Protein Malnutrition Research Articles

Prognostic value of C-reactive protein / albumin ratio for amputation and/or mortality after lower extremity revascularization in haemodialysis patients with peripheral artery disease

Abstract Background Hypoalbuminemia, a manifestation of protein-energy wasting (PEW) or malnutrition, which is commonly observed in patients with chronic kidney disease, is associated with increasing cardiovascular risk. Recently, C-reactive protein (CRP) / albumin ratio has been developed as a newly surrogate marker of the PEW because the PEW seems to result not only from an inadequate diet but also rather be induced by chronic inflammatory status. The aim of this study was to clarify whether pre-procedural CRP/albumin ratio levels could predict amputation and/or mortality after lower extremity revascularization for peripheral artery disease (PAD) in patients on haemodialysis (HD). Methods A total of consecutive 1,850 HD patients successfully undergoing lower extremity revascularization (494 bypass surgery and 1,356 endovascular therapy) were enrolled in this study. Patients were divided into tertiles according to pre-procedural CRP/albumin ratio levels; low (<0.6, n=619), middle (0.6-3.7, n=609) and high tertile (>3.7, n=622). They were followed up for up to 8-year. The primary endpoint was defined as amputation and/or mortality. Results During follow-up period (median of 53 months), 162 major amputation (8.8%) was performed and 508 patients (27.5%) died. Cumulative incidence rates of amputation and/or mortality at 8-year were 47.4%, 56.2% and 70.0% in low, middle and high tertile of CRP/albumin ratio, respectively (p<0.0001). After adjustment for male, age, traditional risk factors, body mass index, history of coronary artery disease or stroke, procedure (bypass vs. endovascular therapy), infrapopliteal disease and ulcer/gangrene, the CRP/albumin ratio was identified as an independent predictor for amputation and/or mortality [adjusted hazard ratio (aHR) 1.39, 95% confidence interval (CI) 1.12-1.72, p=0.0028 for middle vs. low tertile, and aHR 2.53, 95% CI 2.07-3.09, p<0.0001 for high vs. low tertile, respectively]. Similar results were also observed even for major amputation and mortality, respectively (aHR 2.73, 95% CI 1.77-4.31 for amputation and aHR 2.32, 95% CI 1.82-2.97 for mortality with p<0.0001 for high vs. low tertile in both, respectively, Figure). Conclusion Pre-procedural CRP/albumin ratio could predict both of amputation and mortality after lower extremity revascularization, and could stratify the risk in HD patients with PAD. Measurement of CRP/albumin ratio in such high-risk population may be useful because this newly surrogate marker of the PEW is simple and can be easily obtained in daily practice.

Low protein uptake during peripuberty impairs the testis, epididymis, and spermatozoa in pubertal and adult Wistar rats.

Protein malnutrition during critical periods poses significant risks to reproductive health. Thus, this study aims to evaluate the immediate and delayed effects of a 30-day low-protein diet on the postnatal development of the male reproductive system. For so, male rats were fed a protein-deficient diet from postnatal day 30-60, followed by evaluations of testis, epididymis, and spermatozoa both at the end of the diet and after a 60-day recovery period. Testicular and epididymal weight was lowered in pubertal animals. Several histological alterations were found in the testis, such as acidophilic cells and vacuoles in the seminiferous epithelium, and sperm production was compromised. In the epididymis, the luminal compartment was diminished, and the stroma was enlarged both in the caput and cauda; in the cauda, the epithelial compartment was enlarged; the transit time of spermatozoa through this organ was diminished. Testosterone production was lowered. Spermatozoa's motility, mitochondrial activation, and acrosomal integrity were impaired, and several alterations in morphology were observed. After the recovery period, testicular and epididymal weight was restored. Tissue remodulation was observed in the epididymis, but the spermatozoa's transit time in this organ was not altered. Sperm and testosterone production, spermatozoa motility, mitochondrial activation, and acrosomal integrity were also restored. However, testicular histological alterations and spermatic morphological abnormalities were maintained in protein-restricted animals. Protein restriction during peripuberty impairs the reproductive maturation of pubertal Wistar rats, impairing testicular and epididymal function, with lasting effects even after dietary correction.

The influence of Muscle Wasting on Patient Outcomes among Burn Patients: A Burn Care Quality Platform Study.

The hypermetabolism that occurs after large burns leads to muscle wasting that can result in weakness, difficulty fighting infections, and other challenges to healing. Overall, rates of muscle wasting are not well established across burn centers. The Burn Care Quality Platform (BCQP), the largest available dataset on burn patients globally, was used to explore the rate of Muscle Wasting using data collected from more than 100 burn centers. "Muscle Wasting" was defined from relevant ICD codes (sarcopenia, muscle cachexia, protein malnutrition). Binomial and logistic regression were used to analyze the role of Muscle Wasting in burn mortality and other outcomes after controlling for demographic and comorbid characteristics. In total, the BCQP provided data from 84,438 adult and pediatric burn patients injured between 2000-2018. Only 2.6% (N=2,159) of the patients in the BCQP were diagnosed with having Muscle Wasting at some point during their admission. While Muscle Wasting was not associated with a statistically significant impact on mortality, it remained an independent predictor of inability to discharge to independent living, longer inpatient days, as well as an average of 10 additional surgical procedures (P<0.001 for all) as compared to patients who did not have Muscle Wasting. Muscle Wasting is an independent risk factor for several adverse outcomes in burn patients, but not mortality in the BCQP. Confidence in these findings would be improved with more accurate data collection, as the diagnosis of Muscle Wasting is likely under-reported, under-diagnosed, or both.

Development of Nutrient-Rich Complementary Food from Sweet Potatoes, Carrots and Crayfish for Combating Infant Malnutrition in Low-income Communities

This study aimed to enhance traditional cereal-based complementary foods in Nigeria by developing and evaluating a nutrient-dense blend of sweet potato, carrot, and crayfish. The objective was to address protein-energy malnutrition in low-resource settings by improving the nutritional profile of local complementary foods. Samples were analyzed in triplicate for proximate composition and selected micronutrients using AOAC standard techniques. Sensory evaluation was conducted using a 5-point hedonic scale with a panel of ten nursing mothers from the Department of Human Nutrition and Dietetics, Lead City University. Results showed that the blend contained 14.74±0.32% crude protein, 72.19±0.51% carbohydrates, and 0.97±0.02% fat. Micronutrient analysis revealed high levels of vitamin C (19.06±0.70 mg/100ml) and phosphorus (497.33±3.37 mg/100ml). Sensory evaluation indicated that the product was well-accepted, with mean scores of 4.2±0.6 for taste (slightly sweet), 4.0±0.7 for color (light brown), and 3.8±0.8 for flavor (mildly fishy). This novel blend significantly improves upon traditional cereal-based complementary foods by providing a more balanced nutrient profile that meets WHO/FAO recommendations. It offers a practical, locally-sourced solution to enhance infant nutrition in low-resource settings, potentially reducing the prevalence of protein-energy malnutrition. Further studies on its long-term effects on child growth and development are recommended.

Important practical aspects in the management of patients with shot bowel syndrome and intestinal failure

Short bowel syndrome is a gastrointestinal disorder resulting from massive resection of the small intestine. The most common causes of resection are acute mesenteric ischemia, Crohn’s disease, abdominal trauma, adhesive intestinal obstruction, intestinal malignancies, and radiation enteritis. Short bowel syndrome with intestinal failure is characterized by severe malabsorption-m aldigestion accompanied by abdominal pain, diarrhea, dehydration, and progression of protein-energy malnutrition. Many patients with SBS develop long-term clinical complications over time due to altered bowel anatomy and physiology or various therapeutic interventions such as parenteral nutrition and central venous catheterization. This review focuses on the most important aspects of diagnosis, treatment, and prevention of several complications that can occur in this patient population, including macronutrient and micronutrient imbalances, diarrhea, fluid and electrolyte imbalances, metabolic bone disease, biliary disorders, bacterial overgrowth in the small intestine, and complications related to venous access. The main therapeutic strategies for SBS with intestinal failure are: special diet, enteral nutritional support with semi-elemental mixtures, parenteral nutrition, oral rehydration, antimicrobal and antidiarrheal drugs, enzymes. Administration of glucagon-like peptide 2 analog, teduglutide, is clinically effective in reducing dependence on parenteral nutrition and improving quality of life. Management of patients with SBS with intestinal failure is a complex long-term process which requires dynamic clinical and laboratory monitoring.

Secondary Sarcopenia in Patients with Locomotor Disorders: Prevalence, Diagnosis and Medical Rehabilitation. A Review

INTRODUCTION. The development of rehabilitation methods for patients with sarcopenia, a generalized age-associated loss of skeletal muscle mass and strength, is important, since sarcopenia leads to pronounced weakness, functional and motor disorders and an increased risk of death in the elderly. AIM. To analyze the prevalence, features of pathogenesis, diagnosis of secondary sarcopenia, including against the background of motor disorders due to stroke, as well as methods of treatment and medical rehabilitation of such patients. MAIN CONTENT. Among the secondary forms, sarcopenia is of the greatest clinical importance against the background of the consequences of acute cerebrovascular accident (ACA), due to muscular atrophy associated with paralysis and immobility, spasticity, inflammation and denervation of muscles, malnutrition and intestinal absorption of protein and vitamin D. Recent studies show that the prevalence of sarcopenia in stroke patients in emergency hospitals is 8.5–33.8 %, according to other data — more than 42 %. Muscle weakness after a stroke contributes to a decrease in physical functions and the development of disability, and sarcopenia leads to adverse outcomes 90 days after a stroke. According to the meta-analysis, which included 7 cohort studies with a total sample of 1,774 patients who underwent ACA, 27.1 % of them had sarcopenia. Moreover, the presence of sarcopenia negatively affected the clinical and functional outcomes of ACA, as well as the results of medical rehabilitation (odds ratio: 2.42, 95 % confidence interval: 1.76–3.33, p 0.001). CONCLUSION. Despite the prevalence and relevance of this pathology, rehabilitation programs for patients with sarcopenia against the background of the consequences of ACA have not been developed. Isolated foreign publications demonstrate the effectiveness of certain methods of physical therapy and electrical stimulation, but the evidence base for their effectiveness is low.

The Spectrum of Pathogens Associated with Infections in African Children with Severe Acute Malnutrition: A Scoping Review.

Understanding the interplay between infections and severe acute malnutrition is critical in attaining good clinical outcomes when managing malnourished children. However, review studies describing the profile of the associated pathogens in the malnourished African paediatric population are sparse in the literature. We aimed to identify the spectrum of pathogens from studies reporting infections in severely malnourished African children, as well as the antibiotic resistance pattern and clinical outcomes. A systematic literature review of the PubMed database was conducted following PRISMA guidelines from January 2001 to June 2024. The search algorithm was ((marasmus) OR (kwashiorkor) OR (severe acute malnutrition) OR (protein energy malnutrition)) AND (Africa). For a more comprehensive retrieval, an additional search algorithm was deployed: ((HIV) OR (tuberculosis)) AND (severe acute malnutrition). We included 60 studies conducted between 2001 and 2024. Most of the studies were from East Africa (n = 45, 75%) and Southern Africa (n = 5, 8.3%). A total of 5845 pathogens were identified comprising 2007 viruses, 2275 bacteria, 1444 parasites, and 119 fungal pathogens. The predominant pathogens were HIV, Mycobacterium tuberculosis, and malaria parasites accounting for 33.8%, 30%, and 24.2% of pathogens identified. Antibiotic susceptibility testing was documented in only three studies. Fatality rates were reported in 45 studies and ranged from 2% to 56% regardless of the category of pathogen. This review affirms the deleterious effect of infections in malnourished patients and suggests a gross underdiagnosis as studies were found from only 17 (31.5%) African countries. Moreover, data on fungal infections in severely malnourished African children were nearly absent despite this population being at risk. Thus, there is an urgent need to prioritize research investigating African children with severe acute malnutrition for fungal infections besides other pathogens and improve the availability of diagnostic tools and the optimized usage of antibiotics through the implementation of antimicrobial stewardship programmes.

7315 Does Protein Energy Malnutrition Impact Outcomes in Hypothyroidism? A National Inpatient Sample Analysis

Abstract Disclosure: S. Karki: None. B. Neupane: None. S. Neupane: None. A. Bhandari: None. U. Farooq: None. K. Rajamani: None. Introduction: Hypothyroidism poses a significant public health burden in the United States, affecting approximately 4.6 % of the population. Various nutritional deficiencies can adversely affect thyroid function, potentially leading to thyroid disorders. Despite this, there is limited literature exploring the influence of Protein Energy Malnutrition (PEM) on outcomes in hypothyroidism. Objective of our study:This investigation aims to assess the impact of PEM on the healthcare burden and costs associated with hospitalizations in patients with and without hypothyroidism. Methods: A retrospective study was conducted using the National Inpatient Sample (NIS) data from 2017 to 2020. Among the 14,418,310 patients aged 18 and above with a primary diagnosis of hypothyroidism, two groups were formed based on the presence or absence of PEM, determined by International Classification of Diseases (ICD-10) codes. Statistical analysis was performed using STATA, employing the student’s t-test and Fischer’s exact test for continuous variables and proportions, respectively. Adjusted odds ratio was calculated through multivariate regression analysis. The primary outcome was mortality, with secondary outcomes encompassing mean length of stay (LOS), total cost, and various medical complications. Trends in mortality, LOS and total cost were compared for both groups. Results: Out of 14,418,310 hypothyroid patients, 7.06% (1,1018,310) were diagnosed with PEM. Patients with PEM exhibited higher mortality (6.80 % vs. 2.39 %, p&amp;lt;0.001), extended mean length of hospital stay (8.88 days vs. 4.85 days, p&amp;lt;0.001), and higher increased total hospitalization costs ($96,443 vs. $58,262, p&amp;lt;0.001). Furthermore, patients with PEM had elevated rates of various complications, including acute coronary syndrome, septic shock, pulmonary edema, mechanical ventilation, acute respiratory failure, acute respiratory distress syndrome, acute kidney injury, and cerebrovascular accident. Increasing trends in mortality, length of stay, and total cost of hospitalization were observed in hypothyroid patients with PEM. A similar upward trend was noted in hypothyroid patients without PEM. Conclusion: Our study underscores that the presence of PEM in hypothyroid patients substantially increases the healthcare burden, which is reflected in elevated mortality rates, prolonged hospital stays, higher total costs, and a range of adverse outcomes. Screening of PEM in hypothyroid patients is recommended, and early nutritional interventions, possibly involving dieticians, may mitigate these adverse effects. Further research is warranted to explore the association between PEM and hypothyroidism, as well as strategies for early identification and intervention. Presentation: 6/1/2024

Conversion of one-anastomosis gastric bypass to Roux-En-Y gastric bypass: mid-term results from the United Arab Emirates.

One-Anastomosis Gastric Bypass (OAGB) is becoming popular, but some patients may need to convert to Roux-en-Y Gastric Bypass (RYGB) due weight-related difficulties or postoperative complications. The data on conversions is currently limited to 30-day or short-term follow-up studies. As such, the objective of this study was to evaluate the indications and mid-term outcomes for OAGB conversions to RYGB at a tertiary referral center in the United Arab Emirates. A retrospective analysis was conducted on patients who underwent conversion from OAGB to RYGB between February 2016 and May 2023. Demographic information, indications for conversion, intraoperative details, and mid-term outcomes were collected and analyzed. Sixty-four patients underwent conversion from previous OAGB to RYGB. The cohort was 73.4% female (n = 47) with a mean age of 40.8years. Indications for conversion included acid reflux (n = 28, 43.7%), intractable nausea/vomiting (n = 20, 31.2%), protein-calorie malnutrition (n = 7, 10.9%), anastomotic ulcer (n = 6, 9.3%) and weight recidivism (n = 3, 4.7%). The mean operative time was 238 ± 78.3min. During the procedure, three intraoperative complications occurred: two cases of bleeding and one case of bowel perforation; all successfully addressed during surgery. The median hospital stay was 3 ± 15.8days. Three patients (4.6%) experienced major postoperative complications comprising 2 anastomotic leaks and 1 small bowel obstruction. The mean follow-up time was 26.2 ± 19.7months, with 96.2% of patients reporting resolution of symptoms. There were no mortalities. Acid reflux is representing 43.7% of the indications for conversion from OAGB to RYGB. The symptom resolution rate holds significance, standing at a remarkable 96.8%. Despite surgical technique advancements, the complication rate after conversions remains significant at 4.6%, with no mortality reported. OAGB patients should be informed about these risks prior to undergoing conversions from OAGB to RYGB.

Outcomes of AKI Hospitalization among Patients with Protein-Calorie Malnutrition: A Nationwide Analysis

Outcomes of AKI Hospitalization among Patients with Protein-Calorie Malnutrition: A Nationwide Analysis

S163 Outcomes in Patients With Protein Energy Malnutrition Admitted With Acute Biliary Pancreatitis: A Nationwide Study

S163 Outcomes in Patients With Protein Energy Malnutrition Admitted With Acute Biliary Pancreatitis: A Nationwide Study

Assessment of Biochemical Parameters as Indicators of Protein Energy Malnutrition in Turkish Children: A Comprehensive and Retrospective Study

This study aims to address this research gap by meticulously analyzing the biochemical parameters of children aged 0-59 months diagnosed with Protein Energy Malnutrition (PEM) within the confines of a state hospital over a two-year period. This study is a retrospective study evaluating the biochemistry and hormone laboratory findings of 302 children aged 0-59 months who were diagnosed with Protein Energy Malnutrition between the years 2020-2022 in the pediatric health and diseases clinic of Iğdır State Hospital. This study investigated the distribution of various biochemical parameters in children diagnosed with protein-energy malnutrition (PEM) and explored their significance within this context. The findings, based on reference values, revealed substantial proportions of children with abnormal values for iron, immunoglobulin (IgM and IgA), liver enzymes (ALT and AST), creatinine, CRP, and vitamin D. Gender-based differences were observed for calcium, IgM, Folate, and TSH, with notable variations between male and female children. Correlations between age and various parameters were identified, underscoring the complex interplay between developmental stages and biochemical values. The study highlights the importance of addressing deficiencies, potential complications, and demographic influences in managing PEM. The absence of demographic data integration in existing studies serves as a limitation, emphasizing the need for comprehensive research in this domain. Overall, these insights contribute to a deeper understanding of biochemical dynamics in children with PEM, aiding targeted interventions for improved health outcomes.

165 Characterizing protein quality with in vitro methodologies

Abstract Nutritional assessment of the quality of a protein source is a complex process with different requirements depending on the jurisdiction being discussed. The Protein Efficiency Ratio (PER) is a growth measurement required in Canada, whereas the United States uses the Protein Digestibility Corrected Amino Acid Score (PDCAAS), which requires the determination of the amino acid profile and digestibility of the protein source. Notably both PER and PDCAAS are in vivo methods, necessitating the use of animals for measurement of growth and protein digestibility. Understandably there is significant interest from both industry and consumers to reduce reliance on animal experimentation for content claims. It is notable that outside of North America there are multiple examples of in vitro protein quality assessment. In Europe protein content claims are based on whether the protein content contributes &amp;gt;12% of the total energy, and in Australia content claims begin at 5 g of protein per serving. As the use of in vitro techniques for protein quality assessment has not led to indices of protein malnutrition in Europe and Australia, should be possible to use in vitro techniques in methods such as PER and PDCAAS thereby removing the reliance on animal use for quality assessment in North America. This can be accomplished by using in vitro methods in the assessment of protein digestibility and relying on recent changes by Health Canada to allow for calculation of PER from PDCAAS values. This presentation will introduce how protein quality is calculated via PER/PDCAAS, and subsequently discuss modifications of these methods to incorporate in vitro techniques to generate values indicating their nutritional quality with positive correlations to in vivo data.

Integrating NIR spectroscopy with machine learning and heuristic algorithm-assisted wavelength selection algorithms for protein content prediction in rice bean (Vigna umbellata L.)

Protein-energy malnutrition (PEM) is a global concern, particularly in underdeveloped and underprivileged regions dependent on plant-based diets. Plant-based meat alternatives offer a potential solution, with rice bean emerging as a promising crop due to its high protein content. However, traditional methods for determining protein content in rice bean are labor-intensive, costly, and time-consuming, thus necessitating more efficient approaches. This study addresses the need for efficient, rapid technique by integrating Near-Infrared Spectroscopy (NIRS) with machine learning models to predict protein content in rice bean (Vigna umbellata L.) germplasm. We developed predictive models using Support Vector Regressor (SVR), Random Forest Regressor (RFR), and Modified Partial Least Square (MPLS) coupled with key wavelengths selection algorithms including Genetic Algorithm (GA), Ant Colony Optimization (ACO), Particle Swarm Optimization (PSO), and Competitive Adaptive Reweighted Sampling (CARS). The MPLS model demonstrated superior performance, achieving an R² (Coefficient of Determination) of 0.81 and an RPD (Residual Prediction Deviation) of 2.14 when combined with the ACO algorithm. The SVR model also performed well when combined with ACO and PSO, yielding an R² of 0.78, an RPD of ∼1.95. In contrast, the RFR model showed relatively lower performance (R² of ∼0.45 and RPD ≤ 1.74). These results indicate that MPLS and SVR, combined with selected wavelength selection algorithms significantly improves prediction accuracy. The study highlights the importance of appropriate model and algorithm selection in enhancing predictive performance of protein content. The developed technology provides a rapid and efficient method for selecting nutritionally superior crop germplasm present in global respositories.

A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge Regarding Prevention of Protein Energy Malnutrition among G. N. M.2nd Year Student of Health and Hygiene Nursing Institute at Alwar

A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge Regarding Prevention of Protein Energy Malnutrition among G. N. M.2nd Year Student of Health and Hygiene Nursing Institute at Alwar

Impact on Incorporation of Purple Yam Flour (Dioscorea alata var. Purpurea) in Development of Multigrain Nutri-Bar

Consumption of wholesome and healthy diet is the most effective way to combat protein-energy malnutrition and micro-nutrient deficiencies. Present study was carried out to develop a nourishing and cost effective nutri-bar from selected locally available yams, cereals, legumes and oil seeds. Incorporation of purple yam flour at 20% (F1), 15% (F2) and 10% (F3) was performed with changing only the ratio of processed rice flour.The highest mean rank scores for all tested sensory properties of appearance, taste, texture, aroma and overall acceptability were observed in F1. Proximate composition of ash, protein, fat, crude fiber, carbohydrate and calorie contents of products ranged 1.26-1.37%, 11.20-12.02%, 6.57-7.29%, 2.69-3.58%, 73.28-73.41% and 397.57 - 406.81 kcal/100g respectively. The highest values for total sugar, crude-fibre, potassium, sodium, calcium were recorded in F1 with 20.06±0.12%, 3.55±0.08%, 3903±2.8mg/kg, 396.50±10.60mg/kg, 305.00±29.70mg/kg respectively. F1 had the highest TPC- 4.120 mg GAE/g, TFC- 0.179 mg QE/g, anthocyanin content- 0.225 mg/g and antioxidant potential through DPPH assay- 3.142 mg TE/g followed by F2 and F3. The anthocyanin content of three formulas showed significantly positive correlation with antioxidant capacity (r =1.00, p&lt;0.05). In conclusion, nutri-bars are the excellent source of nutrients supplements especially for undernourished population.

Quality Assessment and Sensory Evaluation of Complementary Food from Orange Flesh Sweet Potato (OFSP), Soybean, and Tropical Almond Seed Composite Flour

Childhood malnutrition especially vitamin A deficiency and protein-energy malnutrition are widely prevalent in many parts of the world, particularly in developing countries due to the high cost of commercial infant food. Complementary food from OFSP, Soybean and Tropical Almond Seed Flour was produced to improve the nutritional content of locally made infant food. The study evaluated the quality and sensory attributes of complementary food. A commercial sample was used as a reference standard. The sample formulations were in the ratios; 100:0:0, 90:5:5, 80:15:5, 70:25:5. The anti-nutrient composition ranged thus: alkaloid (0.122-0.961%), trypsin inhibitor (0.003-0.455%), tannin (0.036-0.321%), oxalate (0.017-0.049%). The total essential and total non-essential amino acid composition respectively ranged thus in the samples; 14.12-59.55 g/100g of protein and 30.21-41.65 g/100g of protein. Sensory evaluation results showed that all the complementary food samples were generally accepted by the panellists. The composite flour herein produced significantly (p&lt;0.05) increased the nutritional, amino acid, and sensory attributes of the complementary food in contrast to the control sample.

Peanut (Arachis hypogaea L.) flour and oilcake flour: Exploring the influence of roasting and varietal differences on proximal composition, elemental profiling, antimicrobial and antioxidant properties

Peanuts are highly valued for their abundance of essential nutrients and health-promoting phenolic compounds. Peanut press cake, an inexpensive and underutilized agro-industrial by-product of oil production, is typically discarded or used as animal feed. This study investigated the influence of thermal processing and varietal disparities on the nutritional composition, phenolic content, and biological properties of peanut flour and oilcake flour, aiming to enhance their value as food ingredients. The findings showed that roasting significantly increased the oil (9.98 ± 0.11–44.13 ± 0.10 %), ash (1.28 ± 0.01–5.45 ± 0.05 %), carbohydrate contents (0.90 ± 0.01–28.09 ± 0.28 %), and energy value (406.69 ± 0.09–609.13 ± 1.08 kcal/100 g), along with the total polyphenol content (28.64 ± 0.19–62.79 ± 1.18 mg GAE/g), total flavonoid content (4.20 ± 0.07–18.35 ± 0.06 mg QE/g) and antioxidant activity in both peanut flour and its oilcake. Conversely, it led to a reduction in the moisture (1.48 ± 0.09–6.25 ± 0.15 %) and protein content (49.50 ± 0.05–54.24 ± 0.01 %). Notable variations were found between the two peanut varieties in terms of these nutritional parameters. Elemental analysis unveiled significant discrepancies among peanut varieties and with roasting, with potassium (12,237.56 ± 101.36–14,513.34 ± 168.62 mg/kg) emerging as the predominant macro-element followed by phosphorus (6156.86 ± 36.19–8815.22 ± 130.70 mg/kg) and magnesium (3037.92 ± 13.87–4096.44 ± 8.54 mg/kg), while zinc (53.98 ± 0.61–81.77 ± 0.44 mg/kg) predominated among the microelements. Moreover, peanut and oilcake flours demonstrated antibacterial activity against several bacteria. It can be inferred that roasted peanut and oilcake flours offer substantial nutritional value, making them promising candidates for addressing protein-energy malnutrition and serving as valuable ingredients in developing new food products.

Video Demonstration of Conversion from One Anastomosis Gastric Bypass to Sleeve Gastrectomy in a Patient with Protein Energy Malnutrition

Video Demonstration of Conversion from One Anastomosis Gastric Bypass to Sleeve Gastrectomy in a Patient with Protein Energy Malnutrition

Nutritional Prehabilitation in the Orthopaedic Trauma Patient

Nutrition is a modifiable factor which should be optimized in the surgical patient. Peri-operative programs, such as “Strong for Surgery”, identify patients with protein malnutrition and provide resources for adequate feeding in the peri-operative period. The Orthopedic Trauma patient benefits from this approach to encourage surgical wound healing, avoidance of septic complication, uneventful bone union, and successful rehabilitation. Acute orthopedic injuries requiring prompt intervention should be assessed for protein malnutrition and receive supplementation when necessary post-operatively. Patients with peri-articular fracture managed staged or for post-traumatic cases, nutrition should be assessed pre-operatively and addressed prior to definitive surgical reconstruction.