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Summary: Background and Aims: Unfavourable changes in body composition are frequently reported in children with cancer. An easy and affordable method to measure body composition is bioelectrical impedance analysis (BIA). In this study, we compared the Tanita MC780-MA Body Composition Analyzer (Tanita) versus the Bodystat Quadscan 4000 analyzer (Bodystat) to determine whether the Tanita is a suitable analyzer for pediatric oncology patients. Methods: In this study, 84 childhood cancer patients/survivors were included. Per patient 1, 2 or 3 visits were planned during or after treatment. During each visit, BIA measurements were performed first with the Tanita analyzer followed by the Bodystat analyzer. In total, 131 measurements were included. Spearman correlation and concordance correlation coefficients of Lin (CCC) were calculated for fat percentage (Fat%), fat mass (FM) and fat free mass (FFM). Bland-Altman plots were constructed to assess the agreement between both analyzers. Results: Fat%, FM and FFM values differed statistically significantly when comparing the BIA devices (Wilcoxon signed rank test, P

Summary: Background & aims: The prognostic nutritional index (PNI), calculated from the serum level of albumin (Alb) and total lymphocyte count (TLC), has been considered to effectively predict the outcomes of critically ill COVID-19 patients. However, since the establishment of COVID-19 treatment regimens, its effectiveness has become unclear. Therefore, we conducted a multicenter study to establish whether PNI is still valid as a prognostic indicator for these patients. Methods: We retrospectively examined the medical records of critically ill COVID-19 patients who required intubation and mechanical ventilatory management (MV) between July 2021 and March 2023. Results: Seventy patients (50 males, mean age 62.9 years) were included and PNI at the start of intensive care was 31.7, which was in the “critical range”. The results obtained showed that PNI was not a predictor of death, whereas the presence of chronic obstructive pulmonary disease (COPD) and a high SOFA score were identified as predictors. The presence of COPD and obesity were also predictive factors for the number of days of MV. Conclusions: Since the establishment of COVID-19 treatment regimens, PNI may not be an effective tool for predicting the risk of death or MV days in critically ill COVID-19 patients.

Summary: Aim: This study aimed to assess dental caries levels, as indicated by the Decay-Missing-Filled Teeth (DMFT) index, and identify risk factors and dietary behaviors associated with DMFT. Material and Methods: A cross-sectional study of 402 adults (aged 18–70) was conducted in 2022, involving individuals attending oral health outpatient centers selected through random sampling. Participants completed a validated nutrition questionnaire to assess dental caries risk factors, and DMFT index assessments were performed at dental centers. Descriptive statistics and multiple linear regression analysis were employed to determine the factors influencing the DMFT index. Results: The majority of the patients (40.3%) fell into the category of “High DMFT index” with a score of >13.9. The “very low DMFT index” group had the lowest percentage among the patients (11.90%). Higher education levels were associated with lower DMFT scores. Among oral health behaviors, frequent tooth brushing and mouthwash use showed the highest association with lower DMFT scores. Conversely, higher consumption of sugary evening snacks, sweetened drinks during evening meals, between-meal snacks, sweetened juice, energy drinks, and soft drinks correlated with higher DMFT scores. Conclusion: This study underscores a significant rise in dental caries risk among participants following the COVID-19 pandemic. The findings highlight the need for targeted interventions, education, and policies to address the increased risk of dental caries and promote oral health among adults.

Summary: Background & aims: Accurate fat mass (FM) and muscle mass (MM) assessment is an informative marker of an individual's health. However, the optimal method for assessing body composition in transgender men remains to be determined. Here, we aim to compare body composition estimates in transgender men by bioimpedance analysis (BIA) using the reference settings for “males” and “females” and by dual x-ray absorptiometry (DXA) scans. Methods: We conducted a cross-sectional pilot study investigating the body composition of 10 transgender men undergoing hormonal therapy using BIA and DXA scans. Results: BIA yielded significantly different estimates of body composition depending on the use of either “female” or “male” settings (P

Summary: Background & Aims: Chewing difficulties are associated with poor physical and mental well-being in elderly populations. Little is known about these relationships in other age groups. Pain and biopsychosocial domains of eating (physical – anatomical, physical – functional, sensory, cognitive, behavioural, social/cultural, and emotional), as defined by the Altered Eating Framework (AEF) (23) have also not been considered as influential factors when exploring the impact of chewing difficulty on well-being. This study aimed to a) investigate relationships between chewing difficulty, pain, AEF domains, and well-being, and b) explore pain as a potential mediator between chewing difficulty and well-being. Method: One-hundred and seventy-nine participants, aged 19–82 years (mean = 43.39 yrs, SD = 15.46 yrs) completed an online survey comprising 8 measures, including chewing difficulty, pain and health, altered eating, and well-being. Data were collected April to November 2023. Results: Chewing difficulty was a significant positive predictor of depression, anxiety, and stress. Pain positively predicted depression and partially mediated the relationship between chewing difficulty and depression. The emotional AEF domain positively predicted depression and stress. Conclusion: Chewing difficulty was associated with poor well-being across a wide age range, findings highlight the importance of considering the impact of pain when exploring such relationships. The emotional AEF domain was most strongly associated with poor well-being, suggesting a possible hierarchical relationship between AEF domains. Future work is needed using prospective designs, and to develop a validated altered eating scale to capture eating experiences and impacts on well-being in real-time.

Summary: Introduction: Metabolic dysfunction-associated fatty liver disease (MAFLD) is on rise, in parallel with the increase in obesity and other lifestyle factors. The systematization of nutritional care is an important tool for diagnosing and intervening appropriately in these cases. However, despite the numerous interventions for MAFLD, few studies explore the systematized approach of the Nutrition Care Process. Objective: To identify the diagnosis and interventions in the nutritional care of people with non-alcoholic hepatic steatosis disease. Method: Descriptive cross-sectional study, of adults with non-alcoholic hepatic steatosis disease who were treated at a specialized outpatient clinic in a public hospital in southern Brazil. Data was collected from February to August 2023, with sociodemographic and clinical data supporting the diagnoses and nutritional interventions. The data was analyzed descriptively by central tendency, simple and relative frequency. Results: 45 people took part, most of them elderly (78%) and obese (93%). The most frequent nutritional problem was excessive energy (62%) and carbohydrate (57%) intake. The main goals set were to reduce energy and simple carbohydrate intake and increase fiber. Conclusion: The most common nutritional diagnosis was Excessive Expected Energy Intake and the need for interventions to reduce energy intake, simple carbohydrates and increase fiber, and all patients required nutritional monitoring. The systematization proposed in the Nutrition Care process standardizes the identification of the diagnosis and appropriate nutritional intervention, making it possible to monitor and evaluate the management of results.

Summary: Background and aims: Food selectivity has been poorly evaluated in dental clinical populations. The frequency of oral health-related food selectivity (i.e. avoiding at least one food item due to oral discomfort) may be underestimated in adult patients with oral health needs. The present study aimed to assess food selectivity in dental and non-dental populations aged 35–65 years. Methods: The food selective behavior of dental patients recruited in a clinic (n=63) and non-dental participants recruited within the general population (n=62) was assessed by using a food selectivity questionnaire based on traditional French dishes. Food selectivity scores, their reason-why and oral characteristics were collected and submitted to a principal component analysis and a cluster analysis to identify clusters among this population. Significance levels were set at p < 0.05. Results: Thirty participants (24.0% of the study sample, with respectively 7 within the non-dental group and 23 within the dental group (X2=10.42, p˂0.05) reported avoiding at least one food product because of oral discomfort. Thus 11.1% of non-dental participants and 37.1% of dental patients reported oral discomfort-related food selectivity. The clustering analysis showed three patterns of food selectivity within the sample study. Among them, a cluster representing 9.6% of the sample presented the highest food selectivity (mean±SD=16.3±5.3 avoided foods) and oral discomfort-related food selectivity scores (mean±SD=11.7±5.0 avoided foods), and included dental patients with high periodontal index, high DMFT index, low teeth and OFUs numbers. Conclusion: These findings indicate that oral-discomfort related food selectivity is increased in dental patients. They suggest the need of integrated care including food intake assessment and diet advice when treating oral disease and poor oral conditions.

Summary: Background: Although the beneficial role of ginger consumption on peptic ulcer disease (PUD) has been shown in experimental studies, there is no clinical trial on patients with PUD. Methods: The current study was performed as a randomized, double blind, placebo-controlled, clinical trial on patients with PUD. Patients were randomized to take either ginger (2000mg/day) or placebo as a supplement after the standard treatment for 6 weeks. At the beginning and the week 8, all participants underwent endoscopic exam, and gastric ulcers were evaluated and biopsied for pathologic assessment. Serum high-sensitive C-reactive protein (hs-CRP), IL-8, and total anti-oxidant capacity (TAC) were measured at the baseline, and the end of the study. Results: There was no significant difference in the number of ulcers at baseline and ending point of the study in the control group (P-value=0.772). Meanwhile, the number of ulcers were significantly lower in the intervention group after 6 weeks of ginger supplementation compared to the baseline (P-value=0.01). Moreover, higher reduction in mean dyspepsia scores was found in the intervention group compared to the control group (P=0.04). As another finding, the mean TAC increase in the intervention group (1.12±0.44 U/ml) was significantly higher than the control group (0.09±0.16 U/ml) (P

Summary: Background & Aims: Branched-chain amino acids (BCAAs), and the marine omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), prevent physical decline in older people. However, their combined effect on physical function in heart failure (HF) is unclear. This study aimed to investigate the association of BCAAs and EPA/DHA with exercise tolerance in people with HF. Methods: In total, 124 patients with HF were prospectively enrolled, and their serum BCAA and EPA/DHA levels, dietary pattern, and 6-minute walking distance (6-MWD) were assessed. Results: Lower 6-MWD quantiles contained more female patients than higher 6-MWD quantiles. Patients with a shorter 6-MWD were older and had a smaller leg circumference, higher B-type natriuretic peptide concentrations, and lower BCAA and EPA/DHA levels than those with longer 6-MWD (all P < 0.05). Patients with a shorter 6-MWD had an imbalanced dietary pattern with low intakes of oily fish, soy products, and vegetables. Meanwhile, their estimated nutrient intakes were high in saturated fatty acids and sucrose and low in polyunsaturated fatty acids and dietary fiber (all P < 0.05). According to multivariate analysis, low EPA/DHA concentrations (per 50 μg/mL decrease) [odds ratio, 95% confidence interval: 1.479 (1.025–2.137)], low dietary fiber intake (per 1 g/1000kcal decrease) [1.524 (1.098–2.119)], and high sucrose intake (per 1 g/1000kcal increase) [1.170 (1.040–1.310)] were independently associated with short 6-MWD (the lowest quantile of 6-MWD,

Summary: Over the past few decades, nutrition and nutritious care have added broad clinical and scientific attention, where increased information on clinical nutrition and metabolism for chronic and acute diseases has led to rapid progress in the advance and clinical application of nutritional care. Currently, increasing demand for functional foods has gained popularity among healthy circles, which play a major role in preventing or reducing some disease risks, besides providing the basic nutritional aspect. As far as we know, this is the first article that produces processed cheese using papaya fruit pulp as a naturally sweet flavor at levels 5, 10, and 15%. Papaya increased the functionality of high-quality and nutritionally processed cheese, improving vitamins (especially K, C A), minerals (K) and antioxidants (β-carotene, TPC). Further, most chemical properties decreased slightly according to papaya ratios, the reductions were greater in Na and Na/K contents, but in contrast, K and total fiber levels increased. The best was 15%, which had the highest overall sensory, flavor properties, easier to spread and more acceptable than other formula samples. In conclusion, adding papaya to processed cheese did not negatively affect its properties and can be presented to consumers as a nutritious functional product with numerous amazing health benefits. Thus, it can be widely recommended for enhancement in other dairy products. This work aims to develop an innovative flavored-processed cheese supplemented with ripe papaya fruit pulp extract and evaluate chemical, nutritional and sensory properties to improve nutrition, and health benefits and provide a solution to nutritional deficiency.

Summary: Background & Aims: Epidemiological studies have indicated a potential association between dietary acid load (DAL) and the risk and prognosis of cancer; however, the evidence needs more research. Hence, we performed an updated systematic review and meta-analysis to comprehensively investigate the relationship between DAL and risk for different types of cancer. Methods: We conducted a systematic literature search in the PubMed, Embase, Web of Science, and Scopus databases from inception to November 2023. We calculated pooled odds risks (ORs) with 95% CIs using a random-effects model. We also conducted analyses on publication bias, subgroups, and sensitivity. This systematic review and meta-analysis included fifteen case-control studies. Results: The pooled OR showed a statistically significant association between potential renal acid load (PRAL) (OR: 2.73, 95%CI: 2.62–2.83, P:

Summary: Background & aims: The ageing process contributes to the declining function of the smell and taste senses, which consequently modifies the eating behaviour of the elderly and adversely impacts their nutritional status and health. The aim of this research was to determine the decline or loss of olfactory perception and salty taste sensitivity, as well as the nutritional status, body composition, and appetite of elderly people, and to find out if associations between impaired sense of smell and salty taste impact the nutritional status of elderly people in nursing homes. Methods: The study included 123 elderly nursing home residents, mean age of 80.7 ± 5.8 y, 76.4% females, and 70 adults with a mean age of 42.8 ± 8.6 y, 90% females. Olfactory function was determined by The European Test of Olfactory Capabilities, parameters measured were detection and identification and based on the results proportion of subjects with hyposmia was calculated. Gustatory function was expressed by salty taste detection and recognition thresholds and measured by the rapid detection threshold method adapted for the elderly. Based on the recognition threshold, three groups of sensitivity to salty taste were developed. Sensory decline was established in comparison to the young adult group of participants. Nutritional status was determined by several methods: anthropometric measures of body mass index and body composition, the Mini Nutritional Assessment, and the Simplified Nutritional Appetite Questionnaire. Results: The study determined a significant decline in the olfactory function of elderly subjects, with 65% of participants having hyposmia and declining salty taste perception (22.1 ± 14.9 mM) (P < 0.0001). The results showed increased body mass with a trend towards obesity, with a mean body mass index of 29.6 ± 5.2 kg/m2, of which 8.1% of subjects were undernourished and 41.5% were overweight or obese. A mini-nutritional assessment showed that most respondents (75.6%) have a normal nutritional status (13.3 ± 0.9), about a fifth of respondents (22.8%) were at risk of malnutrition (9.8 ± 1.0), and 1.6% of respondents were malnourished (5.5 ± 2.1). Nutritional appetite analysis determined that 32.5% of elderly people were at a significant risk of at least 5% weight loss within six months. A significant impact of chemosensory function on measured parameters of nutritional status was only found in olfactory perception between individuals with normal status and those with malnutrition. Conclusions: Elderly people, residents of nursing homes, have a declining chemosensory function, but there is also a high percentage of overweight and obese individuals. A potential weak effect of olfactory function was found on nutritional status; however, nutritional status seems to be independent of a decline in salty taste perception. Although this research did not show a significant impact of chemosensory function on nutritional status, further research is needed to clarify the causal effect for this group of elderly people.

Summary: Ageing affects food choices, food-related life and the nutritional status of older people. The latter may be addressed through the targeted development of specific food products. For example, the development of protein-fortified foods could help older adults increase their protein consumption, thus contributing to the prevention of age-related diseases. This exploratory qualitative study focused on exploring the factors affecting the choice of protein-fortified foods amongst community-dwelling Irish adults ≥ 55 years of age. Sixteen community-dwelling adults (between 55 and 89 years) residing in Ireland were interviewed online in relation to their preferences and perceptions of these foods. Thematic analysis of the transcribed interviews revealed that the willingness to consume protein-fortified foods was low and that the interviewees generally preferred to consume foods naturally high in protein. However, if they had to consume protein-fortified foods, their choice and acceptance would depend on the product characteristics such as its sensory properties, functionality, composition, nutritional value and digestibility. Moreover, most of the interviewees would prefer to consume savoury (e.g. bread, soup) rather than sweet (e.g. pancake, ice cream) products. The study also revealed individual-related factors that affected acceptance of protein-fortified foods including sociodemographic characteristics (living situation), physiological factors (health issues), food-related life (diet and food habits) and food-related awareness (lack of information about protein). This preliminary qualitative study provides valuable information to help guide the development of protein-fortified foods acceptable by the target population.

Summary: Background: An optimal nutritional strategy has not been established for the patients with muscle atrophy. Moreover, acute critical illness causes drastic changes in skeletal muscles, complicating nutritional treatment. Here, we present a case of myotonic dystrophy suffered acute respiratory distress syndrome (ARDS). We aimed to describe the changes in skeletal muscle as well as nutrition therapy. Methods: A female in her 30s with myotonic dystrophy received mechanical ventilation for severe ARDS. Her respiratory status improved by day 15 of admission, but she developed severe weakness. We evaluated the cross-sectional area and mean computed tomography (CT) value of the psoas muscle at the level of the third lumber vertebra using abdominal CT scans performed on days 1 and 15. We also performed bioelectrical impedance analyses (BIA) on days 37 and 44. The patient received enteral nutrition from day 4, which was increased to administer 21.1 kcal/kg of energy and 1.05 g/kg of protein per day as the maintenance dose. Results: The cross-sectional area remarkably decreased from 8.59 cm2 on day 1–7.39 cm2 on day 15. The CT values decreased from 47.2 HU to 13.6 HU. BIA performed during the recovery phase showed impaired muscle quality (phase angle of 2.6 or 2.9°). The muscle volume was preserved with maintenance doses of enteral nutrition. Conclusion: Acute muscle volume loss and deteriorating muscle quality was observed during acute critical illness in a patient with myotonic dystrophy. The patient received a standard dose of energy and protein, and the muscle volume was preserved.

Summary: Introduction: Research has shown that the Covid-19 pandemic may have had negative effects on lifestyle factors of people in the UK, however research is limited in terms of the impact on people living with neurological conditions such as Multiple Sclerosis (MS), Parkinson's (PD) and spinal cord injury (SCI). This study explores the impact that the pandemic had on mental health and lifestyle factors such as dietary habits, supplement use and exercise in those with MS, PD and SCI. Methods: A cross-sectional, online, questionnaire study was carried out on a cohort of 134 people in the United Kingdom during the Covid-19 pandemic. Participants completed the questionnaire between June 2021–February 2022. Eligibility criteria included being over the age of 18 years, and declaring having been formally diagnosed with either MS (n=27, female=81%), PD (n=84, female=35%), SCI (n=23, female=61%). Results: 33% of participants reported an increased consumption of alcohol and 29% a decreased consumption of fruit and vegetables. However, 64% of participants reported no change in diet (p < 0.001). Vitamin D, multivitamin/minerals, probiotic and fish oil were the most commonly consumed supplements by participants. Although intake of any supplement was not significantly impacted by Covid-19 for the total cohort, by condition, and by sex, a generalised linear mixed model indicated SCI participants consumed more supplement types during Covid-19 than before (OR:1.98; 95% CI [1.04, 3.77]). Additionally, 29% of participants reported they contacted their families less than pre-pandemic (p=0.001), and 60% reported they experienced more fatigue since the pandemic. Open-ended questions added quality context to the categorical data. Conclusion: This study suggests that the impact Covid-19 has had on people with neurological conditions is complex and individual, yet the negative effects may be more pronounced than the general public. Overall, there were changes in lifestyle behaviours, some which may be detrimental to health and life quality in these already vulnerable groups. Therefore, these changes need to be considered in the aftermath of the pandemic.

Summary: SARS-CoV-2 has had a significant worldwide impact, leading to widespread illness and mortality. With the lack of specific antiviral treatments, there is a growing interest in exploring the potential therapeutic effects of various nutritional supplements, including vitamin D. Vitamin D plays an essential role in health, has been implicated in modulating the immune response and reducing inflammation, which may have implications in the prevention and management of coronavirus disease 2019 (COVID-19). Patients having low level of vitamin D are predisposed to severe consequences. Vitamin D and COVID-19 have shown an inverse relationship. This review is an understanding of the remedial effects of vitamin D in COVID-19, including its potential mechanism of action, evidence from clinical studies, and recommendations for supplementation of vitamin D in patients suffering from COVID-19. Material and Methods: Google scholar, Sci-Hub, pubmed.

Summary: Background & Aims: Sarcopenia and myosteatosis are proving to be major factors to predict mortality in intensive care patients. Few studies are currently focusing on evaluating the functional impact after intensive care discharge and none has considered sarcopenia and myosteatosis as prognostic factors.The aim of our study was to determine whether sarcopenia and myosteatosis are reliable prognostic factors for mid-term functional impact in critical patients a few months after intensive care discharge. Methods: We carried out a retrospective monocentric study using computed-tomography scanner performed on intensive care admission and/or three months after discharge to assess sarcopenia and myosteatosis in 43 patients with critical illnesses who underwent a multidisciplinary evaluation on a multidisciplinary consultation's day hospital.We used L3 and/or T4 computed-tomography-scan levels to assess sarcopenia with the skeletal muscle index and myosteatosis with skeletal muscle density. These data were compared with main patient characteristics on intensive care admission and during intensive care stay and with functional assessments at the post intensive care multidisciplinary consultations, based on hand grip strength test, 6-minute walking test, and peak inspiratory pressure. Results: We found a good correlation of both skeletal muscle index and skeletal muscle density for T4 and L3 levels. Skeletal muscle index was correlated with hand grip strength test, and skeletal muscle density with 6-minute walking test, which are both functional tests recommended in the algorithm of the European Working Group on Sarcopenia in Older People to diagnose sarcopenia. Peak inspiratory pressure was correlated with both skeletal muscle index and skeletal muscle density and also with other functional tests. Conclusions: We confirmed the reliability of thoracic computed-tomography-scan to assess sarcopenia and myosteatosis. We found that skeletal muscle index and skeletal muscle density are independent but complementary predictive factors for functional impact at mid-term in intensive care patients. Peak inspiratory pressure could be a useful tool for the assessment and management of sarcopenia.

Summary: Purpose: To identify what impacts the ketogenic diet (KD) may have on the outcomes of the highly prevalent neurological diseases (NDs) in the UK. These NDs are migraine, traumatic brain injury (TBI), stroke, fibromyalgia and restless legs syndrome (RLS). Additionally, if KD does impact the NDs outcomes, to identify by what biochemical mechanisms that does occur. Methods: Studies using KD as an intervention to treat NDs were identified through electronic database searches which comprise of 4 main themes (highly prevalent NDs, KD, neurological outcomes and biochemical mechanisms). Quality appraisal tools and Grading of Recommendations Assessment, Development and Evaluation (GRADE) were used to assess the quality of studies and evidence identified. Results: Twelve articles were identified and no studies for fibromyalgia and RLS. KD had positive impacts on all outcomes in migraine (attack frequency, duration, intensity, etc.) and stroke (balance & coordination, sensation, etc.). KD also had positive impacts on all outcomes in TBI ranging from physical, mental & behaviour and cognitive aspects, except no impact on “anxiety-like behaviour” and “brain oedema”. Improvement of mitochondria metabolism and reduction of neuroinflammation are the common biochemical mechanisms of KD improving the NDs outcomes. The specific mechanisms for migraine, TBI and stroke include inhibition of neuronal excitability, preservation of brain volume and increase in adenosine activity respectively. Conclusion: KD improved almost all outcomes in migraine, TBI and stroke by different biochemical mechanisms. However, cautions are needed to be taken while interpreting the results as RCTs on humans were lacking in this review.

Summary: Background/aims: During the first outbreak of COVID-19 knowledge regarding nutritional status and target areas of the nutritional treatment to patients admitted to the hospitals with COVID-19 was limited. Therefore, the aim was 1) to describe baseline characteristics including nutritional status, nutritional risk, energy- and protein intake, nutritional route, and Nutrition Impact Symptoms (NIS) known to have an impact on the nutritional intake; 2) to compare these characteristics in patients who, respectively, survived or died within 30 days after discharge and 3) to describe nutritional aspects in the transition between hospitalisation and a home setting. Methods: This was an observational study. Patients admitted with COVID-19 in 2020 and referred to clinical dietitians were enrolled. Data on nutritional status, nutritional risk, NIS, nutritional treatment, grade of inflammation, 30-days mortality and readmissions rate and nutritional aspects after discharge were collected from the patient journal. Results: We included 81 patients, 41 (51%) male, median age 75 (IQR: 63–83). Patients were referred to the clinical dietitians at median day 4 (IQR: 3–8) of the hospital stay. The median BMI was 25 (IQR: 21–28) and 58 (83%) were at nutritional risk. Nutrition route was primarily oral (89%). The three most common NIS were; decreased appetite (88%), shortness of breath (55%), and early satiety (47%).At the 30 days follow-up 23 (28%) patients were deceased, of these 16 (70%) before discharge. The patients who died were older (median 82 vs. 72 y, P=0.002), and more were admitted from a care facility (48 vs. 17%, P=0.005). Further, among those who died fewer covered their energy requirement (25 vs. 43%, P=0.001), and protein requirement (23 vs. 34%, P=0.032). Also chewing- and swallowing problems were more prevalent in those who died (45 vs. 17%, P=0.048). There were no differences in nutritional status, nutritional risk, or nutritional route among the two groups. A total of 21 (26%) patients were readmitted within 30 days.At discharge only 11 (14%) patients had a nutritional discharge plan made by the clinical dietician. Up to one fifth still experienced NIS with early satiety (20%), chewing or swallowing problems (15%) and respiratory problems (15%) being the most frequent. Conclusions: Hospitalized patients with COVID-19 had several NIS, a high prevalence of nutritional risk and the majority had a nutritional intake below requirement. The mortality was high, especially during hospitalisation, and those patients that died had a lower intake of energy and protein and hence also coverage of requirement. Most patients were fed orally during hospitalisation. More than one fourth of the patients were readmitted within 30 days. Few patients had a nutritional discharge plan made by the dietitian and up till one fifth of the patients still suffered from NIS.Therefore, nutritional treatment is relevant in this group of patients.

Summary: Objective: Sarcopenia, characterized by the loss of muscle mass and function, is prevalent in peritoneal dialysis (PD) patients. Early diagnosis is crucial, but universal screening is often hindered by the complexity of diagnostic algorithms and limited clinical resources. Therefore, this study aims to investigate the ability of bioelectrical impedance analysis-derived phase angle (PhA), a convenient and cost-effective technique, in detecting sarcopenia among PD patients. Methods: A single-center cross-sectional study was conducted on 130 multi-ethnic PD patients in Malaysia. Sarcopenia was assessed using Asian Working Group for Sarcopenia (AWGS) 2019 diagnostic algorithm. PhA was measured by a multi-frequency bioelectrical impedance analysis device at 50kHz. Multivariable logistic regression was used to determine predictability of PhA on sarcopenia. Receiver operating characteristics analysis was used to evaluate the discriminative performance of PhA in detecting sarcopenia. Optimal gender-specific PhA cut-off values for sarcopenia detection were determined based on desired sensitivity and specificity. Results: Sarcopenia was identified in 25.4% of the PD patients. PhA emerged as an independent predictor of sarcopenia (adjOR= 0.147; 95%CI =0.042–0.516; P =0.003), exhibiting excellent discriminative power in identifying sarcopenia (adjAUCoverall= 0.818±0.041; bootstrapped 95%CI =0.734–0.899, P

Summary: Context: Hepatic and renal damages manifest in patients with acute or chronic heart failure after the incidence of myocardial infarction (MI). Objective: Our objective in this study was aimed to investigate the protective effects of coenzyme Q10 (CoQ10) and taurine, which are bioactive compounds with protective functions, on liver and kidney toxicity rat exposed to isoprenaline, a popular tool for MI induction. Materials and methods: Following two (2) consecutive days of exposure to isoprenaline (200 mg/kg, i.p.), adult Wistar rats were treated with CoQ10 (10 mg/kg, i.p.) and taurine (100 mg/kg, i.p.) singly and in combination for 19 days. Following 21 days of experimentation, blood, liver and kidney were collected for biochemical and histological studies indicative of hepatic and kidney damage. Results: Our result showed that CoQ10 and taurine significantly decreased serum LDH, AST, ALT, and ALP, indicative of hepatic damage compared to isoprenaline groups. The increased creatinine and urea release suggestive of kidney dysfunction were suppressed by CoQ10 and taurine relative to the isoprenaline group. Additionally, CoQ10 and taurine significantly reversed isoprenaline-mediated oxidative stress-induced liver and kidney damage, which are shown by decreased malondialdehyde and nitrite accompanied by increased antioxidants (SOD, CAT, GST, GSH). Modifications to cellular histoarchitectural and fibrosis of the hepatic and renal tissues were attenuated by CoQ10 and taurine therapy. Discussion and conclusion: The findings from this study suggest that CoQ10 and taurine supplements may prevent isoprenaline-induced hepatorenal dysfunctions, possibly by alleviating oxidative stress and histoarchitectural protective functions of the hepatic and kidney cells.

Summary: Around 40% of cancer patients undergoing chemotherapy are malnourished, i.e. they suffer from an imbalance between nutritional intake and requirements, particularly in terms of energy and protein. This condition is deleterious, as it can lead to a loss of quality of life for the patient, increased mortality, and higher risks of recurrence and progression. In cancer patients, the onset of undernutrition is mainly due to reduced food intake and metabolic alterations, mainly due to the side effects of chemotherapy treatments. Indeed, treatment can lead to alterations in taste and smell, as well as loss of appetite, nausea, difficulty swallowing … Consequently, it is advisable to adapt the patient's nutritional management according to the degree of severity.The aim of this work is to propose food solutions providing protein enrichment to limit muscle loss and energy enrichment to limit weight loss. More specifically, culinary creativity sessions were conducted to propose enriched versions of standard recipes and a preference tests was conducted with patients to evaluate the recipes.The culinary workshop involving multidisciplinary experts (chefs, sensory and nutrition experts) led to the development of enriched recipes for oncology services, a starter, a main course and a dessert. A survey was then carried out with 237 cancer patients and measured their appreciation of the recipes developed. Using nutritional, sensory and preference performances of experimental recipes allowed to define the optimum variants to propose to undernourished patients.This study demonstrated the value of involving chefs and patients in the creation of enriched recipes in order to offer tasty, nutritious and adapted meals.

Summary: Background: Optimal blood glucose management is essential for optimal managing type 1 diabetes (T1D). Exercise is an efficacious, non-pharmacological, and cost-efficient adjunctive treatment that provides additional health benefits. Nevertheless, many adolescents with T1D are not meeting recommended physical activity levels and struggle with implementing appropriate management strategies around exercise. Aims: To investigate in adolescents with T1D: 1) physical activity levels; 2) management strategies utilised around physical activity; and 3) barriers and facilitators to physical activity engagement. Methods: Physical activity levels were assessed using the PAQ-C and PAQ-A questionnaires. A cut-off score of 2.75 was adopted to classify participants as meeting the recommended ≥60 minutes of moderate-to-vigorous daily physical activity. Semi-structured interviews with 16 adolescents were conducted, followed by NVivo-assisted thematic analysis. Results: The mean PAQ-score was 2.7(SD±0.77), with 25% adhering to the recommended physical activity guidelines. Themes related to management strategies were explored, including blood glucose monitoring, insulin-related, exercise-related, and nutrition-related strategies. Identified barriers included limited T1D management knowledge, negative social impact, difficulty with technology, poor planning and organisation, individual physiological responses, and the burden of T1D management. Facilitators included the ability to optimally manage the condition, having supportive people who understand and service supports. Conclusions: This study identified barriers and facilitators to managing blood glucose levels around and during physical activity in adolescents with T1D. This provides clinical insights into the management strategies utilised around physical activity and factors affecting participation that can inform the future promotion of physical activity in this population. In this cohort, two-thirds did not meet the recommended physical activity levels. Physical activity participation was primarily influenced by adolescents' confidence and ability to manage their condition around exercise. Exercise promotion strategies should focus on supporting optimal exercise management patterns for adolescents with T1D.

Summary: Background and Objectives: Dadih is an Indonesian traditional fermented buffalo milk produced and consumed by the West Sumatran Minangkabau ethnic group with its nutritional composition and lactic acid bacteria. Lactic acid bacteria of dadih have the potential to provide benefits to children's growth and development. The objective of this study is to follow up the effect of Dadih and Zinc given to pregnant mothers for 6 months on nutritional status, childrens' growth at aged 6–24 months. Methods: A prospective cohort trial was conducted in two districts on 138 pregnant mothers for 6 months, randomly assigned into three groups, namely Control, Dadih, and combination of Dadih and Zinc groups. Then, the combination of Dadih and Zinc groups was supplemented to expecting mothers, respectively, six times a week during 6 months intervention study. Anthropometric measurement of children was assessed on birth, 6, 9, 24 months. Results: The mothers of those children were supplemented with Dadih, Dadih and Zinc, and normal diet, respectively, during pregnancy. There is an effect of giving dadih, dadih and zinc interventions with controls on pregnancy outcomes, namely head circumference variables (P = 0.02) and underweight variables at 9 months follow-up (P = 0.049). Conclusions: Dadih and Zinc are potential for improving nutritional status of the children. In addition, the two types of supplementations are recommended to pregnant mothers, in order to reduce the prevalence of stunting.

Summary: Objective: The aim of this study was to determine factors including biochemical markers, dietary habits, and social-anthropometric associated with uncontrolled hypertension among elderly hypertension in rural regions of Vietnam. Methods: This study included 272 hypertension patients aged over 60 years. Demographic data, anthropometric measurements, and risk factors associated with hypertension were from the cross-sectional study of 272 customers at the Medical Examination Department, Samson General Hospital, Thanh Hoa Province, Vietnam. Biochemical markers including total cholesterol, triglycerides, and fasting blood glucose were measured. Dietary habits were by using a frequency questionnaire. Uncontrolled hypertension was defined as systolic blood pressure of ≥140 mmHg and/or diastolic blood pressure of ≥90 mmHg in a patient taking anti-hypertensive medication.Generalized multiple linear regression was used to assess the impact of related factors on blood pressure, which were used as the dependent variables. Logistic regression analysis was used to calculate the odds ratios (ORs) and 95% confidence intervals (95% CIs) of related factors for hypertension status. Results: The study found that men had more uncontrolled hypertension than women among the elderly population. The prevalences of hyperglycemia, hypertriglyceridemia, and hypercholesterolemia were high in both controlled and uncontrolled groups. There was an inverse association between fruits (p=0.021) and vegetable consumption (p=0.038) and a positive correlation between salty habits (p=0.040) and processed food (p

Summary: Background & Aims: Polyphenols are plant secondary compounds that possess antioxidant properties associated with preventing inflammation-mediated ailments such as cardiovascular disease and cancer. Recent studies hint at their capacity to enhance exercise performance. Berries, in addition to containing high amounts of essential vitamins and minerals, are extremely rich in polyphenols. Therefore, the aim of this systematic review and meta-analysis was to compile relevant human randomized controlled trials exploring the potential of polyphenol-rich berries to enhance exercise performance and associated biomarkers. Methods: The PubMed, Web of Science, and SPORTDiscus databases were searched using keywords related to berry supplementation, exercise performance, and biomarkers of performance. In total, 2374 articles were screened and 14 were included in the analysis. Results: The results indicate no statistically significant effect of berry supplementation on exercise performance and its associated biomarkers. However, there is a trend towards a positive pooled effect size of berry supplementation on time to exhaustion (SMD: 0.57, Z: 1.51, P-value: 0.13). Furthermore, all pooled effect sizes favor berry supplementation. Conclusions: Due to variations in testing protocols and biomarkers of interest among the studies included, no more than 7 articles were included for any given outcome measure. This underscores the necessity for additional high-quality randomized controlled trials (RCTs) to strengthen the evidence and allow for recommendations to be made regarding the performance enhancing effects of berry consumption. This systematic review and meta-analysis was registered on Open Science Framework (DOI 10.17605/OSF.IO/NCAVJ).

Summary: Background & Aims: Adoption and maintenance of healthy diets among vulnerable populations, such as cancer patients, can be challenging. The preliminary study of sensory-hedonic responses through the modulation of key sensory properties in food models in healthy participants, could contribute to explore a new method to answer to nutrition in cancer's issue. Sensory and hedonic responses are affected, among other factors, by sensory responsiveness and psychological traits.With the perspective of using the approach to investigate individual differences in sensory and hedonic responses in cancer patients undergoing chemotherapy experiencing taste alterations, two food models were designed and pre-tested with healthy participants. Methods: 223 healthy participants (68% women, 18–70 y.o., 40 mean age; 118 from France and 105 from Italy) participated in the study. Sensory-hedonic responses to four apple juice samples, spiked with four increasing concentrations of mint syrup corresponding to variations in perceived coolness, and to four chickpea cream samples, spiked with glucose-fructose syrup to modulate the perception of sweetness in contrast to the sourness induced by citric acid, were measured. Food neophobia, disgust sensitivity, sensitivity to reward and PROP (6-n-propylthiouracil) responsiveness were measured. Results: Sensory-hedonic responses to the food models were found to vary across participants and allowed to identify different groups. Two clusters were established for the apple juice differing in liking for the coolest sample: Moderate and Extreme Coolness Dislikers. Instead, three clusters were identified for the chickpea cream: 1) Sweet Likers – perceiving sweet as less intense in all samples and showing liking increments with increasing sweetness and decreasing sourness; 2) Sweet Dislikers – tended to perceive higher sweetness intensity and liking raised with increasing sourness and decreasing sweetness; 3) Inverted U-Shaped – with an optimum liking corresponding to intermediate concentrations. Clusters' differences were found in age and in sensitivity to reward, with Sweet Likers being the youngest and the most sensitive to reward. The approach allowed identifying the level of sensory properties that minimized rejection and maximized liking within and across clusters. Conclusions: The two food models will be adopted to study the effect of cancer therapy on taste perception and liking responses, for the development of tailor-made products well accepted by patients experiencing taste alterations.

Summary: Background: Hyperemesis gravidarum (HG) is the most widespread reason for admission to the hospital during the first half of pregnancy. HG etiology is not clear in many cases. However, maternal body composition and pre-pregnancy diet are suggested as possible factors. This hospital-based case-control study aims to determine the link between the Mediterranean diet score (MDS) and pre-pregnancy anthropometric indicators with Hyperemesis gravidarum. Methods: A total of 45 women with incident HG and 126 controls were entered into this case-control study between April 2020 and June 2021. A repeatable and accurate 168-item semi-quantitative food frequency questionnaire was used to define the MDS. The association between MDS and HG odds was examined through adjustment by possible confounders by the estimation of multivariate regression models. Results: The median (interquartile range) pre-pregnancy body mass index of participants was 22.7 (21.7–25.9) and 22.9 (21.4–25) Kg/m2 in cases and controls, respectively (P=0.284). The adjusted analyses found that the MDS was associated with a 25% reduced odds of HG (odds ratio (OR): 0.75, 95% confidence interval (95%CI): 0.24–0.91). Body mass index and waist circumference before pregnancy were not significantly associated with HG odds in both regression models. Conclusions: The odds of HG during pregnancy are lower in women with a higher MDS before pregnancy. Also, a high intake of fruits and nuts, vegetables, legumes, and fish before pregnancy is liked with a lower HG odds.

Summary: Background: The globally rising prevalence of obesity highlights the importance of implementing effective methods for prevention and treatment. In this context, personalized nutrition (PN) is being discussed as a promising approach. The Food4Me study, a clinical trial investigating the effectiveness of PN interventions, demonstrated that tailoring dietary advice to individual needs is more likely to initiate behavior changes than standard dietary guidelines. However, the accessibility of PN remains a challenge due to financial and structural barriers. ChatGPT, a freely available, natural language processing model published in 2022, might provide a solution to increase the availability of personalized nutrition to a broader population. Methods: To investigate ChatGPT's potential to provide accurate and reliable personalized dietary recommendations, we conducted a comparative analysis, comparing its recommendations with those of the Food4Me algorithm. We selected 20 obese subjects of the German Food4Me sub-cohort and entered their baseline data into ChatGPT (version 3.5). For each subject, a separate chat space was set up, maintaining consistent wording and prompt order throughout all chats to ensure comparability. The prompts were written from a first-person perspective, simulating an authentic scenario of average users asking for dietary recommendations. ChatGPT's responses were compared to the Food4Me feedback reports that had been provided to the selected subjects within the study. Results: ChatGPT may provide suitable personalized dietary advice and holds some noteworthy advantages over the Food4Me algorithm, but still tends to produce recommendations with inconsistent and unpredictable errors, for example, regarding intakes of macro- or micronutrients. Conclusion: Currently, it is not advisable for individuals without nutritional expertise to rely on ChatGPT for personalized dietary recommendations. Nevertheless, ChatGPT remains a promising approach and may develop into a reliable tool for PN with further updates and fine-tuning in the future.

Summary: Background & aims: Poor nutritional status has been shown to have a detrimental effect on the prognosis of patients undergoing surgery. Oral nutritional supplements (ONS) are commonly used in the preoperative period to improve the nutritional status of patients. However, the impact of ONS on postoperative clinical outcomes remains controversial. This systematic review aims to evaluate the effectiveness of preoperative ONS on clinical outcomes of patients undergoing colorectal cancer surgery. Methods: Nine databases, including English databases (PubMed, Embase, the Cochrane Library, Web of Science, CINAHL) and Chinese databases (China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, China Science and Technology Journal Database, China Biology Medicine disc), were searched from their establishment to October 2022. The last search was conducted in June 2023, and the language was limited to Chinese and English. The secondary outcomes included wound infection, anastomotic leakage, and length of hospital stay. A meta-analysis was performed using RevMan 5.4 software. Results: Seven randomized controlled trials involving 737 subjects were included, 363 in the treatment group and 374 in the control group. All seven trials involved patients with colorectal cancer. Patients in the intervention group received ONS, while those in the control group received a conventional diet or an isoenergetic and isonitrogenous diet. The fixed effect model showed that the total incidence of postoperative complications in the intervention group was significantly lower than that in the control group [RR=0.83, 95%CI (0.70, 0.98), P=0.03, I2=29%, n=737]. However, there was no statistical significance in reducing wound infection, anastomotic leakage, or urinary tract infection. Conclusion: This study provides evidence that preoperative ONS can reduce the incidence of postoperative complications, but there is still a need for further research to support their routine use as preoperative nutritional support.

Summary: Background: Based on available data, acarbose may have an effect on body weight reduction. Nevertheless, the results were inconsistent and inconclusive. Therefore, the purpose of this review and meta-analysis of randomized placebo-controlled trials (RCTs) was to assess the existing data as thoroughly as possible. Methods: The relevant keywords were used to search the online databases to identify RCTs that examined the effect of acarbose on body weight, body mass index (BMI), and waist circumference (WC) up to April 2023. A random-effects model was applied to examine the weighted mean difference (WMD) and 95% confidence interval (CI). Results: Seventy-one RCTs with 73 effect sizes were included in this meta-analytic work. The effect sizes for body weight, BMI, and WC were 45, 47, and 9, respectively. The pooled analysis demonstrated significant decrease in body weight (WMD = −1.21 kg; 95%CI, −1.67, −0.75; p

Summary: This systematic review and meta-analysis examine the impact of synbiotics on non-alcoholic fatty liver disease (NAFLD) by evaluating changes in lipid, glucose, and inflammatory profiles. A search across PubMed/Medline, Cochrane Library, Scopus, Cambridge Core, and CINAHL yielded 302 articles, with 11 meeting the criteria for randomized controlled trials. The studies consistently reported that synbiotic treatment for NAFLD led to a reduction in liver enzymes ALT and AST, with significant effect sizes (SMD = -1.27, 95% CI: -2.07 to -0.46, P = .002; SMD = -0.67, 95% CI: -0.86 to -0.47, P = .00001). Additionally, synbiotics demonstrated a favorable impact on lipid profiles, lowering TC and LDL levels (SMD = -0.32, 95% CI: -0.56 to -0.07, P = .01; SMD = -0.05, 95% CI: -0.90 to -0.21, P = .002). The treatment also improved glucose profiles, as evidenced by reduced Glucose and HOMA-IR levels (SMD = -0.29, 95% CI: -0.53 to -0.04, P = .02; SMD = -2.45, 95% CI: -3.79 to -1.11, P = .0003), while pro-inflammatory cytokines, TNF-α, decreased significantly (SMD = -1.01, 95% CI: -1.32 to -0.71, P = .00001). In conclusion, synbiotic therapy emerges as a promising approach for enhancing liver function and metabolic profiles in NAFLD patients, as supported by the findings of this review.

Summary: Olfaction plays a priming role in both the anticipation and consumption phases of eating behavior. Olfactory dysfunction can therefore lead to changes in various aspects of eating behavior, such as food choice, appetite, and food intake. In light of the increasing prevalence of persistent olfactory dysfunction among patients affected by Covid-19, providing proper care and dietary advice to individuals with olfactory dysfunction is imperative. Therefore, this scoping review seeks to gain a better understanding of the impact of olfactory dysfunction on eating behavior. Following the PRISMA guidelines, 49 papers were included, the outcomes were presented by dividing them into two categories: 1) anticipatory eating behavior, including (anticipatory) food liking, appetite and craving, food preferences, food neophobia, and cooking habits; and 2) consummatory behavior, including, food intake, consumption frequency, adherence to dietary guidelines, (experienced) food liking, food enjoyment, and eating habits. Our results show that in the anticipatory phase of eating behavior, food liking, and, food preferences, and in the consummatory phase, food enjoyment is most affected in people who experienced a sudden change in olfactory function rather than a gradual decline. Moreover, changes in food flavor perception due to olfactory dysfunction, result in a shift of food preferences towards more “taste-based” preferences, such as salty or savory (i.e., umami) foods. Subsequently, changes in preferences can affect food intake and adherence to dietary guidelines, but only to a limited extent. Appetite is more likely to be low in individuals with short-term olfactory dysfunction compared to those with long-term changes. Generally, eating behavior is more impacted in individuals with a distorted sense of smell than in those with smell loss, and the effect becomes more pronounced over time. Due to the heterogeneity of methods used to measure different aspects of eating behavior, this review stresses the importance of more research on olfaction and eating behavior using standardized and validated assessments. Such research is essential to better understand the effects of olfactory dysfunction on each aspect of eating behavior and provide effective interventions.

Summary: Age-related neurodegeneration is an important public health challenge with the increasing burden of geriatric disease in the aging world population. Interest in nutraceuticals in the prevention and management of age-related neurodegeneration is therefore becoming more important than ever, especially in the management of neurodegenerative diseases and mild cognitive impairments, which are major contributors to the burden of geriatric disease. Polyunsaturated fatty acids are considered one of the most important nutraceuticals with their biochemical mechanisms, especially antioxidant and anti-inflammatory. Potential mechanisms by which PUFAs alleviate or prevent neurodegeneration include suppression of neuroinflammation and neurotoxicity, neuro-recovery, and support of the blood-brain barrier integrity. This review will consider the mechanisms and current information on the effect of supplementation or dietary intake of polyunsaturated fatty acids as nutraceuticals on neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease.

Summary: Background and aim: People with dementia, and particularly those living in care homes are at risk of suboptimal hydration and dehydration. Individual, contextual and staffing factors affect drinking behaviour in this population, hence multicomponent hydration care interventions have been promoted. The aim was to assess the feasibility and acceptability of a multicomponent Think Drink intervention for supporting hydration for people living with dementia in English care homes. Methods: A cluster randomised controlled feasibility study compared 6 intervention care homes and 5 control homes, over 3-months. Data (fluid intake; admission to hospital/dehydration; falls; laxative use; urinary tract infection and upper respiratory tract infection) was collected from 50 residents living with dementia in the intervention group and 37 control group pre and post intervention. Post intervention, 45 care home staff took part in 9 individual and 17 small group interviews. Results: Think Drink was feasible and acceptable to participating care home staff. The findings highlighted how Think Drink changed staff knowledge of hydration requirements and new hydration practices were implemented in care homes. No significant positive change in fluid intake was found in the intervention group in terms of mean and median fluid intake in previous seven days, and proportion of population achieving an intake greater than 1,600 mls per day. This could be attributed to improvement in recording fluid intake following the intervention. Conclusions: Whilst Think Drink is acceptable to care home staff further research is required to address methodological issues in assessing efficacy in supporting fluid intake.

Summary: Background: Changes in the oral mucosa occur in more than one-fourth of the population aged 17 and older and in one-tenth of children aged 2–17 years old, and consequence on the oral health-related quality of life. Oral mucosal diseases affect the oral cavity and vary greatly. OMDs have been reported to be associated with several factors, such as vitamin B12 deficiencies. Objective: This systematic review aims to investigate the vitamin B12 serum levels in patients with OMD. Method: This systematic review was conducted using the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. Article searches with specific keywords were conducted through PubMed, Science Direct, and Ebscohost-CINAHL, published from 2018 to 2023. The search for articles was limited to human studies, cross-sectional and case-control designs, papers written in English, and the full-text availability. The risk assessment of bias uses tools from the National Heart, Lung, and Blood Institute (NHLBI). Results: Twelve articles that meet the inclusion criteria were analyzed. The types of oral mucosal disease studied include atrophic glossitis (3 articles), OLP (2 articles), RAS (2 articles), OSF (2 articles), BMS (1 article), geographic tongue (1 article), and oral precancer (1 article). Vitamin B12 levels in OMD patients were significantly lower than healthy controls in 9 articles, while the levels were similar in 3 articles. Conclusion: Patients with OMD have lower vitamin B12 levels than individuals without OMD.

Summary: Background & aims: Olfactory disorders impact mental health, with adverse effects on quality of life, particularly in the area of eating. Despite their high prevalence in the population, olfactory disorders are poorly managed, with patients still lacking easy access to rapid diagnosis and treatment. In this context, the present study offers a new screening tool and compares the efficiency of different olfactory training protocols. Methods: A screening test was set up and different olfactory training paradigms were compared for their effect on the recovery of the sense of smell on the one hand, and quality of life on the other. The study population was composed of post-COVID-19 dysosmic patients (with a loss of more than 6 weeks). Three training protocols were used, differing in terms of number of odors and in format (either lab-supplied odorant kits, or the use of odorants found at home). All three protocols were implemented over a 12-week period. Results: The screening test distinguished dysosmics from normosmics with an accuracy of 73%. During training, 69% of patients completed the evaluation protocol and 77% of them performed more than half of the training sessions, resulting in a 53% completion rate. Olfactory performances improved significantly after training, irrespective of the training paradigm and 59% of patients displayed a clinically significant improvement of their sense of smell. These improvements were positively associated with assiduity along training. Finally, olfactory disorders negatively affected quality of life. After olfactory training, this overall negative impact on quality of life was reduced, especially with regard to the pleasure of eating. Conclusion: This study introduces a new screening tool for olfactory deficits. It also provides important insights into the optimization of olfactory training protocols and their effects on quality of life, and on eating behavior in particular.

Summary: Background & Aims: Age-related changes in body composition and the apparent protective effects of being overweight suggest that specific guidance is required for the clinical management of overweight and obesity for older adults (≥65 years). This study aimed to synthesise content on older adults from clinical practice guidelines for the management of overweight and obesity in adults. Methods: Twenty-three clinical practice guidelines on the management of overweight and obesity in the general adult population were identified from a recent scoping review. These guidelines were analysed for content relating to older adults. Data extraction focused on the assessment, diagnosis, and management of overweight and obesity in older adults, and specific guidance/recommendations on the management of overweight and obesity in older adults. Data were synthesised narratively. Results: Of the 23 guidelines, nine included text specific for older adults. Of these guidelines, four contained cautions regarding relevance of body mass index (BMI) cutoffs for older adults, and an additional two guidelines contained statements that BMI is a poor predictor of mortality. Information on waist circumference was inconsistent across five guidelines. Five guidelines cautioned against pursuing weight loss goals with older adults. Age-related considerations for diet, exercise, use of pharmacological interventions for weight management, and bariatric surgery were identified in several guidelines. Guidance to encourage older adults to participate in diet and exercise interventions was the most common recommendation. Recommendations on pharmacological interventions for weight management and bariatric surgery were inconsistent. Conclusions: Few guidelines incorporate content and recommendations for older adults, and there are inconsistencies between guidelines regarding the management of overweight and obesity. With evidence showing body composition and mortality risk associated with overweight change with age, there is a need to provide recommendations for older adults within clinical practice guidelines for the management of overweight and obesity.

Summary: Background & Aims: Nutrition assessment is integral to dietetic practice. TeleNutrition enabled dietitians to continue nutrition care provision during the COVID-19 pandemic but created challenges with undertaking nutrition assessment. The aim of the present study was to describe how dietitians in three Nordic countries perceived their nutrition assessment practice when physically distant from patients. Methods: The present study is a sub-analysis from one research project undertaken by the Global TeleNutrition Consortium, GTNC. Data was generated from a digital survey of a convenience sample of dietitians in Denmark, Norway, and Sweden who had a minimum of one adult patient interaction per week, distributed through the dietetic professional and/or regulatory bodies of each country, as well as closed social networks. Data from free-text questions were assessed using thematic analysis where the construction of final themes were guided by the Technology Acceptance Model (TAM). Results: In total, 146 dietitians participated in the study (Denmark 16%, Norway 34%, and Sweden 50%). The qualitative analysis of answers from 24 free-text questions resulted in four themes (key constructs) related to dietitians' experience of performing nutrition assessment using TeleNutrition: Perceived usefulness, Perceived ease of use, Perceived barriers, and Perceived facilitators. Each theme was divided into two to three sub-themes (explanatory dimensions). Conclusions: To best support dietitians in the new era of healthcare digitalisation, internationally accepted standards or protocols for performing nutrition assessment using TeleNutrition ought to be established. This is especially critical for nutrition assessment measures that require physical examination.

Summary: Background & aims: To test the validity and reliability of an inexpensive caliper against the gold standard caliper for the measure of triceps skinfold thickness (TSF) in children with cerebral palsy (CP). Methods: 50 children with CP were recruited in an academic medical center clinic. Two providers measured TSF using both the Holtain and Slim Guide. The intraclass correlation coefficient was obtained. Duplicate measures were used to calculate the technical errors of measurement (TE) and the coefficient of variation (CV) between the same provider with different calipers and different providers with the same caliper. Results: The correlation between the TSF measured using the Holtain versus the Slim Guide was 0.982 by provider 1 and 0.992 by provider 2. Intraobserver TE was 1.20 mm and 0.84 mm and CV was 9.7% and 7.1% for provider 1 and 2, respectively. Combining measurements of both observers, the TE and CV between calipers were 1.03 and 8.5%, respectively. Conclusion: The Slim Guide provides measurements that are reliable and valid. The error between calipers is similar to inter-rater error in published studies using the gold standard, and differences are unlikely to impact clinical management. With an affordable caliper, skinfold measurements can become more widely utilized, enhancing clinical care and research.

Summary: Background: Regular audits on nutrition screening, therapy, and dietary intake monitoring are essential for ensuring optimal nutrition practice. This study aimed to investigate the prevalence of nutritional risk, nutritional coverage, and nutrition impact symptoms (NIS) in hospitalized patients. Methods: A cross-sectional study was conducted, including adult patients admitted for ≥5 days on November 1, 2023. Data were collected from medical records to estimate the prevalence of nutritional risk using the NRS-2002 score. Additionally, data on dietary intake and NIS were collected through interviews with patients identified as being at nutritional risk. Results: A total of 104 patients (48% females) were included in the study, with 51% identified as being at nutritional risk. Patients at nutritional risk and those not at risk differed significantly in terms of length of admission (median 9 (IQR: 7–17) vs. 7 days (6–11), P = 0.015) and BMI (median 22.3 (IQR: 20.3–27.7) vs. 25.9 (22.9–29.7), P = 0.015). Patients at nutritional risk had a median energy coverage of 60% (IQR: 38–87) and a median protein coverage of 45% (IQR: 36–82). However, only 42% of them achieved an energy intake of ≥75% of the estimated requirement, while 28% met the same level for protein intake. The most prevalent NIS affecting dietary intake was ‘diarrhea, constipation, or discomfort from the stomach’, reported by 50% of patients. Conclusion: This study highlights the significant prevalence of nutritional risk among hospitalised patients, with one in every two patients identified as being at risk. Despite efforts, nutritional needs were not adequately met, particularly regarding protein intake. Regular audits and interdisciplinary collaboration are necessary for improving nutritional care and outcomes in hospital settings.

Summary: Donor milk obtained from milk banks is a source of infant nutrition for mothers that cannot produce their own milk. Milk banks quality control the milk when donated, testing for the presence of pathogenic bacteria, protein and fat concentrations and total energy content. The macronutrient analysis allows the milk bank to decide if they need to add fortifiers to the milk and whether to continue accepting milk from a specific donor. The data registered is a large knowledge base for understanding how the macronutrient content in human milk changes with e.g. time, maternal health and gestational age. Using information from 331 donated milk samples from 74 different donors, all from Denmark, this paper looks at trends in macronutrient content relative to several parameters. Our results show that there is a statistically significant change in content over time and gestational age, but also that other parameters, not covered by the available data, can have an effect on the quality of donated human milk.

Summary: Background & aims: The world is experiencing steady increasing in both number of cases and prevalence of diabetes with urban settings being more affected areas. Good adherence to dietary management is a key non-pharmacological management for effective management of blood glucose for people living with type 2 diabetes. For effective glycemic control, people with diabetes are recommended to eat less carbohydrates (quarter plate size), more fruits and vegetables (half plate size) and more lean protein (quarter plate size). This study aims to assess the consumption patterns of grains/cereals, vegetable and fruits and its association with glycemic control among people living with diabetes. Materials & Methods: The study design was a cross sectional among outpatients attending routine diabetic clinics. Structured questionnaire was used to collect information from the patient through face to face interview. Demographic information, dietary history and selected medical history were collected from patients. Data analysis was done by running the frequencies, percentages, chi-square test and logistics regression at 95% confidence interval. Results: About 109 (33.1%) of respondents were aged less than 40 years. One hundred and fifty-two respondents had been living with diabetes for less than past 5 years 152 (46.2%). More than 80% of the respondents had uncontrolled glycemic. Daily consumption patterns of grains/cereals food were (90.0%), vegetables (97.3%) and fruits (33.4%). Plate portion size consumed were; ≤¼ for grains/cereals (50.5%), ≥¼ for vegetables (96.4%) and ≥¼ for fruits (30.7%). The most types of food consumed were legumes (85.1%), whole grains/cereals (57.1%), leafy green vegetables (70.2%) and low GI fruits (59.9%). The odds of having hyperglycaemia were; increasing with increase in portion size of grains/cereals food (ref: one fifth; one quarter, AOR = 10.22; one third, AOR = 47.19; one half or more, AOR = 42.91); increasing with consumption of high GI fruits (AOR = 2.40) and decreasing with increase in portion size of fruits (AOR = 3.13). Conclusion: Grains/cereals, vegetables and fruits consumption pattern among patient with type 2 diabetes need to improve to achieve optimal blood glucose. Reducing staples portion sizes (grains/cereals), increases portion size for mixed fruits, eating whole grains/cereals and choosing of low GI fruits may help to curb the severity of hyperglycemia among patients with T2DM.

Summary: Aim: We aimed to study the low, moderate, and high glycemic indexes of fruit meal sequence among T2DM patients in Indonesia by measuring Fasting Blood Glucose (FBG) and insulin levels, Homeostasis model assessment of β-cell function (HOMA-β), and Dipeptidyl peptidase-4 (DPP4) activity. Methods: A randomized controlled trial (RCT), which included 48 participants, was conducted from November 2018 to March 2019. The meal sequence treatments were done in two intervals: 1–7 days fruit last meal (FL) and 14–21 days fruit first meal (FF). Results: Significant differences in insulin and HOMA-β between control and low GI were observed in both intervals. However, no significant changes in Insulin level (5.16±3.47 vs. 5.51±6.16 μIU/ml, p=0.819) and HOMA-β (17.61±11.33 vs. 20.65±17.88, p=0.465) were observed from low GI in two different intervals. Conclusions: Our study clearly uncovered that low GI fruit consumption is beneficial in increasing insulin levels and HOMA-β but is independent of fruit meal sequence. Moderate and high GI fruits showed beneficial effects on insulin levels and HOMA-β only if consumed after the main meal. Although a significant decrease in FBG levels after 7 and 21 days was observed, the analysis on intervals (day 7-1 and 21-14) showed no changes in FBG levels after fruit sequence after or before meal. Further studies are needed to investigate the long-term effects of fruit meal sequence on glycemic parameters.This study provides evidence on how fruit meal sequence can directly affect the FBG level, insulin level, and HOMA-β. Given the essential effects of fruit meal sequence, this study gives insight into the integration of optimization of fiber intake from fruits and the meal sequence in T2DM management.

Summary: Background and aims: Oral nutritional supplements (ONS) are prescribed for older adults with malnutrition and sarcopenia to prevent nutritional and functional deterioration. Studies investigating ONS effectiveness commonly provide the same ONS prescription for participants. This scoping review aimed to provide an overview of studies that have personalized ONS prescription in older adults with malnutrition or sarcopenia. Methods: In July 2023, PubMed, CINAHL, SCOPUS and EMBASE were searched for studies wherein older adults with malnutrition, risk of malnutrition or sarcopenia received personalized ONS. Data extracted were synthesized into tables and descriptively summarized. Results: Fifteen studies met the inclusion criteria, all in developed countries: 10 randomized controlled, 3 cross-over, 1 non-randomized and 1 single-arm trials. Fourteen studies included older adults at risk of malnutrition/malnourished. One study included older adults with sarcopenia. Studies included between 34 and 671 participants aged 70–88 years. Dietitians (10 studies) or trained nutritionists (5 studies) personalized the ONS prescription. Personalization included: (i) providing ONS for protein requirements based on weight (11 studies) or (ii) current dietary intake (2 studies), or (iii) offering ONS flavors based on personal preference (2 studies). Outcome measures included nutritional status, change in body weight/composition and quality of life. Definition and methods of assessing adherence varied. Seven studies showed a significant improvement in primary outcomes when personalized ONS were prescribed. Conclusion: 15 studies which personalized ONS for older adults with malnutrition/sarcopenia were identified. Further research on optimizing personalized approaches with standardized outcome measures is warranted.

Summary: Changes in taste have been perceived as a common side effect of different cancers and may lead to malnutrition. Hence, the importance of understanding cancer patients' sensory taste perceptions and its impact on nutritional status, quality of life (QoL), and oral nutrition supplements (ONS) compliance becomes crucial. This qualitative study involved semi-structured, in-depth interviews with 24 adults (15 with multiple myeloma and 9 with head & neck cancer). The interviews were transcribed and the data analysis was conducted using reflexive thematic analysis and template analysis. This guided the development of four themes: 1. Taste and smell changes, 2. Impact on nutritional status and quality of life, 3. Information and help available for people experiencing changes in their taste, and 4. ONS and its compliance. Our findings show significant negative impact of chemosensory changes on nutritional status, quality of life and ONS compliance. Patient's experience with the level of support received for the management of taste changes during cancer treatment varied widely. Providing adequate information and support in a timely manner about changes in taste during treatment can improve patients' coping strategies and maintain their nutritional status. Overall, the findings highlight the importance of addressing taste changes and ONS compliance for people with multiple myeloma and head and neck cancer undergoing treatment. Specifically, the taste changes and its impact experienced by people with head and neck cancer were found to be more severe than those experienced by multiple myeloma patients. This study provides an understanding of changes in sensory taste perception experienced by cancer patients and its impact on nutritional status and QoL. This understanding can provide insight into ways to improve ONS consumption and compliance for preventing malnutrition. It is crucial to further conduct ONS sensory evaluations that cater to the specific needs of this cohort to help prevent malnutrition among cancer patients.

Summary: Purpose: Older adults have a higher risk of malnutrition and hospitalization and, likewise, malnutrition can be a risk factor for hospitalization. The purpose of the present study was to determine the possible association between malnutrition and hospitalization in older adults at the Naval Medical Center “Cirujano Mayor Santiago Távara'' in Peru. Patients and Methods: A cross-sectional analytical study was conducted in older adults over 60 years of age attended by the outpatient and Day Clinic during the period 2010–2015. Malnutrition was assessed using the Mini Nutritional Assessment scale. Multivariate analysis of the association between malnutrition and hospitalization with control of confounding variables was performed using a Poisson regression model with robust variance, obtaining an adjusted prevalence ratio (aPR). Results: The study included 1865 older adults. 58.7% were male, and 46% were between 70 and 80 years of age. 16.3% had malnutrition, 80.6% had at least one emergency department visit, and 35.6% were hospitalized at least once. Multivariate analysis showed a statistically significant association between malnutrition and hospitalization (aPR = 3.22; 95% confidence interval [CI]: 2.56–4.03), as well as between depressive symptoms and hospitalization (aPR = 1.54; 95% CI: 1.23–1.93). On the other hand, emergency department visits were associated with a lower frequency of hospitalization (aPR = 0.70; 95% CI: 0.54–0.90). Conclusion: Malnutrition and depressive symptoms were associated with hospitalization in retired naval personnel and their families at the Naval Medical Center, while emergency department visits constituted a protective factor.

Summary: Background: The concomitant loss of lean muscle mass and bone mineral density is known as osteosarcopenia. This disorder can result in increased physical impairment in addition to an increased risk of falls and fractures. Although the diagnostic of osteoporosis and sarcopenia has been described, the inflammatory mediators that identify the presence of osteosarcopenia and propose possible inflammatory mechanisms implicated in muscle and bone loss are unknown. The objective of this study was to evaluate a panel of inflammatory biomarkers and investigate its relationship with the presence of osteosarcopenia. Methods: Body composition was assessed using Dual X-ray absorptiometry and handgrip strength using a Jamar dynamometer. Blood samples were collected for evaluation the plasmatic concentrations of adiponectin, brain-derived neurotrophic factor (BDNF), interferon ɣ (IFN), interleukins 2, 4, 5, 6, 8 and 10, leptin, resistin, tumour necrosis factor (TNF) and its soluble receptors (sTNFr) 1 and 2. Results: In seventy-one older women the age was 75 (±7) years, BMI 26.1 (±4.5) kg/m2, handgrip strength 19 (±6) kgf and the muscle mass index was 6.39 (±1.05) kg/m2. The diagnosis of osteosarcopenia was found in 25% of the sample. Analysis of the distribution of biomarkers demonstrate the osteosarcopenia group presented greater concentrations among all markers measured, and significant differences was found in plasmatic concentrations of interleukin 8 (p = 0.02). Subgroup analysis showed that group with osteopenia plus sarcopenia had significantly greater IL-6 (p = 0.03) and IL-8 (p = 0.007) concentrations. Conclusions: In a panel of biomarkers, IL-6 and IL-8 were found to be related with diagnosis of osteosarcopenia in community-dwelling older women. These results may contribute to understand the inflammatory mechanisms and suggest a diagnostic strategy for these patients, also informing new strategies for prevention, monitoring, and treatment of osteosarcopenia.

Summary: Among the side effects of chemotherapy, dysgeusia stands out a disturbance or damage to taste perception that profoundly affects the patient's biopsychosocial well-being. Recognizing and appropriately managing this issue is paramount. This study aims to develop a systematic review protocol for evaluating multidisciplinary strategies aimed at alleviating dysgeusia in chemotherapy-treated patients. The protocol involves a thorough examination of database articles related to dysgeusia, primarily concentrating on the disorder but extending to related topics. The methodology places a strong emphasis on both methodological rigor and the relevance of selected studies. Consistent data extraction is followed by a comprehensive synthesis, providing a holistic perspective. Key objectives of this protocol include analyzing the dysgeusia problem in chemotherapy patients, identifying multidisciplinary strategies to mitigate dysgeusia, determining the most effective interventions for reducing dysgeusia, and recommending a specific assessment tool for this condition.

Summary: Introduction: Aging is related to decrease in taste perception. As appetite is considered crucial for maintenance of proper nutritional status of older adults, its decrease during aging raises questions about its relation to gustatory functions and further prevention possibilities. Aim of the study: The aim was to assess the characteristics and eating behaviors of the patients who reported a self-perceived reduction in taste perception in the context of appetite. Material and methods: This semi-qualitative study was conducted between November 2021 and March 2022 in the Department of Internal Medicine and Geriatrics of the University Hospital in Krakow. Patients were assessed using an original appetite assessment scale, which allowed for an in-depth interview on areas related to the decline in gustatory function. Additionally, nutritional assessment was performed using Mini Nutritional Assessment and Council on Nutrition Appetite Questionnaire (CNAQ) and anthropometric measurements. Results: The most common characteristics of patients with gustatory dysfunction were early satiety, decreased appetite in the three months prior to the study and polypharmacy. A significant difference was observed in the CNAQ scores between the group of patients with and without gustatory dysfunction. Conclusion: Careful identification of patients presenting with gustatory dysfunction can provide an important cue for an individualised approach aimed at preventing malnutrition. In our work, we suggest the areas that can be addressed during a nutritional interview to enable the selection of an optimal approach.