Nutrition and Metabolic Insights最新文献

{"title":"Is Energy Delivery Guided by Indirect Calorimetry Associated With Improved Clinical Outcomes in Critically Ill Patients? A Systematic Review and Meta-analysis.","authors":"Oana A Tatucu-Babet,&nbsp;Kate Fetterplace,&nbsp;Kate Lambell,&nbsp;Eliza Miller,&nbsp;Adam M Deane,&nbsp;Emma J Ridley","doi":"10.1177/1178638820903295","DOIUrl":"https://doi.org/10.1177/1178638820903295","url":null,"abstract":"<p><strong>Background: </strong>Indirect calorimetry (IC) is recommended to guide energy delivery over predictive equations in critical illness due to its precision. However, the impact of using IC to measure energy expenditure on clinical outcomes is uncertain.</p><p><strong>Objective: </strong>To evaluate whether using IC to measure energy expenditure to inform energy delivery reduced hospital mortality and improved other important outcomes compared to using predictive equations in critically ill adults.</p><p><strong>Methods: </strong>A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Medline, Embase, CINAHL, and the Cochrane Library were searched for studies using IC to guide energy delivery compared to a predictive equation in adult critically ill patients with the primary outcome (hospital mortality) or any of the secondary outcomes reported (including but not limited to hospital and intensive care unit (ICU) length of stay (LOS) and duration mechanical ventilation (MV). Risk of bias within studies was assessed using the Cochrane \"Risk of Bias\" 1 tool. Random-effect meta-analyses were used when heterogeneity between studies existed (I² > 50%). Data are reported as median (interquartile range [IQR]), binomial outcomes as odds ratio (OR), 95% confidence interval (CI), and continuous outcomes as mean difference (MD).</p><p><strong>Results: </strong>Of 4060 articles, 4 randomized controlled trials were identified with 396 patients included in analysis. Three studies were considered low risk of bias and 1 as high risk. Two studies reported hospital mortality (n = 130 and 40 participants, respectively). When combined, no association between IC-guided energy delivery and hospital mortality was found (OR = 0.81, 95% CI = [0.25, 2.67], <i>P</i> = 0.73, I² = 52). No differences were reported with ICU mortality and hospital LOS between groups, but ICU LOS and duration of MV varied across all studies. According to the meta-analysis, no differences were observed in ICU LOS (MD = 1.39, 95% CI = [-5.01, 7.79], <i>P</i> = 0.67, I² = 81%), although the duration of MV was increased when energy delivery was guided by IC (MD = 2.01, 95% CI = [0.45, 3.57], <i>P</i> = 0.01, I² = 26%). In all 4 studies, prescribed energy targets were more closely met when energy delivery was informed by IC compared to a predictive equation. Three studies reported the percentage delivered versus the prescribed energy target, with the median (IQR) delta between the IC and predictive equation arms 19% (10%-32%).</p><p><strong>Conclusion: </strong>Limited data exist to assess the impact of using IC to inform energy delivery in comparison to predictive equations on hospital mortality. The association of IC use with other important outcomes, including duration of MV, needs to be further explored before definitive conclusions can be made.</p>","PeriodicalId":19396,"journal":{"name":"Nutrition and Metabolic Insights","volume":"13 ","pages":"1178638820903295"},"PeriodicalIF":1.7,"publicationDate":"2020-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1178638820903295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37787223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Network Intervention Reduces Added Sugar Intake Among Baltimore Public Housing Residents: A Feasibility Study.","authors":"Kimberly A Gudzune,&nbsp;Onumara Opara,&nbsp;Jonathan C Martinez,&nbsp;Ruchi S Doshi,&nbsp;David M Levine,&nbsp;Carl A Latkin,&nbsp;Jeanne M Clark","doi":"10.1177/1178638820909329","DOIUrl":"https://doi.org/10.1177/1178638820909329","url":null,"abstract":"<p><p>Public housing residents have high intake of added sugars, which is associated with sugar-sweetened beverage (SSB) consumption in their social networks. In this feasibility study, we designed and tested a network-oriented intervention to decrease added sugar intake by encouraging reduced SSB consumption. We conducted a 6-month single-arm trial testing a small-group curriculum (9 sessions) that combined behavior change strategies to reduce added sugar intake by promoting SSB reduction with a peer outreach approach. We recruited and trained public housing residents to be \"Peer Educators,\" who then communicated information and made changes to reduce SSB with their network members. We calculated the median number of group sessions attended and determined the percentage of individuals satisfied with the program. We estimated added sugar intake using a 5-factor dietary screener and compared baseline and 6-month median values using Wilcoxon signed rank tests. We recruited 17 residents and 17 of their network members (n = 34). Mean age was 45.7 years, 79.4% were women, and 97.1% were African American. Median number of sessions attended was 9 (interquartile range: 4-9), and 88.2% were very satisfied with the program. Overall, baseline median added sugar intake was 38.0 tsp/day, which significantly declined to 17.2 tsp/day at 6 months (<i>P</i> < .001). Residents and network members achieved similar results at 6 months (17.4 vs 16.9 tsp/day, respectively). In conclusion, our results demonstrate that a social network intervention aimed at reducing SSB consumption is feasible and can produce significant decreases in adult added sugar intake, which warrants further investigation in a randomized controlled trial.</p>","PeriodicalId":19396,"journal":{"name":"Nutrition and Metabolic Insights","volume":"13 ","pages":"1178638820909329"},"PeriodicalIF":1.7,"publicationDate":"2020-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1178638820909329","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37732526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meeting Calorie and Protein Needs in the Critical Care Unit: A Prospective Observational Pilot Study.","authors":"Shinobu Yamamoto,&nbsp;Karen Allen,&nbsp;Kellie R Jones,&nbsp;Sarah S Cohen,&nbsp;Kemuel Reyes,&nbsp;Maureen B Huhmann","doi":"10.1177/1178638820905992","DOIUrl":"https://doi.org/10.1177/1178638820905992","url":null,"abstract":"<p><strong>Background: </strong>Inadequate calorie and protein intake during critical illness is associated with poor clinical outcomes. Unfortunately, most critically ill patients do not consume adequate levels of these nutrients. An enteral formula with appropriate macronutrient composition may assist patients in meeting nutritional goals.</p><p><strong>Design: </strong>This study was a single center, prospective, observational study of 29 adults in the medical intensive care unit who required enteral nutrition for at least 3 days. Subjects received a calorically dense, enzymatically hydrolyzed 100% whey peptide-based enteral formula for up to 5 days to assess the ability to achieve 50% of caloric goals within the first 3 days (primary outcome), the daily percentage of protein goals attained and gastrointestinal tolerance (secondary outcomes).</p><p><strong>Result: </strong>A total of 29 subjects consented and began the study. Four subjects dropped out before first day and 25 subjects were included in analyses. Subjects were aged 55.5 ± 16.9 years with mean body mass index (BMI) of 27.9 ± 7.5 kg/m². Most (92%) subjects were on a mechanical ventilator and experienced organ failure. At least 50% of caloric and protein goals were achieved in 78.9% and 73.7% of the subjects, respectively, during the first 3 days. Overall, 75.0 ± 26.3% and 69.3 ± 26.7% of calorie and protein goals were achieved using the study formula.</p><p><strong>Conclusions: </strong>Subjects fed enterally with a calorically dense, enzymatically hydrolyzed 100% whey peptide-based enteral formula exceeded 50% of caloric and protein goals in most critically ill subjects included in this study. Use of study formula did not lead to severe gastrointestinal intolerance.</p>","PeriodicalId":19396,"journal":{"name":"Nutrition and Metabolic Insights","volume":"13 ","pages":"1178638820905992"},"PeriodicalIF":1.7,"publicationDate":"2020-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1178638820905992","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37721871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipophilic Antioxidants and Cognitive Function in the Elderly.","authors":"Karen L Niemchick,&nbsp;Carla Riemersma,&nbsp;Grace A Lasker","doi":"10.1177/1178638820903300","DOIUrl":"https://doi.org/10.1177/1178638820903300","url":null,"abstract":"<p><strong>Objective: </strong>To determine the relationship between blood serum lipophilic antioxidant levels and cognitive function (CF) in older adults aged 60 and above guided by the oxidative stress theory of aging.</p><p><strong>Methods: </strong>Cross-sectional data from the National Health and Nutrition Examination Survey (<i>n</i> = 291) for older adults aged 60 and above were examined using Pearson correlation coefficient and multiple linear regression to determine whether blood serum antioxidant status predicted CF while controlling for age, sex, race, hypertension, smoking status, and body mass index.</p><p><strong>Results: </strong>Alpha-tocopherol, retinyl palmitate, trans-lycopene, and retinyl stearate were all significantly correlated with CF. After controlling for covariates, α-tocopherol and retinyl palmitate were associated with CF. Age, sex, and current smoking status were significant predictors of CF.</p><p><strong>Conclusions: </strong>The benefits of antioxidants in CF may be a part of nutritional recommendations which include α-tocopherol and retinyl palmitate for delay of CI, and subsequently a better quality of life.</p>","PeriodicalId":19396,"journal":{"name":"Nutrition and Metabolic Insights","volume":"13 ","pages":"1178638820903300"},"PeriodicalIF":1.7,"publicationDate":"2020-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1178638820903300","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37655501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a 3-Month Anti-inflammatory Dietary Intervention Focusing on Watermelon on Body Habitus, Inflammation, and Metabolic Markers: A Pilot Study.","authors":"Michael D Wirth, Nitin Shivappa, Samira Khan, Shraddha Vyas, Lynae Beresford, Jameson Sofge, James R Hébert","doi":"10.1177/1178638819899398","DOIUrl":"10.1177/1178638819899398","url":null,"abstract":"<p><p>An anti-inflammatory dietary intervention called the Inflammation Management Intervention (IMAGINE) was adapted to emphasize watermelon due to its anti-inflammatory properties. This pilot study (n = 23) tested the effect of a watermelon-enhanced IMAGINE intervention (n = 15) on body habitus and markers of inflammation and metabolism. This 3-month self-selection trial, consisting of weekly in-person classes and online education for 12 weeks, focused on incorporating watermelon into an already anti-inflammatory diet. Controls (n = 8) received basic health education via email and blogs. Measurements, including diet, anthropometrics, actigraphy, and a blood draw, were made at baseline and immediately postintervention. Linear regression analyses were conducted using intervention status as the main exposure. Post hoc analyses then ignored intervention assignment and grouped participants based on their change in their energy-adjusted Dietary Inflammatory Index (E-DII^TM) score. There were no group-by-time interactions for any of the studied outcomes. However, some intervention participants' diets became more proinflammatory, and several control participants' diets became more anti-inflammatory. Those participants below the median of E-DII change (ie, more anti-inflammatory changes) showed reductions in body fat percent (-1.27% vs +0.90%, respectively, <i>P</i> = .01), body mass index (-0.66 vs +0.38 kg/m², respectively, <i>P</i> = .06) and body weight (-0.99 vs +0.54 kg, respectively, <i>P</i> = .08) compared to those above the median of E-DII change. This study demonstrates that individuals who adopt a more anti-inflammatory diet containing watermelon will have improvements in body anthropometrics. Future studies should focus on increasing adherence and compliance to intervention prescriptions, exploring options to extend interventions to evaluate long-term changes, and further examining changes in inflammatory biomarkers. Clinical Trials Registration: NCT03158740.</p>","PeriodicalId":19396,"journal":{"name":"Nutrition and Metabolic Insights","volume":"13 ","pages":"1178638819899398"},"PeriodicalIF":2.3,"publicationDate":"2020-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/08/10.1177_1178638819899398.PMC6958645.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37574462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cooking Online With a Chef: Health Professionals' Evaluation of a Live Culinary Coaching Module.","authors":"Rani Polak,&nbsp;Adi Finkelstein,&nbsp;Sabrina Paganoni,&nbsp;Rob Welch,&nbsp;Julie K Silver","doi":"10.1177/1178638819887397","DOIUrl":"https://doi.org/10.1177/1178638819887397","url":null,"abstract":"<p><strong>Introduction: </strong>Cooking Online With a Chef (COWC) is a live, telemedicine module delivered by a health coach chef to participants who log in from their home kitchen. Our purpose is to identify health professionals' perceptions on its educational value and to determine feasibility for clinical practice.</p><p><strong>Method: </strong>Sixty-four health care professionals participated in a 75-minute COWC module as active participants during a live remote Continuing Medical Education (CME) program that includes five 75-minute telemedicine sessions. Post-program questionnaire elicited feedback on the module educational value and relevance to clinical practice through Likert-type scale and open-ended questions. This report presents descriptive analysis of the Likert-type scale questions and thematic qualitative analysis of the open-ended question.</p><p><strong>Results: </strong>Seventy percent of health care professional participants rated the quality of the COWC module as either very good or excellent, and 73% rated its relevance to clinical practice as very good or excellent. Open-ended question feedback showed appreciation of the learning experience with specific suggestions about how to improve participants' preparation for the module.</p><p><strong>Conclusions: </strong>The COWC telemedicine module was well received by self-selected health care professionals. Future studies are being planned to determine the efficacy of the module on patients' nutrition.</p>","PeriodicalId":19396,"journal":{"name":"Nutrition and Metabolic Insights","volume":"12 ","pages":"1178638819887397"},"PeriodicalIF":1.7,"publicationDate":"2019-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1178638819887397","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37471474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifestyle and Circadian Health: Where the Challenges Lie?","authors":"N. J. Gupta","doi":"10.1177/1178638819869024","DOIUrl":"https://doi.org/10.1177/1178638819869024","url":null,"abstract":"Modern life is facilitated by extended light hours at night and longer hours of eating. Compromised sleep, sedentary life, and modern diet adversely affect human health. Studies emphasizing importance of evidence-driven longitudinal studies on daily rhythms of human eating and sleeping behaviour provide a baseline for adequate insight into causal factors for circadian misalignment. Molecular chronobiology studies in animal models debrief endogenous regulation of organismal circadian clock; their regulation by environmental cues and how they segregate incompatible processes. But effective utilization of the knowledge needs randomized chrono-therapeutic intervention trials in humans. However, nutrition, activity, and lifestyle being society specific, baseline longitudinal studies must precede intervention trials as primary method to decipher circadian disruption. Our pilot survey studies investigating current lifestyle trends responsible for circadian rhythm disruption revealed that accelerated urban life, more than 8 hours work operations and long commutes to work inflict a sleep loss in Indian working women living in metropolitan cities. This sleep loss is sufficient to adversely impact their wellness. Besides, daily work routines and fast-food popularity have contributed to circadian disruption in daily rhythms of eating and sleep, enhancing disease consequences.","PeriodicalId":19396,"journal":{"name":"Nutrition and Metabolic Insights","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1178638819869024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48866210","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":"Primary Care and Food Bank Collaboration to Address Food Insecurity: A Pilot Randomized Trial.","authors":"Robert L Ferrer, Luz-Myriam Neira, Gualberto L De Leon Garcia, Kristin Cuellar, Jasmine Rodriguez","doi":"10.1177/1178638819866434","DOIUrl":"10.1177/1178638819866434","url":null,"abstract":"<p><p>Food insecurity is common in the United States and linked to poor control of conditions influenced by diet. We conducted a pilot randomized trial to test whether a novel partnership between a primary care practice and a municipal food bank would improve control of type 2 diabetes among patients with food insecurity. Participants received food bank produce delivered twice monthly to the practice site, brief teaching from a food bank dietitian, and home-based education from a community health worker. After 6 months, glycosylated hemoglobin decreased (absolute change) by 3.1% in the intervention group vs 1.7% in the control group (<i>P</i> = .012). Scores on Starting the Conversation-Diet, a brief dietary measure, improved in the intervention group by 2.47 on a 14-point scale (<i>P</i> < .001). Body mass indexes (BMIs) were unchanged. In this early-stage study, onsite collaboration between primary care and a regional food bank generated clinically meaningful reductions in HbA_1c and improvements in diet.</p>","PeriodicalId":19396,"journal":{"name":"Nutrition and Metabolic Insights","volume":"12 ","pages":"1178638819866434"},"PeriodicalIF":2.3,"publicationDate":"2019-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/92/38/10.1177_1178638819866434.PMC6664622.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41207409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can the Antisecretory Factor Be Considered a New Therapy for the Short Bowel Syndrome?","authors":"Maria Teresa Viggiani,&nbsp;Alfredo Di Leo,&nbsp;Michele Barone","doi":"10.1177/1178638819852061","DOIUrl":"https://doi.org/10.1177/1178638819852061","url":null,"abstract":"<p><strong>Background and objective: </strong>The antisecretory factor (AF) exerts antisecretory and anti-inflammatory properties in the bowel. The aim of this study was to evaluate the effect of exogenous AF (Salovum) or cereals stimulating the endogenous AF (SPC-Flakes), given alone or in combination, in patients with short bowel syndrome (SBS).</p><p><strong>Methods: </strong>Patients received Salovum alone at T₀ -T₁, Salovum plus SPC-Flakes at T₁ -T₂, and SPC-Flakes alone at T₂ -T₃. At T₀ and T₃, water balance, weight, lean mass (FFM), total body water (TBW), extracellular water (ECW), and nutritional and inflammatory biochemical parameters were evaluated. The water balance was also measured at T₁, T₂, and 30 days (T_S) from the end of treatment.</p><p><strong>Results: </strong>Among the 7 patients enrolled, 2 discontinued treatment due to side effects and 1 was excluded after a cancer was diagnosed. Salovum alone or with SPC-Flakes did not improve the intestinal absorption in patients with SBS, while the administration of SPC-Flakes alone lead towards a trend of increased faecal volume. Weight, FFM, TBW, and ECW, as well as nutritional and inflammatory status, did not statistically change at the end of treatment (T₃) as compared with T₀. At T_S water balance was restored.</p><p><strong>Conclusion: </strong>The administration of exogenous AF or the stimulation of endogenous AF seems to be unable to offer an effective therapy in patients with SBS. On the contrary, their administration appears to aggravate fluid loss and induce side effects.</p>","PeriodicalId":19396,"journal":{"name":"Nutrition and Metabolic Insights","volume":"12 ","pages":"1178638819852061"},"PeriodicalIF":1.7,"publicationDate":"2019-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1178638819852061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37074536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart Rate Variability: A Potential Tool for Monitoring Immunomodulatory Effects of Parenteral Fish Oil Feeding in Patients With Sepsis.","authors":"Vasilios Papaioannou,&nbsp;Ioannis Pnevmatikos","doi":"10.1177/1178638819847486","DOIUrl":"https://doi.org/10.1177/1178638819847486","url":null,"abstract":"<p><p>Fish oil, rich in the very-long chain omega (ω)-3 polyunsaturated fatty acids (PUFAs), has been found to have immunomodulatory effects in different groups of critically ill patients. In addition, its parenteral administration seems to attenuate the inflammatory response within 2 to 3 days. The activation of the cholinergic anti-inflammatory pathway has been suggested to mediate such immunoregulatory effects. As different experimental studies have convincingly illustrated that enhanced vagal tone can decrease pro-inflammatory cytokine secretion, novel monitoring tools of its activity at the bedside could be developed, to evaluate nutritional manipulation of immune response in the critically ill. Heart rate variability (HRV) is the variability of R-R series in the electrocardiogram and could be a promising surrogate marker of immune response and its modulation during fish oil feeding, rich in ω-3 PUFAs. Heart rate variability is an indirect measure of autonomic nervous system (ANS) output, reflecting mainly fluctuations in ANS activity. Through HRV analysis, different \"physiomarkers\" can be estimated that could be used as early and more accurate \"smart alarms\" because they are based on high-frequency measurements and are much more easy to get at the bedside. On the contrary, various \"biomarkers\" such as cytokines exhibit marked interdependence, pleiotropy, and their plasma concentrations fluctuate from day to day in patients with sepsis. In this respect, an inverse relation between different HRV components and inflammatory biomarkers has been observed in patients with severe sepsis and septic shock, whereas a beneficial effect of ω-3 PUFAs on HRV has been demonstrated in patients with cardiovascular diseases. Consequently, in this article, we suggest that a beneficial effect of ω-3 PUFAs on HRV and clinical outcome in patients with sepsis merits further investigation and could be tested in future clinical trials as a real-time monitoring tool of nutritional manipulation of the inflammatory response in the critically ill.</p>","PeriodicalId":19396,"journal":{"name":"Nutrition and Metabolic Insights","volume":"12 ","pages":"1178638819847486"},"PeriodicalIF":1.7,"publicationDate":"2019-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1178638819847486","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37255448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}