Impact Of Nutritional Supplementation Research Articles

Impact of Nutritional Supplementation on Bone Healing and Recovery in Patients with Osteoporosis-Related Fractures

Impact of Nutritional Supplementation on Bone Healing and Recovery in Patients with Osteoporosis-Related Fractures

Impact of Nutritional Supplements on the Fitness of the Parasitoid Binodoxys communis (Gahan).

Alterative nutritional foods consumed by adult parasitoids play an important role in their fitness and ability to control pests because of food scarcity in many crops. While adult parasitoids feed on various sugars, they vary in their nutritional value for parasitoids. We assessed the effects of seven sugars (fructose, glucose, sucrose, trehalose, maltose, melezitose, and sorbitol) on the longevity, parasitism ability, parasitism behavior, and flight ability of B. communis, an important parasitoid of cotton aphids. We found that access to glucose, sucrose, or fructose, increased B. communis adult longevity more than the other sugars offered. All sugars except trehalose increased the parasitism rate to more than 50% compared to the starved control (only provided with water). We then compared parasitoid behaviors of wasps fed glucose, sucrose, or fructose to that of the starved control (with access only to water) and found that those fed B. communis spent more time either examining or attacking aphids than parasitoids in the control group, which spent more time walking or resting. Also, consumption of glucose, sucrose, or fructose also significantly improved the flight ability (the total flight distance, flight time, and average flight speed) of B. communis.

Does nutritional support under programmatic settings result in weight and body mass index changes among tuberculosis patients? Evidence on the impact of nutritional support through Pradhan Mantri Tuberculosis Mukt Bharat Abhiyan under national tuberculosis elimination programme from Ramgarh district of Jharkhand

Background: To increase community participation in tuberculosis (TB) elimination efforts, the government of India has launched ‘Pradhan Mantri TB Mukt Bharath Abhiyan’ (PMTBMBA) under the national TB elimination programme. The scheme allows interested parties (Ni-kshay mitras) to offer nutritional support to TB patients. This study aims to understand the impact of such a support in improving weight and body mass index (BMI) among TB patients as most available evidence comes from research settings. Methods: This is a retrospective cross-sectional study carried out in Ramgarh district of Jharkhand, India, for the period first quarter 2023. Relevant data was extracted from Ni-kshay web portal and TB treatment cards. The data is analyzed using excel 365. Results: Of the 114 participants, 69 received nutritional support during the entire duration of treatment and 45 received support partially. Single factor ANOVA on weight and BMI gain revealed statistically significant difference in mean weight/BMI between the two groups with F (1, 110)=35.4660, p=3.16×10-08 and F (1, 110)=22.9994, p=5.12×10-06. Correlation analysis showed a moderate correlation between the number of nutritional kits received and the weight/BMI gain with correlation coefficients r=0.5, p=1.07×10-07 and r=0.4, p=1.65×10-05 respectively. Conclusions: The study concludes that the impact of nutritional supplementation in programmatic setting is comparable with that of implementation research study settings.

Mortality among non-severely under nourished children with pneumonia globally: protocol for a systematic review and meta-analysis

Background Pneumonia remains the commonest cause of ill health and mortality among children worldwide. Severe undernutrition increases the mortality risk among children with pneumonia. While children with pneumonia are at increased risk of developing malnutrition, the impact of pneumonia on mortality and nutritional status of non-severely undernourished children is not well described. The impact of nutritional supplementation on mortality and nutritional status in this population is not well understood. This review will collate available evidence on the all-cause mortality and anthropometric indices outcomes following pneumonia, as well as the impact of nutritional supplementation on mortality and anthropometry among non-severely malnourished children with pneumonia. Methods The review will be done using a priori criteria developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Data will be obtained from data bases, grey literature, and bibliographies. An experienced librarian will conduct article search in PUBMED, MEDLINE, EMBASE, Web of Science, Google scholar, and Scopus. Retrieved articles will be entered in Endnote ver 9.0, duplicates removed, and transferred to Epi-reviewer for screening and data abstraction. Risk of bias in the included articles will be assessed using standard criteria. Heterogeneity will be assessed using I2-statistic and sub-group analysis will be done. Data will be analysed using both narrative and quantitative synthesis. Quantitative synthesis will be done using DeSimonian and Laird Random-effects model in STATA ver 15.0. Conclusions The results will provide baseline information about the mortality and anthropometric outcomes of pneumonia among non-severely malnourished children as well as the potential effect of nutritional supplementation on these outcomes. This will provide a basis to explore the potential for nutritional supplementation improving clinical outcomes like mortality and occurrence of severe acute malnutrition among children with severe pneumonia worldwide. Registration The review has been registered in PROSPERO (CRD42021257272; 15 July 2021).

Impact of nutritional supplementation with bioactive compounds on improving the intake of cancer patients: The Alisenoc study

Impact of nutritional supplementation with bioactive compounds on improving the intake of cancer patients: The Alisenoc study

Mortality among non-severely under nourished children with pneumonia globally: protocol for a systematic review and meta-analysis.

Pneumonia remains the commonest cause of ill health and mortality among children worldwide. Severe undernutrition increases the mortality risk among children with pneumonia. While children with pneumonia are at increased risk of developing malnutrition, the impact of pneumonia on mortality and nutritional status of non-severely undernourished children is not well described. The impact of nutritional supplementation on mortality and nutritional status in this population is not well understood. This review will collate available evidence on the all-cause mortality and anthropometric indices outcomes following pneumonia, as well as the impact of nutritional supplementation on mortality and anthropometry among non-severely malnourished children with pneumonia. The review will be done using a priori criteria developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Data will be obtained from data bases, grey literature, and bibliographies. An experienced librarian will conduct article search in PUBMED, MEDLINE, EMBASE, Web of Science, Google scholar, and Scopus. Retrieved articles will be entered in Endnote ver 9.0, duplicates removed, and transferred to Epi-reviewer for screening and data abstraction. Risk of bias in the included articles will be assessed using standard criteria. Heterogeneity will be assessed using I 2-statistic and sub-group analysis will be done. Data will be analysed using both narrative and quantitative synthesis. Quantitative synthesis will be done using DeSimonian and Laird Random-effects model in STATA ver 15.0. The results will provide baseline information about the mortality and anthropometric outcomes of pneumonia among non-severely malnourished children as well as the potential effect of nutritional supplementation on these outcomes. This will provide a basis to explore the potential for nutritional supplementation improving clinical outcomes like mortality and occurrence of severe acute malnutrition among children with severe pneumonia worldwide. The review has been registered in PROSPERO (CRD42021257272; 15 July 2021).

Impact and Cost-Effectiveness Evaluation of Nutritional Supplementation and Complementary Interventions for Tuberculosis Treatment Outcomes under Mukti Pay-for-Performance Model in Madhya Pradesh, India: A Study Protocol

Background: A ”pay-for-performance” (P4P) intervention model for improved tuberculosis (TB) outcomes, called “Mukti,” has been implemented in an underdeveloped tribal area of central India. The target of this project is to improve nutritional status, quality of life (QoL), and treatment outcomes of 1000 TB patients through four interventions: food baskets, personal counseling, peer-to-peer learning and facilitation for linkage to government schemes. The current study aims to assess the success of this model by evaluating its impact and cost-effectiveness using a quasi-experimental approach. Methods: Data for impact assessment have been collected from 1000 intervention and control patients. Study outcomes such as treatment completion, sputum negativity, weight gain, and health-related QoL will be compared between matched samples. Micro costing approach will be used for assessing the cost of routine TB services provision under the national program and the incremental cost of implementing our interventions. A decision and Markov hybrid model will estimate long-term costs and health outcomes associated with the use of study interventions. Measures of health outcomes will be mortality, morbidity, and disability. Cost-effectiveness will be assessed in terms of incremental cost per quality-adjusted life-years gained and cost per unit increase in patient weight in intervention versus control groups. Results: The evidence generated from the present study in terms of impact and cost-effectiveness estimates will thus help to identify not only the effectiveness of these interventions but also the optimal mode of financing such measures. Our estimates on scale-up costs for these interventions will also help the state and the national government to consider scale-up of such interventions in the entire state or country. Discussion: The study will generate important evidence on the impact of nutritional supplementation and other complementary interventions for TB treatment outcomes delivered through P4P financing models and on the cost of scaling up these to the state and national level in India.

Plasma Metabolomic Profiles Are Imbalanced in Adults Thalassemia Patients with Malnutrition and That Imbalance Is Alleviated By Oral Nutritional Supplements: A Prospective Randomized Controlled Trial

Background: Malnutrition is a common condition observed in children with thalassemia. However, the prevalence of malnutrition, alterations of plasma metabolomes, and the impact of nutritional supplements in adults with thalassemia were still unclear. Objectives: To evaluate the prevalence of malnutrition and plasma metabolomic profiles of adult thalassemia when compared with healthy control, as well as to evaluate the effects of oral nutritional supplements (ONS) on nutritional status and metabolomic profiles in those thalassemia patients with malnutrition Methods: Adult thalassemia (n=100) and healthy control (n=20) aged ≥ 18 years old were enrolled in the present study. This study was divided into 2 phases. Phase I of the study: All participants were assessed nutritional status by nutrition assessment 2013 (NT-2013), serum biomarkers (albumin, transferrin), and anthropometry. Plasma metabolomes including amino acids, long-chain free fatty acids, acylcarnitines (C0-18), and Krebs cycle metabolites were measured by liquid chromatography-quadrupole time-of-flight mass spectrometry (LC/Q-TOF-MS). All outcomes were compared among 3 groups including thalassemia with malnutrition, thalassemia without malnutrition, and healthy control. Phase II of the study, thalassemia patients with malnutrition, defined as NT-2013 score of 5 or more, were randomized into two subgroups. Each subgroup received either ONS or nutritional advice by a nutritionist for 3 months. ONS consisted of oral complete formula (Blendera-MF®) and/or whey protein based on the assessment by food questionnaire to achieve the target of individual total daily energy expenditure (Harris-Benedict equation multiplied with activity factor) and total protein of 1.3 g/kg/day. NT-2013, anthropometric parameters, serum biomarkers, and plasma metabolomes were re-evaluated after 12 weeks in each subgroup. ONS adherence was assessed every 2 weeks during the study period. Those with less than 80% ONS adherence were excluded from the final analysis. Results: A total of 100 patients were enrolled with a mean age of 34.9 years (range 18-60). Of which, 65.3% were females and 58.1% were transfusion-dependent thalassemia (TDT). The prevalence of malnutrition was 20% (15% mild, 85% moderate degree). Malnutrition was more common in TDT than non-TDT (30.9% vs 6.7%, p=0.003). Twenty age, sex, and body mass index-matched healthy controls were also enrolled. Regarding plasma amino acids, baseline alanine, proline, and tyrosine were significantly increased while arginine was significantly decreased in malnourished patients. Fatty acid-derived acylcarnitines (C12-18) were significantly increased in malnourished patients compared to the control group. Long-chain free fatty acids were not different between groups. Considering Krebs cycle, citrate was significantly decreased, but malate was significantly increased in malnourished patients compared to the control group (Table 1). Three participants had less than 80% ONS adherence. After 12 weeks, the mean NT-2013 score in overall malnourished patients significantly improved, when compared to their baseline (6.0±1.1 to 5.2±1.5, p=0.029). However, there was a trend of more improvement in ONS group than nutritional advice group (6.1±1.0 to 5.0±1.5, p=0.084 vs. 5.9±1.2 to 5.5±1.5, p=0.223). Fatty acid-derived acylcarnitines (C8-18) and malate were significantly decreased after ONS (Table 2). Anthropometric parameters, serum biomarkers, long-chain free fatty acids, and amino acids were not changed. Conclusions: The prevalence of malnutrition in adult thalassemia was 20%. Plasma metabolomic profiles suggested that the malnourished thalassemia had imbalanced protein turnover and incomplete fatty acid oxidation, resulting in the disruption of Krebs' cycle. Among thalassemia patients with malnutrition, both ONS and nutritional advice led to improve nutritional status. ONS for 12 weeks also promoted more complete fatty acid oxidation in malnourished thalassemia. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

The Impact of Nutritional Supplementation on Donor Kidneys During Oxygenated Ex Vivo Subnormothermic Preservation.

Background.Evidence suggests that nutritional supplementation during normothermic ex vivo perfusion improves organ preservation. However, it is unclear whether the same benefit is observed during room temperature (subnormothermic) oxygenated perfusion. In this study, we tested the impact of providing complete nutrition during subnormothermic perfusion on kidney outcomes.Methods.Porcine kidneys were recovered after 30 min of cross clamping the renal artery in situ to simulate warm ischemic injury. After flushing with preservation solution, paired kidneys were cannulated and randomly assigned to perfusion with either (1) hemoglobin-carrier hemoglobin-based oxygen carrier or (2) hemoglobin-based oxygen carrier + total parenteral nutrition (TPN) for 12 h at 22 °C. To mimic reperfusion injury, all kidneys were reperfused with whole blood for an additional 4 h at 37 °C. Kidney function and damage were assessed.Results.Kidneys preserved with or without TPN performed equally well, showing similar renal function postreperfusion. Histological findings indicated similar levels of damage from apoptosis staining and acute tubular necrosis scores in both groups. Additionally, markers of renal damage (KIM-1) and inflammation (IL-6; high-mobility group box 1) were similar between the groups.Conclusions.Unlike other studies using normothermic oxygenated perfusion platforms, nutritional supplementation does not appear to provide any additional benefit during ex vivo kidney preservation over 12 h evaluated by whole blood-based reperfusion method at subnormothermic temperature. Further study should include a kidney autotransplant model to assess the role of TPN in vivo.

The Impact of Nutritional Supplementation During Pregnancy on the Incidence of Gestational Diabetes and Glycaemia Control.

The nutritional state before and throughout pregnancy has a critical impact on the women's health and the baby's development and growth. The release of placental hormones during pregnancy induces/ increases maternal insulin resistance and promotes nutrition utilization by the fetus. Gestational Diabetes Mellitus (GDM) is the most common medical complication in pregnancy and is associated with significant maternal and fetal morbidity. Several studies have examined the effect of physical activity, healthy eating, and various food supplements on the risk of developing gestational diabetes (GDM) and related outcomes. Among those, Myo-Inositol supplementation has shown encouraging results in the prevention of GDM. Maternal vitamin D deficiency has been associated with an elevated risk of GDM, and supplementation can improve glucose haemostasis by lowering fasting blood glucose, HbA1c, and serum insulin concentration. Probiotics modulate the gut microbiota leading to an improved glucose and lipid metabolism, which is proposed to reduce the risk of GDM. We aim to review the strength and limitation of the current evidence for using some nutritional supplements either as single agents or in combinations on the risk of developing GDM and on glycaemic control.

A Systematic Review of Oral Nutritional Supplement and Wound Healing.

To explore the current literature for effects of oral nutritional supplement on wound healing rates in humans. A systematic review of the literature was performed using the Medline and PubMed database following PRISMA guidelines. The PubMed database was searched using terms relating to oral nutritional supplement and wound healing from 1837 to March 2020. Study inclusion criteria were: (i) design: randomized controlled trials, clinical studies, observational studies, clinical trials; (ii) population: adults; and (iii) intervention: oral nutritional supplement. The search yielded 2433 studies, 313 of which were clinical trials or clinical studies. After abstract review, 28 studies qualified to be included in the review evaluating the following supplementation categories on wound healing: protein and amino acids (10), mineral, vitamin and antioxidants (9), probiotics (1), and mixed nutrients (8). Arginine and omega-3 supplement were shown to improve wound healing in head and neck cancer patients with surgical wounds by decreasing incidence of postoperative complications and reducing length of hospital stay. Mineral, vitamins, and antioxidants enriched supplements were more beneficial in increasing wound healing than non-enriched protein supplement for diabetic foot and pressure ulcers. Supplementation of a variety of nutrients had variable effects on improving wound healing in different types of wounds. However, further research on the impact of nutritional supplements on surgical wound healing is necessary. The impact of multiple nutrient formulations may also need to be further evaluated for efficacy.

Meditation and Preventive Cardiac Health

Thanks to advancements in medical and technical therapy, heart failure (HF) patients are now better predicted. A longer lifespan is linked to an increase in the number of risky lifestyle factors and behaviours that put a person at risk for heart failure (HF) early on in life. Doctors dealing with this challenging illness place emphasis only on medicinal products or medical equipment, although changes in lifestyles may assist to prevent and cure heart failure and are often neglected. The effects of weight reduction and exercise on cardiovascular disease (HF), as well as the impact of nutritional supplements and mindfulness on the illness's causes, physiopathology, and therapy, were studied by researchers.

Cyperus esculentus L. and Tetracarpidium conophorum Müll. Arg. Supplemented Diet Improved Testosterone Levels, Modulated Ectonucleotidases and Adenosine Deaminase Activities in Platelets from L-NAME-Stressed Rats.

In hypertensive individuals, platelet morphology and function have been discovered to be altered, and this has been linked to the development of vascular disease, including erectile dysfunction (ED). The impact of nutritional supplementation with Cyperus esculentus (tiger nut, TN) and Tetracarpidium conophorum (walnut, WN) on androgen levels, ectonucleotidases, and adenosine deaminase (ADA) activities in platelets from L-NAME (Nω-nitro-L-arginine methyl ester hydrochloride) challenged rats were investigated. We hypothesized that these nuts may show a protective effect on platelets aggregation and possibly enhance the sex hormones, thereby reverting vasoconstriction. Wistar rats (male; 250–300 g; n = 10) were grouped into seven groups as follows: basal diet control group (I); basal diet/L-NAME/Viagra (5 mg/kg/day) as positive control group (II); ED-induced group (basal diet/L-NAME) (III); diet supplemented processed TN (20%)/L-NAME (IV); diet supplemented raw TN (20%)/L-NAME (V); diet supplemented processed WN (20%)/L-NAME (VI); and diet supplemented raw WN (20%)/L-NAME (VII). The rats were given their regular diet for 2 weeks prior to actually receiving L-NAME (40 mg/kg/day) for ten days to induce hypertension. Platelet androgen levels, ectonucleotidases, and ADA were all measured. L-NAME considerably lowers testosterone levels (54.5 ± 2.2; p < 0.05). Supplementing the TN and WN diets revealed improved testosterone levels as compared to the control (306.7 ± 5.7), but luteinizing hormone levels remained unchanged. Compared to control groups, the L-NAME-treated group showed a rise in ATP (127.5%) hydrolysis and ADA (116.7%) activity, and also a decrease in ADP (76%) and AMP (45%) hydrolysis. Both TN and WN supplemented diets resulted in substantial (p < 0.05) reversal effects. Enhanced testosterone levels and modulation of the purinergic system in platelets by TN and WN could be one of the mechanisms by which they aid in vasoconstriction control.

The Impact of Nutritional Supplementation on Sweat Metabolomic Content: A Proof-of-Concept Study

Sweat is emerging as a prominent biosource for real-time human performance monitoring applications. Although promising, sources of variability must be identified to truly utilize sweat for biomarker applications. In this proof-of-concept study, a targeted metabolomics method was applied to sweat collected from the forearms of participants in a 12-week exercise program who ingested either low or high nutritional supplementation twice daily. The data establish the use of dried powder mass as a method for metabolomic data normalization from sweat samples. Additionally, the results support the hypothesis that ingestion of regular nutritional supplementation semi-quantitatively impact the sweat metabolome. For example, a receiver operating characteristic (ROC) curve of relative normalized metabolite quantities show an area under the curve of 0.82 suggesting the sweat metabolome can moderately predict if an individual is taking nutritional supplementation. Finally, a significant correlation between physical performance and the sweat metabolome are established. For instance, the data illustrate that by utilizing multiple linear regression modeling approaches, sweat metabolite quantities can predict VO2 max (p = 0.0346), peak lower body Windage (p = 0.0112), and abdominal circumference (p = 0.0425). The results illustrate the need to account for dietary nutrition in biomarker discovery applications involving sweat as a biosource.

Impact and cost-effectiveness evaluation of nutritional supplementation and complementary interventions for tuberculosis treatment outcomes under mukti pay-for-performance model in Madhya Pradesh, India: A study protocol.

A. Data for impact assessment have been collected from 1000 intervention and control patients. Study outcomes such as treatment completion, sputum negativity, weight gain, and health-related QoL will be compared between matched samples. Micro costing approach will be used for assessing the cost of routine TB services provision under the national program and the incremental cost of implementing our interventions. A decision and Markov hybrid model will estimate long-term costs and health outcomes associated with the use of study interventions. Measures of health outcomes will be mortality, morbidity, and disability. Cost-effectiveness will be assessed in terms of incremental cost per quality-adjusted life-years gained and cost per unit increase in patient weight in intervention versus control groups. The evidence generated from the present study in terms of impact and cost-effectiveness estimates will thus help to identify not only the effectiveness of these interventions but also the optimal mode of financing such measures. Our estimates on scale-up costs for these interventions will also help the state and the national government to consider scale-up of such interventions in the entire state or country. The study will generate important evidence on the impact of nutritional supplementation and other complementary interventions for TB treatment outcomes delivered through P4P financing models and on the cost of scaling up these to the state and national level in India.

Marginal structural models for repeated measures where intercept and slope are correlated: An application exploring the benefit of nutritional supplements on weight gain in HIV-infected children initiating antiretroviral therapy.

BackgroundThe impact of nutritional supplements on weight gain in HIV-infected children on antiretroviral treatment (ART) remains uncertain. Starting supplements depends upon current weight-for-age or other acute malnutrition indicators, producing time-dependent confounding. However, weight-for-age at ART initiation may affect subsequent weight gain, independent of supplement use. Implications for marginal structural models (MSMs) with inverse probability of treatment weights (IPTW) are unclear.MethodsIn the ARROW trial, non-randomised supplement use and weight-for-age were recorded monthly from ART initiation. The effect of supplements on weight-for-age over the first year was estimated using generalised estimating equation MSMs with IPTW, both with and without interaction terms between baseline weight-for-age and time. Separately, data were simulated assuming no supplement effect, with use depending on current weight-for-age, and weight-for-age trajectory depending on baseline weight-for-age to investigate potential bias associated with different MSM specifications.ResultsIn simulations, despite correctly specifying IPTW, omitting an interaction in the MSM between baseline weight-for-age and time produced increasingly biased estimates as associations between baseline weight-for-age and subsequent weight trajectory increased. Estimates were unbiased when the interaction between baseline weight-for-age and time was included, even if the data were simulated with no such interaction. In ARROW, without an interaction the estimated effect was +0.09 (95%CI +0.02,+0.16) greater weight-for-age gain per month’s supplement use; this reduced to +0.03 (-0.04,+0.10) including the interaction.DiscussionThis study highlights a specific situation in which MSM model misspecification can occur and impact the resulting estimate. Since an interaction in the MSM (outcome) model does not bias the estimate of effect if the interaction does not exist, it may be advisable to include such a term when fitting MSMs for repeated measures.

Impact of Nutritional Supplementation on Canine Dermatological Disorders.

Nutritional supplements, also known as complementary feeds, are products administered with the aim of furnishing health benefits, regardless of nutritional needs. They have been used since ancient times in veterinary dermatology, and a number of studies have focused on investigating the health benefits of some ingredients found in commercially available complementary feed for dogs. The aim of this paper is to review the literature available on the use of nutritional supplementation for the management of canine skin diseases, critically appraising the clinical efficacy of such interventions and summarizing the current state of knowledge. This review highlights how these feeds can be considered useful in the management of dermatological disorders and outlines their beneficial effects in the prevention of dietary deficiencies and treatment of diseases, alone, or in addition to conventional pharmacological therapy. In recent years, nutritional supplements have found increasing potential application in veterinary medicine, and the scientific proofs of their beneficial effects are described in this review.

Assessment of nutritional status, pre-operative nutrition supplementation and its’ impact on the outcome of surgery in gastrointestinal malignancies: a prospective study

Background: Gastrointestinal (GI) cancers are responsible for more deaths from cancer than any other cancers. These patients are at risk for disease-related malnutrition which has been linked to an increase in post operative complications. Despite research, guidelines for preoperative nutritional assessment are lacking. The study was aimed to assess the nutritional status of patients in gastrointestinal malignancy, impact of nutritional supplementation and its impact on outcome of surgery.Methods: This cross-sectional study was conducted on patients of gastrointestinal malignancy attending Dept. of Surgery, Dr. D.Y. Patil Medical College, and Hospital, Pimpri, Pune. Institute Ethics Committee clearance was obtained before starting the study. 45 newly diagnosed patients of gastrointestinal malignancy were included in the study after informed consent.Results: At the start of this study 26.66% were well nourished, 35.55% moderately nourished, and 37.77% poorly nourished. At 6 weeks after supplementation 60 % were well nourished, 24.4 % moderately nourished, and 7 % poorly nourished. Surgical site infection (SSI) occurred in 7 patients of which 57.14% were poorly nourished, 28.57 % were moderately nourished. Anastomotic leak occurred in 3 patients of which 66.66% patients were poorly nourished. Average number of days of hospital stay for well nourished patients was 6.23 and for poorly nourished patients 14.14.Conclusions: Malnutrition is a concern in gastrointestinal malignancies. Delay in surgery upto 6 weeks is permissible to enhance patients’ nutritional status. Proper nutritional supplementation significantly improves nutritional status. Complications like SSI and anastomotic leak; hospital stay are significantly reduced after improvement in nutritional status.

Impact of Nutritional Supplementation on Sleep Quality and Gut Microbiome Composition in Older Adults

Impact of Nutritional Supplementation on Sleep Quality and Gut Microbiome Composition in Older Adults

Impact of nutritional supplementation during pregnancy on antibody responses to diphtheria-tetanus-pertussis vaccination in infants: A randomised trial in The Gambia.

BackgroundExposure to a nutritionally deficient environment during fetal life and early infancy may adversely alter the ontogeny of the immune system and affect an infant’s ability to mount an optimal immune response to vaccination. We examined the effects of maternal nutritional supplementation during pregnancy on infants’ antibody responses to the diphtheria-tetanus-pertussis (DTP) vaccine included in the Expanded Programme on Immunisation (EPI).Methods and findingsThe Early Nutrition and Immune Development (ENID) trial was a randomised, partially blinded trial conducted between April 2010 and February 2015 in the rural West Kiang region of The Gambia, a resource-poor region affected by chronic undernutrition. Pregnant women (<20 weeks’ gestation) with a singleton pregnancy (n = 875) were randomised to receive one of four supplements: iron-folic acid (FeFol; standard of care), multiple micronutrient (MMN), protein-energy (PE), or PE + MMN daily from enrolment (mean [SD] 13.7 [3.3] weeks’ gestation) until delivery. Infants were administered the DTP vaccine at 8, 12, and 16 weeks of age according to the Gambian Government protocol. Results for the primary outcome of the trial (infant thymic size) were described previously; here, we report on a secondary outcome, infant antibody response to vaccination. The effects of supplementation on mean DTP antibody titres measured in blood samples collected from infants at 12 weeks (n = 710) and 24 weeks (n = 662) were analysed with adjustment for confounders including maternal age, compliance to supplement, and infant sex and season. At 12 weeks, following a single dose of the vaccine, compared with FeFol (mean 95% confidence interval [CI]; 0.11 IU/mL, 0.09–0.12), antenatal supplementation with MMN or MMN + PE resulted in 42.4% (95% CI 20.1–64.6; p < 0.001) and 29.4% (6.4–52.5; p = 0.012) higher mean anti-diphtheria titres, respectively. Mean anti-tetanus titres were higher by 9.0% (5.5–12.5), 7.8% (4.3–11.4), and 7.3% (4.0–10.7) in MMN, PE, and PE + MMN groups (all, p < 0.001), respectively, than in the FeFol group (0.55 IU/mL, 0.52–0.58). Mean anti-pertussis titres were not significantly different in the FeFol, MMN, and PE + MNN groups but were all higher than in the PE group (all, p < 0.001). At 24 weeks, following all three doses, no significant differences in mean anti-diphtheria titres were detected across the supplement groups. Mean anti-tetanus titres were 3.4% (0.19–6.5; p = 0.038) higher in the PE + MMN group than in the FeFol group (3.47 IU/mL, 3.29–3.66). Mean anti-pertussis titres were higher by 9.4% (3.3–15.5; p = 0.004) and 15.4% (9.6–21.2; p < 0.001) in PE and PE + MMN groups, compared with the FeFol group (74.9 IU/mL, 67.8–82.8). Limitations of the study included the lack of maternal antibody status (breast milk or plasma) or prevaccination antibody measurements in the infants.ConclusionAccording to our results from rural Gambia, maternal supplementation with MMN combined with PE during pregnancy enhanced antibody responses to the DTP vaccine in early infancy. Provision of nutritional supplements to pregnant women in food insecure settings may improve infant immune development and responses to EPI vaccines.Trial registrationISRCTN49285450.