Global nutrition epidemiology and trends.

2012 

Bhutta ZA, Salam RA.

Source

Division of Women and Child Health, Aga Khan University, Karachi, Pakistan.

Abstract

In the year 2011, 6.9 million children under the age of 5 years died worldwide, one third of them related to increased susceptibility to illnesses due to under nutrition. An estimated 178 million children under 5 years are stunted, 55 million are wasted, and 19 million of these are severely affected and are at a higher risk of premature death, the vast majority being from sub-Saharan Africa and South-Central Asia. Globally, over 2 billion people are at risk for vitamin A, iodine, and/or irondeficiency. Other micronutrient deficiencies of public health concern include zinc, folate, and the B vitamins. 

The risk factors for undernutrition include low birth weight, inadequate breastfeeding, improper complementary feeding, and recurrent infections. Infectious diseases often coexist with micronutrient deficiencies and exhibit complex interactions leading to the vicious cycle of malnutrition and infections. Diarrhea along with the poor selection and intake of complementary food are the major contributors to undernutrition. 

Possible strategies to combat malnutrition include promotion of breastfeeding, dietary supplementation of micronutrients, prevention of protein-energy malnutrition, and improvement in the standard of preparation and hygiene of available weaning foods. The universal coverage with the full package of these proven interventions at observed levels of program effectiveness could prevent about one quarter of child deaths under 36 months of age and reduce the prevalence of stunting at 36 months by about one third. 

The median coverage rate of interventions along the continuum of care for Countdown countries has however beenlesws then 80 percent for vaccination and vitamin A supplementation. However, for several interventions, including early initiation and exclusive breastfeeding below 6 months of age and case management of childhood illnesses, the median coverage rate hovers at or below fifty percent. This suggests that interventions requiring strong health systems or behavior change appear to be stalled and need to be re-examined to find more effective ways of delivery.

Karger

Nutrition in Wound Healing

Nutrition in Wound Healing

During wound healing, as during all illnesses, it is important to provide the body with adequate nutrients and calories. It is suggested that a person needs 30-35 calories/kg/day, 1.25-2 grams protein/kg/day and vitamins. (12) These include a multi-vitamin, vitamin C for collagen (a component of skin) formation, vitamin A for increased cell development, and zinc for wound healing. (12) Zinc will also correct yellow nail syndrome associated with chronic lymphedema.

It should be noted that patients with lymphedema are encouraged to eat enough food and supplemental protein. While the thought may be that decreasing protein intake will decrease the high protein levels in lymph fluid, and thus decrease lymphedema, this is not true. Rather, too little protein may weaken connective tissue and worsen the lymphedema condition. Easily digestible protein, such as chicken, fish and tofu, is advised. (11)

A balanced healthy diet that includes whole grains, fruits and vegetables and fish not only promotes optimal weight, but makes you feel good. Furthermore, a healthy diet can maintain the body's immune system, which will help prevent and treat infections. It is advised to restrict fatty foods or those with high cholesterol, to increase low sodium/high fiber foods, to avoid excessive alcohol and to avoid smoking.

In her article, Living with Lymphedema, Dr. Sabrina S. Selim presents a paragraph on nutrition.

“During wound healing, as during all illnesses, it is important to provide the body with adequate nutrients and calories. It is suggested that a person needs 30-35 calories/kg/day, 1.25-2 grams protein/kg/day and vitamins. (12) These include a multi-vitamin, vitamin C for collagen (a component of skin) formation, vitamin A for increased cell development, and zinc for wound healing. (12) Zinc will also correct yellow nail syndrome associated with chronic lymphedema.

It should be noted that patients with lymphedema are encouraged to eat enough food and supplemental protein. While the thought may be that decreasing protein intake will decrease the high protein levels in lymph fluid, and thus decrease lymphedema, this is not true. Rather, too little protein may weaken connective tissue and worsen the lymphedema condition. Easily digestible protein, such as chicken, fish and tofu, is advised. (11)

A balanced healthy diet that includes whole grains, fruits and vegetables and fish not only promotes optimal weight, but makes you feel good. Furthermore, a healthy diet can maintain the body's immune system, which will help prevent and treat infections. It is advised to restrict fatty foods or those with high cholesterol, to increase low sodium/high fiber foods, to avoid excessive alcohol and to avoid smoking.” See: Living with Lymphedema

See also:

Understanding the role of nutrition and wound healing.

Feb. 2010

Stechmiller JK.

Source

University of Florida College of Nursing, Health Professions, Nursing and Pharmacy Complex, Office 3222, PO Box 100187, Gainesville, FL 32610-0187, USA. stechjk@ufl.edu

Abstract

Optimal wound healing requires adequate nutrition. Nutrition deficiencies impede the normal processes that allow progression through stages of wound healing. Malnutrition has also been related to decreased wound tensile strength and increased infection rates. Malnourished patients can develop pressure ulcers, infections, and delayed wound healing that result in chronic nonhealing wounds. Chronic wounds are a significant cause of morbidity and mortality for many patients and therefore constitute a serious clinical concern.

Because most patients with chronic skin ulcers suffer micronutrientstatus alterations and malnutrition to some degree, current nutrition therapies are aimed at correcting nutrition deficiencies responsible for delayed wound healing. This review provides current information on nutrition management for simple acute wounds and complex nonhealing wounds and offers some insights into innovative future treatments. SAGE Journal

and

Nutritional supplements in critical illness.

Dec 2911

Hayes GL, McKinzie BP, Bullington WM, Cooper TB, Pilch NA.

Source

Medical University of South Carolina, Charleston, SC 29425, USA. luehrs@musc.edu

Abstract

Poor nutritional intake during critical illness can contribute to increased morbidity and mortality. Although nutrition strategies for critically ill patients attempt to provide essential macronutrients, recent evidence suggests that certain micronutrients and supplements may improve wound healing and decrease infectious and inflammatory complications. This review will focus on mechanism of action, adverse effects and drug interactions reported in the literature, and appropriate dosing and outcomes data for specific nutritional supplements in various critically ill adult populations. Advanced Critical Care