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.
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Amrein, Karin
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Barazzoni, Rocco
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Bindels, Laura
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Bretón, Irene
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Calder, Philip C.
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Cappa, Stefano
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Cuerda, Cristina
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D'Amelio, Patrizia
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de Man, Angélique
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Delzenne, Nathalie M.
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Forbes, Alastair
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Genton, Laurence
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Gombart, Adrian F.
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Joly, Francisca
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Laviano, Alessandro
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Matthys, Christophe
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Phyo, Pyi Pyi
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Ravasco, Paula
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Serlie, Mireille J.
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Shenkin, Alan
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Stoffel, Nicole U.
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Talwar, Dinesh
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van Zanten, Arthur R.H.
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January 2024
Berger, Mette M.
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Amrein, Karin
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Barazzoni, Rocco
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Bindels, Laura
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Bretón, Irene
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Calder, Philip C.
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Cappa, Stefano
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Cuerda, Cristina
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D'Amelio, Patrizia
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de Man, Angélique
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Delzenne, Nathalie M.
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Forbes, Alastair
a730bceb-41bf-497c-a308-6fcedbfb2006
Genton, Laurence
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Gombart, Adrian F.
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Joly, Francisca
dd4378ec-e7d9-48cc-a072-3638b82daf65
Laviano, Alessandro
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Matthys, Christophe
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Phyo, Pyi Pyi
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Ravasco, Paula
d114adc3-07f2-4dfd-a2a7-d9a371908b95
Serlie, Mireille J.
8b8521b7-7fae-493a-b4c5-04010e23af35
Shenkin, Alan
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Stoffel, Nicole U.
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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
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Restricted to Repository staff only until 9 December 2024.
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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
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Date deposited: 11 Dec 2023 17:30
Last modified: 18 Mar 2024 02:41
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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
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