Need For Nutritional Intervention Research Articles

Nutritional status of children with cerebral palsy in Ghana.

Limited knowledge on nutritional epidemiology in Ghanaian children with Cerebral Palsy (CP) necessitates a comprehensive investigation for an improved understanding of malnutrition in this population. We aimed to describe the epidemiology of malnutrition among children with CP in Ghana. The study used data collected as part of the Ghana CP Register (GCPR). The GCPR is an institution-based surveillance of children with CP aged < 18 years in Ghana. Between October 2018 and April 2020, N = 455 children with CP were registered. Data were collected on (i) weight, length or height, mid-upper-arm-circumference of children with CP; (ii) socio-demographic characteristics; (iii) motor type and topography, gross motor function classification system level (GMFCS); (iv) associated impairments; (v) educational and rehabilitation status for each child. Descriptive and bivariate analyses were performed. Mean and standard deviation age of the registered children at assessment was 5.9 ± 4.1 years, and 42.1% were female. Two-thirds of the children had ≥ one form of undernutrition (underweight or severely underweight: 38.9%, stunted or severely stunted: 51.2%, thin or severely thin: 23.8%). In the adjusted analysis, low maternal education, GMFCS-IV, speech impairment and epilepsy significantly increased the odds of undernutrition among participating children (aOR: 2.6 [95% CI:1.3-5.4]; 2.2 [95% CI:1.0-4.8]; 2.0 [95% CI:1.1-3.6]; 2.9 [95% CI:1.1-7.5] respectively). The high malnutrition rate indicates an urgent need for nutrition interventions and translational research to improve nutritional status and prevent adverse outcomes among children with CP in Ghana. Our study contributes important data and a framework to develop guidelines and evidence-based interventions for children with CP in Ghana.

Casuística em endocrinologia veterinária: Análise dos atendimentos de 263 casos de cães e gatos durante o ano de 2023

This article presents a detailed analysis of 263 cases treated in the endocrinology sector of the Anclivepa Mazei Unit during the year 2023, exposing a significant change in the profile of endocrine diseases in dogs and cats. The results indicated a marked prevalence of obesity, reaching 20,53% of cases, and diabetes mellitus, representing 19,39%. Notably, the distribution by sex revealed a predominance of females (57.79%), of which a large proportion were castrated (80.26%). In terms of age groups, the highest proportion of animals treated were over 8 years old (68.82%). Furthermore, the analysis of the body score condition showed that, in addition to obese animals, 28.52% were overweight and 33.08% maintained an ideal weight, highlighting the need for nutritional intervention and weight management. Comparatively, the observed frequency of hypothyroidism was only 4.94%, marking a significant contrast with previous studies that highlighted this condition as one of the most prevalent in endocrine clinical settings. This study suggests that changes in pet lifestyle, influenced by owner practices, along with advances in diagnostic methods, play a crucial role in observed endocrine health trends. We also highlight the critical need to educate owners in regards to proper feeding and exercise practices for their animals, in addition to the importance of advancing the diagnosis and treatment of these conditions.

Value of the modified Patient-Generated Subjective Global Assessment in indicating the need for nutrition intervention and predicting overall survival in patients with malignant tumors in at least two organs.

Although the Patient-Generated Subjective Global Assessment (PG-SGA) is a reference standard used to assess a patient's nutrition status, it is cumbersome to administer. The aim of the present study was to estimate the value of a simpler and easier-to-use modified PG-SGA (mPG-SGA) to evaluate the nutrition status and need for intervention in patients with malignant tumors present in at least two organs. A total of 591 patients (343 male and 248 female) were included from the INSCOC study. A Pearson correlation analysis was conducted to assess the correlation between the mPG-SGA and nutrition-related factors, with the optimal cut-off defined by a receiver operating characteristic curve (ROC). The consistency between the mPG-SGA and PG-SGA was compared in a concordance analysis. A survival analysis was used to determine the effects of nutritional intervention among different nutrition status groups. Univariable and multivariable Cox analyses were applied to evaluate the association of the mPG-SGA with the all-cause mortality. The mPG-SGA showed a negative association with nutrition-related factors. Individuals with an mPG-SGA ≥ 5 (rounded from 4.5) were considered to need nutritional intervention. Among the malnourished patients (mPG-SGA ≥ 5), the overall survival (OS) of those who received nutrition intervention was significantly higher than that of patients who did not. However, the OS was not significantly different in the better-nourished patients (mPG-SGA < 5). Our findings support that the mPG-SGA is a feasible tool that can be used to guide nutritional interventions and predict the survival of patients with malignant tumors affecting at least two organs.

Qualité de l’alimentation par l’indice KIDMED et troubles des conduites alimentaires chez une population pédiatrique présentant une surcharge pondérale

Introduction. Obesity has become one of the most prevalent nutritional disor-ders, characterized by excess adipose tissue with physical and psychosocial conse-quences, affecting negatively quality of life. Objectives. To study the diet quality and identify eating disorders (TCA) in a pediatric population suffering from overweight. Population and methods. Thirty patients (16 girls/14 boys), aged 5 to 17 years, were recruited from the Pediatric Department of Oran University Hospital. Anthropometric parameters were measured. Physical activity level as well as diet quality by the KIDMED index were evaluated. The Binge Eating Scale (ADO-BED), and the Child-Three Factor Eating Questionnaire (CTFEQ) were used to identify possible eating disorders. Results. Obesity was noted in 77% of the pediatric population, while 23% were overweight. Only 40% of patients practiced sporting activity, while 60% had sedentary behavior on weekends. The KIDMED score calculation showed low adherence to the Mediterranean diet (RM), in 83% of the population. Although the ADO-BED questionnaire indicated a low risk of binge episodes in 97% of patients, CTFEQ data revealed that 67% had signs of loss of eating control, 7% had cognitive restriction, and 7% had emotional eating. Conclusion. Poor dietary habits, associated with sedentary lifestyle, are observed in the studied overweight pediatric population. These results highlight the need for nutritional intervention and psychological care for these patients.

Dietary diversity and nutritional status of adults living with HIV during the COVID-19 era.

The coronavirus Disease 2019 (COVID-19) pandemic has brought about unique challenges in healthcare and nutrition, particularly for people living with HIV (PLHIV). Understanding their dietary patterns and nutritional status is crucial for developing targeted interventions and improving health outcomes. Therefore, this study assessed the dietary diversity and nutritional status of PLHIV during the COVID-19 era. We adopted a facility-based cross-sectional study design to enroll 220 PLHIV from two hospitals in the Central Region of Ghana. Dietary intakes were assessed using 24-hour recall. Anthropometric and body composition data were collected with a stadiometer and a body composition monitor. Dietary diversity was evaluated using the FAO's Individual Dietary Diversity Score (IDDS). Data analysis was conducted with SPSS version 20. Significance level was set p-value less than 0.05. A significant proportion (33.2%) of PLHIV had low dietary diversity, with the majority (55.5%) categorized as needing dietary improvement. Approximately 2 out of every 10 of the participants were identified as underweight. Participants aged 40 to 59 years were more likely to exhibit higher dietary diversity (adjusted odds ratio (AOR) = 1.966, 95% Confidence Interval (CI): 1.045-4.987). Participants who consumed meals at least three times daily were more likely to have a high IDDS (AOR = 1.641, 95% CI: 1.221, 8.879). Employed participants (public sector and private sector) were also more likely to have a high IDDS compared to unemployed participants (AOR = 1.448, 95% CI: 1.028-3.042; AOR = 1.165, 95% CI: 1.030-9.329, respectively). Factors associated with undernutrition included being female (AOR = 1.829, 95% CI: 1.294, 3.872) and first-line antiretroviral therapy ART (AOR = 1.683, 95% CI: 1.282-2.424). The study emphasizes the need for nutritional interventions for PLHIV, particularly during crises. It advocates for a policy collaboration to address food insecurity and promote resilient health outcomes.

Plasma Carotenoids and Polyphenols and Their Association with MetS: The Need for Nutritional Interventions.

Metabolic syndrome (MetS) is characterized by increased pro-oxidative stress and a chronic inflammation state and their consequent alterations. Several studies have highlighted the protective effect of carotenoids and polyphenols in MetS patients. This study aimed to evaluate the plasma level of selected carotenoids and polyphenols and to determine their relationship with MetS severity, MetS components, and inflammatory markers in Polish adults with metabolic disorders. It was designed as a cross-sectional study. The final study group comprised 275 adults, including 158 women and 117 men. Data were collected on the frequency of consumption of selected food groups. Anthropometric measurements and blood samples were taken to determine the concentration of carotenoids, polyphenols, and indicators (parameters) of metabolic disorders. Plasma concentrations of selected carotenoids and polyphenols were low in adults with MetS. The highest concentrations of carotenoids and polyphenols in the blood were observed for lutein and phenolic acids (including gallic and p-coumaric acids). Nevertheless, a correlation was found between the individual bioactive compounds and MetS components. In terms of the lipid profile, our study showed that the plasma of the selected carotenoids and polyphenols positively correlated with HDL cholesterol (zeaxanthin; total carotenoids), LDL cholesterol (chlorogenic acid), triglycerides (lycopene), and the total cholesterol (kaempferol). We found that the level of CRP as a marker of inflammation negatively correlated with the concentration of zeaxanthin. In our study group, no relationship was found between the dietary antioxidant intensity and the variables studied, which may be attributed to the low frequency of consumption of the sources of bioactive compounds, such as carotenoids and polyphenols, but also to the metabolic disorders. Further research is needed to determine whether these associations are causally related to the metabolic syndrome or are a result of the pathologies of the syndrome or improper diet with a low intake of vegetables and fruit.

Nutritional Assessment in Early Allogenic Hematopoietic Stem Cell Transplant Patients, a Cross-Sectional Study

Background Our study aims to comprehensively assess nutrition status and malnutritional prevalence in early allogenic hematopoietic stem cell transplant (allo-HSCT) patients. Methods This single-center, cross-sectional study included 171 patients within the 90 days post-transplantation (from September 2019 to April 2020). Data collected included demographic, 3 day 24-h diet record, a Patient-Generated Subjective Global Assessment (PG-SGA) tool, laboratory tests, anthropometric indices, and body composition. Results One hundred and seventy-one patients with a mean age of 37.8 ± 11.3 and a male to female ratio of 102 to 69 were included. According to PG-SGA, 115 (67.3%) indicated the critical need for nutritional intervention and symptom management (PG-SGA score > 9). Forty-three (43.3%) of patients had experienced insufficient intakes of energy according to a 24-h diet record. Our study found that 120 (70.2%) patients had a body fat percentage and high triacylglycerol (64.9%). Reduced free fat mass index and low hand-grip strength were found in 133 (77.78%) and 104 (60.81%), respectively. The prevalence of malnutrition was 24.6% and the prevalence of sarcopenia was 13.5%. Conclusion Although the prevalence was not high, this research has demonstrated a high risk of malnutrition and a lower muscle mass in early allo-HSCT. Furthermore, our study confirmed body composition assessment would be an excellent way to identify malnutrition precisely.

Assessment of Nutritional Status and Health Perception among Male Inmates in Israeli Prisons.

The nutritional and health perceptions of inmates are crucial to their overall well-being. However, limited research has been conducted on this topic. This study aimed to assess the nutritional and health perception state of male inmates in eleven prisons in Israel. A cross-sectional study was conducted between February and September 2019 with 176 voluntary participants. Structured questionnaires were used to collect data on socio-demographic characteristics, healthy habits, subjective health status, and prison situation variables. The study found that the prevalence of overweight (40%) and obesity (18.1%) among 18-34-year-old inmates was significantly higher than in the reference Israeli population. Short detention periods (up to one year) predicted less weight gain, while older age predicted poorer health status. Better emotional status significantly predicted better subjective health status among male inmates. There is a need for nutrition interventions to improve the health of inmates. The significant weight gain during incarceration and the associated lower health index and stress highlights the importance of increasing knowledge and promoting a healthier lifestyle in incarceration as early as possible and continuing over time.

Nutritional interventions in the framework of a person-centered model of health care and geroprotection

The existing system of prevention of age-related diseases that focused on cohort-based risk factors shows insufficient effectiveness; thus, practicable methodology of health promotion compliant with the principles of P4 medicine, with a special focus on nutritional interventions, is needed. The study outlines an algorithm of nutritional interventions designed in accordance with the principles of person-centered organizational model of healthcare. The algorithm is based on the modern concept of exposome and its influence on the key mechanisms of accelerated aging and pathogenesis of age-related diseases. The proposed approach to personalized nutritional interventions is implemented in three steps: (1) the need for nutritional intervention is identified through the evaluation of the signs and symptoms of health impairment and accelerated aging that have very probable association with suboptimal nutrition, (2) individual exposome factors are evaluated as potential sources of health problems, and (3) first-line nutritional interventions are selected and implemented. The algorithm focused on eliminating the shortcomings of the diagnosis-centered organizational model of healthcare prevailing worldwide: to enable early detection of distress, use of the most effective and affordable interventions (diet and nutrition), and maximum involvement of the patient in health management. The algorithm bears a good potential of automation through decision support for patients regarding health. The use of original questionnaires and patient-centered data reduces the cost and expands the possibilities of scaling the algorithms of intervention. The algorithm can become the basis for the wide introduction of the principles of predictive, personalized, and participatory prevention of age-related diseases.

Assessment of nutritional status of oncology patients at hospital admission: A Portuguese real-world study.

BackgroundNutritional status in patients with cancer has a determining role in the evolution of the disease and tolerance to treatments. Severity of undernutrition impacts morbidity and mortality in cancer patients and can limit patient response to the optimal therapies if nutritional issues are not appropriately addressed and managed. Despite the importance of malnutrition for the clinical evolution of oncology patients, there is not yet a universally accepted standard method for evaluating malnutrition in such patients. The aim of this study was to stratify the nutritional status of inpatients at an Oncology Department.MethodsThis is an observational study with 561 cancer patients, assessed at admission to a Medical Oncology Department from November 2016 to February 2020. All patients were considered eligible. Non-compliant and/or comatose patients were excluded. Nutritional status was assessed using the PG-SGA, BMI classified with the WHO criteria, and calculation of the percentage of weight loss in the previous 3–6 months.ResultsA total of 561 patients (303 F: 258 M; mean age 65 ± 13 years) were included. One-third of the patients, n=191/561 (34%), lost 6% of their weight in the month prior to admission and 297/561 (53%) patients lost 10.2% of weight in the previous 6 months. Mean BMI was 24.1 ± 5.8 kg/m2; N = 280/561 (50%) patients had regular BMI according to the WHO criteria. N = 331/561 (59%) patients reported eating less in the month prior to admission. N = 303/561 (54%) had moderate/severe deficits of muscle and adipose compartments. The PG-SGA identified 499/561 (89%) patients as moderately/severely malnourished, of which 466/561 (83%) patients scored ≥9 points, meeting criteria for a critical need for nutritional support. Fifteen percent of patients scored >4 points, indicating a need for directed therapy for symptom control and only 1% scored <2 points (maintenance nutritional counseling).ConclusionIn this oncological setting, a higher proportion of patients were nutritionally-at-risk or with moderate/severe malnutrition. The large majority of patients in this study presented with a critical need for nutritional intervention. These findings highlight the need for an integrated assessment of nutritional status at patient referral. This will allow early and timely nutrition care, which is recommended to prevent or reverse further deterioration of the condition and to optimize treatment administration.

Nutritional status of children with autism spectrum disorder at caring centers for autistic children in Vietnam

Objectives: To describe nutritional status of children with ASD at caring centers for autistic children in Vietnam in 2021. Methods: This research is conducted at 18 centers raising children with ASD in Vietnam during two weeks in December 2021. A cross-sectional design was applied. Participants: The research was conducted on children who diagnosed with ASD and their caregivers. Data was collected by REDcap systerm through online interview. Results: According to height for age of Z-score, stunted and severely stunted children had the same percentage (12.1%) of under 5 years old group and in the group of 5-15 years old children, the percentage were 6.8% and 19.3% respectively. Moreover, in compliance with weight for age of Z-score, the percentage of underweight (6.7%) was five times higher than severely underweight ones (1.3) in the 5 years old group. And classification by BMI for age Z-Score, the rate of overweight and obesity was 30.9% and 37.3% respectively in two age groups. Conclusion: The rate of malnutrition is not high with underweight, stunted and the rate of malnutrition wasted mainly being moderate. However, the rate of overweight and obesity was significantly higher in both age groups. These findings emphasize the need for nutrition interventions to prevent malnutrition in the under 5-year-old children and overweight-obesity in the older group.

A comparative analysis of the nutritional status of children attending early childhood development centres in Gauteng, North-west and Limpopo province, South Africa

The nutritional status of children is a valuable indicator of health status and can indicate inequalities in health faced by the populations. The preschool period is the critical stage of active development and growth of physical, social, and mental well-being of children. Children eating patterns and food preferences develop over a lifetime and are influenced by family, ethnicity, and social environment. The purpose of the study was to do a comparative analysis of the nutritional status of children aged 2 to 5 years attending early childhood development centres in South Africa. A quantitative descriptive design was used to assess the nutritional status of 872 children attending preschool in the Soshanguve, Moretele, and Makhuduthamaga areas, and data was collected using a structured, researcher-administered questionnaire. The variables collected were age, sex, weight, height, mid-upper arm circumference. Gender and age-specific BMI cut-off points were used to determine the nutritional status. The study sample consisted of 872 preschool children, of which 422 (48%) were males, and 450 (52%) were females. The prevalence of overweight; obesity, and undernutrition were 7.7%, 3.4%, and 3.2%, respectively. The findings of this study showed that in all ECDs areas, most of the male children had normal weight. In this study, the age of children (p=0.007), as well as ECDs area (p=0.000), influenced the BMI of the children (p=0.007), and that overweight was higher amongst older children, 4 &amp; 5 years from rural ECD area. The prevalence of overweight amongst children was 4.2% (Soshanguve), 9.3% (Moretele), and 9.6% (Makhuduthamaga), and the prevalence of underweight amongst children was 3.9% in Soshanguve, 2.7% in Moretele, and 3.1% in Makhuduthamaga. The prevalence of underweight was higher in urban ECD areas as compared to ECDs in rural areas. In this study, overnutrition was more prevalent as compared to undernutrition. Therefore, there is a need for nutritional intervention which promotes a healthy lifestyle in preschools. Key words: Weight, height, preschool children, nutritional status, overnutrition, undernutrition

Reevaluation of the Merits and Demerits of Prophylactic Gastrostomy in Patients with Head and Neck Cancer Undergoing Concurrent Chemoradiotherapy

AbstractConcurrent chemoradiotherapy (CCRT) is one of the standard treatment strategies for patients with locally advanced head and neck squamous cell carcinoma (HNSCC). Prophylactic percutaneous gastrostomy (pPEG) has been reported to be useful for nutritional intervention during CCRT. On the other hand, disadvantages such as complications of gastrostomy itself and long-term PEG dependence have also been reported. In the present study, we conducted a retrospective review of the data of HNSCC cases treated with CCRT and reevaluate the merit and demerit of pPEG. Patients with pharyngeal carcinoma treated by CCRT between 2015 and 2020 were enrolled for this analysis. In this study, we limited our analysis to those who received the following treatments: Radiation therapy was planned for a total dose of 70 Gy, and the concomitant chemotherapy regimen was high-dose (100 mg/m2) CDDP administered intravenously once every three weeks (three cycles). A total of 54 patients who underwent pPEG met the inclusion criteria. Fifteen patients who had received similar treatment without pPEG during the study period were used as a control group for comparison. The results revealed that in the pPEG group, there were fewer cases with a weight loss of 10% or more, nutritional intervention was started relatively early, and the hospitalization period after the end of CCRT was shorter as compared with the status in the non-PEG group. In regard to PEG tube dependence, the rate of PEG tube usage at 6 months after CCRT was relatively low, at approximately 13%. No significant factor was identified in this study regarding the need for nutritional intervention by routes, including PEG tube, nasogastric tube, and total parenteral nutrition, other than oral intake. In the review of the literature, it seemed difficult to make a simple comparison due to the lack of uniformity in the selection criteria for pPEG, patient background, and treatment intensity.

Assessment of nutritional risk in elderly adults of a senior residence – a case study

Elderly adults have reduced appetite and energy expenditure, and possible malnutrition is related to the decline in biological and physiological functions, as well as its consequences. The aim of this study was to assess the nutritional status and malnutrition risk in elderly adults living in a senior residence. A cross-sectional observational analysis was carried out between February and March 2019 in a private senior residence in which the complete Mini Nutritional Assessment (MNA) was applied. It was observed that of the total of 45 participants, 5 individuals had a normal nutritional status, 18 had malnutrition and 22 were at risk. Malnutrition was related to a decrease in intake in the last 3 months (p=0.015) or to the fact that they experienced some type of psychological stress or acute illness in the same period (p=0.023). A higher incidence of malnutrition was also found in bedridden individuals or those in wheelchairs (p&lt;0.001), as well as in patients with severe dementia (p=0.010), with the presence of skin lesions or bedsores (p=0.006), weight loss in the previous 3 months (p=0.003), and decreased fluid consumption (p=0.017). In conclusion, in this residence we verified that the malnutrition and malnutrition risk values are high, highlighting the need for nutritional intervention. Keywords: Elderly adults, Malnutrition, Nutrition assessment, Nutritional status

Evaluating malnutrition in cancer patients in the emergency department.

Malnutrition is an important contributing factor to mortality in cancer patients. Several scoring systems can be used to evaluate malnutrition in cancer patients. We hypothesized that one or more of these scoring systems should be used to assess malnutrition in emergency departments (EDs). This prospective observational study was conducted in the ED of a tertiary care center. From October 1, 2019, to March 31, 2020, we prospectively collected data on cancer patients aged 18 and over who were evaluated in the ED but did not present with any nutrition-related complaint, and not had any prior nutritional support. Malnutrition levels were determined using the Patient-Generated Subjective Global Assessment (PG-SGA1) instrument. The patients were grouped according to the presence and degree of malnutrition (PG-SGA categories A and B vs PG-SGA category C) and their need for nutritional intervention according to the Nutritional Triage Recommendation Scores (NTRS2 < 9 vs NTRS ≥9). Twelve female (31.5%) and 26 male (68.5%) cancer patients, with a mean age of 70.29±11.49years, were enrolled in the study. According to the PG-SGA, 84.2% of the patients were at risk for malnutrition, and 97.4% required nutritional intervention. Thirty patients (78.9%) had experienced problems with eating in the preceding two weeks. There were statistically significant differences in these patients' body mass indexes (BMIs) (25.46±4.3kg/m2 vs 20.95±3.66kg/m2, p<0.05) and ages (64.6±10.5years vs 74.9±10.3years, p<0.05) according to the PG-SGA. There were also statistically significant differences between the patients' BMIs (25.73±3.51kg/m2 vs 22.11±4.50kg/m2, p<0.05), according to the NTRS. There was no relationship between whether the patients had undergone surgery to remove tumors (p>0.05), chemotherapy (p>0.05), or radiotherapy (p>0.05) according to the PG-SGA and NTRS. Malnutrition is common in cancer patients. These patients may be malnourished even if their BMI is within normal limits. Malnutrition can be detected and evaluated in the ED using instruments such as the PG-SGA. We suggest that evaluation for malnutrition should be a standard component of patient care in the ED.

Nutritional Status Impairment Due to Neoadjuvant Chemotherapy Predicts Post-Radical Cystectomy Complications.

Background: Radical cystectomy (RC) is the standard treatment for muscle invasive bladder cancer (MIBC). Neoadjuvant chemotherapy (NAC) is associated with improved patient survival. The impact of NAC on nutritional status is understudied, while the association between malnutrition and poor surgical outcomes is well known. This study aims to examine the association between NAC, nutritional status impairment, and post-operative morbidity. Materials and Methods: We included MIBC patients who underwent RC and received NAC from multiple academic centers in Israel. Cross-sectional imaging was used to measure the psoas muscle area and normalized it by height (smooth muscle index, SMI). Pre- and post-NAC SMI difference was calculated (represents nutritional status change). The primary outcomes were post-RC ileus, infection, and a composite outcome of any complication. Logistic regression models were fit to identify independent predictors of the outcomes. Results: Ninety-one patients were included in the study. The median SMI change was −0.71 (−1.58, −0.06) cm2/m2. SMI decline was significantly higher in patients with post-RC complications (−18 vs. −203, p < 0.001). SMI change was an independent predictor of all complications, ileus, infection, and other complications. The accuracy of SMI change for predicting all complications, ileus, infection, and other complications was 0.85, 0.87, 0.75, and 0.86, respectively. Conclusions: NAC-related nutritional deterioration is associated with increased risk of complications after RC. Our results hint towards the need for nutritional intervention during NAC prior to RC.

Nutritional profile of cancer patients treated at an outpatient oncology center in the south region of Brazil

To evaluate the nutritional profile of cancer patients treated at an oncology center in South Brazil. This is a descriptive, exploratory and sectional study that was developed in a process that involved 100 patients aged between 18 and 75 years old, suffering from cancer. The anthropometric variables studied were weight, height, Body Mass Index (BMI), arm circumference (AC), arm muscle circumference (AMC), triceps skinfold (TSF) and corrected arm muscle area (cAMA). For subjective nutritional assessment, we used the Patient-Generated Subjective Global Assessment (PG-SGA). Nearly half of the patients evaluated had a critical need for nutritional intervention. There was a statistically significant association between cAMA and marital status, age and gender; between AC and age, gender and staging; between AMC and staging; between BMI and marital status and age; and between TSF and marital status. Patients diagnosed with IV stage had the lowest values for nutritional variables. There was no significant association between nutritional status of patients obtained by the PG-SGA instrument and sociodemographic characteristics. Malnutrition should be diagnosed as soon as possible, aiming at early intervention and improving survival and quality of life. Therefore, early nutritional assessment in cancer patients is required, combining subjective and objective methods.

Supportive care needs among older Mexican adults with metastatic cancer.

198 Background: Supportive care (SC) in oncology includes the prevention and management of cancer- and treatment-related symptoms and adverse effects. Previous studies have shown that SC needs may differ depending on clinical stage, patients’ gender, comorbidities, and chronological age. The goal of this study was to describe the SC needs of older adults with metastatic cancer enrolled in a SC patient navigation program at Instituto Nacional Ciencias Medicas Salvador Zubiran, an academic, public hospital in Mexico City, and to compare them with those of their younger counterparts. Methods: This was a secondary analysis of a prospective study which included adult patients with newly diagnosed metastatic solid tumors. The patients’ SC needs and symptoms were assessed by a patient navigator using validated questionnaires, and then a multidisciplinary team created a personalized SC plan to address those needs. Potential SC interventions included pain management, physical therapy, geriatric assessment/intervention, mitigation of caregiver burden, depression/anxiety management, and nutritional assessment/intervention. Patients were divided into two age groups (≥65 and &lt; 65 years), and differences in SC needs between groups were compared using Chi square, Student’s T and Mann-Whitney tests. Results: Out of 337 patients with metastatic solid tumors included between April 2018 and October 2020 (median age 64 years, range 19-94 years), 164 (48%) were aged ≥65 years. Among older patients (≥65 years), 130 (79%) had an abnormal geriatric screening and were referred for a comprehensive geriatric assessment. Older adults were more likely than younger patients to report malnutrition needing nutritional assessment/intervention (81 vs. 65%, p &lt; 0.01) and to experience fatigue needing a referral to physical therapy (77 vs. 66%, p = 0.03). We found no differences in moderate/severe pain (45 vs 47%, p = 0.79), depression/anxiety (69 vs 77%, p = 0.09), caregiver burden (42 vs 34%, p = 0.12) or sleep disturbances (54 vs 64%, p = 0.07) between groups. However, the total number of SC needs was significantly higher for older adults than for their younger counterparts (4.9 vs. 3.9, p &lt; 0.01). Conclusions: The results of this study show that older adults with metastatic solid tumors have more SC needs and require more symptom management interventions than their younger counterparts. The need for nutritional interventions and physical therapy was significantly higher among older patients, thus, these components should be considered an essential part of geriatric oncology multidisciplinary programs. Oncologists treating older adults with advanced cancer should screen for SC needs among older patients in order to provide targeted interventions.

Mother-to-Child Transmission of Human T-Cell Leukemia Virus Type 1: Mechanisms and Nutritional Strategies for Prevention.

Simple SummaryMother-to-child transmission (MTCT) of human T-cell leukemia virus type 1 (HTLV-1) is a major cause of adult T-cell leukemia (ATL). Owing to the poor prognosis of ATL and the fact that more than one million people have been infected with this virus, the HTLV-1 antibody screening test was established in Japan in 2010 for all pregnant women to detect carriers and prevent MTCT. Because breastfeeding is the most common route of postnatal MTCT, exclusive formula feeding is widely used as a measure to prevent MTCT. Recently, it was reported that there is no obvious difference in the efficacy of short-term breastfeeding for ≤3 months in preventing MTCT compared to that in exclusive formula feeding, and that a duration of breastfeeding that does not exceed four months can be effective for preventing MTCT.Approximately 95% of mother-to-child transmission (MTCT) of human T-cell leukemia virus type-1 (HTLV-1) is derived from prolonged breastfeeding, which is a major cause of adult T-cell leukemia (ATL). Exclusive formula feeding (ExFF) is therefore generally used to prevent MTCT. A recent cohort study revealed that 55% of pregnant carriers chose short-term breastfeeding for ≤3 months in Japan. Our meta-analysis showed that there was no significant increase in the risk of MTCT when breastfeeding was carried out for ≤3 months compared with ExFF (pooled relative risk (RR), 0.72; 95% confidence interval (CI), 0.30–1.77), but there was an almost threefold increase in risk when breastfeeding was carried out for up to 6 months (pooled RR, 2.91; 95% CI, 1.69–5.03). Thus, short-term breastfeeding for ≤3 months may be useful in preventing MTCT. Breastmilk is the best nutritional source for infants, and any approach to minimizing MTCT by avoiding or limiting breastfeeding must be balanced against the impact on the child’s health and mother–child bonding. To minimize the need for nutritional interventions, it is necessary to identify factors that predispose children born to carrier mothers to MTCT and thereby predict MTCT development with a high degree of accuracy.

O-160 The effect of 6-month nutritional intervention on the anthropometric, biochemical, and reproductive profile of Lebanese women with Polycystic ovarian syndrome

Abstract Study question This study aims to assess the efficacy of, design, and implement a public health nutrition intervention designed to enhance healthy eating and life style management among PCOS patients. Summary answer After 6 months, this intervention decreased initial body weight by 5%-10%, increased pregnancy rate by 70%, and significantly improved psychological, metabolic and endocrine profiles. What is known already Polycystic ovary syndrome (PCOS) is a common endocrinopathy among women in their reproductive age and is characterized by imbalanced hormones, irregular menses, and fertility problems. PCOS has been linked to obesity and insulin resistance in many studies and this association suggests that a weight management intervention consisting of a lifestyle modification (LSM) program might improve the metabolic, reproductive and biochemical profiles of PCOS patients, especially that studies showed that weight loss among PCOS women reduces hyperandrogenism and thus improve ovulation. Study design, size, duration The study is a randomized control trial studying the effect of a 6 month weight management program with nutritional guidelines. 588 female participants attending the obstetrics/gynecology clinic, aged between 18 and 45 years old, were recruited. There were two obese/overweight (experimental and control) and two lean subgroups (experimental and control). Experimental groups received the intervention under study while the controls were given the usual programs (except for the non-PCOS lean group that received no intervention). Participants/materials, setting, methods Data on socio-demographic variables, nutritional status, physical activity, psychological and medical status were collected using a pre-validated questionnaire. Data on biochemical variables were collected from blood analysis. Data collection took place at baseline, after 3 and 6 months from intervention. Patients who were in the intervention groups were subject to nutritional education/counseling (following the proposed guidelines) as well as the structural weight loss program for obese patients. Main results and the role of chance After 6 months, PCOS women lost 8.2 kg (P = 0.001), non-PCOS women lost 11.6kg among while controls gained weight. The biochemical, psychological and reproductive profile showed significant improvements among PCOS women. In fact, the percentage weight loss of 10 % in the overweight/obese intervention group showed significant changes in some of the biochemical markers (total cholesterol FBS, CRP, LDL, and testosterone) (P &amp;lt; 0.001). PCOS patients who got the intervention had a shorter time to ovulation, than those who didn’t and had more average number of cycles during the 6 months study duration (P &amp;lt; 0.001). Regarding the pregnancy rate for PCOS patients, it was shown that it increased significantly with intervention patients in all groups compared to controls (from 0% to 70% compared from 0% to 15 % respectively). Limitations, reasons for caution Limitations of the study includes inability to objectively assess patient compliance with innervation and inability to follow up with the participants for a longer period of time (12 months or more) for long term outcomes. Wider implications of the findings The findings of our study are in synchrony with previous studies that implied that nutritional and life style interventions improved PCOS outcome. This suggests the need for nutritional interventions and guidelines on additional to the traditioned gynecological treatment to improve PCOS outcome. Trial registration number Not applicable