Caloric Requirements Research Articles

Obstacles to meeting nutritional recommendations in a tertiary pediatric intensive care unit.

Optimal nutrition is associated with positive outcomes in critically ill children. In 2017, the Society of Critical Care Medicine (SCCM) and the American Society of Parenteral and Enteral Nutrition (ASPEN) updated guidelines for nutritional support for this population. However, implementation of these guidelines may be delayed due to clinical barriers. We aimed to assess our practice against the recommendations of the ASPEN guidelines, hypothesizing that caregiver bias and clinical factors may hinder their implementation in our pediatric intensive care unit (PICU). We focused on two ASPEN recommendations: (1) feeding within 48 h (48H) of admission and (2) meeting two thirds of estimated caloric requirements after seven calendar days. All children aged 1 month to 16 years admitted to our PICU from July 2017 to January 2020 were eligible. Using a retrospective chart review, nutritional and clinical data were collected at the time of admission, at 48H, and 7 calendar days after admission. A total of 533 patients were included. After 48H of admission to the PICU, 402 out of 533 (75.4%) patients received feeding. The following factors were associated with not reaching nutritional goals at 48H: invasive ventilation support, inotropic and vasoactive support, and extracorporeal life support. After 7 days, 95 out of 118 (80.5%) received two thirds of caloric needs. At 7 days, the main obstacle to meeting caloric goals was invasive ventilation. In a representative tertiary PICU, barriers to meeting ASPEN nutritional recommendations included hemodynamic instability or invasive ventilator support, especially within the first 48H of admission.

Owners’ perceptions of dog treat management in Western Romania

IntroductionWithin the broader-than-ever palette of pet foods, dog treats are an assortment sustained by powerful marketing tools and compelling advertising. The wide range and availability of these products often pair with the fondness of owners for their companions, leading to overfeeding them with rewards.MethodsThis study explored owner treat provision behaviors among 890 voluntarily participating dog owners in Western Romania through an online survey conducted between June and November 2023.ResultsThe majority of respondents were women (72%) and younger adults aged 18–24 (39%). Emotional attachment was the primary motivation for providing treats (52%), followed by perceived health benefits (35%) and training purposes (25%). However, 84% of respondents did not account for the caloric value of treats in their dogs' daily diet, and only 16% adjusted their dogs' main meals to compensate for treat provision. Preferences leaned toward treats with dental benefits (58%) and biscuits (52%). Many owners reported offering treats multiple times daily, highlighting the role of treats in owner-dog bonding. Chi-square tests of independence, with Bonferroni-adjusted post-hoc pairwise comparisons, revealed significant associations between treat provision frequency, owner demographics, and dog characteristics. Younger owners (18–24 years) were significantly more likely to provide treats at higher frequencies, with 31.8% giving treats 'multiple times daily' compared to 7.1% of older owners (>55 years) (p<0.002). Similarly, single owners provided treats more frequently, with 31.9% giving treats 'once daily' and 42.1% 'multiple times daily', compared to 7.1% and 22.4%, respectively, among owners in committed relationships (p<0.005). Owners who provided treats less frequently, 'seldom' (80.7%) or 'a few times a week' (87.8%), were more likely to have dogs with an ideal weight, while higher treat frequencies – 'once daily' (40.0%) or 'multiple times daily' (52.7%), were significantly associated with overweight or obese dogs (p<0.003).DiscussionThese findings underscore the importance of educating dog owners on aligning treat provision with caloric requirements and promoting responsible feeding practices. Veterinarians play a critical role in guiding owners toward balanced feeding strategies that incorporate treats into comprehensive dietary plans. Addressing treat provision behaviors is essential to mitigating health risks, improving canine nutrition, and promoting overall well-being.

Serial Transverse Enteroplasty and The Re-establishment of Enteral Autonomy Among The Adult Population

Objective(S): To define the evolving role of serial transverse enteroplasty(STEP) in the surgical management of intestinal failure(IF) in patients with short bowel syndrome(SBS) especially among the adult population. Background: The current literature is lacking the rationale and long-term efficacy of STEP as a part of the multidisciplinary management of SBS-IF adult population. Methods: The study included a total of 64 total parenteral nutrition (TPN) dependent patients. The causes of SBS were wide-ranging with residual bowel length of 79+47 cm and plasma citrulline level of 22+12 umol/L. Partial or full colon was preserved in 56(88%) patients. STEP was primary in 32 patients and integrated with autologous gut reconstruction(AGR) in the remaining 32. Integrated STEP was technically feasible in 44% of the preoperative candidates. To assess the therapeutic benefits of integrated STEP, 32 of the contemporaneous AGR-only patients were statistically identified by propensity-score matching as control group. Results: With a mean follow-up of 35+24 months, the 64 study patients received a total of 81 STEP procedures. The 5-year disease-specific survival was 91% with a respective restored enteral autonomy (EA) rate of 80%. Compared to the matched control, integrated STEP significantly(P=0.02) enhanced the cumulative restoration of EA. The ASA comorbidity class IV was the only significant(P=0.05) survival risk factor. Preoperative TPN caloric requirements and total increment in bowel length were independent predictors of STEP-associated EA. Consequently, STEP was a significant predictor of restored EA among the overall SBS-IF patients. Conclusions: This study underscores the wide-applicability and long-term therapeutic efficacy of STEP among the SBS-patients including adults. Accordingly, the procedure should be increasingly utilized for all ages and promptly considered as an integral part of the SBS-IF management armamentarium.

What is the role of parenteral nutrition in the management of the patient with severe acute pancreatitis?

Severe acute pancreatitis often presents as a complex critical illness associated with a high rate of infectious morbidity, multiple organ failure, and in-hospital mortality. Breakdown of gut barrier defenses, dysbiosis of intestinal microbiota, and exaggerated immune responses dictate that early enteral nutrition (EN) is preferred over parenteral nutrition (PN) as the primary route of nutrition therapy. EN, however, is not feasible in all cases because of intolerance, risk of complications, or a direct contraindication to enteral feeding. For these patients, PN can be provided in a manner that is safe, is metabolically appropriate, and follows the principles of modern critical care nutrition. Adherence to goal-directed fluid resuscitation, provision of trophic doses of PN to meet 20%-25% of protein and/or calorie requirements through the acute phases of illness, use of less-inflammatory intravenous lipid emulsions, and close monitoring of electrolytes, triglyceride levels, and signs of refeeding syndrome all serve to optimize the response to this route of nutrition support. For these reasons, prescribing PN remains an important strategy in the management of this difficult population of patients.

Comparison of total and partial parenteral nutrition to achieve calorie target among treated children in the intensive care unit.

The achievement of recommended calorie targets for parenteral nutrition in pediatric patients receiving treatment in the pediatric intensive care unit (PICU) in Indonesia remains suboptimal, necessitating cautious implementation of this nutritional intervention alone. The aim of this study was to compare the effectiveness of total parenteral nutrition (TPN) and partial parenteral nutrition (PPN) in achieving the calorie requirements of pediatric patients receiving treatments in the PICU. A cross-sectional study was conducted in the PICU at H. Adam Malik General Hospital, Medan, Indonesia, among patients aged between 28 days to 18 years. The consecutive sampling method was employed to collect samples based on predetermined inclusion and exclusion criteria. The assessments of recommended calorie achievement targets were conducted up to 240 hours after initial nutrition treatment. Other possible factors associated with the achievement of the nutrition target were also assessed between groups, such as demographic data, length of treatment, nutritional status, and underlying diseases. A total of 30 patients were included in each group (TPN and PPN). There were no significant differences in age, weight, height, sex, or underlying diseases between groups. All patients in both groups achieved the target calorie requirements after 168 hours. Our data indicated that the percentage of patients who met the target calorie requirements was significantly different at initial treatment, 72 hours, and 120 hours post-treatment between groups (all had p<0.001). The percentages of patients who met the nutritional requirements (carbohydrate and protein) were also significantly different between the TPN and PPN groups (all had p<0.001). This study highlights that the administration of PPN to children resulted in faster achievement of calorie targets compared to TPN.

The contribution of the Gaza Envelope Region to Israel’s food security

BackgroundArmed conflicts can severely impact food security by displacing farmers, destroying farms and agricultural infrastructure, disrupting supply chains, and limiting governance control over highly volatile food markets. In this study, we aim to gain an initial understanding of the impact of the ongoing Israel-Hamas War on local food production in Israel.MethodsThis study examined the challenges of food production in the Gaza Envelope region, a border area in Israel that has been profoundly affected by the recent conflict. The analysis focused on the allocation of land to specific agricultural crops and sectors, along with the nutritional output of these edible crops. The nutritional output was standardized based on the dietary needs of the Israeli population, considering population size and demographic factors. These methods aimed to understand the effects of conflict on crop diversity, the risks posed to specific crops, and the implications for nutritional security.ResultsWe found that the Gaza Envelope region is crucial for the propagation of several key crops, notably cherry tomatoes, radishes, and sweet potatoes. We identified 16 crops whose local production is particularly vulnerable due to their proximity to the conflict, including radishes and potatoes. The nutritional output of the edible crops from the Gaza Envelope region is extensive, producing over 50% of the annual caloric requirements of the Israeli population. Beyond the caloric contribution, the produce from the region is nutrient-dense, supplying more than 100% of the annual Dietary Reference Intakes for the Israeli population of 12 vital nutrients, which include dietary fiber, six vitamins such as Vitamin A, Vitamin C, and Vitamin K, and five minerals including potassium and iron. These findings suggest that the Israel-Hamas War is having detrimental ramifications on local food production in Israel.ConclusionsThe ongoing conflict highlights the critical need for data informed agricultural support and policy adjustments to protect food production in conflict-affected areas. Up-to-date and accurate land use data are essential to assess the initial impact of any disaster swiftly and reliably on these zones. This approach will enable more effective responses to safeguard food security under crisis conditions.

The relationship between caloric intake and clinical outcomes in critically ill patients: A retrospective study

Despite ongoing research, the optimal nutritional support strategy in the first week of intensive care unit (ICU) stay remains unclear, given the complex interplay of the dynamic metabolic change and evolving nutritional requirements. In this study, we assessed the impact of calorie deficiency during this period on the nutritional care of critically ill patients. In this retrospective study, we examined ICU admissions from January 2018 to September 2021, focusing on patients whose ICU stay exceeded 7 days. Data were collected from days 2-7 of ICU admission. The "average caloric intake (%)" was calculated as the actual calorie intake divided by the calculated calorie requirement over 6 days. Cox proportional hazard models were employed for analyzing the 28-day mortality, supplemented by sensitivity and subgroup analyses. The analysis of 3544 patients revealed that those receiving less than 60% of their target calories in the first ICU week experienced higher 28-day mortality (hazard ratio (HR): 1.41, 95% confidence interval (CI): 1.19-1.67, p<0.0001). Daily caloric intake below 30% of the goal from day 5 onward was associated with a gradual increase in mortality risk. Conversely, a significant reduction in 28-day mortality was noted in patients with a daily intake of >80% starting from day 6. Our study underscores the correlation between caloric deficit (<60%) in the initial ICU week and heightened mortality risk. It suggests the potential benefits of aggressive nutritional intervention toward the end of the week. These insights offer valuable guidance for clinicians in critical care settings.

Caloric requirement targets for nutritional support in adult autoimmune encephalitis: a retrospective cohort study.

Autoimmune encephalitis (AE) is a severe neurological disease often accompanied by consciousness disturbances, severe swallowing difficulties, and gastrointestinal dysfunction, increasing the risk of malnutrition. However, the optimal caloric intake target during the acute phase of AE remains unclear. This study aims to evaluate the impact of caloric intake on short-term clinical outcomes in AE patients, specifically focusing on the improvement in Clinical Assessment Scale for Autoimmune Encephalitis (CASE) scores, to provide recommendations for nutritional support during the acute phase. A retrospective study analyzed clinical data from 128 adult AE patients requiring nutritional support, admitted to West China Hospital, Sichuan University, from January 2020 to January 2024. Patients were categorized into low-calorie intake (below 70% of requirements), standard-calorie intake (70-100% of requirements), and high-calorie intake (above 100% of requirements) groups. Multivariate linear and logistic regression models were used to quantify the associations. Higher caloric intake was significantly associated with improved CASE scores (β = 8.58, SE = 3.75, 95% CI = 1.14 to 16.03, p = 0.02). Low caloric intake negatively impacted the improvement of CASE scores (p = 0.049), particularly in seizures and speech problems. The low-calorie intake group had significantly longer hospital stays and nutrition therapy durations (45.79 ± 30.98 days, p < 0.01; 40.39 ± 31.92 days, p = 0.02). Adequate caloric intake has a significant positive impact on the short-term clinical outcomes of AE patients, suggesting that meeting or exceeding caloric requirements may promote neurological recovery in AE patients. Future prospective studies are needed to validate these findings and further optimize nutritional support strategies.

Determining food intake, the requirement, and weighing the relative risk between food secure and insecure households in rural areas of Ethiopia: The case of West Hararghe zone

The severity of food insecurity in Ethiopia is among the worst globally, with record-breaking food assistance needs by various factors. This study tries to uncover various aspects of food security related to food availability, food access, food utilization and food stability dimensions of food security. The study was executed in the west Hararghe zone of the Oromia region of Ethiopia. Its main objective was to determine the food security status of households, with specific objectives aiming at computing individual daily kilo calorie intake, determining the average food requirement, comparing the relative risk between food secure and insecure households and identifying factors that affect household food security status. A multi-stage sampling procedure, involving the purposive selection of; the Zone and Woreda, and a simple random selection of households, to draw the required number of representative sample respondents, was adopted. Hence, from 4163 total households, 134 were selected for collecting primary data. Data were analyzed using descriptive statistics, relative risk analysis using Cohorts and independent tests using ANOVA. Food security status was measured using the Household Food Balance Model (HFBM). Using this model, the study obtained 1973 kilo calories per individual per day intake and 2108 kilo calorie as their requirement, which indicated households were energy deficient by 135 kilo calorie with 2-sided-value &lt; 0.1 critical level (t= -1.747, df =133 &amp; sig2-sided. 0.083). Independent test results showed that farm income (at p-value &lt; 0.1), gross product (at p-value &lt; 0.05), age of household head (at p-value &lt; 0.1), years of owning land (at p &lt; 0.1) and family size (at p-value &lt; 0.1) contributed significantly to food security status. Cross-tabulation showed a linear relationship between food security and higher education level (at p-value &lt; 0.05), which urges a concern in improving farming societies’ literacy to the desired level. In the study areas, about 91.8% of the population produces crops depending on the seasonal rainfall and their daily kilo calorie consumed depends on it; this is statistically correlated with the food insecurity problem at p-value &lt; 0.1 critical level (lambada = 1.75 &amp; sig. = 0.08). Therefore, to tackle the food insecurity problem, alternative method of crop production should be devised such as the establishment of irrigation schemes, water harvesting structures, and water conservation practices, among others. Key words: food security, calorie requirement, food availability, relative risk

Correlation of calorie intake with 24-hour urinary urea nitrogen level changes in critically ill patients at RSUI Depok, Indonesia

Calorie together with protein intake has been proven to be important factors that play a role in critically ill patients. Hypermetabolism in the early acute phase increases energy expenditure and calorie requirement. Insufficient calorie intake will increase protein degradation for gluconeogenesis, which can be assessed by the level of 24-hour urinary urea nitrogen (UUN). Adequate daily calorie intake is expected to improve the UUN level in patients. This study aims to investigates the correlation of calorie intake with UUN level changes in critically ill patients.

Effect of standard feeding with a high-protein diet on arterial blood gases in patients admitted to the intensive care units: A study protocol for a double-blinded, randomized controlled clinical trial

Critically ill patients admitted to the intensive care units (ICUs) often face numerous challenges, including severe metabolic stress, systemic inflammation, and compromised immune function. Studies have suggested that critically ill patients frequently experience a negative nitrogen balance due to a hypercatabolic state, leading to impaired organ function and muscle wasting, which can cause severe muscle weakness and physical disability for years after discharge. Arterial blood gases (ABG) reflect patients' oxygenation and acid-base status and are crucial indicators of respiratory and metabolic function in critically ill individuals. We aim to address this by conducting a double-blinded, randomized controlled clinical trial to compare the effects of standard feeding with a high-protein diet on ABG in ICU patients. In this double-blinded, randomized controlled clinical trial, we will use block randomization of 80 patients aged between 18 to 65 years old and Patients expected to be hospitalized in the ICU for at least 3 days from Kosar Hospital, Kurdistan, Iran. The intervention group (n=40) will receive a protein diet (consisting of 18.7% protein, 45% carbohydrates, and 35% fat per 1000cc). A control group (n=40) will receive a standard diet (14.4% protein, 54% carbohydrates, and 32.4% fat per 1000cc) for the same duration in addition to usual care. The caloric requirements of each patient will be determined by a nutritionist based on their nutritional status, height, weight, age, and initial diagnosis, utilizing the Harris-Benedict formula. The parameters of ABG, including PO2, PCO2, SAO2, HCO3, BE, and pH, will be assessed. By optimizing protein intake through a high-protein diet, we aim to improve the nutritional status of patients and enhance their overall clinical outcomes. This reassures us of the potential benefits of our study.

Impact and tolerance mechanism of heat stress in wheat (Triticum aestivum L.): A review

Wheat is one of the major cereal crops preferred by world’s population. About 55% of world’s population depend on wheat to meet their 20% calorie requirement. Wheat being a winter crop grows best in 15-25 degree Celsius of temperature range. But due to increasing global warming climatic requirement of wheat is not fulfilled and suffer different abiotic stresses such as heat, drought, salinity, cold, excess water etc. Among which heat stress is one of the major abiotic stresses faced by wheat. It has different morphological, biochemical and physiological consequences on wheat for instance poor grain quality, decreased grain number and weight, decreased photosynthesis due to disruption in chlorophyll structure and function, reduced starch content due to poor efficiency of enzyme required in biosynthesis. To cope up with all these impacts of heat stress wheat has developed various tolerance mechanisms such as release of heat shock protein, antioxidant defense mechanism, membrane thermostability, stay green, omics approaches etc. Heat shock protein helps to prevent death of cell, accumulation of denatured protein, refolding of protein, transmission of heat shock responses etc. While omics approaches help in gene profiling, protein identification etc. knowledge about both the effect and tolerance mechanism of heat stress in wheat helps to develop heat tolerant varieties with collaborative effort of plant breeder, physiologist etc. that helps to maintain food security.

502 Cat and mouse: The effect of consuming four different diet formants (intact mice, raw, canned wet and kibble) on energy expended to consume a meal and immediately post-prandial in domestic cats

Abstract Cats are obligate carnivores; however, we feed them a variety of different diet formats without a clear understanding of feeding behavior and metabolism among diet formats. Whole-prey or raw diets may mimic a more natural diet and require more energy to consume. However, there is currently a dearth of literature examining feline energy expenditure (EE) during the consumption of and immediate post-prandial period when fed different diet formats. The present study aimed to investigate differences in the energetics of adult cats consuming four different diet formats in isocaloric offerings: raw intact mice, commercial raw, canned wet, and kibble diets. Adult neutered male cats [n = 12; body weight (BW) = 4.82 ± 0.164 kg) were used in a 4 x 4 replicated Latin square design and adapted to consuming each diet format before the initiation of the study. Following a 2-d adaptation period, cats were fed 25% of their daily caloric requirement (50.77 ± 1.549 kcal) in indirect calorimetry chambers in which VO2 and VCO2 exchange were measured. Energy expenditure (kcal/BW0.67 kg) was calculated for the consumption period, 15 min immediately post-prandial and 2 h post-prandial. Respiratory gases were measured for one fasted reading, followed by the first feeding. During each feeding, measurements were taken during the consumption period and 15 min post-prandial. For the following 2 h, respiratory gases were measured every 25 min for an additional 4 measures of respiratory gases. All data were analyzed using a generalized linear mixed model considering the effects of treatment, time and their interaction as fixed, and the effects of cat and period as random. A spatial power covariance structure was used to model repeated measures. Significance was considered at P &amp;lt; 0.05 and Tukey’s post-hoc test was performed to separate means. Energy expenditure during consumption and 15 min post-prandial was similar among treatments, and EE for 15 min post-prandial was greater than EE during consumption (P &amp;lt; 0.001). During the 2 h post-prandial, EE for the mice diet was greater than the kibble and canned wet diets (P &amp;lt; 0.001), while EE for the raw diet was only greater than the kibble diet (P &amp;lt; 0.001). Energy expenditure was similar between the kibble and canned wet diets (P = 0.919) and between the mice and raw diets (P = 0.598). Among all treatments and time periods, the mouse diet had the greatest mean EE. An increase in EE during the feeding period and post-prandial could benefit sedentary indoor cats who may be in positive energy balance. Feeding cats a naturalistic diet, such as intact mice or a raw diet, may increase activity levels and EE, but the longer-term effects of these feeding formats on energy balance need to be explored.

Adherence to resistance training and hypocaloric diet among persons near retirement age — A secondary data analysis of three randomized controlled trials

ObjectivesAdherence to lifestyle interventions is crucial for the treatment of obesity. However, there is little research about adherence to lifestyle interventions in persons around retirement age. The objectives of this study are (1) to identify factors associated with the adherence to resistance training and a hypocaloric diet and (2) to describe the association between adherence and changes in body composition outcome parameters. DesignThis secondary data analysis included three randomized controlled trials. Setting & participantsThe inclusion criteria of the participants were an age of 55–75 years, a BMI ≥ 25 kg/m2 and receiving both a hypocaloric diet and resistance training. All participants were residing in the community. MeasurementsAdherence to hypocaloric diet was measured through the mean dietary intake on the basis of a 3-day dietary record. If the participant consumed at least 600 kcal less than the individual caloric requirements, they were considered adherent. Adherence to resistance training was achieved if ≥67% of the recommended training sessions were attended over the course of the study periods. Results232 participants were included, 47.0% female, mean age 64.0 (±5.5) years. 80.2% adhered to resistance training and 51.3% adhered to a hypocaloric diet. Older age (Beta 0.41; 95% CI 0.05, 0.78; p = 0.028) and male sex (Beta 7.7; 95% CI 3.6, 11; p < 0.001) were associated with higher resistance training adherence. A higher BMI at baseline (Beta 6.4; 95% CI 3.6, 9.2; p < 0.001) and male sex (Beta 65; 95% CI 41, 88; p < 0.001) were associated with higher adherence to hypocaloric diet. ConclusionWe identified several associated factors (sex, age and BMI at baseline) that should be considered to promote adherence in future lifestyle intervention studies in persons around retirement age. We recommend including behavior change techniques in lifestyle interventions and consider sex-specific interventions to improve the adherence of women.

Sleep Duration Alters Overfeeding-mediated Reduction in Insulin Sensitivity.

Weight gain and sleep restriction both reduce insulin sensitivity. However, it is not known if sleep duration alters glucose metabolism in response to overfeeding. To examine the effect of sleep duration on overfeeding-mediated alterations in carbohydrate metabolism and insulin sensitivity. Retrospective exploratory analysis of a longitudinal overfeeding study in healthy participants (n = 28, age: 26.9 ± 5.5 years, body mass index: 25.74 ± 2.45 kg/m2). After providing baseline study measures, participants were overfed 40% above weight maintenance calorie requirements for 8 weeks. Insulin sensitivity was determined by a 2-step hyperinsulinemic-euglycemic clamp. Baseline habitual sleep duration was estimated by accelerometry, and sleep groups were created based on median sleep duration (5.2 hours/night). Overfeeding led to an average body weight gain of 7.3 ± .4 kg. Habitual sleep duration did not alter overfeeding-mediated body weight gain, fat gain, and fat distribution (all P > .15). Compared to participants with more sleep, fasting insulin (P = .01) and homeostatic model assessment for insulin resistance (P = .02) increased while fasting glucose remained unchanged (P = .68) with overfeeding in participants with shorter sleep duration. Glucose infusion rate during high insulin dose was reduced with overfeeding in participants with short sleep duration but not in participants with more sleep (P < .01). Overfeeding mediated weight gain reduced liver, adipose, and whole-body insulin sensitivity prominently in individuals with short sleep duration but not in individuals with longer sleep duration. This suggests that promoting adequate sleep during short periods of overeating may prevent detrimental effects on glucose metabolism.

Can Foraging for Earthworms Significantly Reduce Global Famine in a Catastrophe?

Earthworms are a resilient group of species thriving in varied habitats through feeding on decaying organic matter, and are therefore predicted to survive an abrupt sunlight reduction scenario, e.g., a nuclear winter. In this study, the feasibility and cost-effectiveness of foraging earthworms to reduce global famine in such a scenario with or without global catastrophic infrastructure loss was considered. Previously reported earthworm extraction methods (digging and sorting, vermifuge application, worm grunting, and electroshocking) were analysed, along with scalability, climate-related barriers to foraging, and pre-consumption processing requirements. Estimations of the global wild earthworm resource suggest it could provide three years of the protein needs of the current world human population, at a median cost of USD 353·kg−1 dry carbohydrate equivalent or a mean cost of USD 1200 (90% confidence interval: 32–8500)·kg−1 dry carbohydrate equivalent. At this price, foraging would cost a median of USD 185 to meet one person’s daily caloric requirement, or USD 32 if targeted to high-earthworm-biomass and low-labour-cost regions; both are more expensive than most existing resilient food solutions. While short-term targeted foraging could still be beneficial in select areas given its quick ramp-up, earthworms may bioaccumulate heavy metals, radioactive material, and other contaminants, presenting a significant health risk. Overall, earthworm foraging cannot be recommended as a scalable resilient food solution unless further research addresses uncertainties regarding cost-effectiveness and food safety.

Protein and Leucine Requirements for Maximal Muscular Development and Athletic Performance Are Achieved with Completely Plant-Based Diets Modeled to Meet Energy Needs in Adult Male Rugby Players.

Rugby athletes consume large amounts of animal protein in accordance with conventional dietary guidance to increase muscle mass and strength. This misaligns with national dietary guidelines, which suggest limiting meat consumption for chronic disease prevention. The ability of completely plant-based diets to satisfy the nutritional needs of rugby players has not been explored. This study scaled nutrient data from a large population consuming completely plant-based diets with limited supplemental protein to meet the calorie requirements of adult male rugby athletes to assess whether protein and leucine recommendations for muscular development and athletic performance would be achieved. Calorie requirements were estimated from research that employed the doubly labeled water method, and dietary data from the Adventist Health Study-2 were scaled to this level. The modeled protein level was 1.68 g/kg/day, which meets recommendations for maximal gains in muscle mass, strength, and athletic performance. The modeled leucine level was 2.9 g/meal for four daily meals, which exceeds the threshold proposed to maximally stimulate muscle protein synthesis in young men. These results indicate that consuming large portions of completely plant-based meals can satisfy protein and leucine requirements for maximal muscular development and athletic performance in adult male rugby athletes while aligning with public health recommendations.

Nutritional Issues among Children with Duchenne Muscular Dystrophy-Incidence of Deficiency and Excess Body Mass.

The progression of Duchenne muscular dystrophy (DMD)requires the assessment of nutritional disturbances at each stage of the disease. The purpose of this study was to assess the nutritional status in various ages of boys with DMD using screening and in-depth evaluation methods. Body composition by Dual X-ray Absorptiometry (DXA), basal metabolic rate (BMR) by indirect calorimetry, a questionnaire of nutritional status-Pediatric Nutrition Screening Tool (PNST)-and laboratory parameters were performed. In the cohort of 93 boys aged 8.54 (5.9-12.6 years), inappropriate nutritional status occurred in 41.8% of boys (underweight 11.8%, overweight 16.0%, and obesity 14.0%). In the 10-13 age group, the occurrence of overweight and underweight was the highest. Based on PNST, 15.1% of patients were at nutritional risk (≥2 points)-the most in the 14-17 age group (29%). A negative correlation was identified between PNST and z-scores of body weight, BMI, and FFMI (r Spearman = -0.49, -0.46, and -0.48, respectively; p < 0.05). There were no differences between BMR results from indirect calorimetry and calculations from the Schofield formula for any age group. In obese boys, the caloric requirement in indirect calorimetry was significantly lower than that indicated by the calculations according to the Schofield formula (p < 0.028). Inappropriate nutritional status occurred in almost half of the children with DMD. The age group in which nutritional disorders were most frequently identified was 10-13 years old. PNST could be considered a tool for screening malnutrition after testing a larger group of DMD patients.

Current practices in the nutrition management of people with amyotrophic lateral sclerosis (ALS): a survey of U.S. ALS care teams

Objective To assess current practices of U.S. professionals providing outpatient ALS nutrition care. Methods A cross-sectional survey assessing nutrition care practices was distributed in February/March 2023 through electronic mailing lists of relevant professional organizations. Results Of the 87 professionals completing the survey, 85.1% were registered dietitians and 50.6% had five or fewer years of experience in ALS care. Many (44.2%) professionals reported receiving no training on the nutrition care of people with ALS (PALS), and 40.2% reported having no other ALS dietitians in their close network. Methods utilized to estimate calorie and protein requirements in PALS varied widely. Although 95.4% of respondents reported that their clinic’s dietitian participates in feeding tube discussions, many practitioners may be waiting until ALS symptoms negatively impact PALS’ breathing, eating, swallowing, or weight to begin discussing feeding tubes. Additionally, few professionals reported institutional practices conducive for refeeding syndrome prevention or monitoring. Conclusions Many professionals providing outpatient nutrition care to PALS possess limited experience, received insufficient training, and are not connected to other ALS dietitians. Specific nutrition care practices, including nutrient need estimation, vary widely among health professionals. Practices surrounding feeding tube discussions and refeeding syndrome may be suboptimal at many institutions. These findings highlight the need for initiatives that educate and connect practitioners providing nutrition care to PALS.

Evaluation of the Antioxidant and Antimicrobial Activity of the Nutritionally Rich Plant, Dioscorea alata L.

Dioscorea alata belongs to Dioscoreaceae or the yam family. Around 600 Dioscorea species are consumed in various regions of the world. Dioscorea alata is well known cultivated tuber consumed by both rural and urban people. In this study, we have investigated the nutrient composition, phytochemicals, and antioxidant and antimicrobial activity of the underground and aerial tubers of Dioscorea alata. The result of the analysis showed that the aerial tuber of D. alata contained a higher amount of moisture (68.51%), ash (4.64%), starch (5.61%), reducing sugar (0.029%), fat (0.33%) and protein (1.39%) than underground tuber of D. alata. At the same time, carbohydrates, free amino acids, vitamin C, sodium, potassium and iron contents were superior in the underground tuber than in the aerial tuber. Further, both underground and aerial tuber was a good source of phenols, flavonoids, tannins and diosgenin. The underground tuber exhibited better DPPH scavenging potential compared to the aerial tuber. Six solvents extract of D. alata showed significant to moderate antibacterial activity toward seven tested clinical stains. Thus, the tuber of D. alata could be used as a better food supplement to meet the calorie requirement and a rich source of relevant antimicrobial agents to treat microbial infections.