Current opinion in clinical nutrition and metabolic care
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To examine the impact of folic acid fortification, including its use as a functional food component, on human health. ⋯ The highly complex and critical biological importance of folic acid-related molecular nutrition makes it a difficult micronutrient to deploy as a simple intervention at a population level - it has far too many biochemical spheres of influence to predict effects in a generalized way. Additionally, several gene variants and other nutrients are interactive factors. It is, therefore, hardly surprising that the scientific community does not have a true consensus view on whether mandatory fortification is appropriate as a population measure. This latter point not withstanding, any ultimate decisions on fortification should be well rooted in scientific fact rather than political expediency.
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Curr Opin Clin Nutr Metab Care · Nov 2009
ReviewSoft drinks and body weight development in childhood: is there a relationship?
The high sugar content of regular soft drinks brought up discussions on their influence on energy balance and body weight especially in childhood and adolescence. This review examines the evidence for a causal relationship between soft drink consumption and excess weight gain in childhood and identifies potential underlying mechanisms. ⋯ The replacement of soft drinks and other sugar-containing beverages such as fruit juices by noncaloric alternatives seems to be a promising approach for the prevention of overweight in childhood and adolescence. However, as the cause of overweight and obesity is multifactorial, the limitation of soft drink consumption needs to be incorporated in a complex strategy for obesity prevention.
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Curr Opin Clin Nutr Metab Care · Sep 2009
ReviewAdvances in understanding and assessing malnutrition.
To describe the varying views on the pathophysiology of malnutrition in different populations and the definitions that result from these views. To propose an umbrella definition for different malnutrition syndromes and principles of assessment of nutritional state. ⋯ There is an increasing acknowledgement of the fact that malnutrition is caused by disturbances in nutrient balance and inflammatory activity. This leads to changes in body composition and diminished function. An umbrella definition has been proposed including the pathogenetic factors, underlying the different malnutrition syndromes and dictating the methods to assess malnutrition.
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Curr Opin Clin Nutr Metab Care · Jul 2009
ReviewDichotomic actions of glutamine in host versus tumour: an emerging concept.
Malignancy is characterized by a systemic deficiency of glutamine (GLN). The debate over whether GLN supplementation should be standard of cancer patients is still topical. This review focuses on recent findings on the effect of GLN administration on the incidence and severity of adverse effects in host due to radiotherapy or chemotherapy or both and on its putative adjuvant role on cytotoxicity of radiotherapy and chemotherapy on tumour. ⋯ Recent studies have shown that GLN could have dichotomic actions in host versus in tumour, probably in link with glutathione metabolism, suggesting that GLN could be used in clinical practice to increase the therapeutic index of oncological treatments.
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Curr Opin Clin Nutr Metab Care · May 2009
ReviewChallenges of nutritional assessment in pediatric ICU.
The nutritional assessment of children in the pediatric ICU is unique in view of the metabolic changes of the underlying disease. This review addresses the use and limitations of anthropometry and laboratorial and body composition markers in the diagnosis of the nutritional status of such patients. ⋯ Nutritional assessment is one of the main aspects of the pediatric intensive care patient and is the most important tool to avoid hospital undernutrition. There is currently no gold standard for nutritional assessment in the pediatric ICU. The results of anthropometric and laboratory markers must be jointly analyzed, but individually interpreted according to disease and metabolic changes, in order to reach a correct diagnosis of the nutritional status and to plan and monitor the nutritional treatment.