High Prevalence Of Malnutrition Research Articles

MORBIDITY AND MORTALITY OF FREE-RANGING AMERICAN BLACK BEARS (URSUS AMERICANUS) UNDERGOING REHABILITATION IN EASTERN TENNESSEE, USA, 1996-2021.

Free-ranging American black bears (Ursus americanus) often share habitat with humans and domestic animals, predisposing them to anthropogenic conflicts. Rehabilitation under professional care is a management option for orphaned, injured, and/or ill bears. Across several southeastern states, rescued bears are assessed and treated at the University of Tennessee and rehabilitated at Appalachian Bear Rescue (ABR). Records from 1996-2021 showed 337 bears (170 males, 166 females, 1 unknown) from nine states were admitted to ABR. Three bears were admitted twice, resulting in 340 admissions (42 neonates <3 mo old, 206 cubs 3-12 mo, 87 yearlings 1-2 yr, and 5 adults >2 yr). Bears presented as orphans (58%), malnourished (24%), injured or ill (12%), or confiscated/other (6%). Individuals were returned to the wild (85%); died or were euthanized (12%); or were placed into professional care (3%). Of released bears, 195 had complete medical records available for evaluation; 31% were healthy upon intake while the remaining were treated successfully for malnutrition and internal parasites (49%), orthopedic (9%) and soft tissue injuries (5%), or other diseases (5%). Causes of death determined during necropsies performed (n=30) were classified as trauma (50%), developmental (13%), undetermined (13%), malnutrition (13%), infectious or inflammatory (7%), and toxicosis (3%). Despite the lack of maternal care and high prevalence of malnutrition and trauma, most bears recovered to release with appropriate husbandry and medical care. This study provides a foundation for research to further improve care of rehabilitating black bears.

Association of nutrition risk screening 2002 and Malnutrition Universal Screening Tool with COVID-19 severity in hospitalized patients in Iran.

BackgroundMalnutrition affects normal body function and is associated with disease severity and mortality. Due to the high prevalence of malnutrition reported in patients with coronavirus disease 2019 (COVID-19), the current study examined the association between malnutrition and disease severity in hospitalized adult patients with COVID-19 in Iran.MethodsIn this prospective observational study, 203 adult patients with COVID-19 verified by real-time polymerase chain reaction test and chest computed tomography were recruited from those admitted to a university hospital in Iran. To determine COVID-19 intensity, patients were categorized into four groups. Malnutrition assessment was based on the Malnutrition Universal Screening Tool (MUST) and nutrition risk screening score (NRS-2002). An ordinal regression model was run to assess the association between malnutrition and disease severity.ResultsIn the studies sample of Iranian patients with COVID-19, 38.3% of patients had severe COVID-19. According to NRS-2002, 12.9% of patients were malnourished. Based on MUST, 2% of patients were at medium, and 13.4% of patients were at high risk of malnutrition. Malnutrition was associated with a higher odds of extremely severe COVID-19 according to NRS-2002 (odds ratio, 1.38; 95% confidence interval, 0.21–2.56; P=0.021).ConclusionsMalnutrition was not prevalent in the studies sample of Iranian patients with COVID-19; however, it was associated with a higher odds of extremely severe COVID-19.

New approaches in the nutritional treatment of advanced chronic kidney disease

IntroductionPatients with advanced chronic kidney disease (ACKD) have a high prevalence of malnutrition. The dietary restrictions that we usually apply in terms of macro and micronutrients force our patients to follow dietary guidelines that deviate from healthy patterns. ObjetivesTo determine if a personalized nutritional intervention program, minimizing the usual restrictions would be justified in case it improved the evolution of kidney disease compared to standard treatment. Secundary objetivesTo determine changes in nutrient intakes and in anthropometric and biochemical parameters, as well as quantify episodes of hyperkalemia. Material and methodsA single-center, randomized and controlled educational intervention clinical trial was conduct in patients from the ERCA outpatients clinic at the Complejo Hospitalario Universitario de Albacete. 75 patients were included, assigning 35 to a Control group and 40 to the Intervention group with 1-year follow-up. The nutritional status was determined using anthropometric data, body composition by Bioimpedance, blood and urine biochemical parameters and a 24-h recall questionnaire. The nutritional intervention was carried out in three different ways: individual, collective and telephone recall. ResultsAt the beginning of the study, the BMI showed a situation of weight excess with a mean of 28.83 kg/m2 (5.4) in men and 26.96 kg/m2 (4.09) in women. 70% of our patients had overweight. The abdominal circumference was 105.3 cm (10.2) and 92.3 cm (13.7) for men and women respectively without significant changes throughout the study. The percentage of fat mass (FM) was high in both groups for men and women throughout the study. We did not find biochemical parameters of malnutrition and only significant differences were observed in glomerular filtration rate (GFR), which increased in the intervention group. No patient presented any episodes of hyperkalemia during the study. The energy intake in both groups showed an inadequate distribution of macronutrients with a poor intake of carbohydrates (CH) that was supplemented with an excess of fat. In the case of micronutrients, we did observe an increase in potassium and fiber intakes with a decrease in sodium and phosphorus in the intervention group. ConclusionsMalnutrition is not exclusively an intake defficit and encompasses both the problems derived from a deficit and an excess of nutrients intake. Un to 70% of our patients showed weight excess and a fat mass higher than desirable. The implementation of an individualized nutritional education program, including a vegetables and fiber rich diet, less atherogenic, not only did not cause electrolyte alterations but also slowed the progression of kidney disease.

Factors for Effective Identification of Patients at Nutritional Risk in Clinical Practice: Thematic Analysis of Qualitative Research.

IntroductionDespite the high prevalence of malnutrition in patients at all levels of healthcare, early prevention and treatment of malnourished patients are often neglected and overlooked in clinical practice. The aim of this systematic literature review was to identify the factors considered most important by healthcare professionals in the identification and treatment of malnourished patients or those at risk of malnutrition.MethodsA systematic literature review of qualitative research was conducted. Documents published in scientific journals in English from 2011 to 2021 were searched in the PubMed (MEDLINE), CINAHL and ProQuest databases. The results were analysed with a thematic analysis of qualitative research findings.ResultsFrom the search set of 1010 results, 7 sources were included in the final analysis. Factors identified by health professionals as important in the identification and treatment of malnourished patients in clinical practice were grouped into five themes: unclear organizational structure; indefinite structure of nutritional care; poor continuity of nutritional care; lack of knowledge and skills of health professionals; lack of time and human resources.ConclusionsHealth policy must provide resources for nutritional care for patients at all levels of health care on the initiative of the highest professional bodies at the state level. To improve the nutritional care of patients in clinical practice, the management of health care institutions must promote and enable the professional and organizational establishment of clinical nutrition as a regular medical activity of the institution, develop clinical nutritional pathways, and promote evidence-based clinical practice and interprofessional collaboration.

Impact of oral or enteral nutritional support on clinical outcomes of patients subjected to cardiac surgery: A systematic review.

Cardiovascular diseases represent the leading cause of death worldwide, in addition to having a direct negative impact on quality of life, functional capacity and nutritional status. Studies show high prevalence of malnutrition in patients undergoing cardiac surgery. It is known that cardiac surgery can also lead to changes in nutritional status, through surgical trauma, systemic inflammation and, often, delay in the initiation of nutritional support. On the other hand, the role of nutritional support as a driver of clinical outcomes in different surgical populations is well described in the literature. To review the literature in order to assess the effect of perioperative oral or enteral nutritional support on clinical outcomes of cardiac patients undergoing cardiac surgery. The search was conducted in February 2021 in the following databases: EMBASE, PubMed/MEDLINE, Scopus and Web of Science. Randomized clinical trials (RCT) and retrospective studies were selected, carried out with patients with heart disease, undergoing cardiac surgery and aged 18 years or over. The Outcomes of interest were: length of hospital stay, length of stay in the ICU, time on ventilatory support, mortality rate, clinical complications and use of vasoactive drugs in the postoperative period. Ten studies were included in this systematic review, of which 7 were RCTs and 3 were cohorts. The most prevalent surgery was myocardial revascularization. Six studies evaluated oral nutritional support, two enteral nutritional support and two analyzed both. Two studies found a significant reduction in the length of hospital and ICU staying associated with preoperative intake of carbohydrate-based beverages. Only one study observed a significant reduction in the requirement for ventilatory support after cardiac surgery, after preoperative carbohydrate-based drinks and early postoperative enteral nutrition. There was no influence of nutritional support on mechanical ventilation length and mortality. Most studies showed that nutritional support did not reduce hospital and ICU staying. Nutritional support benefits were demonstrated in studies that offered preoperative oral carbohydrate drinks. No association was observed between nutritional support and duration of mechanical ventilation or mortality rate. Most studies did not find any influence of nutritional support on the need and/or dosage of vasoactive drugs in the postoperative period of cardiac surgery.

Risk factors for the double burden of malnutrition in children younger than 5 years in the Gaza Strip: a systematic review

BackgroundMalnutrition, the coexistence of both undernutrition and obesity, poses a considerable public health and economic burden worldwide. Globally, undernutrition is the largest cause of death in children younger than 5 years, being responsible for 3·1 million, or approximately 45%, of deaths in this population. Conversely, WHO estimated that, in 2016, 41 million children younger than 5 years were overweight or obese. The global problem of malnutrition can be ascribed to changing dietary and lifestyle habits and to the epidemiological transition of most countries. Developing communities, such as in the Gaza Strip, are thus subject to a double burden of preexisting widespread undernutrition and emerging obesity and chronic diseases. MethodsA systematic search and literature review was done in PubMed, Embase, and the Cochrane Library for articles discussing risk factors for obesity and undernutrition among Palestinians. Additionally, we reviewed UN Relief and Works Agency and Ministry of Health of the occupied Palestinian territory health annual reports. We included all original, population-based studies, irrespective of their design or publication status, language, or age of participants. We independently screened titles, abstracts, and full texts for eligibility, then extracted relevant data and assessed the risk of bias. We pooled the most common reported risk factors for the double burden of malnutrition in the occupied Palestinian territories (Gaza Strip and West Bank) for the period of June, 2017, to June, 2018. FindingsOf 432 publications retrieved, we included 23 eligible articles. The pooled risk factors for undernutrition and obesity in the Gaza Strip were poverty and poor socioeconomic situations (63%), poor awareness of healthy diets and lifestyle among communities (26%), developmental transition and urbanisation (6%), and others (5%). The political situation and the blockade in the Gaza Strip contributed to different weights of the risk factors above mentioned. All studies had a moderate to high risk of bias, especially selection bias. Annual health reports of UN Relief and Works Agency and Ministry of Health of the occupied Palestinian territory showed that overweight was in high prevalence in children younger than 5 years (6·5%), as were other problems of undernutrition, such as stunting (7·1%). InterpretationThe poor political and socioeconomic situation in Gaza compound the risk factors contributing to the high prevalence of malnutrition in the area. In addition, awareness about healthy lifestyles is scarce, which increases the prevalence of overweight and obesity in children. Urbanisation and developmental factors such as globalisation and technological developments added a small risk of overweight and obesity. FundingNone.

The Role of Gut Dysbiosis in Malnutrition Mechanism in CKD-5 HD Patients

Patients with terminal stage chronic kidney disease who have undergone hemodialysis (PGK-5 HD) have a high risk of developing malnutrition, which is characterized by wasting protein-energy and micronutrient deficiencies. Studies show a high prevalence of malnutrition in CKD-5 HD patients. The pathogenic mechanisms of malnutrition in CKD-5 HD are complex and involve the interaction of several pathophysiological changes including decreased appetite and nutrient intake, hormonal disturbances, metabolic imbalances, inflammation, increased catabolism, and abnormalities associated with dialysis action. A clear understanding of the pathophysiological mechanisms involved in the development of malnutrition in CKD-5 HD is required to develop strategies and interventions that are appropriate, effective, and reduce negative clinical outcomes. This article is a review of the pathophysiological mechanisms of malnutrition in CKD-5 HD patients caused by chronic inflammation due to intestinal dysbiosis.

High Prevalence of Malnutrition and Micronutrient Deficiencies in Patients With Inflammatory Bowel Disease Early in Disease Course.

Patients with inflammatory bowel disease (IBD) are at an increased risk of malnutrition. The goal of this study was to define the prevalence of malnutrition and micronutrient deficiencies in recently diagnosed IBD patients and to compare the performance of existing malnutrition screening tools in identifying IBD patients at increased risk for malnutrition. This was a retrospective cohort study of adult patients with recently diagnosed IBD (≤18 months disease duration). A diagnosis of malnutrition was made utilizing the European Society for Clinical Nutrition and Metabolism malnutrition criteria. Serum micronutrient levels were included. The sensitivity of 5 malnutrition screening tools in identifying patients at moderate-high risk of malnutrition was determined based on the European Society for Clinical Nutrition and Metabolism malnutrition definition. Descriptive statistics summarized the data and univariate analyses tested associations. A total of 182 patients were included for analysis; 65 (36%) met criteria for malnutrition. A total of 135 (74%) patients had ≥1 micronutrient level checked and 105 (78%) had ≥1 deficiency. Patients with prior surgery (odds ratio [OR], 4.5; P = .004), active Crohn's disease (OR, 2.8; P = .03), and diarrhea (OR, 2.1; P = .02) were more likely to be malnourished. The Malnutrition Universal Screening Tool and Saskatchewan IBD Nutrition Risk Tool had the highest sensitivity (100%) in predicting those at moderate-high risk of malnutrition at the time of screening. Patients with recently diagnosed IBD have a high prevalence of malnutrition and micronutrient deficiencies. Both the Malnutrition Universal Screening Tool and Saskatchewan IBD Nutrition Risk Tool can be used to identify those at increased risk of malnutrition. Future studies and screening tool development are necessary to identify those at risk of developing malnutrition to facilitate timely referral for nutritional evaluation and prevent disease related complications.

High prevalence of malnutrition and vitamin A deficiency among schoolchildren of rural areas in Malaysia using a multi-school assessment approach.

Childhood malnutrition is known as a public health concern globally. The present study aims to assess the anthropometry and blood biochemical status of rural primary schoolchildren in Malaysia. A total of 776 children (7-11 years old) from ten rural primary schools from five states were included in this study. Nutritional outcomes were assessed based on sex, age group and school categories among the children (median age: 9 years (P25:8, P75:10)). The overall prevalence of malnutrition was 53·4 %. Vitamin A deficiency (VAD) was recorded at 20·6 and 39·8 % based on retinol and retinol-binding protein (RBP) levels, respectively. Anaemia, iron deficiency (ID), iron-deficiency anaemia (IDA) and elevated inflammation were found at 14·9, 17·9, 9·1 and 11·5 %, respectively. Malnutrition, VAD, anaemia, ID, IDA and elevated inflammation were more prevalent among Orang Asli (OA) schoolchildren compared with Non-Orang Asli schoolchildren. Higher occurrences of VAD and anaemia were also found among children aged <10 years. Retinol, RBP, α-carotene, ferritin and haemoglobin levels were lower among undernourished children. Besides, overweight/obese children exhibited a higher level of high-sensitivity C-reactive protein. Multivariate analysis demonstrated that OA school children (adjusted OR (AOR): 6·1; 95 % CI 4·1, 9·0) and IDA (AOR: 3·6; 95 % CI 1·9, 6·6) were associated with stunting among this population. The present study revealed that malnutrition, micronutrient deficiencies and anaemia are prevalent among rural primary schoolchildren in Malaysia, especially those from OA schools and younger age children (<10 years). Hence, more appropriate and targeted measures are needed to improve the nutritional status of these children.

Nutritional Status and Severity Correlation Of COPD Patients Admitted in Tertiary Care Hospital

Background: Malnourishment is highly prevalent among COPD patients. The study was carried out to assess the nutritional status of hospital admitted COPD patients to evaluate the relationships between the nutritional indices and the pulmonary function parameters with severity correlation. Methods: A cross-sectional observational study was done constituting 50 spirometryproven COPD patients admitted at Dhaka Medical College Hospital. Lung function was measured by routine spirometry. Anthropometric measures, biochemical parameters, and Mini Nutritional Assessment (MNA) score were used for nutritional assessment. Results: Mean age of study population was 64.31 years.22% (n = 11), 42% (n = 21) 32% (n = 16) &amp; 4% (n = 2) of the patients were of stage I, II, III and IV of COPD respectively.According to MNA scalethe study population were malnourished 46% (n = 23), at risk of malnutrition 40% (n = 20) and normal nutritional status 14% (n = 7).13 patients were found malnourished according to BMI scale and were in stage I COPD 15.38% (n = 2), stage II 38.46% (n = 5), stage III 38.46% (n = 5) and stage IV 7.69% (n = 1). Mid arm circumference (MAC), mid-calf circumference (MCC), MNA scale score and BMI score showed a significant decline of mean value with increasing severity of stages of COPD. The correlation between BMI and FEV1 (R2 = 0.087 and p value= 0.038), body weight and FEV1 (R2 = 0.173 and p value= 0.003), MUAC and FEV1 (R2: 0.202, p value = 0.001) and MNA scale and FEV1 (R2 = 0.144 and p value= 0.007). All correlations were statistically significant. Conclusion: The high prevalence of malnutrition among hospitalized COPD patients is related to their lung function. Weight, mean MNA, and BMI score decrease with increasing severity of COPD. Bangladesh J Medicine 2022; 33: 186-192

Association between food texture levels consumed and the prevalence of malnutrition and sarcopenia in older patients after stroke.

Texture-modified diets (TMDs) may affect nutritional status and sarcopenia in patients after stroke. This study aimed to investigate the association of food texture levels consumed by patients after stroke with the prevalence of malnutrition and sarcopenia. This was a two-center cross-sectional study. A total of 443 patients aged ≥65 years undergoing post-stroke rehabilitation and with oral intake in rehabilitation wards in Shizuoka prefecture and Okinawa prefecture, Japan, were included in the analysis. Food textures were categorized according to the International Dysphagia Diet Standardization Initiative (IDDSI) framework. Malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition and sarcopenia was assess by the European Working Group on Sarcopenia in Older People 2 criteria. The Cochran-Armitage trend test was used to examine the prevalence of malnutrition and sarcopenia by consumption of lower food texture levels. Malnutrition and sarcopenia were diagnosed in 245 (55.3%) and 275 (62.1%) participants, respectively. Consumption of lower food texture levels was associated with a higher prevalence of malnutrition and severe malnutrition (P &lt; 0.001 for both). In addition, consumption of lower food texture levels was associated with a higher prevalence of probable sarcopenia and sarcopenia (P &lt; 0.001 for both). On multivariate analysis, significant associations were observed between IDDSI levels 5 (P &lt; 0.001) and 4 (P = 0.009) and malnutrition, and between IDDSI levels 6 (P = 0.015), 5 (P = 0.033), and 4 (P = 0.015) and sarcopenia. In patients with stroke, consumption of lower food texture levels categorized by the IDDSI framework was associated with a higher prevalence of malnutrition and sarcopenia.

Yaşlı Evde Sağlık Hastalarında Malnütrisyon Prevalansı ve Malnütrisyon Riski

Objective: The elderly are more susceptible to undernourishment, and those receiving home-care services have a higher prevalence of malnutrition. The study aimed to determine the prevalence of the community-dwelling elderly with malnutrition and those at risk of malnutrition enrolled in the home healthcare system. Method: A cross-sectional, descriptive study was conducted using the Mini-Nutritional Assessment short-form among community-dwelling elderly home-care patients living in Adana, Turkey. Individuals the age of 65 and over and receiving home-care services were included. Patients were interviewed once at his or her residence individually, and on-site MNA questionnaires were completed. Results: Among the 321 patients included in the analysis, 126 were malnourished (39.25%), and 132 were at risk of malnutrition (41.12%). The mean MNA-SF was 8.28±3.36. There was a strong association between malnutrition and literacy, with a third of the study group found to be illiterate (n=108, 33.64%, p=0.001). Conclusion: The study showed that the majority of the patients were malnourished or at risk of malnutrition. Implementation of nutritional screening and interventions focusing on malnutrition might be required in home-care services.

The nutritional management of people living with Amyotrophic Lateral Sclerosis (ALS): a cross-sectional survey of UK Dietitians’

People living with Amyotrophic Lateral Sclerosis (pwALS) face many challenges to taking adequate nutrition and hydration (1). Reduced dietary intake, combined with raised resting energy expenditure (REE) (2), contribute to the high prevalence of malnutrition in ALS (3), with low BMI and weight loss being independent prognostic indicators of survival (4). There is a lack of evidence focusing on the nutritional management of people living with ALS.

Assessment of nutritional status of elderly population living at high altitude regions of India utilizing Mini Nutritional Assessment (MNA) methodology

Background: Malnutrition is associated with increased risk of morbidity and mortality amongst elderly population. There is lack of scientific evidence on the staus of malnutrition amongst elderly population residing at high altitude regions of Uttarakhand, India. Background: Malnutrition is associated with increased risk of morbidity and mortality amongst elderly population. Lack of scientific evidence exists on the status of malnutrition amongst elderly population residing at high altitude regions of Uttarakhand, India. Materials and methods: A community based cross-sectional study was conducted in high altitude regions of District Nainital. A total of 980 elderly subjects were selected from 30 clusters identified using population proportionate to size sampling method. Nutritional status of the elderly population was assessed using Mini Nutritional Assessment (MNA) tool. Data was entered in MS Excel 2007 and analyzed using SPSS version 20.0. Results: The results of MNA revealed that 14.3% of the elderly subjects were malnourished. High prevalence of malnutrition was found among subjects who were illiterate (74.5%), financially dependent (75.2%), belonged to low monthly income (43.3%) had poor appetite (71.6%) and chewing problems (63.1%); (p&lt;0.0001). Conclusions: High prevalence of malnutrition was present amongst the elderly population in India. There is a need for timely assessment of malnutrition for maintenance of nutritional status and prevention of chronic diseases. Materials and methods: A community based cross-sectional study was conducted in high altitude regions of District Nainital. A total of 980 elderly subjects were selected from 30 clusters identified using population proportionate to size sampling method. Nutritional status of the elderly population was assessed using Mini Nutritional Assessment (MNA) tool. Data was entered in MS Excel 2007 and analyzed using SPSS version 20.0. Results: The results of MNA revealed that 14.3% of the elderly subjects were malnourished. High prevalence of malnutrition was found among subjects who were illiterate (74.5%), financially dependent (75.2%), belonged to low monthly income (43.3%) had poor appetite (71.6%) and chewing problems (63.1%); (p&lt;0.0001). Conclusions: High prevalence of malnutrition was present amongst the elderly population in India. There is a need for timely assessment of malnutrition for maintenance of nutritional status and prevention of chronic diseases.

The Determination of a Consensus Nutritional Approach for Cancer Patients in Spain Using the Delphi Methodology.

Malnutrition has a multifactorial origin and can be caused by cancer. This study determined the consensus of a panel of experts on the nutritional approach for cancer patients in Spain using a multidisciplinary approach. Using the Delphi methodology, a 74-question questionnaire was prepared and sent to 46 experts. The areas of knowledge addressed were the nutritional status of the cancer patient, nutritional screening, nutritional therapy, patient referral, and multidisciplinary care. A total of 91.7% of the experts agreed with the questions posed on nutritional status, 60.0% with those on nutritional screening, 76.7% with those on nutritional therapy, and the entire panel of experts agreed with the questions posed on patient referral and multidisciplinary care. The experts agreed upon a high prevalence of malnutrition among cancer patients in Spain. Unlike medical and radiation oncologists, medical nutrition specialists believe that body composition assessment should not be carried out in all types of cancer patients during nutritional screening and that interventions can be conducted outside the oncology clinic. In general, it is recommended that nursing staff routinely perform nutritional screening before starting cancer treatment. It is necessary to develop a multidisciplinary action protocol that includes nutritional and/or sarcopenia screening.

Prevalence of child malnutrition and household socioeconomic deprivation: A case study of marginalized district in Punjab, Pakistan.

Better socioeconomic status and well-being in households decrease malnutrition and health risks in children. The objective of the present study is to assess the current nutritional status of pre-school children and to correlate the prevalence of malnutrition with Household Deprivation Status (HDS) in one of the deprived districts of the Punjab province in Pakistan. Using primary data collected from 384 households through a proportional purposive random sampling technique, this study calculates the z-scores of weight-for-age (WAZ), weight-for-height (WHZ), and height-for-age (HAZ). The study has used a cut-off point which is -2 standard deviations below the median of the WHO/NCHS reference population for each anthropometric indicator. The results indicate that the underweight, stunting, and wasting prevalence rates are 46.1%, 34.83%, and 15.49% respectively in district Rahimyar Khan. Also, the expected tendency of malnutrition is worst for HDS-1 and HDS-2 which are the most deprived segments of the population. As the household shifts from HDS-1 to HDS-2 and further to HDS-3, the rates of stunting (HAZ) and underweight (WAZ) decreases but wasting (WHZ) does not. The study concludes that the high prevalence of malnutrition in the district is correlated with overall socio-economic deprivation.

Tình trạng dinh dưỡng, tần suất tiêu thụ thực phẩm và một số yếu tố liên quan đến tình trạng dinh dưỡng ở người cao tuổi dân tộc Khmer tại huyện Trà Cú, tỉnh Trà Vinh năm 2020

Background: Malnutrition in the elderly is a very common problem in developing countries. There are many factors affecting the nutritional status of the elderly, especially the habit of consuming foods. Objective: To determine nutritional status and frequency of food consumption and some factors related to nutritional status among the Khmer elderly people. Methods: A descriptive cross-sectional study was conducted on 614 subjects in 10/17 communes in Tra Cu district, Tra Vinh province in 2020. Results: The rate of malnutrition classified by Mini Nutritional Assessment (MNA) was 23,9%; and 62,1% was at risk of malnutrition and 14,0% had normal nutritional status. According to Body Mass Index (BMI), the rate of malnutrition was 27,5%; the rate of overweight and obesity was 14,2% and 58,3% had normal nutritional status. The food groups with the highest frequency of consumption were meat, fish, eggs, tofu, and beans. Nutritional status was related to the frequency of food consumption, low level of physical activity and some characteristics of the study subjects. Conclusion: The study results show a high prevalence of malnutrition, an unequal consumption of food groups and some related factors. Therefore, it is necessary to improve behaviors related to lifestyle and proper dietary practice to prevent malnutrition.

Prevalence and factors associated with malnutrition in hospitalized patients with proximal femur fracture: Experience at Hospital Universitari Mutua Terrassa

IntroductionMalnutrition is commonly associated with elderly patients with femoral fractures. Approximately 50% of hospitalized patients with a femoral fracture are malnourished or at risk of malnourishment. This situation may have a negative impact on outcomes and results for these patients. Malnourishment has been associated with an increased risk of complications, mortality, poor recovery, and delayed length of stay. MethodA retrospective observational study was conducted at our institution to evaluate the prevalence of malnutrition or risk of malnourishment in 766 hospitalized patients from January 2016 to December 2019. Furthermore, we identified factors that are associated with malnutrition. We also compared length of stay and mortality according to the degree of malnutrition. ResultsThe mean age for patients included was 84.6 years and 75% of patients were female. The Mini Nutritional Assessment test results showed 7.9% of patients were malnourished and 31.5% at risk of malnourishment. ConclusionsOur study results indicate a high prevalence of malnutrition and risk of malnourishment in hospitalized elderly patients with a femoral fracture.

The Impact of Malnutrition on the Quality of Life of Colorectal Cancer Patients in a Tertiary Hospital

Malnutrition among colorectal cancer patients can impair quality of life and decrease survival. This study evaluated the nutritional status of colorectal cancer patients and its association with quality of life among Filipino colorectal cancer patients seen in a tertiary hospital. A cross-sectional study was conducted among colorectal cancer patients seen at the Philippine General Hospital between December 1, 2019 and February 28, 2020. Nutritional status was evaluated using the Subjective Global Assessment, while quality of life was assessed using the EORTC QLQ-C30. Descriptive statistics, ANOVA and logistic regression were employed for analysis. Among 292 patients, malnutrition was noted in 76.4%. Stage III cancer had a higher odds for malnutrition (OR (odds ratio) = 6.22, 95% confidence interval (CI): 1.59, 24.42). Patients who received or were currently receiving chemotherapy were less likely to develop malnutrition (OR = 0.35, 95% CI: 0.18–0.69). Global health status and all functional subscale scores for the severely malnourished group were lower while the scores for symptom scales increased with the degree of malnutrition. There was a high prevalence of malnutrition among colorectal cancer patients and this was associated with poor quality of life. Future directions emphasizing early nutritional screening and assessment are recommended.

The modified NUTRIC score (mNUTRIC) is associated with increased 28-day mortality in critically ill COVID-19 patients: Internal validation of a prediction model.

BackgroundHigh prevalence of malnutrition was found in critically ill COVID-19 patients. The modified Nutrition Risk in the Critically ill (mNUTRIC) score is frequently used for nutritional risk assessment in intensive care unit (ICU) COVID-19 patients. The aim of this study was to investigate the role of mNUTRIC score to predict 28-day mortality in critically ill COVID-19 patients admitted to ICU.MethodsA cohort of consecutive COVID-19 critically ill patients admitted to ICU was retrospectively evaluated and the nutritional risk was assessed with the use of mNUTRIC score. A multivariable Cox regression model to predict 28-day mortality was therefore developed including the mNUTRIC as a covariate. Internal validation was performed using the bootstrap resampling technique to reduce possible bias in the estimated risks. The performance of the prediction model was assessed via calibration and discrimination.ResultsA total of 98 critically ill COVID-19 patients with a median age of 66 years (56–73 IQR), 81 (82.7%) males were included in this study. A high nutritional risk (mNUTRIC ≥5 points) was observed in 41.8% of our critically ill COVID-19 patients while a low nutritional risk (mNUTRIC <5 points) was observed in 58.2%. Forty-five patients (45.9%) died within 28 days after ICU admission. In multivariable model after internal validation, mNUTRIC ≥5 (optimism adjusted HR 2.38, 95% CI 1.08–5.25, p = 0.02) and high-sensitivity C-reactive protein values (CRP) (optimism adjusted HR 1.02, 95% CI 1.01–1.07, p = 0.005) were independent predictors of 28-day mortality.ConclusionsA high prevalence of malnutrition as revealed by mNUTRIC was found in our critically ill COVID-19 patients once admitted in ICU. After adjustment for covariables, mNUTRIC ≥5 and CRP levels were independently associated with 28-day mortality in critically ill COVID-19 patients. The final model revealed good discrimination and calibration. Nutritional risk assessment is essential for the management of critically ill COVID-19 patients as well as for outcome prediction.