News Round-up
NICE Launch Clinical Knowledge Summary (CKS) Focused on Adult Malnutrition
The CKS topic covers screening, identification, management and monitoring of adults with malnutrition or those at risk of malnutrition, who need nutrition support in primary care.
Content has been created from a literature review (Nov 2023) to identify evidence-based guidelines, UK policy, systematic reviews, and key randomised controlled trials. The evidence base has been reviewed in detail, and recommendations are clearly justified and transparently linked to the supporting evidence, including the National Institute for Health and Care Excellence (NICE) clinical guideline ‘Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition’, the British Association for Parenteral and Enteral Nutrition (BAPEN) nutritional toolkit ‘Malnutrition matters. Meeting quality standards in nutritional care’, the Malnutrition Pathway publications Managing adult malnutrition in the community, Ten top tips for implementing the Malnutrition Pathway: GPs, and Managing malnutrition in COPD, as well as associated articles and expert opinion.
Anne Holdoway, Chair of the Managing Adult Malnutrition in the Community guidance (www.malnutritionpathway.co.uk), said: “The Malnutrition pathway panel - many of whom are active members of BAPEN – are delighted to see many of the Malnutrition Pathway evidence-based materials and resources, highlighted throughout the Clinical Knowledge Summary produced by NICE. We hope that the creation of this CKS on adult malnutrition by NICE will further emphasise the importance of identifying, treating and preventing malnutrition in today’s health and social care environments.”
Visit: https://cks.nice.org.uk/topics/adult-malnutrition/
‘Unhealthy’ Gut Microbiome Patterns Linked to Heightened Risk of Death after Organ Transplant
‘Unhealthy’ gut microbiome patterns are linked to a heightened risk of death after a solid organ transplant, finds research published online in the journal Gut.
While these particular microbial patterns are associated with deaths from any cause, they are specifically associated with deaths from cancer and infection, regardless of the organ-kidney, liver, heart, or lung-transplanted, the findings show.
Researchers analysed the microbiome profiles from 1337 faecal samples provided by 766 kidney, 334 liver, 170 lung, and 67 heart, transplant recipients and compared those with the gut microbiome profiles of 8208 people living in the same geographical area of northern Netherlands. The average age of the transplant recipients was 57, and over half were men (784; 59%). On average, they had received their transplant 7.5 years previously.
During a follow-up period of up to 6.5 years, 162 recipients died: 88 kidney; 33 liver; 35 lung; and 6 heart, recipients. Forty eight (28%) died from an infection, 38 (23%) from cardiovascular disease, 38 (23%) from cancer, and 40 (25%) from other causes.
The researchers looked at several indicators of gut dysbiosis in these samples: microbial diversity; how much their gut microbiomes differed from the average microbiome of the general population; the prevalence of antibiotic resistance genes; and virulence factors which help bacteria to invade cells and evade immune defences.
The analysis revealed that the more the gut microbiome patterns of the transplant recipients diverged from those of the general population, the more likely they were to die sooner after their procedure, irrespective of the organ transplanted.
The researchers identified 23 bacterial species among all the transplant recipients that were associated with either a heightened or lower risk of death from all causes.
The researchers further analysed all bacterial species simultaneously using AI. This revealed a second pattern of 19 different species that were also associated with an increased risk of death.
This is an observational study, and as such, no definitive conclusions can be drawn about the causal roles of particular bacteria.
The researchers concluded: “Our results support emerging evidence showing that gut dysbiosis is associated with long-term survival, indicating that gut microbiome targeting therapies might improve patient outcomes, although causal links should be identified first.”
Visit: https://gut.bmj.com/content/early/2024/06/04/gutjnl-2023-331441
Food and Nutrition Experts Welcome the Prescribed Use of GLP-1/ GIP Receptor Agonists for People Living with Obesity and/ or Type 2 Diabetes, when Offered Alongside Dietary Support and Physical Activity
However, until everyone can benefit from this medication, with equal access – irrespective of postcode or budget, their success will be limited, warns British Dietetic Association.
In a joint position statement by the British Dietetic Association (BDA) and the British Nutrition Foundation (BNF), the prescribed use of GLP-1/ GIP Receptor Agonists for people living with obesity and/or type 2 diabetes has been broadly supported. However, concerns have been raised about how the people that need them most are able to access them safely and if they are being given the ongoing support they need, to achieve long-term results.
Visit: https://bit.ly/45AApnU
Treating the Gut-Brain Connection with B Vitamins to Treat Parkinson’s Disease
A study led by Nagoya University Graduate School of Medicine in Japan has revealed a link between gut microbiota and Parkinson's disease (PD). The researchers found a reduction in the gut bacteria of genes responsible for synthesising the essential B vitamins B2 and B7. They also identified a relationship between the lack of these genes and low levels of agents that help maintain the integrity of the intestinal barrier.
This barrier prevents toxins from entering the bloodstream, which causes the inflammation seen in PD. Their findings, published in npj Parkinson’s Disease, suggest that treatment with B vitamins to address these deficiencies can be used to treat PD.
Visit: https://bit.ly/3xeio21
Association of Omega-3 Polyunsaturated Fatty Acids with Sarcopenia in Liver Cirrhosis Patients with Hepatocellular Carcinoma
The study was recently published in the Journal of Clinical and Translational Hepatology.
This retrospective study elucidated that FA levels, especially n-3 PUFAs, were decreased with impaired hepatic reserve, and a low n-3 PUFA level was associated with sarcopenia in patients with liver cirrhosis and hepatocellular carcinoma (HCC). Further prospective and multicentre studies are needed to elucidate whether intervention with n-3 PUFAs can prevent sarcopenia and improve the prognosis and quality of life in patients with HCC and cirrhosis.
Visit: https://bit.ly/3KP1Wbl
European Practice Survey on the use of Vitamin Supplements in Cystic Fibrosis (CF)
A survey, particularly for British dietitians specialising in cystic fibrosis, aimed at understanding vitamin supplement prescription practices among dietitians in Europe, with a particular focus on cystic fibrosis management.
To complete the survey click here.