Energy Intake and Clinical Trajectories in End-Stage Aspiration Pneumonia: A Retrospective Cohort Study

Objective: To investigate the association between sufficient energy intake and improvement in activities of daily living (ADL) after hospitalization in patients with cervical spinal cord injury (CSCI) undergoing post-acute rehabilitation. Design: Retrospective cohort study. Setting: Post-acute care hospital from September 2013 to December 2020. Participants: Patients with CSCI admitted to a post-acute care hospital for rehabilitation. Intervention: Not applicable. Outcome measure(s): Multiple regression analysis was performed to investigate the relationship of sufficient energy intake to Motor Functional Independence Measure (mFIM) gain, mFIM score at discharge, and body weight change during hospitalization. Results: In total, 116 patients (104 men and 12 women), median age: 55 (interquartile range [IQR] 41−65) years were included in the analysis. Then, 68 (58.6%) were in the energy-sufficient group, and 48 (41.4%) patients were classified under the energy-deficient group. The two groups did not significantly differ in terms of mFIM gain and mFIM score at discharge. The energy-sufficient group maintained body weight change during hospitalization than the energy-deficient group (0.6 [−2.0−2.0] vs. −1.9 [−4.0−−0.3], P < 0.001). Multiple regression analysis showed no association between sufficient energy intake and outcomes. Conclusion: Sufficient energy intake within the first 3 days of admission did not affect ADL improvement during hospitalization in patients with a post-cute CSCI undergoing rehabilitation.

In this multicentre prospective observational study, we aimed to investigate changes in energy intake and nutritional indices, including cardiovascular, cerebrovascular, respiratory, and musculoskeletal conditions, among older adults hospitalised in general hospitals who required long-term rehabilitation. This study included patients aged ≥65 years who were admitted to 41 National Hospital Organization hospitals between September 2019 and March 2020 with cardiovascular, cerebrovascular, respiratory, or musculoskeletal diseases. Physical measurements, blood test values, energy intake, and activities of daily living were evaluated at admission and discharge. The analysis includ-ed 222 patients (125 men, 97 women; mean age, 78.9 years). On admission, 75.7% of patients were malnourished or at risk of malnutrition based on the Mini Nutritional Assessment-Short Form score, with the highest prevalence (84.1%) observed in patients with respiratory disease. Although energy intake significantly increased during hospitalisation in all disease groups, only 31.1% of patients met the estimated energy requirements at discharge, and their body mass index and nutritional indices decreased. Logistic regression analysis showed that older age, female sex, higher energy intake at admission, and lower inflammation were associated with sufficient energy intake at discharge. Energy intake at admission was consistently associated with sufficient energy intake at discharge regardless of disease category, whereas other associated factors dif-fered by disease. Nutritional management in general hospitals may be inadequate for older adults requiring long-term rehabilitation. These findings suggest the need for early individualised nutritional management in hospitalised older adults undergoing long-term rehabilitation.

Background: Sufficient food and other nutrient intake are necessary for recovery of hospitalized patients. Insufficient food intake may decrease nutrient metabolism, which in turn may cause malnutrition. Malnutrition in all hospital is categorized as high (about 40-45%). However, the influence of food intake on hospital malnutrition in Indonesia is still unknown.Objective: To assess the influence of nutrient intake on the occurence of hospital malnutrition.Method: This was an observational with prospective cohort study. This study as conducted in Dr. M. Jamil Padang Hospital, Dr. Sardjito Yogyakarta Hospital, and Sanglah Denpasar Hospital. Subjects were 228 adult patients from internal and neurology units in 1st, 2nd, and 3rd class who were hospitalized for six days or more, receiving oral diet, compos mentis, cooperative, non edema, and non ascites. Data of body weight and body height were measured at admission and discharge. Food intake data collected in this study included hospital and non-hospital food. Data analyzed by FP2 programme and STATA software.Results: Among 228 subjects of study, 51,8% had insufficient intake in the first three days of hospitalization. On average, their protein and energy intakes were lower than subjects with sufficient intake. There was a significant correlation between the first three days intake and intake during hospitalization (p&lt;0,05). Subjects with insufficient energy intake were 2,1 times more likely to be malnourished in hospital than subjects with sufficient energy intake. Meanwhile, subjects with insufficient protein intake were 1,56 times more likely to be malnourished than subjects with sufficient protein intake. There was a significant association between energy intake and hospital malnutrition (p&lt;0,05).Conclusions: Patients with insufficient nutrient intakes are more likely to be malnourished than those with sufficient nutrient intakes.

Findings regarding dietary protein and frailty are inconsistent. This inconsistency may be attributed to variations in energy intake adequacy. We hypothesized that the prevalence of frailty in older adults with sufficient energy intake is inversely associated with the intake of total, animal, and plant proteins; however, in those with deficient energy intake, this association may not be observed. This cross-sectional study included data of 5,768 adults aged ≥65 years from the Korea National Health and Nutrition Examination Survey 2014-2018. Frailty was assessed using a modified Cardiovascular Health Study frailty index. Protein intake was measured via a 24-h recall and analyzed using multivariable logistic regression. In older adults with sufficient energy intake, frailty was inversely associated with the intake of total (odds ratio [OR], 0.67; 95% confidence interval [CI], 0.46-0.97; p = 0.032), animal (OR, 0.59; 95% CI, 0.43-0.82; p = 0.001), and plant proteins (OR, 0.68; 95% CI, 0.50-0.92; p = 0.043). In those with deficient energy intake, total and animal protein intake showed no significant associations with frailty, whereas plant protein intake was inversely associated with frailty. Adequate energy intake appears essential for the protective effects of total and animal protein against frailty. Higher plant protein intake appears to confer benefits regardless of energy intake, highlighting its potential role in frailty prevention.

The present study investigated the effects of three consecutive days of endurance training under conditions of low energy availability (LEA) on the muscle glycogen content, muscle damage markers, endocrine regulation, and endurance capacity in male runners. Seven male long-distance runners (19.9 ± 1.1 yr, 175.6 ± 4.7 cm, 61.4 ± 5.3 kg, maximal oxygen uptake [V˙O2max]: 67.5 ± 4.3 mL·kg·min) completed two trials consisting of three consecutive days of endurance training under LEA (18.9 ± 1.9 kcal·kg FFM·d) or normal energy availability (NEA) (52.9 ± 5.0 kcal·kg FFM·d). The order of the two trials was randomized, with a 2-wk interval between trials. The endurance training consisted of 75 min of treadmill running at 70% of V˙O2max. Muscle glycogen content, respiratory gas variables, and blood and urine variables were measured in the morning for three consecutive days of training (days 1-3) and on the following morning after training (day 4). As an indication of endurance capacity, time to exhaustion at 19.0 ± 0.8 km·h to elicit 90% of V˙O2max was evaluated on day 4. During the training period, body weight, fat-free mass, and skeletal muscle volume were significantly reduced in LEA (P = 0.02 for body weight and skeletal muscle volume, P = 0.01 for fat-free mass). Additionally, muscle glycogen content was significantly reduced in LEA (~30%, P < 0.001), with significantly lower values than those in NEA (P < 0.001). Time to exhaustion was not significantly different between the two trials (~20 min, P = 0.39). Three consecutive days of endurance training under LEA decreased muscle glycogen content with lowered body weight. However, endurance capacity was not significantly impaired.

&lt;p&gt;&lt;em&gt;Patients of Down Syndrom mostly do not get proper support and care from their families, it is likely that families keep distance from public due to embarrasement of having a family member with such condition. Family support in this term plays an essential role in terms of child growth, which may be influential to physical aspect, self-care, communication, socialization, mentality, and emotion. Children &lt;/em&gt;&lt;em&gt;will be&lt;/em&gt;&lt;em&gt; malnourished if the nutrition necessary to support growth process is not fulfilled appropriately. The purpose of this research is to identify the relation between family support and energy intake in children with mental retardation in SLB N 01 of Bantul, Yogyakarta. This research was a quantitative research with cross sectional design. Population in this research was all children with mental retardation since the age of elementary school until senior high school. Samples in this research were 66 &lt;/em&gt;&lt;em&gt;subjects&lt;/em&gt;&lt;em&gt;. Data collection used questionnaires and systematic&lt;/em&gt;&lt;em&gt; random sampling&lt;/em&gt;&lt;em&gt;. Data was analyzed by &lt;/em&gt;&lt;em&gt;using&lt;/em&gt;&lt;em&gt; Kendal Tau statistical test. Results found that respondents who had good family support and sufficient energy intake were 27 &lt;/em&gt;&lt;em&gt;subjects&lt;/em&gt;&lt;em&gt; (40&lt;/em&gt;&lt;em&gt;.&lt;/em&gt;&lt;em&gt;9%), &lt;/em&gt;&lt;em&gt;subjects&lt;/em&gt;&lt;em&gt; who had &lt;/em&gt;&lt;em&gt;fair&lt;/em&gt;&lt;em&gt; family support and sufficient energy intake were 13 &lt;/em&gt;&lt;em&gt;subjects&lt;/em&gt;&lt;em&gt; (19&lt;/em&gt;&lt;em&gt;.&lt;/em&gt;&lt;em&gt;7%), &lt;/em&gt;&lt;em&gt;subjects with &lt;/em&gt;&lt;em&gt;sufficient family support and insufficient energy intake were 10 &lt;/em&gt;&lt;em&gt;subjects&lt;/em&gt;&lt;em&gt; (15,2%). According to Kendal Tau analysis, it was &lt;/em&gt;&lt;em&gt;showed&lt;/em&gt;&lt;em&gt; that p&lt;/em&gt;&lt;em&gt;-&lt;/em&gt;&lt;em&gt;value &lt;/em&gt;&lt;em&gt;was &lt;/em&gt;&lt;em&gt;0&lt;/em&gt;&lt;em&gt;.&lt;/em&gt;&lt;em&gt;001 (p&amp;lt;0&lt;/em&gt;&lt;em&gt;.&lt;/em&gt;&lt;em&gt;05) which described that there was a significant relation betweeen family support and energy intake in children with mental retardation in SLB N 01 of Bantul, Yogyakarta. Therefore, it is essential &lt;/em&gt;&lt;em&gt;to provide motivation and education for parents with mentally retarded children, especially on child food intake&lt;/em&gt;&lt;em&gt;.&lt;/em&gt;&lt;/p&gt;

Energy intake and rehabilitation time individually contribute to the improvement of activities of daily living (ADL). This study aimed to investigate the additive effect of energy intake and rehabilitation time on ADL improvement in acute stroke patients with sarcopenia. The study included 140 patients (mean age 82.6 years, 67 men) with stroke. Energy intake during the first week of hospitalization was classified as “Sufficiency” or “Shortage” based on the reported cutoff value and rehabilitation time was classified as “Long” or “Short” based on the median. The study participants were categorized into four groups based on the combination of energy intake and rehabilitation time. The primary outcome was the gain of functional independence measure (FIM) motor during hospitalization. The secondary outcomes were length of stay and home discharge rates. Multivariate analysis was performed with primary/secondary outcomes as the dependent variable, and the effect of each group on the outcome was examined. Multivariate analysis showed that “long rehabilitation time and sufficient energy intake” (β = 0.391, p < 0.001) was independently associated with the gain of FIM motor items. The combination of high energy intake and sufficient rehabilitation time was associated with ADL improvement in acute stroke patients with sarcopenia.

Energy Intake as a Dominant Factor in the Incidence of Underweight Toddlers in Bogor Regency Background: Being underweight is still a health problem for children under five in Indonesia. The direct factors that cause nutritional problems are food intake and infectious diseases. Objective: The prevalence of underweight among children aged 12-59 months in Bogor Regency is still relatively high. The purpose of this study was to prove energy intake as the dominant factor in the occurrence of underweight. Objectives: The prevalence of underweight among toddlers aged 12-59 months in Bogor is still high. The purpose of this study was to prove energy intake as a dominant factor in the occurrence of underweight. Methods: This research design is conducted using a cross sectional study design. This research is a quantitative study using secondary data from the 2019 Hibah PITTA B research from the Universitas Indonesia. The samples are 450 toddlers aged 12-59 months. The data analysis used chi-square test to determine the relationship between independent and dependent variables. Multivariate analysis also conducted by using multiple logistic regression tests to determine the factors that contribute to the incidence of underweight in children under five. Results: The prevalence of underweight in children under five in Babakan Madang Sub-District in 2019 was 23.1%. The results of multivariable logistic regression analysis found that energy intake was the only significant predictor of the incidence of underweight children aged 12-59 months. Toddlers with deficit energy intake had 1.92 times the risk of being underweight compared to toddlers with sufficient energy intake. Conclusion : Energy intake shown as the dominant factor in the incidence of underweight in children aged 12-59 months in Bogor. The prevalence of underweight contributes to lost productivity, as well as high morbidity and mortality rates. Multisectoral collaboration is very important in implementing intervention strategies to prevent underweight in children under five based on the problem of toddler food intake and other contributing factors.

Background:Chronic kidney disease is a global public health priority that continues to grow and is associated with high morbidity rates and is the third fastest growing cause of death in the world and the fifth leading cause of death. Malnutrition often occurs in end-stage renal disease patients undergoing hemodialysis (HD). Malnutrition is caused by catabolic events during the hemodialysis process. Objective: The aim of the study was to analyze energy intake, protein and nutritional status of chronic kidney failure patients on hemodialysis at Harapan and Doa Regional Hospital, Bengkulu City. Materials/Methods: Explanatory research type, with a cross sectional approach. The study population was all chronic kidney failure sufferers who underwent hemodialysis at Harapan and Doa Hospital, Bengkulu City in June-July 2023. Data were collected by interviews and anthropometric measurements, 3x24 hour recall forms and SGA forms and from patient medical records. Data processing was carried out using univariate tests. Result:This study shows that 98% of respondents' energy intake before hemodialysis had insufficient energy intake (&lt; 80%) and 2% had sufficient energy intake (80), protein intake before hemodialysis 92% protein intake is less (&lt; 80%) during hemodialysis and after hemodialysis 85% with less protein intake (&lt; 80%), nutritional status of chronic kidney failure patients with hemodialysis good nutritional status (SGA score A), namely (54%) lack of protein intake, poor/moderate nutritional status (SGA B score), namely (43%), poor nutritional status (SGA C score), namely (3%). Conclusion:The conclusion of this study is that energy intake, protein and nutritional status in chronic kidney failure patients on hemodialysis are still lacking. Therefore, increasing intake needs to be done by paying attention to the patient's nutritional status

Children with motor disabilities are at increased risk of compromised bone health due to impaired weight bearing. Poor nutritional status may be an additional risk factor. The aim of this study was to evaluate energy and nutrient intakes in children with motor disability. Fifty-four children with motor disability (cerebral palsy in 59%) were included. Three-day food diaries were collected and analysed. The results were compared with recommended dietary allowances for age and sex. The median age was 10.9 years. The median energy intake was 76% of the recommendation and <80% in 57% of children. Of the total energy, 17% was from protein, 32% from fat and 50% from carbohydrates. The medians were for calcium intake 142% and for vitamin D intake 76% of the recommendation; serum 25-hydroxy-vitamin D concentrations were low (median 46 nmol/L). Children with low energy intake were shorter and lighter and had more severe motor disability than children with sufficient energy intake. Insufficient energy and nutrient intake is common in children with motor disability. This may have adverse health effects especially when associated with low vitamin D intake. Energy and vitamin D supplements should be considered.

The prevalence of hypertension in people aged ≥ 18 years has increased in 2018. The research aims to describe the sociodemographic features, smoking habits and food intake in hypertensive patients. This type of research is descriptive with cross sectional involving 64 respondents with purposive sampling, the research was conducted in February 2023 at the Kramat Jati District Work Area Health Center. Data collection on weight, height, characteristics questionnaire, smoking habits and food intake. The results of this study were that the highest blood pressure was hypertension stage 1 (70.3%), age 56-65 years (62.5%), female gender (62.5%), high school education (45.3%), not working (62.5%), income ≤ (75.0%), never smoked (59.4%). excessive energy intake (46.9%), sufficient protein intake (54.7%), excessive fat intake (57.8%), sufficient carbohydrate intake (69.8%), overweight (48.4%). In conclusion, hypertensive patients are in the late elderly age group, female, have a high school education, do not work, have a low income, do not have a smoking habit, have sufficient energy intake, sufficient protein intake, high fat intake, and sufficient carbohydrate intake.

Dietary management is highly important for the maintenance of renal function in patients with chronic kidney disease (CKD). Cerebral oxygen saturation (rSO2) was reportedly associated with the estimated glomerular filtration rate (eGFR) and cognitive function. However, data concerning the association between cerebral rSO2 and dietary intake of CKD patients is limited. This was a single-center observational study. We recruited 67 CKD patients not undergoing dialysis. Cerebral rSO2 was monitored using the INVOS 5100c oxygen saturation monitor. Energy intake was evaluated by dietitians based on 3-day meal records. Daily protein and salt intakes were calculated from 24-h urine collection. Multivariable regression analysis showed that cerebral rSO2 was independently associated with energy intake (standardized coefficient: 0.370) and serum albumin concentration (standardized coefficient: 0.236) in Model 1 using parameters with p < 0.10 in simple linear regression analysis (body mass index, Hb level, serum albumin concentration, salt and energy intake) and confounding factors (eGFR, serum sodium concentration, protein intake), and the energy/salt index (standardized coefficient: 0.343) and Hb level (standardized coefficient: 0.284) in Model 2 using energy/protein index as indicated by energy intake/protein intake and energy/salt index by energy intake/salt intake in place of salt, protein and energy intake. Cerebral rSO2 is affected by energy intake, energy/salt index, serum albumin concentration and Hb level. Sufficient energy intake and adequate salt restriction is important to prevent deterioration of cerebral oxygenation, which might contribute to the maintenance of cognitive function in addition to the prevention of renal dysfunction in CKD patients.

ObjectiveTo analyze whether sufficient energy intake (EI) improves performance of activities of daily living (ADL) in patients with hip fracture admitted to rehabilitation hospitals. The adequate amount of EI for improving performance of ADL in patients with hip fracture remains unknown.MethodsThis retrospective cohort study included all patients with hip fracture (n=234) admitted to rehabilitation hospitals in Japan. The inclusion criteria for this study were age >65 years and body mass index <30.0 kg/m2. Patients who were transferred to an acute hospital and those with missing case data were excluded. According to the amount of EI, the patients were classified into energy sufficiency and shortage groups (EI/total energy expenditure ≥1.0 and <1.0, respectively). The Functional Independence Measure (FIM) and FIM gain were used to evaluate the patient disability level and change in patient status in response to rehabilitation. Finally, FIM gain was calculated as the discharge FIM score minus the admission FIM score.ResultsThe final analysis targeted 202 patients—53 (26.2%) were in the energy shortage group and 149 (73.8%) were in the energy sufficiency group. The energy sufficiency group had a greater FIM gain than the energy shortage group (mean, 25.1±14.2 vs. 19.7±16.4; p=0.024). Furthermore, sufficient EI in the first week since admission (β=0.165; 95% confidence interval, 0.392–5.230; p=0.023) was an independent factor of FIM gain.ConclusionAmong elderly patients with hip fracture admitted to rehabilitation hospitals in Japan, the amount of EI during the first week after admission was an independent factor of FIM gain.

Underweight in children is still remains the public health problems in the world. The prevalence of underweight children under five in Depok City in 2022 is 12.1 percent. This study aimed to analyze energy intake and other factors with the incidence of underweight in children aged 6 - 59 months old in Depok City. This study a used cross-sectional study design. This study used secondary data from Grant research of indexed publication Q2 TA 2022/202 Batch 3 Kemenristek. The samples were 311 with the criteria of children aged 6 – 59 months old with complete data and non-extreme data. Chi-square test was used to determine the relationship between sex, low birth weight, deworming, complete immunization, ARI, diarrhea, energy intake, protein intake, fat intake, carbohydrate intake and family income and underweight. A multivariate binary logistic regression was employed to determine the factors that contribute to the incidence of underweight in children aged 6 - 59 months old. The results of multivariabel logistic regression analysis showed energy intake as the dominant factor in the incidence of underweight in children aged 6 - 59 months old (p-value 0.001). Children with insufficient energy intake are 10.06 times more likely to be underweight than children with sufficient energy intake.

BackgroundDietary management is highly important for the maintenance of renal function in patients with chronic kidney disease (CKD). Cerebral oxygen saturation (rSO2) was reportedly associated with the estimated glomerular filtration rate (eGFR) and cognitive function. However, data concerning the association between cerebral rSO2 and dietary intake of CKD patients is limited.MethodsThis was a single-center observational study. We recruited 67 CKD patients not undergoing dialysis. Cerebral rSO2 was monitored using the INVOS 5100c oxygen saturation monitor. Energy intake was evaluated by dietitians based on 3-day meal records. Daily protein and salt intakes were calculated from 24-h urine collection.ResultsMultivariable regression analysis showed that cerebral rSO2 was independently associated with energy intake (standardized coefficient: 0.370) and serum albumin concentration (standardized coefficient: 0.236) in Model 1 using parameters with p < 0.10 in simple linear regression analysis (body mass index, Hb level, serum albumin concentration, salt and energy intake) and confounding factors (eGFR, serum sodium concentration, protein intake), and the energy/salt index (standardized coefficient: 0.343) and Hb level (standardized coefficient: 0.284) in Model 2 using energy/protein index as indicated by energy intake/protein intake and energy/salt index by energy intake/salt intake in place of salt, protein and energy intake.ConclusionsCerebral rSO2 is affected by energy intake, energy/salt index, serum albumin concentration and Hb level. Sufficient energy intake and adequate salt restriction is important to prevent deterioration of cerebral oxygenation, which might contribute to the maintenance of cognitive function in addition to the prevention of renal dysfunction in CKD patients.