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2.
Klin Padiatr ; 232(1): 20-28, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31569262

RESUMO

OBJECTIVE: The prevalence and follow-up of the clinical real-world data focussing on existing or risk of malnutrition in a tertiary hospital general paediatric ward including 4 months of follow-up was assessed. METHODS: Measurements included anthropometric measurements, a nutrition interview and an extended version of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP). R Studio 3.4.2 was used for statistical analysis and diagnosing malnutrition by calculating height-for-age (HfAz)-, weight-for-age (WfAz)- weight-for-height (WfHz)-, body mass index-for-age (BMIz) and mid-upper-arm circumference (MUACz)-z-scores with the childsds package with KIGGS and WHO for reference. RESULTS: The median age of the 68 participants was 8.00 (4.00-13.00) years. The main reasons for hospitalisation in the tertiary centre were gastrointestinal diseases, diabetes mellitus and rheumatic diseases. At admission 39.71%, at the second examination 36.00% and at the third examination 45.90% were malnourished. 68% of inpatients lost weight during their clinical stay, of which 35.29% lost more than 3% of their initial weight. However, changes were not significantly different. CONCLUSION: A significant share of patients was diagnosed to be malnourished at admission, the majority of patients lost weight during their hospital stay and the 4 months after admission. Due to the far reaching consequences for patients, doctors, health insurance and politics, the early diagnosis and treatment of malnutrition should take greater account in the future.


Assuntos
Desnutrição/diagnóstico , Programas de Rastreamento/métodos , Hipernutrição/diagnóstico , Pediatria , Adolescente , Índice de Massa Corporal , Peso Corporal , Criança , Seguimentos , Humanos , Desnutrição/epidemiologia , Hipernutrição/epidemiologia , Prevalência
3.
Lancet ; 395(10217): 65-74, 2020 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-31852602

RESUMO

The double burden of malnutrition (DBM), defined as the simultaneous manifestation of both undernutrition and overweight and obesity, affects most low-income and middle-income countries (LMICs). This Series paper describes the dynamics of the DBM in LMICs and how it differs by socioeconomic level. This Series paper shows that the DBM has increased in the poorest LMICs, mainly due to overweight and obesity increases. Indonesia is the largest country with a severe DBM, but many other Asian and sub-Saharan African countries also face this problem. We also discuss that overweight increases are mainly due to very rapid changes in the food system, particularly the availability of cheap ultra-processed food and beverages in LMICs, and major reductions in physical activity at work, transportation, home, and even leisure due to introductions of activity-saving technologies. Understanding that the lowest income LMICs face severe levels of the DBM and that the major direct cause is rapid increases in overweight allows identifying selected crucial drivers and possible options for addressing the DBM at all levels.


Assuntos
Desnutrição/epidemiologia , Obesidade/epidemiologia , Sobrepeso/epidemiologia , África ao Sul do Saara/epidemiologia , Qualidade dos Alimentos , Humanos , Indonésia/epidemiologia , Desnutrição/etiologia , Estado Nutricional , Valor Nutritivo , Obesidade/etiologia , Sobrepeso/etiologia , Pobreza , Prevalência , Fatores Socioeconômicos
4.
Lancet ; 395(10217): 75-88, 2020 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-31852605

RESUMO

Malnutrition has historically been researched and addressed within two distinct silos, focusing either on undernutrition, food insecurity, and micronutrient deficiencies, or on overweight, obesity, and dietary excess. However, through rapid global nutrition transition, an increasing proportion of individuals are exposed to different forms of malnutrition during the life course and have the double burden of malnutrition (DBM) directly. Long-lasting effects of malnutrition in early life can be attributed to interconnected biological pathways, involving imbalance of the gut microbiome, inflammation, metabolic dysregulation, and impaired insulin signalling. Life-course exposure to early undernutrition followed by later overweight increases the risk of non-communicable disease, by imposing a high metabolic load on a depleted capacity for homoeostasis, and in women increases the risk of childbirth complications. These life-course trajectories are shaped both by societal driving factors-ie, rapidly changing diets, norms of eating, and physical activity patterns-and by broader ecological factors such as pathogen burden and extrinsic mortality risk. Mitigation of the DBM will require major societal shifts regarding nutrition and public health, to implement comprehensive change that is sustained over decades, and scaled up into the entire global food system.


Assuntos
Desnutrição/metabolismo , Obesidade/metabolismo , Sobrepeso/metabolismo , África ao Sul do Saara/epidemiologia , Idade de Início , Exercício , Feminino , Microbioma Gastrointestinal , Humanos , Indonésia/epidemiologia , Masculino , Desnutrição/epidemiologia , Desnutrição/microbiologia , Redes e Vias Metabólicas , Estado Nutricional , Obesidade/epidemiologia , Obesidade/microbiologia , Sobrepeso/epidemiologia , Sobrepeso/microbiologia , Prevalência
5.
Rev Fac Cien Med Univ Nac Cordoba ; 76(4): 233-237, 2019 12 03.
Artigo em Espanhol | MEDLINE | ID: mdl-31833747

RESUMO

Background: Malnutrition at admission of paediatric hospitalization is a risk factor for negative evolution and is associated with increased morbidity and mortality. The main objective was to learn about the frequency of malnutrition and undernourishment as well as the nutritional risk at hospital admission, through a sample of paediatric patients. Material and Methods: A descriptive cross-sectional was taken, chosen from long term patients in Hospital Dr. Humberto Notti. A nutritional screening (Strong Kids) was applied, assessing nutritional risk within 48 hours. of hospital admission and nutritional diagnosis was obtained with the corresponding anthropometric data. For the statistical analysis, Fisher Test and Student test were used. Results: 134 patients were admitted (59% women), 4 years of age, (1 to 9 years) (medium sized and IQR), and hospitalization lasted 4 days (3 to 7 days). At the ingress, 17% presented acute malnutrition, and 60% presented moderate nutritional risk. Those who suffered from high nutritional risk, went through more frequent pain, change of weight, less eating, diarrhea, and signs of undernourishment, than those who suffered from moderated nutritional risk. (Fisher < 0, 0001). Conclusion: Malnutrition or undernourishment at hospital admission affects about the 20% of patients and more than half presents moderated nutritional risk. These two observations justify the systematic carrying out of an evaluation of the nutritional status


Assuntos
Hospitalização/estatística & dados numéricos , Desnutrição/diagnóstico , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Tempo de Internação , Masculino , Desnutrição/epidemiologia , Avaliação Nutricional , Projetos Piloto , Fatores de Risco
7.
Afr Health Sci ; 19(2): 1897-1909, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31656473

RESUMO

Background: One of the public health problems in developing countries is child malnutrition. An important factor for children's well-being is good nutrition. Therefore, the malnutrition status of children under the age of five is an important outcome measure for children's health. This study uses the proportional odds model to identify risk factors associated with child malnutrition in Ethiopia using the 2016 Ethiopian Demographic and Health Survey data. Methods: This study uses the 2016 Ethiopian Demographic and Health Survey results. Based on weight-for-height anthropometric index (Z-score) child nutrition status is categorized into four levels namely- underweight, normal, overweight and obese. Since this leads to an ordinal variable for nutrition status, an ordinal logistic regression (OLR)proportional odds model (POM) is an obvious choice for analysis. Results: The findings and comparison of results using the cumulative logit model with and without complex survey design are presented. The study results revealed that to produce the appropriate estimates and standard errors for data that were obtained from complex survey design, model fitting based on taking the survey sampling design into account is better. It has also been found that for children under the age of five, weight of a child at birth, mother's age, mother's Body Mass Index (BMI), marital status of mother and region (Affar, Dire Dawa, Gambela, Harari and Somali) were influential variables significantly associated with underfive children's nutritional status in Ethiopia. Conclusion: This child's age of a child, sex, weight of child at birth, mother's BMI and region of residence were significant determinants of malnutrition of children under five years in Ethiopia. The effect of these determinants can be used to develop strategies for reducing child malnutrition in Ethiopia. Moreover, these findings show that OLR proportional odds model is appropriate assessing thedeterminants of malnutrition for ordinal nutritional status of underfive children in Ethiopia.


Assuntos
Transtornos da Nutrição Infantil/epidemiologia , Desnutrição/epidemiologia , Estado Nutricional , Antropometria , Índice de Massa Corporal , Peso Corporal , Criança , Transtornos da Nutrição Infantil/diagnóstico , Pré-Escolar , Etiópia/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Desnutrição/etiologia , Obesidade/epidemiologia , Prevalência , Características de Residência , Fatores Socioeconômicos , Magreza/epidemiologia
8.
Arq Gastroenterol ; 56(4): 447-450, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31618398

RESUMO

BACKGROUND: Malnutrition is associated with clinical factors, including longer hospital stay, increased morbidity and mortality and hospital costs. OBJECTIVE: To investigate the prevalence of malnutrition using different nutritional indicators and to identify factors that contribute to malnutrition in hospitalized patients. METHODS: We investigated anthropometric, laboratory standards, nutritional risk screening (NRS), subjective global assessment (SGA), mini nutritional assessment and habitual energy consumption (HEC). Chi-square, Fisher's exact test, Mann-Whitney test and univariate and multiple Cox regression analysis were used, at 5% significance level. RESULTS: It was found 21.01% of malnourished individuals by ASG; a total of 34.78% with nutritional risk according to NRS and 11.59% with low weight (BMI). There was no statistically significant difference in the prevalence of malnutrition by ASG (P=0.3344) and nutritional risk by NRS (P=0.2286), among the types of disorders. Patients with nutritional risk were of higher median age (64.5 vs 58.0 years; P=0.0246) and had lower median values of HEC (1362.1 kcal vs 1525 kcal, P=0.0030), of calf circumference (32.0 cm vs 33.5 cm, P=0.0405) of lymphocyte count (1176.5 cell/mm3 vs 1760.5 cell/ mm3, P=0.0095); and higher percentage of low body weight according to the BMI (22.9% vs 5.6%; P=0.0096). Lymphocyte count was associated with nutritional risk (P=0.0414; HR= 1.000; IC95%= 0.999; 1.000). CONCLUSION: NRS was more sensitive than other indicators in the diagnosis of malnutrition. Patients at risk were older and had lower HEC values, calf circumference, BMI and lymphocyte count. Low lymphocyte count was considered a factor associated with nutritional risk by the NRS.


Assuntos
Hospitalização , Desnutrição/diagnóstico , Estudos Transversais , Humanos , Desnutrição/epidemiologia , Prevalência , Fatores de Risco , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-31505822

RESUMO

This study examined whether maternal nutritional intake and breast milk macronutrient content influence the weight of breastfed infants. We investigated 129 healthy mothers with singleton babies born from July 2016 to December 2017 in a university hospital in Tokyo, Japan. Information was obtained by a self-administered food frequency questionnaire at 1 (valid response n = 92; mean age, 34 years) and 3 (n = 57) months after delivery. Breast milk was sampled at 1 and 3 months and the macronutrient contents were analyzed. The average pre-pregnancy body mass index and weight gain during pregnancy were 20.7 ± 2.6 kg/m2 and 9.6 ± 3.7 kg, respectively. At 1 month, average maternal calorie intake was 1993 ± 417 kcal/day, which was lower than the intake recommended by Japanese Dietary Reference Intakes for breastfeeding mothers. There were no significant differences with regard to maternal calorie and protein intake, and breast milk macronutrient content between breastfed infants with weight above and below the 25th percentile of its distribution at both 1 and 3 months. This study suggests that suboptimal calorie intake by breastfeeding mothers and breast milk macronutrient content were not associated with weight of their infants at 1 and 3 months after delivery.


Assuntos
Peso Corporal , Aleitamento Materno , Recém-Nascido/fisiologia , Desnutrição/epidemiologia , Fenômenos Fisiológicos da Nutrição Materna , Leite Humano/química , Nutrientes/análise , Feminino , Humanos , Lactente , Recém-Nascido/crescimento & desenvolvimento , Desnutrição/etiologia , Prevalência , Fatores de Tempo , Tóquio/epidemiologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-31509998

RESUMO

The objective of this study was to determine the prevalence and socio-demographic predictors of malnutrition in two urbanized economically active provinces (Gauteng N = 733, Western Cape N = 593) in South Africa. A multistage stratified cluster random sampling design was applied. Fieldworkers visited homes, measured children aged 1-<10-years old (N = 1326) and administered a questionnaire (mother/primary caregiver). In under-five year old children (N = 674) 21.6% were stunted [height-for-age z-score < -2 SD], 5.6 % underweight [weight-for-age z-score < -2 SD], 10.3% overweight (body mass index-for-age z-score) (BAZ)> +2 SD ≤ +3 SD] and 7.0% obese (BAZ > +3 SD). In 5-<10-year olds (N = 626) 6.7% were stunted, 6.8% underweight, 13.4% overweight and 6.8% obese. Stunting and overweight in the same child was present in 5.7% under-five year olds and 1.7% in 5-<10-year olds. Multiple logistic regression analyses identified having a mother with a post-grade 12 qualification (OR = 0.34) and having an obese mother (OR 0.46) as protectors and being in the under-five age group (OR = 3.73) as a risk factor for stunting. Being in the under-five age group was also a risk factor for a BAZ > 1 (OR 2.39), while being in the third wealth quintile was protective (OR = 0.62). Results indicate that stunting and overweight/obesity are still present at concerning levels, especially in the under-five age group.


Assuntos
Transtornos do Crescimento/epidemiologia , Desnutrição/epidemiologia , Sobrepeso/epidemiologia , Magreza/epidemiologia , Criança , Pré-Escolar , Inquéritos sobre Dietas , Feminino , Humanos , Lactente , Masculino , Mães , Prevalência , Fatores de Risco , África do Sul/epidemiologia , Inquéritos e Questionários , Urbanização
11.
Pan Afr Med J ; 33: 119, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489097

RESUMO

Introduction: The prison population in low-income countries is a group vulnerable to undernutrition, particularly incarcerated women. The aim of the study is to assess the nutritional status of women in prison and to determine the social profile and prison conditions related to undernutrition. Methods: A cross-sectional study was conducted among 125 women prisoners in Antanimora prison located in the city of Antananarivo, Madagascar. All women detained for 3 months or more at the time of the survey were included in the study. Data collection was conducted in May and June 2013. A survey of women and anthropometric measurements were carried out to collect the data. Results: The proportion of undernourished female prisoners is 38.4%. Five percent of pregnant and lactating women and 44.3% of non-lactating and non-pregnant women are undernourished. The factors related to undernutrition of women prisoners are: taking two meals a day instead of three meals (p = 0.003), insufficient energy intake (p < 0.001), incarceration duration of more than 10 months (p < 0.001), absence of family visits (p = 0.013) and lack of financial assistance from family (p = 0.013). Conclusion: Improving the prisoners' diets and assistance from family both help to fight against prisoner undernutrition in prisons.


Assuntos
Ingestão de Energia/fisiologia , Desnutrição/epidemiologia , Estado Nutricional , Prisioneiros/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Dieta , Feminino , Humanos , Lactação/fisiologia , Madagáscar/epidemiologia , Pessoa de Meia-Idade , Gravidez , Complicações na Gravidez/epidemiologia , Adulto Jovem
12.
BMC Res Notes ; 12(1): 504, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412922

RESUMO

OBJECTIVE: The objective of the study was to assess the prevalence of stunting and associated factors among under-five children of Wukro town, Tigray, Ethiopia, 2017-2018. RESULT: Totally 394 under-five children were participated in this study with a response rate of 98.5%. A total of 222 (56.3%) of respondents were females and 106 (26.95%) were in the age group of 12-23 month. One hundred ninety-eight (50.3%) of the participants were between 2 and 3 in birth order and 194 (49.2%) had 4 to 5 house hold size. The overall prevalence of stunting was 194 (49.2%). Being female and presence of washing facilities nearby latrine were significantly associated with stunting. Under-five female children were 35.4% lower odds of stunting compared to male children (p = .041, OR = .644, and 95% CI (.422, .983)).


Assuntos
Aparelho Sanitário/estatística & dados numéricos , Transtornos do Crescimento/epidemiologia , Higiene das Mãos/estatística & dados numéricos , Desnutrição/epidemiologia , Fatores Socioeconômicos , Aparelho Sanitário/normas , Criança , Estudos Transversais , Etiópia/epidemiologia , Feminino , Higiene das Mãos/normas , Humanos , Lactente , Masculino , Prevalência , Fatores de Risco , Fatores Sexuais , Inquéritos e Questionários
13.
BMC Public Health ; 19(1): 1087, 2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31399048

RESUMO

BACKGROUND: In South Africa, the occurrence of the double burden of malnutrition is on the rise at a household level predisposing children and their mothers to negative health outcomes. However, few studies have been conducted at a household level. Therefore, we studied a double burden of malnutrition using child-mother pairs in a rural setting. METHODS: A cross-sectional quantitative survey was conducted among 508 child-mother pairs selected from primary schools using a multistage sampling in a rural Dikgale Health and Demographic Site in Limpopo Province, South Africa. Anthropometric measurements of children and mothers, and socio-demographic data were collected. WHO AnthroPlus was used to generate body-mass-index z-scores of children and the BMI was used to indicate overweight and obesity among the mothers. Mann Whitney test was used to compare the means of variables between sexes and age groups, while the prevalence of thinness and overweight/obesity were compared using a chi-square. Multivariate logistic regression with a stepwise backward elimination procedure, controlling for confounding, was used to determine the association between the thinness and overweight/obesity and the covariates. RESULTS: Twenty five percent (25%) of the children were thin, 4% were overweight and 1% obese, while mothers were overweight (27.4%) and 42.3% obesity (42.3%) were observed among the mothers. The odds of being thin were higher in boys than in girls (AOR = 1.53, 95%CI: 1.01-2.35). Overweight/obese mothers were more likely to have thin children (AOR = 1.48, 95% CI: 1.01-2.18) and less likely to have overweight/obese children (AOR = 0.18, 95%CI: 0.07-0.46). CONCLUSION: A double burden of malnutrition was observed on a household level with thinness among children and overweight/obesity among mothers. A need to address the dual problems of undernutrition and rapidly rising trends of overweight/obesity cannot be over-emphasized.


Assuntos
Desnutrição/epidemiologia , Vigilância da População , Saúde da População Rural/estatística & dados numéricos , Adulto , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Mães/estatística & dados numéricos , Instituições Acadêmicas , África do Sul/epidemiologia
14.
Nutrients ; 11(8)2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31394737

RESUMO

Short maternal stature is identified as a strong predictor of offspring undernutrition in low and middle-income countries. However, there is limited information to confirm an intergenerational link between maternal and under-five undernutrition in Bangladesh. Therefore, this study aimed to assess the association between short maternal stature and offspring stunting and wasting in Bangladesh. For analysis, this study pooled the data from four rounds of Bangladesh Demographic and Health Surveys (BDHS) 2004, 2007, 2011, and 2014 that included about 28,123 singleton children aged 0-59 months born to mothers aged 15-49 years. Data on sociodemographic factors, birth history, and anthropometry were analyzed using STATA 14.2 to perform a multivariable model using 'Modified Poisson Regression' with step-wise backward elimination procedures. In an adjusted model, every 1 cm increase in maternal height significantly reduced the risk of stunting (relative risks (RR) = 0.960; 95% confidence interval (CI): 0.957, 0.962) and wasting (RR = 0.986; 95% CI: 0.980, 0.992). The children of the short statured mothers (<145 cm) had about two times greater risk of stunting and three times the risk of severe stunting, 1.28 times the risk of wasting, and 1.43 times the risk of severe wasting (RR = 1.43; 95% CI: 1.11, 1.83) than the tall mothers (≥155 cm). These findings confirmed a robust intergenerational linkage between short maternal stature and offspring stunting and wasting in Bangladesh.


Assuntos
Estatura , Transtornos do Crescimento/epidemiologia , Mães , Síndrome de Emaciação/epidemiologia , Adolescente , Adulto , Bangladesh/epidemiologia , Estatura/genética , Estatura/fisiologia , Pré-Escolar , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Masculino , Desnutrição/epidemiologia , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
15.
Pan Afr Med J ; 33: 61, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31448023

RESUMO

Introduction: Mortality in patients with chronic renal failure is high compared to the general population. The objective of our study is to evaluate the predictive factors related to mortality in hemodialysis. Methods: This is a retrospective study involving 126 hemodialysis patients in the Nephrology Department of Ibn Rochd Hospital, Casablanca. Data were collected between January 2012 and January 2016. For each of our patients, we analyzed demographic, clinical, biological and anthropometric data. The Kaplan-Meier method and the log-rank test were used to evaluate and compare survival curves. To evaluate the effect of predictors of mortality, we used the proportional Cox hazard model. Results: The analysis of the results showed that the surviving patients were younger than the deceased patients (43.07±13.52 years versus 53.09±13.56 years, p=0.001). Also, the latter has a significantly lower albumin and prealbumin levels (p=0.01 and p=0.04 respectively). Overall survival was 80.2%. Cox regression analysis at age (HR=1.26, p<0.0002), inflammation (HR=1.15, p<0.03), AIP> 0.24 (HR=2.1, p<0.002) and cardiovascular disease (RR=2.91, p<0.001) were associated with global and cardiovascular mortality. Conclusion: Our study showed that the mortality rate is high in our cohort. In addition, cardiovascular diseases, under nutrition and inflammation are predictive factors for mortality. Treatment and early management of these factors are essential for reducing morbidity and mortality.


Assuntos
Doenças Cardiovasculares/mortalidade , Falência Renal Crônica/terapia , Diálise Renal/métodos , Adulto , Idoso , Doenças Cardiovasculares/epidemiologia , Estudos de Coortes , Feminino , Humanos , Inflamação/epidemiologia , Inflamação/mortalidade , Estimativa de Kaplan-Meier , Falência Renal Crônica/mortalidade , Masculino , Desnutrição/epidemiologia , Desnutrição/mortalidade , Pessoa de Meia-Idade , Marrocos , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco
16.
BMC Res Notes ; 12(1): 532, 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31429806

RESUMO

OBJECTIVES: The purpose of this study was to assess the prevalence and factors associated with stunting among under five children in Adama town, Central Ethiopia, 2013. A community based cross sectional study was conducted on 616 parent child pairs of under five children using structured questionnaire and anthropometric measurements. World health organization new growth reference was used to convert height measurements into Z-scores of the height for age indices considering age and sex of the children. Bivariate and multivariate logistic regression analysis were performed at P value < 0.05. RESULTS: This study revealed that 44.4% of under five children were stunted. The findings showed that a significant positive association between stunting and mother educational status (AOR = 3.69 95% CI 1.42, 9.58), number of under five children in the house hold (AOR = 2.8 95% CI 1.77, 4.42), decision making on the use of money only by husband (AOR = 4.43 95% CI 2.51, 7.80), age of complementary foods started (AOR = 7.52 95% CI 3.39, 16.68), presence of diarrhea in the last two week (AOR = 1.79 95% CI 1.13, 2.83). Therefore, this study recommends intervention strategies focusing on encouraging women education, family planning and education on child caring practice.


Assuntos
Desnutrição/epidemiologia , Saúde da Criança , Pré-Escolar , Doença Crônica , Estudos Transversais , Dieta , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Masculino , Prevalência
17.
Nutrients ; 11(8)2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31434232

RESUMO

We examined the nutritional status and its association with behavioral psychiatric symptoms of dementia (BPSD) among 741 memory clinic patients (normal cognition (NC), 152; mild cognitive impairment (MCI), 271; early-stage Alzheimer disease (AD), 318). Nutritional status and BPSD were assessed using the Mini Nutritional Assessment Short-Form (MNA-SF) and the Dementia Behavior Disturbance Scale (DBD), respectively. Compared to subjects with NC, more subjects with MCI and early-stage AD were at risk of malnutrition (MNA-SF, 8-11: NC, 34.2%; MCI, 47.5%; early-stage AD, 53.8%) and were malnourished (MNA-SF, 0-7: NC, 4.6%; MCI, 5.9%; early-stage AD, 8.2%). Among patients with MCI or early-stage AD, those at risk of/with malnutrition showed higher DBD scores than those well-nourished (12.7 ± 9.0 vs. 9.5 ± 7.3; p < 0.001). Moreover, analysis of covariance adjusting for confounders showed that nutritional status was significantly associated with specific BPSD, including "verbal aggressiveness/emotional disinhibition" (F = 5.87, p = 0.016) and "apathy/memory impairment" (F = 15.38, p < 0.001), which were revealed by factor analysis of DBD. Our results suggest that malnutrition is common among older adults with mild cognitive decline, and possibility that nutritional problems are associated with individual BPSD.


Assuntos
Doença de Alzheimer/psicologia , Comportamento , Disfunção Cognitiva/psicologia , Demência/psicologia , Desnutrição/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Desnutrição/complicações , Desnutrição/epidemiologia , Avaliação Nutricional , Estado Nutricional , Escalas de Graduação Psiquiátrica
18.
Artigo em Inglês | MEDLINE | ID: mdl-31438531

RESUMO

BACKGROUND: Overweight and obesity are increasing at an alarming rate in South Africa, while childhood undernutrition remains persistently high. This study determined the magnitude and predictors of stunting and underweight among schoolchildren in the Dikgale and Health Demographic Surveillance System Site, a rural site in South Africa. METHODS: A cross sectional study using multistage sampling was conducted among 508 schoolchildren and their mothers. Anthropometric measurements were taken from children and their mothers, while sociodemographic information was obtained from mothers using a questionnaire. The World Health Organization Anthro Plus was used to generate height-for-age and weight-for-age z-scores to indicate stunting and underweight, respectively, among the children. Maternal overweight and obesity were assessed using body mass index. Bivariate and multivariate logistic regression analyses were used to evaluate the predictors of stunting and underweight among schoolchildren. RESULTS: Twenty-two percent (22%) of children were stunted and 27% were underweight, while 27.4% of the mothers were overweight and 42.3% were obese. The odds of being stunted were lower in younger children, whereas having a mother who was overweight/obese and had a short stature increased the odds of stunting. Access to water, having a refrigerator, and having a young mother were protective against being underweight. Having a mother who was overweight/obese increased the odds of being underweight. CONCLUSIONS: The study showed a high prevalence of stunting and underweight among children, and overweight and obesity among mothers, indicating a household double burden of malnutrition. The age of the child and maternal overweight/obesity and short stature were predictors of stunting and underweight, while having a younger mother and access to water and a refrigerator were protective against being underweight. The need for an evidence-based and feasible nutrition program for schoolchildren, especially those in rural schools, cannot be over-emphasized.


Assuntos
Transtornos do Crescimento/epidemiologia , Desnutrição/epidemiologia , Adolescente , Adulto , Índice de Massa Corporal , Peso Corporal , Criança , Estudos Transversais , Características da Família , Feminino , Humanos , Masculino , Mães , Estado Nutricional , Prevalência , Fatores de Risco , Saúde da População Rural , População Rural/estatística & dados numéricos , Instituições Acadêmicas , África do Sul/epidemiologia , Inquéritos e Questionários
19.
BMC Public Health ; 19(1): 1045, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382936

RESUMO

BACKGROUND: Undernutrition is a serious health problem and highly prevalent in developing countries. There is no as such confirmatory test to measure undernutrition. The objective of the present study is to determine a new Composite Score using anthropometric measurements. Composite Score was then compared with other methods like body mass index (BMI) and mid-upper arm circumference (MUAC) classification, to test the significance of the method. METHODS: Anthropometric data were collected from 780 adult Oraon (Male = 387, Female = 393) labourers of Alipurduar district of West Bengal, India, following standard instruments, and protocols. Nutritional status of the study participants were assessed by conventional methods, BMI and MUAC. Confirmatory factor analysis was carried out to reduce 12 anthropometric variables into a single Composite Score (C) and classification of nutritional status was done on the basis of the score. Furthermore, all the methods (BMI, MUAC and C) were compared and discriminant function analysis was adopted to find out the percentage of correctly classified individuals by each of the three methods. RESULT: The frequency of undernutrition was 45.9% according to BMI category, 56.7% according to MUAC category and 51.8% according to newly computed Composite Score. Further analysis showed that Composite Score has a higher strength of correct classification (98.7%), compared to BMI (95.9%) and MUAC (96.2%). CONCLUSION: Therefore, anthropometric measurements can be used to identify nutritional status in the population more correctly by calculating Composite Score of the measurements and it is a non-invasive and relatively correct way of identification.


Assuntos
Antropometria/métodos , Desnutrição/diagnóstico , Avaliação Nutricional , Adulto , Braço/anatomia & histologia , Índice de Massa Corporal , Feminino , Humanos , Índia/epidemiologia , Masculino , Desnutrição/epidemiologia , Pessoa de Meia-Idade , Análise Multivariada , Reprodutibilidade dos Testes
20.
Ann Acad Med Singapore ; 48(6): 171-180, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31377761

RESUMO

INTRODUCTION: Frailty begins in middle life and manifests as a decline in functional fitness. We described a model for community frailty screening and factors associated with prefrailty and frailty and fitness measures to distinguish prefrail/frail from robust older adults. We also compared the Fatigue, Resistance, Ambulation, Illnesses and Loss of weight (FRAIL) scale against Fried frailty phenotype and Frailty Index (FI). MATERIALS AND METHODS: Community-dwelling adults ≥55 years old were designated robust, prefrail or frail using FRAIL. The multidomain geriatric screen included social profiling and cognitive, psychological and nutritional assessments. Physical fitness assessments included flexibility, grip strength, upper limb dexterity, lower body strength and power, tandem and dynamic balance and cardiorespiratory endurance. RESULTS: In 135 subjects, 99 (73.3%) were robust, 34 (25.2%) were prefrail and 2 (1.5%) were frail. After adjusting for age and sex, depression (odds ratio [OR], 2.90; 95% confidence interval [CI], 1.05-7.90; P = 0.040) and malnutrition (OR, 6.07; 95% CI, 2.52-14.64; P <0.001) were independently associated with prefrailty/frailty. Prefrail/frail participants had significantly poorer performance in upper limb dexterity (P = 0.030), lower limb power (P = 0.003), tandem and dynamic balance (P = 0.031) and endurance (P = 0.006). Except for balance and flexibility, all fitness measures differentiated prefrail/frail from robust women. In men, only lower body strength was significantly associated with frailty. Area under receiver operating characteristic curves for FRAIL against FI and Fried were 0.808 (0.688-0.927, P <0.001) and 0.645 (0.546-0.744, P = 0.005), respectively. CONCLUSION: Mood and nutrition are targets in frailty prevention. Physical fitness declines early in frailty and manifests differentially in both genders.


Assuntos
Depressão/epidemiologia , Fragilidade/diagnóstico , Desnutrição/epidemiologia , Força Muscular , Resistência Física , Aptidão Física , Atividades Cotidianas , Idoso , Teste de Esforço , Feminino , Fragilidade/epidemiologia , Avaliação Geriátrica , Força da Mão , Humanos , Vida Independente , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Razão de Chances , Características de Residência , Fatores de Risco , Fatores Sexuais , Singapura/epidemiologia , Classe Social , Teste de Caminhada
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