Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Non-alcoholic fatty liver disease (NAFLD) is mostly related to increased BMI and sedentary life, even if it not directly attributable only to these or to single specific factors. Unhealthy lifestyle and obesity are the most probable causes, also in non-diabetic and without alcohol abuse patients, even if lean individuals can be involved. NAFLD treatment is currently warranted and driven by comprehensive lifestyle intervention, a valuable objective that is more often wished for than actually achieved. The aim is to re-assess the effectiveness of an intervention focused to increase the Adherence to Mediterranean Diet Score (AMDS) and the level of physical exercise, investigating the factors associated with failure and reporting the time that must elapse before such intervention becomes effective. ⋯ Adherence to Mediterranean Diet is a significant predictor of changes in the fat content of the liver in overweight patients with NAFLD. The effect of the diet is gradual and favorable and it is independent of other lifestyle changes.
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Increased homocysteine concentration and oxidative stress and decreased antioxidant capacities are thought to affect carcinogenesis. However, the associations of homocysteine, cysteine, pyridoxal 5'-phosphate (PLP) and folate with oxidative stress and antioxidant capacities in patients with colorectal cancer are unclear. The purpose of this study was to determine the associations of homocysteine, cysteine, PLP and folate with oxidative stress indicators and antioxidant capacities, and to further analyze their relationships with respect to risk for colorectal cancer. ⋯ Increased homocysteine was strongly associated with the risk of colorectal cancer independently of oxidative stress indicators and antioxidant capacities. However, cysteine, PLP and folate were not found to be related to oxidative stress, antioxidant capacities and the risk of colorectal cancer.
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Pragmatic Clinical Trial
Multidisciplinary, multi-modal nutritional care in acute hip fracture inpatients - results of a pragmatic intervention.
Malnutrition is highly prevalent and resistant to intervention following hip fracture. This study investigated the impact of individualised versus multidisciplinary nutritional care on nutrition intake and outcomes in patients admitted to a metropolitan hospital acute hip fracture unit. ⋯ Multidisciplinary nutritional care improves nutrition intake and outcomes in acute hip fracture inpatients. Similar pragmatic study designs should be considered in other elderly inpatient populations perceived resistant to nutritional intervention.
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Randomized Controlled Trial
A single-blinded randomised clinical trial of permissive underfeeding in patients requiring parenteral nutrition.
The importance of adequate nutritional support is well established, but characterising what 'adequate nutrition' represents remains contentious. In recent years there has been increasing interest in the concept of 'permissive underfeeding' where patients are intentionally prescribed less nutrition than their calculated requirements. The aim of this study was to evaluate the effect of permissive underfeeding on septic and nutrition related morbidity in patients requiring short term parenteral nutrition (PN). ⋯ Permissive underfeeding in patients requiring short term PN appears to be safe and may results in reduced septic and feed-related complications.
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The Geriatric Nutritional Risk Index (GNRI) is a promising tool initially proposed to predict nutrition-related complications in sub-acute care setting. So, the main aim of this study was to validate the use of GNRI in hospitalized elderly patients by testing its ability to predict patients' outcome through the comparison with Mini Nutritional Assessment (MNA). ⋯ GNRI showed a higher prognostic value for describing and classification of nutritional status and nutritional-related complications in hospitalized elderly patients in addition to its simplicity.