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SHR Neuro Cancer Cardio Lipid Metab Microb

Berger, MM; Shenkin, A; Schweinlin, A; Amrein, K; Augsburger, M; Biesalski, HK; Bischoff, SC; Casaer, MP; Gundogan, K; Lepp, HL; de, Man, AME; Muscogiuri, G; Pietka, M; Pironi, L; Rezzi, S; Cuerda, C.
ESPEN micronutrient guideline.
Clin Nutr. 2022; 41(6): 1357-1424. Doi: 10.1016/j.clnu.2022.02.015
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Co-authors Med Uni Graz
Amrein Karin
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Abstract:
BACKGROUND: Trace elements and vitamins, named together micronutrients (MNs), are essential for human metabolism. Recent research has shown the importance of MNs in common pathologies, with significant deficiencies impacting the outcome. OBJECTIVE: This guideline aims to provide information for daily clinical nutrition practice regarding assessment of MN status, monitoring, and prescription. It proposes a consensus terminology, since many words are used imprecisely, resulting in confusion. This is particularly true for the words "deficiency", "repletion", "complement", and "supplement". METHODS: The expert group attempted to apply the 2015 standard operating procedures (SOP) for ESPEN which focuses on disease. However, this approach could not be applied due to the multiple diseases requiring clinical nutrition resulting in one text for each MN, rather than for diseases. An extensive search of the literature was conducted in the databases Medline, PubMed, Cochrane, Google Scholar, and CINAHL. The search focused on physiological data, historical evidence (published before PubMed release in 1996), and observational and/or randomized trials. For each MN, the main functions, optimal analytical methods, impact of inflammation, potential toxicity, and provision during enteral or parenteral nutrition were addressed. The SOP wording was applied for strength of recommendations. RESULTS: There was a limited number of interventional trials, preventing meta-analysis and leading to a low level of evidence. The recommendations underwent a consensus process, which resulted in a percentage of agreement (%): strong consensus required of >90% of votes. Altogether the guideline proposes sets of recommendations for 26 MNs, resulting in 170 single recommendations. Critical MNs were identified with deficiencies being present in numerous acute and chronic diseases. Monitoring and management strategies are proposed. CONCLUSION: This guideline should enable addressing suboptimal and deficient status of a bundle of MNs in at-risk diseases. In particular, it offers practical advice on MN provision and monitoring during nutritional support.
Find related publications in this database (using NLM MeSH Indexing)
Dietary Supplements - administration & dosage
Humans - administration & dosage
Micronutrients - administration & dosage
Trace Elements - administration & dosage
Vitamin A - administration & dosage
Vitamins - administration & dosage

Find related publications in this database (Keywords)
Keywords
Trace
elements
Vitamins
De ficiency
Prescription
Diagnosis
Dosage
Monitoring
Enteral
nutrition
Parenteral
Chromium
Cobalt
Copper
Fluoride
Iodine
Iron
Manganese
Molybdenum
Selenium
Zinc
Thiamin
Ribo flavin
Niacin
Pantothenic
acid
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