Search

Objective: This study aimed to test the hypothesis that patients with malnutrition and impaired muscle function determined by hand grip strength (HGS) will have adverse outcomes. Approach: We condu...

Summary Background & aims COVID-19 patients present a high hospitalization rate with a high mortality risk for those requiring intensive care. When these patients have other comorbid conditions and older age, the risk for severe disease and poor outcomes after ICU admission are increased. The present work aims to describe the preliminary results of the ongoing NUTRICOVID study about the nutritional and functional status and the quality of life of adult COVID-19 survivors after ICU discharge, emphasizing the in-hospital and discharge situation of this population. Methods A multicenter, ambispective, observational cohort study was conducted in 16 public hospitals of the Community of Madrid with COVID-19 survivors who were admitted to the ICU during the first outbreak. Preliminary results of this study include data retrospectively collected. Malnutrition and sarcopenia were screened at discharge using MUST and SARC-F; the use of healthcare resources was measured as the length of hospital stay and requirement of respiratory support and tracheostomy during hospitalization; other study variables were the need for medical nutritional treatment; and patients’ functional status (Barthel index) and health-related quality of life (EQ-5D-5L). Results A total of 176 patients were included in this preliminary analysis. Most patients were male and older than 60 years, who suffered an average (SD) weight loss of 16.6% (8.3%) during the hospital stay, with a median length of stay of 53 (27–89.5) days and a median ICU stay of 24.5 (11–43.5) days. At discharge, 83.5% and 86.9% of the patients were at risk of malnutrition and sarcopenia, respectively, but only 38% were prescribed medical nutrition therapy. In addition, more than 70% of patients had significant impairment of their mobility and to conduct their usual activities at hospital discharge. Conclusions This preliminary analysis evidences the high nutritional and functional impairment of COVID-19 survivors at hospital discharge and highlights the need for guidelines and systematic protocols, together with appropriate rehabilitation programs, to optimize the nutritional management of these patients after discharge.

Background & aims Severe acute COVID-19 has taken on pandemic proportions with growing interest in identification of prognostic factors for mortality. Standardized bioelectrical impedance (BI) phase angle (SPhA), which is PhA adjusted by age and sex, has been related to mortality in patients with several diseases but never investigated in COVID-19. Inflammation, a consequence of COVID-19 infection, affects fluid status (hydration) and can be identified with PhA. The aim of this study was to determine the predictive role of PhA on 90 days survival of adults with COVID-19. Methods We studied 127 consecutive patients diagnosed with COVID-19. BI measurements determined with a 50 kHz phase-sensitive BI device, body composition parameters and laboratory markers were evaluated as predictors of mortality. Results Non-surviving COVID-19 patients had significantly lower PhA and SPhA values (p

BACKGROUND & AIMS: Patients affected by COVID-19 may develop disease related malnutrition (DRM) due to the catabolic situation, symptoms that interfere with intake and prolonged hospital stay. This study aims to know the percentage of patients admitted for COVID-19 who required artificial nutrition (AN), their clinical characteristics, as well as the prevalence of DRM and the risk of sarcopenia at hospital discharge and after 6 months. MATERIAL AND METHODS: Observational, prospective study, with successive inclusion of adult patients admitted for COVID-19 in whom institutional nutritional support (NS) care protocol was applied. Those who received AN underwent a nutritional screening by Short Nutritional Assessment Questionnaire (SNAQ) and an assessment by Subjective Global Assessment (SGA) at hospital discharge, as well as a screening for sarcopenia (SARC-F test) and SNAQ re-test 15 days and 6 months after by a phone call. Symptoms related to food intake, anthropometric and analytical data were also collected. RESULTS: We evaluated 936 patients with a mean age of 63.7 ± 15.3 years; predominantly male (59.7%), overweight 41%, obesity 40.4%; hypertension 52.9%; diabetes mellitus 26.6% and cancer 10.4%. The stay hospital length was 17.3 ± 13.8 days and 13.6% patients died during hospitalization. The modality of nutritional support was: 86.1% dietary adaptation + oral nutritional supplements (ONS); 12.4% enteral nutrition (EN) by nasogastric (NG) tube; 0.9% parenteral nutrition (PN) and 0.6% EN plus PN. Focusing on patients who received AN, follow-up post discharge was possible in 62 out of 87 who survived. Of these, at the time of hospital discharge, 96.7% presented nutritional risk by SNAQ and 100% malnutrition by SGA (20% B; 80% C). During admission, 82.3% presented intense anorexia and the mean weight loss was 10.9 ± 6 Kg (p

Summary Background & aims Coronavirus disease 2019 (COVID-19) is an ongoing pandemic outbreak leading to more than 1 million deaths worldwide as reported in 2020. Several risk assessment tools, including individual vulnerability to COVID-19, have been developed. The present study aimed to characterize a high-risk population using such a tool and examine risk factors and nutritional status in the national survey data and estimate the region-specific population size. Methods The study included 17,540 Korean adults who participated in the Korea National Health and Nutrition Examination Survey (KNHANES). The risk scores for individual vulnerability to COVID-19 were calculated based on age, sex, smoking status, and comorbidities, and a high-risk population was defined as having risk scores ≥11. Nutritional status was compared between the high-risk population and the remaining participants in the KNHANES data. The region-specific population size was estimated using national statistics. Results The proportion of the high-risk population was estimated to be 10.5%, which corresponds to approximately 4.6 million adults in South Korea. About 20% of them had inadequate intake of all of vitamins A, B1, B2, B3, and C below the estimated average requirement. The high-risk population showed 1.65 [95% confidence interval: 1.39, 1.96] higher odds of inadequate intake of multiple vitamins than the remaining participants. In the ecological analysis, the region-specific numbers of the high-risk population correlated significantly with the actual numbers of deaths due to COVID-19 (P value = 0.013). Conclusions These results suggest that individuals vulnerable to COVID-19, in particular those are living in densely populated regions, should pay particular attention to the protection against this pandemic and have adequate nutritional status, which may support optimal immune function.

Objective: Since its development, cumulative evidence has accumulated regarding the prognostic value of the Malnutrition-Inflammation Score (MIS/Kalantar score) prognostic value; however, there is a shortage of recent and large studies with comprehensive statistical methodologies that contribute to support a higher level of evidence and a consensual cutoff. The aim of this study was to assess the strength of MIS association with hospitalization and mortality in a nationwide cohort. Methods: This was a historical cohort study of hemodialysis patients from 25 outpatient centers followed up for 48 months. Univariable and multivariable Cox additive regression models were used to analyze the data. The C-index was estimated to assess the performance of the final model. Results: Two thousand four hundred forty-four patients were analyzed, 59.0% males, 32.0% diabetic, and median age of 71 years (P25 = 60, P75 = 79). During a median period of 45-month follow-up, with a maximum of 48 months (P25 = 31; P75 = 48), 875 patients presented an MIS

The use of extracorporeal membrane oxygenation (ECMO) in patients with severe cardiorespiratory failure has seen significant growth in the last decade. Despite this, there is paucity of data surrounding the optimum nutritional management for ECMO patients. This review aimed to describe current nutrition practices in patients receiving ECMO, critically appraise available studies and identify areas for future research. A literature search was conducted in PubMed, MEDLINE, and CINAHL Plus to identify all randomized trials and observational studies published between July 2000 and July 2020 investigating nutrition practices in critically ill adults receiving ECMO. The primary outcomes were nutritional adequacy, gastrointestinal complications, and physical function. Secondary outcomes included mortality, length of stay, and duration on ECMO support. From a total of 31 studies identified, 12 met the inclusion criteria. Nine observational studies were reviewed following eligibility assessment. Early enteral nutrition was deemed safe and feasible for ECMO patients; however, meeting nutritional targets was challenging. Utilizing alternative nutrition routes is an option, although risks and benefits should be taken into consideration. Data on gastrointestinal complications and other clinical outcomes were inconsistent, and no data were identified investigating the effects of nutrition on the physical and functional recovery of ECMO patients. Nutrition therapy in ECMO patients should be provided in line with current guidelines for nutrition in critical illness until further data are available. Further prospective, randomized studies investigating optimum nutrition practices and effects on clinical and functional outcomes are urgently required.

It is unclear how running modality influences telomere length (TL). This single laboratory visit study compared the TL of master sprinters and endurance runners with their young counterparts. The correlation between leukocyte and buccal cell TL in athletes was also explored. Participants consisted of 11 young controls, 11 young sprinters, 12 young endurance runners, 12 middle-aged controls, 11 master sprinters, and 12 master endurance runners. Blood and buccal samples were collected and randomized for analysis of TL by quantitative polymerase chain reaction. Young endurance runners displayed longer telomeres than master athletes (p p > .05). A positive correlation existed between leukocyte and buccal cell TL in athletes (r = .567, p

Summary Background /Objective: As a new immune-nutritional marker, the controlled nutritional status (CONUT) score has been reported to predict the prognosis of cancer patients. We aimed to elucidate the prognostic value of preoperative CONUT score in pancreatic cancer patients undergoing radical surgery, and to construct a nomogram based on CONUT score to predict individual survival. Methods Preoperative CONUT scores were calculated prospectively in 382 patients with pancreatic cancer who underwent radical surgery. Evaluated the relationship between CONUT score and pancreatic cancer prognosis. Cox proportional hazard models were used to determine predictors of survival and a new nomogram was established to predict pancreatic cancer overall survival (OS). Results The area under curve of CONUT score was higher than other immune-nutritional indexes. The OS of the high-CONUT group were significantly lower than that of low-CONUT group. Multivariate analysis showed that CONUT score, gender, AJCC stage, complications and reoperation were independent prognostic factors for OS. Nomogram based on these variables has better discriminant ability in predicting survival compared with other traditional staging systems. Conclusions Preoperative CONUT score is an effective independent predictor of OS in pancreatic cancer patients undergoing radical surgery. This new CONUT based nomogram provides accurate, individualized survival prediction for pancreatic cancer.

Malnutrition is associated with the prognosis of malignant disease. The geriatric nutritional risk index (GNRI), based on serum albumin (ALB) levels and the present and ideal body weight, is a simple screening tool with which to predict the risk of malnutrition and mortality in patients. We hypothesised that nutritional markers could predict the prognosis of patients with oral squamous cell carcinoma (OSCC). The primary predictor variable was the GNRI score and the primary outcome variable was overall survival (OS). Univariate and multivariate analyses were performed using a Cox proportional hazard model to identify independent prognostic factors. The sample comprised 155 patients, of whom 17 presented with a low GNRI score (≤98) and 138 with a high GNRI score (≥ 98). There was a significant difference in OS when patients were stratified according to GNRI scores, with OS rates of 29.2% and 76.4% for scores of 98 and under and scores of over 98, respectively (p 0.001). Univariate analyses showed that OS was significantly associated with GNRI score, age, T classification, N classification, stage, body mass index (BMI), prognostic nutrition index, and ALB levels. Analysis identified three independent predictive factors for OS: age (hazard ratio (HR) 2.184; 95% confidence interval (CI) 1.119 to 4.261; p = 0.022), stage (HR 2.684; 95% CI 1.457 to 5.367; p = 0.011), and GNRI score (HR 4.559; 95% CI 2.172 to 9.570; p0.001). The results suggest that the GNRI score (98 vs ≤98) is a good prognostic marker in patients with OSCC, along with age and stage.

Resumen Introduccion Aunque las recomendaciones actuales sugieren el empleo de formulas especificas en nutricion enteral en personas con diabetes, hay poca evidencia de su efectividad a largo plazo en el control glucemico. El objetivo principal de este estudio es evaluar la eficacia a largo plazo (24 semanas) de una formula de nutricion enteral hipercalorica hiperproteica especifica para personas con diabetes en control glucemico y mejora del estado nutricional. Metodologia Estudio multicentrico observacional prospectivo en vida real de pacientes con prescripcion de nutricion enteral de larga duracion a traves de sonda de gastrostomia o nasogastrica que recibieron una formula hipercalorica hiperproteica especifica para diabetes. Una vez obtenido el consentimiento informado del participante y comprobados los criterios de inclusion y exclusion, se recogieron datos relativos a control glucemico, parametros de inflamacion, bioquimicos, situacion nutricional y tolerancia gastrointestinal a 0, 12 y 24 semanas. Resultados Se recluto a 112 pacientes, 44,6% mujeres, edad 75,0 (12,0) anos y tiempo medio de evolucion de la diabetes 18,1 (9,5) anos. El porcentaje de pacientes con desnutricion segun la valoracion global subjetiva descendio a lo largo del tratamiento del 78,6% al 29,9% (p Conclusion Nuestro estudio en vida real apoya que el empleo de una formula hipercalorica hiperproteica especifica para diabetes durante un tratamiento nutricional a 6 meses permite un adecuado control glucemico y evolucion nutricional, con una buena tolerancia gastrointestinal.

Objective: To evaluate the complementary feeding practices, food intake, and nutritional status of infants on a cow’s milk protein elimination diet. Methods: A cross-sectional and observational study was conducted to compare infants aged 4-18 months who were on a cow’s milk protein elimination diet with a control group of healthy infants without any dietary restrictions. General information on the child’s health, demographic data, and food consumption were collected. Results: The study included 96 infants in the elimination diet group and 99 in the control group. In the elimination diet group, the median age (in months) of introduction of solid foods (5.0 × 4.0; p < 0.001) and water (5.5 × 4.0; p < 0.05) was later, consumption of soft drinks and industrialized cookies was less frequent (p < 0.05), and a lower index of complementary feeding inadequacies (2.75 × 3.50; p < 0.001) was observed. The elimination diet group presented lower individual values of Z scores for weight/age, weight/height, and body mass index/age, although they were fed with higher amounts of energy (117.4 × 81.3 kcal/kg of weight; p < 0.001) and macro-and micronutrients, except for vitamin A. In the elimination diet group, breast milk and its substitutes contributed to more than 67% of energy intake. Although calcium consumption was a deficit in 31.5% of the infants, none received supplementation. Conclusion: Infants on an elimination diet presented more adequate complementary feeding practices and higher nutritional intake, despite lower body weight values.

The status of malnutrition and malnutrition is caused by various interrelated factors, including family behavior factors in providing food, breastfeeding and complementary feeding, and nutrition service efforts. This study aims to analyze the relationship between nutritionally conscious families (Kadarzi) and the nutritional status of children under five in the Work Area of the Puskesmas Pelambuan, Banjarmasin. This study used an analytic method with a cross sectional approach. The sampling technique used was proportional random sampling with a sample size of 82 parents of children under five. The measuring instrument used was a questionnaire and observation with weighing tools, the data analysis used the Spearman rank test. The location of this research was conducted in the Working Area of the Pelambuan Health Center, Banjarmasin City. Based on the results of the study, families who were aware of nutrition tended to have normal nutritional status totaling 27 (79.4%) and more than 7 (20.6%). Meanwhile, families who were not aware of nutrition tended to have malnutrition status, amounting to 31 people (64.6%) and malnutrition status 17 (35.4%). The spearman rank statistical test obtained p value 0.000 smaller than α = 0.05. There is a relationship between nutritionally conscious families (adarzi) with the nutritional status of children under five in the working area of Puskesmas Pelambuan, Banjarmasin City. Keywords : Nutritional awareness family, nutritional status, children

Background Mesentery thickening and enlarged lymphnodes are typical findings of Crohn's disease (CD), but their role is unknown. Aim of the present study was to evaluate their prevalence and significance on postoperative complications and long-term surgical recurrence after CD surgery. Methods 1272 consecutive, unselected patients were retrospectively reviewed, divided into 4 groups based on the presence or absence of a thickened mesentery and enlarged lymphnodes, and stratified for primary or recurrent surgical procedure. In all patients but those treated with strictureplasty the mesentery and lymphnodes were removed. Patients’ characteristics, peri-operative findings, and long-term recurrence were compared by univariate and multivariate analysis. Results Thickened mesentery and enlarged lymphnodes were not present in all cases, were typical of ileal location and penetrating behaviour, had a constant decrease over recurrences, were independent of either pre-operative medical therapy or surgical approach, did not increase the duration of surgery and complications, presented similar 20-years recurrence rate to normal mesentery and lymphnodes. Lymphopathy was associated to a worst nutritional status during disease recurrences. At multivariate analysis, age, location, and behaviour, but not mesenteric characteristics, were related to an increased risk of surgical recurrence. Conclusions This study provides new information on mesentery and lymphnodes in CD patients. Further studies are needed to clarify the appropriate surgical approach.

Background The food system is a social determinant of health and leverage point for reducing diet-related racial inequities. Yet, food system interventions have not resulted in sustained improvement in dietary outcomes for underrepresented minorities living in neighborhoods with a history of disinvestment. Research is needed to illuminate the dynamics structuring food systems in racialized neighborhoods to inform intervention development. Objective Conduct participatory research examining the complexity and inequity of food systems in historically redlined neighborhoods to identify feedback mechanisms to leverage in efforts to transform system outcomes for racial equity. Methods We conducted a mixed-methods study in Cleveland, Ohio, USA from 2018-21 using participatory system dynamic modeling with 30 academic and community partners, in-depth qualitative interviews with 22 key stakeholders, and public convenings with 250 local food policy council affiliates. Data were synthesized into causal loop diagrams depicting feedback mechanisms reinforcing or balancing neighborhood-level food system dynamics. Results We identified 10 feedback mechanisms structuring nutrition equity, which was identified as a meta-goal for food systems in racialized neighborhoods. Feedback mechanisms were organized in three domains: 1. meeting basic food needs with dignity (i.e., side hustle, government benefits, emergency food assistance, stigma and stereotypes), 2. local food supply and demand dynamics (i.e., healthy food retail, job security, food culture and norms), and 3. community empowerment and food sovereignty (i.e., community power, urban agriculture, risk of gentrification). Five exogenous factors moderate feedback dynamics: neighborhood crisis, neighborhood investments, household costs, government benefit funding, and voter participation. Conclusions We identified nutrition equity as an overarching goal for local food systems, which reflects a state of having freedom, agency, and dignity in food traditions resulting in people and communities healthy in body, mind, and spirit. It is a transformative goal designed to spur system-level interventions that further racial equity through improved local food system dynamics.

Objective: The aim of this study was to explore the changes in nutritional status before dialysis initiation and to identify modifiable risk factors of nutritional status decline in older adults with advanced renal disease.& nbsp;Design and Methods: The European Quality Study on treatment in advanced chronic kidney disease (EQUAL) is a prospective, observational cohort study involving six European countries. We included 1,103 adults > 65 years with incident estimated glomerular filtration rate < 20 mL/min/1.73 m(2) not on dialysis, attending nephrology care. Nutritional status was assessed with the 7-point Subjective Global Assessment tool (7-p SGA), patient-reported outcomes with RAND-36 and the Dialysis Symptom Index. Logistic regression was used to estimate the associations between potential risk factors and SGA decline.& nbsp;Results: The majority of the patients had a normal nutritional status at baseline, 28% were moderately malnourished (SGA = 2 points). The proportion of patients with low SGA (

Background Nearly a third of young US children take multivitamin/mineral (MVM) dietary supplements, yet it is unclear how formulations compare with requirements. Objective Describe the number and amounts of micronutrients contained in MVMs for young children and compare suggested amounts on product labels to micronutrient requirements. Design Cross-sectional. Setting All 288 MVMs on the market in the United States in the National Institutes of Health’s Dietary Supplement Label Database in 2018 labeled for children 1 to Main outcome measures Number of MVM products and amounts per day of micronutrients in each product suggested on labels compared with requirements represented by age-appropriate Daily Values (DV). Micronutrients of public health concern identified by the Dietary Guidelines for Americans (DGA) 2015-2020 (DGA 2015) and DGA 2020-2025 (DGA 2020) or those of concern for exceeding the upper tolerable intake levels. Statistical analyses Number of products and percent DV per day provided by each micronutrient in each product. Results The 288 MVMs contained a mean of 10.1 ± 2.27 vitamins and 4.59 ± 2.27 minerals. The most common were, in rank order, vitamins C, A, D, E, B6, B12; zinc, biotin, pantothenic acid, iodine, and folic acid. For micronutrients denoted by the DGA 2015 and DGA 2020 of public health concern, 56% of the 281 products containing vitamin D, 4% of the 144 with calcium, and none of the 60 containing potassium provided at least half of the DV. The upper tolerable intake level was exceeded by 49% of 197 products with folic acid, 17% of 283 with vitamin A, and 14% of 264 with zinc. Most MVMs contained many of 16 other vitamins and minerals identified in national surveys as already abundant in children’s diets. Conclusions A reexamination of the amounts and types of micronutrients in MVMs might consider formulations that better fill critical gaps in intakes and avoid excess.

Wound healing is a complex and energy-demanding process. The relationship between nutrition and wound healing has been recognized for many centuries. Several studies have indicated that nutritional deficiencies are more prevalent among patients with chronic wounds. Malnutrition may alter the inflammatory response, collagen synthesis, and wound tensile strength, all of which are crucial for wound healing. Although the specific role of nutrition and supplementation in wound care remains uncertain, it is necessary to identify and correct nutritional imbalances to avoid any potential deterioration of the healing process. It is also important to recognize the differences in pathophysiology between acute and chronic wounds. A burn, surgical, or a traumatic wound is different from a diabetic foot ulcer, which is different from a pressure ulcer. Chronic wounds are more prevalent in the aging population, and patients often have underlying comorbidities, such as diabetes mellitus, peripheral vascular disease, connective tissue disease, or other systemic illnesses that may alter energy metabolism and contribute to impaired healing. Management approaches to acute wound care may not apply universally to chronic wounds. In this review, we discuss the available data and possible roles for nutrition in wound healing.

As chronic kidney disease (CKD) progresses, the requirements and utilization of different nutrients change substantially. These changes are accompanied by multiple nutritional and metabolic abnormalities that are observed in the continuum of kidney disease. To provide optimal care to patients with CKD, it is essential to have an understanding of the applicable nutritional principles: methods to assess nutritional status, establish patient-specific dietary needs, and prevent or treat potential or ongoing nutritional deficiencies and derangements. This installment of AJKD's Core Curriculum in Nephrology provides current information on these issues for the practicing clinician and allied health care workers and features basic, practical information on epidemiology, assessment, etiology, and prevention and management of nutritional considerations in patients with kidney disease. Specific emphasis is made on dietary intake and recommendations for dietary patterns, and macro- and micronutrients. In addition, special conditions such as acute kidney injury and approaches to obesity treatment are reviewed.

Background Zinc biofortification of rice could sustainably improve zinc status in countries where zinc deficiency is common and rice is a staple, but its efficacy has not been tested. Fatty acid desaturases (FADS) are putative new zinc status biomarkers. Objectives Our objective was to test the efficacy of zinc-biofortified rice (BFR) in preschool-aged children with zinc deficiency. Our hypothesis was that consumption of BFR would increase plasma zinc concentration (PZC). Methods We conducted a 9-mo, double-masked intervention trial in 12–36-mo-old rural Bangladeshi children, most of whom were zinc-deficient (PZC 0.05). There was a time–treatment interaction for height-for-age z-scores (P < 0.001) favoring the BFR group. The morbidity longitudinal prevalence ratio was 1.08 (95% CI: 1.05, 1.12) comparing the BFR and CR groups, due to more upper respiratory tract illness in the BFR group. Conclusions Consumption of BFR for 9 mo providing ∼1 mg of additional zinc daily to Bangladeshi children did not significantly affect PZC, prevalence of zinc deficiency, or FADS activity. The trial was registered at clinicaltrials.gov as NCT03079583., The American Journal of Clinical Nutrition, 115 (3), ISSN:0002-9165, ISSN:1938-3207

Context No consensus exists about the optimal duration of the low-iodine diet (LID) in the preparation of 131I therapy in differentiated thyroid cancer (DTC) patients. Objective This work aimed to investigate if a LID of 4 days is enough to achieve adequate iodine depletion in preparation for 131I therapy. In addition, the nutritional status of the LID was evaluated. Methods In this prospective study, 65 DTC patients treated at 2 university medical centers were included between 2018 and 2021. The patients collected 24-hour urine on days 4 and 7 of the LID and kept a food diary before and during the LID. The primary outcome was the difference between the 24-hour urinary iodine excretion (UIE) on both days. Results The median 24-hour UIE on days 4 and 7 of the LID were not significantly different (36.1 mcg [interquartile range, 25.4-51.2 mcg] and 36.5 mcg [interquartile range, 23.9-47.7 mcg], respectively, P = .43). On day 4 of the LID, 72.1% of the DTC patients were adequately prepared (24-hour UIE Conclusion The 24-hour UIE on day 4 of the LID did not differ from day 7, and therefore shortening the LID from 7 to 4 days seems justified to prepare DTC patients for 131I therapy in areas with sufficient iodine intake and may be beneficial to maintain a sufficient nutritional intake during DTC treatment.

Summary: Background: Obesity is associated with suboptimal levels in vitamin D, a nutrient important for bone health and immune function. Seasonal variation in vitamin D may exacerbate this deficiency in persons with obesity, as exposure to ultraviolet B rays in sunlight is necessary for the conversion of vitamin D to its active form in the body. The aim of this study was to determine the relationship between season and vitamin D levels in persons with obesity pursuing bariatric surgery. Materials and Methods: This retrospective cohort study from a single academic medical center investigated adult patients undergoing either primary sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) over a 20-year period. Demographics and serum 25-hydroxyvitamin D3 levels were collected from the first presenting visit to the bariatrics center. Continuous vitamin D3 levels were compared across seasons using a one-way Analysis of Variance (ANOVA). Vitamin D3 categories were examined across seasons using a Chi square test of independence. Results: 1,256 persons pursuing bariatric surgery (SG: N=697, RYGB: N=559) met the inclusion criteria. Baseline vitamin D values were available in 1,071 of the eligible patients. Overall, serum 25-hydroxyvitamin D3 levels showed a significant variation across the seasons of the year (P

To determine whether nutritional status at hospital admission is independently associated with new-onset delirium (NOD) in elderly, orthopaedic trauma patients.Single-center, retrospective, cross-sectional study.Data from patients at a large teaching hospital in Boston, MA, were analyzed.All patients were ≥65 years and hospitalized for acute surgical management of their major fractures after trauma.None.Nutritional status was assessed at admission using the Mini Nutritional Assessment-Short Form (MNA-SF). Delirium was assessed using the Confusion Assessment Method within 24 hours of admission and daily throughout hospitalization.The incidence of delirium was 20% (94/471). Each unit decrement in MNA-SF was associated with a 14% higher risk of NOD (adjusted OR 1.14; 95% CI 1.05-1.28). Moreover, malnourished patients (MNA-SF score 0-7) were twice as likely to develop NOD (adjusted OR 2.07; 95% CI 1.01-4.35) compared with patients who were not malnourished (MNA-SF score 8-14).In hospitalized, elderly, orthopaedic trauma patients, poor nutritional status may be a modifiable risk factor for NOD. Future studies are needed to determine whether aggressive nutritional interventions can reduce the incidence of NOD and improve outcomes in this cohort of patients.Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Transportation is a stressful event for cattle, as it may involve various handling practices, commingling, deprivation of food and water, and fluctuating temperatures. Calves are particularly susceptible to these stressors because their physiological and immune systems are still developing. There has been no formal synthesis of the scientific literature evaluating the effect of transportation on young dairy calf health and performance; the aim of this scoping review is to describe and characterize this body of work. We targeted both descriptive and analytic studies examining transport of calves, including listing how the effect of transport has been evaluated. Eight databases were searched for relevant articles with eligible studies being primary research articles investigating transportation of calves of either sex who were younger than 60 d of age or weighed less than 100 kg. Two reviewers independently screened the title and abstracts of 6,859 articles with 361 potentially relevant articles screened at full text. Of these, 46 were relevant and had data extracted. Articles reporting study location were conducted in the United States (n = 5), Australia (n = 3), Japan (n = 3), and New Zealand (n = 3). Common transport-related variables evaluated included time in transit (n = 13), distance of transportation (n = 8), vehicle-related factors (n = 8), and age at time of transportation (n = 4). Outcome measures varied greatly, including blood parameters (n = 28), health assessments (n = 20), weight (n = 17), behavioral metrics (n = 14), mortality (n = 7), feed intake following transportation (n = 4), salivary cortisol concentrations (n = 3), morbidity (n = 3), and isolation of Salmonella Dublin in fecal samples (n = 2). Outcome parameters were measured during transport or ranged from immediately after to one year following transportation. As the transport-related risk factors and outcomes measured assessed varied widely between studies, future quantitative synthesis (e.g., meta-analysis) in this area may be limited. Several knowledge gaps were identified, including methods to prepare calves for transportation, such as improving nutrition, administering medication, or transporting calves at an older age or weight. Further research could also focus on consistent and clear reporting of key items related to study conduct and analysis, as well as the development of a core outcome set for calf transport studies.

Cycling is predominantly an endurance sport in which fuel utilization for energy production relies on the availability and delivery of oxygen to exercising muscle. Nutrition and training interventions to improve endurance performance are continually evolving, but ultimately, prescription should aim to generate improvements in cycling power and velocity while prioritizing athlete health and well-being. The wide range of cycling events and the different environments in which events take place pose a variety of nutrition-related challenges for cyclists. This review addresses some of these challenges and highlights recent advancements in nutrition for cycling performance.

Children under the age of five or under five are a group that is prone to nutrition, because they are prone to malnutrition due to lack of food needed. Malnutrition in children will cause decreased immunity, which means that the ability to defend themselves against bacterial infection decreases. Children who have less nutritional status have the potential to suffer from pyoderma. Lack of the amount of food consumed both in quality and quantity can reduce the nutritional status of children. The purpose of this study was to determine the relationship between nutritional status and the incidence of pyoderma in toddlers (1-5 years) in Kuok Village, the working area of Puskesmas Kuok in 2020. This study used an analytical research design with a case control design. The sample in this study were 62 children (1-5 years). 31 samples for the case group and 31 samples for the control group. data collection through questionnaires. Data processing used univariate and bivariate analysis with the Chi-Square test. The results showed that there was a significant relationship between nutritional status and the incidence of pyoderma in toddlers (1-5 years) with p value = 0.001. By holding this research, the researchers expected parents of toddlers to pay more attention to the nutritional status of their children in order to avoid infectious diseases such as pyoderma.

During the first 1000 days of life is the basis for a child's future health established.To evaluate the impact of a prenatal educational intervention in pregnant women on the nutritional status of the child from birth to 4 months of age.Quasi-experimental intervention design in women with at least 12 weeks of gestation, who were randomly assigned to an intervention group (IG) to participate in five group and three individual sessions on feeding practices and maternal perception of the child's weight and signals of hunger-satiety; the control group (CG) received routine care that included at least three prenatal consultations.Thirty women were included in each group. After the intervention, women in the CG practiced less exclusive breastfeeding, were more likely to underestimate or overestimate the children's weight, and perceived hunger-satiety signals with less intensity (p0.05). 80 % of the infants in the IG had normal weight, whereas 63 % of those in the CG had a combination of overweight and obesity (p0.05).The prenatal education program in pregnant women showed a significant effect on postnatal nutritional status of infants four months after birth.Durante los primeros 1000 días de vida se establece la base para la salud futura de un niño.Evaluar el impacto de una intervención educativa prenatal en mujeres embarazadas sobre el estado nutricional del hijo desde el nacimiento hasta los cuatro meses de edad.Diseño cuasiexperimental de intervención con mujeres a partir de la semana 12 de gestación, asignadas aleatoriamente a un grupo de intervención (GI) para recibir cinco sesiones grupales y tres individuales sobre prácticas de alimentación y percepción materna del peso del hijo y de señales de hambre-saciedad; el grupo control (GC) recibió atención de rutina que incluía al menos tres consultas prenatales.30 mujeres conformaron cada grupo. Después de la intervención, las mujeres del GC practicaron menos lactancia materna exclusiva, fueron propensas a subestimar o sobrestimar el peso del hijo y percibieron con menor intensidad las señales de hambre-saciedad (p0.05). El 80 % de los lactantes del GI presentaron peso normal y 63 % de los niños del GC, una combinación de sobrepeso y obesidad (p0.05).El programa de educación prenatal en mujeres embarazadas mostró un efecto significativo en el estado nutricional de los lactantes después de cuatro meses del nacimiento.

Background The average body weight of the Chinese population is rising rapidly over the past two decades and the old 2001 body mass index (BMI) cut-off value for malnutrition may underestimate malnutrition diagnosis. We explored the BMI cut-off value for malnutrition diagnosis based on national BMI data over the past 30 years and applied it to the Global Leadership Initiative on Malnutrition (GLIM) criteria when investigating malnutrition in hospitalized older adult patients. Methods To explore the BMI cut-off value for malnutrition, we established a linear stepwise model to predict the annual increasing BMI trend based on data from the national BMI dataset (1990-2009). The new cut-off value was applied to a large-scale dataset from a cross-sectional study pertaining to older hospitalized patients (≥65) recruited from 30 large hospitals in China. Results The average BMI increased from 21.8 to 23 kg/m2 in two decades. Using the linear model, we calculated that the net BMI increase will be 1.49 kg/m2 from 2009 to 2019. We subsequently proposed that the BMI cut-off value for malnutrition should rise to 20 kg/m2 . This cut-off value was applied to the validation dataset, containing 8,725 patients, and the GLIM-determined malnutrition rate was 24.58% (using the NRS-2002) and 23.32% (using the MNA-SF). The results significantly differed from those obtained using the 2001 Chinese BMI criteria (p Conclusion The GLIM tool has good applicability in Asian populations, especially in Chinese older adult patients. The BMI cut-off value for malnutrition should be adjusted to 20 kg/m2 for Chinese adults. This article is protected by copyright. All rights reserved.

В огляді літератури наведені актуальні дані про сучасний стан розрахунку вихідного нутритивного статусу пацієнтів при розширених оперативних втручаннях. У багатьох сучасних дослідженнях доведено, що пацієнти з патологією шлунково-кишкового тракту мають нутритивну недостатність і термін її виявлення та строки початку лікування є важливим фактором, що впливає на одужання. У сучасній клінічній практиці немає чітких та однозначних критеріїв визначення метаболічних порушень, що, у свою чергу, призводить до зниження ефективності лікування, збільшення кількості інфекційних ускладнень, терміну перебування у реанімації. Оцінка ефективності та доцільності нутритивної підтримки складається з суми об’єктивних і суб’єктивних параметрів. Розробка єдиних простих і зрозумілих критеріїв дозволить оцінити ефективність лікування, вибір і спосіб уведення препаратів нутритивної підтримки.

Review objective: from the position of the International National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, Pan Pacific Pressure Injury Alliance, there are presented the issues of terminology, statistics, risk factors, international classification, main directions of prevention, differential diagnostis, examinationof the skin and paperwork management, aggressive medical therapy of pressure ulcers. Pressure ulcers are localized damages to the skin and/or subjacent tissues, usually at the sites of the bony prominences, as a result of a pressure or pressure combined with friction, dislocation, scratching or skin deflection. Statistics. In the USA, pressure ulcers are annually developed in 2.5 million of patients (from 2.3 up to 18 % in urgent patients); 60,000 patients die every year due to complications of pressure ulcers; implementation of programs on pressure ulcers prevention is associated with 50% reduction in their number. There are presented risk factors for the development of pressure ulcers. International classification of pressure ulcers is set forth; 4 categories of complexity are identified, measures are established to ensure the process reversibility. Principles of differential diagnosis, examinationof the skin and paperwork management are set forth. To predict the risk of pressure ulcers, there is used Braden scale, which includes the following factors: sensory perception, skin humidity, activity, mobility, nutrition, friction and slip followed by evaluation of the scores. Pressure Ulcer Scale for Healing (PUSH Toll, 2008) is designed to predict the dynamics and outcome of pressure ulcers. There are presented key issues of aggressive medical therapy depending on the outcome of the pressure ulcers category; there is presented SPECIAL rule; re­commendations of the Institute for Clinical Systems Improvement working group. There is published practical guidance of American Physical Therapy Association, the leading ideology of which is the choice of treatment strategy depending on the stage of the wounds and the purpose of therapy; the effectiveness increases with the inclusion in the complex of aggressive medical therapy of sessions of hyperbaric oxygenation, electrotherapy, vacuum therapy of wounds, electrical stimulation, topical use of recombinant growth factor. Particular attention is paid to such positions of nutrition intervention as: initial assessment of nutritional status, determination of calorie insufficiency, use of adequate doses of protein, adequate prescription of liquid, vitamins, microelements.

Background The relationship between nutritional status and the incidence or prognosis of atrial fibrillation (AF) has been reported, but no studies have described the relationship between the outcomes of AF catheter ablation (CA) and nutritional status as assessed by various scoring tools. We aimed to verify the hypothesis that preoperative nutritional status is associated with arrhythmia recurrence after CA for AF.Methods and Results:We evaluated 913 patients (age, 67±10 years; men, 72%; paroxysmal AF, 56%) who underwent CA for AF between November 2011 and November 2017. Patients were systematically followed with an endpoint of atrial tachyarrhythmia recurrence, the predictive value of which was compared among 3 scoring tools (Controlling Nutritional Status [CONUT] score / Geriatric Nutritional Risk Index [GNRI] / Prognostic Nutritional Index [PNI]). Patients were divided into normal nutrition (CONUT 98 [n=836] / PNI >38 [n=910]) and undernutrition (CONUT ≥2 [n=276] / GNRI ≤98 [n=77] / PNI ≤3 [n=3]) groups. AF recurred in 274 patients (mean follow-up, 2.3±0.8 years). The AF recurrence rate was higher in patients with undernutrition than in those with normal nutrition (CONUT/GNRI) status. Multivariate Cox regression analysis identified undernutrition status (GNRI ≤98) as an independent predictor of atrial tachyarrhythmia recurrence. Conclusions The AF recurrence rate after CA was higher in patients with undernutrition than in those with normal nutrition as stratified by the nutrition scoring tools.

The features of the functional state of the gastrointestinal tract in children with bronchopulmonary dysplasia have been analyzed. It has been shown that children with bronchopulmonary dysplasia have significantly lower indicators of physical development than apparently healthy children. The dependence between hypoproteinemia in the blood serum and pathological changes in stool test of children with bronchopulmonary dysplasia was established that should be taken into account during the clinical management of these patients.

The article deals with exocrine pancreatic insufficiency (EPI), which is being detected in a significant number (30–50 %) of patients with diabetes mellitus (DM) type I and II and could potentially affect the compensation of DM. Enzyme replacement therapy should be considered as one of the most promising treatments in patients with DM. This therapy is preferably to be carried out in accordance with clinical guidelines set out in the recent consensuses, however, with higher doses of modern fourth-generation enzyme preparations such as Pangrol® 25000. Additional methods of treatment for EPI in patients with DM are correction of nutritional status using appropriate diet, as well as vitamin replacement therapy., Статья посвящена проблеме экзокринной панкреатической недостаточности (ЭПН), которая имеется у значительного числа (30–50 %) больных сахарным диабетом (СД) I и II типа и потенциально может влиять на компенсацию СД. Заместительную ферментную терапию следует рассматривать как один из перспективных методов лечения больных СД. Ее желательно проводить в соответствии с клиническими рекомендациями, изложенными в последних консенсусах, однако более высокими дозами современных ферментных препаратов IV поколения, таких как Пангрол®25000. Дополнительными методами лечения ЭПН у больных СД являются коррекция нутритивного статуса с помощью соответствующей диеты, а также заместительная витаминотерапия., Стаття присвячена проблемі екзокринної панкреатичної недостатності (ЕПН), що є в значного числа (30–50 %) хворих на цукровий діабет (ЦД) I і II типу і потенційно може впливати на компенсацію ЦД. Замісну ферментну терапію слід розглядати як один із перспективних методів лікування хворих на ЦД. Її бажано проводити відповідно до клінічних рекомендацій, викладених в останніх консенсусах, однак більш високими дозами сучасних ферментних препаратів IV покоління, таких як Пангрол®25000. Додатковими методами лікування ЕПН у хворих на ЦД є корекція нутритивного статусу за допомогою відповідної дієти, а також замісна вітамінотерапія.

The article deals with the study of nutritional status in patients with chronic inflammatory bowel disease (CIBD) using bioimpedancemetry. 40 patients with CIBD were examined. The high prevalence of deviations in the percentage of fat mass in the body (87.5 %) has been detected, with a predominance of nutritional deficiency (65.0 %) associated with a decrease in the body’s adaptive capabilities and severe course of the disease. 70.0 % of patients were characterized by redistribution of water sectors of the body due to increased amount of extracellular fluid and reduced amount of intracellular fluid, which was more significant in patients with increased nutritional status compared to patients with nutritional deficiency. More expressed changes of the component composition of the body were in patients with Crohn’s disease.

Difficulty eating in children cause malnutrition, dehydration, underweight, electrolyte imbalance, impaired cognitive development, anxiety disorders, and in more severe cases can be a life-threatening condition. Tuina massage is a massage technique that can overcome eating difficulties in toddlers. The purpose of this activity is to increase the knowledge and skills of health cadres about nutritional health and Tuina massage. The service was carried out in Pasir Lor village, Karanglewas district, which was attended by 23 cadres. Data collection techniques were carried out using questionnaires about toddler nutrition and observation sheets to assess Tuina's massage skills. The results of the activity showed that the knowledge of cadres before training was mostly in the sufficient category, while the knowledge of cadres after attending the training showed that the level of knowledge of cadres was mostly in the good category. Most of the health cadres have good skills in doing Tuina massage. The training activities were effective and able to increase the knowledge and skills of cadres about toddler nutrition and developmental problems and Tuina massage.

Anemia in adolescent girls still shows a high prevalence rate. The prevalence of anemia in Indonesia at the age of 5-14 is 26.4%, 18.4% of patients aged 15-24 years, and women have a high risk of anemia, especially in adolescent girls. Adolescent girls with anemia will have changed the menstrual cycle. The importance of learning adolescent nutritional status will be strategic planning for decreased nutritional macro and micro deficiencies in women. This community dedication aimed to present information about the risk of anemia through student empowerment and hematological examination (hemoglobin-hematocrit). A piece of good and proper knowledge about balanced Nutrition is an essential point of anemia prevention in adolescents.

In 2017, the study, Vision Impairment and Intracranial Pressure and Psychological Envihab Research, dubbed VaPER, was conducted in the:envihab facility in Cologne, Germany to determine whether 30 days of bed rest at 6° head down tilt in an increased ambient CO2 (hypercapnic) environment contributes to the deterioration of ocular anatomy and to changes in musculoskeletal, nutritional, hematological, immunological, behavioral, and balance functions. A set of international standard measures were used to evaluate bone, muscle, and nutritional status, and to assess the function of the cardiovascular, sensorimotor, visual, and immune systems, and psychological state. Strict 6° head-down tilt bed rest in an elevated ambient CO2 environment induced mild immunological dysregulation. After bed rest, selenium, urinary iodine, and folate status were lower in the subjects of the VaPER study than they were in subjects of previous bed rest studies of similar duration, which likely reflects regional differences in diet and nutritional status. Bed rest induced optic disc edema in 5 of the 11 subjects. Interestingly, the subjects who were diagnosed with optic disc edema, as determined by fundoscopy imaging, also tended to exhibit higher body temperature and overall higher levels of anxiety and insomnia during bed rest.