Current opinion in clinical nutrition and metabolic care
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Curr Opin Clin Nutr Metab Care · Nov 2010
ReviewDo all sedentary activities lead to weight gain: sleep does not.
To discuss the benefits of having a good night's sleep for body weight stability. ⋯ Short sleep duration appears to be a novel and independent risk factor for obesity. With the growing prevalence of chronic sleep restriction, any causal association between reduced sleep and obesity would have substantial importance from a public health standpoint. Future research is needed to determine whether sleep extension in sleep-deprived obese individuals will influence appetite control and/or reduce the amount of body fat.
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Obese individuals have impaired respiratory function relative to their normal-weight counterparts. Despite these negative effects, obesity is paradoxically associated with better survival in individuals with chronic obstructive pulmonary disease (COPD). The purpose of this review is to describe this 'obesity paradox', to discuss the effects of obesity on respiratory function, and to speculate as to whether obesity-related alterations in respiratory mechanics can influence the natural history of COPD. ⋯ Obese patients with COPD do not appear to be at a disadvantage during exercise relative to lean COPD patients. Obesity may be associated with improved survival in COPD but specific mechanisms for this paradox remain to be elucidated.
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Curr Opin Clin Nutr Metab Care · Sep 2010
ReviewThe impact of nutrition on cirrhotic patients awaiting liver transplantation.
To review the most recent aspects of nutrition therapy of cirrhotic patients on the waiting list for liver transplantation. ⋯ We report the latest findings on nutrition care of patients with end-stage liver disease on the waiting list for liver transplantation such as the impact of the nutritional status on outcome, probiotic and branched-chain amino acid supplementation, as well as the use of immunomodulating formula. Another important strategy that has been shown to improve these patients' nutritional care is the offering of nocturnal meals and micronutrient supplementation.
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Curr Opin Clin Nutr Metab Care · Mar 2010
ReviewConsidering energy deficit in the intensive care unit.
A discrepancy has emerged between experts' recommendations on how to feed ICU patients according to their requirements using parenteral nutrition, if enteral nutrition is not reaching the target. This review describes the differences in the recent guidelines issued by the American Society of Parenteral and Enteral Nutrition (ASPEN) and the European Society of Clinical Nutrition and Metabolism (ESPEN) regarding these aspects. ⋯ The energy deficit accumulated by underfed ICU patients during the first days of stay may play an important role in ICU and hospital outcomes for long-staying ICU patients. To reach calorie requirements by artificial nutritional support without harming the patient is still a subject of debate. Future studies, some already on their way will clarify this discussion.
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Curr Opin Clin Nutr Metab Care · Mar 2010
ReviewWhich factors influence glycemic control in the intensive care unit?
Intensive insulin therapy titrated to restore and maintain blood glucose between 80 and 110 mg/dl (4.4-6.1 mmol/l) was found to improve survival of critically ill patients in one pioneering proof-of-concept study performed in a surgical intensive care unit. The external validity of these findings was investigated. ⋯ Before a better understanding and delineation of the conditions associated with and improved outcome by tight glycemic control, the choice of an intermediate glycemic target appears as a safe and effective solution.