Early Nutritional Intervention Research Articles

Effects of early nutritional intervention on oral mucositis and basic conditions in patients receiving radiotherapy for head and neck cancer: Randomized controlled trial (ChiCTR2000031418)

Background & AimsThis study aims to observe the effects of early nutritional intervention on radiation-induced oral mucositis (OM) and the nutritional status of patients with head and neck cancer (HNC) receiving radiotherapy. MethodsEligible patients receiving radiotherapy for HNC were randomly divided into an early nutritional intervention group (enteral nutritional intervention was administered at the beginning of radiotherapy) and a late nutritional intervention group (enteral nutritional intervention was administered at the beginning of eating restriction) in a 1:1 ratio. The primary endpoint was radiation-induced OM. Secondary endpoints included nutrition-related indicators, immune function, overall survival (OS), progression-free survival (PFS), quality of life, and other radiotherapy-induced adverse effects. ResultsA total of 100 patients were enrolled between 2020 and 2021, including 50 each in the early nutritional intervention group and in the late group. The incidence of Grade-III/IV OM was lower in the early treatment group than in the late treatment group (2% vs 14%, P = 0.059). By week 7 weight loss was significantly lower in the early group than in the late group (1.08 kg, 95% CI: 0.08-2.09, P = 0.035). Regarding the PG-SGA scores after receiving radiotherapy, the early group comprised more well-nourished and fewer malnourished patients than those in the late group (P = 0.002). The scores of the immune function indices of T cell CD3+, CD4+/CD8+, and B cell CD19+ were slightly higher in the early group than in the late group; however, the difference was not statistically significant (all P > 0.05). PFS and OS were better in the early group than in the late group; however, the differences were not statistically significant (P > 0.05). ConclusionsEarly nutritional intervention can effectively improve the nutritional status and reduce the incidence of high-grade OM in patients with HNC receiving radiotherapy. Trial registrationChinese Clinical Trials Registry (http://www.chictr.org.cn) ChiCTR-IDChiCTR2000031418.

Coffee polyphenols ameliorate early-life stress-induced cognitive deficits in male mice

Stress exposure during the sensitive period of early development has been shown to program the brain and increases the risk to develop cognitive deficits later in life. We have shown earlier that early-life stress (ES) leads to cognitive decline at an adult age, associated with changes in adult hippocampal neurogenesis and neuroinflammation. In particular, ES has been shown to affect neurogenesis rate and the survival of newborn cells later in life as well as microglia, modulating their response to immune or metabolic challenges later in life. Both of these processes possibly contribute to the ES-induced cognitive deficits. Emerging evidence by us and others indicates that early nutritional interventions can protect against these ES-induced effects through nutritional programming. Based on human metabolomics studies, we identified various coffee-related metabolites to be part of a protective molecular signature against cognitive decline in humans. Caffeic and chlorogenic acids are coffee-polyphenols and have been described to have potent anti-oxidant and anti-inflammatory actions. Therefore, we here aimed to test whether supplementing caffeic and chlorogenic acids to the early diet could also protect against ES-induced cognitive deficits. We induced ES via the limited nesting and bedding paradigm in mice from postnatal(P) day 2–9. On P2, mice received a diet to which 0.02% chlorogenic acid (5-O-caffeoylquinic acid) + 0.02% caffeic acid (3′,4′-dihydroxycinnamic acid) were added, or a control diet up until P42. At 4 months of age, all mice were subjected to a behavioral test battery and their brains were stained for markers for microglia and neurogenesis. We found that coffee polyphenols supplemented early in life protected against ES-induced cognitive deficits, potentially this is mediated by the survival of neurons or microglia, but possibly other mechanisms not studied here are mediating the effects. This study provides additional support for the potential of early nutritional interventions and highlights polyphenols as nutrients that can protect against cognitive decline, in particular for vulnerable populations exposed to ES.

Impact of Malnutrition on Survival and Treatment-Related Morbidity of Cancer in Children

Background: Malnutrition is a prevalent and severe issue in pediatric oncology, affecting treatment outcomes and survival rates significantly. In developing countries, where access to comprehensive healthcare is limited, malnutrition's impact is even more profound, complicating treatment protocols and increasing morbidity and mortality rates among children with cancer. Objective: To evaluate the effects of malnutrition on survival rates and treatment-related morbidity in pediatric cancer patients, and to assess the efficacy of nutritional interventions in improving these outcomes. Methods: This retrospective study was conducted at SKMCH & RC, involving 160 newly diagnosed cancer patients aged between one and eighteen years. Patients were followed from January 2021 through March 2023. Malnutrition was assessed using WHO growth charts and defined using BMI and weight/height Z-scores. Data analysis was performed using SPSS software, version 25, focusing on survival rates, incidence of febrile neutropenia (FN), and nutritional status changes over time. Statistical significance was set at a p-value of 0.025. Results: At diagnosis, 42.5% (n=68) of the children were malnourished. After six months, 35% (n=56) remained malnourished, indicating some improvement. Malnourished children showed significantly lower survival rates, with those having a BMI Z-score ≤ -2 at six months post-diagnosis having a mortality rate HR of 4.05 (95% CI= 1.58-6.33, P = 0.009). Children experiencing a weight/height loss of >10% had an HR of 1.98 (95% CI= 1.23-6.91, P=0.04) for increased mortality. Increased episodes of FN were correlated with severe malnutrition (HR 7.32, 95% CI=1.98-10.14, P=0.0007). Conclusion: Malnutrition significantly impacts the survival rates and treatment-related morbidity in pediatric cancer patients. Early and aggressive nutritional interventions can improve survival outcomes and reduce the rate of hospitalizations due to complications like febrile neutropenia.

The efficacy of nutritional screening indexes in predicting the incidence of osteosarcopenia and major osteoporotic fracture in the elderly.

The effect of nutritional status on osteosarcopenia (OS) and major osteoporotic fracture (MOF) among the elderly is still unclear. So we aimed to compare the efficacy of the Mini-Nutrition Assessment-Short Form (MNA-sf), the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status (CONUT) for predicting OS and MOF among the elderly. A total of 409 participants were enrolled in this prospective study. Blood biochemical indexes, nutritional status, and bone- and muscle-related examinations were assessed at initial visit to the outpatient. Participants were divided into 4 groups: (1) control; (2) osteopenia/osteoporosis; (3) sarcopenia; (4) osteosarcopenia, and then followed for 5years, recording the occurrence time of MOF. The frequency values of osteopenia/osteoporosis, sarcopenia, and OS, at baseline, were respectively 13.4, 16.1, and 12% among the study samples. Correlation analysis showed that nutritional status scores were associated with body mass index, handgrip strength, albumin, bone mineral density, and physical functions. According to multivariate models, poor nutritional status was significantly associated with a higher risk of OS and MOF (P<0.05). Survival analysis showed that the MOF rate in malnutrition group was significantly higher than normal nutrition group (P<0.05). The receiver operator characteristic curve shows that the value of MNA-sf to diagnose OS and MOF is greater (P<0.05). The poor nutritional status was associated with a higher risk of both OS and MOF. MNA-sf showed a superior diagnostic power for OS and MOF among the elderly. Early nutrition assessments and interventions may be key strategies to prevent OS and fractures.

Nutritional risk and adverse health outcomes in Chinese community-dwelling older adults: a study based on Elderly Nutritional Indicators for Geriatric Malnutrition Assessment (ENIGMA)

ObjectivesMalnutrition and nutritional risk are risk factors for many adverse health outcomes in older adults, but they have rarely been assessed in China. The aim of this study was to evaluate the availability of Elderly Nutritional Indicators for Geriatric Malnutrition Assessment (ENIGMA), a nutritiona scale originally developed to predict mortality, in assessing nutritional risks and predicting adverse health outcomes in Chinese community-dwelling older adults. MethodsThis was a population-based longitudinal cohort study (Chinese Longitudinal Healthy Longevity Survey, CLHLS), with a 4-year follow-up of 2063 community-dwelling adults aged ≥65 years. Nutritional risks were assessed via ENIGMA and Geriatric Nutritional Risk Index (GNRI) at baseline (the 2014 wave). Cognitive impairment, functional limitation and frailty were evaluated using the Chinese version of MMSE, ADL/IADL scale and Frailty index, respectively, at baseline and 4-year follow-up (the 2018 wave). Mortality was measured by survival status and duration of exposure to death from baseline to follow-up. The associations of nutritional risks with prevalent/incident cognitive impairment, functional limitation and frailty, and 4-year mortality were estimated using logistic regression and Cox proportional hazards regression models, adjusting for confounders. The discriminatory accuracy of ENIGMA and GNRI for the above adverse health outcomes were assessed and compared the receiver operating characteristic (ROC) analyses. ResultsAccording to ENIGMA, 48.6% of the Chinese community-dwelling older adults (age: 86.5±11.3 years) showed moderate and high nutritional risk. Nutritional risks defined by the ENIGMA were significantly associated with increased prevalence and incidence of cognitive impairment, functional limitation and frailty [odds ratio (ORs) ranging from 1.79 to 89.6, P values ranging from <0.001 to 0.048], but were mostly insignificant for that defined by GNRI. With respect to 4-year mortality, Nutritional risks as defined by GNRI showed better predicting effects than those defined by ENIGMA. ROC analyses indicated that nutritional risks defined by ENIGMA had better discriminatory accuracy than those defined by GNRI for prevalent and incident cognitive impairment (C=0.73 vs 0.64, P<0.001; C=0.65 vs 0.59, P=0.015, respectively), functional limitation (C=0.74 vs 0.63, P<0.001 at baseline; C=0.61 vs 0.56, P=0.016 at follow-up), frailty (C=0.85 vs 0.67, P<0.001 at baseline; C=0.64 vs 0.55, P<0.001 at follow-up), and even 4-year mortality (C=0.68 vs 0.64, P=0.020). ConclusionsENIGMA could serve as a nutritional risk screening tool that has a robust predicting role for cognitive impairment, functional limitation, and frailty in Chinese community-dwelling older adults. It may be recommended for early nutritional risk screening and have the potential to guide early nutritional intervention in communities and primary care settings in China.

Epigenetics, Nutrition, and the Brain: Improving Mental Health through Diet.

The relationship between nutrition and brain health is intricate. Studies suggest that nutrients during early life impact not only human physiology but also mental health. Although the exact molecular mechanisms that depict this relationship remain unclear, there are indications that environmental factors such as eating, lifestyle habits, stress, and physical activity, influence our genes and modulate their function by epigenetic mechanisms to shape mental health outcomes. Epigenetic mechanisms act as crucial link between genes and environmental influences, proving that non-genetic factors could have enduring effects on the epigenome and influence health trajectories. We review studies that demonstrated an epigenetic mechanism of action of nutrition on mental health, focusing on the role of specific micronutrients during critical stages of brain development. The methyl-donor micronutrients of the one-carbon metabolism, such as choline, betaine, methionine, folic acid, VitB6 and VitB12 play critical roles in various physiological processes, including DNA and histone methylation. These micronutrients have been shown to alter gene function and susceptibility to diseases including mental health and metabolic disorders. Understanding how micronutrients influence metabolic genes in humans can lead to the implementation of early nutritional interventions to reduce the risk of developing metabolic and mental health disorders later in life.

Indices of Nutrition Status of Kidney and Pancreas Transplant Candidates

Nutritional assessment is used to implement early nutritional interventions and reduce complications associated with malnutrition, which plays a crucial role in improving postoperative outcomes for patients undergoing pancreas and/or kidney transplantation. ObjectiveThe aim of this study was to analyze the nutritional status (NS) in patients eligible for kidney transplantation (KTx) and simultaneous kidney-pancreas transplantation (SPKTx). MethodsWe analyzed the database of hospitalized patients from 2020 to 2023 to identify preoperative parameters of NS in patients eligible for KTx and SPKTx. A total of 59 patients participated in the study, all of whom were candidates for KTx-23 or SPKTx-36. The study population consisted of 35 women (W) and 24 men (M), with an overall mean age of 44.8 ± 10.2 years (43.5 ± 10.2 years for W and 46.2 ± 10.9 years for M). Both groups included patients on hemodialysis (n = 34) and peritoneal dialysis (n = 12), and patients in the predialysis period (pre-emptive, n = 13). The examined parameters included Onodera's prognostic nutritional index (PNIO), the nutritional risk index (NRI), proper body mass calculated using the Lorenz formula, and the neutrophil-to-lymphocyte ratio (NLR). All patients were assessed according to the NRS 2002 scale. ResultsAnalysis of the obtained results revealed that the NLR was only one differentiating parameter between Ktx and SPKtx group. Multivariate analysis adjusted for patients’ age and gender, comparing quantitative NS indicators was performed. Albumin serum concentration was not dependent on patients’ group (KTx/SPKTx) neither age nor gender P = .382. BMI was dependent on patients’ age and gender, but not a group (KTx/SPKTx) P = .008. PNIO, NRI, and NRL were not dependent on patients’ group (KTx/SPKTx) neither age nor gender. ConclusionsAdditional effort should be devoted to the development of a proper nutrition plan for SPKTx a especially in peritoneal dialysis patients. Toward patients on the waiting list, the regular assessment of nutritional status should be performed which is not a rule in dialysis centers. SPKTx candidates in the perioperative period should receive proper nutrition taking into account their caloric and protein needs.

Risk Factors for Long-term Body Weight Loss After Proximal Gastrectomy: A Retrospective Analysis.

Proximal gastrectomy (PG) is a therapy for early-stage proximal gastric cancer and offers advantages such as the preservation of food storage capacity and less body weight loss (BWL). Nevertheless, significant BWL following PG may occur, affecting the patient's well-being and survival. In this study, we aimed to identify the relevant factors for BWL following PG by analyzing an institutional database of patients. We enrolled 58 consecutive patients who underwent PG for gastric or esophagogastric junction cancer at our institution between April 2004 and March 2021. Based on BWL at 12 months postoperatively, we retrospectively compared and examined patient characteristics, surgical details, and nutritional markers. The mean BWL of the 58 patients included in this analysis was 14.0±7.2%. When the patients were divided into BWL-moderate (n=29) and BWL-severe (n=29) groups using a cutoff value of 15.7%, the latter experienced early BWL within 1 month postoperatively, primarily due to body fat mass reduction, with no recovery during the 60 months of follow up. In contrast, gradual recovery was observed among patients in the BWL-moderate group after experiencing the lowest body weight 24 months postoperatively. A greater decrease in body fat mass than in muscle mass was observed in both groups. Blood hemoglobin levels did not recover in the BWL-severe group. The BWL-severe group after proximal gastrectomy demonstrated significantly greater early postoperative BWL, primarily attributed to a reduction in body fat mass, with hardly any recovery. Early postoperative nutritional intervention might be proposed to prevent long-term BWL.

Comparison of Goal Achievement during an Early, Intensive Nutrition Intervention Delivered to People with Upper Gastrointestinal Cancer by Telephone Compared with Mobile Application.

This study is aimed at exploring whether the mode of nutrition intervention delivery affected participant goal achievement in a three-arm randomised controlled trial of early and intensive nutrition intervention delivered to upper gastrointestinal cancer patients. Newly diagnosed upper gastrointestinal cancer patients were recruited from four tertiary hospitals in Melbourne, Australia. Participants in the intervention groups received a regular nutrition intervention for 18 weeks from an experienced dietitian via telephone or mobile application (app) using behaviour change techniques to assist in goal achievement. Univariate and multiple regression models using STATA determined goal achievement, dose, and frequency of contact between groups. A p value <0.05 was considered statistically significant. The telephone group (n = 38) had 1.99 times greater frequency of contact with the research dietitian (95% CI: 1.67 to 2.36, p < 0.001) and 2.37 times higher frequency of goal achievement (95% CI: 1.1 to 5.11, p = 0.03) compared with the mobile app group (n = 36). The higher dose (RR 0.03) of intervention and more behaviour change techniques employed in the telephone group compared with the mobile app group increased participant goal achievement (95% CI: 0.01 to 0.04, p < 0.001). Discussion. Telephone nutrition intervention delivery led to a higher frequency of goal achievement compared to the mobile app intervention. There was also a higher number of behaviour change techniques employed which may have facilitated the greater goal achievement. Mobile app-based delivery may have poorer acceptance in this population with high levels of withdrawal. Practice Implications. We need to ensure that specifically designed technologies for our target populations are fit for purpose, efficacious, and acceptable to both patients and healthcare providers. This trial is registered with ACTRN12617000152325.

IMPACT OF MALNUTRITION ON PEDIATRIC HEART FAILURE ANALYZING Z-SCORES AT PRESENTATION

Pediatric heart failure represents a critical health concern characterized by the heart's inability to effectively pump blood, often resulting from congenital heart defects, myocarditis, and cardiomyopathies. Malnutrition has emerged as a recognized comorbidity in pediatric heart failure, significantly impacting patient outcomes. This study aimed to investigate the relationship between malnutrition and pediatric heart failure by analyzing Z-scores at presentation to guide targeted interventions and improve patient management. The study employed a retrospective observational design and was conducted at the Department of Pediatric Cardiology, Lady Reading Hospital, Peshawar, from January 2023 to January 2024. A total of 764 pediatric patients with heart failure were included in the analysis. Nutritional status was assessed using weight and height measurements, and Z-scores were calculated based on WHO Child Growth Standards. Data analysis was performed using IBM SPSS version 22. Results revealed varying degrees of malnutrition among pediatric heart failure patients, with 62.8% classified as severely malnourished, 28.4% as moderately malnourished, and 8.8% as mildly malnourished. The calculated Z-score of -3.2 indicated significant malnutrition among the study population. Furthermore, a negative correlation (r = -0.32, p &lt; 0.001) between Z-score and left ventricular ejection fraction was observed, suggesting a link between malnutrition severity and cardiac dysfunction. These findings underscore the high prevalence of malnutrition among pediatric heart failure patients and its substantial impact on outcomes. Early nutritional assessment and intervention are crucial for optimizing patient care and enhancing outcomes in children with heart failure. Collaborative, multidisciplinary approaches that integrate cardiac and nutritional management strategies can comprehensively address the diverse needs of this vulnerable population.

Nutrition Status Plays a Partial Mediation Role in the Relationship between Number of Teeth and Frailty: A Cross-Sectional Multicenter Study

Introduction: Although the relationship between the number of teeth and frailty has been extensively studied, the mediating role of nutrition status in the association between the number of teeth and frailty remains to be clarified. Methods: A number of 6,664 participants lived in the communities of West China were analyzed in our study. Physical frailty was determined based on the phenotype established by Fried. Nutrition status was evaluated using the Mini Nutrition Assessment-Short Form (MNA-SF) scale. Multiple linear regression was employed to evaluate the direct relationships between the number of teeth, nutrition, and frailty. Mediation models and structural equation model (SEM) pathway analysis were used to test the mediating role of nutrition status in the relationship between the number of teeth and frailty. Results: Among the 6,664 participants aged over 50 years old, the prevalence of frailty was 6.2%. Multiple linear regression analysis showed a significant total relationship between the number of teeth (β = −0.359, 95% CI: −0.473 to −0.244, p < 0.001) and frailty. After adjusting for MNA-SF scores, the relationship between the number of teeth and frailty remained significant (β = −0.327, 95% CI: −0.443 to −0.211, p < 0.001), indicating a partial mediating effect of nutrition. Mediation analysis verified that nutrition partially mediated the relationship between the number of teeth and frailty (indirect effect estimate = −0.0121, bootstrap 95% CI: −0.0151 to −0.0092; direct effect estimate = −0.0874, bootstrap 95% CI: −0.1086 to −0.0678) in the fully adjusted model. This mediating effect occurred through influencing weight loss, low level of physical activity, and debility. SEM framework pathway analysis confirmed the association between the number of teeth, nutrition, and frailty. Conclusions: Our findings demonstrated that frailty was correlated with the number of teeth and poorer nutritional status, with nutrition partially mediating the correlation between the number of teeth and frailty. Our results supported early nutritional evaluation and intervention in oral health to decrease the risk of frailty.

The impact of early nutritional support on postoperative wound healing in patients with complex fractures: A meta-analysis review.

Complex fractures present significant challenges in orthopaedic surgery, particularly in terms of postoperative wound healing. Nutritional status plays a crucial role in the recovery process, with early nutritional support potentially influencing wound healing outcomes. This meta-analysis aimed to assess the impact of early nutritional interventions on postoperative wound healing and scar formation in patients with complex fractures. From an initial pool of 1742 articles, 7 studies were selected for analysis. The results revealed that preoperative nutritional support significantly improved early wound healing, as indicated by lower REEDA scores (SMD = -14.06, 95% CI: [-16.79, -11.32], p < 0.01) 1 week post-surgery. Furthermore, there was a notable reduction in scar formation, as demonstrated by lower Manchester Scar Scale scores (SMD = -25.03, 95% CI: [-30.32, -19.74], p < 0.01) 3 months post-surgery. These findings highlight the importance of incorporating nutritional strategies into the management of complex fractures to optimize postoperative recovery.

Factors Associated with the Nutritional Status of Mechanically Ventilated Patients in Intensive Care Unit: A Cross Sectional Study

Background: Nutritional status significantly impacts the outcomes of critically ill patients in intensive care units (ICU), with malnutrition being a common complication that can exacerbate morbidity and mortality rates. The Nutrition Risk in the Critically ill (NUTRIC) score is a valuable tool for identifying patients at risk of malnutrition and guiding nutritional interventions. Objective: This study aimed to evaluate the factors influencing the nutritional status, as assessed by the NUTRIC score, of mechanically ventilated patients in ICUs across tertiary care hospitals, and to explore the association between nutritional risk and patient outcomes. Methods: A cross-sectional descriptive study was conducted in five tertiary care hospitals in Khyber Pakhtunkhwa, Pakistan, from August to December 2023. The study included patients aged 18 and above, who were mechanically ventilated for more than 48 hours. The NUTRIC score was calculated based on data collected on demographics, clinical characteristics, and laboratory investigations. Multiple linear regression analysis was performed to identify factors affecting the NUTRIC score using SPSS version 25. Results: Out of 335 patients, 75.2% were male, and 51.3% were aged between 50-75 years. A high NUTRIC score (indicating higher risk of malnutrition) was found in 25% of patients, while 74.9% had a low NUTRIC score. Factors significantly affecting the NUTRIC score included ventilation status (invasive/non-invasive), number of comorbidities, age, status of life (alive/deceased), and length of stay in ICU. The mortality rate was 3.9%, with a higher prevalence in older age groups. Conclusion: The study highlights the prevalence of nutritional risk among mechanically ventilated ICU patients and underscores the importance of early nutritional assessment and intervention. Targeted nutritional support, especially for patients with higher risk profiles, is crucial for improving outcomes and reducing mortality rates in this vulnerable population.

A Meta-analysis of the Correlation Between Nutritional Risk and Prognosis in Stroke Patients Assessed by Different Scales

Background: Stroke is the second leading cause of death worldwide, with high morbidity and disability rates. In recent years, some scholars have used commonly nutrition screening and evaluation tools to screen and evaluate the nutritional status of patients with stroke. Some scholars have also selected some subjective nutritional evaluation scales to study the prognosis of stroke. However, there is a lack of relevant systems to evaluate the association of different nutritional screening and assessment scales with stroke outcomes.Methods: Pubmed, Embass, Web of science, and Cochrane databases were searched to induce cross-sectional studies of stroke outcomes using nutritional assessment scales. The main indicators and secondary indicators were extracted for meta-subgroup analysis.Results: Thirty articles were included in this study, involving 11604 patients from 14 regions. Two types of data analysis were performed on NRS-2002, MUST, MNA, MNA-SF, SGA, and PG-SGA to predict and evaluate the prognosis of stroke, among which NRS-2002 was 0.44 [95% CI: 0.37–0.52], MUST was 0.58 [95% CI: 0.45–0.70], MNA was 0.29 [95% CI: 0.10–0.52], MNA-SF was 0.11 [95% CI: 0.00–0.42], and SGA and PG-SGA were 0.22 [95% CI: 0.00–0.71]. Continuous data analysis of the mNUTRIC, NRS-2002, and SGA scales used for analysis revealed a value of 13.059 [95% CI: 8.856–17.263].Conclusion: MNA and MNA-SF are valuable in predicting life activities after stroke in elderly patients and evaluating the stage of recovery after stroke. However, mNUTRIC scale is more effective in the assessment of acute stroke. The results of MUST and NRS-2002 provided a basis for early nutritional intervention. SGA and PG-SGA can be continuously to evaluate nutritional interventions after stroke.

Impact of Early Nutrition Interventions on the Growth and Development of Preterm Infants: A Narrative Review.

Preterm birth remains a significant global health concernas it can lead to various health complications and long-term developmental challenges. Early nutrition intervention plays a crucial role in optimizing the growth, development, and overall health outcomes of premature infants. This review aims to summarize and analyze the existing literature regarding the effect of early nutrition interventions on premature babies. A comprehensive search was conducted through various electronic databases, including PubMed, Scopus, and Google Scholar, focusing on nutrition interventions specifically targeting premature infants. The review highlights the benefits of early nutrition interventions, including enteral and parenteral feeding, human milk, and the provision of specific nutrients. These interventions have been shown to enhance growth rates, promote neurodevelopmental outcomes, reduce the incidence and severity of retinopathy of prematurity (ROP), reduce the risk of infection, and improve overall morbidity and mortality rates in premature babies. Overall, the findings from this review suggest that early nutrition interventions have a positive impact on the health and developmental outcomes of premature babies. However, further research is required to determine the optimal approaches, optimal timing, and long-term effects of various interventions. Collaboration between healthcare providers, researchers, and families is crucial in implementing evidence-based nutrition practices and supporting the growth and development of premature infants.

Early nutritional risk detection and intervention in COVID-19 hospitalized patients through the implementation of electronic automatized alarms

IntroductionHospitalized COVID-19 patients may present acute malnutrition which could influence morbidity and mortality. In the first wave of the pandemic severe weight loss was observed in many hospitalized patients. This pilot study evaluates the usefulness of an electronic automatized alarm for the early quantification of a low food intake as a predictor of the risk of malnutrition using COVID-19 disease as a model of severe illness. MethodsObservational prospective nutritional screening with a daily automatized warning message to the Endocrinology and Nutrition Service provided by the Information Systems. All adult patients admitted for COVID-19 from November 2020 to February 2021 were included. When diet intake was <50% during consecutive 48h, an automated message was generated identifying the patient as “at nutritional risk (NR)” and additional specialist nutritional evaluation and therapy was performed within the next 24h. Results205 patients out of 1176 (17.4%) were detected by automatized alarm and were considered as presenting high NR; 100% were concordant by the validated nutritional screening SNAQ. Nutritional support after detection was: 77.6% dietary adaptation+oral supplements; 9.3% enteral nutrition (EN); 1.5% parenteral nutrition (PN); 1% EN+PN and 10.7% no intervention is performed due to an end-of-life situation. Median weight loss during admission was 2.5kg (p25 0.25–p75: 6kg). Global mortality was 6.7% while in those detected by automatized alarm was 31.5%. ConclusionsThe implementation of an electronic NR screening tool was feasible and allowed the early nutritional assessment and intervention in COVID-19 hospitalized patients and can be useful in patients hospitalized for other pathologies.

Factors associated with children's cognitive, language, and motor development in deprived urban settings in Bangladesh.

Children's development is multifactorial. Although there have been several studies exploring the association of children's development with maternal, child, and environmental factors, we are unaware of any study that assessed those factors in children whose mothers were enrolled in a social safety net programme in low- and middle-income countries. This study aimed to identify the factors associated with disadvantaged children's cognitive, language, and motor development at age 6-16 months in deprived settings of urban Bangladesh and to identify relative importance of these factors of children's development. We also explored if there were any gender differences in child development. This cross-sectional study was conducted in a deprived setting of urban Bangladesh. Bayley III was used for assessing children's cognitive, language, and motor development. Multivariable linear regression model was used to find the factors associated with children's development, and dominance analysis was used to explore the relative importance of the factors. Out of the total 599 mother-child dyads, 303 (50.58%) were girls. The factors associated with children's development were length-for-age Z-score (cognitive: B = 1.21 [95% CI = 0.31, 2.11], P = 0.008; language: 1.67 [0.79, 2.55] P < 0.001; motor: 2.15 [1.01, 3.29] P < 0.001) and home environment (cognitive: 0.58 [0.27, 0.89] P < 0.001; language: 0.59 [0.27, 0.92], P < 0.001; motor: 0.44 [0.09, 0.79] P = 0.013). Girls had higher cognitive (1.90 [0.17, 3.6], P = 0.031) and language (2.53 [0.55, 4.51], P = 0.013) development compared with boys. Families with a higher number of under five children within the households had lower language (-1.57 [-2.78, -0.36], P = 0.011) development. Violence against the mother and the families' food security status were not associated with the children's development. Children's length-for-age Z-score (27%) and home stimulation environment (23%) were the most important factors of cognitive development. Children's nutritional status and home environment are important factors for disadvantaged children's development in deprived urban settings of Bangladesh. Both early child development-focussed parenting and nutrition interventions should be considered when designing child development programmes in urban settings in low- and middle-income countries.

Assessment of malnutrition in patients undergoing chemotherapy at the National Oncology Centre of the Korle-Bu Teaching Hospital, Accra, Ghana

Background: Globally, cancer is on the rise despite several interventions. The link between nutrition and cancer has long beenestablished with the consequences of poor nutrition on cancer pathway being dire. Early nutrition intervention is recommended for all cancer patients.Objective: To assess malnutrition among patients undergoing chemotherapy at the National Radiotherapy Oncology and Nuclear Medicine Centre of the Korle-Bu Teaching hospital (KBTH) in Accra, Ghana.Methods: A cross-sectional study was conducted among 123 patients with different types and stages of cancer who were undergoingchemotherapy. Data was collected from December 2018 to January 2019. The PG-SGA tool was used to assess weight loss at one and six months, food intake and nutrition impact symptoms. A correlation test was used to test the association between PGSGA score and Nutritional triaging. A T-test was used to determine the association between chemotherapy cycles and nutrition. A p-value &lt;0.05 was considered to be significant.Results: The results revealed that 5.7% (n= 7) of the patients were well nourished, 31.7% (n= 39) were suspected of being malnourished and 62.6% (n=77) were severely malnourished. About half of the participants (48%) had experienced weight loss ranging between 1-20kg with weight loss ≤5kg being most prevalent at both one month and six months prior to the study. More than half (56.9%, n=70) of the participants were consuming less than their usual intake. Majority of the participants had 4-6 nutritional symptoms (39.0%) with symptoms being mostly mild (39.1%). Poor nutritional status was positively correlated with nutritional symptoms (r=0.747, p&lt;0.001).Conclusion: The PGSGA tool identified that more than half of the patients were severely malnourished hence the need for early nutrition intervention in cancer patients.

Combination of Perioperative Comprehensive Nursing and Early Postoperative Nutritional Intervention Promotes Recovery and Immune Function of Patients Undergoing Thoracoscopic Radical Resection of Lung Cancer

This study aimed to explore the effects of perioperative comprehensive nursing combined with early postoperative nutritional intervention on the postoperative recovery and immune function of patients undergoing thoracoscopic radical resection of lung cancer. The study included 116 patients at the People’s Hospital of Danyang from March 2020 to March 2023. Patients in the control group received routine nursing + routine intravenous nutrition, while those in the study group received perioperative comprehensive nursing + early enteral nutrition. The study group presented a shorter time for getting out of bed, anal exhaust, first feeding, and hospitalization than the control group. In the study group, the levels of forced vital capacity and expiratory volume in one second exceeded than those in the control group; the Hamilton Anxiety Scale and Hamilton Depression Scale scores were lower; the total protein, prealbumin, and albumin levels were higher; and the CD3+, CD4+, and CD4+/CD8+ levels were higher, while CD8+ levels were lower. The study group presented a lower incidence of complications than the control group, and the SF-36 scores were higher. Overall, perioperative comprehensive nursing combined with early postoperative nutritional intervention can accelerate postoperative recovery and promote the immune function of patients undergoing thoracoscopic radical resection of lung cancer.

Maternal–child consumption of ultra-processed foods and sugar-sweetened beverages in informal settlements in Mumbai, India

BackgroundThe global nutrition transition is associated with increased consumption of ultra-processed snack foods and sugar-sweetened beverages (UPF/SSB), contributing to the double burden of child obesity and undernutrition.MethodsThis cross-sectional study describes the prevalence of maternal and child UPF/SSB consumption and the factors associated with frequent consumption in a convenience sample of 749 children ages 6 months through 6 years and their mothers participating in a community-based child oral health program in five informal settlement communities in Mumbai, India. Mothers were interviewed regarding maternal and child oral health and nutrition characteristics, including consumption of beverages and foods associated with tooth decay—milk, soda, tea with sugar, sweets, and chips/biscuits—using standardized questionnaires. Spearman correlations were used to assess for associations between various social factors and the frequency of maternal and child consumption of the five food categories. Chi-square tests were used to assess differences in child consumption patterns by age groups.ResultsThough reported soda consumption was low among both mothers and children, nearly 60% of children consumed sweets and chips/biscuits daily, four to five times the rate of mothers. Factors associated with children’s frequent consumption of UPF/SSB included lower maternal education level, frequent maternal consumption of UPF/SSB, greater number of household members, greater amount of money given to the child, and closer proximity to a store.ConclusionOur findings demonstrate social factors that may promote UPF/SSB consumption. The nutritional dangers of sugary drinks and non-nutritious snacks for mothers and young children should be addressed across maternal–child health, education, and social service programs. Early childhood nutrition interventions should involve the entire family and community and emphasize the need to limit children’s consumption of unhealthy foods and beverages from an early age.