早产儿不同喂养方法时血浆胃动素变化的研究

目的比较早产儿生后早期间断鼻十二指肠喂养和鼻胃管喂养对进奶量、生长情况、喂养相关并发症的影响及血浆胃动素的变化.方法将40例早产儿随机分为鼻十二指肠喂养和鼻胃管喂养组,用同一种配方乳喂养.记录喂养1用的入液量、体格生长指标、大便性状、喂养相关并发症.测定喂养前及喂养1w后血浆胃动素水平.结果喂养后1周鼻十二指肠喂养组较鼻胃管喂养组平均进奶量显著增加(P＜0.001);恢复出生体重时间明显缩短(P＜0.05);高胆红素血症发生率显著减少(P＜0.01).两组喂养1w后身长、头围的变化无明显差异(P＞0.05),但两组血浆胃动素水平均较喂养前显著增加(P＜0.001).结论间断鼻十二指肠喂养是早产儿生后早期较适宜的喂养方法.     

Whey hydrolysate compared with cow's milk-based formula for weaning at about 6 months of age in high allergy-risk infants: effects on atopic disease and sensitization

Ninety-one high atopy-risk infants were prospectively followed up to 18 months of age with regard to the development of allergic/atopic manifestations and sensitization. They were randomized into one of two feeding groups, i.e., a hydrolyzed, ultrafiltered cow's milk whey formula, Profylac® ( n = 32), or an ordinary cow's milk formula ( n = 39), for 12 months, started after exclusive breast-feeding for 0–9 (median 6.0) months. Lactating mothers avoided milk, egg, and fish, as did the infants up to 12 months of age. Twenty of the 91 infants were breast-fed exclusively for more than 9 months and regarded as a control group. All infants were followed-up by questionnaires, physical examinations, skin prick tests, and determination of serum total IgE and cow's milk-specific IgE. The frequency of allergic/atopic disease was similar in the three groups. However, all three infants who developed cow's milk allergy with skin symptoms belonged to the cow's milk formula group. The skin prick test with whey hydrolysate was negative in all, while with cow's milk it was positive in eight infants. Growth was similar in the three groups. The study comprises too few infants to allow us to make statistically based statements. However, the difficulties encountered and the limited effects obtained by the use of whey hydrolysate at weaning at about 6 months of age made us conclude that we can spare high atopy-risk families this extra burden.     

武汉市地铁工作人员营养与饮食行为分析

目的 调查武汉市地铁工作人员营养与饮食行为状况,分析饮食行为影响因素。方法 采用分层随机抽样的方式对武汉市地铁集团402名员工进行问卷调查,收集基本信息、膳食摄入及日常饮食行为情况,运用秩和检验、χ2检验和多因素logistic回归分析对营养状况和饮食行为及其影响因素进行评价。结果 地铁工作人员日均蔬菜类、水果类、蛋类、奶及奶制品和水摄入量低于推荐量;畜禽肉类摄入量高于建议量;三班制和四班制员工的蔬菜摄入量低于不轮班和两班制员工（P＜0.05）。不经常吃早餐的比例,客运值班员和行车值班员高于行政管理人员（χ2 = 19.307,P＜0.05）,三班制和四班制高于不轮班（χ2 = 20.513,P＜0.05）。点外卖的比例,女性高于男性（χ2 = 10.195,P＜0.05）,客运值班员和行车值班员高于电动客车司机和行政管理人员（χ2 = 31.061,P＜0.05）,三班制和四班制高于不轮班（χ2 = 19.735,P＜0.05）。51.3%的员工吃饭过快。多因素logistic分析显示,男性（OR = 0.595,95%CI:0.357～0.990）、非行政管理人员工种（客运值班员:OR = 0.169,95%CI:0.036～0.794; 行车值班员:OR = 0.095,95%CI:0.020～0.452; 电动客车司机:OR = 0.107,95%CI:0.022～0.527）与健康饮食行为呈负相关,年龄小（20～25岁:OR = 4.568,95%CI:1.784～11.694;＞25～30岁:OR = 3.553,95%CI:1.528～8.261）与健康饮食行为呈正相关。结论 武汉市地铁工作人员存在某些食物种类摄入不合理情况,性别、年龄和工种是健康饮食行为的影响因素。     

Are We Ready for a New Approach to Comparing Coverage and Reimbursement Policies for Medical Nutrition in Key Markets: An ISPOR Special Interest Group Report

ObjectivesHealthcare policy makers should ensure optimal patient access to medical nutrition (MN) as part of the management of nutrition-related disorders and conditions. Questions remain whether current healthcare policies reflect the clinical and economic benefits of MN. The objective of this article is to characterize coverage and reimbursement of MN, defined as food for special medical purposes/medical food for a diverse set of countries, including Australia, Belgium, Brazil, Canada, China, France, Germany, Hong Kong, Italy, Japan, The Netherlands, Singapore, Spain, United Kingdom, and United States.MethodsData sources included published literature and online sources. ISPOR’s Nutrition Economics Special Interest Group developed a data collection form to guide data extraction that included reimbursement coverage, years that reimbursement policies were established, and presence of a formal health technology assessment (HTA) for MN technologies.ResultsReimbursement coverage of MN technologies varied across the countries that were reviewed. All but 3 countries limited coverage to specific formulations of products, regardless of demonstrated clinical benefit. The year that reimbursement policies were established varied across countries (ranging from 1984 to 2017), and only 4 countries regularly update policies. France and Brazil are the only countries with a formal HTA process for MN technologies.ConclusionsMost countries have limited MN reimbursement, have not updated reimbursement policies, and lack HTA for MN technologies. These limitations may lead to suboptimal access to MN technologies where they are indicated to manage nutrition-related disorders and conditions, with the potential of negatively affecting patient and healthcare system outcomes.     

结构性营养护理对ICU脑卒中患者免疫功能、营养状况及神经功能的影响

目的：分析结构性营养护理用于重症监护室(ICU)脑卒中患者的效果。方法：选取在商丘市第一人民医院2020年1月至2020年12月诊治的140例ICU脑卒中患者,随机分成对照组、观察组,每组70例。对照组患者进行常规护理,观察组患者给予结构性营养干预,比较两组患者护理效果。结果：护理后,观察组患者美国国立卫生研究院脑卒中量表(NIHSS)评分显著低于对照组,差异具有统计学意义(P <0.05);护理后,观察组患者总蛋白、白蛋白、血红蛋白水平均高于对照组,差异具有统计学意义(P <0.05);护理后,观察组患者CD4⁺、CD8⁺、白细胞介素–6(IL–6)水平均低于对照组,CD4⁺/CD8⁺、白细胞介素–10(IL–10)水平高于对照组,差异具有统计学意义(P <0.05);护理后,观察组患者日常饮食管理行为、饮食依从行为态度、遵医饮食行为、家属支持态度以及总分均高于对照组,差异具有统计学意义(P <0.05)。结论：对ICU脑卒中患者实施结构性的营养管理策略,能提高患者免疫功能...     

Diet Quality of Elite Australian Athletes Evaluated Using the Athlete Diet Index

While athletes’ nutrient intakes have been widely reported, few studies have assessed the diet quality of athletes. This is the first study to evaluate the diet quality of athletes using the purpose-built Athlete Diet Index (ADI). A convenience sample of 165 elite athletes from Australian sporting institutions completed the ADI online, with subsequent automated results provided to their respective accredited sports dietitians (ASDs). At the completion of athlete participation, ASDs (n = 12) responded to a range of survey items using a Likert scale (i.e., 1 = strongly agree to 5 = strongly disagree) to determine the suitability of the ADI in practice. Differences in ADI scores for demographics and sport-specific variables were investigated using independent t-tests, analysis of variance (ANOVA) and Bonferroni multiple comparisons. Spearman’s rank correlation was used to assess the association between total scores and demographics. The mean total ADI score was 91.4 ± 12.2 (range 53–117, out of a possible 125). While there was no difference in total scores based on demographics or sport-specific variables; team sport athletes scored higher than individual sport athletes (92.7 vs. 88.5, p < 0.05). Athletes training fewer hours (i.e., 0–11 h/week) scored higher on Dietary Habits sub-scores compared with athletes training more hours (≥12 h/week; p < 0.05), suggesting that athletes who train longer may be at risk of a compromised dietary pattern or less than optimal nutrition practices that support training. Most (75%) ASDs surveyed strongly agreed with the perceived utility of the ADI for screening athletes and identifying areas for nutrition support, confirming its suitability for use in practice.     

Assessing Diet Quality of Indigenous Food Systems in Three Geographically Distinct Solomon Islands Sites (Melanesia,Pacific Islands)

Indigenous Solomon Islanders, like many living in Pacific Small Island Developing States (PSIDS), are currently experiencing the global syndemic—the combined threat of obesity, undernutrition, and climate change. This mixed-method study aimed to assess nutrition transitions and diet quality by comparing three geographically unique rural and urban indigenous Solomon Islands populations. Participants in rural areas sourced more energy from wild and cultivated foods; consumed a wider diversity of foods; were more likely to meet WHO recommendations of >400 g of non-starchy fruits and vegetables daily; were more physically active; and had significantly lower body fat, waist circumference, and body mass index (BMI) when compared to urban populations. Urban populations were found to have a reduced ability to self-cultivate agri-food products or collect wild foods, and therefore consumed more ultra-processed foods (classified as NOVA 4) and takeout foods, and overall had less diverse diets compared to rural populations. Clear opportunities to leverage traditional knowledge and improve the cultivation and consumption of underutilized species can assist in building more sustainable and resilient food systems while ensuring that indigenous knowledge and cultural preferences are respected.     

Alcoholic and Non-Alcoholic Beer Modulate Plasma and Macrophage microRNAs Differently in a Pilot Intervention in Humans with Cardiovascular Risk

Beer is a popular beverage and some beneficial effects have been attributed to its moderate consumption. We carried out a pilot study to test if beer and non-alcoholic beer consumption modify the levels of a panel of 53 cardiometabolic microRNAs in plasma and macrophages. Seven non-smoker men aged 30–65 with high cardiovascular risk were recruited for a non-randomised cross-over intervention consisting of the ingestion of 500 mL/day of beer or non-alcoholic beer for 14 days with a 7-day washout period between interventions. Plasma and urine isoxanthohumol were measured to assess compliance with interventions. Monocytes were isolated and differentiated into macrophages, and plasma and macrophage microRNAs were analysed by quantitative real-time PCR. Anthropometric, biochemistry and dietary parameters were also measured. We found an increase in plasma miR-155-5p, miR-328-3p, and miR-92a-3p after beer and a decrease after non-alcoholic beer consumption. Plasma miR-320a-3p levels decreased with both beers. Circulating miR-320a-3p levels correlated with LDL-cholesterol. We found that miR-17-5p, miR-20a-5p, miR-145-5p, miR-26b-5p, and miR-223-3p macrophage levels increased after beer and decreased after non-alcoholic beer consumption. Functional analyses suggested that modulated microRNAs were involved in catabolism, nutrient sensing, Toll-like receptors signalling and inflammation. We concluded that beer and non-alcoholic beer intake modulated differentially plasma and macrophage microRNAs. Specifically, microRNAs related to inflammation increased after beer consumption and decreased after non-alcoholic beer consumption.     

Risks in Management of Enteral Nutrition in Intensive Care Units: A Literature Review and Narrative Synthesis

Critically ill patients in the intensive care unit (ICU) have a high risk of developing malnutrition, and this is associated with poorer clinical outcomes. In clinical practice, nutrition, including enteral nutrition (EN), is often not prioritized. Resulting from this, risks and safety issues for patients and healthcare professionals can emerge. The aim of this literature review, inspired by the Rapid Review Guidebook by Dobbins, 2017, was to identify risks and safety issues for patient safety in the management of EN in critically ill patients in the ICU. Three databases were used to identify studies between 2009 and 2020. We assessed 3495 studies for eligibility and included 62 in our narrative synthesis. Several risks and problems were identified: No use of clinical assessment or screening nutrition assessment, inadequate tube management, missing energy target, missing a nutritionist, bad hygiene and handling, wrong time management and speed, nutritional interruptions, wrong body position, gastrointestinal complication and infections, missing or not using guidelines, understaffing, and lack of education. Raising awareness of these risks is a central aspect in patient safety in ICU. Clinical experts can use a checklist with 12 identified top risks and the recommendations drawn up to carry out their own risk analysis in clinical practice.     

Body Composition Changes after a Weight Loss Intervention: A 3-Year Follow-Up Study

Studies comparing different types of exercise-based interventions have not shown a consistent effect of training on long-term weight maintenance. The aim of this study was to compare the effects of exercise modalities combined with diet intervention on body composition immediately after intervention and at 3 years’ follow-up in overweight and obese adults. Two-hundred thirty-nine people (107 men) participated in a 6-month diet and exercise-based intervention, split into four randomly assigned groups: strength group (S), endurance group (E), combined strength and endurance group (SE), and control group (C). The body composition measurements took place on the first week before the start of training and after 22 weeks of training. In addition, a third measurement took place 3 years after the intervention period. A significant interaction effect (group × time) (p = 0.017) was observed for the fat mass percentage. It significantly decreased by 5.48 ± 0.65%, 5.30 ± 0.65%, 7.04 ± 0.72%, and 4.86 ± 0.65% at post-intervention for S, E, SE, and C, respectively. Three years after the intervention, the fat mass percentage returned to values similar to the baseline, except for the combined strength and endurance group, where it remained lower than the value at pre-intervention (p < 0.05). However, no significant interaction was discovered for the rest of the studied outcomes, neither at post-intervention nor 3 years later. The combined strength and endurance group was the only group that achieved lower levels of fat mass (%) at both post-intervention and 3 years after intervention, in comparison with the other groups.