Estimated Energy Requirements Research Articles

PSX-10 Pilot Study Estimating Energy Expenditure in Dogs Using a Quantified Health Approach Indicates Potential to Improve Estimation of Energy Requirements

Abstract Over 50% of dogs in the USA are overweight or obese indicating that owners find it difficult to know how much food their dog needs. Feeding guidelines are based on the average energy requirements of dogs and do not take into account measured activity levels, which may lead to overfeeding by well-intentioned owners. The most common published energy prediction equation is (RER*AF) where RER is Resting Energy Requirement [70*(BW kg)0.75)] and AF is the Activity Factor, which generally ranges between 1 (body weight loss) and 8 (heavy work). This equation requires the user to estimate activity levels when selecting an AF, which may result in under- or overfeeding. The objective of this pilot study was to determine the ability of collar-worn activity monitors to more accurately predict the energy expenditure of dogs. Ten weight-stable beagles were group-housed at the Hill’s Pet Nutrition Center in Topeka, KS. Dogs were provided daily access to open, outdoor play space and human interaction; water was freely available. Dogs were weighed before feeding on days 1 and 5 of each of the 2 test periods. Accelerometer-based activity monitors were attached to the collars of the dogs on day 1 of each test period and activity was continually measured throughout the study using the activity monitor. Daily food consumption in grams was recorded and was converted to energy intake using the caloric density of the food. Daily energy requirements were calculated for each dog using the standard RER equation and either a standard AF of 1.6 or the estimated energy required for activity, in which newly established algorithms for quantification of walking, trotting, and running behaviors were paired with estimated caloric expenditure based on level of exertion (quantified health approach). The mean absolute error (MAE) of each method was calculated as the absolute value of the difference between the daily energy requirement vs. the daily caloric intake for each dog. The MAE was averaged across all dogs and all days for each of the two methods. The MAE ± SD of the standard RER and AF was 103 ± 126 kcal/day (Range -21.5 to 216 kcal/day). The MAE ± SD of the quantified health approach was 86 ± 90 kcal/day (Range -37.6 to 164.4 kcal/day). Both approaches resulted in normal MAE distributions. In this pilot study, quantifying energy expenditure using a wearable activity monitor reduced over-feeding by 16.5% compared with standard equations. In the future, energy predictions based on measured activity could result in more accurate feeding recommendations than traditional approaches. Future research aimed at optimizing energy predictions may help address the problem of pet obesity. This study was approved by the Hill’s Internal Animal Care and Use Committee. Funding: This study was funded by Hill’s Pet Nutrition, Inc.

Updated Estimated Energy Requirements: How Do They Measure up to Indirect Calorimetry?

Updated Estimated Energy Requirements: How Do They Measure up to Indirect Calorimetry?

Enhancing energy efficiency in a smart home through window-based support vector regression for energy consumption prediction

Efficient energy management is greatly facilitated by accurately predicting energy consumption in a smart home, benefiting both consumers and utilities alike. The conventional forecasting techniques rely on pre-trained statistical models built upon extensive historical data, which may experience performance degradation due to the dynamic nature of power load demands. To address this limitation, this study proposes a novel approach employing Window-based Support Vector Regression (WSVR) to accurately estimate energy requirements from a smart grid within a smart home. The dataset utilized for this research is sourced from Pecan Street in Texas, USA. To assess the efficacy of the proposed model, it is compared to several other time series data prediction models, including ARIMA, Holt Winter's, Linear Regression, Support Vector Machine, and Support Vector Regression. The performance of each model is evaluated, and the results are thoroughly examined and discussed.

Validation of predictive equations for resting energy expenditure in children and adolescents with different body mass indexes

BackgroundAccurate estimation of resting energy expenditure (REE) in children and adolescents is important to establish estimated energy requirements. The objective of this study was to assess the validity of existing equations in literature and a newly developed equation in estimating REE in children and adolescents.Methods275 participants (148 boys, 127 girls) aged 6–18 years included in the study were classified as normal-weighted, overweight, obese based on BMI z-scores for age according to WHO-2007 growth curves for 5–19 years of age. REEs were measured using an indirect calorimeter, with various equations, and a newly established equation [REE = 505.412+(24.383*FFM);Adjusted R2 = 0.649] were compared with REE measured using Bland-Altman and further validation parameters.ResultsWhen the predicted REEs were compared with the measured REEs, the highest prediction accuracy was achieved using the new Eq. (64.8%) and IOM (63.8%) for normal-weight participants, Müller FFM and new Eq. (59.6%) for overweight participants and Lazzer (44.9%) for obese participants. In normal and overweight participants, lowest root mean squared error (RMSE) values were acquired from Schmelzle’s equation (respectively 136.2;159.9 kcal/d), and the highest values were found in Kim’s Eq. (315.2; 295.2 kcal/d respectively). RMSE value of the new equation was 174.7 kcal/d for normal-weight children and adolescents, and 201.9 kcal/d for overweight ones. In obese participants, the lowest RMSE value was obtained from Schmelzle’s Eq. (305.4 kcal/d) and the new Eq. (317.4 kcal/d), while the highest value was obtained from IOM Eq. (439.9 kcal/d). RMSE was higher in obese groups compared to the other BMI groups.ConclusionIndirect-calorimeter is the most suitable method for REE measurement in especially obese children and adolescents. The new equation and Schmelzle’s equation appear to be most accurate equations for normal and overweight children and adolescents.

Energy assessment of some nuts and dried fruits grown in Pakistan’s climate and their role for weight control management

The aim of the present study is to assess the energy contents of different dry fruits consumed in Pakistan. Six samples of tree nuts (walnut, almond, pine nut, pistachio, cashew nut, and coconut), one sample of the ground nut (peanut), and four samples of dried fruits (figs, apricot, dates, and raisins) were selected for this purpose. The energy contents of nuts and dried fruits were estimated using oxygen bomb calorimeter. Peanut was identified as the energy rich fruit (875.86 Cal/100g), followed by walnut (818.84 Cal/100g), coconut (787.36 Cal/100g), almond (785.61 Cal/100g), pine nut (772.31 Cal/100g), Pistachio (624.72 Cal/100g), and the cashew nut (616.46 Cal/100g). The energy values of the dry fruits were found higher in nuts (875.86-616.46 Cal/100g), compare to dried fruits (352.04–505.31 Cal/100g). Protein and fats contribute to the energy values of nuts; while carbohydrates make a valuable contribution to the energy content of dried fruits. The recommended serving of dry fruits was found to fulfill 20.26−4.40 % of the minimum estimated energy requirement (EER) of persons of different life styles. On the basis of the caloric content of the studied dry fruits, one can easily calculate the required amount of a particular dry fruit per day in accordance to gender, age and PAL life style. Therefore, the study would be helpful to plan weight balance strategies for individuals interested in energy dense food.

Dietary intake and occupational status among female youths of Thai Nguyen, Vietnam.

Adolescence is a sensitive transition time that affects rights, roles, and responsibilities in food choice, yet limited evidence exists on dietary intakes during this critical period. This study assessed the food consumption pattern and the adequacy of energy, macronutrient, and micronutrient intakes among female youth belonging to three occupational groups in Vietnam. Dietary intakes were measured for 1001 participants aged 16-22 years using INDDEX24's 24-h recall method. Multivariate regression analyses were conducted to examine differences in diet outcomes among the three occupational groups. Dietary diversity was similar across groups but workers, compared to high school and college students, consumed less baked/grain-based sweets and fast foods, and more soft drinks, other sweets, and processed meat. Two-thirds of the sample showed energy intake lower than the estimated energy requirement, while a substantial percentage had insufficient or excessive intake of carbohydrate and fat. The mean probability of adequacy of nutrient intakes was low (0.33) and not different across all three occupational groups except for folate, which favored workers. Our study provides novel evidence supporting the development and implementation of interventions to achieve national targets, with emphasis on female youths who undergo special transitions in education, occupation, and lifestyle.

Comparison of predictive equations and indirect calorimetry in critical care: Does the accuracy differ by body mass index classification?

Nutrition support professionals are tasked with estimating energy requirements for critically ill patients. Estimating energy leads to suboptimal feeding practices and adverse outcomes. Indirect calorimetry (IC) is the gold standard for determining energy expenditure. However, access is limited, so clinicians must rely on predictive equations. A retrospective chart review of critically ill patients who underwent IC in 2019 was conducted. The Mifflin-St Jeor equation (MSJ), Penn State University equation (PSU), and weight-based nomograms were calculated using admission weights. Demographic, anthropometric, and IC data were extracted from the medical record. Data were stratified by body mass index (BMI) classifications, and relationships between estimated energy requirements and IC were compared. Participants (N = 326) were included. Median age was 59.2 years, and BMI was 30.1. The MSJ and PSU were positively correlated with IC in all BMI classes (all P < 0.001). Median measured energy expenditure was 2004 kcal/day, which was 1.1-fold greater than PSU, 1.2-fold greater than MSJ, and 1.3-fold greater than weight-based nomograms (all P < 0.001). Despite the significant relationships between measured and estimated energy requirements, the significant fold-differences suggest that using predictive equations leads to significant underfeeding, which may result in poor clinical outcomes. Clinicians should rely on IC when available, and increased training in the interpretation of IC is warranted. In the absence of IC, the use of admission weight in weight-based nomograms could serve as a surrogate, as these calculations provided the closest estimate to IC in participants with normal weight and overweight, but not obesity.

Effect of Characteristic Impedance in Estimating Specific Energy and Average Fragment Size at High Strain Rates of Some Peridotitic Rock Materials at Laboratory Scale

In this study, the application of characteristic impedance in estimating specific energy and average fragment size of rocks was investigated during rock breakage at high strain rates. To achieve this, rock specimen was prepared in accordance with recommendations of the International Society for Rock Mechanics and broken at high strain rates using the split Hopkinson’s pressure bar system. Results reveal that although strain rate is well related to specific energy and average fragment size of broken rocks, the product of characteristic impedance and strain rate is more reliable for estimating the forementioned parameters. In addition, strain rate and dissipated energy generally increase at higher incident energies while the average fragment size of broken rocks reduces at higher strain rates. Based on these findings, more studies on indirect estimation of energy requirement for rock breakage to desired average fragment sizes is recommended from the product of characteristic impedance and strain rate.

Associations between Oxidant/Antioxidant Status and Circulating Adipokines in Non-Obese Children with Prader-Willi Syndrome.

Oxidative stress is implicated in the pathophysiology of Prader-Willi syndrome (PWS), but there are no data on these disorders in non-obese children with PWS. Therefore, the presented study examined total oxidant capacity (TOC), total antioxidant capacity (TAC), the oxidative stress index (OSI), and adipokine levels in 22 non-obese children with PWS during dietary intervention and growth hormone treatment compared with 25 non-obese healthy children. Serum concentrations of TOC, TAC, nesfatin-1, leptin, hepcidin, ferroportin, and ferritin were determined using immunoenzymatic methods. We found that TOC concentrations were higher by 50% (p = 0.006) in patients with PWS than in healthy children, but no significant differences in TAC concentrations were observed between these groups. The OSI was higher in children with PWS than in the controls (p = 0.002). We found positive associations between TOC values and the percentage of the Estimated Energy Requirement, body mass index (BMI) Z-score, percentage of fat mass, and leptin, nesfatin-1, and hepcidin concentrations in patients with PWS. A positive association was also found between the OSI and nesfatin-1 levels. These observations suggest that higher daily energy intake and weight gain may be accompanied by an increasing prooxidant state in these patients. Adipokines such as leptin, nesfatin-1, or hepcidin may also play a role in the prooxidant state in non-obese children with PWS.

Associations of food choice values and food literacy with overall diet quality: a nationwide cross-sectional study in Japanese adults.

To date, a limited number of studies have examined aspects of food choice values and food literacy in relation to some aspects of dietary behaviours. The aim of this cross-sectional study was to comprehensively examine the associations of food choice values and food literacy with diet quality. In total, 2231 Japanese adults aged 19-80 years completed questionnaires asking about food choice values (accessibility, convenience, health/weight control, tradition, sensory appeal, organic, comfort and safety) and food literacy characterised by nutrition knowledge, cooking skills, food skills and eating behaviours (hunger, food responsiveness, emotional overeating, enjoyment of food, satiety responsiveness, emotional undereating, food fussiness and slowness in eating). As a measure of diet quality, the Healthy Eating Index-2015 (HEI-2015) was calculated using a brief-type diet history questionnaire (BDHQ) or a food combination questionnaire (FCQ). In males, after adjustment for potential confounding factors (including age, BMI and the ratio of reported energy intake to estimated energy requirement), the HEI-2015 derived from BDHQ and that derived from FCQ were associated significantly (P ≤ 0·02) and positively with the food choice values of organic and inversely with food fussiness. In females, the HEI-2015 showed positive associations with the food choice values of health/weight control, nutrition knowledge and cooking skills and an inverse association with food fussiness, irrespective of the dietary assessment questionnaire (P ≤ 0·03). In conclusion, this study suggests that several aspects of food choice values and food literacy were associated with diet quality, and the aspects related differed between males and females.

Total Usual Nutrient Intakes and Nutritional Status of United Arab Emirates Children (4 Years-12.9 Years): Findings from the Kids Nutrition and Health Survey (KNHS) 2021.

This study aims at investigating the anthropometric status and food consumption patterns of children in the United Arab Emirates (UAE) and assessing their adherence to nutrient and dietary recommendations. It is a population-based cross-sectional survey of 690 children (4-12.9 years), from 3 major Emirates. Socio-demographic and anthropometric characteristics were collected. Dietary intakes were assessed using the 24-hour recall approach. Of the total sample, 4% were stunted, 8% were wasted and 28% were overweight/obese. A third of participating children consumed above the Estimated Energy Requirement, while the majority's intakes carbohydrate, total fat, and protein were within the recommendations; whereas over 70% and 90% of participants consumed above the WHO daily limits of free sugars and saturated fats, respectively. Inadequate intakes of linoleic acid (36% of children), alpha-linolenic acid (91%) and dietary fiber (100%) were observed. All children failed to meet the recommendation for vitamin D and considerable proportions had inadequate intakes of vitamin A, calcium, zinc, folate, and magnesium. Compared with the American Heart Association/American Academy of Pediatrics recommendations, low dietary adherence was noted for fruits (9%), vegetables (4%), and milk/dairy (14%). These findings may be used in the development of nutritional policies aimed at improving the diets of children in the UAE.

Total Energy Expenditure in Healthy Ambulatory Older Adults Aged ≥80 Years: A Doubly Labelled Water Study

Introduction: The life expectancy of older adults continues to increase; however, knowledge regarding their total energy requirements is lacking. This study aimed to compare the total energy expenditure (TEE) of older adults ≥80 years measured using doubly labelled water (DLW), with estimated TEE. The hypothesis was that the Mifflin, Ikeda, and Livingston equations will more closely estimate energy requirements than the commonly used Schofield equation. Methods: Resting metabolic rate (RMR) and TEE were measured using the reference methods of indirect calorimetry and DLW, respectively. Bland-Altman plots compared measured RMR and TEE with predicted RMR using equations (Mifflin, Ikeda, Livingston, Schofield) and predicted TEE (predicted RMR × physical activity level). Results: Twenty-one older adults (age range 80.7–90.1 years, BMI 26.1 ± 5.5 kg/m2) were included. The Schofield equation demonstrated the greatest bias from measured RMR, overestimating approximately up to double the mean difference (865 ± 662 kJ/day) compared with the three other equations. The Schofield equation exhibited the greatest bias (overestimation of 641 ± 1,066 kJ/day) compared with measured TEE. The other three equations underestimated TEE, with the least bias from Ikeda (37 ± 1,103 kJ/day), followed by Livingston (251 ± 1,108 kJ/day), and Mifflin (354 ± 1,140 kJ/day). Data are mean ± SD. Conclusions: In older adults ≥80 years, the Ikeda, Mifflin, and Livingston equations provide closer estimates of TEE than the widely used Schofield equation. The development of nutrition guidelines therefore should consider the utilization of equations which more accurately reflect age-specific requirements.

Estimating Battery Size Requirements for Tractor Electrification of Row-Crop Planting Operations

Highlights Calculate and compare engine power needed for row-crop planting from ASAE standards and reported CAN data. Estimate energy requirements and the equivalent electric battery’s volume and mass for row-crop tractor. Discuss the feasibility for electrification of a fully electric row-crop tractor. Abstract. Power sources such as batteries, used for both on-road and off-road vehicles, are advancing at a rapid pace. Electric batteries are becoming more power dense, thus allowing them to be used as a power source to replace previous diesel or gasoline-powered systems. Efforts are underway to transition off-road agricultural vehicles from Internal Combustion Engine (ICE) vehicles to electric vehicles (EVs); however, the energy requirements of typical agricultural field operations need to be fully understood before such a transition can occur. Theoretical prediction equations available in the American Society of Agricultural and Biological Engineers (ASABE) standards or the use of engine load data from a tractor’s Controller Area Network (CAN) bus are two methods for determining the energy demands of implements on tractors. In this study, tractor CAN bus data was collected from multiple no-till corn planting operations to estimate the energy requirements of the planting operation in kWh. The estimated energy requirement was used to determine the equivalent physical mass and volume of a lithium-ion battery needed to power a hypothetical fully electric tractor for comparable planting operations. The estimated battery capacities using the worst-case field-use scenario in this study were 1117 kWh for operating a 16-row planter to plant 68 ha (168 acre) in a day at an average ground speed of 8.6 km h-1 (5.4 mph) for 14 hours, and 2658 kWh for operating a 48-row planter to plant 158 ha (391 acre) in a day at an average ground speed of 8.9 km h-1 (5.6 mph) for 15 hours. Given the current battery energy density requirements, the equivalent battery masses and volumes were found to be 5,319 kg and 3.33 m3, 12,657 kg and 7.93 m3, for 16-row planter and 48-row planter, respectively. These high kWh estimates needed to power future fully-electric tractor power units are based on worst-case scenarios that could be encountered in real field operations that use wide planters over long operating hours. Keywords: Battery, Controller Area Network, Electric Vehicles, Electrification, No-till, Planting, Row-crop, Tractor.

Validation of the physical activity classification table for Korean youth and assessment of total energy expenditure, estimated energy requirement and physical activity in Korean children and adolescents

Validation of the physical activity classification table for Korean youth and assessment of total energy expenditure, estimated energy requirement and physical activity in Korean children and adolescents

Development of nutrient-based nutritional standards for foodservice at shelters during disasters in the Republic of Korea.

In times of disaster, simplified and minimized nutritional standards are necessary for a quick response to provide nutritious relief food. This study aimed to develop nutrient-based nutritional standards for foodservice at shelters during disasters in the Republic of Korea (South Korea). The standards were developed in 2 phases. First, nutrients to be included in the standards were selected. Initial candidates were selected considering 3 aspects: preceding standards, insufficient intake during disasters, and inadequate intake among South Koreans. Final selection was made by excluding nutrients for 3 reasons: nutrients for which there is no deficiency concern in South Korea, nutrients whose intake data were not available, or nutrients whose values presented by Dietary Reference Intakes for Koreans are difficult to achieve based on the current diet among South Koreans. Second, the reference values of energy and the selected nutrients were calculated. The reference values for the entire population who were 1-year-old and over were calculated by multiplying the estimated energy requirements or the recommended nutrient intake and the proportion of each age and sex group. Respective reference values were also calculated for 4 different age groups (1-5, 6-11, 12-64, and ≥ 65-year-old). The standards for the entire population were 2,000 kcal for energy, 55 g for protein, 650 µg retinol activity equivalents for vitamin A, 95 mg for vitamin C, 1.1 mg for thiamin, 1.3 mg for riboflavin, 14 mg niacin equivalents for niacin, 350 µg dietary folate equivalents for folic acid, 750 mg for calcium, and 11 mg for iron. Four additional standards corresponding to each age group were developed. The nutritional standards during disasters were developed for South Korea, including energy and 9 nutrients with reference values for the entire population and 4 different age groups. The standards will contribute to maintaining the health of disaster evacuees in South Korea.

327: NUTRITION IN NEONATAL AND PEDIATRIC EXTRACORPOREAL LIFE SUPPORT: A SURVEY OF CURRENT PRACTICES

Introduction: Adequate nutritional support is essential for children in the ICU. Malnourishment during critical illness is associated with increased morbidity and mortality, and improved enteral nutrition (EN) and protein intake are associated with decreased 60-day mortality. ICU patients with cardiac and/or respiratory failure who require ECMO are at increased risk due to high rates of protein catabolism and challenges in estimating energy requirements. These patients also have unclear metabolic needs and safety risks with both parenteral nutrition (PN) and EN. Assessing current national practices is crucial for standardized guideline development and recommendations. We aim to provide an update on current practices since a 2015 survey and hypothesized more respondents would report utilizing EN during ECMO with few differences between ICU physicians (MD/DOs) and registered dieticians (RDs). Methods: We distributed a survey via Qualtrics to 100 ECMO medical directors who had previously participated in survey-based research and those who requested participation during PediECMO presentations of this study. We also requested they forward the survey to their center RDs. Results: In total, 36 MD/DOs and 19 RDs responded. Respondents utilize PN more than EN (59%; 49%) at least half of the time. Respondents were more likely to start PN than EN during the first 24 hours (32%; 23%) but were equally likely to start PN and EN during the 24–48-hour window (34%; 32%). Respondents considered volume, calories, and protein to be the most critical nutritional goals with some variance in order between groups. Continuous feeds were preferred to bolus EN (70%; 17%). EN was preferred in respiratory distress syndrome and heart disease with biventricular physiology whereas PN was preferred for single ventricle physiology, ileus, and diaphragmatic hernia. Conclusions: Nutrition is a key component of reduction in morbidity and mortality; however, there is great variability in its delivery. Compared to 2015, EN is more commonly utilized than previously reported (49%; 24%) despite less protocol use (14%; 38%). These data support the need for development of a universal stepwise nutrition support algorithm to determine the safety of early EN versus PN as recommended by the ELSO Nutrition Guidelines published July 2022.

Cross-Sectional Study of Nutritional Status and Dietary Nutrient Intake in Children with Duchenne Muscular Dystrophy (DMD) in China

To investigate the dietary nutrient intake and the nutritional status of children with Duchenne muscular dystrophy (DMD), and to explore the correlation between them, so as to provide theoretical basis for the formulation of proper nutritional treatment for children with DMD. A total of 223 children aged 2 to 14 years who came to West China Second University Hospital, Sichuan University from July 2017 to April 2021, and who were diagnosed with DMD by genetic testing were enrolled as the subjects of the study. Dietary assessment was conducted with a 3-day 24-hour dietary recall, and serum vitamin D level was measured by chemiluminescence method. Only 33.2% of the children with DMD were found to be of normal nutritional status. The incidences of stunted growth, underweight, overweight and obesity were 13.5%, 14.4%, 14.3% and 8.1%, respectively. Among the children with DMD, those with serum vitamin D deficiency and insufficiency accounted for 9.0% and 89.7%, respectively. According to the dietary recall of the children with MDM, the daily energy ratio of carbohydrate, protein and fat were (47.40±6.64)%, (14.46±2.22)%, and (38.17±5.30)%, respectively. The daily intake of dietary calcium and vitamin D were (433.32±164.39) mg per day and (155.73±89.30) IU per day, respectively. The ratio of daily protein intake to the estimated average requirement for protein ( P=0.003) and ratio of daily energy intake to the estimated energy requirement ( P=0.007) were lower in children with stunted growth than those of DMD children of normal nutritional status. The dietary structure of children with DMD is obviously not suited to their condition and nutritional deficiency coexists with overnutrition among them. Further research needs to be done for developing appropriate nutritional guidance programs and standardized nutritional management measures for children with DMD.

Nutritional status and function after high-calorie formula vs. Chinese food intervention in undernourished children with cerebral palsy.

AimTo investigate the efficacy and safety of high-calorie formula vs. Chinese daily food on the nutritional status and motor function of undernourished children with cerebral palsy (CP).MethodsIn this prospective, assessor-blind, and randomized controlled trial, we recruited children (1–10 years) with CP and undernutrition based on the WHO and the American Society for Parenteral and Enteral Nutrition criteria from the National Children's Medical Center. Participants were randomly allocated (1:1) to a high-calorie formula group or a Chinese daily food diet group (control group) for 6 months. Indirect calorimetry was used to estimate energy requirements. We compared the nutritional status and gross motor function of participants in both groups based on weight, height, z-scores (weight-for-age, height-for-age, weight-for-height, and BMI-for-age), and the Gross Motor Function Measure (GMFM), respectively, at baseline, 3-, and 6-months follow-up. In addition, the effective rate of nutritional intervention, and adverse events were simultaneously assessed.ResultsFrom July 2020 to December 2021, a total of 119 participants were enrolled and randomized, and 110 participants completed the study (with 54 children in the high-calorie formula group and 56 children in the control group). After 6 months of treatment, the weight, height, z-scores (weight-for-height, weight-for-age, and BMI-for-age), and GMFM of both groups were significantly improved (p < 0.05). There were significant differences in changes in weight, weight-for-age z-scores, and GMFM between the two groups (p < 0.05). During the study period, 16 children experienced at least one mild adverse event [9 (16.7%) in the formula group and 7 (12.5%) in the control group].ConclusionNutritional intervention with a high-calorie formula may be an effective and safe option in children with CP for improving undernutrition and gross motor dysfunction.Clinical trial registrationwww.chictr.org.cn, identifier: ChiCTR2000033878.

Weight loss and all-cause mortality: A propensity score matching cohort study

BackgroundWeight loss was supposed to help with decreasing risk of premature mortality. However, results on this topic remain debatable and limited by study design. ObjectiveThe present study aimed to investigate the association between weight loss and all-cause mortality among US adults with overweight or obesity in a national cohort study by using propensity score matching (PSM) analysis. MethodsA total of 5486 pairs of participants were matched in the National Health and Nutrition Examination Survey (NHANES, 2003–2015) after PSM. Hazard ratios (95% confidence intervals) (HRs (95% CIs)) were employed to evaluate the association between weight loss indicated by long-term weight loss (LTWL) and all-cause mortality by using Cox proportional hazards regression models. ResultsDuring a median follow-up of 6.8 years, 674 participants died from all-cause mortality. In each PSM match, compared with participants with LTWL < 5%, the HRs (95% CIs) for participants with LTWL of 5–9.9% (2877 pairs), 10–14.9% (1315 pairs), and ≥ 15% (1294 pairs) were 1.18 (0.83–1.68) (P = 0.366), 1.65 (1.17–2.34) (P = 0.005), and 1.91 (1.21–3.00) (P = 0.006), respectively. The significant increased risk of all-cause mortality for LTWL ≥ 15% remained among male, female, participants aged ≥ 65 years, without weight loss intention, with non-communicable diseases, and without exceeding estimated energy requirement. ConclusionWeight loss especially for being ≥ 15% should be cautious for US adults with overweight or obesity.

Gastrointestinal and sensory manifestations, nutrition management, and energy-protein intake in hospitalized patients with COVID-19.

BackgroundGastrointestinal and sensory manifestations (GSMs) of coronavirus disease 2019 (COVID‐19) may affect food intake, resulting in malnutrition and poor outcomes. We characterized the impact of GSMs and oral nutrition supplementation on energy‐protein intake (EPI) and hospital discharge in adult patients with COVID‐19.MethodsPatients from two hospitals were enrolled (n = 357). We recorded the presence and type of GSM at admission, estimated energy requirements (EER) and the EPI based on regular food intake (plate diagram sheets) during hospital stays. Patients not achieving 60% of their EER from food over 2 consecutive days received oral nutrition supplementation (ONS) with a high‐energy‐protein oral drink.ResultsMost patients (63.6%) presented with GSMs at admission. Anorexia was the most common manifestation (44%). Patients with anorexia or more than one GSMs were more likely to not achieve 60% EER on the first day of follow‐up and to require the ONS intervention (P ≤ 0.050). Prevalence of at least one GSM was higher in patients who did not achieve hospital discharge than in patients who achieved it (74.2% vs 54.6%, P = 0.038). The patients requiring ONS (26.9%) demonstrated good adherence to the intervention (79.3%), achieved their EER during 95.7% of the supplementation time, and presented with hospital discharge rates similar to patients not requiring ONS (92.2% vs 91.9%, respectively; P = 1.000).ConclusionsGSM were prevalent in COVID‐19 and it impaired EER attendance and patient recovery. ONS was well‐tolerated, aided EER attendance, and potentially facilitated hospital discharge.