News Round-up
OPEN CONSULTATION – Oral nutritional supplements: ACBS policy
Your views are needed on changes being proposed to the Advisory Committee on Borderline Substances (ACBS) policy about oral nutritional supplements listed in part XV of the Drug Tariff.
The proposed changes cover:
- The standardising of pack sizes to 125 ml and 200 ml
- The listing of no more than one volume of each product
- The recommending of 1 kcal/ml ONS for certain clinical conditions only
- Criteria for oral nutritional supplements prescribed for use once per day
- The use of ‘complete’ and ‘fibre’ in brand names and when describing products.
Don’t miss the chance to have your say…
The consultation closes at on 27 June 2021. Visit: www.gov.uk/government/consultations/oral-nutritional-supplements-acbs-policy
Psychosocial support for families of children with neurodisability who have or are considering a gastrostomy
The research aimed to investigate best practice psychosocial support for families of children with neurodisability who had or were considering a gastrostomy. The study used a mixed-methods design with a qualitative case study as the primary method to identify how psychosocial support was accomplished across four exemplar service configurations, the resources involved and an estimate of the costs of provision.
The research highlighted that both children and families were underserved by the formal psychosocial services. Innovative mechanisms for embedding support were identified, although support was generally integrated into clinical appointments and provided by different members of the multi-disciplinary team. Healthcare professionals reported spending a lot of time supporting families but this ‘hidden work’ was rarely coded or documented in ways which made the support visible or allowed the costs of support to be measured. Parents reported different needs for support suggesting a personalised approach is preferred. Support for families from peer parents with lived experience of caring for children with a gastrostomy was rarely standard practice or formalised due to concerns about confidentiality and matching parents.
Recommendations included training to support teams to implement psychosocial care and to formally assess and record needs and supportive practices.
This study was funded by the National Institute for Health Research (NIHR) Health Services & Delivery Research Programme (NIHR 14/04/40). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. For more information contact Dr Gill Craig (Chief Investigator GPATH SUPPORT) at: gillian.craig@city.ac.uk. The study report is available at: www.journalslibrary.nihr.ac.uk/hsdr/hsdr08380/#/abstract
Probiotic strain helps pregnant women maintain healthy iron levels
A new study published in Acta Obstetricia et Gynecologica Scandinavica found that taking a particular probiotic strain improves iron levels in healthy pregnant women and may therefore help to prevent iron deficiency.
A total of 326 healthy women were randomized to receive a placebo or the probiotic strain Lactiplantibacillus plantarum 299v (Lp299v) administered with a low dose of iron, folic acid, and ascorbic acid. They took the placebo or the combination product twice daily during pregnancy.
Compared with taking placebo, taking the probiotic product reduced the prevalence of iron deficiency (78% versus 59%) and iron deficiency anaemia (21% versus 7.4%) towards the end of pregnancy. (When a person develops iron deficiency anaemia, the body cannot get the amount of oxygen it needs).
Iron deficiency is common in women of childbearing age and is a global health problem. In a pregnant woman, this can lead to a number of complications for the mother and her child.
"We have previously shown that the Lp299v strain together with a low dose of iron increase iron absorption. With this study, we proved that this translates into an improved iron status in pregnant women," said lead author Ulrika Axling, PhD, of Probi AB, in Sweden. "Iron deficiency is especially common during pregnancy and high-dose iron supplements are often recommended. Since these typically come with side effects such as stomach pain and constipation, there is a need for new solutions. This probiotic product could offer a novel and safe approach for improving iron status during pregnancy."
Paper: The effect of Lactiplantibacillus plantarum 299v together with a low dose of iron on iron status in healthy pregnant women: A randomized clinical trial. Acta Obstetricia et Gynecologica Scandinavica; https://doi.org/10.1111/aogs.14153.
Leeds Beckett leads research into protein-based supplements for treating and preventing muscle wasting conditions
A research programme which aims to help people with a muscle wasting condition, which contributes to poor health and quality of life is being led by Leeds Beckett University.
Sarcopenia is a muscle wasting condition which is highly prevalent in inactive, older adults and in those recovering from diseases such as Cancer and Covid-19.
Lockdown restrictions and increased hospitalisations have exacerbated sarcopenia rates, so greater efforts are now needed to address it. The combination of exercise and dietary protein intake offers a solution to this problem – exercise sensitises the muscle to the anabolic potential of protein, which provides the key ingredients called essential amino acids (EAA).
Eating the right amount of high-quality proteins helps because it provides all available EAA. However, it can be difficult to get older people and patients who may suffer from a reduced appetite to eat the right amount of high protein food, so we need to look at alternatives – the best option being EAA nutritional supplements.
Dr Theocharis Ispoglou, from the Carnegie School of Sport, who is leading the research explains how it is being used: “The key findings of the research were presented in a recent review that explored the efficacy of EAA ingestion as a strategy to optimise protein intake and successfully manage sarcopenia. As part of the programme, we have developed palatable EAA supplements that don’t supress appetite, can be taken alongside food, and potentially address protein and energy deficiencies. They are also easily absorbed into the body and can improve muscle strength and functional performance.”
The next step of the research is to work with clinicians from Leeds Teaching Hospitals to investigate the acceptability and feasibility of these nutritional prototypes in cancer and frail patients undergoing different treatment stages.
Inflammatory diet linked to testosterone deficiency in men
Consuming a diet high in pro-inflammatory foods – including foods that contain refined carbohydrates and sugar as well as polyunsaturated fats – may be associated with increased odds of developing testosterone deficiency among men, suggests a study in The Journal of Urology®.
The risk of testosterone deficiency is greatest in men who are obese and consume a refined diet that scores high on the dietary inflammatory index (DII), according to the new research by Qiu Shi, MD, Zhang Chichen, MD, and colleagues of West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. "While these findings do not prove causation, they do support previous research suggesting a pro-inflammatory diet can contribute to testosterone deficiency, among other potentially debilitating health issues," Doctors Qiu and Zhang comment.
Human and animal studies have linked testosterone deficiency with increased levels of inflammation in the body. Men with low testosterone have higher levels of pro-inflammatory cytokines: small proteins released by cells during injury, infection or in response to inflammatory factors in the environment. The DII has emerged as a tool for assessing the inflammatory potential of a person's diet, particularly in relation to other markers of health.
The researchers studied the association between the DII and testosterone deficiency in 4,151 men from the National Health and Nutrition Examination Survey, all of whom completed a 24-hour dietary interview and underwent sex hormone testing. Each participant's DII was calculated based on the dietary history interview.
Calculated DII scores ranged from +5.05 (most anti-inflammatory) to +5.48 (most pro-inflammatory). Average total testosterone level was 410.42 ng/dL in men with the most pro-inflammatory diet versus 422.71 ng/dL in those with the most anti-inflammatory diet. Overall, about 26% of the men had testosterone deficiency.
For men with the most pro-inflammatory diet, the odds of testosterone deficiency were about 30% higher compared to men with the most anti-inflammatory diet. The associations remained significant after adjustment for other characteristics, including body mass index and smoking.
In a fully adjusted analysis, the risk of testosterone deficiency was greatest in men who were obese and had a higher DII. For this group, the odds of testosterone deficiency were nearly 60% higher compared to men with obesity who had a lower DII.
Paper: The Association between Dietary Inflammatory Index and Sex Hormones among Men in the United States. The Journal of Urology; https://doi.org/10.1097/JU.0000000000001703.
Nutrition & Hydration Week postponed
Due to the current pandemic and the pressures currently facing healthcare workers, Nutrition & Hydration Week has been postponed until June.
Nutrition & Hydration Week is an annual event and aims ‘…to highlight, promote and celebrate improvements in the provision of nutrition and hydration locally, nationally and globally.'
The week will now take place on 14-20 June 2021.
For further details, please click here.