Nutritional status and adequacy of enteral nutrition in pediatric cancer patients at a reference center in northeastern Brazil.

INTRODUCTION: Individualized nutritional support is important to pediatric cancer patients and should be integrated to the overall treatment of these patients. OBJECTIVE: Analyze the nutritional status of cancer patients submitted to enteral nutrition (EN) and assess the adequacy of this form of nutrition. METHODS: A case series study was carried out at the Pediatric Oncology Unit of the Institute of Integrative Medicine Professor Fernando Figueira (IMIP, Brazil, Recife-PE) between January and December 2009. Clinical and anthropometric data were obtained from medical charts and nutritional follow-up charts. Z scores for height for age, weight for age and body mass index for age indicators (H/A, W/A and BMI/A, respectively) were calculated using the AnthroPlus program. Caloric and protein requirements were calculated based on the recommendations of the Brazilian National Council of Oncologic Nutrition. RESULTS: At the beginning of EN, 32.4% of the sample had short stature and 23.9% were underweight based on the BMI/A indicator. The assessment of EN adequacy demonstrated that 49.3% reached the caloric requirements and 76.1% reached the protein requirements, with maximal intakes of 65.6 Kcal/Kg/day and 1.95 g of protein/kg/day. Malnourished patients had greater mean Z scores for W/A and BMI/A at the end of EN, whereas no significant changes were found among patients with adequate nutritional status and significant reductions in these indicators were found among those with overweight or obesity. CONCLUSION: The patients either maintained or achieved a significant improvement in nutritional status, which demonstrates the importance of nutritional support and follow up during hospitalization.

Body fat assessment by bioelectrical impedance and its correlation with anthropometric indicators.

INTRODUCTION: Since the excess of body fat is associated with higher morbid-mortality rates (mainly in adults), precise, reliable, cost-effective, and broadly applicable methods are necessary for its assessment in population-based studies and in clinical practice. OBJECTIVE: To evaluate the correlation between body fat estimated either by bioelectrical impedance or by the sum of skinfold thicknesses and anthropometric indicators of fat distribution. METHODS: A cross-sectional study was conducted enrolled 348 undergraduate students (median 21 years), from the Federal University of Pernambuco, Northeast Brazil. RESULTS: 262 of the subjects were women. Mean body fat assessed by bioelectrical impedance was 22.3 ± 6.2% in women and 15.2 ± 4.2% in men. Body fat obtained by the sum of skinfold thicknesses was similar to that assessed by bioelectrical impedance only in men. A strong correlation was observed between body fat assessed by bioelectrical impedance and that assessed by the sum of the skinfold thicknesses, waist circumference and waist-to-height ratio. Regarding the conicity index, there was a moderate correlation for men and a weak correlation for women. CONCLUSIONS: The sum of skinfold thicknesses surrogate of body fat percentage and can be used to assess body fat when BIA is not available in the field. Additional information about central fat distribution can be supply by measuring the waist circumference or waist-to-height ratio.

Nutritional screening in clinical patients at a University Hospital in Northeastern Brazil.

OBJECTIVES: According to the Brazilian Hospital Nutritional Assessment Inquiry, malnutrition in hospitals reaches 48.1% in Brazil, with this figure reaching as high as 63.9% in the northern and northeastern regions of the country. Despite its high prevalence, hospital malnutrition is not well identified by the majority of professionals on healthcare teams. The aim of the present study was to identify nutritional risk in patients hospitalized for clinical conditions. METHOD: This study was conducted at a university hospital in northeastern Brazil. Data were collected using the NRS 2002 screening tool (score ≥ 3 for nutritional risk) within 48 hours after admission to hospital. RESULTS: Ninety-nine patients (44.4% men and 55.6% women; 58.6% elderly individuals and 41.4%) were studied between April and October 2010. Nutritional risk was identified in 39.4% upon admission to hospital. Reduced food intake and body mass index were associated with nutritional risk. CONCLUSIONS: A high percentage of clinical patients were at nutritional risk, which corroborates findings described in the literature. Low food intake was associated with nutritional risk. These results underscore the importance of nutritional care upon admission to hospital, which can contribute to improving or maintaining nutritional status and the avoidance of complications throughout the hospitalization period.

Risk factors associated with hepatic steatosis: a study in patients in the Northeast Brazil.

INTRODUCTION: Although there are several studies in the international literature regarding hepatic steatosis, few large-scale studies of risk factors are available. OBJECTIVE: To verify potential risk factors associated with hepatic steatosis, such as: alcohol consumption, overweight, dyslipidemia, hypertension, and type 2 diabetes mellitus. METHODS: This is a case series study including a control group (without hepatic steatosis), carried out at the gastroenterology outpatient clinic in Northeast Brazil. The sample was composed of 219 patients with hepatic steatosis and 82 without the disease. RESULTS: There was an association between hepatic steatosis and socioeconomic status. Prevalence Ratio (PR) for family income ≤ 2 minimum wage was (PR = 1.35 CI 95%, 1.18-1.54) and education level < primary education (PR = 1.44, CI 95%,1.27-1.64). Regarding anthropometric and clinical characteristics and lipid profile, there was an association with overweight (PR = 1.59, CI 95%, 1.38-1.83), abdominal circumference in the range of very high risk (PR = 2.28, IC 95%,1.68-3.09), hypertension (PR = 1.30, CI 95%, 1.15-1.48) and type 2 diabetes mellitus (PR = 1.23, CI 95%, 1.07-1.64), low HDL-cholesterol (PR = 1,96, CI 95%, 1.55-2.48), hypertriglyceridemia (PR = 2.10, CI 95%, 1.64-2.68). In the regression model three variables remained independently associated to hepatic steatosis, abdominal circumference in the range of very high risk (PRadjusted = 1.74), low HDL-cholesterol (PRadjusted = 1.39) and overweight (PRadjusted = 1.28). CONCLUSION: The results showed an association of hepatic steatosis with some risk factors, being abdominal circumference (very high risk) the most strongly associated, followed by low HDL-cholesterol and overweight.