Nutrition
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Dietary supplementation with nutrients that have physiologic effects on immune function has been shown to be beneficial in subsets of patients with surgical and medical critical illness. However, several meta-analyses have suggested potential harm when immune nutrients are used inappropriately. ⋯ This article discusses the mechanisms by which immune nutrients can be used to modulate alterations in innate and acquired immunity associated with critical illness. In addition, recent evidence-based clinical practice guidelines for use of immunonutrition in adults is reviewed as a means to clarify some of the more controversial issues and provide a "roadmap" for the practitioner.
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We investigated the antioxidant potential and hypocholesterolemic effects of acai (Euterpe oleracea Mart.) pulp ingestion in rats fed a standard or hypercholesterolemic diet. ⋯ These results suggest that the consumption of acai improves antioxidant status and has a hypocholesterolemic effect in an animal model of dietary-induced hypercholesterolemia.
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Comparative Study
Fat-free mass depletion in cystic fibrosis: associated with lung disease severity but poorly detected by body mass index.
Malnutrition in cystic fibrosis (CF) is associated with poorer survival, but the determinants of fat-free mass (FFM) depletion are not well-characterized. It is unknown whether routine nutritional indicators, including body mass index (BMI), are adequate for detecting FFM depletion. This study aimed to determine the prevalence of FFM depletion in adults with CF, to compare fat-free mass index (FFMI) with BMI, and to identify predictors of FFM depletion. ⋯ FFM depletion was found in 14% of adults with CF, but was undetectable by BMI in 58% of these patients. These findings, together with the association of FFMI with forced expiratory volume in 1 s predicted, suggest a role for body composition assessment in adult CF care.
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Insulin is an important regulator of glucose, lipid, and protein metabolism. It suppresses hepatic glucose and triglyceride production, inhibits adipose tissue lipolysis and whole-body and muscle proteolysis, and stimulates glucose uptake in muscle. ⋯ Potential differences exist in the regulation of plasma triglyceride concentration and protein metabolism by insulin and in changes in insulin action in response to stimuli (e.g., weight loss and exercise) that are known to alter insulin sensitivity. However, these areas have not been studied comprehensively enough to draw firm conclusions.
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Randomized Controlled Trial
Gastrointestinal tolerance to an inulin-rich soluble roasted chicory extract after consumption in healthy subjects.
We aimed to assess in healthy subjects 1) the effect of two doses of a new naturally inulin-rich soluble chicory extract (IRSCE) on overall gastrointestinal discomfort after short-term ingestion and 2) the effect on gastrointestinal symptoms of long-term consumption of IRSCE administered at a dose compatible with its future commercial use. ⋯ Short- and long-term consumptions of IRSCE, given at a daily dose containing 5 g of inulin, are well tolerated by healthy subjects.