Risk Factors For Malnutrition Research Articles

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.

Covid-19 hospitalized patients at nutritionday: use of enteral nutrition, parenteral nutrition or oral nutritional supplements is associated with being bedridden, not being allowed to eat, low appetite and low bmi

Rationale: Assessment, monitoring and treatment of malnutrition is recommended to be included in the management of COVID-19 patients. We investigated the prevalence of malnutrition risk factors in hospitalized COVID-19 positive patients and the association with nutritional support at nutritionDay 2020.

The Role of Iodine for Thyroid Function in Lactating Women and Infants.

Iodine is a micronutrient needed for the production of thyroid hormones, which regulate metabolism, growth, and development. Iodine deficiency or excess may alter the thyroid hormone synthesis. The potential effects on infant development depend on the degree, timing, and duration of exposure. The iodine requirement is particularly high during infancy because of elevated thyroid hormone turnover. Breastfed infants rely on iodine provided by human milk, but the iodine concentration in breast milk is determined by the maternal iodine intake. Diets in many countries cannot provide sufficient iodine, and deficiency is prevented by iodine fortification of salt. However, the coverage of iodized salt varies between countries. Epidemiological data suggest large differences in the iodine intake in lactating women, infants, and toddlers worldwide, ranging from deficient to excessive intake. In this review, we provide an overview of the current knowledge and recent advances in the understanding of iodine nutrition and its association with thyroid function in lactating women, infants, and toddlers. We discuss risk factors for iodine malnutrition and the impact of targeted intervention strategies on these vulnerable population groups. We highlight the importance of appropriate definitions of optimal iodine nutrition and the need for more data assessing the risk of mild iodine deficiency for thyroid disorders during the first 2 years in life.

Risk Factors for Malnutrition among IBD Patients.

(1) Background: Malnutrition is a highly prevalent complication in patients with inflammatory bowel diseases (IBD). It is strongly associated with poor clinical outcomes and quality of life. Screening for malnutrition risk is recommended routinely; however, current malnutrition screening tools do not incorporate IBD specific characteristics and may be less adequate for screening these patients. Therefore, we aimed to identify IBD-related risk factors for development of malnutrition. (2) Methods: A retrospective case-control study among IBD patients attending the IBD clinic of the Tel-Aviv Medical Center for ≥2 consecutive physician consultations per year during 2017–2020. Cases who had normal nutritional status and developed malnutrition between visits were compared to matched controls who maintained normal nutritional status. Detailed information was gathered from medical files, including: demographics, disease phenotype, characteristics and activity, diet altering symptoms and comorbidities, medical and surgical history, annual healthcare utility, nutritional intake and the Malnutrition Universal Screening Tool (MUST) score. Univariate and multivariate analyses were used to identify malnutrition risk factors. The independent risk factors identified were summed up to calculate the IBD malnutrition risk score (IBD-MR). (3) Results: Data of 1596 IBD patients met the initial criteria for the study. Of these, 59 patients developed malnutrition and were defined as cases (n = 59) and matched to controls (n = 59). The interval between the physician consultations was 6.2 ± 3.0 months, during which cases lost 5.3 ± 2.3 kg of body weight and controls gained 0.2 ± 2.3 kg (p < 0.001). Cases and controls did not differ in demographics, disease duration, disease phenotype or medical history. Independent IBD-related malnutrition risk factors were: 18.5 ≤ BMI ≤ 22 kg/m2 (OR = 4.71, 95%CI 1.13–19.54), high annual healthcare utility (OR = 5.67, 95%CI 1.02–31.30) and endoscopic disease activity (OR = 5.49, 95%CI 1.28–23.56). The IBD-MR was positively associated with malnutrition development independently of the MUST score (OR = 7.39, 95%CI 2.60–20.94). Among patients with low MUST scores determined during the index visit, identification of ≥2 IBD-MR factors was strongly associated with malnutrition development (OR = 8.65, 95%CI 2.21–33.82, p = 0.002). (4) Conclusions: We identified IBD-related risk factors for malnutrition, highlighting the need for a disease-specific malnutrition screening tool, which may increase malnutrition risk detection.

Empowering Mothers through Mentoring on 6-60 Months Children’s Nutrition Care: An Effort to Prevent Child Malnutrition

The prevalence of malnutrition in Indonesia in the last 20 years remains high. This shows that management through curative aspects is not enough. A new strategy is needed to solve the problem as well as to overcome the risk factors. The root cause of malnutrition in Indonesia is the lack of maternal knowledge and power towards their nutrition status. This study aims to determine the mentoring that To do through a tutorial module on malnutrition risk factors. This expects to empower mothers on caring for 6-60 months old children. This research is a two-sample experimental study with controls. Respondents were mothers who had children aged 6-60 months. A total of 39 mothers choose a control group and 38 mothers as a treatment group. The mentoring method was given to the treatment group while providing counseling to the control group: multivariate ANOVA and independent t-tests to show maternal empowerment. Mentoring on caregiving was very effective in increasing mothers’ abilities to care for their children’s nutrition (p <0.05). Hence, the mentoring method could empower mothers to care for their children (p = 0.005). It took six months to empower 13.2% of mothers with a minimum knowledge score of 2.5 and practice of 3.1 times, respectively, much higher than the counseling method. Mothers who are already empowering will be aware of any deviation in their children’s nutritional status.

A multi-centre survey on hospital malnutrition: result of PNSI study

BackgroundDisease-related malnutrition is associated with adverse outcomes such as increased rates of morbidity and mortality, prolonged hospital stay, and extra costs of health care. This study was conducted to assess nutritional status among patients and to determine the risk factors for malnutrition in Iran university f.MethodsPersian Nutritional Survey In Hospitals (PNSI) was a cross-sectional study that conducted in 20 university hospitals across Iran. All the patients with age range of 18 to 65 years, who were admitted or discharged, were assessed by subjective global assessment (SGA).ResultsIn total, 2109 patients were evaluated for malnutrition. Mean values of age and body mass index were 44.68 ± 14.65 years and 25.44 ± 6.25 kg/m2, respectively. Malnutrition (SGA-B & C) was identified in 23.92% of the patients, 26.23 and 21% of whom were among the admitted and discharged patients, respectively. The highest prevalence of malnutrition was in burns (77.70%) and heart surgery (57.84%) patients. Multivariate analysis presented male gender (OR = 1.02, P < 0.00), malignant disease (OR = 1.40, P < 0.00), length of hospital stay (OR = 1.20, P < 0.00), and polypharmacy (OR = 1.06, P < 0.00) as independent risk factors for malnutrition. Malnutrition was not associated with age (P = 0.10).ConclusionThis study provides an overall and comprehensive illustration of hospital malnutrition in Iran university hospitals, finding that one out of four patients were malnourished; thus, appropriate consideration and measures should be taken to this issue.

The correlation between skeletal muscle index of the L3 vertebral body and malnutrition in patients with advanced lung cancer

BackgroundStudies have shown that the skeletal muscle index at the third lumbar vertebra (L3 SMI) had reasonable specificity and sensitivity in nutritional assessment and prognostic prediction in digestive system cancers, but its performance in lung cancer needs further investigation.MethodsA retrospective study was performed on 110 patients with advanced lung cancer. The L3 SMI, the Patient-Generated Subjective Global Assessment score (PG-SGA score), body mass index (BMI), and serological indicators were analyzed. According to PG-SGA scores, patients were divided into severe malnutrition (≥9 points), mild to moderate malnutrition (≥3 points and ≤ 8 points), and no malnutrition (≤2 points) groups. Pearson correlation and logistic regression analysis were adopted to find factors related to malnutrition, and a forest plot was drawn. The receiver operating characteristic (ROC) curve was performed to compare the diagnostic values of malnutrition among factors, which were expressed by the area under curve (AUC).Results1. The age of patients in the severe malnutrition group, the mild to moderate malnutrition group, and the no malnutrition group significantly differed, with mean ages of 63.46 ± 10.01 years, 60.42 ± 8.76 years, and 55.03 ± 10.40 years, respectively (OR = 1.062, 95%CI: 1.008 ~ 1.118, P = 0.024; OR = 1.100, 95%CI: 1.034 ~ 1.170, P = 0.002). Furthermore, the neutrophil to lymphocyte ratio (NLR) of the severe malnutrition group was significantly higher than that of the no malnutrition group, with statistical significance. The difference between the mild to moderate malnutrition group and the no malnutrition group were not statistically significant, with NLR of 4.07 ± 3.34 and 2.47 ± 0.92, respectively (OR = 1.657,95%CI: 1.036 ~ 2.649, P = 0.035). The L3 SMI of patients in the severe malnutrition and mild to moderate malnutrition groups were significantly lower than that of the patients in the no malnutrition group, with statistical significance. The L3 SMI of patients in the severe malnutrition group, mild to moderate malnutrition group, and no malnutrition group were 27.40 ± 4.25 cm2/m2, 38.19 ± 6.17 cm2/m2, and 47.96 ± 5.02 cm2/m2, respectively (OR = 0.600, 95%CI: 0.462 ~ 0.777, P < 0.001; OR = 0.431, 95%CI: 0.320 ~ 0.581, P < 0.001).2. The Pearson correlation analysis showed that the PG-SGA score positively correlated with age (r = 0.296, P < 0.05) but negatively correlated with L3 SMI (r = − 0.857, P < 0.05). The L3 SMI was also negatively correlated with age (r = − 0.240, P < 0.05).3. The multivariate analysis showed that the L3 SMI was an independent risk factor for malnutrition (OR = 0.446, 95%CI: 0.258 ~ 0.773, P = 0.004; OR = 0.289, 95%CI: 0.159 ~ 0.524, P < 0.001).Conclusion1. The differences in the L3 SMI was statistically significant among advanced lung cancer patients with different nutritional statuses.2. In the nutritional assessment of patients with lung cancer, the L3 SMI was consistent with the PG-SGA.3. The L3 SMI is an independent predictor of malnutrition in patients with advanced lung cancer.

Barrier analysis for adequate daily fruit and vegetable consumption among low-income residents of Hanoi, Vietnam and Ibadan, Nigeria

Inadequate fruit and vegetable intake is a risk factor for malnutrition and non-communicable diseases, particularly in low- and middle-income countries. This study aimed to identify the determinants of daily fruit and vegetable consumption among low-income households in urban and peri-urban areas of Hanoi, Vietnam and Ibadan, Nigeria. We used the barrier analysis rapid assessment tool to assess the influence of psychosocial and individual factors and perceived characteristics of the food environment. In Hanoi, determinants were family preferences and habits, home production, and perceived benefits and action efficacy. In Ibadan, consumption was determined by affordability. Gender- and neighbourhood-related differences were found to be influential factors. As results are contextual, we recommend that interventions promoting fruit and vegetable consumption assess local determinants.

Demographic Risk Factors for Malnutrition in Patients With Cleft Lip and Palate.

Patients with cleft lip and/or palate (CLP) are at increased risk of malnutrition. Acute and chronic malnutrition have been associated with elevated risk of postsurgical wound complications, adding morbidity and cost to patients and their families. To study the association between demographic factors, including insurance type, race, and median neighborhood income (MNI), and malnutrition in patients with CLP. Retrospective cohort study. Retrospective review was performed in patients undergoing their first cleft-related surgery at a large tertiary pediatric hospital from 2006 to 2018. Demographic data, weight and height at surgery, type of insurance, race, and primary residential address were collected. Geocoded information on MNI was generated using patient address. World Health Organization Z-scores for weight-for-age (WFA) and height-for-age (HFA) were used as proxies for acute and chronic malnutrition, respectively. Linear regression models were generated to analyze the relationship of insurance type, race, and MNI on WFA and HFA Z-scores. About 313 patients met inclusion criteria. Increasing MNI predicted increasing WFA Z-score (0.05 increase in WFA per $1,000 increase, P=.047) as well as HFA Z-score (0.09 increase in HFA per $1,000 increase, P=.011). The effect of MNI was not independently modified by race for either WFA (P=.841) nor HFA (P=.404). Race and insurance type did not predict WFA or HFA. Lower MNI is a significant independent risk factor for acute and chronic malnutrition in children with CLP. Combined with previous investigation linking malnutrition to surgical outcomes in this population, this offers a target area for intervention to improve patient outcomes. 3 Laryngoscope, 132:1482-1486, 2022.

Malnutrition and other risk factors of geriatric depression: a community-based comparative cross-sectional study in older adults in rural Bangladesh

BackgroundMalnutrition and depression are highly prevalent in older adults and can lead to disparaging outcomes. Analytical studies on geriatric depression (GD) and its association with malnutrition are very scarce in Bangladesh, although the size of the older population is increasing fast in the country. The current study aimed to assess the association between malnutrition and depression and associated risk factors in rural older adults.MethodsA community-based comparative cross-sectional study was conducted in 600 older adult residents (aged ≥60 years) of three rural communities of Bangladesh from January to October 2019. The study enrolled two groups of participants; 300 depressed as cases and another 300 non-depressed older adults as a comparison group matching their age and living area. We used a semi-structured questionnaire to collect data through a face-to-face interview. Geriatric Depression Scale-15 was used to determine depression, and a score of ≥5 was considered as depressed. We used the Bangla version of the Mini-Nutritional Assessment-Short Form to assess nutritional status, which comprised questions related to appetite, weight loss, mobility, recent illness/stress, dementia/depression, and BMI, and considered a score of 0–7 as the cutoff score for malnutrition. Measures included baseline and personal characteristics, malnutrition, GD, and its associated risk factors. A binary logistic regression model was fitted to identify variables associated with the risk of GD.ResultsThe study found no significant difference in gender (male Vs. female) between depressed (44.0% Vs. 56.0%) and non-depressed (46.0% Vs. 54.0%) older individuals. The study revealed that malnutrition was significantly (p < 0.01) higher in depressed (56.0%) than in non-depressed (18.0%) rural older adults. The malnourished older adults had around three times (AOR = 3.155; 95% CI: 1.53–6.49, p = 0.002) more risk of having depression than the well-nourished older individuals. Older adults who were unemployed (AOR = 4.964; 95% CI: 2.361–10.440; p = 0.0001) and from lower and middle class (AOR = 3.654; 95% CI: 2.266–7.767; p = 0.001) were more likely to experience depression. Older adults having a ‘poor diet’ were more likely to experience depression (AOR = 3.384; 95% CI: 1.764–6.703; p = 0.0001). The rural older adults who were single (AOR = 2.368; 95% CI: 1.762–6.524; p = 0.001) and tobacco users (AOR = 2.332; 95% CI: 1.663–5.623; p = 0.003) were found more likely to experience depression.ConclusionsA significant association between malnutrition and depression was evident by the current study in the rural older individuals of Bangladesh. It will be a prolific initiative if policymakers merge malnutrition and the risk factors associated with geriatric depression in providing universal health care for better health and well-being of the rural older populations.

Determination of Malnutrition Status and Risk Factors in Orthopedic Patients

Giriş ve Amaç: Bu çalışmanın amacı ortopedi hastalarının malnütrisyon durumlarının ve risk faktörlerinin belirlenmesidir.&#x0D; Gereç ve Yöntemler: Kesitsel tipteki çalışma 05/2017 -12/2018 tarihleri arasında XXX hastanesinde Ortopedi ve Travmatoloji Kliniğinde toplam 123 hasta ile gerçekleştirildi. Araştırma verileri, Hasta Tanılama ve Klinik Formu, Nutrisyonel Risk Taraması Ölçeği (Nutritional Risk Screening) kullanılarak toplanmıştır.&#x0D; Bulgular: Hastaların yaş ortalaması 65,72±20,79 dır. Cerrahi girişim geçiren hastaların aç kalma süre ortalamaları ameliyat öncesi 10,82±3,20 saat, ameliyat sonrası ise 11,01±10,84 saattir. Hastaların %31,7’sinin malnütriyon riski altında olduğu ve tamamının beslenme desteği almadığı saptandı. Malnütrisyon riski olan hastaların yaş ortalaması daha yüksekti (t=-4,087, p=0,000). Malnütriyon riski olan hastaların ameliyat öncesi aç kalma süreleri, riski olmayanlara göre daha uzundu (t=-3,019, p=0,000). Ameliyat olup malnütrisyon riski olan hastaların ameliyat sonrası ilk mobilizasyonları daha uzun sürede gerçekleşmişti (t=-4,113, p=0,000). Hastaların albumin değerleri ile NRS skorları arasında istatiksel olarak anlamlı bir fark saptandı (t=5,751, p=0,000). Katılımcıların cinsiyet (X2=4,809 p=0,028), eğitim düzeyleri (X2=10,358, p=0,0016), kronik hastalık varlığı (X2=5,890, p=0,015) ve enfeksiyonu durumu (X2=7,566, p=0,006) ile NRS skorları arasında istatiksel olarak anlamlı fark saptandı.&#x0D; Sonuç: Çalışmamızda yaklaşık üç hastadan birinin malnütriyon riski altında olduğu saptanmıştır. Araştırma sonuçları hastaların malnütrisyon riskini etkileyen diğer seçilmiş faktörlerin yaş, cinsiyet, hastaların eğitim düzeyi, komorbit hastalık varlığı, düşük albumin düzeyi, ameliyat öncesi açlık süresi ve ameliyat sonrası enfeksiyon gelişmesi olduğunu göstermiştir. Ayrıca malnütrisyon riski olan hastaların ameliyat sonrası ilk mobilizasyon sürelerinin daha geç olduğu saptanmıştır. Güncel rehberler doğrultusunda, profesyonel bir ekip yaklaşımı ile beslenme desteği yaklaşımları standart haline getirilmelidir.

Risk and Adverse Outcome Factors of Severe Acute Malnutrition in Children: A Hospital-Based Study in Odisha.

Background Malnutrition is prevalent in 41% of children less than five years old in developing countries.ObjectiveTo determine the clinical spectrum, identify the risk factors, and find out the factors responsible for the adverse outcomes of severe acute malnutrition (SAM) in children.MethodsIn this prospective cohort, children aged one month to five years with SAM from October 2016 to September 2018 were enrolled. Clinical profile, contributing factors, treatment, and outcome of cases (n=198) were noted.ResultsSAM was diagnosed in 323 (1.6%) of admitted cases. The unimmunized children were 123 (62.1%). Common co-morbidities were acute gastroenteritis (n=89, 44.9%), respiratory tract infection (n=88, 44.4%), and septicemia (n=54, 26.7%). Children not on exclusive breastfeeding (n=157, 79.1%), early complementary feeding (<6 months) (n=157, 88.2%), bottle-feeding (n=138, 77.55%), low birth weight (157, 79.1%), living in kutcha houses (115, 58.2%), and unavailability of safe drinking water (131, 66.4%) were the significant risk factors. Pneumonia, diarrhea, nutritional edema, hypothermia, and circulatory shock at the time of admission were responsible for adverse outcomes. One hundred and eighty-three (92.4%) children were cured and discharged and 15 (7.6%) children died.ConclusionsWrong feeding practices and unavailability of safe drinking water have an important bearing on the development of SAM children. Pneumonia, diarrhea, nutritional edema, hypothermia, and circulatory shock at the time of admission were responsible for adverse outcomes.