Miller LJ, Douglas C, McCullough FS, Stanworth SJ, Calder PC. Clin Nutr. 2022 Oct;41(10):2135-2146. doi: 10.1016/j.clnu.2022.07.039. Epub 2022 Aug 10. PMID: 36067585.

There is increasing awareness of the importance of nutritional support in cancer treatment including the interaction with immunity. Immunonutrition is the provision of one or more nutrients (e.g. Vitamins A, D, or E, omega-3 fatty acids, arginine and glutamine) known to modulate immune function when given at levels above those normally encountered in the diet in order to support immune system function or modulate its activity, including control of inflammation. We reviewed the role of oral or enteral immunonutrition versus standard nutrition on infection and infection-related biomarkers in adult cancer patients undergoing chemotherapy.

Prado CM, Landi F, Chew STH, Atherton PJ, Molinger J, Ruck T, Gonzalez MC. Clin Nutr. 2022 Oct;41(10):2244-2263. doi: 10.1016/j.clnu.2022.07.041. Epub 2022 Aug 7. PMID: 36081299.

Low muscle mass and malnutrition are prevalent conditions among adults of all ages, with any body weight or body mass index, and with acute or chronic conditions, including COVID-19. This article synthesizes the latest research advancements in muscle health and malnutrition, and their impact on immune function, and clinical outcomes. We provide a toolkit of illustrations and scientific information that healthcare professionals can use for knowledge translation, educating patients about the importance of identifying and treating low muscle mass and malnutrition. We focus on the emerging evidence of mitochondrial dysfunction in the context of aging and disease, as well as the cross-talk between skeletal muscle and the immune system. We address the importance of myosteatosis as a component of muscle composition, and discuss direct, indirect and surrogate assessments of muscle mass including ultrasound, computerized tomography, deuterated creatine dilution, and calf circumference. Assessments of muscle function are also included (handgrip strength, and physical performance tests). Finally, we address nutrition interventions to support anabolism, reduce catabolism, and improve patient outcomes. These include protein and amino acids, branched-chain amino acids, with a focus on leucine; β-hydroxy-β-methylbutyrate (HMB), vitamin D; n-3 polyunsaturated fatty acids (n-3 PUFA), polyphenols, and oral nutritional supplements. We concluded with recommendations for clinical practice and a call for action on research focusing on evaluating the impact of body composition assessments on targeted nutrition interventions, and consequently their ability to improve patient outcomes.

Lima J, Brizola Dias AJ, Burgel CF, Bernardes S, Gonzalez MC, Silva FM. Clin Nutr. 2022 Oct;41(10):2325-2332. doi: 10.1016/j.clnu.2022.08.022. Epub 2022 Aug 26. PMID: 36099668.

The Global Leadership Initiative on Malnutrition (GLIM) proposed a two-step approach for the malnutrition diagnosis: screening to identify "at risk" patients by any validated nutritional screening tool (NST), followed by a detailed nutritional assessment for diagnosis and grading the severity of malnutrition. Since there are several validated NST, this study aimed to evaluate the complementarity of five NST to GLIM criteria for malnutrition diagnosis in a sample of hospitalized patients.

Slingerland-Boot R, van der Heijden I, Schouten N, Driessen L, Meijer S, Mensink M, van Zanten A. Clin Nutr. 2022 Oct;41(10):2124-2134. doi: 10.1016/j.clnu.2022.07.031. Epub 2022 Aug 9. PMID: 36067584.

Nutrition plays an essential role in the recovery of critical illness. In the post-Intensive Care Unit (ICU) period, patients typically return to oral nutrition gradually. However, studies quantifying nutritional intake in the post-ICU hospitalization period are scarce and formal guidelines are lacking. This study aims to describe energy and protein intake in detail over the entire post-ICU hospitalization period and explore associations between protein intake and clinical outcomes.

Holdoway A, Page F, Bauer J, Dervan N, Maier AB. Nutrients. 2022 Aug 27;14(17):3534. doi: 10.3390/nu14173534. PMID: 36079795; PMCID: PMC9460401.

Revisión de la literatura científica existente de guías de nutrición centradas en la prevención y el manejo de la desnutrición relacionada con la enfermedad (cuidados intensivos, COVID-19, cáncer y personas mayores) centrada en cómo realizar la mejora atención nutricional individualizada (ANI). Se entienda la ANI como el soporte nutricional que se adapta a las necesidades, preferencias, valores y objetivos específicos de un paciente. Se sustentan en cuatro pilares: lo que importa a los pacientes, la toma de decisiones compartida, la atención nutricional multimodal basada en la evidencia y la evaluación de los resultados. La presencia de desnutrición en un paciente implica peores resultados en salud, pero lo que realmente preocupa al paciente, desde el punto de vista nutricional no se suele tener en cuenta ni se investiga. Los estudios en grupos específicos de pacientes muestran que el ANI mejora los resultados de salud independientemente del grado de complejidad del soporte nutricional utilizado. Se propone un modelo específico denominado proceso de atención nutricional (PAN) basado en cuatro pasos que incluyen el empleo de indicadores de resultados apropiados. Como conclusiones: existe evidencia para apoyar el uso de INC en la práctica, pero es preciso investigar cómo realizarlo de modo sistemático, cómo incorporarlo en los estudios científicos y los resultados esperables en distintas situaciones clínicas. Además se desarrolla un modelo práctico (PAN) a emplear y que podría ayudar a los profesionales de la salud a identificar y promover la medición de los resultados que importan a los pacientes.