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Current Opinion in Clinical Nutrition and Metabolic Care

Annic Baumgartner, Katja Hoskin, Philipp Schuetz
PURPOSE OF REVIEW: Malnutrition before and during hematopoietic stem cell transplantation (HSCT) is an independent risk factor for mortality in patients undergoing hematopoietic stem cell transplantation. Yet, optimal use of nutritional support to improve outcomes remains controversial. Our aim was to do an up-to-date literature review regarding nutritional therapy in allogeneic HSCT, the neutropenic diet and the use of immunonutrients. RECENT FINDINGS: Several observational studies find malnutrition to be associated with poor outcome, increased complications and lower overall survival...
February 19, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Najate Achamrah, Agnès Ditisheim
PURPOSE OF REVIEW: Although not fully understood, the physiopathology of preeclampsia is thought to involve abnormal placentation, diffuse endothelial cell dysfunction and increased systemic inflammation. As micronutrients play a key role in placental endothelial function, oxidative stress and expression of angiogenic factors, periconceptional micronutrient supplementation has been proposed to reduce the risk of preeclampsia. However, recent studies reported conflicting results. RECENT FINDINGS: Calcium intake (>1 g/day) may reduce the risk of preeclampsia in women with low-calcium diet...
February 19, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Etienne Nel
PURPOSE OF REVIEW: Advances in our understanding of the treatment of severe acute malnutrition (SAM) in a resource-limited environment are needed to improve outcome. RECENT FINDINGS: Ready-to-use therapeutic foods (RUTFs) made from local products and with reduced milk content lower costs and may be effective in older children. None of the therapeutic foods used to treat severely malnourished children correct long chain polyunsaturated fatty acid deficiencies.Routine short-term antibiotic (amoxicillin) treatment, in the context of adequate healthcare supervision, does not improve the recovery rate...
February 15, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Kamilla G Eriksen, Sophie H Christensen, Mads V Lind, Kim F Michaelsen
PURPOSE OF REVIEW: This review highlights relevant studies published between 2015 and 2017 on human milk composition and the association with infant growth. RECENT FINDINGS: High-quality studies investigating how human milk composition is related to infant growth are sparse. Recent observational studies show that human milk concentrations of protein, fat, and carbohydrate likely have important influence on infant growth and body composition. Furthermore, some observational studies examining human milk oligosaccharides and hormone concentrations suggest functional relevance to infant growth...
February 15, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Martin Schwarzer
PURPOSE OF REVIEW: This review focuses on the recent discoveries about the impact of intestinal microbiota on mammalian host juvenile growth. RECENT FINDINGS: Intestinal microbiota is a powerful modulator of many facets of multicellular host's physiology. Recent results from human field studies and animal research have clearly shown that not only the nutrition, but also the intestinal microbiota impacts host postnatal growth kinetics. Absence of microbiome leads to stunted growth in mammalian gnotobiotic models and changes in the composition of the intestinal microbiota can impact the postnatal growth kinetics both positively and negatively under normal nutritional conditions as well as in undernutrition...
February 9, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Luise V Marino, Philippa C Thomas, Robert M Beattie
PURPOSE OF REVIEW: The development of nutritional screening tools has done much to raise the profile of nutrition and encourage healthcare practitioners to consider how to identify children at nutritional risk. However, the next challenge is to ensure nutritional screening accurately identifies those who have immediate and ongoing risk and therefore the potential to impact on it. RECENT FINDINGS: In this article, we review recent evidence which suggests that the large-scale use of these tools outside of a research setting is not always helpful...
February 9, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Luc Tappy
PURPOSE OF REVIEW: There is increasing concern that dietary fructose may contribute to the development of noncommunicable diseases. This review identifies major new findings related to fructose's physiological or adverse effects. RECENT FINDINGS: Fructose is mainly processed in splanchnic organs (gut, liver, kidneys) to glucose, lactate, and fatty acids, which can then be oxidized in extrasplanchnic organs and tissues. There is growing evidence that splanchnic lactate production, linked to extrasplanchnic lactate metabolism, represents a major fructose disposal pathway during and after exercise...
February 5, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Mariëlle P K J Engelen, Nicolaas E P Deutz
PURPOSE OF REVIEW: β-Hydroxy β-methylbutyrate (HMB) has been used for many years in athletes for muscle buildup and strength, and endurance enhancement. In recent years, its interest quickly expanded in older (diseased) populations and during (exercise) rehabilitation and recovery from hospitalization and surgery. We will discuss recent literature about HMB metabolism, its pharmacokinetics compared with the frequently used metabolite leucine, effectiveness of HMB to improve outcome in older diseased adults, and novel approaches for HMB use...
February 5, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Bernardo L Horta, Bruno A de Sousa, Christian L de Mola
PURPOSE OF REVIEW: Breastfeeding has clear short-term benefits for child survival. Concerning its long-term consequences, it has been reported that subjects who had been breastfed would have a better performance in intelligence tests. In this review, we perused the recently published studies on the association of breastfeeding with developmental outcomes. RECENT FINDINGS: A meta-analysis published in 2015 reported that intelligence quotient (IQ) was 3.44 points (95% confidence interval: 2...
January 30, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Stefano Schiaffino, Kenneth A Dyar, Elisa Calabria
PURPOSE OF REVIEW: The review is focused on the unexpected role of myogenic regulatory factor 4 (MRF4) in controlling muscle mass by repressing myocyte enhancer binding factor 2 (MEF2) activity in adult skeletal muscle, and on the emerging role of MEF2 in skeletal muscle growth. RECENT FINDINGS: The MRF4s of the MyoD family (MyoD, MYF5, MRF4, myogenin) and the MEF2 factors are known to play a major role in embryonic myogenesis. However, their function in adult muscle tissue is not known...
January 30, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Anne Jouinot, Clara Vazeille, François Goldwasser
PURPOSE OF REVIEW: Cachexia is a multifactorial syndrome associated with morbidity and mortality in cancer patients and represents a major challenge in cancer management. Elevated energy expenditure is supposed to contribute to cachexia. The current article presents the recent findings on the resting energy expenditure (REE) in cancer and the clinical implications for anticancer treatments. RECENT FINDINGS: Half of cancer patients present with hypermetabolism (measured REE >110% of predicted REE)...
January 23, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Mette M Berger, Najate Achamrah, Claude Pichard
PURPOSE OF REVIEW: Parenteral nutrition alone or as supplemental parenteral nutrition (SPN) has been shown to prevent negative cumulative energy balance, to improve protein delivery and, in some studies, to reduce infectious morbidity in ICU patients who fail to cover their needs with enteral nutrition alone. RECENT FINDINGS: The optimization of energy provision to an individualized energy target using either early parenteral nutrition or SPN within 3-4 days after admission has recently been reported to be a cost-saving strategy mediated by a reduction of infectious complications in selected intensive care patients...
January 19, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Marc Francaux, Louise Deldicque
PURPOSE OF REVIEW: To highlight recent evidence for the ability of polyphenols and their derivatives to reduce muscle wasting in different pathological states. RECENT FINDINGS: From January 2016 to August 2017, four articles dealt with the effects of polyphenols on muscle wasting, which were all carried out in mice. The four studies found that polyphenols reduced muscle mass loss associated with cancer cachexia, acute inflammation or sciatic nerve section. One study even showed that muscle mass was totally preserved when rutin was added to the diet of mice undergoing cancer cachexia...
January 19, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Elisabeth De Waele, Patrick M Honoré, Manu L N G Malbrain
PURPOSE OF REVIEW: To review the recent findings on metabolic monitoring and possible beneficial effects of an adequate nutrition therapy, based on indirect calorimetry as the golden standard to predict energy expenditure. RECENT FINDINGS: in the last decades, major steps are taken in the field of metabolism and nutrition, evolving from nutrition as a baseline support to a therapeutic intervention. The aspect of energy expenditure is of cardinal importance, and technical possibilities have impressively improved: from the first 'calorimetre' in 1789 to the new generation, clinical applicable indirect calorimeters and the high accuracy and easy use model reaching high technology readiness level [Oshima et al...
March 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Michele ApSimon
PURPOSE OF REVIEW: Intravenous lipid emulsions (IVLEs) are an essential component of parenteral nutrition. With the recent incorporation of new lipid emulsions into the Canadian and American market, the clinician responsible for prescribing these lipids should be educated regarding the different fatty acid (FA) profiles of these lipids, as well as their metabolic and functional effects. RECENT FINDINGS: New IVLEs contain a mix of soybean oil and olive oil, or a mix of soybean oil, coconut oil, olive oil and fish oil...
March 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Kenneth B Christopher
PURPOSE OF REVIEW: Disruption of metabolic homeostasis is universal in the critically ill. Macronutrients and micronutrients are major environmental regulators of metabolite production through their gene regulation effects. The study of large numbers of circulating metabolites is beginning to emerge through the comprehensive profiling of the critically ill. In the critically ill, metabolomic studies consistently show that changes in fatty acids, lipids and tryptophan metabolite pathways are common and are associated with disease state and outcomes...
March 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Stuart R Gray, Bettina Mittendorfer
PURPOSE OF REVIEW: Muscle mass and function decline progressively starting in middle age, which can result in sarcopenia and affect people's mobility and independence later in life. Exercise training and increased protein intake are typically recommended to counteract the age-associated decline in muscle mass and function. However, few people comply with exercise recommendations and the effectiveness of high-protein intake to halt the decline in muscle mass and function has not been proven...
March 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Danielle E Bear, Selina M Parry, Zudin A Puthucheary
PURPOSE OF REVIEW: Trials of physical rehabilitation post critical illness have yet to deliver improved health-related quality of life in critical illness survivors. Muscle mass and strength are lost rapidly in critical illness and a proportion of patients continue to do so resulting in increased mortality and functional disability. Addressing this issue is therefore fundamental for recovery from critical illness. RECENT FINDINGS: Altered mitochondrial function occurs in the critically ill and is likely to result in decreased adenosine tri-phosphate (ATP) production...
March 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Jayshil J Patel, Martin D Rosenthal, Daren K Heyland
PURPOSE OF REVIEW: Early enteral nutrition is recommended in critically ill adult patients. The optimal method of administering enteral nutrition remains unknown. Continuous enteral nutrition administration in critically ill patients remains the most common practice worldwide; however, its practice has recently been called into question in favor of intermittent enteral nutrition administration, where volume is infused multiple times per day. This review will outline the key differences between continuous and intermittent enteral nutrition, describe the metabolic responses to continuous and intermittent enteral nutrition administration and outline recent studies comparing continuous with intermittent enteral nutrition administration on outcomes in critically ill adults...
March 2018: Current Opinion in Clinical Nutrition and Metabolic Care
Simona Serini, Gabriella Calviello
PURPOSE OF REVIEW: Recently, concerns have been raised with regard to the recommended doses of marine long-chain omega-3 polyunsaturated fatty acids (LC-omega-3 PUFAs) especially in relation to cancer risk and treatment. There is urgent need to clarify this point. This review considers the most recent evidence related to the potential risk of developing cancer with high LC-omega-3 PUFA intakes, and possible research strategies to better elucidate this matter. RECENT FINDINGS: The latest published recommendations have still highlighted the usefulness of an increased dietary intake of LC-omega-3 PUFAs for the prevention of some cardiovascular diseases...
March 2018: Current Opinion in Clinical Nutrition and Metabolic Care
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