scholarly journals A systematic review of enteral feeding by nasogastric tube in young people with eating disorders

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Kristen Hindley ◽  
Clare Fenton ◽  
Jennifer McIntosh
Keyword(s):  
Systematic Review ◽  
Eating Disorders ◽  
Young People ◽  
Enteral Feeding ◽  
Oral Intake ◽  
Risk Of Bias ◽  
Calorie Intake ◽  
Primary Research ◽  
Total Calorie ◽  
Total Calorie Intake

Abstract Background Adolescents with severe restrictive eating disorders often require enteral feeding to provide lifesaving treatment. Nasogastric feeding (NG) is a method of enteral nutrition often used in inpatient settings to treat medical instability, to supplement poor oral intake or to increase nutritional intake. This systematic review sets out to describe current practice of NG in young people with eating disorders. Methods A systematic review following PRISMA guidelines was conducted by searching AMED, EMBASE and MEDLINE databases from 2000 to 2020. Inclusion terms were: enteral feeding by nasogastric tube, under 18 years, eating disorders, and primary research. Exclusion terms: psychiatric disorders other than eating disorders; non-primary research; no outcomes specific to NG feeding and participants over 18 years. Titles and abstracts were screened by all authors before reviewing full length articles. Quality assessment, including risk of bias, was conducted by all authors. Results Twenty-nine studies met the full criteria. 86% of studies were deemed high or medium risk of bias due to the type of study: 34.4% retrospective cohort and 10.3% RCT; 17.2% were qualitative. Studies identified 1) a wide range of refeeding regimes depending on country, settings, and the reason for initiation; 2) standard practice is to introduce Nasogastric feeds (NG) if medically unstable or oral intake alone is inadequate; 3) NG may enable greater initial weight gain due to increased caloric intake; 4) there are 3 main types of feeding regime: continuous, nocturnal and bolus; 5) complications included nasal irritation, epistaxis, electrolyte disturbance, distress and tube removal; 6) where NG is routinely implemented to increase total calorie intake, length of stay in hospital may be reduced; however where NG is implemented in correlation to severity of symptoms, it may be increased; 7) both medical and psychiatric wards most commonly report using NG in addition to oral intake. Conclusions NG feeding is a safe and efficacious method of increasing total calorie intake by either supplementing oral intake or continuously. There are currently no direct comparisons between continuous, nocturnal or bolus regimes, which may be used to direct future treatment for YP with ED.

scholarly journals A Systematic Review of Enteral Feeding By Nasogastric Tube in Young People With Eating Disorders

2021 ◽  
Author(s):  
Kristen Hindley ◽  
Clare Fenton ◽  
Jennifer McIntosh
Keyword(s):  
Systematic Review ◽  
Eating Disorders ◽  
Young People ◽  
Enteral Feeding ◽  
Nasogastric Tube ◽  
Oral Intake ◽  
Risk Of Bias ◽  
Primary Research ◽  
Tube Removal ◽  
Wide Range

Abstract BackgroundAdolescents with severe restrictive eating disorders often require enteral feeding to provide lifesavinglifesaving treatment.Nasogastric feeding (NGF) is a method of enteral nutrition often used in inpatient settings to treat medical instability, to supplement minimal poor oral intake or to boostincrease nutritional intake. This systematic review sets out to describe current practice for of NG in young people with eating disordersF. MethodsA systematic review following PRISMA guidelines was conducted by searching AMED, EMBASE and MEDLINE databases from 2000-2020. Inclusion terms were: enteral feeding by nasogastric tube, under 18 years, eating disorders, and primary research. Exclusion terms: mental disorders other than eating disorders; non-primary research; no outcomes specific to NG feeding and participants over 18 years. Titles and abstracts were screened by all authors before reviewing full length articles. Quality assessment, including risk of bias, was conducted by all authors. Results29 studies met the full criteria. 86% of studies were deemed high or medium risk of bias due to the type of study: 34.4% retrospective cohort and 10.3% RCT; 17.2% were qualitative. Studies identified 1) a wide range of practices in different countries, settings, and the reason for initiation; 2) In the UK, standard practice is to introduce Nasogastric feeds (NG) if medically unstable or oral intake is inadequate; 3) NG may enable greater initial weight gain due to increased caloric intake; 4) there are 3 main types of feeding regime: continuous, nocturnal and bolus; 5) high calorie feeds are not typically associated with increased risk of refeeding syndrome; 6) complications included nasal irritation, epistaxis, electrolyte disturbance, distress and tube removal; 7) length of stay in hospital is dependent on reason of initiating NG; 8) psychiatric and medical wards differ in approach; 9) therapeutic interventions can occur alongside NG.ConclusionsA large number of studies were deemed to have a high risk of bias and no studies were able to provide a direct comparison between continuous, nocturnal or bolus NG feeds. This review highlights the need for further high quality research in this area.

scholarly journals A Systematic Review of Enteral Feeding by Nasogastric Tube in Young People with Eating Disorders

2021 ◽  
Author(s):  
Kristen Hindley ◽  
Clare Fenton ◽  
Jennifer McIntosh
Keyword(s):  
Systematic Review ◽  
Eating Disorders ◽  
Enteral Feeding ◽  
Nasogastric Tube ◽  
Oral Intake ◽  
Risk Of Bias ◽  
Primary Research ◽  
Increased Risk ◽  
Tube Removal ◽  
Wide Range

Abstract BackgroundAdolescents with severe restrictive eating disorders often require enteral feeding to provide lifesaving treatment.Nasogastric feeding (NGF) is a method of enteral nutrition often used in inpatient settings to treat medical instability, to supplement minimal oral intake or to boost nutritional intake. This systematic review sets out to describe current practice for NGF. MethodsA systematic review following PRISMA guidelines was conducted by searching AMED, EMBASE and MEDLINE databases from 2000-2020. Inclusion terms were: enteral feeding by nasogastric tube, under 18 years, eating disorders, and primary research. Exclusion terms: mental disorders other than eating disorders; non-primary research; no outcomes specific to NG feeding and over 18 years. Titles and abstracts were screened by all authors before reviewing full length articles. Quality assessment, including risk of bias, was conducted by all authors. Results29 studies met the full criteria. 86% of studies were deemed high or medium risk of bias due to the type of study: 34.4% retrospective cohort and 10.3% RCT; 17.2% were qualitative. Studies identified 1) a wide range of practices in different countries, settings, and the reason for initiation; 2) In the UK, standard practice is to introduce NGF if either oral intake is not met or patients are medically unstable; 3) NGF may enable greater initial weight gain due to increased caloric intake; 4) there are 3 main types of feeding regime: continuous, nocturnal and bolus; 5) high calorie feeds are not typically associated with increased risk of refeeding syndrome; 6) complications included nasal irritation, epistaxis, electrolyte disturbance, distress and tube removal; 7) length of stay in hospital is dependent on reason of initiating NGF; 8) psychiatric and medical wards differ in approach; 9) concurrent therapy is often used to facilitate NGF.ConclusionsNGF is currently often implemented in specialist settings where oral intake has been refused or insufficient, in hospital due to medical instability, nocturnally to supplement day-time oral intake, or continuously as standard protocol. Due to high risk of bias as a result of the nature of the studies conducted in adolescents with ED, recommendations for clinical practice cannot yet be justified.

When Food is Feared: A Systematic Review of Enteral Feeding by Nasogastric Tube in Young People with Eating Disorders

2020 ◽  
Author(s):  
Kristen Hindley ◽  
Clare Fenton ◽  
Jennifer McIntosh
Keyword(s):  
Systematic Review ◽  
Eating Disorders ◽  
Young People ◽  
Enteral Feeding ◽  
Nasogastric Tube ◽  
Primary Research ◽  
Nasogastric Feeding ◽  
Nasal Irritation ◽  
Increased Risk ◽  
Tube Removal

Abstract BackgroundAdolescents with severe restrictive eating disorders often require enteral feeding. Nasogastric feeding is occasionally used during hospitalisation to treat medical instability as a result of malnourishment, or in a specialist setting to supplement minimal oral intake by underweight patients. There is minimal guidance for clinicians to determine when nasogastric feeding should be implemented, how it should be provided and how to complement feeding with a nasogastric tube. This systematic review sets out to determine best practice for NG feeding.MethodsA systematic review following PRISMA guidelines was conducted by searching AMED, EMBASE and MEDLINE databases from 2000-2020. Inclusion terms used were as follows: enteral feeding by nasogastric tube, under 18 years, eating disorders, and primary research. Exclusion terms: mental disorders other than eating disorders; non-primary research; no outcomes specific to NG feeding and over 18 years. Titles and abstracts were screened by all authors before reviewing full length articles.Results28 studies met the full criteria. 51.7% of studies were deemed high risk of bias due to the type of study: 37.9% retrospective cohort and 10.3% RCT; 17.2% were qualitative. Studies identified 1) 6-66% required NG feeding; 2) staff and young people understand its necessity but generally view it negatively; 3) there are 3 main types of feeding regime: continuous, nocturnal and bolus; 4) high calorie feeds are not associated with increased risk of refeeding syndrome; 5) Common complications were nasal irritation, epistaxis, electrolyte disturbance, distress and tube removal; 6) length of stay in hospital may be longer in patients requiring NG feeding; 7) psychiatric and medical wards differ in approach; 8) concurrent therapy reduces NG use and aids recovery.ConclusionsAll studies which reviewed the use of NG over a period of time found that it had increased significantly in recent years. Due to the possibility of patient removal of the tube, it may be beneficial in practice to deliver feeds using a bolus regime which has been tailored to the individual caloric needs of the patient. This review enables cautious recommendations to be made and highlights the lack of high-quality evidence around the use of NG feeding in eating disordered young people.

Nutritional Intervention May Improve Body Mass Index of Malnourished Hospitalized Psychiatric Patients – A Preliminary Observation

2019 ◽  
Vol 18 (3) ◽  
pp. 256-259
Author(s):  
Hou Y.C. ◽  
Hsieh Y.L. ◽  
Tzeng I.S. ◽  
Kuo C.Y.
Keyword(s):  
Body Weight ◽  
Psychiatric Patients ◽  
Psychiatric Hospitals ◽  
Nutritional Intervention ◽  
Nutrition Intervention ◽  
Calorie Intake ◽  
Psychiatric Ward ◽  
Increased Risk ◽  
Total Calorie ◽  
Total Calorie Intake

Malnutrition is an important issue in hospitalized patients. Poor nutrition may lead to increased risk of morbidity and death, impaired mental and physical conditions, apathy, depression, self-neglect, increased risk of medical complications, increased risk of pressure ulcers, reduced immune response, delayed wound healing, longer hospital stays, and reduced quality of life. However, few studies have investigated malnutrition in psychiatric patients. Psychiatric patients are known to have an increased risk of malnutrition, but psychiatric hospitals rarely conduct physical examinations and nutritional assessments. In this preliminary study, patients from a psychiatric ward of the Taipei Tzu Chi Hospital were chosen using the Malnutrition Universal Screening Tool. We used the before-and-after analysis to test the effect of a nutrition intervention on the selected parameters. We found that patients who had an impaired nutritional status showed significant increases in body weight (mean: 43.6 ± 7.5 vs. 46.5 ± 8.2 kg; P < 0.001), BMI (mean: 16.8 ± 2.0 vs. 17.9 ± 2.1 kg/m2; P < 0.001), and total calorie intake (mean: 1128 ± 230 vs. 1378 ± 320 Kcal; P < 0.001). Nutritional intervention significantly improved body weight, BMI, and total calorie intake. Nutritional intervention may help prevent malnutrition and improve the management of psychiatric patients.

scholarly journals Comparative efficacy of teat sealants given prepartum for prevention of intramammary infections and clinical mastitis: a systematic review and network meta-analysis

2019 ◽  
Vol 20 (2) ◽  
pp. 182-198 ◽  
Author(s):  
C. B. Winder ◽  
J. M. Sargeant ◽  
D. Hu ◽  
C. Wang ◽  
D. F. Kelton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Clinical Mastitis ◽  
Risk Of Bias ◽  
Comparative Efficacy ◽  
Primary Research ◽  
Quality Of Reporting ◽  
Intramammary Infections ◽  
Bismuth Subnitrate

AbstractA systematic review and network meta-analysis were conducted to assess the relative efficacy of internal or external teat sealants given at dry-off in dairy cattle. Controlled trials were eligible if they assessed the use of internal or external teat sealants, with or without concurrent antimicrobial therapy, compared to no treatment or an alternative treatment, and measured one or more of the following outcomes: incidence of intramammary infection (IMI) at calving, IMI during the first 30 days in milk (DIM), or clinical mastitis during the first 30 DIM. Risk of bias was based on the Cochrane Risk of Bias 2.0 tool with modified signaling questions. From 2280 initially identified records, 32 trials had data extracted for one or more outcomes. Network meta-analysis was conducted for IMI at calving. Use of an internal teat sealant (bismuth subnitrate) significantly reduced the risk of new IMI at calving compared to non-treated controls (RR = 0.36, 95% CI 0.25–0.72). For comparisons between antimicrobial and teat sealant groups, concerns regarding precision were seen. Synthesis of the primary research identified important challenges related to the comparability of outcomes, replication and connection of interventions, and quality of reporting of study conduct.

scholarly journals Az energiamentes édesítőszerek hatása az egyes anyagcsere-paraméterekre

2016 ◽  
Vol 157 (Supplement 1) ◽  
pp. 8-13
Author(s):  
Tibor Hidvégi
Keyword(s):  
Body Weight ◽  
Caloric Intake ◽  
Postprandial Blood Glucose ◽  
Calorie Intake ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Randomized Controlled Studies ◽  
Total Calorie ◽  
Scientific Statement ◽  
Total Calorie Intake

Nonnutritive sweeteners can be found in many other foods apart from soft drinks. Producers of foodstuffs often use a combination of several sweeteners or sweetener and sugar mixes in a single product mainly to achieve a sweeter taste with a lower calorie count. According to the 2012 Scientific Statement of the American Heart and Diabetes Association, reduction of sugar intake plays an important role in establishing an optimal diet and the maintenance of an appropriate body weight. Controlled intervention studies show that during use of calorie-free sweeteners body weight did not change, moreover, in some cases weight even fell. This was also demonstrated in a recently published summary study of randomized controlled studies, according to which calorie-free sweeteners contributed to both loss and maintenance of body weight. According to the summary of the American Dietetic Association, the use of calorie-free sweeteners does not influence the glycemic response and does not increase postprandial blood glucose levels in diabetics. The results thus far, then, show that the use of nonnutritive sweeteners can reduce the consumption of carbohydrates, by which total calorie intake can also be lowered. Their use can promote weight loss and maintenance as well as can help to improve the values of other metabolic parameters (eg. blood sugar, triglycerides). In addition to this, it is important to note that these benefits will not fully materialize if consumption of nonnutritive sweeteners is accompanied by an increase in compensatory caloric intake. Orv. Hetil., 2016, 157(Suppl. 1), 8–13.

scholarly journals Using Dietary Macronutrient Patterns to Predict Sarcopenic Obesity in Older Adults: A Representative Korean Nationwide Population-Based Study

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4031
Author(s):  
Jun-Hyuk Lee ◽  
Hye-Min Park ◽  
Yong-Jae Lee
Keyword(s):  
Older Adults ◽  
Population Based ◽  
Sarcopenic Obesity ◽  
Calorie Intake ◽  
Macronutrient Intake ◽  
Dietary Recall ◽  
Adverse Health Outcomes ◽  
Increased Risk ◽  
Total Calorie ◽  
Total Calorie Intake

Older adults with sarcopenic obesity (SO) are at increased risk of adverse health outcomes. It has not been identified which pattern of macronutrient intake is appropriate in relation to SO. We aimed to compare the patterns of macronutrient intake for predicting SO in older adults. Data from a total of 3828 older adults who participated in the 2008–2011 Korea National Health and Nutrition Examination Survey were analyzed. The one-day 24 h dietary recall method was used to assess macronutrient intake. SO was defined by a combination of body mass index (BMI) ≥ 25 kg/m2 and BMI adjusted-appendicular skeletal muscle mass <0.789 for men and <0.512 for women. Weighted logistic regression analysis revealed the odds ratio (95% confidence interval) for SO of total calorie intake per 100 increments and carbohydrate (CHO) intake (g/kg/day) per 1 increment to be 0.95 (0.91–0.99) and 0.83 (0.74–0.94), respectively, after adjusting for confounding variables in women. The predictive power for SO of CHO intake (g/kg/day) was higher compared with the other patterns of macronutrient intake both in men and women. In conclusion, total calorie intake and CHO intake (g/kg/day) are inversely related to SO in women. CHO intake (g/kg/day) could be the best index for determining SO.

Abstract 11809: Sodium Intake is Correlated to Total Calorie Intake and Potassium

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yoon Juneyoung ◽  
Kyoung-Woo Seo ◽  
Jin-Sun Park ◽  
Hyoung-Mo Yang ◽  
Hong-Seok Lim ◽  
...  
Keyword(s):  
General Population ◽  
Predictive Value ◽  
Sodium Intake ◽  
Quantitative Relationship ◽  
Calorie Intake ◽  
Nutrition Survey ◽  
Cutoff Value ◽  
Cutoff Values ◽  
Total Calorie ◽  
Total Calorie Intake

Background: Selecting lower-sodium diets are not successful to reduce sodium intake in general population. If systemic approach is considered lowering sodium intake because of the culinary tendencies, we need to aware of the quantitative relationship between nutrients and sodium in daily usual food of the general population. Hypothesis: We assessed the hypotheses that are the positive correlation between total calorie intake, potassium and sodium intake; the cutoff values for sodium recommendation (≤2300 mg per day). Method: We studied 55,544 individuals who completed health examination and nutrition survey in 168,157 randomly selected participants that could represent the country from the 1998-2013 Korea National Health and Nutrition Examination Survey (KNHANES). The nutrition survey was 24 hours recall method to estimate the amount of standardized Korean food. We analyzed the quantitative relationship, and estimated the cutoff value of the total calories and potassium at the recommendation of the sodium intake. Result: The mean values were total calorie 1922±834 Kcal, sodium 4904±3218 mg, potassium 2935±1563 mg, protein 70±41 g (15% in total calorie), fat 37±31 (18%), and carbohydrate 312±123 (67%) in mean value. The standardized coefficients were potassium 0.309, protein 0.226, fat 0.070, carbohydrate 0.097 in model 1 (R2=0.402); total calorie 0.271 and potassium 0.368 in model 2 (R2=0.384) with cardiovascular risk factors in multiple linear regression analysis (table). The optical cutoff value of the total calorie for sodium 2300mg is 1520 Kcal (74% sensitivity, 74% specificity, 93% positive predictive value, 38% negative predictive value, area under the curve: 0.826, 95% CI: 0.82 to 0.83 ; p < 0.001) and the potassium is 1956 mg (82% sensitivity, 69% specificity, 92% PPV, 44% NPV, AUC: 0.825, 95% CI: 0.82 to 0.83 ; p <0.001). Conclusion: In conclusion, the cutoff values for the sodium 2300 mg are the total calorie 1520 Kcal and potassium 1956 mg.

What Are Infants Fed in the United States?

PEDIATRICS ◽  
1975 ◽  
Vol 56 (3) ◽  
pp. 350-354
Author(s):  
Samuel J. Fomon
Keyword(s):  
United States ◽  
The United States ◽  
Calorie Intake ◽  
Personal Communications ◽  
Total Calorie ◽  
Relative Prevalence ◽  
Total Calorie Intake

Estimates of calorie intake from various sources during infancy are presented in relation to age. The estimates, based on published reports and personal communications to the author, concern total calorie intake and its distribution between milk or formula and beikost (i.e., foods other than milk or formula fed to infants), relative prevalence of breast, formula- and milk-feedings, relative popularity of specific commercially prepared formulas, and percentage of calories consumed in the form of commercially prepared strained and junior foods and "table" foods.

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