Science.gov

Sample records for adequate nutritional support

  1. Nutrition support in pancreatitis.

    PubMed

    Curtis, Caitlin S; Kudsk, Kenneth A

    2007-12-01

    Nutrition support is especially important in patients who have pancreatitis, as these patients have high metabolic needs and are usually unable to ingest sufficient calories from an oral diet because of pain or intestinal dysfunction. Clinicians must assess severity of the disease carefully, as initiation and timing of nutrition support are crucial. Depending on the severity, early nutrition support may be unnecessary, while late support ultimately may lead to worse outcomes. Route of nutrition support also plays an important role in treatment. The clinician has many alternatives from which to choose, including enteral nutrition given nasogastrically or nasojejunally, or parenteral nutrition given through a central line. This article explores the role of nutrition support in the outcome of pancreatitis and provides guidelines to aid the clinician in caring for patients who have acute and chronic pancreatitis.

  2. Nutrition support in pancreatitis.

    PubMed

    Marulendra, S; Kirby, D F

    1995-04-01

    Nutrition support in patients with pancreatitis has created a challenge for clinicians. Because the pancreas is normally stimulated by the ingestion of food, particularly fat, patients are often denied oral nutrition. This reduction in the ingestion of food, together with the increased metabolic demands of this disease, often results in a negative energy balance and occasionally undernutrition or malnutrition. This review summarizes the etiologies and methods for staging pancreatitis, the physiology of pancreatic exocrine secretion and the response of the pancreas to different methods of nutrition support. The results of clinical trials, which examine both parenteral and enteral nutrition in animals and humans with this disease, are reviewed. Recommendations for nutrition management of patients with acute and chronic pancreatitis and areas for future research are discussed.

  3. Do Beginning Teachers Receive Adequate Support from Their Headteachers?

    ERIC Educational Resources Information Center

    Menon, Maria Eliophotou

    2012-01-01

    The article examines the problems faced by beginning teachers in Cyprus and the extent to which headteachers are considered to provide adequate guidance and support to them. Data were collected through interviews with 25 school teachers in Cyprus, who had recently entered teaching (within 1-5 years) in public primary schools. According to the…

  4. Aedes aegypti disregard humidity-related conditions with adequate nutrition.

    PubMed

    Canyon, D V; Muller, R; Hii J, L K

    2013-03-01

    Weather variations have clear associations with the epidemiology of dengue fever and populations of Aedes aegypti mosquitoes. Data on humidity associations, however, lags with respect to its effect on host-biting, nectar-seeking and survival. This experimental study on Ae. aegypti, sourced from the arid tropics, investigated the effect of low and high relative humidity and diet in relation to host-biting, temporal variations in feeding frequency, and mosquito mortality. In each environmental setting, 10 replicates, containing one male and five female mosquitoes, were challenged with different nutritional sources every six hours over 12 days. Results showed that host-biting did not diminish in low humidity and was six times higher than expected. Sucrose feeding was observed to significantly moderate host-biting and water alone was inadequate for survival. The high host-biting rates help to explain the intensity of dengue epidemics, while the ability of the mosquito to disregard adverse humidity-related conditions helps to explain how dengue epidemics in arid tropical regions can be just as devastating as those in the wet tropics.

  5. What Is Nutrition Support Therapy?

    MedlinePlus

    ... Professional Development Webinars Calendar of Events What Is Nutrition Support Therapy All people need food to live. ... patient populations from pediatrics to geriatrics. Key Terms: Nutrition Support Therapy The provision of enteral or parenteral ...

  6. Perioperative nutritional support.

    PubMed

    Morán López, Jesús Manuel; Piedra León, María; García Unzueta, María Teresa; Ortiz Espejo, María; Hernández González, Miriam; Morán López, Ruth; Amado Señaris, José Antonio

    2014-01-01

    The relationship between preoperative malnutrition and morbi-mortality has been documented for years. Despite the existence of tools that allow its detection, and therefore treat this entity, their introduction into clinical practice is not wide-spread. Both perioperative insulin resistance and hyperglycemia are associated with increased perioperative morbidity and length of hospital stay. The intake of carbohydrate-rich drinks 2-4h prior to surgery reduces insulin resistance. In the immediate postoperative period, the enteral route is safe and well tolerated and its early use reduces hospital stay and postoperative complications compared with parenteral nutritional support. Inmunonutrition has been proven effective to decrease postoperative complications and hospital stay. In view of these data we opted for the adoption of these measures replacing bowel rest and the indiscriminate use of postoperative parenteral nutrition.

  7. State of nutrition support teams.

    PubMed

    DeLegge, Mark Henry; Kelly, Andrea True; Kelley, Andrea True

    2013-12-01

    The incidence of malnutrition in hospitalized patients is relatively high (up to 55%) despite breakthroughs in nutrition support therapies. These patients have increased morbidity and mortality, extended hospital stays, and care that is associated with higher costs. These patients are often poorly managed due to inadequate nutrition assessment and poor medical knowledge and practice in the field of nutrition. Nutrition support teams (NSTs) are interdisciplinary support teams with specialty training in nutrition that are often comprised of physicians, dietitians, nurses, and pharmacists. Their role includes nutrition assessment, determination of nutrition needs, recommendations for appropriate nutrition therapy, and management of nutrition support therapy. Studies have demonstrated significant improvements in patient nutrition status and improved clinical outcomes as well as reductions in costs when patients were appropriately managed by a multispecialty NST vs individual caregivers. Despite this, there has been steady decline in the number of formal NST in recent years (65% of hospitals in 1995 to 42% in 2008) as hospitals and other healthcare organizations look for ways to cut costs. Given the importance of nutrition status on clinical outcomes and overall healthcare costs, a number of institutions have introduced and sustained strong nutrition training and support programs and teams, demonstrating both clinical and economic benefit. The benefits of NST, training and implementation strategies, and tips for justifying these clinically and economically beneficial groups to healthcare organizations and governing bodies are discussed in this review.

  8. Nutritional support and gastrointestinal disease.

    PubMed

    Hennessy, K

    1989-06-01

    The use of nutritional support in patients with acute gastrointestinal disease requires a thorough knowledge of the pathophysiology and nutritional alterations that are caused by the disease process. Although nutritional therapy of a patient with gastrointestinal disease is not curative of the underlying disease, it does provide essential support to the patient, which improves response to, and eventual recovery from, illness. Special considerations need to be made to avoid complicating the patient's condition by inappropriate use of nutritional support solutions, which can lead to abnormal liver function. PMID:2498848

  9. Nutritional support of reptile patients.

    PubMed

    De Voe, Ryan S

    2014-05-01

    Providing nutritional support to reptile patients is a challenging and often misunderstood task. Ill reptiles are frequently anorexic and can benefit greatly from appropriate nutrition delivered via a variety of assist-feeding techniques. Neonatal reptiles can also be very challenging patients because many fail to thrive without significant efforts to establish normal feeding behaviors. This article presents ideas supporting the benefit of timely nutritional support as well as specific recommendations for implementation of assist feeding. Also discussed are a few nutritional issues that affect captive reptile species.

  10. An adequate Fe nutritional status of maize suppresses infection and biotrophic growth of Colletotrichum graminicola.

    PubMed

    Ye, Fanghua; Albarouki, Emad; Lingam, Brahmasivasenkar; Deising, Holger B; von Wirén, Nicolaus

    2014-07-01

    Iron (Fe) is an essential element for plant pathogens as well as for their host plants. As Fe plays a central role in pathogen virulence, most plants have evolved Fe-withholding strategies to reduce Fe availability to pathogens. On the other hand, plants need Fe for an oxidative burst in their basal defense response against pathogens. To investigate how the plant Fe nutritional status affects plant tolerance to a hemibiotrophic fungal pathogen, we employed the maize-Colletotrichum graminicola pathosystem. Fungal infection progressed rapidly via biotrophic to necrotrophic growth in Fe-deficient leaves, while an adequate Fe nutritional status suppressed the formation of infection structures of C. graminicola already during the early biotrophic growth phase. As indicated by Prussian blue and 3,3'-diaminobenzidine (DAB) staining, the retarding effect of an adequate Fe nutritional status on fungal development coincided temporally and spatially with the recruitment of Fe to infection sites and a local production of H2 O2 . A similar coincidence between local Fe and H2 O2 accumulation was found in a parallel approach employing C. graminicola mutants affected in Fe acquisition and differing in virulence. These results indicate that an adequate Fe nutritional status delays and partially suppresses the fungal infection process and the biotrophic growth phase of C. graminicola, most likely via the recruitment of free Fe to the fungal infection site for a timely oxidative burst.

  11. Patients requiring perioperative nutritional support.

    PubMed

    Enomoto, T Miko; Larson, Dawn; Martindale, Robert G

    2013-11-01

    One of the most important factors affecting outcome and recovery from surgical trauma is preoperative nutritional status. Research in perioperative nutritional support has suffered from a lack of consensus as to the definition of malnutrition, no recognition of which nutrients are important to surgical healing, and a paucity of well-designed studies. In the past decade, there has been some activity to address this situation, recognizing the importance of nutrition as a therapy before surgery, after surgery, and possibly even during surgery.

  12. Nutrition support in acute pancreatitis.

    PubMed

    McClave, Stephen A

    2007-03-01

    The benefit of early enteral nutrition (EN) for the disease process and for patient outcome in severe acute pancreatitis is dramatic. A narrow window of opportunity exists during which there is potential for EN to decrease disease severity and reduce overall complications. Most patients with severe pancreatitis tolerate enteral feeds. Any signs of symptom exacerbation or increasing inflammation in response to EN may be ameliorated by subtle adjustments in the feeding strategy. In this manner, provision of EN represents primary therapy in the management of the patient with acute pancreatitis and is emerging as the gold standard of therapy in nutrition support for this disease process.

  13. Human milk feeding supports adequate growth in infants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Despite current nutritional strategies, premature infants remain at high risk for extrauterine growth restriction. The use of an exclusive human milk-based diet is associated with decreased incidence of necrotizing enterocolitis (NEC), but concerns exist about infants achieving adequate growth. The ...

  14. Use of Linear Programming to Develop Cost-Minimized Nutritionally Adequate Health Promoting Food Baskets

    PubMed Central

    Tetens, Inge; Dejgård Jensen, Jørgen; Smed, Sinne; Gabrijelčič Blenkuš, Mojca; Rayner, Mike; Darmon, Nicole; Robertson, Aileen

    2016-01-01

    Background Food-Based Dietary Guidelines (FBDGs) are developed to promote healthier eating patterns, but increasing food prices may make healthy eating less affordable. The aim of this study was to design a range of cost-minimized nutritionally adequate health-promoting food baskets (FBs) that help prevent both micronutrient inadequacy and diet-related non-communicable diseases at lowest cost. Methods Average prices for 312 foods were collected within the Greater Copenhagen area. The cost and nutrient content of five different cost-minimized FBs for a family of four were calculated per day using linear programming. The FBs were defined using five different constraints: cultural acceptability (CA), or dietary guidelines (DG), or nutrient recommendations (N), or cultural acceptability and nutrient recommendations (CAN), or dietary guidelines and nutrient recommendations (DGN). The variety and number of foods in each of the resulting five baskets was increased through limiting the relative share of individual foods. Results The one-day version of N contained only 12 foods at the minimum cost of DKK 27 (€ 3.6). The CA, DG, and DGN were about twice of this and the CAN cost ~DKK 81 (€ 10.8). The baskets with the greater variety of foods contained from 70 (CAN) to 134 (DGN) foods and cost between DKK 60 (€ 8.1, N) and DKK 125 (€ 16.8, DGN). Ensuring that the food baskets cover both dietary guidelines and nutrient recommendations doubled the cost while cultural acceptability (CAN) tripled it. Conclusion Use of linear programming facilitates the generation of low-cost food baskets that are nutritionally adequate, health promoting, and culturally acceptable. PMID:27760131

  15. Nutritional support in acute and chronic pancreatitis.

    PubMed

    Grant, John P

    2011-08-01

    Nutritional support can have a significant beneficial impact on the course of moderate to severe acute pancreatitis. Enteral nutrition is preferred, with emphasis on establishment of jejunal access; however, parenteral nutrition can also be of value if intestinal failure is present. Early initiation of nutritional support is critical, with benefits decreasing rapidly if begun after 48 hours from admission. Severe malnutrition in chronic pancreatitis can be avoided or treated with dietary modifications or enteral nutrition.

  16. Nutritional support in critically ill patients with cancer.

    PubMed

    Wong, P W; Enriquez, A; Barrera, R

    2001-07-01

    Nutritional depletion is a common problem seen in critically ill patients with cancer and is associated with increased morbidity and mortality. Infection and injury activate a cascade of metabolic events that leads to a poor nutritional state and wasteful energy consumption. The goals of nutritional support entail minimizing starvation, preventing nutrient deficiencies, supporting or improving immune function, and facilitating tissue repair and wound healing. Further understanding of the metabolic changes of illness will improve effective regulation of the inflammatory events occurring in critically ill patients. Multiple clinical parameters are available to assess the nutritional status in critically ill patients, but no standard recommendations can be made at this time. The use of these parameters can be appropriate, provided that their limitations are understood clearly. The development and standardization of objective parameters to identify patients at risk or with subclinical malnutrition are needed. Enteral and parenteral feedings are safe and effective methods to deliver nutrients to critically ill patients with cancer who are unable to ingest adequate amounts orally. Early nutritional support should be instituted in the appropriate clinical setting. Specialized nutritional solutions and supplements require careful consideration in patients with renal, hepatic, cardiac, or pulmonary disorders. The unselective use of nutritional support is not indicated in well-nourished patients with cancer undergoing surgery, chemotherapy, or radiotherapy in whom adequate oral intake is anticipated. Nutritional support remains an important adjunctive therapy in the overall management of critically ill patients. Continued clinical investigations in nutrition are necessary to identify other groups of patients who can benefit from nutritional interventions. PMID:11525056

  17. New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition.

    PubMed

    Akbulut, Gamze

    2011-07-01

    Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between pro-inflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counseling, oral supplementation, enteral or total parenteral nutrition). Nutritional support has been widely advocated as adjunctive therapy for a variety of underlying illnesses, including surgery and medical oncotherapy (radiation or chemotherapy for cancer). Glutamine, n-3 fatty acids and probiotics/prebiotics are therapeutic factors that potentially modulate gastrointestinal toxicity related to cancer treatments. Enteral and parenteral nutrition may help improve patient survival, functional status and QoL, yet the benefits appear to be primarily limited to patients with good functional status and with gastrointestinal disease affecting nutritional intake. Parenteral nutrition offers the possibility of increased or maintenance of the nutrient intake in patients for whom normal food intake is inadequate and for whom enteral nutrition is not feasible, is contraindicated or is not accepted by the patient. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with cancer.

  18. [Nutritional support in oncology. The outpatient].

    PubMed

    Camilo, M E

    1994-04-01

    The process of tissue regeneration and healing requires individualized nutrition, often with dietary manipulation of regular foodstuffs and supplements to prevent or correct previous or iatrogenic deficiencies. A practical approach to problem-solving in order to provide the best possible nutritional support at home is presented.

  19. Strategies for Creating Supportive School Nutrition Environments

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2014

    2014-01-01

    Good nutrition is vital to optimal health. The school environment plays a fundamental role in shaping lifelong healthy behaviors and can have a powerful influence on students' eating habits. A supportive school nutrition environment includes multiple elements: access to healthy and appealing foods and beverages available to students in school…

  20. [Nutritional support in oncology. The outpatient].

    PubMed

    Camilo, M E

    1994-04-01

    The process of tissue regeneration and healing requires individualized nutrition, often with dietary manipulation of regular foodstuffs and supplements to prevent or correct previous or iatrogenic deficiencies. A practical approach to problem-solving in order to provide the best possible nutritional support at home is presented. PMID:8048357

  1. Polish experience in nutrition support in children.

    PubMed

    Laskowska, Justyna; Friedman-Gruszczyńska, Joanna; Popińska, Katarzyna; Lyszkowska, Małgorzata; Książyk, Janusz

    2011-01-01

    Organization of enteral nutrition programme in Poland has developed rapidly in the last years, however, the underdiagnosis and late diagnosis of malnutrition are still the major challenges. For those children who are unable to tolerate enteral diet, intravenous support is required. Main achievements in our parenteral nutrition programme (PN) consist in decreasing septic complication rate and introducting fish oil based emulsions for prevention of PN-related liver disease. The challenge to combat in the future comprises development of a network of nutritional centres covering the whole country, which will take care of patients requiring nutrition support. The Children's Memorial Health Institute in Warsaw will remain the reference centre for the management of the most complicated cases. The organization of postgraduate courses should lead to continuous reduction of nutrition related complications rate. The important problem remains the relatively low number of patients weaned off PN. The widespread introduction of intestine rehabilitation programme is essential to improve this issue. PMID:22006489

  2. Nutritional Support of Medical Practice.

    ERIC Educational Resources Information Center

    Schneider, Howard A., Ed.; And Others

    This book is intended to assemble for the medical practitioner in the developed countries those features of nutritional science which are clearly useful and clinically applicable in day-to-day medical practice. The book contains 32 chapters structured into three parts. After a brief description from the viewpoint of human biology, the first main…

  3. [Nutritional support in liver transplantation].

    PubMed

    Planas, M; Farriol, M; Schwartz, S; López, J; Pérez, A; Padró, J B

    1991-01-01

    Given the malnutrition present in patients suffering from advanced hepatic illness, as well as the implications of this in the post-hepatic transplant period, a study was made of various biochemical parameters (prealbumin, retinol-bound protein, zinc, magnesium, cholesterol and amino acid pattern) as indicators of the nutritional condition of a series of 15 patients who underwent hepatic transplants and required total parenteral nutrition (TPN) during the first 10 post-transplant days. Before the transplants were carried out, all the patients studied showed a decrease in all evaluated parameters. Ten days after the transplant, and having been fed parenterally during this time, the different parameters corrected themselves, with the exception of cholesterol. TPN, administered with enrichment of branched amino acids by 35%, practically normalized the plasma amino acid pattern. PMID:1764532

  4. Maintaining adequate nutrition, not probiotic administration, prevents growth stunting and maintains skeletal muscle protein synthesis rates in a piglet model of colitis.

    PubMed

    Harding, Scott V; Adegoke, Olasunkanmi A J; Fraser, Keely G; Marliss, Errol B; Chevalier, Stéphanie; Kimball, Scot R; Jefferson, Leonard S; Wykes, Linda J

    2010-03-01

    Malnutrition and cytokine-induced catabolism are pervasive in children with inflammatory bowel diseases (IBD), however, the benefits of aggressive nutrition support or of probiotics on nutrient and functional deficiencies and growth remain unclear. Piglets with dextran sulfate (DS)-induced colitis consuming a 50% macronutrient restricted diet (C-MR) were compared with those receiving probiotics (C-MRP) or adequate nutrition (C-WN) and with healthy well-nourished controls (REF). C-WN versus REF had reduced growth (-34% chest circumference and -22% snout-to-rump length gain) and a tendency toward lesser weight gain, but no differences in skeletal muscle protein fractional synthesis rates (FSR) or initiation of translation via the mTOR pathway were observed. Compared with C-WN, the C-MR and C-MRP piglets had lower weight gain, growth, and skeletal muscle FSR, and lower phosphorylated p70S6K1 with higher eIF4E*4E-BP1, indicative of reduced initiation of protein translation. Finally, plasma leucine concentrations were positively correlated with weight and phosphorylated p70S6K1, whereas negatively correlated with eIF4E*4E-BP1. In conclusion, reductions in weight gain, growth, protein turnover, skeletal muscle FSR, and initiation of protein translation with moderate macronutrient restriction in colitis are not ameliorated by probiotic supplementation. However, maintaining adequate nutrient intake during colitis preserves whole body protein metabolism, but growth remains compromised.

  5. Nutritional support in surgical practice: Part II.

    PubMed

    Meguid, M M; Campos, A C; Hammond, W G

    1990-04-01

    On admission, a group of high-risk patients who are potential candidates for surgery can be identified, in whom prompt initiation of preoperative enteral or parenteral nutrition may reduce postoperative morbidity and mortality irrespective of the nutritional status. Among these are patients with inflammatory bowel disease, gastrointestinal fistulas, and pancreatitis. Substantial nutritional support has little or no direct effect upon the pathogenesis of the disease, but the discontinuance of oral intake may well have a beneficial effect on the basic disease process. Thus, the provision of enteral or parenteral nutrition gives the patient an optimal opportunity to marshal host defenses in support of healing. In organ system failures, e.g., acute renal failure, liver failure, and pulmonary failure, appropriate nutritional support may assist the patient in coping with the abnormal intermediary metabolism resulting from such failure until satisfactory organ system function returns. From this review, it seems reasonably clear that the initially malnourished patient is less able to successfully withstand the adverse effects of vigorous therapy and/or severe illness than is the well-nourished individual. Hence, correction of malnutrition, either before initiating therapy or concomitant with the treatment, is very likely to be beneficial. PMID:2107771

  6. Nutritional support during liver failure.

    PubMed

    Gecelter, G R; Comer, G M

    1995-07-01

    Critically ill patients in varying degrees of liver failure are catabolic and consequently require expeditious caloric support. Unique problems in this group of patients essentially revolve around the diagnosis and management of hepatic encephalopathy. From the overview provided in this text, it can be concluded that, only in overt hepatic coma, should all nitrogen products be withheld while precipitating causes are evaluated. Protein should be reintroduced as rapidly as possible to avoid the consequences of protein deprivation. Once the acute intercurrent illness has resolved, the cirrhotic patient returns to baseline energy and protein requirements indistinguishable from the population at large. PMID:7552976

  7. The Need for Domestic Violence Laws with Adequate Legal and Social Support Services.

    ERIC Educational Resources Information Center

    Hemmons, Willa M.

    1981-01-01

    Describes the need for comprehensive domestic violence programs that include medical, legal, economic, psychological, and child care services. Although most states have family violence legislation, more work is needed to adequately implement these programs. (Author/JAC)

  8. Nutritional support of the pediatric oncology patient.

    PubMed

    Andrassy, R J; Chwals, W J

    1998-01-01

    The child with a malignancy frequently will have associated cachexia with significant weight loss and malnutrition. The reasons for this are multifactorial and may be related directly to the tumor, such as increased metabolic rate, circulating peptides leading to anorexia, and decreased intake due to poor appetite or gut involvement. There appears to be other reasons involved, including increased whole body protein breakdown, increased lipolysis, and increased gluconeogenesis. Release of certain cytokines, such as tumor necrosis factor, interleukin-1, interleukin-6, and others may increase the cancer cachexia. Malnutrition in these children leads to intolerance of chemotherapy and radiotherapy as well as increased local and systemic infections. For many years, oncologists were hesitant to provide nutrition support to cancer patients for fear that tumor growth would be enhanced. Pediatric oncologists learned early that starvation plays no positive role in cancer therapy. Adjunctive nutritional support, either enterally or parenterally, supports the patient during therapy with surgery, chemotherapy, or radiation. Many studies have now shown that the nutritionally replete patient tolerates therapy better and in some pediatric malignancies may enhance survival.

  9. Nutritional support: we have failed in our ability to support patients with sepsis and cancer.

    PubMed

    Fischer, Josef E

    2011-06-01

    Despite the success of both parenteral and enteral nutrition in supporting patients who cannot eat, patients with either sepsis or cancer cannot be adequately supported. A proposed mechanism by which aerobic glycolysis leads to a shortage of energy production in the liver is discussed. According to this hypothesis, the proximity of sodium-potassium ATPase and glycogen, its fuel source, leads to the continuation of gluconeogenesis with continued proteolysis and muscle wasting. Myostatin and lipokine, newly discovered factors, may also play a role. PMID:21621701

  10. Home Nutrition Support: Ethics and Reimbursement.

    PubMed

    Martin, Karen; McGinnis, Carol

    2016-06-01

    Ethical dilemmas challenge providers on both sides of the hospital and clinic doors. In addition to establishing the nutrition care plan and guiding the client into the home setting with safe and effective parenteral or enteral nutrition therapy, procuring home nutrition support involves meeting documentation requirements and verifying that clients meet reimbursement criteria for home therapy based on third-party payer criteria. Providers have entered a realm for which training has been scarce and they face moral and ethical dilemmas involving serving as patient advocates, possibly stretching the truth to fit the clinical documentation to criteria vs maintaining professional integrity. Nutrition research and evidence-based practice have outpaced modifications to policies including Medicare's national and local coverage determinations, the bulk of which have not seen revisions in 32 years. This review elucidates clinical dilemmas and urges a political call to action to advocate for changes in current, outdated requirements for reimbursement. Given the current healthcare environment and trend toward expedited hospital stays, patients may be better served (and nourished) with revised guidelines.

  11. Home Nutrition Support: Ethics and Reimbursement.

    PubMed

    Martin, Karen; McGinnis, Carol

    2016-06-01

    Ethical dilemmas challenge providers on both sides of the hospital and clinic doors. In addition to establishing the nutrition care plan and guiding the client into the home setting with safe and effective parenteral or enteral nutrition therapy, procuring home nutrition support involves meeting documentation requirements and verifying that clients meet reimbursement criteria for home therapy based on third-party payer criteria. Providers have entered a realm for which training has been scarce and they face moral and ethical dilemmas involving serving as patient advocates, possibly stretching the truth to fit the clinical documentation to criteria vs maintaining professional integrity. Nutrition research and evidence-based practice have outpaced modifications to policies including Medicare's national and local coverage determinations, the bulk of which have not seen revisions in 32 years. This review elucidates clinical dilemmas and urges a political call to action to advocate for changes in current, outdated requirements for reimbursement. Given the current healthcare environment and trend toward expedited hospital stays, patients may be better served (and nourished) with revised guidelines. PMID:27072855

  12. Provision of nutrition support therapies in the recent Iraq and Afghanistan conflicts.

    PubMed

    Stankorb, Susan M; Ramsey, Casside; Clark, Heidi; Osgood, Tamara

    2014-10-01

    This article describes the experience of nutrition support practitioners, specifically dietitians, providing care to combat casualties. It provides a brief overview of dietitians' induction into armed service but focuses primarily on their role in providing nutrition support during the most recent conflicts in Iraq and Afghanistan. The current system of combat casualty care is discussed with specific emphasis on providing early and adequate nutrition support to U.S. combat casualties from injury, care in theater combat support hospitals (CSHs)/expeditionary medical support (EMEDs), and en route care during critical care air transport (CCAT) up to arrival at treatment facilities in the United States. The article also examines practices and challenges faced in the CSHs/EMEDs providing nutrition support to non-U.S. or coalition patients. Over the past decade in armed conflicts, dietitians, physicians, nurses, and other medical professionals have risen to challenges, have implemented systems, and continue working to optimize treatment across the spectrum of combat casualty care.

  13. [Enteral Nutritional Support in Gastrointestinal and Liver Diseases].

    PubMed

    Kim, Eun Ran

    2015-06-01

    Nutritional support is important because malnutrition is a major contributor to increased morbidity and mortality, decreased quality of life, increased length of hospital stay, and higher healthcare costs. Patients with gastrointestinal disease are at an increased risk of nutritional deterioration due to therapeutic dietary restriction, fasting for the diagnostic tests, loss of appetite due to anorexia or altered nutritional requirement caused by the disease itself. Therefore, it is important that gastroenterologists are aware of the nutritional status of patients and plan a treatment strategy considering patient's nutritional status. Enteral nutrition is preferred to parenteral nutrition as it is more physiologic, has fewer complications, help to prevent mucosal atrophy and maintain gut barrier function, which decrease intestinal bacterial translocation. Hence, enteral nutrition has been considered to be the most effective route for nutritional support. In this article, we will review enteral nutrition (oral nutritional supplements, enteral tube feeding) as a treatment for the patients with gastrointestinal, liver and pancreatic disease at risk of malnutrition.

  14. Nutrition and food technology for a Controlled Ecological Life Support System (CELSS)

    NASA Technical Reports Server (NTRS)

    Glaser, P. E.; Mabel, J. A.

    1981-01-01

    Food technology requirements and a nutritional strategy for a Controlled Ecological Life Support System (CELSS) to provide adequate food in an acceptable form in future space missions are discussed. The establishment of nutritional requirements, dietary goals, and a food service system to deliver acceptable foods in a safe and healthy form and the development of research goals and priorities were the main objectives of the study.

  15. The role of albumin in nutritional support.

    PubMed

    Mobarhan, S

    1988-12-01

    Hypoalbuminemia is considered one of the hallmarks of protein-calorie malnutrition and chronic liver disease. Recently, serum albumin has also been proposed as a critical predictor of the response to nutritional support and tolerance to enteral feeding in critically ill patients. Albumin is essential for maintenance of plasma colloidal osmotic pressure, prevention of edema, and transport of certain drugs and nutrients. Experimental studies have shown that rapid plasma expansion and reduced plasma protein concentration and osmotic pressure induce a net secretion of sodium and water into the small intestinal lumen. However, the effects of chronic hypoalbuminemia per se on intestinal absorption, independent of malnutrition, have not been fully studied. It is documented that both chronic illness and malnutrition may profoundly affect intestinal anatomical structure and function, inducing some degree of malabsorption. In the last few years, some have advocated albumin infusion to improve clinical response to patients with hypoalbuminemia receiving parenteral nutritional support or to reduce intestinal intolerance and diarrhea in patients receiving enteral tube feeding. A review of the literature shows that both clinical and experimental data to support these suggestions are scarce and further investigations are needed. Hypoalbuminemia is one of many parameters of malnutrition, and it is unlikely that correction of a single parameter for a short time would lead to major clinical benefits. PMID:3147998

  16. [Contribution of nutritional support to fight cancer cachexia].

    PubMed

    Planas, M; Puiggrós, C; Redecillas, S

    2006-05-01

    To increase dietary intake and to fight anorexia several measures to treat symptoms and administer the most adequate diet according to composition, texture and flavour are proposed. However, in the anorexia-caquexia present in cancer patients not always these measures are effective. Now a day it seems more reasonable to approach this problem with different strategies directed to modulate the pathologic alterations associated. The analysis of specific nutritional support as part as the treatment of these patients from a systematic review conclude that no high methodological quality studies to analyze the impact of oral supplementation on a specific group of patients, neither the study of functional effects are done. However, an increase in the total energy intake, not maintained over the time, was observed. The effects on weight and corporal composition are variable, with small differences between groups with o without supplementation and confuse due to, mainly, the heterogeneity of the patients included in the different studies analyzed. The analysis of the effects of nutritional supplements administered by enteral feeding shown an increase in the energy intake with an increase in body weight or a lack of decrease it, and with some functional and clinical beneficial effects. Despite the results and conclusions obtained, a strong recommendation to conduct clinical trials in specific group of cancer patients with different antineoplasic treatment seems necessary. N-3 fatty acids, especially eicosapentaenoic acid may have anticachectic properties. Although further trials are necessary the limited results available suggests that nutritional supplements enriched with EPA may reverse cachexia in cancer patients.

  17. Development of clinical application for a nutritional prescription support system for total parenteral/enteral nutrition.

    PubMed

    Masuda, Syuzo; Oka, Ryusho; Uwai, Koji; Matsuda, Yumi; Shiraishi, Tadashi; Nakagawa, Yoshito; Shoji, Tohru; Mihara, Chie; Takeshita, Mitsuhiro; Ozawa, Koichiro

    2009-09-01

    One of the important roles of pharmacists as members of a nutrition support team is nutritional prescription support. We developed a nutritional prescription support system (NPSS) that facilitates prescription support and analysis and evaluated its usefulness in nutritional therapy. An NPSS for prescription support and the management of patient information was created. With this NPSS, the nutritional status was assessed, and, on the basis of the results, such variables as the total energy expenditure were calculated. This system allows prescription support for parenteral nutrition (PN) therapy, enteral nutrition (EN) therapy, and the transition period between them. This system was used for 2 representative patients and evaluated. In a malnourished patient receiving oral warfarin, EN solutions were compared by means of the NPSS, and an appropriate EN solution was selected. In addition, the prothrombin time-international normalized ratio was monitored, and favorable results were obtained regarding the adjustment of the warfarin dose and nutritional management. In a patient with aspiration pneumonia, continuous nutritional management to EN from PN therapy was straightforwardly performed with the NPSS. This NPSS allows rapid, comprehensive nutritional management during the transition period to EN from PN therapy, despite these therapies being considered separately in conventional nutritional management. The NPSS is useful for simplifying prescription support and facilitating information sharing among members of a nutrition support team.

  18. Food and nutritional security requires adequate protein as well as energy, delivered from whole-year crop production

    PubMed Central

    Wratten, Stephen D.; Porter, John R.

    2016-01-01

    Human food security requires the production of sufficient quantities of both high-quality protein and dietary energy. In a series of case-studies from New Zealand, we show that while production of food ingredients from crops on arable land can meet human dietary energy requirements effectively, requirements for high-quality protein are met more efficiently by animal production from such land. We present a model that can be used to assess dietary energy and quality-corrected protein production from various crop and crop/animal production systems, and demonstrate its utility. We extend our analysis with an accompanying economic analysis of commercially-available, pre-prepared or simply-cooked foods that can be produced from our case-study crop and animal products. We calculate the per-person, per-day cost of both quality-corrected protein and dietary energy as provided in the processed foods. We conclude that mixed dairy/cropping systems provide the greatest quantity of high-quality protein per unit price to the consumer, have the highest food energy production and can support the dietary requirements of the highest number of people, when assessed as all-year-round production systems. Global food and nutritional security will largely be an outcome of national or regional agroeconomies addressing their own food needs. We hope that our model will be used for similar analyses of food production systems in other countries, agroecological zones and economies. PMID:27478691

  19. Food and nutritional security requires adequate protein as well as energy, delivered from whole-year crop production.

    PubMed

    Coles, Graeme D; Wratten, Stephen D; Porter, John R

    2016-01-01

    Human food security requires the production of sufficient quantities of both high-quality protein and dietary energy. In a series of case-studies from New Zealand, we show that while production of food ingredients from crops on arable land can meet human dietary energy requirements effectively, requirements for high-quality protein are met more efficiently by animal production from such land. We present a model that can be used to assess dietary energy and quality-corrected protein production from various crop and crop/animal production systems, and demonstrate its utility. We extend our analysis with an accompanying economic analysis of commercially-available, pre-prepared or simply-cooked foods that can be produced from our case-study crop and animal products. We calculate the per-person, per-day cost of both quality-corrected protein and dietary energy as provided in the processed foods. We conclude that mixed dairy/cropping systems provide the greatest quantity of high-quality protein per unit price to the consumer, have the highest food energy production and can support the dietary requirements of the highest number of people, when assessed as all-year-round production systems. Global food and nutritional security will largely be an outcome of national or regional agroeconomies addressing their own food needs. We hope that our model will be used for similar analyses of food production systems in other countries, agroecological zones and economies. PMID:27478691

  20. Food and nutritional security requires adequate protein as well as energy, delivered from whole-year crop production.

    PubMed

    Coles, Graeme D; Wratten, Stephen D; Porter, John R

    2016-01-01

    Human food security requires the production of sufficient quantities of both high-quality protein and dietary energy. In a series of case-studies from New Zealand, we show that while production of food ingredients from crops on arable land can meet human dietary energy requirements effectively, requirements for high-quality protein are met more efficiently by animal production from such land. We present a model that can be used to assess dietary energy and quality-corrected protein production from various crop and crop/animal production systems, and demonstrate its utility. We extend our analysis with an accompanying economic analysis of commercially-available, pre-prepared or simply-cooked foods that can be produced from our case-study crop and animal products. We calculate the per-person, per-day cost of both quality-corrected protein and dietary energy as provided in the processed foods. We conclude that mixed dairy/cropping systems provide the greatest quantity of high-quality protein per unit price to the consumer, have the highest food energy production and can support the dietary requirements of the highest number of people, when assessed as all-year-round production systems. Global food and nutritional security will largely be an outcome of national or regional agroeconomies addressing their own food needs. We hope that our model will be used for similar analyses of food production systems in other countries, agroecological zones and economies.

  1. Violence as an Under-Recognized Barrier to Women's Realization of Their Right to Adequate Food and Nutrition: Case Studies From Georgia and South Africa.

    PubMed

    Bellows, Anne C; Lemke, Stefanie; Jenderedjian, Anna; Scherbaum, Veronika

    2015-10-01

    This article addresses under-acknowledged barriers of structural violence and discrimination that interfere with women's capacity to realize their human rights generally, and their right to adequate food and nutrition in particular. Case studies from Georgia and South Africa illustrate the need for a human rights-based approach to food and nutrition security that prioritizes non-discrimination, public participation, and self-determination. These principles are frustrated by different types of structural violence that, if not seriously addressed, pose multiple barriers to women's economic, public, and social engagement. PMID:26139694

  2. Violence as an Under-Recognized Barrier to Women's Realization of Their Right to Adequate Food and Nutrition: Case Studies From Georgia and South Africa.

    PubMed

    Bellows, Anne C; Lemke, Stefanie; Jenderedjian, Anna; Scherbaum, Veronika

    2015-10-01

    This article addresses under-acknowledged barriers of structural violence and discrimination that interfere with women's capacity to realize their human rights generally, and their right to adequate food and nutrition in particular. Case studies from Georgia and South Africa illustrate the need for a human rights-based approach to food and nutrition security that prioritizes non-discrimination, public participation, and self-determination. These principles are frustrated by different types of structural violence that, if not seriously addressed, pose multiple barriers to women's economic, public, and social engagement.

  3. Position of the American Dietetic Association: local support for nutrition integrity in schools.

    PubMed

    Bergman, Ethan A; Gordon, Ruth W

    2010-08-01

    It is the position of the American Dietetic Association (ADA) that schools and communities have a shared responsibility to provide students with access to high-quality, affordable, nutritious foods and beverages. School-based nutrition services, including the provision of meals through the National School Lunch Program and the School Breakfast Program, are an integral part of the total education program. Strong wellness policies promote environments that enhance nutrition integrity and help students to develop lifelong healthy behaviors. ADA actively supported the 2004 and proposed 2010 Child Nutrition reauthorization which determines school nutrition policy. ADA believes that the Dietary Guidelines for Americans should serve as the foundation for all food and nutrition assistance programs and should apply to all foods and beverages sold or served to students during the school day. Local wellness policies are mandated by federal legislation for all school districts participating in the National School Lunch Program. These policies support nutrition integrity,including a healthy school environment. Nutrition integrity also requires coordinating nutrition education and promotion and funding research on program outcomes. Registered dietitians and dietetic technicians, registered, and other credentialed staff, are essential for nutrition integrity in schools to perform in policy-making, management, education, and community building roles. A healthy school environment can be achieved through adequate funding of school meals programs and through implementation and evaluation of strong local wellness policies. PMID:20677413

  4. Nutritional support and quality of life in cancer patients undergoing palliative care.

    PubMed

    Prevost, V; Grach, M-C

    2012-09-01

    In palliative care, the nutrition provided has to be tailored to the patient's needs, enhancing patient comfort and quality of life (QoL). We conducted a literature search to review methods of measuring QoL, and modalities of nutritional intervention and their influence on QoL of cancer patients in palliative care. Original papers published in English were selected from PubMed database by using the search terms, palliative medicine, cancer, nutrition and quality of life. Specific tools that are particularly recommended to assess QoL in a palliative care setting are reviewed. The main goal in palliative care is to maintain oral nutrition by providing nutritional counselling. Enteral nutritional support showed inconsistent effects on survival and QoL. An evidence-base for parenteral nutrition is still lacking. Ethical considerations concerning provision of food and hydration in end-of-life care are discussed. Nutritional status should be assessed early and regularly during treatment using appropriate tools. In the particularly acute context of palliative care, optimal patient management requires adequate education and counselling to patients and families. Meaningful interactions between the patient, caregivers and medical team would also increase the chance of resolving nutrition-related issues and help to fulfil each patient's specific nutritional needs and thus improve the QoL.

  5. Team Nutrition School Activity Planner. A How-To Guide for Team Nutrition Schools and Supporters.

    ERIC Educational Resources Information Center

    Food and Consumer Service (USDA), Washington, DC.

    This "how-to" guide for Team Nutrition fairs and tasting activities helps Team Nutrition supporters and schools understand how to work together to improve the health and education of children. Team Nutrition is the implementation tool for the U.S. Department of Agriculture's School Meals Initiative for Healthy Children. Section 1 of the guide…

  6. Endoscopic approaches to enteral nutritional support.

    PubMed

    DiSario, James A

    2006-01-01

    Enteral is preferred to parenteral nutritional support for acute and chronic diseases because it is more physiological and associated with fewer infection complications. Nasal tube feedings are generally used for 30 days or less and percutaneous access for the longer-term. Feeding by naso-gastric tubes is appropriate for most critically ill patients. However, trans-pyloric feeding is indicated for those with regurgitation and aspiration of gastric feeds. Deep naso-jejunal tube feeding is appropriate for patients with severe acute pancreatitis. There are several methods for endoscopic placement of naso-enteric tubes. Percutaneous endoscopic gastrostomy is used for most persons requiring long-term support. Long-term jejunal feeding is most often used for persons with chronic aspiration of gastric feeds, chronic pancreatitis intolerant to eating, or persons in need of concomitant gastric decompression. Percutaneous endoscopic gastrostomy with a jejunal tube extension is fraught with tube dysfunction and dislocation. Direct percutaneous endoscopic jejunostomy tubes may be more robust, but are less commonly performed.

  7. Can nutrition support interfere with recovery from acute critical illness?

    PubMed

    Schulman, Rifka C; Mechanick, Jeffrey I

    2013-01-01

    Malnutrition, following critical illness-related metabolic and immune neuroendocrine derangements, is exacerbated by energy and protein deficits beginning early in the intensive care unit (ICU) stay. While nutrition support is an important component of ICU care, adverse effects can occur. Underfeeding, due to insufficient energy and/or protein is associated with poor patient outcomes. Overfeeding carbohydrates, lipids, and/or protein can result in hyperglycemia, hypertriglyceridemia, hepatic dysfunction, and/or azotemia. Individualization of the nutritional prescription with clinical monitoring and repeated adjustment is necessary to avoid harm. Appropriate use of tight glycemic control protocols in combination with nutrition support can prevent hyperglycemia, while minimizing glycemic variability and hypoglycemic events. While the enteral route is favored for nutrition support, early supplemental parenteral nutrition should be considered in selected high-risk patients. Thus, risk stratification of patients upon admission to the ICU can be helpful to design individualized nutritional prescriptions maximizing benefit while avoiding potential interference with recovery. PMID:23075588

  8. [Analysis of the mainstreaming of the perspective of the Human Right to Adequate Food in the institutional design of the National School Nutrition Program].

    PubMed

    de Siqueira, Renata Lopes; Cotta, Rosângela Minardi Mitre; Ribeiro, Rita de Cássia Lanes; Sperandio, Naiara; Priore, Sílvia Eloíza

    2014-01-01

    Being a signatory to international agreements that recognize the Human Right to Adequate Food (HRAF) and having enshrined this right into its Constitution, the Brazilian state imposes a duty to provide, protect and promote the HRAF. For this it is necessary to incorporate the principles of the HRAF into the process of planning and executing the actions of Food and Nutrition Security (FNS). The objective was to analyze the process of mainstreaming of the HRAF in the new institutional design of the National School Nutrition Program (NSNP). This is in line with the principles laid down in General Comment No 12 of the Guide for Policy Analysis and Public Programs and nutritional Food Security under the Perspective of Human Rights and the Organic Law on Food and Nutrition Security (OLFNS). The results show that the new regulatory framework of the NSNP indicates a paradigm shift that is characterized by a gradual decline in the perception of NSNP as policy of a welfare nature. Concomitantly, there is an increase in the concept of the benefit of school food as a right, with the caveat that the construction of a new regulatory framework, although essential, is not sufficient for full implementation of the HRAF. PMID:24473626

  9. [Recommendations for artificial nutritional support in critically ill patients].

    PubMed

    de Luis, Daniel; Aller, Rocío; Culebras, Jesús

    2006-07-01

    The development of artificial nutritional support has been increased in the last years. Access routes and composition of formulas have been improved. Critic patients is a group of great controversy in this topic area. Enteral nutrition is better than parenteral nutrition in patients with inflammatory bowel disease, acute pancreatitis, burn and septic with a A level of evidence. Enteral nutrition is better than parenteral nutrition in patients with short bowel disease, chronic hepatopathy, surgery ot digestive tract in patients with cancer disease, patients with HIV infection and patients with politraumatism. Parenteral nutrition is better than enteral nutrition in patients with haematopoyetic transplantation with a B level of evidence. Some nutrients have been shown a beneficial effect in artificial nutritional support such as (diets low in fat and high in complex carbohydrates) (level A), diets with inmunonutrients in patients with surgery of digestive tract cancer (level B), diet enhanced with w3 fatty acids in patients with acute respiratory distress syndrome (level C), and patients with HIV infection (level B), diets enriched with glutamin in patients with politraumatism and haematopoyetic transplantation (level B). Specific diets have not been shown beneficial effects in some pathologies (short bowel syndrome, acute pancreatitis, renal insufficiency treated with dialysis, and respiratory insufficiency). Diets with arginine are contraindicated in septic critically ill patients (level A). In conclusion, artificial nutritional support in critic patients is a controversy topic area with a high level of change in knowledgments with new improvements in access route, diets and designs of interventional trials.

  10. [Solved and unsolved problems of nutritional support in surgical gastroenterology].

    PubMed

    Kostiuchenko, L N; Smirnova, O A; Kuz'mina, T N

    2013-01-01

    The article has revealed the relevance of nutriciology as a science, classification and types of nutritional support. Nutritional support--diagnostics and the metabolic correction of arising violations of various kinds of homeostasis, aimed at ensuring the functioning of the systems of protein-energy synthesis and intermediate exchange of nutrients, vitamins, macro--and microelements, or a temporary replacement therapy of their failure. The notions of "lack of food", "artificial" food, protein-energy insufficiency with the exception of the syndromes of malabsorption, alimentary anemia, the effects of protein-energy malnutrition, consumptive disease, starvation have been interpreted. It was noted that nutriciology has taken place as a science. The problems of prognostification of nutritional deficiency, assessment of nutritional risk, the organization of nutritional support in the hospital and at home have been presented. Some fundamental bases of enteral probe feeding have been described. PMID:23947157

  11. Circulating Vitamin D3 and 25-hydroxyvitamin D in Humans: An Important Tool to Define Adequate Nutritional Vitamin D Status

    PubMed Central

    Hollis, Bruce W.; Wagner, Carol L.; Drezner, Mark K.; Binkley, Neil C.

    2007-01-01

    Circulating 25-hydroxyvitamin D [25(OH)D] is generally considered the means by which we define nutritional vitamin D status. There is much debate, however, with respect to what a healthy minimum level of circulation 25(OH)D should be. Recent data using various biomarkers such as intact parathyroid hormone (PTH), intestinal calcium absorption, and skeletal density measurements suggest this minimum level to be 80 nmol (32 ng/mL). Surprisingly, the relationship between circulating vitamin D3 and its metabolic product—25(OH)D3 has not been studied. We investigated this relationship in two separate populations: the first, individuals from Hawaii who received significant sun exposure; the second, subjects from a lactation study who received up to 6,400 IU vitamin D3/day for six months. Results: 1) The relationship between circulating vitamin D3 and 25(OH)D in both groups was not linear, but appeared saturable and controlled; 2) Optimal nutritional vitamin D status appeared to occur when molar ratios of circulating vitamin D3 and 25(OH)D exceeded 0.3; at this point, the Vmax of the 25-hydroxylase appeared to be achieved. This was achieved when circulating 25(OH)D exceeded 100 nmol. We hypothesize that as humans live today, the 25-hydroxylase operates well below its Vmax because of chronic substrate deficiency, namely vitamin D3. When humans are sun (or dietary) replete, the vitamin D endocrine system will function in a fashion as do these other steroid synthetic pathways, not limited by substrate. Thus, the relationship between circulating vitamin D and 25(OH)D may represent what “normal” vitamin D status should be. PMID:17218096

  12. Nutritional support in patients with GVHD of the digestive tract: state of the art.

    PubMed

    van der Meij, B S; de Graaf, P; Wierdsma, N J; Langius, J A E; Janssen, J J W M; van Leeuwen, P A M; Visser, O J

    2013-04-01

    An important complication of allo-SCT is GVHD, which commonly affects the skin, liver and digestive tract. Clinical symptoms of GVHD of the digestive tract (GVHD-DT) include excessive diarrhoea, abdominal pain and cramps, nausea and vomiting, gastrointestinal bleeding, dysphagia, and weight loss. Treatment is complicated and regarding nutritional support, only a few guidelines are available. Our aim was to critically appraise the literature on nutritional assessment, nutritional status and nutritional support for patients with GVHD-DT. Evidence shows that GVHD-DT is often associated with malnutrition, protein losing enteropathy, magnesium derangements, and deficiencies of zinc, vitamin B12 and vitamin D. Limited evidence exists on derangements of magnesium, resting energy expenditure, bone mineral density and pancreatic function, and some beneficial effects of n-3 polyunsaturated fatty acids and pancreatic enzyme replacement therapy. Expert opinions recommend adequate amounts of energy, at least 1.5 g protein/kg body weight, supplied by total parenteral nutrition in cases of severe diarrhoea. When diarrhoea is <500 mL a day, a stepwise oral upgrade diet can be followed. No studies exist on probiotics, prebiotics, dietary fibre and immunonutrition in GVHD-DT patients. Future research should focus on absorption capacity, vitamin and mineral status, and nutritional support strategies.

  13. Nutrition support of the traumatically injured warfighter.

    PubMed

    McCarthy, Mary S; Fabling, Janet; Martindale, Robert; Meyer, Stephanie Ann

    2008-03-01

    Major trauma induces metabolic alterations that contribute to the systemic immune suppression in severely injured patients and increase the risk of infection and posttraumatic organ failure. Nutrition modulation of cellular processes has evolved into a high-priority therapy, backed by substantial scientific evidence. The appropriate selection, timing, and dose of nutrients required for metabolic resuscitation must be individualized and goal directed. Ideally, the nutritional interventions for warfighters will be developed strategically based on the extent of injuries and underlying deficiencies and will be designed to provide the nutrients necessary to balance hypermetabolic processes, heal wounds, and promote optimal recovery. PMID:18206585

  14. [Recommendations for nutritional assessment and specialized nutritional support of critically ill patients].

    PubMed

    Ortiz Leyba, C; Montejo Gonzalez, J C; Jiménez Jiménez, F Javier; Lopez Martinez, J; García de Lorenzo y Mateos, A; Grau Carmona, T; Acosta Escribano, J; Mesejo Arizmendi, A; Fernandez Ortega, F; Ordoñez Gonzalez, F J; Bonet Saris, A; Blesa Malpica, A

    2005-06-01

    Due to the characteristics of critically ill patients, elaborating recommendations on nutritional support for these patients is difficult. Usually the time of onset of nutritional support or its features are not well established, so that its application is based on experts' opinion. In the present document, recommendations formulated by the Metabolism and Nutrition Working Group of the Spanish Society of Intensive and Critical Medicine and Coronary Units (SEMICYUC) are presented. Recommendations are based on the literature analysis and further discussion by the working group members in order to define, consensually, the more relevant issues of metabolic and nutritional support of patients in a critical condition. Several clinical situations have been considered which are developed in the following articles of this publication. The present recommendations aim at providing a guideline for the less experienced clinicians when considering the metabolic and nutritional issues of critically ill patients.

  15. The Nutritional Impact of the Dairy Price Support Program.

    ERIC Educational Resources Information Center

    Heien, Dale; Wessells, Cathy Roheim

    1988-01-01

    Examined the impact of the dairy price support program and its resulting higher prices on nutrition intake, especially calcium. A demand system emphasizing dairy products was estimated. Concluded that nutrient intake would increase substantially if the program was terminated. (JOW)

  16. Nutritional support in critically ill patients.

    PubMed Central

    Grant, J P

    1994-01-01

    OBJECTIVE: The author reviews the newer nutritional substrates in use or under investigation for enteral and parenteral nutrition. Management of the critically ill patient remains a significant challenge to clinicians, and it is hoped that dietary manipulations, such as those outlined, may augment host barriers and immune function and improve survival. SUMMARY BACKGROUND DATA: The role of nutrition in patient well-being has long been recognized, but until the past 25 years, the technology to artificially provide nutrients when patients could not eat was not developed. With current, new methods for enteral and vascular access, patients can be fed nonvolitionally with little difficulty. Continued efforts have been directed toward identifying optimal feeding formulations, which have resulted in a multitude of commercially available products. In the past several years, attention has been turned to evaluation of four specialized nutrients and the use of other substrates as pharmacologic agents. METHODS: Pertinent laboratory and clinical data were reviewed to present the pros and cons for each nutritive substrate. CONCLUSIONS: Medium-chain fatty acids, branched-chain amino acids, and glutamine have been shown to be of clinical benefit and should be in common use in the near future. Short-chain fatty acids still are under investigation. Albumin, vitamins E and C, arginine, glutamine, and omega-3 fatty acids show great promise as pharmacologic agents to manipulate the stress response. Nucleotides remain investigational. CONTENTS SUMMARY: The application of some new nutritional substrates for use in critically ill patients, both as caloric sources and as pharmacologic agents, are reviewed. PMID:7979608

  17. Public Support for Policies to Improve the Nutritional Impact of the Supplemental Nutritional Assistance Program (SNAP)

    PubMed Central

    Long, Michael W.; Leung, Cindy W.; Cheung, Lilian W.Y.; Blumenthal, Susan J.; Willett, Walter C.

    2013-01-01

    OBJECTIVE To determine public attitudes towards federal spending on nutrition assistance programs and support for policies to improve nutritional impact of the Supplemental Nutrition Assistance Program (SNAP). DESIGN Participants answered survey questions by telephone assessing support for SNAP spending and proposed program policy changes. SETTING United States. SUBJECTS Survey of 3,024 adults selected by random digit dialing conducted in April 2012, including 418 SNAP participants. RESULTS A majority (77%; 95% CI: 75, 79) of all respondents supported maintaining or increasing SNAP benefits, with higher support among Democrats (88%; 95% CI: 86, 90) than Republicans (61%; 95% CI: 58, 65). The public supported policies to improve the nutritional impact of SNAP. 82% (95% CI: 80, 84) of respondents supported providing additional benefits to program participants that can only be used on healthful foods. 69% (95% CI: 67, 71) of respondents supported removing SNAP benefits for sugary drinks. A majority of SNAP participants (54%; 95% CI: 48, 60) supported removing SNAP benefits for sugary drinks. Of the 46% (95% CI: 40, 52) of SNAP participants who initially opposed removing sugary drinks, 45% (95% CI: 36, 54) supported removing SNAP benefits for sugary drinks if the policy also included additional benefits to purchase healthful foods. CONCLUSIONS The U.S. public broadly supports increasing or maintaining spending on SNAP. The majority of respondents, including SNAP participants, supported policies to improve the nutritional impact of SNAP by restricting the purchase of sugary drinks and incentivizing purchase of healthful foods with SNAP benefits. PMID:23218178

  18. [Introduction on postoperative nutritional support in neonatal cardiac surgery].

    PubMed

    Oeschger, Vanesa Verónica; Mazza, Carmen Silvia; Araujo, María Beatriz; Sauré, Carola

    2014-10-01

    Malnutrition is common in newborn patients after cardiac surgery, because of the low metabolic reserves, increased energy expenditure caused by the injury, and reduced or delayed nutritional support they receive, as well as their inability to metabolize the nutrients administered. It is important to achieve appropriate nutrition; a better metabolic response after surgery has a significant impact on length of stay, wound healing, susceptibility to infections and surgical outcome. This guideline intended to establish the practical foundation for parenteral and enteral nutritional support in the newborn with cardiac surgery, considering water restriction, optimizing macro and micronutrients required in the postoperative time.

  19. Provision of nutrition support therapies in the recent Iraq and Afghanistan conflicts.

    PubMed

    Stankorb, Susan M; Ramsey, Casside; Clark, Heidi; Osgood, Tamara

    2014-10-01

    This article describes the experience of nutrition support practitioners, specifically dietitians, providing care to combat casualties. It provides a brief overview of dietitians' induction into armed service but focuses primarily on their role in providing nutrition support during the most recent conflicts in Iraq and Afghanistan. The current system of combat casualty care is discussed with specific emphasis on providing early and adequate nutrition support to U.S. combat casualties from injury, care in theater combat support hospitals (CSHs)/expeditionary medical support (EMEDs), and en route care during critical care air transport (CCAT) up to arrival at treatment facilities in the United States. The article also examines practices and challenges faced in the CSHs/EMEDs providing nutrition support to non-U.S. or coalition patients. Over the past decade in armed conflicts, dietitians, physicians, nurses, and other medical professionals have risen to challenges, have implemented systems, and continue working to optimize treatment across the spectrum of combat casualty care. PMID:25606636

  20. Systematic Nutritional Support in Allogeneic Hematopoietic Stem Cell Transplant Recipients.

    PubMed

    Fuji, Shigeo; Einsele, Hermann; Savani, Bipin N; Kapp, Markus

    2015-10-01

    Allogeneic hematopoietic stem cell transplantation (HSCT) has become an established treatment modality for various hematological diseases. However, in allogeneic HSCT, patients often suffer from severe gastrointestinal complications caused by the conditioning regimen and acute/chronic graft-versus-host disease, which requires support by multidisciplinary nutritional support teams (NST). In addition, pretransplantation nutritional status can affect the clinical outcome after allogeneic HSCT. Therefore, it is important to refer the patient to a NST when becoming aware of nutritional problems before allogeneic HSCT. It is also important to follow nutritional status over the long term, as patients often suffer from various nutritional problems, such as malnutrition and metabolic syndrome, even late after allogeneic HSCT. In summary, NST can contribute to the improvement of nutritional status and possibly prognosis at every stage before and after allogeneic HSCT. Here, we aim to give a comprehensive overview of current understanding about nutritional support in allogeneic HSCT and try to provoke a constructive discussion to stimulate further investigation.

  1. Hurricane Sandy nutrition support during disasters.

    PubMed

    Trento, Laura; Allen, Sarah

    2014-10-01

    Natural disasters and weather-related emergencies can strike at a moment's notice. Individuals with chronic health conditions and other special needs are especially vulnerable. Basic services such as water, electricity, gas, and telephone service may not be available. Home parenteral and enteral nutrition consumers are at a serious risk as they depend on clean water and power for nutrient delivery. Creating a comprehensive emergency preparedness plan is imperative for both the home parenteral and enteral consumer and home care provider to ensure that special needs are met. Home care providers can assist home parenteral and enteral consumers in disaster and emergency planning.

  2. Hurricane Sandy: Nutrition Support During Disasters.

    PubMed

    Trento, Laura; Allen, Sarah

    2014-06-25

    Natural disasters and weather-related emergencies can strike at a moment's notice. Individuals with chronic health conditions and other special needs are especially vulnerable. Basic services such as water, electricity, gas, and telephone service may not be available. Home parenteral and enteral nutrition consumers are at a serious risk as they depend on clean water and power for nutrient delivery. Creating a comprehensive emergency preparedness plan is imperative for both the home parenteral and enteral consumer and home care provider to ensure that special needs are met. Home care providers can assist home parenteral and enteral consumers in disaster and emergency planning.

  3. Significant Publications for Pharmacy Nutrition Support Practice in 2013

    PubMed Central

    Kumpf, Vanessa J.; Rollins, Carol J.; Frankel, Eric H.; Kraft, Michael D.; Canada, Todd W.; Crill, Catherine M.

    2014-01-01

    Abstract Purpose: To assist the pharmacy clinician engaged in nutrition support in staying current with the most pertinent literature. Methods: Several experienced board-certified clinical pharmacists in nutrition support compiled a list of publications published in 2013 that they considered to be important to their practice. The citation list was compiled into a Web-based survey whereby pharmacist members of the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), GI-Liver-Nutrition Practice Research Network of the American College of Clinical Pharmacy, and the Pharmacy and Pharmacology Section of the Society of Critical Care Medicine were asked to rank each article according to level of importance in their practice. Results: A total of 30 articles were identified by the author group. Thirty-six participants responded to the survey. The top-ranked papers by participants from the Web-based survey were reviewed by the authors. Due to its high level of importance, the parenteral nutrition safety consensus recommendations article, to be published in 2014 by A.S.P.E.N., was also reviewed. Conclusion: It is recommended that the informed pharmacist, who is engaged in nutrition support therapy, be familiar with the majority of these publications. PMID:25477597

  4. [The "Bolsa Família" family grant scheme: the interface between professional practice and the human right to adequate food and nutrition].

    PubMed

    Ramos, Camila Irigonhé; Cuervo, Maria Rita Macedo

    2012-08-01

    The Human Right to Adequate Nutrition must be ensured through the public policies included in SAN, namely the Food and Nutritional Security campaign. Besides the income transfer geared to ensuring access to basic social rights, the "Bolsa Família" Program (PBF) is included in this context. This study seeks to analyze the operational aspects of the PBF and also ascertain whether or not the health professionals see the program as a core element of the SAN public policy. With this in mind, semi-structured interviews were conducted with primary healthcare workers involved directly both with the PBF and with the families who receive this benefit. By the end of the study, it was possible to perceive the importance of training health professionals who work in this area, because when one dissociates the social reality in which the beneficiaries live from the program objectives, this can lead to the simple mechanization of these practices. In this respect, it should be stressed that health professionals need to understand the proposals of the program as political and social strategies which, in addition to providing immediate relief, strive to overcome the problems related to poverty and hunger.

  5. Nutritional Support for Exercise-Induced Injuries.

    PubMed

    Tipton, Kevin D

    2015-11-01

    Nutrition is one method to counter the negative impact of an exercise-induced injury. Deficiencies of energy, protein and other nutrients should be avoided. Claims for the effectiveness of many other nutrients following injuries are rampant, but the evidence is equivocal. The results of an exercise-induced injury may vary widely depending on the nature of the injury and severity. Injuries typically result in cessation, or at least a reduction, in participation in sport and decreased physical activity. Limb immobility may be necessary with some injuries, contributing to reduced activity and training. Following an injury, an inflammatory response is initiated and while excess inflammation may be harmful, given the importance of the inflammatory process for wound healing, attempting to drastically reduce inflammation may not be ideal for optimal recovery. Injuries severe enough for immobilization of a limb result in loss of muscle mass and reduced muscle strength and function. Loss of muscle results from reductions in basal muscle protein synthesis and the resistance of muscle to anabolic stimulation. Energy balance is critical. Higher protein intakes (2-2.5 g/kg/day) seem to be warranted during immobilization. At the very least, care should be taken not to reduce the absolute amount of protein intake when energy intake is reduced. There is promising, albeit preliminary, evidence for the use of omega-3 fatty acids and creatine to counter muscle loss and enhance hypertrophy, respectively. The overriding nutritional recommendation for injured exercisers should be to consume a well-balanced diet based on whole, minimally processed foods or ingredients made from whole foods. The diet composition should be carefully assessed and changes considered as the injury heals and activity patterns change. PMID:26553492

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

    PubMed

    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. PMID:26066922

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

    PubMed

    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.

  8. The eNutrition Academy: Supporting a New Generation of Nutritional Scientists around the World.

    PubMed

    Geissler, Catherine; Amuna, Paul; Kattelmann, Kendra K; Zotor, Francis B; Donovan, Sharon M

    2016-01-01

    Nutrition training and building capacity to provide a competent workforce to support national and regional efforts to combat malnutrition remain a major challenge in Africa and other developing regions of the world. The capacity to provide the necessary intellectual drive for nutrition research, policy, and practice in countries lacking in readiness for nutrition actions is imperative to improve the health of their people. To help address this need, the eNutrition Academy (eNA) was formed as a global partnership organization by the African Nutrition Society, the Federation of African Nutrition Societies, the Nutrition Society of the United Kingdom and Ireland, the ASN, and the International Union of Nutritional Sciences, supported by Cambridge University Press. The primary objective of this partnership is to provide an online learning platform that is free to access, enabling users to benefit from a wide range of learning materials from basic tools to more-advanced learning materials for teachers and researchers in developing countries. The goal of this article was to summarize the findings of a symposium held at the ASN Scientific Sessions and Annual Meeting at Experimental Biology 2015, which explored the themes of international capacity development, with a particular focus on the African continent, online learning, and the eNA e-learning platform. Given the vast human capacity present in Africa that is poised to create new solutions to address the public health needs of the continent, now is an opportune time to establish South-North and South-South partnerships to develop the next generation of African nutritional scientists. PMID:27180382

  9. The eNutrition Academy: Supporting a New Generation of Nutritional Scientists around the World.

    PubMed

    Geissler, Catherine; Amuna, Paul; Kattelmann, Kendra K; Zotor, Francis B; Donovan, Sharon M

    2016-01-01

    Nutrition training and building capacity to provide a competent workforce to support national and regional efforts to combat malnutrition remain a major challenge in Africa and other developing regions of the world. The capacity to provide the necessary intellectual drive for nutrition research, policy, and practice in countries lacking in readiness for nutrition actions is imperative to improve the health of their people. To help address this need, the eNutrition Academy (eNA) was formed as a global partnership organization by the African Nutrition Society, the Federation of African Nutrition Societies, the Nutrition Society of the United Kingdom and Ireland, the ASN, and the International Union of Nutritional Sciences, supported by Cambridge University Press. The primary objective of this partnership is to provide an online learning platform that is free to access, enabling users to benefit from a wide range of learning materials from basic tools to more-advanced learning materials for teachers and researchers in developing countries. The goal of this article was to summarize the findings of a symposium held at the ASN Scientific Sessions and Annual Meeting at Experimental Biology 2015, which explored the themes of international capacity development, with a particular focus on the African continent, online learning, and the eNA e-learning platform. Given the vast human capacity present in Africa that is poised to create new solutions to address the public health needs of the continent, now is an opportune time to establish South-North and South-South partnerships to develop the next generation of African nutritional scientists.

  10. [Glossary of bioethics terms frequently used in nutrition support].

    PubMed

    Moreno Villares, J M; Alvarez Hernández, J; Wanden-Berghe Lozano, C; Lozano Fuster, M

    2010-01-01

    Bioethical decisions are present in every clinical decision. Nutrition support participates the same situation. Feeding critically ill patients, etriminal patients or in permanent vegetative status is almost always involved in bioethical dilemmas. A common problem is the confusion in concepts regarding bioethics. This lack of uniformity does not help in the deliberation process. From the Working Group in Bioethics of the Spanish Society for Parenteral and Enteral Nutrition Support (SENPE) it has been considered to gather the commonest terms used in our academic area. Each term is accompanied by a definition, a description or a commentary related to its main application.

  11. Nutrition.

    PubMed

    Durnin, J V

    1976-07-01

    Nutrition appeared somewhat late on the scene in the I.B.P. projects in the U.K., but eventually it occupied an integral part of many of the H.A. (human adaptability) investigations. The nutritional data obtained in the studies of isolated and nearisolated communities in Tristan da Cunha and in New Guinea provided information of wide nutritional significance. There were also detailed and extensive studies in Israel which, similarly to those in New Guinea, attempted to relate nutritional factors to enviroment, working conditions, and physical fitness. Some extraordinarily low energy intakes found in Ethiopians have induced much speculation on the extent which man can adequately adapt to restricted food supplies. Interesting nutritional observations, of general importance, have also arisen from results obtained on such disparate groups as Glasgow adolescents, Tanzanian and Sudanese students, children in Malawi and vegans in the U.K.

  12. An evidence-based approach to perioperative nutrition support in the elective surgery patient.

    PubMed

    Miller, Keith R; Wischmeyer, Paul E; Taylor, Beth; McClave, Stephen A

    2013-09-01

    In surgical practice, great attention is given to the perioperative management of the elective surgical patient with regard to surgical planning, stratification of cardiopulmonary risk, and postoperative assessment for complication. However, growing evidence supports the beneficial role for implementation of a consistent and literature-based approach to perioperative nutrition therapy. Determining nutrition risk should be a routine component of the preoperative evaluation. As with the above issues, this concept begins with the clinician's first visit with the patient as risk is assessed and the severity of the surgical insult considered. If the patient is an appropriate candidate for benefit from preoperative support, a plan for initiation and reassessment should be implemented. Once appropriate nutrition end points have been achieved, special consideration should be given to beneficial practices the immediate day preceding surgery that may better prepare the patient for the intervention from a metabolic standpoint. In the operating room, consideration should be given to the potential placement of enteral access during the index operation as well as judicious and targeted intraoperative resuscitation. Immediately following the intervention, adequate resuscitation and glycemic control are key concepts, as is an evidence-based approach to the early advancement of an enteral/oral diet in the postoperative patient. Through the implementation of perioperative nutrition therapy plans in the elective surgery setting, outcomes can be improved. PMID:24009248

  13. Nutritional care and support among adults living with HIV at Hawassa Referral Hospital, southern Ethiopia: A qualitative study.

    PubMed

    Tafese, Zelalem; Birhan, Yifru; Abebe, Hiwot

    2013-11-01

    Background Improving nutritional care and support for people living with HIV (PLHIV) is an integral part of comprehensive HIV treatment according to the National Nutritional Strategy of Ethiopia. However, there is no adequate published study that assesses the nutritional care and support services for adult people living with HIV/ AIDS (PLHIV) in this setting. Objective The objective of the study was to identify the existing nutritional care and support services and determine the challenges facing adults living with HIV at Hawassa Referral Hospital in southern Ethiopia. Methods A qualitative study was carried out using focus group discussions (FGDs), in-depth interviews and participant observation. Four FDGs were held and five in-depth interviews were conducted. A two-week participant observation was also conducted by trained nurses. All interviews and FDGs were tape-recorded and transcribed; those conducted in Amharic were translated back to English. Finally thematic analysis of the transcripts was performed. Results Most of the FDG participants were unsatisfied with their nutritional care and support services and expressed difficulty with disclosing their HIV status for fear of stigma and discrimination. The in-depth interviews and participant observation showed results similar to those of the FDG. Some key informants expressed a fear that such poor nutritional care and support may threaten the quality of life of people living with HIV and suggested that all stakeholders work on improving the services. Conclusion Current nutritional care and support services for people living with HIV are not well coordinated. They focus mainly on monthly supplementation of antiretroviral drugs and occasional handouts of food. The need to provide health education on antiretroviral drugs and nutrition, and to emphasise strategies aimed at improving the nutritional status of peoples living with HIV is critical. Furthermore, the study recommended strengthening the initiatives of some

  14. Nutritional support for the patient with pancreatobiliary disease.

    PubMed

    Kohn, C L; Brozenec, S; Foster, P F

    1993-03-01

    Critically ill patients with severe pancreatobiliary disease exhibit multiple nutritional alterations compounded by the stress response. Acute pancreatitis may present as a life-threatening illness; patients are likely to be hypermetabolic and may have hyperglycemia and hypocalcemia. Nutritional support from parenteral or enteral feeding will probably be required in patients presenting with three or more positive risk factors as determined by Ranson criteria. Nutritional therapies for liver disease vary according to the specific disorder manifested. Patients with fulminant hepatic failure need to be monitored for profound hypoglycemia. Encephalopathy may develop in patients with acute-on-chronic liver disease, necessitating a protein restriction. Patients undergoing liver transplant are a perioperative challenge due to the combination of preoperative malnutrition, an extensive surgical procedure, and postoperative stress. Such patients require individualized assessment and management. PMID:8448001

  15. [Nutrition, lifestyle, physical activity, and supportive care during chemotherapeutic treatment].

    PubMed

    Lümmen, G; Jäger, T; Sommer, F; Ebert, T; Schmitz-Draeger, B

    2006-05-01

    With improvements in cancer survival rates, more patients with cancer are living longer and the influence of nutrition, lifestyle, physical activity as well as supportive care during and after chemotherapy is of increasing interest. In several malignancies smoking cessation increases cancer survival. Similar effects are expected by healthy nutrition. Regular physical activity of cancer patients reduces drug interactions of chemotherapy, decreases the number of comorbid conditions, and helps patients maintain independence as long as possible. For supportive care during chemotherapy the 5-HT3 receptor antagonists are more effective for the prevention of chemotherapy-induced nausea and vomiting. There are several colony-stimulating factors (e.g. GCSF, erythropoietin) for hematopoietic recovery post-chemotherapy. Altogether supportive care of chemotherapy reduces toxicity and increases efficacy.

  16. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): nutritional assessment].

    PubMed

    Ruiz-Santana, S; Arboleda Sánchez, J A; Abilés, J

    2011-11-01

    Current parameters to assess nutritional status in critically-ill patients are useful to evaluate nutritional status prior to admission to the intensive care unit. However, these parameters are of little utility once the patient's nutritional status has been altered by the acute process and its treatment. Changes in water distribution affect anthropometric variables and biochemical biomarkers, which in turn are affected by synthesis and degradation processes. Increased plasma levels of prealbumin and retinol -proteins with a short half-life- can indicate adequate response to nutritional support, while reduced levels of these proteins indicate further metabolic stress. The parameters used in functional assessment, such as those employed to assess muscular or immune function, are often altered by drugs or the presence of infection or polyneuropathy. However, some parameters can be used to monitor metabolic response and refeeding or can aid prognostic evaluation.

  17. Prospective study of nutritional support during pelvic irradiation

    SciTech Connect

    Kinsella, T.J.; Malcolm, A.W.; Bothe, A. Jr.; Valerio, D.; Blackburn, G.L.

    1981-04-01

    A prospective study of nutritional support during pelvic irradiation was carried out in 32 patients with a primary pelvic malignancy and prior weight loss. Both curative and palliative patients were eligible for the study. Seventeen patients were randomized to receive intravenous hyperalimentation (IVH) and fifteen patients served as controls who were maintained on their regular diet. Patients were stratified by percent body weight loss. Tolerance to therapy was assessed by evaluation of functional status and by using nutritional parameters of body weight change, change in serum protein levels, and response to delayed hypersensitivity skin tests. The curative IVH group tolerated therapy well by both functional and nutritional measurements. All curative IVH patients completed the planned radiation therapy without a treatment break and were fully active following treatment. Patients gained an average of 4.0 kg body weight during irradiation, which was significantly different from the curative control patients. They demonstrated a significant increase in serum transferrin reflecting an improvement in visceral protein. In addition, all showed a positive response to delayed hypersensitivity skin tests at the completion of irradiation. The palliative IVH patients often did poorly because of progression of disease and demonstrated only an elevation of serum transferrin during treatment. The results in the curative IVH group suggest a potential adjunctive role for intravenous hyperalimentation in the malnourished cancer patient undergoing pelvic irradiation. Clearly, further study of nutritional support during pelvic irradiation is needed using curative patients with a single tumor type and significant prior weight loss.

  18. Integration of nutrition support into oncologic treatment protocols for high and low nutritional risk children with Wilms' tumor. A prospective randomized study.

    PubMed

    Rickard, K A; Godshall, B J; Loghmani, E S; Coates, T D; Grosfeld, J L; Weetman, R M; Lingard, C D; Foland, B B; Yu, P L; McGuire, W

    1989-07-15

    Benefits and risks of nutrition support were evaluated in 31 malnourished children with newly diagnosed Wilms' tumor managed according to the third National Wilms' Tumor Study protocol. Patients were classified at diagnosis as being at high nutritional risk (HNR, n = 19) or low nutritional risk (LNR, n = 12). Ten HNR patients were randomized to central parenteral nutrition (CPN) and nine HNR patients were randomized to peripheral parenteral nutrition (PPN) plus enteral nutrition (EN) for 4 weeks of initial intense treatment and EN (nutritional counseling, oral foods and supplements) thereafter. Thirteen HNR patients (seven CPN, six PPN) completed the protocol. Twelve LNR patients received EN; 11 Stage I malnourished patients were randomized to 10 or 26 weeks of chemotherapy. Dietary, anthropometric, and biochemical data were determined for HNR patients at weeks 0-4, 6, 13, 19, and 26 and for LNR patients at weeks 1, 2, 5, and 26. In HNR patients, adequate parenteral nutrition support reversed protein energy malnutrition (PEM), and prevented chemotherapy and radiotherapy delays due to granulocytopenia. CPN was superior to PPN in reversing PEM: energy intake, weight gain, and retinol binding protein were higher (P less than 0.05). LNR patients lost weight and fat reserves in the first 2 weeks of treatment; depletion persisted at week 5, and 25% had chemotherapy delays. Thereafter, EN reversed PEM in patients with both chemotherapy regimens. These data suggest that CPN is preferable during initial intense treatment for HNR patients, and that, although EN is ineffective in preventing depletion and treatment delays in the first 5 weeks of treatment for LNR patients, it is effective thereafter.

  19. A quantitative summary of nutrition support services in a veterinary teaching hospital.

    PubMed

    Donoghue, S

    1991-04-01

    A full-time nutrition support service provided 1,133 consultations in a small animal teaching hospital from July 1986 to June 1988, consisting of 840 dogs, 260 cats, 23 exotic species, and 10 consultations with incomplete information. The dog and cat consultations represented 2.1 and 3.7% of canine and feline admissions, respectively. Consultations involved the determination of nutritional goals which led to recommendations of specific dietary regimens. Most frequent requests were for diet evaluation and diet formulation to meet estimated calorie and protein needs during illness and stress (23%), for specific calorie or nutrient modification given a working diagnosis (23%), and for avoidance of tissue utilization or weight loss (23%). Frequently involved single organ systems were gastrointestinal (16%), liver (12%), kidney (9%), and pancreas (4%), but multiple system involvement was more common (19%). Most frequent diagnostic categories were metabolic disorders (17%), chronic organ failure (17%), and neoplasia (12%). Enteral nutrition was preferred for 98% of consultations. Voluntary consumption was deemed adequate in 81% of consultations, and highly palatable balanced homemade diets and specialty products were recommended in 74% of these. Human hospital liquid enteral products were used in 95% of consultations recommending involuntary feeding, either fed alone, blended with petfoods, or supplemented with modules of protein or fat. The service demonstrated that full-time nutrition support can be utilized effectively in a small animal teaching hospital. Further development of such services will depend on research focused especially on determination of case-specific nutritional goals, patient responses, and cost effectiveness. PMID:2029836

  20. Nutritional risk, malnutrition and nutritional support among hospitalized patients in orthopedics/spinal surgery of a Hohhot teaching hospital.

    PubMed

    Wang, Nannan; Dong, Yalin; Huo, Ting; Shao, Yanqing; Xing, Wenhua; Li, Shuwen

    2016-01-01

    The evolution of nutritional status (the prevalence of nutritional risk, malnutrition, overweight and obesity) and the nutritional support of the hospitalized patients from admission to discharge or over a two-week period in orthopedics/ spinal surgery of a teaching hospital in Hohhot were investigated. 432 patients from two wards of the orthopedics/spinal surgery from Jan to Dec 2013, the traditional spinal surgery and the minimally invasive spinal surgery, were selected and detected in this study. The Nutritional Risk Score 2002 (NRS 2002) was used to determine the patients' nutritional status within 48 h after admission and during their hospitalization. The overall prevalence of nutritional risk, malnutrition, overweight and obesity at admission was 11.6%, 12.7%, 35.9% and 7.41%, respectively. Overall, there were 88.0% of the patients who were at nutritional risk received nutritional support, while 14.1% of non-risk patients received a redundant nutritional support. The overall prevalence of nutritional risk changed from 11.6% at admission to 19.4% upon discharge (p<0.05), and the prevalence of malnutrition changed from 12.7% to 20.6% (p<0.05). The prevalence of overweight and obesity, which changed from 35.9% to 31.0% and from 7.41% to 5.79% respectively, didn't experience statistically significant evolution. NRS 2002 was a feasible nutritional risk screening tool for patients in spinal surgery of orthopedics department. Patients' prevalence of nutritional risk and malnutrition increased significantly in spinal surgery of this hospital. Some inappropriate uses of nutritional support were observed in orthopedics/spinal surgery, and nutritional support guidelines or protocols should be promoted by a professional committee.

  1. Evidence supporting early nutritional support with parenteral amino acid infusion.

    PubMed

    Denne, Scott C; Poindexter, Brenda B

    2007-04-01

    Postnatal growth of extremely low birth weight (ELBW) infants remains poor and does not come close to approximating rates of in utero growth. There is good evidence that early deficiencies in protein may be an important contributor to the poor growth outcomes observed in this population. Protein losses are inversely related to gestational age, and ELBW infants lose 1% to 2% of their total endogenous body protein stores each day that they receive glucose alone. It is now abundantly clear from a variety of studies that providing intravenous amino acids to sick premature infants in early postnatal life can improve protein balance and can increase protein accretion, even at low caloric intakes. Provision of approximately 1 g/kg/day of amino acids will result in a net protein balance close to zero, whereas delivery of 3 g/kg/day will accomplish protein accretion. Although data from metabolic studies, observational studies, and even a few randomized clinical trials overwhelmingly support the short-term safety and efficacy of early amino acids in reversing protein loss, there is much less known about the effects of early amino acid administration on longer-term outcomes such as growth and neurodevelopment in extremely premature infants. Based on the sum of currently available evidence presented, providing ELBW infants with 2.5 to 3.5 g/kg/day of intravenous amino acids as soon as possible after birth is a reasonable recommendation. Future studies are required to determine whether provision of 3 to 3.5 g/kg/day of amino acids is "aggressive" enough for optimal growth and neurodevelopmental outcome of ELBW infants.

  2. Rationale and clinical data supporting nutritional intervention in Alzheimer's disease.

    PubMed

    Engelborghs, S; Gilles, C; Ivanoiu, A; Vandewoude, M

    2014-01-01

    Adequate nutrition plays an important role in the maintenance of cognitive function, particularly during aging. Malnutrition is amongst the risk factors for developing mild cognitive impairment (MCI) and Alzheimer's disease (AD). Epidemiological studies have associated deficiencies in some nutrients with a higher risk of cognitive dysfunction and/or AD. Cognitive decline in AD is correlated with synaptic loss and many of the components required to maintain optimal synaptic function are derived from dietary sources. As synapses are part of the neuronal membrane and are continuously being remodelled, the availability of sufficient levels of nutritional precursors (mainly uridine monophosphate, choline and omega-3 fatty acids) to make the phospholipids required to build neuronal membranes may have beneficial effects on synaptic degeneration in AD. In addition, B-vitamins, phospholipids and other micronutrients act as cofactors to enhance the supply of precursors required to make neuronal membranes and synapses. Despite this, no randomized controlled trial has hitherto provided evidence that any single nutrient has a beneficial effect on cognition or lowers the risk for AD. However, a multi-target approach using combinations of (micro)nutrients might have beneficial effects on cognitive function in neurodegenerative brain disorders like AD leading to synaptic degeneration. Here we review the clinical evidence for supplementation, based on a multi-target approach with a focus on key nutrients with a proposed role in synaptic dysfunction. Based on preclinical evidence, a nutrient mixture, Souvenaid(®) (Nutricia N.V., Zoetermeer, The Netherlands) was developed. Clinical trials with Souvenaid(®) have shown improved memory performance in patients with mild AD. Further clinical trials to evaluate the effects of nutritional intervention in MCI and early dementia due to AD are on-going. PMID:24635394

  3. Metabolism and nutritional support in the surgical neonate.

    PubMed

    Pierro, Agostino

    2002-06-01

    Various factors can influence the metabolism of surgical neonates. These include prematurity, operative stress, critical illness, and sepsis. The nutritional management of surgical infants with congenital or acquired intestinal abnormalities has improved after the introduction of parenteral nutrition. This article is focused on the energy and protein metabolism of surgical neonates with particular reference to the metabolic response to operative trauma and sepsis. The metabolic utilization of intravenous nutrients also is discussed. The metabolic response to operative trauma is different between neonates and adults. Infants have high rates of protein turnover and are avid retainers of nitrogen. Energy expenditure increases only transiently (4 to 6 hours) after major surgery in neonates. Protein turnover and catabolism seems not to be affected by major operative procedures in neonates. In neonates on parenteral nutrition, carbohydrate and fat have an equivalent effect on protein metabolism. The main determinants of fat utilization are carbohydrate intake and resting energy expenditure. Parenteral nutrition in surgical neonates is associated with increased production of oxygen-free radicals. This seems to be related to intravenous fat administration. Promoting fat utilization by reducing the carbohydrate to fat ratio in the intravenous diet reduces free radical activity to a similar extent as fat exclusion. Glutamine appears to be safe for use in neonates and infants and is "conditionally essential" in very-low birth weight infants and in septic neonates. Enteral glutamine supplementation in very-low birth weight infants reduces the risk of sepsis. The metabolism of surgical neonates is affected by operative trauma, critical illness, and sepsis. Nutritional support in surgical neonates has a profound impact on outcome. Exogenous glutamine can modulate immune, metabolic, and inflammatory responses. Further investigations are needed to clarify the clinical benefit of

  4. [Origin, functions and expectations of the specialty in nutritional support].

    PubMed

    Peñaloza Santillán, Jesús Alfonso

    2005-01-01

    Considerations are presented on the causes and frequency at the beginning or worsening of malnutrition in hospitalized patients. Most of the children had a more accelerated metabolism, and we examined how this malnutrition modifies their metabolic and functional responses and increases morbidity and mortality. During the 20th century the study and treatment with total parenteral nutrition (TPN) began. This allows the patient's nourishment to be maintained through the administration of nutrients directly into the circulatory system because of the inability of the patient to receive food by the digestive route. The benefits, as well as the risks and complications of the procedure, have been documented for the last 30 years. On the other hand, the technology has allowed the modification of the physicochemical characteristics of the nutrients. This is an alternative for some of the digestive processes to favor its absorption in the intestine in those patients who cannot receive natural nourishment. This procedure is known as specialized enteral nutrition (SEN). These two groups of procedures (TPN and SEN) are the cornerstones of a new specialty. The meanings of this specialty are several, including nutritional support and metabolic support. The adoption of the term "endonutrition" is proposed.

  5. Innovative Operations Measures and Nutritional Support for Mass Endurance Events.

    PubMed

    Chiampas, George T; Goyal, Anita V

    2015-11-01

    Endurance and sporting events have increased in popularity and participation in recent years worldwide, and with this comes the need for medical directors to apply innovative operational strategies and nutritional support to meet such demands. Mass endurance events include sports such as cycling and running half, full and ultra-marathons with over 1000 participants. Athletes, trainers and health care providers can all agree that both participant outcomes and safety are of the utmost importance for any race or sporting event. While demand has increased, there is relatively less published guidance in this area of sports medicine. This review addresses public safety, operational systems, nutritional support and provision of medical care at endurance events. Significant medical conditions in endurance sports include heat illness, hyponatraemia and cardiac incidents. These conditions can differ from those typically encountered by clinicians or in the setting of low-endurance sports, and best practices in their management are discussed. Hydration and nutrition are critical in preventing these and other race-related morbidities, as they can impact both performance and medical outcomes on race day. Finally, the command and communication structures of an organized endurance event are vital to its safety and success, and such strategies and concepts are reviewed for implementation. The nature of endurance events increasingly relies on medical leaders to balance safety and prevention of morbidity while trying to help optimize athlete performance.

  6. Innovative Operations Measures and Nutritional Support for Mass Endurance Events.

    PubMed

    Chiampas, George T; Goyal, Anita V

    2015-11-01

    Endurance and sporting events have increased in popularity and participation in recent years worldwide, and with this comes the need for medical directors to apply innovative operational strategies and nutritional support to meet such demands. Mass endurance events include sports such as cycling and running half, full and ultra-marathons with over 1000 participants. Athletes, trainers and health care providers can all agree that both participant outcomes and safety are of the utmost importance for any race or sporting event. While demand has increased, there is relatively less published guidance in this area of sports medicine. This review addresses public safety, operational systems, nutritional support and provision of medical care at endurance events. Significant medical conditions in endurance sports include heat illness, hyponatraemia and cardiac incidents. These conditions can differ from those typically encountered by clinicians or in the setting of low-endurance sports, and best practices in their management are discussed. Hydration and nutrition are critical in preventing these and other race-related morbidities, as they can impact both performance and medical outcomes on race day. Finally, the command and communication structures of an organized endurance event are vital to its safety and success, and such strategies and concepts are reviewed for implementation. The nature of endurance events increasingly relies on medical leaders to balance safety and prevention of morbidity while trying to help optimize athlete performance. PMID:26553491

  7. Critical evaluation of the role of nutritional support with chemotherapy.

    PubMed

    Chlebowski, R T

    1985-01-01

    Although weight loss has an adverse impact on cancer patient survival, the ability of caloric provision via total parenteral nutrition (TPN) to favorably influence outcome in chemotherapy-treated populations is not established. In randomized trials, no significant improvement in either response or survival was associated with TPN addition to chemotherapeutic treatment of adult patients with lymphoma, sarcoma, colon cancer, adenocarcinoma and small cell carcinoma of the lung, or testicular carcinoma. In two instances, TPN addition was associated with decreased survival, again raising the concern that caloric support in the absence of effective antitumor therapy might stimulate cancer growth. In any event, the hypothesis that nutritional repletion of a malnourished cancer patient receiving chemotherapy will improve clinical outcome remains to be critically tested, as studies demonstrating sequential improvement in lean body mass have not been reported. Most recently, consideration of potential mechanisms underlying the development of cancer cachexia has led to new strategies for nutritional intervention. For example, hypogonadism or low testosterone levels have been described in male patient populations with advanced cancer and correlated with weight loss and adverse outcome, leading to trial of replacement therapy with nandrolone decanoate. Similarly, the frequent identification of abnormal glucose metabolism in the patients with cancer cachexia has stimulated clinical trials with agents such as hydrazine sulfate and insulin designed to reverse the metabolic abnormality. Whether such efforts designed to alter metabolic abnormalities associated with cancer cachexia will improve clinical outcome will be determined in ongoing clinical trials.

  8. Incidence of nutritional support complications in patient hospitalized in wards. multicentric study

    PubMed Central

    Giraldo, Nubia Amparo; Aguilar, Nora Luz; Restrepo, Beatriz Elena; Vanegas, Marcela; Alzate, Sandra; Martínez, Mónica; Gamboa, Sonia Patricia; Castaño, Eliana; Barbosa, Janeth; Román, Juliana; Serna, Ángela María; Hoyos, Gloria Marcela

    2012-01-01

    Introduction: Nutritional support generates complications that must be detected and treated on time. Objective: To estimate the incidence of some complications of nutritional support in patients admitted to general hospital wards who received nutritional support in six high-complexity institutions. Methods: Prospective, descriptive and multicentric study in patients with nutritional support; the variables studied were medical diagnosis, nutritional condition, nutritional support duration, approach, kind of formula, and eight complications. Results: A total of 277 patients were evaluated; 83% received enteral nutrition and 17% received parenteral nutrition. Some 69.3% presented risk of malnourishment or severe malnourishment at admittance. About 35.4% of those receiving enteral nutrition and 39.6% of the ones who received parenteral nutrition had complications; no significant difference per support was found (p= 0.363). For the enteral nutrition, the most significant complication was the removal of the catheter (14%), followed by diarrhea (8.3%); an association between the duration of the enteral support with diarrhea, constipation and removal of the catheter was found (p < 0.05). For parenteral nutrition, hyperglycemia was the complication of highest incidence (22.9%), followed by hypophosphatemia (12.5%); all complications were associated with the duration of the support (p < 0.05). Nutritional support was suspended in 24.2% of the patients. Conclusions: Complications with nutritional support in hospital-ward patients were frequent, with the removal of the catheter and hyperglycemia showing the highest incidence. Duration of the support was the variable that revealed an association with complications. Strict application of protocols could decrease the risk for complications and boost nutritional support benefits. PMID:24893056

  9. Guidelines for specialized nutritional and metabolic support in the critically-ill patient: update. Consensus SEMICYUC-SENPE: gastrointestinal surgery.

    PubMed

    Sánchez Álvarez, C; Zabarte Martínez de Aguirre, M; Bordejé Laguna, L

    2011-11-01

    Gastrointestinal surgery and critical illness place tremendous stress on the body, resulting in a series of metabolic changes that may lead to severe malnutrition, which in turn can increase postsurgical complications and morbidity and mortality and prolong the hospital length of stay. In these patients, parenteral nutrition is the most widely used form of nutritional support, but administration of enteral nutrition early in the postoperative period is effective and well tolerated, reducing infectious complications, improving wound healing and reducing length of hospital stay. Calorie-protein requirements do not differ from those in other critically-ill patients and depend on the patient's underlying process and degree of metabolic stress. In patients intolerant to enteral nutrition, especially if the intolerance is due to increased gastric residual volume, prokinetic agents can be used to optimize calorie intake. When proximal sutures are used, tubes allowing early jejunal feeding should be used. Pharmaconutrition is indicated in these patients, who benefit from enteral administration of arginine, omega 3 and RNA, as well as parenteral glutamine supplementation. Parenteral nutrition should be started in patients with absolute contraindication for use of the gastrointestinal tract or as complementary nutrition if adequate energy intake is not achieved through the enteral route.

  10. Once upon a storm: Katrina and nutrition support or the lack thereof.

    PubMed

    Barrocas, Albert; Moten-Bickham, Paulette; Tonini, Jeff; Beck-McCullough, Carol

    2014-10-01

    Nutrition support teams face many challenges to establish, fund, maintain, and justify their existence. Some of the challenges can be resolved over time. However, the challenge of providing nutrition in general and nutrition support in specific during a natural disaster is void of the luxury of time experienced with the previously delineated challenges. The experience of Methodist Hospital in New Orleans, Louisiana, during Hurricane Katrina in 2005 in providing nutrition and nutrition support is summarized in this invited article. The recollections of various represented disciplines are bolstered by tables and figures that outline the 7 days before and after Katrina. Transdisciplinarity was exhibited through the performance of nontraditional functions or tasks by a variety of professionals who lived 5 days or longer in the “Methodist Island.” Lessons learned and considerations for disaster preparedness as it relates to nutrition and nutrition support as well as general considerations are provided.

  11. Once upon a storm: Katrina and nutrition support or the lack thereof.

    PubMed

    Barrocas, Albert; Moten-Bickham, Paulette; Tonini, Jeff; Beck-McCullough, Carol

    2014-10-01

    Nutrition support teams face many challenges to establish, fund, maintain, and justify their existence. Some of the challenges can be resolved over time. However, the challenge of providing nutrition in general and nutrition support in specific during a natural disaster is void of the luxury of time experienced with the previously delineated challenges. The experience of Methodist Hospital in New Orleans, Louisiana, during Hurricane Katrina in 2005 in providing nutrition and nutrition support is summarized in this invited article. The recollections of various represented disciplines are bolstered by tables and figures that outline the 7 days before and after Katrina. Transdisciplinarity was exhibited through the performance of nontraditional functions or tasks by a variety of professionals who lived 5 days or longer in the “Methodist Island.” Lessons learned and considerations for disaster preparedness as it relates to nutrition and nutrition support as well as general considerations are provided. PMID:25606635

  12. Once Upon a Storm: Katrina and Nutrition Support or the Lack Thereof.

    PubMed

    Barrocas, Albert; Bickham, Paulette-Moten; Tonini, Jeff; Beck-McCollough, Carol

    2014-08-22

    Nutrition support teams face many challenges to establish, fund, maintain, and justify their existence. Some of the challenges can be resolved over time. However, the challenge of providing nutrition in general and nutrition support in specific during a natural disaster is void of the luxury of time experienced with the previously delineated challenges. The experience of Methodist Hospital in New Orleans, Louisiana, during Hurricane Katrina in 2005 in providing nutrition and nutrition support is summarized in this invited article. The recollections of various represented disciplines are bolstered by tables and figures that outline the 7 days before and after Katrina. Transdisciplinarity was exhibited through the performance of nontraditional functions or tasks by a variety of professionals who lived 5 days or longer in the "Methodist Island." Lessons learned and considerations for disaster preparedness as it relates to nutrition and nutrition support as well as general considerations are provided. PMID:25151261

  13. Systematic review of peri-operative nutritional support for patients undergoing hepatobiliary surgery

    PubMed Central

    Liu, Yin

    2015-01-01

    Background Malnutrition is prevalent among peri-operative patients undergoing hepatobiliary surgery and is an important prognostic factor. Both hepatobiliary disease and surgical trauma significantly affects body’s metabolism and environment. Therefore, it is very important for patients with liver diseases undergoing hepatobiliary surgery to receive essential nutritional support during peri-operative period. Methods We summarized our clinical experience and reviewed of related literature to find the way for implementing the appropriate nutritional strategy. Results We found after comprehensively evaluating nutrition status, function of liver and gastrointestinal tract, nutritional strategy would be selected correctly. In severe malnutrition, initiation of enteral nutrition (EN) and/or parenteral nutrition (PN) with essential or special formulae is often recommended. Especially nasojejunal feeding is indicated that early application can improve nutritional status and liver function, reduce complications and prolong survival. Conclusions The reasonable peri-operative nutritional support therapy can improve the effect of surgical treatment and promote the patients’ recovery. PMID:26605277

  14. Changes in body composition of cancer patients following combined nutritional support

    SciTech Connect

    Cohn, S.H.; Vartsky, D.; Vaswani, A.N.; Sawitsky, A.; Rai, K.; Gartenhaus, W.; Yasumura, S.; Ellis, K.J.

    1982-01-01

    The effects of combined nutritional support (parenteral, enteral, and oral) were measured in cancer patients unable to maintain normal alimentation.Changes in body composition were quantified by measurement of total body levels of nitrogen, potassium, water, and fat. The protein-calorie intake of the patients was also evaluated by dietary survey (4-day recall). Standard anthropometric and biochemical measurements for nutritional assessment were obtained for comparison. The dietary evaluation indicated that the dietary supplementation for all patients was more than adequate to meet their energy requirements. Determination of body composition indicated that change in body weight was equal to the sum of the changes in body protein, total body water, and total body fat. Information on the nature of the tissue gained was obtained by comparison of body composition data with the ratio of protein:water:lean body mass for normal tissue. The mean gain of protein in the cancer patients was quite small (0.3-0.6 kg). The main change in body weight appeared to be the result of gains in body water and body fat. The total body nitrogen to potassium ratio served to define the extent of tissue anabolism following hyperalimentation. The ratio dropped in the cancer patients following hyperalimentation toward the value of the control subjects on ad libitum diets. Total body nitrogen was determined by prompt gamma neutron activation analysis, total body potassium by whole-body counting. (JMT)

  15. Parents and Nutrition.

    ERIC Educational Resources Information Center

    Boehnlein, Mary Maher

    Parents and the extended family are the most influential factors in the child's lifelong eating habits, general health and development, and brain power. Convincing parents of diet components that insure adequate nutrition is of prime importance; if the home does not support the content of the school's nutritional curriculum, the child may feel…

  16. Guidelines for parenteral and enteral nutrition support in geriatric patients in China.

    PubMed

    Wei, Junmin; Chen, Wei; Zhu, Mingwei; Cao, Weixin; Wang, Xinying; Shi, Hanping; Dong, Birong; Sun, Jianqin; Chen, Huaihong; Zhou, Yeping; Zhou, Suming; Xu, Jingyong

    2015-01-01

    The mortality and morbidity of geriatric patients is much higher than for younger patients, especially when critically ill. This may be attributed to a lower reserve capacity in most organs and systems, reduced ability to deal with physical stress and the presence of acute or chronic co-mobidities. Parenteral and enteral nutrition support can improve the clinical condition of the elderly patient and result in better outcomes, such as lower mortality, reduced hospital stay and reduced medical costs. There is a need to standardize nutrition screening and assessment, and the implementation of appropriate evidence based nutritional support of geriatric patients in China. The Chinese Medical Association's Group of Geriatric Nutrition Support has developed guidelines by researching the present situation in Chinese hospitals and by referring to the guidelines from both American Society for Parenteral and Enteral Nutrition (ASPEN) and the European Society for Clinical Nutrition and Metabolism (ESPEN).

  17. Treatment of upper gastrointestinal fistula and leakage with personal stage nutrition support

    PubMed Central

    Wang, Qun; Liu, Zhi-Su; Qian, Qun; Sun, Quan; Pan, Ding-Yu; He, Yue-Ming

    2008-01-01

    AIM: To investigate the feasibility of treatment for upper gastrointestinal fistula and leakage with personal stage nutrition support. METHODS: Forty-three patients with upper gastrointestinal fistula and leakage were randomly divided into two groups. Patients in group A were treated with personal stage nutrition support and patients in group B were treated with total parental nutrition (TPN) in combination with operation. Nutritional states of the candidates were evaluated by detecting albumin (Alb) and pre-Alb. The balance between nutrition and hepatic function was evaluated by measurement of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and total bilirubin (Tbill) before and after operation. At the same time their complications and hospitalized time were surveyed. RESULTS: Personal stage nutrition support improved upper gastrointestinal fistula and leakage. The nutrition state and hepatic function were better in patients who received personal stage nutrition support than in those who did not receive TPN. There was no significant difference in the complication and hospitalized time in the two groups of patients. CONCLUSION: Upper gastrointestinal fistula and leakage can be treated with personal stage nutrition support which is more beneficial for the post-operation recovery and more economic than surgical operation. PMID:18763292

  18. Nutrition education training of health workers and other field staff to support chronically deprived communities.

    PubMed

    Calderon, T A

    2001-12-01

    This paper focuses on the provision of adequate training in nutrition education to health and other community development workers for their improved performance and achievement. The difficulties encountered and special care needed when dealing with low-income, chronically deprived communities are raised. A brief analysis of past and present trends in nutrition education is presented to show the progress made from restricted, authoritative and not very successful proposals to more comprehensive and participatory approaches. The need to train and update regional and field-level personnel on the new approaches, theories and models offered by nutrition education is highlighted, but the scant availability of resources for training activities may be a great limitation for this undertaking. The contribution of educational, social, psychological and communication sciences, as well as marketing, in improving and broadening the performance of health and nutrition education is recognised. Some successful nutrition education projects, implemented in different regions, using various approaches, have managed to improve the nutrition situation of low-income groups and could be used as good examples to be followed. Recommendations for implementing nutrition education projects or activities need to consider some prerequisites, such as good knowledge and analysis of the nutrition situation, careful selection of the strategies and methods, careful planning and implementation, and clear definition of the procedures and instruments for follow-up and evaluation.

  19. A.S.P.E.N. Standards for Nutrition Support: Home and Alternate Site Care.

    PubMed

    Durfee, Sharon M; Adams, Stephen C; Arthur, Elaine; Corrigan, Mandy L; Hammond, Kathleen; Kovacevich, Debra S; McNamara, Kevn; Pasquale, Jack A

    2014-06-25

    The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) is a professional society of physicians, nurses, dietitians, pharmacists, nurse practitioners, physician assistants, other allied health professionals, and researchers. A.S.P.E.N. envisions an environment in which every patient receives safe, efficacious, and high-quality nutrition care. A.S.P.E.N.'s mission is to improve patient care by advancing the science and practice of clinical nutrition and metabolism. These combined Standards for Nutrition Support: Home Care and Alternate Site Care are an update of the 2005 and 2006 standards. PMID:24964788

  20. Enteral Nutrition Support to Treat Malnutrition in Inflammatory Bowel Disease

    PubMed Central

    Altomare, Roberta; Damiano, Giuseppe; Abruzzo, Alida; Palumbo, Vincenzo Davide; Tomasello, Giovanni; Buscemi, Salvatore; Lo Monte, Attilio Ignazio

    2015-01-01

    Malnutrition is a common consequence of inflammatory bowel disease (IBD). Diet has an important role in the management of IBD, as it prevents and corrects malnutrition. It is well known that diet may be implicated in the aetiology of IBD and that it plays a central role in the pathogenesis of gastrointestinal-tract disease. Often oral nutrition alone is not sufficient in the management of IBD patients, especially in children or the elderly, and must be combined with oral supplementation or replaced with tube enteral nutrition. In this review, we describe several different approaches to enteral nutrition—total parenteral, oral supplementation and enteral tube feeding—in terms of results, patients compliance, risks and and benefits. We also focus on the home entaral nutrition strategy as the future goal for treating IBD while focusing on patient wellness. PMID:25816159

  1. [Quality of support by artificial nutrition: difficulties with AIDS patients].

    PubMed

    Ayúcar Ruiz de Galarreta, A; Cordero Lorenzana, M L; García Filgueira, P; Martínez-Puga, E

    1998-01-01

    The use of Enteral Nutrition (EN) in patients with AIDS with a severe nutritional deterioration, is the most common route, not only because of the risk/benefit relation, bur also because this is a physiological route that is easily managed and is profitable in terms of renutrition. However, and given the characteristics of the affected population, whose origin in a large percentage is the addiction to parenteral drugs, implanting this route in these patients is a challenge, as these patients refuse in more than 50% of the cases. Moreover, the risk group is not only a factor in the difficulty for applying the ideal across route, but also the combination of other elements like sex or the disease itself, force the clinical to use more aggressive methods (Parenteral Nutrition) or those that are less profitable nutritionally (Supplements). The negative aspects with regard to tube feeding of these patients are shown, in relation to the factors, and these are compared with the negative aspects of other diagnosis groups (rest of the Hospital).

  2. Reconceiving SNAP: Is Nutritional Assistance Really Income Support?

    ERIC Educational Resources Information Center

    Besharov, Douglas J.

    2016-01-01

    Since its creation, the Supplemental Nutrition Assistance Program (SNAP) has changed from an antihunger program to an income-supplementation program. Because the program (and its predecessor Food Stamp Program) was not designed for this purpose, the result is a program that has many unintended and, many believe, negative effects. The key challenge…

  3. Nutritional Support in Cancer Patients: A Position Paper from the Italian Society of Medical Oncology (AIOM) and the Italian Society of Artificial Nutrition and Metabolism (SINPE).

    PubMed

    Caccialanza, Riccardo; Pedrazzoli, Paolo; Cereda, Emanuele; Gavazzi, Cecilia; Pinto, Carmine; Paccagnella, Agostino; Beretta, Giordano Domenico; Nardi, Mariateresa; Laviano, Alessandro; Zagonel, Vittorina

    2016-01-01

    Malnutrition is a frequent problem in cancer patients, which leads to prolonged hospitalization, a higher degree of treatment-related toxicity, reduced response to cancer treatment, impaired quality of life and a worse overall prognosis. The attitude towards this issue varies considerably and many malnourished patients receive inadequate nutritional support. We reviewed available data present in the literature, together with the guidelines issued by scientific societies and health authorities, on the nutritional management of patients with cancer, in order to make suitable and concise practical recommendations for appropriate nutritional support in this patient population. Evidence from the literature suggests that nutritional screening should be performed using validated tools (the Nutritional Risk Screening 2002 [NRS 2002], the Malnutrition Universal Screening Tool [MUST], the Malnutrition Screening Tool [MST] and the Mini Nutritional Assessment [MNA]), both at diagnosis and at regular time points during the course of disease according to tumor type, stage and treatment. Patients at nutritional risk should be promptly referred for comprehensive nutritional assessment and support to clinical nutrition services or medical personnel with documented skills in clinical nutrition, specifically for cancer patients. Nutritional intervention should be actively managed and targeted for each patient; it should comprise personalized dietary counseling and/or artificial nutrition according to spontaneous food intake, tolerance and effectiveness. Nutritional support may be integrated into palliative care programs. "Alternative hypocaloric anti-cancer diets" (e.g. macrobiotic or vegan diets) should not be recommended as they may worsen nutritional status. Well-designed clinical trials are needed to further our knowledge of the nutritional support required in different care settings for cancer patients.

  4. Nutritional Support in Cancer Patients: A Position Paper from the Italian Society of Medical Oncology (AIOM) and the Italian Society of Artificial Nutrition and Metabolism (SINPE)

    PubMed Central

    Caccialanza, Riccardo; Pedrazzoli, Paolo; Cereda, Emanuele; Gavazzi, Cecilia; Pinto, Carmine; Paccagnella, Agostino; Beretta, Giordano Domenico; Nardi, Mariateresa; Laviano, Alessandro; Zagonel, Vittorina

    2016-01-01

    Malnutrition is a frequent problem in cancer patients, which leads to prolonged hospitalization, a higher degree of treatment-related toxicity, reduced response to cancer treatment, impaired quality of life and a worse overall prognosis. The attitude towards this issue varies considerably and many malnourished patients receive inadequate nutritional support. We reviewed available data present in the literature, together with the guidelines issued by scientific societies and health authorities, on the nutritional management of patients with cancer, in order to make suitable and concise practical recommendations for appropriate nutritional support in this patient population. Evidence from the literature suggests that nutritional screening should be performed using validated tools (the Nutritional Risk Screening 2002 [NRS 2002], the Malnutrition Universal Screening Tool [MUST], the Malnutrition Screening Tool [MST] and the Mini Nutritional Assessment [MNA]), both at diagnosis and at regular time points during the course of disease according to tumor type, stage and treatment. Patients at nutritional risk should be promptly referred for comprehensive nutritional assessment and support to clinical nutrition services or medical personnel with documented skills in clinical nutrition, specifically for cancer patients. Nutritional intervention should be actively managed and targeted for each patient; it should comprise personalized dietary counseling and/or artificial nutrition according to spontaneous food intake, tolerance and effectiveness. Nutritional support may be integrated into palliative care programs. “Alternative hypocaloric anti-cancer diets” (e.g. macrobiotic or vegan diets) should not be recommended as they may worsen nutritional status. Well-designed clinical trials are needed to further our knowledge of the nutritional support required in different care settings for cancer patients. PMID:26819635

  5. Nutritional Support in Cancer Patients: A Position Paper from the Italian Society of Medical Oncology (AIOM) and the Italian Society of Artificial Nutrition and Metabolism (SINPE).

    PubMed

    Caccialanza, Riccardo; Pedrazzoli, Paolo; Cereda, Emanuele; Gavazzi, Cecilia; Pinto, Carmine; Paccagnella, Agostino; Beretta, Giordano Domenico; Nardi, Mariateresa; Laviano, Alessandro; Zagonel, Vittorina

    2016-01-01

    Malnutrition is a frequent problem in cancer patients, which leads to prolonged hospitalization, a higher degree of treatment-related toxicity, reduced response to cancer treatment, impaired quality of life and a worse overall prognosis. The attitude towards this issue varies considerably and many malnourished patients receive inadequate nutritional support. We reviewed available data present in the literature, together with the guidelines issued by scientific societies and health authorities, on the nutritional management of patients with cancer, in order to make suitable and concise practical recommendations for appropriate nutritional support in this patient population. Evidence from the literature suggests that nutritional screening should be performed using validated tools (the Nutritional Risk Screening 2002 [NRS 2002], the Malnutrition Universal Screening Tool [MUST], the Malnutrition Screening Tool [MST] and the Mini Nutritional Assessment [MNA]), both at diagnosis and at regular time points during the course of disease according to tumor type, stage and treatment. Patients at nutritional risk should be promptly referred for comprehensive nutritional assessment and support to clinical nutrition services or medical personnel with documented skills in clinical nutrition, specifically for cancer patients. Nutritional intervention should be actively managed and targeted for each patient; it should comprise personalized dietary counseling and/or artificial nutrition according to spontaneous food intake, tolerance and effectiveness. Nutritional support may be integrated into palliative care programs. "Alternative hypocaloric anti-cancer diets" (e.g. macrobiotic or vegan diets) should not be recommended as they may worsen nutritional status. Well-designed clinical trials are needed to further our knowledge of the nutritional support required in different care settings for cancer patients. PMID:26819635

  6. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): cardiac patient].

    PubMed

    Jiménez Jiménez, F J; Cervera Montes, M; Blesa Malpica, A L

    2011-11-01

    Patients with cardiac disease can develop two types of malnutrition: cardiac cachexia, which appears in chronic congestive heart failure, and malnutrition due to the complications of cardiac surgery or any other type of surgery in patients with heart disease. Early enteral nutrition should be attempted if the oral route cannot be used. When cardiac function is severely compromised, enteral nutrition is feasible, but supplementation with parenteral nutrition is sometimes required. Sustained hyperglycemia in the first 24 hours in patients admitted for acute coronary syndrome, whether diabetic or not, is a poor prognostic factor for 30-day mortality. In critically-ill cardiac patients with stable hemodynamic failure, nutritional support of 20-25 kcal/kg/day is effective in maintaining adequate nutritional status. Protein intake should be 1.2*-1.5 g/kg/day. Routine polymeric or high protein formulae should be used, according to the patient's prior nutritional status, with sodium and volume restriction according to the patient's clinical situation. The major energy source for myocytes is glutamine, through conversion to glutamate, which also protects the myocardial cell from ischemia in critical situations. Administration of 1 g/ day of omega-3 (EPA+DHA) in the form of fish oil can prevent sudden death in the treatment of acute coronary syndrome and can also help to reduce hospital admission for cardiovascular events in patients with chronic heart failure.

  7. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): gastrointestinal surgery].

    PubMed

    Sánchez Álvarez, C; Zabarte Martínez de Aguirre, M; Bordejé Laguna, L

    2011-11-01

    Gastrointestinal surgery and critical illness place tremendous stress on the body, resulting in a series of metabolic changes that may lead to severe malnutrition, which in turn can increase postsurgical complications and morbidity and mortality and prolong the hospital length of stay. In these patients, parenteral nutrition is the most widely used form of nutritional support, but administration of enteral nutrition early in the postoperative period is effective and well tolerated, reducing infectious complications, improving wound healing and reducing length of hospital stay. Calorie-protein requirements do not differ from those in other critically-ill patients and depend on the patient's underlying process and degree of metabolic stress. In patients intolerant to enteral nutrition, especially if the intolerance is due to increased gastric residual volume, prokinetic agents can be used to optimize calorie intake. When proximal sutures are used, tubes allowing early jejunal feeding should be used. Pharmaconutrition is indicated in these patients, who benefit from enteral administration of arginine, omega 3 and RNA, as well as parenteral glutamine supplementation. Parenteral nutrition should be started in patients with absolute contraindication for use of the gastrointestinal tract or as complementary nutrition if adequate energy intake is not achieved through the enteral route.

  8. Nutritional support in the treatment of chronic hepatic encephalopathy.

    PubMed

    Milke García, María del Pilar

    2011-06-01

    The prevalence of under nutrition in cirrhotic patients is 61% and it usually progresses as the disease becomes more advanced. The deterioration in the nutritional status and its associated metabolic derangements has raised doubts about the benefits of severe and prolonged protein restriction as a treatment for hepatic encephalopathy. However, the practice of dietary protein restriction for patients with liver cirrhosis is deeply embedded among medical practitioners and dietitians. To date, no solid conclusions may be drawn about the benefit of protein restriction. However, the negative effects of protein restriction are clear, that is, increased protein catabolism, the release of amino acids from the muscle, and possible worsening of hepatic encephalopathy. In conclusion, chronic protein restriction causes progressive and harmful protein depletion and must be avoided. PMID:22228881

  9. Relationship between social support and the nutritional status of patients receiving radiation therapy for cancer

    SciTech Connect

    Pulliam, L.W.

    1985-01-01

    The purpose of this descriptive, correlational study was to ascertain if there is a relationship between social support and the nutritional status of patients receiving radiation therapy for cancer. The data collection instruments used included the Norbeck Social Support Questionnaire (NSSQ), the Personal Characteristics Form, the abbreviated Health History, the Flow Sheet for Nutritional Data, and the Interview Schedule. For the analysis of data descriptive statistics were utilized to provide a profile of subjects, and correlational statistics were used to ascertain if there were relationships among the indicators of nutritional status and the social support variables. A convenience sample was comprised of 50 cancer patients deemed curable by radiation therapy. Findings included significant decreases in anthropometric measurements and biochemical tests during therapy. Serial assessments of nutritional status, therefore, are recommended for all cancer patients during therapy in order to plan and implement strategies for meeting the self-care requisites for food and water. No statistically significant relationships were found between the social support variables as measured by the NSSQ and the indicators of nutritional status. This suggests that nurses can assist patients by fostering support from actual and potential nutritional confidants.

  10. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): patient with sepsis].

    PubMed

    Ortiz Leyba, C; Montejo González, J C; Vaquerizo Alonso, C

    2011-11-01

    Nutritional metabolic management, together with other treatment and support measures used, is one of the mainstays of the treatment of septic patients. Nutritional support should be started early, after initial life support measures, to avoid the consequences of malnutrition, to provide adequate nutritional intake and to prevent the development of secondary complications such as superinfection or multiorgan failure. As in other critically-ill patients, when the enteral route cannot be used to ensure calorie-protein requirements, the association of parenteral nutrition has been shown to be safe in this subgroup of patients. Studies evaluating the effect of specific pharmaconutrients in septic patients are scarce and are insufficient to allow recommendations to be made. To date, enteral diets with a mixture of substrates with distinct pharmaconutrient properties do not seem to be superior to standard diets in altering the course of sepsis, although equally there is no evidence that these diets are harmful. There is insufficient evidence to recommend the use of glutamine in septic patients receiving parenteral nutrition. However, given the good results and absence of glutamine-related adverse effects in the various studies performed in the general population of critically-ill patients, these patients could benefit from the use of this substance. Routine use of omega-3 fatty acids cannot be recommended until further evidence has been gathered, although the use of lipid emulsions with a high omega-6 fatty acid content should be avoided. Septic patients should receive an adequate supply of essential trace elements and vitamins. Further studies are required before the use of high-dose selenium can be recommended.

  11. Guidelines for specialized nutritional and metabolic support in the critically-ill patient: update. Consensus SEMICYUC-SENPE: liver failure and liver transplantation.

    PubMed

    Montejo González, J C; Mesejo, A; Bonet Saris, A

    2011-11-01

    Patients with liver failure have a high prevalence of malnutrition, which is related to metabolic abnormalities due to the liver disease, reduced nutrient intake and alterations in digestive function, among other factors. In general, in patients with liver failure, metabolic and nutritional support should aim to provide adequate nutrient intake and, at the same time, to contribute to patients' recovery through control or reversal of metabolic alterations. In critically-ill patients with liver failure, current knowledge indicates that the organ failure is not the main factor to be considered when choosing the nutritional regimen. As in other critically-ill patients, the enteral route should be used whenever possible. The composition of the nutritional formula should be adapted to the patient's metabolic stress. Despite the physiopathological basis classically described by some authors who consider amino acid imbalance to be a triggering factor and key element in maintaining encephalopathy, there are insufficient data to recommend "specific" solutions (branched-chain amino acid-enriched with low aromatic amino acids) as part of nutritional support in patients with acute liver failure. In patients undergoing liver transplantation, nutrient intake should be started early in the postoperative period through transpyloric access. Prevention of the hepatic alterations associated with nutritional support should also be considered in distinct clinical scenarios. PMID:22411515

  12. American Society for Parenteral and Enteral Nutrition and Academy of Nutrition and Dietetics: revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in nutrition support.

    PubMed

    Brantley, Susan L; Russell, Mary K; Mogensen, Kris M; Wooley, Jennifer A; Bobo, Elizabeth; Chen, Yimin; Malone, Ainsley; Roberts, Susan; Romano, Michelle M; Taylor, Beth

    2014-12-01

    This 2014 revision of the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for Registered Dietitian Nutritionists (RDNs) in Nutrition Support represents an update of the 2007 Standards composed by content experts of the American Society for Parenteral and Enteral Nutrition and the Academy of Nutrition and Dietetics. The revision is based on the Revised 2012 SOP in Nutrition Care and SOPP for RDs, which incorporates the Nutrition Care Process and the following six domains of professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. These SOP and SOPP are designed to promote the provision of safe, effective, and efficient nutrition support services; facilitate evidence-based practice; and serve as a professional evaluation resource for RDNs who specialize in or wish to specialize in nutrition support therapy. These standards should be applied in all patient/client care settings in which RDNs in nutrition support provide care. These settings include, but are not limited to, acute care, ambulatory/outpatient care, and home and alternate site care. The standards highlight the value of the nutrition support RDN's roles in quality management, regulatory compliance, research, teaching, consulting, and writing for peer-reviewed professional publications. The standards assist the RDN in nutrition support to distinguish his or her level of practice (competent, proficient, or expert) and would guide the RDN in creating a personal development plan to achieve increasing levels of knowledge, skill, and ability in nutrition support practice.

  13. American Society for Parenteral and Enteral Nutrition and Academy of Nutrition and Dietetics: Revised 2014 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Nutrition Support.

    PubMed

    Brantley, Susan L; Russell, Mary K; Mogensen, Kris M; Wooley, Jennifer A; Bobo, Elizabeth; Chen, Yimin; Malone, Ainsley; Roberts, Susan; Romano, Michelle M; Taylor, Beth

    2014-12-01

    This 2014 revision of the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for Registered Dietitians Nutritionists (RDNs) in Nutrition Support represents an update of the 2007 Standards composed by content experts of the American Society for Parenteral and Enteral Nutrition and the Academy of Nutrition and Dietetics. The revision is based upon the Revised 2012 SOP in Nutrition Care and SOPP for RDs, which incorporates the Nutrition Care Process and the six domains of professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. These SOP and SOPP are designed to promote the provision of safe, effective, and efficient nutrition support services, facilitate evidence-based practice, and serve as a professional evaluation resource for RDNs who specialize or wish to specialize in nutrition support therapy. These standards should be applied in all patient/client care settings in which RDNs in nutrition support provide care. These settings include, but are not limited to, acute care, ambulatory/outpatient care, and home and alternate site care. The standards highlight the value of the nutrition support RDN's roles in quality management, regulatory compliance, research, teaching, consulting, and writing for peer-reviewed professional publications. The standards assist the RDN in nutrition support to distinguish his or her level of practice (competent, proficient, or expert) and would guide the RDN in creating a personal development plan to achieve increasing levels of knowledge, skill, and ability in nutrition support practice.

  14. American Society for Parenteral and Enteral Nutrition and Academy of Nutrition and Dietetics: Revised 2014 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Nutrition Support.

    PubMed

    Brantley, Susan L; Russell, Mary K; Mogensen, Kris M; Wooley, Jennifer A; Bobo, Elizabeth; Chen, Yimin; Malone, Ainsley; Roberts, Susan; Romano, Michelle M; Taylor, Beth

    2014-12-01

    This 2014 revision of the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for Registered Dietitians Nutritionists (RDNs) in Nutrition Support represents an update of the 2007 Standards composed by content experts of the American Society for Parenteral and Enteral Nutrition and the Academy of Nutrition and Dietetics. The revision is based upon the Revised 2012 SOP in Nutrition Care and SOPP for RDs, which incorporates the Nutrition Care Process and the six domains of professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. These SOP and SOPP are designed to promote the provision of safe, effective, and efficient nutrition support services, facilitate evidence-based practice, and serve as a professional evaluation resource for RDNs who specialize or wish to specialize in nutrition support therapy. These standards should be applied in all patient/client care settings in which RDNs in nutrition support provide care. These settings include, but are not limited to, acute care, ambulatory/outpatient care, and home and alternate site care. The standards highlight the value of the nutrition support RDN's roles in quality management, regulatory compliance, research, teaching, consulting, and writing for peer-reviewed professional publications. The standards assist the RDN in nutrition support to distinguish his or her level of practice (competent, proficient, or expert) and would guide the RDN in creating a personal development plan to achieve increasing levels of knowledge, skill, and ability in nutrition support practice. PMID:25362700

  15. Metabolism, Metabolomics, and Nutritional Support of Patients with Sepsis.

    PubMed

    Englert, Joshua A; Rogers, Angela J

    2016-06-01

    Sepsis is characterized by profound changes in systemic and cellular metabolism that disrupt normal metabolic homeostasis. These metabolic changes can serve as biomarkers for disease severity. Lactate, a metabolite of anaerobic metabolism, is the most widely used ICU biomarker and it is incorporated into multiple management algorithms. Technological advances now make broader metabolic profiling possible, with early studies identifying metabolic changes associated with sepsis mortality. Finally, given the marked changes in metabolism in sepsis and the association of worse prognosis in patients with severe metabolic derangements, we summarize the seminal trials conducted to optimize nutrition in the ICU. PMID:27229648

  16. Nutrition

    MedlinePlus

    ... into your diet. These include brightly colored and dark fruits and vegetables. Balance the food you eat ... can also order your free copy of Nutrition Matters and visit our Ask about Nutrition forum. << Back ...

  17. Nutrition

    MedlinePlus

    Nutrition Health Education During the 2 years preceding the study: • The percentage of states that provided funding for staff development or offered staff development on nutrition and dietary behavior to those who teach health ...

  18. Evaluation of food provision and nutrition support at the London 2012 Olympic Games: the opinion of sports nutrition experts.

    PubMed

    Pelly, Fiona; Meyer, Nanna L; Pearce, Jeni; Burkhart, Sarah J; Burke, Louise M

    2014-12-01

    The aim of this study was to evaluate the food provision and nutrition support at the London 2012 Olympic (OG) and Paralympic Games (PG) from the perspective of sports nutrition experts attending the event. Participants (n = 15) were asked to complete an online survey and rate on a Likert scale menu qualities, food safety, sustainability practices, nutrition labeling, and provision for cultural needs, dietary regimes and specific situations. Open-ended responses were incorporated to explore expert opinion and areas for improvement. Participants rated their overall experience of the food provision as 7.6 out of 10 (range 5 to 10), with the majority (n = 11) rating it greater than 7. The variety, accessibility, presentation, temperature, and freshness of menu items rated as average to good. A below average rating was received for recovery food and beverages, provision of food for traveling to other venues, taking suitable snacks out of the dining hall and provision of food at other venues. However, the variety and accessibility of choices for Ramadan, and provision of post-competition food were rated highly. A number of comments were received about the lack of gluten free and lower energy/fat items. The inclusion of allergens on nutrition labeling was considered more important than nutrient content. While dietetic review of the menu in advance of the OG and PG is clearly a valuable process that has resulted in improvements in the food supply, there are still areas that need to be addressed that are currently not implemented during the event.

  19. [Recent advances in nutritional support and postnatal growth in premature infants].

    PubMed

    Senterre, T; Rigo, J

    2013-02-01

    Nutrition has always been described as challenging in premature infants, especially in very low birth weight (VLBW, < 1500 g) infants. Therefore, postnatal malnutrition is frequently observed in these infants and most develop a severe postnatal growth restriction with a very high incidence of hypotrophy at term corrected age. Otherwise, both insufficient nutritional intakes and postnatal growth restriction during the perinatal period have been associated with adverse developmental outcomes. In this article, an optimized nutritional policy characterized by a standardization of nutritional support is discussed. This policy implies the use of one standardized parenteral nutrition solution and a rapidly enriched feeding regimen. Recent studies in VLBW infants have demonstrated that this approach is associated with significant improvement of nutritional support, postnatal growth and biological homeostasis. Only 6% of appropriate for gestational age infants at birth were described small for gestational age at discharge. This policy has recently been reproduced by the industry that developed the first manufactured triple-chamber parenteral nutrition bags specifically designed for premature infants. It represents a great opportunity for premature infants to improve their development and long-term outcomes.

  20. [Systematic review of nutritional support in pressure ulcer].

    PubMed

    de Luis, D; Aller, R

    2007-07-01

    Pressure ulcer is an area of localised damage to the skin and underlying tissue caused by pressure, shear, friction and/or combination of these things. Prevalence of this entity is between 3 and 66%, depending of the patients and the pathology. Pressure ulcer is associated with an increased risk of morbidity and mortality. One of the most important risk factors to develop a pressure ulcer is nutritional status. We can use different interventional strategies, first of all (primary intervention) before the patient has developed a ulcer and secondly, the treatment of a established ulcer (secondary prevention). In the most important primary prevention study with 662 patients, two oral nutritional supplements per day were given to the patients. The incidence of pressure ulcer was 40% (118/295) in the interventional group and 48% (181/377) in control group. A relative risk to develop a pressure ulcer with supplementation of 0.83 (CI95%: 0.70 a 0.99). In the studies with secondary prevention, when we analyze in an individual way the different nutrients, zinc has not demonstrated the utility in an independent way. Vitamin C shows contradictory data in two randomized clinical trial with the same dose (500 mg each 12 hours). Recently, some randomized clinical trials have demonstrated an improvement in healing rates with enhanced enteral formulas (zinc, arginine, vitamin C). Oral supplementation without taking account micronutrients decreases risk of pressure ulcer. However, studies of secondary prevention due to heterogeneity have not let clear conclusions. However, enteral enhanced formula could improve ulcer healing.

  1. 34 CFR 85.900 - Adequate evidence.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Adequate evidence. 85.900 Section 85.900 Education Office of the Secretary, Department of Education GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 85.900 Adequate evidence. Adequate evidence means information sufficient to support...

  2. Nutritional support to maintain proper immune status during intense training.

    PubMed

    Gleeson, Michael

    2013-01-01

    Prolonged exercise and heavy training are associated with depressed immune function which can increase the risk of picking up minor infections. To maintain robust immunity, athletes should eat a well-balanced diet sufficient to meet their energy, carbohydrate, protein, and micronutrient requirements. Dietary deficiencies of protein and specific micronutrients have long been associated with immune dysfunction and an adequate intake of iron, zinc, and vitamins A, D, E, B6 and B12 is particularly important in the maintenance of immune function. Consuming carbohydrate during prolonged strenuous exercise attenuates rises in stress hormones and appears to limit the degree of exercise-induced immune depression. Similar effects can be seen with daily ingestion of high-dose antioxidant vitamin supplements, though concerns have been expressed that excessive antioxidant intake may impair exercise training adaptations. It is safe to say with reasonable confidence that individual amino acids, colostrum, Echinacea, and zinc are unlikely to boost immunity or reduce infection risk in athletes. The ingestion of carbohydrate during exercise and daily consumption of probiotic and plant polyphenol (e.g. quercetin)-containing supplements or foodstuffs (e.g. non-alcoholic beer) currently offer the best chance of success. This approach is likely to be most effective for individuals who are particularly prone to illness. PMID:23765353

  3. Social Support, Nutrition Intake, and Physical Activity in Cancer Survivors

    PubMed Central

    Coleman, Shanice; Berg, Carla J.; Thompson, Nancy J.

    2015-01-01

    Objectives To examine depressive symptoms, hope, social support, and quality of life in relation to fruit and vegetable (FV) intake and physical activity (PA) among cancer survivors diagnosed within the past 4 years. Methods In 2010, participants were recruited from a southeastern US cancer center and completed a mail-based survey (response rate 22.7%) assessing these psychosocial factors, FV intake, and PA. Results Among 128 participants, 72% consumed ≥5 FV/ day; 77.8% walked for exercise ≥4 times/ week. Controlling for sociodemographics, consuming ≥5 FV/day was associated with greater significant other social support (p = .004); walking for exercise ≥4 times/week was associated with greater friend support (p = .003). Conclusions These findings can inform tertiary cancer prevention interventions. PMID:24636037

  4. Position of the academy of nutrition and dietetics: promoting and supporting breastfeeding.

    PubMed

    Lessen, Rachelle; Kavanagh, Katherine

    2015-03-01

    It is the position of the Academy of Nutrition and Dietetics that exclusive breastfeeding provides optimal nutrition and health protection for the first 6 months of life, and that breastfeeding with complementary foods from 6 months until at least 12 months of age is the ideal feeding pattern for infants. Breastfeeding is an important public health strategy for improving infant and child morbidity and mortality, improving maternal morbidity, and helping to control health care costs. Research continues to support the positive effects of human milk on infant and maternal health, as it is a living biological fluid with many qualities not replicable by human milk substitutes. Recent research advancements include a greater understanding of the human gut microbiome, the protective effect of human milk for premature infants and those born to women experiencing gestational diabetes mellitus, the relationship of breastfeeding with human immunodeficiency virus, and the increased ability to characterize cellular components of human milk. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, should continue efforts to shift the norm of infant feeding away from use of human milk substitutes and toward human milk feeds. The role of registered dietitian nutritionists and nutrition and dietetics technicians, registered, in breastfeeding promotion and support, in the context of the professional code of ethics and the World Health Organization's International Code of Marketing of Breast-Milk Substitutes, are discussed in the "Practice Paper of the Academy of Nutrition and Dietetics: Promoting and Supporting Breastfeeding," published on the Academy website at: www.eatright.org/positions. PMID:25721389

  5. Enteral nutrition support of the preterm infant in the neonatal intensive care unit.

    PubMed

    Groh-Wargo, Sharon; Sapsford, Amy

    2009-01-01

    The delivery of a preterm baby is a nutrition emergency. Growth and the accumulation of nutrient reserves are higher during the third trimester of pregnancy than at any other time during the life cycle. Enteral nutrition is the preferred mode of support and human milk the preferred source of enteral nutrition. Human milk is highly digestible and contains many anti-infective components, which confer a lower risk of infection. The mother of a preterm infant requires education, equipment, and encouragement to successfully initiate and sustain lactation. Human milk requires nutrient fortification to meet the protein and mineral needs of the rapidly growing preterm infant. Commercial human milk fortifiers are available. If human milk is unavailable or the volume is insufficient, preterm formulas are available. Preterm formulas have different sources of macronutrients and greater density of all nutrients than formulas intended for term newborns. Preterm infants benefit from early enteral feedings with slow but steady increases in feedings to achieve full support. Infants born at <35 weeks gestational age are supported with tube feedings. A transition to feedings at the breast or to bottle feedings is gradually made as the baby matures. Nutrient recommendations specific to the preterm infant are available. Special products and feeding strategies exist to respond to common medical conditions that can complicate nutrition management. Optimal nutrition care of the preterm infant offers the opportunity to improve outcomes for children.

  6. Evaluation of food provision and nutrition support at the London 2012 Olympic Games: the opinion of sports nutrition experts.

    PubMed

    Pelly, Fiona; Meyer, Nanna L; Pearce, Jeni; Burkhart, Sarah J; Burke, Louise M

    2014-12-01

    The aim of this study was to evaluate the food provision and nutrition support at the London 2012 Olympic (OG) and Paralympic Games (PG) from the perspective of sports nutrition experts attending the event. Participants (n = 15) were asked to complete an online survey and rate on a Likert scale menu qualities, food safety, sustainability practices, nutrition labeling, and provision for cultural needs, dietary regimes and specific situations. Open-ended responses were incorporated to explore expert opinion and areas for improvement. Participants rated their overall experience of the food provision as 7.6 out of 10 (range 5 to 10), with the majority (n = 11) rating it greater than 7. The variety, accessibility, presentation, temperature, and freshness of menu items rated as average to good. A below average rating was received for recovery food and beverages, provision of food for traveling to other venues, taking suitable snacks out of the dining hall and provision of food at other venues. However, the variety and accessibility of choices for Ramadan, and provision of post-competition food were rated highly. A number of comments were received about the lack of gluten free and lower energy/fat items. The inclusion of allergens on nutrition labeling was considered more important than nutrient content. While dietetic review of the menu in advance of the OG and PG is clearly a valuable process that has resulted in improvements in the food supply, there are still areas that need to be addressed that are currently not implemented during the event. PMID:24903640

  7. Feeding the critically ill obese patient: the role of hypocaloric nutrition support.

    PubMed

    Miller, Jerad P; Choban, Patricia Smith

    2006-12-01

    Obesity and its many metabolic and physiologic comorbidities are becoming more common. Thus, a strategy to approach the nutritional needs of obese critically ill patients is warranted. The adverse effect of obesity on the respiratory system is well established. The obesity may be an inciting event or merely an additional burden in the obese critically ill patient. A strategy of hypocaloric nutrition support avoids the many detrimental effects of overfeeding and has been considered for all critically ill patients. In the obese patient, the strategy addresses the additional problem of the excessive fat store and has the additional benefit of fat reduction while sparing lean body mass. In the patient with normal renal and hepatic function, hypocaloric nutrition support simplifies care and may improve outcome. PMID:17150433

  8. Concluding remarks: nutritional strategies to support the adaptive response to prolonged exercise training.

    PubMed

    van Loon, Luc J C; Tipton, Kevin D

    2013-01-01

    Nutrition plays a key role in allowing the numerous training hours to be translated into useful adaptive responses of various tissues in the individual athlete. Research over the last decade has shown many examples of the impact of dietary interventions to modulate the skeletal muscle adaptive response to prolonged exercise training. Proper nutritional coaching should be applied throughout both training and competition, each with their specific requirements regarding nutrient provision. Such dietary support will improve exercise training efficiency and, as such, further increase performance capacity. Here, we provide an overview on the properties of various nutritional interventions that may be useful to support the adaptive response to exercise training and competition and, as such, to augment exercise training efficiency.

  9. Nutrition

    NASA Technical Reports Server (NTRS)

    Lane, Helen W.

    1990-01-01

    This is a collection of viewgraphs on the Johnson Space Center's work on nutrition for long duration space missions. Nutritional requirements are affected by isolation, workloads, and cold as well as the psychological needs, metabolism, and fluid balance of an individual.

  10. Use of the Web To Provide Learning Support for a Large Metabolism and Nutrition Class.

    ERIC Educational Resources Information Center

    Henly, Debra C.; Reid, Athol E.

    2001-01-01

    Describes the introduction of a web-based package, WebCT, to support student learning in a large metabolism and nutrition class. Reports that student usage of the site was generally high and that students who achieved a high overall score completed on average three times as many formative assessments as students who did poorly. (Author/MM)

  11. Nutrition Education and Support Program for Community-Dwelling Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Humphries, Kathleen; Traci, Meg Ann; Seekins, Tom

    2008-01-01

    To test the efficacy, acceptability, and appropriateness of a nutrition education and support program, 4 community-based group homes for adults with intellectual or developmental disabilities participated in a pilot intervention with extended baseline period and pre--post-test design. Adults (N = 32) with intellectual or developmental…

  12. Six Characteristics of Nutrition Education Videos That Support Learning and Motivation to Learn

    ERIC Educational Resources Information Center

    Ramsay, Samantha A.; Holyoke, Laura; Branen, Laurel J.; Fletcher, Janice

    2012-01-01

    Objective: To identify characteristics in nutrition education video vignettes that support learning and motivation to learn about feeding children. Methods: Nine focus group interviews were conducted with child care providers in child care settings from 4 states in the western United States: California, Idaho, Oregon, and Washington. At each focus…

  13. A Prospective Multi-Center Audit of Nutrition Support Parameters Following Burn Injury.

    PubMed

    Kurmis, Rochelle; Heath, Kathryn; Ooi, Selena; Munn, Zachary; Forbes, Sharon; Young, Vicki; Rigby, Paul; Wood, Kate; Phillips, Frances; Greenwood, John

    2015-01-01

    The importance of nutrition support delivery to the severe burn-injured patient is well recognized, however, nutrition provision to the patient may be sub optimal in practice. The aim of this study was to conduct a prospective multi-center audit across Australia and New Zealand using the Joanna Briggs Institute Burns Node Nutrition audit criteria. Thirty-four patients with severe burn injury (≥20% TBSA in adults and ≥10% TBSA in children) were identified on admission or on referral to the Dietitian at the eight participating Burn Units between February 1, 2012 and April 30, 2012 for inclusion in the study. De-identified patient data was analyzed using the Joanna Briggs Institute, Practical Application of Clinical Evidence System. Compliance with individual audit criterion ranged from 33 to 100%. Provision of prescribed enteral feed volumes and weekly weighing of patients were highlighted as key areas for clinical improvement. Clinical audit is a valuable tool for evaluating current practice against best evidence to ensure that quality patient care is delivered. The use of the Joanna Briggs Institute Burns Node audit criteria has allowed for a standardized multi-center audit to be conducted. Improving nutrition support delivery in burn patients was identified as a key area requiring ongoing clinical improvement across Australia and New Zealand. Clinician feedback on use of the audit criteria will allow for future refinement of individual criterion, and presentation of results of this audit has resulted in a review of the Bi-National Burns Registry nutrition quality indicators.

  14. Adjuvant Efficacy of Nutrition Support During Pulmonary Tuberculosis Treating Course: Systematic Review and Meta-analysis

    PubMed Central

    Si, Zhuang-Li; Kang, Ling-Ling; Shen, Xu-Bo; Zhou, Yuan-Zhong

    2015-01-01

    Background: Malnutrition and tuberculosis (TB) tend to interact with each other. TB may lead to nutrition deficiencies that will conversely delay recovery by depressing immune functions. Nutrition support can promote recovery in the subject being treated for TB. The aim of this study was to evaluate the effectiveness of nutrition support on promoting the recovery of adult pulmonary TB patients with anti-TB drug therapy. Methods: English database of the Cochrane Controlled Trials Register, PubMed, EMBASE, and Chinese database of CBM, CNKI, VIP, and WANFANG were searched. Randomized controlled trials comparing nutrition support (given for more than 2 weeks) with no nutrition intervention, nutrition advice only, or placebo-control for TB patients being anti-TB treated were included. Two reviewers conducted data extraction, assessed the quality of the studies independently, and any discrepancies were solved by the third reviewer. Data were entered and analyzed by RevMan 5.2 software, and meta-analysis was done using risk ratios (RRs) for dichotomous variables and mean differences (MDs) for continuous variables with 95% confidence intervals (CIs). Results: A total of 19 studies (3681 participants) were included. In nutritional support for TB patients, pooled RR and its 95% CI of sputum smears- or culture-negative conversion rate and chest X-ray (CXR) absorption rate were 1.10 (1.04, 1.17) and 1.22 (1.08, 1.39), respectively, the pooled MD and its 95% CI of body mass index (BMI) and time of sputum smears or culture negativity were 0.59 (0.16, 1.2) and − 5.42 (−7.93, −2.92), respectively, compared with the control group. The differences in outcomes of CXR zone affected, TB score, serum albumin, and hemoglobin were not statistically significant (P = 0.76, 0.24, 0.28, and 0.20, respectively) between the intervention group and the control group. No systemic adverse events were recorded. Conclusions: During anti-TB course, nutrition support may be helpful in treatment

  15. Nutrition

    MedlinePlus

    ... you would like to see a registered dietitian nutritionist for nutritional guidance when you have lung cancer. ... seek out the expertise of a registered dietitian nutritionist (RDN) who works with lung cancer patients. This ...

  16. American Society for Parenteral and Enteral Nutrition and Academy of Nutrition and Dietetics: revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in nutrition support.

    PubMed

    Brantley, Susan L; Russell, Mary K; Mogensen, Kris M; Wooley, Jennifer A; Bobo, Elizabeth; Chen, Yimin; Malone, Ainsley; Roberts, Susan; Romano, Michelle M; Taylor, Beth

    2014-12-01

    This 2014 revision of the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for Registered Dietitian Nutritionists (RDNs) in Nutrition Support represents an update of the 2007 Standards composed by content experts of the American Society for Parenteral and Enteral Nutrition and the Academy of Nutrition and Dietetics. The revision is based on the Revised 2012 SOP in Nutrition Care and SOPP for RDs, which incorporates the Nutrition Care Process and the following six domains of professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. These SOP and SOPP are designed to promote the provision of safe, effective, and efficient nutrition support services; facilitate evidence-based practice; and serve as a professional evaluation resource for RDNs who specialize in or wish to specialize in nutrition support therapy. These standards should be applied in all patient/client care settings in which RDNs in nutrition support provide care. These settings include, but are not limited to, acute care, ambulatory/outpatient care, and home and alternate site care. The standards highlight the value of the nutrition support RDN's roles in quality management, regulatory compliance, research, teaching, consulting, and writing for peer-reviewed professional publications. The standards assist the RDN in nutrition support to distinguish his or her level of practice (competent, proficient, or expert) and would guide the RDN in creating a personal development plan to achieve increasing levels of knowledge, skill, and ability in nutrition support practice. PMID:25443567

  17. Nutrition support for wound healing in the intensive care unit patient.

    PubMed

    Theilla, Miriam

    2013-01-01

    The integumentary system is not considered immediately vital to the survival of the acutely and critically ill patient. The skin, however, is a vibrant organ that functions as a physical and immunological barrier between the external world and the sterile underlying tissues. Preclinical and observational studies depict the deleterious effect of insufficient energy, protein, and micronutrients on wound healing and on pressure ulcer (PU) burden, and demonstrate that serious PUs raise patients' daily energy expenditure. In addition, several randomized controlled trials (RCTs) have assessed the impact of a nutritional intervention on the incidence and healing of PUs. RCTs have been heterogeneous vis- à- vis patient population and healthcare setting, methodological quality, type (e.g. single vs. multiple nutrients) and duration of nutritional support, method of PU assessment, etc. Most studies evaluate oral supplementation in hospitalized patients and institutionalized elderly. The paucity of RCTs focusing on intensive care unit (ICU) nutrition in the support of wound healing and the prevention of pathologic healing precludes formulation of evidence-based guidelines for clinicians. Nevertheless, supplying ICU patients with at- least the required quantities of calories, protein and micronutrients (in accordance with ICU nutrition guidelines) can be endorsed with sufficient certainty, in order to prevent and treat PUs. Initial evidence suggests that immunonutrition that includes long-chain omega- 3 fatty acids may prove to be cost-effective in preventing PUs in high- risk patients, and in treating existent ulcers.

  18. Effect of nutrition support on immunity in paediatric patients with beta-thalassaemia major.

    PubMed

    Tienboon, Prasong

    2003-01-01

    Nutritional deficiencies have been variably observed in thalassaemia and the aetiology of many of the immune abnormalities in thalassaemic children are poorly defined. Therefore, we tested the hypothesis that certain immune abnormalities have a nutritional basis. Nutritional status, selective quantitative and functional indices of immunity were studied in twelve children (7 females, 5 males; mean age 28 months, SD 5 and range 19.8-35.5), with thalassaemia major before and after a one month period of intensive nutrition support (the study diet consisted of 'Enfapro' liquid formula (Mead Johnson) with added dextrose and corn oil to achieve a caloric density of 1.1 kcal/cc in addition to vitamins and minerals). Each child was provided approximately 150 kcal/day and 4 g of protein/day. Lymphocyte proliferation to Concanavalin A (Con A) (P = 0.008) and Purified Protein Derivative (PPD) (P = 0.002) was depressed upon entry into the study, however the response to Con A attained normal values by the end of the intervention. Compared to baselines, the proliferative response to Con A (P = 0.005) and Phytohemagglutinin A (PHA) (P = 0.031) both improved after the nutrition support. Although there was no general correlation of zinc status with lymphocyte proliferation, normal baseline zinc status was associated with improvement of proliferation. The %CD4 increased (P = 0.036), primarily because of a decrease in total lymphocytes and to lesser extent a decrease in CD8 lymphocytes. Serum immunoglobulin concentrations were found to be elevated on admission but were not significantly affected by the nutrition intervention. C3 concentrations were uniformly depressed on admission but increased by the end of the study protocol (P = 0.037). C4 and CH50 activity were not significantly influenced by the intervention. In conclusion, children with beta thalassaemia have abnormalities of lymphocyte function as well as key complement components that are responsive to nutrition support. In

  19. Nutrition.

    ERIC Educational Resources Information Center

    Saur, Susan

    An elementary level nutrition unit provides teachers with student background information, suggested activities, and student worksheets. Part 1 focuses on the relationship of food to growth, health, and energy. In part 2, students learn about the four main food groups. Part 3 deals with nutrients and provides information about carbohydrates, fats,…

  20. [Treatment of alcoholic liver diseases. Abstinence, nutritional support, drug therapy, liver transplantation].

    PubMed

    Pár, A

    2000-04-16

    The review summarizes clinically established treatment forms of alcoholic liver disease in four main chapters: abstinence, nutritional supportation, drug therapy and liver transplantation are discussed. Drug therapy is described according to the three types of alcoholic hepatopathies (fatty liver, hepatitis and cirrhosis). Early diagnosis and treatment depending on the severity and stage of alcoholic liver disease are of importance for the attempts to retard progression and improve prognosis. PMID:10817009

  1. Can Hypocaloric, High-Protein Nutrition Support Be Used in Complicated Bariatric Patients to Promote Weight Loss?

    PubMed

    Beebe, Mara Lee; Crowley, Nina

    2015-08-01

    Bariatric surgery, an effective treatment for morbid obesity, may result in complications that require nutrition support. Common goals for nutrition support in post-bariatric surgery patients include nutrition repletion, avoiding overfeeding, preserving lean body mass, and promoting wound healing. It is often questioned if continued weight loss can be part of the nutrition goals and if weight loss is safe for patients who become critically ill following bariatric surgery. Recent clinical practice guidelines from both the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) and Society of Critical Care Medicine (SCCM) have recommended the use of hypocaloric, high-protein nutrition support in both critically and non-critically ill obese patients. Hypocaloric feedings of 50%-70% of estimated energy requirements based on predictive equations or <14 kcal/kg actual body weight, as well as high-protein feedings of 1.2 g/kg actual weight or 2-2.5 g/kg ideal body weight, are suggested by A.S.P.E.N. in the 2013 clinical guidelines for nutrition support of hospitalized adult patients with obesity. Two small studies in complicated post-bariatric surgery patients requiring nutrition support have shown that the strategy of hypocaloric, high-protein feedings can result in positive outcomes, including positive nitrogen balance, wound healing, weight loss, and successful transition to oral diets. Additional research, including large, randomized studies, is still needed to validate these findings. However, based on a review of available clinical practice guidelines, predictive equations, indirect calorimetry, case studies, and systematic reviews, hypocaloric, high-protein nutrition support appears to at least be equal to eucaloric feedings and may be a useful tool for clinicians to achieve continued weight loss in complicated bariatric surgery patients requiring nutrition support.

  2. Enhancing the intrinsic work motivation of community nutrition educators: how supportive supervision and job design foster autonomy.

    PubMed

    Dickin, Katherine L; Dollahite, Jamie S; Habicht, Jean-Pierre

    2011-01-01

    Mixed-methods research investigated the work motivation of paraprofessional community nutrition educators (CNEs) delivering a long-running public health nutrition program. In interviews, CNEs (n = 9) emphasized "freedom," supportive supervision, and "making a difference" as key sources of motivation. Community nutrition educator surveys (n = 115) confirmed high levels of autonomy, which was associated with supervisors' delegation and support, CNE decision-making on scheduling and curricula, and job satisfaction. Supervisors (n = 32) rated CNEs' job design as having inherently motivating characteristics comparable to professional jobs. Supervisory strategies can complement job design to create structured, supportive contexts that maintain fidelity, while granting autonomy to paraprofessionals to enhance intrinsic work motivation.

  3. [Nutritional support in a pregnant woman with brain death. Case report and literature review].

    PubMed

    Hurtado Torres, G F; Zarazúa Juárez, M; Sandoval Munro, L; Mendoza Huerta, M

    2007-01-01

    The occurence of brain death in pregnancy represents a catastrophic entity although infrequent. The aims of continue medical management are focused in a double purpose: to preserve intrauterine product's life and fetal maturation until delivery and to consider the mother as a potential organ donor. Ethical considerations together with gestational age, fetal well being and relatives' wishes are cardinal for continuing medical support. Modern critical care units allow us to obtain favourable results, supported in scientifical reports that describe successful outcomes. Nutritional aspects plays a cardinal role in the medical management, allowing to preserve the mother's organs' viability and also to preserve fetal intrauterine growth and development.

  4. [Is there an indication for parenteral nutrition support in the terminally ill cancer patient?].

    PubMed

    Gutman, Mordechai; Singer, Pierre; Gimmon, Zvi

    2008-03-01

    Cancer cachexia is mediated by cytokines affecting intermediate metabolism of energy, proteins, carbohydrate and lipid. It is aggravated by common therapeutic measures: surgery, chemotherapy and radiotherapy that reduce oral intake as well as increase catabolism. Enteral or parenteral nutrition support decreases the catabolic rate of the patient, helping the patient withstand the side effects of the therapeutic measures, but do not reverse to anabolism. Terminally ill cancer patients who are refractory to the different therapeutic measures need palliative care. Nutrition is a basic human right and is conceived by the patient and his family, as well as by the medical community and human society, to be vital for survival. We obviously make every effort to feed our cancer patients as long as they can tolerate food via the alimentary system. However, we are reluctant to administer parenteral feeding, due to fear of accelerated tumor growth, complications, cost and futility, thereby leading to unnecessary prolongation of suffering. However, there is a group of patients who, although they are not candidates for any antineoplastic therapy, are still in good physical and mental condition, with expected life spans of three months or more, suffering from conditions such as intestinal obstruction, fistulas or any condition which makes the preferred route of enteral nutrition impossible. In these specific patients, palliative parenteral nutrition should be considered. The functional status of the patient has to be reasonable (Karnofsky status > 50, ECOG< 3). The decision should be taken after careful multidisciplinary discussion. The patient and caregivers should be aware that this is not a cancer-specific treatment and probably will not prolong the patient's life. Total parenteral nutrition (TPN) in this situation is best if provided at the patient's home.

  5. Position of the American Dietetic Association: local support for nutrition integrity in schools.

    PubMed

    Pilant, Vivian B

    2006-01-01

    It is the position of the American Dietetic Association that the schools and the community have a shared responsibility to provide all students with access to high-quality foods and school-based nutrition services as an integral part of the total education program. Educational goals, including the nutrition goals of the National School Lunch Program and the School Breakfast Program, should be supported and extended through school district wellness policies that create overall school environments that promote access to healthful school meals and physical activity and provide learning experiences that enable students to develop lifelong healthful eating habits. The National School Lunch and School Breakfast Programs are an important source of nutrients for school-age children, and especially for those of low-income status. The American Dietetic Association was actively involved in the 2004 reauthorization of these programs, ensuring access through continued funding, promoting nutrition education and physical activity to combat overweight and prevent chronic disease, and promoting local wellness policies. The standards established for school meal programs result in school meals that provide nutrients that meet dietary guidelines, but standards do not apply to foods and beverages served and sold outside of the school meal. Labeled as competitive foods by the US Department of Agriculture, there is a growing concern that standards should be applied to food in the entire school environment. Legislation has mandated that all school districts that participate in the US Department of Agriculture's Child Nutrition Program develop and implement a local wellness policy by the school year 2006-2007. Resources are available to assist in the development of wellness policies, and dietetics professionals can assist schools in developing policies that meet nutrition integrity standards. PMID:16390677

  6. Funding the Formula Adequately in Oklahoma

    ERIC Educational Resources Information Center

    Hancock, Kenneth

    2015-01-01

    This report is a longevity, simulational study that looks at how the ratio of state support to local support effects the number of school districts that breaks the common school's funding formula which in turns effects the equity of distribution to the common schools. After nearly two decades of adequately supporting the funding formula, Oklahoma…

  7. The application of nutrition support in conservative treatment of chylous ascites after abdominal surgery

    PubMed Central

    Pan, Wu; Cai, Shen-Yang; Luo, Hai-Long; Ouyang, Shu-Rui; Zhang, Wen-Duo; Wei, Zai-Rong; Wang, Da-Li

    2016-01-01

    Background Chylous ascites is the pathologic leakage of triglycerides-rich lymphatic fluid into the peritoneal cavity. Chylous ascites is a rare complication in abdominal surgery. This study aimed to find a relatively better method for nutrition support in the treatment of chylous ascites after abdominal surgery. Methods This study was a retrospective study. This study retrospectively reviewed patients who underwent abdominal surgery and developed chylous ascites, from the year 2010 to 2014, at the West China Hospital of Sichuan University and the Affiliated Hospital of Zunyi Medical College. Fifty-eight patients who developed chylous ascites after abdominal surgery were included in the study. The clinical effect of somatostatin was evaluated. The differences in the curative efficacy among a daily diet, a low-fat diet supplemented with medium-chain triglyceride (MCT), and total parenteral nutrition (TPN) were also analyzed in this study. Results Complete clinical success was reached earlier in patients treated with somatostatin (P<0.001). The tube removal time, the time to resumption of an oral diet, and the length of hospital stay after chylous leakage were significantly different between patients treated with and without somatostatin. The curative efficacies of the enteral nutrition (EN) + MCT plan and the TPN plan were quite similar, with no significant difference, however, were significantly different from the MCT regime, which was the worst. However, using the EN + MCT plan was more cost-effective (P=0.038). Conclusion In treating chylous ascites, EN + MCT instead of TPN was the best nutrition support. Moreover, somatostatin or its analog octreotide should be used immediately. The treatment with somatostatin in combination with EN + MCT is recommended in the conservative treatment of postoperative chylous ascites. PMID:27143902

  8. The provision of enteral nutritional support during definitive chemoradiotherapy in head and neck cancer patients.

    PubMed

    Bishop, Sarah; Reed, Warren Michael

    2015-12-01

    Combination chemoradiation is the gold standard of management for locally advanced squamous cell carcinomas of the head and neck. One of the most significant advantages of this approach to treatment is organ preservation which may not be possible with radical surgery. Unfortunately, few treatments are without side-effects and the toxicity associated with combined modality treatment causes meaningful morbidity. Patients with head and neck cancer (HNC) may have difficulties meeting their nutritional requirements as a consequence of tumour location or size or because of the acute toxicity associated with treatment. In particular, severe mucositis, xerostomia, dysgeusia and nausea and vomiting limit intake. In addition to this, dysphagia is often present at diagnosis, with many patients experiencing silent aspiration. As such, many patients will require enteral nutrition in order to complete chemoradiotherapy (CRT). Feeding occurs via catheters placed transnasally (nasogastric tubes) or directly into the stomach through the anterior abdominal wall (percutaneous gastrostomy tubes). In the absence of clear evidence concerning the superiority of one method over another, the choice of feeding tube tends to be dependent on clinician and patient preference. This review examines key issues associated with the provision of enteral nutritional support during definitive CRT in HNC patients, including feeding methods, patient outcomes and timing of tube insertion and use. PMID:27512573

  9. A quick guide to ethical theory in healthcare: solving ethical dilemmas in nutrition support situations.

    PubMed

    Ferrie, Suzie

    2006-04-01

    Ethical dilemmas can be challenging for the nutrition support clinician who is accustomed to evidence-based practice. The emotional and personal nature of ethical decision making can present difficulties, and conflict can arise when people have different ethical perspectives. An understanding of ethical terms and ethical theories can be helpful in clarifying the source of this conflict. These may include prominent ethical theories such as moral relativism, utilitarianism, Kantian absolutism, Aristotle's virtue ethics and ethics of care, as well as the key ethical principles in healthcare (autonomy, beneficence, nonmaleficence, and justice). Adopting a step-by-step approach can simplify the process of resolving ethical problems.

  10. A quick guide to ethical theory in healthcare: solving ethical dilemmas in nutrition support situations.

    PubMed

    Ferrie, Suzie

    2006-04-01

    Ethical dilemmas can be challenging for the nutrition support clinician who is accustomed to evidence-based practice. The emotional and personal nature of ethical decision making can present difficulties, and conflict can arise when people have different ethical perspectives. An understanding of ethical terms and ethical theories can be helpful in clarifying the source of this conflict. These may include prominent ethical theories such as moral relativism, utilitarianism, Kantian absolutism, Aristotle's virtue ethics and ethics of care, as well as the key ethical principles in healthcare (autonomy, beneficence, nonmaleficence, and justice). Adopting a step-by-step approach can simplify the process of resolving ethical problems. PMID:16556920

  11. Approaches to nutritional support for battle casualties and trauma: current military practice and lessons learned from the civilian sector.

    PubMed

    Shikora, S A

    1995-06-01

    In conflict, military medicine differs greatly from its civilian counterpart. Treatment strategies are designed to manage a potentially large number of severely wounded and function in an often hostile and poorly equipped environment. The most severely injured are stabilized and prepared for transport away from the war zone to a larger, better-equipped facility. At present no formal military policy exists concerning nutrition support. Traditionally, it has not been employed until the wounded arrived at a major medical center. Factors including the limited capacity to transport formula, lack of sophistication of battle zone facilities, and the rapid movement of wounded have been major drawbacks to providing early nutrition. The care of the urban trauma patient is relevant for the battle wounded of the military. There is ample evidence in the literature to support the use of nutrition support soon after injury. This article briefly describes the limitations of the military medical system in reference to nutrition support and the role of nutrition support for the civilian trauma patient. The lessons learned from the civilian experience may help formulate a nutrition strategy for the battle wounded that may become included into the standardized care policy.

  12. Nutrition and sepsis.

    PubMed

    Cohen, Jonathan; Chin, w Dat N

    2013-01-01

    The effect of nutritional support in critically ill patients with sepsis has received much attention in recent years. However, many of the studies have produced conflicting results. As for all critically ill patients, nutritional support, preferably via the enteral route, should be commenced once initial resuscitation and adequate perfusion pressure is achieved. Where enteral feeding is impossible or not tolerated, parenteral nutrition (either as total or complimentary therapy) may safely be administered. Most positive studies relating to nutritional support and sepsis have been in the setting of sepsis prevention. Thus, the administration of standard nutrition formulas to critically ill patients within 24 h of injury or intensive care unit admission may decrease the incidence of pneumonia. Both arginine-supplemented enteral diets, given in the perioperative period, and glutamine-supplemented parenteral nutrition have been shown to decrease infections in surgical patients. Parenteral fish oil lipid emulsions as well as probiotics given in the perioperative period may also reduce infections in patients undergoing major abdominal operations, such as liver transplantation. There is little support at the present time for the positive effect of specific pharmaconutrients, in particular fish oil, probiotics, or antioxidants, in the setting of established sepsis. More studies are clearly required on larger numbers of more homogeneous groups of patients. PMID:23075593

  13. Nutrition and sepsis.

    PubMed

    Cohen, Jonathan; Chin, w Dat N

    2013-01-01

    The effect of nutritional support in critically ill patients with sepsis has received much attention in recent years. However, many of the studies have produced conflicting results. As for all critically ill patients, nutritional support, preferably via the enteral route, should be commenced once initial resuscitation and adequate perfusion pressure is achieved. Where enteral feeding is impossible or not tolerated, parenteral nutrition (either as total or complimentary therapy) may safely be administered. Most positive studies relating to nutritional support and sepsis have been in the setting of sepsis prevention. Thus, the administration of standard nutrition formulas to critically ill patients within 24 h of injury or intensive care unit admission may decrease the incidence of pneumonia. Both arginine-supplemented enteral diets, given in the perioperative period, and glutamine-supplemented parenteral nutrition have been shown to decrease infections in surgical patients. Parenteral fish oil lipid emulsions as well as probiotics given in the perioperative period may also reduce infections in patients undergoing major abdominal operations, such as liver transplantation. There is little support at the present time for the positive effect of specific pharmaconutrients, in particular fish oil, probiotics, or antioxidants, in the setting of established sepsis. More studies are clearly required on larger numbers of more homogeneous groups of patients.

  14. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): liver failure and transplantation].

    PubMed

    Montejo González, J C; Mesejo, A; Bonet Saris, A

    2011-11-01

    Patients with liver failure have a high prevalence of malnutrition, which is related to metabolic abnormalities due to the liver disease, reduced nutrient intake and alterations in digestive function, among other factors. In general, in patients with liver failure, metabolic and nutritional support should aim to provide adequate nutrient intake and, at the same time, to contribute to patients' recovery through control or reversal of metabolic alterations. In critically-ill patients with liver failure, current knowledge indicates that the organ failure is not the main factor to be considered when choosing the nutritional regimen. As in other critically-ill patients, the enteral route should be used whenever possible. The composition of the nutritional formula should be adapted to the patient's metabolic stress. Despite the physiopathological basis classically described by some authors who consider amino acid imbalance to be a triggering factor and key element in maintaining encephalopathy, there are insufficient data to recommend "specific" solutions (branched-chain amino acid-enriched with low aromatic amino acids) as part of nutritional support in patients with acute liver failure. In patients undergoing liver transplantation, nutrient intake should be started early in the postoperative period through transpyloric access. Prevention of the hepatic alterations associated with nutritional support should also be considered in distinct clinical scenarios. PMID:22309749

  15. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): liver failure and transplantation].

    PubMed

    Montejo González, J C; Mesejo, A; Bonet Saris, A

    2011-11-01

    Patients with liver failure have a high prevalence of malnutrition, which is related to metabolic abnormalities due to the liver disease, reduced nutrient intake and alterations in digestive function, among other factors. In general, in patients with liver failure, metabolic and nutritional support should aim to provide adequate nutrient intake and, at the same time, to contribute to patients' recovery through control or reversal of metabolic alterations. In critically-ill patients with liver failure, current knowledge indicates that the organ failure is not the main factor to be considered when choosing the nutritional regimen. As in other critically-ill patients, the enteral route should be used whenever possible. The composition of the nutritional formula should be adapted to the patient's metabolic stress. Despite the physiopathological basis classically described by some authors who consider amino acid imbalance to be a triggering factor and key element in maintaining encephalopathy, there are insufficient data to recommend "specific" solutions (branched-chain amino acid-enriched with low aromatic amino acids) as part of nutritional support in patients with acute liver failure. In patients undergoing liver transplantation, nutrient intake should be started early in the postoperative period through transpyloric access. Prevention of the hepatic alterations associated with nutritional support should also be considered in distinct clinical scenarios.

  16. Nutritional models for a Controlled Ecological Life Support System (CELSS): Linear mathematical modeling

    NASA Technical Reports Server (NTRS)

    Wade, Rose C.

    1989-01-01

    The NASA Controlled Ecological Life Support System (CELSS) Program is involved in developing a biogenerative life support system that will supply food, air, and water to space crews on long-duration missions. An important part of this effort is in development of the knowledge and technological capability of producing and processing foods to provide optimal diets for space crews. This involves such interrelated factors as determination of the diet, based on knowledge of nutrient needs of humans and adjustments in those needs that may be required as a result of the conditions of long-duration space flight; determination of the optimal mixture of crops required to provide nutrients at levels that are sufficient but not excessive or toxic; and consideration of the critical issues of spacecraft space and power limitations, which impose a phytomass minimization requirement. The complex interactions among these factors are examined with the goal of supplying a diet that will satisfy human needs while minimizing the total phytomass requirement. The approach taken was to collect plant nutritional composition and phytomass production data, identify human nutritional needs and estimate the adjustments to the nutrient requirements likely to result from space flight, and then to generate mathematical models from these data.

  17. Mobile application for guidance and provision of toddler's nutrition to support e-PKK

    NASA Astrophysics Data System (ADS)

    Rochimah, S.; Sianipar, F. Y.; Anggraini, R. N. E.

    2016-01-01

    Pembinaan Kesejahteraan Keluarga(PKK)is an Indonesian community with women as its member, especially housewife. It has many purposes, such ascollaborating the knowledges among members, monitoring children's health, supporting healthy life style in the family. This article is part of our research in building e-PKK, an integrated application to support many activities in PKK's business processes. In this paper we build a module to guide and provise toddler's nutrition to be used by mother. This application is very useful since baby's growth phase is an important phase to be noticed by mother.Using this application, mother can easily obtain baby's growth information whenever and wherever they are via their smartphone. This mobile device applications using backward chaining and forward chaining method. Backward chaining method is a method that uses a goal-based approach, while the forward chaining conducting a set of data for later inference process to find optimal conclusion. Moreover, this apllication provides recommendations of groceries, recipes, as well as the suitability of foodstuffs according to the age of early baby's growth and the type of baby's allergic. In addition, it also provide information about baby's nutrition, growth benchmarks, and first aid. Besides, the application can be used to monthly baby growth record like Kartu Menuju Sehat (KMS) or Growth Monitoring Card, storing toddlers weighing, immunization and provision of vitamin A. An additional feature of this application is the complaints system, where other can ask directly to health care center about toddlers’ growth.

  18. The first 500 days of life: policies to support maternal nutrition

    PubMed Central

    Mason, John B.; Shrimpton, Roger; Saldanha, Lisa S.; Ramakrishnan, Usha; Victora, Cesar G.; Girard, Amy Webb; McFarland, Deborah A.; Martorell, Reynaldo

    2014-01-01

    Background From conception to 6 months of age, an infant is entirely dependent for its nutrition on the mother: via the placenta and then ideally via exclusive breastfeeding. This period of 15 months – about 500 days – is the most important and vulnerable in a child's life: it must be protected through policies supporting maternal nutrition and health. Those addressing nutritional status are discussed here. Objective and design This paper aims to summarize research on policies and programs to protect women's nutrition in order to improve birth outcomes in low- and middle-income countries, based on studies of efficacy from the literature, and on effectiveness, globally and in selected countries involving in-depth data collection in communities in Ethiopia, India and Northern Nigeria. Results of this research have been published in the academic literature (more than 30 papers). The conclusions now need to be advocated to policy-makers. Results The priority problems addressed are: intrauterine growth restriction (IUGR), women's anemia, thinness, and stunting. The priority interventions that need to be widely expanded for women before and during pregnancy, are: supplementation with iron–folic acid or multiple micronutrients; expanding coverage of iodine fortification of salt particularly to remote areas and the poorest populations; targeted provision of balanced protein energy supplements when significant resources are available; reducing teenage pregnancies; increasing interpregnancy intervals through family planning programs; and building on conditional cash transfer programs, both to provide resources and as a platform for public education. All these have known efficacy but are of inadequate coverage and resourcing. The next steps are to overcome barriers to wide implementation, without which targets for maternal and child health and nutrition (e.g. by WHO) are unlikely to be met, especially in the poorest countries. Conclusions This agenda requires policy

  19. Video fluoroscopy swallow study and nutritional support during ambulatory venovenous extracorporeal membrane oxygenation as a bridge to lung transplantation.

    PubMed

    Hayes, Don; Tobias, Joseph D; Galantowicz, Mark; Preston, Thomas J; Tzemos, Kallirroe K; McConnell, Patrick I

    2014-01-01

    We present the successful completion of a video fluoroscopy swallow study and subsequent nutritional plan of a child bridged to lung transplantation with ambulatory venovenous (VV) extracorporeal membrane oxygenation (ECMO). With a limited number of programs bridging pediatric patients to lung transplantation with VV ECMO, a better understanding of nutritional support is needed to provide optimal care to this patient population awaiting organ donation. PMID:24403362

  20. The nutritional adequacy of a limited vegan diet for a Controlled Ecological Life-Support System

    NASA Technical Reports Server (NTRS)

    Saha, P. R.; Trumbo, P. R.; Mitchell, C. A. (Principal Investigator)

    1996-01-01

    Purdue University, as well as the Johnson and Kennedy Space Centers and NASA Ames Research Center, are investigating approximately 5-10 plants that will be grown hydroponically to provide not only the energy and nutrients, but also the oxygen for humans habitating in Mars and lunar bases. The growth and nutritional status of rats fed either a control diet (adequate in all macro- and micronutrients) or a strict vegetarian diet consisting of 5 (vegan-5) or 10 (vegan-10) candidate crop species were investigated. In addition, vegan-10 diets were supplemented with mineral and/or vitamin mix at a level similar to the control diets to assess the effect of supplementation on nutrient status. The assessment of inedible plant material as an alternative food source was also investigated. Results of this study demonstrated that consumption of the vegan-10 diet significantly improved weight gain of rats compared to that for rats fed the vegan-5 diet. Mineral supplementation, at a level present in the control diet, to the vegan-10 diet improved growth and nutrient status, but growth was significantly lower compared to the control-fed rats. Inclusion of inedible plant material, high in ash content, improved some indices of nutrient status, without improving growth.

  1. The nutritional adequacy of a limited vegan diet for a controlled ecological life-support system

    NASA Astrophysics Data System (ADS)

    Saha, P. R.; Trumbo, P. R.

    Purdue University, as well as the Johnson and Kennedy Space Centers and NASA Ames Research Center, are investigating approximately 5-10 plants that will be grown hydroponically to provide not only the energy and nutrients, but also the oxygen for humans habitating in Mars and lunar bases. The growth and nutritional status of rats fed either a control diet (adequate in all macro- and micronutrients) or a strict vegetarian diet consisting of 5 (vegan-5) or 10 (vegan-10) candidate crop species were investigated. In addition, vegan-10 diets were supplemented with mineral and/or vitamin mix at a level similar to the control diets to assess the effect of supplementation on nutrient status. The assessment of inedible plant material as an alternative food source was also investigated. Results of this study demonstrated that consumption of the vegan-10 diet significantly improved weight gain of rats compared to that for rats fed the vegan-5 diet. Mineral supplementation, at a level present in the control diet, to the vegan-10 diet improved growth and nutrient status, but growth was significantly lower compared to the control-fed rats. Inclusion of inedible plant material, high in ash content, improved some indices of nutrient status, without improving growth.

  2. The nutritional adequacy of a limited vegan diet for a Controlled Ecological Life-Support System.

    PubMed

    Saha, P R; Trumbo, P R

    1996-01-01

    Purdue University, as well as the Johnson and Kennedy Space Centers and NASA Ames Research Center, are investigating approximately 5-10 plants that will be grown hydroponically to provide not only the energy and nutrients, but also the oxygen for humans habitating in Mars and lunar bases. The growth and nutritional status of rats fed either a control diet (adequate in all macro- and micronutrients) or a strict vegetarian diet consisting of 5 (vegan-5) or 10 (vegan-10) candidate crop species were investigated. In addition, vegan-10 diets were supplemented with mineral and/or vitamin mix at a level similar to the control diets to assess the effect of supplementation on nutrient status. The assessment of inedible plant material as an alternative food source was also investigated. Results of this study demonstrated that consumption of the vegan-10 diet significantly improved weight gain of rats compared to that for rats fed the vegan-5 diet. Mineral supplementation, at a level present in the control diet, to the vegan-10 diet improved growth and nutrient status, but growth was significantly lower compared to the control-fed rats. Inclusion of inedible plant material, high in ash content, improved some indices of nutrient status, without improving growth.

  3. The nutritional adequacy of a limited vegan diet for a Controlled Ecological Life-Support System.

    PubMed

    Saha, P R; Trumbo, P R

    1996-01-01

    Purdue University, as well as the Johnson and Kennedy Space Centers and NASA Ames Research Center, are investigating approximately 5-10 plants that will be grown hydroponically to provide not only the energy and nutrients, but also the oxygen for humans habitating in Mars and lunar bases. The growth and nutritional status of rats fed either a control diet (adequate in all macro- and micronutrients) or a strict vegetarian diet consisting of 5 (vegan-5) or 10 (vegan-10) candidate crop species were investigated. In addition, vegan-10 diets were supplemented with mineral and/or vitamin mix at a level similar to the control diets to assess the effect of supplementation on nutrient status. The assessment of inedible plant material as an alternative food source was also investigated. Results of this study demonstrated that consumption of the vegan-10 diet significantly improved weight gain of rats compared to that for rats fed the vegan-5 diet. Mineral supplementation, at a level present in the control diet, to the vegan-10 diet improved growth and nutrient status, but growth was significantly lower compared to the control-fed rats. Inclusion of inedible plant material, high in ash content, improved some indices of nutrient status, without improving growth. PMID:11538816

  4. Nutritional support of bone marrow transplant recipients: a prospective, randomized clinical trial comparing total parental nutrition to an enteral feeding program

    SciTech Connect

    Szeluga, D.J.

    1985-01-01

    Allogeneic and autologous bone marrow transplantation (BMT) have been associated with nutritionally-depleting side effects. Total parental nutrition (TPN) has become the standard, but it has not been demonstrated that TPN is the appropriate method of nutritional support. Therefore, in a prospective, randomized clinical trial TPN and enteral feeding were compared for their effectiveness in maintaining the nutritional status of patients through the first 29 post-transplant days. Nutritional assessment included measurement of serum proteins, body weight, anthropometry and isotope dilution analysis of body composition. Total body water (TBW) and extracellular fluid (ECF) were quantified by standard radioisotope dilution techniques using tritiated water and /sup 169/ytterbium-diethylenetriaminepentaacetate, respectively as the tracers. Consenting patients 10-58 years of age were stratified by type of BMT (autologous or allogeneic) and randomized to either TPN plus ad libitum oral feeding or the individualized enteral feeding program (EFP), which included one-on-one counseling, meal-by-meal menu selection, special snacks and tube feeding. There were no differences in the rate of hematologic recovery, incidence of graft-versus-host disease, organ toxicity, length of hospitalization or survival. Therefore, the observed changes in body composition were not clinically significant. Even allowing for increased dietary service, the EFP was only half as expensive as TPN. It was concluded that TPN is not superior to the EFP and therefore, TPN should be reserved for patients who demonstrate intolerance to enteral feeding.

  5. Successful Intervention for Pressure Ulcer by Nutrition Support Team: A Case Report.

    PubMed

    Inui, Shigeki; Konishi, Yuko; Yasui, Yoko; Harada, Toshiko; Itami, Satoshi

    2010-07-02

    A 23-year-old woman with heart failure developed pressure ulcer on her sacral area due to a long-term bed rest and impaired hemodynamics. The ulcer improved only slightly after 2 months with povidone-iodine sugar ointment because of severe nausea and anorexia. Then, the nutrition support team (NST) started intervention and estimated the patient's malnutrition from her body weight (30.1 kg), body mass index (BMI) (13.9), triceps skinfold thickness (TSF) (3.5 mm), arm circumference (AC) (17.2 cm) and serum albumin (2.6 g/dl). The NST administrated an enteral nutrition formula through a nasogastric tube and tried to provide meals according to the patient's taste. Although DESIGN score improved to 7 (DESIGN: d2e1s2i1g1n0 = 7) 2 months later, severe nausea prevented the patient from taking any food perorally. However, after nasogastric decannulation, her appetite improved and 1 month later her body weight increased to 32.8 kg, her BMI to 15.2, TSF to 7.5 mm, AC to 19.7 cm and serum albumin to 4.1 g/dl, and the wound completely healed.

  6. Nutritional considerations in the patient with gastroparesis.

    PubMed

    Parrish, Carol Rees

    2015-03-01

    Gastroparesis, or delayed gastric emptying, has many origins and can wax and wane depending on the underlying cause. Not only do the symptoms significantly alter quality of life, but the clinical consequences can also be life threatening. Once a patient develops protracted nausea and vomiting, providing adequate nutrition, hydration, and access to therapeutics such as prokinetics and antiemetics can present an exceptional challenge to clinicians. This article reviews the limited evidence available for oral nutrition, as well as enteral and parenteral nutritional support therapies. Practical strategies are provided to improve the nutritional depletion that often accompanies this debilitating condition.

  7. A dedicated website for cancer subjects, the nutritional support study: preliminary results

    PubMed Central

    Gnagnarella, P; Misotti, AM; Santoro, L; Akoumianakis, D; Milolidakis, G; De Lorenzo, F; Lombardo, C; Sullivan, R; Mcvie, G

    2011-01-01

    Background The Internet has become a widely used resource for information on cancer and for support. As part of the EuroCancerComs project (www.eurocancercoms.eu), an intervention study has been designed. The study aims to help patients with cancer providing an Internet “space” where to find information about nutritional care. Methods The study consists of a randomized 6-month intervention. The website (www.supportonutrizionale.it) hosts a contents area, prepared according to guidelines and recommendations, a forum and a blog. Subjects have been randomly allocated in intervention (IG) and control group (CG). IG has a free access to the website and it is involved in live activities, discussions and examinations. CG receives the same information by e-mail, without having access to the website. Three questionnaires are used to evaluate the effectiveness of the approach, concerning quality of life (QoL), psychological status and nutrition facts. Results Since the study startup, 191 subjects have been screened, and 58 (30%) have been randomized. Participants in both groups are mainly females, married and have at least a high school education level. Participants experienced a high psychological distress for 27% of IG and 33% of CG considering the four classes of scores at the baseline. Regarding QoL, a low “role functioning” score for IG and “emotional functioning” and “social functioning” scores for both groups are reported, while “fatigue” and “nausea and vomiting” respectively for IG and CG are the worsened symptoms compared with reference values. Considering the nutrition facts questionnaire, subjects showed a medium-high score profile and the worst scale regards “Nutrition and cancer knowledge”. From the beginning of the study, a total of 48 actions have been registered, including votes to contents, comments and forum messages. Conclusion The Internet has made possible the new forms of interaction and knowledge, and it is likely to become

  8. [Pre-operative nutrition support in patients waiting for digestive surgery at Hospital Mateu Orfila (Maó-Menorca)].

    PubMed

    Lluch Taltavull, Josep; Mercadal Orfila, Gabriel; Alcaide Matas, Fernando

    2014-09-01

    Malnutrition is associated with high postoperative morbidity and mortality rates. This pilot study evaluated the effectiveness of a peri-operative nutritional support programme for patients who were about to undergo major gastrointestinal surgery. A high-calorie/high-protein enteral formula was administered peri-operatively to the group of patients at nutritional risk/with malnutrition (NR/MN). In order to assess the effectiveness of the preoperative nutritional intervention, the results were compared to a retrospective control group. Statistically-significant differences were found between the two NR/MN groups in incidence of vomiting; wound infection; hyperglycaemia; death in hospital; length of hospital stay; time in ICU; and administration of TPN. Postoperative progress was found to be better in the group of NR/MN patients supplemented preoperatively with an enteral nutrition formula.

  9. Nutritional Alterations Associated with Neurological and Neurosurgical Diseases.

    PubMed

    Dionyssiotis, Yannis; Papachristos, Aris; Petropoulou, Konstantina; Papathanasiou, Jannis; Papagelopoulos, Panayiotis

    2016-01-01

    Neurological and neurosurgical diseases lead to complications producing malnutrition increasing pathology and mortality. In order to avoid complications because of malnutrition or overcome deficiencies in nutrients supplements are often used for these subjects. The physiopathological mechanisms of malnutrition, methods of nutritional assessment and the supplemental support are reviewed in this paper based on the assumption that patients need to receive adequate nutrition to promote optimal recovery, placing nutrition as a first line treatment and not an afterthought in the rehabilitation. PMID:27563361

  10. Nutritional Alterations Associated with Neurological and Neurosurgical Diseases

    PubMed Central

    Dionyssiotis, Yannis; Papachristos, Aris; Petropoulou, Konstantina; Papathanasiou, Jannis; Papagelopoulos, Panayiotis

    2016-01-01

    Neurological and neurosurgical diseases lead to complications producing malnutrition increasing pathology and mortality. In order to avoid complications because of malnutrition or overcome deficiencies in nutrients supplements are often used for these subjects. The physiopathological mechanisms of malnutrition, methods of nutritional assessment and the supplemental support are reviewed in this paper based on the assumption that patients need to receive adequate nutrition to promote optimal recovery, placing nutrition as a first line treatment and not an afterthought in the rehabilitation. PMID:27563361

  11. Indirect calorimetry: a guide for optimizing nutritional support in the critically ill child.

    PubMed

    Sion-Sarid, Racheli; Cohen, Jonathan; Houri, Zion; Singer, Pierre

    2013-09-01

    The metabolic response of critically ill children is characterized by an increase in resting energy expenditure and metabolism, and energy needs of the critically ill child are dynamic, changing from a hypermetabolic to hypometabolic state through the continuum of the intensive care unit (ICU) stay. It therefore appears essential to have a precise evaluation of energy needs in these patients in order to avoid underfeeding and overfeeding, loss of critical lean body mass, and worsening of any existing nutrient deficiencies. However, there are no clear definitions regarding either the exact requirements or the ideal method for determining metabolic needs. In clinical practice, energy needs are determined either by using predictive equations or by actual measurement using indirect calorimetry. Although many equations exist for predicting resting energy expenditure, their accuracy is not clear. In addition, very few clinical trials have been performed so that no firm evidence-based recommendations are available regarding optimal nutritional management of critically ill children and infants. Most studies have come to the same conclusion (i.e., current predictive equations do not accurately predict required energy needs in the pediatric ICU population and predictive equations are unreliable compared with indirect calorimetry). The recent American Society for Parenteral and Enteral Nutrition clinical guidelines for nutrition support of the critically ill child suggest that indirect calorimetry measurements be obtained when possible in pediatric patients with suspected metabolic alterations or malnutrition, according to a list of criteria that may lead to metabolic instability, thus making standardized predictive equations even less reliable. Although the standard use of indirect calorimetry is limited due to equipment availability, staffing, and cost, the accuracy of the commercially available devices continues to improve and the measurements have become more reliable and

  12. A Validation of an Intelligent Decision-Making Support System for the Nutrition Diagnosis of Bariatric Surgery Patients

    PubMed Central

    Martins, Cristina; Dias, João; Pinto, José S

    2014-01-01

    Background Bariatric surgery is an important method for treatment of morbid obesity. It is known that significant nutritional deficiencies might occur after surgery, such as, calorie-protein malnutrition, iron deficiency anemia, and lack of vitamin B12, thiamine, and folic acid. Objective The objective of our study was to validate a computerized intelligent decision support system that suggests nutritional diagnoses of patients submitted to bariatric surgery. Methods There were fifteen clinical cases that were developed and sent to three dietitians in order to evaluate and define a nutritional diagnosis. After this step, the cases were sent to four bariatric surgery expert dietitians who were aiming to collaborate on a gold standard. The nutritional diagnosis was to be defined individually, and any disagreements were solved through a consensus. The final result was used as the gold standard. Bayesian networks were used to implement the system, and database training was done with Shell Netica. For the system validation, a similar answer rate was calculated, as well as the specificity and sensibility. Receiver operating characteristic (ROC) curves were projected to each nutritional diagnosis. Results Among the four experts, the rate of similar answers found was 80% (48/60) to 93% (56/60), depending on the nutritional diagnosis. The rate of similar answers of the system, compared to the gold standard, was 100% (60/60). The system sensibility and specificity were 95.0%. The ROC curves projection showed that the system was able to represent the expert knowledge (gold standard), and to help them in their daily tasks. Conclusions The system that was developed was validated to be used by health care professionals for decision-making support in their nutritional diagnosis of patients submitted to bariatric surgery. PMID:25601419

  13. Nutrition Support for Children Undergoing Congenital Heart Surgeries: A Narrative Review.

    PubMed

    Wong, Judith J M; Cheifetz, Ira M; Ong, Chengsi; Nakao, Masakazu; Lee, Jan Hau

    2015-07-01

    Energy imbalance in infants and children with congenital heart disease (CHD) is common and influenced by age, underlying cardiac diagnoses, and presence or absence of congestive heart failure. During the surgical hospitalization period, these children are prone to nutritional deterioration due to stress of surgery, anesthetic/perfusion techniques, and postoperative care. Poor nutrition is associated with increased perioperative morbidity and mortality. This review aims to examine various aspects of nutrition in critically ill children with CHD, including (1) energy expenditure, (2) perioperative factors that contribute to energy metabolism, (3) bedside practices that are potentially able to optimize nutrient delivery, and (4) medium- to long-term impact of energy balance on clinical outcomes. We propose a nutrition algorithm to optimize nutrition of these children in the perioperative period where improvements in nutrition status will likely impact surgical outcomes.

  14. Is Omega-3 Fatty Acids Enriched Nutrition Support Safe for Critical Ill Patients? A Systematic Review and Meta-Analysis

    PubMed Central

    Chen, Wei; Jiang, Hua; Zhou, Zhi-Yuan; Tao, Ye-Xuan; Cai, Bin; Liu, Jie; Yang, Hao; Lu, Charles Damien; Zeng, Jun

    2014-01-01

    Objective: To systematically review the effects of omega-3 poly unsaturated fatty acids (FA) enriched nutrition support on the mortality of critically illness patients. Methods: Databases of Medline, ISI, Cochrane Library, and Chinese Biomedicine Database were searched and randomized controlled trials (RCTs) were identified. We enrolled RCTs that compared fish oil enriched nutrition support and standard nutrition support. Major outcome is mortality. Methodological quality assessment was conducted based on Modified Jadad’s score scale. For control heterogeneity, we developed a method that integrated I2 test, nutritional support route subgroup analysis and clinical condition of severity. RevMan 5.0 software (The Nordic Cochrane Centre, Copenhagen, Denmark) was used for meta-analysis. Results: Twelve trials involving 1208 patients that met all the inclusion criteria. Heterogeneity existed between the trials. A random model was used, there was no significant effect on mortality RR, 0.82, 95% confidence interval (CI) (0.62, 1.09), p = 0.18. Knowing that the route of fish oil administration may affect heterogeneity, we categorized the trials into two sub-groups: parenteral administration (PN) of omega-3 and enteral administration (EN) of omega-3. Six trials administered omega-3 FA through PN. Pooled results indicated that omega-3 FA had no significant effect on mortality, RR 0.76, 95% CI (0.52, 1.10), p = 0.15. Six trials used omega-3 fatty acids enriched EN. After excluded one trial that was identified as source of heterogeneity, pooled data indicated omega-3 FA enriched EN significant reduce mortality, RR=0.69, 95% CI [0.53, 0.91] (p = 0.007). Conclusion: Omega-3 FA enriched nutrition support is safe. Due to the limited sample size of the included trials, further large-scale RCTs are needed. PMID:24886987

  15. Bilateral sequential cochlear implantation in the congenitally deaf child: evidence to support the concept of a 'critical age' after which the second ear is less likely to provide an adequate level of speech perception on its own.

    PubMed

    Graham, John; Vickers, Debi; Eyles, Julie; Brinton, Julie; Al Malky, Ghada; Aleksy, Wanda; Martin, Jane; Henderson, Lise; Mawman, Deborah; Robinson, Philip; Midgley, Elizabeth; Hanvey, Kate; Twomey, Tracey; Johnson, Susan; Vanat, Zebunnisa; Broxholme, Cath; McAnallen, Cecilia; Allen, Agnes; Bray, Monica

    2009-09-01

    This study attempts to answer the question of whether there is a 'critical age' after which a second contralateral cochlear implant is less likely to provide enough speech perception to be of practical use. The study was not designed to predict factors that determine successful binaural implant use, but to see if there was evidence to help determine the latest age at which the second ear can usefully be implanted, should the first side fail and become unusable.Outcome data, in the form of speech perception test results, were collected from 11 cochlear implant programmes in the UK and one centre in Australia. Forty-seven congenitally bilaterally deaf subjects who received bilateral sequential implants were recruited to the study. The study also included four subjects with congenital unilateral profound deafness who had lost all hearing in their only hearing ear and received a cochlear implant in their unilaterally congenitally deaf ear. Of those 34 subjects for whom complete sets of data were available, the majority (72%) of those receiving their second (or unilateral) implant up to the age of 13 years scored 60 per cent or above in the Bamford Kowal Bench (BKB) sentence test, or equivalent. In contrast, of those nine receiving their second or unilateral implant at the age of 15 or above, none achieved adequate levels of speech perception on formal testing: two scored 29 per cent and 30 per cent, respectively, and the rest seven per cent or less.A discriminant function analysis performed on the data suggests that it is unlikely that a second contralateral implant received after the age of 16 to 18 years will, on its own, provide adequate levels of speech perception. As more children receive sequential bilateral cochlear implants and the pool of data enlarges the situation is likely to become clearer.The results provide support for the concept of a 'critical age' for implanting the second ear in successful congenitally deaf unilateral cochlear implant users. This

  16. Nutritional Status and Liver Transplantation

    PubMed Central

    Merli, Manuela; Giusto, Michela; Giannelli, Valerio; Lucidi, Cristina; Riggio, Oliviero

    2012-01-01

    Chronic liver disease has a profound effect on nutritional status and undernourishment is almost universally present in patients with end-stage liver disease undergoing liver transplantation. In the last decades, due to epidemiological changes, a trend showing an increase in patients with end-stage liver disease and associated obesity has also been reported in developed countries. Nutrition abnormalities may influence the outcome after transplantation therefore, the importance to carefully assess the nutritional status in the work-up of patients candidates for liver transplantation is widely accepted. More attention has been given to malnourished patients as they represent the greater number. The subjective global nutritional assessment and anthropometric measurements are recognized in current guidelines to be adequate in identifying those patients at risk of malnutrition. Cirrhotic patients with a depletion in lean body mass and fat deposits have an increased surgical risk and malnutrition may impact on morbidity, mortality and costs in the post-transplantation setting. For this reason an adequate calorie and protein intake should always be ensured to malnourished cirrhotic patient either through the diet, or using oral nutritional supplements or by enteral or parenteral nutrition although studies supporting the efficacy of nutritional supplementation in improving the clinical outcomes after transplantation are still scarce. When liver function is restored, an amelioration in the nutritional status is expected. After liver transplantation in fact dietary intake rapidly normalizes and fat mass is progressively regained while the recovery of muscle mass can be slower. In some patients unregulated weight gain may lead to over-nutrition and may favor metabolic disorders (hypertension, hyperglycemia, hyperlipidemia). This condition, defined as ‘metabolic syndrome’, may play a negative role on the overall survival of liver transplant patients. In this report we

  17. A Simple Widespread Computer Help Improves Nutrition Support Orders and Decreases Infection Complications in Critically Ill Patients

    PubMed Central

    Conseil, Mathieu; Carr, Julie; Molinari, Nicolas; Coisel, Yannaël; Cissé, Moussa; Belafia, Fouad; Delay, Jean-Marc; Jung, Boris; Jaber, Samir; Chanques, Gérald

    2013-01-01

    Aims To assess the impact of a simple computer-based decision-support system (computer help) on the quality of nutrition support orders and patients' outcome in Intensive-Care Unit (ICU). Methods This quality-improvement study was carried out in a 16-bed medical-surgical ICU in a French university hospital. All consecutive patients who stayed in ICU more than 10 days with non-oral feeding for more than 5 days were retrospectively included during two 12-month periods. Prescriptions of nutrition support were collected and compared to French national guidelines as a quality-improvement process. A computer help was constructed using a simple Excel-sheet (MicrosoftTM) to guide physicians' prescriptions according to guidelines. This computer help was displayed in computers previously used for medical orders. Physicians were informed but no systematic protocol was implemented. Patients included during the first (control group) and second period (computer help group) were compared for achievement of nutrition goals and ICU outcomes. Results The control and computer help groups respectively included 71 and 95 patients. Patients' characteristics were not significantly different between groups. In the computer help group, prescriptions achieved significantly more often 80% of nutrition goals for calorie (45% vs. 79% p<0.001) and nitrogen intake (3% vs. 37%, p<0.001). Incidence of nosocomial infections decreased significantly between the two groups (59% vs. 41%, p = 0.03). Mortality did not significantly differ between control (21%) and computer help groups (15%, p = 0.30). Conclusions Use of a widespread inexpensive computer help is associated with significant improvements in nutrition support orders and decreased nosocomial infections in ICU patients. This computer-help is provided in electronic supplement. PMID:23737948

  18. Estimating resting energy expenditure in patients requiring nutritional support: a survey of dietetic practice.

    PubMed

    Green, A J; Smith, P; Whelan, K

    2008-01-01

    Estimation of resting energy expenditure (REE) involves predicting basal metabolic rate (BMR) plus adjustment for metabolic stress. The aim of this study was to investigate the methods used to estimate REE and to identify the impact of the patient's clinical condition and the dietitians' work profile on the stress factor assigned. A random sample of 115 dietitians from the United Kingdom with an interest in nutritional support completed a postal questionnaire regarding the estimation of REE for 37 clinical conditions. The Schofield equation was used by the majority (99%) of dietitians to calculate BMR; however, the stress factors assigned varied considerably with coefficients of variation ranging from 18.5 (cancer with cachexia) to 133.9 (HIV). Dietitians specializing in gastroenterology assigned a higher stress factor to decompensated liver disease than those not specializing in gastroenterology (19.3 vs 10.7, P=0.004). The results of this investigation strongly suggest that there is wide inconsistency in the assignment of stress factors within specific conditions and gives rise to concern over the potential consequences in terms of under- or overfeeding that may ensue. PMID:17311053

  19. An Automated Telephone Nutrition Support System for Spanish-Speaking Patients With Diabetes

    PubMed Central

    Stoddard, Pamela J.; Gonzales, Elizabeth N.; Villagran-Flores, Mariana; Thomson, Joan; Bayard, Paul; Palos Lucio, Ana Gabriela; Schillinger, Dean; Bertozzi, Stefano; Gonzales, Ralph

    2014-01-01

    In the United States, Spanish-speaking patients with diabetes often receive inadequate dietary counseling. Providing language and culture-concordant dietary counseling on an ongoing basis is critical to diabetes self-care. To determine if automated telephone nutrition support (ATNS) counseling could help patients improve glycemic control by duplicating a successful pilot in Mexico in a Spanish-speaking population in Oakland, California. A prospective randomized open-label trial with blinded endpoint assessment (PROBE) was performed. The participants were seventy-five adult patients with diabetes receiving care at a federally qualified health center in Oakland, California. ATNS, a computerized system that dialed patients on their phones, prompted them in Spanish to enter (via keypad) portions consumed in the prior 24 hours of various cultural-specific dietary items, and then provided dietary feedback based on proportion of high versus low glycemic index foods consumed. The control group received the same ATNS phone calls 14 weeks after enrollment. The primary outcome was hemoglobin A1c % (A1c) 12 weeks following enrollment. Participants had no significant improvement in A1c (–0.3% in the control arm, –0.1% in the intervention arm, P = .41 for any difference) or any secondary parameters. In our study, an ATNS system did not improve diabetes control in a Spanish-speaking population in Oakland. PMID:25239122

  20. Nutritional support during radiotherapy for head and neck cancer: the role of prophylactic feeding tube placement.

    PubMed

    Cady, Jormain

    2007-12-01

    Significant weight loss and resultant malnutrition in patients undergoing radiotherapy for head and neck carcinomas are recognized and preventable clinical concerns. Morbidity related to weight loss during treatment may include dehydration, hospitalization, compromised treatment efficacy, and reduced quality of life and may impact survival. Malnutrition effects on wound healing may prolong recovery following treatment and increase the risk of morbidity for those undergoing subsequent salvage surgery. Multiple interventions have been implemented to help ameliorate the impact of treatment on weight loss and nutritional status, including the use of percutaneous endoscopic gastrostomy (PEG) tubes. The value of prophylactic PEG tube placement at treatment initiation increasingly is being recognized, and evidence suggests that patients experience better outcomes. Criteria for patient selection have not been defined completely, and a great deal of variation in clinical practice exists, contributing to underuse of this supportive intervention. According to a literature review, patients who require therapeutic PEG tube placement in response to significant weight loss during treatment suffer greater morbidity than patients who receive PEG tubes prophylactically. Understanding patient-, tumor-, and treatment-related risk factors to systematically identify patients most likely to benefit from prophylactic PEG tube placement is an important aspect of nursing care.

  1. An automated telephone nutrition support system for Spanish-speaking patients with diabetes.

    PubMed

    Khanna, Raman; Stoddard, Pamela J; Gonzales, Elizabeth N; Villagran-Flores, Mariana; Thomson, Joan; Bayard, Paul; Palos Lucio, Ana Gabriela; Schillinger, Dean; Bertozzi, Stefano; Gonzales, Ralph

    2014-11-01

    In the United States, Spanish-speaking patients with diabetes often receive inadequate dietary counseling. Providing language and culture-concordant dietary counseling on an ongoing basis is critical to diabetes self-care. To determine if automated telephone nutrition support (ATNS) counseling could help patients improve glycemic control by duplicating a successful pilot in Mexico in a Spanish-speaking population in Oakland, California. A prospective randomized open-label trial with blinded endpoint assessment (PROBE) was performed. The participants were seventy-five adult patients with diabetes receiving care at a federally qualified health center in Oakland, California. ATNS, a computerized system that dialed patients on their phones, prompted them in Spanish to enter (via keypad) portions consumed in the prior 24 hours of various cultural-specific dietary items, and then provided dietary feedback based on proportion of high versus low glycemic index foods consumed. The control group received the same ATNS phone calls 14 weeks after enrollment. The primary outcome was hemoglobin A1c % (A1c) 12 weeks following enrollment. Participants had no significant improvement in A1c (-0.3% in the control arm, -0.1% in the intervention arm, P = .41 for any difference) or any secondary parameters. In our study, an ATNS system did not improve diabetes control in a Spanish-speaking population in Oakland.

  2. Nutritional support of estuary perch ( Macquaria colonorum) in a temperate Australian inlet: Evaluating the relative importance of invasive Spartina

    NASA Astrophysics Data System (ADS)

    Hindell, J. S.; Warry, F. Y.

    2010-12-01

    The invasive saltmarsh grass Spartina is widely considered a threat to the health of coastal ecosystems in south-eastern Australia, however, the ecological impacts of Spartina on estuarine communities are poorly understood. The largest infestation of Spartina in Victoria occurs in Anderson Inlet. The relative contribution of Spartina, vs. non-invasive autotrophs, to the nutrition of an estuarine fish, Macquaria colonorum was assessed using stable isotopes and gut content analyses. The δ 13C and δ 15N compositions of autotrophs and M. colonorum varied spatially across the study area. Based on gut content analyses, adults and juveniles were between two and three trophic levels above autotrophs. Isosource modelling of δ 13C signatures, suggested several autotrophs contributed to the nutrition of M. colonorum with a combination of seagrass and Spartina likely important contributors, particularly for adults. Isotopic sulphur was subsequently used to distinguish between seagrass and Spartina. Modelling of δ 13C and δ 34S signatures of M. colonorum and a subset of autotrophs again indicated a combination of seagrass and Spartina was likely a major contributor to nutritional support of M. colonorum. Given the limited areal extent of seagrass within Anderson Inlet, current Spartina eradication programs may compromise the nutritional support of M. colonorum.

  3. Growth retardation in sickle-cell disease treated by nutritional support.

    PubMed

    Heyman, M B; Vichinsky, E; Katz, R; Gaffield, B; Hurst, D; Castillo, R; Chiu, D; Kleman, K; Ammann, A J; Thaler, M M

    1985-04-20

    The effect of increased nutritional intake was evaluated in 5 growth-retarded children with sickle-cell disease. Growth on recommended daily calorie and protein intakes had been inadequate in all 5. Fat absorption and intestinal mucosal morphology were normal in all 5. 2 children were given nutritional supplementation by nasogastric intubation, 1 received nightly oral formula supplements, and 2 were supplemented with zinc, iron, folate, and vitamin E only. Nutritional supplementation by the nasogastric route produced a rapid sustained increase in growth rate, associated with striking reductions in pain crises and infections which had previously necessitated many hospital admissions. Oral supplementation improved the clinical course but had no effect on growth rate. Mineral and vitamin supplements influenced neither the growth rate nor the clinical course. The observations indicate that nasogastric nutritional supplementation may accelerate growth and reduce the incidence and severity of complications in growth-retarded children with sickle-cell disease. PMID:2858749

  4. Growth retardation in sickle-cell disease treated by nutritional support.

    PubMed

    Heyman, M B; Vichinsky, E; Katz, R; Gaffield, B; Hurst, D; Castillo, R; Chiu, D; Kleman, K; Ammann, A J; Thaler, M M

    1985-04-20

    The effect of increased nutritional intake was evaluated in 5 growth-retarded children with sickle-cell disease. Growth on recommended daily calorie and protein intakes had been inadequate in all 5. Fat absorption and intestinal mucosal morphology were normal in all 5. 2 children were given nutritional supplementation by nasogastric intubation, 1 received nightly oral formula supplements, and 2 were supplemented with zinc, iron, folate, and vitamin E only. Nutritional supplementation by the nasogastric route produced a rapid sustained increase in growth rate, associated with striking reductions in pain crises and infections which had previously necessitated many hospital admissions. Oral supplementation improved the clinical course but had no effect on growth rate. Mineral and vitamin supplements influenced neither the growth rate nor the clinical course. The observations indicate that nasogastric nutritional supplementation may accelerate growth and reduce the incidence and severity of complications in growth-retarded children with sickle-cell disease.

  5. Have the Answers to Common Legal Questions Concerning Nutrition Support Changed Over the Past Decade? 10 Questions for 10 Years.

    PubMed

    Barrocas, Albert; Cohen, Michael L

    2016-06-01

    Clinical nutrition specialists (CNSs) are often confronted with technological, ethical, and legal questions, that is, what can be done technologically, what should be done ethically, and what must be done legally, which conflict at times. The conflict represents a "troubling trichotomy" as discussed in the lead article of this issue of Nutrition in Clinical Practice (NCP). During Clinical Nutrition Week in 2006, a symposium covering these 3 topics was presented, and later that year, an article covering the same topic was published in NCP In this article, we revisit several legal questions/issues that were raised 10 years ago and discuss current answers and approaches. Some of the answers remain unchanged. Other answers have been modified by additional legislation, court decisions, or regulations. In addition, new questions/issues have arisen. Some of the most common questions regarding nutrition support involve the following: liability, informed consent, medical decisional incapacity vs legal competence, advance directive specificity, surrogate decision making, physician orders for life-sustaining treatment and electronic medical orders for life-sustaining treatment, legal definition of death, patient vs family decision making, the noncompliant patient, and elder abuse obligations. In the current healthcare environment, these questions and issues are best addressed via a transdisciplinary team that focuses on function rather than form. The CNS can play a pivotal role in dealing with these challenges by applying the acronym ACT: being Accountable and Communicating with all stakeholders while actively participating as an integral part of the transdisciplinary Team.

  6. [Do our elderly have an adequate nutritional status?].

    PubMed

    Méndez Estévez, Eugenia; Romero Pita, Juana; Fernández Domínguez, Ma José; Troitiño Álvarez, Patricia; García Dopazo, Silvia; Jardón Blanco, Milagros; Rey Charlo, Manuela; Rivero Cotilla, María Isabel; Rodríguez Fernández, Cristina; Menéndez Rodríguez, Martín

    2013-01-01

    Determinar el estado nutricional de los ancianos de un área de salud rural y ver si la institucionalización es un factor de riesgo. Diseño del estudio: Estudio observacional descriptivo en SAP de Xinzo de Limia 3. Sujetos: El tamaño muestral fue de 311 pacientes mayores de 75 años, seleccionados por muestreo aleatorio simple. Mediciones: Edad, sexo, estado civil, nivel de estudios, institucionalización o no, estado nutricional: valorado mediante el cuestionario MNA y parámetros antropométricos; apoyo social: medido mediante la escala de Duke- Unc; Calidad de vida: con la escala Euro-Quol; patologías asociadas; trastornos de la deglución; tratamiento habitual: tipo de dieta, fármacos. Resultados principales: La mediana de edad era de 82,55 años (DT 4,83 años) y el 51,8% eran mujeres, el 52,7% estaba casado y el 76,8% referían estudios primarios. La mediana de patologías por individuo era del 3 (DT: 1,42) y del número de fármacos usados era de 4 (DT 2,44). El 54,70% vivía acompañado por su pareja u otro familiar. Estaban institucionalizados el 17,4%. La mediana de calidad de vida era de 6,84. Según los resultados del MNA no encontramos ningún caso de desnutrición, pero un 20.3% de los pacientes presentan valores de riesgo. En el análisis multivariante encontramos relación entre la presencia o no de desnutrición y la institucionalización OR = 0,40 (IC 95%, 0,18- 0,87), con el nº de patologías OR = 1,30 (IC 95%, 1,03-1,64), calidad de vida OR = 1,40 (IC 95%, 1,14-1,71). Conclusiones: Los pacientes ancianos validos estudiados presentan un buen estado nutricional. Los pacientes con riesgo de presentar desnutrición son un 20,3%, siendo la institucionalización, los mayores de 85 años con mayor número de patologías los que presentan mayor riesgo de desnutrición. La peor calidad de vida y el menor apoyo social influyen negativamente.

  7. An Interdisciplinary Nutrition Support Team Improves Clinical and Hospitalized Outcomes of Esophageal Cancer Patients with Concurrent Chemoradiotherapy

    PubMed Central

    Cong, Ming-Hua; Li, Shu-Luan; Cheng, Guo-Wei; Liu, Jin-Ying; Song, Chen-Xin; Deng, Ying-Bing; Shang, Wei-Hu; Yang, Di; Liu, Xue-Hui; Liu, Wei-Wei; Lu, Shi-Yan; Yu, Lei

    2015-01-01

    Background: The prevalence of malnutrition is very high in patients with cancer. The purpose of this study was to investigate whether or not a nutrition support team (NST) could benefit esophageal cancer patients undergoing chemoradiotherapy (CRT). Methods: Between June 2012 and April 2014, 50 esophageal cancer patients undergoing concurrent CRT were randomly assigned into two groups: The NST group and the control group. The nutritional statuses of 25 patients in the NST group were managed by the NST. The other 25 patients in the control group underwent the supervision of radiotherapy practitioners. At the end of the CRT, nutritional status, the incidence of complications, and completion rate of radiotherapy were evaluated. Besides, the length of hospital stay (LOS) and the in-patient cost were also compared between these two groups. Results: At the completion of CRF, the nutritional status in the NST group were much better than those in the control group, as evidenced by prealbumin (ALB), transferrin, and ALB parameters (P = 0.001, 0.000, and 0.000, respectively). The complication incidences, including bone marrow suppression (20% vs. 48%, P = 0.037) and complications related infections (12% vs. 44%, P = 0.012), in the NST group were lower and significantly different from the control group. In addition, only one patient in the NST group did not complete the planned radiotherapy while 6 patients in the control group had interrupted or delayed radiotherapy (96% vs. 76%, P = 0.103). Furthermore, the average LOS was decreased by 4.5 days (P = 0.001) and in-patient cost was reduced to 1.26 ± 0.75 thousand US dollars person-times (P > 0.05) in the NST group. Conclusions: A NST could provide positive effects in esophageal cancer patients during concurrent CRT on maintaining their nutrition status and improving the compliance of CRF. Moreover, the NST could be helpful on reducing LOS and in-patient costs. PMID:26608978

  8. Dietary and nutritional treatments for attention-deficit/hyperactivity disorder: current research support and recommendations for practitioners.

    PubMed

    Hurt, Elizabeth A; Arnold, L Eugene; Lofthouse, Nicholas

    2011-10-01

    Evidence for dietary/nutritional treatments of attention-deficit/hyperactivity disorder (ADHD) varies widely, from double-blind, placebo-controlled trials to anecdotal. In guiding patients, clinicians can apply the SECS versus RUDE rule: treatments that are Safe, Easy, Cheap, and Sensible (SECS) require less evidence than those that are Risky, Unrealistic, Difficult, or Expensive (RUDE). Two nutritional treatments appear worth general consideration: Recommended Daily Allowance/Reference Daily Intake multivitamin/mineral supplements as a pediatric health intervention not specific to ADHD and essential fatty acids, especially a mix of eicosapentaenoic acid, docosahexaenoic acid, and γ-linolenic acid as an ADHD-specific intervention. Controlled studies support the elimination of artificial food dyes to reduce ADHD symptoms, but this treatment may be more applicable to the general pediatric population than to children with diagnosed ADHD. Mineral supplementation is indicated for those with documented deficiencies but is not supported for others with ADHD. Carnitine may have a role for inattention, but the evidence is limited. Dimethylaminoethanol probably has a small effect. Herbs, although "natural," are actually crude drugs, which along with homeopathic treatments have little evidence of efficacy. Consequences of delayed proven treatments need consideration in the risk-benefit assessment of dietary/nutritional treatments.

  9. Developing a mentoring program in clinical nutrition.

    PubMed

    Martindale, Robert G; McClave, Stephen; Heyland, Daren; August, David

    2010-01-01

    Mentoring programs in nutrition are essential to the survival of clinical nutrition as we know it today. The best method known to maintain an influx of talent to a discipline is by developing an active mentoring program. This paper describes 1 concept for development of a viable mentor program. Mentoring should be flexible and based on mentees' training background. Realistic goals should be set, with written and verbal feedback, to sustain a successful program. Programs should incorporate the Socratic Method whenever possible. Factors that leave doubt about the survival of nutrition as a viable area of focus for physicians include the inability to generate adequate funds to support oneself and limited numbers of mentors available with dedicated time to be a mentor. A healthy, sustainable mentoring program in clinical nutrition will ensure survival of physician-based nutrition programs.

  10. Is a vegetarian diet adequate for children.

    PubMed

    Hackett, A; Nathan, I; Burgess, L

    1998-01-01

    The number of people who avoid eating meat is growing, especially among young people. Benefits to health from a vegetarian diet have been reported in adults but it is not clear to what extent these benefits are due to diet or to other aspects of lifestyles. In children concern has been expressed concerning the adequacy of vegetarian diets especially with regard to growth. The risks/benefits seem to be related to the degree of restriction of he diet; anaemia is probably both the main and the most serious risk but this also applies to omnivores. Vegan diets are more likely to be associated with malnutrition, especially if the diets are the result of authoritarian dogma. Overall, lacto-ovo-vegetarian children consume diets closer to recommendations than omnivores and their pre-pubertal growth is at least as good. The simplest strategy when becoming vegetarian may involve reliance on vegetarian convenience foods which are not necessarily superior in nutritional composition. The vegetarian sector of the food industry could do more to produce foods closer to recommendations. Vegetarian diets can be, but are not necessarily, adequate for children, providing vigilance is maintained, particularly to ensure variety. Identical comments apply to omnivorous diets. Three threats to the diet of children are too much reliance on convenience foods, lack of variety and lack of exercise.

  11. Nutritional Supplements in Support of Resistance Exercise to Counter Age-Related Sarcopenia12

    PubMed Central

    Phillips, Stuart M

    2015-01-01

    Age-related sarcopenia, composed of myopenia (a decline in muscle mass) and dynapenia (a decline in muscle strength), can compromise physical function, increase risk of disability, and lower quality of life in older adults. There are no available pharmaceutical treatments for this condition, but evidence shows resistance training (RT) is a viable and relatively low-cost treatment with an exceptionally positive side effect profile. Further evidence suggests that RT-induced increases in muscle mass, strength, and function can be enhanced by certain foods, nutrients, or nutritional supplements. This brief review focuses on adjunctive nutritional strategies, which have a reasonable evidence base, to enhance RT-induced gains in outcomes relevant to sarcopenia and to reducing risk of functional declines. PMID:26178029

  12. Nutritional supplements in support of resistance exercise to counter age-related sarcopenia.

    PubMed

    Phillips, Stuart M

    2015-07-01

    Age-related sarcopenia, composed of myopenia (a decline in muscle mass) and dynapenia (a decline in muscle strength), can compromise physical function, increase risk of disability, and lower quality of life in older adults. There are no available pharmaceutical treatments for this condition, but evidence shows resistance training (RT) is a viable and relatively low-cost treatment with an exceptionally positive side effect profile. Further evidence suggests that RT-induced increases in muscle mass, strength, and function can be enhanced by certain foods, nutrients, or nutritional supplements. This brief review focuses on adjunctive nutritional strategies, which have a reasonable evidence base, to enhance RT-induced gains in outcomes relevant to sarcopenia and to reducing risk of functional declines. PMID:26178029

  13. Critical evaluation of the role of nutritional support for radiation therapy patients

    SciTech Connect

    Pezner, R.; Archambeau, J.O.

    1985-01-01

    Nutritional intake or absorption may be compromised by radiation therapy (RT) when large portions of the gastrointestinal tract are treated. Dietary counseling, oral supplements, tube feedings and intravenous hyperalimentation (IVH) have been employed to limit weight loss and lessen intestinal RT side effects. Unfortunately, no prospective study reviewed has shown improved tumor control or patient survival. Special diets and IVH have also been employed in select patients to relieve chronic malabsorption from severe radiation enteritis.

  14. Nutritional implications for the patient undergoing extracorporeal membrane oxygenation.

    PubMed

    Farías, María Magdalena; Olivos, Cristina; Díaz, Rodrigo

    2015-06-01

    Extracorporeal membrane oxygenation (ECMO) for cardiovascular collapse or catastrophic respiratory failure in the critically ill patient imposes a multidisciplinary approach. Nutritional support is one of the issues that must be faced, as this population presents a state of increased metabolic activity, elevated catabolism of protein and rapid accumulating energy deficiency. Provision of adequate nutritional therapy is hard to achieve due to different factors. This article provides a brief overview of the current literature regarding nutritional support during ECMO in adult patients, as no current guidelines address this issue.

  15. Effect of Glutamine Enriched Nutrition Support on Surgical Patients with Gastrointestinal Tumor: A Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Kang, Kai; Shu, Xiao-Liang; Zhang, Yong-Sheng; Liu, Xian-Li; Zhao, Jian

    2015-01-01

    Background: Associations between glutamine (Gln) enriched nutrition support and surgical patients with gastrointestinal (GI) tumor remain controversy. The purpose of this meta-analysis was to assess the effect of Gln enriched nutrition support on surgical patients with GI tumor in term of relevant biochemical indices, immune indices, and clinical outcomes. Methods: Six databases were systematically searched to find eligible randomized controlled trials (RCTs) from 1966 to May 2014. When estimated the analysis indexes, the relative risk (RR) was used as the effect size of the categorical variable, while the weighted mean difference (MD) was used as the effect size of a continuous variable. Meta-analysis was conducted with Rev Man 5.2. Results: Thirteen RCTs, involving 1034 patients, were included in the meta-analysis. The analysis showed that Gln enriched nutrition support was more effective in increasing serum albumin (MD: 0.10; 95% confidence interval [CI]: 0.02–0.18; P < 0.05), serum prealbumin (MD: 1.98; 95% CI: 1.40–2.55; P < 0.05) and serum transferring (MD: 0.35; 95% CI: 0.12–0.57; P < 0.05), concentration of IgG (MD: 1.26; 95% CI: 0.90–1.63; P < 0.05), IgM (MD: 0.18; 95% CI: 0.11–0.25; P < 0.05), IgA (MD: 0.22; 95% CI: 0.10–0.33; P < 0.05), CD3+ (MD: 3.71; 95% CI: 2.57–4.85; P < 0.05) and CD4/CD8 ratio (MD: 0.27; 95% CI: 0.12–0.42; P < 0.05). Meanwhile, it was more significant in decreasing the incidence of infectious complications (RR: 0.67; 95% CI: 0.50–0.90; P < 0.05) and shortening the length of hospital stay (MD: −1.72; 95% CI: −3.31–−0.13; P < 0.05). Conclusions: Glutamine enriched nutrition support was superior in improving immune function, reducing the incidence of infectious complications and shortening the length of hospital stay, playing an important role in the rehabilitation of surgical GI cancer patients. PMID:25591570

  16. Development and implementation of a novel online breastfeeding support resource: the Maternal Virtual Infant Nutrition Support Clinic.

    PubMed

    Geoghegan-Morphet, Nicola; Yuen, Doris; Rai, Esther; Angelini, Michelle; Christmas, Melissa; da Silva, Orlando

    2014-12-01

    Exclusive breastfeeding is the optimal method of infant feeding for the first 6 months of life for both term and preterm infants. This recommendation is based on indisputable evidence that breastfeeding offers numerous infant and maternal health benefits. Several trials have shown the beneficial effect of peer and/or professional support on the duration of any breastfeeding up to 6 months. Although many well-established programs exist that provide this support in-person or via telephone, the Internet is a relatively new means to deliver breastfeeding help. Yet, mothers have a vast presence online and a clear desire to seek healthcare information on the Internet. The availability and accessibility of interactive communication technologies via the internet provide the opportunity for developing new methods of healthcare delivery. Our project uses information technology to deliver an innovative and cost-effective way to support breastfeeding mothers. Our new online breastfeeding support clinic has the potential to improve access to specialized professional breastfeeding support in combination with interactive peer support. This new online clinic can be readily implemented to all regions in Canada with reliable Internet access, with the potential to significantly impact the health of all Canadian infants and their families. PMID:25244066

  17. Development and implementation of a novel online breastfeeding support resource: the Maternal Virtual Infant Nutrition Support Clinic.

    PubMed

    Geoghegan-Morphet, Nicola; Yuen, Doris; Rai, Esther; Angelini, Michelle; Christmas, Melissa; da Silva, Orlando

    2014-12-01

    Exclusive breastfeeding is the optimal method of infant feeding for the first 6 months of life for both term and preterm infants. This recommendation is based on indisputable evidence that breastfeeding offers numerous infant and maternal health benefits. Several trials have shown the beneficial effect of peer and/or professional support on the duration of any breastfeeding up to 6 months. Although many well-established programs exist that provide this support in-person or via telephone, the Internet is a relatively new means to deliver breastfeeding help. Yet, mothers have a vast presence online and a clear desire to seek healthcare information on the Internet. The availability and accessibility of interactive communication technologies via the internet provide the opportunity for developing new methods of healthcare delivery. Our project uses information technology to deliver an innovative and cost-effective way to support breastfeeding mothers. Our new online breastfeeding support clinic has the potential to improve access to specialized professional breastfeeding support in combination with interactive peer support. This new online clinic can be readily implemented to all regions in Canada with reliable Internet access, with the potential to significantly impact the health of all Canadian infants and their families.

  18. Nutritional interventions to prevent and treat osteoarthritis. Part II: focus on micronutrients and supportive nutraceuticals.

    PubMed

    Lopez, Hector L

    2012-05-01

    Osteoarthritis (OA) is the most common cause of musculoskeletal disability in the elderly, and it places an enormous economic burden on society, which will remain a major health care challenge with an aging population. Management of OA is primarily focused on palliative relief using agents such as nonsteroidal anti-inflammatory drugs (NSAID) and analgesics. However, such an approach is limited by a narrow therapeutic focus that fails to address the progressive and multimodal nature of OA. Given the favorable safety profile of most nutritional interventions, identifying disease-modifying pharmaconutrients capable of improving symptoms and also preventing, slowing, or even reversing the degenerative process in OA should remain an important paradigm in translational and clinical research. The goals of pharmaconutrition for metabolic optimization are to drive biochemical reactions in a desired direction and to meet health condition-specific metabolic demands. Applying advances in nutritional science to musculoskeletal medicine remains challenging, given the fluid and dynamic nature of the field, along with a rapidly developing regulatory climate over manufacturing and commerce requirements. The purpose of this article is to review the available literature on effectiveness and potential mechanism for OA of micronutrient vitamins; minerals; glycosaminoglycans; avocado-soybean unsaponifiable fractions; methylsulfonylmethane; s-adenosylmethionine; undenatured and hydrolyzed collagen preparations; phytoflavonoid compounds found in fruits, vegetables, spices, teas, and nuts; and other nutrients on the horizon. There also is a discussion on the concept of rational polysupplementation via the strategic integration of multiple nutraceuticals with potential complementary mechanisms for improving outcomes in OA. As applied nutritional science evolves, it will be important to stay on the forefront of proteomics, metabolomics, epigenetics, and nutrigenomics, because they hold

  19. Malnutrition and the role of nutritional support for radiation therapy patients.

    PubMed

    Thiel, H J; Fietkau, R; Sauer, R

    1988-01-01

    The nutritional status of a tumor patient can be negatively influenced by the local and systemic effects of the malignant tumor (tumor cachexia, anorexia, difficult oral food intake), by the effects of the various antitumoral therapy modalities (surgery, radiotherapy, chemotherapy), and by the complications associated with such modalities (anorexia, nausea, vomiting, mucositis, xerostomia, alterations of the smell and taste sensations, odynophagia, dysphagia, maldigestion, malabsorption, diarrhea, steatorrhea, conditioned aversions, radiogenic late effects), as well as by the psychological reactions of the patient to the real or feared existence of his tumor. The radiation-induced nutritional disorders depend on the tumor localization, the region irradiated, the dose and length of radiotherapy, the fractionation, the volume irradiated, and the combination with other therapeutic modalities ("combined modality therapy"). The acute radiation-induced reactions are usually of limited duration and for this reason tend to interfere with the nutritional status to a lesser extent than the permanent chronic consequences of irradiation. Weight loss and malnutrition tend to develop particularly in patients in whom segments of the gastrointestinal tract are subjected to irradiation. The incidence and severity of deficient nutrition depend not only on the region irradiated (head-neck region, thorax, abdomen, pelvis) but also, and most particularly, on the volume of the digestive tract irradiated. Chemotherapy and radiotherapy combined act very strongly on rapidly proliferating cell populations (skin, mucosa, epithelium of the gastrointestinal tract). In this context, actinomycin D and adriamycin act like real sensitizers, whereas the majority of the other drugs are likely to produce only an additive effect. The first named cytostatics give rise to the so-called recall phenomenon, i.e., the reactivation of latent radiation effects in response to the subsequent administration of

  20. Nutritional strategies to support adaptation to high-intensity interval training in team sports.

    PubMed

    Gibala, Martin J

    2013-01-01

    Team sports are characterized by intermittent high-intensity activity patterns. Typically, play consists of short periods of very intense or all-out efforts interspersed with longer periods of low-intensity activity. Fatigue is a complex, multi-factorial process, but intense intermittent exercise performance can potentially be limited by reduced availability of substrates stored in skeletal muscle and/or metabolic by-products associated with fuel breakdown. High-intensity interval training (HIT) has been shown to induce adaptations in skeletal muscle that enhance the capacity for both oxidative and non-oxidative metabolism. Nutrient availability is a potent modulator of many acute physiological responses to exercise, including various molecular signaling pathways that are believed to regulate cellular adaptation to training. Several nutritional strategies have also been reported to acutely alter metabolism and enhance intermittent high-intensity exercise performance. However, relatively little is known regarding the effect of chronic interventions, and whether supplementation over a period of weeks or months augments HIT-induced physiological remodeling and promotes greater performance adaptations. Theoretically, a nutritional intervention could augment HIT adaptation by improving energy metabolism during exercise, which could facilitate greater total work and an enhanced chronic training stimulus, or promoting some aspect of the adaptive response during recovery, which could lead to enhanced physiological adaptations over time.

  1. Differences in the technical and applied nutrition knowledge of older adults.

    PubMed

    Hand, R; Antrim, L R; Crabtree, D A

    1990-01-01

    Although elder adults are much more knowledgeable about nutrition than ever before, diet behavior is not consistent with nutrition knowledge. One of the reasons for this inconsistency may be that the ability to apply technical nutrition knowledge is still inadequate. To test the hypothesis that technical nutrition knowledge is superior to applied nutrition knowledge, 96 volunteer seniors were given technical nutrition knowledge tests associated with heart disease, cancer, and high blood pressure. After the technical knowledge tests, subjects were asked to choose from among pairs the item that contained: (a) cholesterol, (b) more saturated fat, (c) more polyunsaturated fat, (d) substances that help to lower blood cholesterol, (e) more fiber, and (f) less sodium. Results support the notion that, in general, elder ability to apply nutrition knowledge is not as adequate as their technical nutrition knowledge.

  2. 12 CFR 380.52 - Adequate protection.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Adequate protection. 380.52 Section 380.52... ORDERLY LIQUIDATION AUTHORITY Receivership Administrative Claims Process § 380.52 Adequate protection. (a... interest of a claimant, the receiver shall provide adequate protection by any of the following means:...

  3. 12 CFR 380.52 - Adequate protection.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Adequate protection. 380.52 Section 380.52... ORDERLY LIQUIDATION AUTHORITY Receivership Administrative Claims Process § 380.52 Adequate protection. (a... interest of a claimant, the receiver shall provide adequate protection by any of the following means:...

  4. 12 CFR 380.52 - Adequate protection.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Adequate protection. 380.52 Section 380.52... ORDERLY LIQUIDATION AUTHORITY Receivership Administrative Claims Process § 380.52 Adequate protection. (a... interest of a claimant, the receiver shall provide adequate protection by any of the following means:...

  5. 21 CFR 1404.900 - Adequate evidence.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Adequate evidence. 1404.900 Section 1404.900 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 1404.900 Adequate evidence. Adequate evidence means information sufficient...

  6. The importance of the one carbon cycle nutritional support in human male fertility: a preliminary clinical report

    PubMed Central

    2014-01-01

    Background Sperm chromatin structure is often impaired; mainly due to oxidative damage. Antioxidant treatments do not consistently produce fertility improvements and, when given at high doses, they might block essential oxidative processes such as chromatin compaction. This study was intended to assess the effect on male sub-fertility of a pure one carbon cycle nutritional support without strong antioxidants. Methods Male partners of couples resistant to at least 2 assisted reproductive technology (ART) attempts, with no evidence of organic causes of infertility and with either DNA fragmentation index (DFI) measured by Terminal deoxynucleotidyl transferase dUTP Nick End Labeling (TUNEL) or nuclear decondensation index (SDI) measured by aniline blue staining exceeding 20%, were invited to take part in a trial of a nutritional support in preparation for a further ART attempt. The treatment consisted of a combination of B vitamins, zinc, a proprietary opuntia fig extract and small amounts of N-acetyl-cysteine and Vitamin E (Condensyl™), all effectors of the one carbon cycle. Results 84 patients were enrolled, they took 1 or 2 Condensyl™ tablets per day for 2 to 12 months. Positive response rates were 64.3% for SDI, 71.4% for DFI and 47.6% for both SDI and DFI. Eighteen couples (21%) experienced a spontaneous pregnancy before the planned ART cycle, all ended with a live birth. The remaining 66 couples underwent a new ART attempt (4 IUI; 18 IVF; 44 ICSI) resulting in 22 further clinical pregnancies and 15 live births. The clinical pregnancy rate (CPR) and the live birth rate (LBR) were 47.6% and 39.3% respectively. The full responders, i.e. the 40 patients achieving an improvement of both SDI and DFI, reported a CPR of 70% and a LBR of 57.5% (p < 0.001). Conclusions Nutritional support of the one carbon cycle without strong antioxidants improves both the SDI and the DFI in ART resistant male partners and results in high pregnancy rates suggesting a positive

  7. [Nutritional support to establish refeeding in a patient with acute gastrointestinal graft-versus-host disease - a case report].

    PubMed

    Matsuoka, Mio; Iijima, Shohei

    2014-12-01

    A patient with acute myeloid leukemia having acute gastrointestinal graft-versus-host disease(aGVHD)was provided nutritional support. Oral intake was not permitted owing to the gastrointestinal injury induced by aGVHD. Our goal was to achieve oral feeding by the time of discharge. The initial aim in reinitiating eating was to stimulate intestinal adaptation to the mucosal injury. Via total parenteral nutrition(TPN), the patient was provided food in the form of a semisolid jelly, which passed through the intestinal tract slowly. After interviewing the patient and ascertaining that no complications had arisen owing to eating, a regular diet was initiated. Considering the unstable nature of the gastrointestinal condition and the associated long-term hospitalization, it is important to ensure that the meal contents comply with the patient's taste, while considering the patients'uneasiness and fear of progress to oral intake. It is difficult to predict improvement of aGVHD. Therefore, it is essential that patients are offered meals via TPN, suitable to their intestinal condition and mental status.

  8. [Croatian guidelines for perioperative enteral nutrition of surgical patients].

    PubMed

    Zelić, Marko; Bender, Darija Vranesić; Kelecić, Dina Ljubas; Zupan, Zeljko; Cicvarić, Tedi; Maldini, Branka; Durut, Iva; Rahelić, Velimir; Skegro, Mate; Majerović, Mate; Perko, Zdravko; Sustić, Alan; Madzar, Tomislav; Kovacić, Borna; Kekez, Tihomir; Krznarić, Zeljko

    2014-01-01

    Nutritional status of patients significantly affects the outcome of surgical treatment, whether it's about being obese or malnutrition with loss of muscle mass. Inadequate nutritional support in the perioperative period compromises surgical procedures even in patients who are adequately nourished. In this paper, particular attention was paid to malnourished patients, and their incidence in population hospitalized in surgical wards can be high up to 30%. Special emphasis was paid to the appropriateness of preoperative fasting and to the acceptance of new knowledge in this area of treatment. The aim of this working group was to make guidelines for perioperative nutritional support with different modalities of enteral nutrition. The development of these guidelines was attended by representatives of Croatian Medical Association: Croatian Society for Digestive Surgery, Croatian Society for Clinical Nutrition, Croatian Society of Surgery, Croatian Society for Endoscopic Surgery, Croatian Trauma Society and the Croatian Society of Anesthesiology and Intensive Care. The guidelines are designed as a set of questions that arise daily in clinical practice when preparing patients for surgery and after the surgical treatment, which relate to the assessment of nutritional status, perioperative nutritional support, duration of preoperative fasting period and the selection of food intake route. Assessment of nutritional status and the use of different modes of enteral nutrition should enter into standard protocols of diagnosis and treatment in the Croatian hospitals.

  9. The role of The Cochrane Collaboration in support of the WHO Nutrition Guidelines.

    PubMed

    Tovey, David

    2014-01-01

    This article describes the background and contribution of The Cochrane Collaboration to the WHO Nutrition Guidelines program. Systematic reviews, augmented by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology for assessing the quality of a body of evidence, form the evidence basis for WHO guidelines. Our shared experience of working together has highlighted a number of issues that are challenging, such as decisions made about selecting appropriate questions for evidence synthesis and the nature of study types that are included, in particular the decision on whether or not to extend a search beyond randomized studies. Although the skills and experience required for evidence synthesis are different from those needed to determine recommendations for policy and practice, our experience suggests that some engagement between the two groups is mutually beneficial. Finally, our experience highlights the recognition that evidence of effectiveness is essential but by no means sufficient to guide decisions on recommendations. Programmatic and implementation considerations are important to guide decision making and the evidence basis for this may be limited; therefore, it is essential that groups involved in delivering interventions to populations are also engaged in the guidelines process. PMID:24425720

  10. Case Study: Nutritional and Lifestyle Support to Reduce Infection Incidence in an International-Standard Premier League Soccer Player.

    PubMed

    Ranchordas, Mayur K; Bannock, Laurent; Robinson, Scott L

    2016-04-01

    Professional soccer players are exposed to large amounts of physiological and psychological stress, which can increase infection risk and threaten availability for training and competition. Accordingly, it is important for practitioners to implement strategies that support player well-being and prevent illness. This case study demonstrates how a scientifically supported and practically applicable nutrition and lifestyle strategy can reduce infection incidence in an illness-prone professional soccer player. In the 3 months before the intervention, the player had 3 upper-respiratory tract infections (URTIs) and subsequently missed 3 competitive matches and 2 weeks' training. He routinely commenced morning training sessions in the fasted state and was estimated to be in a large daily energy deficit. Throughout the 12-week intervention, the amount, composition, and timing of energy intake was altered, quercetin and vitamin D were supplemented, and the player was provided with a daily sleep and hygiene protocol. There was a positive increase in serum vitamin D 25(OH) concentration from baseline to Week 12 (53 n·mol-1 to 120 n·mol-1) and salivary immunoglobulin-A (98 mg·dl-1 to 135 mg·dl-1), as well as a decline in the number of URTI symptoms (1.8 ± 2.0 vs. 0.25 ± 0.5 for Weeks 0-4 and Weeks 8-12, respectively). More important, he maintained availability for all training and matches over the 12-week period. We offer this case study as a real-world applied example for other players and practitioners seeking to deploy nutrition and lifestyle strategies to reduce risk of illness and maximize player availability. PMID:26479983

  11. Executive summary: evaluation of the evidence to support practice guidelines for nutritional care of preterm infants-the Pre-B Project.

    PubMed

    Raiten, Daniel J; Steiber, Alison L; Hand, Rosa K

    2016-02-01

    Preterm birth (infants born at <37 wk of gestational age) is a significant clinical and public health challenge in the United States and globally. No universally accepted practice guidelines exist for the nutritional care of preterm infants. To address the current state of knowledge and to support systematic reviews that will be used to develop evidence-informed guidance, a consortium consisting of the American Academy of Pediatrics, the ASN, the American Society for Parenteral and Enteral Nutrition, the Academy of Nutrition and Dietetics, the Food and Drug Administration, the CDC, the USDA/Agricultural Research Service (USDA/ARS), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development/NIH initiated the Pre-B Project. The project included the constitution of 4 thematic working groups charged with the following tasks: 1) develop a series of topics/questions for which there is sufficient evidence to support a systematic review process to be conducted by the Academy of Nutrition and Dietetics' Evidence Analysis Library (EAL), leading to the development of new guidelines for nutritional care of preterm infants, and 2) develop a targeted research agenda to address priority gaps in our understanding of the role of nutrition in the health and development of preterm/neonatal intensive care unit infants. This review consists of a project overview including a summary of a workshop hosted by the USDA/ARS Children's Nutrition Research Center and summary reports of the 4 working groups established to address the following themes: 1) nutrient specifications, 2) clinical/practical issues in enteral feeding, 3) gastrointestinal and surgical issues, and 4) current standards for assessing infant feeding outcomes. These reports will serve as the basis for the ultimate guideline development process to be conducted by the Academy of Nutrition and Dietetics' EAL. PMID:26791179

  12. Nutrition Education Guide.

    ERIC Educational Resources Information Center

    Edmonds School District 15, Lynnwood, WA.

    This study guide is an attempt to relate the serving of adequate and nutritious meals to the total education process and to teach the importance of and the necessity for establishing lifetime nutrition practices. Designed for school food service personnel, it outlines an approach to nutrition education at various levels from preschool through…

  13. 77 FR 26287 - Cooperative Agreement To Support the Joint Institute for Food Safety and Applied Nutrition...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-03

    ... to support public health policy. The goal of JIFSAN is to advance sound strategies that improve... administrative structure and policies of UMCP-JIFSAN offer the flexibility needed to create and operate strategic... outreach programs that foster implementation of effective food safety practices (i.e., Good...

  14. Supporting Nutrition in Early Care and Education Settings: The Child and Adult Care Food Program (CACFP)

    ERIC Educational Resources Information Center

    Stephens, Samuel A.

    2016-01-01

    Child care centers, Head Start programs, and family child care providers serving young children--as well as after school programs and homeless shelters that reach older children, adults, and families--are supported in providing healthy meals and snacks by reimbursements through the Child and Adult Care Food Program (CACFP). Administered by the…

  15. Nutritional support in patients undergoing haematopoietic stem cell transplantation: a multicentre survey of the Gruppo Italiano Trapianto Midollo Osseo (GITMO) transplant programmes

    PubMed Central

    Botti, Stefano; Liptrott, Sarah Jayne; Gargiulo, Gianpaolo; Orlando, Laura

    2015-01-01

    A survey within Italian haematopoietic stem cell transplant (HSCT) programmes was performed, in order to obtain a snapshot of nutritional support (NS) in patients undergoing HSCT. The primary objective was to verify whether an evidence-based practice (EBP) approach to NS was implemented in HSCT centres. A multicentre survey was performed by questionnaire, covering the main areas of NS (screening, treatment planning, monitoring, nutritional counselling, and methods of nutritional support). The results indicated a significant variation between clinical practice and evidence-based guidelines in terms of clinical pathways, decision-making, and care provision regarding NS. Further research is required to identify reasons for the limited application of EBP and measures that may be undertaken to address such issues. Development of a multidisciplinary educational programme in order to raise awareness of the issue should be undertaken. PMID:26180544

  16. Perioperative nutrition in cancer patients.

    PubMed

    Daly, J M; Redmond, H P; Gallagher, H

    1992-01-01

    Cancer patients have the highest incidence of protein-calorie malnutrition seen in hospitalized patients, with significant malnutrition occurring in more than 30% of cancer patients undergoing major upper gastrointestinal procedures. Clinically significant malnutrition occurs as a result of diminished nutrient intake, increased nutrient losses, and tumor-induced derangements in host metabolism. In the absence of adequate exogenous nutrients, the body utilizes endogenous substrates to satisfy the ongoing requirements of both host and tumor for energy and protein. In those patients with malignant obstruction of the gastrointestinal tract, the tumor itself may induce diminished nutrient intake. Present day treatment modalities including gastrointestinal resection, chemotherapy, and radiotherapy compound these metabolic derangements, further increasing the risk of postoperative morbidity and death. The presence of malnutrition in cancer patients has prognostic importance. In a review of more than 3000 cancer patients, DeWys and colleagues identified significantly improved survival in those patients without weight loss compared with those had lost 6% of their body weight (Am J Med 69:491-497, 1980). Other investigators have noted increased postoperative morbidity and mortality associated with malnutrition. Early hypotheses suggested that reversal of weight loss would improve survival. The development and refinements of enteral and parenteral nutrition have provided the opportunity for studying the relationship between nutritional supplementation and postoperative prognosis. Nutrition support is therefore often instituted to improve nutritional status and thereby reduce the risks of postoperative complications. This article addresses the beneficial role of preoperative nutrition therapy in cancer patients.

  17. Nutritional and cultural aspects of plant species selection for a controlled ecological life support system

    NASA Technical Reports Server (NTRS)

    Hoff, J. E.; Howe, J. M.; Mitchell, C. A.

    1982-01-01

    The feasibility of using higher plants in a controlled ecological life support system is discussed. Aspects of this system considered important in the use of higher plants include: limited energy, space, and mass, and problems relating to cultivation and management of plants, food processing, the psychological impact of vegetarian diets, and plant propagation. A total of 115 higher plant species are compared based on 21 selection criteria.

  18. Sports Nutrition for Young Athletes

    ERIC Educational Resources Information Center

    Cotugna, Nancy; Vickery, Connie E.; McBee, Sheldon

    2005-01-01

    Nutritional needs for peak athletic performance include sufficient calorie intake, adequate hydration, and attention to timing of meals. Student athletes and their advisors often are misinformed or have misconceptions about sports nutrition. This paper identifies nutritional needs of young athletes, reviews common misconceptions, and examines the…

  19. Evaluation of a breastfeeding peer support program for fathers of Hispanic participants in a Texas special supplemental nutrition program for women, infants, and children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In 2002, the Special Supplemental Nutrition Program for Women, Infants, and Children(WIC) introduced an innovative approach for breastfeeding mothers and their spouses. The Pilot Peer Dad Program targeted fathers to promote and support their spouse in breastfeeding. This study evaluated duration of...

  20. Nutrient Intake and Nutritional Status Indicators of Participant and Nonparticipant Pupils of a Parent-Supported School Lunch Program in Kenya

    ERIC Educational Resources Information Center

    Walingo, Mary K.; Musamali, Betty

    2008-01-01

    Objective: To compare nutrient intake and indicators of nutritional status of western Kenyan pupil participants and nonparticipants of a parent-supported school lunch program. Design: Pupils and their caregivers were interviewed to assess their 24-hour dietary intake and the socioeconomic status of the family. Pupils' weights and heights were…

  1. Farm to School and the Child Nutrition Act: Improving School Meals through Advocating Federal Support for Farm-to-School Programs. Program Results Report

    ERIC Educational Resources Information Center

    Wood, James

    2011-01-01

    From 2009 to 2010, the Community Food Security Coalition advocated for more federal support and funding for farm-to-school programs as Congress considered reauthorizing the Child Nutrition Act. Farm-to-school initiatives aim to improve the quality and healthfulness of student meals through the inclusion of more fresh fruits and vegetables provided…

  2. Nutrition in Medicine: Nutrition Education for Medical Students and Residents

    PubMed Central

    Adams, Kelly M.; Kohlmeier, Martin; Powell, Margo; Zeisel, Steven H.

    2015-01-01

    Proper nutrition plays a key role in disease prevention and treatment. Many patients understand this link and look to physicians for guidance diet and physical activity. Actual physician practice, however, is often inadequate in addressing the nutrition aspects of diseases such as cancer, obesity, and diabetes. Physicians do not feel comfortable, confident, or adequately prepared to provide nutrition counseling, which may be related to suboptimal knowledge of basic nutrition science facts and understanding of potential nutrition interventions. Historically, nutrition education has been underrepresented at many medical schools and residency programs. Our surveys over a decade show that most medical schools in the United States are still not ensuring adequate nutrition education, and they are not producing graduates with the nutrition competencies required in medical practice. Physicians, residents, and medical students clearly need more training in nutrition assessment and intervention. The Nutrition in Medicine (NIM) project, established to develop and distribute a core nutrition curriculum for medical students, offers a comprehensive online set of courses free of charge to medical schools. The NIM medical school curriculum is widely used in the United States and abroad. A new initiative, Nutrition Education for Practicing Physicians, offers an innovative online medical nutrition education program for residents and other physicians-in-training, but with targeted, practice-based educational units designed to be completed in 15 minutes or less. The NIM project is strengthening medical nutrition practice by providing a free, comprehensive, online nutrition curriculum with clinically relevant, evidence-based medical education for undergraduate and postgraduate learners. PMID:20962306

  3. [Rectal temperature trends during 24 hours in a hot climate with and without nutritional support].

    PubMed

    Cisse, F; Seck-Gassama, S; Gueye, L; Seck, D; Samb, A; Ndoye, R; Martineaud, J P

    1997-01-01

    A group of 22 young subjects staying in rest was studied in the aim to follow the nycthemeral evolution of the rectal temperature, according to two situations: 1) normal feeding, 2) absence of feeding. The use of drinking water was not limited. The experimentation was carried out in tropical area, Kédougou (Eastern Senegal), during a high period of temperature. The mean of day temperature was 38 degrees C and the night temperature, 22 degrees C. The skin and rectal temperature, the arterial pressure and the cardiac frequency were measured every three hours. The results showed a significant difference in the nycthemeral rythm of the rectal temperatures. The nocturnal temperatures were not different in the two conditions. We observed a significant elevation (delta = 0.31 +/- 0.18 degree C) of the diurne post prandial temperature. The results supported that the thermic modification observed during the experience were linked to the feed.

  4. Working group reports: evaluation of the evidence to support practice guidelines for nutritional care of preterm infants-the Pre-B Project.

    PubMed

    Raiten, Daniel J; Steiber, Alison L; Carlson, Susan E; Griffin, Ian; Anderson, Diane; Hay, William W; Robins, Sandra; Neu, Josef; Georgieff, Michael K; Groh-Wargo, Sharon; Fenton, Tanis R

    2016-02-01

    The "Evaluation of the Evidence to Support Practice Guidelines for the Nutritional Care of Preterm Infants: The Pre-B Project" is the first phase in a process to present the current state of knowledge and to support the development of evidence-informed guidance for the nutritional care of preterm and high-risk newborn infants. The future systematic reviews that will ultimately provide the underpinning for guideline development will be conducted by the Academy of Nutrition and Dietetics' Evidence Analysis Library (EAL). To accomplish the objectives of this first phase, the Pre-B Project organizers established 4 working groups (WGs) to address the following themes: 1) nutrient specifications for preterm infants, 2) clinical and practical issues in enteral feeding of preterm infants, 3) gastrointestinal and surgical issues, and 4) current standards of infant feeding. Each WG was asked to 1) develop a series of topics relevant to their respective themes, 2) identify questions for which there is sufficient evidence to support a systematic review process conducted by the EAL, and 3) develop a research agenda to address priority gaps in our understanding of the role of nutrition in health and development of preterm/neonatal intensive care unit infants. This article is a summary of the reports from the 4 Pre-B WGs. PMID:26791182

  5. A randomized study of oral nutritional support versus ad lib nutritional intake during chemotherapy for advanced colorectal and non-small-cell lung cancer.

    PubMed

    Evans, W K; Nixon, D W; Daly, J M; Ellenberg, S S; Gardner, L; Wolfe, E; Shepherd, F A; Feld, R; Gralla, R; Fine, S

    1987-01-01

    One hundred ninety-two patients with previously untreated metastatic cancer (102 non-small-cell lung cancer [NSCLC]; 90 colorectal cancer) were randomized to receive either ad lib nutritional intake (control group) or specific nutritional intervention during a 12-week study period when chemotherapy was administered. Those patients randomized to nutritional interventions were counselled to take oral nutrients with caloric intake equal to 1.7 to 1.95 times their basal energy expenditure, depending on their pretreatment nutritional status ("standard" group). An augmented group was counselled to have a caloric intake equivalent to that of the standard group but with 25% of calories provided as protein and additional supplements of zinc and magnesium. Counselling increased caloric intake in both tumor types but reduced weight loss in the short term only for lung cancer patients. Ninety-three NSCLC patients were evaluable for tumor response to vindesine and cisplatin. Overall, only 20.4% of the patients responded, and there were no significant differences in response rates, median time to progression, or overall duration of survival between the nutrition intervention groups and the control group. The tumor response rate to time-sequenced 5-fluorouracil (5-FU) and methotrexate in the 81 evaluable patients with colorectal cancer was only 14.8%, and no significant differences in tumor response rates were noted between the three groups. Furthermore, the median time to progression and overall duration of survival were not different for the control, standard, and augmented groups. Nutritional interventions using dietary counselling had no impact on the percent of planned chemotherapy dose administered, the degree of toxicity experienced by patients, or the frequency of treatment delays. A multivariate prognostic factor analysis demonstrated that for lung cancer, the percent of weight loss, serum albumin concentration, and presence of liver metastases were significant (P less

  6. Nutritional Concerns of Spaceflight

    NASA Technical Reports Server (NTRS)

    Smith, Scott M.; Rice, Barbara L.

    2002-01-01

    Nutrition has played a critical role throughout the history of exploration, and space exploration is no exception. While a one- to two-week flight aboard the Space Shuttle might be analogous to a camping trip, adequate nutrition is absolutely critical while spending several months on the International Space Station (Figure 1) or several years on a mission to another planet. To ensure adequate nutrition, space nutrition specialists must know how much of the individual nutrients astronauts need, and these nutrients must be available in the spaceflight food system. To complicate matters, these spaceflight nutritional requirements are influenced by many of the physiological changes that occur during spaceflight. In this chapter, we describe some of these changes, their impact on crew health, and ways NASA is investigating how to minimize these changes. We also review the space food systems, issues involved in setting up a cafeteria in a weightless environment, and information about dietary intake of nutrients during space missions

  7. Development of Standard Reference Materials to support assessment of iodine status for nutritional and public health purposes.

    PubMed

    Long, Stephen E; Catron, Brittany L; Boggs, Ashley Sp; Tai, Susan Sc; Wise, Stephen A

    2016-09-01

    The use of urinary iodine as an indicator of iodine status relies in part on the accuracy of the analytical measurement of iodine in urine. Likewise, the use of dietary iodine intake as an indicator of iodine status relies in part on the accuracy of the analytical measurement of iodine in dietary sources, including foods and dietary supplements. Similarly, the use of specific serum biomarkers of thyroid function to screen for both iodine deficiency and iodine excess relies in part on the accuracy of the analytical measurement of those biomarkers. The National Institute of Standards and Technology has been working with the NIH Office of Dietary Supplements for several years to develop higher-order reference measurement procedures and Standard Reference Materials to support the validation of new routine analytical methods for iodine in foods and dietary supplements, for urinary iodine, and for several serum biomarkers of thyroid function including thyroid-stimulating hormone, thyroglobulin, total and free thyroxine, and total and free triiodothyronine. These materials and methods have the potential to improve the assessment of iodine status and thyroid function in observational studies and clinical trials, thereby promoting public health efforts related to iodine nutrition. PMID:27534629

  8. The management of perioperative nutrition in patients with end stage liver disease undergoing liver transplantation.

    PubMed

    Zhang, Qi-Kun; Wang, Meng-Long

    2015-10-01

    Malnutrition is found in almost 100% of patients with end stage liver disease (ESLD) awaiting transplantation and malnutrition before transplantation leads to higher rates of post-transplant complications and worse graft survival outcomes. Reasons for protein energy malnutrition include several metabolic alterations such as inadequate intake, malabsorption, and overloaded expenditure. And also, stress from surgery, gastrointestinal reperfusion injury, immunosuppressive therapy and corticosteriods use lead to delayed bowl function recovery and disorder of nutrients absorption. In the pretransplant phase, nutritional goals include optimization of nutritional status and treatment of nutrition-related symptoms induced by hepatic decompensation. During the acute post-transplant phase, adequate nutrition is required to help support metabolic demands, replenish lost stores, prevent infection, arrive at a new immunologic balance, and promote overall recovery. In a word, it is extremely important to identify and correct nutritional deficiencies in this population and provide an adequate nutritional support during all phases of liver transplantation (LT). This study review focuses on prevalence, nutrition support, evaluation, and management of perioperative nutrition disorder in patients with ESLD undergoing LT.

  9. Nutrition therapy: Integral part of liver transplant care.

    PubMed

    Anastácio, Lucilene Rezende; Davisson Correia, Maria Isabel Toulson

    2016-01-28

    Managing malnutrition before liver transplantation (LTx) while on the waiting list and, excessive weight gain/metabolic disturbances in post-surgery are still a challenge in LTx care. The aim of this review is to support an interdisciplinary nutrition approach of these patients. Cirrhotic patients are frequently malnourished before LTx and this is associated with a poor prognosis. Although the relation between nutritional status versus survival, successful operation and recovery after LTx is well established, prevalence of malnutrition before the operation is still very high. Emerging research has also demonstrated that sarcopenia pre and post-transplant is highly prevalent, despite the weight gain in the postoperative period. The diagnosis of the nutritional status is the first step to address the adequate nutritional therapy. Nutritional recommendations and therapy to manage the nutritional status of LTx patients are discussed in this review, regarding counseling on adequate diets and findings of the latest research on using certain immunonutrients in these patients (branched chain amino-acids, pre and probiotics). Nutrition associated complications observed after transplantation is also described. They are commonly related to the adverse effects of immunosuppressive drugs, leading to hyperkalemia, hyperglycemia and weight gain. Excessive weight gain and post-transplant metabolic disorders have long been described in post-LTx and should be addressed in order to reduce associated morbidity and mortality. PMID:26819518

  10. Nutrition therapy: Integral part of liver transplant care.

    PubMed

    Anastácio, Lucilene Rezende; Davisson Correia, Maria Isabel Toulson

    2016-01-28

    Managing malnutrition before liver transplantation (LTx) while on the waiting list and, excessive weight gain/metabolic disturbances in post-surgery are still a challenge in LTx care. The aim of this review is to support an interdisciplinary nutrition approach of these patients. Cirrhotic patients are frequently malnourished before LTx and this is associated with a poor prognosis. Although the relation between nutritional status versus survival, successful operation and recovery after LTx is well established, prevalence of malnutrition before the operation is still very high. Emerging research has also demonstrated that sarcopenia pre and post-transplant is highly prevalent, despite the weight gain in the postoperative period. The diagnosis of the nutritional status is the first step to address the adequate nutritional therapy. Nutritional recommendations and therapy to manage the nutritional status of LTx patients are discussed in this review, regarding counseling on adequate diets and findings of the latest research on using certain immunonutrients in these patients (branched chain amino-acids, pre and probiotics). Nutrition associated complications observed after transplantation is also described. They are commonly related to the adverse effects of immunosuppressive drugs, leading to hyperkalemia, hyperglycemia and weight gain. Excessive weight gain and post-transplant metabolic disorders have long been described in post-LTx and should be addressed in order to reduce associated morbidity and mortality.

  11. Nutrition therapy: Integral part of liver transplant care

    PubMed Central

    Anastácio, Lucilene Rezende; Davisson Correia, Maria Isabel Toulson

    2016-01-01

    Managing malnutrition before liver transplantation (LTx) while on the waiting list and, excessive weight gain/metabolic disturbances in post-surgery are still a challenge in LTx care. The aim of this review is to support an interdisciplinary nutrition approach of these patients. Cirrhotic patients are frequently malnourished before LTx and this is associated with a poor prognosis. Although the relation between nutritional status versus survival, successful operation and recovery after LTx is well established, prevalence of malnutrition before the operation is still very high. Emerging research has also demonstrated that sarcopenia pre and post-transplant is highly prevalent, despite the weight gain in the postoperative period. The diagnosis of the nutritional status is the first step to address the adequate nutritional therapy. Nutritional recommendations and therapy to manage the nutritional status of LTx patients are discussed in this review, regarding counseling on adequate diets and findings of the latest research on using certain immunonutrients in these patients (branched chain amino-acids, pre and probiotics). Nutrition associated complications observed after transplantation is also described. They are commonly related to the adverse effects of immunosuppressive drugs, leading to hyperkalemia, hyperglycemia and weight gain. Excessive weight gain and post-transplant metabolic disorders have long been described in post-LTx and should be addressed in order to reduce associated morbidity and mortality. PMID:26819518

  12. Nutrition for adventure racing.

    PubMed

    Ranchordas, Mayur K

    2012-11-01

    Adventure racing requires competitors to perform various disciplines ranging from, but not limited to, mountain biking, running, kayaking, climbing, mountaineering, flat- and white-water boating and orienteering over a rugged, often remote and wilderness terrain. Races can vary from 6 hours to expedition-length events that can last up to 10-consecutive days or more. The purpose of this article is to provide evidence-based nutritional recommendations for adventure racing competitors. Energy expenditures of 365-750 kcal/hour have been reported with total energy expenditures of 18 000-80 000 kcal required to complete adventure races, and large negative energy balances during competitions have been reported. Nutrition, therefore, plays a major role in the successful completion of such ultra-endurance events. Conducting research in these events is challenging and the limited studies investigating dietary surveys and nutritional status of adventure racers indicate that competitors do not meet nutrition recommendations for ultra-endurance exercise. Carbohydrate intakes of 7-12 g/kg are needed during periods of prolonged training to meet requirements and replenish glycogen stores. Protein intakes of 1.4-1.7 g/kg are recommended to build and repair tissue. Adequate replacement of fluid and electrolytes are crucial, particularly during extreme temperatures; however, sweat rates can vary greatly between competitors. There is considerable evidence to support the use of sports drinks, gels and bars, as they are a convenient and portable source of carbohydrate that can be consumed during exercise, in training and in competition. Similarly, protein and amino acid supplements can be useful to help meet periods of increased protein requirements. Caffeine can be used as an ergogenic aid to help competitors stay awake during prolonged periods, enhance glycogen resynthesis and enhance endurance performance. PMID:23006142

  13. Nutritional Issues in Cystic Fibrosis.

    PubMed

    Solomon, Missale; Bozic, Molly; Mascarenhas, Maria R

    2016-03-01

    The importance of maintaining adequate nutrition in patients with cystic fibrosis has been well known for the past 3 decades. Achieving normal growth and maintaining optimal nutrition is associated with improved lung function. Comprehensive and consistent nutritional assessments at regular intervals can identify those at risk of nutritional failure and uncover micronutrient deficiencies contributing to malnutrition. Management of malnutrition in cystic fibrosis should follow a stepwise approach to determine the causes and comorbidities and to develop a nutritional plan. Nutritional management is crucial at every stage in a person's life with cystic fibrosis and remains a cornerstone of management.

  14. Adequate mathematical modelling of environmental processes

    NASA Astrophysics Data System (ADS)

    Chashechkin, Yu. D.

    2012-04-01

    In environmental observations and laboratory visualization both large scale flow components like currents, jets, vortices, waves and a fine structure are registered (different examples are given). The conventional mathematical modeling both analytical and numerical is directed mostly on description of energetically important flow components. The role of a fine structures is still remains obscured. A variety of existing models makes it difficult to choose the most adequate and to estimate mutual assessment of their degree of correspondence. The goal of the talk is to give scrutiny analysis of kinematics and dynamics of flows. A difference between the concept of "motion" as transformation of vector space into itself with a distance conservation and the concept of "flow" as displacement and rotation of deformable "fluid particles" is underlined. Basic physical quantities of the flow that are density, momentum, energy (entropy) and admixture concentration are selected as physical parameters defined by the fundamental set which includes differential D'Alembert, Navier-Stokes, Fourier's and/or Fick's equations and closing equation of state. All of them are observable and independent. Calculations of continuous Lie groups shown that only the fundamental set is characterized by the ten-parametric Galilelian groups reflecting based principles of mechanics. Presented analysis demonstrates that conventionally used approximations dramatically change the symmetries of the governing equations sets which leads to their incompatibility or even degeneration. The fundamental set is analyzed taking into account condition of compatibility. A high order of the set indicated on complex structure of complete solutions corresponding to physical structure of real flows. Analytical solutions of a number problems including flows induced by diffusion on topography, generation of the periodic internal waves a compact sources in week-dissipative media as well as numerical solutions of the same

  15. Asbestos/NESHAP adequately wet guidance

    SciTech Connect

    Shafer, R.; Throwe, S.; Salgado, O.; Garlow, C.; Hoerath, E.

    1990-12-01

    The Asbestos NESHAP requires facility owners and/or operators involved in demolition and renovation activities to control emissions of particulate asbestos to the outside air because no safe concentration of airborne asbestos has ever been established. The primary method used to control asbestos emissions is to adequately wet the Asbestos Containing Material (ACM) with a wetting agent prior to, during and after demolition/renovation activities. The purpose of the document is to provide guidance to asbestos inspectors and the regulated community on how to determine if friable ACM is adequately wet as required by the Asbestos NESHAP.

  16. Development of a Website Providing Evidence-Based Information About Nutrition and Cancer: Fighting Fiction and Supporting Facts Online

    PubMed Central

    Beijer, Sandra; Adriaans, Anika Maria Alberdina; Vogel-Boezeman, Jeanne; Kampman, Ellen

    2015-01-01

    Background Although widely available, the general public, cancer patients, and cancer survivors have difficulties accessing evidence-based information on nutrition and cancer. It is challenging to distinguish myths from facts, and sometimes conflicting information can be found in different places. The public and patients would benefit from evidence-based, correct, and clear information from an easily recognizable source. Objective The aim of this project is to make scientific information available for the general public, cancer patients, and cancer survivors through a website. The aim of this paper is to describe and evaluate the development of the website as well as related statistics 1st year after its launch. Methods To develop the initial content for the website, the website was filled with answers to frequently asked questions provided by cancer organizations and the Dutch Dietetic Oncology Group, and by responding to various fiction and facts published in the media. The website was organized into 3 parts, namely, nutrition before (prevention), during, and after cancer therapy; an opportunity for visitors to submit specific questions regarding nutrition and cancer was included. The website was pretested by patients, health care professionals, and communication experts. After launching the website, visitors’ questions were answered by nutritional scientists and dieticians with evidence- or eminence-based information on nutrition and cancer. Once the website was live, question categories and website statistics were recorded. Results Before launch, the key areas for improvement, such as navigation, categorization, and missing information, were identified and adjusted. In the 1st year after the launch, 90,111 individuals visited the website, and 404 questions were submitted on nutrition and cancer. Most of the questions were on cancer prevention and nutrition during the treatment of cancer. Conclusions The website provides access to evidence- and eminence

  17. Human rights in nutrition and nutrition in human rights.

    PubMed

    Florencio, C A

    1996-03-01

    Many countries around the world are involved in nutrition planning and nutrition program implementation. This concern and activity with regard to nutrition, however, has failed to give the issue proper and adequate consideration in development plans and programs of action. The author proposes a two-pronged approach to promote nutrition as a human right. One approach is to include nutrition as a human right in educational and training programs in nutrition. Another approach is to include nutrition as a human right in educational and training programs on human rights. These approaches are described using examples from experiences in the Philippines. Families, universities, and other training institutions have roles to play in making sure that individuals and groups receive the nutrition they need. It should be stressed that nutrition is both a right and an input for development.

  18. [Nutrition management for COPD].

    PubMed

    Miki, Keisuke; Maekura, Ryoji

    2016-05-01

    Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory reaction of the lung and of the whole body, and pulmonary cachexia often occurs during the advanced stage. The effects of nutritional support upon the management of under-nutrition in COPD remain controversial. However, a study of the effects of nutritional supplement therapy upon such patients with COPD has recently been published. The present report comprises a review of recent articles about the nutritional support of patients with COPD, especially those with cachexia, and a discussion about the roles of nutritional supplement therapy, focusing on exercise and treatment with ghrelin and vitamin D in the management of COPD. PMID:27254950

  19. Supervision of Student Teachers: How Adequate?

    ERIC Educational Resources Information Center

    Dean, Ken

    This study attempted to ascertain how adequately student teachers are supervised by college supervisors and supervising teachers. Questions to be answered were as follows: a) How do student teachers rate the adequacy of supervision given them by college supervisors and supervising teachers? and b) Are there significant differences between ratings…

  20. Small Rural Schools CAN Have Adequate Curriculums.

    ERIC Educational Resources Information Center

    Loustaunau, Martha

    The small rural school's foremost and largest problem is providing an adequate curriculum for students in a changing world. Often the small district cannot or is not willing to pay the per-pupil cost of curriculum specialists, specialized courses using expensive equipment no more than one period a day, and remodeled rooms to accommodate new…

  1. Toward More Adequate Quantitative Instructional Research.

    ERIC Educational Resources Information Center

    VanSickle, Ronald L.

    1986-01-01

    Sets an agenda for improving instructional research conducted with classical quantitative experimental or quasi-experimental methodology. Includes guidelines regarding the role of a social perspective, adequate conceptual and operational definition, quality instrumentation, control of threats to internal and external validity, and the use of…

  2. An Adequate Education Defined. Fastback 476.

    ERIC Educational Resources Information Center

    Thomas, M. Donald; Davis, E. E. (Gene)

    Court decisions historically have dealt with educational equity; now they are helping to establish "adequacy" as a standard in education. Legislatures, however, have been slow to enact remedies. One debate over education adequacy, though, is settled: Schools are not financed at an adequate level. This fastback is divided into three sections.…

  3. Nutritional Biochemistry of Spaceflight

    NASA Technical Reports Server (NTRS)

    Smith, Scott M.

    2000-01-01

    Adequate nutrition is critical for crew health and safety during spaceflight. To ensure adequate nutrition, the nutrient requirements need to be both accurate and available from the spaceflight food system. The existing nutritional requirements for extended-duration spaceflight have been defined largely by extrapolation from ground-based research. However, nutritional requirements are influenced by most of the physiological consequences of spaceflight, including loss of lean, adipose, and bone tissue; changes in blood composition; and increased risk of renal stone formation. This review focuses on key areas where information has been gained in recent years: dietary intake and energy metabolism, bone health, fluid and electrolyte homeostasis, and hematological changes. Areas in which specific nutrients have the potential to serve as countermeasures to the negative effects of spaceflight are also reviewed. Dietary Intake

  4. Extraction of mineral elements from inedible wastes of biological components of a life-support system and their utilization for plant nutrition

    NASA Astrophysics Data System (ADS)

    Gribovskaya, I. V.; Gladchenko, I. A.; Zinenko, G. K.

    Two methods of extracting mineral elements from otherwise deadlock products of a life-support system are presented. We describe first optimum conditions for recovering elements by water extraction from dry wastes of plants, biomass ash, and solid human wastes after passing them through the catalytic furnace; and, second, we describe acid extracts of biogenous elements by 1N and 2N HNO_3 from these products. Ways to use the extracts of elements in plant nutrition are considered in order to increase the extent to which the mineral loop of a life-support system can be closed.

  5. Undergraduate Training in Nutritional Science

    ERIC Educational Resources Information Center

    Briggs, George M.

    1972-01-01

    Discusses need to establish minimum standards of training for nutrition educators,'' and standardized curricula at the undergraduate level. Gives attention to definitions, adequate training, and suggested guidelines as a starting point for further discussion. (LK)

  6. [Services portfolio of a department of endocrinology and clinical nutrition].

    PubMed

    Vicente Delgado, Almudena; Gómez Enterría, Pilar; Tinahones Madueño, Francisco

    2011-03-01

    Endocrinology and Clinical Nutrition are branches of Medicine that deal with the study of physiology of body glands and hormones and their disorders, intermediate metabolism of nutrients, enteral and parenteral nutrition, promotion of health by prevention of diet-related diseases, and appropriate use of the diagnostic, therapeutic, and preventive tools related to these disciplines. Development of Endocrinology and Clinical Nutrition support services requires accurate definition and management of a number of complex resources, both human and material, as well as adequate planning of the care provided. It is therefore essential to know the services portfolio of an ideal Department of Endocrinology and Clinical Nutrition because this is a useful, valid and necessary tool to optimize the available resources, to increase efficiency, and to improve the quality of care. PMID:21382754

  7. [Services portfolio of a department of endocrinology and clinical nutrition].

    PubMed

    Vicente Delgado, Almudena; Gómez Enterría, Pilar; Tinahones Madueño, Francisco

    2011-03-01

    Endocrinology and Clinical Nutrition are branches of Medicine that deal with the study of physiology of body glands and hormones and their disorders, intermediate metabolism of nutrients, enteral and parenteral nutrition, promotion of health by prevention of diet-related diseases, and appropriate use of the diagnostic, therapeutic, and preventive tools related to these disciplines. Development of Endocrinology and Clinical Nutrition support services requires accurate definition and management of a number of complex resources, both human and material, as well as adequate planning of the care provided. It is therefore essential to know the services portfolio of an ideal Department of Endocrinology and Clinical Nutrition because this is a useful, valid and necessary tool to optimize the available resources, to increase efficiency, and to improve the quality of care.

  8. Clinical practice guidelines from the French Health High Authority: nutritional support strategy in protein-energy malnutrition in the elderly.

    PubMed

    Raynaud-Simon, Agathe; Revel-Delhom, Christine; Hébuterne, Xavier

    2011-06-01

    These guidelines were produced at the request of the General Directorate of Health within the scope of the French Nutrition and Health Program (PNNS). They concern the management of malnutrition in elderly persons living at home, in institutional care, or in hospital. They belong to a recent series of studies published by ANAES(1) or HAS. Preceding studies concerned the "Diagnostic assessment of protein-energy malnutrition in hospitalized adults" (ANAES, September 2003) and the work conducted by the Committee for the Assessment of Devices and Health Technologies (CEPP) on "Reimbursement procedures for dietary foods for special medical purposes for nutritional supplementation and home enteral nutrition" (HAS, September 2006). The objective of these guidelines is to develop a tool for identifying and managing elderly subjects who are malnourished or at risk of malnutrition.

  9. Amino acid composition in parenteral nutrition: what is the evidence?

    PubMed Central

    Yarandi, Shadi S.; Zhao, Vivian M.; Hebbar, Gautam; Ziegler, Thomas R.

    2011-01-01

    Purpose of review Complete parenteral nutrition solutions contain mixed amino acid products providing all nine essential amino acids and a varying composition of nonessential amino acids. Relatively little rigorous comparative efficacy research on altered parenteral nutrition amino acid composition has been published in recent years. Recent findings Limited data from randomized, double-blind, adequately powered clinical trials to define optimal doses of total or individual amino acids in parenteral nutrition are available. An exception is the growing number of studies on the efficacy of glutamine supplementation of parenteral nutrition or given as a single parenteral agent. Parenteral glutamine appears to confer benefit in selected patients; however, additional data to define optimal glutamine dosing and the patient subgroups who may most benefit from this amino acid are needed. Although some promising studies have been published, little data are available in the current era of nutrition support on the clinical efficacy of altered doses of arginine, branched chain amino acids, cysteine, or taurine supplementation of parenteral nutrition. Summary Despite routine use of parenteral nutrition, surprisingly little clinical efficacy data are available to guide total or specific amino acid dosing in adult and pediatric patients requiring this therapy. This warrants increased attention by the research community and funding agencies to better define optimal amino acid administration strategies in patient subgroups requiring parenteral nutrition. PMID:21076291

  10. Removing life support: motivations, obligations. An opinion on NCCB Committee for Pro-Life Activities' statement on artificial hydration and nutrition.

    PubMed

    O'Rourke, K D; deBlois, J

    1992-01-01

    In April 1992 the Committee for Pro-Life Activities of the National Conference of Catholic Bishops issued a resource paper titled "Nutrition and Hydration: Moral and Pastoral Reflections." At best, this document and its conclusions may be viewed as a pastoral statement, offering some tentative reasoning and conclusions to be considered in cases that concern the use of medically assisted nutrition and hydration. When discussing the question, is the withholding or withdrawing of medically assisted hydration and nutrition always direct killing? the document applies two principles--"no reasonable hope of benefit" and "involving excessive burdens." The document's crucial part is its admission that artificial hydration and nutrition may be removed without the intention of causing death, and that "this kind of decision should not be equated with a decision to kill or with suicide." The committee assigns decision-making responsibility to patients, families, and healthcare professionals, but continues its discussion for 20 pages and offers cautions conclusions concerning removal of such therapy. Two assumptions seem to underlie the document's overly cautious conclusions, the first being that mere vegetative function mandates continued life support. The first assumption overemphasizes the value of physiological functioning insofar as the purpose of human life is concerned. It also is contrary to the goal of medicine, which envisions restoration of cognitive-affective function as an element of successful therapy. The second assumption is that withdrawal of artificial hydration and nutrition from persons in PVS may lead to euthanasia. But mandating the continuation of nonbeneficial therapy simply because it prolongs physiological function seems to lead people to favor euthanasia rather than reject it.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. [Protocol for the diagnosis and treatment of catheter related infections in patients with home parenteral nutrition].

    PubMed

    de la Cuerda Compés, C; Bretón Lesmes, I; Bonada Sanjaume, A; Planas Vila, M

    2005-08-01

    One of the most frequent complications of home parenteral nutrition is parenteral nutrition catheter infection. Prevention of these complications by adequate protocols on the catheter cares manages to decrease significantly the number of infections. Diagnosis and treatment of these infections should be done early to avoid loss of central venous accesses that may affect the treatment with this nutritional support modality in the long term. The existence of a protocol for the diagnosis and treatment of infections related with the catheter is, thus, of great value in the treatment of these patients.

  12. [Nutrition and anthropobiology].

    PubMed

    Froment, A

    1992-01-01

    In analyzing the connections between nutrition and anthropology, it should be noted that the state of knowledge and available techniques are not yet sufficiently developed to support conclusions about such questions as the universality of dietary norms. Food choices are above all cultural, although they are limited by the physical environment and technological capacities. Human beings have some dietary constraints imposed by metabolic needs, but they manifest great ability to adapt to different dietary regimes, from the exclusive vegetarianism of Hindus to the almost exclusively animal-based diet of the Eskimos. In most parts of the world, the contribution of proteins is remarkably stable at about 12% of total caloric intake. Numerous examples of genetic adaptation illustrate the flexibility of humans. Many African populations, for example, have deficits of intestinal lactase, but herding groups do not. the diet of parts of the New Guinea highlands is almost completely lacking in proteins, but body growth is not inhibited. Such examples raise questions about the applicability of Recommended Dietary Allowances and evaluation of nutritional risks. Daily protein intake ranging from .2 to 5 gm/kg of body weight has been measured in different societies. WHO recommended 1.3 gm, but this norm has changed through time, and it is currently believed that total caloric intake is more important in insuring adequate growth. Food supplementation programs based on protein have generally failed. For most societies, the diet is varied enough to contain a sufficient portion of essential nutrients. Specific lacks have often been noted under very artificial conditions such as on ships at sea or in prisons. A reduction of body format may be biologically fixed quantity of food. The population of Mexico represents 24% of that of the US in individuals but only 17% in body mass. Clinical methods allow signs of deficiency at an earlier phase of development has been costly and disappointing

  13. Nutritional Status Assessment During the Phase IIA and Phase III Lunar/Mars Life Support Test Project

    NASA Technical Reports Server (NTRS)

    Smith, Scott M.; Block, Gladys; Davis-Street, Janis E.; DeKerlegand, Diane E.; Fanselow, Stephanie A.; Fesperman, J. Vernell; Gillman, Patricia L.; Nillen, Jeannie I.; Rice, Barbara L.; Smith, Myra D.

    2000-01-01

    Nutrition is a critical concern for extended-duration space missions (Smith and Lane, 1999). Loss of body weight is a primary consequence of altered nutrition, and is frequently observed during space flight (Smith and Lane; 1999). Other existing dietary concerns for space flight include excessive intakes of sodium and iron, and insufficient intakes of water and vitamin D (Smith and Lane, 1999). Furthermore, dependence on closed or semi-closed food systems increases the likelihood of inadequate intakes of key nutrients. This is a significant concern for extended-duration space missions. Space nutrition research often necessitates detailed recording of all food consumption. While this yields extremely accurate data, it requires considerable time and effort, and thus is not suitable for routine medical monitoring during space flight. To alleviate this problem, a food frequency questionnaire (FFQ) was designed to provide a quick and easy, yet reasonably accurate, method for crewmembers to provide dietary intake information to the ground. We report here a study which was designed to assess nutritional status before, during, and after the 60-d and 91-d chamber stays. An additional goal of the study was to validate a food frequency questionnaire designed specifically for use with space flight food systems.

  14. [Optimization of the mineral nutrition of plants constituting the phototrophic component of closed biological life support systems].

    PubMed

    Tikhomirov, A A; Ushakova, S A; Golovko, T K; Velichko, V V; Tabalenkova, G N; Zakhozhiĭ, I G; Garmash, E V

    2012-01-01

    Applicability of a new substrate for crops cultivation in bioregenerative LSSs with a high degree of mass-exchange closure was tested. Optimization of leaf cabbage nutrition by supplementing the basic substrate fabricated of plant and animal residues with ion-exchange resins proved to have a success.

  15. Supportive care in oncology.

    PubMed

    Levy, M H; Rosen, S M; Ottery, F D; Hermann, J

    1992-01-01

    Pain management, nutritional support, and psychosocial support are fundamental services that enhance patients' ability to cope with their cancer and its therapy. The common goal of symptom prevention mandates that each of these supportive services be provided to all patients throughout their cancer experience. Comprehensive cancer pain management begins with identifying the origin of all of the patient's pains and treating each one specifically. Pain prevention can be achieved through around-the-clock opioid administration with as-needed supplements for breakthrough pain and dose titration. Common narcotic side effects such as constipation and nausea also must be prevented. Successful opioid analgesia requires that patient and family concerns regarding addiction and tolerance be dispelled at the outset. Cancer pain prevention can be further optimized with the use of appropriate coanalgesics in response to the pathophysiology of the patient's pains. Cognitive and behavioral therapies may also be useful adjuncts to reduce both pain and suffering. Procedure-oriented pain control should be considered when systemic pharmacologic therapy does not provide adequate pain relief or is associated with intolerable side effects. The only absolute contraindications for pain-relieving procedures are untreatable coagulopathy and a decrease in mental status not related to medical pain management. Useful neurodestructive techniques include radiofrequency lesioning, cryoanalgesia, and chemical neurolysis with agents such as phenol, alcohol, and hypertonic saline. The most beneficial pain-relieving procedures and percutaneous cordotomy, spinal narcotics, celiac and hypogastric plexus ablation, spinal neurolysis, and epidural injection of steroids and hypertonic saline. Procedure selection depends on the cause of the pain and the patient's prognosis. Common indications for pain-relieving procedures include unilateral pain below the shoulder, upper abdominal visceral pains, pelvic

  16. [Detection of opportunities for improvement of the quality of parenteral nutrition in patients subjected to gastrointestinal surgery].

    PubMed

    Schoenenberger Arnaiz, J A; Rodríguez Pozo, A; Sales Rufi, S; García, F; Cano Marrón, S M

    1999-01-01

    The nutritional support team must justify its role by proving that it provides an adequate quality control and supervises the administration of the nutritional support to avoid its inappropriate use. The measures based on the process reported on the improvement opportunities while those based on the results allow an evaluation of the quality. The objective of this study is to present the results of a systematic search for improvement opportunities in two fundamental activities of the nutritional support team: the evaluation of the patient needs, and the adequation of the caloric supply to these needs. The data corresponding to nutritional support and nutritional assessment of 217 patients who initiated central parenteral nutrition during the perioperative surgery period for a laparotomy were registered between January of 1996 and June of 1997. These data were used to calculate 8 selected quality indicators to report on the quality of the activities subject to the evaluation. Moreover, the initial and final values of the nutritional assessment parameters of a sub-group of patients were compared with the aim of obtaining a measure of the result of parenteral nutrition. The final average levels of albumin, prealbumin, transferin, and the Nutritional Prognostic Index were significantly better than the initial data in the subgroup in which these data were available. The analysis of the process indicators allowed the detection of the need to reduce the caloric supply in relation to the protein supply and to promote the use of programs with a caloric supply that was better adjusted to the BMI and/or the patients' weight. It was also shown that it is necessary to increase the number of patients assessed from a nutritional point of view at the beginning and at the end of parenteral nutrition.

  17. Nutrition Assessment, Counseling, and Support (NACS) interventions to improve health-related outcomes in people living with HIV/AIDS: a systematic review of the literature

    PubMed Central

    Tang, AM; Quick, T; Chung, M; Wanke, CA

    2015-01-01

    Background While numerous studies have shown that severe to moderate wasting at the time of antiretroviral therapy (ART) initiation is strongly predictive of mortality, it remains unclear whether nutritional interventions at or prior to ART initiation will improve outcomes. This review examines data on nutrition assessment, counseling, and support (NACS) interventions in resource-limited settings. Methods We identified articles published between 2005 and 2014 on the effectiveness of NACS interventions, particularly its impact on five outcomes: mortality, morbidity, retention in care, quality of life, and/or prevention of ongoing HIV transmission. We rated the overall quality of individual articles and summarized the body of evidence and expected impact for each outcome. Results Twenty-one articles met all inclusion criteria. The overall quality of evidence was weak, predominantly due to few studies being designed to directly address the question of interest. Only two studies were randomized trials with proper control groups. The remainder were randomized studies of one type of food support versus another, cohort (non-randomized) studies, or single-arm studies. Ratings of individual study quality ranged from “medium” to “weak,” and the quality of the overall body of evidence ranged from “fair” to “poor.” We rated the expected impact on all outcomes as “uncertain.” Conclusion Rigorous, better designed studies in resource-limited settings are urgently needed to understand the effectiveness of nutrition assessment and counseling alone, as well as studies to understand better modalities of food support (targeting, timing, composition, form, and duration) to improve both short- and long-term patient retention in care and treatment, and clinical outcomes. PMID:25768873

  18. Nutritional Assessment: Its Significance in Medical Education.

    ERIC Educational Resources Information Center

    Ozerol, Nail H.

    1982-01-01

    Medical educators must make every effort to achieve an adequate level of nutrition education for all health professionals. Medical schools should adopt a basic, required curriculum including biochemical and physiological aspects of nutrients, a clinical nutrition program for prevention of health hazards, and a course in nutritional assessment.…

  19. Children's Nutrition and Learning. ERIC Digest.

    ERIC Educational Resources Information Center

    ERIC Clearinghouse on Elementary and Early Childhood Education, Urbana, IL.

    This digest reviews research on the link between children's nutrition and their ability to learn from the prenatal through school years. It also discusses the importance of nutrition education for children. The need for adequate nutrition during pregnancy and the preschool years is highlighted by research that indicates that low birthweight…

  20. Cachexia: a nutritional syndrome?

    PubMed

    Anker, Stefan D; Morley, John E

    2015-12-01

    Cachexia leads to nutritional deficits including anorexia and loss of fat and muscle mass. In persons with precachexia or early cachexia, for example, old persons with weight loss and chronic obstructive pulmonary disease, there is strong evidence that nutritional support improves outcomes. Limited evidence suggests that this may be true for heart failure and chronic kidney disease. The evidence for nutritional support in refractory cachexia is, not surprisingly, less dramatic. It would appear that early in the cachectic process, nutrition, coupled with exercise, may be an important therapeutic approach. PMID:26675043

  1. 45 CFR 1326.15 - Nutrition services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Nutrition services. 1326.15 Section 1326.15 Public... INDIAN TRIBES FOR SUPPORT AND NUTRITION SERVICES § 1326.15 Nutrition services. (a) In addition to providing nutrition services to older Indians, a tribal organization may: (1) Provide nutrition services...

  2. Nutrition rehabilitation in the intensive care unit.

    PubMed

    Massanet, Pablo Lucas; Petit, Laurent; Louart, Benjamin; Corne, Philippe; Richard, Celine; Preiser, Jean Charles

    2015-05-01

    The maintenance of homeostasis after severe injury requires the restoration of the physiological regulation of food intake. A wide array of functional alterations can hinder the intake of adequate amounts of nutrients to support the recovery from critical illness. These alterations encompass changes in the preprandial phase, reflected by a loss of appetite; changes in the prandial phase, yielding swallowing disorders; and changes in the postprandial phase, including impairments of gastric emptying, gut motility, and satiety. This tutorial aims to review these often overlooked features and to suggest recommendations for the nutrition rehabilitation of the critically ill.

  3. Nutrition rehabilitation in the intensive care unit.

    PubMed

    Massanet, Pablo Lucas; Petit, Laurent; Louart, Benjamin; Corne, Philippe; Richard, Celine; Preiser, Jean Charles

    2015-05-01

    The maintenance of homeostasis after severe injury requires the restoration of the physiological regulation of food intake. A wide array of functional alterations can hinder the intake of adequate amounts of nutrients to support the recovery from critical illness. These alterations encompass changes in the preprandial phase, reflected by a loss of appetite; changes in the prandial phase, yielding swallowing disorders; and changes in the postprandial phase, including impairments of gastric emptying, gut motility, and satiety. This tutorial aims to review these often overlooked features and to suggest recommendations for the nutrition rehabilitation of the critically ill. PMID:25587007

  4. Nutrition and earthquakes: experience and recommendations.

    PubMed

    Tsuboyama-Kasaoka, Nobuyo; Purba, Martalena Br

    2014-01-01

    In order to sustain life during the occurrence of a natural disaster, it is vital to ensure that people's intake of water and food is adequate (prioritizing first energy, then protein and water-soluble vitamins). Infants, pregnant women, patients, and the elderly are particularly vulnerable to insufficiencies in food intake, even if they are provided with the same quantity of food as others, and providing them with dietary and nutritional support becomes a high priority as their insufficient intake of energy and protein becomes long term. It is necessary to have a system in place for identifying those who are vulnerable and in need of support and providing them with the items (food) and nutritional care that they require. Eating is equivalent to living, and if the vulnerable themselves recognize the importance of food and nutrition, this will help improve the nutritional situation of the entire population. It is recommended that measures be taken in non-emergency periods such as stockpiling food for special dietary uses.

  5. Nutrition and metabolism in sepsis and multisystem organ failure.

    PubMed

    Baue, A E

    1991-06-01

    Sepsis and organ failure produce profound metabolic changes that contribute to hepatic and musculoskeletal failure. When multiple organ failure develops, the mortality rate is high, and therapy is unlikely to be effective unless the causative process (e.g., infection, low cardiac output) can be eliminated. Thus, the prevention of multiple organ failure and the prevention or early treatment of infection are paramount. Organ and nutritional support to prevent complications is necessary. The gastrointestinal tract should be used for nutrition whenever possible with a blenderized regular diet with fiber, glutamine, and short-chain fatty acids to protect and preserve the gut. If parenteral nutrition is necessary, special solutions may be necessary for the liver, kidneys, or lungs. If not, protein with 45% branched-chain amino acid, medium- and short-chain triglycerides, glutamine supplementation, and carbohydrates seem best. Other substances are being evaluated that may be helpful in nutrition and organ support, including arginine, xylitol, growth hormone, and anabolic steroids. Multiple organ failure should be prevented, if at all possible, by stopping or controlling the injury, removing as much necrotic tissue as possible, improving blood flow and oxygen consumption, supporting metabolism, and preventing infection or treating it early and adequately. Nutritional support plays a key role in preventing metabolic failure.

  6. [Ensure - complete and balanced nutrition, convenient on work].

    PubMed

    Kurenkov, A V; Iuriatin, A A

    2013-01-01

    The work conditions often may compromise a company ability to supply their employees with adequate, hot meals. For heavy labor workers and some office employees it is important to restore energy and nutrients with food, balanced in nutrients. The lack of adequate nutritive support can give a negative impact on different organs functions. One of the main principles of healthy nutrition is - diet must be balanced in nutrients. Which is easy to say, but difficult to implement, especially on some industries. Complete and balanced liquid and ready-to-use nutrition is new trend in nutrition of healthy people who cannot consume optimal diet, and in people with the risk of nutrient deficiencies. One-two packs of Ensure daily can significantly improve a worker ration. 2 and more packs could serve as a real complete and balanced lunch (>or=780 kcal). Also Ensure is easy to store and to deliver in distant places of work and can be recommended for use as a convenient, complete and balanced nutrition on work. PMID:24000730

  7. Nutritional assessment in the critically ill.

    PubMed

    Manning, E M; Shenkin, A

    1995-07-01

    these methods are validated extensively in the critically ill as well as in more stable patients, not only in terms of analytical accuracy, but also to define the point at which altered body composition influences clinical outcome. The biochemical measurement of levels of vitamins, minerals, and trace elements is invaluable in demonstrating specific deficiencies associated with disease and assessing whether long-term nutritional support is adequate. Such measurements rarely are necessary to make the initial clinical decision to give nutritional support, however. The most widely used measures of nutritional state are nitrogen balance and secretory protein concentrations, and these indices improve when sick patients recover.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:7552973

  8. Position of the academy of nutrition and dietetics: nutrition security in developing nations: sustainable food, water, and health.

    PubMed

    Nordin, Stacia M; Boyle, Marie; Kemmer, Teresa M

    2013-04-01

    It is the position of the Academy of Nutrition and Dietetics that all people should have consistent access to an appropriately nutritious diet of food and water, coupled with a sanitary environment, adequate health services, and care that ensure a healthy and active life for all household members. The Academy supports policies, systems, programs, and practices that work with developing nations to achieve nutrition security and self-sufficiency while being environmentally and economically sustainable. For nations to achieve nutrition security, all people must have access to a variety of nutritious foods and potable drinking water; knowledge, resources, and skills for healthy living; prevention, treatment, and care for diseases affecting nutrition status; and safety-net systems during crisis situations, such as natural disasters or deleterious social and political systems. More than 2 billion people are micronutrient deficient; 1.5 billion people are overweight or obese; 870 million people have inadequate food energy intake; and 783 million people lack potable drinking water. Adequate nutrient intake is a concern, independent of weight status. Although this article focuses on nutritional deficiencies in developing nations, global solutions for excesses and deficiencies need to be addressed. In an effort to achieve nutrition security, lifestyles, policies, and systems (eg, food, water, health, energy, education/knowledge, and economic) contributing to sustainable resource use, environmental management, health promotion, economic stability, and positive social environments are required. Food and nutrition practitioners can get involved in promoting and implementing effective and sustainable policies, systems, programs, and practices that support individual, community, and national efforts.

  9. Nutrition in dialysis patients.

    PubMed

    Sen, D; Prakash, J

    2000-07-01

    Malnutrition is a common clinical problem in dialysis patients, which is multifactorial in origin. It is most often found in a patient of chronic renal failure (CRF) during the period when the glomerular filtration rate (GFR) falls below 10 ml/min, but dialysis is yet to be started. The loss of proteins, aminoacids and other essential nutrients during the procedure of dialysis may further aggravate the malnutrition. Poor nutrition in dialysis patients is associated with increased morbidity and mortality in the form of delayed wound healing, malaise, fatigue, increased susceptibility to infection and poor rehabilitation. In view of the above consequences, all patients on dialysis must undergo nutritional assessment. It is very vital to maintain good nutritional status in-patients on dialysis by adequate protein and calories intake, appropriate supplementation of iron, calcium, minerals and water-soluble vitamins and, of course, the supplementation should be individualised. Nutritional needs are enhanced in presence of stresses like infection or surgery to limit excessive tissue catabolism and therefore, these are the situations, which demand intensive nutrition therapy. Total parenteral nutrition (TPN) may be required for patients on dialysis in intensive care unit, using a central venous catheter. However, enteral route is always preferred to parenteral ones, whenever possible. Even after adequate dialysis has been given, dietary counselling is often required for both hemodialysis and peritoneal dialysis patients to ensure that they ingest the recommended amount of protein, calories and essential micronutrients.

  10. Nutrition in dialysis patients.

    PubMed

    Sen, D; Prakash, J

    2000-07-01

    Malnutrition is a common clinical problem in dialysis patients, which is multifactorial in origin. It is most often found in a patient of chronic renal failure (CRF) during the period when the glomerular filtration rate (GFR) falls below 10 ml/min, but dialysis is yet to be started. The loss of proteins, aminoacids and other essential nutrients during the procedure of dialysis may further aggravate the malnutrition. Poor nutrition in dialysis patients is associated with increased morbidity and mortality in the form of delayed wound healing, malaise, fatigue, increased susceptibility to infection and poor rehabilitation. In view of the above consequences, all patients on dialysis must undergo nutritional assessment. It is very vital to maintain good nutritional status in-patients on dialysis by adequate protein and calories intake, appropriate supplementation of iron, calcium, minerals and water-soluble vitamins and, of course, the supplementation should be individualised. Nutritional needs are enhanced in presence of stresses like infection or surgery to limit excessive tissue catabolism and therefore, these are the situations, which demand intensive nutrition therapy. Total parenteral nutrition (TPN) may be required for patients on dialysis in intensive care unit, using a central venous catheter. However, enteral route is always preferred to parenteral ones, whenever possible. Even after adequate dialysis has been given, dietary counselling is often required for both hemodialysis and peritoneal dialysis patients to ensure that they ingest the recommended amount of protein, calories and essential micronutrients. PMID:11273510

  11. Nutrition in Cancer.

    PubMed

    Ravasco, Paula

    2015-01-01

    In cancer patients, oral nutrition is the preferred route of feeding since it is a significant part of the patient's daily routine and contributes to the patient's autonomy. It represents a privileged time to spend with family and friends, avoiding the tendency for isolation in these patients. The acknowledgement that the prescribed diet is individualized, adapted and adequate to individual needs empowers the patient with a feeling of control, and thus it is also a highly effective approach of psychological modulation. All these factors may potentially contribute to improve the patient's quality of life and may modulate treatment morbidity. The referral to a nutrition professional responsible for the individualized dietary counseling should always be based on evidence-based decision-making plans. The implementation of individualized nutritional counseling should consider the common causes for a poor nutritional intake in elderly cancer patients. A proper approach through counseling requires professionals with specific experience in both nutrition and oncology. Oral nutritional supplements are a simple and practical way to meet nutritional requirements when normal food intake is compromised. Ideally, oral nutritional supplements should be in addition to and not instead of meals. Supplements should be administered at a time which does not interfere with the appetite of the patient. The administration after the meal theoretically potentiates the anabolic effect on protein metabolism. Supplements with high energy density (>1 kcal/ml) or enriched with ω-3 fatty acid are probably the most effective. PMID:26544599

  12. [Nutrition in the critically ill].

    PubMed

    Weimann, A; Andrä, J; Sablotzki, A

    2011-11-01

    The prognostic impact of inadequate energy and protein supply in malnourished intensive care patients has been recently reemphasized. Consent exists about the beneficial effects of early enteral nutrition in the critically ill. However, gastrointestinal intolerance of the critically ill may be a major problem for the feasibility of enteral nutrition bearing additional risks. In case adequate enteral nutrition cannot be realized, there is controversy about the appropriate time to start total parenteral or combined enteral / parenteral nutrition. Due to potential adverse effects immune-enhancing substrates have to be cautiously administered. For standardization implementation of a guideline based nutritional protocol is recommended. The review refers to the recent guidelines of the European Society for Clinical Nutrition and Metabolism (2009), the American Society for Parenteral and Enteral Nutrition (ASPEN) (2009) and the German Sepsis Society (DSG) (2010).

  13. Social protection to support vulnerable children and families: the potential of cash transfers to protect education, health and nutrition

    PubMed Central

    Adato, M.; Bassett, L.

    2009-01-01

    Investing in social protection in sub-Saharan Africa has taken on a new urgency as HIVand AIDS interact with other drivers of poverty to simultaneously destabilise livelihoods systems and family and community safety nets. Cash transfer programmes already reach millions of people in South Africa, and in other countries in southern and East Africa plans are underway to reach tens and eventually hundreds of thousands more. Cash transfers worldwide have demonstrated large impacts on the education, health and nutrition of children. While the strongest evidence is from conditional cash transfer evaluations in Latin America and Asia, important results are emerging in the newer African programmes. Cash transfers can be implemented in conjunction with other services involving education, health, nutrition, social welfare and others, including those related to HIV and AIDS. HIV/ AIDS-affected families are diverse with respect to household structure, ability to work and access to assets, arguing for a mix of approaches, including food assistance and income-generation programmes. However, cash transfers appear to offer the best strategy for scaling up to a national system of social protection, by reaching families who are the most capacity constrained, in large numbers, relatively quickly. These are important considerations for communities hard-hit by HIV and AIDS, given the extent and nature of deprivation, the long-term risk to human capital and the current political willingness to act. PMID:22380980

  14. Social protection to support vulnerable children and families: the potential of cash transfers to protect education, health and nutrition.

    PubMed

    Adato, M; Bassett, L

    2009-01-01

    Investing in social protection in sub-Saharan Africa has taken on a new urgency as HIV and AIDS interact with other drivers of poverty to simultaneously destabilise livelihoods systems and family and community safety nets. Cash transfer programmes already reach millions of people in South Africa, and in other countries in southern and East Africa plans are underway to reach tens and eventually hundreds of thousands more. Cash transfers worldwide have demonstrated large impacts on the education, health and nutrition of children. While the strongest evidence is from conditional cash transfer evaluations in Latin America and Asia, important results are emerging in the newer African programmes. Cash transfers can be implemented in conjunction with other services involving education, health, nutrition, social welfare and others, including those related to HIV and AIDS. HIV/AIDS-affected families are diverse with respect to household structure, ability to work and access to assets, arguing for a mix of approaches, including food assistance and income-generation programmes. However, cash transfers appear to offer the best strategy for scaling up to a national system of social protection, by reaching families who are the most capacity constrained, in large numbers, relatively quickly. These are important considerations for communities hard-hit by HIV and AIDS, given the extent and nature of deprivation, the long-term risk to human capital and the current political willingness to act.

  15. Plant diversity to support humans in a CELSS ground based demonstrator

    NASA Technical Reports Server (NTRS)

    Howe, J. M.; Hoff, J. E.

    1981-01-01

    A controlled ecological life support system (CELSS) for human habitation in preparation for future long duration space flights is considered. The success of such a system depends upon the feasibility of revitalization of food resources and the human nutritional needs which are to be met by these food resources. Edible higher plants are prime candidates for the photoautotrophic components of this system if nutritionally adequate diets can be derived from these plant sources to support humans. Human nutritional requirements information based on current knowledge are developed for inhabitants envisioned in the CELSS ground based demonstrator. Groups of plant products that can provide the nutrients are identified.

  16. Nutrition in acute pancreatitis.

    PubMed

    Nompleggi, D J

    1999-08-01

    Pancreatitis is a common disorder. Numerous factors have been implicated in the pathogenesis of acute and chronic pancreatitis, but the exact mechanisms of these conditions are still poorly understood. Depending on the cause of the disorder, patients who have pancreatitis are usually not malnourished and are able to eat within 5 to 7 days of disease onset. In these patients, nutritional support is unnecessary. However, severe disease induces a catabolic state similar to that seen in trauma and sepsis, resulting in rapid weight loss and increased morbidity and mortality. Thus, vigorous nutritional support may be useful in the treatment of severe pancreatitis. Studies have shown that parenteral and enteral nutritional support are well tolerated and can maintain or improve nutritional status in patients with pancreatitis. This article reviews nutritional assessment and therapy in pancreatitis.

  17. Nutritional Hormesis and Aging

    PubMed Central

    Hayes, Daniel P.

    2009-01-01

    Nutritional hormesis has the potential to serve as a pro-healthy aging intervention by reducing the susceptibility of the elderly to various chronic degenerative diseases and thereby extending human healthspan. Supportive evidence for nutritional hormesis arising from essential nutrients (vitamins and minerals), dietary pesticides (natural and synthetic), dioxin and other herbicides, and acrylamide will be reviewed and discussed. PMID:20221283

  18. Nutrition and Osteoporosis: Preliminary data of Campania Region of European PERsonalised ICT Supported Service for Independent Living and Active Ageing

    PubMed Central

    Vuolo, L.; Barrea, L.; Savanelli, MC; Savastano, S.; Rubino, M.; Scarano, E.; Soprano, M.; Illario, M.; Colao, A.; Di Somma, C.

    2015-01-01

    Background: Bone impairment and malnutrition are associated with significant disability and mortality. PERSSILAA is an European project developing health services to detect and prevent frailty in older adults by addressing cognitive, physical and nutritional. Methods: Subjects underwent anthropometric measurements, calcaneal quantitative ultrasound (QUS) scan and PREDIMED (PREvención con DIeta MEDiterránea) questionnaire. Aim: To investigate the association between adherence to the Mediterranean Diet (MD) and bone health. Results: 87 subjects (4 males and 83 females) 70.1±4.9 aged, were examined. Mean Body Mass Index (BMI) was 28.7±4.7(kg/m2): in particular 28 subjects (32.2%) resulted obese, 42 (48.3%) overweight, and only 17 (19.5%) with normal weight. Mean T score was −1.2±1.2: in particular 13 subjects (14.9%) resulted osteoporotic; 43 (49.5%) osteopenic; and 31 (35.6%) with normal bone mineral density. Regarding adherence to MD, 9 subjects (10.3%) were poorly adherent; 41 (47.2%) average adherent; 37 (42.5%) highly adherent. T-score was associated with PREDIMED score and osteoporotic subjects presented the lowest PREDIMED score (5.8±2.2). Conclusions: These preliminary data show a significant correlation between the adherence to the MD and bone health parameters. The association between MD and bone health highlights the potential beneficial effects of nutritional interventions promoting a Mediterranean food pattern, as safe adjuvant treatment in ageing. PMID:27042428

  19. Nutrition in dialysis patients.

    PubMed

    Sharma, R K; Sahu, K M

    2001-04-01

    Adequate nutrition is very important for dialysis patients for a better overall outcome. Protein energy malnutrition is highly prevalent (25-50%) among dialysis patients and is associated with increased morbidity and mortality. Causes of malnutrition in dialysis patients include anorexia (inadequate calorie or protein intake), metabolic acidosis (stimulation of amino acid and protein degradation), and infection/inflammation (stimulation of protein degradation). Anorexia resulting into decreased intake is probably the most important factor. Nutritional assessment can be done by anthropometric measurements, laboratory parameters, subjective global assessment, dialysis malnutrition score, near infra-red interactance and other methods. Subjective global assessment is currently the most accepted one and classifies patients into three nutritional categories: Well nourished, moderately malnourished, and severely malnourished. Prevention of malnutrition by proper dietary counselling and adequate dietary intake starting from redialysis days is probably the most effective therapeutic approach. Other therapeutic approaches include adequate dialysis delivery, avoidance of acidaemia, aggressive treatment of catabolic illnesses and food supplements: Oral, enteral or parenteral, particulary intradialytic parenteral nutrition. Experimental approaches for treatment of malnutrition in dialysis patients include amino acids in peritoneal or haemodialysate, appetite stimulants and use of recombinant human growth hormone and insulin like growth factor I. There are few randomised controlled trials unequivocally proving the efficacy of any treatment modality. Large scale, randomised trials are urgently needed to establish effective therapy for malnutrition in dialysis patients. This applies more so for Indian patients.

  20. The Role of Nutrition in Frailty: An Overview.

    PubMed

    Goisser, S; Guyonnet, S; Volkert, D

    2016-01-01

    Inadequate nutritional intake is an important modifiable risk factor for frailty. Existing evidence supports the importance of adequate dietary quantity and especially quality to ensure sufficient intakes of energy, protein and micronutrients. However, to date no nutritional intervention or supplementation concept has emerged as being effective for the prevention or treatment of frailty. Further research, including specifically the group of frail older persons and those at risk of frailty, and focussing on functional benefits as an outcome, is needed to allow definite recommendations for optimal diet, i.e. food and nutrient intakes, for this population. This article aims to give a short overview on current knowledge concerning the role of nutrition for the prevention and treatment of frailty, while providing readers with references giving an overview for further reading. PMID:27224496

  1. A Chartless Record—Is It Adequate?

    PubMed Central

    Stead, W.W.; Hammond, W.E.; Straube, M.J.

    1982-01-01

    The computerized medical record supported by The Medical Record (TMR) has been the only record of physician patient encounters on the nephrology service of the Durham Veteran's Administration Medical Center since April 1981. Physicians using the system evaluated the adequacy of the computerized record as a replacement for the paper chart. The computerized record was able to capture and display all pertinent data. Manual or computerized narratives provided a useful supplement to the core computerized record only in those rare instances that a physician needed to point out which of the data in the record were important to his decision making.

  2. Nutrition and Dementia: Evidence for Preventive Approaches?

    PubMed Central

    Canevelli, Marco; Lucchini, Flaminia; Quarata, Federica; Bruno, Giuseppe; Cesari, Matteo

    2016-01-01

    In recent years, the possibility of favorably influencing the cognitive trajectory through promotion of lifestyle modifications has been increasingly investigated. In particular, the relationship between nutritional habits and cognitive health has attracted special attention. The present review is designed to retrieve and discuss recent evidence (published over the last 3 years) coming from randomized controlled trials (RCTs) investigating the efficacy of nutritional interventions aimed at improving cognitive functioning and/or preventing cognitive decline in non-demented older individuals. A systematic review of literature was conducted, leading to the identification of 11 studies of interest. Overall, most of the nutritional interventions tested by the selected RCTs were found to produce statistically significant cognitive benefits (defined as improved neuropsychological test scores). Nevertheless, the clinical meaningfulness of such findings was not adequately discussed and appears controversial. In parallel, only 2 studies investigated between-group differences concerning incident dementia and mild cognitive impairment cases, reporting conflicting results. Results of the present review suggest that several dietary patterns and nutritional components may constitute promising strategies in postponing, slowing, and preventing cognitive decline. However, supporting evidence is overall weak and further studies are needed. PMID:26959055

  3. [Management of clinical nutrition].

    PubMed

    Martín Folgueras, Tomás

    2015-05-07

    Proper management of Clinical Nutrition requires careful planning of the resources required to delineate the activities to be performed by each of the participants and consider the need for continued evaluation of the results to improve. Units of Nutrition and Nutritional Support Teams must have a multidisciplinary composition, incorporating professionals with training and experience in Clinical Nutrition. Whenever conditions permit and activity of each center indicates, the staff's dedication to nutrition must be complete. The organization of processes and use of clinical practice protocols facilitates the monitoring of the activities carried out by teams of Nutrition. Each stage of a process has quality criteria based on scientific knowledge, and some key objectives whose degree of achievement can be measured by monitoring quality indicators and their comparison with standards. Successive cycles of measurement indicators, evaluation and corrective interventions lead to continuous process improvement.

  4. The Federal Government and Nutrition.

    ERIC Educational Resources Information Center

    Powers, Margaret A.

    1980-01-01

    Both the Department of Agriculture and the Department of Health and Human Services conduct research related to food and human nutrition. Several federal programs supporting nutrition research and education are reviewed. Footnotes provide addresses and ways to obtain more detailed information about nutrition related programs. (JN)

  5. Parenteral nutrition.

    PubMed

    Thibault, Ronan; Pichard, Claude

    2013-01-01

    Parenteral nutrition (PN) is a technique of nutritional support, which consists of intravenous administration of macronutrients (glucose, amino acids, and triglycerides), micronutrients (vitamins and trace elements), water, and electrolytes. Early studies indicate that the use of total PN was associated with increased mortality and infectious morbidity. These detrimental effects of PN were related to hyperglycemia and overfeeding at a period when PN was administered according to the principle that the higher calories the patients received, the better their outcome would be. Enteral nutrition (EN) then replaced PN as the gold standard of nutritional care in the intensive care unit (ICU). However, EN alone is frequently associated with insufficient energy coverage, and subsequent protein-energy deficit is correlated with a worse clinical outcome. Infectious and metabolic complications of PN could be prevented if PN is used by a trained team using a validated protocol, only when indicated, not within the first 2 days following ICU admission, and limited through the time. In addition, energy delivery has to be matched to the energy target, and adapted glucose control should be obtained. In patients with significant energy deficit (>40%), the combination of PN and EN, i.e. supplemental PN, from day 4 of the ICU stay, could improve the clinical outcome of ICU patients as compared with EN alone. Therefore, PN should be integrated in the management of ICU patients with the aim of prevent the worsening of energy deficits, allowing the preservation of lean body mass loss, and reducing the risk of undernutrition-related complications. PMID:23075587

  6. Military nutrition: maintaining health and rebuilding injured tissue

    PubMed Central

    Hill, Neil; Fallowfield, Joanne; Price, Susan; Wilson, Duncan

    2011-01-01

    Food and nutrition are fundamental to military capability. Historical examples demonstrate that a failure to supply adequate nutrition to armies inevitably leads to disaster; however, innovative measures to overcome difficulties in feeding reap benefits, and save lives. In barracks, UK Armed Forces are currently fed according to the relatively new Pay As You Dine policy, which has attracted criticism from some quarters. The recently introduced Multi-Climate Ration has been developed specifically to deal with issues arising from Iraq and the current conflict in Afghanistan. Severely wounded military personnel are likely to lose a significant amount of their muscle mass, in spite of the best medical care. Nutritional support is unable to prevent this, but can ameliorate the effects of the catabolic process. Measuring and quantifying nutritional status during critical illness is difficult. A consensus is beginning to emerge from studies investigating the effects of nutritional interventions on how, what and when to feed patients with critical illness. The Ministry of Defence is currently undertaking research to address specific concerns related to nutrition as well as seeking to promote healthy eating in military personnel. PMID:21149358

  7. Nutrition in the management of cirrhosis and its neurological complications.

    PubMed

    Bémeur, Chantal; Butterworth, Roger F

    2014-06-01

    Malnutrition is a common feature of chronic liver diseases that is often associated with a poor prognosis including worsening of clinical outcome, neuropsychiatric complications as well as outcome following liver transplantation. Nutritional assessment in patients with cirrhosis is challenging owing to confounding factors related to liver failure. The objectives of nutritional intervention in cirrhotic patients are the support of liver regeneration, the prevention or correction of specific nutritional deficiencies and the prevention and/or treatment of the complications of liver disease per se and of liver transplantation. Nutritional recommendations target the optimal supply of adequate substrates related to requirements linked to energy, protein, carbohydrates, lipids, vitamins and minerals. Some issues relating to malnutrition in chronic liver disease remain to be addressed including the development of an appropriate well-validated nutritional assessment tool, the identification of mechanistic targets or therapy for sarcopenia, the development of nutritional recommendations for obese cirrhotic patients and liver-transplant recipients and the elucidation of the roles of vitamin A hepatotoxicity, as well as the impact of deficiencies in riboflavin and zinc on clinical outcomes. Early identification and treatment of malnutrition in chronic liver disease has the potential to lead to better disease outcome as well as prevention of the complications of chronic liver disease and improved transplant outcomes.

  8. Characteristics of mineral nutrition of plants in the bio-technical life support system with human wastes included in mass exchange

    NASA Astrophysics Data System (ADS)

    Tikhomirova, Natalia; Ushakova, Sofya; Kalacheva, Galina; Tikhomirov, Alexander

    2016-09-01

    The study addresses the effectiveness of using ion exchange substrates (IES) to optimize mineral nutrition of plants grown in the nutrient solutions containing oxidized human wastes for application in bio-technical life support systems. The study shows that the addition of IES to the root-inhabited substrate is favorable for the growth of wheat vegetative organs but causes a decrease in the grain yield. By contrast, the addition of IES to the nutrient solution does not influence the growth of vegetative organs but favors normal development of wheat reproductive organs. Thus, to choose the proper method of adjusting the solution with IES, one should take into account specific parameters of plant growth and development and the possibility of multiple recycling of IES based on the liquid products of mineralization of human wastes.

  9. Eating‐related distress and need for nutritional support of families of advanced cancer patients: a nationwide survey of bereaved family members

    PubMed Central

    Maeda, Isseki; Morita, Tatsuya; Okajima, Yoshiro; Hama, Takashi; Aoyama, Maho; Kizawa, Yoshiyuki; Tsuneto, Satoru; Shima, Yasuo; Miyashita, Mitsunori

    2016-01-01

    Abstract Background A number of advanced cancer patients are suffering from physical and psychosocial burdens because of cancer cachexia, and these burdens also greatly impact on their family members and relationships between patients and family members. It is necessary to consider the psychosocial impact of cancer cachexia on family members of advanced cancer patients. Methods A cross‐sectional anonymous nationwide survey was conducted involving 925 bereaved family members of cancer patients who had been admitted to 133 inpatient hospices throughout Japan. Results A total of 702 bereaved family members returned the questionnaires (response rate, 75.9%). Concerning eating‐related distress, ‘I served what the patient wanted without consideration of calories and nutritional composition’ was highest (75.1%), and ‘I tried making many kinds of meals for the patient’ and ‘I was concerned about planning meals for the patient every day’ followed (63.0% and 59.4%, respectively). The top 5 of the 19 items were categorized as ‘fighting back’. Need for nutritional support was high (72.2%), and need for explanations about the reasons for anorexia and weight loss of patients was moderate (41.4%). Explanatory factor analysis of eating‐related distress identified the following four domains: (factor 1) feeling that family members forced the patient to eat to avoid death, (factor 2) feeling that family members made great efforts to help the patient eat, (factor 3) feeling that eating was a cause of conflicts between the patient and family members, and (factor 4) feeling that correct information was insufficient. Results of multiple logistic regression analysis showed that spouse, fair/poor mental status, factors 1, and 4 were identified as independent determinants of major depression {odds ratio [OR] 3.27 [95% confidence interval (CI) 1.24–8.60], P = 0.02; OR 4.50 [95% CI 2.46–8.25], P < 0.001; OR 2.51 [95% CI 1.16–5.45], P = 0.02; OR 2.33 [95

  10. Nutrition in cachexia: from bench to bedside.

    PubMed

    Konishi, Masaaki; Ishida, Junichi; von Haehling, Stephan; Anker, Stefan D; Springer, Jochen

    2016-05-01

    As malnutrition is often present in cachexia, nutritional intervention has been one of the widely accepted strategies. A literature review of cachexia models with dietary interventions in the present issue of this journal pointed out that the majority of nutrient intervention studies were of n-3 fatty acid, mainly eicosapentaenoic acid and docosahexaenoic acid. Effect on protein catabolism and anti-inflammation are most pronounced benefits of n-3 fatty acid. The effectiveness of n-3 fatty acid may depend on control diet or even be attributed to the polyunsaturated fatty acid deficiency inadvertently produced in control group. However, there is not enough clinical evidence to support a benefit of n-3 fatty acid substitution in patients with cachexia. The second important result from this review is that the majority of studies did not provide information about dietary design or did not standardize design, content, source, and overall composition. To guide dietary design for researchers in preclinical studies, a model has been proposed in this review, which may be useful to predict the efficacy of new dietary intervention in cachexia science. From a clinical point of view, the limited effectiveness of nutritional support in cachexia may partly be explained by the multifactorial nature of this condition. Cachexia differs from malnutrition inasmuch as malnutrition can be reversed by adequate nutrition and/or by overcoming problems of absorption or utilization of nutrients, but cachexia cannot be successfully treated by nutrition alone. Multidisciplinary approach including the assessment and intervention in feeding, appetite, swallowing, exercise, psychosocial, and psychological issue may be needed to improve nutrition in patients with cachexia.

  11. Nutrition in cachexia: from bench to bedside.

    PubMed

    Konishi, Masaaki; Ishida, Junichi; von Haehling, Stephan; Anker, Stefan D; Springer, Jochen

    2016-05-01

    As malnutrition is often present in cachexia, nutritional intervention has been one of the widely accepted strategies. A literature review of cachexia models with dietary interventions in the present issue of this journal pointed out that the majority of nutrient intervention studies were of n-3 fatty acid, mainly eicosapentaenoic acid and docosahexaenoic acid. Effect on protein catabolism and anti-inflammation are most pronounced benefits of n-3 fatty acid. The effectiveness of n-3 fatty acid may depend on control diet or even be attributed to the polyunsaturated fatty acid deficiency inadvertently produced in control group. However, there is not enough clinical evidence to support a benefit of n-3 fatty acid substitution in patients with cachexia. The second important result from this review is that the majority of studies did not provide information about dietary design or did not standardize design, content, source, and overall composition. To guide dietary design for researchers in preclinical studies, a model has been proposed in this review, which may be useful to predict the efficacy of new dietary intervention in cachexia science. From a clinical point of view, the limited effectiveness of nutritional support in cachexia may partly be explained by the multifactorial nature of this condition. Cachexia differs from malnutrition inasmuch as malnutrition can be reversed by adequate nutrition and/or by overcoming problems of absorption or utilization of nutrients, but cachexia cannot be successfully treated by nutrition alone. Multidisciplinary approach including the assessment and intervention in feeding, appetite, swallowing, exercise, psychosocial, and psychological issue may be needed to improve nutrition in patients with cachexia. PMID:27030816

  12. Nutrition and nutritional issues for dancers.

    PubMed

    Sousa, Mónica; Carvalho, Pedro; Moreira, Pedro; Teixeira, Vítor H

    2013-09-01

    Proper nutrition, not simply adequate energetic intake, is needed to achieve optimal dance performance. However, little scientific research exists concerning nutrition in dance, and so, to propose nutritional guidelines for this field, recommendations need to be based mainly on studies done in other physically active groups. To diminish the risk of energy imbalance and associated disorders, dancers must consume at least 30 kcal/kg fat-free mass/day, plus the training energy expenditure. For macronutrients, a daily intake of 3 to 5 g carbohydrates/kg, 1.2 to 1.7 g protein/kg, and 20 to 35% of energy intake from fat can be recommended. Dancers may be at increased risk of poor micronutrient status due to their restricted energy intake; micronutrients that deserve concern are iron, calcium, and vitamin D. During training, dancers should give special attention to fluid and carbohydrate intake in order to maintain optimal cognition, motivation, and motor skill performance. For competition/stage performance preparation, it is also important to ensure that an adequate dietary intake is being achieved. Nutritional supplements that may help in achieving specific nutritional goals when dietary intake is inadequate include multivitamins and mineral, iron, calcium, and vitamin D supplements, sports drinks, sports bars, and liquid meal supplements. Caffeine can also be used as an ergogenic aid. It is important that dancers seek dietary advice from qualified specialists, since the pressure to maintain a low body weight and low body fat levels is high, especially in styles as ballet, and this can lead to an unbalanced diet and health problems if not correctly supervised.

  13. Advances in clinical nutrition in GI surgery.

    PubMed

    Holst, Mette; Rasmussen, Henrik H; Irtun, Oivind

    2015-04-01

    This review addresses recent relevant advances to clinical nutrition regarding gastrointestinal disease surgery. Medline Ovid, EMBASE and Central were searched systematically in April 2014. Inclusion criteria were randomized controlled trials, non-randomized controlled trials and observational studies evaluating nutritional support in gastrointestinal surgery published within 5 years. The review included 56 relevant studies. Themes were: nutrition screening and risk factors predict outcome; preoperative nutritional support; shortening fasting periods and including carbohydrate solutions; early nutrition after surgery; immune modulating nutrition; synbiotics, growth hormone, omega-3 and oral, enteral and parenteral nutrition in combination. Screening for nutritional risk is profound, with special focus on dietary intake in the past week. Age and severity of disease need to be included in the screening system. Patients at severe nutritional risk benefit from nutritional therapy before surgery. New standards are developing quickly and clinical guidelines on surgery should include updated knowledge within clinical nutrition.

  14. L-carnitine-supplemented parenteral nutrition improves fat metabolism but fails to support compensatory growth in premature Korean infants.

    PubMed

    Seong, So-Hui; Cho, Soo-Chul; Park, Yongsoon; Cha, Youn-Soo

    2010-04-01

    We have previously shown that pregnant Korean mothers often have especially poor carnitine status, which may be responsible for the suboptimal carnitine levels of newborn Korean infants. This study tested the hypothesis that carnitine obtained from premature infant formula alone is adequate in sustaining optimal lipid metabolism and growth in premature infants. Accordingly, we investigated the effects of parenteral carnitine supplementation on carnitine status, growth parameters, and lipid metabolism in premature infants by measuring serum lipid profiles, carnitine and beta-hydroxybutyrate concentrations, and body weight, size, and length. Twenty-five low-birth weight Korean infants were randomly assigned to control (LCNS, n = 12) or L-carnitine-supplemented (10 mg/[kg d], LCS, n = 13) groups. On day 9, the triacylglycerol concentration was lower in the LCS group; but the high-density lipoprotein cholesterol concentration and free, acyl, and total carnitine and beta-hydroxybutyrate were significantly increased compared with the LCNS group. The ratio of acyl carnitine to free carnitine was significantly lower on day 5 in the LCS compared with the LCNS group. Body weight, height, Apgar score (1 and 5 minute), head circumference, and chest circumference were recorded on day 0; and body weight was measured again on days 5 and 9. Infant formula intake was recorded every day. There was no significant difference in body weight or growth parameters between the groups from days 0 to 9.Therefore, we concluded that, in low-birth weight infants, the addition of 10 mg/(kg d) supplemental carnitine significantly improves lipid profiles and serum carnitine level but does not enhance growth. PMID:20534325

  15. The Extent and Nature of Need for Mealtime Support among Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Ball, S. L.; Panter, S. G.; Redley, M.; Proctor, C.-A.; Byrne, K.; Clare, I. C. H.; Holland, A. J.

    2012-01-01

    Background: For many adults with an intellectual disability (ID), mealtimes carry significant health risks. While research and allied clinical guidance has focused mainly on dysphagia, adults with a range of physical and behavioural difficulties require mealtime support to ensure safety and adequate nutrition. The extent of need for and nature of…

  16. Nutrition competencies in health professionals' education and training: a new paradigm.

    PubMed

    Kris-Etherton, Penny M; Akabas, Sharon R; Douglas, Pauline; Kohlmeier, Martin; Laur, Celia; Lenders, Carine M; Levy, Matthew D; Nowson, Caryl; Ray, Sumantra; Pratt, Charlotte A; Seidner, Douglas L; Saltzman, Edward

    2015-01-01

    Most health care professionals are not adequately trained to address diet and nutrition-related issues with their patients, thus missing important opportunities to ameliorate chronic diseases and improve outcomes in acute illness. In this symposium, the speakers reviewed the status of nutrition education for health care professionals in the United States, United Kingdom, and Australia. Nutrition education is not required for educating and training physicians in many countries. Nutrition education for the spectrum of health care professionals is uncoordinated, which runs contrary to the current theme of interprofessional education. The central role of competencies in guiding medical education was emphasized and the urgent need to establish competencies in nutrition-related patient care was presented. The importance of additional strategies to improve nutrition education of health care professionals was highlighted. Public health legislation such as the Patient Protection and Affordable Care Act recognizes the role of nutrition, however, to capitalize on this increasing momentum, health care professionals must be trained to deliver needed services. Thus, there is a pressing need to garner support from stakeholders to achieve this goal. Promoting a research agenda that provides outcome-based evidence on individual and public health levels is needed to improve and sustain effective interprofessional nutrition education.

  17. Nutrition Competencies in Health Professionals’ Education and Training: A New Paradigm123

    PubMed Central

    Kris-Etherton, Penny M; Akabas, Sharon R; Douglas, Pauline; Kohlmeier, Martin; Laur, Celia; Lenders, Carine M; Levy, Matthew D; Nowson, Caryl; Ray, Sumantra; Pratt, Charlotte A; Seidner, Douglas L; Saltzman, Edward

    2015-01-01

    Most health care professionals are not adequately trained to address diet and nutrition-related issues with their patients, thus missing important opportunities to ameliorate chronic diseases and improve outcomes in acute illness. In this symposium, the speakers reviewed the status of nutrition education for health care professionals in the United States, United Kingdom, and Australia. Nutrition education is not required for educating and training physicians in many countries. Nutrition education for the spectrum of health care professionals is uncoordinated, which runs contrary to the current theme of interprofessional education. The central role of competencies in guiding medical education was emphasized and the urgent need to establish competencies in nutrition-related patient care was presented. The importance of additional strategies to improve nutrition education of health care professionals was highlighted. Public health legislation such as the Patient Protection and Affordable Care Act recognizes the role of nutrition, however, to capitalize on this increasing momentum, health care professionals must be trained to deliver needed services. Thus, there is a pressing need to garner support from stakeholders to achieve this goal. Promoting a research agenda that provides outcome-based evidence on individual and public health levels is needed to improve and sustain effective interprofessional nutrition education. PMID:25593146

  18. 45 CFR 1328.15 - Nutrition services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Nutrition services. 1328.15 Section 1328.15 Public... SUPPORTIVE AND NUTRITIONAL SERVICES TO OLDER HAWAIIAN NATIVES § 1328.15 Nutrition services. (a) In addition to providing nutrition services to older Hawaiian Natives, a grantee may: (1) Provide...

  19. Nutrition and the eye.

    PubMed

    Congdon, N G; West, K P

    1999-12-01

    The topic "nutrition and the eye" cannot adequately be covered in a single review article; indeed, dozens of books and hundreds of articles have been written on the subject. This review concentrates on three areas in which specific nutrients are known or theorized to have a major impact on vision and the visual system: vitamin A deficiency; antioxidants and their proposed role in the prevention of age-related cataract and macular degeneration; and nutritional optic neuropathies, including those of the recent Cuban epidemic. In addition, this article touches on nutritional treatments that have been suggested for several less common eye diseases and, finally, considers several less prevalent conditions in which deficiency of or excess exposure to a particular nutrient has been associated with ocular pathology. PMID:10662253

  20. Improved growth and clinical, nutritional, and respiratory changes in response to nutritional therapy in cystic fibrosis.

    PubMed

    Shepherd, R; Cooksley, W G; Cooke, W D

    1980-09-01

    To investigate the role of nutritional factors in growth and in the clinical, nurtitional, and respiratory status in cystic fibrosis, we studied 12 problem CF patients from six months before to six months after a period of supplemental parenteral nutrition. During the initial six months' observation period on appropriate conventional therapy, the patients (aged 0.5 to 11 years) had inadequate growth and weight gain, a total of 21 active pulmonary infections, and, despite dietary supplements, inadequate ad libitum nutrient intakes. After nutritional therapy, providing a balanced consistent hypercaloric intake for 21 days, catch-up weight gain occurred by one month and continued at six months; catch-up in linear growth was observed by three months and continued at six months. In addition, significantly fewer pulmonary infections were observed in the six months' post-therapy (n = 3), sustained and significant improvements were noted in clinical score and plumonary function, and there was a marked improvement in well-being and ad libitum nutrient intake. We conclude that adequate nutritional support can favorably affect growth, clinical status, and the course of chronic pulmonary disease in problem cases of CF. PMID:6774070

  1. Improved growth and clinical, nutritional, and respiratory changes in response to nutritional therapy in cystic fibrosis.

    PubMed

    Shepherd, R; Cooksley, W G; Cooke, W D

    1980-09-01

    To investigate the role of nutritional factors in growth and in the clinical, nurtitional, and respiratory status in cystic fibrosis, we studied 12 problem CF patients from six months before to six months after a period of supplemental parenteral nutrition. During the initial six months' observation period on appropriate conventional therapy, the patients (aged 0.5 to 11 years) had inadequate growth and weight gain, a total of 21 active pulmonary infections, and, despite dietary supplements, inadequate ad libitum nutrient intakes. After nutritional therapy, providing a balanced consistent hypercaloric intake for 21 days, catch-up weight gain occurred by one month and continued at six months; catch-up in linear growth was observed by three months and continued at six months. In addition, significantly fewer pulmonary infections were observed in the six months' post-therapy (n = 3), sustained and significant improvements were noted in clinical score and plumonary function, and there was a marked improvement in well-being and ad libitum nutrient intake. We conclude that adequate nutritional support can favorably affect growth, clinical status, and the course of chronic pulmonary disease in problem cases of CF.

  2. [Perioperatory artificial nutrition].

    PubMed

    de Luis, D A; Aller, R; Izaola, O

    2008-06-01

    Malnutrition increases post surgical morbimortality, hospital stance and economical costs. Possibilities of nutritional intervention in surgical patients are important. Early enteral nutrition is better than total parenteral nutrition in patients under surgery. Periroperaoty nutritional support must be administrated to patients with severe or middle undernutrition and will be under surgery, during 7-14 days before surgical intervention, if this intervention could be delayed. Total parenteral nutrition will be not used regularly in patients under mayor digestive surgical procedures. Inmunonutrition has been demonstrated useful in surgical patients. Evidence demonstrates that inmunotritional formulas decrease incidence of infections, hospital stance and time of ventilation in patients in UCI wards. New research areas have been explored in this topic area, carbohydrate utility in presurgical patients and probiotic in enteral formulas.

  3. Nutrition for swimming.

    PubMed

    Shaw, Gregory; Boyd, Kevin T; Burke, Louise M; Koivisto, Anu

    2014-08-01

    Swimming is a sport that requires considerable training commitment to reach individual performance goals. Nutrition requirements are specific to the macrocycle, microcycle, and individual session. Swimmers should ensure suitable energy availability to support training while maintaining long term health. Carbohydrate intake, both over the day and in relation to a workout, should be manipulated (3-10 g/kg of body mass/day) according to the fuel demands of training and the varying importance of undertaking these sessions with high carbohydrate availability. Swimmers should aim to consume 0.3 g of high-biological-value protein per kilogram of body mass immediately after key sessions and at regular intervals throughout the day to promote tissue adaptation. A mixed diet consisting of a variety of nutrient-dense food choices should be sufficient to meet the micronutrient requirements of most swimmers. Specific dietary supplements may prove beneficial to swimmers in unique situations, but should be tried only with the support of trained professionals. All swimmers, particularly adolescent and youth swimmers, are encouraged to focus on a well-planned diet to maximize training performance, which ensures sufficient energy availability especially during periods of growth and development. Swimmers are encouraged to avoid rapid weight fluctuations; rather, optimal body composition should be achieved over longer periods by modest dietary modifications that improve their food choices. During periods of reduced energy expenditure (taper, injury, off season) swimmers are encouraged to match energy intake to requirement. Swimmers undertaking demanding competition programs should ensure suitable recovery practices are used to maintain adequate glycogen stores over the entirety of the competition period. PMID:24903758

  4. ENSURING ADEQUATE SAFETY WHEN USING HYDROGEN AS A FUEL

    SciTech Connect

    Coutts, D

    2007-01-22

    Demonstration projects using hydrogen as a fuel are becoming very common. Often these projects rely on project-specific risk evaluations to support project safety decisions. This is necessary because regulations, codes, and standards (hereafter referred to as standards) are just being developed. This paper will review some of the approaches being used in these evolving standards, and techniques which demonstration projects can implement to bridge the gap between current requirements and stakeholder desires. Many of the evolving standards for hydrogen-fuel use performance-based language, which establishes minimum performance and safety objectives, as compared with prescriptive-based language that prescribes specific design solutions. This is being done for several reasons including: (1) concern that establishing specific design solutions too early will stifle invention, (2) sparse performance data necessary to support selection of design approaches, and (3) a risk-adverse public which is unwilling to accept losses that were incurred in developing previous prescriptive design standards. The evolving standards often contain words such as: ''The manufacturer shall implement the measures and provide the information necessary to minimize the risk of endangering a person's safety or health''. This typically implies that the manufacturer or project manager must produce and document an acceptable level of risk. If accomplished using comprehensive and systematic process the demonstration project risk assessment can ease the transition to widespread commercialization. An approach to adequately evaluate and document the safety risk will be presented.

  5. Nutrition and behavior of lemurs.

    PubMed

    Junge, Randall E; Williams, Cathy V; Campbell, Jennifer

    2009-05-01

    Attention to nutritional and behavioral factors is important for appropriate care of lemurs in captivity. Although only a few species are commonly held in captivity, differences between them are important. Knowledge of feeding ecology and natural diet guide nutrition guidelines, as well as management and prevention of common nutrition-related disorders, including obesity, diabetes, and iron-storage disease. Behavioral characteristics that influence captive management are related to social organization, reproductive behavior, territoriality, and infant care. Housing animals in appropriate social groupings in adequately complex environments reduces abnormal behaviors, and addition of enrichment activities and operant conditioning encourages normal behaviors.

  6. Life Course Perspective: evidence for the role of nutrition.

    PubMed

    Herman, Dena R; Taylor Baer, Marion; Adams, Elizabeth; Cunningham-Sabo, Leslie; Duran, Nelida; Johnson, Donna B; Yakes, Elizabeth

    2014-02-01

    The "Life Course Perspective" proposes that environmental exposures, including biological, physical, social, and behavioral factors, as well as life experiences, throughout the entire life span, influence health outcomes in current and future generations. Nutrition, from preconception to adulthood, encompasses all of these factors and has the potential to positively or negatively shape the individual or population health trajectories and their intergenerational differences. This paper applies the T2E2 model (timing, timeline, equity and environment), developed by Fine and Kotelchuck, as an overlay to examine advances in nutritional science, as well as the complex associations between life stages, nutrients, nutrigenomics, and access to healthy foods, that support the life course perspective. Examples of the application of nutrition to each of the four constructs are provided, as well as a strong recommendation for inclusion of nutrition as a key focal point for all health professionals as they address solutions to optimize health outcomes, both domestically and internationally. The science of nutrition provides strong evidence to support the concepts of the life course perspective. These findings lend urgency to the need to improve population health across the life span and over generations by ensuring ready access to micronutrient-dense foods, opportunities to balance energy intake with adequate physical activity and the need for biological, social, physical, and macro-level environments that support critical phases of human development. Recommendations for the application of the life course perspective, with a focus on the emerging knowledge of nutritional science, are offered in an effort to improve current maternal and child health programs, policies, and service delivery.

  7. Nutrition Counter

    MedlinePlus

    ... Counter: A Reference For The Kidney Patient AAKP Nutrition Counter: A Reference For The Kidney Patient Buy ... Harum RD, CSR, LD Certified Specialist in Renal Nutrition, Miami, Florida Reviewed by: 2005 – Maria Karalis, MBA, ...

  8. Nutritional management of the patient with advanced cancer.

    PubMed

    Theologides, A

    1977-02-01

    Protein-calorie malnutrition, vitamin and other deficiencies, and weight loss frequently develop in cancer patients. Although there is no evidence that aggressive nutritional management prolongs survival, it may improve the quality of life. Efforts should be made to maintain adequate daily caloric intake with appropriate food selection and with control of complications interfering with nutrition. In selected patients, intravenous hyperalimentation can provide adequate nutrition during potentially effective chemotherapy or radiotherapy. Elemental diets also may be a source of complete or supplemental nutrition. Further experience with both approaches will help to clarify their role in the nutritional management of the patient with advanced cancer.

  9. Nutrition and pubertal development

    PubMed Central

    Soliman, Ashraf; De Sanctis, Vincenzo; Elalaily, Rania

    2014-01-01

    Nutrition is one of the most important factors affecting pubertal development. Puberty entails a progressive nonlinear process starting from prepubescent to full sexual maturity through the interaction and cooperation of biological, physical, and psychological changes. Consuming an adequate and balanced healthy diet during all phases of growth (infancy, childhood and puberty) appears necessary both for proper growth and normal pubertal development. Girls begin puberty at an earlier age compared to past decades. Excessive eating of many processed, high-fat foods, may be the cause of this phenomenon. Overweight or obese children are more likely to enter puberty early. Some evidence suggests that obesity can accelerate the onset of puberty in girls and may delay the onset of puberty in boys. Moreover, the progression of puberty is affected by nutrition. On the other hand, puberty triggers a growth spurt, which increases nutritional needs including macro and micronutrients. Increased caloric, protein, iron, calcium, zinc and folate needs have to be provided during this critical period of rapid growth. Severe primary or secondary malnutrition also can delay the onset and progression of puberty. The higher incidence of anorexia nervosa and bulimia in adolescents imposes a nutritional risk on pubertal development. Moreover, many environmental endocrine disruptors (EDs) have been identified that can significantly impair the normal course of puberty. This mini-review sums up some important findings in this important complex that link nutrition and pubertal development. PMID:25538876

  10. Nutrition in the elderly.

    PubMed

    Pirlich, M; Lochs, H

    2001-12-01

    Malnutrition is more common in elderly persons than in younger adults. Ageing itself, however, neither leads to malabsorption nor to malnutrition with the exception of a higher frequency of atrophic gastritis in older persons. Malnutrition in elderly people is therefore a consequence of somatic, psychic or social problems. Typical causes are chewing or swallowing disorders, cardiac insufficiency, depression, social deprivation and loneliness. Undernutrition is associated with a worse prognosis and is an independent risk factor for morbidity and mortality. Awareness of this problem is therefore important. For the evaluation of nutritional status, it must be remembered that most normal values are derived from younger adults and may not necessarily be suitable for elderly persons. Suitable tools for evaluating the nutritional status of elderly persons are e.g. the body mass index, weight loss within the last 6 months, the Mini Nutritional Assessment (MNA) or the Subjective Global Assessment (SGA). An improvement in the nutritional status can be achieved by simple methods such as the preparation of an adequate diet, hand feeding, additional sip feeding or enteral nutrition.

  11. Northern Nutrition.

    ERIC Educational Resources Information Center

    Northwest Territories Dept. of Education, Yellowknife.

    This guide contains nutrition information and nutrition education strategies aimed at residents of the Canadian Arctic. Section I: (1) defines nutrition terms; (2) describes the sources and functions of essential nutrients; (3) explains Canada's food guide and special considerations for the traditional northern Native diet and for lactose…

  12. Nutrition Education.

    ERIC Educational Resources Information Center

    Chauliac, Michel; And Others

    1991-01-01

    Nutrition education is the theme of this issue of "Children in the Tropics," which emphasizes an analysis of the situation of nutrition education programs, particularly in third world countries. It is noted that in most cases, it is necessary to integrate aspects of nutrition education into broader programs that encompass agricultural and food…

  13. The New Nutrition: Teacher's Guide.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Instructional Materials Center.

    This teacher's guide is designed for use by consumer and homemaking education teachers in classes emphasizing nutrition. The guide is organized into 19 topics and is based on the 7 Dietary Guidelines for Americans: (1) to eat a variety of food; (2) to maintain ideal weight; (3) to avoid too much fat; (4) to eat foods with adequate starch and…

  14. Position of the Academy of Nutrition and Dietetics: Health Implications of Dietary Fiber.

    PubMed

    Dahl, Wendy J; Stewart, Maria L

    2015-11-01

    It is the position of the Academy of Nutrition and Dietetics that the public should consume adequate amounts of dietary fiber from a variety of plant foods. Dietary fiber is defined by the Institute of Medicine Food Nutrition Board as "nondigestible carbohydrates and lignin that are intrinsic and intact in plants." Populations that consume more dietary fiber have less chronic disease. Higher intakes of dietary fiber reduce the risk of developing several chronic diseases, including cardiovascular disease, type 2 diabetes, and some cancers, and have been associated with lower body weights. The Adequate Intake for fiber is 14 g total fiber per 1,000 kcal, or 25 g for adult women and 38 g for adult men, based on research demonstrating protection against coronary heart disease. Properties of dietary fiber, such as fermentability and viscosity, are thought to be important parameters influencing the risk of disease. Plant components associated with dietary fiber may also contribute to reduced disease risk. The mean intake of dietary fiber in the United States is 17 g/day with only 5% of the population meeting the Adequate Intake. Healthy adults and children can achieve adequate dietary fiber intakes by increasing their intake of plant foods while concurrently decreasing energy from foods high in added sugar and fat, and low in fiber. Dietary messages to increase consumption of whole grains, legumes, vegetables, fruits, and nuts should be broadly supported by food and nutrition practitioners.

  15. Hypocaloric compared with eucaloric nutritional support and its effect on infection rates in a surgical intensive care unit: a randomized controlled trial12345

    PubMed Central

    Charles, Eric J; Petroze, Robin T; Metzger, Rosemarie; Hranjec, Tjasa; Rosenberger, Laura H; Riccio, Lin M; McLeod, Matthew D; Guidry, Christopher A; Stukenborg, George J; Swenson, Brian R; Willcutts, Kate F; O'Donnell, Kelly B; Sawyer, Robert G

    2014-01-01

    Background: Proper caloric intake goals in critically ill surgical patients are unclear. It is possible that overnutrition can lead to hyperglycemia and an increased risk of infection. Objective: This study was conducted to determine whether surgical infection outcomes in the intensive care unit (ICU) could be improved with the use of hypocaloric nutritional support. Design: Eighty-three critically ill patients were randomly allocated to receive either the standard calculated daily caloric requirement of 25–30 kcal · kg–1 · d–1 (eucaloric) or 50% of that value (hypocaloric) via enteral tube feeds or parenteral nutrition, with an equal protein allocation in each group (1.5 g · kg–1 · d–1). Results: There were 82 infections in the hypocaloric group and 66 in the eucaloric group, with no significant difference in the mean (±SE) number of infections per patient (2.0 ± 0.6 and 1.6 ± 0.2, respectively; P = 0.50), percentage of patients acquiring infection [70.7% (29 of 41) and 76.2% (32 of 42), respectively; P = 0.57], mean ICU length of stay (16.7 ± 2.7 and 13.5 ± 1.1 d, respectively; P = 0.28), mean hospital length of stay (35.2 ± 4.9 and 31.0 ± 2.5 d, respectively; P = 0.45), mean 0600 glucose concentration (132 ± 2.9 and 135 ± 3.1 mg/dL, respectively; P = 0.63), or number of mortalities [3 (7.3%) and 4 (9.5%), respectively; P = 0.72]. Further analyses revealed no differences when analyzed by sex, admission diagnosis, site of infection, or causative organism. Conclusions: Among critically ill surgical patients, caloric provision across a wide acceptable range does not appear to be associated with major outcomes, including infectious complications. The optimum target for caloric provision remains elusive. PMID:25332331

  16. Home parenteral nutrition in a child with Menetrier disease.

    PubMed

    Ling, L J; Hershenson, M B; Young, S; Traisman, H S

    1986-02-01

    A 4-year-old boy is described with abdominal pain, emesis, weight loss, hypoproteinemia and edema. The diagnosis of Menetrier disease was made based on radiographic studies, gastroscopy and gastric biopsy. There was little response to medical treatment and enteral feedings were poorly tolerated for many weeks. Although Menetrier disease in children has a benign and transient course, we found the use of home hyperalimentation significantly shortened the length of hospitalization and provided adequate nutritional support until the gastric lesions began to resolve.

  17. Quantifying variability within water samples: the need for adequate subsampling.

    PubMed

    Donohue, Ian; Irvine, Kenneth

    2008-01-01

    Accurate and precise determination of the concentration of nutrients and other substances in waterbodies is an essential requirement for supporting effective management and legislation. Owing primarily to logistic and financial constraints, however, national and regional agencies responsible for monitoring surface waters tend to quantify chemical indicators of water quality using a single sample from each waterbody, thus largely ignoring spatial variability. We show here that total sample variability, which comprises both analytical variability and within-sample heterogeneity, of a number of important chemical indicators of water quality (chlorophyll a, total phosphorus, total nitrogen, soluble molybdate-reactive phosphorus and dissolved inorganic nitrogen) varies significantly both over time and among determinands, and can be extremely high. Within-sample heterogeneity, whose mean contribution to total sample variability ranged between 62% and 100%, was significantly higher in samples taken from rivers compared with those from lakes, and was shown to be reduced by filtration. Our results show clearly that neither a single sample, nor even two sub-samples from that sample is adequate for the reliable, and statistically robust, detection of changes in the quality of surface waters. We recommend strongly that, in situations where it is practicable to take only a single sample from a waterbody, a minimum of three sub-samples are analysed from that sample for robust quantification of both the concentrations of determinands and total sample variability. PMID:17706740

  18. Nutrition policy process challenges in Iran

    PubMed Central

    Goshtaei, Massomeh; Ravaghi, Hamid; Sari, Ali Akbari; Abdollahi, Zahra

    2016-01-01

    Introduction Nutrition transition is occurring rapidly in the world, especially in developing countries. The nutrition transition occurred in Iran very fast due to urbanization and changes in the lifestyle of people, leading to overweight and obesity. However, nutritional deficiencies are still detected due to economic factors and low nutritional knowledge. Nutrition policies do not adequately respond to the nutrition challenges in Iran. This study was conducted to evaluate and analyze the nutrition policy process challenges in Iran. Methods A qualitative study using semi-structured interviews was conducted with 59 policy makers and nutrition experts of medical universities across Iran. Interviews were continued until data saturation was achieved. Data were supplemented with surveys and documentary analysis. Thematic analysis was guided by the propositions of the stages heuristic framework. Results The results were categorized into four main themes and eight sub-themes. The main themes were 1) nutrition problem definition, 2) policy formulation, 3) implementation of the policies, and 4) evaluation of the policies. However, the multi-faceted nature of the nutritional problem makes it difficult to deal with, so a multi-sectoral approach is needed. Conclusion Nutrition policies have been implemented in Iran with varying degrees of success and with different levels of cross-sectoral collaboration. The nutrition policies sometimes have not been able to respond to the nutritional problems. One of the important reasons is that nutrition is not a priority for policy makers. Many policies suffer from a lack of adequate and appropriate resource allocation. Cooperation mechanisms to resolve nutritional problems are sometimes ineffective and inefficient. PMID:27053992

  19. 40 CFR 51.354 - Adequate tools and resources.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 2 2013-07-01 2013-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain the administrative resources necessary to perform all of the program functions including...

  20. 40 CFR 51.354 - Adequate tools and resources.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 2 2014-07-01 2014-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain the administrative resources necessary to perform all of the program functions including...

  1. 40 CFR 51.354 - Adequate tools and resources.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 2 2012-07-01 2012-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain the administrative resources necessary to perform all of the program functions including...

  2. 10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Responsibility for maintaining adequate safeguards. 1304.114 Section 1304.114 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.114 Responsibility for maintaining adequate safeguards. The Board has the responsibility for maintaining...

  3. 13 CFR 108.200 - Adequate capital for NMVC Companies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... VENTURE CAPITAL (âNMVCâ) PROGRAM Qualifications for the NMVC Program Capitalizing A Nmvc Company § 108.200 Adequate capital for NMVC Companies. You must meet the requirements of §§ 108.200-108.230 in order to... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Adequate capital for...

  4. 34 CFR 200.20 - Making adequate yearly progress.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 1 2012-07-01 2012-07-01 false Making adequate yearly progress. 200.20 Section 200.20... Basic Programs Operated by Local Educational Agencies Adequate Yearly Progress (ayp) § 200.20 Making... State data system; (vi) Include, as separate factors in determining whether schools are making AYP for...

  5. 34 CFR 200.20 - Making adequate yearly progress.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 1 2013-07-01 2013-07-01 false Making adequate yearly progress. 200.20 Section 200.20... Basic Programs Operated by Local Educational Agencies Adequate Yearly Progress (ayp) § 200.20 Making... State data system; (vi) Include, as separate factors in determining whether schools are making AYP for...

  6. 34 CFR 200.20 - Making adequate yearly progress.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Making adequate yearly progress. 200.20 Section 200.20... Basic Programs Operated by Local Educational Agencies Adequate Yearly Progress (ayp) § 200.20 Making... State data system; (vi) Include, as separate factors in determining whether schools are making AYP for...

  7. 34 CFR 200.20 - Making adequate yearly progress.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false Making adequate yearly progress. 200.20 Section 200.20... Basic Programs Operated by Local Educational Agencies Adequate Yearly Progress (ayp) § 200.20 Making... State data system; (vi) Include, as separate factors in determining whether schools are making AYP for...

  8. 34 CFR 200.20 - Making adequate yearly progress.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Making adequate yearly progress. 200.20 Section 200.20... Basic Programs Operated by Local Educational Agencies Adequate Yearly Progress (ayp) § 200.20 Making... State data system; (vi) Include, as separate factors in determining whether schools are making AYP for...

  9. 40 CFR 716.25 - Adequate file search.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Adequate file search. 716.25 Section... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a person's responsibility to search records is limited to records in the location(s) where the...

  10. 40 CFR 716.25 - Adequate file search.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 32 2013-07-01 2013-07-01 false Adequate file search. 716.25 Section... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a person's responsibility to search records is limited to records in the location(s) where the...

  11. 40 CFR 716.25 - Adequate file search.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Adequate file search. 716.25 Section... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a person's responsibility to search records is limited to records in the location(s) where the...

  12. 40 CFR 716.25 - Adequate file search.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 32 2012-07-01 2012-07-01 false Adequate file search. 716.25 Section... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a person's responsibility to search records is limited to records in the location(s) where the...

  13. 40 CFR 716.25 - Adequate file search.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Adequate file search. 716.25 Section... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a person's responsibility to search records is limited to records in the location(s) where the...

  14. 9 CFR 305.3 - Sanitation and adequate facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Sanitation and adequate facilities. 305.3 Section 305.3 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... OF VIOLATION § 305.3 Sanitation and adequate facilities. Inspection shall not be inaugurated if...

  15. 9 CFR 305.3 - Sanitation and adequate facilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Sanitation and adequate facilities. 305.3 Section 305.3 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... OF VIOLATION § 305.3 Sanitation and adequate facilities. Inspection shall not be inaugurated if...

  16. 40 CFR 51.354 - Adequate tools and resources.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 2 2011-07-01 2011-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain the administrative resources necessary to perform all of the program functions including...

  17. 40 CFR 51.354 - Adequate tools and resources.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain the administrative resources necessary to perform all of the program functions including...

  18. 10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Responsibility for maintaining adequate safeguards. 1304.114 Section 1304.114 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.114 Responsibility for maintaining adequate safeguards. The Board has the responsibility for maintaining...

  19. 10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Responsibility for maintaining adequate safeguards. 1304.114 Section 1304.114 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.114 Responsibility for maintaining adequate safeguards. The Board has the responsibility for maintaining...

  20. 10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Responsibility for maintaining adequate safeguards. 1304.114 Section 1304.114 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.114 Responsibility for maintaining adequate safeguards. The Board has the responsibility for maintaining...

  1. 10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Responsibility for maintaining adequate safeguards. 1304.114 Section 1304.114 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.114 Responsibility for maintaining adequate safeguards. The Board has the responsibility for maintaining...

  2. 13 CFR 107.200 - Adequate capital for Licensees.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Adequate capital for Licensees. 107.200 Section 107.200 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SMALL BUSINESS INVESTMENT COMPANIES Qualifying for an SBIC License Capitalizing An Sbic § 107.200 Adequate capital...

  3. 21 CFR 201.5 - Drugs; adequate directions for use.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Drugs; adequate directions for use. 201.5 Section 201.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL LABELING General Labeling Provisions § 201.5 Drugs; adequate directions for use....

  4. 21 CFR 201.5 - Drugs; adequate directions for use.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Drugs; adequate directions for use. 201.5 Section 201.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL LABELING General Labeling Provisions § 201.5 Drugs; adequate directions for use....

  5. 7 CFR 4290.200 - Adequate capital for RBICs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Adequate capital for RBICs. 4290.200 Section 4290.200 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND... Qualifications for the RBIC Program Capitalizing A Rbic § 4290.200 Adequate capital for RBICs. You must meet...

  6. "Something Adequate"? In Memoriam Seamus Heaney, Sister Quinlan, Nirbhaya

    ERIC Educational Resources Information Center

    Parker, Jan

    2014-01-01

    Seamus Heaney talked of poetry's responsibility to represent the "bloody miracle", the "terrible beauty" of atrocity; to create "something adequate". This article asks, what is adequate to the burning and eating of a nun and the murderous gang rape and evisceration of a medical student? It considers Njabulo…

  7. Fluid and Electrolyte Nutrition

    NASA Technical Reports Server (NTRS)

    Lane, Helen W.; Smith, Scott M.; Leach, Carolyn S.; Rice, Barbara L.

    1999-01-01

    Studies of fluid and electrolyte homeostasis have been completed since the early human space flight programs, with comprehensive research completed on the Spacelab Life Sciences missions SLS-1 and SLS-2 flights, and more recently on the Mir 18 mission. This work documented the known shifts in fluids, the decrease in total blood volume, and indications of reduced thirst. Data from these flights was used to evaluate the nutritional needs for water, sodium, and potassium. Interpretations of the data are confounded by the inadequate energy intakes routinely observed during space flight. This in turn results in reduced fluid intake, as food provides approximately 70% water intake. Subsequently, body weight, lean body mass, total body water, and total body potassium may decrease. Given these issues, there is evidence to support a minimum required water intake of 2 L per day. Data from previous Shuttle flights indicated that water intake is 2285 +/- 715 ml/day (mean +/- SD, n=26). There are no indications that sodium intake or homeostasis is compromised during space flight. The normal or low aldosterone and urinary sodium levels suggest adequate sodium intake (4047 +/- 902 mg/day, n=26). Because excessive sodium intake is associated with hypercalciuria, the recommended maximum amount of sodium intake during flight is 3500 mg/day (i.e., similar to the Recommended Dietary Allowance, RDA). Potassium metabolism appears to be more complex. Data indicate loss of body potassium related to muscle atrophy and low dietary intake (2407 +/- 548 mg/day, n=26). Although possibly related to measurement error, the elevations in blood potassium suggest alterations in potassium homeostasis. The space RDA for minimum potassium intake is 3500 mg/day. With the documented inadequate intakes, efforts are being made to increase dietary consumption of potassium.

  8. Nutritional Considerations for Cancer Patients

    PubMed Central

    Chen, Angela

    1985-01-01

    Although weight loss is a frequent, though not invariable, component of the cancer syndrome, the associated malnutrition is a poor prognostic sign among both children and adults. This article describes the possible mechanisms of cancer cachexia; reviews the present state of nutritional support in cancer patients; identifies nutritional problems and workable approaches during the pre- and post-treatment periods; discusses the unconventional nutritional practices commonly encountered and lists resource materials for patients and families. PMID:21274086

  9. Nutrition and Chronic Wounds

    PubMed Central

    Molnar, Joseph Andrew; Underdown, Mary Jane; Clark, William Andrew

    2014-01-01

    Significance: Nutrition is one of the most basic of medical issues and is often ignored as a problem in the management of our chronic wound patients. Unfortunately, malnutrition is widespread in our geriatric patients even in nursing homes in developed countries. Attention to basic nutrition and providing appropriate supplements may assist in the healing of our chronic wounds. Recent Advances: Recent research has revealed the epidemiology of malnutrition in developed countries, the similarities to malnutrition in developing countries, and some of the physiologic and sociologic causes for this problem. More information is now available on the biochemical effects of nutrient deficiency and supplementation with macronutrients and micronutrients. In some cases, administration of isolated nutrients beyond recommended amounts for healthy individuals may have a pharmacologic effect to help wounds heal. Critical Issues: Much of the knowledge of the nutritional support of chronic wounds is based on information that has been obtained from trauma management. Due to the demographic differences of the patients and differences in the physiology of acute and chronic wounds, it is not logical to assume that all aspects of nutritional support are identical in these patient groups. Before providing specific nutritional supplements, appropriate assessments of patient general nutritional status and the reasons for malnutrition must be obtained or specific nutrient supplementation will not be utilized. Future Directions: Future research must concentrate on the biochemical and physiologic differences of the acute and chronic wounds and the interaction with specific supplements, such as antioxidants, vitamin A, and vitamin D. PMID:25371850

  10. Nutrition and Chronic Wounds.

    PubMed

    Molnar, Joseph Andrew; Underdown, Mary Jane; Clark, William Andrew

    2014-11-01

    Significance: Nutrition is one of the most basic of medical issues and is often ignored as a problem in the management of our chronic wound patients. Unfortunately, malnutrition is widespread in our geriatric patients even in nursing homes in developed countries. Attention to basic nutrition and providing appropriate supplements may assist in the healing of our chronic wounds. Recent Advances: Recent research has revealed the epidemiology of malnutrition in developed countries, the similarities to malnutrition in developing countries, and some of the physiologic and sociologic causes for this problem. More information is now available on the biochemical effects of nutrient deficiency and supplementation with macronutrients and micronutrients. In some cases, administration of isolated nutrients beyond recommended amounts for healthy individuals may have a pharmacologic effect to help wounds heal. Critical Issues: Much of the knowledge of the nutritional support of chronic wounds is based on information that has been obtained from trauma management. Due to the demographic differences of the patients and differences in the physiology of acute and chronic wounds, it is not logical to assume that all aspects of nutritional support are identical in these patient groups. Before providing specific nutritional supplements, appropriate assessments of patient general nutritional status and the reasons for malnutrition must be obtained or specific nutrient supplementation will not be utilized. Future Directions: Future research must concentrate on the biochemical and physiologic differences of the acute and chronic wounds and the interaction with specific supplements, such as antioxidants, vitamin A, and vitamin D.

  11. NUTRITIONAL SUPPORT FOR FULMINANT HEPATITIS.

    PubMed

    Ramos Figueira, Estela Regina; Rocha Filho, Joel Avancini; Souto Nacif, Lucas; Carneiro D'Albuquerque, Luiz; Linetzky Waitzberg, Dan

    2015-12-01

    Introducción: la hepatitis fulminante se asocia a un exacerbado hipercatabolismo, la hipoglicemia y la hiperamonemia están acompañadas por la liberación de citocinas proinflamatorias y hormonas catabólicas en la circulación sistémica, empeorando la condición clínica del paciente. El apoyo nutricional es un elemento crucial para la recuperación de estos pacientes. Objetivos: el objetivo de esta revisión es actualizar el apoyo nutricional para la hepatitis fulminante. Métodos: la revisión se llevó a cabo mediante la búsqueda electrónica en Medline-PubMed, utilizando malla de términos. Resultados y discusión: no hay muchos datos disponibles sobre el apoyo nutricional para lahepatitis fulminante o fallo hepático agudo. Las estrategias de intervención nutricional inicial se centran en el control de los trastornos metabólicos de la hepatitis fulminante descritos anteriormente, que deben ser individualizadas de acuerdo a la gravedad de la situación clínica del paciente. Energía y proteína se pueden proporcionar en cantidades de 25‑40 kcal / kg / día y 0,8-1,2 g / kg / día, respectivamente. La terapia nutricional enteral está indicada en pacientes con encefalopatía avanzada o para aquellos que no pueden ser adecuadamente alimentados por vía oral. Se debe obtener una euglicemia y la ingesta de proteínas puede estar basada en fórmulas de BCAA. Los lípidos se pueden administrar como suplemento energético con precaución. Una terapia nutricional adecuada puede potencialmente reducir la morbilidad y la mortalidad de los pacientes con hepatitis fulminante.

  12. Medical Nutrition Therapy in Hospitalized Patients with Diabetes

    PubMed Central

    Gosmanov, Aidar R.

    2013-01-01

    Medical nutrition therapy (MNT) plays an important role in management of hyperglycemia in hospitalized patients with diabetes mellitus. The goals of inpatient MNT are to optimize glycemic control, to provide adequate calories to meet metabolic demands, and to create a discharge plan for follow-up care. All patients with and without diabetes should undergo nutrition assessment on admission with subsequent implementation of physiologically sound caloric support. The use of a consistent carbohydrate diabetes meal-planning system has been shown to be effective in facilitating glycemic control in hospitalized patients with diabetes. This system is based on the total amount of carbohydrate offered rather than on specific calorie content at each meal, which facilitates matching the prandial insulin dose to the amount of carbohydrate consumed. In this article, we discuss general guidelines for the implementation of appropriate MNT in hospitalized patients with diabetes. PMID:21997598

  13. Nutrition Training Improves Health Workers’ Nutrition Knowledge and Competence to Manage Child Undernutrition: A Systematic Review

    PubMed Central

    Sunguya, Bruno F.; Poudel, Krishna C.; Mlunde, Linda B.; Urassa, David P.; Yasuoka, Junko; Jimba, Masamine

    2013-01-01

    Background: Medical and nursing education lack adequate practical nutrition training to fit the clinical reality that health workers face in their practices. Such a deficit creates health workers with poor nutrition knowledge and child undernutrition management practices. In-service nutrition training can help to fill this gap. However, no systematic review has examined its collective effectiveness. We thus conducted this study to examine the effectiveness of in-service nutrition training on health workers’ nutrition knowledge, counseling skills, and child undernutrition management practices. Methods: We conducted a literature search on nutrition interventions from PubMed/MEDLINE, CINAHL, EMBASE, ISI Web of Knowledge, and World Health Organization regional databases. The outcome variables were nutrition knowledge, nutrition-counseling skills, and undernutrition management practices of health workers. Due to heterogeneity, we conducted only descriptive analyses. Results: Out of 3910 retrieved articles, 25 were selected as eligible for the final analysis. A total of 18 studies evaluated health workers’ nutrition knowledge and showed improvement after training. A total of 12 studies with nutrition counseling as the outcome variable also showed improvement among the trained health workers. Sixteen studies evaluated health workers’ child undernutrition management practices. In all such studies, child undernutrition management practices and competence of health workers improved after the nutrition training intervention. Conclusion: In-service nutrition training improves quality of health workers by rendering them more knowledge and competence to manage nutrition-related conditions, especially child undernutrition. In-service nutrition training interventions can help to fill the gap created by the lack of adequate nutrition training in the existing medical and nursing education system. In this way, steps can be taken toward improving the overall nutritional status

  14. [Enteral nutrition: ways of access and formulas].

    PubMed

    Sauret, C; Humanes, A; Trallero, R

    1999-03-01

    Enteral nutrition is a very adequate method to feed those patients who can not receive food by oral means, to be used only when their gastrointestinal functions are preserved and carry out a proper assimilation of nutrients. Starting from these facts, this article analyzes the various access ways which can be used in enteral nutrition, and the most commonly used enteral nutrition formulas, noting their possible classifications. The nutritional modules and the material necessary to employ this form of feeding, as well as the administrative guidelines, are also presented in this article.

  15. Parenteral nutrition in esophageal cancer patients.

    PubMed Central

    Daly, J M; Massar, E; Giacco, G; Frazier, O H; Mountain, C F; Dudrick, S J; Copeland, E M

    1982-01-01

    A review of operative therapy in 244 patients with esophageal cancer from 1960 to 1980 was done to evaluate the impact of TPN in 72 patients treated from 1973 to 1980 with 43 non-TPN patients treated during the same period and to 129 patients operated upon before 1973. Mean age, sex distribution, site, stage, and treatment of the disease were similar for the two study groups. The TPN group lost less weight during treatment (3 lbs vs. 11 lbs) and had fewer overall complications postoperatively (24% vs. 41%). Significant reductions in major wound, infectious, and postoperative complications were noted in these patients who received at least 5 days of preoperative TPN compared with postoperative TPN or the non-TPN groups (4% vs. 24% and 23%). Malnourished esophageal cancer patients can more safely undergo aggressive operative therapy and radiation treatment when adequate perioperative nutritional support is added to the treatment armamentarium. PMID:6807225

  16. The Healthy Communities Study Nutrition Assessments

    PubMed Central

    Ritchie, Lorrene D.; Wakimoto, Patricia; Woodward-Lopez, Gail; Thompson, Frances E.; Loria, Catherine M.; Wilson, Dawn K.; Kao, Janice; Crawford, Patricia B.; Webb, Karen L.

    2015-01-01

    Multifaceted community interventions directed at improving food environments are emerging, but their impact on dietary change and obesity prevalence has not been documented adequately. The Healthy Communities Study (HCS) is seeking to identify characteristics and combinations of programs and policies that are associated with children’s diets and obesity-related outcomes in various types of communities across the U.S. The purpose of this paper is to describe the methods used in 2013–2015 in the HCS to assess dietary intake, school nutrition environments, and other nutrition-related behaviors. The conceptual framework of the HCS is based on the socioecological model and behaviors shown in previous studies to be related to obesity in children-guided selection of domains. Nine domains were identified as essential measures of nutrition in the HCS: (1) intake of selected foods and beverages; (2) food patterns and behaviors; (3) social support; (4) home environment; (5) school environment; (6) community environment; (7) breastfeeding history; (8) household food insecurity; and (9) dieting behaviors and body image. Children’s dietary intake was assessed using a dietary screener and up to two automated 24-hour recalls. Dietary-related behaviors were assessed by a survey administered to the parent, child, or both, depending on child age. School nutrition measures were obtained from a combination of school staff surveys and researcher observations. Information from these measures is expected to contribute to a better understanding of “what is working” to improve the dietary behaviors that are likely to prevent obesity and improve health in children. PMID:26384936

  17. Nutrition Labeling

    NASA Astrophysics Data System (ADS)

    Metzger, Lloyd E.

    Nutrition labeling regulations differ in countries around the world. The focus of this chapter is on nutrition labeling regulations in the USA, as specified by the Food and Drug Administration (FDA) and the Food Safety and Inspection Service (FSIS) of the United States Department of Agriculture (USDA). A major reason for analyzing the chemical components of foods in the USA is nutrition labeling regulations. Nutrition label information is not only legally required in many countries, but also is of increasing importance to consumers as they focus more on health and wellness.

  18. On Adequate Comparisons of Antenna Phase Center Variations

    NASA Astrophysics Data System (ADS)

    Schoen, S.; Kersten, T.

    2013-12-01

    One important part for ensuring the high quality of the International GNSS Service's (IGS) products is the collection and publication of receiver - and satellite antenna phase center variations (PCV). The PCV are crucial for global and regional networks, since they introduce a global scale factor of up to 16ppb or changes in the height component with an amount of up to 10cm, respectively. Furthermore, antenna phase center variations are also important for precise orbit determination, navigation and positioning of mobile platforms, like e.g. the GOCE and GRACE gravity missions, or for the accurate Precise Point Positioning (PPP) processing. Using the EUREF Permanent Network (EPN), Baire et al. (2012) showed that individual PCV values have a significant impact on the geodetic positioning. The statements are further supported by studies of Steigenberger et al. (2013) where the impact of PCV for local-ties are analysed. Currently, there are five calibration institutions including the Institut für Erdmessung (IfE) contributing to the IGS PCV file. Different approaches like field calibrations and anechoic chamber measurements are in use. Additionally, the computation and parameterization of the PCV are completely different within the methods. Therefore, every new approach has to pass a benchmark test in order to ensure that variations of PCV values of an identical antenna obtained from different methods are as consistent as possible. Since the number of approaches to obtain these PCV values rises with the number of calibration institutions, there is the necessity for an adequate comparison concept, taking into account not only the numerical values but also stochastic information and computational issues of the determined PCVs. This is of special importance, since the majority of calibrated receiver antennas published by the IGS origin from absolute field calibrations based on the Hannover Concept, Wübbena et al. (2000). In this contribution, a concept for the adequate

  19. Nutritional epigenetics

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This chapter is intended to provide a timely overview of the current state of research at the intersection of nutrition and epigenetics. I begin by describing epigenetics and molecular mechanisms of eigenetic regulation, then highlight four classes of nutritional exposures currently being investiga...

  20. Sports Nutrition.

    ERIC Educational Resources Information Center

    Missouri State Dept. of Health, Jefferson City.

    This guide deals with various aspects of sports and nutrition. Twelve chapters are included: (1) "Sports and Nutrition"; (2) "Eat to Compete"; (3) "Fit Folks Need Fit Food"; (4) "The Food Guide Pyramid"; (5) "Fat Finder's Guide"; (6) "Pre- and Post-Event Meals"; (7) "Tips for the Diabetic Athlete"; (8) "Pinning Down Your Optimal Weight"; (9)…

  1. Nutrition Education.

    ERIC Educational Resources Information Center

    Christy, Kathy J.; Dawes, Marge

    Included in this booklet are nutrition learning activities intended to help elementary school students acquire knowledge that will enable them to select diets that meet their bodies' needs, both now and in the future. The learning activities correspond to specific nutrition education objectives and are presented separately for students in the…

  2. [Community nutrition].

    PubMed

    Aranceta Bartrina, J; Pérez Rodrigo, C; Serra Majem, L I

    2006-01-01

    A growing body of scientific and epidemiological evidence indicates that diet and health are related: diet may be a risk factor or have potential protective effects. As a consequence, the focus of nutrition research has experienced a shift towards qualitative aspects of diet which could influence chronic disease, longevity, quality of life and physical and cognitive performance, leading to the development of Community Nutrition. The main undertakings in a Community Nutrition Unit are related to the identification, assessment and monitoring of nutrition problems at the community level and to planning, design, implementation and evaluation of nutrition intervention programs. Such programs combine a number of suitable strategies in a whole population approach, a high risk approach or an approach targeted at specific population groups, and are implemented in different settings, such as the work place, schools or community organizations. Community nutrition interventions aim to gradually achieve change in eating patterns towards a healthier profile. Community Nutrition programs require the use of a combination of strategies and a working group of people from different backgrounds. Many factors influence the nutritional status of an individual or a population. In order to gain effective work output, sound understanding of these patterns and a practical surveillance system are required. PMID:17424768

  3. Nutritional Epidemiology

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Although observations on relationships between diet and health have always been recognized—the systematic science of nutritional epidemiology in populations is relatively recent. Important observations propelling the field of nutrition forward were numerous in the 18th and 19th centuries, as it was...

  4. Sports Nutrition.

    ERIC Educational Resources Information Center

    Houtkooper, Linda; And Others

    This kit provides coaches, physical education teachers, and health professionals with current nutrition information and guidelines for applying that information in classes and athletic training programs. The kit contains four components. A "Key Terms" section provides an index to nutrition-fitness terminology and concepts. The instructional…

  5. Nutrition: A Primary Therapy in Pediatric Acute Respiratory Distress Syndrome

    PubMed Central

    Wilson, Bryan; Typpo, Katri

    2016-01-01

    Appropriate nutrition is an essential component of intensive care management of children with acute respiratory distress syndrome (ARDS) and is linked to patient outcomes. One out of every two children in the pediatric intensive care unit (PICU) will develop malnutrition or have worsening of baseline malnutrition and present with specific micronutrient deficiencies. Early and adequate enteral nutrition (EN) is associated with improved 60-day survival after pediatric critical illness, and, yet, despite early EN guidelines, critically ill children receive on average only 55% of goal calories by PICU day 10. Inadequate delivery of EN is due to perceived feeding intolerance, reluctance to enterally feed children with hemodynamic instability, and fluid restriction. Underlying each of these factors is large practice variation between providers and across institutions for initiation, advancement, and maintenance of EN. Strategies to improve early initiation and advancement and to maintain delivery of EN are needed to improve morbidity and mortality from pediatric ARDS. Both, over and underfeeding, prolong duration of mechanical ventilation in children and worsen other organ function such that precise calorie goals are needed. The gut is thought to act as a “motor” of organ dysfunction, and emerging data regarding the role of intestinal barrier functions and the intestinal microbiome on organ dysfunction and outcomes of critical illness present exciting opportunities to improve patient outcomes. Nutrition should be considered a primary rather than supportive therapy for pediatric ARDS. Precise nutritional therapies, which are titrated and targeted to preservation of intestinal barrier function, prevention of intestinal dysbiosis, preservation of lean body mass, and blunting of the systemic inflammatory response, offer great potential for improving outcomes of pediatric ARDS. In this review, we examine the current evidence regarding dose, route, and timing of nutrition

  6. Nutrition during pregnancy

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The optimal nutritional support of a mother and her developing fetus begins before conception. This poses a challenge for pediatricians caring for pregnant adolescents. Approximately 1 million teenagers become pregnant in the United States each year. Of these pregnancies, 51% end in live births, 35%...

  7. Reprint of: Nutrition in the Management of Cirrhosis and its Neurological Complications.

    PubMed

    Bémeur, Chantal; Butterworth, Roger F

    2015-03-01

    Malnutrition is a common feature of chronic liver diseases that is often associated with a poor prognosis including worsening of clinical outcome, neuropsychiatric complications as well as outcome following liver transplantation. Nutritional assessment in patients with cirrhosis is challenging owing to confounding factors related to liver failure. The objectives of nutritional intervention in cirrhotic patients are the support of liver regeneration, the prevention or correction of specific nutritional deficiencies and the prevention and/or treatment of the complications of liver disease per se and of liver transplantation. Nutritional recommendations target the optimal supply of adequate substrates related to requirements linked to energy, protein, carbohydrates, lipids, vitamins and minerals. Some issues relating to malnutrition in chronic liver disease remain to be addressed including the development of an appropriate well-validated nutritional assessment tool, the identification of mechanistic targets or therapy for sarcopenia, the development of nutritional recommendations for obese cirrhotic patients and liver-transplant recipients and the elucidation of the roles of vitamin A hepatotoxicity, as well as the impact of deficiencies in riboflavin and zinc on clinical outcomes. Early identification and treatment of malnutrition in chronic liver disease has the potential to lead to better disease outcome as well as prevention of the complications of chronic liver disease and improved transplant outcomes.

  8. Reprint of: Nutrition in the Management of Cirrhosis and its Neurological Complications.

    PubMed

    Bémeur, Chantal; Butterworth, Roger F

    2015-03-01

    Malnutrition is a common feature of chronic liver diseases that is often associated with a poor prognosis including worsening of clinical outcome, neuropsychiatric complications as well as outcome following liver transplantation. Nutritional assessment in patients with cirrhosis is challenging owing to confounding factors related to liver failure. The objectives of nutritional intervention in cirrhotic patients are the support of liver regeneration, the prevention or correction of specific nutritional deficiencies and the prevention and/or treatment of the complications of liver disease per se and of liver transplantation. Nutritional recommendations target the optimal supply of adequate substrates related to requirements linked to energy, protein, carbohydrates, lipids, vitamins and minerals. Some issues relating to malnutrition in chronic liver disease remain to be addressed including the development of an appropriate well-validated nutritional assessment tool, the identification of mechanistic targets or therapy for sarcopenia, the development of nutritional recommendations for obese cirrhotic patients and liver-transplant recipients and the elucidation of the roles of vitamin A hepatotoxicity, as well as the impact of deficiencies in riboflavin and zinc on clinical outcomes. Early identification and treatment of malnutrition in chronic liver disease has the potential to lead to better disease outcome as well as prevention of the complications of chronic liver disease and improved transplant outcomes. PMID:26041952

  9. Reprint of: Nutrition in the Management of Cirrhosis and its Neurological Complications☆

    PubMed Central

    Bémeur, Chantal; Butterworth, Roger F.

    2015-01-01

    Malnutrition is a common feature of chronic liver diseases that is often associated with a poor prognosis including worsening of clinical outcome, neuropsychiatric complications as well as outcome following liver transplantation. Nutritional assessment in patients with cirrhosis is challenging owing to confounding factors related to liver failure. The objectives of nutritional intervention in cirrhotic patients are the support of liver regeneration, the prevention or correction of specific nutritional deficiencies and the prevention and/or treatment of the complications of liver disease per se and of liver transplantation. Nutritional recommendations target the optimal supply of adequate substrates related to requirements linked to energy, protein, carbohydrates, lipids, vitamins and minerals. Some issues relating to malnutrition in chronic liver disease remain to be addressed including the development of an appropriate well-validated nutritional assessment tool, the identification of mechanistic targets or therapy for sarcopenia, the development of nutritional recommendations for obese cirrhotic patients and liver-transplant recipients and the elucidation of the roles of vitamin A hepatotoxicity, as well as the impact of deficiencies in riboflavin and zinc on clinical outcomes. Early identification and treatment of malnutrition in chronic liver disease has the potential to lead to better disease outcome as well as prevention of the complications of chronic liver disease and improved transplant outcomes. PMID:26041952

  10. What is Nutrition?

    ERIC Educational Resources Information Center

    Taylor, T. G.

    1982-01-01

    Discusses the science of nutrition, including: (1) nutrition as a branch of science and social science; (2) nutrition instruction in schools; (3) careers in nutrition; (4) training nutritionists; and (5) current issues in nutrition research. (JN)

  11. Iron nutrition in adolescence.

    PubMed

    Mesías, Marta; Seiquer, Isabel; Navarro, M Pilar

    2013-01-01

    Adolescence is an important period of nutritional vulnerability due to increased dietary requirements for growth and development. Iron needs are elevated as a result of intensive growth and muscular development, which implies an increase in blood volume; thus, it is extremely important for the adolescent's iron requirements to be met. Diet, therefore, must provide enough iron and, moreover, nutrients producing adequate iron bioavailability to favor element utilization and thus be sufficient for needs at this stage of life. Currently, many adolescents consume monotonous and unbalanced diets which may limit mineral intake and/or bioavailability, leading to iron deficiency and, consequently, to ferropenic anemia, a nutritional deficit of worldwide prevalence. Iron deficiency, apart from provoking important physiological repercussions, can adversely affect adolescents' cognitive ability and behavior. Accordingly, promoting the consumption of a varied, adjusted, and balanced diet by adolescents will facilitate iron utilization, benefiting their health both at present and in adulthood. This review discusses how physiological changes during adolescence can cause iron requirements to increase. Consequently, it is important that diet should contribute an appropriate amount of this mineral and, moreover, with an adequate bioavailability to satisfy needs during this special period of life.

  12. Practice paper of the Academy of Nutrition and Dietetics abstract: nutrition and lifestyle for a healthy pregnancy outcome.

    PubMed

    Kaiser, Lucia L; Campbell, Christina G

    2014-09-01

    It is the position of the Academy of Nutrition and Dietetics that women of childbearing age should adopt a lifestyle optimizing health and reducing risk of birth defects, suboptimal fetal development, and chronic health problems in both mother and child.Components leading to healthy pregnancy outcome include healthy pre-pregnancy weight, appropriate weight gain and physical activity during pregnancy, consumption of a wide variety of foods, appropriate vitamin and mineral supplementation, avoidance of alcohol and other harmful substances, and safe food handling. Nutrition assessment needs to encompass changes in anthropometric,biochemical, and clinical indicators throughout pregnancy. Pregnant women should gain weight according to the 2009 Institute of Medicine Guidelines. Energy needs are no higher than the Estimated Energy Requirement for nonpregnant women until the second trimester; thereafter, the extra energy need per day is 340 kcal and 452 kcal in the second and third trimesters,respectively. Using the 2010 Dietary Guidelines for Americans, registered dietitian nutritionists and dietetics technicians, registered,can help pregnant women select a food plan based on age, physical activity, trimester, weight gain, and other considerations.Women are encouraged to participate in at least 150 minutes of moderate-intensity aerobic activity spread throughout the week or 30 minutes of moderately intense exercise on most days of the week.When good food choices are made, food consumption to meet extra energy needs and the increased absorption and efficiency of nutrient utilization that occurs in pregnancy are generally adequate to meet most nutrient needs. However, vitamin and mineral supplementation may be important in vulnerable cases including food insecurity; alcohol, tobacco, or other substance dependency; anemia; strict vegetarian (vegan) diet; or poor eating habits. Multiple strategies are needed to support healthy lifestyles for all women, from preconception

  13. Practice paper of the Academy of Nutrition and Dietetics abstract: nutrition and lifestyle for a healthy pregnancy outcome.

    PubMed

    Kaiser, Lucia L; Campbell, Christina G

    2014-09-01

    It is the position of the Academy of Nutrition and Dietetics that women of childbearing age should adopt a lifestyle optimizing health and reducing risk of birth defects, suboptimal fetal development, and chronic health problems in both mother and child.Components leading to healthy pregnancy outcome include healthy pre-pregnancy weight, appropriate weight gain and physical activity during pregnancy, consumption of a wide variety of foods, appropriate vitamin and mineral supplementation, avoidance of alcohol and other harmful substances, and safe food handling. Nutrition assessment needs to encompass changes in anthropometric,biochemical, and clinical indicators throughout pregnancy. Pregnant women should gain weight according to the 2009 Institute of Medicine Guidelines. Energy needs are no higher than the Estimated Energy Requirement for nonpregnant women until the second trimester; thereafter, the extra energy need per day is 340 kcal and 452 kcal in the second and third trimesters,respectively. Using the 2010 Dietary Guidelines for Americans, registered dietitian nutritionists and dietetics technicians, registered,can help pregnant women select a food plan based on age, physical activity, trimester, weight gain, and other considerations.Women are encouraged to participate in at least 150 minutes of moderate-intensity aerobic activity spread throughout the week or 30 minutes of moderately intense exercise on most days of the week.When good food choices are made, food consumption to meet extra energy needs and the increased absorption and efficiency of nutrient utilization that occurs in pregnancy are generally adequate to meet most nutrient needs. However, vitamin and mineral supplementation may be important in vulnerable cases including food insecurity; alcohol, tobacco, or other substance dependency; anemia; strict vegetarian (vegan) diet; or poor eating habits. Multiple strategies are needed to support healthy lifestyles for all women, from preconception

  14. Integrating nutrition and child development interventions: scientific basis, evidence of impact, and implementation considerations.

    PubMed

    Black, Maureen M; Pérez-Escamilla, Rafael; Rao, Sylvia Fernandez

    2015-11-01

    The Millennium Development Goals (MDGs) have contributed to unprecedented reductions in poverty and improvement in the lives of millions of men, women, and children in low- and middle-income countries. Yet, hundreds of millions of children under 5 y of age are not reaching their developmental potential. This article reviews the scientific basis for early childhood nutrition and child development interventions, the impact of integrated interventions on children's linear growth and cognitive development, and implementation strategies for integrated nutrition and child development programs. Advances in brain science have documented that the origins of adult health and well-being are grounded in early childhood, from conception through age 24 mo (first 1000 d) and extending to age 5 y (second 1000 d). Young children with adequate nutrition, nurturant caregiving, and opportunities for early learning have the best chances of thriving. Evidence from adoption, experimental, and quasi-experimental studies has shown that stunting prevention is sensitive during the first 1000 d, and sensitivity to child development interventions extends through the second 1000 d. Cognitive development responds to interventions post–1000 d with effect sizes that are inversely associated with initial age and length of program exposure. Integrated interventions need governance structures that support integrated policies and programming, with attention to training, supervision, and monitoring. The MDGs have been replaced by the Sustainable Development Goals (SDGs), with targets for the next 15 y. Achievement of the SDGs depends on children receiving adequate nutrition, nurturant caregiving, and learning opportunities from conception through age 5. PMID:26875208

  15. Integrating nutrition and child development interventions: scientific basis, evidence of impact, and implementation considerations.

    PubMed

    Black, Maureen M; Pérez-Escamilla, Rafael; Rao, Sylvia Fernandez

    2015-11-01

    The Millennium Development Goals (MDGs) have contributed to unprecedented reductions in poverty and improvement in the lives of millions of men, women, and children in low- and middle-income countries. Yet, hundreds of millions of children under 5 y of age are not reaching their developmental potential. This article reviews the scientific basis for early childhood nutrition and child development interventions, the impact of integrated interventions on children's linear growth and cognitive development, and implementation strategies for integrated nutrition and child development programs. Advances in brain science have documented that the origins of adult health and well-being are grounded in early childhood, from conception through age 24 mo (first 1000 d) and extending to age 5 y (second 1000 d). Young children with adequate nutrition, nurturant caregiving, and opportunities for early learning have the best chances of thriving. Evidence from adoption, experimental, and quasi-experimental studies has shown that stunting prevention is sensitive during the first 1000 d, and sensitivity to child development interventions extends through the second 1000 d. Cognitive development responds to interventions post–1000 d with effect sizes that are inversely associated with initial age and length of program exposure. Integrated interventions need governance structures that support integrated policies and programming, with attention to training, supervision, and monitoring. The MDGs have been replaced by the Sustainable Development Goals (SDGs), with targets for the next 15 y. Achievement of the SDGs depends on children receiving adequate nutrition, nurturant caregiving, and learning opportunities from conception through age 5.

  16. Adequate iron stores and the 'Nil nocere' principle.

    PubMed

    Hollán, S; Johansen, K S

    1993-01-01

    There is a need to change the policy of unselective iron supplementation during periods of life with physiologically increased cell proliferation. Levels of iron stores to be regarded as adequate during infancy and pregnancy are still not well established. Recent data support the view that it is not justified to interfere with physiological adaptations developed through millions of years by sophisticated and precisely coordinated regulation of iron absorption, utilization and storage. Recent data suggest that the chelatable intracellular iron pool regulates the expression of proteins with central importance in cellular iron metabolism (TfR, ferritin, and erythroid 5-aminolevulinic synthetase) in a coordinately controlled way through an iron dependent cytosolic mRNA binding protein, the iron regulating factor (IRF). This factor is simultaneously a sensor and a regulator of iron levels. The reduction of ferritin levels during highly increased cell proliferation is a mirror of the increased density of TfRs. An abundance of data support the vigorous competition for growth-essential iron between microbial pathogens and their vertebrate hosts. The highly coordinated regulation of iron metabolism is probably crucial in achieving a balance between the blockade of readily accessible iron to invading organisms and yet providing sufficient iron for the immune system of the host. The most evident adverse clinical effects of excess iron have been observed in immunodeficient patients in tropical countries and in AIDS patients. Excess iron also increases the risk of initiation and promotion of malignant processes by iron binding to DNA and by the iron-catalysed release of free radicals. Oxygen radicals were shown to damage critical biomolecules leading, apart from cancer, to a variety of human disease states, including inflammation and atherosclerosis. They are also involved in processes of aging and thrombosis. Recent clinical trials have suggested that the use of iron

  17. Understanding Your Adequate Yearly Progress (AYP), 2011-2012

    ERIC Educational Resources Information Center

    Missouri Department of Elementary and Secondary Education, 2011

    2011-01-01

    The "No Child Left Behind Act (NCLB) of 2001" requires all schools, districts/local education agencies (LEAs) and states to show that students are making Adequate Yearly Progress (AYP). NCLB requires states to establish targets in the following ways: (1) Annual Proficiency Target; (2) Attendance/Graduation Rates; and (3) Participation Rates.…

  18. 15 CFR 970.404 - Adequate exploration plan.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 3 2014-01-01 2014-01-01 false Adequate exploration plan. 970.404...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS OF THE ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Certification of...

  19. 15 CFR 970.404 - Adequate exploration plan.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 15 Commerce and Foreign Trade 3 2012-01-01 2012-01-01 false Adequate exploration plan. 970.404...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS OF THE ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Certification of...

  20. 15 CFR 970.404 - Adequate exploration plan.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 15 Commerce and Foreign Trade 3 2013-01-01 2013-01-01 false Adequate exploration plan. 970.404...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS OF THE ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Certification of...

  1. 15 CFR 970.404 - Adequate exploration plan.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 3 2011-01-01 2011-01-01 false Adequate exploration plan. 970.404...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS OF THE ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Certification of...

  2. 15 CFR 970.404 - Adequate exploration plan.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Adequate exploration plan. 970.404...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS OF THE ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Certification of...

  3. Adequate Schools and Inadequate Education: An Anthropological Perspective.

    ERIC Educational Resources Information Center

    Wolcott, Harry F.

    To illustrate his claim that schools generally do a remarkably good job of schooling while the society makes inadequate use of other means to educate young people, the author presents a case history of a young American (identified pseudonymously as "Brad") whose schooling was adequate but whose education was not. Brad, jobless and homeless,…

  4. Comparability and Reliability Considerations of Adequate Yearly Progress

    ERIC Educational Resources Information Center

    Maier, Kimberly S.; Maiti, Tapabrata; Dass, Sarat C.; Lim, Chae Young

    2012-01-01

    The purpose of this study is to develop an estimate of Adequate Yearly Progress (AYP) that will allow for reliable and valid comparisons among student subgroups, schools, and districts. A shrinkage-type estimator of AYP using the Bayesian framework is described. Using simulated data, the performance of the Bayes estimator will be compared to…

  5. 13 CFR 107.200 - Adequate capital for Licensees.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false Adequate capital for Licensees. 107.200 Section 107.200 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SMALL BUSINESS... operate actively in accordance with your Articles and within the context of your business plan,...

  6. Assessing Juvenile Sex Offenders to Determine Adequate Levels of Supervision.

    ERIC Educational Resources Information Center

    Gerdes, Karen E.; And Others

    1995-01-01

    This study analyzed the internal consistency of four inventories used by Utah probation officers to determine adequate and efficacious supervision levels and placement for juvenile sex offenders. Three factors accounted for 41.2 percent of variance (custodian's and juvenile's attitude toward intervention, offense characteristics, and historical…

  7. 4 CFR 200.14 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... identifiable personal data and automated systems shall be adequately trained in the security and privacy of... records in which identifiable personal data are processed or maintained, including all reports and output... personal records or data; must minimize, to the extent practicable, the risk that skilled technicians...

  8. The Healthy Communities Study Nutrition Assessments: Child Diet and the School Nutrition Environment.

    PubMed

    Ritchie, Lorrene D; Wakimoto, Patricia; Woodward-Lopez, Gail; Thompson, Frances E; Loria, Catherine M; Wilson, Dawn K; Kao, Janice; Crawford, Patricia B; Webb, Karen L

    2015-10-01

    Multifaceted community interventions directed at improving food environments are emerging, but their impact on dietary change and obesity prevalence has not been adequately documented. The Healthy Communities Study (HCS) is seeking to identify characteristics and combinations of programs and policies that are associated with children's diets and obesity-related outcomes in various types of communities across the U.S. The purpose of this paper is to describe the methods used in 2013-2015 in the HCS to assess dietary intake, school nutrition environments, and other nutrition-related behaviors. The conceptual framework of the HCS is based on the socioecological model and behaviors shown in previous studies to be related to obesity in children guided selection of domains. Nine domains were identified as essential measures of nutrition in the HCS: (1) intake of selected foods and beverages; (2) food patterns and behaviors; (3) social support; (4) home environment; (5) school environment; (6) community environment; (7) breastfeeding history; (8) household food insecurity; and (9) dieting behaviors and body image. Children's dietary intake was assessed using a dietary screener and up to two automated 24-hour recalls. Dietary-related behaviors were assessed by a survey administered to the parent, child, or both, depending on child age. School nutrition measures were obtained from a combination of school staff surveys and researcher observations. Information from these measures is expected to contribute to a better understanding of "what is working" to improve the dietary behaviors that are likely to prevent obesity and improve health in children. PMID:26384936

  9. [Nutritional problems of female adolescents].

    PubMed

    Jiménez Ortega, Ana Isabel; González Iglesias, María José; Gimeno Pita, Patricia; Ortega, Rosa M

    2015-07-18

    Feeding in infancy is necessary to allow proper growth and development. Health of these early stages of life may influence the development of many diseases in the future (atherosclerosis, osteoporosis, hypertension, obesity ...). Furthermore habits set in childhood will endure throughout life. Therefore, getting adequate dietary and health patterns in childhood is vital. In adolescence occur a number of changes: rapid growth, development of secondary sexual characteristics, changes in body composition, ... that will be a challenge when getting or keeping that adequate feeding and habits. In female population requirements of different micronutrients are increased (mainly iron) and also higher energy requirement than in later stages of life occurs. However, adolescents are the main population at risk for developing eating disorders, which can pose serious problems to meet these nutritional requirements to achieve optimal development. These features and others, such as pregnant adolescents, are what make them a population that should be taken special care from nutritional point of view.

  10. Clinical nutrition and drug interactions.

    PubMed

    Ekincioğlu, Aygin Bayraktar; Demirkan, Kutay

    2013-01-01

    A drug's plasma level, pharmacological effects or side effects, elimination, physicochemical properties or stability could be changed by interactions of drug-drug or drug-nutrition products in patients who receive enteral or parenteral nutritional support. As a result, patients might experience ineffective outcomes or unexpected effects of therapy (such as drug toxicity, embolism). Stability or incompatibility problems between parenteral nutrition admixtures and drugs might lead to alterations in expected therapeutic responses from drug and/or parenteral nutrition, occlusion in venous catheter or symptoms or mortality due to infusion of composed particles. Compatibilities between parenteral nutrition and drugs are not always guaranteed in clinical practice. Although the list of compatibility or incompatibilities of drugs are published for the use of clinicians in their practices, factors such as composition of parenteral nutrition admixture, drug concentration, contact time in catheter, temperature of the environment and exposure to light could change the status of compatibilities between drugs and nutrition admixtures. There could be substantial clinical changes occurring in the patient's nutritional status and pharmacological effects of drugs due to interactions between enteral nutrition and drugs. Drug toxicity and ineffective nutritional support might occur as a result of those predictable interactions. Although administration of drugs via feeding tube is a complex and problematic route for drug usage, it is possible to minimise the risk of tube occlusion, decreased effects of drug and drug toxicity by using an appropriate technique. Therefore, it is important to consider pharmacological dosage forms of drugs while administering drugs via a feeding tube. In conclusion, since the pharmacists are well-experienced and more knowledgeable professionals in drugs and drug usage compared to other healthcare providers, it is suggested that provision of information and

  11. Nutrition Education.

    ERIC Educational Resources Information Center

    Devadas, Rajammal P.

    1981-01-01

    Discusses principles, methods, places, and outcomes of nutrition education. Suggests that in order to have the active cooperation of participants, healthy relationships between the various agencies, officials, local functionaries, and nutritionists should be maintained. (Author/KC)

  12. Diet & Nutrition

    MedlinePlus

    ... in MS is growing. Resources Find a dietician / nutritionist Academy of Nutrition and Dietetics – Provides an online search tool to locate registered dietician nutritionists (RDNs). Offers many consumer-geared resources. Food assistance ...

  13. Nutritional Assessment.

    PubMed

    Eirmann, Laura

    2016-09-01

    Nutritional assessment focuses on evaluation of animal-specific, diet-specific, feeding management, and environmental factors. Assessment includes evaluation of a patient's medical history, comprehensive diet history, and physical examination including body weight, body condition, and muscle condition. Diagnostic testing may identify comorbidities associated with obesity or concurrent health conditions that need to be considered when developing a nutrition plan. When obesity is diagnosed during the nutritional assessment this finding along with health implications must be clearly communicated to the pet owner. Careful consideration of animal-specific, diet-specific, owner-specific, and environmental factors allows the clinician to develop a specific nutrition plan tailored to the needs of pet and owner. PMID:27364967

  14. Clinical nutrition in pancreatitis.

    PubMed

    McClave, S A; Snider, H; Owens, N; Sexton, L K

    1997-10-01

    In patients with acute pancreatitis or an acute flare of chronic pancreatitis, a discrepancy exists between increased protein/calorie requirements induced by a hypermetabolic stress state and reduced ingestion/assimilation of exogenous nutrients, which promotes progressive nutritional deterioration. Patients with severe pancreatitis (defined by > or =3 Ranson criteria, an APACHE II score of > or =10, development of major organ failure, and/or presence of pancreatic necrosis) are more likely to require aggressive nutritional support than patients with mild disease. The type of formula and level of the gastrointestinal tract into which nutrients are infused determine the degree to which pancreatic exocrine secretion is stimulated. Animal studies and early prospective randomized controlled trials in humans suggest that total enteral nutrition via jejunal feeding may be the preferred route to parenteral alimentation in this disease setting.

  15. Total parenteral nutrition. Conquering the complexities.

    PubMed

    McClave, S A; Short, A F; Mattingly, D B; Fitzgerald, P D

    1990-07-01

    Delivery of total parenteral nutrition (TPN) is a complex procedure requiring a basic knowledge of nutritional physiology and an understanding of the impact of various disease states on utilization of nutrient substrates. The goals of TPN are to reverse catabolism, promote anabolism, and build structural protein. It is important to infuse an adequate amount of calories and protein but to avoid the stress of overfeeding. Various laboratory values may be monitored to ensure that each of the nutrients administered is being adequately tolerated by the patient. Keeping these principles in mind, primary care physicians can deliver a TPN regimen specifically suited for individual patients and can anticipate and prevent any potential complications.

  16. Cardiogenic shock and nutrition: safe?

    PubMed

    Thibault, Ronan; Pichard, Claude; Wernerman, Jan; Bendjelid, Karim

    2011-01-01

    Cardiogenic shock is a common diagnosis in patients in the intensive care unit (ICU), and is characterized by a decreased cardiac output in the presence of adequate intravascular volume associated with an inadequate tissue perfusion including a physiological reduction in the splanchnic territory. It may occur in isolation as a reflection of cardiac pathology, or it may be part of a shock syndrome involving other pathogenic mechanisms. As the use of enteral nutrition (EN) is associated with an increase in mesenteric arterial output, EN could be deleterious by overwhelming the mechanisms of mesenteric adaptation. Accordingly, EN has been suspected to increase the risk of mesenteric ischaemia, bacterial translocation and sepsis in ICU patients with cardiogenic shock. International guidelines recommend a cautious use of EN within 72 h following cardiogenic shock. Recent evidence indicates that mesenteric arterial output may decrease during parenteral nutrition administration, suggesting that parenteral nutrition could have a protective effect on splanchnic organs in ICU patients with cardiogenic shock. Contrary to former beliefs, several meta-analyses have shown that parenteral nutrition is not associated with increased mortality. Exclusive EN is associated with negative energy balance and the combination of EN with supplemental parenteral nutrition during the first days following ICU admission has been proposed to prevent negative energy balance. Such a nutritional strategy could also be beneficial for the mesenteric circulation in cardiogenic shock, and consequently may improve the clinical outcome of patients with cardiogenic shock. Clinical trials are warranted to verify these hypotheses. PMID:21086113

  17. Space Nutrition

    NASA Technical Reports Server (NTRS)

    Smith, Scott M.

    2009-01-01

    Optimal nutrition will be critical for crew members who embark on space exploration missions. Nutritional assessment provides an opportunity to ensure that crewmembers begin their missions in optimal nutritional status, to document changes during a mission and, if necessary, to provide intervention to maintain that status throughout the mission, and to assesses changes after landing in order to facilitate the return to their normal status as soon as possible after landing. We report here the findings from our nutritional assessment of astronauts who participated in the International Space Station (ISS) missions, along with flight and ground-based research findings. We also present ongoing and planned nutrition research activities. These studies provide evidence that bone loss, compromised vitamin status, and oxidative damage are the critical nutritional concerns for space travelers. Other nutrient issues exist, including concerns about the stability of nutrients in the food system, which are exposed to longterm storage and radiation during flight. Defining nutrient requirements, and being able to provide and maintain those nutrients on exploration missions, will be critical for maintaining crew member health.

  18. SNAP benefits: Can an adequate benefit be defined?

    PubMed

    Yaktine, Ann L; Caswell, Julie A

    2014-01-01

    The Supplemental Nutrition Assistance Program (SNAP) increases the food purchasing power of participating households. A committee convened by the Institute of Medicine (IOM) examined the question of whether it is feasible to define SNAP allotment adequacy. Total resources; individual, household, and environmental factors; and SNAP program characteristics that affect allotment adequacy were identified from a framework developed by the IOM committee. The committee concluded that it is feasible to define SNAP allotment adequacy; however, such a definition must take into account the degree to which participants' total resources and individual, household, and environmental factors influence the purchasing power of SNAP benefits and the impact of SNAP program characteristics on the calculation of the dollar value of the SNAP allotment. The committee recommended that the USDA Food and Nutrition Service investigate ways to incorporate these factors and program characteristics into research aimed at defining allotment adequacy.

  19. SNAP benefits: Can an adequate benefit be defined?

    PubMed

    Yaktine, Ann L; Caswell, Julie A

    2014-01-01

    The Supplemental Nutrition Assistance Program (SNAP) increases the food purchasing power of participating households. A committee convened by the Institute of Medicine (IOM) examined the question of whether it is feasible to define SNAP allotment adequacy. Total resources; individual, household, and environmental factors; and SNAP program characteristics that affect allotment adequacy were identified from a framework developed by the IOM committee. The committee concluded that it is feasible to define SNAP allotment adequacy; however, such a definition must take into account the degree to which participants' total resources and individual, household, and environmental factors influence the purchasing power of SNAP benefits and the impact of SNAP program characteristics on the calculation of the dollar value of the SNAP allotment. The committee recommended that the USDA Food and Nutrition Service investigate ways to incorporate these factors and program characteristics into research aimed at defining allotment adequacy. PMID:24425718

  20. [Nutrition and cancer patients].

    PubMed

    Katsuramaki, T; Hirata, K; Isobe, M

    1998-03-01

    Nutritional therapy for cancer patients includes various objectives such as improvement of cachexia, elucidation of the mechanism of malnutrition, development of therapy for anorexia, nutrition support during chemotherapy or radiotherapy, and inhibition of tumor growth under controlled caloric intake. This review describes recent remarkable developments in nutritional therapy for cancer patients. Cytokines such as interleukin (IL)-1, IL-6, and tumor necrosis factor which induce proteolysis and lipolysis are involved in the cause of malnutrition and cachexia in cancer patients. IL-1 also plays a significant role in the development of cancer anorexia via direct action in the brain. For anorexia therapy, progestogens have been shown to improve appetite and food intake in cancer patients. Moreover, glutamine supplementation improves the host protein metabolism without enhancement of tumor growth during chemotherapy. Among the effects of caloric intake on anticancer therapy, AO-90, a methionine-free intravenous amino acid solution, has been shown to increase the antitumor effect of 5-fluorouracil in clinical studies. From these observations, recent progress in nutritional therapy for cancer patients has been remarkable. Further study of nutritional therapy is required in order to maintain or improve the quality of life of cancer patients in the future.

  1. [Supplemental parenteral nutrition for intensive care patients: a logical combination with enteral nutrition].

    PubMed

    Heidegger, Claudia-Paula; Thibault, Ronan; Berger, Mette M; Pichard, Claude

    2009-12-01

    Undernutrition is a widespread problem in the intensive care and is associated with a worse clinical outcome. Enteral nutrition is the recommended nutritional support in ICU patients. However, enteral nutrition is frequently insufficient to cover protein-energy needs. The initiation of supplemental parenteral nutrition, when enteral nutrition is insufficient, could optimize the nutritional therapy. Such a combination could allow reducing morbidity, length of stay and recovery, as well as improving quality of life and health care costs. Prospective studies are currently underway to test this hypothesis.

  2. [Healthy nutrition - prerequisite for life enjoyment and quality of life].

    PubMed

    Ritzel, G

    1978-12-01

    Bad nutritional habits can cause or enhance various, especially chronic, diseases. The right amount of calories, an adequate composition and the distribution of the meals over the day are the basis of good nutrition. A coordinating office could improve the information of our population, since many different professions must cooperate. Nutritions education must be improved. Industry, professional organisations, nutritionists, consumer organisations and specialists for communication must cooperate to solve the difficult problem of nutritional habits and to demonstrate that good nutrition can--as the gastrotonomy of the future--help to enjoy life. PMID:735436

  3. Nutrition in acute pancreatitis: a critical review.

    PubMed

    Lodewijkx, Piet J; Besselink, Marc G; Witteman, Ben J; Schepers, Nicolien J; Gooszen, Hein G; van Santvoort, Hjalmar C; Bakker, Olaf J

    2016-01-01

    Severe acute pancreatitis poses unique nutritional challenges. The optimal nutritional support in patients with severe acute pancreatitis has been a subject of debate for decades. This review provides a critical review of the available literature. According to current literature, enteral nutrition is superior to parenteral nutrition, although several limitations should be taken into account. The optimal route of enteral nutrition remains unclear, but normal or nasogastric tube feeding seems safe when tolerated. In patients with predicted severe acute pancreatitis an on-demand feeding strategy is advised and when patients do not tolerate an oral diet after 72 hours, enteral nutrition can be started. The use of supplements, both parenteral as enteral, are not recommended. Optimal nutritional support in severe cases often requires a tailor-made approach with day-to-day evaluation of its effectiveness. PMID:26823272

  4. Specific nutritional problems in acute kidney injury, treated with non-dialysis and dialytic modalities

    PubMed Central

    Fiaccadori, Enrico; Regolisti, Giuseppe; Cabassi, Aderville

    2010-01-01

    Patients who develop AKI, especially in the intensive care unit (ICU), are at risk of protein–energy malnutrition, which is a major negative prognostic factor in this clinical condition. Despite the lack of evidence from controlled trials of its effect on outcome, nutritional support by the enteral (preferentially) and/or parenteral route appears clinically indicated in most cases of ICU-acquired AKI, independently of the actual nutritional status of the patient, in order to prevent deterioration in the nutritional state with all its known complications. Extrapolating from data in other conditions, it seems intrinsically unlikely that starvation of a catabolic patient is more beneficial than appropriate nutritional support by an expert team with the skills to avoid the potential complications of the enteral and parenteral nutrition methodologies. By the same token, it is ethically impossible to conduct a trial in which the control group undergoes prolonged starvation. The primary goals of nutritional support in AKI, which represents a well-known inflammatory and pro-oxidative condition, are the same as those for other critically ill patients with normal renal function, i.e. to ensure the delivery of adequate nutrition, to prevent protein–energy wasting with its attendant metabolic complications, to promote wound healing and tissue repair, to support immune system function, to accelerate recovery and to reduce mortality. Patients with AKI on RRT should receive a basic intake of at least 1.5 g/kg/day of protein with an additional 0.2 g/kg/day to compensate for amino acid/protein loss during RRT, especially when daily treatments and/or high efficiecy modalities are used. Energy intake should consist of no more than 30 kcal non-protein calories or 1.3 × BEE (Basal Energy Expenditure) calculated by the Harris–Benedict equation, with ∼30–35% from lipid, as lipid emulsions. For nutritional support, the enteral route is preferred, although it often needs to be

  5. Nutritional considerations for vegetarian athletes.

    PubMed

    Barr, Susan I; Rideout, Candice A

    2004-01-01

    With the growing interest in the potential health benefits of plant-based diets, it is relevant to consider whether vegetarian dietary practices could influence athletic performance. Accordingly, this review examines whether nutrients that may differ between vegetarian and omnivorous diets could affect physical performance. We also describe recent studies that attempt to assess the effects of a vegetarian diet on performance and comment on other nutritional aspects of vegetarianism of relevance to athletes. Although well-controlled long-term studies assessing the effects of vegetarian diets on athletes have not been conducted, the following observations can be made: 1) well-planned, appropriately supplemented vegetarian diets appear to effectively support athletic performance; 2) provided protein intakes are adequate to meet needs for total nitrogen and the essential amino acids, plant and animal protein sources appear to provide equivalent support to athletic training and performance; 3) vegetarians (particularly women) are at increased risk for non-anemic iron deficiency, which may limit endurance performance; and 4) as a group, vegetarians have lower mean muscle creatine concentrations than do omnivores, and this may affect supramaximal exercise performance. Because their initial muscle creatine concentrations are lower, vegetarians are likely to experience greater performance increments after creatine loading in activities that rely on the adenosine triphosphate/phosphocreatine system. 5) Coaches and trainers should be aware that some athletes may adopt a vegetarian diet as a strategy for weight control. Accordingly, the possibility of a disordered eating pattern should be investigated if a vegetarian diet is accompanied by unwarranted weight loss.

  6. Nutrition economics - characterising the economic and health impact of nutrition.

    PubMed

    Lenoir-Wijnkoop, I; Dapoigny, M; Dubois, D; van Ganse, E; Gutiérrez-Ibarluzea, I; Hutton, J; Jones, P; Mittendorf, T; Poley, M J; Salminen, S; Nuijten, M J C

    2011-01-01

    There is a new merging of health economics and nutrition disciplines to assess the impact of diet on health and disease prevention and to characterise the health and economic aspects of specific changes in nutritional behaviour and nutrition recommendations. A rationale exists for developing the field of nutrition economics which could offer a better understanding of both nutrition, in the context of having a significant influence on health outcomes, and economics, in order to estimate the absolute and relative monetary impact of health measures. For this purpose, an expert meeting assessed questions aimed at clarifying the scope and identifying the key issues that should be taken into consideration in developing nutrition economics as a discipline that could potentially address important questions. We propose a first multidisciplinary outline for understanding the principles and particular characteristics of this emerging field. We summarise here the concepts and the observations of workshop participants and propose a basic setting for nutrition economics and health outcomes research as a novel discipline to support nutrition, health economics and health policy development in an evidence and health-benefit-based manner. PMID:20797310

  7. Priority nutrition messages.

    PubMed

    1991-01-01

    The Philippine Food and Nutrition Program deliver priority short, simple, clear, and action filled nutrition messages in different languages and dialects to different audiences. Its 1st priority task is to promote breast feeding. It informs mothers that breast milk is the most nutritious food for infants and that it protects them from infectious diseases. The program also encourages breast feeding as long as possible. If mothers cannot breast feed, they should talk to an infant nutrition expert to help them choose the best formula and learn about proper preparation. A 4-6 month infant needs to begin eating small amounts of semisolid nutritious foods. Moreover these foods must include body building foods, such as meat and eggs, and energy providing foods, such as corn and rice. Mothers must 1st attend to food needs of infants and preschoolers since they are more likely to suffer malnutrition than older children and adults. This is especially important when they suffer from an infection. Specifically, the very young need a variety of foods each day including the vitamin and mineral rich vegetables and fruits. In fact, families should grow their own fruits and vegetables to ensure an adequate supply. Hands must be cleaned with soap and water after defecation and before preparing foods. Mothers should add fats and oils when preparing foods because they provide concentrated energy, fatty acids, and fat soluble vitamins. Pregnant mothers must consume increased amounts of fish, beans, and other body building foods as well as regulating foods (vegetables and fruits). Mothers must also space births. They should weigh children each month to monitor nutritional levels. Moreover they must pay attention to signs indicating inadequate and insufficient food intake e.g., underweight and night blindness.

  8. Priority nutrition messages.

    PubMed

    1991-01-01

    The Philippine Food and Nutrition Program deliver priority short, simple, clear, and action filled nutrition messages in different languages and dialects to different audiences. Its 1st priority task is to promote breast feeding. It informs mothers that breast milk is the most nutritious food for infants and that it protects them from infectious diseases. The program also encourages breast feeding as long as possible. If mothers cannot breast feed, they should talk to an infant nutrition expert to help them choose the best formula and learn about proper preparation. A 4-6 month infant needs to begin eating small amounts of semisolid nutritious foods. Moreover these foods must include body building foods, such as meat and eggs, and energy providing foods, such as corn and rice. Mothers must 1st attend to food needs of infants and preschoolers since they are more likely to suffer malnutrition than older children and adults. This is especially important when they suffer from an infection. Specifically, the very young need a variety of foods each day including the vitamin and mineral rich vegetables and fruits. In fact, families should grow their own fruits and vegetables to ensure an adequate supply. Hands must be cleaned with soap and water after defecation and before preparing foods. Mothers should add fats and oils when preparing foods because they provide concentrated energy, fatty acids, and fat soluble vitamins. Pregnant mothers must consume increased amounts of fish, beans, and other body building foods as well as regulating foods (vegetables and fruits). Mothers must also space births. They should weigh children each month to monitor nutritional levels. Moreover they must pay attention to signs indicating inadequate and insufficient food intake e.g., underweight and night blindness. PMID:12284666

  9. Essentials of Nutrition Education in Medical Schools: A National Consensus.

    ERIC Educational Resources Information Center

    Academic Medicine, 1996

    1996-01-01

    The American Medical Student Association's Nutrition Curriculum Project assembled a 10-member advisory board to develop a comprehensive list of nutrition topics deemed essential for the adequate training of physicians. The resulting 92 topics are divided into 5 major categories: (1) biochemistry/physiology/pathophysiology; (2) nutrition…

  10. Evaluation of engineering foods for closed Ecological Life Support System (CELSS)

    NASA Technical Reports Server (NTRS)

    Karel, M.

    1982-01-01

    A nutritionally adequate and acceptable diet was evaluated and developed. A design for a multipurpose food plant is discussed. The types and amounts of foods needed to be regenerated in a partially closed ecological life support system (PCELSS) were proposed. All steps of food processes to be utilized in the multipurpose food plant of PCELSS were also considered. Equipment specifications, simplification of the proposed processes, and food waste treatment were analyzed.

  11. Nutrition and cancer education: ten years of progress.

    PubMed

    Ashley, J M; St Jeor, S T; Veach, T L; Mackintosh, F R; Anderson, J L; Perumean-Chaney, S E; Krenkel, J A; Scott, B J

    2000-01-01

    The Nutrition Education and Research Program at the University of Nevada School of Medicine was awarded two separate NIH/NCI R25 cancer education grants over a ten-year period. With this support, a four-year longitudinal nutrition curriculum was implemented, including the required 20-hour freshman Medical Nutrition Course, junior and senior nutrition electives, and a senior assignment in nutrition and cancer during the rural rotation with faculty preceptors. Funding has also supported nutrition integration into the basic science courses, patient care courses, and specialty clerkships. A unique nutrition fellowship for medical students who specialize in nutrition during their four years of training and graduate with special Qualifications in Nutrition (SQIN) has also been instituted. The curriculum reflects a longitudinal, interdisciplinary, but flexible, integration of nutrition into an already crowded medical school education.

  12. A Nutrition Knowledge Test for Nutrition Educators.

    ERIC Educational Resources Information Center

    Byrd-Bredbenner, Carol

    1981-01-01

    Describes the development of a criterion-referenced instrument for assessing nutrition knowledge of potential nutrition educators. Discusses results which demonstrate that the instrument discriminates between groups of professionals who are trained in nutrition and those who are not. (CS)

  13. Nutrition and Diet

    MedlinePlus

    ... Thai HbH:Vietnamese Relevant links Living with Thalassemia NUTRITIONNutrition and Diet ▶ Diet for the Non-transfused ... booklet ▶ 3 Simple Suggestions for a Healthy Diet Nutrition and Diet Nutritional deficiencies are common in thalassemia, ...

  14. Nutritional Therapy.

    PubMed

    Schwartz, Julie

    2016-03-01

    This article provides the reader with steps needed to accurately assess patient nutrition behaviors that contribute to weight gain, inability to lose weight, or inability to sustain weight loss. Evidence-based approaches in nutrition therapy that can create the daily energy deficit needed to produce 1/2 to 2 pounds of weight loss per week, and the strategies to create the energy deficit, are presented. To optimize health, long-term weight loss maintenance is needed. The benefits of using a multidisciplinary team approach in treating obesity are highlighted.

  15. Promoting nutrition in breastfeeding women.

    PubMed

    Wilson, Patty R; Pugh, Linda C

    2005-01-01

    Nurses have a vital role in providing nutritional education to breastfeeding women. In this article, the authors discuss the nutritional requirements for breast-feeding women in terms of micronutrients, macronutrients, and minerals. They provide recommendations for women with vegetarian diets and low-income women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children program who may have dietary deficiencies, and they present a directed case study to provide an example of how to perform a dietary assessment and the educational support that may be offered by nurses to breastfeeding women.

  16. Nutritional recommendations for the management of sarcopenia.

    PubMed

    Morley, John E; Argiles, Josep M; Evans, William J; Bhasin, Shalender; Cella, David; Deutz, Nicolaas E P; Doehner, Wolfram; Fearon, Ken C H; Ferrucci, Luigi; Hellerstein, Marc K; Kalantar-Zadeh, Kamyar; Lochs, Herbert; MacDonald, Neil; Mulligan, Kathleen; Muscaritoli, Maurizio; Ponikowski, Piotr; Posthauer, Mary Ellen; Rossi Fanelli, Filippo; Schambelan, Morrie; Schols, Annemie M W J; Schuster, Michael W; Anker, Stefan D

    2010-07-01

    The Society for Sarcopenia, Cachexia, and Wasting Disease convened an expert panel to develop nutritional recommendations for prevention and management of sarcopenia. Exercise (both resistance and aerobic) in combination with adequate protein and energy intake is the key component of the prevention and management of sarcopenia. Adequate protein supplementation alone only slows loss of muscle mass. Adequate protein intake (leucine-enriched balanced amino acids and possibly creatine) may enhance muscle strength. Low 25(OH) vitamin D levels require vitamin D replacement. PMID:20627179

  17. [Abdominal cure procedures. Adequate use of Nobecutan Spray].

    PubMed

    López Soto, Rosa María

    2009-12-01

    Open abdominal wounds, complicated by infection and/or risk of eventration tend to become chronic and usually require frequent prolonged cure. Habitual changing of bandages develop into one of the clearest risk factors leading to the deterioration of perilesional cutaneous integrity. This brings with it new complications which draw out the evolution of the process, provoking an important deterioration in quality of life for the person who suffers this and a considerable increase in health costs. What is needed is a product and a procedure which control the risk of irritation, which protect the skin, which favor a patient's comfort and which shorten treatment requirements while lowering health care expenses. This report invites medical personnel to think seriously about the scientific rationale, and treatment practice, as to why and how to apply Nobecutan adequately, this reports concludes stating the benefits in the adequate use of this product. The objective of this report is to guarantee the adequate use of this product in treatment of complicated abdominal wounds. This product responds to the needs which are present in these clinical cases favoring skin care apt isolation and protection, while at the same time, facilitating the placement and stability of dressings and bandages used to cure wounds. In order for this to happen, the correct use of this product is essential; medical personnel must pay attention to precautions and recommendations for proper application. The author's experiences in habitual handling of this product during various years, included in the procedures for standardized cures for these wounds, corroborates its usefulness; the author considers use of this product to be highly effective while being simple to apply; furthermore, one succeeds in providing quality care and optimizes resources employed.

  18. Meta-analysis is not enough: The critical role of pathophysiology in determining optimal care in clinical nutrition.

    PubMed

    Soeters, Peter; Bozzetti, Federico; Cynober, Luc; Elia, Marinos; Shenkin, Alan; Sobotka, Lubos

    2016-06-01

    Evidence based medicine has preferably been based on prospective randomized controlled trials (PRCT's) and subsequent meta-analyses in many fields including nutrition and metabolism. These meta-analyses often yield convincing, contradictory or no proof of effectiveness. Consequently recommendations and guidelines of varying validity and quality have been published, often failing to convince the medical, insurance and government worlds to support nutritional care. Causes for lack of adequate proof of effectiveness are manifold. Many studies and meta-analyses lacked pathophysiological depth in design and interpretation. Study populations were not homogenous and endpoints not always clearly defined. Patients were included not at nutritional risk, unlikely to benefit from nutritional intervention. Others received nutrients in excess of requirements or tolerance due to organ failure. To include all available studies in a meta-analysis, study quality and homogeneity were only assessed on the basis of formal study design and outcome rather than on patient characteristics. Consequently, some studies showed benefit but included patients suffering harm, other studies were negative but contained patients that benefited. Recommendations did not always emphasize these shortcomings, confusing the medical and nutritional community and creating the impression that nutritional support is not beneficial. Strong reliance on meta-analyses and guidelines shifts the focus of education from studying clinical and nutritional physiology to memorizing guidelines. To prevent or improve malnutrition more physiological knowledge should be acquired to personalize nutritional practices and to more correctly value and evaluate the evidence. This also applies to the design and interpretation of PRCT's and meta-analyses.

  19. Let's Talk About Food. Answers to your Questions About Foods and Nutrition.

    ERIC Educational Resources Information Center

    White, Philip L., Ed.; Selvey, Nancy, Ed.

    This book on the subject of nutrition is written in the form of often-asked questions and detailed, informative answers. In ten chapters the following range of nutrition topics is covered: (1) meaning of RDA, nutrition labeling, calorie tables, nutrient density; (2) adequate diet, pregnancy, physical fitness, vitamins, diet for athletes, baby…

  20. Nutritional Needs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The dramatic growth of infants during the 1st yr of life (a 3-fold increase in weight; a 50% increase in length) and continued growth, albeit at lower rates, from 1 yr of age through adolescence impose unique nutritional needs. The needs for growth are superimposed on relatively high maintenance nee...

  1. Nutritional requirements

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The dramatic growth of infants during the first year of life (e.g., a 3-fold increase in weight and a 2-fold increase in length) and continued growth, albeit at lower rates, from a year of age through adolescence impose unique nutritional needs. Moreover, these needs for growth are superimposed on ...

  2. Addressing the nutritional needs of university students

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The USDA Delta Obesity Prevention Research Project seeks to identify and evaluate dietary and physical activity patterns in African American students to develop an educational intervention that is nutritionally adequate and culturally relevant for 18- to 24-year-old African-American university stude...

  3. Nutrition in the Curriculum: Medical Experience.

    ERIC Educational Resources Information Center

    Shils, Maurice E.

    1990-01-01

    A review of current curricula in United States medical schools indicates a continued need for more adequate instruction of clinical nutrition to physicians in training and in practice. A major problem is failure to provide patient-oriented, case-related teaching in clinical years to all clinical clerks. (Author/MSE)

  4. Quantifying dose to the reconstructed breast: Can we adequately treat?

    SciTech Connect

    Chung, Eugene; Marsh, Robin B.; Griffith, Kent A.; Moran, Jean M.; Pierce, Lori J.

    2013-04-01

    To evaluate how immediate reconstruction (IR) impacts postmastectomy radiotherapy (PMRT) dose distributions to the reconstructed breast (RB), internal mammary nodes (IMN), heart, and lungs using quantifiable dosimetric end points. 3D conformal plans were developed for 20 IR patients, 10 autologous reconstruction (AR), and 10 expander-implant (EI) reconstruction. For each reconstruction type, 5 right- and 5 left-sided reconstructions were selected. Two plans were created for each patient, 1 with RB coverage alone and 1 with RB + IMN coverage. Left-sided EI plans without IMN coverage had higher heart Dmean than left-sided AR plans (2.97 and 0.84 Gy, p = 0.03). Otherwise, results did not vary by reconstruction type and all remaining metrics were evaluated using a combined AR and EI dataset. RB coverage was adequate regardless of laterality or IMN coverage (Dmean 50.61 Gy, D95 45.76 Gy). When included, IMN Dmean and D95 were 49.57 and 40.96 Gy, respectively. Mean heart doses increased with left-sided treatment plans and IMN inclusion. Right-sided treatment plans and IMN inclusion increased mean lung V{sub 20}. Using standard field arrangements and 3D planning, we observed excellent coverage of the RB and IMN, regardless of laterality or reconstruction type. Our results demonstrate that adequate doses can be delivered to the RB with or without IMN coverage.

  5. The concept of adequate causation and Max Weber's comparative sociology of religion.

    PubMed

    Buss, A

    1999-06-01

    Max Weber's The Protestant Ethic and the Spirit of Capitalism, studied in isolation, shows mainly an elective affinity or an adequacy on the level of meaning between the Protestant ethic and the 'spirit' of capitalism. Here it is suggested that Weber's subsequent essays on 'The Economic Ethics of World Religions' are the result of his opinion that adequacy on the level of meaning needs and can be verified by causal adequacy. After some introductory remarks, particularly on elective affinity, the paper tries to develop the concept of adequate causation and the related concept of objective possibility on the basis of the work of v. Kries on whom Weber heavily relied. In the second part, this concept is used to show how the study of the economic ethics of India, China, Rome and orthodox Russia can support the thesis that the 'spirit' of capitalism, although it may not have been caused by the Protestant ethic, was perhaps adequately caused by it. PMID:15260028

  6. Translating nutrition research into action in humanitarian emergencies.

    PubMed

    Reed, Barbara A; Habicht, Jean-Pierre; Garza, Cutberto

    2002-07-01

    Except for the management of severe malnutrition, there has been little research specifically conducted to support emergency food and nutrition programs. Lacking empirically based guidance regarding how accurately to identify problems and select the most effective means to achieve desired objectives, programming decisions have been based on extrapolations, anecdotal evidence and intuition, with hopes of doing the right thing. Consequently, donors, implementers and affected governments, who often hold contradictory opinions, expend time and resources on controversies about when and how to act. These controversies reveal inadequate knowledge for which research is urgently needed. Two past controversies are presented as illustrations: one related to ration energy requirements and the other to sales of food aid. Appropriate action depends on context and research to support emergency programming must encompass a broad range of sectors and disciplines. Furthermore, emergency contexts are characterized by extremes and dynamic change and investigations in such contexts demand special approaches and caution. Institutional structures need to be changed so that they can adequately support emergency nutrition research.

  7. Nutritional Biochemistry of Space Flight

    NASA Technical Reports Server (NTRS)

    Smith, Scott M.

    2000-01-01

    Adequate nutrition is critical for maintenance of crew health during and after extended-duration space flight. The impact of weightlessness on human physiology is profound, with effects on many systems related to nutrition, including bone, muscle, hematology, fluid and electrolyte regulation. Additionally, we have much to learn regarding the impact of weightlessness on absorption, mtabolism , and excretion of nutrients, and this will ultimately determine the nutrient requirements for extended-duration space flight. Existing nutritional requirements for extended-duration space flight have been formulated based on limited flight research, and extrapolation from ground-based research. NASA's Nutritional Biochemistry Laboratory is charged with defining the nutritional requirements for space flight. This is accomplished through both operational and research projects. A nutritional status assessment program is included operationally for all International Space Station astronauts. This medical requirement includes biochemical and dietary assessments, and is completed before, during, and after the missions. This program will provide information about crew health and nutritional status, and will also provide assessments of countermeasure efficacy. Ongoing research projects include studies of calcium and bone metabolism, and iron absorption and metabolism. The calcium studies include measurements of endocrine regulation of calcium homeostasis, biochemical marker of bone metabolism, and tracer kinetic studies of calcium movement in the body. These calcium kinetic studies allow for estimation of intestinal absorption, urinary excretion, and perhaps most importantly - deposition and resorption of calcium from bone. The Calcium Kinetics experiment is currently being prepared for flight on the Space Shuttle in 2001, and potentially for subsequent Shuttle and International Space Station missions. The iron study is intended to assess whether iron absorption is down-regulated dUl1ng

  8. Uncovering the nutritional landscape of food.

    PubMed

    Kim, Seunghyeon; Sung, Jaeyun; Foo, Mathias; Jin, Yong-Su; Kim, Pan-Jun

    2015-01-01

    Recent progresses in data-driven analysis methods, including network-based approaches, are revolutionizing many classical disciplines. These techniques can also be applied to food and nutrition, which must be studied to design healthy diets. Using nutritional information from over 1,000 raw foods, we systematically evaluated the nutrient composition of each food in regards to satisfying daily nutritional requirements. The nutrient balance of a food was quantified and termed nutritional fitness; this measure was based on the food's frequency of occurrence in nutritionally adequate food combinations. Nutritional fitness offers a way to prioritize recommendable foods within a global network of foods, in which foods are connected based on the similarities of their nutrient compositions. We identified a number of key nutrients, such as choline and α-linolenic acid, whose levels in foods can critically affect the nutritional fitness of the foods. Analogously, pairs of nutrients can have the same effect. In fact, two nutrients can synergistically affect the nutritional fitness, although the individual nutrients alone may not have an impact. This result, involving the tendency among nutrients to exhibit correlations in their abundances across foods, implies a hidden layer of complexity when exploring for foods whose balance of nutrients within pairs holistically helps meet nutritional requirements. Interestingly, foods with high nutritional fitness successfully maintain this nutrient balance. This effect expands our scope to a diverse repertoire of nutrient-nutrient correlations, which are integrated under a common network framework that yields unexpected yet coherent associations between nutrients. Our nutrient-profiling approach combined with a network-based analysis provides a more unbiased, global view of the relationships between foods and nutrients, and can be extended towards nutritional policies, food marketing, and personalized nutrition.

  9. Uncovering the Nutritional Landscape of Food

    PubMed Central

    Kim, Seunghyeon; Sung, Jaeyun; Foo, Mathias; Jin, Yong-Su; Kim, Pan-Jun

    2015-01-01

    Recent progresses in data-driven analysis methods, including network-based approaches, are revolutionizing many classical disciplines. These techniques can also be applied to food and nutrition, which must be studied to design healthy diets. Using nutritional information from over 1,000 raw foods, we systematically evaluated the nutrient composition of each food in regards to satisfying daily nutritional requirements. The nutrient balance of a food was quantified and termed nutritional fitness; this measure was based on the food’s frequency of occurrence in nutritionally adequate food combinations. Nutritional fitness offers a way to prioritize recommendable foods within a global network of foods, in which foods are connected based on the similarities of their nutrient compositions. We identified a number of key nutrients, such as choline and α-linolenic acid, whose levels in foods can critically affect the nutritional fitness of the foods. Analogously, pairs of nutrients can have the same effect. In fact, two nutrients can synergistically affect the nutritional fitness, although the individual nutrients alone may not have an impact. This result, involving the tendency among nutrients to exhibit correlations in their abundances across foods, implies a hidden layer of complexity when exploring for foods whose balance of nutrients within pairs holistically helps meet nutritional requirements. Interestingly, foods with high nutritional fitness successfully maintain this nutrient balance. This effect expands our scope to a diverse repertoire of nutrient-nutrient correlations, which are integrated under a common network framework that yields unexpected yet coherent associations between nutrients. Our nutrient-profiling approach combined with a network-based analysis provides a more unbiased, global view of the relationships between foods and nutrients, and can be extended towards nutritional policies, food marketing, and personalized nutrition. PMID:25768022

  10. Prenatal nutrition: special considerations.

    PubMed

    Cox, J T; Phelan, S T

    2009-10-01

    Awareness of the importance of nutrition during pregnancy has increased in recent years.Pregnancy outcomes vary by prepregnant weight as well as gestational weight gain. Inappropriate gain may have both short- and long-term consequences for mother and infant. This review article includes the newly released US Institute of Medicine prenatal weight gain guidelines, as well as the Dietary Reference Intakes for the US and selected European societies.Food safety topics are discussed including Listeria, Toxoplasma, peanuts, mercury and other contaminants. Preconceptual nutrition is discussed, as are specific at-risk prenatal nutrients, including folic acid, choline, vitamin B12, omega-3 fatty acids, iodine, calcium, vitamin D, and iron. Current controversies are discussed and practical suggestions are given to safely optimize nutrient intake. As part of the medical team, a local Registered Dietitian or other nutrition professional can give much more detailed guidance and support for a pregnant woman given her particular risk factors, including her pre-existing medical conditions and cultural concerns, and will emphasize nutritional quality rather than just pounds gained. PMID:19749670

  11. Partly Fermented Infant Formulae With Specific Oligosaccharides Support Adequate Infant Growth and Are Well-Tolerated

    PubMed Central

    Huet, Frédéric; Abrahamse-Berkeveld, Marieke; Tims, Sebastian; Simeoni, Umberto; Beley, Gérard; Savagner, Christoph; Vandenplas, Yvan; Hourihane, Jonathan O’B.

    2016-01-01

    ABSTRACT Objective: Fermented formulae (FERM) and a specific mixture of 90% short-chain galacto-oligosaccharides and 10% long-chain fructo-oligosaccharides (scGOS/lcFOS; 9:1) have a potential beneficial effect on gastrointestinal function and microbiota development in infants. The present study assessed the safety and tolerance of the combination of partly fermented infant milk formulae and scGOS/lcFOS compared with either 1 feature, in healthy term infants. Methods: Four hundred thirty-two infants were enrolled before 28 days of age and followed up to 17 weeks of age and assigned to 1 of the 4 groups: (i) formula with scGOS/lcFOS, (ii) scGOS/lcFOS + 15% FERM, (iii) scGOS/lcFOS + 50% FERM, or (iv) 50% fermented formula (50% FERM). Primary outcome was daily weight gain during intervention (equivalence criterion: difference in daily weight gain ≤3 g/day). Infants’ anthropometrics, formula intake, number, and type of (serious) AEs were monitored monthly. Stool samples were collected at baseline and after 17 weeks for analysis of physiological and microbiological parameters. Results: Equivalence of weight gain per day was demonstrated in both the intention-to-treat and per-protocol population, with a mean weight gain (SD) of 29.7 (6.1), 28.2 (4.8), 28.5 (5.0), and 28.7 (5.9) g/day for the groups i to iv respectively. No differences were observed in other growth parameters, formula intake, and the number or severity of AEs. In all scGOS/lcFOS-containing formulae, a beneficial effect of scGOS/lcFOS was observed, indicated by the lower pH, lower Clostridium difficile levels, and higher secretory immunoglobulin A levels. Conclusions: The partly fermented infant milk formulae containing the specific mixture scGOS/lcFOS were well-tolerated and resulted in normal growth in healthy infants. PMID:27472478

  12. Hepatitis and the Need for Adequate Standards in Federally Supported Day Care.

    ERIC Educational Resources Information Center

    Silva, Richard J.

    1980-01-01

    This article examines findings in three epidemiological studies of day care centers and concludes that higher standards of care can reduce the incidence of hepatitis among parents and staff. (Author/DB)

  13. Nutritional assessment and screening for malnutrition.

    PubMed

    Benoist, S; Brouquet, A

    2015-08-01

    Malnutrition can be detected in up to 50% of patients with gastrointestinal cancer. Although malnutrition reflects the severity of cancer, it is important to underline that anticancer treatments including surgery likely increase the severity of malnutrition. Additionally, malnutrition is associated with an increased risk of perioperative morbidity and mortality. Nutritional assessment should be a part of pre-treatment work up of gastrointestinal cancer patients because nutritional support has been shown to limit the negative impact of malnutrition on perioperative outcome. The objective of these practice guidelines is to address the following questions regarding nutritional screening in gastrointestinal cancer patients: who should benefit from nutritional assessment, when nutritional assessment should be proposed, how nutritional assessment should be carried out and why nutritional assessment is indicated.

  14. Choices for achieving adequate dietary calcium with a vegetarian diet.

    PubMed

    Weaver, C M; Proulx, W R; Heaney, R

    1999-09-01

    To achieve adequate dietary calcium intake, several choices are available that accommodate a variety of lifestyles and tastes. Liberal consumption of dairy products in the diet is the approach of most Americans. Some plants provide absorbable calcium, but the quantity of vegetables required to reach sufficient calcium intake make an exclusively plant-based diet impractical for most individuals unless fortified foods or supplements are included. Also, dietary constituents that decrease calcium retention, such as salt, protein, and caffeine, can be high in the vegetarian diet. Although it is possible to obtain calcium balance from a plant-based diet in a Western lifestyle, it may be more convenient to achieve calcium balance by increasing calcium consumption than by limiting other dietary factors.

  15. Genetic Modification of Preimplantation Embryos: Toward Adequate Human Research Policies

    PubMed Central

    Dresser, Rebecca

    2004-01-01

    Citing advances in transgenic animal research and setbacks in human trials of somatic cell genetic interventions, some scientists and others want to begin planning for research involving the genetic modification of human embryos. Because this form of genetic modification could affect later-born children and their offspring, the protection of human subjects should be a priority in decisions about whether to proceed with such research. Yet because of gaps in existing federal policies, embryo modification proposals might not receive adequate scientific and ethical scrutiny. This article describes current policy shortcomings and recommends policy actions designed to ensure that the investigational genetic modification of embryos meets accepted standards for research on human subjects. PMID:15016248

  16. Symposium on ‘Nutrition and health in children and adolescents’ Session 1: Nutrition in growth and development

    PubMed Central

    Prentice, Ann; Schoenmakers, Inez; Laskey, M. Ann; de Bono, Stephanie; Ginty, Fiona; Goldberg, Gail R.

    2007-01-01

    The growth and development of the human skeleton requires an adequate supply of many different nutritional factors. Classical nutrient deficiencies are associated with stunting (e.g. energy, protein, Zn), rickets (e.g. vitamin D) and other bone abnormalities (e.g. Cu, Zn, vitamin C). In recent years there has been interest in the role nutrition may play in bone growth at intakes above those required to prevent classical deficiencies, particularly in relation to optimising peak bone mass and minimising osteoporosis risk. There is evidence to suggest that peak bone mass and later fracture risk are influenced by the pattern of growth in childhood and by nutritional exposures in utero, in infancy and during childhood and adolescence. Of the individual nutrients, particular attention has been paid to Ca, vitamin D, protein and P. There has also been interest in several food groups, particularly dairy products, fruit and vegetables and foods contributing to acid–base balance. However, it is not possible at the present time to define dietary reference values using bone health as a criterion, and the question of what type of diet constitutes the best support for optimal bone growth and development remains open. Prudent recommendations (Department of Health, 1998; World Health Organization/Food and Agriculture Organization, 2003) are the same as those for adults, i.e. to consume a Ca intake close to the reference nutrient intake, optimise vitamin D status through adequate summer sunshine exposure (and diet supplementation where appropriate), be physically active, have a body weight in the healthy range, restrict salt intake and consume plenty of fruit and vegetables. PMID:17181901

  17. Nutrition for cyclists.

    PubMed

    Grandjean, A C; Ruud, J S

    1994-01-01

    Good nutrition is important at every stage of training and competition. Both the serious competitive cyclist as well as the recreational cyclist should eat a balanced diet that provides calories adequate to meet energy demands. Athletes consuming less than 2000 calories a day may have difficulty meeting nutrient needs, particularly for iron and calcium. Weight loss, glycogen depletion, and dehydration also are possible results of an inadequate diet. Dietary strategies to enhance or maintain the body's carbohydrate stores are necessary for performance, especially for cyclists with high training miles or participating in road racing and other endurance events. Additionally, cyclists should be encouraged to drink plenty of fluids, especially when in a hot environment. It appears that protein requirements of endurance athletes increase as the duration and intensity of exercise increases. However, factors such as total calorie intake and protein quality should be considered when determining protein needs. Many athletes are concerned about vitamin and mineral intake and often use nutritional supplements both for "insurance" as well as performance reasons. The supplements taken most often include vitamin C, the B-complex, and iron. Vitamins and minerals in excess of the RDA do not improve performance and can be toxic when consumed in large amounts. On the other hand, vegetarians and cyclists with low-calorie intakes may benefit from a multivitamin or mineral supplement.

  18. Nutrition for winter sports.

    PubMed

    Meyer, Nanna L; Manore, Melinda M; Helle, Christine

    2011-01-01

    Winter sports are played in cold conditions on ice or snow and often at moderate to high altitude. The most important nutritional challenges for winter sport athletes exposed to environmental extremes include increased energy expenditure, accelerated muscle and liver glycogen utilization, exacerbated fluid loss, and increased iron turnover. Winter sports, however, vary greatly regarding their nutritional requirements due to variable physiological and physique characteristics, energy and substrate demands, and environmental training and competition conditions. What most winter sport athletes have in common is a relatively lean physique and high-intensity training periods, thus they require greater energy and nutrient intakes, along with adequate food and fluid before, during, and after training. Event fuelling is most challenging for cross-country skiers competing in long events, ski jumpers aiming to reduce their body weight, and those winter sport athletes incurring repeated qualification rounds and heats. These athletes need to ensure carbohydrate availability throughout competition. Finally, winter sport athletes may benefit from dietary and sport supplements; however, attention should be paid to safety and efficacy if supplementation is considered.

  19. Nutrition for distance events.

    PubMed

    Burke, Louise M; Millet, Gregoire; Tarnopolsky, Mark A

    2007-01-01

    The goal of training is to prepare the distance athlete to perform at his or her best during major competitions. Whatever the event, nutrition plays a major role in the achievement of various factors that will see a runner or walker take the starting line in the best possible form. Everyday eating patterns must supply fuel and nutrients needed to optimize their performance during training sessions and to recover quickly afterwards. Carbohydrate and fluid intake before, during, and after a workout may help to reduce fatigue and enhance performance. Recovery eating should also consider issues for adaptation and the immune system that may involve intakes of protein and some micronutrients. Race preparation strategies should include preparation of adequate fuel stores, including carbohydrate loading for prolonged events such as the marathon or 50-km walk. Fluid and carbohydrate intake during races lasting an hour or more should also be considered. Sports foods and supplements of value to distance athletes include sports drinks and liquid meal supplements to allow nutrition goals to be achieved when normal foods are not practical. While caffeine is an ergogenic aid of possible value to distance athletes, most other supplements are of minimal benefit. PMID:18049981

  20. Total parenteral nutrition in the cancer patient.

    PubMed

    Mahaffey, S M; Copeland, E M

    1987-01-01

    Malnutrition is a common accompaniment of malignant disease and clearly places the cancer patient at increased risk. Adequate nutritional rehabilitation of the malnourished cancer patient can correct abnormal nutritional indices. In the surgical patient, this has been shown to decrease perioperative morbidity and mortality. Nutritionally repleted patients undergoing radiation or chemotherapy may be more tolerant and, therefore, more likely to respond to treatment although, thus far, a favorable effect on outcome has not been demonstrated conclusively. Patients who are to receive multimodal treatment with chemotherapy, radiotherapy, and surgery are at a particularly high risk for the development of malnutrition, and the institution of one treatment may be predicated on recovery from the previous therapy. When a major abdominal surgical procedure is part of the treatment plan, TPN may be required to prevent malnutrition in an otherwise nutritionally intact patient at the outset of therapy. For patients in whom TPN is indicated, adequate nutritional restoration is of paramount importance. Calories and nitrogen in excess of amounts predicted for noncancer patients may be required. Sequential nutritional assessment is a must to assure the adequacy of nutritional repletion. Considerations of cost and simplicity make the enteral route the preferred avenue for nutritional repletion if the gut is available for use. Certainly, when indicated, however, the risk and expense of parenteral nutrition is justified, particularly in the surgical patient. At present there are no data to justify the use of one particular amino acid formulation or energy source over another. A balanced amino acid solution with glucose as the primary energy source seems equally as efficacious as specialized amino acid formulas and lipid as the primary calorie source.

  1. The effects of composting on the nutritional composition of fibrous bio-regenerative life support systems (BLSS) plant waste residues and its impact on the growth of Nile tilapia ( Oreochromis niloticus)

    NASA Astrophysics Data System (ADS)

    Gonzales, John M.; Lowry, Brett A.; Brown, Paul B.; Beyl, Caula A.; Nyochemberg, Leopold

    2009-04-01

    Utilization of bio-regenerative life support systems (BLSS) plant waste residues as a nutritional source by Nile tilapia ( Oreochromis niloticus) has proven problematic as a result of high concentrations of fibrous compounds in the plant waste residues. Nutritional improvement of plant waste residues by composting with the oyster mushroom ( Pleurotus ostreatus), and the effects on growth and nutrient utilization of Nile tilapia fed such residues were evaluated. Five Nile tilapia (mean weight = 70.9 ± 3.1 g) were stocked in triplicate aquaria and fed one of two experimental diets, cowpea (CP) and composted cowpea (CCP), twice daily for a period of 8 weeks. Composting of cowpea residue resulted in reduced concentrations of nitrogen-free extract, hemi-cellulose and trypsin inhibitor activity, though trypsin inhibitor activity remained high. Composting did not reduce crude fiber, lignin, or cellulose concentrations in the diet. No significant differences ( P < 0.05) were observed in weight gain, specific growth rate, survival rate, daily consumption, and food conversion ratio between tilapia fed CP and CCP. These results suggest that P. ostreatus is not a suitable candidate for culture in conjunction with the culture of Nile tilapia. Additional work is needed to determine what, if any, benefit can be obtained from incorporating composted residue as feed for Nile tilapia.

  2. Nutrition and immunity in cancer.

    PubMed

    Valdés-Ramos, Roxana; Benítez-Arciniega, Alejandra D

    2007-10-01

    The purpose of this article is to give a general overview of the effects of nutrition on the development of cancer as well as part of a therapeutic approach. There is much evidence that diet and lifestyle can alter the risk of cancer development as is the case for many other chronic diseases. This may be through a direct action on the immune system, either by enhancing or suppressing it, as well as on the development of the tumour itself, by modulating gene expression or by antioxidant activity. Protective effects can be achieved by adequate intakes of vitamins A and C, beta-carotene, selenium and n-3 fatty acids among others, while negative effects are found mainly with high intakes of n-6 and saturated fatty acids. Weight gain, obesity and lack of regular physical activity have also been associated with an increased risk of cancer. The protective effects are best observed when adequate diet and lifestyle are present together. With respect to the therapeutic role of nutrition in cancer, it has been observed that the use of pre- or post-operative enteral or parenteral nutrition may improve patients' survival rates and quality of life; however, more research is needed in this particular area. Breast, colon, rectum, prostate, stomach and lung are the types of cancer most commonly associated with diet or dietary components.

  3. Improving maternal nutrition for better pregnancy outcomes.

    PubMed

    Nnam, N M

    2015-11-01

    Much has been learned during the past several decades about the role of maternal nutrition in the outcome of pregnancy. While the bulk of the data is derived from animal models, human observations are gradually accumulating. There is need to improve maternal nutrition because of the high neonatal mortality rate especially in developing countries. The author used a conceptual framework which took both primary and secondary factors into account when interpreting study findings. Nutrition plays a vital role in reducing some of the health risks associated with pregnancy such as risk of fetal and infant mortality, intra-uterine growth retardation, low birth weight and premature births, decreased birth defects, cretinism, poor brain development and risk of infection. Adequate nutrition is essential for a woman throughout her life cycle to ensure proper development and prepare the reproductive life of the woman. Pregnant women require varied diets and increased nutrient intake to cope with the extra needs during pregnancy. Use of dietary supplements and fortified foods should be encouraged for pregnant women to ensure adequate supply of nutrients for both mother and foetus. The author concludes that nutrition education should be a core component of Mother and Child Health Clinics and every opportunity should be utilised to give nutrition education on appropriate diets for pregnant women.

  4. Determining median urinary iodine concentration that indicates adequate iodine intake at population level.

    PubMed Central

    Delange, François; de Benoist, Bruno; Burgi, Hans

    2002-01-01

    OBJECTIVE: Urinary iodine concentration is the prime indicator of nutritional iodine status and is used to evaluate population-based iodine supplementation. In 1994, WHO, UNICEF and ICCIDD recommended median urinary iodine concentrations for populations of 100- 200 micro g/l, assuming the 100 micro g/l threshold would limit concentrations <50 micro g/l to 100 micro g/l. The total population was 55 892, including 35 661 (64%) schoolchildren. Median urinary iodine concentrations were 111-540 (median 201) micro g/l for all populations, 100-199 micro g/l in 23 (48%) populations and >/=200 micro g/l in 25 (52%). The frequencies of values <50 micro g/l were 0-20.8 (mean 4.8%) overall and 7.2% and 2.5% in populations with medians of 100-199 micro g/l and >200 micro g/l, respectively. The frequency reached 20% only in two places where iodine had been supplemented for <2 years. CONCLUSION: The frequency of urinary iodine concentrations <50 micro g/l in populations with median urinary iodine concentrations >/=100 micro g/l has been overestimated. The threshold of 100 micro g/l does not need to be increased. In populations, median urinary iodine concentrations of 100-200 micro g/l indicate adequate iodine intake and optimal iodine nutrition. PMID:12219154

  5. Untold nutrition.

    PubMed

    Campbell, T Colin

    2014-01-01

    Nutrition is generally investigated, and findings interpreted, in reference to the activities of individual nutrients. Nutrient composition of foods, food labeling, food fortification, and nutrient recommendations are mostly founded on this assumption, a practice commonly known as reductionism. While such information on specifics is important and occasionally useful in practice, it ignores the coordinated, integrated and virtually symphonic nutrient activity (wholism) that occurs in vivo. With reductionism providing the framework, public confusion abounds and huge monetary and social costs are incurred. Two examples are briefly presented to illustrate, the long time misunderstandings (1) about saturated and total fat as causes of cancer and heart disease and (2) the emergence of the nutrient supplement industry. A new definition of the science of nutrition is urgently needed. PMID:25036857

  6. Nutritional metabolomics: Progress in addressing complexity in diet and health

    PubMed Central

    Jones, Dean P.; Park, Youngja; Ziegler, Thomas R.

    2013-01-01

    Nutritional metabolomics is rapidly maturing to use small molecule chemical profiling to support integration of diet and nutrition in complex biosystems research. These developments are critical to facilitate transition of nutritional sciences from population-based to individual-based criteria for nutritional research, assessment and management. This review addresses progress in making these approaches manageable for nutrition research. Important concept developments concerning the exposome, predictive health and complex pathobiology, serve to emphasize the central role of diet and nutrition in integrated biosystems models of health and disease. Improved analytic tools and databases for targeted and non-targeted metabolic profiling, along with bioinformatics, pathway mapping and computational modeling, are now used for nutrition research on diet, metabolism, microbiome and health associations. These new developments enable metabolome-wide association studies (MWAS) and provide a foundation for nutritional metabolomics, along with genomics, epigenomics and health phenotyping, to support integrated models required for personalized diet and nutrition forecasting. PMID:22540256

  7. Pediatric nutrition.

    PubMed

    Greco, Deborah S

    2014-03-01

    This article discusses pediatric nutrition in puppies and kittens. Supplementation of basic nutrients such as fat, protein, minerals, vitamins, and essential fatty acids of the bitch is essential for the proper growth and development of puppies during the lactation period. Milk replacers are compared for use in puppies and kittens. Supplements such as colostrum and probiotics for promotion of a healthy immune system and prevention or treatment of stress-induced and weaning diarrhea are also discussed. PMID:24580990

  8. Pediatric nutrition.

    PubMed

    Greco, Deborah S

    2014-03-01

    This article discusses pediatric nutrition in puppies and kittens. Supplementation of basic nutrients such as fat, protein, minerals, vitamins, and essential fatty acids of the bitch is essential for the proper growth and development of puppies during the lactation period. Milk replacers are compared for use in puppies and kittens. Supplements such as colostrum and probiotics for promotion of a healthy immune system and prevention or treatment of stress-induced and weaning diarrhea are also discussed.

  9. Nutritional Biochemistry

    NASA Technical Reports Server (NTRS)

    Smith, Scott M.

    2010-01-01

    This slide presentation reviews some of the effects that space flight has on humans nutritional biochemistry. Particular attention is devoted to the study of protein breakdown, inflammation, hypercatabolism, omega 3 fatty acids, vitamin D, calcium, urine, folate and nutrient stability of certain vitamins, the fluid shift and renal stone risk, acidosis, iron/hematology, and the effects on bone of dietary protein, potassium. inflammation, and omega-3 fatty acids

  10. Dietary intake of nutrients with adequate intake values in the dietary reference intakes for Japanese.

    PubMed

    Tsuboyama-Kasaoka, Nobuyo; Takizawa, Asuka; Tsubota-Utsugi, Megumi; Nakade, Makiko; Imai, Eri; Kondo, Akiko; Yoshida, Kazue; Okuda, Nagako; Nishi, Nobuo; Takimoto, Hidemi

    2013-01-01

    The Adequate Intake (AI) values in the Dietary Reference Intakes for Japanese (DRIs-J) 2010 were mainly determined based on the median intakes from 2 y of pooled data (2005-2006) from the National Health and Nutrition Survey-Japan (NHNS-J). However, it remains unclear whether 2 y of pooled data from the NHNS-J are appropriate for evaluating the intake of the population. To clarify the differences in nutrient intakes determined from 2 and 7 y of pooled data, we analyzed selected nutrient intake levels by sex and age groups using NHNS-J data. Intake data were obtained from 64,624 individuals (age: ≥1 y; 47.4% men) who completed a semi-weighed 1-d household dietary record that was part of the NHNS-J conducted annually in Japan from 2003 to 2009. There were no large differences between the median intakes calculated from 2 or 7 y of pooled data for n-6 or n-3 polyunsaturated fatty acids (PUFAs), vitamin D, pantothenic acid, potassium, or phosphorus. When the AI values and median intakes were compared, there was no large difference in the values for n-6 or n-3 PUFAs, pantothenic acid, or phosphorus. Conversely, the AI values for vitamin D and potassium differed from the median intakes of these nutrients for specific sex and age groups, because values were not based on NHNS-J data. Our results indicate that 2 y of pooled data from the NHNS-J adequately reflect the population's intake, and that the current system for determination of AI values will be applicable for future revisions.

  11. Clinical nutrition knowledge of gastroenterology fellows: is there anything omitted?

    PubMed

    Eslamian, Ghazaleh; Jacobson, Kevan; Hekmatdoost, Azita

    2013-01-01

    Despite the increased emphasis on chronic non-communicable diseases, there are notable deficits about nutrition education in many medicine training programs particularly gastroenterology fellowship programs. In the present cross-sectional study, we examined the nutritional knowledge related to clinical nutrition among Iranian gastroenterology fellows. Thirty-six gastroenterology fellows currently enrolled in a gastroenterology fellowship program completed a questionnaire, including two sections. The first of which assessed the gastroenterology fellows experience about nutrition training, nutrition management of patients with gastrointestinal (GI) disorders and evaluating perceived nutrition education needs. The second section consisted of multiple choice questions that assessed nutritional knowledge. A total of 32 gastroenterology fellows completed the first section. The majority of gastroenterology fellows failed to partake in any nutrition education during their fellowship training particularly for inpatients despite the availability to participate in the nutrition training especially for the purpose of nutrition support. Mean correct response rates for the second section was 38%. The highest mean score was seen in nutrition assessment (48.1%), followed by scores of 40.5% in nutrition support, 37.0% nutrition in GI disease, and 25.0% in micro and macronutrients. Iranian gastroenterology fellows have serious deficits in their nutrition knowledge. This study paves the way for the development of an education program to improve nutritional knowledge of gastroenterology fellows.

  12. Nutrition communication in the Pacific.

    PubMed

    White, Leticia; Saweri, Wila

    2007-09-01

    This paper summarises the findings of a scoping study to analyse and guide nutrition communication in some countries in the Pacific region. Nutrition is fundamental to achieving good health and preventing the rising prevalence of non-communicable disease. Dietary patterns are influenced by many factors and complex interactions, such as income, food prices, individual preference and beliefs, cultural traditions, as well as geographical, environmental and social factors. These interactions, the quantitative and qualitative changes in the diet, and the accompanying lifestyle changes seen in recent years, make a collaborative approach to behaviour change essential. This study suggests that by supporting nutritionists to promote nutrition, improve public awareness and by addressing key areas influencing nutrition communication, gains towards improving public health can be made at a regional level. PMID:19588610

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

    PubMed

    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.

  14. Preterm nutrition and the brain.

    PubMed

    Ramel, Sara E; Georgieff, Michael K

    2014-01-01

    The brain is the most highly metabolic organ in the preterm neonate and consumes the greatest amount of nutrient resources for its function and growth. As preterm infants survive at greater rates, neurodevelopment has become the primary morbidity outcome of interest. While many factors influence neurodevelopmental outcomes in preterm infants, nutrition is of particular importance because the healthcare team has a great deal of control over its provision. Studies over the past 30 years have emphasized the negative neurodevelopmental consequences of poor nutrition and growth in the preterm infant. While all nutrients are important for brain development, certain ones including glucose, protein, fats (including long-chain polyunsaturated fatty acids), iron, zinc, copper, iodine, folate and choline have particularly large roles in the preterm infant. They affect major brain processes such as neurogenesis, neuronal differentiation, myelination and synaptogenesis, all of which are proceeding at a rapid pace between 22 and 42 weeks' post-conception. At the macronutrient level, weight gain, linear growth (independent of weight gain) and head circumference growth are markers of nutritional status. Each has been associated with long-term neurodevelopment. The relationship of micronutrients to neurodevelopment in preterm infants is understudied in spite of the large effect these nutrients have in other young populations. Nutrients do not function alone to stimulate brain development, but rather in concert with growth factors, which in turn are dependent on adequate nutrient status (e.g. protein, zinc) as well as on physiologic status. Non-nutritional factors such as infection, corticosteroids, and inflammation alter how nutrients are accreted and distributed, and also suppress growth factor synthesis. Thus, nutritional strategies to optimize brain growth and development include assessment of status at birth, aggressive provision of nutrients that are critical in this time

  15. Dose Limits for Man do not Adequately Protect the Ecosystem

    SciTech Connect

    Higley, Kathryn A.; Alexakhin, Rudolf M.; McDonald, Joseph C.

    2004-08-01

    It has been known for quite some time that different organisms display differing degrees of sensitivity to the effects of ionizing radiations. Some microorganisms such as the bacterium Micrococcus radiodurans, along with many species of invertebrates, are extremely radio-resistant. Humans might be categorized as being relatively sensitive to radiation, and are a bit more resistant than some pine trees. Therefore, it could be argued that maintaining the dose limits necessary to protect humans will also result in the protection of most other species of flora and fauna. This concept is usually referred to as the anthropocentric approach. In other words, if man is protected then the environment is also adequately protected. The ecocentric approach might be stated as; the health of humans is effectively protected only when the environment is not unduly exposed to radiation. The ICRP is working on new recommendations dealing with the protection of the environment, and this debate should help to highlight a number of relevant issues concerning that topic.

  16. DARHT - an `adequate` EIS: A NEPA case study

    SciTech Connect

    Webb, M.D.

    1997-08-01

    The Dual Axis Radiographic Hydrodynamic Test (DARHT) Facility Environmental Impact Statement (EIS) provides a case study that is interesting for many reasons. The EIS was prepared quickly, in the face of a lawsuit, for a project with unforeseen environmental impacts, for a facility that was deemed urgently essential to national security. Following judicial review the EIS was deemed to be {open_quotes}adequate.{close_quotes} DARHT is a facility now being built at Los Alamos National Laboratory (LANL) as part of the Department of Energy (DOE) nuclear weapons stockpile stewardship program. DARHT will be used to evaluate the safety and reliability of nuclear weapons, evaluate conventional munitions and study high-velocity impact phenomena. DARHT will be equipped with two accelerator-driven, high-intensity X-ray machines to record images of materials driven by high explosives. DARHT will be used for a variety of hydrodynamic tests, and DOE plans to conduct some dynamic experiments using plutonium at DARHT as well.

  17. Parenteral nutrition: never say never

    PubMed Central

    2015-01-01

    This review emphasizes the benefits of parenteral nutrition (PN) in critically ill patients, when prescribed for relevant indications, in adequate quantities, and in due time. Critically ill patients are at risk of energy deficit during their ICU stay, a condition which leads to unfavorable outcomes, due to hypercatabolism secondary to the stress response and the difficulty to optimize feeding. Indirect calorimetry is recommended to define the energy target, since no single predictive equation accurately estimates energy expenditure. Energy metabolism is intimately associated with protein metabolism. Recent evidence calls for adequate protein provision, but there is no accurate method to estimate the protein requirements, and recommendations are probably suboptimal. Enteral nutrition (EN) is the preferred route of feeding, but gastrointestinal intolerance limits its efficacy and PN allows for full coverage of energy needs. Seven recent articles concerning PN for critically ill patients were identified and carefully reviewed for the clinical and scientific relevance of their conclusions. One article addressed the unfavorable effects of early PN, although this result should be more correctly regarded as a consequence of glucose load and hypercaloric feeding. The six other articles were either in favor of PN or concluded that there was no difference in the outcome compared with EN. Hypercaloric feeding was not observed in these studies. Hypocaloric feeding led to unfavorable outcomes. This further demonstrates the beneficial effects of an early and adequate feeding with full EN, or in case of failure of EN with exclusive or supplemental PN. EN is the first choice for critically ill patients, but difficulties providing optimal nutrition through exclusive EN are frequently encountered. In cases of insufficient EN, individualized supplemental PN should be administered to reduce the infection rate and the duration of mechanical ventilation. PN is a safe therapeutic option

  18. Isotope ratio measurements of iron in blood samples by multi-collector ICP-MS to support nutritional investigations in humans.

    PubMed

    Benkhedda, Karima; Chen, Heidi; Dabeka, Robert; Cockell, Kevin

    2008-05-01

    With the perspective of embarking on a human study using a double iron (Fe) stable isotope tracer protocol to assess iron bioavailability, investigations were conducted on Fe isotope ratios in blood samples using a VG Axiom Multi-collector ICP-MS. The factors affecting the precision and accuracy of Fe isotopic ratios, such as spectral- and matrix-induced interferences and Fe recoveries from sample preparation, have been identified and optimized. Major polyatomic interferences (e.g., Ar-O, Ar-OH, and FeH) were significantly reduced by using an Aridus nebulizer and desolvating system. Isobaric metal (e.g., (54)Cr(+) on (54)Fe(+) and (58)Ni(+) on (58)Fe(+)) interferences and Ca-oxides and hydroxides were quantitatively removed during chemical purification of blood samples and selective isolation of Fe by anion-exchange resin, after mineralization of the blood samples by microwave digestion. Quantitative recoveries of Fe from different steps of sample preparation were verified using whole blood reference material. Fe isotopic compositions of the samples were corrected for instrumental mass bias by the standard-sample bracketing method using the certified reference standard IRMM-014. External precisions on the order of 0.008-0.05 (% RSD), 0.007-0.015 (% RSD), and 0.03-0.09 (% RSD) were obtained for (54)Fe/(56)Fe, (57)Fe/(56)Fe, and (58)Fe/(56)Fe, respectively, in the blood for three replicate measurements. The level of precision obtained in this work enables the detection of low enrichments of Fe in blood, which is highly desired in nutrition tracer studies.

  19. Household-level technologies to improve the availability and preparation of adequate and safe complementary foods.

    PubMed

    Mensah, Patience; Tomkins, Andrew

    2003-03-01

    Plant-based complementary foods are the main source of nutrients for many young children in developing countries. They may, however, present problems in providing nutritionally adequate and safe diets for older infants and young children. The high starch content leads to low-nutrient diets that are bulky and dense, with high levels of antinutritive factors such as phytates, tannins, lectins, and enzyme inhibitors. Phytates impair mineral bioavailability, lectins interfere with intestinal structure, and enzyme inhibitors inhibit digestive enzymes. In addition, there is often microbial contamination, which leads to diarrhea, growth-faltering, and impaired development, and the presence of chemical contaminants may lead to neurological disease and goiter. The fact that some fruits containing carotenoids are only available seasonally contributes to the vulnerability of children receiving predominantly plant-based diets. Traditional household food technologies have been used for centuries to improve the quality and safety of complementary foods. These include dehulling, peeling, soaking, germination, fermentation, and drying. While modern communities tend to reject these technologies in favor of more convenient fast-food preparations, there is now a resurgence of interest in older technologies as a possible means of improving the quality and safety of complementary foods when the basic diet cannot be changed for economic reasons. This paper describes the biology, safety, practicability, and acceptability of these traditional processes at the household or community level, as well as the gaps in research, so that more effective policies and programs can be implemented to improve the quality and safety of complementary foods.

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

    PubMed

    Morton, Alison M

    2009-11-01

    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. PMID:19698200

  1. [Maternal nutrition during pregnancy conditions the fetal pancreas development, hormonal status and diabetes mellitus and metabolic syndrome biomarkers at birth].

    PubMed

    Sánchez-Muniz, F J; Gesteiro, E; Espárrago Rodilla, M; Rodríguez Bernal, B; Bastida, S

    2013-01-01

    Pregnancy is a vital period where several hyperplasic, hypertrophic processes together with metabolic adaptation and preparation for extra-uterine life take place. Present review accounts for central aspects of nutrition throughout gestation on the embryonic and fetal periods. It is centered in the major changes occurring in fetal pancreas, with special mention to the susceptibility of this main glucose homeostasis organ to support nutritional changes during maturation and development. Studies performed in animal models as human are commented considering the role of maternal nutrition on β-cell mass size, insulin and other pancreatic hormones production, and insulin sensitivity. Details of both the thrifty genotype and phenotype hypothesis are given, indicating that hypo/subnutrition causes metabolic adaptations that permit the future body to grow and develop itself in limited environmental and energetic conditions. The Barker hypothesis is considered suggesting that this metabolic hypothesis is a double-edged sword in the actual abundance World. Lastly the review, taking into account our own research and other papers, analyses less known aspects that relate maternal diet with insulin resistance/sensitivity markers at delivery. Particularly the role of the saturated fatty acid/carbohydrate and omega-6/omega-3 ratios in the frame of maternal diet is reviewed considering the quality of those diets under the Healthy Eating Index and the Adherence to Mediterranean Diet scores and the relationship with insulin resistance profile at birth. Present review ends indicating that nutritional habits should be strongly stated before gestation in order to assure a proper nutrition since the first moment of pregnancy. This will support an adequate fetal and pancreatic growth and development, and in turn, adequate glucose homeostasis during pregnancy and later in life, slowing down or preventing from degenerative diseases related with metabolic syndrome and type 2 diabetes

  2. Improving access to adequate pain management in Taiwan.

    PubMed

    Scholten, Willem

    2015-06-01

    There is a global crisis in access to pain management in the world. WHO estimates that 4.65 billion people live in countries where medical opioid consumption is near to zero. For 2010, WHO considered a per capita consumption of 216.7 mg morphine equivalents adequate, while Taiwan had a per capita consumption of 0.05 mg morphine equivalents in 2007. In Asia, the use of opioids is sensitive because of the Opium Wars in the 19th century and for this reason, the focus of controlled substances policies has been on the prevention of diversion and dependence. However, an optimal public health outcome requires that also the beneficial aspects of these substances are acknowledged. Therefore, WHO recommends a policy based on the Principle of Balance: ensuring access for medical and scientific purposes while preventing diversion, harmful use and dependence. Furthermore, international law requires that countries ensure access to opioid analgesics for medical and scientific purposes. There is evidence that opioid analgesics for chronic pain are not associated with a major risk for developing dependence. Barriers for access can be classified in the categories of overly restrictive laws and regulations; insufficient medical training on pain management and problems related to assessment of medical needs; attitudes like an excessive fear for dependence or diversion; and economic and logistical problems. The GOPI project found many examples of such barriers in Asia. Access to opioid medicines in Taiwan can be improved by analysing the national situation and drafting a plan. The WHO policy guidelines Ensuring Balance in National Policies on Controlled Substances can be helpful for achieving this purpose, as well as international guidelines for pain treatment.

  3. Are women with psychosis receiving adequate cervical cancer screening?

    PubMed Central

    Tilbrook, Devon; Polsky, Jane; Lofters, Aisha

    2010-01-01

    ABSTRACT OBJECTIVE To investigate the rates of cervical cancer screening among female patients with psychosis compared with similar patients without psychosis, as an indicator of the quality of primary preventive health care. DESIGN A retrospective cohort study using medical records between November 1, 2004, and November 1, 2007. SETTING Two urban family medicine clinics associated with an academic hospital in Toronto, Ont. PARTICIPANTS A random sample of female patients with and without psychosis between the ages of 20 and 69 years. MAIN OUTCOME MEASURES Number of Papanicolaou tests in a 3-year period. RESULTS Charts for 51 female patients with psychosis and 118 female patients without psychosis were reviewed. Of those women with psychosis, 62.7% were diagnosed with schizophrenia, 19.6% with bipolar disorder, 17.6% with schizoaffective disorder, and 29.4% with other psychotic disorders. Women in both groups were similar in age, rate of comorbidities, and number of full physical examinations. Women with psychosis were significantly more likely to smoke (P < .0001), to have more primary care appointments (P = .035), and to miss appointments (P = .0002) than women without psychosis. After adjustment for age, other psychiatric illnesses, number of physical examinations, number of missed appointments, and having a gynecologist, women with psychosis were significantly less likely to have had a Pap test in the previous 3 years compared with women without psychosis (47.1% vs 73.7%, respectively; odds ratio 0.19, 95% confidence interval 0.06 to 0.58). CONCLUSION Women with psychosis are more than 5 times less likely to receive adequate Pap screening compared with the general population despite their increased rates of smoking and increased number of primary care visits. PMID:20393098

  4. Improving access to adequate pain management in Taiwan.

    PubMed

    Scholten, Willem

    2015-06-01

    There is a global crisis in access to pain management in the world. WHO estimates that 4.65 billion people live in countries where medical opioid consumption is near to zero. For 2010, WHO considered a per capita consumption of 216.7 mg morphine equivalents adequate, while Taiwan had a per capita consumption of 0.05 mg morphine equivalents in 2007. In Asia, the use of opioids is sensitive because of the Opium Wars in the 19th century and for this reason, the focus of controlled substances policies has been on the prevention of diversion and dependence. However, an optimal public health outcome requires that also the beneficial aspects of these substances are acknowledged. Therefore, WHO recommends a policy based on the Principle of Balance: ensuring access for medical and scientific purposes while preventing diversion, harmful use and dependence. Furthermore, international law requires that countries ensure access to opioid analgesics for medical and scientific purposes. There is evidence that opioid analgesics for chronic pain are not associated with a major risk for developing dependence. Barriers for access can be classified in the categories of overly restrictive laws and regulations; insufficient medical training on pain management and problems related to assessment of medical needs; attitudes like an excessive fear for dependence or diversion; and economic and logistical problems. The GOPI project found many examples of such barriers in Asia. Access to opioid medicines in Taiwan can be improved by analysing the national situation and drafting a plan. The WHO policy guidelines Ensuring Balance in National Policies on Controlled Substances can be helpful for achieving this purpose, as well as international guidelines for pain treatment. PMID:26068436

  5. The impact of early percutaneous endoscopic gastrostomy placement on treatment completeness and nutritional status in locally advanced head and neck cancer patients receiving chemoradiotherapy.

    PubMed

    Atasoy, Beste M; Yonal, Oya; Demirel, Birsen; Dane, Faysal; Yilmaz, Yusuf; Kalayci, Cem; Abacioglu, Ufuk; Imeryuz, Nese

    2012-01-01

    To investigate the impact of early insertion of percutaneous endoscopic gastrostomy-tube on nutritional status and completeness of concurrent chemotherapy in locally advanced head and neck cancer patients treated with chemoradiotherapy. Twenty-three patients were enrolled into this prospective study. Gastrostomy-tube was inserted in patients before the initiation of chemoradiotherapy. There was not any significant change in nutritional parameters of patients that used their tube during treatment. Despite the grade 3 mucositis, the planned concurrent chemotherapy could be given in 70% of the patients. However, nine patients had weak compliance and their body weight (P = 0.01) and body mass index (P = 0.01) deteriorated in the first 4 weeks of chemoradiotherapy. The completeness of concurrent chemo-rate was 44% in these patients. Toxicity, requiring aggressive supportive care, may limit the chemotherapy part of curative concomitant chemoradiotherapy. By providing adequate enteral nutrition the insertion of gastrostomy-tube can increase the completeness rate of concurrent chemotherapy.

  6. Social Cognitive Determinants of Nutrition and Physical Activity Among Web-Health Users Enrolling in an Online Intervention: The Influence of Social Support, Self-Efficacy, Outcome Expectations, and Self-Regulation

    PubMed Central

    Winett, Richard A; Wojcik, Janet R

    2011-01-01

    /day, mean 4.03, SD 2.33). The Web-health users had good self-efficacy and outcome expectations for health behavior change; however, they perceived little social support for making these changes and engaged in few self-regulatory behaviors. Consistent with SCT, theoretical models provided good fit to Web-users’ data (root mean square error of the approximation [RMSEA] < .05). Perceived social support and use of self-regulatory behaviors were strong predictors of physical activity and nutrition behavior. Web users’ self-efficacy was also a good predictor of healthier levels of physical activity and dietary fat but not of fiber, fruits, and vegetables. Social support and self-efficacy indirectly predicted behavior through self-regulation, and social support had indirect effects through self-efficacy. Conclusions Results suggest Web-health users visiting and ultimately participating in online health interventions may likely be middle-aged, well-educated, upper middle class women whose detrimental health behaviors put them at risk of obesity, heart disease, some cancers, and diabetes. The success of Internet physical activity and nutrition interventions may depend on the extent to which they lead users to develop self-efficacy for behavior change, but perhaps as important, the extent to which these interventions help them garner social-support for making changes. Success of these interventions may also depend on the extent to which they provide a platform for setting goals, planning, tracking, and providing feedback on targeted behaviors. PMID:21441100

  7. Maintaining Adequate CO2 Washout for an Advanced EMU via a New Rapid Cycle Amine Technology

    NASA Technical Reports Server (NTRS)

    Chullen, Cinda; Conger, Bruce

    2012-01-01

    Over the past several years, NASA has realized tremendous progress in Extravehicular Activity (EVA) technology development. This has been evidenced by the progressive development of a new Rapid Cycle Amine (RCA) system for the Advanced Extravehicular Mobility Unit (AEMU) Portable Life Support Subsystem (PLSS). The PLSS is responsible for the life support of the crew member in the spacesuit. The RCA technology is responsible for carbon dioxide (CO2) and humidity control. Another aspect of the RCA is that it is on-back vacuum-regenerable, efficient, and reliable. The RCA also simplifies the PLSS schematic by eliminating the need for a condensing heat exchanger for humidity control in the current EMU. As development progresses on the RCA, it is important that the sizing be optimized so that the demand on the PLSS battery is minimized. As well, maintaining the CO2 washout at adequate levels during an EVA is an absolute requirement of the RCA and associated ventilation system. Testing has been underway in-house at NASA Johnson Space Center and analysis has been initiated to evaluate whether the technology provides exemplary performance in ensuring that the CO2 is removed sufficiently and the ventilation flow is adequate for maintaining CO2 washout in the AEMU spacesuit helmet of the crew member during an EVA. This paper will review the recent developments of the RCA unit, testing planned in-house with a spacesuit simulator, and the associated analytical work along with insights from the medical aspect on the testing. 1

  8. Nutrition in Space: Benefits on Earth

    NASA Technical Reports Server (NTRS)

    Smith, Scott M.

    2006-01-01

    History has often proven the criticality for adequate nutrition to ensure expedition success. Space exploration will be no different, with the exception of the certainty that food will not be found along the journey. Ensuring the health and safety of astronauts is critical and nutrition will serve several functions to that end. Nutritional assessment of International Space Station (ISS) crewmembers not only serves to evaluate the nutritional health of individuals, but also allows a better understanding of how space flight affects nutritional requirements, and how nutrition can serve in mitigating the negative effects of weightlessness on the human. Available data suggest that the nutritional status of astronauts is compromised during and after flight. Inadequate dietary intake and subsequent weight loss are often considered hallmarks of space flight, although exceptions to this do exist, and provide hope. However, beyond energy intake, specific nutrient issues also exist. Several vitamins, including D and folate, are affected in space travelers. Hematological and antioxidant defense systems are impacted, with increased iron storage, and increased markers of oxidative damage. Bone loss during space flight remains a critical challenge. Ground-based studies have proven that nutrition is a potent modulator of the bone response to simulated weightlessness. Protein and sodium are two nutrients which tend to exacerbate bone resorption and loss, likely mediated through acid base balance. Defining nutrient requirements, and being able to provide and maintain those nutrients on exploration missions, will be critical for maintaining crew member health. Both flight and ground-based research provide a unique situation, one where healthy individuals are put in a unique and challenging environment. A full understanding of the role of nutrition during space flight will not only enhance crew health and safety during flight, but will also expand our understanding of the role of

  9. Onset and evolution of stunting in infants and children. Examples from the Human Nutrition Collaborative Research Support Program. Kenya and Egypt studies.

    PubMed

    Neumann, C G; Harrison, G G

    1994-02-01

    The etiology of the early onset of stunting is diverse among populations of varying biological, environmental and cultural circumstances. This is exemplified within the Nutrition CRSP project, which took place in three different populations and ecological conditions. Within each study area a different mix and varying proportions of causative factors were identified. At least in Kenya, and probably in Mexico, the problem has its antecedents in prepregnancy and pregnancy. Powerful determinants of the infants' size at birth and during the first 6 months of life are maternal size upon entry into pregnancy, and weight and fat gain during pregnancy and lactation. In all three countries a low pregnancy weight gain was observed. Notably in Kenya, where the energy intake of the mother decreases progressively throughout pregnancy, not only do mothers gain only half as much as European or North American women, but they even lose weight and fat in the last month of pregnancy, and some mothers gain no weight or lose weight during the whole of pregnancy. Mothers in Kenya start lactation with relatively poor fat stores. Although their energy intake increases somewhat during lactation, preliminary estimates suggest that these increases may be insufficient to maintain their bodily integrity, to carry out their normal tasks of daily living, and to produce a sufficient amount of milk for optimal infant growth. In addition to an energy deficit, diet quality is a problem, particularly in Kenya and Mexico and less so in Egypt. Intakes of animal products and animal protein are very low. Zinc and iron intakes are not only low, but the bioavailability of these nutrients is poor because of the high phytate, fiber and tea content of the diet. Also vitamin B12 intake is extremely low, and at least mild-to-moderate iodine deficiency (IDD) is present in Kenya. The above micronutrients have been demonstrated to affect the linear growth of the Kenyan children, even after confounding factors have

  10. Planning strategies for development of effective exercise and nutrition countermeasures for long-duration space flight

    NASA Technical Reports Server (NTRS)

    Convertino, Victor A.

    2002-01-01

    Exercise and nutrition represent primary countermeasures used during space flight to maintain or restore maximal aerobic capacity, musculoskeletal structure, and orthostatic function. However, no single exercise, dietary regimen, or combination of prescriptions has proven entirely effective in maintaining or restoring cardiovascular and musculoskeletal functions to preflight levels after prolonged space flight. As human space flight exposures increase in duration, identification, assessment, and development of various effective exercise- and nutrition-based protective procedures will become paramount. The application of adequate dietary intake in combination with effective exercise prescription will be based on identification of basic physiologic stimuli that maintain normal function in terrestrial gravity, and understanding how specific combinations of exercise characteristics (e.g., duration, frequency, intensity, and mode) can be combined with minimal nutritional requirements that mimic the stimuli normally produced by living in Earth's gravity environment. This can be accomplished only with greater emphasis of research on ground-based experiments targeted at understanding the interactions between caloric intake and expenditure during space flight. Future strategies for application of nutrition and exercise countermeasures for long-duration space missions must be directed to minimizing crew time and the impact on life-support resources.

  11. Nutritional impact on the energy cost of fat fuel mobilization in polytrauma victims.

    PubMed

    Jeevanandam, M; Young, D H; Schiller, W R

    1990-02-01

    In the "flow" phase of severe injury, mobilization of body fat and protein sources are accelerated to meet increased demands. Fat mobilization usually exceeds the need for oxidative substrates and the leftover fatty acids are re-esterified, resulting in a "futile" TG/FFA cycle. This contributes to increased energy expenditure and provision of nutrients may alter the activity of this cycle. We measured in nine adult (age 40 +/- 7 years, weight, 80 +/- 4 kg) severely traumatized (ISS 32 +/- 4) patients, the resting energy expenditure (REE) and net fat oxidation rate (NFO) by indirect calorimetry and whole body lipolysis rate (WBLR) by a two-stage, primed-constant infusion of glycerol. Fasting postinjury kinetic studies were performed within 48-96 hours after admission when the patients were receiving saline without calories or nitrogen. Glucose-based nutritional therapy was then started and continued for 5 to 7 days. The kinetic measurements were repeated after the nutritive solutions were replaced by normal saline for 12 to 15 hours to achieve a postabsorptive state. Trauma elicits an accelerated rate of fat mobilization with increased TG/FFA cycle activity. Adequate nutritional support for 5 to 7 days tends to reduce but cannot normalize the lipid metabolism. In acute trauma 47 +/- 7% of the mobilized fat was recycled to triglyceride and this is increased to 54 +/- 9% after providing nutrition. The energy cost of this cycling was 38 kcal/day, which is five times that seen in normals and corresponds to 1.34% REE.

  12. Nutrition and liver diseases.

    PubMed

    Teran, J C

    1999-08-01

    Malnutrition and micronutrient deficiencies are common in patients with liver diseases. The pathogenesis of protein-energy malnutrition in cirrhosis involves many factors, including poor oral intake, malabsorption, and metabolic abnormalities similar to stress. Encephalopathy may complicate cirrhosis but is usually not caused by diet. Protein restriction is only necessary in rare patients with refractory encephalopathy. The use of branched-chain amino-acid solutions is not supported by the literature. Chronic liver diseases without cirrhosis are not usually associated with protein-energy malnutrition, but vitamin and mineral deficiencies are common, especially with significant cholestasis. Fatty liver may result from excessive triglyceride uptake and production by the liver or by a secretory defect. Therapy for fatty liver depends on its cause. Chronic total parenteral nutrition may induce fatty liver and inflammation especially in patients with short-bowel syndrome. Deficiency of choline in parenteral nutrition has been proposed as the mechanism for liver disease. Acute liver diseases such as fulminant hepatic failure or alcoholic hepatitis are considered hypercatabolic diseases and thus require prompt nutritional intervention with a high-calorie enteral or parenteral formula. In fulminant hepatic failure, low-protein, fluid-restricted formulas are recommended. PMID:10980970

  13. [Nutrition and chronic renal failure].

    PubMed

    Ayúcar Ruiz de Galarreta, A; Cordero Lorenzana, M L; Martínez-Puga y López, E; Gómez Seijo, A; Escudero Alvarez, E

    2000-01-01

    The causes of malnutrition in chronic terminal kidney failure are reviewed in the situation both before and after dialysis, as are the malnutrition rates in both circumstances and their treatment. Malnutrition has a high prevalence in terminal kidney patients, partly as a result of the therapeutic restriction on calories and proteins, but also due to the metabolic reactions typical of the disease and to anorexia. In patients subjected to dialytical methods, certain other mechanisms are added. In addition to malnutrition, there are alterations in the metabolism of calcium, phosphorus and potassium, as well as lipids, thus limiting nutritional therapy's ability to restore the nutritional status to normal. An awareness of energy expenditure in chronic terminal kidney failure and the consequences of malnutrition have led to new challenges in nutritional therapy, both in the dose and quality of the proteins, with a debate raging over the advantages of ketoanalogues, and also in the methods for providing nutrients. The ideal nutritional method for repletion is oral administration, but this can be enhanced with artificial support such as oral supplements, parenteral nutrition during dialysis or such alternatives as enteral nutrition at home in the case of chronic kidney problems in children, using percutaneous endoscopic gastrostomy (PEG), in order to nourish the patients and minimize growth disorders.

  14. Healthy Diet and Nutrition Education Program among Women of Reproductive Age: A Necessity of Multilevel Strategies or Community Responsibility

    PubMed Central

    Dunneram, Yashvee; Jeewon, Rajesh

    2015-01-01

    Background: Reproductive years represent a major proportion of women‟s life. This review focuses on recommended nutritional considerations, physical activity pattern as well as the effect of nutrition education (NE) on behavior modification and health outcomes of women of reproductive age using either single-level, multiple-level or community-level interventions. Methods: For this narrative review, numerous searches were conducted on databases of PubMed, Science Direct and Google Scholar search engine using the keywords women, reproductive age, NE, interventions, community-based. Results: Even though single intervention is effective, multiple intervention programmes in addition to behavior modification components are even more successful in terms of modified behaviors and health outcomes. Moreover, community based interventions using multilevel strategies are further useful for improved health outcomes and behavior modification. Conclusion: NE programmes have been effective in positive behavior modification measured in terms of eating pattern and health quality. Thus, it is recommended that health professionals use multiple intervention strategies at community level to ensure improved outcomes. Political support is also required to create culturally sensitive methods of delivering nutritional programmes. Finally, as policy is dependent on program cost, nutritional programmes need to combine methods of cost analysis to show cost effectiveness of supplying adequate nutrition for women throughout the lifecycle. PMID:26290827

  15. Report of the American Medical Student Association's Nutrition Curriculum Project. Essentials of nutrition education in medical schools: a national consensus.

    PubMed

    1997-05-01

    Medical students of the American Medical Student Association established the Nutrition Curriculum Project (NCP) with the goals of ensuring that adequate nutrition information be taught to medical students; ensuring that there be a framework for integration of nutrition topics at all levels of medical education; and formulating and disseminating essential information for nutrition assessment and management in clinical practice. As a first step, the NCP assembled a ten-member advisory board to develop a comprehensive list of nutrition topics deemed essential for the adequate training of physicians. The advisory board consisted of medical and nutrition educators, physicians, and clinical specialists representing major U.S. professional nutrition organizations. The NCP's director coordinated the decision-making process through its three iterations. Final accord on 92 topics was achieved with unanimous approval of the board in 1994. These topics, organized in five major categories, are offered as a guide to the reform of nutrition education and as the basis of a satisfactory nutrition curriculum.

  16. Essentials of nutrition education in medical schools: a national consensus. American Medical Student Association's Nutrition Curriculum Project.

    PubMed

    1996-09-01

    Medical students of the American Medical Student Association established the Nutrition Curriculum Project (NCP) with the goals of ensuring that adequate nutrition information be taught to medical students; ensuring that there be a framework for integration of nutrition topics at all levels of medical education; and formulating and disseminating essential information for nutrition assessment and management in clinical practice. As a first step, the NCP assembled a ten-member advisory board to develop a comprehensive list of nutrition topics deemed essential for the adequate training of physicians. The advisory board consisted of medical and nutrition educators, physicians, and clinical specialists representing major U.S. professional nutrition organizations. The NCP's director co-ordinated the decision-making process through its three iterations. Final accord on 92 topics was achieved with unanimous approval of the board in 1994. These topics, organized in five major categories, are offered as a guide to the reform of nutrition education and as the basis of a satisfactory nutrition curriculum.

  17. Food-Based Science Curriculum Yields Gains in Nutrition Knowledge

    ERIC Educational Resources Information Center

    Carraway-Stage, Virginia; Hovland, Jana; Showers, Carissa; Díaz, Sebastián; Duffrin, Melani W.

    2015-01-01

    Background: Students may be receiving less than an average of 4?hours of nutrition instruction per year. Integrating nutrition with other subject areas such as science may increase exposure to nutrition education, while supporting existing academics. Methods: During the 2009-2010 school year, researchers implemented the Food, Math, and Science…

  18. Lead - nutritional considerations

    MedlinePlus

    Lead poisoning - nutritional considerations; Toxic metal - nutritional considerations ... utensils . Old paint poses the greatest danger for lead poisoning , especially in young children. Tap water from lead ...

  19. [Importance of artificial nutrition in the resolution and etiologic diagnosis of severe chronic diarrhea: a propos of a case].

    PubMed

    Arrieta, F J; Gómez, F J; Aragón, C; Rueda, A; Balsa, J A; Zamarrón, I; Carrero, C; Botella Carretero, J I; Montalbán, C; Vázquez, C

    2008-01-01

    We present a case of severe chronic diarrhea requiring parenteral nutritional support to both cover the nutritional needs and allow for intestinal rest for later adaptation to enteral nutrition, altogether allowing for the etiologic diagnosis and disease healing.

  20. The Effects of Nutrition Education on 6th Graders Knowledge of Nutrition in Nine-Year Primary Schools in Slovenia

    ERIC Educational Resources Information Center

    Kostanjevec, Stojan; Jerman, Janez; Koch, Verena

    2011-01-01

    Incorporating nutrition topics in the primary school curricula should support the acquisition of nutrition knowledge in different ways and indirectly the development of healthy eating habits in children and teenagers. In Slovenia, nutrition education is part of all primary school education levels and may take the form of compulsory and/or elective…

  1. [Primary diagnostics of nutritional status in draftees].

    PubMed

    Myznikov, I L; Vas'ko, F V; Sadchenko, S N

    2012-01-01

    Economic crisis phenomena primarily affect negatively the consumer market of foods. And a human being needs adequate nutrition. In adolescence, the growing organism is most susceptible to imbalanced and physical activity-inadequate nutrition. The authors propose to use the Quetlet body mass index estimated in draftees for the sociohygienic monitoring of the population's well-being and an actual and economic access to foodstuffs in the broad segments of the population. The efficiency of the approach has been demonstrated during a long-term follow-up of navy draftees (about 150 thousand recruits in 1995-2010).

  2. Nutrition Assistance Programs: Cause or Solution to Obesity.

    PubMed

    Kennedy, Eileen; Guthrie, Joanne F

    2016-06-01

    Three nutrition assistance programs-Supplemental Nutrition Assistance Program (SNAP), Special Nutrition Program for Women, Infants and Children (WIC), and National School Lunch Program (NSLP)-serve as the backbone of the nutrition safety net in the USA. These programs have been successful in achieving many of their initial goals of improving food purchases, food intake, and/or nutritional status of low-income, vulnerable Americans. The emphasis in these programs has now broadened to also include an obesity prevention focus. Recent changes in program components demonstrate the revised objectives of the program. SNAP, WIC, and NSLP increase economic access to an adequate diet but access alone is unlikely to be the total solution to obesity prevention. An ecological approach, incorporating the nutrition programs, appears to be a more promising strategy to leverage the impact of SNAP, WIC, and NSLP. PMID:27033876

  3. Engaging Community With Promotores de Salud to Support Infant Nutrition and Breastfeeding Among Latinas Residing in Los Angeles County: Salud con Hyland's.

    PubMed

    Rios-Ellis, Britt; Nguyen-Rodriguez, Selena T; Espinoza, Lilia; Galvez, Gino; Garcia-Vega, Melawhy

    2015-01-01

    The Salud con Hyland's Project: Comienzo Saludable, Familia Sana [Health With Hyland's Project: Healthy Start, Healthy Family],was developed to provide education and support to Latina mothers regarding healthy infant feeding practices and maternal health. The promotora-delivered intervention was comprised of two charlas (educational sessions) and a supplemental, culturally and linguistically relevant infant feeding and care rolling calendar. Results indicate that the intervention increased intention to breastfeed exclusively, as well as to delay infant initiation of solids by 5 to 6 months. Qualitative feedback identified barriers to maternal and child health education as well as highlighted several benefits of the intervention.

  4. Strength nutrition.

    PubMed

    Volek, Jeff S

    2003-08-01

    Muscle strength is determined by muscle size and factors related to neural recruitment. Resistance training is a potent stimulus for increasing muscle size and strength. These increases are, to a large extent, influenced and mediated by changes in hormones that regulate important events during the recovery process following exercise. Provision of nutrients in the appropriate amounts and at the appropriate times is necessary to optimize the recovery process. This review discusses the results of research that has examined the potential for nutrition and dietary supplements to impact the acute response to resistance exercise and chronic adaptations to resistance training. To date, the most promising strategies to augment gains in muscle size and strength appear to be consumption of protein-carbohydrate calories before and after resistance exercise, and creatine supplementation.

  5. Are family medicine residents adequately trained to deliver palliative care?

    PubMed Central

    Mahtani, Ramona; Kurahashi, Allison M.; Buchman, Sandy; Webster, Fiona; Husain, Amna; Goldman, Russell

    2015-01-01

    Objective To explore educational factors that influence family medicine residents’ (FMRs’) intentions to offer palliative care and palliative care home visits to patients. Design Qualitative descriptive study. Setting A Canadian, urban, specialized palliative care centre. Participants First-year (n = 9) and second-year (n = 6) FMRs. Methods Semistructured interviews were conducted with FMRs following a 4-week palliative care rotation. Questions focused on participant experiences during the rotation and perceptions about their roles as family physicians in the delivery of palliative care and home visits. Participant responses were analyzed to summarize and interpret patterns related to their educational experience during their rotation. Main findings Four interrelated themes were identified that described this experience: foundational skill development owing to training in a specialized setting; additional need for education and support; unaddressed gaps in pragmatic skills; and uncertainty about family physicians’ role in palliative care. Conclusion Residents described experiences that both supported and inadvertently discouraged them from considering future engagement in palliative care. Reassuringly, residents were also able to underscore opportunities for improvement in palliative care education. PMID:27035008

  6. Vegetarian diets : nutritional considerations for athletes.

    PubMed

    Venderley, Angela M; Campbell, Wayne W

    2006-01-01

    The quality of vegetarian diets to meet nutritional needs and support peak performance among athletes continues to be questioned. Appropriately planned vegetarian diets can provide sufficient energy and an appropriate range of carbohydrate, fat and protein intakes to support performance and health. The acceptable macronutrient distribution ranges for carbohydrate, fat and protein of 45-65%, 20-35% and 10-35%, respectively, are appropriate for vegetarian and non-vegetarian athletes alike, especially those who perform endurance events. Vegetarian athletes can meet their protein needs from predominantly or exclusively plant-based sources when a variety of these foods are consumed daily and energy intake is adequate. Muscle creatine stores are lower in vegetarians than non-vegetarians. Creatine supplementation provides ergogenic responses in both vegetarian and non-vegetarian athletes, with limited data supporting greater ergogenic effects on lean body mass accretion and work performance for vegetarians. The potential adverse effect of a vegetarian diet on iron status is based on the bioavailability of iron from plant foods rather than the amount of total iron present in the diet. Vegetarian and non-vegetarian athletes alike must consume sufficient iron to prevent deficiency, which will adversely affect performance. Other nutrients of concern for vegetarian athletes include zinc, vitamin B12 (cyanocobalamin), vitamin D (cholecalciferol) and calcium. The main sources of these nutrients are animal products; however, they can be found in many food sources suitable for vegetarians, including fortified soy milk and whole grain cereals. Vegetarians have higher antioxidant status for vitamin C (ascorbic acid), vitamin E (tocopherol), and beta-carotene than omnivores, which might help reduce exercise-induced oxidative stress. Research is needed comparing antioxidant defences in vegetarian and non-vegetarian athletes.

  7. Routine supplementation does not warrant the nutritional status of vitamin d adequate after gastric bypass Roux-en-Y.

    PubMed

    da Rosa, Cintia Leticia; Dames Olivieri Saubermann, Ana Paula; Jacqueline, Jacqueline; Pereira, Silvia Elaine; Saboya, Carlos; Ramalho, Andréa

    2013-01-01

    La cirugía bariátrica puede llevar deficiencias nutrionales, incluyendo aquellas relacionadas a perdida ósea. El objetivo de este estudio fue avaluar las concentraciones séricas de cálcio, vitamina D y PTH en adultos obesos, antes y seis meses pos cirugía de bypass Gástrico en Y-de-Roux (RYGB) y avaluar las dosis de calcio y vitamina D utilizada después da la cirugía. Métodos: Estudio longitudinal retrospectivo con pacientes adultos de ambos sexos que fueron submetidos al RYGB. Fueron obtenidos datos de peso, estatura e IMC y las concentraciones de 25-hidroxivitamina D, calcio iónicos y PTH. Pos cirugía, los pacientes recibieron la suplementación dietética diaria de 500 mg de carbonato de calcio y 400 UI de vitamina D. Resultados: Fueron avaluados 56 mujeres y 27 hombres. El preoperatorio las concentraciones séricas de vitamina D presentaron inadecuadas en 45% de las mujeres y 37% de los hombres, mientras en el periodo posoperatorio 91% de las mujeres y 85% de los hombres presentaron deficiencia de esta vitamina. Ninguna alteración en las concentraciones séricas de calcio fue encontrada antes ni pos la cirugía. Las concentraciones séricas de PTH en el preoperatorio se mantuvieron adecuadas en 89% de los individuos de ambos sexos. Pos la cirugía las concentraciones séricas se mantuvieron adecuadas en 89% y mujeres y 83% de los hombres avaluados. Conclusión: la obesidad puede ser un factor de riesgo para el desarrollo de la deficiencia de vitamina D. Los resultados enseñan que la suplementación fue incapaz de sanar y prevenir la deficiencia de vitamina D en adultos obesos submetidos RYGB.

  8. Nutrition Knowledge, Attitude, Dietary Behavior, and Commitment to Nutrition Education of Nutrition Educators.

    ERIC Educational Resources Information Center

    Byrd-Bredbenner, Carol; Shear, Twyla

    1982-01-01

    Nutrition educators, defined as those individuals with baccalaureate level training who teach nutrition, were surveyed. Results suggest close interrelationships among nutrition knowledge, food/nutrition attitude, dietary behavior, and commitment to nutrition education. (SK)

  9. [Use of the ion-exchange substrate to optimize mineral nutrition of plants within a bio-engineering life support system with a high level of closure].

    PubMed

    Tikhomirova, N A; Ushakova, S A; Kudenko, Yu A; Anishchenko, O V; Tikhomirov, A A

    2014-01-01

    Purpose of the work was to test manageability of nutrient solutions containing mineralized human exometabolites by using an ion-exchange substrate (IES) for cultivating wheat in a bio-engineering life support system with a high level of closure. Object of the investigation was wheat Triticum aestivum L. (Lysovsky cv. l. 232). Crops were raised on clayite in a growth chamber of a hydroponic conveyor system under continuous light. Correction of nutrient solution was to lift the limits of crop supply with minerals. The experimental crop grew in nutrient solution with immersed IES "BIONA-312"; nutrient solution for the control crop was corrected by adding mineral salts. Solution correction did not have a noteworthy effect on the yield, CO2-gas exchange or mineral composition of wheat plants. IES makes simple the technology of plant cultivation on solutions enriched with human exometabolites.

  10. Integrating nutrition support for food-insecure patients and their dependents into an HIV care and treatment program in Western Kenya.

    PubMed

    Mamlin, Joseph; Kimaiyo, Sylvester; Lewis, Stephen; Tadayo, Hannah; Jerop, Fanice Komen; Gichunge, Catherine; Petersen, Tomeka; Yih, Yuehwern; Braitstein, Paula; Einterz, Robert

    2009-02-01

    The Academic Model Providing Access to Healthcare (AMPATH) is a partnership between Moi Teaching and Referral Hospital, Moi University School of Medicine, and a consortium of universities led by Indiana University. AMPATH has over 50,000 patients in active care in 17 main clinics around western Kenya. Despite antiretroviral therapy, many patients were not recovering their health because of food insecurity. AMPATH therefore established partnerships with the World Food Program and United States Agency for International Development and began high-production farms to complement food support. Today, nutritionists assess all AMPATH patients and dependents for food security and refer those in need to the food program. We describe the implementation, challenges, and successes of this program. PMID:19059851

  11. [Use of the ion-exchange substrate to optimize mineral nutrition of plants within a bio-engineering life support system with a high level of closure].

    PubMed

    Tikhomirova, N A; Ushakova, S A; Kudenko, Yu A; Anishchenko, O V; Tikhomirov, A A

    2014-01-01

    Purpose of the work was to test manageability of nutrient solutions containing mineralized human exometabolites by using an ion-exchange substrate (IES) for cultivating wheat in a bio-engineering life support system with a high level of closure. Object of the investigation was wheat Triticum aestivum L. (Lysovsky cv. l. 232). Crops were raised on clayite in a growth chamber of a hydroponic conveyor system under continuous light. Correction of nutrient solution was to lift the limits of crop supply with minerals. The experimental crop grew in nutrient solution with immersed IES "BIONA-312"; nutrient solution for the control crop was corrected by adding mineral salts. Solution correction did not have a noteworthy effect on the yield, CO2-gas exchange or mineral composition of wheat plants. IES makes simple the technology of plant cultivation on solutions enriched with human exometabolites. PMID:26035997

  12. Nutrition in Patients with Gastric Cancer: An Update

    PubMed Central

    Rosania, Rosa; Chiapponi, Costanza; Malfertheiner, Peter; Venerito, Marino

    2016-01-01

    Background Nutritional management of patients with gastric cancer (GC) represents a challenge. Summary This review provides an overview of the present evidence on nutritional support in patients with GC undergoing surgery as well as in those with advanced disease Key Message For patients undergoing surgery, the preoperative nutritional condition directly affects postoperative prognosis, overall survival and disease-specific survival. Perioperative nutritional support enriched with immune-stimulating nutrients reduces overall complications and hospital stay but not mortality after major elective gastrointestinal surgery. Early enteral nutrition after surgery improves early and long-term postoperative nutritional status and reduces the length of hospitalization as well. Vitamin B12 and iron deficiency are common metabolic sequelae after gastrectomy and warrant appropriate replacement. In malnourished patients with advanced GC, short-term home complementary parenteral nutrition improves the quality of life, nutritional status and functional status. Total home parenteral nutrition represents the only modality of caloric intake for patients with advanced GC who are unable to take oral or enteral nutrition Practical Implications Early evaluations of nutritional status and nutritional support represent key aspects in the management of GC patients with both operable and advanced disease. PMID:27403412

  13. Do we teach earth science in situ adequately?

    NASA Astrophysics Data System (ADS)

    Rakhmenkulova, I.; Zhitov, E.; Zhitova, L.

    2006-12-01

    . Among them are very poor financial support from the Government, old-fashioned equipment, lack of even simple tools for educational purposes, isolation of Russia from the world professional community, absence of young professors and lecturers, and many others. This work was supported by the Ministry for Russian Science and Education, Grant #DSP.2.1.1.702.

  14. [Nutrition recommendations for children who practice sports].

    PubMed

    Sánchez-Valverde Visus, F; Moráis López, A; Ibáñez, J; Dalmau Serra, J

    2014-08-01

    Several health benefits have been attributed to sports practice, and an adequate nutrition status helps to maintain an optimal performance. Children most frequently practice non-competitive and non-endurance activities in a school setting. The dietary intake of children who practice sports should be similar to the general population, properly meeting their energy and nutrient requirements. During the activity performance, correct hydration should be aimed for, with water appearing to be an adequate source in most cases. General calorie and micronutrient supplementation should not be commonly recommended in children. Paediatricians must control nutritional status and dietary habits of children who practice sports, especially in those cases when weight-loss is aimed for, as well as take into account the psychological implications of competitive sports practice.

  15. Home Parenteral Nutrition: Fat Emulsions and Potential Complications.

    PubMed

    Mundi, Manpreet S; Salonen, Bradley R; Bonnes, Sara

    2016-10-01

    Since the first intravenous nutrition support attempt with olive oil in the 17th century, intravenous fat emulsions (IVFEs) have evolved to become an integral component in the management of patients receiving home parenteral nutrition (HPN). IVFEs serve as a calorie source and provide essential fatty acids (linoleic acid and α-linolenic acid) in patients unable to achieve adequate intake of these fatty acids through alternative means. However, IVFE use is also associated with multiple complications, including increased infection risk, liver disease, and systemic proinflammatory states. In the United States, most IVFEs are composed of 100% soybean oil; internationally multiple alternative IVFEs (using fish oil, olive oil, and long- and medium-chain triglycerides) are available or being developed. The hope is that these IVFEs will prevent, or decrease the risk of, some of the HPN-associated complications. The goal of this article is to review how IVFEs came into use, their composition and metabolism, options for IVFE delivery in HPN, benefits and risks of IVFE use, and strategies to minimize the risks associated with IVFE use in HPN patients.

  16. Home Parenteral Nutrition: Fat Emulsions and Potential Complications.

    PubMed

    Mundi, Manpreet S; Salonen, Bradley R; Bonnes, Sara

    2016-10-01

    Since the first intravenous nutrition support attempt with olive oil in the 17th century, intravenous fat emulsions (IVFEs) have evolved to become an integral component in the management of patients receiving home parenteral nutrition (HPN). IVFEs serve as a calorie source and provide essential fatty acids (linoleic acid and α-linolenic acid) in patients unable to achieve adequate intake of these fatty acids through alternative means. However, IVFE use is also associated with multiple complications, including increased infection risk, liver disease, and systemic proinflammatory states. In the United States, most IVFEs are composed of 100% soybean oil; internationally multiple alternative IVFEs (using fish oil, olive oil, and long- and medium-chain triglycerides) are available or being developed. The hope is that these IVFEs will prevent, or decrease the risk of, some of the HPN-associated complications. The goal of this article is to review how IVFEs came into use, their composition and metabolism, options for IVFE delivery in HPN, benefits and risks of IVFE use, and strategies to minimize the risks associated with IVFE use in HPN patients. PMID:27533943

  17. Review article: Nutritional therapy in alcoholic liver disease.

    PubMed

    Stickel, F; Hoehn, B; Schuppan, D; Seitz, H K

    2003-08-15

    Chronic alcohol consumption may lead to primary and secondary malnutrition. In particular, protein energy malnutrition not only aggravates alcoholic liver disease but also correlates with impaired liver function and increased mortality. Therefore, in these patients, adequate nutritional support should be implemented in order to improve their prognosis. Clinical trials addressing this issue have shown that nutritional therapy either enterally or parenterally improves various aspects of malnutrition, and there is increasing evidence that it may also improve survival. Therefore, malnourished alcoholics should be administered a diet rich in carbohydrate- and protein-derived calories preferentially via the oral or enteral route. Micronutrient deficiencies typically encountered in alcoholics, such as for thiamine and folate, require specific supplementation. Patients with hepatic encephalopathy may be treated with branched-chain amino acids in order to achieve a positive nitrogen balance. Fatty liver represents the early stage of alcoholic liver disease, which is usually reversible with abstinence. Metadoxine appears to improve fatty liver but confirmatory studies are necessary. S-adenosyl-L-methionine may be helpful for patients with severe alcoholic liver damage, since various mechanisms of alcohol-related hepatotoxicity are counteracted with this essential methyl group donor, while a recent large trial showed that the use of polyenylphosphatidylcholine is of limited efficacy. PMID:12940921

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

    PubMed

    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.

  19. Evaluation of space adequateness of shrimp farms in Southern Brazil.

    PubMed

    Freitas, Rodrigo R; Hartmann, Carlos; Tagliani, Paulo R A; Poersch, Luís H

    2011-09-01

    In Rio Grande do Sul State, there are four marine shrimp (Litopenaeus vannamei) farms in the municipal districts of São José do Norte and Rio Grande, and other four with previous license for operation. Thus, the present study aimed to identify and characterize areas for marine shrimp farming located in the Southern portion of the Patos Lagoon estuary (32º00'S 52º00'W) by employing the analysis of satellite remote sensing (Landsat TM and ETM+/Google Earth), airborne remote sensing (35mm system ADAR 1000), terrestrial remote sensing (RICOH 500SE), and field expeditions, integrating data in a Geographical Information System (IDRISI Andes). As a result, the enterprises were built on coastal fields or in obliterated dune areas, which are favorable for cultivation. The proximity of possible consuming markets and local labor, relatively good access roads and local technical support also favor the projects. However, there must be caution in terms of changes in the original projects, which could cause environmental impacts and noncompliance of environmental norms, such as the occupation of salt marsh areas. Based on the obtained information, instruments can be created to help inherent legal decision-making to manage the activity for futures enterprises.

  20. Nutritional management of patients with urea cycle disorders.

    PubMed

    Singh, R H

    2007-11-01

    The nutritional management of patients with urea cycle disorders (UCDs) involves restriction of dietary protein along with provision of adequate protein-free energy, essential amino acid supplements, and vitamins and minerals in combination with nitrogen-scavenging drugs. The present paper discusses nutrition therapy for a range of circumstances: during an acute hyperammonaemic episode and at hospital discharge; before, during, and after surgery; and for lifelong chronic management of UCDs.