Nutritional Questionnaire Research Articles

Poor oral health and anorexia in older rehabilitation patients.

To investigate the association between anorexia and comprehensive oral health status in older inpatients. Anorexia in older inpatients is a major concern, but whether it is associated with oral problems is currently unclear. This cross-sectional study included 160 participants (42.5% men) aged ≥65years (mean age 78.6±7.9) who had been admitted to a rehabilitation hospital. A score of ≤14 on the Simplified Nutritional Appetite Questionnaire for Japanese Elderly indicated anorexia. A score of ≥3 on the Oral Health Assessment Tool (OHAT) indicated poor oral health. Malnutrition was diagnosed according to the criteria set out by the Global Leadership Initiative on Malnutrition. Multivariate logistic regression was used to investigate the association between poor oral health and anorexia and, additionally, which subcategory of the OHAT (represented by a score ≥1) was associated with anorexia. Anorexia and poor oral health status were observed in 86 (53.8%) and 85 (53.1%), respectively. Poor oral health was associated with anorexia after adjusting for potential confounders (adjusted odds ratio [AOR] 2.7; 95% confidence interval [CI]: 1.3-5.9). Additionally, poor status of dentures (AOR 2.6; 95% CI: 1.2-5.7) and poor oral cleanliness (AOR 3.0; 95% CI: 1.4-6.4) were independently associated with anorexia. Poor oral health was associated with anorexia in older inpatients. Detection of poor oral health status using a comprehensive oral health assessment may be useful for anorexic patients. Early detection for poor oral health using comprehensive oral health assessments and oral care and prosthetic treatment may be useful for anorexic patients.

Short Nutritional Assessment Questionnaire as a predictor of undernutrition in cancer patients receiving outpatient chemotherapy: A retrospective study.

The purpose of this retrospective study was to verify whether the revised Short Nutritional Assessment Questionnaire© (SNAQ), a simplified nutritional assessment, could be comparable with serum albumin (ALB) levels as a predictor of undernutrition in cancer patients receiving outpatient chemotherapy. Of 111 patients, 79 patients with baseline ALB levels ≥3.5g/dL were included in the analysis. Patients completed the revised SNAQ, which evaluated items including appetite loss, weight loss, nutritional supplement usage, age, and body mass index, using a maximum of 12 points (a score of ≥3 was marked as severe undernutrition). ALB levels were then monitored for 1 year using patient medical records. There was a significant difference in event-free survival (EFS) when the SNAQ scores were classified into two groups [i.e., scores of ≤3 (SNAQ3) or scores of ≥4 (SNAQ4)]. The 150-day EFS rate was 86.8% and 57.6% for SNAQ3 and SNAQ4, respectively (hazard ratio: 2.92; 95% confidence interval: 1.31-6.51; p=0.009). Based on the Cox proportional-hazards analysis, a higher risk of undernutrition was associated with SNAQ4 (compared with SNAQ3), C-reactive protein levels, and serum transthyretin levels. The revised SNAQ is a predictor of undernutrition in cancer patients receiving outpatient chemotherapy. In particular, it is important that patients with a SNAQ score of ≥4 receive dietary guidance at an early stage as they are likely to become undernourished within a year.

Dynamic Scoring of Appetite Predicts Inpatient Survival in Patients with Acute-on-Chronic Liver Failure

Background and Aim: Decreased appetite is common in patients with liver disease and may be mediated by inflammatory cytokines. Acute-on-chronic liver failure (ACLF) is associated with raised inflammatory cytokines. The aim of this study was to evaluate appetite scoring as a predictor of inhospital survival in patients with ACLF. Methods: In a prospective observational study, consecutive hospitalized patients with ACLF were recruited. Appetite was assessed daily using Simplified Nutritional Appetite Questionnaire (SNAQ). The total SNAQ score ranged from 4 to 20, and a change in SNAQ score ≥1 was considered significant. Patients received standard medical care. Outcome was defined as good when patient was discharged in a stable condition and as poor if patient died or was discharged in terminal state. Results: Seventy-five ACLF patients (mean age 44 years; 66 males) were recruited. The median length of hospital stay was 5 (range: 1–20) days. Outcome was good in 50 and poor in 25 patients. Patients with good outcome had higher Day 1 SNAQ score (median: 12, range: 7–16) than patients with poor outcome (median: 10, range: 5–16) (P < 0.001). The area under receiver operating characteristic curve to predict poor outcome was 0.71 (95% confidence interval [CI]: 0.56–0.86) for Day 1 SNAQ score and 0.90 (95% CI: 0.82–0.98) for SNAQ δ. When divided into tertiles based on Day 1 SNAQ score, the outcome was good for all patients whose appetite improved and poor for all patients whose appetite worsened on Day 3. Conclusion: Appetite (SNAQ) scores on Day 1 and change on Day 3 predict inhospital survival in ACLF patients. SNAQ is a simple bedside tool which may help in guiding therapeutic decisions in ACLF patients. Further larger studies are required to validate these findings.

The influence of olfactory dysfunction on risk of malnutrition is mediated by depressive symptoms in cancer patients undergoing chemotherapy.

Malnutrition is common and detrimental in cancer patients undergoing chemotherapy. There are close associations between olfactory dysfunction, depression, and malnutrition, but how they correlate in cancer patients undergoing chemotherapy remains unclear. Two hundred and one cancer patients undergoing chemotherapy were recruited to this study. Their risk of malnutrition was assessed using the Simplified Nutritional Appetite Questionnaire (SNAQ); odor identification was assessed by Sniffin' Sticks test; self-measurement of olfaction was assessed by Self-reported Mini Olfactory Questionnaire (Self-MOQ); and depressive symptoms were assessed using the Beck Depression Inventory (BDI). Correlation analyses and mediation analyses were used to explore the relationships between olfaction, depression, and risk of malnutrition. The SNAQ score was negatively correlated with the Self-MOQ score and BDI score, and positively correlated with body mass index (BMI) scores and odor identification. The Self-MOQ score was negatively correlated with odor identification and positively correlated with BDI scores, and the duration of chemotherapy was negatively correlated with odor identification. Mediation analyses suggested that BDI scores exhibited a partial mediation effect on the relationship between Self-MOQ score and SNAQ scores. The influence of olfactory dysfunction on risk of malnutrition is mediated by depressive symptoms in cancer patients undergoing chemotherapy. Early intervention of olfactory dysfunction and depressive symptoms may be helpful in reducing the risk malnutrition in cancer patients undergoing chemotherapy.

Impact of quality of life on nutritional risk and malnutrition: a cross-sectional study in elderly patients

Objectives: To investigate prevalence of malnutrition and nutritional risk, related factors, and the association between nutritional status and quality of life in the elderly.
 Material and Method: Cross-sectional study. Participants; elderly (≥65 years) patients without severe hearing and vision impairment and dependency on a bed or wheel chair who admitted internal medicine outpatient clinics. Measurements; the mini nutritional assessment questionnaire, Charlson comorbidity index, the World Health Organization quality of life (WHOQOL-OLD) questionnaire. Intervention; none.
 Results: The study included 532 patients with a mean age of 70.8±5.4 years. The median Mini Nutritional Assessment score was 26, and the total prevalence of nutritional risk and malnutrition was 26.7%. There were significant differences between the nutritional groups regarding the educational, living, and marital status, smoking history, presence of any systemic disease, Charlson Comorbidity Index, and polypharmacy (p

Applicability of the GLIM criteria for the diagnosis of malnutrition in older adults in the emergency ward: A pilot validation study

Acutely ill older adults are at higher risk of malnutrition. This study aimed to explore the applicability and accuracy of the GLIM criteria to diagnose malnutrition in acutely ill older adults in the emergency ward (EW). We performed a retrospective secondary analysis, of an ongoing cohort study, in 165 participants over 65 years of age admitted to the EW of a Brazilian university hospital. Nutrition assessment included anthropometry, the Simplified Nutritional Assessment Questionnaire (SNAQ), the Malnutrition Screening Tool (MST), and the Mini-Nutritional Assessment (MNA). We diagnosed malnutrition using GLIM criteria, defined by the parallel presence of at least one phenotypic [nonvolitional weight loss (WL), low BMI, low muscle mass (MM)] and one etiologic criterion [reduced food intake or assimilation (RFI), disease burden/inflammation]. We used the receiver operating characteristic (ROC) curves and Cox and logistic regression for data analyses. GLIM criteria, following the MNA-SF screening, classified 50.3% of participants as malnourished, 29.1% of them in a severe stage. Validation of the diagnosis using MNA-FF as a reference showed good accuracy (AUC=0.84), and moderate sensitivity (76%) and specificity (75.1%). All phenotypic criteria combined with RFI showed the best metrics. Malnutrition showed a trend for an increased risk of transference to intensive care unit (OR=2.08, 95% CI 0.99, 4.35), and severe malnutrition for in-hospital mortality (HR=4.23, 95% CI 1.2, 14.9). GLIM criteria, following MNA-SF screening, appear to be a feasible approach to diagnose malnutrition in acutely ill older adults in the EW. Nonvolitional WL combined with RFI or acute inflammation were the best components identified and are easily accessible, allowing their potential use in clinical practice.

Physical activity, lifestyle and nutrition as important indicators in the body mass index of children aged 3-6 years in the municipality of Mitrovica

The purpose of this paper was to determine the level of physical activity and healthy nutrition in children aged 3-6 years from Mitrovica. The research was attended by 94 children aged 3 - 6 years from two kindergartens in Mitrovica. As a parameter that measured the weight and height of the children, it was calculated with the standardized procedure of Body Mass Index (BMI) then was calculated according to the standard formula used by (Betterhealth, 2016). Also, after extracting other information through the questionnaire, a quantitative research was conducted through the parents of 94 children who were part of the measurements. A questionnaire was used to collect the data, which was previously translated and adapted into Albanian with permission to use it. The questionnaire was combined by three different questionnaires such as: the lifestyle questionnaire (Wilson et al., 2008), the physical activity questionnaire Pre-PAQ test (Dwyer et al., 2011) and the nutrition questionnaire (Rysha et al., 2017). The data collected during the research were placed in the statistical program SPSS version 21.0, and the presentation of this data was done through a descriptive analysis. The results that came from this research showed that the effect of physical activity, lifestyle and nutrition have quite a high impact on body mass index in children. From the results we saw that the children of the two kindergartens from the municipality of Mitrovica did quite well in terms of physical activity, where in the questionnaires that were answered 89.4% of children were active more than an hour a day by walking and doing other activities. Also, the results regarding the questions in which they were asked about the time that children use the phone were at a satisfactory level, where a large percentage of parents, 77.7%, declared that their children did not use the phone more than an hour a day. While in terms of nutrition, there have been many results which need more detailed analysis and to take preventive measures such as consumption of energy drinks, carbonated beverages, fast food, etc. From the measurement of children aged 3-4 years only one child turned out to be overweight with BMI = 18.7, while the rest came out with BMI with normal limits. As for children aged 4-5 years, one child turned out to be underweight with BMI = 12.4 and one obese with BMI = 21.9 and the others with BMI with normal limits. And out of children aged 5-6 years one child came out overweight with BMI = 17.7 and two others obese, one with BMI = 19.7 and the other BMI = 19.8 and the other children had normal weight (Betterhealth, 2016).

Efficacy and Tolerability of Cyproheptadine in Poor Appetite: A Multicenter, Randomized, Double-blind, Placebo-controlled Study

PurposeCyproheptadine, an antihistamine and antiserotonergic agent, is an appetite stimulant that is efficacious in promoting weight gain in children and adults with poor appetite. Despite numerous studies showing that cyproheptadine achieved positive outcomes, studies documenting its effectiveness on appetite are limited. This study evaluated the efficacy and tolerability of cyproheptadine in adults with poor appetite in South Korea. MethodsPatients aged 19 to 64 years with poor appetite were randomly assigned to receive either cyproheptadine or placebo for 8 weeks. The primary end point was the difference between the groups in change in appetite, as measured by the Korean version of the Edmonton Symptom Assessment System from the beginning to the end of the study period. The secondary end points included effects on weight, anthropometrics, body composition, Simplified Nutritional Appetite Questionnaire–measured appetite, and toxicities. A total of 375 patients were randomly assigned to the two groups (189 cyproheptadine, 186 placebo). FindingsThe cyproheptadine group experienced a mean (SD) change in appetite score of –2.42 (0.12) compared with –2.03 (0.13) in the placebo arm, representing a statistically significant appetite gain in the cyproheptadine group (difference, +0.38 [0.18]; 95% CI, –0.73 to –0.04; P = 0.0307). Patients in the cyproheptadine group experienced significant increases in weight and body mass index. The most common adverse event was somnolence, as predicted. Cyproheptadine was well tolerated, with one serious adverse event (colitis) which was classified as a moderate adverse effect unlikely to be related to the study drug. ImplicationsWe present the largest randomized, double-blind, placebo-controlled clinical trial of cyproheptadine versus placebo in healthy adults with poor appetite using the lowest effective dosage of cyproheptadine. Cyproheptadine is a safe treatment option in patients with poor appetite. Our findings provide important information for the use of cyproheptadine to ameliorate poor appetite in adults. Further randomized studies focused on the effect of cyproheptadine in older populations are needed.

Accuracy of the Simplified Nutritional Appetite Questionnaire for Malnutrition and Sarcopenia Screening among Older Patients Requiring Rehabilitation.

This cross-sectional study aimed to examine the accuracy of the Simplified Nutritional Appetite Questionnaire (SNAQ) and the SNAQ for Japanese Elderly (SNAQ-JE) for the Global Leadership Initiative on Malnutrition (GLIM)-defined malnutrition and sarcopenia screening in older persons. We included 380 inpatients aged ≥65 years (mean age, 79.3 ± 7.9; 60.0% women) and admitted to rehabilitation units. Undernutrition and sarcopenia were diagnosed based on GLIM criteria and the Asian Working Group for Sarcopenia, respectively, using bioimpedance analysis. Poor appetite was defined as an SNAQ score of <14 points and an SNAQ-JE score of ≤14 points. The sensitivity, specificity, and accuracy of these tools for detecting poor appetite for GLIM-defined malnutrition and sarcopenia were assessed. The rates of GLIM-defined malnutrition and sarcopenia were 56.8% and 59.2%, respectively. The number of patients with poor appetite was 94 (24.7%) for the SNAQ and 234 (61.6%) for the SNAQ-JE. The sensitivity and specificity of the SNAQ measured against GLIM-defined malnutrition were 32.9% and 73.1%, respectively, and against sarcopenia were 29.8% and 70.2%, respectively. The sensitivity and specificity of the SNAQ-JE measured against GLIM-defined malnutrition were 82.6% and 51.0%, respectively, and against sarcopenia were 86.0% and 53.7%, respectively. The SNAQ-JE showed fair accuracy for GLIM-defined malnutrition and sarcopenia in older patients admitted to rehabilitation units.

Assessment of the nutritional knowledge of undergraduate pharmacy students: The need to advance nutrition education in the training of pharmacy students

Objective: This study aimed to assess pharmacy students’ knowledge of aspects of nutrition relevant to pharmacy practice and as a means of imparting information through feedback to support learning and professional development. Method: 230 pharmacy students completed a 30-item nutritional informal assessment questionnaire, along with confidence assessment questions. Students were asked about the sources of information they used to answer the knowledge assessment questions, their learning experience with regards to nutrition, and their inclination to learn more about nutrition. Results: Generally, Year four pharmacy students had significantly higher scores than Year two students. However, their overall performance was still lower than that expected of graduate pharmacists. About 75.0% of the study participants agreed that they would like to learn more about nutrition. Conclusion: This study indicates the need to integrate better nutritional education into the undergraduate pharmacy curriculum. The results also suggest a need for Malaysian schools of pharmacy to offer focused learning on nutrition aligned with national health priorities and the competency level in relation to nutrition of pharmacy graduates in the country.

Changes in Serum Levels of Retinol Binding Protein 4, Glucose and Insulin in Adaptation to Nettle Supplementation and Combination Training in Overweight Men With Type 2 Diabetes

Background and Objectives Diabetes is one of the most common chronic diseases in the world, and its increasing growth has led to numerous health and socioeconomic problems in the community. Subjects and Methods In this quasi-experimental study, 40 men with type 2 diabetes were selected from the volunteers based on a nutritional questionnaire, exercise abilities, body mass index, and physical health. They were randomly divided into four groups: exercise, nettle, exercise plus nettle, and control. The resistance training program was performed for 8 weeks, 3 sessions per week with an intensity of 60% to 70% of a maximum repetition, and aerobic exercise with an intensity of 60% to 80% of maximum heart rate. The dose of nettle was 100 mg per day. Blood sampling was performed before fasting and 48 hours after the last training session. Data were analyzed using paired t test and analysis of variance. Results After eight weeks of intervention, there was a significant difference in fasting insulin and glucose levels between the groups (P= 0.001 and P= 0.001, respectively). There was no significant difference in the retinol levels bound to protein 4 between all groups (P= 0.096). Conclusion The results showed that both exercise and nettle interventions reduce fasting insulin and glucose levels, but reducing retinol levels bound to protein 4, exercise and nettle interventions are needed.

Malnutrition screening in head and neck cancer patients with oropharyngeal dysphagia.

Malnutrition in head and neck cancer (HNC) patients is associated with increased morbidity and mortality. The purpose of this study is two-fold: to identify the risk of malnutrition in patients with oropharyngeal dysphagia (OD) secondary to HNC, and to determine the relationship between the risk of malnutrition versus tumor characteristics, treatment modality, time interval (between the end of oncological treatment and swallowing assessment date), level of oral intake, body mass index (BMI), aspiration, pharyngeal pooling, and OD-related quality of life (QoL). The Short Nutritional Assessment Questionnaire (SNAQ) was used to screen patients for the risk of malnutrition. Patients underwent a standardized swallowing examination protocol including an endoscopic evaluation of swallowing. Seventy-five dysphagic HNC patients were included. Forty-eight percent of the patients presented a high risk of malnutrition using SNAQ. The majority of the patients (81.3%) was on a total oral diet. Moreover, BMI did not appear to be a reliable measure to screen for malnutrition as a normal BMI was often associated with an increased risk of malnutrition on the SNAQ. In contrast, patients who were underweight or overweight did not show an association with a high risk of malnutrition. With the exception of BMI, no other patient and tumor characteristics were found to be associated with the risk of malnutrition. This study emphasizes the importance of early nutritional screening in dysphagic HNC patients, as almost half of these patients presented a high risk of malnutrition. Malnutrition screening using SNAQ can identify HNC patients with OD who are at risk of malnutrition and subsequently need to be referred to a dietician for additional nutritional assessment, diagnosis of malnutrition, and nutritional support, even when their BMI is within normal range.

Appetite is an important factor for dietary intake in patients with heart failure - a comparison study

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden, the Swedish Heart and Lung Foundation. Background Loss of appetite and suboptimal dietary intake is common in heart failure, which can result in malnutrition. Malnutrition is associated with poor prognosis and needs to be identified and treated. Despite this, few studies have investigated whether appetite and dietary intake may be intertwined. Purpose To compare dietary intake between heart failure patents with poor and good appetite. Methods A cross-sectional observational study design was used, and patients were recruited from three outpatient heart failure clinics in Sweden. The sample included 186 patients with confirmed heart failure with NYHA class II-IV (Mdn = NYHA class II). The mean age was 70 (SD = 11) years and 119 were male 69%. Dietary intake was assessed by a 3-day self-recorded food diary, including two weekdays and one week-end-day. Components including energy intake, macronutrients, fiber, minerals, vitamins, and water were collected, entered, and calculated by a dietician using the software Dietist XP. Appetite was self-reported using the Council on Nutritional Appetite Questionnaire (CNAQ). The total score ranges between 8-40, low scores indicate poor appetite. Mann-Whitney U test was used to investigate differences in dietary intake between patients with poor appetite (CNAQ ≤ 28) and good appetite (CNAQ &amp;gt; 28). The eta2 (Z2/N-1) was used to estimate the effect size. Results Patients with poor appetite (n = 71, 38%) reported significantly lower intake (p &amp;lt; 0.05) of calories, protein, fat, fiber, vitamin B6 and B12, thiamin, riboflavin, niacin, folate, phosphor, potassium, sodium, magnesium, iron, zinc, selenium and water compared to those with good appetite (n = 115, 62%). The effect size was small (eta2 = 0.02-0.09). Conclusions This study shows that poor appetite contributes to a significant lower intake of essential nutrients compared to patients with good appetite. Health care professionals should assess appetite routinely during heart failure follow-up since poor appetite may contribute to inadequate dietary intake with risk for malnutrition. Future longitudinal studies are required to increase the knowledge whether assessment of appetite can be used to determine malnutrition in heart failure.

Sleep disorders in a sample of Lebanese children: the role of parental mental health and child nutrition and activity

BackgroundSleep habits are an important component of a child’s health and it is affected by parent–child relationship. Also, child’s diet and nutrition appear to be an important factor affecting sleep health. Few studies have addressed the effect of parental emotional disturbance that can leave on children’s sleep. Therefore, the objective of our study was to assess the prevalence of sleep disorders in pre- and school-aged children and evaluate its relation with parental mental health and child’s nutrition and activity.MethodsA cross-sectional study, conducted between October 2020 and January 2021, which enrolled 402 Lebanese parents from all over Lebanon. The questionnaire was distributed online using the snowball technique. The Pediatric Sleep Questionnaire (PSQ) was used to assess pediatric sleep behaviors and the Family Nutrition and physical activity questionnaire was used to assess parental behaviors that might predispose children for obesity.ResultsA total of 76 (19%) children had sleep disorders (PSQ scores of 8 or more). The multivariable analysis showed that higher paternal depression (Beta = 0.079, p = 0.010), maternal depression (Beta = 0.089, p = 0.001) and higher anxiety in the father (Beta = 0.064, p = 0.021) were significantly associated with higher PSQ scores (worse sleep) in the child. Higher Family Nutrition and Physical Activity Screening Tool scores in the child (Beta = -0.161, p < 0.001) was significantly associated with lower PSQ scores (better sleep).ConclusionPaternal anxiety and depression, as well as maternal depression, were factors associated with children’s sleeping disorders. Future studies are needed to assess parental influence on child’s development.

Knowledge, attitude, practice (KAP) and dietary intake of young university athletes following sports nutrition education

Introduction: Nutrition plays a vital role in sports. Athletes must understand the importance of diet and ensure that they meet the nutrient requirements to enhance sports performance. The lack of understanding in sports nutrition will lead to poor dietary practices that can cause detrimental effects on athletic achievements. This study aims to evaluate the effects of knowledge, attitude, and practice (KAP) regarding sports nutrition and dietary intake among young university athletes. Methods: Twenty-one local university athletes (23.8±3.4 years) were recruited, and their anthropometric and socio-demographic data were assessed. All participants attended a 1-day sports nutrition class. The KAP-Sports nutrition questionnaire was administered. Three days of dietary intake were also recorded at the same timepoints among the participants. Results: There was a significant increment (p&lt;0.05) in the mean scores for KAP among the participants. Total energy and total carbohydrate intakes per day were significantly increased (p&lt;0.05). However, overall protein and fat intakes did not improve as the readings were higher than the recommended values. Conclusion: In this study, sports nutrition education improved participants’ KAP, but not the actual dietary intake. Changes in habit require more effort, with extra attention on protein and fat intakes.

A retrospective study on the efficacy of Ninjin’yoeito on fatigue in patients with interstitial pneumonia

IntroductionFatigue, caused by dyspnea associated with progression of interstitial pneumonia (IP), can negatively affect patients' quality of life (QOL). Ninjin’yoeito (NYT), a Chinese herbal medicine, is prescribed for general symptoms of fatigue and for fatigue associated with various respiratory diseases. However, there is a lack of integrated research on the effects of NYT in patients with IP. Therefore, we retrospectively investigated the efficacy of NYT in patients with IP and fatigue. Materials and methodsFrom the IP patients who had taken NYT, 19 who met the following inclusion criteria were included: (1) age of ≥20 years, (2) fatigue, and (3) history of NYT administration. The primary endpoint was fatigue, which was assessed using the Chalder Fatigue Scale (CFS). The secondary endpoints were loss of appetite and dyspnea, which were evaluated using the Simplified Nutritional Appetite Questionnaire (SNAQ) and modified Medical Research Council (mMRC) scores, respectively. All items were measured before and after 12 weeks of NYT administration. ResultsIn the enrolled 19 patients (male, 12; female, 7; mean age, 65.8 ± 12.7 years), the underlying diseases were idiopathic pulmonary fibrosis (n = 8), idiopathic pleuroparenchymal fibroelastosis (n = 5), connective tissue disease-related interstitial pneumonia (n = 2), chronic hypersensitivity pneumonitis (n = 3), and nonspecific interstitial pneumonia (n = 1). The CFS score decreased from 17.1 ± 6.8 before administration to 13.4 ± 5.7 after administration of NYT (p = 0.0389). The SNAQ score did not change markedly. The median mMRC score decreased from 3 to 2, however, the difference was not significant. ConclusionMany subtypes of IP are progressive, and a cure cannot be expected in cases of irreversible lung fibrosis. Therefore, a multifaceted approach to improve and maintain the QOL is needed in addition to the standard of care. This study showed that NYT can improve fatigue and help maintain the QOL in IP patients.

COVID-19: Patient care after discharge from the Intensive Care Unit.

IntroductionThe Ibn Rochd CHU is a tertiary care structure that provides care for the most severe cases of COVID‐19 requiring hospitalisation in intensive care. The objective of study is to describe the complementary medical and psychological care of patients with COVID‐19 in the endocrinology department after a stay in intensive care.Patients and MethodsThis is a descriptive observational study of patients transferred from the intensive care unit to the endocrinology service following a COVID‐19 infection during the period from 17 April 2020 to May 26, 2020. Clinical characteristics of the patients and complications related to COVID‐19 infection were studied; a nutritional assessment using the MNA nutritional status assessment questionnaire; psychological assessment using quality‐of‐life questionnaires (Hamilton depression and anxiety, HAD, SF36, PCLS); a treatment satisfaction questionnaire (TQCMII) and an assessment of patient autonomy by the ADL score.ResultOur study included 41 patients with an average age of 55 years (19‐85 years), a sex ratio M/F of 1.05, 43.9% were diabetic, 34.1% hypertensive, 4.9% asthmatic and 5% obese, and 51.2% were severe and critical cases. The average ICU stay is 8.42 days, requiring intubation in 12.2% of cases. All patients were treated with the Hydroxychloroquine, Azithromycin, vitamin C, zinc and corticosteroid protocol, 14.6% had undernutrition and 65.9% had a risk of undernutrition. The average BMI was 25.34 kg/m2 (17‐42), 61% had experienced weight loss, which was greater than 8 kg in 26.1% of cases, 12.2% of patients were not autonomous, 12.2% had moderate depression, 2.4% severe depression, 14.6% mild to moderate anxiety, 12.2% severe anxiety and 29.3% suffered acute post‐traumatic stress disorder.ConclusionPatients with COVID‐19 are, in addition to the complications from coronavirus infection, vulnerable to undernutrition, psychological and motor complications. Additional care before discharge is essential for better integration of patients into their families.

The Influence of Sport Nutrition Knowledge on Body Composition and Perceptions of Dietary Requirements in Collegiate Athletes

Sport nutrition knowledge has been shown to influence dietary habits of athletes. The purpose of the current study was to examine relationships between sport nutrition knowledge and body composition and examine potential predictors of body weight goals in collegiate athletes. Participants included National Collegiate Athletic Association Division III women (n = 42, height: 169.9 ± 6.9 cm; body mass: 67.1 ± 8.6 kg; fat-free mass: 51.3 ± 6.6 kg; body fat percent: 24.2 ± 5.3%) and men (n = 25, height: 180.8 ± 7.2 cm; body mass: 89.2 ± 20.5 kg; fat-free mass: 75.9 ± 12.2 kg; body fat percent: 13.5 ± 8.9%) athletes. Body composition was assessed via air displacement plethysmography. Athletes completed a validated questionnaire designed to assess sport nutrition knowledge and were asked questions about their perceived dietary energy and macronutrient requirements, as well as their body weight goal (i.e., lose, maintain, gain weight). Athletes answered 47.98 ± 11.29% of questions correctly on the nutrition questionnaire with no differences observed between sexes (men: 49.52 ± 11.76% vs. women: 47.03 ± 11.04%; p = 0.40). An inverse relationship between sport nutrition knowledge scores and body fat percentage (BF%) (r = −0.330; p = 0.008), and fat mass (r = −0.268; p = 0.032) was observed for all athletes. Fat mass (β = 0.224), BF% (β = 0.217), and body mass index (BMI) (β = 0.421) were all significant (p < 0.05) predictors of body weight goal in women. All athletes significantly (p < 0.001) underestimated daily energy (−1360 ± 610.2 kcal/day), carbohydrate (−301.6 ± 149.2 grams/day [g/day]), and fat (−41.4 ± 34.5 g/day) requirements. Division III collegiate athletes have a low level of sport nutrition knowledge, which was associated with a higher BF%. Women athletes with a higher body weight, BF% and BMI were more likely to select weight loss as a body weight goal. Athletes also significantly underestimated their energy and carbohydrate requirements based upon the demands of their sport, independent of sex.

Food frequency questionnaire is a valid assessment tool of quercetin and kaempferol intake in Iranian breast cancer patients according to plasma biomarkers

In epidemiological and clinical studies, the most common nutritional tool to assess dietary flavonol intake is the food frequency questionnaire (FFQ), which needs to contain a detailed list of plant-based foods and be previously validated. Our study aimed to assess the accuracy of dietary flavonol (quercetin, kaempferol, and isorhamnetin) intake from a food frequency questionnaire (FFQ) compared to fasting plasma flavonol concentrations, as biomarkers of exposure, in breast cancer patients. In a consecutive case series, newly diagnosed patients with breast cancer (n = 140) were recruited at Nour-Nejat Hospital, Tabriz, Iran. Flavonol intake was assessed using a validated FFQ. Plasma flavonol concentrations were measured using high-performance liquid chromatography-ultraviolet detection. The accuracy of dietary status was evaluated using a receiver operating characteristic (ROC) and area under the ROC curve (AUC). Dietary status was shown in dichotomous using ROC-cutoff point. The plasma concentrations of quercetin were moderately correlated with dietary intake of quercetin (Spearman's correlation coefficient (rs) = 0.188, P < .05; rpartial= 0.330, P < .01) and plasma concentrations of isorhamnetin (rs = 0.337, P < .001). A linear correlation between dietary levels and plasma concentrations of kaempferol was attained (rpartial = 0.240, P < .05). Using a ROC-cutoff of 61.9 nmol/L for plasma quercetin (test reference), we were able to differentiate between lower and higher consumers of quercetin with an AUCROC-based reference =0.65 (P < .01, sensitivity = 61.8%, and specificity = 60.0%). Using a plasma kaempferol concentration of 60.1 nmol/L (ROC-cutoff), it was possible to detect significant differences between higher and lower intakes of kaempferol (AUCROC-based reference = 0.64, P < .05). The correlations and diagnostic performance with plasma concentrations could present a significant accuracy rate (validity), which seems acceptable for a nutritional questionnaire (FFQ) to assess intakes intake levels of quercetin and kaempferol. An improvement in the accuracy of the flavonol exposure can provide more precise relationship with health outcomes, which may increase their clinical significance.

Measuring the sports nutrition knowledge of elite Australian athletes using the Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaire.

To evaluate the nutrition knowledge of elite Australian athletes, and to obtain feedback from sports dietitians on the Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaires' (PEAKS-NQ) suitability. Sports dietitians from the National Institute Network across Australia recruited athletes to complete the online, 50-item PEAKS-NQ which contained two sections (General Nutrition and Sports Nutrition). Sports dietitians provided feedback on the PEAKS-NQ using a 14-item questionnaire (with two open-ended items). The main outcome measures were nutrition knowledge score and tool suitability (usefulness, acceptability and feasibility) scores. For knowledge scores, independent t-tests, ANOVA and Chi-square tests were used to evaluate differences between groups. Suitability was evaluated using descriptive statistics. Twelve sports dietitians from the National Institute Network in Australia recruited a convenience sample of 240 athletes (21.3 ± 4.3 years, 63.5% female, 63.3% competed internationally). Athletes scored 70.7 ± 10.5%, with better general vs sports nutrition knowledge. Females had higher overall scores (P < .001) with no differences for age or sport played. University-educated athletes scored higher than non-tertiary educated athletes (P=.004). Knowledge gaps were identified in fats (role and food sources), recovery nutrition and managing body composition. Sports dietitians rated suitability of PEAKS-NQ positively with complete agreement on 8 of 12 items. Athletes have greater understanding of general nutrition compared to sports nutrition concepts and may benefit from education on applying nutrition in sports-specific contexts. Sports dietitians' responses showed PEAKS-NQ was a highly acceptable, feasible and useful measure.