Dietary Intake of Chinese Lactating Women Is Associated with the Fatty Acid Profile of Their Milk

<b><i>Introduction:</i></b> The present study aimed to explore the relationship between the dietary intake and the human milk (HM) fatty acid (FA) profile of Chinese lactating women. <b><i>Methods:</i></b> HM samples and food records were obtained from 122 Chinese women over 5 visits between 0 and 51 days postpartum. Adjusted multiple regression was performed to explore associations between maternal dietary intakes of energy, macronutrients, FAs and foods, and the HM FA profile. Analyses were performed separately for colostrum and mature milk. <b><i>Results:</i></b> Dietary intakes of total polyunsaturated FAs (PUFAs), eicosapentaenoic acid (EPA), and docosahexaenoic acid were positively associated with the HM contents of PUFAs, omega-6 (n-6) PUFAs, and linoleic acid (LA), and the intakes of n-3 PUFAs and α-linolenic acid (ALA) were negatively associated with saturated FA levels in HM. Associations were stronger for mature milk. Intakes of milk/dairy, meat/poultry, and eggs were negatively associated with n-6 PUFAs, LA, and EPA in mature milk, whereas the opposite was seen for fish/shrimp. Positive associations were also found between fish/shrimp and total and n-3 PUFAs in mature milk. <b><i>Conclusion:</i></b> The HM FA profile of Chinese women is associated with their diet, and in particular with their FA intake. Tailored nutritional advice based on HM FA composition may optimize HM FA profile and thereby contribute to healthy infant development.

EP.TU.575One Man's Meat: Nutritional guidance for ileostomy care should consider pre-existing comorbidities

Aims (1) To assess the prevalence of comorbidities which can be influenced by dietary changes in a cohort of our patients with ileostomies and (2) To compare the standard dietary recommendations for these conditions against nutritional advice for patients with ileostomies. Methods We performed a cross-sectional study of patients with ileostomies identified from a prospectively maintained database in January 2020. Patient demographics, comorbidities and records of formal nutritional advice were analysed. Dietary recommendations for common chronic illnesses were obtained through a literature review. Results Twenty-one patients (15 men, 6 women) were included. Median (IQR) age was 63 (51-73) years. The median (IQR) length of time for which patients had ileostomies was 60 (24-144) months. The most common chronic illnesses include hypertension (38%), diabetes (24%) and chronic kidney disease (14%). All patients received standard dietary advice for ileostomy management without consideration of pre-existing comorbidities. Literature review revealed a lack of high-quality evidence for dietary recommendations in patients with ileostomies and conflicting advice for those with comorbidities. Conclusion Existing nutritional guidance for patients with ileostomies lacks a firm evidence base and does not consider the potential modifications required for pre-existing comorbidities.

Nutritional outcome of appropriate feeding during and after acute diarrhoea in children

A sample of 120 children with acute diarrhoea was divided into two equal study groups. There was no difference between groups in pre-intervention and post-intervention findings during the acute phase of diarrhoea. Upon discharge, Group A patients were supplied weekly with sufficient milk formula and cereal together with adequate nutritional advice while Group B patients were supplied with food or nutritional advice only if requested by the mothers. Forty nine patients from each group were followed each week for four weeks. Group B infants showed a higher incidence of recurrent diarrhoeal attacks and a significantly longer duration of recurrent diarrhoea than Group A infants. Moreover, Group A infants scored a significantly higher weight increment than Group B ones after four weeks of follow up

Mediterranean diet in axial spondyloarthritis: an observational study in an Italian monocentric cohort

Background Little evidence is available about the impact of diet on disease activity of axial spondyloarthritis (axSpA). This study evaluated the impact of a 6-month nutritional advice based on the Mediterranean diet on the disease activity of axSpA. Methods We prospectively collected the information of a group of axSpA patients who were offered nutritional advice for a 6-month period, who were compared to axSpA patients followed at the same center who were not on a specific diet. A nutritionist gave suggestions for dietary modification at baseline and thereafter every 2 months until month 6. Adherence to the Mediterranean diet was evaluated with the PREDIMED questionnaire ranging from 0 (no adherence) to 10 (optimal adherence); disease activity was evaluated with ASDAS-CRP. A multivariable regression analysis was conducted to identify independent predictors of PREDIMED and of ASDAS-CRP improvement (improvement ≥ 20% of each score). Results A total of 161 patients were included: 81 receiving nutritional advice and 80 controls; 47 in the nutritional group and 63 controls had complete information until month 6. Overall, 40 (36.4%) were females, the mean age was 51.7 ± 1.3 years, and 58 (52.7%) were affected with psoriasis. No relevant change of anthropometric or laboratory measures was observed in either group. Adherence to the Mediterranean diet was moderate (PREDIMED score 6.7 ± 1.8 at baseline; 7.6 ± 2.1 at month 6) and improved more in the nutritional group compared to controls (p = 0.020). Predictors of a PREDIMED improvement ≥ 20% were receiving nutritional advice (OR 4.53, 1.36–15.1, p = 0.014), age (per 10-year increase OR 1.05, 1.02–1.68, p = 0.007), and BMI (OR 0.77, 0.63–0.9, p = 0.006). An ASDAS-CRP improvement ≥ 20% was more frequent in the nutritional group compared to controls (p = 0.020). A PREDIMED improvement ≥ 20% was associated with a ASDAS-CRP improvement ≥ 20% (OR 6.75,1.8–25.3, p = 0.005). Psoriasis and disease duration were negatively but not significantly associated to the ASDAS-CRP improvement. Conclusions Improving adherence to the Mediterranean diet may have a beneficial impact on the activity of axSpA. Patients with a lower BMI and older patients are less prone to modify their diet towards the Mediterranean diet following nutritional advice. Patients with psoriasis may have a limited benefit from dietary improvement. Study registration Protocol No. 52723, Padova Hospital Medical Ethical Committee (October 11, 2010).

Effectiveness of Nutritional Advice for Community-Dwelling Obese Older Adults With Frailty: A Systematic Review and Meta-Analysis

Objectives: This systematic review was aimed to examine the effectiveness of nutritional advise interventions compared with usual care, or exercise, or exercise combined with nutritional advice as a means of improving the body weight, body composition, physical function, and psychosocial well-being of frail, obese older adults.Methods: CINAHL, Cochrane Library, Embase, MEDLINE, PsycINFO, and Scopus databases were searched to identify relevant studies. The quality of the included studies was assessed using Cochrane's risk of bias tool 2. Meta-analysis was performed with respect to body weight and fat mass. Other outcomes were synthesized narratively.Results: Eight articles (from two studies) with a total of 137 participants were included in the review. The results revealed that nutritional advice was more effective than exercise in reducing body weight and fat mass. The nutritional advice was also beneficial in enhancing physical function and psychosocial well-being. However, it was less effective than exercise or combined interventions in increasing muscle strength and preventing lean mass loss.Conclusions: Nutritional advice is an essential intervention for reducing body weight and fat mass, for enhancing physical function, and for improving the psychosocial well-being of obese older adults experiencing frailty. The limited number of studies included in this review suggests that there is a need for more well-designed interventional studies in order to confirm these findings.

Novel Insights Into Monogenic Obesity Syndrome Due to INPP5E Gene Variant: A Case Report of a Female Patient

A Caucasian girl with consanguineous parents presented with early severe obesity and retinal dystrophy. A novel, homozygous gene truncating variant (c.1897C&gt;T) in the INPP5E gene confirmed the diagnosis of MORMS (OMIM #610156). A novel clinical finding in the presented syndrome is progressive cone-rod type retinal dystrophy diagnosed at the age of four months that progressed in the 1st decade of life. Severe obesity, insulin resistance with hyperinsulinism, and impaired glucose tolerance developed alongside other components of the metabolic syndrome - dyslipidemia, arterial hypertension, and obstructive hypopnea in sleep. At the age of 14 years, primary amenorrhea persists. The patient is managed by regular nutritional advice, metformin, antihypertensive medication, and non-invasive respiratory support during sleep. Differential diagnosis of this rare entity is discussed in extend.