Survival in critically ill pediatric surgical patients with elevated PYMS and caloric deficit

Introduction: The nutritional counseling of the critical surgical pediatric patient is complex, it requires nutritional monitoring tools to improve their survival. The Pediatric Yorkhill Malnutrition Score (PYMS) is highly valid for determining nutritional risk. In Cuba there are no comparative studies on survival and PYMS. Objective: To determine survival in pediatric surgical patients with high PYMS and caloric deficit. Methods: An observational, prospective, cross-sectional and survival study was carried out in the Pediatric Intensive Care Unit of the Octavio de la Concepción de la Pedraja Pediatric Hospital, Holguín, Cuba, in the period from January 2018 to January 2019. analyzed 21 demographic and nutritional variables. Pearson's correlation coefficient was used for the bivariate variables. Kaplan Mier survival curves and ROC curves were created to determine optimal cut-off points for mortality. Results: All patients who did not survive presented high PYMS (p = 0.001) log Rank: X2 10.5, the patients with better caloric adequacy had better survival (p = 0.513) log Rank: X2 0.428 but without statistical significance. The area under the curve to determine mortality according to the PYMS score was higher (0.891) than caloric deficit (0.468) with a sensitivity of 1 and a specificity of 0.66. Conclusions: The survival of critical surgical pediatric patients with high PYMS and caloric deficit was determined. The non-survivors of the study had an elevated PYMS. The PYMS score is a better predictor of mortality than the caloric deficit. Demonstrating its excellent utility in advising nutritional risk in pediatric intensive care.

Greater lactate accumulation following an acute bout of high-intensity exercise in males suppresses acylated ghrelin and appetite postexercise

We used sodium bicarbonate to increase lactate accumulation or sodium chloride as a placebo. Our findings further implicate lactate as a mediator of exercise-induced appetite suppression given exercise-induced increases in lactate during the sodium bicarbonate session altered peripheral concentrations of appetite-regulating hormones, culminating in a reduction of appetite. This supports a lactate-dependent mechanism of appetite suppression following high-intensity exercise and highlights the potential of using lactate as a means of inducing a caloric deficit.

Four Weeks of Time-Restricted Feeding Combined with Resistance Training Does Not Differentially Influence Measures of Body Composition, Muscle Performance, Resting Energy Expenditure, and Blood Biomarkers

Recently, interest in time-restricted feeding (TRF) has increased from reports highlighting improvements in body composition and muscular performance measures. Twenty-six recreationally active males were randomly assigned to either TRF (n = 13; ~22.9 years; 82.0 kg; 178.1 cm; 8 h eating window, 25% caloric deficit, 1.8 g/kg/day protein) or normal diet (ND; n = 13; ~22.5 years; 83.3 kg; 177.5 cm; normal meal pattern; 25% caloric deficit, 1.8 g/kg/day protein) groups. Participants underwent 4-weeks of supervised full body resistance training. Changes in body composition (fat mass (FM), fat free mass (FFM), and body fat percentage (BF%)), skeletal muscle cross sectional area (CSA) and muscle thickness (MT) of the vastus lateralis (VL), rectus femoris, (RF), and biceps brachii (BB) muscles, resting energy expenditure (REE), muscular performance, blood biomarkers, and psychometric parameters were assessed. Significant (p < 0.05) decreases were noted in BM, FM, BF%, testosterone, adiponectin, and REE, along with significant increases in BP1RM, LP1RM, VJHT, VJPP, VLCSA, BBCSA, and BBMT in both groups. Plasma cortisol levels were significantly elevated at post (p = 0.018) only in ND. Additionally, FFM was maintained equally between groups. Thus, a TRF style of eating does not enhance reductions in FM over caloric restriction alone during a 4-week hypocaloric diet.