Nutrients
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Sepsis is a devastating disease that carries an enormous toll in terms of human suffering and lives lost. Over 100 novel pharmacologic agents that targeted specific molecules or pathways have failed to improve the outcome of sepsis. ⋯ HAT therapy is based on the concept that a combination of readily available, safe and cheap agents, which target multiple components of the host's response to an infectious agent, will synergistically restore the dysregulated immune response and thereby prevent organ failure and death. This paper reviews the rationale for HAT therapy with a focus on vitamin C.
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Regulation of appetite and food intake is partly regulated by N-acylethanolamine lipids oleoylethanolamide (OEA), stearoylethanolamide (SEA), and palmitoylethanolamide (PEA), which induce satiety through endogenous formation in the small intestine upon feeding, but also when orally or systemic administered. OEA, SEA, and PEA are present in human milk, and we hypothesized that the content of OEA, SEA, and PEA in mother's milk differed for infants being heavy (high weight-for-age Z-score (WAZ)) or light (low WAZ) at time of milk sample collection. ⋯ Mean OEA, SEA, and PEA concentrations were lower in the high compared to the low WAZ group (all p < 0.02), and a higher concentration of SEA was associated with lower anthropometric measures, e.g., triceps skinfold thickness (mm) (β = -2.235, 95% CI = -4.04, -0.43, p = 0.016), and weight gain per day since birth (g) (β = -8.169, 95% CI = -15.26, -1.08, p = 0.024). This raises the possibility, that the content of satiety factors OEA, SEA, and PEA in human milk may affect infant growth.
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Functional disorders are common, with irritable bowel syndrome (IBS) being the commonest and most extensively evaluated functional bowel disorder. It is therefore paramount that effective therapies are available to treat this common condition. Diet appears to play a pivotal role in symptom generation in IBS, with a recent interest in the role of dietary therapies in IBS. ⋯ However, there are questions with regards to which components of wheat lead to symptom generation, as well as the effect of a GFD on nutritional status, gut microbiota and long-term outcomes. Further studies are required, although the design of dietary studies remain challenging. The implementation of a GFD should be performed by a dietitian with a specialist interest in IBS, which could be achieved via the delivery of group sessions.
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The clinical conditions of critically ill patients are highly heterogeneous; therefore, nutrient requirements should be personalized based on the patient's nutritional status. However, nutritional status is not always considered when evaluating a patient's nutritional therapy in the medical intensive care unit (ICU). We conducted a retrospective cross-sectional study to assess the effect of ICU patients' nutrition risk status on the association between energy intake and clinical outcomes (i.e., hospital, 14-day and 28-day mortality). ⋯ Higher mean energy intake was associated with lower hospital, 14-day and 28-day mortality rates in patients with high nutrition risk; while there were no significant associations between mean energy intake and clinical outcomes in patients with low nutrition risk. Further examination of the association between amount of energy intake and clinical outcomes showed that patients with high nutrition risk who consumed at least 800 kcal/day had significantly lower hospital, 14-day and 28-day mortality rates. Although patients with low nutrition risk did not benefit from high energy intake, patients with high nutrition risk are suggested to consume at least 800 kcal/day in order to reduce their mortality rate in the medical ICU.
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Randomized Controlled Trial
Short-Term Hemodynamic Effects of Modern Wheat Products Substitution in Diet with Ancient Wheat Products: A Cross-Over, Randomized Clinical Trial.
Recent evidence suggests that bioactive compounds isolated from cereals and legumes could exert some metabolic and vascular effects in humans. Due to the recent identification of a non-specific lipid transfer protein (nsLTP2) in wheat with antioxidant and anti-inflammatory activity, we aimed to comparatively test the hemodynamic and metabolic effects of ancient wheat foodstuffs (made of organic KAMUT® khorasan wheat) or modern wheat ones, made of a mixture of organic modern commercial durum (T. durum) varieties and soft wheat (T. aestivum), with different nsLTP2 content. ⋯ After ancient wheat foodstuffs intake, subjects experienced a significant improvement in triglycerides (-9.8% vs. baseline and -14.5% versus modern wheat), fasting plasma glucose (-4.3% versus baseline and -31.6% versus modern wheat), diurnal SBP (-3.1% vs. baseline and ⁻30.2% vs. modern wheat) and nocturnal SBP (-3.2% vs. baseline and -36.8% vs. modern wheat), and pulse volume change (+4.2% vs. baseline and +2.3% vs. modern wheat) (p < 0.05 vs. baseline and versus modern wheat foodstuffs intake). Therefore, our findings show that substituting modern wheat products in diet with ancient wheat ones, might exert a mild improvement in 24-h SBP and endothelial reactivity in pre-hypertensive healthy subjects.