Browsing by Author "Meija, Laila"

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    Alkilrezorcīnu, lignānu metabolīti un D vitamīns priekšdziedzera vēža pacientiem. Promocijas darba kopsavilkums
    (Rīgas Stradiņa universitāte, 2014) Meija, Laila; Lejnieks, Aivars; Lietuvietis, Vilnis
    Uzturs ir nepieciešams visu cilvēka bioloģisko procesu normālai funkcionēšanai. Pilnvērtīgs uzturs šūnu līmenī nodrošina visu organismu ar uzturvielām, kas nepieciešamas audu struktūras un funkcijas saglabāšanai. Turklāt uzturs ir viens no ietekmējamiem onkoloģisko slimību riska faktoriem. Uzskata, ka ar uzturu var novērst trešdaļas vēžu veidošanos. Priekšdziedzera vēzis ir otra biežākā ļaundabīgā onkoloģiskā slimība vīriešiem visā pasaulē. Latvijā tas ir pirmais biežākais vēzis un otrs biežākais nāves cēlonis starp visiem vēža veidiem vīriešiem. Augstā slimības prevalence un bieži lēnā attīstība padara priekšdziedzera vēzi par ļoti piemērotu prevencijai. Par uzturu kā priekšdziedzera vēža risku ietekmējošo faktoru lika domāt zemā priekšdziedzera vēža incidence un prevalence Āzijas valstīs, kur protektīvo ietekmi saistīja ar fitoestrogēnu – sojas produktu – iespējamo iedarbību. Rietumvalstīs galvenie fitoestrogēnu avoti ir lignāni. Ziemeļvalstīs galvenais lignānu avots ir rudzu maize, kas ir arī bagāts šķiedrvielu avots. Šķiedrvielas maizē saistītas ar daudzām bioloģiski aktīvām vielām, tostarp lignāniem un alkilrezorcīniem. Cits iespējamais faktors, kas var ietekmēt priekšdziedzera vēža attīstību, ir D vitamīns, kam, iespējams, piemīt ne tikai imunitāti modulējošā, bet arī antikancerogēnā aktivitāte. Pētījuma mērķis bija izpētīt, kurš alkilrezorcīnu metabolīts ir vispiemērotākais, lai novērtētu rudzu maizes un rudzu maizes šķiedrvielu daudzumu uzturā, kā arī izvērtēt alkilrezorcīnu un lignānu metabolītu saistību ar priekšdziedzera vēža risku. Otrs mērķis bija novērtēt pilngraudu rudzu maizes iespējamo ietekmi uz priekšdziedzera vēža progresēšanu. Cits mērķis bija novērtēt D vitamīna iespējamo saistību ar priekšdziedzera vēža risku. Lai izpildītu izvirzītos mērķus, noteicām potenciāli bioloģiski aktīvo vielu – alkilrezorcīnu un lignānu – daudzumu Latvijas maizes veidos, novērtējām uzņemto uzturu, tostarp maizes, rudzu maizes, šķiedrvielu, alkilrezorcīnu, lignānu un D vitamīna daudzumu uzturā, kā arī alkilrezorcīnu metabolītu (DHPPA – 3-(3,5-dihidroksifenil) propānskābes un DHBA – 3,5-dihidroksibenzoskābes) un lignānu metabolīta (ENL – enterolaktona) daudzumu asins plazmā, 12 stundu dienas un 12 stundu nakts urīnā un D vitamīna līmeni serumā priekšdziedzera vēža un kontroles grupas pacientiem. Lai novērtētu rudzu maizes iespējamo ietekmi uz priekšdziedzera vēža progresēšanu, nozīmējām rudzu maizes lietošanu un veicām izmeklējumus pirms un pēc rudzu maizes iekļaušanas uzturā – noteicām priekšdziedzera specifisko antigēnu (PSA), alkilrezorcīnu un lignānu metabolītus plazmā, dzimumhormonus, kā arī tika veikti morfoloģiskie izmeklējumi. Mūsu pētījuma rezultāti parādīja, ka alkilrezorcīnu un lignānu daudzums Latvijas sēklu un rudzu maizē, kā arī uzturā kopumā ir augsts. Alkilrezorcīnu koncentrāciju maizē var izmantot par marķieri kliju un šķiedrvielu daudzumam maizē. Arī uzturā alkilrezorcīnu un lignānu daudzums ir augsts. Galvenie lignānu avoti uzturā bija sēklu un rudzu maize. Nebija atšķirību uzņemtā uztura datos, tostarp maizes daudzumā un veidā, kā arī alkilrezorcīnu un lignānu daudzumā starp priekšdziedzera vēža un kontroles grupas vīriešiem. Piemērotākais biomarķieris rudzu maizes un rudzu šķiedrvielu daudzuma uzturā novērtēšanai ir DHPPA 12 stundu nakts urīnā. Alkilrezorcīnu metabolītu koncentrācijas plazmā un urīnā saistība ar uztura datiem atšķīrās abās pētījuma grupās. Iespējamais atšķirības iemesls ir kavēts alkilrezorcīnu metabolisms priekšdziedzera vēža pacientiem. Analizējot lignānu metabolītu ENL, konstatējām, ka tā koncentrācija bioloģiskajos šķidrumos atspoguļo lignānu daudzumu uzturā tikai intervences pētījuma apstākļos. Konstatējām, ka rudzu maize, iespējams, kavē priekšdziedzera vēža pro- gresēšanu. Potenciālie darbības mehānismi – dzimumhormonu saistošā globulīna, enterolaktona un alkilrezorcīnu metabolītu koncentrācijas palielināšanās plazmā, kā rezultātā pazeminājās PSA un tika novērota apoptozes rādītāju pieauguma tendence. Jāturpina pētījumi ar lielāku dalībnieku skaitu, tie jāveic ilgākā laika periodā, un jāizmanto rudzu maize ar vēl augstāku rudzu šķiedrvielu daudzumu. Analizējot D vitamīna līmeni, konstatējām, ka D vitamīna deficīts un/vai nepietiekamība ir plaši izplatīta priekšdziedzera vēža grupā un kontroles grupas vīriešiem pēc 45 gadu vecuma. Atšķirības D vitamīna koncentrācijā serumā starp grupām netika konstatētas. Ar uzturu netiek nodrošināts nepieciešamais D vitamīna daudzums abās pētījuma grupās. Lai sasniegtu vēlamo D vitamīna koncentrāciju serumā un lai izvērtētu D vitamīna iespējamo protektīvo efektu priekšdziedzera vēža prevencijā, ieteicams lietot D vitamīna neaktīvās formas preparātus un uzturā vairāk lietot zivis. Iegūtie rezultāti izmantojami kā pamats turpmākiem padziļinātiem pētījumiem par pilngraudu produktu un D vitamīna lomu priekšdziedzera vēža prevencijā.
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    Alkilrezorcīnu, lignānu metabolīti un D vitamīns priekšdziedzera vēža pacientiem. Promocijas darbs
    (Rīgas Stradiņa universitāte, 2014) Meija, Laila; Lejnieks, Aivars; Lietuvietis, Vilnis
    Uzturs ir nepieciešams visu cilvēka bioloģisko procesu normālai funkcionēšanai. Pilnvērtīgs uzturs šūnu līmenī nodrošina visu organismu ar uzturvielām, kas nepieciešamas audu struktūras un funkcijas saglabāšanai. Turklāt uzturs ir viens no ietekmējamiem onkoloģisko slimību riska faktoriem. Uzskata, ka ar uzturu var novērst trešdaļas vēžu veidošanos. Priekšdziedzera vēzis ir otra biežākā ļaundabīgā onkoloģiskā slimība vīriešiem visā pasaulē. Latvijā tas ir pirmais biežākais vēzis un otrs biežākais nāves cēlonis starp visiem vēža veidiem vīriešiem. Augstā slimības prevalence un bieži lēnā attīstība padara priekšdziedzera vēzi par ļoti piemērotu prevencijai. Par uzturu kā priekšdziedzera vēža risku ietekmējošo faktoru lika domāt zemā priekšdziedzera vēža incidence un prevalence Āzijas valstīs, kur protektīvo ietekmi saistīja ar fitoestrogēnu – sojas produktu – iespējamo iedarbību. Rietumvalstīs galvenie fitoestrogēnu avoti ir lignāni. Ziemeļvalstīs galvenais lignānu avots ir rudzu maize, kas ir arī bagāts šķiedrvielu avots. Šķiedrvielas maizē saistītas ar daudzām bioloģiski aktīvām vielām, tostarp lignāniem un alkilrezorcīniem. Cits iespējamais faktors, kas var ietekmēt priekšdziedzera vēža attīstību, ir D vitamīns, kam, iespējams, piemīt ne tikai imunitāti modulējošā, bet arī antikancerogēnā aktivitāte. Pētījuma mērķis bija izpētīt, kurš alkilrezorcīnu metabolīts ir vispiemērotākais, lai novērtētu rudzu maizes un rudzu maizes šķiedrvielu daudzumu uzturā, kā arī izvērtēt alkilrezorcīnu un lignānu metabolītu saistību ar priekšdziedzera vēža risku. Otrs mērķis bija novērtēt pilngraudu rudzu maizes iespējamo ietekmi uz priekšdziedzera vēža progresēšanu. Cits mērķis bija novērtēt D vitamīna iespējamo saistību ar priekšdziedzera vēža risku. Lai izpildītu izvirzītos mērķus, noteicām potenciāli bioloģiski aktīvo vielu – alkilrezorcīnu un lignānu – daudzumu Latvijas maizes veidos, novērtējām uzņemto uzturu, tostarp maizes, rudzu maizes, šķiedrvielu, alkilrezorcīnu, lignānu un D vitamīna daudzumu uzturā, kā arī alkilrezorcīnu metabolītu (DHPPA – 3-(3,5-dihidroksifenil) propānskābes un DHBA – 3,5-dihidroksibenzoskābes) un lignānu metabolīta (ENL – enterolaktona) daudzumu asins plazmā, 12 stundu dienas un 12 stundu nakts urīnā un D vitamīna līmeni serumā priekšdziedzera vēža un kontroles grupas pacientiem. Lai novērtētu rudzu maizes iespējamo ietekmi uz priekšdziedzera vēža progresēšanu, nozīmējām rudzu maizes lietošanu un veicām izmeklējumus pirms un pēc rudzu maizes iekļaušanas uzturā – noteicām priekšdziedzera specifisko antigēnu (PSA), alkilrezorcīnu un lignānu metabolītus plazmā, dzimumhormonus, kā arī tika veikti morfoloģiskie izmeklējumi. Mūsu pētījuma rezultāti parādīja, ka alkilrezorcīnu un lignānu daudzums Latvijas sēklu un rudzu maizē, kā arī uzturā kopumā ir augsts. Alkilrezorcīnu koncentrāciju maizē var izmantot par marķieri kliju un šķiedrvielu daudzumam maizē. Arī uzturā alkilrezorcīnu un lignānu daudzums ir augsts. Galvenie lignānu avoti uzturā bija sēklu un rudzu maize. Nebija atšķirību uzņemtā uztura datos, tostarp maizes daudzumā un veidā, kā arī alkilrezorcīnu un lignānu daudzumā starp priekšdziedzera vēža un kontroles grupas vīriešiem. Piemērotākais biomarķieris rudzu maizes un rudzu šķiedrvielu daudzuma uzturā novērtēšanai ir DHPPA 12 stundu nakts urīnā. Alkilrezorcīnu metabolītu koncentrācijas plazmā un urīnā saistība ar uztura datiem atšķīrās abās pētījuma grupās. Iespējamais atšķirības iemesls ir kavēts alkilrezorcīnu metabolisms priekšdziedzera vēža pacientiem. Analizējot lignānu metabolītu ENL, konstatējām, ka tā koncentrācija bioloģiskajos šķidrumos atspoguļo lignānu daudzumu uzturā tikai intervences pētījuma apstākļos. Konstatējām, ka rudzu maize, iespējams, kavē priekšdziedzera vēža pro- gresēšanu. Potenciālie darbības mehānismi – dzimumhormonu saistošā globulīna, enterolaktona un alkilrezorcīnu metabolītu koncentrācijas palielināšanās plazmā, kā rezultātā pazeminājās PSA un tika novērota apoptozes rādītāju pieauguma tendence. Jāturpina pētījumi ar lielāku dalībnieku skaitu, tie jāveic ilgākā laika periodā, un jāizmanto rudzu maize ar vēl augstāku rudzu šķiedrvielu daudzumu. Analizējot D vitamīna līmeni, konstatējām, ka D vitamīna deficīts un/vai nepietiekamība ir plaši izplatīta priekšdziedzera vēža grupā un kontroles grupas vīriešiem pēc 45 gadu vecuma. Atšķirības D vitamīna koncentrācijā serumā starp grupām netika konstatētas. Ar uzturu netiek nodrošināts nepieciešamais D vitamīna daudzums abās pētījuma grupās. Lai sasniegtu vēlamo D vitamīna koncentrāciju serumā un lai izvērtētu D vitamīna iespējamo protektīvo efektu priekšdziedzera vēža prevencijā, ieteicams lietot D vitamīna neaktīvās formas preparātus un uzturā vairāk lietot zivis. Iegūtie rezultāti izmantojami kā pamats turpmākiem padziļinātiem pētījumiem par pilngraudu produktu un D vitamīna lomu priekšdziedzera vēža prevencijā.
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    Alkylresorcinol, Lignan Metabolites and Vitamin D in Prostate Cancer Patients. Summary of the Doctoral Thesis
    (Rīga Stradiņš University, 2014) Meija, Laila; Lejnieks, Aivars; Lietuvietis, Vilnis
    Food is essential in all biological processes of the human body. Food provides human body with all nutrients needed to maintain its tissue structure and run its functions. Furthermore, food is an important factor affecting the course of oncological disease one can change. There is some evidence showing that one third of all cancers can be prevented. Prostate cancer is the second most common cancer in men worldwide, while it is the first most common cancer and second leading cause of death from cancer in Latvian men. The high prevalence and often slow progression of prostate cancer makes it suitable for prevention. The low incidence and prevalence of prostate cancer in Asia suggests that nutrition may play a role in the progression of prostate cancer. It has been suggested that the protective effect found in Asia may be due to soy products rich in phytoestrogens. Lignans are the most important phytoestrogen sources in the Western countries. In North Europe, rye bread is the main source of lignans, which is also rich in fiber. Bread ‘fiber complex’ is linked to many bioactive compounds, including lignans and alkylresorcinols. An insufficient concentration of vitamin D is another possible risk factor of prostate cancer because vitamin D may have not only immunomodulating, but also anticarcinogenic effects. The objective of this thesis was to find out alkylresorcinol metabolites most suitable to estimate rye bread and rye bread fiber intake and also to evaluate relationships between metabolites of alkylresorcinols and lignans and their links to the risk of prostate cancer. The second objective was to assess any possible effect of whole grain rye bread on the progression of prostate cancer. The third objective of the thesis was to evaluate any possible links between vitamin D and the risk of prostate cancer. We detected alkylresorcinols and lignans, bioactive compounds, in Latvian breads while carrying out dietary assessment. This included intake of bread, rye bread, fiber, alkylresorcinols, lignans and vitamin D, concentrations of alkylresorcinols` metabolites (DHPPA-3-(3,5-dihydroxyphenyl)-1-propanoic acid and DHBA –3,5-dihydroxy-benzoic acid), and lignan metabolite (ENL – enterolactone) in plasma, 12-h day and 12-h night urine and serum concentration of vitamin D in prostate cancer in the group of PC patients and the control group. Using dietary intervention of rye bread, we investigated the effects on prostate cancer progression by assessing Prostate Specific Antigen (PSA), metabolites of alkylresorcinols and lignans in plasma, sex hormones and morphological examination before and after the intervention. The results show that alkylresorcinol and fiber concentration are high in Latvian breads. Alkylresorcinols` concentration in bread may be used as a marker of bran and fiber amount in bread. Alkylresorcinol and lignan intake were also found to be high. Seed and rye breads were found to be the main dietary sources of lignans. There was no difference found between the prostate cancer and control groups in the dietary intake data, including bread quantity and bread types, alkylresorcinol and lignan intake. DHPPA in 12 h overnight urine may be the most suitable alkylresorcinol metabolite to estimate the intake of rye bread and rye fiber. Differences were found between the prostate cancer and the control group regarding associations between alkylresorcinol metabolite concentrations in plasma, urine and food intake data, possibly due to a delay in the metabolism of alkylresorcinols in the prostate cancer group. It was found that enterolactone, a lignan metabolite, is linked to the intake of lignans only under the conditions of intervention. The results of the intervention study reveal a possible delay in the progression of prostate cancer via elevated concentration of sex hormone binding globulin, enterolactone and alkyresorcinols metabolites in the group of prostate cancer, which resulted in lower rates of PSA and presumably increased apoptosis. We suggest the future studies on this subject with longer time periods covered, with larger numbers of participants and the use of bread with higher concentrations of rye fiber. We found that vitamin D deficiency and/or insufficiency is highly prevalent in the group of prostate cancer and in men aged over 45 in the control group. There were no differences found between the groups in the concentration of vitamin D in serum. Vitamin D dietary intake was found to be insufficient in both study groups. To assess possible vitamin D protective effect in the prevention of prostate cancer, it is advisable to reach higher concentrations of the vitamin using vitamin D supplementation, also a higher amount of fish in the diet.
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    Body height affects the strength of immune response in young men, but not young women
    (2014-08-28) Krams, Indrikis A.; Skrinda, Ilona; Kecko, Sanita; Moore, Fhionna R.; Krama, Tatjana; Kaasik, Ants; Meija, Laila; Lietuvietis, Vilnis; Rantala, Markus J.; Rīga Stradiņš University
    Body height and other body attributes of humans may be associated with a diverse range of social outcomes such as attractiveness to potential mates. Despite evidence that each parameter plays a role in mate choice, we have little understanding of the relative role of each, and relationships between indices of physical appearance and general health. In this study we tested relationships between immune function and body height of young men and women. In men, we report a non-linear relationship between antibody response to a hepatitis-B vaccine and body height, with a positive relationship up to a height of 185 cm, but an inverse relationship in taller men. We did not find any significant relationship between body height and immune function in women. Our results demonstrate the potential of vaccination research to reveal costly trai.
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    Changes in Health Behaviour and Emotional Well-Being of Pregnant Women during the COVID-19 Pandemic in Latvia
    (2022-02-01) Rezgale, Roberta; Cauce, Vinita; Bule, Violeta; Piskurjova, Anna; Meija, Laila; Rīga Stradiņš University
    Pregnancy is a vulnerable period of life for changes in physical and mental health, which could be exacerbated by COVID-19. The aim of this study was to assess the impact of COVID-19 on health behaviour and emotional well-being among pregnant women in Latvia. The cross-sectional study included 269 women: pregnant women in the third trimester and women until the 7th day post-partum. The study was conducted between July and October 2020, performed by a trained interviewer. Information regarding demographic, anthropometric data, self-assessment of changes in nutritional habits, daily physical activities, and emotional well-being due to the COVID-19 pandemic was collected. 31.6% reported cooking at home more often and only 10.4% reported eating more often and/or larger portions, 23.2% were going on walks outdoors more often, 32.9% were feeling anxious, insecure about health of themselves and relatives, and 24.8% were lacking communication with friends and family. Latvian women were emotionally more affected than other nationalities (p = 0.015). Overall, women 30+ years of age were more often affected then women aged up to 30 years (p = 0.014). These results suggest that the COVID-19 pandemic had notable impact on health behaviour and emotional well-being in pregnant women in Latvia, especially on women 30+ years of age, who may need more careful counselling.
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    Consumption of the whole-grain rye bread and progression of prostate cancer
    (2013-11-01) Meija, Laila; Cauce, Vinita; Siksna, Inese; Joffe, Rafaels; Ignace, Gita; Bobere, Natalija; Lietuvietis, Vilnis; Lejnieks, Aivars; Söderholm, Paivi; Adlercreutz, Herman; Rīga Stradiņš University
    Whole-grain rye intake has been suggested to have anti-cancer effect, including changes in serum hormones and reduced prostate specific antigen (PSA) in animals and humans. In this study, we investigated the effect of high intake of whole-grain rye bread on prostate cancer progression as assessed by PSA concentration in men diagnosed with prostate cancer. Fifteen men with prostate cancer who did not receive prior therapy were randomised and given a daily supplement of 250 g refined wheat bread for two weeks and, afterwards, 250 g whole-grain rye bread for six weeks. Blood samples were taken from fasting men at baseline and after two and six weeks to measure the PSA and sex hormones. The dietary intake was: energy intake 3452 kcal; protein intake 166 g, carbohydrate intake 334 g, fat 149 g, saturated fat intake 52 g, and fibre intake 40 g. Plasma total PSA, free PSE, testosterone concentrations and free androgen index tended to be higher after refined white bread treatment and lower after whole-grain rye treatment. However, none of the differences were statistically significant. There were no significant changes in sex hormone binding globulin, luteinising hormone, and follicle stimulating hormone. In this intervention trial, whole-grain rye consumption did not result in significant changes in PSA and sex hormones, which may be related to high fat intake. Further prospective trials are indicated to evaluate the potential of whole-grain rye bread, taking into account other factors.
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    Content of alkylresorcinols in cereals grown in Latvia determined by high performance liquid chromatography with UV
    (2013-11-01) Bobere, Natalija; Podjava, Antons; Meija, Laila; Jakobsone, Ida; Rīga Stradiņš University
    Cereal alkylresorcinols (ARs) are a group of phenolic lipids mainly found in the outer parts of grains of rye and wheat. They have been suggested for use as selective biomarkers for intake of whole grain and bran products of these cereals. Consumption of whole grains and whole grain products has been associated with reduced risk of developing chronic diseases, such as cardiovascular disease, diabetes type 2, obesity and some types of cancer. In this article a sensitive and rapid method of High Performance Liquid Chromatography with UV detection for quantitative determination of ARs in the cereals grown in Latvia is described. Instrument detection limits (IDL) were determined for C17:0, C19:0 and C21:0 homologues (coefficient of variation < 3%). According to the results of these studies, ARs were found in rye (87.1-112.0 mg/100 g), wheat (24.0-40.2 mg/100 g), triticale (32.1-74.4 mg/100 g), and in small amounts in barley (2.2-3.7 mg/100 g), but not in oats.
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    Dažādu metožu pielietojums nepieciešamās enerģijas izvērtēšanai enterālās barošanas pacientiem
    (Rīga Stradiņš University, 2024) Rusecka, Svetlana; Meija, Laila; Faculty of Residency; Rezidentūras studiju fakultāte
    Enteral nutrition (EN) is an important part of the patient's nutrition and complex treatment. EB allows nutrients to be delivered in the gastrointestinal tract to patients who cannot take in sufficient amounts orally at all. There are many and often complex diseases that necessitate the provision of EN. More common include swallowing disorders due to neurological diseases and malignant tumors, diseases of the gastrointestinal tract. An integral part of successful EN provision is prevention of the risk of malnutrition or overfeeding the patient, a personalized approach and achieving the goal of energy and protein intake by evaluating the individually required amount of energy for each patient. This study was created to evaluate the required amount of energy for EN patients, to find out the compliance of energy requirements with the recommended amount of energy according to the guidelines, as well as to draw conclusions that will help doctors to better understand the real energy consumption of EN patients. In my work, I put emphasis on oncology patients who receive EN, because data from the world literature show that the number of new oncology patients who need EN is increasing significantly, as well as the duration of EN is increasing, which indicates the need to monitor patients and adjust the EN plan. My study included 24 patients who had their resting state energy consumption measured using indirect calorimetry (IC) and bioelectrical impedance analysis (BIA) methods. The obtained data were compared with each other and with the amounts recommended in the ESPEN guidelines. Results: A statistically reliable difference was observed between the two methods when comparing both the results of basal metabolism (BM) and the results of the amount of required energy (RE). Comparison of RE volume obtained by indirect calorimetry and bioelectrical impedance analysis showed a difference of up to 2 kcal/kg/day in some cases. Comparing the obtained results with those recommended in the guidelines, only 10(41.7%) of the participants in IC and respectively 9(37.5% )of the patients in BIA showed the RE volume indicated according to the guidelines. For all other study participants, the amount of RE was less than recommended in the guidelines or exceeded the recommended energy consumption.
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    ESPEN guideline on hospital nutrition
    (2021-12) Thibault, Ronan; Abbasoglu, Osman; Ioannou, Elina; Meija, Laila; Ottens-Oussoren, Karen; Pichard, Claude; Rothenberg, Elisabet; Rubin, Diana; Siljamäki-Ojansuu, Ulla; Vaillant, Marie France; Bischoff, Stephan C.; Rīga Stradiņš University
    In hospitals through Europe and worldwide, the practices regarding hospital diets are very heterogeneous. Hospital diets are rarely prescribed by physicians, and sometimes the choices of diets are based on arbitrary reasons. Often prescriptions are made independently from the evaluation of nutritional status, and without taking into account the nutritional status. Therapeutic diets (low salt, gluten-free, texture and consistency modified, …) are associated with decreased energy delivery (i.e. underfeeding) and increased risk of malnutrition. The European Society for Clinical Nutrition and Metabolism (ESPEN) proposes here evidence-based recommendations regarding the organization of food catering, the prescriptions and indications of diets, as well as monitoring of food intake at hospital, rehabilitation center, and nursing home, all of these by taking into account the patient perspectives. We propose a systematic approach to adapt the hospital food to the nutritional status and potential food allergy or intolerances. Particular conditions such as patients with dysphagia, older patients, gastrointestinal diseases, abdominal surgery, diabetes, and obesity, are discussed to guide the practitioner toward the best evidence based therapy. The terminology of the different useful diets is defined. The general objectives are to increase the awareness of physicians, dietitians, nurses, kitchen managers, and stakeholders towards the pivotal role of hospital food in hospital care, to contribute to patient safety within nutritional care, to improve coverage of nutritional needs by hospital food, and reduce the risk of malnutrition and its related complications.
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    Glycaemic profile and insulin response after consuming triticale flakes
    (2017-12) Havensone, Guna; Meija, Laila; Balode, Liga; Sturite, Ieviņa; Lejnieks, Aivars; Rīga Stradiņš University
    Daily intake of cereal fibre reduces incidence and progression of metabolic diseases. Very little is known on how triticale (Triticosecale) influences human health and its role in regulating carbohydrate metabolism. The aim of the study was to investigate glycaemic and insulin response in blood after consuming whole grain triticale cereal flakes. A group of twelve healthy, young people, aged from 18 to 30 years participated in the test. The participants in fasted state were given equivalent carbohydrate amounts of triticale cereal and reference food (glucose solution). Postprandial blood glucose and plasma insulin concentrations were measured according to Brouns et al. (2005). Whole grain triticale cereal flakes elicited lower metabolic responses compared to glucose solution. Intake of the triticale cereal flakes induced significantly lower incremental insulin area (iAUC 0-120 min) 1672.9 ± 619.85 than glucose solution 2646.65 ± 1260.56 and showed lower insulinemic indices (II) 68 ± 19.0 (p < 0.05). A low insulin incremental peak was associated with less severe late post-prandial hypoglycaemia. Our study showed that triticale cereal product caused low acute insulinemic response and improved glycaemic profiles, similarly to the rye products studied before. The results also suggested that the triticale cereal flakes could have beneficial appetite regulating properties. Thus, triticale flakes would be a wonderful option for functional breakfast cereal mixtures that might influence course of metabolic syndrome prevention.
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    The Intake of Omega-3 Fatty Acids, the Omega-3 Index in Pregnant Women, and Their Correlations with Gestational Length and Newborn Birth Weight
    (2024-07) Nikolajeva, Ksenija; Aizbalte, Olga; Rezgale, Roberta; Cauce, Vinita; Zacs, Dzintars; Meija, Laila; Department of Doctoral Studies; Rīga Stradiņš University; Faculty of Medicine; Department of Public Health and Epidemiology
    Background: During pregnancy, the demand for omega-3 fatty acids, notably docosahexaenoic acid (DHA), escalates for both maternal and foetal health. Insufficient levels can lead to complications and can affect foetal development. This study investigated omega-3 status and its relation to dietary intake in pregnant Latvian women, along with its impact on gestational duration and newborn birth weight. Methods: The study comprised 250 pregnant and postpartum women with a mean age of 31.6 ± 4.8 years. Nutrition and omega-3 supplementation data were collected through a questionnaire covering 199 food items and 12 supplements. Fatty acids in erythrocyte membrane phospholipids were analysed via gas chromatography with flame ionization detection. Results: The median omega-3 fatty acid intake, including eicosapentaenoic acid (EPA) and DHA from diet and supplements, was 0.370 g/day, which is deemed sufficient. However, the median weekly fish intake (126.0 g) and daily nut/seed intake (7.4 g) were insufficient. The median omega-3 supplement intake was 1.0 g/day. No correlation between omega-3 supplement intake and the omega-3 index was observed. There was a weak correlation between the DHA intake from fish and the omega-3 index (r = 0.126, p = 0.047), while a significant correlation between the total EPA and DHA intake from various sources and the omega-3 index was noted (r = 0.163, p = 0.01). Most women (61.6%) had an omega-3 index < 4%, while 34.8% had an index between 4 and 8%, and only 3.6% had an index > 8%. Notably, significant differences in EPA levels and the omega-3 index were found among respondents with differing infant birth weights (p < 0.05). Conclusions: The omega-3 intake during pregnancy adheres to the established guidelines, although fish consumption remains insufficient. A preconception evaluation of the omega-3 index is advocated to optimize prenatal intake. The indications suggest potential correlations between EPA levels, the omega-3 index, and infant birth weight.
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    Iron Status in Pregnant Women in Latvia : An Epidemiological, Cross-Sectional, Multicenter Study According to WHO and UK Criteria
    (2022-07) Rezgale, Roberta; Pudule, Iveta; Cauce, Vinita; Klaramunta Antila, Kristine; Bule, Violeta; Lazdane, Gunta; Rezeberga, Dace; Meija, Laila; Faculty of Medicine; Rīga Stradiņš University
    Background and Objectives: During pregnancy, iron deficiency anaemia is a common problem associated with health risks for both the mother and her foetus/infant. This study aimed to investigate the prevalence of iron deficiency, iron deficiency anaemia, and related dietary patterns in pregnant women in Latvia. Materials and Methods: This cross-sectional, multicentre study included pregnancy data from 974 women. The sample selection was based on the stratification principle (population of women of childbearing age in regions of Latvia). Maternal demographic details, anthropometric measurements, iron status, dietary patterns, and supplementation information were obtained from maternal files and during interviews held in eight outpatient departments of medical institutions and maternity departments. The prevalence was assessed. Chi-square tests and logistic regression were used to identify associations between iron deficiency and sociodemographic characteristics, dietary patterns, and iron supplement intake during pregnancy. The criterion used for the diagnosis of iron deficiency anaemia is a Hb level < 110 g/L in the 1st and 3rd trimesters and <105 g/L during the 2nd trimester as recommended by the WHO. However, the UK guideline was used for borderline iron deficiency, which is an SF level < 30 μg/L in all trimesters. Results: The observed prevalence of anaemia was 2.8% in the first trimester, 7.9% in the second trimester, and 27.0% in the third trimester. The prevalence of iron deficiency was 46.7% in the first trimester, 78.1% in the second trimester, and 91.7% in the third trimester. No associations with dietary patterns were found. Single women had 1.85 times the odds (95% CI 1.07 to 3.18) of being anaemic than married women. Conclusions: Iron deficiency affects a large proportion of pregnant women in Latvia in all trimesters, with iron deficiency anaemia affecting pregnant women in the third trimester. Monitoring and intervention should be performed in a timely and more targeted manner.
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    Netiešās kalorimetrijas metodes pielietošana pamata vielmaiņas noteikšanai pacientiem ar ķermeņa termisku apdegumu
    (Rīga Stradiņš University, 2024) Baibekova, Irita; Meija, Laila; Faculty of Residency; Rezidentūras studiju fakultāte
    Topicality of research: The metabolism of patients with thermal burns of different degrees and extent is affected by various factors. Thus, it is difficult to accurately predict the amount of energy required using only mathematical calculation methods such as the Harris-Benedict equation. The application of indirect calorimetry is particularly recommended for the development of nutritional therapy in critically ill patients to prevent the negative effects of under- and over-feeding. The dynamics of energy expenditure are complex, and clinical studies of indirect calorimetry in these patients are limited. Aim of the research: To measure rest energy expenditure in patients with body thermal burns using the indirect calorimetric method. Methods: A cross-sectional study was conducted. The study included 22 patients who, during the study period, were in the RAKUS State Burns Center's inpatient facility and were being treated for body thermal burns. The real basal metabolic rate (REE) was determined using the indirect calorimetry method. The indirect calorimetry device COSMED Q-NRG (COSMED – Metabolic Monitor for Indirect Calorimetry, n.d.-b) was used for the measurement. Results and conclusions: Indirect calorimetry shows a different resting metabolic rate compared to that measured by mathematical calculation equations. However, a statistically reliable, close positive correlation was observed between the measured basic metabolism and the one calculated by the Harris-Benedict equation. Compared with equations, indirect calorimetry is the method of choice to provide an efficient and accurate assessment of energy expenditure in patients with body thermal burns. Indirect calorimetry makes it possible to accurately assess the rest energy expenditure, as it takes into account not only anthropometric data, but also the current state of the disease and co-morbidities. The Cosmed Q-NRG calorimeter provides accurate and fast measurement of energy consumption. This device is particularly suitable for clinical use because it is easy to use and provides fast results. The measurements offer a personalized approach to measuring energy expenditure, which is particularly important for critically ill patients and patients with special nutritional needs.
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    Postprandial Glycaemic and Insulinaemic Responses after Consumption of Activated Wheat and Triticale Grain Flakes
    (2019) Meija, Laila; Havensone, Guna; Lejnieks, Aivars; Rīga Stradiņš University
    Increasing evidence shows that whole grain consumption is protective against metabolic disorders. Protective bioactive substances of whole grains include fibre and antioxidants. Activation of grains can increase the amount of phenolic compounds and their bioavailability, but there is little evidence about their effect on glycaemic and insulinemic responses. Therefore, the aim of this study was to investigate glycaemic and insulinemic responses after consumption of flakes made from activated wheat and activated triticale grains. Eighteen healthy subjects (7 men and 11 women) were given activated wheat or activated triticale flakes. As a reference, a standard glucose solution was used. Plasma glucose and serum insulin were measured during 120 minutes. Both, activated wheat and activated triticale flakes, show improved glycaemic profile, inducing a lower and more stable glycaemic response. However, statistically significant differences in insulin response were found only in the group who have taken activated triticale flakes and not in the group who have taken activated wheat flakes. Activated triticale flakes induced lower insulin response in all postprandial phases and a more stable concentration of insulin. Thus, activated triticale flakes could be beneficial for the prevention and treatment of metabolic disorders.
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    Vitamin D Intake and Serum Levels in Pregnant and Postpartum Women
    (2023-08) Meija, Laila; Piskurjova, Anna; Nikolajeva, Ksenija; Aizbalte, Olga; Rezgale, Roberta; Lejnieks, Aivars; Cauce, Vinita; Department of Sports and Nutrition; Department of Public Health and Epidemiology; Department of Doctoral Studies; Department of Internal Diseases
    Maternal vitamin D deficiency, which is highly prevalent in pregnant women in Europe, is linked to adverse health effects for both the mother and child. The objective was to assess vitamin D status in pregnant women by evaluating their dietary and supplemental vitamin D intake, serum vitamin D levels, parathyroid hormone levels, and lifestyle factors. This cross-sectional study, with a total of 735 participants (145 pregnant and 590 up to the seventh day postpartum), took place in Latvia. Blood samples, a food frequency questionnaire, and medical documentation were used for data collection. The median serum vitamin D concentration was 34.0 ng/mL, with pregnant women having higher levels (42.9 ng/mL) than postpartum women (31.8 ng/mL). There was no association between vitamin D serum concentration and dietary intake of vitamin D (p > 0.05), whereas there was a significant correlation with use of vitamin D supplements (r = 0.41; p < 0.001 in pregnant women and r = 0.35; p < 0.001 in postpartum women). This study demonstrated that a minority of pregnant women (21.9%) had optimal serum vitamin D concentration (>45 ng/mL), and diet had no significant impact on vitamin D levels. Thus, our proposed recommendation for vitamin D intake during pregnancy was 63 mcg (2500 IU) year-round for optimal levels in pregnant women in Northeastern Europe.