Improvement In Nutritional Status Research Articles

Association of poor oral health with increased incidence of dysphagia and impaired improvement in nutritional status among patients with acute heart failure: a prospective cohort study.

This study aimed to clarify the association between oral health and the incidence of dysphagia as well as the recovery of nutritional status and improvement of dysphagia in hospitalized patients with acute heart failure. Hospitalized patients with AHF were prospectively enrolled. Oral health was evaluated using the Japanese Version of the Oral Health Assessment Tool (OHAT-J) after circulation dynamics improved (defined as baseline), and participants were classified into good and poor oral health groups (OHAT-J 0-2 and ≧ 3, respectively). The primary outcome measure was the incidence of dysphagia evaluated using the Food Intake Level Scale (FILS) at baseline. Secondary outcome measures were nutritional status and FILS score at discharge. Nutritional status was assessed using the Mini Nutritional Assessment Short Form (MNA-SF). Univariate and multivariate logistic regression analyses were used to determine the association between oral health and the study outcomes. Of the 203 recruited patients (mean age, 79.5years; 50.7% female), 83 (40.9%) were in the poor oral health group. Participants with poor oral health were significantly older, had lower skeletal muscle mass and strength, lower nutrient intake and nutritional status, worse swallowing status, as well as lower cognitive level, and physical function than those with good oral health. In multivariate logistic regression analyses, baseline poor oral health was significantly associated with the incidence of dysphagia (odds ratio = 1.036, P = 0.020), as well as with the improvement in nutritional status (odds ratio = 0.389, P = 0.046) and dysphagia (odds ratio = 0.199, P = 0.026) at discharge. Poor baseline oral health was associated with the incidence of dysphagia, as well as with the lack of improvement in nutritional status and dysphagia in patients with acute heart failure.

Therapy of gram-negative infection in the complex treatment of cystic fibrosis

Chronic lung infections are a consequence of the disturbance of mucociliary clearance process in cystic fibrosis. For most patients with cystic fibrosis, chronic lung infection is associated with a poor prognosis. The impact of chronic Pseudomonas aeruginosa infection on progressive deterioration of lung function and nutritional status has been established. Timely and effective antibiotic therapy aimed at eradication or control of gram-negative flora affects the duration and quality of life. The purpose of the study. To investigate the safety and efficacy of inhaled administration of sodium colistimethate (Colimistin®). Methods. The study enrolled 42 patients (27 patients aged 5 to 17 years and 15 patients over 18 years) with an established diagnosis of cystic fibrosis, 38 with monoculture of P. aeruginosa or various associations, 4 with Achromobacter spp. culture. Microbial status, external respiratory function, nutritional status, assessment of well-being, adverse reactions, exacerbations, and use of antibiotic therapy during colimistin inhalations were recorded in all patients at baseline and at 3 months. Results. A significant improvement in nutritional status in terms of weight (p < 0.007) and height (p < 0.001) was shown in the general patient group and the children’s group. In the group of children, there was a significant increase in weight (p < 0.034) and height (p < 0.0001). In the group of patients older than 18 years, there was a significant increase in weight (p < 0.045) and BMI three months after therapy (p < 0.013). There were no significant improvements in FVC and FEV1. The treatment efficacy was shown by the assessment of well-being in the general patient group (p < 0.001) and in the children’s group (p < 0.002). No significant difference was found in the adult patient group (p < 0.067). Two patients dropped out of the study due to ADR at the start of therapy. Conclusion. Sodium colistimethate showed efficacy and safety in bronchopulmonary infections caused by P. aeruginosa in monoculture and in association with Achromobacter spp. and may be recommended for use in children and adults with cystic fibrosis.

MATERNAL NUTRITIONAL KNOWLEDGE AND DETERMINANTS OF THE CHILD NUTRITIONAL STATUS IN THE NORTHERN REGION OF BANGLADESH

This present study investigates the factors that affect child nutrition and the status of maternal Knowledge in the northern region of Bangladesh. For this purpose, this study employs a cross-sectional data survey of two divisions in the northern region of Bangladesh, namely Rangpur and Rajshahi, from which three districts were chosen from each division using a simple random sampling process. This survey collected data from 527 respondents with face-to-face direct interview method. The questionnaire is in the native language for their understanding. This study applies Weight for Age, Height for Age, Weight for Height, and Weight for Height for the nutritional status of children. This study uses bivariate logistic analysis for factor analysis and descriptive analysis for mothers' nutritional Knowledge. The result shows that sanitation, mothers' Employment, maternal nutritional Knowledge, wealth index, maternal educational status, and antenatal care are the key significant determinants of child nutritional status. In addition, this study also reveals that only 30% of the total respondents were aware of the child's nutritional status while feeding their children, that is 158 out of 537 mothers. The findings of this study indicate that improvement in the rate of a child's dietary diversity, women's dietary diversity, and also self-esteem leads to an improvement in the child's nutritional status in a significant manner. It also indicates that moving towards an upward ceiling for cases including compulsory higher education for women, spreading awareness about child nutritional issues, and prohibiting child marriage and early premature pregnancy may enhance sustaining lives for them.

Elexacaftor-tezacaftor-ivacaftor in patients with cystic fibrosis ineligible for clinical trials: a 24-week observational study.

Introduction: Seminal clinical trials with the triple combination of elexacaftor-tezacaftor-ivacaftor (ETI) demonstrated clinical efficacy in people with cystic fibrosis (pwCF) who carry at least one F508del mutation. However, due to exclusion criteria of these clinical trials, the effect of ETI was not studied in a substantial number of pwCF. Thus, we ran a single center trial to evaluate a clinical efficacy of ETI treatment in adult pwCF who were ineligible for enrollment in registration studies. Methods: PwCF on ETI with prior lumacaftor-ivacaftor therapy, severe airway obstruction, well-preserved lung function, or with airway infection with pathogens at risk of more rapid decline in lung function formed the study group, while all the others on ETI formed the control group. Lung function, nutritional status and sweat chloride concentration were assessed before and after initialization of ETI therapy over a 6-month period. Results: Approximately a half of the ETI-treated pwCF at the adult Prague CF center (49 of 96) were assigned to the study group. Their mean changes in body mass index ( + 1.04kg/m2) and in sweat chloride concentration (-48.4mmol/L) were similar to the control group ( + 1.02kg/m2; -49.7mmol/L), while the mean change in percent predicted forced expiratory volume in 1s (ppFEV1; + 10.3 points) was significantly lower than in the control group ( + 15.8 points) (p = 0.0015). In the subgroup analysis, pwCF with severe airway obstruction (ppFEV1 <40) and pwCF with well-preserved lung function (ppFEV1 >90) showed a less potential for improvement in lung function during the ETI treatment than controls (median change in ppFEV1 + 4.9 points and + 9.5 points, respectively). Conclusion: PwCF not eligible for inclusion in clinical trials demonstrated improvement in lung function and nutritional status following the initiation of treatment with the ETI combination. Moderate increase in ppFEV1 was observed in those with severe airway obstruction or well-preserved lung function.

P326 Impact of the elexacaftor/tezacaftor/ivacaftor on the nutrition parameters and gastrointestinal symptoms in adult cystic fibrosis patients in the cystic fibrosis centre of Brno, Czech Republic

Published studies showed improvement in nutritional status and quality of life, even pancreatic insufficiency conversion, mostly in pediatric patients treated with ivacaftor. Although data from clinical trials with elexacaftor/tezacaftor/ivacaftor in older patients don’t suggest restoration in exocrine pancreas function, the long-term effect and quality data of the nutrition parameters and pancreatic function outcome in adults are still lacking. The aim of our study was to show the effect of elexacaftor/tezacaftor/ivacaftor therapy in adult patients with CF on the nutritional status and digestive function. We hypothesize the improvement of nutritional parameters and gastrointestinal symptoms, the reduction of pancreatic enzyme replacement therapy, however the improvement of exocrine pancreatic function is questionable.

Evaluation of Proximate Composition and Mineral Contents of Selected Locally Produced Beverages in Southwest Nigeria

The study evaluates the proximate composition and mineral contents of selected locally produced beverages in southwest Nigeria.Four locally produced beverages namely; Tigernuts, Kunu Zobo, and Coconut milk drinks were prepared and subjected to laboratory analysis for their nutritional and mineral contents using the standard method. The result showed that the four beverages are rich in moisture content and contained other nutrients to varying degrees. The study also discovered that the mineral content of the drinkis also appreciably high which makes them better alternatives to carbonated soft drinks that have been widely attributed to many health challenges. The study however discovered a wide variation in terms of the nutritional and mineral contents of the drinks as indicated by the results of the analysis of variance (ANOVA) tests with a p-value less than 5% level (p &lt; 0.05). It is believed that moderate consumption of these local drinks by people of different categories and especially tourists will no doubt contribute to the overall health and welfare of the populace. Furthermore, it is also believed that the production and distribution of these local beverages can engender economic prosperity, especially for the unemployed. These local drinks could provide many benefits, especially in developing countries by playing important roles in ensuring food security, enhancing livelihoods, improvement of nutritional status and social well-being of the vulnerable groups.

Implementation of Android Platform Application "PSG Balita" ISO/IEC 25010 Standardized to Improve Nutritional Status Data for Toddler

The need to obtain data and information on nutritional status based on the name by address is required for nutrition reporting. Thus, we should use technological advances to support the quality of toddler nutritional status data. The "PSG Balita" application has ISO/IEC 25010 standards and allows proper recording. This study aimed to measure the effect of implementing an Android-based "PSG Balita" application with ISO/IEC 25010 standards on the quality of toddler nutritional status data. A quasi-experimental research design was conducted in Banda Aceh City in 2021, involving 30 nutritionists at a health center. Data were collected through interviews and observations using a questionnaire that included timeliness, completeness, accuracy, and usefulness. The intervention was conducted through training using the Android-based "PSG Balita" application for one month. Data analysis using the Repeated Measures ANOVA test. Results, the "PSG Balita" application has shown a significant effect in improving the quality of nutritional status data for children under five (p &lt; 0.05). It was found that after implementing the application for one month, the aspects of timeliness (p= 0.000), completeness (p= 0.000), accuracy (p= 0.001), and usefulness (p= 0.002) could improve the quality of nutritional status data for toddlers. In conclusion, the "PSG Balita" application has made it easier for users to monitor the nutritional status of a toddler, has good accuracy, and allows early identification of the risk of malnutrition. The "PSG Balita" application, which adheres to ISO/IEC 25010 standards, can enhance the accuracy of nutritional status data for young children.

Impact of nutritional and educational support on home enteral nutrition

BackgroundHome Enteral Nutrition (HEN) is used to prevent or correct malnutrition in outpatients. Due to the complexity of this process, the indication, follow-up, and results of an educational program of HEN patients was evaluated.MethodsA prospective, observational, real-life, multicenter study was performed in 21 Spanish Hospital. Patients receiving HEN by nasogastric tube or ostomy were included. The following variables were collected: age, gender, HEN indication, type of formula, nutritional requirements, laboratory variables, complications, and quality standards of the educational program. To calculate the energy and protein requirements, the FAO/WHO/UNU formula was used considering the adjusted weight of the patients. All data were analyzed using SPSS.24.Results414 patients were included. Most conditions diagnosed were neurodegenerative diseases (64.8%). 100 (25.3%) were diabetic. The mean weight was 59.3 ± 10.4 kg and BMI 22.6 ± 3.2. Moderate protein-calorie malnutrition was predominant at baseline (46.4%). Improvement in nutritional status at six months was recorded in more than 75% of patients (p < 0.05). Tolerance problems, diarrhea and abdominal distension fell between the 3- and 6-month visits (p < 0.05). Patients who received intermittent EN had fewer tolerance-related effects (OR 0.042; 95% CI 0.006–0.279) and less diarrhoea (OR 0.042; 95% CI 0.006–0.279). At the baseline and 6-month visits, compliance with the educational measures proposed by the prescriber was ≥ 99%.ConclusionThe nutritional assessment to prescribe individualized HEN to each patient, together with educational measures and training in the proper use of this treatment for both patients and trainers, improves nutritional status and reduces the onset of adverse events.

P240 PREOPERATIVE OPTIMISATION FOR A PATIENT WITH HEART FAILURE UNDERGOING MAJOR NON–CARDIAC SURGERY: AN EXAMPLE OF COLLABORATION BETWEEN THE MULTIMODAL PREHABILITATION CENTRE AND THE HEART FAILURE CLINIC AT CAREGGI UNIVERSITY HOSPITAL

Abstract Introduction Heart failure (HF) is a risk factor for postoperative mortality in major non–cardiac surgery. Collaboration between the Multimodal Preoperative Prehabilitation unit (MPP) and Heart Failure Clinic (HFC) could allow optimization of heart failure therapy and negative prognostic factors such as reduced functional capacity (FC), malnutrition, and sarcopenia to improve the prognosis of these patients. Case report: Mrs. C.M. is a 58–year–old patient who presents to the MPP unit in anticipation of total colectomy for drug–refractory ulcerative colitis. Mrs. C.M. has a past medical history significant for heart failure with reduced ejection fraction (EF 25%) of presumably valvular–arrhythmic etiology. She underwent tricuspid annuloplasty and mitral replacement surgery some years ago and is affected by atrial fibrillation. At the MPP unit, Mrs. C.M. had a reduced FC and was malnourished and sarcopenic. Blood tests showed iron deficiency anemia. Heart failure therapy (NYHA II) was not optimized according to guidelines. Therefore, the patient started multimodal prehabilitation consisting of aerobic and resistance exercise, nutritional intervention, intravenous iron infusion, and optimization of HF therapy. After the patient was evaluated at the HFC, she started empagliflozin, sacubitril/valsartan, and ranolazine; intermittent levosimendan therapy was also performed. She also underwent cardiac NMR, which showed non–ischemic fibrosis, and coronary angiography, which was negative. Finally, she underwent PM–ICD implantation. After six months of multimodal prehabilitation, there was an increase in EF (38% vs. 25%), a reduction in NT–proBNP (700 vs 4988 pg/mL), and mitigation of HF symptoms. There was also a marked improvement in FC (383 vs 269 meters at 6–minute walking test), nutritional status (stage B vs stage C at PG–SGA test), and muscle strength (handgrip strength test 14.6 vs 8.5 kg). Considering the excellent preoperative optimization response, it was decided to proceed with surgery after a collegial discussion (anesthetist, heart failure cardiologist, surgeon, and patient). Conclusions Multimodal preoperative prehabilitation, based on the collaboration between the Multimodal Preoperative Prehabilitation Unit and Heart Failure Clinic, can effectively improve the preoperative functional capacity of HF patients.

Yingyangbao Intervention Was Associated with the Improvement of Body Growth and Nutrition Status of Infants and Young Children in Poor Rural Areas of China: The Annual Comparison from 2012 to 2020.

Yingyangbao (YYB) is a soy-based micronutrient-fortified powder used in the Nutrition Improvement Project on Children in Poor Areas of China. After the baseline study in 2012, YYB intervention gradually spread to 21 provinces in China. From 2015 to 2020, a secular trend study was carried out to evaluate the body growth and nutritional status of 6-23-month-old infants and young children (IYC) under YYB intervention. The aim of this research was to investigate whether YYB intervention was associated with the improvement of body growth and development in large populations from broad areas with national and multi-year survey results. The anthropometric data collected in the baseline study and cross-sectional surveys were compared, and the correlation between YYB intake amount and body growth were analyzed. Compared with the results of the baseline study, the 6-23-month-old IYC under YYB intervention showed a significant increase in body weight, body length and Z scores since 2015, and the stunting rate decreased from 9.7% in 2012 to 5.3% in 2020. Significantly positive correlations were observed between the YYB intake amount and the body growth indicators. Therefore, YYB intervention was associated with the improvement of body growth and nutrition status of Chinese IYC. In the future, long-term and continuous efforts are still needed to further reveal the health benefits of YYB in depth.

Weight Gain and Nutritional Improvement After Magnetically Controlled Growing Rod Surgery in Early-Onset Scoliosis: A Single Centre Analysis of 68 Patients.

Early-onset scoliosis (EOS) is frequently associated with complex spine and chest wall deformities that may lead to severe cardiopulmonary impairment and malnutrition. The aim of this study is to evaluate the change in the nutritional status of EOS patients after treatment with magnetically controlled growing rod instrumentation (MCGR) in a single center. We prospectively collected data of patients treated with MCGR for EOS in a single center. Exclusion criteria were <2 years' follow-up and incomplete weight-for-age Z-scores (WAZ) data. Preoperative and postoperative WAZ, radiographic parameters, including major coronal curve, kyphosis angle, space available for lung ratios, thoracic height, and unplanned returns to the operating room (UPROR), were analyzed. SD and 95% Confidence intervals (CI) are presented with means. Sixty-eight patients (37 males/31 females) were included. The mean age at surgery was 8.2 years (SD 2.8, range 1.8-14.2), and the mean follow-up time was 3.8 years (SD 1.0, range 2.1-6.8). The study population was categorized by the primary diagnosis as follows: 23 neuromuscular, 18 idiopathic, 15 congenital, and 12 syndromic patients. The major coronal curve improved between the preoperative and latest visits by 40% ( P <0.005, SD 27, CI 33-47), while the space available for lung ratios improved by 8% ( P <0.005, SD 13, CI 5-12). Thoracic height increased by 25% ( P <0.005, SD 13, CI 22-28), and kyphosis angle decreased by 25% ( P <0.005, SD 26, CI 9-39). Eighteen patients (27%) required a total of 53 UPRORs. WAZ improved significantly between the preoperative and the latest follow-up ( P =0.005). Regression analysis showed WAZ improvements were most significant in the underweight patients and the Idiopathic or Syndromic EOS patients. UPROR was not associated with deterioration in WAZ. Treatment of EOS patients with MCGR resulted in an improvement in nutritional status, as evidenced by the significant increase in WAZ. Underweight, Idiopathic and Syndromic EOS patients, and those who required UPROR all had significant improvement in their WAZ with MCGR treatment. Therapeutic Study-Level II.

Co-Inoculation of Arbuscular Mycorrhizal Fungi and Plant Growth-Promoting Rhizobacteria Improve Growth, Biochemical Attributes, and Nutritional Status of Potato (Solanum tuberosum L.) Minitubers

Co-Inoculation of Arbuscular Mycorrhizal Fungi and Plant Growth-Promoting Rhizobacteria Improve Growth, Biochemical Attributes, and Nutritional Status of Potato (Solanum tuberosum L.) Minitubers

Профілактика захворювань порожнини рота в дітей з бульозним епідермолізом: опис клінічного випадку та огляд стану проблеми

Today, more than 300 million people worldwide suffer from one or more rare diseases. Epidermolysis bullosa (EB) is a heterogeneous group of hereditary diseases characterized by a genetic predisposition to a hypersensitive body reaction to minor skin damage, characterized by the formation of blisters and erosions on the skin and mucous membranes, followed by scarring. It is one of the most severe hereditary dermatoses. In EB, pathological conditions also occur in the oral cavity. Thus, patients with EB require a special “atraumatic” approach to medical procedures, hygienic care, professional oral hygiene, etc. Purpose - to systematize clinical recommendations for oral care for patients with BE on the basis of a clinical case. Clinical case. We present a clinical case of a patient with a dystrophic EB and a diagnosis of acute chronic granulating periodontitis. Examination of the oral cavity revealed microstomia, multiple caries, erosions and ulcers on the oral mucosa, signs of chronic catarrhal gingivitis, as well as dentoalveolar anomalies. After achieving a satisfactory degree of mouth opening using a set of exercises for the maxillofacial muscles, treatment of the acute chronic granulating periodontitis of the tooth 23 was performed. As a result of the clinical observation and analysis of the literature, we systematized practical recommendations aimed at facilitating the treatment of oral diseases in patients with EB. Conclusions. Treatment of oral diseases in patients with EB is primarily aimed at preventing pain and preventing secondary infection of affected areas. Treatment of dental caries contributes to the correct position of the tongue, improved swallowing and phonetics, as well as to improvement in nutritional status and aesthetic appearance. Oral hygiene reduces the risk of injury to the oral and pharyngeal mucosa. In the treatment of patients with EB, it is important to use a multidisciplinary approach with the involvement of specialists of different specialties. Implementation of simple but effective recommendations made by pediatric dentists will increase the effectiveness of prevention of oral diseases in these children. The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent of parents and child was obtained for the study. No conflict of interests was declared by the authors.

Nutritional Status and Its Detection in Patients with Inflammatory Bowel Diseases.

Malnutrition is an important issue in patients with inflammatory bowel diseases (IBDs) including Crohn's disease (CD) and ulcerative colitis (UC). It is caused by altered digestion and absorption within the small bowel, inadequate food intake, and drug-nutrient interactions in patients. Malnutrition is an essential problem because it is related to an increased risk of infections and poor prognosis in patients. It is known that malnutrition is also related to an increased risk of postsurgery complications in IBD patients. Basic nutritional screening involves anthropometric parameters with body mass index (BMI) and others (fat mass, waist-to-hip ratio, muscle strength), medical history concerning weight loss, and biochemical parameters (including the Prognostic Nutritional Index). Besides standard nutritional screening tools, including the Subjective Global Assessment (SGA), Nutritional Risk Score 2002 (NRS 2002), and Malnutrition Universal Screening Tool (MUST), specific nutritional screening tools are used in IBD patients, such as the Saskatchewan Inflammatory Bowel Disease-Nutrition Risk Tool (SaskIBD-NR Tool and IBD-specific Nutritional Screening Tool). There is a higher risk of nutrient deficiencies (including iron, zinc, magnesium) and vitamin deficiencies (including folic acid, vitamin B12 and D) in IBD patients. Therefore, regular evaluation of nutritional status is important in IBD patients because many of them are undernourished. An association between plasma ghrelin and leptin and nutritional status in IBD patients has been observed. According to some authors, anti-tumor necrosis factor (anti-TNFα) therapy (infliximab) can improve nutritional status in IBD patients. On the other hand, improvement in nutritional status may increase the response rate to infliximab therapy in CD patients. Optimization of nutritional parameters is necessary to improve results of conservative and surgical treatment and to prevent postoperative complications in patients with IBDs. This review presents basic nutritional screening tools, anthropometric and laboratory parameters, dietary risk factors for IBDs, common nutrient deficiencies, associations between anti-TNFα therapy and nutritional status, selected features regarding the influence of nutritional status, and surgical outcome in IBD patients.

Government-Industry-Academia Alliance: A multisectoral collaboration for improved nutrition of children and well-being of mothers

Introduction: Consistent with the Sustainable Development Goal 17 highlighting partnership to achieve development, this study demonstrated the convergence among government, industry and academe in carrying out a nutrition intervention to improve the nutritional status, knowledge, attitude and behaviour of school community (school children and mothers). Methods: A school-based intervention study comprising of school lunch feeding and nutrition lessons was conducted. Quasi-experimental design was used in the intervention research. Data were analysed using Stata 12.0. Descriptive statistics were generated using the survey module (svy) of Stata. The food and nutrition intervention mix composed of the governmentpartner School Feeding Programme (SFP) and the nutrition education campaign. The government-partner SFP involved lunch feeding of 7 to 9 years old students based on the standardised Pinggang Pinoy® recipes. The government-partner nutrition education component involved teaching of the developed modules to students and their mothers. Results: The intervention resulted in improvements in nutritional status, knowledge, attitude and behaviour of students. Investing an average of Php 15.00 or USD 0.29 (as of 2017) in a school feeding programme following the government-partner food and nutrition intervention mix improved nutritional status and shifted the number of underweight children to normal nutritional status by 25.3% after 120 feeding days. This intervention was implemented through a multisectoral collaboration during the pre-implementation, implementation, and post-implementation phases of the study. Conclusion: Partnerships among stakeholders provided the context towards healthier children as demonstrated by improved nutritional status, knowledge, attitude and behaviour of participants.

Market-based approach to promoting home fortification of diets with micronutrient powder through volunteer frontline health workers: A qualitative study.

The potential of market-based approach in distributing micronutrient powder (MNP) through volunteer frontline health workers has been recognized. BRAC, the largest non-government organization (NGO) in Bangladesh, uses Shasthya Shebikas as volunteer frontline health workers to sell MNP for promotion of home fortification (HF) of diets for under-5 children. We aimed to understand the opportunities and challenges of BRAC's market-based approach in promoting HF with MNP. We conducted a descriptive qualitative study in the four selected districts of Bangladesh: Faridpur, Gaibandha, Rangpur, and Rajbari. In-depth interviews, key informant interviews, and focus group discussions were deployed to collect data from purposively-selected Shasthya Shebikas and their immediate supervisors at the field level-Shasthya Kormis, Field Organizers, Managers, and mothers or caregivers of under-5 children. We performed thematic analysis to analyze data. We have found that the Shasthya Shebikas play a critical role in promoting access of MNP by the mother/caregivers of children aged 6-59 months at the community level. They counsel the caregivers to seek primary advice about the product and also informally identify undernourished children so that they can receive special attention regarding the use of MNP. However, low profit margins, over-due payments for the sold sachets, poor collaboration with and free distribution of MNP by other NGOs, and inadequate training of Shasthya Shebikas on marketing of MNP have posed major challenges for them to perform as effective sales agents of the product. The market-based approach in promoting HF with MNP through frontline volunteer health workers shows much potential, with ample opportunities and few possible challenges. Considering the dynamics, the intervention should fine-tune the factors crucial to maximizing the potentials of Shasthya Shebikas for marketing MNP and promoting HF in order to improve nutrition status of the infants and young children.

Six-Month Synbio® Administration Affects Nutritional and Inflammatory Parameters of Older Adults Included in the PROBIOSENIOR Project

The physiological changes associated with ageing contribute to the incidence of diseases, morbidity, and mortality. For modern society, it is essential to find solutions to improve elderly people's health and quality of life. Among promising strategies, the PROBIOSENIOR project proposed a daily six-month supplementation with new probiotic functional foods and nutraceuticals. The aim of this work was to evaluate the modulating effects of the probiotic diet on inflammatory markers and nutritional status. Ninety-seven elderly volunteers were randomly assigned to either a placebo-diet group or a probiotic-diet group (SYNBIO®). Faeces, urine, and blood samples were collected before and after the supplementation to determine serum cytokines, biogenic amines, and inflammation markers. Comparing the results obtained before and after the intervention, probiotic supplementations significantly decreased the TNF-α circulating levels and significantly increased those of IGF-1. Biogenic-amine levels showed high variability, with significant variation only for histamine that decreased after the probiotic supplementation. The supplementation influenced the serum concentration of some crucial cytokines (IL-6, IL-8, and MIP-1α) that significantly decreased in the probiotic group. In addition, the Mini Nutritional Assessment questionnaire revealed that the probiotic-supplemented group had a significant improvement in nutritional status. In conclusion, the PROBIOSENIOR project demonstrated how SYNBIO® supplementation may positively influence some nutritional and inflammatory parameters in the elderly.

The Effects of SGLT2 Inhibitors on Liver Cirrhosis Patients with Refractory Ascites: A Literature Review.

Decompensated liver cirrhosis is often complicated by refractory ascites, and intractable ascites are a predictor of poor prognosis in patients with liver cirrhosis. The treatment of ascites in patients with cirrhosis is based on the use of aldosterone blockers and loop diuretics, and occasionally vasopressin receptor antagonists are also used. Recent reports suggest that sodium-glucose cotransporter 2 (SGLT2) inhibitors may be a new treatment for refractory ascites with a different mechanism with respect to conventional agents. The main mechanisms of ascites reduction with SGLT2 inhibitors appear to be natriuresis and osmotic diuresis. However, other mechanisms, including improvements in glucose metabolism and nutritional status, hepatoprotection by ketone bodies and adiponectin, amelioration of the sympathetic nervous system, and inhibition of the renin-angiotensin-aldosterone system, may also contribute to the reduction of ascites. This literature review describes previously reported cases in which SGLT2 inhibitors were used to effectively treat ascites caused by liver cirrhosis. The discussion of the mechanisms involved is expected to contribute to establishing SGLT2 therapy for ascites in the future.

Nutritional Status and Frailty Improvement through Senior-Friendly Diet among Community-Dwelling Older Adults in South Korea

Considering that Korea's aging population is rapidly increasing, health serves as an indicator of older adults' quality of life, and dietary life directly affects their health. For health maintenance and improvement, preventive healthcare measures including safe food selection and nutritional supply are needed. This study aimed to evaluate the effect of senior-friendly diet on nutrition and health status improvement in older adults receiving community care. A total of 180 older adults were analyzed, with 154 and 26 in the senior-friendly diet intervention group and the general diet group, respectively. Surveys, blood tests, and frailty evaluations were conducted before and after the study. After 5 months of intervention, the blood status, nutrient intake, and frailty level were evaluated. The participants' mean age was 82.7 years, and 89.4% of them were living alone. In both groups, energy, protein, vitamin A, vitamin D, vitamin C, calcium, and magnesium intake were insufficient initially but generally improved after the intervention. Especially in the intervention group, energy, protein, vitamin D, vitamin C, and folic acid intake significantly increased. The frailty level also slightly improved, and the malnutrition rate was reduced. Even after the passage of time, the improvement effect size significantly differed between the groups. Therefore, resolving and supporting meals corresponding to the physiological needs of the older adults has a great impact on improving their quality of life, and such special consideration is a reasonable way to respond to a super-aged society.

The Use of Whatsapp Social Media Group for Nutrition Counselling among Parents with Children of Congenital Heart Defects

Background: Ignorance about appropriate Infant and Young Child Feeding (IYCF) Practices among parents of children with Congenital Heart Defects (CHD) can exacerbate malnutrition in these children leading to significant morbidity and mortality. Use of novel methods for Intensive Nutrition Counselling such as Whatsapp social media group can lead to considerable improvement in nutritional status of the child.&#x0D; Objectives: To assess the efficacy of Whatsapp group for Intensive Nutritional Counselling to parents of children with CHD. &#x0D; Methods: This is a two-year prospective interventional study, one-group before-after study design. Here, intervention is in the form of specialised focussed nutrition counselling for parents of children with CHD through Whatsapp social media group.&#x0D; Results: Majority of the patients 16 (30.0%) were in the age group of 7-12 months, predominant diagnosis (25 patients i.e. 48.9%) was Ventricular Septal Defect (VSD). Sixty-eight percent patient-families belonged to lower socio-economic class. Before intervention, 71.1% of children (37 of 52) were found to be underweight, 35.5% children were stunted and 65.6% children were wasted. Post intervention there was significant improvement in all the 3 anthropometric indicators. This intervention particularly helped improve IYCF habits for the age group of 7-12 months. Post intervention all parents included the 8 food groups in their children’s diet thus providing them wholesome nutrition whereas earlier only 2-3 food groups were given to children on a daily basis.&#x0D; Conclusion: This is the first study to explore use of Whatsapp group to educate parents of children with CHD about specific nutrition counselling, resulting in improvement in child anthropometric indices.