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Dietary management of blood glucose in medical critically ill patients with overweight/obesity
Purpose of review As the obesity epidemic continues, there is a greater proportion of patients with overweight, obesity, and other forms of adiposity-based chronic disease that require intensive care. Nutrition therapy in the ICU is a vital part of critical care but can be challenging in this setting because of the increased risk of stress hyperglycemia and adverse impact of obesity- and diabetes-related complications. Recent findings Current guidelines favor early nutritional therapy with a hypocaloric, high-protein diet in patients with overweight/obesity. More aggressive protein intake may be useful in those with g...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2020 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Peter J.M. Weijs and Stephen A. McClave Source Type: research

Nutrition intake in the post-ICU hospitalization period
Purpose of review The care of critically ill patients has evolved over recent years, resulting in significant reductions in mortality in developed countries; sometimes with prolonged issues with recovery. Nutrition research has focused on the early, acute period of critical illness, until more recently, where the post-ICU hospitalization period in critical care survivors has become a focus for nutrition rehabilitation. In this period, nutrition rehabilitation may be a vital component of recovery. Recent findings Overall, oral nutrition is the most common mode of nutrition provision in the post-ICU period. Compared wit...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2020 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Peter J.M. Weijs and Stephen A. McClave Source Type: research

Do micronutrient deficiencies contribute to mitochondrial failure in critical illness?
Purpose of review Mitochondrial dysfunction seems to be the common denominator of several critical care conditions and particularly of sepsis. Faced with relative failure, and limited progress of sepsis therapies aiming at blocking some oxidative and/or inflammatory pathways, the question of antioxidants micronutrient therapy, particularly of selenium, ascorbic acid and thiamine remains open. Recent findings The rationale for the essentiality of numerous micronutrients within the mitochondria is well established. Many studies have tested single micronutrients in animal and in-vitro models and provide positive evidence...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2020 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Peter J.M. Weijs and Stephen A. McClave Source Type: research

Metabolic aspects of muscle wasting during critical illness
Purpose of review Skeletal muscle wasting during critical illness is the result of disturbed metabolism. No proven effective interventions targeting skeletal muscle mass and function during critical illness currently exist. This review summarizes recent advances regarding the complexity of metabolic factors involved and the challenge of establishing the clinical effects of metabolic interventions targeting the muscle. Recent findings Although the catabolic state is limited to the acute phase of critical illness, its subsequent impact on muscle mass and function persists long after ICU discharge. Immobilization, inflam...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2020 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Peter J.M. Weijs and Stephen A. McClave Source Type: research

Evaluating the TARGET and EAT-ICU trials: how important are accurate caloric goals? Point-counterpoint: the pro position
Purpose of review Controversies about the adequate amount of energy to deliver to critically ill patients are still going on, trying to find if hypocaloric or normocaloric regimen is beneficial in this population. Our purpose is to review recent publications using or not indirect calorimetry. Recent findings Numerous studies have compared hypocaloric to normocaloric regimen using predictive equations. However, these equations have been demonstrated to be inaccurate in most of the cases. Some recent PRCT using indirect calorimetry are finding some advantages to isocalorie regimens, but others not. Timing of the nutriti...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2020 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Peter J.M. Weijs and Stephen A. McClave Source Type: research

Editorial: The relevance of nutrition therapy on outcome from critical illness: early feeding in the ICU versus ongoing support following discharge to the ward
No abstract available (Source: Current Opinion in Clinical Nutrition and Metabolic Care)
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2020 Category: Nutrition Tags: NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Peter J.M. Weijs and Stephen A. McClave Source Type: research

N − 3 fatty acids during chemotherapy: toward a higher level of evidence for clinical application
Purpose of review Recommendations for intakes of n − 3 fatty acids (FAs) in patients who are receiving chemotherapy for cancer are based on weak evidence. This review highlights themes within the emergent literature to suggest improvements in the design of studies that provide n − 3 FA supplements concurrent with cytotoxic agents. Recent findings Following earlier research in animal models and human pilot studies, recent human studies have evaluated the effect of providing n − 3 FAs during delivery of single agent and multiagent chemotherapy regimens for breast and gastro-intestinal cancers. Regimens...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2020 Category: Nutrition Tags: LIPID METABOLISM AND THERAPY: Edited by Philip C. Calder and Richard J. Deckelbaum Source Type: research

Pro-resolving lipid mediators in sepsis and critical illness
Purpose of review Sepsis is a life-threatening condition caused by a dysregulated host response to infection that remains a huge clinical challenge. Recent evidence indicates that bioactive lipid mediators derived from polyunsaturated fatty acids termed specialized pro-resolving mediators (SPMs) are promising new candidates for treating critical illness. Recent findings We highlight herein the protective actions of SPMs in experimental sepsis, cardiac dysfunction, and also lung and cerebral injury, and discuss their mechanisms of action. We also emphasize that failed resolution responses and dysregulated SPM pathways ...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2020 Category: Nutrition Tags: LIPID METABOLISM AND THERAPY: Edited by Philip C. Calder and Richard J. Deckelbaum Source Type: research

The fat brain
Purpose of review The purpose of this brief review is to gain an understanding on the multiple roles that lipids exert on the brain, and to highlight new ideas in the impact of lipid homeostasis in the regulation of synaptic transmission. Recent findings Recent data underline the crucial function of lipid homeostasis in maintaining neuronal function and synaptic plasticity. Moreover, new advances in analytical approaches to study lipid classes and species is opening a new door to understand and monitor how alterations in lipid pathways could shed new light into the pathogenesis of neurodegeneration. Summary Lipids ...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2020 Category: Nutrition Tags: LIPID METABOLISM AND THERAPY: Edited by Philip C. Calder and Richard J. Deckelbaum Source Type: research

Editorial: Is it time to separate EPA from DHA when using omega-3 fatty acids to protect heart and brain?
No abstract available (Source: Current Opinion in Clinical Nutrition and Metabolic Care)
Source: Current Opinion in Clinical Nutrition and Metabolic Care - February 11, 2020 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, 2020 Category: Nutrition Tags: EDITORIAL INTRODUCTIONS Source Type: research

Tackling the question of micronutrients intake as one of the main levers in terms of Inuit food security
Purpose of review The Inuit population living in North Canada is facing a drastic change in lifestyle, which has brought about a dramatic nutrition transition characterized by a decrease in the traditional foods consumption and an increasing reliance on processed, store-bought foods. This rapid dietary shift leads to a significant public health concern, as wild-harvested country foods are rich in many micronutrients including vitamins, trace elements and minerals while the most frequently eaten Western foods mainly provide energy, fat, carbohydrates and sodium. This review addresses the emerging strategies to tackle food...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - November 28, 2019 Category: Nutrition Tags: SPECIAL COMMENTARY Source Type: research

Protein intake and outcome in critically ill patients
The objective of this review is to describe the impact of protein intake on the outcomes of critically ill patients in the literature published in the preceding 2 years. Recent findings Observational studies showed inconsistent results regarding the association of higher protein intake and outcomes of critically ill patients. Randomized controlled trials that directly compared higher versus lower protein intake in ICU patients are scarce, varied considerably in their designs and primary outcomes, and generally had relatively small differences in the amount of delivered protein between the study arms. Systematic reviews ...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - November 28, 2019 Category: Nutrition Tags: PROTEIN, AMINO ACID METABOLISM AND THERAPY: Edited by Rajavel Elango and Alessandro Laviano Source Type: research

Effect of branched-chain amino acid supplementation, dietary intake and circulating levels in cardiometabolic diseases: an updated review
Purpose of review Branched-chain amino acids (BCAAs) are essential amino acids derived from diet. BCAA supplementation has been recommended in elderly and athletes, but recent studies suggest an association between high dietary BCAAs and blood levels of BCAAs with greater risk of cardiometabolic diseases (CMD). This review aims to integrate current epidemiological evidence analyzing the association between BCAAs and related-CMD risk factors. Recent findings Most epidemiological studies consistently show that dietary BCAAs are associated with higher risk of type-2 diabetes (T2D) whereas there is limited evidence relate...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - November 28, 2019 Category: Nutrition Tags: PROTEIN, AMINO ACID METABOLISM AND THERAPY: Edited by Rajavel Elango and Alessandro Laviano Source Type: research

Arginine supplementation and cardiometabolic risk
Purpose of review Because arginine is the substrate for nitric oxide synthesis, which is pivotal to vascular homeostasis and linked to the insulin response, it has long been posited that supplemental arginine could benefit cardiometabolic health. Recent findings Recent data have supported the view that supplemental arginine could alleviate the initiation and development of endothelial dysfunction and also shown that it may reduce the risk of type 2 diabetes. One important finding is that these effects may indeed vary as a function of the amount of arginine, its form and notably the metabolic status of the population. ...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - November 28, 2019 Category: Nutrition Tags: PROTEIN, AMINO ACID METABOLISM AND THERAPY: Edited by Rajavel Elango and Alessandro Laviano Source Type: research