The science of micronutrients in clinical practice

Article Article scientifique Article The science of micronutrients in clinical practice - Report on the ESPEN symposium eng 2023-12-09 2024-01 author Berger Mette author Amrein Karin author Barazzoni Rocco author Bindels Laure author Breton Irene author Calder Philip author Cappa Stefano 983792 author Cuerda Cristina author D'Amelio Patrizia author de Man Angélique author Delzenne Nathalie author Forbes Alastair author Genton Graf Laurence 0000-0002-0037-5203 514243 Département de médecine (DEMED) author Gombart Adrian author Joly Francisca author Laviano Alessandro author Matthys Christophe author Phyo Pyi Pyi author Ravasco Paula author Serlie Mireille author Shenkin Alan author Hofer Stoffel Nicole 798581 author Talwar Dinesh author van Zanten Arthur 268-283 10.1016/j.clnu.2023.12.006 38104489 0261-5614 https://www.sciencedirect.com/science/article/pii/S0261561423004284 Background & aims: The European Society for Clinical Nutrition and Metabolism published its first clinical guidelines for use of micronutrients (MNs) in 2022. A two-day web symposium was organized in November 2022 discussing how to apply the guidelines in clinical practice. The present paper reports the main findings of this symposium. Methods: Current evidence was discussed, the first day being devoted to clarifying the biology underlying the guidelines, especially regarding the definition of deficiency, the impact of inflammation, and the roles in antioxidant defences and immunity. The second day focused on clinical situations with high prevalence of MN depletion and deficiency. Results: The importance of the determination of MN status in patients at risk and diagnosis of deficiencies is still insufficiently perceived, considering the essential role of MNs in immune and antioxidant defences. Epidemiological data show that deficiencies of several MNs (iron, iodine, vitamin D) are a global problem that affects human health and well-being including immune responses such as to vaccination. Clinical conditions frequently associated with MN deficiencies were discussed including cancer, obesity with impact of bariatric surgery, diseases of the gastrointestinal tract, critical illness, and aging. In all these conditions, MN deficiency is associated with worsening of outcomes. The recurrent problem of shortage of MN products, but also lack of individual MN-products is a worldwide problem. Conclusion: Despite important progress in epidemiology and clinical nutrition, numerous gaps in practice persist. MN depletion and deficiency are frequently insufficiently searched for in clinical conditions, leading to inadequate treatment. The symposium concluded that more research and continued education are required to improve patient outcome. Deficiency Epidemiology Immunity Inflammation Trace element Vitamin Dewey 616 56 Département de médecine 221 false 1386 Nutrition et chronobiologie 1038 Clinical nutrition 43 1 e08ed8c4-18f4-48f8-8a8d-ff4a3c2667a5 Article (Published version) Public Berger2023.pdf 1754671 application/pdf CC BY-4.0 c73262c42db9077623ad2656e2da462dc7babad37ccefdaf2466a997b7f77017 openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

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The science of micronutrients in clinical practice - Report on the ESPEN symposium	Clinical nutrition			2024	195	614

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Hofer Stoffel, Nicole