The science of micronutrients in clinical practice – report on the ESPEN symposium
The science of micronutrients in clinical practice – report on the ESPEN symposium
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
268-283
Berger, Mette M.
a7be1789-bd44-481d-afa9-ac86d090a2eb
Amrein, Karin
d68f9594-06df-4cf2-913c-db8a3bd6e69d
Barazzoni, Rocco
c5bc5c6b-1851-4c42-8ddc-7e108bf958fb
Bindels, Laura
6f725e47-05cd-43e1-b411-b98235c4180f
Bretón, Irene
c7f2e93c-62cb-42f1-82d5-72419dceabb4
Calder, Philip C.
1797e54f-378e-4dcb-80a4-3e30018f07a6
Cappa, Stefano
f63d5bc0-d698-4dff-a1fa-4cfe362570f4
Cuerda, Cristina
8261fbec-adcd-42f1-8f6a-d548c18009fb
D'Amelio, Patrizia
fe56e95d-4546-4063-819a-f1ad7142b6e5
de Man, Angélique
2f2e592d-812b-42d6-b77c-c5cf836613b7
Delzenne, Nathalie M.
220f8656-5d07-4611-8a96-75a37f46fd75
Forbes, Alastair
a730bceb-41bf-497c-a308-6fcedbfb2006
Genton, Laurence
8b6cefb1-a216-44d3-a2ef-06f384fbcc51
Gombart, Adrian F.
2d3affaf-f8dd-4f82-9b98-6f463e798694
Joly, Francisca
dd4378ec-e7d9-48cc-a072-3638b82daf65
Laviano, Alessandro
ecb1ad05-7d2d-4089-b380-4b31df95fb29
Matthys, Christophe
bf63534d-dae6-470f-b562-4cba17b00675
Phyo, Pyi Pyi
73294232-565e-4c9d-8731-1e43026542c4
Ravasco, Paula
d114adc3-07f2-4dfd-a2a7-d9a371908b95
Serlie, Mireille J.
8b8521b7-7fae-493a-b4c5-04010e23af35
Shenkin, Alan
0d4bc9c6-ae09-40e5-81dc-88b43707421a
Stoffel, Nicole U.
599e60ee-a4fa-46b4-a75b-e767b720947a
Talwar, Dinesh
4281a7cb-affd-456a-a09f-3096769e3078
van Zanten, Arthur R.H.
031c1b26-d14f-41a7-87a6-193d17a1272e
January 2024
Berger, Mette M.
a7be1789-bd44-481d-afa9-ac86d090a2eb
Amrein, Karin
d68f9594-06df-4cf2-913c-db8a3bd6e69d
Barazzoni, Rocco
c5bc5c6b-1851-4c42-8ddc-7e108bf958fb
Bindels, Laura
6f725e47-05cd-43e1-b411-b98235c4180f
Bretón, Irene
c7f2e93c-62cb-42f1-82d5-72419dceabb4
Calder, Philip C.
1797e54f-378e-4dcb-80a4-3e30018f07a6
Cappa, Stefano
f63d5bc0-d698-4dff-a1fa-4cfe362570f4
Cuerda, Cristina
8261fbec-adcd-42f1-8f6a-d548c18009fb
D'Amelio, Patrizia
fe56e95d-4546-4063-819a-f1ad7142b6e5
de Man, Angélique
2f2e592d-812b-42d6-b77c-c5cf836613b7
Delzenne, Nathalie M.
220f8656-5d07-4611-8a96-75a37f46fd75
Forbes, Alastair
a730bceb-41bf-497c-a308-6fcedbfb2006
Genton, Laurence
8b6cefb1-a216-44d3-a2ef-06f384fbcc51
Gombart, Adrian F.
2d3affaf-f8dd-4f82-9b98-6f463e798694
Joly, Francisca
dd4378ec-e7d9-48cc-a072-3638b82daf65
Laviano, Alessandro
ecb1ad05-7d2d-4089-b380-4b31df95fb29
Matthys, Christophe
bf63534d-dae6-470f-b562-4cba17b00675
Phyo, Pyi Pyi
73294232-565e-4c9d-8731-1e43026542c4
Ravasco, Paula
d114adc3-07f2-4dfd-a2a7-d9a371908b95
Serlie, Mireille J.
8b8521b7-7fae-493a-b4c5-04010e23af35
Shenkin, Alan
0d4bc9c6-ae09-40e5-81dc-88b43707421a
Stoffel, Nicole U.
599e60ee-a4fa-46b4-a75b-e767b720947a
Talwar, Dinesh
4281a7cb-affd-456a-a09f-3096769e3078
van Zanten, Arthur R.H.
031c1b26-d14f-41a7-87a6-193d17a1272e
Berger, Mette M., Amrein, Karin, Barazzoni, Rocco, Bindels, Laura, Bretón, Irene, Calder, Philip C., Cappa, Stefano, Cuerda, Cristina, D'Amelio, Patrizia, de Man, Angélique, Delzenne, Nathalie M., Forbes, Alastair, Genton, Laurence, Gombart, Adrian F., Joly, Francisca, Laviano, Alessandro, Matthys, Christophe, Phyo, Pyi Pyi, Ravasco, Paula, Serlie, Mireille J., Shenkin, Alan, Stoffel, Nicole U., Talwar, Dinesh and van Zanten, Arthur R.H.
(2024)
The science of micronutrients in clinical practice – report on the ESPEN symposium.
Clinical Nutrition, 43 (1), .
(doi:10.1016/j.clnu.2023.12.006).
Abstract
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.
Text
ClNu 25271 Science of MNs R1_27NOV-clean_Accepted
- Accepted Manuscript
Restricted to Repository staff only until 9 December 2024.
Request a copy
Slideshow
Figures Science of MNs-R1_Accepted
- Accepted Manuscript
Restricted to Repository staff only until 9 December 2024.
Request a copy
More information
Accepted/In Press date: 7 December 2023
e-pub ahead of print date: 9 December 2023
Published date: January 2024
Additional Information:
Publisher Copyright:
© 2023 The Authors
Keywords:
Deficiency, Epidemiology, Immunity, Inflammation, Trace element, Vitamin
Identifiers
Local EPrints ID: 485554
URI: http://eprints.soton.ac.uk/id/eprint/485554
ISSN: 0261-5614
PURE UUID: 63a66abc-a327-4d80-a227-1cd9ce96ec80
Catalogue record
Date deposited: 11 Dec 2023 17:30
Last modified: 17 Aug 2024 01:35
Export record
Altmetrics
Contributors
Author:
Mette M. Berger
Author:
Karin Amrein
Author:
Rocco Barazzoni
Author:
Laura Bindels
Author:
Irene Bretón
Author:
Stefano Cappa
Author:
Cristina Cuerda
Author:
Patrizia D'Amelio
Author:
Angélique de Man
Author:
Nathalie M. Delzenne
Author:
Alastair Forbes
Author:
Laurence Genton
Author:
Adrian F. Gombart
Author:
Francisca Joly
Author:
Alessandro Laviano
Author:
Christophe Matthys
Author:
Pyi Pyi Phyo
Author:
Paula Ravasco
Author:
Mireille J. Serlie
Author:
Alan Shenkin
Author:
Nicole U. Stoffel
Author:
Dinesh Talwar
Author:
Arthur R.H. van Zanten
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics
