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1.
J Am Coll Nutr ; 39(5): 438-442, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31770075

RESUMO

Objective: To assess whether dietary habits can be associated with the presence of primary open angle glaucoma (POAG), while taking into account hereditary factors and metabolic disease.Methods: A case-control study of 100 POAG patients and 100 controls who were queried on their dietary habits. A nonlinear canonical correlation analysis is employed to assess and plot the relationships between the measured variables.Results: Controls had lower consumption of sweets containing processed sugar and avoided eating visible fat on their meat or meat sausages (which tend to contain high amounts of meat fats not plainly obvious) while consuming pure fruit juice and pears more frequently.Conclusions: Dietary habits and practices may have both research and clinical significance in POAG; Caffeine, processed sugar and animal fat appear to have noteworthy negative effects and while caffeine has been researched extensively, more research is needed in the negative role of the other two factors. Other important dietary factors that may be implicated is fruit fiber and various fruit antioxidants and flavonoids.


Assuntos
Dieta/efeitos adversos , Dieta/estatística & dados numéricos , Comportamento Alimentar/fisiologia , Glaucoma de Ângulo Aberto/etiologia , Estado Nutricional , Idoso , Cafeína/efeitos adversos , Cafeína/análise , Estudos de Casos e Controles , Inquéritos sobre Dietas , Gorduras na Dieta/efeitos adversos , Gorduras na Dieta/análise , Açúcares da Dieta/efeitos adversos , Açúcares da Dieta/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Fatores de Risco
2.
Nutr Health ; 26(3): 163-166, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32420830

RESUMO

BACKGROUND: Primary open-angle glaucoma (POAG) has been associated with cardiovascular and dietary risk factors. AIM: This study aimed to determine whether dietary practices correlate with POAG, after controlling for the most important risk factors, namely heredity and cardiovascular risk factors (diabetes mellitus, hypertension and dyslipidaemia). METHODS: Two samples of equal sizes (N = 100) were randomly selected from glaucoma outpatient services with and without POAG. Dietary habits and risk factors for POAG were recorded. RESULTS: Clinical cases can be discerned from controls in 90.5% of all cases, on account of having a familial history of glaucoma, eating less meat per week which is cooked more and with more visible fat and drinking less pure fruit juice. CONCLUSIONS: Drinking pure fruit juice, consuming more meat with less visible fat cooked to a lower effect and modest salt consumption during cooking is practical and easy-to-observe dietary advice for any patients at risk or already suffering from POAG.


Assuntos
Dieta/efeitos adversos , Comportamento Alimentar , Glaucoma de Ângulo Aberto/etiologia , Glaucoma de Ângulo Aberto/genética , Doenças Metabólicas , Doenças Cardiovasculares/complicações , Feminino , Humanos , Masculino , Doenças Metabólicas/complicações , Pessoa de Meia-Idade , Fatores de Risco
3.
J Sex Med ; 15(2): 176-182, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29325831

RESUMO

BACKGROUND: Sexual dysfunction is relatively common in young men, presenting in diverse manifestations, including erectile dysfunction (ED), for which dietary modifications, including increased intake of dietary antioxidants, have been suggested as promising and cost-efficient approaches. AIM: To assess the consumption of selected dietary antioxidants, in particular flavonoids, in relation to ED symptoms in young men. METHODS: Men 18 to 40 years old were invited to complete an anonymous web-based questionnaire for this case-control study. ED was diagnosed with the International Index of Erectile Function (IIEF) and flavonoid intake was recorded using food-frequency questionnaires, with an emphasis on flavonoid-rich foods such as coffee, fruits, etc. Participants without ED (IIEF score ≥ 26; n = 264) formed the control group and those with ED (IIEF score < 26; n = 86) formed the case group. OUTCOMES: Dietary flavonoid intake. RESULTS: Men with ED reported a lower median monthly intake of total flavonoids (-2.18 g, 95% CI = -3.15 to -1.21, P < .001) and all flavonoid subclasses (P < .001) compared with controls. Adjustment of intake for age and body mass index showed that consumption of flavonoids 50 mg/day lowered the risk for ED by 32% (odds ratio = 0.68, 95% CI = 0.55-0.85, P < .001). Of all recorded flavonoids, flavones appeared to contribute the most to healthy erectile function. Controls reported a greater consumption of vegetables and fruits, a lower intake of dairy and alcoholic beverages, and a less intense smoking habit compared with cases (P < .001). CLINICAL IMPLICATIONS: Increased intake of fruits, vegetables, and flavonoids decreases the risk of ED in young men. STRENGTH AND LIMITATIONS: The strength of this study stems from the innovative hypothesis, the young age of participants, and the suggested therapeutic effects of cheap dietary components against ED. Limitations include the relatively small sample and cross-sectional design. CONCLUSION: Low flavonoid-in particular flavone-intake is associated with ED in young adult men. Mykoniatis I, Grammatikopoulou MG, Bouras E, et al. Sexual Dysfunction Among Young Men: Overview of Dietary Components Associated With Erectile Dysfunction. J Sex Med 2018;15:176-182.


Assuntos
Antioxidantes/administração & dosagem , Dieta , Disfunção Erétil/epidemiologia , Adolescente , Adulto , Índice de Massa Corporal , Estudos de Casos e Controles , Estudos Transversais , Disfunção Erétil/fisiopatologia , Flavonas/administração & dosagem , Flavonoides/administração & dosagem , Frutas , Humanos , Masculino , Razão de Chances , Inquéritos e Questionários , Adulto Jovem
4.
Eat Weight Disord ; 23(4): 459-467, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29779146

RESUMO

PURPOSE: Health sciences, and in particular Nutrition and Dietetics students, have been shown to exhibit an increased prevalence of disordered eating. The aim of the present cross-sectional study was to evaluate other specified feeding and eating disorders (OSFEDs), including stress-related eating, food addiction, and orthorexia, in relation to the dietary intake, among nutrition/dietetics students. METHODS: A total of 176 undergraduate students from a Department of Nutrition and Dietetics, in Greece, participated in the study. Dietary intake was recorded, and the prevalence of Eating and Appraisal Due to Emotion and Stress (EADES), food addiction (with the modified Yale Food Addition scale mYFAS), and orthorexia were assessed. Chi-square and t tests were performed between sexes, orthorexic and non-orthorexic students, as well as between food-addicted and non-addicted participants. Multiple linear regression analysis assessed relationships between energy intake, BMI or waist circumference, and the food-related psychometric scales. RESULTS: Among participating students, 4.5% had food addiction and 68.2% demonstrated orthorexia. No differences were observed between men and women, concerning the prevalence of food addiction and orthorexia, the sum of mYFAS symptoms, or individual EADES factors. Orthorexic students exhibited increased BMI, reduced energy, and saturated fat intake. In addition, orthorexic men consumed more vegetables. Multiple linear regression analysis revealed that orthorexic behavior was associated with increased BMI, waist circumference and energy intake. Lower BMI was associated with increasing ability to cope with emotion-and-stress-related eating and increasing appraisal of ability and resources to cope with emotions and stress. Emotion-and-stress-related eating was negatively associated with BMI. Appraisal of ability and resources to cope with emotions and stress was associated with the energy intake. Finally, age was positively correlated with the appraisal of outside stressors/influences, indicating increased ability to cope with outside stressors among older students. CONCLUSIONS: The study shows that despite the suggested interventions, the problem of OSFEDs among nutrition and dietetics students is still valid. Regular screening, counseling, and education is needed to reduce its prevalence. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Dependência de Alimentos/epidemiologia , Estresse Psicológico/epidemiologia , Adolescente , Adulto , Estudos Transversais , Dietética/educação , Emoções/fisiologia , Comportamento Alimentar/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Dependência de Alimentos/psicologia , Grécia , Humanos , Masculino , Comportamento Obsessivo/epidemiologia , Comportamento Obsessivo/psicologia , Prevalência , Estresse Psicológico/psicologia , Estudantes/psicologia , Inquéritos e Questionários , Universidades , Adulto Jovem
5.
Crit Care ; 21(1): 131, 2017 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-28583157

RESUMO

Nutrition support is a necessary therapy for critically ill cardiac surgery patients. However, conclusive evidence for this population, consisting of well-conducted clinical trials is lacking. To clarify optimal strategies to improve outcomes, an international multidisciplinary group of 25 experts from different clinical specialties from Germany, Canada, Greece, USA and Russia discussed potential approaches to identify patients who may benefit from nutrition support, when best to initiate nutrition support, and the potential use of pharmaco-nutrition to modulate the inflammatory response to cardiopulmonary bypass. Despite conspicuous knowledge and evidence gaps, a rational nutritional support therapy is presented to benefit patients undergoing cardiac surgery.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Doenças Cardiovasculares/dietoterapia , Consenso , Apoio Nutricional/tendências , Adulto , Humanos , Comunicação Interdisciplinar , Internacionalidade , Metabolismo/fisiologia , Estado Nutricional
6.
Ann Nutr Metab ; 65(2-3): 101-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25413647

RESUMO

Growth and development are central characteristics of childhood. Deviations from normal growth can indicate serious health challenges. The adverse impact of early growth faltering and malnutrition on later health has long been known. In contrast, the impact of rapid early weight and body fat gain on programming of later disease risk have only recently received increased attention. Numerous observational studies related diet in early childhood and rapid early growth to the risk of later obesity and associated disorders. Causality was confirmed in a large, double-blind randomised trial testing the 'Early Protein Hypothesis'. In this trial we found that attenuation of protein supply in infancy normalized early growth and markedly reduced obesity prevalence in early school age. These results indicate the need to describe and analyse growth patterns and their regulation through diet in more detail and to characterize the underlying metabolic and epigenetic mechanisms, given the potential major relevance for public health and policy. Better understanding of growth patterns and their regulation could have major benefits for the promotion of public health, consumer-orientated nutrition recommendations, and the development of improved food products for specific target populations.


Assuntos
Fenômenos Fisiológicos da Nutrição do Lactente , Obesidade/epidemiologia , Obesidade/prevenção & controle , Peso Corporal , Aleitamento Materno , Dieta , Proteínas Alimentares/administração & dosagem , Epigênese Genética , Humanos , Lactente , Fórmulas Infantis/química , Estado Nutricional , Prevalência , Saúde Pública , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco
7.
Ann Nutr Metab ; 64(3-4): 187-96, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25300259

RESUMO

At The Power of Programming 2014 Conference, researchers from multiple disciplines presented and discussed the effects of early nutrition and other environmental cues during the first thousand days of life and beyond on the lifelong risk of noncommunicable diseases. This paper aims to summarize the concepts and some of the first achievements of the EarlyNutrition research project that initiated the conference. The EarlyNutrition consortium is a multinational, multidisciplinary research collaboration of researchers from Europe, the USA, and Australia. A focus is placed on exploration of the developmental origins of obesity, adiposity, and related health outcomes. Here we report on the first findings of experimental approaches, cohort studies, randomized clinical trials, and systematic reviews of current information, as well as position papers, which have all been developed with the involvement of project partners. We conclude that the EarlyNutrition project has successfully established itself during the first 2 project years as a very strong platform for collaborative research on early programming effects. The first results, available already at this early stage of the project, point to great opportunities for health prevention strategies via the implementation of dietary and lifestyle modifications, with large effect sizes. Further results are expected which should support improved recommendations and related policies for optimized nutrition and lifestyle choices before and during pregnancy, in infancy, and in early childhood.


Assuntos
Desenvolvimento Infantil , Desenvolvimento Fetal , Promoção da Saúde , Fenômenos Fisiológicos da Nutrição do Lactente , Fenômenos Fisiológicos da Nutrição Materna , Política Nutricional , Obesidade/prevenção & controle , Adiposidade , Austrália/epidemiologia , Congressos como Assunto , Dieta/efeitos adversos , Europa (Continente)/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Estilo de Vida , Masculino , Obesidade/epidemiologia , Obesidade/etiologia , Gravidez , Fatores de Risco , Estados Unidos/epidemiologia
8.
J Community Health ; 39(5): 972-9, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24519180

RESUMO

The purpose of this study was to examine self-care behaviors of adults with type 2 diabetes mellitus living in the Metropolitan Area of Thessaloniki in Northern Greece. The Summary of Diabetes Self-Care behaviors measurement was administered to 215 patients, out of which 177 were eligible to participate (87 males). Patients, aged 30 years or more, were recruited through a university hospital day-clinic. Older patients (>65 years), as well as those with "higher educational level" did not distribute their daily carbohydrate intake equally. Nevertheless, they were more likely to adapt to their physician's recommendations regarding medication and to regularly perform suggested blood glucose checking. Exercise patterns were more often found for higher educated, earlier diagnosed males. Younger patients were less likely to follow their healthcare professional's recommendations, regarding diet, medication intake, blood glucose checking, foot care and exercise compared to older patients. These results pose a higher risk for complications and morbidity in younger patients with type 2 diabetes mellitus, who most possibly will require intensive treatment in the future.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Autocuidado/psicologia , Adulto , Fatores Etários , Idoso , Automonitorização da Glicemia/psicologia , Automonitorização da Glicemia/estatística & dados numéricos , Diabetes Mellitus Tipo 2/psicologia , Pé Diabético/prevenção & controle , Escolaridade , Feminino , Grécia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Autocuidado/estatística & dados numéricos
9.
Curr Dev Nutr ; 8(6): 103764, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38813480

RESUMO

Most authorized health claims on foods have been established on the basis of single dietary components, mainly micronutrients, such as vitamins, minerals, and possibly bioactives. Failure to sufficiently define and characterize the nutritional profile of a food product is one of the main reasons for rejection or incomplete status for thousands of health claim applications, whereas the food's contaminant profile is simply not accounted for. The objective of this work was to highlight the accumulating scientific evidence supporting a reform of the health claim evaluation process for foods toward more holistic approaches. This would entail the characterization of multiple nutrient-contaminant pairs and contaminant mixture profiles at contaminant levels currently considered "safe," including their interactions that would impact human health outcome(s) in a net positive or negative direction. The notion of a stable nutritional profile in food commodities has been challenged by studies reporting a variable food contaminant content and a declining content of proteins/micronutrients in crops due to anthropogenic greenhouse gas emissions. A holistic approach in the health claim process for foods would entail the incorporation of cumulative risk assessment and/or risk-benefit protocols that effectively combine health risks and benefits associated with multiple nutritional and contaminant attributes of the food/diet under evaluation.

10.
Nutrients ; 16(11)2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38892649

RESUMO

The level of NCP implementation varies across countries due to differences identified in major components of health systems such as infrastructures, legislation, training, and cultural diversities. Dietitians in Greece receive sufficient training in the implementation of the NCP as part of their main studies; however, the level of awareness and adoption of the NCP model is still quite low, with limited information on the potential barriers. The primary aim of this study was to gain a deeper understanding of the perspectives of Greek dietitians on the NCP and the use of digital tools. An online survey was created and distributed through the platform "SurveyMonkey version 4.1.1". The overall structure of the questionnaire was modeled according to the validated NCP/NCPT INIS Tool. A total of 279 subjects were included in this study, and 192 were aware of the NCP tool. The most important challenges for the implementation of the NCP included communication with other healthcare professionals (68.2%), provision of appropriate care (33.9%), and insufficient access to continuous education (29.2%). Of the 192 participants who knew the NCP, 81.3% reported using digital applications for the collection and assessment of health data, while 18.8% indicated that they did not utilize such tools. No relationship was found between the use of digital applications by dietitians, NCP knowledge, and demographic characteristics. Our findings highlight the need for targeted educational interventions and appropriate application of standardized protocols by Greek dietitians in daily practice. National Dietetic Associations should provide sufficient guidance on digital tool utilization in facilitating patient data management and enhancing NCP implementation.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Nutricionistas , Humanos , Grécia , Feminino , Masculino , Inquéritos e Questionários , Adulto , Pessoa de Meia-Idade , Terapia Nutricional
11.
Clin Nutr ; 43(6): 1599-1626, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38772068

RESUMO

BACKGROUND & AIMS: Dementia is accompanied by a variety of changes that result in an increased risk of malnutrition and low-intake dehydration. This guideline update aims to give evidence-based recommendations for nutritional care of persons with dementia in order to prevent and treat these syndromes. METHODS: The previous guideline version was reviewed and expanded in accordance with the standard operating procedure for ESPEN guidelines. Based on a systematic search in three databases, strength of evidence of appropriate literature was graded by use of the SIGN system. The original recommendations were reviewed and reformulated, and new recommendations were added, which all then underwent a consensus process. RESULTS: 40 recommendations for nutritional care of older persons with dementia were developed and agreed, seven at institutional level and 33 at individual level. As a prerequisite for good nutritional care, organizations caring for persons with dementia are recommended to employ sufficient qualified staff and offer attractive food and drinks with choice in a functional and appealing environment. Nutritional care should be based on a written care concept with standardized operating procedures. At the individual level, routine screening for malnutrition and dehydration, nutritional assessment and close monitoring are unquestionable. Oral nutrition may be supported by eliminating potential causes of malnutrition and dehydration, and adequate social and nursing support (including assistance, utensils, training and oral care). Oral nutritional supplements are recommended to improve nutritional status but not to correct cognitive impairment or prevent cognitive decline. Routine use of dementia-specific ONS, ketogenic diet, omega-3 fatty acid supplementation and appetite stimulating agents is not recommended. Enteral and parenteral nutrition and hydration are temporary options in patients with mild or moderate dementia, but not in severe dementia or in the terminal phase of life. In all stages of the disease, supporting food and drink intake and maintaining or improving nutrition and hydration status requires an individualized, comprehensive approach. Due to a lack of appropriate studies, most recommendations are good practice points. CONCLUSION: Nutritional care should be an integral part of dementia management. Numerous interventions are available that should be implemented in daily practice. Future high-quality studies are needed to clarify the evidence.


Assuntos
Desidratação , Demência , Desnutrição , Humanos , Demência/terapia , Demência/dietoterapia , Desidratação/terapia , Desidratação/prevenção & controle , Desnutrição/terapia , Desnutrição/prevenção & controle , Desnutrição/diagnóstico , Estado Nutricional , Avaliação Nutricional , Apoio Nutricional/métodos , Apoio Nutricional/normas , Idoso , Terapia Nutricional/normas , Terapia Nutricional/métodos , Hidratação/métodos , Hidratação/normas
12.
Clin Nutr ; 43(6): 1678-1683, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38471980

RESUMO

Primary care healthcare professionals (PCHPs) are pivotal in managing chronic diseases and present a unique opportunity for nutrition-related disease prevention. However, the active involvement of PCHPs in nutritional care is limited, influenced by factors like insufficient education, lack of resources, and time constraints. In this position paper The European Society for Clinical Nutrition and Metabolism (ESPEN) promotes the active engagement of PCHPs in nutritional care. We emphasize the importance of early detection of malnutrition by screening and diagnosis, particularly in all individuals presenting with risk factors such as older age, chronic disease, post-acute disease conditions and after hospitalization for any cause. ESPEN proposes a strategic roadmap to empower PCHPs in clinical nutrition, focusing on education, tools, and multidisciplinary collaboration. The aim is to integrate nutrition into medical curricula, provide simple screening tools for primary care, and establish referral pathways to address malnutrition systematically. In conclusion, we urge for collaboration with PCHP organizations to raise awareness, enhance nutrition skills, facilitate dietitian accessibility, establish multidisciplinary teams, and promote referral pathways, thereby addressing the underestimated clinical challenge of malnutrition in primary care.


Assuntos
Desnutrição , Atenção Primária à Saúde , Humanos , Desnutrição/diagnóstico , Desnutrição/prevenção & controle , Desnutrição/terapia , Avaliação Nutricional , Europa (Continente) , Terapia Nutricional/métodos
13.
Clin Nutr ; 43(2): 413-445, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-38169175

RESUMO

BACKGROUND: Nutritional status is paramount in Cystic Fibrosis (CF) and is directly correlated with morbidity and mortality. The first ESPEN-ESPGHAN-ECFS guidelines on nutrition care for infants, children, and adults with CF were published in 2016. An update to these guidelines is presented. METHODS: The study was developed by an international multidisciplinary working group in accordance with officially accepted standards. Literature since 2016 was reviewed, PICO questions were discussed and the GRADE system was utilized. Statements were discussed and submitted for on-line voting by the Working Group and by all ESPEN members. RESULTS: The Working Group updated the nutritional guidelines including assessment and management at all ages. Supplementation of vitamins and pancreatic enzymes remains largely the same. There are expanded chapters on pregnancy, CF-related liver disease, and CF-related diabetes, bone disease, nutritional and mineral supplements, and probiotics. There are new chapters on nutrition with highly effective modulator therapies and nutrition after organ transplantation.


Assuntos
Fibrose Cística , Terapia Nutricional , Lactente , Criança , Adulto , Humanos , Fibrose Cística/terapia , Estado Nutricional , Vitaminas , Vitamina A
14.
Nutrition ; 123: 112396, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38554461

RESUMO

OBJECTIVE: Parenteral nutrition represents a therapeutic option for patients with type 3 intestinal failure. If used exclusively, parenteral nutrition has to be complete to provide all essential nutrients. The aim was to assess the availability of parenteral nutrition in all parts of the world, to better comprehend the global situation, and to prepare an action plan to increase access to parenteral nutrition. METHODS: An international survey using an electronic questionnaire was conducted in August 2019 and repeated in May 2022. An electronic questionnaire was sent to 52 members or affiliates of the International Clinical Nutrition Section of the American Society for Parenteral and Enteral Nutrition. Questions addressed the availability of parenteral nutrition admixtures and their components, reimbursement, and prescribing pre- and post-COVID-19 pandemic. All participating countries were categorized by their economic status. RESULTS: Thirty-six country representatives responded, answering all questions. Parenteral nutrition was available in all countries (100%), but in four countries (11.1%) three-chamber bags were the only option, and in six countries a multibottle system was still used. Liver-sparing amino acids were available in 18 (50%), kidney-sparing in eight (22.2%), and electrolyte-free in 11 (30.5%) countries (30.5%). In most countries (n = 28; 79.4%), fat-soluble and water-soluble vitamins were available. Trace elements solutions were unavailable in four (11.1%) countries. Parenteral nutrition was reimbursed in most countries (n = 33; 91.6%). No significant problems due to the coronavirus pandemic were reported. CONCLUSIONS: Despite the apparent high availability of parenteral nutrition worldwide, there are some factors that may have a substantial effect on the quality of parenteral nutrition admixtures. These shortages create an environment of inequality.


Assuntos
COVID-19 , Nutrição Parenteral , Humanos , COVID-19/epidemiologia , Nutrição Parenteral/estatística & dados numéricos , Nutrição Parenteral/métodos , Inquéritos e Questionários , Saúde Global , SARS-CoV-2 , Pandemias , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Soluções de Nutrição Parenteral/provisão & distribuição
15.
Nutrients ; 15(6)2023 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-36986138

RESUMO

Phase angle (PhA) and muscle strength are predictors of clinical outcomes in critically ill patients. Malnutrition may affect body composition measurements. The aim of this prospective study was to investigate the association between PhA and handgrip strength (HGS), and clinical outcomes in hospitalized COVID-19 patients. The study included a total of 102 patients. Both PhA and HGS were measured twice, within 48 h of hospital admission and on the 7th day of hospitalization. The primary outcome was the clinical status on the 28th day of hospitalization. Secondary outcomes included the hospital length of stay (LOS), the concentrations of ferritin, C-reactive protein and albumin, oxygen requirements and the severity of pneumonia. A one-way analysis of variance (ANOVA) test and Spearman rS correlation coefficient were used for statistical analysis. No differences were found for PhA [on day 1 (p = 0.769) and day 7 (p = 0.807)] and the primary outcome. A difference was found between HGS on day 1 and the primary outcome (p = 0.008), while no difference was found for HGS on day 7 (p = 0.476). Body mass index was found to be associated with the oxygen requirement on day 7 (p = 0.005). LOS was correlated neither with PhA (rs = -0.081, p = 0.422) nor with HGS (rs = 0.137, p = 0.177) on the first day. HGS could be a useful indicator of clinical outcomes in COVID-19 patients, while PhA does not seem to have a clinical impact. However, further research is needed to validate the results of our study.


Assuntos
COVID-19 , Desnutrição , Humanos , Força da Mão/fisiologia , Estudos Prospectivos , COVID-19/terapia , Índice de Massa Corporal
16.
Nutr Hosp ; 40(4): 858-885, 2023 Aug 28.
Artigo em Espanhol | MEDLINE | ID: mdl-37409729

RESUMO

Introduction: This ESPEN practical guideline will inform physicians, nurses, dieticians, pharmacists, caregivers and other home enteral nutrition (HEN) providers in a concise way about the indications and contraindications for HEN, as well as its implementation and monitoring. This guideline will also inform interested patients requiring HEN. Home parenteral nutrition is not included but will be addressed in a separate ESPEN guideline. The guideline is based on the ESPEN scientific guideline published before, which consists of 61 recommendations that have been reproduced and renumbered, along with the associated commentaries that have been shorted compared to the scientific guideline. Evidence grades and consensus levels are indicated. The guideline was commissioned and financially supported by ESPEN and the members of the guideline group were selected by ESPEN.


Introducción: Esta guía práctica de la European Society for Clinical Nutrition and Metabolism (ESPEN) proporciona información a médicos, enfermeras, dietistas, farmacéuticos, cuidadores y otros proveedores de nutrición enteral domiciliaria (NED) de forma concisa, sobre las indicaciones y contraindicaciones de la NED, así como sobre su administración y seguimiento. Esta guía también ofrece información a los pacientes interesados que necesiten NED. La nutrición parenteral domiciliaria no está incluida, pero se abordará en otra guía de la ESPEN. La guía se basa en la guía científica de la ESPEN publicada anteriormente, que consta de 61 recomendaciones (que se han reproducido y renumerado), junto con los comentarios asociados (que se han resumido en relación a la guía científica). Se indican los grados de evidencia y los niveles de consenso. La ESPEN encargó y financió la guía y seleccionó también a los miembros del grupo.


Assuntos
Nutrição Enteral , Nutrição Parenteral no Domicílio , Humanos , Sociedades Científicas , Consenso
17.
JPEN J Parenter Enteral Nutr ; 47(5): 604-613, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-36912124

RESUMO

BACKGROUND: Cardiac surgery patients with a prolonged stay in the intensive care unit (ICU) are at high risk for acquired malnutrition. Medical nutrition therapy practices for cardiac surgery patients are unknown. The objective of this study is to describe the current nutrition practices in critically ill cardiac surgery patients worldwide. METHODS: We conducted a prospective observational study in 13 international ICUs involving mechanically ventilated cardiac surgery patients with an ICU stay of at least 72 h. Collected data included the energy and protein prescription, type of and time to the initiation of nutrition, and actual quantity of energy and protein delivered (maximum: 12 days). RESULTS: Among 237 enrolled patients, enteral nutrition (EN) was started, on average, 45 h after ICU admission (range, 0-277 h; site average, 53 [range, 10-79 h]). EN was prescribed for 187 (79%) patients and combined EN and parenteral nutrition in 33 (14%). Overall, patients received 44.2% (0.0%-117.2%) of the prescribed energy and 39.7% (0.0%-122.8%) of the prescribed protein. At a site level, the average nutrition adequacy was 47.5% (30.5%-78.6%) for energy and 43.6% (21.7%-76.6%) for protein received from all nutrition sources. CONCLUSION: Critically ill cardiac surgery patients with prolonged ICU stay experience significant delays in starting EN and receive low levels of energy and protein. There exists tremendous variability in site performance, whereas achieving optimal nutrition performance is doable.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Estado Terminal , Humanos , Estado Terminal/terapia , Ingestão de Energia , Apoio Nutricional , Nutrição Enteral , Unidades de Terapia Intensiva
18.
Clin Nutr ; 41(12): 2869-2886, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-34140163

RESUMO

The COVID-19 pandemics has created unprecedented challenges and threats to patients and healthcare systems worldwide. Acute respiratory complications that require intensive care unit (ICU) management are a major cause of morbidity and mortality in COVID-19 patients. Among other important risk factors for severe COVID-19 outcomes, obesity has emerged along with undernutrition-malnutrition as a strong predictor of disease risk and severity. Obesity-related excessive body fat may lead to respiratory, metabolic and immune derangements potentially favoring the onset of COVID-19 complications. In addition, patients with obesity may be at risk for loss of skeletal muscle mass, reflecting a state of hidden malnutrition with a strong negative health impact in all clinical settings. Also importantly, obesity is commonly associated with micronutrient deficiencies that directly influence immune function and infection risk. Finally, the pandemic-related lockdown, deleterious lifestyle changes and other numerous psychosocial consequences may worsen eating behaviors, sedentarity, body weight regulation, ultimately leading to further increments of obesity-associated metabolic complications with loss of skeletal muscle mass and higher non-communicable disease risk. Therefore, prevention, diagnosis and treatment of malnutrition and micronutrient deficiencies should be routinely included in the management of COVID-19 patients in the presence of obesity; lockdown-induced health risks should also be specifically monitored and prevented in this population. In the current document, the European Society for Clinical Nutrition and Metabolism (ESPEN) aims at providing clinical practice guidance for nutritional management of COVID-19 patients with obesity in various clinical settings.


Assuntos
COVID-19 , Desnutrição , Humanos , Controle de Doenças Transmissíveis , Obesidade/complicações , Obesidade/terapia , Desnutrição/etiologia , Desnutrição/terapia , Desnutrição/diagnóstico , Micronutrientes
19.
Clin Nutr ; 41(2): 468-488, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35007816

RESUMO

This ESPEN practical guideline will inform physicians, nurses, dieticians, pharmacists, caregivers and other home enteral nutrition (HEN) providers in a concise way about the indications and contraindications for HEN, as well as its implementation and monitoring. This guideline will also inform interested patients requiring HEN. Home parenteral nutrition is not included but will be addressed in a separate ESPEN guideline. The guideline is based on the ESPEN scientific guideline published before, which consists of 61 recommendations that have been reproduced and renumbered, along with the associated commentaries that have been shorted compared to the scientific guideline. Evidence grades and consensus levels are indicated. The guideline was commissioned and financially supported by ESPEN and the members of the guideline group were selected by ESPEN.


Assuntos
Nutrição Enteral/normas , Serviços de Assistência Domiciliar/normas , Consenso , Gastroenterologia/normas , Humanos , Sociedades Científicas
20.
Appetite ; 57(2): 377-83, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21651931

RESUMO

The aim of this study was the evaluation of dietary habits in regard to cardiovascular risk status in university students in Northern Greece. 215 students (101 males) (age 21.5±2.3 years) participated in the study. Dietary intake was determined by using 3-day food record (1 weekend day). Recorded energy and nutrient intakes were compared to RDA and recommendations given by the American Heart Association (AHA). Students' smoking status and familial chronic diseases were recorded. A percentage of 55.8% (males) and 45.7% (females) were physically moderately active. When compared to AHA guidelines, the students had averagely significantly higher intake of total fat, saturated fat, sodium and dietary cholesterol and lower intake of polyunsaturated fat, monounsaturated fat, folate, vitamin E and fiber. 95% of them failed to meet all AHA dietary recommendations, with polyunsaturated to saturated fat ratio and the percentage of total fat being the top two failed parameters and sodium (10.2%) being the one less problematic. Dietary habits of Greek university students differ from what is considered as health promoting and, in the case that it they are not altered, may have an adverse effect on their CV health, despite the fact that their mean body weight is only moderately high.


Assuntos
Doenças Cardiovasculares/epidemiologia , Dieta , Comportamento Alimentar , American Heart Association , Colesterol na Dieta/administração & dosagem , Gorduras na Dieta/administração & dosagem , Fibras na Dieta/administração & dosagem , Ingestão de Energia , Feminino , Ácido Fólico/administração & dosagem , Grécia/epidemiologia , Guias como Assunto , Humanos , Masculino , Política Nutricional , Fatores de Risco , Sódio na Dieta/administração & dosagem , Estados Unidos , Vitamina E/administração & dosagem , População Branca , Adulto Jovem
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