Nutritional Pathways Research Articles

Research Progress on Enteral Nutrition in Patients with Esophageal Cancer

Patients with esophageal cancer often experience symptoms such as dysphagia due to the progression of the disease, resulting in insufficient intake and energy consumption caused by their own diseases. Eventually, this leads to malnutrition, decreased immunity, increased inflammation levels, and affects the quality of life. After surgery, negative nitrogen balance is also caused by factors such as surgical trauma and stress. Therefore, enteral nutrition has become a nutritional support method for patients with esophageal cancer. To promote better development in the field of enteral nutrition research for patients with esophageal cancer, this article summarizes the research status in this field through literature review and data access. It elaborates from aspects such as the nutritional status of patients, enteral nutrition pathways, and the timing of implementing enteral nutrition, summarizes its advantages and disadvantages, promotes further development in this field, and provides more effective and safe enteral nutrition plans for patients with esophageal cancer.

Association between consensus-based nutrition pathway and growth faltering in infants with gastroschisis: A retrospective cohort study.

The University of California Fetal Consortium published that 55% of infants with gastroschisis develop growth faltering by hospital discharge. To address this problem, we developed a nutrition pathway emphasizing (1) early provision of parenteral macronutrients, (2) use of human milk, and (3) growth faltering treatment. This study's goals were to assess adherence to and efficacy of this pathway in infants with gastroschisis across six California hospitals. In 2015, the consortium standardized the care for infants with gastroschisis. To decrease growth faltering rates, between 2019 and 2020, nutrition guidelines were proposed, discussed, revised, and initiated. This study's primary outcome was weight or linear growth faltering (z score decline ≥0.8 in weight or length) at hospital discharge. Adherence measures were assessed. One hundred twenty-six infants with gastroschisis were born prepathway; 52 were born postpathway. Median gestational age was similar between cohorts. Adherence to components of the pathway ranged from 58% to 95%. The proportion of infants with weight or linear growth faltering at discharge was lower after pathway initiation (59.4% vs 36.2%, P = 0.0068). Adjusting for gestational age and fetal growth restriction, the pathway was associated with decreased weight or linear growth faltering (odds ratio [OR] 0.35 [0.16-0.75], P = 0.0060) and decreased linear growth faltering (OR 0.24 [0.096-0.56], P = 0.0062) at discharge. Hypertriglyceridemia, cholestasis, and days to full feeds were similar to published cohorts. Fewer infants with gastroschisis experienced weight or length growth faltering at hospital discharge following the implementation of a multicenter nutrition pathway.

Integrating “fast” and “slow” systems therapeutics for physiological renormalization in neurodegenerative disorders

In our previous paper, we provided evidence that simultaneously activating multiple cannabinergic pathways, CB1 and CB2, a systems therapeutic approach, was harnessed to provide “fast” protection from neurodegenerative diseases by renormalizing the physiology of the retina. We had used an animal model of glaucoma, using glutamate-induced neurodegeneration of the retina. Other forms of chronic or acute neurotoxicity throughout the CNS may likewise benefit from a systems approach to cannabinergic mediated rescue of neural tissue. However, from a systems biology perspective, cannabinergic pathways act in many ways, not fully explained in our previous paper, and must act in synergy with many other pathways, including the molecules (e.g. HSP) released by adjacent stem cells, to optimally yield neuroprotection. In addition to the “fast” pathways previously described, we’ll address “slow” acting, lifestyle and nutritional pathways too. Building on our previous paper, we highlight some of the important “fast and “slow” neuroprotective pathways that should be activated together through a systems therapeutic approach.

Survival study of enteral and parenteral nutrition pathways in critically ill patients receiving vasopressors: an analysis of the Medical Information Mart for Intensive Care-IV database.

This study compared survival outcomes between intensive care unit (ICU) patients receiving enteral nutrition (EN) and parenteral nutrition (PN) with vasopressor support, explored risk factors affecting clinical outcomes and established an evaluation model. Data from 1046 ICU patients receiving vasopressor therapy within 24 h from 2008 to 2019 were collected. Patients receiving nutritional therapy within 3 d of ICU admission were divided into EN or PN (including PN+EN) groups. Cox analysis and regression were used to determine relevant factors and establish a nomogram for predicting survival. The 28-d survival rate was significantly better in the EN group compared with the PN/PN+EN group. Risk factors included age, peripheral capillary oxygen saturation, red cell distribution width, international normalised ratio, potassium level, mean corpuscular Hg, myocardial infarction, liver disease, cancer status and nutritional status. The nomogram showed good predictive performance. In ICU patients receiving vasopressor drugs, patients receiving EN had a better survival rate than PN. Our nomogram had favourable predictive value for 28-d survival in patients. However, it needs further validation in prospective trials.

EP359 - Introduction of a pathway to improve post operative nutrition for patients undergoing a Whipple procedure - a closed loop audit

Abstract Aim Adequate nutrition in the post operative phase is an essential part of recovery following pancreaticoduodenectomy. A pathway was introduced in the regional hepatobiliary unit to standardise post operative nutrition for this patient group. Methods Three audit cycles were completed by retrospective data collection following each intervention. The first cycle was completed between March and May 2023 (n=9). The nutrition pathway was then updated so patients were on the same oral pathway regardless of whether they received parenteral nutrition or not. The second cycle was completed from May-June 2023 (n=8) and a third cycle was completed from August-October 2023 (n=7) after an education session with surgical trainees by a registered dietitian. Results Day 1 of the pathway and prescribing of CREON and supplements were consistently done well. Improvements were seen in adherence to the pathway at day 2 (22%/75%/57%) and day 3 (11%/63%/43%) post op, median number of days to establishing soft diet (from 8 to 5), median day to stopping parenteral nutrition (from 9 to 6) and median length of stay reduced from 15 to 10 days. Conclusion Adhering to a post operative nutritional pathway for patients following pancreaticoduodenectomy establishes patients on oral nutrition earlier, allowing for earlier stopping of parenteral nutrition (and thus removal of central venous access) and facilitating earlier discharge from hospital. Future work will involve re-audit with a larger cohort and incorporating education on the pathway into the biannual induction to the unit for trainees.

Evaluating food security and nutritional pathways of rural farm families: Empirical evidence from northeast India

The study aimed to ascertain a relationship between agricultural status, socioeconomic factors, and nutrition of farm families. The study was conducted in selected villages in the West Garo Hills district of Meghalaya, using Stratified Random Sampling (St. RS). Using pretested interview schedules, we collected primary data from respondents in 2020 and 2021, focusing on socioeconomic variables, body mass index, and income from agriculture and related sectors. The data was analysed using correlation analyses and separate combined regression estimates for each year and month were obtained. Results from the study indicate that agricultural income significantly influenced nutritional status (p < 0.05) and household income growth was also found significant. The region's agricultural production of cereals, pulses, and vegetables was insufficient, as was the production of meat and meat products, milk, and milk products. Hence, expenditure towards purchasing the above food groups from the market was found to be significant (p < 0.05). Therefore, the markets near the mainland especially in the hilly region play a crucial role in the nutritional pathway of rural farm families.

Targeting Syntaxin1A via RNA interference inhibits feeding and midgut development in Locusta migratoria.

Syntaxin1A (Syx1A) has diverse and indispensable functions in animals. Previous studies have mainly focused on the roles of Syx1A in Drosophila, and so how Syx1A operates during the development of other insects remains poorly understood. This study investigated whether disrupting LmSyx1A using RNA interference (RNAi) affects the growth and development of Locusta migratoria. LmSyx1A was expressed in all tissues tested, with the highest expression observed in the fat body. After 5th-instar nymphs were injected with double-stranded LmSyx1A (dsLmSyx1A), none of the nymphs were able to molt normally and all eventually died. The silencing of LmSyx1A resulted in the cessation of feeding, body weight loss, and atrophy of the midgut and gastric cecum in locusts. Hematoxylin and eosin (H&E) staining showed that the columnar cells in the midgut were severely damaged, with microvilli defects visible in dsLmSyx1A-injected nymphs. Secretory vesicles were observed with transmission electron microscopy (TEM). In addition, reverse transcription quantitative polymerase chain reaction (RT-qPCR) further indicates that silencing LmSyx1A repressed the expression of genes involved in the insulin/mammalian target of rapamycin (mTOR)-associated nutritional pathway. Taken together, these results suggest that LmSyx1A significantly affects the midgut cell layer of locust nymphs, which was partially associated with the downregulation of the insulin/mTOR-associated nutritional pathway. Thus, we argue that LmSyx1A is a suitable target for developing dsRNA-based biological pesticides for managing L.migratoria.

Curcumin effects on age-related changes in oral immunity: an in vivo study.

The current study aimed to investigate the effects of ageing on oral immunity using β-defensin (DEFB) 1/2 as a marker and evaluate the effects of curcumin (CUR) on these processes. The study sample included thirty male C57BL/6J mice divided into three groups based on the treatment method used. The young control (YC) and old control (OC) groups received 0·5 % methylcellulose-400 (CUR vehicle) orally for 5 days, whereas the CUR group of older mice received a CUR solution suspended in 0·5 % methylcellulose-400 (dose: 3·0 mg/kg body). DEFB1/2 and immune indicator levels were measured in the saliva and salivary glands post-treatment. The saliva volume and protein content were significantly reduced in the OC group compared with the YC group. CUR administration restored these parameters, decreased DEFB1 expression in the salivary gland and increased DEFB1/2 secretion and DEFB2 expression. These findings were supported by epigenetic gene regulation and partial cytokine activation from changes in WD40 repeat protein 5, TNF alpha and IL-1beta. CUR can partially restore age-related changes in oral immune responses and promote oral health, thereby preventing frailty in the older population through a nutritional therapeutic pathway.

The Longitudinal Relationship between Edentulism and the Progress of Multimorbidity.

To examine the longitudinal relationship between edentulism, nutritional intake, and the progress of multimorbidity among older Americans. We used data from the Health and Retirement Study (2006-2018), a longitudinal survey of older Americans that has collected data biennially since 1992. Edentulism was assessed in 2006 while nutritional intake was assessed in 2013. Multimorbidity was indicated by five self-reported chronic conditions: diabetes, heart conditions, lung diseases, cancer, and stroke. Individuals with two or more conditions at baseline were excluded from the analysis. Nutritional intake was calculated by summing 10 nutrients (protein, vitamins C, D, B12 and E, calcium, zinc, polyunsaturated fatty acids, folate, and ß-carotene). Structural equation modelling (SEM) was used to examine the nutritional pathway between edentulism (2006) and the increase in multimorbidity from 2006 to 2018. The number of individuals included in the analysis was 3463. The incidence of multimorbidity between 2006 and 2018 was 24.07%, while the percentage of edentate participants in 2006 was 16.42%. The mean total nutrition in 2013 was 4.50 (4.43, 4.55). The SEM analysis showed that edentulism was negatively associated with nutritional intake {estimate -0.15 (95%CI: -0.30, -0.01)}. A negative association was found between total nutrition and multimorbidity {estimate -0.008 (95%CI: -0.01, -0.002)}. Age, wealth, and smoking were included in the analysis and had statistically significant associations with multimorbidity. The analysis demonstrated a longitudinal association between edentulism, nutritional intake, and the progress of multimorbidity.

Role of Nutrition in Alzheimer’s Disease and Nutrify Genie AI Tool Uses for the Discovery of Nutritional Pathways Related to Solutions and Its Significance

Role of Nutrition in Alzheimer’s Disease and Nutrify Genie AI Tool Uses for the Discovery of Nutritional Pathways Related to Solutions and Its Significance

Rbpms2 promotes female fate upstream of the nutrient sensing Gator2 complex component Mios

Reproductive success relies on proper establishment and maintenance of biological sex. In many animals, including mammals, the primary gonad is initially ovary biased. We previously showed the RNA binding protein (RNAbp), Rbpms2, is required for ovary fate in zebrafish. Here, we identified Rbpms2 targets in oocytes (Rbpms2-bound oocyte RNAs; rboRNAs). We identify Rbpms2 as a translational regulator of rboRNAs, which include testis factors and ribosome biogenesis factors. Further, genetic analyses indicate that Rbpms2 promotes nucleolar amplification via the mTorc1 signaling pathway, specifically through the mTorc1-activating Gap activity towards Rags 2 (Gator2) component, Missing oocyte (Mios). Cumulatively, our findings indicate that early gonocytes are in a dual poised, bipotential state in which Rbpms2 acts as a binary fate-switch. Specifically, Rbpms2 represses testis factors and promotes oocyte factors to promote oocyte progression through an essential Gator2-mediated checkpoint, thereby integrating regulation of sexual differentiation factors and nutritional availability pathways in zebrafish oogenesis.

Cognition of diet quality and dietary management in elderly patients with coronary and other atherosclerotic vascular disease in western China, a qualitative research study

BackgroundHealthy eating is one of the most important nonpharmacologic treatments for patients with atherosclerosis(AS). However, it is unclear how elderly AS patients in western China perceive their dietary status and which type of nutritional assistance they would be willing to receive. Therefore, the primary purpose of this study was to understand the level of knowledge about current dietary habits and healthy eating habits among elderly AS patients in western China, and the secondary purpose was to identify acceptable nutritional assistance measures or pathways for those patients to help them manage disease progression.MethodsAn implementation study approach was used to recruit elderly patients with AS-related diseases in western China for semistructured interviews.Results14 participants were included in the study, and the following three themes were identified from the interviews:(1) the diet with regional characteristics; (2) low nutrition-related health literacy; (3) complex attitudes towards nutritional assistance. Most participants had misconceptions about healthy eating, and the sources of their knowledge might not be trustworthy. Participants expressed a preference for personalized nutritional assistance, especially that provided by medical-nursing combined institutions.ConclusionPatients in western China need nutritional assistance for their regional dietary habits; therefore, healthy dietary patterns consistent with the regional culture are proposed to improve the prevailing lack of knowledge about healthy diets, improve the dietary structure of patients, and control the development of the disease.

1965-LB: Metabolomic and Transcriptomic Signatures of Gestational Diabetes Mellitus (GDM) Suggest Nutritional and Inflammatory Pathways in Intergenerational Transfer of Risk

1965-LB: Metabolomic and Transcriptomic Signatures of Gestational Diabetes Mellitus (GDM) Suggest Nutritional and Inflammatory Pathways in Intergenerational Transfer of Risk

Perioperative nutrition optimization: a review of the current literature†

Abstract Objective This article aims to elaborate the recent research status of perioperative nutrition optimization, in order to help clinical practice. Methods This study employed a comprehensive and systematic method to search prominent databases, including PubMed and Web of Science, using carefully selected keywords. Following meticulous screening, the inclusion of high-quality studies was prioritized, and a thorough review of the references was conducted to comprehensively analyze the latest evidence on perioperative nutrition optimization. Results The main contents include preoperative nutritional risk screening and assessment, nutritional support pathway, immune enhancing nutrition, preoperative and postoperative nutritional management, as well as personalized nutrition optimization strategies for specific populations (such as children, bariatric surgery patients, and cancer patients). Conclusions In clinical practice, the importance of perioperative nutrition should be emphasized, and personalized nutrition management plans should be developed based on the characteristics and needs of patients. Further research and promotion of perioperative nutrition optimization strategies will help improve the overall prognosis and quality of life of surgical patients.

Nutrition pathway redesign for oesophagogastric (OG) cancer: success from effective collaboration and digital innovation

Nutrition pathway redesign for oesophagogastric (OG) cancer: success from effective collaboration and digital innovation

An agricultural livelihood intervention is associated with reduced HIV stigma among people with HIV.

HIV stigma undermines antiretroviral treatment (ART) adherence and viral suppression. Livelihood interventions may target drivers of negative attitudes towards people with HIV (PWH) by improving their health and strengthening their economic contributions. We examined the effects of a multisectoral agricultural livelihood intervention on HIV stigma among PWH in western Kenya. Sixteen health facilities were randomly allocated (1 : 1) to intervention or control arms in Shamba Maisha , a cluster randomized controlled trial that aimed to improve HIV-related health through behavioral, mental health, and nutritional pathways. The intervention included a farming loan and agricultural and financial training. Participants had access to farmland and surface water and were at least 18 years old, on ART for more than 6 months, and moderately-to-severely food insecure. We measured internalized, anticipated, and enacted HIV stigma semiannually over 2 years using validated scales. In blinded intent-to-treat analyses, we compared changes in scores over 24 months by study arm, using longitudinal multilevel difference-in-differences linear regression models that accounted for clustering. Of 720 enrolled participants (354 intervention), 55% were women, and the median age was 40 years [interquartile range 34-47 years]. Two-year retention was 94%. Compared with the control arm, the intervention resulted in significant decreases ( P < 0.001) of 0.42 points [95% confidence interval (CI) -0.52 to -0.31) in internalized stigma, 0.43 points (95% CI -0.51 to -0.34) in anticipated stigma, and 0.13 points (95% CI -0.16 to -0.09) in enacted stigma over 24 months. The agricultural livelihood intervention reduced HIV stigma among PWH. Poverty-reduction approaches may be a novel strategy for reducing HIV stigma.

Comprehensive Multi-Omic Evaluation of the Microbiota and Metabolites in the Colons of Diverse Swine Breeds.

Pigs stand as a vital cornerstone in the realm of human sustenance, and the intricate composition of their intestinal microbiota wields a commanding influence over their nutritional and metabolic pathways. We employed multi-omic evaluations to identify microbial evidence associated with differential growth performance and metabolites, thereby offering theoretical support for the implementation of efficient farming practices for Tibetan pigs and establishing a robust foundation for enhancing pig growth and health. In this work, six Duroc × landrace × yorkshi (DLY) pigs and six Tibetan pigs were used for the experiment. Following humane euthanasia, a comprehensive analysis was undertaken to detect the presence of short-chain fatty acids (SCFAs), microbial populations, and metabolites within the colonic environment. Additionally, metabolites present within the plasma were also assessed. The outcomes of our analysis unveiled the key variables affecting the microbe changes causing the observed differences in production performance between these two distinct pig breeds. Specifically, noteworthy discrepancies were observed in the microbial compositions of DLY pigs, characterized by markedly higher levels of Alloprevotella and Prevotellaceae_UCG-003 (p < 0.05). These disparities, in turn, resulted in significant variations in the concentrations of acetic acid, propionic acid, and the cumulative SCFAs (p < 0.05). Consequently, the DLY pigs exhibited enhanced growth performance and overall well-being, which could be ascribed to the distinct metabolite profiles they harbored. Conversely, Tibetan pigs exhibited a significantly elevated relative abundance of the NK4A214_group, which consequently led to a pronounced increase in the concentration of L-cysteine. This elevation in L-cysteine content had cascading effects, further manifesting higher levels of taurine within the colon and plasma. It is noteworthy that taurine has the potential to exert multifaceted impacts encompassing microbiota dynamics, protein and lipid metabolism, as well as bile acid metabolism, all of which collectively benefit the pigs. In light of this, Tibetan pigs showcased enhanced capabilities in bile acid metabolism. In summation, our findings suggest that DLY pigs excel in their proficiency in short-chain fatty acid metabolism, whereas Tibetan pigs exhibit a more pronounced competence in the realm of bile acid metabolism. These insights underscore the potential for future studies to leverage these breed-specific differences, thereby contributing to the amelioration of production performance within these two distinct pig breeds.

Effect of patient-specific factors on regeneration in lumbar spine at healthy disc and total disc replacement. Computer simulation

Background and ObjectiveDegenerative diseases of the spine have a negative impact on the quality of life of patients. This study presents the results of numerical modelling of the mechanical behaviour of the lumbar spine with patient-specific conditions at physiological loads. This paper aims to numerically study the influence of degenerative changes in the spine and the presence of an endoprosthesis on the creation of conditions for tissue regeneration. MethodsA numerical model of the mechanical behaviour of lumbar spine at healthy and after total disc replacement under low-energy impacts equivalent to physiological loads is presented. The model is based on the movable cellular automaton method (discrete elements), where the mechanical behaviour of bone tissue is described using the Biot poroelasticity accounting for the presence and transfer of interstitial biological fluid. The nutritional pathways of the intervertebral disc in cases of healthy and osteoporotic bone tissues were predicted based on the analysis of the simulation results according to the mechanobiological principles. ResultsSimulation of total disc replacement showed that osseointegration of the artificial disc plates occurs only in healthy bone tissue. With total disc replacement in a patient with osteoporosis, there is an area of increased risk of bone resorption in the near-contact area, approximately 1 mm wide, around the fixators. Dynamic loads may improve the osseointegration of the implant in pathological conditions of the bone tissue. ConclusionsThe results obtained in the case of healthy spine and osteoporotic bone tissues correspond to the experimental data on biomechanics and possible methods of IVD regeneration from the position of mechanobiological principles. The results obtained with an artificial disc (with keel-type fixation) showed that the use of this type of endoprosthesis in healthy bone tissues allows to reproduce the function of the natural intervertebral disc and does not contribute to the development of neoplastic processes. In the case of an artificial disc with osteoporosis of bone tissues, there is a zone with increased risk of tissue resorption and development of neoplastic processes in the area near the contact of the implant attachment. This circumstance can be compensated by increasing the loading level.

Molecular landscape of glucose metabolism in glioblastoma and the normal human brain: A narrative review

Glioblastoma multiforme (GBM) is one of the most aggressive tumors known to occur in the brain. Metabolism is one of the driving factors enabling the successful proliferation of tumor cells, thus increasing the tumor mass. Tumor metabolism is now recognized as a major hallmark of oncogenesis. Since the brain largely relies on its glucose supply for growth, glucose metabolism significantly contributes to oncogenesis in brain cancers. Here, we review the major metabolic pathways seen in normal brain physiology in addition to the Warburg effect, aberrant tricarboxylic acid cycle, and oxidative phosphorylation observed in GBM. We highlight the important differences in glucose metabolism between the normal and cancerous environments. In addition, we provide insights into lactate shuttling, the pentose phosphate pathway, and immune interactions with glucose metabolism, which drive the nutritional pathways in both the normal and cancerous environment.

RNA interference-mediated silencing of coat protein II (COPII) genes affects the gut homeostasis and cuticle development in Locusta migratoria

The coat protein II (COPII) complex consists of five primary soluble proteins, namely the small GTP-binding protein Sar1, the inner coat Sec23/Sec24 heterodimers, and the outer coat Sec13/Sec31 heterotetramers. COPII is essential for cellular protein and lipid trafficking through cargo sorting and vesicle formation at the endoplasmic reticulum. However, the roles of COPII assembly genes remain unknown in insects. In present study, we identified five COPII assembly genes (LmSar1, LmSec23, LmSec24, LmSec13 and LmSec31) in Locusta migratoria. RT-qPCR results revealed that these genes showed different expression patterns in multiple tissues and developmental days of fifth-instar nymphs. Injection of double-stranded RNA against each LmCOPII gene induced a high RNAi efficiency, and considerably suppressed feeding, and increased mortality to 100 %. Results from the micro-sectioning and hematoxylin–eosin staining of midguts showed that the brush border was severely damaged and the number of columnar cells was significantly reduced in dsLmCOPII-injected nymphs, as compared with the control. The dilated endoplasmic reticulum phenotype of columnar cells was observed by transmission electron microscopy. RT-qPCR results further indicated that silencing any of the five genes responsible for COPII complex assembly repressed the expression of genes involved in insulin/mTOR-associated nutritional pathway. Therefore, COPII assembly genes could be promising RNAi targets for insect pest management by disrupting gut and cuticle development.