scholarly journals P-OGC01 Prevalence and treatment of nutritional deficiencies following Upper Gastrointestinal Surgery for Oesophageal or Gastric Cancer

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Vida Dossou ◽  
Amy Murphy
Keyword(s):  
Vitamin D ◽  
Folic Acid ◽  
Gastrointestinal Surgery ◽  
Digital Systems ◽  
Nutritional Deficiencies ◽  
Initial Assessment ◽  
Contributing Factors ◽  
Mineral Supplement ◽  
Chi Squared ◽  
Upper Gastrointestinal

Abstract Background Patients undergoing Upper Gastrointestinal (UGI) surgery for cancer are left nutritionally vulnerable due to alterations in digestion and absorption this is becoming increasingly evident as more patients are achieving five year survival.  Patients are more likely to endure nutritional deficiencies in particular B12, Iron, Vitamin D, Calcium, Zinc and folic acid.  Reduced absorption and inadequate dietary intake of calories, protein and micronutrients are the main contributing factors post operatively and longer term.  At 2 years post UGI resection the following nutritional deficiencies have been observed: 48% Iron, 42% B12, 40% Folic Acid, 34% Calcium, 33% Zinc, 24% Vitamin D. Methods Data was collected retrospectively from various systems on our Trusts Network.  The trusts reporting system was utilised for blood results.  Digital systems were used to confirm if any action had been taken and if this was appropriate. Additional digital systems were used to obtain clinic lists for the last 6 months.  The Data was collected and entered into an Excel spread sheet for comparison.  Chi squared testing was utilised to compare deficiency rate between different Upper GI surgeries.  Results Chi squared statistical analysis of the nutritional deficiencies in the three main Cancer surgery types (Ivor Lewis / Total OG / Sub-total OG) found there was no statistical difference in prevalence of nutritional deficiency.  Comparison of deficiencies indicated that the main prevalence was or Zinc and Vitamin D pre and post operatively.   Conclusions Nutritional deficiencies should be corrected pre operatively. Monitoring thereafter of nutritional vitamin and mineral status should be individually tailored to suit the patient.  All UGI patients should be commenced on a nutritionally complete vitamin and mineral supplement at the point of initial assessment in the UGI surgical clinic pre operatively.  The recommendation would be to commence Forceval vitamin and mineral supplement as this offers optimal trace element coverage.  Vitamin D deficiency pre operatively should have supplementation to maintain 25(OH)D levels greater than 50nmol/L and rechecked after 3 months. Zinc replacement should be monitored routinely. 

scholarly journals Dramatic Increase in Dietary Supplement Use During Covid-19

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 207-207
Author(s):  
Elif Aysin ◽  
Murat Urhan
Keyword(s):  
Vitamin D ◽  
Immune System ◽  
Dietary Supplements ◽  
Dietary Supplement ◽  
Nutritional Deficiencies ◽  
Upper Respiratory Tract ◽  
Mineral Supplement ◽  
Supplement Use ◽  
Dietary Supplement Use ◽  
Tract Infections

Abstract Objectives When the SARS-CoV-2 Virus was seen in Wuhan, China at the end of 2019, people's interest in vitamin and mineral supplement use has increased all over the world. This study aims to investigate changes in supplement use during pandemic on Turkish people living in Asia, America, Europe and Turkey. Methods An online cross-sectional survey was carried out among total 1678 individuals (women, n = 1329 and men, n = 369, Asia n = 139, America n = 507, Europe n = 292 and Turkey n = 760) older than 18 years in January 2021. An online questionnaire was taken by the volunteered participants. In this study, individuals were asked about dietary supplement use before and after the pandemic, which dietary supplements they used in the pandemic process, and why they were used. Results Individual's dietary supplement use before and during the pandemic were Asia (29.5% and 71.9%), America (40.6% and 75.7%), Europe (30.8% and 68.7%), and Turkey (21.3% and 62.2%) respectively. Vitamin C (74.7%), Vitamin D (58.2%) and multi vitamins (34.2%), Zinc (19.7%), Fish oil (17.9%), Probiotics (13.4%), and Propolis (11.1%) are the most commonly used dietary supplements in all regions. Individuals stated that improving the immune system was the main reason to use dietary supplements (53%). Individuals use it as a result of the diagnosis of nutritional deficiency (14%). The maximum use of dietary supplements in all regions is in between the ages of 31–50. Conclusions This study showed that dietary supplement use increased during the pandemic in all regions. Although most of the individuals stated that they took supplements to strengthen the immune system, it is known that supplements do not prevent Covid-19. However, it has been stated that the use of vitamin D, C, Zinc and selenium supplements may be beneficial, especially in those with diagnosed nutritional deficiencies and those with upper respiratory tract infections. Healthy individuals should be made aware of supplements and usage conditions. Funding Sources None

scholarly journals An investigation of vitamin and mineral supplement recommendation among first-trimester pregnancies

2019 ◽  
Vol 47 (9) ◽  
pp. 958-962 ◽  
Author(s):  
Buse Güler ◽  
Dilek Bilgiç ◽  
Hülya Okumuş ◽  
Hande Yağcan ◽  
Murat Alan
Keyword(s):  
Vitamin D ◽  
Folic Acid ◽  
Vitamin B12 ◽  
Pregnant Women ◽  
Medical Records ◽  
Iron Supplementation ◽  
First Trimester ◽  
Mean Corpuscular Hemoglobin ◽  
Mineral Supplement ◽  
Nutrient Supplements

Abstract Background Healthy and balanced nutrition in pregnancy can affect the mother’s and the fetus’ health. Therefore, health professionals should provide information about this issue to pregnant women. The aim of the study was to examine the rate of vitamin and mineral supplement recommendation among first-trimester pregnant women. Methods The study sample consisted of 697 first-trimester pregnant women between 18 and 40 years of age. The pregnant women who registered to an obstetric outpatient clinic between January and June 2018 were retrospectively reviewed, and data were collected from patient medical records using a questionnaire. Results Physician’s laboratory test orders from the women included the following: ferritin was 18.4%, mean corpuscular hemoglobin (MCH) was 99.7%, folic acid was 10.2%, vitamin D was 6.3%, vitamin B12 was 17.2% and calcium was 20.4%. All of the women’s hemoglobin levels had been examined. A total of 58.8% of the women were recommended to take folic acid, 32.7% iron, 25.7% iodine, 18.8% calcium, 17.2% vitamin A, 21.1% vitamin B12, 17.4% vitamin C, 31.6% vitamin D and 17.5% vitamin E supplements. Conclusion It was determined that ferritin, vitamins B12 and D, calcium, folic acid, iron and iodine levels were not examined routinely in this study. Folic acid and iron supplementation were the most commonly suggested nutrient supplements in the first trimester.

scholarly journals Actualización sobre deficiencias nutricionales en la mujer deportista a partir de la literatura científica

2021 ◽  
Vol 70 (3) ◽  
pp. 164-177
Author(s):  
Mireya Vázquez Franco ◽  
Nuria Giménez-Blasi ◽  
José Antonio Latorre ◽  
Manuel Martínez-Bebia ◽  
Anna Bach ◽  
...  
Keyword(s):  
Vitamin D ◽  
Folic Acid ◽  
Vitamin B12 ◽  
Female Athletes ◽  
Nutritional Deficiencies ◽  
Sports Performance ◽  
Study Objective ◽  
Vitamina D ◽  
Bibliographic Search ◽  
Las Mujeres

Los déficits nutricionales en la mujer deportista causan numerosos problemas de salud, así como un empeoramiento en el rendimiento deportivo, como consecuencia de estas deficiencias nutricionales. El conocimiento de estos déficits y su prevención deben ser un aspecto principal para cualquier responsable deportivo. Establecer la importancia del estudio de los déficits de energía, proteínas, minerales (Fe, Ca y Mg) y vitaminas (Vitamina D, ácido fólico y vitamina B12) que pueden desarrollar las mujeres deportistas y su relación con la prevalencia de la tríada femenina y constatar la importancia del conocimiento por parte de los responsables deportivos de los problemas derivados de los déficits nutricionales. Se realizó una búsqueda bibliográfica de artículos, entre 2013-2020, relevantes para el objetivo de estudio. Se usaron bases de datos científicas como PubMed y Pennutrition, siguiendo los criterios de exclusión e inclusión elegidos para este estudio. 51 artículos fueron encontrados. Los resultados mostraron la prevalencia de energía, Fe, vitamina D y Ca, así como un suficiente aporte proteico, faltan estudios para determinar los niveles de vitamina B12 y ácido fólico. Se observó, además la prevalencia de mujeres que cumplen con uno o varios factores de riesgo para el desarrollo de la tríada de la deportistas femenina. Es imprescindible la prevención o, el tratamiento, de los déficits nutricionales en las mujeres deportistas para asegurar un correcto estado de salud y un rendimiento deportivo óptimo. Nutritional deficiencies in women athletes cause numerous health problems, as well as a worsening of sports performance, as a result of these nutritional deficiencies. Awareness of these deficiencies and their prevention should be a major aspect for any sports manager. The aim of the study was to establish the importance of studying the deficits of energy, protein, minerals (Fe, Ca and Mg) and vitamins (Vitamin D, folic acid and vitamin B12) that can be developed by female athletes and their relationship with the prevalence of the female triad and to establish the importance of knowledge by sports managers of the problems arising from nutritional deficiencies. 51 papers were found. A bibliographic search of relevant articles for the study objective was carried out (2013-2020). Scientific databases such as PubMed and Pennutrition were used, following the exclusion and inclusion criteria chosen for this study. The results showed the prevalence of energy, Fe, vitamin D and Ca, as well as sufficient protein intake and a lack of studies to determine the levels of vitamin B12 and folic acid. In addition, the prevalence of women meeting one or more risk factors for the development of the female sports triad was observed. It is essential the prevention or, treatment, of nutritional deficits in female athletes to ensure proper health status and optimal sports performance.

Efficacy of Adding Folic Acid to Foods

2012 ◽  
Vol 82 (3) ◽  
pp. 177-186 ◽  
Author(s):  
Violeta Fajardo ◽  
Gregorio Varela-Moreiras
Keyword(s):  
Folic Acid ◽  
Age Groups ◽  
Nutritional Deficiencies ◽  
Physiological Status ◽  
Food Fortification ◽  
Limited Information ◽  
Dietary Recommendations ◽  
Nutritional Education ◽  
Food Composition Tables ◽  
Staple Foods

In the past, food fortification along with nutritional education and the decrease in food costs relative to income have proven successful in eliminating common nutritional deficiencies. These deficiencies such as goiter, rickets, beriberi, and pellagra have been replaced with an entirely new set of “emergent deficiencies” that were not previously considered a problem [e.g., folate and neural tube defects (NTDs)]. In addition, the different nutrition surveys in so-called affluent countries have identified “shortfalls” of nutrients specific to various age groups and/or physiological status. Complex, multiple-etiology diseases, such as atherosclerosis, diabetes, cancer, and obesity have emerged. Food fortification has proven an effective tool for tackling nutritional deficiencies in populations; but today a more reasonable approach is to use food fortification as a means to support but not replace dietary improvement strategies (i. e. nutritional education campaigns). Folic acid (FA) is a potential relevant factor in the prevention of a number of pathologies. The evidence linking FA to NTD prevention led to the introduction of public health strategies to increase folate intakes: pharmacological supplementation, mandatory or voluntary fortification of staple foods with FA, and the advice to increase the intake of folate-rich foods. It is quite contradictory to observe that, regardless of these findings, there is only limited information on food folate and FA content. Data in Food Composition Tables and Databases are scarce or incomplete. Fortification of staple foods with FA has added difficulty to this task. Globally, the decision to fortify products is left up to individual food manufacturers. Voluntary fortification is a common practice in many countries. Therefore, the “worldwide map of vitamin fortification” may be analyzed. It is important to examine if fortification today really answers to vitamin requirements at different ages and/or physiological states. The real impact of vitamin fortification on some key biomarkers is also discussed. An important question also to be addressed: how much is too much? It is becoming more evident that chronic excessive intakes may be harmful and a wide margin of safety seems to be a mandatory practice in dietary recommendations. Finally, the “risk/benefit” dilemma is also considered in the “new” FA-fortified world.

scholarly journals Obesity, oxidative DNA damage and vitamin D as predictors of genomic instability in children and adolescents

2021 ◽  
Author(s):  
Moonisah Usman ◽  
Maria Woloshynowych ◽  
Jessica Carrilho Britto ◽  
Ivona Bilkevic ◽  
Bethany Glassar ◽  
...  
Keyword(s):  
Vitamin D ◽  
Dna Damage ◽  
Genomic Instability ◽  
Oxidative Dna Damage ◽  
Nutritional Deficiencies ◽  
Aetiological Factor ◽  
Enzyme Linked Immunosorbent Assay ◽  
Childhood And Adolescence ◽  
Paediatric Obesity ◽  
Vitamin D Levels

Abstract Background/objectives Epidemiological evidence indicates obesity in childhood and adolescence to be an independent risk factor for cancer and premature mortality in adulthood. Pathological implications from excess adiposity may begin early in life. Obesity is concurrent with a state of chronic inflammation, a well-known aetiological factor for DNA damage. In addition, obesity has been associated with micro-nutritional deficiencies. Vitamin D has attracted attention for its anti-inflammatory properties and role in genomic integrity and stability. The aim of this study was to determine a novel approach for predicting genomic instability via the combined assessment of adiposity, DNA damage, systemic inflammation, and vitamin D status. Subjects/methods We carried out a cross-sectional study with 132 participants, aged 10–18, recruited from schools and paediatric obesity clinics in London. Anthropometric assessments included BMI Z-score, waist and hip circumference, and body fat percentage via bioelectrical impedance. Inflammation and vitamin D levels in saliva were assessed by enzyme-linked immunosorbent assay. Oxidative DNA damage was determined via quantification of 8-hydroxy-2′-deoxyguanosine in urine. Exfoliated cells from the oral cavity were scored for genomic instability via the buccal cytome assay. Results As expected, comparisons between participants with obesity and normal range BMI showed significant differences in anthropometric measures (p < 0.001). Significant differences were also observed in some measures of genomic instability (p < 0.001). When examining relationships between variables for all participants, markers of adiposity positively correlated with acquired oxidative DNA damage (p < 0.01) and genomic instability (p < 0.001), and negatively correlated with vitamin D (p < 0.01). Multiple regression analyses identified obesity (p < 0.001), vitamin D (p < 0.001), and oxidative DNA damage (p < 0.05) as the three significant predictors of genomic instability. Conclusions Obesity, oxidative DNA damage, and vitamin D deficiency are significant predictors of genomic instability. Non-invasive biomonitoring and predictive modelling of genomic instability in young patients with obesity may contribute to the prioritisation and severity of clinical intervention measures.

Nutrient supplementation among pregnant women in China: an observational study

2021 ◽  
pp. 1-19
Author(s):  
Tao Han ◽  
Jingwen Dong ◽  
Jiangtao Zhang ◽  
Chenxiao Zhang ◽  
Yuxuan Wang ◽  
...  
Keyword(s):  
Vitamin D ◽  
Folic Acid ◽  
Pregnant Women ◽  
Family Members ◽  
Primary Source ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Nutrient Supplementation ◽  
Face To Face ◽  
Source Of Information

Abstract Objective: To clarify nutrient supplementation usage and primary source of information among pregnant women in China. Design: This cross-sectional study used information on nutrient supplementation and primary source of information collected via face-to-face interviews. Data on the usage of folic acid, calcium/vitamin D, iron, vitamins, docosahexaenoic acid, and other dietary supplements were collected. Primary source of information were categorized as family/relatives, friends/co-workers, the Internet, books/magazines, television/radio, doctors, other people, and oneself. Setting: Maternal and Child Health Hospital in Chengdu, China. Participants: 1081 Chinese pregnant women aged ≥ 20 years with singleton pregnancies. Results: In all three trimesters of pregnancy, usage was highest and most stable for folic acid (81.7%), followed by vitamins (vitamin A, B-group vitamins, vitamin C, and multivitamins; 75.0%), whereas calcium/vitamin D (51.4%) and iron (18.1%) usage was low, potentially indicating a deficiency risk. All supplementation usage percentages increased with pregnancy duration (p < 0.05). Notably, approximately 10% of the pregnant women in our study did not use any nutrient supplementation, and this was especially common in early pregnancy. More than 50% of the women reported getting information on nutrient supplementation from family members, and about 30% reported getting this information from doctors. Conclusions: Among pregnant women in China, awareness about nutrient supplementation increases as the pregnancy progresses, but some types of nutrient supplementation (such as calcium/vitamin D and iron) remain at low levels. It is necessary to pay more attention to the health education of pregnant women in China, and the influence of family members should be emphasized.

scholarly journals A colour atlas of upper gastrointestinal surgery

Gut ◽  
1983 ◽  
Vol 24 (10) ◽  
pp. 965-965
Author(s):  
A G Johnson
Keyword(s):  
Gastrointestinal Surgery ◽  
Upper Gastrointestinal

scholarly journals OC-122 Enhanced recovery after upper gastrointestinal surgery (ERAUGIS) improves outcomes in upper gastrointestinal (UGI) cancer: Abstract OC-122 Table 1

Gut ◽  
2012 ◽  
Vol 61 (Suppl 2) ◽  
pp. A53.1-A53 ◽  
Author(s):  
A J Beamish ◽  
D S Y Chan ◽  
T D Reid ◽  
R Barlow ◽  
I Howell ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Gastrointestinal Surgery ◽  
Upper Gastrointestinal

Intra-abdominal Trocar-Free Vacuum Liver Retractor for Upper-Gastrointestinal Surgery

2017 ◽  
Vol 24 (2) ◽  
pp. 186-191 ◽  
Author(s):  
Christian Benzing ◽  
Helmut Weiss ◽  
Felix Krenzien ◽  
Matthias Biebl ◽  
Johann Pratschke ◽  
...  
Keyword(s):  
Gastrointestinal Surgery ◽  
Obese Patients ◽  
Liver Retraction ◽  
Upper Gi ◽  
Single Port Surgery ◽  
Clinical Series ◽  
Liver Retractor ◽  
Study Population ◽  
Male Patients ◽  
Upper Gastrointestinal

Background. In laparoscopic upper-gastrointestinal (GI) surgery, an adequate retraction of the liver is crucial. Especially in single-port surgery and obese patients, problems may occur during liver retraction. The current study seeks to evaluate the efficacy and safety of the LiVac trocar-free liver retractor in laparoscopic upper-GI surgery. Methods. The present study is a nonrandomized dual-center clinical series describing our preliminary results using the LiVac system for liver retraction. The primary end points of the present study included the effectiveness and safety of the LiVac device as well as complications and documentation of problems with the device during surgery. Results. The device was used in 11 patients for simple and complex laparoscopic procedures. The mean age of the study population was 59.6 years (SD = 20.6; range = 30-84). There were 6 female and 5 male patients with a mean body mass index (BMI) of 31.9 kg/m2 (SD = 8.1; range = 26.0-45.3). The efficacy of the device was excellent in all cases, reducing the number of trocars needed. There were no device-related complications. Conclusion. The LiVac liver retractor is easy to use and provides a good exposure of the operative field in upper-GI laparoscopic surgery, even in obese patients with a high BMI.

Vitamins for the First 1000 Days: Preparing for Life

2012 ◽  
Vol 82 (5) ◽  
pp. 342-347 ◽  
Author(s):  
Ibrahim Elmadfa ◽  
Alexa L. Meyer
Keyword(s):  
Vitamin D ◽  
Folic Acid ◽  
Young Children ◽  
Pregnant Women ◽  
Bone Mineralization ◽  
Type I ◽  
Lactation Performance ◽  
Balanced Diet ◽  
Diabetes Mellitus Type I ◽  
In Pregnancy

Vitamins are essential nutrients for many body functions and particularly important during growth. Adequate supply in pregnancy and in early infancy is therefore crucial, but there is still a lack of knowledge about the needed amounts of vitamins of children older than six months and also during pregnancy. Recommendations for intake levels are generally derived by extrapolation from data for infants based in turn on the contents in breast milk and those for adults. A vitamin of particular importance in pregnancy is folic acid due to its role in the development of the brain and nerve system and the prevention of fetal neural tube defects (NTD). Mandatory fortification of flour and certain other grain products in many countries has been associated with a reduction in NTD incidence. However, other deficiencies or suboptimal status of B vitamins, especially B6 and B12 have been repeatedly reported in pregnant women also in high-income countries. Vitamin A is one of the three most critical micronutrients globally and pregnant women and young children are especially vulnerable to deficiencies. Night blindness, anemia, and immunodeficiency are major consequences of inadequate supply in these populations. Much attention has recently been accorded vitamin D that is also critical in pregnant women and young children for instance because of its involvement in bone mineralization but also its more recently discovered immune-modulating function that is thought to prevent development of autoimmune diseases like diabetes mellitus type I. A healthy balanced diet provides the best basis for optimal pregnancy outcome, lactation performance, and complementary feeding. However, supplements or fortified foods may be needed to cover the high requirements especially of critical vitamins such as vitamin D and folic acid and to correct unfavorable dietary patterns in women or to adapt foods to the needs of young children.

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