Nutritional Outcomes Research Articles

Association between geospatial disparities in food security with weight loss and nutritional outcomes of metabolic surgery.

Food insecurity has been linked to higher rates of obesity. It has also been shown to diminish the effectiveness of weight loss strategies, including intensive lifestyle interventions. One essential component of food insecurity ishaving a geospatial disadvantage in access to healthy, affordable food, such as living within a food desert. This study aims to determine if food insecurity also impacts weight loss and nutritional outcomes in patients who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Clinical outcomes of patients who underwent RYGB or SG at Cleveland Clinicor affiliate regionalhospitals in the United States from 2010 to 2018 were collected. Modified Retail Food Environmental Index (mRFEI) data was collected from the Center for Disease Control and merged with patient census tract data, allowing the patient cohort to be divided into those living in areas identified as food secure (mRFEI > 10%), food swamps (mRFEI = 1-10%), or food deserts (mRFEI = 0). Postoperative weight change was evaluated with quadratic growth mixture models and stratified by surgery type. A total of 5097 patients were included in this study cohort, including 3424 patients who underwent RYGB and 1673 who underwent SG. The median duration of follow-up was 2.3years (IQR 0.89-3.6years). Food security status was not associated with postoperative weight change (RYGB p = 0.73, SG p = 0.60), weight loss nadir (RYGB p = 0.60, SG p = 0.79), or weight regain (RYGB p = 0.93, SG p = 0.85). Deficiencies in nutritional markers at 1-2years after surgery were also not significantly different between food security groups. Despite the established relationship between food insecurity and obesity, food insecurity does not negatively impact weight loss or nutritional outcomes following RYGB or SG, demonstrating metabolic surgery as a powerful and equitable tool for treating obesity. IV.

Peri-urban agriculture and household food and nutrition security around Eldoret, Kenya

Rapid urbanisation in low- and middle-income countries, which has encroached on agricultural lands but has not been consistently accompanied by corresponding improvements in water and sanitation services, has raised questions about its impact on the food and nutrition security of households living in transitional, peri-urban areas. Through an analysis of survey data collected from 518 households living around the town of Eldoret, Kenya, we investigate the existing links between peri-urban households’ engagement in agriculture, their dietary behaviour, and their children’s nutrition outcomes. We find that peri-urban households engaged in agriculture, particularly in crop growing and in the sales of their agricultural produce, have more diverse and nutritious diets than agriculturally non-engaged households, all other things being equal. However, a significant improvement in children’s health outcomes is observed in these households only when coupled with improved water, sanitation, and hygiene conditions.

The Impact of Dietary Intake and Nutritional Status on Birth Outcomes Among Pregnant Adolescents: A Systematic Review

Birth outcomes have been linked to the overall maternal general health including nutrition as well as maternal age during pregnancy. Compared to adults, delivery outcomes during adolescence are poor. Nutrient intake and nutrition status during adolescent pregnancy may be linked to birth outcomes. This review aims to identify the association between dietary intake and nutrition status of pregnant adolescents and their maternofetal outcomes. Literature search on nutrient intake and nutritional status of pregnant adolescents (aged 11-19 years) which identified 17 English papers from 1995 to 2019 was reviewed. Papers that did not include data on birth outcomes in relation to nutrient intake or nutritional status were excluded. The review showed that most micronutrients with the exception of Riboflavin, vitamins B12 and C were below the recommended levels whilst macronutrients levels were above the recommended levels. Energy intakes were also below the recommended levels. Most studies presented normal hemoglobin levels in the first trimester of pregnancy but these levels decreased as pregnancy progressed to the third trimester leading to a high prevalence of anemia. Well-regulated provision and intake of micronutrient supplementation and nutrition education to improve healthy eating habits will significantly reduce poor birth outcomes such as low birth weights (LBW), still births, preterm deliveries, small or large for gestational age (SGA and LGA) and intrauterine growth restrictions in pregnant adolescents. This review provides to a large extent evidence to support the importance of adolescent nutrition and birth outcomes. There is the need to implement policies to improve adolescent nutrition through a multisectoral approach.

Effects of a Specialized Oral Nutritional Supplement with Dietary Counseling on Nutritional Outcomes in Community-Dwelling Older Adults at Risk of Malnutrition: A Randomized Controlled Trial.

This study investigated the effects of oral nutritional supplements (ONSs) along with dietary counseling (DC) in community-dwelling older adults at risk of malnutrition. In this randomized controlled trial, 196 older adults who were at risk of malnutrition, as identified by the Malnutrition Universal Screening Tool (MUST) were randomly assigned to receive ONSs twice daily with DC (intervention) or DC-only (control) for 60 days. Primary outcome was change in body weight from baseline to day 60. Nutritional status, energy, and macronutrient intakes were measured. A significant larger weight gain was observed in the intervention compared to the control from baseline to day 60 (1.50 ± 0.22 kg, p < 0.0001). The intervention group also showed a significantly greater increase in weight at day 30 (p < 0.0001). Intakes of energy and macronutrients were significantly higher in the intervention group compared to the control group at both days 30 and 60 (all p < 0.0001). The odds of achieving better nutritional status were significantly higher in the intervention group than in the control group (OR:3.9, 95% CI: 1.9, 8.2, p = 0.0001). ONS supplementation combined with DC significantly improved body weight and nutritional outcomes in community-dwelling older adults at risk of malnutrition.

Religious Dietary Practices: Health Outcomes and Psychological Insights From Various Countries.

Religious beliefs profoundly influence dietary practices across diverse cultures and communities, guiding what foods are acceptable, how they are prepared, and the timing of consumption. This narrative review examines the intricate relationship between religious dietary practices and their health and psychological well-being implications. Religious dietary practices, deeply rooted in various cultural and historical contexts, significantly influence followers' food consumption patterns. This narrative review aims to discuss how religions such as Judaism, Islam, Hinduism, and Buddhism prescribe specific dietary laws and guidelines, impacting nutritional intake and health outcomes. Furthermore, it delves into the psychological mechanisms, such as cognitive dissonance and social identity theories, that underpin adherence to these dietary practices. The review also highlights the role of community and social support in reinforcing dietary habits within religious contexts, contributing to mental health and social cohesion. By synthesizing insights from nutrition, psychology, and religious studies, this narrative review aims to provide healthcare providers with culturally sensitive dietary advice, ultimately improving patient care and promoting holistic health. Religious dietary practices provide numerous health benefits, including reduced risks of chronic diseases and enhanced mental well-being, achieved through disciplined and conscientious eating habits. Nevertheless, these practices also pose nutritional challenges that necessitate meticulous management and dietary planning.

A five domains assessment of sow welfare in a novel free farrowing system.

The Maternity Ring was developed as a free farrowing alternative to crates that preserved space whilst providing the sow with unrestricted movement. This experiment aimed to apply the Five Domains model to assess sow welfare in the Maternity Ring in comparison with the farrowing crate. Eighty-eight sows were housed in a farrowing crate (FC) and 83 in a Maternity Ring (MR), and measures collected focussed on nutrition, environment, health, behaviour, and mental state outcomes. MR sows consumed less feed than FC sows (total feed intake: 93.8 ± 3.06 kg vs. 111.2 ± 3.13 kg; p < 0.001) but had reduced P2 backfat loss during lactation (0.0 ± 0.11 vs. 1.2 ± 0.11, p < 0.001). Fewer frustrated and pain-related behaviours during farrowing were observed in MR sows (bar biting: FC 3.3 ± 2.12 vs. MR 0.5 ± 0.29 events, p = 0.038, and back leg forward: FC 227 ± 50.7 vs. MR 127 ± 26.4 events, p = 0.019), and a decreased proportion of MR sows had facial injuries after farrowing (10% CI [5, 20] vs. 67% CI [47, 95], p < 0.001). More FC sows had udder damage at weaning (70% CI [48, 97] vs. 10% CI [6, 24], p < 0.001), and their piglets were medicated more frequently when compared to those in MR (51% CI [40, 61] vs. 30% [21, 41], p = 0.008). MR sows tended to have a higher reaction score to piglet processing (MR 2.0 ± 0.38 vs. FC 1.2 ± 0.27, p = 0.094) and had more contact with piglets once the procedure was complete than FC sows (13.5 ± 2.55 vs. 6.9 ± 1.26 events, respectively, p = 0.016). Whilst there was no difference in anticipation of a feeding event (p > 0.05), MR sows displayed a reduced startle response to an aversive noise stimulus at day 18 (FC 2.8 ± 0.35, MR 0.7 ± 0.16, p < 0.001). Using the Five Domains framework, sows housed in the MR during farrowing and lactation have improved welfare than those in FC and can be thought of as being in a positive affective state.

Women's empowerment, household dietary diversity, and child anthropometry among vulnerable populations in Odisha, India.

Women's empowerment has been promoted by researchers and development practitioners as one of the most promising strategies to address widespread hunger and malnutrition. However, the relationship between women's empowerment and dietary diversity and child nutrition has rarely been studied among vulnerable populations or individuals at greater risk of poor physical and social health status. Moreover, the effects of different domains of women's empowerment on nutritional outcomes, including dietary diversity and child anthropometry, have rarely been examined, especially with panel data. Using two rounds of panel data from 1900 households and fixed effects regression models, we analyze the effect of women's empowerment on household dietary diversity score (HDDS) and child anthropometry among the particularly vulnerable tribal groups in Odisha, India. We also estimate the effects of various decision-making domains of women's empowerment on HDDS and child anthropometry to understand which empowerment domains matter for nutrition. Results show that women's empowerment is positively associated with HDDS (coef. 0.41 food groups; p < 0.1) and reduces the prevalence of underweight (coef. 39%; p < 0.05) and wasting (coef. 56%; p < 0.1) in children but has no effect on the prevalence of child stunting. Women's empowerment in agricultural input use; output sales; income; food purchases; and credit, group membership, and employment contribute to improved dietary diversity and child nutrition. We conclude that women's empowerment contributes to improved dietary diversity and child nutrition and is a promising strategy to improve farm household diets and child nutrition among vulnerable populations. Strengthening women's empowerment through the promotion of women's access to land and other agricultural inputs, market participation, access to information, capital, and credit is important.

Baseline Nutritional Status and Rehabilitation Progress in Individuals Requiring Inpatient Rehabilitation: A Retrospective Cohort Study

ObjectiveTo evaluate the relationships between baseline nutritional status, medical events (MEs), and rehabilitation outcomes in individuals undergoing inpatient rehabilitation (IR). DesignA retrospective single center cohort study. SettingAn IR ward. ParticipantsThis study included 409 patients (mean age, 80 years; men, 170 [42%]) undergoing IR for hospital-associated deconditioning, neurologic disorders, or musculoskeletal diseases. Participants were grouped according to the Controlling Nutritional Status score at admission: normal nutrition (NN): 0 to 1, mild malnutrition (MM): 2 to 4, and moderate/severe malnutrition (M/SM): 5 to 12. InterventionsNone. Main Outcome MeasuresThe primary outcomes included MEs leading to death or acute illness requiring transfer to other hospitals for specialized treatments. The secondary outcomes were the rehabilitation efficiency scores (changes in Functional Independence Measure [FIM] score divided by length of stay) for motor function (FIM-M) and cognitive function (FIM-C). ResultsAmong the 409 participants, 300 (73%) were malnourished at admission. The adjusted hazard ratios (95% confidence interval) for MEs in the MM and M/SM groups relative to the NN group were 1.48 (0.67-3.27) and 0.98 (0.34-2.81), respectively. No significant differences were observed among the 3 groups in FIM-M efficiency scores (mean ± SD, NN: 0.49±0.51 vs MM: 0.41±0.57 vs M/SM: 0.44±1.06, P=.7) or FIM-C efficiency scores (0.04±0.06 vs 0.04±0.06 vs 0.08±0.4, P=0.1). Analysis of covariance showed no significant association between MM or M/SM group and FIM-M efficiency score (beta coefficient = -0.038, P=.6; beta coefficient = 0.15, P=.1, respectively) or FIM-C efficiency score (beta coefficient = 0.004, P=.8; beta coefficient = 0.047, P=.08, respectively). ConclusionNo significant associations were observed between the baseline nutritional status and MEs, FIM-M efficiency score, or FIM-C efficiency score in individuals undergoing IR.

Associations between maternal nutritional status, haemodynamic parameters and delivery outcomes in low-risk pregnancies: a prospective observational study

Associations between maternal nutritional status, haemodynamic parameters and delivery outcomes in low-risk pregnancies: a prospective observational study

Low levels and determinants of appropriate complementary feeding practices among children aged 6–23 months from Tigray, Ethiopia: a community-based cross-sectional study

IntroductionComplementary feeding is considered appropriate when introduced timely at 6 months of age, and where it fulfils the minimum meal frequency, minimum dietary diversity and minimum acceptable diet. Sufficient evidence...

A Geospatial Framework of Food Demand Mapping

Spatial mapping of food demand is essential for understanding and addressing disparities in food accessibility, which significantly impact public health and nutrition. This research presents an innovative geospatial framework designed to map food demand, integrating individual dietary behaviors with advanced spatial analysis techniques. This study analyzes the spatial distribution of eating habits across Lithuania using a geospatial approach. The methodology involves dividing Lithuania into 60,000 points and interpolating survey data with Shepard’s operator, which relies on a weighted average of values at data points. This flexible approach allows for adjusting the number of points based on spatial resolution and sample size, enhancing the reliability and applicability of the generated maps. The procedure includes generating a structured grid system, incorporating measurements into the grid, and applying Shepard’s operator for interpolation, resulting in precise representations of food demand. This framework provides a comprehensive understanding of dietary behaviors, informing targeted policy interventions to improve food accessibility and nutrition. Traditional food spatial mapping approaches are often limited to specific polygons and lack the flexibility to achieve high granular detail. By applying advanced interpolation techniques and ensuring respondent location data without breaching privacy concerns, this study creates high-resolution maps that accurately represent regional differences in eating habits. The methodology’s flexibility allows for adjustments in spatial resolution and sample size, enhancing the maps’ validity and applicability. This novel approach facilitates the creation of detailed food demand maps at any granular level, providing valuable insights for policymakers and stakeholders. These insights enable the development of targeted strategies to improve food accessibility and nutrition. Additionally, the obtained information can be used for computer simulations to further analyze and predict food demand scenarios. By leveraging spatial data integration, this study contributes to a deeper understanding of the complex dynamics of food demand, identifying critical areas such as food deserts and swamps, and paving the way for more effective public health interventions and policies aimed at achieving equitable food distribution and better nutritional outcomes.

Swallowing impairment in older persons following burn injury: Validation of incidence and predictive factors for dysphagia

BackgroundEarly retrospective data identify that dysphagia is common in older persons with burn injury, suggesting a rate of 47 %, and that it is associated with medical, burn, and nutritional outcomes. AimsTo prospectively (1) explore the incidence, (2) describe associations, and (3) evaluate risk factors for dysphagia in patients ≥ 75 years old hospitalised with burn injury. MethodsAll patients > 75 years old admitted to Concord-Repatriation-General-Hospital with burn injury over 4 years (2019–2023) were assessed for dysphagia on presentation and were continually monitored throughout their admission. Burn injury, demographic, and nutritional data were prospectively captured and analysed for association with dysphagia. ResultsSixty-two patients (33 male) aged 75–95 years (median=83 years) were recruited. Dysphagia was identified in 50 %. Dysphagia was associated with burn size (p = 0.002), pre-existing cognitive impairment (p = 0.000), hospital length of stay (p = 0.001), in-hospital complications (p = 0.000), feeding dependence (p = 0.002), nutritional status (p = 0.013) and enteral feeding duration (p = 0.030). Cognitive impairment was the most sensitive predictor for dysphagia at 100 % (specificity=29 %, NPV=100 %, PPV=59 %). Development of secondary comorbidities was less sensitive at 52 % (NPV 65 %), but was associated with high specificity (90 %) and PPV (84 %). ConclusionsOne in every two patients ≥ 75 years admitted with burn injury will demonstrate dysphagia during their hospital admission. Those with pre-existing cognitive impairment are most at risk.

The Impact of Mid-Day Meal Scheme on the Nutritional and Educational Status among Rural School Children in Bihar, India

In India, in particular in rural regions, the Mid-Day Meal Scheme (MDMS) has been crucial in treating malnutrition and improving access to education for schoolchildren. The Mid-Day Meal Scheme's implementation and efficacy in the Bihar district of Arwal are both investigated in this study. this study highlights how significantly the Mid-Day Meal Scheme has improved the nutritional and academic outcomes of rural schoolchildren in Bihar while also highlighting areas that need more focus for programme improvement. A representative sample of rural schools was used to gather data using a quantitative methodology. By using many sorts of indicators, including attendance, dropout rates, and academic achievement, the study evaluated the nutritional and educational status of children. The result illustrate the benefits of the programme by showing improvements in height, weight, classroom hunger, enrollment, retention, attendance, and a decrease in dropout rates. On the other hand, assessments regarding academic ability and attention span were less favourable. When parents and instructors were asked about their opinions of the classroom hunger and attendance, both groups of people said that things had much improved. On the subject of academic achievement and attention span, differences were identified. The report highlights the need for additional study to fully comprehend the Mid-Day Meal Scheme's long-term effect.

Knowledge and practice of essential nutrition actions among pregnant women in Ibadan, South-western Nigeria

Background: Maternal nutrition during the first 1,000 days has important influences on children’s nutrition and pregnancy outcomes. This study therefore assessed the knowledge, attitude and practice of essential nutrition actions among pregnant women utilizing antenatal care services in Ibadan municipality, South-western Nigeria. Methods: A descriptive cross-sectional study was conducted among pregnant women (15-49 years) receiving antenatal care (ANC) services across selected private and public health facilities. A semi-structured questionnaire was used to collect data on optimal dietary intake, prevention and control of anaemia and promotion of supportive lifestyle and care, according to the essential nutrition actions framework. Results: The mean age of respondents was 29.85±4.89 years while the mean gestational age of pregnancy at respondents’ ANC booking was 18.33±6.12 weeks. About one-third (33.60%) of the respondents had poor knowledge scores (mean knowledge score 5.70±1.50 out of 10), with no significant difference across type of health facility. Mean attitude score was 13.76±2.44 out of 20, while practice was generally poor (mean practice score 4.80±1.34 out of 10). Respondents attending larger tertiary hospitals for ANC had higher knowledge and practice compared to those who attended smaller primary health care centers/mission homes. Additionally, the time of booking, parity, and type of antenatal care center were statistically significant to knowledge and practice (p&lt;0.05). Conclusions: Antenatal care is still a valid platform for delivering maternal knowledge and encouraging practice of essential nutritional actions. It is recommended that expertise in tertiary hospitals be diffused to lower cadre of health care facilities to further strengthen ANC service delivery.

Effects of sanitation on child growth in Serbian Roma communities

Abstract Poor sanitation may be associated with growth faltering, but empirical evidence on the association between household sanitation infrastructure and child nutrition has been mixed. This article assessed whether sanitation infrastructure is associated with growth penalties for Roma children. Design This is a Roma nationally representative population-based study. Proxies of child nutritional outcomes included children’s height-for-age Z scores below two standard deviations from the median of WHO’s reference population. Multiple and logistic regressions estimated the association between the type of toilet usage, outcomes, and sociodemographic determinants. Setting Data were from UNICEF’s fifth and sixth Multiple Indicator Cluster Surveys for Serbian Roma settlements. Subjects Children aged 0–24 (n = 1,150) and 25–59 (n = 2,024) months born to women aged 15–48 years were included in this study. Results About 16% of children resided in households with no toilet service, and 23% of children were stunted. Roma children aged 25–59 months in households with no toilet service and in rural areas were more likely to be stunted and of significantly shorter stature than their counterparts. Children up to 24 months of age were not affected by the type of toilet, likely due to protective effects of breastfeeding. Child’s age, number of siblings, and birth spacing negatively influenced growth outcomes, while maternal age, birthweight above 2.5 kg, and being a female mitigated against poor growth outcomes. Conclusions The relationship between the type of toilet and growth outcomes among Roma children varied with age and area: having no toilet and living in rural areas were associated with compromised child growth for children aged 25–59 months. Maternal and child characteristics additionally accounted for children’s growth.

PREDICTING UNDERNUTRITION RISK FACTORS USING MACHINE LEARNING TECHNIQUES IN NIGERIAN UNDER FIVE CHILDREN

Childhood undernutrition remains a critical global health challenge with far-reaching consequences. This study developed and compare predictive models for three key indicators of under-five child undernutrition in Nigeria: stunting, wasting, and underweight. By leveraging various machine learning (ML) algorithms, we identified the most significant socio-demographic determinants of these nutritional outcomes. The study utilizes data from the Nigerian Multiple Indicator Cluster Survey (MICS6) 2021, a comprehensive nationwide survey. Four ML algorithms were employed to predict the risk factors for the under-5 child nutritional status: k-nearest neighbors (KNN), random forest (RF), decision tree (DT), and logistic regression (LR). These models were evaluated and compared based on their predictive performance. The study encompasses households across Nigeria, providing a broad representation of the country's diverse population. Preliminary analysis reveals significant regional disparities in the prevalence of stunting, wasting, and underweight among Nigerian children. Among the four ML algorithms tested, the KNN model demonstrated superior predictive capability across all evaluation metrics, including accuracy (89.65%, 95.00%, 80.04%), precision (91.02%, 87.79%, 93.53), recall (99.98%, 100%, 100%), and F1-score (94.44%, 98.83%, 88.60%). This outperformance was consistent for all three undernutrition indicators. The KNN model, identified as the most effective predictor, highlighted several key determinants of childhood undernutrition. These factors varied somewhat across the three outcomes but commonly included: household wealth index, geopolitical zone, source of drinking water, child age, birth size, mother's education level, and residential area (urban/rural) among others. This study demonstrates the efficacy of machine learning approaches, particularly the KNN algorithm, in predicting and understanding the determinants of children undernutrition in Nigeria. The findings provide valuable insights for targeted interventions and policy formulation. These results can inform evidence-based decision-making and resource allocation in Nigeria's efforts to improve child nutrition and achieve related Sustainable Development Goals.

An Overview of Livestock Role in Ensuring Food and Nutrition Security: The Case of Ethiopia

This review aimed to deliver and document summarized information on the contribution of livestock to food and nutrition security, both generally and specifically in the case of Ethiopia. Livestock have made both positive and negative contributions to food and nutrition security. Positively, they provide high biological value, palatable, and nutrient-dense food sources such as milk, meat, and eggs for human consumption. They also offer quick income, employment, source of fuel, social functions, raw materials for industry (hide and skin…. etc.), input for soil fertility (manure) and draft power, indirectly contributing to stable food cultivation. However, livestock also pose negative impacts on food and nutrition supply by competing with humans for grains, utilizing fodder crop lands, emitting greenhouse gases, and transmitting zoonotic diseases to humans. In Ethiopia, trends in livestock populations and food production levels reveal disparities between actual consumption and productivity compared to available resources. Energy, protein, and fat supply from the livestock sector has increased from 2010 to 2021. Yet, the country's per capita consumption of dairy, meat, and eggs remains below global averages, exacerbating undernutrition, particularly in rural areas. Livestock products are rich in high-quality protein and essential micronutrients crucial for growth and development, especially in children and infants. Enhancing nutritional outcomes in Ethiopia necessitates addressing barriers to livestock output and promoting the consumption of livestock-derived foods. Tackling underlying issues impeding livestock productivity is equally vital as efforts to enhance productivity and ensure access to livestock-based foods.

Geriatric nutrition risk index in the prediction of all-cause and cardiovascular mortality in older adults with hyperlipidemia: NHANES 1999–2018

BackgroundMalnutrition is linked to a higher risk of unfavorable outcomes in various illnesses. The present investigation explored the correlation between inadequate nutritional condition and outcomes in older individuals diagnosed with hyperlipidemia.MethodsThe geriatric nutritional risk index (GNRI) was used to evaluate the nutritional status. All patients were divided into two groups according to GNRI. A Kaplan-Meier analysis was used to assess the survival rates of different groups at risk of malnutrition. In addition, GNRI was used in COX proportional risk regression models to evaluate its predictive effect on both overall mortality and cardiovascular mortality among patients with hyperlipidemia. Furthermore, the study employed restricted cubic splines (RCS) to examine the nonlinear correlation between GNRI and mortality.ResultsThe study included 4,532 elderly individuals diagnosed with hyperlipidemia. During a median follow-up duration of 139 months, a total of 1498 deaths from all causes and 410 deaths from cardiovascular causes occurred. The Kaplan-Meier analysis demonstrated significantly poorer survival among individuals at risk of malnutrition, as indicated by the GNRI. In the malnutrition risk group, the modified COX proportional hazards model revealed that a decrease in GNRI was associated with a higher risk of all-cause mortality (HR=1.686, 95% CI 1.212-2.347) and cardiovascular mortality (HR=3.041, 95% CI 1.797-5.147). Furthermore, the restricted cubic splines revealed a non-linear association between GNRI and both all-cause mortality and cardiovascular mortality (p-value for non-linearity = 0.0039, p-value for non-linearity=0.0386).ConclusionsIn older patients with hyperlipidemia, lower levels of GNRI are associated with mortality. The GNRI could potentially be used to predict all-cause mortality and cardiovascular mortality.

The evolution of nutritional care in preterm infants with a focus on the extreme preterm infant.

The evolution of nutritional care in preterm infants, particularly those classified as extremely preterm, has undergone significant advancements in recent years. These infants, born at less than 28 weeks of gestation, face unique challenges related to their elevated nutrient requirements, underdeveloped organ systems and minimal reserves, posing a need for timely and specialised nutritional strategies. Historically, the nutritional management of preterm infants focussed on short-term goals to promote survival. In recent years, the focus has shifted to the quality of nutrient provision to optimise neurodevelopment and longer-term health outcomes. This review highlights the shift from a generalised nutritional approach to a robust, evidence-based approach for preterm infants, acknowledging the intricate interplay between nutrition, holistic care and developmental outcomes. As neonatal care continues to evolve, ongoing research will refine nutritional interventions, optimise growth and enhance the long-term health outcomes of these vulnerable infants.

Race as social determinant of growth and body composition among infants born very preterm.

Racism leads to disparities in health outcomes. Our objective was to determine if black race was independently associated with differences in fat accretion at discharge in a large cohort of very preterm infants (32 weeks of gestation or less). De-identified demographic, anthropometric and body composition data were collected from seven neonatal units around the United States. Weight, length, and head circumference z-scores at birth and at the time of body composition assessment or hospital discharge were calculated. The median gestational age and birthweight for this cohort (n = 888) were 29 weeks [IQR, 27-30] and 1167 g [SD, 354], respectively. The study population included 53% black preterm infants. Birthweight was lower in black preterm infants compared with white infants (1112 ± 334 g vs. 1228 ± 366 g; p < 0.0001). After adjusting for birthweight, gestational age, and birthweight-for-age z-score, black preterm infants had more weight gain (adjusted mean difference: 0.5 g/kg/day; p = 0.03) but not higher BF% z-scores at hospital discharge (adjusted mean: 1.2 vs. 1.3; p = 0.14) than white infants. After adjusting for covariates, black race was associated with higher weight gain velocity but not higher BF% z-scores. This study presents findings from a large-scale multicenter cohort. Racial differences were observed in birth weight and the rate of weight gain; however, these differences were not associated with dissimilarities in body composition outcomes. Understanding nutrition and growth outcomes across racial groups is necessary to combat racial disparities in the neonatal intensive care unit (NICU).