Knowledge of physiological aspects, clinical management, and nutrition among patients with type 2 diabetes mellitus

Objective: To evaluate the knowledge about physiological aspects, clinical management, and nutrition of primary care patients with type 2 diabetes mellitus by sociodemographic, economic, and clinical variables. Material and methods: We conducted an observational cross-sectional study in 22 Family Health Strategy units in the city of Montes Claros, Minas Gerais, in 2015 among 353 patients registered with type 2 diabetes mellitus. A structured questionnaire was used to assess sociodemographic and clinical characteristics. Knowledge was assessed using the diabetes knowledge scale questionnaire. Data were presented with absolute frequencies and percentages and analyzed using Poisson regression. Results: Most respondents demonstrated satisfactory knowledge in the field of physiology (60.30%) and unsatisfactory knowledge in clinical management (67.7%) and nutrition (61.5%). Schooling was associated with knowledge in the areas of physiology, clinical management and nutrition, and treatment associated with clinical management. Conclusion: Knowledge about type 2 diabetes mellitus was related to sociodemographic characteristics and treatment. The importance of health education for coping with this chronic condition is evident.

Objetivo: Evaluar los conocimientos sobre aspectos fisiológicos, manejo clínico y nutrición de usuarios con diabetes mellitus tipo 2 registrados en unidades de Atención Primaria y su análisis según variables sociodemográficas, económicas y clínicas. Métodos: Se trata de un estudio observacional y transversal realizado en 22 unidades de la Estrategia Salud de la Familia de la ciudad de Montes Claros, Minas Gerais, en 2015 con 353 pacientes registrados con diabetes mellitus tipo 2. Se utilizó un cuestionario estructurado para evaluar las características sociodemográficas y clínicas. El conocimiento se evaluó mediante el cuestionario de la escala de conocimiento de la diabetes. Los datos se presentaron en frecuencias absolutas y porcentajes. El análisis de datos utilizó la regresión de Poisson. Resultados: La mayoría de los encuestados demostró conocimientos satisfactorios en el campo de fisiología (60,30%) y conocimientos insatisfactorios en manejo clínico (67,7%) y nutrición (61,5%). La escolaridad se asoció con conocimientos en las áreas de Fisiología, Manejo Clínico y Nutrición e treatment con Manejo Clínico. Conclusión: El conocimiento sobre la diabetes mellitus tipo 2 está relacionado con las características sociodemográficas y el. tratamento. La importancia de la educación en salud para el enfrentamiento de esta condición crónica es evidente.

Dietary recommendations to customize canteen menus according to the nutritional and sensory needs of individuals with autism spectrum disorder.

Individuals with autism spectrum disorders (ASD) are often characterized by food-selectivity, food-neophobia and a marked preference for mild flavor, semi-liquid foods with pale colors. Therefore, they adopt a monotonous dietary pattern, and they prefer ultra-processed food, leading to a high risk of developing malnutrition. In Italy, where 75,072 individuals are diagnosed with ASD, center-based services play a crucial role in their daily management. Despite the centrality of nutrition in maintaining a good state of health, even more for vulnerable subjects, no validated protocol at collective catering level has been developed yet. The manuscript presents customized dietary recommendations aimed at managing the meals for individuals with ASD at collective catering service, derived from a non-systematic literature review exploring food behaviors and nutritional needs in individuals with ASD. Simple practical tips for mealtimes, such as eating together, proper seating, lighting, smell control, presenting food in a simple manner and using the same type of tableware at each meal, to meet the needs of individuals with ASD, were described. The proposal could represent a starting point in developing official guidelines aimed at ASD individuals, in collective catering service.Level of Evidence: Level V.

Comparison of the effect of various sources of saturated fatty acids on infant follow-on formulas oxidative stability and nutritional profile.

Fortification of infant follow-on formulas (IFF) with docosahexaenoic acid (DHA), which is prone to lipid oxidation, is required by European regulation. This study aimed to identify lipid formulation parameters that improve the nutritional profile and oxidative stability of IFF. Model IFF were formulated using different lipid and emulsifier sources, including refined (POM) or unrefined red palm oil (RPOM), coconut oil (COM), dairy fat (DFOM), soy lecithin, and dairy phospholipids (DPL). After an accelerated storage, RPOM and DFOM with DPL had improved oxidative stability compared to other IFF. Specifically, they had a peroxide value twice lower than POM and 20% less loss of tocopherols for DFOM-DPL. This higher stability was mainly explained by the presence of compounds such as carotenoids in RPOM and sphingomyelin in DFOM-DPL very likely acting synergistically with tocopherols. Incorporation of dairy lipids and carotenoids into DHA-enriched IFF compositions seems promising to enhance their stability and nutritional quality.

Daily Nutritional Intake of Pediatric Patients (N = 64) on Extracorporeal Membrane Oxygenation from 2018 to 2022: A Single-Center Report.

Nutrition in pediatric populations who require life-saving extracorporeal membrane oxygenation (ECMO) remains a debate. We sought to identify if nutritional needs were met in a patient cohort. A retrospective chart review of patients (N = 64) requiring ECMO at Helen DeVos Children's Hospital between 2018 and 2022 was evaluated for demographics, daily nutritional data, laboratory values, ECMO complications, and outcome data, with primary outcome measures of percent protein and percent caloric intake. Secondary outcome measures included the intensive care unit length of stay, time on ECMO, mortality, and day 1 severity of illness scores (Pediatric Logistic Organ Dysfunction). The timeline partially overlapped with the COVID-19 pandemic. Data were collected for 467 ECMO days with a median age of 2.6 months; 57.8% of patients were male and 65.6% were with one pre-existing comorbidity. Venoarterial (VA) ECMO was utilized in 84.4% of patients; the ECMO indication was cardiac in 53.1% of patients. The 28-day mortality was 43.8%. The proportion of days in which the caloric goal was met was 0%; the proportion of days in which protein goals were met was 33.3%. Non-cardiac ECMO patients had a greater number of days where caloric goals were met (p-value = 0.04). Mortality at 28 days was not statistically significant (p-value = 0.28) for calories or protein administered. The patient cohort struggled to meet calorie and protein goals while on ECMO.

Qualitative Study on the Factors Influencing the Utilisation of Products Labelled "Food for Special Medicinal Use" (FSMP).

This study aimed to investigate Romanian physicians' awareness, recommendation practices, and opinions regarding the use of Foods for Special Medical Purposes (FSMPs) products. A total of ten physicians were interviewed using a structured questionnaire, and their responses were analysed using thematic content analysis. The study found that physicians were aware of FSMPs and recommended them to their patients based on nutritional deficits, weight loss, or deglutition impairments. In addition, disease stage, treatment scheme, taste, affordability, and availability were identified as factors influencing the recommendation and use of FSMPs. While physicians generally did not consult clinical trials, clinical experience was deemed essential for recommending FSMPs to patients. Patients' feedback regarding the usage and sourcing of FSMPs was generally positive, with some expressing concerns about the availability of different flavours and the costs of purchasing the products. This study concluded that physicians play a vital role in recommending FSMPs to patients and ensuring they have the necessary nutritional support during treatment. However, it may be imperative to consider the provision of additional patient education materials and fostering collaborative efforts with nutritionists in order to optimise the prospects of positive outcomes in oncology treatment, while simultaneously alleviating the financial burdens faced by patients.

Dietary Consumption With Vitamin D Status Among Pregnant Women: A Descriptive-Analytic Study.

AIM: This study aimed to investigate the relationship between vitamin D status and diet between pregnant and non-pregnant women who attended a Maternity Teaching Hospital (MTH) in Sulaymaniyah, Iraq. MATERIALS AND METHODS: A descriptive-analytic (cross-sectional) study was conducted at the MTH in Sulaymaniyah, Iraq. Data was collected from January to October 2022, including demographics, obstetric information, and dietary data. Vitamin D levels were measured using the Roche Elecsys assay (Roche Diagnostics, Indianapolis, Indiana, United States). The non-pregnant group consisted of women who were not pregnant at the time of this study, and the pregnant group had women with second trimester pregnancy at the time of enrollment. RESULT: The study revealed a significant prevalence of vitamin D deficiency among pregnant women. In the study, pregnant participants (56.0% aged 30-39) and non-pregnant participants (54.3% aged 20-29) had similar ages (p>0.05). Both groups mostly had overweight individuals, with pregnant participants having a slightly higher mean body mass index (BMI). While vitamin D deficiency was more prevalent among pregnant women, the differences were not statistically significant. Notably, higher dairy intake was positively associated with higher vitamin D levels. Urban residency was common in both groups. Dietary habits were mostly similar, except for tea consumption (p<0.05), with non-tea drinkers having higher vitamin D levels. However, dietary patterns did not strongly correlate with vitamin D levels in the non-pregnant group. CONCLUSION: This study reveals a significant prevalence of vitamin D deficiency among pregnant women, although the differences between pregnant and non-pregnant groups were not statistically significant. The positive association between higher dairy intake and increased vitamin D levels underscores the potential impact of dietary choices on vitamin D status during pregnancy. However, the study also suggests that dietary patterns alone may not strongly correlate with vitamin D levels in non-pregnant women. Overall, this highlights the importance of addressing vitamin D deficiency in pregnant women and underscores the need for personalized dietary guidance, taking into account individual preferences and habits to promote better maternal health.

Indicadores de qualidade em terapia nutricional enteral em unidades de terapia intensiva / Quality indicators in enteral nutritional therapy in intensive care units

desnutrição é uma condição frequente em pacientes críticos. Isso pode ser acentuado devido uma oferta inadequada, por meio da nutrição enteral. Objetivo: Analisar indicadores de qualidade para identificar frequência de eventos relacionados à terapia nutricional enteral. Métodos: Estudo transversal, retrospectivo, realizado em um hospital de urgência e trauma, na cidade de Goiânia (GO), com pacientes internados em Unidades de Terapia Intensiva (UTIs), no período de outubro de 2021. A coleta de dados foi realizada por meio de prontuários eletrônicos preenchidos por profissionais médicos, enfermeiros e nutricionistas da unidade. Resultados: A adequação de volume prescrito versus volume infundido foi de 86,59%. A frequência de administração de energia resultou em 3,23% de adequação de energia. A frequência de dias de administração adequada de proteína apresentou-se adequada, correspondendo a ≥ 10% da frequência de dias de administração adequada de proteína. Conclusão: O volume prescrito versus volume infundido e dias de administração adequada de proteína apresentaram-se adequados. Houve relevantes inadequações calóricas entre calorias prescritas e calorias recebidas, sugerindo que os pacientes se encontravam com déficits energéticos importantes. Esta inadequação de ingestão calórica, caso não seja revertida, é prejudicial a estes pacientes, ocasionando diversas complicações clínicas, afetando diretamente o desfecho e/ou a alta do paciente

Malnutrition is a frequent condition in critically ill patients. This can be accentuated due to inadequate supply through enteral nutrition. Objective: To analyze quality indicators to identify the frequency of events related to enteral nutritional therapy. Methods: Cross-sectional, retrospective study, carried out in an emergency and trauma hospital, in the city of Goiânia (GO), with patients admitted to Intensive Care Units (ICUs), in the period of October 2021. Data collection was carried out through electronic medical records completed by medical professionals, nurses and nutritionists at the unit. Results: The adequacy of prescribed volume versus infused volume was 86.59%. The frequency of energy delivery resulted in 3.23% energy adequacy. The frequency of days of adequate protein administration was adequate, corresponding to ≥ 10% of the frequency of days of adequate protein administration. Conclusion: The prescribed volume versus infused volume and days of adequate protein administration were adequate. There were relevant caloric inadequacies between prescribed and received calories, suggesting that patients had significant energy deficits. This inadequacy of caloric intake, if not reversed, is harmful to these patients, causing several clinical complications, directly affecting the outcome and/or discharge of the patient

A Prospective Validation Study of the Functional Bedside Aspiration Screen with Endoscopy: Is It Clinically Applicable in Acute Stroke?

The purpose of this study was to investigate the reliability of the novel Functional Bedside Aspiration Screen (FBAS) to predict aspiration risk in acute stroke and to guide initial therapy needs. We conducted a prospective validation study of the FBAS 10-point scale in 101 acute ischemic stroke patients. Outcome measures were compared with the Penetration Aspiration Scale (PAS) via the Flexible Endoscopic Swallowing Study. Correlations with the Functional Oral Intake Scale (FOIS) and the Therapy Requirement Scale (TRS) were analyzed. We observed a 65.8% sensitivity and 70.2% specificity (p = 0.004) for predicting penetration risk (for PAS score ≥ 3) and a 73% sensitivity and 62% specificity for predicting aspiration risk (PAS score ≥ 6). For patients with a modified ranking scale 0-2 (n = 44) on admission, the predictive measurements of the FBAS yielded sensitivity and specificity values of 66.7% and 88.6% (p = 0.011). A significant negative correlation was found with PAS measurements, whereas a positive correlation was observed regarding FOIS. Significantly lower FBAS scores were observed in patients with high requirements for therapeutic interventions and dietary modification. FBAS may be regarded as an alternative time-efficient clinical support tool in settings in which instrumentation is not directly accessible. Further studies including a larger cohort of acute stroke patients with more severe neurological deficits are necessary.

Evaluación de las ingestas dietéticas y prácticas alimentarias en niños de 6 a 23 meses en una localidad del noreste argentino / Assessment of dietary intakes and feeding practices in children aged 6­23 months in a town in the Northeast region of Argentina

Introducción. Una alimentación complementaria adecuada en cantidad y calidad resulta esencial durante los primeros dos años de vida. El objetivo del estudio fue evaluar la ingesta de nutrientes y prácticas alimentarias en niños de 6 a 23 meses de una localidad del noreste argentino. Población y métodos. Estudio descriptivo transversal (segundo semestre del 2019). Se evaluaron las ingestas de 24 horas mediante recordatorios a los cuidadores de niños de 6 a 23 meses. Los datos se compararon con las ingestas dietéticas de referencia. Las prácticas alimentarias se evaluaron según los indicadores establecidos por la Organización Mundial de la Salud. Resultados. Se evaluaron 138 niños de 6 a 23 meses de edad. La energía y las vitaminas A, D y E presentaron porcentajes medios de adecuación inferiores al 100 % en todas las edades, mientras que las proteínas alcanzaron una adecuación promedio del 142,8 % y el 168,1 % para los niños de 7-12 meses y de 13-23 meses, respectivamente. Los nutrientes que presentaron una proporción considerable de casos con ingestas por debajo del requerimiento promedio estimado en todos los grupos fueron la energía y la vitamina A. En cuanto a los indicadores de prácticas alimentarias, 50,8 % de los lactantes recibió una dieta mínima aceptable. Conclusiones. Existe una alta prevalencia de inadecuación energética y de nutrientes críticos durante la alimentación complementaria en los niños de 6 a 23 meses incluidos en el estudio. Intervenciones nutricionales que promuevan prácticas alimentarias que mejoren la ingesta de micronutrientes serían de suma importancia para su salud actual y futura.

Introduction. An adequate quantity and quality of complementary feeding is essential during the first 2 years of life. The objective of this study was to assess dietary intakes and feeding practices in children aged 6­23 months in a town in the Northeast region of Argentina. Population and methods. Descriptive, cross-sectional study (second semester of 2019). Intakes from 24-hour dietary recall interviews conducted among caregivers of children aged 6­23 months were assessed. Data were compared to dietary reference intakes. Feeding practices were assessed as per the World Health Organization's indicators. Results. A total of 138 children aged 6­23 months were assessed. The mean adequacy ratio of energy and vitamins A, D, and E was below 100% for all ages, whereas the protein adequacy for children aged 7-12 and 13-23 months was 142.8% and 168.1%, respectively. A remarkable number of cases had energy and vitamin A intakes below the estimated average requirement. In relation to feeding practice indicators, 50.8% of infants received a minimum acceptable diet. Conclusions. There is a high prevalence of an inadequate level of energy and critical nutrient intake during complementary feeding of the children aged 6­23 months included in the study. Nutritional interventions that promote feeding practices to improve micronutrient intake would be highly important for children's current and future health.

Assessment of dietary intakes and feeding practices in children aged 6-23 months in a town in the Northeast region of Argentina. / Evaluación de las ingestas dietéticas y prácticas alimentarias en niños de 6 a 23 meses en una localidad del noreste argentino.

INTRODUCTION: An adequate quantity and quality of complementary feeding is essential during the first 2 years of life. The objective of this study was to assess dietary intakes and feeding practices in children aged 6-23 months in a town in the Northeast region of Argentina. POPULATION AND METHODS: Descriptive, crosssectional study (second semester of 2019). Intakes from 24-hour dietary recall interviews conducted among caregivers of children aged 6-23 months were assessed. Data were compared to dietary reference intakes. Feeding practices were assessed as per the World Health Organization's indicators. RESULTS: A total of 138 children aged 6-23 months were assessed. The mean adequacy ratio of energy and vitamins A, D, and E was below 100% for all ages, whereas the protein adequacy for children aged 7-12 and 13-23 months was 142.8% and 168.1%, respectively. A remarkable number of cases had energy and vitamin A intakes below the estimated average requirement. In relation to feeding practice indicators, 50.8% of infants received a minimum acceptable diet. CONCLUSIONS: There is a high prevalence of an inadequate level of energy and critical nutrient intake during complementary feeding of the children aged 6-23 months included in the study. Nutritional interventions that promote feeding practices to improve micronutrient intake would be highly important for children's current and future health.

Introducción. Una alimentación complementaria adecuada en cantidad y calidad resulta esencial durante los primeros dos años de vida. El objetivo del estudio fue evaluar la ingesta de nutrientes y prácticas alimentarias en niños de 6 a 23 meses de una localidad del noreste argentino. Población y métodos. Estudio descriptivo transversal (segundo semestre del 2019). Se evaluaron las ingestas de 24 horas mediante recordatorios a los cuidadores de niños de 6 a 23 meses. Los datos se compararon con las ingestas dietéticas de referencia. Las prácticas alimentarias se evaluaron según los indicadores establecidos por la Organización Mundial de la Salud. Resultados. Se evaluaron 138 niños de 6 a 23 meses de edad. La energía y las vitaminas A, D y E presentaron porcentajes medios de adecuación inferiores al 100 % en todas las edades, mientras que las proteínas alcanzaron una adecuación promedio del 142,8 % y el 168,1 % para los niños de 7-12 meses y de 13-23 meses, respectivamente. Los nutrientes que presentaron una proporción considerable de casos con ingestas por debajo del requerimiento promedio estimado en todos los grupos fueron la energía y la vitamina A. En cuanto a los indicadores de prácticas alimentarias, 50,8 % de los lactantes recibió una dieta mínima aceptable. Conclusiones. Existe una alta prevalencia de inadecuación energética y de nutrientes críticos durante la alimentación complementaria en los niños de 6 a 23 meses incluidos en el estudio. Intervenciones nutricionales que promuevan prácticas alimentarias que mejoren la ingesta de micronutrientes serían de suma importancia para su salud actual y futura.

Improving Underweight Mothers' Essential Newborn Care During Early Infancy: A Single-Blinded, Parallel-Randomized, Controlled Trial.

OBJECTIVE: To evaluate the effectiveness of using a standardized Essential Newborn Care (ENC) module taught by pediatric residents on ENC skills and growth of offspring born to underweight primigravida mothers. STUDY DESIGN: This facility-based, single-blinded, parallel, randomized controlled trial was conducted between May 2018 and March 2019. Eighty-eight underweight primigravida mothers and their vaginally delivered offspring were blindly allocated into the intervention group (IG) or control group (CG). The IG mothers received education on ENC through pictorial aids, demonstrations, and practice sessions. All mothers received information from ongoing public health programs. A trained hospital nurse, blinded to the study, assessed the mothers' neonatal care skills on the second postnatal day. The infants were followed until 6 months. Weight, length, and head circumference were measured at birth and age 6 weeks, 10 weeks, 14 weeks, and 6 months (±1 week). RESULTS: Mothers in the IG had significantly better ENC skills in all domains (P < .001). Their infants had a statistically significant increase in weight (at 10 and 14 weeks and 6 months), length (at 14 weeks and 6 months), and head circumference (at 6 months). Infants' z-scores indicated significant improvements in anthropometry in the IG compared with the CG. At age 6 months, the number of infants with weight <3rd percentile decreased in the IG (from 20 of 44 to 5 of 41) and increased in the CG (from 17 of 44 to 22 of 42) compared with birth percentiles. CONCLUSIONS: An educational intervention to strengthen maternal ENC knowledge and skills soon after delivery improved physical growth in infants born to underweight primigravida mothers. TRIAL REGISTRATION: Clinical Trials Registry-India: CTRI/2018/04/013096.

Breastfed and Formula-Fed Infants: Need of a Different Complementary Feeding Model?

Suboptimal nutrient quality/quantity during complementary feeding (CF) can impact negatively on infants' healthy growth, even with adequate energy intake. CF must supplement at best human milk (HM) or formulas, which show nutritional differences. Considering this, a differentiated CF is probably advisable to correctly satisfy the different nutritional needs. To assess whether current needs at 6-24 months of age can still be met by one single CF scheme or different schemes are needed for breastfed vs. formula/cow's milk (CM) fed infants, protein, iron and calcium intakes were assessed from daily menus using the same type and amount of solid food, leaving same amounts of HM and follow-up formula at 9 and again 18 months of age, when unmodified CM was added. Depending on the child's age, calcium- and iron-fortified cereals or common retail foods were used. The single feeding scheme keeps protein intake low but higher than recommended, in HM-fed children while in formula/CM-fed ones, it achieves much higher protein intakes. Iron Population Recommended Intake (PRI) and calcium Adequate Intakes (AI) are met at the two ages only when a formula is used; otherwise, calcium-fortified cereals are needed. ESPGHAN statements on the futility of proposing different CF schemes according to the milk type fed do not allow to fully meet the nutritional recommendations issued by major Agencies/Organizations/Societies for all children of these age groups.

Influence of Microclimate Factors on Halyomorpha halys Dehydration.

Understanding the interaction between insects and microclimate can be essential in order to plan informed and efficient treatments against agricultural pests. Microclimatic factors such as humidity and temperature can influence the population dynamics of the invasive agricultural pest Halyomorpha halys, the brown marmorated stink bug. The aim of this work was to evaluate the level of transpiration of H. halys in dry, normal and humid microclimates according to the sex, physiological conditions and developmental stage of individuals. Water loss during diapause and the effect of population density on insects' transpiration were also assessed, as were the nutritional preferences of adults upon exiting diapause. Our data demonstrate that microclimatic conditions significantly influence the transpiration of this pest species. The effect of sex and feeding status on insects' water loss is marked, while population density does not influence water loss in diapausing individuals. The first nutritional need of the overwintering generations is represented by hydration, likely due to the water loss during diapause.

Malnutrition in Pediatric Chronic Cholestatic Disease: An Up-to-Date Overview.

Despite recent advances, the causes of and effective therapies for pediatric chronic cholestatic diseases remain elusive, and many patients progress to liver failure and need liver transplantation. Malnutrition is a common complication in these patients and is a well-recognized, tremendous challenge for the clinician. We undertook a narrative review of both recent and relevant older literature, published during the last 20 years, for studies linking nutrition to pediatric chronic cholestasis. The collected data confirm that malnutrition and failure to thrive are associated with increased risks of morbidity and mortality, and they also affect the outcomes of liver transplantation, including long-term survival. Malnutrition in children with chronic liver disease is multifactorial and with multiple potential nutritional deficiencies. To improve life expectancy and the quality of life, patients require careful assessments and appropriate management of their nutritional statuses by multidisciplinary teams, which can identify and/or prevent specific deficiencies and initiate appropriate interventions. Solutions available for the clinical management of these children in general, as well as those directed to specific etiologies, are summarized. We particularly focus on fat-soluble vitamin deficiency and malnutrition due to fat malabsorption. Supplemental feeding, including medium-chain triglycerides, essential fatty acids, branched-chain amino acids, and the extra calories needed to overcome the consequences of anorexia and high energy requirements, is reviewed. Future studies should address the need for further improving commercially available and nutritionally complete infant milk formulae for the dietary management of this fragile category of patients. The aid of a specialist dietitian, educational training regarding nutritional guidelines for stakeholders, and improving family nutritional health literacy appear essential.

Evaluation of Nutrition Risk in Patients Over 65 Years of Age With Nontraumatic Acute Abdominal Syndrome.

BACKGROUND: The objective of this study is to investigate the power of CRP/Albumin ratio, NRS-2002, mNUTRIC scores to predict nutritional needs and mortality in patients over 65 years of age diagnosed with acute abdominal syndrome in the emergency department and then transferred to the surgical intensive care unit. MATERIAL AND METHOD: CRP/Albumin ratio, APACHE II, SOFA, NRS-2002 and mNUTRIC scores were calculated. The analysis of the data was conducted in IBM SPSS Statistics Base 22.0 package program. RESULTS: In the analytical evaluation made for nutritional needs, AUC value for mNUTRIC was found to be: 0,683, 95% CI 0,611-0,755, p < 0.001. It was found out that mortality of patients had a statistically significant and moderate correlation with mNUTRIC score (r = 0.537; p < 0.001). In the analytical evaluation made for mortality, mNUTRIC's AUC value (AUC: 0.808, 95% CI 0.736-0.880, p < 0.001) was found to be the highest. When the cut-off value determined to predict mortality was taken as 3.5 for mNUTRIC score, sensitivity was 75.9% and specificity was 69.4%. CONCLUSION: The evaluation of the risk of malnutrition through nutritional risk tools in intensive care patients over 65 years of age with acute abdominal syndrome can also predict nutritional needs in the early period besides mortality. Based on our data, the fact that mNUTRIC score cut-off value in older patients hospitalized in intensive care is 3.5 and higher may be a predictor for ICU mortality.

Children and adults should avoid consuming animal products to reduce risk for chronic disease: NO.

Excessive attention to the animal versus plant binary food choice reflects society's moral views on eating right. To claim that avoidance of animal products is required to prevent chronic disease is not supported by evidence, makes little sense from an evolutionary perspective, and distracts policy makers from common-sense approaches to achieve adequate nutrition. Animal products provide highly bioavailable nutrients, some of which are not easily obtained from plants, and can play a key role in meeting the nutritional challenges of populations in both high- and low-income countries. This role goes beyond the need for protein and relates to vitamins, minerals, and numerous often-overlooked nutrients, such as long-chain fatty acids, taurine, and choline. Restrictive dietary prescriptions that exclude animal products complicate the quest for optimal nutrition by undermining dietary diversity and flexibility, and by introducing a dependency on fortification and supplementation. Thus, a vegan diet may put the general population at increased risk of poor nutrition, a problem of particular concern for those with special nutritional requirements.

Dietary Variation among Children Meeting and Not Meeting Minimum Dietary Diversity: An Empirical Investigation of Food Group Consumption Patterns among 73,036 Children in India.

BACKGROUND: Minimum Dietary Diversity (MDD) is a widely used indicator of adequate dietary micronutrient density for children 6-23 mo old. MDD food-group data remain underutilized, despite their potential for further informing nutrition programs and policies. OBJECTIVES: We aimed to describe the diets of children meeting MDD and not meeting MDD in India using food group data, nationally and subnationally. METHODS: Food group data for children 6-23 mo old (n = 73,036) from the 2015-16 National Family Health Survey in India were analyzed. Per WHO standards, children consuming ≥5 of the following food groups in the past day or night met MDD: breast milk; grains, roots, or tubers; legumes or nuts; dairy; flesh foods; eggs; vitamin A-rich fruits and vegetables; and other fruits and vegetables. Children not meeting MDD consumed <5 food groups. We analyzed the number and types of foods consumed by children meeting MDD and not meeting MDD at the national and subnational geographic levels. RESULTS: Nationally, children not meeting MDD most often consumed breast milk (84.5%), grains, roots, and tubers (62.0%), and/or dairy (42.9%). Children meeting MDD most often consumed grains, roots, and tubers (97.6%), vitamin A-rich fruits and vegetables (93.8%), breast milk (84.1%), dairy (82.1%), other fruits and vegetables (79.5%), and/or eggs (56.5%). For children not meeting MDD, district-level dairy consumption varied the most (6.4%-79.9%), whereas flesh foods consumption varied the least (0.0%-43.8%). For children meeting MDD, district-level egg consumption varied the most (0.0%-100.0%), whereas grains, roots, and tubers consumption varied the least (66.8%-100.0%). CONCLUSIONS: Children not meeting MDD had low fruit, vegetable, and protein-rich food consumption. Many children meeting MDD also had low protein-rich food consumption. Examining the number and types of foods consumed highlights priorities for children experiencing the greatest dietary deprivation, providing valuable complementary information to MDD.

Nutrition for Female Soccer Players-Recommendations.

Soccer is one of the most popular sports in the world. As its number of players is increasing, the number of female players is also on the rise. However, there are limited data about how the diets of female soccer players should be designed. Thus, the aim of our work is to deliver concise nutritional recommendations for women practicing this sport. Based on a literature review, we emphasize that individual adjustment of the energy value of the diet is the key factor for the physical performance of female soccer players. Appropriate macronutrient intake makes it possible to achieve the proper energy value of the diet (5-10 g/kg body mass/day carbohydrates; 1.2-1.7 g/kg body mass/day proteins; <30% fats from energy). The micronutrients should be consumed in amounts corresponding to individual values recommended in national standards. Soccer players should pay special attention to the proper consumption of such micronutrients, as well as vitamins such as iron, calcium, and vitamin D. The right amount of fluid intake, consistent with the player's needs, is crucial in maximizing exercise performance. The diet of a female practicing soccer is usually characterized with low energy values, which increases the risk of various health consequences related to low energy availability. Monitoring the diets of female soccer players is, therefore, necessary.

Terapia nutricional enteral pediátrica para vítimas de queimaduras: quando iniciar? / Pediatric enteral nutrition therapy for burn victims: when should it be initiated?

RESUMO Objetivo: Revisar as evidências científicas que reportem o período de início da nutrição enteral na população pediátrica vítima de queimadura e seus achados. Métodos: Revisão sistemática e metanálise de estudos clínicos randomizados comparando nutrição enteral precoce e nutrição enteral tardia em indivíduos de 1 mês de idade a 18 anos com queimaduras. As bases de dados MEDLINE/PubMed, Embase e Cochrane Library foram acessadas utilizando os termos "burns", "fires", "child nutrition disorders", "nutritional support" e termos relacionados. Resultados: Três artigos foram identificados, sendo incluídos 781 pacientes. Não houve diferença significativa na taxa de mortalidade entre os grupos precoce e tardio (RC = 0,72; IC95% 0,46 - 1,15; p = 0,17). Pacientes que receberam nutrição enteral precoce tiveram o tempo de internação reduzido em 3,69 dias (diferença média = -3,69; IC95% -4,11 - -3,27; p < 0,00001). Houve maior incidência de diarreia e vômito, além de diminuição da permeabilidade intestinal no grupo precoce. Esse grupo também apresentou concentração maior de insulina sérica e relação insulina/glucagon, além de menor déficit calórico e perda ponderal em comparação com o grupo controle. Conclusão: As análises das diferentes variáveis intragrupos sugerem a importância de iniciar o suporte nutricional de forma precoce. A necessidade de estudos robustos com maior impacto científico é importante, considerando o número de casos de queimaduras em pacientes pediátricos.

ABSTRACT Objective: To review the scientific evidence regarding the initiation of enteral nutrition in the pediatric burn population. Methods: This study was a systematic review and meta-analysis of randomized clinical trials comparing early enteral nutrition and late enteral nutrition in individuals aged 1 month to 18 years with burns. The MEDLINE/PubMed, Embase and Cochrane Library databases were searched using the terms "burns", "fires", "child nutrition disorders", "nutritional support" and related terms. Results: Three articles that included a total of 781 patients were identified. There was no significant difference in the mortality rate between the early and late groups (OR = 0.72, 95%CI = 0.46 - 1.15, p = 0.17). Patients who received early enteral nutrition had a 3.69-day reduction in the length of hospital stay (mean difference = -3.69, 95%CI = -4.11 - -3.27, p < 0.00001). There was a higher incidence of diarrhea and vomiting and decreased intestinal permeability in the early group. This group also presented higher a serum insulin concentration and insulin/glucagon ratio as well as lower caloric deficit and weight loss when compared to the control group. Conclusion: Analysis of the different intragroup variables suggests the importance of starting nutritional support early. Considering the number of pediatric burn patients, there is a need for robust studies with greater scientific impact.

Nutritional service needs of pregnant and lactating adolescent girls in Trans-Mara East Sub-County, Narok County: focus on access and utilization of nutritional advice and services.

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.