Screening Of Nutritional Status Research Articles

Evaluation of nutritional status and malnutrition screening tests of elderly individuals living in nursing homes

Evaluation of nutritional status and malnutrition screening tests of elderly individuals living in nursing homes

Skrining Status Gizi Remaja Putri dalam Upaya Peningkatan Kesehatan Remaja

Adolescents are a group aged 10-18 years who need various nutrients. Adolescents need more nutrients, because it is a transition period from childhood to adulthood. Assessment and monitoring of adolescent nutritional status needs to be done to prevent nutritional and health problems in adulthood. This community service was carried out on 11 female adolescents who were willing to undergo nutritional status screening. The activities to be carried out include measuring hemoglobin (Hb) levels, measuring upper arm circumference (LiLA), and providing education about adolescent nutrition. The results of the activity obtained an increase in participant knowledge about nutritional status after being given education, there were 2 participants who had anemia with Hb examination results <12g/dL and there were 3 participants who had LiLa <23.5 cm. Participants already understand and are able to perform Hb examinations using the Easy Touch GCHb tool and LiLA measurements.

2324 Feasibility of screening for frailty, sarcopenia and nutritional status in elective surgery for colorectal cancer

Abstract Introduction Preoperative frailty is a key determinant of post-surgical outcomes and often co-exists with sarcopenia and malnutrition. Older patients account for a significant proportion of patients undergoing surgery for colorectal cancer and are therefore more likely to be affected by these risk factors. Methods Patients aged 65 and over undergoing planned surgery for colorectal cancer were recruited across five sites. Participants were screened preoperatively using the Clinical Frailty Scale (CFS) and Groningen Frailty Indicator (GFI). Nutritional status was assessed using the short form mini nutritional assessment (MNA-SF) and participant collection of spot urine samples to objectively measure habitual dietary intake. Sarcopenia was assessed through grip strength, gait speed and psoas muscle measurement using preoperative CT imaging. The non-radiological screening measures were repeated eight-weeks postoperatively, with additional urine samples collected in the first and fourth weeks. Results Forty-three participants (mean age 76 years, 60% male) were recruited, of which 32% were frail. Using the mini-nutritional assessment 42% of participants were identified as at risk of malnutrition and 9% as malnourished. Urine assessment of habitual dietary intake is ongoing. There was a high prevalence of sarcopenia - 67% determined by hand grip strength and 42% by CT analysis. Mean length of stay following surgery was 6.9 days. 28% of participants were unable to complete the in-person post-operative follow up due to ill health, poor appetite and exhaustion. Conclusions This ongoing study has demonstrated the feasibility of incorporating frailty, nutritional status and sarcopenia screening alongside routine clinical care, in older adults undergoing surgery. However, retaining participants in observational studies during postoperative periods of convalescence, or whilst undergoing adjuvant treatment, is challenging. This study has also highlighted the potential of home urine sampling as a viable method of dietary assessment within community settings to aid malnutrition screening.

Systematic nutritional screening and assessment in older patients: Rationale for its integration into oncology practice

As the global population ages, so does the number of older people being diagnosed, treated and surviving cancer. Challenges to providing appropriate healthcare management stem from the heterogeneity common in this population. Although malnutrition is highly prevalent in older people with cancer, ranging between 30 % and 80 % according to some analyses, is associated with frailty, and has been shown to be a major risk factor for poor treatment response and worse overall survival, addressing nutrition status is not always a priority among oncology healthcare providers. Evaluation of nutritional status is a two-step process: screening identifies risk factors for reduced nutritional intake and deficits that require more in-depth assessment. Screening activities can be as simple as taking weight and BMI measurements or using short nutritional questionnaires and asking the patient about unintentional weight loss to identify potential nutritional risk. Using geriatric assessment, deficits in the nutritional domain as well as in others reveal potentially reversible geriatric and medical problems to guide specific therapeutic interventions. The authors of this paper are experts in the fields of geriatric medicine, oncology, and nutrition science and believe that there is not only substantial evidence to support regularly performing screening and assessment of nutritional status in older patients with cancer, but that these measures lead to the planning and implementation of patient-centered approaches to nutrition management and thus enhanced geriatric-oncology care. This paper presents rationale for systematic nutrition screening and assessment in older adults with cancer.

Screening and assessment of nutritional status and some related factors in patients who have laparoscopic surgery for colon cancer

Background: Preoperative malnutrition is a significant problem for cancer and colon cancer patients, so screening, monitoring, and supporting this condition becomes increasingly essential in the surgical field. In colorectal cancer, malnutrition is significantly associated with several consequences, including mortality and increasing the length of hospital stay after surgery. The NRS 2002 and SGA scores are practical malnutrition assessment tools widely used in clinical practice today. Materials and methods: A cross-sectional descriptive study was performed on 53 patients undergoing laparoscopic surgery due to colon cancer at Hue University of Medicine and Pharmacy Hospital and Hue Central Hospital. The NRS-2002 tool was used for risk screening, and the SGA was used to assess the patient’s nutritional status. Information about the disease and related factors are referenced from medical records combined with asking the patient. Results: The average age was 61.5±14.5, of which 50.9% were male. ASA 1 accounted for the majority at 66.0%. Complications of surgical site infection accounted for 11.3%. Two patients with subcutaneous emphysema accounted for 3.8%, and one with urinary retention accounted for 1.9% were treated with conservative treatment. One patient had early postoperative small bowel obstruction due to abdominal drainage and was successfully treated medically, accounting for 1.9%. There were no major complications requiring reoperation and short-term mortality. The average hospital stay was 7.4 ± 2.1 days. According to the 2002 NRS score, there were 19 (35.8%) cases of nutritional at-risk; the SGA rating had 1.9% SGA-C and 15.1% SGA-B cases. There was a relationship between NRS-2002 and the patient’s blood albumin concentration. Conclusion: The prevalence of patients at nutritional risk and malnutrition is quite common. It is necessary to carry out routine screening and nutritional risk assessment to support colon cancer treatment. Key words: malnutrition, colorectal cancer, NRS 2002, SGA score.

Comparing Mid-Upper Arm Circumference With Body Mass Index for Assessing Nutritional Status in Indian Adults: Evidence From the National Family Health Survey 2015-16 (NFHS-4).

Background The surge in the twin burden of malnutrition - undernutrition and overweight/obesity - poses a severe threat worldwide including India. The adult group, primarily considered as an economic pillar of the society, suffered significant health problems, yet their nutritional issues are often neglected. Screening of nutritional status through anthropometric measurements is widely accepted. Body mass index (BMI) is commonly used but has certain limitations. Mid-upper arm circumference (MUAC), another simpler tool, is universally accepted in children, but its use in adults is debatable. The current research aims to determine the MUAC cutoffs and their predictive accuracies corresponding to BMI cutoffs for adult men and nonpregnant women. Subject and methods A cross-sectional analysis was conducted of the anthropometric data of Indian adult men and nonpregnant women collected in 2015-16 via the National Family Health Survey (NFHS-4). The receiver operating characteristic (ROC) curve analysis was performed to derive the MUAC cutoffs against BMI cutoffs. Results A significant moderate correlation for both men (r=0.56) and women (r=0.68) was observed. In relation to ROC analysis, the MUAC cutoffs against the BMI cutoffs of 18.5, 23, 25, and 30 kg/m2 were approximated to be 25, 26, 28, and 30 cm for men and 23, 25, 27, and 28 cm for women, respectively. These MUAC cutoffs showed good predictive accuracy with a high range of sensitivity and specificity for both men and women. Conclusions The non-invasive MUAC method correlates very well with BMI and offers several advantages, including accuracy, ease of measurement, and minimal logistical support and training, and can assess the nutritional status even in geographically remote areas. Therefore, it can be an important tool in public health, especially in resource-limited settings, for identifying populations at risk of malnutrition.

Food Consumption, Purchasing and Dietary Pattern of Farm Women in Dharwad District, Karnataka State, India

Present study was undertaken to analyze the socio-economic and nutritional status of women involved in farm activities and to know the impact of nutri-farms on food, nutrition and health security. Using 300 farm women in Chamarajanagar district. Health and nutritional status assessment, food intake, nutritional adequacy and screening for iron deficiency anaemia and KAP study on health and nutrition was conducted. Malnutrition is still one of the crucial problems in developing countries which is relationship between nutrition and health among a majority of the population. The objective of the study was dietary pattern of before and after intervention. This paper tries to analyze the food consumption and dietary pattern of women involved in farm activities and to know the impact of nutri-farms on food and nutrition security by using of 500 farm women in Dharwad district. A well-structured questionnaire was framed to gather the information on dietary pattern of the subjects was assessed by 24– hour diet recall method before and after intervention. The results revealed that, Among cereals, rice was consumed daily (90.4%) by all the families, where as food intake was observed that Pulses (67.67), milk and milk products (167.60), roots and tubers (67.80), GLV’s (47.17), other vegetables (96.47), fruits (37.33), fats and oil (17.70) consumption is very low when compared to RDA whereas consumption of cereal was on par with the recommended dietary allowances. The mean nutrient intake of energy (1794.5 kcal), protein (36.95 g), fat (17.95 g), iron (18.98 mg) and Vitamin C(42.85 mg) were less when compared to the RDA. The results shows that all nutrients and food intake consumption was found inadequate.

Optimalisasi Kesehatan dan Gizi Lansia Melalui Penyuluhan dan Pendampingan Gizi di Kelurahan Cipadu Jaya

The percentage of the elderly population in RW 01, Cipadu Village, has increased, indicating that in 2023, this area has entered the era of an aging population, where the percentage of the population aged 60 and above is almost reaching 10% or more. The purpose of this community service is to raise awareness among the community about a healthy lifestyle to prevent non-communicable diseases, to practice the preparation of healthy drinks, and early detection of health status through anthropometry and stick test methods. The methods used in this community service include counseling with the theme "Optimizing the Health and Nutrition of the Elderly," practical measurement of nutritional status, screening for Non-Communicable Diseases using the stick test method, followed by guidance and monitoring of older people. There has been a 21.1% increase in knowledge about balanced nutrition for older people and the preparation of healthy drinks. Screening for nutritional status shows that 37.3% are obese. Health checks indicate that out of 51 people, 78.4% have high blood pressure, 66,7% have high cholesterol levels, 43,1% have high uric acid levels, and 5.8% have diabetes. Assistance for one month on adopting a healthy lifestyle, including getting used to new healthy drinks, has reduced weight and blood pressure, but blood sugar and cholesterol have not consistently improved. Practicing a healthy lifestyle with assistance has not optimally achieved a healthy status. Therefore, periodic education on elderly nutrition and early detection is necessary to maintain and monitor healthy lifestyles.

Relationship Between Multimorbidity, Nutritional Status and Duration of ARV Treatment to Major Signs of HIV at RSUD Dr. Soetomo Surabaya

People living with HIV/AIDS (PLWHA) can have better health outcomes with early identification of the AIDS phase. In the first three years, PLWHA may progress to the AIDS stage. This cross-sectional study aimed to determine the relationship between multimorbidity, nutritional status and duration of Antiretroviral (ARV) treatment on major signs of PLWHA. This study was conducted in the Intermediate and Infectious Disease Treatment Unit (UPIPI) at regional public hospital (RSUD) Dr. Soetomo Surabaya from January to February 2023. As many as 52 PLWHA who started HIV treatment at RSUD Dr. Soetomo in 2020 to 2021 were sampled in this study, which was obtained from medical records. The dependent variable in this study was the major sign of HIV. Independent variables in this study were multimorbidity, nutritional status, and the duration of ARV treatment. This study found that 76.9% of PLWHA experienced major signs. Multimorbidity and duration of ARV treatment did not have an association with major signs of HIV (<em>p</em>-value > 0.05). Nutritional status has a significant association with major clinical symptoms of HIV (<em>p</em>-value < 0.05). PLWHA with underweight had higher odds of having a major sign (<em>p</em>-value = 0.017; PR = 1.507; 95% CI 1.131-2.008) than PLWHA with normal nutritional status. Thereby, it is hoped that the hospital will be assisted in determining health promotion needs such as screening and evaluation of nutritional status to monitor the nutritional status of patients, which will improve their health outcomes.

Nutrological and pharmacological approaches to cancer cachexia: a systematic review

Introduction: Cancer cachexia (CC) is a multifactorial syndrome that is generally characterized by the continuous loss of skeletal muscle mass with or without fat loss, often accompanied by anorexia, weakness, and fatigue. Cancer cachexia is associated with poor tolerance to antitumor treatments, reduced quality of life, and a negative impact on survival. Unintentional weight loss has been associated with a negative impact on multiple outcomes in cancer patients, including survival and quality of life. Objective: It was to present the main evidence of the nutrological and pharmacological treatment of cancer cachexia through a systematic review. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from October a December 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 127 articles were found. A total of 67 articles were evaluated and 24 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 10 studies with a high risk of bias and 10 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X2=74.5%>50%. Based on the results, symptoms associated with cancer cachexia are thought to be caused by tumor-induced changes in host metabolism that result in systemic inflammation and abnormal neurohormonal responses. The sarcopenia seen in many patients with cancer cachexia is caused, in part, by increased activation of circulating proteolysis-inducing factor (PIF) and skeletal muscle protein breakdown by the ubiquitin-proteasome pathways. The nutritional consequences of cancer treatments must be identified early with screening and assessment of nutritional status. Nutritional intervention includes screening and appropriate nutritional assessment, which should begin early in the disease course to reduce or delay negative effects on therapy and quality of life. Liquid nutritional supplements may be useful to help increase caloric intake. Numerous investigations have reported orexigenic activity associated with progestational agents such as megestrol acetate and medroxyprogesterone. Megestrol acetate has received the most attention in randomized controlled trials of cancer patients. Also noteworthy was the use of corticosteroids and mirtazapine for weight gain and pain control.

Preparing for and Not Waiting for Surgery.

Cancer surgery is an essential treatment strategy but can disrupt patients' physical and psychological health. With worldwide demand for surgery expected to increase, this review aims to raise awareness of this global public health concern, present a stepwise framework for preoperative risk evaluation, and propose the adoption of personalised prehabilitation to mitigate risk. Perioperative medicine is a growing speciality that aims to improve clinical outcome by preparing patients for the stress associated with surgery. Preparation should begin at contemplation of surgery, with universal screening for established risk factors, physical fitness, nutritional status, psychological health, and, where applicable, frailty and cognitive function. Patients at risk should undergo a formal assessment with a qualified healthcare professional which informs meaningful shared decision-making discussion and personalised prehabilitation prescription incorporating, where indicated, exercise, nutrition, psychological support, 'surgery schools', and referral to existing local services. The foundational principles of prehabilitation can be adapted to local context, culture, and population. Clinical services should be co-designed with all stakeholders, including patient representatives, and require careful mapping of patient pathways and use of multi-disciplinary professional input. Future research should optimise prehabilitation interventions, adopting standardised outcome measures and robust health economic evaluation.

PEMBERIAN EDUKASI GIZI DAN PSIKOLOGI PERKEMBANGAN ANAK KEPADA ORANGTUA SISWA DI SD INPRES OEPURA 3 KOTA KUPANG

School-age children are children aged between 6-12 years. The 6-12 years period is a time when children experience rapid growth and development. Foods that contain nutritional elements are needed for the growth and development process of children. The 2018 Riskesdas results show that nutrition problems in school-age children need attention from all parties. In NTT, the prevalence of very short and short in children aged 5-12 years reached 41.1%, very thin and thin reached 18.5%, and fat and obese 6.1%. One of the efforts to improve the nutritional status of school children is to provide education to parents about balanced nutrition and child development psychology so that there is an increase in maternal knowledge and children's nutritional status. Baseline results at SD Impres Oepura 3 parents have never done nutritional status screening and education on balanced nutrition and psychology of school children's development. The purpose of this community service is to increase parents' knowledge about balanced nutrition and child development psychology and have a picture of the nutritional status of elementary school students. Activities were carried out at SD Inpres Oepura 3. Activities were carried out in the form of counseling using lecture methods and pocket book tools involving parents. Evaluation of activities is carried out in the form of pre-post tests. The results of education have increased parental knowledge by 81.5%.

Screening for Nutritional Status in the Outpatient Setting Across Different Clinical Specialities in Turkiye: A Cross-Sectional NutritionDay Awareness Survey

Objective: To screen the nutritional status and determine the prevalence of malnutrition (MN) or MN risk among newly diagnosed and follow-up patients in different outpatient speciality clinics across Turkey.
 Methods: A total of 3521 patients from 52 outpatient speciality clinics across Turkiye were included in this cross-sectional study. MN risk and/or MN were evaluated using Nutritional Risk Screening 2002 (NRS 2002) and Mini Nutritional Assessment (MNA) tools. Time of diagnosis (new admissions vs. follow-up patients) was compared with the nutritional status.
 Results: Overall, 652 (18.7%) of 3492 patients were at risk of MN according to NRS 2002, while 381 (40.9%) of 931 geriatric patients assessed by MNA were either malnourished (scores <17, 14.7%) or at risk of MN (scores 17-23.5, 26.2%). MN risk was more prevalent in medical oncology patients (44.1%), as well as in new vs. follow-up patients (23.1% vs. 19.0%, P = .007), particularly in radiation oncology (30.5% vs. 15.7%, respectively), medical oncology (47.2% vs. 41.6%, respectively) and geriatric (69.6% vs. 46.5%) clinics. In geriatric outpatient clinics, NRS 2002 showed MN risk in 35.3% of the patients those were at MN risk according to MNA, which was only 45.9% for those with MN (MNA score lower than 17).
 Conclusion: In conclusion, this screening study in the outpatient setting across different clinical specialities revealed poor nutritional status in 1 out of every 5 patients overall, and nearly 1 out of 2 patients admitted to medical oncology and geriatrics clinics, respectively. In geriatric patients, NRS 2002 seems to underestimate MN risk compared to MNA. Given the higher MN risk prevalence in cancer and geriatric patients, it is important to screen nutritional status in those patients, especially during the first admission.

Preoperative screening and prehabilitation strategies prior to ileocolic resection in patients with Crohn’s disease are not incorporated in routine care

PurposeRecently, recommendations on perioperative care have been published to optimize postoperative outcomes in preoperative patients with inflammatory bowel disease. This study evaluated the current use of preoperative screening and prehabilitation strategies (PS) prior to elective ileocolic resection (ICR) in patients with Crohn’s disease (CD).MethodsPatients with CD who underwent an elective ICR were identified from a Dutch prospective cohort study. Primary endpoint was to evaluate to what extent IBD-relevant PS were applied in patients with CD prior to ICR according to the current recommendations.ResultsIn total, 109 CD patients were included. Screening of nutritional status was performed in 56% of the patients and revealed malnutrition in 46% of these patients. Of the malnourished patients, 46% was referred to a dietitian. Active smoking and alcohol consumption were reported in 20% and 28%; none of these patients were referred for a cessation program. A preoperative anemia was diagnosed in 61%, and ferritin levels were assessed in 26% of these patients. Iron therapy was started in 25% of the patients with an iron deficiency anemia. Exposure to corticosteroids at time of ICR was reported in 29% and weaned off in 3%. Consultation of a dietitian, psychologist, and physiotherapist was reported in 36%, 7%, and 3%. Physical fitness was assessed in none of the patients.ConclusionPS are not routinely applied and not individually tailored in the preoperative setting prior to elective ICR in patients with CD. Prior to implementation, future research on the costs and effectiveness of PS on postoperative outcomes and quality of life is necessary.

Comparison of three malnutrition screening tools prior to allogeneic hematopoietic stem-cell transplantation.

Previous studies have shown that malnutrition before hematopoietic stem cell transplantation (HSCT) is associated with poor patient prognoses. There is inconsistency among studies on which nutritional status screening tool is appropriate for malnutrition diagnosis before allo-HSCT. The present study aimed to compare nutritional screening tools in patients with leukemia before allo-HSCT. An observational, cross-sectional, and single-center study was conducted in Tehran, Iran. One hundred four adults allo-HSCT candidates aged 18-55 years with leukemia were selected sequentially. Malnutrition assessment was done using three tools, the Global Leadership Initiative on Malnutrition (GLIM), nutritional risk screening 2002 (NRS-2002) and European Society for Clinical Nutrition and Metabolism (ESPEN) criteria. The agreement between malnutrition assessment tools was evaluated with Cohen's kappa. The agreement between GLIM and NRS-2002 was perfect (κ = 0.817, p < 0.001), while the agreement between GLIM and ESPEN was fair (κ = 0.362, p < 0.001). The agreement between NRS-2002 and ESPEN was fair (κ = 0.262, p < 0.001). We also found a moderate agreement for all tools (κ = 0.489, p < 0.001). NRS-2002 is an accepted tool for screening malnutrition in hospitalized patients. In the current study, the GLIM criterion perfectly agreed with the NRS-2002. Further studies in the HSCT setting are needed to introduce a valid tool.

Pengukuran Lingkar Lengan Atas pada Wanita Usia Subur di Kabupaten Jayawijaya

Measurement of Upper Arm Circumference (MUAC) is one form of an indicator used to assess the status of Chronic Energy Deficiency (CED) in pregnant and adult women. The purpose of the Community Engagement Program (CEP) is to conduct nutritional status screening on Women of Reproductive Age (WRA) through MUAC measurement in Jayawijaya Regency. The CEP was conducted in Napua District, Jayawijaya Regency, in October 2022, targeting 110 WRA aged between 15 and 49 years. The activities were carried out through data collection, community education, and the practice of MUAC measurement on WRA. The results of this program found that approximately 71% of WRA had MUAC measurements greater than 23.5 cm, and there was an increase of about 18.1% in knowledge about CED. Additionally, there was a 24.5% increase in WRA's knowledge in conducting MUAC measurements before and after the intervention. The screening also identified a small percentage of WRA with nutritional status below 23.5 cm. The education and practice of MUAC measurement were found to have a significant impact on increasing WRA's knowledge. Therefore, the CEP recommends periodic education provided by nutrition experts during every integrated health post activity and conducting door-to-door visits for pregnant women with CED. Furthermore, there is a need for an increase in the provision of Supplementary Food (SF) such as biscuits and local food.

Pelaksanaan Pendampingan Catin Untuk Mencegah Stunting Dengan Skrinning Status Gizi Dan Indeks Masa Tubuh (Tagindas)

Chronic lack of energy is a major cause of stunting. Based on the results of a preliminary study conducted in November 2022 in the working area of the Salam Babaris Health Center, Tapin District, data on the total number of catin as many as 86 people were obtained. Researchers conducted an examination with 10 catin people found that 4 catin people had nutritional status (lila measurement) below normal size and body mass index with thin classification. The purpose of the study was to determine the implementation of catin (bride-to-be) assistance to prevent stunting by screening nutritional status and body mass index (TAGINDAS) in the work area of the Salam Babaris Health Center in 2022. Type of descriptive research with cross sectional design, univariate analysis test. Total sampling technique. The sample amounted to 32 catin people. The results of the study showed that most respondents of catin (bride-to-be) health status to prevent stunting were not at risk of stunting as many as 21 people (65.6%), respondents in the nutritional status category were not at risk as many as 21 people (65.6% and most respondents in the normal BMI category were 18 people (56.3%).

Healthy Lifestyle Education to Teenagers in The Adaptation Era of New Normal at SMK Negeri 7 Makassar

One of the problems for teenagers in the post-pandemic adaptation era is an unhealthy lifestyle. The lifestyle of SMK 7 Makassar students is mostly classified as sedentary life is playing gadgets and sitting relaxed. The importance of healthy lifestyle educational activities and nutritional status screening in teenagers can identify and reduce the risk of disease in children in the future. The purpose of this program is to educate and increase teenagers knowledge about the importance of a healthy lifestyle, assess the nutritional status of teenagers and find out the description of teenagers blood pressure in the adaptation era of new normal at SMK Negeri 7 Makassar. Based on the results of community service activities on 149 teenagers, the average value obtained includes age is 16 years, body weight is 51 kg, height is 155 cm, systolic blood pressure is 110.88 mmHg and diastolic is 71.84 mmHg, good nutritional status is 70.5% and normal blood pressure as much as 81.2%. There was a significant difference in the level of knowledge of teenagers based on the pre-post test after education, namely p=0.001. This shows the importance of education given to teenagers to increase understanding of a healthy lifestyle as a preventive action. The important role of health workers in the Puskesmas work area to identify and intervene the effects of unhealthy lifestyles as well as the support of the school and parents to prevent short and long term health impacts that occur in teenagers.

The role and relevance of nutritional diagnosis in pediatric oncology

In the Russian Federation the incidence of cancer remains high. Depending on the nosology of the tumor, the probability of malnutrition during primary hospitalization may be 10-50%, and during treatment it may reach 100%. Undernutrition and obesity are independent factors of poor prognosis, reducing the overall effectiveness of treatment. At the same time, the diagnosis of nutritional status (NS) in pediatric oncology is not clearly regulated, which, in the presence of a large number of factors affecting the functioning of the digestive, nervous, endocrine and other systems, creates prerequisites for untimely recognition of nutritional disorders and, accordingly, inadequate nutritional support. Taking into account the mentioned tendencies above it is of great value to establish the foundations for recommendations on the assessment of NS and for making nutritional diagnosis in pediatric oncology. In order to highlight and resolve this challenge the interpretation of clinical aspects, advantages and disadvantages of existing screening scales for NS assessing, anthropometric indicators, methods for body composition evaluation, eating disorders classification according to the World Health Organization, the International Classification of Diseases 10 revision and specialized medical associations was carried out. Based on modern convictions regarding the pathogenesis of protein-energy malnutrition and cachexia, side effects and complications of antitumor treatment, available tools for assessing NS, their systematization, a unified nutritional diagnosis structure was formed. It includes: NS screening, nutritional history, anthropometry dynamics, evaluation of the gastrointestinal tract state and the presence of metabolic disorders, alimentation level, determination of nutritional risk factors. NS is a complex indicator and its reflection can be a nutritional diagnosis, which will potentially allow determining the current NS state, predicting the risks of malnutrition developing, implementing rational nutritional support, and thus improving the effectiveness of cancer treatment.

Are Guideline Recommendations on Supportive Nutrition and Exercise Therapy for Cancer Patients Implemented in Clinical Routine? A National Survey with Real-Life Data.

Malnutrition and cancer cachexia are highly prevalent comorbidities of cancer, limiting patients' quality of life and being relevant to prognosis. International and national clinical guidelines recommend supportive nutrition and exercise therapy for cancer patients. However, there is little current epidemiological evidence on the implementation of these guideline recommendations in clinical routine. To close this data gap, a national survey in Germany using an online questionnaire was conducted. There were 261 of a total of 5074 contacted hospitals and medical offices who participated in the survey (5.1% response rate). The data indicated that nutrition and exercise therapy for cancer patients is so far inadequately implemented, with 59% of the respondents reporting nutrition therapy as an integral part of oncological treatment, 66.7% having a nutrition specialist/team, and 65.1% routinely conducting a screening for nutritional status. Only half of the participants stated that there are defined goals in nutrition therapy. The majority of respondents (85.8%) generally recommend exercise therapy, but only a few of them provide specific offers at their own institution (19.6%) or at cooperation partners (31.7%). In order to implement the recommended combined nutrition and exercise therapy as part of regular care, there is a need for nationwide availability of multidisciplinary nutrition teams and targeted offers of individualized exercise therapy. Health policy support would be important to create the structural, financial, and staff conditions for appropriate guideline implementation in order to achieve the optimal treatment of cancer patients.