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1.
Monaldi Arch Chest Dis ; 90(2)2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32548994

RESUMO

The COVID-19 outbreak is having a significant impact on both cardiac rehabilitation (CR) inpatient and outpatient healthcare organization. The variety of clinical and care scenarios we are observing in Italy depends on the region, the organization of local services and the hospital involved. Some hospital wards have been closed to make room to dedicated beds or to quarantine the exposed health personnel. In other cases, CR units have been converted or transformed into COVID-19 units.  The present document aims at defining the state of the art of CR during COVID-19 pandemic, through the description of the clinical and management scenarios frequently observed during this period and the exploration of the future frontiers in the management of cardiac rehabilitation programs after the COVID-19 outbreak.


Assuntos
Reabilitação Cardíaca/normas , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Síndrome Coronariana Aguda/reabilitação , Reabilitação Cardíaca/psicologia , Cardiotônicos/efeitos adversos , Cardiotônicos/uso terapêutico , Exercício Físico , Feminino , Insuficiência Cardíaca/reabilitação , Humanos , Itália/epidemiologia , Masculino , Terapia Nutricional , Pandemias , Tromboembolia/reabilitação
3.
Rev Assoc Med Bras (1992) ; 66(4): 521-527, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32578790

RESUMO

Severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2 infection) is a new challenge for all countries, and children are predisposed to acquire this disease. Some studies have demonstrated more severe diseases in adults, but critically ill pediatric patients have been described in all ages. Pulmonary involvement is the major feature, and ventilatory support is common in critical cases. Nevertheless, other very important therapeutic approaches must be considered. In this article, we reviewed extensively all recent medical literature to point out the main clinical attitudes to support these pediatric patients during their period in respiratory support. Radiologic findings, fluid therapy, hemodynamic support, use of inotropic/vasopressors, nutritional therapy, antiviral therapy, corticosteroids, antithrombotic therapy, and immunoglobulins are analyzed to guide all professionals during hospitalization. We emphasize the importance of a multi-professional approach for adequate recovery.


Assuntos
Infecções por Coronavirus/terapia , Medicina Geral/métodos , Pneumonia Viral/terapia , Respiração Artificial/métodos , Adolescente , Betacoronavirus , Criança , Estado Terminal , Hidratação/métodos , Monitorização Hemodinâmica/métodos , Humanos , Terapia Nutricional/métodos , Pandemias , Modalidades de Fisioterapia
4.
Curr Opin Clin Nutr Metab Care ; 23(4): 288-293, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32487876

RESUMO

PURPOSE OF REVIEW: The Covid-19 pandemic has daunted the world with its enormous impact on healthcare, economic recession, and psychological distress. Nutrition is an integral part of every person life care, and should also be mandatorily integrated to patient care under the Covid-19 pandemic. It is crucial to understand how the Covid-19 does develop and which risk factors are associated with negative outcomes and death. Therefore, it is of utmost importance to have studies that respect the basic tenets of the scientific method in order to be trusted. The goal of this review is to discuss the deluge of scientific data and how it might influence clinical reasoning and practice. RECENT FINDINGS: A large number of scientific manuscripts are daily published worldwide, and the Covid-19 makes no exception. Up to now, data on Covid-19 have come from countries initially affected by the disease and mostly pertain either epidemiological observations or opinion papers. Many of them do not fulfil the essential principles characterizing the adequate scientific method. SUMMARY: It is crucial to be able to critical appraise the scientific literature, in order to provide adequate nutrition therapy to patients, and in particular, to Covid-19 infected individuals.


Assuntos
Infecções por Coronavirus , Transtornos Nutricionais , Terapia Nutricional/normas , Fenômenos Fisiológicos da Nutrição , Pandemias , Pneumonia Viral , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Humanos , Transtornos Nutricionais/epidemiologia , Transtornos Nutricionais/etiologia , Transtornos Nutricionais/terapia , Terapia Nutricional/métodos , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Fatores de Risco
5.
J Pak Med Assoc ; 70(Suppl 3)(5): S124-S130, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32515395

RESUMO

Corona virus disease (COVID-19) emerged as an epidemic from China, with quick spread globally. The disease can lead to serious problems, like pneumonia or even death especially among vulnerable people with existing health conditions. Its treatment and management require huge efforts from medical professionals often at the cost of their own health and life. Nutrition is the epicenter for the management of such diseases which works synergistically with the medical treatment for quick and better recovery. It has been associated with great human and economic toll and it is still not contained. Currently over two million people are affected and over 300,000 deaths globally. However, due to its newness and unfamiliarity, the understanding of this novel virus is still evolving. This viral infection poses numerous metabolic challenges to those severely affected and addressing them is a key to better outcomes. Medical nutritional therapy is thus among the mainstay of core components of comprehensive treatment measures for patients with COVID-19. This manuscript therefore aims to highlight the role of nutritional management and support in covid-19 disease.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Terapia Nutricional , Pneumonia Viral/terapia , Humanos , Fenômenos Fisiológicos da Nutrição , Pandemias
7.
Nutrients ; 12(5)2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32438620

RESUMO

The novel coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has engulfed the world, affecting more than 180 countries. As a result, there has been considerable economic distress globally and a significant loss of life. Sadly, the vulnerable and immunocompromised in our societies seem to be more susceptible to severe COVID-19 complications. Global public health bodies and governments have ignited strategies and issued advisories on various handwashing and hygiene guidelines, social distancing strategies, and, in the most extreme cases, some countries have adopted "stay in place" or lockdown protocols to prevent COVID-19 spread. Notably, there are several significant risk factors for severe COVID-19 infection. These include the presence of poor nutritional status and pre-existing noncommunicable diseases (NCDs) such as diabetes mellitus, chronic lung diseases, cardiovascular diseases (CVD), obesity, and various other diseases that render the patient immunocompromised. These diseases are characterized by systemic inflammation, which may be a common feature of these NCDs, affecting patient outcomes against COVID-19. In this review, we discuss some of the anti-inflammatory therapies that are currently under investigation intended to dampen the cytokine storm of severe COVID-19 infections. Furthermore, nutritional status and the role of diet and lifestyle is considered, as it is known to affect patient outcomes in other severe infections and may play a role in COVID-19 infection. This review speculates the importance of nutrition as a mitigation strategy to support immune function amid the COVID-19 pandemic, identifying food groups and key nutrients of importance that may affect the outcomes of respiratory infections.


Assuntos
Anti-Inflamatórios/administração & dosagem , Betacoronavirus , Infecções por Coronavirus/terapia , Inflamação/terapia , Terapia Nutricional/métodos , Estado Nutricional , Pneumonia Viral/terapia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/virologia , Citocinas/sangue , Dieta/métodos , Humanos , Inflamação/imunologia , Estado Nutricional/imunologia , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/imunologia , Pneumonia Viral/virologia
9.
Clin Nutr ; 39(6): 1631-1638, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32305181

RESUMO

The COVID-19 pandemics is posing 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. Patients with worst outcomes and higher mortality are reported to include immunocompromised subjects, namely older adults and polymorbid individuals and malnourished people in general. ICU stay, polymorbidity and older age are all commonly associated with high risk for malnutrition, representing per se a relevant risk factor for higher morbidity and mortality in chronic and acute disease. Also importantly, prolonged ICU stays are reported to be required for COVID-19 patients stabilization, and longer ICU stay may per se directly worsen or cause malnutrition, with severe loss of skeletal muscle mass and function which may lead to disability, poor quality of life and additional morbidity. Prevention, diagnosis and treatment of malnutrition should therefore be routinely included in the management of COVID-19 patients. In the current document, the European Society for Clinical Nutrition and Metabolism (ESPEN) aims at providing concise guidance for nutritional management of COVID-19 patients by proposing 10 practical recommendations. The practical guidance is focused to those in the ICU setting or in the presence of older age and polymorbidity, which are independently associated with malnutrition and its negative impact on patient survival.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Desnutrição/prevenção & controle , Desnutrição/terapia , Terapia Nutricional/métodos , Pneumonia Viral/terapia , Fatores Etários , Idoso , Comorbidade , Infecções por Coronavirus/epidemiologia , Humanos , Unidades de Terapia Intensiva , Desnutrição/diagnóstico , Necessidades Nutricionais , Pandemias , Pneumonia Viral/epidemiologia , Prognóstico , Respiração Artificial , Fatores de Risco
10.
Nutrients ; 12(4)2020 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-32252338

RESUMO

The world is in the grip of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40-60 ng/mL (100-150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Terapia Nutricional , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Vitamina D/fisiologia , Vitamina D/uso terapêutico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Suplementos Nutricionais , Humanos , Influenza Humana/epidemiologia , Influenza Humana/mortalidade , Influenza Humana/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Fatores de Risco , Estações do Ano , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/prevenção & controle
11.
PLoS One ; 15(3): e0229698, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32187182

RESUMO

BACKGROUND: Globally, Severe Acute Malnutrition (SAM) has been reduced by only 11% over the past 20 years and continues to be a significant cause of morbidity and mortality. So far, in Sub-Saharan Africa, several primary studies have been conducted on recovery rate and determinants of recovery from SAM in under-five children. However, comprehensive reviews that would have a shred of strong evidence for designing interventions are lacking. So, this review and meta-analysis was conducted to bridge this gap. METHODS: A systematic review of observational studies published in the years between 1/1/2000 to 12/31/2018 was conducted following the Meta-analysis of Observational Studies in Epidemiology (MOOSE) statement. Two reviewers have been searched and extracted data from CINAHL (EBSCO), MEDLINE (via Ovid), Emcare, PubMed databases, and Google scholar. Articles' quality was assessed using the Newcastle-Ottawa Scale by two independent reviewers, and only studies with fair to good quality were included in the final analysis. The review presented the pooled recovery rate from SAM and an odds ratio of risk factors affecting recovery rate after checking for heterogeneity and publication bias. The review has been registered in PROSPERO with protocol number CRD42019122085. RESULT: Children with SAM from 54 primary studies (n = 140,148) were included. A pooled rate of recovery was 71.2% (95% CI: 68.5-73.8; I2 = 98.9%). Children who received routine medication (Pooled Odds ratio (POR):1.85;95% CI: 1.49-2.29; I2 = 0.0%), older age (POR: 1.99;95% CI: 1.29-3.08; I2 = 80.6%), and absence of co-morbidity (POR:3.2;95% CI: 2.15-4.76; I2 = 78.7%) had better odds of recovery. This systematic review and meta-analysis suggestes HIV infected children had lower recovery rate from SAM (POR; 0.19; 95% CI: 0.09-0.39; I2 = 42.9%) compared to those non-infected. CONCLUSION: The meta-analysis deciphers that the pooled recovery rate was below the SPHERE standard, and further works would be needed to improve the recovery rate. So, factors that were identified might help to revise the plan set by the countries, and further research might be required to explore health fascilities fidelity to the WHO SAM management protocol.


Assuntos
Desnutrição Aguda Grave/dietoterapia , África ao Sul do Saara/epidemiologia , Pré-Escolar , Feminino , Infecções por HIV/complicações , Humanos , Masculino , Terapia Nutricional , Estudos Observacionais como Assunto , Avaliação de Resultados em Cuidados de Saúde , Desnutrição Aguda Grave/complicações , Desnutrição Aguda Grave/epidemiologia
12.
Einstein (Sao Paulo) ; 18: eAE4799, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32215466

RESUMO

The Brazilian Consensus on Nutrition in Hematopoietic Stem Cell Transplantation: Graft- versus -host disease was approved by Sociedade Brasileira de Transplante de Medula Óssea , with the participation of 26 Brazilian hematopoietic stem cell transplantation centers. It describes the main nutritional protocols in cases of Graft- versus -host disease, the main complication of hematopoietic stem cell transplantation.


Assuntos
Conferências de Consenso como Assunto , Doença Enxerto-Hospedeiro/dietoterapia , Doença Enxerto-Hospedeiro/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Terapia Nutricional/normas , Necessidades Nutricionais , Brasil , Congressos como Assunto , Gastroenteropatias/dietoterapia , Gastroenteropatias/etiologia , Gastroenteropatias/fisiopatologia , Doença Enxerto-Hospedeiro/fisiopatologia , Humanos , Terapia Nutricional/métodos , Índice de Gravidade de Doença
13.
BMC Health Serv Res ; 20(1): 148, 2020 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-32106848

RESUMO

BACKGROUND: Nutrition is vital for health and recovery during hospitalisation, however most patients fail to meet minimum dietary requirements and up to 50% of patients are malnourished in hospital. When patients participate in nutrition care, their dietary intakes are improved. Advances in health information technology (HIT) have broadened the ways by which patients can participate in care. Our team has developed an innovative, HIT-based intervention (called NUTRI-TEC; engaging patients in their nutrition care using technology), facilitating patient participation in their nutrition care in hospital. This paper aims to describe the systematic and iterative process by which the intervention was developed. METHODS: NUTRI-TEC development was informed by the Medical Research Council guidance for developing complex interventions and underpinned by theoretical frameworks and concepts (i.e. integrated knowledge translation and patient participation in care), existing evidence and a rigorous program of research. The intervention was co-developed by the multidisciplinary research team and stakeholders, including health consumers (patients), health professionals and industry partners. We used an iterative development and evaluation cycle and regularly tested the intervention with hospital patients and clinicians. RESULTS: The NUTRI-TEC intervention involves active patient participation in their nutrition care during hospitalisation. It has two components: 1) Patient education and training; and 2) Guided nutrition goal setting and patient-generated dietary intake tracking. The first component includes brief education on the importance of meeting energy/protein requirements in hospital; and training on how to use the hospital's electronic foodservice system, accessed via bedside computer screens. The second component involves patients recording their food intake after each meal on their bedside computer and tracking their intakes relative to their goals. This is supported with brief, daily goal-setting sessions with a health care professional. CONCLUSIONS: NUTRI-TEC is a HIT intervention designed to enable patient participation in their nutrition care in hospital. As research on HIT interventions to engage patients in health care in the hospital setting is in its infancy, and as gaps and inconsistencies in the development of such interventions exist, this paper will inform future development of HIT-based interventions in the hospital setting.


Assuntos
Pacientes Internados/psicologia , Informática Médica , Terapia Nutricional , Participação do Paciente/psicologia , Difusão de Inovações , Pesquisa sobre Serviços de Saúde , Humanos
14.
PLoS One ; 15(2): e0229396, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32092109

RESUMO

OBJECTIVE: This study is aimed at determining the preoperative nutritional status of patients with hepatic alveolar echinococcosis (HAE), and subsequently establish a concise and reasonable nutritional evaluation indicator. The established evaluation method could be used for clinical preoperative risk assessment and prediction of post-operation recovery. METHODS: The basic patient information on height, body weight, BMI and hepatic encephalopathy of 93 HAE patients were examined. Subsequently, abdominal ultrasonography, blood coagulation and liver function tests were done on the patients. Liver function was assessed using the Child-Pugh improved grading method while nutritional status was evaluated using the European Nutrition Risk Screening 2002 (NRS 2002) method. Additional parameters including hospitalization time, the hemoglobin (HGB) level on the 3rd day after the operation, and the number of postoperative complications of HAE patients were also recorded. RESULTS: The NRS 2002 score was negatively correlated with body weight, body mass index (BMI)and albumin (ALB) (P<0.01), and positively correlated with the transverse and longitudinal diameters of the lesions (P<0.01). A worse grading of liver function was associated with a low ALB and a high NRS 2002 score (P<0.01). Results of the NRS 2002 score indicate that the hospitalization time of the normal nutrition group was significantly shorter than that of the malnourished group (P < 0.05). The HGB level of the control group on the 3rd day after the operation was significantly higher than that of the malnourished group (P < 0.05), and the number of postoperative complications was lower than that of malnutrition group (P < 0.05). CONCLUSION: Malnutrition is common in HAE patients. The nutritional status of HAE patients is related to many clinical factors, such as Child-Pugh classification of liver function, size of the lesion, and ALB among others. Although both BMI and ALB can be used as primary screening indicators for malnutrition in HAE patients, NRS 2002 is more reliable and prudent in judging malnutrition in HAE patients. Therefore, BMI and ALB are more suitable for preoperative risk assessment and prediction of postoperative recovery.


Assuntos
Equinococose Hepática/diagnóstico , Equinococose Hepática/cirurgia , Avaliação Nutricional , Estado Nutricional , Complicações Pós-Operatórias/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Equinococose Hepática/complicações , Equinococose Hepática/dietoterapia , Feminino , Hepatectomia/efeitos adversos , Hepatectomia/reabilitação , Humanos , Testes de Função Hepática , Masculino , Desnutrição/diagnóstico , Desnutrição/dietoterapia , Desnutrição/etiologia , Desnutrição/cirurgia , Pessoa de Meia-Idade , Terapia Nutricional , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Cuidados Pré-Operatórios/métodos , Período Pré-Operatório , Prognóstico , Recuperação de Função Fisiológica , Medição de Risco , Adulto Jovem
15.
Einstein (Sao Paulo) ; 18: AE4530, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32049129

RESUMO

The nutritional status of patients submitted to hematopoietic stem cell transplant is considered an independent risk factor, which may influence on quality of life and tolerance to the proposed treatment. The impairment of nutritional status during hematopoietic stem cell transplant occurs mainly due to the adverse effects resulting from conditioning to which the patient is subjected. Therefore, adequate nutritional evaluation and follow-up during hematopoietic stem cell transplant are essential. To emphasize the importance of nutritional status and body composition during treatment, as well as the main characteristics related to the nutritional assessment of the patient, the Brazilian Consensus on Nutrition in Hematopoietic Stem Cell Transplant: Adults was prepared, aiming to standardize and update Nutritional Therapy in this area. Dietitians, nutrition physicians and hematologists from 15 Brazilian centers thar are references in hematopoietic stem cell transplant took part.


Assuntos
Transplante de Células-Tronco Hematopoéticas/normas , Terapia Nutricional/normas , Estado Nutricional , Adulto , Antropometria , Brasil , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Avaliação Nutricional , Terapia Nutricional/métodos , Nutrição Parenteral/métodos , Nutrição Parenteral/normas , Condicionamento Pré-Transplante
17.
Rev Assoc Med Bras (1992) ; 66Suppl 1(Suppl 1): s59-s67, 2020 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-31939537

RESUMO

A healthy diet is an essential requirement to promote and preserve health, even in the presence of diseases, such as chronic kidney disease (CKD). In this review, nutritional therapy for CKD will be addressed considering not only the main nutrients such as protein, phosphorus, potassium, and sodium, which require adjustments as a result of changes that accompany the reduction of renal functions, but also the benefits of adopting dietary patterns associated with better outcomes for both preventing and treating CKD. We will also emphasize that these aspects should also be combined with a process of giving new meaning to a healthy diet so that it can be promoted. Finally, we will present the perspective of an integrated approach to the individual with CKD, exploring the importance of considering biological, psychological, social, cultural, and economic aspects. This approach has the potential to contribute to better adherence to treatment, thus improving the patient's quality of life.


Assuntos
Terapia Nutricional , Insuficiência Renal Crônica/dietoterapia , Dieta/classificação , Proteínas na Dieta , Ingestão de Energia , Comportamento Alimentar , Humanos , Fósforo , Potássio , Qualidade de Vida , Sódio
19.
Phys Med Rehabil Clin N Am ; 31(1): 25-37, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31760992

RESUMO

Children with cerebral palsy (CP) are at risk of growth and nutrition disorders. There are numerous challenges to measure and assess growth and nutritional status in children with CP. Addressing these challenges is imperative, because the consequences of poor growth and malnutrition range from decreased bone density, muscle mass, and quality of life to impacts on intellectual quotient, behavior, attention, social participation, healthcare utilization, and health care costs. In addition to discussing approaches to assess growth and nutrition, this article examines some of the methods of optimizing nutrition and bone health, including when preparing for and recovering from surgery.


Assuntos
Densidade Óssea , Paralisia Cerebral/metabolismo , Terapia Nutricional , Estado Nutricional , Paralisia Cerebral/fisiopatologia , Criança , Transtornos da Nutrição Infantil/prevenção & controle , Fenômenos Fisiológicos da Nutrição Infantil , Humanos , Exame Físico , Qualidade de Vida , Vitamina D/uso terapêutico , Suporte de Carga
20.
Public Health ; 180: 114-116, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31881465

RESUMO

OBJECTIVES: Pregnancy is a time when optimization of nutrition is critically important, yet pregnant women with substance use disorders face unique nutritional challenges. The aim of this short communication is to summarize existing knowledge about nutritional interventions used in substance use disorders for pregnant and parenting women with opioid use disorder (OUD) and substance use disorders and to inform program development by maternity care and treatment providers. STUDY DESIGN: We conducted a narrative review of nutritional interventions for pregnant women with OUD and performed environmental scanning to explore current practice. METHODS: To gain knowledge about the unique nutritional needs of pregnant women with OUD, we searched the medical literature using Medical Subject Headings terms and key words combining the concepts of nutrition, pregnancy, and substance use. To explore current practice, we interviewed staff of a geographically diverse sample of 35 programs treating women with substance use disorders across the United Stated and Canada on their approach to prenatal nutrition for clients. RESULTS: Literature review identified two studies evaluating the nutritional status of pregnant women with substance use disorders, but neither described nutritional interventions. Lower body mass index and folate, B12, and iron deficiencies were found in women with OUD compared with women without OUD. Two additional studies integrated nutritional interventions in substance use treatment for non-pregnant populations, resulting in significant improvements in dietary habits and psychological well-being for participants. Of 15 substance use treatment programs that responded to our query, only two incorporated longitudinal nutrition curricula for pregnant women. CONCLUSIONS: Pregnancy is a time when a healthy diet is critically important for maternal, fetal, and neonatal health; however, pregnant women with OUD are at significant risk of malnutrition. There is an urgent need to address food insecurity and develop targeted nutrition education programs for pregnant women in early recovery.


Assuntos
Desnutrição/prevenção & controle , Serviços de Saúde Materna/organização & administração , Terapia Nutricional , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Feminino , Humanos , Desnutrição/epidemiologia , Gravidez
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