Clinical nutrition ESPEN最新文献

{"title":"Behavioural, cognitive, and neurophysiological effects of a synbiotic supplementation enriched with pigmented corn extract or cornstarch in drug-naïve children with attention-deficit hyperactivity disorder: a randomised, double-blind, comparison-controlled clinical trial.","authors":"Sara Trezzi, Gaia Scaccabarozzi, Roberta Nossa, Caterina Piazza, Alessandro Rodolfo Bianchi, Eleonora Rosi, Federica Tizzoni, Maddalena Mauri, Laura Camillo, Andrea Baragetti, Massimo Molteni, Vania Campanella, Luca Mauro, Paola Cremonesi, Marco Severgnini, Mariela Mejia Monroy, Bianca Castiglioni, Francesca Sparvoli, Simone Pisano, Marco Pozzi, Alessandro Crippa, Maria Nobile","doi":"10.1016/j.clnesp.2024.12.016","DOIUrl":"https://doi.org/10.1016/j.clnesp.2024.12.016","url":null,"abstract":"<p><strong>Background & aims: </strong>Considerable interest has been recently given to the potential role of the gut-brain axis (GBA) -a two-way communication network between the gut microbiota and the central nervous system- in the pathogenesis of attention-deficit hyperactivity disorder (ADHD), suggesting the potential usefulness of probiotic and synbiotic supplementations. In light of the limited available evidence, synbiotic efficacy in ADHD children not taking medications should be clarified. This study aimed to investigate the efficacy of a synbiotic dietary supplementation on fatty acids levels as well as on microbiota composition, behaviour, cognition, and brain function in children with ADHD.</p><p><strong>Methods: </strong>A total of 41 drug-naïve school-aged children diagnosed with ADHD were enrolled in a 3-month randomised, double-blind, comparison-controlled clinical trial, receiving either a synbiotic mix (COMP group) or the same synbiotic mix enriched with an additional extract from pigmented corn (EXP group). Changes in levels of some specific short-chain and branched-chain fatty acids were considered as primary outcomes. Secondary outcome measures included gut microbiota profiling, Child Behaviour Checklist, Conners Parent Rating Scale-revised, computerised cognitive tasks, and haemodynamic response to a Go-NoGo task measured by fNIRS.</p><p><strong>Results: </strong>No superiority of the EXP synbiotic mix was observed. Analysis of fatty acids did not reveal any significant difference between groups. Children in the COMP group reported a slightly greater improvement than those in the EXP group in focused attention and in the haemodynamic response to a cognitive task.</p><p><strong>Conclusions: </strong>This study shows that pigmented corn extract does not enhance the effects of the synbiotic supplementation in ADHD children in terms of fatty acid production, microbiota composition, clinical, cognitive and neurophysiological measures. However, a synbiotic mix of probiotics plus prebiotic acacia fibre and cornstarch could have some promising effects on ADHD symptoms, which warrants further research. Future studies should also continue to explore the potential of fNIRS for monitoring the effects of interventions that target the GBA.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT06005506.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Worldwide trends in childhood overweight and obesity over the last 20 years.","authors":"Sara Lema Muyulema, Tannia Valeria Carpio-Arias, Nervo Verdezoto, Verónica Elizabeth Guanga Lara, Angelica Solís Manzano, Hector Pulgar, María Fernanda Vinueza Veloz","doi":"10.1016/j.clnesp.2024.12.013","DOIUrl":"https://doi.org/10.1016/j.clnesp.2024.12.013","url":null,"abstract":"<p><strong>Background: </strong>Child overweight and obesity is associated with an increased risk of non-communicable diseases. The present work aimed to explain the global trends of overweight in children under 5 years during the last two decades in comparison to the global nutrition targets.</p><p><strong>Methods: </strong>We analysed secondary data from the Global Nutrition Report 2020 report for the years 2000 to 2020 from 194 countries, distributed in 23 sub-regions to examine the changes in prevalence and trends of overweight and obesity in children under five years of age. We also analysed the number of countries with applied national policies on overweight and obesity and their progress against the global nutrition targets.</p><p><strong>Results: </strong>The analysis from 194 countries showed that children under five years constituted 8% of the world population. In the last 20 years, the global prevalence of childhood overweight and obesity has risen from 5.4% to 5.7% since 2000 to 2022. North and South Africa, West, and East Asia, North and South America, Eastern and Northern Europe, Polynesia, Micronesia, Australia, and New Zealand are the subregions with the highest prevalence of overweight and obesity. Furthermore, regions with the highest number of children affected include Asia with more than 18 million (48%) and Africa with more than 10 million (27%). More than half of the countries for which data were available had not reached the global nutrition target for childhood overweight by 2020.</p><p><strong>Conclusion: </strong>The prevalence of childhood overweight in most of the regions of the world has been steadily increasing during the last two decades. Our findings indicate that if public health measures are not implemented, 2025 World Health Organization´s global nutrition targets and 2020 Sustainable Development Goals will not be reached.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical nutrition in patients with Acute Kidney Injury: Traditional approaches and emerging perspectives.","authors":"Francesca Di Mario, Alice Sabatino, Enrico Fiaccadori","doi":"10.1016/j.clnesp.2024.12.015","DOIUrl":"10.1016/j.clnesp.2024.12.015","url":null,"abstract":"<p><p>Acute kidney injury (AKI) is a complex clinical syndrome characterized by a rapid decline in kidney function, often resulting in complex metabolic and hormonal derangements. A major concern in managing AKI patients is the development of protein energy wasting (PEW), a condition marked by loss of lean body mass and negative impact on overall health outcomes. Additionally, the need of Kidney Replacement Therapy (KRT) for the most severe forms of AKI may further increase the risk of PEW, with a substantial impact on fluid and metabolic balance. Adequate nutritional support is crucial in the management of AKI, as it plays a pivotal role in muscle mass preservation, morbidity reduction and recovery of renal function. This paper aims to evaluate the current evidence regarding nutritional strategies in AKI patients, focusing on energy and protein requirements, timing and route of nutritional intervention, and impact of individualized nutrition plans on PEW prevention and management.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"348-356"},"PeriodicalIF":2.9,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and tolerability of Monoacylglycerol-rich oil as a novel predigested dietary fat source of an enteral formula in healthy adults and adolescents: Two single-arm, open-label studies.","authors":"Boutaina Zemrani, Laura-Florina Krattinger, Francesca Giuffrida, John Corthésy, Rinat Rivka Ran-Ressler, Jalil Benyacoub","doi":"10.1016/j.clnesp.2024.12.014","DOIUrl":"10.1016/j.clnesp.2024.12.014","url":null,"abstract":"<p><strong>Background & aims: </strong>Enteral formulas containing predigested lipids to support the needs of patients with fat maldigestion are currently unavailable. Monoacylglycerol (MAG)-rich oils offer potential benefits for fat absorption without prior digestion, but their safety and tolerability in enteral formulas need evaluation. We assessed the safety and tolerability of a new formula containing predigested lipids in the form of MAG-rich oil.</p><p><strong>Methods: </strong>Two cohorts of healthy volunteers, consisting of 12 adults (aged ≥18 years) followed by 12 adolescents (aged 12-17 years) were recruited. Participants consumed an oral nutritional supplement containing MAG-rich oil as the main lipid source (up to 37 g/day) three times daily for 13 days. Safety, tolerability, gastrointestinal (GI) symptoms, anthropometric, and blood parameters were assessed.</p><p><strong>Results: </strong>All 24 participants completed the study without discontinuing the formula with good compliance. Median Visual Analog Scale scores for GI symptoms were low (on average 0.2 out of 10) in both groups, and the Gastrointestinal Symptom Rating Scale scores remained mostly unchanged (1-2 out of 7), indicating no or minimal discomfort. Stool frequency and consistency remained within normal limits throughout the study. Serum triglyceride and cholesterol levels showed no clinically significant changes, and the fatty acid profile and fat-soluble vitamins showed a favorable trend at the end of the study. Adverse events (AEs) were minor, and none were serious.</p><p><strong>Conclusions: </strong>The new formula containing MAG-rich oil was safe and well tolerated in healthy adults and adolescents. This formula could potentially address a gap in the nutritional management of patients with EPI and fat maldigestion. Further studies are required to assess the efficacy of this new formula in the target population.</p><p><strong>Trial registration: </strong>https://clinicaltrials.gov/: NCT05100901 and NCT05923593.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"339-347"},"PeriodicalIF":2.9,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WITHDRAWN: Micronutrients and risk of gastroenteropancreatic neuroendocrine tumours: a Mendelian randomisation study","authors":"Ruilin Wang, Yuxiu Ma, Xuelin Liu, Chunyan Dang, Hongling Li","doi":"10.1016/j.clnesp.2024.11.003","DOIUrl":"10.1016/j.clnesp.2024.11.003","url":null,"abstract":"<p><p>This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause.\u0000The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative immunonutrition and postoperative outcomes in patients with cancer undergoing major abdominal surgery: Retrospective cohort study.","authors":"Mauricio Chona Chona, Lina Maria López Basto, Carolina Pinzón Ospina, Ana Cristina Pardo Coronado, María Paula Guzmán Silva, Marjorie Marín, Alvaro Vallejos, Gloria Esperanza Castro Osmán, Carlos Saavedra, Jorge Díaz Rojas, Jorge Medina-Parra, Ricardo Alfonso Merchán-Chaverra","doi":"10.1016/j.clnesp.2024.12.011","DOIUrl":"10.1016/j.clnesp.2024.12.011","url":null,"abstract":"<p><strong>Background and objectives: </strong>Surgical resection is a first-line treatment for patients with cancer, but preoperative malnutrition is a risk factor for postoperative complications. This study aimed to evaluate the association between preoperative administration of an immunonutrition regimen and postoperative clinical outcomes in patients with cancer undergoing major abdominal surgery.</p><p><strong>Methods: </strong>The Surgical Prehabilitation Multimodal Oncology (SUPREMO) retrospective cohort study, conducted from January 2021 to December 2023, included patients with cancer undergoing major abdominal surgery. Patients were categorized based on whether they received a complete immunonutrition regimen or an incomplete or no regimen. Demographic and clinical data were extracted from electronic health records for descriptive analysis. Logistic regression was used to assess the impact of immunonutrition on the risk of infectious complications, with clinical and demographic variables as explanatory factors.</p><p><strong>Results: </strong>A total of 620 patients were included, with 49 % receiving a complete preoperative immunonutrition regimen. Bivariate analysis indicated that complete regimen administration was associated with lower intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and vasopressor support requirements (p = 0.005, p = 0.019, and p = 0.032, respectively). The logistic regression model showed a significant reduction in in-hospital infectious complications (odds ratio 0.54, 95 % confidence interval 0.31-0.98; p = 0.044).</p><p><strong>Conclusion: </strong>Administering a complete preoperative immunonutrition regimen may be associated with reduced infectious complications, ICU and IMV requirements, and vasopressor support use.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"324-330"},"PeriodicalIF":2.9,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An open-label, randomized, controlled trial on the benefit of β-hydroxy-β-methyl butyrate, l-arginine, l-glutamine combination beverages and locomotion training as supportive care for the treatment of unresectable hepatocellular carcinoma using lenvatinib: A pilot study (HELLO study).","authors":"Atsushi Naganuma, Fujio Makita, Rie Sugimoto, Masahiro Kikuchi, Kiyoshi Furuta, Satoru Iwamoto, Ryotaro Sakamori, Hirotaka Kouno, Keisuke Ario, Hiroshi Yatsuhashi","doi":"10.1016/j.clnesp.2024.12.005","DOIUrl":"10.1016/j.clnesp.2024.12.005","url":null,"abstract":"<p><strong>Introduction: </strong>Hand-foot-skin reaction (HFSR) is the most common side effect of multi-tyrosine kinase inhibitor therapy for unresectable hepatocellular carcinoma (uHCC). Sarcopenia has been reported to be a poor prognostic factor for HCC. Here, we performed a randomized controlled trial (RCT) of the efficacy of a β-hydroxy-β-methyl butyrate/l-arginine/l-glutamine (HMB/Arg/Gln) beverage and locomotion training as supportive care in the treatment of uHCC with lenvatinib.</p><p><strong>Methods: </strong>A total of 20 patients were enrolled from the jRCTs031190252 trial in this pilot study. HFSR was the primary endpoint, and other adverse events and skeletal muscle index at the third lumbar level (L3-SMI) were secondary endpoints.</p><p><strong>Results: </strong>Twelve patients had albumin-bilirubin grade 1, and eight had grade 2. No difference in HFSR was observed. Although interesting differences were observed in the secondary endpoints, a slight retention of L3-SMI values in the intervention group compared with that in the control group was observed (96.5 % vs. 89.9 %, p = 0.407).</p><p><strong>Conclusion: </strong>Although the HMB/Arg/Gln beverage and locomotion training did not reduce adverse events caused by lenvatinib, they might be useful in maintaining skeletal muscle mass. Further validation studies with a larger number of patients are warranted.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"357-364"},"PeriodicalIF":2.9,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between probiotics and prebiotics, kidney dysfunction and mortality - Results from a longitudinal cohort study and Mendelian randomization.","authors":"Ruiyan Xie, Sze Kit Yuen, Zoe Tsang, William C S Tai, Desmond Y H Yap","doi":"10.1016/j.clnesp.2024.11.035","DOIUrl":"10.1016/j.clnesp.2024.11.035","url":null,"abstract":"<p><strong>Introduction: </strong>The benefits of probiotics/prebiotics consumption on chronic kidney disease (CKD) and mortality remains controversial.</p><p><strong>Objectives: </strong>This study investigates the association of probiotics/prebiotics consumption with chronic kidney disease (CKD) and mortality.</p><p><strong>Methods: </strong>Clinical data were retrieved from the National Health and Nutrition Examination Survey (NHANES) 2005-2016 database. Weighted multivariable logistic and liner regression models, cox proportional hazards models and stratified analysis were used to analyse the relationships between consumption of probiotics/prebiotics, renal parameters, CKD and mortality. We also conducted a two-sample Mendelian randomization (MR) analysis of single nucleotide polymorphisms (SNPs) related to different genera of gut microbiota to assess their causal relationships with CKD and mortality.</p><p><strong>Results: </strong>15,291 subjects were analysed (897 with consumption of probiotics/prebiotics and 14,394 without). The use of probiotics/prebiotics showed an inverse correlation with urinary albumin-to-creatinine ratio (UACR) (P < 0.05). Probiotics/prebiotics use was associated with lower risk of CKD in subjects with hypertension, hyperlipidaemia and diabetes mellitus. The consumption of probiotics/prebiotics was associated with a significantly lower risk of all-cause mortality in different regression models (P < 0.001, for all), but the lower risk of cardiovascular mortality did not reach statistical significance (P > 0.05, for all)]. MR analysis showed negative associations between the genetically predicted genus Flavonifractor and risk of CKD and diabetic kidney disease (DKD).</p><p><strong>Conclusion: </strong>After multivariable regression, and cox proportional hazards analysis, we found that the use of probiotics/prebiotics was associated with improved kidney and mortality outcomes in the general population from NHANES database. The two-sample MR analysis provided further genetic evidence that a distinct genus of gut microbiota was associated with reduced risk of CKD, DKD and mortality.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"272-281"},"PeriodicalIF":2.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Paradoxical Relationship Among Diabetes Mellitus, Osteoporosis and Sarcopenia: The PARADOS Study.","authors":"Tülay Tiftik, Murat Kara, Cevriye Mülkoğlu, İrem Çiftçi, Ömer Faruk Çelik, Mahmut Esad Durmuş, Özgür Kara, Şerife Mehlika Kuşkonmaz, Hakan Genç, Bayram Kaymak, Levent Özçakar","doi":"10.1016/j.clnesp.2024.12.009","DOIUrl":"10.1016/j.clnesp.2024.12.009","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes mellitus (DM), osteoporosis (OP) and sarcopenia are major public health problems related with higher fall/fracture risks, morbidity and mortality. Due to the lack of a comprehensive analysis among OP, sarcopenia and DM; we aimed to explore the relationships between DM and the aforementioned conditions in postmenopausal women.</p><p><strong>Methods: </strong>This cross-sectional study included postmenopausal women who consecutively admitted to the Departments of Physical & Rehabilitation Medicine, and Endocrinology and Metabolism. Demographic data, nutrition/cognition status and frailty scores of the participants were recorded. Sarcopenia-related parameters including, anterior thigh muscle thickness, handgrip strength, chair stand test, gait speed, and one-leg stand test (OLST) were measured. ISarcoPRM algorithm was used for the diagnosis of sarcopenia.</p><p><strong>Results: </strong>A total of 444 postmenopausal women were consecutively enrolled. DM patients (N = 158) had higher frequency of sarcopenia (23.4 % vs. 12.9 %), but lower frequency of OP (33.5 % vs. 50.7 %) than controls (both p < 0.01). As regards regression analyses; menopause duration was positively (OR: 1.054, 95 % CI 1.030-1.077), but weight (OR: 0.957, 95 % CI 0.940-0.975) and DM (OR: 0.477, 95 % CI 0.310-0.733) were negatively related with OP (all p < 0.001). On the other hand, age (OR: 1.094, 95 % CI 1.056-1.133), body mass index (OR: 1.131, 95 % CI 1.067-1.198), and DM (OR: 1.887, 95 % CI 1.107-3.218) were positively related with sarcopenia (all p < 0.05). In addition, age (β = -0.355, p < 0.001), body mass index (β = -0.108, p = 0.021) and DM (β = -0.209, p < 0.001) were negatively related with OLST values.</p><p><strong>Conclusion: </strong>DM has paradoxical associations with bone mass and muscle mass/function. Although it has negative relationship with OP (about two times lower odds), it has positive relationship with sarcopenia (about two times higher odds).</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"258-263"},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substrate utilization of carbohydrates, fat, and protein in the late acute phase of critically ill surgical patients: A retrospective longitudinal study.","authors":"Noam Goder, Oded Sold, Noa Gosher, Amir Gal Oz, Dekel Stavi, Asaph Nini, Pierre Singer, Yael Lichter","doi":"10.1016/j.clnesp.2024.12.004","DOIUrl":"10.1016/j.clnesp.2024.12.004","url":null,"abstract":"<p><strong>Background and aims: </strong>Tailoring nutrition to measured energy expenditure (EE) and provision of adequate protein amounts, is considered gold standard for critically ill patients. There are currently no recommendations to measure specific substrate utilization or to adapt nutrition accordingly.</p><p><strong>Methods: </strong>In this retrospective longitudinal study, we analyzed results of 316 simultaneous measurements of indirect calorimetry (IC) and urinary urea nitrogen (UUN) in 191 mechanically ventilated, critically ill patients, admitted to the surgical intensive care unit (SICU) in a tertiary medical center. We calculated substrate utilization, compared it to administered nutrition, investigated factors that may influence it and tested the added value of routine UUN measurements over IC alone.</p><p><strong>Results: </strong>The mean total EE, measured using the indirect calorimetry module, was 1600 ± 451 kcal/day The mean daily fat, carbohydrates and protein oxidation were 118.3 ± 63.9 g, 53.3 ± 114.1 g and 64.7 ± 36.0 g, respectively, accounting for 68.8 % ± 31.4 %, 14.2 % ± 29.6 % and 17.0 % ± 8.6 % of the total EE. Fasting and noradrenaline administration were the only factors that influenced substrate utilization, resulting in higher fat and lower carbohydrate utilization (p < 0.045 for all). There were significant differences between percentage of substrate utilization and supply, with average differences of +28.5 % for fat, -38 % for carbohydrates and +1.9 % for protein (p < 0.006 for all).</p><p><strong>Conclusions: </strong>SICU patients demonstrated very high fat utilization and lower than expected carbohydrate utilization, that differed significantly from amounts supplied. Further prospective studies are needed to elucidate the clinical impact of these findings.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"264-271"},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}