Nutritional Issues Research Articles

Assessing Nutritional Status in Gastric Cancer Patients after Total versus Subtotal Gastrectomy: Cross-Sectional Study.

Gastric cancer (GC) remains a significant global health concern, ranking as the third leading cause of cancer-related deaths. Malnutrition is common in GC patients and can negatively impact prognosis and quality of life. Understanding nutritional issues and their management is crucial for improving patient outcomes. This cross-sectional study included 51 GC patients who underwent curative surgery, either total or subtotal gastrectomy. Various nutritional assessments were conducted, including anthropometric measurements, laboratory tests, and scoring systems such as Eastern Cooperative Oncology Group/World Health Organization Performance Status (ECOG/WHO PS), Observer-Reported Dysphagia (ORD), Nutritional Risk Screening-2002 (NRS-2002), Patient-Generated Subjective Global Assessment (PG-SGA), and Simplified Nutritional Appetite Questionnaire (SNAQ). Serum carcinoembryonic antigen (CEA) levels were significantly higher in the subtotal gastrectomy group. Nutritional assessments indicated a higher risk of malnutrition in patients who underwent total gastrectomy, as evidenced by higher scores on ORD, NRS-2002, and PG-SGA. While total gastrectomy was associated with a higher risk of malnutrition, no single nutritional parameter emerged as a strong predictor of surgical approach. PG-SGA predominantly identified malnutrition, with its occurrence linked to demographic factors such as female gender and age exceeding 65 years.

Comparing Mid-Upper Arm Circumference With Body Mass Index for Assessing Nutritional Status in Indian Adults: Evidence From the National Family Health Survey 2015-16 (NFHS-4).

Background The surge in the twin burden of malnutrition - undernutrition and overweight/obesity - poses a severe threat worldwide including India. The adult group, primarily considered as an economic pillar of the society, suffered significant health problems, yet their nutritional issues are often neglected. Screening of nutritional status through anthropometric measurements is widely accepted. Body mass index (BMI) is commonly used but has certain limitations. Mid-upper arm circumference (MUAC), another simpler tool, is universally accepted in children, but its use in adults is debatable. The current research aims to determine the MUAC cutoffs and their predictive accuracies corresponding to BMI cutoffs for adult men and nonpregnant women. Subject and methods A cross-sectional analysis was conducted of the anthropometric data of Indian adult men and nonpregnant women collected in 2015-16 via the National Family Health Survey (NFHS-4). The receiver operating characteristic (ROC) curve analysis was performed to derive the MUAC cutoffs against BMI cutoffs. Results A significant moderate correlation for both men (r=0.56) and women (r=0.68) was observed. In relation to ROC analysis, the MUAC cutoffs against the BMI cutoffs of 18.5, 23, 25, and 30 kg/m2 were approximated to be 25, 26, 28, and 30 cm for men and 23, 25, 27, and 28 cm for women, respectively. These MUAC cutoffs showed good predictive accuracy with a high range of sensitivity and specificity for both men and women. Conclusions The non-invasive MUAC method correlates very well with BMI and offers several advantages, including accuracy, ease of measurement, and minimal logistical support and training, and can assess the nutritional status even in geographically remote areas. Therefore, it can be an important tool in public health, especially in resource-limited settings, for identifying populations at risk of malnutrition.

Voice, access, and ownership: enabling environments for nutrition advocacy in India and Nigeria

What constitutes an enabling environment for nutrition advocacy in low- and middle-income countries? While a sizeable body of scholarship considers the enabling environment for nutrition policy, we focus specifically on the necessary conditions for advocacy. We argue that three factors—voice, access, and ownership—provide a useful lens into the advocacy enabling environment. These are operationalized, respectively, as the space to articulate and frame policy positions, entry points to interact with policy decision makers, and the existence of committed decision makers rather than those responding to pressures from external actors. These three factors are explored vis-à-vis a comparative analysis of two federal democracies—India and Nigeria—that each have vibrant advocacy communities confronting persistent malnutrition. Drawing on more than 100 structured interviews with nutrition advocates, government actors, donors, and researchers in the two countries, we highlight the ways in which voice, access, and ownership interactively shape advocacy efforts. In doing so, we find that Nigeria has a less ideological approach to certain nutrition issues than in India but also perceived to be more beholden to external actors in defining its nutrition actions. Recent restrictions on freedom of speech and association shrunk the civic space in India but these were less problematic in Nigeria. In both countries, the multi-tiered, multi-party system offers many different points of access into the policy arena, with sometimes negative implications for coordination. Overall, the paper contributes more broadly to the literature on enabling environments by highlighting potential indicators to guide nutrition advocates in other settings.

Self –reported knowledge and understanding of added sugars by consumers in Ghana

The consumption of added sugars has been a major concern among consumers and researchers around the world. Some of these added sugars pose health threats such as obesity, and liver diseases to consumers. Therefore, consumers' understanding and knowledge of added sugars is important in regulating the intake of food items that contain different types and levels of added sugar. In this study, the knowledge and understanding of staff (consumers) of the University of Energy and Natural Resources, Ghana, was assessed through survey The results showed that about 38.5 % of consumers always read food labels whereas 3.1 % never read the labels of food they purchased. However, only about 20 % of consumers considered added sugars as most important information on food labels while most (about 38 %) were concerned about the calorie level in food items purchased. Based on the consumer's knowledge of sugars and sweeteners, there was a high level of disparity in classifying sugars in food as sugars and sweeteners. In addition, most consumers reported that they would adversely avoid food items containing lactose, isoglucose, and saccharin. The awareness of the consumers to the WHO recommendation for sugar reduction, the gender (P = 0.278), age (P = 0.959), level of education (P = 0.888), and staff category (P = 0.944) did not influence their decisions on purchasing food items with added sugars Most consumers were interested in issues of food and nutrition. Therefore, it is recommended that staff are taken through aspects of food nutrition as well as the consumption of added sugar towards the recommended levels.

Actions alimentation-nutrition pratiquées dans les établissements médicosociaux et de santé de Nouvelle-Aquitaine, intérêt et utilisation des services proposés par le centre de ressources en nutrition (Cerenut) de cette région

Introduction and objectiveThe functioning of establishments for elderly or disabled people regarding food and nutrition is poorly understood. In the French Nouvelle-Aquitaine region, there is a Nutrition Resource Center (Cerenut) responsible for helping establishments on these issues. The study aimed to find out the main food and nutrition actions practiced in medico-social and health establishments in Nouvelle-Aquitaine, their perception of the interest of the various services offered by Cerenut and the levels of use of these services. MethodA secure questionnaire was sent electronically to 2625 establishments. Declarative data was collected automatically over a period of one month. ResultsThe number of responding establishments was 172 (6.6% of establishments contacted). The use of oral nutritional supplements, weighing at least once a month and the presence of a menu committee were the most frequent actions. Nutritional issues were an important concern for establishment budgets. The nutritional assessment of residents upon entry and the use of dietary time remained infrequent, as did the practice of enteral nutrition. Establishments for people with disabilities were the worst off. Cerenut's services relating to team training were considered the most interesting and the most used. ConclusionSeveral fundamental food and nutrition actions were not carried out in the establishments surveyed, likely to hamper the nutritional assessment of residents, their care and the enhancement of their stays. Cerenut offers training and can provide structures with appropriate assistance in many cases.

Developing a Nutritional Assessment Tool for Toddlers Using Anthropometry and IoT Technology

Data from the Indonesian Toddler Nutrition Status Survey (SSGBI) in 2021, the prevalence of stunting in Indonesia is still quite high, at 24.4%, which is equivalent to 5.33 million toddlers. This figure is still above the standard tolerated by WHO, which is below 20%. Therefore, efforts are needed to accelerate stunting reduction so that the prevalence of stunting in toddlers decreases to 19.4% by 2024. This research aims to develop a tool for measuring toddlers' height and weight to assess their nutritional status promptly, aiming to preemptively address any nutritional abnormalities and prevent exacerbation. Anthropometry serves as the primary method for assessing toddlers' nutritional status in this study. The tool's design incorporates the ESP32 as the main control unit, the HC-SR04 sensor for height measurements, and the HX711 module and loadcell sensor as weight sensors. Data from the sensor are transmitted from the ESP32 master to the ESP32 slave for processing, culminating in a nutritional status assessment. Notably, the tool boasts a minimal error rate of 0.18% for weight measurement with 99.82% accuracy and a 2.66% error rate for height measurement with 97.34% accuracy. Furthermore, the tool's integration with IoT technology offers additional advantages. It facilitates real-time data transmission and analysis, enabling healthcare professionals to promptly identify any nutritional issues in toddlers. This, in turn, allows for timely intervention and appropriate management strategies to prevent the development or exacerbation of stunting. Overall, the benefits of this research for the Anthropometry Stunting Monitor based on IoT are manifold. It enhances accuracy and efficiency in measuring toddlers' height and weight, enables early detection of stunting, and facilitates timely intervention to address nutritional abnormalities. This holds significant promise for improving pediatric healthcare outcomes and reducing the prevalence of stunting among children.

Nutritional Content of Underutilized Vegetable Crops: A Source for Nutritional Security and Human Health

Vegetables are essential to a balanced diet and are the primary force behind the achievement of global nutritional security due to their presence of nutrients, vitamins, and minerals. Vegetable crops classified as underused are those that are neither widely traded nor farmed on a commercial basis. Underutilized crop species have the potential to boost the country's economy but have not received enough attention because of a decline in focus on their production, consumption, and utilization. An examination of the literature found that most underutilized crop species are nutritious, and some even have medicinal properties. Vegetables that are underutilized may be significant locally or regionally, but they are typically not valued or approved nationally. The plant species that are traditionally used for food, fiber, fodder, oil, or medicinal purposes are the underutilized vegetable crops. Nonetheless, such species have untapped potential to provide environmental benefits, economic production, nutrition, health, and food security. Using underused crops improves rural populations' health and contributes to the fight against malnutrition-related problems. Unused vegetables are a rich source of energy, fats, proteins, carbohydrates, and vitamins and minerals. These nutrients can help prevent and treat a number of illnesses, including hypertension, cancer, kwashiorkor, marasmus, night blindness, anemia, diabetes, and hidden hunger. Important underutilized vegetable crops include kale, broad beans, asparagus, amaranthus, basella, moringa, ivy gourds, globe artichokes, and others. India's soil and climate are ideal for growing a variety of underutilised vegetables. As a result, the Indian government has started to promote the underutilized vegetables. In conclusion, underutilized vegetable production can help address the shortage of per capita consumption availability and address nutritional issues while creating jobs and raising rural residents' incomes, all of which have the potential to boost the national economy.

Allgrove Syndrome: A Case Report and Review of the Literature

Allgrove syndrome, or Triple A syndrome, is a very rare autosomal recessive disorder with three key clinical features: achalasia, alacrima, and adrenal insufficiency. Around a third of patients present with additional features, such as neurological and autonomic manifestations (making it syndrome 4A). Alacrima usually appears in early childhood, while achalasia and adrenal insufficiency manifest later. In adulthood, the presentation is predominantly neurological, with autonomic impairment and polyneuropathy. We report the case of a 7-year-old female patient who consulted us with delayed weight gain and nutritional issues, alacrimia, and chronic vomiting since the age of 6 months. Clinical examination revealed malnutrition, with weight and BMI less than 3 standard deviations. Alacrima was confirmed by a positive Schirmer's test. Oesogastroduodenal transit, gastric fibroscopy, and manometry confirmed achalasia. In our case, there was no neurological involvement nor adrenal insufficiency. Treatment consisted of optimal managing of the manifestations of the disease.

Characterization of a symbiotic beverage based on water-soluble soybean extract fermented by Lactiplantibacillus plantarum ATCC 8014.

The health benefits of functional foods are associated with consumer interest and have supported the growth of the market for these types of foods, with emphasis on the development of new formulations based on plant extracts. Therefore, the present study aimed to characterize a symbiotic preparation based on water-soluble soy extract, supplemented with inulin and xylitol and fermented by Lactiplantibacillus plantarum ATCC 8014. Regarding nutritional issues, the symbiotic formulation can be considered a source of fiber (2g/100mL) and proteins (2.6g/100mL), and it also has a low-fat content and low caloric value. This formulation, in terms of microbiological aspects, remained adequate to legal standards after storage for 60days under refrigeration and also presented an adequate quantity of the aforementioned probiotic strain, corresponding to 9.11 Log CFU.mL-1. These viable L. plantarum cells proved to be resistant to simulated human gastrointestinal tract conditions, reaching the intestine at high cell concentrations of 7.95 Log CFU.mL-1 after 60days of refrigeration. Regarding sensory evaluation, the formulation showed good acceptance, presenting an average overall impression score of 6.98, 5.98, and 5.16, for control samples stored for 30 and 60days under refrigeration, respectively. These results demonstrate that water-soluble soy extract is a suitable matrix for fermentation involving L. plantarum ATCC 8014, supporting and providing data on the first steps towards the development of a symbiotic functional food, targeting consumers who have restrictions regarding the consumption of products of animal origin, diabetics, and individuals under calorie restrictions.

Blood Flow Rate Of Hemodialysis Patients; A Hospital Based Study

Background: In chronic renal disease, impaired kidney function hinders waste elimination.Hemodialysis is fundamental for removing creatinine, urea, and excess water. The study explores blood flow rates in hemodialysis patients with chronic renal disease, shedding light on dialytic dynamics in this context.Materials and Methods: A total of 100 patients were selected irrespective of age and gender. All hemodialysis patients were recruited in Institute of Kidney Diseases, Hayatabad,Peshawar. Blood flow rate and demographic information were entered into a performa.Microsoft Excel 2007 was used to enter and analyze data.Results: Out of total, 58.3% and 41.7% were found male and female respectively. Highest number of patients observed in age greater than 55 years. The study revealed varying blood flow rates, with 43.9% at 300 ml/min, highlighting the distribution among hemodialysis patients. Three hours hemodialysis were found frequently among dialysis patients.Conclusion: Despite improvements in dialysis care, challenges such as recirculation, co-morbidities, and nutritional issues persist, emphasizing the need for innovative therapeutic approaches and ongoing research to enhance patient outcomes. The study's findings provide valuable insights into optimizing hemodialysis effectiveness.

Development of a Tool for Reporting Key Dietary Indicators from Sales Data in Remote Australian Aboriginal and Torres Strait Islander Community Stores.

Reporting key dietary indicators from sales data can help us guide store decision makers in developing effective store policy to support healthier customer purchases. We aimed to develop a web-based reporting tool of key dietary indicators from sales data to support health-promoting policy and practice in stores in geographically remote Aboriginal and Torres Strait Islander communities. Tool development included identifying key dietary indicators (informed by sales data from 31 stores), community consultation (19 Aboriginal and Torres Strait Islander store directors and two store managers) and a web-build. Tool evaluation involved feedback interviews with stakeholders (25 store managers and two nutritionists). Key dietary indicators aligned with Australian Dietary Guideline food groupings and recommendations. An online portal for accessing and customising reports was built. Stakeholder feedback indicated that the strengths of the reports were the visuals, ease of interpretation, providing information that was not currently available and potential to increase capacity to support healthy food retailing. Difficulties were defining healthiness classification with alignment to other nutrition guidelines used and ensuring reports reached relevant store decision makers. This tool may be valuable to support store decision makers in identifying and prioritising nutrition issues and optimising the health-enabling attributes of stores.

Knowledge, attitude and behaviours towards food sustainability in a group of Italian consumers. A cross-sectional study

Sustainability is crucial for transforming the food system, addressing environmental and nutrition issues and depends on consumer perceptions and values. This cross-sectional study investigates the relationship between sustainability attitudes, knowledge, and eating behaviours. Nearly half reported high level of knowledge regarding food sustainability while 24% expressed high attitude towards food sustainability. Women reported higher levels of knowledge and attitude towards food sustainability. Logistic regression analyses, adjusted for age, sex, and education, revealed that using public transport, biking, or walking was significantly associated with higher odds of having a more positive overall attitude towards food sustainability (OR = 1.77). The overall knowledge score was a strong predictor of a positive overall attitude score (OR = 2.11). Examining individual knowledge-related items, almost all were associated with higher levels of knowledge, except those regarding food and environment interaction. These findings underline a complex scenario where consumers’ awareness and knowledge highly influence the applicability of sustainable food choices.

The role of nutritional interventions in the prevention and treatment of chronic lung disease of prematurity.

Chronic lung disease of prematurity or bronchopulmonary dysplasia (BPD) is a common complication of preterm birth. Nutrition may affect incidence and severity of BPD. In this context, the Section on Nutrition, Gastroenterology and Metabolism, the Pulmonary Section of the European Society for Paediatric Research (ESPR) and SPR have joined forces to review the current knowledge on nutritional issues related to BPD. The aim of this narrative review is to discuss the clinical implications for nutritional practice. Nutrient deficiencies may influence pathogenesis of BPD. Adequate nutrition and growth can play a crucial role in the prevention of and recovery from BPD. Optimal nutrition strategy is an important principle, especially in the early postnatal period. As optimal energy intake in infants at risk of BPD or with evolving BPD is not yet defined, further research with well-designed studies on nutritional strategies for preterm infants with BPD is urgently needed. IMPACT: Based on current evidence it seems reasonable to recommend that BPD diagnosed infants should receive an energy supply ranging from 120 to 150 Kcal/kg/d. Exclusive MOM feed with adequate fortification should be encouraged as this is associated with a significant reduction in the risk of BPD. Suboptimal nutritional delivery is often seen in preterm infants with BPD compared to controls.

Global Lake Health in the Anthropocene: Societal Implications and Treatment Strategies

AbstractThe world's 1.4 million lakes (≥10 ha) provide many ecosystem services that are essential for human well‐being; however, only if their health status is good. Here, we reviewed common lake health issues and classified them using a simple human health‐based approach to outline that lakes are living systems that are in need of oxygen, clean water and a balanced energy and nutrient supply. The main reason for adopting some of the human health terminology for the lake health classification is to increase the awareness and understanding of global lake health issues. We show that lakes are exposed to various anthropogenic stressors which can result in many lake health issues, ranging from thermal, circulatory, respiratory, nutritional and metabolic issues to infections and poisoning. Of particular concern for human well‐being is the widespread lake drying, which is a severe circulatory issue with many cascading effects on lake health. We estimated that ∼115,000 lakes evaporate twice as much water as they gain from direct precipitation, making them vulnerable to potential drying if inflowing waters follow the drying trend, putting more than 153 million people at risk who live in close vicinity to those lakes. Where lake health issues remain untreated, essential ecosystem services will decline or even vanish, posing a threat to the well‐being of millions of people. We recommend coordinated multisectoral and multidisciplinary prevention and treatment strategies, which need to include a follow‐up of the progress and an assessment of the resilience of lakes to intensifying threats. Priority should be given to implementing sewage water treatment, mitigating climate change, counteracting introductions of non‐native species to lakes and decreasing uncontrolled anthropogenic releases of chemicals into the hydro‐, bio‐, and atmosphere.

IJCM_132A: The impact of eating habits on BMI: a cross-sectional study among college students in Kerala

Background: Major nutritional issues in today’s world are overweight and underweight which is greatly influenced by lifestyle choices and eating habits. Healthy eating and lifestyle habits are shaped during the adolescent period and become permanent, so adolescence is a crucial period for establishing long-term habits. This study aims to explore the correlation between college students’ eating habits and their Body Mass Index (BMI). Objectives: 1. To evaluate the prevalence of overweight and obesity among college students in Kerala. 2. To determine the association between the effects of eating habits and lifestyle factors on BMI. Methodology: A cross-sectional study was conducted among college students belonging to different professional colleges in Kerala from February 2023 to August 2023. A random sampling technique was used to select colleges in Kerala. A total of 502 students participated in the study. Study variables included sociodemographic data, BMI and eating habits assessed through a structured questionnaire. Participants who didn’t give consent were excluded from the study. Statistical analysis was done using SPSS v22. Results: The total number of students who participated in the study was 502 including 157 males and 345 females. Most of the students were belonging to the age group of 20-23 years. Female students formed the majority of study subjects (68.72%). According to the Asia Pacific BMI classification, 20.3 were found to be obese. Among the students, obesity was found more commonly among male students (30.6%) compared to female students (15.7%). Obese students were found to eat more under stress (51%) compared to students with normal BMI (30.3%) and it was found to be statistically significant (p Conclusion: The study showed that changing lifestyle patterns such as eating fatty foods and fried foods and eating under stress were found to have a direct impact on BMI.

THE ROLE OF DAIRY FOODS FOR HEALTHY AGING

Nutrition is a variable risk factor that may be associated with aging. As individuals age, they may experience various nutritional deficiencies and health issues related to inadequate and excessive nutrition. These can include problems with the musculoskeletal system, diminished immune function, metabolic disorders, and cognitive decline. The World Health Organisation has developed a model of healthy aging that focuses on optimizing many aspects of individuals’ intrinsic ability, such as cognition, psychological well-being, sensory function, vitality, and movement. Milk and dairy foods have the potential to help prevent physical and cognitive decline. Milk and dairy foods play a crucial role in providing a variety of essential nutrients, especially during specific stages of life. Dairy products have a significant opportunity to play a vital role in reducing geriatric malnutrition and the loss of muscle mass, bone strength, and functionality. This review aims to comprehensively analyze the potential health benefits of milk and dairy foods. By examining the evidence of associations between these products and the reduction in the incidence of chronic diseases, this study highlights the potential for older adults to lead longer and healthier lives.

Counseling on balanced nutrition 'isi piringku' to prevent stunting in toddlers aged 1-5 years

Toddlers are a vulnerable group affected by child nutrition issues, one of which is stunting. Stunting is a condition where a child experiences growth impairment, resulting in their height not matching their age due to chronic nutritional problems, specifically prolonged nutrient deficiency. Stunting is caused by two factors: the history of exclusive breastfeeding and maternal knowledge about nutrition. This community service activity aims to increase public knowledge about balanced nutrition guidelines through the "isi piringku" campaign. The activity is carried out using educational methods, utilizing posters and leaflets as aids for 55 participants. The results of the activity show an increase in knowledge after the "isi piringku" campaign, where before the campaign, the level of good knowledge was only 9.09% and increased to 81.82%.

The Use of Oxandrolone in the Management of Severe Burns: A Multi-service Survey of Burns Centres and Units Across the United Kingdom.

Introduction Severe thermal burns are a catastrophic injury. Those surviving the initial insult are subject to life-long disability, prolonged hospital admission, nutritional issues and poor wound healing. Oxandrolone has been shown to reduce hospital duration and promote lean body mass. Despite not being licenced for use in burns trauma within the United Kingdom (UK), services across the country utilise Oxandrolone in the management of severe burns. We aim to analyse the use of Oxandrolone in major burns across burns services within the UK. Methods We conducted a survey across all burn centres and units across the UK. Any burns service provider with experience in patient management of patients sustaining burns with a total body surface area >15% was included. All services were identified using the British Burns Association website. We conducted a survey of all centres and units and contacted them via telephone through the trust's switchboard. Responses were accepted from any healthcare staff familiar with the day-to-day in-patient care of patients on the ward. Services with no in-patient services were excluded. Results A total of 24 burns centres and services responded to our survey. Twelve of the respondents were in a burns unit and 12 were in a burns centre. Eight respondents were paediatric facilities, and the remaining 16 dealt with adult burns. In total, 16/24 (66.6%) services reported using Oxandrolone. Conversely, 8/24 (33.3%) burns services denied using Oxandrolone. 7/12 (58.3%) burns units use Oxandrolone in the management of burns. 5/12 (42.7%) burns units do not use Oxandrolone in severe burns. 9/12 (75%) of burns centres described using Oxandrolone, whilst the remaining 3/12 (25%) did not. Discussion Oxandrolone is used varyingly across burns services across the UK. Burns centres were more likely to use Oxandrolone compared to units. We also find that more paediatric services used Oxandrolone in comparison to adult services. Studies have shown that the benefit of Oxandrolone is not age-dependent. Further work is required to assess the impact of this medication on patients with severe burns and national guidance would help further improve burns management across the UK.

Introduction to the first issue of World Nutrition for 2024

Introduction to the first issue of World Nutrition for 2024

The Alarming Rate of Malnutrition after Single Anastomosis Sleeve Ileal Bypass. A single Centre Experience.

Single anastomosis sleeve ileal (SASI) bypass is a modification of sleeve gastrectomy with transit bipartition (SG + TB). This study aims to assess the safety and efficacy of SASI as a primary metabolic and bariatric surgery (MBS). This is a retrospective case series of 30 patients who underwent SASI bypass from January to December 2021. All patients completed at least 12months of follow-up. Among the 30 patients, 93.3% were women, the mean age was 37.4years, and the mean body mass index (BMI) was 45.6kg/m2. The percentage of total body weight loss (TWL%) was 42.7%, the percent excess body weight loss (EWL%) was 92.7%, and the mean BMI at 12months went from 45.6(35.2-58.4) to 25.8kg/m2 (19.2-33.4). The obesity-associated complications remission rate was 87.5% for type 2 diabetes (T2D), 71.4% for hypertension (HTN) and 100% for obstructive sleep apnea (OSA). Thirteen patients (43.3%) had diarrhea, 7 (23.3%) had hypoalbuminemia, defined as serum albumin < 3g/dl, and 6 (20%) underwent reversal of their index SASI. As for other nutritional issues, iron deficiency anemia was present in 21 patients (70%), while 19 patients (63.3%) had vitamin D, and 2(6.6%) had vitamin B12 deficiency. Despite good short-term weight loss and improvement of obesity-associated complications, SASI is accompanied by high alarming malnutrition, even in short-term follow-up. Novel MBS should be judged for their long-term effects and compared to well-tested standard operations before they are used in routine clinical practice.