Nutrition in Clinical Practice最新文献

{"title":"Growing with and within ASPEN: A dietitian's unique group perspective.","authors":"Carol Ireton-Jones, Denise Baird Schwartz","doi":"10.1002/ncp.11317","DOIUrl":"10.1002/ncp.11317","url":null,"abstract":"","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"982-983"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral parenteral nutrition: A retrospective observational study to evaluate utility and complications.","authors":"Emma Bidgood, Joanna Huang, Elise Murphy, Ralley Prentice, Beth Hede, David Russell","doi":"10.1002/ncp.11237","DOIUrl":"10.1002/ncp.11237","url":null,"abstract":"<p><strong>Background: </strong>Peripheral parenteral nutrition (PPN) provides an alternative nutrition support strategy to centrally administered PN for specific patients requiring short-term PN. Previous studies have demonstrated limited use of PPN and variable complication rates. This study aimed to evaluate PPN complications and usage at this center.</p><p><strong>Methods: </strong>This was a single-center retrospective observational study of all adult patients who received at least 1 day of PPN from June 2018 to December 2023. Demographic and clinical data were collected, including complications, indications for PN and reason for PPN, duration of therapy, reason for cessation of PPN, nutrition status, energy and protein provision, and central line insertion rates.</p><p><strong>Results: </strong>381 patients were included, the median age was 62 (interquartile range = 28-74) years, and 235 were men (61.7%). The most common indication for PN was ileus (n = 153, 40%) followed by gastrointestinal obstruction (n = 93, 24%). The median time receiving PPN was 3 (2-4) days. Patients received a median of 65% (55%-75%) of energy and 58% (50%-69%) of protein requirements with PPN. Malnutrition was diagnosed in 47.5% (n = 181) of this cohort. Total complication rates were 8.7% (n = 33), with cannula infiltration being the most common complication (6.6%, n = 25). 213 (56%) patients proceeded to central line insertion.</p><p><strong>Conclusion: </strong>PPN proved to be a safe and effective therapy for short-term PN when managed by a nutrition support team. PPN has the potential to attenuate short-term nutrition deficits and prevent central venous access device insertion in selected patients, making it a valuable nutrition support therapy.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"942-949"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malnutrition is associated with clinical outcomes in mechanically ventilated patients with pneumonia and other lung manifestations: A retrospective cohort study.","authors":"Joseline Silva-García, Alan García-Grimaldo, Nadia Carolina Rodríguez-Moguel, Ana Lucia Gómez-Rodriguez, Martin Armando Rios-Ayala, Carmen Margarita Hernández-Cardenas, Josue Daniel Cadeza-Aguilar, Ivan Armando Osuna-Padilla","doi":"10.1002/ncp.11269","DOIUrl":"10.1002/ncp.11269","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition is a highly prevalent condition in patients who are critically ill that has been previously associated with adverse clinical outcomes. The aims of this study are to describe the prevalence of malnutrition using Global Leadership Initiative on Malnutrition (GLIM) criteria and analyze the associations with clinical outcomes using original criteria or the presence of one phenotypic criterion with inflammation measured by C-reactive protein (CRP) in patients with pneumonia and other lung manifestations who are mechanically ventilated.</p><p><strong>Methods: </strong>This retrospective cohort study included patients who are critically ill. Malnutrition was classified using the original GLIM criteria (reduced muscle mass and the assumption of present inflammation because of critical illness) and one phenotypic criterion with severe inflammation (CRP >5 mg/dl). Associations between both groups with clinical outcomes (duration of invasive mechanical ventilation [IMV], length of stay [LOS] on ICU, hospital LOS, ICU mortality, and prolonged ICU LOS) were assessed.</p><p><strong>Results: </strong>Two hundred and thirty-four patients who were critically ill were included. The prevalence of malnutrition in the established methods GLIM and phenotypic criterion with severe inflammation was 38.4% and 27.7%, respectively. Patients who survived and were diagnosed with malnutrition using inflammation criterion at baseline had longer hospital LOS (31 vs 25 days, P = 0.04). After adjusting for age, clinical diagnosis at admission, and SOFA and APACHE II scores, phenotypic criterion with severe inflammation was associated with duration of IMV (β: 5.7; 95% confidence interval: 0.7-10.7; P = 0.02) and ICU LOS (β: 6.1; 95% CI: 0.8-11.5; P = 0.02).</p><p><strong>Conclusions: </strong>Malnutrition considering a phenotypic criterion and CRP >5 mg/dl upon ICU admission was associated with duration of IMV and ICU LOS.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"870-879"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of nutrition education intervention for caregivers on the nutrition status of the elderly receiving home care: A 1-year follow-up interventional trial.","authors":"Çağdaş Salih Meriç, Nurcan Yabanci Ayhan","doi":"10.1002/ncp.11273","DOIUrl":"10.1002/ncp.11273","url":null,"abstract":"<p><strong>Background: </strong>The high prevalence of malnutrition among those of older age and the lack of nutrition knowledge among the elderly and their caregivers underscore the need for a nutrition education intervention (NEI) for caregivers.</p><p><strong>Materials and methods: </strong>Patients enrolled in the \"home care program\" who were dependent, were >65 years of age, and had caregivers (n = 94) were included in the study. A nutritionist conducted initial NEI sessions for caregivers and subsequently monitored them monthly at home for 12 months. Mini Nutritional Assessment (MNA) and World Health Organization Quality of Life Elderly Module (WHOQOL-OLD) were used to evaluate the nutrition status and quality of life scores of those of older age, respectively. Additional assessments included dietary intake, anthropometric measurements, and biochemical measurements. Other measures included current medical history and Barthel Index for Activities of Daily Living. All measurements were recorded over 12 months.</p><p><strong>Results: </strong>The mean age of the participants was 84.4 ± 6.9 years, with 61.7% being women. Significant differences were observed postintervention for MNA (Δ = +1.4; P < 0.001) and WHOQOL-OLD (Δ = +3.0; P < 0.001). The NEI was associated with improved nutrition status and quality of life. Post-intervention, significant improvements were noted in body weight (Δ = +0.4 kg; P < 0.001), waist circumference (Δ = +0.3 cm; P < 0.05), BMI (Δ = +0.2 kg/m²; P < 0.05), energy intake (Δ = +77 kcal/day; P < 0.001), protein intake (Δ = +5.4 g/day; P < 0.001), carbohydrate intake (Δ = +16.2 g/day; P < 0.001), and intakes of vitamin B2 (Δ = +0.3 mg/day; P < 0.001), vitamin C (Δ = +24.0 mg/day; P < 0.05), calcium (Δ = +133 mg/day; P < 0.001), and phosphorus (Δ = +116 mg/day; P < 0.001).</p><p><strong>Conclusions: </strong>NEI for caregivers may reduce the malnutrition prevalence among those of older age and improve their dietary habits, quality of life, anthropometric measurements, biochemical parameters, and nutritional intake.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"959-972"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Comment on: A liberalized diet does not improve caloric intake during neutropenia in patients undergoing hematopoietic stem cell transplants: A prospective randomized controlled trial.","authors":"J N Schulz, K H McGee, M T Weaver, J R Wingard, P D Williams, C L Cline, N Farhadfar, D Lynch-Kelly, Z A Al-Mansour, W J Dahl","doi":"10.1002/ncp.11309","DOIUrl":"10.1002/ncp.11309","url":null,"abstract":"","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"986-987"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bowel regimen medication use and its effect on bowel movements in a pediatric intensive care unit: A retrospective study.","authors":"Emmanuel Messele, Samuel Hickey, Susan Hamilton, Alireza Akhondi-Asl, Tracy Walton, Thomas Kuriakose, Nilesh M Mehta, Enid E Martinez","doi":"10.1002/ncp.11300","DOIUrl":"10.1002/ncp.11300","url":null,"abstract":"<p><strong>Background: </strong>Constipation affects up to 50% of critically ill children and is associated with poor clinical outcomes. The best approach to promote bowel movements in critically ill children is not known.</p><p><strong>Methods: </strong>We performed a retrospective study including children admitted for >24 h to an intensive care unit who received enteral nutrition (EN). Demographic and clinical characteristics, ordered and administered bowel regimen medications (categorized into enteral softener/osmotic, enteral/intravenous stimulant agents, and rectal softener/osmotic agents), and number of bowel movements were collected for the first 4 days of EN. A multistate model analysis, controlling for severity of illness, assessed the probability of having a bowel movement based on exposure to the categories of medications.</p><p><strong>Results: </strong>We included 121 patients, median age 53 months (<1 month, 118 months) and 45% female. A medication was ordered for 77 of 121 (64%) patients and administered in 59 of 77 (77%). Enteral softener/osmotic agents were ordered in 64%-90% and rectal agents in 38%-56% of instances. The multistate model analysis identified a greater probability of having a bowel movement after receiving a rectal agent for 1 or 2 days compared with other agents. The most common reason for an ordered medication not being administered was an \"as needed\" order status.</p><p><strong>Conclusion: </strong>Rectal agents, the least ordered/administered medication category, were the most effective. Ordering medications in an \"as needed\" order status reduced the rate of administration. These findings suggest practical changes that may improve the prevention and management of constipation in pediatric critical illness.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"922-930"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical nutrition therapy in chronic obstructive pulmonary disease: A narrative review.","authors":"Patricia Savino-Lloreda, David López-Daza, Alejandro Casas-Herrera","doi":"10.1002/ncp.11329","DOIUrl":"10.1002/ncp.11329","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous lung condition characterized by persistent airflow obstruction, associated with cardiovascular, metabolic and musculoskeletal comorbidities. In 2022, approximately 480 million people were affected by this disease, making it the third leading cause of mortality worldwide. Projections indicate that by 2050, this number could rise to 600 million. Nutrition status is a fundamental component in managing COPD patients, as it is a critical prognostic factor for morbidity and mortality. Patients with COPD may display different body composition phenotypes, ranging from cachexia to obesity to sarcopenia. Assessing body composition is essential to determine muscle mass, the latter crucial for respiratory function, and also to identify potential health risks and complications. Likewise, involuntary weight loss and decreased fat-free mass are associated with increased mortality. COPD should be viewed as a syndrome, or as a multimorbidity coexisting with other conditions, requiring comprehensive clinical and nutrition assessment for effective management. Nutrition intervention, including oral supplements, is crucial to preserve muscle mass and weight. Supplementation with protein, ω-3 fatty acids, and antioxidants, along with pulmonary rehabilitation, improves muscle strength and exercise tolerance. This narrative review examines nutrition phenotypes and highlights the importance of nutrition interventions in patients with COPD. A multimodal approach combining nutrition support, physical exercise, and pharmacological treatments is essential for managing COPD and its associated comorbidities.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"793-804"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving nutrition therapy in cystic fibrosis: Adapting to the CFTR modulator era.","authors":"Kay Vavrina, Tara B Griffin, Angel M Jones, Terri Schindler, Trang N Bui, Senthilkumar Sankararaman","doi":"10.1002/ncp.11332","DOIUrl":"10.1002/ncp.11332","url":null,"abstract":"<p><p>Cystic fibrosis transmembrane regulator (CFTR)-directed therapies, such as modulators, have transformed the medical management of people with CF, resulting in better lung function, weight, and body mass index in recent years. With improved nutrition status in people on CFTR modulators, the emphasis on a high-energy, high-fat diet (the legacy CF diet) is declining, with an increased focus on a healthy diet. The increased survival and median predicted age of people with CF have created a need for more attention to metabolic diseases, including hypertension, dyslipidemia, and cardiovascular diseases. The effects of modulators on extrapulmonary manifestations associated with CF, such as CF-related diabetes, CF hepatobiliary involvement, gastrointestinal tract disorders, and pancreatic manifestations, are currently unknown. Approximately 95% of people with CF qualify for treatment with a CFTR modulator. This review discusses the basics of CFTR gene mutations and changes in nutrition status related to treatment with CFTR modulators.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"816-828"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenia screening and clinical outcomes in surgical patients: A longitudinal study.","authors":"Micheli da Silva Tarnowski, Camila Ferri Burgel, Andressa Amaral Dariva, Isabela Canquerini Marques, Lana Porto Alves, Mileni V Beretta, Flávia Moraes Silva, Catarina B Andreatta Gottschall","doi":"10.1002/ncp.11243","DOIUrl":"10.1002/ncp.11243","url":null,"abstract":"<p><strong>Background: </strong>The SARC-CalF was developed as a screening tool for sarcopenia, but little is still known about its validity in surgical patients. Thus, this study aimed to assess the prognostic value of SARC-CalF in predicting clinical outcomes in patients admitted for any elective surgery in a hospital.</p><p><strong>Methods: </strong>Cohort study with prospective data collection of surgical patients ≥18 years of age screened for sarcopenia within 48 h of admission using the SARC-CalF (score ≥11 points classified patients at suggestive signs of sarcopenia). A standard questionnaire for sociodemographic and clinical data was filled and anthropometric data were measured. Clinical outcomes of interest comprised postoperative complications, length of postoperative hospital stay (LPHS), length of hospital stay (LOS), and in-hospital death.</p><p><strong>Results: </strong>Among the 303 patients admitted for elective surgery across various specialties (58.2 ± 14.6 years; 53.8% men) included, 21.5% presented suggestive signs of sarcopenia (SARC-CalF ≥11). LOS (16.0 [10.0-29.0] vs 13.5 [8.0-22.0] days; P < 0.05) and LPHS (6.0 [3.0-14.5] vs 5.0 [1.0-8.2] days; P < 0.05) were longer in patients with SARC-CalF ≥11 compared with those without this condition. The frequency of severe postoperative complications (23.1% vs 8.8%; P < 0.05) and the incidence of death (12.3% vs 2.9%; P < 0.05) were higher in patients with SARC-CalF ≥11. However, in the multivariate analyses, no association between SARC-CalF ≥11 and clinical outcomes was found.</p><p><strong>Conclusion: </strong>Signs of sarcopenia (SARC-CalF ≥11) were present in >20% of patients who were hospitalized for any elective surgery, but it was not an independent predictor of extended hospital stay, complications, and death.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"950-958"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing nutrition risk and malnutrition rates in patients with chronic obstructive pulmonary disease: A cross-sectional study.","authors":"Buse Sarıkaya, Şule Aktaç, Erdoğan Çetinkaya","doi":"10.1002/ncp.11331","DOIUrl":"10.1002/ncp.11331","url":null,"abstract":"<p><strong>Background: </strong>Nutrition screening is crucial in chronic obstructive pulmonary disease (COPD) management. This study aimed to assess the nutritional status of patients with COPD at different severity levels.</p><p><strong>Methods: </strong>This cross-sectional study included 52 patients with COPD aged 50-80 years. COPD severity was classified according to forced expiratory volume in 1 s (FEV₁) using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Nutritional status was assessed using a two-step approach: initial screening with the Mini Nutritional Assessment-Short Form (MNA-SF), followed by malnutrition diagnosis in at-risk individuals according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Body composition was assessed using the bioelectrical impedance analysis (BIA) method.</p><p><strong>Results: </strong>The MNA-SF identified 23.1% of patients as at risk, whereas GLIM diagnosed malnutrition in 13.5%. Compared to the well-nourished group, malnourished patients had significantly lower body mass index (BMI) (21.4 ± 3.7 vs 26.8 ± 3.2 kg/m²; P < 0.05) and skeletal muscle mass (22.3 ± 3.3 vs 27.7 ± 3.2 kg; P < 0.05). Patients with severe COPD had lower BMI and fat-free mass index (FFMI) than those with moderate COPD (P < 0.05). Malnutrition was associated with prolonged hospital stays (7.7 ± 5.7 vs 5.8 ± 3.2 days; P < 0.05) and lower FEV₁ values (P < 0.05).</p><p><strong>Conclusions: </strong>The MNA-SF does not consider disease-specific factors, whereas GLIM, despite incorporating muscle mass evaluation, is influenced by COPD-related complications. A comprehensive approach that accounts for COPD-related physiological changes is needed for accurate malnutrition assessment.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"880-892"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}