Nutritional Supplements Research Articles

Evaluation of postoperative results after a presurgical optimisation programme

BackgroundPresurgical optimisation programmes decrease the risk of postoperative complications, reduce hospital stays and speed up patient recovery. They usually involve a multidisciplinary team addressing physical, nutritional and psychosocial issues. The objective of this study was to assess the results of implementing a presurgical optimisation programme led by a liaison nurse in patients undergoing major surgery in a primary general hospital.MethodsAn observational, retrospective, descriptive, cross-sectional, comparative study based on the revision of patients’ health records undergoing major surgery between January 2019 and December 2022. Patients entering the presurgical optimisation programme (intervention group) were compared with patients receiving usual medical care (control group). The presurgical optimisation programme consisted of oral nutritional supplementation, physical exercise, strengthening of lung capacity and psychological and emotional support. Frequency (%) of surgery complications and use of healthcare resources (duration of hospitalisation, time spent in the intensive care unit (ICU), and readmission) at day 30 were recorded. Descriptive statistics were applied.ResultsTwo hundred eleven patients (58.5% men, mean age: 65.76 years (SD 11.5), 75.2%. non-smokers; mean body mass index (BMI): 28.32 (SD 5.38); mean Nutritional Risk Score (NRS) 3.71 (SD 1.35; oncology diagnosis: 88.6%) were included: 135 in the intervention group, and 76 in the control group. The average duration of the presurgical optimisation programme was 20 days (SD 5). Frequency of postoperative complications was 25% (n = 33) in the intervention group and 52.6% (n = 40) in the control group (p < 0.001) [odds ratio (OR) = 3.4; 95% confidence interval (CI) (1.8; 6.2)]. 14.5% (n = 19) of patients in the intervention group and 34.2% (n = 26) in the control group had remote postoperative complications [OR = 3.1; 95% CI (1.6; 6.2)]. Patients in the intervention group spent fewer days in the hospital [mean 8.34 (SD 6.70) vs 11.63 (SD 10.63)], and there were fewer readmissions at 30 days (7.6% vs 19.7%) compared with the control group.ConclusionsA presurgical optimisation programme led by a liaison nurse decreases the rate of immediate and late surgical complications and reduces hospital stays and readmissions in patients undergoing major surgery.

Specialized nutritious foods and behavior change communication interventions during the first 1000 d of life to prevent stunting: a quasi-experimental study in Afghanistan

BackgroundConsiderable evidence supports the effectiveness of nutritional supplementation with or without nutrition education in preventing stunting in developing countries, but evidence from Afghanistan is scarce. ObjectivesThis project aimed to assess the effectiveness of specialized nutritious food (SNF), social and behavior change communication (SBCC) intervention to prevent stunting among children under 2 y during the first 1000 d of life in Badakhshan, Afghanistan. MethodsWe used a community-based quasi-experimental pre–post study design with a control group. Pregnant and lactating women received a monthly ration of 7.5 kg of super cereal (250 g/d) during pregnancy and the first 6 mo of breastfeeding. Children aged 6–23 mo received 30 sachets of medium-quantity lipid-based nutrient supplement (50 g/sachet/d) monthly. We compared pre- and postintervention assessments of the intervention and control groups to isolate the effect of the intervention on key study outcomes at the endline by difference-in-differences (DID) estimates. ResultsA total of 2928 and 3205 households were surveyed at baseline and endline. DID estimates adjusted for child, maternal, and household characteristics indicated a significant reduction in stunting (DID: −5% (95% confidence interval [CI]: −9.9, −0.2) and underweight (DID: −4.6% (95% CI: −8.6, −0.5) among children <2 y of age. However, DID estimates for wasting among children in the intervention and control groups were not significantly different (DID: −1.7 (95% CI: −5.1, 1.6). Furthermore, exposure to the SBCC messages was associated with improvements in the early initiation of breastfeeding (DID: 19.6% (95% CI: 15.6, 23.6), exclusive breastfeeding under 6 mo (DID: 11.0% (95% CI: 2.3, 19.7), minimum meal frequency (DID: 23% (95% CI: 17.7, 28.2), and minimum acceptable diet (DID: 13% (95% CI: 9.8, 16.3). ConclusionsThe provision of SNF in combination with SBCC during the first 1000 d of life was associated with reduction in stunting and underweight and improvements in infant and young child feeding practices among children under 2 y of age.This trial was registered at clinicaltrials.gov as NCT04581993.

Assessment of Elemental Deficiency of Crossbred Dairy Cows and Mineral Composition in Natural Feed and Nutritional Supplements in the Northern and Northwestern Provinces in Sri Lanka.

This study assessed the elemental status of cross-bred dairy cows in small holder farms in Sri Lanka, with the aim to establish the elemental baseline and identify possible deficiencies. For this purpose, 458 milk, hair, serum and whole blood samples were collected from 120 cows in four regions of Northern and Northwestern Sri Lanka, (namely Vavaniya, Mannar, Jaffna and Kurunegala). Farmers also provided a total of 257 samples of feed, which included local fodder as well as 79 supplement materials. The concentrations of As, Ca, Cd, Co, Cr, Cu, Fe, I, K, Mg, Mn, Mo, Na, Ni, Pb, Se, V and Zn were determined by inductively coupled plasma mass spectrometry (ICP-MS). Evaluation of the data revealed that all cows in this study could be considered deficient in I and Co (18.6-78.5µg L-1 I and 0.06-0.65µg L-1 Co, in blood serum) when compared with deficiency upper boundary levels of 0.70 µg L-1 Co and 50µg L-1 I. Poor correlations were found between the composition of milk or blood with hair, which suggests that hair is not a good indicator of mineral status. Most local fodders meet dietary requirements, with Sarana grass offering the greatest nutritional profile. Principal component analysis (PCA) was used to assess differences in the elemental composition of the diverse types of feed, as well as regional variability, revealing clear differences between forage, concentrates and nutritional supplements, with the latter showing higher concentrations of non-essential or even toxic elements, such as Cd and Pb.

Uses of Citrus Peels for Encouraging Food Nutrition: A Review

Orange peel (Citrus sinensis) belong to the family Rutaceae and it is well known promising source of multiple beneficial nutrients for human being. Global orange production is about 51 million metric tons. In India, area under citrus is 9.23 lakh hector which produces 86.08 lakh tones of fruits. Maharashtra is second largest state after Andhra Pradesh in the country and contributes to about 18.9 per cent to the total production of citrus in country. Orange peel obtains new healthy fruit products because peel friction has interesting and not very well known nutritional components such as Phenolic compound, Flavonoids, Dietary fiber. Part of orange such as peel and rind are used in food preparations. The peel of orange is use to make herbal tea, candied fruits peel and marmalade. Peels are regarded as waste material and is usually dried and ground to make citrus meal, a substitute cattle feed. Orange peels are also used as flavoring liqueurs, orange peel flavors is most desirable natural flavors. They are used in beverage, confectionery, bakery, pharmaceutical, cosmetic and perfumery industries. The citrus fruit residues, which are generally discarded as waste in the environment, can act as potential nutraceutical resources. Due to their low cost and easy availability such wastes are capable of offering significant low-cost nutritional dietary supplements in the form of orange peel powder in cookies. the orange peel powder waste used in various proportion viz, 0, 5, 10, 15, 20 per cent levels for incorporation in cookies by replacing the Maida in the basis of overall sensory attributes, cookies prepared with 10 per cent orange peel powder were recorded higher acceptability as compared to other samples. It is calculated that orange peel powder and Maida can be substituted up to 10 per cent in Maida to prepared orange peel powder without adversely affecting attributes.

Oral nutritional supplementation with dietary counseling improves linear catch-up growth and health outcomes in children with or at risk of undernutrition: a randomized controlled trial.

Childhood undernutrition is associated with increased morbidity, mortality and a high socio-economic burden. Supporting Pediatric GRowth and Health OUTcomes (SPROUT) is a randomized, controlled trial evaluating the effects of an oral nutritional supplement (ONS) with dietary counseling (DC; n = 164) compared to a DC-only group who continued consuming their habitual milk (n = 166; NCT05239208). Children aged 24-60 months who were at risk or with undernutrition, as defined by weight-for-age [WAZ] < -1 and height-for-age [HAZ] < -1 according to the WHO Growth Standards, and who also met the criterion of weight-for-height [WHZ] < 0, were enrolled in Vietnam. ONS + DC had a larger WAZ increase at day 120 (primary endpoint) vs. DC (least squares mean, LSM (SE): 0.30 (0.02) vs. 0.13 (0.02); p < 0.001), and larger improvements in all weight, BMI and weight-for-height indices at day 30 and 120 (all p < 0.01). Height gain was larger in ONS + DC in all indices, including height-for-age difference [HAD; cm: 0.56 (0.07) vs. 0.10 (0.07); p < 0.001], at day 120. ONS + DC had larger arm muscle but not arm fat indices, higher parent-rated appetite, physical activity and energy levels, longer night sleep, fewer and shorter awakenings, and better sleep quality than DC. Adding ONS to DC, compared to DC-alone, improves growth in weight and height, linear catch-up growth, and health outcomes in children with or at risk of undernutrition.

Development of Banana Peel Powder Incorporated Functional Cookies

Nendran Banana is one of the most common fruits consumed worldwide, and it contributes significantly to the waste produced by food consumption. Banana peel waste has a significant amount of food fibre, phenols, flavonoids, antioxidants, antibacterial, and anticarcinogenic substances. Repurposing banana processing waste, such as peel, has the potential to boost raw material output and, as a result, reduce food industry waste while simultaneously improving the availability of nutritional and nutraceutical potential among the human population. This study is aimed to assess the nutritional, functional and bioactive compounds of prepared nendran banana peel flour and its incorporation in to various proportion of cookies formulation. Nendran bananas were purchased from a local market, sorted, peeled, soaked in 2% lime juice for 15 minutes, dried, powdered with a mixer grinder, sieved to produce a fine powder, and analysed for physical and functional properties such as length, width, and dimension, water and oil holding capacity, swelling powder, and proximate composition such as moisture, ash, carbohydrate, protein, fat, and fibre. The approximate composition of the banana flour was determined using AOAC standard techniques. Bioactive components were also assessed. The two varieties of cookies were prepared with the incorporation of nendran banana peel powder at the rate of 5 % and 10% and analysed for their nutritional components. The functional features of nendran banana peel powder revealed that it had a higher water-holding capacity, good oil-holding capacity, high solubility, and a high swelling capacity. Nendran Banana Peel Flour was discovered to be high in protein and crude fibre. It possesses greater antioxidant scavenging activity as well as possible polyphenolic substances. The produced food formulation was organoleptically evaluated using a 5-point hedonic rating scale, and the best product was chosen based on the sensory scores. The study suggested that the nendran banana peel flour is a versatile nutritional supplementation and provides a great health impact.

Long-Term Effects of Oral Nutritional Supplements After Gastrectomy for Gastric Cancer: A Survival Analysis from a Multicenter, Open-Label, Randomized Controlled Trial.

Weight loss (WL) after gastrectomy for gastric cancer is associated with both decreased compliance with adjuvant chemotherapy and impaired survival. This study examined the effects of administering oral nutritional supplements (ONS) for 3months after gastrectomy in terms of compliance with adjuvant chemotherapy and survival outcomes. This large-scale, multicenter, open-label, randomized controlled trial enrolled 1,003 gastric cancer patients undergoing curative gastrectomy. Patients were assigned to the control group (n = 503) or ONS group (n = 500). In the ONS group, 400kcal/day of ONS was recommended in addition to a regular diet for 3months after gastrectomy. Compliance with adjuvant chemotherapy and survival outcomes were compared between the two groups. Compared with the control group, the ONS group showed significantly decreased WL at 3months after gastrectomy (8.6 ± 6.1 vs. 7.2 ± 5.7%, respectively, P = 0.0004). The control and ONS groups did not differ regarding the induction rate of adjuvant chemotherapy (84.9 vs. 82.8%, respectively, P = 0.614) or the continuation rate at 3months postoperatively (75.3 vs. 76.6%, respectively, P = 0.809). Oral nutritional supplements for 3months showed no survival benefit; the 3- and 5-year overall survival (OS) rates were 91.3% and 87.6% in the control group and 89.6% and 86.4% in the ONS group, respectively, indicating no significant difference (P = 0.548). Subgroup analysis could not detect a population in which ONS administration increased OS. Administration of ONS for 3months after gastrectomy was not associated with increased compliance with adjuvant chemotherapy or with improved prognosis.

Gaps in Long COVID treatments research: A scoping review

Background Long COVID affects 6 to 10% of people following SARS-CoV-2 infection. It has been documented worldwide, with over 200 symptoms reported. This scoping review assesses the evidence on Long COVID treatments to identify gaps in the evidence-base to inform research prioritisation. Methods We searched four databases (MEDLINE, Embase, Cochrane’s Trial register, Epistemonikos) supplemented by a grey literature search up to April 2023. Two reviewers screened articles and extracted data. Data were analysed using a thematic approach. Results Of 3675 records identified, 26 studies were included. Most were in high-income countries (92%), with two in upper-middle-income countries (8%). None reported inclusion of children, nor pregnant women and only 37.5% included adults over 64 years. Five (20.8%) presented ethnicity data, of these 92.9% of participants were of white ethnicity. Treatments included nutritional supplements (46%), conventional medicines (38%), hyperbaric medicine (8%), COVID-19 vaccination (4%) and complementary, alternative medicine (4%). Conclusion This scoping review highlights that more than four years after the start of the pandemic, research gaps remain for Long COVID treatments. There is a lack of research in low-income countries, despite trials being best placed locally to reflect different population demographics. There is a lack of inclusion of population sub-groups, particularly children, pregnant women and ethnic minority groups. Inclusion of these groups in future research is important given they may be at a higher risk of adverse outcomes of COVID-19, and a lack of appropriate treatments for Long COVID may contribute to the widening of health inequalities.

Adherence with oral nutritional supplements and influencing factors in postoperative patients with digestive tract tumors: a cross-sectional study.

This study aims to use structural equation modeling to explore the pathways and effect sizes of factors influencing the adherence of postoperative patients with digestive tract tumor to oral nutritional supplements, providing a theoretical basis for future nursing intervention measures. A total of 300 postoperative patients with digestive tract tumor within 30days after surgery were conveniently sampled. Surveys were conducted using a General Information Questionnaire, Morisky Medication Adherence Scale, Digestive System Tumor Patient Nutrition Knowledge-Attitude-Behavior Questionnaire, Multidimensional Social Perception Scale, Beliefs about Medical Questionnaire, and General Self-Efficacy Scale. Structural equation modeling was employed to analyze the factors and pathways affecting adherence with oral nutritional supplements. The adherence score of postoperative patients with digestive tract tumor to oral nutritional supplements was 1.61 ± 1.38. The structural equation model had a good fit (χ2/df = 2.685, GFI = 0.930, CFI = 0.913, AGFI = 0.887, IFI = 0.915, and RMSEA = 0.075). Nutrition knowledge, social support, medication beliefs, and self-efficacy were found to be factors influencing adherence with oral nutritional supplements in postoperative patients with digestive tract tumor, with total effects of 0.539, 0.264, 0.215, and 0.180, respectively. Nutrition knowledge indirectly affected adherence through self-efficacy and medication beliefs, while social support indirectly affected adherence through self-efficacy. Adherence with oral nutritional supplements in postoperative patients with digestive tract tumor is at a low level. Improving social support, enhancing patients nutrition knowledge, increasing self-efficacy, and strengthening medication beliefs are effective ways to improve patient adherence.

Moderate-dose caffeine enhances anaerobic performance without altering hydration status.

The effects of direct nutritional supplements on athletic performance are still being investigated and arouse curiosity. Only one study in the literature was found that investigated the kicking speed performance of futsal players following low-dose caffeine supplementation (3 mg/kg); thus, the question of whether caffeine supplementation improves kicking speed as well as essential physical parameters in soccer players is still controversial. Therefore, the aim of this study was to determine the effect of caffeine supplementation on vertical jump (VJ), sprint, reaction time, balance, change of direction (COD), and ball-kicking speed in soccer players. In a double-blind, cross-over design, nine moderately trained male soccer players (21.11 ± 2.02 years, 171.22 ± 6.14 cm, 71.78 ± 10.02 kg) consumed caffeine (6 mg/kg) or a placebo 60 min before completing balance, reaction time, vertical jump, agility, 30 m sprint, and ball-kicking speed tests. Greater VJ height (p = 0.01) and power (p = 0.08), and faster completion time according to the Illinois Agility Test (p = 0.08) were found following caffeine supplementation compared to placebo. Elapsed time (p = 0.01), average (p = 0.01) time, and the slowest reaction times (p = 0.016) were significantly reduced after caffeine consumption compared to placebo supplementation. Caffeine intake significantly improved VJ, agility, and reaction time (p < 0.05) but did not affect 30 m sprint, ball-kicking speed, balance, and RPE values in soccer players (p > 0.05). Although non-significant, caffeine intake also improved sprint (0.67%) and ball kicking (2.7%) performance percentages. Also, caffeine consumption did not induce dehydration, and the athletes' body hydration levels were normal. These findings support the use of caffeine supplementation as an effective nutritional ergogenic aid to enhance anaerobic performance, at least for vertical jumps, COD speed, and reaction time, in trained male soccer players.

Correlation of Parathyroid Hormone Values With Lung Function Parameters in Patients With Chronic Obstructive Pulmonary Disease.

The aim of this study was to determine the disturbances in the concentration of parathyroid hormone (PTH) and 25-hydroxyvitamin D (vitamin D) in patients with stable chronic obstructive pulmonary disease (COPD)and its correlation with airflow obstruction. A prospective study included 200 patients with a confirmed diagnosis of COPD in the Department of Lung Diseases and Tuberculosisand Pulmonology Polyclinic of University Clinical Hospital Mostar in the period of three years, between May 2021 and May 2024. Inclusion criteria were a stable phase of COPD, hemodynamically stable patients older than 40 years, forced vital capacities in the first second (FEV1)/forced vital capacities (FVC)<0.7, and patients with PTH, vitamin D, calcium, and phosphate measurements. Exclusion criteria wereacute exacerbation of COPD in the last month; current treatment with nutritional supplements, vitamins, and statins; lack of availability of lung function data; use of systemic corticosteroids in the previous three months; chronic renal insufficiency, respiratory diseases other than COPD (asthma, pneumonia, tuberculosis, and bronchiectasis), and other diseases (cancerand parathyroid disease). Medical records about demographic data (age and gender), pulmonary function test (FVC, FEV1, FEV1%FVC, mean expiratory flow (MEF)50), body mass index (BMI), COPD assessment test (CAT), Modified Medical Research Council(mMRC) Dyspnea Scale, and serum PTH, vitamin D, calcium, and phosphate levels were obtained. Patients with higher COPD stagehad lower spirometry values,most significantly MEF50. The higher the COPD group (Global Initiative for Chronic Obstructive Lung Disease (GOLD) D), the lower vitamin D ​​and the higher PTH levels were. Calcium and phosphate values ​​were the same for all groups. Vitamin D and PTH levels significantly ​​correlated with MEF50 values. The lower MEF50 level, the higher PTH levels, ​​and lower vitamin D levels were found (P<0.05). Our study showed that the patients in the higher COPD group have lower vitamin D levels ​​and higher PTH levels, indicating that they developed secondary hyperparathyroidism. The levels of vitamin D and PTH correlated the most with MEF50 values while other spirometry parameters did not significantly correlate with vitamin D and PTH levels.

Herbal and Dietary supplements for Hypertension Management.

Abstract: Herbal and dietary supplements are products that add more nutritional value to the diet. The use of these products has increased worldwide and has become widespread. Recently, the food products market has witnessed significant advancements in improving the health and well-being of individuals with increased nutritional requirements or in preventing related diseases and issues. Overall, dietary supplements possess pharmacological properties that are not crucial for disease control, such as high blood pressure but are essential for various physiological processes. To report the recent pre-clinically and clinically proven benefits of different hypertension treatments, an extensive literature search was conducted using widely available scientific databases of oral supplements. This review aims to raise awareness about commonly used dietary and herbal products, particularly among individuals with high blood pressure. Additionally, this paper highlights several nutritional supplements that hold promise for future research.

The Effectiveness of Nutritional Interventions Implemented through Lady Health Workers on the Reduction of Stunting in Children under 5 in Pakistan: The Difference-in-Difference Analysis.

In Pakistan, the 2018 National Nutrition Survey reported that 40% of children under five years old were stunted. This study assessed the effectiveness of nutritional supplementation in reducing stunting among children under five years old in two rural districts in Sindh, Pakistan. This was a mixed-method quasi-experimental study comprising intervention and control populations, with 3397 and 3277 children under five years old participating in the baseline and end-line surveys, respectively. The study areas were similar in terms of demographic and economic circumstances. In the intervention group, pregnant and lactating women (first six months post-partum) received wheat soy blend, children 6-23 months old received Wawamum (lipid-based supplement), and children 24-59 months old received micronutrient powders, all through lady health workers. This was underpinned by nutrition behaviour change communication for appropriate complementary feeding practices and hygiene promotion targeted at primary caregivers. The control group received no intervention. The impact was assessed using the difference-in-difference analysis with kernel propensity score matching to adjust the differences among the control and intervention populations. The overall DID analysis indicated that the intervention did not significantly reduce the prevalence of stunting (under 5 years) [DID = -5.1, p = 0.079]. The adjusted DID indicated a significant decrease of 13% [DID = -13.0, p = 0.001] in the number of stunted children 24-59 months of age at the endline survey. A significant reduction in underweight among children 24-59 months old was also observed (DID = -9.4%, p = 0.014). In conclusion, this evidence further establishes that nutrient uptake through an intervention for a short duration cannot effectively reduce stunting. It requires continuous nutritional supplementation for mothers during the pregnancy and an initial six months of lactation and then nutritional supplementation for children 6-59 months of age underpinned by effective behaviour change communication targeting mothers and other caregivers for improving complementary feeding practices and hygiene promotion.

The Intake of Omega-3 Fatty Acids, the Omega-3 Index in Pregnant Women, and Their Correlations with Gestational Length and Newborn Birth Weight.

During pregnancy, the demand for omega-3 fatty acids, notably docosahexaenoic acid (DHA), escalates for both maternal and foetal health. Insufficient levels can lead to complications and can affect foetal development. This study investigated omega-3 status and its relation to dietary intake in pregnant Latvian women, along with its impact on gestational duration and newborn birth weight. The study comprised 250 pregnant and postpartum women with a mean age of 31.6 ± 4.8 years. Nutrition and omega-3 supplementation data were collected through a questionnaire covering 199 food items and 12 supplements. Fatty acids in erythrocyte membrane phospholipids were analysed via gas chromatography with flame ionization detection. The median omega-3 fatty acid intake, including eicosapentaenoic acid (EPA) and DHA from diet and supplements, was 0.370 g/day, which is deemed sufficient. However, the median weekly fish intake (126.0 g) and daily nut/seed intake (7.4 g) were insufficient. The median omega-3 supplement intake was 1.0 g/day. No correlation between omega-3 supplement intake and the omega-3 index was observed. There was a weak correlation between the DHA intake from fish and the omega-3 index (r = 0.126, p = 0.047), while a significant correlation between the total EPA and DHA intake from various sources and the omega-3 index was noted (r = 0.163, p = 0.01). Most women (61.6%) had an omega-3 index < 4%, while 34.8% had an index between 4 and 8%, and only 3.6% had an index > 8%. Notably, significant differences in EPA levels and the omega-3 index were found among respondents with differing infant birth weights (p < 0.05). The omega-3 intake during pregnancy adheres to the established guidelines, although fish consumption remains insufficient. A preconception evaluation of the omega-3 index is advocated to optimize prenatal intake. The indications suggest potential correlations between EPA levels, the omega-3 index, and infant birth weight.

Comparison of nasojejunal nutrition and intravenous nutrition supplementation in patients with upper gastrointestinal tract strictures and analysis of risk factors for malnutrition.

This study examines the effectiveness of nasojejunal and intravenous nutrition in supplementing nutrition for patients with upper gastrointestinal (GI) strictures and analyzes the risk factors associated with malnutrition to provide references for clinical nutrition strategies. A retrospective analysis was conducted on 71 patients with upper GI strictures caused by esophageal and gastric cancers, who received nutritional support from January 2015 to January 2023. Out of these, 53 patients had complete baseline and follow-up data. We collected general clinical and perioperative data for comparison of the efficacy between nasojejunal nutrition and intravenous nutrition. Risk factors for malnutrition were analyzed using univariate and multivariate logistic regression. Malnutrition occurred in 24.53% (13/53) of the patients with upper GI strictures. The incidence of malnutrition was 6.06% (2/33) in the nasojejunal nutrition group compared to 55.00% (11/20) in the intravenous nutrition group, with a statistically significant difference (P < .001). Univariate and multivariate regression analyses identified diabetes (P < .001), initial blood K (P = .011), pathological staging (P < .001), and pathological grading (P < .001) as risk factors for malnutrition in patients with upper GI strictures. Diabetes (P = .028), initial blood K (P = .018), and pathological staging (P = .011) were found to be independent risk factors. Nasojejunal nutrition results in a lower incidence of malnutrition compared to intravenous nutrition in patients with upper GI strictures. Diabetes, initial blood K, pathological staging, and pathological grading are risk factors for malnutrition, with diabetes, initial blood K, and pathological staging serving as independent risk factors.

Exploring the Potential of Carotenoids in Obesity Management: A Comprehensive Overview.

Obesity is a global health concern with numerous comorbidities, including cardiovascular diseases, type 2 diabetes, and certain cancers. Carotenoids, found in a variety of natural sources like fruits and vegetables, are known for their potential health benefits. Emerging research suggests that certain carotenoids may play a major role in combating obesity through mechanisms involving inflammation, oxidative stress, and lipid metabolism. Understanding the influence of carotenoids on metabolic health could offer valuable revelation about obesity management strategies. To summarize the main findings on carotenoids that help in the management and prevention of obesity, exploring their potential benefits in weight management, metabolic health, and overall well-being. An extensive literature survey was done on the management of obesity using PubMed, Elsevier, ScienceDirect, and Springer. The results were then filtered based on the titles, abstracts, and accessibility of the complete texts. The search engine Google Scholar was accessed for the literature data mining. This review highlights the diverse functions of carotenoids, such as their antioxidant properties, anti-inflammatory effects, and regulation of lipid metabolism, which contribute to their potential role in combating obesity. Studies suggest that carotenoids may help reduce adiposity, lipid accumulation, improve insulin sensitivity, and promote overall metabolic health, making them promising candidates for obesity management. Obesity is synonymous with the appearance of major diseases and an overall decline in physical and mental performance. Overall, the findings of this review endorse the possible application of carotenoids as a nutritional supplement for the management and prevention of obesity. Further research is needed to clarify the mechanisms underlying the beneficial impacts of carotenoids on obesity-related consequences and to optimize their utilization in clinical practice and public health campaigns.

Nutrition Screening for 2-5 Years Old Children by Screening Tool for the Assessment of Malnutrition in Paediatrics in Outpatient Setting

Abstract Introduction and Aim of the work Malnutrition is the primary causative factor of pediatric mortality and repeated hospitalization. The aim of this study is to highlight the role of nutrition screening in identifying those at risk of malnutrition who may benefit from nutritional interventions and test whether the nutritional supplements are essential during nutritional rehabilitation. Patients and methods Screening for malnutrition of 3640 children at the outpatient clinic of Ain Shams Pediatric hospital by Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) followed by assessing 100 patients at high risk of malnutrition by anthropometric measurements, then BMI and z scores were computed. Oral nutritional supplement was advised in the rehabilitation program only in group A. Nutritional response testing was performed by reassessment at three and six months. Results The prevalence of underweight, stunting and wasting were 5.9%, 15.6%, and 9.4% respectively. As per STAMP, 14.7% were found to be nutritionally at low risk, 7.3% at intermediate risk, and 5.1% at high risk compared to 72.83% without risk for malnutrition. STAMP showed a significant increase in patients at low risk and decrease in patients at high risk through follow up in both groups with better percentages in group A which coincides with improvement in anthropometric indices. Conclusion STAMP is a sensitive, quick, and easy to use nutritional screening tool with a crucial role in identifying nutrition risk at outpatient services which can lead to implementing prompt nutritional rehabilitation. Tailored nutritional plans can accomplish good response and adding a nutritional supplement to the dietary plan ensures earlier goal achievement.

Effectiveness of Nutritional Supplementation in Liver Transplant Recipients during Early Postoperative Course: A Systematic Review and Meta-Analysis

Abstract Background Nutrition is an integral part of health maintenance. The liver is the largest and most important metabolic organ, playing a pivotal role in integrating several biochemical pathways of carbohydrate, fat, protein, and vitamin metabolism. Malnutrition is a common complication of end- stage liver disease (ESLD). Progressive deterioration of nutritional status has been associated with poor outcome in cirrhotic patients. Liver transplantation (LT) revolutionized the management of liver disease. Nutritional therapy is an integral part of liver transplant care. Objective To identity the efficacy of different dietary nutritional supplements as zinc, vit D and immunonutrients (glutamine, omega 3, arginine and ribonucleic acid) for recipient at early post operative course. Material and Methods In this systematic review and meta-analysis we enrolled a total of 7 studies for assessing the clinical outcomes of ICU patients underwent liver transplantation surgery and supplied with dietary supplements during early postoperative period. The studies also assessed the laboratory assessment of patients postoperatively during ICU admission period. Results Regarding postoperative dietary supplementations with HMB, we found significant difference for appendicular skeletal muscle mass (ASMI) regarding the baseline and the postoperative ASMI in the intervention group with HMB. But we did not report significant difference regarding the baseline and the postoperative Fat-free mass index (FFMI) in both intervention and control group with HMB. Also we did not find significant difference between base line and postoperative in both groups for Mid-arm muscle-circumference (MAMC), Fat mass index (FMI), 6-minute walk test (6MWT), and Handgrip (HG). Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021. Conclusion BCAA as dietary supplementation showing a significant favorable effect regarding the baseline and the postoperative BTR levels, also for BCAA levels, Tyrosine levels, prealbumin levels, retinol binding protein and PTINR levels in both intervention and control groups. For HMB, we found significant difference for appendicular skeletal muscle mass (ASMI) regarding the baseline and the postoperative ASMI in the intervention group with HMB. But we did not report significant difference regarding the baseline and the postoperative Fat-free mass index (FFMI) in both intervention and control group with HMB.

589 Survivorship After Radical Gastrectomy with Adjuvant Chemoradiotherapy for Locally Advanced Gastric and Junctional Adenocarcinoma

Abstract Introduction In the US Intergroup-0116 trial adjuvant chemoradiotherapy (aCRT) significantly improved overall survival (OS) compared with surgery alone for locally advanced gastric adenocarcinoma. Subsequently, the CRITICS and ARTIST-2 trials demonstrated no additional benefit to aCRT compared with chemotherapy alone. The aim of this study was to evaluate long-term outcomes in survivorship among patients previously treated with radical D2 gastrectomy and aCRT (MacDonald Regimen). Method Consecutive patients who underwent aCRT following radical D2 gastrectomy between 2002-2018 were identified from a prospectively maintained database. Among patients without evidence of recurrence at 1 year postoperatively, long-term radiotherapy complications were coded using the framework of the Common Toxicity Criteria for Adverse Events (CTCAE) V5, and use of nutritional adjuncts and micronutrient supplementation recorded. Results Some 49 patients were included (pT3-4, 88%; pN2-3, 61%; diffuse type, 45%). Median, 1-, 3- and 5-year OS were 29.8 months, 90%, 45% and 41%. Late effects data were available for 18 patients. Gastrointestinal late effects were evident in 81% (most commonly dysphagia, subacute obstructive symptoms, food intolerance and diarrhoea). Small bowel obstruction occurred in 2 patients, small intestinal bacterial overgrowth in 2 patients and pancreatic exocrine insufficiency in 2 patients. 3 patients required long-term oral nutritional supplementation, and 2 required home enteral nutrition. Conclusions Despite adverse pathological features, long-term survival was achieved in a significant proportion of patients. However, these data highlight that adjuvant chemoradiotherapy following radical gastrectomy with D2 lymphadenectomy may be associated with considerable late effects in survivorship, and management within specialist multidisciplinary teams is advocated.

The efficacy of simple oral nutritional supplements versus usual care in postoperative patients with gastric cancer: study protocol for a multicenter, open-label, parallel, randomized controlled trial

BackgroundBody weight loss (BWL) after gastrectomy impact on the short- and long-term outcomes. Oral nutritional supplement (ONS) has potential to prevent BWL in patients after gastrectomy. However, there is no consistent evidence supporting the beneficial effects of ONS on BWL, muscle strength and health-related quality of life (HRQoL). This study aimed to evaluate the effects of ONS formulated primarily with carbohydrate and protein on BWL, muscle strength, and HRQoL.MethodsThis will be a multicenter, open-label, parallel, randomized controlled trial in patients with gastric cancer who will undergo gastrectomy. A total of 120 patients who will undergo gastrectomy will be randomly assigned to the ONS group or usual care (control) group in a 1:1 ratio. The stratification factors will be the clinical stage (I or ≥ II) and surgical procedures (total gastrectomy or other procedure). In the ONS group, the patients will receive 400 kcal (400 ml)/day of ONS from postoperative day 5 to 7, and the intervention will continue postoperatively for 8 weeks. The control group patients will be given a regular diet. The primary outcome will be the percentage of BWL (%BWL) from baseline to 8 weeks postoperatively. The secondary outcomes will be muscle strength (handgrip strength), HRQoL (EORTC QLQ-C30, QLQ-OG25, EQ-5D-5L), nutritional status (hemoglobin, lymphocyte count, albumin), and dietary intake. All analyses will be performed on an intention-to-treat basis.DiscussionThis study will provide evidence showing whether or not ONS with simple nutritional ingredients can improve patient adherence and HRQoL by reducing BWL after gastrectomy. If supported by the study results, nutritional support with simple nutrients will be recommended to patients after gastrectomy for gastric cancer.Trial registrationjRCTs051230012; Japan Registry of Clinical Trails. Registered on Apr. 13, 2023.