Do Nutrient Supplements Have Any Effect on Mental Disorders?

A growing number of studies have examined the benefits of nutrient supplementation in people with mental disorders. But which supplements have been proven to work — and for which disorders? Click here for PsychCentral article

Daily intake of nutritional supplements cannot prevent depression

The largest randomized clinical trial to study the effects of nutritional strategies on the prevention of major depressive disorder concludes that daily intake of nutritional supplements cannot prevent depression. Read ScienceDaily article here

Raw fruit and vegetables provide better mental health outcomes

Researchers have discovered raw fruit and vegetables may be better for your mental health than cooked, canned and processed fruit and vegetables. Click here to see Sciencedaily article

NIHR Signal Enriched food and snacks can increase nutritional intake in older people in hospital

NIHR Signal Enriched food and snacks can increase nutritional intake in older people in hospital


Enriching hospital food with energy or protein may improve nutrition in older people in hospital.
Studies assessed in a systematic review showed consistent effects of enriched or fortified foods compared with usual nutrition. The extent of increased consumption varied depending on the amount and type of foods added.


Published on 20 March 2018
full document available at: https://discover.dc.nihr.ac.uk/portal/article/4000973/enriched-food-and-snacks-can-increase-nutritional-intake-in-older-people-in-hospital

UHCW publication: Impact of Dietary Fiber Consumption on Insulin Resistance and the Prevention of Type 2 Diabetes

Impact of Dietary Fiber Consumption on Insulin Resistance and the Prevention of Type 2 Diabetes
Weickert MO, Pfeiffer, AFH
The Journal of Nutrition, Volume 148, Issue 1, 1 January 2018, Pages 7–12
Abstract
Large prospective cohort studies consistently show associations of a high dietary fiber intake (>25 g/d in women and >38 g/d in men) with a 20–30% reduced risk of developing type 2 diabetes (T2D), after correction for confounders. It is less well recognized that these effects appear to be mainly driven by high intakes of whole grains and insoluble cereal fibers, which typically are nonviscous and do not relevantly influence postprandial glucose responses [i.e., glycemic index (GI)] or are strongly fermented by the gut microbiota in the colon. In contrast, a dietary focus on soluble, viscous, gel-forming, more readily fermentable fiber intakes derived from fruit and certain vegetables yields mixed results and generally does not appear to reduce T2D risk. Although disentangling types of fiber-rich foods and separating these from possible effects related to the GI is an obvious challenge, the common conclusion that key metabolic effects of high-fiber intake are explained by mechanisms that should mainly apply to the soluble, viscous type can be challenged. More recently, studies in humans and animal models focused on gaining mechanistic insights into why especially high-cereal-fiber (HCF) diets appear to improve insulin resistance (IR) and diabetes risk. Although effects of HCF diets on weight loss are only moderate and comparable to other types of dietary fibers, possible novel mechanisms have emerged, which include the prevention of the absorption of dietary protein and modulation of the amino acid metabolic signature. Here we provide an update of our previous review from 2008, with a focus on mechanistic insights of how HCF diets may improve IR and the risk of developing T2D.


Read the full article at https://academic.oup.com/jn/article/148/1/7/4823705 (free access)

Nutrition and hydration

These resources from NHS Improvement on using nutrition and hydration to reduce the incidence of pressure ulcers and promote good wound healing, include evidence and recommendations for assessment and action when assessing an individual’s risk of developing a pressure ulcer; five top tips to prevent pressure ulcers; and three case studies.

Hidden hunger and malnutrition in the elderly

This report from the All Party Parliamentary Group on Hunger calls on the government to look more closely at malnutrition in older people which is estimated to cost the NHS and social care £15.7 billion a year by 2030. It argues that targeted investment in services which protect older people from malnutrition would deliver significant annual savings to the NHS, not least by reducing the number of hospital admissions and limiting the number of days older people spend in hospital.

Oesophago-gastric cancer: assessment and management in adults [NG 83]

New:  NICE guideline

1.1 Information and support

1.2 Organisation of services

1.3 Assessment after diagnosis

1.4 Radical treatment

1.5 Palliative management

1.6 Nutritional support

1.7 Follow-up

Screening for malnutrition in patients with gastro-entero-pancreatic neuroendocrine tumours: a cross-sectional study

BMJ Open. 2016 May 4;6(5):e010765. doi: 10.1136/bmjopen-2015-010765.

OBJECTIVES: To investigate whether screening for malnutrition using the validated malnutrition universal screening tool (MUST) identifies specific characteristics of patients at risk, in patients with gastro-entero-pancreatic neuroendocrine tumours (GEP-NET).

CONCLUSIONS: Given the frequency of patients identified at malnutrition risk using MUST in our relatively large and diverse GEP-NET cohort and the clinical implications of detecting malnutrition early, we recommend routine use of malnutrition screening in all patients with GEP-NET, and particularly in patients who are treated with long-acting somatostatin analogues.

UHCW Research: Qureshi SA, Burch N, Hattersley JG, Khan S, Gopalakrishnan K, Darby C, Wong JL, Davies L, Fletcher S, Shatwell W, Sothi S, Randeva HS, Dimitriadis GK and Weickert MO.

Your mood depends on the food you eat, and what you should eat changes as you get older

Young adults and mature adults require different food to improve their mental health Click here for ScienceDaily article

NIHR Signal Low FODMAP diet may improve irritable bowel symptoms more than other diets

Adults with irritable bowel syndrome (IBS) who followed a low FODMAP diet had fewer symptoms than those who followed standard dietary advice. They scored their symptoms about 50 points better on a 500 point scale.

The low FODMAP diet is an emerging approach for IBS. It is based on the theory that certain carbohydrates can expand or ferment in the gut and cause symptoms for some people.

From the NIHR Dissemination Centre

Naltrexone–bupropion for managing overweight and obesity [TA494]

New:  Technology appraisal guidance

Naltrexone–bupropion is not recommended within its marketing authorisation for managing overweight and obesity in adults alongside a reduced-calorie diet and increased physical activity.

This recommendation is not intended to affect treatment with naltrexone–bupropion that was started in the NHS before this guidance was published. Adults having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.

State of the Nation: an overview of older people and malnutrition in the UK

The Malnutrition Task Force has launched its ‘State of the Nation’ report which aims to shine a light on the scale and challenges of malnutrition in later life in the UK today.

It has brought together information, statistics and evidence from across the health and social care system to provide a unique snapshot of what is happening to older people who are malnourished or at risk of malnutrition in England.

Nutritional care tool report 2017

The BAPEN nutritional care tool report provides organisational-level data on how nutritional care is organised and patient-level data on the quality of nutrition in hospitals, care homes and community organisations.

Comparing assessment tools for detecting undernutrition in patients with liver cirrhosis

Clinical Nutrition ESPEN. DOI: http://dx.doi.org/10.1016/j.clnesp.2017.10.009

Undernutrition in cirrhotic patients is often poorly recognised until late-stages. The current UK screening tool, the Malnutrition Universal Screening Tool, can miss undernutrition in patients with ascites/fluid retention. A 6-question Liver Disease Undernutrition Screening Tool (LDUST) has been developed in America.

We sought to compare LDUST with MUST in the detection of undernutrition in 50 inpatients and 50 outpatients with liver cirrhosis in a secondary care setting. This was then validated by a dietitian assessment.

UHCW Research: M. McFarlane, C. Hammond, T. Roper, J. Mukarati, R. Ford, J. Burrell, V. Gordon

and N. Burch

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N. Burch

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Affiliations

OC28 Home Parenteral Nutrition (HPN) In Palliative Oncology Patients: A UK Single Centre Case Series

Abstracts / Clinical Nutrition ESPEN 22 (2017) 116e147

Malnourishment is common in cancer patients. Resultant sarcopenia, seen alongside advanced disease, leads to increased rates of perioperative complications, increased rates of infection and decreased tolerance of anti-cancer treatment. A subset of these patients are unable to maintain enteral
nutrition, for instance those with bowel obstruction, and improving nutrition in this group is an area of expanding interest. Since the establishment of home parenteral nutrition (HPN), its use in cancer patients in the UK has increased annually (British Artificial Nutrition Survey 2015). Despite this, literature in this area remains sparse and randomised controlled trials are understandably non-existent. This paper aims to review current practice with HPN in patients with non-curable cancer at a
large teaching hospital in the UK to assess outcomes and suggest areas for future research.

UHCW Research: H. Bridgestock, C. Bell, R. Whitefield, S. Sothi, N. Burch.

Volixibat for non-alcoholic steatohepatitis (NASH)

Currently, there are no approved therapies for the treatment of NASH, but doctors recommend dietary changes and exercise to prevent or slow disease progression. Volixibat is a new experimental once-daily oral tablet that may improve NASH by targeting and blocking a protein (apical sodium-dependent bile acid transporter) found in the liver. This is thought to improve liver function by reducing the amount of cholesterol (fatty substance) in this organ. If licensed, volixibat has the potential to establish itself as a single-agent and the first treatment specifically for NASH.


From the NIHR Innovation Observatory

Setmelanotide for pro-opiomelanocortin deficiency obesity

Body fat and food intake are regulated by signals from the brain to the gut. One of the important hormones that is responsible for this is pro-opiomelanocortin (POMC). In a very small group of people there is a lack of this hormone (due to a genetic mutation), referred to as POMC deficiency. This causes severe overeating which leads to obesity and high blood sugar in children. Very few adults have been observed with this condition, which may be due to high death rates in adolescence. Pale skin that does not tan and red hair are common signs of POMC deficiency obesity.
Currently there are no licensed treatment options for POMC deficiency obesity, however weight loss medicines orlistat and methylcellulose are the only treatment options offered. Setmelanotide is being developed to treat pro-opiomelanocortin (POMC) deficiency obesity. If marketed setmelanotide could be the first effective treatment option aimed specifically at this patient group as it replaces one of the key hormones that is lacking in POMC deficiency patients (melanocytestimulating hormone). It has been shown to reduce hunger and has resulted in substantial weight loss in previous patients.


From NIHR Innovation Observatory

NHS targets super-sized chocolate bars in battle against obesity, diabetes and tooth-decay

Hospitals have been ordered to take super-size chocolate bars and “grab bags” of sugary snacks off the shelves in the latest step of the NHS plan to fight obesity, diabetes and tooth-decay.

NHS England chief executive Simon Stevens has announced a 250 calorie limit on confectionery sold in hospital canteens, stores, vending machines and other outlets.

Hospital chiefs will have to ensure that four out of five items purchased on their premises do not bust the limit, which is an eighth of a woman’s and a tenth of a man’s recommended daily intake, or lose out on funding ring-fenced for improving the health of staff, patients and their visitors.

Unhealthy sandwiches and drinks are also being targeted as the NHS, Europe’s largest employer, takes a lead in tackling the availability of unhealthy food and drinks that are fuelling an obesity crisis.

People with type 2 diabetes should 'save carbs for last'

"Diabetics should save bread for last at mealtime to keep their blood sugar under control," the Mail Online reports. A small study found that people with type 2 diabetes who saved their carbohydrates until the end of their meal were less likely to experience a sudden rise in their blood sugar (glucose) levels. The medical term for this spike in blood sugar levels is postprandial hyperglycaemia.

Postprandial hyperglycaemia is best avoided as not only can it make the day-to-day symptoms of diabetes worse, it has also been linked to an increased risk of developing cardiovascular disease.

It has been suggested that leaving carbohydrates until the end of a meal could slow the emptying of the stomach and give it a chance to digest the protein and vegetables first, which could help prevent a blood glucose spike. The researchers wanted to see whether this was true.

This study included just 16 people who ate the foods of their meal in different orders to test which order was most effective at lowering blood sugar and related hormones. They either ate carbohydrates first, carbohydrates last, or all nutrients together at the same time.

The researchers generally found that consuming carbohydrates last was better at lowering blood sugar levels and insulin secretion when compared to the other ways of eating carbohydrates.

While the results are interesting, the study was far too small to form the basis of any firm medical guidance. For now, it's best to follow current advice, which is to consume a healthy diet and keep active to help you manage your blood sugar level. This will also help you control your weight and generally feel better.