Nutrition Therapy Research Articles

Effects of additional physical exercise on the nutritional status and disease progression during the low-protein diet in Chronic Kidney Disease Patients: a systematic review and meta-analysis.

Low-protein diet (LPD) is the core of dietary and nutritional therapy for non-dialysis chronic kidney disease (CKD) patients. In addition, physical exercise could prevent and treat various illnesses and chronic diseases. The objective of the study was to search for and appraise evidence on the effect of additional physical exercise on patients' nutritional status and indicators of disease progression when compared with the LPD alone. PubMed Central, Embase, Cochrane, and Web of Knowledge for randomized controlled trials (published between January 1, 1956 and May 17, 2023) were searched. A total of 8698 identified studies, 9 were eligible and were included in our analysis (N = 250 participants). Compared with the LPD alone, additional physical exercise reduced serum creatinine by a mean of -0.21 mg/dL (95% CI -0.39 to -0.03) in CKD patients. Similarly, blood pressure decreased after physical exercise, with systolic blood pressure decreasing by -7.05 mm Hg (95% CI -13.13 to -0.96) and diastolic blood pressure decreasing by -5.31 mm Hg (95% CI -7.99 to -2.62). Subgroup analyses revealed that resistance exercise (RE) was effective in decreasing estimated glomerular filtration rate (eGFR) of -1.71 mL/min per 1.73 m² (95% CI -3.29 to -0.14). In addition, the VO2peak increasing by 2.41 mL/kg/min (95% CI 0.13 to 4.70) when physical exercise was continued for 24 weeks. The above results suggest that the LPD with additional physical exercise care is more beneficial for patients with CKD.

Preoperative Crohn's Disease Exclusion Diet and Exclusive Enteral Nutrition in Adults with Crohn's Disease: A Feasibility Randomised Controlled Trial.

Preoperative exclusive enteral nutrition (EEN) improves nutritional status, reduces intestinal inflammation, and likely improves surgical outcomes. Crohn's disease exclusion diet with partial enteral nutrition (CDED) also reduces intestinal inflammation but its safety preoperatively is unknown. This single-blinded, multicentre, randomised controlled trial of three preoperative nutritional therapies aimed to assess the feasibility of recruiting and retaining patients and collecting primary and secondary effectiveness outcomes. Adults undergoing elective Crohn's disease surgery with a body mass index (BMI) > 18.5 kg/m2 and without significant weight loss were eligible to participate. Patients were randomly assigned to six weeks of preoperative EEN, CDED, or standard care. Feasibility, nutritional, radiological, and surgical outcomes were recorded. Over 18 months, 48 patients were screened, 17 (35%) were randomised, and 13/17 (76%) patients were retained in the intervention phase. It was feasible to collect primary and secondary effectiveness data; at day 30, three patients had Clavien Dindo Grade 2 complications, and 10 had no complications. Nutritional therapy adherence of patients retained in the study was high. Recruitment and retention of patients who need elective Crohn's disease surgery for preoperative nutritional therapy is possible, although a shorter duration may improve EEN completion. The impact on surgical outcomes should be assessed in a larger study.

Disparities and Differential Allocation of Nutritional Therapies

Disparities and Differential Allocation of Nutritional Therapies

Changes in Interprofessional Practice During the COVID-19 Pandemic and the Effect on Patient Outcomes: A Retrospective Observational Study.

Changes in healthcare delivery were required during the first year of the COVID-19 pandemic. The purpose of this study was to determine the impact of the approach to care of the COVID-19 patient on nursing sensitive indicators and nutrition therapy and the utilization of rehabilitation services during the first year of the pandemic in the acute care setting. A retrospective study of 894 patients admitted with a COVID-19 diagnosis was conducted between March 2020 and February 2021 in 3-month cohorts. All charts were reviewed for general demographics and hospital data, nursing quality indicators, and nutritional and rehabilitation services for the first 30 days of admission. Differences in patient characteristics were noted among the cohorts. Variations were observed between time points in hospital-acquired pressure injury occurrence, with mechanical ventilation and proning being independent predictors of hospital-acquired pressure injuries. There were differences noted in the percentage of patients with a central line-associated bloodstream infection among the time points (P < .001), but there were no differences noted in catheter-associated urinary tract infections (P = .20). Overall, 15.5% had a malnutrition diagnosis, with most patients receiving 50% of prescribed calorie and protein needs. Rehabilitation services increased over time with these services being initiated earlier in the later cohorts (P < .001). The results of this study demonstrated the impact of the pandemic on outcomes in the areas of nursing, nutrition, and rehabilitation, which varied across quarterly cohorts as we learned and developed new practices and adapted to a novel pandemic.

A Novel Nutritional Therapy Through Lysophosphatidyl Choline DHA on Arsenic Exposed Dams and Pups, Postdoctoral Research Associate

A Novel Nutritional Therapy Through Lysophosphatidyl Choline DHA on Arsenic Exposed Dams and Pups, Postdoctoral Research Associate

Current updates on the epidemiology, pathogenesis and development of small molecule therapeutics for the treatment of Ebola virus infections

Ebola virus disease (EVD) is a rare, highly contagious and a deadly disease with a variable fatality rate ranging from 30% to 90%. Over the past two decades, Ebola pandemic has severely affected the sub-Sahara region including Democratic Republic of the Congo (DRC), and Uganda. The causative agents of the most EVD cases are three distinct species out of six Ebolaviruses namely Zaire Ebolavirus (ZEBOV), Sudan Ebolavirus (SUDV) and Bundibugyo Ebolavirus (BDBV). In recent years, significant strides have been made in therapeutic interventions. Notably, the US Food and Drug Administration has approved two monoclonal antibodies: InmazebTM (REGN-EB3) and Ansuvimab or Ebanga™. Additionally, many small molecules are currently in the developmental stage, promising further progress in medical treatment. Addressing the critical need for preventive measures, this review provides an in-depth analysis of the licensed Ebola vaccines-Ervebo and the combination of Zabdeno (Ad26.ZEBOV) and Mvabea (MVA-BN-Filo) as well as the vaccines which are currently being tested for their efficacy and safety in clinical studies. These vaccines might play an important role in curbing the spread and mitigating the impact of this lethal disease. The current treatment landscape for EVD encompasses both nutritional (supportive) and drug therapies. The review comprehensively details the origin, pathogenesis, and epidemiology of EVD, shedding light on the ongoing efforts to combat this devastating disease. It explores small molecules in various stages of the development, discusses patents filed or granted, and delves into the clinical and supportive therapies that form the cornerstone of EVD management. This review aims to provide the recent developments made in the design and synthesis of small molecules for scientific community to facilitate a deeper understanding of the disease and fostering the development of effective strategies for prevention, treatment, and control of EVD.

Assessing the Impact of Continuous Glucose Monitoring and Personalized Nutrition Therapy on Dietary Intake in Overweight and Obese Individuals With Prediabetes

Assessing the Impact of Continuous Glucose Monitoring and Personalized Nutrition Therapy on Dietary Intake in Overweight and Obese Individuals With Prediabetes

A pilot study of Keto Prescribed+: A healthy thinking and eating educational program for African American women.

African American (AA) women have the highest prevalence of obesity in addition to health disparities in preventable diet-related diseases (i.e., diabetes, hypertension), which places them at increased risk for cardiovascular disease. The purpose of this pilot study was to assess the feasibility, acceptability, and preliminary effectiveness of the Keto Prescribed+ (KetoRx+) program on associated physical and psychosocial outcomes among this population. The KetoRx+ program is a healthy eating and thinking educational intervention. The program combined online and in-person community group sessions over 8 weeks. The Keto Prescribed+ was found to be feasible and acceptable with comments on ways to increase acceptability from participants completing program (n = 10). Physical outcomes changed showed an average decrease in weight of 10lbs (SD = 5), baseline average 226lbs. Waist-to-hip ratio and systolic blood pressure also trended down. Psychosocial outcomes showed improvement trends. The KetoRx+ program is feasible and acceptable for overweight or obese AA women. Preliminary efficacy was established for most physical and psychosocial outcomes. However, more research is needed to identify specific program components contributing to healthy lifestyle behavior change and to establish program efficacy and effectiveness. Culturally adapted community-based biopsychosocial interventions using ketogenic nutrition therapy may help improve cardiovascular health of adult AA women.

Comparison of Dietary Patterns and Daily Food Intake Across Kidney Disease Stages in England: An A-Posteriori Cluster Analysis

ObjectiveDietary patterns are rapidly becoming a major focus of medical nutrition therapy in CKD and the analysis of dietary patterns has emerged as a practical approach to evaluate qualitative as well as quantitative aspects of overall diet. In an a-posteriori data-driven approach, dietary patterns are based on the actual food intake of the population evaluated. Investigation of dietary patterns in CKD are not well described, and, to our knowledge, have not been conducted in a UK-based cohort. MethodsAdult participants with a diagnosed kidney condition (CKD 1-5 not requiring dialysis) were recruited into a multi-centre observational cross-sectional study. Dietary intake was assessed using the European Prospective Investigation of Cancer in Norfolk Food Frequency Questionnaire. Logistic Principal Components Analysis was used to identify food group clusters. Differences between groups were assessed using univariate general linear modelling. ResultsIn total, 696 patients were included. The mean age was 64.7 (±14.0) years, 61% of the cohort were male. Most participants were White British (89%). The mean eGFR was 36.6 (±20.9) ml/min/1.732. We found differences in food group intake across stages (e.g., greater intake of nuts and seeds intake in CKD 1-2 versus CKD 4) and across sex (e.g., females had a higher intake of fruit and vegetables versus males). Comparison with the reference cohort revealed that, overall, the CKD cohort had reduced intakes of food stuffs such as cereals and cereal products, but higher intakes of groups such as meat and meat products. There were limited differences in micronutrients, although Vitamin B2 and calcium were higher in earlier stages. ConclusionOverall, the findings from a novel a-posteriori approach underline the complex diversity of food patterns in CKD. The findings from our study may inform dieticians and other healthcare providers about the need to consider treatment modalities and stages when giving dietary recommendations.

Sustainable Eating in Medical Nutrition Therapy for Type 2 Diabetes – A Qualitative Exploration of Clinical Practice Guidelines and Patient Education Resources

Sustainable Eating in Medical Nutrition Therapy for Type 2 Diabetes – A Qualitative Exploration of Clinical Practice Guidelines and Patient Education Resources

Effectiveness of Medical Nutrition Therapy Provided by Dietitians in Adults With Malnutrition: A Systematic Review

Effectiveness of Medical Nutrition Therapy Provided by Dietitians in Adults With Malnutrition: A Systematic Review

Expert consensus on clinical practice of parenteral nutrition therapy for critically ill patients in China (2024)

Critical patients have a high incidence of malnutrition, which can lead to adverse outcomes such as infections and ICU-acquired weakness. Improving the nutritional status of critically ill patients is currently an important challenge. Parenteral nutrition (PN) is an important component of medical nutrition, but there is still much controversy over how to implement a reasonable and standardized PN for critically ill patients. To further standardize the PN strategy for critically ill patients, the Critical Care Medicine Branch of the Zhejiang Medical Association convened experts in the field of critical care medicine and formulated the Expert consensus on clinical practice of parenteral nutrition therapy for critically ill patients in China (2024). This consensus is based on the GRADE evidence quality grading standard, problem oriented, and summarizes evidence-based medicine evidence from multiple aspects such as PN timing, suitable population, nutritional plan, and ingredient ratio, providing professional suggestions for the standardization and implementation of PN in clinical nutrition practice.

Ability To Meet Enteral Nutritional Therapy Goals With a 100%-Whey Protein Peptide-Based Formula With Prebiotic Ingredient

Ability To Meet Enteral Nutritional Therapy Goals With a 100%-Whey Protein Peptide-Based Formula With Prebiotic Ingredient

Dietary consumption patterns in breast cancer survivors: Pilot evaluation of diet, supplements and clinical factors

PurposeAdherence to dietary intake guidelines is recommended for optimal nutrition and outcomes in breast cancer survivors. The purpose of this study was to examine dietary quality in a cohort of breast cancer survivors related to current guidelines, guiding further education-based research. MethodsThis exploratory evaluation examined compliance with current dietary guidelines. Data collected included demographics, medical histories and repeated, three-day 24-h dietary recalls. Women with early-stage breast cancer (n = 97) who completed breast cancer treatment between 6 and 24 months were recruited. Descriptive statistics and frequencies were calculated for demographic and lifestyle characteristics, reported fish consumption, body mass index categories, supplement consumption, and adequacy of macronutrient and micronutrient consumption (classified as below, meeting, or exceeding needs). ResultsIn this cohort, 28.9% were classified as overweight and 35% were obese. The mean dietary macronutrient consumption was 44.3% (±8.9%) carbohydrates, 36.6% (±7.3%) fat, and 17.3% (±4.7%) protein. Additionally, 32.3% participants consumed >45 g sugar/d. The mean n-6 to n-3 ratio was 8.0 (±3.3):1. Further, 38% of survivors reported consuming less than 1 serving of fish per week. Participants consumed between 0 and 1.03 servings of fish per day, with an average consumption of 0.16 (±0.26) servings per day and 61.5% (n = 59) consuming 0 servings per day. The mean daily combined dietary and supplement consumption of multiple micronutrients was below the Recommended Daily Allowance for Vitamin D (30%), Calcium (52.6%), Magnesium (42.1%), and Vitamin E (80%). ConclusionBreast cancer survivors 0.5–2 years post-treatment are not meeting recommended nutrition consumption guidelines for a number of nutrients. Findings suggested that nutrition therapy targeting weight loss through reduced sugar, total and saturated fat, while increasing foods rich in omega-3, and ensuring adequate micronutrient consumption would promote better nutritional consumption patterns and improve overall health during survivorship.

Chinese expert consensus on perioperative nutritional support for elderly surgical patients (2024)

The increasing aging population in China leads to an increase in the number of elderly patients undergoing surgical procedures. Elderly patients are characterized with conditions such as multiple comorbidities, high nutritional risk, frailty, decreased organ function, etc. Nutritional support is one of the most significant elements in the perioperative period of elderly surgical patients. Currently, there is a lack of guidelines or expert consensus on nutritional support. To promote the standardized development of clinical work in this field, the Geriatric Surgery Professional Committee of the Chinese Research Hospital Association gathered experts and formulated relevant recommendations for perioperative nutritional therapy for elderly surgical patients based on existing research evidence. This consensus included several parts: preoperative nutritional assessment, indications, goals, ingredients and approaches of perioperative nutritional support, nutritional complications and management, nutritional intervention for surgical complications, and nutritional follow-up. It is expected to provide valuable suggestions for standardizing nutritional support for elderly surgical patients.

Intensive Medical Nutrition Therapy at a Community Clinic Serving Hispanic Immigrants Is Effective for Weight Management

Intensive Medical Nutrition Therapy at a Community Clinic Serving Hispanic Immigrants Is Effective for Weight Management

Monitoring for providing optimal nutrition therapy in critically ill patients

Monitoring for providing optimal nutrition therapy in critically ill patients

Predictors of Insulin Therapy Requirement in Gestational Diabetes: A Cohort Study

Managing Gestational Diabetes Mellitus (GDM) typically involves a combination of dietary control and/or Antenatal Insulin Therapy (AIT). The aim of this study was to evaluate the efficiency of diverse maternal characteristics and biological indicators identified during GDM diagnosis in anticipating the requirement for AIT to achieve glucose targets. It is a retrospective longitudinal study that included women diagnosed with GDM. A cohort of 380 women was examined, and a range of demographic and medical variables were evaluated. The average age in our patient group was 34 ± 5 years, ranging from 20 to 46 years. Among them, 73% needed AIT, while 100 patients achieved glycemic goals solely through Medical Nutrition Therapy (MNT). Notably, those requiring insulin had prior history of obesity (24%), gestational diabetes (12%), and macrosomia (18%) (p=10-3). The average hemoglobin level was 12.4 g/dl, and none of our patients were anemic. Patients meeting glycemic targets via MNT had higher total carbohydrate intake upon GDM diagnosis (p=0.02). Those necessitating AIT were diagnosed at an average gestational age (GA) of 24±6 weeks, significantly earlier than the 25±6 weeks observed in patients following MNT (p &lt; 10-3). Recognizing the diverse spectrum of glucose intolerance severity among women with GDM necessitates a stratified classification for management strategies. Notably, a higher HbA1C at diagnosis signals the potential need for intensified monitoring by specialized healthcare providers.

Physiological Mechanisms by Which the Functional Ingredients in Beer Impact Human Health.

Nutritional therapy, for example through beer, is the best solution to human chronic diseases. In this article, we demonstrate the physiological mechanisms of the functional ingredients in beer with health-promoting effects, based on the PubMed, Google, CNKI, and ISI Web of Science databases, published from 1997 to 2024. Beer, a complex of barley malt and hops, is rich in functional ingredients. The health effects of beer against 26 chronic diseases are highly similar to those of barley due to the physiological mechanisms of polyphenols (phenolic acids, flavonoids), melatonin, minerals, bitter acids, vitamins, and peptides. Functional beer with low purine and high active ingredients made from pure barley malt, as well as an additional functional food, represents an important development direction, specifically, ginger beer, ginseng beer, and coix-lily beer, as consumed by our ancestors ca. 9000 years ago. Low-purine beer can be produced via enzymatic and biological degradation and adsorption of purines, as well as dandelion addition. Therefore, this review paper not only reveals the physiological mechanisms of beer in overcoming chronic human diseases, but also provides a scientific basis for the development of functional beer with health-promoting effects.

BCLA CLEAR presbyopia: Management with scleral techniques, lens softening, pharmaceutical and nutritional therapies

The aging eye undergoes the same progressive crosslinking which occurs throughout the body, resulting in increased rigidity of ocular connective tissues including the lens and the sclera which impact ocular functions. This offers the potential for a scleral treatment that is based on restoring normal biomechanical movements. Laser Scleral Microporation is a laser therapy that evaporates fractional areas of crosslinked tissues in the sclera, reducing ocular rigidity over critical anatomical zones of the accommodation apparatus, restoring the natural dynamic range of focus of the eye.Although controversial and challenged, an alternative theory for presbyopia is Schachar’s theory that suggests a reduction in the space between the ciliary processes and the crystalline lens. Widening of this space with expansion bands has been shown to aid near vision in people with presbyopia, a technique that has been used in the past but seems to be obsolete now.The use of drugs has been used in the treatment of presbyopia, either to cause pupil miosis to increase depth of focus, or an alteration in refractive error (to induce myopia in one eye to create monovision). Drugs and laser ablation of the crystalline lens have been used with the aim of softening the hardened lens. Poor nutrition and excess exposure to ultraviolet light have been implicated in the onset of presbyopia. Dietary nutritional supplements, lifestyle changes have also been shown to improve accommodation and the question arises whether these could be harnessed in a treatment for presbyopia as well.