scholarly journals Secondary Malnutrition and Nutritional Intervention in Cholestatic Liver Diseases in Infants

2021 ◽  
Vol 8 ◽  
Author(s):  
Alfredo Larrosa-Haro ◽  
Erika A. Caro-Sabido

We aimed to conduct an updated review on the pathophysiology, diagnosis, and nutritional intervention of CCLD and secondary malnutrition in infants. Protein-energy malnutrition, impaired linear growth, fat-soluble vitamin deficiencies, and hepatic osteodystrophy can occur in up to 80% of cases. The proposed pathophysiological mechanisms include insufficient energy intake, lipid- and fat-soluble vitamin malabsorption, increased energy expenditure, altered intermediate metabolism, hormonal dysregulation, and systemic inflammation. The current approach to diagnosis is the identification of the deviation of growth parameters, body composition, and serum concentration of micronutrients, which determines the type and magnitude of malnutrition. Currently, liver transplantation is the best therapeutic alternative for the reversal of nutritional impairment. Early and effective portoenteroanatomosis can extend survival in patients with biliary atresia. Medical and dietary interventions in some storage and metabolic diseases can improve liver damage and thus the nutritional status. A proportion of patients with biliary atresia have fat-soluble vitamin deficiencies despite receiving these vitamins in a water-soluble form. With aggressive enteral nutrition, it may be possible to increase fat stores and preserve muscle mass and growth. The nutritional issues identified in the pre- and post-transplantation stages include muscle mass loss, bone demineralization, growth retardation, and obesity, which seems to correspond to the natural history of CCLD. Due to the implications for the growth and development of infants with CCLD with this complex malnutrition syndrome, innovative projects are required, such as the generation of prediction and risk models, biomarkers of growth and body composition, and effective strategies for nutritional prevention and intervention.

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2163 ◽  
Author(s):  
Hsu ◽  
Liao ◽  
Tsai ◽  
Chen

People with sarcopenic obesity (SO) are characterized by both low muscle mass (sarcopenia) and high body fat (obesity); they have greater risks of metabolic diseases and physical disability than people with sarcopenia or obesity alone. Exercise and nutrition have been reported to be effective for both obesity and sarcopenia management. Thus, we aimed to investigate the effects of exercise and nutrition on body composition, metabolic health, and physical performance in individuals with SO. Studies investigating the effects of exercise and nutrition on body composition, metabolic health, and physical performance in SO individuals were searched from electronic databases up to April 2019. Fifteen studies were included in the meta-analysis. Aerobic exercise decreased body weight and fat mass (FM). Resistance exercise (RE) decreased FM and improved grip strength. The combination of aerobic exercise and RE decreased FM and improved walking speed. Nutritional intervention, especially low-calorie high-protein (LCHP) diet, decreased FM but did not affect muscle mass and grip strength. In addition to exercise training, nutrition did not provide extra benefits in outcome. Exercise, especially RE, is essential to improve body composition and physical performance in individuals with SO. Nutritional intervention with LCHP decreases FM but does not improve physical performance.


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2712
Author(s):  
Alejandro Martínez-Rodríguez ◽  
Bernardo J. Cuestas-Calero ◽  
María Martínez-Olcina ◽  
Pablo Jorge Marcos-Pardo

The human population is increasing due to lengthening life expectancy, but the quality of life and health of people is moving in the opposite direction. The purpose of this study is to evaluate how aquatic resistance interval training can influence body composition, body image perception and adherence to the Mediterranean diet (MD) in older women participants in a nutrition education program and to study the relation between these variables. Thirty-four participants aged 69 ± 4 years were randomly assigned into two groups: experimental (aquatic resistance interval training plus nutritional intervention) and control (nutritional intervention). The intervention consisted of resistance training in an aquatic environment carried out for 14 weeks (three sessions per week; 60 min each). Body composition, body image perception and adherence to MD diet were evaluated at baseline and 14 weeks. No significant differences were found between groups regarding body image perception and adherence to the MD. There was a significant increase in muscle mass (kg) (p < 0.001) and a significant decrease in fat mass (kg) (p < 0.001) in the intervention group when compared to the control group. The addition of aquatic resistance interval training to a nutritional intervention was not sufficient to change body image perception and adherence to MD but produced improvement in body composition (through an increase in muscle mass and decrease on fat mass) in older women.


2019 ◽  
Vol 25 (22) ◽  
pp. 2467-2473 ◽  
Author(s):  
Enrique Reyes-Muñoz ◽  
Federica Di Guardo ◽  
Michal Ciebiera ◽  
Ilker Kahramanoglu ◽  
Thozhukat Sathyapalan ◽  
...  

Background: Gestational Diabetes Mellitus (GDM), defined as glucose intolerance with onset or first recognition during pregnancy, represents one of the most common maternal-fetal complications during pregnancy and it is associated with poor perinatal outcomes. To date, GDM is a rising condition over the last decades coinciding with the ongoing epidemic of obesity and Type 2 Diabetes Mellitus (T2DM). Objective: The aim of this review is to discuss the role of diet and nutritional interventions in preventing GDM with the explanation of the special role of myo-inositol (MI) in this matter. Methods: We performed an overview of the most recent literature data on the subject with particular attention to the effectiveness of diet and nutritional interventions in the prevention of GDM with the special role of MI. Results: Nutritional intervention and physical activity before and during pregnancy are mandatory in women affected by GDM. Moreover, the availability of insulin-sensitizers such as different forms of inositol has dramatically changed the scenario, allowing the treatment of several metabolic diseases, such as those related to glucose dysbalance. Although the optimal dose, frequency, and form of MI administration need to be further investigated, diet supplementation with MI appears to be an attractive alternative for the GDM prevention as well as for the reduction of GDM-related complications. Conclusion: More studies should be conducted to prove the most effective nutritional intervention in GDM. Regarding the potential effectiveness of MI, further evidence in multicenter, randomized controlled trials is needed to draw firm conclusions.


Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 340
Author(s):  
Edyta Łuszczki ◽  
Anna Bartosiewicz ◽  
Katarzyna Dereń ◽  
Maciej Kuchciak ◽  
Łukasz Oleksy ◽  
...  

Establishing the amount of energy needed to cover the energy demand of children doing sport training and thus ensuring they achieve an even energy balance requires the resting energy expenditure (REE) to be estimated. One of the methods that measures REE is the indirect calorimetry method, which may be influenced by many factors, including body composition, gender, age, height or blood pressure. The aim of the study was to assess the correlation between the resting energy expenditure of children regularly playing football and selected factors that influence the REE in this group. The study was conducted among 219 children aged 9 to 17 using a calorimeter, a device used to assess body composition by the electrical bioimpedance method by means of segment analyzer and a blood pressure monitor. The results of REE obtained by indirect calorimetry were compared with the results calculated using the ready-to-use formula, the Harris Benedict formula. The results showed a significant correlation of girls’ resting energy expenditure with muscle mass and body height, while boys’ resting energy expenditure was correlated with muscle mass and body water content. The value of the REE was significantly higher (p ≤ 0.001) than the value of the basal metabolic rate calculated by means of Harris Benedict formula. The obtained results can be a worthwhile suggestion for specialists dealing with energy demand planning in children, especially among those who are physically active to achieve optimal sporting successes ensuring proper functioning of their body.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1432.2-1432
Author(s):  
N. Toroptsova ◽  
O. Dobrovolskaya ◽  
N. Demin ◽  
L. Shornikova

Background:Rheumatoid arthritis (RA) is a complex inflammatory disease that modifies body composition. Using the dual-energy x-ray absorptiometry (DXA) in RA patients could be a method for body composition changes detection.Objectives:To study the body composition using DXA in patients with RA.Methods:The study involved 79 women with RA, median age 60 [55; 65] years. The bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry using «Discovery A» (Hologic, USA). Assessment of body composition was carried out, using the program «Whole body». Sarcopenia (SP) was diagnosed as a decrease in appendicular mass index (AMI) <6.0 kg/m2. Osteoporosis (OP) was diagnosed as a decrease in T-score <-2.5 SD. Osteosarcopenia was determined when T-score was <-1.0 SD, AMI was <6.0 kg/m2, osteosarcopenic obesity - T-score was <-1.0 SD, AMI was <6.0 kg/m2and total fat was >35%.Results:The mean duration of RA was 9 [3; 11] years. The mean body mass index (BMI) was 27.6±4.8 kg/m2. Disease activity score in 28 joints-erythrocyte sedimentation rate was 4.5±1.3 points for the group. 39 (49.3%) patients used oral glucocorticoids continuously. Appendicular muscle mass and AMI were on average 17.8±3.0 kg and 6.8±1.0 kg/m2, respectively. AMI <6 kg/m2was detected in 20 (25.3%) patients. 56 (70.9%) women with RA had total fat > 35%, while only 22 (27.8%) of women with RA had obesity according to BMI (BMI >30 kg/m2). Isolated OP was found in 13 (16.5%), osteosarcopenia in 7 (8.9%) and osteosarcopenic obesity in 13 (16.5%) patients RA. No cases with isolated sarcopenia or sarcopenic obesity were detected. Only 3 (3.8%) patients did not have appendicular muscle mass, AMI and BMD decrease and overfat or obesity.Conclusion:About 97% women with RA had abnormal body composition phenotype: 16,5% - OP, 8.9% -osteosarcopenia, 16,5% - osteosarcopenic obesity and 54,4% - overfat.Disclosure of Interests:None declared


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Linan Pinto ◽  
R Pinto ◽  
S Charneca ◽  
J Vasques ◽  
M Lemos Pires ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Introduction  Cardiovascular disease (CVD) is recognized as a major public health issue and remains the leading cause of mortality worldwide. There is a clear association between adiposity, blood lipid profile, and adherence to the Mediterranean diet (MD) with the risk of CVD. However, the assessment of body composition parameters, dietary patterns and nutritional intervention in CVD patients undergoing a cardiovascular rehabilitation (CR) program remains insufficient.  Purpose  to characterize body composition, lipid profile and MD adherence in patients with CVD who were attending an exercise-based CR program during COVID-19 era.  Methods  The study was developed between October 2020 and January 2021 in a phase III centre-based CR program. Body composition was assessed by dual energy x-ray absorptiometry Hologic Explorer-W. Adherence to the MD was assessed by the 14-item MD questionnaire. Fasting blood sample was taken for measurement of lipid profile.  Results  A sample of 41 patients (mean age 64.4 ± 7.9 years, 87.8% male) was evaluated. The most prevalent CVD were coronary artery disease (89.5%) and heart failure (21.1%). The main CVD risk factors at admission in the CR program were dyslipidaemia (71.1%), hypertension (68.4%), physical inactivity (26.3%) and diabetes mellitus (21.0%). In our sample the mean body mass index was 28 ± 3.8 kg/m2, being most patients overweight (75.6%), and having a substantially increased risk of metabolic complications (85.3%) accordingly to waist-hip ratio. Body composition assessment showed that 14.6% of the patients had a body fat mass index above 90th percentile. Although only 9.8% of the patients had reduced fat free mass, 17.1% showed appendicular lean mass below the reference value. In addition, less than one third of the patients (31.7%) revealed a high adherence to the MD pattern. A sub-analysis on blood lipids (n = 26) showed that most patients had levels of LDL cholesterol (76.9%) and non-HDL cholesterol (65.4%) above the therapeutic target and 15.4% had triglycerides higher than 150 mg/dl.  Conclusion  Body composition, lipid profile and dietary patterns, play a major role in CVD secondary prevention. Our findings showed that a substantial number of CVD patients, in COVID-19 era, did not have optimal body composition, were above lipid profile targets, and had a low/medium adherence to the MD. Thus, this study highlights the relevance of nutrition on cardiometabolic status and demonstrates the crucial role of nutritional intervention as an integrated part of a long-term phase III CR program. Moreover, further research about nutritional intervention in patients undergoing CR is warranted.


Molecules ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 503
Author(s):  
Györgyi Horváth ◽  
Eszter Csikós ◽  
Eichertné Violetta Andres ◽  
Tímea Bencsik ◽  
Anikó Takátsy ◽  
...  

Melilotus officinalis is known to contain several types of secondary metabolites. In contrast, the carotenoid composition of this medicinal plant has not been investigated, although it may also contribute to the biological activities of the drug, such as anti-inflammatory effects. Therefore, this study focuses on the isolation and identification of carotenoids from Meliloti herba and on the effect of isolated (all-E)-lutein 5,6-epoxide on primary sensory neurons and macrophages involved in nociception, as well as neurogenic and non-neurogenic inflammatory processes. The composition of the plant extracts was analyzed by high performance liquid chromatography (HPLC). The main carotenoid was isolated by column liquid chromatography (CLC) and identified by MS and NMR. The effect of water-soluble lutein 5,6-epoxide-RAMEB (randomly methylated-β-cyclodextrin) was investigated on Ca2+-influx in rat primary sensory neurons induced by the activation of the transient receptor potential ankyrin 1 receptor agonist to mustard-oil and on endotoxin-induced IL-1β release from isolated mouse peritoneal macrophages. (all-E)-Lutein 5,6-epoxide significantly decreased the percent of responsive primary sensory neurons compared to the vehicle-treated stimulated control. Furthermore, endotoxin-evoked IL-1β release from macrophages was significantly decreased by 100 µM lutein 5,6-epoxide compared to the vehicle-treated control. The water-soluble form of lutein 5,6-epoxide-RAMEB decreases the activation of primary sensory neurons and macrophages, which opens perspectives for its analgesic and anti-inflammatory applications.


Molecules ◽  
2021 ◽  
Vol 26 (8) ◽  
pp. 2237
Author(s):  
Leonid Kaluzhskiy ◽  
Pavel Ershov ◽  
Evgeniy Yablokov ◽  
Tatsiana Shkel ◽  
Irina Grabovec ◽  
...  

Widespread pathologies such as atherosclerosis, metabolic syndrome and cancer are associated with dysregulation of sterol biosynthesis and metabolism. Cholesterol modulates the signaling pathways of neoplastic transformation and tumor progression. Lanosterol 14-alpha demethylase (cytochrome P450(51), CYP51A1) catalyzes one of the key steps in cholesterol biosynthesis. The fairly low somatic mutation frequency of CYP51A1, its druggability, as well as the possibility of interfering with cholesterol metabolism in cancer cells collectively suggest the clinical importance of CYP51A1. Here, we show that the natural flavonoid, luteolin 7,3′-disulfate, inhibits CYP51A1 activity. We also screened baicalein and luteolin, known to have antitumor activities and low toxicity, for their ability to interact with CYP51A1. The Kd values were estimated using both a surface plasmon resonance optical biosensor and spectral titration assays. Unexpectedly, in the enzymatic activity assays, only the water-soluble form of luteolin—luteolin 7,3′-disulfate—showed the ability to potently inhibit CYP51A1. Based on molecular docking, luteolin 7,3′-disulfate binding suggests blocking of the substrate access channel. However, an alternative site on the proximal surface where the redox partner binds cannot be excluded. Overall, flavonoids have the potential to inhibit the activity of human CYP51A1 and should be further explored for their cholesterol-lowering and anti-cancer activity.


2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii372-iii373
Author(s):  
Ana Valente ◽  
Ana Laura Flores ◽  
Cristina Garagarza

Some of the constituent amino-acids of fibroin (degummed silk) are determined. Special attention is directed to histidine, owing to its use in the calculation of the molecular weight of fibroin. A value of 0⋅45% has been found by methods in which the histidine is isolated as nitranilate or di-(3:4-dichlorobenzenesulphonate). Other values obtained are serine 12⋅6%, threonine 1⋅5%, tyrosine 10⋅6%, and proline 1⋅5%. Hydroxyproline appears to be absent, but the presence of small amounts of some hydroxyamino-acid other than serine and threonine is indicated. The mean residue weight of fibroin is determined by three methods, one of which is a new method based on analysis of the complex formed between fibroin and cupri-ethylenediamine. This method gives a Cu:fibroin-N ratio of 1:1⋅92 and, if allowance is made for co-ordination with the tyrosine hydroxy1 group, an equivalence of 1⋅964 atoms of peptide-nitrogen to 1 atom of copper is obtained. The three methods give an average value of 78⋅0 for the mean residue weight of fibroin. This value, together with the most acceptable data for amino-acid constituents, indicate that the unidentified anhydro-residues (about 20%) have a mean residue weight of about 107. Evidence is presented that fibroin contains no amide-nitrogen. Methods for the determination of amide-nitrogen at present in use, which indicate a content of 1 to 2%, are considered to be unreliable. Fibroin dissolved in cupri-ethylenediamine gives, on neutralization and dialysis of the resulting solution, a water-soluble protein. The production of this water-soluble protein is attended by little or no degradation of the original fibroin as shown by determinations of fluidity, amino-nitrogen, and acid- and alkali-combining power. The water-soluble protein is precipitated by the normal protein-precipitating reagents, but in every instance examined the precipitated material exhibits an insolubility comparable with that of the original fibroin. Factors responsible for the solubilization process are investigated and data for molecular weight, titration values, ultra-violet absorption spectra, reducing activity, optical rotation, tryptic hydrolysis, and viscosity for both soluble and dispersed fibroin are given. Soluble fibroin has [ α ] D 15 — 53⋅1° and dispersed fibroin [ α ] D 15 — 58⋅9°, both in aqueous media. The preparation and properties of films and filaments of fibroin are described. Films of fibroin can be prepared that are water-soluble. On stretching, these films show strain-birefringence, acquire considerable tensile strength, and become insoluble in water, but X-ray examination gives the β -keratin pattern for both the stretched and unstretched films. Reasons are advanced for considering the water-soluble form of fibroin to be the native or renatured protein and the original protein to be the denatured form. The denaturation of fibroin is discussed on the basis that denaturation is essentially an unfolding of a coiled long-chain molecule. The subsequent aggregation of the uncoiled molecules to give an insoluble product is considered to be a secondary process. Some aspects of protein and polypeptide chains as macro-molecules are also discussed.


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