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Papers by Marleen Genetello

Journal of Human Nutrition and Dietetics, 2019

M. (2020) The long-term effect and adherence of a low fermentable oligosaccharides disaccharides ... more M. (2020) The long-term effect and adherence of a low fermentable oligosaccharides disaccharides monosaccharides and polyols (FODMAP) diet in patients with irritable bowel syndrome.

Journal of Pediatric Gastroenterology and Nutrition

An abstract is unavailable. This article is available as HTML full text and PDF.

Cystic fibrosis (CF) was originally described as an exclusively digestive dis-ease causing early ... more Cystic fibrosis (CF) was originally described as an exclusively digestive dis-ease causing early death in infants due to extreme malnutrition before any sign of respira-tory illness had developed. Once the pathological etiology was established, the suggestion was logical to introduce pancreatic enzyme therapy. One of the key findings in the care for people with CF was that energy is the magic cornerstone, which should be provided by food, rich in taste and calories. The next important step was to introduce enteral feeding using nasogastric tube and subsequently via gastrostomy. The help of psychologists is al-so invaluable in behavioural feeding problems at any age but especially in pre-school children. Since the earliest years, fat soluble vitamins were supposed to be problematic in CF because of the fat malabsorption. Their supplementation has been introduced and nowadays new specific preparations are available. Essential fatty acids and ω-3 long chain polyunsaturated fatty acids ...

Journal of Cystic Fibrosis, 2005

Journal of Cystic Fibrosis, 2006

Introduction: CF patients have higher requirements for fat-soluble vitamins (vit A, D, E, and K) ... more Introduction: CF patients have higher requirements for fat-soluble vitamins (vit A, D, E, and K) than healthy men and women. European CF guidelines recommend doctors to subscribe supplements of these vitamins. Aim of the study: To assess the intake of fat-soluble vitamins in adult CF patients registered at CF Center Utrecht. Subjects and Methods: We invited 111 out-clinic patients to take part in a telephone survey by a dietitian to assess type, frequency, dosage, duration and prescriber of the supplements. Results: Of the 93 respondents (age 28±8 years, 52 men), 75 (81%) used vitamin and/or mineral supplements. Fat-soluble vitamins as mono-supplements were exclusively used on prescription and had been used for >1 year. Thirty (40%) patients used vit A, 32 (43%) vit D, 51 (68%) vit E, and 23 (31%) vit K. Multivitamins were an important source of vitamins A, D, E and were used by 36 patients. The mean (range) intake from mono+multivitamin supplements was 492 (26 1212) gg/d of vit A, 5.9 (0.7 21) gg/d ofvit D, 99 (5 600) mg/d ofvit E, and 63.7 (0.7 1500) gg/d ofvit K. Discussion: We did not collect data on vitamin intake from food and on serum values. Thus, no conclusion on the vitamin status of the patients could be drawn. Conclusion: Most patients used supplemental vitamins A, D, E and K, mainly on prescription. Recommended supplement use was met by only 12% of the patients for vit A, 27% for vit D, 55% for vit E and 45% for vit K. Moreover, even in supplement users the intake of vitamins was below the recommendations in the majority of patients. Thus, doctors and dieticians should be more alert on vitamin supplementation. A yearly check of serum vitamin levels is recommended in CF patients.

Journal of Cystic Fibrosis, 2007

Aim: evaluate the relation of clinical parameters & genotype with the serum phospholipids FA comp... more Aim: evaluate the relation of clinical parameters & genotype with the serum phospholipids FA composition in CF patients. Methods: CF patients, with stable pulmonary disease, followed for min 6 m were taken a blood sample for phospholipids FA composition & vitamin E concentration. The genotype, age, pancreatic function, nutritional status, caloric intake, pulmonary function & presence of pseudomonas colonisation, liver disease or diabetes mellitus were recorded. Patients were divided in 2 groups according to genotype (group A: mutation class I, II, or III, group B: mutation class IV, V). Results: CF patients (group A and B together) have significant lower docosahexaenoic acid (DHA) (P < 0.007) and linoleic acid (LA) (P < 0.0001) and higher dihomogammalinolenic acid (DHGLA) (P < 0.0001), oleic acid (OA) (P < 0.0001) and mead acid (MA) (P < 0.0001), resulting in an increased ratio of arachidonic acid (AA)/DHA (P < 0.004), MA/AA (p < 0.0001) and OA/LA (P < 0.0001). Group A had compared to group B a lower LA (p < 0.002) and a higher DHGLA (p < 0.002), 22:4 w6 (p < 0.03), 22:5 w6 (p < 0.03) and 20:3 w9 (p < 0.04). There was however no significant difference between the groups for pulmonary function, nutritional status, age, vitamin E concentration. There was no relation of FA with gender, pulmonary function, pseudomonas colonisation, diabetes mellitus, pancreatic function, nutritional status or caloric intake. Patients with CF liver disease had an even lower DHA than the patients of the same genotype. Conclusion: Fatty acid disturbances are related to genotype and the presence of CF related liver disease. Future studies should take these parameters into account.

Journal of Cystic Fibrosis, 2007

Aims: To investigate the intake of vitamin A, E, D in 898 Scandinavian CF patients (median age 18... more Aims: To investigate the intake of vitamin A, E, D in 898 Scandinavian CF patients (median age 18.3 (0.3−66) y) and relate the intake to serum concentration and the fatty acid pattern of serum phospholipids (s-PLs). Methods: Vitamin (vit) intake was calculated from self-reported food records and vit supplements. S-retinol, s-a tocopherol, s-25-hydroxy vit D and s-PLs were analysed. Sub analyses were made from 407 CF patients completing a 7d precoded food record. Results: Around 90% of the patients reported supplementation with vit A, E and D. There were no differences between the countries, no gender but an age difference. Median vit A intake from supplements were 1714 (DK), 857(N) and 1350(S) mg (p total <0.001; all p < 0.001), for vit E 144, 126 and 209 mg (p total <0.001; DK vs N = ns). More Danish revealed low levels of vit A (<0.7 mmol/l) than Norwegian and Swedish patients (p < 0.01). More Danish and Norwegian patients revealed low levels (<11.6 mmol/l) of vit E than did Swedish ones (p < 0.01). For PI patients low levels of vit A were seen in 3.2 of children and 5.7% of adults, and of vit E in 10.1 and 18% respectively, with center differences. More PI adults than children revealed low levels of vit E and D (p < 0.01 and p < 0.001). There was a correlation between s-levels of vit E and mole% LA, AA and DHA. Conclusions: Adherence to vitamin therapy was higher than previously described. Patients at centres that do not monitor s-vitamin levels regularly revealed lower levels of the vit studied. Adult CF patients are more at risk of having decreased s-vitamin levels than children.

Annals of Nutrition and Metabolism, 2007

Objective: To evaluate the relation of clinical parameters and genotype with the serum phospholip... more Objective: To evaluate the relation of clinical parameters and genotype with the serum phospholipid fatty acid (FA) composition in cystic fibrosis (CF) patients. Methods: A blood sample was taken from CF patients with stable pulmonary disease for the determination of phospholipid FA composition and vitamin E concentration who had been followed for at least 6 months at our Cystic Fibrosis Centre. Genotype, age, pancreatic function, nutritional status, caloric intake, pulmonary function and presence of Pseudomonas colonization, liver disease or diabetes mellitus were recorded. Patients were divided into two groups according to their genotype (group A: mutation class I, II, or III, group B: mutation class IV, V). Results: CF patients (group A and B together) have significantly lower docosahexaenoic acid (DHA) (p < 0.007) and linoleic acid (LA) (p < 0.0001) and higher dihomogammalinolenic acid (DHGLA) (p < 0.0001), oleic acid (OA) (p < 0.0001) and Mead acid (MA) (p < 0.00...

Tijdschrift Voor Geneeskunde, 2010

Journal of Human Nutrition and Dietetics, 2019

M. (2020) The long-term effect and adherence of a low fermentable oligosaccharides disaccharides ... more M. (2020) The long-term effect and adherence of a low fermentable oligosaccharides disaccharides monosaccharides and polyols (FODMAP) diet in patients with irritable bowel syndrome.

Journal of Pediatric Gastroenterology and Nutrition

An abstract is unavailable. This article is available as HTML full text and PDF.

Cystic fibrosis (CF) was originally described as an exclusively digestive dis-ease causing early ... more Cystic fibrosis (CF) was originally described as an exclusively digestive dis-ease causing early death in infants due to extreme malnutrition before any sign of respira-tory illness had developed. Once the pathological etiology was established, the suggestion was logical to introduce pancreatic enzyme therapy. One of the key findings in the care for people with CF was that energy is the magic cornerstone, which should be provided by food, rich in taste and calories. The next important step was to introduce enteral feeding using nasogastric tube and subsequently via gastrostomy. The help of psychologists is al-so invaluable in behavioural feeding problems at any age but especially in pre-school children. Since the earliest years, fat soluble vitamins were supposed to be problematic in CF because of the fat malabsorption. Their supplementation has been introduced and nowadays new specific preparations are available. Essential fatty acids and ω-3 long chain polyunsaturated fatty acids ...

Journal of Cystic Fibrosis, 2005

Journal of Cystic Fibrosis, 2006

Introduction: CF patients have higher requirements for fat-soluble vitamins (vit A, D, E, and K) ... more Introduction: CF patients have higher requirements for fat-soluble vitamins (vit A, D, E, and K) than healthy men and women. European CF guidelines recommend doctors to subscribe supplements of these vitamins. Aim of the study: To assess the intake of fat-soluble vitamins in adult CF patients registered at CF Center Utrecht. Subjects and Methods: We invited 111 out-clinic patients to take part in a telephone survey by a dietitian to assess type, frequency, dosage, duration and prescriber of the supplements. Results: Of the 93 respondents (age 28±8 years, 52 men), 75 (81%) used vitamin and/or mineral supplements. Fat-soluble vitamins as mono-supplements were exclusively used on prescription and had been used for >1 year. Thirty (40%) patients used vit A, 32 (43%) vit D, 51 (68%) vit E, and 23 (31%) vit K. Multivitamins were an important source of vitamins A, D, E and were used by 36 patients. The mean (range) intake from mono+multivitamin supplements was 492 (26 1212) gg/d of vit A, 5.9 (0.7 21) gg/d ofvit D, 99 (5 600) mg/d ofvit E, and 63.7 (0.7 1500) gg/d ofvit K. Discussion: We did not collect data on vitamin intake from food and on serum values. Thus, no conclusion on the vitamin status of the patients could be drawn. Conclusion: Most patients used supplemental vitamins A, D, E and K, mainly on prescription. Recommended supplement use was met by only 12% of the patients for vit A, 27% for vit D, 55% for vit E and 45% for vit K. Moreover, even in supplement users the intake of vitamins was below the recommendations in the majority of patients. Thus, doctors and dieticians should be more alert on vitamin supplementation. A yearly check of serum vitamin levels is recommended in CF patients.

Journal of Cystic Fibrosis, 2007

Aim: evaluate the relation of clinical parameters & genotype with the serum phospholipids FA comp... more Aim: evaluate the relation of clinical parameters & genotype with the serum phospholipids FA composition in CF patients. Methods: CF patients, with stable pulmonary disease, followed for min 6 m were taken a blood sample for phospholipids FA composition & vitamin E concentration. The genotype, age, pancreatic function, nutritional status, caloric intake, pulmonary function & presence of pseudomonas colonisation, liver disease or diabetes mellitus were recorded. Patients were divided in 2 groups according to genotype (group A: mutation class I, II, or III, group B: mutation class IV, V). Results: CF patients (group A and B together) have significant lower docosahexaenoic acid (DHA) (P < 0.007) and linoleic acid (LA) (P < 0.0001) and higher dihomogammalinolenic acid (DHGLA) (P < 0.0001), oleic acid (OA) (P < 0.0001) and mead acid (MA) (P < 0.0001), resulting in an increased ratio of arachidonic acid (AA)/DHA (P < 0.004), MA/AA (p < 0.0001) and OA/LA (P < 0.0001). Group A had compared to group B a lower LA (p < 0.002) and a higher DHGLA (p < 0.002), 22:4 w6 (p < 0.03), 22:5 w6 (p < 0.03) and 20:3 w9 (p < 0.04). There was however no significant difference between the groups for pulmonary function, nutritional status, age, vitamin E concentration. There was no relation of FA with gender, pulmonary function, pseudomonas colonisation, diabetes mellitus, pancreatic function, nutritional status or caloric intake. Patients with CF liver disease had an even lower DHA than the patients of the same genotype. Conclusion: Fatty acid disturbances are related to genotype and the presence of CF related liver disease. Future studies should take these parameters into account.

Journal of Cystic Fibrosis, 2007

Aims: To investigate the intake of vitamin A, E, D in 898 Scandinavian CF patients (median age 18... more Aims: To investigate the intake of vitamin A, E, D in 898 Scandinavian CF patients (median age 18.3 (0.3−66) y) and relate the intake to serum concentration and the fatty acid pattern of serum phospholipids (s-PLs). Methods: Vitamin (vit) intake was calculated from self-reported food records and vit supplements. S-retinol, s-a tocopherol, s-25-hydroxy vit D and s-PLs were analysed. Sub analyses were made from 407 CF patients completing a 7d precoded food record. Results: Around 90% of the patients reported supplementation with vit A, E and D. There were no differences between the countries, no gender but an age difference. Median vit A intake from supplements were 1714 (DK), 857(N) and 1350(S) mg (p total <0.001; all p < 0.001), for vit E 144, 126 and 209 mg (p total <0.001; DK vs N = ns). More Danish revealed low levels of vit A (<0.7 mmol/l) than Norwegian and Swedish patients (p < 0.01). More Danish and Norwegian patients revealed low levels (<11.6 mmol/l) of vit E than did Swedish ones (p < 0.01). For PI patients low levels of vit A were seen in 3.2 of children and 5.7% of adults, and of vit E in 10.1 and 18% respectively, with center differences. More PI adults than children revealed low levels of vit E and D (p < 0.01 and p < 0.001). There was a correlation between s-levels of vit E and mole% LA, AA and DHA. Conclusions: Adherence to vitamin therapy was higher than previously described. Patients at centres that do not monitor s-vitamin levels regularly revealed lower levels of the vit studied. Adult CF patients are more at risk of having decreased s-vitamin levels than children.

Annals of Nutrition and Metabolism, 2007

Objective: To evaluate the relation of clinical parameters and genotype with the serum phospholip... more Objective: To evaluate the relation of clinical parameters and genotype with the serum phospholipid fatty acid (FA) composition in cystic fibrosis (CF) patients. Methods: A blood sample was taken from CF patients with stable pulmonary disease for the determination of phospholipid FA composition and vitamin E concentration who had been followed for at least 6 months at our Cystic Fibrosis Centre. Genotype, age, pancreatic function, nutritional status, caloric intake, pulmonary function and presence of Pseudomonas colonization, liver disease or diabetes mellitus were recorded. Patients were divided into two groups according to their genotype (group A: mutation class I, II, or III, group B: mutation class IV, V). Results: CF patients (group A and B together) have significantly lower docosahexaenoic acid (DHA) (p < 0.007) and linoleic acid (LA) (p < 0.0001) and higher dihomogammalinolenic acid (DHGLA) (p < 0.0001), oleic acid (OA) (p < 0.0001) and Mead acid (MA) (p < 0.00...

Tijdschrift Voor Geneeskunde, 2010