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1.
Medicine (Baltimore) ; 100(14): e25287, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832097

RESUMO

ABSTRACT: It is important for patients to maintain a good nutritional status as a health promotion strategy to improve the immune function and thus the prognosis of coronavirus disease 2019 (COVID-19).The objective of this retrospective study is to analyze the relationships of nutritional status with inflammation levels, protein reserves, baseline immune status, severity, length of hospital stay, and prognosis of COVID-19 patients.A total of 63 COVID-19 patients hospitalized in the People's Hospital and the Traditional Chinese Medicine Hospital of the Xinzhou District, Wuhan, China, from January 29, 2020 to March 17, 2020. Sixty-three patients were divided into 3 groups according to the guidelines, moderate (n = 22), severe (n = 14), and critical (n = 25), respectively. The differences in the total nutrition risk screening (NRS) score, inflammation level, protein reserve, baseline immune status, length of hospital stay, and prognosis were compared among patients with moderate, severe, and critical COVID-19.Patients with higher NRS scores tend to have more severe COVID-19, higher C-reactive protein and serum procalcitonin levels, higher white blood cell counts, lower lymphocyte counts, and higher mortality rates (P < .05).Nutritional status may be an indirect factor of the severity and prognosis of COVID-19.


Assuntos
/fisiopatologia , Estado Nutricional/fisiologia , Adulto , Idoso , Proteínas Sanguíneas , Sedimentação Sanguínea , Proteína C-Reativa/análise , Feminino , Globulinas/análise , Humanos , Tempo de Internação/estatística & dados numéricos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Pró-Calcitonina/sangue , Prognóstico , Proteínas , Estudos Retrospectivos , Albumina Sérica/análise , Índice de Gravidade de Doença
3.
Value Health ; 24(3): 317-324, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33641764

RESUMO

OBJECTIVES: To investigate the impact of public health insurance coverage, specifically the New Cooperative Medical Scheme (NCMS), on childhood nutrition in poor rural households in China, and to identify the mechanisms through which health insurance coverage affects nutritional intake. METHODS: Longitudinal data on 3291 children were taken from four time periods (2004, 2006, 2009, and 2011) from the China Health and Nutrition Survey (CHNS). Panel data analysis was performed with the fixed-effect model and the propensity score matching with difference-in-differences (PSM-DID) approach. RESULTS: The introduction of the NCMS was associated with a decline in calories, fat, and protein intake, and an increase in the intake of carbohydrates. The NCMS had the greatest negative effect on children aged 0 to 5 years, particularly girls. Out-of-pocket medical expenses were identified as the main channel through which the NCMS affected the nutritional intake of children. CONCLUSIONS: The study showed that the NCMS neither significantly improved the nutritional status of children nor enhanced intake of high-quality nutrients among rural poor households. These findings were attributed to the way in which health-seeking behavior was modified in the light of NCMS coverage. Specifically, NCMS coverage tended to increase healthcare utilization, which in turn increased out-of-pocket medical expenditures. This encouraged savings to aid financial risk protection and resulted in less disposable income for food consumption.


Assuntos
Ingestão de Energia/fisiologia , Financiamento Pessoal/estatística & dados numéricos , Estado Nutricional/fisiologia , População Rural/estatística & dados numéricos , Cobertura Universal do Seguro de Saúde/estatística & dados numéricos , Fatores Etários , Criança , Pré-Escolar , China , Dieta , Feminino , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Modelos Econométricos , Inquéritos Nutricionais , Pontuação de Propensão , Saúde Pública , Fatores Sexuais
4.
Horm Mol Biol Clin Investig ; 42(1): 77-85, 2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33544528

RESUMO

COVID-19 has resulted in an ongoing global pandemic, which spread largely among people who have had close contact with the infected person. The immunopathology of the SARS-CoV-2 virus includes the production of an excess amount of pro-inflammatory cytokines "a cytokine-storm". The respiratory system (main), cardiovascular system and the gastrointestinal tract are the most affected body systems during viral infection. It has been found that most of the patients who require admission to hospital are elderly or have chronic underlying diseases. Higher cases of malnutrition and co-morbidities like diabetes mellitus and cardiovascular diseases are reported in elderly patients due to which, the immune system weakens and hence, the response to the virus is diminished in magnitude. A deficiency of micronutrients results in impaired immune responses leading to improper secretion of cytokines, alterations in secretory antibody response and antibody affinity which increases susceptibility to viral infection. The deficiency of various micronutrients in COVID-19 patient can be treated by appropriate nutritional supplements, prescribed after evaluating the patients' nutritional status. Here we aim to highlight the role of a few particular nutrients namely Vitamin D, Vitamin C, Omega-3 fatty acids, Zinc and Magnesium along with the synergistic roles they play in enhancing immunity and thus, maintaining homeostasis.


Assuntos
/epidemiologia , Desnutrição/epidemiologia , Ácido Ascórbico/fisiologia , /imunologia , Suplementos Nutricionais , Ácidos Graxos Ômega-3/fisiologia , Humanos , Sistema Imunitário/fisiologia , Magnésio/fisiologia , Desnutrição/complicações , Desnutrição/imunologia , Desnutrição/terapia , Micronutrientes/fisiologia , Estado Nutricional/fisiologia , Pandemias , Vitamina D/fisiologia , Zinco/fisiologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-33467012

RESUMO

The relapse into undernutrition after nutritional recovery among those enrolled in a nutritional program is a common challenge of nutritional programs in HIV care settings, but there is little evidence on the determinants of the relapse. Nutritional programs in HIV care settings in many countries are not well designed to sustain the gains obtained from enrolment in a nutritional program. This study examined relapse into undernutrition and associated factors among people living with HIV in the Tigray region of Ethiopia. The study employed a mixed-methods approach, involving quantitative and qualitative studies. Among those who graduated from the nutritional program, 18% of adults and 7% of children relapsed into undernutrition. The mean time to relapse for adults was 68.5 months (95% CI, 67.0-69.9). Various sociodemographic, clinical, and nutritional characteristics were associated with a relapse into undernutrition. A considerable proportion of adults and children relapsed after nutritional recovery. Food insecurity and poor socioeconomic status were a common experience among those enrolled in the nutritional program. Hence, nutritional programs should design strategies to sustain the nutritional gains of those enrolled in the nutritional programs and address the food insecurity which was reported as one of the contributors to relapse into undernutrition among the program participants.


Assuntos
Infecções por HIV/tratamento farmacológico , Desnutrição/complicações , Desnutrição/epidemiologia , Adolescente , Adulto , Terapia Antirretroviral de Alta Atividade , Estudos Transversais , Etiópia/epidemiologia , Feminino , Abastecimento de Alimentos/estatística & dados numéricos , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional/fisiologia , Pobreza/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Recidiva , Fatores Socioeconômicos , Adulto Jovem
6.
J Nutr Health Aging ; 25(1): 71-76, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33367465

RESUMO

PURPOSE: To identify an association between bone mineral density (BMD) and nutritional status, body composition and bone metabolism in older patients. METHODS: Cross-sectional study, involving older adults, with osteopenia/osteoporosis and with normal BMD. The mineral density of the lumbar spine from L1 to L4 and the proximal region of the femur was assessed using dual energy X-ray absorptiometry. Biochemical analyzes were performed of 25(OH)-D, calcium and parathormone. Weight, knee height, and abdominal (AC), mid-upper arm (MUAC) and calf (CC) circumferences were measured. The percentage of body fat (%BF) and Fat-Free Mass (FFM) were quantified by electrical bioimpedance analysis. The Body Mass Index (BMI) was calculated. The statistical analysis used bivariate and multivariate, parametric and/or non-parametric tests, and was considered significant when p <0.05. RESULTS: Of the total 51 older adults assessed, 30 of them (58.8%) were diagnosed with osteopenia/osteoporosis. Body weight (p = 0.001), BMI (p = 0.001), % BF (p = 0.030) and serum concentrations of 25(OH)-D (p = 0.003) were higher in the group without changes in BMD. BMI and serum levels of 25(OH)-D demonstrated a positive correlation with the BMD of all bone compartments and the AC displayed a positive correlation with the lumbar vertebrae. In the logistic regression models, adjusted for sex and age, the BMI and the serum concentration of 25(OH)-D were presented as a protective factor against osteopenia/osteoporosis. CONCLUSIONS: Higher body weight, BMI, AC and %BF, and sufficient serum levels of vitamin D, were shown to be promoters of BMD.


Assuntos
Composição Corporal/fisiologia , Densidade Óssea/fisiologia , Osso e Ossos/metabolismo , Estado Nutricional/fisiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino
7.
Support Care Cancer ; 29(1): 49-66, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32734392

RESUMO

PURPOSE: Taste and smell disturbances in patients affected by cancer are very common, but often under-recognized symptoms. If not addressed properly, they may impact nutritional status, food enjoyment, and quality of life. Treatment tools available for clinicians to manage chemosensory alterations are limited and are often based on personal clinical experiences. The aim of this study was to assess current oncological and palliative care literature through a scoping review, in order to identify available treatments for taste and smell alterations in cancer patients. METHODS: Medline, Embase, CINAHL, ProQuest Dissertations and Theses, and Google Scholar were searched from inception until January 2020, with subject headings relevant to the domains of chemosensory alterations, palliative, and cancer care. A total of 10,718 English and French language publications were reviewed, yielding 43 articles on the researched topic. RESULTS: The heterogeneity of selected articles led to difficulties in interpretation and analysis of the available evidence. Included publications differed in study design, population sample, anticancer treatments, and measures of assessment for taste and smell disturbances. A broad variety of treatment options were described including zinc and polaprezinc, radio-protectors, vitamins and supplements, anti-xerostomia agents, active swallowing exercises, nutritional interventions, delta-9-tetrahydrocannabinol, and photobiomodulation. CONCLUSION: This scoping review identifies the current state of knowledge regarding chemosensory alterations within supportive cancer care. Despite not reaching firm conclusions, this article offers therapeutic venues to further explore in larger and more methodologically sound studies.


Assuntos
Transtornos do Olfato/tratamento farmacológico , Olfato/fisiologia , Distúrbios do Paladar/tratamento farmacológico , Paladar/fisiologia , Adulto , Amifostina/uso terapêutico , Carnosina/análogos & derivados , Carnosina/uso terapêutico , Dronabinol/uso terapêutico , Humanos , Neoplasias/tratamento farmacológico , Estado Nutricional/fisiologia , Transtornos do Olfato/patologia , Compostos Organometálicos/uso terapêutico , Cuidados Paliativos/métodos , Qualidade de Vida/psicologia , Selênio/uso terapêutico , Distúrbios do Paladar/patologia , Compostos de Zinco/uso terapêutico
8.
Nutr. hosp ; 37(6): 1166-1172, nov.-dic. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-198308

RESUMO

INTRODUCCIÓN: actualmente, el ejercicio físico practicado de manera regular es la mejor herramienta disponible para fomentar el bienestar de las personas y una mejor salud. OBJETIVO: el objetivo del estudio fue determinar el nivel de condición física y el estado nutricional, así como la relación entre estos, en estudiantes de enseñanza básica de la ciudad de Chillán. MÉTODOS: el estudio es de tipo descriptivo, de corte transversal y relacional. Participaron 2500 estudiantes. Para evaluar la condición física se utilizaron los siguientes test: Wells y Dillons (flexibilidad), Sargent Test (potencia miembros inferiores), Test de 1 Milla de la AAPHARD (capacidad aeróbica) y Abdominales en 30 segundos (capacidad muscular localizada). RESULTADOS: al comparar por sexos, los hombres presentaron diferencias estadísticas significativas en las variables físicas de capacidad aeróbica (p = 0,00), abdominales (p = 0,00) y salto (p = 0,00); solo en el caso de la flexibilidad las mujeres presentaron mejores resultados (p = 0,01). Al relacionar el IMC con la capacidad física se observa una relación negativa en ambos sexos, es decir: a mayor IMC, menor es la cantidad de abdominales realizados (r = -0,032; r = -0,084, mujeres y hombres, respectivamente) y la capacidad aeróbica (r = -0,063 y r = -0,023, mujeres y hombres, respectivamente). En flexibilidad y salto se observa una correlación positiva, aunque esta es insignificante. CONCLUSIÓN: los hombres y las mujeres con normopeso presentan una mejor condición física en comparación con quienes presentan sobrepeso u obesidad. En cuanto al sexo, los hombres presentan una mejor condición física salvo en la prueba de flexibilidad, donde las mujeres presentan los mejores resultados. Además, se observa una relación negativa en ambos sexos entre la condición física y la composición corporal, donde un IMC elevado se traduce en un bajo nivel de rendimiento físico


INTRODUCTION: currently, regular physical exercise is the best tool available to promote people's well-being and improve their health. OBJECTIVE: the objective of the study was to determine the level of physical condition and nutritional status, as well as the relationship between them, in elementary school students in the city of Chillán. METHODS: the study is of the descriptive, cross-sectional, relational type. A total of 2500 students participated. To evaluate physical condition, the followingtests were used: Wells and Dillons (flexibility), Sargent Test (lower limb power), AAPHARD's 1-Mile Test (cardiorespiratory resistance), and Sit-ups in 30 seconds (localized muscular resistance). RESULTS: when comparing by sex, men presented significant statistical differences in the physical variables of aerobic capacity (p = 0.00), situps (p = 0.00) and jumping (p = 0.00); only in the case of flexibility did women present better results (p = 0.01). When relating BMI to physical capacity a negative relationship is observed in both sexes-that is, the higher the BMI, the lower the amount of sit-ups (r = -0.032; r = -0.084, women and men, respectively) and aerobic capacity (r = -0.063 and r = -0.023, women and men, respectively). In flexibility and jump a positive though negligible correlation was observed. CONCLUSION: normal-weight men and women have a better physical condition as compared to those with overweight or obesity. As for sex, men have a better physical condition except for the flexibility test, where women obtain the best results. In addition, a negative relationship is observed in both sexes between physical condition and body composition, where a high BMI results in a low level of physical performance


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Valor Nutritivo/fisiologia , Estado Nutricional/fisiologia , Estudantes/estatística & dados numéricos , Nível de Saúde , Exercício Físico/fisiologia , Estudos de Coortes , Chile , Estudos Transversais , Composição Corporal , Desempenho Físico Funcional , Antropometria , Sobrepeso/epidemiologia , Obesidade/epidemiologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-33317794

RESUMO

Malnutrition and the broad spectrum of cancer cachexia frequently occur in patients with malignant disease of all tumour stages and impact on survival and quality of life of patients. Structured screening for the risk of malnutrition with validated tools and nutritional assessment are the prerequisite for adequate nutritional support in cancer patients. In patients receiving tumour directed therapy, the patients diet should meet the requirements to give optimal support, while later on comfort feeding is part of symptom focused palliation. The basis of nutritional support in a malnourished patient is nutritional counselling, and nutritional support can be offered within a step-up approach meeting the patient's needs. A combination of nutritional support with interventions targeting metabolic changes and physical exercise is suggested to treat cancer cachexia.


Assuntos
Caquexia/terapia , Nutrição Enteral/métodos , Gastroenteropatias/terapia , Estado Nutricional/fisiologia , Apoio Nutricional/métodos , Cuidados Paliativos/métodos , Qualidade de Vida/psicologia , Assistência Terminal/normas , Idoso , Humanos
10.
PLoS One ; 15(12): e0244449, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33382776

RESUMO

Dietary changes during pregnancy (DP) and post-partum are essential for women's nutrition status and the health of their offspring. We compared the diet quality DP and at 3-year post-partum (3YPP) and assessed the relationship between maternal diet quality and nutritional status using a prospective cohort design among women in East Jakarta. In total, 107 women were recruited from the study in 2014 and followed up at 3YPP in 2018. The mid-upper arm circumference (MUAC), weight, and height were evaluated. Food consumption data were collected from repeated 24-h recalls. The validated US Diet Quality Index-Pregnancy (DQI-P) scores with eight components were calculated using the food consumption data and compared between DP and 3YPP. Associations of the DQI-P score with the MUAC and weight gain DP and body mass index (BMI) at 3YPP were analyzed using multivariable linear and logistic regression. The median of the DQI-P score DP was significantly higher than at 3YPP [35 (27; 42) versus 27 (19; 30); p-value <0.001, respectively]. The higher DQI-P score was associated with increased weight gain DP of 3.3 kg (adjusted ß = 3.30, 95% confidence interval = 1.06-5.54) after adjusting for the mother's age and household income. The DQI-P score was not associated with an increased risk of chronic energy deficiency DP and overweight-obesity at 3YPP. Thus, the diet adequacy was associated with weight gain DP but did not affect the MUAC DP and BMI at 3YPP. The DQI-P score DP was slightly better than the diet at 3YPP; however, the overall diet quality was inadequate. In conclusion, a higher DQI-P score was associated with increased weight gain DP of 3.3 kg but was not associated with other nutritional status indices in DP and 3YPP. Innovative dietary quality improvement programs are required to reduce malnutrition risk in pregnant and reproductive-age women.


Assuntos
Ganho de Peso na Gestação/fisiologia , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Obesidade/epidemiologia , Período Pós-Parto/fisiologia , Adulto , Índice de Massa Corporal , Feminino , Seguimentos , Humanos , Indonésia/epidemiologia , Avaliação Nutricional , Estado Nutricional/fisiologia , Obesidade/fisiopatologia , Obesidade/prevenção & controle , Gravidez , Estudos Prospectivos , Adulto Jovem
11.
Nutrients ; 12(12)2020 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-33339130

RESUMO

Vitamin A- (retinol), vitamin B12- (haptocorrin) and vitamin D-binding proteins are the major circulatory transporters of their respective ligands; they are also constituents of the salivary proteome, the origins of which, remain unclear. The aim of this study was to explore how these proteins enter saliva and their relationship (if any) with vitamin status. Firstly, the three vitamin-binding proteins were quantified in resting whole mouth saliva and chewing-stimulated saliva from healthy donors (n = 10) to determine if they enter the mouth by salivary secretion or from the circulation. Secondly paired whole mouth saliva and serum samples were analysed from healthy donors (n = 14) to determine the relationships between the vitamin-binding proteins and vitamin status. Salivary output of all three vitamin-binding proteins studied increased when secretion was stimulated, suggesting they are secreted by the salivary glands. Whilst retinol-binding protein and haptocorrin were secreted by all major salivary glands, vitamin D-binding protein was restricted to the mucus glands. Salivary vitamin-binding protein concentrations were not found to be indicative of systemic vitamin status.


Assuntos
Saliva/química , Vitamina A/metabolismo , Vitamina B 12/metabolismo , Proteína de Ligação a Vitamina D/metabolismo , Adulto , Estudos Transversais , Feminino , Voluntários Saudáveis , Humanos , Masculino , Mastigação/fisiologia , Mucosa Bucal/metabolismo , Estado Nutricional/fisiologia , Proteoma/metabolismo , Glândulas Salivares/metabolismo
12.
PLoS One ; 15(11): e0240526, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33141833

RESUMO

In-person (face-to-face) data collection methods offer many advantages but can also be time-consuming and expensive, particularly in areas of difficult access. We take advantage of the increasing mobile phone penetration rate in rural areas to evaluate the feasibility of using cell phones to monitor the provision of key health and nutrition interventions linked to the first 1,000 days of life, a critical period of growth and development. We examine response rates to calendarized text messages (SMS) and phone calls sent to 1,542 households over a period of four months. These households have children under two years old and pregnant women and are located across randomly selected communities in Quiche, Guatemala. We find that the overall (valid) response rate to phone calls is over 5 times higher than to text messages (75.8% versus 14.4%). We also test whether simple SMS reminders improve the timely reception of health services but do not find any effects in this regard. Language, education, and age appear to be major barriers to respond to text messages as opposed to phone calls, and the rate of response is not correlated with a household's geographic location (accessibility). Moreover, response veracity is high, with an 84-91% match between household responses and administrative records. The costs per monitored intervention are around 1.12 US dollars using text messages and 85 cents making phone calls, with the costs per effective answer showing a starker contrast, at 7.76 and 1.12 US dollars, respectively. Our findings indicate that mobile phone calls can be an effective, low-cost tool to collect reliable information remotely and in real time. In the current context, where in-person contact with households is not possible due to the COVID-19 crisis, phone calls can be a valuable instrument for collecting information, monitoring development interventions, or implementing brief surveys.


Assuntos
Telefone Celular/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Monitorização Fisiológica/estatística & dados numéricos , Estado Nutricional/fisiologia , Pandemias , Pneumonia Viral/epidemiologia , População Rural/estatística & dados numéricos , Adulto , Telefone Celular/economia , Pré-Escolar , Feminino , Guatemala/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Monitorização Fisiológica/economia , Gravidez , Sistemas de Alerta/economia , Sistemas de Alerta/estatística & dados numéricos , Inquéritos e Questionários , Telemedicina/economia , Telemedicina/estatística & dados numéricos , Envio de Mensagens de Texto/economia , Envio de Mensagens de Texto/estatística & dados numéricos
13.
Med Sci (Paris) ; 36(10): 900-907, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-33026333

RESUMO

Retinopathy of prematurity (ROP) is one of the leading cause of preventable blindness in children. Its incidence increases with increasing survival of extremely preterm babies. ROP results from a multifactorial impairment of retinal development, the retinal vascular network, involving both oxygen-dependent and nutritional factors. The numerous factors involved in ROP development suggest that preventive strategies should be synergistic and complementary, including tight control of oxygen therapy, optimized nutritional intakes and postnatal growth, breastfeeding, adequate ω-3 PUFAs supply and control of hyperglycemic episodes associated with prematurity. ROP requires a multidisciplinary management, which includes systematic screening, appropriate treatment and long-term follow-up. Current screening modalities are based on wide-field digital retinal imaging systems, which also allow screening by telemedicine. The gold-standard treatment for ROP remains laser photocoagulation. It may be combined with intravitreal anti-VEGF administration, which is currently being evaluated, or surgery for advanced stages.


Assuntos
Retinopatia da Prematuridade/prevenção & controle , Retinopatia da Prematuridade/terapia , Humanos , Incidência , Recém-Nascido , Recém-Nascido Prematuro , Monitorização Fisiológica/métodos , Estado Nutricional/fisiologia , Oxigênio/efeitos adversos , Retinopatia da Prematuridade/epidemiologia , Retinopatia da Prematuridade/etiologia , Fatores de Risco
14.
Geriatr Gerontol Int ; 20(9): 811-816, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33058420

RESUMO

AIM: The Geriatric Nutritional Risk Index (GNRI) can predict nutritional risk. However, just a few studies have validated the optimal cut-off value of GNRI for nutrition screening in older patients. Hence, this study aimed to determine the optimal value of GNRI to screen the risk of malnutrition among older patients. METHODS: This retrospective cross-sectional study was carried out with 5867 consecutive older adult patients who were admitted to an academic hospital in Japan. Receiver operating characteristic curve analyses were carried out to obtain the optimal cut-off value of GNRI, and the results were compared against the Mini Nutritional Assessment - Short Form and Malnutrition Universal Screening Tool. The validation of the obtained cut-off value was examined on the concordance rate of malnutrition diagnosis based on the European Society of Clinical Nutrition and Metabolism criteria. RESULTS: The mean age of the patients was 76.0 ± 7.0 years. The optimal cut-off value of GNRI for Mini Nutritional Assessment - Short Form ≤11 points was 95.92 (area under the curve 0.827 [0.817-0.838], P < 0.001), and that for Malnutrition Universal Screening Tool ≥1 point was 95.95 (area under the curve 0.788 [0.776-0.799], P < 0.001). By adapting GNRI <96 points as an initial screening cut-off in the European Society of Clinical Nutrition and Metabolism-defined malnutrition process, the concordance rates of comparisons were 98.5% and 98.5% for Mini Nutritional Assessment - Short Form-based and MUST-based diagnosis, respectively. CONCLUSIONS: The study showed GNRI <96 points as the optimal cut-off value for nutritional screening. GNRI might be one of the easy-to-use tools for nutritional screening and for diagnosing malnutrition in older adults. Geriatr Gerontol Int 2020; 20: 811-816.


Assuntos
Desnutrição/diagnóstico , Programas de Rastreamento/métodos , Avaliação Nutricional , Estado Nutricional/fisiologia , Idoso , Idoso de 80 Anos ou mais , Antropometria , Estudos Transversais , Feminino , Avaliação Geriátrica/métodos , Hospitalização , Hospitais Universitários , Humanos , Japão , Masculino , Curva ROC , Estudos Retrospectivos
15.
Lancet Diabetes Endocrinol ; 8(11): 915-930, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32949497

RESUMO

Prospective observational studies support the use of long-chain omega-3 polyunsaturated fatty acids (PUFAs) in the primary prevention of atherosclerotic cardiovascular disease; however, randomised controlled trials, have often reported neutral findings. There is a long history of debate about the potential harmful effects of a high intake of omega-6 PUFAs, although this idea is not supported by prospective observational studies or randomised controlled trials. Health effects of PUFAs might be influenced by Δ-5 and Δ-6 desaturases, the key enzymes in the metabolism of PUFAs. The activity of these enzymes and modulation by variants in encoding genes (FADS1-2-3 gene cluster) are linked to several cardiometabolic traits. This Review will further consider non-genetic determinants of desaturase activity, which have the potential to modify the availability of PUFAs to tissues. Finally, we discuss the consequences of altered desaturase activity in the context of PUFA intake, that is, gene-diet interactions and their clinical and public health implications.


Assuntos
Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/metabolismo , Ácidos Graxos Ômega-3/metabolismo , Ácidos Graxos Ômega-6/metabolismo , Doenças Metabólicas/dietoterapia , Doenças Metabólicas/metabolismo , Animais , Ácidos Graxos Ômega-3/administração & dosagem , Ácidos Graxos Ômega-6/administração & dosagem , Interação Gene-Ambiente , Humanos , Estado Nutricional/fisiologia , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos
16.
Nutrients ; 12(9)2020 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-32911778

RESUMO

The pandemic caused by the new coronavirus has caused shock waves in many countries, producing a global health crisis worldwide. Lack of knowledge of the biological mechanisms of viruses, plus the absence of effective treatments against the disease (COVID-19) and/or vaccines have pulled factors that can compromise the proper functioning of the immune system to fight against infectious diseases into the spotlight. The optimal status of specific nutrients is considered crucial to keeping immune components within their normal activity, helping to avoid and overcome infections. Specifically, the European Food Safety Authority (EFSA) evaluated and deems six vitamins (D, A, C, Folate, B6, B12) and four minerals (zinc, iron, copper and selenium) to be essential for the normal functioning of the immune system, due to the scientific evidence collected so far. In this report, an update on the evidence of the contribution of nutritional factors as immune-enhancing aspects, factors that could reduce their bioavailability, and the role of the optimal status of these nutrients within the COVID-19 pandemic context was carried out. First, a non-systematic review of the current state of knowledge regarding the impact of an optimal nutritional status of these nutrients on the proper functioning of the immune system as well as their potential role in COVID-19 prevention/treatment was carried out by searching for available scientific evidence in PubMed and LitCovid databases. Second, a compilation from published sources and an analysis of nutritional data from 10 European countries was performed, and the relationship between country nutritional status and epidemiological COVID-19 data (available in the Worldometers database) was evaluated following an ecological study design. Furthermore, the potential effect of genetics was considered through the selection of genetic variants previously identified in Genome-Wide Association studies (GWAs) as influencing the nutritional status of these 10 considered nutrients. Therefore, access to genetic information in accessible databases (1000genomes, by Ensembl) of individuals from European populations enabled an approximation that countries might present a greater risk of suboptimal status of the nutrients studied. Results from the review approach show the importance of maintaining a correct nutritional status of these 10 nutrients analyzed for the health of the immune system, highlighting the importance of Vitamin D and iron in the context of COVID-19. Besides, the ecological study demonstrates that intake levels of relevant micronutrients-especially Vitamins D, C, B12, and iron-are inversely associated with higher COVID-19 incidence and/or mortality, particularly in populations genetically predisposed to show lower micronutrient status. In conclusion, nutrigenetic data provided by joint assessment of 10 essential nutrients for the functioning of the immune system and of the genetic factors that can limit their bioavailability can be a fundamental tool to help strengthen the immune system of individuals and prepare populations to fight against infectious diseases such as COVID-19.


Assuntos
Infecções por Coronavirus , Nutrigenômica , Estado Nutricional , Pandemias , Pneumonia Viral , Adolescente , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/fisiopatologia , Feminino , Estudo de Associação Genômica Ampla , Humanos , Masculino , Metais Pesados/sangue , Pessoa de Meia-Idade , Estado Nutricional/genética , Estado Nutricional/imunologia , Estado Nutricional/fisiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Pneumonia Viral/fisiopatologia , Selênio/sangue , Vitaminas/sangue , Adulto Jovem
17.
Anticancer Res ; 40(10): 5343-5349, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32988852

RESUMO

BACKGROUND/AIM: The present study aimed to examine the association of the controlling nutritional status (CONUT) score with outcomes in patients undergoing esophagectomy for esophageal cancer (EC). MATERIALS AND METHODS: A systematic literature review was carried out to investigate the impact of the CONUT score in EC. Next, meta-analysis of long-term outcomes was performed. RESULTS: The search found six eligible retrospective studies, and five studies with 952 patients were included in the meta-analysis. Meta-analysis found a significant association of the CONUT score with outcomes including overall survival [hazard ratio (HR)=2.51, 95% confidence interval (CI)=1.75-3.60, p<0.001], cancer-specific survival (HR=2.60, 95%CI=1.53-4.41, p<0.001), and recurrence free survival (HR=2.08, 95%CI=1.39-3.12, p<0.001). CONCLUSION: The CONUT score may be an independent predictor associated with prognosis in patients undergoing esophagectomy for EC. However, further studies are needed to clarify the association of the CONUT score with postoperative outcomes in EC patients.


Assuntos
Neoplasias Esofágicas/metabolismo , Estado Nutricional/fisiologia , Complicações Pós-Operatórias/metabolismo , Intervalo Livre de Doença , Neoplasias Esofágicas/epidemiologia , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Esofagectomia/efeitos adversos , Humanos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/patologia , Modelos de Riscos Proporcionais
18.
Medicine (Baltimore) ; 99(38): e21840, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957308

RESUMO

BACKGROUND: The prognostic significance of preoperative prognostic nutritional index (PNI) in ovarian cancer (OC) is uncertain, and this study is aimed to clarify the prognostic significance. METHODS: We used 4 common databases for conducting a systematic review and meta-analysis, and eligible studies were included in the analysis. The association of preoperative PNI with overall survival (OS), progression-free survival (PFS), and clinicopathological parameters was analyzed. RESULTS: A total of 2050 patients with OC receiving the surgical treatment were analyzed in this study. Patients with low PNI tended to have a shorter OS (hazard ratio [HR] = 1.82, 95% CI = 1.30-2.55, P < .01) and PFS (HR = 1.91, 95% CI = 1.53-2.39, P < .01) compared with those with high PNI. Besides, low PNI was significantly associated with more advanced International Federation of Gynecology and Obstetrics stage (P < .01), the occurrence of ascites (P < .01), larger residual tumor (P < .01), insensitive to chemotherapy (P < .01), and higher CA125 (P < .01) compared with high PNI in OC. CONCLUSION: Low preoperative PNI is associated with shorter OS, shorter PFS, and worse clinicopathological parameters in OC. Low preoperative PNI is an unfavorable prognostic indicator of patients with OC.


Assuntos
Estado Nutricional/fisiologia , Neoplasias Ovarianas/mortalidade , Antígeno Ca-125/sangue , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Proteínas de Membrana/sangue , Prognóstico , Modelos de Riscos Proporcionais
19.
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
20.
PLoS One ; 15(9): e0239274, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32946506

RESUMO

This systematic review evaluated the association between frequency of family meals (FFM) and nutritional status (NS) and/or food consumption (FC) in adolescents. The protocol was registered with PROSPERO (CRD42017062180) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. No publication date, language, or meal type restrictions were imposed. Only full-text original articles were included; qualitative studies were excluded. Studies were identified by searching 5 electronic databases (PubMed, Web of Science, Scopus, BVS Brazil, and Adolec) and gray literature (Google Scholar) and by scanning reference lists of included articles. Risk of bias was assessed using the Newcastle-Ottawa scale for cohort and cross-sectional studies. Initial search yielded 2001 results and 47 articles were included. An updated literature search added 3 articles. Of the 50 studies included, 25 studied the association between FFM and NS, 32 investigated the association between FFM and FC, being that seven studies analyzed both outcomes. Thirty-four were cross-sectional studies, 12 were longitudinal studies, and 4 studies analyzed both cross-sectional and longitudinal data. Thirty-five studies were rated as having good quality, whereas 19 were of fair quality. Sample size ranged from 140 to 102 072 participants. Most investigations evaluated the frequency of breakfast, lunch, and/or dinner/supper/evening meals over a 1-week period. Seventeen studies identified a positive relationship between high FFM and better NS, and 26 found a positive association between high FFM and better FC. In conclusion, this review showed an association between FFM and healthy dietary patterns, such as increased consumption of fruits and vegetables. Further research is needed to understand the association between FFM and NS, since some studies showed a protective role of family meals against obesity in this age group, whereas other studies identified no significant association between these variables.


Assuntos
Comportamento Alimentar/fisiologia , Estado Nutricional/fisiologia , Obesidade/epidemiologia , Adolescente , Brasil/epidemiologia , Criança , Gerenciamento de Dados , Dieta , Família , Feminino , Humanos , Almoço , Masculino , Refeições , Obesidade/metabolismo , Obesidade/fisiopatologia
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