Mediterranean Journal of Nutrition and Metabolism - Volume 6, issue 2
Purchase individual online access for 1 year to this journal.
Price: EUR 75.00
Mediterranean Journal of Nutrition and Metabolism publishes original scientific papers on metabolism, including diabesity and eating disorders; nutrition (epidemiological, basic, clinical and artificial); dietary and nutritional practices and management and their impact on health from prevention to treatment.
The journal hosts the proceedings of relevant congresses and presents shorter notices focused on the original character of the Mediterranean nutritional civilisation. In addition, this journal is intended as a platform for scientific debate and knowledge-sharing among students and clinical practitioners, and between them and the broader scientific community, and finally as a tool for promoting and enhancing scientific cooperation.
Abstract: Diabetic retinopathy is a frequent complication of longstanding diabetes mellitus. While using a specialized medical nutrition therapy plus a blend of arginine, glutamine and β-hydroxy-β-metilbutyrate proven to be effective to normalize the body composition in diabetics and improve the rate of healing of the foot ulcers (DFU), we observed a marked improvement in some markers of retinopathy progression.
Keywords: Diabetic retinopathy, Medical nutrition therapy, Foot ulcer
Abstract: Anecdotal data in the last few years suggest that protein-sparing modified diet (PSMF) delivered by naso-gastric tube enteral (with continuous feeding) could attain an significant weight loss and control of appetite oral feeding, but no phase II studies on safety and efficacy have been done up to now. To verify the safety and efficacy of a protein-sparing modified fast administered by naso-gastric tube (ProMoFasT) for 10 days followed by 20 days of a low-calorie diet, in patients with morbid obesity (appetite control, fat free mass maintenance, pulmonary function tests and metabolic pattern, side effects), 26 patients with a BMI ≥30…kg/m2 have been selected. The patients had to follow a protein-sparing fast by enteral nutrition (ProMoFasT) for 24 h/day, for 10 days followed by 20 days of low-calorie diet (LCD). The endpoint was represented by body weight, BMI, abdominal circumference, Haber's appetite test, body composition by body impedance assessment (BIA), handgrip strength test, metabolic pattern, pulmonary function test. Safety was assessed by evaluation of complications and side effects of PSMF and/or enteral nutrition. In this report the results on safety and efficacy are described after 10 and 30 days of treatment. After the recruiting phase, a total of 22 patients out of 26 enrolled [14 (63.6 %) females] were evaluated in this study. Globally almost all clinical parameters changed significantly during first 10 days. Total body weight significantly decreased after 10 days (Δ−6.1 ± 2; p < 0.001) and this decrease is maintained in the following 20 days of LCD (Δ = −5.88 ± 1.79; p < 0.001). Also the abdominal circumference significantly decreased after 10 days [median (range): −4.5 (−30 to 0); p < 0.001] maintained then in the following 20 days of LCD [median (range) = −7 (−23.5 to −2); p < 0.001]. All BIA parameters significantly changed after 10 and 30 days from baseline. All parameters except BF had a significant change after 10 days of treatment while the difference at 30 days was lower than at 10 days for TBW, FFM and MM with no significant differences from baseline for the last two characteristics. For VAS appetite the difference was significant after 10 days and the decrease in appetite was maintained at 30 days with no significant difference (p = 0.83) between 10 and 30 days. No significant differences in the first 30 days were detected for PA and for both left and right hand grip strength. Particularly, a significant reduction of 1.82 kg in FFM after 10 days was detected, but not after 30 days. In contrast, a decrease of 3.8 kg of BF is observed after 30 days. As far as the respiratory functional tests (RFT) are concerned, a significant difference at 10 days was globally observed for functional residual capacity (p = 0.012) and expiratory reserve volume (p = 0.025). There are no reported major complications and side effects resulting from the enteral nutrition or PSMF. In particular, cardiac arrhythmias have not been reported. From the clinical point of view the PSMF with naso-gastric tube (ProMoFasT) method appears safe, it is associated with a significant weight loss related to decrease of FM and not to loss of FFM and appetite decreases. It is relevant that the RFT are significantly improved after only 10 days suggesting the efficacy of this regime in short period, too. These preliminary data underline the necessity to increase the number of RCT for this method, which could represent a possible alternative to other methodologies, such as the intragastric balloon, in particular when it is recommended to improve RFT before bariatric, gynecological, orthopedic and lymphatic surgery.
Keywords: VLCD, PSMF, Tube feeding, Enteral nutrition, Protein, NEP, Ketogenic diet, Pulmonary function test, Hand grip strength, Obesity, Appetite, Enteral nutrition, Protein-sparing modified fasting by tube, ProMoFasT
Abstract: Chronic constipation is a widespread pathology resulting in a very low frequency of evacuation, and defecation can be also very difficult. In addition to colo-rectal cancer or pelvic floor disfunction, stipsi can be determined by low fibre intake. In our experiment, we tested the efficacy of a linseed-based snack on the defecation frequency in a cohort affected by stipsi. Enrolled people received for 21 days a high fibre and linseed-based snack (30 g)—the severity of constipation was evaluated with the Constipation Scoring System (CSS) determined at the beginning and at the end of the experiment. The consumption of this biscuit…significantly increased defecation frequency and reduced difficult or incomplete evacuation. As a consequence of this improvement, the CSS was significantly reduced: 9.19 vs. 4.52. No adverse effects, due to the consumption of the tested snack, were observed.