Inflammation as the Key Interface of the Medical and Nutrition Universes: A Provocative Examination of the Future of Clinical Nutrition and Medicine

Abstract

There has been tremendous interest in inflammation by researchers, the medical community, and the lay public. Modulation of injury response is felt to represent a tenuous balance of pro- and anti-inflammatory cytokines. Adverse outcomes may result from severe, sustained, or repeated bouts of inflammation. A critical observation is that nutrition support alone is inadequate to prevent muscle loss during active inflammation. It is necessary to take inflammation into consideration in conducting appropriate nutrition assessment, intervention, and monitoring. A host of medical conditions are actually inflammatory states that have important implications for nutrition care. Multifaceted interventions that may include anti-inflammatory diets, glycemic control, physical activity, appetite stimulants, anabolic agents, anti-inflammatory agents, anticytokines, and probiotics, will be necessary to blunt undesirable aspects of inflammatory response to preserve body cell mass and vital organ functions. Nutrition practitioners can seize this opportunity to be a part of the future medical team that brings highly individualized patient care to the bedside.

Consensus Statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: Characteristics Recommended for the Identification and Documentation of Adult Malnutrition (Undernutrition)

“…Inflammation is increasingly identified as an important underlying factor that increases risk for malnutrition, and that may contribute to suboptimal response to nutrition intervention and increased risk of mortality (7)(8)(9). As such, individuals may exhibit a wide range of characteristics from "severe malnutrition" to those with non-severe (mild to moderate) malnutrition that if left unrecognized and unaddressed is likely to progress to a severely malnourished state (3)(4)(5)(6)(7)(8)(9)(10)(11). Although various laboratory tests and physical signs or symptoms have been suggested as potential markers for inflammation, and some are briefly mentioned in passing in this document, the Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)…”

“…Malnutrition is a major contributor to increased morbidity and mortality, decreased function and quality of life, increased frequency and length of hospital stay, and higher health care costs (2,(7)(8)(9)(10)(11). Jensen and colleagues propose an overarching definition of malnutrition as "decline in lean body mass with the potential for functional impairment" at multiple levels-ie, molecular, physiologic, and/or gross motor (8).…”

“…Jensen and colleagues propose an overarching definition of malnutrition as "decline in lean body mass with the potential for functional impairment" at multiple levels-ie, molecular, physiologic, and/or gross motor (8). The diagnosis of malnutrition in a patient is an undeniably complicating condition that in many cases significantly increases resource utilization in the acute care setting beyond that experienced by the patient in nutritional health (7)(8)(9)(10)(11).…”

Malnutrition in Older Adults - Urgent Need for Action: A Plea for Improving the Nutritional Situation of Older Adults

“…This also applies to several laboratory parameters - albumin, transferrin or lymphocyte count - commonly used for nutritional assessment in previous years. Because these reflect illness rather than true nutritional deficiencies [7], they have retreated into the background of nutritional assessment and made room for malnutrition screening tools which are currently considered state of the art for the identification of subjects with malnutrition or at risk of malnutrition [10]. Considering several aspects of malnutrition simultaneously, screening tools cope better with the complex nature of malnutrition, and are therefore more suitable than single parameters in identifying it.…”

Applicability of a Human Lactoferrin in Pediatric Practice

“…В дальнейшем снижается содержание короткоживущих белков крови (преальбумина, трансферрина, церуло-плазмина и др.) и уменьшается концентрация альбумина и общего белка [17].…”