Glycemic Indices of Multiple Oral Nutritional Supplements: A Randomized Cross-Over Study in Indian Adults

Background: A randomized cross-over study was conducted to assess the glycemic index (GI) of seven Oral Nutritional Supplements (ONSs). These ONSs are designed to support the nutritional requirements of different age-groups, physiological states, or health conditions among Indian adults. Methods: The study had two phases viz., phase1 (n = 18) studied two ONSs: A1 and B1 and phase 2 (n = 20) studied five ONSs: A2, B2, C2, D2 & E2. The subjects were healthy, non-diabetic adults, aged between 20 - 44 years with a mean Body Mass Index of 21.2 ± 1.52 kg/m2 (Phase 1) and 21.0 ± 1.45 kg/m2 (Phase 2). All these ONSs were compared with reference drinks (glucose). The carbohydrates in one serving of each ONS were matched to carbohydrates from 25 grams of glucose following ISO 2010 guidelines. Capillary blood was assessed for blood glucose response at baseline, 15, 30, 45, 60, 90 and 120 minutes. GI was calculated as the incremental area under the curve (iAUC) for the test drinks and expressed as a percentage of the average iAUC from glucose. Results: Phase 1 indicated that the high fiber diabetes-specific nutrition supplement A1 with higher protein (23% energy), higher fat (25% energy) and reduced carbohydrates (40% energy) had a significantly (p = 0.002) lower GI [34 (±6)] as compared to B1 [63 (±7)] (protein 19%, fat 7% and carbohydrates 60% energy) even with similar amount (22%) and type of fiber. Phase 2 reported that all test products [A2 (32 ± 5), B2 (37 ± 4), C2 (31 ± 5), D2 (31 ± 5) and E2 (55 ± 4)] had a low GI. As compared to phase 1, ONSs in phase 2 had lower fiber content (1.6% - 4.6% energy). Conclusion: The glycemic index of oral nutrition supplements is influenced not only by their fiber content, but also by the overall macronutrient composition including protein (≥17% energy), fat (≥10% - 27% energy) and carbohydrates (40% - 57.5% energy).

Prognostic Nutritional Index Predicts Life Expectancy of Patients with End-Stage Oral Cancer: A Retrospective Study

Background: Generally, clinicians do not accurately estimate life expec-tancy in terminally ill patients with cancer. Aim: To evaluate the value of the Prognostic Nutritional Index (PNI) for accurately estimating the life expectancy of patients with end-stage oral cancer. Design: A longitudinal section study. Setting/participants: Fifteen patients (12 men;mean age: 71.7 years) who died of oral cancer between 2005 and 2014 (the terminal group) were included. The mean PNI values at the initial visit and at 3, 2, and 1 months before the deaths were comparatively analyzed. Results: The mean follow-up period was 133 days. At the initial examination, the PNI values were 49.1 ± 4.5 (p = 0.6723). The PNI value of the terminal group was 35.6 ± 5.1 at 2 months before death and 28.6 ± 3.0 at 1 month before death. The PNI values at 3, 2, and 1 months before death in the terminal group significantly differed from each other and from that at the initial visit and steadily decreased until death. Conclusions: Our findings suggest the utility of PNI as a prognostic index in patients with end-stage oral cancer patients. Furthermore, the PNI should be routinely considered in the nutritional management of patients with oral cancer nearing death.

Analysis of auxiliary diagnosis, cell survival, angiogenesis and nutritional support in patients with oral cancer

Objective:To investigate the changes and clinical significance of auxiliary diagnosis, cell survival, angiogenesis and nutritional support in patients with oral cancer.Methods: 50 patients with oral cancer treated in our hospital from June 2016 to September 2017 were selected as the observation group and 50 healthy people as the control group. The expression levels of auxiliary diagnosis [including secretory immunoglobulin A (SIgA), catalase (CAT)], cell survival [including survivin, focal adhesion kinase (FAK)], angiogenesis [including vascular endothelial growth factor (VEGF), hepatocyte growth (HGF), urokinase-type plasminogen activator (uPA)] and nutritional support [including lead (Pb), magnesium (Mg), calcium (Ca), iron (Fe), zinc (Zn) and copper (Cu)] related indicators in the two groups were observed and compared.Results:The levels of SIgA [(83.30±6.05) ug/mL], Mg [(1.21±0.17) mmol/L], Fe [(6.75±1.03)mmol/L] and Zn [(87.11±15.31) ug/L] in the observation group were significantly lower than those in the control group (P<0.05), while the levels of CAT [(39.87±9.18) U/mL], survivin [(131.63±10.53) ng/L], FAK [(62.27±5.20) ng/mL], VEGF[(533.73±150.63)ng/L], HGF[(411.32±181.72)ng/L], uPA[(5.12±1.31)mg/L], Pb[(65.55±20.76)μg/L], Ca[(1.55±0.20)mmol/L] and Cu[(14.90±5.30)μmol/L] were significantly higher than that of the control group. The difference was statistically significant (P<0.05).Conclusions:Patients with oral cancer, the immune function of salivary mucosa decreased and cell survival was abnormal. Oral cancer patients are easy to regenerate tumor blood vessels. Tumor cells and vascular endothelial cells are active in proliferation, migration and invasion. The expression of trace elements is also abnormal, which is not conducive to the nutritional support of the body. The relevant indicators should be strengthened in clinical practice, so as to provide evidence for early diagnosis and treatment of the disease.

Optimal timing and route of nutritional support after esophagectomy: A review of the literature

Some controversy surrounds the postoperative feeding regimen utilized in patients who undergo esophagectomy.Variation in practices during the perioperative period exists including the type of nutrition started,the delivery route,and its timing.Adequate nutrition is essential for this patient population as these patients often present with weight loss and have altered eating patterns after surgery,which can affect their ability to regain or maintain weight.Methods of feeding after an esophagectomy include total parenteral nutrition,nasoduodenal/nasojejunal tube feeding,jejunostomy tube feeding,and oral feeding.Recent evidence suggests that early oral feeding is associated with shorter LOS,faster return of bowel function,and improved quality of life.Enhanced recovery pathways after surgery pathways after esophagectomy with a component of early oral feeding also seem to be safe,feasible,and cost-effective,albeit with limited data.However,data on anastomotic leaks is mixed,and some studies suggest that the incidence of leaks may be higher with early oral feeding.This risk of anastomotic leak with early feeding may be heavily modulated by surgical approach.No definitive data is currently available to definitively answer this question,and further studies should look at how these early feeding regimens vary by surgical technique.This review aims to discuss the existing literature on the optimal route and timing of feeding after esophagectomy.

学龄前儿童长期补充碳酸钙制剂效果的研究

目的 研究碳酸钙长期补充对学龄前儿童骨量、钙、铁代谢的影响。 方法 以成都市幼儿园 12 3名 3～ 6岁儿童为研究对象。将入选的儿童随机分成试验组与对照组。试验组每日服用 30 0mg钙 (6日 /周 ) ,对照组不给任何钙剂。试验前后观测右足跟骨骨量 ,检验血清铁蛋白、钙。在试验前、试验 1个月、3个月 ,6个月后检验尿钙。 结果 (1)成都市学龄前儿童膳食钙摄入量低 ,试验前血钙、尿钙水平低 ;补钙后试验组升至正常水平。 (2 )碳酸钙剂补充对跟骨骨量发育有促进作用。 (3)补充钙剂 6个月对血清铁蛋白无明显影响。 结论 钙补充对学龄前儿童的骨量提高有促进作用 ,对铁代谢无明显影响。学龄前儿童钙摄入少 ,建议每日补充 30 0mg元素钙。

Glycemic responses to glycemia-targeted specialized-nutrition beverages with varying carbohydrates compared to a standard nutritional beverage in adults with type 2 diabetes

Background: Postprandial plasma glucose concentration is an important diabetes management target. Glycemia-targeted specialized-nutrition (GTSN) beverages, containing various quantities and types of carbohydrates (CHO), have been formulated to blunt postprandial hyperglycemia. The objective of this research was to evaluate the effectiveness of these products on postprandial glycemic and hormonal responses based on comparisons of GTSN with differing carbohydrate quantities or types. Methods: In two randomized, double-blind, crossover studies, participants (mean age 61 years) with type 2 diabetes consumed GTSN in a meal tolerance test. In the CHO Quantity Study, a standard nutritional beverage (STD) was compared to a low carbohydrate nutritional beverage with tapioca dextrin (GTSN-TDX) and a balanced carbohydrate nutritional beverage containing a blend of the slowly-digesting carbohydrates maltodextrin and sucromalt (GTSN-SDC). In the CHO Type Study, the GTSN beverages had similar carbohydrate quantities but varied in carbohydrate composition with GTSN-SDC compared to a formula with tapioca starch and fructose (GTSN-TS&F), and one with isomaltulose and resistant starch (GTSN-I&RS). Postprandial (0-240 min) concentrations of blood glucose, insulin (CHO Quantity Study only) and glucagon-like-peptide (GLP)-1 (CHO Quantity Study only) were measured. Results: Despite having substantially different carbohydrate quantities, the GTSN blunted the glucose positive area under the curve (AUC0-240 min) by 65% to 82% compared to the STD formulation (p < 0.001). GTSN also elicited ~50% lower insulin positive AUC0-240 min (p < 0.05), while postprandial GLP-1 responses were increased (p = 0.018) vs. STD. In the CHO Type Study, glucose positive AUC0-240 min tended to be lower for GTSN-SDC (1477 ± 460) than GTSN-TS&F (2203 ± 412;p = 0.062) and GTSN-I&RS (2190 ± 412;p = 0.076). No differences were observed between GTSN-TS&F and GTSN-I&RS. Conclusions: These results demonstrate the effectiveness of several GTSN products and suggest that both CHO quantity and type play important roles in postprandial glycemic response in men and women with type 2 diabetes. Furthermore, GTSN products containing slow-digesting carbohydrates can blunt postmeal glucose and insulin concentration despite delivering greater total grams of CHO, which provides a dietary benefit for people with diabetes.

Efficacy of Alzer^®and Diamel, Nutritional Supplements, in the Prevention of Severe Diabetic Macular Edema

Introduction: Macular edema is the main cause of low vision in diabetic patients. Laser photocoagulation continues to be the treatment of choice in conjunction with the use of steroids and anti-angiogenics, but these treatments include possible ocular complications. The nutritional supplement Alzer (whose primary active ingredient is Ginkgo biloba, a powerful antioxidant that acts on vascular factors and oxidative damage, which are two of the mechanisms implicated in the pathogenesis of diabetic macular edema), which has been used on other non-diabetic macular conditions, along with the Diamel nutritional supplement has been shown to be effective on glycemic control and could represent a treatment alternative for mild to moderate macular edema by reducing the thickness of the macular retina and preventing the progression of other more advanced clinical presentations that are harder to treat. Objective: Identify the effect of Alzer along with Diamel in reduction of the thickness of the macular retina among patients with mild to moderate diabetic macular edema. Materials and Methods: A phase II double-blind clinical trial was conducted in 64 patients with non-severe diabetic macular edema over the course of non-proliferative diabetic retinopathy, who attended the ophthalmology service of the Institute of Endocrinology of Havana from January 2016 to December 2016. The treatment was randomly assigned to two groups: one received Alzer plus Diamel (n = 32) and the other group received Alzer placebo + Diamel placebo (n = 32). All patients were given an initial clinical evaluation, blood testing and ophthalmological evaluation at the start of treatment and after one year of follow-up. Results: There was a clinical improvement in the macular thickness upon the conclusion of the study in the patients treated with Alzer and Diamel. This decrease in thickness was statistically significant in the left eye. There was no decrease in visual acuity one year after treatment. Adverse events were mild and uncommon. Conclusions: Severe macular edema did not evolve in the Alzer and Diamel group. The clinical, but not statistically significant, success obtained in the experimental group proves the protocol hypothesis regarding the efficacy of the product being researched. The positive results in this small sample lead to the suggestion of performing larger-scale studies (Phase III). The clinical trial was registered in Clinical Trials.gov Identifier: NCT03533478.

Oral frailty and neurodegeneration in Alzheimer’s disease

Frailty is a critical intermediate status of the aging process with a multidimensional and multisystem nature and at higher risk for adverse health-related outcomes,including falls,disability,hospitalizations,institutionalization,mortality,dementia,and Alzheimer’s disease.Among different frailty phenotypes,oral frailty has been recently suggested as a novel construct defined as a decrease in oral function with a coexisting decline in cognitive and physical functions.We briefly reviewed existing evidence on operational definitions of oral frailty,assessment and screening tools,and possible relationships among oral frailty,oral microbiota,and Alzheimer’s disease neurodegeneration.Several underlying mechanism may explain the oral health-frailty links including undernutrition,sarcopenia linked to both poor nutrition and frailty,psychosocial factors,and the chronic inflammation typical of oral disease.Oral microbiota may influence Alzheimer’s disease risk through circulatory or neural access to the brain and the interplay with periodontal disease,often causing tooth loss also linked to an increased Alzheimer’s disease risk.On this bases,COR388,a bacterial protease inhibitor targeting Porphyromonas gingivalis implicated in periodontal disease,is now being tested in a double-blind,placebocontrolled Phase II/III study in mild-to-moderate Alzheimer’s disease.Therefore,oral status may be an important contributor to general health,including Alzheimer’s disease and latelife cognitive disorders,suggesting the central role of preventive strategies targeting the novel oral frailty phenotype and including maintenance and improvement of oral function and nutritional status to reduce the burden of both oral dysfunction and frailty.

Effect of FFD-410 (HiOwna-Jr.), a Balanced Herbal Nutritional Supplement on Biochemical, Hematological, Immunological and Cognitive Parameters of Wistar Rats

Present study was aimed to evaluate the effect HiOwna-Jr. (FFD-410) on vital biochemical, hematological, immunological and cognitive functions in rats;also in vitro antioxidant studies were carried out to evaluate the antioxidant capacity of FFD-410. Animals of respective groups were treatment with FFD-410 for 90 days and blood samples were collected for the estimation of biochemical, hematological parameters and serum immunoglobulin levels;haemoagglutination assay was carried out using Sheep Red blood cells (SRBC’s). In addition, effect of FFD-410 on cognition and memory was evaluated by modified elevated plus maze test. Apart from in vivo studies, in vitro studies such as DPPH radical scavenging assay, reducing power assay and ORAC assays were carried out to evaluate the free radical scavenging and antioxidant activity of FFD-410. Pretreatment with FFD-410 for 90 days did not bring about any change in serum biochemical and hematological parameters and relative organ weights etc., which could account for its wide safety margin at tested dose levels (2.5 and 5.0 g/kg, p.o.). However, FFD-410 showed potent immunostimulant activity by elevating the serum immunoglobulins and haemoagglutination titer values, also the pretreatment with FFD-410 showed dose dependent improvement in short-term cognition and memory in elevated plus maze test. Furthermore, in vitro antioxidant studies FFD-410 exhibited significant and dose dependent free radical scavenging and antioxidant activity as assessed by DPPH (IC50 value of 1162.6 μg/ml), reducing power and ORAC assays (Trolox equivalence/g of 76.1). These findings suggest that, FFD-410 possess very good antioxidant, cognition improving and potent immunostimulant properties. Also, there was no significant change in the serum biochemical and hematological parameters and relative organ weights were observed after 90 days treatment with FFD-410, which could account for its wide safety of margin at tested dose levels (2.5 and5.0 g/kg. p.o.).

Dietary supplements and pediatric non-alcoholic fatty liver disease: Present and the future

Non-alcoholic fatty liver disease(NAFLD) is the most common chronic liver disease in children.High prevalence of pediatric obesity and sedentary lifestyle has augmented the incidence of NAFLD in children.Obesity is associated with an increased risk of NAFLD through various mechanisms such as intensification of insulin resistance and increased levels of inflammatory markers.There is no approved medical intervention for treatment of pediatric NAFLD;the only proven strategy in management of pediatric NAFLD is lifestyle modification.Recently,the effects of nutritional supplements have been examined in the management of pediatric NAFLD.The purpose of this review is to summarize the studies evaluating the effects of nutritional supplements on pediatric NAFLD and explain the future direction in this field.

Drug Seeking Behavior of Amphetamine Addicted Sprague-Dawley Rats Is Eliminated after Nutritional Supplementation

Aim: The effectiveness of nutritional supplementation on drug-seeking behavior of amphetamine-addicted rats during withdrawal was investigated using a biased conditioned place preference (CPP) paradigm. Method: Twenty-four male Sprague-Dawley rats exhibiting baseline preference for the black chamber during a 20-minute pre-conditioning exploration of the CPP box completed the study. On alternate days of an 8-day schedule, twelve rats (Group AMP) were randomly selected, given either amphetamine sulfate (5 mg/ml, i.p.) and confined to the white chamber;or vehicle (1 ml saline, i.p.) and confined to the black chamber. A significant increased percentage time spent and number of entries made by Group AMP to the drug-paired, white chamber on the test day confirmed amphetamine addiction. Group AMP subsequently received increasing doses of amphetamine over 6 days. Following acute drug withdrawal, their CPP performance was compared with that of vehicle treated rats (Group SAL). Groups AMP and SAL were equally divided and randomly assigned to animals fed chow reconstituted with the nutritional supplement (AMP-S and SAL-S) over 8 weeks or standard rat chow (AMP-N and SAL-N). CPP performances for all rats were determined blindly from video recordings following this period. Results: Nutritionally supplemented, amphetamine withdrawn rats (AMP-S) exhibited significantly decreased percentage entries and time spent in the white chamber (p ?ve, control animals. Conclusion: Drug-seeking behavior by amphetamine-addicted animals was eliminated after treatment with a nutritionally supplemented diet.

Oral creatine supplementation:A potential adjunct therapy for rheumatoid arthritis patients

Creatine is one of the most popular forms of protein supplements and is known to improve performance in healthy athletic populations via enhanced muscle mass and adenosine triphosphate energy regeneration.Clinical use of creatine may similarly benefit patients with rheumatoid arthritis(RA), an inflammatory condition characterised by generalised muscle loss termed"rheumatoid cachexia". The adverse consequences of rheumatoid cachexia include reduced strength, physical function and, as a consequence, quality of life.Whilst regular high-intensity exercise training has been shown to increase muscle mass and restore function in RA patients, this form of therapy has very low uptake amongst RA patients. Thus, acceptable alternatives are required. The aim of this review is to consider the potential efficacy of creatine as an anabolic and ergonomic therapy for RA patients. To date, only one study has supplemented RA patients with creatine, and the findings from this investigation were inconclusive. However, trials in populations with similar losses of muscle mass and function as RA, including older adults andthose with other muscle wasting conditions, indicate that creatine is an efficacious way of improving muscle mass, strength and physical function, and may offer an easy, safe and cheap means of treating rheumatoid cachexia and its consequences.

Efficacy of a Diabetes Specific Nutritional Supplement (DSNS) on Glycemic Response in Prediabetic Adults: A Two-Armed, Open-Labelled Randomized Controlled Study

It is well known that Diabetes Specific Nutritional Supplements (DSNSs) are linked to improved glycemic control in individuals with diabetes. However, data on efficacy of DSNSs in prediabetics is limited. This was a two-armed, open-labelled, randomized controlled six-week study on 199 prediabetics [30 - 65 years;Glycosylated Hemoglobin (HbA1c) 5.7% - 6.4% and/or Fasting Blood Glucose (FBG) 100-125 mg/dl]. Two parallel phases were conducted: Acute Blood Glucose Response (ABGR) and Intervention phase. Prediabetic participants were randomized into test (n = 100) and control (n = 99). The primary objective was to assess the ABGR of DSNS versus an isocaloric snack, measured by incremental Area under the Curve (iAUC). Test and control received 60 g of DSNS and 56 g of isocaloric snack (cornflakes) respectively, both in 250 ml double-toned milk on visit days 1, 15, 29 and 43. Postprandial Blood Glucose (PPG) was estimated at 30, 60, 90, 120, 150 and 180 minutes. During the 4 weeks intervention phase, the test group received DSNS with lifestyle counselling (DSNS + LC) and was compared with the control receiving lifestyle counselling alone (LC alone). Impact was studied on FBG, HbA1C, anthropometry, body composition, blood pressure, nutrient intake, and physical activity. The impact of DSNS was also studied using CGM between two 14-day phases: CGM1 baseline (days 1 - 14) and CGM2 endline (days 28 - 42). DSNS showed significantly lower PPG versus isocaloric snack at 30 (p 12, and chromium were reported by DSNS + LC versus LC alone. No other significant changes were reported between groups. It may be concluded that DSNS may be considered as a snack for prediabetic or hyperglycemic individuals requiring nutritional support for improved glycemic control.

Assessment of Nutritional Status of Clinical Patients by Determining Normal Range of Oral Mucosal Apoptosis and Proliferation Rate

The normal range of oral mucosal cell apoptosis and proliferation rate through a larger sample of non-malnourished crowd was investigated,and the nutritional status of clinical patients was assessed.Of 194 clinical patients selected according to 'NRS2002' guidance,there were 167 non-malnourished patients and 27 malnourished cases,respectively.Twelve patients with toxic reactions of grade III after postoperative chemotherapy (POC) were chosen.The oral mucosal epithelial apoptosis and proliferation rate were measured by using flow cytometry.The statistical significance was processed by using unpaired t-test.The results showed that there was no significant difference in gender,age and body weight between malnourished and non-malnourished groups.The normal range of oral mucosal epithelial apoptosis and the proliferation rate was (27.50±1.50)% and (15.12±1.68)% in non-malnourished patients,and that was (19.90±4.14)% and (6.66±5.83)% in the malnourished patients,respectively.It is concluded that the normal range of oral mucosa cell apoptosis and proliferation rate is achieved,which can not be influenced by gender,age,weight and other factors,and could be used as a sensitive and accurate index to assess the nutritional status of clinical patients.

Benefits of post-operative oral protein supplementation in gastrointestinal surgery patients: A systematic review of clinical trials

AIM: To evaluate published trials examining oral postoperative protein supplementation in patients having undergone gastrointestinal surgery and assessment of reported results.METHODS: Database searches(MEDLINE, BIOSIS, EMBASE, Cochrane Trials, Cinahl, and CAB), searches of reference lists of relevant papers, and expert referral were used to identify prospective randomized controlled clinical trials. The following terms were used to locate articles: "oral'' or "enteral'' and "postoperative care'' or "post-surgical'' and "proteins' ' or "milk proteins' ' or "dietary proteins' ' or "dietary supplements' ' or "nutritional supplements' '. In databases that allowed added limitations, results were limited to clinical trials that studied humans, and publications between 1990 and 2014. Quality of collated studies was evaluated using a qualitative assessment tool and the collective results interpreted.RESULTS: Searches identified 629 papers of which, following review, 7 were deemed eligible for qualitative evaluation. Protein supplementation does not appear to affect mortality but does reduce weight loss, and improve nutritional status. Reduction in grip strength deterioration was observed in a majority of studies, and approximately half of the studies described reduced complication rates. No changes in duration of hospital stay or plasma protein levels were reported. There is evidence to suggest that protein supplementation should be routinely provided post-operatively to this population. However, despite comprehensive searches, clinical trials that varied only the amount of protein provided via oral nutritional supplements(discrete from other nutritionalcomponents) were not found. At present, there is some evidence to support routinely prescribed oral nutritional supplements that contain protein for gastrointestinal surgery patients in the immediate post-operative stage.CONCLUSION: The optimal level of protein supplementation required to maximise recovery in gastrointestinal surgery patients is effectively unknown, and may warrant further study.

the role of nutrition and nutraceutical supplements in the treatment of hypertension

Vascular biology,endothelial and vascular smooth muscle and cardiac dysfunction play a primary role in the initiation and perpetuation of hypertension,cardiovascular disease and target organ damage.Nutrientgene interactions and epigenetics are predominant factors in promoting beneficial or detrimental effects in cardiovascular health and hypertension.Macronutrients and micronutrients can prevent,control and treat hypertension through numerous mechanisms related to vascular biology.Oxidative stress,inflammation and autoimmune dysfunction initiate and propagate hypertension and cardiovascular disease.There is a role for the selected use of single and component nutraceutical supplements,vitamins,antioxidants and minerals in the treatment of hypertension based on scientifically controlled studies which complement optimal nutrition,coupled with other lifestyle modifications.

Exploring choices of early nutritional support for patients with sepsis based on changes in intestinal microecology

BACKGROUND Sepsis exacerbates intestinal microecological disorders leading to poor prognosis.Proper modalities of nutritional support can improve nutrition,immunity,and intestinal microecology.AIM To identify the optimal modality of early nutritional support for patients with sepsis from the perspective of intestinal microecology.METHODS Thirty patients with sepsis admitted to the intensive care unit of the General Hospital of Ningxia Medical University,China,between 2019 and 2021 with indications for nutritional support,were randomly assigned to one of three different modalities of nutritional support for a total of 5 d:Total enteral nutrition(TEN group),total parenteral nutrition(TPN group),and supplemental parenteral nutrition(SPN group).Blood and stool specimens were collected before and after nutritional support,and changes in gut microbiota,short-chain fatty acids(SCFAs),and immune and nutritional indicators were detected and compared among the three groups.RESULTS In comparison with before nutritional support,the three groups after nutritional support presented:(1)Differences in the gut bacteria(Enterococcus increased in the TEN group,Campylobacter decreased in the TPN group,and Dialister decreased in the SPN group;all P<0.05);(2)different trends in SCFAs(the TEN group showed improvement except for Caproic acid,the TPN group showed improvement only for acetic and propionic acid,and the SPN group showed a decreasing trend);(3)significant improvement of the nutritional and immunological indicators in the TEN and SPN groups,while only immunoglobulin G improved in the TPN group(all P<0.05);and(4)a significant correlation was found between the gut bacteria,SCFAs,and nutritional and immunological indicators(all P<0.05).CONCLUSION TEN is recommended as the preferred mode of early nutritional support in sepsis based on clinical nutritional and immunological indicators,as well as changes in intestinal microecology.

Hypo-activity induced skeletal muscle atrophy and potential nutritional interventions: A review

Periods of hypo-activity result in profound changes in skeletal muscle morphology and strength. This review primarily addresses the differential impact of de-training, bed-rest, limb immobilisation and unilateral lower limb suspension on muscle morphology, strength and fatigability. The degree of muscle atrophy differs depending on the hypo-activity model and the muscles in question, with the leg and postural muscles being the most susceptible to atrophy. Hypo-activity also results in the dramatic loss of strength that often surpasses the loss of muscle mass, and consequently, the nervous system and contractile properties adapt to adjust for this excessive loss of strength. In addition, the degree of muscle strength loss is different depending on the hypo-activity model, with immobilisation appearing to have a greater impact on strength than unloaded models. There is a step-wise difference in the magnitude of muscle loss so that, even after accounting for differential durations of interventions immobilisation ≥ unilateral lower limb suspension ≥ bed-rest ≥ de-training. Muscle fatigability varies between hypoactivity models but the results are equivocal and thismay be due to task-specific adaptations. This review also addresses potential nutritional interventions for attenuating hypo-activity induced muscle atrophy and strength declines, in the absence of exercise. Essential amino acid supplementation stands as a strong candidate but other supplements are good contenders for attenuating hypo-activity induced atrophy and strength losses. Several potential nutritional supplements are highlighted that could be used to combat muscle atrophy but extensive research is needed to determine the most effective.

Antioxidant,nutritional and anti-nutritional composition of Garcinia kola and Chrysophyllum albidum from rainforest ecosystem of Ondo State,Nigeria

Tropical forests contain many tree species that have supplied edible fruits for centuries.These fruits have contributed to human diets due to their richness in nutrients,vitamins,minerals,antioxidants and their low antinutrients content.We investigated the antioxidant,nutritional and anti-nutritional composition of Garcinia kola and Chrysophyllum albidum fruit parts.The nutritional,anti-nutritional and antioxidant compositions differed depending on the fruit part.Irrespective of fruit part,moisture content was high（72–93 %）.While the edible part（fruit pulp） of C.albidum proved a better source of protein（4）,fibre（17 %） and fat（2 %）,the seed kernel was a better source of ash（2 %） and carbohydrate（15 %）.Carbohydrate（22 %）,protein（2 %）,fat（1 %） and fibre（3 %） were higher in G.kola seed kernel（edible part） than in the pulp and pod.Anti-nutrient content in G.kola and C.albidum fruits was low,indicating that their consumption would not pose nutritional or health problems.The antioxidant compositions（especially phenolic content（10–21 mg g-1） and DPPH（1,1-diphenyl–2 picrylhydrazyl）（26–55 %）） of C.albidum fruit pulp and G.kola seed kernel were high,implying that they could be good sources of natural antioxidants and could be used as supplements in food manufacturing.

Diet and nutritional factors in inflammatory bowel diseases

Inflammatory bowel disease(IBD) development is affected by complex interactions between environmental factors, changes in intestinal flora, various predisposing genetic properties and changes in the immune system. Dietary factors seem to play an underestimated role in the etiopathogenesis and course of the disease. However, research about food and IBD is conflicting. An excessive consumption of sugar, animal fat and linoleic acid is considered a risk factor for IBD development, whereas a high fiber diet and citrus fruit consumption may play a protective role. Also, appropriate nutrition in particular periods of the disease may facilitate achieving or prolonging remissions and most of all, improve the quality of life for patients. During disease exacerbation, a low fiber diet is recommended for most patients. In the remission time, an excessive consumption of alcohol and sulfur products may have a negative effect on the disease course. Attempts are also made at employing diets composed in detail in order to supplement IBD therapy. A diet with a modified carbohydrate composition, a semi-vegetarian diet and a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols are under investigation. Due to chronic inflammation as well as side effects of chronically used medications, patients with IBD are also at increased risk of nutritional factor deficiencies, including iron, calcium, vitamin D, vitamin B12, folic acid, zinc, magnesium and vitamin A. It should also be remembered that there is no single common diet suitable for all IBD patients; each of them is unique and dietary recommendations must be individually developed for each patient, depending on the course of the disease, past surgical procedures and type of pharmacotherapy.