Role Of Nutritional Status Research Articles

Role of nutritional status and physical activity in the relationship between sleep quality and cardiometabolic profile of children.

ObjectiveTo verify if there is an association between sleep quality and cardiometabolic risk factors (CMRF) score of children and the role of nutritional status and physical activity (PA) levels in this relationship.Material and MethodsCross- sectional study, with 83 schoolchildren, aged 6 and 11 years, from Porto Alegre, Brazil. PA was assessed with accelerometer and nutritional status through body mass index. Total cholesterol, triglycerides, glucose, and insulin were collected to calculate CMRF score. Parents’ perception of their children’s sleep was evaluated through a question. Generalized linear models were used.ResultsPoor sleep quality was positively associated with CMRF (ß=0.48; CI 95%=0.23;0.73) in relation to those with good sleep quality. A positive association was found in overweight children with poor sleep quality (ß=0.52; CI 95%=0.17;0.86), as well as in inactive children with poor sleep quality (ß=0.58; CI 95%=0.14;1.02) with CMRF.ConclusionPoor sleep quality integrated with overweight and physical inactivity influences on CMRF of children.

Nutritional status impacts dengue virus infection in mice

BackgroundDengue virus (DENV) is estimated to infect 390 million people annually. However, few host factors that alter disease severity are known. Malnutrition, defined as both over- and undernutrition, is a growing problem worldwide and has long been linked to dengue disease severity by epidemiological and anecdotal observations. Accordingly, we sought to establish a mouse model to assess the impact of nutritional status on DENV disease severity.ResultsUsing transiently immunocompromised mice, we established a model of mild dengue disease with measurable viremia. We then applied it to study the effects of healthy weight, obese, and low-protein diets representing normal, over-, and undernutrition, respectively. Upon infection with DENV serotype 2, obese mice experienced more severe morbidity in the form of weight loss and thrombocytopenia compared to healthy weight groups. Additionally, obesity altered cytokine expression following DENV infection. Although low protein-fed mice did not lose significant weight after DENV2 infection, they also experienced a reduction in platelets as well as increased spleen pathology and viral titers.ConclusionsOur results indicate that obese or undernourished mice incur greater disease severity after DENV infection. These studies establish a role for nutritional status in DENV disease severity.

Role of nutritional status and nutritional support in outcome of hepatitis B virus-associated acute-on-chronic liver failure.

BACKGROUNDHepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) is an important type of liver failure in Asia. There is a direct relationship between HBV-ACLF and gastrointestinal barrier function. However, the nutritional status of HBV-ACLF patients has been poorly studied.AIMTo investigate the nutritional risk and nutritional status of HBV-ACLF patients and evaluated the impact of nutritional support on the gastrointestinal barrier and 28-d mortality.METHODSNutritional risk screening assessment and gastrointestinal barrier biomarkers of patients with HBV-ACLF (n = 234) and patients in the compensatory period of liver cirrhosis (the control group) (n = 234) were compared during the period between 2016 and 2018. Changes were analyzed after nutritional support in HBV-ACLF patients. Valuable biomarkers have been explored to predict 28-d death. The 28-d survival between HBV-ACLF patients with nutritional support (n = 234) or no nutritional support (2014-2016) (n = 207) was compared.RESULTSThe nutritional risk of the HBV-ACLF patients was significantly higher than that of the control group. The nutritional intake of the patients with HBV-ACLF was lower than that of the control group. The decrease in skeletal muscle and fat content and the deficiency of fat intake were more obvious (P < 0.001). The coccus-bacillus ratio, secretory immunoglobulin A, and serum D-lactate were significantly increased in HBV-ACLF patients. The survival group had a lower nutritional risk, lower D-lactate, and cytokine levels (endotoxin, tumor necrosis factor alpha, interleukin-10, and interleukin-1). Interleukin-10 may be a potential predictor of death in HBV-ACLF patients. The 28-d survival of the nutritional support group was better than that of the non-nutritional support group (P = 0.016).CONCLUSIONPatients with HBV-ACLF have insufficient nutritional intake and high nutritional risk, and their intestinal barrier function is impaired. Individualized and dynamic nutritional support is associated with a better prognosis of 28-d mortality in HBV-ACLF patients.

Measured and Predicted Resting Energy Expenditure in Malnourished Older Hospitalized Patients: A Cross-Sectional and Longitudinal Comparison.

A number of equations have been proposed to predict resting energy expenditure (REE). The role of nutritional status in the accuracy and validity of the REE predicted in older patients has been paid less attention. We aimed to compare REE measured by indirect calorimetry (IC) and REE predicted by the Harris–Benedict formula in malnourished older hospitalized patients. Twenty-three malnourished older patients (age range 67–93 years, 65% women) participated in this prospective longitudinal observational study. Malnutrition was defined as Mini Nutritional Assessment Long Form (MNA-SF) score of less than 17. REE was measured (REEmeasured) and predicted (REEpredicted) on admission and at discharge. REEpredicted within ±10% of the REEmeasured was considered as accuracy. Nutritional support was provided to all malnourished patients during hospitalization. All patients were malnourished with a median MNA-LF score of 14. REEmeasured and REEpredicted increased significantly during 2-week nutritional therapy (+212.6 kcal and +19.5 kcal, respectively). Mean REEpredicted (1190.4 kcal) was significantly higher than REEmeasured (967.5 kcal) on admission (p < 0.001). This difference disappeared at discharge (p = 0.713). The average REEpredicted exceeded the REEmeasured on admission and at discharge by 29% and 11%, respectively. The magnitude of difference between REEmeasured and REEpredicted increased along with the degree of malnutrition (r = 0.42, p = 0.042) as deviations ranged from −582 to +310 kcal/day in severe to mildly malnourished patients, respectively. REEpredicted by the Harris–Benedict formula is not accurate in malnourished older hospitalized patients. REE measured by IC is considered precise, but it may not represent the true energy requirements to recover from malnutrition. Therefore, the effect of malnutrition on measured REE must be taken into account when estimating energy needs in these patients.

The Role of Nutritional Status, Age, Genetic Factors, and Lifestyle on the Hypertension Prevalence among Community in Indonesian Coastal Area

Hypertension is one of cardiovascular disease which has the highest mortality rate. This study aims to determine the risk factors of hypertension among the community in the coastal area of Medan Labuhan in Medan city, Indonesia. The study population was the population who live in the coastal area of Medan Labuhan district in Medan City. The number of participants in this study was 108 people recruited by continuous and consecutive sampling method. Assessment of nutritional status was based on body mass index (BMI) that calculated from the body weight and height which measured at the same day of the interview; blood pressure measurements were performed twice with a 5-minute interval by using a calibrated blood pressure meter. The assessment of smoking habits, coffee consumption, consumption of fruits and vegetables, physical activity, and mental stress was using a valid and reliable questionnaire. The data analysis was using the chi-square test with SPSS computer program. The confidence interval was 95%, and a p-value of &lt;0.05 was considered significant. This study found significant relationships between hypertension with a genetic factor, smoking habits, regular consuming coffee, fruits, and vegetable consumption, and less physical activity (p&lt;0,05). Based on this study, the health practitioner mainly family doctors could conduct health promotions that could improve the awareness of society on prevention of hypertension, they also conduct a proper regular treatment of hypertension especially community in the coastal area, because they have more risks become hypertension.

Nutritional Status and Functional Outcomes in Older Adults Admitted to Geriatric Rehabilitations: The SAFARI Study

Objective: Evidence about the role of nutritional status (NS) on functional outcomes (FO) after rehabilitation in older adults is scarce. Our aim was to analyze the association between NS and FO in older adults admitted to geriatric rehabilitation units.Methods: The Sarcopenia And Function in Aging Rehabilitation (SAFARI) multicenter study enrolled patients aged ≥65 years admitted to geriatric rehabilitation units in Italy and Spain. FO were absolute and relative functional gain (AFG-RFG) in Barthel Index (BI) at 1 and 3 months after admission. The association between NS (Mini Nutritional Assessment–Short Form) and FO was explored using linear regression and mixed models, adjusted for potential confounders. Analyses were then stratified for diagnosis at admission.Results: We included 415 patients (mean age 81.4 years [SD: 7.7]; 67% female; 9.4% malnourished [MN], 42.7% at risk of malnutrition [RM], and 48% well nourished [WN]). Admission diagnoses were hip fracture (39.5%), elective orthopedic surgery (EOS) (29.5%), and stroke (31%). In an adjusted linear mixed model, MN and RM participants had lower BI compared to WN (MN: β: −8.47, p = 0.023; RM: β: −5.22, p = 0.031), and differences between groups remained stable over time. After stratification for admission diagnosis, only MN patients admitted after EOS had worse FO, both at 30 days (AFG: β adjusted: −13.54, p < 0.001; RFG: β: −32, p < 0.001) and 3 months (AFG: β adjusted: −17.79, p < 0.001; RFG: β: −26.77, p = 0.002).Conclusions: In our sample, poor NS is associated with worse BI in older adults admitted to geriatric rehabilitation units; in patients undergoing EOS, MN is associated with worse FO. Our results documented for the first time the importance of assessing nutritional status before EOS.

Care practices during pregnancy, infant feeding practices and their association with nutritional status of infants in Gujarat, India

Background: Infant feeding practices plays an important role in nutritional status of children. Aims &amp; Objectives: To assess ante-natal care, delivery and infant feeding practices and their association with nutritional status. Material &amp; Methods: A community-based, cross-sectional study was carried out in all the districts using systematic random sampling. Information was collected from the selected household on socio-demographic, delivery and feeding practices and anthropometric measurements were carried out. Nutritional status was assessed using WHO Child Growth Standard. Proportion test, bivariate and multivariate regression analysis was done. Results: The overall prevalence of underweight, stunting and wasting was 26%, 21.5% and 16.5% respectively. Logistic regression analysis showed that the risk of underweight and stunting was 1.4-1.5 times higher among infant whose mother had undergone ?3 ANCs or not availed ANCs, 1.4 times higher among infants delivered at home, having morbidity during previous fortnight and 3.6 times higher among low birth weight children. The risk of underweight and wasting was 1.2 times higher among infants with birth interval less than 2 years and 1.3-1.5 times higher among children whose mothers were washing their hands only with water after defecation. Conclusion: The undernutrition is associated with ante-natal care, delivery practices, low birth weight and hygienic practices.

Role of nutritional status in the early postoperative prognosis of patients operated for retroperitoneal liposarcoma (RLS): A single center experience

PurposeTo assess the nutritional status and its role in the outcome of patients operated for retroperitoneal liposarcoma (RLS). Material and methodsRetrospective study on consecutive patients operated with en bloc compartment resection for primary or local recurrence of RLS between 2016 and 2017. Preoperative nutritional and laboratory assessment comprising serum albumin, serum transthyretin, orosomucoid, and CRP was systematically performed. The following preoperative parameters were analysed: weight, body mass index (BMI), significant weight loss (>5% in one month and/or >10% in 6 months), serum albumin, transthyretin, CRP, orosomucoid. PINI (prognostic inflammatory and nutritional index) was calculated. ResultsThere were 40 patients operated for RLS: 22 women and 18 men with a median age of 61 years (34–90). Median tumour was 280 mm (80–530). Median preoperative BMI was 24.8 (18–42) and median postoperative BMI was 23 (17.8–44). Twenty-one patients (52.5%) were considered to be malnourished: 3 with biological signs of malnutrition and 18 with weight loss. Eleven (47.6%) in the group of malnourished patients and 4 (26.3%) in the group with satisfactory nutritional status developed postoperative complications (p = 0.042). A PINI score>1 was related to significantly longer hospitalisation time 21.8 days (10–58) in comparison with 14.9 [9–30] in patients with PINI < 1, p = 0.003. ConclusionsThe malnourished patients with RLS experienced more postoperative complications and longer hospitalisation. Nutritional status and biological markers contribute to the global management of RLS with improved postoperative behaviour including fewer complications and shorter hospitalisation. A prospective larger study with longer follow-up is necessary to refine these results.

Pengaruh Pengetahuan Gizi Ibu Dan Sosial Ekonomi Keluarga Terhadap Status Gizi Balita Umur 6-24 Bulan Di Wilayah Kerja Puskesmas Tamalanrea Jaya

Mothers’ nutritional knowledge play an important role in nutritional status of children since mothers have responsibility to provide food for family, particularly for children. Although mothers have good knowledge in nutrition, but if their level of socioeconomic is low, it will affect to nutritional status of children.The aim of this research is to determine effect of mothers’ nutritional knowledge and socioecomic family on nutritional status of children aged 6 to 24 months at Tamalanrea Jaya public health center. The kind of this research is analityc research. Sample consists of 69 children aged 6 to 24 months and their mother are the respondents who are chosen by purposive sampling. The effect of variable is detected by chi-squared test and data is demonstrated by table and narration.Result of this research shows that there are influence of mothers’ nutritional knowledge and parents revenue with nutritional status of children aged 6 to 24 months which are explained by p-value = 0.002 &lt; α = 0.05 and p-value = 0.026 &lt; α = 0.05 respectively. However, level of mothers’ education and mothers’ job did not have influence to nutritional status of children aged 6 to 24 months which are proved by p-value = 0.587 &gt; α = 0.05 and p-value = 0.69 &gt; α = 0.05 respectively.This research is suggestible to mothers to improve their knowledge in nutritional problem by following nutritional counselling or reading nutrition books for increasing insight about nutritional problem

Joint Data Analysis in Nutritional Epidemiology: Identification of Observational Studies and Minimal Requirements

Joint data analysis from multiple nutrition studies may improve the ability to answer complex questions regarding the role of nutritional status and diet in health and disease. The objective was to identify nutritional observational studies from partners participating in the European Nutritional Phenotype Assessment and Data Sharing Initiative (ENPADASI) Consortium, as well as minimal requirements for joint data analysis. A predefined template containing information on study design, exposure measurements (dietary intake, alcohol and tobacco consumption, physical activity, sedentary behavior, anthropometric measures, and sociodemographic and health status), main health-related outcomes, and laboratory measurements (traditional and omics biomarkers) was developed and circulated to those European research groups participating in the ENPADASI under the strategic research area of "diet-related chronic diseases." Information about raw data disposition and metadata sharing was requested. A set of minimal requirements was abstracted from the gathered information. Studies (12 cohort, 12 cross-sectional, and 2 case-control) were identified. Two studies recruited children only and the rest recruited adults. All studies included dietary intake data. Twenty studies collected blood samples. Data on traditional biomarkers were available for 20 studies, of which 17 measured lipoproteins, glucose, and insulin and 13 measured inflammatory biomarkers. Metabolomics, proteomics, and genomics or transcriptomics data were available in 5, 3, and 12 studies, respectively. Although the study authors were willing to share metadata, most refused, were hesitant, or had legal or ethical issues related to sharing raw data. Forty-one descriptors of minimal requirements for the study data were identified to facilitate data integration. Combining study data sets will enable sufficiently powered, refined investigations to increase the knowledge and understanding of the relation between food, nutrition, and human health. Furthermore, the minimal requirements for study data may encourage more efficient secondary usage of existing data and provide sufficient information for researchers to draft future multicenter research proposals in nutrition.

Experience in the application of Ciklovita® vitamin-mineral complex in the treatment of menstrual irregularities

A study of the effectiveness of the vitamin-mineral complex (VMC) Ciklovita in the complex treatment of menstrual irregularities was carried out on the basis of the SBIPH MR MRRIOG. Complex therapy was used in patients with dysmenorrhea (n=40), amenorrhea (n=40) and oligomenorrhea (n=40); there were no significant abnormalities in the patients' hormonal status. Patients underwent pathogenetic and symptomatic therapy for 3 months with subsequent connection of VMC Ciklovita®. The general course of treatment was 6 months. The positive dynamics in relation to the symptoms of the diseases was most pronounced by the 6 month of therapy, with a complex approach with the use of the VMC Ciklovita®. The obtained results once again confirm the important role of nutritional status in the genesis of functional disorders of the menstrual cycle and provide a basis for widespread introduction of VMC Ciklovita® in to the routine practice of obstetrician-gynecologists.

The Role of Nutritional Status in Elderly Patients with Heart Failure.

Evidence indicates that malnutrition very frequently co-occurs with chronic heart failure (HF) and leads to a range of negative consequences. Studies show associations between malnutrition and wound healing disorders, an increased rate of postoperative complications, and mortality. In addition, considering the increasing age of patients with HF, a specific approach to their treatment is required. Guidelines proposed by the European Society of Cardiology (ESC) for treating acute and chronic HF refer to the need to monitor and prevent malnutrition in HF patients. However, the guidelines feature no strict nutritional recommendations for HF patients, who are at high nutritional risk as a group, nor do they offer any such recommendations for the poor nutritional status subgroup, for which high morbidity and mortality rates have been observed. In the context of multidisciplinary healthcare, recommended by the ESC and proven by research to offer multifaceted benefits, nutritional status should be systematically assessed in HF patients. Malnutrition has become a challenge within healthcare systems and day-to-day clinical practice, especially in developed countries, where it affects the course of disease and patients' prognosis.

Folate and vitamin D: The role of nutritional status and nutrigenetics in predicting levels of extracellular microRNA and circulation DNA methylation

Folate and vitamin D: The role of nutritional status and nutrigenetics in predicting levels of extracellular microRNA and circulation DNA methylation

Role of nutritional status and intervention in oesophageal cancer treated with definitive chemoradiotherapy: outcomes from SCOPE1

Background:Malnutrition is common in oesophageal cancer. We aimed to identify nutritional prognostic factors and survival outcomes associated with nutritional intervention in the SCOPE1 (Study of Chemoradiotherapy in OesoPhageal Cancer with or without Erbitux) trial.Methods:Two hundred and fifty eight patients were randomly allocated to definitive chemoradiotherapy (dCRT) +/− cetuximab. Nutritional Risk Index (NRI) scores were calculated; NRI<100 identified patients at risk of malnutrition. Nutritional intervention included dietary advice, oral supplementation or major intervention (enteral feeding/tube placement). Univariable and multivariable analyses using Cox proportional hazard modelling were conducted.Results:At baseline NRI<100 strongly predicted for reduced overall survival (hazard ratio (HR) 12.45, 95% CI 5.24–29.57; P<0.001). Nutritional intervention improved survival if provided at baseline (dietary advice (HR 0.12, P=0.004), oral supplementation (HR 0.13, P<0.001) or major intervention (HR 0.13, P=0.003)), but not if provided later in the treatment course. Cetuximab patients receiving major nutritional intervention had worse outcomes compared with controls (13 vs 28 months, P=0.003).Conclusions:Pre-treatment assessment and correction of malnutrition may improve survival outcomes in oesophageal cancer patients treated with dCRT. Nutritional Risk Index is a simple and objective screening tool to identify patients at risk of malnutrition.

Which parameters affect long-term mortality in older adults: is comprehensive geriatric assessment a predictor of mortality?

Determining predictors of mortality among older adults might help identify high-risk patients and enable timely intervention. The aim of the study was to identify which variables predict geriatric outpatient mortality, using routine geriatric assessment tools. We analyzed the data of 1141 patients who were admitted to the geriatric medicine outpatient clinic between 2001 and 2004. Comprehensive geriatric assessment was performed by an interdisciplinary geriatric team. Mortality rate was determined in 2015. The parameters predicting survival were examined. Median age of the patients (415 male, 726 female) was 71.7years (53-95years). Mean survival time was 12.2years (95% CI; 12-12.4years). In multivariate analysis, age (OR: 1.16, 95% CI: 1.09-1.23, p<0.001), smoking (OR: 2.51, 95% CI: 1.18-5.35, p=0.017) and metabolic syndrome (OR: 2.20, 95% CI: 1.05-4.64, p=0.038) were found to be independent risk factors for mortality. MNA-SF scores (OR: 0.84, 95% CI: 0.71-1.00, p=0.050) and free T3 levels (OR: 0.70, 95% CI: 0.49-1.00, p=0.052) had borderline significance. The present study showed that the risk conferred by metabolic syndrome is beyond its individual components. Our findings confirm previous studies on the prognostic role of nutritional status, as reflected by MNA-SF. Serum fT3, a simple laboratory test, may also be used in geriatric outpatient clinics to identify individuals at risk. The results of the study demonstrated the need for addressing modifiable risk factors such as smoking, metabolic syndrome, and undernutrition in older adults.

The possible role of nutritional status on the pro and anti-inflammatory cytokine balance of children with malaria from Imo State, Nigeria

The possible role of nutritional status on the pro and anti-inflammatory cytokine balance of children with malaria from Imo State, Nigeria

Role of nutritional status as predictor of survival in oesophageal cancer treated with definitive chemoradiation (dCRT): outcome from SCOPE1, a phase II/III randomised trial of dCRT +/- cetuximab.

103 Background: Malnutrition is common in oesophageal cancer and may be related to the disease or treatment. We aimed to identify nutritional prognostic factors and the outcome of nutritional intervention in patients recruited to the SCOPE1 trial. Methods: 258 patients were randomly allocated to dCRT with or without the addition of cetuximab. Data was collected prior to induction chemotherapy (iCT) and before commencing concurrent CRT. Nutritional Risk Index (NRI) was calculated and categorised; ≥ 100 (no risk of malnutrition), 97.5-100 (mild risk), and &lt; 97.5 (moderate to severe risk). The maximal nutritional intervention (MNI) received was classified as: none, dietary advice, oral supplementation or major intervention (enteral feeding/tube placement). Univariate and multivariate analyses using Cox proportional hazard modelling were conducted to identify predictive factors and important interactions involving MNI. Results: An NRI score &lt; 100 at baseline strongly predicted reduced median overall survival (OS) in multivariate analysis (HR = 12.45, 95% CI 5.24 – 29.57; p = &lt; 0.001). Furthermore, OS was improved in this group if they received dietary advice (HR = 0.12, p = 0.004), oral supplementation (HR = 0.13, p = &lt; 0.001) or major intervention (HR = 0.13, p = 0.003) prior to commencement of iCT, but there was no benefit if intervention occurred after commencement of iCT. Patients on cetuximab arm undergoing major intervention had worse outcomes compared to control (13 months vs 28 months, p = 0.003). Conclusions: Assessment and correction of poor nutritional state at baseline may improve survival outcomes in oesophageal cancer patients treated with dCRT. The benefit of intervention is no longer observed once treatment has commenced, highlighting the need for early nutritional assessment and intervention. Reason for poor OS in patients on cetuximab requiring major intervention is unclear. Clinical trial information: 47718479.

Nutrition status and small intestinal bacterial overgrowth in patients with virus-related cirrhosis.

Malnutrition and small intestinal bacterial overgrowth (SIBO) is frequently present in patients with liver cirrhosis (LC). However, the direct relationship between SIBO and nutrition status in the LC patients has not been elucidated. The aim of this study was to investigate whether there was an association between nutrition status, evaluated by the subjective global assessment (SGA) and SIBO in patients with Hepatitis B virus (HBV) or hepatitis C virus (HCV) related cirrhosis. A total of 120 patients with HBV or HCV-related cirrhosis and 30 healthy controls were included. Nutritional status was determined according to SGA and anthropometry. All patients and healthy controls underwent a glucose hydrogen breath test for SIBO. The prevalence of malnutrition for the patients with HBV or HCV related cirrhosis ranged 19.4%-60% in China. The highest prevalence of malnutrition was detected by SGA, the lowest by triceps skinfold thickness. The frequency of SIBO was significantly higher in the malnourished (SGA-B/C) than in the well-nourished (SGA-A) patients with HBV or HCV related cirrhosis [41/72 (56.9%) vs 12/48 (25.0%) (p=0.001)]. Univariate analysis showed that SIBO, ascites, and Child-Turcotte-Pugh (CTP) class were associated with malnutrition. Multivariate analysis demonstrated that SIBO [odds ratio (OR) 8.10; p=0.002] and ascites (OR 4.56; p=0.022) were independently associated with the occurrence of malnutrition (SGA-B/C) in the same subjects. SIBO is independently related to the occurrence of malnutrition (SGA-B/C) in patients with HBV or HCV cirrhosis. We deduce that SIBO may play an important role in nutrition status in patients with HBV or HCV cirrhosis.

SUN-LB001: The Role of Nutritional Status in Parkinson’s Disease Patients and its Effects on Quality of Life

SUN-LB001: The Role of Nutritional Status in Parkinson’s Disease Patients and its Effects on Quality of Life

SUN-PP229: The Role of Nutritional Status in the Association Between Grip Strength and Risk of Falling in the Old age: Results from the Kora-Age Study

SUN-PP228 CHARACTERISTICS OF SKELETAL MUSCLE MASS OF PATIENTS IN AN ACUTE CARE HOSPITAL: A CROSS-SECTIONAL STUDY Y. Ogawa1, A. Naganuma1, Y. Kawahake1, E. Takahashi1, H. Tanaka1, M. Inagawa1, H. Shimizu1, T. Tanaka1, T. Ogawa1, K. Sato2, S. Kakizaki2. 1Nutrition Support Team, Takasaki General Medical Center, National Hospital Organization, Takasaki, 2Department of Medicine and Molecular Science, Gunma University, Maebashi, Japan