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Zoetermeer, Netherlands

Barret M.,Service de Gastro enterologie et Endoscopie Digestive | Barret M.,University of Paris Descartes | Antoun S.,Institute Gustave Roussy | Dalban C.,Center Georges Francois Leclerc | And 6 more authors.
Nutrition and Cancer

Chemotherapy toxicity could be linked to decreased skeletal muscle (sarcopenia). We evaluated the effect of sarcopenia on chemotherapy toxicity among metastatic colorectal cancer (mCRC) patients. All consecutive mCRC patients in 3 hospitals were enrolled in this prospective, cross-sectional, multicenter study. Several nutritional indexes and scores were generated. Computed tomography (CT) images were analyzed to evaluate cross-sectional areas of muscle tissue (MT), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Toxicities were evaluated in the 2 mo following clinical evaluation. Fifty-one mCRC patients were included in the study. Sarcopenia was observed in 71% of patients (39% of women and 82% of men) whereas only 4% and 18% were considered as underweight using body mass index (BMI) or severely malnourished using the Nutritional Risk Index (NRI), respectively. Grade 3-4 toxicities were observed in 28% of patients. In multivariate analysis including age, sex, BMI, sarcopenia, SAT, and VAT, the only factor associated with Grade 3-4 toxicities was sarcopenia (odds ratio = 13.55; 95% confidence interval [1.08; 169.31], P = 0.043). In mCRC patients undergoing chemotherapy, sarcopenia was much more frequently observed than visible malnutrition. Despite the small number of patients included in our study, we found sarcopenia to be significantly associated with severe chemotherapy toxicity. © 2014 Copyright Taylor & Francis Group, LLC. Source

MacDonald A.,Birmingham Childrens Hospital | Cochrane B.,Royal Hospital for Sick Children | Wopereis H.,Danone Research | Loveridge N.,Nutricia Advanced Medical Nutrition
Molecular Genetics and Metabolism

Objective: This exploratory study investigated the influence of adding a patented, specific mixture of prebiotic oligosaccharides (scGOS/lcFOS [9:1 ratio], Danone Research) to a protein substitute suitable for infants with Phenylketonuria (PKU); PKU Anamix Infant (Nutricia). Design: This was an 8-week open-label, single-arm, pilot intervention study in 9 infants (8-week median age) diagnosed with PKU. On study entry, infants were prescribed PKU Anamix Infant to replace an infant phenylalanine-free protein substitute without prebiotics (IPS). Blood phenylalanine concentrations were monitored and stool samples analyzed for pH/bacterial groups. Results: PKU Anamix infant was well tolerated and accepted with no adverse events reported. Overall, plasma phenylalanine and tyrosine concentrations were maintained within target ranges throughout the study (120-360 μmol/l phenylalanine, 30-100 μmol/l tyrosine). All infants exhibited microbiota dominated by bifidobacteria (median 58.97% at Week 8), although no statistically significant change from baseline was observed at study endpoint. No infants showed abnormally high levels of Clostridium histolyticum/lituseburense or potentially pathogenic enterobacteriaceae at any point during the study. A significant reduction in median stool pH versus baseline was observed at Week 4 (pH reduced from 6.79 to 5.83), but this significance was not present at Week 8 (pH = 6.61). Conclusions: PKU Anamix Infant maintains phenylalanine control in line with established IPS without prebiotics and maintains levels of bifidobacteria and lowers stool pH. In exclusively breast-fed infants the latter two factors have been associated with a reduced risk of infection and may be of particular importance in infants with PKU. © 2011 Elsevier Inc. Source

Ferreira C.,University of Lisbon | Camilo M.,University of Lisbon | Pena R.,Nutricia Advanced Medical Nutrition | Ravasco P.,University of Lisbon
e-SPEN Journal

Background & aims: It is acknowledged the interrelationship between nutrition and cancer. Health professionals (HP) and caregivers play a central role in undernutrition prevention/treatment. Our aims were to appraise the knowledge of Oncology HP and cancer caregivers about undernutrition and nutritional supplements (NS) and to assess the relevance given to NS. Methods: 103HP and 394 adult caregivers of cancer patients were randomly selected to the inquiry. Results: HP and caregivers stated that cancer patients were at higher undernutrition risk (95%, p<. 0.001 & 57%, p<. 0.05, respectively) and considered that undernutrition increase cancer severity (85%, p<. 0.002 and 69%, p<. 0.01, respectively). The majority of the caregivers (65%, p<. 0.01) defined undernutrition as an inadequate food intake. Only 35% of caregivers were satisfied with the information received about nutrition. Once undernutrition was diagnosed, 46% physicians and 45% nurses advised the use of NS (. p<. 0.05). Only 14% of caregivers knew cancer NS (p<. 0.001). Reasons for low NS consumption were price (60%, p<. 0.009) and lack of information (57%, p<. 0.01). Conclusions: For the HP involved in this study, cancer is a major risk factor for undernutrition and which in turn worsens the disease. The lack of knowledge about nutrition among caregivers was obvious. Proving information about prevention/consequences of undernutrition is essential. Professionals and caregivers agreed that NS can be an effective strategy when intake is limited, however the cost can be limiting. © 2011 European Society for Clinical Nutrition and Metabolism. Source

Burks A.W.,University of North Carolina at Chapel Hill | Harthoorn L.F.,Nutricia Research | Van Ampting M.T.J.,Nutricia Research | Oude Nijhuis M.M.,Nutricia Research | And 8 more authors.
Pediatric Allergy and Immunology

Background: Children with cow's milk allergy (CMA) are at risk for inadequate nutritional intake and growth. Dietary management of CMA, therefore, requires diets that are not only hypoallergenic but also support adequate growth in this population. This study assessed growth of CMA infants when using a new amino acid-based formula (AAF) with prebiotics and probiotics (synbiotics) and evaluated its safety in the intended population. Methods: In a prospective, randomized, double-blind controlled study, full-term infants with diagnosed CMA received either an AAF (control; n = 56) or AAF with synbiotics (oligofructose, long-chain inulin, acidic oligosaccharides, Bifidobacterium breve M-16V) (test; n = 54) for 16 wk. Primary outcome was growth, measured as weight, length and head circumference. Secondary outcomes included allergic symptoms and stool characteristics. Results: Average age (±SD) of infants at inclusion was 4.5 ± 2.4 months. Both formulas equally supported growth according to WHO 2006 growth charts and resulted in similar increases of weight, length and head circumference. At week 16, differences (90% CI) in Z-scores (test-control) were as follows: weight 0.147 (-0.10; 0.39, p = 0.32), length -0.299 (-0.69; 0.09, p = 0.21) and head circumference 0.152 (-0.15; 0.45, p = 0.40). Weight-for-age and length-for-age Z-scores were not significantly different between the test and control groups. Both formulas were well tolerated and reduced allergic symptoms; the number of adverse events was not different between the groups. Conclusions: This is the first study that shows that an AAF with a specific synbiotic blend, suitable for CMA infants, supports normal growth and growth similar to the AAF without synbiotics. This clinical trial is registered as NCT00664768. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Source

Peter S.,DSM Nutritional Products Ltd | Eggersdorfer M.,DSM Nutritional Products Ltd | Eggersdorfer M.,University of Groningen | Van Asselt D.,Medical Center Leeuwarden | And 14 more authors.

Worldwide approximately two billion people have a diet insufficient in micronutrients. Even in the developed world, an increasing number of people consume nutrient-poor food on a regular basis. Recent surveys in Western countries consistently indicate inadequate intake of nutrients such as vitamins and minerals, compared to recommendations. The International Osteoporosis Foundation’s (IOF) latest figures show that globally about 88% of the population does not have an optimal vitamin D status. The Lancet’s “Global Burden of Disease Study 2010” demonstrates a continued growth in life expectancy for populations around the world; however, the last decade of life is often disabled by the burden of partly preventable health issues. Compelling evidence suggests that improving nutrition protects health, prevents disability, boosts economic productivity and saves lives. Investments to improve nutrition make a positive contribution to long-term national and global health, economic productivity and stability, and societal resilience. © 2014 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license. Source

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