Nutritional Evaluation Research Articles

Barriers and Facilitators to Adherence to a Healthy Diet Across the Spectrum of Chronic Kidney Disease.

A healthy diet plays an important role for chronic kidney disease (CKD) treatment, but adherence to nutritional recommendations is frequently low. The aim of the present study was to describe barriers and facilitators to adherence to a healthy diet in people with CKD. Cross-sectional study; 80 predialysis (n=20), hemodialysis (n=20), peritoneal dialysis (n=20) and transplant (n=20) patients matched by age and sex, were included. Nutritional evaluation included subjective global assessment, anthropometry, quality of food consumption (Mini-ECCA v.2), self-perception about diet and willingness to change. Barriers and facilitators were evaluated with a qualitative approach (semi-structured interviews). Concepts were converted into "in vivo" and "theoretical" codes, then, grouped into categories. A second analysis was performed with the ATLAS.ti software. Frequency of malnutrition was 50% in people receiving dialysis. Quality of food consumption was healthier on people with CKD stages 3b-5 (40%) and people with kidney transplant (65%) compared to peritoneal dialysis (25%) and hemodialysis (0%). The main themes influencing adherence to a healthy diet were: need for nutritional guidance, economy, dietary restrictions, willingness to change, relationship with consequences in disease control and health status, aversion for healthy foods, bad and good self-perception, family support, feelings and emotions, environment, eating habits and CKD itself. Lack of time, work, economy, food preferences and cravings were the main barriers in people with CKD stage 3b-5 and transplant, while low willingness to eat healthy foods and dietary restrictions were the main barriers in people receiving dialysis. Personal, environmental, health professional-related, CKD related as well as feelings and emotions aspects that people with CKD face in a daily basis, act as barriers or facilitators when trying to follow a healthy diet. Individualizing nutritional treatment taking into account people with CKD perspectives and situations is of utmost importance to improve adherence to nutritional treatment.

Simultaneous Determination of Vitamins A and E and Their Generated Metabolites in Human Serum by LC-MS/MS.

In the context of personalized and precision medicine, simultaneous monitoring of different forms of vitamins A and E and their metabolites could help us better understand the status of vitamins A and E in the body. The aim of this study was to establish a method for simultaneous determination of 13 kinds of vitamins A and E and their metabolites in human serum. Serum samples were directly detected by LC-MS/MS after deproteinization. Chromatographic and mass spectrometry parameters were optimized to achieve good separation and sensitivity for these analytes, especially for isomers. Finally, all analytes were effectively separated on Kinetex biphenyl stationary phase. The method covered a large profile of vitamins A and E and their metabolites in a run time only of 10 min. Good linearities were achieved in the quantitative range for each analyte with the correlation coefficients higher than 0.9916. The recoveries were in the range of 78.8%-111.6% with the intraday and interday precisions within 9.6%. This method was simple, sensitive, and accurate and had been successfully applied for the determination of vitamins A and E and their metabolites in human serum samples and could provide technical support for clinical nutritional evaluation of these vitamins.

Could Selected Adipokines/Cytokines Serve as Markers of Adipose Tissue Dysfunction?

Elevated levels of pro-inflammatory adipokines and cytokines increase the risk of developing metabolic disorders and diseases. The aim of this study was to conduct a comparative analysis of selected adipokines/cytokines in the blood serum of adults with obesity and normal body weight. The study also evaluated the correlation of these adipokines/cytokines with selected biochemical blood parameters. The study included 46 individuals with first- and second-degree obesity and 35 individuals with normal body weight. The participants underwent nutritional status assessments, biochemical tests, and evaluations of adipokine and cytokine concentrations in blood serum. The study found higher median CRP concentrations in women with obesity than in those with normal weight. This increase was statistically significant. The results also showed significantly higher IL-6 levels in the obesity group compared to the control group in both women and men. Resistin and MMP-2 were significantly different between women with obesity and women with normal body weight. Multiple regression results indicated that higher total fat content was significantly associated with higher serum CRP and IL-6 levels and lower adiponectin levels. Interleukin 6 was the strongest predictor of adipose tissue dysfunction in both women and men. Potential markers in women could also include resistin and MMP-2. The findings suggest that gender significantly influences the regulation of inflammatory factors.

Determination of Bioactive Components in Chrysanthemum Tea (Gongju) Using Hyperspectral Imaging Technique and Chemometrics.

The bioactive components of chrysanthemum tea are an essential indicator in evaluating its nutritive and commercial values. Combining hyperspectral imaging (HSI) with key wavelength selection and pattern recognition methods, this study developed a novel approach to estimating the content of bioactive components in chrysanthemums, including the total flavonoids (TFs) and chlorogenic acids (TCAs). To determine the informative wavelengths of hyperspectral images, we introduced a variable similarity regularization term into particle swarm optimization (denoted as VSPSO), which can focus on improving the combinatorial performance of key wavelengths and filtering out the features with higher collinearity simultaneously. Moreover, considering the underlying relevance of the phytochemical content and the exterior morphology characteristics, the spatial image features were also extracted. Finally, an ensemble learning model, LightGBM, was established to estimate the TF and TCA contents using the fused features. Experimental results indicated that the proposed VSPSO achieved a superior accuracy, with R2 scores of 0.9280 and 0.8882 for TF and TCA prediction. Furthermore, after the involvement of spatial image information, the fused spectral-spatial features achieved the optimal model accuracy on LightGBM. The R2 scores reached 0.9541 and 0.9137, increasing by 0.0308-0.1404 and 0.0181-0.1066 in comparison with classical wavelength-related methods and models. Overall, our research provides a novel method for estimating the bioactive components in chrysanthemum tea accurately and efficiently. These discoveries revealed the potential effectiveness for constructing feature fusion in HSI-based practical applications, such as nutritive value evaluation and heavy metal pollution detection, which will also facilitate the development of quality detection in the food industry.

Nutrition Support Pharmacy Services in Critically Ill Cancer Patients Admitted to Intensive Care Units: A Retrospective Analysis of Clinical Pharmacists’ Interventions

Objectives: This study aimed to analyze clinical pharmacists' interventions in managing nutrition support therapy in critically ill cancer patients admitted to intensive care units. Methods: A retrospective analysis of 9949 electronically reported clinical pharmacist interventions of patients admitted to ICU from January 2020 to December 2022 was conducted. All patients’ records with clinical pharmacists’ interventions related to nutrition support therapy in ICU cancer patients were included and analyzed. Results: The number of interventions for managing nutrition support therapy was 95 (0.95 %). Parenteral nutrition (n = 83, 87.4 %) was the most frequently used class of nutrition support therapies. The evaluation, adjustment, and monitoring of total parenteral nutrition (n = 75, 78.9 %) was the most frequent intervention of clinical pharmacists. The acceptance rate of clinical pharmacists' interventions in nutrition support therapy by physicians was 100 %. Conclusion: Clinical pharmacists have a role in managing specialized nutrition support therapy in critically ill cancer patients. The prevailing clinical pharmacists’ intervention was evaluating, adjusting, and monitoring total parenteral nutrition. More studies are needed to investigate the barriers that prevent the application of nutrition support pharmacy services in Jordan and to find the impact of these services on patient outcomes.

Nutritional evaluation of white corn grain for tortilla manufacturing

Objective: Agronomic characteristics such as density, hectoliter weight, grain hardness and nutritional value of maize (Zea mays L.) grain in terms of protein, starch and oil content were evaluated. Design/Methodology/Approach: Using the Dickey John INSTALAB 700® equipment, hybrid and native maize grains from different commercial houses that are planted in Durango, central region of northern Mexico. The seeds evaluated were of the certified type and evaluated in the Agricultural Biology laboratory of the Technological Institute of the Guadiana Valley. The grains were prepared following CIMMYT laboratory protocols in order to evaluate the nutritional and industrial quality of maize. indings/Conclusions: Ten genotypes exhibited soft grain hardness, one showed intermediate hardness and six showed hard hardness with values ​​higher than a hectoliter weight of 74 kg hL-1, the latter having the greatest potential to be planted extensively for use in the production of tortilla dough. Conclusions: The protein content in the corn evaluated was not statistically significant, but the starch content varied from 52 to 62% with an oil content of 3.5 to 6.9%.

Nutritional Quality Evaluation of Cookies Enriched with Orange-fleshed Sweet Potato Flour, Starch, and Residue

Nutritional Quality Evaluation of Cookies Enriched with Orange-fleshed Sweet Potato Flour, Starch, and Residue

Nutritional and Antinutritional Evaluation of the Pulp and Seed of Terminalia catappa l. (Tropical Almond) Fruit and Physicochemical Properties of Its Seed Oil

Aims: This study aimed at determining the nutritional and antinutritional composition of the pulp and seeds as well as physicochemical characteristics of the seed oil of Terminalia catappa L. (tropical almond). Methodology: The analyses were done in the Agroecology and life science laboratory of the University of Buea between June 2023 and May 2024. The experimental design was employed. Oil was extracted using soxhlet method. UV-visible spectrophotometer was used for nutritional and antinutritinal analyses; while gas chromatography and titrimetry were used to analyse the fatty acid profile and physicochemical properties of the seed oil respectively. Results: Results revealed that the seeds recorded more concentrated energy (596.28 Kcal/100g) than the pulps (403.42 Kcal/100g). Total phenolic (133.70 ± 0.15 mg/100g), tannin (77.90 ± 0.01 mg/100g), oxalate (15.01 ± 0.01 mg/100g) and phytic acid (2.81 ± 0.06 mg/100g) contents were displayed by the pulp and 29.70 ± 0.25, 18.00 ± 0.07, 20.92 ± 0.07 and 1.88 ± 0.01 mg/100g, respectively for seeds. The abundant minerals in the pulp were K, Ca, Na, and P, those in the seeds were Mg, K, P and Fe. The Acid value, Saponification value, Iodine value, Peroxide value and P-anisdine value of the seed oil were 2.24 ± 1.16 mgKOH/g, 222.2 ± 3.11 mgKOH/g, 78.50 ± 0.54 gI2/100g, 5.50 ± 0.71 mEq/kg and 3.65 ± 0.23, respectively. Fatty acid profiling showed 66.68% unsaturated fatty acids of which 19.86% and 9.81% were linoleic and linolenic, respectively and 33.32% saturated. Conclusion: The pulps and seeds of T. catappa have a significantly high content of macro and micronutrients that can meet up the nutritional needs of a population and the quality assessment of the oil suggests that it can be recommended as suitable for industrial usage.

Factors Associated with Malnutrition in Older Patients with Type 2 Diabetes in Bangkok, Thailand

OBJECTIVE: Malnutrition is a widespread but often neglected concern among older individuals with type 2 diabetes mellitus (T2DM), especially in Thailand, where research on this issue is limited. In this group, malnutrition can result in adverse outcomes, such as diminished physical function, decreased quality of life, longer hospitalizations, and increased mortality. This study aimed to examine the prevalence of malnutrition and the factors contributing to it among older adults with T2DM.METHODS: This cross-sectional study was conducted in August and September 2024 at our local hospital. Older patients diagnosed with T2DM for at least 6 months were included in the analysis. Nutritional status was evaluated using the Global Leadership Initiative on Malnutrition criteria, which assess weight loss, low body mass index, and reduced muscle mass. Logistic regression was used to determine predictors of malnutrition.RESULTS: Of the 176 participants, 30.1% were malnourished. Factors significantly associated with malnutrition included being underweight (adjusted odds ratio [AOR]: 11.07, 95% CI: 2.69–45.53), being married (AOR: 5.29, 95% CI: 1.14–24.64), living with diabetes for more than 10 years (AOR: 2.99, 95% CI: 1.23–7.25), poor medication adherence (AOR: 2.55, 95% CI: 1.06–6.17), and having a glomerular filtration rate below 60 (AOR: 4.70, 95% CI: 1.95–11.34).CONCLUSION: Malnutrition is prevalent in older individuals with T2DM. Routine nutritional evaluations should be implemented to reduce health risks and improve patient outcomes in this population.

Nutritional and toxicological evaluation of Jojoba (Simmondisa chinensis) oil meal in the complete feed of rabbits

Fourty New Zealand white rabbits were randomly allotted to four equal dietary treatments consisting of complete mixed rations (16% CP; 15% CF) without (T0) and with 5 (T1), 15 (T2) and 25 (T3) per cent jojoba (Simmodsin chinensis) oil meal to study the toxicity as well as bone and meat characteristics. Supplementation of jojoba oil meal caused absolute mortality and the extent of mortality followed the dose response pattern. Fifty per cent of mortality rate was documented in T3 as early as 3rd week of experiment and at the end of 3rd week all experimental animals succumbed to death while no mortality recorded in control group. Chemical composition of meat and bone indicated significantly lower crude protein and ether extract contents in treated rabbits. Autopsy of rabbits which died in jojoba oil meal incorporated complete feed showed mild to severe dilated and congested mesenteric blood vessels and enlarged liver and kidney. Toxicopathological changes include hepatocellular swelling, bile duct hyperplasia, glomerular nephritis and thyroiditis indicative of simmondsin toxicity in rabbits due to jojoba oil meal.

Comprehensive Evaluation of Dietary Nutrition Based on Normalization and Linear Weighted Model

Comprehensive Evaluation of Dietary Nutrition Based on Normalization and Linear Weighted Model

Sensory and Nutrition Evaluation of Soups Supplemented with Fresh Hibiscus rosa sinensis Flowers

Sensory and Nutrition Evaluation of Soups Supplemented with Fresh Hibiscus rosa sinensis Flowers

The role of red rice in craft beer: A sensory and nutritional evaluation

AbstractBackground and ObjectivesRed rice is widely cultivated in the semi‐arid regions of Northeastern Brazil and is notable for its rich phenolic content and nutritional value. The use of red rice as a nonconventional adjunct in brewing can enhance the sensory and nutritional qualities of craft beers, offering a unique product profile that appeals to the growing demand for differentiated and artisanal beverages. This study aimed to evaluate the sensory and nutritional impact of incorporating red rice from two distinct regions, Bahia and Paraíba, into the brewing process.FindingsThe study analyzed the effects of red rice from Bahia and Paraíba on the antioxidant capacity, phenolic content, and volatile composition of the resulting beers. Beers produced with Paraíba red rice exhibited a higher phenolic content and antioxidant capacity, while the Bahia variety contributed to a more complex aromatic profile. Sensory evaluations showed that the Bahia rice beer received higher ratings for aroma and overall acceptance, whereas the Paraíba rice beer stood out in antioxidant properties.ConclusionsThe inclusion of red rice as a brewing adjunct in craft beer formulations enhances both antioxidant capacity and sensory complexity, contributing positively to consumer acceptance. Utilizing regionally sourced red rice varieties adds distinct sensory attributes to the beers, increasing their appeal within the specialty beverage market.Significance and NoveltyThis research demonstrates the potential of red rice as an innovative and sustainable adjunct for the craft beer industry, offering a nutritionally enriched and sensory‐diverse product. The findings underscore the value of integrating locally grown ingredients to create high‐quality, artisanal beverages that support regional agriculture and promote sensory diversity in the beverage industry.

Formulation and Nutritional Evaluation of Extruded Vermicelli from Browntop Millet

The rising awareness of health benefits associated with millets has led to the increased interest in utilizing them for value-added food products. Browntop millet (Brachiaria ramosa), a highly nutritious, drought-tolerant grain, is one such millet that is rich in fiber, protein and essential micronutrients like iron and zinc. This study focuses on the development of extruded vermicelli from browntop millet to create a convenient, nutrient-dense alternative to traditional refined wheat products. Blends of browntop millet flour with whole wheat flour were developed that indicated the vermicelli with 50 per cent browntop millet (T2) demonstrated enhanced nutritional properties, including a significant increase in fiber (4.45 g), protein (14.48 g), fat (1.48 g) and essential minerals such as iron (4.51 mg), zinc (4.44 mg) and copper (0.58 mg) when compared to the conventional counterpart. Despite the improved nutritional profile, the browntop millet vermicelli also exhibited higher levels of antinutritional factors, such as phytic acid (1039.78 mg/100 g) and polyphenols (186.05 mg/100 g). The product displayed favourable cooking qualities, with a cooking time of 7.15 minutes and a cooking loss of 12.24 per cent. Consumer acceptability revealed acceptance in key attributes, including flavour, consistency and appearance. Over a 90-day storage period, the millet-based vermicelli exhibited lower bacterial counts (2.58 × 104 CFU/g) compared to the control sample (3.08 × 104 CFU/g), while yeast and mold levels remained within acceptable limits. Although there was gradual increase in moisture, free fatty acids and peroxide values during storage, these remained within permissible limits, indicating good storage stability. The development of browntop millet-based extruded vermicelli offers a promising, health-oriented option for consumers, catering to the increasing demand for convenience foods that support both nutrition and convenience.

Single-cell protein (SCP) meals from Methylovorus menthalis as feed ingredients for freshwater Atlantic salmon (Salmo salar L.): Digestibility, growth performance, nutrient utilization, and fish health

This study provides nutritional evaluations of single-cell protein (SCP) meals produced from a naturally-occurring methylotrophic microorganism (Methylovorus menthalis) in feeds for freshwater-phase Atlantic salmon (Salmo salar L., <30 g initial weight). Three trials were conducted (in triplicate) to: 1. determine ‘single-ingredient’ apparent digestibility coefficients (ADCs) in an 80:20 ingredient substitution digestion assay (Trial 1), 2. examine effects of partial (50 %) or complete (100 %) substitution of major plant-protein ingredients on feed consumption (a proxy for palatability) and digestibility using nutritionally-balanced test diets (Trial 2), and 3. evaluate effects of graded inclusion levels (up to 30 %) at partial or complete substitution of marine and plant-based ingredients on growth performance, nutrient utilization, and fish health (Trial 3). In Trial 1, dry matter (DM), crude protein (CP), gross energy (GE), and essential amino acids (EAAs) in M. menthalis SCP meal were highly digestible at 85, 92, 88, and 86–96 %, respectively. In Trial 2, feed consumption of nutritionally-balanced diets were unaffected by up to 26 % M. menthalis SCP meal inclusion (100 % substitution of major plant-proteins), but compared to the control diet showed higher ADCs for DM, GE, and methionine, the same ADC for tryptophan, and with only minor reductions in ADCs for CP and other EAAs. For Trial 3, inclusion of up to 30 % M. menthalis SCP meal did not impact fork length, Fulton's condition factor, survival, haematocrit, packed red blood cell counts, viscerosomatic index, feed conversion ratio, or protein efficiency ratio, however apparent feed intake, protein intake, final body weight, weight gain, and specific growth rate decreased, most notably at levels exceeding 10–20 % of the diet. Feed consumption (and nutrient/energy intakes) by fish fed increasing dietary SCP meal levels was linearly suppressed and had a cascading effect in reducing whole-body protein, lipid, and energy gains. However, this was not reflected in their corresponding apparent net retention efficiencies for protein, lipid, or energy, where no differences were observed at any SCP meal inclusion level, suggesting a possible ‘correctable’ diet palatability issue at high inclusion levels. Feeding diets with up to 30 % M. menthalis SCP meal had no impacts on plasma analyte biochemistry or intestinal histopathology. Collectively, results demonstrate that SCP meals derived from a naturally-occurring methylotrophic microorganism (M. menthalis) produced under scalable aerobic fermentation can be effectively included in Atlantic salmon pre-smolt feeds at 10–20 % at substitution of conventional marine and plant-protein ingredients with minimal or no effects on feed intake, nutrient digestibility, production performance, whole-body composition, nutrient utilization, intestinal histopathology, and fish health.

Preoperative Nutritional Status Screened by MNA-SF Predicts Major Complications in Elderly Patients Undergoing Lumbar Fusion Surgery.

To investigate the role of Mini Nutritional Assessment-Short Form (MNA-SF) in predicting postoperative complications in older patients (≥75 years) undergoing lumbar fusion surgery. Patients who had undergone posterior lumbar fusion surgery between June 2019 and September 2021 were enrolled. Those with an MNA-SF score of 12 or higher were categorized as the Nourished group, while those with a score less than 12 were placed in the Malnutrition-Risk group. Preoperative, intraoperative, and postoperative variables between groups were compared. Patients were then re-classified based on the presence of major complications, univariate analysis and multivariate logistic regression was used to identify risk factors for major complications. A total of 240 patients were enrolled, with 182 in the Nourished group and 58 in the Malnutrition-Risk group. The Malnutrition-Risk group exhibited a higher incidence of major complications (46.6% vs 23.1%, p = 0.001) and comprehensive complications index (18.42 ± 18.00 vs 12.65 ± 15.87, p = 0.021), Oswestry Disability Index (27.52 ± 23.44 vs 20.45 ± 20.42, p = 0.029) and longer recovery times (12.53 days vs 10.15 days, p =0.033). Length of stay (LOS) were also increased in the Malnutrition-Risk group (19.22 ± 10.67 vs 16.04 ± 7.69, p = 0.014). Multiple regression analysis identified nutritional risk and malnutrition, as assessed by MNA-SF, as independent factors associated with postoperative major complications (OR 2.81, 95% CI 1.42-5.53, p = 0.003). Preoperative nutritional risk or malnutrition is an independent risk factor for major complications among older patients undergoing posterior lumbar fusion surgery. The MNS-SF emerges as a convenient and effective tool for promptly screening the nutritional status of older patients, prompting subsequent nutritional evaluation or intervention before surgery.

The effectiveness of onodera`s prognostic nutritional in predicting the prognosis of tongue squamous cell carcinoma.

To clarify the effects of preoperative nutritional evaluation on the prognosis of patients with tongue squamous cell carcinoma. This retrospective cohort study involves 126 consecutive patients who underwent radical surgery as their initial treatment and received treatment for >3 years. The markers considered in this study are GGT (γ-GTP), CAR (C-reactive protein (CRP)-to-Alb Ratio), GLR (GGT-to-Lymphocytes Ratio), GPR (GGT-to-Platelet ratio), GNR (GGT-to-Neutrophil ratio), NLR (Neutrophil-to-Lymphocyte ratio), PLR (platelet-to-lymphocytes ratio), OPNI (Onodera`s prognostic nutritional index), PINI (Prognostic Immune and Nutritional Index) and Albumin (Alb). Each marker was calculated from blood test results up to one month before the initial surgery to assess overall survival (OS) and disease-free survival (DFS). Univariate analysis of OS identified the depth of invasion (DOI P = 0.004), stage classification (P < 0.001), Body mass index (BMI) (P = 0.007), OPNI (P = 0.005), prognostic inflammatory and nutritional indices (PINI, P = 0.011), and albumin (Alb) (P = 0.006) as significant predictors. Cox regression analysis revealed significant differences in BMI, pathological grade, and OPNI. The OPNI cut-off value was 51.05, indicating its effectiveness in predicting tongue cancer prognosis. With regard to DFS, only BMI showed a significant difference, with no notable difference among other markers. The OPNI may be a useful prognostic factor for tongue cancer.

The role of nutrition background on motivations, barriers, and adherence to a vegan diet: A qualitative study of the vegan eating habits and nutritional evaluation survey (VEGAN-EatS)

This study aims to investigate the motivations, enablers, barriers and attitudes towards the vegan movement within people with distinct formal backgrounds in nutrition. To that end, a cross-sectional, qualitative study was conducted with two groups of vegan individuals: registered dietitians or undergraduate nutrition students (NUT) and non-health professionals (NHP). Participants filled out The General Knowledge on Nutrition Questionnaire and attended to focus groups, analyzed using MAXQDA software. Twenty individuals (NUT:7F,3M; NHP:9F,1M), with mean age of 32 ± 12 years, and 24 ± 4 kg/m2 BMI were assessed. NUT presented a higher score of nutritional knowledge. Both groups were motivated by animal welfare and environmental concerns, although NUT group was also influenced by personal relationships, while NHP group highlighted seeking health benefits. Being enrolled in a graduate nutrition program was viewed as a tool to have access to resources, people and knowledge that supported their dietary decisions. NUT group demonstrated greater concern about food quality, choosing unprocessed foods, whilst NHP group demonstrated ethical concerns, preferring to consume from small producers and local businesses. Participant's perceptions were also influenced by their experiences and knowledge, with NHP believing that vegan diets are inherently healthier, while NUT attributed the improved food quality to vegans' careful attention to their dietary choices. Our findings suggest that while both groups share common motivations, their different depths of nutritional knowledge seem to have important impacts on their experience in adhering to a vegan diet, highlighting the critical role of seeking knowledge on nutrition in supporting sustainable vegan dietary practices.

An Investigation of the Risk Factors Related to Frailty in Older Adults Receiving Home Care Services.

(1) Background: Frailty in older adults is a condition that involves an interaction of psychological, biological, and social factors. This study aimed to assess the frailty status of older adults (65 years old and above) who receive home care services. Additionally, this work aimed to explore the key factors that have a statistically significant impact on the frailty of this vulnerable population. (2) Methods: This study represents the first phase of an intervention trial involving individuals aged 65 and over who received primary healthcare services and resided in the municipality of Archanes-Asterousia in Crete, Greece. Frailty was assessed using the SHARE-Frailty Instrument, while nutritional status was evaluated with the Mini Nutritional Assessment. Diet-related factors were analyzed, including health factors (oral hygiene, depression, cognitive decline, impaired functioning, quality of life), social factors (educational attainment, marital status, type of work before the age of 60), and lifestyle factors (smoking, alcohol consumption, diet). (3) Results: A total of 730 older adults were evaluated (31.5% male), with an average age (±SD) of 76.83 (±6.68) years. The frailty status analysis revealed 108 (14.8%) to be frail, 249 (34.1%) to be pre-frail, and 373 (51.1%) to be non-frail. Statistically significant associations were found between the MNA and Barthel scores (rs = 0.822, p < 0.001). Higher nutritional evaluations (MNA) were revealed in non-frail adults (mean (±SD); 26.97 ± 1.96) compared to pre-fail (mean (±SD); 19.37 ± 3.36) and frail adults (mean (±SD); 13.08 ± 3.16), as well as in pre-fail compared to frail adults (F = 1338.08, p < 0.001). Functional independence (Barthel) significantly differed with the frailty status of older adults (H = 521.98, p < 0.001; median for non-frail: 20.00, pre-fail: 19.00, frail adults: 15.00). (4) Conclusions: This study demonstrated that good nutritional status, good oral health, functional independence, and good quality of life are strongly correlated with lower frailty. Additionally, having chronic conditions is positively associated with one's frailty status. Educational programs for both healthcare personnel and older adults are recommended.

Knowledge and Implementation of Nutrition Care Process (NCP) in Hospitals in a Philippine Province

Introduction: The Nutrition Care Process (NCP) was established and ought to be implemented by nutrition and dietetics practitioners all over the world in an effort to create a framework for critical thinking and decision-making for dieticians and nutrition professionals. Despite the advantages it offers, the implementation of NCP among dietitians is yet to occur specifically in some Asian countries. Objective: This study aimed to examine the relationship between the level of knowledge in NCP and the level of its implementation by the chief dieticians working in government and private hospitals in Laguna Philippines. It also aimed to identify the common barriers to NCP implementation. Theoretical Framework: The goal of NCP is to standardize a process describing the workflow of NCP, which includes four distinct and interrelated steps namely: nutrition assessment and reassessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring and evaluation. Method: This descriptive-correlational study surveyed 30 chief dietitians in a Philippine province and used a validated and pilot-tested four-point Likert scale instrument which was converted into online questionnaire to facilitate distribution and retrieval. Ethics approval was granted in the conduct of the study. Statistical treatments used included weighted mean, Pearson r moment correlation and ranking. Results and Discussion: Results revealed that though the respondents are highly knowledgeable in NCP, there was a less implementation of NCP in Laguna hospitals, indicating a gap between theory and practice of NCP. This was supported by the test of relationship which showed that knowledge on NCP did not correlate with its implementation. Barriers to implementation include lack of manpower in the dietary department, problems in the coordination among physicians, nurses, dieticians, and pharmacists, the lack of adequate training in NCP, and the lack of awareness on the implementing guidelines of NCP as provided by the Department of Health (DOH) of the Philippine government. Research Implications: While the sample size of the study was small and the findings cannot be generalized to a wider population of dietitians, results of the study can invite researchers and policy makers to explore, in a more cross-sectional setting, how challenges in implementing NCP can affect the quality of providing nutritional care to various populations. Originality/Value: The results of this investigation could invite researchers and policy makers in nutrition to explore, in a more cross-sectional context, how challenges in implementing NCP can affect the quality of providing nutritional care to various populations and identify other variables which may affect the successful implementation of nutrition care process and the best practises exhibited by hospitals in its realisation.