Nutrition reviews
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Supplementation of enteral nutritional formulas and parenteral nutrition lipid emulsions with omega-3 fatty acids is a recent area of research in patients with critical illness. It is hypothesized that omega-3 fatty acids may help reduce inflammation in critically ill patients, particularly those with sepsis and acute lung injury. ⋯ The results of the research available to date are contradictory for both enteral and parenteral omega-3 fatty acid administration. Supplementation with omega-3 fatty acids may influence the acute inflammatory response in critically ill patients, but more research is needed before definitive recommendations about the routine use of omega-3 fatty acids in caring for critically ill patients can be made.
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The beneficial effect of probiotic Escherichia coli strain Nissle 1917 (EcN) suggests the gut epithelium plays a basic role in immune interactions with bacteria. Contrary to other commensal strains of Escherichia coli, EcN profoundly modulates the gut barrier to elevate its resistance to microbial pathogens. The present review documents the properties of EcN that have led to the protection of gnotobiotic pigs against lethal enteric infections. This effect could be important in light of the growing number of acquired deficiencies that paralyze gut immunity in humans.
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A high prevalence of maternal vitamin D inadequacy during pregnancy and at delivery has been demonstrated in various ethnic populations living at different latitudes. Because placental transfer of 25(OH)D is the major source of vitamin D to the developing human fetus, there is growing concern about adverse health impacts that hypovitaminosis D during pregnancy may have on the mother as well as the offspring in utero, in infancy, and later in life. While there is lack of consensus regarding the optimal circulating 25(OH)D concentration in pregnancy, it is evident that prior levels used to establish intake recommendations and vitamin D content of prenatal vitamin supplements were too conservative. This review summarizes vitamin D metabolism in the perinatal period, examines evidence regarding outcomes of insufficiency in the mother and offspring, discusses risk factors and prevalence of insufficiency, and considers strategies for public health intervention.
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Chronic inflammation is known to promote the development of many chronic diseases. Pattern recognition receptors (PRRs), Toll-like receptors (TLRs), and nucleotide-binding oligomerization domain proteins (NODs) mediate both infection-induced inflammation and sterile inflammation by recognizing pathogen- associated molecular patterns and endogenous molecules, respectively. PRR-mediated inflammation is an important determinant in altering the risk of many chronic diseases. ⋯ However, n-3 polyunsaturated fatty acids (PUFAs) inhibit agonist-induced activation of PRRs. These results suggest that SFAs and n-3 PUFAs can reciprocally modulate PRR-mediated inflammation, and that PRRs and their downstream signaling components are molecular targets for dietary strategies to reduce chronic inflammation and subsequent risk of chronic diseases. This advancement in knowledge provides a new paradigm for understanding the mechanism by which different dietary fatty acids modify risk of chronic diseases including insulin resistance, atherosclerosis, and cancer.
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Fortified blended foods were developed in the 1960s to improve the nutritional status of children suffering from malnutrition. The present review was conducted to examine the impact that fortified blended foods used in humanitarian relief programs have had on the health and nutritional status of infants and young children with moderate malnutrition, or at risk of undernutrition, in developing countries. Published articles were identified using electronic databases and general Web searches. ⋯ Positive effects on recovery from moderate acute malnutrition and weight gain were observed when fortified blended foods were distributed as dietary supplements. Prevention of severe micronutrient deficiencies in populations reliant on food aid has been reported, but measurements of micronutrient status have rarely been conducted. Evidence of the efficacy of fortified blended foods for improving nutritional outcomes is currently limited and weak.