ABSTRACT
BACKGROUND: The role of CB2R gene variants on weight loss after a dietary intervention has been investigated in few studies. OBJECTIVE: We evaluate the effect of this genetic variant (rs3123554) of CB2R gene on cardiovascular risk factors and weight loss secondary to high monounsaturated fat vs a high polyunsaturated fat hypocaloric diets. DESIGN: A Caucasian population of 362 obese patients was enrolled. Patients were randomly allocated during 3 months to one of two diets (Diet P high polyunsaturated (PUFAs) fat hypocaloric diet vs, Diet M high monounsaturated (MUFAs) fat hypocaloric diet). RESULTS: In both genotype groups (GG vs GA+AA), body weight, body mass index (BMI), fat mass, waist circumference and systolic blood pressure decreased after diet P and M. Body weight, BMI, fat mass and waist circumference were higher in A allele carriers than non A allele carriers. The improvement of these parameters was higher in non A allele carriers than A allele carriers. In non A allele carriers with both diets, the decrease of total cholesterol, LDL-cholesterol, insulin and HOMA-IR was higher than A allele carriers after both diets. After diet P, triglyceride levels decrease in non A allele carriers. CONCLUSION: Our data suggest that carriers of the minor allele of rs3123554 variant of CB2R gene lose less body weight during to different hypocaloric diets with different fatty acid. Moreover, non A-allele carriers showed a better response of LDL-cholesterol, HOMA-IR and insulin levels than A-carriers with both hypocaloric diets.
Subject(s)
Diet, Reducing/methods , Obesity , Polymorphism, Single Nucleotide/genetics , Receptor, Cannabinoid, CB2/genetics , Adult , Blood Pressure , Body Mass Index , Dietary Fats/metabolism , Fatty Acids, Unsaturated/metabolism , Female , Humans , Male , Middle Aged , Obesity/diet therapy , Obesity/epidemiology , Obesity/metabolism , Weight Loss/geneticsABSTRACT
OBJECTIVE: Non-alcoholic fatty liver disease (NAFLD) is an increasingly recognized health problem. Various treatment strategies such as thiazolidinediones, metformin, lipid-lowering agents and antioxidants have been evaluated. So far, no single intervention has convincingly improved liver histology. Experience of using silymarin alone or in combination with other agents in patients with NAFLD is limited in the medical literature. The present study was conducted to evaluate the efficacy of silymarin plus vitamin E in the treatment of NAFLD. PATIENTS AND METHODS: A sample of 36 patients was enrolled. The diagnosis of NAFLD was confirmed by percutaneous liver biopsy. All patients were randomized to one of the following intervention groups: group I: treated with 2 tablets per day of silymarin plus vitamin E (Eurosil 85®, MEDAS SL) and a lifestyle modification program consisting of hypocaloric diet (1520 kcal, 52% of carbohydrates, 25% of lipids and 23% of proteins) and exercise for 3 months and group II (only with the hypocaloric diet). Anthropometric variables as waist circumference, weight, body mass index (BMI) were measured. Biochemical parameters: Glucose, triglycerides, AST, ALT, GGt levels and insulin resistance (HOMA-IR) were determined under fasting conditions. Non-invasive NAFLD-index were applied before and after the treatments: Fatty liver index (FLI), liver accumulation product (LAP) and NAFLD-Fibrosis score (FS). RESULTS: The mean age was 47.4 ± 11.2 years old (range 18-67); 22 men and 14 women. In group I, 11 patients (61%) have a NAS-score > 5 and 10 (55.5%) in the group II (NS). Anthropometric parameters decreased after treatment in both groups. Patients in both groups showed a decrease in GGt levels after treatment (group I: 68 IU/L vs. 46.2 ± 27 IU/L; p < 0.05 and group II 80.5 ± 46 IU/L vs. 50.3 ± 27 IU/L; p < 0.05). Only in group II we observed a significant decrease in AST and ALT levels. In both groups, we observed a decrease in: FLI index (group I: 86.2 ± 19 vs. 76.9 + 20; p < 0.05 and in group II: 85.2 ± 18 vs. 77.5 ± 23; p < 0.05), and NAFLD-FS index (group I: -1.6 ± 1.8 vs. -2.1 ± 1.5; p < 0.05 and in group II -1 ± 1.9 vs. -1.5 ± 2.1; p < 0.05). Patients in group I who did not get a 5% loss of weight also displayed decreased GGt levels, and in the FLI and NAFLD-FS indexes; whereas patients in group II without decrease of 5% by weight showed no improvement in any of the analyzed parameters. CONCLUSIONS: Treatment with silymarin plus vitamin E and a hypocaloric diet ameliorate function hepatic test, and non-invasive NAFLD index. Silymarin can be an alternative valid therapeutic option particularly when other drugs are not indicated or have failed or as a complementary treatment associated with other therapeutic programs.
Subject(s)
Non-alcoholic Fatty Liver Disease/drug therapy , Silymarin/administration & dosage , Vitamin E/administration & dosage , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Non-alcoholic Fatty Liver Disease/pathology , Pilot Projects , Silymarin/adverse effects , Vitamin E/adverse effects , Young AdultABSTRACT
OBJECTIVE: Patients with head and neck cancer undergoing surgery have a high occurrence of postoperative complications. The aim of our study was to investigate whether postoperative nutrition of head and neck cancer patients, using an enhanced enteral formula with three different doses of arginine could improve nutritional variables as well as clinical outcome, depending of arginine dose. PATIENTS AND METHODS: A population of 84 patients with oral and laryngeal cancer was enrolled. At surgery patients were randomly assigned to three different treatment groups, each one containing at less 28 patients. Group I (28 patients) received an enteral diet supplements with a low physiological dose of arginine (5.7 g per day), group II (28 patients) received an isocaloric, isonitrogenous enteral formula with a medium dose of arginine (12.3 g per day) and group III (28 patients) received an isocaloric, isonitrogenous enteral formula with a high dose of arginine (18.9 g per day). RESULTS: The length of postoperative stay had a trend to be better with high dose of arginine received (31.9 ± 17.2 days in group I vs 27.8 ± 15.2 days in group II vs 24.8 ± 18.3 days in group III: p = 0.034). No differences were detected in postoperative infections complications and diarrhea. Fistula was less frequent in groups II and III than I (10.7% group I vs 3.6% group II vs 3.6% group III: p = 0.033), The length of postoperative stay had a trend to be better with high dose of arginine received (31.9 ± 17.2 days in group I vs 27.8 ± 15.2 days in group II vs 24.8 ± 18.3 days in group III: p = 0.034). CONCLUSIONS: Our results suggest that these patients could benefit from a high dose of arginine enhanced enteral formula to decrease length of hospital stay and fistula wound complications.
Subject(s)
Arginine/administration & dosage , Enteral Nutrition/methods , Head and Neck Neoplasms/therapy , Nutritional Status/drug effects , Postoperative Care/methods , Postoperative Complications/therapy , Aged , Dose-Response Relationship, Drug , Female , Head and Neck Neoplasms/diagnosis , Humans , Length of Stay/trends , Male , Middle Aged , Postoperative Complications/diagnosis , Prospective Studies , Single-Blind Method , Treatment OutcomeABSTRACT
BACKGROUND: Patients with head and neck cancer undergoing surgery have a high risk of nutritional complications. OBJECTIVE: The aim of our study was to investigate the influence of a hypercaloric and hyperproteic oral supplement enriched with w3 FATTY ACIDS and fiber in clinical parameters in head and neck tumor postsurgical ambulatory patients with or without radiotherapy. DESIGN: A population of 37 ambulatory postsurgical patients with oral and laryngeal cancer was enrolled. At Hospital discharge postsurgical head and neck cancer patients were asked to consume two units per day of a hypercaloric and hyperproteic oral supplement for a twelve week period. RESULTS: The mean age was 63.8+/-7.1 years (16 female/ 21 males). Duration of supplementation was 98.1±19.1 days. A significant increase of albumin and transferrin levels was observed, in total group and in patients undergoing radiotherapy and without it. No differences were detected in weight and other anthropometric parameters in total group and in patients with radiotherapy during the protocol. Nevertheless, patients without radiotherapy showed a significant improvement of BMI; weight, fat free mass and fat mass. CONCLUSIONS: An omega 3 and fiber enriched formula improved seric protein levels in ambulatory postoperative head and neck cancer patients. Improvement of weight, fat mass and fat free mass was observed in patients whom not received radiotherapy during the follow up.
Antecedentes: Los pacientes con tumores de cabeza y cuello sometidos a cirugía presentan un alto riesgo de complicaciones nutricionales. Objetivo: El principal objetivo de nuestro trabajo fue evaluar la influencia de un suplemento hiperenergético e hiperproteico enriquecido en ácidos grasos w3 y fibra en pacientes postquirúrgicos ambulatorios con tumores de cabeza y cuello, con y sin radioterapia. Diseño: Una muestra de 37 pacientes postquirúrgicos ambulatorios con tumores de cabeza y cuello fue evaluada. Tras el alta hospitalaria, los pacientes recibieron dos envases al día de un suplemento hiperproteico e hipercalórico durante 12 semanas. Resultados: La edad media fue de 63.8+/-7.1 años (16 mujeres/21 varones). La duración media de la suplementación fue de 98.1±19.1 días. Se detectó un aumento significativo en los niveles de albúmina y transferrina en los pacientes del grupo global, en los que recibieron radioterapia y en los que no al recibieron. El peso y los parámetros antropométricos no mejoraron en el grupo global ni en los que recibieron radioterapia. Sin embargo los pacientes que no recibieron radioterapia tuvieron un aumento de la masa magra, peso y masa grasa Conclusiones: La formula enriquecida en omega 3 y fibra mejoró lo niveles de proteínas séricas. Por otra parte los pacientes que no recibieron radioterapia durante el seguimiento presentaron un aumento del peso, masa grasa y masa magra.
Subject(s)
Dietary Fiber/administration & dosage , Dietary Proteins/administration & dosage , Dietary Supplements , Energy Intake/physiology , Fatty Acids, Omega-3/administration & dosage , Head and Neck Neoplasms/surgery , Aged , Body Weight , Enteral Nutrition , Female , Head and Neck Neoplasms/diet therapy , Humans , Male , Middle Aged , Postoperative Care , Treatment OutcomeABSTRACT
BACKGROUND: Patients with head and neck cancer undergoing surgery have a high risk of nutritional complications. OBJECTIVE: The aim of our study was to investigate the influence of an oral w3 enriched immunoenhanced powdered formula in nutritional and biochemical parameters in postsurgical ambulatory patients with head and neck tumor. DESIGN: A population of 33 ambulatory postsurgical patients with oral and laryngeal cancer was enrolled. At Hospital discharge postsurgical head and neck cancer patients were asked to consume two units per day of a w3 enriched immunoenhanced powdered formula for a twelve week period. RESULTS: The mean age was 61.3 ± 9.1 years (6 female/27 males). Duration of supplementation was 95.9 ± 21.1 days. A significant increase of albumin and transferrin levels was observed, in total group and in patients undergoing radiotherapy and without it. No differences were detected in weight and other anthropometric parameters in total group and in patients with radiotherapy during the protocol. Nevertheless, patients without radiotherapy showed a significant improvement of BMI; weight, fat free mass and fat mass. CONCLUSIONS: At dose used, an omega 3 enriched powdered formula improved seric protein levels in ambulatory postoperative head and neck cancer patients. Improvement of weight, fat mass and fat free mass was observed in patients whom not received radiotherapy during the follow up.
Antecedentes: Los pacientes con tumores de cabeza y cuello sometidos a cirugía presentan un alto riesgo de complicaciones nutricionales. Objetivo: El principal objetivo de nuestro trabajo fue evaluar la influencia de un suplemento oral en polvo inmunoenriquecido con ácidos grasos omega 3 en pacientes postquirúrgicos ambulatorios con tumores de cabeza y cuello. Diseño: Una muestra de 33 pacientes postquirúrgicos ambulatorios con tumores de cabeza y cuello fue evaluada. Tras el alta hospitalaria, los pacientes recibieron dos envases al día de un suplemento inmunoenriquecido con omega 3 en polvo durante 12 semanas. Resultados: La edad media fue de 61,3 ± 9,1 años (6 mujeres/27 varones). La duración media de la suplementación fue de 95,9 ± 21,1 días. Se detectó un aumento significativo en los niveles de albúmina y transferrina en los pacientes del grupo global, en los que recibieron radioterapia y en los que no al recibieron. El peso y los parámetros antropométricos no mejoraron en el grupo global ni en los que recibieron radioterapia. Sin embargo los pacientes que no recibieron radioterapia tuvieron un aumento de la masa magra, peso y masa grasa Conclusiones: A la dosis usada, la formula en polvo enriquecida en omega 3 mejoró lo niveles de proteínas séricas. Por otra parte los pacientes que no recibieron radioterapia durante el seguimiento presentaron un aumento del peso, masa grasa y masa magra.
Subject(s)
Dietary Supplements , Fatty Acids, Omega-3/therapeutic use , Food, Formulated , Head and Neck Neoplasms/surgery , Malnutrition/prevention & control , Postoperative Complications/prevention & control , Female , Humans , Male , Middle Aged , Powders , Prospective StudiesABSTRACT
OBJECTIVES: The aim of our study was to investigate whether two different daily doses of a high monounsaturated fatty acid (MUFA) specific diabetes enteral formula could improve nutritional variables as well as metabolic parameters. PATIENTS AND METHODS: We conducted a randomized, open-label, multicenter, parallel group study. 27 patients with diabetes mellitus type 2 with recent weight loss were randomized to one of two study groups: group 1 (two cans per day) and group 2 (three cans per day) for a ten week period. RESULTS: A significative decrease of HbA1c was detected in both groups. The decrease 0.98% (confidence interval 95% 0.19-1.88) was higher in group 2 than group 1 0.60% (confidence interval 95% 0.14-1.04). A significant increase of weight, body mass index, fat mass, albumin, prealbumin and transferrin was observed in both groups without statistical differences in this improvement between both groups. The increase of weight 4.59kg (confidence interval 95% 1.71-9.49) was higher in group 2 than group 1 1.46% (confidence interval 95% 0.39-2.54). Gastrointestinal tolerance (diarrhea episodes) with both formulas was good, without statistical differences (7.60% vs 7.14%: ns). CONCLUSIONS: A high monounsaturated fatty acid diabetes-specific supplement improved HbA1c and nutritional status. These improvements were higher with three supplements than with two per day.
Subject(s)
Diabetes Mellitus, Type 2/therapy , Fatty Acids, Monounsaturated/administration & dosage , Aged , Aged, 80 and over , Diabetes Mellitus, Type 2/blood , Dietary Supplements , Enteral Nutrition , Female , Glycated Hemoglobin/analysis , Humans , Male , Nutritional StatusABSTRACT
INTRODUCTION: Postsurgical patients with head and neck cancer could have a high rate of ambulatory complications. The aim was to investigate whether oral ambulatory nutrition of head and neck cancer patients with recent weight loss, using two different doses of an omega 3 fatty acids and arginine enhanced diets could improve nutritional parameters. DESIGN: At Hospital discharge post surgical head and neck cancer patients (n=37) were asked to consume two or three cans per day of a designed omega 3 fatty acid and arginine enhanced supplement for a twelve week period. RESULTS: Albumin, prealbumin, transferrin and lymphocytes levels improved in both groups. Weight, fat mass and fat free mass improved during supplementation in group II (3 bricks per day). No differences were detected in anthropometric parameters in group I. Gastrointestinal tolerance with both formulas was good, no episodes were reported. There are no differences between both formulas on postsurgical complications rates. CONCLUSIONS: Omega 3 and arginine enhanced formulas improved blood protein concentrations and lymphocyte levels in ambulatory postoperative head and neck cancer patients. A high dose of arginine and omega 3 fatty acids formula improved weight, too.
Subject(s)
Arginine/administration & dosage , Fatty Acids, Omega-3/administration & dosage , Head and Neck Neoplasms/drug therapy , Administration, Oral , Adult , Aged , Female , Head and Neck Neoplasms/blood , Humans , Lymphocyte Count , Male , Middle Aged , Prospective Studies , Serum Albumin/analysis , Transferrin/analysisABSTRACT
BACKGROUND: Cannabis is the illicit drug most widely used by young people in high-income countries. Allergy symptoms have only occasionally been reported as one of the adverse health effects of cannabis use. OBJECTIVES: To study IgE-mediated response to cannabis in drug users, atopic patients, and healthy controls. METHODS: Asthmatic patients sensitised to pollen, and all patients sensitised to tobacco, tomato and latex, considered as cross-reacting allergens, were selected from a data base of 21,582 patients. Drug users attending a drug-rehabilitation clinic were also included. Controls were 200 non-atopic blood donors. Specific IgE determination, prick tests and specific challenge with cannabis extracts were performed in patients and controls. RESULTS: Overall, 340 patients, mean age 26.9±10.7 years, were included. Males (61.4%) were the most sensitised to cannabis (p<0.001). All cannabis-sensitised patients were alcohol users. Eighteen (72%) of the patients allergic to tomato were sensitised to cannabis, but a positive specific challenge to cannabis was highest in patients sensitised to tobacco (13/21, 61.9%), (p<0.001). Pollen allergy was not a risk factor for cannabis sensitisation. Prick tests and IgE for cannabis had a good sensitivity (92 and 88.1%, respectively) and specificity (87.1 and 96%) for cannabis sensitisation. CONCLUSIONS: Cannabis may be an important allergen in young people. Patients previously sensitised to tobacco or tomato are at risk. Cannabis prick tests and IgE were useful in detecting sensitisation.
Subject(s)
Allergens/immunology , Antigens, Plant/immunology , Asthma/immunology , Cannabis , Population Groups , Adolescent , Adult , Allergens/adverse effects , Asthma/diagnosis , Asthma/epidemiology , Cannabis/immunology , Cross Reactions , Female , Humans , Illicit Drugs/immunology , Immunoglobulin E/immunology , Solanum lycopersicum/immunology , Male , Pollen/adverse effects , Risk , Sensitivity and Specificity , Skin Tests , Spain , Nicotiana/immunologyABSTRACT
BACKGROUND AND AIMS: Dietary counseling and oral supplementation have unclear results in preventing the progressive weight loss in human deficiency virus (HIV)-infection. The aim of the study was to compare the progression of nutritional indicators with or without a formula enriched with n-3 fatty acids. PATIENTS AND METHODS: 30 HIV patients were enrolled. 15 were randomized to group I (standard formula) and 15 were randomized to group II (formula enriched with n-3 fatty acids). A nutritional evaluation was realized at basal time and at 3 months. RESULTS: An increase in protein and calories intakes was detected in both. There was a significant increase in n3 fatty acid intake from baseline in group II, without statistical changes in group I. Treatment with both supplements resulted in a significant and sustained increase in weight (4.5% in group I and 5.4%, in group II). This increase was mostly due to fat free mass in group I. In group II it was due to an increase in fat free mass and fat mass. CONCLUSIONS: Oral nutritional supplements for a 3-months period were well tolerated and resulted in body weight gain in HIV-infected patients with previous weight loss.
Subject(s)
Enteral Nutrition/methods , Fatty Acids, Omega-3/therapeutic use , HIV Infections/complications , Weight Loss/drug effects , Adult , Ambulatory Care , Dietary Proteins/administration & dosage , Dietary Supplements , Energy Intake , Fatty Acids, Omega-3/administration & dosage , Humans , Middle Aged , Prospective Studies , Time Factors , Treatment Outcome , Weight Gain/drug effectsABSTRACT
OBJECTIVES: Patients with head and neck cancer undergoing surgery have a high incidence of postoperative complications. The aim of our study was to investigate whether postoperative nutrition of head and neck cancer patients, using an enteral high dose of arginine (20 g per day) vs a medium dose (12.3 g per day) could improve nutritional variables as well as clinical outcome. MATERIAL AND METHODS: A population of 115 patients with oral and laryngeal cancer was enrolled. At surgery patients were randomly allocated to two groups: group I (58 patients) received an enteral diet supplements with a high dose of arginine (20 g per day) and group II (57 patients) received an isocaloric, isonitrogenous enteral formula with a medium dose of arginine (12.3 g per day). RESULTS: Gastrointestinal tolerance (diarrhea) of both formulas was good (3.44% group I and 3.51% group II: ns). The postoperative infections complications were similar in both groups (8.6% group I and 12.2% group II: ns). Fistula was less frequent in enriched nutrition group (3.4% group I and 10.5% group II: p = 0.006). The length of postoperative stay was similar in both groups (27.2 +/- 17.8 days in group I vs 25.7 +/- 18.8 days in group II: ns). CONCLUSIONS: Enriched arginine formula improves fistula wound complications in postoperative head and neck cancer patients. Our results suggest that these patients could benefit from a high dose of arginine enhanced enteral formula.
Subject(s)
Arginine/administration & dosage , Enteral Nutrition , Head and Neck Neoplasms/surgery , Adult , Aged , Double-Blind Method , Female , Humans , Male , Middle Aged , Postoperative Complications/epidemiology , Surgical Wound Infection/prevention & controlABSTRACT
BACKGROUND: Patients with head and neck cancer undergoing surgery have a high incidence of ambulatory postoperative complications. OBJECTIVE: The aim of our study was to investigate the influence of an oral immunoenhanced supplement (arginine and glutamine) on nutritional and biochemical parameters in postsurgical ambulatory patients with head and neck tumor. DESIGN: A population of 39 ambulatory postsurgical patients with oral and laryngeal cancer was enrolled. At Hospital discharge postsurgical head and neck cancer patients were asked to consume two units per day of a specially designed enhanced supplement for a twelve week period. RESULTS: The mean age was 60.2+/-13.1 years (9 female/30 males). Duration of supplementation was 90.8+20 days. A significant increase of albumin (3.1±0.6 g/dl vs 4.12+0.7 g /dl; p<0.05), prealbumin (21.4±6.3 mg/dl vs 22.4+5.9 mg/dl; p<0.05) and transferrin (198.8±45.2 mg/dl vs 253.8+60.7 mg/dl; p<0.05) levels were observed. No differences were detected in weight and other anthropometric parameters. Ten patients (41.3%) received radiotherapy along the enhanced supplementation period and only 5 (20% of patients with radiotherapy) developed a clinical oral mucositis. CONCLUSIONS: At dose used, arginine and glutamine enhanced formula improved seric protein levels in ambulatory postoperative head and neck cancer patients with a low rate of oral mucositis in the subgroup with radiotherapy.
Subject(s)
Dietary Supplements , Food, Formulated , Head and Neck Neoplasms/immunology , Immunity/drug effects , Aged , Anthropometry , Arginine/adverse effects , Arginine/therapeutic use , Body Weight/physiology , Combined Modality Therapy , Dietary Supplements/adverse effects , Female , Glutamine/adverse effects , Glutamine/therapeutic use , Head and Neck Neoplasms/surgery , Head and Neck Neoplasms/therapy , Humans , Male , Middle Aged , Prealbumin/metabolism , Radiotherapy/adverse effects , Serum Albumin/metabolism , Stomatitis/etiology , Transferrin/metabolismABSTRACT
UNLABELLED: Patients with intestinal failure who receive HPN are at high risk of developing MBD. The origin of this bone alteration is multifactorial and depends greatly on the underlying disease for which the nutritional support is required. Data on the prevalence of this disease in our environment is lacking, so NADYA-SEMPE group has sponsored this transversal study with the aim of knowing the actual MBD prevalence. MATERIAL AND METHODS: Retrospective data from 51 patients from 13 hospitals were collected. The questionnaire included demographic data as well as the most clinically relevant for MBD data. Laboratory data (calciuria, PTH, 25 -OH -vitamin D) and the results from the first and last bone densitometry were also registered. RESULTS: Bone mineral density had only been assessed by densitometry in 21 patients at the moment HPN was started. Bone quality is already altered before HPN in a significant percentage of cases (52%). After a mean follow up of 6 years, this percentage increases up to 81%. Due to retrospective nature of the study and the low number of subjects included it has not been possible to determine the role that HPN plays in MBD etiology. Only 35% of patients have vitamin D levels above the recommended limits and the majority of them is not on specific supplementation. CONCLUSIONS: HPN is associated with very high risk of MBD, therefore, management protocols that can lead to early detection of the problem as well as guiding for follow up and treatment of these patients are needed.
Subject(s)
Bone Diseases, Metabolic/epidemiology , Bone Diseases, Metabolic/etiology , Parenteral Nutrition, Home/adverse effects , Adolescent , Adult , Age Factors , Aged , Bone Density , Densitometry , Female , Humans , Male , Middle Aged , Nutritional Status , Nutritional Support , Osteoporosis/epidemiology , Osteoporosis/etiology , Retrospective Studies , Sex Factors , Spain/epidemiology , Vitamin D Deficiency/epidemiology , Vitamin D Deficiency/etiology , Young AdultABSTRACT
OBJECTIVE: Patients with head and neck cancer undergoing surgery have a high incidence of postoperative complications. The aim of our study was to investigate whether postoperative nutrition of head and neck cancer patients, using a higher dose of arginine (20 g per day) could improve nutritional variables. MATERIALS AND METHODS: A population of 72 patients with oral and laryngeal cancer was enrolled. At surgery patients were randomly allocated to two groups: a) patients were receiving an enteral diet supplements with arginine and fiber (group I); b) patients were receiving an isocaloric, isonitrogenous enteral formula (group II). RESULTS: No significant intergroup differences in the trend of the three serum proteins and lymphocytes were detected. Gastrointestinal tolerance (diarrhea) of both formulas was good (7.89% group I and 5.88% group II: ns). The postoperative infections complications were similar in both groups (23.6% group I and 20.6% group II: ns). Fistula was less frequent in enriched nutrition group (5.2% group I and 17.6% group II: p = 0.026). The length of postoperative stay was better 24.3 +/- 14 days in the immunonutrition group than 36.1 +/- 27 days in the control group (p = 0.036). CONCLUSIONS: Enriched formula improves local wound complications in postoperative head and neck cancer patients and decreases length of stay.
Subject(s)
Arginine/therapeutic use , Enteral Nutrition , Head and Neck Neoplasms/therapy , Postoperative Complications/prevention & control , Aged , Arginine/adverse effects , Diarrhea/chemically induced , Dose-Response Relationship, Drug , Double-Blind Method , Enteral Nutrition/adverse effects , Female , Fistula/etiology , Head and Neck Neoplasms/surgery , Humans , Length of Stay , Male , Middle Aged , Nutritional Status , Postoperative Care/methods , Surgical Wound Infection/prevention & controlABSTRACT
BACKGROUND AND OBJECTIVES: Epidemiological and interventional studies suggest that a high dietary intake of n-3 polyunsaturated fatty acids may confer a protective effect against atherosclerotic disease and reduce serum triglycerides levels. The aim of our study was to investigate the effectivity on triglyceride levels and inflammatory markers of a concentrated of n-3 fatty acids in patients with type 2 diabetes mellitus and hypertriglyceridaemia. SUBJECTS: A total of 30 patients (16 males and 14 females) with diabetes mellitus type 2 and hypertriglyceridemia (> 200 mg/dl) were included in the study. Patients received two capsules of eicosapentaenoic 465 mg and docosahexanoic 375 mg daily for 12 weeks. RESULTS: Triglycerides levels and non HDL-cholesterol decreased (326 +/- 113.5 vs. 216.4 +/- 57 mg/dl; p < 0.05) and (103.87 +/- 44 vs. 89.6 +/- 14 mg/dl; p < 0.05), respectively. HDL-cholesterol levels increased (39.6 +/- 10.7 vs. 46.4 +/- 8.7 mg/dl; p < 0.05). C reactive protein decreased (5.98 +/- 3.9 vs. 3.9 +/- 1.6 mg/dl; p < 0.05) and TNF-alpha levels decreased (16.24 +/- 5.5 vs. 13.3 +/- 5.8 pg/dl; p < 0.05), without significant changes in IL-6 levels. In conclusion, an n-3 polyunsaturated intervention improved lipid profile and inflammatory markers in patients with diabetes mellitus type 2 and hypertriglyceridaemia.
Subject(s)
Cardiovascular System/metabolism , Diabetes Mellitus, Type 2/drug therapy , Fatty Acids, Omega-3/therapeutic use , Hypertriglyceridemia/drug therapy , C-Reactive Protein/metabolism , Cholesterol/blood , Cytokines/blood , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/metabolism , Docosahexaenoic Acids/administration & dosage , Docosahexaenoic Acids/therapeutic use , Eicosapentaenoic Acid/administration & dosage , Eicosapentaenoic Acid/therapeutic use , Fatty Acids, Omega-3/administration & dosage , Female , Humans , Hypertriglyceridemia/complications , Hypertriglyceridemia/metabolism , Male , Middle Aged , Risk Factors , Triglycerides/bloodABSTRACT
The aim of our study was to investigate whether oral ambulatory nutrition of post surgical head and neck cancer patients with recent weight loss, using two different omega 3 fatty acids enhanced diets could improve nutritional variables as well as clinical outcome. A sample of 65 ambulatory post surgical patients with oral and laryngeal cancer and recent weight loss was enrolled. At Hospital discharge post surgical head and neck cancer patients were asked to consume two cans per day of either a specially designed omega 3 fatty acid enhanced supplement with a high ratio of omega3/omega6 (I) or a omega 3 fatty acid enhanced supplement with a low ratio of omega3/omega6 (II). Serum albumin, prealbumin and transferrin concentrations improved with both enhanced formula. Weight stabilization was reached with both formulas. Gastrointestinal tolerance (diarrhea episodes) with both formulas was good (6.45 vs 5.88%: ns). The postoperative infectious complications were similar in both groups (29 group I vs 15.7% group II: ns). No local complications were detected in surgery wound. In conclusion, at dose taken, omega 3 enhanced formulas with different omega3/omega6 ratios improved serum protein concentrations in ambulatory postoperative head and neck cancer patients with good tolerance.
Subject(s)
Fatty Acids, Omega-3/administration & dosage , Head and Neck Neoplasms/therapy , Aged , Ambulatory Care , Dietary Supplements , Female , Humans , Immune Tolerance , Male , Malnutrition/therapy , Middle Aged , Patient ComplianceABSTRACT
INTRODUCTION: Postsurgical patients with head and neck cancer could have a high rate of ambulatory complications. The aim of our study was to investigate whether oral ambulatory nutrition of post surgical head and neck cancer patients with recent weight loss, using an omega 3 fatty acids and arginine diet could improve nutritional status and complications. DESIGN: A population of 30 ambulatory post surgical patients with oral and laryngeal cancer and recent weight loss was enrolled. At Hospital discharge post surgical head and neck cancer patients were asked to consume two cans per day of a specially designed omega 3 fatty acid and arginine enhanced supplement during 12 weeks. RESULTS: The average age was 62.7 + 11.1 years (3 females/27 males). The average days of dietary suplementation was 90.8 + 22 days. Blood albumin, prealbumin, transferring and lymphocites concentrations improved. C reactive protein decreased. Neither weight improvement nor other anthropometric parameters improved. A positive correlation between ratio w3/w6and kg of fat mass (r = 0.69; p < 0.05) and with midarm circumference (r = 0.62; p < 0.05) were detected. Patients were divided in two groups; group I (ratio dietary intake w3/w6 < 0,51) and group II (ratio dietary intake w3/w6 > 0,51). Group II had more final fat mass than group I (17.52 + 6.3 kg vs. 13.9 + 5.1 kg; p < 0.05). CONCLUSION: At dose taken, inmuno-enhanced formula increased blood proteins (albumin, prealbumin and transferrin) concentrations and decresed CRP. The increase of fat mass was higher in patients with better w3/w6 ratios.
Subject(s)
Ambulatory Care , Arginine/administration & dosage , Dietary Supplements , Fatty Acids, Omega-3/administration & dosage , Head and Neck Neoplasms/metabolism , Head and Neck Neoplasms/therapy , Laryngeal Neoplasms/metabolism , Laryngeal Neoplasms/therapy , Mouth Neoplasms/metabolism , Mouth Neoplasms/therapy , Administration, Oral , Aged , Analysis of Variance , Data Interpretation, Statistical , Energy Intake , Female , Head and Neck Neoplasms/pathology , Humans , Laryngeal Neoplasms/pathology , Larynx/pathology , Male , Middle Aged , Mouth/pathology , Mouth Neoplasms/pathology , Neoplasm Staging , Prospective Studies , Time FactorsABSTRACT
Malnutrition increases post surgical morbimortality, hospital stance and economical costs. Possibilities of nutritional intervention in surgical patients are important. Early enteral nutrition is better than total parenteral nutrition in patients under surgery. Periroperaoty nutritional support must be administrated to patients with severe or middle undernutrition and will be under surgery, during 7-14 days before surgical intervention, if this intervention could be delayed. Total parenteral nutrition will be not used regularly in patients under mayor digestive surgical procedures. Inmunonutrition has been demonstrated useful in surgical patients. Evidence demonstrates that inmunotritional formulas decrease incidence of infections, hospital stance and time of ventilation in patients in UCI wards. New research areas have been explored in this topic area, carbohydrate utility in presurgical patients and probiotic in enteral formulas.
Subject(s)
Digestive System Surgical Procedures , Enteral Nutrition , Malnutrition/prevention & control , Nutritional Support/methods , Parenteral Nutrition, Total , Arginine/therapeutic use , Dietary Carbohydrates/therapeutic use , Fatty Acids, Omega-3/therapeutic use , Glutamine/therapeutic use , Humans , Intensive Care Units , Length of Stay , Malnutrition/diet therapy , Postoperative Care , Preoperative Care , Probiotics/therapeutic use , Randomized Controlled Trials as Topic , Respiration, Artificial , Time FactorsABSTRACT
Pressure ulcer is an area of localised damage to the skin and underlying tissue caused by pressure, shear, friction and/or combination of these things. Prevalence of this entity is between 3 and 66%, depending of the patients and the pathology. Pressure ulcer is associated with an increased risk of morbidity and mortality. One of the most important risk factors to develop a pressure ulcer is nutritional status. We can use different interventional strategies, first of all (primary intervention) before the patient has developed a ulcer and secondly, the treatment of a established ulcer (secondary prevention). In the most important primary prevention study with 662 patients, two oral nutritional supplements per day were given to the patients. The incidence of pressure ulcer was 40% (118/295) in the interventional group and 48% (181/377) in control group. A relative risk to develop a pressure ulcer with supplementation of 0.83 (CI95%: 0.70 a 0.99). In the studies with secondary prevention, when we analyze in an individual way the different nutrients, zinc has not demonstrated the utility in an independent way. Vitamin C shows contradictory data in two randomized clinical trial with the same dose (500 mg each 12 hours). Recently, some randomized clinical trials have demonstrated an improvement in healing rates with enhanced enteral formulas (zinc, arginine, vitamin C). Oral supplementation without taking account micronutrients decreases risk of pressure ulcer. However, studies of secondary prevention due to heterogeneity have not let clear conclusions. However, enteral enhanced formula could improve ulcer healing.
Subject(s)
Nutritional Support , Pressure Ulcer/therapy , Humans , Wound HealingABSTRACT
BACKGROUND: Although liquid supplements are formulated to provide extra energy, minerals, vitamins and proteins, much of the success of supplementation depends upon the acceptability of the product and the ability of the patients to take large volumes over a period of time. OBJECTIVE: This study was set up to evaluate the acceptability by haematological cancer patients of 3 commercially available nutritional supplements. DESIGN: A population of 32 haematological cancer patients with reduced food intakes (less than 50% of calorie requirements by Harrist Benedict formula) was enrolled. Supplements were randomly assigned to each patient. Patients could try the drinks over 2 days period. They were asked to rate the acceptability of supplement, rating the product with a visual scale from 1 to 5 points with five parameters (color, taste, smell, texture, and temperature). RESULTS: Ten patients received first ONS (oral nutritional supplements), 12 second ONS, and 10 third ONS. No epidemiological differences were detected among three groups. Total calorie and macronutrient consumption improved with all supplements. Average values of color, taste, smell, temperature and texture were similar on three oral nutritional supplements (ONS). Analogic scale was analyze in a categoric way with frequencies, too. Frequencies of 1 and 2 points (very good and good responses) with taste were better with second ONS (85%; p < 0.05) than first ONS (50%) and third ONS (55.5%). Frequencies with smell were better with second ONS (83.3%; p < 0.05) than first (55.5%) and third ONS (62.5%). Frequencies with texture were higher in first ONS (90%; p < 0.05) and second ONS (100%; p < 0.05) than third ONS (66.7%). Temperature and color frequencies were similar in all ONS. CONCLUSIONS: Oral nutritional supplements had different acceptability in haematological cancer patients. Taste, smell and texture could be better in some ONS in these patients.