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2.
Nutr Rev ; 79(1): 114-116, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-32651592

RESUMO

The coronavirus 2019 disease (COVID-19) pandemic has led to food shortages, increased food prices, and loss of income. As a result, global food insecurity alerts have been issued. The pandemic threatens millions of children and adolescents and their families currently living with or at risk for development of food insecurity. The lack of consistent access to nutritious food sources is associated with chronic physical and mental health problems and death. Studies on food insecurity and eating pathology have heightened our concern about the impact the added effect of the pandemic may have on eating behaviors of children and adolescents. Here, we want to draw attention to the need for making food security and healthy eating attitudes and behaviors a global priority during the COVID-19 pandemic to guarantee the current and future health and well-being of our children and adolescents.


Assuntos
/economia , Dieta Saudável/economia , Prioridades em Saúde/economia , Desnutrição/prevenção & controle , Adolescente , Criança , Comportamento Alimentar , Feminino , Humanos , Fome , Renda , Masculino , Desnutrição/economia
3.
Medicine (Baltimore) ; 99(52): e23913, 2020 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-33350793

RESUMO

INTRODUCTION: Lung cancer is the leading cause of cancer-related death worldwide. Anorexia is the most common cause of malnutrition in lung cancer patients as well as an independent prognostic factor for cancer survival. This review will deal with the clinical evidence of herbal medicine use for reducing anorexia in lung cancer patients. METHODS AND ANALYSIS: Fourteen electronic databases will be searched from inception until October 2020. We will include randomized controlled trials (RCTs) assessing herbal medicines for anorexia in lung cancer patients. Interventions of any herbal medicines will be included. The methodological qualities of the included RCTs will be assessed via the Cochrane Collaboration tool for assessing the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) instrument will be used to evaluate the confidence in the cumulative evidence. ETHICS AND DISSEMINATION: This systematic literature review does not require an ethics review. This review will be published in a peer-reviewed journal and disseminated electronically and in print. The review will be updated to inform and guide healthcare practices. REGISTRATION NUMBER: reviewregistry1038.


Assuntos
Anorexia , Neoplasias Pulmonares/complicações , Desnutrição , Fitoterapia/métodos , Anorexia/etiologia , Anorexia/terapia , Humanos , Desnutrição/etiologia , Desnutrição/prevenção & controle , Medicina Tradicional/métodos , Metanálise como Assunto , Plantas Medicinais , Projetos de Pesquisa , Revisões Sistemáticas como Assunto
4.
Lancet Gastroenterol Hepatol ; 5(11): 1017-1026, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33065041

RESUMO

Patients with gastroparesis often have signs and symptoms including nausea, vomiting, epigastric discomfort, and early satiety, thus leading to inadequate food intake and a high risk of malnutrition. There is a considerable scarcity of data about nutritional strategies for gastroparesis, and current practices rely on extrapolated evidence. Some approaches include the modification of food composition, food consistency, and food volume in the context of delayed gastric emptying. If the patient is unable to consume adequate calories through a solid food diet, stepwise nutritional interventions could include the use of liquid meals, oral nutrition supplements, enteral nutrition, and parenteral nutrition. This Review discusses the role, rationale, and current evidence of diverse nutritional interventions in the management of gastroparesis.


Assuntos
Dietoterapia/métodos , Gastroparesia , Desnutrição , Apoio Nutricional/métodos , Gastroparesia/complicações , Gastroparesia/dietoterapia , Gastroparesia/fisiopatologia , Humanos , Desnutrição/etiologia , Desnutrição/prevenção & controle
6.
Nat Commun ; 11(1): 5203, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-33060603

RESUMO

Ending all forms of hunger by 2030, as set forward in the UN-Sustainable Development Goal 2 (UN-SDG2), is a daunting but essential task, given the limited timeline ahead and the negative global health and socio-economic impact of hunger. Malnutrition or hidden hunger due to micronutrient deficiencies affects about one third of the world population and severely jeopardizes economic development. Staple crop biofortification through gene stacking, using a rational combination of conventional breeding and metabolic engineering strategies, should enable a leap forward within the coming decade. A number of specific actions and policy interventions are proposed to reach this goal.


Assuntos
Biofortificação/métodos , Engenharia Metabólica/métodos , Cruzamento , Produtos Agrícolas/genética , Países em Desenvolvimento , Abastecimento de Alimentos , Alimentos Fortificados , Saúde Global , Humanos , Desnutrição/prevenção & controle , Micronutrientes , Minerais , Oryza , Plantas/genética , Plantas Geneticamente Modificadas , Formulação de Políticas , Provitaminas , Desenvolvimento Sustentável/economia , Desenvolvimento Sustentável/tendências , Nações Unidas , Vitaminas
7.
Br J Community Nurs ; 25(Sup8): S6-S10, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32936703

RESUMO

The impact of nutrition on recovery from various illnesses is well recognised. Malnutrition can affect duration of hospitalisation and impede recovery, and therefore it is important to monitor this condition, especially in at-risk groups, such as older adults and those with chronic disease. Underlying malnutrition impairs the immune system, potentially making people more vulnerable to infections such as COVID-19 and impacting recovery. Patients recovering from severe illness are likely to have muscle wasting or feel weak and may have increased protein needs. In addition individuals who have been discharged from hospital may need ongoing nutritional rehabilitation. This article explores the range of symptoms of COVID-19 that can interfere with dietary intake, such as respiratory issues, loss of taste and smell and fatigue and weakness. It goes on to describe how community nurses can identify risk of malnutrition and dietary issues when working remotely. Additionally, it signposts to a range of resources developed to assist patients and carers in accessing appropriate dietary advice.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Desnutrição/diagnóstico , Desnutrição/prevenção & controle , Pneumonia Viral/complicações , Enfermagem em Saúde Comunitária , Infecções por Coronavirus/terapia , Suplementos Nutricionais , Humanos , Desnutrição/etiologia , Papel do Profissional de Enfermagem , Estado Nutricional , Apoio Nutricional , Pandemias , Pneumonia Viral/terapia
8.
PLoS One ; 15(9): e0239036, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32946500

RESUMO

Malnutrition is a huge problem in Burundi. In order to improve the health system response, the Ministry of Health piloted the introduction of malnutrition prevention and care indicators within its performance-based financing (PBF) scheme. Paying for units of services and for qualitative indicators is expected to enhance provision and quality of these nutrition services. The objective of this study is to assess the impacts of this intervention, on both child acute malnutrition recovery rates at health centre level and prevalence of chronic and acute malnutrition among children at community level. This study follows a cluster-randomized controlled evaluation design: 90 health centres (HC) were randomly selected for the study, 45 of them were randomly assigned to the intervention and received payment related to their performance in malnutrition activities, while the other 45 constituted the control group and got a simple budget allocation. Data were collected from baseline and follow-up surveys of the 90 health centres and 6,480 households with children aged 6 to 23 months. From the respectively 1,067 and 1,402 moderate and severe acute malnutrition transcribed files and registers, findings suggest that the intervention had a positive impact on moderate acute malnutrition recovery rates (OR: 5.59, p = 0.039 -at the endline, 78% in the control group and 97% in the intervention group) but not on uncomplicated severe acute malnutrition recovery rate (OR: 1.16, p = 0.751 -at the endline, 93% in the control group and 92% in the intervention group). The intervention also had a significant increasing impact on the number of children treated for acute malnutrition. Analyses from the anthropometric data collected among 12,679 children aged 6-23 months suggest improvements at health centre level did not translate into better results at community level: prevalence of both acute and chronic malnutrition remained high, precisely at the endline, acute and chronic malnutrition prevalence were resp. 8.80% and 49.90% in the control group and 8.70% and 52.0% in the intervention group, the differences being non-significant. PBF can contribute to a better management of malnutrition at HC level; yet, to address the huge problem of child malnutrition in Burundi, additional strategies are urgently required.


Assuntos
Transtornos da Nutrição Infantil/prevenção & controle , Estado Nutricional/fisiologia , Reembolso de Incentivo/economia , Pesos e Medidas Corporais/métodos , Burundi/epidemiologia , Pré-Escolar , Características da Família , Feminino , Humanos , Lactente , Masculino , Desnutrição/prevenção & controle , Prevalência , Reembolso de Incentivo/tendências , Desnutrição Aguda Grave/prevenção & controle , Inquéritos e Questionários
9.
Cochrane Database Syst Rev ; 8: CD011504, 2020 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-32761615

RESUMO

BACKGROUND: After decades of decline since 2005, the global prevalence of undernourishment reverted and since 2015 has increased to levels seen in 2010 to 2011. The prevalence is highest in low- and middle-income countries (LMICs), especially Africa and Asia. Food insecurity and associated undernutrition detrimentally affect health and socioeconomic development in the short and long term, for individuals, including children, and societies. Physical and economic access to food is crucial to ensure food security. Community-level interventions could be important to increase access to food in LMICs. OBJECTIVES: To determine the effects of community-level interventions that aim to improve access to nutritious food in LMICs, for both the whole community and for disadvantaged or at-risk individuals or groups within a community, such as infants, children and women; elderly, poor or unemployed people; or minority groups. SEARCH METHODS: We searched for relevant studies in 16 electronic databases, including trial registries, from 1980 to September 2019, and updated the searches in six key databases in February 2020. We applied no language or publication status limits. SELECTION CRITERIA: We included randomised controlled trials (RCTs), cluster randomised controlled trials (cRCTs) and prospective controlled studies (PCS). All population groups, adults and children, living in communities in LMICs exposed to community-level interventions aiming to improve food access were eligible for inclusion. We excluded studies that only included participants with specific diseases or conditions (e.g. severely malnourished children). Eligible interventions were broadly categorised into those that improved buying power (e.g. create income-generation opportunities, cash transfer schemes); addressed food prices (e.g. vouchers and subsidies); addressed infrastructure and transport that affected physical access to food outlets; addressed the social environment and provided social support (e.g. social support from family, neighbours or government). DATA COLLECTION AND ANALYSIS: Two authors independently screened titles and abstracts, and full texts of potentially eligible records, against the inclusion criteria. Disagreements were resolved through discussion or arbitration by a third author, if necessary. For each included study, two authors independently extracted data and a third author arbitrated disagreements. However, the outcome data were extracted by one author and checked by a biostatistician. We assessed risk of bias for all studies using the Effective Practice and Organization of Care (EPOC) risk of bias tool for studies with a separate control group. We conducted meta-analyses if there was a minimum of two studies for interventions within the same category, reporting the same outcome measure and these were sufficiently homogeneous. Where we were able to meta-analyse, we used the random-effects model to incorporate any existing heterogeneity. Where we were unable to conduct meta-analyses, we synthesised using vote counting based on effect direction. MAIN RESULTS: We included 59 studies, including 214 to 169,485 participants, and 300 to 124, 644 households, mostly from Africa and Latin America, addressing the following six intervention types (three studies assessed two different types of interventions). Interventions that improved buying power: Unconditional cash transfers (UCTs) (16 cRCTs, two RCTs, three PCSs): we found high-certainty evidence that UCTs improve food security and make little or no difference to cognitive function and development and low-certainty evidence that UCTs may increase dietary diversity and may reduce stunting. The evidence was very uncertain about the effects of UCTs on the proportion of household expenditure on food, and on wasting. Regarding adverse outcomes, evidence from one trial indicates that UCTs reduce the proportion of infants who are overweight. Conditional cash transfers (CCTs) (nine cRCTs, five PCSs): we found high-certainty evidence that CCTs result in little to no difference in the proportion of household expenditure on food and that they slightly improve cognitive function in children; moderate-certainty evidence that CCTs probably slightly improve dietary diversity and low-certainty evidence that they may make little to no difference to stunting or wasting. Evidence on adverse outcomes (two PCSs) shows that CCTs make no difference to the proportion of overweight children. Income generation interventions (six cRCTs, 11 PCSs): we found moderate-certainty evidence that income generation interventions probably make little or no difference to stunting or wasting; and low-certainty evidence that they may result in little to no difference to food security or that they may improve dietary diversity in children, but not for households. Interventions that addressed food prices: Food vouchers (three cRCTs, one RCT): we found moderate-certainty evidence that food vouchers probably reduce stunting; and low-certainty evidence that that they may improve dietary diversity slightly, and may result in little to no difference in wasting. Food and nutrition subsidies (one cRCT, three PCSs): we found low-certainty evidence that food and nutrition subsidies may improve dietary diversity among school children. The evidence is very uncertain about the effects on household expenditure on healthy foods as a proportion of total expenditure on food (very low-certainty evidence). Interventions that addressed the social environment: Social support interventions (one cRCT, one PCS): we found moderate-certainty evidence that community grants probably make little or no difference to wasting; low-certainty evidence that they may make little or no difference to stunting. The evidence is very uncertain about the effects of village savings and loans on food security and dietary diversity. None of the included studies addressed the intervention category of infrastructure changes. In addition, none of the studies reported on one of the primary outcomes of this review, namely prevalence of undernourishment. AUTHORS' CONCLUSIONS: The body of evidence indicates that UCTs can improve food security. Income generation interventions do not seem to make a difference for food security, but the evidence is unclear for the other interventions. CCTs, UCTs, interventions that help generate income, interventions that help minimise impact of food prices through food vouchers and subsidies can potentially improve dietary diversity. UCTs and food vouchers may have a potential impact on reducing stunting, but CCTs, income generation interventions or social environment interventions do not seem to make a difference on wasting or stunting. CCTs seem to positively impact cognitive function and development, but not UCTs, which may be due to school attendance, healthcare visits and other conditionalities associated with CCTs.


Assuntos
Participação da Comunidade/economia , Países em Desenvolvimento , Assistência Alimentar/economia , Abastecimento de Alimentos/economia , Renda , Desnutrição/prevenção & controle , Adulto , Criança , Cognição , Participação da Comunidade/métodos , Dieta , Abastecimento de Alimentos/métodos , Transtornos do Crescimento/prevenção & controle , Humanos , Desnutrição/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Apoio Social , Síndrome de Emaciação/prevenção & controle
10.
Cochrane Database Syst Rev ; 7: CD011504, 2020 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-32722849

RESUMO

BACKGROUND: After decades of decline since 2005, the global prevalence of undernourishment reverted and since 2015 has increased to levels seen in 2010 to 2011. The prevalence is highest in low- and middle-income countries (LMICs), especially Africa and Asia. Food insecurity and associated undernutrition detrimentally affect health and socioeconomic development in the short and long term, for individuals, including children, and societies. Physical and economic access to food is crucial to ensure food security. Community-level interventions could be important to increase access to food in LMICs. OBJECTIVES: To determine the effects of community-level interventions that aim to improve access to nutritious food in LMICs, for both the whole community and for disadvantaged or at-risk individuals or groups within a community, such as infants, children and women; elderly, poor or unemployed people; or minority groups. SEARCH METHODS: We searched for relevant studies in 16 electronic databases, including trial registries, from 1980 to September 2019, and updated the searches in six key databases in February 2020. We applied no language or publication status limits. SELECTION CRITERIA: We included randomised controlled trials (RCTs), cluster randomised controlled trials (cRCTs) and prospective controlled studies (PCS). All population groups, adults and children, living in communities in LMICs exposed to community-level interventions aiming to improve food access were eligible for inclusion. We excluded studies that only included participants with specific diseases or conditions (e.g. severely malnourished children). Eligible interventions were broadly categorised into those that improved buying power (e.g. create income-generation opportunities, cash transfer schemes); addressed food prices (e.g. vouchers and subsidies); addressed infrastructure and transport that affected physical access to food outlets; addressed the social environment and provided social support (e.g. social support from family, neighbours or government). DATA COLLECTION AND ANALYSIS: Two authors independently screened titles and abstracts, and full texts of potentially eligible records, against the inclusion criteria. Disagreements were resolved through discussion or arbitration by a third author, if necessary. For each included study, two authors independently extracted data and a third author arbitrated disagreements. However, the outcome data were extracted by one author and checked by a biostatistician. We assessed risk of bias for all studies using the Effective Practice and Organization of Care (EPOC) risk of bias tool for studies with a separate control group. We conducted meta-analyses if there was a minimum of two studies for interventions within the same category, reporting the same outcome measure and these were sufficiently homogeneous. Where we were able to meta-analyse, we used the random-effects model to incorporate any existing heterogeneity. Where we were unable to conduct meta-analyses, we synthesised using vote counting based on effect direction. MAIN RESULTS: We included 59 studies, including 214 to 169,485 participants, and 300 to 124, 644 households, mostly from Africa and Latin America, addressing the following six intervention types (three studies assessed two different types of interventions). Interventions that improved buying power: Unconditional cash transfers (UCTs) (16 cRCTs, two RCTs, three PCSs): we found high-certainty evidence that UCTs improve food security and make little or no difference to cognitive function and development and low-certainty evidence that UCTs may increase dietary diversity and may reduce stunting. The evidence was very uncertain about the effects of UCTs on the proportion of household expenditure on food, and on wasting. Regarding adverse outcomes, evidence from one trial indicates that UCTs reduce the proportion of infants who are overweight. Conditional cash transfers (CCTs) (nine cRCTs, five PCSs): we found high-certainty evidence that CCTs result in little to no difference in the proportion of household expenditure on food and that they slightly improve cognitive function in children; moderate-certainty evidence that CCTs probably slightly improve dietary diversity and low-certainty evidence that they may make little to no difference to stunting or wasting. Evidence on adverse outcomes (two PCSs) shows that CCTs make no difference to the proportion of overweight children. Income generation interventions (six cRCTs, 11 PCSs): we found moderate-certainty evidence that income generation interventions probably make little or no difference to stunting or wasting; and low-certainty evidence that they may result in little to no difference to food security or that they may improve dietary diversity in children, but not for households. Interventions that addressed food prices: Food vouchers (three cRCTs, one RCT): we found moderate-certainty evidence that food vouchers probably reduce stunting; and low-certainty evidence that that they may improve dietary diversity slightly, and may result in little to no difference in wasting. Food and nutrition subsidies (one cRCT, three PCSs): we found low-certainty evidence that food and nutrition subsidies may improve dietary diversity among school children. The evidence is very uncertain about the effects on household expenditure on healthy foods as a proportion of total expenditure on food (very low-certainty evidence). Interventions that addressed the social environment: Social support interventions (one cRCT, one PCS): we found moderate-certainty evidence that community grants probably make little or no difference to wasting; low-certainty evidence that they may make little or no difference to stunting. The evidence is very uncertain about the effects of village savings and loans on food security and dietary diversity. None of the included studies addressed the intervention category of infrastructure changes. In addition, none of the studies reported on one of the primary outcomes of this review, namely prevalence of undernourishment. AUTHORS' CONCLUSIONS: The body of evidence indicates that UCTs can improve food security. Income generation interventions do not seem to make a difference for food security, but the evidence is unclear for the other interventions. CCTs, UCTs, interventions that help generate income, interventions that help minimise impact of food prices through food vouchers and subsidies can potentially improve dietary diversity. UCTs and food vouchers may have a potential impact on reducing stunting, but CCTs, income generation interventions or social environment interventions do not seem to make a difference on wasting or stunting. CCTs seem to positively impact cognitive function and development, but not UCTs, which may be due to school attendance, healthcare visits and other conditionalities associated with CCTs.


Assuntos
Participação da Comunidade/economia , Países em Desenvolvimento , Assistência Alimentar/economia , Abastecimento de Alimentos/economia , Renda , Desnutrição/prevenção & controle , Adulto , Criança , Cognição , Participação da Comunidade/métodos , Abastecimento de Alimentos/métodos , Transtornos do Crescimento/prevenção & controle , Humanos , Apoio Social , Síndrome de Emaciação/prevenção & controle
11.
Pediatr Blood Cancer ; 67 Suppl 3: e28378, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32614140

RESUMO

Nutrition therapy is a therapeutic approach to treating medical conditions and symptoms via diet, which can be done by oral, enteral or parenteral routes. It is desirable to include nutritional interventions as a standard of care in pediatric cancer units (PCUs) at all levels of care. The interventions are dependent on available resources and personnel across all clinical settings. Enteral nutrition is easy, inexpensive, uses the gastrointestinal tract, maintains gut mucosal integrity, and allows for individualized nutritional strategies. This narrative review describes enteral nutritional interventions for children undergoing cancer treatment and is aimed at PCUs of all levels of care located in a low- and middle-income country.


Assuntos
Nutrição Enteral/métodos , Desnutrição/terapia , Neoplasias/dietoterapia , Neoplasias/tratamento farmacológico , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Criança , Nutrição Enteral/normas , Humanos , Masculino , Desnutrição/prevenção & controle
12.
BMJ ; 370: m2397, 2020 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-32699176

RESUMO

OBJECTIVE: To assess the effects of food supplementation on improving working memory and additional measures including cerebral blood flow in children at risk of undernutrition. DESIGN: Randomized controlled trial. SETTING: 10 villages in Guinea-Bissau. PARTICIPANTS: 1059 children aged 15 months to 7 years; children younger than 4 were the primary population. INTERVENTIONS: Supervised isocaloric servings (≈1300 kJ, five mornings each week, 23 weeks) of a new food supplement (NEWSUP, high in plant polyphenols and omega 3 fatty acids, within a wide variety and high fortification of micronutrients, and a high protein content), or a fortified blended food (FBF) used in nutrition programs, or a control meal (traditional rice breakfast). MAIN OUTCOME MEASUREMENTS: The primary outcome was working memory, a core executive function predicting long term academic achievement. Additional outcomes were hemoglobin concentration, growth, body composition, and index of cerebral blood flow (CBFi). In addition to an intention-to-treat analysis, a predefined per protocol analysis was conducted in children who consumed at least 75% of the supplement (820/925, 89%). The primary outcome was assessed by a multivariable Poisson model; other outcomes were assessed by multivariable linear mixed models. RESULTS: Among children younger than 4, randomization to NEWSUP increased working memory compared with the control meal (rate ratio 1.20, 95% confidence interval 1.02 to 1.41, P=0.03), with a larger effect in the per protocol population (1.25, 1.06 to 1.47, P=0.009). NEWSUP also increased hemoglobin concentration among children with anemia (adjusted mean difference 0.65 g/dL, 95% confidence interval 0.23 to 1.07, P=0.003) compared with the control meal, decreased body mass index z score gain (-0.23, -0.43 to -0.02, P=0.03), and increased lean tissue accretion (2.98 cm2, 0.04 to 5.92, P=0.046) with less fat (-5.82 cm2, -11.28 to -0.36, P=0.04) compared with FBF. Additionally, NEWSUP increased CBFi compared with the control meal and FBF in both age groups combined (1.14 mm2/s×10-8, 0.10 to 2.23, P=0.04 for both comparisons). Among children aged 4 and older, NEWSUP had no significant effect on working memory or anemia, but increased lean tissue compared with FBF (4.31 cm2, 0.34 to 8.28, P=0.03). CONCLUSIONS: Childhood undernutrition is associated with long term impairment in cognition. Contrary to current understanding, supplementary feeding for 23 weeks could improve executive function, brain health, and nutritional status in vulnerable young children living in low income countries. Further research is needed to optimize nutritional prescriptions for regenerative improvements in cognitive function, and to test effectiveness in other vulnerable groups. TRIAL REGISTRATION: ClinicalTrials.gov NCT03017209.


Assuntos
Anemia/dietoterapia , Disfunção Cognitiva/dietoterapia , Suplementos Nutricionais/efeitos adversos , Desnutrição/dietoterapia , Estado Nutricional/fisiologia , Sucesso Acadêmico , Anemia/epidemiologia , Estudos de Casos e Controles , Circulação Cerebrovascular/fisiologia , Criança , Pré-Escolar , Cognição/fisiologia , Disfunção Cognitiva/fisiopatologia , Suplementos Nutricionais/estatística & dados numéricos , Feminino , Alimentos Fortificados/provisão & distribução , Guiné-Bissau/epidemiologia , Humanos , Lactente , Análise de Intenção de Tratamento/métodos , Masculino , Desnutrição/epidemiologia , Desnutrição/prevenção & controle , Micronutrientes/provisão & distribução , Medição de Risco
13.
Sante Publique ; Vol. 32(1): 113-122, 2020 Jun 18.
Artigo em Francês | MEDLINE | ID: mdl-32706221

RESUMO

INTRODUCTION: Madagascar has adopted strategies to fight against maternal malnutrition, but the evaluation of their implementation is not effective.Purpose of research: The present study aims to describe beneficiary appreciation of interventions to fight maternal malnutrition and to identify their expectations. METHOD: A qualitative study was conducted in the Amoron’i Mania region, Madagascar. The study included mothers of children under 5, pregnant women, and other family members and community members (fathers, grandmothers, matrons and community workers). Six focus groups and 16 individual interviews were conducted to collect the data. The thematic analysis was used. RESULTS: Food supplementation, improved production of agriculture and livestock, and nutrition education, operated by NGOs, are the best-known interventions. The health centers were not mentioned as interveners and their interventions were ignored. The effectiveness of the intervention is generally judged on the benefits perceived by the beneficiaries. Interveners working on a project basis were assessed as unsustainable. Two main problems were mentioned: first, the insufficiency of agricultural production resulting in the inaccessibility of the ingredients required for the nutrition education, and second the low coverage of the interventions. The improvement of agricultural production is the main suggestion mentioned to fight against maternal undernutrition. CONCLUSIONS: Beneficiaries thought that existing interventions in the region are insufficient to address the problem of malnutrition among mothers.


Assuntos
Desnutrição/prevenção & controle , Fenômenos Fisiológicos da Nutrição Materna , Mães/estatística & dados numéricos , Agricultura/estatística & dados numéricos , Feminino , Grupos Focais , Abastecimento de Alimentos , Educação em Saúde , Humanos , Madagáscar/epidemiologia , Desnutrição/epidemiologia , Gravidez , Pesquisa Qualitativa
14.
Nutr Hosp ; 34(3): 622-630, 2020 Jul 13.
Artigo em Espanhol | MEDLINE | ID: mdl-32603180

RESUMO

Introduction: The current COVID-19 pandemic mainly affects older people, those with obesity or other coexisting chronic diseases such as type-2 diabetes and high blood pressure. It has been observed that about 20 % of patients will require hospitalization, and some of them will need the support of invasive mechanical ventilation in intensive care units. Nutritional status appears to be a relevant factor influencing the clinical outcome of critically ill patients with COVID-19. Several international guidelines have provided recommendations to ensure energy and protein intake in people with COVID-19, with safety measures to reduce the risk of infection in healthcare personnel. The purpose of this review is to analyze the main recommendations related to adequate nutritional management for critically ill patients with COVID-19 in order to improve their prognosis and clinical outcomes.


Assuntos
Betacoronavirus , Infecções por Coronavirus/dietoterapia , Cuidados Críticos/métodos , Estado Terminal , Desnutrição/dietoterapia , Pandemias , Pneumonia Viral/dietoterapia , Doenças Cardiovasculares/epidemiologia , Comorbidade , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Proteínas na Dieta/administração & dosagem , Nutrição Enteral/efeitos adversos , Nutrição Enteral/métodos , Gastroenteropatias/complicações , Humanos , Inflamação/epidemiologia , Inflamação/fisiopatologia , Desnutrição/diagnóstico , Desnutrição/etiologia , Desnutrição/prevenção & controle , Metanálise como Assunto , Micronutrientes/administração & dosagem , Avaliação Nutricional , Necessidades Nutricionais , Apoio Nutricional , Obesidade/epidemiologia , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Síndrome da Realimentação/prevenção & controle , Respiração Artificial , Sarcopenia/epidemiologia
15.
PLoS One ; 15(6): e0233908, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32502158

RESUMO

BACKGROUND: This paper investigates actions that combine nutrition and physical activity which hold potential for 'double duty action' to tackle multiple forms of malnutrition simultaneously. Expanding on previous research on single component actions, we assessed the state of the literature to map integrated interventions across the life course to analyse potential double duty effects, and identify knowledge gaps and needs for future design, implementation, evaluation and research for effective double duty action. METHODS: A scoping review of peer-reviewed and grey literature was conducted to explore the pathways that extend from combined physical activity and nutrition promotion interventions, with potential synergistic effects on outcomes other than obesity. Electronic databases were searched for studies published between 1 January 2010 and 31 January 2020. Out of 359 articles retrieved, 31 peer-reviewed and 5 grey literature sources met inclusion criteria. Findings from 36 papers reporting on 34 interventions/initiatives were organised into 6 categories, based on implementation across multiple stages of the life course. Double-duty potential was assessed through a further stage of analysis. FINDINGS: This review has identified actions that hold potential for tackling not only obesity, but healthy diets, sedentary behaviour and quality of life more generally, as well as actions that explicitly tackle multiple forms of malnutrition. Importantly, it has identified crucial gaps in current methods and praxis that call for further practice-oriented research, in order to better understand and exploit the synergistic effects of integrated interventions on outcomes other than obesity. CONCLUSIONS: Findings from across implementation settings suggest that even in situations where interventions are aimed at, or framed in terms of, obesity prevention and control, there are unexploited pathways for broader outcomes of relevance to nutrition and health and wellbeing more generally. Future design and evaluation of multisectoral approaches will benefit from an explicit framing of interventions as double-duty oriented.


Assuntos
Exercício Físico/fisiologia , Comportamento Alimentar/fisiologia , Promoção da Saúde/métodos , Desnutrição/prevenção & controle , Obesidade/prevenção & controle , Carga Global da Doença , Humanos , Desnutrição/epidemiologia , Desnutrição/fisiopatologia , Obesidade/epidemiologia , Obesidade/fisiopatologia , Qualidade de Vida
16.
Int J Equity Health ; 19(1): 87, 2020 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-32503613

RESUMO

Due to the ongoing nationwide lockdown in Nepal, women and children face a greater risk of malnutrition and eventually leading to mortality and morbidity. To harness the progress made so far in improving the nutritional status of women and children, a focus on nutrition should be a part of the COVID-19 response plan.


Assuntos
Infecções por Coronavirus/epidemiologia , Desnutrição/prevenção & controle , Estado Nutricional , Pneumonia Viral/epidemiologia , Criança , Feminino , Humanos , Desnutrição/epidemiologia , Nepal/epidemiologia , Pandemias
18.
Medicina (Kaunas) ; 56(6)2020 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-32545556

RESUMO

The epidemic that broke out in Chinese Wuhan at the beginning of 2020 presented how important the rapid diagnosis of malnutrition (elevating during intensive care unit stay) and the immediate implementation of caloric and protein-balanced nutrition care are. According to specialists from the Chinese Medical Association for Parenteral and Enteral Nutrition (CSPEN), these activities are crucial for both the therapy success and reduction of mortality rates. The Chinese have published their recommendations including principles for the diagnosis of nutritional status along with the optimal method for nutrition supply including guidelines when to introduce education approach, oral nutritional supplement, tube feeding, and parenteral nutrition. They also calculated energy demand and gave their opinion on proper monitoring and supplementation of immuno-nutrients, fluids and macronutrients intake. The present review summarizes Chinese observations and compares these with the latest European Society for Clinical Nutrition and Metabolism guidelines. Nutritional approach should be an inseparable element of therapy in patients with COVID-19.


Assuntos
Infecções por Coronavirus , Desnutrição , Estado Nutricional , Apoio Nutricional , Pandemias , Pneumonia Viral , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Infecções por Coronavirus/dietoterapia , Infecções por Coronavirus/epidemiologia , Cuidados Críticos/métodos , Humanos , Desnutrição/diagnóstico , Desnutrição/etiologia , Desnutrição/prevenção & controle , Apoio Nutricional/métodos , Apoio Nutricional/normas , Pneumonia Viral/complicações , Pneumonia Viral/dietoterapia , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto
19.
Am J Clin Nutr ; 112(2): 251-256, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32559276

RESUMO

Coronavirus disease 2019 (COVID-19) continues to ravage health and economic metrics globally, including progress in maternal and child nutrition. Although there has been focus on rising rates of childhood wasting in the short term, maternal and child undernutrition rates are also likely to increase as a consequence of COVID-19 and its impacts on poverty, coverage of essential interventions, and access to appropriate nutritious foods. Key sectors at particular risk of collapse or reduced efficiency in the wake of COVID-19 include food systems, incomes, and social protection, health care services for women and children, and services and access to clean water and sanitation. This review highlights key areas of concern for maternal and child nutrition during and in the aftermath of COVID-19 while providing strategic guidance for countries in their efforts to reduce maternal and child undernutrition. Rooted in learnings from the exemplars in Global Health's Stunting Reduction Exemplars project, we provide a set of recommendations that span investments in sectors that have sustained direct and indirect impact on nutrition. These include interventions to strengthen the food-supply chain and reducing food insecurity to assist those at immediate risk of food shortages. Other strategies could include targeted social safety net programs, payment deferrals, or tax breaks as well as suitable cash-support programs for the most vulnerable. Targeting the most marginalized households in rural populations and urban slums could be achieved through deploying community health workers and supporting women and community members. Community-led sanitation programs could be key to ensuring healthy household environments and reducing undernutrition. Additionally, several COVID-19 response measures such as contact tracing and self-isolation could also be exploited for nutrition protection. Global health and improvements in undernutrition will require governments, donors, and development partners to restrategize and reprioritize investments for the COVID-19 era, and will necessitate data-driven decision making, political will and commitment, and international unity.


Assuntos
Saúde da Criança , Infecções por Coronavirus , Saúde do Lactente , Recém-Nascido , Desnutrição , Saúde Materna , Estado Nutricional , Pandemias , Pneumonia Viral , Criança , Transtornos da Nutrição Infantil/prevenção & controle , Pré-Escolar , Coronavirus , Infecções por Coronavirus/complicações , Características da Família , Abastecimento de Alimentos , Saúde Global , Transtornos do Crescimento/prevenção & controle , Humanos , Lactente , Desnutrição/complicações , Desnutrição/prevenção & controle , Pneumonia Viral/complicações , Pobreza
20.
Chin J Traumatol ; 23(5): 290-294, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32423779

RESUMO

PURPOSE: Malnutrition is a common problem among hospitalized patients, especially among traumatic brain injury (TBI) patients. It is developed from hypermetabolism and the condition may worsen under the circumstance of underfeeding or incompatible dietary management. However, the data of nutrient intake especially calorie and protein among TBI patients were scarce. Hence, this study aimed to determine the calorie and protein intake among acute and sub-acute TBI patients receiving medical nutrition therapy in hospital Sultanah Nur Zahirah, Terengganu. METHODS: This observational study involved 50 patients recruited from the neurosurgical ward. Method of 24 h dietary recall was utilized and combined with self-administered food diaries for 2-8 days. Food consumptions including calorie intake and protein intake were analyzed using Nutritionist PRO™ (Woodinville, USA) and manual calculation based on the Malaysian food composition database (2015). RESULTS: Patients consisted of 56% males and 44% females with the median age of 28.0 (IQR = 22.8-36.5) years, of which 92% were diagnosed as mild TBI and the remaining (8%) as moderate TBI. The Glasgow coma scale (GCS) was adopted to classify TBI severity with the score 13-15 being mild and 9-12 being moderate. The median length of hospital stay was 2 (IQR = 2.0-3.3) days. Calorie and protein intake improved significantly from day 1 to discharge day. However, the intake during discharge day was still considered as suboptimal, i.e. 75% of calorie requirement, whilst the median protein intake was only 61.3% relative to protein requirement. Moreover, the average percentages of calorie and protein intakes throughout hospitalization were remarkably lower, i.e. 52.2% and 41.0%, respectively. CONCLUSION: Although the calorie and protein intakes had increased from baseline, hospitalized TBI patients were still at a risk to develop malnutrition as the average intakes were considerably low as compared to their requirements. Optimum nutrient intakes especially calorie and protein are crucial to ensure optimum recovery process as well as to minimize risks of infection and complications.


Assuntos
Lesões Encefálicas Traumáticas/dietoterapia , Proteínas na Dieta/administração & dosagem , Ingestão de Energia , Desnutrição/prevenção & controle , Nutrientes/administração & dosagem , Adulto , Lesões Encefálicas Traumáticas/fisiopatologia , Estudos Transversais , Feminino , Hospitalização , Humanos , Tempo de Internação , Masculino , Recuperação de Função Fisiológica , Risco
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