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Nutrients Jun 2023Data regarding the nutritional management of preterm small for gestational age (SGA) infants are scarce. In the recent report of ESPGHAN, the recommended energy for very... (Review)
Review
Data regarding the nutritional management of preterm small for gestational age (SGA) infants are scarce. In the recent report of ESPGHAN, the recommended energy for very preterm infants during hospitalization has been increased, yet this may not fit the needs of all preterm infants. It is important to distinguish fetal growth-restricted (FGR) infants from constitutional SGA infants, as well as preterm SGA from preterm AGA infants, since they may have different nutritional needs. Preterm FGR infants, and specifically infants < 29 weeks' gestation, accumulate nutrient deficits due to intrauterine malnutrition, prematurity, morbidities, delayed initiation of feeding, and feeding intolerance. Therefore, these infants may need more aggressive nutrition for optimal catch-up growth and neurologic development. However, a balance should be kept between optimal and excessive catch-up growth, since the combination of intrauterine malnutrition and excessive postnatal growth has been linked with later adverse metabolic consequences. Furthermore, multiple gestation is often complicated by FGR and prematurity. There is controversy in the definition of FGR in multiple gestations, and it should be noted that FGR in multiple gestation usually differs etiologically from FGR in singletons. The aim of this review is to summarize existing knowledge regarding the nutritional needs of preterm FGR and FGR infants of multiple gestation.
Topics: Pregnancy; Female; Infant, Newborn; Humans; Infant; Infant, Premature; Infant, Small for Gestational Age; Fetal Growth Retardation; Pregnancy, Multiple; Gestational Age; Malnutrition
PubMed: 37375640
DOI: 10.3390/nu15122736 -
Arquivos de Gastroenterologia 2021Cirrhosis is a chronic and progressive liver disease that occurs from prolonged hepatocellular injury. Malnutrition causes complications in cirrhosis patients that... (Review)
Review
BACKGROUND
Cirrhosis is a chronic and progressive liver disease that occurs from prolonged hepatocellular injury. Malnutrition causes complications in cirrhosis patients that worsen the condition to liver failure. Both are closely linked and increase the chances of morbidity and mortality. Regular nutritional screening and monitoring is prime concern for such patients including comprehensive dietary history, laboratory tests, and evaluation of muscle loss and strength capabilities to determine the degree of frailty. For efficient assessment of liver cirrhosis patients Subjective Global Assessment has been used worldwide. The nutritional objectives for such individuals should be to regain liver functions, to prevent complications associated, and to overcome nutritional deficiencies causing malnutrition.
METHODS
We conducted a literature review using PubMed, Google Scholar and Science Direct for this purpose, a total of 130 articles were reviewed out of which 80 (from the past 5 years) including originally published research, review articles and abstracts were also included. Exclusion criteria of the selected studies was year of publication, irrelevancy and animal studies based on the purpose of current study. The aim of this study was to check nutritional management in patients having complications of liver cirrhosis.
RESULTS
According to the guidelines, for the conservation of normal nutritional status of the malnourished patients', energy should be provided 35 kcal/kg/day while to prevent hypoalbuminemia and maintain the protein stores in the body, 1.5 g/kg/day protein has been recommended. Carbohydrates and fats for cirrhosis patients are recommended 50% to 60% and 10% to 20% of the total dietary intake respectively.
CONCLUSION
Initial identification and prevention of malnutrition have the probability to lead to better health outcomes, prevention of complications of the disease, and improving quality of life.
Topics: Humans; Liver Cirrhosis; Malnutrition; Nutrition Assessment; Nutritional Status; Quality of Life
PubMed: 34287534
DOI: 10.1590/S0004-2803.202100000-43 -
Nutrients Dec 2022This systematic review analyzed the prevalence of malnutrition in patients with Parkinson's Disease. (Review)
Review
OBJECTIVES
This systematic review analyzed the prevalence of malnutrition in patients with Parkinson's Disease.
STUDY DESIGN
a systematic review.
METHOD
Four databases-Cochrane, PubMed, Embase and Web of Science-were searched from October 2021 to June 2022 by two independent researchers. The inclusion criteria were as follows: patients above 18 years old with confirmed Parkinson's Disease, performed screening nutritional assessment, cohort studies, case-control studies, and cross-sectional studies. Patients without Parkinson's Disease and with other parkinsonian syndromes were excluded.
RESULTS
49 studies were included in this systematic review. Patients ranged in age from 20 to 96 years. There were 5613 subjects included. According to Mini Nutritional Assessment, 23.9% ( = 634) participants were at risk of malnutrition and 11.1% ( = 294) were malnourished. According to BMI score, most patients were either obese or overweight.
CONCLUSIONS
the prevalence of malnutrition or risk of malnutrition in the study group was significant. Therefore, more specific and detailed studies on the prevalence of malnutrition in patients with Parkinson's Disease are needed.
Topics: Humans; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Adolescent; Parkinson Disease; Cross-Sectional Studies; Malnutrition; Nutrition Assessment; Prevalence; Nutritional Status
PubMed: 36501224
DOI: 10.3390/nu14235194 -
Globalization and Health Oct 2021The major threat to human societies posed by undernutrition has been recognised for millennia. Despite substantial economic development and scientific innovation,... (Review)
Review
The major threat to human societies posed by undernutrition has been recognised for millennia. Despite substantial economic development and scientific innovation, however, progress in addressing this global challenge has been inadequate. Paradoxically, the last half-century also saw the rapid emergence of obesity, first in high-income countries but now also in low- and middle-income countries. Traditionally, these problems were approached separately, but there is increasing recognition that they have common drivers and need integrated responses. The new nutrition reality comprises a global 'double burden' of malnutrition, where the challenges of food insecurity, nutritional deficiencies and undernutrition coexist and interact with obesity, sedentary behaviour, unhealthy diets and environments that foster unhealthy behaviour. Beyond immediate efforts to prevent and treat malnutrition, what must change in order to reduce the future burden? Here, we present a conceptual framework that focuses on the deeper structural drivers of malnutrition embedded in society, and their interaction with biological mechanisms of appetite regulation and physiological homeostasis. Building on a review of malnutrition in past societies, our framework brings to the fore the power dynamics that characterise contemporary human food systems at many levels. We focus on the concept of agency, the ability of individuals or organisations to pursue their goals. In globalized food systems, the agency of individuals is directly confronted by the agency of several other types of actor, including corporations, governments and supranational institutions. The intakes of energy and nutrients by individuals are powerfully shaped by this 'competition of agency', and we therefore argue that the greatest opportunities to reduce malnutrition lie in rebalancing agency across the competing actors. The effect of the COVID-19 pandemic on food systems and individuals illustrates our conceptual framework. Efforts to improve agency must both drive and respond to complementary efforts to promote and maintain equitable societies and planetary health.
Topics: Forecasting; Global Health; Humans; Malnutrition
PubMed: 34627303
DOI: 10.1186/s12992-021-00767-4 -
Clinical Nutrition (Edinburgh, Scotland) Oct 2022Twenty years ago, ESPEN published its "Guidelines for nutritional screening 2002", with the note that these guidelines were based on the evidence available until 2002,...
Twenty years ago, ESPEN published its "Guidelines for nutritional screening 2002", with the note that these guidelines were based on the evidence available until 2002, and that they needed to be updated and adapted to current state of knowledge in the future. Twenty years have passed, and tremendous progress has been made in the field of malnutrition risk screening. Many screening tools have been developed and validated for different patient groups and different health care settings. Some countries even have introduced mandatory screening for malnutrition at admission to hospital. Yet, changes in society and healthcare require a reflection on current practice and policies regarding malnutrition risk screening. In this opinion paper, we share our perspectives on malnutrition risk screening in the twenty-twenties, addressing the changing and varying profile of the malnourished individual, the goals of screening and screening tools (i.e., preventive or reactive), the construct of malnutrition risk (i.e., screening for risk factors or screening for existing malnutrition), and screening alongside a patient's journey.
Topics: Hospitalization; Humans; Malnutrition; Mass Screening; Nutrition Assessment; Nutritional Status
PubMed: 36067588
DOI: 10.1016/j.clnu.2022.08.007 -
Clinical Nutrition ESPEN Jun 2021Malnutrition is inevitable in patients with Coronavirus Disease 2019 (COVID-19) due to its effect on the gastrointestinal system, immune system, and high metabolic... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Malnutrition is inevitable in patients with Coronavirus Disease 2019 (COVID-19) due to its effect on the gastrointestinal system, immune system, and high metabolic activity. However, the prevalence of malnutrition and its outcomes is uncertain. This study aimed to investigate the prevalence and outcome of malnutrition among patients with COVID-19.
METHOD
A comprehensive search was conducted in PubMed/Medline; Science direct and LILACS from December 29, 2019 to September, 2020 without language restriction. All observational studies reporting the prevalence of malnutrition were included while case reports and reviews were excluded. The data were extracted with two independent authors with a customized format and the disagreements were resolved by the other authors. The methodological quality of included studies was evaluated using a standardized critical appraisal tool.
RESULTS
A total of 511 articles were identified from different databases and 27 articles were selected for evaluation after the successive screening. Fourteen articles with 4187 participants were included. The pooled prevalence of malnutrition among hospitalized patients with COVID-19 was 49.11% (95% CI: 31.67 to 66.54). The odd of mortality among patients COVID-19 with malnutrition was 10 times more likely as compared to those who were well-nourished.
CONCLUSION
The prevalence of malnutrition and mortality associated with malnutrition among COVID-19 hospitalized patients was very high which entails a mitigating strategy by different stakeholders to prevent and manage malnutrition and its outcomes.
REGISTRATION
This systematic review was registered in Prospero's international prospective register of systematic reviews (CRD42020215396).
Topics: Adult; Aged; Aged, 80 and over; COVID-19; Female; Hospital Mortality; Hospitalization; Humans; Male; Malnutrition; Middle Aged; Prevalence; SARS-CoV-2
PubMed: 34024511
DOI: 10.1016/j.clnesp.2021.03.002 -
PLoS Medicine Mar 2022Zulfiqar A. Bhutta discusses prevention and treatment strategies for optimization of community-based management of severe acute malnutrition in children.
Zulfiqar A. Bhutta discusses prevention and treatment strategies for optimization of community-based management of severe acute malnutrition in children.
Topics: Child; Child Nutrition Disorders; Humans; Infant; Malnutrition; Severe Acute Malnutrition
PubMed: 35231022
DOI: 10.1371/journal.pmed.1003924 -
BMC Neurology Dec 2023Thrombosis of dural sinuses and/or cerebral veins (CVT) is an uncommon form of cerebrovascular disease. Malnutrition is common in patients with cerebrovascular disease,... (Observational Study)
Observational Study
BACKGROUNDS
Thrombosis of dural sinuses and/or cerebral veins (CVT) is an uncommon form of cerebrovascular disease. Malnutrition is common in patients with cerebrovascular disease, and early assessment of malnutrition and individualized nutritional treatment have been reported to improve functional outcomes of these patients. As for CVT patients, little is known about whether these patients would suffer from malnutrition. Also, the correlation between malnutrition and cerebral intraparenchymal damage (CID) in CVT patients was rarely studied.
METHODS
Patients with CVT were retrospectively included in this observational study. Multivariate logistic regressions were used to investigate the effects of nutritional indexes on the risk of CID. Subsequently, we used the independent risk factors to construct the nomogram model, and the consistency index (C-index), calibration curve and decision curve analysis (DCA) to assess the reliability and applicability of the model.
RESULTS
A total of 165 patients were included in the final analysis. Approximately 72.7% of CVT patients were regarded as malnourished by our malnutrition screening tools, and malnutrition is associated with an increased risk of CID. Prognostic Nutritional Index (PNI) (OR = 0.873; CI: 0.791, 0.963, p = 0.007) remained as an independent predictor for CID after adjustment for other risk factors. The nomogram model showed that PNI and gender have a great contribution to prediction. Besides, the nomogram model was consistent with the actual observations of CID risk (C-index = 0.65) and was of clinical significance.
CONCLUSIONS
We reported that malnutrition, as indicated by PNI, was associated with a higher incidence of CID in CVT patients. Also, we have constructed a nomogram for predicting the risk of CID in these patients.
Topics: Humans; Cerebral Veins; Retrospective Studies; Reproducibility of Results; Thrombosis; Malnutrition; Intracranial Thrombosis
PubMed: 38124042
DOI: 10.1186/s12883-023-03491-1 -
Journal of Nutritional Science and... 2022The munber of chronic kidney disease (CKD) patients is increasing globally because kidney function is affected by aging and lifestyle habits. Malnutrition, muscle...
The munber of chronic kidney disease (CKD) patients is increasing globally because kidney function is affected by aging and lifestyle habits. Malnutrition, muscle weakness, and a decline in activities of daily living (ADL) are often observed in elderly CKD patients and dialysis patients, and are related to their CKD prognosis and life prognoses. Chronic inflammation and atherosclerotic disease are associated with malnutrition. Because malnutrition and its related factors affect patients' prognoses, it is necessary to identify and treat patients with malnutrition at an early stage. The state in which the stored protein and energy sources are reduced in CKD is called protein energy wasting (PEW). PEW is diagnosed on the basis of biochemical test findings such as hypoalbuminemia, unhealthy physique, and decreased muscle mass and dietary intake. For evaluating PEW, a complex nutritional index taking into account the pathophysiology specific to CKD patients is useful. Not only nutritional therapy but also exercise therapy is necessary to stop the vicious cycle associated with PEW and the decline in ADL.
Topics: Humans; Aged; Protein-Energy Malnutrition; Activities of Daily Living; Nutritional Status; Japan; Renal Insufficiency, Chronic; Cachexia; Malnutrition
PubMed: 36437025
DOI: 10.3177/jnsv.68.S76 -
BMC Family Practice Jul 2019Malnutrition (specifically undernutrition) in older, community-dwelling adults reduces well-being and predisposes to disease. Implementation of screen-and-treat policies... (Review)
Review
BACKGROUND
Malnutrition (specifically undernutrition) in older, community-dwelling adults reduces well-being and predisposes to disease. Implementation of screen-and-treat policies could help to systematically detect and treat at-risk and malnourished patients. We aimed to identify barriers and facilitators to implementing malnutrition screen and treat policies in primary/community care, which barriers have been addressed and which facilitators have been successfully incorporated in existing interventions.
METHOD
A data-base search was conducted using MEDLINE, Embase, PsycINFO, DARE, CINAHL, Cochrane Central and Cochrane Database of Systematic Reviews from 2012 to June 2016 to identify relevant qualitative and quantitative literature from primary/community care. Studies were included if participants were older, community-dwelling adults (65+) or healthcare professionals who would screen and treat such patients. Barriers and facilitators were extracted and mapped onto intervention features to determine whether these had addressed barriers.
RESULTS
Of a total of 2182 studies identified, 21 were included (6 qualitative, 12 quantitative and 3 mixed; 14 studies targeting patients and 7 targeting healthcare professionals). Facilitators addressing a wide range of barriers were identified, yet few interventions addressed psychosocial barriers to screen-and-treat policies for patients, such as loneliness and reluctance to be screened, or healthcare professionals' reservations about prescribing oral nutritional supplements.
CONCLUSION
The studies reviewed identified several barriers and facilitators and addressed some of these in intervention design, although a prominent gap appeared to be psychosocial barriers. No single included study addressed all barriers or made use of all facilitators, although this appears to be possible. Interventions aiming to implement screen-and-treat approaches to malnutrition in primary care should consider barriers that both patients and healthcare professionals may face.
REVIEW REGISTRATIONS
PROSPERO: CRD42017071398 . The review protocol was registered retrospectively.
Topics: Aged; Humans; Independent Living; Malnutrition; Mass Screening; Primary Health Care
PubMed: 31307402
DOI: 10.1186/s12875-019-0983-y