Evidence-Based Approach to Inform Clinical Nutrition Practice

2014 ◽  
pp. 1-6
Author(s):  
Mei Chung ◽  
Joseph Lau
Keyword(s):  
Clinical Nutrition ◽  
Evidence Based ◽  
Nutrition Practice

Transforming personalized nutrition practice

2020 ◽  
Vol 78 (12) ◽  
pp. 1046-1051 ◽  
Author(s):  
Michelle Barrow ◽  
Linda Bell ◽  
Celia Bell
Keyword(s):  
Social Life ◽  
Food Industry ◽  
Clinical Nutrition ◽  
Evidence Based ◽  
Personalized Nutrition ◽  
Patient Centered ◽  
Network Modelling ◽  
Anthropometric Measures ◽  
Practice Approach ◽  
Nutrition Practice

Abstract The strengths and limitations of current approaches to clinical nutrition practice and their underpinning research are explored in this article. It describes how a personalized nutrition practice approach supported by evidence-based pathophysiological reasoning could direct additional research, which could then transform practice and support food industry developments. Current use of the term “personalized nutrition” is reviewed and a definition is provided. Also explored are current approaches to personalized nutrition practice and evidence-based practice in clinical nutrition. Patient-centered practice, which involves individuals in their healthcare decisions, is currently being provided under the name “personalized.” An evidence-based personalized practice approach should include the use of robust, standardized, and validated tools that gather a patient’s signs and symptoms, health history, family history, genetics, environment, lifestyle, social life, diet, behavior and other factors that have an impact on physiological processes. It should also gather anthropometric measures as well as functional, diagnostic, and prognostic biomarkers for pathophysiological mechanisms. Such tools would pool n = 1 data into a case-by-case evidence base that uses computational network modelling to predict the efficacy of personalized nutrition interventions. Prediction of the efficacy of interventions should also be validated using, when possible, blinded, randomized, controlled, stratified intervention studies. This model would provide practitioners with data that support evidence-based pathophysiological reasoning. It would enable clinicians to prioritize interventions on the basis of the mechanisms of action of interventions and to ameliorate the mechanisms of pathophysiology, which are a priority for the individual. Interventions then may be applied using a patient-centered practice approach. This would transform evidence-based nutrition practice into a P4 medicine approach that is personalized, preventive, predictive, and participatory. Developing pathophysiological mechanistic understanding also provides new opportunities for stakeholders, including the food industry, researchers, healthcare practitioners, and consumers.

scholarly journals Challenges in Clinical Nutrition during the COVID-19 Pandemic

2020 ◽  
Vol 1 (1) ◽  
pp. 13-15
Author(s):  
Christina N.  Katsagoni
Keyword(s):  
Artificial Ventilation ◽  
Clinical Nutrition ◽  
Tube Insertion ◽  
Nutritional Screening ◽  
Nutrition Management ◽  
Muscle Catabolism ◽  
Key Aspects ◽  
Inflammatory Syndrome ◽  
Nutrition Practice ◽  
Nasogastric Tube Insertion

The viral epidemic caused by the new Coronavirus SARS-CoV-2 is responsible for the new Coronavirus disease-2019 (Covid-19). Fifteen percent of the Covid-19 patients will require hospital stay, and 10% of them will need urgent respiratory and hemodynamic support in the intensive care unit (ICU). Covid-19 is an infectious disease characterized by inflammatory syndrome, itself leading to reduced food intake and increased muscle catabolism. Therefore Covid-19 patients are at high risk of being malnourished, making the prevention of malnutrition and the nutritional management key aspects of care. Urgent, brutal and massive arrivals of patients needing urgent respiratory care and artificial ventilation lead to the necessity to reorganize hospital care, wards and staff. In that context, nutritional screening and care may not be considered a priority. Moreover, at the start of the epidemic, due to mask and other protecting material shortage, the risk of healthcare givers contamination have led to not using enteral nutrition, although indicated, because nasogastric tube insertion is an aerosol-generating procedure. Clinical nutrition practice based on the international guidelines should therefore adapt and the use of degraded procedures could unfortunately be the only way. Based on the experience from the first weeks of the epidemic in France, we emphasize ten challenges for clinical nutrition practice. The objective is to bring objective answers to the most frequently met issues to help the clinical nutrition caregivers to promote nutritional care in the hospitalized Covid-19 patient. We propose a flow chart for optimizing the nutrition management of the Covid-19 patients in the non-ICU wards.

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