Tara Ramaswamy , Michael P DeWane , Hassan S Dashti , Meghan Lau , Paul E Wischmeyer , Alexander Nagrebetsky , Jamie Sparling
{"title":"Nine Myths about Enteral Feeding in Critically Ill Adults: An Expert Perspective","authors":"Tara Ramaswamy , Michael P DeWane , Hassan S Dashti , Meghan Lau , Paul E Wischmeyer , Alexander Nagrebetsky , Jamie Sparling","doi":"10.1016/j.advnut.2024.100345","DOIUrl":"10.1016/j.advnut.2024.100345","url":null,"abstract":"<div><div>Malnutrition is a well-studied and significant prognostic risk factor for morbidity and mortality in critically ill perioperative patients. Common nutrition myths in the critically ill may prevent early, consistent, and adequate delivery of enteral nutrition. We outlined 9 common intensive care unit (ICU) nutrition misconceptions and our recommendations to optimize enteral nutrition in critically ill patients based on the review of available literature. Our approach is to treat every patient admitted to the ICU as at risk for malnutrition and to initiate enteral nutrition upon admission in the absence of contraindications. Early enteral nutrition via the gastric route is more beneficial than delaying feeding while awaiting small bowel access and daytime-intermittent nutrition support can safely be initiated over continuous feeding. Gastric residual volumes to assess feeding tolerance should no longer be routinely measured. For perioperative nutrition, we recommend continuing enteral nutrition for most patients with secure airways undergoing anesthesia and resuming nutrition within 24 h of abdominal surgery; even patients with open abdomens can be safely fed in the absence of bowel injury. Critically ill patients who are proned, paralyzed, and on vasopressors can usually continue enteral nutrition. Finally, continuing enteral nutrition before extubation may optimize nutrition without compromising extubation success. In this review, we highlight several common misconceptions regarding ICU nutrition that may prevent achieving nutrition goals and subsequently lead to increased malnutrition, morbidity, and mortality. This knowledge may contribute to increased implementation of early and consistent enteral nutrition strategies to improve outcomes in critically ill adult patients.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 1","pages":"Article 100345"},"PeriodicalIF":8.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
John W Carbone , Stuart M Phillips , Connie M Weaver , Julie M Hughes , Stefan M Pasiakos
{"title":"Exploring Opportunities to Better Characterize the Effects of Dietary Protein on Health across the Lifespan","authors":"John W Carbone , Stuart M Phillips , Connie M Weaver , Julie M Hughes , Stefan M Pasiakos","doi":"10.1016/j.advnut.2024.100347","DOIUrl":"10.1016/j.advnut.2024.100347","url":null,"abstract":"<div><div>Remarkable advances have been made over the last 30 y in understanding the role of dietary protein in optimizing muscle health across the lifespan. That is, acute (<24 h) stable isotope-derived measures of muscle protein synthesis have led to established recommendations for protein quantity, quality, source, and timing of protein ingestion to support muscle health at rest, post exercise, and to overcome age-related anabolic resistance in older adults. Although muscle health is undoubtedly important, moving from muscle to other associated or disease-specific outcomes is a critical next step for the field, given the mounting evidence documenting the effects of dietary protein on measures of chronic disease and age-related decline (for example, cardiovascular disease, type 2 diabetes mellitus, obesity, frailty, and osteoporosis). In this narrative review, we posit that future studies evaluating the potential role of dietary protein build off of the existing knowledge base generated from decades of past research and focus their efforts on closing unanswered knowledge gaps pertaining to dietary protein and health across the lifespan. Throughout this review, we highlight potential methodologies and novel outcome measures that researchers may consider as starting points to facilitate the next 30 y of advances in the field of dietary protein and health.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 1","pages":"Article 100347"},"PeriodicalIF":8.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabrielle Viscardi , Songhee Back , Amna Ahmed , Shuting Yang , Sonia Blanco Mejia , Andreea Zurbau , Tauseef A Khan , Amanda Selk , Mark Messina , Cyril WC Kendall , David JA Jenkins , John L Sievenpiper , Laura Chiavaroli
{"title":"Effect of Soy Isoflavones on Measures of Estrogenicity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Gabrielle Viscardi , Songhee Back , Amna Ahmed , Shuting Yang , Sonia Blanco Mejia , Andreea Zurbau , Tauseef A Khan , Amanda Selk , Mark Messina , Cyril WC Kendall , David JA Jenkins , John L Sievenpiper , Laura Chiavaroli","doi":"10.1016/j.advnut.2024.100327","DOIUrl":"10.1016/j.advnut.2024.100327","url":null,"abstract":"<div><div>Despite recommendations to increase plant food consumption for public and planetary health and the role that soy foods can play in plant-predominant diets, controversies around the effects of soy foods, especially soy isoflavones, are a barrier to their intake. Given their cardioprotective effects and ability to alleviate menopausal symptoms, addressing these concerns is particularly relevant to women. This systematic review and meta-analysis of randomized controlled trials aimed to determine the effect of soy isoflavones on measures of estrogenicity in postmenopausal women. MEDLINE, Embase, and Cochrane Library were searched through August 2024 for randomized trials <span><math><mrow><mo>≥</mo></mrow></math></span>3-mo investigating soy isoflavones compared with non-isoflavone controls in postmenopausal women. Outcomes included endometrial thickness (ET), vaginal maturation index (VMI), follicle-stimulating hormone (FSH), and estradiol. Independent authors extracted data and assessed risk of bias. Grading of Recommendations, Assessment, Development and Evaluation was used to assess certainty of evidence. We included 40 trials (52 trial comparisons, <em>n</em> = 3285) assessing the effect of a median reported dose of 75 mg/d of soy isoflavones in substitution for non-isoflavone controls over a median of 24 wk. Soy isoflavones had no statistically significant effect on any measure of estrogenicity; ET [mean difference, –0.22 mm (95% confidence interval, –0.45, 0.01 mm), <em>P</em><sub>MD</sub> = 0.059], VMI [2.31 (–2.14, 6.75), <em>P</em><sub>MD</sub> = 0.310], FSH [–0.02 IU/L (–2.39, 2.35 IU/L), <em>P</em><sub>MD</sub> = 0.987], and estradiol [1.61 pmol/L (–1.17, 4.38 pmol/L), <em>P</em><sub>MD</sub> = 0.256]. The certainty of evidence was high to moderate for all outcomes. Current evidence suggests that soy isoflavones do not exhibit estrogenic effects compared with non-isoflavone controls on 4 measures of estrogenicity in postmenopausal women. This synthesis supports that soy isoflavones likely act as selective estrogen receptor modulators, differing clinically from the hormone estrogen. Addressing public health concerns may promote soy foods as high-quality plant protein sources with low environmental impact and cost, particularly benefiting postmenopausal women and aligning with sustainable dietary patterns and guidelines.</div><div>This study was registered in PROSPERO as CRD42023439239.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 1","pages":"Article 100327"},"PeriodicalIF":8.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kelly A Higgins , Rita Rawal , Matthew Kramer , David J Baer , Aaron Yerke , David M Klurfeld
{"title":"An Overview of Reviews on the Association of Low Calorie Sweetener Consumption With Body Weight and Adiposity","authors":"Kelly A Higgins , Rita Rawal , Matthew Kramer , David J Baer , Aaron Yerke , David M Klurfeld","doi":"10.1016/j.advnut.2024.100239","DOIUrl":"10.1016/j.advnut.2024.100239","url":null,"abstract":"<div><h3>Background</h3><div>Numerous systematic reviews (SR) and meta-analyses (MA) on low calorie sweeteners (LCS) have been published in recent years, concluding that LCS have beneficial, neutral, or detrimental effects on various health outcomes, depending on the review.</div></div><div><h3>Objectives</h3><div>The objective of this overview of reviews was to determine how the methodologies of SR investigating the association between LCS consumption and body weight (BW) influence their findings and whether MA results can provide a consistent estimated effect.</div></div><div><h3>Methods</h3><div>Systematic searches of PubMed, Scopus, and Cochrane Library were conducted in November 2022 to identify SR of randomized controlled trials (RCT) or non-randomized studies (NRS) investigating the association between LCS consumption and BW. The methods, MA results, and conclusions were extracted from each eligible SR.</div></div><div><h3>Results</h3><div>Of the 985 search results, 20 SR evaluated the association between LCS and BW, drawing from publications of 75 RCT, 42 prospective cohort studies, and 10 cross-sectional studies. There was a considerable lack of overlap of studies included within each SR attributed, in part, to the inclusion of studies based on design; thus, each SR synthesized results from distinctly different studies. Evidence synthesis methods were heterogeneous and often opaque, making it difficult to determine why results from certain studies were excluded or why disparate results were observed between SR.</div></div><div><h3>Conclusions</h3><div>SR investigating the effect of LCS on BW implement different methodologies to answer allegedly the same question, drawing from a different set of heterogeneous studies, ignoring the basic assumptions required for MA, resulting in disparate results and conclusions. Previous MA show the large effects of study design, which results in inconsistent estimates of the effect of LCS on BW between MA of RCT and NRS. Given the availability of long-term RCT, these studies should be the basis of determining causal relationships (or lack thereof) between LCS and BW.</div><div>This trial was registered at PROSPERO as CRD42022351200.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"15 12","pages":"Article 100239"},"PeriodicalIF":8.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alan Espinosa , Kenny Mendoza , Hugo Laviada-Molina , Jorge Aarón Rangel-Méndez , Fernanda Molina-Segui , Qi Sun , Deirdre K. Tobias , Walter C. Willett , Josiemer Mattei
{"title":"Effects of Nonnutritive Sweeteners on the BMI of Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Prospective Cohort Studies","authors":"Alan Espinosa , Kenny Mendoza , Hugo Laviada-Molina , Jorge Aarón Rangel-Méndez , Fernanda Molina-Segui , Qi Sun , Deirdre K. Tobias , Walter C. Willett , Josiemer Mattei","doi":"10.1016/j.advnut.2024.100292","DOIUrl":"10.1016/j.advnut.2024.100292","url":null,"abstract":"<div><div>The effect of nonnutritive sweeteners (NNSs) on the body mass index [BMI (in kg/m<sup>2</sup>)] of children and adolescents remains unclear despite rising consumption. Detailed systematic evaluations are warranted. We aimed to summarize evidence on NNS consumption and BMI sex- and age-specific absolute changes (kg/m<sup>2</sup>) in pediatric populations, by NNS type, study design, duration, analysis type, conflicts of interest (COI), geographical region, age, sex, and baseline BMI. We searched randomized controlled trials (RCTs) and prospective cohort studies in children (2–9 y), adolescents (10–24 y), and young adults (20–24 y). Pooled estimates derived from random-effects meta-analysis for BMI changes, and the evidence quality was evaluated overall and by subgroup. From 2789 results, we included 4 RCTs [<em>n</em> = 1372; mean follow-up = 42.6 wk (standard deviation = 18.4); 2 (50%) with COI], and 8 prospective cohort studies [<em>n</em> = 35,340; median follow-up 2.5 y (interquartile range = 1.7–6.3), 2 (25%) with COI]. No identified studies evaluated NNS in food, NNS beverages compared with water, or participants aged 20–24 y. Random allocation to NNS beverages (25–2400 mg/d, from beverages) showed less BMI gain [mean difference = −0.114 kg/m<sup>2</sup> (95% confidence interval [CI]: −0.207, −0.021); <em>I</em><sup>2</sup> = 87.02%] compared with sugar-sweetened beverages (SSBs). Stratified estimates resulted in less BMI gain in adolescents, participants with baseline obesity, consumers of mixed NNS, longer trials, and trials without COI. Pooled estimates from prospective cohorts showed a nonsignificant association between NNS beverages and BMI gain [0.05 kg/m<sup>2</sup> (95% CI: −0.03, 0.13); <em>I</em><sup>2</sup> = 75.06%; per daily 355 mL serving]. Stratified estimates remained consistent. Removing studies with COI attenuated estimates. Evidence had low to moderate quality. In summary, pooled results from RCTs comparing NNS beverages compared with SSBs showed less BMI gain in adolescents with obesity. Meta-analyses of long-term cohort studies did not display a significant association between NNS beverages and BMI changes.</div><div>This trial was registered at PROSPERO as CRD42022352284.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"15 12","pages":"Article 100292"},"PeriodicalIF":8.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alessandra Consales , Carlo Agostoni , Roberta Cazzola , Roberta Ottria , Maria Lorella Giannì
{"title":"Tracing Zinc’s Role in Preterm Infants’ Health: A Narrative Review","authors":"Alessandra Consales , Carlo Agostoni , Roberta Cazzola , Roberta Ottria , Maria Lorella Giannì","doi":"10.1016/j.advnut.2024.100295","DOIUrl":"10.1016/j.advnut.2024.100295","url":null,"abstract":"<div><div>Zinc (Zn) is a trace element involved in numerous physiological processes, including enzyme function, gene transcription, and cell signaling. Its importance is especially pronounced in preterm infants, who are at high risk of Zn deficiency due to disrupted transplacental transfer, high nutrient demands, and medical complications. The inherent risk of Zn deficiency in this population is further increased by poor Zn dietary intake. Human milk from preterm mothers contains low concentrations of Zn, although it is highly bioavailable. Additionally, the Zn content steadily declines from colostrum (first few days postpartum) to mature milk (>10–14 d postpartum). Formula milk contains higher Zn concentrations to compensate for nutrient losses during production and storage, and lower bioavailability compared with human milk, which is further decreased in case of high phytate content, such as in soy milk-based formulas. Zn supplements may prove useful in meeting the preterm infant’s needs, although caution is warranted regarding potential interactions with other nutrients within multinutrient supplements. Early detection of Zn deficiency is challenging due to the lack of reliable Zn status biomarkers, necessitating a high index of suspicion. Clinical signs of Zn deficiency can range from mild, nonspecific symptoms to severe, multisystem involvement. Chronic deficiency may lead to failure to thrive. Zn supplementation can support growth and mitigate comorbidities in preterm infants, although variability across studies complicates efforts to establish optimal dosing, and define safety and long-term effects. Although rare, Zn toxicity in preterm infants should not be overlooked, especially in infants on long-term parenteral nutrition. This narrative review aimed to consolidate existing knowledge and identify research gaps, highlighting the critical role of Zn in supporting preterm infants’ health. Further research is needed to establish evidence-based practices to improve health outcomes in this vulnerable population.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"15 12","pages":"Article 100295"},"PeriodicalIF":8.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wenhui Feng , Hailey Fromkin , J Becket Harney , Ryan Evans , Colin M Gerrity , Sean B Cash
{"title":"Perspective: Food Access at Dollar Stores and Its Implications for Public Health—Report of a Workshop on Identifying Research Priorities","authors":"Wenhui Feng , Hailey Fromkin , J Becket Harney , Ryan Evans , Colin M Gerrity , Sean B Cash","doi":"10.1016/j.advnut.2024.100319","DOIUrl":"10.1016/j.advnut.2024.100319","url":null,"abstract":"<div><div>The rapid growth of dollar stores as retail sources of food in the United States is a phenomenon with implications for diets, nutrition, and well-being. We convened a broadly interdisciplinary group of researchers and experts from government and academia at the 2-day Food Access at Dollar Stores (FADS) workshop, held in Boston, MA in 2022. The event brought together economists, social scientists, public health researchers, and advocates to discuss the concerns and research questions raised by the growth of dollar stores and their increased role in food retail and access. In-person, moderated discussions on day 2 of the workshop generated a range of topics considered important for future research. A subsequent survey, using a modified Delphi approach, identified priority research areas. Nine research area categories emerged as a result of discussion at the FADS workshop and received prioritization from the experts: Local community impacts; Health and nutrition impacts; Policy and programs; Systemic issues – racism, poverty, and food access; Store offerings and locations; Shoppers and customers; Employees and employment; Corporate distribution, strategy, and marketing; and Dollar stores compared with other food sources. The growth of dollar stores as food retailers remains an under-researched area of study for food access and nutrition that requires interdisciplinary expertise and collaboration to understand.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"15 12","pages":"Article 100319"},"PeriodicalIF":8.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tauseef A Khan , Sabrina Ayoub-Charette , John L Sievenpiper
{"title":"Non-nutritive Sweeteners and Health: Reconciling Evidence and Interrogating Guideline Disconnects","authors":"Tauseef A Khan , Sabrina Ayoub-Charette , John L Sievenpiper","doi":"10.1016/j.advnut.2024.100328","DOIUrl":"10.1016/j.advnut.2024.100328","url":null,"abstract":"","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"15 12","pages":"Article 100328"},"PeriodicalIF":8.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rethinking Zinc—Do We Need Catch-Up Evidence or Just Catch-Up Care?","authors":"Stephanie P Gilley, Nancy F Krebs","doi":"10.1016/j.advnut.2024.100320","DOIUrl":"10.1016/j.advnut.2024.100320","url":null,"abstract":"","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"15 12","pages":"Article 100320"},"PeriodicalIF":8.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}