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Background: People diagnosed with intestinal failure (IF) as a result of short bowel syndrome are dependent on home parenteral nutrition (HPN). Measuring nutritional status is essential for monitoring treatment. The present study aimed to determine the agreement and feasibility of three methods bioelectrical impedance analysis (BIA), ultrasound and air displacement plethysmography (ADP) for measuring body composition in people receiving HPN. Methods: Body composition data were collected from patients attending an IF clinic. Results: There were 50 participants recruited and data were collected for BIA (n = 46), ultrasound (n = 49) and ADP (n = 9). Numbers for ADP were much lower because of a lack of participant uptake. Fat‐free mass (FFM) measured by BIA and ultrasound in comparison to ADP was found to have good intraclass correlation (ICC) 0.791 (95% confidence interval (CI) CI  −0.21 to 0.96) and a moderate ICC 0.659 [95% (CI) −0.27 to 0.92], respectively. Fat mass (FM) measured by both BIA and ultrasound in comparison to ADP was found to have moderate ICC 0.660 (95% CI −0.28 to 0.92) and poor ICC −0.005 (95% CI −0.73 to 0.65), respectively. Conclusions: Compared to ADP, BIA indicated moderate to good agreement for measuring body composition, whereas ultrasound indicated far less agreement, particularly when measuring FM. The lack of uptake of ADP suggests that participants found the Bodpod (COSMED Srl, Shepperton, UK) unfavourable. Considering that ultrasound has limited agreement and ADP was not the preferred option for participants, BIA shows some potential. However, the difference between ADP and BIA was larger for FM compared to FFM, which needs to be considered in the clinical setting. [ABSTRACT FROM AUTHOR]

Background: Perioperative oral supplementation has been shown to reduce post-operative complications. However, the use of preoperative standard oral supplements in a cohort of colorectal cancer patients has not been evaluated. The present study examined whether preoperative supplements are beneficial in this group. Methods: In a randomised controlled trial, patients were assigned to receive 400 mL of oral supplement and dietary advice or dietary advice alone. Primary outcome was the number of post-operative complications. One hundred and twenty-five patients were recruited (59 randomised to the intervention group and 66 to the control group) and nine were excluded. Results: In the intervention group, 24 (44%) patients had a complication compared to 26 (42%) in the control group ( P = 0.780). In the intervention and control groups, there were eight (15%) and 16 (25%) surgical site infections, respectively ( P = 0.140) and seven (13%) and 11 (17%) chest infections, respectively ( P = 0.470). Subgroup analysis for hypothesis generation included 83 (71%) weight-losing patients, where there was a significant reduction in surgical site infections using the Buzby definition ( P = 0.034), although this was not the case for the Centre for Disease Control definition ( P = 0.052). Conclusions: There was no evidence that preoperative supplements were beneficial in reducing the number of complications, although there may be some benefit for surgical site infections in selected weight-losing preoperative patients. [ABSTRACT FROM AUTHOR]

Mid upper arm anthropometry (MUAA) is often used as a measure of nutritional status to detect changes in body composition. The aim of this study was to investigate the reliability and validity of MUAA including mid arm circumference (MAC) and triceps skin fold thickness (TSFT) to determine the usefulness in clinical practice. We measured MUAA in 158 consecutive admissions along with subjective global assessment (SGA) and body mass index (BMI). Inter- and intra-rater reliability was evaluated in an additional 50 patients. The sensitivity and specificity of MUAA <5th percentile was compared with SGA and BMI. MAC and TSFT had a low sensitivity and a high specificity with low positive predictive values when compared with criterion values which were BMI ≤18 and SGA-C. The intra-class correlation coefficient for inter- and intra-rater reliability for MAC were 0.98 (95% CI 0.96–0.98) and 0.99 (95% CI 0.98–0.99) respectively and for TSFT were 0.97 (95% CI 0.91–0.97) and 0.98 (95% CI 0.95–0.98) respectively. MUAA <5th percentile had a high specificity but low sensitivity when compared with indicators of malnutrition. Although MUAA could be reliably measured, it has poor validity and is thus unlikely to be a good predictor of clinical outcome. Percentiles based on healthy populations do not generalize well to the individuals seen in clinical practice. [ABSTRACT FROM AUTHOR]