The possibility of use of the ketogenic diet and medium chain triglycerides supplementation in the support therapy of Alzheimer disease
Purpose of review Diet-induced ketosis has a fasting-like effect and brings the body to increase the production of ketone bodies (KB). Works over the last decades have provided evidence of the therapeutic potential of the ketogenic diet (KD). This review focus on mainly clinical research on the effectiveness of the KD and medium-chain triglycerides (MCT) supplementation in ameliorating the severity of symptoms in Alzheimer disease (AD). Recent findings A limited number of clinical studies (short-time and with a small number of participants) evaluated the role of the KD and MCT supplementation in AD as a potentia...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: HOT TOPIC Source Type: research

Physiological responses to carbohydrate overfeeding
Purpose of review To consider emerging research into the physiological effects of excessive dietary carbohydrate intake, with a particular focus on interactions with physical activity. Recent findings A single episode of massive carbohydrate overload initiates physiological responses to stimulate additional peptide hormone secretion by the gut and the conversion of carbohydrate into lipid by the intestine, liver and adipose tissue. These acute responses maintain glycaemic control both via increased oxidation of carbohydrate (rather than lipid) and via nonoxidative disposal of surplus carbohydrate into endogenous...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: CARBOHYDRATES: Edited by Bettina Mittendorfer and Faidon Magkos Source Type: research

Ketogenic diet therapy in Alzheimer's disease: an updated review
Purpose of review Ketogenic diets (KD) are validated treatments of pharmacoresistant epilepsy. Their interest in neurodegenerative diseases such as Alzheimer's disease (AD) has been suggested, because ketone bodies may reduce neuroinflammation, improve neurotransmitters transport pathway, synaptic maintenance, and reduce brain β-amyloid deposition. In this updated review, we aimed at critically examining the evidence of the past 2 years regarding KD or ketogenic supplements (KS) on cognitive and biological/neuropathological outcomes. We conducted our search in preclinical studies (animal models of AD) or in humans...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: CARBOHYDRATES: Edited by Bettina Mittendorfer and Faidon Magkos Source Type: research

Carb-conscious: the role of carbohydrate intake in recovery from exercise
Purpose of review The present review summarized evidence on the role of carbohydrates in recovery from exercise within the context of acute and chronic effects on metabolism and performance. Recent findings Recent studies demonstrate that, in contrast to recovery of muscle glycogen stores, the recovery of liver glycogen stores can be accelerated by the co-ingestion of fructose with glucose-based carbohydrates. Three recent studies suggest this can extend time-to-exhaustion during endurance exercise tests. However, periodically restricting carbohydrate intakes during recovery from some training sessions to slow t...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: CARBOHYDRATES: Edited by Bettina Mittendorfer and Faidon Magkos Source Type: research

Ketogenic diets and appetite regulation
Purpose of review The popularity of ketogenic diets in the treatment of obesity has increased dramatically over the last years, namely due to their potential appetite suppressant effect. The purpose of this review was to examine the latest evidence regarding the impact of ketogenic diets on appetite. Recent findings The majority of the studies published over the last 2 years adds to previous evidence and shows that ketogenic diets suppress the increase in the secretion of the hunger hormone ghrelin and in feelings of hunger, otherwise see when weight loss is induced by non-ketogenic diets. Research done using ...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: CARBOHYDRATES: Edited by Bettina Mittendorfer and Faidon Magkos Source Type: research

Dietary carbohydrates and weight loss maintenance
Purpose of review Aim of the present review is to provide an overview of the effect of manipulating dietary carbohydrates (content, type) after a period of weight loss on weight loss maintenance and its potential underlying mechanisms. Recent findings Few recent studies directly tested whether lower carbohydrate/glycaemic load or higher fibre diets help to limit weight regain after weight loss and they did not provide evidence supporting a role of a reduction of the carbohydrate or an increase of the fibre content of the diet in the prevention of weight regain after weight loss. Some evidence is emerging that pe...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: CARBOHYDRATES: Edited by Bettina Mittendorfer and Faidon Magkos Source Type: research

Beyond weight loss in nonalcoholic fatty liver disease: the role of carbohydrate restriction
Purpose of review The low fat diet (LFD) is currently the first choice to treat nonalcoholic fatty liver disease (NAFLD) alongside with physical activity. However, low carbohydrate diets (LCDs) and ketogenic diets have gained attention lately, thanks to their favourable impact in reducing intrahepatic triglyceride content. We therefore aimed at providing an update on recent evidence evaluating the hepatoprotective effects of such dietary interventions. Recent findings Novel findings confirmed previous evidence by showing beneficial effects on liver fat content reduction for both LFDs and LCDs. The further restri...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: CARBOHYDRATES: Edited by Bettina Mittendorfer and Faidon Magkos Source Type: research

Carbohydrate intake and circadian synchronicity in the regulation of glucose homeostasis
Purpose of review Glucose metabolism is under circadian regulation, with insulin secretion and sensitivity being highest in the morning as compared to the evening. The present review will discuss the existing evidence for the role of meal and macronutrient timing to improve glucose metabolism and reset circadian clocks, with a focus on the evidence in humans. Recent findings Shortening the daily eating window (also known as time-restricted eating), or skewing food intake towards breakfast and away from the evening meal both improve glucose control in people with impaired glucose metabolism. Insulin is recently p...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: CARBOHYDRATES: Edited by Bettina Mittendorfer and Faidon Magkos Source Type: research

Editorial: Is reducing dietary carbohydrate the way to go?
No abstract available (Source: Current Opinion in Clinical Nutrition and Metabolic Care)
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: CARBOHYDRATES: Edited by Bettina Mittendorfer and Faidon Magkos Source Type: research

Diurnal rhythms and obesity
Purpose of review This review will discuss the recent studies that implicate disturbed diurnal rhythms with the development of obesity. The second part of the review will discuss studies that use feeding time to restore diurnal rhythms and rescue obesity. Recent findings Studies in patients with obesity and diabetes reveal attenuated circadian and metabolic rhythms in adipose tissue. The use of animal models furthers our mechanistic insight on how environmental disturbances such as high-fat diet and shift work disturb circadian and metabolic rhythms. Studies in both animals and humans describe how disturbance of...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: GENES AND CELL METABOLISM: Edited by Anastasia Z. Kalea and Dorothy Klimis-Zacas Source Type: research

Genetic architecture of type 2 diabetes and its shared genetic component with low birth weight in African Americans
Purpose of review Recent large-scale multiancestry efforts has contributed to our knowledge of the hereditary basis of type 2 diabetes (T2D). The present review will summarize findings of the genetic basis of T2D in African Americans, a population group with a disproportionate burden of this disease. Recent findings To date,>400 risk genetic variants have been found to be associated with the risk of T2D across populations of different ancestries. Although these findings are based on primarily European-ancestry populations, most of the identified loci show similar associations in African Americans. Ancestry-sp...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: GENES AND CELL METABOLISM: Edited by Anastasia Z. Kalea and Dorothy Klimis-Zacas Source Type: research

Precision nutrition based on phenotypical traits and the (epi)genotype: nutrigenetic and nutrigenomic approaches for obesity care
Purpose of review The purpose of this article is to rationally review and critically appraise the current knowledge in the most relevant nongenetic and genetic factors influencing obesity predisposition. This information may be translated into the implementation of personalized nutrition approaches involving precision nutrigenetic and nutrigenomic strategies for obesity monitoring and weight management. Recent findings The importance and influence of several nongenetic contributors to obesity onset and individual responses to weight-loss interventions have been highlighted including the role of age, sex or perin...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: GENES AND CELL METABOLISM: Edited by Anastasia Z. Kalea and Dorothy Klimis-Zacas Source Type: research

Recent advances in understanding the adaptive evolution of metabolic genes and traits
Purpose of review This review summarizes the recent advances in understanding the adaptive evolution of metabolic genes and traits, providing insights into gene-diet interactions in human evolution and health. Recent findings The rapid accumulation of ancient DNA across time and geography illuminates unprecedented details of some well-established examples of genetic adaptation to diet, such as the LCT and FADS genes. Novel cases of thrifty genes were identified, especially a microRNA at the LCT locus that controls energy expenditure and glucose homeostasis, connecting the historical adaptation to present-day met...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: GENES AND CELL METABOLISM: Edited by Anastasia Z. Kalea and Dorothy Klimis-Zacas Source Type: research

The role of dietary supplements that modulate one-carbon metabolism on stroke outcome
Purpose of review Ischemic stroke results in disability and mortality worldwide. Nutrition is a modifiable risk factor for stroke. For example, deficiencies in one-carbon metabolism have been linked to increased risk of stroke through elevated levels of homocysteine. Some countries world-wide fortify their diets with folates to prevent neural tube defects, but deficiencies in other one-carbon metabolites, such as vitamin B12 and choline are still present in many populations. The aim of this review is to understand the current evidence on how dietary supplementation by nutrients which modulate one-carbon metabolism impa...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: GENES AND CELL METABOLISM: Edited by Anastasia Z. Kalea and Dorothy Klimis-Zacas Source Type: research

Purine metabolites and complex diseases: role of genes and nutrients
Purpose of review Purines have several important physiological functions as part of nucleic acids and as intracellular and extracellular signaling molecules. Purine metabolites, particularly uric acid, have been implicated in congenital and complex diseases. However, their role in complex diseases is not clear and they have both beneficial and detrimental effects on disease pathogenesis. In addition, the relationship between purines and complex diseases is affected by genetic and nutritional factors. This review presents latest findings about the relationship between purines and complex diseases and the effect of genes...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: GENES AND CELL METABOLISM: Edited by Anastasia Z. Kalea and Dorothy Klimis-Zacas Source Type: research

Recent advances and current controversies in genetic testing for personalized nutrition
Purpose of review Considerable interest in personalized nutrition exists among the general public, policymakers, healthcare organizations and the private sector, but there is also skepticism of its utility. The present review aims to provide a summary of current controversies in the field of nutrigenomics, and to highlight recent research on the potential impact of implementing genetic testing for personalized nutrition in practice. Recent findings Numerous companies already offer genetic testing for personalized nutrition based on research developments in nutritional genomics. However, controversy exists over w...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: GENES AND CELL METABOLISM: Edited by Anastasia Z. Kalea and Dorothy Klimis-Zacas Source Type: research

Editorial: Nutrition, precision and nature: the focus on the individual, not the average individual
No abstract available (Source: Current Opinion in Clinical Nutrition and Metabolic Care)
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: GENES AND CELL METABOLISM: Edited by Anastasia Z. Kalea and Dorothy Klimis-Zacas Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Clinical Nutrition and Metabolic Care)
Source: Current Opinion in Clinical Nutrition and Metabolic Care - June 11, 2021 Category: Nutrition Tags: EDITORIAL INTRODUCTIONS Source Type: research

Early or delayed parenteral nutrition for infants: what evidence is available?
Purpose of review To review the current evidence evaluating early versus delayed commencement of parenteral nutrition in infants. Recent findings Recent studies in very premature infants (3.5 g/kg/day immediately after birth) may cause metabolic acidosis, elevated blood urea, slower head growth and refeeding-hypophosphatemia syndrome. A recent multicentre randomized controlled trial found that commencement of parenteral nutrition within 24-h of admission increases the risk of infections and prolongs the duration of ventilation and ICU stay in full-term neonates, older infants and children. The study also found...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - April 9, 2021 Category: Nutrition Tags: PAEDIATRICS: Edited by Berthold Koletzko and Raanan Shamir Source Type: research

Ready-to-use therapeutic foods for the treatment of malnourished children and infants
Purpose of review Ready-to-use therapeutic foods (RUTF) allow effective community-based management of severe acute malnutrition (SAM). Current interest focuses on their optimal composition and use. Recent findings Studies of alternative RUTF have yielded differing results. Partial soybean, sorghum flour, and whey protein replacement RUTF were inferior to standard RUTF. In contrast, soy-based RUTF was as effective as milk-based RUTF and an alternative RUTF with added oats lead to superior recovery in comparison to standard RUTF. Reducing the dose of RUTF in the later phases of SAM recovery resulted in small re...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - April 9, 2021 Category: Nutrition Tags: PAEDIATRICS: Edited by Berthold Koletzko and Raanan Shamir Source Type: research

Large-scale food fortification has great potential to improve child health and nutrition
Purpose of review Undernutrition, including micronutrient deficiencies, continues to plague children across the world, particularly in low and middle-income countries (LMICs). The situation has worsened alongside the SARS-CoV-2 pandemic because of major systemic disruptions to food supply, healthcare, and employment. Large-scale food fortification (LSFF) is a potential strategy for improving micronutrient intakes through the addition of vitamins and minerals to staple foods and improving the nutritional status of populations at large. Recent findings Current evidence unquestionably supports the use of LSFF to im...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - April 9, 2021 Category: Nutrition Tags: PAEDIATRICS: Edited by Berthold Koletzko and Raanan Shamir Source Type: research

Iodine supplementation: is there a need?
Purpose of review To review the recent data on iodine deficiency, the impact of iodine deficiency on health outcomes and the need for iodine supplementation in at-risk populations, that is, pregnant and lactating women, infants and young children. Recent findings The 2019 Iodine Global Network Annual Report highlighted that only 23 countries worldwide (including Finland, Germany, and Norway in Europe) were classified as having insufficient iodine intake in 2019, down from 54 in 2003 and 113 in 1993. Even if severe iodine deficiency during pregnancy has a negative impact on cognitive outcomes later in life, the c...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - April 9, 2021 Category: Nutrition Tags: PAEDIATRICS: Edited by Berthold Koletzko and Raanan Shamir Source Type: research

Vitamin D requirements in infancy: an updated systematic review
Purpose of review Systematic review looking for new evidence for recommendations for vitamin D supplementation in healthy infants based upon the most recent (4 years) available literature. Recent findings Randomized controlled trials published since 1 January 2017 that related to vitamin D doses in infancy were reviewed. They do not provide any additional evidence that larger, more generous amounts of daily vitamin D beyond the customary recommended 400 international units (IU) daily dose, affect any significant outcome. Larger amounts may lead to serum 25-hydroxyvitamin D [25(OH)D] concentrations that have be...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - April 9, 2021 Category: Nutrition Tags: PAEDIATRICS: Edited by Berthold Koletzko and Raanan Shamir Source Type: research

Human milk proteome: what's new?
Purpose of review The proteome is one of the most complicated and multifunctional components in human milk. Recently, numerous novel characteristics of the human milk proteome have been discovered, which are described and critically examined in this review. Recent findings Recent human milk proteomics studies have focused on how external factors like geography and environment, or maternal and infant's factors affect the milk proteins, endogenous peptides, their posttransitional modifications (PTMs) and infant utilization. Most of these studies have shown that major protein and endogenous peptide profiles are sim...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - April 9, 2021 Category: Nutrition Tags: PAEDIATRICS: Edited by Berthold Koletzko and Raanan Shamir Source Type: research

The impact of feeding experiences during infancy on later child eating behaviours
Purpose of review Individual differences in appetite and eating behaviours appear early in infancy. This review synthesizes recent research investigating the impact of feeding experiences during infancy on later appetite and energy intake regulation, and appraises the consistency and longevity of any effects. Recent findings Three themes of early feeding experiences were identified; breastfeeding, infants’ first foods and caregivers’ feeding practices. Recent findings suggest that breastfeeding alone is unlikely to promote better regulation of food intake later in childhood. It remains unclear whethe...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - April 9, 2021 Category: Nutrition Tags: PAEDIATRICS: Edited by Berthold Koletzko and Raanan Shamir Source Type: research

Iron deficiency in infancy: current insights
Purpose of review Iron deficiency is the most common micronutrient deficiency and infants are at particular risk. The purpose of this review is to summarize recent studies that explored the metabolism of iron in infants as well as the risks and benefits of iron supplementation in different populations. Recent findings The ability of infants to regulate iron homeostasis is not fully known but most likely different from adults. Reducing iron deficiency has beneficial effects on neurodevelopment but iron overload may have adverse functional effects including diarrhea and even poor neurodevelopment. Recent studies h...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - April 9, 2021 Category: Nutrition Tags: PAEDIATRICS: Edited by Berthold Koletzko and Raanan Shamir Source Type: research

Editorial: Light shielding of bags and tubing used for parenteral nutrition of infants
Purpose of review In July 2019, the Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medicines Agency (EMA) recommended light protection of all parenteral nutrition (PN) solutions containing amino acids (AA) and/or lipids, with or without admixture of vitamins or trace elements, during administration for preterm infants, term infants and children less than 2 years of age. The aim of the present paper was to review the available evidence and to provide recommendations for in hospital and home PN light protection in children. Recent findings Lipid emulsions and multivitamins are susceptible to ph...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - April 9, 2021 Category: Nutrition Tags: PAEDIATRICS: Edited by Berthold Koletzko and Raanan Shamir Source Type: research

Coronavirus disease 2019 pandemic and alterations of body composition
Purpose of review This manuscript reviews evidence collected during COVID-19 pandemic and provides information on the impact of body composition on severity and outcomes of the disease, analysing methods used for body composition assessment. Malnutrition-screening tools will also be discussed to screen and diagnose the patients at higher risk of COVID-19 severity and related worse outcomes. Recent findings COVID-19 can occur in a wide range of presentation, from asymptomatic to severe forms. Among the major risk factors for worse severity, overnutrition, undernutrition and body composition play a role in the abi...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - April 9, 2021 Category: Nutrition Tags: TRANSLATIONAL RESEARCH IN WASTING DISEASES: Edited by Claude Pichard and Mariëlle P.K.J. Engelen Source Type: research

Oral nutritional supplements, physical activity, and sarcopenia in cancer
Purpose of review Sarcopenia is prevalent in cancer patients and can occur as a result of cancer as well as cancer-related therapies. It is related to high postoperative complications, long hospitalization, slow recovery as well as low tolerance to chemotherapy. Patients with sarcopenia also have poor oncological outcomes. Oral nutritional supplements (ONS) and physical activity have shown great potentials in managing this debilitating condition. We summarized the recent developments in the assessment of sarcopenia and its management with ONS and physical activity. Recent findings Many methods were developed to ...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - April 9, 2021 Category: Nutrition Tags: TRANSLATIONAL RESEARCH IN WASTING DISEASES: Edited by Claude Pichard and Mariëlle P.K.J. Engelen Source Type: research

From bench to bedside: updates in basic science, translational and clinical research on muscle fatigue in cancer cachexia
Purpose of review Cancer cachexia is a syndrome of loss of weight and muscle mass that leads to reduced strength, poor physical performance and functional impairment. Muscular fatigue is a distressing syndrome that patients with cachexia suffer from and can impair quality of life. Here, we review recent updates in muscular fatigue in cancer cachexia research with a focus on mechanisms, biomarkers and potential therapies. Recent findings Both in mice and humans, research has shown that muscle fatigue can be independent of muscular atrophy and can happen early in cancer development or in precachexia. Inflammatory ...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - April 9, 2021 Category: Nutrition Tags: TRANSLATIONAL RESEARCH IN WASTING DISEASES: Edited by Claude Pichard and Mariëlle P.K.J. Engelen Source Type: research

Gut microbiota and motoric-cognitive frailty in hospitalized older persons
Purpose of review In older people, many systems spontaneously change without diseases. Because of the ageing process, the gut microbiota undergoes a reduced species richness, altered balance between species, with an increased interindividual variability. The result is the reduced resilience in the presence of diseases and medications. These changes are more evident in older persons with neurodegenerative diseases and cognitive-motoric frailty. Recent findings A relationship between liver alteration, gut microbiota and the presence of viruses and gram-bacteria is conceivable. They determine the acceleration of ne...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - April 9, 2021 Category: Nutrition Tags: TRANSLATIONAL RESEARCH IN WASTING DISEASES: Edited by Claude Pichard and Mariëlle P.K.J. Engelen Source Type: research

Editorial: Interplay between systemic health features and gut dysbiosis in aging and clinical (wasting) conditions
No abstract available (Source: Current Opinion in Clinical Nutrition and Metabolic Care)
Source: Current Opinion in Clinical Nutrition and Metabolic Care - April 9, 2021 Category: Nutrition Tags: TRANSLATIONAL RESEARCH IN WASTING DISEASES: Edited by Claude Pichard and Mariëlle P.K.J. Engelen Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Clinical Nutrition and Metabolic Care)
Source: Current Opinion in Clinical Nutrition and Metabolic Care - April 9, 2021 Category: Nutrition Tags: EDITORIAL INTRODUCTIONS Source Type: research

Prioritizing nutrition during recovery from critical illness
Purpose of review Patients admitted to the intensive care unit (ICU) often experience a significant decline in nutritional status due to a combination of the physiologic response to critical illness and insufficient calorie intake. The majority of research related to nutrition interventions for this population focuses on nutrition support during the acute phase. Minimal attention is given to the nutritional status of ICU patients during the recovery phase. This review will describe calorie intake when ICU care ends, provide an overview of barriers that limit intake, and possible interventions to improve nutritional sta...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Michael P. Casaer and Adam M. Deane Source Type: research

Should evidence generated in well developed countries inform critical care nutrition in all countries?
Purpose of review Critically ill patients who survive the ICU face issues such as reduced quality of life and increased disability and nutritional therapy during ICU stay may be used to reduce these adverse effects. Although evidence and guidelines are available to direct clinical nutrition for ICU patients, critical care practices and settings differ substantially between developed and developing countries. Recent findings The implementation of evidence generated in well developed countries regarding critical care nutrition depends heavily on factors such as operation model, the structure of the unit, different...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Michael P. Casaer and Adam M. Deane Source Type: research

Using technology to assess nutritional status and optimize nutrition therapy in critically ill patients
Purpose of review Malnutrition is prevalent in critically ill patients and is linked to worse outcomes such as prolonged mechanical ventilation, length of intensive care unit (ICU) stay, and increased mortality. Therefore, nutritional therapy is important. However, it is often difficult to accurately identify those at high malnutrition risk and to optimize nutritional support. Different technological modalities have therefore been developed to identify patients at high nutritional risk and to guide nutritional support in an attempt to optimize outcomes. Recent findings Computed tomography (CT), ultrasound (US), ...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Michael P. Casaer and Adam M. Deane Source Type: research

Are periods of feeding and fasting protective during critical illness?
Purpose of review To review the mechanisms how intermittent feeding regimens could be beneficial in critically ill patients. Recent findings Large randomized controlled trials (RCTs) have failed to demonstrate consistent benefit of early, enhanced nutritional support to critically ill patients, and some trials even found potential harm. Although speculative, the absence of a clear benefit could be explained by the continuous mode of feeding in these trials, since intermittent feeding regimens had health-promoting effects in healthy animals and humans through mechanisms that also appear relevant in critical illne...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Michael P. Casaer and Adam M. Deane Source Type: research

Parenteral nutrition in critical illness: total, supplemental or never?
Purpose of review The current review summarizes recent evolutions in knowledge and discusses the concept of whom and when parenteral nutrition should be considered in critically ill patients as a total form of nutrition, in a supplemental form, or never. Recent findings Recent developments in our understanding of the application of parenteral nutrition in critical care include the phases of illness, avoidance of overfeeding and the population in whom parenteral nutrition may be appropriate for. Importantly, one of the greatest lessons of recent times may be who not to provide parenteral nutrition to; however, a ...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Michael P. Casaer and Adam M. Deane Source Type: research

Micronutrients early in critical illness, selective or generous, enteral or intravenous?
Purpose of review Micronutrients have essential antioxidant and immune functions, while low blood concentrations are frequently observed in critically ill patients. This has led to the concepts of complementation, repletion, or even pharmacological supplementation. Over the last three decades, many clinical studies have tested the latter strategy, with controversial or negative results. Therefore, this review aims at evaluating micronutrient-related interventions that are mandatory or need to be assessed in future trials or clinical registries in all or specific critically ill patients. Recent findings In the cr...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Michael P. Casaer and Adam M. Deane Source Type: research

Enteral nutrition in circulatory shock: friend or foe?
Purpose of review Circulatory shock is associated with reduced splanchnic blood flow and impaired gut epithelial barrier function (EBF). Early enteral nutrition (EN) has been shown in animal models to preserve EBF. There are limited human data informing early EN in circulatory shock and critical care nutrition guidelines provide disparate recommendations regarding the optimal timing and dose. The purpose of this review is to describe the harms and benefits of early EN in circulatory shock by identifying and appraising recent human data. Recent findings The cumulative risk of nonocclusive bowel ischemia and necro...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Michael P. Casaer and Adam M. Deane Source Type: research

Electrolyte disorders during the initiation of nutrition therapy in the ICU
Purpose of review To summarize recent evidence on prevalence, risk factors, significance, treatment, and prevention of electrolyte disorders in critically ill with a specific focus on disorders during the initiation of nutrition. Recent findings Electrolyte disturbances appear to occur often during critical illness, and most of them seem to be associated with impaired outcome. However, a recent systematic review indicated insufficient evidence to answer clinically relevant questions regarding hypophosphatemia. Similar questions (which thresholds of serum levels are clinically relevant; how serum levels should be...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Michael P. Casaer and Adam M. Deane Source Type: research

Energy expenditure and delivery: does the Micawber principle apply during critical illness?
Purpose of review To determine from existing literature if achieving energy balance in critically ill patients improves outcome. Only randomized clinical trials were considered. Furthermore, the intent had to be that energy intake of the treatment group would reach 100% of requirement, and that the requirement was measured and not estimated. Recent findings Six studies meeting the above criteria were identified. Truly positive energy balance was rarely achieved in these studies and protein intake was a confounder because it often varied with the energy intake. The two studies in which energy balance came closest...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Michael P. Casaer and Adam M. Deane Source Type: research

Editorial: Five false arguments for using parenteral nutrition during the first week of critical illness
No abstract available (Source: Current Opinion in Clinical Nutrition and Metabolic Care)
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Michael P. Casaer and Adam M. Deane Source Type: research

Editorial: A broader perspective of nutritional therapy for the critically ill
No abstract available (Source: Current Opinion in Clinical Nutrition and Metabolic Care)
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Michael P. Casaer and Adam M. Deane Source Type: research

n – 3 Docosapentaenoic acid: the iceberg n – 3 fatty acid
Purpose of review Docosapentaenoic acid (DPA) is a minor omega-3 fatty acid (FA) which has been frequently overlooked in lipid research. This review examines the biochemical and physiological outcomes of human trials which have used pure preparations of DPA (n − 3 DPA) and also recent developments in specialized proresolving lipid mediators (SPMs) derived from n − 3 DPA. Recent findings There have been only been two human studies and eleven animal studies with pure n − 3 DPA. The doses of n − 3 DPA used in the human trials have been 1–2 g/day. n − 3 DPA a...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: LIPID METABOLISM AND THERAPY: Edited by Philip C. Calder and Richard J. Deckelbaum Source Type: research

Emerging roles of bile acids in control of intestinal functions
Purpose of review Bile acids and their signalling pathways are increasingly recognized as potential therapeutic targets for several diseases. This review summarizes new insights in bile acid physiology, focussing on regulatory roles of bile acids in intestinal functions. Recent findings Recent studies have highlighted the interactions between bile acids and gut microbiome: interfering with microbiome composition may be beneficial in treatment of liver and metabolic diseases by modulating bile acid composition, as different bile acid species have different signalling functions. In the intestine, bile acid recepto...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: LIPID METABOLISM AND THERAPY: Edited by Philip C. Calder and Richard J. Deckelbaum Source Type: research

Recent insights into low-density lipoprotein metabolism and therapy
Purpose of review Elevated levels of low-density lipoprotein cholesterol (LDL-C) are causal to atherosclerosis and, thus, the reduction of LDL-C represents a major objective for the prevention of cardiovascular disease. Aim of this review is to provide an overview on novel strategies to lower LDL-C. Recent findings Although inhibiting liver cholesterol biosynthesis by statins is used as the main therapeutic approach to increase hepatic LDL-receptor expression and lower plasma cholesterol levels, novel insights into lipid and lipoprotein biology have led to the development of additional lipid-lowering therapies t...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: LIPID METABOLISM AND THERAPY: Edited by Philip C. Calder and Richard J. Deckelbaum Source Type: research

Omega-3 fatty acids and human skeletal muscle
Purpose of review To examine recent findings related to the influence of omega-3 (ω-3) fatty acid supplementation on skeletal muscle anabolism with a particular focus on situations of skeletal muscle disuse. Recent findings Skeletal muscle disuse results in a reduction in fed and fasted rates of skeletal muscle protein synthesis leading to the loss of skeletal muscle mass. Recent evidence has suggested that supplementation with ω-3 fatty acids during a period of skeletal muscle disuse increases the ω-3 fatty acid composition of skeletal muscle membranes, heightens rates of skeletal muscle prote...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: LIPID METABOLISM AND THERAPY: Edited by Philip C. Calder and Richard J. Deckelbaum Source Type: research

Editorial: Omega-3 fatty acids: new studies, new data, new questions
No abstract available (Source: Current Opinion in Clinical Nutrition and Metabolic Care)
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: LIPID METABOLISM AND THERAPY: Edited by Philip C. Calder and Richard J. Deckelbaum Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Clinical Nutrition and Metabolic Care)
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2021 Category: Nutrition Tags: EDITORIAL INTRODUCTIONS Source Type: research