Disease-related malnutrition: a time for action

This fact sheet on disease-related malnutrition is intended for national and regional policymakers for health care. It provides a concise overview of the actions recommended by ESPEN in guidelines and position papers to strengthen nutritional care for the prevention and management of disease-related malnutrition in primary care and for hospital outpatients and inpatients. It includes a recommendation that health-care professionals be trained in nutritional care.

西太平洋区域保护儿童免受食品营销有害影响行动框架 [Regional action framework on protecting children from the harmful impact of food marketing in the Western Pacific]

经济快速增长、城市化和全球化改变了本区域的食品体系，廉价的加工食品更加方便易得。儿童比以往任何时候都更容易受到母乳代用品和高饱和脂肪酸、高反式脂肪酸、高游离糖或高盐食品营销的危害。本《区域行动框架》旨在支持会员国努力避免儿童受到食品营销的有害影响。本《框架》包括政策框架、多部门和多利益相关方合作、宣传和沟通、监测与评价四大行动支柱以及十项建议采取的行动。以此方式，会员国可以根据自己的需要和优先事项来调整行动。

Public health nutrition in Afghanistan-policies, strategies and capacity-building: current scenario and initiatives

Background: Afghanistan is grappling with high burden of malnutrition in women and children and a rising burden of noncommunicable diseases. Aims: A narrative review was conducted with the aim of mapping current nutrition policies and capacity development initiatives to assess policy and the institutional environment and identify gaps and opportunities. Methods: A comprehensive, broad based search was conducted, including databases and websites and policy and programme documents. Results: The policy focuses on multisectoral efforts to address nutrition challenges; however; implementation of nutrition-specific and nutrition-sensitive interventions is not delivered uniformly at the community level due to continued conflic situations and geographic inaccessibility, lack of availability of trained human resources and weak institutions. There is limited evidence on the effectiveness of nutrition programmes in Afghanistan. Limited policy provisions are available to address nutrition issues due to the rising burden of noncommunicable diseases, urbanization and changing dietary patterns. The shortage of skilled nutritional professionals is a critical issue. Lack of institutional capacity, educational standards and accreditation mechanism poses major challenges. Ongoing training programmes are fragmented and fail to meet the requirements of a professional nutrition workforce. Conclusion: The findings highlight that well-structured policies and strategies focusing on maternal and child nutrition provide an enabling policy environment to scale up nutrition interventions. Evidence on the implementation of programmes is needed to aid policy recommendations. The lack of an institutional mechanism for professional nutrition education highlights the great need for action in Afghanistan for public health nutrition and education.

Association of malnutrition and low quality of life among cancer patients receiving chemotherapy, Palestine

Background: Malnutrition is significantly associated with poor clinical outcomes and reduced quality of life among cancer patients. Although the number of cancer patients receiving chemotherapy has increased in Palestine, there has been limited research on the relationship between malnutrition and quality of life. Aims: To determine the relationship between nutritional status and quality of life of cancer patients receiving chemotherapy at Al-Hussein Governmental Hospital in Biet-Jala, Palestine. Methods: This cross-sectional study included all the patients receiving chemotherapy between 2018 and 2019. Nutritional status was assessed using anthropometric measurements and biochemical data retrieved from the participating patients’ files. The clinical assessment of malnutrition was done using the Subjective Global Assessment, and quality of life was assessed using the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire version 3. Results: One hundred patients (79 females, 21 male) were included in the final analysis. The results revealed that 25% of the patients were severely malnourished, and 42% were mildly to moderately malnourished. There was a significant relationship between malnutrition and quality of life in the following domains: physical functioning, cognitive functioning and fatigue. Conclusions: Malnutrition is prevalent among Palestinian cancer patients receiving chemotherapy, and it is associated with poor quality of life. The results of the study highlight the need for nutritional support programmes for cancer patients to enhance their nutritional status and improve their quality of life.