Showing papers by "Claude Pichard published in 2003"
TL;DR: BMI alone cannot provide information about the respective contribution of FFM or fat mass to body weight, so FFMI and BFMI values that correspond to low, normal, overweight, and obese BMIs are presented.
382 citations
TL;DR: BIA permits the prediction of ASMM in healthy volunteers and patients between 22 and 94 years of age and a slightly larger, though clinically not significant, error was noted in patients.
169 citations
TL;DR: It is found that in the acute stage of critical illness, the bi-weekly measurement of transthyretin together with acute-phase response protein plasma levels seems to be a ‘window’ on the metabolic condition (anabolism versus catabolism).
Abstract: Purpose of reviewThis review analyses the recently published literature focusing on nutritional assessment in intensive care unit patients. The metabolic response to nutritional intervention is difficult to evaluate in critically ill patients whose body weight is influenced largely by massive fluid
132 citations
TL;DR: The assessment of fat‐free mass and body fat provides valuable information about changes in body composition with weight gain or loss and physical activity, and during ageing.
Abstract: Purpose of reviewThis review presents the latest clinical applications of bioelectrical impedance analysis. It discusses the evaluation of nutritional status by using fat-free mass and body fat, percentiles of fat-free mass and body fat, height-normalized fat-free mass and body fat mass indices and
128 citations
TL;DR: Geneva and Berlin patients had lower FFM and higher BF than age-and height-matched volunteers and a higher prevalence of low FFm and high BF.
119 citations
TL;DR: The study on single effects of nutrients on the individual's phenotype as well as the serial analyses of gene expression patterns in response to specific nutrients will help to understand how metabolic homeostasis is maintained.
43 citations
TL;DR: The three QUS technologies tested against hip fractures seem to show the same discriminatory ability, however, there are some differences in the definition of the diagnostic threshold underlying the nonusability of the World Health Organization (WHO) osteoporosis definition.
41 citations
TL;DR: The results suggest that despite posttransplant infections and grafts rejection, LTR permits FFM recovery, and two-thirds reached normal levels of FFM by year 2.
Abstract: Both undernutrition and overnutrition can affect the quality of life and survival of patients with pulmonary disease and lead to quantitative and functional alterations of fat-free mass (FFM). This longitudinal study determines the changes in weight, FFM, and body fat before and up to 4 years after lung transplant (LTR).
36 citations
TL;DR: Recent studies indicate that genotypic factors may influence the effectiveness of such immunonutrients as anti-oxidants and n-3 polyunsaturated fatty acids, which will help in the targeting of nutritional therapy.
33 citations
TL;DR: The prevalence of low FFMI was high prior to and remained important 2 years after LTR, whereas BFMI was lower Prior to and higher 2 yearsafter LTR; and very high BFMI increased and was higher in patients than VOL after L TR.
Abstract: The aim of this study was to determine the prevalence of
low fat-free mass index (FFMI) and high and very high body fat
mass index (BFMI) after lung transplantation (LTR). A total of
37 LTR patients were assessed prior to and at 1 month, 1 year
and 2 years for FFM and compared to 37 matched volunteers (VOL).
FFM was calculated by the Geneva equation and normalized for
height (kg/m2). Subjects were
classified as FFMI “low”, ≤17.4 in men and ≤15.0 in women; BFMI
”high”, 5.2–8.1 in men and 8.3–11.7 in women; or “very high”
>8.2 kg/m2 in men and >11.8
kg/m2 in women. In 23 M/14 F, body
mass index (BMI) was 22.3±4.4 and 20.1±4.9
kg/m2, respectively. The prevalence
of low FFMI was 80% at 1 month and 33% at 2 years after LTR.
Prevalence of very high BFMI increased and was higher in
patients than VOL after LTR. The prevalence of low FFMI was high
prior to and remained important 2 years after LTR, whereas BFMI
was lower prior to and higher 2 years after LTR.
20 citations
TL;DR: It is surprised and perturbed that the authors have missed some important issues regarding the nutrition of patients in intensive care units (ICUs), exchanging sensationalism for sound scientific discussion.
Abstract: “Death by parenteral nutrition” was the title of the controversial editorial published in the June issue of Intensive Care Medicine by P.E. Marik and M. Pinsky [1]. One might believe that a real event was being described by the authors. Imagine our astonishment, which quickly turned to dismay, when we read the words: “…a poison or toxin is a substance that through its chemical action usually kills, injures or impairs an organism… and by this definition TPN meets all criteria of a poison/toxin, in the critically ill patient receiving parenteral nutrition.” We are surprised and perturbed that the authors have missed some important issues regarding the nutrition of patients in intensive care units (ICUs), exchanging sensationalism for sound scientific discussion.
TL;DR: Eight papers in which the focus is on one half of the anabolic–catabolic homeostatic equation, namely catabolism are presented, which summarizes the approximate energy stores in the hypothetical 70 kg man and in a 100 kg obese and a 50 kg cachectic individual.
Abstract: In this issue of Current Opinion in Clinical Nutrition and Metabolic Care we present eight papers in which the focus is on one half of the anabolic–catabolic homeostatic equation, namely catabolism. In its simplest physiological definition it is the phase of metabolism in which complex compounds break down into simpler compounds. In this context it refers to the orderly breakdown of ‘ingested nutrients’ to produce energy as heat, energy stored as adenosine triphosphate in glycogen and fat, as well as the production of precursors for anabolism to maintain the integrity of the fat-free mass: the oxygen-utilizing, potassium-rich muscle mass [1]. Table 1, in which data are abstracted from a number of different studies [2,3], summarizes the approximate energy stores in the hypothetical 70 kg man and in a 100 kg obese and a 50 kg cachectic individual.
TL;DR: SBTX improved the nutritional state and growth of the graft recipient although body composition, femoral bone mineral densities, and intestinal absorption had not completely normalised after four years.
Abstract: While small bowel transplantation (SBTX) may allow parenteral nutrition independence in the case of short bowel syndrome, its effects on body composition and growth are unclear. For the first time, a paediatric living related SBTX was performed between monozygotic twins. This case report describes their four year nutritional follow up. The 13 year old recipient and his healthy brother underwent measurements of body composition by 50 kHz bioimpedance analysis and bone mineral density of the femoral neck and total femur by dual energy x ray absorptiometry. Xylose tests and measurements of faecal fat evaluated gut absorption. All tests were performed before and after SBTX. Body weight increased from 34.7 to 51.9 kg in the recipient and from 45.0 to 53.2 kg in the donor within four years. The recipient caught up with the height and fat free mass of his brother within two years. Fat mass, and total femur and femoral neck densities are still lower in the recipient than in the donor four years after SBTX (-1.2 kg, -0.087 g/cm(2), -0.035 g/cm(2)). The xylose test of the recipient was still abnormally low after four years (1.37 mmol/l) and faecal fat was high until two years after SBTX (March 2001: 12 g/24 h). The donor always showed normal xylose tests and faecal fat, except for one episode of high faecal fatty acids about 10 months after SBTX. SBTX improved the nutritional state and growth of the graft recipient although body composition, femoral bone mineral densities, and intestinal absorption had not completely normalised after four years.
TL;DR: Refeeding in underweight LTR patients is geared to normalizing depleted FFM, whereas later FFM gains were similar toFFM gains in normal and overweight subjects, which resulted in a larger ratio ΔFFM:ΔBW in thin subjects versus normal and obese subjects.
Abstract: Malnutrition occurs frequently prior to lung transplantation (LTR), but patients gain weight after LTR. The study aimed to determine the ratio changes of fat-free mass (AFFM): changes of body weight (ABW) during refeeding. A total of 37 LTR patients were measured for weight and FFM and body fat by bioimpedance analysis at 1 month post-LTR, then annually for 3 years. Linear regressions determined the ratio ΔFFM:ΔBW during refeeding. ΔFFM was: year-1=1.822+0.389* ΔBW, r 2 =0.397; yr-2=0.611+0.246* ΔBW, r 2 =0.441; yr-3=-0.17+0.208 * ΔBW, r 2 =0.319. Refeeding during year-1 in thin subjects resulted in a ratio ΔFFM:ΔBW of 0.389, whereas the change in ratio ΔFFM:ΔBW during year-2 and 3 was 0.246 and 0.208, respectively. Refeeding resulted in a larger ratio ΔFFM:ΔBW in thin subjects versus normal and overweight subjects. Thus, refeeding in underweight LTR patients is geared to normalizing depleted FFM, whereas later FFM gains were similar to FFM gains in normal and overweight subjects.
TL;DR: This review aims to assess the reliability of BIA to detect protein-calorie malnutrition at hospital admission or during nutritional follow-up of patients.
Abstract: Resume La prevalence de la malnutrition hospitaliere est elevee et tend a se pejorer au cours de l'hospitalisation. En l'absence d'une methode fiable et applicable a toutes les situations cliniques, l'evaluation de l'etat nutritionnel repose sur une approche globale, dont fait partie l'analyse de la composition corporelle par bio-impedance electrique (BIA). Cette methode permet d'evaluer la masse non grasse, la masse grasse et l'eau corporelle, afin de depister une malnutrition, un etat de sur-hydratation ou sous-hydratation, et d'adapter l'intervention nutritionnelle. La precision de la BIA repose sur l'utilisation d'equations de prediction comprenant plusieurs parametres (poids, taille, sexe, âge, ethnie, etc.) permettant de reduire les variations d'impedance entre individus et d'etre specifiques aux populations etudiees. La BIA est neanmoins imprecise lors de distribution anormale des compartiments corporels (ascite, dialyse, lypodystrophie, etc.) ou de corpulence extreme (obesite, cachexie). Le developpement de mesures de BIA a frequences multiples ou segmentaire vise a preciser les variations hydriques et geometriques. Ces techniques sont encore a valider. La BIA ayant ses limites, cette revue evalue dans quelle mesure elle peut etre utilisee dans le depistage de la malnutrition proteinocalorique a l’admission a l’hopital ou lors de suivi nutritionnel.
Journal Article•
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TL;DR: Pourrait-on imaginer que, dans un proche avenir, the prevention and le traitement of certaines pathologies puissent se faire par le biais de l'alimentation.
Abstract: La comprehension du role des nutriments dans la stabilisation, la reparation de l'ADN et les differentes etapes de l'expression des genes est devenue l'un des secteurs de recherche prioritaires dans le domaine de la nutrition. Pour cela, il faut necessairement integrer les resultats de deux approches complementaires et d' egale importance : l'etude de l'effet des nutriments sur le phenotype individuel et l'analyse en serie de l'expression des genes en reponse a des nutriments specifiques qui vont nous aider a comprendre comment l'organisme peut maintenir son homeostase metabolique. Si on considere que les nutriments peuvent moduler l'expression de proteines deleteres ou protectrices pour la cellule, le concept d'une alimentation-medication pourrait alors etre developpe. De plus, certaines vitamines semblent avoir des effects protecteurs sur l'ADN et stabilisateurs sur le genome. Ainsi pourrait-on imaginer que, dans un proche avenir, la prevention et le traitement de certaines pathologies puissent se faire par le biais de l'alimentation. Dans cette revue, nous aborderons les connaissances actuelles dans le domaine de la genetique de la nutrition.
Journal Article•
TL;DR: The different methods available for predicting and measuring energy expenditure are looked at and particular cases encountered (intensive care unit, anorexia and severe obesity, geriatrics, HIV infection, etc) will also be discussed.
Abstract: A patient's nutritional support is a critical part of his general health care scheme. It aims to prevent or correct malnutrition, reduce morbidity, length of hospital stay and treatment costs. It equally optimises the patient's convalescence and quality of life. An optimal support requires the nutritional evaluation of the patient which includes determination of the energy expenditure. Once the energy needs have been evaluated, the clinician is then able to treat any nutritional deficiencies. This article therefore looks at the different methods available for predicting and measuring energy expenditure. The clinical limitations of these techniques and particular cases encountered (intensive care unit, anorexia and severe obesity, geriatrics, HIV infection, etc) will also be discussed.
Journal Article•
TL;DR: This article summarizes the recommendation of the Europe Council regarding the nutritional evaluation and treatment of patients and finds that a large portion of hospital food is not consumed by the patients but is wasted.
Abstract: Malnutrition is very frequent in hospitalized patients, particularly if they are elderly and suffer of chronic diseases. Many studies show the correlation between the degree of malnutrition and the frequency of complications, the length of hospital stay and the rate of mortality. However, despite the rising interest of scientists for the role of nutrition in the pathogenesis of the diseases, little attention is devoted to the nutritional status of patients. This article reviews the recent literature regarding hospital malnutrition. At hospital admission, 30 to 40% of patients presents a certain degree of malnutrition. However, only a small percentage is recognized to be malnourished and receive an adequate treatment. The reason for this attitude of medical and paramedical teams seems to be a low priority assigned to nutrition. In addition, they seem to lack the most basic knowledge regarding the metabolic needs of their patients. Another finding, reported by several surveys, is that a large portion of hospital food is not consumed by the patients but is wasted. In fact, meals are not sufficiently-adapted to the taste and the appetite of those for whom they are prepared. This article summarizes the recommendation of the Europe Council regarding the nutritional evaluation and treatment of patients.