To provide a snapshot of the current use of oral nutritional supplements, its association with inpatient characteristics, and with a focus on the role of nursing monitoring of food intake and ...implementing nutritional interventions for patients with low intake.
Retrospective cohort study.
The study collected data from a hospital database regarding oral nutritional supplement initiation and variables of patients hospitalised in internal medicine departments, who did not receive enteral or parenteral nutrition.
Of the 5155 admissions, 1087 fulfilled the inclusion criteria (47% female; mean age, 72.4 ± 14.6 years; mean length of stay, 14.6 ± 11.4 days). Sufficient food intake reporting was noted in 74.6% of the patients; of these 17% had decreased intake. Oral nutritional supplements and non-oral nutritional supplements groups did not differ in terms of sex, age, length of stay, Charlson Comorbidity Index, proportion of nursing reports, and absence of intake monitoring. Oral nutritional supplements were initiated in 31.9% of patients with a Malnutrition Universal Screening Tool score ≥2 and in 34.6% with decreased food intake. On multivariable analysis, hypoalbuminemia (adjusted odds ratio, 3.70), decreased food intake (adjusted odds ratio, 3.38), Malnutrition Universal Screening Tool score ≥2 (adjusted odds ratio, 2.10), and age <70 years (adjusted odds ratio, 1.56) were significantly associated with oral nutritional supplements use.
The prevalence of oral nutritional intervention was suboptimal in patients at risk of malnutrition during acute hospitalisation, although decreased food intake and Malnutrition Universal Screening Tool score ≥2 independently increased the probability of oral nutritional supplements initiation.
Understanding the clinical practice and nursing impact of care management in relation to nutritional intervention can assist in reviewing and improving patient care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE IMPACT (ADDRESSING): This study informs clinical management and influences nursing practice standards related to assessing, monitoring, and managing malnutrition risk.
The study impacts the quality of care for patients at risk of malnutrition.
We adhered to the STROBE Checklist for cohort studies.
No Patient or Public Contribution.
Low muscle strength is strongly tied to poor nutrition status, and nutritional interventions are likewise linked to maintenance and restoration of muscle strength and functional status. Nutrition ...plays a vital role in muscle mass, strength, and function, and losses in muscle (strength, function, and mass) are associated with poor health outcomes and added costs for healthcare services. For this study of outpatients, the main objective was to identify those at risk for low muscle strength, as evidenced by low handgrip strength (HGS) measures with risk stratified by age and sex.
This was a two-part study on HGS measures in adults attending outpatient clinics in India. In part one, we conducted HGS tests on dominant and non-dominant hands of patients who qualified for the study. For HGS measures, we used a validated tool, the SQUEGG device, a smart handgrip trainer, along with its companion Bluetooth-connected app, the Muscle Strength Assessment Tool (MSAT) app. In part two, we collected Healthcare Practitioners' (HCPs) feedback via a short digital survey on the use of the SQUEGG device + the MSAT app to do HGS risk screening as an indicator of needed nutritional intervention.
Nearly a third of community-living adults in India exhibited low HGS among the 3036 sampled. At each age stratum, dominant-hand HGS in women was lower by 25%–35% compared to men. Among 353 HCPs, 293 (83%) provided insights via survey, and 85% of surveyed HCPs (n = 249) strongly agreed or agreed that the SQUEGG device + MSAT app helped them identify HGS issues among their patients, and 85% (n = 248) agreed or strongly agreed they would like to continue using the SQUEGG device + MSAT app to inform their practice. Nearly all surveyed HCPs (98%, n = 288) recommended an oral nutritional supplement (ONS) to their patients with identified low HGS.
Our findings demonstrate that HCPs would like to continue use of the SQUEGG device + MSAT app as it helped them identify adult patients who had decreased HGS (about 30% of the study population), in turn identifying opportunities to use nutritional interventions such as ONS to address nutrition shortfalls and to restore functional status.
The Healthcare Nutrition Council (HNC) represents manufacturers of enteral nutrition formulas and oral nutrition supplements, including those categorized as medical foods and parenteral nutrition. ...HNC member companies, Abbott’s Nutrition Division, Nestlé Health Science, and Nutricia North America, a subsidiary of Danone S.A., manufacture a majority of the medical foods consumed in the United States. HNC is proposing a modernized interpretation of the medical food framework to reflect the evolution of nutrition science and health care. The medical food category was first defined in 1988 as part of the Orphan Drug Act. Since then, the scientific community's understanding of nutrition and the role it can play in disease management has progressed. HNC believes that a patient-centric approach is needed to foster research and innovation and to position medical foods as a viable solution in the dietary management of disease. HNC proposes that distinctive nutritional requirements refer to the clinical need for a specific nutritional intake (compared with the intake of healthy populations), which may exist by reason of abnormal physiologic manifestation or physical impairment associated with a disease or condition. The dietary management of these diseases and conditions results in clinically meaningful improvements, including but not limited to nutritional status, health outcomes, or quality of life. HNC believes that abnormal physiologic manifestation or physical impairment would include a limited, impaired, or disturbed capacity to ingest, digest, absorb, metabolize, or excrete ordinary food or certain nutrients or metabolites or other medically determined requirements for nutrients or other food substances of biological value. HNC recommends our position be considered as we build consensus across the industry. We request that the Food and Drug Administration modify and codify the current definition to reflect this. Patients and the health care system will benefit from a strong regulatory interpretation of the medical foods framework.
Cross Country is a modality of mountain bike cycling (MTB), whose competitions are characterized by giving a certain number of laps to a circuit with a distance from 6-9km to 40-200km. In these ...events, it is important to plan a dietetic-nutritional strategy to mitigate the appearance of nutrition-related adverse outcomes. The purpose of the study was to plan the dietetic-nutritional planning of a MTB cyclist who competes in a Cross Country competition. The cyclist is a 27-year-old male (VO2max=74.46 ml•kg-1•min-1; MAP=420W; height=1.81m; weight=78.6kg; % fat mass=9.47; sum of 8 skinfolds=61.9mm) with 3 years of experience in training and competing in MTB events at a regional level. The intervention took place in the Alinua cabinet of the University of Alicante, whose purpose was to improve the body composition and to elaborate a dietetic-nutritional program to dispute a MTB race on 23-2-2020 in the province of Alicante. The intervention included the recommendations for endurance athletes and was divided into a preparation period, a period of 3 weeks before the race and a competitive period. Finally, the participant successfully completed the race according to the planning and did not manifest any problems. For a cyclist, facing an event of these characteristics successfully requires theoretical-practical advice and dietary-nutritional programming in an individualized way that tries to contribute at a nutritional level before, during and after physical exercise, as well as to reduce the possible appearance of setbacks that may jeopardize performance and health.
El cross country es una modalidad del ciclismo de mountain bike (MTB), cuyas competiciones se caracterizan por dar un determinado número de vueltas a un circuito con una distancia desde 6-9km hasta 40-200km. En estos eventos, es importante planificar una estrategia dietético-nutricional para mitigar la aparición de resultados adversos relacionados con la nutrición. El objetivo de este estudio fue realizar la planificación dietético-nutricional de un ciclista de MTB que disputa una competición de cross country. El ciclista es un varón de 27 años (VO2max=74.46 ml•kg-1•min-1; PAM=420W; altura=1.81m; peso=78.6kg; % masa grasa=9.47, sumatorio de pliegues=61.9mm) con 3 años de experiencia en el entrenamiento y competición de pruebas MTB a nivel regional. La intervención tuvo lugar en el gabinete Alinua de la Universidad de Alicante, cuya finalidad fue mejorar la composición corporal y elaborar una programación dietético-nutricional para disputar una carrera de MTB el 23-2-2020 en la provincia de Alicante. La intervención incluía las recomendaciones para deportistas de resistencia y se dividió en un periodo de preparación, periodo de 3 semanas previas a la carrera y periodo competitivo. El participante realizó satisfactoriamente la prueba, se adhirió a la planificación, y no manifestó ningún problema. Para un ciclista, afrontar un evento de estas características con éxito requiere de un asesoramiento teórico-práctico y una programación dietético-nutricional de manera individualizada que trate de contribuir nutricionalmente antes, durante y después de la práctica del ejercicio, así como aminorar la posible aparición de contratiempos que puedan poner en riesgo el rendimiento y la salud.
The safety and potential benefits of home enteral route nutrition (HERN), referring specifically to home enteral nutrition (HEN) and oral nutritional supplements (ONS) in this article, after upper ...gastrointestinal (GI) resection are inconsistent.
To evaluate the impact of HERN on nutritional status, complications, and quality of life (QOL) after upper GI resection.
This systematic review was conducted in accordance with the PRISMA statement. Nine databases were searched from inception to October 2019. Randomized controlled trials (RCTs) comparing the impact of HERN after upper gastrointestinal resection were included. Relative risk/weighted mean difference/standardized mean difference (RR/WMD/SMD) and corresponding 95% confidence intervals (95% CI) were calculated using fixed- or random-effects models.
Overall, 15 RCTs involving 1059 patients were included. Compared with normal oral diet, HERN significantly prevented weight loss (−3.95 vs −5.82 kg; SMD: 1.98 kg; 95% CI: 1.24–2.73); improved added-level of albumin (3.48 vs 2.41 g/L; SMD: 1.36 g/L; 95% CI: 0.81–1.91), hemoglobin (6.54 vs −1.29 g/L; WMD: 7.45 g/L; 95% CI: 5.05–9.86), pre-albumin (37.59 vs 7.35 mg/L; WMD: 21.6 mg/L; 95% CI: 5.96–37.24), and transferrin (63.08 vs 50.45 mg/L; WMD: 16.44 mg/L; 95% CI: 13.51–19.38); and reduced the incidence of malnutrition or latent malnutrition (RR = 0.54; P < 0.01). Subgroup analysis based on the approach of HERN showed that weight loss in the HEN subgroup was significantly lower than that of the control group (WMD = 2.69, P < 0.01), while there was no significant difference between the ONS subgroup and the control group (P = 0.1). The same results were found in albumin. Physical function (WMD: 5.29; 95% CI: 1.86–8.73) and fatigue (WMD: −8.59; 95% CI: −12.61, −4.58) dimensions in QOL were significantly better in the HERN group. No significant differences in gastrointestinal and tube-related complications.
HERN improved nutritional status and some dimensions of QOL in upper GI malignancy patients after surgery, without increasing complications. Subgroup analysis showed that HEN experienced more benefits than ONS.
Proper nutrition to optimise immune function is mandatory as at present there is no specific medicine to cure COVID-19. Our study aimed to investigate the use of nutritional supplements and their key ...immunity enhancing components among Sri Lankans.
This current study was an online survey conducted during the period from 27th May to 2nd June 2021 disseminated via various social media platforms. Details were collected on highlighting the frequency and composition of nutritional supplements consumed.
In a total of 3707 responders, a proportion of 25.5% (944) of the participants took supplements regularly, and 32.6% (1210), 14.5% (538), 27.4% (1015) intake were occasionally, rarely and never respectively. Older participants (>40 years of age) had a significantly higher intake of supplements than the younger counterpart of 31–35 years age group (OR: 0.604; 95% CI, 0.451–0.809; p < 0.001). Almost half (46.0%) took vitamin C supplements and females tend to take more (OR: 1.325; 95% CI, 1.120–1.567; p < 0.001) of vitamin C when compared to males. Comparatively to the other groups regarding monthly income, the participants with the highest income category are more likely to take vitamin D (OR:1.899; 95% CI, 1.034–3.490; p = 0.039) and multivitamin (OR: 3.222; 95% CI, 1.737–5.977; p < 0.001). The most commonly used main ingredient in home-made remedy was coriander in Sri Lanka.
The use of nutritional supplements and natural products to improve immunity during the pandemic were frequent among Sri Lankan adults. In general, older, female gender and high income was significantly associated with increased intake of the nutrient supplements.
Lipoic acid (LA) has been an antioxidant with proven benefits in different species of productive interest. However, there is evidence of the effect of LA as a growth repressor and, consequently, of ...zootechnical performance. This study evaluated the effect of the co-administration of LA and short-chain fatty acid, sodium acetate (SA), as an additional source of energy on the utilization of yolk nutrients in Artemia sp. nauplii. A factorial experiment was designed with four levels of LA (0.0, 0.05, 0.5, and 5.0 μM) and four levels of SA (0.0, 2.0, 4.0, and 8.0 mM). Over 24 h, with sampling every 6 h, the total ammoniacal nitrogen (TAN) concentration in water, the concentration of protein, triglycerides, glucose, and the antioxidant capacity (ACAP) was evaluated in the artemia. The electron transporter system (ETS) activity and production of reactive oxygen species (ROS) in vivo were also recorded. Both LA and SA decreased TAN production. At 18 h, LA caused significant decreases in glucose content at the concentrations of 0.5 and 5.0 μM. On the other hand, SA preserved protein values in a dose-dependent manner at 12 h. Regarding ACAP, the LA showed ambivalent effects on this parameter, promoting a higher ACAP at 6 h; however, it promoted a more pro-oxidant state in the metanauplii at 24 h. While the ETS activity increased at 6 h, as an effect of the SA and LA administered separately, the co-administration of LA and SA revealed a possible antagonism that caused a decrease in the ETS activity by the action of LA. As for ROS, a decrease in production rates was found with the administration of LA, which was more noticeable at LA concentrations within the 0 and 2 mM levels of SA from 18 h onwards. Finally, the final energy content showed a scenario of the preservation of the energy reserves of artemia nauplii with the addition of SA. As expected, the LA negatively affected the energy content of the animals; however, the treatment with the highest energy content was the one that received 0.05 μM LA and 8.0 mM SA, suggesting the possibility of using these compounds together in order to compensate the side-effects of LA.
•Lipoic acid and sodium acetate can modify Artemia sp. yolk nutrient use via energy metabolism modulation.•Lipoic acid can deplete nutrients in Artemia sp. nauplii dose-dependently, promoting glucose use for energy, potentially sparing protein.•Sodium acetate may preserve Artemia sp. nutrition, possibly as an energy substrate and yolk nutrient catabolism inhibitor.•Lipoic acid and sodium acetate co-administration can synergistically preserve protein and energy in Artemia sp. nauplii.
Honey Bee Nutrition Tsuruda, Jennifer M.; Chakrabarti, Priyadarshini; Sagili, Ramesh R.
The Veterinary clinics of North America. Food animal practice,
November 2021, Volume:
37, Issue:
3
Journal Article
Peer reviewed
Open access
Optimal nutrition is crucial for honey bee colony growth and robust immune systems. Honey bee nutrition is complex and depends on the floral composition of the landscape. Foraging behavior of honey ...bees depends on both colony environment and external environment. There are significant gaps in knowledge regarding honey bee nutrition, and hence no optimal diet is available for honey bees, as there is for other livestock. In this review, we discuss (1) foraging behavior of honey bees, (2) nutritional needs, (3) nutritional supplements used by beekeepers, (4) probiotics, and (5) supplemental forage and efforts integrating floral diversity into cropping systems.
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