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1.
Einstein (Sao Paulo) ; 18: AE4530, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32049129

RESUMEN

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.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas/normas , Terapia Nutricional/normas , Estado Nutricional , Adulto , Antropometría , Brasil , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Humanos , Evaluación Nutricional , Terapia Nutricional/métodos , Nutrición Parenteral/métodos , Nutrición Parenteral/normas , Acondicionamiento Pretrasplante
3.
Presse Med ; 48(12): 1496-1501, 2019 Dec.
Artículo en Francés | MEDLINE | ID: mdl-31757727

RESUMEN

Nonalcoholic fatty liver disease (NAFLD) is strongly associated with obesity and insulin resistance. There is currently no pharmacological treatment validated in steatosis. The combination of weight loss and adequate physical activity can improve liver steatosis. In randomized trials and cohort studies, a weight loss of at least 7% and a diet approaching the Mediterranean diet have been associated with an improvement in hepatic fat content, an improvement in hepatic biomarkers, and regression of histological signs of steatosis. Bariatric surgery by losing weight can lead to an improvement in hepatic fat content.


Asunto(s)
Hígado Graso/dietoterapia , Enfermedad del Hígado Graso no Alcohólico/dietoterapia , Terapia Nutricional/métodos , Cirugía Bariátrica/métodos , Ejercicio/fisiología , Hígado Graso/cirugía , Humanos , Enfermedad del Hígado Graso no Alcohólico/cirugía , Pérdida de Peso/fisiología
5.
Nutrients ; 11(9)2019 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-31540227

RESUMEN

The Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD) conducted a review of existing systematic reviews and meta-analyses to explain the relationship between different dietary patterns and patient-important cardiometabolic outcomes. To update the clinical practice guidelines for nutrition therapy in the prevention and management of diabetes, we summarize the evidence from these evidence syntheses for the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), Portfolio, Nordic, liquid meal replacement, and vegetarian dietary patterns. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. We summarized the evidence for disease incidence outcomes and risk factor outcomes using risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs), respectively. The Mediterranean diet showed a cardiovascular disease (CVD) incidence (RR: 0.62; 95%CI, 0.50, 0.78), and non-significant CVD mortality (RR: 0.67; 95%CI, 0.45, 1.00) benefit. The DASH dietary pattern improved cardiometabolic risk factors (P < 0.05) and was associated with the decreased incidence of CVD (RR, 0.80; 95%CI, 0.76, 0.85). Vegetarian dietary patterns were associated with improved cardiometabolic risk factors (P < 0.05) and the reduced incidence (0.72; 95%CI: 0.61, 0.85) and mortality (RR, 0.78; 95%CI, 0.69, 0.88) of coronary heart disease. The Portfolio dietary pattern improved cardiometabolic risk factors and reduced estimated 10-year coronary heart disease (CHD) risk by 13% (-1.34% (95%CI, -2.19 to -0.49)). The Nordic dietary pattern was correlated with decreased CVD (0.93 (95%CI, 0.88, 0.99)) and stroke incidence (0.87 (95%CI, 0.77, 0.97)) and, along with liquid meal replacements, improved cardiometabolic risk factors (P < 0.05). The evidence was assessed as low to moderate certainty for most dietary patterns and outcome pairs. Current evidence suggests that the Mediterranean, DASH, Portfolio, Nordic, liquid meal replacement and vegetarian dietary patterns have cardiometabolic advantages in populations inclusive of diabetes.


Asunto(s)
Diabetes Mellitus/dietoterapia , Dieta , Terapia Nutricional/métodos , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/mortalidad , Enfermedades Cardiovasculares/prevención & control , Complicaciones de la Diabetes/epidemiología , Complicaciones de la Diabetes/prevención & control , Dieta Mediterránea , Dieta Vegetariana , Enfoques Dietéticos para Detener la Hipertensión , Humanos , MEDLINE , Metaanálisis como Asunto , Enfermedades Metabólicas/epidemiología , Enfermedades Metabólicas/prevención & control , Factores de Riesgo , Países Escandinavos y Nórdicos , Revisiones Sistemáticas como Asunto
7.
Arch. prev. riesgos labor. (Ed. impr.) ; 22(3): 129-133, jul.-sept. 2019. tab
Artículo en Español | IBECS | ID: ibc-186415

RESUMEN

Se presenta el caso de un profesor de 47 años, no fumador, con riesgo-cardiovascular (RCV) moderado (2%) según HeartScore: obesidad (Índice-masa-muscular: 32,8 kg/m2); índice cintura-cadera: 1,08, tensión-arterial alta: 150/101mmHg, hipercolesterolemia: 223 mg/dl. La anamnesis-alimentaria inicial (2016) muestra consumo: 2100 kcal/día (distribuidas en 24% proteínas, 45% grasas, 31% carbohidratos) y, potasio (51%) y vitamina-D (42%) bajos; consume 2 bebidas-alcohólicas/semana. El tratamiento dietético consistió en 2500kcal/día (distribuidas en 14% proteína, 32% grasas, 51% carbohidratos) y aumento vitamina-D (10,50 μg/día), basado en directrices de la Guía Europea de Prevención Cardiovascular. Después de 1 año de tratamiento se mostraron cambios favorables: Índice-masa-muscular (30,5 kg/m2), índice cintura-cadera (0,98), tensión-arterial (128/90mmHg) evidenciados por datos bioquímicos y dietéticos. Este artículo presenta aspectos relevantes de una intervención dietético-nutricional individualizada de factores de RCV en el ámbito laboral y destacan las competencias del dietista-nutricionista y la coordinación del Servicio-Prevención-universitario como activos de salud comunitarios, para revertir parámetros de RCV especialmente antropométricos y tensión-arterial


We present the case of a 47 year old nonsmoking university professor with moderate cardiovascular risk (CVR) (2%) according to HeartS-core: obesity (body mass index, 32.8kg/m2); waist-to-hip ratio: 1.08; high blood pressure, 150/101 mmHg; and hypercholesterolemia: 223 mg/dL). The initial food inventory (2016) showed a consumption pattern of 2100 kcal/day (24% proteins, 45% fats, 31% carbohydrates); low intake of potassium (51%) and vitamin-D (42%); consumption of two alcoholic drinks/ per week. Dietary treatment consisted of 2500 kcal/day (distributed as 14% protein, 32% fat, 51% carbohydrates), and increased vitamin D intake (10.50 μg/day), following the European Cardiovascular Prevention Guide. Favorable changes were apparent after one year of treatment: body mass index (30.5kg/m2), waist-to-hip ratio (0.98), blood pressure (128/90mmHg), supported by laboratory and dietary data. This article presents relevant aspects of an individualized nutritional intervention targeting CVR factors in the workplace. It highlights the competencies of the dietitian and the coordination of the university-based occupational health service as community health assets, to revert CVR parameters, especially anthropometric and blood pressure data


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Obesidad/dietoterapia , Enfermedades Cardiovasculares/dietoterapia , Enfermedades Cardiovasculares/prevención & control , Terapia Nutricional/métodos , Servicios de Salud del Trabajador , Factores de Riesgo
8.
Artículo en Inglés | MEDLINE | ID: mdl-31398932

RESUMEN

Obese children are exposed to short and long-term health consequences, such as dyslipidemia, hypertension and diabetes mellitus. For these reasons, the prevention and treatment of obesity in the pediatric population is a challenge for health care professionals. The aim of this study was to evaluate whether an intensive intervention based on diet and physical activity has a better impact on the auxological and biochemical parameters than standard care (intervention). The study included 20 children (six boys, 14 girls), of the mean age 8.9 (SD 1.4) before puberty. The participants were randomly assigned to two groups: Group I (starting treatment with intensive intervention), and II (starting treatment with standard intervention). After three months, the groups were switched. The comparison of the two interventions in the study group indicates a better effectiveness of intensive intervention in the improvement of anthropometric parameters and majority of biochemical ones (except for insulin concentration, HOMA IR index and LDL cholesterol). As the result of intensive intervention, the mean % of weight-to-height excess and hip circumference decreased significantly (p < 0.005). Our results confirm that complex intervention based on systematic control visits, including personalized dietitian counselling and physician care, during the weight reduction process is more effective than a one-off standard visit.


Asunto(s)
Terapia Conductista/métodos , Ejercicio/fisiología , Terapia Nutricional/métodos , Obesidad Pediátrica/prevención & control , Pubertad/fisiología , Maduración Sexual/fisiología , Pérdida de Peso/fisiología , Índice de Masa Corporal , Tamaño Corporal , Niño , Femenino , Humanos , Masculino , Polonia
10.
Rev Assoc Med Bras (1992) ; 65(7): 952-958, 2019 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-31389504

RESUMEN

PURPOSE: In this prospective observational study, we aimed to investigate the role of the maximum compressed (MC) and uncompressed (UC) thickness of the quadriceps femoris muscle (QFMT) measured by ultrasonography (USG) in the detection of nutritional risk in intensive care patients (ICPs) with different volume status. METHODS: 55 patients were included. Right, left, and total ucQFMT and mcQFMT measurements were obtained by a standard USG device within the first 48 hours after ICU admission. Clinical examination and the USG device were used to determine the volume status of the patients. SOFA, APACHE II, modified NUTRIC scores, and demographic data were collected. RESULTS: There was a significant difference between the nutritional risk of patients in terms of left, right, and total mcQFMT measurements (p=0.025, p=0.039; p=0.028, respectively), mechanical ventilation requirement (p=0.014), presence of infection (p=0.019), and sepsis (p=0.006). There was no significant difference between different volume statuses in terms of mcQFMT measurements. In the multi-variance analysis, mcQFMT measurements were found to be independently associated with high nutritional risk (p=0.019, Exp(B)=0.256, 95%CI=0.082-0.800 for modified NUTRIC score ≥ 5), and higher nutritional risk (p=0.009, Exp(B)=0.144, 95%CI=0.033-0.620 for modified NUTRIC score ≥ 6). a Total mcQFMT value below 1.36 cm was a predictor for higher nutritional risk with 79% sensitivity and 70% specificity (AUC=0.749, p=0.002, likelihood ratio=2.04). CONCLUSION: Ultrasonographic measurement of total mcQFMT can be used as a novel nutritional risk assessment parameter in medical ICPs with different volume statuses. Thus, patients who could benefit from aggressive nutritional therapy can be easily identified in these patient groups.


Asunto(s)
Estado Nutricional/fisiología , Músculo Cuádriceps/diagnóstico por imagen , Músculo Cuádriceps/patología , Ultrasonografía/métodos , APACHE , Anciano , Anciano de 80 o más Años , Enfermedad Crítica , Femenino , Humanos , Unidades de Cuidados Intensivos , Tiempo de Internación , Modelos Logísticos , Masculino , Desnutrición/diagnóstico por imagen , Desnutrición/patología , Desnutrición/fisiopatología , Persona de Mediana Edad , Evaluación Nutricional , Terapia Nutricional/métodos , Estudios Prospectivos , Músculo Cuádriceps/fisiopatología , Valores de Referencia , Respiración Artificial/efectos adversos , Medición de Riesgo , Sensibilidad y Especificidad
11.
Nutrients ; 11(8)2019 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-31382527

RESUMEN

Personalised nutrition approaches provide healthy eating advice tailored to the nutritional needs of the individual[...].


Asunto(s)
Terapia Nutricional/métodos , Medicina de Precisión/métodos , Conducta , Conducta Alimentaria , Humanos , Necesidades Nutricionales
12.
BMC Pregnancy Childbirth ; 19(1): 229, 2019 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-31277585

RESUMEN

BACKGROUND: An understanding of the association between adolescent nutrition, adolescent pregnancy and their quest for healthcare services may elucidate a basis for intervention and formulation of programs that enhance post-partum and increase the lifespan of the newborn, improve the quality of life and bridge morbidity, mortality and healthcare-associated cost. However, the nutritional needs of pregnant and lactating adolescent girls aged below 10 years resident in Trans Mara East Sub-County, Kenya remained unestablished. The objective of this study was to assess the nutritional needs of pregnant and lactating adolescent girls (under 19) when accessing and utilizing nutritional advice and services in Trans-Mara East Sub-County, Narok County. METHODS: The study adopted a cross-sectional approach that employed mixed methods with both quantitative and qualitative research approaches. Cochran formula was applied to arrive at a minimum of 291 households. Probability proportionate to size sampling techniques using cluster and simple random methods were used to practically access adolescents who are pregnant or lactating. Data was collected using questionnaires, in-depth interview and Focus Group Discussion. Quantitative data was analyzed descriptively using frequencies and inferentially using odds ratio and z-test. Framework analysis was employed to analyze qualitative data. p ≤ 0.05 was considered statistically significant. RESULTS: The study revealed that access of pieces of nutritional-related advice represented by 67.8% was significantly higher than expected frequency of 50%. Nutrition supplementation, food fortification or blending and complementary feeding were significantly below the expectant frequency (p < 0.01) of 50%. Nutrition service areas such as provision and collection of vitamin A and IFAS were significantly lower than expected frequency (p < 0.01). CONCLUSIONS: The most widely utilized were nutrition services that falls within the preventive-focused services followed by curative-focused services. Nutritionist and nurse more likely to increase overall utilization of nutrition services.


Asunto(s)
Servicios de Salud del Adolescente , Accesibilidad a los Servicios de Salud , Servicios de Salud Materna , Evaluación de Necesidades , Terapia Nutricional , Aceptación de la Atención de Salud , Adolescente , Servicios de Salud del Adolescente/organización & administración , Servicios de Salud del Adolescente/estadística & datos numéricos , Fenómenos Fisiológicos Nutricionales de los Adolescentes , Lactancia Materna , Niño , Estudios Transversales , Femenino , Promoción de la Salud/métodos , Promoción de la Salud/organización & administración , Promoción de la Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/organización & administración , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Recién Nacido , Kenia , Lactancia , Fenómenos Fisiologicos Nutricionales Maternos , Terapia Nutricional/métodos , Terapia Nutricional/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Embarazo , Adulto Joven
13.
BMC Cancer ; 19(1): 737, 2019 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-31345179

RESUMEN

BACKGROUND: Patients with breast cancer undergoing chemotherapy and radiotherapy experience fatigue and other treatment side effects. Integrative therapies combining physical activity and dietary counseling are recommended; however to date no large randomized controlled trial has been conducted during adjuvant therapy. The Adapted Physical Activity and Diet (APAD) intervention was evaluated for its ability to decrease fatigue (primary outcome), anxiety, depression, body mass index (BMI), and fat mass, and enhance muscular and cognitive performances, and quality-of-life (QoL). METHODS: Women diagnosed with early breast cancer (N = 143, mean age = 52 ± 10 years) were randomized to APAD or usual care (UC). APAD included thrice-weekly moderate-intensity mixed aerobic and resistance exercise sessions and 9 dietetic consultations. Patient-reported outcomes (PROs) and anthropometric, muscular, and cognitive variables were measured at baseline, 18 weeks (end of chemotherapy), and 26 weeks (end of radiotherapy and intervention), and at 6- and 12-month post-intervention follow-ups. Multi-adjusted linear mixed-effects models were used to compare groups over time. RESULTS: Significant beneficial effects of the APAD intervention were observed on all PROs (i.e., fatigue, QoL, anxiety, depression) at 18 and 26 weeks. The significant effect on fatigue and QoL persisted up to 12-month follow-up. Significant decreases in BMI, fat mass, and increased muscle endurance and cognitive flexibility were observed at 26 weeks, but did not persist afterward. Leisure physical activity was enhanced in the APAD group vs UC group at 18 and 26 weeks. No significant effect of the intervention was found on major macronutrients intake. CONCLUSIONS: A combined diet and exercise intervention during chemotherapy and radiotherapy in patients with early breast cancer led to positive changes in a range of psychological, physiological and behavioral outcomes at the end of intervention. A beneficial effect persisted on fatigue and QoL at long term, i.e., 1 year post-intervention. Diet-exercise supportive care should be integrated into the management of early breast cancer patients. TRIAL REGISTRATION: The APAD study was prospectively registered on ClinicalTrials.gov (NCT01495650; date of registration: December 20, 2011).


Asunto(s)
Neoplasias de la Mama/terapia , Quimioradioterapia Adyuvante/efectos adversos , Terapia por Ejercicio/métodos , Fatiga/terapia , Terapia Nutricional/métodos , Adolescente , Adulto , Anciano , Ansiedad/etiología , Ansiedad/psicología , Ansiedad/terapia , Neoplasias de la Mama/complicaciones , Terapia Combinada/métodos , Consejo/métodos , Depresión/etiología , Depresión/psicología , Depresión/terapia , Fatiga/diagnóstico , Fatiga/etiología , Femenino , Humanos , Mastectomía , Persona de Mediana Edad , Medición de Resultados Informados por el Paciente , Estudios Prospectivos , Calidad de Vida , Resultado del Tratamiento , Adulto Joven
14.
BMC Med ; 17(1): 148, 2019 07 30.
Artículo en Inglés | MEDLINE | ID: mdl-31357989

RESUMEN

Cancer Research UK and Ludwig Cancer Research convened an inaugural international Cancer Prevention and Nutrition Conference in London on December 3-4, 2018. Much of the discussion focused on the need for systematic, interdisciplinary approaches to better understand the relationships of nutrition, exercise, obesity and metabolic dysfunction with cancer development. Scientists at the meeting underscored the importance of studying the temporal natural history of exposures that may cumulatively impact cancer risk later in life.A robust dialogue identified obesity as a major risk for cancer, and the food environment, especially high energy and low nutrient processed foods, as strong and prevalent risk factors for obesity. Further engagement highlighted challenges in the post-diagnostic setting, where similar opportunities to understand the complex interplay of nutrition, physical activity, and weight will inform better health outcomes.Going forward, holistic research approaches, encompassing insights from multiple disciplines and perspectives, will catalyze progress urgently needed to prevent cancer and improve public health.


Asunto(s)
Investigación Biomédica , Investigación Interdisciplinaria , Neoplasias/dietoterapia , Neoplasias/prevención & control , Terapia Nutricional , Investigación Biomédica/métodos , Investigación Biomédica/tendencias , Peso Corporal/fisiología , Congresos como Asunto , Dieta , Ejercicio/fisiología , Alimentos , Humanos , Comunicación Interdisciplinaria , Investigación Interdisciplinaria/métodos , Investigación Interdisciplinaria/tendencias , Terapia Nutricional/métodos , Terapia Nutricional/tendencias , Estado Nutricional , Obesidad/complicaciones , Obesidad/dietoterapia , Obesidad/epidemiología , Factores de Riesgo , Reino Unido/epidemiología
15.
Cochrane Database Syst Rev ; 6: CD011695, 2019 Jun 17.
Artículo en Inglés | MEDLINE | ID: mdl-31204795

RESUMEN

BACKGROUND: Nutritional interventions to prevent stunting of infants and young children are most often applied in rural areas in low- and middle-income countries (LMIC). Few interventions are focused on urban slums. The literature needs a systematic assessment, as infants and children living in slums are at high risk of stunting. Urban slums are complex environments in terms of biological, social, and political variables and the outcomes of nutritional interventions need to be assessed in relation to these variables. For the purposes of this review, we followed the UN-Habitat 2004 definitions for low-income informal settlements or slums as lacking one or more indicators of basic services or infrastructure. OBJECTIVES: To assess the impact of nutritional interventions to reduce stunting in infants and children under five years old in urban slums from LMIC and the effect of nutritional interventions on other nutritional (wasting and underweight) and non-nutritional outcomes (socioeconomic, health and developmental) in addition to stunting. SEARCH METHODS: The review used a sensitive search strategy of electronic databases, bibliographies of articles, conference proceedings, websites, grey literature, and contact with experts and authors published from 1990. We searched 32 databases, in English and non-English languages (MEDLINE, CENTRAL, Web of Science, Ovid MEDLINE, etc). We performed the initial literature search from November 2015 to January 2016, and conducted top up searches in March 2017 and in August 2018. SELECTION CRITERIA: Research designs included randomised (including cluster-randomised) trials, quasi-randomised trials, non-randomised controlled trials, controlled before-and-after studies, pre- and postintervention, interrupted time series (ITS), and historically controlled studies among infants and children from LMIC, from birth to 59 months, living in urban slums. The interventions included were nutrition-specific or maternal education. The primary outcomes were length or height expressed in cm or length-for-age (LFA)/height-for-age (HFA) z-scores, and birth weight in grams or presence/absence of low birth weight (LBW). DATA COLLECTION AND ANALYSIS: We screened and then retrieved titles and abstracts as full text if potentially eligible for inclusion. Working independently, one review author screened all titles and abstracts and extracted data on the selected population, intervention, comparison, and outcome parameters and two other authors assessed half each. We calculated mean selection difference (MD) and 95% confidence intervals (CI). We performed intervention-level meta-analyses to estimate pooled measures of effect, or narrative synthesis when meta-analyses were not possible. We used P less than 0.05 to assess statistical significance and intervention outcomes were also considered for their biological/health importance. Where effect sizes were small and statistically insignificant, we concluded there was 'unclear effect'. MAIN RESULTS: The systematic review included 15 studies, of which 14 were randomised controlled trials (RCTs). The interventions took place in recognised slums or poor urban or periurban areas. The study locations were mainly Bangladesh, India, and Peru. The participants included 9261 infants and children and 3664 pregnant women. There were no dietary intervention studies. All the studies identified were nutrient supplementation and educational interventions. The interventions included zinc supplementation in pregnant women (three studies), micronutrient or macronutrient supplementation in children (eight studies), nutrition education for pregnant women (two studies), and nutrition systems strengthening targeting children (two studies) intervention. Six interventions were adapted to the urban context and seven targeted household, community, or 'service delivery' via systems strengthening. The primary review outcomes were available from seven studies for LFA/HFA, four for LBW, and nine for length.The studies had overall high risk of bias for 11 studies and only four RCTs had moderate risk of bias. Overall, the evidence was complex to report, with a wide range of outcome measures reported. Consequently, only eight study findings were reported in meta-analyses and seven in a narrative form. The certainty of evidence was very low to moderate overall. None of the studies reported differential impacts of interventions relevant to equity issues.Zinc supplementation of pregnant women on LBW or length (versus supplementation without zinc or placebo) (three RCTs)There was no evidence of an effect on LBW (MD -36.13 g, 95% CI -83.61 to 11.35), with moderate-certainty evidence, or no evidence of an effect or unclear effect on length with low- to moderate-certainty evidence.Micronutrient or macronutrient supplementation in children (versus no intervention or placebo) (eight RCTs)There was no evidence of an effect or unclear effect of nutrient supplementation of children on HFA for studies in the meta-analysis with low-certainty evidence (MD -0.02, 95% CI -0.06 to 0.02), and inconclusive effect on length for studies reported in a narrative form with very low- to moderate-certainty evidence.Nutrition education for pregnant women (versus standard care or no intervention) (two RCTs)There was a positive impact on LBW of education interventions in pregnant women, with low-certainty evidence (MD 478.44g, 95% CI 423.55 to 533.32).Nutrition systems strengthening interventions targeting children (compared with no intervention, standard care) (one RCT and one controlled before-and-after study)There were inconclusive results on HFA, with very low- to low-certainty evidence, and a positive influence on length at 18 months, with low-certainty evidence. AUTHORS' CONCLUSIONS: All the nutritional interventions reviewed had the potential to decrease stunting, based on evidence from outside of slum contexts; however, there was no evidence of an effect of the interventions included in this review (very low- to moderate-certainty evidence). Challenges linked to urban slum programming (high mobility, lack of social services, and high loss of follow-up) should be taken into account when nutrition-specific interventions are proposed to address LBW and stunting in such environments. More evidence is needed of the effects of multi-sectorial interventions, combining nutrition-specific and sensitive methods and programmes, as well as the effects of 'up-stream' practices and policies of governmental, non-governmental organisations, and the business sector on nutrition-related outcomes such as stunting.


Asunto(s)
Países en Desarrollo , Trastornos del Crecimiento/prevención & control , Terapia Nutricional/métodos , Áreas de Pobreza , Población Urbana , Bangladesh , Estudios de Casos y Controles , Preescolar , Estudios Controlados Antes y Después , Suplementos Dietéticos , Humanos , India , Lactante , Micronutrientes/administración & dosificación , Madres/educación , Nutrientes/administración & dosificación , Perú , Mujeres Embarazadas , Ensayos Clínicos Controlados Aleatorios como Asunto , Delgadez/dietoterapia , Síndrome Debilitante/dietoterapia , Zinc/administración & dosificación
16.
Medicine (Baltimore) ; 98(25): e16043, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31232938

RESUMEN

BACKGROUND: Multiple sclerosis (MS) is a chronic immune mediated disease which affects the central nervous system (CNS), having a substantial financial, functional, and quality of life (QOL) impact on these people. The vitamin A supplementation has been studied as a therapeutic possibility for in MS. Therefore, the objective of this protocol is to build an outline for a future systematic review, which will provide up-to-date available evidence about the clinical impact of nutritional supplementation of vitamin A in the outcomes related to the symptoms in patients with this pathology. METHODS: The search will be performed in the following databases: PubMed, Embase, Scopus, cinahl, Scielo, Web of Science, the Cochrane Library and Science Direct, randomized clinical trials published until May 2019 that evaluate the relationship of the supplementation of vitamin A and health-related outcomes in patients with MS will be included. Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) will be used to outline the protocol, and PRISMA to the systematic review. Undergraduate handbook of quality of evidence and strength of recommendations for decision making in health (GRADE) will be used to assess the quality of evidence and the strength of the recommendation, and the JADAD scale to assess the internal validity of selected studies. For the extraction of all the data found a database in Microsoft Excel will be created. For the summary of the findings the Cochrane Collaboration Handbook recommendations will be used, and for the meta-analysis standard statistical techniques the RevMan software will be used. RESULTS: In this study, we hope to find a considerable number of articles presenting evidence about the effectiveness of vitamin A supplementation in patients with MS. CONCLUSION: Currently, many lines of evidence have been produced when it comes to the use of food supplements. This systematic review proposal might provide recent, important, and trusted information for better treatment of patients. RECORD OF SYSTEMATIC REVIEW: This review was recorded in the International Register of Prospective Systematic Reviews (PROSPERO) on the January 30, 2019 (registration: CRD42019121757). Available at: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42019121757.


Asunto(s)
Suplementos Dietéticos/normas , Metaanálisis como Asunto , Esclerosis Múltiple/dietoterapia , Ensayos Clínicos Controlados Aleatorios como Asunto/normas , Literatura de Revisión como Asunto , Humanos , Terapia Nutricional/métodos , /normas , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Vitamina A/uso terapéutico , Vitaminas/uso terapéutico
17.
Nutr Hosp ; 36(Spec No2): 57-60, 2019 Jul 01.
Artículo en Español | MEDLINE | ID: mdl-31189324

RESUMEN

Introduction: Nutrition therapy and exercise form an essential tandem to maintain the functional capacity of patients and, therefore, improve your quality of life. Oral nutritional supplements are part of the medical nutrition treatment. The success of taking nutritional supplements, lies in the therapeutic adherence. The therapeutic adherence is defined by who as "the degree to which the behavior of a patient, in relation to the taking of medication, monitoring a diet or modifying life habits correspond to the recommendations agreed with the health professional ". There are some factors that limit its achievement. Therefore, we must identify them and have tools to solve them so that the patient does not interrupt the prescribed treatment, both from prevention and intervention.


Asunto(s)
Terapia por Ejercicio/métodos , Ejercicio , Fuerza Muscular/fisiología , Terapia Nutricional/métodos , Terapia Combinada , Suplementos Dietéticos , Humanos , Cooperación del Paciente
18.
Crit Care ; 23(Suppl 1): 139, 2019 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-31200741

RESUMEN

Critically ill patients require adequate nutritional support to meet energy requirements both during and after intensive care unit (ICU) stay to protect against severe catabolism and prevent significant deconditioning. ICU patients often suffer from chronic critical illness causing an increase in energy expenditure, leading to proteolysis and related muscle loss. Careful supplementation and modulation of caloric and protein intake can avoid under- or overfeeding, both associated with poorer outcomes. Indirect calorimetry is the preferred method for assessing resting energy expenditure and the appropriate caloric and protein intake to counter energy and muscle loss. Physical exercise may have favorable effects on muscle preservation and should be considered even early in the hospital course of a critically ill patient. After liberation from the ventilator or during non-invasive ventilation, oral intake should be carefully evaluated and, in case of severe dysphagia, should be avoided and replaced by enteral of parenteral nutrition. Upon transfer from the ICU to the ward, adequate nutrition remains essential for long-term rehabilitation success and continued emphasis on sufficient nutritional supplementation in the ward is necessary to avoid a suboptimal nutritional state.


Asunto(s)
Enfermedad Crítica/psicología , Terapia Nutricional/métodos , Ingestión de Energía/fisiología , Ejercicio/fisiología , Humanos , Unidades de Cuidados Intensivos/organización & administración , Tiempo de Internación , Estado Nutricional , Apoyo Nutricional/métodos , Calidad de Vida/psicología , Estrés Fisiológico/fisiología
19.
Afr Health Sci ; 19(1): 1566-1573, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31148985

RESUMEN

Background: Nationwide studies have focused only on prevalence of malnutrition in hospitalized children, while medical nutrition therapies and assessing nutritional interventions is neglected. Methods: This research was conducted in tertiary level children hospitals in the NorthEastern region of Iran for 1 year from 2016 to 2017. Five questions were included in the initial assessment form and, if there was even one positive response, nutritional interventions were prescribed for the patients. Results: A total of 65 children aged ≥ 5 years and hospitalized for ≥ two days were included. 24.6% of patients had 2 >BMI Z-score>-2 at time of admission. At the beginning of the study, weight loss more than 10%, and appetite loss or decreased food intake was observed in 10.8% and 20% of the study population, respectively. Median BMI percentile of patients with nutritional intervention was 8.9 (0.1-98.7) at the beginning of the study and 12.7 (0.1-98.4) at discharge time which shows a significant difference (P=0.01). Conclusion: Medical nutrition therapy employed in this study prevented deterioration of nutritional status of children during hospitalization and was effective in stabilizing indices of nutritional status.


Asunto(s)
Desnutrición/diagnóstico , Desnutrición/terapia , Tamizaje Masivo/métodos , Terapia Nutricional/métodos , Adolescente , Índice de Masa Corporal , Niño , Preescolar , Estudios Transversales , Femenino , Hospitalización , Humanos , Irán/epidemiología , Tiempo de Internación , Masculino , Desnutrición/epidemiología , Evaluación Nutricional , Estado Nutricional
20.
Nutrients ; 11(6)2019 May 29.
Artículo en Inglés | MEDLINE | ID: mdl-31146408

RESUMEN

Those with peripheral arterial disease (PAD) require important considerations with respect to food and nutrition, owing to advanced age, poor diet behaviours and immobility associated with the disease process and co-morbid state. These considerations, coupled with the economic effectiveness of medical nutrition therapy, mandate that dietetic care plays a vital role in the management of PAD. Despite this, optimising dietetic care in PAD remains poorly understood. This narrative review considers the role of medical nutrition therapy in every stage of the PAD process, ranging from the onset and initiation of disease to well established and advanced disease. In each case, the potential benefits of traditional and novel medical nutrition therapy are discussed.


Asunto(s)
Desnutrición/terapia , Terapia Nutricional/métodos , Enfermedad Arterial Periférica/terapia , Conducta de Reducción del Riesgo , Humanos , Desnutrición/diagnóstico , Desnutrición/epidemiología , Desnutrición/fisiopatología , Estado Nutricional , Valor Nutritivo , Enfermedad Arterial Periférica/diagnóstico , Enfermedad Arterial Periférica/epidemiología , Enfermedad Arterial Periférica/fisiopatología , Factores Protectores , Ingesta Diaria Recomendada , Medición de Riesgo , Factores de Riesgo , Resultado del Tratamiento
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