better physical appearance and enhancement of athletic performance were the major motivations for supplement intake. These findings indicate the necessity of a comprehensive nutrition education program targeting not only athletes and parents, but also coaching staff, health trainers and all sport team officials.

  12. Nutritional supplements as radioprotectors -- A review and proposal

    Energy Technology Data Exchange (ETDEWEB)

    Muscatello, A.C.

    1998-12-31

    The scientific literature contains several reports that show nutritional substances, such as vitamins, minerals, and phytochemicals (plant chemicals), provide substantial radioprotective effects in animal studies. Incorporating these substances to the human diet, already voluntarily practiced by a large segment of the population, in addition to providing other favorable health effects, may also provide a radioprotective effect. This potential radioprotective effect would be very useful in mitigating the effects of occupational radiation exposure to astronauts (especially future Mars explorers), airline crews, nuclear workers, both commercial and government, and populations exposed to nuclear accidents, e.g. Chernobyl. This paper reviews the existing evidence of radioprotective effects by nutritional supplements and proposes that their efficacy be evaluated, first with animal studies, followed by human tests with astronauts and cosmonauts on long-term missions, such as to the Mir space station and the International Space Station (ISS).

  13. Nutritional supplements as radioprotectors -- A review and proposal

    International Nuclear Information System (INIS)

    Muscatello, A.C.

    1998-01-01

    The scientific literature contains several reports that show nutritional substances, such as vitamins, minerals, and phytochemicals (plant chemicals), provide substantial radioprotective effects in animal studies. Incorporating these substances to the human diet, already voluntarily practiced by a large segment of the population, in addition to providing other favorable health effects, may also provide a radioprotective effect. This potential radioprotective effect would be very useful in mitigating the effects of occupational radiation exposure to astronauts (especially future Mars explorers), airline crews, nuclear workers, both commercial and government, and populations exposed to nuclear accidents, e.g. Chernobyl. This paper reviews the existing evidence of radioprotective effects by nutritional supplements and proposes that their efficacy be evaluated, first with animal studies, followed by human tests with astronauts and cosmonauts on long-term missions, such as to the Mir space station and the International Space Station (ISS)

  14. Using Nutrition Against Aging and Degenerative Disease.

    Science.gov (United States)

    Rokosz, Francis M.

    A review of historical and research literature presents various perspectives on the growing controversy surrounding the use of vitamin and mineral supplements to maintain good health and for preventive health care. Several points are made in opposition to many health professionals' opinions that most nutritional supplements are unnecessary.…

  15. Direct observation of the nutrition care practices of Australian general practitioners

    Directory of Open Access Journals (Sweden)

    Ball LE

    2014-06-01

    Full Text Available INTRODUCTION: Nutrition care refers to nutrition-related advice or counselling provided by health professionals in an attempt to improve the nutrition behaviour of patients. AIM: The aim of this study was to describe the practices of a sample of Australian general practitioners (GPs when providing nutrition care to adult patients. METHODS: Eighteen GPs (13 male, 5 female were observed by fourth-year medical students during their general practice rotation. Each GP was observed for five consultations that included nutrition care, totalling 90 observed consultations. In each consultation, students completed a 31-item nutrition care checklist of nutrition care practices that could feasibly occur in a standard consultation. Each practice was marked with either a ‘yes’ (completed, ‘no’ (did not complete or ‘completed by practice nurse prior to or after the consultation’. RESULTS: Twenty-eight nutrition care practices were observed at least once. The most frequently observed practices were measuring and discussing blood pressure (76.7%; n=69, followed by general questions about current diet (74.4%; n=67. Approximately half of the consultations included a statement of a nutrition-related problem (52.2%; n=47, and the provision of nutrition advice that focused on a nutrient (45.6%; n=41 or food group (52.2%; n=47. Consultations with male GPs, as well as GPs with more than 25 years of experience, were associated with an increased number of nutrition care practices per consultation. DISCUSSION: The GPs performed nutrition care practices in varying frequencies. Further research is required to identify the most effective GP nutrition care practices to improve the nutrition behaviour of patients.

  16. Role of Diet and Nutritional Supplements in Parkinson’s Disease Progression

    Directory of Open Access Journals (Sweden)

    Laurie K. Mischley

    2017-01-01

    Full Text Available Objectives. The goal of this study is to describe modifiable lifestyle variables associated with reduced rate of Parkinson’s disease (PD progression. Methods. The patient-reported outcomes in PD (PRO-PD were used as the primary outcome measure, and a food frequency questionnaire (FFQ was used to assess dietary intake. In this cross-sectional analysis, regression analysis was performed on baseline data to identify the nutritional and pharmacological interventions associated with the rate of PD progression. All analyses were adjusted for age, gender, and years since diagnosis. Results. 1053 individuals with self-reported idiopathic PD were available for analysis. Foods associated with the reduced rate of PD progression included fresh vegetables, fresh fruit, nuts and seeds, nonfried fish, olive oil, wine, coconut oil, fresh herbs, and spices (P<0.05. Foods associated with more rapid PD progression include canned fruits and vegetables, diet and nondiet soda, fried foods, beef, ice cream, yogurt, and cheese (P<0.05. Nutritional supplements coenzyme Q10 and fish oil were associated with reduced PD progression (P=0.026 and P=0.019, resp., and iron supplementation was associated with faster progression (P=0.022. Discussion. These are the first data to provide evidence that targeted nutrition is associated with the rate of PD progression.

  17. Nutrition in care homes and home care: How to implement adequate strategies

    DEFF Research Database (Denmark)

    Arvanitakis, M.; Beck, Anne Marie; Coppens, P.

    2008-01-01

    are various: medical, social, environmental, organizational and financial. Lack of alertness of individuals, their relatives and health-care professionals play an important role. Undernutrition enhances the risk of infection, hospitalization, mortality and alter the quality of life. Moreover, undernutrition...... related-disease is an economic burden in most countries. Nutritional assessment should be part of routine global management. Nutritional support combined with physical training and an improved ambiance during meats is mandatory. Awareness, information and collaboration with all the stakeholders should...... facilitate implementation of nutritional strategies. Conclusions: Undernutrition in home care and care home settings is a considerable problem and measures should be taken to prevent and treat it. (C) 2008 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved....

  18. Barriers for nutritional care in the transition from hospital to the community among older patients.

    Science.gov (United States)

    Ginzburg, Yulia; Shmilovitz, Inbar; Monastyrsky, Nechama; Endevelt, Ronit; Shahar, Danit R

    2018-06-01

    Data on the continuity of nutritional care in the transition from the hospital to the community is scarce although its impact on medical complications is highly significant. The aim of the current study is to determine level of adherence to dietary recommendations after hospitalization and identify barriers for adherence. A prospective study among patients age ≥65 who were treated with oral nutritional supplements (ONS) during their hospitalization and discharged with dietary recommendations. Data was obtained in the hospital and at a 3-month home-visit. Adherence was assessed monthly and barriers for non-adherence were determined. Adherence levels were summed for 3 months and then divided into: 1. Full adherence: complete consumption as prescribed; 2. Partial adherence: partial consumption of the prescription [at least half]; or 3. No adherence: not consumed or less than half. Health-status was obtained from medical records; nutritional-status using anthropometric measurements, depressive symptoms using GDS [Geriatric Depression Scale], and functional abilities using FIM [Functional Independence Measure] were determined. Dietary intake was assessed by 24-h recall. Eighty-six patients were recruited (56 women) and followed for 3-months after discharge; 47.7% were advised in their discharge letter to consume at least one liquid ONS daily, 29% daily powder ONS, and 23.3% were advised to consume both. Adherence with liquid ONS was significantly higher among both groups, p nutritional supplements. In a regression model patients who were edentulous (OR = 9.13), with more depression symptoms (OR = 5.12), or lower BMI (OR = 1.13) were significantly more likely to adhere to ONS than patients with full dentition, fewer depression symptoms, and higher BMI. Providing a prescription for ONS by a primary care physician was a significant predictor [OR = 4.7] for adherence. Our results show low adherence to nutritional treatment in the community. Improving hospital

  19. Nutritional Supplementation Inhibits the Increase in Serum Malondialdehyde in Patients with Wet Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Toshiyuki Matsuura

    2017-01-01

    Full Text Available Purpose. To compare serum levels of malondialdehyde (MDA in patients with wet age-related macular degeneration (wAMD, patients with dry AMD (dAMD, and patients without AMD and to evaluate the efficacy of nutritional supplementation for treating elevated serum MDA in patients with wAMD. Methods. MDA levels were measured in sera from 20 patients with wAMD, 20 with dAMD, and 24 without AMD. Patients with wAMD were randomized to receive or not receive nutritional supplementation (10 patients in each group, and MDA levels were measured after 3 months of treatment. Results. MDA levels in patients with wAMD were significantly greater compared with patients without AMD. In eyes with wAMD, there was a significant correlation between MDA levels and choroidal neovascularization lesion area. Serum MDA levels decreased in most patients that received supplementation and significantly increased in those who did not. Conclusion. Baseline serum MDA levels were elevated in patients with wAMD, and MDA levels were directly correlated with choroidal neovascularization lesion area. In addition, nutritional supplementation appeared to exert a protective effect against oxidative stress in patients with wAMD.

  20. Role of young child formulae and supplements to ensure nutritional adequacy in U.K. young children

    DEFF Research Database (Denmark)

    Vieux, Florent; Brouzes, Chloé M C; Maillot, Matthieu

    2016-01-01

    The European Food Safety Authority (EFSA) states that young child formulae (YCFs) “cannot be considered as a necessity to satisfy the nutritional requirements” of children aged 12–36 months. This study quantifies the dietary changes needed to ensure nutritional adequacy in U.K. young children who...... consume YCFs and/or supplements and in those who do not. Dietary data from 1147 young children (aged 12–18 months) were used to identify, using linear programming models, the minimum changes needed to ensure nutritional adequacy: (i) by changing the quantities of foods initially consumed by each child....../day, respectively). Increasing YCF and supplement consumption was the shortest way to cover the EFSA nutrient requirements of U.K. children....

  1. Iodine Supplementation for Pediatric Patients Receiving Long-Term Parenteral Nutrition.

    Science.gov (United States)

    Santoro, Jonathan D; Nespor, Colleen; Poole, Robert L; Kerner, John A

    2016-04-01

    Patients dependent on parenteral nutrition (PN) are among a group at risk of developing iodine deficiency. Supplementation with iodine in this population has been debated in a number of studies, resulting in variable clinical practices. The Committee on Clinical Practice Issues of the American Society for Clinical Nutrition recommends a dose of 1 mcg/kg/d of parenteral iodine for patients receiving PN. At our institution, PN trace elements do not include iodine, although this is not the case internationally. Our study sought to assess iodine levels and thyroid function in a cohort of PN-dependent pediatric patients. A retrospective analysis studied 32 pediatric patients with a variety of medical diagnoses who received PN as a primary means of nutrition for 6 months or longer. Patients received variable proportions of their total caloric intake as PN, which ranged from 14%-100%. Iodine and thyroid function levels were obtained by serum sampling. No patient in our cohort of 32 demonstrated thyroid dysfunction or developed iodine deficiency. The length of time on PN and the percentage of total nutrition intake as PN were not associated with iodine levels (P Parenteral and Enteral Nutrition.

  2. Nutrition in the neurocritical care unit

    Directory of Open Access Journals (Sweden)

    Swagata Tripathy

    2015-01-01

    Full Text Available The aim of intensive care is to support the physiology of the body till the treatment or the reparative process of the body kicks in to the rescue. Maintaining an adequate nutrition during this period is of vital importance to counteract the catabolic effect of the critical disease process. The guidelines for nutritional care in the neuro intensive care unit (ICU are sparse. This article collates the current evidence and best practice recommendations as applicable to the critically ill patient in the neuro ICU. The use of screening tests to identify patients at a risk of malnutrition and related complications is presently recommended for all patients with an emphasis on early initiation of caloric support. Over-aggressive feeding in an attempt to revert the catabolic effects of critical illness have not proven beneficial, just as the attempts to improve patient outcomes by altering the routes of nutrition administration. Special patient population such as traumatic brain injury, stroke, subarachnoid haemorrhage or spinal cord injury may have varying nutritional requirements; individualised approach in the neurocritical ICU with the help of the intensivist, nutritionist and pharmacology team may be of benefit.

  3. Combining pain therapy with lifestyle: the role of personalized nutrition and nutritional supplements according to the SIMPAR Feed Your Destiny approach.

    Science.gov (United States)

    De Gregori, Manuela; Muscoli, Carolina; Schatman, Michael E; Stallone, Tiziana; Intelligente, Fabio; Rondanelli, Mariangela; Franceschi, Francesco; Arranz, Laura Isabel; Lorente-Cebrián, Silvia; Salamone, Maurizio; Ilari, Sara; Belfer, Inna; Allegri, Massimo

    2016-01-01

    Recently, attention to the lifestyle of patients has been rapidly increasing in the field of pain therapy, particularly with regard to the role of nutrition in pain development and its management. In this review, we summarize the latest findings on the role of nutrition and nutraceuticals, microbiome, obesity, soy, omega-3 fatty acids, and curcumin supplementation as key elements in modulating the efficacy of analgesic treatments, including opioids. These main topics were addressed during the first edition of the Study In Multidisciplinary Pain Research workshop: "FYD (Feed Your Destiny): Fighting Pain", held on April 7, 2016, in Rome, Italy, which was sponsored by a grant from the Italian Ministry of Instruction on "Nutraceuticals and Innovative Pharmacology". The take-home message of this workshop was the recognition that patients with chronic pain should undergo nutritional assessment and counseling, which should be initiated at the onset of treatment. Some foods and supplements used in personalized treatment will likely improve clinical outcomes of analgesic therapy and result in considerable improvement of patient compliance and quality of life. From our current perspective, the potential benefit of including nutrition in personalizing pain medicine is formidable and highly promising.

  4. Combining pain therapy with lifestyle: the role of personalized nutrition and nutritional supplements according to the SIMPAR Feed Your Destiny approach

    Science.gov (United States)

    De Gregori, Manuela; Muscoli, Carolina; Schatman, Michael E; Stallone, Tiziana; Intelligente, Fabio; Rondanelli, Mariangela; Franceschi, Francesco; Arranz, Laura Isabel; Lorente-Cebrián, Silvia; Salamone, Maurizio; Ilari, Sara; Belfer, Inna; Allegri, Massimo

    2016-01-01

    Recently, attention to the lifestyle of patients has been rapidly increasing in the field of pain therapy, particularly with regard to the role of nutrition in pain development and its management. In this review, we summarize the latest findings on the role of nutrition and nutraceuticals, microbiome, obesity, soy, omega-3 fatty acids, and curcumin supplementation as key elements in modulating the efficacy of analgesic treatments, including opioids. These main topics were addressed during the first edition of the Study In Multidisciplinary Pain Research workshop: “FYD (Feed Your Destiny): Fighting Pain”, held on April 7, 2016, in Rome, Italy, which was sponsored by a grant from the Italian Ministry of Instruction on “Nutraceuticals and Innovative Pharmacology”. The take-home message of this workshop was the recognition that patients with chronic pain should undergo nutritional assessment and counseling, which should be initiated at the onset of treatment. Some foods and supplements used in personalized treatment will likely improve clinical outcomes of analgesic therapy and result in considerable improvement of patient compliance and quality of life. From our current perspective, the potential benefit of including nutrition in personalizing pain medicine is formidable and highly promising. PMID:27994480

  5. The nursing contribution to nutritional care in cancer cachexia.

    Science.gov (United States)

    Hopkinson, Jane B

    2015-11-01

    Cancer cachexia is a complex syndrome. Its defining feature is involuntary weight loss, which arises, in part, because of muscle atrophy and is accompanied by functional decline. International expert consensus recommends that nutritional support and counselling is a component of multimodal therapy for cancer cachexia, as poor nutritional intake can contribute to progression of the syndrome. The present paper focuses on what is presently known about the nursing contribution to nutritional care in cancer cachexia. There is potential for nurses to play an important role. However, obstacles to this include lack of a robust evidence base to support their nutritional care practices and unmet need for education about nutrition in cancer. The nursing role's boundaries and the outcomes of nurse-delivered nutritional care in cancer cachexia are both uncertain and should be investigated.

  6. Perception of need for nutritional support in advanced cancer patients with cachexia: a survey in palliative care settings.

    Science.gov (United States)

    Amano, Koji; Morita, Tatsuya; Miyamoto, Jiro; Uno, Teruaki; Katayama, Hirofumi; Tatara, Ryohei

    2018-03-05

    Few studies have investigated the need for nutritional support in advanced cancer patients in palliative care settings. Therefore, we conducted a questionnaire to examine the relationship between the perception of need for nutritional support and cancer cachexia and the prevalence of specific needs, perceptions, and beliefs in nutritional support. We conducted a questionnaire in palliative care settings. Patients were classified into two groups: (1) non-cachexia/pre-cachexia and (2) cachexia/refractory cachexia. A total of 117 out of 121 patients responded (96.7%). A significant difference was observed in the need for nutritional support between the groups: non-cachexia/pre-cachexia (32.7%) and cachexia/refractory cachexia (53.6%) (p = 0.031). The specific needs of patients requiring nutritional support were nutritional counseling (93.8%), ideas to improve food intake (87.5%), oral nutritional supplements (83.0%), parenteral nutrition and hydration (77.1%), and tube feeding (22.9%). The top perceptions regarding the best time to receive nutritional support and the best medical staff to provide nutritional support were "when anorexia, weight loss, and muscle weakness become apparent" (48.6%) and "nutritional support team" (67.3%), respectively. The top three beliefs of nutritional treatments were "I do not wish to receive tube feeding" (78.6%), "parenteral nutrition and hydration are essential" (60.7%), and "parenteral hydration is essential" (59.6%). Patients with cancer cachexia expressed a greater need for nutritional support. They wished to receive nutritional support from medical staff when they become unable to take sufficient nourishment orally and the negative impact of cachexia becomes apparent. Most patients wished to receive parenteral nutrition and hydration.

  7. The Effect of Educational Package on Nutritional Knowledge and Behavior toward the Coping with Complication and Supplement Consumption

    Directory of Open Access Journals (Sweden)

    S Mohammad Alizadeh chrnabi

    2013-07-01

    Background & aim: Proper nutrition is essential in the prevention and improvement of maternal problems and fetal health during pregnancy. The aim of this study was to determine the effect of nutrition education package on knowledge and nutritional behavior of pregnant women coping with problems and taking supplements during pregnancy. Methods: In the present clinical trial, a number of 88 pregnant women referred to health centers in Karaj, Iran, were selected and randomly divided into two groups (Intervention and control group. Two sessions of approximately 60 minutes including classes on nutrition during pregnancy was held for the intervention group using presentation, booklets, and educational film sex education with similar method was held for the control group. Data were collected through a questionnaire. The collected data was analyzed by analysis of variance with repeated measures analysis of covariance and logistic regression analyzes. Results: In the intervention group, in the field of knowledge dealing with problems during pregnancy and after the intervention supplements in two stages were significantly higher than the control group (p˂001. Scores in the intervention group in the field of nutritional problems during pregnancy included constipation, heartburn, swollen hands and feet, anemia and urinary tract infections during both stages of the intervention were better than the control group (p˂005. Iron and multivitamin supplementation in the intervention group during two phases after the intervention phase was better than the control group (p˂005. Conclusion: The content of educational package was evaluated as an appropriate policy in promoting nutritional knowledge and behavior among pregnant women. Key words: Education, knowledge behavior, nutritional supplements, pregnancy

  8. Review of randomized controlled trials of nutritional supplementation in people living with HIV

    Directory of Open Access Journals (Sweden)

    Sneij A

    2016-04-01

    Full Text Available Alicia Sneij, Adriana Campa, Marianna K Baum Stempel College of Public Health and Social Work, Florida International University, Modesto Maidique Campus, Miami, FL, USA Background: Nutritional deficiencies are widespread in people living with HIV (PLWH, prior to the antiretroviral treatment (ART. Nutrient deficiencies and other nutrition-related conditions, however, have been identified in patients receiving ART. Trials of nutritional supplementation have been conducted to alleviate these nutritional conditions and improve or reverse nutrition-related outcomes. This review aims to evaluate the benefits of supplementation, its unintended adverse effects, and the difference in approach and focus, research design, formulations, and outcomes between those randomized clinical trials (RCTs conducted before and after the initiation of ART. Methods: An evidence-based systematic review of the literature was conducted using electronic databases and the resources of the Florida International University Research Library. Forty-two RCTs were selected for review, and their design and outcomes were compared and contrasted conceptually and in the form of tables. Results: Most of the RCTs (n=31 were conducted before the advent of ART, and their aims were delaying disease progression, reversing malnutrition, and improving pregnancy outcomes in women and infants infected with HIV. The RCTs conducted with coadministration of ART were fewer (n=11, with relative smaller sample size, of shorter duration, and mainly focused on preventing or ameliorating the nutrition-related conditions generated by the chronic infection, its treatment, and the aging of PLWH. Conclusion: As ART is becoming more accessible worldwide, and people are living longer with the disease, more longitudinal trials of nutritional interventions with larger sample sizes are needed to study the nutritional consequences and potential treatments for PLWH. Keywords: HIV, antiretroviral therapy

  9. Preoperative oral nutritional interventions in surgery, including arginine- and glutamine-enhanced supplements

    NARCIS (Netherlands)

    Brinkmann, S.J.H.; Buijs, N.; Luttikhold, J.; Mahdavian Delavary, B.; Niessen, F.B.; van Leeuwen, P.A.M.

    2013-01-01

    The patients' condition prior to surgery is of major importance for clinical outcome. It is believed nowadays that artificial nutrition in the form of a preoperative drink may improve postoperative outcome. Until now, a clear overview concerning the effects of preoperative supplementation on

  10. Effects of peridialytic oral supplements on nutritional status and quality of life in chronic hemodialysis patients.

    Science.gov (United States)

    Scott, Meri Kay; Shah, Niyati A; Vilay, A Mary; Thomas, Joseph; Kraus, Michael A; Mueller, Bruce A

    2009-03-01

    Our objective was to determine the effects of peridialytic oral supplements on nutritional markers and quality of life (QOL) in patients receiving maintenance hemodialysis. This trial was open, prospective, nonrandomized, and comparative. This study was performed at an outpatient hemodialysis unit in a teaching hospital. This study included 88 adults with chronic kidney disease at stage 5. This study involved directly observed nutrition therapy with >or=1 can of enteral nutrition (Nepro) with each hemodialysis session thrice weekly for 3 months, or standard care. Changes in biochemical markers of nutritional status and QOL, as measured by the Kidney Disease Quality of Life-Short Form, were determined. Peridialytic oral nutrition resulted in a significant difference between the nutrition and comparison groups in serum albumin change over time (P = .03; repeated-measures analysis of variance with covariates). Mean (+/-SD) serum albumin concentration did not differ between baseline and month 3 in the nutrition group (3.68 +/- 0.33 g/dL vs. 3.75 +/- 0.40 g/dL; P = .12), but in the comparison group, serum albumin levels declined significantly (3.93 +/- 0.34 g/dL at baseline versus 3.81 +/- 0.37 g/dL at month 3; P = .04). The "role-physical" domain score of the Kidney Disease Quality of Life-Short Form significantly changed over time in the nutrition group versus the comparison group (P = .02; repeated-measures analysis of variance with covariates). Nepro was well-tolerated, and greater than 80% of the prescribed therapy was consumed. Oral nutrition, as part of structured, directly observed peridialytic therapy in chronic hemodialysis patients, was well-accepted, and resulted in the maintenance of serum albumin levels and QOL with respect to impact of physical health on daily activities. These findings need to be confirmed in a randomized, controlled trial.

  11. Dynamics and Determinants of Supplemental Nutrition Assistance Program Participation from 2008 to 2012

    OpenAIRE

    James Mabli; Thomas Godfrey; Nancy Wemmerus; Joshua Leftin; Stephen Tordella

    2014-01-01

    Mathematica nutrition experts recently conducted research on the dynamics and determinants of Supplemental Nutrition Assistance Program (SNAP) participation. A study examines SNAP participation dynamics between October 2008 and December 2012. In particular, it describes patterns of SNAP entry, length of time on the program, and re-entry for policy-relevant subgroups, and discusses how these patterns have changed over time. This work was conducted in conjunction with an analysis presented on t...

  12. Comparing the Effectiveness of a Supplemental Online Tutorial to Traditional Instruction with Nutritional Science Students

    Science.gov (United States)

    Zubas, Patrice; Heiss, Cindy; Pedersen, Mary

    2006-01-01

    The purpose of this study was to ascertain if an online computer tutorial on diabetes mellitus, supplemented to traditional classroom lecture, is an effective tool in the education of nutrition students. Students completing a web-based tutorial as a supplement to classroom lecture displayed greater improvement in pre- vs. post-test scores compared…

  13. An innovative brioche enriched in protein and energy improves the nutritional status of malnourished nursing home residents compared to oral nutritional supplement and usual breakfast: FARINE+ project.

    Science.gov (United States)

    Van Wymelbeke, Virginie; Brondel, Laurent; Bon, Francis; Martin-Pfitzenmeyer, Isabelle; Manckoundia, Patrick

    2016-10-01

    To compare the effects of a 12-week nutritional intervention, in which an innovative protein-and-energy-enriched brioche, an oral nutritional supplement or a usual breakfast were eaten, on food intake and nutritional status in nursing home residents. Three-armed, multicentre, controlled trial. Eight nursing homes in Burgundy, France. Sixty-eight malnourished participants aged between 70 and 99 years old. Participants were randomly assigned to one of three groups according to the breakfast provided: brioche group, one portion of 65 g brioche enriched in protein and energy (12.8 g and 180 kcal) added to usual breakfast; supplement group, 200-ml of a ready-to-use, energy-dense liquid (14 g protein and 200 kcal) added to usual breakfast or control group, a usual breakfast only. Total energy intakes were assessed for three days at different periods of the study (day 0, day 30 and day 90); blood parameters, nutritional status (mini nutritional assessment, weight) and functional capacities (grip strength and activity level) were measured at the beginning and at the end of the nutritional intervention study (day 0 and day 90). The participants of the brioche group had higher total energy intakes at day 30 (p value 0.004) and at day 90 (p value 0.018) compared with the supplement group and the control group. At the end of the interventional study, 72% of the participants in the brioche group had reached the recommended minimum level of protein of 0.8 g/kg/day, compared with 53% in the supplement group and 36% in the control group (p value 0.036). In addition, between day 0 and day 90 in the brioche group, blood levels of vitamins B 9 , B 2 , D (all p value <0.001), B 6 (p value 0.026) and B 12 (p value 0.036) had increased and plasma homocysteine had decreased (p value 0.024). The protein-and-energy-enriched brioche effectively increased energy and protein intakes and improved the nutritional status of elderly people living in nursing homes. It could be a good

  14. The use of nutritional supplements in dressage and eventing horses

    Science.gov (United States)

    Agar, C.; Gemmill, R.; Hollands, T.; Freeman, S. L.

    2016-01-01

    The aim of the study was to determine which types of nutritional supplements were used in dressage and eventing horses, and the reasons that owners used supplements. An online questionnaire was distributed through British Eventing and Dressage websites, to collect data on demographics of owners and their horses, supplements used and their opinion on health and performance problems. Data were evaluated using descriptive analysis, Sign and Fisher's exact tests for quantitative data, and categorisation of qualitative data. In total, 599 responses met the inclusion criteria (441 dressage and 158 eventing horse owners). Participants had 26.4 (3–60) (mean (range)) years of riding experience, owned 1.2 (0–10) horses and used 2 (0–12) supplements in their highest performing horse. The main health and performance issues identified for dressage were ‘energy/behaviour’, ‘lameness’ and ‘back and muscle problems’. The main issues for eventing were ‘stamina and fitness levels’,’ lameness’ and ‘energy/behaviour’. The main reasons for using supplements in their highest performing horse were ‘joints and mobility’, and ‘behaviour’ for dressage, and ‘electrolytes’, and ‘joints and mobility’ for eventing. Lameness and behavioural problems were significant concerns within both disciplines. There was incongruence between owners’ opinions of problems within their discipline and their reasons for using supplements. PMID:26925239

  15. Impact of Early Parenteral Nutrition on Metabolism and Kidney Injury

    OpenAIRE

    Gunst, Jan; Vanhorebeek, Ilse; Casaer, Michaël P.; Hermans, Greet; Wouters, Pieter J.; Dubois, Jasperina; Claes, Kathleen; Schetz, Miet; Van den Berghe, Greet

    2013-01-01

    A poor nutritional state and a caloric deficit associate with increased morbidity and mortality, but a recent multicenter, randomized controlled trial found that early parenteral nutrition to supplement insufficient enteral nutrition increases morbidity in the intensive care unit, including prolonging the duration of renal replacement therapy, compared with withholding parenteral nutrition for 1 week. Whether early versus late parenteral nutrition impacts the incidence and recovery of AKI is ...

  16. Improvement of Nutritive Value and Ruminal Fermentation of Silage by Molasses and Urea Supplementation

    Directory of Open Access Journals (Sweden)

    K. Phesatcha

    2016-08-01

    Full Text Available Leucaena silage was supplemented with different levels of molasses and urea to study its nutritive value and in vitro rumen fermentation efficiency. The ensiling study was randomly assigned according to a 3×3 factorial arrangement in which the first factor was molasses (M supplement at 0%, 1%, and 2% of crop dry matter (DM and the second was urea (U supplement as 0%, 0.5%, and 1% of the crop DM, respectively. After 28 days of ensiling, the silage samples were collected and analyzed for chemical composition. All the nine Leucaena silages were kept for study of rumen fermentation efficiency using in vitro gas production techniques. The present result shows that supplementation of U or M did not affect DM, organic matter, neutral detergent fiber, and acid detergent fiber content in the silage. However, increasing level of U supplementation increased crude protein content while M level did not show any effect. Moreover, the combination of U and M supplement decreased the content of mimosine concentration especially with M2U1 (molasses 2% and urea 1% silage. The result of the in vitro study shows that gas production kinetics, cumulation gas at 96 h and in vitro true digestibility increased with the increasing level of U and M supplementation especially in the combination treatments. Supplementation of M and U resulted in increasing propionic acid and total volatile fatty acid whereas, acetic acid, butyric acid concentrations and methane production were not changed. In addition, increasing U level supplementation increased NH3-N concentration. Result from real-time polymerase chain reaction revealed a significant effect on total bacteria, whereas F. succinogenes and R. flavefaciens population while R. albus was not affected by the M and U supplementation. Based on this study, it could be concluded that M and urea U supplementation could improve the nutritive value of Leucaena silage and enhance in vitro rumen fermentation efficiency. This study also

  17. Importance of vitamin and mineral supplementation in HIV/AIDS patients to improve their nutritional and immunological status

    International Nuclear Information System (INIS)

    Oguntibeju, O.O.; Schalkwyk, F.V; Heever, WMJ. V.den.; Veldman, F.J.

    2003-01-01

    Nutrition intervention aimed at preventing or reversing weight loss and wasting in HIV infection may help to improve quality of life and prolong survival. Micronutrient supplementation may help to strengthen the immune system and reduce the severity and impact of opportunistic infections in people living with HIV / AIDS. HIV contributes to malnutrition for physiological reasons related to the infection itself. HIV /AIDS, being a disease of the immune system, new strategies, including specific dietary nutrients (nutrient supplementation) to improve immune functions, quality of life and prolong survival in infected individuals, could provide additional/alternative approaches for therapeutic treatment in HIV infected subjects. Several vitamins and minerals are important in fighting HIV infection and its resultant effects, hence nutritional supplementation has been advocated. This review focuses on the importance of vitamin/mineral supplementation in HIV / AIDS subjects. (author)

  18. The effect of conjugated linoleic acid supplementation on the nutritional status of COPD patients

    Directory of Open Access Journals (Sweden)

    Ghobadi H

    2016-10-01

    Full Text Available Hassan Ghobadi,1 Somaieh Matin,2 Ali Nemati,3 Abbas Naghizadeh-baghi4 1Pulmonary Division, 2Internal Medicine Department, 3Biochemistry and Nutrition Department, 4Basic Sciences Department, Ardabil University of Medical Sciences, Ardabil, Iran Background: COPD patients are susceptible to anorexia, reduction of caloric intake, weight loss, and malnutrition. One of the possible mechanisms is the increase of inflammatory markers such as interleukin 1β (IL1β, is highly correlated with anorexia. Considering the anti-inflammatory role of conjugated linoleic acid (CLA, this study aimed to investigate the effect of CLA supplementation on the nutritional status of COPD patients.Patients and methods: In a double-blind clinical trial, 93 COPD patients who volunteered to participate in the study and who filled out a written consent form, were randomly assigned to control or supplementation groups. The patients in the supplementation group received 3.2 g of CLA on a daily basis for 6 weeks, while those in the control group received placebo on a daily basis for 6 weeks. For IL1β assessment, the patients’ anthropometric indices and appetite score were checked and their blood samples were collected both before and after the treatment. Moreover, in order to investigate the changes in the caloric intake trend during the study, their dietary intake levels were assessed using 24-hour dietary recall, 3 days a week at the onset, in the 4th week, and at the end of the study. Eventually, 90 patients completed the study.Results: The results demonstrated a significant increase in appetite score (P=0.001, average caloric intake (P=0.01, and macronutrient intake (P<0.05, while a significant decrease was observed in the serum level of IL1β among the patients of the supplementation group (P=0.008. Meanwhile, although the supplementation group’s body mass index was also higher on completion, compared to their own initial state as well as to that in the control

  19. Measuring the Effect of Supplemental Nutrition Assistance Program (SNAP) Participation on Food Security.

    OpenAIRE

    James Mabli; Jim Ohls; Lisa Dragoset; Laura Castner; Betsy Santos

    2013-01-01

    The Supplemental Nutrition Assistance Program (SNAP) provides food assistance to more than 47 million low-income Americans every month. It aims to reduce hunger by facilitating beneficiaries’ access to enough food for a healthy, active lifestyle, otherwise known as "food security." Our study conducted for the Food and Nutrition Service of the U.S. Department of Agriculture shows that SNAP participation is associated with improved food security. The study is the largest and most rigorous one...

  20. Moderation of the Relation of County-Level Cost of Living to Nutrition by the Supplemental Nutrition Assistance Program.

    Science.gov (United States)

    Basu, Sanjay; Wimer, Christopher; Seligman, Hilary

    2016-11-01

    To examine the association of county-level cost of living with nutrition among low-income Americans. We used the National Household Food Acquisition and Purchase Survey (2012-2013; n = 14 313; including 5414 persons in households participating in the Supplemental Nutrition Assistance Program [SNAP]) to examine associations between county-level cost-of-living metrics and both food acquisitions and the Healthy Eating Index, with control for individual-, household-, and county-level covariates and accounting for unmeasured confounders influencing both area of living and food acquisition. Living in a higher-cost county-particularly one with high rent costs-was associated with significantly lower volume of acquired vegetables, fruits, and whole grains; greater volume of acquired refined grains, fats and oils, and added sugars; and an 11% lower Healthy Eating Index score. Participation in SNAP was associated with nutritional improvements among persons living in higher-cost counties. Living in a higher-cost county (particularly with high rent costs) is associated with poorer nutrition among low-income Americans, and SNAP may mitigate the negative nutritional impact of high cost of living.

  1. The Important Role of Carbohydrates in the Flavor, Function, and Formulation of Oral Nutritional Supplements

    Directory of Open Access Journals (Sweden)

    Smaro Kokkinidou

    2018-06-01

    Full Text Available Patients who are malnourished or at-risk for malnutrition often benefit from the consumption of oral nutritional supplements (ONS. ONS supply a range of micro- and macro-nutrients, and they can be used to supplement a diet or provide total nutrition. Since ONS are specially formulated products, all ONS ingredients—including carbohydrates—are added ingredients. This may seem to be at odds with the growing public health discourse on the need to reduce “added sugars” in the diet. However, carbohydrate is an essential nutrient for human health and is a critical ingredient in ONS. Helping to educate patients on the value of “added sugars” in ONS may be useful to improve compliance with nutritional recommendations when ONS are indicated. This perspective paper reviews the important roles of “added sugars” in ONS, in terms of flavor, function, and product formulation.

  2. The Effect of BCAA and ISO-WHEY Oral Nutritional Supplements on Dialysis Adequacy.

    Science.gov (United States)

    Afaghi, Effat; Tayebi, Ali; Ebadi, Abbas; Sobhani, Vahid; Einollahi, Behzad; Tayebi, Mehdi

    2016-11-01

    Protein-energy malnutrition is a common problem in hemodialysis patients and has different outcomes such as reduced quality of life, longer hospitalization time, lower dialysis adequacy, and higher mortality rate. Investigation of dialysis adequacy is an important method for assessing hemodialysis patients, and improving the dialysis adequacy is an important healthcare team goal. The present study aims to investigate and compare the effects of BCAA and ISO-WHEY oral nutritional supplements on dialysis adequacy. In a clinical trial study, 66 hemodialysis patients were randomly divided into three groups: Group A (n = 22), Group B (n = 22), and Group C or the control group (n = 22). In Groups A and B, as prescribed and controlled by nutritionists and nephrologists, respectively, ISO-WHEY and BCAA protein powder were used for 2 months on a daily basis. For all groups, before intervention and 1 and 2 months after intervention, the dialysis adequacy was measured using URR and Kt/V. Finally, the data were analyzed using IBM SPSS Statistics Base 21.0 software. Out of 66 patients, 61 (19 in Group A, 20 in Group B, and 22 in Group C) completed the study period, and before intervention, all groups were equal in terms of quality and quantity variables (P > 0.05). After intervention, there was a significant difference between the three groups with regard to the variables of dialysis adequacy based on Kt/V and URR to independent-t test and repeated measures ANOVA (P < 0.05). Results show that the intake of oral nutritional supplements leads to an improvement in the dialysis adequacy of hemodialysis patients. Therefore, the use of nutritional supplements along with patients' training and regular consultation will be helpful in improving the nutritional status, dialysis adequacy, and eventually the quality of life.

  3. Knowledge, attitudes and practices in the provision of nutritional care.

    LENUS (Irish Health Repository)

    Fletcher, Antoinette

    2012-02-01

    The nutritional care of patients is one of the primary responsibilities of all registered nurses (Persenius et al, 2008). A poor nutritional status can lead to malnutrition, which can have serious consequences for an individual\\'s quality of life (Field and Smith, 2008). This paper commences with an introduction to the concept of nutrition, provides an overview of nutritional guidelines and nutritional screening tools which identify those at risk of malnutrition. It reviews the literature on nurses\\' knowledge, attitudes and practices in the provision of nutritional care and debates challenges and opportunities encountered to help nurses ensure adequate patient nutrition.

  4. Why US children use dietary supplements

    Science.gov (United States)

    Bailey, Regan L.; Gahche, Jaime J.; Thomas, Paul R.; Dwyer, Johanna T.

    2013-01-01

    Background: Dietary supplements are used by one-third of children. We examined motivations for supplement use in children, the types of products used by motivations, and the role of physicians and health care practitioners in guiding choices about supplements. Methods: We examined motivations for dietary supplement use reported for children (from birth to 19 y of age; n = 8,245) using the National Health and Nutrition Examination Survey 2007–2010. Results: Dietary supplements were used by 31% of children; many different reasons were given as follows: to “improve overall health” (41%), to “maintain health” (37%), for “supplementing the diet” (23%), to “prevent health problems” (20%), and to “boost immunity” (14%). Most children (~90%) who use dietary supplements use a multivitamin–mineral or multivitamin product. Supplement users tend to be non-Hispanic white, have higher family incomes, report more physical activity, and have health insurance. Only a small group of supplements used by children (15%) were based on the recommendation of a physician or other health care provider. Conclusion: Most supplements used by children are not under the recommendation of a health care provider. The most common reasons for use of supplements in children are for health promotion, yet little scientific data support this notion in nutrient-replete children. PMID:24002333

  5. Current state of knowledge about nutritional care of pregnant women

    Directory of Open Access Journals (Sweden)

    Luciana Barretto

    2014-12-01

    Full Text Available Pregnancy involves a significant anabolic activity that leads to increased nutritional needs relative to the preconception period. This paper aims to review the current understanding of the energy needs of macro and micronutrients during pregnancy as well as guidelines to address common gastrointestinal disorders during pregnancy, the issue of pica and anthropometric assessment to ensure an optimum weight gain. With the exception of iron, most of the nutrients needed by the pregnancy can be provided by a complete and balanced diet. Currently the scientific evidence shows that routine supplementation with iron and folic acid during pregnancy is a practice that prevents iron deficiency anemia, neural tube disorders and preterm births. Intermittent iron supplementation can also be an appropriated intervention. If the diet does not guarantee and adequate support, iodine, vitamin B12 and vitamin D supplements should also be necessaries. The anthropometric assessment by the pattern of weight gain should be present at each prenatal care visit to prevent maternal and fetal complications. In situations where the mother’s weight cannot be assessed, arm muscle circumference is possible to make an overall assessment as it correlates with maternal weight gain alternative. Measurements of biceps, triceps and subscapular skinfolds are another alternative that is useful to evaluate the fatty deposits and their location, in a complementary way to gain weight.

  6. Effect of incorporation of soy flour on functional, nutritional, and sensory properties of mushroom-moringa-supplemented healthy soup.

    Science.gov (United States)

    Mohajan, Suman; Orchy, Tania N; Farzana, Tasnim

    2018-05-01

    The research study was conducted to evaluate the effect of soy flour on functional, nutritional, and sensory properties of mushroom-moringa-supplemented soup which could be used as a protein-supplemented ready-to-eat food. In this study, corn flour was supplemented with soy flour at different levels such as 20% (T4), 15% (T3), 10% (T2), and 5% (T1), and without soy flour was kept as control (T0). Fixed amount of mushroom and moringa leaf powder was added in all soup powders. Soup powders were analyzed for functional, nutritional, and sensory parameters. Bulk density (0.82-0.74 g/ml), dispersibility (82.1%-75.9%), pH (6.17-6.13), swelling capacity (3.98-3.65 ml/g), and viscosity were decreased, while water absorption capacity (70%-94%) was increased with increasing of soy flour percentages. Protein content of all the treatment groups increased from 10.66% to 19.97% along with a significant increased in fat (1.43%-6.97%), fiber (1.10%-2.30%), ash (15.77%-16.40%), and energy value (328.38-353.21 kcal/100 g) while decreased in moisture and carbohydrate content. On sensory evaluation, soup powders with 10% (T2) level of soy flour incorporation had highest scores for all the sensory attributes evaluated. Based on these results, it can be concluded that soy flour has effect on functional, nutritional, and sensory properties of soup powders and 10% supplementation of soy flour is suitable for ready-to-eat soup formulation. Besides these, use of mushroom and moringa leaf may also increase its nutritional value. Soup developed in this way may be sufficient to meet day-to-day nutritional requirements as a supplement.

  7. FINDING POTENTIALLY UNSAFE NUTRITIONAL SUPPLEMENTS FROM USER REVIEWS WITH TOPIC MODELING.

    Science.gov (United States)

    Sullivan, Ryan; Sarker, Abeed; O'Connor, Karen; Goodin, Amanda; Karlsrud, Mark; Gonzalez, Graciela

    2016-01-01

    Although dietary supplements are widely used and generally are considered safe, some supplements have been identified as causative agents for adverse reactions, some of which may even be fatal. The Food and Drug Administration (FDA) is responsible for monitoring supplements and ensuring that supplements are safe. However, current surveillance protocols are not always effective. Leveraging user-generated textual data, in the form of Amazon.com reviews for nutritional supplements, we use natural language processing techniques to develop a system for the monitoring of dietary supplements. We use topic modeling techniques, specifically a variation of Latent Dirichlet Allocation (LDA), and background knowledge in the form of an adverse reaction dictionary to score products based on their potential danger to the public. Our approach generates topics that semantically capture adverse reactions from a document set consisting of reviews posted by users of specific products, and based on these topics, we propose a scoring mechanism to categorize products as "high potential danger", "average potential danger" and "low potential danger." We evaluate our system by comparing the system categorization with human annotators, and we find that the our system agrees with the annotators 69.4% of the time. With these results, we demonstrate that our methods show promise and that our system represents a proof of concept as a viable low-cost, active approach for dietary supplement monitoring.

  8. Malnutrition and nutritional care practices in hospital wards for older people.

    Science.gov (United States)

    Vanderwee, Katrien; Clays, Els; Bocquaert, Ilse; Verhaeghe, Sofie; Lardennois, Miguel; Gobert, Micheline; Defloor, Tom

    2011-04-01

    This paper is a report of a study conducted to gain a better insight into the current nutritional care practices in Belgian hospital wards for older people, and to study the association between these practices and the prevalence of malnutrition. In 1999, the Council of Europe assessed nutritional care practices and support in 12 European countries and showed them to be sparse and inconsistent. At the time of research, no studies had described the association between nutritional care practices and malnutrition prevalence in Belgium. In 2007, a cross-sectional survey was carried out in a representative sample of Belgian hospital wards for older people. In total, 2094 patients from 140 wards for older people were included. The overall prevalence rate of malnutrition in wards for older people was 31.9%. Nutritional care practices such as nutritional screening and assessment, use of a standardized screening instrument and a nutritional protocol were suboptimal. Multilevel analysis revealed that ward characteristics explained for 9.1% whether a patient was malnourished or not. None of the registered nutritional care practices could explain a patient's individual risk. Malnutrition is a frequently occurring problem on hospital wards for older people. Increased consciousness among healthcare professionals and hospital policy makers of the importance of nutritional care will contribute to further improvement in care quality. © 2010 The Authors. Journal of Advanced Nursing © 2010 Blackwell Publishing Ltd.

  9. The use of oral nutritional supplements in an Irish community setting.

    LENUS (Irish Health Repository)

    Kennelly, S

    2009-12-01

    The frequency of oral nutritional supplement (ONS) prescribing has been increasing steadily in the Republic of Ireland (ROI). Available evidence indicates that health professionals in the community setting in the ROI have a poor level of knowledge about ONS. The objectives of the present study were to investigate ONS prescribing practices and to identify the types of patient who were prescribed these products.

  10. Nutrition status and associated factors among children in public ...

    African Journals Online (AJOL)

    Background: Malnutrition among school-age children is due to inadequacies in one or more of the three main preconditions for good nutrition: food, care and health. Children stunted at school age are likely to have been exposed to poor nutrition since early childhood. Interventions for school age children can supplement ...

  11. Qualifying instrument for evaluation of food and nutritional care in hospital.

    Science.gov (United States)

    Díez García, R W; Souza, A A; Proença, R P C

    2012-01-01

    Establishing criteria for hospital nutrition care ensures that quality care is delivered to patients. The responsibility of the Hospital Food and Nutrition Service (HFNS) is not always well defined, despite efforts to establish guidelines for patient clinical nutrition practice. This study describes the elaboration of an Instrument for Evaluation of Food and Nutritional Care (IEFNC) aimed at directing the actions of the Hospital Food and Nutrition Service. This instrument was qualified by means of a comparative analysis of the categories related to hospital food and nutritional care, published in the literature. Elaboration of the IEFNC comprised the following stages: (a) a survey of databases and documents for selection of the categories to be used in nutrition care evaluation, (b) a study of the institutional procedures for nutrition practice at two Brazilian hospitals, in order to provide a description of the sequence of actions that should be taken by the HFNS as well as other services participating in nutrition care, (c) design of the IEFNC based on the categories published in the literature, adapted to the sequence of actions observed in the routines of the hospitals under study, (d) application of the questionnaire at two different hospitals that was mentioned in the item (b), in order to assess the time spent on its application, the difficulties in phrasing the questions, and the coverage of the instrument, and (e) finalization of the instrument. The IEFNC consists of 50 open and closed questions on two areas of food and nutritional care in hospital: inpatient nutritional care and food service quality. It deals with the characterization and structure of hospitals and their HFNS, the actions concerning the patients' nutritional evaluation and monitoring, the meal production system, and the hospital diets. "This questionnaire is a tool that can be seen as a portrait of the structure and characteristics of the HFNS and its performance in clinical and meal

  12. Age-Related Macular Degeneration: Pathogenesis, Genetic Background, and the Role of Nutritional Supplements

    Directory of Open Access Journals (Sweden)

    Marilita M. Moschos

    2014-01-01

    Full Text Available Age-related macular degeneration (ARMD is the leading cause of severe vision loss and blindness worldwide, mainly affecting people over 65 years old. Dry and wet ARDM are the main types of the disease, which seem to have a multifactorial background. The aim of this review is to summarize the mechanisms of ARMD pathogenesis and exhibit the role of diet and nutritional supplements in the onset and progression of the disease. Environmental factors, such as smoking, alcohol, and, diet appear to interact with mutations in nuclear and mitochondrial DNA, contributing to the pathogenesis of ARMD. Inflammatory mediators and oxidative stress, induced by the daily exposure of retina to high pressure of oxygen and light radiation, have been also associated with ARMD lesions. Other than medical and surgical therapies, nutritional supplements hold a significant role in the prevention and treatment of ARMD, eliminating the progression of macular degeneration.

  13. Nutritional status in patients with cutaneous leishmaniasis and a study of the effects of zinc supplementation together with antimony treatment

    Directory of Open Access Journals (Sweden)

    Miguel Guzman-Rivero

    2014-11-01

    Full Text Available Background: The role of micronutrient status for the incidence and clinical course of cutaneous leishmaniasis is not much studied. Still zinc supplementation in leishmaniasis has shown some effect on the clinical recovery, but the evidence in humans is limited. Objective: To compare biochemical nutritional status in cutaneous leishmaniasis patients with that in controls and to study the effects of zinc supplementation for 60 days. Design: Twenty-nine patients with cutaneous leishmaniasis were treated with antimony for 20 days. Fourteen of them got 45 mg zinc daily and 15 of them got placebo. Biomarkers of nutritional and inflammatory status and changes in size and characteristics of skin lesions were measured. Results: The level of transferrin receptor was higher in patients than in controls but otherwise no differences in nutritional status were found between patients and controls. No significant effects of zinc supplementation on the clinical recovery were observed as assessed by lesion area reduction and characteristics or on biochemical parameters. Conclusions: It is concluded that nutritional status was essentially unaffected in cutaneous leishmaniasis and that oral zinc supplementation administered together with intramuscular injection of antimony had no additional clinical benefit.

  14. Predictors of the relationships between nutritional supplement use and weight-modification goals of U.S. Army soldiers.

    Science.gov (United States)

    Austin, Krista G; Carvey, Christina E; Farina, Emily K; Lieberman, Harris R

    2013-08-01

    U.S. Army Soldiers must meet body weight and composition standards and consequently may use nutritional supplements (NS) purported to assist in weight modification (WM). Nutritional supplements are dietary supplements (DS) and foods intended to supplement the diet. This study assessed relationships between NS use, demographic characteristics, health-related behaviors, and WM goals among U.S. Army personnel. Participants (N = 990) self-reported NS use, categorized as energy drinks, sport nutrition products, or DS, and WM goal (lose, gain, or maintain) was ascertained by survey. DS were subcategorized as health, weight-loss, weight-gain, or other DS. Chi-square and logistic regression were used to assess relationships between predictors, NS use, and WM goal. Most respondents (70.3% ± 1.7%) consumed some NS; however, overall NS use was not related to WM goal. Significant relationships were observed between predictors (tobacco use, age, body-mass index, fitness score, general health, and eating habits) and both WM goal and NS use. Respondents attempting to lose or maintain weight were less likely to consume energy drinks and weight-gain DS. WM goal is related to multiple health behaviors including tobacco use, physical fitness score, and self-perception of health and eating behavior. NS are consumed in this population regardless of WM goal.

  15. 32 CFR 199.16 - Supplemental Health Care Program for active duty members.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Supplemental Health Care Program for active duty... (CHAMPUS) § 199.16 Supplemental Health Care Program for active duty members. (a) Purpose and applicability... the supplemental health care program for active duty members of the uniformed services, the provision...

  16. COST-EFFECTIVENESS OF A 3-MONTH INTERVENTION WITH ORAL NUTRITIONAL SUPPLEMENTS IN DISEASE RELATED MALNUTRITION: A RANDOMIZED CONTROLLED PILOT STUDY

    OpenAIRE

    Norman , Kristina; Pirlich , Matthias; Smoliner , Christine; Kilbert , Anne; Schulzke , Jörg-Dieter; Ockenga , Johann; Lochs , Herbert; Reinhold , Thomas

    2011-01-01

    Abstract Background: Nutritional intervention with oral nutritional supplements (ONS) has been shown to increase quality of life in malnourished patients. We investigated whether post-hospital supplementation with ONS is cost-effective according to international benchmarks in malnourished patients. Methods: 114 malnourished patients (50.6?16.1 years, 63 female) with benign gastrointestinal disease were included and randomised to receive either ONS for three months and dietary co...

  17. Nutritional care in a nursing home in Italy.

    Directory of Open Access Journals (Sweden)

    Lorenzo Maria Donini

    Full Text Available INTRODUCTION: Malnutrition is a clinical condition due to the imbalance among needs, intake and use of nutrients, leading to the increase of morbidity and mortality, and to the impairment of quality of life. Even in industrialized countries undernutrition is becoming an alarming phenomenon, especially involving elderly institutionalized subjects. A multicentric study called PIMAI (Project Iatrogenic MAlnutrition in Italy, was carried out in Italy over 2005. The aims of this study were to determine the prevalence of malnutrition in hospitals and in nursing care homes (NH, to assess the level of nutritional attention and to measure the perceived quality in food and nutritional care. This paper represents a preliminary analysis of data collected in a NH included in the PIMAI project. MATERIALS AND METHODS: A total of 100 subjects (29 males and 71 females, aged 80.2±10 years, were recruited from January to June 2005 at the Clinical Rehabilitation Institute "Villa delle Querce" in Nemi (Rome, among patients in the NH facility. All the participants underwent a multidimensional geriatric evaluation (considering nutritional, clinical, functional and cognitive parameters, and a survey on "perceived quality" of nutritional care. RESULTS AND DISCUSSION: According to nutritional status defined by the Mini Nutritional Assessment®, data analysis showed a high prevalence of malnutrition (36% especially related to advanced age, chewing, cognitive and functional impairments. Patients seemed to consider nutrition to be important for their health; on the other hand, they were not thoroughly satisfied with the quality of food. Particularly, it was observed scarce attention to nutritional status from medical and nursing staff. CONCLUSIONS: Our study confirms the need to pay greater attention to nutritional status in elderly institutionalized subjects. Medical and nursing teams need to be aware of the importance to perform an evaluation of nutritional status in

  18. Effect of structured physical activity and nutritional supplementation on physical function in mobility-limited older adults: results from the VIVE2 randomized trial

    Science.gov (United States)

    Objectives: The interactions between nutritional supplementation and physical activity on changes in physical function among older adults remain unclear. The primary objective of this study was to examine the impact of nutritional supplementation plus structured physical activity on 400M walk capaci...

  19. [Does nutrition matter? Why nutritional care is neglected in Italian hospitals?].

    Science.gov (United States)

    Lucchin, Lucio

    2015-02-01

    It is surprising how little attention nutrition has received from healthcare providers, in particular in the hospital environment. The discipline of nutrition is also no longer included in regular graduate courses in medicine. The underlying causes of this phenomenon are hard to determine, but they are part of the current paradigmatic shift underway in medicine. Nutrition is a complex and challenging science for most care givers, as it also pertains to their behaviours that should be consistent with health and nutrition messages they deliver to patients. The clinical and economic impact is of great relevance, raising serious ethical issues if not adequately addressed. It is time to re-establish at least a basic level of appropriate nutrition prescription beyond general counseling, with the aim to restore the integrity of the doctor-patient relationship.

  20. Nutritional assessment methods for zinc supplementation in prepubertal non-zinc-deficient children

    Directory of Open Access Journals (Sweden)

    Márcia Marília Gomes Dantas Lopes

    2015-10-01

    Full Text Available Background: Zinc is an essential nutrient that is required for numerous metabolic functions, and zinc deficiency results in growth retardation, cell-mediated immune dysfunction, and cognitive impairment. Objective: This study evaluated nutritional assessment methods for zinc supplementation in prepubertal non-zinc-deficient children. Design: We performed a randomised, controlled, triple-blind study. The children were divided into a control group (10% sorbitol, n=31 and an experimental group (10 mg Zn/day, n=31 for 3 months. Anthropometric and dietary assessments as well as bioelectrical measurements were performed in all children. Results: Our study showed (1 an increased body mass index for age and an increased phase angle in the experimental group; (2 a positive correlation between nutritional assessment parameters in both groups; (3 increased soft tissue, and mainly fat-free mass, in the body composition of the experimental group, as determined using bioelectrical impedance vector analysis; (4 increased consumption of all nutrients, including zinc, in the experimental group; and (5 an increased serum zinc concentration in both groups (p<0.0001. Conclusions: Given that a reference for body composition analysis does not exist for intervention studies, longitudinal studies are needed to investigate vector migration during zinc supplementation. These results reinforce the importance of employing multiple techniques to assess the nutritional status of populations.

  1. Nutritional Recommendations for Adult Bariatric Surgery Patients: Clinical Practice12

    Science.gov (United States)

    Sherf Dagan, Shiri; Goldenshluger, Ariela; Globus, Inbal; Schweiger, Chaya; Kessler, Yafit; Kowen Sandbank, Galit; Ben-Porat, Tair; Sinai, Tali

    2017-01-01

    Bariatric surgery is currently the most effective treatment for morbid obesity and its associated metabolic complications. To ensure long-term postoperative success, patients must be prepared to adopt comprehensive lifestyle changes. This review summarizes the current evidence and expert opinions with regard to nutritional care in the perioperative and long-term postoperative periods. A literature search was performed with the use of different lines of searches for narrative reviews. Nutritional recommendations are divided into 3 main sections: 1) presurgery nutritional evaluation and presurgery diet and supplementation; 2) postsurgery diet progression, eating-related behaviors, and nutritional therapy for common gastrointestinal symptoms; and 3) recommendations for lifelong supplementation and advice for nutritional follow-up. We recognize the need for uniform, evidence-based nutritional guidelines for bariatric patients and summarize recommendations with the aim of optimizing long-term success and preventing complications. PMID:28298280

  2. The Supplemental Nutrition Assistance Program: Analysis of Program Administration and Food Law Definitions.

    Science.gov (United States)

    Pomeranz, Jennifer L; Chriqui, Jamie F

    2015-09-01

    Under the current version of the Supplemental Nutrition Assistance Program (SNAP), participants can purchase virtually any food or beverage (collectively, food). Research indicates that SNAP recipients may have worse dietary quality than income-eligible nonparticipants. Policymakers have urged the U.S. Department of Agriculture (USDA) to pilot SNAP purchasing restrictions intended to support a healthier diet, and state legislators have proposed similar bills. The USDA rejected these invitations, stating that it would be administratively and logistically difficult to differentiate among products, amid other concerns. However, the USDA's Dietary Guidelines for Americans and the Supplemental Nutrition Program for Women, Infants, and Children (WIC) do just that. Further, state governments define and differentiate among foods and beverages for tax purposes. This paper reviews several factors intended to inform future policy decisions: the science indicating that SNAP recipients have poorer diet quality than income-eligible nonparticipants; the public's support for revising the SNAP program; federal, state, and city legislators' formal proposals to amend SNAP based on nutrition criteria and the USDA's public position in opposition to these proposals; state bills to amend eligible foods purchasable with SNAP benefits; state retail food tax laws; and the retail administration and program requirements for both WIC and SNAP. The paper finds that the government has a clear ability to align SNAP benefits with nutrition science and operationalize this into law. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  3. [Does the nutritional care plan and report upon discharge under the health care system substitute the nutrition support team summary at patient discharge?].

    Science.gov (United States)

    Hidaka, Kumi; Matsuoka, Mio; Kajiwara, Kanako; Hinokiyama, Hiromi; Mito, Saori; Doi, Seiko; Konishi, Eriko; Ibata, Takeshi; Komuro, Ryutaro; lijima, Shohei

    2013-12-01

    Our nutrition support team (NST) designed the NST summary for cooperation among personnel providing medical care for nutritional management of high-need patients in our area. After the introduction of the NST fee under the health care system, the number of summary publications decreased. The requested NST fee is necessary for publication of a nutritional care plan and report upon patient discharge. We hypothesized that the nutritional care plan and discharge report were being substituted for the NST summary at the time of patient discharge. We retrospectively investigated 192 cases with NST fee. There were only 13 cases of overlapping publication, and the NST summary was necessary for 107 of 179 cases in which no NST summary had been prepared. Since the space on the report form is limited, it can provide only limited information. However, the NST summary can convey detailed supplementary information. Therefore, there is a high need for the NST summary, and publication of NST summaries for the appropriate cases must continue.

  4. Training Nonnursing Staff to Assist with Nutritional Care Delivery in Nursing Homes: A Cost-Effectiveness Analysis.

    Science.gov (United States)

    Simmons, Sandra F; Hollingsworth, Emily K; Long, Emily A; Liu, Xulei; Shotwell, Matthew S; Keeler, Emmett; An, Ruopeng; Silver, Heidi J

    2017-02-01

    To determine the effect and cost-effectiveness of training nonnursing staff to provide feeding assistance for nutritionally at-risk nursing home (NH) residents. Randomized, controlled trial. Five community NHs. Long-stay NH residents with an order for caloric supplementation (N = 122). Research staff provided an 8-hour training curriculum to nonnursing staff. Trained staff were assigned to between-meal supplement or snack delivery for the intervention group; the control group received usual care. Research staff used standardized observations and weighed-intake methods to measure frequency of between-meal delivery, staff assistance time, and resident caloric intake. Fifty staff (mean 10 per site) completed training. The intervention had a significant effect on between-meal caloric intake (F = 56.29, P staff time to provide assistance. It is cost effective to train nonnursing staff to provide caloric supplementation, and this practice has a positive effect on residents' between-meal intake. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  5. Exercise and Nutritional Supplementation on Community-Dwelling Elderly Japanese Women With Sarcopenic Obesity: A Randomized Controlled Trial.

    Science.gov (United States)

    Kim, Hunkyung; Kim, Miji; Kojima, Narumi; Fujino, Ken; Hosoi, Erika; Kobayashi, Hisamine; Somekawa, Shinji; Niki, Yoshifumi; Yamashiro, Yukari; Yoshida, Hideyo

    2016-11-01

    To investigate the effects of exercise and/or nutritional supplementation on body composition, blood components, and physical function in community-dwelling elderly Japanese women with sarcopenic obesity. Randomized controlled trial. Urban community in Tokyo, Japan. Among 1213 community-dwelling elderly women over 70 years of age, 307 were defined with sarcopenic obesity, and 139 women participated in the study. Participants were randomly assigned to one of four intervention groups. The exercise and nutrition (Ex + N) and exercise only (Ex) groups attended 60-minute exercise classes twice a week for 3 months. The Ex + N and nutrition only (N) groups were provided with essential amino acid supplementation and tea fortified with catechins to be taken daily for 3 months. Health education classes were provided to the control (HE) group every 2 weeks. Bioelectric impedance analysis was used to measure body composition. Skeletal muscle mass index was calculated using measures of muscle mass and height. Physical function measures included grip strength, knee extension strength, usual walking speed, and walking parameters (stride, step length, width, walking angles). Blood samples were obtained to analyze levels of albumin, triglycerides, cholesterol, hemoglobin A1c, leptin, cystatin C, vitamin D, interleukin-6, and high-sensitivity C-reactive protein. Significant between-group × time interactions were observed in usual walking speed (P = .012), stride (P = .004), right step length (P = .003), average number of steps (P = .029), and vitamin D (P exercise and nutrition have beneficial effects on individual variables of body composition, blood components, and physical function, improvements in muscle mass and variable combinations such as percent fat + skeletal muscle mass index or percent fat + physical functions were not observed in this population. Further large-scale and long-term investigation is necessary. Copyright © 2016 AMDA – The Society

  6. [Purple urine bag syndrome in elderly woman with nutritional supplements].

    Science.gov (United States)

    Domínguez Alegría, A R; Vélez Díaz-Pallares, M; Moreno Cobo, Ma A; Arrieta Blanco, F; Bermejo Vicedo, T

    2012-01-01

    The purple urine bag syndrome is a rare entity which typically affects elderly women with prolonged urinary catheterization and weakening chronic diseases. Other predisposing factors are previous urologic pathology, immobility syndrome and chronic constipation. The purple color is due to the presence of high loads of bacteria with sulphatase--phosphatase activity which develop in an alkaline environment as well as the presence of other factors. In the case we present the administration of nutritional supplements containing tryptophan conditioned the generation of this syndrome.

  7. Health-Care Costs, Glycemic Control and Nutritional Status in Malnourished Older Diabetics Treated with a Hypercaloric Diabetes-Specific Enteral Nutritional Formula.

    Science.gov (United States)

    Sanz-Paris, Alejandro; Boj-Carceller, Diana; Lardies-Sanchez, Beatriz; Perez-Fernandez, Leticia; Cruz-Jentoft, Alfonso J

    2016-03-09

    Diabetes-specific formulas are an effective alternative for providing nutrients and maintaining glycemic control. This study assesses the effect of treatment with an oral enteral nutrition with a hypercaloric diabetes-specific formula (HDSF) for one year, on health-care resources use, health-care costs, glucose control and nutritional status, in 93 type-2 diabetes mellitus (T2DM) malnourished patients. Changes in health-care resources use and health-care costs were collected the year before and during the year of intervention. Glucose status and nutritional laboratory parameters were analyzed at baseline and one-year after the administration of HDSF. The administration of HDSF was significantly associated with a reduced use of health-care resources, fewer hospital admissions (54.7%; p Health-care costs were reduced by 65.6% (p nutritional parameters were improved at one year (albumin: +10.6%, p nutritional parameters. The use of health-care resources and costs were significantly reduced during the nutritional intervention.

  8. A cluster randomised feasibility trial evaluating six-month nutritional interventions in the treatment of malnutrition in care home-dwelling adults: recruitment, data collection and protocol.

    Science.gov (United States)

    Stow, Ruth; Rushton, Alison; Ives, Natalie; Smith, Christina; Rick, Caroline

    2015-01-01

    Protein energy malnutrition predisposes individuals to disease, delays recovery from illness and reduces quality of life. Care home residents are especially vulnerable, with an estimated 30%-42% at risk. There is no internationally agreed protocol for the nutritional treatment of malnutrition in the care home setting. Widely used techniques include food-based intervention and/or the use of prescribed oral nutritional supplements, but a trial comparing the efficacy of interventions is necessary. In order to define outcomes and optimise the design for an adequately powered, low risk of bias cluster randomised controlled trial, a feasibility trial with 6-month intervention is being run, to assess protocol procedures, recruitment and retention rates, consent processes and resident and staff acceptability. Trial recruitment began in September 2013 and concluded in December 2013. Six privately run care homes in Solihull, England, were selected to establish feasibility within different care home types. Residents with or at risk of malnutrition with no existing dietetic intervention in place were considered for receipt of the allocated intervention. Randomisation took place at the care home level, using a computer-generated random number list to allocate each home to either a dietetic intervention arm (food-based or prescribed supplements) or the standard care arm, continued for 6 months. Dietetic intervention aimed to increase daily calorie intake by 600 kcal and protein by 20-25 g. The primary outcomes will be trial feasibility and acceptability of trial design and allocated interventions. A range of outcome assessments and data collection tools will be evaluated for feasibility, including change in nutrient intake, anthropometric parameters and patient-centric measures, such as quality of life and self-perceived appetite. The complexities inherent in care home research has resulted in the under representation of this population in research trials. The results of this

  9. Response of appetite and potential appetite regulators following intake of high energy nutritional supplements.

    Science.gov (United States)

    Fatima, Sadia; Gerasimidis, Konstantinos; Wright, Charlotte; Tsiountsioura, Melina; Arvanitidou, Eirini-Iro; Malkova, Dalia

    2015-12-01

    The net clinical benefit of high-energy nutritional supplements (HENSDs) consumption is lower than expected. To investigate the extent to which consumption of oral HENSD in the fasted state reduces energy intake in slim females during consecutive breakfast and lunch, and whether this relates to changes in appetite and metabolic appetite regulators. Twenty three females of 24.4 ± 2.8 years with BMI of 18.2 ± 0.8 kg/m(2) consumed HENSD (2.5 MJ) or PLACEBO (0.4 MJ) in fasted state in a single blind randomized cross-over study. Appetite and metabolic rate measurements and blood collection were conducted prior to and during 240 min after the intake of the supplements. Energy intake was recorded during ad libitum buffet breakfast and lunch served 60 min and 240 min post supplementation respectively. Energy intake during breakfast was significantly (P appetite measures were not significantly different between HENSD and PLACEBO trials. Correlations for the within participant relations between the responses of plasma hormones and appetite scores were significant (P < 0.05) for PYY and insulin but not CCK. The energy expended above resting metabolic rate was significantly (P < 0.05) higher in the HENDS trial but relative increase in energy expenditure was not significantly different between the two trials. Oral high-energy nutritional supplements have a partial and relatively short lived suppressive action on energy intake and can be expected to increase net energy intake by approximately half the energy value of the supplement consumed. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  10. Enhancement of the nutritional value of whey drink by supplementing with leaves of moringa oleifera

    International Nuclear Information System (INIS)

    Nadeem, M.; Hussain, I.; Abdullah, M.; Rehman, F.

    2013-01-01

    The effect of supplementing Moringa oleilera leaf powder (MOLP) on the nutritional and sensory characteristics of whey drink was investigated. Whey drink was supplemented with MOLP at four different concentrations i.e., 1% MOLP (TO, 2% MOLP (T.,), 3% MOLP (T,), 4% MOLP (1.4) and compared with a control (To). The addition of MOLP at any level did not have a negative effect on p11 and acidity of whey drink. Iron content of T, increased from 0.17 to 115 mg/100 mL, total phenolic content of MOLP was 7.4 g/100 g on dry weight basis (gallic acid). Vitamin C increased from 1.46 to 2.20 mg/100 g in -1.4. The overall acceptability score of T, was 6.9 out 9 (total score) which was more than 76%. These results suggest that nutritional value of whey can be increased by supplementing with 4% dry leaves of M. oleifera in the form of a whey based drink with acceptable sensory characteristics. (author)

  11. How nutritional status, diet and dietary supplements can affect autism. A review.

    Science.gov (United States)

    Kawicka, Anna; Regulska-Ilow, Bozena

    2013-01-01

    continual monitoring of the diet and nutritional status of children with ASD is required. It is also essential to start adequate dietary management in autistic patients with overweight, obesity or wasting, caused by improper nutrition. Frequently only a dietary therapy is insufficient to effectively treat autism. Many studies demonstrate the need to supplement the nutritional deficiencies of autistic patients with fatty acids omega-3, probiotics, vitamins and minerals in combination with medical and psychological interventions. A properly designed elimination diet adapted to the patient's individual may also lead to relief of the autism symptoms and the occurrence of gastrointestinal disorders. Parents and caregivers should therefore be aware of the benefits of nutritional therapy and need for proper monitoring the treatment of patients with ASD. A review of nutritional factors, dietary treatments and diet supplementation in patients with ASD is presented.

  12. Preferences for food and nutritional supplements among adult people living with HIV in Malawi

    NARCIS (Netherlands)

    Rodas Moya, Carlos; Kodish, Stephen; Manary, Mark; Grede, Nils; Pee, de Saskia

    2016-01-01

    Objective: To elucidate the factors influencing food intake and preferences for potential nutritional supplements to treat mild and moderate malnutrition among adult people living with HIV (PLHIV). Design: Qualitative research using in-depth interviews with a triangulation of participants and an

  13. Integrated nutritional intervention in the elderly after hip fracture. A process evaluation.

    Science.gov (United States)

    Breedveld-Peters, José J L; Reijven, Petronella L M; Wyers, Caroline E; van Helden, Svenhjalmar; Arts, J J Chris; Meesters, Berry; Prins, Martin H; van der Weijden, Trudy; Dagnelie, Pieter C

    2012-04-01

    Within a multicentre randomized controlled trial aimed at improving the nutritional status and increase the speed of recovery of elderly hip fracture patients, we performed a process evaluation to investigate the feasibility of the intervention within the present Dutch health care system. Patients in the intervention group received nutritional counseling during 10 contacts. Oral nutritional supplements were advised as needed until three months after hip fracture surgery. The intervention was evaluated with respect to dieticians' adherence to the study protocol, content of nutritional counseling, and patients' adherence to recommendations given. We included 66 patients (mean age of 76, range 55-92 years); 74% women. Eighty-three percent of patients received all 10 contacts as planned, but in 62% of the patients one or more telephone calls had to be replaced by face to face contacts. Nutritional counseling was complete in 91% of contacts. Oral nutritional supplementation was needed for a median period of 76 days; 75% of the patients took the oral nutritional supplements as recommended. Nutritional counseling in elderly hip fracture patients through face to face contacts and telephone calls is feasible. However, individual tailoring of the intervention is recommended. The majority of hip fracture patients needed >2 months oral nutritional supplements to meet their nutritional requirements. The trial was registered at clincialtrails.gov as NCT00523575. Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  14. Behavioral Economics and the Supplemental Nutrition Assistance Program:: Making the Healthy Choice the Easy Choice.

    Science.gov (United States)

    Ammerman, Alice S; Hartman, Terry; DeMarco, Molly M

    2017-02-01

    The Supplemental Nutrition Assistance Program (SNAP) serves as an important nutritional safety net program for many Americans. Given its aim to use traditional economic levers to provide access to food, the SNAP program includes minimal nutritional requirements and restrictions. As food choices are influenced by more than just economic constraints, behavioral economics may offer insights and tools for altering food purchases for SNAP users. This manuscript outlines behavioral economics strategies that have potential to encourage healthier food choices within the SNAP program. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Changes in Nutrition Policies and Dietary Intake in Child Care Homes Participating in Healthy Eating and Active Living Initiative.

    Science.gov (United States)

    Woodward-Lopez, Gail; Kao, Janice; Kuo, Elena S; James, Paula; Lenhart, Kitty; Becker, Christina; Boyle, Kathryn; Williamson, Dana; Rauzon, Suzanne

    2018-05-01

    From 2012 to 2014, a total of 17 family child care homes participated in a multisector, community-wide initiative to prevent obesity. Strategies included staff workshops, materials, site visits, and technical assistance regarding development and implementation of nutrition policies. The purpose of the evaluation was to examine the impact of the initiative on family child care home nutrition-related policies and practices and child dietary intake. Pre- and post-intervention without control group. Measures taken at baseline and follow-up included structured observations and questionnaires regarding nutrition policies, practices, and environments; documentation of lunch foods served on 5 days; and lunch plate waste observations on 2 days. Paired t-tests were used to determine the significance of change over time. Seventeen family child care homes in a low-income diverse community in Northern California; children aged 2-5 years who attended the family child care homes. Change in nutrition-related policies and practices, lunch foods served and consumed. Data was collected at 17 sites for an average of 5.2 children aged 2-5 years per site per day at baseline and 4.6 at follow-up for a total of 333 plate waste observations. There were significant increases in staff training, parental involvement, and several of the targeted nutrition-related practices; prevalence of most other practices either improved or was maintained over time. There were significant increases in the number of sites meeting Child and Adult Care Food Program meal guidelines, variety of fruit and frequency of vegetables offered, and reductions in frequency of juice and high-fat processed meats offered. Adequate portions of all food groups were consumed at both time points with no significant change over time. A simple, policy-focused intervention by a child care resource and referral agency was successful at reinforcing and improving upon nutrition-related practices at family child care homes. Children

  16. Combined intensive nutrition education and micronutrient powder supplementation improved nutritional status of mildly wasted children on Nias Island, Indonesia.

    Science.gov (United States)

    Inayati, Dyah A; Scherbaum, Veronika; Purwestri, Ratna C; Wirawan, Nia N; Suryantan, Julia; Hartono, Susan; Bloem, Maurice A; Pangaribuan, Rosnani V; Biesalski, Hans K; Hoffmann, Volker; Bellows, Anne C

    2012-01-01

    To assess the impact of intensive nutrition education (INE) with or without the provision of micronutrient powder (MNP) on the nutritional status of mildly wasted children in Nias, Indonesia, two groups of mildly wasted (>=-1.5 to children aged >=6 to children who were living at a clear distance from INE and INE+MNP villages were selected to receive a monthly non-intensive nutrition education program (NNE) with or without MNP (n=50 both respectively). WHZ, weight, height, haemoglobin (Hb) level, and morbidity data were assessed at admission, during the study, and at individual discharge. Children's weight gain (g/kg body weight/day) was highest in INE+MNP group (2.2±2.1), followed by INE (1.1±0.9), NNE+MNP (0.3±0.5) and NNE (0.3±0.4) group. In both MNP intervention groups (INE+MNP, NNE+MNP), supplements significantly increased Hb value (g/L) of respective children (10.0±10.0; pchildren who reached discharge criterion was highest among the INE+MNP (70.6%; n=36), followed by INE (64.1%; n=41), NNE+MNP (26.0%; n=13), and NNE (20.0%; n=10) groups (pchildren in the INE+MNP group (29.9 days), followed by INE (40.0 days), NNE+MNP (80.6 days), and NNE (86.2 days) respectively (pnutrition education supported by MNP supplementation produced the best results regarding weight gain and haemoglobin status of mildly wasted children.

  17. Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation

    OpenAIRE

    Helms, Eric R; Aragon, Alan A; Fitschen, Peter J

    2014-01-01

    The popularity of natural bodybuilding is increasing; however, evidence-based recommendations for it are lacking. This paper reviewed the scientific literature relevant to competition preparation on nutrition and supplementation, resulting in the following recommendations. Caloric intake should be set at a level that results in bodyweight losses of approximately 0.5 to 1%/wk to maximize muscle retention. Within this caloric intake, most but not all bodybuilders will respond best to consuming ...

  18. Consumer Education: A Teaching-Learning Unit on Consumer Health Care.

    Science.gov (United States)

    Tennessee Univ., Knoxville.

    This health education handbook covers the following topics: (1) the consumer and health care; (2) diet and nutrition; (3) additives, supplements, and health foods; (4) prescription drugs; (5) over-the-counter drugs; (6) doctors, hospitals, and surgery; and (7) providing and paying for health care. A teacher's supplement health care unit is…

  19. Determinants of nutrition guidance practices of primary-care physicians

    NARCIS (Netherlands)

    Hiddink, G.J.

    1996-01-01


    The aim of the studies described in this thesis was to analyze nutrition guidance practices of primary-care physicians (PCPs), their nutritional attitudes and knowledge and their interest in the role of nutrition in health and disease. A second objective was to identify the determinants

  20. Dietary aspects in fibromyalgia patients: results of a survey on food awareness, allergies, and nutritional supplementation.

    Science.gov (United States)

    Arranz, Laura-Isabel; Canela, Miguel-Ángel; Rafecas, Magda

    2012-09-01

    Fibromyalgia (FM) is a common disease that results in poor quality of life, causing widespread musculoskeletal pain and stiffness, fatigue, sleep disorders, and cognitive impairment among other symptoms. The lack of an effective treatment makes necessary a multidimensional management. FM patients usually seek, from different sources, information about possible benefits from foods, nutrients, or diets. Our objective was to investigate the dietary awareness, food allergies and/or intolerances (FAIs), and nutritional supplement (NS) consumption of FM patients. A questionnaire was prepared with six questions regarding dietary habits, FAIs, and NS use. The questionnaire was filled out by patients recruited in local fibromyalgia associations. One hundred and one women were suffering from FM, diagnosed for more than 6 months, mean age of 53.88 ± 7.78 years; 30% of them changed their diet because of their disease, trying to improve it, and most of them were also using some NS; 7% of women in this group had FAIs, a figure slightly higher than the FAI prevalence in the general population (2-5%) and positively associated with consumption of supplements. Among NS users, some differences were observed; past NS users currently consume a wider range of products, more than new NS users. Magnesium was one of the supplements most recommended specifically for FM. Seventy-four percentage of these patients used NS following advice from health professionals. Once patients are diagnosed, they change their dietary habits and nutritional supplement intake, seeking nutritional strategies to improve their symptoms. Health professionals' advice plays a relevant role.

  1. Perioperative Alanyl-Glutamine-Supplemented Parenteral Nutrition in Chronic Radiation Enteritis Patients With Surgical Intestinal Obstruction: A Prospective, Randomized, Controlled Study.

    Science.gov (United States)

    Yao, Danhua; Zheng, Lei; Wang, Jian; Guo, Mingxiao; Yin, Jianyi; Li, Yousheng

    2016-04-01

    A prospective, randomized, controlled study was performed to evaluate the effects of perioperative alanyl-glutamine-supplemented parenteral nutrition (PN) support on the immunologic function, intestinal permeability, and nutrition status of surgical patients with chronic radiation enteritis (CRE)-induced intestinal obstruction. Patients who received 0.4 g/kg/d alanyl-glutamine and isonitrogenous PN were assigned to an alanyl-glutamine-supplemented PN (Gln-PN) group and a control group, respectively. Serum levels of alanine aminotransferase and glutamine, body fat mass (FM), immunologic function, and intestinal permeability were measured before and after surgery. Serum glutamine levels of the Gln-PN group significantly exceeded that of the control group (P nutrition state and intestinal motility of surgical patients with CRE-induced intestinal obstruction. © 2015 American Society for Parenteral and Enteral Nutrition.

  2. Effect of life skills building education and micronutrient supplements provided from preconception versus the standard of care on low birth weight births among adolescent and young Pakistani women (15-24 years): a prospective, population-based cluster-randomized trial.

    Science.gov (United States)

    Baxter, Jo-Anna B; Wasan, Yaqub; Soofi, Sajid B; Suhag, Zamir; Bhutta, Zulfiqar A

    2018-05-31

    Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her own health and pregnancy are at an increased risk for adverse outcomes. Offering preconception care from adolescence could provide an opportunity for health and nutrition promotion to improve one's own well-being, as well as future pregnancy outcomes and the health of the next generation. The Matiari emPowerment and Preconception Supplementation (MaPPS) Trial is a population-based two-arm, cluster-randomized, controlled trial of life skills building education and multiple micronutrient supplementation provided in a programmatic context to evaluate the impact on pre-identified nutrition and health outcomes among adolescent and young women (15-24 years) in Matiari district Pakistan, and the infants born to them within the context of the trial. The primary aim is to assess the effect of the intervention on the prevalence of low birth weight births (< 2500 g). The intervention includes bi-monthly life skills building education provided from preconception, and supplementation with multiple micronutrients during preconception (twice-weekly), pregnancy (daily), and post-partum (daily to 6 months). The standard of care includes non-regulated community-based health sessions and daily iron and folic acid supplementation during pregnancy. Additional outcome information will also be collected at set time periods. Among participants, these relate to nutrition (anthropometry, nutritional status), morbidity, and mortality. Among infants, these include birth outcomes (stillbirth, preterm birth, length of gestation, small for gestational age, birth defects), anthropometry, morbidity, and mortality. Preconception care from adolescence that includes interventions targeting life skills development and nutrition is suggested to be important to improving the health and nutrition of adolescent and young women and their future

  3. Supplementation of infant formula with probiotics and/or prebiotics: a systematic review and comment by the ESPGHAN committee on nutrition

    NARCIS (Netherlands)

    Braegger, Christian; Chmielewska, Anna; Decsi, Tamas; Kolacek, Sanja; Mihatsch, Walter; Moreno, Luis; Pieścik, Małgorzata; Puntis, John; Shamir, Raanan; Szajewska, Hania; Turck, Dominique; van Goudoever, Johannes

    2011-01-01

    Infant formulae are increasingly supplemented with probiotics, prebiotics, or synbiotics despite uncertainties regarding their efficacy. The present article, developed by the Committee on Nutrition of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition, systematically

  4. Developing supplemental activities for primary health care maternity services.

    Science.gov (United States)

    Panitz, E

    1990-12-01

    Supplemental health care activities are described in the context of the augmented product. The potential benefits of supplemental services to recipients and provider are discussed. The author describes a study that was the basis for (re)developing a supplemental maternity service. The implementation of the results in terms of changes in the marketing mix of this supplemental program is discussed. The effects of the marketing mix changes on program participation are presented.

  5. [The Nutrition Care of Severe Burn Patients].

    Science.gov (United States)

    Hsieh, Yu-Hsiu

    2016-02-01

    In addition to recent advances in burn patient care techniques such as maintaining warm circumambient temperature, the early excision of wounds, and the use of closed dressing, providing nutrition support through early feeding has proven instrumental in greatly increasing the survival rate of burn patients. Severe burns complicated by many factors initiate tremendous physiological stress that leads to postburn hypermetabolism that includes enhanced tissue catabolism, the loss of muscle mass, and decreases in the body's reservoirs of protein and energy. These problems have become the focus of burn therapy. Treating severe burns aims not only to enhance survival rates but also to restore normal bodily functions as completely as possible. Recent research evaluating the application of anabolic agents and immune-enhance formula for severe burns therapy has generated significant controversy. Inadequate caloric intake is one of the main differences among the related studies, with the effect of many special nutrients such as bran acid amides not taken into consideration. Therefore, considering the sufficiency of caloric and protein intake is critical in assessing effectiveness. Only after patients receive adequate calories and protein may the effect of special nutrients such as glutamine and supplements be evaluated effectively.

  6. Nutrition care-related practices and factors affecting nutritional intakes in hospital patients at risk of pressure ulcers.

    Science.gov (United States)

    Roberts, S; Chaboyer, W; Desbrow, B

    2015-08-01

    Malnutrition is common in hospitals and is a risk factor for pressure ulcers. Nutrition care practices relating to the identification and treatment of malnutrition have not been assessed in patients at risk of pressure ulcers. The present study describes nutrition care practices and factors affecting nutritional intakes in this patient group. The study was conducted in four wards at two hospitals in Queensland, Australia. Adult patients at risk of pressure ulcers as a result of restricted mobility were observed for 24 h to determine their daily oral intake and practices such as nutrition screening, documentation and intervention. Independent samples t-tests and chi-squared tests were used to analyse dietary intake and nutrition care-related data. Predictors of receiving a dietitian referral were identified using logistic regression analyses. Two hundred and forty-one patients participated in the present study. The observed nutritional screening rate was 59% (142 patients). Weight and height were documented in 71% and 34% of cases. Sixty-nine patients (29%) received a dietitian referral. Predictors of receiving a dietitian referral included lower body mass index and longer length of stay. On average, patients consumed 73% and 72% of the energy and protein provided, respectively. Between 22% and 38% of patients consumed meals. Nutrition care practices including malnutrition risk screening and documentation of nutritional parameters appear to be inadequate in patients at risk of pressure ulcers. A significant proportion of these patients eat inadequately at main meals, further increasing their risk of malnutrition and pressure ulcers. © 2014 The British Dietetic Association Ltd.

  7. Clinical benefits of oral nutritional supplementation for elderly hip fracture patients: a single blind randomised controlled trial.

    Science.gov (United States)

    Myint, Ma Wai Wai; Wu, Jenny; Wong, Euann; Chan, Suk Ping; To, Tze Shing Jess; Chau, Mei Wa Rosanna; Ting, Kwai Hing; Fung, Pui Man; Au, Kit Sing Derrick

    2013-01-01

    malnutrition is an important risk factor for poor outcome in patients recovering after hip fracture surgery. This study aimed to investigate the clinical, nutritional and rehabilitation effects of an oral nutritional supplementation (ONS) in an inpatient rehabilitation setting. this was an observer-blinded randomised controlled trial of elderly post-surgical proximal femoral fracture patients. A ready-to-use oral liquid nutritional supplementation (18-24 g protein and 500 kcal per day) in addition to hospital diet was compared with hospital diet only. Both groups received usual rehabilitation therapy and oral calcium and vitamin D supplements. Outcomes were compared at discharge from rehabilitation and after 4 weeks of discharge. The primary outcome parameters were the serum albumin level, the body mass index (BMI), the functional independence measure (FIM) and the elderly mobility scale (EMS). Secondary outcome parameters were frequency of complications, inpatient length of stay, mortality and acute hospital use within 6 months after discharge. a total of 126 patients were recruited, 65 in the supplementation arm and 61 in the control arm. There was a significant difference in change in BMI with a decrease of 0.25 and 0.03 kg/m(2) in the ONS group and 0.72 and 0.49 kg/m(2) in the control group at hospital discharge and follow-up, respectively (P = 0.012). The length of stay in rehabilitation ward was shortened by 3.80 (SE = 1.81, P = 0.04) days favouring the ONS group. The total number of infection episodes was also reduced significantly. No difference was observed in the rate of change of the serum albumin level, the FIM and the EMS. clinical and nutritional benefits were seen in this trial but rehabilitation benefits could not be demonstrated.

  8. Comprehensive care improves physical recovery of hip-fractured elderly Taiwanese patients with poor nutritional status.

    Science.gov (United States)

    Liu, Hsin-Yun; Tseng, Ming-Yueh; Li, Hsiao-Juan; Wu, Chi-Chuan; Cheng, Huey-Shinn; Yang, Ching-Tzu; Chou, Shih-Wei; Chen, Ching-Yen; Shyu, Yea-Ing L

    2014-06-01

    The effects of nutritional management among other intervention components have not been examined for hip-fractured elderly persons with poor nutritional status. Accordingly, this study explored the intervention effects of an in-home program using a comprehensive care model that included a nutrition-management component on recovery of hip-fractured older persons with poor nutritional status at hospital discharge. A secondary analysis of data from a randomized controlled trial with 24-month follow-up. A 3000-bed medical center in northern Taiwan. Subjects were included only if they had "poor nutritional status" at hospital discharge, including those at risk for malnutrition or malnourished. The subsample included 80 subjects with poor nutritional status in the comprehensive care group, 87 in the interdisciplinary care group, and 85 in the usual care group. The 3 care models were usual care, interdisciplinary care, and comprehensive care. Usual care provided no in-home care, interdisciplinary care provided 4 months of in-home rehabilitation, and comprehensive care included management of depressive symptoms, falls, and nutrition as well as 1 year of in-home rehabilitation. Data were collected on nutritional status and physical functions, including range of motion, muscle power, proprioception, balance and functional independence, and analyzed using a generalized estimating equation approach. We also compared patients' baseline characteristics: demographic characteristics, type of surgery, comorbidities, length of hospital stay, cognitive function, and depression. Patients with poor nutritional status who received comprehensive care were 1.67 times (95% confidence interval 1.06-2.61) more likely to recover their nutritional status than those who received interdisciplinary and usual care. Furthermore, the comprehensive care model improved the functional independence and balance of patients who recovered their nutritional status over the first year following discharge

  9. [Vitamin D supplementation in the elderly: guidelines and practice].

    Science.gov (United States)

    Chel, V G M; Elders, P J M; Tuijp, M L M; van den Berg, H H; van Drongelen, K I; Siedenburg, R C; Ooms, M E; Lips, P T A

    2013-01-01

    In 2008, the Health Council of the Netherlands published an advice on vitamin D supplementation for the elderly. Nevertheless, suspicion arose at the Ministry of Health, Welfare and Sport and the Netherlands Nutrition Centre that vitamin D supplementation in the elderly is still insufficient. We aimed to determine the extent to which general practitioners and elderly care physicians actually followed the advice of the Health Council. Questionnaire study. Brief questionnaires were sent to all elderly care physicians in the Netherlands. Some questions were also posed to general practitioners at a network meeting of the Academic Network of GP Practices of the VU University Medical Center in Amsterdam. More than two-thirds of the respondents, both elderly care physicians and general practitioners, are familiar with the guidelines of the Health Council of the Netherlands on vitamin D supplementation in the elderly, but about half do not prescribe vitamin D when the guideline advises to do so. When supplementation is prescribed, about half of the elderly care physicians and a fifth of the general practitioners uses an insufficient dose. The guidelines of the Health Council of the Netherlands on vitamin D supplementation in the elderly are not sufficiently followed by elderly care physicians and general practitioners. Awareness of and support for the vitamin D supplementation guidelines among health care providers is still limited.

  10. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition.

    Science.gov (United States)

    Mehta, Nilesh M; Skillman, Heather E; Irving, Sharon Y; Coss-Bu, Jorge A; Vermilyea, Sarah; Farrington, Elizabeth Anne; McKeever, Liam; Hall, Amber M; Goday, Praveen S; Braunschweig, Carol

    2017-07-01

    role of supplemental parenteral nutrition has been highlighted, and a delayed approach appears to be beneficial. Immunonutrition cannot be currently recommended. Overall, the pediatric critical care population is heterogeneous, and a nuanced approach to individualizing nutrition support with the aim of improving clinical outcomes is necessary.

  11. Assessing the impact of a food supplement on the nutritional status and body composition of HIV-infected Zambian women on ARVs.

    Science.gov (United States)

    Zulu, Rodah M; Byrne, Nuala M; Munthali, Grace K; Chipeta, James; Handema, Ray; Musonda, Mofu; Hills, Andrew P

    2011-09-21

    Zambia is a sub-Saharan country with one of the highest prevalence rates of HIV, currently estimated at 14%. Poor nutritional status due to both protein-energy and micronutrient malnutrition has worsened this situation. In an attempt to address this combined problem, the government has instigated a number of strategies, including the provision of antiretroviral (ARV) treatment coupled with the promotion of good nutrition. High-energy protein supplement (HEPS) is particularly promoted; however, the impact of this food supplement on the nutritional status of people living with HIV/AIDS (PLHA) beyond weight gain has not been assessed. Techniques for the assessment of nutritional status utilising objective measures of body composition are not commonly available in Zambia. The aim of this study is therefore to assess the impact of a food supplement on nutritional status using a comprehensive anthropometric protocol including measures of skinfold thickness and circumferences, plus the criterion deuterium dilution technique to assess total body water (TBW) and derive fat-free mass (FFM) and fat mass (FM). This community-based controlled and longitudinal study aims to recruit 200 HIV-infected females commencing ARV treatment at two clinics in Lusaka, Zambia. Data will be collected at four time points: baseline, 4-month, 8-month and 12-month follow-up visits. Outcome measures to be assessed include body height and weight, body mass index (BMI), body composition, CD4, viral load and micronutrient status. This protocol describes a study that will provide a longitudinal assessment of the impact of a food supplement on the nutritional status of HIV-infected females initiating ARVs using a range of anthropometric and body composition assessment techniques. Pan African Clinical Trial Registry PACTR201108000303396.

  12. Pilot Study: Mother's Attitude and Practices toward Antenatal Care, Micronutrient Supplementation and Breastfeeding in Salmaniya Medical Complex

    International Nuclear Information System (INIS)

    Husain, Dana

    2014-01-01

    Full text: Good nutrition in the first 1000 days provides a stable long term foundation for society, as it ensures a child's growth to his/her potential (1). Pregnant women who suffer from multiple micronutrient deficiencies have been associated with poor pregnancy outcomes including Low Birth weight-LBW (4). Iron deficiency anemia is linked to an increased risk of infections (4), and is still a health problem in the kingdom of Bahrain with the prevalence of 22.7% to 54% (5). The World Health Organization (WHO), United Nation Children's fund (UNICEF) and American Academy of Pediatrics recommendations are to initiate breastfeeding within the first hour of life and to and sustain exclusive breastfeeding for 6 months (6). Several studies have shown a downward trend of breastfeeding in developing countries such as Kingdom of Saudi Arabia (7,8). Studies in Kingdom of Saudi Arabia and Kingdom of Bahrain have shown partial breastfeeding at early months<6month age (8,9) Aim: To provide a preliminary evaluation of the mother's attitude/practices toward antenatal care, micronutrient supplementation and breastfeeding in Salmaniya Medical Complex (SMC), Kingdom of Bahrain. Methods: A sample of 62 Bahraini mothers - inpatients and outpatients- within the age group of 20 years to 35 years old at SMC were asked by dietitians and diet technicians to answer 7 closed ended questions about importance of antenatal care, compliance to nutritional recommendations during pregnancy and breastfeeding practices. Statistical Package for Social Science (SPSS) was used in analyzing data collected. Fisher Exact test and Chi-Square test were used to correlate the determinants (age and education level) with mother's attitude/practices. Statistical significance was assumed at p<0.05 Results: Scores showed no significant correlation between education level mother's attitude/practices toward antenatal care, micronutrient supplementation and breastfeeding. As for age, we found more mothers above 25

  13. Diet and Nutrition in Cancer Survivorship and Palliative Care

    Directory of Open Access Journals (Sweden)

    Anthony J. Bazzan

    2013-01-01

    Full Text Available The primary goal of palliative cancer care is typically to relieve suffering and improve quality of life. Most approaches to diet in this setting have focused only on eating as many calories as possible to avoid cachexia. However, as the concept of palliative care has evolved to include all aspects of cancer survivorship and not just end of life care, there is an increasing need to thoughtfully consider diet and nutrition approaches that can impact not only quality of life but overall health outcomes and perhaps even positively affect cancer recurrence and progression. In this regard, there has been a recent emphasis in the literature on nutrition and cancer as an important factor in both quality of life and in the pathophysiology of cancer. Hence, the primary purpose of this paper is to review the current data on diet and nutrition as it pertains to a wide range of cancer patients in the palliative care setting.

  14. Issues in Nutrition: Dietary Supplements.

    Science.gov (United States)

    Thompson, Margaret E; Noel, Mary Barth

    2017-01-01

    The majority of American adults report use of one or more dietary supplements every day or occasionally. The Dietary Supplement Health and Education Act of 1994 defines dietary supplements and regulates their manufacture and distribution. One of the most commonly used supplements is vitamin D. Measurement of serum levels of vitamin D must be undertaken with the caveats that different laboratories define normal levels differently, and that there is rarely a clinical correlation with the actual level. Patients should understand that supplements should not be used to excess, as there are toxicities and other adverse effects associated with most of them. There currently is considerable research being performed on probiotics and how the gut microbiome affects health and disease states. Protein supplements may be useful in reducing mortality rates in elderly patients but they do not appear to increase quality of life. If used, protein supplements should contain essential amino acids. Casein and whey supplements, derived from dairy sources, help transport essential amino acids to tissues. Although there have been many studies investigating the role of vitamin supplements in disease prevention, there have been few conclusive positive results. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  15. Objective and subjective nutritional assessment of patients with cancer in palliative care.

    Science.gov (United States)

    Kwang, Ang Yee; Kandiah, Mirnalini

    2010-03-01

    This study aimed to evaluate the nutritional status of patients with cancer in palliative care and to examine the interrelationship between objective and subjective nutritional assessment measures. Patients' nutritional status in a palliative care unit of a Malaysian government hospital and a hospice facility were assessed using anthropometric measurements, weight loss at 1/6 months, and the scored patient-generated subjective global assessment (PG-SGA). Moderate-to-severe malnutrition was observed in a range from 31% to 69% using both measurements. Common nutritional impact symptoms were pain, xerostomia, and anorexia. Patient-generated subjective global assessment scores were significantly correlated with anthropometric measurements (P nutritional status assessment of patients with cancer in palliative care.

  16. Nurse Practitioners' attitude to nutritional challenges dealing with the patients' nutritional needs and ability to care for themselves in a fast track program

    DEFF Research Database (Denmark)

    Graarup, Jytte; Pedersen, Preben Ulrich; Bjerrum, Merete

    2014-01-01

    Background: Nutrition plays an important role to the success of fast track programs, but under nutrition are still reported. Nutritional care seems to be a low priority among nurses even though it is well-known that insufficient nutrition has severe consequences for the patients. The aim is to re......Background: Nutrition plays an important role to the success of fast track programs, but under nutrition are still reported. Nutritional care seems to be a low priority among nurses even though it is well-known that insufficient nutrition has severe consequences for the patients. The aim...... is to report to what extent a training program has made Nutritional Nurse Practitioners aware of the nutritional care for short-term hospitalized patients, and how they deal with patients’ nutritional needs and ability to provide self-care in the context of a fast track program. Methods: Deductive content...... analysis was used to analyse data from four focus group interviews. Sixteen Nutritional Nurse Practitioners from either medical or surgery wards participated. The Nutritional Nurse Practitioners were interviewed twice. The interviews were recorded and verbally transcribed. Results: In the Nutritional Nurse...

  17. Maternal and infant nutritional supplementation practices in Ireland: implications for clinicians and policymakers.

    LENUS (Irish Health Repository)

    Tarrant, R C

    2011-06-01

    This prospective Irish observational study examined maternal and infant nutritional supplement use. From an initial sample of 539 mothers recruited from the Coombe Women and Infants University Hospital in Dublin (during 2004-2006), 450 eligible mothers were followed up at 6 weeks and 6 months postpartum. Only 200 women (44.4%) complied with peri-conceptional folic acid at the recommended time with strong social patterning associated with its uptake. Almost 10% of the sample (n = 44) consumed a combined multivitamin and mineral supplement during pregnancy. A vitamin D-containing supplement was provided to only 5 (1.1%) and 15 (3.3%) infants at 6 weeks and 6 months, respectively. A national guideline that advises on adequate and safe use of both vitamin and multivitamin supplements during pregnancy with particular reference to vitamin A and D is warranted. Given the re-emergence of rickets in Ireland, and the reported morbidities associated with vitamin D insufficiency, promoting and monitoring compliance with 200 IU [5 microg] daily vitamin D supplements to all infants particularly those from higher risk groups from birth to 1 year, should be a public health priority.

  18. Nutritional strategies to boost immunity and prevent infection in elderly individuals.

    Science.gov (United States)

    High, K P

    2001-12-01

    Older adults are at risk for malnutrition, which may contribute to their increased risk of infection. Nutritional supplementation strategies can reduce this risk and reverse some of the immune dysfunction associated with advanced age. This review discusses nutritional interventions that have been examined in clinical trials of older adults. The data support use of a daily multivitamin or trace-mineral supplement that includes zinc (elemental zinc, >20 mg/day) and selenium (100 microg/day), with additional vitamin E, to achieve a daily dosage of 200 mg/day. Specific syndromes may also be addressed by nutritional interventions (for example, cranberry juice consumption to reduce urinary tract infections) and may reduce antibiotic use in older adults, particularly those living in long-term care facilities. Drug-nutrient interactions are common in elderly individuals, and care providers should be aware of these interactions. Future research should evaluate important clinical end points rather than merely surrogate markers of immunity.

  19. Effect of changed organisation of nutritional care of Danish medical inpatients

    Directory of Open Access Journals (Sweden)

    Nyholm Ruth

    2008-08-01

    Full Text Available Abstract Background Many patients are undernourished during hospitalisation. The clinical consequences of this include lassitude, an increased risk of complications and prolonged convalescence. The aim of the study is 1 to implement a new organisation with a focus on improving the quality of the nutritional care of medical inpatients at risk of undernutrition, and 2 to investigate the effect of the intervention. Methods Social and healthcare assistants are educated to the higher level of nutritional and healthcare assistants to provide nutritional care in daily practice to undernourished medical inpatients. The effect of the intervention is investigated before and five months after the employment of the nutritional and healthcare assistants. Data are obtained from structured interviews with patients and staff, and the amount of ordered and wasted food is recorded. Results Patients regard the work of the nutritional and healthcare assistant as very important for their recovery and weight gain: the assistant takes care of the individual patient's nutritional requirements and wishes, and she imparts knowledge to the patient about optimum nutrition. Staff members benefit from the knowledge and dedication of the nutritional and healthcare assistant and from her work; the staff is often too busy with other nursing tasks to make it a priority to ensure that patients who are nibblers get sufficient nutrition. The choices of food from the production kitchen are utilised to a higher degree, and more of the food is eaten by the patients. Before the intervention, a 20% increase in ordered food in relation to the food budget is found. During the intervention a 20% decrease in ordered food in relation to the food budget is found, and food wastage decreases from 55% to 18% owing to the intervention. Conclusion The job function of the nutritional and healthcare assistants on the medical wards is of great value to patients, nursing staff members and the

  20. CORRECTION OF MALNUTRITION IN CANCER P ATIENTS WITH ORAL SUPPLEMENTS (SIPING

    Directory of Open Access Journals (Sweden)

    V. M. Khomyakov

    2015-01-01

    Full Text Available Abstract:Malnutrition occurs in 40 to 80 percent of cancer patients. Malnutrition in cancer patients is associated with poorer overall survival, reduced benefit from surgical and medical therapies, increased therapy-related toxicity, poorer quality of life. Early diagnostics of malnutrition and purpose of nutritional therapy is one of important components of supportive care at all steps of anticancer treatment. The modern tools for evaluation of the nutritional status and the principles of nutritional support at cancer patients, including oral nutritional supplements (siping are presented in the article.

  1. Positive effect of protein-supplemented hospital food on protein intake in patients at nutritional risk

    DEFF Research Database (Denmark)

    Munk, T; Beck, A M; Holst, M

    2014-01-01

    BACKGROUND: New evidence indicates that increased dietary protein ingestion promotes health and recovery from illness, and also maintains functionality in older adults. The present study aimed to investigate whether a novel food service concept with protein-supplementation would increase protein...... and energy intake in hospitalised patients at nutritional risk. METHODS: A single-blinded randomised controlled trial was conducted. Eighty-four participants at nutritional risk, recruited from the departments of Oncology, Orthopaedics and Urology, were included. The intervention group (IG) received...... of hospital stay did not differ between groups. CONCLUSIONS: The novel food service concept had a significant positive impact on overall protein intake and on weight-adjusted energy intake in hospitalised patients at nutritional risk....

  2. Performance and nutritional evaluation of beef cattle raised on pasture, castrated at different ages, with and without supplementation

    Directory of Open Access Journals (Sweden)

    Anilza Andréia da Rocha

    2012-04-01

    Full Text Available The objective of this study was to evaluate performance and nutritional traits of beef cattle raised on pastures, castrated at different ages, with and without supplementation. Forty-four crossbred young bulls with predominance of Zebu breed at initial average age of 120±30 days were used in the experiment. Animals were distributed in a completely randomized design in a factorial arrangement with four ages of castration and two supplementation systems. The animals were distributed into four groups and placed on Brachiaria decumbens Stapf pastures, where they were fed concentrate supplementation or mineral salt ad libtum (control. Animals were castrated at 120, 240 and 360 days of age with average body weight of 115, 175 and 276 kg, castrated or not, in each supplementation group. Concentrate supplement composition and the amount supplied to the animals varied according to the time of the year and development phase of the animals. Trials were carried out to evaluate nutritional variables in each of the following phases: suckling, growth in the dry season and growth in the dry/rainy transition season. Concentrate supplementation improved the use of pasture, although it may have caused substitutive effect in all seasons evaluated. Castration of the animals before the dry season impaired animal development until the following dry/rainy transition season, especially when carried out during weaning. Concentrate supply may reduce some effects of this stress.

  3. Assessing the impact of a food supplement on the nutritional status and body composition of HIV-infected Zambian women on ARVs

    Directory of Open Access Journals (Sweden)

    Musonda Mofu

    2011-09-01

    Full Text Available Abstract Background Zambia is a sub-Saharan country with one of the highest prevalence rates of HIV, currently estimated at 14%. Poor nutritional status due to both protein-energy and micronutrient malnutrition has worsened this situation. In an attempt to address this combined problem, the government has instigated a number of strategies, including the provision of antiretroviral (ARV treatment coupled with the promotion of good nutrition. High-energy protein supplement (HEPS is particularly promoted; however, the impact of this food supplement on the nutritional status of people living with HIV/AIDS (PLHA beyond weight gain has not been assessed. Techniques for the assessment of nutritional status utilising objective measures of body composition are not commonly available in Zambia. The aim of this study is therefore to assess the impact of a food supplement on nutritional status using a comprehensive anthropometric protocol including measures of skinfold thickness and circumferences, plus the criterion deuterium dilution technique to assess total body water (TBW and derive fat-free mass (FFM and fat mass (FM. Methods/Design This community-based controlled and longitudinal study aims to recruit 200 HIV-infected females commencing ARV treatment at two clinics in Lusaka, Zambia. Data will be collected at four time points: baseline, 4-month, 8-month and 12-month follow-up visits. Outcome measures to be assessed include body height and weight, body mass index (BMI, body composition, CD4, viral load and micronutrient status. Discussion This protocol describes a study that will provide a longitudinal assessment of the impact of a food supplement on the nutritional status of HIV-infected females initiating ARVs using a range of anthropometric and body composition assessment techniques. Trial Registration Pan African Clinical Trial Registry PACTR201108000303396.

  4. Impact of internet vs traditional Special Supplemental Nutrition Program for Women, Infants, and Children nutrition education on fruit and vegetable intake.

    Science.gov (United States)

    Bensley, Robert J; Anderson, Judith V; Brusk, John J; Mercer, Nelda; Rivas, Jason

    2011-05-01

    The purpose of this project was to compare the impact of Internet nutrition education to traditional nutrition education on Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participant fruit and vegetable consumption. Interventions were delivered at 15 WIC clinics after normal WIC clinic operations or delivered online. A total of 692 and 872 participants from eight WIC agencies self-enrolled into two phases. A quasi-experimental design using an interrupted time series to determine the impact of two methods of nutrition education and follow-up nutrition counseling was used. Data were collected online and at Michigan WIC clinics during 2005-2007 at 3-month intervals during a 9-month period (per phase). Two Internet nutrition education modules were compared to WIC traditional nutrition education, which included either group classes or a self-guided nutrition education information mall. All interventions were based on the same program learning objectives. Optional motivational negotiation counseling followed 3 months post-intervention. Stage of change progression, belief in ability to change, and fruit and vegetable consumption were measured at baseline, immediately after the intervention, and 3 and 6 months post-intervention. Significance (PInternet group experienced substantial positive differences in stage of change progression, perception that the intervention was helpful and easy to use, and fruit and vegetable consumption. Traditional nutrition education required follow-up counseling to achieve fruit and vegetable consumption levels similar to the Internet nutrition education group. Based on these findings, this study supports Internet nutrition education as a viable alternative to traditional nutrition education for increasing fruit and vegetable consumption in some WIC clients. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

  5. Effect of Free Fatty Acids Supplementation on Digestibility, Nutritive Value and Rumen Fermentation in Local Sheep

    International Nuclear Information System (INIS)

    El-Foly, H.A.; Mohamed, A.K.; Mustafa, M.M.M.

    2014-01-01

    Twelve mature local sheep, with a mean body weight of 49.2±3 kg were randomly distributed into three digestibility trail groups to evaluate the effects of inclusion some oils industry by-products, soft fatty acid (SFA) and hard fatty acid (HFA) on dry matter intake, digestibility coefficients, nutritive values, nitrogen and energy utilization and some rumen and blood parameters. The experimental diets were basal diet un-supplemented (control) or supplemented 3% SFA (T1) and 3% HFA (T2). The results showed that non-significant differences in total dry matter intake and water consumption among the tested diets were observed.The digestibility of dry matter (DM), organic matter (OM) and nitrogen free extract (NFE) were significantly increased (P<0.05) by addition of SFA while digestibility of crude protein (CP) and ether extract (EE) was significantly increased (P<0.05) by addition of HFA as compared with control. However, digestibility of crude fiber (CF) was significantly decreased (P<0.05) in T2 as compared with control and T1. Fatty acids supplementation significantly increased (P<0.05) the nutritive values such as TDN, SV and DCP as compared with control.The nitrogen utilization was significantly improved (P<0.05) by the addition of both additives. The values of total volatile fatty acid concentrations (TVFA) and pH values after feeding were significantly increased (P<0.05) with HFA supplementation as compared with the values of other groups. However, the rumina l ammonia-N concentrations after feeding significantly decreased (P<0.05) with fatty acids supplementation as compared with control. The results of digestible and metabolizable energy showed non-significant differences between the tested groups. Blood serum urea, albumen, cholesterol, triglycerides and phosphorus values were significantly increased (P<0.05) with HFA as compared with the values of other groups.The mean values of serum alanine transaminase (ALT), aspartate transaminase (AST

  6. Prevention of nutritional rickets in Nigerian children with dietary calcium supplementation.

    Science.gov (United States)

    Thacher, Tom D; Fischer, Philip R; Isichei, Christian O; Zoakah, Ayuba I; Pettifor, John M

    2012-05-01

    Nutritional rickets in Nigerian children usually results from dietary calcium insufficiency. Typical dietary calcium intakes in African children are about 200mg daily (approximately 20-28% of US RDAs for age). We sought to determine if rickets could be prevented with supplemental calcium or with an indigenous food rich in calcium. We enrolled Nigerian children aged 12 to 18months from three urban communities. Two communities were assigned calcium, either as calcium carbonate (400mg) or ground fish (529±109mg) daily, while children in all three communities received vitamin A (2500IU) daily as placebo. Serum markers of mineral homeostasis and forearm bone density (pDEXA) were measured and radiographs were obtained at enrollment and after 18months of supplementation. The overall prevalence of radiographic rickets at baseline was 1.2% and of vitamin D deficiency [serum 25(OH)DRickets developed in 1, 1, and 2 children assigned to the calcium tablet, ground fish, and control groups, respectively (approximate incidence 6.4/1000 children/year between 1 and 3years of age). Children who developed rickets in the calcium-supplemented groups had less than 50% adherence. Compared with the group that received no calcium supplementation, the groups that received calcium had a greater increase in areal bone density of the distal and proximal 1/3 radius and ulna over time (Prickets. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Sustained benefits of a community dietetics intervention designed to improve oral nutritional supplement prescribing practices.

    LENUS (Irish Health Repository)

    Kennelly, S

    2011-10-01

    Healthcare professionals working in the community do not always prescribe oral nutritional supplements (ONS) according to best practice guidelines for the management of malnutrition. The present study aimed to determine the impact of a community dietetics intervention on ONS prescribing practices and expenditure 1 year later.

  8. Severe Hypothyroidism From Iodine Deficiency Associated With Parenteral Nutrition.

    Science.gov (United States)

    Golekoh, Marjorie C; Cole, Conrad R; Jones, Nana-Hawa Yayah

    2016-11-01

    Parenteral nutrition is crucial for supply of nutrients in children who cannot tolerate a full enteral diet. In the United States, it is not standard of care to give iodine to children dependent on parenteral nutrition, hence iodine is not routinely included in the micronutrient package. Herein, we present a case of a boy with hypothyroidism secondary to iodine deficiency after prolonged exclusive use of parenteral nutrition. Our case highlights the importance of screening for iodine deficiency and administering timely iodine supplementation in these at-risk children to prevent iatrogenic hypothyroidism. © 2015 American Society for Parenteral and Enteral Nutrition.

  9. Multidisciplinary nutritional support for undernutrition in nursing home and home-care

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Gøgsig Christensen, Annette; Stenbæk Hansen, Birthe

    2016-01-01

    Objective To assess the effect of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care identified with the validated Eating Validation Scheme (EVS). Methods An 11 wk cluster randomized trial with a home-care (3 clusters) or nursing home (3 clusters.......3] versus 1.3 [0.5], P = 0.021) was observed. There was a almost significant difference in mortality (2% versus 13%, P = 0.079). Conclusions Multidisciplinary nutritional support in older adults in nursing home and home-care could have a positive effect on quality of life, muscle strength, and oral care....... means of EuroQol-5D-3L), physical performance (30-seconds chair stand), nutritional status (weight and hand-grip strength), oral care, fall incidents, hospital admissions, rehabilitation stay, moving to nursing homes (participants from home-care), and mortality. Results Respectively, 55 (46 from 2 home...

  10. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine

    OpenAIRE

    Kreider, Richard B.; Kalman, Douglas S.; Antonio, Jose; Ziegenfuss, Tim N.; Wildman, Robert; Collins, Rick; Candow, Darren G.; Kleiner, Susan M.; Almada, Anthony L.; Lopez, Hector L.

    2017-01-01

    Creatine is one of the most popular nutritional ergogenic aids for athletes. Studies have consistently shown that creatine supplementation increases intramuscular creatine concentrations which may help explain the observed improvements in high intensity exercise performance leading to greater training adaptations. In addition to athletic and exercise improvement, research has shown that creatine supplementation may enhance post-exercise recovery, injury prevention, thermoregulation, rehabilit...

  11. Complex Dietary Supplements from Raw Plants Provide Nutrition for Athletes

    Directory of Open Access Journals (Sweden)

    Dmitriy M. Uvarov

    2017-03-01

    Full Text Available The aim of this study was to investigate the effectiveness of mechanically activated complexes from plant substances to enhance athletes’ adaptability to intense physical activity. Methods: The object of the study was the dietary supplement Kladorod, which is based on the reindeer lichen Cladonia rangiferina and Rhodiola rosea in weight ratio of 10:1. To test the dietary supplement, we developed a special scheme for the experiment and selected 10 elite athletes (boxers and mixfighters. Athletes were divided into 2 groups and were under the same conditions (nutrition, medical monitoring, living conditions and training process. Athletes of the experimental group were given the dietary supplement Kladorod (capsule of 0.4 g by mouth between meals 4 times a day for 28 days. The control group was given placebo (Ringer-Locke powder capsules in the same terms in a similar way. During the experiment, the athletes were medically examined 3 times: at the beginning, in the middle, and after the course of intervention. We measured muscle performance, fat mass, muscle mass, and serum concentrations of cortisol and total testosterone. Results: It was established that during the intensive training of boxers and mixfighters for rating fights, administration of the dietary supplement Kladorod for 28 days stabilized the absolute and relative muscle mass, preventing its reduction, in comparison with the placebo group. At the same time, indicators of fat mass decreased significantly in the experimental group. After administering the course of Kladorod, we did not observe a significant decrease in testosterone/cortisol ratio, compared to the control group Thus, the use of biologically active supplements based on lichen raw materials and complexes of lichen raw materials with different plant substances enables the body to increase its adaptive potential and physical capacity.

  12. Characterization of inorganic compounds in nutritional supplements by the instrumental neutron activation analysis

    International Nuclear Information System (INIS)

    Nardi, Daniela T.; Saiki, Mitiko; Vasconcellos, Maria B.A.

    2000-01-01

    In this work instrumental neutron activation analysis was applied in the analyses of samples of nutritional supplements in order to evaluate the composition of their essential inorganic components. Results obtained in these analyses presented, in general, a good agreement with the label values. Precision and accuracy of the results were also evaluated by analyzing NIST 2704 Buffalo River Sediment and NIST 1400 Bone Ash reference materials. (author)

  13. Comparing the nutrition environment and practices of home- and centre-based child-care facilities.

    Science.gov (United States)

    Martyniuk, Olivia J M; Vanderloo, Leigh M; Irwin, Jennifer D; Burke, Shauna M; Tucker, Patricia

    2016-03-01

    To assess and compare the nutrition environment and practices (as they relate to pre-schoolers) of centre- and home-based child-care facilities. Using a cross-sectional study design, nineteen child-care facilities (ten centre-based, nine home-based) were assessed for one full day using the Environment and Policy Assessment and Observation (EPAO) tool (consisting of a day-long observation/review of the nutrition environment, practices and related documents). Specifically, eight nutrition-related subscales were considered. Child-care facilities in London, Ontario, Canada. Child-care facilities were recruited through directors at centre-based programmes and the providers of home-based programmes. The mean total nutrition environment EPAO scores for centre- and home-based facilities were 12·3 (sd 1·94) and 10·8 (sd 0·78) out of 20 (where a higher score indicates a more supportive environment with regard to nutrition), respectively. The difference between the total nutrition environment EPAO score for centre- and home-based facilities was approaching significance (P=0·055). For both types of facilities, the highest nutrition subscale score (out of 20) was achieved in the staff behaviours domain (centre mean=17·4; home mean=17·0) and the lowest was in the nutrition training and education domain (centre mean=3·6; home mean=2·0). Additional research is needed to confirm these findings. In order to better support child-care staff and enhance the overall nutrition environment in child care, modifications to food practices could be adopted. Specifically, the nutritional quality of foods/beverages provided to pre-schoolers could be improved, nutrition-related training for child-care staff could be provided, and a nutrition curriculum could be created to educate pre-schoolers about healthy food choices.

  14. Nutritional supplements and herbal medicines for women with polycystic ovary syndrome; a systematic review and meta-analysis.

    Science.gov (United States)

    Arentz, Susan; Smith, Caroline A; Abbott, Jason; Bensoussan, Alan

    2017-11-25

    Polycystic ovary syndrome (PCOS) is a common, reproductive endocrinopathy associated with serious short and long term health risks. Many women with PCOS use ingestible complementary medicines. This systematic review examined the effect on menstrual regulation and adverse effects from randomised controlled trials. Randomised controlled trials (RCTs) that compared herbal or nutritional supplements to placebo or active controls in women with PCOS were eligible for inclusion. Electronic databases were searched to July 2017. Study selection and assessment of quality were conducted independently by two review authors. Twenty four studies (1406 women) investigating seven nutritional supplements and four herbal medicines were included. No one study was assessed as having a low risk of bias. Four trials reported on the primary endpoint menstrual regulation. There was no evidence on improved menstrual regularity for calcium plus vitamin D compared to Metformin (RR: 0.66, 95% CI 0.35 to 1.23, p = 0.19), reduced amenorrhoea for Camellia sinensis compared to placebo (RR: 0.17, 95% CI 0.02 to 1.72, p = 0.13) and no difference in the number of menses per month for Cinnamomum sp. against placebo (MD 0.05, 95% CI -0.36 to 1.36, p = 0.26). Adverse effects were investigated in seven studies (164 women). Mild adverse effects were found for Cinnamomum sp. compared to placebo (17 women, RR: 0.36, 95% CI 0.03 to 0.70, p = 0.03). No difference was found for adverse effects between inositol, B complex vitamins, vitamin D, chromium and placebo. Improved reproduction, metabolic hormones and hyperandrogenism was found for inositol and improved cholesterol for omega three fish oils. There is no high quality evidence to support the effectiveness of nutritional supplements and herbal medicine for women with PCOS and evidence of safety is lacking. High quality trials of nutritional supplements and herbal medicines examining menstrual regulation and adverse effects in women with PCOS

  15. Smartphone apps and the nutrition care process: Current perspectives and future considerations.

    Science.gov (United States)

    Chen, Juliana; Gemming, Luke; Hanning, Rhona; Allman-Farinelli, Margaret

    2018-04-01

    To provide dietitians with practical guidance on incorporating smartphone applications (apps) in the nutrition care process (NCP) to optimize patient education and counseling. The current evidence-base for mobile health (mHealth) apps was searched using PubMed and Google Scholar. Where and how apps could be implemented by dietitians across the four steps of the NCP is discussed. With functionality to automatically convert patient dietary records into nutrient components, nutrition assessment can be streamlined using nutrition apps, allowing more time for dietitians to deliver education and nutrition counseling. Dietitians could prescribe apps to provide patients with education on nutrition skills and in counseling for better adherence to behavior change. Improved patient-provider communication is also made possible through the opportunity for real-time monitoring and evaluation of patient progress via apps. A practical framework termed the 'Mobile Nutrition Care Process Grid' provides dietitians with best-practice guidance on how to use apps. Including apps into dietetic practice could enhance the efficiency and quality of nutrition care and counseling delivered by dietitians. Apps should be considered an adjunct to enable dietetic counseling and care, rather than to replace the expertise, social support and accountability provided by dietitians. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Nutritional Therapy in Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Ahmed Hammad

    2017-10-01

    Full Text Available Protein-energy malnourishment is commonly encountered in patients with end-stage liver disease who undergo liver transplantation. Malnutrition may further increase morbidity, mortality and costs in the post-transplantation setting. The importance of carefully assessing the nutritional status during the work-up of patients who are candidates for liver replacement is widely recognized. The metabolic abnormalities induced by liver failure render the conventional assessment of nutritional status to be challenging. Preoperative loss of skeletal muscle mass, namely, sarcopenia, has a significant detrimental impact on post-transplant outcomes. It is essential to provide sufficient nutritional support during all phases of liver transplantation. Oral nutrition is preferred, but tube enteral nutrition may be required to provide the needed energy intake. Herein, the latest currently employed perioperative nutritional interventions in liver transplant recipients are thoroughly illustrated including synbiotics, micronutrients, branched-chain amino acid supplementation, immunonutrition formulas, fluid and electrolyte balance, the offering of nocturnal meals, dietary counselling, exercise and rehabilitation.

  17. Effect of Agaricus sylvaticus supplementation on nutritional status and adverse events of chemotherapy of breast cancer: a randomized, placebo-controlled, double-blind clinical trial.

    Science.gov (United States)

    Valadares, Fabiana; Garbi Novaes, Maria Rita Carvalho; Cañete, Roberto

    2013-01-01

    Breast cancer (BC) represents the highest incidence of malignancy in women throughout the world. Medicinal fungi can stimulate the body, reduce side-effects associated with chemotherapy and improve the quality of life in patients with cancer. To evaluate the effects of dietary supplementation of Agaricus sylvaticus on clinical and nutritional parameters in BC patients undergoing chemotherapy. A randomized, placebo-controlled, double-blind, clinical trial was carried out at the Oncology Clinic, Hospital of the Federal District-Brazil from September 2007 to July 2009. Forty six patients with BC, Stage II and III, were randomly assigned to receive either nutritional supplement with A. sylvaticus (2.1 g/day) or placebo. Patients were evaluated during treatment period. Patient supplemented with A. sylvaticus improved in clinical parameters and gastrointestinal functions. Poor appetite decreased by 20% with no changes in bowel functions (92.8%), nausea and vomiting (80%). Dietary supplementation with A. sylvaticus improved nutritional status and reduced abnormal bowel functions, nausea, vomiting, and anorexia in patients with BC receiving chemotherapy.

  18. Combined effects of functionally-oriented exercise regimens and nutritional supplementation on both the institutionalised and free-living frail elderly (double-blind, randomised clinical trial

    Directory of Open Access Journals (Sweden)

    Grodzicki Tomasz

    2009-01-01

    Full Text Available Abstract Background Consistently swelling proportion of the frail elderly within a modern society challenges the overstrained public health sector to provide both adequate medical care and comprehensive assistance in their multiple functional deficits of daily living. Easy-to-apply and task-specific ways of addressing this issue are being sought out, with a view to proposing systemic solutions for nationwide application. Methods The present randomised, double-blind, placebo-controlled, 7-week clinical trial aimed to determine whether specifically structured, intensive exercise regimens, combined with nutritional supplementation, might improve and help sustain individual muscle strength and mobility, and possibly enhance individual functional capabilities in an on-going quest for active prevention of care-dependency. Ninety-one frail elderly (F 71 M 20; mean age 79 years were recruited from both nursing home residents and community dwellers and randomly split into four groups: Group I – progressive resistance exercises (PRE + functionally-oriented exercises (FOE + nutritional supplementation (NS, Group II – PRE + FOE + placebo, Group III – standard exercises (SE + FOE + NS, Group IV – SE + FOE + placebo. Each group pursued a 45 min. exercise session 5 times weekly. The subjects' strength with regard to four muscle groups, i.e. hip and knee extensors and flexons, was assessed at 80% (1 RM weekly, whereas their balance and mobility at baseline and at the end of the study. Results The study was completed by 80 subjects. Despite its relatively short duration significant differences in muscle strength were noted both in Group I and Group II (p = 0.01; p = 0.04; respectively, although this did not translate directly into perceptible improvement in individual mobility. Notable improvements in individual mobility were reported in Group III and Group IV (p = 0.002, although without positive impact on individual muscle strength. Conclusion

  19. Protein supplementation with sports protein bars in renal patients.

    Science.gov (United States)

    Meade, Anthony

    2007-05-01

    Malnutrition prevalence in patients on dialysis is well established. The protein requirements for both hemodialysis and peritoneal dialysis have been documented elsewhere, including the Kidney Disease Outcomes Quality Initiative Clinical Practice Guidelines for Nutrition in Chronic Renal Failure. The clinical challenge is to assist patients in meeting these targets, especially in those with anorexia. Traditional supplements have included fluid, which is an issue for patients who are fluid restricted. The study objectives were to (1) investigate the range of sports protein supplements that may be suitable for patients on hemodialysis to use and (2) trial nonfluid protein supplements in patients on hemodialysis. Known manufacturers of sports protein bars and other sports supplements available in Australia were contacted for the nutrient breakdown of high-protein products, specifically potassium, protein, and phosphorus contents. As a result, selected high-protein sports bars (Protein FX, Aussie Bodies, Port Melbourne, Victoria, Australia) were used as an alternative to the more commonly used renal-specific fluid supplements (Nepro, Abbott Laboratories, Abbott Park, IL; Novasource Renal, Novartis Nutrition Corporation, Fremont, MI; and Renilon, Nutricia, Wiltshire, UK) in patients with poor nutritional status requiring supplementation. Patient satisfaction and clinical nutrition markers were investigated. The study took place at inpatient, in-center, and satellite hemodialysis settings in Adelaide, South Australia. A total of 32 patients (16 females and 16 males) with an average age of 62.9 years (range 32-86 years) undergoing hemodialysis (acute and maintenance) were included. Subjects were selected by the author as part of routine clinical nutrition care. Patients trialed sports protein bars as a protein supplement alone or in conjunction with other supplementary products. All patients were in favor of the trial, with 22 of 32 patients continuing with the protein

  20. Nutritional supplements in eating disorders.

    Science.gov (United States)

    Díaz-Marsá, Marina; Alberdi-Páramo, Iñigo; Niell-Galmés, Lluis

    2017-09-01

    Eating disorders (EDs) are a series of differentiated nosological entities sharing the common link of a continuous alteration in food intake or in food intake-related behavior. Within this classification, the following disorders are noteworthy: anorexia nerviosa (AN) and bulimia nerviosa (BN). Anorexia nervosa is a chronic disorder characterized mainly by negative or decreased food intake accompanied by a distortion of body image and intense accompanying fear of weight gain. The estimated vital prevalence of this disorder in adolescence is approximately 0.5%-1%.1 The primary feature of BN is the presence of binge eating accompanied by compensatory behavior (in the form of intense exercise and the use of laxatives and diuretics, etc.). The prevalence of BN is estimated to be between 2% and 4% in young women, and it generally starts at somewhat later stages than AN. It is believed that biological, psychological, and environmental factors, as well as genetic vulnerability, influence the pathogenesis of EDs. A variety of therapies exist, both biological and psychological, whose effectiveness is supported by the scientific literature. Nonetheless, we find these therapies only partially effective and new targets as well as new treatments should be sought. Although the etiopathogenesis of EDs is unclear, some of the neurobiological dysfunction found suggests that diet and nutrient supplementation could be relevant in their treatment. We review in this article new treatments focusing on nutritional deficits.

  1. Comparing quality of nutritional care in Dutch and German nursing homes.

    Science.gov (United States)

    van Nie-Visser, Noémi C; Meijers, Judith M M; Schols, Jos M G A; Lohrmann, Christa; Bartholomeyczik, Sabine; Halfens, Ruud J G

    2011-09-01

    This study investigates possible differences in malnutrition prevalence rates in Dutch and German nursing homes. It seeks to provide insight into the screening, prevention and treatment of malnutrition and the indicators for nutritional care policy. For decades, malnutrition has been an important problem in health care settings worldwide. A considerable percentage of frail older people suffer from malnutrition. In European nursing homes, the reported prevalence rates range widely (2% to 85%). This is a multicentre, cross-sectional prevalence study of malnutrition in Dutch and German nursing homes using standardised methodology, with the participation of respectively 5848 and 4923 residents (65+ years). Patient characteristics differed significantly between the two countries. Dutch residents were more often male, younger, more care-dependent and significantly more at risk of malnutrition (31·7%). However, overall malnutrition prevalence rates did not differ significantly (Netherlands 26·8% and Germany 26·5%). All German residents were screened at admission, whereas only 73·1% of the Dutch residents were. As part of screening, nutritional screening tools were used in 38·0% of Dutch and 42·1% of the German residents. A dietician was consulted for 36·7% Dutch and 9·3% German malnourished residents. The proportion of malnourished receiving nutritional intervention was larger in Germany than in the Netherlands. Structural indicators for nutritional policy were fulfilled more often in the Netherlands care at institutional level whereas in Germany they were fulfilled more often at ward level. In this study, German residents had a somewhat better nutritional status than Dutch residents and more is done to enhance nutritional status in German nursing homes. The differences would be somewhat larger if both populations were more comparable. Comparing malnutrition prevalence rates, prevention and interventions in health care institutions and countries gives insight into

  2. Nutritional Deficiency in Patients with Heart Failure

    Directory of Open Access Journals (Sweden)

    Edoardo Sciatti

    2016-07-01

    Full Text Available Heart failure (HF is the main cause of mortality and morbidity in Western countries. Although evidence-based treatments have substantially improved outcomes, prognosis remains poor with high costs for health care systems. In patients with HF, poor dietary behaviors are associated with unsatisfactory quality of life and adverse outcome. The HF guidelines have not recommended a specific nutritional strategy. Despite the role of micronutrient deficiency, it has been extensively studied, and data about the efficacy of supplementation therapy in HF are not supported by large randomized trials and there is limited evidence regarding the outcomes. The aim of the present review is to analyze the state-of-the-art of nutritional deficiencies in HF, focusing on the physiological role and the prognostic impact of micronutrient supplementation.

  3. Effect of supplemental sericea lespedeza pellets on internal parasite infection and nutritional status of grazing goats

    Science.gov (United States)

    Feeding supplemental Sericea lespedeza (SL; Lespedeza cuneata) leaf meal pellets has been shown to reduce the effects of infection with gastrointestinal nematodes (GIN) and coccidia (Eimeria spp.) in sheep and goats, but effects on nutritional status of parasitized small ruminants are unclear. A 14...

  4. The effect of conjugated linoleic acid supplementation on the nutritional status of COPD patients.

    Science.gov (United States)

    Ghobadi, Hassan; Matin, Somaieh; Nemati, Ali; Naghizadeh-Baghi, Abbas

    2016-01-01

    COPD patients are susceptible to anorexia, reduction of caloric intake, weight loss, and malnutrition. One of the possible mechanisms is the increase of inflammatory markers such as interleukin 1β (IL 1β ), is highly correlated with anorexia. Considering the anti-inflammatory role of conjugated linoleic acid (CLA), this study aimed to investigate the effect of CLA supplementation on the nutritional status of COPD patients. In a double-blind clinical trial, 93 COPD patients who volunteered to participate in the study and who filled out a written consent form, were randomly assigned to control or supplementation groups. The patients in the supplementation group received 3.2 g of CLA on a daily basis for 6 weeks, while those in the control group received placebo on a daily basis for 6 weeks. For IL 1β assessment, the patients' anthropometric indices and appetite score were checked and their blood samples were collected both before and after the treatment. Moreover, in order to investigate the changes in the caloric intake trend during the study, their dietary intake levels were assessed using 24-hour dietary recall, 3 days a week at the onset, in the 4th week, and at the end of the study. Eventually, 90 patients completed the study. The results demonstrated a significant increase in appetite score ( P =0.001), average caloric intake ( P =0.01), and macronutrient intake ( P nutritional status of patients suffering from COPD through adjusting the serum level of IL 1β .

  5. Military-specific application of nutritional supplements: a brief overview [v1; ref status: indexed, http://f1000r.es/548

    Directory of Open Access Journals (Sweden)

    Kyle Hoedebecke

    2015-03-01

    Full Text Available The Soldiers of America's military endure numerous physical and mental challenges that demand strict physical fitness regimens, extreme mental agility, and a perpetual readiness to deploy at a moment's notice. The chronicity of these stressors has the potential to dramatically reduce performance - both directly and indirectly.  Because of this risk, many Soldiers turn to nutritional supplements with hopes of optimizing performance. Increasing amounts of research have demonstrated that various supplements may enhance overall physical prowess, health, and offer quicker recovery in the face of corporal or psychological extremes. Most individuals, including many medical and nutrition professionals, possess only an elementary comprehension of nutritional supplements and their effect on Soldiers in training or combat environments. Nevertheless, a grasp of these details is required for safety and optimal benefits. Various compounds have been evaluated - to include evidence within the military setting - and found to augment endurance, increase cognitive function, decrease knee pain, or offer hearing or lung protection in the face of high-energy impulses. These efficacious outcomes may serve to augment the health and longevity of these Soldiers; however, continued research is needed for efficacy and long-term safety within specific environments.

  6. Impact of Moringa oleifera lam. Leaf powder supplementation versus nutritional counseling on the body mass index and immune response of HIV patients on antiretroviral therapy: a single-blind randomized control trial.

    Science.gov (United States)

    Tshingani, Koy; Donnen, Philippe; Mukumbi, Henri; Duez, Pierre; Dramaix-Wilmet, Michèle

    2017-08-22

    To achieve effective antiretroviral therapy (ART) outcomes, adherence to an antiretroviral regimen and a good immunometabolic response are essential. Food insecurity can act as a real barrier to adherence to both of these factors. Many people living with human immunodeficiency virus (PLHIV) treated with ART in the Democratic Republic of the Congo (DRC) are faced with nutritional challenges. A significant proportion are affected by under nutrition, which frequently leads to therapeutic failure. Some HIV care facilities recommend supplementation with Moringa oleifera (M.O.) Lam. leaf powder to combat marginal and major nutritional deficiencies. This study aims to assess the impact of M.O. Lam. leaf powder supplementation compared to nutritional counseling on the nutritional and immune status of PLHIV treated with ART. A single-blind randomized control trial was carried out from May to September 2013 at an outpatient clinic for HIV-infected patients in Kinshasa (DRC). Sixty adult patients who were at stable HIV/AIDS clinical staging 2, 3 or 4 according to the World Health Organization (WHO), and were undergoing ART were recruited. After random allocation, 30 patients in the Moringa intervention group (MG) received the M.O. Lam. leaf powder daily over 6 months, and 30 in the control group (CG) received nutritional counseling over the same period. Changes in the body mass index (BMI) were measured monthly and biological parameters were measured upon admission and at the end of the study for the patients in both groups. The two study groups were similar in terms of long-term nutritional exposure, sociodemographic, socioeconomic, clinical, and biological features. At 6 months follow-up, patients in the MG exhibited a significantly greater increase in BMI and albumin levels than those in the CG. The interaction between the sociodemographic, clinical, and biological characteristics of patients in the two groups was not significant, with the exception of professional

  7. Confiscated black market products and nutritional supplements with non-approved ingredients analyzed in the Cologne Doping Control Laboratory 2009.

    Science.gov (United States)

    Kohler, Maxie; Thomas, Andreas; Geyer, Hans; Petrou, Michael; Schänzer, Wilhelm; Thevis, Mario

    2010-01-01

    Doping control laboratories are frequently confronted with new substances that may be misused by athletes. Besides new pharmaceuticals, where method development for their detection is dependent on the availability of the substance and corresponding administration studies, some professional and amateur athletes are using illicit 'black market' products, which either differ from known pharmaceuticals but cause similar effects or still are undergoing clinical trials and are therefore rarely available to doping control laboratories. In the Cologne Doping Control Laboratory, different confiscated products and legally obtained nutritional supplements were analyzed in 2009, and various findings were reported including GH-labelled injection vials without any pharmacologically active content; combinations of products indicating the attempt to mask growth hormone abuse; unpurified long-R(3) -IGF-1; nutritional supplements containing the growth hormone releasing peptide-2 (GHRP-2); and ampoules containing the selective androgen receptor modulator Andarine (S-4). This review provides an overview on the substances that were analyzed in 2009. Ingredients relevant for doping control were identified by means of liquid chromatography and mass spectrometry methods. The awareness of new products on the black market and in nutritional supplements is of utmost importance for laboratories to develop detection methods accordingly and screen for new substances as early as possible. Copyright © 2010 John Wiley & Sons, Ltd.

  8. Nutritional support of children in the intensive care unit.

    OpenAIRE

    Seashore, J. H.

    1984-01-01

    Nutritional support is an integral and essential part of the management of 5-10 percent of hospitalized children. Children in the intensive care unit are particularly likely to develop malnutrition because of the nature and duration of their illness, and their inability to eat by mouth. This article reviews the physiology of starvation and the development of malnutrition in children. A method of estimating the nutritional requirements of children is presented. The techniques of nutritional su...

  9. Placebo in sports nutrition: a proof-of-principle study involving caffeine supplementation.

    Science.gov (United States)

    Saunders, B; de Oliveira, L F; da Silva, R P; de Salles Painelli, V; Gonçalves, L S; Yamaguchi, G; Mutti, T; Maciel, E; Roschel, H; Artioli, G G; Gualano, B

    2017-11-01

    We investigated the effects of supplement identification on exercise performance with caffeine supplementation. Forty-two trained cyclists (age 37 ± 8 years, body mass [BM] 74.3 ± 8.4 kg, height 1.76 ± 0.06 m, maximum oxygen uptake 50.0 ± 6.8 mL/kg/min) performed a ~30 min cycling time-trial 1 h following either 6 mg/kgBM caffeine (CAF) or placebo (PLA) supplementation and one control (CON) session without supplementation. Participants identified which supplement they believed they had ingested ("caffeine", "placebo", "don't know") pre- and post-exercise. Subsequently, participants were allocated to subgroups for analysis according to their identifications. Overall and subgroup analyses were performed using mixed-model and magnitude-based inference analyses. Caffeine improved performance vs PLA and CON (P ≤ 0.001). Correct pre- and post-exercise identification of caffeine in CAF improved exercise performance (+4.8 and +6.5%) vs CON, with slightly greater relative increases than the overall effect of caffeine (+4.1%). Performance was not different between PLA and CON within subgroups (all P > 0.05), although there was a tendency toward improved performance when participants believed they had ingested caffeine post-exercise (P = 0.06; 87% likely beneficial). Participants who correctly identified placebo in PLA showed possible harmful effects on performance compared to CON. Supplement identification appeared to influence exercise outcome and may be a source of bias in sports nutrition. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. The nutritional care of people living with dementia at home: A scoping review.

    Science.gov (United States)

    Mole, Louise; Kent, Bridie; Abbott, Rebecca; Wood, Chloë; Hickson, Mary

    2018-01-24

    There are an increasing number of people with dementia living in their own home for longer, often supported by a family member. The symptoms of dementia can affect an individual's nutritional status, which can lead to a reduced quality of life for the person with dementia and their family members. A scoping review was conducted from July 2016 until September 2016, using a recognised framework, to explore what is currently known, and identify any gaps in the research regarding the nutritional care of people living with dementia at home. This included any interventions that may have been trialled or implemented, and the views of those living with dementia, carers and clinicians. Six electronic databases were searched from inception to July 2016. A review team was involved in screening and data extraction for selected articles. Published qualitative and quantitative studies were included that explored the nutritional care of people living with dementia at home. Methods included data extraction and conventional content analysis. Stakeholders were involved in the development of final categories. Following screening, 61 studies reported in 63 articles were included. Most studies were cross-sectional (n = 24), cohort (n = 15) or qualitative (n = 9). Only three were randomised controlled trials. Three overarching categories represented the results: Timely identification of nutritional risk and subsequent regular monitoring of nutritional status, multi-component tailored interventions and the influence of the care-giving dyad on nutritional status. Many studies identify people living at home with dementia as a vulnerable group prone to malnutrition; however, a lack of interventions exists to address the increased risk. There is a lack of research exploring the role of home care providers and healthcare professionals in the provision of nutritional care. Further research is required to explore how the emotional aspect of the care-giving dyad influences nutritional care

  11. Multidisciplinary, multi-modal nutritional care in acute hip fracture inpatients - results of a pragmatic intervention.

    Science.gov (United States)

    Bell, Jack J; Bauer, Judith D; Capra, Sandra; Pulle, Ranjeev Chrys

    2014-12-01

    Malnutrition is highly prevalent and resistant to intervention following hip fracture. This study investigated the impact of individualised versus multidisciplinary nutritional care on nutrition intake and outcomes in patients admitted to a metropolitan hospital acute hip fracture unit. A prospective, controlled before and after comparative interventional study aligning to the CONSORT guidelines for pragmatic clinical trials. Randomly selected patients receiving individualised nutritional care (baseline) were compared with post-interventional patients receiving a new model of nutritional care promoting nutrition as a medicine, multidisciplinary nutritional care, foodservice enhancements, and improved nutrition knowledge and awareness. Malnutrition was diagnosed using the Academy of Nutrition and Dietetics criteria. Fifty-eight weighed food records were available for each group across a total of 82 patients (n = 44, n = 38). Group demographics were not significantly different with predominantly community dwelling (72%), elderly (82.2 years), female (70%), malnourished (51.0%) patients prone to co-morbidities (median 5) receiving early surgical intervention (median D1). Multidisciplinary nutritional care reduced intake barriers and increased total 24-h energy (6224 vs. 2957 kJ; p hip fracture inpatients. Similar pragmatic study designs should be considered in other elderly inpatient populations perceived resistant to nutritional intervention. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  12. [Nutrition in pregnancy - Practice recommendations of the Network "Healthy Start - Young Family Network"].

    Science.gov (United States)

    Koletzko, B; Bauer, C-P; Bung, P; Cremer, M; Flothkötter, M; Hellmers, C; Kersting, M; Krawinkel, M; Przyrembel, H; Rasenack, R; Schäfer, T; Vetter, K; Wahn, U; Weißenborn, A; Wöckel, A

    2012-06-01

    Nutrition, physical activity and lifestyle in pregnancy influence maternal and child health. The "Healthy start - Young Family Network" supported by the German Government with the national action plan IN FORM developed recommendations on nutrition in pregnancy. Folic acid supplements (400 µg/day) should be started before pregnancy and continue for at least the first trimester. Iodine rich foods and salt and an iodine supplement (100-150 µg/day) are recommended. Long-chain omega-3 fatty acids should be provided with ≥ 1 weekly portion of oily sea fish, or a DHA-supplement if regular fish consumption is avoided. Vitamin D supplementation is advisable unless there is regular exposure to sunlight. Iron supplements should be used based on medical history and blood testing. Vegetarian diets with nutritional supplements can provide adequate nutrition, but counselling is recommended. In contrast, a vegan diet is inadequate and requires additional micronutrient supplementation. For risk reduction of listeriosis and toxoplasmosis, raw animal foods, soft cheeses and packed fresh salads should be avoided; fresh fruit, vegetables and salad should be washed well and consumed promptly. Pregnant women should remain physically active and perform sports with moderate intensity. They should avoid alcohol, active and passive smoking. Up to 3 daily cups of coffee are considered harmless, but energy drinks should be avoided. Childhood allergy is not reduced by avoiding certain foods in pregnancy whereas oily sea fish is recommended. Health care professions should lead parents to health-promoting lifestyles. Subjects of part 1 of the article are practice recommendations on nutrition, on energy needs, micronutrient needs and body weight/weight gain in pregnancy. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Proteomics in quality control: Whey protein-based supplements.

    Science.gov (United States)

    Garrido, Bruno Carius; Souza, Gustavo H M F; Lourenço, Daniela C; Fasciotti, Maíra

    2016-09-16

    The growing consumption of nutritional supplements might represent a problem, given the concern about the quality of these supplements. One of the most used supplements is whey protein (WP); because of its popularity, it has been a target of adulteration with substitute products, such as cheaper proteins with lower biological value. To investigate this type of adulteration, this study used shotgun proteomics analyses by MS(E) (multiplexed, low- and high-collision energy, data-independent acquisition) of WP-based supplements. Seventeen WP-based supplement samples were evaluated. Chicken, maize, rice, potato, soybean, and wheat proteins were considered as probable sources of bovine whey adulteration. Collectively, 523 proteins were identified across all 16 samples and replicates, with 94% of peptides inside a normal distribution within 10ppm of maximum error. In 10 of the 16 samples analyzed, only proteins from bovine whey could be detected, while in the other samples several other protein sources were detected in high concentrations, especially soybean, wheat, and rice. These results point out a probable adulteration and/or sample contamination during manufacturing that could only be detected using this proteomic approach. The present work shows how shotgun proteomics can be used to provide reliable answers in quality control matters, especially focusing on Whey Protein nutritional supplements which are a very popular subject in food and nutrition. In order to achieve an appropriate methodology, careful evaluation was performed applying extremely rigorous quality criteria, established for the proteomic analysis. These criteria and the methodological approach used in this work might serve as a guide for other authors seeking to use proteomics in quality control. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine.

    Science.gov (United States)

    Kreider, Richard B; Kalman, Douglas S; Antonio, Jose; Ziegenfuss, Tim N; Wildman, Robert; Collins, Rick; Candow, Darren G; Kleiner, Susan M; Almada, Anthony L; Lopez, Hector L

    2017-01-01

    Creatine is one of the most popular nutritional ergogenic aids for athletes. Studies have consistently shown that creatine supplementation increases intramuscular creatine concentrations which may help explain the observed improvements in high intensity exercise performance leading to greater training adaptations. In addition to athletic and exercise improvement, research has shown that creatine supplementation may enhance post-exercise recovery, injury prevention, thermoregulation, rehabilitation, and concussion and/or spinal cord neuroprotection. Additionally, a number of clinical applications of creatine supplementation have been studied involving neurodegenerative diseases (e.g., muscular dystrophy, Parkinson's, Huntington's disease), diabetes, osteoarthritis, fibromyalgia, aging, brain and heart ischemia, adolescent depression, and pregnancy. These studies provide a large body of evidence that creatine can not only improve exercise performance, but can play a role in preventing and/or reducing the severity of injury, enhancing rehabilitation from injuries, and helping athletes tolerate heavy training loads. Additionally, researchers have identified a number of potentially beneficial clinical uses of creatine supplementation. These studies show that short and long-term supplementation (up to 30 g/day for 5 years) is safe and well-tolerated in healthy individuals and in a number of patient populations ranging from infants to the elderly. Moreover, significant health benefits may be provided by ensuring habitual low dietary creatine ingestion (e.g., 3 g/day) throughout the lifespan. The purpose of this review is to provide an update to the current literature regarding the role and safety of creatine supplementation in exercise, sport, and medicine and to update the position stand of International Society of Sports Nutrition (ISSN).

  15. Implementing the Academy of Nutrition and Dietetics Benchmarks for Nutrition Education for Children: Child-Care Providers' Perspectives.

    Science.gov (United States)

    Dev, Dipti A; Carraway-Stage, Virginia; Schober, Daniel J; McBride, Brent A; Kok, Car Mun; Ramsay, Samantha

    2017-12-01

    National childhood obesity prevention policies recommend that child-care providers educate young children about nutrition to improve their nutrition knowledge and eating habits. Yet, the provision of nutrition education (NE) to children in child-care settings is limited. Using the 2011 Academy of Nutrition and Dietetics benchmarks for NE in child care as a guiding framework, researchers assessed child-care providers' perspectives regarding delivery of NE through books, posters, mealtime conversations, hands-on learning, and sensory exploration of foods to young children (aged 2 to 5 years). Using a qualitative design (realist method), individual, semistructured interviews were conducted until saturation was reached. The study was conducted during 2012-2013 and used purposive sampling to select providers. Final sample included 18 providers employed full-time in Head Start or state-licensed center-based child-care programs in Central Illinois. Child-care providers' perspectives regarding implementation of NE. Thematic analysis to derive themes using NVivo software. Three overarching themes emerged, including providers' motivators, barriers, and facilitators for delivering NE to children. Motivators for delivering NE included that NE encourages children to try new foods, NE improves children's knowledge of healthy and unhealthy foods, and NE is consistent with children's tendency for exploration. Barriers for delivering NE included that limited funding and resources for hands-on experiences and restrictive policies. Facilitators for delivering NE included providers obtain access to feasible, low-cost resources and community partners, providers work around restrictive policies to accommodate NE, and mealtime conversations are a feasible avenue to deliver NE. Providers integrated mealtime conversations with NE concepts such as food-based sensory exploration and health benefits of foods. Present study findings offer insights regarding providers' perspectives on

  16. Effect of nutritional supplement combined with exercise intervention on sarcopenia in the elderly: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Dan Luo

    2017-10-01

    Full Text Available Objectives: This systematic review was conducted to explore whether nutritional supplement can improve the benefits of exercise intervention on sarcopenia in the elderly. Methods: Databases, including PubMed, Embase, Cochrane Library, Web of Science, CINAHL, CBM, CNKI, WANFANG, and VIP, were searched. All related papers with randomized controlled trials (RCT methodology that were included in the databases from inception to 19 July 2016 were selected for the study. The tool “assessing risk of bias” from Cochrane Handbook 5.10 was used to evaluate the quality of included papers. A meta-analysis of eligible studies was performed using Stata12.0. Data that we were unable to convene or merge were subjected to descriptive analysis. Results: Six trials were included in our study, which included 429 elderly patients with sarcopenia. The overall methodological quality of the trials was moderate. Compared with the exercise group, patients who were given nutritional supplements gained a bigger boost in fat-free mass (standard mean difference (SMD = 5.78, 95% CI: 5.17 to 6.40, P = 0.000 and muscle mass (SMD = 2.048, 95% CI: 0.907 to 3.189, P = 0.000, as well as showed enhancement of keen extension strength (SMD = 1.08, 95% CI: 0.71 to 1.45, P = 0.000 and usual walk speed (SMD = 0.570, 95% CI: 0.19 to 0.95, P = 0.003. Conclusion: Nutritional supplementation may magnify the effect of exercise intervention on sarcopenia elderly in terms of muscle mass, muscle strength, and physical performance. Inconsistencies were present among research studies. More robust studies are needed to determine the most suitable type of nutrient and target population and to explore the actual role of combined intervention in managing sarcopenia in the elderly. Keywords: Sarcopenia, Exercise, Nutritional status, Meta-analysis

  17. Association between Oral Nutritional Supplementation and Clinical Outcomes among Patients with ESRD

    Science.gov (United States)

    Cheu, Christine; Pearson, Jeffrey; Dahlerus, Claudia; Lantz, Brett; Chowdhury, Tania; Sauer, Peter F.; Farrell, Robert E.; Port, Friedrich K.

    2013-01-01

    Summary Background and objectives Oral nutritional supplementation (ONS) was provided to ESRD patients with hypoalbuminemia as part of Fresenius Medical Care Health Plan’s (FMCHP) disease management. This study evaluated the association between FMCHP’s ONS program and clinical outcomes. Design, setting, participants, & measurements Analyses included FMCHP patients with ONS indication (n=470) defined as 2-month mean albumin <3.8 g/dl until reaching a 3-month mean ≥3.8 g/dl from February 1, 2006 to December 31, 2008. Patients did not receive ONS if deemed inappropriate or refused. Patients on ONS were compared with patients who were not, despite meeting ONS indication. Patients with ONS indication regardless of use were compared with Medicare patients with similar serum albumin levels from the 2007 Centers for Medicare and Medicaid Services Clinical Performance Measures Project (CPM). Cox models calculated adjusted hospitalization and mortality risks at 1 year. Results Among patients with indication for ONS, 276 received supplements and 194 did not. ONS use was associated with 0.058 g/dl higher serum albumin overall (P=0.02); this difference decreased by 0.001 g/dl each month (P=0.05) such that the difference was 0.052 g/dl (P=0.04) in month 6 and the difference was no longer significant in month 12 . In analyses based on ONS use, ONS patients had lower hospitalization at 1 year (68.4%; P<0.01) versus patients without ONS (88.7%), but there was no significant reduction in mortality risk (P=0.29). In analyses based on ONS indication, patients with indication had lower mortality at 1 year (16.2%) compared with CPM patients (23.4%; P<0.01). Conclusions These findings suggest that ONS use was associated with significantly lower hospitalization rates but had no significant effect on mortality in a disease management setting. PMID:23085729

  18. Performance, nutritional behavior, and metabolic responses of calves supplemented with forage depend on starch fermentability.

    Science.gov (United States)

    Mojahedi, S; Khorvash, M; Ghorbani, G R; Ghasemi, E; Mirzaei, M; Hashemzadeh-Cigari, F

    2018-05-16

    This study evaluated the interactive effects of forage provision on performance, nutritional behavior, apparent digestibility, rumen fermentation, and blood metabolites of dairy calves when corn grains with different fermentability were used. Sixty 3-d-old Holstein calves were randomly assigned to 1 of 4 treatments in a 2 × 2 factorial arrangement. Dietary treatments were (1) steam-flaked (SF) corn without alfalfa hay (AH) supplementation (SF-NO), (2) SF corn with AH supplementation (SF-AH), (3) cracked (CR) corn without AH supplementation (CR-NO), and (4) CR corn with AH supplementation (CR-AH). All calves received the same amount of pasteurized whole milk and weaned on d 56 of the experiment; the study was terminated on d 70. Steam-flaked corn contained higher amounts of gelatinized starch in comparison with cracked corn (44.1 vs. 12.5% of total starch, respectively). Starter intake was not affected by corn processing methods or AH provision during the pre- or postweaning periods. However, we noted an interaction between corn processing methods and forage supplementation for starter intake during d 31 to 50 of the experiment, where calves fed on SF-AH starter had greater starter intake than those fed SF-NO starter, but the starter intake was not different between CR-NO and CR-AH fed calves. Furthermore, AH increased average daily gain (ADG) of calves fed an SF-based diet but not in calves fed a CR-based diet during the preweaning and overall periods. Interaction between forage provision and time was significant for ADG and feed efficiency, as calves supplemented with forage had higher ADG (0.982 vs. 0.592, respectively) and feed efficiency compared with forage unsupplemented calves at the weaning week. Forage supplementation resulted in more stable ruminal condition compared with nonforage-fed calves, as evidenced by higher ruminal pH (5.71 vs. 5.29, respectively) at postweaning and lower non-nutritive oral behavior around weaning time (55 vs. 70.5 min

  19. Oral nutritional support in malnourished elderly decreases functional limitations with no extra costs.

    Science.gov (United States)

    Neelemaat, Floor; Bosmans, Judith E; Thijs, Abel; Seidell, Jaap C; van Bokhorst-de van der Schueren, Marian A E

    2012-04-01

    Older people are vulnerable to malnutrition which leads to increased health care costs. The aim of this study was to evaluate the cost-effectiveness of nutritional supplementation from a societal perspective. This randomized controlled trial included hospital admitted malnourished elderly (≥ 60 y) patients. Patients in the intervention group received nutritional supplementation (energy and protein enriched diet, oral nutritional support, calcium-vitamin D supplement, telephone counselling by a dietician) until three months after discharge from hospital. Patients in the control group received usual care (control). Primary outcomes were Quality Adjusted Life Years (QALYs), physical activities and functional limitations. Measurements were performed at hospital admission and three months after discharge. Data were analyzed according to the intention-to-treat principle and multiple imputation was used to impute missing data. Incremental cost-effectiveness ratios were calculated and bootstrapping was applied to evaluate cost-effectiveness. Cost-effectiveness was expressed by cost-effectiveness planes and cost-effectiveness acceptability curves. 210 patients were included, 105 in each group. After three months, no statistically significant differences in quality of life and physical activities were observed between groups. Functional limitations decreased significantly more in the intervention group (mean difference -0.72, 95% CI-1.15; -0.28). There were no differences in costs between groups. Cost-effectiveness for QALYs and physical activities could not be demonstrated. For functional limitations we found a 0.95 probability that the intervention is cost-effective in comparison with usual care for ceiling ratios > €6500. A multi-component nutritional intervention to malnourished elderly patients for three months after hospital discharge leads to significant improvement in functional limitations and is neutral in costs. A follow-up of three months is probably too

  20. The influence of nutritional supplement drinks on providing adequate calorie and protein intake in older adults with dementia.

    Science.gov (United States)

    Allen, V; Methven, L; Gosney, M

    2013-09-01

    Investigate the impact of the provision of ONS on protein and energy intake from food and ability to meet protein and calorie requirements in people with dementia. After consent by proxy was obtained, participants took part in a cross over study comparing oral intake on an intervention day to an adjacent control day. The study occurred in Nursing homes and hospitalised settings. Older adults with dementia over the age of 65 were recruited. 26 participants (aged 83.9+/-8.4years, MMSE 13.08+/-8.13) took part. Intervention (if any): On the intervention day nutritional supplement drinks were provided three times. Each drink provided 283.3+/-41.8 Kcal of energy and 13.8+/-4.7g of protein. Supplements were removed approximately 1 hour before meals were served and weighed waste (g) was obtained. Intake of food consumed was determined on intervention and control days using the quartile method (none, quarter, half, three quarters, all) for each meal component. More people achieved their energy and protein requirements with the supplement drink intervention with no sufficient impact on habitual food consumption. Findings from these 26 participants with dementia indicate that supplement drinks may be beneficial in reducing the prevalence of malnutrition within the group as more people meet their nutritional requirements. As the provision of supplement drinks is also demonstrated to have an additive effect to consumption of habitual foods these can be used alongside other measures to also improve oral intake.

  1. Improvement the Yoghurt Nutritional Value, Organoleptic Properties and Preferences by Spirulina (Spirulina platensis) Supplementation

    Science.gov (United States)

    Suzery, M.; Hadiyanto; Sutanto, H.; Widiastuti, Y.; Judiono

    2018-04-01

    Spirulina sp has been identified as potential source food functional such as protein, amino acids and other high added value compounds from microalgae. One of the compounds is phycocyanin as also known for antioxidant use. This research was aimed to increase the nutritional value and organoleptic properties and preferences yoghurt by Spirulina platensis supplementation. Completely randomized controlled group design conducted by 31 respondents. Spirulina Research accomplished in Food Technology, Microbiology and Chemistry Laboratory at Bandung Health Polytechnic in Bandung. Samples divided randomly into three groups: (1) yoghurt standard supplemented 50 ml, (2) yoghurt and spirulina 1% supplemented 50 ml, (3) yoghurt and spirulina 1,2% supplemented 50 ml. Spirulina was added concentration by 0, 1, 1,2 % calculated by dx trial. Proximate analysis revealed the highest protein in enriched by spirulina 1%. However fat was lower 3.48 – 3.56 compare to control. All products found growing Lactobacillus acidophilus with a pH of 4.0 range. There was no microbial contamination such as E coli, Salmonella sp, Pseudomonas sp. Supplementation of spirulina to yoghurt products can be accepted by organoleptic, chemical and microbiological tests of concentrations of 1 and 1.2%. The material makes the blue colours more attractive and can be accepted by the expert panellist.

  2. Alternative therapies for the holistic care of the HIV / AIDS patient ...

    African Journals Online (AJOL)

    Alternative therapies that can be used for the holistic nursing care of HIV / AIDS infection include psychological, mental and emotional therapies, therapeutic touch, nutrition, vitamins, minerals and nutritional supplements, herbal medicine, Chinese medicine and homeopathy, traditional medicine, lifestyle changes and ...

  3.  Nutritional care of Danish medical in-patients - patients' perspectives

    DEFF Research Database (Denmark)

    Lassen, Karin Østergaard; Kruse, Filip; Bjerrum, Merete

    2005-01-01

    with the nutritional care.The patients includeed a total of 91 medical inpatients at two internal medical wards, aarhus University Hospital, Denmark. Their average age was 72 (+/-) 11 yerars. They were individually interviewed about the fodd service ad the nutritinal care upon discharge.Patients satifaction...... with the meals was overall high (90%). About 80% found the meals to be very important, but they lacked information about the food service, and the patient-staff communication about the food service was poor. The reults indicate that the nursing staff was exercising a 'knowledge monopoly' in relation to the food...... service. In conclusion, a majority of the patients dis not perceive the nutritional care as part of the therapy and nursing care during their hospitalization....

  4. The symbolic dimension of prenatal nutrition care in diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Raphaela Corrêa Monteiro MACHADO

    Full Text Available ABSTRACT Objective Aimed at analysing the symbolic dimension of prenatal nutritional care in diabetes. Methods Participants were 17 puerperal adults diagnosed with previous or gestational diabetes. Participant observation and semi-structured interviews were conducted to collect data. The data were interpreted according to an adaptation of Bardin’s Thematic Content Analysis. Results The main meaning of diabetes was the need for changing eating habits. Nutritional care based on the Traditional Method or the Carbohydrate Counting Method was understood as an opportunity for dietary re-education. Weight loss was considered desirable by some participants, albeit against the advice of nutritionists. Pregnant women adopted the standard meal plan, rarely used the food substitution list, and reported occasional dietary transgressions, self-allowed in small portions. Foods containing sucrose were perceived as less harmful to health than added sugars. Conclusion Each pregnant woman experienced prenatal nutritional care in diabetes not as a dietary method, but as part of her lifestyle.

  5. Checklist and Decision Support in Nutritional Care for Burned Patients

    Science.gov (United States)

    2016-10-01

    able to construct a checklist of a clinical and physiologic model and then a computerised decision support system that will perform two functions: the...the provision of nutritional therapy, and assessment of use by nursing and physician staff KEYWORDS Nutrition, severe burn, decision support... clinical testing. Checklist and Decision Support in Nutritional Care for Burned Patients Proposal Number: 12340011 W81XWH-12-2-0074 PI: Steven E

  6. Additive effects of nutritional supplementation, together with bisphosphonates, on bone mineral density after hip fracture: a 12-month randomized controlled study

    Directory of Open Access Journals (Sweden)

    Flodin L

    2014-07-01

    Full Text Available Lena Flodin,1,2 Maria Sääf,3 Tommy Cederholm,4 Amer N Al-Ani,2,5 Paul W Ackermann,5,6 Eva Samnegård,7 Nils Dalen,7 Margareta Hedström2,51Department of Geriatric Medicine, Karolinska University Hospital Stockholm, Sweden; 2Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden; 3Department of Endocrinology, Metabolism, and Diabetes, Karolinska University Hospital, Stockholm, Sweden; 4Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden; 5Department of Orthopedics, Karolinska University Hospital, Stockholm, Sweden; 6Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; 7Department of Clinical Science, Division of Orthopedics, Karolinska Institutet, Danderyd Hospital, Stockholm, SwedenBackground: After a hip fracture, a catabolic state develops, with increased bone loss during the first year. The aim of this study was to evaluate the effects of postoperative treatment with calcium, vitamin D, and bisphosphonates (alone or together with nutritional supplementation on total hip and total body bone mineral density (BMD.Methods: Seventy-nine patients (56 women, with a mean age of 79 years (range, 61–96 years and with a recent hip fracture, who were ambulatory before fracture and without severe cognitive impairment, were included. Patients were randomized to treatment with bisphosphonates (risedronate 35 mg weekly for 12 months (B; n=28, treatment with bisphosphonates along with nutritional supplementation (40 g protein, 600 kcal daily for the first 6 months (BN; n=26, or to controls (C; n=25. All participants received calcium (1,000 mg and vitamin D3 (800 IU daily. Total hip and total body BMD were assessed with dual-energy X-ray absorptiometry at baseline, 6, and 12 months. Marker of bone resorption C-terminal telopeptide of collagen I and 25-hydroxy vitamin D were analyzed in serum

  7. Preferences for food and nutritional supplements among adult people living with HIV in Malawi

    OpenAIRE

    Rodas Moya, Carlos; Kodish, Stephen; Manary, Mark; Grede, Nils; Pee, de, Saskia

    2016-01-01

    Objective: To elucidate the factors influencing food intake and preferences for potential nutritional supplements to treat mild and moderate malnutrition among adult people living with HIV (PLHIV). Design: Qualitative research using in-depth interviews with a triangulation of participants and an iterative approach to data collection. Setting: The study was conducted in a health clinic of rural Chilomoni, a southern town of Blantyre district, Malawi. Subjects: Male and female participants, age...

  8. Consumer involvement in oral nutritional supplements purchasing behavior

    Directory of Open Access Journals (Sweden)

    Dwi Meilia Fitriyani

    2017-06-01

    Full Text Available The paper aimed to get insight of consumer involvement in purchasing behavior towards ONS (Oral Nutritional Supplements for children. By implementing an online survey with sample size of 100, the research investigated the factors (motivation and stimulus factor influencing consumer involvement and the causality between consumer involvement with the product knowledge as well as purchasing behavior. The research tool used was a 5-points Likert questionnaire in which respondents were asked to show their agreements about 40 items of 5 constructs. A partial least square - structural equation modeling by Smart-PLS software used to test the model. The results of this research also comes to conclusion that motivation and stimulus factor had significant affects on consumer involvement, consumer involvement had significant influence to product knowledge as well as ONS purchasing behavior, however product knowledge did not have significant affects on purchasing behavior. The results also showed that the product involvement has an important influence on consumers behavior.

  9. Promotion of nutrition care by Australian fitness businesses: a website analysis.

    Science.gov (United States)

    Barnes, K; Ball, L; Desbrow, B

    2016-11-01

    To investigate the intention of fitness businesses to promote the provision of nutrition care from personal trainers. Cross-sectional evaluation of webpage content. Fitness businesses within two Australian federal electorates were identified using the Fitness Australia list of registered fitness businesses. Inductive content analysis of these fitness business websites and associated social media sites was undertaken to compare website content to the Fitness Australia Position Statement outlining the Roles and Responsibilities of Registered Fitness Professionals. Fitness businesses were classified as 'within scope of practice' if they referred to national nutrition guidelines or dietetic services. 'At risk of being beyond scope' included websites which did not include enough information to definitively state within or beyond scope. Fitness businesses were classified as 'definitely beyond scope of practice' if they advertised nutrition care which clearly extended beyond translation of the national dietary guidelines. Of the businesses reviewed, 15% were within scope despite none referring to a dietitian; 34% were at risk of being beyond scope; and 51% were beyond scope as they advertised nutrition care such as personalized diets without indicating dietetic input. A considerable portion of fitness businesses reviewed advertised their personal trainers as able to provide nutrition care outside the recommended scope of practice. Strategies that help fitness businesses and personal trainers to support clients to have healthy dietary behaviours without extending outside the scope of practice are warranted. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  10. Evaluation of a Continuing Educational Intervention for Primary Health Care Professionals about Nutritional Care of Patients at Home.

    Science.gov (United States)

    Berggren, E; Orrevall, Y; Olin, A Ödlund; Strang, P; Szulkin, R; Törnkvist, L

    2016-04-01

    Evaluate the effectiveness of a continuing educational intervention on primary health care professionals' familiarity with information important to nutritional care in a palliative phase, their collaboration with other caregivers, and their level of knowledge about important aspects of nutritional care. Observational cohort study. 10 primary health care centers in Stockholm County, Sweden. 140 district nurses/registered nurses and general practitioners/physicians working with home care. 87 professionals participated in the intervention group (IG) and 53 in the control group (CG). The intervention consisted of a web-based program offering factual knowledge; a practical exercise linking existing and new knowledge, abilities, and skills; and a case seminar facilitating reflection. The intervention's effects were measured by a computer-based study-specific questionnaire before and after the intervention, which took approximately 1 month. The CG completed the questionnaire twice (1 month between response occasions). The intervention effects, odds ratios, were estimated by an ordinal logistic regression. In the intra-group analyses, statistically significant changes occurred in the IG's responses to 28 of 32 items and the CG's responses to 4 of 32 items. In the inter-group analyses, statistically significant effects occurred in 20 of 32 statements: all 14 statements that assessed familiarity with important concepts and all 4 statements about collaboration with other caregivers but only 2 of the 14 statements concerning level of knowledge. The intervention effect varied between 2.5 and 12.0. The intervention was effective in increasing familiarity with information important to nutritional care in a palliative phase and collaboration with other caregivers, both of which may create prerequisites for better nutritional care. However, the intervention needs to be revised to better increase the professionals' level of knowledge about important aspects of nutritional care.

  11. Discovering the link between nutrition and skin aging.

    Science.gov (United States)

    Schagen, Silke K; Zampeli, Vasiliki A; Makrantonaki, Evgenia; Zouboulis, Christos C

    2012-07-01

    Skin has been reported to reflect the general inner-health status and aging. Nutrition and its reflection on skin has always been an interesting topic for scientists and physicians throughout the centuries worldwide. Vitamins, carotenoids, tocopherols, flavonoids and a variety of plant extracts have been reported to possess potent anti-oxidant properties and have been widely used in the skin care industry either as topically applied agents or oral supplements in an attempt to prolong youthful skin appearance. This review will provide an overview of the current literature "linking" nutrition with skin aging.

  12. Stuck in tradition - A qualitative study on barriers for implementation of evidence-based nutritional care perceived by nursing staff

    DEFF Research Database (Denmark)

    O Connell, Malene Barfod; Jensen, Pia Søe; Andersen, Signe Lindgård

    2018-01-01

    -based practice. Barriers for nutritional care are grounded in lack of knowledge among nursing staff and insufficient collaboration between nursing staff and the doctors. There is a need for nutritional education for the nursing staff and better support from the organisation to help nursing staff provide evidence......AIM: To explore the barriers for nutritional care as perceived by nursing staff at an acute orthopedic ward, aiming to implement evidence-based nutritional care. BACKGROUND: Previous studies indicate that nurses recognize nutritional care as important, but interventions are often lacking....... These studies show that a range of barriers influence the attempt to optimize nutritional care. Before the implementation of evidence-based nutritional care, we examined barriers for nutritional care among the nursing staff. DESIGN: Qualitative study. METHODS: Four focus groups with thirteen members...

  13. SPORT SUPPLEMENTATION

    OpenAIRE

    Alexandаr Marinkov

    2016-01-01

    Sport supplementation is essential for athletes performance and achievements. The well balanced and structured supplementation is a challenge for sport medicine because must be done a balance between potential benefits and potential risks (anti-doping rule violations and others). In this review are structured the most used categories sport supplementations. Nutritional supplements used in sport could be divided in some main categories like: amino acids, vitamins, proteins and antioxidants. Fo...

  14. Supplementation of adjuvants for increasing the nutritive value and cell viability of probiotic fermented milk beverage.

    Science.gov (United States)

    Shobharani, P; Agrawal, Renu

    2009-01-01

    Probiotic are microorganisms that, upon ingestion in adequate amounts, exert a beneficial effect on the host. In the present work, the potent probiotic Leuconostoc mesenteroides was used as a starter culture in the preparation of fermented milk beverage. The product was analyzed for protein, titrable acidity, fat, total sugar, fatty acids and minerals. The viability of culture and nutrition in the product was further enhanced with supplementation of adjuvants like tryptone, casein hydrolysate, cysteine hydrochloride and ascorbic acid. After 5 days, maximum viability was observed on supplementation of tryptone (100 mg/l). The protein content was enhanced by 1.1-fold in the presence of tryptone (100 mg/l) as compared with control after 5 days of storage. Fermented milk supplemented with tryptone (100 mg/l) showed maximum bioavailability of the minerals like iron (92.05%), zinc (95.02%) and magnesium (92.04%) as compared with control. The increase in the composition of beneficial fatty acids on supplementation of adjuvants supports the therapeutic value of the product.

  15. Rehabilitation nutrition for sarcopenia with disability: a combination of both rehabilitation and nutrition care management

    OpenAIRE

    Wakabayashi, Hidetaka; Sakuma, Kunihiro

    2014-01-01

    Malnutrition and sarcopenia often occur in rehabilitation settings. The prevalence of malnutrition and sarcopenia in older patients undergoing rehabilitation is 49–67 % and 40–46.5 %, respectively. Malnutrition and sarcopenia are associated with poorer rehabilitation outcome and physical function. Therefore, a combination of both rehabilitation and nutrition care management may improve outcome in disabled elderly with malnutrition and sarcopenia. The concept of rehabilitation nutrition as a c...

  16. Nutrition and psychological well-being among long-term care residents with dementia.

    Science.gov (United States)

    Muurinen, S; Savikko, N; Soini, H; Suominen, M; Pitkälä, K

    2015-02-01

    To examine the relationship between nutritional status of service housing and nursing home residents with dementia and their psychological well-being (PWB), and the associations of nutritional care and PWB. This cross-sectional nutrition study was carried out in 2011. The study included all older long-term care residents (N=4966) living in nursing homes and service housing units (N=61) in Helsinki. The response rate of was 72%. Of the respondents, only persons who had a diagnosis of dementia were included in this analysis (N=2379). The Mini Nutritional Assessment (MNA) tool and a structured questionnaire were used in assessing the residents. Six dimensions of PWB were included in the questionnaire. Information was also retrieved from medical records. Of residents 9% were well-nourished and 28% malnourished according to the MNA. PWB was good in 50% (score ≥ 0.80) and poor in 10% (score snacks were associated with poor PWB. Mild cognitive impairment was more often associated with poor PWB, whereas moderate or severe impairment was more often associated with good PWB. Nutritional status and nutritional care of residents with dementia were significantly associated with their psychological well-being. The residents suffering from malnutrition had the poorest psychological well-being.

  17. Long-term nutritional impact of sleeve gastrectomy.

    Science.gov (United States)

    Caron, M; Hould, F S; Lescelleur, O; Marceau, S; Lebel, S; Julien, F; Simard, S; Biertho, Laurent

    2017-10-01

    Sleeve gastrectomy (SG) has become a predominant bariatric procedure throughout the world. However, the long-term nutritional impact of this procedure is unknown. To describe the nutritional deficiencies before and after SG and to analyze the influence of baseline weight on nutritional status. University-affiliated tertiary care center. All patients who underwent SG as a standalone procedure between 2008 and 2012 were included in this study. Patients were given multivitamin supplementation. Data were obtained from our prospectively maintained electronic database and are reported as mean ± standard deviation and percentage. Bivariate analyses were conducted to evaluate the influence of selected variables on outcomes. The mean age of the 537 patients was 48.0 ± 11.3 years, with an initial body mass index of 48.1 ± 8.7 kg/m 2 . Excess weight loss and total weight loss were 56.2% and 28.0% at 1 year and 43.0% and 21.1% at 5 years, respectively (Pvitamin B12 in 30.3% and 16.4% (Pvitamin D 63.2% and 24.3% (Pvitamin A insufficiency peaked from 7.9% preoperatively to 28.7% at 3 months (Pvitamin B12 and vitamin D. Nutritional deficiencies are common in patients with morbid obesity before and after surgery. Preoperative supplementation and long-term nutritional follow-up are required to prevent nutritional deficiencies. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  18. Registered nurses' and older people's experiences of participation in nutritional care in nursing homes: a descriptive qualitative study.

    Science.gov (United States)

    Sjögren Forss, Katarina; Nilsson, Jane; Borglin, Gunilla

    2018-01-01

    The evaluation and treatment of older people's nutritional care is generally viewed as a low priority by nurses. However, given that eating and drinking are fundamental human activities, the support and enhancement of an optimal nutritional status should be regarded as a vital part of nursing. Registered nurses must therefore be viewed as having an important role in assessing and evaluating the nutritional needs of older people as well as the ability to intervene in cases of malnutrition. This study aimed to illuminate the experience of participating in nutritional care from the perspectives of older people and registered nurses. A further aim is to illuminate the latter's experience of nutritional care per se. A qualitative, descriptive design was adopted. Data were collected through semi-structured interviews ( n  = 12) with eight registered nurses and four older persons (mean age 85.7 years) in a city in the southern part of Sweden. The subsequent analysis was conducted by content analysis. The analysis reflected three themes: 'participation in nutritional care equals information', 'nutritional care out of remit and competence' and 'nutritional care more than just choosing a flavour'. They were interpreted to illuminate the experience of participation in nutritional care from the perspective of older people and RNs, and the latter's experience of nutritional care in particular per se. Our findings indicate that a paternalistic attitude in care as well as asymmetry in the nurse-patient relationship are still common characteristics of modern clinical nursing practice for older people. Considering that participation should be central to nursing care, and despite the RN's awareness of the importance of involving the older persons in their nutritional care this was not reflected in reality. Strategies to involve older persons in their nutritional care in a nursing home context need to take into account that for this population participation might not always be

  19. Clinical and nutritional aspects of cystic fibrosis patients assisted by a home enteral nutrition program in Brazil

    OpenAIRE

    Haack, Adriana; Garbi Novaes, Maria Rita

    2013-01-01

    This study to assessed 47 cystic fibrosis (CF) patients assisted by a program of Home Enteral Nutrition. Anthropometric measurements included weight, height, triceps skinfold thickness, waist circunference and spirometry was also performed. Enzymes, nutritional and fat-soluble vitamin supplementations were recorded. There were no associations with enzymes and vitamin supplements between groups that did or did not have a nutritional deficit. Spirometry of patients without nutritional deficit, ...

  20. Oral nutritional support in malnourished elderly decreases functional limitations with no extra costs

    NARCIS (Netherlands)

    Neelemaat, Floor; Bosmans, Judith E; Thijs, Abel; Seidell, Jaap C; van Bokhorst-de van der Schueren, Marian A E

    2012-01-01

    BACKGROUND & AIMS: Older people are vulnerable to malnutrition which leads to increased health care costs. The aim of this study was to evaluate the cost-effectiveness of nutritional supplementation from a societal perspective. DESIGN: This randomized controlled trial included hospital admitted

  1. Malnutrition on the menu: nutritional status of institutionalised elderly Australians in low-level care.

    Science.gov (United States)

    Woods, J L; Walker, K Z; Iuliano Burns, S; Strauss, B J

    2009-10-01

    Most studies reporting malnutrition in the elderly relate to high-level care. However, one third of Australians in aged care reside in low-level care facilities. Data is limited on their nutritional status. To investigate the nutritional status of elderly in low-level care facilities. A cross sectional study design. 14 low-level aged care facilities in metropolitan Melbourne. Convenience sample of 103 ambulatory elderly (86 +/- 6.6 years (mean +/- SD), 76% female, comprising 15% of the hostel population) able to perform daily functions of living. Nutritional intake assessed by three-day weighed food records, and nutritional status by haematological and biochemical markers and body composition (dual energy X-ray absorptiometry). FOOD served did not supply the estimated average requirements (EAR) for 5 of the 14 nutrients analysed. Compared with EAR, 34% of participants were protein malnourished and 62% had energy intake deficits. Micronutrient intake was low for calcium, magnesium, folate, zinc (for men) and dietary fibre. Vitamin D deficiency (serum 25OH Vitamin D sarcopenia, 28% of men and 44% women had excess body fat (> 28% and >40%, respectively) and 14% of men and 12 % of women were sarcopenic-obese. Only 12% showed no sign of undernutrition using seven different nutritional indicators. Around 65% had two or more indicators of undernutrition. These findings highlight the need for the supply of more, better quality, nutrient dense food to residents and better detection of undernutrition in aged care facilities. Maintenance of nutritional status has the potential to reduce morbidity and delay the transition to high-level care.

  2. Malnutrition and nutritional care practices in hospital wards for older people

    OpenAIRE

    Vanderwee, Katrien; Clays, Els; Bocquaert, Ilse; Verhaeghe, Sofie; Lardennois, Miguel; Gobert, Micheline; Defloor, Tom

    2010-01-01

    AIMS: This paper is a report of a study conducted to gain a better insight into the current nutritional care practices in Belgian hospital wards for older people, and to study the association between these practices and the prevalence of malnutrition. BACKGROUND: In 1999, the Council of Europe assessed nutritional care practices and support in 12 European countries and showed them to be sparse and inconsistent. At the time of research, no studies had described the association between nutritio...

  3. Symposium 6: Young people, artificial nutrition and transitional care. The nutritional challenges of the young adult with cystic fibrosis: transition.

    LENUS (Irish Health Repository)

    Morton, Alison M

    2012-02-01

    Cystic fibrosis (CF) is a complex multisystem disorder affecting mainly the gastrointestinal tract and respiratory system. Intestinal malabsorption occurs in approximately 90% of patients. In the past, malnutrition was an inevitable consequence of disease progression, leading to poor growth, impaired respiratory muscle function, decreased exercise tolerance and immunological impairment. A positive association between body weight and height and survival has been widely reported. The energy requirements of patients with CF vary widely and generally increase with age and disease severity. For many young adults requirements will be 120-150% of the age-related estimated average requirement. To meet these energy needs patients are encouraged to eat a high-fat high-energy diet with appropriate pancreatic enzyme supplements. Many patients are unable to achieve an adequate intake as a result of a variety of factors including chronic poor appetite, infection-related anorexia, gastro-oesophageal reflux and abdominal pain. Oral energy supplements and enteral tube feeding are widely used. Nutritional support has been shown to improve nutritional status and stabilise or slow the rate of decline in lung function. With such emphasis on nutritional intake and nutritional status throughout life, poor adherence to therapies and issues relating to body image are emerging. The median survival of patients with CF is increasing. CF is now considered a life-limiting disease of adulthood rather than a terminal childhood illness. With increased longevity new challenges are emerging that include the transition of young adults with CF to adult services, CF-related diabetes, disordered eating, osteoporosis, liver disease and transplantation.

  4. Effect of early supplemental parenteral nutrition in the paediatric ICU: a preplanned observational study of post-randomisation treatments in the PEPaNIC trial.

    Science.gov (United States)

    Vanhorebeek, Ilse; Verbruggen, Sascha; Casaer, Michaël P; Gunst, Jan; Wouters, Pieter J; Hanot, Jan; Guerra, Gonzalo Garcia; Vlasselaers, Dirk; Joosten, Koen; Van den Berghe, Greet

    2017-06-01

    Large randomised controlled trials have shown that early supplemental parenteral nutrition in patients admitted to adult and paediatric intensive care units (PICUs) is harmful. Overdosing of energy with too little protein was suggested as a potential reason for this. This study analysed which macronutrient was associated with harm caused by early supplemental parenteral nutrition in the Paediatric Early versus Late Parenteral Nutrition In Critical Illness (PEPaNIC) randomised trial. Patients in the initial randomised controlled trial were randomly assigned to receive suppplemental parenteral nutrition (PN) within 24 h of PICU admission (early PN) or to receive such PN after 1 week (late PN) when enteral nutrition was insufficient. In this post-randomisation, observational study, doses of glucose, lipids, and aminoacids administered during the first 7 days of PICU stay were expressed as % of reference doses from published clinical guidelines for age and weight. Independent associations between average macronutrient doses up to each of the first 7 days and likelihood of acquiring an infection in the PICU, of earlier live weaning from mechanical ventilation, and of earlier live PICU discharge were investigated using multivariable Cox proportional hazard analyses. The three macronutrients were included in the analysis simultaneously and baseline risk factors were adjusted for. From June 18, 2012, to July 27, 2015, 7519 children aged between newborn and 17 years were assessed for eligibility. 6079 patients were excluded, and 1440 children were randomly assigned to receive either early PN (n=723) or late PN (n=717). With increasing doses of aminoacids, the likelihood of acquiring a new infection was higher (adjusted hazard ratios [HRs] per 10% increase between 1·043-1·134 for days 1-5, p≤0·029), while the likelihood of earlier live weaning from mechanical ventilation was lower (HRs 0·950-0·975 days 3-7, p≤0·045), and the likelihood of earlier live PICU

  5. Muscle Mass and Weight Gain Nutritional Supplements

    Science.gov (United States)

    Campbell, Bill

    There are numerous sports supplements available that claim to increase lean body mass. However, for these sports supplements to exert any favorable changes in lean body mass, they must influence those factors regulating skeletal muscle hypertrophy (i.e., satellite cell activity, gene transcription, protein translation). If a given sports supplement does favorably influence one of these regulatory factors, the result is a positive net protein balance (in which protein synthesis exceeds protein breakdown). Sports supplement categories aimed at eliciting a positive net protein balance include anabolic hormone enhancers, nutrient timing pre- and postexercise workout supplements, anticatabolic supplements, and nitric oxide boosters. Of all the sports supplements available, only a few have been subject to multiple clinical trials with repeated favorable outcomes relative to increasing lean body mass. This chapter focuses on these supplements and others that have a sound theoretical rationale in relation to increasing lean body mass.

  6. Health care costs matter: a review of nutrition economics – is there a role for nutritional support to reduce the cost of medical health care?

    OpenAIRE

    Naberhuis,Jane K; Hunt,Vivienne; Bell,Jvawnna; Partridge,Jamie; Goates,Scott; Nuijten,Mark

    2017-01-01

    Jane K Naberhuis,1 Vivienne N Hunt,2 Jvawnna D Bell,3 Jamie S Partridge,3 Scott Goates,3 Mark JC Nuijten4 1Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA; 2Abbott Nutrition, Research and Development, Singapore; 3Abbott Nutrition, Research and Development, Columbus, OH, USA; 4A2M (Ars Accessus Medica), Amsterdam, The Netherlands Background and aims: As policy-makers assess the value of money spent on health care, researc...

  7. Nutritional support in the treatment of aplastic anemia.

    Science.gov (United States)

    Jia, Li; Yu, Jingda; He, Ling; Wang, Huaxin; Jiang, Lili; Miao, Xiaoyan; Wu, Wenguo; Yang, Peiman

    2011-01-01

    Whether a specific nutritional support promotes healing of aplastic anemia (AA) patients is still unclear. Therefore, we explored the potential of a high-nucleotide, arginine, and micronutrient nutritional supplement on the nutritional rehabilitation of AA mice. The BALB/c AA mice model was treated with hypodermic injections of acetylphenylhydrazine (100 mg/kg), x-ray (2.0 Gy), and intraperitoneal injections of a cyclophosphamide (80 mg/kg) combination. Then AA mice were fed with nutritional supplements in a dose-dependent manner (1445.55, 963.7, 674.59 mg/kg/d) for 7 wk. At the end of the experimental period, mice were autopsied. A full blood count was performed, and femoral marrow cell suspensions were prepared to assess the total femoral nucleated cell count and the number of committed hemopoietic progenitor cells (colony-forming units). The pathologic changes of liver and spleen were analyzed. The significant increases of nutrient mixture groups were evident in many peripheral blood parameters. The femoral nucleated cell count and colony-forming units of nutritional supplements groups were markedly increased, compared with the AA group. Transmission electron microscopy showed that the number of mitochondria in similar bone marrow cells was increased in nutritional supplements groups. The nutritional supplements also affected the recovery of livers and spleens of AA mice. Specific nutritional supplements accelerated rehabilitation of AA mice and can be used as nutritional support in the treatment of AA. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. ISSN exercise & sport nutrition review: research & recommendations

    Science.gov (United States)

    2010-01-01

    Sports nutrition is a constantly evolving field with hundreds of research papers published annually. For this reason, keeping up to date with the literature is often difficult. This paper is a five year update of the sports nutrition review article published as the lead paper to launch the JISSN in 2004 and presents a well-referenced overview of the current state of the science related to how to optimize training and athletic performance through nutrition. More specifically, this paper provides an overview of: 1.) The definitional category of ergogenic aids and dietary supplements; 2.) How dietary supplements are legally regulated; 3.) How to evaluate the scientific merit of nutritional supplements; 4.) General nutritional strategies to optimize performance and enhance recovery; and, 5.) An overview of our current understanding of the ergogenic value of nutrition and dietary supplementation in regards to weight gain, weight loss, and performance enhancement. Our hope is that ISSN members and individuals interested in sports nutrition find this review useful in their daily practice and consultation with their clients.

  9. ISSN exercise & sport nutrition review: research & recommendations

    Directory of Open Access Journals (Sweden)

    Mendel Ron

    2010-02-01

    Full Text Available Abstract Sports nutrition is a constantly evolving field with hundreds of research papers published annually. For this reason, keeping up to date with the literature is often difficult. This paper is a five year update of the sports nutrition review article published as the lead paper to launch the JISSN in 2004 and presents a well-referenced overview of the current state of the science related to how to optimize training and athletic performance through nutrition. More specifically, this paper provides an overview of: 1. The definitional category of ergogenic aids and dietary supplements; 2. How dietary supplements are legally regulated; 3. How to evaluate the scientific merit of nutritional supplements; 4. General nutritional strategies to optimize performance and enhance recovery; and, 5. An overview of our current understanding of the ergogenic value of nutrition and dietary supplementation in regards to weight gain, weight loss, and performance enhancement. Our hope is that ISSN members and individuals interested in sports nutrition find this review useful in their daily practice and consultation with their clients.

  10. Improving the nutritional quality and shelf life of broiler meat by feeding diets supplemented with fermented pomegranate (Punica granatum L.) by-products.

    Science.gov (United States)

    Ahmed, S T; Ko, S-Y; Yang, C-J

    2017-12-01

    1. Four experimental diets containing 0, 0.5, 1.0 and 2.0% fermented pomegranate by-products (FPB) were supplied to 320d-old broilers to evaluate the effects of FPB on growth performance, nutritional composition, fatty acid profile and oxidative stability of meat. 2. Dietary supplementation of FPB linearly increased the weight gain and feed intake of broilers with linear reduction in feed conversion ratio. 3. The crude protein, iron, magnesium, and sodium content were linearly higher, whereas cholesterol was linearly lower in the breast meat of FPB-supplemented broilers. In thigh meat, linearly lower ether extract and cholesterol with higher moisture was noted in response to increasing levels of FPB. 4. The proportion of saturated fatty acids was both linearly and quadratically lower in breast and thigh meat, whereas those of monounsaturated fatty acids of breast (linear and quadratic) and n-3 fatty acids of breast and thigh (linear) meat was higher in the FPB-supplemented broilers. The n-6/n-3 ratio of breast meat was linearly lower in response to FPB supplementation. The hypocholesterolaemic to hypercholesterolaemic ratio of thigh meat was higher in the FPB-supplemented groups. 5. The thiobarbituric acid reactive substances and pH value were lower in the breast and thigh meat of FPB-supplemented broilers. 6. Thus, additive supplementation of the diet with up to 2% FPB improved the nutritional quality, fatty acid profile and shelf life of broiler meat.

  11. [Continuity of nutritional care at discharge in the era of ICT].

    Science.gov (United States)

    Martínez Olmos, Miguel Ángel

    2015-05-07

    Telemedicine represents the union of information technology and telecommunication services in health. This allows the improvement of health care, especially in underserved areas, bringing professionals working in continuing education and improving patient care at home. The application of telemedicine in various hospital complexes, clinics and health centers, has helped to provide a better service, within the parameters of efficiency, effectiveness, cost-benefit, with increasing satisfaction of medical staff and patients. The development and application of various types of telemedicine, the technological development of audio, text, video and data, and constant improvement of infrastructure in telecommunications, have favored the expansion and development of telemedicine in various medical specialties. The use of electronic health records by different health professionals can have a positive impact on the care provided to patients. This should also be supported by the development of better health policies, legal security and greater awareness in health professionals and patients regarding the potential benefits. Regarding the clinical activity in Nutrition, new technologies also provide an opportunity to improve in various educational, preventive, diagnostic and treatment aspects, including shared track between Nutrition Units and Primary Care Teams, for patients who need home nutritional care at, with shared protocols, providing teleconsultation in required cases and avoiding unnecessary travel to hospital.

  12. Formulation and nutritional evaluation of a healthy vegetable soup powder supplemented with soy flour, mushroom, and moringa leaf.

    Science.gov (United States)

    Farzana, Tasnim; Mohajan, Suman; Saha, Trissa; Hossain, Md Nur; Haque, Md Zahurul

    2017-07-01

    The research study was conducted to develop a healthy vegetables soup powder supplemented with soy flour, mushroom, moringa leaf and compare its nutritional facts with locally available soup powders. Proximate analysis and sensory evaluation were done by standard method. In this study, moisture, ash, protein, fat, fiber, carbohydrate, and energy content were ranged from 2.83% to 5.46%, 9.39% to 16.48%, 6.92% to 16.05%, 4.22% to 6.39%, 0.22% to 1.61%, 58.81% to 75.41%, and 337.42 to 386.72 kcal/100 g, respectively. Highest content of vitamin D, minerals, protein, and fiber and lowest content of moisture, fat, and carbohydrate were found in the presently developed soy-mushroom-moringa soup powder compare to locally available soup powders. Vitamin C was also found significantly higher than locally available soup powders S1, S2, and S3. Heavy metals were not found in any of the soup powders. On the sensory and microbiological point of view, the presently developed soup powder was found highly acceptable up to 6 months. So, the developed soy-mushroom-moringa soup powder is nutritionally superior to locally available soup powders and sufficient to meet day-to-day nutritional requirements as a supplement.

  13. Nutritional supplement during the treatment with ionizing radiations in patients with head and neck tumors in advanced stages

    International Nuclear Information System (INIS)

    Chon Rivas, Ivonne; Roca Muchuli, Carlos; Vilau Prieto, Luis; Rubio Hernandez, Maria C.; Rodriguez Diaz, Ronald; Leon, Roberto; Rodriguez Abascal, Alicia; Mederos, Nuria

    2005-01-01

    Malnutrition in the patient with advanced cancer favors immunosuppression and implies a low Karnofsky index, poor tolerance and response to the onco specific curative or palliative treatments, high susceptibility to infections and, as a result, a decline of the quality of life. Patients with head and neck tumors in advanced stages (III-IV) are one of the groups of high risk for malnutrition due to the reduction of the intake of nutrients, anorexia, alterations of the deglutition mechanism, and mechanical obstruction of the upper digestive tract, among other causes.Numerous studies show the convenience of the nutritional supplement in these patients during the onco specific treatment. A prospective study that included 15 patients with head and neck neoplasia in advanced stages, and with clinical signs of malnutrition, was conducted in order to evaluate the necessary calorie-energy supplement. All of them were administered an oral nutritional supplement (Adn-22 %) during the radiation treatment to assess the possibility of improving their tolerance and response to the treatment. Of the 15 studied cases, 13 presented complications in connection with the treatment, but most them were mild, and they did not affect in a significant way the time of duration and the total dose of treatment. There was a favorable response in relation to the tumor

  14. Health care costs matter: a review of nutrition economics – is there a role for nutritional support to reduce the cost of medical health care?

    OpenAIRE

    Naberhuis JK; Hunt VN; Bell JD; Partridge JS; Goates S; Nuijten MJC

    2017-01-01

    Jane K Naberhuis,1 Vivienne N Hunt,2 Jvawnna D Bell,3 Jamie S Partridge,3 Scott Goates,3 Mark JC Nuijten4 1Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA; 2Abbott Nutrition, Research and Development, Singapore; 3Abbott Nutrition, Research and Development, Columbus, OH, USA; 4A2M (Ars Accessus Medica), Amsterdam, The Netherlands Background and aims: As policy-makers assess the value of money spent on health care, research in the fie...

  15. Compliance of zinc supplementation by care givers of children suffering from diarrhea

    Directory of Open Access Journals (Sweden)

    Smita S Valekar

    2014-12-01

    Full Text Available Background: Over 2 million children die as a result of diarrhea and dehydration every year. A new ORS formula and introduction of Zinc supplementation offers much improved outcomes for the treatment of childhood diarrhea. Aims: To assess the compliance of Zinc supplementation by caregivers Objectives: 1. To assess the compliance of Zinc supplementation by caregivers, 2. To find out the reason for non-compliance 3. To study the association of socio-demographic variables and non-compliance of children suffering from diarrhea Materials & Method:  Study Design: Cross-sectional survey Study Period: from 1st Sept. 2014 to 31st Oct. 2014 Study Area: Pediatric Outpatient department of Tertiary Care Hospital Inclusion Criteria: Under five children suffering from diarrhea attending Pediatric OPD Study Tool: Questionnaire was administered to care givers and follow up was done on 3rd, 7th & 14th day of Zinc supplementation. Result: 84% of non-compliance was seen in this study. Conclusion: The compliance of Zinc supplementation is poor among caretakers of children suffering from diarrhea.

  16. Nurse care manager contribution to quality of care in a dual-eligible special needs plan.

    Science.gov (United States)

    Roth, Carol P; Ganz, David A; Nickles, Lorraine; Martin, David; Beckman, Robin; Wenger, Neil S

    2012-07-01

    We evaluated the quality of care provided to older patients with complex needs in a dual-eligible, community-based Medicare Special Needs Plan that used a nurse care manager model. Care provided by physicians was substantially supplemented by nurse care managers, as measured by Assessing Care of Vulnerable Elders quality indicators. We describe selected nurse care manager activities for six geriatric conditions (falls, dementia, depression, nutrition, urinary incontinence, and end-of-life care) during provision of patient care coordination and management for patients in the highest decile of clinical complexity. We identify areas of high nurse performance (i.e., falls screening, functional assessment, behavioral interventions for dementia problems, advance care planning) and areas of potential missed opportunities (i.e., follow up for new memory problems, targeted dementia counseling, nutrition, and behavioral approaches to urinary incontinence). Increasing the collaborative interaction between nurses providing care in this model and physicians has the potential to enhance nurses' contributions to primary care for vulnerable older adults.

  17. Association between Travel Times and Food Procurement Practices among Female Supplemental Nutrition Assistance Program Participants in Eastern North Carolina

    Science.gov (United States)

    Jilcott, Stephanie B.; Moore, Justin B.; Wall-Bassett, Elizabeth D.; Liu, Haiyong; Saelens, Brian E.

    2011-01-01

    Objective: To examine associations between self-reported vehicular travel behaviors, perceived stress, food procurement practices, and body mass index among female Supplemental Nutrition Assistance Program (SNAP) participants. Analysis: The authors used correlation and regression analyses to examine cross-sectional associations between travel time…

  18. 76 FR 51381 - Supplemental Awards to Seven Unaccompanied Alien Shelter Care Providers

    Science.gov (United States)

    2011-08-18

    ... Seven Unaccompanied Alien Shelter Care Providers AGENCY: Office of Refugee Resettlement, ACF, HHS... grants to seven Unaccompanied Alien Shelter Care Providers. CFDA Number: 93.676. Statutory Authority...) announces the award of single-source expansion supplement grants to seven unaccompanied alien shelter care...

  19. NUTRITIONAL ASPECTS AND THE USE OF NUTRITIONAL SUPPLEMENTS BY WOMEN WHO UNDERWENT GASTRIC BYPASS.

    Science.gov (United States)

    Trindade, Elisangela Mara; Gebara, Telma Souza E Silva; Cambi, Maria Paula Carlini; Baretta, Giorgio Alfredo Pedroso

    2017-01-01

    Bariatric surgery is deemed one of the most effective procedures for the treatment of obesity and it aims at the reduction and maintenance of weight loss in long term, as the control of the related comorbidities. Quantify the occurrence of alterations of the gastrointestinal tract, suggestive signs of nutritional deficiencies and the use of supplements in a group of women undergoing bariatric surgery. The sample consisted of women aged 20-65 years submitted to Roux-en-Y gastric bypass with monitoring equal to or higher than 24 months. For the qualitative analysis, the Feeding Frequency Questionnaire was used. In the postoperative period, alopecia was the most reported (79.3%), followed by changes in the texture of the nails, both considered predictive of nutritional deficiencies. Changes in the gastrointestinal tract were described in 86.2%, and episodes of dumping were reported in 65.5%. Qualitative analysis has shown reduced daily consumption of sources of animal and plant proteins. After bariatric surgery can occur flatulence, vomiting and dumping syndrome as the most frequent representative symptoms of digestive functional disorders. Alopecia and nail changes are the most important signs of nutritional deficiency. The use of dietary supplements in the postoperative period is scarce and sporadic. A cirurgia bariátrica é considerada um dos procedimentos mais eficazes para tratamento da obesidade e objetiva a redução e manutenção da perda de peso em longo prazo, assim como, o controle das comorbidades associadas. Quantificar a ocorrência de alterações funcionais do trato gastrointestinal, sinais sugestivos de carências nutricionais e o uso de suplementos em um grupo de mulheres submetidas à cirurgia bariátrica. A amostra foi constituída por mulheres com idades entre 20-65 anos submetidas ao bypass gástrico em Y-de-Roux com seguimento igual ou superior a 24 meses. Para análise qualitativa foi utilizado o Questionário de Frequência Alimentar. No per

  20. Practitioner and lay perspectives of the service provision of nutrition information leaflets in primary care.

    Science.gov (United States)

    McClinchy, Jane; Dickinson, Angela; Barron, Duncan; Thomas, Hilary

    2011-12-01

    In primary care, leaflets are often used to communicate health information. Increasingly, primary healthcare practitioners need to provide dietary advice. There is limited research exploring how nutrition information leaflets are used in primary care. The present study explored practitioner and lay experiences with respect to providing and receiving nutrition information in primary care, focusing in particular on the use of leaflets for nutrition information. A qualitative design was used incorporating focus groups with 57 practitioners based at seven general practitioner practices and a purposive sample of 30 lay participants attending six Consumer Health Organisations within one primary care trust. Focus groups were taped and transcribed verbatim and data were analysed thematically, assisted by computer software n6® (QSR International Pty Ltd, Melbourne, Australia). Practitioners discussed barriers to giving nutritional advice, access to leaflets, lay receptiveness to advice and their perceptions about the value of leaflets to lay people. Food was not considered in terms of its nutritional components by lay participants and the need for nutritional information was not perceived to be relevant until they had received a medical diagnosis. Lay participants discussed the importance of receiving nutritional advice relating to their medical diagnosis and the altered status of written information that was delivered personally. Practitioner and lay groups suggested improvements to ensure that nutritional advice be supported by relevant and appropriate written information. This research has underlined the continuing importance of nutrition information leaflets and concludes that there is particular value in involving lay participants in the development of nutrition information leaflets. © 2011 The Authors. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

  1. 48 CFR 852.222-70 - Contract Work Hours and Safety Standards Act-nursing home care contract supplement.

    Science.gov (United States)

    2010-10-01

    ... Safety Standards Act-nursing home care contract supplement. 852.222-70 Section 852.222-70 Federal...—nursing home care contract supplement. As prescribed in 822.305, for nursing home care requirements, insert the following clause: Contract Work Hours and Safety Standards Act—Nursing Home Care Contract...

  2. Annual Research Review: Improved nutrition--pathway to resilience.

    Science.gov (United States)

    Yousafzai, Aisha K; Rasheed, Muneera A; Bhutta, Zulfiqar A

    2013-04-01

    Early child nutritional deficiencies are prevalent in low- and middle-countries with consequences linked not only to poor survival and growth, but also to poor development outcomes. Children in disadvantaged communities face multiple risks for nutritional deficiencies, yet some children may be less susceptible or may recover more quickly from malnutrition. A greater understanding is needed about factors which moderate the effects of nutrition-related risks and foster resilience to protect against or ameliorate poor development outcomes. A literature review was undertaken from August to December 2011 and updated in August 2012. Key word searches using terms Nutrition, Malnutrition, Child Development, Responsive Care, Stimulation, Low and Middle Income Countries and Resilience were undertaken using PubMed and Psychinfo. Dietary adequacy is critical for growth and development, but current evidence indicates that nutrition supplementation alone is insufficient to foster resilience to protect against, mitigate, and recover from nutritional threats and to promote healthy development. The combination of nutrition interventions with stimulation and responsive care is necessary. Combined nutrition and psychosocial stimulation approaches can potentially work effectively together to promote protective factors and mitigate risks for poor cognitive, motor, social, and affective functioning helping children to adapt in times of adversity. However, there are gaps in our existing knowledge to combine nutrition and psychosocial stimulation interventions effectively and promote these interventions at scale. Research needs to address barriers at the level of family, community, programme, and policy which have prevented thus far the uptake of combined nutrition and psychosocial intervention strategies. Further investigations are needed on how to provide support to caregivers, enabling them to implement appropriate care for feeding and stimulation. Finally, the effect of combined

  3. [Study of vitamin D supplementation in people over 65 years in primary care].

    Science.gov (United States)

    Breysse, Cécile; Guillot, Pascale; Berrut, Gilles

    2015-06-01

    Most of the elderly have vitamin D deficiency, which is defined as a serum level below 30 ng/mL. To identify the characteristics of patients over 65 receiving vitamin D supplements by their primary care physician. A descriptive and transverse study was performed on patients over 65 years old admitted to Care Following at the La Croix Rouge in Nantes from September 2012 to February 2013. The criteria for vitamin D supplementation, the type (vitamin D2 or D3, continuous prescription or not, route of administration) and starting date of vitamin D supplementation were identified. Serum 25-hydroxyvitamin D (25OHD) was measured at admission. Of 163 patients included, 44% received vitamin D supplements (n=71). The patient aged over 80 benefited more often from vitamin D supplementation (p=0.019), so did women (p=0.034), patients with fractures (p=0.05), patients with osteoporosis treatments (pvitamin D supplementation less often than the others (p=0.046). The dosage of the vitamin D was normal for 28% of patients (n=46). The prescription of vitamin D supplements to the elderly is still too scarce and should be encouraged, especially in non-bone indications.

  4. Problems of actuality in meal and nutrition care

    DEFF Research Database (Denmark)

    Krogh, Line Hesselvig; Beck, Anne Marie; Hansen, Mette Weinreich

    2018-01-01

    related to undernutrition among older adults. It is a qualitative study that lends itself to ethnography and ethnomethodology, with data collected through the use of semi-structured interviews and insights into patients´ medical charts. Through explications of nurses’ methods in meal and nutrition care...

  5. Nutrition services in managed care: new paradigms for dietitians.

    Science.gov (United States)

    Laramee, S H

    1996-04-01

    Managed care systems are transforming the health care system in the United States. Dietitians will need to review practice opportunities in new and different settings, and develop additional skills to make a successful transition to the transformed health care environment. The shift in health care financing from a fee-for-service model to a capitated system will have the most dramatic impact on the profession. Not all the answers are available, but the focus for the future is clear--customer satisfaction, outcomes research, and cost-effective nutrition services.

  6. Quality of nutrition services in primary health care facilities: Implications for integrating nutrition into the health system in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Sk Masum Billah

    Full Text Available In 2011, the Bangladesh Government introduced the National Nutrition Services (NNS by leveraging the existing health infrastructure to deliver nutrition services to pregnant woman and children. This study examined the quality of nutrition services provided during antenatal care (ANC and management of sick children younger than five years.Service delivery quality was assessed across three dimensions; structural readiness, process and outcome. Structural readiness was assessed by observing the presence of equipment, guidelines and register/reporting forms in ANC rooms and consulting areas for sick children at 37 primary healthcare facilities in 12 sub-districts. In addition, the training and knowledge relevant to nutrition service delivery of 95 healthcare providers was determined. The process of nutrition service delivery was assessed by observing 381 ANC visits and 826 sick children consultations. Satisfaction with the service was the outcome and was determined by interviewing 541 mothers/caregivers of sick children.Structural readiness to provide nutrition services was higher for ANC compared to management of sick children; 73% of ANC rooms had >5 of the 13 essential items while only 13% of the designated areas for management of sick children had >5 of the 13 essential items. One in five (19% healthcare providers had received nutrition training through the NNS. Delivery of the nutrition services was poor: <30% of women received all four key antenatal nutrition services, 25% of sick children had their weight checked against a growth-chart and <1% had their height measured. Nevertheless, most mothers/caregivers rated their satisfaction of the service above average.Strengthening the provision of equipment and increasing the coverage of training are imperative to improve nutrition services. Inherent barriers to implementing nutrition services in primary health care, especially high caseloads during the management of sick under-five children, should

  7. [USE, EFFECTS, AND KNOWLEDGE OF THE NUTRITIONAL SUPPLEMENTS FOR THE SPORT IN UNIVERSITY STUDENTS].

    Science.gov (United States)

    Colls Garrido, Christian; Gómez-Urquiza, José Luis; Cañadas-De la Fuente, Guillermo Arturo; Fernández-Castillo, Rafael

    2015-08-01

    consumption and marketing of supplements that help improve athletic performance has increased in semi-professional sport. Moreover, in the market are increasingly a wide variety of such products pressure and high performance requirements push many young athletes to have recourse to the use of supplements to improve your fitness. However, this type of treatment should be advised and guided by an expert since improper use of such supplements favors the appearance of adverse effects and can be harmful to the health of the individual. to know the use of supplements to improve athletic performance by college athletes methods: was a systematic review in the Pubmed database, care, BIREME CUIDEN, BIREME (IBECS y Scielo) and CINHAL limited to articles published in the last ten years. 25 articles were analyzed. The main themes were found in the literature reviewed have been three: the "levels of supplements to increase athletic performance in college students", "effect of sports supplements" and "knowledge, behaviors and motivations for sports supplements". taking into account that the around 55% of University athletes using supplements but show a lack significant knowledge is necessary to provide a health education on such supplements. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  8. Assessment of nutrition, supplementation and body composition parameters on the example of professional volleyball players.

    Science.gov (United States)

    Zapolska, Joanna; Witczak, Katarzyna; Mańczuk, Angelika; Ostrowska, Lucyna

    2014-01-01

    Volleyball is a team game belonging to a group of sports disciplines that involve indirect fighting. Adequate energy coverage in athletes is a crucial issue. It depends primarily on the type, intensity and duration of physical activity related to the sports discipline practiced and to the training cycle duration. The average energy requirement in sportsmen is 50% higher than that of adults. The aim of the study was to characterize the mode of nutrition, including dietary supplements and to assess somatic indices in female volleyball players of the AZS Bialystok team. The study involved 17 women. Research tools included a questionnaire consisting of 24-hour recall, a questionnaire survey concerning supplement intake and body composition analysis performed using a bioimpedance analyzer InBody 220. Data analysis indicates that the anthropometric characteristics and body composition of the AZS Bialystok players meet the recommendations associated with the somatic features in volleyball. Daily diet of the volleyball players were of low-energy with regard to the recommendations for physically active people, with very low supply of carbohydrates and dietary fiber, excessive proportion of saturated fatty acids and dietary cholesterol, and too low content of monounsaturated and polyunsaturated fatty acids. Supply of vitamins and minerals was found to be alarmingly low, especially of iron and calcium; diet supplementation was insufficient. No significant abnormalities were noted in body composition of the study athletes. However, they are recommended to increase muscle mass and slightly reduce body fat. Results of diet evaluation show the need for education in the field of nutrition and the necessity of further research into dietary habits among sportsmen.

  9. Relationships between body image, nutritional supplement use, and attitudes towards doping in sport among adolescent boys: implications for prevention programs

    OpenAIRE

    Yager, Zali; O’Dea, Jennifer A

    2014-01-01

    Background Reports of high levels of use of protein powders and nutritional supplements among young men is a concern because these substances may act as a gateway for the use of drugs and illegal substances to enhance appearance or sports performance. The aim of this study was to investigate the relationship between body dissatisfaction, weight change behaviors, supplement use, and attitudes towards doping in sport among an adolescent male sample. Methods Participants were 1148 male adolescen...

  10. Ecological Nutrition: Redefining Healthy Food in Health Care

    OpenAIRE

    Klein, Kendra C.

    2013-01-01

    Within what can be called the healthy food in health care (HFHC) movement, a growing coalition of actors are leveraging scientific data on the environmental health impacts of the conventional, industrial food system to inspire and legitimize a range of health care initiatives aligned with alternative agrifood ideals. They are shifting the definition of food-related health from a nutritionism model, eating the right balance of nutrients and food groups, to what I call an ecological nutrition ...

  11. Anesthesiologists’ Choice of Nutritional Therapy of Intensive Care Patients: A Survey Study

    Directory of Open Access Journals (Sweden)

    Ahmet Şen

    2015-08-01

    Full Text Available Objective: Providing adequate nutrition to critical patients as early as possible following internalization is important. Hospitalized patients are among the highest risk groups for malnutrition. Material and Method: A questionnaire including 21 questions about clinician’s demographics and nutritional therapies in intensive care units was e-mailed to anesthesiologists only. Partially answered questionnaires were not included in the analysis. Results: A total of 121 questionnaires were analyzed. Every three out of four clinician reported application of nutritional therapy in intensive care unit, and according to the guidelines. While 75% of the clinicians following the guidelines were routinely evaluating nutritional status of their patients, this ratio was only 19% in clinicians not following the guidelines (p=0.0003. Enteral nutrition was the first choice of all clinicians, and majority of the clinicians (90, 74.4% preferred central venous catheter for parenteral nutrition. The most important criteria for the choice of parenteral nutritional solution were reported as calories per volume and presence of the solution at the hospital by all clinicians. Among the clinicians following the guidelines, 70% were administering fish oil, 95% were administering glutamin to their patients. Among the clinicians not following the guidelines, these ratios were 44% and 80%, respectively (p=0.01 and 0.02. Conclusion: We are in opinion that following the guidelines instead of the clinician’s individual forecasts may improve the nutritional therapy.

  12. Modeling of Food and Nutrition Surveillance in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Santuzza Arreguy Silva VITORINO

    Full Text Available ABSTRACT Objective: To describe the modeling stages of food and nutrition surveillance in the Primary Health Care of the Unified Health Care System, considering its activities, objectives, and goals Methods: Document analysis and semi-structured interviews were used for identifying the components, describe the intervention, and identify potential assessment users. Results: The results include identification of the objectives and goals of the intervention, the required inputs, activities, and expected effects. The intervention was then modeled based on these data. The use of the theoretical logic model optimizes times, resources, definition of the indicators that require monitoring, and the aspects that require assessment, identifying more clearly the contribution of the intervention to the results Conclusion: Modeling enabled the description of food and nutrition surveillance based on its components and may guide the development of viable plans to monitor food and nutrition surveillance actions so that modeling can be established as a local intersectoral planning instrument.

  13. Nursing Minimum Data Sets for documenting nutritional care for adults in primary healthcare: a scoping review.

    Science.gov (United States)

    Håkonsen, Sasja Jul; Pedersen, Preben Ulrich; Bjerrum, Merete; Bygholm, Ann; Peters, Micah D J

    2018-01-01

    To identify all published nutritional screening instruments that have been validated in the adult population in primary healthcare settings and to report on their psychometric validity. Within health care, there is an urgent need for the systematic collection of nursing care data in order to make visible what nurses do and to facilitate comparison, quality assurance, management, research and funding of nursing care. To be effective, nursing records should accurately and comprehensively document all required information to support safe and high quality care of patients. However, this process of documentation has been criticized from many perspectives as being highly inadequate. A Nursing Minimum Data Set within the nutritional area in primary health care could therefore be beneficial in order to support nurses in their daily documentation and observation of patients. The review considered studies that included adults aged over 18 years of any gender, culture, diagnosis and ethnicity, as well as nutritional experts, patients and their relatives. The concepts of interest were: the nature and content of any nutritional screening tools validated (regardless of the type of validation) in the adult population in primary healthcare; and the views and opinions of eligible participants regarding the appropriateness of nutritional assessment were the concept of interest. Studies included must have been conducted in primary healthcare settings, both within home care and nursing home facilities. This scoping review used a two-step approach as a preliminary step to the subsequent development of a Nursing Minimum Data Set within the nutritional area in primary healthcare: i) a systematic literature search of existing nutritional screening tools validated in primary health care; and ii) a systematic literature search on nutritional experts opinions on the assessment of nutritional nursing care of adults in primary healthcare as well as the views of patients and their relatives

  14. Nutrition and OI

    Science.gov (United States)

    Nutrition and OI Introduction To promote bone development and optimal health, children and adults with osteogenesis imperfecta ( ... no foods or supplements that will cure OI. Nutrition Related Problems Difficulties eating solid food have been ...

  15. Diet and Nutrition in Cancer Survivorship and Palliative Care

    OpenAIRE

    Anthony J. Bazzan; Andrew B. Newberg; William C. Cho; Daniel A. Monti

    2013-01-01

    The primary goal of palliative cancer care is typically to relieve suffering and improve quality of life. Most approaches to diet in this setting have focused only on eating as many calories as possible to avoid cachexia. However, as the concept of palliative care has evolved to include all aspects of cancer survivorship and not just end of life care, there is an increasing need to thoughtfully consider diet and nutrition approaches that can impact not only quality of life but overall health ...

  16. Selective determination of inorganic cobalt in nutritional supplements by ultrasound-assisted temperature-controlled ionic liquid dispersive liquid phase microextraction and electrothermal atomic absorption spectrometry

    International Nuclear Information System (INIS)

    Berton, Paula; Martinis, Estefanía M.; Martinez, Luis D.; Wuilloud, Rodolfo G.

    2012-01-01

    Highlights: ► Synergy of ultrasound energy and TILDLME technique for improved metal extraction. ► Highly selective determination of inorganic Co species at trace levels. ► Speciation analysis of Co in several nutritional supplements with highly complex matrices. ► Development of an environmentally friendly microextraction technique with minimal waste production and sample consumption. - Abstract: In the present work, a simple and rapid analytical method based on application of ionic liquids (ILs) for inorganic Co(II) species (iCo) microextraction in a variety of nutrient supplements was developed. Inorganic Co was initially chelated with 1-nitroso-2-naphtol (1N2N) reagent followed by a modern technique named ultrasound-assisted temperature-controlled ionic liquid dispersive liquid phase microextraction (USA-TILDLME). The extraction was performed with 1-hexyl-3-methylimidazolium hexafluorophosphate [C 6 mim][PF 6 ] with the aid of ultrasound to improve iCo recovery. Finally, the iCo-enriched IL phase was solubilized in methanol and directly injected into an electrothermal atomic absorption spectrometer (ETAAS). Several parameters that could influence iCo microextraction and detection were carefully studied. Since the main difficulty in these samples is caused by high concentrations of potential interfering ions, different approaches were evaluated to eliminate interferences. The limit of detection (LOD) was 5.4 ng L −1 , while the relative standard deviation (RSD) was 4.7% (at 0.5 μg L −1 Co level and n = 10), calculated from the peak height of absorbance signals. Selective microextraction of iCo species was achieved only by controlling the pH value during the procedure. The method was thus successfully applied for determination of iCo species in nutritional supplements.

  17. Selective determination of inorganic cobalt in nutritional supplements by ultrasound-assisted temperature-controlled ionic liquid dispersive liquid phase microextraction and electrothermal atomic absorption spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Berton, Paula; Martinis, Estefania M. [Analytical Chemistry Research and Development Group (QUIANID), (LISAMEN-CCT-CONICET-Mendoza), Av. Ruiz Leal S/N Parque General San Martin, M 5502 IRA Mendoza (Argentina); Martinez, Luis D. [INQUISAL-CONICET, Departamento de Quimica Analitica, Facultad de Quimica, Bioquimica y Farmacia, Universidad Nacional de San Luis, San Luis (Argentina); Wuilloud, Rodolfo G., E-mail: rwuilloud@mendoza-conicet.gob.ar [Analytical Chemistry Research and Development Group (QUIANID), (LISAMEN-CCT-CONICET-Mendoza), Av. Ruiz Leal S/N Parque General San Martin, M 5502 IRA Mendoza (Argentina); Instituto de Ciencias Basicas, Universidad Nacional de Cuyo, Mendoza (Argentina)

    2012-02-03

    Highlights: Black-Right-Pointing-Pointer Synergy of ultrasound energy and TILDLME technique for improved metal extraction. Black-Right-Pointing-Pointer Highly selective determination of inorganic Co species at trace levels. Black-Right-Pointing-Pointer Speciation analysis of Co in several nutritional supplements with highly complex matrices. Black-Right-Pointing-Pointer Development of an environmentally friendly microextraction technique with minimal waste production and sample consumption. - Abstract: In the present work, a simple and rapid analytical method based on application of ionic liquids (ILs) for inorganic Co(II) species (iCo) microextraction in a variety of nutrient supplements was developed. Inorganic Co was initially chelated with 1-nitroso-2-naphtol (1N2N) reagent followed by a modern technique named ultrasound-assisted temperature-controlled ionic liquid dispersive liquid phase microextraction (USA-TILDLME). The extraction was performed with 1-hexyl-3-methylimidazolium hexafluorophosphate [C{sub 6}mim][PF{sub 6}] with the aid of ultrasound to improve iCo recovery. Finally, the iCo-enriched IL phase was solubilized in methanol and directly injected into an electrothermal atomic absorption spectrometer (ETAAS). Several parameters that could influence iCo microextraction and detection were carefully studied. Since the main difficulty in these samples is caused by high concentrations of potential interfering ions, different approaches were evaluated to eliminate interferences. The limit of detection (LOD) was 5.4 ng L{sup -1}, while the relative standard deviation (RSD) was 4.7% (at 0.5 {mu}g L{sup -1} Co level and n = 10), calculated from the peak height of absorbance signals. Selective microextraction of iCo species was achieved only by controlling the pH value during the procedure. The method was thus successfully applied for determination of iCo species in nutritional supplements.

  18. Nutritional support for liver disease.

    Science.gov (United States)

    Koretz, Ronald L; Avenell, Alison; Lipman, Timothy O

    2012-05-16

    Weight loss and muscle wasting are commonly found in patients with end-stage liver disease. Since there is an association between malnutrition and poor clinical outcome, such patients (or those at risk of becoming malnourished) are often given parenteral nutrition, enteral nutrition, or oral nutritional supplements. These interventions have costs and adverse effects, so it is important to prove that their use results in improved morbidity or mortality, or both. To assess the beneficial and harmful effects of parenteral nutrition, enteral nutrition, and oral nutritional supplements on the mortality and morbidity of patients with underlying liver disease. The following computerised databases were searched: the Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, EMBASE, and Science Citation Index Expanded (January 2012). In addition, reference lists of identified trials and review articles and Clinicaltrials.gov were searched. Trials identified in a previous systematic handsearch of Index Medicus were also considered. Handsearches of a number of medical journals, including abstracts from annual meetings, were done. Experts in the field and manufacturers of nutrient formulations were contacted for potential references. Randomised clinical trials (parallel or cross-over design) comparing groups of patients with any underlying liver disease who received, or did not receive, enteral or parenteral nutrition or oral nutritional supplements were identified without restriction on date, language, or publication status. Six categories of trials were separately considered: medical or surgical patients receiving parenteral nutrition, enteral nutrition, or supplements. The following data were sought in each report: date of publication; geographical location; inclusion and exclusion criteria; the type of nutritional support and constitution of the nutrient formulation; duration of

  19. Perceptions and experiences of nutritional care following the overwhelming experience of lower extremity amputation; a qualitative study

    DEFF Research Database (Denmark)

    Jensen, P S; Green, S M; Petersen, J

    2018-01-01

    INTRODUCTION: Good nutritional care of people following major lower extremity amputation is essential as poor nutritional status can lead to delayed wound healing. Working with patients to identify their perspectives on food, views on nutritional care and the need for dietary counselling enables...... the development of optimised nutritional care. AIM: To explore hospital patients' perspectives on food, dietary counselling, and their experiences of nutritional care following lower extremity amputation. DESIGN: A qualitative, explorative study design was employed. METHOD: An inductive content analysis of semi......-structured interviews with a purposive sample of 17 people over 50 years of age, who had recently undergone major lower extremity amputation, was undertaken. The study was reported according to the COREQ guideline. FINDINGS: Three themes emerged; Responsible for own dietary intake, Diet based on preferences...

  20. [Severe vitamin D deficiency in children from Punta Arenas, Chile: Influence of nutritional status on the response to supplementation].

    Science.gov (United States)

    Brinkmann, Karin; Le Roy, Catalina; Iñiguez, Germán; Borzutzky, Arturo

    2015-01-01

    There is a high risk of vitamin D (VD) deficiency in the population of southern Chile that can be treated with VD supplements. Weight excess (WE) can influence the response to supplements. To study the prevalence of VD deficiency and the effect of cholecalciferol (VD3) supplements in healthy children from Punta Arenas, Chile, and evaluate a possible association with nutritional status. Demographic and anthropometric data, as well as laboratory assessment of serum 25-hidroxyvitamin D (25OHD) and other bone metabolism parameters were evaluated. After baseline evaluation, children were supplemented with VD3 1600 IU/day for one month, after which 25OHD was retested. Of the 108 children studied, 50% were boys, and had a mean age of 9.6±0.5 years. Nutritional assessment showed that 39% had normal weight, 46% were overweight, and 15% were obese. Median 25OHD was 10.9ng/ml: 96.3% had deficiency (30ng/ml). Children with WE had a significantly lower increase in 25OHD than children with normal weight (5±5.5 vs. 7.7±4.9, p=03). Children with WE may require 32% higher VD dose than normal weight children to attain the same 25OHD concentration. Chilean schoolchildren from Punta Arenas have high prevalence of WE and VD deficiency, with a majority in the range of severe VD deficiency. WE interferes in the response to VD supplementation, leading to a lower increase in 25OHD. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Bicarbonate supplementation enhanced biofuel production potential as well as nutritional stress mitigation in the microalgae Scenedesmus sp. CCNM 1077.

    Science.gov (United States)

    Pancha, Imran; Chokshi, Kaumeel; Ghosh, Tonmoy; Paliwal, Chetan; Maurya, Rahulkumar; Mishra, Sandhya

    2015-10-01

    The aim of the present study was to find out the optimum sodium bicarbonate concentration to produce higher biomass with higher lipid and carbohydrate contents in microalgae Scenedesmus sp. CCNM 1077. The role of bicarbonate supplementation under different nutritional starvation conditions was also evaluated. The results clearly indicate that 0.6 g/L sodium bicarbonate was optimum concentration resulting in 20.91% total lipid and 25.56% carbohydrate along with 23% increase in biomass production compared to normal growth condition. Addition of sodium bicarbonate increased the activity of nutrient assimilatory enzymes, biomass, lipid and carbohydrate contents under different nutritional starvation conditions. Nitrogen starvation with bicarbonate supplementation resulted in 54.03% carbohydrate and 34.44% total lipid content in microalgae Scenedesmus sp. CCNM 1077. These findings show application of bicarbonate grown microalgae Scenedesmus sp. CCNM 1077 as a promising feedstock for biodiesel and bioethanol production. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. How much do residential aged care staff members know about the nutritional needs of residents?

    Science.gov (United States)

    Beattie, Elizabeth; O'Reilly, Maria; Strange, Elise; Franklin, Sara; Isenring, Elisabeth

    2014-03-01

    Undernutrition, weight loss and dehydration are major clinical issues for people with dementia in residential care, with excessive weight loss contributing to increased risk of frailty, immobility, illness and premature morbidity. This paper discusses a nutritional knowledge and attitudes survey conducted as part of a larger project focused on improving nutritional intake of people with dementia within a residential care facility in Brisbane, Australia. The specific aims of the survey were to identify (i) knowledge of the nutritional needs of aged care facility residents; (ii) mealtime practices; and (iii) attitudes towards mealtime practices and organisation. A survey based on those used in other healthcare settings was completed by 76 staff members. The survey included questions about nutritional knowledge, opinions of the food service, frequency of feeding assistance provided and feeding assessment practices. Nutritional knowledge scores ranged from 1 to 9 of a possible 10, with a mean score of 4.67. While 76% of respondents correctly identified risk factors associated with malnutrition in nursing home residents, only 38% of participants correctly identified the need for increased protein and energy in residents with pressure ulcers, and just 15% exhibited correct knowledge of fluid requirements. Further, while nutritional assessment was considered an important part of practice by 83% of respondents, just 53% indicated that they actually carried out such assessments. Identified barriers to promoting optimal nutrition included insufficient time to observe residents (56%); being unaware of residents' feeding issues (46%); poor knowledge of nutritional assessments (44%); and unappetising appearance of food served (57%). An important step towards improving health and quality of life for residents of aged care facilities would be to enhance staff nutritional awareness and assessment skills. This should be carried out through increased attention to both preservice

  3. Importance of nutrition in preventing and treating pressure ulcers.

    Science.gov (United States)

    Taylor, Carolyn

    2017-06-30

    Pressure ulcers are painful, and affect patients' health, mobility and well-being. They also cost the NHS between £1.4-2.1 billion a year. Although a large proportion of pressure ulcers are avoidable, many still occur and, because pressure ulcer incidence is an indicator of care quality, it can put carers under scrutiny. The National Institute for Health and Care Excellence states that adequate risk assessment of pressure ulcer development, including the role of malnutrition, improves care. Adequate nutrition is vital for the prevention of pressure ulcers and malnutrition can hinder healing when pressure ulcers have developed. The risk of malnutrition should be assessed with a recognised tool, such as the Malnutrition Universal Screening Tool, and appropriate treatment plans should be drawn up for patients identified as being at risk of malnutrition to improve their nutritional state. For example, the dietary intake of people with poor appetite can be supplemented with nutritious snacks between meals. The aims of this article are to help readers understand risk factors for malnutrition and how dietary intake can be manipulated to improve patients' nutritional state. It also aims to highlight how improving nutritional intake helps to prevent pressure ulcers. On completing the article, readers will be able to consider and review their own practice.

  4. Assessing patients' attitudes towards dietary supplements.

    Science.gov (United States)

    Wierzejska, Regina; Jarosz, Mirosław; Siuba, Magdalena; Rambuszek, Michał

    2014-01-01

    There is currently many over the counter products on the market that exert nutritional or physiological effects on the human body. The differences between dietary supplements and non-prescription drugs are however poorly understood by the average consumer and may thus affect their expectations as to the desired effect produced on the body. To evaluate patients' knowledge and attitudes towards dietary supplements as compared to non-prescription drugs. Subjects were 335 patients of the Mazowiecki Voivodeship Hospital in Warsaw, Poland. The data were collected from a face-to-face interview using a single and multiple choice questionnaire with 10 questions on dietary supplements. Statistical analysis used the Chi-square (χ2) test. The majority of respondents were found to be familiar with the term 'dietary supplements', but had difficulties in classifying these products into appropriate categories. Over 55% do not consider dietary supplements to be foodstuffs and more than 40% considered such products to be drugs. Most respondents thought that the main purpose of taking dietary supplements is to improve nutrition, but over one third expected them to also treat disease. Over 70% declared taking notice to which category the non-prescription products they bought belongs to ie. whether non-prescription drugs (medicinal products) or dietary supplements. Many patients mistakenly believe that dietary supplements are drugs and can be used to treat disease and health disorders. dietary supplements, opinion on dietary supplements, nutrition, dietary supplement vs. medicinal product.

  5. Supplementation of irradiated and non-irradiated cowpea bean (Vigna unguiculata L. Walp) protein with cereal proteins - supplementation of soup with a protein blend of appropriate nutritional value

    International Nuclear Information System (INIS)

    Dario, A.C.; Salgado, J.M.

    1994-01-01

    The quality of the cowpea bean protein was improved through supplementations with flours from beans exposed to microwave oven treated with cereal proteins such as wheat, rice, corn, and sorghum. Biological assays results with these blends showed that the casein exceeded the other diets concerning digestibility only; however, in parameters such as biological value, net protein utilization (NPU), protein efficiency ratio (PER) and nutritional efficiency ratio (NER), no significant differences occurred. Among all elaborated blends, the one with irradiated beans submitted to microwave oven for 30 minutes (65%) + rice (35%) presented the best results. The soup elaborated with the best supplemented blend was satisfactory concerning color, odor, flavor and texture

  6. Benefits, Potential Harms, and Optimal Use of Nutritional Supplementation for Preventing Progression of Age-Related Macular Degeneration.

    Science.gov (United States)

    Rojas-Fernandez, Carlos H; Tyber, Kevin

    2017-03-01

    To briefly review age-related macular degeneration (AMD), the main findings from the Age Related Eye Disease Study (AREDS) report number 8 on the use of nutritional supplements for AMD, and to focus on data suggesting that supplement use should be guided using genetic testing of AMD risk genes. A literature search (January 2001 through October 26, 2016) was conducted using MEDLINE and the following MeSH terms: Antioxidants/therapeutic use, Genotype, Macular Degeneration/drug therapy, Macular degeneration/genetics, Dietary Supplements, Proteins/genetics, and Zinc Compounds/therapeutic use. Bibliographies of publications identified were also reviewed. English-language studies assessing AREDS supplement response in patients with AMD in relation to complement factor H gene ( CFH) and age-related maculopathy susceptibility 2 gene ( ARMS2) risk alleles were evaluated. Three of the 4 studies demonstrated a treatment interaction between ARMS2 and CFH genotypes and a differential response to supplements. The fourth study documented an interaction for the CFH genotype only. Reported response interactions included attenuated response, no response, and good response, whereas a subset showed increased progression of AMD. Conversely, one study reported no interactions between CFH and ARMS2 risk alleles and response to supplements. The weight of the evidence supports using genetic testing to guide selection of ocular vitamin use. This approach will avoid using supplements that could speed the progression of AMD in vulnerable patients, avoid using supplements that will have little to no effect in others, and result in appropriately using supplements in those that are likely to derive meaningful benefits.

  7. Evaluation of Nutrition and Physical Activity Policies and Practices in Child Care Centers within Rural Communities.

    Science.gov (United States)

    Foster, Jaime S; Contreras, Dawn; Gold, Abby; Keim, Ann; Oscarson, Renee; Peters, Paula; Procter, Sandra; Remig, Valentina; Smathers, Carol; Mobley, Amy R

    2015-10-01

    Although some researchers have examined nutrition and physical activity policies within urban child care centers, little is known about the potentially unique needs of rural communities. Child care centers serving preschool children located within low-income rural communities (n = 29) from seven states (Indiana, Kansas, Michigan, North Dakota, Ohio, South Dakota, and Wisconsin) were assessed to determine current nutrition and physical activity (PA) practices and policies. As part of a large-scale childhood obesity prevention project, the Community Healthy Living Index's previously validated Early Childhood Program Assessment Tool was used to collect data. Descriptive statistical analysis was conducted to identify high-priority areas. Healthy People 2020 and the Academy of Nutrition and Dietetics' recommendations for nutrition and PA policies in child care centers were used as benchmarks. Reports of not fully implementing (nutrition-related policies or practices within rural early child care centers were identified. Centers not consistently serving a variety of fruits (48%), vegetables (45%), whole grains (41%), limiting saturated fat intake (31%), implementing healthy celebration guidelines (41%), involving children in mealtime (62%), and referring families to nutrition assistance programs (24%) were identified. More than one third of centers also had limited structured PA opportunities. Although eligible, only 48% of the centers participated in the Child and Adult Care Food Program. Overall, centers lacked parental outreach, staff training, and funding/resources to support nutrition and PA. These results provide insight into where child care centers within low-income, rural communities may need assistance to help prevent childhood obesity.

  8. Is Branched-Chain Amino Acids Supplementation an Efficient Nutritional Strategy to Alleviate Skeletal Muscle Damage? A Systematic Review

    Directory of Open Access Journals (Sweden)

    Alexandre Fouré

    2017-09-01

    Full Text Available Amino acids and more precisely, branched-chain amino acids (BCAAs, are usually consumed as nutritional supplements by many athletes and people involved in regular and moderate physical activities regardless of their practice level. BCAAs have been initially shown to increase muscle mass and have also been implicated in the limitation of structural and metabolic alterations associated with exercise damage. This systematic review provides a comprehensive analysis of the literature regarding the beneficial effects of BCAAs supplementation within the context of exercise-induced muscle damage or muscle injury. The potential benefit of a BCAAs supplementation was also analyzed according to the supplementation strategy—amount of BCAAs, frequency and duration of the supplementation—and the extent of muscle damage. The review protocol was registered prospectively with Prospective Register for Systematic Reviews (registration number CRD42017073006 and followed Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Literature search was performed from the date of commencement until August 2017 using four online databases (Medline, Cochrane library, Web of science and ScienceDirect. Original research articles: (i written in English; (ii describing experiments performed in Humans who received at least one oral BCAAs supplementation composed of leucine, isoleucine and valine mixture only as a nutritional strategy and (iii reporting a follow-up of at least one day after exercise-induced muscle damage, were included in the systematic review analysis. Quality assessment was undertaken independently using the Quality Criteria Checklist for Primary Research. Changes in indirect markers of muscle damage were considered as primary outcome measures. Secondary outcome measures were the extent of change in indirect markers of muscle damage. In total, 11 studies were included in the analysis. A high heterogeneity was found regarding the

  9. [Effects of vitamin A supplementation on nutritional status of iron in healthy adults].

    Science.gov (United States)

    Li, Zuwen; Fan, Ping; Deng, Gangbo; Du, Zhen; Shao, Zewei; Wang, Zhixu

    2012-05-01

    To investigate the effect of vitamin A (VA) supplementation on the nutritional status of iron in healthy adults. One hundred and fifteen healthy adults were recruited and divided randomly into four groups, with 28 or 29 adults in each group. VA supplements with different doses of retinyl acetate in capsules were given for 4-month. The equivalent doses of supplemented retinyl acetate were 600 microg/d, 400 microg/d, 200 microg/d and 0 microg/d (control) of retinol, respectively. The capsules were administered orally by double blind method. During the experiment, the subjects kept their usual dietary pattern but avoided high VA or pre-VA carotenoids foods from their diets. A 24-h dietary recall was carried out monthly on every subject. Before and after the intervention, the fast blood samples were collected from each subject, and were determined for hemoglobin concentration, levels of serum retinol, iron, ferrtin and transferrtin receptor. Total 108 subjects finished the experiment, with 27, 28, 27 and 26 persons left in group A, B, C and D, respectively. The subjects from each group had similar dietary intakes of energy nutrients, VA and iron (both were P > 0.05) during the experimental period. The serum retinol concentration of subjects from group A increased from 1.63 +/- 0.55 micromol/L of baseline to 1.93 +/-0.52 micromol/L at the end of the experiment (P 0.05). There was no significant difference on Hb concentration before and after the experiment as well as between groups (all were P > 0.05). In subjects of group A, serum iron concentration increased (P < 0.05) and serum ferrtin and transferrtin receptor concentration decreased significantly (both were P < 0.05) after VA supplement intervention. No such changes were observed in group B and C (P < 0.05). It seems that the intervention of VA supplement with relative high dose of retinol at dietary level could enhance the iron status further in no-anemic healthy adults even without dietary iron supplementation.

  10. Effect of conventional milling on the nutritional value and antioxidant capacity of wheat types common in Ethiopia and a recovery attempt with bran supplementation in bread.

    Science.gov (United States)

    Heshe, Genet Gebremedhin; Haki, Gulelat Desse; Woldegiorgis, Ashagrie Zewdu; Gemede, Habtamu Fekadu

    2016-07-01

    The effect of wheat flour refined milling on nutritional and antioxidant quality of hard and soft grown in Ethiopia was evaluated. Bread was prepared with the supplementation of the white wheat flour with different levels (0%, 10%, 20%, and 25%) of wheat bran. Whole (100% extraction) and white wheat (68% extraction) flours were analyzed for proximates, minerals, and antioxidants. Results indicated that at a low extraction rate (68%), the protein, fat, fiber, ash, iron, zinc, phosphorous, and antioxidant contents of the samples significantly (P breads increased significantly (P bread, and the highest values (protein, 12.0 g/100 g; fat, 2.6 g/100 g; fiber, 2.5 g/100 g; ash, 3.3 g/100 g; iron, 4.8 mg/100 g and zinc, 2.33 mg/100 g) were found in 25% bran supplemented bread. The sensory evaluation of bread showed that all the supplementation levels had a mean score above 4 for all preferences on a 7- point hedonic scale. The results indicated that refined milling at 68% extraction significantly reduces the nutritional and antioxidant activity of the wheat flours. Bread of good nutritional and sensory qualities can be produced from 10% and 20% bran supplementations.

  11. Verbal and visual memory improve after choline supplementation in long-term total parenteral nutrition: a pilot study.

    Science.gov (United States)

    Buchman, A L; Sohel, M; Brown, M; Jenden, D J; Ahn, C; Roch, M; Brawley, T L

    2001-01-01

    Previous investigations have demonstrated that choline deficiency, manifested in low plasma-free choline concentration and hepatic injury, may develop in patients who require long-term total parenteral nutrition (TPN). Preliminary studies have suggested lecithin or choline supplementation might lead to improved visual memory in the elderly and reverse abnormal neuropsychological development in children. We sought to determine if choline-supplemented TPN would lead to improvement in neuropsychological test scores in a group of adult, choline-deficient outpatients receiving TPN. Eleven subjects (8 males, 3 females) who received nightly TPN for more than 80% of their nutritional needs for at least 12 weeks before entry in the study were enrolled. Exclusion criteria included active drug abuse, mental retardation, cerebral vascular accident, head trauma, hemodialysis or peritoneal dialysis, (prothrombin time [PT] >2x control), or acquired immune deficiency syndrome (AIDS). Patients were randomly assigned to receive their usual TPN regimen (n = 6, aged 34.0 +/- 12.6 years) over a 12-hour nightly infusion or their usual TPN regimen plus choline chloride (2 g) (n = 5, aged 37.3 +/- 7.3 years). The following neuropsychological tests were administered at baseline and after 24 weeks of choline supplementation (or placebo): Weschler Adult Intelligence Scale-Revised (WAIS-R, intellectual functioning), Weschler Memory Scale-Revised (WMS-R, two subtests, verbal and visual memory), Rey-Osterrieth Complex Figure Test (visuospatial functioning and perceptual organization), Controlled Oral Word Association Test (verbal fluency), Grooved Pegboard (manual dexterity and motor speed), California Verbal Learning Test (CVLT, rote verbal learning ability), and Trail Making Parts A & B (visual scanning, psychomotor speed and set shifting). Scores were reported in terms of standard scores including z scores and percentile ranks. Mean absolute changes in raw scores were compared between groups

  12. The Evolving Role of Multivitamin/Multimineral Supplement Use among Adults in the Age of Personalized Nutrition

    Directory of Open Access Journals (Sweden)

    Jeffrey B. Blumberg

    2018-02-01

    Full Text Available Micronutrient deficiencies occur in segments of the adult population in the United States. Multivitamin/multimineral supplements (MVMS are widely used by this population, which reduces inadequacies in micronutrient intake, but the potential for exceeding tolerable upper intake levels in others should be considered. There are concerns associated with the excessive intake of certain nutrients, particularly folic acid, and potential untoward consequences. The advent of nutrigenomics and the enhanced ability to directly study the interactions between nutrition and genetic variants and expression will allow for the conduct of more targeted studies with specific endpoints and may ultimately lead to progress in the field of personalized nutrition. The role of MVMS in health maintenance and chronic disease prevention remains controversial. Conducting studies in this area has been hampered by, among other factors, inconsistent definitions of MVMS, ranging from as few as three vitamins to broad-spectrum products containing more than two dozen vitamins and minerals. Results from some observational studies and large-scale, randomized, controlled trials suggest that MVMS may reduce the risk of some forms of cancer and, potentially, cardiovascular disease. The ongoing COcoa Supplement and Multivitamin Outcomes Study (COSMOS is expected to build on this research and provide additional insights into these areas.

  13. Nutrition care by general practitioners: Enhancing women's health during and after pregnancy.

    Science.gov (United States)

    Ball, Lauren; Wilkinson, Shelley

    2016-08-01

    The importance of healthy dietary behaviours during pregnancy and after birth is well recognised given the short-term and long-term effects on the health of mothers and infants. Pregnancy is an ideal time to implement health behaviour changes, as women are receptive to health messages at this time. The majority of pregnant women have regular, ongoing contact with general practitioners (GPs), particularly during early pregnancy. This paper provides an overview of the latest evidence regarding the nutrition requirements of women during and after birth, and describes simple ways that GPs can incorporate brief, effective nutrition care into standard consultations. Two approaches for enhancing the nutrition care provided by GPs are presented. These approaches are for GPs to feel confident in raising the topic of nutrition in standard consultations and being equipped with effective, evidence-based messages that can be incorporated into consultations. Collectively, these approaches promote healthy dietary behaviours for intergenerational benefits.

  14. Improving the uptake of preconception care and periconceptional folate supplementation: what do women think?

    Directory of Open Access Journals (Sweden)

    Chapman Anna

    2010-12-01

    Full Text Available Abstract Background Despite strong evidence of the benefits of preconception interventions to improve pregnancy outcomes, the delivery and uptake of preconception care in general and periconceptional folate supplementation in particular remains low. The aim of this study was to determine women's views of the barriers and enablers to the uptake of preconception care and periconceptional folate supplementation. Methods Focus groups were undertaken in 2007 with 17 women of reproductive age (18-45 years. To identify key issues and themes within the data, focus groups were analysed using an inductive process of thematic analysis. Results Most women were unaware of the need to attend for preconception care and were surprised at the breadth of issues involved. Women also felt general practitioners (GPs should be more proactive in promoting preconception care availability but acknowledged that they themselves had to be thinking about pregnancy or becoming pregnant to be receptive to it. Barriers to periconceptional folate supplementation included confusion about reasons for use, dose, duration, timing and efficacy of folate use. Enablers included the desire to do anything they could to ensure optimum pregnancy outcomes, and promotional material and letters of invitation from their GP to advise them of the availability and the need for preconception care. Conclusion A number of important barriers and enablers exist for women regarding the delivery and uptake of preconception care and periconceptional folate supplementation. It is essential that these patient perspectives are addressed in both the implementation of evidence based clinical practice guidelines and in the systematic design of an intervention to improve preconception care delivery.

  15. Prehabilitation with Whey Protein Supplementation on Perioperative Functional Exercise Capacity in Patients Undergoing Colorectal Resection for Cancer: A Pilot Double-Blinded Randomized Placebo-Controlled Trial.

    Science.gov (United States)

    Gillis, Chelsia; Loiselle, Sarah-Eve; Fiore, Julio F; Awasthi, Rashami; Wykes, Linda; Liberman, A Sender; Stein, Barry; Charlebois, Patrick; Carli, Francesco

    2016-05-01

    A previous comprehensive prehabilitation program, providing nutrition counseling with whey protein supplementation, exercise, and psychological care, initiated 4 weeks before colorectal surgery for cancer, improved functional capacity before surgery and accelerated functional recovery. Those receiving standard of care deteriorated. The specific role of nutritional prehabilitation alone on functional recovery is unknown. This study was undertaken to estimate the impact of nutrition counseling with whey protein on preoperative functional walking capacity and recovery in patients undergoing colorectal resection for cancer. We conducted a double-blinded randomized controlled trial at a single university-affiliated tertiary center located in Montreal, Quebec, Canada. Colon cancer patients (n=48) awaiting elective surgery for nonmetastatic disease were randomized to receive either individualized nutrition counseling with whey protein supplementation to meet protein needs or individualized nutrition counseling with a nonnutritive placebo. Counseling and supplementation began 4 weeks before surgery and continued for 4 weeks after surgery. The primary outcome was change in functional walking capacity as measured with the 6-minute walk test. The distance was recorded at baseline, the day of surgery, and 4 weeks after surgery. A change of 20 m was considered clinically meaningful. The whey group experienced a mean improvement in functional walking capacity before surgery of +20.8 m, with a standard deviation of 42.6 m, and the placebo group improved by +1.2 (65.5) m (P=0.27). Four weeks after surgery, recovery rates were similar between groups (P=0.81). Clinically meaningful improvements in functional walking capacity were achieved before surgery with whey protein supplementation. These pilot results are encouraging and justify larger-scale trials to define the specific role of nutrition prehabilitation on functional recovery after surgery. Copyright © 2016 Academy of

  16. Selenium supplementation for critically ill adults

    DEFF Research Database (Denmark)

    Allingstrup, Mikkel; Afshari, Arash

    2015-01-01

    BACKGROUND: Selenium is a trace mineral essential to health and has an important role in immunity, defence against tissue damage and thyroid function. Improving selenium status could help protect against overwhelming tissue damage and infection in critically ill adults. This Cochrane review...... was originally published in 2004 updated in 2007 and again 2015. OBJECTIVES: The primary objective was to examine the effect of nutrition supplemented with selenium or ebselen on mortality in critically ill patients.The secondary objective was to examine the relationship between selenium or ebselen...... supplementation and number of infections, duration of mechanical ventilation, length of intensive care unit stay and length of hospital stay. SEARCH METHODS: In this update, we searched the current issue of the Cochrane Central Register of Controlled Trials, the Cochrane Library (2014, Issue 5); MEDLINE (Ovid SP...

  17. Nutritional Supplement of Hatchery Eggshell Membrane Improves Poultry Performance and Provides Resistance against Endotoxin Stress.

    Science.gov (United States)

    Makkar, S K; Rath, N C; Packialakshmi, B; Zhou, Z Y; Huff, G R; Donoghue, A M

    2016-01-01

    Eggshells are significant part of hatchery waste which consist of calcium carbonate crust, membranes, and proteins and peptides of embryonic origins along with other entrapped contaminants including microbes. We hypothesized that using this product as a nutritional additive in poultry diet may confer better immunity to the chickens in the paradigm of mammalian milk that enhances immunity. Therefore, we investigated the effect of hatchery eggshell membranes (HESM) as a short term feed supplement on growth performance and immunity of chickens under bacterial lipopolysaccharide (LPS) challenged condition. Three studies were conducted to find the effect of HESM supplement on post hatch chickens. In the first study, the chickens were fed either a control diet or diets containing 0.5% whey protein or HESM as supplement and evaluated at 5 weeks of age using growth, hematology, clinical chemistry, plasma immunoglobulins, and corticosterone as variables. The second and third studies were done to compare the effects of LPS on control and HESM fed birds at 5 weeks of age following at 4 and 24 h of treatment where the HESM was also sterilized with ethanol to deplete bacterial factors. HESM supplement caused weight gain in 2 experiments and decreased blood corticosterone concentrations. While LPS caused a significant loss in body weight at 24 h following its administration, the HESM supplemented birds showed significantly less body weight loss compared with the control fed birds. The WBC, heterophil/lymphocyte ratio, and the levels of IgG were low in chickens fed diets with HESM supplement compared with control diet group. LPS challenge increased the expression of pro-inflammatory cytokine gene IL-6 but the HESM fed birds showed its effect curtailed, also, which also, favored the up-regulation of anti-inflammatory genes compared with control diet fed chickens. Post hatch supplementation of HESM appears to improve performance, modulate immunity, and increase resistance of

  18. Nutritional Issues and Nutrition Support in Older Home Care Patients in the City of Zagreb.

    Science.gov (United States)

    Vranešić Bender, Darija; Kovačević, Marta; Hanževački, Miro; Vrabec, Božena; Benković, Vanesa; Domislović, Viktor; Krznarić, Željko

    2017-12-01

    Population aging is a global demographic trend showing continuous growth and among its consequences is a rise in malnutrition that is characteristic for the elderly. The objective of this study was to evaluate nutritional status of elderly home care patients immediately after hospital discharge and to determine factors that affect nutritional status using questionnaires based on validated tools (NRS-2002, DETERMINE checklist) and basic medical history data. The study involved 76 elderly individuals (51.3% of them older than 70) living in the City of Zagreb. The nutritional status assessment using the NRS-2002 tool showed that 57.6% of the subjects were at nutritional risk. The findings of the assessment by use of the DETERMINE tool were also unfavorable, indicating that 82.1% of persons older than 70 were categorized as being at a high nutritional risk, while 17.9% were at moderate risk. The DETERMINE checklist elements (illness; reduced intake of fruits, vegetables or dairy products; alcohol consumption; oral health problems; and weight loss) were linked to a higher NRS score. The mean number of hospital days in subjects at nutritional risk was 14.27 (the mean number in the Republic of Croatia is 8.56 days). Although the study involved a small number of subjects, the results showed a substantial presence of malnutrition among the elderly. A timely -intervention by the healthcare system and training of healthcare personnel can be a step towards achieving a better nutritional status.

  19. Parenteral Nutrition Basics for the Clinician Caring for the Adult Patient.

    Science.gov (United States)

    Derenski, Karrie; Catlin, Jennifer; Allen, Livia

    2016-10-01

    Parenteral nutrition (PN) is a life-sustaining therapy providing nutrients to individuals with impaired intestinal tract function and enteral access challenges. It is one of the most complex prescriptions written routinely in the hospital and home care settings. This article is to aid the nutrition support clinician in the safe provision of PN, including selecting appropriate patients for PN, vascular access, development of a PN admixture, appropriate therapy monitoring, recognition of preparation options, and awareness of preparation and stability concerns. © 2016 American Society for Parenteral and Enteral Nutrition.

  20. Comparison of a commercially available oral nutritional supplement and intravenous fluid therapy for dehydration in dairy calves.

    Science.gov (United States)

    Taylor, Jared D; Rodenburg, Merel; Snider, Timothy A

    2017-06-01

    Calf scours is a primary cause of morbidity and mortality in the dairy industry. Effective treatments are needed to minimize death, maximize welfare, and maintain growth and productivity. The objective of this trial was to compare the efficacy of a commercially available nutritional supplement (Diaque, Boehringer-Ingelheim Vetmedica Inc., St. Joseph, MO) and i.v. lactated Ringer's solution (LRS) in rehydrating, preventing acidemia, and correcting electrolyte imbalances in an experimental model for calf scours. Twenty-four colostrum-fed suckling dairy calves were used in a modified crossover design. An osmotic diarrhea was induced by orally feeding commercial milk replacer modified with high level of sucrose to create a hypertonic milk solution, and administering oral hydrochlorothiazide and spironolactone for 48 h. The intention was to create a challenge sufficient to result in moderately dehydrated, standing calves without producing severe depression or loss of suckle. The efficacy of i.v. fluid therapy and a commercial nutritional supplement were subsequently compared for reversing the effects of the diarrheal disease. Treatment A consisted of administering the nutritional supplement according to label directions (100 g in 1.9 L of warm water, 3 times a day), and treatment B consisted of i.v. LRS (2 L, once a day). Clinical signs and laboratory results were obtained once daily by a blinded observer. The induction method was effective in creating the desired effect, as demonstrated by weight loss and subjective health and hydration scores. Both treatment groups experienced increases in body weight, base excess, and bicarbonate, and decreases in total protein and packed cell volume following treatment. Both i.v. LRS and Diaque are effective methods to correct hypovolemia and control derangements in acid-base status in calves with diarrhea and dehydration. The Authors. Published by the Federation of Animal Science Societies and Elsevier Inc. on behalf of the

  1. Doctors' attitudes and confidence towards providing nutrition care in practice: Comparison of New Zealand medical students, general practice registrars and general practitioners.

    Science.gov (United States)

    Crowley, Jennifer; Ball, Lauren; Han, Dug Yeo; McGill, Anne-Thea; Arroll, Bruce; Leveritt, Michael; Wall, Clare

    2015-09-01

    Improvements in individuals' nutrition behaviour can improve risk factors and outcomes associated with lifestyle-related chronic diseases. This study describes and compares New Zealand medical students, general practice registrars and general practitioners' (GPs') attitudes towards incorporating nutrition care into practice, and self-perceived skills in providing nutrition care. A total of 183 New Zealand medical students, 51 general practice registrars and 57 GPs completed a 60-item questionnaire investigating attitudes towards incorporating nutrition care into practice and self-perceived skills in providing nutrition care. Items were scored using a 5-point Likert scale. Factor analysis was conducted to group questionnaire items and a generalised linear model compared differences between medical students, general practice registrars and GPs. All groups indicated that incorporating nutrition care into practice is important. GPs displayed more positive attitudes than students towards incorporating nutrition in routine care (ppractice registrars were more positive than students towards performing nutrition recommendations (p=0.004), specified practices (p=0.037), and eliciting behaviour change (p=0.024). All groups displayed moderate confidence towards providing nutrition care. GPs were more confident than students in areas relating to wellness and disease (pmedical students, general practice registrars and GPs have positive attitudes and moderate confidence towards incorporating nutrition care into practice. It is possible that GPs' experience providing nutrition care contributes to greater confidence. Strategies to facilitate medical students developing confidence in providing nutrition care are warranted.

  2. Computer-Based Training in Eating and Nutrition Facilitates Person-Centered Hospital Care: A Group Concept Mapping Study.

    Science.gov (United States)

    Westergren, Albert; Edfors, Ellinor; Norberg, Erika; Stubbendorff, Anna; Hedin, Gita; Wetterstrand, Martin; Rosas, Scott R; Hagell, Peter

    2018-04-01

    Studies have shown that computer-based training in eating and nutrition for hospital nursing staff increased the likelihood that patients at risk of undernutrition would receive nutritional interventions. This article seeks to provide understanding from the perspective of nursing staff of conceptually important areas for computer-based nutritional training, and their relative importance to nutritional care, following completion of the training. Group concept mapping, an integrated qualitative and quantitative methodology, was used to conceptualize important factors relating to the training experiences through four focus groups (n = 43), statement sorting (n = 38), and importance rating (n = 32), followed by multidimensional scaling and cluster analysis. Sorting of 38 statements yielded four clusters. These clusters (number of statements) were as follows: personal competence and development (10), practice close care development (10), patient safety (9), and awareness about the nutrition care process (9). First and second clusters represented "the learning organization," and third and fourth represented "quality improvement." These findings provide a conceptual basis for understanding the importance of training in eating and nutrition, which contributes to a learning organization and quality improvement, and can be linked to and facilitates person-centered nutritional care and patient safety.

  3. Oral calorie supplements for cystic fibrosis.

    Science.gov (United States)

    Smyth, Rosalind L; Rayner, Oli

    2017-05-04

    Poor nutrition occurs frequently in people with cystic fibrosis and is associated with other adverse outcomes. Oral calorie supplements are used to increase total daily calorie intake and improve weight gain. However, they are expensive and there are concerns they may reduce the amount of food eaten and not improve overall energy intake. This is an update of a previously published review. To establish whether in people with cystic fibrosis, oral calorie supplements: increase daily calorie intake; and improve overall nutritional intake, nutritional indices, lung function, survival and quality of life. To assess adverse effects associated with using these supplements. We searched the Cochrane Cystic Fibrosis Trials Register comprising references from comprehensive electronic database searches, handsearches of relevant journals and abstract books of conference proceedings. We contacted companies marketing oral calorie supplements.Last search: 18 October 2016. Randomised or quasi-randomised controlled trials comparing use of oral calorie supplements for at least one month to increase calorie intake with no specific intervention or additional nutritional advice in people with cystic fibrosis. We independently selected the included trials, assessed risk of bias and extracted data. We contacted the authors of included trials and obtained additional information for two trials. We identified 21 trials and included three, reporting results from 131 participants lasting between three months and one year. Two trials compared supplements to additional nutritional advice and one to no intervention. Two of the included trials recruited only children. In one trial the risk of bias was low across all domains, in a second trial the risk of bias was largely unclear and in the third mainly low. Blinding of participants was unclear in two of the trials. Also, in one trial the clinical condition of groups appeared to be unevenly balanced at baseline and in another trial there were

  4. Health economics evidence for medical nutrition: are these interventions value for money in integrated care?

    Science.gov (United States)

    Walzer, Stefan; Droeschel, Daniel; Nuijten, Mark; Chevrou-Séverac, Hélène

    2014-01-01

    Health care decision-makers have begun to realize that medical nutrition plays an important role in the delivery of care, and it needs to be seen as a sole category within the overall health care reimbursement system to establish the value for money. Indeed, improving health through improving patients' nutrition may contribute to the cost-effectiveness and financial sustainability of health care systems. Medical nutrition is regulated by a specific bill either in Europe or in the United States, which offers specific legislations and guidelines (as provided to patients with special nutritional needs) and indications for nutritional support. Given that the efficacy of medical nutrition has been proven, one can wonder whether the heterogeneous nature of its coverage/reimbursement across countries might be due to the lack of health-related economic evidence or value-for-money of nutritional interventions. This paper aims to address this knowledge gap by performing a systematic literature review on health economics evidence regarding medical nutrition, and by summarizing the results of these publications related to the value for money of medical nutrition interventions. A systematic literature search was initiated and executed based on a predefined search protocol following the population, intervention, comparison, and outcomes (PICO) criteria. Following the systematic literature search of recently published literature on health economics evidence regarding medical nutrition, this study aims to summarize the results of those publications that are related to the value for money of medical nutrition interventions. The evaluations were conducted by analyzing different medical nutrition according to their indications, the economic methodology or perspective adopted, the cost source and utility measures, selected efficiency measures, as well as the incremental cost-effectiveness ratio. A total of 225 abstracts were identified for the detailed review, and the data were

  5. Biological evaluation of a nutritional supplement prepared with QPM Maize cultivar BR 473 and other traditional food items

    Directory of Open Access Journals (Sweden)

    Paula Heberth de

    2004-01-01

    Full Text Available Quality Protein Maize (QPM cultivar BR 473 was employed, together with soybean flour, brown sugar, banana meal and oat meal, for the preparation of a nutritional supplement.. 21-day old male Fisher rats were fed diets containing the supplement as a protein source, both with and without soybean flour; casein diets with 10 or 7% protein served as respective controls. Protein Efficiency Ratio (PER, Net Protein Utilization (NPU, Net Protein Retention (NPR and Digestibility were determined. Blood biochemical parameters (glucose, cholesterol, urea, hemoglobin, albumin and total protein were also measured in the animals and showed that all were in good health condition at the end of the experiment. The obtained results for PER, NPU and NPR indicated that the supplement prepared with QPM maize cultivar BR 473 was a good protein source, especially when soybean flour was added.

  6. Evolução antropométrica e sintomas gastrointestinais em pacientes que receberam suplementos nutricionais ou nutrição enteral Anthropometric evolution and gastrointestinal complaints in oral nutritional supplementation and enteral nutritional therapy

    Directory of Open Access Journals (Sweden)

    Juliana Maria Faccioli Sicchieri

    2009-01-01

    Full Text Available OBJETIVO: Em pacientes hospitalizados, comparar a evolução de variáveis antropométricas e a ocorrência de efeitos adversos relacionados ao consumo de suplementos nutricionais e infusão de nutrição enteral. MÉTODOS: 10 pacientes que recebiam suplementos nutricionais (Grupo SN e 20 em nutrição enteral (Grupo NE, pareados para o gênero, idade (50 ± 21 vs 49 ± 23 anos e afecções de base foram submetidos à avaliação antropométrica ao início e término da terapêutica. Diariamente, foi aplicado um questionário semi-estruturado referente às queixas gastrointestinais. Determinaram-se as diferenças estatísticas obtidas entre o início e o final da terapêutica (teste t para amostras dependentes e entre os grupos de estudo (teste t para amostras independentes. RESULTADOS: A circunferência muscular do braço aumentou nos pacientes do Grupo NE (80 ± 15 vs 85 ± 15% de adequação, p = 0,009 e diminuiu no Grupo SN (96 ± 14 vs 92 ± 14% de adequação, p = 0,04. Náuseas e vômitos foram mais frequentes no Grupo SN (60 vs 10%, p = 0,01 e as queixas relacionadas ao sabor dos produtos ocorreram em 30% dos casos. CONCLUSÃO: Os pacientes que receberam suplementos nutricionais apresentaram maior ocorrência de queixas gastrointestinais e evolução desfavorável dos parâmetros antropométricos. Os dados obtidos no estudo não evidenciam o benefício da suplementação nutricional de rotina em pacientes hospitalizados.OBJECTIVE: To compare the evolution of anthropometric variables and the occurrence of adverse effects related to the ingestion of nutritional food supplements and enteral diet administration in hospitalized patients. METHODS: The study was performed in the Clinical Medicine wards of the Hospital of the School of Medicine of Ribeirão Preto, USP, with 10 patients receiving nutrition supplements, and 20 patients under enteral nutrition therapy, paired by gender, age (50 ± 21 vs 49 ± 23 years and basic afflictions. All

  7. Effect of a Nutrition Supplement and Physical Activity Program on Pneumonia and Walking Capacity in Chilean Older People: A Factorial Cluster Randomized Trial

    Science.gov (United States)

    Dangour, Alan D.; Albala, Cecilia; Allen, Elizabeth; Grundy, Emily; Walker, Damian G.; Aedo, Cristian; Sanchez, Hugo; Fletcher, Olivia; Elbourne, Diana; Uauy, Ricardo

    2011-01-01

    Background Ageing is associated with increased risk of poor health and functional decline. Uncertainties about the health-related benefits of nutrition and physical activity for older people have precluded their widespread implementation. We investigated the effectiveness and cost-effectiveness of a national nutritional supplementation program and/or a physical activity intervention among older people in Chile. Methods and Findings We conducted a cluster randomized factorial trial among low to middle socioeconomic status adults aged 65–67.9 years living in Santiago, Chile. We randomized 28 clusters (health centers) into the study and recruited 2,799 individuals in 2005 (∼100 per cluster). The interventions were a daily micronutrient-rich nutritional supplement, or two 1-hour physical activity classes per week, or both interventions, or neither, for 24 months. The primary outcomes, assessed blind to allocation, were incidence of pneumonia over 24 months, and physical function assessed by walking capacity 24 months after enrolment. Adherence was good for the nutritional supplement (∼75%), and moderate for the physical activity intervention (∼43%). Over 24 months the incidence rate of pneumonia did not differ between intervention and control clusters (32.5 versus 32.6 per 1,000 person years respectively; risk ratio = 1.00; 95% confidence interval 0.61–1.63; p = 0.99). In intention-to-treat analysis, after 24 months there was a significant difference in walking capacity between the intervention and control clusters (mean difference 33.8 meters; 95% confidence interval 13.9–53.8; p = 0.001). The overall cost of the physical activity intervention over 24 months was US$164/participant; equivalent to US$4.84/extra meter walked. The number of falls and fractures was balanced across physical activity intervention arms and no serious adverse events were reported for either intervention. Conclusions Chile's nutritional supplementation program for older

  8. Effect of a nutrition supplement and physical activity program on pneumonia and walking capacity in Chilean older people: a factorial cluster randomized trial.

    Directory of Open Access Journals (Sweden)

    Alan D Dangour

    2011-04-01

    Full Text Available Ageing is associated with increased risk of poor health and functional decline. Uncertainties about the health-related benefits of nutrition and physical activity for older people have precluded their widespread implementation. We investigated the effectiveness and cost-effectiveness of a national nutritional supplementation program and/or a physical activity intervention among older people in Chile.We conducted a cluster randomized factorial trial among low to middle socioeconomic status adults aged 65-67.9 years living in Santiago, Chile. We randomized 28 clusters (health centers into the study and recruited 2,799 individuals in 2005 (~100 per cluster. The interventions were a daily micronutrient-rich nutritional supplement, or two 1-hour physical activity classes per week, or both interventions, or neither, for 24 months. The primary outcomes, assessed blind to allocation, were incidence of pneumonia over 24 months, and physical function assessed by walking capacity 24 months after enrollment. Adherence was good for the nutritional supplement (~75%, and moderate for the physical activity intervention (~43%. Over 24 months the incidence rate of pneumonia did not differ between intervention and control clusters (32.5 versus 32.6 per 1,000 person years respectively; risk ratio = 1.00; 95% confidence interval 0.61-1.63; p = 0.99. In intention-to-treat analysis, after 24 months there was a significant difference in walking capacity between the intervention and control clusters (mean difference 33.8 meters; 95% confidence interval 13.9-53.8; p = 0.001. The overall cost of the physical activity intervention over 24 months was US$164/participant; equivalent to US$4.84/extra meter walked. The number of falls and fractures was balanced across physical activity intervention arms and no serious adverse events were reported for either intervention.Chile's nutritional supplementation program for older people is not effective in reducing the

  9. Impact of supplementation with amino acids or their metabolites on muscle wasting in patients with critical illness or other muscle wasting illness: a systematic review.

    Science.gov (United States)

    Wandrag, L; Brett, S J; Frost, G; Hickson, M

    2015-08-01

    Muscle wasting during critical illness impairs recovery. Dietary strategies to minimise wasting include nutritional supplements, particularly essential amino acids. We reviewed the evidence on enteral supplementation with amino acids or their metabolites in the critically ill and in muscle wasting illness with similarities to critical illness, aiming to assess whether this intervention could limit muscle wasting in vulnerable patient groups. Citation databases, including MEDLINE, Web of Knowledge, EMBASE, the meta-register of controlled trials and the Cochrane Collaboration library, were searched for articles from 1950 to 2013. Search terms included 'critical illness', 'muscle wasting', 'amino acid supplementation', 'chronic obstructive pulmonary disease', 'chronic heart failure', 'sarcopenia' and 'disuse atrophy'. Reviews, observational studies, sport nutrition, intravenous supplementation and studies in children were excluded. One hundred and eighty studies were assessed for eligibility and 158 were excluded. Twenty-two studies were graded according to standardised criteria using the GRADE methodology: four in critical care populations, and 18 from other clinically relevant areas. Methodologies, interventions and outcome measures used were highly heterogeneous and meta-analysis was not appropriate. Methodology and quality of studies were too varied to draw any firm conclusion. Dietary manipulation with leucine enriched essential amino acids (EAA), β-hydroxy-β-methylbutyrate and creatine warrant further investigation in critical care; EAA has demonstrated improvements in body composition and nutritional status in other groups with muscle wasting illness. High-quality research is required in critical care before treatment recommendations can be made. © 2014 The British Dietetic Association Ltd.

  10. Do structural quality indicators of nutritional care influence malnutrition prevalence in Dutch, German, and Austrian nursing homes?

    Science.gov (United States)

    van Nie, Noémi C; Meijers, Judith M M; Schols, Jos M G A; Lohrmann, Christa; Spreeuwenberg, Marieke; Halfens, Ruud J G

    2014-01-01

    The aim of this study was to explore whether structural quality indicators for nutritional care influence malnutrition prevalence in the Netherlands, Germany, and Austria. Furthermore, differences in malnutrition prevalence and structural quality indicators for nutritional care nursing homes in the three countries were examined. This was a cross-sectional, multicenter study using a standardized questionnaire at the patient, ward, and institutional levels. Malnutrition was assessed by low body mass index, undesired weight loss, and reduced intake. Structural quality indicators of nutritional care were measured at the ward and institutional levels. The prevalence of malnutrition differed significantly between the three countries (Netherlands 18%, Germany 20%, and Austria 22.7%). Structural quality indicators related to nutritional care as having a guideline of prevention and treatment of malnutrition were related to malnutrition and explained malnutrition prevalence variance between the Netherlands and Germany. Differences between the Netherlands and Austria in malnutrition prevalence still existed after controlling for these quality structural indicators. Structural quality indicators of nutritional care are important in explaining malnutrition variance between the Netherlands and Germany. However, they did not explain the difference in malnutrition prevalence between the Netherlands and Austria. Investigating the role of process indicators may provide insight in the role of structural quality indicators of nutritional care in explaining the malnutrition prevalence differences between the Netherlands and Austria. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Effects of supplementation of fertilizers on human selenium status in Finland.

    Science.gov (United States)

    Aro, A; Alfthan, G; Varo, P

    1995-03-01

    The Se concentration of foods can be increased by supplementing fertilizers with soluble Se compounds. In Finland the availability of soil Se for plants is poor owing to the relatively low Se concentration, low pH and high iron content of the soil. Since 1984 multimineral fertilizers have been supplemented with Se (16 mg kg-1 to fertilizers for grain production and 6 mg kg-1 to those for fodder production) in the form of sodium selenate. Within two years a three-fold increase of mean Se intake was observed. The supplementation affected the Se content of all major food groups with the exception of fish. The concomitant human serum Se concentration increased by 70%. In 1990 the amount of Se that was supplemented was reduced to 6 mg kg-1 for all fertilizers. This reduced the mean Se intake by 30% and the serum Se concentration decreased by 25% from the highest levels observed in 1989. Plants take up part of the supplemented selenate and transform it into organic Se compounds, mainly selenomethionine. This affects human nutrition by increasing the Se content of foods of both animal and vegetable origin. According to data obtained in Finland, supplementation of fertilizers with Se is a safe and effective means of increasing the Se intake of both animals and humans that is feasible in countries with relatively uniform geochemical conditions. This kind of intervention requires careful monitoring of the effects on both animal and human nutrition and the environment.

  12. The self-perceived knowledge, skills and attitudes of Australian practice nurses in providing nutrition care to patients with chronic disease.

    Science.gov (United States)

    Martin, Louise; Leveritt, Michael D; Desbrow, Ben; Ball, Lauren E

    2014-04-01

    Nutrition is important for the management of chronic diseases. While practice nurses have numerous roles in primary care, the expectations on practice nurses to provide nutrition care for chronic disease management are increasing. The self-perceived knowledge, skills and attitudes of practice nurses in providing nutrition care has not been widely investigated. The aim of the present study was to investigate the perceptions of Australian practice nurses on the provision of nutrition care for chronic disease management, including specific nutrition-related activities. A cross-sectional online survey was completed by 181 Australian practice nurses in 2013. Descriptive analyses were conducted on each survey item. The survey sample was tested for representation of the Australian practice nurse workforce, and associations between respondents' demographic characteristics and responses to survey items were explored. Almost all practice nurses (89%) felt it was important to address diet whenever they cared for a patient. Over half of practice nurses (61%) were unsure if their practices were effective in increasing patients' compliance with nutritional recommendations. Nearly all practice nurses (98%) perceived further education on nutrition would assist them in their role. Practice nurses perceive they have an important role and favourable attitudes towards providing nutrition care; however, further training and education to enhance their self-perceived effectiveness is warranted. Future research should clarify whether an increase in nutrition-focused training results in improved effectiveness of nutrition care provided by practice nurses in terms of patient health outcomes.

  13. Nutritional and Metabolic Derangements in Pancreatic Cancer and Pancreatic Resection

    Directory of Open Access Journals (Sweden)

    Taylor M. Gilliland

    2017-03-01

    Full Text Available Pancreatic cancer is an aggressive malignancy with a poor prognosis. The disease and its treatment can cause significant nutritional impairments that often adversely impact patient quality of life (QOL. The pancreas has both exocrine and endocrine functions and, in the setting of cancer, both systems may be affected. Pancreatic exocrine insufficiency (PEI manifests as weight loss and steatorrhea, while endocrine insufficiency may result in diabetes mellitus. Surgical resection, a central component of pancreatic cancer treatment, may induce or exacerbate these dysfunctions. Nutritional and metabolic dysfunctions in patients with pancreatic cancer lack characterization, and few guidelines exist for nutritional support in patients after surgical resection. We reviewed publications from the past two decades (1995–2016 addressing the nutritional and metabolic status of patients with pancreatic cancer, grouping them into status at the time of diagnosis, status at the time of resection, and status of nutritional support throughout the diagnosis and treatment of pancreatic cancer. Here, we summarize the results of these investigations and evaluate the effectiveness of various types of nutritional support in patients after pancreatectomy for pancreatic adenocarcinoma (PDAC. We outline the following conservative perioperative strategies to optimize patient outcomes and guide the care of these patients: (1 patients with albumin < 2.5 mg/dL or weight loss > 10% should postpone surgery and begin aggressive nutrition supplementation; (2 patients with albumin < 3 mg/dL or weight loss between 5% and 10% should have nutrition supplementation prior to surgery; (3 enteral nutrition (EN should be preferred as a nutritional intervention over total parenteral nutrition (TPN postoperatively; and, (4 a multidisciplinary approach should be used to allow for early detection of symptoms of endocrine and exocrine pancreatic insufficiency alongside implementation of

  14. Whole or ground millet grain provided in two supplementation frequencies for grazing beef cattle: nutritional parameters

    Directory of Open Access Journals (Sweden)

    João Marcos Beltrame Benatti

    2014-05-01

    Full Text Available The objective of this study was to evaluate the processing of millet grain provided at two supplementation frequencies for grazing beef cattle during the dry season on nutritional parameters. Five rumen-cannulated crossbred steers, with 24 to 26 months of age and average body weight of 428.6±26.06 kg, were assigned to a Latin square design (5 × 5 in a 2 × 2 + 1 factorial arrangement, as follows: two forms of millet grain (whole grains - or ground; WG - GG, two strategies of concentrate supplementation (daily distribution - 7X; or three times a week - 3X and a control treatment (mineral mixture - MM. Animals were kept in five paddocks of 0.24 ha each with Marandu grass pastures. Concentrate supplements were supplied at 2.00 and 4.66 kg/animal/day for treatments 7X and 3X, respectively. The concentrate supplementation enhanced the intake of total dry matter (DM and organic matter (OM and nutrients compared with mineral supplementation. No differences were found between dry matter intake and forage organic matter intake. The values of digestibility coefficients of DM, OM, ether extract, total carbohydrates and non-fiber carbohydrates were increased by concentrate supplementation. Regarding concentrations of rumen ammonia nitrogen, the interactions among time × treatment × day and day × treatment had effects on the measurements of ruminal pH. Plasma urea nitrogen, urinary urea excretion and urinary urea N excretion differed only between MM treatment and the others, with no interference of grain physical form and supplementation frequency on those variables. The millet grain processing does not alter forage intake, but improves digestibility. Daily supplementation increases digestibility of dry matter and neutral detergent fiber.

  15. [ENTERAL NUTRITION ON THE NUTRITIONAL STATUS OF CANCER].

    Science.gov (United States)

    Escortell Sánchez, Raquel; Reig García-Galbis, Manuel

    2015-10-01

    to identify what effect causes enteral nutrition on nutritional status of cancer. a search was performed using the keywords "Cancer" AND "Enteral Nutrition" AND "Supplementation" in four document databases: Pubmed, EBSCO, ProQuest, and Web of Science. age of the sample, major than 18 years; submitted to surgery for cancer; that the intervention program was including diet and employment or not of nutritional Supplementation; clinical trials published between January 2004 and December 2014, in scientific journals indexed. we analyzed 660 articles, of which only 2% has been included. 58% of intervention programs are applied outside Spain; 84% of the interventions was carried out in a hospitable ambient; 58% of the sample is formed by adults older than 54 years; 33% of the interventions were multidisciplinary and its duration ranges between 1 and 4 years. we found just a few national interventions in cancer participants and there two types of interventions: by exclusive polymeric enteral formula or mixed with immunonutrition. enteral nutrition shows against the parenteral and its introduction at an early stage, it helps to improve nutritional status of the patient; polymeric formulas next immunonutrition, it helps to reduce the time of hospitalization; the analytical parameters are shown as a measurement pattern when assessing the improvement in nutritional status in cancer. It is recommended to increase the research in this field, especially in children. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  16. Nutritional supplements modulate fluorescent protein-bound advanced glycation endproducts and digestive enzymes related to type 2 diabetes mellitus.

    Science.gov (United States)

    Koch, Emily R; Deo, Permal

    2016-09-01

    Chronic hyperglycemia enhances the formation of advanced glycation endproducts (AGEs) and reactive oxygen species (ROS), contributing to diabetic complications. Thus, controlling blood glucose levels, inhibiting the formation of AGEs and reducing ROS are key therapeutic targets in early stage type 2 diabetes. The inhibitory effects of seven commercial liquid nutritional supplements against carbohydrate hydrolysing enzymes, α-amylase and α-glucosidase, was determined by dinitrosalicylic (DNS) reagent and p-nitrophenyl-α-D-glucopyranoside solution, respectively. Antiglycation activity was determined using the formation of fluorescent protein-bound AGEs. Total phenolic and flavonoid content and antioxidant properties (1,1-diphenyl-2-picrylhydrazyl antioxidant activity (DPPH) and ferric reducing antioxidant power (FRAP)) were determined for correlation among these components and inhibitory activities. Samoan noni juice showed the greatest inhibitory effects against α-amylase, whereas chlorophyll extracts showed the greatest inhibitory effect against α-glucosidase. Inhibition of α-glucosidase correlated with TFC (r(2) = 0.766; p 1) and FRAP (r(2) = 0.750; p 1) whereas no correlation was observed for α-amylase inhibition. All supplements inhibited fluorescent protein-bound AGEs, with the greatest effect exerted by Olive Leaf Extract, Blood Sugar Support (IC50 = 0.5 mg/ml). The IC50 values negatively correlated with TPC (r(2) = -0.707; p 1) and DPPH scavenging activities (r(2) = 0.515; p nutritional supplements in managing and treating type 2 diabetes mellitus.

  17. Glycine does not add to the beneficial effects of perioperative oral immune-enhancing nutrition supplements in high-risk cardiac surgery patients

    NARCIS (Netherlands)

    Tepaske, Robert; te Velthuis, Henk; Oudemans-van Straaten, Heleen M.; Bossuyt, Patrick M. M.; Schultz, Marcus J.; Eijsman, Leon; Vroom, Margreeth

    2007-01-01

    Background: Elderly patients and patients with a poor cardiac function have increased morbidity rates when undergoing cardiac surgery. The aim of this study was to determine whether addition of glycine to a standard preoperative oral immune-enhancing nutrition supplement (OIENS) improves outcome.

  18. Serial changes in selected serum constituents in low birth weight infants on peripheral parenteral nutrition with different zinc and copper supplements.

    Science.gov (United States)

    Lockitch, G; Pendray, M R; Godolphin, W J; Quigley, G

    1985-07-01

    One hundred and five infants of birth weight 2000 g or less who received peripherally administered parenteral nutrition for periods of three or more weeks, were randomly assigned to groups receiving different amounts of zinc and copper supplement. The blood concentrations of zinc, copper, retinol-binding protein, prealbumin, alkaline phosphatase and aspartate transaminase were followed weekly. Mean serum zinc, retinol-binding protein and prealbumin declined significantly over time while alkaline phosphatase rose. Only the group receiving the highest zinc supplement maintained a mean serum zinc concentration within the normal range at seven weeks. No difference in the protein or enzyme concentrations was found between the different zinc supplement groups. No difference was seen in serum copper or ceruloplasmin between copper dose groups although one intravenous supplement was double that of the other.

  19. Realist synthesis of educational interventions to improve nutrition care competencies and delivery by doctors and other healthcare professionals

    Science.gov (United States)

    Mogre, Victor; Scherpbier, Albert J J A; Stevens, Fred; Aryee, Paul; Cherry, Mary Gemma; Dornan, Tim

    2016-01-01

    Objective To determine what, how, for whom, why, and in what circumstances educational interventions improve the delivery of nutrition care by doctors and other healthcare professionals work. Design Realist synthesis following a published protocol and reported following Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMESES) guidelines. A multidisciplinary team searched MEDLINE, CINAHL, ERIC, EMBASE, PsyINFO, Sociological Abstracts, Web of Science, Google Scholar and Science Direct for published and unpublished (grey) literature. The team identified studies with varied designs; appraised their ability to answer the review question; identified relationships between contexts, mechanisms and outcomes (CMOs); and entered them into a spreadsheet configured for the purpose. The final synthesis identified commonalities across CMO configurations. Results Over half of the 46 studies from which we extracted data originated from the USA. Interventions that improved the delivery of nutrition care improved skills and attitudes rather than just knowledge; provided opportunities for superiors to model nutrition care; removed barriers to nutrition care in health systems; provided participants with local, practically relevant tools and messages; and incorporated non-traditional, innovative teaching strategies. Operating in contexts where student and qualified healthcare professionals provided nutrition care in developed and developing countries, these interventions yielded health outcomes by triggering a range of mechanisms, which included feeling competent, feeling confident and comfortable, having greater self-efficacy, being less inhibited by barriers in healthcare systems and feeling that nutrition care was accepted and recognised. Conclusions These findings show how important it is to move education for nutrition care beyond the simple acquisition of knowledge. They show how educational interventions embedded within systems of healthcare can improve

  20. Nutritional intervention and quality of life in adult oncology patients.

    Science.gov (United States)

    Marín Caro, Mónica María; Laviano, Alessandro; Pichard, Claude

    2007-06-01

    The evaluation of quality of life (QoL) assesses patients' well-being by taking into account physical, psychological and social conditions. Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of QoL. These metabolic changes lead to decreased food intake and promote wasting. Cancer-related malnutrition can evolve to cancer cachexia due to complex interactions between pro-inflammatory cytokines and host metabolism. Beside and beyond the physical and the metabolic effects of cancer, patients often suffer as well from psychological distress, including depression. Depending on the type of cancer treatment (either curative or palliative) and on patients' clinical conditions and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counselling, oral supplementation, enteral or total parenteral nutrition). Such an approach, which should be started as early as possible, can reduce or even reverse their poor nutritional status, improve their performance status and consequently their QoL. Nutritional intervention accompanying curative treatment has an additional and specific role, which is to increase the tolerance and response to the oncology treatment, decrease the rate of complications and possibly reduce morbidity by optimizing the balance between energy expenditure and food intake. In palliative care, nutritional support aims at improving patient's QoL by controlling symptoms such as nausea, vomiting and pain related to food intake and postponing loss of autonomy. The literature review supports that nutritional care should be integrated into the global oncology care because of its significant contribution to QoL. Furthermore, the assessment of QoL should be part of the evaluation of any nutritional support to optimize its adequacy to the patient's needs and expectations.

  1. The successful accomplishment of nutritional and clinical outcomes via the implementation of a multidisciplinary nutrition support team in the neonatal intensive care unit.

    Science.gov (United States)

    Jeong, Eurim; Jung, Young Hwa; Shin, Seung Han; Kim, Moon Jin; Bae, Hye Jung; Cho, Yoon Sook; Kim, Kwi Suk; Kim, Hyang Sook; Moon, Jin Soo; Kim, Ee-Kyung; Kim, Han-Suk; Ko, Jae Sung

    2016-07-28

    Nutritional support is critical for preterm infants in the neonatal intensive care unit (NICU). A multidisciplinary nutritional support team (NST) that focuses on providing optimal and individualized nutrition care could be helpful. We conducted a thorough evaluation of clinical and nutritional outcomes in a tertiary NICU following the implementation of an NST. This study used a retrospective approach with historical comparisons. Preterm neonates nutritional outcomes were compared before and after the establishment of the NST. Medical records were reviewed, and clinical and nutritional outcomes were compared between the two groups. In total, 107 patients from the pre-NST period and 122 patients from the post-NST period were included. The cumulative energy delivery during the first week of life improved during the post-NST period (350.17 vs. 408.62 kcal/kg, p nutrition to preterm infants in the first week of life. There were also favorable clinical outcomes, such as increased weight gain and reduced length of ICU stay. Evaluable data remain sparse in the NICU setting with premature neonatal populations; therefore, the successful outcomes identified in this study may provide support for NST practices.

  2. Application of Dairy Proteins as Technological and Nutritional Improvers of Calcium-Supplemented Gluten-Free Bread

    Directory of Open Access Journals (Sweden)

    Cristina M. Rosell

    2013-11-01

    Full Text Available Effect of dairy proteins on gluten-free dough behavior, and nutritional and technological properties of gluten-free bread was evaluated. Experimental doughs, containing dairy powders, showed low consistency. Obtained gluten-free breads were rich in proteins, and, regarding the energy value delivered by proteins, they could be considered as a source of proteins or high in proteins. Applied dairy proteins affected the technological properties of experimental breads causing a significant (p < 0.05 increase of the specific volume, crust darkening, and crumb lightness, depending on the dairy supplementation level, rather than the protein type. Dairy proteins incorporated at a 12% level, significantly (p < 0.05 decreased the hardness; nevertheless, the highest amount of proteins tested led to the opposite effect. These results indicate that milk proteins tested could be successfully added to gluten-free bread with beneficial effects on technological and nutritional properties.

  3. Nutrition Care Process Implementation: Experiences in Various Dietetics Environments in Sweden.

    Science.gov (United States)

    Lövestam, Elin; Boström, Anne-Marie; Orrevall, Ylva

    2017-11-01

    The Nutrition Care Process (NCP) and Nutrition Care Process Terminology (NCPT) are currently being implemented by nutrition and dietetics practitioners all over the world. Several advantages have been related to this implementation, such as consistency and clarity of dietetics-related health care records and the possibility to collect and research patient outcomes. However, little is known about dietitians' experiences of the implementation process. The aim of this qualitative study was to explore Swedish dietitians' experiences of the NCP implementation process in different dietetics environments. Thirty-seven Swedish dietitians from 13 different dietetics workplaces participated in seven focus group discussions that were audiotaped and carefully transcribed. A thematic secondary analysis was performed, after which all the discussions were re-read, following the implementation narrative from each workplace. In the analysis, The Promoting Action on Research Implementation in Health Services implementation model was used as a framework. Main categories identified in the thematic analysis were leadership and implementation strategy, the group and colleagues, the electronic health record, and evaluation. Three typical cases are described to illustrate the diversity of these aspects in dietetics settings: Case A represents a small hospital with an inclusive leadership style and discussion-friendly culture where dietitians had embraced the NCP/NCPT implementation. Case B represents a larger hospital with a more hierarchical structure where dietitians were more ambivalent toward NCP/NCPT implementation. Case C represents the only dietitian working at a small multiprofessional primary care center who received no dietetics-related support from management or colleagues. She had not started NCP/NCPT implementation. The diversity of dietetics settings and their different prerequisites should be considered in the development of NCP/NCPT implementation strategies. Tailored

  4. Improved nutrition in the first 1000 days and adult human capital and health.

    Science.gov (United States)

    Martorell, Reynaldo

    2017-03-01

    The aim of this article is to review why the first 1000 days of life are a vulnerable period of human development and the long-term effects of a nutrition experiment carried out in Guatemala (1969-1977). In 1969-77, a supplement called Atole, containing high quality protein, energy and micronutrients, was provided to women during pregnancy and lactation and to children nutritional requirements, greater susceptibility to infections, high sensitivity to programming effects and full dependence on others for care, nutrition, and social interaction. Compared with Fresco, Atole improved total nutrient intakes (protein, energy, and micronutrients) and reduced stunting, but only in children nutrition intervention. This provides a powerful argument for promoting improvements in nutrition in pregnant women and young children in low income countries. © 2017 Wiley Periodicals, Inc.

  5. Vitamin D nutritional status in preterm infants and response to supplementation.

    LENUS (Irish Health Repository)

    McCarthy, Roberta A

    2013-07-14

    Little is known about vitamin D status in preterm infants and their response to supplementation. To investigate this, we assessed serum 25-hydroxyvitamin D (25OHD) levels using RIA in a consecutive sample of stable preterm very low birth weight (VLBW) infants (born ≤ 32 weeks gestation or birth weight ≤ 1·5 kg), and we explored associated factors. Serum 25OHD level was first assessed once infants were tolerating feeds (n 274). If this first 25OHD level was below 50 nmol\\/l (20 ng\\/ml), which is the level associated with covering requirements in terms of skeletal health in the majority, then we recommended prolonged augmented vitamin D intake ( ≥ 10 μg (400 IU) daily) from a combination of fortified feeds and vitamin supplements and follow-up re-assessment at approximately 6 weeks corrected age (n 148). The first assessment, conducted at a median for chronological age of 18 (interquartile range (IQR) 11-28) d, found that 78 % had serum 25OHD levels below 50 nmol\\/l. Multivariable analysis demonstrated that the determinants of serum 25OHD levels were duration of vitamin D supplementation and gestational age at birth (r 2 0·215; P< 0·001). At follow-up, after a median of 104 (IQR 78-127) d, 87 % achieved levels ≥ 50 nmol\\/l and 8 % had levels >125 nmol\\/l, a level associated with potential risk of harm. We conclude that low 25OHD levels are an issue for preterm VLBW infants, warranting early nutritional intervention. In infants with serum 25OHD levels < 50 nmol\\/l, a vitamin D intake of ≥ 10 μg (400 IU) daily achieves target levels in the majority; however, further work is needed to determine the exact dose to safely meet target levels without overcorrection.

  6. The role of care in nutrition programmes: current research and a research agenda.

    Science.gov (United States)

    Engle, P L; Bentley, M; Pelto, G

    2000-02-01

    The importance of cultural and behavioural factors in children's nutrition, particularly with regard to feeding, has been recognized only recently. The combination of evidence regarding the importance of caregiving behaviour for good nutrition, and improved strategies for measuring behaviour have led to a renewed interest in care. The UNICEF conceptual framework suggests that care, in addition to food security and health care services, are critical for children's survival, growth and development. The present paper focuses on the care practice of complementary feeding, specifically behavioural factors such as parental interaction patterns, feeding style and adaptation of feeding to the child's motor abilities (self-feeding or feeding by others). Three kinds of feeding styles (Birch & Fisher, 1995) are identified: controlling; laissez-faire; responsive. Probable effects of each feeding style on nutrient intake are described. A number of studies of feeding behaviour have suggested that the laissez-faire style is most frequently observed among families and communities with a higher prevalence of malnourished children. Nutrition interventions that have been able to show significant effects on outcomes, such as the Hearth Model in Vietnam (Sternin et al. 1997), have usually incorporated behavioural components in their intervention. At this time, there have been no tests of the efficacy of behavioural interventions to improve feeding practices. Research is needed to understand behavioural factors in complementary feeding, and to identify and test intervention strategies designed to improve nutrient intake of young children. Finally, the paper concludes with a discussion of how nutrition programmes might change if care were incorporated.

  7. Protein and energy supplementation in elderly people at risk from malnutrition.

    Science.gov (United States)

    Milne, Anne C; Potter, Jan; Vivanti, Angela; Avenell, Alison

    2009-04-15

    Evidence for the effectiveness of nutritional supplements containing protein and energy, often prescribed for older people, is limited. Malnutrition is more common in this age group and deterioration of nutritional status can occur during illness. It is important to establish whether supplementing the diet is an effective way of improving outcomes for older people at risk from malnutrition. This review examined trials for improvement in nutritional status and clinical outcomes when extra protein and energy were provided, usually as commercial 'sip-feeds'. We searched The Cochrane Library, MEDLINE, EMBASE, Healthstar, CINAHL, BIOSIS, CAB abstracts. We also hand searched nutrition journals and reference lists and contacted 'sip-feed' manufacturers. Randomised and quasi-randomised controlled trials of oral protein and energy supplementation in older people, with the exception of groups recovering from cancer treatment or in critical care. Two reviewers independently assessed trials prior to inclusion and independently extracted data and assessed trial quality. Authors of trials were contacted for further information as necessary. Sixty-two trials with 10,187 randomised participants have been included in the review. Maximum duration of intervention was 18 months. Most included trials had poor study quality. The pooled weighted mean difference (WMD) for percentage weight change showed a benefit of supplementation of 2.2% (95% confidence interval (CI) 1.8 to 2.5) from 42 trials. There was no significant reduction in mortality in the supplemented compared with control groups (relative risk (RR) 0.92, CI 0.81 to 1.04) from 42 trials. Mortality results were statistically significant when limited to trials in which participants (N = 2461) were defined as undernourished (RR 0.79, 95% CI 0.64 to 0.97).The risk of complications was reduced in 24 trials (RR 0.86, 95% CI 0.75 to 0.99). Few trials were able to suggest any functional benefit from supplementation. The WMD for length

  8. Position of the Academy of Nutrition and Dietetics: nutrition services for individuals with intellectual and developmental disabilities and special health care needs.

    Science.gov (United States)

    Ptomey, Lauren T; Wittenbrook, Wendy

    2015-04-01

    It is the position of the Academy of Nutrition and Dietetics that nutrition services provided by registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered (NDTRs), who work under RDN supervision, are essential components of comprehensive care for adults with intellectual and developmental disabilities (IDD) and children and youth with special health care needs (CYSHCN). Nutrition services should be provided throughout life in a manner that is interdisciplinary, family-centered, community based, and culturally competent. Individuals with IDD and CYSHCN have many risk factors requiring nutrition interventions, including growth alterations (eg, failure to thrive, obesity, or growth retardation), metabolic disorders, poor feeding skills, drug-nutrient interactions, and sometimes partial or total dependence on enteral or parenteral nutrition. Furthermore, these individuals are also more likely to develop comorbid conditions, such as obesity or endocrine disorders that require nutrition interventions. Poor nutrition-related health habits, limited access to services, and long-term use of multiple medications are considered health risk factors. Timely and cost-effective nutrition interventions can promote health maintenance and reduce risk and cost of comorbidities and complications. Public policy for individuals with IDD and CYSHCN has evolved, resulting in a transition from institutional facilities and programs to community and independent living. The expansion of public access to technology and health information on the Internet challenges RDNs and NDTRs to provide accurate scientific information to this rapidly growing and evolving population. RDNs and NDTRs with expertise in this area are best prepared to provide appropriate nutrition information to promote wellness and improve quality of life. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  9. Use of Nutrition Supplements for the Elderly

    OpenAIRE

    Tenglerová, Dana

    2014-01-01

    The primary goal of my thesis was to describe the use of food supplements by seniors. Most seniors use medications prescribed by physicians and some of them also use over-the-counter food supplements that are more easily accessible. Seniors, in particular, are susceptible to considering food supplements to be as efficient as medications under the incessant influence of massive advertising on TV and other media, and many of them are willing to spend considerable amounts from their income on su...

  10. Delivering Summer Electronic Benefit Transfers for Children through the Supplemental Nutrition Assistance Program or the Special Supplemental Nutrition Program for Women, Infants, and Children: Benefit Use and Impacts on Food Security and Foods Consumed.

    Science.gov (United States)

    Gordon, Anne R; Briefel, Ronette R; Collins, Ann M; Rowe, Gretchen M; Klerman, Jacob A

    2017-03-01

    The Summer Electronic Benefit Transfers for Children (SEBTC) demonstration piloted summer food assistance through electronic benefit transfers (EBTs), providing benefits either through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) or the Supplemental Nutrition Assistance Program (SNAP) EBT. To inform food assistance policy and describe how demonstrations using WIC and SNAP models differed in benefit take-up and impacts on food security and children's food consumption. Sites chose to deliver SEBTC using the SNAP or WIC EBT system. Within each site, in 2012, households were randomly assigned to a benefit group or a no-benefit control group. Grantees (eight states and two Indian Tribal Organizations) selected school districts serving many low-income children. Schoolchildren were eligible in cases where they had been certified for free or reduced-price meals during the school year. Before the demonstration, households in the demonstration sample had lower incomes and lower food security, on average, than households with eligible children nationally. Grantees provided selected households with benefits worth $60 per child per summer month using SNAP or WIC EBT systems. SNAP-model benefits covered most foods. WIC-model benefits could only be used for a specific package of foods. Key outcomes were children's food security (assessed using the US Department of Agriculture food security scale) and food consumption (assessed using food frequency questions). Differences in mean outcomes between the benefit and control groups measured impact, after adjusting for household characteristics. In WIC sites, benefit-group households redeemed a lower percentage of SEBTC benefits than in SNAP sites. Nonetheless, the benefit groups in both sets of sites had similar large reductions in very low food security among children, relative to no-benefit controls. Children receiving benefits consumed more healthful foods, and these impacts were larger in WIC

  11. Discovering the link between nutrition and skin aging

    OpenAIRE

    Schagen, Silke K.; Zampeli, Vasiliki A.; Makrantonaki, Evgenia; Zouboulis, Christos C.

    2012-01-01

    Skin has been reported to reflect the general inner-health status and aging. Nutrition and its reflection on skin has always been an interesting topic for scientists and physicians throughout the centuries worldwide. Vitamins, carotenoids, tocopherols, flavonoids and a variety of plant extracts have been reported to possess potent anti-oxidant properties and have been widely used in the skin care industry either as topically applied agents or oral supplements in an attempt to prolong youthful...

  12. 7 CFR 247.18 - Nutrition education.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Nutrition education. 247.18 Section 247.18 Agriculture... CHILD NUTRITION PROGRAMS COMMODITY SUPPLEMENTAL FOOD PROGRAM § 247.18 Nutrition education. (a) What are the State agency's responsibilities in ensuring that nutrition education is provided? The State agency...

  13. Becoming Food Aware in Hospital: A Narrative Review to Advance the Culture of Nutrition Care in Hospitals.

    Science.gov (United States)

    Laur, Celia; McCullough, James; Davidson, Bridget; Keller, Heather

    2015-06-01

    The Nutrition Care in Canadian Hospitals (2010-2013) study identified the prevalence of malnutrition on admission to medical and surgical wards as 45%. Nutrition practices in the eighteen hospitals, including diagnosis, treatment and monitoring of malnourished patients, were ad hoc. This lack of a systematic approach has demonstrated the need for the development of improved processes and knowledge translation of practices aimed to advance the culture of nutrition care in hospitals. A narrative review was conducted to identify literature that focused on improved care processes and strategies to promote the nutrition care culture. The key finding was that a multi-level approach is needed to address this complex issue. The organization, staff, patients and their families need to be part of the solution to hospital malnutrition. A variety of strategies to promote the change in nutrition culture have been proposed in the literature, and these are summarized as examples for others to consider. Examples of strategies at the organizational level include developing policies to support change, use of a screening tool, protecting mealtimes, investing in food and additional personnel (healthcare aides, practical nurses and/or diet technicians) to assist patients at mealtimes. Training for hospital staff raises awareness of the issue, but also helps them to identify their role and how it can be modified to improve nutrition care. Patients and families need to be aware of the importance of food to their recovery and how they can advocate for their needs while in hospital, as well as post-hospitalization. It is anticipated that a multi-level approach that promotes being "food aware" for all involved will help hospitals to achieve patient-centred care with respect to nutrition.

  14. Nutritional self-care among a group of older home-living people in rural Southern Norway

    Directory of Open Access Journals (Sweden)

    Dale B

    2015-01-01

    Full Text Available Bjørg Dale, Ulrika SöderhamnCentre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, NorwayBackground: Older home-living people are an at-risk group for undernutrition, particularly those who are living alone. Lack of knowledge about healthy dietary habits, altered taste sensation, and declined health status are shown to be some of the factors related to undernutrition. The aims of this study were to explore how a small group of older people in Southern Norway perceived their nutritional self-care.Methods: An exploratory qualitative approach, combined with a simple self-report questionnaire, was used. Five persons living in rural areas in Southern Norway, who in a former study were screened and found to be at risk for undernutrition, participated. Qualitative data assessed by means of individual self-care talks in the persons' own homes were analyzed using directed content analysis. A simple self-report questionnaire containing demographic variables, two health-related questions, and the Nutritional Form For the Elderly (NUFFE-NO instrument was filled out at baseline and 6 months after the self-care talks.Results: The qualitative data showed that the participants had adequate knowledge about healthy and nutritious diets. They were aware of and motivated to adapt their diet to their current state of health and to perform the necessary actions to maintain an optimal nutritional status and nutritional self-care.Conclusion: Older people living at home are a diverse group. However, this study showed that they may have sufficient knowledge, willingness, and ability to perform nutritional self-care, even if they live alone and have several chronic illnesses and impaired health.Keywords: adapting, decision-making, knowledge, self-care talks

  15. Parenteral nutrition in the ICU setting: need for a shift in utilization.

    Science.gov (United States)

    Oshima, Taku; Hiesmayr, Michael; Pichard, Claude

    2016-03-01

    The difficulties to feed the patients adequately with enteral nutrition alone have drawn the attention of the clinicians toward the use of parenteral nutrition, although recommendations by the recent guidelines are conflicting. This review focuses on the intrinsic role of parenteral nutrition, its new indication, and modalities of use for the critically ill patients. A recent trial demonstrated that selecting either parenteral nutrition or enteral nutrition for early nutrition has no impact on clinical outcomes. However, it must be acknowledged that the risk of relative overfeeding is greater when using parenteral nutrition and the risk of underfeeding is greater when using enteral nutrition because of gastrointestinal intolerance. Both overfeeding and underfeeding in the critically ill patients are associated with deleterious outcomes. Thus, early and adequate feeding according to the specific energy needs can be recommended as the optimal feeding strategy. Parenteral nutrition can be used to substitute or supplement enteral nutrition, if adequately prescribed. Testing for enteral nutrition tolerance during 2-3 days after ICU admission provides the perfect timing to start parenteral nutrition, if needed. In case of absolute contraindication for enteral nutrition, consider starting parenteral nutrition carefully to avoid overfeeding.

  16. Nutritional care routines in Italy: results from the PIMAI (Project: Iatrogenic MAlnutrition in Italy) study.

    Science.gov (United States)

    Cereda, E; Lucchin, L; Pedrolli, C; D'Amicis, A; Gentile, M G; Battistini, N C; Fusco, M A; Palmo, A; Muscaritoli, M

    2010-08-01

    Disease-related malnutrition is a common comorbidity at hospital admission. The purpose of the present report was to describe the data on nutritional care routines collected during the Project: Iatrogenic MAlnutrition in Italy (PIMAI) study, as these may be helpful to avoid iatrogenic malnutrition and improve nutritional policies. Standards of nutritional care were assessed on the basis of (1) adherence to study protocol (completeness of data collected); (2) attitude in assessing the nutritional status; (3) prescription of nutritional therapy (within 3 days) at least in patients presenting with overt malnutrition (body mass index (BMI) or=10% in 3 months and/or >or=5% in the last month)), regardless of its adequacy, and adherence to current guidelines and (4) attitude in monitoring nutritional status during the stay (number of weight measurements performed compared with those expected). In total, 1583 subjects were assessed. A minimum data set for performing the Nutritional Risk Screening 2002 tool was available in 1284 patients (81.1%), but nutritional screening was possible in every patient by alternative analytical criteria related to food intake, anthropometry and biochemistry. However, several missing values were recorded, particularly in biochemical parameters due to lack of prescription by admission wards. According to ward practices, only 38.2% of the patients had the BMI calculated. A nutritional support was prescribed only to 26/191 patients (13.6%) presenting with overt malnutrition. Finally, we recorded that only 21.6% of the patients (207/960 were randomly selected) had their weight monitored on a scheduled basis. This reality was worse in surgical rather than medical departments (17 vs 26%; P<0.001). Present results confirm that in Italy, nutritional care routines are still poor and need improvements.

  17. Nutritional Supplement of Hatchery Eggshell Membrane Improves Poultry Performance and Provides Resistance against Endotoxin Stress.

    Directory of Open Access Journals (Sweden)

    S K Makkar

    Full Text Available Eggshells are significant part of hatchery waste which consist of calcium carbonate crust, membranes, and proteins and peptides of embryonic origins along with other entrapped contaminants including microbes. We hypothesized that using this product as a nutritional additive in poultry diet may confer better immunity to the chickens in the paradigm of mammalian milk that enhances immunity. Therefore, we investigated the effect of hatchery eggshell membranes (HESM as a short term feed supplement on growth performance and immunity of chickens under bacterial lipopolysaccharide (LPS challenged condition. Three studies were conducted to find the effect of HESM supplement on post hatch chickens. In the first study, the chickens were fed either a control diet or diets containing 0.5% whey protein or HESM as supplement and evaluated at 5 weeks of age using growth, hematology, clinical chemistry, plasma immunoglobulins, and corticosterone as variables. The second and third studies were done to compare the effects of LPS on control and HESM fed birds at 5 weeks of age following at 4 and 24 h of treatment where the HESM was also sterilized with ethanol to deplete bacterial factors. HESM supplement caused weight gain in 2 experiments and decreased blood corticosterone concentrations. While LPS caused a significant loss in body weight at 24 h following its administration, the HESM supplemented birds showed significantly less body weight loss compared with the control fed birds. The WBC, heterophil/lymphocyte ratio, and the levels of IgG were low in chickens fed diets with HESM supplement compared with control diet group. LPS challenge increased the expression of pro-inflammatory cytokine gene IL-6 but the HESM fed birds showed its effect curtailed, also, which also, favored the up-regulation of anti-inflammatory genes compared with control diet fed chickens. Post hatch supplementation of HESM appears to improve performance, modulate immunity, and increase

  18. Contribution of nitrogen derived from mineral supplementation for soybean seedlings

    Directory of Open Access Journals (Sweden)

    Gerusa Massuquini Conceição

    Full Text Available ABSTRACT Seeds can absorb N from mineral supplementation, thus stimulating seedling development in soybeans (Glycine max (L. Merrill. This study aimed to evaluate the contribution to soybean seedlings of N derived from mineral supplementation in seeds with different nutritional contents. Seeds of the cultivar BMX Potência RR received mineral supplementation enriched with 2.5% excess 15N. The treatments were performed in seeds in two lots, one with high and one with low nutritional content. At 2, 6 and 10 days after sowing on paper towels, the seedlings were collected and separated into cotyledons, roots and shoots. Dry matter production, root length and root volume were assessed. Total N and 15N values were analyzed in the seedling organ tissues. The seeds from the lot with lower nutritional content absorbed more N from the mineral supplement, which was accumulated in the cotyledons and redistributed to the root systems and cotyledons. At 10 days after sowing, most of the N in the organs of soybean seedlings was derived from the seed reserves, regardless of nutritional content. Thus, application of N through mineral supplementation is of low importance for the development and nutrition of seedlings.

  19. Supplementation prevalence and adverse effects in physical exercise practitioners.

    Science.gov (United States)

    da Silva, Walkíria Valeriano; de Andrade Gomes Silva, Maria Irene; Tavares Toscano, Luciana; Dantas de Oliveira, Klébya Hellen; de Lacerda, Lavoisiana Mateus; Sérgio Silva, Alexandre

    2014-01-01

    The use of nutritional supplements is prevalent among physical exercise practitioners and some adverse effects have been reported, however not sufficiently substantial, because they originate from isolated cases. Investigate nutritional supplements consumption prevalence and adverse effects of the use of such products. An epidemiological, representative and transversal study, with 180 physical exercise practitioners in gyms, who answered questionnaires about sports supplementation, associated factors and self-perceived adverse effects. In a subsample of 86 individuals, blood pressure was measured and blood was collected for the evaluation of lipid profile markers, hepatic and renal function. The supplementation prevalence level was 58.3%, whereas the physicians and nutritionists indicated only 21.9%. The reported adverse effects were observed only by supplement users (acne, insomnia, aggressiveness, headaches and tachycardia). Systolic blood pressure was higher in the supplemented group when compared to the control group (p = 0.04), as in the subgroup of thermogenic users (p nutritional supplements without specialized orientation was elevated among physical exercise practitioners, being associated to adverse effects both by the users themselves and by clinical diagnosis.

  20. Supplementation of total parenteral nutrition with butyrate acutely increases structural aspects of intestinal adaptation after an 80% jejunoileal resection in neonatal piglets

    DEFF Research Database (Denmark)

    Bartholome, Anne L; Albin, David M; Baker, David H

    2004-01-01

    BACKGROUND: Supplementation of total parenteral nutrition (TPN) with a mixture of short-chain fatty acids (SCFA) enhances intestinal adaptation in the adult rodent model. However, the ability and timing of SCFA to augment adaptation in the neonatal intestine is unknown. Furthermore, the specific...

  1. Evaluation of Online and In-Person Nutrition Education Related to Salt Knowledge and Behaviors among Special Supplemental Nutrition Program for Women, Infants, and Children Participants.

    Science.gov (United States)

    Au, Lauren E; Whaley, Shannon E; Gurzo, Klara; Meza, Martha; Rosen, Nila J; Ritchie, Lorrene D

    2017-09-01

    The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) differs from other federal nutrition programs in that nutrition education is a required component. WIC programs traditionally provide in-person education, but recently some WIC sites have started offering online education. Education focused on reducing salt intake is an important topic for WIC participants because a high-sodium diet has been associated with high blood pressure, and low-income populations are at increased risk. Our aim was to examine the impacts of traditional in-person and online nutrition education on changes in knowledge, self-efficacy, and behaviors related to reducing salt intake in low-income women enrolled in WIC. Although a comparison of groups was not the primary focus, a randomized trial examining the impact of online and in-person nutrition education on participant knowledge, self-efficacy, and behaviors related to salt intake was conducted. Five hundred fourteen WIC participants from three Los Angeles, CA, WIC clinics received either in-person (n=257) or online (n=257) education. Questionnaires assessing salt-related knowledge, self-efficacy, and behaviors were administered at baseline and 2 to 4 months and 9 months later from November 2014 through October 2015. Positive changes in knowledge and self-efficacy were retained 2 to 4 months and 9 months later for both groups (Peducation resulted in improvements during a 9-month period in knowledge, self-efficacy, and reported behaviors associated with reducing salt intake in a low-income population. Offering an online education option for WIC participants could broaden the reach of nutrition education and lead to long-term positive dietary changes. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  2. Use of nutritional supplements by Danish elite athletes and fitness customers

    DEFF Research Database (Denmark)

    Solheim, Sara Amalie; Nordsborg, Nikolai Baastrup; Ritz, Christian

    2017-01-01

    The nutritional supplement (NS) industry is one of the fastest growing in the world, and NS use in Denmark is among the highest in Europe. However, the exact use in elite athletes and fitness customers targeted for doping control is unknown. Information from 634 doping control forms obtained...... an association between NS and doping abuse. The present results demonstrate a very high prevalence of NS usage in both elite athletes and fitness customers. This highlights the importance of a strong national regulation of NS to avoid contamination of NS with doping substances....... in 2014 was evaluated (elite athletes: n = 361; fitness customers: n = 273). The majority of female (92.6%) and male (85.0%) elite athletes and female (100.0%) and male (94.0%) fitness customers declared using one or more NS. The use of non-ergogenic NS was more prevalent in women than in men...

  3. FEATURES OF INTENSIVE NUTRITIONAL SUPPORT OF PREMATURE INFANTS IN INTENSIVE CARE UNIT (PART 1

    Directory of Open Access Journals (Sweden)

    K.V. Romanenko

    2011-01-01

    Full Text Available The article presents the modern approaches to preterm infants feeding, principles of parenteral and enteral nutrition. The importance of adequate control of deficit status in preterm infants at different periods of developmental care is marked. Arguments for using the enriched milk or specialized formulas for prematurity during the in-clinic and out-clinic periods of care are provided.Key words: premature infants, enteral nutrition, formulas for premature infants, breast milk, breast milk enriches.

  4. Nutritional screening for improving professional practice for patient outcomes in hospital and primary care settings.

    Science.gov (United States)

    Omidvari, Amir-Houshang; Vali, Yasaman; Murray, Susan M; Wonderling, David; Rashidian, Arash

    2013-06-06

    Given the prevalence of under-nutrition and reports of inadequate nutritional management of patients in hospitals and the community, nutritional screening may play a role in reducing the risks of malnutrition. Screening programmes can invoke costs to health systems and patients. It is therefore important to assess the effectiveness of nutritional screening programmes. To examine the effectiveness of nutritional screening in improving quality of care (professional practice) and patient outcomes compared with usual care. We searched the following databases: CENTRAL (The Cochrane Library), MEDLINE, EMBASE and CINAHL up to June 2012 to find relevant studies. Randomised controlled studies, controlled clinical trials, controlled before-after studies and interrupted time series studies assessing the effectiveness of nutritional screening were eligible for inclusion in the review. We considered process outcomes (for example patient identification, referral to dietitian) and patient outcomes (for example mortality, change in body mass index (BMI)). Participants were adult patients aged 16 years or over. We included studies conducted in different settings, including hospitals, out-patient clinics, primary care or long term care settings. We independently assessed the risk of bias and extracted data from the included studies. Meta-analysis was considered but was not conducted due to the discrepancies between the studies. The studies were heterogeneous in their design, setting, intervention and outcomes. We analysed the data using a narrative synthesis approach. After conducting initial searches and screening the titles and abstracts of the identified literature, 77 full text papers were retrieved and read. Ultimately three studies were included. Two controlled before-after studies were conducted in hospital settings (one in the UK and one in the Netherlands) and one cluster randomised controlled trial was conducted in a primary care setting (in the USA).The study conducted in

  5. A critical look at medical nutrition terminology and definitions,

    NARCIS (Netherlands)

    Claassen, E.; Weenen, T.C.; Commandeur, H

    2014-01-01

    A plethora of terms and definitions for medical nutrition has resulted in an ambiguity in the way "medical nutrition" is termed and defined across various societal levels. The terms medical nutrition, clinical nutrition, enteral nutrition, parenteral nutrition, oral nutritional supplements, medical

  6. Becoming Food Aware in Hospital: A Narrative Review to Advance the Culture of Nutrition Care in Hospitals

    Directory of Open Access Journals (Sweden)

    Celia Laur

    2015-06-01

    Full Text Available The Nutrition Care in Canadian Hospitals (2010–2013 study identified the prevalence of malnutrition on admission to medical and surgical wards as 45%. Nutrition practices in the eighteen hospitals, including diagnosis, treatment and monitoring of malnourished patients, were ad hoc. This lack of a systematic approach has demonstrated the need for the development of improved processes and knowledge translation of practices aimed to advance the culture of nutrition care in hospitals. A narrative review was conducted to identify literature that focused on improved care processes and strategies to promote the nutrition care culture. The key finding was that a multi-level approach is needed to address this complex issue. The organization, staff, patients and their families need to be part of the solution to hospital malnutrition. A variety of strategies to promote the change in nutrition culture have been proposed in the literature, and these are summarized as examples for others to consider. Examples of strategies at the organizational level include developing policies to support change, use of a screening tool, protecting mealtimes, investing in food and additional personnel (healthcare aides, practical nurses and/or diet technicians to assist patients at mealtimes. Training for hospital staff raises awareness of the issue, but also helps them to identify their role and how it can be modified to improve nutrition care. Patients and families need to be aware of the importance of food to their recovery and how they can advocate for their needs while in hospital, as well as post-hospitalization. It is anticipated that a multi-level approach that promotes being “food aware” for all involved will help hospitals to achieve patient-centred care with respect to nutrition.

  7. Effects on anthropometry and appetite of vitamins and minerals given in lipid nutritional supplements for malnourished HIV-infected adults referred for antiretroviral therapy

    DEFF Research Database (Denmark)

    Rehman, Andrea M; Woodd, Susannah; PrayGod, George

    2015-01-01

    in malnourished patients starting ART and that vitamin and mineral supplementation would improve appetite and permit nutritional recovery. DESIGN:: The randomised controlled Nutritional Support for Africans Starting Antiretroviral Therapy (NUSTART) trial was conducted in Mwanza, Tanzania and Lusaka, Zambia. ART......-upper-arm circumference. CONCLUSIONS:: Provision of high levels of vitamins and minerals to patients referred for ART, delivered with substantial macronutrients, increased nutritional recovery but did not appear to act through treatment group differences in appetite.This is an open access article distributed under......BACKGROUND:: The evidence base for effects of nutritional interventions for malnourished HIV-infected patients starting antiretroviral therapy (ART) is limited and inconclusive. OBJECTIVE:: We hypothesised that both vitamin and mineral deficiencies and poor appetite limit weight gain...

  8. Cost-effectiveness Analysis of Nutritional Support for the Prevention of Pressure Ulcers in High-Risk Hospitalized Patients.

    Science.gov (United States)

    Tuffaha, Haitham W; Roberts, Shelley; Chaboyer, Wendy; Gordon, Louisa G; Scuffham, Paul A

    2016-06-01

    To evaluate the cost-effectiveness of nutritional support compared with standard care in preventing pressure ulcers (PrUs) in high-risk hospitalized patients. An economic model using data from a systematic literature review. A meta-analysis of randomized controlled trials on the efficacy of nutritional support in reducing the incidence of PrUs was conducted. Modeled cohort of hospitalized patients at high risk of developing PrUs and malnutrition simulated during their hospital stay and up to 1 year. Standard care included PrU prevention strategies, such as redistribution surfaces, repositioning, and skin protection strategies, along with standard hospital diet. In addition to the standard care, the intervention group received nutritional support comprising patient education, nutrition goal setting, and the consumption of high-protein supplements. The analysis was from a healthcare payer perspective. Key outcomes of the model included the average costs and quality-adjusted life years. Model results were tested in univariate sensitivity analyses, and decision uncertainty was characterized using a probabilistic sensitivity analysis. Compared with standard care, nutritional support was cost saving at AU $425 per patient and marginally more effective with an average 0.005 quality-adjusted life years gained. The probability of nutritional support being cost-effective was 87%. Nutritional support to prevent PrUs in high-risk hospitalized patients is cost-effective with substantial cost savings predicted. Hospitals should implement the recommendations from the current PrU practice guidelines and offer nutritional support to high-risk patients.

  9. The IAEA Supports Member States’ Nutrition Programmes: What They Have to Say

    International Nuclear Information System (INIS)

    Ouedraogo, Jean-Bosco; Medoua, Gabriel; Hernandez Triana, Manuel; Kurpad, Anura; Aguenaou, Hassan; Elmanchawy, Imane; Winichagoon, Pattanee; Wade, Salimata; Diop, Cheikh Anta

    2014-01-01

    The following programmes are briefly described: IAEA Capacity Building in Burkina Faso; Building the Capacity to Evaluate Vitamin A Supplementation Programmes in Cameroon; Isotope Studies in Cuba Influence the National Nutrition Recommendations; The IAEA’s Collaborating Centre in Nutrition in Bangalore, India; Promoting Good Nutrition through Isotope Techniques in Morocco; Improving Nutrition in Thailand; IAEA-Supported Studies Influence Nutrition Supplementation Policy in Senegal

  10. The IAEA Supports Member States’ Nutrition Programmes: What They Have to Say

    Energy Technology Data Exchange (ETDEWEB)

    Ouedraogo, Jean-Bosco [IRSS (Burkina Faso); Medoua, Gabriel [Centre for Food and Nutrition Research, Yaoundé (Cameroon); Hernandez Triana, Manuel [Institute of Nutrition and Food Hygiene, Havana (Cuba); Kurpad, Anura [St John’s Research Institute, Bangalore (India); Aguenaou, Hassan; Elmanchawy, Imane [Joint Unit for Nutrition and Food Research at Ibn Tofaïl University, National Centre for Nuclear Energy, Sciences and Technology (CNESTEN) (Morocco); Winichagoon, Pattanee [Mahidol University, Bangkok (Thailand); Wade, Salimata; Diop, Cheikh Anta [University, Dakar (Senegal)

    2014-03-15

    The following programmes are briefly described: IAEA Capacity Building in Burkina Faso; Building the Capacity to Evaluate Vitamin A Supplementation Programmes in Cameroon; Isotope Studies in Cuba Influence the National Nutrition Recommendations; The IAEA’s Collaborating Centre in Nutrition in Bangalore, India; Promoting Good Nutrition through Isotope Techniques in Morocco; Improving Nutrition in Thailand; IAEA-Supported Studies Influence Nutrition Supplementation Policy in Senegal.

  11. Becoming Food Aware in Hospital: A Narrative Review to Advance the Culture of Nutrition Care in Hospitals

    OpenAIRE

    Laur, Celia; McCullough, James; Davidson, Bridget; Keller, Heather

    2015-01-01

    The Nutrition Care in Canadian Hospitals (2010–2013) study identified the prevalence of malnutrition on admission to medical and surgical wards as 45%. Nutrition practices in the eighteen hospitals, including diagnosis, treatment and monitoring of malnourished patients, were ad hoc. This lack of a systematic approach has demonstrated the need for the development of improved processes and knowledge translation of practices aimed to advance the culture of nutrition care in hospitals. A narrativ...

  12. Pressure ulcer care: nutritional therapy need not add to costs.

    NARCIS (Netherlands)

    Schols, J.M.G.A.; Kleijer, C.N.; Lourens, C.

    2003-01-01

    Fewer patients with pressure ulcers in Dutch nursing homes receive nutritional therapy via sip feeds, possibly because of cost concerns. But this therapy would not cost more if it reduced the duration of nursing care by even one day, this paper argues.

  13. AN ETHNOGRAPHY STUDY OF NUTRITIONAL CONDITIONS OF PREGNANT WOMEN IN BANTEN INDONESIA

    Directory of Open Access Journals (Sweden)

    Setyowati

    2010-06-01

    Full Text Available Maternal mortality in childbirth in developing countries is still high. The study describes the qualitative methods used to examine the knowledge, attitude, beliefs and behaviour related to nutrition and nutritional supplementation of pregnant women. The role of village midwives and cadres’ in relation to nutrition education resulted in improving nutritional behaviour of pregnant women to some extent, but poverty and culture restricted the ability of pregnant women to access better food. The study shows that the position of pregnant woman is low within the hierarchy of both the health care system and the power structures of the broader community. Husbands, mothers-in-law, village midwives, cadres and village leaders all have more power in determining nutrition during pregnancy. However, some women tried to eat better and more nutritious food in secret, thereby subverting culture and the authority of husbands and mothers-in-law.

  14. Efficacy of a multi-component exercise programme and nutritional supplementation on musculoskeletal health in men treated with androgen deprivation therapy for prostate cancer (IMPACT): study protocol of a randomised controlled trial.

    Science.gov (United States)

    Owen, Patrick J; Daly, Robin M; Livingston, Patricia M; Mundell, Niamh L; Dalla Via, Jack; Millar, Jeremy L; Fraser, Steve F

    2017-10-03

    Prostate cancer is the most commonly diagnosed cancer in men in developed countries. Androgen deprivation therapy (ADT) is a systemic treatment shown to increase survival in selected patients with prostate cancer. The use of ADT continues to increase for all stages and grades of prostate cancer despite known treatment-induced adverse effects. The primary aim of this study is to examine the efficacy of a targeted, multi-component resistance and impact-loading exercise programme together with a daily protein-, calcium- and vitamin D-enriched supplement on bone health in men treated with ADT for prostate cancer. Secondary aims are to determine the effects of this intervention on measures of total body and regional body composition, cardiometabolic risk, inflammatory markers, health-related quality of life and cognitive function. This study is a two-arm randomised controlled trial. Men currently treated with ADT for prostate cancer will be randomised to either a 52-week, community-based, exercise training and nutritional supplementation intervention (n = 51) or usual care control (n = 51). Participants will be assessed at baseline, 26 weeks and 52 weeks for all measures. The primary outcome measures are proximal femur and lumbar spine areal bone mineral density (BMD). Secondary outcomes comprise: changes in tibial and radial bone structure and strength, total body and regional body composition, muscle strength and function, as well as cardiometabolic health, catabolic/inflammatory and anabolic/anti-inflammatory cytokines, health-related quality of life and cognitive function. This study investigates whether a multi-component intervention incorporating a targeted bone and muscle-loading programme in combination with a protein-, calcium- and vitamin D-enriched supplement can ameliorate multiple adverse effects of ADT when compared to usual care. The results will contribute to the development of exercise training and nutrition guidelines for optimising overall

  15. Nutritional Patterns in Pregnant Women Referred to Yasuj Health Care Centers

    Directory of Open Access Journals (Sweden)

    Seyed Mohammad Amin Rezaei

    2017-12-01

    Full Text Available Background: The quality and quantity of nutrition during pregnancy is very important. This study aimed at determining the nutritional patterns in pregnant women referred to Yasuj Health Care Centers. Methods: In this cross-sectional study, 360 pregnant women in the third trimester of pregnancy referred to Yasuj Health Care Centers were enrolled. FFQ questionnaire was used to determine the nutritional patterns. Results: The mean age was 26.4±4.9 years. Totally, 67.2% of pregnant women used frying as the method of cooking. Solid oils were used for cooking in 21.7% of participants. Monthly consumption of carbonated beverages was higher than milk and 67.5% of women received more and 24.2% received less calories than needed and only 8.3% received calories equivalent to their need. Totally, 81.1%, 63.3%, 55% 48.9%, and 83.9% iron, zinc, calcium, magnesium and folate were less than recommendation by the RDA, respectively. Conclusion: The result of the present study revealed that the intakes of fruits, vegetables and some micronutrients such as iron, zinc, calcium, magnesium and folate were less than recommendations in pregnant women in Yasuj. But fat intake and the intakes of food items in miscellaneous group were more than the recommendations. Nutritional educational programs seems necessary in order to create a healthy and desirable food pattern in this group.

  16. Effect of nutritional support on terminally ill patients with cancer in a palliative care unit.

    Science.gov (United States)

    Amano, Koji; Morita, Tatsuya; Baba, Mika; Kawasaki, Muneyoshi; Nakajima, Shinichiro; Uemura, Minako; Kobayashi, Yuka; Hori, Moeko; Wakayama, Hiroshi

    2013-11-01

    The role of nutritional support on terminally ill patients with cancer in a palliative care unit has not been clarified. A total of 63 patients were retrospectively investigated; the patients receiving individualized nutritional support (intervention group [n = 22]) were compared to the others (control group [n = 41]). The intervention group received individualized nutritional support. There were no significant differences in the characteristics of patients between the groups. The prevalence of bedsores was significantly lower in the intervention group (14% vs 46%, P = .012). The prevalence of edema and the use of antibiotic therapies tended to be lower in the intervention group than in the control group (36% vs 54%, P = .19; 14% vs 27%, P = .34, respectively). Some terminally ill patients with cancer in a palliative care unit might benefit from nutritional support.

  17. Nutritional care of Danish medical inpatients: Effect on dietary intake and the occupational groups' perspectives of intervention

    Directory of Open Access Journals (Sweden)

    Jensen Lillian

    2004-09-01

    Full Text Available Abstract Background Many patients do not eat and drink sufficiently during hospitalisation. The clinical consequences of this under nutrition include lassitude, an increased risk of complications and prolonged convalescence. The aim of the study was 1 to introduce intervention targeting nutritional care for medical inpatients, 2 to investigate the effect of this intervention, and 3 to investigate the occupational groups' attitudes towards nutritional intervention and nutritional care in general. Methods The design was to determinate the extent to which the protein and energy requirements of medical inpatients were met before and after intervention. Dietary protein and energy intakes were assessed by 72-hour weighed food records. A total number of 108 medical patients at four bed sections and occupational groups in the two intervention bed sections, Aarhus University Hospital, Denmark participated. The intervention included introduction and implementation of nursing procedures targeting nutritional care during a five-month investigation period using standard food produced at the hospital. The effect of intervention for independent groups of patients were tested by one-way analysis of variance. After the intervention occupational groups were interviewed in focus groups. Results Before the intervention hospital food on average met 72% of the patients' protein requirement and 85% of their energy requirement. After intervention hospital food satisfied 85% of the protein and 103% of the energy requirements of 14 patients in one intervention section and 56% of the protein and 76% of the energy requirement of 17 patients in the other intervention section. Hospital food satisfied 61% of the protein and 75% of the energy requirement in a total of 29 controls. From the occupational groups' point of view lack of time, lack of access to food, and lack of knowledge of nutritional care for patients were identified as barriers to better integration of

  18. Parenteral nutrition in the critically ill.

    Science.gov (United States)

    Gunst, Jan; Van den Berghe, Greet

    2017-04-01

    Feeding guidelines have recommended early, full nutritional support in critically ill patients to prevent hypercatabolism and muscle weakness. Early enteral nutrition was suggested to be superior to early parenteral nutrition. When enteral nutrition fails to meet nutritional target, it was recommended to administer supplemental parenteral nutrition, albeit with a varying starting point. Sufficient amounts of amino acids were recommended, with addition of glutamine in subgroups. Recently, several large randomized controlled trials (RCTs) have yielded important new insights. This review summarizes recent evidence with regard to the indication, timing, and dosing of parenteral nutrition in critically ill patients. One large RCT revealed no difference between early enteral nutrition and early parenteral nutrition. Two large multicenter RCTs showed harm by early supplementation of insufficient enteral nutrition with parenteral nutrition, which could be explained by feeding-induced suppression of autophagy. Several RCTs found either no benefit or harm with a higher amino acid or caloric intake, as well as harm by administration of glutamine. Although unanswered questions remain, current evidence supports accepting low macronutrient intake during the acute phase of critical illness and does not support use of early parenteral nutrition. The timing when parenteral nutrition can be initiated safely and effectively is unclear.

  19. The intensive care medicine research agenda in nutrition and metabolism

    NARCIS (Netherlands)

    Arabi, Yaseen M; Casaer, Michael P; Chapman, Marianne; Heyland, Daren K; Ichai, Carole; Marik, Paul E; Martindale, Robert G; McClave, Stephen A; Preiser, Jean-Charles; Reignier, Jean; Rice, Todd W; Van den Berghe, Greet; van Zanten, Arthur R H; Weijs, Peter J M

    PURPOSE: The objectives of this review are to summarize the current practices and major recent advances in critical care nutrition and metabolism, review common beliefs that have been contradicted by recent trials, highlight key remaining areas of uncertainty, and suggest recommendations for the top

  20. Feasibility and effect of life skills building education and multiple micronutrient supplements versus the standard of care on anemia among non-pregnant adolescent and young Pakistani women (15-24 years): a prospective, population-based cluster-randomized trial.

    Science.gov (United States)

    Baxter, Jo-Anna B; Wasan, Yaqub; Soofi, Sajid B; Suhag, Zamir; Bhutta, Zulfiqar A

    2018-05-30

    Adolescence is a critical period for physical and psychological growth and development, and vitamin and mineral requirements are correspondingly increased. Health and health behaviours correspond strongly from adolescence to adulthood. Developing a preconception care package for adolescent and young women in resource-limited settings could serve to empower them to make informed decisions about their nutrition, health, and well-being, as well as function as a platform for the delivery of basic nutrition-related interventions to address undernutrition. In this population-based two-arm, cluster-randomized, controlled trial of life skills building education (provided bi-monthly) and multiple micronutrient supplementation (provided twice-weekly; UNIMMAP composition), we aim to evaluate the effectiveness of the intervention on the prevention of anemia (hemoglobin concentration nutrition (anthropometry [height, weight, middle upper arm circumference (MUAC)], nutritional status [iron, vitamin A, vitamin D]); general health (morbidity, mortality); and empowerment (age at marriage, completion of the 10th grade, use of personal hygienic materials during menstruation) will also be assessed. Participants will be enrolled in the study for a maximum of 2 years. Empowering adolescent and young women with the appropriate knowledge to make informed and healthy decisions will be key to sustained behavioural change throughout the life-course. Although multiple micronutrient deficiencies are known to exist among adolescent and young women in low-resource settings, recommendations on preconception multiple micronutrient supplementation do not exist at this time. This study is expected to offer insight into providing an intervention that includes both education and supplements to non-pregnant adolescent and young women for a prolonged duration of time within the existing public health programmatic context. This study is part of the Matiari emPowerment and Preconception Supplementation

  1. A protocol for sustained reduction of Total Parenteral Nutrition and cost savings by improvement of nutritional care in hospitals.

    Science.gov (United States)

    van Schaik, Rian; Van den Abeele, Kurt; Melsens, Glenn; Schepens, Peter; Lanssens, Truus; Vlaemynck, Bernadette; Devisch, Maria; Niewold, Theo A

    2016-10-01

    Malnutrition and the use of Total Parenteral Nutrition (TPN) contribute considerably to hospital costs. Recently, we reported on the introduction of malnutrition screening and monitoring of TPN use in our hospital, which resulted in a large (40%) reduction in TPN and improved quality of nutritional care in two years (2011/12). Here, we aimed to assure continuation of improved care by developing a detailed malnutrition screening and TPN use protocol involving instruction tools for hospital staff, while monitoring the results in the following two years (2013/14). A TPN decision tree for follow up of TPN in patients and a TP-EN instruction card for caregivers was introduced, showing TPN/EN introduction schedules based on the energy needs of patients according to EB guidelines, also addressing the risk of refeeding syndrome. TPN patients were monitored by dietitians and TPN usage and costs were presented to the (medical) staff. Screening and treatment of malnourished patients by dietitians is simultaneously ongoing. In 2014 48% of patients, hospitalized for at least 48 h, were screened on malnutrition, 17% of them were diagnosed at risk, 7.9% malnourished and treated by dietitians. TPN usage dropped by 53% and cost savings of 51% were obtained due to 50% decrease of TPN users in 2014 versus 2010. TPN over EN ratio dropped from 2.4 in 2010 to 1.2 in 2014. Sustained improvement of nutritional care and reduction of TPN usage and costs is possible by introduction of procedures embedded in the existing structures. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  2. Self-reported use of vitamins and other nutritional supplements in adult patients with cystic fibrosis. Is daily practice in concordance with recommendations?

    NARCIS (Netherlands)

    Hollander, F.M.; Roos, de N.M.; Dopheide, J.

    2010-01-01

    Background: In cystic fibrosis (CF), prophylactic supplementation of the fat-soluble vitamins A, D, E, and K is recommended. Limited data is available describing vitamin prescription adherence by adult patients. The aim of this study was to assess the use of prescribed vitamins and other nutritional

  3. Modulation of leptin, insulin, and growth hormone in obese pony mares under chronic nutritional restriction and supplementation with ractopamine hydrochloride.

    Science.gov (United States)

    Buff, Preston R; Johnson, Philip J; Wiedmeyer, Charles E; Ganjam, Venkataseshu K; Messer Iv, Nat T; Keisler, Duane H

    2006-01-01

    Horses fed beyond their nutritional requirement and that are physically inactive will develop obesity, which is often accompanied by insulin resistance and heightened risk of laminitis. The use of pharmacologic agents in combination with nutritional restriction may promote weight loss in obese horses unable to exercise because of laminitic pain. This study shows that reducing feed intake of brome grass hay to 75% of ad libitum intake in obese pony mares reduces body weight without induced exercise. Additional supplementation of ractopamine hydrochloride for 6 weeks resulted in a tendency for increased weight loss. Subsequent modulation of obesity-associated hormones, leptin and insulin, as a result of caloric restriction was observed.

  4. Evaluation and Reauthorization of the Special Supplemental Food Program for Women, Infants, and Children (WIC). Hearings before the Committee on Agriculture, Nutrition, and Forestry, United States Senate; and the Subcommittee on Nutrition of the Committee on Agriculture, Nutrition, and Forestry, United States Senate. Ninety-Eighth Congress Second Session, March 15 and April 9, 1984.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Senate Committee on Agriculture, Nutrition, and Forestry.

    This document records hearings before the U.S. Senate Committee on Agriculture, Nutrition, and Forestry and its sub-committee on Nutrition. The hearings, dated March 15 and April 9, 1984, were conducted in order to evaluate and reauthorize the special supplemental food program for Women, Infants and Children (WIC), due to expire in 1984. Testimony…

  5. Nutrition Care for Patients with Weight Regain after Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    Carlene Johnson Stoklossa

    2013-01-01

    Full Text Available Achieving optimal weight outcomes for patients with obesity is important to the management of their chronic disease. All interventions present risks for weight regain. Bariatric surgery is the most efficacious treatment, producing greater weight losses that are sustained over more time compared to lifestyle interventions. However, approximately 20–30% of patients do not achieve successful weight outcomes, and patients may experience a regain of 20–25% of their lost weight. This paper reviews several factors that influence weight regain after bariatric surgery, including type of surgery, food tolerance, energy requirements, drivers to eat, errors in estimating intake, adherence, food and beverage choices, and patient knowledge. A comprehensive multidisciplinary approach can provide the best care for patients with weight regain. Nutrition care by a registered dietitian is recommended for all bariatric surgery patients. Nutrition diagnoses and interventions are discussed. Regular monitoring of weight status and early intervention may help prevent significant weight regain.

  6. Effectiveness of nutritional intervention in overweight women in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Nathália Luíza Ferreira

    2014-12-01

    Full Text Available Objective: To assess the effectiveness of nutritional intervention in overweight women undergoing Primary Health Care.Methods: An intervention study was conducted with overweight adult and elderly women aged 20 years or older (body mass index ≥25.0 kg/m² and ≥27.0 kg/m², respectively who were subjected to 12 months of individual nutritional monitoring. The effectiveness of the intervention was assessed by dietary, health, and anthropometric indicators.Results: Most of the 71 individuals were adults with a low income and poor level of education. After the intervention, there was an increase in number of meals and in the frequency of breakfasting. Moreover, there were more fruits and vegetables consumed, in addition to a decrease in household availability of salt, sugar, oil, and fried foods consumption. An improvement in health and weight self-perception was observed, as well as a decrease in body mass and abdominal adiposity, in particular among those participating in several consultations (n >9.Conclusion: The proposed nutritional intervention was effective and viable for improving the care of overweight individuals and those suffering from destabilized comorbidities, and may be extended to other contexts.

  7. Social Media as a Supplement to Face-to-Face Education: The Perspectives of Expanded Food and Nutrition Education Program Paraprofessionals and Graduates

    Science.gov (United States)

    Elmer, Sarah R.; Harrison, Judy A.; da Silva, Vanessa R.

    2016-01-01

    Using social media is an inexpensive, innovative approach to supplementing direct education provided by the Expanded Food and Nutrition Education Program (EFNEP). Focus group research was conducted with EFNEP paraprofessionals (n = 33) and participants (n = 39) to inform the development of a social media presence for the program. Although…

  8. Impacto da multimistura no estado nutricional de pré-escolares matriculados em creches Impact of a dietary supplement on the nutritional status of preschool children enrolled in day care centers

    Directory of Open Access Journals (Sweden)

    Susy Mary Souto de Oliveira

    2006-04-01

    Full Text Available OBJETIVO: Avaliar o impacto da suplementação da dieta com multimistura sobre o estado nutricional de crianças em fase pré-escolar em risco nutricional. MÉTODOS: Trata-se de estudo tipo duplo cego com duração de dois meses e acompanhamento longitudinal de 135 crianças na faixa etária de um a seis anos. As crianças foram divididas em três grupos: intervenção 1 (GI1 n=48, intervenção 2 (GI2 n=45 e controle (GC n=42, recebendo 5g e 10g de multimistura e placebo, respectivamente. O estado nutricional das crianças em estudo foi avaliado antes e após a suplementação. RESULTADOS: Não houve diferença significativa nos indicadores peso/idade, altura/idade e peso/altura entre os grupos estudados na linha base (p=0,251 p=0,248 e p=0,399, respectivamente. Após a intervenção a diferença na prevalência de déficit antropométrico entre os grupos também não foi significante (p=0,100 p=0,435 e p=0,210, respectivamente. A comparação das médias antes e depois da intervenção, igualmente, não demonstrou diferenças (p>0,05 utilizando os métodos estatísticos de Kruskall - Wallis e Análise de Variância. CONCLUSÃO: Frente ao impacto das pequenas quantidades consumidas de suplemento, no caso a mistura de farelo de cereais, não se justifica esperar alterações significativas sobre a recuperação de crianças em risco nutricional, já que esses suplementos contêm somente pequenas quantidades de calorias e de macro e micronutrientes.OBJECTIVE: The objective of this study was to evaluate the impact of a diet supplemented with a bran-based cereal mixture on the nutritional status of preschool children presenting nutritional risk. METHODS: This was a two-month double-blinded study with a longitudinal follow up using 135 children with ages ranging from one to six years old and divided into three groups: intervention 1 (GI1=48, intervention 2 (GI2 n=45 and control (CG n=42, receiving 5g and 10g of the multi-mixture and placebo

  9. Potential of as a Nutritional Supplement in Malnourished HIV-Infected Adults in Sub-Saharan Africa: A Randomised, Single-Blind Study

    Directory of Open Access Journals (Sweden)

    M. Azabji-Kenfack

    2011-01-01

    Full Text Available Background Malnutrition is a major global public health issue and its impact on communities and individuals is more dramatic in Sub-Saharan Africa, where it is compounded by widespread poverty and generalized high prevalence of human immunodeficiency virus (HIV. Therefore, malnutrition should be addressed through a multisectorial approach, and malnourished individuals should have access to nutritional rehabilitation molecules that are affordable, accessible, rich in nutrient and efficient. We thus assessed the efficacy of two affordable and accessible nutritional supplements, spirulina platensis versus soya beans among malnourished HIV-infected adults. Methods Undernourished patients, naïve of, but eligible to antiretroviral treatment (ART, aged 18 to 35 years were enrolled and randomly assigned to two groups. The first group received spirulina (Group A as food supplement and the second received soya beans (Group B. Patients were initiated ART simultaneously with supplements. Food supplements were auto-administered daily, the quantity being calculated according to weight to provide 1.5 g/kg body weight of proteins with 25% from supplements (spirulina and soya beans. Patients were monitored at baseline and followed-up during twelve weeks for anthropometric parameters, body composition, haemoglobin and serum albumin, CD4 count and viral load. Results Fifty-two patients were enrolled (Group A: 26 and Group B: 26. The mean age was 26.4 ± 4.9 years (Group A and 28.7 ± 4.8 (Group B with no significant difference between groups ( P = 0.10. After 12 weeks, weight and BMI significantly improved in both groups ( P < 0.001 within each group. The mean gain in weight and BMI in Group A and B were 4.8 vs. 6.5 kg, ( P = 0.68 and 1.3 vs. 1.90 Kg/m 2 , ( P = 0.82 respectively. In terms of body composition, fat free mass (FFM did not significantly increase within each group (40.5 vs. 42.2 Kg, P = 0.56 for Group A; 39.2 vs. 39.0 Kg, P = 0.22 for Group B. But

  10. Dietary supplements for football.

    Science.gov (United States)

    Hespel, P; Maughan, R J; Greenhaff, P L

    2006-07-01

    Physical training and competition in football markedly increase the need for macro- and micronutrient intake. This requirement can generally be met by dietary management without the need for dietary supplements. In fact, the efficacy of most supplements available on the market is unproven. In addition, players must be cautious of inadequate product labelling and supplement impurities that may cause a positive drug test. Nonetheless, a number of dietary supplements may beneficially affect football performance. A high endurance capacity is a prerequisite for optimal match performance, particularly if extra time is played. In this context, the potential of low-dose caffeine ingestion (2 - 5 mg . kg body mass(-1)) to enhance endurance performance is well established. However, in the case of football, care must be taken not to overdose because visual information processing might be impaired. Scoring and preventing goals as a rule requires production of high power output. Dietary creatine supplementation (loading dose: 15 - 20 g . day(-1), 4 - 5 days; maintenance dose: 2 - 5 g g . day(-1)) has been found to increase muscle power output, especially during intermittent sprint exercises. Furthermore, creatine intake can augment muscle adaptations to resistance training. Team success and performance also depend on player availability, and thus injury prevention and health maintenance. Glucosamine or chondroitin may be useful in the treatment of joint pain and osteoarthritis, but there is no evidence to support the view that the administration of these supplements will be preventative. Ephedra-containing weight-loss cocktails should certainly be avoided due to reported adverse health effects and positive doping outcomes. Finally, the efficacy of antioxidant or vitamin C intake in excess of the normal recommended dietary dose is equivocal. Responses to dietary supplements can vary substantially between individuals, and therefore the ingestion of any supplement must be assessed

  11. Caring for patients on home enteral nutrition: Reported complications by home carers and perspectives of community nurses.

    Science.gov (United States)

    Lim, Mei Ling; Yong, Bei Yi Paulynn; Mar, Mei Qi Maggie; Ang, Shin Yuh; Chan, Mei Mei; Lam, Madeleine; Chong, Ngian Choo Janet; Lopez, Violeta

    2018-07-01

    To explore the experiences of community nurses and home carers, in caring for patients on home enteral nutrition. The number of patients on home enteral nutrition is on the increase due to advancement in technology and shift in focus of providing care from acute to community care settings. A mixed-method approach was adopted. (i) A face-to-face survey design was used to elicit experience of carers of patients on home enteral nutrition. (ii) Focus group interviews were conducted with community nurses. Ninety-nine carers (n = 99) were recruited. Patient's mean age that they cared for was aged 77.7 years (SD = 11.2), and they had been on enteral feeding for a mean of 29 months (SD = 23.0). Most were bed-bound (90%) and required full assistance with their feeding (99%). Most were not on follow-up with dietitians (91%) and dentists (96%). The three most common reported gastrointestinal complications were constipation (31%), abdominal distension (28%) and vomiting (22%). Twenty community nurses (n = 20) were recruited for the focus group interviews. Four main themes emerged from the analysis: (i) challenge of accessing allied health services in the community; (ii) shorter length of stay in the acute care setting led to challenges in carers' learning and adaptation; (iii) transition gaps between hospital and home care services; and (iv) managing expectations of family. To facilitate a better transition of care for patients, adequate training for carers, standardising clinical practice in managing patients with home enteral nutrition and improving communication between home care services and the acute care hospitals are needed. This study highlighted the challenges faced by community home care nurses and carers. Results of this study would help to inform future policies and practice changes that would improve the quality of care received by patients on home enteral nutrition. © 2018 John Wiley & Sons Ltd.

  12. Nutritional status of care-dependent people with dementia in shared-housing arrangements--a one-year follow-up.

    Science.gov (United States)

    Meyer, Saskia; Gräske, Johannes; Worch, Andreas; Wolf-Ostermann, Karin

    2015-12-01

    Malnutrition in the elderly is an important nursing challenge. Persons with dementia disease are often affected by malnutrition. During recent years, shared-housing arrangements (SHA) for older care-dependent people, frequently with dementia disease, have evolved in Germany. SHA can be an alternative to traditional residential care in nursing homes. The prevalence of malnutrition in SHA is compared to the prevalence in community dwellings and lower than the prevalence of malnutrition in nursing homes. There are no scientific data about the development of the nutritional status of older care-dependent people in SHA over one year. The aim of this study is to describe the nutritional status of care-dependent people with dementia disease living in SHA and to investigate changes over a period of one year. A longitudinal study with a one-year follow-up was performed. Standardised interviews with nurses were conducted concerning nutritional status (Mini Nutritional Assessment--MNA), cognitive capacities (Mini Mental State Examination--MMSE), activities of daily living (Extended Barthel-Index--EBI) and socio-demographic characteristics. Nutritional data were available for 45 residents at baseline and 36 residents at follow-up. At baseline, 45 residents with an average age of 78.4 years living in SHA in the state of Berlin, Germany, were included in the study. Predominantly, residents were female (73.3%) and diagnosed with dementia (88.9%), with a moderate to severe cognitive impairment (MMSE: 10.8) and low daily living abilities (EBI: 33.7). Most residents (80.6%) have a risk of malnutrition regarding the MNA. The average MNA score did decline slightly within one year (t0 = 20.8 vs. t1 = 19.7). Regular screenings for malnutrition using validated standardised assessments, which are easy to apply, should be implemented in SHA to avoid nutritional and health-related problems arising from malnutrition. Flexible structures for care, as in SHA, can facilitate coping with

  13. Prevalence, Adverse Events, and Factors Associated with Dietary Supplement and Nutritional Supplement Use by US Navy and Marine Corps Personnel

    Science.gov (United States)

    2016-04-12

    DMDC included the service member’s name, branch of service, pay grade (rank), postal address, e-mail address, sex, age, marital status, education...resistance training but few relationships with aerobic training. The discrepancies in the literature can possibly be explained by different definitions of...dietary supplements. JAMA Int Med. 2013;173(3):355-361. 32. Owens GM. Gender differences in health care expenditures, resource utilization, and quality of

  14. Special Supplemental Nutrition Program for Women, Infants, and Children participation and infants' growth and health: a multisite surveillance study.

    Science.gov (United States)

    Black, Maureen M; Cutts, Diana B; Frank, Deborah A; Geppert, Joni; Skalicky, Anne; Levenson, Suzette; Casey, Patrick H; Berkowitz, Carol; Zaldivar, Nieves; Cook, John T; Meyers, Alan F; Herren, Tim

    2004-07-01

    The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is the largest food supplement program in the United States, serving almost 7 500 000 participants in 2002. Because the program is a grant program, rather than an entitlement program, Congress is not mandated to allocate funds to serve all eligible participants. Little is known about the effects of WIC on infant growth, health, and food security. To examine associations between WIC participation and indicators of underweight, overweight, length, caregiver-perceived health, and household food security among infants 95th percentile, varied from 7% to 9% and did not differ among the 3 groups but were higher than the 5% expected from national growth charts. Rates of food insecurity were consistent with national data for minority households with children. Families that did not receive WIC assistance because of access problems had higher rates of food insecurity (28%) than did WIC participants (23%), although differences were not significant after covariate control. Caregivers who did not perceive a need for WIC services had more economic and personal resources than did WIC participants and were less likely to be food-insecure, but there were no differences in infants' weight-for-age, perceived health, or overweight between families that did not perceive a need for WIC services and those that received WIC assistance. Infants participation. Health care providers should promote WIC utilization for eligible families and advocate that WIC receive support to reduce waiting lists and eliminate barriers that interfere with access.

  15. Multistrategy childcare-based intervention to improve compliance with nutrition guidelines versus usual care in long day care services: a study protocol for a randomised controlled trial

    Science.gov (United States)

    Seward, Kirsty; Finch, Meghan; Wiggers, John; Wyse, Rebecca; Jones, Jannah; Gillham, Karen; Yoong, Sze Lin

    2016-01-01

    Introduction Interventions to improve child diet are recommended as dietary patterns developed in childhood track into adulthood and influence the risk of chronic disease. For child health, childcare services are required to provide foods to children consistent with nutrition guidelines. Research suggests that foods and beverages provided by services to children are often inconsistent with nutrition guidelines. The primary aim of this study is to assess, relative to a usual care control group, the effectiveness of a multistrategy childcare-based intervention in improving compliance with nutrition guidelines in long day care services. Methods and analysis The study will employ a parallel group randomised controlled trial design. A sample of 58 long day care services that provide all meals (typically includes 1 main and 2 mid-meals) to children while they are in care, in the Hunter New England region of New South Wales, Australia, will be randomly allocated to a 6-month intervention to support implementation of nutrition guidelines or a usual care control group in a 1:1 ratio. The intervention was designed to overcome barriers to the implementation of nutrition guidelines assessed using the theoretical domains framework. Intervention strategies will include the provision of staff training and resources, audit and feedback, ongoing support and securing executive support. The primary outcome of the trial will be the change in the proportion of long day care services that have a 2-week menu compliant with childcare nutrition guidelines, measured by comprehensive menu assessments. As a secondary outcome, child dietary intake while in care will also be assessed. To assess the effectiveness of the intervention, the measures will be undertaken at baseline and ∼6 months postbaseline. Ethics and dissemination The study was approved by the Hunter New England Human Research Ethics Committee. Study findings will be disseminated widely through peer-reviewed publications. PMID

  16. MALDI-TOF MS for quality control of high protein content sport supplements.

    Science.gov (United States)

    De Ceglie, Cristina; Calvano, Cosima D; Zambonin, Carlo G

    2015-06-01

    High protein content sport nutritional supplements are found as powder products containing, as ingredients, amino acids and proteins with important nutritional values as milk, soy and egg proteins. An EU Food Supplements Directive (2002) requires that supplements should be safe, both in dosages and in purity. It is important, then, to develop rapid and sensitive methods to be employed for the quality control of these substances. In this work, we apply, for the first time, matrix-assisted laser desorption ionization-mass spectrometry as a fast, reproducible and sensitive method for the quality control of sport nutritional supplements based on proteins. To this aim, several commercial egg- and/or milk-based powder products have been processed by in gel or in solution digestion and analyzed in comparison to pure standard products. This strategy allowed to assess the reliability of the indications on proteins (as caseins, whey proteins and ovalbumin) declared in the label of several sport nutritional supplements. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Protein turnover in malnourished patients with cystic fibrosis: Effects of elemental and nonelemental nutritional supplements

    International Nuclear Information System (INIS)

    Pelekanos, J.T.; Holt, T.L.; Ward, L.C.; Cleghorn, G.J.; Shepherd, R.W.

    1990-01-01

    To evaluate the relative efficacy of nonelemental versus semielemental enteral supplements for nutritional rehabilitation of cystic fibrosis (CF) patients, whole-body protein turnover using the [ 15 N]glycine method was studied in nine malnourished CF patients during enteral feedings, in a block design study comparing a semielemental formula (Criticare), a higher protein density but nonelemental formula (Traumacal) (T), and a nonelemental formula that had been modified to become isocaloric and isonitrogenous to the semielemental formula (modified Traumacal, MT). No significant differences in rates of protein synthesis or catabolism were observed comparing the three formulas. However, the higher protein density nonelemental formula resulted in higher net protein deposition compared to the other two formulas (T + 0.42 g kg-1 10 h-1 versus 0.33 g kg-1 10 h-1 for Criticare and -0.59 g kg-1 10 h-1 for MT), although this was significant (p less than 0.05) for the MT versus T comparison only. This study lends support to the use of less expensive nonelemental formulas for the nutritional management of malnourished patients with CF

  18. ISSN Exercise & Sport Nutrition Review: Research & Recommendations

    Directory of Open Access Journals (Sweden)

    Mendel Ron

    2004-05-01

    Full Text Available Abstract Sport nutrition is a constantly evolving field with literally thousands of research papers published annually. For this reason, keeping up to date with the literature is often difficult. This paper presents a well-referenced overview of the current state of the science related to how to optimize training through nutrition. More specifically, this article discusses: 1. how to evaluate the scientific merit of nutritional supplements; 2. general nutritional strategies to optimize performance and enhance recovery; and, 3. our current understanding of the available science behind weight gain, weight loss, and performance enhancement supplements. Our hope is that ISSN members find this review useful in their daily practice and consultation with their clients.

  19. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets.

    Science.gov (United States)

    Munns, Craig F; Shaw, Nick; Kiely, Mairead; Specker, Bonny L; Thacher, Tom D; Ozono, Keiichi; Michigami, Toshimi; Tiosano, Dov; Mughal, M Zulf; Mäkitie, Outi; Ramos-Abad, Lorna; Ward, Leanne; DiMeglio, Linda A; Atapattu, Navoda; Cassinelli, Hamilton; Braegger, Christian; Pettifor, John M; Seth, Anju; Idris, Hafsatu Wasagu; Bhatia, Vijayalakshmi; Fu, Junfen; Goldberg, Gail; Sävendahl, Lars; Khadgawat, Rajesh; Pludowski, Pawel; Maddock, Jane; Hyppönen, Elina; Oduwole, Abiola; Frew, Emma; Aguiar, Magda; Tulchinsky, Ted; Butler, Gary; Högler, Wolfgang

    2016-02-01

    Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describe the strength of the recommendation and the quality of supporting evidence. Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required.

  20. Should nutritional supplements and sports drinks companies sponsor sport? A short review of the ethical concerns.

    Science.gov (United States)

    Outram, Simon M; Stewart, Bob

    2015-06-01

    This paper proposes that the sponsorship of sport by nutritional supplements and sport drinks companies should be re-examined in the light of ethical concerns about the closeness of this relationship. A short overview is provided of the sponsorship of sport, arguing that ethical concerns about its appropriateness remain despite the imposition of severe restrictions on tobacco sponsorship. Further, the paper examines the main concerns about supplement use and sports drinks with respect to efficacy, health and the risks of doping. Particular consideration is given to the health implications of these concerns. It is suggested that they, of themselves, do not warrant the restriction of sponsorship by companies producing supplements and sports drinks. Nevertheless, it is argued that sports sponsorship does warrant further ethical examination--above and beyond that afforded to other sponsors of sport--as sport sponsorship is integral to the perceived need for such products. In conclusion, it is argued that sport may have found itself lending unwarranted credibility to products which would otherwise not necessarily be seen as beneficial for participation in sports and exercise or as inherently healthy products. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Nutritional rickets in immigrant and refugee children.

    Science.gov (United States)

    Thacher, Tom D; Pludowski, Pawel; Shaw, Nick J; Mughal, M Zulf; Munns, Craig F; Högler, Wolfgang

    2016-01-01

    Immigrant and refugee populations bring public health challenges to host nations. In the current global refugee crisis, children are the most vulnerable subpopulation. Diseases that were considered rare in the host nation may be highly prevalent among immigrant children. The prevalence of nutritional rickets is increasing in high-income countries, largely driven by an influx of immigrant populations. Nutritional rickets is a bone disease in early childhood resulting in bone pain, delayed motor development, and bending of the bones, caused by vitamin D deficiency and/or inadequate dietary calcium intake. The consequences of nutritional rickets include stunted growth, developmental delay, lifelong bone deformities, seizures, cardiomyopathy, and even death. Nutritional rickets is most commonly seen in children from the Middle East, Africa, and South Asia in high-income countries. Dark skin pigmentation, sun avoidance, covering the skin, and prolonged breast feeding without vitamin D supplementation, are important risk factors for vitamin D deficiency, and combined with a lack of dairy products in the diet, these deficiencies can result in insufficient calcium supply for bone mineralization. We recommend screening all immigrant and refugee children under 5 years of age from these ethnic groups for nutritional rickets, based on clinical features, and confirming the diagnosis with radiographs of the wrists and knees. Because nutritional rickets is entirely preventable, public health policies must address the need for universal vitamin D supplementation and adequate dietary calcium to protect children from this scourge. Vitamin D supplementation of all infants and children with 400 IU/d during the first year of life and dietary or supplemental intakes of at least 600 IU/d of vitamin D and 500 mg/d of calcium thereafter, will effectively prevent nutritional rickets. We call on national health authorities of host countries to implement health check lists and prevention

  2. Calcium Supplements: Do Men Need Them Too?

    Science.gov (United States)

    ... Lifestyle Nutrition and healthy eating Should men take calcium supplements? Answers from Katherine Zeratsky, R.D., L. ... Most healthy men don't need to take calcium supplements. Calcium is important for men for optimal ...

  3. Nutritional status, dietary habits, nutritional knowledge and self-care assessment in a group of older adults attending community centres in Pavia, Northern Italy.

    Science.gov (United States)

    Turconi, G; Rossi, M; Roggi, C; Maccarini, L

    2013-02-01

    The population of industrialised countries is ageing as a consequence of an increase in life expectancy. As a result of the increasing ageing process, the assessment of nutritional status and dietary habits, as well as the assessment of self-care, is needed to plan selected actions aimed at improving the quality of life in the third and fourth life spans. A cross-sectional study was carried out on a randomly selected sample of 200 healthy older adults (≥65 years old), attending community centres for older people in Pavia, Northern Italy. Ninety-two percent of the recruited subjects participated in the survey. Anthropometric measurements and the Mini Nutritional Assessment were performed. Dietary habits, nutritional knowledge and self-care were investigated using a questionnaire administered by two dietitians. The majority of subjects were low socio-economic status and overweight [mean (SD) body mass index = 28.4 (4.3) kg/m(2) ], 12% were malnourished according to their Mini Nutritional Assessment score and the majority of the arm muscle circumference measurements were below the 10th percentile, predicting accelerated loss of lean mass, even in the healthy independently living older adults. Only 30% of the sample had adequate dietary habits, whereas the ability to self-care was good for the whole sample. The unhealthy and unbalanced diet, frequently too rich in sugar and fats and low in protein intake, might explain being overweight and the loss of lean mass in the study subjects. © 2012 The Authors Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

  4. Perceptions of the characteristics of the Alberta Nutrition Guidelines for Children and Youth by child care providers may influence early adoption of nutrition guidelines in child care centres.

    Science.gov (United States)

    Nikolopoulos, Hara; Farmer, Anna; Berry, Tanya R; McCargar, Linda J; Mager, Diana R

    2015-04-01

    In 2008, the Alberta government released the Alberta Nutrition Guidelines for Children and Youth (ANGCY) as a resource for child care facilities to translate nutrition recommendations into practical food choices. Using a multiple case study method, early adoption of the guidelines was examined in two child care centres in Alberta, Canada. Key constructs from the Diffusion of Innovations framework were used to develop an interview protocol based on the perceived characteristics of the guidelines (relative advantage, compatibility, complexity, trialability and observability) by child care providers. Analysis of the ANGCY was conducted by a trained qualitative researcher and validated by an external qualitative researcher. This entailed reviewing guideline content, layout, organisation, presentation, format, comprehensiveness and dissemination to understand whether characteristics of the guidelines affect the adoption process. Data were collected through direct observation, key informant interviews and documentation of field notes. Qualitative data were analysed using content analysis. Overall, the guidelines were perceived positively by child care providers. Child care providers found the guidelines to have a high relative advantage, be compatible with current practice, have a low level of complexity, easy to try and easy to observe changes. It is valuable to understand how child care providers perceive characteristics of guidelines as this is the first step in identifying the needs of child care providers with respect to early adoption and identifying potential educational strategies important for dissemination. © 2012 Blackwell Publishing Ltd.

  5. Improving nutrition and physical activity in child care: what parents recommend.

    Science.gov (United States)

    Benjamin, Sara E; Haines, Jess; Ball, Sarah C; Ward, Dianne S

    2008-11-01

    A large percentage of children in the United States spend part of their day in out-of-home child care. As rates of obesity continue to rise, especially among young children, child care has become a focus for nutrition and physical activity intervention. Parental involvement is an important component of these efforts. During summer 2006, parents of children in child care were surveyed to better understand their perceived quality of meals, snacks, and physical activity at the child-care center, and their recommendations for improvement. Parents of children who attended 94 licensed child-care centers in North Carolina were invited to complete a brief survey of perceived quality of meals, snacks, and physical activity at their centers using close-ended questions. Open-ended questions were used to identify suggestions for improvement. Five hundred eight parents from 91 child-care centers completed the questionnaire. The majority of parents reported quality of meals and snacks at the center as either excellent (30% meals, 27% snacks) or good (42% meals, 46% snacks). The main recommendations for improving meals and snacks were to increase fruits and vegetables and provide a variety of healthful foods. The majority of parents categorized the quality of physical activity at the center as excellent (36%) or good (46%), and suggested more structured, outdoor activities for children. Findings from this study provide insight into key areas of concern for parents regarding the nutrition and activity environment of child-care centers. This information may be used to create or modify interventions or policies and to help motivate parents to become advocates for change in child care.

  6. [Nutrition and Metabolism Group of the Spanish Neonatology Society: recommendations and evidence for dietary supplementation with probiotics in very low birth weight infants].

    Science.gov (United States)

    Narbona López, E; Uberos Fernández, J; Armadá Maresca, M I; Couce Pico, M L; Rodríguez Martínez, G; Saenz de Pipaon, M

    2014-12-01

    Clinical practice guidelines are an important tool for improving healthcare. In recent years there has been accumulating evidence on the impact of nutritional supplementation with probiotics in the very low birth weight infants. With no uniformity in microorganisms and strains used. The Spanish Neonatology Society (SENeo), through its Nutrition and Metabolism Group has undertaken to develop recommendations that will be useful as a guide for the neonatologist in this field. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  7. The pattern of LH secretion and the ovarian response to the 'ram effect' in the anoestrous ewe is influenced by body condition but not by short-term nutritional supplementation.

    Science.gov (United States)

    Scaramuzzi, R J; Oujagir, L; Menassol, J-B; Freret, S; Piezel, A; Brown, H M; Cognié, J; Fabre Nys, C

    2014-10-01

    In sheep, the 'ram effect' induces out-of-season fertility and good nutrition increases prolificacy. This experiment determined if fatness or short-term nutritional supplementation modified the response to the 'ram effect'. A group of 48 Île-de-France ewes were fed diets that produced groups with body-condition scores (BCS) of >3.0 and <2.0. Within each BCS group animals were supplemented daily with 500g of lupins from Day -5 to Day 0 (ram introduction) resulting in four groups: low BCS, supplemented (n=7) and non-supplemented (n=8) and high BCS, supplemented (n=12) and non-supplemented (n=11). The blood concentrations of glucose and insulin and the LH response to gonadotrophin-releasing hormone (GnRH) were determined. After the 'ram effect' the pattern of LH pulsatility, the LH surge and ovarian responses were analysed. Low BCS ewes had lower glucose and insulin (P<0.001) and supplementation increased both (P≤0.001). The increase in LH induced by GnRH was reduced in low BCS ewes (P=0.015) but it was not affected by supplementation. Similarly, LH pulsatility was reduced in low BCS ewes (P<0.05). The LH surge and ovarian cyclicity were not affected but the follow-up cycle was delayed (P=0.034) and progesterone was reduced (P=0.029) in low BCS ewes. There was an effect of BCS on ovulation rate (P<0.05). These results show that the BCS can modify the response to the 'ram effect' and that supplementation has little effect on this response.

  8. The accuracy and consistency of nutrition care process terminology use in cases of refeeding syndrome.

    Science.gov (United States)

    Matthews, Kylie L; Palmer, Michelle A; Capra, Sandra M

    2017-11-08

    Using standardised terminology in acute care has encouraged consistency in patient care and the evaluation of outcomes. As such, the Nutrition Care Process (NCP) and Nutrition Care Process Terminology (NCPT) may assist dietitian nutritionists in the delivery of high quality nutrition care worldwide; however, limited research has been conducted examining the consistency and accuracy of its use. We aimed to examine the NCPT that dietitian nutritionists would use to formulate a diagnostic statement relating to refeeding syndrome (RFS). A multimethod action research approach was used, incorporating two projects. The first was a survey examining Australian dietitian nutritionists' (n = 195) opinions regarding NCPT use in cases of RFS. To establish if results were similar internationally, an interview was then conducted with 22 dietitian nutritionists working within 10 different countries. 'Imbalance of nutrients' was only identified as a correct code by 17% of respondents in project 1. No mention of this term was made in project 2. Also 86% of respondents incorrectly selected more than one diagnostic code. The majority of respondents (80%, n = 52/65) who incorrectly selected 'Malnutrition', without also selecting 'Imbalance of nutrients', selected 'reduce intake' as an intervention, suggesting some misunderstanding in the requirement for interrelated diagnoses, interventions and goals. Our findings demonstrate that there is limited accuracy and consistency in selecting nutritional diagnostic codes in relation to RFS. Respondents also demonstrated limited knowledge regarding appropriate application of the NCP and NCPT. Implementation practices may require further refinement, as accurate and consistent use is required to procure the benefits of standardised terminology. © 2017 Dietitians Association of Australia.

  9. Nutritional supplements in age-related macular degeneration.

    Science.gov (United States)

    Schmidl, Doreen; Garhöfer, Gerhard; Schmetterer, Leopold

    2015-03-01

    Age-related macular degeneration (AMD) is the most frequent cause of blindness in the Western World. While with new therapies that are directed towards vascular endothelial growth factor (VEGF), a potentially efficient treatment option for the wet form of the disease has been introduced, a therapeutic regimen for dry AMD is still lacking. There is evidence from several studies that oral intake of supplements is beneficial in preventing progression of the disease. Several formulations of micronutrients are currently available. The present review focuses on the role of supplements in the treatment and prevention of AMD and sums up the current knowledge about the most frequently used micronutrients. In addition, regulatory issues are discussed, and future directions for the role of supplementation in AMD are highlighted. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  10. The effect of nutrition training for health care staff on learner and patient outcomes in adults: a systematic review and meta-analysis.

    Science.gov (United States)

    Marples, Owen; Baldwin, Christine; Weekes, C Elizabeth

    2017-07-01

    Background: Nutrition training for health care staff has been prioritized internationally as a key means of tackling malnutrition; however, there is a lack of clear evidence to support its implementation. Systematic reviews in other fields of training for health care staff indicate that training strategies may have a beneficial impact on learner and patient outcomes. Objectives: We assessed whether nutrition training for health care staff caring for nutritionally vulnerable adults resulted in improved learner and patient outcomes and evaluated the effectiveness of different training strategies. Design: A systematic review of trials of nutrition training for health care staff was conducted. Six databases were searched with key terms relating to malnutrition and nutrition training. Studies were categorized according to cognitive (didactic teaching), behavioral (practical implementation of skills), and psychological (individualized or group feedback and reflection) training strategies. Where sufficient data were available, meta-analysis was performed according to study design and training strategy. All study designs were eligible. The risk of bias was evaluated in accordance with Cochrane guidance. Results: Twenty-four studies met the eligibility criteria: 1 randomized controlled trial, 4 nonrandomized controlled trials, 3 quasi-experimental trials, 13 longitudinal pre-post trials, 2 qualitative studies, and 1 cross-sectional survey. Results from a number of low-quality studies suggest that nutrition training for health care staff may have a beneficial effect on staff nutrition knowledge, practice, and attitude as well as patient nutritional intake. There were insufficient data to determine whether any particular training strategy was more effective than the others. Conclusions: In the absence of high-quality evidence, low-quality studies suggest that nutrition training for health care staff has some positive effects. However, further randomized controlled trials are

  11. Effects of Nutritional Status and Supplementation on Resumption of ...

    African Journals Online (AJOL)

    Context: Breastfeeding patterns, ethnic variation and nutrition have been shown to influence the return of menstruation after childbirth, but the role played by nutritional status requires further elucidation, particularly in a place like Nigeria where undernutrition is common. Objectives: To determine the effects of nutrition and ...

  12. Nurses' Knowledge and Responsibility toward Nutritional Assessment for Patients in Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Mahmoud Al Kalaldeh

    2014-09-01

    Full Text Available Introduction: Nutritional assessment is a prerequisite for nutritional delivery. Patients in intensive care suffer from under-nutrition and nutritional failure due to poor assessment. Nursing ability to early detect nutritional failure is the key for minimizing imparities in practice and attaining nutritional goals. Aim of this article is to examine the ability of Jordanian ICU nurses to assess the nutritional status of critically ill patients, considering biophysical and biochemical measures.Methods: This cross sectional study recruited nurses from different health sectors in Jordan. ICU nurses from the governmental sector (two hospitals and private sectors (two hospitals were surveyed using a self-administered questionnaire. Nurses' knowledge and responsibility towards nutritional assessment were examined.Results: A total of 220 nurses from both sectors have completed the questionnaire. Nurses were consistent in regard to knowledge, responsibility, and documentation of nutritional assessment. Nurses in the governmental hospitals inappropriately perceived the application of aspiration reduction measures. However, they scored higher in applying physical examination and anthropometric assessment.  Although both nurses claimed higher use of biochemical measurements, biophysical measurements were less frequently used. Older nurses with longer clinical experience exhibited better adherence to biophysical measurement than younger nurses.Conclusion: Nursing nutritional assessment is still suboptimal to attain nutritional goals. Assessment of body weight, history of nutrition intake, severity of illness, and function of gastrointestinal tract should be considered over measuring albumin and pre-albumin levels.  A well-defined evidence-based protocol as well as a multidisciplinary nutritional team for nutritional assessment is the best to minimize episodes of under-nutrition.

  13. Challenges and opportunities for nutrition education and training in the health care professions: intraprofessional and interprofessional call to action1234

    Science.gov (United States)

    DiMaria-Ghalili, Rose Ann; Mirtallo, Jay M; Tobin, Brian W; Hark, Lisa; Van Horn, Linda; Palmer, Carole A

    2014-01-01

    Understanding and applying nutrition knowledge and skills to all aspects of health care are extremely important, and all health care professions need basic training to effectively assess dietary intake and provide appropriate guidance, counseling, and treatment to their patients. With obesity rates at an all-time high and the increasing prevalence of diabetes projected to cost the Federal government billions of dollars, the need for interprofessional nutrition education is paramount. Physicians, physician assistants, nurses, nurse practitioners, pharmacists, dentists, dental hygienists, occupational therapists, physical therapists, speech and language pathologists, and others can positively affect patient care by synchronizing and reinforcing the importance of nutrition across all specialty areas. Although nutrition is a critical component of acute and chronic disease management, as well as health and wellness across the health care professions, each profession must reevaluate its individual nutrition-related professional competencies before the establishment of meaningful interprofessional collaborative nutrition competencies. This article discusses gaps in nutrition education and training within individual health professions (ie, nursing, pharmacy, dentistry, and dietetics) and offers suggestions for educators, clinicians, researchers, and key stakeholders on how to build further capacity within the individual professions for basic and applied nutrition education. This “gaps methodology” can be applied to all health professions, including physician assistants, physical therapists, speech and language pathologists, and occupational therapists. PMID:24646823

  14. Determination of total selenium in nutritional supplements and selenised yeast by Zeeman-effect graphite furnace atomic absorption spectrometry

    DEFF Research Database (Denmark)

    Larsen, Erik Huusfeldt; Ekelund, J.

    1989-01-01

    A method for the determination of total selenium in nutritional supplements and selenised yeast is described. The samples were ashed in nitric acid. Hydrochloric acid was used to prevent precipitation of, in particular, iron salts. After appropriate dilutions, the selenium was determined by Zeeman......-effect background corrected graphite furnace atomic absorption spectrometry. A furnace ashing step at 1100 °C was necessary in order to obtain a total recovery of selenium when present in the organic form. Palladium nitrate-magnesium nitrate was used as a matrix modifier. Independent methods were used to determine...... the content of selenium in a selenised yeast check sample. Accuracy was assured using this sample and by recovery experiments. Between-day random error showed a coefficient of variation of 4.2%. Results from the analysis of eight different commercial supplements were in good agreement with declared contents....

  15. Physical and social functional abilities seem to be maintained by a multifaceted randomized controlled nutritional intervention among old (> 65 years) Danish nursing home residents

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Damkjær, K.; Sorbye, L. W.

    2010-01-01

    of nutrition (chocolate, homemade oral supplements), group exercise (moderate intensity) and oral care. Measurements taken were weight, body mass index (BMI), energy and protein intake, and functional abilities (activities of daily living = ADL, cognitive performance, and social engagement). The results showed...

  16. Micronutrient Intakes in 553 Dutch Elite and Sub-Elite Athletes: Prevalence of Low and High Intakes in Users and Non-Users of Nutritional Supplements

    NARCIS (Netherlands)

    Wardenaar, Floris; Brinkmans, Naomi; Ceelen, Ingrid; Rooij, Van Bo; Mensink, Marco; Witkamp, Renger; Vries, De Jeanne

    2017-01-01

    This study investigated whether athletes meet micronutrient recommendations and whether the adequacy of their intake is related to the use of dietary supplements, sport nutrition products or a combination. Micronutrient intakes of 553 Dutch (sub-) elite athletes were assessed using web-based 24-h

  17. Assessment of parenteral nutrition prescription in Canadian acute care settings.

    Science.gov (United States)

    Adjemian, Daniela; Arendt, Bianca M; Allard, Johane P

    2018-05-01

    Parenteral nutrition (PN) prescription can be challenging in patients with complex conditions and has potential complications. To assess PN prescription, monitoring, and PN-related complications in a Canadian acute care setting. This was a prospective cohort study in which patients receiving PN were assessed by an auditor for nutritional status, PN-related prescription, monitoring, and complications. In addition, length of stay and mortality were recorded. 147 patients (mean ± SD 56.1 ± 16.4 y) with complex diseases (Charlson comorbidity index, median [p25-p75] 2 [1-4]) were enrolled. Before starting PN, 18.6%, 63.9%, and 17.5% of patients were classified as subjective global assessment A, B, and C, respectively. Body mass index remained unchanged during the period on PN. On average, 89% and 73% of patients received <90% of their energy and protein requirements, respectively, but 65% received oral or enteral nutrition at some point during PN. The average daily energy provided by PN increased and stabilized on day 10, reaching 87.2 ± 20.1% of the requirements. Line sepsis (6.8% of patients) and hyperglycemia (6.9%) were the most common complications. The overall mortality was 15.6%. For those alive, length of stay was 30 (range: 4-268) d. PN was discontinued because of transitioning to an oral diet (56.6%), enteral nutrition (17.6%), home PN (14.7%), palliative care (5.1%), death (4.4%), or other (1.5%). Most patients were malnourished at the start of PN. Energy and protein provided from PN were less than requirements, and the goals were reached with delay. Mortality was high, possibly as a result of complex diseases. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Sports nutrition

    Directory of Open Access Journals (Sweden)

    Tomanić Milena

    2016-01-01

    Full Text Available Due to higher energy consumption, physically active people have higher nutritional requirements. In addition to other important factors for sports, such as good health and physical predisposition, adequate nutrition is a fundamental component. Sports nutrition must be well planned and individually adapted based on physical characteristics, tendencies towards gaining or losing weight, frequency, duration and intensity of training sessions. Studies have shown that a well-balanced ratio of macro and micronutrients, with the support of supplements and adequate hydration, can significantly improve athletic performance and plays a key role in achieving better results. An optimally designed nutritional program, with realistic and achievable goals, which complements a well-planned training program, is the basis for success in sports. Only when nutritional requirements are met, deficits can be prevented and performance in sport pushed to the limit.

  19. Cost-effectiveness of a disease-specific oral nutritional support for pressure ulcer healing.

    Science.gov (United States)

    Cereda, Emanuele; Klersy, Catherine; Andreola, Manuela; Pisati, Roberto; Schols, Jos M G A; Caccialanza, Riccardo; D'Andrea, Federico

    2017-02-01

    The Oligo Element Sore Trial has shown that supplementation with a disease-specific nutritional formula enriched with arginine, zinc, and antioxidants improves pressure ulcer (PU) healing in malnourished patients compared to an isocaloric-isonitrogenous support. However, the use of such a nutritional formula needs to be supported also by a cost-effectiveness evaluation. This economic evaluation - from a local healthcare system perspective - was conducted alongside a multicenter, randomized, controlled trial following a piggy-back approach. The primary efficacy endpoint was the percentage of change in PU area at 8 weeks. The cost analysis focused on: the difference in direct medical costs of local PU care between groups and incremental cost-effectiveness ratio (ICER) of nutritional therapy related to significant study endpoints (percentage of change in PU area and ≥40% reduction in PU area at 8 weeks). Although the experimental formula was more expensive (mean difference: 39.4 Euros; P costs of local PU care (difference, -74.3 Euros; P = 0.013). Therefore, given its efficacy it proved to be a cost-effective intervention. The robustness of these results was confirmed by the sensitivity analyses. The use of a disease-specific oral nutritional formula not only results in better healing of PUs, but also reduces the costs of local PU care from a local healthcare system perspective. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  20. [Audit of artificial nutrition in an intensive care unit].

    Science.gov (United States)

    Blesa Malpica, A L; Salaverría Garzón, I; Prado López, L M; Simón García, M J; Reta Pérez, O; Ramos Polo, J

    2001-01-01

    To study compliance with an artificial nutrition protocol at an Intensive Care Unit. During a second stage and after introducing the modifications considered appropriate in the protocol, to verify its implementation and compare both series. REFERENCE POPULATION: All patients with artificial nutrition support were included. Artificial nutrition (AN) was deemed to be the dispensation of commercial preparations for enteral nutrition, formulas with amino acids and glucose and the parenteral provision of fat, including propofol in this case, even where it was the only source of energy. The provision of crystalloid solutions was not considered to be AN. The period of observation was two months in both cases. The provision of AN to all such patients was systematically recorded on a daily basis. After analysis of the first series, the members at the unit agreed to increase the nitrogen provision. A second series was recorded, with the data being collected for patients with AN during a similar period. The study of the first series revealed the provisions of energy and nitrogen were below theoretical levels (both in the corrected Harris-Benedict test and at the fixed prescription of 25 kcal/kg). In the second series, there was greater agreement between the theoretical values and the amounts actually received. The deviation in energy and nitrogen was significantly less in the second series. And although the total nitrogen load per patient did not reveal any differences, there were discrepancies in the daily provision per patient. On most days, the diet provided covered over 75% of the energy requirements. With parenteral nutrition on its own or in combination with enteral nutrition, the requirements of energy and nitrogen were exceeded. There were no differences between the two series. The type of provision was enteral on 55% of the days and parenteral on 18%. There was no difference in the type of provision between the two series, although there was a difference in the type

  1. Ethical imperatives against item restriction in the Supplemental Nutrition Assistance Program.

    Science.gov (United States)

    Chrisinger, Benjamin W

    2017-07-01

    The Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps) is the federal government's largest form of food assistance, and a frequent focus of political and scholarly debate. Previous discourse in the public health community and recent proposals in state legislatures have suggested limiting the use of SNAP benefits on unhealthy food items, such as sugar-sweetened beverages (SSBs). This paper identifies two possible underlying motivations for item restriction, health and morals, and analyzes the level of empirical support for claims about the current state of the program, as well as expectations about how item restriction would change participant outcomes. It also assesses how item restriction would reduce individual agency of low-income individuals, and identifies mechanisms by which this may adversely affect program participants. Finally, this paper offers alternative policies to promote healthier purchasing and eating among SNAP participants that can be pursued without reducing individual agency. Health advocates and officials must more fully weigh the attendant risks of implementing SNAP item restrictions, including the reduction of individual agency of a vulnerable population. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Nutrition support of the pediatric patient with AIDS.

    Science.gov (United States)

    Bentler, M; Stanish, M

    1987-04-01

    Maintaining optimal nutrition in the pediatric patient with Acquired Immune Deficiency Syndrome (AIDS) is challenging, but it may be one of the most effective therapies. Patients experience numerous complications that compromise nutritional status. Infection, fever, diarrhea, feeding problems, and decreased intake all contribute to malnutrition, which in turn predisposes the patient even more to infection and malabsorption. Nutrition assessment should be done routinely so that new problems may be identified and treated. High-calorie, high-protein feedings, vitamin supplementation, and, when necessary, gavage feedings or parenteral nutrition are recommended to improve nutritional status and prevent further deficits. Maintaining optimal nutrition in the pediatric patient with Acquired Immune Deficiency Syndrome (AIDS) poses a significant challenge to the health care team. Patients may experience numerous complications that compromise nutritional status. The patient is at high risk for opportunistic infections, especially of the lungs, central nervous system, gastrointestinal (GI) tract, and skin. Such infections are common causes of morbidity and mortality. Impaired nutritional status may further impair the patient's immunocompetence. A study by Kotler and Gaety demonstrated severe progressive malnutrition in adult AIDS patients, with the lowest measures of lean body mass occurring in those patients close to death at the time of the study. While no studies of children with AIDS have been done to date, we have subjectively observed feeding problems, weight loss, and malnutrition in most of the patients we have seen.

  3. The oncologist as coordinator of the nutritional approach.

    Science.gov (United States)

    Bozzetti, Federico

    2015-04-01

    Although the nutritional approach, especially when delivered through a gastric or jejunal tube or in a central vein, is handled by the nutritional support team or a specialist in nutrition, it is the responsibility of the oncologist, who knows the natural history of the disease and the impact of the oncologic therapy, to identify the potential candidates for the nutritional support, to recommend the nutritional strategy and to integrate it within the oncologic program. If gastrointestinal function is preserved, the initial nutritional approach should be through oral supplementation, followed by tube feeding if previous attempts are unsuccessful or upper gastrointestinal tract is not accessible. Parenteral nutrition is the obligatory resort when patients are (sub)obstructed but it may also be a practical way to integrate an insufficient oral nutrient intake (so called "supplemental" parenteral nutrition). Depending on the patient's condition and the disease's stage, artificial nutrition may have a "permissive" role in patients receiving aggressive oncologic therapy or represent just a supportive treatment in patients likely to succumb from starvation sooner than from tumor progression. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation.

    Science.gov (United States)

    Helms, Eric R; Aragon, Alan A; Fitschen, Peter J

    2014-01-01

    The popularity of natural bodybuilding is increasing; however, evidence-based recommendations for it are lacking. This paper reviewed the scientific literature relevant to competition preparation on nutrition and supplementation, resulting in the following recommendations. Caloric intake should be set at a level that results in bodyweight losses of approximately 0.5 to 1%/wk to maximize muscle retention. Within this caloric intake, most but not all bodybuilders will respond best to consuming 2.3-3.1 g/kg of lean body mass per day of protein, 15-30% of calories from fat, and the reminder of calories from carbohydrate. Eating three to six meals per day with a meal containing 0.4-0.5 g/kg bodyweight of protein prior and subsequent to resistance training likely maximizes any theoretical benefits of nutrient timing and frequency. However, alterations in nutrient timing and frequency appear to have little effect on fat loss or lean mass retention. Among popular supplements, creatine monohydrate, caffeine and beta-alanine appear to have beneficial effects relevant to contest preparation, however others do not or warrant further study. The practice of dehydration and electrolyte manipulation in the final days and hours prior to competition can be dangerous, and may not improve appearance. Increasing carbohydrate intake at the end of preparation has a theoretical rationale to improve appearance, however it is understudied. Thus, if carbohydrate loading is pursued it should be practiced prior to competition and its benefit assessed individually. Finally, competitors should be aware of the increased risk of developing eating and body image disorders in aesthetic sport and therefore should have access to the appropriate mental health professionals.

  5. American College of Sports Medicine position stand. Nutrition and athletic performance.

    Science.gov (United States)

    Rodriguez, Nancy R; Di Marco, Nancy M; Langley, Susie

    2009-03-01

    and mineral supplements are not needed if adequate energy to maintain body weight is consumed from a variety of foods. However, athletes who restrict energy intake, use severe weight-loss practices, eliminate one or more food groups from their diet, or consume unbalanced diets with low micronutrient density may require supplements. Because regulations specific to nutritional ergogenic aids are poorly enforced, they should be used with caution and only after careful product evaluation for safety, efficacy, potency, and legality. A qualified sports dietitian and, in particular, the Board Certified Specialist in Sports Dietetics in the United States, should provide individualized nutrition direction and advice after a comprehensive nutrition assessment.

  6. Nutritional planning to run an Ultra-marathon, the Transvulcania: Case report

    Directory of Open Access Journals (Sweden)

    José Antonio López-Gómez

    2016-05-01

    Full Text Available The Transvulcania is an individual mountain competition with 74,6km. The event has provisioning areas to meet the needs of nutrition and hydration of the participants. The importance of dietarynutritional preparation is in preventing or reducing gastrointestinal problems, dehydration, hyponatremia, fatigue, among others. The aim is to describe the dietary and nutritional planning an athlete in this event. Eating habits, supplement intake and body composition were evaluated in a 37 years old male with 10 years of sports experience. Dietary and nutritional recommendations for athletes in competition, test time, refreshment areas and possible food intake/supplements were taken into account for dietary planning during the competition. The dietary and nutritional planning in ultra-endurance events is important to successfully perform the competition, tolerating and taking foods/supplements properly, and avoiding nutritional risk and dehydration, fatigue, gastrointestinal disturbances, etc.

  7. Changes in serum phosphate and potassium and their effects on mortality in malnourished African HIV-infected adults starting antiretroviral therapy and given vitamins and minerals in lipid-based nutritional supplements

    DEFF Research Database (Denmark)

    Rehman, Andrea Mary; Woodd, Susannah Louise; Heimburger, Douglas Corbett

    2017-01-01

    Malnourished HIV-infected patients starting antiretroviral therapy (ART) are at high risk of early mortality, some of which may be attributed to altered electrolyte metabolism. We used data from a randomised controlled trial of electrolyte-enriched lipid-based nutritional supplements to assess...... that changes in serum electrolytes, largely irrespective of the starting point and the direction of change, were more strongly associated with mortality than were absolute electrolyte levels. Although K and phosphate are required for tissue deposition during recovery from malnutrition, further studies...... are needed to determine whether specific supplements exacerbate physiologically adverse shifts in electrolyte levels during nutritional rehabilitation of ill malnourished HIV patients....

  8. Desserts with a high nutritional value in the industry employees nutrition

    Directory of Open Access Journals (Sweden)

    L. Telegenko

    2017-04-01

    Full Text Available In the article there are considered questions of the sweet foods with a high nutritional value development. Evaluation of the organoleptic and physical-chemical properties of model jelly samples with jost and spirulina showed that the proposed formula and technology gives a product with high consumer properties. There is a theoretically substantiated expediency of a jost and spirulina jelly implementation in such restaurant enterprises as dining rooms in the industrial plants. Using the jost and spirulina nutritional supplements can expand the range of the preventive nutrition foods.

  9. Enteral nutrition practices in the intensive care unit: Understanding of nursing practices and perspectives

    Directory of Open Access Journals (Sweden)

    Babita Gupta

    2012-01-01

    Full Text Available Background: Adequate nutritional support is important for the comprehensive management of patients in intensive care units (ICUs. Aim: The study was aimed to survey prevalent enteral nutrition practices in the trauma intensive care unit, nurses′ perception, and their knowledge of enteral feeding. Study Design: The study was conducted in the ICU of a level 1 trauma center, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India. The study design used an audit. Materials and Methods: Sixty questionnaires were distributed and the results analyzed. A database was prepared and the audit was done. Results: Forty-two (70% questionnaires were filled and returned. A majority (38 of staff nurses expressed awareness of nutrition guidelines. A large number (32 of staff nurses knew about nutrition protocols of the ICU. Almost all (40 opined enteral nutrition to be the preferred route of nutrition unless contraindicated. All staff nurses were of opinion that enteral nutrition is to be started at the earliest (within 24-48 h of the ICU stay. Everyone opined that the absence of bowel sounds is an absolute contraindication to initiate enteral feeding. Passage of flatus was considered mandatory before starting enteral nutrition by 86% of the respondents. Everyone knew that the method of Ryle′s tube feeding in their ICU is intermittent boluses. Only 4 staff nurses were unaware of any method to confirm Ryle′s tube position. The backrest elevation rate was 100%. Gastric residual volumes were always checked, but the amount of the gastric residual volume for the next feed to be withheld varied. The majority said that the unused Ryle′s tube feed is to be discarded after 6 h. The most preferred (48% method to upgrade their knowledge of enteral nutrition was from the ICU protocol manual. Conclusion: Information generated from this study can be helpful in identifying nutrition practices that are lacking and may be used to review and revise enteral feeding

  10. Do dietary supplements improve micronutrient sufficiency in children and adolescents?

    Science.gov (United States)

    Bailey, Regan L; Fulgoni, Victor L; Keast, Debra R; Lentino, Cindy V; Dwyer, Johanna T

    2012-11-01

    To examine if children use supplements to fill gaps in nutritionally inadequate diets or whether supplements contribute to already adequate or excessive micronutrient intakes from foods. Data were analyzed for children (2-18 years) from the National Health and Nutrition Examination Survey 2003-2006, a nationally representative, cross-sectional survey (n = 7250). Diet was assessed using two 24-hour recalls, and dietary supplement use was assessed with a 30-day questionnaire. Prevalence of supplements use was 21% (vitamin D intakes were low for all children. Inadequate intakes of phosphorus, copper, selenium, folate, and vitamins B-6 and B-12 were minimal from foods alone among 2-8 year olds. However, among 9-18 year olds, a higher prevalence of inadequate intakes of magnesium, phosphorus, and vitamins A, C, and E were observed. Supplement use increased the likelihood of intakes above the upper tolerable intake level for iron, zinc, copper, selenium, folic acid, and vitamins A and C. Even with the use of supplements, more than a one-third of children failed to meet calcium and vitamin D recommendations. Children 2-8 years old had nutritionally adequate diets regardless of supplement use. However, in children older than 8 years, dietary supplements added micronutrients to diets that would have otherwise been inadequate for magnesium, phosphorus, vitamins A, C, and E. Supplement use contributed to the potential for excess intakes of some nutrients. These findings may have implications for reformulating dietary supplements for children. Published by Mosby, Inc.

  11. Position of the American Dietetic Association: Providing nutrition services for people with developmental disabilities and special health care needs.

    Science.gov (United States)

    Van Riper, Cynthia L; Wallace, Lee Shelly

    2010-02-01

    It is the position of the American Dietetic Association that nutrition services provided by registered dietitians (RDs) and dietetic technicians, registered (DTRs), are essential components of comprehensive care for all people with developmental disabilities and special health care needs. Nutrition services should be provided throughout life in a manner that is interdisciplinary, family-centered, community-based, and culturally competent. People with developmental disabilities and special health care needs frequently have nutrition concerns, including growth alterations (failure to thrive, obesity, or growth retardation), metabolic disorders, poor feeding skills, medication-nutrient interactions, and sometimes partial or total dependence on enteral or parenteral nutrition. Individuals with special needs are also more likely to develop comorbid conditions such as obesity or endocrine disorders that require nutrition interventions. Poor health habits, limited access to services, and long-term use of multiple medications are considered health risk factors. Health maintenance and avoidance of complications can be promoted by timely and cost-effective nutrition interventions. Public policy for individuals with special needs has evolved over time, resulting in a transition from institutional facilities and programs to community living. The expansion of public access to technology and health information on the Internet challenges RDs and DTRs to provide accurate scientific information for those with developmental disabilities and special health care needs. Nationally credentialed RDs and DTRs are best prepared to provide appropriate nutrition information for wellness and quality of life.

  12. Effectiveness of Oral Nutritional Supplementation for Older Women after a Fracture: Rationale, Design and Study of the Feasibility of a Randomized Controlled Study

    Directory of Open Access Journals (Sweden)

    Lockwood Keri A

    2011-06-01

    Full Text Available Abstract Background Malnutrition is a problem for many older people recovering from a hip and other major fractures. Oral supplementation with high calorie high protein nutrients is a simple intervention that may help older people with fractures to improve their recovery in terms of rehabilitation time, length of hospital stay and mortality. This paper reports a pilot study to test the feasibility of a trial initiated in a hospital setting with an oral supplement to older people with recent fractures. Method A randomized controlled trial with 44 undernourished participants admitted to a hospital following a fracture. The intervention group (n = 23 received a high calorie high protein supplement for forty days in addition to their diet of choice. The control group (n = 21 received high protein milk during their hospital stay in addition to their diet of choice and their usual diet when discharged from hospital. Results All participants were women and their mean age was 85.3 (± 6.1 years. Twenty nine (65% participants had a hip fracture. At baseline no differences were measured between the two groups regarding their nutritional status, their cognitive ability or their abilities in activities of daily living. There were no significant differences between the intervention and control group with reference to nutritional or functional parameters at 40 day and 4 month follow-ups. Median length of stay in hospital was 18.0 days, with 12 participants being readmitted for a median of 7.0 days. Conclusion It is feasible to perform a randomised trial in a hospital and community setting to test the effect of an oral high energy high protein supplement for older people. Due to the limited number of participants and incomplete adherence with use of the supplements no conclusion can be drawn about the efficacy or effectiveness of this intervention.

  13. An Open-Label Evaluator Blinded Study of the Efficacy and Safety of a New Nutritional Supplement in Androgenetic Alopecia: A Pilot Study.

    Science.gov (United States)

    Nichols, Anna J; Hughes, Olivia Bosshardt; Canazza, Agnese; Zaiac, Martin N

    2017-02-01

    Objective: To evaluate the effectiveness of a novel oral supplement, Forti5 ® , containing green tea extract, omega 3 and 6 fatty acids, cholecalciferol, melatonin, beta-sitosterol, and soy isoflavones, and in the management of subjects with androgenetic alopecia. Design: A prospective case series of 10 subjects. Setting: Open-label, evaluator-blinded, proof-of-concept study. Participants: Ten adult subjects with androgenetic alopecia completed the study. Subjects were not allowed to use oral or topical hair growth products in the 24 weeks preceding the study or during the study. The nutritional supplement was administered at a dosage of two tablets daily for 24 weeks. Measurements: Clinical evaluations were performed at baseline and at 24 weeks. Efficacy was evaluated using hair mass index measured by cross section trichometer, terminal hair count measured with dermoscopy and Investigator Global Photography Assessment. Results: Overall 80 percent of subjects (8/10) were rated as improved after 24 weeks of supplementation (mean change of +1.4 equivalent to slightly-to-moderately increased). Forty percent of subjects (4/10) were rated as moderately improved (2+), and 10 percent (1/10) were rated as greatly improved (3+). There was a significant improvement in terminal hair count (mean increase of 5.9% or 4.2 more terminal hairs in the area examined, p =0.014) and in Hair Mass Index (mean increase of 9.5% or 4.5 higher Hair Mass Index, p =0.003). Conclusion: These preliminary results indicate that Forti5 ® a novel nutritional supplement that contains cholecalciferol, omega 3 and 6 fatty acids, melatonin, antioxidants, and botanical 5-alpha reductase inhibitors, may be a useful adjunct in the treatment of androgenetic alopecia.

  14. 7 CFR 246.10 - Supplemental foods.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Supplemental foods. 246.10 Section 246.10 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE... nutritional needs of the participant. The food packages are as follows: (1) Food Package I—Infants birth...

  15. Effects of host nutrition on virulence and fitness of entomopathogenic nematodes: Lipid- and protein-based supplements in Tenebrio molitor diets

    Science.gov (United States)

    Shapiro-Ilan, David; Rojas, M. Guadalupe; Morales-Ramos, Juan A.; Lewis, Edwin E.; Tedders, W. Louis

    2008-01-01

    Entomopathogenic nematodes, Heterorhabditis indica and Steinernema riobrave, were tested for virulence and reproductive yield in Tenebrio molitor that were fed wheat bran diets with varying lipid- and protein-based supplements. Lipid supplements were based on 20% canola oil, peanut, pork or salmon, or a low lipid control (5% canola). Protein treatments consisted of basic supplement ingredients plus 0, 10, or 20% egg white; a bran-only control was also included. Some diet supplements had positive effects on nematode quality, whereas others had negative or neutral effects. All supplements with 20% lipids except canola oil caused increased T. molitor susceptibility to H. indica, whereas susceptibility to S. riobrave was not affected. Protein supplements did not affect host susceptibility, and neither lipid nor protein diet supplements affected reproductive capacity of either nematode species. Subsequently, we determined the pest control efficacy of progeny of nematodes that had been reared through T. molitor from different diets against Diaprepes abbreviatus and Otiorhynchus sulcatus. All nematode treatments reduced insect survival relative to the control (water only). Nematodes originating from T. molitor diets with the 0% or 20% protein exhibited lower efficacy versus D. abbreviatus than the intermediate level of protein (10%) or bran-only treatments. Nematodes originating from T. molitor lipid or control diets did not differ in virulence. Our research indicates that nutritional content of an insect host diet can affect host susceptibility to entomopathogenic nematodes and nematode fitness; therefore, host media could conceivably be optimized to increase in vivo nematode production efficiency. PMID:19259513

  16. Implementation of nutrition care service development plan at Banning Memorial Hospital: a case study.

    Science.gov (United States)

    Ben Oumlil, A; Rao, C P

    1992-01-01

    Health care service markets in general and hospital care service markets in particular are characterized by many competitive developments. Hence, hospital marketing managers are forced to respond to these emerging competitive pressures. However, in formulating appropriate marketing management strategies, hospital managers need to have detailed knowledge about consumers and their behaviors in the marketplace. This paper focuses on the Nutrition Care division of the Department of Nutrition Service at a hospital and its venture into new service development. This case study is intended to emphasize the significance of acquiring adequate knowledge of customers in the health care services industry. It particularly emphasizes the critical role that this type of information concerning customer behavior plays in the development and implementation of an appropriate business expansion strategy. Furthermore, the aim of this case study is to help the reader to relate the acquired marketing information to the problem at hand, and make the appropriate marketing management decision.

  17. The Supplemental Nutrition Assistance Program, Food Insecurity, Dietary Quality, and Obesity Among U.S. Adults.

    Science.gov (United States)

    Nguyen, Binh T; Shuval, Kerem; Bertmann, Farryl; Yaroch, Amy L

    2015-07-01

    We examined whether Supplemental Nutrition Assistance Program (SNAP) participation changes associations between food insecurity, dietary quality, and weight among US adults. We analyzed adult dietary intake data (n = 8333) from the 2003 to 2010 National Health and Nutrition Examination Survey. Bivariate and multivariable methods assessed associations of SNAP participation and 4 levels of food security with diet and weight. Measures of dietary quality were the Healthy Eating Index 2010, total caloric intake, empty calories, and solid fat; weight measures were body mass index (BMI), overweight, and obesity. SNAP participants with marginal food security had lower BMI (1.83 kg/m2; P < .01) and lower probability of obesity (9 percentage points; P < .05). SNAP participants with marginal (3.46 points; P < .01), low (1.98 points; P < .05), and very low (3.84 points; P < .01) food security had better diets, as illustrated by the Healthy Eating Index. Associations between SNAP participation and improved diet and weight were stronger among Whites than Blacks and Hispanics. Our research highlights the role of SNAP in helping individuals who are at risk for food insecurity to obtain a healthier diet and better weight status.

  18. Herbal Supplements: What to Know Before You Buy

    Science.gov (United States)

    ... Nutrition and healthy eating Regulations ensure that herbal supplements meet manufacturing standards but don't guarantee that ... of herbal remedies goes on and on. Herbal supplements, sometimes called botanicals, are one type of dietary ...

  19. Prevalence of malnutrition among older people in medical and surgical wards in hospital and quality of nutritional care: A multicenter, cross-sectional study.

    Science.gov (United States)

    Bonetti, Loris; Terzoni, Stefano; Lusignani, Maura; Negri, Marina; Froldi, Marco; Destrebecq, Anne

    2017-12-01

    To determine and compare the prevalence of malnutrition in medical and surgical hospital units; to assess quality of nutritional care and patients' perception about quality of food and nutritional care. Hospital malnutrition in older people leads to increased mortality, length of stay, risk of infections and pressure ulcers. Several studies show that malnutrition is often caused by hospitalisation and related to poor nutritional care. Few studies report data on surgical older patients. A cross-sectional, multicenter study was conducted in 12 hospitals in northern Italy. Malnutrition prevalence was determined according to the Mini Nutritional Assessment full-version. Head nurses were interviewed in 80 units, through a validated questionnaire regarding quality of nutritional care. Semi-structured interviews were administered to a sample of patients, to investigate their perception about quality of food and nutritional care. Two hundred twenty-eight patients of 1,066 were malnourished (21.4%). Medical patients were at higher risk, so were women, patients aged 85 or more, with impaired autonomy, pressure ulcers or taking more than three drugs. The lack of personnel impacts on quality of care: in 55% of the units, no nutritional screening is performed; nutritional history is investigated in 48% only. No protocols for nutritional problems exist in 70% of the wards; hardly ever the intake is measured. Patients are mostly satisfied, even though they report that food has no taste and is not well presented. They remark the need for more personnel. Prevalence was high, as found in other studies. Medical patients were at higher risk. Nutritional care was inadequate, and often no measures were adopted to prevent malnutrition. Staffing should be increased during meals. These findings will provide indications on the strategies needed to overcome such barriers. © 2017 John Wiley & Sons Ltd.

  20. Nutritional interventions for preventing and treating pressure ulcers.

    Science.gov (United States)

    Langer, Gero; Fink, Astrid

    2014-06-12

    Pressure ulcers affect approximately 10% of people in hospitals and older people are at highest risk. A correlation between inadequate nutritional intake and the development of pressure ulcers has been suggested by several studies, but the results have been inconsistent. To evaluate the effects of enteral and parenteral nutrition on the prevention and treatment of pressure ulcers. In March 2014, for this first update, we searched The Cochrane Wounds Group Specialised Trials Register, the Cochrane Central register of Controlled Trials (The Cochrane Library), the Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library), the Health Technology Assessment Database (HTA) (The Cochrane Library), the Cochrane Methodology Register (The Cochrane Library), NHS Economic Evaluation Database (The Cochrane Library), Ovid Medline, Ovid Embase and EBSCO CINAHL. No date, language or publication status limits were applied. Randomised controlled trials (RCTs) evaluating the effects of enteral or parenteral nutrition on the prevention and treatment of pressure ulcers, which measured the incidence of new ulcers, ulcer healing or changes in pressure ulcer severity. There were no restrictions on types of patient, setting, date, publication status or language. Two review authors independently screened for inclusion, and disagreement was resolved by discussion. Two review authors independently extracted data and assessed quality using the Cochrane Collaboration tool for assessing risk of bias. We included 23 RCTs, many were small (between 9 and 4023 participants, median 88) and at high risk of bias.Eleven trials compared a combination of nutritional supplements, consisting of a minimum of energy and protein in different dosages, for the prevention of pressure ulcers. A meta-analysis of eight trials (6062 participants) that compared the effects of mixed nutritional supplements with standard hospital diet found no clear evidence of an effect of supplementation on pressure

  1. Comparison of multi-modal early oral nutrition for the tolerance of oral nutrition with conventional care after major abdominal surgery: a prospective, randomized, single-blind trial.

    Science.gov (United States)

    Sun, Da-Li; Li, Wei-Ming; Li, Shu-Min; Cen, Yun-Yun; Xu, Qing-Wen; Li, Yi-Jun; Sun, Yan-Bo; Qi, Yu-Xing; Lin, Yue-Ying; Yang, Ting; Lu, Qi-Ping; Xu, Peng-Yuan

    2017-02-10

    Early oral nutrition (EON) has been shown to improve recovery of gastrointestinal function, length of stay and mortality after abdominal surgery; however, early oral nutrition often fails during the first week after surgery. Here, a multi-modal early oral nutrition program is introduced to promote recovery of gastrointestinal function and tolerance of oral nutrition. Consecutive patients scheduled for abdominal surgery were randomized to the multimodal EON group or a group receiving conventional care. The primary endpoint was the time of first defecation. The secondary endpoints were outcomes and the cost-effectiveness ratio in treating infectious complications. The rate of infectious-free patients was regarded as the index of effectiveness. One hundred seven patients were randomly assigned to groups. Baseline characteristics were similar for both groups. In intention-to-treat analysis, the success rate of oral nutrition during the first week after surgery in the multimodal EON group was 44 (83.0%) versus 31 (57.4%) in the conventional care group (P = 0.004). Time to first defecation, time to flatus, recovery time of bowel sounds, and prolonged postoperative ileus were all less in the multimodal EON group (P oral nutrition group (P oral nutrition program was an effective way to improve tolerance of oral nutrition during the first week after surgery, decrease the length of stay and improve cost-effectiveness after abdominal surgery. Registration number: ChiCTR-TRC-14004395 . Registered 15 March 2014.

  2. Nutritional recommendations for cardiovascular disease prevention.

    Science.gov (United States)

    Eilat-Adar, Sigal; Sinai, Tali; Yosefy, Chaim; Henkin, Yaakov

    2013-09-17

    Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD). This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food items, and nutritional supplements. The dietary patterns reviewed include low carbohydrate diet, low-fat diet, Mediterranean diet, and the DASH diet. Foods reviewed in the second section include: whole grains and dietary fiber, vegetables and fruits, nuts, soy, dairy products, alcoholic drinks, coffee and caffeine, tea, chocolate, garlic, and eggs. Supplements reviewed in the third section include salt and sodium, omega-3 and fish oil, phytosterols, antioxidants, vitamin D, magnesium, homocysteine-reducing agents, and coenzyme Q10.

  3. Nutritional Recommendations for Cardiovascular Disease Prevention

    Directory of Open Access Journals (Sweden)

    Yaakov Henkin

    2013-09-01

    Full Text Available Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD. This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food items, and nutritional supplements. The dietary patterns reviewed include low carbohydrate diet, low-fat diet, Mediterranean diet, and the DASH diet. Foods reviewed in the second section include: whole grains and dietary fiber, vegetables and fruits, nuts, soy, dairy products, alcoholic drinks, coffee and caffeine, tea, chocolate, garlic, and eggs. Supplements reviewed in the third section include salt and sodium, omega-3 and fish oil, phytosterols, antioxidants, vitamin D, magnesium, homocysteine-reducing agents, and coenzyme Q10.

  4. Nutritional Recommendations for Cardiovascular Disease Prevention

    Science.gov (United States)

    Eilat-Adar, Sigal; Sinai, Tali; Yosefy, Chaim; Henkin, Yaakov

    2013-01-01

    Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD). This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food items, and nutritional supplements. The dietary patterns reviewed include low carbohydrate diet, low-fat diet, Mediterranean diet, and the DASH diet. Foods reviewed in the second section include: whole grains and dietary fiber, vegetables and fruits, nuts, soy, dairy products, alcoholic drinks, coffee and caffeine, tea, chocolate, garlic, and eggs. Supplements reviewed in the third section include salt and sodium, omega-3 and fish oil, phytosterols, antioxidants, vitamin D, magnesium, homocysteine-reducing agents, and coenzyme Q10. PMID:24067391

  5. Performance enhancement with supplements: incongruence between rationale and practice

    Directory of Open Access Journals (Sweden)

    Mazanov Jason

    2007-11-01

    Full Text Available Abstract Background Athletes are expected to consider multiple factors when making informed decision about nutritional supplement use. Besides rules, regulations and potential health hazards, the efficacy of different nutritional supplements in performance enhancement is a key issue. The aim of this paper was to find evidence for informed decision making by investigating the relationship between specific performance-related reasons for supplement use and the reported use of nutritional supplements. Methods The 'UK Sport 2005 Drug Free Survey' data (n = 874 were re-analysed using association [χ2] and 'strength of association' tests [ϕ] to show the proportion of informed choices and to unveil incongruencies between self-reported supplement use and the underlying motives. Results Participants (n = 520 reported supplement use in the pattern of: vitamin C (70.4%, creatine (36.1%, whey protein (30.6%, iron (29.8%, caffeine (23.8%, and ginseng (8.3% for the following reasons: strength maintenance (38.1%, doctors' advice (24.2%, enhancing endurance (20.0%, ability to train longer (13.3%, and provided by the governing body (3.8%. Of thirty possible associations between the above supplements and reasons, 11 were predictable from literature precedents and only 8 were evidenced and these were not strong (ϕ 2 = 49.14, p 2 = 97.08, p 2 = 97.82, p Conclusion This study provided a platform for assessing congruence between athletes' reasons for supplement use and their actual use. These results suggest that a lack of understanding exists in supplement use. There is an urgent need to provide accurate information which will help athletes make informed choices about the use of supplements.

  6. Medical Issues: Nutrition

    Science.gov (United States)

    ... support & care > living with sma > medical issues > nutrition Nutrition Good nutrition is essential to health and growth. ... must make decisions based on their own needs. Nutrition Considerations Since we are still waiting for clinical ...

  7. Positive effect of protein-supplemented hospital food on protein intake in patients at nutritional risk: a randomised controlled trial.

    Science.gov (United States)

    Munk, T; Beck, A M; Holst, M; Rosenbom, E; Rasmussen, H H; Nielsen, M A; Thomsen, T

    2014-04-01

    New evidence indicates that increased dietary protein ingestion promotes health and recovery from illness, and also maintains functionality in older adults. The present study aimed to investigate whether a novel food service concept with protein-supplementation would increase protein and energy intake in hospitalised patients at nutritional risk. A single-blinded randomised controlled trial was conducted. Eighty-four participants at nutritional risk, recruited from the departments of Oncology, Orthopaedics and Urology, were included. The intervention group (IG) received the protein-supplemented food service concept. The control group (CG) received the standard hospital menu. Primary outcome comprised the number of patients achieving ≥75% of energy and protein requirements. Secondary outcomes comprised mean energy and protein intake, body weight, handgrip strength and length of hospital stay. In IG, 76% versus 70% CG patients reached ≥75% of their energy requirements (P = 0.57); 66% IG versus 30% CG patients reached ≥75% of their protein requirements (P = 0.001). The risk ratio for achieving ≥75% of protein requirements: 2.2 (95% confidence interval = 1.3-3.7); number needed to treat = 3 (95% confidence interval = 2-6). IG had a higher mean intake of energy and protein when adjusted for body weight (CG: 82 kJ kg(-1) versus IG: 103 kJ kg(-1) , P = 0.013; CG: 0.7 g protein kg(-1) versus 0.9 g protein kg(-1) , P = 0.003). Body weight, handgrip strength and length of hospital stay did not differ between groups. The novel food service concept had a significant positive impact on overall protein intake and on weight-adjusted energy intake in hospitalised patients at nutritional risk. © 2014 The British Dietetic Association Ltd.

  8. Nutritional rickets around the world: an update.

    Science.gov (United States)

    Creo, Ana L; Thacher, Tom D; Pettifor, John M; Strand, Mark A; Fischer, Philip R

    2017-05-01

    Worldwide, nutritional rickets continues to be an evolving problem with several causes. This paper provides an updated literature review characterising the prevalence, aetiology, pathophysiology and treatment of nutritional rickets worldwide. A systematic review of articles on nutritional rickets from various geographical regions was undertaken. For each region, key information was extracted, including prevalence, cause of rickets specific to the region, methods of confirming the diagnosis and current treatment and preventive measures. Calcium deficiency continues to be a major cause of rickets in Africa and Asia. Vitamin D deficiency rickets is perhaps increasing in the Americas, Europe and parts of the Middle East. There continues to be a distinct presentation of calcium-predominant versus vitamin D predominant rickets, although there are overlapping features. More careful diagnosis of rickets and reporting of 25-OHD concentrations has improved accurate knowledge of rickets prevalence and better delineated the cause. Nutritional rickets continues to be an evolving and multi-factorial problem worldwide. It is on a spectrum, ranging from isolated vitamin D deficiency to isolated calcium deficiency. Specific areas which require emphasis include a consistent community approach to screening and diagnosis, vitamin D supplementation of infants and at-risk children, prevention of maternal vitamin D deficiency and the provision of calcium in areas with low calcium diets.

  9. The effect of oligofructose-enriched inulin supplementation on gut microbiota, nutritional status and gastrointestinal symptoms in paediatric coeliac disease patients on a gluten-free diet: study protocol for a pilot randomized controlled trial.

    Science.gov (United States)

    Krupa-Kozak, Urszula; Drabińska, Natalia; Jarocka-Cyrta, Elżbieta

    2017-08-22

    A lifelong gluten-free diet (GFD) is regarded as the only proven and accepted therapy for coeliac disease (CD). However, even patients who strictly follow a GFD often suffer from intestinal symptoms and malabsorption. Selective modulation of intestinal microbiota with prebiotics could remedy various symptoms associated with CD. The use of prebiotics in the treatment of intestinal diseases remains insufficiently investigated. To our knowledge, this study makes the first attempt to evaluate the effect of prebiotic supplementation on gastrointestinal symptoms and nutritional status of children with CD. We hypothesized that adherence to a GFD supplemented with oligofructose-enriched inulin (Synergy 1) would deliver health benefits to children suffering from CD without any side effects, and that it would alleviate intestinal inflammation, restore and stabilize gut microbial balance and reverse nutritional deficiencies through enhanced absorption of vitamins and minerals. A randomized, placebo-controlled clinical trial was designed to assess the impact of the Synergy 1 on paediatric CD patients following a GFD. We randomized 34 children diagnosed with CD into an intervention group receiving 10 g of the Synergy 1 supplement daily and a placebo group (receiving maltodextrin) during a 12-week nutritional intervention. Selected biochemical parameters, nutritional status and the characteristics of faecal bacteria will be determined in samples collected before and after the intervention. Analysis of vitamins and amino acids concentration in biological fluids will allow to assess the dietary intake of crucial nutrients. The compliance to a GFD will be confirmed by a Food Frequency Questionnaire (FFQ-6) and the analysis of serum anti-tissue transglutaminase and faecal gluten immunogenic peptides (GIP). The identification of the beneficial effects of the Synergy 1 supplement on children with CD could have important implications for nutritional recommendations for CD patients and

  10. Promoting Healthy Growth or Feeding Obesity? The Need for Evidence-Based Oversight of Infant Nutritional Supplement Claims

    Directory of Open Access Journals (Sweden)

    Michelle Lampl

    2016-11-01

    Full Text Available The Developmental Origins of Health and Disease (DOHaD model recognizes growth in infancy and childhood as a fundamental determinant of lifespan health. Evidence of long-term health risks among small neonates who subsequently grow rapidly poses a challenge for interventions aiming to support healthy growth, not merely drive weight gain. Defining healthy growth beyond “getting bigger” is essential as infant and young child feeding industries expand. Liquid-based nutritional supplements, originally formulated for undernourished children, are increasingly marketed for and consumed by children generally. Clarifying the nature of the evidentiary base on which structure/function claims promoting “healthy growth” are constructed is important to curb invalid generalizations. Evidence points to changing social beliefs and cultural practices surrounding supplementary feeding, raising specific concerns about the long-term health consequences of an associated altered feeding culture, including reduced dietary variety and weight gain. Reassessing the evidence for and relevance of dietary supplements’ “promoting healthy growth” claims for otherwise healthy children is both needed in a time of global obesity and an opportunity to refine intervention approaches among small children for whom rapid subsequent growth in early life augments risk for chronic disease. Scientific and health care partnerships are needed to consider current governmental oversight shortfalls in protecting vulnerable populations from overconsumption. This is important because we may be doing more harm than good.

  11. Study protocol: cost-effectiveness of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care: cluster randomized controlled trial.

    Science.gov (United States)

    Beck, Anne Marie; Gøgsig Christensen, Annette; Stenbæk Hansen, Birthe; Damsbo-Svendsen, Signe; Kreinfeldt Skovgaard Møller, Tina; Boll Hansen, Eigil; Keiding, Hans

    2014-08-28

    Older adults in nursing home and home-care are a particularly high-risk population for weight loss or poor nutrition. One negative consequence of undernutrition is increased health care costs. Several potentially modifiable nutritional risk factors increase the likelihood of weight loss or poor nutrition. Hence a structured and multidisciplinary approach, focusing on the nutritional risk factors and involving e.g. dieticians, occupational therapists, and physiotherapist, may be necessary to achieve benefits. Up till now a few studies have been done evaluating the cost-effectiveness of nutritional support among undernourished older adults and none of these have used such a multidisciplinary approach. An 11 week cluster randomized trial to assess the cost-effectiveness of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care, identified by screening with the Eating validation Scheme. Before start of the study there will be performed a train-the-trainer intervention involving educated nutrition coordinators.In addition to the nutrition coordinator, the participants assigned to the intervention group strategy will receive multidisciplinary nutrition support. Focus will be on treatment of the potentially modifiable nutritional risk factors identified by screening, by involving physiotherapist, registered dietician, and occupational therapist, as relevant and independent of the municipality's ordinary assessment and referral system.The primary outcome parameter will be change in quality of life (by means of Euroquol-5D-3L). Secondary outcomes will be: physical performance (chair stand), nutritional status (weight, Body Mass Index and hand-grip strength), oral care, fall incidents, hospital admissions, rehabilitation stay, moving to nursing homes (for participants from home-care), use of social services and mortality.An economic evaluation will be conducted to evaluate the cost-effectiveness of the multidisciplinary

  12. Relationships among sense of coherence, oral health status, nutritional status and care need level of older adults according to path analysis.

    Science.gov (United States)

    Dewake, Nanae; Hamasaki, Tomoko; Sakai, Rie; Yamada, Shima; Nima, Yuko; Tomoe, Miki; Kakuta, Satoko; Iwasaki, Masanori; Soh, Inho; Shimazaki, Yoshihiro; Ansai, Toshihiro

    2017-11-01

    Sense of coherence (SOC) is a measurement of ability of an individual to cope with psychological stress and remain in good health. The aim of the present study was to examine the relationships among SOC score, oral health status, nutritional status and care need level of older adults using path analysis. We enrolled 53 older adults (17 men and 36 women) who were attending a day care service (mean age 80.4 ± 6.5 years). SOC was assessed using a 13-item, seven-scale instrument. Oral health status (number of present teeth, denture use) and nutritional status (assessed with Mini-Nutritional Assessment Short-Form) were also evaluated. Path analysis was used to examine the relationship of SOC with other related factors, including care need level. The mean SOC score was 57.0 ± 13.9. Mini-Nutritional Assessment Short-Form results showed that one participant (1.8%) was malnourished, 26 (49.1%) were at risk of malnutrition and 26 (49.1%) had normal nutritional status. Participants with high SOC scores showed a strong positive attitude, had a relatively large number of teeth, were in good nutritional condition and showed low care need levels. The present results showed that maintaining a high SOC level and good oral health help to reduce care need levels in older adults, and also prevent a worsening of their nutritional condition. Geriatr Gerontol Int 2017; 17: 2083-2088. © 2017 Japan Geriatrics Society.

  13. Quantitation of underivatized branched-chain amino acids in sport nutritional supplements by capillary electrophoresis with direct or indirect UV absorbance detection.

    Science.gov (United States)

    Qiu, Jun; Wang, Jinhao; Xu, Zhongqi; Liu, Huiqing; Ren, Jie

    2017-01-01

    The branched-chain amino acids (BCAAs) including leucine (Leu), isoleucine (Ile) and valine (Val) play a pivotal role in the human body. Herein, we developed capillary electrophoresis (CE) coupled with conventional UV detector to quantify underivatized BCAAs in two kinds of sport nutritional supplements. For direct UV detection at 195 nm, the BCAAs (Leu, two enantiomers of Ile and Val) were separated in a background electrolyte (BGE) consisting of 40.0 mmol/L sodium tetraborate, and 40.0 mmol/L β-cyclodextrin (β-CD) at pH 10.2. In addition, the indirect UV detection at 264 nm was achieved in a BGE of 2.0 mmol/L Na2HPO4, 10.0 mmol/L p-aminosalicylic acid (PAS) as UV absorbing probe, and 40.0 mmol/L β-CD at pH 12.2. The β-CD significantly benefited the isomeric separation of Leu, L- and D-Ile. The optimal conditions allowed the LODs (limit of detections) of direct and indirect UV absorption detection to be tens μmol/L level, which was comparable to the reported CE inline derivatization method. The RSDs (relative standard deviations) of migration time and peak area were less than 0.91% and 3.66% (n = 6). Finally, CE with indirect UV detection method was applied for the quantitation of BCAAs in two commercial sport nutritional supplements, and good recovery and precision were obtained. Such simple CE method without tedious derivatization process is feasible of quality control and efficacy evaluation of the supplemental proteins.

  14. Quantitation of underivatized branched-chain amino acids in sport nutritional supplements by capillary electrophoresis with direct or indirect UV absorbance detection.

    Directory of Open Access Journals (Sweden)

    Jun Qiu

    Full Text Available The branched-chain amino acids (BCAAs including leucine (Leu, isoleucine (Ile and valine (Val play a pivotal role in the human body. Herein, we developed capillary electrophoresis (CE coupled with conventional UV detector to quantify underivatized BCAAs in two kinds of sport nutritional supplements. For direct UV detection at 195 nm, the BCAAs (Leu, two enantiomers of Ile and Val were separated in a background electrolyte (BGE consisting of 40.0 mmol/L sodium tetraborate, and 40.0 mmol/L β-cyclodextrin (β-CD at pH 10.2. In addition, the indirect UV detection at 264 nm was achieved in a BGE of 2.0 mmol/L Na2HPO4, 10.0 mmol/L p-aminosalicylic acid (PAS as UV absorbing probe, and 40.0 mmol/L β-CD at pH 12.2. The β-CD significantly benefited the isomeric separation of Leu, L- and D-Ile. The optimal conditions allowed the LODs (limit of detections of direct and indirect UV absorption detection to be tens μmol/L level, which was comparable to the reported CE inline derivatization method. The RSDs (relative standard deviations of migration time and peak area were less than 0.91% and 3.66% (n = 6. Finally, CE with indirect UV detection method was applied for the quantitation of BCAAs in two commercial sport nutritional supplements, and good recovery and precision were obtained. Such simple CE method without tedious derivatization process is feasible of quality control and efficacy evaluation of the supplemental proteins.

  15. Nutritional Care of Gastric Cancer Patients with Clinical Outcomes and Complications: A Review.

    Science.gov (United States)

    Choi, Wook Jin; Kim, Jeongseon

    2016-04-01

    The incidence and mortality of gastric cancer have been steadily decreased over the past few decades. However, gastric cancer is still one of the leading causes of cancer deaths across many regions of the world, particularly in Asian countries. In previous studies, nutrition has been considered one of significant risk factors in gastric cancer patients. Especially, malnourished patients are at greater risk of adverse clinical outcomes (e.g., longer hospital stay) and higher incidence of complications (e.g., wound/infectious complications) compared to well-nourished patients. Malnutrition is commonly found in advanced gastric cancer patients due to poor absorption of essential nutrients after surgery. Therefore, nutritional support protocols, such as early oral and enternal feeding, have been proposed in many studies, to improve unfavorable clinical outcomes and to reduce complications due to delayed application of oral nutritional support or parental feeding. Also, the supplied with enternal immune-enriched diet had more benefits in improving clinical outcomes and fewer complications compared to a group supplied with control formula. Using nutritional screening tools, such as nutritional risk index (NRI) and nutritional risk screening (NRS 2002), malnourished patients showed higher incidence of complications and lower survival rates than non-malnourished patients. However, a long-term nutritional intervention, such as nutritional counseling, was not effective in the patients. Therefore, early assessment of nutritional status in patients using a proper nutritional screening tool is suggested to prevent malnutrition and adverse health outcomes. Further studies with numerous ethnic groups may provide stronger scientific evidences in association between nutritional care and recovery from surgery in patients with gastric cancer.

  16. Association between consumption of Herbalife nutritional supplements and acute hepatotoxicity.

    Science.gov (United States)

    Elinav, Eran; Pinsker, Galia; Safadi, Rifaat; Pappo, Orit; Bromberg, Michal; Anis, Emilia; Keinan-Boker, Lital; Broide, Efrat; Ackerman, Zvi; Kaluski, Dorit Nitzan; Lev, Boaz; Shouval, Daniel

    2007-10-01

    Nutritional supplements are frequently considered to be harmless but indiscriminate use of unlabelled ingredients may lead to significant adverse reactions. In 2004, identification of four index cases of acute hepatitis associated with Herbalife intake led to a ministry of health investigation in all Israeli hospitals. Twelve patients with acute idiopathic liver injury in association with consumption of Herbalife products were investigated. Eleven of the patients were females, aged 49.5+/-13.4 y. One patient had stage I primary biliary cirrhosis and another had hepatitis B. Acute liver injury was diagnosed after 11.9+/-11.1 months of initiation of Herbalife consumption. Liver biopsies demonstrated active hepatitis, portal inflammation rich with eosinophils, ductular reaction and parenchymal inflammation with peri-central accentuation. One patient developed sub-fulminant and two fulminant episodes of hepatic failure. Hepatitis resolved in eleven patients, while one patient succumbed to complications following liver transplantation. Three patients resumed consumption of Herbalife products following normalization of liver enzymes, resulting in a second bout of hepatitis. An association between intake of Herbalife products and acute hepatitis was identified in Israel. We call for prospective evaluation of Herbalife products for possible hepatotoxicity. Until then, caution should be exercised by consumers, especially among individuals suffering from underlying liver disease.

  17. Nutritional care of the elite child and adolescent athlete: Part I ...

    African Journals Online (AJOL)

    Nutritional care of the elite child and adolescent athlete: Part I - Energy and nutrient needs. ... assessed with skin folds or body fat percentages. Anthropometric measurements should be limited to twice yearly and too much ... 1300 mg calcium per day which can be achieved by having ~3 milk and/or dairy servings per day.

  18. Too little, too late: comparison of nutritional status and quality of life of nutrition care and support recipient and non-recipients among HIV-positive adults in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Oketch, Jecinter Akinyi; Paterson, Marie; Maunder, Eleni Winfred; Rollins, Nigel Campbell

    2011-03-01

    Compare the nutritional vulnerability, risk of malnutrition, nutritional status and quality of life (QoL) between recipients and non-recipients of nutrition care and support (NCS) of HIV-positive adults. In 2009, a household-based cross-sectional study of HIV-positive adults, NCS recipients (n=97) and non-NCS recipients (n=203) from KwaZulu-Natal was conducted. Nutritional vulnerability (socio-economic status; food security; self-reported health status; nutritional knowledge and attitude), risk of malnutrition (nutrition assessment screening tool), anthropometry (body mass index; mid-upper arm circumference; waist-to-hip ratio) and QoL (general health; self-care; physical functioning) were compared between the two groups. Although the result suggests a modest impairment of QoL, NCS recipients were twice as likely to have severe impairment of general health; self-care functioning and QoL. Overweight and obesity were common despite indications of high prevalence of food insecurity, possible-risk of malnutrition and diets predominantly of cereals. NCS recipients were more frequently taking anti-retroviral drugs, receiving social grants, reporting good eating plans and owning kitchen gardens. Non-NCS recipients had been generally sick, reported fatigue, nausea, appetite loss and diarrhoea. NCS recipients were twice as likely to experience oral thrush. Contextual factors such as low dietary diversity and household food insecurity that exacerbates nutritional vulnerability and malnutrition should be considered when providing NCS to fully achieve nutritional recovery and QoL of HIV-positive adults. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  19. Effect of oral nutritional supplementation on wound healing in diabetic foot ulcers: a prospective randomized controlled trial.

    Science.gov (United States)

    Armstrong, D G; Hanft, J R; Driver, V R; Smith, A P S; Lazaro-Martinez, J L; Reyzelman, A M; Furst, G J; Vayser, D J; Cervantes, H L; Snyder, R J; Moore, M F; May, P E; Nelson, J L; Baggs, G E; Voss, A C

    2014-09-01

    Among people with diabetes, 10-25% will experience a foot ulcer. Research has shown that supplementation with arginine, glutamine and β-hydroxy-β-methylbutyrate may improve wound repair. This study tested whether such supplementation would improve healing of foot ulcers in persons with diabetes. Along with standard of care, 270 subjects received, in a double-blinded fashion, (twice per day) either arginine, glutamine and β-hydroxy-β-methylbutyrate or a control drink for 16 weeks. The proportion of subjects with total wound closure and time to complete healing was assessed. In a post-hoc analysis, the interaction of serum albumin or limb perfusion, as measured by ankle-brachial index, and supplementation on healing was investigated. Overall, there were no group differences in wound closure or time to wound healing at week 16. However, in subjects with an albumin level of ≤ 40 g/l and/or an ankle-brachial index of healed at week 16 compared with control subjects (P = 0.03 and 0.008, respectively). Those with low albumin or decreased limb perfusion in the supplementation group were 1.70 (95% CI 1.04-2.79) and 1.66 (95% CI 1.15-2.38) times more likely to heal. While no differences in healing were identified with supplementation in non-ischaemic patients or those with normal albumin, addition of arginine, glutamine and β-hydroxy-β-methylbutyrate as an adjunct to standard of care may improve healing of diabetic foot ulcers in patients with risk of poor limb perfusion and/or low albumin levels. Further investigation involving arginine, glutamine and β-hydroxy-β-methylbutyrate in these high-risk subgroups might prove clinically valuable. © 2014 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  20. Individual and structural environmental influences on utilization of iron and folic acid supplementation among pregnant women in Harare, Zimbabwe.

    Science.gov (United States)

    Tinago, Chiwoneso B; Annang Ingram, Lucy; Blake, Christine E; Frongillo, Edward A

    2017-07-01

    Micronutrient deficiencies are prevalent among Zimbabweans with serious health and social implications. Due to a lack of a national micronutrient food fortification policy, the Zimbabwe Ministry of Health and Child Care established a policy for the prevention of maternal micronutrient deficiencies, which centres on pregnant women receiving daily iron and folic acid (IFA) at their first antenatal care visit and throughout pregnancy. Despite these efforts, utilization of IFA supplementation in pregnancy in Zimbabwe is low. This study aimed to understand the experiences and knowledge of IFA supplementation among pregnant women and healthcare workers in Harare, Zimbabwe, and the influence of health-service and social environments on utilization. Semi-structured in-depth interviews were conducted in Shona and English, with pregnant women (n = 24) and healthcare workers (n = 14) providing direct antenatal care services to pregnant women in two high-density community clinics. Data were analysed thematically using NVivo 10. Influences on utilization were at the individual and structural environmental levels. Reasons for low utilization of IFA supplementation included forgetting to take IFA, side effects, misconceptions about IFA, limited access to nutrition information, delayed entry or non-uptake of antenatal care and social norms of pregnant women for IFA supplementation. Utilization was enhanced by knowledge of risks and benefits of supplementation, fear of negative health complications with non-utilization, family support and healthcare worker recommendation for supplementation. Study findings can inform approaches to strengthen micronutrient supplementation utilization to improve the micronutrient status of pregnant women to decrease maternal mortality and improve overall maternal and child health in Zimbabwe. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.

  1. The Clinical Nutrition Research Agenda in Indonesia and beyond: ecological strategy for food in health care delivery.

    Science.gov (United States)

    Lukito, Widjaja; Wibowo, Lindawati; Wahlqvist, Mark L

    2017-06-01

    Despite progress with the food-associated health agenda in the public health and clinical domains, much remains to be done in Indonesia. There are reasons to be optimistic which include economic development, increasing literacy, progress towards universal health coverage and community organizational arrangements across the archipelago which focus on health through some 10,000 puskesmas. These community health centres are variably staffed with voluntary cadres from the community, bidans (nurses) and general medical practitioners. For more effective prevention and management of nutritionally-related health problems, innovative community and clinical nutrition research and expertise is required. With rapid urbanisation, the growth of the digital economy, increasing socio-economic inequity and climate change, there are imperatives for ecologically sustainable, nonemployment dependent livelihoods which provide energy, food, water, education and health care security. A relevant health care workforce will include those who research and practice clinical nutrition. Here we gather together an account of an extensive body of published and emerging literature which makes a case collectively for a more ecological approach to nutrition and health and how it might revitalise the Indonesian and other health care systems.

  2. Use of micronutrient supplements among pregnant women in Alberta: results from the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort.

    Science.gov (United States)

    Gómez, Mariel Fajer; Field, Catherine J; Olstad, Dana Lee; Loehr, Sarah; Ramage, Stephanie; McCargar, Linda J

    2015-10-01

    Maternal nutrient intake in the prenatal period is an important determinant of fetal growth and development and supports maternal health. Many women, however, fail to meet their prenatal nutrient requirements through diet alone and are therefore advised to consume nutrient supplements. The purpose of this study was to describe the use of natural health products (NHP) by pregnant women in each trimester of pregnancy. Women (n = 599) participating in the first cohort of the Alberta Pregnancy Outcomes and Nutrition (APrON) study completed an interviewer-administered supplement intake questionnaire during each trimester of pregnancy. NHP use was high, with >90% taking multivitamin/mineral supplements, and nearly half taking at least one additional single-nutrient supplement. Compliance with supplementation guidelines was high for folic acid (>90%), vitamin D (∼70%) and calcium (∼80%), but low for iron (<30%) and for all four nutrients together (≤11%). On average, women met or exceeded the recommended dietary allowance for folic acid, vitamin D and iron from NHPs alone, with median daily intakes of 1000 μg, 400 IU and 27 mg, respectively. The median calcium intake was 250 mg d(-1) . Up to 26% of women exceeded the tolerable upper intake level for folic acid and up to 19% did so for iron at some point of their pregnancy. Findings highlight the need to consider both dietary and supplemental sources of micronutrients when assessing the nutrient intakes of pregnant women. © 2013 John Wiley & Sons Ltd.

  3. Contribution of Dietary Supplements to Nutritional Adequacy by Socioeconomic Subgroups in Adults of the United States

    Directory of Open Access Journals (Sweden)

    Jeffrey B. Blumberg

    2017-12-01

    Full Text Available Many Americans have inadequate intakes of several nutrients, and the Dietary Guidelines for Americans 2015–2020 identified vitamins A, C, D, and E, in addition to calcium, magnesium, iron, potassium, choline, and fiber as “underconsumed nutrients”. Based on nationally representative data on 10,698 adults from National Health and Nutrition Examination Surveys (NHANES, 2009–2012, assessments were made of socioeconomic differences, based on the Poverty Income Ratio (PIR, in terms of the association of dietary supplement use on nutrient intake and nutrient inadequacies. Compared to food alone, the use of any dietary supplement plus food was associated with significantly (p < 0.01 higher intakes of 15–16 of 19 nutrients examined in all socioeconomic groups; and significantly reduced rates of inadequacy for 10/17 nutrients in the subgroup PIR > 1.85 (not poor, but only 4–5/17 nutrients (calcium and vitamins A, C, D, E for the poor and nearly poor subgroups (PIR < 1.35 and PIR 1.35 to ≤1.85, respectively. An increased prevalence of intakes above the Tolerable Upper Intake Level (UL was seen for 3–9/13 nutrients, but all were less than 5% in the PIR subgroups. In conclusion, dietary supplement use was associated with an increased micronutrient intake, decreased inadequacies, and a slight increase in the prevalence of intakes above the UL, with greater benefits seen in the PIR > 1.85 subgroup.

  4. Agricultural production - Phase 2. Indonesia. Nutritional strategies for ruminants fed on local feed supplemented with molasses multi-nutrient blocks

    International Nuclear Information System (INIS)

    Nolan, J.V.

    1992-01-01

    At the request of the Government of Indonesia, an IAEA expert undertook a three-week mission from 18 June 1989 to 7 July 1989 at the Centre for the Application of Isotopes and Radiation (PAIR/BATAN), National Atomic Energy Agency, Jakarta, within the framework of a project entitled: ''Assessment of molasses/multi-nutrient blocks for ruminants in Indonesia (with emphasis on small-farm holders)'' (INS/88/013 - 11.66 - Agricultural Production). The project involves field evaluations of supplementation strategies at a number of provinces and is backed by controlled laboratory studies at PAIR/BATAN. Recent field studies confirm the potential for improved production from goats, sheep, dairy cattle and buffaloes in response to supplementation. The increased production is justified by cost/benefit analysis but further improvements should be possible when least cost supplements are devised for local conditions. The Expert worked closely with the leader of the group in the Animal Nutrition and Production Section, Dr. C. Hendratno, and her staff to interpret, summarize and report on results of recently completed, existing field studies; to initiate new field studies in different provinces of Java; to develop nuclear and other techniques for use in planned intensive laboratory studies aimed at identifying the ingredients in urea-molasses multi-nutrient blocks that are responsible for their success as supplements for goats, dairy cattle and buffaloes in a number of locations in Java. (author)

  5. Nutritional and Metabolic Derangements in Pancreatic Cancer and Pancreatic Resection.

    Science.gov (United States)

    Gilliland, Taylor M; Villafane-Ferriol, Nicole; Shah, Kevin P; Shah, Rohan M; Tran Cao, Hop S; Massarweh, Nader N; Silberfein, Eric J; Choi, Eugene A; Hsu, Cary; McElhany, Amy L; Barakat, Omar; Fisher, William; Van Buren, George

    2017-03-07

    Pancreatic cancer is an aggressive malignancy with a poor prognosis. The disease and its treatment can cause significant nutritional impairments that often adversely impact patient quality of life (QOL). The pancreas has both exocrine and endocrine functions and, in the setting of cancer, both systems may be affected. Pancreatic exocrine insufficiency (PEI) manifests as weight loss and steatorrhea, while endocrine insufficiency may result in diabetes mellitus. Surgical resection, a central component of pancreatic cancer treatment, may induce or exacerbate these dysfunctions. Nutritional and metabolic dysfunctions in patients with pancreatic cancer lack characterization, and few guidelines exist for nutritional support in patients after surgical resection. We reviewed publications from the past two decades (1995-2016) addressing the nutritional and metabolic status of patients with pancreatic cancer, grouping them into status at the time of diagnosis, status at the time of resection, and status of nutritional support throughout the diagnosis and treatment of pancreatic cancer. Here, we summarize the results of these investigations and evaluate the effectiveness of various types of nutritional support in patients after pancreatectomy for pancreatic adenocarcinoma (PDAC). We outline the following conservative perioperative strategies to optimize patient outcomes and guide the care of these patients: (1) patients with albumin 10% should postpone surgery and begin aggressive nutrition supplementation; (2) patients with albumin endocrine and exocrine pancreatic insufficiency alongside implementation of appropriate treatment to improve the patient's quality of life.

  6. Position of the Academy of Nutrition and Dietetics: oral health and nutrition.

    Science.gov (United States)

    Touger-Decker, Riva; Mobley, Connie

    2013-05-01

    It is the position of the Academy of Nutrition and Dietetics that nutrition is an integral component of oral health. The Academy supports integration of oral health with nutrition services, education, and research. Collaboration between dietetics practitioners and oral health care professionals is recommended for oral health promotion and disease prevention and intervention. Scientific and epidemiological data suggest a lifelong synergy between diet, nutrition, and integrity of the oral cavity in health and disease. Oral health and nutrition have a multifaceted relationship. Oral infectious diseases, as well as acute, chronic, and systemic diseases with oral manifestations, impact an individual's functional ability to eat and their nutrition status. Likewise, nutrition and diet can affect the development and integrity of the oral cavity and progression of oral diseases. As knowledge of the link between oral and nutrition health increases, dietetics practitioners and oral health care professionals must learn to provide screening, education, and referrals as part of comprehensive client/patient care. The provision of medical nutrition therapy, including oral and overall health, is incorporated into the Standards of Practice for registered dietitians and dietetic technicians, registered. Inclusion of didactic and clinical practice concepts that illustrate the role of nutrition in oral health is essential in education programs for both professional groups. Collaborative endeavors between dietetics, dentistry, medicine, and allied health professionals in research, education, and delineation of practice roles are needed to ensure comprehensive health care. The multifaceted interactions between diet, nutrition, and oral health in practice, education, and research in both dietetics and dentistry merit continued, detailed delineation. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  7. The evidence for the use of nutritional support in liver disease.

    Science.gov (United States)

    Koretz, Ronald L

    2014-03-01

    Although there is a well established association between malnutrition and poorer clinical outcomes in patients with liver disease, that fact alone does not prove that improving the malnutrition will improve outcome. The best way to determine if nutritional interventions are effective is to compare them to untreated control groups in well designed and executed randomized clinical trials. A recent systematic review assessed 37 trials that compared parenteral nutrition, enteral nutrition, or nutritional supplements to no nutritional therapy in patients with a variety of liver diseases. Since the publication of that review, an additional three trials have become available. Whereas all but one of the trials did have methodologic shortcomings that may have allowed the introduction of bias (which usually results in an overestimation of benefit), the trials failed to show much, if any, benefit. In fact, the single trial at low risk of bias found that more deaths occurred in the recipients of the supplements. Although malnutrition may be associated with a poor outcome, the current best evidence indicates that the provision of adjunctive nutritional support (parenteral or enteral nutrition, or nutritional supplements) to patients with a variety of liver diseases (alcoholic hepatitis, cirrhosis, hepatocellular carcinoma, liver surgery, liver transplantation, obstructive jaundice, hepatitis C antiviral treatment) does not improve clinical outcomes.

  8. IOC consensus statement: dietary supplements and the high-performance athlete

    Science.gov (United States)

    Maughan, Ronald J; Burke, Louise M; Dvorak, Jiri; Larson-Meyer, D Enette; Peeling, Peter; Rawson, Eric S; Walsh, Neil P; Garthe, Ina; Geyer, Hans; Meeusen, Romain; van Loon, Lucas J C; Shirreffs, Susan M; Spriet, Lawrence L; Stuart, Mark; Vernec, Alan; Currell, Kevin; Ali, Vidya M; Budgett, Richard GM; Ljungqvist, Arne; Mountjoy, Margo; Pitsiladis, Yannis P; Erdener, Uğur; Engebretsen, Lars

    2018-01-01

    Nutrition usually makes a small but potentially valuable contribution to successful performance in elite athletes, and dietary supplements can make a minor contribution to this nutrition programme. Nonetheless, supplement use is widespread at all levels of sport. Products described as supplements target different issues, including (1) the management of micronutrient deficiencies, (2) supply of convenient forms of energy and macronutrients, and (3) provision of direct benefits to performance or (4) indirect benefits such as supporting intense training regimens. The appropriate use of some supplements can benefit the athlete, but others may harm the athlete’s health, performance, and/or livelihood and reputation (if an antidoping rule violation results). A complete nutritional assessment should be undertaken before decisions regarding supplement use are made. Supplements claiming to directly or indirectly enhance performance are typically the largest group of products marketed to athletes, but only a few (including caffeine, creatine, specific buffering agents and nitrate) have good evidence of benefits. However, responses are affected by the scenario of use and may vary widely between individuals because of factors that include genetics, the microbiome and habitual diet. Supplements intended to enhance performance should be thoroughly trialled in training or simulated competition before being used in competition. Inadvertent ingestion of substances prohibited under the antidoping codes that govern elite sport is a known risk of taking some supplements. Protection of the athlete’s health and awareness of the potential for harm must be paramount; expert professional opinion and assistance is strongly advised before an athlete embarks on supplement use. PMID:29540367

  9. IOC Consensus Statement: Dietary Supplements and the High-Performance Athlete.

    Science.gov (United States)

    Maughan, Ronald J; Burke, Louise M; Dvorak, Jiri; Larson-Meyer, D Enette; Peeling, Peter; Phillips, Stuart M; Rawson, Eric S; Walsh, Neil P; Garthe, Ina; Geyer, Hans; Meeusen, Romain; van Loon, Luc; Shirreffs, Susan M; Spriet, Lawrence L; Stuart, Mark; Vernec, Alan; Currell, Kevin; Ali, Vidya M; Budgett, Richard G M; Ljungqvist, Arne; Mountjoy, Margo; Pitsiladis, Yannis; Soligard, Torbjørn; Erdener, Uğur; Engebretsen, Lars

    2018-03-01

    Nutrition usually makes a small but potentially valuable contribution to successful performance in elite athletes, and dietary supplements can make a minor contribution to this nutrition program. Nonetheless, supplement use is widespread at all levels of sport. Products described as supplements target different issues, including the management of micronutrient deficiencies, supply of convenient forms of energy and macronutrients, and provision of direct benefits to performance or indirect benefits such as supporting intense training regimens. The appropriate use of some supplements can offer benefits to the athlete, but others may be harmful to the athlete's health, performance, and/or livelihood and reputation if an anti-doping rule violation results. A complete nutritional assessment should be undertaken before decisions regarding supplement use are made. Supplements claiming to directly or indirectly enhance performance are typically the largest group of products marketed to athletes, but only a few (including caffeine, creatine, specific buffering agents and nitrate) have good evidence of benefits. However, responses are affected by the scenario of use and may vary widely between individuals because of factors that include genetics, the microbiome, and habitual diet. Supplements intended to enhance performance should be thoroughly trialed in training or simulated competition before implementation in competition. Inadvertent ingestion of substances prohibited under the anti-doping codes that govern elite sport is a known risk of taking some supplements. Protection of the athlete's health and awareness of the potential for harm must be paramount, and expert professional opinion and assistance is strongly advised before embarking on supplement use.

  10. Impact of short-term nutritional supplementation on surrogate markers of undernutrition in hemodialysis patients - prospective real-life interventional study.

    Science.gov (United States)

    Ocepek, Andreja; Bevc, Sebastjan; Ekart, Robert

    Hemodialysis (HD) patients are at increased risk for undernutrition, especially protein wasting. We present the results of a prospective study in HD patients after 4 months of intervention with oral nutritional supplements (ONS). After a 3-month wash-out period, 92 HD patients were enrolled in the study. Patients were tested for undernutrition with composite parameters, laboratory tests, bioelectrical impedance analysis (BIA), and hand-grip strength test (HGS). All patients fulfilling criteria for, or at high risk of, undernutrition were given ONS in addition to their regular diet. The impact of short-term ONS on surrogate markers of undernutrition was statistically analyzed. Data for 84 patients, 45 (53.6%) male, average age 63.3 years, were available for analysis after 4 months. Patients were divided into three groups: group A (n = 28), patients with normal nutritional status (NUS) at baseline not necessitating ONS; group B (n = 43), patients entitled to receive ONS; group C (n = 13), patients entitled to receive but refused to take ONS. In group B patients, received on average 4.1 bottles of ONS (902 mL; 1,623.6 kcal; 73.06 g protein) per week. Baseline results showed statistically-significant differences between groups in serum albumin levels and phase angle (PhA) but not in HGS. After 4 months of ONS, we noticed stagnation of observed markers in group B. Interestingly, in group A, significant deterioration of serum albumin and PhA was observed, but HGS improved. There was a trend towards worsening of serum albumin levels and HGS in group C not reaching statistical significance. In undernourished HD patients after ONS we did not find statistically-significant improvement of NUS evaluating surrogate markers. Nevertheless, in undernourished patients not receiving ONS, serum albumin and HGS showed a trend towards worsening, and even in well-nourished patients, nutritional markers (serum albumin and PhA) declined. We speculate that a certain positive

  11. [The Nutritional Care Experience of a Post-Operative Periampullary Cancer Patient With Cachexia].

    Science.gov (United States)

    Liou, Yan-Ting; Chiang, Pin-Yi; Shun, Shiow-Ching

    2016-04-01

    Cachexia is one of the most widely overlooked of the syndromes that are experienced by cancer patients. This syndrome is especially prevalent among patients with gastroenterology tract cancer. Although the National Comprehensive Cancer Network (NCCN) issued palliative-care practice guidelines for cachexia in 2015, guidelines have yet to be issued for the clinical setting. The authors reviewed the literature and applied their clinical experience to create an approach for identifying the degree of cachexia in a post-operative patient with periampullary cancer. This approach assesses the nutritional status, physical status, laboratory results, and gastrointestinal system functions of the patient using the Cachexia Assessment Scale (CAS) and NCCN Practice Guidelines for Cachexia. The patient improved under nursing care with an increase in nutritional intake and physical activity facilitating their process of post-surgical physical recovery. The authors hope that this experience using the combined CAS-NCCN Practice Guidelines will help clinical caregivers better understand how to apply the relevant guidelines in clinical settings. The developed approach may help nurses assess the comprehensive nutrition status of patients and related factors in order to provide interventions that will decrease the progression of cachexia effectively and promote quality of life.

  12. A Prospective Randomized Controlled Trial to Study the Impact of a Nutrition-Sensitive Intervention on Adult Women With Cancer Cachexia Undergoing Palliative Care in India.

    Science.gov (United States)

    Kapoor, Neha; Naufahu, Jane; Tewfik, Sundus; Bhatnagar, Sushma; Garg, Rakesh; Tewfik, Ihab

    2017-03-01

    Advanced cancer patients with disease progression develop cachexia. Nevertheless, cancer patients at nutritional risk have shown improved body weight and quality of life with oral nutritional supplements. This was a randomized controlled trial in adult female cancer patients (n = 63) attending palliative clinics, with symptoms of cachexia. Eligible patients were randomly distributed into control (n = 33) and intervention (n = 30) groups. Both groups were provided with nutritional and physical activity counseling, but the intervention group received an additional 100 g of Improved Atta (IAtta) for 6 months daily consumption. This study was designed to assess the efficacy of IAtta (with counseling) in enhancing the health status of cachexic patients. Anthropometric measurements, dietary intake, physical activity level and quality of life parameters were assessed at baseline, after 3 months, and at the end of 6 months. Patients in the control group (n = 15) had significantly decreased body weight ( P = .003), mid-upper-arm circumference ( P = .002), and body fat ( P = .002) by the end of intervention. A trend of body weight gain in the intervention group (n = 17; P = .08) and significant increase of body fat ( P = .002) was observed; moreover, patients reported a significant improvement in fatigue ( P = .002) and appetite scores ( P = .006) under quality-of-life domains at the end of intervention. Embedding a nutrition-sensitive intervention ( IAtta ) within Indian palliative care therapy may improve quality of life and stabilize body weight in cancer cachexia patients.

  13. Reliability and validity of a nutrition and physical activity environmental self-assessment for child care

    Directory of Open Access Journals (Sweden)

    Ammerman Alice S

    2007-07-01

    Full Text Available Abstract Background Few assessment instruments have examined the nutrition and physical activity environments in child care, and none are self-administered. Given the emerging focus on child care settings as a target for intervention, a valid and reliable measure of the nutrition and physical activity environment is needed. Methods To measure inter-rater reliability, 59 child care center directors and 109 staff completed the self-assessment concurrently, but independently. Three weeks later, a repeat self-assessment was completed by a sub-sample of 38 directors to assess test-retest reliability. To assess criterion validity, a researcher-administered environmental assessment was conducted at 69 centers and was compared to a self-assessment completed by the director. A weighted kappa test statistic and percent agreement were calculated to assess agreement for each question on the self-assessment. Results For inter-rater reliability, kappa statistics ranged from 0.20 to 1.00 across all questions. Test-retest reliability of the self-assessment yielded kappa statistics that ranged from 0.07 to 1.00. The inter-quartile kappa statistic ranges for inter-rater and test-retest reliability were 0.45 to 0.63 and 0.27 to 0.45, respectively. When percent agreement was calculated, questions ranged from 52.6% to 100% for inter-rater reliability and 34.3% to 100% for test-retest reliability. Kappa statistics for validity ranged from -0.01 to 0.79, with an inter-quartile range of 0.08 to 0.34. Percent agreement for validity ranged from 12.9% to 93.7%. Conclusion This study provides estimates of criterion validity, inter-rater reliability and test-retest reliability for an environmental nutrition and physical activity self-assessment instrument for child care. Results indicate that the self-assessment is a stable and reasonably accurate instrument for use with child care interventions. We therefore recommend the Nutrition and Physical Activity Self-Assessment for

  14. ISSN Exercise & Sport Nutrition Review: Research & Recommendations

    OpenAIRE

    Kreider, Richard B; Almada, Anthony L; Antonio, Jose; Broeder, Craig; Earnest, Conrad; Greenwood, Mike; Incledon, Thomas; Kalman, Douglas S; Kleiner, Susan M; Leutholtz, Brian; Lowery, Lonnie M; Mendel, Ron; Stout, Jeffrey R; Willoughby, Darryn S; Ziegenfuss, Tim N

    2004-01-01

    Abstract Sport nutrition is a constantly evolving field with literally thousands of research papers published annually. For this reason, keeping up to date with the literature is often difficult. This paper presents a well-referenced overview of the current state of the science related to how to optimize training through nutrition. More specifically, this article discusses: 1.) how to evaluate the scientific merit of nutritional supplements; 2.) general nutritional strategies to optimize perf...

  15. Profile and performance of nutritionists in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Dixis FIGUEROA PEDRAZA

    Full Text Available ABSTRACT Objective To describe the profile and performance of nutritionists in Primary Health Care. Methods A cross-sectional study was carried out, and all nutritionists in two municipalities of Paraíba, Brazil, were interviewed. Information was collected through structured interviews on demographic characteristics, professional qualification, development of food and nutrition activities, knowledge and use of essential bibliography for the work in Primary Care. Results In one municipality there were 28 teams of the Family Health Strategy and in the other, nineteen teams. In all, nineteen nutritionists were interviewed, fourteen of whom were working in the health teams and five were working exclusively in the Family Health Support Centers. All but one were women and the majority were between 20 and 39 years; the majority (n=10 had no graduate training. Nutritionists from the basic health teams developed more public health nutrition actions, such as defining nutritional care protocols and vitamin A and iron supplementation than those from the Family Health Support Centers (11 versus 1; and 13 versus 1, respectively. About half were satisfied with work in general, and dissatisfaction was related to deficiencies in the availability and quality of anthropometric equipment, physical structure and material. Conclusion Nutritionists work in food and nutrition actions in collective health, emphasizing the importance of qualification and practices that better combine the programmatic agenda of this area with Primary Care.

  16. Experiences with nutrition-related information during antenatal care of pregnant women of different ethnic backgrounds residing in the area of Oslo, Norway.

    Science.gov (United States)

    Garnweidner, Lisa M; Sverre Pettersen, Kjell; Mosdøl, Annhild

    2013-12-01

    to explore experiences with nutrition-related information during routine antenatal care among women of different ethnical backgrounds. individual interviews with seventeen participants were conducted twice during pregnancy. Data collection and analysis were inspired by an interpretative phenomenological approach. participants were purposively recruited at eight Mother and Child Health Centres in the area of Oslo, Norway, where they received antenatal care. participants had either immigrant backgrounds from African and Asian countries (n=12) or were ethnic Norwegian (n=5). Participants were pregnant with their first child and had a pre-pregnancy Body Mass Index above 25 kg/m(2). participants experienced that they were provided with little nutrition-related information in antenatal care. The information was perceived as presented in very general terms and focused on food safety. Weight management and the long-term prevention of diet-related chronic diseases had hardly been discussed. Participants with immigrant backgrounds appeared to be confused about information given by the midwife which was incongruent with their original food culture. The participants were actively seeking for nutrition-related information and had to navigate between various sources of information. the midwife is considered a trustworthy source of nutrition-related information. Therefore, antenatal care may have considerable potential to promote a healthy diet to pregnant women. Findings suggest that nutrition communication in antenatal care should be more tailored towards women's dietary habits and cultural background, nutritional knowledge as well as level of nutrition literacy. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Bacterial contamination of ready-to-use 1-L feeding bottles and administration sets in severely compromised intensive care patients

    NARCIS (Netherlands)

    Mathus-Vliegen, L. M.; Binnekade, J. M.; de Haan, R. J.

    2000-01-01

    OBJECTIVE: In intensive care patients, enteral feeding requires sterile feedings because of infectious complications and adequate supplements to meet nutritional needs. Heretofore, prepacked, large-volume formula containers were developed, but bacterial contamination occurred in 4% to 15%. Our

  18. Relationship between cognitive impairment and nutritional assessment on functional status in Calabrian long-term-care.

    Science.gov (United States)

    Malara, Alba; Sgrò, Giovanni; Caruso, Chiara; Ceravolo, Francesco; Curinga, Giuseppe; Renda, Grazia Francesca; Spadea, Fausto; Garo, Michele; Rispoli, Vincenzo

    2014-01-01

    The interaction between dementia and nutritional state is very complex and not yet fully understood. The aim of the present study was to assess the interaction between cognitive impairment and nutritional state in a cohort of residential elderly in relationship with functional condition of patients and their load of assistance in long-term-care facilities of the National Association of Third Age Structures (ANASTE) Calabria. One hundred seventy-four subjects (122 female and 52 male) were admitted to the long-term-care ANASTE Calabria study. All patients underwent multidimensional geriatric assessment. Nutritional state was assessed with the Mini Nutritional Assessment (MNA), whereas cognitive performance was evaluated by the Mini-Mental State Examination (MMSE). The functional state was assessed by Barthel Index (BI) and Activity Daily Living (ADL). The following nutritional biochemical parameters were also evaluated: albumin, cholesterol, iron, and hemoglobin. All patients were reassessed 180 days later. A severe cognitive impairment in MMSE performance was displayed in 49.7% patients, while 39.8% showed a moderate deficit; 6.9% had a slight deficit; and 3.4% evidenced no cognitive impairment. In MNA, 30% of patients exhibited an impairment of nutritional state; 56% were at risk of malnutrition; and 14% showed no nutritional problems. Malnutrition was present in 42% of patients with severe cognitive impairment, but only 4% of malnourished patients showed moderate cognitive deficit. The statistical analysis displayed a significant correlation between MNA and MMSE (Pnutritional state (P<0.005) as well as with the functional state (P<0.05) and mortality (P<0.01). The present study clearly shows that malnutrition may play an important role in the progression of cognitive loss.

  19. Avaliação protéica de uma nova multimistura com base no milho QPM BR 473 Protein evaluation of a nutritional supplement based on QPM BR 473 maize

    Directory of Open Access Journals (Sweden)

    Enara Cristina Silva Glória

    2004-09-01

    Full Text Available A multimistura tem sido utilizada no Brasil pela Pastoral da Criança, em parceria com governos municipais, a fim de reduzir a desnutrição infantil. Não obstante, a eficácia deste suplemento tem sido constantemente arguida, devido à possível presença de fatores antinutricionais. No presente trabalho descrevemos a avaliação biológica de um suplemento contendo milho QPM BR473. Trinta e seis ratos Wistar machos, com 21-23 dias de idade, foram divididos em seis grupos de seis animais cada e alimentados com dietas de caseína contendo multimistura pura, com QPM BR473, láctea (contendo leite em pó, láctea contendo QPM BR473 ou a multimistura proposta (contendo QPM BR473, farinhas de aveia, soja e banana e açúcar mascavo. Mediu-se a Retenção Protéica Líquida. A condição microbiológica dos suplementos e seu custo foram também determinados. Os resultados obtidos mostraram que o QPM BR473 pode ser usado em suplementos nutricionais, com alto valor nutritivo, expresso por sua qualidade protéica, e com baixa relação custo/benefício.Nutritional supplements, known as "multimisturas", prepared with low cost ingredients have been distributed in Brazil by municipal governments, in partnership with non-governmental organizations, in order to reduce infant malnutrition. Nevertheless the efficacy of these supplements has been constantly argued, due to the possible presence of anti-nutritional factors. The present work describes the biological evaluation of a supplement containing Quality Protein Maize BR 473. Thirty six 21-23-day old male Wistar rats were divided into six groups of six animals each. The groups were fed casein diets, each containing respectively: "multimistura", "multimistura" with QPM BR 473, "multimistura" with powdered milk, "multimistura" with powderedmilk and QPM BR 473 or the proposed new supplement (containing QPM BR 473 flour, oat meal, soybean flour, brown sugar and banana meal. Net protein retention was measured

  20. Prevalence of celiac disease in nutritional anemia at a tertiary care center.

    Science.gov (United States)

    Kavimandan, Amit; Sharma, Meenakshi; Verma, Anil K; Das, Prasenjit; Mishra, Prabhash; Sinha, Sanjeev; Mohan, Anant; Sreenivas, V; Datta Gupta, Siddhartha; Makharia, Govind K

    2014-03-01

    While anemia occurs in 80 % to 90 % of patients with celiac disease (CD), it may be the sole manifestation of CD. The prevalence of CD in Indian patients with nutritional anemia is not known. Adolescent and adult patients presenting with nutritional anemia were prospectively screened for CD using IgA anti-tissue transglutaminase antibody (anti-tTG Ab) followed, if positive, by upper gastrointestinal endoscopy and duodenal biopsy. Ninety-six patients [mean ± SD age 32.1 ± 13.1 years and median duration of anemia 11 months (range 1 to 144 months)] were screened. Of these patients, 80 had iron deficiency anemia, 11 had megaloblastic anemia, and 5 had dimorphic anemia. Seventy-three patients were on hematinics and 36.4 % had received blood transfusions. Nineteen had a history of chronic diarrhea and the mean ± SD duration of diarrhea in them was 9.7 ± 35.8 months. IgA anti-tTG Ab was positive in 13 patients, of whom 12 agreed to undergo duodenal biopsy. Ten patients had villous atrophy (Marsh grade 3a in three, 3b in one, and 3c in six) and two did not. Thus, 10 patients with nutritional anemia (iron deficiency 9, vitamin B12 deficiency 1) were diagnosed to have CD. On multivariate logistic regression, age, duration of symptoms, and presence of diarrhea were found to be the predictors of CD. All the patients with CD were put on gluten-free diet and with iron and vitamin supplementations and showed a significant improvement in hemoglobin concentration. CD screening should be included in the work up of otherwise unexplained nutritional anemia.