Successful management of severe hypoglycemia induced by total parenteral nutrition in patients with hepatocellular injury: Three cases reports

BACKGROUND Glucose imbalance is common in total parenteral nutrition(TPN).Hypoglycemia seems to be less frequent than hyperglycemia,but it influences the clinical outcome to a greater extent.Therefore,it should be effectively prevented and treated.However,there is no relevant report on how to treat hypoglycemia caused by TPN in patients with liver cell injury.CASE SUMMARY We present three patients with liver cell injury who developed severe hypo-glycemia during or after TPN infusion.The causes of severe hypoglycemia and glucose-raising strategies were discussed.According to the physiological charac-teristics of the hepatocellular injury,the ratio of nutrition components prescribed in TPN was appropriately adjusted for the three cases.We simultaneously reduced the dose of insulin and fat emulsion,and increased the dose of glucose in TPN.The blood glucose level was restored to normal range and clinical symptoms were eliminated.CONCLUSION When hypoglycemia occurs during or after TPN in patients with hepatocellular injury,physicians need to simultaneously reduce insulin and fat emulsion,and increase glucose,and correct severe hypoglycemia in time to reduce its adverse consequences.

Evaluation of the Application Effect of Enteral and Parenteral Nutrition Therapy Combined with a Health Belief Education Model in Patients with Inflammatory Bowel Disease

Objective:To evaluate the application effect of enteral and parenteral nutrition therapy combined with a health belief education model in patients with inflammatory bowel disease.Methods:80 patients with inflammatory bowel disease admitted to the Shanghai Zhangjiang Institute of Medical Innovation were chosen.This study was carried out from August 2022 to October 2023.The patients were randomly divided into a study group(40 cases)and a control group(40 cases).The treatment plan for the control group was the conventional treatment model,while the treatment plan for the study group was to provide enteral and parenteral nutrition therapy combined with a health belief education model based on the control group.The efficacy of both groups was compared.Results:In the study group,the therapeutic effect for 31 patients(77.50%)was markedly effective and 7 was effective(17.50%),accounting for 95.0%of the total,which was higher than the control group at 80.0%(P<0.05).The relief time of relevant symptoms in the study group was shorter than that of the control group(P<0.05).Before treatment,there were no differences in the high-sensitivity C-reactive protein(hs-CRP),interleukin 10(IL-10),and tumor necrosis factor-α(TNF-α)between both groups(P>0.05).After treatment,the levels of inflammatory factors in the study group(hs-CRP(8.02±1.13)mg/L,IL-10(9.24±1.25)pg/mL,and TNF-α(7.19±1.04)ng/L)were lower than those in the control group(P<0.05).Conclusion:Enteral and parenteral nutritional therapy combined with a health belief education model showed significant efficacy in inflammatory bowel disease patients.Patient symptoms were relieved and inflammatory reactions were reduced.This method is worthy of popularization.

Nutrition impacts of non-solid cooking fuel adoption on under-five children in developing countries

This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demographic and Health Surveys(DHS).Results from both fixed effects(FE)and instrumental variable(IV)estimates show that using non-solid cooking fuel significantly improves the nutrition outcomes of under-five children.Compared with their peers from households mainly using solid fuel,children from households mainly using non-solid fuel exhibit a lower probability of experiencing stunting(by 5.9 percentage points)and being underweight(by 1.2 percentage points).Our further investigation provides evidence for several underlying mechanisms,such as improved indoor air quality,induced reduction in children’s respiratory symptoms,benefits on maternal health,and reduction in maternal time spent on fuel collection or cooking.Heterogenous analyses suggest that the nutrition benefits of using non-solid cooking fuel are more prominent among boys,children above three years old,and those from households of lower socioeconomic status,rural areas,and Southeast Asia.

The impact of the Rural Minimum Living Standard Guarantee(Rural Dibao)Program on child nutrition outcomes

The Rural Minimum Living Standard Guarantee(Rural Dibao)is an important unconditional cash transfer program to alleviate poverty in rural China.Despite the importance of children’s nutrition in breaking poverty cycles,little is known about the impact of Rural Dibao on child nutrition outcomes.Using China Family Panel Studies(CFPS),this paper examines the effects of Rural Dibao on child nutrition outcomes and investigates potential pathways and heterogeneous effects.We exploit propensity score matching and difference-in-differences techniques to evaluate the effects of the Rural Dibao program on child nutrition outcomes.Our results suggest that Rural Dibao significantly impacts the nutrition outcomes of children up to 15 years of age.Specifically,our results suggest that Rural Dibao improves child height-to-age z-scores by 1.05 standard deviations and lowers the probability of stunting by 11.9 percentage points.Additional analyses suggest that increased protein intake is the main pathway through which Rural Dibao participation contributes to better nutrition outcomes.We also find that the effect of the program is more pronounced among girls,children who are non-left-behind or live with highly educated mothers,and those from low-income families and poor areas.Our findings suggest that Rural Dibao participation helps improve child nutrition outcomes through improving diet quality.

Nutritional Assessment Tools for Patients with Cancer:A Narrative Review

Cancer patients are at high risk of malnutrition,which can lead to adverse health outcomes such as prolonged hospitalization,increased complications,and increased mortality.Accurate and timely nutritional assessment plays a critical role in effectively managing malnutrition in these patients.However,while many tools exist to assess malnutrition,there is no universally accepted standard.Although different tools have their own strengths and limitations,there is a lack of narrative reviews on nutritional assessment tools for cancer patients.To address this knowledge gap,we conducted a non-systematic literature search using PubMed,Embase,Web of Science,and the Cochrane Library from their inception until May 2023.A total of 90 studies met our selection criteria and were included in our narrative review.We evaluated the applications,strengths,and limitations of 4 commonly used nutritional assessment tools for cancer patients:the Subjective Global Assessment(SGA),Patient-Generated Subjective Global Assessment(PG-SGA),Mini Nutritional Assessment(MNA),and Global Leadership Initiative on Malnutrition(GLIM).Our findings revealed that malnutrition was associated with adverse health outcomes.Each of these 4 tools has its applications,strengths,and limitations.Our findings provide medical staff with a foundation for choosing the optimal tool to rapidly and accurately assess malnutrition in cancer patients.It is essential for medical staff to be familiar with these common tools to ensure effective nutritional management of cancer patients.

Assessement of Nutritional Status of Households Using Weighed Food Intake in North West Region of Cameroon

This study determined the nutritional status of households in North western region of Cameroon using weighed food intake. Twenty–two rural and 106 urban households were randomly selected for weighed food intake Descriptive and inferential statistics were used to analyze collected data and significance at p < 0.05 accepted. Corn fufu with huckleberry was the most frequently consumed meal with little or no animal-source protein. Protein and B group vitamins intake of respondents in both communities were below the FAO/WHO recommended values while energy, iron, and vitamins A and C were in excess for most age groups. Adolescents 10 - 19 years and adults 20 years and above failed to meet at least 85% of RNI for calcium.

Nutrition Awareness and Knowledge and Body Mass Index in Adolescents in Public Junior Secondary Schools

Background: Non-communicable diseases are increasing among adolescents. The decision about diet is the foundation of eating habits that could persist to adulthood. Dietary decisions, which usually are hard to change later in life, make nutrition education at school paramount to prevent obesity and NCDs, and promote healthy eating. Objectives: To assess level of nutrition awareness and knowledge of healthy eating and food intake behaviors and association with Body Mass Index (BMI) and age. Methods: A cross sectional study that included measures such as age, gender, socioeconomic status, BMI, and nutrition knowledge was conducted in 264 respondents from 18th June 2015 to 9th July 2015. The nutrition knowledge questionnaire was composed of 24 questions divided into food nutrients, food contents, healthiest foods, and energy expenditure and nutrition benefits. CDC BMI chart for 2-20-year-olds was used to plot respondent’s weight and height. Results: The mean age of the respondents was 14.3 years (SD 0.79). Most of the respondents (153/252, 53.6%) had a low socio-economic status as categorized by the present study. The mean (SD) BMI was 20.08 (3.90). Most respondents (56.3%, 142/252) failed the knowledge test and scored below 50% and only two respondents (0.8%) had excellent nutrition knowledge. The mean percentage achieved was 46.1% (SD 15.91) ranging from 8.3% to 87.5%. There was a significant correlation between nutrition knowledge and BMI (p = 0.001). Conclusion: The study shows that adolescents do not have adequate nutrition knowledge, placing them at risk for developing non-communicable diseases later in life. Nutrition education programs are urgently needed for teachers, parents, and children.

Relationship between nutritional therapy and beneficial bacteria ratio in severe disease

Objective:To evaluate relationship between changes in the beneficial bacteria in intensive care unit(ICU)patients and nutritional therapy type.Methods:Ten patients aged≥18 years admitted to the ICU between January and December 2020,were included.Good enteral nutrition was defined as early achievement of target calorie intake through enteral feeding.The ratio of beneficial bacteria at the first and second bowel movements after each patient’s admission was calculated and the patients were classified into the increase or decrease group.Among all patients,five each were in the increase and decrease groups.We investigated patient background,changes in sequential organ failure assessment(SOFA)and acute physiology and chronic health evaluation(APACHE)Ⅱscores,nutritional doses or methods,and clinical outcomes.Results:No relationship was found between changes in the ratio of beneficial bacteria and changes in SOFA/APACHEⅡscores at the time of admission.The rate of good enteral nutrition was significantly higher in the increase group than in the decrease group(4/5 vs.0/5,P=0.01).Conclusions:An increase in beneficial bacteria may be significantly related to the early establishment of enteral nutrition.In the future,accumulating cases may make it possible to establish a new nutritional strategy for critically ill patients from an intestinal microbiota perspective.

Transforming agri-food systems for multiple wins in nutrition,inclusion and environment

The call for agri-food system transformation is urgent in many global development agendas(UN 2023).Food systems have contributed to economic prosperity and feeding the world,but they are also associated with numerous challenges,including climate change,continued hunger,poor diets and malnutrition,and increasing disparities(Webb et al.2020;Fanzo et al.2021).

Nutritional Screening Tools in Institutionalized People: A Case Study of Using Nutritional Risk Screening (NRS 2002) and Mini Nutritional Assessment (MNA)

Nutritional status expresses the physiological and nutritional needs to maintain the composition and adequate functioning of the organism. NRS 2002 and MNA protocols were applied to short-term institutionalized patients in Rio Verde (Brazil). Older adults and people with special needs of all ages, both sexes, regardless of possible pathology they may have, except if it causes contagion, were included, patients duly authorized by the person responsible for the institution and who were able to undergo evaluation. Thirty-eight patients from the institution were evaluated, of which ten were excluded from the research according to pre-established criteria. More than 50% of participants were male, with an overall average age of 63.43 years. The characteristics related to nutritional status by NRS 2002 and MNA showed that the risk of malnutrition and its absence are associated with a wide age range. The MNA presents a more nuanced nutritional risk classification, showing that even 61% of the 96% of participants who would be out of nutrition risk, according to the NRS 2002, are “at risk of malnutrition”. Applying the MNA can demonstrate more conservative results than the NRS 2002.

The Use of Secondary Grape Biomass in Beef Cattle Nutrition on Carcass Characteristics, Quality and Shelf Life of Meat

We determined whether the inclusion of 100 g/kg dry matter of grape pomace silage (GPS) and grape pomace bran (GPB) as substitutes for other traditional fiber sources in the diet of steers (Charolais x Nellore) would improve carcass characteristics, meat quality and composition, and shelf life. Twenty-four animals (248 ± 19.32 kg of initial body weight) were fed a high concentrate diet for 121 days. Carcass characteristics were measured, and the longissimus dorsi muscle was analyzed for fatty acid (FA) profile and composition. The meat was sliced and stored in air-permeable packages for 10 days. On each sampling day (d 1, 3, 7, and 10), oxidative stability, bacterial load, lipid and protein oxidation, and staining were analyzed. The experimental diets influenced the pH of cold carcasses only. The GPS group had a higher pH than the control. The GPS and GPB groups showed improved oxidant status (i.e., lower lipid peroxidation and concentrations of reactive oxygen species were in the meat of both groups than in control). On the first day of storage, the antioxidant enzyme glutathione S-transferase activity was more significant in the meat of the GPS and GPB groups than in the control. The bacterial loads in the meat were attenuated by GPS inclusion;there were lower total coliform counts and a trend toward lower counts for enterobacteria in the control group. The diets altered the FA profile of the meat;i.e., the GPB diet allowed for a more significant amount of the n-6 omegas in the meat, while the GPS diet showed a tendency for a more significant amount of n-6 and 9 omegas. Both diets (GPS and GPB) increased the amounts of long-chain FAs. The GPS diet decreased saturated FA levels. We conclude that the dietary treatments GPS and GPB are a promising alternative to maintain meat quality standards throughout in real-world retail conditions. These treatments gave rise to an improvement in the nutritional value of the meat due to the more significant amounts of FAs that improve human health.

Effect of Biostimulants Based on Natural Products on the Growth and Nutritional Value of Bean (Phaseolus vulgaris L.)

Beans (Phaseolus vulgaris L.) are widely grown in Cameroon and play a key role in the fight against food insecurity, malnutrition and poverty. However, its cultivation encounters problems due to abiotic and biotic stresses, which leads to the use of synthetic fertilizers and pesticides, which cause significant damage to the environment and human health due to the presence of synthetics residues in the seeds, pods and in the leaves that are eaten. Promoting the use of natural products is becoming a necessity for organic and eco-responsible agriculture that limits contamination problems and improves people’s purchasing power. This study aims to assess the effect of biostimulants based on natural products on the growth and nutritional value of common bean (Phaseolus vulgaris L.). Bean seedlings from white variety (MEX-142) and red variety (DOR-701) were treated every seven days in the field from their pre-emergence, emergence and growth to their maturation under a randomized block experimental design. Six treatments and three repetitions with the biostimulants based on natural products and controls were thus performed and the agromorphological parameters were measured. After 120 days, the contents of growth biomarkers and defense-related enzymes were evaluated in leaves, while the contents of macromolecules, minerals and antinutrients were evaluated in seeds. These biostimulants significantly increased (P P < 0.0001) of antinutrients including oxalates, phytates, tannins and saponins in seeds compared to controls (T+ and T−). Treatment with biostimulants, in particular BS4, improves the performance of bean plants in the field as well as the biofortification of seeds regardless of the variety.

Physico-Chemical and Nutritional Properties of a Food Broth Based on Nere (Parkia biglobosa)

Purpose: Diet and eating habits are major risk factors for the health and the development of disease, such as, for example, metabolic disorder leading to cardiovascular pathology and cancer, decreased immunity exposing to infections. This study of the physico-chemical and nutritional properties of a soumara-based food broth was carried out with the aim of promoting the consumption of organic broth made from nere seeds (soumara). That is to alleviate certain metabolic diseases, which is a matter of food safety, and also to limit the risk for the health about the consumption of some cooking stocks on the market. Methods: Several natural ingredients such as nere seeds (soumara), ginger, black pepper, parsley and garlic were used to create a nere-based stock. All these ingredients were freeze-dried and the powder obtained was used to make the broth, regarding their physical and chemical properties. Results: The broth had a good protein content of 17.41 ± 0.367 g/100g, a lipid content of 16.80 ± 0.08 g/100g and a fiber content of 8.66 ± 0.04 g/100g. In terms of nutritional values, the broth showed good levels of calcium 184.21 ± 0.09 mg/100g, potassium 50.04 ± 1.45 mg/100g and iron and zinc. In terms of antioxidant activity, the broth also showed good antioxidant activity. Conclusion: Regarding the properties of our food broth, whose composition is based on natural ingredients, could be recommended for consumption and, its properties, could play an important role in preventing and combating certain metabolic diseases.

Optimizing nutrition in hepatic cirrhosis:A comprehensive assessment and care approach

Cirrhosis is considered a growing cause of morbidity and mortality,which represents a significant public health problem.Currently,there is no effective treatment to reverse cirrhosis.Treatment primarily centers on addressing the underlying liver condition,monitoring,and managing portal hypertension-related complications,and evaluating the potential for liver transplantation in cases of decompensated cirrhosis,marked by rapid progression and the emer-gence of complications like variceal bleeding,hepatic encephalopathy,ascites,malnutrition,and more.Malnutrition,a prevalent complication across all disease stages,is often underdiagnosed in cirrhosis due to the complexities of nutritional assessment in patients with fluid retention and/or obesity,despite its crucial impact on prognosis.Increasing emphasis has been placed on the collaboration of nutritionists within hepatology and Liver transplant teams to deliver compre-hensive care,a practice that has shown to improve outcomes.This review covers appropriate screening and assessment methods for evaluating the nutritional status of this population,diagnostic approaches for malnutrition,and context-specific nutrition treatments.It also discusses evidence-based recommendations for supplementation and physical exercise,both essential elements of the standard care provided to cirrhotic patients.

Learning about good nutrition with the 5-color front-of-package label"Nutri-Score":an experimental study

The Nutri-Score is a 5-color front-of-pack nutrition label designed to provide consumers with an easily understandable guideline to the healthiness of food products.The impact that the Nutri-Score may have on consumers'choices is unclear since different experimental paradigms have found vastly different effect sizes.In the present study,we have investigated how student participants change a hypothetical personal 1-daydietary plan after a learning phase during which they learn about the Nutri-Scores of the available food items.Participants were instructed to compose a healthy diet plan in order that the question of whether the NutriScore would improve their ability to compose a healthy dietary plan could be investigated,independent of the question of whether they would apply this knowledge in their ordinary lives.We found a substantial(Cohen's d=0.86)positive impact on nutritional quality(as measured by the Nutrient Profiling System score of the Food Standards Agency)and a medium-sized(Cohen's d=0.43)reduction of energy content.Energy content reduction was larger for participants who had initially composed plans with higher energy content.The results suggest that the Nutri-Score has the potential to guide consumers to healthier food choices.It remains unclear,however,whether this potential will be reflected in real-life dietary choices.

Comparison of different preoperative objective nutritional indices for evaluating 30-d mortality and complications after liver transplantation

BACKGROUND The nutritional status is closely related to the prognosis of liver transplant re-cipients,but few studies have reported the role of preoperative objective nutri-tional indices in predicting liver transplant outcomes.AIM To compare the predictive value of various preoperative objective nutritional indicators for determining 30-d mortality and complications following liver transplantation(LT).METHODS A retrospective analysis was conducted on 162 recipients who underwent LT at our institution from December 2019 to June 2022.RESULTS This study identified several independent risk factors associated with 30-d mor-tality,including blood loss,the prognostic nutritional index(PNI),the nutritional risk index(NRI),and the control nutritional status.The 30-d mortality rate was 8.6%.Blood loss,the NRI,and the PNI were found to be independent risk factors for the occurrence of severe postoperative complications.The NRI achieved the highest prediction values for 30-d mortality[area under the curve(AUC)=0.861,P<0.001]and severe complications(AUC=0.643,P=0.011).Compared to those in the high NRI group,the low patients in the NRI group had lower preoperative body mass index and prealbumin and albumin levels,as well as higher alanine aminotransferase and total bilirubin levels,Model for End-stage Liver Disease scores and prothrombin time(P<0.05).Furthermore,the group with a low NRI exhibited significantly greater incidences of intraabdominal bleeding,primary graft nonfunction,and mortality.CONCLUSION The NRI has good predictive value for 30-d mortality and severe complications following LT.The NRI could be an effective tool for transplant surgeons to evaluate perioperative nutritional risk and develop relevant nutritional therapy.

The multiple roles of crop structural change in productivity,nutrition and environment in China:A decomposition analysis

China's crop structure has undergone significant changes in the last two decades since 2000,with an increase in the share of cereals,vegetables,and fruit,squeezing out other crops.As a result,land productivity,nutrient supply,and carbon emissions have changed.How to reallocate limited farmland among crops to achieve the multiple goals of agrifood systems becomes an important issue.This study explores the sources of land productivity and nutrition supply growth and carbon emissions reduction,and identifies the multiple roles of crop structural change from 2003 to 2020 based on a decomposition analysis.The results reveal that the growth within crops is still the primary driver in land productivity and nutrition supply and the reduction in carbon emissions.However,structural change also plays various roles at different periods.From 2003 to 2010,crop structural change increased the total calorie supply but lowered land productivity and contributed at least 70%of the total growth of carbon emissions.The crop structure was relatively stable,and their effects were modest from 2010 to 2015.From 2015 to 2020,the crop structural change began to play a greater role and generate synergistic effects in improving land productivity,micronutrient supply,and reducing carbon emissions,contributing to approximately a quarter of the growth of land productivity and 30%of total carbon emissions reduction.These results suggest that strategies for crop structural change should comprehensively consider its multiple impacts,aiming to achieve co-benefits while minimizing trade-offs.

Accurate models and nutritional strategies for specific oxidative stress factors: Does the dose matter in swine production?

Oxidative stress has been associated with a number of physiological problems in swine,including reduced production efficiency.Recently,although there has been increased research into regulatory mechanisms and antioxidant strategies in relation to oxidative stress-induced pig production,it remains so far largely unsuccessful to develop accurate models and nutritional strategies for specific oxidative stress factors.Here,we discuss the dose and dose intensity of the causes of oxidative stress involving physiological,environmental and dietary factors,recent research models and the antioxidant strategies to provide theoretical guidance for future oxidative stress research in swine.

A cross-sectional study to assess medication safety,knowledge,attitude,and practices regarding nutrition and medication among pregnant women

Objective:To assess pregnant women's knowledge,attitude,and practice regarding nutrition and medication usage,analyse the prescribing pattern,and categorize them based on the Food and Drug Administration(FDA)guidelines.Methods:A cross-sectional study was conducted with 264 pregnant women in the obstetrics and gynaecology department of a tertiary care hospital from October 2022 to August 2023.A knowledge,attitude,and practice(KAP)questionnaire was prepared in English language by the researchers and validated by an expert panel consisting of 12 members.The validated questionnaire was then translated into regional languages,Kannada and Malayalam.The reliability of the questionnaire was assessed with test-retest method with a representative sample population of 30 subjects(10 subjects for each language).The subjects'knowledge,attitude,and practice were evaluated using the validated KAP questionnaire.The safety of the medication was assessed using the FDA drug safety classification for pregnancy.Results:The mean scores for nutritional and medication usage knowledge,attitude,and practice were 4.14±1.15,4.50±1.09,and 3.00±1.47,respectively.Among 30 prescribed medications,3 belong to category A(no risk in human studies),8 belong to category B(no risk in animal studies),18 belong to category C(risk cannot be ruled out)and 1 drug is not classified.A significant association was observed between medication knowledge and practice(r=0.159,P=0.010).Conclusions:Most of the study population knows the need to maintain good dietary and medication practices during pregnancy.Counselling pregnant women regarding diet and medication usage is crucial in maternal care.

Mapping global research trends: Nutrition associations with nonalcoholic fatty liver disease - a Scopus bibliometric analysis

BACKGROUND Several bibliometric analyses have been carried out to identify research hotspots and trends in nonalcoholic fatty liver disease(NAFLD)research.Nonetheless,there are still significant knowledge gaps that must be filled to advance our understanding of and ability to treat NAFLD.AIM To evaluate,through bibliometric and visual analysis,the current status of related research,related research frontiers,and the developmental trends in the field of diet and NAFLD.METHODS We retrieved publications about diet and NAFLD published between 1987 and 2022 from Scopus.Next,we used VOSviewer 1.6.20 to perform bibliometric analysis and visualization.RESULTS We found a total of 1905 studies,including 1637(85.93%)original articles and 195(10.24%)reviews,focused on the examination of NAFLD and its correlation with diet that were published between 1987 and 2022.Among the remaining five types of documents,38 were letters,notes,editorials,meeting minutes,or brief surveys,representing 1.99%of the total documents.The countries with the most publications on this topic were China(n=539;28.29%),followed by the United States(n=379;19.90%),Japan(n=133;6.98%),and South Korea(n=127;6.6%).According to the citation analysis,the retrieved papers were cited an average of 32.3 times and had an h-index of 106,with 61014 total citations.The two main clusters on the map included those related to:(1)Inflammation and oxidative stress;and(2)Dietary interventions for NAFLD.CONCLUSION This was the first study to use data taken from Scopus to visualize network mapping in a novel bibliometric analysis of studies focused on diet and NAFLD.After 2017,the two domains that received the most attention were“dietary interventions for NAFL”’and“‘inflammation and oxidative stress implicated in NAFLD and its correlation with diet.”We believe that this study provides important information for academics,dietitians,and doctors,and that additional research on dietary interventions and NAFLD is warranted.