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1.
Symposium 'understanding and managing satiety: processes and opportunities'.
Mandalari, G
Journal of nutritional science. 2020;:e42
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Abstract
This brief report summarises a framework for understanding satiety presented at the 13th European Nutrition Conference, FENS 2019 - Malnutrition in an Obese World: European Perspectives. Aspects of satiety phenotyping and role of food hedonics in satiation are considered in the context of appetite control and obesity. Almonds are evaluated for their unique composition and structure which affect their behaviour in the human gastrointestinal tract. Their role in appetite control and management of satiety has been explored.
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GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community.
Cederholm, T, Jensen, GL, Correia, MITD, Gonzalez, MC, Fukushima, R, Higashiguchi, T, Baptista, G, Barazzoni, R, Blaauw, R, Coats, A, et al
Clinical nutrition (Edinburgh, Scotland). 2019;(1):1-9
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Abstract
RATIONALE This initiative is focused on building a global consensus around core diagnostic criteria for malnutrition in adults in clinical settings. METHODS In January 2016, the Global Leadership Initiative on Malnutrition (GLIM) was convened by several of the major global clinical nutrition societies. GLIM appointed a core leadership committee and a supporting working group with representatives bringing additional global diversity and expertise. Empirical consensus was reached through a series of face-to-face meetings, telephone conferences, and e-mail communications. RESULTS A two-step approach for the malnutrition diagnosis was selected, i.e., first screening to identify "at risk" status by the use of any validated screening tool, and second, assessment for diagnosis and grading the severity of malnutrition. The malnutrition criteria for consideration were retrieved from existing approaches for screening and assessment. Potential criteria were subjected to a ballot among the GLIM core and supporting working group members. The top five ranked criteria included three phenotypic criteria (non-volitional weight loss, low body mass index, and reduced muscle mass) and two etiologic criteria (reduced food intake or assimilation, and inflammation or disease burden). To diagnose malnutrition at least one phenotypic criterion and one etiologic criterion should be present. Phenotypic metrics for grading severity as Stage 1 (moderate) and Stage 2 (severe) malnutrition are proposed. It is recommended that the etiologic criteria be used to guide intervention and anticipated outcomes. The recommended approach supports classification of malnutrition into four etiology-related diagnosis categories. CONCLUSION A consensus scheme for diagnosing malnutrition in adults in clinical settings on a global scale is proposed. Next steps are to secure further collaboration and endorsements from leading nutrition professional societies, to identify overlaps with syndromes like cachexia and sarcopenia, and to promote dissemination, validation studies, and feedback. The diagnostic construct should be re-considered every 3-5 years.
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Nutritional status assessment in geriatrics: Consensus declaration by the Spanish Society of Geriatrics and Gerontology Nutrition Work Group.
Camina-Martín, MA, de Mateo-Silleras, B, Malafarina, V, Lopez-Mongil, R, Niño-Martín, V, López-Trigo, JA, Redondo-del-Río, MP
Maturitas. 2015;(3):414-9
Abstract
Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, because elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología, SEGG) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories seeks to aid in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment associated to laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is to further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics.
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[Clinical practice guidelines for evaluation and treatment of osteoporosis associated to endocrine and nutritional conditions. Bone Metabolism Working Group of the Spanish Society of Endocrinology].
Reyes García, R, Jódar Gimeno, E, García Martín, A, Romero Muñoz, M, Gómez Sáez, JM, Luque Fernández, I, Varsavsky, M, Guadalix Iglesias, S, Cano Rodriguez, I, Ballesteros Pomar, MD, et al
Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion. 2012;(3):174-96
Abstract
OBJECTIVE To provide practical recommendations for evaluation and treatment of osteoporosis associated to endocrine diseases and nutritional conditions. PARTICIPANTS Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology, a methodologist, and a documentalist. METHODS Recommendations were formulated according to the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed), using the following terms associated to the name of each condition: AND "osteoporosis", "fractures", "bone mineral density", and "treatment". Papers in English with publication date before 18 October 2011 were included. Current evidence for each disease was reviewed by two group members, and doubts related to the review process or development of recommendations were resolved by the methodologist. Finally, recommendations were discussed in a meeting of the Working Group. CONCLUSIONS The document provides evidence-based practical recommendations for evaluation and management of endocrine and nutritional diseases associated to low bone mass or an increased risk of fracture. For each disease, the associated risk of low bone mass and fragility fractures is given, recommendations for bone mass assessment are provided, and treatment options that have shown to be effective for increasing bone mass and/or to decreasing fragility fractures are listed.
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Nutrition in the age-related disablement process.
Inzitari, M, Doets, E, Bartali, B, Benetou, V, Di Bari, M, Visser, M, Volpato, S, Gambassi, G, Topinkova, E, De Groot, L, et al
The journal of nutrition, health & aging. 2011;(8):599-604
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Abstract
The transition from independence to disability in older adults is characterized by detectable changes in body composition and physical function. Epidemiologic studies have shown that weight loss, reduced caloric intake and the reduced intake of specific nutrients are associated with such changes. The mechanisms underlying these associations remain unclear, and different hypotheses have been suggested, including the reduction of the antioxidant effects of some nutrients. Changes in muscle mass and quality might play a central role in the pathway linking malnutrition, its biological and molecular consequences, and function. A different approach aims at assessing diets by dietary patterns, which capture intercorrelations of nutrients within a diet, rather than by selective foods or nutrients: epidemiologic evidence suggests that some types of diet, such as the Mediterranean diet, might prevent negative functional outcomes in older adults. However, despite a theoretical and empirical basis, intervention studies using nutritional supplementation have shown inconclusive results in preventing functional impairment and disability. The present work is the result of a review and consensus effort of a European task force on nutrition in the elderly, promoted by the International Association of Gerontology and Geriatrics (IAGG) European Region. After the critical review of different aspects related to the role of nutrition in the transition from independence to disability, we propose future lines for research, including the determination of levels of inadequacy and target doses of supplements, the study of interactions (between nutrients within a diet and with other lifestyle aspects), and the association with functional outcomes.
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Effective nutrition programming for children and the role of UNICEF: consensus points from an expert consultation.
Schultink, W, Arabi, M
Food and nutrition bulletin. 2009;(2):189-96
Abstract
Countries of the world have agreed on eradicating extreme poverty and hunger and reducing the mortality rate of children under five by two-thirds by 2015 as part of the Millennium Development Goals, and without mainstreaming maternal, infant, and young child nutrition in the development agenda, these goals cannot be achieved. Although the recent Lancet Series on Maternal and Child Undernutrition brought attention to the importance of early nutrition interventions to improve child health, nutrition, and future economic productivity, there needs to be a more concerted effort at clarifying the path forward, focusing on moving beyond projects and evidence from randomized, controlled trials towards developing large-scale programs with sound plausibility design to achieve results for children. In an effort to cast a fresh eye on nutrition programming in light of the new evidence, UNICEF Headquarters hosted an Expert Consultation on effective nutrition programming with participants from various academic organizations and United Nations agencies to discuss effective program strategies in nutrition. The consultation resulted in recommendations for UNICEF on eight focus areas for programming and recognition of six overarching themes. It is clear that more action is needed to accelerate progress: more effective global coalitions, better coordination, more coherence, and better targeting of efforts.
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Fatigue and illness in athletes.
Nimmo, MA, Ekblom, B, ,
Journal of sports sciences. 2007;:S93-102
Abstract
Adequate nutrition before, during, and after training and competition is a key element to maintaining health. During both sprint and endurance exercise, the availability of glycogen is fundamental to performance and any deficit will lead to early fatigue. In addition, strategies to offset the negative effects of the products of metabolism are presented. Although nutritional strategies can attenuate the immunosuppressive effects of exercise, there remains a period of susceptibility to infection after a hard exercise session and when this is repeated without sufficient recovery an athlete can enter a period of "overtraining" during which performance deteriorates. The aetiology and identification of this state is not clear and some current ideas are discussed. Finally, gastrointestinal problems during running can negate any training benefits and we propose some suggestions to reduce this problem.
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ESPEN Guidelines on Enteral Nutrition: Geriatrics.
Volkert, D, Berner, YN, Berry, E, Cederholm, T, Coti Bertrand, P, Milne, A, Palmblad, J, Schneider, S, Sobotka, L, Stanga, Z, et al
Clinical nutrition (Edinburgh, Scotland). 2006;(2):330-60
Abstract
Nutritional intake is often compromised in elderly, multimorbid patients. Enteral nutrition (EN) by means of oral nutritional supplements (ONS) and tube feeding (TF) offers the possibility to increase or to insure nutrient intake in case of insufficient oral food intake. The present guideline is intended to give evidence-based recommendations for the use of ONS and TF in geriatric patients. It was developed by an interdisciplinary expert group in accordance with officially accepted standards and is based on all relevant publications since 1985. The guideline was discussed and accepted in a consensus conference. EN by means of ONS is recommended for geriatric patients at nutritional risk, in case of multimorbidity and frailty, and following orthopaedic-surgical procedures. In elderly people at risk of undernutrition ONS improve nutritional status and reduce mortality. After orthopaedic-surgery ONS reduce unfavourable outcome. TF is clearly indicated in patients with neurologic dysphagia. In contrast, TF is not indicated in final disease states, including final dementia, and in order to facilitate patient care. Altogether, it is strongly recommended not to wait until severe undernutrition has developed, but to start EN therapy early, as soon as a nutritional risk becomes apparent.