Risk Factors For Malnutrition Research Articles

Inappropriate feeding practices as a risk factor for severe acute malnutrition in children aged between one month to five years: a case control study

Background: In developing country like India, inappropriate feeding practices like lack of exclusive breastfeeding, early or late introduction of complimentary diet, lack of direct breastfeeding, prelacteal feed, bottle feeding are the major risk factors for development of severe acute malnutrition in children aged between one month to five years.Methods: It was a case control study, 109 children aged between one month to five years with severe acute malnutrition (SAM) who fulfilled the WHO criteria for SAM admitted to KIMS Hubli were taken as cases and 109 children aged between one month to five years without SAM admitted to KIMS Hubli were taken as control, the data gathering tool was questionnaire of children and mother. Data were entered and analysed using SPSS software version 11. Proportions were compared using Chi square (χ2) test of significance, categorical variables were assessed using χ2. Odds ratio (OR) and 95% confidence interval (CI) were calculated. To estimate the independent effect of the factors that were significantly associated with SAM and to control the confounding effect they may have on each other, logistic regression analysis was done. In all the above test the p value of less than 0.05 was accepted as indicating statistical significance.Results: In the study lack of EBF (exclusive breastfeeding), DBF (direct breastfeeding), h/o prelacteal feeds, h/o bottle feed and late initiation of complimentary diet >6 months were significantly associated with SAM (p value less than 0.05).Conclusions: The findings of this study clearly establishes the association of SAM with inappropriate infant feeding practices prevailing in our country.

P116 Screening for low BMI and unintentional weight loss alone is insufficient to identify patients at risk for malnutrition in an outpatient IBD population

Abstract Background Inflammatory bowel disease (IBD) is associated with malnutrition, which can further impair disease course and quality of life. Therefore, guidelines advocate screening of patients in clinical practice. The prevalence of malnutrition in IBD-cohorts however, varies widely, mainly due to differences in parameters used. The primary aim of the present study was to assess the prevalence of malnutrition using single and a combined set of parameters (Global Leadership Initiative on Malnutrition (GLIM) criteria). Secondary aims were i) to evaluate the accuracy of screening recommendations given in current IBD guidelines and ii) to explore which patients have an increased risk of malnutrition. Methods Malnutrition was defined by the GLIM criteria, based on the combination of a phenotypic (i.e. non-volitional weight loss, low body mass index (BMI), or reduced muscle mass) and an etiologic criterium (i.e. reduced food intake or assimilation, and disease burden or inflammation). Malnutrition was also determined using single parameters for impaired body composition, muscle strength or caloric intake (Table 1), and the combination of low BMI and unintentional weight loss as advised in current IBD guidelines. To screen for malnutrition, the Short Nutritional Assessment Questionnaire (SNAQ) and Malnutrition Universal Screening Tool (MUST) were completed. Independent risk factors (i.e. clinical and demographic factors) for malnutrition were analyzed by multivariable logistic regression. Results Of the 200 included patients (139 CD, 61 UC), 41 (20.5%) fulfilled the GLIM criteria, 95 (47.5%) had at least one parameter for malnutrition impaired (Figure 1). The fat free mass index was most often affected. When unintentional weight loss and/or low BMI was used as screening marker for nutritional status in line with current IBD guidelines, 29 (14.5%) patients would have been identified (Figure 2). Screening for malnutrition using the SNAQ and MUST detected 44 (22.0%) and 23 (12.9%) patients with a positive score. Only female sex was associated with malnutrition when at least one parameter was impaired (OR 2.47, 95% CI 1.35–4.51). Conclusion Malnutrition prevalence among IBD outpatients according to the GLIM criteria was found to be 20.5%. Almost half of the IBD outpatients had malnutrition as defined by various single parameters and irrespective of disease characteristics. Screening instruments and/or markers according to current IBD guidelines, did not identify a substantial part of the patients. Therefore, screening for malnutrition is recommended for all IBD outpatients by multiple parameters, with special attention for assessing fat free mass and reduced intake.

Human gut microbiome aging clocks based on taxonomic and functional signatures through multi-view learning

ABSTRACT The human gut microbiome is a complex ecosystem that is closely related to the aging process. However, there is currently no reliable method to make full use of the metagenomics data of the gut microbiome to determine the age of the host. In this study, we considered the influence of geographical factors on the gut microbiome, and a total of 2604 filtered metagenomics data from the gut microbiome were used to construct an age prediction model. Then, we developed an ensemble model with multiple heterogeneous algorithms and combined species and pathway profiles for multi-view learning. By integrating gut microbiome metagenomics data and adjusting host confounding factors, the model showed high accuracy (R2 = 0.599, mean absolute error = 8.33 years). Besides, we further interpreted the model and identify potential biomarkers for the aging process. Among these identified biomarkers, we found that Finegoldia magna, Bifidobacterium dentium, and Clostridium clostridioforme had increased abundance in the elderly. Moreover, the utilization of amino acids by the gut microbiome undergoes substantial changes with increasing age which have been reported as the risk factors for age-associated malnutrition and inflammation. This model will be helpful for the comprehensive utilization of multiple omics data, and will allow greater understanding of the interaction between microorganisms and age to realize the targeted intervention of aging.

Optimal Assessment of Nutritional Status in Older Subjects with the Chronic Obstructive Pulmonary Disease-A Comparison of Three Screening Tools Used in the GLIM Diagnostic Algorithm.

Chronic obstructive pulmonary disease (COPD) is a recognized risk factor for malnutrition. The European Respiratory Society (ERS) statement included nutritional status assessment and dietary intervention as essential components of comprehensive management in subjects with COPD. According to the GLIM algorithm, the first step in diagnosing malnutrition is risk screening with a validated tool. Our study aimed to assess the diagnostic performance of three screening tools (MNA-SF, MUST, and NRS-2002) used in the GLIM algorithm in older patients with COPD. Additionally, we evaluated the agreement between these tools in the diagnostics of malnutrition. We performed a cross-sectional study of 124 patients aged at least 60 years with COPD diagnosed, based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD). We assessed the participants’ nutritional status with the three examined screening questionnaires (MNA-SF, MUST, and NRS-2002). Regardless of their results, we performed full malnutrition diagnostics following the GLIM algorithm in all subjects. The proportion of malnourished participants varied from 18.5% for the MUST questionnaire to 27.4% for the MNA-SF and 57.3% for the NRS-2002 score. Based on the GLIM criteria, malnutrition was diagnosed in 48 subjects (38.7%). All assessed questionnaires had an unsatisfactory sensitivity against the GLIM criteria for malnutrition: it was fair (58.3%) for the MNA-SF tool and poor for the MUST and NRS-2002 questionnaires (47.9% for both questionnaires). Considering the negative health consequences of malnutrition, a full diagnostic including GLIM etiologic and phenotypic criteria should be recommended in all elderly patients with COPD, regardless of the screening results.

Relationship between time-dependent variability in cardiometabolic risk factors and biochemical markers with cytokine and adipokine levels in hemodialysis patients

Hemodialysis patients (HP) are exposed to malnutrition, cardiometabolic and pro-inflammatory risk factors. However, limited knowledge of the variability of these risk factors remains a serious barrier to the proper clinical management of HP. From a longitudinal study, we investigated the relationship between time-dependent variability in cardiometabolic risk factors and biochemical markers with cytokine and adipokine circulating levels in HP. Thirty-eight HP (women = 15, men = 23) aged 54.13 ± 16.78 years old underwent three independent anthropometric, nutritional, biochemical and immunological assessments (1, 6 and 12 months). Patient’s characteristics (body mass, comorbidities, history of kidney disease and time on hemodialysis) were similar after sex stratification. From grouped data, 31.6–100.0% HP exhibited multiple malnutrition and cardiometabolic risk factors in all time-points evaluated. All anthropometric and nutritional results, and most biochemical markers were similar in 1, 6 and 12 months follow-up, indicating a marked time-dependent stability. Urea, creatinine, total proteins, albumin, adipokines (adiponectin, leptin and resistin) and cytokines (TNF, IL-6 and IL-10) levels were highly variable in 12 months follow-up. Direct correlations between leptin and fat mass, TNF and IL-6 with creatinine and pre-dialysis urea were observed in all time-points (1, 6 and 12 months). Creatinine and pre-dialysis urea were negatively correlated with IL-10 for the entire follow-up. Fat mass, creatinine and pre-dialysis urea were predictive markers of leptin, TNF, IL-6 and IL-10 variability. Our findings indicated that biochemical, nutritional and cardiovascular risk factors exhibit low time-dependent variability in HP under clinical and nutritional monitoring. However, adipokines and cytokines are highly variables, which can potentially be influenced by body adiposity, creatinine and urea clearance. Thus, these parameters can contribute to predict the inflammatory status in HP.

Évolution du statut nutritionnel d’une cohorte d’enfants tunisiens au cours de l’hospitalisation : facteurs de risque de la dénutrition hospitalière

ObjectivesStudy the evolution of the nutritional status of a cohort of hospitalized children and identify the risk factors of hospital malnutrition. MethodsProspective, cross-sectional study carried out in a pediatric department over a period of six months, including all children aged≥30days, hospitalized for a period≥six days. Anthropometric data were assessed on admission and discharge. Food consumption was assessed using the flower tool. We identified the risk factors for hospital undernutrition (HUN) by multivariate analysis. ResultsWe included 120 patients with a mean age 46.3months. The prevalence of acute undernutrition at admission was 21.7% and that of chronic undernutrition was 10%. The prevalence of acute undernutrition at discharge rose to 34%. Weight loss during hospitalization was noted in 68.3% of cases. The prevalence of HUN was 55% considering a decrease in BMI or P/PAT z-score≥25%. The risk factors for HUN were: age≤24months (P=0.039; OR 95% CI=2.67 [1.05–6.82]), the presence of undernutrition on admission (P=0.002; OR 95% CI=2.32 [0.93–6.51]) and average food consumption<50% during hospitalization (P<10−3; OR 95% CI=6.69 [2.57–17.40]). ConclusionScreening for undernutrition on admission to hospital as well as assessment of the nutritional risk in hospitalized children is essential so that preventive or curative nutritional care can be taken.

Prevalence of Malnutrition, Its Risk Factors, and the Use of Nutrition Support in Patients with Inflammatory Bowel Disease.

Malnutrition is prevalent among patients with inflammatory bowel disease (IBD). Nutritional profiles among Asian patients with IBD have seldom been investigated. We assessed the prevalence of and risk factors for malnutrition, use of nutrition support, and sociopsychological status associated with malnutrition among patients with IBD in China. Patients with ulcerative colitis and Crohn's disease (CD) recruited from 43 tertiary referral hospitals were screened for malnutrition and nutrient deficiencies in this cross-sectional study. The use of nutrition support was recorded. The sociopsychological status was assessed by subjective questionnaires. Factors associated with malnutrition were analyzed, and multivariate regression was used to determine independent predictors for malnutrition. We recruited 1013 patients with a median age of 35.0 years, 58.5% of them had CD, and 61.4% of all patients were male. Overall, 49.5% (n = 501) of patients were diagnosed with malnutrition, including 57.0% of patients with CD, 38.8% of patients with ulcerative colitis, and 44.1% of patients with quiescent or mildly active disease. Nutrient deficiencies were prevalent despite the absence of malnutrition. Malnutrition was associated with adverse sociopsychological status, including decreased social support, higher perceived stress, and impaired quality of life. Moderate to severe disease activity and extensive disease were 2 independent risk factors for malnutrition. In total, 41.6% of patients received nutrition support, and patients with risk factors were more likely to receive nutrition support. Malnutrition was highly prevalent and associated with adverse consequences in Chinese patients with IBD. Malnutrition screening and early initiation of nutrition support are essential components in IBD care.

Risk factors for inpatient malnutrition and length of stay assessed by 'NutritionDay' in China.

NutritionDay is a yearly global point-prevalence study of malnutrition or nutritional risk in hospitals. We aimed to provide a comprehensive nutritional survey of hospitalized patients and analyze the risk factors of malnutrition and prolonged hospitalization in Chinese inpatients. The international daylong cross-sectional survey was performed on November 07th, 2019. Ten hospitals were invited to participate in this NutritionDay survey. Nutritional risk was identified by nutritional risk screening 2002, and malnutrition was identified by the ESPEN criteria. We measured the incidence of malnutrition and nutritional risk. And we analysed risk factors for malnutrition and length of stay in Chinese hospitalized patients. 875 hospitalized patients from 6 departments were included in the analysis. The malnutrition rate was 11.6% and the incidence of nutritional risk was 17.8%. It was analyzed that tumor load, end-stage disease, motility, self-rated health, types of oral medicine, and food intake during the past week were independent risk factors for malnutrition or nutritional risk. 56.2% (118/210) of patients at nutritional risk or malnutrition received extra nutritional support, whereas 22.5% (88/391) well-nourished patients did. Moreover, nutrition status, ever stayed in ICU and self-rated health were associated with prolonged length of stay. In a word, the prevalence of malnutrition or nutritional risk was about 29.4%. Patients with malnutrition or nutritional risk had a higher transfer rate, lower rehabilitation rate and longer hospital stays. The attention to malnutrition patients needs to be further strengthened.

Prognostic factors for malnutrition in patients with colorectal cancer

Introduction: patients undergoing major abdominal surgery, including colorectal surgery, particularly if they are oncological patients, are at risk of malnutrition with a worse postoperative evolution and an increase in complications. Objectives: to assess the prevalence of malnutrition in patients undergoing colon and rectal surgery in our hospital, and to identify the different risk factors for malnutrition. Methods: a retrospective cohort study including all patients operated on for colorectal cancer in our environment. Results: a total of 382 patients with a mean age of 69.93 years were included in the study. Considering different risk factors for malnutrition, we obtained that 50.6 % of the patients had some of the risk indicators for malnutrition altered at the time of admission. The variables that proved to be independent factors related to malnutrition were age, DM, baseline malnutrition, and heart disease. Preoperative malnutrition turned out to be the greatest risk factor for presenting moderate/severe malnutrition in the postoperative period with an OR of 3.83 (2.1-6.9; p < 0.001), and was also associated with a higher incidence of postoperative complications and longer hospital stays. We obtained that the percentage of postoperative complications was significantly higher in the group of patients diagnosed with peroperative malnutrition (36.3 % vs 22.0 %, p = 0.004). Conclusions: the percentage of malnutrition in patients with colorectal cancer is high, an aspect that is underestimated in most surgical services. In our study, malnutrition leads to worse outcomes with an increase in complications.

Prevalence and Biochemical Risk Factors of Severe Acute Malnutrition in Infants Under 6 Months Old in Single Tertiary Referral Hospital

Severe acute malnutrition remains to be a burden in developing countries, including Indonesia. Recent studies and researches started to highlight the importance of recognizing severe acute malnutrition in infants under 6 months old. This is a cross-sectional study aims to know the prevalence and biochemical risk factors of severe acute malnutrition in infants under 6 months old in our single tertiary referral hospital, Sanglah General Hospital, Denpasar, Bali, Indonesia. From January 2017 to December 2018, there were 138 children with severe acute malnutrition admitted to Sanglah General Hospital, Denpasar. From 138 subjects, 19 were below 6 months old of age (13,8%) and 119 were older than 6 months old (86,2%). Majority of our study samples were males with ratio of 1,5:1, had length of stay of more than 15 days (60,9%) and were marasmic (96,4%). Death occurred in 44,9% of study samples. Bivariate analysis including gender, length of stay, death, comorbidities, anemia, hypoalbuminemia, hypokalemia, hyponatremia and hypocalcemia. Of all the variables analyzed, only hypocalcemia yielded significant result with prevalence ratio between below and older than 6 months old age group was 0,432 (<i>p value </i>0,045). The prevalence of hypocalcemia in infants under 6 months old with acute severe malnutrition is lower than children above 6 months old of age.

Malnutrition among under-five children in St. Martin's Island, Bangladesh: A cross-sectional study on prevalence and associated factors.

Objectives:Early childhood nutrition is critical for physical and mental development, and any hindrance (malnutrition) at this stage adversely affects adulthood which makes them more susceptible to a variety of communicable and non-communicable diseases. St. Martin’s Island was the focus of this study, which examined the prevalence and risk factors for malnutrition among under-five children.Methods:In this cross-sectional study, 256 children aged under five were assessed for anthropometry, and multiple logistic regression models were fitted to identify potential predictors of malnutrition. For analysis, SPSS and WHO Anthro software were used.Results:The prevalence of stunting, wasting, underweight, and overweight were 34.4%, 17.6%, 18.9%, and 6.9% respectively among children under-five years of age in St. Martin’s Island. An increase in child’s age decreases their risk of being stunted (AOR = 0.97, p = 0.006). Males were more likely than females to be wasted (AOR = 2.03, p = 0.001). Both stunting (AOR = 2.42, p = 0.004) and wasting (AOR = 2.82, p = 0.015) rate were higher among the poorer section as compared to the richest. On the contrary, underweight was low among the poorest section (AOR = 0.37, p = 0.024). Other socio-economic factors, for example, household food insecurity, and parental occupation affect these forms of malnutrition significantly.Conclusion:Prevalence of all forms of malnutrition except underweight was higher as compared to the national perspective in St. Martin’s Island among the under-five children. Community-based approaches by the local government in collaboration with various non-government organizations should be taken to reduce and prevent malnutrition among children.

The Association Between Nutritional Status on Admission and Hospital-Acquired Malnutrition in Pediatric Patients at Sanglah General Hospital

<i>Introduction:</i> Hospital-acquired malnutrition is one aspect of childhood malnutrition that healthcare professionals might not recognize. The prevalence of hospital-acquired malnutrition globally and in developing countries is still high varies between 6.1%-40.9%. Various factors contributed to the frequency of hospital-acquired malnutrition, including the nutritional status at the onset of the disease. <i>Material and Methods:</i> The prospective cohort study was conducted on the patients in Pediatric Ward at Sanglah General Hospital, Denpasar Bali period July 2020 and January 2021. We Include children aged one month to 18 years old. Samples were taken by consecutive sampling. Hospital-acquired malnutrition was marked by more than 2% loss of weight from the measurement during admission. Univariate analysis was performed using the chi-square test. Nutritional status presented as Prevalence Ratio (PR) and 95% Confidence Interval (95% CI). The result is considered as significant if p<0.05. <i>Results:</i> 208 subjects were included and analyzed in this study. Malnutrition incidence was 15.4%. The risk factors significantly associated with hospital-acquired malnutrition were an underlying disease, length of stay, admission nutritional status. Malnutrition, length of stay and underlying condition were the independent risk factors for hospital-acquired malnutrition with PR 7.528 (95% CI, 2.528-21.033; p=0.001), PR 9.061 (95% CI, 2.925-28.066; p=0.001) and PR 2.638 (95% CI, 1.0325-6.724; p=0.042). <i>Conclusion:</i> The incidence of hospital acquired malnutrition in Sanglah Hospital was 15.4%. Children with malnutrition, prolonged hospitalization length, and underlying disease are associated with hospital-acquired malnutrition.

Malnutrition risk frequency and independent risk factors associated with mortality in hospitalized elderly patients with COVID-19 in Turkey.

Malnutrition is common in elderly patients and is an important geriatric syndrome that increases mortality. We aim to examine the frequency of malnutrition and independent risk factors associated with mortality in hospitalized elderly patients with COVID-19. Patients aged 65 years and older with COVID-19, who were hospitalized between 15th March and 30th April 2020, were included. Demographic characteristics of the patients, their comorbid diseases, medications, malnutrition, and mortality status were recorded. Nutritional Risk Screening-2002 was used as a malnutrition risk screening tool. The factors affecting mortality were analyzed using multivariate Binary Logistic regression analysis. Of the 451 patients included in the study, the mean age was 74.8±7.46 and 51.2% of them were female. The mean number of comorbid diseases was 1.9±1.28. Malnutrition risk was 64.7%, polymorbidity rate was 57.6% and polypharmacy was 19.3%. Mortality rate was found 18.4%. The risk factors affecting mortality were presented as malnutrition risk (OR: 3.26, p=0.013), high number of comorbid diseases (OR: 1.48, p=0.006), and high neutrophil/lymphocyte ratio (OR: 1.18, p<0.001), C-reactive protein (OR: 1.01, p<0.001), and ferritin (OR: 1.01, p=0.041) in elderly patients with COVID-19. Malnutrition risk (3.3 times), multiple comorbid diseases (1.5 times), and high neutrophil/lymphocyte ratio (1.2 times) were independent risk factors that increased the mortality. The frequency of malnutrition risk and mortality in elderly patients with COVID-19 is high. The independent risk factors affecting mortality in these patients are the risk of malnutrition, multiple comorbid diseases, and a high neutrophil/lymphocyte ratio.

Review of Risk Factors of Malnutrition in Maintenance Hemodialysis Patients

Review of Risk Factors of Malnutrition in Maintenance Hemodialysis Patients

Determinants of nutritional status among old age population in eastern Ethiopia: a general linear model approach.

As the world's aging population grows, nutrition and health issues are becoming a major concern. The aim of the present study was to identify the factors associated with nutritional status among old age population. A community-based cross-sectional study was employed among randomly selected 739 elders over the age of 60 in Dire Dawa City administration, eastern Ethiopia. The validated full mini nutritional assessment tool and appetite test (SNAQ) was used to assess the nutritional status of the study population. Considering the ranked nature of the data, a bivariate and multivariable ordinal logistic regression model (under the generalised linear model) was conducted, with crude and adjusted odds ratios reported along with 95 % confidence intervals. Statistically significant associations are declared at P-value less than 0⋅05. In this study, 22 % (95 % CI: 19 %, 25 %) of elders were malnourished. Participants with >75 years old (AOR 4⋅95; 95 % CI 1⋅54, 8⋅4), being female (AOR 1⋅6; 95 % CI 1⋅1, 2⋅2), illiterate (AOR 1⋅5; 95 % CI 1⋅01, 2⋅2), severe depression (AOR 13⋅9; 95 % CI 8⋅2, 23⋅7) and with poor appetite (AOR 3⋅3; 95 % CI 2⋅3, 4⋅8) were important predictors of malnutrition among older age group. We found that the prevalence of malnutrition and the risk of malnutrition is a public health concern that warrants intervention in the area. Advanced age, illiteracy, depression and poor appetite were important risk factors for malnutrition among older age group. The identified risk factors will guide public health professionals and programmes in the design, implementation of interventions to improve the nutritional status of older age group.

Risk Factors of Malnutrition among under Five Children Admitted in Kanti Children’s Hospital in Nepal

Background World Health Organization (WHO) stated that malnutrition is a major global health and social problem from which many people are suffering, particularly children. Poor feeding and care practices, insufficient nutrient intake, high rate of infection and teenage pregnancy are the immediate causes of chronic malnutrition.&#x0D; Objective To identify the risk factors for malnutrition among under five children.&#x0D; Method A case control study was carried out among the mothers having under-5 years’ children who were admitted in the Kanti Children’s Hospital of Nepal from 1st August 2019 to 7th September 2020. Non-probability purposive sampling technique was used to select 50 children with malnutrition and 100 children without malnutrition matched on age, sex and setting. A structured interview was used to collect data from mothers of both cases and controls. Descriptive and inferential statistics were used to analyze the data.&#x0D; Result Present study reveals that 58% girl got marriage before 20 years. After confounders adjusted, mother’s age ≥ 20 years at marriage (OR: 2.74, 95% CI: 0.98-7.63. p=0.05), and mother’s age ≥ 20 years at child birth (OR: 7.74, 95% CI: 2.37-25.27. p=0.001), were significantly associated with having malnutrition among under five children. Similarly, accessibility of health facility (OR: 3.31, 95% CI: 1-10.94. p=0.05), fathers who completed master in education (OR: 0.08, 95% CI: 0.01-0.88. p=0.04), children who lived in joint family (OR: 0.25, 95% CI: 0.07-0.86. p=0.03), child &lt; 2.5 kg at birth (OR: 0.18, 95% CI: 0.05-0.62. p=0.01), and second and third or above in order (OR: 0.09, 95% CI: 0.01-1.04. p=0.05) had significantly less chance of having malnutrition. Children’s whose birth interval was 2-3 years were significantly (OR: 9.74, 95% CI: 1.16-82.23. p=0.04) associated with the occurrence of malnutrition. Children who had suffered from multiple co-morbidities in last one year were (OR: 4.55, 95% CI: 0.48-43.03. p=0.18) more chance of having malnutrition.&#x0D; Likewise, the mothers who feed colostrum to their child had (OR: 2.28, 95% CI: 0.52- 9.26. p=0.29) almost two-fold less chance of having malnutrition. Mothers who had done exclusive breast feeding ≥ 4 months had (OR: 40.55, 95% CI: 3.35-1.490.92. p=0.008) significantly associated with having malnutrition.&#x0D; Conclusion Low education status of father, living in single family, exclusive breast feeding ≥ 4 months, lack of balance diet were significant risk factors of malnutrition. Based on finding, reliable longitudinal studies, interventions and program to educate parent for prevention of malnutrition are necessary in future.

Feasibility and Acceptability of VideoChat During Meals in Adults Aging in Place of Average Age 88

Older adults in the United States prefer to age-in-place. However, living and eating alone are risk factors for malnutrition. Using videochat during mealtimes, i.e., VideoDining, can provide commensality and social facilitation to improve nutritional intake. The objective of this study was to determine if older adults aging-in-place can independently VideoDine with family or friends. We recruited eleven older adults from Full Circle America Steuben, a virtual assisted living program for adults aging-in-place in rural New York. All participants had Amazon EchoShow devices for videochat. Participants were instructed on VideoDining and asked to independently schedule four VideoDine sessions with a family/friend in four weeks. Surveys were collected at baseline, after VideoDine sessions, and end-of-study. Participants were 91% female and 100% white. The average age was 88 years. All participants were widowed and living alone except for one married couple. Overall, 45% of participants VideoDined four times, 36% of participants VideoDined two to three times, and 27% not at all, for an average of 2.7 sessions in a month. Participants VideoDined during all meals, although dinner was most common (66% of meals), and breakfast least common (12% of meals). Average comfort was rated 7.6/10 (1=not comfortable, 10=comfortable), median enjoyment was 9.3/10 (1=not enjoyable, 10=enjoyable), and median ease of VideoDining was 4.1/5 (1=very difficult, 5=very easy). On average, participants rated their VideoDining meal experience a 7.6/10 (1=poor, 10=excellent). With access to videochat technology, older adults can connect with a dining partner and have a favorable experience sharing a meal over videochat.

The clinical application value of the extracellular-water-to-total-body-water ratio obtained by bioelectrical impedance analysis in people with advanced cancer

ObjectivesBody-composition analysis using bioelectrical impedance analysis is gradually becoming more widely used in clinical practice. The ratio of extracellular water (ECW) to total body water (TBW) is thought to be related to the prognosis of a variety of diseases. However, its performance in people with advanced cancer deserves further discussion. MethodsA retrospective analysis was performed on 784 people with advanced cancer. Anthropometric indicators, serologic indicators, nutritional status, health-related quality of life, and body composition were analyzed. Participants were grouped into two groups according to ECW/TBW ratio. We used t tests and χ2 tests to analyze differences between the groups. Univariate and multivariate Cox regressions were conducted to analyze the factors influencing overall survival. Logistic regression was used to analyze the related factors of malnutrition, and linear regression for factors of health-related quality of life. ResultsAge, body mass index, Patient-Generated Subjective Global Assessment score, Karnofsky Performance Status questionnaire score, skeletal muscle mass index, and fat-free mass index were statistically different between the non-overhydrated and overhydrated groups. Univariate and multivariate Cox regression models showed that an ECW/TBW ≥ 0.40 is a risk factor for poor prognosis in people with advanced cancer (hazard ratio = 1.511; 95% confidence interval, 1.103–2.070; P = 0.010). Subgroup analyses were next conducted according to tumor type, with ECW/TBW ≥ 0.40 emerging as a risk factor for poor prognosis for people with advanced breast cancer and advanced gastric cancer. Logistic regression showed that ECW/TBW ≥ 0.40 is a risk factor for malnutrition in people with advanced cancer (odds ratio = 1.988; 95% confidence interval, 1.049–3.767; P = 0.035). The univariate and multivariate linear regression models showed that the ECW/TBW ratio is an influencing factor for health-related quality of life in the domains of physical functioning, role functioning, and constipation. ConclusionWe found that in people with cancer, an ECW/TBW ≥ 0.40 was a risk factor for malnutrition and lower health-related quality of life, and in people with advanced cancer, it was a risk factor for poor prognosis.

Malnutrition Risk Among Chronic Kidney Disease Patients Attending the Nephrology Clinic in Hospital Tengku Ampuan Afzan, Pahang

Objective: The prevalence of chronic kidney disease among adult in Malaysia has been increasing and it is forecasted that the pattern will remain. The risk for malnutrition is prominent especially in the later stage of chronic kidney disease. Early detection of malnutrition is important to prevent further complications. However, limited studies on malnutrition risk has been conducted in Malaysia. Therefore, this study was performed to determine the prevalence and associated risk factor of malnutrition among chronic kidney disease patient attending Nephrology Clinic in Hospital Tengku Ampuan Afzan, Kuantan, Pahang. Methods: A cross-sectional study was conducted among 70 chronic kidney disease patients using convenience sampling. All patients were explained about the study and informed consent obtained prior the administration of questionnaire. There were three parts of questionnaire to be answered which were on sociodemographic, clinical characteristic and dietary information along with Malnutrition Risk Screening Tool-Hospital to measure the risk for malnutrition. Results: Most of the participants were married (75.7%), had completed primary school (58.6%), currently not working (32.9%), had income between RM 1000 to RM 1999 (37.1%) and living with three or four members in a household (24.3%). Majority had at least one precipitating disease that causes chronic kidney disease such as hypertension (71.4%) followed by diabetes (61.4%) and high cholesterol (30.0%). Almost 21.4% of chronic kidney disease patients screened were at risk for malnutrition. Further inferential analysis shows an association between weight loss (p=0.001) towards risk for malnutrition. Conclusion: Overall, the risk for malnutrition among chronic kidney disease patient was fairly high. This warrant close attention of the healthcare professional that caring for the patients particularly in detection of detrimental weight loss during each follow up visit. A referral to the dietician is important to ensure the patients received adequate counselling and education on dietary management.

Prevalence and associated factors of malnutrition in patients with Parkinson's disease using CONUT and GNRI

ObjectiveParkinson's disease (PD) is a common neurodegenerative disease, but its nutritional problems have not received enough attention. This study aims to identify the prevalence and associated factors of malnutrition in PD patients using two simple nutritional tools. MethodsWe conducted a large-scale cross-sectional study with 1478 PD patients and equal healthy controls (HC). The controlling nutritional status score (CONUT) and geriatric nutritional risk index (GNRI) were used for malnutrition stratification. ResultsBy CONUT or GNRI, the prevalence of malnutrition in PD patients was higher than that in HC (40.7% vs. 25.3% and 11.1% vs. 2.1%, respectively). The binary logistic regression model showed that malnutrition in PD was associated with male sex (OR = 0.600, P < 0.001), older age (OR = 1.015, P = 0.003), lower body mass index (BMI) (OR = 0.942, P < 0.001), higher levodopa equivalent daily doses (LEDD) (OR = 1.001, P < 0.001), worse motor symptoms (OR = 1.012, P = 0.004), more serious perceptual problems/hallucinations (OR = 1.067, P = 0.019) by CONUT. In comparison, older age (OR = 1.045, P < 0.001), lower blood lymphocyte count (OR = 0.607, P = 0.006), lower serum total cholesterol levels (OR = 0.991, P < 0.001), dyskinesia (OR = 2.231, P = 0.002), worse motor symptoms (OR = 1.016, P = 0.015), more severe depression (OR = 1.028, P = 0.008) and perceptual problems/hallucinations (OR = 1.061, P = 0.033) were associated with malnutrition in PD by GNRI. ConclusionsOur study indicated that malnutrition is more prevalent in PD patients than HC. Multidimensional risk factors for malnutrition in PD should be taken seriously.