The role of nutrition and pancreatic enzyme replacement therapy in children with cystic fibrosis

Background Cystic fibrosis (CF) is an inherited genetic disorder with high mortality and morbidity. CF is strongly correlated with malnutrition due to higher energy losses, pancreatic insufficiency, chronic inflammation, higher resting energy expenditure, and feeding problems. Malnutrition in CF patients associated with worse survival. Thus, appropriate and prompt nutritional intervention should be addressed to reduced malnutrition in CF patients. Methods The literature search was performed on 9 August 2021 in four major databases such as MEDLINE, EBSCOhost, Cochrane Reviews, and Web of Sciences to find the role of nutrition and pancreatic enzyme replacement therapy in pediatrics population with cystic fibrosis. Recent findings In recent decades, early nutritional management and pancreatic enzyme replacement therapy (PERT) have been shown to improve CF patient’s outcomes. Nutrition should be given in higher calories compared to healthy individuals with close and regular nutritional status monitoring. High protein and fat diets are essential for CF patient’s overall survival. Adequate level of micronutrients should be ensured to avoid morbidity caused by micronutrients deficiency. Regular pancreatic insufficiency screening should be done annually in order to start PERT early. Further research focusing on body composition, growth chart, protein intake, and PERT are needed to further improve the management of CF patient. Conclusion Nutritional intervention and PERT play an important role in prolonging CF patient survival. Both treatments should be initiated early with nutritional status close monitoring and tailored to each individual. Collaboration with parents and children is critical to warrant that CF patients followed the dietary advice.

Protein and iron intake adequacy among high school girls in Depok, Indonesia

Introduction: Iron deficiency anemia is the most common type of anemia among adolescent girls. The prevalence of anemia among pregnant women increased from 2013 to 2018, and females age 15-24 years had the highest prevalence of anemia. Therefore, knowing the baseline status of protein and iron intake —particularly animal-sourced protein as the main source of heme iron—is important to design future intervention program. Thus, this study was aimed to assess the protein and iron intake adequacy of High School girls in Depok, Indonesia. Methods: 211 girls from Senior High School in Depok, Indonesia participated in this study. Subjects were selected using a multi-stage random sampling method. A questionnaire was administered to obtain general characteristics. Dietary intake data were obtained using a 3-day non-consecutive 24hr recall 1 weekend 2 weekdays interview. Anthropometric status was measured and calculated. Data were analyzed using IBM SPSS Statistics 20. Spearman’s correlation (significance p<0.05) was used to determine the factors related to protein and iron intake. Results: This population had inadequate intake of energy (97.2%), protein (59.7%), and iron (98.6%). However, intake of fat was higher than recommended in 59.2% of participants. Protein and iron intake were not correlated with age, father’s education, mother’s education, and the number of household member.

Dietary intake and obesity in oil and gas workers: A literature review

Introduction Working in oil and gas industries was found to be associated with unhealthy lifestyle, obesity, and non-communicable diseases (NCDs). This study aimed to systematically review the dietary intake, obesity status, and identify possible workplace health promotion strategies for oil and gas setting. Methods: This literature review was conducted through a comprehensive search of Scopus database. Search terms included diet (and synonym), worker (and synonyms), oil and gas (and synonym). The search was limited to paper in English and Indonesian. Combinations of the keyword yielded 76 papers, of which 13 articles were relevant. Results: Reviewed studies implied that diet consist high amount of fat, particularly saturated fat, and cholesterol, with low intake of dietary fiber. Fatigue, boredom, and inadequate sleep may influence unhealthy food choices. All studies revealed that mean BMI among oil and gas workers was found to be higher than general adult population, ranged from 24 to almost 30 kg/m2. Possible health promotion components to be modified are knowledge and beliefs, self-care, peer support, food availability and time restriction at cafeterias. Conclusion: It is confirmed that obesity and NCDs prevalence were high in oil and gas worker, however the updated studies addressing their dietary intake are needed. Health promotion initiative made by oil and gas company are unlikely to be found in scientific paper. There is a need for more health promotion program that scientifically designed so that the outcome and cost effectiveness can be measured properly

A diagnostic test for malnutrition in adults: mid-upper arm circumference towards body mass index: A literature review

Body mass index is commonly used for detecting malnutrition. At certain conditions, body mass index cannot be measured, so mid-upper arm circumference can be an alternative measurement for detecting malnutrition. Several studies have proposed the cut-off point of mid-upper arm circumference in adults along with its sensitivity, specificity, and area under the ROC curve (AUC). This article aims to describe the diagnostic test for malnutrition using the upper arm circumference in adults and summarize the results of the related studies.

Effects of enteral glutamine supplementation on intestinal permeability in acute pancreatitis: A literature review

Background. Glutamine has been shown to improve the gut mucosal barrier. However, the evidence for benefit of enteral glutamine on intestinal permeability in acute pancreatitis (AP) is limited. Objective. To identify the effect of enteral glutamine supplementation on intestinal permeability in patients with AP. Method. A systematic search was conducted by extracting evidence from published studies on enteral glutamine supplementation in three databases (PubMed, Cochrane Central Register of Controlled Trials, and SciElo) relevant to AP from 1 January 2010 till 31 December 2020. Outcomes assessed were intestinal permeability, infectious complication, hospital length of stay, and mortality rate. Results. A total of 6 studies found by search, in which 2 human RCTs with 7 days duration of intervention with 1b-1c quality based on Criteria by Center of Evidence-Based Medicine, University of Oxford. Both studies showed the benefit of early enteral glutamine supplementation on intestinal permeability in patients with AP. Conclusions. Enteral glutamine supplementation has been shown to improve the gut mucosal barrier in AP. Despite its significant improvement in intestinal permeability, glutamine supplementation did not display a consistently positive effect on clinical outcomes.

How COVID-19 pandemic affect nutritional status

In Indonesia, COVID-19 has primarily affected food access and causes drop of income. The poor and vulnerable groups have difficulties in affording high nutritional value food thus resulting in, not only decline of food intake, but also lower dietary quality.4

Probiotics administration as a prevention for postoperative infectious complications in colorectal cancer patients: A literature review

Background Colorectal cancer is the third leading cause of death from cancer in adults in the United States, with increasing prevalence in other countries. Radical resection is the gold standard of treatment in most cases of colorectal cancer, with a high rate of postoperative complications. Perioperative probiotics can improve the immune response and the postoperative intestinal microbiota environment. Although several studies have shown the benefits of probiotics in preventing postoperative complications of infection, the administration of perioperative probiotics in colorectal cancer patients is still controversial. Objective. The purpose of this critical appraisal is to know the effectiveness of administering probiotics to prevent infectious complications in colorectal cancer patients. Methods. Literature research using Pubmed, Cochrane, and EBSCOhost was carried out and 2 articles were obtained in the form of meta-analysis using STATA v11 and Revman v5.2 that was critically examined using the FAITH method. A comprehensive search for all studies was done to find all relevant studies using both MeSH terms and text words. The article should describe the assessment of quality and criteria used in method section, also provide information on the quality of individual studies in result section to minimize bias. The result section should state whether heterogeneity exists and mention possible reasons. Results. Based on 2 meta-analyses that have been critically examined, which each consisting of 13 and 7 studies, giving probiotics can reduce the overall infection rate after colorectal cancer surgery. One meta-analysis showed an odds ratio (OR) of 0.51 (95% CI: 0.38 – 0.68, p = 0.00). Probiotics, such as Lactobacillus acidophilus and Bifidobacterium longum can also reduce the incidence of surgical site infections (OR = 0.59, 95% CI 0.39 – 0.88, p = 0.01) and pneumonia (OR = 0.56, 95% CI 0.32 – 0.98, p = 0.04). Probiotics did not provide statistically significant benefits in preventing urinary tract infections, leakage of anastomosis, and duration of postoperative pyrexia compared to the control group. Seven articles analyzed in the second meta-analysis showed probiotics to be useful in preventing postoperative infections with OR 0.5388 (95% CI, 0.4058-0.7154, P <0.0001). Conclusions. Combination of more than one strain of probiotics such as Lactobacillus and Bifidobacterium is promising for the prevention of infections in patients undergoing colorectal cancer surgery.

The effect of dietary fiber on insulin resistance in obesity: A literature review

Introduction Obesity has become a significant public health problem in developing countries such as Indonesia. According to WHO, 13% of adults aged 18 years and over were obese in 2016. In Indonesia, 21.8% of adults were obese. In obesity, the body's resistance to insulin will develop. Some studies showed a probable link between dietary fiber and insulin resistance. This research aims to investigate the role of the dietary fiber on insulin resistance in obesity. Methods: This study is a literature study to determine the effect of dietary fiber on insulin resistance in obesity with sources from scientific publications 10 years back. The databases were PubMed and Google Scholar. The search term used was using the explode function for subgroup terms with operators (“and,” or) for “dietary fiber”, “obesity”, “insulin resistance”. Hand-searching was used to identify further potential eligible studies. There were no language restrictions, however only publications with full texts available were included. Total 138 publications titles and abstract were screened for their relevance to this literature review. Results: A total of 25 publications were finally included. There are cross-sectional studies, randomized clinical trial, cohort studies, and article review. Some studies showed that dietary fiber had an effect on improve insulin resistance, but other studies did not find this effect. Conclusion: The studies of dietary fiber effect on insulin resistance have inconsistent results. In the future, further studies are required for better understanding about the effect of dietary fiber on insulin resistance in obesity

Investing in adult nutrition to reduce mobility problems in ageing population

As people age, most body organs deteriorate. Osteoporosis, arthritis, sarcopenia, muscle aches, low back pain and neuropathy are common mobility issues in the elderly. Body mass index (BMI), physical inactivity, and having comorbidities increase the likelihood to have mobility health problems. One in every ten adults over the age of 45 years in Indonesia develops these mobility problems, and one in every fifteen adults has difficulty in walking/stepping before entering the elderly age. Nutrition has been reported to have important role in controlling weight and physical locomotive organs. Generally, 46% adults in Indonesia have vitamin A deficiency, 70% vitamin C deficiency, 77% vitamin E deficiency, and inadequate calcium intake. Low nutrition intake can result in increasing mobility problems that lead to health issues in the aging population. Dietary strategies are necessary to achieve healthy ageing. Currently, no standardized guideline has been developed for preventing mobility health problems in Indonesia. This calls for urgent need to hinder poor quality of life in elderly population.

Effect of intermittent fasting on fat mass and fat free mass among obese adult: A literature review

Introduction Obesity is a serious hurdle facing by the world nowadays. Even though so many efforts have been done, yet the prevalence is keep rising. Intermittent fasting is seen as an effective and optimal approach for improving nutrition status without undesirable side effect. Objective to identify the effect of intermittent fasting on fat mass and fat free mass among obese adult. Methods: a literature exploration was conducted from January to October 2020 by searching the relevant studies from several databases. Results: many human clinical trials recommended that IF affects beneficial on body composition and body weight. Consuming calorie only in a certain time frame per day for 4-12 months put the body into a fast metabolism which influence the reduction of fat mass from 0.03–16.4% intervention and increasing of fat free mass for around 0.64 to 0.86%. Conclusion: intermittent fasting may reduce fat mass and increase fat free mass in obese adult through the reduction of energy intake (fasting) and the benefit to adipose tissue, liver, pancreas, skeletal muscle, and the brain.