Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
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Probiotics are living microorganisms that, when ingested in adequate amounts, provide benefits to the host. The benefits include either a shortened duration of infections or decreased susceptibility to pathogens. Proposed mechanisms of beneficial effects include improving gastrointestinal barrier function, modification of the gut flora by inducing host cell antimicrobial peptides and/or local release of probiotic antimicrobial factors, competition for epithelial adherence, and immunomodulation. ⋯ However, probiotic research will likely be hindered in the future given a recent ruling by the U. S. Food and Drug Administration.
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The prevalence of disease-related malnutrition in hospital inpatients is high; many patients do not meet individual nutrition requirements while hospitalized. To better understand the reasons for inadequate nutrition intake, this study describes patient satisfaction, food provision, food intake, and waste of hospital meals. ⋯ The standard meals provided by the hospital kitchen provide adequate amounts of energy and protein. However, most patients do not consume complete meals. It may be concluded that food waste is largely attributed to the inadequate intake of many hospitalized patients. Patients who experienced the worst health status ate the least.
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The currently available, standard soybean oil (SO)-based intravenous fat emulsions (IVFEs) meet the needs of most parenteral nutrition (PN) patients. There are alternative oil-based fat emulsions, such as medium-chain triglycerides (MCTs), olive oils (OOs), and fish oils (FOs), that, based on extensive usage in Europe, have an equivalent safety profile to SO. These alternative IVFEs are metabolized via different pathways, which may lead to less proinflammatory effects and less immune suppression. ⋯ Many patients who require IVFEs are already in a compromised state. Such patients could potentially have better clinical outcomes when receiving one of the alternative IVFEs to diminish the intake of the potentially proinflammatory ω-6 fatty acid-linoleic acid-which comprises more than 50% of the fatty acid profile in SO. Further research is needed on these alternative oil-based IVFEs to identify which IVFE oils or which combination of oils may be most clinically useful for specific patient populations.