Prevalence Rates Of Malnutrition Research Articles

Phase angle as an indicator of sarcopenia and malnutrition in patients with chronic obstructive pulmonary disease

BackgroundPhase angle (PhA), which is measured using bioelectrical impedance analysis, is an indicator of muscle quality and malnutrition. PhA has been shown to be correlated with sarcopenia and malnutrition; however, studies on patients with chronic obstructive pulmonary disease (COPD) are limited. In this study, we investigated the correlation between PhA and sarcopenia and malnutrition and determined the cutoff values of PhA for those in patients with COPD. MethodsThis study included 105 male patients with COPD (mean age 75.7 ± 7.7 years, mean forced expiratory volume in 1s % predicted [%FEV1] 57.0 ± 20.1%) and 12 male controls (mean age 74.1 ± 3.8 years) who were outpatients between December 2019 and March 2024. PhA was measured using the InBody S10, and its correlation with sarcopenia and malnutrition was assessed. The cutoff PhA values for sarcopenia and malnutrition were determined using receiver operating characteristic curves. ResultsThe prevalence rates of sarcopenia and malnutrition were 31% and 22%, respectively, in patients with COPD. PhA significantly correlated with sarcopenia- and malnutrition-related indicators. Multivariate logistic regression analysis independently correlated PhA with sarcopenia and malnutrition. The cutoff values of the PhA for sarcopenia and malnutrition were 4.75° (AUC = 0.78, 95% CI = 0.68–0.88) and 4.25° (AUC = 0.75, 95% CI = 0.63–0.86), respectively. ConclusionsPhA was significantly correlated with sarcopenia and malnutrition in Japanese patients with COPD and may be a useful diagnostic indicator.

Validity and applicability of the global leadership initiative on malnutrition criteria in non-dialysis patients with chronic kidney disease.

There are no standardized assessment criteria for selecting nutritional risk screening tools or indicators to assess reduced muscle mass (RMM) in the Global Leadership Initiative on Malnutrition (GLIM) criteria. We aimed to compare the consistency of different GLIM criteria with Subjective Global Assessment (SGA) and protein-energy wasting (PEW). In this study, nutritional risk screening 2002 first four questions (NRS-2002-4Q), Nutritional Risk Screening 2002 (NRS-2002), Malnutrition Universal Screening Tool (MUST), and Mini-Nutritional Assessment Short-Form (MNA-SF) tools were used as the first step of nutritional risk screening for the GLIM. The RMM is expressed using different metrics. The SGA and PEW were used to diagnose patients and classify them as malnourished and non-malnourished. Kappa (κ) tests were used to compare the concordance between the SGA, PEW, and GLIM of each combination of screening tools. A total of 157 patients were included. Patients with Chronic kidney disease (CKD) stage 1-3 accounted for a large proportion (79.0%). The prevalence rates of malnutrition diagnosed using the SGA and PEW were 18.5% and 19.7%, respectively. The prevalence of GLIM-diagnosed malnutrition ranges from 5.1% to 37.6%, depending on the different screening methods for nutritional risk and the different indicators denoting RMM. The SGA was moderately consistent with the PEW (κ = 0.423, p < 0.001). The consistency among the GLIM, SGA, and PEW was generally low. Using the NRS-2002-4Q to screen for nutritional risk, GLIM had the best agreement with SGA and PEW when skeletal muscle index (SMI), fat-free mass index (FFMI), and hand grip strength (HGS) indicated a reduction in muscle mass (SGA: κ = 0.464, 95% CI 0.28-0.65; PEW: κ = 0.306, 95% CI 0.12-0.49). The concordance between the GLIM criteria and the SGA and PEW depended on the screening tool used in the GLIM process. The inclusion of RMM in the GLIM framework is important. The addition of HGS could further improve the performance of the GLIM standard compared to the use of body composition measurements.

Progress in the fight against malnutrition in Mozambique: A review of policies, action plans, and nutritional intervention programs

Malnutrition is a public health problem in Mozambique, where 37% of children under five suffer from chronic malnutrition and 4% from acute malnutrition. Since national independence in 1975, action plans have been implemented to reverse this situation. Objective: To analyze the progress made in the fight against malnutrition through the policies, action plans and programmes implemented in the country since independence. Methodology: Documentary study, whose main data sources consisted of Demographic and Health Survey reports, Family Budget Surveys, SMART Surveys, Integrated Classification of Food Security Stages reports, information from FAO databases, as well as other studies on the nutritional situation in the country. The WHO and UNICEF classifications were used to describe the prevalence rates of malnutrition. Results: Except for acute malnutrition, which reduced from high to low between 1997-2023, the prevalence of chronic malnutrition had no statistically significant reductions and remains very high. Factors such as food insecurity, high illiteracy rates, armed conflict in northern Mozambique, poverty, unequal distribution of basic resources between provinces, weak monitoring and evaluation systems in the action plans implemented, poor investment in agriculture, covid-19, as well as the effect of climate change, which constantly affects the country, are the main causes. Conclusion: Despite efforts, malnutrition continues not to show significant reductions, which calls for further study and improvement of policies, as well as the control of risk factors.

The associations of osteoporosis and possible sarcopenia with disability, nutrition, and cognition in community-dwelling older adults

BackgroundOsteoporosis and sarcopenia, respectively, have detrimental impact on health, and combination of both conditions, termed osteosarcopenia, is becoming an increasingly important disorder in older adults as populations age. This study aimed to explore the relationship between osteoporosis and possible sarcopenia and their joint effect on physical performance, nutritional status, and cognition in community-dwelling older adults.MethodsThis study was conducted at a medical center in Taiwan, which included the adjacent community care station. The participants were recruited through regular activities at the community care station between January 01, 2015 and February 28, 2022. During the study period, dual-energy X-ray absorptiometry and comprehensive geriatric assessment consisting of comorbidity burden, functional status, cognition, mood, and nutritional status were performed during the study period. Possible sarcopenia was identified utilizing the criteria set by the Asian Working Group on Sarcopenia in 2019 using the criteria of low muscle strength alone, and osteoporosis was defined by the World Health Organization criteria. Accordingly, the study subjects were divided into four groups: normal, only osteoporosis, only possible sarcopenia, and possible osteosarcopenia.ResultsThere were 337 participants (68.6% female) with a median age of 78.0 years (interquartile range: 71.0–85.0 y/o). According to the clinical definition of osteosarcopenia, 78 participants were normal, 69 participants showed possible sarcopenia, 61 participants had osteoporosis, and 129 had osteoporosis with possible sarcopenia. Among the four groups, the prevalence rates of chronic illness, functional capacity, physical performance, cognitive impairment, and malnutrition revealed statistically significant differences. Using logistic regression analysis after adjusting for the other covariates, osteoporosis with possible sarcopenia was associated with an increased odds ratio of cognitive impairment.ConclusionsThe findings suggest that compared to osteoporosis or possible sarcopenia alone, osteoporosis with possible sarcopenia was more likely to be associated with cognitive impairment. Early identification and targeted interventions for cognitive impairment in older adults with osteosarcopenia may be valuable in maintaining cognitive well-being and overall quality of life.

Health inequalities of global protein-energy malnutrition from 1990 to 2019 and forecast prevalence for 2044: data from the Global Burden of Disease Study 2019

ObjectivesProtein-energy malnutrition poses a serious medical problem worldwide. This study aims to describe the global burden, trends, and health inequalities of protein-energy malnutrition and forecasts for future prevalence. Study designThis was a comprehensive analysis based on data provided by the Global Burden of Disease Study 2019. MethodsData were obtained from the Global Health Data Exchange query tool, including prevalence, deaths, disability-adjusted life years (DALYs) and sociodemographic index (SDI). The estimated annual percentage changes were calculated to evaluate temporal trends. We quantified cross-country inequalities in protein-energy malnutrition burden and predicted the prevalence number and rate to 2044. ResultsGlobally, there were 147,672,757 (130,405,923 to 167,471,359) cases of protein-energy malnutrition in 2019, with 212,242 (185,403 to 246,217) deaths. Eastern Sub-Saharan Africa had the highest age-standardised death and DALY rates in 2019. From 1990 to 2019, the global age-standardised prevalence rate of protein-energy malnutrition showed an upward trend, while the age-standardised death rate showed a downward trend. A significant decline occurred in SDI-related health inequality, from 2126.1 DALYs per 100,000 persons between the poorest and richest countries in 1990 to 357.9 DALYs per 100,000 persons in 2019. There was a trend of decreasing age-standardised death and DALY rates along with increases in the SDI. Frontier analyses showed that there is much room for improving the current situation of protein-energy malnutrition in some countries. In the next 35 years, the prevalence of protein-energy malnutrition will continue to increase. ConclusionAlthough the disease burden of protein-energy malnutrition has greatly decreased since 1990 and health inequalities between countries are shrinking, the prevalence in Asian and African countries may continue to increase. Focussing on regional differences and strengthening the nutritional intake of people in underdeveloped areas are necessary to reduce future burdens.

Prevalence of Malnutrition and the Value of Predicting Pancreatic Fistula in Patients with Laparoscopic Pancreatoduodenectomy.

Background: Pancreatoduodenectomy is a standard surgical procedure for periampullary tumors. With recent improvements in perioperative management, postoperative mortality has decreased significantly in recent years; however, postoperative pancreatic fistula (POPF) is still one of the most prevalent and dangerous complications. The purpose of this study was to analyze the prevalence of malnutrition and the value of predicting POPF in patients with laparoscopic pancreatoduodenectomy (LPD). Methods: We retrospectively analyzed the perioperative data of 747 patients undergoing LPD in the Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, China. Simultaneously, we analyzed the prevalence rate of malnutrition with three different nutritional assessment scores and explored the independent risk variables for POPF to identify potential predictive value. Results: Malnutrition was observed in 20.1% of patients with the prognostic nutritional index (PNI), 85.0% of patients with the controlling nutritional status (CONUT) score, and 73.1% of patients with the NRI score. Univariate and multivariate analyses all showed that the risk factors for POPF were pancreatic texture, pancreatic duct diameter, abdominal infection, body mass index (BMI), nomogram-revised risk index (NRI), and PNI. The receiver operating characteristic curve indicated that the BMI/PNI ratio was capable of predicting the occurrence of clinical POPF following LPD, with an area under the curve of 0.708. Conclusions: Compared with no malnourished patients, malnutrition is associated with a higher risk of POPF among patients with LPD. In addition, the BMI/PNI ratio has some predictive value in the development of POPF following LPD.

PREVALENCE AND ASSOCIATED RISK FACTORS OF MALNUTRITION AMONG UNDER FIVE YEARS OF CHILDREN IN THE FIELD PRACTICE AREA OF RURAL HEALTH TRAINING CENTRE, NAILA JAIPUR

Objective: Malnutrition among children under the age of five is a global health concern, particularly in developing countries. In India, prevalent nutritional problems include stunting, wasting, anemia, poverty, and low birth weight. These forms of malnutrition have severe consequences for children's health and overall well-being, making malnutrition a leading risk factor for children under five worldwide. Efforts to address malnutrition in developing countries, including India, have been a focus of United Nations' Millennium Development Goals (MDGs) aimed at improving child health outcomes. However, despite these efforts, malnutrition remains a significant concern, particularly among women and children in India.&#x0D; Methods: The study was conducted in the rural community of Jamuwaramgarh block in Rajasthan, Jaipur District, India. The sample size was calculated based on a prevalence rate of malnutrition among under-five children. Ethical approval was obtained, and only mothers with children aged 6-59 mo were included in the study. A multistage sampling procedure was used to select the study participants, including sub-block, primary health centers, villages, and households. Data on socio-demographic characteristics, obstetric history, immunization, breastfeeding, and weaning practices were collected through interviews. Anthropometric measurements were taken, and the data were entered into Microsoft Excel for analysis.&#x0D; Results: The study included 700 children under the age of five. The prevalence of malnutrition among children in the study area was determined. The data collected on socio-demographic characteristics, obstetric history, and other variables were analyzed to identify the determinants of malnutrition among rural Indian children.&#x0D; Conclusion: Malnutrition among children under the age of five remains a significant public health concern, particularly in developing countries like India. Stunting and wasting are prevalent forms of malnutrition, with serious consequences for children's growth and development. Despite efforts to address the issue, progress has been slow, and the prevalence of malnutrition in India is still alarmingly high.

#3246 THE ASSOCIATION OF THE CO-OCCURRENCE OF MALNUTRITION AND SARCOPENIA WITH MORTALITY IN HEMODIALYSIS PATIENTS: A MULTICENTER PROSPECTIVE COHORT STUDY

Abstract Background and Aims Frailty is widely acknowledged as an age-related fragile state characterized by physiological vulnerability to stress, and it is prevalent among patients undergoing maintenance hemodialysis therapy. Various factors are interconnected and can be theoretically consolidated into a cycle of frailty, with malnutrition and sarcopenia at the core. These can result in numerous negative health outcomes in patients on hemodialysis and prompt identification and treatment are necessary. However, limited research has investigated the impact of the overlap between malnutrition and sarcopenia on mortality in this patient population. In this study, we examined the association of the overlap between malnutrition and sarcopenia with all-cause mortality in patients undergoing maintenance hemodialysis. Method The present prospective cohort study recruited outpatients on hemodialysis from three facilities in Japan. At the study baseline, data on patients' characteristics including age, gender, body mass index, duration of dialysis, primary kidney diseases, 11 comorbid conditions, and laboratory parameters (including serum albumin level) were collected from medical records. In addition, muscle mass (skeletal muscle index [SMI]), muscle strength (handgrip strength), and physical performance (short physical performance battery [SPPB]) were measured by physical therapists. A comorbidity index was used to quantify the severity of comorbid illnesses, which was calculated based on primary kidney diseases and the 11 comorbidities. Malnutrition was identified based on geriatric nutritional risk index &amp;lt;98, which was calculated using the serum albumin level and body weight. Sarcopenia was diagnosed when patients had low muscle mass (SMI &amp;lt;7.0 kg/m2 for males and &amp;lt;5.7 kg/m2 for females) and low muscle strength (handgrip strength &amp;lt;28.0kg for males and &amp;lt;18 kg for females) or low physical performance (SPPB ≤9), in accordance with the Asian Working Group for Sarcopenia 2019 criteria. After classifying the study participants into four groups based on the absence or presence of malnutrition and sarcopenia, the mortality risk was evaluated using the Kaplan-Meier method and Cox proportional hazard analysis. This study was approved by the Research Ethics Committee and conducted in accordance with the principles of the Declaration of Helsinki. Results A total of 379 patients on hemodialysis were included in the analysis. The mean age of the patients was 69.5±12.6 years, and 40.2% of the cohort being female. The mean duration of dialysis was 7.9±4.5 years. The most prevalent underlying kidney disease was diabetes mellitus. At baseline, the prevalence rates of malnutrition and sarcopenia were 32.7% and 28.2%, respectively. Over a mean follow-up period of 4.3 years, 23 patients died. The Kaplan-Meier analysis demonstrated a lower cumulative survival rate in patients with malnutrition and/or sarcopenia. After adjustment for the effect of age, gender, duration of dialysis, and comorbidity index, the hazard ratio in patients with both malnutrition and sarcopenia was significantly higher than in patients without both (hazard ratio [HR] 5.78, 95% confidence interval [CI] 1.86-17.94). However, the hazard ratios in patients suffering from either malnutrition or sarcopenia alone were not significantly different (Table 1). Conclusion The present study has demonstrated the strong association of a state of co-occurrence between malnutrition and sarcopenia, which implies starvation and muscle wasting, with a poor prognosis in patients undergoing hemodialysis. The findings of this study have accentuated the significance of addressing both malnutrition and sarcopenia in routine clinical practice for patients undergoing maintenance hemodialysis.

Trends in the prevalence and mortality rate of protein-energy malnutrition in Tunisia

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Malnutrition, Frailty, and Health-Related Quality of Life Among Rural Older Adults in Vietnam: A Cross-Sectional Study.

Rural older adults are more likely to be malnourished than urban older adults, particularly those living in lower-middle-income countries like Vietnam. Therefore, this study aimed to address the prevalence of malnutrition and its association with frailty and health-related quality of life in older rural Vietnamese adults. This cross-sectional study was conducted on community-dwelling older adults (aged ≥ 60 years) living in a rural province in Vietnam. Nutritional status was determined using the Mini Nutritional Assessment Short Form (MNA-SF), and frailty was evaluated using the FRAIL scale. The 36-Item Short Form Survey (SF-36) was used to evaluate health-related quality of life. Among the 627 participants, 46 (7.3%) were malnourished (MNA-SF score <8), and 315 (50.2%) were at risk of malnutrition (MNA-SF score: 8-11). Individuals with malnutrition had significantly higher rates of impairments in instrumental activities of daily living and activities of daily living than those without malnutrition (47.8% vs 27.4% and 26.1% vs 8.7%, respectively). The prevalence of frailty was 13.5%. Risk of malnutrition and malnutrition were associated with high risks of frailty, with odds ratios of 2.14 (95% confidence interval [CI]: 1.16-3.93) and 4.78 (1.86-12.32), respectively. Furthermore, the MNA-SF score was positively correlated with eight domains of the health-related quality of life among rural older adults. The prevalence rates of malnutrition, risk of malnutrition, and frailty were high among older adults in Vietnam. A strong association was observed between nutritional status and frailty. Therefore, this study reinforces the importance of screening for malnutrition and risk of malnutrition among older rural individuals. Further studies should explore whether early nutritional intervention reduces the risk of frailty among older adults and increase their health-related quality of life in the Vietnamese population.

Persistent Malnutrition among Children under five in Pastoral Communities of Aweil Centre, South Sudan

Malnutrition is one of the leading causes of morbidity and mortality among children globally, and has been linked to 60% of the 10.9M deaths annually of under-fives. High prevalence of infectious diseases contributes to malnutrition and vice versa making the situation even worse. In WHO’s African region, the median stunting prevalence is 31.3%.&#x0D; The worst scenarios are seen in the war tone countries; for example Aweil Center of South Sudan has consistently high malnutrition rates despite running nutrition projects by UN agencies, government and other partners with relative stability. Results from Survey carried out in 2013 indicated poverty levels at 76%, severe acute malnutrition (SAM) prevalence rate of 6.3% (95% CI, 4.5-8.9), Global acute malnutrition (GAM) rate of 22.4% (95% CI, 17.8-27.7) with under five mortality rate of 152 deaths/ 1,000 live births.&#x0D; A cross-sectional study with two-stage cluster sampling method done to determine the associated factors of malnutrition among children 6-59 months in Aweil Center County. The results showed high burden of infectious diseases like fever, diarrhea, eye, skin and respiratory tract infections at 94.5% with p-value 0.00022 (95%C.I, 0.1667-0.291). Very low household dietary diversity score of only 24 % (125out of 513 families). There was low coverage of primary health care interventions; e.g. Vitamin A, LLITN and measles vaccinations at 53%, 52.8% and 55% respectively. Accessibility to CBDs for iCCM associated with better nutrition status of children p-value 0.032 and OR 0.62 (95% CI 0.41-0.94). Poor feeding methods, family planning practices; and poor access roads to markets impact on nutrition status of children.&#x0D; Multifaceted approach is needed to root out the persistent malnutrition from Aweil Center: Shift from food aid to support of food production, scale up of primary health care and iCCM interventions to include IPT for malnourished children and community awareness on feeding practices and family planning

Relationship between preoperative malnutrition, frailty, sarcopenia, body composition, and anthropometry in elderly patients undergoing major pancreatic and biliary surgery.

To analyze the correlation between preoperative nutritional status, frailty, sarcopenia, body composition, and anthropometry in geriatric inpatients undergoing major pancreatic and biliary surgery. This is a cross-sectional study of the database from December 2020 to September 2022 in the department of hepatopancreatobiliary surgery, Beijing Hospital. Basal data, anthropometry, and body composition were recorded. NRS 2002, GLIM, FFP 2001, and AWGS 2019 criteria were performed. The incidence, overlap, and correlation of malnutrition, frailty, sarcopenia, and other nutrition-related variables were investigated. Group comparisons were implemented by stratification of age and malignancy. The present study adhered to the STROBE guidelines for cross-sectional study. A total of 140 consecutive cases were included. The prevalence of nutritional risk, malnutrition, frailty, and sarcopenia was 70.0, 67.1, 20.7, and 36.4%, respectively. The overlaps of malnutrition with sarcopenia, malnutrition with frailty, and sarcopenia with frailty were 36.4, 19.3, and 15.0%. There is a positive correlation between every two of the four diagnostic tools, and all six p-values were below 0.002. Albumin, prealbumin, CC, GS, 6MTW, ASMI, and FFMI showed a significantly negative correlation with the diagnoses of the four tools. Participants with frailty or sarcopenia were significantly more likely to suffer from malnutrition than their control groups with a 5.037 and 3.267 times higher risk, respectively (for frailty, 95% CI: 1.715-14.794, p = 0.003 and for sarcopenia, 95% CI: 2.151-4.963, p<0.001). Summarizing from stratification analysis, most body composition and function variables were worsen in the ≥70 years group than in the younger group, and malignant patients tended to experience more intake reduction and weight loss than the benign group, which affected the nutrition diagnosis. Elderly inpatients undergoing major pancreatic and biliary surgery possessed high prevalence and overlap rates of malnutrition, frailty, and sarcopenia. Body composition and function deteriorated obviously with aging.

Epidemiological profile of malnutrition status and spatial distribution of children and adolescents living with HIV/AIDS in Tanzania.

To determine the prevalence of malnutrition status, analyse the association between malnutrition status and individual-level factors, and explore the spatial variation among children and adolescents living with HIV/AIDS in Tanzania. The study is based on large-scale baseline routine data from the National AIDS Control Programme on people living with HIV from January 2016 to December 2021 in mainland Tanzania. 70,102 children and adolescents aged 5-19 years receiving active antiretroviral therapy were included in the analysis. Nutritional status of participants was assessed by anthropometric measurement. Pearson's Chi-square test was used to describe the association between individual-level factors with all malnutrition outcomes and spatial analysis was used to investigate spatial distribution of malnutrition. The excess risk of malnutrition for each region was calculated while Anselin Local Moran's I and Getis-Ord statistical tools were used to identify significant hot spots regions of malnutrition. The mean age of participants was 11.1 (SD 4.7) years, with 71.7% in the 5-14-year age group and 58.4% being girls. 39.2% were attending care and treatment clinics services at hospital level with public ownership. 53.4% started using ARV at age 5-14 years and 55.5% had already switched to second- or third-line ARV with 61.1% using ARV for less than 3 years. 51.2% were in WHO HIV clinical stage III or IV. The prevalence of malnutrition was 36.0% for stunting, 28.9% for underweight, 13.0% for wasting, and 48.0% for anthropometric failure. Individual-level factors which accounted for a higher proportion of malnutrition based on anthropometric failure were male sex (56.3%), age 5-14 years (50.0%), being unmarried (52.9%), being on second- or third-line ARV treatment (51.4%), ART initiation at age 5-14 years (55.7%), ARV for more than 3 years (49.4%), and stage IV of WHO HIV clinical status (57.8%). There were regional hot spots (p< 0.05): the prevalence rate and excess risk of malnutrition for stunting and anthropometric failure were highest in the southern highlands regions, for underweight in the central regions, and for wasting in the northern regions. Children and adolescents living with HIV/AIDS in Tanzania suffer from poor nutritional status. Malnutrition does not occur arbitrarily, and the regions identified as hot spots should be given priority for nutritional intervention. Effective nutritional interventions for children living with HIV/AIDS should incorporate multiple approaches by considering unique geographical factors.

Impact of diet type on the anemia level of adolescent girls

Adolescence is the most vulnerable stage in human life for malnutrition. When the need for nutrients increases during the growth phase. The prevalence rate of malnutrition among adolescent girls (11-18 years) in 11 states and 16 districts, of which 7.1 per cent, was found to be severe anemia, in India, by the recent state-level nutrition plan. Malnutrition is affecting about 50 per cent of the population in India. This problem is affecting women more than men. An estimated 20-40 per cent of maternal deaths in India are due to malnutrition and one out of every two Indian women (56 %) suffers from some form of malnutrition. According to several studies, the prevalence of malnutrition is very high (80-90 %) among pre-school children, pregnant and lactating women and adolescent girls in India. According to a report, more than half (56 %) of adolescent girls in India suffer from malnutrition. Comparing the nutritional status of adolescent girls in India, it was found that 47 per cent of adolescent girls in the age group of 15-19 years in India are victims of undernutrition.

GLIM in nursing homes; practical implications

Only very few papers have described malnutrition prevalence rates according to the Global Leadership Initiative on Malnutrition (GLIM) criteria in nursing homes, likely due to practical reasons such as missing data on body composition, dietary intake, or acute disease/inflammation. Data was collected in 5 different nursing homes. Food intake measurements took place over 3 days of observations, and intakes below 90% of energy or protein requirements were regarded as insufficient. The GLIM diagnosis was based on body weight loss and/or low BMI in combination with insufficient food intake. Additionally, we also studied the sensitivity of GLIM with the question from the Mini Nutritional Assessment Short Form (MNA-SF) on insufficient food intake (GLIMMNA) versus GLIM with measured food intake. Out of 176 participants, 21.0% were categorized as malnourished according to GLIM. Observations revealed an insufficient food intake in 81.3% (N=143) of residents; only 39% of those (N=56) scored positive on the MNA-SF question regarding low food intake. GLIMMNA diagnosed 17.0% of residents as malnourished. Sensitivity of GLIMMNA for GLIM was 62.2%, and specificity 95.0% (kappa=0.61). Twenty-one percent of nursing home residents were diagnosed malnourished based on a limited set of GLIM criteria. The MNA question on insufficient food intake missed ∼60% of residents with a truly low food intake. Herewith, malnutrition prevalence rates with GLIMMNA decreased to 17%. We advise measuring food intake for studies, and to be aware of too low prevalence rates of GLIM when an estimate of reduced food intake is applied.

Prevalence and Management Recommendations for Disease-Related Malnutrition in Chronic Kidney Disease Patients with and without Diabetes.

To investigate the nutritional risk, malnutrition, severe malnutrition, and malnutrition prevalence of different stages in chronic kidney disease (CKD) patients with and without diabetes mellitus using the Global Leadership Initiative on Malnutrition (GLIM), and to analyze the causes of malnutrition and to improve the clinical outcomes of patients for early intervention. A total of 683 patients with CKD who were hospitalized in our hospital from January 2020 to January 2021 were enrolled and divided into subgroups 1 to 5 according to whether they were complicated with diabetes and glomerular filtration rate. Using the second step of the malnutrition (GLIM) diagnostic tool and 2 previously commonly used malnutrition assessment methods (body mass index <18.5 kg/m2 with poor general condition, 3 points for nutritional deficiency in nutritional risk screening), combined with clinical research on the main causes of malnutrition, the intervention measures were discussed. The prevalence of malnutrition was 16.7% (114/683) in the patients included in the survey using the diagnostic criteria of malnutrition (GLIM) (excluding whole body muscle mass index). The prevalence of malnutrition in CKD patients with and without diabetes was 23.7% and 12.6%, respectively. The overall prevalence rate of severe malnutrition was 14.2%, and the prevalence rates of those with and without diabetes were 19.0% and 11.4%, respectively; the results of the two methods of malnutrition assessment showed that the prevalence of malnutrition in CKD patients with diabetes was higher than that in the uncombined group. There was no severe malnutrition in patients with CKD stages 1 and 2. From CKD stage 3 onwards, the severe malnutrition in the diabetic group was significantly higher than that in the uncombined group. With the progression of CKD, the incidence of malnutrition also gradually increased, indicating that malnutrition is related to primary diseases and concomitant diseases. Attention should be paid to the malnutrition of CKD patients with diabetes, and clinical medical staff need to pay early attention to various diseases that lead to the progression of CKD, such as diabetes, primary nephropathy, and other factors, to prevent complications and delay the progression of CKD.

Malnutrition risk screening: New insights in a new era

Twenty years ago, ESPEN published its "Guidelines for nutritional screening 2002", with the note that these guidelines were based on the evidence available until 2002, and that they needed to be updated and adapted to current state of knowledge in the future. Twenty years have passed, and tremendous progress has been made in the field of malnutrition risk screening. Many screening tools have been developed and validated for different patient groups and different health care settings. Some countries even have introduced mandatory screening for malnutrition at admission to hospital. Yet, changes in society and healthcare require a reflection on current practice and policies regarding malnutrition risk screening. In this opinion paper, we share our perspectives on malnutrition risk screening in the twenty-twenties, addressing the changing and varying profile of the malnourished individual, the goals of screening and screening tools (i.e., preventive or reactive), the construct of malnutrition risk (i.e., screening for risk factors or screening for existing malnutrition), and screening alongside a patient's journey.

The association between polypharmacy and malnutrition(risk) in older people: A systematic review.

Malnutrition adversely influences a broad range of physical and psychological symptoms. Although polypharmacy is often mentioned to be associated with malnutrition, especially in older people it is unclear to what extent. The aim of this systematic review was to investigate the extent of the association between polypharmacy and malnutrition in older people. The methodology followed the guidelines of the Cochrane Collaboration. Literature search was performed in PubMed, CINAHL and Embase. The population of interest for this systematic review were people of 65 years and older with polypharmacy. Because there is ambiguity with regard to the actual definition of malnutrition and polypharmacy, in this systematic review all articles describing malnutrition prevalence rates were included, regardless of the criteria used. Both observational and intervention studies were screened for eligibility. Selection and quality assessment of the included full text studies was assessed by two reviewers independently. A level of evidence and methodological quality score was adjudged to each article based on this assessment. A total of 3126 studies were retrieved by the literature search, of which seven studies were included in this systematic review. There was considerable variation in the definition of polypharmacy between studies. Two studies defined polypharmacy as the use of five or more drugs, two studies as the use of six or more drugs, two studies provided a mean and standard deviation that corresponded to the minimum of five drugs, and one study distinguished between polypharmacy (five or more drugs) and excessive polypharmacy (ten or more drugs). However, all studies showed a statistically significant association between (the risk) of becoming malnourished and polypharmacy regardless the instrument or criterion used to define risk of malnutrition. Studies presented the associations respectively as OR ≥ 1.177, p-value ≤ 0.028, β≥-0.62 and r≥-0.31. This review demonstrated a statistically significant association between polypharmacy and malnutrition. Further research is required to determine the magnitude of the effect by increased number of drugs in combination with the type of drugs, on the risk of malnutrition.

High Nutritional Vulnerability and Associated Risk Factors of Bangladeshi Wetland Community People Aged 50 Years and Older

People aged 50 years and over often show nutritional vulnerability in South Asia, including Bangladesh. Consequently, they present physical weakness and illness that escalate overtime. Community-focused investigations have the potential to inform healthcare interventions in Bangladesh, but current studies examine older adults’ nutrition status which are not all-encompassing (e.g., wetland communities). We, therefore, assessed the malnutrition status among wetland community-dwelling older adults aged ≥50 years in Bangladesh. A cross-sectional survey was conducted with 400 older adults living in the north-eastern wetland community of the country through simple random sampling. Demographics and general health information were collected using a structured questionnaire, and the Nestlé Mini Nutrition Assessment—Short Form was used to assess nutrition status. Respondents’ socio-demographic and health profiles were assessed, and the Pearson Chi-square test was performed to identify the associated risk factors of malnutrition. The prevalence of malnutrition and risk of malnutrition were 59.75 and 39.75 percent, respectively. The malnutrition prevalence rate was higher with increasing of age and females were more malnourished than males. Age, gender, educational status, occupation, and income were significantly associated with the participants’ malnutrition. The wetland community-dwelling people suffering from sleep disorders and having poor health condition, were found to be more malnourished. The findings confirm that the prevalence of malnutrition and risk of malnutrition are high among the wetland community-dwelling people aged ≥50 years. Our findings suggest health professionals to implement public health nutrition surveillance and clinical interventions simultaneously in wetland elderly to improve nutritional status of this cohort.

Prevalence of Diarrhea and Association with Socio-Demographic Factors among Children Under Five in Mayo Camp-Khartoum State Sudan

Background: Diarrhoeal diseases remain among the most common causes of mortality and morbidity in children, particularly in low- and middle-income countries (LMICs). In 2013, of the 6.3 million children worldwide who died before they reached their fifth birthday, about half (3.2 million) died from infectious diseases, with diarrhoea killing more than 500,000 children. Sudan has one of highest prevalence rates of diarrhoea and Global Acute Malnutrition. Objectives: To determine the prevalence of diarrhea and impact of socio-demographic factors on the prevalence among Children under five years, Methodology: a community-based cross-sectional research was carried out to study the prevalence of diarrhoea among children under 5 years of age. Results: The average prevalence of diarrheal cases occurring during the 2 weeks preceding the interview was 35.0 percent (n = 311). The prevalence was higher among boys than among girls (25% and 10%, respectively). Our research showed that sociodemographic factors such as family size, number of &lt; 5 siblings and occupation of the mother were not significantly correlated with diarrheal disease in children under 5 years of age, whereas the research showed a high significance between the educational level of the mother and the diarrheal disease family income in children under 5 years of age. Conclusions: our study showed High prevalence of diarrhea in children under the age of five, with the highest prevalence among male compared with female. correlation highly associated between education of mothers, income levels, and diarrheal disease. Keywords: Prevalence, Diarrhea, sociodemographic, children, Association