Nutrients

Research

16 pages, 3296 KiB

Open AccessArticle

Effect of Dewaxed Coffee on Gastroesophageal Symptoms in Patients with GERD: A Randomized Pilot Study

by Barbara Polese, Luana Izzo, Nicola Mancino, Marcella Pesce, Sara Rurgo, Maria Cristina Tricarico, Sonia Lombardi, Barbara De Conno, Giovanni Sarnelli and Alberto Ritieni

Nutrients 2022, 14(12), 2510; https://doi.org/10.3390/nu14122510 - 16 Jun 2022

Cited by 4 | Viewed by 4115

Abstract

Gastroesophageal Reflux Disease (GERD) is multifactorial pathogenesis characterized by the abnormal reflux of stomach contents into the esophagus. Symptoms are worse after the ingestion of certain foods, such as coffee. Hence, a randomized pilot study conducted on 40 Italian subjects was assessed to [...] Read more.

Gastroesophageal Reflux Disease (GERD) is multifactorial pathogenesis characterized by the abnormal reflux of stomach contents into the esophagus. Symptoms are worse after the ingestion of certain foods, such as coffee. Hence, a randomized pilot study conducted on 40 Italian subjects was assessed to verify the effect of standard (SC) and dewaxed coffee (DC) consumption on gastroesophageal reflux symptoms and quality of life in patients with gastrointestinal diseases. The assessment of patient diaries highlighted a significant percentage reduction of symptoms frequency when consuming DC and a significant increase in both heartburn-free and regurgitation-free days. Consequentially, patients had a significant increase of antacid-free days during the DC assumption. Moreover, the polyphenolic profile of coffee pods was ascertained through UHPLC-Q-Orbitrap HRMS analysis. Chlorogenic acids (CGAs) were the most abundant investigated compounds with a concentration level ranging between 7.316 (DC) and 6.721 mg/g (SC). Apart from CGAs, caffeine was quantified at a concentration level of 5.691 mg/g and 11.091 for DC and SC, respectively. While still preliminary, data obtained from the present pilot study provide promising evidence for the efficacy of DC consumption in patients with GERD. Therefore, this treatment might represent a feasible way to make coffee more digestible and better tolerated. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

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9 pages, 1016 KiB

Open AccessArticle

In-Hospital Patient Education Markedly Reduces Alcohol Consumption after Alcohol-Induced Acute Pancreatitis

by Rita Nagy, Klementina Ocskay, Alex Váradi, Mária Papp, Zsuzsanna Vitális, Ferenc Izbéki, Eszter Boros, László Gajdán, Andrea Szentesi, Bálint Erőss, Péter Jenő Hegyi, Áron Vincze, Judit Bajor, Patricia Sarlos, Alexandra Mikó, Katalin Márta, Dániel Pécsi, Andrea Párniczky and Péter Hegyi

Nutrients 2022, 14(10), 2131; https://doi.org/10.3390/nu14102131 - 20 May 2022

Cited by 9 | Viewed by 2937

Abstract

Although excessive alcohol consumption is by far the most frequent cause of recurrent acute pancreatitis (AP) cases, specific therapy is still not well established to prevent recurrence. Generally, psychological therapy (e.g., brief intervention (BI)) is the cornerstone of cessation programs; however, it is [...] Read more.

Although excessive alcohol consumption is by far the most frequent cause of recurrent acute pancreatitis (AP) cases, specific therapy is still not well established to prevent recurrence. Generally, psychological therapy (e.g., brief intervention (BI)) is the cornerstone of cessation programs; however, it is not yet widely used in everyday practice. We conducted a post-hoc analysis of a prospectively collected database. Patients suffering from alcohol-induced AP between 2016 and 2021 received 30 min BI by a physician. Patient-reported alcohol consumption, serum gamma-glutamyl-transferase (GGT) level, and mean corpuscular volume (MCV) of red blood cells were collected on admission and at the 1-month follow-up visit to monitor patients’ drinking habits. Ninety-nine patients with alcohol-induced AP were enrolled in the study (mean age: 50 ± 11, 89% male). A significant decrease was detected both in mean GGT value (294 ± 251 U/L vs. 103 ± 113 U/L, p < 0.001) and in MCV level (93.7 ± 5.3 U/L vs. 92.1 ± 5.1 U/L, p < 0.001) in patients with elevated on-admission GGT levels. Notably, 79% of the patients (78/99) reported alcohol abstinence at the 1-month control visit. Brief intervention is an effective tool to reduce alcohol consumption and to prevent recurrent AP. Longitudinal randomized clinical studies are needed to identify the adequate structure and frequency of BIs in alcohol-induced AP. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

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17 pages, 2782 KiB

Open AccessArticle

Hyaluronic Acid 35 kDa Protects against a Hyperosmotic, Formula Feeding Model of Necrotizing Enterocolitis

by Kathryn Burge, Jeffrey Eckert, Adam Wilson, MaJoi Trammell, Shiloh R. Lueschow, Steven J. McElroy, David Dyer and Hala Chaaban

Nutrients 2022, 14(9), 1779; https://doi.org/10.3390/nu14091779 - 24 Apr 2022

Cited by 8 | Viewed by 2824

Abstract

Necrotizing enterocolitis (NEC), an inflammatory disease of the intestine, is a common gastrointestinal emergency among preterm infants. Intestinal barrier dysfunction, hyperactivation of the premature immune system, and dysbiosis are thought to play major roles in the disease. Human milk (HM) is protective, but [...] Read more.

Necrotizing enterocolitis (NEC), an inflammatory disease of the intestine, is a common gastrointestinal emergency among preterm infants. Intestinal barrier dysfunction, hyperactivation of the premature immune system, and dysbiosis are thought to play major roles in the disease. Human milk (HM) is protective, but the mechanisms underpinning formula feeding as a risk factor in the development of NEC are incompletely understood. Hyaluronic acid 35 kDa (HA35), a bioactive glycosaminoglycan of HM, accelerates intestinal development in murine pups during homeostasis. In addition, HA35 prevents inflammation-induced tissue damage in pups subjected to murine NEC, incorporating Paneth cell dysfunction and dysbiosis. We hypothesized HA35 treatment would reduce histological injury and mortality in a secondary mouse model of NEC incorporating formula feeding. NEC-like injury was induced in 14-day mice by dithizone-induced disruption of Paneth cells and oral gavage of rodent milk substitute. Mortality and histological injury, serum and tissue cytokine levels, stool bacterial sequencing, and bulk RNA-Seq comparisons were analyzed. HA35 significantly reduced the severity of illness in this model, with a trend toward reduced mortality, while RNA-Seq analysis demonstrated HA35 upregulated genes associated with goblet cell function and innate immunity. Activation of these critical protective and reparative mechanisms of the small intestine likely play a role in the reduced pathology and enhanced survival trends of HA-treated pups subjected to intestinal inflammation in this secondary model of NEC, providing potentially interesting translational targets for the human preterm disease. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

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13 pages, 308 KiB

Open AccessArticle

Bowel Health in U.S. Vegetarians: A 4-Year Data Report from the National Health and Nutrition Examination Survey (NHANES)

by Maximilian Andreas Storz, Gianluca Rizzo, Alexander Müller and Mauro Lombardo

Nutrients 2022, 14(3), 681; https://doi.org/10.3390/nu14030681 - 6 Feb 2022

Cited by 10 | Viewed by 5357

Abstract

Dietary fiber is of paramount importance in the prevention of large-bowel diseases, yet fiber intake in many high income countries is well below daily recommendations. Vegetarian diets high in fiber-rich plant-foods have been associated with a higher frequency of bowel movements and softer [...] Read more.

Dietary fiber is of paramount importance in the prevention of large-bowel diseases, yet fiber intake in many high income countries is well below daily recommendations. Vegetarian diets high in fiber-rich plant-foods have been associated with a higher frequency of bowel movements and softer stools. Thus, vegetarians appear to suffer less frequently from constipation and other bowel disorders. The number of studies investigating these associations, however, is limited. The present study sought to investigate bowel health and constipation prevalence in a self-identified vegetarian population from the U.S. National Health and Nutrition Examination Survey (2007–2010). Bowel health assessment included Bristol Stool Scale (BSS), Bowel Movement (BM) frequency and Fecal Incontinence Severity Index (FISI). The present study included 9531 non-vegetarians and 212 vegetarians. We found no associations between vegetarian status and all examined bowel health items (BM frequency, BSS and FISI). Vegetarians consumed significantly more fiber than omnivores (21.33 vs. 16.43 g/d, p < 0.001) but had a lower moisture intake (2811.15 vs. 3042.78 g/d, p = 0.045). The lack of an association of vegetarian status and bowel health is surprising, and may be a result of the relatively low fiber intake in this particular vegetarian cohort, which did not meet the daily fiber recommendations. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

Review

Jump to: Research, Other

36 pages, 5124 KiB

Open AccessReview

Metabolic and Nutritional Issues after Lower Digestive Tract Surgery: The Important Role of the Dietitian in a Multidisciplinary Setting

by Alejandra Utrilla Fornals, Cristian Costas-Batlle, Sophie Medlin, Elisa Menjón-Lajusticia, Julia Cisneros-González, Patricia Saura-Carmona and Miguel A. Montoro-Huguet

Nutrients 2024, 16(2), 246; https://doi.org/10.3390/nu16020246 - 12 Jan 2024

Cited by 1 | Viewed by 9388

Abstract

Many patients undergo small bowel and colon surgery for reasons related to malignancy, inflammatory bowel disease (IBD), mesenteric ischemia, and other benign conditions, including post-operative adhesions, hernias, trauma, volvulus, or diverticula. Some patients arrive in the operating theatre severely malnourished due to an [...] Read more.

Many patients undergo small bowel and colon surgery for reasons related to malignancy, inflammatory bowel disease (IBD), mesenteric ischemia, and other benign conditions, including post-operative adhesions, hernias, trauma, volvulus, or diverticula. Some patients arrive in the operating theatre severely malnourished due to an underlying disease, while others develop complications (e.g., anastomotic leaks, abscesses, or strictures) that induce a systemic inflammatory response that can increase their energy and protein requirements. Finally, anatomical and functional changes resulting from surgery can affect either nutritional status due to malabsorption or nutritional support (NS) pathways. The dietitian providing NS to these patients needs to understand the pathophysiology underlying these sequelae and collaborate with other professionals, including surgeons, internists, nurses, and pharmacists. The aim of this review is to provide an overview of the nutritional and metabolic consequences of different types of lower gastrointestinal surgery and the role of the dietitian in providing comprehensive patient care. This article reviews the effects of small bowel resection on macronutrient and micronutrient absorption, the effects of colectomies (e.g., ileocolectomy, low anterior resection, abdominoperineal resection, and proctocolectomy) that require special dietary considerations, nutritional considerations specific to ostomized patients, and clinical practice guidelines for caregivers of patients who have undergone a surgery for local and systemic complications of IBD. Finally, we highlight the valuable contribution of the dietitian in the challenging management of short bowel syndrome and intestinal failure. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

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31 pages, 2886 KiB

Open AccessReview

Evaluation and Management of Nutritional Consequences of Chronic Liver Diseases

by Silvia Espina, Diego Casas-Deza, Vanesa Bernal-Monterde, María José Domper-Arnal, Sandra García-Mateo and Alberto Lué

Nutrients 2023, 15(15), 3487; https://doi.org/10.3390/nu15153487 - 7 Aug 2023

Cited by 6 | Viewed by 4080

Abstract

Liver diseases are the major predisposing conditions for the development of malnutrition, sarcopenia, and frailty. Recently, the mechanism of the onset of these complications has been better established. Regardless of the etiology of the underlying liver disease, the clinical manifestations are common. The [...] Read more.

Liver diseases are the major predisposing conditions for the development of malnutrition, sarcopenia, and frailty. Recently, the mechanism of the onset of these complications has been better established. Regardless of the etiology of the underlying liver disease, the clinical manifestations are common. The main consequences are impaired dietary intake, altered macro- and micronutrient metabolism, energy metabolism disturbances, an increase in energy expenditure, nutrient malabsorption, sarcopenia, frailty, and osteopathy. These complications have direct effects on clinical outcomes, survival, and quality of life. The nutritional status should be assessed systematically and periodically during follow-up in these patients. Maintaining and preserving an adequate nutritional status is crucial and should be a mainstay of treatment. Although general nutritional interventions have been established, special considerations are needed in specific settings such as decompensated cirrhosis, alcohol-related liver disease, and metabolic-dysfunction-associated fatty liver disease. In this review, we summarize the physiopathology and factors that impact the nutritional status of liver disease. We review how to assess malnutrition and sarcopenia and how to prevent and manage these complications in this setting. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

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16 pages, 1660 KiB

Open AccessReview

Nutritional Considerations in Celiac Disease and Non-Celiac Gluten/Wheat Sensitivity

by Fardowsa Abdi, Saania Zuberi, Jedid-Jah Blom, David Armstrong and Maria Ines Pinto-Sanchez

Nutrients 2023, 15(6), 1475; https://doi.org/10.3390/nu15061475 - 19 Mar 2023

Cited by 15 | Viewed by 9016

Abstract

A gluten-free diet (GFD) is the only available treatment for celiac disease (CeD), and it may also improve symptoms in non-celiac gluten/wheat sensitivity (NCGWS). In CeD, gluten triggers an immune reaction leading to enteropathy, malabsorption, and symptoms; in NCGWS, the mechanism leading to [...] Read more.

A gluten-free diet (GFD) is the only available treatment for celiac disease (CeD), and it may also improve symptoms in non-celiac gluten/wheat sensitivity (NCGWS). In CeD, gluten triggers an immune reaction leading to enteropathy, malabsorption, and symptoms; in NCGWS, the mechanism leading to symptoms is unknown, and neither wheat nor gluten triggers enteropathy or malabsorption. A strict GFD is, therefore, necessary for CeD, but a gluten-restricted diet (GRD) may suffice to achieve symptom control for NCGWS. Regardless of this distinction, the risk of malnutrition and macro- and micronutrient deficiencies is increased by the adoption of a GFD or GRD. Thus, patients with CeD or NCGWS should undergo nutritional assessment and subsequent monitoring, based on evidence-based tools, under the care of a multidisciplinary team involving physicians and dietitians, for the long-term management of their nutrition. This review gives an overview of available nutrition assessment tools and considerations for the nutritional management of CeD and NCGWS populations. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

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24 pages, 4836 KiB

Open AccessReview

Dietary and Nutritional Support in Gastrointestinal Diseases of the Upper Gastrointestinal Tract (I): Esophagus

by Miguel A. Montoro-Huguet

Nutrients 2022, 14(22), 4819; https://doi.org/10.3390/nu14224819 - 14 Nov 2022

Cited by 7 | Viewed by 5231

Abstract

The esophagus is the centerpiece of the digestive system of individuals and plays an essential role in transporting swallowed nutrients to the stomach. Diseases of the esophagus can alter this mechanism either by causing anatomical damage that obstructs the lumen of the organ [...] Read more.

The esophagus is the centerpiece of the digestive system of individuals and plays an essential role in transporting swallowed nutrients to the stomach. Diseases of the esophagus can alter this mechanism either by causing anatomical damage that obstructs the lumen of the organ (e.g., peptic, or eosinophilic stricture) or by generating severe motility disorders that impair the progression of the alimentary bolus (e.g., severe dysphagia of neurological origin or achalasia). In all cases, nutrient assimilation may be compromised. In some cases (e.g., ingestion of corrosive agents), a hypercatabolic state is generated, which increases resting energy expenditure. This manuscript reviews current clinical guidelines on the dietary and nutritional management of esophageal disorders such as severe oropharyngeal dysphagia, achalasia, eosinophilic esophagitis, lesions by caustics, and gastroesophageal reflux disease and its complications (Barrett’s esophagus and adenocarcinoma). The importance of nutritional support in improving outcomes is also highlighted. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

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20 pages, 1004 KiB

Open AccessReview

Nutritional Support in Pancreatic Diseases

by Pablo Cañamares-Orbís, Guillermo García-Rayado and Enrique Alfaro-Almajano

Nutrients 2022, 14(21), 4570; https://doi.org/10.3390/nu14214570 - 31 Oct 2022

Cited by 22 | Viewed by 6824

Abstract

This review summarizes the main pancreatic diseases from a nutritional approach. Nutrition is a cornerstone of pancreatic disease and is sometimes undervalued. An early identification of malnutrition is the first step in maintaining an adequate nutritional status in acute pancreatitis, chronic pancreatitis and [...] Read more.

This review summarizes the main pancreatic diseases from a nutritional approach. Nutrition is a cornerstone of pancreatic disease and is sometimes undervalued. An early identification of malnutrition is the first step in maintaining an adequate nutritional status in acute pancreatitis, chronic pancreatitis and pancreatic cancer. Following a proper diet is a pillar in the treatment of pancreatic diseases and, often, nutritional counseling becomes essential. In addition, some patients will require oral nutritional supplements and fat-soluble vitamins to combat certain deficiencies. Other patients will require enteral nutrition by nasoenteric tube or total parenteral nutrition in order to maintain the requirements, depending on the pathology and its consequences. Pancreatic exocrine insufficiency, defined as a significant decrease in pancreatic enzymes or bicarbonate until the digestive function is impaired, is common in pancreatic diseases and is the main cause of malnutrition. Pancreatic enzymes therapy allows for the management of these patients. Nutrition can improve the nutritional status and quality of life of these patients and may even improve life expectancy in patients with pancreatic cancer. For this reason, nutrition must maintain the importance it deserves. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

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24 pages, 436 KiB

Open AccessReview

Parenteral Nutrition Overview

by David Berlana

Nutrients 2022, 14(21), 4480; https://doi.org/10.3390/nu14214480 - 25 Oct 2022

Cited by 41 | Viewed by 15032

Abstract

Parenteral nutrition (PN) is a life-saving intervention for patients where oral or enteral nutrition (EN) cannot be achieved or is not acceptable. The essential components of PN are carbohydrates, lipids, amino acids, vitamins, trace elements, electrolytes and water. PN should be provided via [...] Read more.

Parenteral nutrition (PN) is a life-saving intervention for patients where oral or enteral nutrition (EN) cannot be achieved or is not acceptable. The essential components of PN are carbohydrates, lipids, amino acids, vitamins, trace elements, electrolytes and water. PN should be provided via a central line because of its hypertonicity. However, peripheral PN (with lower nutrient content and larger volume) can be administered via an appropriate non-central line. There are alternatives for the compounding process also, including hospital pharmacy compounded bags and commercial multichamber bags. PN is a costly therapy and has been associated with complications. Metabolic complications related to macro and micronutrient disturbances, such as hyperglycemia, hypertriglyceridemia, and electrolyte imbalance, may occur at any time during PN therapy, as well as infectious complications, mostly related to venous access. Long-term complications, such as hepatobiliary and bone disease are associated with longer PN therapy and home-PN. To prevent and mitigate potential complications, the optimal monitoring and early management of imbalances is required. PN should be prescribed for malnourished patients or high-risk patients with malnutrition where the feasibility of full EN is in question. Several factors should be considered when providing PN, including timing of initiation, clinical status, and risk of complications. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

24 pages, 853 KiB

Open AccessReview

Role of Dairy Foods, Fish, White Meat, and Eggs in the Prevention of Colorectal Cancer: A Systematic Review of Observational Studies in 2018–2022

by Iker Alegria-Lertxundi, Luis Bujanda and Marta Arroyo-Izaga

Nutrients 2022, 14(16), 3430; https://doi.org/10.3390/nu14163430 - 21 Aug 2022

Cited by 16 | Viewed by 6123

Abstract

There is limited evidence to support the relationship between the consumption of animal-source foods other than red meat and processed meat and colorectal cancer (CRC) risk. We aimed to examine the recent available evidence from observational studies about the association between these food [...] Read more.

There is limited evidence to support the relationship between the consumption of animal-source foods other than red meat and processed meat and colorectal cancer (CRC) risk. We aimed to examine the recent available evidence from observational studies about the association between these food groups’ intake and CRC risk. For this systematic review, we searched the PubMed database for the last five years. A total of fourteen cohort studies and seven case–control studies comprising a total of >60,000 cases were included. The studies showed a consistent significant decrease in CRC risk, overall and by subsites, associated with a high consumption of total dairy products. Less strong effects associated with the consumption of any subtype of dairy product were observed. Fish consumption, overall and by subtypes (oily or non-oily and fresh or canned), showed a mild inverse association with CRC risk. The association between white meat and egg intake and CRC risk was low and based on a small number of studies; thus, these findings should be interpreted with caution. In conclusion, a high consumption of total dairy products was associated with a lower CRC risk. However, evidence for fish, white meat, and eggs and the CRC risk were not as strong. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

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12 pages, 460 KiB

Open AccessReview

Efficacy of an Irritable Bowel Syndrome Diet in the Treatment of Small Intestinal Bacterial Overgrowth: A Narrative Review

by Justyna Paulina Wielgosz-Grochowska, Nicole Domanski and Małgorzata Ewa Drywień

Nutrients 2022, 14(16), 3382; https://doi.org/10.3390/nu14163382 - 17 Aug 2022

Cited by 12 | Viewed by 10719

Abstract

Small intestinal bacterial overgrowth (SIBO) is highly prevalent in irritable bowel syndrome (IBS). The eradication of bacterial overgrowth with antibiotics is the first-line treatment. However, focusing only on the antimicrobial effects without taking care to improve lifestyle factors, especially dietary patterns, may predispose [...] Read more.

Small intestinal bacterial overgrowth (SIBO) is highly prevalent in irritable bowel syndrome (IBS). The eradication of bacterial overgrowth with antibiotics is the first-line treatment. However, focusing only on the antimicrobial effects without taking care to improve lifestyle factors, especially dietary patterns, may predispose patients to intestinal microbiota dysfunction. The objective of this study is to determine whether the current recommendations regarding nutrition in IBS are suitable for patients with SIBO. A narrative literature review was carried out using databases, including PubMed, ScienceDirect and Google Scholar. Recent studies indicate that dietary manipulation may have a role in alleviating SIBO gastrointestinal symptoms. A low FODMAP diet proposed for IBS may promote a negative shift in the gut microbiota and deepen the existing state of dysbiosis in SIBO patients. Supplementation with soluble fiber can lessen the symptoms in IBS and SIBO. Targeted probiotic therapy may also increase the effectiveness of antibiotic treatment and regulate bowel movements. Therefore, optimal dietary patterns play a key role in the treatment of SIBO. Based on currently available literature, the potential efficacy of the IBS diet in SIBO is largely hypothetical. Future research is needed to characterize a specific diet for the treatment of SIBO. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

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18 pages, 336 KiB

Open AccessReview

Home Parenteral and Enteral Nutrition

by Jamie Bering and John K. DiBaise

Nutrients 2022, 14(13), 2558; https://doi.org/10.3390/nu14132558 - 21 Jun 2022

Cited by 17 | Viewed by 5975

Abstract

While the history of nutrition support dates to the ancient world, modern home parenteral and enteral nutrition (HPEN) has been available since the 1960s. Home enteral nutrition is primarily for patients in whom there is a reduction in oral intake below the amount [...] Read more.

While the history of nutrition support dates to the ancient world, modern home parenteral and enteral nutrition (HPEN) has been available since the 1960s. Home enteral nutrition is primarily for patients in whom there is a reduction in oral intake below the amount needed to maintain nutrition or hydration (i.e., oral failure), whereas home parenteral nutrition is used for patients when oral-enteral nutrition is temporarily or permanently impossible or absorption insufficient to maintain nutrition or hydration (i.e., intestinal failure). The development of home delivery of these therapies has revolutionized the field of clinical nutrition. The use of HPEN appears to be increasing on a global scale, and because of this, it is important for healthcare providers to understand all that HPEN entails to provide safe, efficacious, and cost-effective support to the HPEN patient. In this article, we provide a comprehensive review of the indications, patient requirements, monitoring, complications, and overall process of managing these therapies at home. Whereas some of the information in this article may be applicable to the pediatric patient, the focus is on the adult population. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

30 pages, 705 KiB

Open AccessEditor’s ChoiceReview

Malnutrition Screening and Assessment

by Carlos Serón-Arbeloa, Lorenzo Labarta-Monzón, José Puzo-Foncillas, Tomas Mallor-Bonet, Alberto Lafita-López, Néstor Bueno-Vidales and Miguel Montoro-Huguet

Nutrients 2022, 14(12), 2392; https://doi.org/10.3390/nu14122392 - 9 Jun 2022

Cited by 95 | Viewed by 22452

Abstract

Malnutrition is a serious problem with a negative impact on the quality of life and the evolution of patients, contributing to an increase in morbidity, length of hospital stay, mortality, and health spending. Early identification is fundamental to implement the necessary therapeutic actions, [...] Read more.

Malnutrition is a serious problem with a negative impact on the quality of life and the evolution of patients, contributing to an increase in morbidity, length of hospital stay, mortality, and health spending. Early identification is fundamental to implement the necessary therapeutic actions, involving adequate nutritional support to prevent or reverse malnutrition. This review presents two complementary methods of fighting malnutrition: nutritional screening and nutritional assessment. Nutritional risk screening is conducted using simple, quick-to-perform tools, and is the first line of action in detecting at-risk patients. It should be implemented systematically and periodically on admission to hospital or residential care, as well as on an outpatient basis for patients with chronic conditions. Once patients with a nutritional risk are detected, they should undergo a more detailed nutritional assessment to identify and quantify the type and degree of malnutrition. This should include health history and clinical examination, dietary history, anthropometric measurements, evaluation of the degree of aggression determined by the disease, functional assessment, and, whenever possible, some method of measuring body composition. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

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15 pages, 288 KiB

Open AccessFeature PaperReview

Enteral Nutrition Overview

by Jennifer Doley

Nutrients 2022, 14(11), 2180; https://doi.org/10.3390/nu14112180 - 24 May 2022

Cited by 35 | Viewed by 12022

Abstract

Enteral nutrition (EN) provides critical macro and micronutrients to individuals who cannot maintain sufficient oral intake to meet their nutritional needs. EN is most commonly required for neurological conditions that impair swallow function, such as stroke, amytrophic lateral sclerosis, and Parkinson’s disease. An [...] Read more.

Enteral nutrition (EN) provides critical macro and micronutrients to individuals who cannot maintain sufficient oral intake to meet their nutritional needs. EN is most commonly required for neurological conditions that impair swallow function, such as stroke, amytrophic lateral sclerosis, and Parkinson’s disease. An inability to swallow due to mechanical ventilation and altered mental status are also common conditions that necessitate the use of EN. EN can be short or long term and delivered gastrically or post-pylorically. The expected duration and site of feeding determine the type of feeding tube used. Many commercial EN formulas are available. In addition to standard formulations, disease specific, peptide-based, and blenderized formulas are also available. Several other factors should be considered when providing EN, including timing and rate of initiation, advancement regimen, feeding modality, and risk of complications. Careful and comprehensive assessment of the patient will help to ensure that nutritionally complete and clinically appropriate EN is delivered safely. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

15 pages, 1291 KiB

Open AccessReview

Carbohydrate Maldigestion and Intolerance

by Fernando Fernández-Bañares

Nutrients 2022, 14(9), 1923; https://doi.org/10.3390/nu14091923 - 4 May 2022

Cited by 16 | Viewed by 9091

Abstract

This review summarizes dietary carbohydrate intolerance conditions and recent advances on the possible role of carbohydrate maldigestion and dietary outcomes in patients with functional bowel disease. When malabsorbed carbohydrates reach the colon, they are fermented by colonic bacteria, with the production of short-chain [...] Read more.

This review summarizes dietary carbohydrate intolerance conditions and recent advances on the possible role of carbohydrate maldigestion and dietary outcomes in patients with functional bowel disease. When malabsorbed carbohydrates reach the colon, they are fermented by colonic bacteria, with the production of short-chain fatty acids and gas lowering colonic pH. The appearance of diarrhoea or symptoms of flatulence depends in part on the balance between the production and elimination of these fermentation products. Different studies have shown that there are no differences in the frequency of sugar malabsorption between patients with irritable bowel disease (IBS) and healthy controls; however, the severity of symptoms after a sugar challenge is higher in patients than in controls. A diet low in ‘Fermentable, Oligo-Di- and Monosaccharides and Polyols’ (FODMAPs) is an effective treatment for global symptoms and abdominal pain in IBS, but its implementation should be supervised by a trained dietitian. A ‘bottom-up’ approach to the low-FODMAP diet has been suggested to avoid an alteration of gut microbiota and nutritional status. Two approaches have been suggested in this regard: starting with only certain subgroups of the low-FODMAP diet based on dietary history or with a gluten-free diet. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

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8 pages, 251 KiB

Open AccessReview

Nutritional and Psychological Considerations for Dietary Therapy in Eosinophilic Esophagitis

by Javier Molina-Infante

Nutrients 2022, 14(8), 1588; https://doi.org/10.3390/nu14081588 - 12 Apr 2022

Cited by 13 | Viewed by 3497

Abstract

The step-up empiric elimination diet, starting from one/two food groups of most local allergens remains the current gold standard for a dietary approach in eosinophilic esophagitis (EoE) patients. Milk, followed by wheat and egg, is the most frequent food that triggers EoE in [...] Read more.

The step-up empiric elimination diet, starting from one/two food groups of most local allergens remains the current gold standard for a dietary approach in eosinophilic esophagitis (EoE) patients. Milk, followed by wheat and egg, is the most frequent food that triggers EoE in pediatric and adult patients. Elimination diets, with restrictions over four food groups, may be limited to highly motivated patients, in which nutritional counseling is recommended. Malnourishment is uncommon in EoE patients and likely multifactorial (concomitant gastrointestinal eosinophilic disorders or IgE-mediated food allergies, feeding difficulties, abnormal feeding behavior). Avoidant/restrictive food intake disorder in EoE children on highly restrictive diets was lately described and may warrant specific psychological support. As for adults, quality of life may be impaired by symptom severity and dietary restrictions, aside from recently reported food impaction-related specific anxiety in up to 43% of patients. Severe symptoms, feeding dysfunction, and diet restrictions may negatively influence psychosocial adjustment for patients and their caregivers. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

31 pages, 465 KiB

Open AccessEditor’s ChoiceReview

Effects of Coffee on the Gastro-Intestinal Tract: A Narrative Review and Literature Update

by Astrid Nehlig

Nutrients 2022, 14(2), 399; https://doi.org/10.3390/nu14020399 - 17 Jan 2022

Cited by 44 | Viewed by 53761

Abstract

The objective of the present research was to review the state of the art on the consequences of drinking coffee at the different levels of the gastrointestinal tract. At some steps of the digestive process, the effects of coffee consumption seem rather clear. [...] Read more.

The objective of the present research was to review the state of the art on the consequences of drinking coffee at the different levels of the gastrointestinal tract. At some steps of the digestive process, the effects of coffee consumption seem rather clear. This is the case for the stimulation of gastric acid secretion, the stimulation of biliary and pancreatic secretion, the reduction of gallstone risk, the stimulation of colic motility, and changes in the composition of gut microbiota. Other aspects are still controversial, such as the possibility for coffee to affect gastro-esophageal reflux, peptic ulcers, and intestinal inflammatory diseases. This review also includes a brief summary on the lack of association between coffee consumption and cancer of the different digestive organs, and points to the powerful protective effect of coffee against the risk of hepatocellular carcinoma. This review reports the available evidence on different topics and identifies the areas that would most benefit from additional studies. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

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17 pages, 2810 KiB

Open AccessSystematic Review

The Effect of Vitamin D Supplementation on the Severity of Symptoms and the Quality of Life in Irritable Bowel Syndrome Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

by Mohamed Abuelazm, Shoaib Muhammad, Mohamed Gamal, Fatma Labieb, Mostafa Atef Amin, Basel Abdelazeem and James Robert Brašić

Nutrients 2022, 14(13), 2618; https://doi.org/10.3390/nu14132618 - 24 Jun 2022

Cited by 14 | Viewed by 4327

Abstract

Irritable bowel syndrome (IBS), a gastrointestinal disorder affecting 7–12% of the population, is characterized by abdominal pain, bloating, and alternating bowel patterns. Data on risk and protective influences have yielded conflicting evidence on the effects of alternative interventions, such as vitamin D. This [...] Read more.

Irritable bowel syndrome (IBS), a gastrointestinal disorder affecting 7–12% of the population, is characterized by abdominal pain, bloating, and alternating bowel patterns. Data on risk and protective influences have yielded conflicting evidence on the effects of alternative interventions, such as vitamin D. This review focuses on the effects of vitamin D on IBS. A systematic review and meta-analysis considered all articles published until 4 April 2022. The search for randomized controlled trials assessing vitamin D efficacy in IBS with outcomes, primary (Irritable Bowel Severity Scoring System (IBS-SSS)) and secondary (IBS quality of life (IBS-QoL) and serum level of calcifediol (25(OH)D)), was performed on six databases, Google Scholar, Web of Science, SCOPUS, EMBASE, PubMed (MEDLINE), and Cochrane Central Register of Controlled Trials. We included six trials with 616 patients. The pooled analysis found no difference between vitamin D and placebo in improving IBS-SSS (MD: −45.82 with 95% CI [−93.62, 1.98], p = 0.06). However, the pooled analysis favored vitamin D over placebo in improving the IBS-Qol (MD: 6.19 with 95% CI [0.35, 12.03], p = 0.04) and serum 25(OH)D (MD: 25.2 with 95% CI [18.41, 31.98], p = 0.00001). Therefore, further clinical trials are required to reach clinically applicable and generalizable findings. Full article

(This article belongs to the Special Issue Nutritional Support in Digestive Diseases, and Nutritional Implications of Dietary Interventions)

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