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1.
Int J Mol Sci ; 22(9)2021 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-34068525

RESUMO

Consuming a balanced, nutritious diet is important for maintaining health, especially as individuals age. Several studies suggest that consuming a diet rich in antioxidants and anti-inflammatory components such as those found in fruits, nuts, vegetables, and fish may reduce age-related cognitive decline and the risk of developing various neurodegenerative diseases. Numerous studies have been published over the last decade focusing on nutrition and how this impacts health. The main objective of the current article is to review the data linking the role of diet and nutrition with aging and age-related cognitive decline. Specifically, we discuss the roles of micronutrients and macronutrients and provide an overview of how the gut microbiota-gut-brain axis and nutrition impact brain function in general and cognitive processes in particular during aging. We propose that dietary interventions designed to optimize the levels of macro and micronutrients and maximize the functioning of the microbiota-gut-brain axis can be of therapeutic value for improving cognitive functioning, particularly during aging.


Assuntos
Antioxidantes/uso terapêutico , Encéfalo/metabolismo , Disfunção Cognitiva/dietoterapia , Envelhecimento Saudável/fisiologia , Encéfalo/efeitos dos fármacos , Disfunção Cognitiva/metabolismo , Disfunção Cognitiva/patologia , Frutas , Microbioma Gastrointestinal/efeitos dos fármacos , Envelhecimento Saudável/metabolismo , Humanos , Micronutrientes/uso terapêutico , Avaliação Nutricional , Estado Nutricional , Nozes , Verduras
2.
Clin Nutr ESPEN ; 43: 223-229, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34024518

RESUMO

BACKGROUND AND AIMS: Several factors that worsen the prognosis of the new coronavirus SARS-CoV-2 have been identified, such as obesity or diabetes. However, despite that nutrition may change in a lockdown situation, little is known about the influence of malnutrition among subjects hospitalized due to COVID-19. Our study aimed to assess whether the presence of malnutrition among patients admitted due to COVID-19 had any impact on clinical outcomes compared with patients with the same condition but well nourished. METHODS: 75 patients admitted to hospital due to COVID-19 were analyzed cross-sectionally. Subjective Global Assessment (SGA) was completed by phone interview. Clinical parameters included were extracted from the electronic medical record. RESULTS: According to the SGA, 27 admitted due to a COVID-19 infection had malnutrition. Patients not well nourished were older than patients with a SGA grade A (65 ± 14.1 vs 49 ± 15.1 years; p < 0.0001). Length of hospital stay among poorly nourished patients was significantly higher (18.4 ± 15.6 vs 8.5 ± 7.7 days; p = 0.001). Mortality rates and admission to ICU were greater among subjects with any degree of malnutrition compared with well-nourished patients (7.4% vs 0%; p = 0.05 and 44.4% vs 6.3%; p < 0.0001). CRP (120.9 ± 106.2 vs 60.8 ± 62.9 mg/l; p = 0.03), D-dimer (1516.9 ± 1466.9 vs 461.1 ± 353.7 ng/mL; p < 0.0001) and ferritin (847.8 ± 741.1 vs 617.8 ± 598.7mcg/l; p = 0.03) were higher in the group with malnutrition. Haemoglobin (11.6 ± 2.1 vs 13.6 ± 1.5 g/dl; p < 0.0001) and albumin 3.2 ± 0.7 vs 4.1 ± 0.5 g/dl; p < 0.0001) were lower in patients with any degree of malnutrition. CONCLUSIONS: The presence of a poor nutritional status is related to a longer stay in hospital, a greater admission in the ICU and a higher mortality.


Assuntos
COVID-19 , Mortalidade Hospitalar , Hospitalização , Unidades de Terapia Intensiva , Tempo de Internação , Desnutrição/complicações , Estado Nutricional , Adulto , Albuminas/metabolismo , Proteína C-Reativa/metabolismo , COVID-19/mortalidade , Controle de Doenças Transmissíveis/métodos , Estudos Transversais , Feminino , Ferritinas/sangue , Hemoglobinas/metabolismo , Humanos , Masculino , Desnutrição/mortalidade , Desnutrição/terapia , Pessoa de Meia-Idade , Avaliação Nutricional , Pandemias , Prognóstico , SARS-CoV-2 , Índice de Gravidade de Doença
3.
Clin Nutr ESPEN ; 43: 239-244, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34024521

RESUMO

BACKGROUND AND AIMS: The prevalence of malnutrition among adult Filipino patients with COVID 19 is 71.83%. Malnutrition has long been associated with poor outcomes among patients with pneumonia. This may be due to the increased risk of malnourished patients to develop impaired muscle and respiratory function. We aimed to determine the outcomes of adult COVID 19 patients admitted in a tertiary government hospital accordingly to nutrition status and risk. METHODS: Retrospective study on the adult COVID 19 patients admitted from July 15 to September 15, 2020 who were screened using the Philippine Society for Parenteral and Enteral Nutrition modified Subjective Global Assessment Grade tool. Chi-square or Fisher exact test, as well as Mann-Whitney U test or Kruskal-Wallis with post-hoc Dunn test, as appropriate were done. Survival analysis for mortality was done with right-censored data length of initial admission in days. Cox proportional hazard regression was done to determine the association of the main variables of interest with mortality with a 95% confidence interval. RESULTS: Malnourished patients were 30% less likely to be discharged [HR 0.70 95% CI (0.50, 0.97)]; malnutrition was also associated with length of hospital stay as those who were malnourished had longer lengths of hospital stay of about 4 days on the average [HR 3.55 95% CI (0.83, 6.27)]. High nutrition risk was significantly associated with length of hospital stay [HR 4.36 95% CI (0.89, 7.83)]. CONCLUSION: The only risk factor for mortality shown in this study is ICU transfer. Malnutrition, moderate nutrition risk, and high nutrition risk were risk factors of having longer lengths of hospital stays. While only malnutrition was the risk factor for being less likely to be discharged. We reiterate that nutrition assessment and support are important in mitigating the effects of COVID 19.


Assuntos
COVID-19/complicações , Mortalidade Hospitalar , Unidades de Terapia Intensiva , Tempo de Internação , Desnutrição/complicações , Estado Nutricional , Centros de Atenção Terciária , Adulto , Idoso , COVID-19/mortalidade , COVID-19/terapia , Feminino , Seguimentos , Governo , Hospitais Públicos , Humanos , Masculino , Desnutrição/mortalidade , Pessoa de Meia-Idade , Avaliação Nutricional , Pandemias , Alta do Paciente , Filipinas/epidemiologia , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2 , Índice de Gravidade de Doença
4.
Clin Nutr ESPEN ; 43: 369-376, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34024542

RESUMO

BACKGROUND AND AIMS: Patients with COVID-19 infection presents with a broad clinical spectrum of symptoms and complications. As a consequence nutritional requirements are not met, resulting in weight- and muscle loss, and malnutrition. The aim of the present study is to delineate nutritional complaints, the (course of the) nutritional status and risk of sarcopenia of COVID-19 patients, during hospitalisation and after discharge. METHODS: In this prospective observational study in 407 hospital admitted COVID-19 patients in four university and peripheral hospitals, data were collected during dietetic consultations. Presence of nutrition related complaints (decreased appetite, loss of smell, changed taste, loss of taste, chewing and swallowing problems, nausea, vomiting, feeling of being full, stool frequency and consistency, gastric retention, need for help with food intake due to weakness and shortness of breath and nutritional status (weight loss, BMI, risk of sarcopenia with SARC-F ≥4 points) before, during hospital stay and after discharge were, where possible, collected. RESULTS: Included patients were most men (69%), median age of 64.8 ± 12.4 years, 60% were admitted to ICU at any time point during hospitalisation with a median LOS of 15 days and an in-hospital mortality rate of 21%. The most commonly reported complaints were: decreased appetite (58%), feeling of being full (49%) and shortness of breath (43%). One in three patients experienced changed taste, loss of taste and/or loss of smell. Prior to hospital admission, 67% of the patients was overweight (BMI >25 kg/m2), 35% of the patients was characterised as malnourished, mainly caused by considerable weight loss. Serious acute weight loss (>5 kg) was showed in 22% of the patents during the hospital stay; most of these patients (85%) were admitted to the ICU at any point in time. A high risk of sarcopenia (SARC-F ≥ 4 points) was scored in 73% of the patients during hospital admission. CONCLUSION: In conclusion, one in five hospital admitted COVID-19 patients suffered from serious acute weight loss and 73% had a high risk of sarcopenia. Moreover, almost all patients had one or more nutritional complaints. Of these complaints, decreased appetite, feeling of being full, shortness of breath and changed taste and loss of taste were the most predominant nutrition related complaints. These symptoms have serious repercussions on nutritional status. Although nutritional complaints persisted a long time after discharge, only a small group of patients received dietetic treatment after hospital discharge in recovery phase. Clinicians should consider the risks of acute malnutrition and sarcopenia in COVID-19 patients and investigate multidisciplinary treatment including dietetics during hospital stay and after discharge.


Assuntos
COVID-19/complicações , Hospitalização , Desnutrição/complicações , Estado Nutricional , Sarcopenia/etiologia , Perda de Peso , Adulto , Idoso , Apetite , Feminino , Hospitais , Humanos , Tempo de Internação , Masculino , Desnutrição/epidemiologia , Pessoa de Meia-Idade , Avaliação Nutricional , Obesidade/complicações , Obesidade/epidemiologia , Pandemias , Alta do Paciente , Estudos Prospectivos , Fatores de Risco , SARS-CoV-2 , Olfato , Paladar
5.
Clin Nutr ESPEN ; 43: 377-382, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34024543

RESUMO

BACKGROUND AND AIM: We conducted the present study to investigate the nutritional status of critically ill COVID-19 patients and validate the GLIM criteria with respect to the SGA. METHODS: In this prospective cohort study, 109 ICU patients were assessed for malnutrition based on GLIM and SGA criteria. The relation between nutrition assessment tools and duration of hospitalization and mortality were also evaluated. The sensitivity and specificity of GLIM criteria concerning the detection of malnutrition was assessed based on the area under the curve. RESULTS: Malnutrition, according to the SGA and GLIM criteria, was found in 68 (62.4%) and 66 (61.5%) of our subjects. There was an optimal agreement between the GLIM criteria and the SGA criteria regarding malnutrition diagnosis (K = 0.85, P < 0.001). The area under curve for the GLIM was stratified based on the SGA results and was 0.927 (95% CI: 0.868-0.985) with a sensitivity and specificity of 92% and 93%, respectively. CONCLUSION: Malnutrition is frequently observed in critically ill COVID-19 patients. GLIM criteria is a valid tool and has a strong association with mortality and longer duration of ICU stay.


Assuntos
COVID-19 , Estado Terminal , Desnutrição/diagnóstico , Avaliação Nutricional , Estado Nutricional , Adulto , Idoso , Antropometria/métodos , Área Sob a Curva , Índice de Massa Corporal , COVID-19/complicações , Feminino , Saúde Global , Humanos , Liderança , Masculino , Desnutrição/complicações , Pessoa de Meia-Idade , Atrofia Muscular , Estudos Prospectivos , Reprodutibilidade dos Testes , SARS-CoV-2 , Sensibilidade e Especificidade , Perda de Peso
6.
Nutr J ; 20(1): 46, 2021 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-34034769

RESUMO

BACKGROUND: Could nutritional status serve as prognostic factors for coronavirus disease 2019 (COVID-19)? The present study evaluated the clinical and nutritional characteristics of COVID-19 patients and explored the relationship between risk for malnutrition at admission and in-hospital mortality. METHODS: A retrospective, observational study was conducted in two hospitals in Hubei, China. Confirmed cases of COVID-19 were typed as mild/moderate, severe, or critically ill. Clinical data and in-hospital death were collected. The risk for malnutrition was assessed using the geriatric nutritional risk index (GNRI), the prognostic nutritional index (PNI), and the Controlling Nutritional Status (CONUT) via objective parameters at admission. RESULTS: Two hundred ninety-five patients were enrolled, including 66 severe patients and 41 critically ill patients. Twenty-five deaths were observed, making 8.47% in the whole population and 37.88% in the critically ill subgroup. Patients had significant differences in nutrition-related parameters and inflammatory biomarkers among three types of disease severity. Patients with lower GNRI and PNI, as well as higher CONUT scores, had a higher risk of in-hospital mortality. The receiver operating characteristic curves demonstrated the good prognostic implication of GNRI and CONUT score. The multivariate logistic regression showed that baseline nutritional status, assessed by GNRI, PNI, or CONUT score, was a prognostic indicator for in-hospital mortality. CONCLUSIONS: Despite variant screening tools, poor nutritional status was associated with in-hospital death in patients infected with COVID-19. This study highlighted the importance of nutritional screening at admission and the new insight of nutritional monitoring or therapy.


Assuntos
COVID-19/epidemiologia , Mortalidade Hospitalar , Desnutrição/epidemiologia , Avaliação Nutricional , Estado Nutricional , SARS-CoV-2 , Adulto , Idoso , China/epidemiologia , Comorbidade , Estado Terminal/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X
7.
BMJ Open ; 11(5): e042067, 2021 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-33986039

RESUMO

INTRODUCTION: Pancreatic exocrine insufficiency (PEI) in patients with pancreatic malignancy is well documented in the literature and is known to negatively impact on overall survival and quality of life. A lack of consensus opinion remains on the optimal diagnostic test that can be adapted for use in a clinical setting for this cohort of patients. This study aims to better understand the prevalence of PEI and the most suitable diagnostic techniques in patients with advanced pancreatic malignancy. METHODS AND ANALYSIS: This prospective observational study will be carried out in patients with pancreatic malignancy (including adenocarcinoma and neuroendocrine neoplasms). Consecutive patients with inoperable pancreatic malignancy referred for consideration of first-line chemotherapy will be considered for eligibility. The study comprises three cohorts: demographic cohort (primary objective to prospectively investigate the prevalence of PEI in patients with inoperable pancreatic malignancy); sample size 50, diagnostic cohort (primary objective to design and evaluate an optimal diagnostic panel to detect PEI in patients with inoperable pancreatic malignancy); sample size 25 and follow-up cohort (primary objective to prospectively evaluate the proposed PEI diagnostic panel in a cohort of patients with inoperable pancreatic malignancy); sample size 50. The following is a summary of the protocol and methodology. ETHICS AND DISSEMINATION: Full ethical approval has been granted by the North West Greater Manchester East Research and Ethics Committee, reference: 17/NW/0597. This manuscript reflects the latest protocol V.8 approved 21 April 2020. Findings will be disseminated by presentation at national/international conferences, publication in peer-review journals and distribution via patient advocate groups. TRIAL REGISTRATION NUMBER: 194255, NCT0361643.


Assuntos
Insuficiência Pancreática Exócrina , Neoplasias Pancreáticas , Insuficiência Pancreática Exócrina/diagnóstico , Insuficiência Pancreática Exócrina/epidemiologia , Insuficiência Pancreática Exócrina/etiologia , Humanos , Avaliação Nutricional , Estudos Observacionais como Assunto , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/epidemiologia , Prevalência , Qualidade de Vida
8.
Clin Med (Lond) ; 21(3): e272-e274, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34001584

RESUMO

Good nutrition is an integral component of patient care. Not only does eating correctly provide substantial physical benefits, it also ensures psychological comfort throughout admission. Nevertheless, our formative years as medical students, and now as junior doctors, have shown us that patient nutrition is frequently neglected both in the clinical setting and in the subject matter of our education.Amid the coronavirus pandemic, this is especially problematic; older, frailer patients, with multiple comorbidities and higher rates of malnutrition, are faring much worse with the virus. Combined with the fact that 40% of patients admitted to hospital are malnourished to some degree, we are looking at a huge population of potential COVID-19 patients facing a further decline in nutritional status and higher mortality as a result of this, making attention to nutrition more important than ever.As junior doctors, we have a role in the nutritional assessment of and support for our patients by ensuring that all patients are suitably assessed using a scoring tool with the appropriate ensuing actions taken. We must also ensure that our knowledge regarding nutritional assessment and support is adequate and aim to supplement this via additional learning to meet the minimum requirements for our curriculum.


Assuntos
COVID-19 , Desnutrição , Humanos , Desnutrição/epidemiologia , Corpo Clínico Hospitalar , Avaliação Nutricional , Estado Nutricional , SARS-CoV-2
9.
F1000Res ; 10: 173, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33968365

RESUMO

Background: Nutritional screening, intervention and assessment in patients with undernutrition are key components of any nutritional care. The goal of any nutritional assessment is to determine the specific nutritional risk(s). Presently, there are no guidelines on any ideal screening tool to be used on admission for identification of children that are at risk of developing malnutrition during their hospital stay. The objective of the study was to develop a valid and simple nutritional screening tool which can be used on hospital admission to identify pediatric patients at risk of malnutrition . Methods: This study was cross sectional analytical that enrolled children (n:161) admitted with acute illness to the general wards at Cairo University Children Hospitals (CUCH). The answers to the developed questionnaire were compared to the Subjective Global Assessment (SGA), those with high accuracy (≥80%) were used for validity with anthropometric measures. Results: In the 'less than two years of age' group, the simple and valid nutritional screening tools were the following questions: (Is there a problem during breast-feeding?), (Is there scanty breast milk?), (Is there appetite loss?). The simple and valid nutritional screening tools during the 'early childhood' group were the following questions: (Is there appetite loss?), (Is there any skipping of meals?), (Are they watching TV, videotapes and/or playing computer games for more than two hours/day?). The simple and valid  nutritional screening tools during the 'late childhood' group were the following questions: (Is there appetite loss?), (Are they watching TV, videotapes and/or playing computer games for more than two hours/day?). Conclusion: The simple and valid nutritional screening tools differ according to age groups. The one which is valid in all ages is the question about the appetite loss.


Assuntos
Avaliação Nutricional , Estado Nutricional , Doença Aguda , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Sensibilidade e Especificidade
10.
Aging Clin Exp Res ; 33(6): 1507-1517, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33991331

RESUMO

BACKGROUND: The capacity of malnutrition screening to predict the onset of sarcopenia is unknown. AIM: Our first objective is to explore the association between the screening of malnutrition and the incidence of sarcopenia and then, to assess the added value of the diagnosis of malnutrition to predict sarcopenia over a 5-year follow-up. METHODS: Malnutrition was screened at baseline according to the MNA short-form (MNA-SF) and long-form (MNA-LF) and was diagnosed by the GLIM definition. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. Kaplan-Meier analysis and adjusted Cox regression were performed to explore the association between nutritional status and the incidence of sarcopenia. RESULTS: A total of 418 participants were analyzed (median age 71.7 years (67.7 - 76.8), 60% women) for our first objective. Among them, 64 (15.3%) became sarcopenic during the follow-up period. In the adjusted model, the incidence of sarcopenia was nonsignificantly associated with the risk of malnutrition for both forms of the MNA (MNA-SF: HR of 1.68 (95% CI 0.95 - 2.99); MNA-LF: HR of 1.67 (95% CI 0.86 - 3.26)). However, among the 337 participants for which a GLIM assessment was possible and in which 46 participants became sarcopenic, malnourished subjects had a higher risk than well-nourished participants of developing sarcopenia after 5 years, with an adjusted HR of 3.19 (95% CI 1.56 - 6.50). CONCLUSION: A full diagnosis of malnutrition seems more useful than a simple malnutrition screening to predict the incidence of sarcopenia over 5 years.


Assuntos
Desnutrição , Sarcopenia , Idoso , Feminino , Avaliação Geriátrica , Humanos , Incidência , Liderança , Masculino , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Avaliação Nutricional , Estado Nutricional , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia
11.
Ann Palliat Med ; 10(5): 5322-5328, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33977754

RESUMO

BACKGROUND: Tuberculosis (TB) is an infectious disease with high incidence and morbidity, which threatens the health of people. This study aims to investigate the nutritional risk status of TB inpatients and its correlation with disease prognosis. METHODS: A total of 295 patients with TB hospitalized in Suining Central Hospital from January 1, 2018 to June 30, 2018 were assessed by nutritional risk screening 2002 system within 2 days of admission. According to their assessment score, patients were divided into two groups: the nutritional risk group and the non-nutritional risk group. The differences in age, gender, TB classification, comorbid diseases, body mass index, serum albumin, complications, and the length of hospital stay were analyzed between the two groups. RESULTS: In the study population, 64.41% of TB inpatients were assessed as being at nutritional risk. There were significant differences in age, combined diseases, body mass index, serum albumin, incidence of complications, and length of hospital stay between the nutritional risk group and the non-nutritional risk group (P<0.05). CONCLUSIONS: TB inpatients are often at nutritional risk, and the incidence of complications in patients with nutritional risk is high and the hospital stay prolongs. The nutritional status of TB inpatients is also related to the progression and prognosis of the disease.


Assuntos
Pacientes Internados , Tuberculose , Humanos , Tempo de Internação , Avaliação Nutricional , Estado Nutricional , Tuberculose/diagnóstico
12.
Zhonghua Xue Ye Xue Za Zhi ; 42(4): 332-337, 2021 Apr 14.
Artigo em Chinês | MEDLINE | ID: mdl-33979979

RESUMO

Objective: To explore the influence of prognostic nutritional index (PNI) and controlling nutritional status (CONUT) on the prognosis of patients with multiple myeloma. Methods: Data of 157 patients with multiple myeloma (MM) at the affiliated hospital of Xuzhou medical university from January 2014 to December 2018 were retrospectively evaluated. The operating characteristic (ROC) curve analysis was adopted as the optimal cut-off point. PNI and CONUT were grouped based on the cut-off points of 44.45 and 3.5, respectively, and the differences between age, gender, serum calcium, ß(2)-microglobulin, serum creatinine, lactate dehydrogenase, and hemoglobin were analyzed. The prognostic factors were analyzed via univariate and Cox multivariate regression analyses. Results: The level of PNI and CONUT is the influencing factor of OS time. The univariate analysis revealed that age, LDH, plasma cell ratio, ß(2)-microglobulin, ISS stage, PNI, and CONUT were the risk factors for the prognosis of patients with MM. The multivariate analysis revealed that age (HR=1.636, 95%CI 1.014-2.640) , plasma cell ratio (HR=1.953, 95%CI 1.232-3.096) , and PNI (HR=0.513, 95%CI 0.287-0.917) were the independent prognostic risk factors of patients with MM. Conclusion: Low PNI in patients with MM indicates a poor prognosis, which is an independent prognosis risk factor.


Assuntos
Mieloma Múltiplo , Avaliação Nutricional , Humanos , Mieloma Múltiplo/diagnóstico , Estado Nutricional , Prognóstico , Estudos Retrospectivos
13.
J Int Med Res ; 49(5): 3000605211010051, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33951980

RESUMO

BACKGROUND: We examined the association of the Geriatric Nutritional Risk Index (GNRI) with the incidence of hypertension. METHODS: We used data of the China Health and Nutrition Survey in this study. Participants aged ≥60 years were eligible. The GNRI was defined as follows: GNRI = [1.489 × albumin (ALB; g/L)] + [41.7 × (actual weight/ideal weight)]. Participants with systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or use of antihypertensive medication were defined as having hypertension. RESULTS: This study included 4853 participants, comprising 3612 control participants and 1241 participants with hypertension. The GNRI, ALB, and body mass index (BMI) were significantly associated with higher incidence of hypertension (HR: 1.030, 1.026, and 1.088; 95% CI: 1.020-1.041, 1.008-1.044, and 1.069-1.107, respectively). The GNRI, ALB, and BMI were associated with an earlier age of hypertension onset (ß = -0.403, -0.613, and -0.321; 95% CI: -0.493 to -0.314, -0.767 to -0.459, and -0.484 to -0.159, respectively). CONCLUSIONS: A higher GNRI was associated with increased incidence of hypertension. An elevated GNRI was associated with earlier age of hypertension onset.


Assuntos
Hipertensão , Avaliação Nutricional , Idoso , China/epidemiologia , Estudos de Coortes , Avaliação Geriátrica , Humanos , Hipertensão/epidemiologia , Medição de Risco , Fatores de Risco
14.
Hu Li Za Zhi ; 68(3): 7-14, 2021 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-34013500

RESUMO

The gastrointestinal dysfunction and nutrient malabsorption associated with gastrointestinal tumors and related treatments may result in malnutrition in gastrointestinal (GI) cancer patients. Malnutrition has been associated with decreased treatment tolerance, poor quality of life, and increased mortality in this patient population. In this article, the relevant literature is reviewed and the factors, assessment tools, and management strategies related to malnutrition are summarized. In clinical care, healthcare providers should conduct early assessments of nutritional status and provide individualization nutritional counselling to promote treatment that effectively prolongs patient survival. This article may be used by nurses as a reference in caring for GI cancer patients.


Assuntos
Neoplasias Gastrointestinais , Desnutrição , Neoplasias Gastrointestinais/terapia , Humanos , Desnutrição/diagnóstico , Desnutrição/etiologia , Desnutrição/terapia , Avaliação Nutricional , Estado Nutricional , Qualidade de Vida
15.
Nutrients ; 13(4)2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33808209

RESUMO

This study aimed to evaluate the relative validity of intake of energy, nutrients and food groups assessed with MijnEetmeter food diary as compared to 24-h dietary recalls, and if this differed between experienced and new users. One hundred men and women aged 18-70 y participated, of whom 47 had prior experience with the tool. Participants kept MijnEetmeter on three days. Trained dietitians called them three times for a 24-h dietary recall interview, once recalling food consumption on the same day as the food recording in MijnEetmeter. Systematic differences and correlations were assessed, and Bland-Altman plots were created; both for 3-day mean intakes and for intakes on the same day. Relative to 24-h dietary recalls, MijnEetmeter underestimated consumption of drinks, added fat, cereal products, and potatoes. Relative underestimation was observed for energy intake (6%) and about half of the nutrients. Experienced MijnEetmeter users underestimated intake the least. For intake of energy and six key nutrients, correlations between 3-day mean intakes were above 0.7 except for sodium intake. In conclusion, MijnEetmeter moderately underestimates intakes of energy and some nutrients and food groups. To improve the self-monitoring of dietary intake, it is recommended that the users record food consumption for several days and that the apps probes for easily forgotten foods and drinks.


Assuntos
Registros de Dieta , Dieta/normas , Alimentos/classificação , Aplicativos Móveis , Adulto , Idoso , Ingestão de Alimentos , Ingestão de Energia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Valor Nutritivo , Reprodutibilidade dos Testes , Adulto Jovem
16.
Artigo em Inglês | MEDLINE | ID: mdl-33808072

RESUMO

The aim of this study was to test validity and reliability of the adapted version of the Nutrition Literacy Assessment Instrument (NLit) for Italian people (NLit-IT). An observational cross-sectional study was conducted, involving a convenience sample of adults (n = 74). To explore the validity of the tool, we considered both diet quality as an outcome of NL, and health literacy (HL) as a construct that presents similarities and differences with NL. Diet quality was measured by adherence to the Mediterranean Diet (Med diet) through the validated Mediterranean Diet Literature-based adherence score (MEDI-Lite). The relationship between NL level and adherence to Med diet was assessed by linear regression analysis and computing correlations between NLit-IT and MEDI-Lite scores (Spearman's Rho). Additionally, we evaluated the correlation between NLit-IT score and the level of HL (Spearman's Rho). Internal consistency and reliability were measured by Cronbach's alpha and intraclass correlation coefficient (ICC) respectively. Internal consistency (ρT = 0.78; 95% CI, 0.69-0.84) and reliability (ICC = 0.68, 95% CI, 0.46-0.85) were confirmed. In addition, NLit-IT total score was correlated with MEDI-Lite score (Rho = 0.25; p-value = 0.031) and multivariate regression analysis confirmed that NL significantly contributed to MEDI-Lite score (R2 = 0.13; ß = 0.13; p-value = 0.008). There was no significant association between the level of HL and NL. In conclusion, NLit-IT showed validity and reliability as a measure of NL for Italian people.


Assuntos
Letramento em Saúde , Avaliação Nutricional , Adulto , Estudos Transversais , Humanos , Itália , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
17.
BMC Cancer ; 21(1): 435, 2021 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-33879101

RESUMO

BACKGROUND: Local recurrence is common after curative resections for rectal cancer. Surgical intervention is among the best treatment choices. However, achieving a negative resection margin often requires extensive pelvic organ resections; thus, the postoperative complication rate is quite high. Recent studies have reported that the inflammatory index could predict postoperative complications. This study aimed to validate the correlation between clinical factors, including inflammatory markers, and severe complications after surgery for local recurrent rectal cancer. METHODS: This retrospective study included 99 patients that underwent radical resections for local recurrences of rectal cancer. Postoperative complications were graded according to the Clavien-Dindo classification. Grades ≥3 were defined as severe complications. Risk factors for severe complications were identified with univariate and multivariate logistic regression models and assessed with receiver-operating characteristic curves. RESULTS: Severe postoperative complications occurred in 38 patients (38.4%). Analyses of correlations between inflammatory markers and severe postoperative complications revealed that the strongest correlation was found between the prognostic nutrition index and severe postoperative complications. The receiver-operating characteristic analysis showed that the optimal prognostic nutrition index cut-off value was 42.2 (sensitivity: 0.790, specificity: 0.508). In univariate and multivariate analyses, a prognostic nutrition index ≤44.2 (Odds ratio: 3.007, 95%CI:1.171-8.255, p = 0.02) and a blood loss ≥2850 mL (Odds ratio: 2.545, 95%CI: 1.044-6.367, p = 0.04) were associated with a significantly higher incidence of severe postoperative complications. CONCLUSIONS: We found that a low preoperative prognostic nutrition index and excessive intraoperative blood loss were risk factors for severe complications after surgery for local recurrent rectal cancer.


Assuntos
Estado Nutricional , Complicações Pós-Operatórias/etiologia , Neoplasias Retais/complicações , Neoplasias Retais/diagnóstico , Idoso , Biomarcadores , Terapia Combinada , Feminino , Humanos , Mediadores da Inflamação , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Avaliação Nutricional , Razão de Chances , Complicações Pós-Operatórias/diagnóstico , Período Pré-Operatório , Prognóstico , Curva ROC , Neoplasias Retais/metabolismo , Neoplasias Retais/cirurgia , Estudos Retrospectivos , Fatores de Risco , Sensibilidade e Especificidade , Índice de Gravidade de Doença
18.
Int J Mol Sci ; 22(8)2021 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-33921697

RESUMO

Heart rate variability (HRV) represents the activity and balance of the autonomic nervous system and its capability to react to internal and external stimuli. As a measure of general body homeostasis, HRV is linked to lifestyle factors and it is associated with morbidity and mortality. It is easily accessible by heart rate monitoring and gains interest in the era of smart watches and self-monitoring. In this review, we summarize effects of weight loss, training, and nutrition on HRV with a special focus on obesity. Besides weight reduction, effects of physical activity and dietary intervention can be monitored by parameters of HRV, including its time and frequency domain components. In the future, monitoring of HRV should be included in any weight reduction program as it provides an additional tool to analyze the effect of body weight on general health and homeostasis. HRV parameters could, for example, be monitored easily by implementation of an electrocardiogram (ECG) every two to four weeks during weight reduction period. Indices presumibly showing beneficial changes could be a reduction in heart rate and the number of premature ventricular complexes as well as an increase in standard deviation of normal-to-normal beat intervals (SDNN), just to name some.


Assuntos
Frequência Cardíaca/fisiologia , Obesidade/fisiopatologia , Perda de Peso/fisiologia , Animais , Eletrocardiografia , Feminino , Humanos , Masculino , Avaliação Nutricional , Obesidade/metabolismo
19.
J Rehabil Med ; 53(5): jrm00193, 2021 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-33871035

RESUMO

The number of patients surviving severe brain injury is increasing; however, many are left in a prolonged disorder of consciousness. With appropriate treatment, patients with prolonged disorders of consciousness can survive for years. Unless an advance directive exists, the treating clinicians can authorize withdrawal of clinically assisted nutrition and hydration for these patients, based on best interests. The classic terminology used in prolonged disorders of consciousness ranges from coma, vegetative state to minimally conscious state. However, a new group of patients with covert cognition has been identified in the last decade, making it necessary to revise the current taxonomy to better reflect our understanding of these conditions. With the introduction of a less ambiguous terminology, the challenges when it comes to withdrawal of clinically assisted nutrition and hydration of these patients may ease. A decision-making pathway for withdrawal of clinically assisted nutrition and hydration for patients with prolonged disorders of consciousness, based on a new taxonomy is proposed. These decisions should be based primarily on best interests. The adoption of a new classification for impairments of consciousness would clarify and improve how we think about these patients. Moreover, the development of accurate prognostic predictors would be a major step in the decision-making process, as it would influence the beneficent pathway towards the best clinical outcome.


Assuntos
Classificação/métodos , Transtornos da Consciência/terapia , Tomada de Decisões/fisiologia , Avaliação Nutricional , Feminino , Humanos , Masculino
20.
Nutrients ; 13(4)2021 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-33801694

RESUMO

Identifying factors that affect mortality requires a robust statistical approach. This study's objective is to assess an optimal set of variables that are independently associated with the mortality risk of 433 older comorbid adults that have been discharged from the geriatric ward. We used both the stepwise backward variable selection and the iterative Bayesian model averaging (BMA) approaches to the Cox proportional hazards models. Potential predictors of the mortality rate were based on a broad range of clinical data; functional and laboratory tests, including geriatric nutritional risk index (GNRI); lymphocyte count; vitamin D, and the age-weighted Charlson comorbidity index. The results of the multivariable analysis identified seven explanatory variables that are independently associated with the length of survival. The mortality rate was higher in males than in females; it increased with the comorbidity level and C-reactive proteins plasma level but was negatively affected by a person's mobility, GNRI and lymphocyte count, as well as the vitamin D plasma level.


Assuntos
Avaliação Geriátrica/métodos , Mortalidade , Avaliação Nutricional , Estado Nutricional , Idoso , Idoso de 80 Anos ou mais , Teorema de Bayes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Modelos de Riscos Proporcionais , Fatores de Risco , Fatores Sociais
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