Evidence-based Nutritional Recommendations Research Articles

Evidence-Based Perioperative Nutrition Recommendations: Optimizing Results and Minimizing Risks.

Plastic surgery patients span the nutritional spectrum from generally healthy, nutritionally competent patients to inherently catabolic, nutritionally deficient, and chronic wound patients. Therefore, plastic and reconstructive surgery affords the opportunity to investigate the impact of nutrition across a heterogeneous patient population following a wide variety of procedures. Although patients may be nutritionally deficient in certain vitamins warranting perioperative repletion, other supplements have the potential to benefit all patients, regardless of nutritional status. Despite these putative benefits, there is a dearth of information regarding nutritional optimization, with the limited, available literature focusing mostly on herbal supplements and their potential side effects. A significant barrier to supplement use is the lack of education and available supporting information regarding the indications, contraindications, and physiology of these adjuncts. The goal of this article is to provide a comprehensive, evidence-based review of available nutritional supplements that can be considered for the plastic surgery patient in the perioperative period to optimize surgical outcomes while minimizing risk. Prospective, well-designed studies using validated, high-quality supplements will be critical in determining the significance that perioperative supplementation can have for surgical outcomes. Until well-done prospective studies are performed, the supplement, dose, and duration should be determined on an individual, patient-per-patient basis at the discretion of the operating surgeon.

Personalized Nutrition Recommendations Improve Plasma Metabolite Concentrations Related to Dietary Intake

Abstract Objectives The objectives of our proof-of-concept study was to assess the efficacy of personalized nutrition interventions on diet and chronic disease risk. Methods Fasting plasma samples were collected at day 1 and day 100 of a cohort of 148 adults (aged 23–65y) volunteers with a median (range) BMI of 25.8 (17.2–48.3). At both time points 119 metabolites were quantitated using LC-MS/MS. Based on their metabolite concentrations and dietary preferences, each participant received their own personalized nutrition recommendations through an AI-assisted online platform and were advised to follow the recommendations for 100 days. Plasma metabolite concentrations from Day 1 and Day 100 were compared using a paired t-test with Holm-Bonferroni correction (P < 0.05). Results After 100 days, statistically significant changes in acylcarnitine, phosphatidylcholine and amino acid concentrations indicated participants had increased their intakes of omega-3 fats and whole grains and decreased their intakes of saturated fat. For example, Betaine, a biomarker of whole grain intake, increased significantly in concentration from Day 1 to Day 100 [mean (SD): 34.3 (13.2) to 45.3 (15.6) umol/l]. Overall, 55 of the analyzed 119 metabolites’ (46%) concentrations had previously been linked to dietary intake according to a systematic literature search that was used to generate evidence-based personalized nutrition recommendations. Concentrations of 33 (60%) of these 55 metabolites changed significantly. The majority [26 (79%)] of the metabolite concentrations changed in a predicted manner consistent with the literature, particularly those metabolites associated to chronic disease risk. For example, a significant decrease in asymmetric dimethylarginine concentration [mean (SD): 0.54 (0.15) to 0.48 (0.12) umol/L] which is understood to result in a decreased cardiovascular disease risk. Conclusions Adherence with an evidence-based personalized nutrition plan based on a panel of serum metabolomic data can significantly modify serum metabolite concentrations in a direction that can reduce the risk of chronic disease. Further analysis in how these changes relate to chronic disease risk is warranted. Funding Sources This study was supported by Mitacs and Molecular You.

Food avoidance in outpatients with Inflammatory Bowel Disease – Who, what and why

Food avoidance is common with Inflammatory Bowel Disease (IBD) and adherence to dietary guidelines is poor, contributing to under and over nutrition. Reasons for food avoidance have not been previously explored in detail. This study of IBD outpatients aimed to describe food avoidance patterns and rationale behind this, and describe source and confidence with dietary advice. A prospective cross-sectional study using structured interview, nutritional assessment and medical record review was conducted in patients with confirmed diagnosis of IBD (n=117) attending outpatient clinics over a six-month period. Participants were interviewed on foods avoided, rationale for food avoidance and previous dietary advice (source and confidence). Means±SD or medians (IQR), percentages and counts were used to describe participant characteristics, food avoidance, and source and confidence in dietary advice. Bivariate analysis was used to explore relationships between food avoidance and disease factors (IBD subtype; disease activity: active disease vs remission), and between confidence in dietary advice and disease activity. Almost all participants reported food avoidance (90%), with more foods avoided during active disease (5.2±3.6 foods/food categories, versus remission 2.9±2.5, p<0.001). Lactose-containing foods were avoided by 40% of patients in active disease and 33% in remission. Pain/cramping, increased bowel motions and diarrhea were the most common reasons for avoiding foods/food categories during both active disease and remission. Participants were most confident in advice received from the internet (3.3±1.2; dietitian: 2.8±1.5) in active disease; in remission participants had greatest confidence in advice received from gastroenterologists (4.1±0.8; dietitian: 3.5±1.2). High prevalence of avoidance of nutritious foods and low confidence in dietetic advice amongst people with IBD is of concern. Further work is needed to build trust and ensure patients are provided with evidence-based nutrition recommendations to manage their symptoms whilst optimizing nutritional quality of their diet.

The impact of diet-based glycaemic response and glucose regulation on cognition: evidence across the lifespan.

The brain has a high metabolic rate and its metabolism is almost entirely restricted to oxidative utilisation of glucose. These factors emphasise the extreme dependence of neural tissue on a stable and adequate supply of glucose. Whereas initially it was thought that only glucose deprivation (i.e. under hypoglycaemic conditions) can affect brain function, it has become apparent that low-level fluctuations in central availability can affect neural and consequently, cognitive performance. In the present paper the impact of diet-based glycaemic response and glucose regulation on cognitive processes across the lifespan will be reviewed. The data suggest that although an acute rise in blood glucose levels has some short-term improvements of cognitive function, a more stable blood glucose profile, which avoids greater peaks and troughs in circulating glucose is associated with better cognitive function and a lower risk of cognitive impairments in the longer term. Therefore, a habitual diet that secures optimal glucose delivery to the brain in the fed and fasting states should be most advantageous for the maintenance of cognitive function. Although the evidence to date is promising, it is insufficient to allow firm and evidence-based nutritional recommendations. The rise in obesity, diabetes and metabolic syndrome in recent years highlights the need for targeted dietary and lifestyle strategies to promote healthy lifestyle and brain function across the lifespan and for future generations. Consequently, there is an urgent need for hypothesis-driven, randomised controlled trials that evaluate the role of different glycaemic manipulations on cognition.

Delivering an action agenda for nutrition interventions addressing adolescent girls and young women: priorities for implementation and research.

Adolescent nutritional behaviors are assuming considerable importance in nutrition interventions given their important relationships with medium- and long-term outcomes. This is the period when young people undergo major anatomical and physiological maturational changes in preparation for adulthood. Nutritional requirements during puberty are higher during adolescence than during the prepubertal stage and during adulthood. A significant proportion of adolescents also become parents, and hence the importance of their health and nutritional status before as well as during pregnancy has its impact on their own health, fetal well-being, and newborn health. In this paper, we describe the evidence-based nutrition recommendations and the current global guidance for nutrition actions for adolescents. Despite the limitations of available information, we believe that a range of interventions are feasible to address outcomes in this age group, although some would need to start earlier in childhood. We propose packages of preventive care and management comprising nutrition-specific and nutrition-sensitive interventions to address adolescent undernutrition, overnutrition, and micronutrient deficiencies. We discuss potential delivery platforms and strategies relevant to low- and middle-income countries. Beyond the evidence synthesis, there is a clear need to translate evidence into policy and for implementation of key recommendations and addressing knowledge gaps through prioritized research.

Acne and Nutrition: A Systematic Review.

Few well-defined, evidence-based nutritional recommendations for people with skin diseases have been published in the scientific literature and standard dermatological textbooks. Using a systematic review of acne vulgaris as an example, the aim of this study was to determine whether there are systematic studies on the topic and, if so, of what quality. Four evidence levels were defined: (A) double-blind randomized study; (B) randomized study with serious limitations/low number of cases; (C) case-control or cohort study; and (D) expert opinion/case report. PubMed and Cochrane searches were performed using combinations of the terms "diet", "nutrition", "meal" and "food" with "acne". Foodstuffs mentioned in relevant articles were subdivided by evidence level and recorded as having a beneficial (+), neutral (0) or adverse (-) effect. However, only a small proportion of studies met sufficiently high scientific standards that would enable therapeutic recommendations to be made in practice.

Food provision in early childhood education and care services: Exploring how staff determine nutritional adequacy

The aim of this study was to explore the methods, processes and strategies used by early childhood education and care (ECEC) services when determining the nutritional adequacy of food provided to children in their care. Semi-structured interviews (n = 22) were conducted with directors, educators and cooks at long day care services (LDCS) (n = 12) regarding nutritional adequacy, the use of tools, guidelines and checklists, menu planning and identification and management of unhealthy foods. A qualitative thematic approach was used to identify anticipated and emergent themes. Case-by-case comparisons were then made, and tables and models were created to allow for comparative analysis. LDCS relied on personal knowledge, experience and 'common sense' when determining the nutritional adequacy of the food provided to children. LDCS demonstrated a lack of awareness and use of current regulatory requirements, nutrition guidelines and recommendations, although the services were confident in providing nutrition advice to parents/carers. LDCS staff use personal knowledge and experience over evidence-based nutrition guidelines and recommendations when determining if the food provided to children is nutritionally adequate. ECEC services are recognised as important settings for obesity prevention and the development of lifetime healthy eating habits. This study highlights the complexities and inconsistencies in providing food that is nutritious and appropriate to children in care while highlighting the need to improve the use and accessibility of nutrition guidelines.

Nutritional considerations during prolonged exposure to a confined, hyperbaric, hyperoxic environment: recommendations for saturation divers.

Saturation diving is an occupation that involves prolonged exposure to a confined, hyperoxic, hyperbaric environment. The unique and extreme environment is thought to result in disruption to physiological and metabolic homeostasis, which may impact human health and performance. Appropriate nutritional intake has the potential to alleviate and/or support many of these physiological and metabolic concerns, whilst enhancing health and performance in saturation divers. Therefore, the purpose of this review is to identify the physiological and practical challenges of saturation diving and consequently provide evidence-based nutritional recommendations for saturation divers to promote health and performance within this challenging environment. Saturation diving has a high-energy demand, with an energy intake of between 44 and 52 kcal/kg body mass per day recommended, dependent on intensity and duration of underwater activity. The macronutrient composition of dietary intake is in accordance with the current Institute of Medicine guidelines at 45–65 % and 20–35 % of total energy intake for carbohydrate and fat intake, respectively. A minimum daily protein intake of 1.3 g/kg body mass is recommended to facilitate body composition maintenance. Macronutrient intake between individuals should, however, be dictated by personal preference to support the attainment of an energy balance. A varied diet high in fruit and vegetables is highly recommended for the provision of sufficient micronutrients to support physiological processes, such as vitamin B12 and folate intake to facilitate red blood cell production. Antioxidants, such as vitamin C and E, are also recommended to reduce oxidised molecules, e.g. free radicals, whilst selenium and zinc intake may be beneficial to reinforce endogenous antioxidant reserves. In addition, tailored hydration and carbohydrate fueling strategies for underwater work are also advised.

Nutritional Needs of the Micropreterm Infant

We have used an expansive definition of a micropreterm infant as <30 weeks' gestation to provide a global perspective to a "high risk" group of preterm infants for which there are little published data to guide nutritional management. Consensus nutritional guidelines for preterm infants have been developed for infants >1000 g birth weight and >28 weeks' gestational age. Micropreterm infants have greater nutritional deficits at birth than more mature preterm infants and accumulate greater postnatal deficits. Nutritional guidelines based on the needs of preterm infants born >28 weeks' gestation are unlikely, on a theoretical basis, to meet nutritional requirements of micropreterm infants. Unfortunately, very few good quality studies have addressed the nutritional requirements of this group specifically; this makes it difficult to formulate solid, evidence-based nutritional recommendations for these neonates. Nutritional management of micropreterm infants is based on recommendations established for preterm infants, which are adjusted after considering an infant's gestational age, birth weight, and clinical status. Minimal enteral feeding should commence on the first or second day of life, with incremental advancement and fortification of human milk when 100 mL/kg is tolerated. Early use of parenteral nutrition is recommended, ideally initiated within the first hours of life and enteral feeds are being established; this will help prevent the accumulation of nutritional deficits and incidence of growth failure. Fortified human milk should be given in order to meet nutritional requirements. When human milk is not available in sufficient quantity, a preterm formula should be given.

Nutrient timing revisited: is there a post-exercise anabolic window?

Nutrient timing is a popular nutritional strategy that involves the consumption of combinations of nutrients--primarily protein and carbohydrate--in and around an exercise session. Some have claimed that this approach can produce dramatic improvements in body composition. It has even been postulated that the timing of nutritional consumption may be more important than the absolute daily intake of nutrients. The post-exercise period is widely considered the most critical part of nutrient timing. Theoretically, consuming the proper ratio of nutrients during this time not only initiates the rebuilding of damaged muscle tissue and restoration of energy reserves, but it does so in a supercompensated fashion that enhances both body composition and exercise performance. Several researchers have made reference to an anabolic “window of opportunity” whereby a limited time exists after training to optimize training-related muscular adaptations. However, the importance - and even the existence - of a post-exercise ‘window’ can vary according to a number of factors. Not only is nutrient timing research open to question in terms of applicability, but recent evidence has directly challenged the classical view of the relevance of post-exercise nutritional intake with respect to anabolism. Therefore, the purpose of this paper will be twofold: 1) to review the existing literature on the effects of nutrient timing with respect to post-exercise muscular adaptations, and; 2) to draw relevant conclusions that allow practical, evidence-based nutritional recommendations to be made for maximizing the anabolic response to exercise.

Nutrition for Adventure Racing

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.

FESNAD-SEEDO consensus summary: Evidence-based nutritional recommendations for the prevention and treatment of overweight and obesity in adults

This paper is a summary of the Spanish Federation of Nutrition, Food and Dietetics Associations (FESNAD) and the Spanish Association for the Study of Obesity (SEEDO) consensus document on the role of diet in prevention and treatment of overweight and obesity. To prepare this document, and in order to achieve the maximum evidence level possible, a systematic review was made of all medical literature published between January 1, 1996 and January 31, 2011 (15 years). The obtained findings were catalogued by evidence level following the Scottish Intercollegiate Guidelines Network system, and recommendations were produced based on data collected. As a result, 65 evidences and 31 recommendations applicable to obese adults without any other pathological process were produced. Evidences and resulting recommendations are provided, and the most significant findings are discussed. This consensus document is intended to provide healthcare professionals with a reference tool that may help them design dietary strategies for prevention and treatment of overweight and obesity.

Evidence-based nutritional recommendations for the prevention and treatment of overweight and obesity in adults (FESNAD-SEEDO consensus document). The role of diet in obesity treatment (III/III).

This study is a consensus document of two Spanish scientific associations, FESNAD (Spanish Federation of Nutrition, Food and Dietetic Associations) and SEEDO (Spanish Association for the Study of Obesity), about the role of the diet in the treatment of overweight and obesity in adults. It is the result of a careful and systematic review of the data published in the medical literature from January 1st 1996 to January 31st 2011 concerning the role of the diet on obesity treatment. The achieved conclusions have been classified into various evidence levels. Subsequently in agreement with these evidence levels, different degree recommendations are established being potentially useful to design food guides as part of strategies addressed to the treatment overweight and obesity.

Evidence-based nutritional recommendations for the prevention and treatment of overweight and obesity in adults (FESNAD-SEEDO consensus document). The role of diet in obesity prevention (II/III).

This study is a consensus document of two Spanish scientific associations, FESNAD (Spanish Federation of Nutrition, Food and Dietetetic Associations) and SEEDO (Spanish Association for the Study of Obesity), about the role of the diet in the prevention and of overweight and obesity in adults. It is the result of a careful and systematic review of the data published in the medical literature from January 1st 1996 to January 31st 2011 concerning the role of the diet on obesity prevention. The conclusions obtained have been classified according several evidence levels. Subsequently, in agreement with these evidence levels, different degree recommendations are established. These recommendations could be potentially useful to design food guides as part of strategies to prevent overweight and obesity.

Evidence-based nutritional recommendations for the prevention and treatment of overweight and obesity in adults (FESNAD-SEEDO consensus document). Methodology and executive summary (I/III).

The present study is a consensus document of two Spanish scientific associations, FESNAD (Spanish Federation of Societies of Nutrition, Food and Dietetics Associations) and SEEDO (Spanish Association for the Study of Obesity), about the role of the diet in the prevention and treatment of overweight and obesity in adults. In this part of the document the methodology and the classification of levels of evidence are described. In order to reach the strongest evidence possible, a systematic review of 543 medical studies dealing with these issues published in the last 15 years (from January 1st 1996 to January 31st 2011) has been conducted. In the executive summary, along with the obtained evidences, a set of degree-classified recommendations are established. These recommendations could constitute a useful tool to design food guides addressed to the nutritional counseling for obesity and overweight treatment.

Nutrition and diabetes mellitus: an overview of the current evidence

Overwhelming evidence exists supporting the benefit of lifestyle and nutritional interventions to prevent or delay type 2 and gestational diabetes and improve glycemic control and co-morbidities in patients of all sub-types of diabetes mellitus. Therefore, nutritional therapy is an indispensable and fundamental treatment component, which has to be based on evidence-based recommendations, adapted for dietary intake and medication, and periodically adapted according to diagnosis and individual course of illness. This overview is based on the currently valid evidence-based nutritional recommendations of the European and American Diabetes Associations for the management of diabetes mellitus. It describes the quality and quantity of beneficial macronutrient (carbohydrates, fat, and protein) and micronutrient intake, alcohol consumption, and food groups. Moreover, the evidence for supplements and functional foods is summarized and the role of body weight and different weight loss diets are discussed.

Anticancer: A New Way of Life

The Journal of Alternative and Complementary MedicineVol. 15, No. 7 Book ReviewsAnticancer: A New Way of LifeDavid Servan-SchreiberDavid Servan-SchreiberSearch for more papers by this authorPublished Online:8 Jul 2009https://doi.org/10.1089/acm.2009.0068AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail "Anticancer: A New Way of Life." , 15(7), pp. 805–806FiguresReferencesRelatedDetailsCited byGlobal wellness: Predicting lower levels of anxiety and depression severity24 November 2021 | Journal of Counseling & Development, Vol. 100, No. 1Development and Initial Validation of Scores on the Lifestyle Practices and Health Consciousness Inventory (LPHCI)3 March 2020 | Measurement and Evaluation in Counseling and Development, Vol. 53, No. 4Positive Psychologie in Arbeit und Beruf2 March 2017Nutrition in Cancer: Evidence-Based Nutrition Recommendations in Cancer Patients and Survivors22 August 2013Communication Issues in Integrative Oncology2 June 2012 Volume 15Issue 7Jul 2009 InformationCopyright 2009, Mary Ann Liebert, Inc.To cite this article:David Servan-Schreiber.Anticancer: A New Way of Life.The Journal of Alternative and Complementary Medicine.Jul 2009.805-806.http://doi.org/10.1089/acm.2009.0068Published in Volume: 15 Issue 7: July 8, 2009Online Ahead of Print:June 17, 2009PDF download

Choose Your Foods: Exchange Lists for Diabetes: The 2008 Revision of Exchange Lists for Meal Planning

Medical nutrition therapy (MNT) for diabetes has undergone many changes since 1550 BC when the Papyrus Ebers noted that “wheat grains, grits, grapes, and sweet beer” were the foods of choice for those who needed to “eliminate urine which is too plentiful,” the earliest known reference to diabetes mellitus.1 Exchange Lists for Meal Planning , a well-known nutrition resource for individuals with diabetes since 1950,2 has been designed as a diabetes nutrition education tool that places foods into groups that can be “exchanged” or traded within a group because of their similar nutrient content. Exchange Lists for Meal Planning has undergone revisions as advances in nutrition recommendations have occurred through the years.3–5 In its most recent version, the 2008 Exchange Lists for Meal Planning has been given a new title, Choose Your Foods: Exchange Lists for Diabetes ,6 and an updated look grounded in evidence-based nutrition recommendations for individuals with diabetes, as well as changes in the food marketplace and the eating patterns of Americans (Figure 1). Figure 1. Cover of Choose Your Foods: Exchange Lists for Diabetes MNT is an integral part of diabetes prevention and management and is best provided by a registered dietitian. Clinical trials and outcome studies of MNT have reported decreases in A1C of ∼1% in type 1 diabetes and 1–2% in type 2 diabetes, depending on the duration of diabetes.7,8 The American Diabetes Association (ADA) has updated its nutrition recommendations,9 and the American Dietetic Association recently updated and expanded the Evidence Analysis Library (www.adaevidencelibrary.com) recommendations for type 1 and type 2 diabetes.10 The goals of MNT for individuals at risk for diabetes or who have pre-diabetes are to decrease the risk of diabetes and cardiovascular disease (CVD) by promoting healthy food choices and physical activity …

Evidence-Based Nutrition Practice Guidelines for Diabetes and Scope and Standards of Practice

In the 1990s, the American Dietetic Association (ADA) began developing nutrition practice guidelines for registered dietitians (RDs) and evaluating how their use affected clinical outcomes. Clinical trials and outcomes research report that diabetes medical nutrition therapy, delivered using a variety of nutrition interventions and multiple encounters, is effective in improving glycemic and other metabolic outcomes. The process of developing nutrition practice guidelines has evolved into evidence-based nutrition practice guidelines, which are disease/condition-specific recommendations and toolkits. An expert work group identified important clinical questions related to diabetes nutrition therapy. Research studies were analyzed and evidence summaries and conclusion statements written and graded for strength of research design. Based on the research conclusions, evidence-based nutrition recommendations and guidelines for adults with type 1 and type 2 diabetes were formulated. The ADA evidence-based nutrition practice guidelines for diabetes are published in the Web-based evidence analysis library. The recommendations are similar to those of the American Diabetes Association, although developed using a different method. To define the RD’s professional practice, the ADA has published the Scope of Dietetics Practice Framework, the Standards of Practice and Standards of Professional Performance, and specialized standards for the RD in diabetes nutrition care. The latter defines the knowledge, skills, and competencies required by RDs to provide diabetes care at the generalist, specialist, and advanced practice level.

Evidence-Based Nutrition Recommendations for the Treatment and Prevention of type 2 Diabetes and the Metabolic Syndrome

Evidence-Based Nutrition Recommendations for the Treatment and Prevention of type 2 Diabetes and the Metabolic Syndrome