Journal of Nutrition, Fasting and Health
Volume:11 Issue: 3, Summer 2023

Critically ill patients admitted to the intensive care unit are often hyper-metabolic, hyper-catabolic, and at malnutrition risk. This study aimed to evaluate the amount of energy and protein intake and its correlation with the required amount in critically ill patients.  A total of 70 patients with critical conditions admitted to the ICU were eligible (age≥18 years and over a 3-day stay in ICU). Basic characteristics, medical history, and laboratory test results were extracted from the patient’s medical records. Anthropometric indicators and the APACHE II questionnaire were assessed. Patients’ energy and protein requirements were 25kcal/kg/day and 1.2g/kg/day, respectively.  The mean age in the target population was 57.69±20.81 years, and 48.6% were men. The mean actual energy intake was significantly lower than the requirement (531.27±365.40 vs. 1583.77±329.36 Kcal/day, P˂0.001). The mean actual protein intake was significantly lower than the requirement (14.94±18.33 vs. 74.11±17.89 gr/day, respectively, P˂0.001). Energy and protein provision to the patients had a growing trend over time. There was a significant reverse correlation between the age of patients and total lymphocyte count (r= -0.38, P=0.003). In addition, there was a significant reverse correlation between the Glasgow coma scale and mechanical ventilation duration (r=-0.49, P˂0.001). The lowest average energy and protein intake were in patients with poisoning.  The energy and protein intake in critically ill patients is significantly less than recommended, requiring routine nutritional assessments.

Understanding food waste is essential to reduce environmental impact and financial burden and ensuring food security in hospital settings. Research on hospital food waste in Iran, especially in Pediatric Intensive Care Units (PICUs), has been limited despite the importance of reducing food waste. Therefore, this study aims to evaluate the amount of food waste in the Akbar Children’s Hospital PICUs department. The findings of these studies can provide evidence to improve food management in hospital settings. 

The rate of food waste among patients admitted to the Akbar Hospital’s PICUs was measured in this cross-sectional study. Food waste was measured by calculating the difference between the total food delivered to the patient and the total food they consumed. Patients or their parents provided information about the proportion of hospital food intake within the past 24 hours. 

Of the 140 patients in the initial sample, 21 received hospital food during the study. The average food waste for the one-week study period was 53.57%, indicating that 90.5% of patients caused varying degrees of food waste, with only 9.5% consuming the entire amount of hospital food they received. No significant association was found between patients’ age or gender and food waste. 

The results suggested a significant amount of food waste in the hospital setting that needs to be addressed to improve patient nutrition and reduce costs.

We launched this study to compare subjective global assessment (SGA) and nutrition risk index (NRI) as malnutrition screening tools for nurses to use in the care of End-stage Liver Disease (ESLD) patients.  This pilot study was conducted on liver transplant patients in two hospitals in Iran from May to September 2021. Sensitivity, specificity, and predictive values of NRI were evaluated compared with SGA in ESLD patients.  Sixty-five cirrhotic patients were assessed. The sensitivity, specificity, positive and negative predictive values for NRI in detecting malnutrition based on SGA were 97.67%, 31.82%, 77.68%, and 87.5%, respectively. However, the agreement between NRI and SGA was low (k=0.349). Changing the NRI cut-off value to 83.7 could yield acceptable sensitivity (72.7%) and specificity (58.1%).  NRI can be used as a screening tool in ESLD patients, but a different cut-off might be required to improve its validity against SGA in ESLD patients.

The development of type 2 diabetes mellitus (T2DM) is associated with lifestyle factors, including dietary patterns. A diet rich in macro- and micronutrients has been reported to reduce the risk of T2DM. Therefore, this study aimed to identify the dietary factors most closely associated with T2DM in subjects within the MASHAD cohort using a decision tree algorithm.  This cross-sectional study was conducted on 9704 individuals from the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD), of whom 5936 participants completed a 24h dietary recall questionnaire. Macronutrients and micronutrients were estimated using Diet Plan 6 software. A decision tree algorithm was utilized to evaluate the most crucial dietary nutrient intakes concerning T2DM.  The algorithm showed a high specificity (81.34%) but low sensitivity (34.21%), which could predict T2DM with a low-to-moderate diagnostic ability (AUC=0.58). Based on the decision tree, eight features, including dietary potassium, total sugar, sucrose, riboflavin, thiamin, sodium, total nitrogen, and magnesium, were T2DM’s most critical dietary components.  Based on the results, consuming sugar, salt, and vitamin B was the most critical related dietary intake to T2DM. Dietary interventions may be a cost-effective strategy for preventing T2DM.

Vascular endothelial dysfunction is one of the consequences of obesity or increased body fat mass. This study aimed to determining the effect of TRX training on myeloperoxidase (MPO) and total antioxidant capacity (TAC) as markers of vascular endothelial function in inactive obese women.  28 inactive middle-aged obese women aged 42±3 years of old (30 ≤ BMI ≤ 36) were randomly divided into of TRX (8 weeks, 3days/weekly, n= 14) and control (no training, n = 14) groups. Fasting levels of TAC and MPO activity and anthropometric indices were measured before and 48 hours after lasting exercise session of groups. Independent and paired t -test use to compare inter and intra-group change of variables (P< 0.05).  No significant difference was found in TAC (P= 0.356) and MPO (P= 0.268) between groups at baseline (P> 0.05). TRX led to a significant increase in TAC activity compared (P= 0.004) but MPO remained no change by TRX (P= 0.459). None of these variables were changed in the control group (P > 0.05).  Emphasizing the increase in TAC, it is concluded that TRX training are associated with improved vascular endothelial function in inactive obese women.

With the increase in the elderly population and their comorbidities, the need for appropriate prevention of their metabolic comorbidities is felt. This study aimed to evaluate the effect of yoga practice with weight and Spirulina supplement on some indicators of metabolic syndrome (Lipid profile) in older women.  This quasi-experimental study was conducted on 40 elderly volunteer women with a body mass index of 25-30kg/m2 living in Bushehr who were randomly divided into four groups of 10 people (control, supplement (Spirulina), exercise, and exercise/supplement). The training protocol consisted of three 60-minute exercise sessions per week for eight weeks. Subjects took three 500g Spirulina supplement capsules thrice daily for eight weeks. Lipid profiles (total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL)) were measured at pretest and posttest phases. Student t-test and one-way analysis of covariance (ANCOVA) were used for statistical analysis with a significance level of P≥0.05.  Yoga with weights, along with Spirulina supplementation, led to a significant decrease in total cholesterol (F=10.22), triglycerides (F=12.20), and LDL (F=16.47). In contrast, HDL increased significantly after eight weeks of exercise and supplement consumption (F=36.02).  The results have shown that practicing yoga with weights for eight weeks has good effects on metabolic indicators, especially with the supplement. Data proved that using Spirulina supplements for eight weeks could not produce a desirable result.

The use of herbal remedies can be helpful in the prevention and treatment of obesity, overweight, and disorders related to these conditions. However, it is still unclear how aerobic exercise and curcumin supplementation interact with adipose tissue. This study sought to determine how leptin and adiponectin gene expression in visceral adipose tissue of rats fed a high-fat diet would be affected by aerobic exercise and supplementation with curcumin extract. For this study, 50 male rats were divided into five groups of equal size: control, high-fat diet, curcumin and high-fat diet, aerobic exercise and high-fat diet, and aerobic exercise and curcumin and high-fat diet. Five sessions per week of aerobic exercise were performed for six weeks at a speed of 25 to 29 meters per minute for 20 to 45 minutes. Rats were given high-fat food emulsion in the amount of 0.5 mg/kg of body weight per day for six weeks in order to simulate high-fat food groups. One-way analysis of variance and Tukey's post hoc test were employed in SPSS22 to analyze the results. There is no difference between the short-term effects of aerobic exercise, a high-fat diet, and curcumin extract on adiponectin gene expression in male rats (P=0.05). The short-term effects of aerobic exercise, a high-fat diet, and curcumin extract on the expression of the leptin gene in adipose tissue in male rats are comparable and not significantly different. The findings of this study demonstrated that consumption of curcumin, an antioxidant, and brief exercise have an impact on how the fat gene expresses itself. As a result, when either agent is consumed alone, the expression of the adiponectin and leptin genes in fat decreases or increases, and when both agents are consumed at the same time, the expression of the adiponectin and leptin genes in these cells' fat tissue increases.

This study aimed to evaluate the impact of 12 weeks of sauna (both dry and steam) on fasting glucose levels, sleep quality, and cortisol hormone levels in middle-aged men residing in Kermanshah, Iran.  This quasi-experimental study employed a pre-test-post-test design with two training intervention groups and one control group and examined all middle-aged men between 45 to 60 years old. Finally, based on the research objectives, 36 men in the age group of 45 to 60 years were chosen as the subjects of the purposive and convenient sampling method. At the end of the familiarization session, the pre-test values ​​of the tested variables (glucose, hunger, sleep quality, cortisol hormone) were measured and then the subjects were randomly divided into three groups including 1) dry sauna 2) steam sauna and 3) control group. Then, the experimental group performed the dry and steam sauna program for 12 weeks. The post-test values ​​in the variables were measured in the same conditions as the pre-test 48 hours after the last training session. One-way analysis of variance and Bonferroni tests were used to analyze the data.  A significant difference was observed between the mean values ​​before and after implementing the dry sauna and steam sauna program in fasting glucose, sleep quality, and cortisol hormone (p≤0.05).  Based on the results, the program involving both dry and steam sauna positively affected glucose. The exercises of the dry sauna program had less impact on sleep quality compared to the steam sauna. The dry sauna program was more influential on cortisol compared to the steam sauna.

Green tea is a well-known source of polyphenol catechins, which possess strong antioxidant properties. However, the impact of green tea polyphenol catechins on biological markers of atherosclerosis, namely oxidized low-density lipoprotein (ox-LDL) and homocysteine (Hcy), following resistance exercise (RE), has not been studied in obese individuals.  In this study, ten obese untrained men (age 43-45 y, BMI 32-33) participated voluntarily. They were randomly assigned to receive either green tea extract (GTE) capsules (two capsules of 500 mg per day) or placebo (PL) capsules (two capsules of 500 mg per day maltodextrin) in a double-blind, placebo-controlled crossover design. The supplementation period lasted for two weeks, followed by a two-week washout period. Afterward, the participants performed a RE protocol at 75% of their one-repetition maximum (1RM). Blood samples were collected before and after the RE session to measure the serum concentrations of Hcy and ox-LDL.  In the placebo condition, there was a significant increase in serum Hcy and ox-LDL levels from pre- to post-RE. However, GTE supplementation mitigated the exercise-induced rise in serum Hcy and ox-LDL concentrations in obese men.  These findings suggest that a two-week supplementation of GTE may offer protection against exercise-induced elevation of Hcy and ox-LDL levels in obese men.

Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases, the prevalence of which is increasing. This study aimed to evaluate the effect of atorvastatin and combined training in NAFLD-induced rats.  This study was conducted on 21 male Wistar rats, divided into two groups: 1) HFFD + combined training + atorvastatin and 2) HFFD + atorvastatin. The groups received HFFD for 15 weeks to induce NAFLD. Atorvastatin was administrated at the dose of 2mg/kg/day. The interventions (atorvastatin and combined training) were performed for eight weeks.  Alanine transaminase (ALT) was significantly reduced, and high-density lipoprotein (HDL) was increased in the HFFD + atorvastatin group. Low-density lipoprotein (LDL) decreased significantly in the HFFD + combined training + atorvastatin. There was no significant difference in the aspartate transaminase (AST), triglyceride (TG), alkaline phosphatase (ALP), and weight between the groups.  Based on the findings, Atorvastatin, along with combined training, improved NAFLD. Therefore, they can be used to reduce the complications of NAFLD. However, more studies are needed to confirm the results.