Nutrition Unit Research Articles

Why do we Need to Evaluate Therapeutic Diets for Cardiac Patients Admitted in Healthcare Institutions?

Cardiovascular Disease (CVD) remains the leading cause of mortality in the Philippines. Proper nutrition is vital in managing and treating these patients, influencing their hospital stay and long-term outcomes. Cardiac patients admitted in healthcare institutions often rely on nutrition and dietetics services including therapeutic meals provided by the facilities depending on the needs of the client. A poorly planned therapeutic diet can exacerbate underlying cardiac conditions, leading to further complications which can prolong hospital stay and readmission. There is no written dietary standards or guidelines that are developed for Filipinos with cardiac health concerns. The dietary regimens intended for cardiac patients and its complications are adapted from other therapeutic diets used in other population (e.g., Mediterranean Diet, Dietary Approach to Stop Hypertension Diet (DASH Diet), American Heart Association (AHA) Diet, etc.). Although based on anecdotal evidence, therapeutic diets intended for cardiac diet patients in the Philippines are usually tagged as the Low Salt, Low Fat Diet and/or Fat-Controlled Diet. According to Hersberger et al (2021), individualized nutrition support as opposed to regular hospital diet significantly reduces the risk of complications and mortality among cardiac patients. In the Philippines, nutrition care is usually provided by the Nutrition and Dietetics Unit of the hospital manned by Registered Nutritionist-Dietitians where therapeutic diets are prepared centrally and delivered in the patient’s room. In 2016, the Department of Health implemented the Administrative Order 2016-0020 suggesting that the minimum meal allowance of at least PHP. 150.00 per patient per day for meals should be imposed. According to Casas et al (2023), the quality of inpatient meals in the Philippine public hospitals had a great difficulty setting up the necessary structures for good nutrition care abiding the nutrition care standards set in 2016. These limitations could potentially exacerbate the absence of guidelines intended for Filipino Cardiac patients needing a dietary regimen that will suit their dietary needs and requirements. These concerns were supported by the findings of Simon and Elopre (2023), indicating the need for improvements in nutritional adequacy and adherence to CVD guidelines of hospital therapeutic diets in selected hospitals in Mindanao. Having these complex issues revolving around therapeutic diets for cardiac patients, a more in-depth evaluation of therapeutic diets should be conducted in the Philippines. In addition, there is a need for consistent monitoring and evaluation as designed in the nutrition care plan as mandated by the Department of Health Administrative Order 2019-003. It is imperative that all public and private hospitals in the country shall provide the necessary logistics and management support to adhere to the Nutrition Care process for hospitalized patients. The guidelines should be also developed that will help the hospitals in the country to serve appropriate therapeutic diets for cardiac patients which are supportive to shorter stay in the hospital and avoidance of readmission for a better quality of life. Hence, there is a need for a purposeful evaluation of therapeutic diets for cardiac patients as a critical component of comprehensive cardiac care. It ensures that the dietary plan supports the patient’s medical needs, contributes to recovery and helps prevent future complications that support better quality of life even after discharge in healthcare institutions.

Application of a good manufacturing practices checklist in food and nutrition units of a socio-educational foundation in the state of Pará, Brazil

The production and supply of meals must occur in an orderly and categorized manner, as quality in processing can negatively impact consumer health. In this context, evaluating good manufacturing and handling Practices through tools that can identify risks and minimize hazards is essential to ensure safe food. Thus, the aim of this study was to evaluate Good Manufacturing Practices in Food and Nutrition Units (UANS) responsible for meals served to adolescents in a Socio-educational Foundation located in the State of Pará, Brazil. A total of 15 UANS were evaluated, of which 6 operated with centralized meal preparation and 9 with decentralized meal preparation. For this purpose, the checklist recommended by the National Health Surveillance Agency, described in RDC No. 275 of October 21, 2002, was applied. The results showed that 33.33% (2/6) of the centralized UANS, which prepare meals within the Socio-educational Unit itself, were classified as Group 1, meaning they were deemed suitable with minor adjustments. However, 100% (9/9) of the decentralized UANS, where meal preparation occurs outside the Socio-educational Unit and only distribution takes place, were classified as Group 2, requiring more significant adjustments related to building infrastructure, facilities, movable equipment, utensils, handlers of raw materials, ingredients, and packaging. Adjustments for non-compliant items are necessary to ensure the provision of safe food from a sanitary perspective for the adolescents served.

The Positive Effect on Preterm Infants' Feeding of Human Milk During Hospitalization and at Discharge after the Opening of a Personalized Nutrition Unit.

Background: Pasteurized donor human milk must be provided when mother's own milk (MOM) is not available for preterm infants. There are concerns that human milk banks (HMBs) and the use of donor milk may potentially reduce breastfeeding rates. Objective: To compare feeding during hospitalization and at discharge before and after the opening of a HMB and to evaluate the proportion of milk provided by mothers of premature babies, comparing the intake of MOM in infants born of donor and no donor mothers. Methods: Retrospective observational cohort study. Data on milk intake and feeding at discharge of newborns <1,500 grams and/or 32 weeks gestational age. Results: There were significant differences in the intake of preterm formula (PF) between the two groups in the first 28 days of life (87.8% versus 54.2%; p = 0.000) and at discharge (34% versus 18.2%; p = 0.000). The intake of MOM during hospitalization (90.5% versus 100%; p = 0.008) and exclusive breastfeeding at discharge (18.7% versus 61.8%; p = 0.000) increased and the intake of PF (71.4% versus 33.8%; p = 0.000) and exclusive PF (EPF) at discharge decreased (27.5% versus 7,3%; p = 0.000) for babies whose mothers were or were not donors. Mothers of preterm babies donated 57.6% of the total milk received by the milk bank. Conclusion: After the opening of a HMB, there was a decrease in PF intake during hospitalization and an increase in MOM intake at discharge in preterm babies, especially for those whose mothers were milk donors.

Ten-year trends in clinical characteristics and outcome of children hospitalized with severe wasting or nutritional edema in Malawi (2011-2021): Declining admissions but worsened clinical profiles.

Severe acute malnutrition (SAM) constitutes a substantial burden in African hospitals. Despite adhering to international guidelines, high inpatient mortality rates persist and the underlying contributing factors remain poorly understood. We evaluated the 10-year trend (2011-2021) in clinical factors and outcomes among children with severe wasting and/or nutritional edema at Malawi's largest nutritional rehabilitation unit (NRU). This retrospective study analyzed trends in presentation and outcomes using generalized additive models. The association between clinical characteristics and mortality or readmission was examined and key features were also related to time to either mortality or discharge. 1497 children (53%, females) were included. Median age at admission (23 months, IQR 14, 34) or anthropometry (i.e., weight-for-age, height-for-age and weight-for-height) did not change over the 10-years. But the prevalence of edema decreased by 40% whereas dehydration, difficulty breathing, and pallor became more common. Yearly HIV testing increased but positive-detection remained around 11%. Reporting of complete vaccination dropped by 49%, and no reduction in 'watch' antibiotic usage was detected. Overall admissions declined but mortality remained around 23% [95%CI; 21, 25], and deaths occurred earlier (5.6 days [95%CI; 4.6, 6.9] in 2011 vs. 3.5 days [95%CI; 2.5, 4.7] in 2021; p<0.001). Duration of hospitalization was shortened and readmissions surged from 4.9% [95%CI; 3.3, 7.4] in 2011 to 25% [95%CI; 18, 33] in 2021 (p<0.001). Age, wasting, having both dehydration and diarrhea, or having vomiting, cough, or difficulty breathing were associated with mortality but these associations did not show any interaction over time. Over 10 years, mortality risk remained high among hospitalized children with SAM and coincided with worsened clinical presentation at admission and increased readmission. Longitudinal data from major NRUs can identify shifts in clinical profiles or outcomes, and this information can be leveraged to promote earlier care-seeking, improved risk stratification, and implementation of more patient-centered treatments.

Invasive candidiasis in a pediatric tertiary hospital: Epidemiology, antifungal susceptibility, and mortality rates.

Invasive infections caused by non-albicans Candida are increasing worldwide. However, there is still a lack of information on invasive candidiasis (IC) in the pediatric setting, including susceptibility profiles and clonal studies. We investigated the clinical, epidemiologic, and laboratory characteristics of IC, possible changes in antifungal susceptibility profiles over time, and the occurrence of clonality in our tertiary children's hospital. We analyzed 123 non-duplicate Candida isolates from sterile sites of pediatric patients in a tertiary hospital in southern Brazil, between 2016 and 2021. Data on demographics, comorbidities, and clinical outcomes were collected. Candida species distribution, antifungal susceptibility profiles, biofilm production, and molecular epidemiology of isolates were assessed using reference methods. The range of IC incidence was 0.88-1.55 cases/1000 hospitalized patients/year, and the IC-related mortality rate was 20.3%. Of the total IC cases, 42.3% were in patients aged<13 months. Mechanical ventilation, parenteral nutrition, and intensive care unit (ICU) admission were common in this group. In addition, ICU admission was identified as a risk factor for IC-related mortality. The main site of Candida spp. isolation was blood, and non-albicans Candida species were predominant (70.8%). No significant clonal spread was observed among isolates of the three most commonly isolated species, and 99.1% of all isolates were biofilm producers. Non-albicans Candida species were predominant in this study. Notably, clonal expansion and emergence of antifungal drug resistance were not observed in our pediatric setting.

CHEMICAL CHARACTERISATION OF COMMONLY USED DIETARY OILS IN BROILER PRODUCTION

CHEMICAL CHARACTERISATION OF COMMONLY USED DIETARY OILS IN BROILER PRODUCTIONT. V. ABOKEDE, O. A. OGUNWOLE, A. O. MOSURO, F. O. JEMISEYE, B. S. ADEDEJI, I. A. OLUDOYI AND O. O. TEWEAgricultural Biochemistry and Nutrition Unit,Department of Animal Science, University of Ibadan, Nigeria. *Correspondence: titilopeabokede@yahoo.com; +2348113333305ABSTRACTThis study was conducted to characterize different dietary oils commonly used in broiler chicken production. Soybean oil (SYO), Palm-kernel oil (PKO), Sheabutter (SHO), Coconut oil (CO) and Groundnut oil (GNO) were each assayed for their physical and chemical characteristics using standard procedures. The SYO had higher (P&lt;0.05) saponification value (14.55 mg/KOH) compared to GNO (12.00mg/KOH), which had the lowest value, SHO had the higher (P&lt;0.05), acid value of (3.65 mgKOH/g), compared to SYO that had the lowest value (0.90) and PKO had the highest value for iodine and peroxide values (2.50) as compared to SYO which had the lowest value of (1.60). For the fatty acid profile, CO was higher (P&lt;0.05) in Arachidonic acid of (2.25) while GNO had the a lower value of (0.07) and Linoleic acid was highest in CO (19.72) as compared to (8.21) of PKO that had the lowest value, linolenic acid was highest in SYO (2.81) compared to SHO (0.16) that had the lowest value. SYO (2.19) had the highest content of vitamin A compared to SHO (1.73) that had the lowest value while SYO had the highest value for vitamin E (53.29) content and SHO had the lowest value (38.25). The different oils have varying level of inherent nutrient which when used as ingredient, may have varying impact on performance of broiler chickensKeywords: Saponification value, Iodine value, Peroxide value, Acid value, Dietary oils.

Portable bioimpedance analyzer for remote body composition monitoring: A clinical investigation under controlled conditions

ObjectivesIn an era when telemedicine is becoming increasingly essential, the development and validation of miniaturized Bioelectrical Impedance Analysis (BIA) devices for accurate and reliable body composition assessment is crucial. This study investigates the BIA Metadieta, a novel miniaturized BIA device, by comparing its performance with that of standard hospital BIA equipment across a diverse demographic. The aim is to enhance remote health monitoring by integrating compact and efficient technology into routine healthcare practices. MethodsA cross-sectional observational study was conducted with 154 participants from the Clinical Nutrition Unit. The study compared resistance (R), reactance (Xc), and phase angle (PhA) measurements obtained from the BIA Metadieta device and a traditional hospital-based BIA device. ResultsAnalysis revealed strong positive correlations between the BIA Metadieta and the hospital-based device for R (r = 0.988, P < 0.001), Xc (r = 0.946, P < 0.001), and PhA (r = 0.929, P < 0.001), indicating the miniaturized device's high accuracy and reliability. These correlations were consistent across different genders and BMI categories, demonstrating the device's versatility. ConclusionsThe BIA Metadieta device, with its miniaturized form factor, represents a significant step forward in the field of remote health monitoring, providing a reliable, accurate, and accessible means for assessing body composition.

Trends in severe acute malnutrition admissions, characteristics, and treatment outcomes in Malawi from 2011 through 2019

Background Community-based Management of Acute Malnutrition (CMAM) has been successfully implemented across Malawi, yet trends in admissions, characteristics, and treatment outcomes in children with severe acute malnutrition (SAM) have not been examined. The objective was therefore to investigate trends in admissions, characteristics including percentage of children with SAM with HIV and oedema, and treatment outcomes across the decade following implementation of CMAM.Methods This research involved a retrospective analysis of existing data routinely collected across Malawi by the Ministry of Health between 2011 and 2019.ResultsThese data showed an increase in outpatient therapeutic feeding (OTP) admissions from 30323 children in 2011 to 37655 in 2019 (p=0.045). However, a significant decrease in nutritional rehabilitation unit (NRU) admissions was observed, from 11389 annual admissions in 2011 to 6271 in 2019 (p=0.006). In children identified with SAM, the percentage with oedema decreased in OTPs with an average annual rate of reduction (AARR) of 5.6% (p=0.001) and by 26.2% in NRUs in this timeframe with an AARR of 8.5% (p&lt;0.001). The percentage of children with SAM who had HIV decreased over time in OTPs with an AARR of 16.1% (p=0.001). HIV rates also decreased in NRUs with an AARR of 7.2% (p=0.4), but this difference was not significant. Death rates decreased in OTPs with an AARR of 6.0% (p=0.01). Mortality rates did not change in NRUs over time with an AARR of 0.9% (p=0.5) with the NRU mortality rate in 2019 being 11.0%.Conclusions These trends indicate that there has been an increase in OTP admissions and a corresponding decrease in NRU admissions. There have been decreases in the percentage of children with oedematous SAM in OTPs and in NRUs and with HIV in OTPs. Children remain at high risk of mortality in NRUs.

Sociodemographic, Clinical Correlates, and Hospitalization Outcomes in 0 to 59 Months Children with Severe Acute Malnutrition in the Therapeutic Nutritional Unit

Background Globally, the mortality and morbidity estimates from Severe Acute Malnutrition (SAM) in under-five children (0-59 months) are highly significant in low-income countries. This study aims to contribute to the fight against SAM in under-five Chadian children. Method A cross-sectional study was performed on data collected from surveys conducted for 30 days on 326 hospitalized patients with SAM of under- five children. The participants included in the study fulfilled the admission criteria at the therapeutic nutritional unit (TNU) of Alerte Sante. This study assessed the sociodemographic characteristics, factors related to healthcare access, dietary patterns and clinical factors, and length of hospitalization and outcomes for the admitted children. MAS types were classified using the mid-upper arm centimeter (MUAC), WHO Weight- to-Height Z-score (WHZ) scale, and edema assessment. Results Among the study population, the male gender was predominant (65.6%). Most of the children (85.9%) belong to Muslim households. Children aged between 12 and 23 months were mainly represented. Marasmus type of SAM was around 90%. The most prevalent chief complaint for admission was Diarrhea (18.8%). The findings revealed 69% of patients discharged after recovery, 11 (3.37%) deaths, from which 54.5% belong to the age group of 12-24 months. Conclusion SAM is still prevalent in N’Djamena for under-five children. The study found several socio-demographic factors associated with SAM. Considering the strong association between diarrhea and related highest- case fatalities, advocacy and health education regarding breastfeeding, hygiene, and nutrition will immensely help

Building Breastfeeding Research Relations and Beyond: An Interview With Fiona Dykes.

Professor Fiona Dykes is Professor Emerita of Maternal and Infant Health at the University of Central Lancashire in the United Kingdom (UCLAN). Fiona has a particular interest in the global, sociocultural, and political influences upon infant and young child feeding practices; her methodological expertise is in ethnography and other qualitative research methods. She founded the Maternal and Infant Nutrition and Nurture Unit (MAINN) in 2000 which she led until she retired from her full-time professorship in 2020. Fiona established the associated MAINN Conference in 2007. The MAINN conference is a 3 day, international, peer reviewed event held bi-annually in the United Kingdom and, more recently, in alternate years overseas (Sydney, Australia; Falun, Dalarna, Sweden; and Florida, United States). The conference draws together key researchers in the field of infant and young child feeding from around the world. Fiona was a founding member of the journal Maternal and Child Nutrition. She is author of Breastfeeding in Hospital: Mothers, Midwives and the Production Line (Routledge) and co-author, with Dr Tanya Cassidy, of Banking on Milk: An Ethnography of Donor Human Milk Relations (Routledge). She is also joint editor of several books including Infant and Young Child Feeding: Challenges to Implementing a Global Strategy (Wiley-Blackwell) and Ethnographic Research in Maternal and Child Health (Routledge). This interview was conducted on April 20, 2023, by Dr. Tanya Cassidy, and is based on a verbatim transcription and edited for readability.TC = Tanya Cassidy; FD = Fiona Dykes.

The hematologist´s perspective. What to offer from the nutrition units

The hematologist´s perspective. What to offer from the nutrition units

The vision of the nutrition unit

The vision of the nutrition unit

The vision of a nutrition unit with management experience

The vision of a nutrition unit with management experience

What response should be given from the clinical nutrition units from a healthcare point of view

What response should be given from the clinical nutrition units from a healthcare point of view

Severe hypomagnesemia: outpatient management in endocrinology and nutrition unit

Severe hypomagnesemia: outpatient management in endocrinology and nutrition unit

Celiac Disease and Autoimmune Diseases in a Pediatric Population in Morocco: A Cross-Sectional Study.

Celiac disease (CD) is defined as an autoimmune disease (AD) caused by gluten ingestion in genetically sensitive individuals. Several publications have demonstrated the increased risk of AD in patients with CD, both adults and children, which requires systematic research. Our study aimed to determine the prevalence of AD in 60 patients diagnosed with CD and to highlight risk factors that may contribute to the emergence of AD. We collected medical data from all CD patients under 16 years of age who also had AD. Our study was conducted in the Gastroenterology-Hepatology and Pediatric Nutrition Unit of the Pediatrics Department of the Mohamed VI Hospital and University Center in Oujda, Morocco, during a seven-year period between January 2017 and January 2024. We studied 60 patients with CD in our study. Eight patients (13%) had an associated AD. Their average age was eight years, with extremes varying between two and 15 years. AD was diagnosed before CD in six cases (75%), in parallel with CD in one patient (12.5%), while in only one case, it was diagnosed after CD (12.5%).All our patients had a single AD associated with CD. These ADs were mainly type 1 diabetes in seven cases and autoimmune thyroiditis in only one case. All our patients followed a gluten-free diet in addition to specific treatment for associated AD. Nevertheless, despite regular medical follow-up and targeted dietary advice for the management of CD and associated AD, three patients encountered difficulties in following the recommended diet. Younger patients with CD have an increased risk of hypothyroidism and insulin-dependent diabetes. These data necessitate improved surveillance to discover these illnesses as early as possible in order to optimize management and reduce related consequences.

The role of the coordinating nurse in a transverse clinical nutrition unit

Malnutrition is a common pathology, often underdiagnosed, and is associated with numerous chronic diseases. Transversal clinical nutrition units (TCNU) are being implemented to improve the screening and management of malnutrition. The coordinating nurse plays a key role within a TCNU: organizing and coordinating personalized care pathways for malnourished patients, especially those with complex pathologies requiring multidisciplinary care. This article outlines the responsibilities of the coordinating nurse based on the experience of the TCNU established at the Pitié-Salpêtrière Hospital (Assistance Publique-Hôpitaux de Paris).

HIV prevalence among children admitted with severe acute malnutrition and associated factors with mother-to-child HIV transmission at Mulago Hospital, Uganda: A mixed methods study.

Despite global efforts to eliminate mother-to-child-transmission of HIV (MTCT), many children continue to become infected. We determined the prevalence of HIV among children with severe acute malnutrition (SAM) and that of their mothers, at admission to Mwanamugimu Nutrition Unit, Mulago Hospital, Uganda. We also assessed child factors associated with HIV-infection, and explored factors leading to HIV-infection among a subset of the mother-child dyads that tested positive. We conducted a cross-sectional evaluation within the REDMOTHIV (Reduce mortality in HIV) clinical trial that investigated strategies to reduce mortality among HIV-infected and HIV-exposed children admitted with SAM at the Nutrition Unit. From June 2021 to December 2022, we consecutively tested children aged 1 month to 5 years with SAM for HIV, and the mothers who were available, using rapid antibody testing upon admission to the unit. HIV-antibody positive children under 18 months of age had a confirmatory HIV-DNA PCR test done. In-depth interviews (IDIs) were conducted with mothers of HIV positive dyads, to explore the individual, relationship, social and structural factors associated with MTCT, until data saturation. Quantitative data was analyzed using descriptive statistics and logistic regression in STATAv14, while a content thematic approach was used to analyze qualitative data. Of 797 children tested, 463(58.1%) were male and 630(79.1%) were ≤18months of age; 76 (9.5%) tested positive. Of 709 mothers, median (IQR) age 26 (22, 30) years, 188(26.5%) were HIV positive. Sixty six of the 188 mother-infant pairs with HIV exposure tested positive for HIV, an MTCT rate of 35.1% (66/188). Child age >18 months was marginally associated with HIV-infection (crude OR = 1.87,95% CI: 1.11-3.12, p-value = 0.02; adjusted OR = 1.72, 95% CI: 0.96, 3.09, p-value = 0.068). The IDIs from 16 mothers revealed associated factors with HIV transmission at multiple levels. Individual level factors: inadequate information regarding prevention of MTCT(PMTCT), limited perception of HIV risk, and fear of antiretroviral drugs (ARVs). Relationship level factors: lack of family support and unfaithfulness (infidelity) among sexual partners. Health facility level factors: negative attitude of health workers and missed opportunities for HIV testing. Community level factors: poverty and health service disruptions due to the COVID-19 pandemic. In this era of universal antiretroviral therapy for PMTCT, a 10% HIV prevalence among severely malnourished children is substantially high. To eliminate vertical HIV transmission, more efforts are needed to address challenges mothers living with HIV face intrinsically and within their families, communities and at health facilities.

Association of dietary patterns with sarcopenia in adults aged 50years and older.

Although numerous studies have investigated the impact of dietary factors on the prevention of decreased muscle mass and function, limited research has examined the relationship between dietary patterns and sarcopenia. This study aimed to assess the associations between dietary patterns, and sarcopenia, muscle strength, and mass in adults following a Mediterranean diet residing in southern Italian cities. This cross-sectional study utilized data from an existing database, comprising 528 individuals aged 50years or older who underwent health-screening tests at the Clinical Nutrition Unit of the "R.Dulbecco" University Hospital. Strength was assessed through handgrip strength, and appendicular skeletal muscle mass was estimated using bioelectrical impedance analysis. Dietary intake information was collected through a food frequency questionnaire linked to the MetaDieta 3.0.1 nutrient composition database. Principal Component Analysis, a statistical technique identifying underlying relationships among different nutrients, was employed to determine dietary patterns. Multinomial logistic regression analysis was conducted to estimate the odds ratio for sarcopenia or low handgrip strength in relation to the lowest tertile of dietary pattern adherence compared to the highest adherence. The participants had a mean age of 61 ± 8years. Four dietary patterns were identified, with only the Western and Mediterranean patterns showing correlations with handgrip strength and appendicular skeletal muscle mass. However, only the Mediterranean pattern exhibited a correlation with sarcopenia (r = - 0.17, p = 0.02). The highest tertile of adherence to the Mediterranean dietary pattern demonstrated significantly higher handgrip strength compared to the lowest tertile (III Tertile: 28.3 ± 0.5kg vs I Tertile: 26.3 ± 0.5kg; p = 0.01). Furthermore, even after adjustment, the highest tertile of adherence to the Mediterranean pattern showed a significantly lower prevalence of sarcopenia than the lowest adherence tertile (4% vs 16%, p = 0.04). The lowest adherence to the Mediterranean dietary pattern was associated with increased odds of having low muscle strength (OR = 2.38; p = 0.03; 95%CI = 1.05-5.37) and sarcopenia (OR = 9.69; p = 0.0295; %CI = 1.41-66.29). A high adherence to the Mediterranean dietary pattern, characterized by increased consumption of legumes, cereals, fruits, vegetables, and limited amounts of meat, fish, and eggs, is positively associated with handgrip strength and appendicular skeletal muscle mass. The highest adherence to this dietary model is associated with the lowest odds of low muscle strength and sarcopenia. Despite the changes brought about by urbanization in southern Italy compared to the past, our findings continue to affirm the superior benefits of the Mediterranean diet in postponing the onset of frailty among older adults when compared to other dietary patterns that are rich in animal foods.

Therapeutic and Evolutionary Profiles of Children Aged 0-59 Months: A Case Study of Severe Acute Malnourished Treated at Hôpital Notre Dame Des Apôtres, N&amp;apos;Djamena

According to the World Health Organization, malnutrition is a pathological condition resulting from the relative or absolute insufficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biological, anthropometric or physiological analyses. It remains a major public health problem. The aim of this study was therefore to determine the therapeutic and evolutionary profiles of Severe Acute Malnutrition patients at Notre Dame des Apôtres Hospital in N&amp;apos;Djaména (Chad). This was a prospective, descriptive study carried out on 7 months, from January 1 to July 31, 2023. This included all severely acutely malnourished children with medical complications admitted to the hospital&amp;apos;s therapeutic nutrition unit. The variables studied were therapeutic and evolutionary. Data were entered and analyzed using Excel 2016 spreadsheet and SSPS 18.0 software. Among the 1454 children admitted to the unit during our study, 41.82% were stabilized, 6.75% cured and 0.79% abandoned, with an average length of stay of 8.67 days. The mortality rate was 1.76%. Children on F75 accounted for 46%, 37% on plumpy nut and 10% on F100. Antibiotics and multivitamins are routinely used in the management of malnourished children. The results of this study show that parent education could be an asset in the management of severe acute malnutrition.