Short-term Nutritional Intervention Research Articles

Parenteral vs Enteral Nutrition: A Retrospective Study on PNI and Inflammatory Status

Background: Malnutrition consists of a functional and structural alteration caused by an imbalance between specific needs, intake, or utilization of foods and nutrients. Objective: The aim of this trial is to establish whether PNI (Prognostic Nutritional Index) is related to the inflammation pattern in our patients and which type of AN gives more advantages in clinical practice in improving PNI, and so the prognosis. Methods: During hospitalization, we have identified the presence of malnutrition and its aetiology- type, and initiated artificial nutrition (AN), enteral (EN), or parenteral (PN). For efficacy, we can use many biochemical tests, such as pre-albumin, transferrin, RBP, PINI, and albumin. The retrospective study was conducted by analyzing 145 patients. At baseline and after 7 days, the concentration of Albumin, Platelets, Neutrophils, Lymphocytes, and RCP was measured and was calculated PNI, PLR, and NLR. The patients were divided into three groups according to the treatment received with artificial nutrition: 32 Parenteral (PG), 15 Enteral (EG), and 17 Combined (CG). Results: Between baseline and 7 days, no change was observed, while in EG a significant increase in albumin and RCP and a significant reduction in PNI were observed, and, in CG a significant increase in lymphocytes, in PNI and a significant reduction in NLR. Conclusion: In conclusion, a short-term nutritional intervention can benefit from a combined approach to improve prognostic such as PNI.

Main urinary biomarkers of golden berries (Physalis peruviana) following acute and short-term nutritional intervention in healthy human volunteers

The metabolites entering the bloodstream and being excreted in urine as a result of consuming golden berries are currently unidentified. However, these metabolites potentially underlie the health benefits observed in various in vitro, animal, and human models. A nutritional intervention with 18 healthy human volunteers was performed, and urine was collected at baseline and after acute and short-term fruit consumption for 19 days. After UPLC-ESI/QToF-MS analysis, untargeted metabolomics was performed on the urine samples, and from the 50 most discriminant ions (VIP > 2) generated by a validated PLS-DA model (CV-ANOVA = 3.7e-35; R^2Y = 0.86, Q^2Y = 0.62 and no overfitting), 22 compounds were identified with relatively high confidence. The most discriminant metabolites confirmed by DHS/GC-MS2 analysis of volatiles in urine were sesquiterpenes (C15H22): 3 stereoisomers, β-vatirenene, β-vetivenene, and β-vetispirene, and 2 isomers, eremophila-1(10),8,11-triene and α-curcumene. Another major urinary biomarker was 4β-hydroxywithanolide E and its phase II derivatives, which were observed in urine for all individual up to 24 h after the fruit was consumed; thus, the bioavailability of this biomarker in humans was demonstrated for the first time. Additionally, the excretion of certain acylcarnitines and hypoxanthine in urine increased after golden berry consumption, which may be associated with a detoxifying effect and may occur because fats were utilized rather than carbohydrates to meet the body’s energy needs. The main biomarkers of golden berry consumption are specific to this fruit, confirming its potential for the functional food market.

Effect of short-term educational intervention on complementary feeding index among infants in rural Bangladesh: a randomized control trial

BackgroundTimely, adequate and appropriate Complementary Feeding (CF) is essential for the growth and cognitive development of infants, but until today, evidence-based information is scarce in terms of impact evaluation of CF index (CFI). The study aimed to examine the effect of the short-term intervention of promoting CF practices on the nutritional status of infants in rural Bangladesh.MethodsAn educational-intervention study followed a randomized controlled trial (RCT) design (NCT03024710). Mothers and family members in the intervention arm received intensive counselling on CF through community health workers (CHWs), whereas existing healthcare services were received in the comparison arm. The study was carried out in the rural Matlab sub-district of Bangladesh between April 2011 and March 2013. In the specified study areas among 360 mother-infant pairs systematically assigned into intervention group and comparison group. Short-term educational intervention on CF was provided for the intervention group and existing services were un-intervened for the comparison group. The outcome of interventions was evaluated after the implementation period using Generalized equation estimation model.ResultsAt baseline, the study participants were not different except mean height (p = 0.04), weight-for-age Z score (WAZ) (p = 0.03) and religion (p = 0.04) in between two groups. The mean CFI was significantly higher at intervention area than the comparison and higher category of CFI (score 10 or more) was significantly higher at intervention area than comparison. After adjustment, one-unit CFI increased height-for-age z score by 0.07 units and decreased WAZ by 0.13 units in the intervention group but not significantly changed observed at comparison group.ConclusionGuided short-term nutritional intervention and developed CFI indicated a significantly better score in intervention area than comparison groups and would be a well adaptable tool for future studies.Trial registrationThe trial was registered (NCT03024710) at clinical trial registration website. Date of registration: 1/19/2017.Name of the registry: Clinical Trial.gov.Date of registration: 19/1/2017 (retrospective registered).URL of trial:https://clinicaltrials.gov/ct2/show/NCT03024710

Higher BMI predicts liver fibrosis among obese children and adolescents with NAFLD - an interventional pilot study

BackgroundNon-alcoholic fatty liver disease (NAFLD) can range from simple steatosis to steatohepatitis with or without fibrosis. The predictors for liver fibrosis and the effect of nutritional intervention on hepatic fibrosis in pediatric population are not well established. We aimed to investigate the predictors for liver fibrosis and the effects of short-term nutritional intervention on steatosis and fibrosis among obese adolescents with NAFLD.MethodsCross-sectional study among obese adolescents. Sociodemographic and clinical data were collected. Liver fibrosis was estimated by Shearwave elastography. All participants were recommended to consume a low carbohydrate diet and were followed biweekly. Blood tests and elastography were performed upon admission and repeated after 3 months.ResultsFifty-seven pediatric patients were recruited (35 males, mean age 13.5±2.9 years, mean body mass index [BMI] 38.8±9.7). Liver fibrosis was diagnosed in 34 (60%) subjects, which was moderate/severe (F≥2) in 24 (70%). A higher BMI Z score and moderate/severe steatosis correlated with moderate/severe fibrosis (P < 0.05). Seventeen patients completed 3 months of follow-up and displayed a decrease in BMI Z score (from BMI Z score 2.6±0.5 before intervention to 2.4±0.5 after intervention), with a significant decrease in liver fibrosis (P = 0.001).ConclusionPediatric patients with high BMIs and severe liver steatosis are at risk for severe liver fibrosis. Nutritional intervention with minimal weight loss may improves hepatic fibrosis among the pediatric population.Trial registrationTRN NCT04561804 (9/17/2020)

Long-term effects of an oral elemental nutritional supplement on post-gastrectomy body weight loss in gastric cancer patients (KSES002).

AimThe present study aimed to evaluate the efficacy of short‐term nutritional intervention with an oral elemental diet (ED; Elental; EA Pharma Co., Ltd, Tokyo, Japan) at 300 kcal/day for 6‐8 weeks in the early post‐gastrectomy period on postoperative long‐term body weight loss (BWL).MethodsWe analyzed consecutive patients who were randomly divided to receive the regular diet with or without ED. The control group received regular diet alone post‐gastrectomy, whereas the ED group received 300 kcal ED plus regular diet for 6‐8 weeks. Primary endpoint was percentage (%) BWL (body weight loss; body weight before surgery minus that at postoperative 1 year) by surgical type. Secondary endpoints included changes in nutrition‐related blood parameters.ResultsOf the patients in the original trial, 106 were eligible for efficacy analyses. %BWL at postoperative 1 year was significantly lower in the ED group than in the control group among patients who underwent total gastrectomy (TG) (n = 19 and n = 17, respectively; 9.66 ± 5.98% [95% confidence interval, CI: 6.77‐12.54] vs 15.11 ± 6.78% [95% CI: 11.63‐18.60], P = .015), but not in patients who underwent distal gastrectomy (n = 38 and n = 32, respectively; 5.81 ± 7.91% [95% CI: 3.21‐8.41] vs 5.96 ± 6.20% [95% CI: 3.72‐8.19], P = .933). In multivariate analysis, ED was the only factor affecting %BWL at postoperative 1 year among patients who underwent TG.ConclusionsDaily nutritional intervention (300 kcal/day ED) for 6‐8 weeks reduced %BWL not only at postoperative 6‐8 weeks but also at 1 year in patients who underwent TG.

Economic value of using partially hydrolysed infant formula for risk reduction of atopic dermatitis in high-risk, not exclusively breastfed infants in Singapore.

Previous trials have demonstrated reductions in atopic dermatitis (AD) incidence when healthy, high-risk, non-exclusively breastfed infants were fed until four months of age with 100% whey-based partially hydrolysed formula (PHF-W) versus standard cow's milk formula (CMF). We assessed the cost-effectiveness of this intervention in Singapore. Modelling techniques were used to simulate, from birth to Month 30, the incidence and clinical/economic burden of AD in high-risk, non-exclusively breastfed infants fed with PHF-W or CMF for up to four months. Epidemiologic and clinical data were from a local comparative trial. Expert opinion informed AD treatment patterns and outcomes. Outcomes included reduction in AD risk, time spent with AD, days without AD flare, quality-adjusted life years (QALYs) and direct/indirect costs. Multivariate probabilistic sensitivity analysis was used to assess model parameter uncertainty. Over 30 months, with the use of PHF-W instead of CMF, the proportion of children who developed AD and the time spent with AD decreased by 16.0% (28.3% vs. 44.3%) and 6.4 months, respectively, while time without AD flare and QALYs increased by 14.9 days and 0.021 QALYs per patient, respectively. Estimated AD-related discounted costs per child for PHF-W and CMF were SGD 771 and SGD 1,309, respectively (net savings: SGD 538). PHF-W was less expensive and more effective than CMF for 73%, and cost less than SGD 50,000 per QALY for 87% of all multivariate simulations. Early short-term nutritional intervention with PHF-W instead of CMF may reduce AD incidence and costs for healthy, high-risk, non-exclusively breastfed infants in Singapore.

Effectiveness of "Fun"tastic Nutrition ProgramSM on Nutrition knowledge and Dietary Behavior of Fourth- and Fifth-Grade Students

There is a lack of evidence for the effectiveness of school programs that develop healthy habits, this is critical given the rising concerns related to childhood obesity. The aim of this study was to assess the effectiveness of a comprehensive nutrition education program in improving nutrition knowledge and behaviors among elementary aged students involving four elementary schools in greater St. Louis metropolitan area, inclusive of East St. Louis, Illinois. Educational lessons providing a comprehensive curriculum of nutrition and health education including interactive lectures, activities, and demonstrations were divided among six topics: My Plate; digestion; heart health; food label reading; skeletal system and calcium; and healthy snacking were evaluated by assessing preand post- surveys to determine changes in knowledge and behavior. Results concluded that a short-term nutrition intervention using a comprehensive nutrition and health education curriculum has the capacity to increase nutrition knowledge in an ethnically diverse population of fourth- and fifth grade students.

Nutrition Knowledge and Associated Behavior Changes in a Holistic, Short-term Nutrition Education Intervention with Low-income Women

To assess the impact of a short-term nutrition intervention using education on acomprehensive array of nutrition and health topics in low-income women. Pre- and postintervention surveys; 1 study condition (intervention group); experiential learning; pilot testing of education sessions. Community centers, homeless shelters, or University of Minnesota, in Minneapolis-St Paul metropolitan area. Ethnically diverse, low-income women (n = 118), 23-45 years of age. Three educational sessions providing a comprehensive curriculum of nutrition and health education via experiential and interactive lectures, activities, and demonstrations. One week to implement knowledge and behavioral changes, and pre- and postsurvey sessions to collect anthropometric data and evaluate changes in knowledge and behavior. Health benefits of all food groups; identification of healthful foods; shopping, cooking, and gardening; and energy balance. Paired t tests, Pearson correlations. Postintervention increases in nutrition knowledge and favorable nutrition behavioral changes (P< .05). A short-term nutrition intervention using comprehensive nutrition andhealth education through experiential and interactive lessons, activities, and demonstrations has the capacity to increase nutrition knowledge and favorably change nutrition behaviors in a sample of low-income women.

Nutri-Metabolomics: Subtle Serum Metabolic Differences in Healthy Subjects by NMR-Based Metabolomics after a Short-Term Nutritional Intervention with Two Tomato Sauces

Postgenomics research and development is witnessing novel intersections of omics data intensive technology and applications in health and personalized nutrition. Chief among these is the nascent field of nutri-metabolomics that harnesses metabolomics platforms to discern person-to-person variations in nutritional responses. To this end, differences in the origin and ripening stage of fruits might have a strong impact on their phytochemical composition, and consequently, on their potential nutri-metabolomics effects on health. The objective of the present study was to evaluate the effects of a 4-week cross-over nutritional intervention on the metabolic status of 24 young healthy subjects. The intervention was carried out with two tomato sauces differing in their natural lycopene content, which was achieved by using tomatoes harvested at different times. Blood samples were drawn from each subject before and after each intervention period. Aqueous and lipid extracts from serum samples were analyzed by 1H-NMR metabolic profiling combined with analysis of variance simultaneous component analysis (ASCA) and multilevel simultaneous component analysis (MSCA). These methods allowed the interpretation of the variation induced by the main factors of the study design (sauce treatment and time). The levels of creatine, creatinine, leucine, choline, methionine, and acetate in aqueous extracts were increased after the intervention with the high-lycopene content sauce, while those of ascorbic acid, lactate, pyruvate, isoleucine, alanine were increased after the normal-lycopene content sauce. In conclusion, NMR-based metabolomics of aqueous and lipid extracts allowed the detection of different metabolic changes after the nutritional intervention. This outcome might partly be due to the different ripening state of the fruits used in production of the tomato sauces. The findings presented herein collectively attest to the emergence of the field of nutri-metabolomics as a novel subspecialty of postgenomics integrative biology.

Nutrition and neurodevelopment in children: focus on NUTRIMENTHE project

There is growing evidence that early nutrition affects later cognitive performance. The idea that the diet of mothers, infants, and children could affect later mental performance has major implications for public health practice and policy development and for our understanding of human biology as well as for food product development, economic progress, and future wealth creation. To date, however, much of the evidence is from animal, retrospective studies and short-term nutritional intervention studies in humans. The positive effect of micronutrients on health, especially of pregnant women eating well to maximise their child's cognitive and behavioural outcomes, is commonly acknowledged. The current evidence of an association between gestational nutrition and brain development in healthy children is more credible for folate, n-3 fatty acids, and iron. Recent findings highlight the fact that single-nutrient supplementation is less adequate than supplementation with more complex formulae. However, the optimal content of micronutrient supplementation and whether there is a long-term impact on child's neurodevelopment needs to be investigated further. Moreover, it is also evident that future studies should take into account genetic heterogeneity when evaluating nutritional effects and also nutritional recommendations. The objective of the present review is to provide a background and update on the current knowledge linking nutrition to cognition and behaviour in children, and to show how the large collaborative European Project NUTRIMENTHE is working towards this aim.

A Short-Term Intervention Improves Nutrition Attitudes in Low-Income Women Through Nutrition Education Relating to Financial Savvy

We examined how a short-term nutrition intervention influenced nutrition attitudes in a low-income, ethnically diverse population of women in Minneapolis–St. Paul, Minnesota (n = 118). Each woman received government assistance for food purchases, yet the majority felt that buying healthful food items was impossible on a tight budget. Educational sessions were aimed at increasing financial savvy in relation to purchasing healthful foods on a limited income. Attitudes regarding the ability to buy nutritious foods increased, whereas those reflecting an inability decreased. Government programs may benefit from financial education components directly related to nutrition to increase the health of poor, urban populations through improved financial literacy.

Short‐Term Oral Nutritional Intervention with Protein and Vitamin D Decreases Falls in Malnourished Older Adults

To evaluate the effects of a short-term nutritional intervention with protein and vitamin D on falls in malnourished older adults. Randomized controlled trial. From hospital admission until 3 months after discharge. Malnourished older adults (≥ 60) newly admitted to an acute hospital (n = 210). Participants were randomized to receive nutritional intervention (energy- and protein-enriched diet, oral nutritional supplements, calcium-vitamin D supplement, telephone counseling by a dietitian) for 3 months after discharge or usual care. Number of participants who fell, fall incidents, serum 25-hydroxyvitamin D, and dietary intake. Measurements were performed on admission to hospital and 3 months after discharge. Three months after discharge, 10 participants (10%) in the intervention group had fallen at least once, compared with 24 (23%) in the control group (hazard ratio = 0.41, 95% confidence interval (CI) = 0.19-0.86). There were 57 fall incidents (16 in the intervention group; 41 in the control group). A significantly higher intake of energy (280 kcal, 95% CI = 37-524 kcal) and protein (11 g, 95% CI = 1-25 g) and significantly higher serum 25-hydroxyvitamin D levels (10.9 nmol/L, 95% CI = 2.9-18.9 nmol/L) were found in participants in the intervention group than in controls. A short-term nutritional intervention consisting of oral nutritional supplements and calcium and vitamin D supplementation and supported by dietetic counseling in malnourished older adults decreases the number of patients who fall and fall incidents.

Short-term fatty acid intervention elicits differential gene expression responses in adipose tissue from lean and overweight men

The goal of this study was to investigate the effect of a short-term nutritional intervention on gene expression in adipose tissue from lean and overweight subjects. Gene expression profiles were measured after consumption of an intervention spread (increased levels of polyunsaturated fatty acids, conjugated linoleic acid and medium chain triglycerides) and a control spread (40 g of fat daily) for 9 days. Adipose tissue gene expression profiles of lean and overweight subjects were distinctly different, mainly with respect to defense response and metabolism. The intervention resulted in lower expression of genes related to energy metabolism in lean subjects, whereas expression of inflammatory genes was down-regulated and expression of lipid metabolism genes was up-regulated in the majority of overweight subjects. Individual responses in overweight subjects were variable and these correlated better to waist–hip ratio and fat percentage than BMI.Electronic supplementary materialThe online version of this article (doi:10.1007/s12263-008-0096-z) contains supplementary material, which is available to authorized users.

Integrating Nutrition Security with Treatment of People Living with HIV: Lessons from Kenya

The increased caloric requirements of HIV-positive individuals, undesirable side effects of treatment that may be worsened by malnutrition (but alleviated by nutritional support), and associated declines in adherence and possible increased drug resistance are all justifications for developing better interventions to strengthen the nutrition security of individuals receiving antiretroviral treatment. To highlight key benefits and challenges relating to interventions aimed at strengthening the nutrition security of people living with HIV who are receiving antiretroviral treatment. Qualitative research was undertaken on a short-term nutrition intervention linked to the provision of free antiretroviral treatment for people living with HIV in western Kenya in late 2005 and early 2006. Patients enrolled in the food program while on treatment regimens self-reported greater adherence to their medication, fewer side effects, and a greater ability to satisfy increased appetite. Most clients self-reported weight gain, recovery of physical strength, and the resumption of labor activities while enrolled in dual (food supplementation and treatment) programs. Such improvements were seen to catalyze increased support from family and community. These findings provide further empirical support to calls for a more holistic and comprehensive response to the coexistence of AIDS epidemics with chronic nutrition insecurity. Future work is needed to clarify ways of bridging the gap between short-term nutritional support to individuals and longer-term livelihood security programming for communities affected by AIDS. Such interdisciplinary research will need to be matched by intersectoral action on the part of the agriculture and health sectors in such environments.

Low Protein Intake: The Impact on Calcium and Bone Homeostasis in Humans

Increasing dietary protein results in an increase in urinary calcium. Despite over 80 y of research, the source of the additional urinary calcium remains unclear. Because most calcium balance studies found little effect of dietary protein on intestinal calcium absorption, it was assumed that the skeleton was the source of the calcium. The hypothesis was that the high endogenous acid load generated by a protein-rich diet would increase bone resorption and skeletal fracture. However, there are no definitive nutrition intervention studies that show a detrimental effect of a high protein diet on the skeleton and the hypothesis remains unproven. Recent studies from our laboratory demonstrate that dietary protein affects intestinal calcium absorption. We conducted a series of short-term nutrition intervention trials in healthy adults where dietary protein was adjusted to either low, medium or high. The highest protein diet resulted in hypercalciuria with no change in serum parathyroid hormone. Surprisingly, within 4 d, the low protein diet induced secondary hyperparathyroidism that persisted for 2 wk. The secondary hyperparathyroidism induced by the low protein diet was attributed to a reduction in intestinal calcium absorption (as assessed by dual stable calcium isotopes). The long-term consequences of these low protein-induced changes in calcium metabolism are not known, but they could be detrimental to skeletal health. Several recent epidemiological studies demonstrate reduced bone density and increased rates of bone loss in individuals habitually consuming low protein diets. Therefore, studies are needed to determine whether low protein intakes directly affect rates of bone resorption, bone formation or both.

The Immune Response to Short-term Nutritional Intervention in Advanced Chronic Obstructive Pulmonary Disease

Nine patients with advanced chronic obstructive pulmonary disease (COPD) and recent weight loss resulting in a state of mild malnutrition were entered into a refeeding program at a clinical research center. They were divided into two groups, one using a hospital diet and the other a hospital diet with supplementation. Both groups of patients gained significant weight. Refeeding and weight gain were associated with a significant increase in absolute lymphocyte count and with an increase in reactivity to skin test antigens after 21 days of refeeding. Few changes occurred in large numbers of additional serum measurements during the study period. These preliminary observations suggest that dietary and supplementary refeeding may improve the immune responses in patients with COPD.