The fatty add composition of red blood cell membranes (which reflects dietary fat intake) was studied in 28 male patients with recent (<3 days) ischemic stroke and 56 matched controls. Fifteen fatty acids were measured by means of chromatographic analysis. Percentages of linoleic, 22:5, and 22:6 acids were significantly lower in red blood cell membranes of stroke patients than in those of matched controls. The results suggest that a low unsaturated fatty acid diet could be an independent risk factor for ischemic brain infarction. {Stroke 1987;18:575-578) I t is widely accepted that dietary fats have a role in the etiology of ischemic heart disese (IHD).' Patients with IHD appear to have a low linoleic acid content in their plasma cholesterol esters 2 as well as in adipose tissue.3 A low content of polyunsaturated fatty acids (PUFA) in serum phospholipids has been shown to be an independent risk factor for IHD. 4 Diets with a high PUFA: saturated fatty acids (SFA) ratio might reduce the risk of IHD through their effect of lowering plasma cholesterol concentration or, possibly, through an antithrombotic property of PUFA. 5 The limited role of hypercholesterolemia as a risk factor in cerebrovascular diseases (CVD) is well known.67 A low alimentary PUFA: SFA ratio was found in IHD patients, 8 but, as far as we are aware, no data are available on this aspect in patients with CVD.The composition of red blood cell membrane phospholipids reflects the type of fats eaten in the preceding weeks, and it is unlikely to change immediately after an acute event such as a stroke.8 Therefore, we studied the composition of red blood cell membrane phospholipids in patients with ischemic stroke and in matched controls to find out whether the type of fats consumed in these two groups was different. Subjects and MethodsWe studied 28 consecutive male patients, aged 40-75, who had suffered a first-event ischemic stroke, defined as an acute focal neurologic deficit lasting > 24 hours that was attributed to ischemia on clinical grounds and confirmed by a computed tomography Address for reprints: Dr. Stefano Ricci, Istituto di Clinica Neurologica, University di Perugia, Via del Giochetto, 06100 Perugia, Italy.Received June 9, 1986; accepted December 22, 1986. (CT) scan within 3 days. We did not study women due to organizational difficulties. We excluded patients with myocardial infarction within the previous 3 months and also patients with other possible cardiac sources of emboli and without other known risk factors for cerebral ischemia (e.g., mitral stenosis with atrial fibrillation in a young, normotensive, normoglycemic patient). Each patient was matched with 2 controls (56 men matched for age ± 5 years, smoking habits, hypertension, and diabetes); these were male inpatients admitted to our hospital in the same period who were not suffering any acute vascular disease and had no stroke or myocardial infarction in their history. Men chosen as controls in this study suffered from a wide spectrum of diseases (tumors, epilepsy, infection...

The novel SARS-CoV-2 virus has led to a severe pandemic, starting from early 2020. Intensive care (ICU) management of the COVID-19 disease is difficult with high morbidity and mortality. Early nutritional support, especially with whey protein, seems to be crucial in this medical case. Thus, we aimed to assess the effects of an adequate nutritional protocol rich in whey protein on nutritional and inflammatory status, extubating time, and mortality of critically ill COVID-19 patients (CICP). Methods: A prospective single-center exploratory observational study was undertaken on 32 consecutive CICP admitted to the ICU of Santa Maria Hospital, Terni, Italy, and treated with whey protein-enriched formula. Patients’ demographics, nutritional status, indexes of inflammation, daily pre-albumin serum levels, duration of mechanical ventilation, and mortality were recorded. Results: Thirty-two patients were enrolled. Ninety-five percent of them showed a gradual reduction in C-reactive protein (CRP) values and increase in pre-albumin levels after the whey protein-enriched formula. Prealbumin levels were not correlated with a better nutritional status but with a shorter extubating time and better survival. Conclusions: An adequate administration of whey protein during COVID-19 patients’ ICU stays can provide fast achievement of protein targets, reducing the duration of mechanical ventilation, and improving inflammatory status and ICU survival. Further prospective and large-scale, controlled studies are needed to confirm these results.

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Background: The SARS-COV 2 pandemic has hit on our lives since early 2020. During different contagion waves, both malnutrition and overweight significantly correlated with patient mortality. Immune-nutrition (IN) has shown promising results in the clinical course of pediatric inflammatory bowel disease (IBD) and in both the rate of extubation and mortality of patients admitted to an intensive care unit (ICU). Thus, we wanted to assess the effects of IN on a clinical course of patients admitted to a semi-intensive COVID-19 Unit during the fourth wave of contagion that occurred at the end of 2021. Methods: we prospectively enrolled patients admitted to the semi-intensive COVID-19 Unit of San Benedetto General hospital. All patients had a biochemical, anthropometric, high-resolution tomography chest scan (HRCT) and complete nutritional assessments at the time of admission, after oral administration of immune-nutrition (IN) formula, and at 15 days interval follow-up. Results: we enrolled 34 consecutive patients (age 70.3 ± 5.4 years, 6 F, BMI 27.0 ± 0.5 kg/m2). Main comorbidities were diabetes (20%, type 2 90 %), hyperuricemia (15%), hypertension (38%), chronic ischemic heart disease (8 %), COPD (8%), anxiety syndrome (5%), and depression (5%). 58% of patients were affected as moderately-to-severely overweight; mini nutritional assessment (MNA) score (4.8 ± 0.7) and phase angle (PA) values (3.8 ± 0.5) suggestive of malnutrition were present in 15% of patients, mainly with a history of cancer. After 15 days upon admission, we recorded 3 deaths (mean age 75.7 ± 5.1 years, BMI 26.3 ± 0.7 kg/m2) and 4 patients were admitted to the ICU. Following IN formula administration, inflammatory markers significantly decreased (p < 0.05) while BMI and PA did not worsen. These latter findings were not observed in a historical control group that did not receive IN. Only one patient needed protein-rich formula administration. Conclusions: in this overweight COVID-19 population immune-nutrition prevented malnutrition development with a significant decrease of inflammatory markers.

Objective SARS-CoV-2 disease is a severe infection that has forced millions of patients to stay in ICU.(2) SARS-CoV-2 pneumonia appears to occur rapidly and is often associated with gastrointestinal disorders that compromise the patient ability to adequately feed, causing a severely malnourished and sarcopenic status.(1) Our hypothesis is that a strategy, based on the use of whey protein, that guarantee a fast achievement of protein and caloric targets, can reduce the duration of ventilation and mortality. Methods and procedures We studied and treated 32 COVID-19 patients from 9/3 to 30/4/2020. The following nutritional targets were followed in all patients ⁃ start of enteral nutrition within 24/48 hours ⁃ protein target> = 1.3 g / kg ⁃ Caloric target 20/25 kcal / kg ⁃ Use of enteral mixtures rich in whey protein ⁃ Daily monitoring of prealbumin Results We observed that the 95% of patients presented a significant increase in prealbumin values (figure1) All patients who achieved a prealbumin value > 20 during hospitalization in ICU had a lower mortality. When the protein target was achieved in 2/3 days the time under mechanical ventilation was reduced ( figure 2-3) Conclusion Although the data are hindered by the small number of patients, in our experience an adequate nutritional support that guarantees a rapid achievement of protein target, reduces ventilation time and mortality.