Gonzalo Rivera Andrades

Introduction: Oncological patients undergoing gastric or colon surgery with malnutrition may present alterations related to the inflammatory response and post-operative complications. Objective: The aim of the following article is to determine, based on a systematic review with meta-analysis, the effect of enteral immunonutrition (arginine, glutamine, omega-3 and nucleotides) as a nutritional strategy in hospitalised cancer patients undergoing major gastrointestinal surgery to reduce post-operative infectious complications and modify changes in the inflammatory response. Material and Methods: An exhaustive search was conducted in Spanish, English and Portuguese for the Medline databases through Ovid, Cochrane (Central), Scopus, Web of Science, EMBASE, Google Scholar and Trip Data Base. Duplicate filtering was performed by two reviewers using the Rayyan tool and data extraction with risk of bias assessment using the ROB-2 tool. Meta-analyses were performed with fixed effects models and publication bias assessment using funnel plots. Results: 18 international randomised clinical trials (RCTs) (5.5 % developed in the Americas, 50 % in Asia and 44.5 % in Europe) were used for the construction of the systematic review. For enteral immunonutrition compared to standard enteral nutrition a low level of certainty was found for the outcomes of post-operative complications due to infections (RR 0.74 CI 95%; 0.60-0.90, p=0.003; I2=12%, random effects model) in patients with gastric and colon cancer. Conclusions: Enteral immunonutrition may have little to no effect on the occurrence of infectious post-operative complications in the oncology patient with major gastrointestinal surgeries.

Background and objective: The global aging population has led to increased noncommunicable diseases, often linked to poor diet and declining muscle strength and mass. This study assessed leucine intake and sarcopenia indicators among 181 adults aged 60–80 in Santiago, Chile, participating in the Program for Complementary Food in Older People (PACAM), with 80% being women. Methods: Sarcopenia was evaluated through muscle strength and mass using the EWGSOP2 criteria for its identification. Results: 78.45% of participants did not meet the recommended leucine intake of 3 g per day and sarcopenia was identified in 17.13% of them. The skeletal muscle index was 48.07%, and hand grip strength was 26.52%, with men showing significantly higher grip strength (48.60% vs. 28.80%, p = 0.00). Inadequate leucine intake was more common in those aged 60–75 (85.9%) than those over 75 (p = 0.03). No significant differences in BMI, grip strength, or muscle mass were found between those with adequate and inadequate leucine intake, and PACAM food consumption did not significantly affect these parameters. A sub-analysis showed significant differences in grip strength among powdered dairy drink consumers (35.20% vs. 17.80%, p = 0.01). Conclusions: Chilean elderly participating in PACAM present a high prevalence of sarcopenia and leucine deficiency among with no notable benefits from PACAM foods intake. Despite the limitations of the local body composition assessment method, this research addresses a critical public health issue in Chile. Future studies should evaluate physical performance and focus on leucine supplementation to clarify its effects on sarcopenia.