scholarly journals Exploring the Nutritional Ecology of Stunting: New Approaches to an Old Problem

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 371
Author(s):  
Daniel J. Raiten ◽  
Andrew A. Bremer
Keyword(s):  
Global Health ◽  
Food Insecurity ◽  
Maternal Nutrition ◽  
Nutritional Assessment ◽  
Current Knowledge ◽  
Clinical Care ◽  
Nutritional Ecology ◽  
Physical Growth ◽  
Poor Growth ◽  
Pregnancy And Lactation

Despite a declining prevalence, stunting remains an elusive target for the global health community. The perception is that stunting represents chronic undernutrition (i.e., due to inadequate nutrient intake associated with food insecurity, low-quality diet, and suboptimal infant feeding practices in the first two years of life). However, other causes include maternal–fetal interactions leading to intrauterine growth retardation, poor maternal nutrition during pregnancy and lactation, and maternal and pediatric infections. Moreover, physical, economic, demographic, and social environments are major contributors to both food insecurity and conditions that limit linear growth. Overall, factors representing both the internal and external “nutritional ecologies” need to be considered in efforts to reduce stunting rates. Nutritional assessment requires better understanding of the mechanism and role of nutrition in growth, clear expectations about the sensitivity and specificity of the tools used, and inclusion of bio-indicators reflecting the extent and nature of the functional effect of poor nutrition and environmental factors contributing to human physical growth. We provide a perspective on current knowledge about: (i) the biology and contribution of nutrition to stunting/poor growth; (ii) our current nutritional assessment toolkit; (iii) the implications of current assessment approaches for clinical care and public interventions; and (iv) future directions for addressing these challenges in a changing global health environment.

scholarly journals The Infant Gut Microbiota and Risk of Asthma: The Effect of Maternal Nutrition during Pregnancy and Lactation

2020 ◽  
Vol 8 (8) ◽  
pp. 1119 ◽  
Author(s):  
Naser A. Alsharairi
Keyword(s):  
Gut Microbiota ◽  
Early Life ◽  
Nutrient Intake ◽  
Maternal Nutrition ◽  
Current Knowledge ◽  
Increased Risk ◽  
Dietary Nutrient ◽  
Pregnancy And Lactation ◽  
Gut Microbiota Composition

Research has amply demonstrated that early life dysbiosis of the gut microbiota influences the propensity to develop asthma. The influence of maternal nutrition on infant gut microbiota is therefore of growing interest. However, a handful of prospective studies have examined the role of maternal dietary patterns during pregnancy in influencing the infant gut microbiota but did not assess whether this resulted in an increased risk of asthma later in life. The mechanisms involved in the process are also, thus far, poorly documented. There have also been few studies examining the effect of maternal dietary nutrient intake during lactation on the milk microbiota, the effect on the infant gut microbiota and, furthermore, the consequences for asthma development remain largely unknown. Therefore, the specific aim of this mini review is summarizing the current knowledge regarding the effect of maternal nutrition during pregnancy and lactation on the infant gut microbiota composition, and whether it has implications for asthma development.

Severe Acute Malnutrition and Food Insecurity: A Model for Making Global Health Education Relevant Locally

2016 ◽  
Vol 16 (6) ◽  
pp. e51 ◽  
Author(s):  
Pallavi Kamra ◽  
Cynthia Howard ◽  
Diana Cutts ◽  
Sarah J. Schwarzenberg ◽  
Emily Borman-Shoap ◽  
...  
Keyword(s):  
Health Education ◽  
Global Health ◽  
Food Insecurity ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Global Health Education

Is GRADE the Right Choice for Clinical Practice Guidelines Developed by the American Academy of Otolaryngology–Head and Neck Surgery Foundation?

2019 ◽  
Vol 161 (1) ◽  
pp. 3-5
Author(s):  
Andrés M. Bur ◽  
Richard M. Rosenfeld
Keyword(s):  
Clinical Practice ◽  
American Academy ◽  
Head And Neck ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Current Knowledge ◽  
Clinical Care ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
The Right

Clinical practice guidelines (CPGs), developed to inform clinicians, patients, and policy makers about what constitutes optimal clinical care, are one way of increasing implementation of evidence into clinical practice. Many factors must be considered by multidisciplinary guideline panels, including strength of available evidence, limitations of current knowledge, risks/benefits of interventions, patient values, and limited resources. Grading of Recommendations Assessment, Development and Evaluation (GRADE) is a framework for summarizing evidence that has been endorsed by many national and international organizations for developing CPGs. But is GRADE the right choice for CPGs developed by the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF)? In this commentary, we will introduce GRADE, discuss its strengths and limitations, and address the question of what potential benefits GRADE might offer beyond existing methodology used by the AAO-HNSF in developing CPGs.

scholarly journals Docosahexaenoic and Arachidonic Acid Supplementation of Toddlers Born Preterm Does Not Affect Short-Term Growth or Adiposity

2019 ◽  
Vol 149 (12) ◽  
pp. 2182-2190 ◽  
Author(s):  
Taniqua T Ingol ◽  
Rui Li ◽  
Kelly M Boone ◽  
Joseph Rausch ◽  
Mark A Klebanoff ◽  
...  
Keyword(s):  
Arachidonic Acid ◽  
Placebo Group ◽  
Corn Oil ◽  
Controlled Trial ◽  
Clinical Care ◽  
Physical Growth ◽  
Fat Percentage ◽  
Short Term ◽  
Z Scores ◽  
First Year Of Life

ABSTRACT Background Dietary DHA intake among US toddlers is low. Healthy physical growth is an important objective for the clinical care of children born preterm. Objectives The aim of the trial was to examine the effects of supplementing toddlers born preterm with DHA and arachidonic acid (AA) for 180 d on growth and adiposity. Methods Omega Tots, a randomized placebo-controlled trial, was conducted between April 2012 and March 2017. Children born at <35 wk gestation who were 10–16 mo in corrected age were assigned to receive daily oral supplements of DHA and AA (200 mg each, “DHA + AA”) or corn oil (placebo) for 180 d. Prespecified secondary outcomes included weight, length, head circumference, mid-upper arm circumference, triceps and subscapular skinfolds, BMI, and their respective z scores, and body fat percentage, which were measured at baseline and trial completion. Mixed-effects regression was used to compare the change in outcomes between the DHA + AA and placebo groups, controlling for baseline values. Results Among 377 children included in the analysis (median corrected age = 15.7 mo, 48.3% female), 348 (92.3%) had growth or adiposity data at baseline and trial end. No statistically significant differences between the DHA + AA and placebo groups in growth or adiposity outcomes were observed. For instance, the change in weight-for-age z scores was 0.1 for the DHA + AA group and 0.0 for the placebo group (effect size = 0.01, P = 0.99). However, post-hoc subgroup analyses revealed a statistically significant interaction between treatment group and sex, suggesting somewhat slower linear growth for females assigned to the DHA + AA group compared with the placebo group. Conclusions Among toddlers born preterm, daily supplementation with DHA + AA for 180 d resulted in no short-term differences in growth or adiposity compared with placebo. If DHA supplementation is implemented after the first year of life, it can be expected to have no effect on short-term growth or adiposity. This trial is registered with clinicaltrials.gov as NCT02199808.

scholarly journals Model-Informed Precision Dosing: Background, Requirements, Validation, Implementation, and Forward Trajectory of Individualizing Drug Therapy

2021 ◽  
Vol 61 (1) ◽  
pp. 225-245 ◽  
Author(s):  
Adam S. Darwich ◽  
Thomas M. Polasek ◽  
Jeffrey K. Aronson ◽  
Kayode Ogungbenro ◽  
Daniel F.B. Wright ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Current Knowledge ◽  
Clinical Care ◽  
Clinical Decision ◽  
Decision Support Tools ◽  
Support Tools ◽  
Drug Regulations ◽  
The Common ◽  
Clinical Decision Support Tools ◽  
Practical Validation

Model-informed precision dosing (MIPD) has become synonymous with modern approaches for individualizing drug therapy, in which the characteristics of each patient are considered as opposed to applying a one-size-fits-all alternative. This review provides a brief account of the current knowledge, practices, and opinions on MIPD while defining an achievable vision for MIPD in clinical care based on available evidence. We begin with a historical perspective on variability in dose requirements and then discuss technical aspects of MIPD, including the need for clinical decision support tools, practical validation, and implementation of MIPD in health care. We also discuss novel ways to characterize patient variability beyond the common perceptions of genetic control. Finally, we address current debates on MIPD from the perspectives of the new drug development, health economics, and drug regulations.

Relationship of maternal high-fat diet during pregnancy and lactation to offspring health

2020 ◽  
Author(s):  
Kinga Gawlińska ◽  
Dawid Gawliński ◽  
Małgorzata Filip ◽  
Edmund Przegaliński
Keyword(s):  
High Fat Diet ◽  
Maternal Nutrition ◽  
System Development ◽  
Maternal Diet ◽  
Nervous System Development ◽  
High Fat ◽  
Preclinical Research ◽  
Intrauterine Development ◽  
Increased Risk ◽  
Pregnancy And Lactation

Abstract A balanced maternal diet is essential for proper fetal development, and the consumption of a nutritionally inadequate diet during intrauterine development and early childhood is associated with a significantly increased risk of metabolic and brain disorders in offspring. The current literature indicates that maternal exposure to a high-fat diet exerts an irreversible influence on the general health of the offspring. This review of preclinical research examines the relationship between a maternal high-fat diet during pregnancy or lactation and metabolic changes, molecular alterations in the brain, and behavioral disorders in offspring. Animal models indicate that offspring exposed to a maternal high-fat diet during pregnancy and lactation manifest increased depressive-like and aggressive behaviors, reduced cognitive development, and symptoms of metabolic syndrome. Recently, epigenetic and molecular studies have shown that maternal nutrition during pregnancy and the suckling period modifies the development of neurotransmitter circuits and many other factors important to central nervous system development. This finding confirms the importance of a balanced maternal diet for the health of offspring.

Nutrition: A Critical Component of Wound Healing

1990 ◽  
Vol 1 (3) ◽  
pp. 585-592 ◽  
Author(s):  
Nancy A. Stotts ◽  
Donna F. Washington
Keyword(s):  
Health Care ◽  
Wound Healing ◽  
Critical Care ◽  
Nutritional Support ◽  
Nutritional Assessment ◽  
Current Knowledge ◽  
Health Care Team ◽  
Critical Component ◽  
Assessment Technique

Nutrients are essential to wound healing and patients in critical care are often at risk for lack of sufficient nutrients that may result in impaired healing. Understanding the role of the various nutrients in healing provides the basis for assessment and therapy. Use of a practical and consistent nutritional assessment technique is an important part of care for critically ill patients with wounds. The health care team must provide care based on current knowledge of the effects of nutrition on wound healing and work collaboratively in doing nutritional assessment and providing nutritional support to optimize wound healing outcomes

Food (In)Security

2014 ◽  
Author(s):  
Maryah Stella Fram
Keyword(s):  
United States ◽  
Food Insecurity ◽  
Current Knowledge ◽  
The United States ◽  
Community Context ◽  
Economic Factors ◽  
Gender Culture ◽  
United States Food ◽  
States Food ◽  
Policies And Programs

This entry provides an overview of current knowledge and thinking about the nature, causes, and consequences of food insecurity as well as information about the major policies and programs aimed at alleviating food insecurity in the United States. Food insecurity is considered at the nexus of person and environment, with discussion focusing on the biological, psychological, social, and economic factors that are interwoven with people’s access to and utilization of food. The diversity of experiences of food insecurity is addressed, with attention to issues of age, gender, culture, and community context. Finally, implications for social work professionals are suggested.

scholarly journals Malnutrition and Food Insecurity Might Pose a Double Burden for Older Adults

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2407
Author(s):  
Konstantinos Gkiouras ◽  
Stavros Cheristanidis ◽  
Theopoula D. Papailia ◽  
Maria G. Grammatikopoulou ◽  
Nikolaos Karamitsios ◽  
...  
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Food Insecurity ◽  
Assessment Tool ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Cross Sectional Study ◽  
Care Utilization ◽  
Double Burden ◽  
Cross Sectional

Although food insecurity has been associated with a disadvantageous socioeconomic status, especially in older adults, its association with comorbidities is less clear. The scope of the present cross-sectional study was to assess the prevalence of food insecurity among older adults and evaluate the association between food insecurity, malnutrition, chronic disease, multimorbidity and healthcare utilization. A total of 121 older adults (mean (standard deviation) age: 72.6 (8.1)) were recruited from a Primary Care Health Center from 10 August 2019 to 10 September 2019. Food insecurity and malnutrition status were assessed by the Household Food Insecurity Access Scale and Mini Nutritional Assessment tool, respectively. Recorded variables included financial, family data and comorbidities. The prevalence of food insecurity in the sample reached 50.4%, with men and older adults malnourished or at risk for malnutrition, exhibiting high risk for food insecurity. Multimorbidity, frequency of health care utilization and medication adherence were not associated with food insecurity, possibly due to the free health services and remunerated medications offered by the Greek government. However, male gender and malnutrition risk were significant predictors of food insecurity in the multiple logistic analyses. This study highlights the need for mainstreaming food insecurity assessment among older adults with comorbidities, especially those at risk for malnutrition.

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