Vol 1, No 2 (spring 2015)
Background: Malnutrition has been the most prevalent problem in hospitalized patients during recent years, which accentuate the paramount importance of comprehensive nutritional support among these patients. This study aimed to provide a review of the recent literature about intensive care unit (ICU) inpatients and their nutritional care.
Methods: This review on energy and nutrient requirements for feeding the ICU inpatients focused on literature in English language. An on-line search using the keywords “nutritional support, malnutrition, ICU inpatients, micronutrient deficiencies, critically ill” in ISI web of science, PubMed, Scopus journals published during the years (June 1979-November 2014) was run. The cross- sectional and prospective studies, as well as the clinical trials, were recruited into this investigation.
Results: Recent studies propose energy provision with 20-25 Kcal/Kg/day or 25-35 Kcal/Kg/day for critically ill patients. The recommended carbohydrate and protein intakes are 2-4 g/Kg/day, 1.2-1.5 g/Kg/day, respectively. The suggested fat intake is 25-30% of a total calorie. The latest studies stressed the need for antioxidant vitamins and trace elements such as A, C, β-carotene, E, selenium, magnesium and zinc among ICU inpatients.
Conclusion: High prevalence of malnutrition among ICU inpatients caution to provide a nutritional health care team, including professionals and dietitians who evaluate the effectiveness of treatment and supplementations. Energy requirement should be determined according to their nutritional and clinical status; then macro and micronutrient needs should be considered for ICU inpatients.
Dietary intake of vitamin D and metabolic syndrome after 3-year follow-up: Tehran lipid and glucose study
Background: The aim of this study was to examine the association between dietary intakes of vitamin D and the metabolic syndrome (MetS) in Tehranian adults, Iran.
Methods: In this population-based prospective study, a sample of 2357 subjects, aged 20-74 years, who had completed a validated food frequency questionnaire, were studied. MetS was defined according to the modified guidelines of the National Cholesterol Education Program Adults Treatment Panel III.
Results: Median intakes of vitamin D were 1.5 and 1.6 µ g/day in men and women respectively. After adjustment for confounding factors, dietary vitamin D intake was inversely associated with fasting blood glucose (β = -0.085, p = 0.004) and waist circumference (β = -0.065, p = 0.035); these associations were attenuated following further adjustment for demographics, body mass index (BMI) and dietary factors ((β = -0.066, p = 0.030) and (β = -0.065, p = 0.044), respectively. An association was observed between incidence of MetS and vitamin D intake (p trend = 0.040), independent of age, gender, smoking, physical activity; this association remained following further adjustment for BMI (p for trend = 0.044) and dietary factors (p for trend = 0.051).
Conclusion: Our findings suggest a significant inverse association between dietary vitamin D intake, MetS, and some of its components after controlling for confounding factors.
Prebiotic supplementation modulates serum immunoglobulin E levels and improves total SCORing atopic dermatitis score in children with atopic dermatitis: a randomized double blind controlled trial
Background: Atopic dermatitis (AD) is a prevalent chronic disease in children aging from 6 months to 12 years old. Recent studies have shown a positive effect of prebiotics in the prevention and treatment of AD. The mechanism of this effect has not been clearly established. The objective of this study was to investigate the effect of supplementation of prebiotic on serum immunoglobulin E (IgE) levels and total SCORing AD (SCORAD) score in 7-24 months old children with AD.
Methods: A total of 70 children with AD in a double-blind controlled clinical trial were randomly divided into two groups. For 3 months, the treated group received prebiotic (inulin + fructooligosaccharide), and the control group received placebo (dextrin powder). At the beginning and at the end of the intervention, the SCORAD test questionnaire was completed for all children by a physician and serum levels of IgE were determined. The collected data were analyzed by SPSS Ver. 18 software, using independent and paired t-tests and regression analysis. p < 0.050 was considered statistically significant.
Results: The total SCORAD score and serum IgE levels before intervention were similar in the treated and control groups, and no correlation was found between these variables. The intervention resulted in a significant improvement in the total SCORAD score in the treatment group compared to control group (p < 0.001). Moreover, prebiotic supplementation resulted in significant decrease in serum IgE levels in the treated compared to control group (p < 0.001). A significant positive correlation was found between total SCORAD score and serum IgE levels in the intervention group (r2 = 0.20; p < 0.001).
Conclusion: Prebiotic supplementation may have beneficial effects on serum IgE, which may improve SCORAD. Our findings suggest prebiotic consumption as an adjuvant treatment of dermatitis.
Background: Previous studies have suggested that sex may be a factor influencing basal metabolic rate (BMR) in adults and school age children. However, few data are available about the effects of sex on BMR in pre-school children. In the present study, we investigated whether sex differences contribute to variations in BMR in pre-school age children.
Methods: Measurements were made on thirty children aged 2-6 years (14 male and 16 female). Measurements were taken of height, age, weight, and total body composition, which was determined using both dual-energy X-ray absorptiometry (DXA) and deuterium dilution. The DXA was also used to determine body composition in different regions of the body. BMR was measured by indirect calorimetry.
Results: We found no significant sex differences with respect to age (F = 0, p = 0.998), weight (F = 0.02, p = 0.884), height (F = 0.33, p = 0.570), and body mass index standard deviation score (F = 0.51, p = 0.480). In addition, no significant difference was found between boys and girls for total fat free mass (FFM) (F = 1.30, p = 0.265) and fat mass (FM) (F = 3.16, p = 0.090) measured by DXA, and total FFM (F = 0.79, p = 0.380) and FM (F = 3.38, p = 0.080) obtained by deuterium dilution. There was no significant difference between pre-school boys and girls for BMR (F = 0.16, p = 0.690). In a multiple regression analysis, only log weight was significantly associated to BMR. The explain variation was 75.3%.
Conclusion: In conclusions we found no significant differences in body composition between pre-school boys and girls and no sex effect on BMR in this age group.
Background: The aim of this study was to determine the type and frequency of dietary supplements use among elite soccer players in 2011/12 season of Iran’s Premier Football League.
Methods: This was a cross-sectional study. We randomly selected 13 teams from 18 teams in 2011/2012 season. All players of each team took part in our study. A total of 234 soccer players enrolled in the study. Data were collected in seven-point times using a questionnaire.
Results: All players consumed at least one single supplement. The most common used supplements among athletes were vitamins C and E. No significant association was found between position played and the type or frequency of supplements use by athletes (p > 0.05). There was no significant relationship between the ranks of teams at the end of season and types or frequency of dietary supplements consumed by players (p > 0.05).
Conclusion: Our findings indicate that the usage of dietary supplements among Iranian elite soccer players is prevalent. Future studies are required to reveal the beneficial and potential hazards of these supplements on athletes’ physical performance and their health.
Provision of nutritional/lifestyle counseling on diabetes self-management: A chance to improve metabolic control in new cases of type 2 diabetes
Background: Type 2 diabetes (T2D) is an increasing public health problem primarily because of increase in the prevalence of a sedentary lifestyle and obesity. The aim of this study was to evaluate the efficacy of self-management education on metabolic control in adults with T2D.
Methods: In a quasi-experimental study, 300 patients with T2D recruited from the Diabetes Society of Natanz, Isfahan, Iran, from October 2012 to January 2013. The patients participated in a 16-week educational program held by trained dietician. At baseline, the intervention group attended a 20 minutes lifestyle and nutritional oral education program. Participants were assessed at baseline, 2 and 4 months follow-up for changes in body mass index, glycemic status, and lipid profile. Non-parametric and parametric descriptive and group × time (pre-post) repeated measure analysis of variance was done.
Results: The mean (± standard deviation) amount of weight lost between baseline and the end of 16 weeks was 0.66 ± 1.62 kg in compared to baseline (p < 0.0010). Significant time × treatment interaction effects were found for triglycerides (p < 0.0001), high density lipoprotein-cholesterol (p = 0.0010), fasting blood sugar (FBS) (p < 0.0001), 2-hour postprandial glucose (p < 0.0001), systolic blood pressure (BP) (p < 0.0001), diastolic BP (p < 0.0001), and hemoglobin A1c (HbA1c) (p = 0.0010). Mean FBS concentrations decreased by 30 mg/dl at week16. There was a non-significant increase in the HbA1c.
Conclusion: Nutritional/lifestyle counseling may improve metabolic control in T2D patients. Hence, it is possible to improve T2D control by means of non- pharmacologic interventions.
Does apolipoprotein A-II polymorphism interact with the association of obesity and serum inflammatory biomarkers in type 2 diabetes patients?
Background: The objective was to investigate the relationship between serum interleukin-18 (IL-18), pentraxin 3 (PTX3), and high-sensitivity C-reactive protein (hs-CRP) levels with body mass index (BMI) and abdominal obesity and also the interaction between genetic variants of apolipoprotein A-II (Apo A-II) and obesity on the levels of these factors in type 2 diabetes patients (T2D).
Methods: A comparative cross-sectional study was conducted in 21 diabetes centers in Tehran. Totally, 180 (35-65 years) T2D patients were divided into two groups of 90 obese (BMI ≥ 30) and 90 non-obese (BMI < 30), according to the BMI with equal numbers of each genotype of Apo A-II: 30 TT, 30 CC, and 30 TC. Serum IL-18, PTX3, and hs-CRP concentrations were compared between two obese and non-obese groups and between subjects with and without central obesity. To investigate the interaction of Apo A-II genetic variants and BMI with inflammatory factors, general linear model was used.
Results: After adjusting data with confounding factors, the mean of serum PTX3 was significantly lower (p < 0.050) in the obese diabetes than non-obese diabetes subjects. Moreover, obese diabetes had higher serum hs-CRP level that on obese subjects (p < 0.010). No significant interaction between Apo A-II 265 T > C polymorphism and BMI on inflammatory biomarkers was observed.
Conclusion: There was a significant difference in inflammatory markers (PTX3 and hs-CRP concentration) between obese and non-obese diabetes. In addition, there was no interaction of Apo A-II 265 T > C genotypes and BMI on inflammatory markers. Weight control may be recommended to modulate inflammation and its complications in obese patients.