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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 abundance is increased in...
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 protein synthesis, 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

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

A brief discussion of the benefit and mechanism of vitamin D supplementation on coronavirus disease 2019
Purpose of review Vitamin D exerts extraskeletal functions, including immunomodulatory activity, protection against respiratory tract infections and pleiotropic effects on the cardiovascular system. Since the outbreak of the coronavirus disease-2019 (COVID-19) pandemic, several articles have suggested the potential involvement of vitamin D in reducing the risk and severity of the disease. Recent findings Epidemiological and observational studies support the hypothesis of a protective role of vitamin D but most studies are retrospective or based on small samples. However, the pandemic progression and the increase...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - December 19, 2020 Category: Nutrition Tags: HOT TOPIC Source Type: research