Triceps Skinfold Thickness Research Articles

The efficacy of fat-free mass index and appendicular skeletal muscle mass index in cancer malnutrition: a propensity score match analysis.

Reduced muscle mass (RMM) is a phenotypic criterion for malnutrition; the appendicular skeletal muscle mass index (ASMI) and fat-free mass index (FFMI) are both applicable indicators in the global leadership initiative on malnutrition (GLIM) guideline. However, their sensitivity and prognostic effect remain unclear. Clinical data of 2,477 patients with malignant tumors were collected. Multi-frequency bioelectrical impedance analysis was used to obtain ASMI and FFMI. RMM was confirmed by ASMI (< 7.0 kg/m2 for men and < 5.7 kg/m2 for women) or FFMI (< 17 kg/m2 for men and < 15 kg/m2 for women). Propensity score match analysis and logistic regression analysis were used to evaluate the efficacy of FFMI and ASMI in diagnosing severe malnutrition and multivariate Cox regression analysis to determine the efficacy of RMM in predicting survival. In total, 546 (22.0%) and 659 (26.6%) participants were diagnosed with RMM by ASMI (RMM.ASMI group) and FFMI (RMM.FFMI group); 375 cases overlapped. Body mass index (BMI), midarm circumference, triceps skinfold thickness, and maximum calf circumference were all significantly larger in the RMM.FFMI group for both sexes (P < 0.05). A 1:1 matched dataset constructed by propensity score match contained 810 cases. RMM.FFMI was an influential factor of severe malnutrition with HR = 3.033 (95% CI 2.068-4.449, P < 0.001), and RMM.ASMI was a predictive factor of overall survival (HR = 1.318, 95% CI 1.060-1.639, P = 0.013 in the RMM.ASMI subgroup, HR = 1.315, 95% CI 1.077-1.607, P = 0.007 in the RMM.FFMI subgroup). In general, RMM indicates negative clinical outcomes; when defined by FFMI, it predicts nutritional status, and when defined by ASMI, it is related to poor survival in cancer patients.

Distribution of Lifestyle Risk Factors and Biophysical/Biochemical Parameters Related to NCD Prevention Among Nurses in Selected Government Hospitals of Chandigarh, India (2020–2022): A Multicentered Cross-sectional Study

Background Non-communicable diseases (NCDs) have a high prevalence among nurses. Among healthcare professionals, disturbed circadian and long working hours lead to physical and mental exertion resulting in health issues such as hypertension, diabetes mellitus, cancer, cerebrovascular diseases, and other NCDs. It is important to assess awareness, preventive measures, and screening strategies related to NCDs among nurses. Objectives To assess the lifestyle risk factors and biophysical/biochemical parameters related to NCD prevention among nurses working in various units of selected government hospitals of Chandigarh, India. Methods Using a simple random sampling technique, a multicentered cross-sectional study was conducted among 137 nursing officers who consented and worked in various units of three government hospitals of Chandigarh, India. Ethical clearance obtained from IEC of enrolled institutes. Data collection methods included self-report, biophysiological assessment, and previous records. A knowledge questionnaire was used to assess the knowledge, Kompan dietary scale for diet, perceived stress scale for stress, Jenkins sleep questionnaire for sleep, and global physical activity questionnaire (GPAQ) were used for physical activity. Weighing/height scale for BMI and measuring tape for waist–hip ratio, Vernier caliper for triceps skinfold thickness, and sphygmomanometer for BP, and appropriate calibrated tools for biochemical parameters were used. Results Almost half of the participants had average and poor knowledge (41.60% and 43.79%) but few had good knowledge (14.59%). The majority of participants had a good attitude towards NCDs (71.53%). Most of the participants were having low pro-healthy diet index (75.9%) and the majority were having non-healthy diet index (94.1%); this indicates that participants had less intake of non-healthy food but the intake of pro-healthy food was also low. The majority had little sleep disturbances (91.97%) as per Jenkins sleep questionnaire and almost everyone had a moderate stress level (97.08%) as per the perceived stress scale. Maximum nurses were in the pre-obese category according to BMI. Almost half (40%) were on the moderate risk of NCDs as per waist–hip ratio. More than 80% having high triceps skinfold thickness. Maximum nurses were having normal blood pressure measurements. The majority were having borderline biochemical parameters but normal blood sugar levels. Conclusion The majority of participants had average knowledge and a good attitude regarding NCDs. The prevalent risk factors of NCD identified among nurses were less intake of healthy food, lack of sleep, moderate stress level, pre-obese, increased waist–hip ratio, and increased triceps skinfold thickness. Hence, nurses need to take adequate measures to control their risk factors aiming for long-term prevention of NCD.

Assessment of handgrip strength in healthy african subjects: Establishing age and gender stratified reference values.

The handgrip strength assesses hand function in traumatic and non-traumatic upper extremity conditions. It is also a surrogate marker for other systemic diseases unrelated to the upper limb. Various reference values have been established in different world regions, with few studies in our population. To determine the average handgrip strength by gender and age categories among healthy subjects in Nigeria. It was a cross-sectional study assessing handgrip strength by age category (ten-year bin width), gender, and handedness in 210 healthy persons aged 10 to 79 in Nigeria. Its relationship with age, height, weight, mid-arm circumference, triceps skinfold thickness, and mid-arm muscle area was evaluated using multiple linear regression. The mean handgrip strength in the dominant and non-dominant hands was 31.09 kg and 28.45 kg, respectively, P < 0.001. Males have higher values than females in all age categories. The grip strength peaked in the 30-39-year age group in both genders and declined afterward. Age exhibited a nonlinear pattern but had an overall negative relationship, while height was positively related to grip strength in both genders. In contrast, mid-arm circumference and mid-arm muscle area predicted handgrip strength only in males. Triceps skinfold thickness was excluded from the model because of multicollinearity with the mid-arm muscle area, while weight did not predict grip strength in either gender. The handgrip strength in this study is less than that in western literature. Hence, test interpretation should reference the values from this study.

Anthropometric measures and arsenic methylation among pregnant women in rural northern Bangladesh

IntroductionArsenic methylation converts inorganic arsenic (iAs) to monomethyl (MMA) and dimethyl (DMA) arsenic compounds. Body mass index (BMI) has been positively associated with arsenic methylation efficiency (higher DMA%) in adults, but evidence in pregnancy is inconsistent. We estimated associations between anthropometric measures and arsenic methylation among pregnant women in rural northern Bangladesh. MethodsWe enrolled pregnant women (n = 784) (median [IQR] gestational week: 14 [13, 15]) in Gaibandha District, Bangladesh from 2018 to 2019. Anthropometric measures were BMI, subscapular and triceps skinfold thicknesses, and mid-upper arm circumference (MUAC), fat area (MUAFA), and muscle area (MUAMA). Arsenic methylation measures were urinary iAs, MMA, and DMA divided by their sum and multiplied by 100 (iAs%, MMA%, and DMA%), primary methylation index (MMA/iAs; PMI), and secondary methylation index (DMA/MMA; SMI). In complete cases (n = 765 [97.6%]), we fitted linear, beta, and Dirichlet regression models to estimate cross-sectional differences in iAs%, MMA%, DMA%, PMI, and SMI per IQR-unit difference in each anthropometric measure, adjusting for drinking water arsenic, age, gestational age, education, living standards index, and plasma folate, vitamin B12, and homocysteine. ResultsMedian (IQR) BMI, subscapular skinfold thickness, triceps skinfold thickness, MUAC, MUAFA, and MUAMA were 21.5 (19.4, 23.8) kg/m2, 17.9 (13.2, 24.2) mm, 14.2 (10.2, 18.7) mm, 25.9 (23.8, 28.0) cm, 15.3 (10.5, 20.3) cm2, and 29.9 (25.6, 34.2) cm2, respectively. Median (IQR) iAs%, MMA%, DMA%, PMI, and SMI were 12.0 (9.3, 15.2)%, 6.6 (5.3, 8.3)%, 81.0 (77.1, 84.6)%, 0.6 (0.4, 0.7), and 12.2 (9.3, 15.7), respectively. In both unadjusted and adjusted linear models, all anthropometric measures were negatively associated with iAs%, MMA%, and PMI and positively associated with DMA% and SMI. For example, fully adjusted mean differences (95% CI) in DMA% per IQR-unit difference in BMI, subscapular skinfolds thickness, triceps skinfold thickness, MUAC, MUAFA, and MUAMA were 1.72 (1.16, 2.28), 1.58 (0.95, 2.21), 1.74 (1.11, 2.37), 1.45 (0.85, 2.06), 1.70 (1.08, 2.31), and 0.70 (0.13, 1.27) pp, respectively. ConclusionsAnthropometric measures were positively associated with arsenic methylation efficiency among pregnant women in the early second trimester.

#5405 MALNUTRITION DIAGNOSIS IN CKD PATIENTS

Abstract Background and Aims Malnutrition is a prevalent condition in patients with chronic kidney disease (CKD) receiving replacement therapy by peritoneal dialysis (PD). Geriatric nutritional risk index (GNRI) is an effective tool for screening nutritional status in maintenance hemodialysis patients. The purpose of this study was to determine the information content of GNRI for the diagnosis of protein-energy malnutrition in patients with CKD receiving replacement therapy with PD when compared to malnutrition inflammation score (MIS) and 7-point subjective global assessment (7p-SGA). Method A prospective cohort study included 222 adults PD-patients (man 100, female 112, age 44±14). All patients received continuous ambulatory peritoneal dialysis. Median duration PD before inclusion in the study was 12 months, the observation period of patients was 36 months. Nutritional status assessment included anthropometric (body mass index, triceps skinfold thickness, midupper arm muscular area) and biochemical (albumin, C-reactive protein, total iron-binding capacity, total cholesterol, hemoglobin and others) examinations as well as bioelectrical impedance analysis (BIA – fat mass). GNRI calculated according to the formula GNRI = 1.489 × albumin (g/dL)] + [41.7 × (body wt/ideal body wt)], where the ideal body weight for women is: height (cm)–100–[(height–152) × 0.2], ideal body weight for men is equal to: height (cm) -100 - [(height - 152) × 0.4]. We used MIS and 7p-SGA as a reference standard, a score ≥6 and ≤5, respectively, defined malnutrition. The cutoff of GNRI the diagnosis of malnutrition were derived from these ROC-analysis. Results Most of the individual nutritional indexes, including the anthropometric, biochemical and BIA indexes, were significantly (P&amp;lt;0.001) lower in the patients with MIS score ≥6 and 7p-SGA score ≤5, thus both nutritional screening tools were considered reasonable as a reference standard to determine the information content GNRI in PD-patients. The GNRI fluctuated in the range 66–126 (median 99), MIS score – 2–24 (median 7) and 7p-SGA score – 2–7 (median 5). The GNRI showed a significantly negative correlation with MIS (r = -0,708, p&amp;lt;0.0001) and a significantly positive correlation with 7p-SGA (r = 0.636, p&amp;lt;0.0001) (Fig. 1). The most accurate GNRI cutoff to identify a malnourished patient according to the MIS was ≤99 (Fig. 2). The frequency of malnutrition among the observed patients was 52.3% when using GNRI≤99, 55.9% when using MIS≥6 and 51.4% when using 7p-SGA≤5 (n.s.). The values for sensitivity and specificity with a GNRI of ≤99 in predicting malnutrition based on the MIS were 77.4% (95%CI 69.0-84.4%) and 79.6% (95%CI 70.3-87.1%) respectively. Positive predictive value and negative predictive value also had high scores respectively 73.7% (95%CI 64.9-80.9%) and 72.2 (95%CI 63.1-79.8%). The application of the GNRI to the PD-patients found significant (p&amp;lt;0.001) differences in the various nutrition-related indexes (anthropometric, biochemical and BIA) between the group with a GNRI≤99 and that with GNRI&amp;gt;99. Mortality from all causes among patients with GNRI&amp;gt;99 was one case per 54.9 patient-years, among patients with GNRI≤99 was one case per 29.7 patient-years. Conclusion In PD-patients GNRI closely correlates with MIS and 7p-SGA, characterized by high sensitivity and specificity. GNRI can be used to determine the nutritional status of PD patients.

Measuring grip strength in adolescents and adults with cerebral palsy in a clinic setting: Feasibility, reliability, and clinical associations.

To determine the feasibility and reliability of measuring grip strength and its association with anthropometrics and diseases among adolescents and adults (≥16 years old) with cerebral palsy (CP). In this cross-sectional study, individuals with CP, classified in Gross Motor Function Classification System (GMFCS)/Manual Ability Classification System (MACS) levels I to V, were recruited to measure grip strength, anthropometrics, and self-reported current/history of disease during a routine clinical visit. Feasibility was determined as the proportion recruited/consented/completed testing. Test-retest reliability of three maximal effort trials per side was assessed. Linear regression determined associations of grip strength with anthropometrics after adjusting for age, sex, and GMFCS. The predictive ability of GMFCS alone, grip strength alone, GMFCS + grip strength, and GMFCS × grip strength for diseases was compared. Of 114 individuals approached, 112 participated and 111 successfully completed all tasks. There was good to excellent reliability of test-retest grip strength between trials for dominant and non-dominant sides for the entire cohort and when stratified by each GMFCS and MACS level (intraclass correlation coefficient range 0.83-0.97). Sex, GMFCS, MACS, body mass, and waist circumference were associated with grip strength (p < 0.05), but not hip circumference, waist:hip ratio, or triceps skinfold thickness. Modeling grip strength with GMFCS had a higher predictive value for relevant diseases than GMFCS alone. Grip strength is a feasible and reliable measurement for CP, and is associated with some demographics and anthropometric measures. Grip strength, in addition to the GMFCS, enhanced prediction of disease outcomes. Measurement of hand grip strength is clinically feasible for adolescents/adults with cerebral palsy. Grip strength has good to excellent test-retest reliability across Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) levels. Grip strength is associated with sex, weight, waist circumference, GMFCS, and especially MACS. Grip strength, in addition to GMFCS, shows promise for enhancing disease prediction in this cohort.

Calorie-restricted diet mitigates weight gain and metabolic abnormalities in obese women with schizophrenia: a randomized controlled trial.

Obesity is a prevalent health problem in patients with schizophrenia, and calorie restriction diet (CRD) achieved effective weight loss and metabolic improvement; however, these have not been rigorously evaluated in obese patients with schizophrenia. To measure the effects of CRD on weight loss and metabolic status in hospitalized obese women with schizophrenia during a 4-week period. Participants were randomly assigned to two groups in a 1:1 ratio. The intervention group (n = 47) was asked to follow a CRD and the control group (n = 48) a normal diet for 4 weeks. Outcomes of body weight, body composition, as well as metabolic parameters were measured at baseline and following the intervention period. Forty-five participants completed the 4-week research in both the intervention and control groups. Compared to the normal diet, adherence to the CRD significantly decreased body weight (2.38 ± 1.30 kg), body mass index (0.94 ± 0.52 kg/m2), waist circumference (4.34 ± 2.75 cm), hip circumference (3.37 ± 2.36 cm), mid-upper circumferences, triceps skin-fold thickness, fat mass and free fat mass with large effect sizes (p = <0.001, ηp2 range between 0.145 and 0.571), as well as total cholesterol (0.69 ± 0.70 mmol/L) with a medium effect size (p = 0.028, ηp2 = 0.054). There were no differences between the CRD and control groups in terms of pre-post changes in triglycerides, high- and low-density lipoprotein-cholesterols, as well as systolic and diastolic blood pressures (p > 0.05). CRD is preventative of weight gain, but not apparent in intervention for metabolic status in hospitalized obese women with schizophrenia.Clinical trial registration: http://www.chictr.org.cn, ChiCTR-INR-16009185.

Hemodiyaliz hastalarında diyetin antioksidan kapasitesi ile serum oksidatif stres indeksi arasındaki ilişki

Purpose: Oxidative stress increases in uremic conditions such as kidney failure and during hemodialysis. In this study, it was aimed to examine the relationship between the total antioxidant capacity of the diet and the serum oxidative stress (sOSI) index in hemodialysis patients.&#x0D; Materials and Methods: In this study conducted with 82 individuals (41 patients and 41 controls). Demographic characteristics and anthropometric measurements of the individuals were taken by researchers. In order to determine the nutritional status of the individuals, 3-day food consumption records were taken and the total antioxidant capacity of the diet was calculated.&#x0D; Results: The mean age of the individuals participating in the study was found to be 54.01±2.24 years. Hemodialysis treatment mean for 4.8±3.12 years. While 41.46% of hemodialysis patients were moderately malnourished. Dietary Oxygen Radical Absorption Capacity (dORAC) (μmol) measurement result was found to be 2415.3±1073.45, 5468.4±2393.85 in the hemodialysis and control groups, respectively. In the multiple logistic regression analysis performed, the decrease in body mass index (OR 2.21 95% CI 1.050-2.317) and triceps skinfold thickness values (OR 3.22 95% CI 1.722-4.001) in hemodialysis patients led to an increase in the sOSI value. It has been observed that when dietary protein (OR 1.23 95% CI 1.003-3.189), vitamin C (OR 2.88 95% CI 1.004-3.106) and dTAC (OR 2.04 95% CI 1.967-2.001) increase, the sOSI value decreases in hemodialysis patients.&#x0D; Conclusion: There is a positive relationship between diet total antioxidant capacity and serum antioxidant level, and it was determined that the dietary antioxidant capacity of hemodialysis patients was significantly lower than that of healthy individuals. According to the results of the study, it is recommended to monitor the food consumption status of hemodialysis patients in order to increase the dietary antioxidant capacity.

The predictive value of temporal muscle thickness measured by ultrasonography for detecting moderate to severe malnutrition in chronic hemodialysis patients.

To determine the predictive value of temporal muscle thickness (TMT) measured by ultrasonography in the diagnosing of moderate to severe malnutrition in chronic hemodialysis (CHD) patients. Adult patients (> 18years) who had been on CHD for at least 3months were included in this cross-sectional study. Patients with infection or inflammatory disease, malignancy, malabsorption syndrome, history of surgery within the last 3months excluded. Demographic, anthropometric, laboratory parameters, and Malnutrition Inflammation Score (MIS) test results recorded. A total of 60 chronic hemodialysis (CHD) patients (median age: 66years, 46.7% female) and 30 healthy individuals (median age: 59.5years, 55% female) were examined. While there were no significant difference between the dry weight (70 vs 71kg) and body mass index (BMI) (25.8 vs 26kg/m2) of the CHD patients and healthy control group, we found that triceps skinfold thickness (TST) (16 vs 19mm) and left and right TMT (9.6 vs 10.7 and 9.8 vs 10.9mm) values were significantly lower in the CHD patients (p < 0.001). CHD patients were divided into two groups according to their MIS values as mild (MIS < 6) and moderate/severe malnutrition (MIS ≥ 6). Patients with moderate/severe malnutrition were older, predominantly female and with longer HD vintage. Left (8.8 vs 11mm) and right TMT (9.1 vs 11.2mm) values were lower in moderate/severe malnutrition group. In the correlation analysis, a negative correlation was found between TMT and age and MIS, and a positive correlation determined with dry weight, BMI, TST and serum uric acid. In the ROC curve analysis, we found that the optimal cut-off value of left and right TMT for predicting moderate/severe malnutrition were 10.05 and 10.45mm, respectively. Multivariate regression analysis showed that HD vintage, URR, and TMT values were independently associated with moderate/severe malnutrition. TMT value measured by ultrasonography in CHD patients can be used as a reliable, easily accessible and non-invasive diagnostic method for predicting moderate/severe malnutrition.

Assessment of nutritional status using objective and subjective methods in Greek patients with cancer

Summary Purpose Malnutrition constitutes an important complication of cancer. Nutritional status is associated with the progression of malignant neoplasms. This study aimed to assess the nutritional status of patients with cancer using objective and subjective assessment methods. Materials and methods The following validated questionnaires were used to assess the nutritional status of 152 patients with cancer recruited in Attica, Greece: Patient-Generated Subjective Global Assessment (PG-SGA), Nutritional Risk Screening-2002 (NRS-2002), Simplified Nutritional Appetite Questionnaire (SNAQ). Geriatric nutritional risk index (GNRI) was calculated, handgrip strength (HGS) test was carried out, and the arm circumference (MUAC) and triceps skinfold thickness (TSF) were measured. Results Based on the PG-SGA assessment, 54.9% of the individuals were severely malnourished. Imminent risk was observed in 83.6% (NRS-2002) and 48.7% of participants were at increased risk of a 5% reduction in body weight within the next 6‑months (SNAQ). Severely malnourished patients experienced significant weight reduction in the 6 months prior to recruitment and had lower HGS and TSF. MUAC was similar within the PG-SGA categories. High risk for malnutrition was estimated for geriatric patients (GNRI: 46.45 [IQR: 5.17]). Malnourishment, based on PG-SGA, was positively associated with percent weight loss within the past 6 months and negatively associated with body mass index (BMI), hemoglobin (Hgb), HGS, and MUAC (all p ≤ 0.05). Conclusion The present study highlighted a high risk of malnutrition in patients with cancer. Poor nutritional status was positively associated with weight loss, Hgb, and MUAC and negatively associated with BMI, HGS, and TSF.

Clinical effect of nighttime snacking on patients with hepatitis B cirrhosis.

Nighttime snacking is an effective intervention to avoid abnormal protein consumption caused by prolonged fasting. This article aims to evaluate the clinical efficacy of nighttime snacking on patients with hepatitis B cirrhosis and to provide new ideas for clinical nutritional intervention. The study participants were randomly assigned to the control group (n = 30) and the observation group (n = 30); the former was administered medical system treatment and routine dietary intervention, and the latter was administered the same treatment with the addition of nighttime snacking. After 3 months of intervention with different dietary guidance, the dry body weight body mass index (BMI), upper arm muscle circumference (AMC), grip strength, triceps skinfold thickness (TSF), third lumbar skeletal muscle index (L3-SMI), albumin (ALB), total bilirubin (T-BIL), cholinesterase (CHE), Fried's frailty phenotype score, Child-Pugh score and various cirrhosis complication rates were compared between the two groups. There was no significant difference in the baseline data between the two groups before the dietary intervention. After 3 months of regular dietary guidance in the control group, the grip strength increased compared with the baseline data (p < 0.05), while the dry body weight BMI, AMC, TSF, L3-SMI, ALB, T-BIL, CHE, prothrombin time, international normalized ratio, prothrombin activity, and Child-Pugh scores were not significantly different (p > 0.05). After 3 months of dietary guidance with nighttime snacking in the observation group, the dry body weight BMI, grip strength, TSF, L3-SMI, and CHE scores all increased, compared with the baseline data, while the Child-Pugh score decreased compared with the baseline level (all p < 0.05). After 3 months of intervention, the Child-Pugh score of the observation group showed a more significant decrease than the control group, while the dry body weight BMI, grip strength, ALB and CHE scores were all significantly higher than those in the control group (all p < 0.05). Overall, the improvement rate was significantly higher in the observation group than in the control group (p < 0.05). Nighttime snacking for hepatitis B cirrhosis patients with nutritional risk is beneficial in terms of the recovery of liver synthesis functions, improvements in clinical indicators, sarcopenia corrections and improvements in malnutrition-related complications.

Effectiveness of smart health-based rehabilitation on patients with poststroke dysphagia: A brief research report.

This study aimed to evaluate the effectiveness of smart health-based rehabilitation on patients with poststroke dysphagia (PSD). We recruited 60 PSD patients and randomly allocated them to the intervention (n = 30) and control (n = 30) groups. The former received the smart health-based rehabilitation for 12 weeks, whereas the latter received routine rehabilitation. Water swallow test (WST), standardized swallowing assessment (SSA), swallow quality-of-life questionnaire (SWAL-QOL), stroke self-efficacy questionnaire (SSEQ), perceived social support scale (PSSS) and nutritional measurements including body weight, triceps skinfold thickness (TSF), total protein (TP), serum albumin (ALB) and serum prealbumin (PA) in both groups were measured. When the baseline WST, SSA, SWAL-QOL, SSEQ, PSSS and nutritional measurements were examined, there was no significant difference between the intervention group and the control group (P > 0.05). After rehabilitation interventions, the WST and SSA scores in the intervention group were significantly lower than those in the control group (P < 0.01). The SWAL-QOL, SSEQ and PSSS scores in the intervention group were significantly higher than in the control group (P < 0.01). Compared with the control group, the intervention group showed an increase in the serum levels of PA (P < 0.01). However, no statistically significant difference existed between the intervention group and the control group in terms of body weight, TSF, TP or ALB (P > 0.05). Overall, our data revealed that smart health-based rehabilitation is significantly beneficial to the swallowing function, quality of life, self-efficacy, and social support for PSD patients when compared with routine rehabilitation. However, nutritional measurements were not significantly improved in such patients under the smart health-based rehabilitation when compared the routine rehabilitation. In the future, it is necessary to extend the intervention time to further evaluate the long-term efficacy of smart health-based rehabilitation on nutritional measurements of PSD patients.

Nutritional Status and Feeding Problems in Pediatric Specific Learning Disability.

This cross-sectional study aims to determine the feeding problems and nutritional status of children diagnosed with specific learning disability (SLD), which is one of the neurodevelopmental disorders. Sociodemographic information, anthropometric measurements, and food consumption records of 76 children (38 boys and 38 girls) diagnosed with SLD were obtained by applying a questionnaire. The Behavioral Pediatrics Feeding Assessment Scale was used to determine the feeding problems of children. About 31.6% of children with SLD are overweight and obese. Feeding behavioral problems were found in 39.5% of the children with SLD. Binary logistic regression analysis showed a significantly higher frequency of feeding behavior problems in children with SLD: (1) lower body mass index (adjusted odds ratio [AOR]: 0.841, 95% confidence interval [CI]: 0.722-0.979), (2) lower tri-ponderal mass index (AOR: 0.738, 95% CI: 0.585-0.933), (3) lower upper middle arm circumference (AOR: 0.772, 95% CI: 0.649-0.918),and (4) lower triceps skinfold thickness (TSFT) (AOR: 0.890, 95% CI: 0.808-0.980). In this study, feeding behavior problems are common in children diagnosed with SLD. Therefore, identifying feeding behavior problems in children diagnosed with SLD and developing solutions specific to the problem are important for gaining healthy eating habits throughout life.

Assessment of fluid removal using ultrasound, bioimpedance and anthropometry in pediatric dialysis: a pilot study

BackgroundFluid overload is associated with morbidity and mortality in children receiving dialysis. Accurate clinical assessment is difficult, and using deuterium oxide (D2O) to measure total body water (TBW) is impractical. We investigated the use of ultrasound (US), bioimpedance spectroscopy (BIS), and anthropometry to assess fluid removal in children receiving maintenance hemodialysis (HD).MethodsParticipants completed US, BIS, and anthropometry immediately before and 1–2 h after HD for up to five sessions. US measured inferior vena cava (IVC) diameter, lung B-lines, muscle elastography, and dermal thickness. BIS measured the volume of extracellular (ECF) and intracellular (ICF) fluid. Anthropometry included mid-upper arm, calf and ankle circumferences, and triceps skinfold thickness. D2O was performed once pre-HD. We assessed the change in study measures pre- versus post-HD, and the correlation of change in study measures with percent change in body weight (%∆BW). We also assessed the agreement between TBW measured by BIS and D2O.ResultsEight participants aged 3.4–18.5 years were enrolled. Comparison of pre- and post-HD measures showed significant decrease in IVC diameters, lung B-lines, dermal thickness, BIS %ECF, mid-upper arm circumference, ankle, and calf circumference. Repeated measures correlation showed significant relationships between %∆BW and changes in BIS ECF (rrm =0.51, 95% CI 0.04, 0.80) and calf circumference (rrm=0.80, 95% CI 0.51, 0.92). BIS TBW correlated with D2O TBW but overestimated TBW by 2.2 L (95% LOA, -4.75 to 0.42).ConclusionBIS and calf circumference may be helpful to assess changes in fluid status in children receiving maintenance HD. IVC diameter, lung B-lines and dermal thickness are potential candidates for future studies.

Entropy-based subset selection principal component analysis for diabetes risk factor identification

Diabetes is one of the most common diseases, with an estimated 10% of the population suffering from this disease. Therefore, it is important to be able to identify the symptoms of this disease as early as possible before the patient's condition worsens and requires more expensive medical treatment. We aimed to study whether the entropy-based subset selection principal component analysis (E-ss PCA) can diagnose if a person is diabetic. The E-ss PCA is a novel machine learning method that can identify important parameters from a dataset. The E-ss PCA method was originally developed to fix the linearity problem that occurred when the principal component could not be written as the linear combination of the original parameters. Through the process, the E-ss PCA generates subsets of data that guarantee the linearity of variables of the subset. Via the E-ss PCA algorithm, we aim to verify which diabetic risk factors, such as pregnancy, triceps skinfold thickness, Body Mass Index (BMI), pedigree function, and age, are significant. Based on a dataset of diabetes patients from the United States National Institute of Diabetes and Digestive and Kidney Diseases, the E-ss PCA method was able to predict whether a person has diabetes or not with an average accuracy of 97.30%, which is higher than the classical PCA with an average accuracy of 94.45%. Furthermore, the proposed algorithm identified that the risk factors that accurately predict diabetes are BMI, triceps skin fold thickness, and blood pressure.

Anthropometric effect of a personalized food avoidance dietary approach to stop hypertension

Background: Body anthropometries are indicators of health and disease. It is universally accepted that it is a useful tool for assessing health status. Objective: The aim of this article is to determine the effect of a personalized food avoidance dietary approach to stop hypertension (PFADASH) on anthropometric parameters: body mass index (BMI), triceps skin fold thickness (TSFT), and abdominal circumference (AC) on study participants. Materials and Methods: This was a longitudinal study and part of an open controlled clinical trial of a PFADASH approved by the University of Nigeria Teaching Hospital Ethics Committee. Anthropometric parameters were compared between study participants with good and poor dietary compliance to a PFADASH. Results: There was no significant difference in the anthropometric parameters: BMI, TSFT, and AC among participants with good and poor dietary compliance to a PFADASH (P > 0.05). Conclusion: There was no negative effect of a PFADASH on anthropometric parameters, despite not being a calorie-restrictive dietary intervention.

Assessment of dietary nutrient intake and its relationship to the nutritional status of patients with Crohn's Disease in Guangdong Province of China.

to investigate the association between the dietary nutrient intake and nutritional status of patients with Crohn's disease (CD). sixty CD patients who had been diagnosed but had not begun treatment were enrolled. The dietary nutrient intake was recorded after three days of 24-hour recall and was calculated using NCCW2006 software. The nutrition levels were assessed using the Patient-Generated Subjective Global Assessment (PG-SGA). Indicators included body mass index (BMI), mid-arm circumference, the circumference of the upper-arm muscle, triceps skinfold thickness, handgrip strength, and the circumference of the lower legs. eighty-five per cent of CD patients did not meet the necessary energy requirements. Of these, the protein and dietary fiber intake in 63.33 % and 100 %, respectively, were below the standard of the Chinese dietary reference. Many patients had insufficient intake of vitamins, as well as other macro- and micronutrients. An inverse association was observed between the risk of malnutrition and higher levels of energy (1,590.0-2,070.6 kcal/d, OR = 0.050, 95 % CI: 0.009-0.279) and protein (55.6-70.5 g/d, OR = 0.150, 95 % CI: 0.029-0.773). Appropriate supplementation of vitamin E, calcium, and other dietary nutrients helped to reduce the risk of malnutrition. significant deficiencies in dietary nutrient intake were found in CD patients, and dietary intake was associated with the nutritional status of the patient. Appropriate adjustment and supplementation of nutrient intake may reduce malnutrition risk in CD patients. The gap between actual consumption and recommendation indicates a need for improved nutritional counseling and monitoring. Early relevant advice for the dietary guidance of CD patients may be beneficial for long-term effects associated with nutritional status.

Utility of Subjective Global Nutritional Assessment Tool for the Assessment of Malnutrition in Pediatric Patients with Chronic Liver Disease.

Approximately 30% of children with chronic liver disease (CLD) are malnourished. However, proper assessment of their nutritional status is difficult. The subjective global nutritional assessment (SGNA) is a comprehensive approach that uses nutrition-focused history and examination, followed by grading of malnourishment. We aimed to study the prevalence of malnutrition in children with CLD using the SGNA tool. This cross-sectional observational study included patients aged <18 years with CLD. Nutritional assessments were recorded using SGNA tool. Conventional anthropometric measurements were performed and corroborated with nutritional status using SGNA tool. A total of 85 children with CLD and mean age of 62 months were enrolled in this study. The prevalence of malnourished children according to SGNA was 34%; 22% were moderately malnourished and 12% were severely malnourished. We found statistically significant differences in anthropometric parameters among the three groups. A moderate degree of agreement was found between SGNA and weight-for-age (W/A) (p=0.020), mid-upper arm circumference (MUAC) (p<0.001), and triceps skin-fold thickness (TSF)-for-age (p=0.029). Furthermore, a fair degree of agreement was found between height-for-age (H/A) (p=0.001) and weight-for-height (W/H) (p<0.001). The sensitivity of W/A for detecting malnutrition was 93%, H/A was 90%, MUAC was 86%, and TSF was 88%. The sensitivity was much lower for W/H and body mass index for age (55% for both). In our study, more than one-third of children with CLD were malnourished. Nutritional assessment using SGNA is a reliable method for evaluating nutritional status and is significantly correlated with common anthropometric measurements.

Circulating leptin levels in the assessment of Crohn's disease activity and its relation to nutritional status.

Objective: to evaluate leptin levels and its relation to nutritional status in Crohn's disease (CD). Methods: the study included 154 CD patients and healthy controls. Leptin level was determined before treatment. Nutrition levels were assessed using the Nutrition Risk Screening 2002 (NRS-2002) and Patient-Generated Subjective Global Assessment (PG-SGA). Indicators included body mass index (BMI), mid-arm circumference, the circumference of the upper-arm muscle, triceps skinfold thickness, and circumference of legs. Results: leptin levels differed between CD patients (1,025 ± 874 ng/ml) and controls (18,481,222 ng/ml). Significant differences were seen in NRS-2002, PG-SGA scores, BMI and other nutritional indicators. Negative correlations were observed between leptin and NRS-2002, PG-SGA scores, while positive correlations were observed with other nutritional indicators. The receiver operating characteristic (ROC) curve showed association between leptin and the diagnosis of CD, suggesting leptin concentration below 803.02 ng/ml as a threshold for CD. Conclusion: dysfunctional leptin regulation may relate to poor nutritional status associated with CD. The leptin level is thus an additional tool for evaluating CD patients, predicting disease activity and clinical response. Leptin may be a potential target for intervention in CD to improve nutritional status.

Алгоритм выбора продукта для нутритивной поддержки и энтерального питания у детей с детским церебральным параличом

Objective. To develop an algorithm for selecting a nutritional support / enteral nutrition product in children with cerebral palsy based on nutritional status indicators and the nature of concomitant pathology. Patients and methods. This study included 261 children aged 2 to 17 years (159 (61%) boys) diagnosed with spastic cerebral palsy. All children were divided into different groups according to the Gross Motor Function Measure (GMFM) level and feeding method (per os / gastrostomy). Nutritional status and characteristics of gastrointestinal symptoms were investigated, and actual nutrition was assessed. Body composition was evaluated by measuring triceps skinfold thickness and mid-upper arm circumference. Dietary adjustments were made considering the identified disorders of nutritional status and gastrointestinal function. Follow-up examination was performed after 6–9 months to assess the efficacy of diet therapy. Results. An underweight condition was detected in 40–79% of cases and was most frequently observed in groups IV, V, VTF of GMFCS levels: 14 (21.9%), 33 (40.7%) and 18 (39.1%) children, respectively (pVTF–V–IV &lt; 0,001). Stunting was recorded in groups IV, V, and VTF. The most common gastrointestinal disorder was constipation (47.1%). Energy deficiency was registered in 213 (81.6%) children and amounted to 12.3–61.8% from the norm. The rate of macronutrient deficiency: protein – 11.4–60.0%, fats – 10.9–61.6%, carbohydrates – 20.3–72.6% from the individual norm / recommended dietary intake. In the follow-up period, statistically significant positive dynamics of weight and height indicators, an increase in fat mass and skeletal muscle mass, and relief of gastrointestinal manifestations were observed against the background of diet therapy. Analysis of findings allowed us to develop an algorithm for selecting a nutritional support / enteral nutrition product for children with cerebral palsy. Conclusion. Evaluation of nutritional status and correction of its disorders requires a comprehensive approach in patients with cerebral palsy. In the absence of positive dynamics after 1–3 months, it is necessary to revise a dietary regimen. Key words: diet therapy algorithm, cerebral palsy, motor activity level, underweight, nutritional support