Nutrition
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Malnutrition is common in liver cirrhosis and is associated with increased rates of complications, hospitalization, and mortality. There are no consensus guidelines for malnutrition assessment in liver cirrhosis and a large number of clinicians do not routinely assess for malnutrition in patients with liver cirrhosis. This review explores the tools available for assessment of malnutrition in patients with liver cirrhosis, including nutritional screening protocols, anthropometric tools, biochemical tools, techniques analyzing body composition and functional assessments. ⋯ Complementing this Bioelectrical Impedance Analysis can be utilized to assess body composition for the diagnosis of malnutrition. Biochemical markers have thus far failed to show a correlation with malnutrition. While hand grip strength is useful for detecting sarcopenia, a common complication of malnutrition, further evidence is required to validate its correlation with malnutrition.
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Review
Fad diets for non-dialysis chronic kidney disease patients: Can "the miracle diet" be a threat?
In the pursuit of an effortless "miracle cure", there has been a significant increase in the proliferation of fad diets. These diets generally exclude a food group or macronutrients and may also restrict energy intake; they become popular quickly but often lack substantial scientific evidence to support their efficacy and safety. ⋯ Most fad diets are generally restrictive in carbohydrates, high in protein, or unbalanced and have low energy intake, which can harm patients with early stages of chronic kidney damage (CKD) who need a low-protein diet with adequate energy intake. This narrative review discusses the risk of fad diet prescriptions for non-dialysis CKD patients.
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The risk of glycolipid metabolic disorders (GLMDs)-which encompass type 2 diabetes mellitus, hyperlipidemia, hypertension, obesity, non-alcoholic fatty liver disease, and atherosclerosis--is rising gradually and posing challenges to health care. With the popularity of healthy lifestyles, anthocyanin-rich berries have emerged as a potential dietary intervention. ⋯ Our examination of the literature underscores the diverse mechanisms by which anthocyanins exert their beneficial effects, including their intricate bioactivity and functional signaling pathways. The insights gleaned from anthocyanin research offer a promising avenue for harnessing the power of nature to support metabolic health and pave the way for integration into clinical strategies for GLMD management.
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The profiles of intensive care cnit (ICU) critically ill inpatients differ from those of other hospitalized patients, since organ dysfunction is a factor that increases the risk for Refeeding Syndrome (RS) development. It is important to understand the influence of feeding methods and caloric intake on mortality and RS incidence among critically ill adult inpatients. A systematic search, following PRISMA guidelines and protocol for systematic reviews, was conducted for interventional and experimental studies analyzing RS occurrence in adults admitted to ICUs. ⋯ Enteral feeding was the most used method, and, in general, progression of caloric intake did not follow the American Society of Parenteral and Enteral Nutrition (ASPEN) or National Institute of Health and Care (NICE) recommendations for RS. In majority, data collection period of studies was less than 7 days; RS was observed in up to 52.5% of patients, and related mortality varied between 15.6 and 83.3%. Due to weak level of evidence and high heterogeneity found within reviewed studies, it is not possible to determine a robust recommendation as to what would be the best and safest feeding method and caloric progression protocol for patients at risk for developing RS.
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The profiles of intensive care cnit (ICU) critically ill inpatients differ from those of other hospitalized patients, since organ dysfunction is a factor that increases the risk for Refeeding Syndrome (RS) development. It is important to understand the influence of feeding methods and caloric intake on mortality and RS incidence among critically ill adult inpatients. A systematic search, following PRISMA guidelines and protocol for systematic reviews, was conducted for interventional and experimental studies analyzing RS occurrence in adults admitted to ICUs. ⋯ Enteral feeding was the most used method, and, in general, progression of caloric intake did not follow the American Society of Parenteral and Enteral Nutrition (ASPEN) or National Institute of Health and Care (NICE) recommendations for RS. In majority, data collection period of studies was less than 7 days; RS was observed in up to 52.5% of patients, and related mortality varied between 15.6 and 83.3%. Due to weak level of evidence and high heterogeneity found within reviewed studies, it is not possible to determine a robust recommendation as to what would be the best and safest feeding method and caloric progression protocol for patients at risk for developing RS.