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Recent Advances in Enteral Nutrition

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (15 December 2014) | Viewed by 156329

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A printed edition of this Special Issue is available here.

Special Issue Editors

Department of Adult Nursing and Paramedic Science, Faculty of Education and Health, University of Greenwich, London, SE9 2UG, UK
Interests: stroke, dementia and clinical nutrition
School of Health Sciences, University of Greenwich, Avery Hill Campus, London SE9 2UG, UK
Interests: nutrition; prebiotics; diabetes; glycaemic index of food; dietary fibre; gut microbiome
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The subject of enteral nutrition is an interesting one both to the healthcare professionals working in this practice area and to the individuals who may benefit from nutritional support. These individuals usually have functional guts but may be suffering from dysphagia (with the underlying neurological deficits) or the effects of radiotherapy treatment. Enteral nutrition involves the administration of nutritional support to individuals whose nutritional requirements cannot be met by a normal diet. Thus, enteral nutrition could be in the form of oral nutritional support and/or involve tube feeding. Often, enteral nutrition provisioning involves the assessment of nutritional status, the determination of nutritional requirements, the establishment of feeding regimes, and the management of patients, pumps, feeds, and feeding tubes.

Researchers in this field are also keen to evaluate the effect of enteral feeding protocols, algorithms, and guidelines on patients with different medical conditions in various care settings. There have also been a series of comparisons between the uses of feeding tubes, feeding methods, and management approaches. Economic evaluations of enteral nutrition and Home Enteral Nutrition (HEN) teams show the benefits of Home Enteral Tube Feeding (HETF); however, due to the rising cost of HETF, there has been intense debate on the subject. There have been reviews on advances, challenges, and prospects in enteral nutrition.

This Special Issue is intended to provide information on recent advances in the area of enteral nutrition.

Dr. Omorogieva Ojo
Dr Joanne Brooke
Guest Editors

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Keywords

  • enteral tube feeding and long term conditions
  • feeding tubes
  • enteral feeds
  • enteral feeding methods
  • evaluation of enteral nutrition
  • evaluation of HEN
  • feeding regimes
  • Recent advances in enteral nutrition
  • challenges in enteral nutrition
  • complications
  • ethics

Published Papers (14 papers)

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Editorial

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171 KiB  
Editorial
Recent Advances in Enteral Nutrition
by Omorogieva Ojo and Joanne Brooke
Nutrients 2016, 8(11), 709; https://doi.org/10.3390/nu8110709 - 08 Nov 2016
Cited by 12 | Viewed by 6428
Abstract
There have been significant advances in the provision of enteral nutrition support in the acute and community healthcare settings.[...] Full article
(This article belongs to the Special Issue Recent Advances in Enteral Nutrition)

Research

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375 KiB  
Article
Enteral Immunomodulatory Diet (Omega-3 Fatty Acid, γ-Linolenic Acid and Antioxidant Supplementation) for Acute Lung Injury and Acute Respiratory Distress Syndrome: An Updated Systematic Review and Meta-Analysis
by Congcong Li, Liyan Bo, Wei Liu, Xi Lu and Faguang Jin
Nutrients 2015, 7(7), 5572-5585; https://doi.org/10.3390/nu7075239 - 09 Jul 2015
Cited by 51 | Viewed by 9304
Abstract
Enteral immunomodulatory nutrition is considered as a promising therapy for the treatment of acute lung injury and acute respiratory distress syndrome (ALI/ARDS). However, there are still some divergences, and it is unclear whether this treatment should be recommended for patients with ALI/ARDS. Therefore, [...] Read more.
Enteral immunomodulatory nutrition is considered as a promising therapy for the treatment of acute lung injury and acute respiratory distress syndrome (ALI/ARDS). However, there are still some divergences, and it is unclear whether this treatment should be recommended for patients with ALI/ARDS. Therefore, we conducted this systematic review and meta-analysis to assess the efficacy and safety of an enteral immunomodulatory diet on the clinical outcomes of ALI/ARDS patients. Methods: We retrieved potentially relevant clinical trials though electronic databases. All trials of enteral immunomodulatory diet for ALI/ARDS were included. Analyses of the overall all-cause mortality, 28-day ventilator-free days and 28-day intensive care unit (ICU) free days were conducted. Results: In total six controlled trials were evaluated. The pooled results did not show a significant reduction in the risk of all-cause mortality (M-H RR (the overall Mantel-Haenszel relative risk), 0.81 (95% CI, 0.50–1.31); p = 0.38; 6 trials, n = 717) in ALI/ARDS patients treated with the immunomodulatory diet. This treatment also did not extend the ventilator-free days and ICU-free days. However, patients with high mortality might benefit from this treatment. Conclusions: The enteral immunomodulatory diet could not reduce the severity of the patients with ALI/ARDS. Whereas, for ALI/ARDS patients with high mortality, this treatment might reduce the all-cause mortality, but its use should be treated with discretion. Full article
(This article belongs to the Special Issue Recent Advances in Enteral Nutrition)
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167 KiB  
Article
A Comparison of Postoperative Early Enteral Nutrition with Delayed Enteral Nutrition in Patients with Esophageal Cancer
by Gongchao Wang, Hongbo Chen, Jun Liu, Yongchen Ma and Haiyong Jia
Nutrients 2015, 7(6), 4308-4317; https://doi.org/10.3390/nu7064308 - 02 Jun 2015
Cited by 42 | Viewed by 6640
Abstract
We examined esophageal cancer patients who received enteral nutrition (EN) to evaluate the validity of early EN compared to delayed EN, and to determine the appropriate time to start EN. A total of 208 esophagectomy patients who received EN postoperatively were divided into [...] Read more.
We examined esophageal cancer patients who received enteral nutrition (EN) to evaluate the validity of early EN compared to delayed EN, and to determine the appropriate time to start EN. A total of 208 esophagectomy patients who received EN postoperatively were divided into three groups (Group 1, 2 and 3) based on whether they received EN within 48 h, 48 h–72 h or more than 72 h, respectively. The postoperative complications, length of hospital stay (LOH), days for first fecal passage, cost of hospitalization, and the difference in serum albumin values between pre-operation and post-operation were all recorded. The statistical analyses were performed using the t-test, the Mann-Whitney U test and the chi square test. Statistical significance was defined as p < 0.05. Group 1 had the lowest thoracic drainage volume, the earliest first fecal passage, and the lowest LOH and hospitalization expenses of the three groups. The incidence of pneumonia was by far the highest in Group 3 (p = 0.019). Finally, all the postoperative outcomes of nutritional conditions were the worst by a significant margin in Group 3. It is therefore safe and valid to start early enteral nutrition within 48 h for postoperative esophageal cancer patients. Full article
(This article belongs to the Special Issue Recent Advances in Enteral Nutrition)
209 KiB  
Article
Serum Phosphorus Levels in Premature Infants Receiving a Donor Human Milk Derived Fortifier
by Katherine E. Chetta, Amy B. Hair, Keli M. Hawthorne and Steven A. Abrams
Nutrients 2015, 7(4), 2562-2573; https://doi.org/10.3390/nu7042562 - 09 Apr 2015
Cited by 7 | Viewed by 6632
Abstract
An elevated serum phosphorus (P) has been anecdotally described in premature infants receiving human milk fortified with donor human milk-derived fortifier (HMDF). No studies have prospectively investigated serum P in premature infants receiving this fortification strategy. In this single center prospective observational cohort [...] Read more.
An elevated serum phosphorus (P) has been anecdotally described in premature infants receiving human milk fortified with donor human milk-derived fortifier (HMDF). No studies have prospectively investigated serum P in premature infants receiving this fortification strategy. In this single center prospective observational cohort study, extremely premature infants ≤1250 grams (g) birth weight (BW) were fed an exclusive human milk-based diet receiving HMDF and serum P levels were obtained. We evaluated 93 infants with a mean gestational age of 27.5 ± 2.0 weeks (Mean ± SD) and BW of 904 ± 178 g. Seventeen infants (18.3%) had at least one high serum P level with a mean serum P of 9.2 ± 1.1 mg/dL occurring at 19 ± 11 days of life. For all infants, the highest serum P was inversely correlated to the day of life of the infant (p < 0.001, R2 = 0.175) and positively correlated with energy density of HMDF (p = 0.035). Serum P was not significantly related to gender, BW, gestational age, or days to full feeds. We conclude that the incidence of hyperphosphatemia was mild and transient in this population. The risk decreased with infant age and was unrelated to gender, BW, or ethnicity. Full article
(This article belongs to the Special Issue Recent Advances in Enteral Nutrition)
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128 KiB  
Article
Development and Evaluation of a Home Enteral Nutrition Team
by Sarah Dinenage, Morwenna Gower, Joanna Van Wyk, Anne Blamey, Karen Ashbolt, Michelle Sutcliffe and Sue M. Green
Nutrients 2015, 7(3), 1607-1617; https://doi.org/10.3390/nu7031607 - 05 Mar 2015
Cited by 28 | Viewed by 8849
Abstract
The organisation of services to support the increasing number of people receiving enteral tube feeding (ETF) at home varies across regions. There is evidence that multi-disciplinary primary care teams focussed on home enteral nutrition (HEN) can provide cost-effective care. This paper describes the [...] Read more.
The organisation of services to support the increasing number of people receiving enteral tube feeding (ETF) at home varies across regions. There is evidence that multi-disciplinary primary care teams focussed on home enteral nutrition (HEN) can provide cost-effective care. This paper describes the development and evaluation of a HEN Team in one UK city. A HEN Team comprising dietetians, nurses and a speech and language therapist was developed with the aim of delivering a quality service for people with gastrostomy tubes living at home. Team objectives were set and an underpinning framework of organisation developed including a care pathway and a schedule of training. Impact on patient outcomes was assessed in a pre-post test evaluation design. Patients and carers reported improved support in managing their ETF. Cost savings were realised through: (1) prevention of hospital admission and related transport for ETF related issues; (2) effective management and reduction of waste of feed and thickener; (3) balloon gastrostomy tube replacement by the HEN Team in the patient’s home, and optimisation of nutritional status. This service evaluation demonstrated that the establishment of a dedicated multi-professional HEN Team focussed on achievement of key objectives improved patient experience and, although calculation of cost savings were estimates, provided evidence of cost-effectiveness. Full article
(This article belongs to the Special Issue Recent Advances in Enteral Nutrition)
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216 KiB  
Article
Fortifier and Cream Improve Fat Delivery in Continuous Enteral Infant Feeding of Breast Milk
by Mika Tabata, Khaled Abdelrahman, Amy B. Hair, Keli M. Hawthorne, Zhensheng Chen and Steven A. Abrams
Nutrients 2015, 7(2), 1174-1183; https://doi.org/10.3390/nu7021174 - 11 Feb 2015
Cited by 18 | Viewed by 9478
Abstract
Premature and high-risk infants require accurate delivery of nutrients to promote appropriate growth. Continuous enteral feeding methods may result in significant fat and micronutrient loss. This study evaluated fat loss in enteral nutrition using current strategies for providing high-risk infants fortified human milk [...] Read more.
Premature and high-risk infants require accurate delivery of nutrients to promote appropriate growth. Continuous enteral feeding methods may result in significant fat and micronutrient loss. This study evaluated fat loss in enteral nutrition using current strategies for providing high-risk infants fortified human milk (HM). The fat content of HM was measured by IR analyzer in a simulated feeding system using the Kangaroo epumpTM and the MedFusionTM 2010 pump. Comparisons in fat loss were made between HM, HM supplemented with donor HM-derived fortifier Prolacta + H2MFTM (H2MF), and HM supplemented with H2MF and donor HM-derived cream ProlactCRTM (cream). When using the Kangaroo epumpTM, the addition of H2MF and cream to HM increased fat delivery efficiency from 75.0% ± 1.2% to 83.7% ± 1.0% (p < 0.0001). When using the MedFusionTM 2010 pump, the addition of H2MF to HM increased fat delivery efficiency from 83.2% ± 2.8% to 88.8% ± 0.8% (p < 0.05), and the addition of H2MF and cream increased fat delivery efficiency to 92.0% ± 0.3% (p < 0.01). The addition of H2MF and cream to HM provides both the benefits of bioactive elements from mother’s milk and increased fat delivery, making the addition of H2MF and cream an appropriate method to improve infant weight gain. Full article
(This article belongs to the Special Issue Recent Advances in Enteral Nutrition)
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Review

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98 KiB  
Review
Enteral Nutrition in Pancreaticoduodenectomy: A Literature Review
by Salvatore Buscemi, Giuseppe Damiano, Vincenzo D. Palumbo, Gabriele Spinelli, Silvia Ficarella, Giulia Lo Monte, Antonio Marrazzo and Attilio I. Lo Monte
Nutrients 2015, 7(5), 3154-3165; https://doi.org/10.3390/nu7053154 - 30 Apr 2015
Cited by 35 | Viewed by 7107
Abstract
Pancreaticoduodenectomy (PD) is considered the gold standard treatment for periampullory carcinomas. This procedure presents 30%–40% of morbidity. Patients who have undergone pancreaticoduodenectomy often present perioperative malnutrition that is worse in the early postoperative days, affects the process of healing, the intestinal barrier function [...] Read more.
Pancreaticoduodenectomy (PD) is considered the gold standard treatment for periampullory carcinomas. This procedure presents 30%–40% of morbidity. Patients who have undergone pancreaticoduodenectomy often present perioperative malnutrition that is worse in the early postoperative days, affects the process of healing, the intestinal barrier function and the number of postoperative complications. Few studies focus on the relation between enteral nutrition (EN) and postoperative complications. Our aim was to perform a review, including only randomized controlled trial meta-analyses or well-designed studies, of evidence regarding the correlation between EN and main complications and outcomes after pancreaticoduodenectomy, as delayed gastric emptying (DGE), postoperative pancreatic fistula (POPF), postpancreatectomy hemorrhage (PPH), length of stay and infectious complications. Several studies, especially randomized controlled trial have shown that EN does not increase the rate of DGE. EN appeared safe and tolerated for patients after PD, even if it did not reveal any advantages in terms of POPF, PPH, length of stay and infectious complications. Full article
(This article belongs to the Special Issue Recent Advances in Enteral Nutrition)
104 KiB  
Review
The Challenges of Home Enteral Tube Feeding: A Global Perspective
by Omorogieva Ojo
Nutrients 2015, 7(4), 2524-2538; https://doi.org/10.3390/nu7042524 - 08 Apr 2015
Cited by 38 | Viewed by 10102
Abstract
The aim of this review is to provide a global perspective of Home Enteral Tube Feeding (HETF) and to outline some of the challenges of home enteral nutrition (HEN) provisions. It is well established that the number of patients on HETF is on [...] Read more.
The aim of this review is to provide a global perspective of Home Enteral Tube Feeding (HETF) and to outline some of the challenges of home enteral nutrition (HEN) provisions. It is well established that the number of patients on HETF is on the increase worldwide due to advances in technology, development of percutaneous endoscopic gastrostomy techniques, and the shift in care provisions from acute to community settings. While the significance of home enteral nutrition in meeting the nutritional requirements of patients with poor swallowing reflexes and those with poor nutritional status is not in doubt, differences exist in terms of funding, standards, management approaches and the level of infrastructural development across the world. Strategies for alleviating some of the challenges militating against the effective delivery of HETF including the development of national and international standards, guidelines and policies for HETF, increased awareness and funding by government at all levels were discussed. Others, including development of HEN services, which should create the enabling environment for multidisciplinary team work, clinical audit and research, recruitment and retention of specialist staff, and improvement in patient outcomes have been outlined. However, more research is required to fully establish the cost effectiveness of the HEN service especially in developing countries and to compare the organization of HEN service between developing and developed countries. Full article
(This article belongs to the Special Issue Recent Advances in Enteral Nutrition)
122 KiB  
Review
Enteral Nutrition in Dementia: A Systematic Review
by Joanne Brooke and Omorogieva Ojo
Nutrients 2015, 7(4), 2456-2468; https://doi.org/10.3390/nu7042456 - 03 Apr 2015
Cited by 40 | Viewed by 19114
Abstract
The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact [...] Read more.
The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life. Full article
(This article belongs to the Special Issue Recent Advances in Enteral Nutrition)
107 KiB  
Review
Enteral Nutrition Support to Treat Malnutrition in Inflammatory Bowel Disease
by Roberta Altomare, Giuseppe Damiano, Alida Abruzzo, Vincenzo Davide Palumbo, Giovanni Tomasello, Salvatore Buscemi and Attilio Ignazio Lo Monte
Nutrients 2015, 7(4), 2125-2133; https://doi.org/10.3390/nu7042125 - 25 Mar 2015
Cited by 31 | Viewed by 8851
Abstract
Malnutrition is a common consequence of inflammatory bowel disease (IBD). Diet has an important role in the management of IBD, as it prevents and corrects malnutrition. It is well known that diet may be implicated in the aetiology of IBD and that it [...] Read more.
Malnutrition is a common consequence of inflammatory bowel disease (IBD). Diet has an important role in the management of IBD, as it prevents and corrects malnutrition. It is well known that diet may be implicated in the aetiology of IBD and that it plays a central role in the pathogenesis of gastrointestinal-tract disease. Often oral nutrition alone is not sufficient in the management of IBD patients, especially in children or the elderly, and must be combined with oral supplementation or replaced with tube enteral nutrition. In this review, we describe several different approaches to enteral nutrition—total parenteral, oral supplementation and enteral tube feeding—in terms of results, patients compliance, risks and and benefits. We also focus on the home entaral nutrition strategy as the future goal for treating IBD while focusing on patient wellness. Full article
(This article belongs to the Special Issue Recent Advances in Enteral Nutrition)
170 KiB  
Review
Guidelines for Feeding Very Low Birth Weight Infants
by Sourabh Dutta, Balpreet Singh, Lorraine Chessell, Jennifer Wilson, Marianne Janes, Kimberley McDonald, Shaneela Shahid, Victoria A. Gardner, Aune Hjartarson, Margaret Purcha, Jennifer Watson, Chris De Boer, Barbara Gaal and Christoph Fusch
Nutrients 2015, 7(1), 423-442; https://doi.org/10.3390/nu7010423 - 08 Jan 2015
Cited by 221 | Viewed by 27236
Abstract
Despite the fact that feeding a very low birth weight (VLBW) neonate is a fundamental and inevitable part of its management, this is a field which is beset with controversies. Optimal nutrition improves growth and neurological outcomes, and reduces the incidence of sepsis [...] Read more.
Despite the fact that feeding a very low birth weight (VLBW) neonate is a fundamental and inevitable part of its management, this is a field which is beset with controversies. Optimal nutrition improves growth and neurological outcomes, and reduces the incidence of sepsis and possibly even retinopathy of prematurity. There is a great deal of heterogeneity of practice among neonatologists and pediatricians regarding feeding VLBW infants. A working group on feeding guidelines for VLBW infants was constituted in McMaster University, Canada. The group listed a number of important questions that had to be answered with respect to feeding VLBW infants, systematically reviewed the literature, critically appraised the level of evidence, and generated a comprehensive set of guidelines. These guidelines form the basis of this state-of-art review. The review touches upon trophic feeding, nutritional feeding, fortification, feeding in special circumstances, assessment of feed tolerance, and management of gastric residuals, gastro-esophageal reflux, and glycerin enemas. Full article
(This article belongs to the Special Issue Recent Advances in Enteral Nutrition)
148 KiB  
Review
Nutritional Interventions in Head and Neck Cancer Patients Undergoing Chemoradiotherapy: A Narrative Review
by Maurizio Bossola
Nutrients 2015, 7(1), 265-276; https://doi.org/10.3390/nu7010265 - 05 Jan 2015
Cited by 111 | Viewed by 15937
Abstract
The present review aimed to define the role of nutritional interventions in the prevention and treatment of malnutrition in HNC patients undergoing CRT as well as their impact on CRT-related toxicity and survival. Head and neck cancer patients are frequently malnourished at the [...] Read more.
The present review aimed to define the role of nutritional interventions in the prevention and treatment of malnutrition in HNC patients undergoing CRT as well as their impact on CRT-related toxicity and survival. Head and neck cancer patients are frequently malnourished at the time of diagnosis and prior to the beginning of treatment. In addition, chemo-radiotherapy (CRT) causes or exacerbates symptoms, such as alteration or loss of taste, mucositis, xerostomia, fatigue, nausea and vomiting, with consequent worsening of malnutrition. Nutritional counseling (NC) and oral nutritional supplements (ONS) should be used to increase dietary intake and to prevent therapy-associated weight loss and interruption of radiation therapy. If obstructing cancer and/or mucositis interfere with swallowing, enteral nutrition should be delivered by tube. However, it seems that there is not sufficient evidence to determine the optimal method of enteral feeding. Prophylactic feeding through nasogastric tube or percutaneous gastrostomy to prevent weight loss, reduce dehydration and hospitalizations, and avoid treatment breaks has become relatively common. Compared to reactive feeding (patients are supported with oral nutritional supplements and when it is impossible to maintain nutritional requirements enteral feeding via a NGT or PEG is started), prophylactic feeding does not offer advantages in terms of nutritional outcomes, interruptions of radiotherapy and survival. Overall, it seems that further adequate prospective, randomized studies are needed to define the better nutritional intervention in head and neck cancer patients undergoing chemoradiotherapy. Full article
(This article belongs to the Special Issue Recent Advances in Enteral Nutrition)
175 KiB  
Review
Microbiome Associations of Therapeutic Enteral Nutrition
by Rajesh Shah and Richard Kellermayer
Nutrients 2014, 6(11), 5298-5311; https://doi.org/10.3390/nu6115298 - 21 Nov 2014
Cited by 13 | Viewed by 8296
Abstract
One of the most effective forms of therapeutic enteral nutrition is designated as “exclusive enteral nutrition” (EEN). EEN constitutes the monotonous enteral delivery of complete liquid nutrition and has been most explored in the treatment Crohn’s disease (CD), a form of inflammatory bowel [...] Read more.
One of the most effective forms of therapeutic enteral nutrition is designated as “exclusive enteral nutrition” (EEN). EEN constitutes the monotonous enteral delivery of complete liquid nutrition and has been most explored in the treatment Crohn’s disease (CD), a form of inflammatory bowel disease. While EEN’s mechanisms of action are not clearly understood, it has been shown to modify the composition of the intestinal microbiome, an important component of CD pathogenesis. The current literature on the intestinal microbiome in healthy individuals and CD patients is reviewed with respect to EEN therapy. Further investigations in this field are needed to better understand the role and potential for EEN in chronic human disorders. Full article
(This article belongs to the Special Issue Recent Advances in Enteral Nutrition)
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128 KiB  
Review
Evaluation of the Role of Enteral Nutrition in Managing Patients with Diabetes: A Systematic Review
by Omorogieva Ojo and Joanne Brooke
Nutrients 2014, 6(11), 5142-5152; https://doi.org/10.3390/nu6115142 - 18 Nov 2014
Cited by 47 | Viewed by 10589
Abstract
The aim of this systematic review is to evaluate the role of enteral nutrition in managing patients with diabetes on enteral feed. The prevalence of diabetes is on the increase in the UK and globally partly due to lack of physical activities, poor [...] Read more.
The aim of this systematic review is to evaluate the role of enteral nutrition in managing patients with diabetes on enteral feed. The prevalence of diabetes is on the increase in the UK and globally partly due to lack of physical activities, poor dietary regimes and genetic susceptibility. The development of diabetes often leads to complications such as stroke, which may require enteral nutritional support. The provision of enteral feeds comes with its complications including hyperglycaemia which if not managed can have profound consequences for the patients in terms of clinical outcomes. Therefore, it is essential to develop strategies for managing patients with diabetes on enteral feed with respect to the type and composition of the feed. This is a systematic review of published peer reviewed articles. EBSCOhost Research, PubMed and SwetsWise databases were searched. Reference lists of identified articles were reviewed. Randomised controlled trials comparing enteral nutrition diabetes specific formulas with standard formulas were included. The studies which compared diabetes specific formulas (DSF) with standard formulas showed that DSF was more effective in controlling glucose profiles including postprandial glucose, HbA1c and insulinemic response. The use of DSF appears to be effective in managing patients with diabetes on enteral feed compared with standard feed. Full article
(This article belongs to the Special Issue Recent Advances in Enteral Nutrition)
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