Nutritional Tool Research Articles

Usefulness of Gastrojejunostomy Prior to Fundoplication in Severe Gastro-Esophageal Reflux Complicating Long-Gap Esophageal Atresia Repair: A Preliminary Study

Background: Gastro-esophageal reflux disease (GERD), requiring surgical correction, and nutritional problems are reported after long-gap esophageal atresia (LGEA) repair and might jeopardize the postoperative course in some babies. We report an exploratory evaluation of the role of transgastric jejunostomy (TGJ) as a temporary nutritional tool before surgery for GERD in LGEA. Methods: Seven infant patients operated on for LGEA with intra-thoracic gastro-esophageal junction (GEJ) and growth failure, requiring improvement in their nutritional profile in anticipation of surgery, were retrospectively evaluated. Post-surgical follow-up, including growth evolution, complications, and parental quality of life (QoL), were considered. Results: The TGJ was placed at a mean age of 8.6 ± 5.6 months. The procedure was uneventful and well-tolerated in all seven cases. At 6.6 ± 2.0 months after TGJ placement, significant weight gain (weight z-score −2.68 ± 0.8 vs −0.9 ± 0.2, p < 0.001) was recorded, allowing the GERD surgery to proceed. A significant difference in hospital admissions between 3 months before and post-TGJ insertion was noted (4.8 ± 0.75 vs. 1.6 ± 0.52, p < 0.01). A significant amelioration of QoL after TGJ placement was also recorded; in particular, the biggest improvements were related to parents’ perceptions of the general health and emotional state of their babies (p < 0.001). Conclusions: The placement of TGJ as a temporary nutritional tool in selected cases of LGEA could improve nutritional conditions and parental QoL before fundoplication, allowing successful surgical treatment of GERD to be carried out.

Nutrition Evaluation Screening Tool: An Easy to Use Screening Tool for Hospitalised Children.

PurposeNutrition screening is vital to ensure patients are appropriately managed in hospital. In paediatrics there is currently no universally accepted nutrition screening tool. The Nutrition Evaluation Screening Tool (NEST) was developed as an easy to use and practical screening tool for hospitalised children. We aim to evaluate compliance of the NEST and assess agreement of the NEST with the already validated nutrition screening tools, Screening Tool for Risk on Nutritional Status and Growth (STRONGkids), Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the Subjective Global Nutritional Assessment (SGNA) tool.MethodsRetrospective review of 102 patient episodes at the Evelina London Children's Hospital. Electronic records were used to assess NEST compliance and to complete the nutrition tools for each patient episode. Cohen's kappa was used to determine the level of agreement between each nutrition tool.ResultsThere was moderate agreement between the NEST and the two screening tools, STRONGkids (κ=0.472) and STAMP (κ=0.416) for patients on initial screening at admission. 87.2% of patient episodes were NEST compliant within 24 hours of admission to hospital.ConclusionThe moderate agreement between these two already validated screening tools enhances the NEST's validity as a paediatric screening tool. The NEST had the strongest correlation with the SGNA tool compared to other screening tools. The NEST is user friendly screening tool for hospitalised children.

Soybean Seed Analysis as a Nutritional Diagnostic Tool

ABSTRACT Our study examined whether the nutrient content analysis of soybean seed could be used to assess the plant nutritional status, generating results as or more accurate than those obtained by leaf analysis. We hypothesized that soybean nutritional assessment could be carried out using seeds as a reference. Nutritional diagnosis in soybean leaves and seeds was assessed using the Mathematical Chance (MCh), Diagnosis and Recommendation Integrated System (DRIS), and Compositional Nutrient Diagnosis (CND) methods. Results showed that optimal nutrient levels in soybean leaves and seeds estimated by DRIS and CND were equal or close to the average content in the reference population, while slightly different values were obtained by MCh method. Nutrient average contents were larger for soybean seeds than for leaves for nitrogen, phosphorus, sulfur, and zinc; and lower for potassium, calcium, magnesium, boron, copper, iron, and manganese. The ranges of optimum levels obtained for seed nutrient content showed normality in results for the three studied methods (MCh, DRIS, and CND). This indicates that using seeds as a diagnostic tissue for assessing soybean nutritional status is promising. Optimal nutrients levels in soybean seeds estimated mainly by the CND and DRIS methods could help to monitor soybean nutritional status.

Low serum selenium in pregnancy is associated with reduced T3 and increased risk of GDM.

Thyroid disorders are the most common endocrine disorders affecting women commencing pregnancy. Thyroid hormone metabolism is strongly influenced by selenium status; however, the relationship between serum selenium concentrations and thyroid hormones in euthyroid pregnant women is unknown. This study investigated the relationship between maternal selenium and thyroid hormone status during pregnancy by utilizing data from a retrospective, cross-sectional study (Maternal Outcomes and Nutrition Tool or MONT study) with cohorts from two tertiary care hospitals in South East Queensland, Australia. Pregnant women (n = 206) were recruited at 26-30 weeks gestation and serum selenium concentrations were assessed using inductively coupled plasma mass spectrometry. Thyroid function parameters were measured in serum samples from women with the lowest serum selenium concentrations (51.2 ± 1.2 µg/L), women with mean concentrations representative of the entire cohort (78.8 ± 0.4 µg/L) and women with optimal serum selenium concentrations (106.9 ± 2.3 µg/L). Women with low serum selenium concentrations demonstrated reduced fT3 levels (P < 0.05) and increased TPOAb (P < 0.01). Serum selenium was positively correlated with fT3 (P < 0.05) and negatively correlated with TPOAb (P < 0.001). Serum fT4 and thyroid-stimulating hormone (TSH) were not different between all groups, though the fT4/TSH ratio was increased in the low selenium cohort (P < 0.05). Incidence of pregnancy disorders, most notably gestational diabetes mellitus, was increased within the low serum selenium cohort (P < 0.01). These results suggest selenium status in pregnant women of South East Queensland may not be adequate, with possible implications for atypical thyroid function and undesirable pregnancy outcomes.

Efficacy of l-glutamic acid, N,N-diacetic acid to improve the dietary trace mineral bioavailability in broilers.

Trace minerals are commonly supplemented in the diets of farmed animals in levels exceeding biological requirements, resulting in extensive fecal excretion and environmental losses. Chelation of trace metal supplements with ethylenediaminetetraacetic acid (EDTA) can mitigate the effects of dietary antagonists by preserving the solubility of trace minerals. Lack of EDTA biodegradability, however, is of environmental concern. l-Glutamic acid, N,N-diacetic acid (GLDA) is a readily biodegradable chelating agent that could be used as a suitable alternative to EDTA. The latter was tested in sequential dose–response experiments in broiler chickens. Study 1 compared the effect of EDTA and GLDA in broilers on supplemental zinc availability at three levels of added zinc (5, 10, and 20 ppm) fed alone or in combination with molar amounts of GLDA or EDTA equivalent to chelate the added zinc, including negative (no supplemental zinc) and positive (80 ppm added zinc) control treatments. Study 2 quantified the effect of GLDA on the availability of native trace mineral feed content in a basal diet containing no supplemental minerals and supplemented with three levels of GLDA (54, 108, and 216 ppm). In study 1, serum and tibia Zn clearly responded to the increasing doses of dietary zinc with a significant response to the presence of EDTA and GLDA (P < 0.05). These results are also indicative of the equivalent nutritional properties between GLDA and EDTA. In study 2, zinc levels in serum and tibia were also increased with the addition of GLDA to a basal diet lacking supplemental trace minerals, where serum zinc levels were 60% higher at the 216 ppm inclusion level. Similar to the reported effects of EDTA, these studies demonstrate that dietary GLDA may have enhanced zinc solubility in the gastrointestinal tract and subsequently enhanced availability for absorption, resulting in improved nutritional zinc status in zinc-deficient diets. As such, GLDA can be an effective nutritional tool to reduce supplemental zinc levels in broiler diets, thereby maintaining health and performance while reducing the environmental footprint of food-producing animals.

Entomophagy: an innovative nutritional and economic navigational tool in race of food security

The dilemma of food security and lack of essential nutrients are two fundamental reasons that draw the world's attention towards insects as an alternative source of nutrients. Insect provide us with better quality proteins, low-fat contents as well as essential micronutrients with a high and quick source of energy than any other conventional source of food. Insect farming has been adopted by many people of different regions at domestic and commercial level because of its low input and high output. Moreover, innovation in processing techniques with effective marketing strategies made entomophagy a more viable source of food. The techno-functional properties of insect proteins make it a more reliable and sustainable source than plants and seeds proteins. Now a days, different attractive products of edible insects are present in the market which enhances its consumer acceptance. Hence, entomophagy is a viable, sustainable, cheaper and highly nutritive tool in the race of food security. Humans should prefer the production and consumption of insect’s products so that burden of crops may reduce and being healthy food, it will improve diet.

Phase Angle From Bioelectrical Impedance for the Assessment of Sarcopenia in Cirrhosis With or Without Ascites

Skeletal muscle index (SMI) from computed tomography (CT) reliably assesses sarcopenia, however, it is expensive and involves serial radiation exposure. Phase angle (PhA) from bioimpedance analysis (BIA) is a noninvasive, low cost, bedside nutritional tool used to monitor changes to nutritional interventions. We aimed to compare the performance of PhA with SMI to assess sarcopenia in cirrhosis. Ambispective cohort study. Consecutive patients with cirrhosis and available images from abdominal CT scan were included. Monofrequency BIA was performed within 2 weeks CT. Spearman's correlation, ROC curve, and survival analysis with Kaplan-Meier, Cox and competing-risk regression were performed. 136 patients were included with a mean age of 54.5 years (60% female). Most had decompensated disease (66%) with ascites in 47%, and a mean MELD of 14 ± 6. We found positive correlations between SMI and PhA (r = 0.58 , P < .001), irrespective of the presence of ascites. The AUROC of PhA-sarcopenia in all patients was 0.702; (0.748 in males,0.677 in females). The best cutoffs of PhA for diagnosing sarcopenia were ≤5.6° in males and ≤5.4° in females. SMI and PhA were significantly associated with survival in Kaplan-Meier curves. In multivariable analyses, SMI was outperformed by age and MELD, whereas PhA remained independently associated with mortality. Considering transplantation as a competing risk, regression analysis showed both SMI and PhA to be independent predictors of mortality (sHR:0.95 [0.90-0.99] and sHR:0.61 [0.42-0.88]). PhA moderately correlates with SMI for the identification of sarcopenia in patients with cirrhosis. However, its prognostic accuracy is comparable to that of SMI, and it is not influenced by ascites.

Metabolic profiling of bioactive compounds from different medicinal plants: An overview

Metabolomics has become an important tool in many research areas like drug discovery, diseases and nutrition, plant physiology, food quality and authenticity assessment, biomarker discovery, environmental and biological-stress studies, functional genomics, integrative systems biology, etc. It can be targeted or non-targeted. Metabolomics has been used as a vast tool for the investigation and quality measurement and assessment of natural products derived from plant and its parts. However, metabolite profiling in crude extracts is not an easy work as natural materials show a very diverse form of structure. It makes use of various analytical techniques like LC-QTOF-MS, GC-QTOF-MS, UPLC-QTOFMS, LC-ESI-QTOF/MS. In the present review, an attempt has been done to enlist metabolic profiling of 50 medicinal plants, along with their part, solvent used and number of bioactive compounds identified. Its various uses have also been discussed.

Starch digestibility modulation significantly improves glycemic variability in type 2 diabetic subjects: A pilot study

Background and aimsIn type 2 diabetes (T2D) patients, the reduction of glycemic variability and postprandial glucose excursions is essential to limit diabetes complications, beyond HbA1c level. This study aimed at determining whether increasing the content of Slowly Digestible Starch (SDS) in T2D patients’ diet could reduce postprandial hyperglycemia and glycemic variability compared with a conventional low-SDS diet. Methods and resultsFor this randomized cross-over pilot study, 8 subjects with T2D consumed a controlled diet for one week, containing starchy products high or low in SDS. Glycemic variability parameters were evaluated using a Continuous Glucose Monitoring System.Glycemic variability was significantly lower during High-SDS diet compared to Low-SDS diet for MAGE (Mean Amplitude of Glycemic Excursions, p < 0.01), SD (Standard Deviation, p < 0.05), and CV (Coefficient of Variation, p < 0.01). The TIR (Time In Range) [140–180 mg/dL[ was significantly higher during High-SDS diet (p < 0.0001) whereas TIRs ≥180 mg/dL were significantly lower during High-SDS diet. Post-meals tAUC (total Area Under the Curve) were significantly lower during High-SDS diet. ConclusionOne week of High-SDS Diet in T2D patients significantly improves glycemic variability and reduces postprandial glycemic excursions. Modulation of starch digestibility in the diet could be used as a simple nutritional tool in T2D patients to improve daily glycemic control. Registration numberin clinicaltrials.gov: NCT 03289494.

Benchmarking the Nutrition-Related Policies and Commitments of Major Food Companies in Australia, 2018

The food industry has an important role to play in efforts to improve population diets. This study aimed to benchmark the comprehensiveness, specificity and transparency of nutrition-related policies and commitments of major food companies in Australia. In 2018, we applied the Business Impact Assessment on Obesity and Population Level Nutrition (BIA-Obesity) tool and process to quantitatively assess company policies across six domains. Thirty-four companies operating in Australia were assessed, including the largest packaged food and non-alcoholic beverage manufacturers (n = 19), supermarkets (n = 4) and quick-service restaurants (n = 11). Publicly available company information was collected, supplemented by information gathered through engagement with company representatives. Sixteen out of 34 companies (47%) engaged with data collection processes. Company scores ranged from 3/100 to 71/100 (median: 40.5/100), with substantial variation by sector, company and domain. This study demonstrated that, while some food companies had made commitments to address population nutrition and obesity-related issues, the overall response from the food industry fell short of global benchmarks of good practice. Future studies should assess both company policies and practices. In the absence of stronger industry action, government regulations, such as mandatory front-of-pack nutrition labelling and restrictions on unhealthy food marketing, are urgently needed.

REACHING NUTRITIONAL TARGETS IN CRITICALLY ILL PATIENTS. MANAGEMENT AND MONITORING. OUR EXPERIENCE

There is growing concern about clinical nutrition in critically ill patients. The latest guidelines identify nutritional targets and monitoring tools to provide an accurate management. Objective of the study was to evaluate benefits of a standardized protocol of intensive monitoring to fulfill clinical standards. A retrospective study was conducted in 2 groups of ICU-patients hospitalized in following periods, before and after the application of the early nutritional protocol. All patients with medical conditions at admission and subject to Enteral Nutrition were included. We analysed 250 patients divided in 2 Clusters, without contraindications to Enteral Nutrition. In Cluster 1 (n=160), patient feeding was guided only by clinical judgment. In Cluster 2 (n=90), enteral nutrition was handled according to the intensive monitoring and management protocol. Demographic and severity criteria were comparable. The main results are summarised in Graph 1. Results suggest that the application of the local protocol allows to reach nutritional standards in critically ill patients and earlier feeding. Furthermore, nutritional discontinuance related to uncertain intolerance (elevated gastric residual volume, vomiting..) was drastically reduced, decreasing the number of potential underfeeding days.

Practical applications of nutritional scores.

Any intensive therapy requires individual adaptation, despite the standardization of the concepts that support them. Among these therapies, nutritional care has repeatedly been shown to influence clinical outcome. In order to evaluate the risk of malnutrition among critically ill patients and to identify those patients who may benefit from medical nutrition therapy is imperative to have a validated screening tool to optimize nutritional care.The scope of this review is to analyze the recent literature on the management of nutritional scores for patients admitted to the ICU. Critically ill patient staying for more than 24-48 h in the ICU, if unable to eat, should be considered at risk for malnutrition. Several nutritional tools have been proposed but not all are validated to screening those patients. The limitations of existing screening tools are described. Nutritional scores should be routinely performed at ICU admission according to recommended guidelines. An approach to incorporate these tools into everyday clinical practice is suggested.

The Representation of Food-Related Environments in Virtual Reality

Abstract Objectives Virtual reality (VR) potentially provides an innovative tool for nutrition education/counselling. The objective of this study was to determine the a) sense of ‘presence’ (the feeling of being in a scene) experienced in two food related VR scenes b) capture information regarding the participants experiences in VR. Methods Two 3D, food-related scenes were created for this study: supermarket or fast food restaurant. The scenes were displayed using a VR head mounted display or on a standard PC monitor. The participants were able to move around each scene and could interact with various elements to obtain nutrition information about a food. Thirty-one adults were recruited for this study and reported to the laboratory on 4 occasions separated by at least 48 hours. Participants were randomized to a treatment order. On reporting to the laboratory, the participants had surface electrodes attached to determine heart rate and electrodermal activity. The participant was then required to sit quietly for 10 minutes for baseline measures to be collected. Then, in the VR treatments, a VR headset was placed on the participants head and the relevant scene displayed. For the PC treatments, the same scenes were displayed on a PC monitor. The participants were required to remain in the different scenes for at least 5 minutes. Then, the headset was removed and the participant completed questionnaires regarding their experiences in the VR and PC scenes. Results Participants ranged in age from &amp;lt;25 years to over 65 years. All participants used computers in their daily life but generally had no or little experience in VR. Participants reported a higher sense of presence in the VR treatments compared to the PC treatments (P &amp;lt; 0.05). The VR scenes also created a greater sense of the scene being the ‘dominant reality’ and elicited a greater sense that the participant were actually in the scene (P &amp;lt; 0.05). There was no difference in the participant's ability to complete tasks in the VR and PC scenes. Moreover, feelings of nausea were not different between the VR and PC scenes. The participant's heart rate was significantly higher in the VR treatments (P &amp;lt; 0.05). Conclusions This study provides data that supports the development of VR as a nutrition education/counselling tool. Further research is required to develop VR as an effective education tool. Funding Sources None.

A Pediatric Nutrition Web Application for Health Professionals to Prevent Early Childhood Obesity

Abstract Objectives To develop a web application for health professionals to easily evaluate infant diets using a validated food frequency questionnaire (FFQ) for infants with the goal of providing customized nutrition counseling during well-child visits to ultimately improve diet and weigh gain in infants. Methods The web application was developed using the model of Analysis, Design, Development, Implementation, and Evaluation (ADDIE). The Analysis stage includes a literature review and online search for available tools to identify the gaps in infant nutrition. The Design stage includes the development of four portals: Infant FFQ, Administrative, Clinician, and Parental. The Developmental stage includes the creation of portals to complete the Infant FFQ, send results to the Administrative, and translate the data into the Clinician and Parental Portals. The Implementation stage includes pilot testing of the web application for feasibility, acceptability, and usability among clinicians and parents. The evaluation includes testing the effects of using the web application on diet and weight gain in infants. Results There are no pediatric nutrition tools available to easily evaluate infant diets. So, in collaboration with the computer science program at Florida International University (FIU), a validated infant FFQ was converted to a web application for parents to complete using a tablet during well-child visits. The results are translated into energy/nutrients and food groups consumed using nutrient/food databases. Then energy/nutrients and food groups consumed below or above the recommended amounts are calculated. This information is shown to health professionals in the Clinician Portal for counseling parents on their infant's diet. The amounts of food and beverages recommended for the infant are shown in the Parental Portal to implement at home. Conclusions The infant FFQ was translated into a web application to be used in the health care system; results are automatically shown to health professionals for appropriate counseling to parents on their infant's diet. This web application could be used to improve infant diet and prevent early childhood obesity. Funding Sources Internal funding at Florida International University.

Eicosapentaenoic Acid-Induced Inhibition of Metabolic Inflammation Is Associated with Preserved Mitochondrial Function and Insulin Sensitivity in Human Primary Myotubes

Abstract Objectives The aim of this study was to investigate whether metabolic inflammation in skeletal muscle may be prevented by eicosapentaenoic acid (EPA) and if this is associated with an improvement in markers of mitochondrial function and insulin sensitivity. Methods Human primary myotubes were treated for 24 hours with palmitic acid (PA, 500 µM) in hyperglycaemic conditions (13 mM glucose), referred to as nutrient overload, in the presence or absence of EPA (100 µM). After the treatments, the expression of peroxisome proliferator-activated receptor-γ coactivator 1-alpha (PGC1α) and interleukin-6 (IL-6) was assessed by q-PCR. Western blot was used to asses the abundance of the inhibitor of nuclear factor kappa-B (IKBα), mitochondrial electron transport chain complex proteins, the phosphorylation of AKT (Ser473) and AKT substrate 160 (AS 160) (Thr642) in response to insulin, the activation of 5'-AMP-activated protein kinase (AMPK) and the inhibition of acetyl-CoA carboxylase (ACC). Mitochondrial dynamics was assessed by immunocytochemistry. Results Nutrient excess activated the proinflammatory nuclear factor kappa-light-chain-enhancer of activated B cells (NFkB) signalling as indicated by the upregulation of IL-6 mRNA (P &amp;lt; 0.001) and a tendency to decrease in IKBα (P = 0.0654), tended to downregulate PGC1α (P = 0.0589) and promoted mitochondrial fragmentation (P &amp;lt; 0.001), all of which were counteracted by EPA. Furthermore, EPA induced complex III-core protein 2 (P &amp;lt; 0.05) relative to control cells, an effect that was absent in the myotubes exposed only to PA and hyperglycaemia. EPA, when administrated in combination with PA and hyperglycaemia, induced the phosphorylation of AMPK (P &amp;lt; 0.05) and its downstream target ACC (P &amp;lt; 0.05) relative to cells exposed to nutrient overload alone. Finally, while fuel surplus impaired insulin-induced phosphorylation of AKT (P &amp;lt; 0.01) and AS160 (P &amp;lt; 0.05), these effects were prevented by EPA. Conclusions EPA inhibited NFkB signalling which was associated with an attenuation of the deleterious effects of PA and hyperglycaemia on markers of mitochondrial function and insulin sensitivity. Thus, EPA may represent a valuable nutritional tool to preserve skeletal muscle mitochondrial function and metabolic health during periods of nutrient overload. Funding Sources CSIRO's Precision Health Future Science Platform (FSP).

Nematicidal Amendments and Soil Remediation.

The intensification of agriculture has created concerns about soil degradation and toxicity of agricultural chemicals to non-target organisms. As a result, there is great urgency for discovering new ecofriendly tools for pest management and plant nutrition. Botanical matrices and their extracts and purified secondary metabolites have received much research interest, but time-consuming registration issues have slowed their adoption. In contrast, cultural practices such as use of plant matrices as soil amendments could be immediately used as plant protectants or organic fertilizers. Herein, we focus on some types of soil amendments of botanical origin and their utilization for nematicidal activity and enhancement of plant nutrition. The mode of action is discussed in terms of parasite control as well as plant growth stimulation.

14 Do Calorie Counts Alter Care or Outcomes in Burn Patients?

Abstract Introduction Calorie counts are often used as a monitoring tool for burn nutrition and require accurate documentation by staff for the nutritionist to properly evaluate and treat the patient. The objective of this project was to determine if completion of calorie counts positively impacts patient outcomes. Methods A quality improvement project was conducted on adult burn patients at a large academic medical center from June 2018 to March 2019. All burn patients with calorie count orders and an admission weight were included. The total number of meal trays with completed calorie count documentation was calculated on a weekly basis, generating a total weekly calorie count compliance rate (CCCR). Data collected included weight change from admission to discharge, standard nutrition labs, and if nutritional interventions were changed. Results A total of 76 adult burn patients with a documented admission weight were included. The average total body surface area (TBSA) burn injury was 10.9%. Average length of stay was 1.3 days/ %TBSA. Of the 9.2% of patients with admission and discharge weights, 14% had increased discharge weight (mean CCCR 43%) and 86% had a decrease in weight (mean CCCR 48%). Weekly total protein levels were obtained in 24 patients with 46% having decreased total protein levels (0.1 to 1.1 g/dL) and a mean CCCR of 74.4%. Eight percent had no change in protein levels with a mean CCCR of 74.3% and 46% had increased total protein levels (0.1 and 0.7 g/dL) with a mean CCCR of 70%. Weekly albumin levels were obtained in 25 patients. Fifty-two percent had decreased albumin levels (0.1 to 0.9 g/dL) with a mean CCCR of 72.1%. Twenty percent had no change in albumin level, with a mean CCCR of 75.1% and 28% of patients had increased albumin levels (0.1 to 0.6 g/dL) with a mean CCCR of 69%. Weekly prealbumin serum levels were obtained in 27 patients. Fifty-six percent had decreased levels (1 to 19 mg/dL) with a mean CCCR of 74.1%. Four percent had no change in serum prealbumin, with a mean CCCR of 69%, and 41% had increased prealbumin levels (1 to 21 mg/dL) with a mean CCCR of 68%. Nutritional therapy was altered in 6% of patients by addition of oral supplementation, dietary modifications, or initiation of tube feeding. Conclusions A very small number of patients on calorie counts had any change in nutritional therapy and calorie count compliance showed no relationship with nutrition labs. However, calorie counts are labor-intensive for nursing staff. Further research should be conducted to identify which patients would benefit from daily calorie counts in the burn patient. Applicability of Research to Practice Use of evidence-based outcome measures can drive clinical practice.

Influence of dietary intake and decision-making during pregnancy on birth outcomes.

This study aimed to examine dietary intake and decision-making in a cohort of pregnant South-East Queensland women to determine compliance with dietary guidelines and the relationships between dietary intake, decision-making and birth outcomes. Pregnant women attending maternity services at participating hospitals reported food frequency and motivations using the Maternal Outcomes and Nutrition Tool, a novel digital instrument. Birth outcomes were sourced from hospital records. A cross-sectional cohort design was used to examine the data. Analysis demonstrated suboptimal intake of core food groups; meat and alternatives (median [IQR]) (2.6 [2.0-3.4] serves/day) and grains (3.1 [2.1-4.1]) fell below recommendations; fruit (3.8 [2.5-5.3]) and discretionary foods (3.1 [2.1-4.4]) exceeded them. Hypertensive disorders demonstrated a negative linear relationship with vegetable intake (P = .017). Cultural diversity was significantly associated with decreased birthweight (P = .022) but increased intake of meat and alternatives (3.1 vs 2.6, P < .001) compared to Caucasian women; median intake of meat and alternatives was lower in women who reported smoking in the examined time frame. Smokers were less likely to declare health motives for food selection than non-smokers; smoking and health were inversely associated with increasing maternal age. Food choice was primarily sensory-driven. This cohort demonstrated poor adherence to dietary guidelines. Culturally and linguistically diverse women and smokers exhibit dietary behaviours which may contribute to suboptimal birth outcomes; targeted nutrition counselling may improve outcomes in these women. These findings highlight the need for transdisciplinary maternity care and provide a foundation for further research aimed at optimising nutrition-related birth outcomes in at-risk groups.

Utilization of text mining as a big data analysis tool for food science and nutrition.

Big data analysis has found applications in many industries due to its ability to turn huge amounts of data into insights for informed business and operational decisions. Advanced data mining techniques have been applied in many sectors of supply chains in the food industry. However, the previous work has mainly focused on the analysis of instrument-generated data such as those from hyperspectral imaging, spectroscopy, and biometric receptors. The importance of digital text data in the food and nutrition has only recently gained attention due to advancements in big data analytics. The purpose of this review is to provide an overview of the data sources, computational methods, and applications of text data in the food industry. Text mining techniques such as word-level analysis (e.g., frequency analysis), word association analysis (e.g., network analysis), and advanced techniques (e.g., text classification, text clustering, topic modeling, information retrieval, and sentiment analysis) will be discussed. Applications of text data analysis will be illustrated with respect to food safety and food fraud surveillance, dietary pattern characterization, consumer-opinion mining, new-product development, food knowledge discovery, food supply-chain management, and online food services. The goal is to provide insights for intelligent decision-making to improve food production, food safety, and human nutrition.

Association Between AND-ASPEN Malnutrition Criteria and Hospital Mortality in Critically Ill Trauma Patients: A Prospective Cohort Study.

Malnutrition is prevalent in trauma victims because of intense muscle wasting triggered by traumatic events and is a mortality risk. The Academy of Nutrition and Dietetics-American Society for Parenteral and Enteral Nutrition (AND-ASPEN) tool has the potential to diagnose malnutrition in this population. This study aims to evaluate this criterion as a malnutrition diagnostic tool and as a hospital mortality predictor in critically ill trauma patients. We performed an observational prospective cohort study from April 2015 to February 2017 in a Brazilian hospital. Patients were >18 years old, remained in the intensive care unit (ICU) >48 hours, and had completed data regarding the recommended clinical characteristics (RCCs) for malnutrition. The main exposure of interest was malnutrition assessed by a specialist dietitian using AND-ASPEN. The primary outcome was all causes of mortality during hospital stay. Secondary outcome was the RCCs assessment, to predict malnutrition and hospital mortality. Included were 414 trauma patients. Malnutrition prevalence was 26.8% at ICU admission. The main analysis showed that malnutrition increases mortality chances 1.96 times (95% CI, 1.13-3.30; P = .015). Secondary analysis showed that all 5 RCCs were significantly associated with malnutrition. The only RCC associated with mortality was energy intake (odds ratio 1.5; 95% CI, 1.1-2.0; P = .008). AND-ASPEN criterion is a feasible and accurate method to recognize malnutrition and predict hospital mortality when applied by trained dietitians for the critical care trauma population. Further studies are needed considering patient subgroups such as obese and elderly.