Nutrition in Clinical Practice最新文献

{"title":"Nutrition care and overall survival.","authors":"Jann Arends","doi":"10.1002/ncp.11247","DOIUrl":"10.1002/ncp.11247","url":null,"abstract":"","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"266"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695730","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 nutrition profile and utility of banana puree as a liquid thickener for medically complex infants with dysphagia.","authors":"Kristin Brinker, Lauren Winn, Anne E Woodbury, Amara Finch, Michelle Taggart, Debbie Thomas, Anna Ermarth, Belinda Chan","doi":"10.1002/ncp.11240","DOIUrl":"10.1002/ncp.11240","url":null,"abstract":"<p><strong>Introduction: </strong>Dysphagia among infants, particularly high-risk and preterm neonates, poses feeding challenges that can impact multiple systemic outcomes and delay hospital discharge. Limited therapeutic options for approved thickening agents for human milk and infant formula necessitate the exploration of alternatives, including banana puree.</p><p><strong>Method: </strong>This study investigated the feasibility of using banana puree as a thickening agent for hospitalized infants with dysphagia. The International Dysphagia Diet Standardisation Initiative (IDDSI) flow test determined optimal volumes of banana puree mixed with infant formulas or human milk to achieve desired liquid thickness levels. Nutrition analysis considered potassium intake and calories from carbohydrates to assess dietary composition.</p><p><strong>Result: </strong>Banana puree effectively achieved IDDSI Levels 1-3, with varying volumes required based on milk types and caloric concentrations. The nutrition analysis revealed the importance of restricting banana puree to 15% of feeding volumes to avoid exceeding recommended potassium levels while promoting appropriate nutrition.</p><p><strong>Conclusion: </strong>Banana puree represents a promising option for thickening feeds in infants with dysphagia, facilitating safe oral feeding opportunities, accelerating the introduction of oral feeding, and, potentially, improving long-term outcomes. Further research is warranted to explore its impact on feeding progression, hospital stays, growth, patient outcomes, and feeding-related behaviors compared with traditional thickening agents.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"227-238"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605112","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":"Global Leadership Initiative on Malnutrition criteria: Clinical benefits for patients with gastric cancer.","authors":"Jingxian Zheng, Xiaojie Wang, Jiami Yu, Qiaoting Hu, Zhouwei Zhan, Sijing Zhou, Jingjie Xu, Qifei Li, Chunhua Song, Chang Wang, Qingchuan Zhao, Hongxia Xu, Hanping Shi, Zengqing Guo","doi":"10.1002/ncp.11224","DOIUrl":"10.1002/ncp.11224","url":null,"abstract":"<p><p>Malnutrition is a prevalent condition among patients with gastric cancer and is associated with poor survival outcomes. This study aimed to evaluate the clinical utility of the Global Leadership Initiative on Malnutrition (GLIM) criteria in predicting survival among patients with gastric cancer. The multicenter retrospective cohort study (INSCOC study) included 1406 patients enrolled between December 2012 and April 2020, with follow-up data collected until June 2023. Various indices for muscle evaluation, such as calf circumference (CC) and body weight-standardized hand grip strength (HGS/W), were used to diagnose malnutrition. Kaplan-Meier curves were used to analyze the relationship between nutrition status, as defined by GLIM criteria, and survival outcomes in these patients. The analysis revealed that using CC or HGS/W as positive indicators of malnutrition effectively identified patients with survival-related malnutrition. The incidence of malnutrition was 54.5%, with patients' median overall survival times of 1169 days for stage I and 575 days for stage II cancer (P < 0.001). Malnutrition was identified as an independent risk factor for survival. Additionally, a nomogram developed through Cox regression analysis demonstrated precise predictive capability, incorporating factors such as tumor node metastasis staging, Karnofsky Performance Status Scale, direct bilirubin levels, and nutrition intervention. The study concludes that the GLIM criteria are effective in diagnosing malnutrition and predicting survival in patients with gastric cancer. Nutrition interventions significantly enhance survival outcomes, underscoring the importance of standardized nutrition treatments in improving patient prognosis.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"239-251"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583508","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":"Effect of multidisciplinary medical nutrition therapy on the nutrition status of patients receiving peritoneal dialysis: A randomized controlled trial.","authors":"Yilan Liang, Fang Xu, Li Guo, Wei Jiang, Jun Li, Peng Shu","doi":"10.1002/ncp.11256","DOIUrl":"10.1002/ncp.11256","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition is a prevalent complication in patients undergoing peritoneal dialysis (PD). This study established a multidisciplinary team for medical nutrition therapy (MNT) to investigate the impact of this approach on enhancing the nutrition, anemic, and microinflammatory status of patients receiving PD.</p><p><strong>Methods: </strong>This randomized controlled trial study involved 81 patients undergoing PD (n = 41 in the intervention group, n = 40 in the control group). The intervention group received comprehensive MNT management, whereas the control group received standard nutrition care. The intervention spanned a 6-month period. Various nutrition parameters, markers of anemia, and microinflammatory indexes were assessed before the intervention, at 3 months, and at 6 months postintervention. Repeated-measures analysis of variance and the nonparametric Scheirer-Ray-Hare test were used for within-group and between-group comparisons.</p><p><strong>Results: </strong>There were no statistically significant differences between the groups in terms of age, sex, duration of dialysis, primary disease, or baseline prenutrition inflammation data. At 6 months postintervention, the intervention group exhibited higher levels of serum albumin, blood calcium, serum iron, hemoglobin, total iron-binding capacity, body mass index, midarm circumference, triceps skinfold thickness, handgrip strength, and daily energy and protein intake compared with the control group (P < 0.05). Additionally, the intervention group demonstrated lower levels of subjective nutrition assessment value, C-reactive protein, and neutrophil-to-lymphocyte ratio than the control group (P < 0.05), with no statistically significant differences in other markers after interventions.</p><p><strong>Conclusion: </strong>Multidisciplinary MNT can ameliorate the nutrition status of patients receiving PD, decrease the incidence of malnutrition, and improve anemia and microinflammatory outcomes.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"106-116"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751435","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":"Nutrition adequacy and survival.","authors":"Jann Arends","doi":"10.1002/ncp.11249","DOIUrl":"10.1002/ncp.11249","url":null,"abstract":"","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"272"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751437","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":"Use of parenteral nutrition in the management of enterocutaneous fistula.","authors":"Vanessa J Kumpf, D Dante Yeh","doi":"10.1002/ncp.11245","DOIUrl":"10.1002/ncp.11245","url":null,"abstract":"<p><p>Nutrition plays an integral role in the management of patients with enterocutaneous fistula (ECF), but practice guidelines are often vague because of limited evidence. As a result, clinicians must rely on expert consensus and sound nutrition principles to guide practice. The initial phase of ECF management involves recognition (eg, fistula location and quantifying output) and stabilization (eg, source control and fluid and electrolyte balance). All patients with ECF should be considered at risk of malnutrition because of malabsorption, high gastrointestinal fluid and nutrient losses, and chronic inflammation. Strict bowel rest in conjunction with parenteral nutrition (PN) is typically warranted on initial presentation, but patients can often transition to oral diet or enteral nutrition if ECF output is low (<500 ml/day) and there is good control of ECF drainage at the skin level. Patients with high-output ECF (>500 ml/day) may require PN to meet fluid, electrolyte, and nutrient requirements to support spontaneous or surgical closure of the ECF. Because the healing process can take months, transfer from the inpatient to home setting should be considered when a patient is medically stable. Preparing for discharge home requires stabilization of fluid and electrolyte balance, achievement of glycemic control, containment of ECF output, and patient and/or caregiver training. A long-term PN treatment plan should be developed that incorporates outpatient monitoring, determination of target weight, and desired PN end point. The purpose of this article is to review the optimal use of PN in adult patients with ECF.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"64-75"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142730998","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":"Complete shielding of multivitamins to reduce toxic peroxides in the parenteral nutrition (C-SMART-PN): A randomized controlled pilot study.","authors":"Nadine El Raichani, Maxime Thibaut, Jean-Claude Lavoie, Ibrahim Mohamed","doi":"10.1002/ncp.11274","DOIUrl":"https://doi.org/10.1002/ncp.11274","url":null,"abstract":"<p><strong>Background: </strong>When exposed to ambient light, parenteral nutrition (PN) contamination with peroxides almost doubles, which increases oxidative stress in preterm infants, contributing to the development of bronchopulmonary dysplasia. The American Society for Parenteral and Enteral Nutrition (ASPEN) recommends complete PN photoprotection to reduce peroxide contamination and optimize its integrity but acknowledges the challenges of its implementation. In this study, a novel photoprotection procedure was tested for its effectiveness in reducing peroxide load and limiting ascorbic acid degradation, and for its feasibility and effectiveness in reducing urinary peroxide levels in preterm infants.</p><p><strong>Methods: </strong>In vitro evaluation included neonatal lipid injectable emulsion-free PN admixtures prepared and infused according to current practice or the suggested photoprotection procedure through separation and complete shielding of intravenous multivitamin preparation from compounding to administration through photoprotected infusion sets. In vivo evaluation included a single-center randomized controlled pilot study of extremely preterm infants receiving PN according to current practice or the suggested photoprotection procedure.</p><p><strong>Results: </strong>In vitro, photoprotection allowed a 44% decrease in peroxide generation (P < 0.001) and reduced by half ascorbic acid degradation in PN admixtures (P < 0.001). In vivo, 28 infants completed the study. Baseline urinary peroxide levels were similar in both groups before PN initiation, and the suggested photoprotection procedure resulted in a significant decrease in urinary peroxide levels over the first week of life (P < 0.05).</p><p><strong>Conclusion: </strong>The suggested procedure appears feasible and effective in reducing peroxide contamination and optimizing PN integrity, representing a step toward integrating complete photoprotection of PN as the standard of care in preterm infants.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047411","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":"Development and implementation of a Sezer gastrostomy care bundle using the Knowledge to Action framework.","authors":"Rana Elcin Sezer Ceren, Melek Serpil Talas, Kezban Akcay, Fatma Basar, Meltem Halil","doi":"10.1002/ncp.11241","DOIUrl":"https://doi.org/10.1002/ncp.11241","url":null,"abstract":"<p><strong>Background: </strong>This project aimed to develop an evidence-based nursing care bundle after gastrostomy feeding tube insertion and implement it into clinical practice using the Knowledge to Action (KTA) framework.</p><p><strong>Methods: </strong>This mixed-method design project was conducted in a university hospital between December 2021 and June 2022. The project was carried out in four phases: (1) development of an evidence-based care bundle, (2) education for care bundle training, (3) implementation of the care bundle, (4) evaluation of the care bundle. Nurses' compliance with bundles was measured using All-or-None measurement. The analysis of the qualitative interview conducted was performed using the content analysis method of Graneheim and Lundman.</p><p><strong>Results: </strong>The developed Sezer gastrostomy care bundle consists of three parameters (peristomal area care, tube feeding, and medication administration through the feeding tube) and a total of 14 elements to be applied by nurses under these parameters. Compliance rates for peristomal area care, tube feeding, and medication administration through feeding tube parameters were 100%, 98.66%, and 98.66%, respectively. Two themes and six subthemes emerged: (1) reflection of using the Sezer gastrostomy care bundle on nursing care and (2) adoption of Sezer gastrostomy care bundle.</p><p><strong>Conclusion: </strong>The gastrostomy care bundle was developed in accordance with the Institute of Healthcare Improvement's recommendations. The KTA framework provided an appropriate structure to transform evidence into practice, meticulously address barriers, evaluate outcomes, and ensure sustainability. The project found that nurses complied with all its parameters. Studies evaluating the effect of the gastrostomy care bundle on patient outcomes are recommended.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047416","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":"https://doi.org/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":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-26","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":"Role of infant and early-childhood nutrition on gut inflammation, stunting, growth, and development in the African context: A narrative review.","authors":"Mohamedraza Ebrahim, Karim Manji","doi":"10.1002/ncp.11270","DOIUrl":"https://doi.org/10.1002/ncp.11270","url":null,"abstract":"<p><p>This article synthesizes the existing research evidence from Tanzania, a low- to middle-income country, highlighting the persistent issue of growth stunting. Stunting begins early in life, potentially even in utero. It is becoming increasingly clear that infant and childhood environmental enteric dysfunction plays a significant role in perpetuating the observed stunting. The repercussions of this condition include poor growth and detrimental effects on neurodevelopment, preventing affected children from reaching their full potential. The economic implications of this are substantial. The manuscript outlines the trajectory from low birth weight and suboptimal lactation to altered weaning practices and changes in the gut microbiome. It also presents current perspectives on how to mitigate these adverse effects, with a focus on early interventions in lactation and feeding during the crucial first 1000 days of life.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142951040","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}