BACKGROUND Type 2 diabetes(T2D)is a major health concern globally and its prevalence is expected to continue to escalate.Lifestyle intervention is an integral part of T2D management.Meal replacements are often used as...BACKGROUND Type 2 diabetes(T2D)is a major health concern globally and its prevalence is expected to continue to escalate.Lifestyle intervention is an integral part of T2D management.Meal replacements are often used as part of lifestyle intervention programs in T2D and weight management programs.There are various trials being carried out to date;however,a thorough review regarding the usage of meal replacement on its types,dosage and associated outcomes and adverse events is still lacking.AIM To provide a comprehensive overview on existing studies regarding meal replacement usage among patients with T2D,and map out glycemic and weightrelated outcomes along with adverse effects incidences.METHODS This scoping review is conducted based on Arksey and O’Malley’s seminal framework for scoping reviews.A systematic search has been done for studies published between January 2020 and January 2024 across six online databases(Cochrane Library,PubMed,Science Direct,Scopus,Web of Science and Ebscohost Discovery)using specific keywords.Two researchers independently assessed the eligibility of the studies and extracted the data.The selected articles and extracted data were reviewed by all researchers.RESULTS The initial search resulted in an initial count of 53922 articles from which 133 articles were included in this review after eligibility screening.Included studies were categorized based on meal replacement type into low calorie/energy,low glycemic index,protein-rich,low-fat,diabetes-specific formulas,and combined lifestyle intervention programs.Fifty-nine studies reported improvements on hemoglobin A1c,and 70 studies reported positive changes in weight or BMI after the meal replacement intervention.The combination of meal replacements with education,counseling or structured lifestyle interventions has proved to be effective.Only 13 studies reported occurrence of adverse events related to the intervention.Most of the reported incidents were of mild occurrences with constipation being the most reported adverse event.CONCLUSION The results suggest that meal replacements,especially when combined with lifestyle intervention programs and counseling,are an effective and safe strategy in glycemic and weight management among patients with T2D.展开更多
Background and Objectives:Bariatric surgery becomes the final option for managing severe obesity.This study aims to identify the complications,changes in anthropometry,adherence to dietary recommendations,and psycholo...Background and Objectives:Bariatric surgery becomes the final option for managing severe obesity.This study aims to identify the complications,changes in anthropometry,adherence to dietary recommendations,and psychological well-being of post-bariatric surgery patients.Methods and Study Design:An observational study was conducted on 63 post-bariatric surgery patients who had undergone bariatric surgery between two weeks and five years after surgery.The participants were assessed for the complications experienced,current comorbidities,anthropometric changes,dietary intake,and psychological well-being.A three-day,24-hour diet recall was done to assess the dietary intake of the patients.The mean macronutrient and micronutrient intakes were compared to several available recommendations.The DASS-21 questionnaire was administered to determine the psychological well-being of the participants.Results:The most common complications experienced by patients after bariatric surgery were hair loss(50.8%),gastroesophageal reflux disease(GERD)(49.2%),and vomiting(41.3%).There were significant differences in mean weight before(129.5(33.0)kg/m2)and after(85.0(32.0)kg/m2)bariatric surgery(p<0.001).The prevalence of clinically severe obesity declined by 55%.Overall,patients had insufficient intake of some nutrients such as protein,fat,calcium,and iron.Majority of the patients experienced a normal level of stress,anxiety,and depression,but some had mild(3.2%),moderate(4.8%),and severe anxiety(1.6%).Conclusions:There were drastic improvements in patients’weight following bariatric surgery.However,there were several complications including nutrient deficiencies.Due to the anatomical changes in the gastrointestinal tract,patients must comply with the dietary and lifestyle changes and follow up with the healthcare professional.A nutrition module will be helpful for patients to prepare for and adapt to the changes after bariatric surgery.展开更多
Importance:During the coronavirus disease 2019(COVID-19)lockdown,changes in the visiting rules in neonatal units might have affected the initiation and continuation of breastfeeding.Objective:To investigate the effect...Importance:During the coronavirus disease 2019(COVID-19)lockdown,changes in the visiting rules in neonatal units might have affected the initiation and continuation of breastfeeding.Objective:To investigate the effects of the implementation of the COVID-19 lockdown in the UK on mother’s own milk(MOM)feeding in hospital and at the time of discharge in two UK neonatal units.Methods:Retrospective cohort study using routinely recorded data from electronic patient records.Data were retrieved from two neonatal services in the UK East Midlands region.Adjusted logistic regression was used to compare the odds of MOM feeding before,and after the implementation of the UK lockdown.Results:Among 2073 infants,after adjusting for maternal and infant characteristics and underlying trends over time,there were no differences in the odds of infants receiving any MOM during admission;any MOM at discharge or exclusive MOM at discharge before and after the imposition of the lockdown.Infants with birthweight<1000 g were three times less likely to receive any MOM at discharge compared to those with birthweight>2500 g(adjusted odds ratio[OR]0.33,95%confidence interval[CI]:0.22–0.50).Younger mothers were less likely,and Black British mothers more likely,to be feeding MOM to their infants at discharge,while women in the least deprived Index of Multiple Deprivation(IMD)quintiles were 2–4 times more likely to do so,compared to those in the most deprived IMD quintile(adjusted OR 2.78,95%CI:1.97–3.90).Interpretation:Despite the difficulties faced during COVID-19 pandemic-induced restrictions,infants in the participating neonatal units continued to receive MOM in similar proportions as before the pandemic.展开更多
文摘BACKGROUND Type 2 diabetes(T2D)is a major health concern globally and its prevalence is expected to continue to escalate.Lifestyle intervention is an integral part of T2D management.Meal replacements are often used as part of lifestyle intervention programs in T2D and weight management programs.There are various trials being carried out to date;however,a thorough review regarding the usage of meal replacement on its types,dosage and associated outcomes and adverse events is still lacking.AIM To provide a comprehensive overview on existing studies regarding meal replacement usage among patients with T2D,and map out glycemic and weightrelated outcomes along with adverse effects incidences.METHODS This scoping review is conducted based on Arksey and O’Malley’s seminal framework for scoping reviews.A systematic search has been done for studies published between January 2020 and January 2024 across six online databases(Cochrane Library,PubMed,Science Direct,Scopus,Web of Science and Ebscohost Discovery)using specific keywords.Two researchers independently assessed the eligibility of the studies and extracted the data.The selected articles and extracted data were reviewed by all researchers.RESULTS The initial search resulted in an initial count of 53922 articles from which 133 articles were included in this review after eligibility screening.Included studies were categorized based on meal replacement type into low calorie/energy,low glycemic index,protein-rich,low-fat,diabetes-specific formulas,and combined lifestyle intervention programs.Fifty-nine studies reported improvements on hemoglobin A1c,and 70 studies reported positive changes in weight or BMI after the meal replacement intervention.The combination of meal replacements with education,counseling or structured lifestyle interventions has proved to be effective.Only 13 studies reported occurrence of adverse events related to the intervention.Most of the reported incidents were of mild occurrences with constipation being the most reported adverse event.CONCLUSION The results suggest that meal replacements,especially when combined with lifestyle intervention programs and counseling,are an effective and safe strategy in glycemic and weight management among patients with T2D.
文摘Background and Objectives:Bariatric surgery becomes the final option for managing severe obesity.This study aims to identify the complications,changes in anthropometry,adherence to dietary recommendations,and psychological well-being of post-bariatric surgery patients.Methods and Study Design:An observational study was conducted on 63 post-bariatric surgery patients who had undergone bariatric surgery between two weeks and five years after surgery.The participants were assessed for the complications experienced,current comorbidities,anthropometric changes,dietary intake,and psychological well-being.A three-day,24-hour diet recall was done to assess the dietary intake of the patients.The mean macronutrient and micronutrient intakes were compared to several available recommendations.The DASS-21 questionnaire was administered to determine the psychological well-being of the participants.Results:The most common complications experienced by patients after bariatric surgery were hair loss(50.8%),gastroesophageal reflux disease(GERD)(49.2%),and vomiting(41.3%).There were significant differences in mean weight before(129.5(33.0)kg/m2)and after(85.0(32.0)kg/m2)bariatric surgery(p<0.001).The prevalence of clinically severe obesity declined by 55%.Overall,patients had insufficient intake of some nutrients such as protein,fat,calcium,and iron.Majority of the patients experienced a normal level of stress,anxiety,and depression,but some had mild(3.2%),moderate(4.8%),and severe anxiety(1.6%).Conclusions:There were drastic improvements in patients’weight following bariatric surgery.However,there were several complications including nutrient deficiencies.Due to the anatomical changes in the gastrointestinal tract,patients must comply with the dietary and lifestyle changes and follow up with the healthcare professional.A nutrition module will be helpful for patients to prepare for and adapt to the changes after bariatric surgery.
文摘Importance:During the coronavirus disease 2019(COVID-19)lockdown,changes in the visiting rules in neonatal units might have affected the initiation and continuation of breastfeeding.Objective:To investigate the effects of the implementation of the COVID-19 lockdown in the UK on mother’s own milk(MOM)feeding in hospital and at the time of discharge in two UK neonatal units.Methods:Retrospective cohort study using routinely recorded data from electronic patient records.Data were retrieved from two neonatal services in the UK East Midlands region.Adjusted logistic regression was used to compare the odds of MOM feeding before,and after the implementation of the UK lockdown.Results:Among 2073 infants,after adjusting for maternal and infant characteristics and underlying trends over time,there were no differences in the odds of infants receiving any MOM during admission;any MOM at discharge or exclusive MOM at discharge before and after the imposition of the lockdown.Infants with birthweight<1000 g were three times less likely to receive any MOM at discharge compared to those with birthweight>2500 g(adjusted odds ratio[OR]0.33,95%confidence interval[CI]:0.22–0.50).Younger mothers were less likely,and Black British mothers more likely,to be feeding MOM to their infants at discharge,while women in the least deprived Index of Multiple Deprivation(IMD)quintiles were 2–4 times more likely to do so,compared to those in the most deprived IMD quintile(adjusted OR 2.78,95%CI:1.97–3.90).Interpretation:Despite the difficulties faced during COVID-19 pandemic-induced restrictions,infants in the participating neonatal units continued to receive MOM in similar proportions as before the pandemic.
