Dr. Yen-Hsuan Ni completed his MD and Ph.D education in National Taiwan University and received his pediatric residency training in Department of Pediatrics of NTU hospital. Later on, he did his post-doc at University of Connecticut Health Center, USA.
Dr. Ni’s clinical expertise is in the field of Pediatric Gastroenterology, Hepatology, and Nutrition. His research and clinical interests are the followings: (1) pediatric liver diseases: viral hepatitis, NAFLD, hereditary diseases, and transplantation (2) gut microbiota, and (3) pediatric IBD. He has already published more than 300 peer-reviewed papers in the aforementioned areas. Because of his achievement, he has won many important academic awards either domestically or internationally.
Dr. Ni participated in many international academic activities; he is the President of 4th World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition (Taipei, 2012), which convened more than 1800 delegates from 88 countries. He delivers more than 20 lectures every year in the international and domestic medical conference/ symposium. He has been appointed to be the Dean of College of Medicine, NTU since 2019, and is now leading Taiwan’s most prestigious medical college in research and education. In the meantime, he is also the President of Taiwan Pediatric Association.
Chomchark Chantrasakul Honorary Speech Topic : From Dysbiosis to Microbiome-based Therapeutics
The gut microbiota modulates the development of immune, metabolic, neurologic, psychiatric systems. And it may impact some disease courses through several different pathways, mainly with neurotransmitters, endocrinological and metabolic factors, and immune cytokines. The diseases involved, such as metabolic diseases, cancers, immunologic diseases, and neurologic disorders, may be attributed to the dysbiosis in the early life. Many factors affect the constitutions of the gut microbiota, including maternal nutrition, delivery routes, diet, geography, genetic factors, age, and drugs, and antibiotics. The diversity of the gut microbiota is one of the measures to define “dysbiosis”. Proteobacteria, Actinobacteria, Bacteroidetes, and Firmicutes are the major bacterial phyla in infancy. The infants’ gut microbiota configurations gradually transit into the adult patterns around the age of three. We have already proven an early colonization with R. gnavus in the gut promoted allergic disease in infants. We also demonstrated that Desulfovibrio could induce non-alcoholic liver diseases in obese children. Recently, we also found out the wax and wane of R. gnavus and A. muciniphila may modulate the clinical course of chronic hepatitis B infection. These gut bacteria exert their effects on these diseases through their metabolic pathways and these metabolites may result in the development of the clinical outcomes. The current focus of microbiota studies is on their metabolites, which are produced by the host-microbiota interaction and then affect many organs and diseases of the hosts. The responsible gut microbiome and its metabolites may become the therapeutic target(s), which will initiate the innovation of the probiotics. A longitudinal monitoring on the development of diseases and the evolution of gut microbiota is pivotal to unravel their roles in human diseases.
Phil Ayers United States of America Chief, Clinical Pharmacy Services, Clinical Associate Professor, Dept. of Pharmacy,
Dr. Ayers received his Bachelor of Science and Doctor of Pharmacy degree from the University of Mississippi. Phil is employed by Baptist Medical Center in Jackson, Mississippi and serves the Department of Pharmacy as Chief of Clinical Pharmacy Services. Dr. Ayers is a Clinical Associate Professor with the School of Pharmacy, University of Mississippi. Phil is currently serving the American Society for Parenteral and Enteral Nutrition (ASPEN) on the Board of Directors as President and is Past Chair of the Parenteral Nutrition Safety Committee. Dr. Ayers is a member of the USP Compounding Committee
Plenary Speech Topic: Parenteral Nutrition Safety: The ASPEN Experience
Parenteral nutrition (PN) is a complex, high-alert medication that may cause significant harm in patients if not prescribed, monitored and administered appropriately. The American Society for Parenteral and Enteral Nutrition (ASPEN) Parenteral Nutrition Safety Task Force was formed in 2013 to develop guidelines and recommendations for the safe use of parenteral nutrition. The Task Force was later elevated to a committee and numerous publications and tools have been developed to educate on the complexity and safe use of parenteral nutrition. This address will review the numerous guidelines, recommendations and tools developed by the Parenteral Nutrition (PN) Safety Committe. Future ASPEN PN projects will also be reviewed in the presentation.
Topic: Nutrition Therapy and COVID-19: The ASPEN Recommendations Reviewed
The Coronavirus disease 2019 (COVID-19) pandemic created many challenges for healthcare systems worldwide. Delivery of care to this patient population included strategies to reduce exposure and spread of the disease along with utilizing methods to provide adequate protection of healthcare providers and preservation of personal protective equipment.
Delivery of nutrition therapy early to this patient population proved to be challenging especially with gastrointestinal intolerance, hemodynamic instability and metabolic derangements. The use of enteral nutrition in prone positioning and extracorporeal membrane oxygenation required staff education for success. The threshold for use of parenteral nutrition (PN) was often lower than other populations of critically ill patients.
This presentation will address the educational efforts of the American Society for Parenteral and Enteral Nutrition (ASPEN) to ensure safe and appropriate nutrition in the COVID-19 patient.
Rocco Barazzoni Italy Associate Professor of Internal Medicine, Department of Medical Sciences, University of Trieste
Rocco Barazzoni, MD, PhD is Associate Professor of Internal Medicine, director of the Postgraduate School of Sports medicine, consultant in Internal Medicine and coordinator for the Obesity Outpatient Unit at Trieste University Hospital. His previous posts include Assistant Professor of Medicine and Research Fellow at Mayo Clinic and Foundation, Rochester, Minnesota. He is the current Chairman of the European Society for Clinical Nutrition and Metabolism (ESPEN). He also co-chairs of the ESPEN Special Interest Group on Obesity, and is president-elect of the Italian Obesity Society (SIO). He has participated in the Editorial Boards of several journals including Diabetes. His research focuses on nutritional and hormonal regulation of energy metabolism and related mechanisms in both clinical and experimental models in the settings of obesity, its metabolic complications and malnutrition. Professor Barazzoni has published more than 190 papers (h-index=48, average IF=4.61) in international peer-reviewed journals, including original research as well as editorials and guidelines.
Plenary Speech Topic: Malnutrition and Sarcopenia: Are We Overlooking Obesity? Strategies to Address Nutritional Problems in Obesity Patients
Obesity prevalence has reached epidemic proportions worldwide posing unprecedented individual, social, and medical challenges, by increasing risk for metabolic diseases, chronic organ failures and cancer, as well as their acute complications. Reducing excess adiposity remains the fundamental treatment for obese individuals. However complex metabolic and lifestyle abnormalities as well as weight reduction therapies per se may compromise the ability to preserve muscle function and mass. Indeed loss of skeletal muscle mass and function (sarcopenia) is common in individuals with obesity due to metabolic changes associated with sedentary lifestyle, adipose tissue derangements, comorbidities and the ageing process.
Strong evidence indicates that low muscle mass and function have a major negative health impact in obese individuals with frailty, disabilities and increased morbidity and mortality, but awareness of the importance of skeletal muscle maintenance in obesity is unfortunately still low among clinicians. The term ‘sarcopenic obesity’ has been introduced to identify obesity with low skeletal muscle mass and function, but its utilization is limited and consensus on its definition and diagnostic criteria also remains low. Knowledge on prevalence of sarcopenic obesity in various clinical conditions and patient subgroups, on its clinical impact in patient risk stratification, and on effective prevention and treatment strategies remain therefore inadequate and are unmet clinical priorities. Optimal lifestyle approaches and potential medical nutritional support strategies to preserve muscle mass in persons with obesity are particularly important, and optimization of body composition should become an additional priority in obesity treatment.
Topic: The Current Status and Improvement Strategies for Nutritional Intervention and Information in Europe
Clinical nutrition and its implementation in clinical practice (nutritional care) have the potential to improve hard outcomes and quality of life in virtually any disease condition. High-quality evidence in recent years has confirmed that screening, monitoring and treating disease-related malnutrition has positive clinical impact, including improved survival. Moreover, nutritional care should be recognized as a human right as a natural extension of the fundamental rights to food and health. Nutritional care remains however unfortunately under-recognized and under-implemented in clinical practice. In order to improve implementation of quality nutritional care, high-quality recommendations are more and more available in clinical guidelines that should be disseminated for both clinical nutrition healthcare professionals and non-nutrition specialists. The international clinical nutrition community has also recently proposed global consensus-based tools for screening, definition and diagnosis of malnutrition. These processes could benefit from increasingly available virtual tools and telemedicine, in order to further improve and optimize effectiveness and outreach. An important, fundamental issue to be addressed is also pre-graduate education, since teaching of nutrition and clinical nutrition are missing from mandatory curricula in most Universities and Countries. Finally and also importantly, advocacy should improve at institutional and political level to enhance awareness on the importance of clinical nutrition, both clinically and ethically, and on its cost-effectiveness, in order to improve existing healthcare policies and resources allocation.
Invited Speakers – International
Stanislaw Klek Poland Head Of The Department, Surgical Oncology Clinic, The Maria Sklodowska-curie National Cancr Research Institute In Krakow
Prof. Stanislaw Klek, MD, PhD, is a specialist in general and cancer surgery. He works as the Head of the Surgical Oncology Clinic as well as Medical Director at the National Cancer Institute in Krakow. He is also the Head of the Intestinal Failure Center at Stanley Dudrick’s Memorial Hospital in Skawina, Poland
Stanislaw Klek has published more than 200 original articles, 30 case reports, 18 book chapters, and over 100 congress abstracts. He was one of the first recipients of the European ESPEN Diploma (2010) and one of the first ESPEN LLL Teachers (2008). He was the Chairman of the Polish Society for Parenteral, Enteral Nutrition and Metabolism (POLSPEN) between 2010-2022. Member of ESPEN Special Interest Group on Acute Intestinal Failure. Associate Editor for Clinical Nutrition and other ESPEN journals (since 2013). Chairman of the International Section of American Society for Enteral and Parenteral Nutrition (ASPEN, 2019-21) and President of the 41st ESPEN Congress in 2019. Co-director of ESPEN LLL (since 2021).
Interested in film, music and sports (completed 14 Ironman 140.6 races, 12 Ironman 70.3 races, 6 Olympic triathlons, three ultramarathons and 19 marathons).
Topic : Updated Home Parenteral Nutrition Guideline and Benefit
Home parenteral nutrition (HPN) is the primary life-saving therapy for patients with chronic intestinal failure (CIF) due to either benign or malignant diseases. HPN may also be provided as palliative nutrition to patients in late phases of end-stage diseases.
Parenteral nutrition (PN) is categorized as total (or exclusive) PN, where it meets the patient’s nutritional needs in entirety, and as supplemental (partial or complementary) PN, where nutrition is also provided via the oral or enteral route.
The first European Society for Clinical Nutrition and Metabolism (ESPEN) guideline on HPN was published in 2009. The second, updated version was published in 2020 and was followed by ESPEN Practical Guidelines in 2023. It consists of 71 recommendations that address the indications for HPN, central venous access device (CVAD) and infusion pump, infusion catheter and CVAD site care, nutritional admixtures, program monitoring and management. The aim of this guideline is to provide recommendations for the appropriate and safe provision of HPN in a short and precise way clinical practice.
Sharon Carey Australia Dietitian Manager, Department of Nutrition and Dietetics, Royal Prince Alfred Hospital
Sharon is currently the Manager of Nutrition and Dietetics at the Royal Prince Alfred Hospital in Sydney, Australia, involving the day-to-day and strategic management of dietitians and dietitian assistants. She also works as the Director of Allied Health Research & Education for the Institute of Academic Surgery at the Royal Prince Alfred Hospital. Sharon has clinical expertise in the area of nutrition and gastroenterology, including advanced GI surgery and intestinal failure. She completed her PhD in 2014, and now holds an Associate Professor position at the University of Sydney, including the supervision of PhD students. Sharon is currently involved in a number strategic committees including the current President of the Australasian Society for Parenteral and Enteral Nutrition (AuSPEN); co-chair of the NSW Agency for Clinical Innovation Home enteral Nutrition Network and a selection committee member for the NSW Churchill Fellowship program. Sharon’s research skills ranges from reviews, quantitative and qualitative methodologies, and has over 60 publications. Her areas of expertise include multidisciplinary research with a strong translational research background. Sharon currently holds an MRFF Translating Research Into Practice Fellowship, and has completed a Specialist Certificate in Implementation Science at University of Melbourne. Sharon also has a strong focus on patient-centered research, including patient-reported outcomes, and consumer involvement. She has completed a Graduate Certificate in Consumer Engagement.
Topic : The Role of Home Parenteral Nutrition in Cancer Patients
Home parenteral nutrition has a role to play in many patient groups, including within the oncology population. This can include pre and post oncology surgery and also within the palliative care setting where appropriate. Careful selection of patients is required with adequate support. This presentation will present the current evidence, outcomes and cost effectiveness for utilizing home parenteral nutrition in the oncology setting, with specific discussion around the surgical oncology patient and the palliative patient.
Topic : Treatment of Obesity in UGI Surgical Oncology
The management of obesity within the perioperative period for surgical oncology patients has been a growing area of research in recent years. The practice of pre-operative weight loss in obese patients having oncological surgery is becoming more common. Contrary, this patient group is also at high risk of sarcopenia, and still have high nutritional requirements. This presentation will present the current evidence for management of obesity in the surgical oncology patient and discuss implications for clinical practice.
Jae-Moon Bae South Korea Professor, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea
Name: Jae-Moon Bae M.D.,Ph.D.,FACS
Professor, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea
1980-1986: Seoul National University, College of Medicine (M.D.)
1987-1995: Graduate School of Medicine, Seoul National University (Ph. D.)
1986-1991: Internship and Residency, Dept. of Surgery Seoul National University Hospital 1998.08~1998.10: Visiting Scientist, National Cancer Center East Hospital, Japan
2000.04~2001.04: Guest researcher, NCI – Lab. of Cell Regulation and Carcinogenesis, NIH, U.S.A.
1991-1994: Captain of Korean Army (Military duty)
1994-2001: Professor, Ewha Womans University, College of Medicine, Seoul
2001-2007: Head of Center for Gastric Cancer, National Cancer Center, Korea Chief, Gastric Cancer Branch, Research Institutes Deputy Director, National Cancer Center Hospital Director, Office Planning & Coordination, National Cancer Center
2007 ~present: Professor, Dept. of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine
2011~2013: Director, Management and supporting Office, Samsung Cancer Center Chief, Dept. of Gastrointestinal Surgery, Samsung Medical Center 2019.05 ~2021.04: Director, Gastric Cancer Center, Samsung Medical Center
2016.04~2018.03: President, Korean Society of Surgical Metabolism and Nutrition (KSSMN) 2020.06~2021.06: Vice president, Korean Cancer Society (KCA)
2019.04~2021.09: Chairman, Board of Directors, Korean Gastric Cancer Association ( KGCA) 2020.09~2022.06: Chairman, Board of Directors, Korean Society of Parenteral and Enteral Nutrition (KSPEN)
2022.06~ 2023.06: President, Korean Society of Parenteral and Enteral Nutrition (KSPEN)
Topic: The Government Policy in Nutritional Care (South Korea)
The appropriate nutritional support for patients has been set up as one of basic medicine, and it is well known that nutritional support has a close relationship with the effectiveness of treatment, and it promoted an early recovery and increased survival by reducing morbidity and mortality after surgical treatment. Nutritional Support Team (NST) is defined as a multidisciplinary group of health care professionals with interest and expertise in the identification, evaluation, and treatment of patient with current or impending malnutrition and nutritionally related problems. The goal of NST is to provide safe, optimal nutrition to all patients, especially in case of need for enteral tube feeding or parenteral nutrition, in a coordinated fashion.
The NST was started as a voluntary and individual movement of each hospital stimulated by KSPEN in Korea. NST activity has been motivated and concretely established by the introduction of medical fee for it in 2014. Since 2014, not only was the activity of NST settled, but quantitative and qualitative growth was also achieved by activating rounds and regular meeting.
Government policy has a tremendous influence on medical practice and medical environment in Korea, because government is the only medical insurance supplier in Korea.
The development of NST activity and government policy will be presented and some problems will be suggested. For the quality control of NST activity, an accreditation program of KSPEN will be introduced.
Medical financing system is very crucially important for NST activity in Korea. NST needs to continually justify its existence by demonstrating value, defined as the best quality in evidence-based outcomes for the minimum cost. If so, NST may evolve as healthcare changer
Topic: Quality of Nutritional Care in South Korea
Nutrition care would cover from critical care to long-term health impacts.
The quality of care (QoC) is a focus on nutrition-related standards, of which these standards could improve quality of nutrition.
The quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes.
Nutritional care includes nutritional screening, assessment, and nutritional intervention. Nutritional screening and assessment will be the first step of nutritional care. The popular nutrition index in Korea will be introduced.
Nutritional Support Team (NST) is defined as a multidisciplinary group of health care professionals with interest and expertise in the identification, evaluation, and treatment of patient with current or impending malnutrition and nutritionally related problems.
NST is a functional unit for nutritional care. The NST activity was started as a voluntary and individual movement of each hospital stimulated by Korean Society of Parenteral and Enteral Nutrition (KSPEN) in Korea.
The quality control of NST may be an important key to manage the quality of nutritional care in Korea, because NST activity has been motivated and concretely established by the introduction of medical fee for it in 2014.
KSPEN started an accreditation of NST of each hospital as early as in 2009. Since then, KSPEN have operated accreditation program of NST of hospitals in Korea. The accreditation program of NST by KSPEN will be introduced.
Enders Kwok-Wai Ng Hong Kong Chief of Service, Department of Surgery, The Chinese University of Hong Kong
Professor Enders Ng is now the Associate Dean (Alumni Affairs) of the Faculty of Medicine, The Chinese University of Hong Kong. His post under Hospital Authority is the Hon. Chief of Service in Surgery at Prince of Wales Hospital and the Cluster Surgery Director of the New Territories East Cluster.
Professor Ng obtained his medical degree from the Chinese University of Hong Kong in 1989. He embarked on both basic and clinical research shortly after finishing his surgical training in the mid-1990s. He received the higher degree of Doctor of Medicine (CUHK) in 1999 for his work on investigating the relationship between Helicobacter pylori and peptic ulcer diseases. Over the years, he was awarded by different authorities and societies for research achievement. He was the Founding President of the Hong Kong Society of Upper Gastrointestinal Surgeons from 2006 to 2010. He is also the President of Hong Kong Society of Parenteral and Enteral Nutrition since 2007. He was repeatedly elected as Councilor of the College of Surgeons of Hong Kong from 2007 to 2019 and appointed Vice-President (Internal Affairs) from 2013 to 2019. Up to now, he has published over 250 original articles in various international peer-reviewed journals and more than 10 book chapters in Surgery and Endoscopy.
Topic: Government Policy on Clinical Nutrition in Hong Kong
Hong Kong health care system bases on two major pillars – the private sector and the public services which is heavily funded by the government. Nearly 90% of the citizens are enjoying the services provided by the Hospital Authority, which receives nearly 6 bilion US dollars per year from the government to run 43 public hospitals and 49 specialist outpatient clinics. Nutrition policy by the government is being implemented through these hospitals and clinics, and it can be divided into in-patient and out-patient settings.
In the hospitals, patients are provided with 3 essential meals per day according to their tolerability by the Central Catering Service for free. The protein-calorie values of the supplied food are closely monitored by the Dietiatic Department. For patients who could not tolerate oral diet, the nutrition team/dietiatic department would be consulted and enteral feeding or parenteral nutrition will be provided via the pharmacy, again for free. However, once a patient is being discharged from the hospital, nutrition, no matter whether it is enteral or parenteral route, becomes a food and the patient would need to pay for it as if buying food from the market. For patietns with financial difficulties, the government has a policy to provide subsidy in form of Disability Allowance which is handled by the Social Welfare Department (independent of Hospital Authority).
Home pareneteral nutrition remains an underdeveloped facet of clinical nutrition service in Hong Kong. The reasons are mutlifactorial. It includes small living space in Hong Kong, lack of government support, communitiy nurse service policy, patient and family acceptance, and lack of trained care-providers. Thus, even the financial burden may be covered by the Disability Allowance given by the Social Welfare Department, there are many hurdles to overcome before it can be more widely practices for short gut syndrome.
Training of professional dietitian is currently being run by a single institute, the SPACE of Hong Kong University as a master degree. There is a voluntary registration system to regulate the dietitian regarding their qualification and practice. However, a stricter legislation scheme is in need to uphold the standard of this profession in the near future.
Naoki Hiki Japan Chairman, Department of Upper-Gastrointestinal Surgery, Kitasato University School of Medicine
Professional Training and Employment:
1990, Apr Passed the Examination of National Board
1990, Jun-1991, Jun. Medical Stuff in General Surgery, University of Tokyo
1991, Jul-1991, Dec. Medical Stuff in Trauma and Critical, Care Center, Teikyo University, Tokyo
1992, Jan-1992, Jun Medical Stuff in Anesthesiology, University of Tokyo
1992, Jul-1993, Jan Research Fellowship in General Surgery, University of Ulm, Ulm, Germany
1993, Feb-1993, Mar Medical Stuff in General Sugery, University of Tokyo
1993, Mar-1995, Mar Medical Stuff in General Surgery, Ohme-City Hospital, Tokyo
1995, April-1998, Apr The University of Tokyo, Postgraduate School
1995, Oct-1997, Oct Research Fellowship in General Surgery, University of Ulm, Ulm, Germany
1998, Apr-2005, Mar Assistant Professor in Department of Gastrointestinal Surgery, The University of Tokyo
2005 Apr-2018, Dec Department of Gastroenterological Surgery, Divsion Director, Gastric Surgery, Department of Director, Clinical Nuturition Cancer Institute Hospital, Tokyo
2014, April-2021, Mar Visiting Professor, Department of Surgery, Institute of Gastroenterology, Tokyo Womens Medical University
2019, Jan-Present Professor and Chirman, Department of Upper Gastrointestinal Surgery, Kitasato University School of Medicine
2021, Jul-Present Vice Director, Kitasato University Hospital
2022, Apr-Present Director, Nutrition Department, Kitasato University Hospital
2023, Jan-Present Visiting Professor, Graduate School of Medicine Hokkaido University.
Topic: Health Care Insurance System in Japan – Focusing on Nutritional Intervention
The medical system around the world differs from country to country, and access to medical institutions and payment methods for medical expenses also differ from country to country.
Japan has achieved a high average life expectancy and standard of medical care through its universal health insurance system. Universal health insurance system in Japan is available to all citizens from infants to the elderly. Insured people pay a fixed amount of insurance premiums every month, and when they receive medical treatment for an illness or injury, they can visit insurance medical institutions, etc. The copayment amount paid at the counter will be 10% to 30% of the medical expenses related to the medical treatment. After the medical treatment, the insured medical institution, etc. requests medical fees from the insurer, and the amount excluding the insured’s co-payment from the medical expenses related to the medical treatment is paid by the insurer to the insured medical institution, etc.
Medical fee point table has been established for medical fees billed by insured medical institutions, which are subdivided into various types of treatment. The medical institution that examined the patient should add up the points for each patient and bill the insurer including NST additions and medical fees for the use of medicines at home.
Jesus Fernando B. Inciong Philippines Associate Professor Department of Surgery St. Luke’s Medical Center – College of Medicine
Dr. Inciong is a practicing surgeon with particular interest in surgical metabolism and nutrition.
Recognizing the value of nutrition in patient outcomes, he was involved in the establishment of the Medical Nutrition Fellowship Program in St. Luke’s Medical Center – Quezon City, which has been in existence for the past 20 years. Concurrent with leading the training program, he is also tasked to be the Head of Weight Intervention and Nutrition Services at the same institution. In the past, Dr Inciong has been Chief of the Section of Surgical Nutrition and Metabolic Support of the Institute of Surgery where he has also been part of the Surgical Training Committee for several years.
Highly motivated in the academe, he is an Associate Professor in Surgery at St. Luke’s Medical Center – College of Medicine and is involved in the examinations of the Philippine Board of Surgery (PBS) and the Philippine Board of Clinical Nutrition (PBCN). Just recently, he is now part of the editorial board of the Journal of Surgical Metabolism and Nutrition (SMN).
Being active in education and research, he has contributed to publications/ book chapters in the field of surgery and nutrition therapy on patients undergoing major gastrointestinal surgery, hospital malnutrition, the critically ill, refeeding syndrome and stroke patients.
Topic: Prehabilitation and Nutrition Support in Surgical Patients
In recent years the field of surgery has evolved and we have discovered novel ways to lessen the effects of the trauma of surgery through minimally invasive techniques and even robotic surgery. Along with these advances, we have a better understanding of the effects of the surgical stress response and the associated loss of lean body amass and functionality that occurs with it. These changes likewise increases the risk of malnutrition in our surgical patients. Thus, despite these scientific enlightenments, major surgery remains to be associated with increased morbidity and mortality.
Knowing these effects in our surgical patients, a program which may increase our patients functional reserves may enable them to have an improved postoperative course and most importantly a better quality of life. Prehabilitation is a mode of preoperative intervention to optimize our patients for the stressors of surgical intervention.
Prehabilitation focuses on eliminating or mitigating modifiable risk factors prior to surgery. These are exercise to improve physical fitness, nutrition support, smoking/alcohol cessation, and psychological stress reduction interventions. These multimodal interventions administered over a period of time may alter shorter clinical outcomes and even some long-term health benefits
Samir Awad United States of America Professor and Vice-Chair for Surgical Quality and Safety, Division of Trauma and Acute Care Surgery, Baylor College of Medicine
Neoplastic diseases represent the second leading cause of death worldwide and the number of new cases is expected to rise significantly over the next decades. Malnutrition is a common feature in cancer patients and is the consequence of both the presence of the tumor and the medical and surgical anticancer treatments. Malnutrition negatively impacts on quality of life and treatment toxicities, and it has been estimated that up to 10-20% of cancer patients die due to consequences of malnutrition rather than for the tumor itself. Nutrition plays a crucial role in multimodal cancer care. Robust evidence indicates that nutritional issues should be taken into account at the time of cancer diagnosis, within a diagnostic and therapeutic pathway, and should be running in parallel to antineoplastic treatments. Worldwide, cancer-related malnutrition is still largely unrecognized, underestimated and undertreated in clinical practice. A case of advanced colorectal cancer patient with severe malnutrition will be presented and review the evidence based approach and pathway to optimize nutritional status as patient receives neoadjuvant therapy, followed by surgical resection to improve patient outcomes.
Mohammad Shukri Jahit Malaysia Consultant Upper Gi Surgeon, Department of Surgery, National Cancer Institute, Putrajaya, Malaysia
Senior Consultant Upper GI & General Surgery, National Cancer Institute, Putrajaya, Malaysia. President of PENSMA since 2011. Special interest in 1. Management of Upper GI cancers 2. Clinical nutrition in surgery, cancer, metabolic diseases including obese patients. Among other achievements are 1. Established the practice and guidelines of prehabilitation in major surgery and Upper GI surgery. 2. Initiating and promoting ERAS concept among the surgical fraternity in Malaysia. 3. Establishment of clinical Nutrition Therapy Teams around Malaysia. 4. Initiating home PN program and establishment of guidelines on the management of Short Bowel Syndrome.
Topic: Quality of Nutrition Care in Malaysia
Clinical Nutrition has been a grey area in the health care system for years as it was not taught in the medical schools for doctors, neither in the nursing colleges for the nurses. Dietary provisions has been the forte of dietitian for years and pharmacists were not well-trained in clinical PN. However in the past 10 years especially the recent 5 years the interest among all stake holders have significantly increase. This is sparked by the exposure to data and improved clinical outcomes among those who were given priority in the nutritional delivery. The society and each fraternity play such an important role to get the ball rolling in initiating and maintaining clinical nutrition education , awareness and training. Now we can see the emergence of Nutrition Therapy Teams all over major hospital in Malaysia. They works either individually or a recognized clinical teams within each institution. PENSMA or the Parenteral andEnteral nutrition Sopciety of Malaysia has played a major role in providing annual credentialing worksop to all Nutrition Therapy Team members.
Željko Krznarić Croatia Head, Department of Gastroenterology, Hepatology and Nutrition, Clinical Hospital Centre & School of Medicine Zagreb
Dr Sanjith is a critical care consultant .After completing his anesthesia from the prestigious lokmanya tilak municipal and general hospital ,Mumbai, India he went on to pursue his critical care diploma from the Ruby Hall clinic neurotrauma unit ,Pune in Maharshtra,India. Subsequently he completed a fellowship of neurotrauma critical care at the Hadassah university teaching hospital at Israel .He is the only Indian doctor to hold this kind of a speciality in India. During this stint he understood the nuances of objectivity in neurotrauma and critical care nutrition.
He has also completed the European diploma in critical care from Brussels. His line of interest lies in neurotrauma critical care ,mechanical ventilation and nutrition in the critically ill patient.
He is an excellent orator and is a teacher of critical care for the Indian society of critical care medicine and nursing ,college of intensive care medicine and the Maharashtra university of health sciences. He is also the teacher for the advanced certification in respiratory technology and all his lectures can be accessed on drsanjith.com and the you tube channel by the name of dr Sanjith Saseedharan.
His infectious interest in critical care has rubbed onto the ICU at Raheja where care is evidenced based, with optimum use of technology like FRC calculation and transpulmonary pressure for mechanical ventilation, use of indirect calorimetry ,use of functional hemodynamic monitoring like volumetric parameters, EV 1000,PICCO,scvo2 and SJVo2 to name a few.
He has 96 peer reviewed articles and presentations in peer reviewed journals ,written 2 books as single author, 12 book chapters,8 best research paper awards to his credit ,a gold medal award winning patented software in the field of critical care nutrition called the “inutrimon”, best innovation award for a technological patient interface called as “vocalizer” and has been a faculty in a number of national and international conferences. He has been the recipient of the Ibn Haithm award for best researcher at the pan Arab critical care congress and has been awarded the clinician of the year 2023 by the Global association of physicians of Indian origin. He remains the organizing secretary of the very sought after annual mechanical ventilation workshop and the nutrition boot camp year after year and was the scientific chair for the recently concluded Pensa 2022 in India. He also been felicitated with awards for best doctor in critical care- Mumbai by the Week and Outlook magazines year after year.
Dr.Sanjith presently heads the dept of critical care at the S.L.Raheja hospital -a Fortis associate and is the president elect of the Indian society of parenteral and enteral nutrition(ISPEN).
Topic: The Application of Artificial Intelligence in Clinical Nutrition
The integration of technology can help in making critical care nutrition significantly scientific, simple and objective by helping to estimate the energy needs of the patient, probably determine the utilization of the proteins and calories and provide real time monitoring of the feed delivery by automated systems .Technology can further help in the data analysis with the help of electronic medical records for improving scientific knowhow . Infact the field of healthcare has witnessed a remarkable transformation in recent years, largely owing to the integration of Artificial Intelligence (AI) into various aspects of medical practice. AI, in its current state, has become a powerful tool for improving patient care, and one of its promising applications is in the realm of clinical nutrition. One noteworthy AI-driven solution in the field of clinical nutrition is iNutrimon which arguably appears to be a game changer in this segment. This innovative tool, co-created by the author of this article is currently deployed in 15 of India’s top-tier hospitals and serves approximately 3000 patients daily which helps in planning, monitoring ,managing and also forms a powerfuk research tool using data nalaytical software to improve the practice of clinical nutrition .The next frontier for similar softwares and the iNutrimon is AI integration, which involves leveraging Large Language Models (LLMs) and semantic search. Integration of such softwares like the inutrimon with search engines like AIDE/pubmed search etc, in the authors opinion, help to provide evidence-based insights to healthcare professionals with 100% accuracy, relying on references from evidence-based papers and documents.
The use of a software like this would help in data generation.Integration of this data on real time basis along with vitals signs and investigations will give an opportunity for analysis.Artificial intelligence tools uses neural networks and fuzzy logic which can quickly learn and allow for the ultimate optimal “smart” system with the ability to learn and adapt to varying situations.As AI continues to evolve and adapt to the specific needs of healthcare, it has the potential to revolutionize clinical nutrition, ultimately leading to improved patient outcomes and a healthier future for all.
Paul Wischmeyer United States of America Professor With Tenure of Anesthesiology and Surgery, Duke University School of Medicine
Paul E. Wischmeyer, MD, EDIC, FCCM, FASPEN is a critical care, perioperative and nutrition physician who serves as a Professor with Tenure of Anesthesiology and Surgery at Duke University School of Medicine. He also serves as the Associate Vice Chair for Clinical Research in the Dept. of Anesthesiology & Director of the Nutrition Team at Duke Hospital. Dr. Wischmeyer’s clinical and research focus is focused helping patients prepare and recover from critical illness and surgery. His research interests include surgical and ICU nutrition and exercise rehabilitation therapy, parenteral nutrition and personalized nutrition trials, perioperative optimization, post-illness muscle mass and functional recovery, and role of probiotics/microbiome in illness, specifically COVID-19 prevention/treatment. Dr. Wischmeyer has received significant funding from the National Institutes of Health and DOD as well as numerous awards for his work from national and international societies, including the Jeffrey Silverstein Award and Memorial Lecture for Humanism in Medicine from the American Delirium Society, Fellow of the Society of Critical Care Medicine (FCCM), the John M. Kinney Award for the most significant contribution to the field of general nutrition, the Stanley Dudrick Research Scholar Award of the American Society for Parenteral and Enteral Nutrition where he is also an honorary Fellow of ASPEN (FASPEN). In 2020 he received the ASPEN George Blackburn Clinical Nutrition Mentorship Award, as well as the Excellence in Nutrition Support Education Award from the American Society for Parenteral and Enteral Nutrition, and he has received the Lifetime Achievement Award of the International Parenteral Nutrition Education and Methodology Advancement for significant contributions to the field of nutrition. He has over 200 publications (H index-70 and 50 papers with > 100 citations) in nutrition, critical care, and perioperative care, including publications in New England Journal of Medicine. He has been an invited speaker at numerous national/international medical meetings, delivering over 1000 invited presentations in his career. Finally, he is an advocate and lecturer for improving the patient experience and teaching provider’s to keep CARE as the focus of healthcare.
Topic: Muscle loss for patients undergoing surgery and its clinical implications
Muscle loss and sarcopenia is are significant pre-operative risk factors for adverse outcomes and mortality in virtually all major surgeries. Further, ongoing muscle loss is a significant consequence of the post-surgery period from bedrest and the underlying disease process leading to the need for surgery, as well as the surgical stress. It is critical that muscle mass and muscle quality is assessed in the preoperative setting to assess risk and for an objective and accurate diagnosis as muscle mass is now an essential component of malnutrition diagnosis in the new GLIM criteria for malnutrition. Muscle-assessment techniques such as CT scan, ultrasound, and BIA are essential for muscle mass assessment and accurate malnutrition diagnosis. Further, ongoing muscle mass assessment following surgery is essential to assess the adequacy and effect of nutrition delivery as well as help guide the need for rehabilitation post-surgery. This lecture will utilize a compelling patient case study to assist in the discussion. The lecture will cover new data for the critical role of muscle mass assessment in predicting the outcome from surgery. Further, existing and new cutting-edge techniques for muscle mass assessment before and after surgery will be discussed. Finally, new and exciting personalized pre-habilitation and post-surgical exercise rehabilitation techniques will be discussed to improve muscle mass and fitness for surgery.
Topic: Parenteral Nutrition In Overweight ICU Patients
Evidence for the safety and benefit of early parenteral nutrition (ePN) has changed significantly in past 10 years. Recent data and recommendations now indicate PN does not carry any increased risk of infection i.e. it is just as safe to put PN through a central line as saline. Further, recent data in abdominal surgery show early supplemental PN significantly reduced infections post-operatively. Further, recent guidelines indicate ePN use is equally safe as early EN and may be used interchangeably based on patient need. While early EN is always preferred, data indicates we routinely fail to feed even 50-60% of energy/protein targets for 12 days, even in ICU. Thus, it is critical ePN start sooner, especially in malnourished patients where it should be started at hospital/ICU admission if EN/oral goals are not reached within 48 h. Even in well-nourished patients, ePN can be started safely when not reaching energy/protein targets in 48-72 h. This emphasizes the challenge of nutritional assessment and when to start PN in obese patients. It is critical to realize obese subjects have impaired physiological responses to trauma/illness, such that despite having large calorie reserves in adipose, they are very inefficient in mobilizing stores and waste muscle mass faster than lean patients, leading to greater muscle mass loss. Further, many obese patients have undetected low muscle mass/sarcopenia and thus are at greater complication risk. Thus, it is critical to utilize GLIM malnutrition criteria via objective muscle measures to assess nutritional status such as muscle ultrasound or CT scan. The old adage- “obese patients should be put on a diet” in ICU must END! It is essential accurate feeding targets utilizing new-generation indirect calorimeters (IC) is employed. IC-use is shown to reduce mortality in ICU and is especially critical in obesity where predictive equations are highly inaccurate. Thus, in obese patients: 1) It is critical nutrition status is determined via objective method per GLIM (i.e. muscle u/s or CT; 2) Nutrition targets set via indirect calorimetry as predictive equations are inaccurate; 3) Early PN may be used safely and interchangeably with EN to meet protein/calorie targets.
Matsuo Koichiro Japan Professor, Department Of Oral Health Sciences For Community Welfare, Tokyo Medical And Dental University
Dr. Matsuo earned both D.D.S. and Ph.D. degrees from Tokyo Medical and Dental University, Tokyo, Japan. He joined the Department of Physical Medicine and Rehabilitation, Johns Hopkins University as a post-doctoral research fellow and an assistant professor for 6 years (2005-08). He was back to Japan in 2008, and appointed to current position in 2021.
His clinical interests include geriatric dentistry for frail elderly individuals having physical disabilities, systemic diseases, and/or feeding difficulties. He is currently working in Oral Health Center to see inpatients with various diseases in a medical hospital. His recent research has focused on oral health and oral frailty in older individuals and fundamental understanding of physiology and pathophysiology of mastication and swallowing.
Topic: Multi-Discilplinary Approach For Postoperative Dysphagia Rehabilitation
Perioperative oral health management is important in preventing postoperative complications such as pneumonia or surgical site infection and enhancing early recovery of oral food intake, which leads to early hospital discharge and shorter length of hospital stay. Since oral bacteria may serve as pathogens for postoperative respiratory infection by entering the lower respiratory tract, perioperative oral hygiene care in patients receiving cancer surgery plays an important role in preventing postoperative complications derived from pathogenic oral bacteria. Post operative early recovery of oral food intake is also important to prevent postoperative complications. Previous studies have reported that sarcopenia is one of risk factors for postoperative complications. Sarcopenia also impacts on eating function since oral and pharyngeal muscle mass and strength can be influenced by sarcopenia as well. Therefore, perioperative oral rehabilitation play essential roles to support early recovery of oral food intake for patients with postoperative dysphagia.
I will introduce team approach of perioperative oral health management to postoperative oral rehabilitation in my presentation.
Kwang Yeong HOW Singapore Senior Consultant, Department of General Surgery, Tan Tock Seng Hospital
Dr How Kwang Yeong is a senior consultant surgeon in the Colorectal Service of the General Surgery Department, Tan Tock Seng Hospital.
He specializes in minimally invasive surgery, including endoscopic, laparoscopic and robotic techniques for the treatment of colon and rectal conditions.
Dr How is a strong advocate for clinical value and quality improvement. He played a key role in establishing the ERAS® program in Tan Tock Seng Hospital, which is recognized by ERAS® Society as a Centre of Excellence. He is an executive member of the ERAS® Society, member of the education and implementation committee, and helps to train other hospitals in setting up ERAS® Programs.
Dr How is also Director of Endoscopy, Clinical Director of Perioperative Recovery Office and current President of the Society of Parenteral and Enteral Nutrition (Singapore).
Topic: The Clinical Importance of Routine Nutritional Evaluation in ERAS
The nutritional status of the patient provides the foundation for recovery after surgery, and opportunities to optimize outcomes exist from the first patient assessment to the early days after surgery. Malnutrition is associated with increased postoperative morbidity and mortality. Nutritional assessment and therapy thus play an important role in improving surgical outcomes and are an important part of ERAS programs. The prevalence of malnutrition in surgical patients can be highly variable, and is affected by patient, disease, socioeconomic and geographical factors. It is therefore crucial to identify malnourished patients, and initiate therapy before and after surgery. Several validated nutritional screening and assessment tools are available, and technology has improved our ability to assess patients more accurately. However, nutritional evaluation in surgery is still not universal and remains a challenge in implementation. Therefore, a mindset and behavioral change is required for this to become routine practice and standard of care.
Marianna Ramona S. Sioson Philippines Vice President, Enhanced Recovery After Surgery – Philippines
Marianna Ramona S. Sioson, MD, MSc, FPAFP, FPCMNP, Manila, Philippines
Dr. Sioson is a medical nutrition physician and a nutrition support team member of various hospitals in Manila. She heads the Section of Medical Nutrition at The Medical City Hospital. She is also faculty of the Medical Nutrition Fellowship programs of her hospital and of St. Luke’s Medical Center.
She was instrumental in making The Medical City Hospital the only Asian LMIC ERAS Center of Excellence. She is the Vice President of ERAS Philippines and the Diversity, Equity, and Inclusion (DEI) Officer of ERAS Society International.
She is a past president of PhilSPEN.
She has co-authored ERAS and nutrition papers including the 2018 Asia Pacific and Middle East Consensus Statement on ICU Nutrition and the 2022 ERAS LMIC Guidelines. She conducts numerous lectures locally and internationally. She teaches at the Ateneo School of Medicine and Public Health in Manila.
Topic: Surgical Outcomes of Nutrition Optimization in Eras Protocols
Nutrition is a key component in the management of patients both preoperatively and postoperatively. Malnutrition at any surgical stage impacts outcomes and postoperative recovery. Enhanced Recovery After Surgery or ERAS protocols ensure that nutrition will be addressed.
The goals of nutrition in an ERAS pathway are to provide adequate and appropriate nutrients to promote recovery and wound healing and to attenuate the inflammatory metabolic response to surgery. It covers 3 periods of care. The remote preoperative period encompasses prehabilitation and nutrition upbuilding; the immediate perioperative phase includes the provision of immunonutrition and carbohydrate loading as well as limiting periods of unnecessary fasting; while the postoperative phase deals with continued monitoring of adequacy of intake and quality of nutrients coupled with mobility exercises.
It is important to remember that a pivotal component in the implementation of an ERAS protocol is audit. This measures performance and compliance with the ERAS elements. Nutrition must be included in this audit.
Although the evidence may be variable, nutrition optimization using these strategies leads to overall improvements in surgical outcomes such as reduced infections, shorter hospital stay, and faster return to normal or usual function.
Hon. Mette M Berger Switzerland
Prof. Emeritus, University of Lausanne
Prof. Hon. Mette M Berger is an Intensive care physician from the Lausanne University Hospital and specialized in burn care and nutrition. She has been responsible for the Lausanne burn center for 30 years
She received her M.D. degree from Lausanne School of Medicine (Switzerland), and her medical Ph.D from the University of Umeå (Sweden). After a first specialty in Anesthesiology (Lausanne University), she became an intensive care specialist. She also trained as a nutritionist in Nancy (France) and acquired an MBA in health economics.
Prof. Berger has held positions as president and treasurer of the Swiss Society of Clinical Nutrition (SSNC), is member of the ESPEN-ICU guidelines group, Honorary member of European Society of Intensive Care Medicine (ESICM and SSNC) and chairs the ESPEN guidelines and special interest group for micronutrients. Prof. Berger has authored over 290 publications on nutritional therapy of the critically ill, burn and trauma care, and micronutrients. She is also a teacher for the LLL-ESPEN training program and lecturing worldwide in 5 languages about individualized nutrition therapy, metabolism and micronutrition.
She has contributed to developing the concept of monitoring nutrition therapy, promoting the use of indirect calorimetry. Committed to education, she has published multiple training documents.
Topic: Specific characteristics of the covid-19 patients
Insufficient feeding is frequent in the intensive care unit (ICU) and causes poor outcome. The analysis of 150 consecutive patients admitted to our ICU’s long-stay program revealed some specific aspects. The admission criterion to the program was a stay > to 10 days). These persistent critically ill patients were aged 60±15 yrs, with a NRS score of 5, and stayed 31[26, 46] days (median IQR). The mortality was 18%: the non-survivors were older (p=0.024), tended to higher SAPSII score (p=0.072), with a significantly higher NRS score (p=0.033). A high admission NRS score was the only nutritional variable that distinguished the patients with poor outcome
Enteral nutrition predominated while combined feeding was little used: feed delivery was highly variable within and between patients. Supplemental parenteral nutrition was rarely (insufficiently) used, resulting in all patients received energy and protein below recommendation and below energy expenditure measured indirect calorimetry value, mostly due to multiple interventions during the days: the proportion of days with fasting was high indeed with 10.8% of days. Higher protein delivery was associated with an increase in prealbumin over time. The study showed that high NRS scores may identify the patients at the highest risk of poor outcome when exposed to underfeeding. Nutrition therapy clearly needs to be monitored form the start to prevent the addition of another disease: iatrogenic underfeeding.
Topic: Micronutrients in critically ill patients – what should we know
Trace elements and vitamins, named together micronutrients (MNs), are essential for human metabolism. The importance of MNs in common pathologies is recognized by recent research, with significant deficiencies impacting the outcome. Recently guidelines were published emphasizing their role in medical nutrition therapy. The importance of delivering MNs to all patients from the first day of feeding in sufficient amounts was stressed and was the fact that some pathologies were associated with higher than standard requirements whatever the feeding route. Some MNs are a high risk of deficiency: thiamine, vitamin D, vitamin C, iron, selenium and zinc.
The impact of the acute phase response during the inflammatory phase of disease was strongly emphasized as the blood levels of the majority of MNs decreases significantly, due to redistribution: simultaneous determination of C-reactive protein enables appreciating this impact. Despite difficulties, blood monitoring based on blood levels, but also on some biomarkers, is essential to individually adapt the treatments. The presentation will discuss the available tools
Winai Ungpinitpong Thailand General Surgeon, Department of Surgery, Surin Hospital,
Dr. Winai Ungpinitpong is a President of Society of Parenteral and Enteral Nutrition of Thailand (SPENT). He works as a general surgeon at Surin Hospital and Lecturer at Faculty of Medicine, Suranaree University of Technology, Thailand.
He worked 10 years as a general surgeon in Khon Kaen and Surin then undertook his clinical fellowship in colorectal surgery at Royal Prince Alfred Hospital, Sydney Australia in 2007. He is past President of Parenteral and Enteral Nutrition of Asia (PENSA), Program director of resident training program of General surgery, Head department of surgery at Surin Hospital. His particular interests include Enhanced Recovery After Surgery (ERAS), Intestinal failure, Colorectal cancer and nutrition in critically ill patients.
Topic: Burden of obesity in gastrointestinal and liver diseases
University Hospital Brussels (UZ Brussel) (Head of the Pediatric Hospital, the “KidZ Health Castle”, Chair of Pediatrics since 1994)
Medical studies at the Vrije Universiteit Brussel.
Defended his Ph.D. thesis on “Esophageal pH monitoring for Gastro-Esophageal Reflux in Infants and Children” in 1991.
Founder and current consultant at “KidZ Health Castle”, at the University Hospital Brussels (UZ Brussel) of the Vrije Universiteit Brussel. From 1994 – 2021 he was the Chair of Pediatrics at the same Institution.
Main interests are functional gastro-intestinal disorders such as gastro-esophageal reflux, colic and constipation, infant nutrition, focusing on probiotics, prebiotics and cow’s milk protein allergy.
Authored over 500 publications listed in Pubmed and presented over 1000 talks at diverse international meetings.
Topic: Microbiota and function gastrointestinal disorders in infant
Functional gastrointestinal disorders (FGIDs) in infants have long-term effects on their quality of life and their families. Extensive research focuses on early-life intestinal microbiota’s connection to FGIDs, affecting immune development, gastrointestinal motility, epithelial barrier integrity, and brain-gut communication.
Recent evidence challenges the belief in a sterile intrauterine environment, suggesting potential microbiota transmission from mother to fetus. Delivery mode affects initial gut microbiota colonization. In addition, feeding method significantly impacts the gut microbiota, with different results observed between breastfeeding and formula feeding. Among them, human milk oligosaccharides (HMOs) are crucial for the development of the infant gut microbiota, and HMOs can be influenced by factors such as the duration of breastfeeding, genetics, and the environment.
FGIDs are believed to be associated with an imbalance of gut microbiota and affects about 50% of infants. Although FGIDs may be temporary, they can have long-term consequences, such as an increased risk of gastrointestinal disorders and attention-deficit/hyperactivity disorder (ADHD) later in life due to infantile colic.
A study with infants experiencing FGIDs showed promising results using a specialized formula with prebiotics, probiotics, and other nutrients, reducing FGIDs within three days and improving quality of life. This nutritional intervention, along with reassurance and guidance, is effective in real-life situations.
The key takeaways are understanding gut microbiota’s role in FGIDs, the impact of maternal-fetal transmission and delivery mode on microbiota colonization, factors affecting human milk composition, and effective nutritional interventions. It informs clinical strategies for managing FGIDs in infants, enhancing health outcomes and quality of life for both infants and families.
Todd W. Rice United States of America Professor of Medicine, Allergy, Pulmonary, And Critical Care Medicine, Vanderbilt University Medical Center
Dr. Rice is a Professor of Medicine with tenure in the Division of Allergy, Pulmonary and Critical Care Medicine and Vice President for Clinical Trials Innovation and Operations for the Vanderbilt Institute for Clinical and Translational Research at Vanderbilt University Medical Center (VUMC). He currently serves as the director of the Vanderbilt University Medical Center Medical ICU and as a co-director of the Learning Healthcare System platform of the Vanderbilt Clinical and Translational Science Award (CTSA). Dr. Rice has published numerous practice-changing multicenter clinical trials in critical care nutrition. He has been continually funded by the NIH since 2005. He is a past president of the American Society of Parenteral and Enteral Nutrition (ASPEN) and currently serves on the board of advisors for ASPEN.
Topic: Early feeding and very high protein usage in ICU
Recent interest has increased on the role of feeding and caloric intake early in the course of critical illness. In addition, the role of higher protein administration has also been investigated, with focus on protein administration early in critical illness. Numerous randomized controlled trials have demonstrated no beneficial effect of higher calorie administration early in critical illness. One recent study (NUTRIREA-3) suggests that higher calorie feeding early in critical illness, especially patients who have shock and respiratory failure, may be detrimental. The recently published EFFORT trial evaluated the effect of higher dose of protein in critically ill patients and found no benefit. In the subgroup of patients with renal injury, there was even a suggestion of potential harm from higher protein administration.
Naomi Nakayama Japan Associate Professor, General Medicine and Community Health Science, Hyogo Medical University
Naomi Nakayama M.D., Ph.D. graduated from Hyogo Medical University and started her carrier in the department of Gastroenterology in Kobe University faculty of Medicine in 1997. She completed her PhD from Shimane University school of medicine. She finished two years research fellowship from The Johns Hopkins University cancer research institution in the U.S.A. She is a general physician and has been engaged in molecular biological cancer research. Now she is focused on clinical nutrition research and practice in acute ward, convalescent ward, nursing facility and home-care. She was the Professor of the University of Shimane, Faculty of health and nutrition from 2018 to 2022. She is currently the Associate Professor of Hyogo Medical University, School of medicine, department of general medicine and community health science. She has published about 68 scientific papers in international peer-reviewed journals and contributes to clinical practice and research of oncology and clinical nutrition field.
Topic: Importance of Nutritional Care in Super Aged Society
In Japan and other advanced aging countries, the importance of healthy life expectancy has come to be recognized instead of biological life expectancy. In order to maintain ADL and continue a life with high QOL, it is necessary to understand physical and biological changes associated with aging and geriatric diseases and take countermeasures against them. Overnutrition and obesity are becoming a social problem due to the increase in metabolic syndrome caused by the Westernization of lifestyles. On the other hand, for elderly population, it is important to deal with geriatric diseases, such as undernutrition, sarcopenia, and cachexia associated with chronic diseases. In particular, sarcopenia has been found to be a high risk of falling and fractures, which is a major cause of need for long-term care, and also has an impact on the prognosis of cancer, which is the leading cause of death in most advanced countries. In this regard, it is essential for medical and nutritional professionals involved in geriatric medicine to understand these geriatric diseases and learn how to deal with them from a nutrition standpoint. Therefore, I will outline the importance of nutritional support through the each stage from pre-nursing care period to the end-of-life period.
Invited Speakers – Taiwan
Hsiang-Lin Tsai Director, Division of Colorectal Surgery, Kaohsiung Medical University Hospital
Cheng-Yen Chuang Chief, Division of Thoracic Surgery, Department of Surgery, Taichung Veteran General Hospital
Tzu-Ming Chang Professor, Surgical Department, Cheng Hsin General Hospital
Tsung-Kun Chang Attending Surgeon, Department of Surgery, Kaohsiung Medical University Hospital
Po-Shan Wu Chief, Division of Clinical Nutrition Department of Dietetics & Nutrition, Taipei Veterans General Hospital
Cheng-Hsi Yeh Attending, General Surgery, Kaohsiung Chang Gung Memorial Hospital
Chih-Jung Wang Assistant Professor, Department of Surgery, National Cheng Kung University Hospital
Yun Chen Professor, Graduate Institute of Medicine, Far Eastern Memorial Hospital and Yuan Ze University
Thomas Tao-Min Huang Attending Physician, Department of Internal Medicine, College of Medicine, National Taiwan University Hospital
Wei-Kuo Chang Attending Physician, Division of Gastroenterology, Tri-service General Hospital
Frank Cheau-Feng Lin Chairman, Total Parenteral Nutrition, Chung-Shan Medical University
Meng-Chuan Huang Professor, Department of Public Health And Environmental Medicine, College of Medicine, Kaohsiung Medical University
Wei-Chih Su Attending Physician, Department of Surgery, Division of Colorectal Surgery, Kaohsiung Medical University Hospital
Tyng-Guey Wang Distinguished Professor, Dept. of Physical Medicine and Rehabilitation, National Taiwan University Hospital
Hui-Chen Su Visiting Staff, Department of Neurology, National Cheng Kung University Hospital
Chien-Hui Cheng Registered Dietitian, Department of Dietetics, National Taiwan University Hospital
Ya-Ling Yang Visiting Staff, Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital
Tsorng-Shyang Yang Anesthesiologist, Anesthesiology & Cardiovascular Center, Cathay General Hospital
Tsann-Long Hwang Professor, Department of Surgery, Chang Gung Memorial Hospital
James Yao-Ming Shih Chief, Surgical Intensive Care Unit, Fu-Jen Catholic University Hospital
Wen-Harn Pan Distinguished Research Fellow, Institute of Biomedical Sciences, Academia Sinica
Po-Jen Yang Attending Physician, Department of Surgery, National Taiwan University Hospital
Hung-Chang Lee Honorary Senior Attending Physician, Department of Pediatrics, Mackay Children Hospital
Hung-Chih Lin Section Head, Department of Pediatrics, China Medical University Children’s Hospital
Yu-Tung Wu Assistant Professor, Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou
Sheng-Yu Chan Attending Physician, Department of Trauma and Emergency Surgery, Linkou Chang Gung Memorial Hospital
Li-Ning Peng Chief, Division of Research, Development and Promotion, Center for Geriatrics and Gerontology, Taipei Veterans General Hospital
Fei-Li Lo Yang Associate Professor, Department of Nutritional Science, Fu Jen Catholic University
Jane Pei-Chen Chang Director, Child Psychiatry Division, China Medical University Hospital
Wei-Li Wu Associate Professor, Department of Physiology, National Cheng Kung University
Yin-Yi Han Attending Physician, Department of Traumatology, National Taiwan Univerity Hospital
Yi-Chia Huang Professor, Department of Nutrition, Chung Shan Medical University
Rwei-Fen S. Huang Chair, Department of Nutritional Science, Fu Jen Catholic University