Wasting

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  • 文章类型: Journal Article
    世界卫生组织最近更新了预防和管理婴儿和5岁以下儿童的消瘦和营养水肿(急性营养不良)的指南。除了关于营养框架的差异,该框架定义了用于门诊治疗严重消瘦和/或营养性水肿的即用治疗食品(RUTF)所需的能量数量,实践指导也存在重要差距。而不是建议的能量摄入量150-185千卡/千克/天,我们的替代计算表明,要求仅为105-120千卡/千克/天。如果为true,这种热量过量喂养的实施可能会产生不利后果。还需要解决实际指导方面的差距,包括过渡到家庭饮食的时机,治疗性进食的最大持续时间,特别是在非响应者中(南亚为50%),以及增强家庭食品作为主要治疗性食品选择的作用。
    The World Health Organization has recently updated the guideline on the prevention and management of wasting and nutritional oedema (acute malnutrition) in infants and children under 5 years. Apart from differences with regard to the nutritional framework that defines the quantity of energy required as Ready-to-Use Therapeutic Food (RUTF) for the outpatient treatment of severe wasting and/or nutritional oedema, there are also important gaps in the practical guidance. Instead of the recommended energy intake of 150-185 kcal/kg/day, our alternative calculations indicate the requirement to be only 105-120 kcal/kg/day. If true, the implementation of such caloric overfeeding can have adverse consequences. Gaps in practical guidance also need to be addressed, including the timing of transition to home-based diets, maximal duration of therapeutic feeding, especially in non-responders (∼50% in South Asia), and the role of augmented home foods as the primary therapeutic food option.
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  • 文章类型: Journal Article
    Over the last 2 decades, there has been a great accumulation of new evidence regarding the management of nutritional and metabolic aspects of kidney disease. The 2020 update to the KDOQI Clinical Practice Guideline for Nutrition in CKD provides a comprehensive up-to-date information on the understanding and care of patients with CKD. It provides updated information on nutritional aspects of kidney disease for the practicing clinician and allied health-care workers. The current manuscript provides an overview of the updated guideline statements on major subjects including nutritional assessment, dietary protein and energy intake, nutritional supplementation, micronutrients, and electrolytes. The guidelines are focused on dietary management rather than all possible nutritional interventions.
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