Importance Of Nutritional Status Research Articles

Nutrition and pharmacology: general principles and implications for HIV

Food and nutrition play an intimate and inextricable role in all aspects of drug metabolism, safety, and effectiveness. Antiretroviral therapies (ART) have assumed a preeminent position in the prevention, care, and treatment of HIV and its comorbidities. The interaction between food, nutrition, and ART has become an expanding area of interest both in terms of clinical standards of care and as a target for research. Since the original review of this topic by the WHO in 2005, much has been learned (8). This article contains a review of what is known about the general relationships between nutrition and pharmacology, as well as issues specific to ART, with particular attention to their use in low- and middle-resource settings. The importance of food and nutrition on the bioavailability of drugs and vice versa has been an area of historical interest. However, much has been learned about the importance of nutritional status on drug metabolism, distribution, and effectiveness. The impact of traditional therapies (herbal/botanical) is highlighted as an area of clinical concern and one in need of further research. Additional attention is focused on the impact of individual micronutrients on drug pharmacokinetics and pharmacodynamics. Finally, attention is given to the nutritional implications of the metabolic consequences of ART, which include the potential impact of "colliding epidemics" of infection (eg, HIV, tuberculosis) and noncommunicable diseases. Much has been learned, but much remains to be accomplished to ensure the effective integration of nutritional considerations into the effective and safe use of ART.

Wound-Nutritional Issues in Wound Healing

Will This Wound Heal? The Development of a Nutritional Assessment Tool for Utilization in the Evaluation of Wound Healing. PURPOSE: The relationship between nutrition and wound healing has been well established by a variety of disciplines including plastic surgery, nutrition and dietetics, pharmacology, biochemistry, and wound care specialties. In the presence of malnutrition there is increased likelihood of pressure ulcer development, wound dehiscence, delayed healing, and infection. Even though it is well accepted that wounds do not typically do well in the presence of poor nutrition, there is no current gold standard for the systematic, objective evaluation of nutritional status and wound healing probability. This poster will propose a tool for the evaluation of nutritional status and the likelihood of wound healing. This tool will be user friendly, have broad application, and serve as a basis for research to evaluate the effectiveness and reliability of using such a tool across a variety of settings. OBJECTIVES: • Develop a tool to assess nutritional status and wound- healing probability. • Present this tool as a stimulus for additional research in the area. OUTCOMES: If this tool proves through research to be reliable in the prediction of wound healing in relation to nutritional status, decisions affecting patient and practitioner goals may be structured in a more definitive manner. This tool may enhance collaboration of disciplines across the continuum of care involved in the care of patients with wounds. The importance of nutritional status in persons with wounds may receive more attention when there is a well-defined set of parameters to serve as a guide in goal setting and intervention implementation. The development of a nutritional assessment tool for utilization in the evaluation of wound healing may be the beginning of much needed research and development in this vital area.

Triglyceride Synthesis in Epididymal Adipose Tissue

The obesity epidemic has generated interest in determining the contribution of various pathways to triglyceride synthesis, including an elucidation of the origin of triglyceride fatty acids and triglyceride glycerol. We hypothesized that a dietary intervention would demonstrate the importance of using glucose versus non-glucose carbon sources to synthesize triglycerides in white adipose tissue. C57BL/6J mice were fed either a low fat, high carbohydrate (HC) diet or a high fat, carbohydrate-free (CF) diet and maintained on 2H2O (to determine total triglyceride dynamics) or infused with [6,6-(2)H]glucose (to quantify the contribution of glucose to triglyceride glycerol). The 2H2O labeling data demonstrate that although de novo lipogenesis contributed approximately 80% versus approximately 5% to the pool of triglyceride palmitate in HC- versus CF-fed mice, the epididymal adipose tissue synthesized approximately 1.5-fold more triglyceride in CF- versus HC-fed mice, i.e. 37+/-5 versus 25+/-3 micromolxday(-1). The [6,6-(2)H]glucose labeling data demonstrate that approximately 69 and approximately 28% of triglyceride glycerol is synthesized from glucose in HC- versus CF-fed mice, respectively. Although these data are consistent with the notion that non-glucose carbon sources (e.g. glyceroneogenesis) can make substantial contributions to the synthesis of triglyceride glycerol (i.e. the absolute synthesis of triglyceride glycerol from non-glucose substrates increased from approximately 8 to approximately 26 micromolxday(-1) in HC- versus CF-fed mice), these observations suggest (i) the importance of nutritional status in affecting flux rates and (ii) the operation of a glycerol-glucose cycle.

Toxicogenetics and Nutrigenetics: Biomarkers in Occupational Medicine and Litigation

Along with other 'omic' technologies, advances in nutritional genomics are likely to lead to increasing personalization in the area of nutrition, diet and health. The power of nutrients to modulate the toxicity of environmental pollutants and the importance of nutritional status in determining longer-term health outcomes may be of major benefit in occupational health and preventive medicine. Advances in metabolomics offer the promise of validating important intermediate and surrogate markers for use in medical monitoring.

Importance of nutritional status in recovery from acute cholecystitis: benefit from enteral nutrition supplementation including medium chain triglycerides.

This study was undertaken to clarify the importance of nutritional status in patients with acute cholecystitis, and also evaluate whether they benefited from enteral nutrition supplementation, including medium-chain triglycerides (MCT), during the convalescent stage. Patients with acute cholecystitis admitted to our hospital between April 1994 and March 2002 were classified into a poor nutrition group (n=40; total serum protein<5.0 g/dl) or a fair nutrition group (n=71; >5.0 g/dl). Patients with poor nutrition were significantly more elderly than those with fair nutrition, and had significantly higher serum C-reactive protein (CRP) concentrations. The two groups did not differ significantly with respect to other laboratory data, gender distribution, or medical treatment. We supplemented ordinary meals with enteral nutrition including MCT in 16 patients during the convalescent stage (MCT group). We compared their length of hospital stay and days required to recovery to pre-admission functional status for activities of daily living (ADL) with the same intervals in 16 patients without supplementation (non-MCT group) selected to match for age, gender, and fair or poor nutritional status from among 111 patients. Hospitalizations were significantly longer in the poor nutrition group (43.0+/-2.2 days) than in the fair nutrition group (27.0+/-8.2 days). Significantly more days were required to recover ADL status in the poor nutrition group (12.0+/-7.2 days) than in the fair group (9.4+/-5.2 days). Hospitalizations were significantly shorter in the MCT group (20.1+/-15 days) than in the non-MCT group (35.4+/-12.8 days). Significantly fewer days were required to recover ADL status in the MCT group (10.9+/-7 days) than in the non-MCT group (13.1+/-6.8 days). Administration of enteral nutrition including MCT during convalescence from acute cholecystitis thus appears to promote functional recovery shorten hospital stay.

Vitamin C Status in Iranian Children With Acute Lymphoblastic Leukemia: Evidence for Increased Utilization

Vitamin C status and total antioxidant capacity (TAC) in children with acute lymphoblastic leukemia (ALL) was assessed in 28 hospitalized patients and 30 apparently healthy control subjects. It was determined that whereas vitamin C intake in patients with ALL was more than twice as much as in controls, plasma and urinary concentrations of vitamin C were more than 10 times and 2.5 times higher in controls than in the patients with ALL, respectively (P < 0.001). Accordingly, serum TAC levels in the patients with ALL were lower than in healthy subjects (P < 0.001). Vitamin C utilization is increased in children with ALL.

Children, cancer, and nutrition--A dynamic triangle in review.

The overall cure rate for cancer in childhood now exceeds 70% and is projected to reach 85% by the year 2010 in industrialized countries. Therefore, major attention is being placed on reducing the side effects of therapy. However, 85% of the world's children live in developing countries, where access to adequate care often is limited and health status frequently is influenced adversely by prevalent infectious diseases and malnutrition. Despite several confounding factors (different definitions of nutritional status, the wide variety of measures used for its assessment, the selection biases by disease and stage, treatment protocols of variable dose intensity and efficacy, small sample sizes of the studies conducted in the last 20 years), it is accepted that the prevalence of malnutrition at diagnosis averages 50% in children with cancer in developing countries; whereas, in industrialized countries, it is related to the type of tumor and the extent of the disease, ranging from < 10% in patients with standard-risk acute lymphoblastic leukemia to 50% in patients with advanced neuroblastoma. The importance of nutritional status in children with cancer is related to its possible influence on the course of the disease and survival. Some authors have described decreased tolerance of chemotherapy associated with altered metabolism of antineoplastic drugs, increased infection rates, and poor clinical outcome in malnourished children. In this article, the authors review methods of nutritional assessment and the pathogenesis of nutritional morbidity in children with cancer as well as correlations of nutritional status with diagnosis, treatment, and outcome.

CT AND MR IMAGING OF THE LIVER. Clinical importance of nutritional status

Purpose: In an experimental study in rats a correlation between nutritional status and hepatic attenuation in CT and signal intensities in MR imaging was shown. Is physiological nutritional status of importance in clinical CT and MR imaging? Material and Methods: In a cross-over study including 12 healthy volunteers (6 women and 6 men, mean age 34 years), CT and MR imaging of the liver were performed with nutritional status at three different levels, i.e., normal, fasting and after glycogen-rich meals. CT and MR were performed on clinical imaging systems and hepatic attenuation and signal intensity, respectively, were assessed. In MR, T1-weighted, proton density-weighted and T2-weighted pulse-sequences were used. Results: In CT there were significantly (p<0.01) higher liver attenuations in normal nutritional status and after glycogen rich-meals compared to the fasting condition. The difference between fasting and glycogen-rich meals were 10.5 HU for men, 7.4 for women and mean 8.8 HU for all 12 volunteers. In MR imaging the differences were small and non-significant. The results of this study are in accordance with an earlier experimental study in rats. Conclusion: In CT it may be of importance not to have patients in a fasting condition as it lowers the attenuation in normal liver tissue. The findings are important for planning of clinical studies where hepatic attenuation will be assessed and may be of some importance in clinical CT. In MR imaging the results indicate that the nutritional status is of less importance.

Ecological study on the risks of esophageal cancer in Ci-Xian, China: the importance of nutritional status and the use of well water.

Our purpose was to determine the environmental risks in the development of esophageal cancer in Ci-Xian, which has one of the highest incidences of esophageal cancer in China. The subjects included 404, 352 and 400 inhabitants living in high-, medium-, and low-incidence areas of esophageal cancer, as well as 301 esophageal cancer patients. A food intake-frequency survey using a 7-day weighted inventory questionnaire was conducted on these individuals. Questions on occupation, working conditions, income per year, family disease history, medical complaints, and demographic features were also included in the questionnaire. The levels of nitrogen compounds in selected samples of well water were also measured in each of the 3 areas. Clear-cut differences in food intake were seen among inhabitants living in the 3 different areas, suggesting that regional differences in nutritional styles do exist. In both males and females, the intake of potatoes, fruit, vegetables, and meat were significantly lower in inhabitants living in the high-incidence area than in the other inhabitants, much the same as that of cancer patients. A low intake of carotene, and vitamins A and C was also seen in populations living in the high-incidence area of esophageal cancer. The well water polluted with nitrogen compounds was significantly related to the high incidence of esophageal cancer. In contrast, tobacco, alcohol consumption, and the intake of pickled vegetables and moldy foods did not relate to the different incidence rates. Our results suggest that low intake of fruit, vegetables, potatoes and meat, and the quality of well water may be important factors in the development of esophageal cancer in Ci-Xian.

Impact of nutrition status on morbidity and mortality in a select population of geriatric rehabilitation patients

To determine whether the level of protein-calorie undernutrition at presentation correlated with the subsequent risk of developing in-hospital complications independently of nonnutrition factors influencing outcomes, a prospective study was conducted of 110 consecutive admissions to a Geriatric Rehabilitation Unit (GRU) of a Veteran's Administration hospital. In total, 54 variables were evaluated as possible predictors of outcomes. The risk of developing at least one complication while on the GRU was studied by using multivariate techniques (discriminant function analysis) and was found to correlate with, in order of significance, functional status as admission, serum albumin concentration at admission, amount of weight lost in the year before admission, and the presence or absence of a renal or pulmonary disease. Nutrition variables also independently correlated with the risk of developing an infectious complication or a major life-threatening complication and dying within the hospital. These data indicate the importance of nutrition status in geriatric rehabilitation patients.