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1.
Nutr Clin Pract ; 36(5): 984-992, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34468046

RESUMO

BACKGROUND: Recent studies indicate critically ill patients with coronavirus disease 2019 (COVID-19) are hypermetabolic; however, protein requirements in critically ill COVID-19 patients are unknown. Our intent was to evaluate the nitrogen accretion response to varying protein intakes for critically ill ventilator-dependent patients with COVID-19. METHODS: Adult patients (age ≥ 18 years) with COVID-19, admitted to the intensive care unit (ICU) and who required mechanical ventilation were retrospectively evaluated. Patients received continuous enteral nutrition (EN), including supplemental protein boluses, and had a 24-h urine collection for determination of nitrogen balance (NBAL). Data are expressed as mean ± SD with a P-value < .05 as significant. RESULTS: Twenty-two patients provided 29 NBAL determinations. Protein intake from EN and protein supplements was 0.9 ± 0.7 g/kg/day at the time of the NBAL with an NBAL of -12.1 ± 10.9 g/day at 7 ± 4 days in the ICU. Combined caloric intake from EN and propofol at the time of the NBAL was 12 ± 8 kcal/kg/day. Nitrogen equilibrium (NBAL of -4 g/day or better) occurred in five patients. Patients achieving nitrogen equilibrium received more protein than those with a negative NBAL (1.2 ± 0.4 g/kg/day vs 0.8 ± 0.8 g/kg/day, P = .046). The linear regression for NBAL in response to graded increases in protein intake was as follows: NBAL = 8.5 × protein intake (g/kg/day) - 18.8 (r = 0.450, P < .001). CONCLUSION: Critically ill ventilator-dependent patients with COVID-19 exhibit significant variability in nitrogen accretion response to increases in protein intake and often have a markedly negative NBAL.


Assuntos
COVID-19 , Estado Terminal , Adolescente , Adulto , Estado Terminal/terapia , Ingestão de Energia , Humanos , Unidades de Terapia Intensiva , Necessidades Nutricionais , Estudos Retrospectivos , SARS-CoV-2 , Ventiladores Mecânicos
2.
J Int Soc Sports Nutr ; 18(1): 64, 2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-34579746

RESUMO

The primary nutritional challenge facing endurance runners is meeting the nutrient requirements necessary to optimize the performance and recovery of prolonged training sessions. Supplement intake is a commonly used strategy by elite and recreational distance runners to meet nutritional recommendations. This study was conducted to investigate the patterns of supplement intake among different groups of distance runners and the potential association between supplement intake and sex, age, running and racing experiences.In a cross-sectional design, from a total of 317 runners participating in this survey, 119 distance runners were involved in the final sample after data clearance, assigned into three groups of 10-km runners (n = 24), half-marathoners (n = 44), and (ultra-)marathoners (n = 51). Personal characteristics, training and racing experiences, as well as patterns of supplement intake, including type, frequency, and dosage, were evaluated by questionnaire. Food Frequency Questionnaire was implemented to assess macronutrient intake. ANOVA and logistic regression were used for statistical analysis.While 50 % of total distance runners reported consuming supplements regularly, no differences between distance groups in consumption of carbohydrate/protein, mineral, or vitamin supplements were observed (p > 0.05). In addition, age, sex, running and racing experience showed no significant association with supplement intake (p > 0.05). Vitamin supplements had the highest intake rate in runners by 43 % compared to minerals (34 %) and carbohydrate/protein supplements (19 %).The present findings provide a window into the targeted approaches of long-distance runners as well as their coaches and sport nutrition specialists when applying and suggesting sustainable nutritional strategies for training and competition.Trial registration: ISRCTN73074080. Retrospectively registered 12th June 2015.


Assuntos
Suplementos Nutricionais , Corrida de Maratona/fisiologia , Fenômenos Fisiológicos da Nutrição Esportiva , Adulto , Atletas , Estudos Transversais , Dieta , Ingestão de Alimentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Necessidades Nutricionais , Resistência Física , Inquéritos e Questionários , Vitaminas/administração & dosagem
3.
Nutrients ; 13(7)2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34371832

RESUMO

Limited research has examined athletes' food and health beliefs and decisions and the congruence of these decisions with recommendations from nutrition professionals. This study aimed to improve understanding of athletes' food-related beliefs and practices to enable nutrition professionals to more effectively enhance performance while protecting athletes' health. Division I college athletes (n = 14, 64% female) from a variety of sports were recruited to participate in 20-min semi-structured phone interviews about food and nutrition-related behaviors and cognitions. Data were content analyzed to identify themes and trends. Prominent factors influencing athletes' food choices were potential benefits to health and performance, availability of foods, and recommendations from sports dietitians. Foods commonly consumed by athletes, including fruits, vegetables, and lean protein, were generally healthy and aligned with sports nutrition recommendations. Athletes avoided energy-dense nutrient-poor foods, such as fast food and fried foods, with the goal of improving performance. Some athletes took supplements (i.e., multivitamin, iron, protein) on the premise that they would improve health and enhance performance or recovery. While athletes' nutrition behaviors are generally congruent with current recommendations, findings highlighted misconceptions held by athletes related to the benefits of some supplements and the belief that packaged/processed foods were inherently less healthy than other options. Nutrition misconceptions held by athletes and incongruities between athletes' nutrition knowledge and behaviors suggest that dietitians should aim to dispel misconceptions held by athletes and provide additional guidance and information to support athletes' current healthful behaviors to ensure these behaviors extend beyond their college athletic career.


Assuntos
Atletas/psicologia , Desempenho Atlético/psicologia , Dieta Saudável/psicologia , Preferências Alimentares/psicologia , Estudantes/psicologia , Adulto , Comportamento de Escolha , Dieta Saudável/estatística & dados numéricos , Suplementos Nutricionais , Feminino , Fidelidade a Diretrizes , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Necessidades Nutricionais , Pesquisa Qualitativa , Ciências da Nutrição e do Esporte/normas , Universidades , Adulto Jovem
4.
Nutrients ; 13(8)2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34444923

RESUMO

The aim of this study was to investigate the nutritional status, determinants of nutritional status, and adequacy of energy and nutrient intake of older family caregivers (FC). Nutritional status was measured using the Mini Nutritional Assessment (MNA), plasma albumin, plasma pre-albumin, and blood hemoglobin concentrations. Dietary intake was assessed with a three-day food record. Comorbidity (B -0.283, 95% CI: -0.492, -0.073), quality of life (B 0.045, 95% CI: 0.018, 0.072) and energy intake (B 0.001, 95% CI: 0.000, 0.002) were significantly associated with the MNA scores of the older FCs (n = 125). It was common for FCs to have lower than recommended intakes of energy and several nutrients, independent of the risk of malnutrition assessed by the MNA. Over half of the FCs had inadequate intake of protein, vitamin A, folate, and fiber, and 25-40% of the FCs had a low intake of vitamin D, vitamin E, thiamine, magnesium, iron, and selenium. It is important to follow both the nutritional status and dietary intake of older FCs regularly to find those with lower than recommended nutrient intake and to avoid poor nutritional status and its adverse effects hampering their ability to serve as FCs.


Assuntos
Cuidadores/estatística & dados numéricos , Ingestão de Alimentos/fisiologia , Desnutrição/epidemiologia , Estado Nutricional/fisiologia , Idoso , Idoso de 80 Anos ou mais , Registros de Dieta , Inquéritos sobre Dietas , Fenômenos Fisiológicos da Nutrição do Idoso , Ingestão de Energia , Feminino , Avaliação Geriátrica , Hemoglobinas/análise , Humanos , Masculino , Avaliação Nutricional , Necessidades Nutricionais , Pré-Albumina/análise , Qualidade de Vida , Albumina Sérica/análise
5.
Nutrients ; 13(8)2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34444915

RESUMO

The feeding of colostrum and mother's transitional milk improves immune protection and neurodevelopmental outcomes. It also helps with gut maturation and decreases the risks of infection. The supply of nutrients from human milk (HM) is not adequate for preterm infants, even though preterm mother's milk contains higher concentrations of protein, sodium, zinc, and calcium than mature HM. The human milk fortifiers, particularly those with protein, calcium, and phosphate, should be used to supplement HM to meet the necessities of preterm infants. The management of fluid and electrolytes is a challenging aspect of neonatal care of preterm infants. Trace minerals such as iron, zinc, copper, iodine, manganese, molybdenum, selenium, chromium, and fluoride are considered essential for preterm infants. Vitamins such as A, D, E, and K play an important role in the prevention of morbidities, such as bronchopulmonary dysplasia, retinopathy of prematurity, and intraventricular hemorrhage. Therefore, supplementation of HM with required nutrients is recommended for all preterm infants.


Assuntos
Nutrição Enteral/métodos , Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia , Doenças do Prematuro/prevenção & controle , Recém-Nascido Prematuro/crescimento & desenvolvimento , Recém-Nascido Prematuro/imunologia , Suplementos Nutricionais , Feminino , Alimentos Fortificados , Humanos , Lactente , Recém-Nascido , Masculino , Necessidades Nutricionais
6.
Nutrients ; 13(8)2021 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-34444948

RESUMO

The present study was conducted to estimate total energy expenditure (TEE) of fire-fighters using tri axial-accelerometers in conjunction with an activity log survey on a large number of subjects undergoing training mimicking a large-scale disaster. Subjects were 240 fire-fighters participating in a two-day fire-fighting training dedicated to large-scale natural disasters. Data was analyzed by job type of activity group and the job rank, and by comparing the average. The average TEE of the total survey training period is about 3619 (±499) kcal, which is the same value of expenditure for professional athletes during the soccer game season. From the activity group, the rescue and other teams consumed significantly more energy than the fire and Emergency Medical Team (EMS) teams. From the job rank, Fire Captain (conducting position) consumed significantly lower energy than the Fire Lieutenant and Fire Sergeant. Furthermore, it was found that a middle position rank consumed the most energy. This research supports a need to reconsider the current rescue food (and protocols) to supplement the energy expenditure of fire-fighters. In addition, since there was a significant difference between the job type and the job rank, it is necessary to examine the energy amount and shape suitable for each.


Assuntos
Acelerometria/métodos , Metabolismo Energético , Bombeiros/estatística & dados numéricos , Trabalho de Resgate , Trabalho/fisiologia , Acelerometria/instrumentação , Adulto , Desastres , Bombeiros/educação , Humanos , Masculino , Necessidades Nutricionais , Treinamento por Simulação , Inquéritos e Questionários
7.
Nutrients ; 13(7)2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34371864

RESUMO

This study determined the intakes of complementary foods (CFs) and milk-based formulas (MFs) by a total of 119 subjects aged 6-23.9 months from urban day care centers. Dietary intakes were assessed using two-day weighed food records. Intake adequacy of energy and nutrients was compared to the Recommended Nutrient Intakes (RNI) for Malaysia. The most commonly consumed CFs were cereals (rice, noodles, bread). The subjects derived approximately half of their energy requirements (kcals) from CFs (57 ± 35%) and MFs (56 ± 31%). Protein intake was in excess of their RNI requirements, from both CFs (145 ± 72%) and MFs (133 ± 88%). Main sources of protein included meat, dairy products, and western fast food. Intake of CFs provided less than the RNI requirements for vitamin A, thiamine, riboflavin, folate, vitamin C, calcium, iron, and zinc. Neither CF nor MF intake met the Adequate Intake (AI) requirements for essential fatty acids. These findings indicate imbalances in the dietary intake of the subjects that may have adverse health implications, including increased risk of rapid weight gain from excess protein intake, and linear growth faltering and intellectual impairment from multiple micronutrient deficiencies. Interventions are needed to improve child feeding knowledge and practices among parents and child care providers.


Assuntos
Proteínas na Dieta/análise , Ácidos Graxos Essenciais/análise , Alimentos Infantis/estatística & dados numéricos , Micronutrientes/análise , População Urbana/estatística & dados numéricos , Animais , Creches , Registros de Dieta , Inquéritos sobre Dietas , Ingestão de Alimentos , Ácidos Graxos Essenciais/deficiência , Feminino , Humanos , Lactente , Alimentos Infantis/análise , Fórmulas Infantis/análise , Fórmulas Infantis/estatística & dados numéricos , Transtornos da Nutrição do Lactente/epidemiologia , Transtornos da Nutrição do Lactente/etiologia , Fenômenos Fisiológicos da Nutrição do Lactente , Malásia/epidemiologia , Masculino , Micronutrientes/deficiência , Leite , Necessidades Nutricionais
8.
Biochim Biophys Acta Mol Basis Dis ; 1867(11): 166231, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34343638

RESUMO

Other than being a physiological process, pregnancy is a condition characterized by major adaptations of maternal endocrine and metabolic homeostasis that are necessary to accommodate the fetoplacental unit. Unfortunately, all these systemic, cellular, and molecular changes in maternal physiology also make the mother and the fetus more prone to adverse outcomes, including numerous alterations arising from viral infections. Common infections during pregnancy that have long been recognized as congenitally and perinatally transmissible to newborns include toxoplasmosis, rubella, cytomegalovirus, and herpes simplex viruses (originally coined as ToRCH infections). In addition, enterovirus, parvovirus B19, hepatitis virus, varicella-zoster virus, human immunodeficiency virus, Zika and Dengue virus, and, more recently, coronavirus infections including Middle Eastern respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS) infections (especially the novel SARS-CoV-2 responsible for the ongoing COVID-19 pandemic), constitute relevant targets for current research on maternal-fetal interactions in viral infections during pregnancy. Appropriate maternal education from preconception to the early postnatal period is crucial to promote healthy pregnancies in general and to prevent and/or reduce the impact of viral infections in particular. Specifically, an adequate lifestyle based on proper nutrition plans and feeding interventions, whenever possible, might be crucial to reduce the risk of virus-related gestational diseases and accompanying complications in later life. Here we aim to provide an overview of the emerging literature addressing the impact of nutrition in the context of potentially harmful viral infections during pregnancy.


Assuntos
Fenômenos Fisiológicos da Nutrição Materna , Complicações Infecciosas na Gravidez/fisiopatologia , Viroses/fisiopatologia , Feminino , Humanos , Necessidades Nutricionais , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Viroses/epidemiologia
9.
Nutrients ; 13(8)2021 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-34444742

RESUMO

Type 2 diabetes is associated with an increased risk for sarcopenia. Moreover, sarcopenia correlates with increased risk for falls, fractures, and mortality. This study aimed to explore relationships among nutrient intakes, diet quality, and functional limitations in a sample of adults across levels of glycemic control. Data were examined from 23,487 non-institutionalized adults, 31 years and older, from the 2005-2016 National Health and Nutrition Examination Survey. Hemoglobin A1c (%) was used to classify level of glycemic control: non-diabetes (<5.7%); pre-diabetes (5.7-6.4%); diabetes (≥6.5%). Dietary data were collected from a single 24-h dietary recall. Participants were categorized as meeting or below the protein recommendation of 0.8 g/kg of body weight. Physical functioning was assessed across 19-discrete physical tasks. Adults below the protein recommendation consumed significantly more carbohydrate and had lower diet quality across all glycemic groups compared to those who met the protein recommendation (p < 0.001). Adults with diabetes who did not meet protein recommendations had significantly poorer diet quality and significantly higher mean number of functional limitations. A greater percent of adults with diabetes who did not meet the protein recommendation reported being physically limited for most activities, with more than half (52%) reporting limitations for stooping, crouching, and kneeling. This study underscores the potential for physical limitations associated with low protein intakes, especially in adults with diabetes. In the longer term, low protein intakes may result in increased risk of muscle loss, as protein intake is a critical nutritional factor for prevention of sarcopenia, functional limitations, and falls.


Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Dieta , Proteínas na Dieta , Valor Nutritivo , Desempenho Físico Funcional , Atividades Cotidianas , Diabetes Mellitus Tipo 2/complicações , Ingestão de Alimentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Necessidades Nutricionais , Sarcopenia/etiologia
10.
Nutrients ; 13(8)2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34444944

RESUMO

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.


Assuntos
Colestase/epidemiologia , Hepatopatias/epidemiologia , Desnutrição/epidemiologia , Estado Nutricional , Adolescente , Criança , Pré-Escolar , Colestase/complicações , Doença Crônica , Dieta/métodos , Ingestão de Energia , Feminino , Humanos , Lactente , Fórmulas Infantis , Hepatopatias/complicações , Falência Hepática/epidemiologia , Falência Hepática/etiologia , Transplante de Fígado , Masculino , Desnutrição/etiologia , Necessidades Nutricionais , Qualidade de Vida , Vitaminas/administração & dosagem
11.
Nutrients ; 13(6)2021 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-34205445

RESUMO

In the last decade, the role of nutritional management in pediatric gastrointestinal diseases has gained increasing popularity. Disease-specific diets have been introduced as conventional treatments by international guidelines. Patients tend to more willingly accept food-based therapies than drugs because of their relatively "harmless" nature. Apart from a diet's therapeutic role, nutritional support is crucial in maintaining growth and improving clinical outcomes in pediatric patients. Despite the absence of classical "side effects", however, it should be emphasized that any dietary modification might have negative consequences on children's growth and development. Hence, expert supervision is always advised, in order to support adequate nutritional requirements. Unfortunately, the media provide an inaccurate perception of the role of diet for gastrointestinal diseases, leading to misconceptions by patients or their caregivers that tends to overestimate the beneficial role of diets and underestimate the potential adverse effects. Moreover, not only patients, but also healthcare professionals, have a number of misconceptions about the nutritional benefits of diet modification on gastrointestinal diseases. The aim of this review is to highlight the role of diet in pediatric gastrointestinal diseases, to detect misconceptions and to give a practical guide for physicians on the basis of current scientific evidence.


Assuntos
Gastroenteropatias/dietoterapia , Terapia Nutricional , Dor Abdominal , Animais , Bovinos , Criança , Pré-Escolar , Dieta , Enterite/dietoterapia , Enterite/fisiopatologia , Eosinofilia/dietoterapia , Eosinofilia/fisiopatologia , Hipersensibilidade Alimentar , Gastrite/dietoterapia , Gastrite/fisiopatologia , Gastroenteropatias/fisiopatologia , Microbioma Gastrointestinal/fisiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Recém-Nascido , Doenças Inflamatórias Intestinais/dietoterapia , Doenças Inflamatórias Intestinais/fisiopatologia , Leite/efeitos adversos , Leite/imunologia , Necessidades Nutricionais , Guias de Prática Clínica como Assunto , Probióticos
12.
Nutrients ; 13(7)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34209814

RESUMO

Sport nutrition knowledge has been shown to influence dietary habits of athletes. The purpose of the current study was to examine relationships between sport nutrition knowledge and body composition and examine potential predictors of body weight goals in collegiate athletes. Participants included National Collegiate Athletic Association Division III women (n = 42, height: 169.9 ± 6.9 cm; body mass: 67.1 ± 8.6 kg; fat-free mass: 51.3 ± 6.6 kg; body fat per cent: 24.2 ± 5.3%) and men (n = 25, height: 180.8 ± 7.2 cm; body mass: 89.2 ± 20.5 kg; fat-free mass: 75.9 ± 12.2 kg; body fat per cent: 13.5 ± 8.9%) athletes. Body composition was assessed via air displacement plethysmography. Athletes completed a validated questionnaire designed to assess sport nutrition knowledge and were asked questions about their perceived dietary energy and macronutrient requirements, as well as their body weight goal (i.e., lose, maintain, gain weight). Athletes answered 47.98 ± 11.29% of questions correctly on the nutrition questionnaire with no differences observed between sexes (men: 49.52 ± 11.76% vs. women: 47.03 ± 11.04%; p = 0.40). An inverse relationship between sport nutrition knowledge scores and body fat percentage (BF%) (r = -0.330; p = 0.008), and fat mass (r = -0.268; p = 0.032) was observed for all athletes. Fat mass (ß = 0.224), BF% (ß = 0.217), and body mass index (BMI) (ß = 0.421) were all significant (p < 0.05) predictors of body weight goal in women. All athletes significantly (p < 0.001) underestimated daily energy (-1360 ± 610.2 kcal/day), carbohydrate (-301.6 ± 149.2 grams/day [g/day]), and fat (-41.4 ± 34.5 g/day) requirements. Division III collegiate athletes have a low level of sport nutrition knowledge, which was associated with a higher BF%. Women athletes with a higher body weight, BF% and BMI were more likely to select weight loss as a body weight goal. Athletes also significantly underestimated their energy and carbohydrate requirements based upon the demands of their sport, independent of sex.


Assuntos
Atletas/psicologia , Composição Corporal , Comportamento Alimentar/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Fenômenos Fisiológicos da Nutrição Esportiva , Índice de Massa Corporal , Peso Corporal , Feminino , Humanos , Masculino , Necessidades Nutricionais , Percepção , Pletismografia , Universidades , Adulto Jovem
13.
Clin Nutr ESPEN ; 44: 211-217, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34330468

RESUMO

BACKGROUND & AIMS: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can rapidly progress into acute respiratory distress syndrome accompanied by multi-organ failure requiring invasive mechanical ventilation and critical care treatment. Nutritional therapy is a fundamental pillar in the management of hospitalized patients. It is broadly acknowledged that overfeeding and underfeeding of intensive care unit (ICU) patients are associated with increased morbidity and mortality. This study aimed to assess the energy demands of long-term ventilated COVID-19 patients using indirect calorimetry and to evaluate the applicability of established predictive equations to estimate their energy expenditure. METHODS: We performed a retrospective, single-center study in 26 mechanically ventilated COVID-19 patients with resolved SARS-CoV-2 infection in three independent intensive care units. Resting energy expenditure (REE) was evaluated by repetitive indirect calorimetry (IC) measurements. Simultaneously the performance of 12 predictive equations was examined. Patient's clinical data were retrieved from electronic medical charts. Bland-Altman plots were used to assess agreement between measured and calculated REE. RESULTS: Mean mREE was 1687 kcal/day and 20.0 kcal relative to actual body weight (ABW) per day (kcal/kg/day). Longitudinal mean mREE did not change significantly over time, although mREE values had a high dispersion (SD of mREE ±487). Obese individuals were found to have significantly increased mREE, but lower energy expenditure relative to their body mass. Calculated REE showed poor agreement with mREE ranging from 33 to 54%. CONCLUSION: Resolution of SARS-CoV-2 infection confirmed by negative PCR leads to stabilization of energy demands at an average 20 kcal/kg in ventilated critically ill patients. Due to high variations in mREE and low agreement with calculated energy expenditure IC remains the gold standard for the guidance of nutritional therapy.


Assuntos
COVID-19/fisiopatologia , Cuidados Críticos/métodos , Metabolismo Energético/fisiologia , Necessidades Nutricionais/fisiologia , Respiração Artificial/métodos , Calorimetria Indireta , Estado Terminal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , SARS-CoV-2 , Tempo
14.
Clin Nutr ESPEN ; 44: 69-77, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34330515

RESUMO

INTRODUCTION: The Coronavirus Disease 2019 (COVID-19) pandemic has overwhelmed hospital systems globally, resulting in less experienced staff caring for critically ill patients within the intensive care unit (ICU). Many guidelines have been developed to guide nutrition care. AIM: To identify key guidelines or practice recommendations for nutrition support practices in critically ill adults admitted with COVID-19, to describe similarities and differences between recommendations, and to discuss implications for clinical practice. METHODS: A literature review was conducted to identify guidelines affiliated with or endorsed by international nutrition societies or dietetic associations which included recommendations for the nutritional management of critically ill adult patients with COVID-19. Data were extracted on pre-defined key aspects of nutritional care including nutrition prescription, delivery, monitoring and workforce recommendations, and key similarities and discrepancies, as well as implications for clinical practice were summarized. RESULTS: Ten clinical practice guidelines were identified. Similar recommendations included: the use of high protein, volume restricted enteral formula delivered gastrically and commenced early in ICU and introduced gradually, while taking into consideration non-nutritional calories to avoid overfeeding. Specific advice for patients in the prone position was common, and non-intubated patients were highlighted as a population at high nutritional risk. Major discrepancies included the use of indirect calorimetry to guide energy targets and advice around using gastric residual volumes (GRVs) to monitor feeding tolerance. CONCLUSION: Overall, common recommendations around formula type and route of feeding exist, with major discrepancies being around the use of indirect calorimetry and GRVs, which reflect international ICU nutrition guidelines.


Assuntos
COVID-19/complicações , Cuidados Críticos/métodos , Desnutrição/complicações , Desnutrição/prevenção & controle , Política Nutricional , Necessidades Nutricionais , Consenso , Estado Terminal , Humanos , Estado Nutricional , SARS-CoV-2
15.
Nutrients ; 13(7)2021 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-34202761

RESUMO

The Paralympic movement is growing in popularity, resulting in increased numbers of athletes with a spinal cord injury (SCI) competing in various sport disciplines. Athletes with an SCI require specialized recommendations to promote health and to maximize performance, as evidenced by their metabolic and physiological adaptations. Nutrition is a key factor for optimal performance; however, scientifically supported nutritional recommendations are limited. This review summarizes the current knowledge regarding the importance of carbohydrates (CHO) for health and performance in athletes with an SCI. Factors possibly affecting CHO needs, such as muscle atrophy, reduced energy expenditure, and secondary complications are analyzed comprehensively. Furthermore, a model calculation for CHO requirements during an endurance event is provided. Along with assessing the effectiveness of CHO supplementation in the athletic population with SCI, the evaluation of their CHO intake from the available research supplies background to current practices. Finally, future directions are identified. In conclusion, the direct transfer of CHO guidelines from able-bodied (AB) athletes to athletes with an SCI does not seem to be reasonable. Based on the critical role of CHOs in exercise performance, establishing recommendations for athletes with an SCI should be the overall objective for prospective research.


Assuntos
Desempenho Atlético/fisiologia , Carboidratos da Dieta/metabolismo , Necessidades Nutricionais/fisiologia , Traumatismos da Medula Espinal/fisiopatologia , Esportes para Pessoas com Deficiência/fisiologia , Carboidratos da Dieta/administração & dosagem , Suplementos Nutricionais , Humanos
16.
Nutrients ; 13(5)2021 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-34063333

RESUMO

Nutritional status is a strong predictor of postoperative outcomes and is recognized as an important component of surgical recovery programs. Adequate nutritional consumption is essential for addressing the surgical stress response and mitigating the loss of muscle mass, strength, and functionality. Especially in older patients, inadequate protein can lead to significant muscle atrophy, leading to a loss of independence and increased mortality risk. Current nutritional recommendations for surgery primarily focus on screening and prevention of malnutrition, pre-surgical fasting protocols, and combating post-surgical insulin resistance, while recommendations regarding macronutrient composition and timing around surgery are less established. The goal of this review is to highlight oral nutrition strategies that can be implemented leading up to and following major surgery to minimize atrophy and the resultant loss of functionality. The role of carbohydrate and especially protein/essential amino acids in combating the surgical stress cascade and supporting recovery are discussed. Practical considerations for nutrient timing to maximize oral nutritional intake, especially during the immediate pre- and post- surgical periods, are also be discussed.


Assuntos
Desnutrição/prevenção & controle , Atrofia Muscular/prevenção & controle , Cuidados Pós-Operatórios , Cuidados Pré-Operatórios , Aminoácidos Essenciais/administração & dosagem , Carboidratos da Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Humanos , Força Muscular , Necessidades Nutricionais , Estado Nutricional , Procedimentos Ortopédicos
17.
J Dairy Sci ; 104(9): 9726-9734, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34127266

RESUMO

Maintenance energy is the energy required to conserve the state of an animal when no work is completed. Dietary energy must be supplied to meet maintenance requirements before milk can be produced. The objectives of the current experiment were to quantify the maintenance energy requirement of Jersey cows when lactating or dry. Energetic measures were collected on 8 Jersey cows and evaluated across 3 physiological phases and nutritional planes: lactation, dry cows fed at maintenance, and fasted dry cows. Through total collection of feces and urine as well as using headbox-style indirect calorimeters, energy balance and heat production data were measured across all phases. Lactation data were collected across four 28-d periods. Data for cows fed at maintenance were collected after 14 d and fasting heat production was measured during the last 24 h of a 96-h fast. Net energy for maintenance (NEM) requirements, and the efficiency of converting metabolizable energy (ME) into net energy were compared between lactating and dry (maintenance or fasting phase) cows. Heat production of dry cows fed at maintenance, which represents ME for maintenance, was 0.146 ± 0.0087 Mcal per unit of metabolic body weight (BW0.75, MBW). Fasting heat production, which represents NEM, was 0.102 ± 0.0071 Mcal/MBW. Energy balance was calculated as tissue energy plus milk energy. When estimated via regressing energy balance on ME intake, NEM was not different between dry and lactating cows (0.120 ± 0.32 vs. 0.103 ± 0.0052 Mcal/MBW). However, the slope of the regression of energy balance on ME intake was greater for dry compared with lactating cows (0.714 ± 0.046 vs. 0.685 ± 0.010) when evaluated with a fixed intercept. This suggests that dry cows were more efficient at converting ME into net energy and that the efficiency of utilizing ME for maintenance may be greater than for lactation. Our measurements of NEM and the slope of ME on energy balance were greater than the value used by the National Research Council (2001), which are 0.080 Mcal/MBW for NEM and approximately 0.64 for the slope. Results of this study suggest that NEM and the efficiency of converting ME into NEM of modern lactating Jersey cows are similar to recent measurements on modern Holstein cows and greater than previous measurements.


Assuntos
Lactação , Leite , Ração Animal , Animais , Bovinos , Dieta/veterinária , Metabolismo Energético , Feminino , Necessidades Nutricionais
18.
Nutrients ; 13(5)2021 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-34069944

RESUMO

There is a lack of data on associations between modern vegetarian and vegan diets and health among children and adolescents. The aim of the Vechi Youth Study was to cross-sectionally examine anthropometry, dietary intakes and nutritional status in a sample of 149 vegetarian, 115 vegan and 137 omnivore children and adolescents (6-18 years old, mean age: 12.7 ± 3.9 years). Group differences of dietary intake (calculated from three-day dietary records), nutrient biomarker and blood lipid concentrations were assessed using an analysis of covariance, adjusted for sex, age and other covariates. The total energy intake did not differ significantly between groups, but intake of carbohydrates was higher among vegetarians and vegans than among omnivores (p = 0.0002, respectively). The median protein intake exceeded 0.9 g/kg body weight/day in all diet groups and was lowest among vegetarians (p < 0.02). There was no significant difference of haemoglobin, vitamin B2, 25-OH vitamin D3, HDL-C and triglycerides blood concentrations between diet groups. Vegan participants had higher folate concentrations than vegetarian participants (p = 0.0053). Ferritin concentration was significantly higher in omnivores than in vegetarians (p = 0.0134) and vegans (p = 0.0404). Vegetarians had lower concentrations of holotranscobalamin (p = 0.0042) and higher concentrations of methylmalonic acid (p = 0.0253) than omnivores. Vegans had the lowest non-HDL-C and LDL-C concentrations in comparison to vegetarians (p = 0.0053 and p = 0.0041) and omnivores (p = 0.0010 and p = 0.0010). A high prevalence (>30%) of 25-OH vitamin D3 and vitamin B2 concentrations below reference values were found irrespective of the diet group. In conclusion, the Vechi Youth Study did not indicate specific nutritional risks among vegetarian and vegan children and adolescents compared to omnivores.


Assuntos
Dieta Vegana/estatística & dados numéricos , Dieta Vegetariana/estatística & dados numéricos , Dieta/estatística & dados numéricos , Nutrientes/análise , Estado Nutricional , Adolescente , Biomarcadores/sangue , Criança , Dieta/métodos , Registros de Dieta , Ingestão de Alimentos , Comportamento Alimentar , Feminino , Alemanha , Humanos , Lipídeos/sangue , Masculino , Necessidades Nutricionais
19.
Nutrients ; 13(6)2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34063783

RESUMO

The paucity of adequate data on dietary and nutrient intakes of school-age children is a barrier to addressing malnutrition and associated risks in Nigeria. This study included 955 children aged 4-13 years from Ibadan, Nigeria, using a stratified random sampling design. Information on family socio-demographic characteristics was reported, and child anthropometrics were measured. Dietary intake data were collected using a multi-pass 24 h dietary recall method; 20% of subjects completed a second 24 h recall to estimate usual nutrient intakes. Means and distributions of usual intakes of energy and nutrients as well as prevalence of inadequacy were estimated. Usual energy intake (kcal/day) was 1345 and 1590 for younger (4-8 years) and older (9-13 years) age groups, respectively. The macronutrient intakes of most children did not conform to Adequate Macronutrient Distribution Ranges (AMDRs), which were characterized by a higher proportion of energy from carbohydrates and lower proportion from total fats. Protein intake was largely within the AMDR. Compared to recommendations, over 60% of 4-8-year-old children had inadequate intakes of calcium, copper, iron, folate, and vitamins A, D, and E. There were more micronutrient inadequacies in the older children. This study identifies nutrition gaps and suggests future research and education to improve child nutrition in Nigeria.


Assuntos
Transtornos da Nutrição Infantil/epidemiologia , Dieta/estatística & dados numéricos , Ingestão de Alimentos , Adolescente , Antropometria , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Inquéritos sobre Dietas , Feminino , Humanos , Masculino , Nigéria/epidemiologia , Avaliação Nutricional , Necessidades Nutricionais , Estado Nutricional , Prevalência
20.
Nutrients ; 13(6)2021 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-34067287

RESUMO

The first month of lactation is a vulnerable nutritional period for the mother. Our aims were (1) to evaluate the nutritional status of breastfeeding women in the first month of lactation, and (2) to explore different aspects of nutrition and lifestyle through a multidimensional approach. A total of 30 healthy breastfeeding women were enrolled in this study. Dietary pattern was assessed through a 72-hour dietary recall questionnaire (days 7 and 28 postpartum) and data were compared with Dietary Recommendation Values (DRV), and through the Adherence to Healthy Food Pyramid (HFP) questionnaire (day 28). Anthropometric parameters were evaluated by bioimpedance. Using factor analysis, nutritional dimensions were extracted, and linear regression models were used to analyze the association between anthropometric parameters and dimensions. Compared to the DRV, women showed insufficient energy, water, vitamin D, and potassium intake and excessive proteins, vitamins B1, B2, B3, B6, B12, and iron intake. We observed a moderate adherence to the HFP, with women being high in the fruits, vegetables, and oil categories, and low adherence to the physical activity, dairy products, and hydration categories. The nutritional dimension, including the HFP categories of physical activity, hydration, and animal protein intake together, was negatively associated with body weight (ß = -3.7 ± 1.7; p-value = 0.047). In conclusion, during the first month postpartum, breastfeeding women exhibited several nutritional imbalances and poor physical activity negatively influencing anthropometric parameters. We propose a multidimensional approach to assess the nutritional status of breastfeeding women as a tool to detect specific deficiencies, allowing for personalized counseling.


Assuntos
Aleitamento Materno/métodos , Lactação , Estilo de Vida , Fenômenos Fisiológicos da Nutrição Materna , Estado Nutricional , Adulto , Dieta/métodos , Ingestão de Energia , Exercício Físico , Comportamento Alimentar , Feminino , Humanos , Análise de Escalonamento Multidimensional , Inquéritos Nutricionais , Necessidades Nutricionais , Período Pós-Parto , Espanha , Fatores de Tempo , Vitaminas/administração & dosagem , Adulto Jovem
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