Specific Nutritional Recommendations Research Articles

Nutrition, Pregnancy, and Transplantation

One benefit of transplantation, along with the restoration of health, is the opportunity for successful pregnancies. A growing number of pregnancies have been reported among all types of solid-organ recipients. There is an increasing need for practice guidelines that include nutrition information in order to assist practitioners caring for and counseling these high-risk patients. In the transplant community, guidelines for managing pregnancies in transplant recipients have been evolving but lack specific nutrition recommendations. As for all pregnancies, there is a need to optimize nutrition for the mother and her infant, with additional consideration given to the transplant recipient's graft. This article reviews outcomes of posttransplant pregnancies and management guidelines, with special emphasis on nutrition in this unique population.

Nutrition for healthy pregnancy outcomes

Many healthcare professionals and their patients are aware of the importance of proper nutrition during pregnancy, but may not be aware of specific nutritional recommendations on how to achieve a healthy pregnancy outcome. This review article aims to discuss the implications maternal nutritional status and weight gain have in both the short and long terms. Babies born to mothers with inadequate weight gain are more likely to be premature and small for gestational age (SGA). They are also predisposed to obesity and metabolic problems later in life. Women with excessive weight gain during pregnancy are at increased risk for developing type II diabetes later in life. Their offspring also have increased body fat as babies and during childhood. Pregnant women need to be informed about appropriate weight gain and how to achieve this, and should be given specific nutritional recommendations and weight-gain goals.

Nutrition, démences vasculaires et maladie d’Alzheimer

Approximately 770,000 persons in France suffer from dementia. Alzheimer’s disease is the most frequent cause of dementia, followed by the vascular and mixed forms of dementia. In mixed dementia, the vascular lesions contribute to the severity of the cognitive impairment linked to neurodegenerative lesions. In fact, although the prevalence of cerebrovascular disease and Alzheimer’s disease are both high, some data suggest that their association is not fortuitous. Some vascular risk factors, that also represent risk factors for the development of dementia, are liable to be modified, and especially by nutrition. The question is to what extent nutritional factors may de implicated in the risk of developing dementia, and thus to estimate the possibility of modulating this risk by environmental measures. Cognitively impaired patients lose weight and present many nutritional deficiencies, but transversal studies do not allow to establish a causal link between nutrition and the risk of developing dementia. Longitudinal and cohort studies show an association between diabetes, hyperhomocysteinemia, hypercholesterolemia, low intake in n-3 fatty acids and oxidative stress and the risk of dementia. These nutritional factors contribute to the process of atherosclerosis, but also seem implicated in the physiopathology of neurodegenerative lesions by complex mechanisms. On the whole, few interventional studies have been conducted. Only these studies will help propose specific nutritional recommendations for the prevention of the risk of dementia, and/or to develop a new therapeutic approach. Meanwhile, the priority seems to prevent vascular risk factors, in accordance with the objectives of the Programme National Nutrition et Santé.

Gastric motility disorders: management that optimizes nutritional status.

Gastric motility disorders are relatively common, and treatment is often challenging. Various etiologies account for numerous clinical sequelae, with weight loss and severe protein-calorie malnutrition often seen in advanced stages of these disorders. In addition to gastrointestinal motor function, an appreciation of visceral sensation is essential to better understand the symptoms found in these patients, as well as possible therapeutic alternatives. This article provides an overview of gut motor and sensory function, techniques available for diagnosing motor disorders, and the principles of nutritional and medical management. Specific nutritional recommendations and a review of pharmacologic agents and novel treatment modalities are provided.

Nutrition for the pediatric athlete.

A paucity of literature exists with regard to research on nutrition for the pediatric athlete. This lack of research makes the development of specific nutritional recommendations for young athletes problematic. This issue is made difficult by the macro- and micronutrient intake required for growth and development in conjunction with that required for sports. Exogenous carbohydrate drinks could be considered for the young athlete engaged in both endurance exercise and high-intensity exercise. Monitoring of the energy intake during resistance training in the pediatric athlete needs to be considered, as there is evidence to suggest that energy deficits may occur. If decrements in exercise performance are noted, then serum ferritin and hemoglobin concentrations should be monitored, as nonanemic iron deficiency is prevalent in the pediatric athlete. The pediatric athlete exercising in the heat is susceptible to voluntary dehydration and evidence exists to suggest that a carbohydrate-electrolyte drink will abolish this phenomenon.

Colon cancer risk factors from nutrition.

Nutrition and health are closely connected and malnutrition can seriously endanger health. The consequences are higher risks of developing diseases. Of these, cancers are of special importance. The most frequent nutrition-associated type of cancer is colon cancer. This review summarises the predisposing factors for the development of colon cancer, and molecular mechanisms responsible for sporadic colon cancer. Moreover, it is pointed out that individual genetic predisposition such as polymorphisms of biotransformation systems might affect susceptibility to cancer risk factors. Selected findings of epidemiological research and nutritional habits, foods, and metabolites that could increase cancer risk are discussed. Furthermore, toxicological assessment of food-related risk factors, e.g. heterocyclic amines, and potential protective effects of food ingredients, e.g. the induction of phase II enzymes or removal of already degenerated cells from tissue by apoptosis, inhibition of proliferation, and cell differentiation are discussed. Risks are not necessarily reduced by avoiding certain substances but by healthy and well-balanced nutrition. Knowledge of individual susceptibility will also make it possible to recognise risks and design more specific nutritional recommendations.

Medical students' readiness to provide lifestyle counseling for overweight patients

In order to assess medical students' readiness to engage in lifestyle counseling regarding nutrition, physical activity, and other health behaviors, the authors examined the knowledge, attitudes, and health behaviors of medical students. The authors analyzed questionnaire responses of 290 medical students in their first, second, or third year. Students were generally knowledgeable about cardiovascular disease risk factors, however they were less knowledgeable about body mass index (BMI) and specific nutrition and physical activity recommendations. Students were confident in the ability of physicians to change patients' health behaviors and had positive attitudes about providing lifestyle counseling. The upper-level students held significantly less positive attitudes than the first-year students. Almost half the sample reported regularly making unhealthy dietary choices. Only 23% of the sample met the public health guidelines for accumulating 30 min of moderate activity on at least 5 days a week. Third-year students engaged in significantly less activity than their underclassmen. Although medical students express positive attitudes toward providing lifestyle counseling, they require more instruction in the areas of weight screening, nutrition, and physical activity recommendations in order to be helpful to their patients. Because physicians who practice health behaviors are more likely to provide counseling, it would be beneficial to integrate an emphasis on student health into medical curricula.

Assessing the Associations Among Facility Design and Management Practices and Drug Use in Ontario Free-Stall Dairy Herds

In recent years, issues centered on drug use in food producing animals have emerged as major food safety concerns in this agricultural sector. The dairy industry must adopt practical management strategies that minimize drug use in cattle. These strategies need to be identified and must focus on husbandry practices and facility design that minimize animal stress, and that contain specific biosecurity, sanitation and nutritional recommendations to minimize disease-and therefore drug use-in food animals.

The Effect of a Marathon Run on Plasma and Urine Mineral and Metal Concentrations

Background: Little data exist on the requirements of trace metals and minerals for endurance athletes. Changes in body status of these elements must be examined before specific nutritional recommendations can be made. This study was designed to determine whether a marathon run was associated with changes in serum and urine metal and mineral concentrations.Methods: Forty subjects who planned to complete the 1996 Houston-Tennaco marathon were recruited. Subjects had blood and urine samples collected 2 weeks prior to the race and immediately following the race. Blood and urine specimens were analyzed for copper, iron, magnesium and zinc concentrations. Blood was also analyzed for calcium concentration and ceruloplasmin activity.Results: Twenty-six subjects (24 male, 2 female) completed the marathon. Finish times varied between 2 hours 43 minutes and 5 hours 28 minutes. There was no significant change in serum calcium, copper or zinc concentrations or ceruloplasmin activity. Serum and urine magnesium concentration decreased significantly (19.55±1.73 to 16.55±1.53 ppm, p=0.00001; 34.02±8.64 to 21.80±12.24 ppm, p=0.003, respectively). Serum iron concentration increased significantly (1.06±0.48 to 1.35±0.42 ppm, p=0.006), while urine copper and iron concentrations were below the limits of detection, zinc concentration did not change.Conclusions: Serum and urinary magnesium concentrations decrease during endurance running, consistant with the possibility of magnesium deficiency. This may be related to increased demand in skeletal muscle. Serum iron concentration increases, possibly related to tissue injury. The exact etiology for these observations, as well as their clinical significance, requires further investigation.

A comparison of outcome focused documentation with soap notes for inpatient care at Saint Francis Medical Center, Peoria, IL

Outcome Focused Documentation (OFD) was initiated eight months ago at Saint Francis Medical Center, a teaching hospital, to improve documentation focus on nutrition concerns and to increase physician response to dietitian recommendations. OFD incorporates a problem list format and charting by exception. Nutrition problems and concerns are clearly identified and focus on an action plan of treatment and patient outcome results through specific nutrition care interventions and recommendations. Following extensive staff training, implementation of OFD and ongoing medical record audits, a survey of inpatient dietitians was conducted. The survey found that 100% of the dietitians agreed that OFD clearly identifies nutrition problems and focuses on outcome results and actions better than SOAP format. To assess physician receptiveness to dietitian recommendations, medical records were reviewed to check for a physician order within 72 hours. Ninety-one notes in SOAP format were reviewed and found a 27% physician response to dietitian recommendations. A review of OFD indicated 74% of dieititan recommendations were implemented by physicians. OFD has significantly improved physician response to dietitian recommendations at Saint Francis Medical Center due to clearly identified patient nutrition problems and a better understanding of the nutrition intervention process among the health care team.

Nutrition principles for the management of diabetes and related complications.

Health professionals and people with diabetes recognize nutrition therapy as one of the most challenging aspects of diabetes care and education (1). Adherence to meal planning principles requires the person with diabetes to learn specific nutrition recommendations. It may require altering previous patterns of eating and implementing new eating behaviors, which requires motivation for a healthy lifestyle and may also require participation in exercise programs. Finally, individuals must be able to evaluate the effectiveness of these lifestyle changes. Despite these challenges, nutrition is an essential component of successful diabetes management.