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

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.

Energy target achievement and its determinants in critically ill COVID-19 patients in Indonesia

Introduction. Achievement of energy target in critically ill Covid-19 patients in Intensive Care Unit (ICU) is challenging. This study was aimed to depict the possibility of achieving energy target and its determinants in critically ill Covid-19 patients. Methods. A cross sectional study was conducted in ICU of dr. Kariadi Hospital Semarang, Indonesia. Secondary data were obtained from Covid-19 patients who were in ICU for minimum 3 days, from March to December 2020. Data collected included age, sex, Body Mass Index (BMI), comorbidities, Modified Nutrition Risk in Critically Ill (mNUTRIC) score, energy intake, route of nutrition delivery (enteral or combination of enteral and parenteral nutrition), lactate status, ICU length of stay (LOS), duration of mechanical ventilator and mortality. Risk Prevalence calculations were conducted to measure risks. Variables with significant associations and p< 0.25 were included in multiple logistic regression. Results. A total of 188 subjects were included in the analysis. Most patients were male (62.8%) and obese (61.8%). As much as 56.9% patients were able to achieve energy target of 20 kcal/kgBW on day 3 of ICU stay. Those with low risk mNUTRIC score and nutrition delivery was through enteral and parenteral route were more likely to achieve target energy of 20 kcal/kgBW in the first 3 days in the ICU. Conclusions. Achieving energy target of 20 kcal on day 3 of ICU stay for critically ill Covid-19 patients is feasible. Low mNutric score and nutrition delivery through enteral and parenteral route were two determinants for the achievement.

Association between apolipoprotein B and dietary fibers

Introduction Global awareness to the importance of natural fibers in vegetables and fruits are still generally very low. Indonesian people consume less fibers, which has been associated with the development of heart disease. Heart disease has been known as the leading cause of morbidity and mortality. Apolipoprotein B (ApoB) is a component of atherogenic particles that can be used as a marker for an increased risk of cardiovascular disease. Researches on apoB profile and its relationship with fiber intake has provided inconsistent results. This is an article review of the current literatures on the relationship between dietary fiber and serum apoB levels. Methods: This is an article review of the current literatures on the relationship between dietary fiber and apoB. We searched PubMed and Google Scholar using keyword “dietary fibers” and “ApoB” to capture meta-analyses, observational and experimental studies. A total of 97 publication and abstracts were screened for this review. After careful screening, nine studies were finally included. Results: Two studies did not find associations between dietary fiber and serum apoB, while other seven found the association. Dietary fiber has been reported to be involved in the metabolism of serum cholesterol and blood pressure; hence, the deficiency of dietary fiber intake is believed to contribute to the epidemic of cardiovascular diseases. Several factors including nutritional status, dietary diet pattern, age, gender, physical activity, and smoking habits might influence the relationship between dietary fiber and serum apoB. Conclusion: More studies are required in the future for better understanding on the effect of dietary fiber on the apoB; hence, the risk of cardiovascular diseases.