Is Percutaneous Endoscopic Gastrostomy Tube Feeding Beneficial for Improving Survival in Patients With Dementia? A Systematic Review and Meta-Analysis of Current Pieces of Evidence

Dementia is a progressive, disabling neurogenic disease that results in serious nutritional deficiencies included dysphagia, malnutrition, and weight loss. The Percutaneous Endoscopic Gastrostomy (PEG) is a long-term enteral feeding method that is routinely used in demented patients with poor food intake as a standard protocol. However, most of the pieces of evidence have not shown the beneficial effects of PEG feeding on complications or survival rates in these patients. Some studies have even reported an increase in mortality. The current systematic review and meta-analysis aimed to evaluate the mortality rate and survival in primary demented patients with PEG. A systematic search was conducted on Pubmed and Scopus databases up to Aug 2019. The data were reviewed according to the Cochrane handbook and preferred reporting items for systematic reviews and meta-analyses (PRISMA) and meta-analysis of observational studies in epidemiology (MOOSE). Based on the random-effects model, the mortality rate and median survival were expressed as risk ratio and weighted mean difference (WMD) and 95% CI, respectively. Among 13 included studies, PEG insertion in patients with primary dementia has no significant effect on 30-day, 90-day, 180-day, 1-year, and 2- year mortality rate or median survival (WMD: 9.77; 95% CI: -22.43 to 41.98; P=0.55). It seems that nasogastric tube (NGT) feeding in compared to PEG in this population is more effective. In conclusion, further prospective studies are needed for comprehensive evaluation of mortality or survival regarding comorbidities, underlying disease, cognitive and physical performance, and nutritional problems in demented patients.

The Effects of One Anastomosis Gastric Bypass Surgery on the Gastrointestinal Tract

One anastomosis gastric bypass (OAGB) is an emerging bariatric procedure, yet data on its effect on the gastrointestinal tract are lacking. This study sought to evaluate the incidence of small-intestinal bacterial overgrowth (SIBO) following OAGB; explore its effect on nutritional, gastrointestinal, and weight outcomes; and assess post-OABG occurrence of pancreatic exocrine insufficiency (PEI) and altered gut microbiota composition. A prospective pilot cohort study of patients who underwent primary-OAGB surgery is here reported. The pre-surgical and 6-months-post-surgery measurements included anthropometrics, glucose breath-tests, biochemical tests, gastrointestinal symptoms, quality-of-life, dietary intake, and fecal sample collection. Thirty-two patients (50% females, 44.5 ± 12.3 years) participated in this study, and 29 attended the 6-month follow-up visit. The mean excess weight loss at 6 months post-OAGB was 67.8 ± 21.2%. The glucose breath-test was negative in all pre-surgery and positive in 37.0% at 6 months (p = 0.004). Positive glucose breath-test was associated with lower reported dietary intake and folate levels and higher vitamin A deficiency rates (p ≤ 0.036). Fecal elastase-1 test (FE1) was negative for all pre-surgery and positive in 26.1% at 6 months (p = 0.500). Both alpha and beta diversity decreased at 6 months post-surgery compared to pre-surgery (p ≤ 0.026). Relatively high incidences of SIBO and PEI were observed at 6 months post-OAGB, which may explain some gastrointestinal symptoms and nutritional deficiencies.

Effects of Different Nutritional Conditions on the Growth and Reproduction of Nilaparvata lugens (Stål)

Growth and reproduction are the two most basic life processes of organisms and the distribution of energy in these processes is a core issue of the life history of organisms. Nilaparvata lugens (Stål), the brown planthopper (BPH), is a single-feeding rice pest. In the present study, this species was used as a model for testing the effects of nutritional conditions on various growth and reproduction indicators. First, the third-instar nymphs were fed with three different concentrations (100, 50, and 25%) of artificial diet until the second day of adulthood. The results showed that as the nutrient concentration decreased, the body development and oviposition of BPH were hindered. The total lipid content in the fat bodies was also significantly reduced. RT-PCR analysis showed compared to the 100% concentration group, the expression levels of vitellogenin (Vg) genes in the fifth-instar nymphs, adults, and in different tissues (ovary, fat body, and other tissues) were significantly decreased in the 50 and 25% treatment groups. Western blot analysis showed that Vg protein expression was highest in the 100% group, followed by the 50% group, with no expression in the 25% group. These results indicate that growth and reproduction in the BPH are regulated by, or correlated with, nutrient concentration. This study is of great significance as it reveals the adaptive strategies of the BPH to nutritional deficiencies and it also provides valuable information for the comprehensive control of this pest.

Modified Dietetic Skim And Cotton Sheet Oil Dan Susu Formula 75 Terhadap Berat Badan Anak Balita Gizi Kurang

Children under five are a group that is prone to malnutrition because they are still experiencing a growth cycle, a development that requires more nutrients than other age groups. The impact of nutritional deficiencies; low body resistance, the body is susceptible to infectious diseases. The purpose of this study was to analyze the effectiveness of giving modified dietetic skim and cotton sheet oil (MODISCO) and Formula-75 milk to increase body weight of malnourished children in Puskesmas Waigete, Sikka Regency. The type of research used is Quasy experimental pretest and posttest design. The population of this research was 181 underweight children with malnutrition. The sampling technique used purposive sampling. The sample of this study was 24 underweight children with malnutrition, divided into 2 (two), namely group A was given MODISCO intervention and group B was given Formula-75 milk. The intervention was given once a day for 1 month at a dose of 150 kcal / kgbb / day for MODISCO and 1000 ml per day for 75 formula milk. Data analysis used Paired t-Test and Independent Samples Test. Paired T-Test analysis, groups A and B obtained P-value (0.000) <0.05, it was concluded that there was an increase in body weight after being given MODISCO and Formula-75 milk. Based on the analysis of the Independent Samples Test, groups A and B obtained a P-value (0.876)> 0.05, it was concluded that there was no difference in body weight for under-nourished toddlers who were given MODISCO and Formula-75 milk. There is no difference in body weight of malnourished underweight children in group A and group B, so it is concluded that MODISCO and Formula-75 milk can increase the weight of malnourished children underweight. The results of this study are an additional intervention to increase the weight of children under malnutrition.

Long-Term Space Nutrition: A Scoping Review

This scoping review aimed to identify current evidence and gaps in the field of long-term space nutrition. Specifically, the review targeted critical nutritional needs during long-term manned missions in outer space in addition to the essential components of a sustainable space nutrition system for meeting these needs. The search phrase “space food and the survival of astronauts in long-term missions” was used to collect the initial 5432 articles from seven Chinese and seven English databases. From these articles, two independent reviewers screened titles and abstracts to identify 218 articles for full-text reviews based on three themes and 18 keyword combinations as eligibility criteria. The results suggest that it is possible to address short-term adverse environmental factors and nutritional deficiencies by adopting effective dietary measures, selecting the right types of foods and supplements, and engaging in specific sustainable food production and eating practices. However, to support self-sufficiency during long-term space exploration, the most optimal and sustainable space nutrition systems are likely to be supported primarily by fresh food production, natural unprocessed foods as diets, nutrient recycling of food scraps and cultivation systems, and the establishment of closed-loop biospheres or landscape-based space habitats as long-term life support systems.

NUTRITIONAL STATUS ASSESSMENT OF ORPHANAGE CHILDREN IN RAWALPINDI

Objective: To evaluate the health and nutritional status of the orphanage, to find frequency of nutritional deficiencies by physical examination findings and to assess their dietary intake and contrast it with individual recommended daily allowances. Study Design: Cross sectional study. Place and Duration of Study: Four orphanages of Rawalpindi, from Jan to May 2020. Methodology: Study was conducted at four orphanages of Rawalpindi on 276 children and adolescents. Children and adolescents in age group of 5-18 years and if they are resident of institution for more than 60 months were included in the study, while children who were extremely sick and mentally retarded were excluded from the study. Data was collected through questionnaire including demographic information, anthropometric assessment, nutritional deficiencies on physical examination and 24 hours food recall. Data was analyzed on SPSS 24. Results: Results showed that 34 (17%) children and adolescents were underweight, 99 (49.5%) stunted, 21 (10.5%) showed thinness and 9 (4.5%) were overweight. Most common nutrient deficiency was protein calorie malnutrition, Iron deficiency and vitamin A and B 12 deficiency. Study population was consuming less protein, Iron and fats in diet as compared to recommended daily allowances. Conclusion: Institutionalized children and adolescents are at risk of developing malnutrition due to financial constraints and ignorance of caregivers, which can lead to ill health of children. Programs are required to be undertaken for nutritional development of the orphanage children.

Decompensated Superior Oblique Palsy Secondary to Bilateral Nutritional Optic Neuropathy Following Bariatric Surgery

Optic neuropathy can occur secondary to nutritional deficiencies in patients who have undergone bariatric surgery. We present a unique case of a 39-year-old man, claiming to be generally healthy, who presented with intermittent vertical diplopia and bilateral decreased vision in each eye. Visual acuity was 6/18 in the right eye and 6/12 in the left eye. Ishihara testing was defective for both eyes. Automated visual fields showed a severe generalized reduction in sensitivity in both eyes. The patient had a left head tilt and a right intermittent hypertropia of 30 prism diopters in primary position. CT of the orbits revealed a right superior oblique of small caliber. On further questioning, the patient admitted to a history of bariatric surgery 7 years prior to presentation with failure to take any nutritional supplements. Blood work demonstrated deficiencies in folate, thiamine, and copper. Within 6 months of initiating nutritional supplements, the vision in each eye was markedly improved and the diplopia resolved. There was an associated normalization of thiamine and copper, but folate levels remained low. We believe that the nutritional deficiency caused a bilateral optic neuropathy and the resulting vision loss precipitated a manifestation of a congenital superior oblique palsy that had previously just been a phoria. The case emphasizes the importance of considering occult sensory etiologies of acquired strabismus.

Factors Associated with Nutritional Deficiency Biomarkers in Candidates for Bariatric Surgery: A Cross-Sectional Study in a Peruvian High-Resolution Clinic

Previous studies have described multiple nutritional deficiencies after bariatric surgery (BS). However, few studies have evaluated these deficiencies prior to BS, specifically in Latin America. This study aimed to determine the factors associated with nutritional deficiency biomarkers in candidates for BS in Peru. We included adults of both sexes, aged 18 to 59 years, admitted to a Peruvian clinic with a body mass index (BMI) ≥ 30 kg/m2; they were candidates for BS from 2017 to 2020. We considered the serum levels of hemoglobin and albumin (in tertiles) as the nutritional deficiency biomarkers. In order to assess the associated factors, we calculated crude (cPR) and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95%CI). We analyzed 255 patients: 63.1% were males, with a mean age of 37.1 ± 10.3 years and mean hemoglobin and albumin values of 14.0 ± 1.5 g/dL and 4.6 ± 0.4 g/dL, respectively. We found that males (aPR = 1.86; 95%CI: 1.26–2.73; p = 0.002), participants between 30 and 49 (aPR = 2.02; 95%CI: 1.24–3.28; p = 0.004) or 50 years or more (aPR = 2.42; 95%CI: 1.35–4.35; p = 0.003), participants with a BMI ≥40 kg/m2 (aPR = 1.68; 95%CI: 1.09–2.60; p = 0.018), participants with impaired high-density lipoprotein levels (aPR = 1.43; 95%CI: 1.01–2.05; p = 0.049) and individuals in the high tertile of C-reactive protein (aPR = 6.94; 95%CI: 3.37–14.32; p < 0.003) had a higher probability of being in the lower tertile of albumin. In addition, we found that the male sex (aPR = 6.94; 95%CI: 3.37–14.32; p < 0.001) and elevated cholesterol levels (aPR = 0.71; 95%CI: 0.52–0.97; p = 0.034) were associated with the lowest hemoglobin tertile. In our setting, nutritional deficiency biomarkers were associated with sociodemographic, anthropometric and laboratory markers. The pre-bariatric surgery correction of nutritional deficiencies is essential, and can prevent major complications after surgery.

Nutritional Deficiencies and Features of Nutritional Provision in Primary School Children

Introduction. The nutrition of primary school children does not always meet modern nutritional standards. The frequency of nutritional deficiencies, including calcium and vitamin D, among this age group remains unstudied. The aim of the study. To establish the characteristics of nutritional provision and the prevalence of nutrient deficiencies in the daily nutrition of primary school children, including calcium and vitamin D deficiencies and to propose methods of correction. Materials and methods. 5 consecutive stages of the study were conducted. At the first stage in 2019, the assessment of eating behavior in 190 children of grades 1-4 of two schools in the city of Lviv was conducted using a questionnaire. In the second stage, the features of the diet and ration and daily nutritional intake were determined using a special licensed program Dietplan 7 (UK). The analysis of daily nutrient intake was performed for 172 children. In the third stage, a study was conducted on the level of total, ionized calcium and 25-hydroxyvitamin D in the blood, and a study on the calcium content in the hair of 56 children with insufficient daily intake of calcium and / or vitamin D. In the fourth stage, 30 children with reduced levels of calcium in the hair were detected, differentiated correction measures were performed. To do this, the children were divided into two groups: the control group - 15 children whose deficiencies were corrected by diet modification, and the main group - 15 children - whose deficiencies were corrected by diet modification and the intake of calcium at a dose of 500.0 mg and vitamin D at a dose of 5.0 mg (200.0 IU) once a day for three months. In the fifth stage, to evaluate the effectiveness of treatment after three months of follow-up, all 30 children were re-analyzed for calcium content in the hair using atomic absorption spectrophotometry. Results. Appetite disturbance was observed in 28.9 % of schoolchildren, 17.4 % ate under duress, 14.3 % ate irregularly, 13.7% ate insufficient portions, 11.0 % were on different diets, many schoolchildren had eating disorders: ate before sleep (83.6 %), while watching TV (33.6 %). The diet was often unbalanced, children consumed insufficient fish (58.9 %), vegetables (43.2 %), dairy products (33.7 %), meat (26.8 %) Low calcium intake was observed in 50.6 % boys and 70.7 % of girls, vitamin D in 84.9 % of boys and 96.9 % of girls. Among children with a reduced daily intake of calcium and vitamin D, 42.9 % of children had a reduced level of total and / or ionized calcium, 48.2 % had a reduced level of vitamin D in the blood serum, and 53.6 % had a reduced calcium content in the hair. After 3 months of correction, we found that in the hair of children in the main group, who underwent dietary correction and were prescribed calcium and vitamin D, a significant increase in the average calcium content (up to 293.6 ± 80.6 mg/kg; p < 0.01) was observed, while in control group children who received only a modified diet, had only a tendency to increase the average amount of calcium in the hair (up to 185.14 ± 82.38 mg/kg; p > 0.05). Conclusions. For most primary school children, nutrition is unbalanced, which does not meet all the needs of a rapidly growing and intensively developing child's metabolism. A significant number of children have eating disorders: they do not eat regularly, do not eat enough food, eat food while watching TV, just before bed, do not have lunch at school, like fast food, 10% of students are on various diets. Almost a third of schoolchildren have a deficiency of daily intake of proteins, fats, carbohydrates and energy, and half of schoolchildren have a deficiency in the consumption of dietary fiber, polyunsaturated fatty acids and monounsaturated fatty acids. Most students have a daily deficiency of iodine, magnesium, selenium, iron and calcium, vitamin E, biotin, vitamin D, retinol, vitamin C, carotene, pantothenate. Among children with reduced daily intake of calcium and vitamin D in 42.9 % of children a reduced content of total and / or ionized calcium in the blood was found, and in 53.6 % of children in this group - in the hair. The use of a non-invasive method of studying the calcium content in the hair allows to determine the calcium deficiency in the child's body and control the process of its recovery. For children with insufficient daily intake of calcium and vitamin D, it is advisable to recommend a diet modification with increased consumption of milk, dairy products, yogurt and cheese, beans, spinach, broccoli, other leafy greens, wheat germ, nuts, sesame seeds, fish. To correct the existing calcium deficiency, it is advisable to use calcium supplements with vitamin D, combining this with a modification of the diet with an increase in food that contains the nutrients mentioned above. Keywords: schoolchildren, food deficiencies, calcium, vitamin D.

Nutritional Deficiencies in Celiac Disease: Current Perspectives

Gluten-induced T-cell-mediated immune response damages the villous structure that significantly affects the functioning of the small intestinal mucosa [...]