Causes Of Malnutrition Research Articles

Overview of nutritional approach in hematopoietic stem cell transplantation: COVID-19 update.

The coronavirus disease 2019 (COVID-19) is caused by the newly discovered SARS-CoV-2. Hematopoietic stem cell transplantation (HSCT) is a high-risk procedure. The novelty of COVID-19 has created more uncertainty during all phases of HSCT. It is thought that HSCT patients taking immunosuppressive agents are more likely to contract COVID-19 than healthy individuals are. Appropriate care precautions should be taken with patients undergoing HSCT to minimize the risk of COVID-19, and appropriate treatment methods must be followed in patients infected with COVID-19. Malnutrition has become a significant problem in HSCT patients during the COVID-19 pandemic. The causes of malnutrition in HSCT patients are multifactorial. However, the most important reason is the decrease in energy and nutrient intake. The HSCT procedure can lead to many complications such as dysgeusia, mucositis, diarrhea, constipation, xerostomia and vomiting/nausea. Improving the nutritional status of HSCT patients by managing each of these special complications with an appropriate nutritional approach is essential for successful engraftment. This review aims to provide a comprehensive overview of the specific complications affecting the nutritional status of HSCT patients and their nutritional approach during the challenging COVID-19 pandemic.

Action Research on Advocating Use of Fortified Foods in the Free-Living Population of Urban Vadodara using Diffusion of Innovation Model

Worldwide, unaffordable healthy diets, dependability over staple food items, and lack of knowledge have been the major cause of malnutrition. Government programs, promoting dietary diversity and supplementation have not given promising results in improving the micronutrient status of the population. Government of India, along with Food Safety and Standards Authority of India have chosen five vehicles, namely, rice, wheat flour, salt, milk, and oil for the fortification process to combat the micronutrient deficiency. Fewer studies aimed at creating advocacy about fortified foods among the free living population and stake holders. The present study undertook the advocacy for fortified foods amongst the free living population using the Diffusion of Innovation Model (DIM) for the purchase of fortified foods. An E- Intervention using graphics, audios and videos were given to the participants on WhatsApp for 1 month. The results in the study have shown significant difference in the awareness, perception and purchase of fortified foods for all the five staples post intervention, which provides enough evidence that the proposed strategy for creating awareness and promoting purchase of fortified foods amongst the selected participants was highly effective. Use of different E-communication channels can be used by researchers at large for creating the awareness about the safe consumption of fortified foods. Besides this, conducive environment is needed for fortification program to be a success, which will ensure the proper supply and demand to make the food fortification program viable.

Enteral nutrition management in stroke patients: a narrative review.

We aimed to summarize the enteral nutrition (EN) management of stroke patients according to recent evidence. Stroke patients have a high incidence of dysphagia, which is the main cause of malnutrition, and stroke with malnutrition leads to high recurrence and mortality. Insufficient food intake caused by dysphagia is the main cause of malnutrition in stroke patients, which is associated with poor prognosis, increased mortality, and deteriorated outcomes in patients with stroke. Dehydration is also worthy of attention. Non-systematic searches of the PubMed database were conducted to retrieve relevant English-language articles, and the CNKI and Wanfang database were searched for relevant Chinese-language articles. Fifteen recent guidelines or expert consensuses on the clinical nutritional management of stroke patients were published between 2013 and 2021, of which eight are from China. Before providing nutritional support, swallowing, hydration, and risk of malnutrition need to be screened by a dietitian or professional. Although the initiation time of nutritional support is different in each guideline, tube feeding is preferable for patients with dysphagia. The appropriate dosage, formula, and treatment of complications need to be further studied. Also, nutritional support for stroke patients at different stages needs to be further improved. The continuous improvement and details of stroke nutrition guidelines contribute to standardized clinical nutrition practices and benefit patients.

Development of home-based ready-to-use supplementary food (RUSF-HB) to overcome nutrition-related problems among children under five during the covid-19 pandemic

The most direct causes of malnutrition are food consumption and infection. Yet the prolonged Covid-19 pandemic has limited low-income families’ ability to fulfil the need for nutrition consumption, particularly for children under five. Responding to this situation, we sought to develop home-based ready-to-use supplementary foods (RUSF-HB) from local ingredients that are energy-protein-dense, affordable, simple and easy to produce at home. We created three milk-free formulas (MFFs) and six standard formulas (STFs). Three cheap and abundant local foods: soybeans, cowpeas, and mung beans were combined with rice flour, refined sugar, and coconut oil. A cross-over study design was used to assess food organoleptic, which showed that the products were comparable in several sensory aspects except for the odour and the taste. Soybeans-based formulas contain slightly more energy and protein compared to mung beans or cowpeas-based ones. However, the mung beans-based formulas were more favourable to caregivers and children, particularly their taste and smell. The products contain slightly less energy than the recommended ones but high enough to supply macronutrient for those in need on a regular basis. The caregivers considered the total price for the products was affordable, and the formula was easy to follow.

A Study to Assess the Knowledge on Iron Deficiency Anemia among Reproductive Age Group (20-45 Year) Women in Selected Rural Area of Lucknow

Background of the study: Anemia continues to be a major public health problem in developing countries including India. It is the most common cause of malnutrition in the world and is the eighth leading cause of diseases in girls and women in developing counties. About one third of the global population is anemic (WHO 2010) [1]. Knowledge regarding the causes, prevention and management of iron deficiency among reproductive age women plays an important role in reducing the mortality and morbidity rates. The aim of this study is to assess the knowledge regarding iron deficiency anemia among reproductive age group women. Methodology: By using descriptive survey design, 50 women who met the criteria were selected by purposive sampling technique. Structured questionnaire was used to gather the data Data were analyzed by descriptive and inferential statistics. Results: Findings shows that 6% of reproductive age group women had inadequate level of knowledge regarding anemia, 72% had moderate level of knowledge and 22% of them had adequate level of knowledge. Conclusion: Overall findings of this study revealed that knowledge on iron deficiency anemia was inadequate among reproductive age group women. There is a need to improve the health care services, facilities and more importantly knowledge among the women on topics related to anemia and its prevention.

High-Protein Dietary Supplementation and Nutritional Status Improvement of Malnourished Patients in Hospital Care

Hospital malnutrition is common in Indonesia and other developing countries. In Asia, the prevalence of hospital malnutrition ranges between 27-39%. The causes of malnutrition in hospital care include insufficient food intake and increased catabolic processes due to underlying causes such as metabolic disease, infection, and malignancy. Several studies have demonstrated that malnutrition increases the morbidity and mortality of hospitalized patients, prolongs hospital stay, and delays recovery. Therefore, healthcare providers must recognize malnutrition early by conducting nutritional screening and assessment to prevent worsening of malnutrition and administer the optimal nutritional therapy to patients. Apart from giving a standard diet, high-protein food supplementation in liquid form remains a suitable alternative for patients, especially since it is easily digestible. A high protein diet is associated with a better mortality rate, better weight gain, and improved SGA score in patients.

Infant and young child feeding practice among mothers of children age 6 to 23 months in Debrelibanos district, North Showa zone, Oromia region, Ethiopia.

Inappropriate infant and young child feeding (IYCF) practice is the leading cause of malnutrition in children. Data is needed to identify children at risk of poor feeding practice and to target interventions to improve IYCF practices. Therefore, this study aimed to assess IYCF practice and associated factors among mothers of children age 6 to 23 months in Debrelibanos district, north Showa zone, Oromia region, Ethiopia. A community-based cross-sectional study design was conducted among 380 mothers of children age 6 to 23 months from March 1 to April 5, 2019. A simple random sampling technique was used to select the respondents. Data was collected using a structured interviewer-administered questionnaire that had been pretested. The data was entered into Epi-Data 3.1 and then transferred to SPSS 21 for analysis. Descriptive statistical analysis was done, and an association between an outcome variable and independent variables was examined in logistic regression models. Overall, 65.8% of mothers practiced appropriate IYCF practice. The study revealed that 70.5% of children started breastfeeding within one hour of birth, and 61.6% were breastfed exclusively for six months. Among studied mothers, 79.5% continued to breastfeed their children until 2 years, and 69.2% of the participants started complementary feeding timely at six months. Minimum dietary diversity was observed in 19.2% of children, while minimum meal frequency was found in 79.2%. The majority of mothers (77.6%) fed their babies with bottles. Mother's educational status of primary school [AOR = 4.50, 95% CI: (1.38,14.61)], husband's occupation being merchant [AOR = 6.45, 95% CI: (1.51, 27.59)]; antenatal care follows up [AOR = 3.15, % CI: (1.22, 8.12)], radio/television ownership [AOR = 7.41, 95% CI: (2.86, 19.20)], child's sex being female [AOR = 4.78, 95% CI: (2.26, 10.064) and sufficient knowledge on child feeding [AOR = 2.82, 95% CI: (1.27, 26.26)] were independent predictors for appropriate IYCF practice. The prevalence of appropriate infant and young child feeding practice indicators was found to be rather high among the mothers in this study. The use of a bottle to feed babies, in particular is very common among the mothers who were studied. To address child malnutrition, it is critical to educate families about proper IYCF practices. This study suggests that mothers be properly educated about IYCF recommendations at health care facilities during their visits, as well as the promotion of appropriate IYCF through various media.

Influence of Various Methods of Zinc Fertilization on Growth and Yield of Finger Millet (Eleusine coracana) Varieties

Background: Zn deficiency was predominant in soils of Chittoor district of Andhra Pradesh, which causes yield reduction in most of the crops especially in finger millet. Zinc has important role in enzyme activation viz., oxidoreductase, transferases, hydrolases, lyases, isomerases and ligases. The deficient soil gives us the zinc deficient food which is said to be the major root cause for malnutrition among the children. Hence present study was intended to find out most appropriate method and time of zinc fertilization for higher productivity, grain quality and zinc fortification with two major finger millet varieties viz., vakula and tirumala. Methods: The field experiment was laid out in split plot design with three replications and two varieties viz., vakula (V1) and tirumala (V2) with seven zinc application treatments which includes: control (T1); NPK (30-30-20) + FYM @ 10t ha-1 (T2); T2 + soil application (SA) of ZnSO4 @ 25 kg ha-1 as basal (T3); T2 + SA of chelated zinc sulphate @ 5 kg ha-1 as basal (T4); T2 + FA of 0.2% ZnSO4 at ear head emergence stage (T5); T2 + foliar application (FA) of 0.2% ZnSO4 at grain filling stage (T6); T2 + FA of 0.2% ZnSO4 at ear head emergence and grain filling stages (T7). Result: Foliar application of 0.2% ZnSO4 at ear head emergence and grain filling stages registered significantly highest grain and straw yield of 3150 kg ha-1 and 7364 kg ha-1, respectively compared to control and other zinc fertilization treatments. Between the two tested varieties tirumala variety recorded higher grain yield (2298 kg ha-1) compared to vakula variety (2230 kg ha-1).

Boosting nutritional security through kitchen gardening: Nutritional security through kitchen gardening

Malnutrition is rapidly growing problem across the country. Malnutrition not only slows down child growth and development but also increases the risk and duration of getting sick and also hindered social and mental development. The main cause of malnutrition is lack of nutrients in the diet. Mostly people depend on grains for food, less consumption of vegetables, green vegetables, fruits and milk are the reasons of malnutrition. Diet diversification is best strategy to improve health and nutrition especially for poor. Fruits and vegetables are best way to make health better, overcoming hunger and malnutrition. A study was conducted to address the malnutrition. For combating malnutrition, nutritional kitchen gardens were developed at farmers' field. After introduction of kitchen garden, there was a significant increase in nutrient content. As compare to their traditional practice of gardening they found 240 kg more vegetable through planned kitchen garden in a year and earned Rs.3400/- . The availability of vegetables increased by 186 at house hold level. % change in Consumption gm/day was 41.6. With the availability of vegetable in the diet, farm families can reduce problem of malnutrition. Cultivation of vegetables at homestead level in systematic manner contributes to household food security as well as income also.

The Relationship between Exclusive Breastfeeding and Diarrhea in Under Six Months Infants in 2017 (Analysis of Indonesian Health Demography Data Survey 2017)

Background: Diarrhea is the main cause of malnutrition in underfive children. One of the efforts to prevent diarrhea in infants is exclusive breastfeeding. Exclusive breastfeeding is infant that receives only breast milk without any additional consumption from 0 to 6 months. Under six months infant who are not exclusively breastfed have a higher risk of developing diarrhea than those who are exclusively breastfed.Methods: This study aims to determine the relationship between exclusive breastfeeding and the incidence of diarrhea in under six months infants in Indonesia. This study analyze secondary data from the 2017 Indonesian Demographic and Health Survey. The sample in this study consist of all live infants aged 0-6 months born to women aged 15-49 years in Indonesia who were successfully interviewed and had a complete answer (no answer missing). After weighting, 1898 samples were obtained.Result: The result found that the proportion of diarrhea incidence in Indonesia is 9.1%. Meanwhile of all infants, 36% were not exclusively breastfed. The results showed that there was a significant relationship between infants who were not exclusively breastfed and diarrhea incidence in Indonesia after adjusted by mother's education level, maternal employment status, mother’s economic level, area of residence, and latrine ownership (PR = 2.12, 95% CI = 1.46-3.07).Conclusion : Infants who were not exclusively breastfed increase the risk for diarrhea. Therefore it is necessary to have a program to increase the coverage of exclusive breastfeeding. The program can take the form of counseling by health workers in health services.

Malnutrition in Older Adults-Recent Advances and Remaining Challenges.

Malnutrition in older adults has been recognised as a challenging health concern associated with not only increased mortality and morbidity, but also with physical decline, which has wide ranging acute implications for activities of daily living and quality of life in general. Malnutrition is common and may also contribute to the development of the geriatric syndromes in older adults. Malnutrition in the old is reflected by either involuntary weight loss or low body mass index, but hidden deficiencies such as micronutrient deficiencies are more difficult to assess and therefore frequently overlooked in the community-dwelling old. In developed countries, the most cited cause of malnutrition is disease, as both acute and chronic disorders have the potential to result in or aggravate malnutrition. Therefore, as higher age is one risk factor for developing disease, older adults have the highest risk of being at nutritional risk or becoming malnourished. However, the aetiology of malnutrition is complex and multifactorial, and the development of malnutrition in the old is most likely also facilitated by ageing processes. This comprehensive narrative review summarizes current evidence on the prevalence and determinants of malnutrition in old adults spanning from age-related changes to disease-associated risk factors, and outlines remaining challenges in the understanding, identification as well as treatment of malnutrition, which in some cases may include targeted supplementation of macro- and/or micronutrients, when diet alone is not sufficient to meet age-specific requirements.

Nutrition and oncology: best practice and the development of a traffic light system

Malnutrition is common in oncology patients, with age, disease stage and tumour type all influencing malnutrition risk. There are several detrimental effects of malnutrition in oncology patients, including weight loss, which is associated with negative oncological outcomes, and reduced survival. The causes of malnutrition in this group may be multifactorial and include effects from the tumour itself, altered metabolism, increased nutritional requirements, and cancer treatments and their associated side effects, which can impact on an individual's ability and desire to eat. Nutritional screening to identify early nutritional risk is essential and should involve the use of a validated screening tool, with commonly used tools usually assessing nutritional risk and weight loss over a period of months, for example a 3- to 6-month period. It is also important to consider weight changes over a shorter time period to identify rapid weight changes. Multidisciplinary teamworking is essential in tackling malnutrition, with collaborative working between the dietitians and the nutrition nurses shown to be beneficial in the authors' practice to develop community pathways and improve their service and manage increasing patient numbers. Malnutrition within oncology can often be managed with additional supplementation with oral nutritional supplements or enteral nutrition, where indicated. A low-volume, energy-dense, high-protein supplement can help to meet nutritional needs and to achieve dietetic aims, with compliance improved by the use of a low-volume product.

The role of vitamin D, zinc and selenium in the development of noncommunicable diseases (literature review)

A healthy diet is a factor in maintaining and improving health, helping to reduce the risk of developing alimentary-dependent diseases. The article presents the causes of malnutrition, data on the actual deficiency of vitamins and minerals in the population of the Russian Federation. Insufficient content of essential micronutrients in the diet is accompanied by a decrease in the body’s adaptive capabilities, contributing to an increase in the risk of developing non-infectious diseases. The article provides information on the role of chronic low-level inflammation and oxidative stress in the development of noncommunicable diseases. Significant contributors are vitamin D, zinc and selenium, and their deficiencies are widespread. Scientific evidence supports the role of vitamin D, zinc, selenium in the development of non-infectious diseases. The review discusses the role of vitamin D in the development of cardiovascular disorders, discusses the dependence on iron and zinc, which has clinical diagnostic and therapeutic value in anaemia and associated pathological conditions. In addition, the article discusses selenium and zinc deficiencies with the risk of the coronary syndrome, stroke, cardiovascular disease and mortality from them. Despite conflicting data on the effectiveness of oral micronutrient supplementation to prevent and treat chronic noncommunicable diseases, healthcare providers should be informed about the consequences of micronutrient deficiencies and identify micronutrient deficiencies correct them. This is important in treatment and prevention activities for people at risk, especially in endemic disadvantaged regions. The literature search was carried out in the databases PubMed, CyberLeninka, e-library.

Penerapan Sistem Informasi Geografis dalam Pemetaan Sebaran Kasus Gizi Buruk

Malnutrition or Malnutrition is a general term that refers to a medical condition caused by an improper or inadequate diet. The main cause of malnutrition is the lack of children in getting enough energy and protein foods. This is with the economic level of the community. In addition, for parents' knowledge about the importance of nutrition for child development. In East Lombok, cases of malnutrition always appear every year, but recently in 2019, cases of malnutrition were rediscovered which ironically was always known too late. This is because the location of malnutrition sufferers is not reachable or is not known by the district government, this is what makes the handling of malnutrition cases in East Lombok district late, which often results in deaths of infants and children. For this reason, in this study the researcher raised the theme of how to map the distribution of the location of well-known cases of malnutrition in East Lombok district. The purpose of this study was to help the East Lombok fogapen government to see the location of people with malnutrition. The research method used is to directly record the coordinates of the location of people with bad nutrition. with this application, it can help the government in alerting the location of cases of malnutrition in East Lombok district

Combined application of zinc-lysine chelate and zinc-solubilizing bacteria improves yield and grain biofortification of maize (Zea mays L.).

Malnutrition a health disorders arising due to over or low use of minerals, vitamins and nutritional substances required for proper functioning of body tissues and organs. Zinc (Zn) is the most important mineral required for the normal metabolism of plants and humans. Zinc-deficiency is one of the major cause of malnutrition globally. Maize is highly susceptible to Zn-deficiency and inflicts Zn-deficiency to humans and other animals being nourished on it. This study evaluated the effect of zinc-lysine chelate alone (0.1, 0.5, 1.0 and 1.5%) as seed priming and in combination with Zn-solubilizing bacteria (PMEL-1, PMEL-48, PMEL-57and PMEL-71)) on grain biofortification of autumn maize. The Zn accumulation in different parts (roots, stem, leaves, grains and cob pith) was quantified. Results indicated that Zn contents were 18.5% higher in the seeds primed with 1.5% solution of Zn-lysine chelate and inoculation of ZSB strains compared to control treatments. Seed priming with 1.5% Zn-lysine chelate in combination with ZSB inoculation significantly improved cob diameter and cob length by 16.75% and 42% during 2016 and by 11.36% and 34.35% during 2017. The increase in 100 grains weight over control was 18.4% and 15.27% for 2016 and 2017, respectively. The Zn contents were increased by 15.3%, 15.6%, 49.1%, and 33.0% in grain, cob-pith, stemand roots, respectively compared from control. Thus, the combined application of 1.5% Zn-lysine chelates along with ZSB inoculation could be used for combating malnutrition.

A pilot study to assess the effectiveness of drumstick leaves powder supplementation in prevention of anemia among adolescent girls

Anemia is one of the most common cause of malnutrition, has a major community health significance affecting adolescent girls, women and children worldwide. Anemia highly prevalent among adolescent girls of Indian population mainly from lower socio-economic status. This study was done with the intention of finding an efficient substitute in the form of non-haem iron of vegetable origin in drumstick leaves by administering as supplementation to treat anemia. Randomized clinical trial design was used in this study, the target group consisted adolescent girls with mild and moderate anemia. 12 (Experimental n=6, Control n=6) adolescent girls with their hemoglobin level between 9-12 gm/dl were selected as samples. Intervention was started with one tea spoon (about 5gm) dried drumstick leaves powder supplementation once a day with meals for 30 days to the experimental group. At the end of intervention, the posttest hemoglobin level was assessed. The result revealed that the subject showed a significant improvement in Hb level at (p<0.001 level), drumstick leaves powder had significantly improved mean Hb levels in the posttest from (10.7167±0.25) to (11.1000±0.32) gm/dl.

The knowledge regarding protein energy malnutrition among urban and rural mothers with under five children

Malnutrition is one of the leading causes of morbidity and mortality in children aged five years and below malnutrition is a contributing cause in more than half of the children's deaths. Almost half of the deaths worldwide are due to being under weight. Risk factors for severe protein energy malnutrition (PEM) have been identified as ignorance, family size, and parent’s education, and poverty, sex of the child and incomplete immunization of the child. The lack of food is not the sole cause of malnutrition. Lack of awareness and knowledge about feeding amount, frequency, type of food etc. contributes significantly to poor nutritional status among children. This study was under taken to assess the knowledge of mothers of under five children regarding prevention of protein-energy malnutrition between urban and rural Area.

Prevalence of diarrhoea among under five children in India and its contextual determinants: A geo-spatial analysis

BackgroundDiarrheal diseases which is one of the leading reason behind global mortality and morbidity is more threatening for infants and young children. Childhood diarrhoea is becoming increasingly prevalent disease in developing countries like India. Moreover, it is a major cause of malnutrition that contributes towards third major cause of under 5 mortalities. This has raised a serious concern in the domain of public health. ObjectivesThe present study attempts to identify the spatial prevalence and clustering of diarrhoea in India based on National Family and Heath Survey (NFHS-4, 2015–16) and also tries to identify the association of prevalence of diarrheal disease among under 5 children with socio-economic factors. MethodsThe study applies spatial analysis software i.e ArcGIS 10.8 and GeoDa 1.18 including Moran's index and logistics regression to show the spatial prevalence and auto-correlation of diarrhoea among neighbourhood districts and their contextual determinants. FindingsThe study finds a total of 71 districts belong to the hot spot area are mostly from central and eastern costal part of India. Analysis of socio-economic determinants show prevalence of diarrhoea among under 5 children is higher in rural areas, among children not staying in Pacca house, living with unimproved sanitation facilities, belonging to under privileged community (highest among OBC followed by SC/STs), children of younger mothers (<25 years) and “poor’ households considering the wealth index. ConclusionThe study recommends to target hot-spot districts with high prevalence of diarrhoea and policy level interventions like improved sanitation to reduce the risk of childhood diarrhoea.

Participatory Nutrition Capacity Assessment and Capacity Development in Six Regions of Ethiopia

Abstract Objectives The multi-faceted causes of malnutrition make capacity development in nutrition complex. Defining capacity development actions requires an understanding of the landscape actors utilize to address the determinants. Thus, six regional health bureaus (RHB) in Ethiopia, in collaboration with Alive &amp; Thrive (A&amp;T), conducted participatory capacity assessments to identify capacity strengths and gaps, and co-developed appropriate maternal, infant, and young child nutrition (MIYCN) capacity development plans linked to achieving targets outlined in the national nutrition program. Methods From April to June 2019, 143 nutrition practitioners in six regions of Ethiopia conducted rapid participatory assessments of their respective regional capacity. They used an adapted assessment tool based on WHO's six system building blocks, and a four-level scoring guide to identify MIYCN capacity strengths and gaps on 87 statements of excellence. Validated by RHB's leadership, the assessors and A&amp;T co-developed region-specific MIYCN capacity development plans for areas rated ‘poor’ and ‘fair’. Results An aggregate assessment score for six regions revealed presence of adequate MIYCN implementation capacity – excellent (25.3%), moderate capacity with basic ones in place or in use – good (37.9%), low capacity needing attention – ‘fair’ (23.6%), and no capacity or critical capacity limitation needing urgent attention – ‘poor’ (9.4%). Using a prioritization matrix, MIYCN-focused performance strengthening plans were designed, tailored to each region's context. Beginning in July 2019, the six RHBs incorporated key MIYCN improvement action items targeted towards ‘poor’ and ‘fair’ performance areas with relevant indicators into their annual plans, budget structure, and M&amp;E framework. A&amp;T and other partners provided technical assistance and coordinated their efforts with RHBs to spirally build regional MIYCN implementation capacities. Conclusions The participatory capacity assessment served to establish a baseline of existing MIYCN implementation capability; and create a strong and shared commitment within the health sector identifying areas for improvement that can be addressed by the government, with little or no external assistance. Funding Sources The Bill &amp; Melinda Gates Foundation.

Nutrition and oncology: best practice and the development of a traffic light system.

Malnutrition is common in oncology patients, with age, disease stage and tumour type all influencing malnutrition risk. There are several detrimental effects of malnutrition in oncology patients, including weight loss, which is associated with negative oncological outcomes, and reduced survival. The causes of malnutrition in this group may be multifactorial and include effects from the tumour itself, altered metabolism, increased nutritional requirements, and cancer treatments and their associated side effects, which can impact on an individual's ability and desire to eat. Nutritional screening to identify early nutritional risk is essential and should involve the use of a validated screening tool, with commonly used tools usually assessing nutritional risk and weight loss over a period of months, for example a 3- to 6-month period. It is also important to consider weight changes over a shorter time period to identify rapid weight changes. Multidisciplinary teamworking is essential in tackling malnutrition, with collaborative working between the dietitians and the nutrition nurses shown to be beneficial in the authors' practice to develop community pathways and improve their service and manage increasing patient numbers. Malnutrition within oncology can often be managed with additional supplementation with oral nutritional supplements or enteral nutrition, where indicated. A low-volume, energy-dense, high-protein supplement can help to meet nutritional needs and to achieve dietetic aims, with compliance improved by the use of a low-volume product.