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1.
BMC Cancer ; 21(1): 656, 2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34078309

RESUMO

BACKGROUND: Nutritional complications in patients with locally advanced head and neck cancer (LA-HNC) treated by concurrent chemoradiotherapy (CCRT) often lead to placement of a prophylactic gastrostomy (PG) tube, while indication lacks harmonization. Our aim was to explore the current PG tube utilization among Belgian radiation oncology centers. METHODS: A survey was distributed to all 24 Belgian Radiation oncology departments, with questions about the number of patient treated per year, whether the PG indication is discussed at the multidisciplinary board, placement technique, time of starting nutrition and removal, its impact on swallowing function and importance of clinical factors. For the latter Relative Importance and Discordance Indexes were calculated to describe the ranking and agreement. RESULTS: All 24 centers submitted the questionnaire. Twenty three treat more than 20 head and neck (HNC) patients per year, while four (1 in 21-50; 3 in 51-100) are not discussing the gastrostomy tube indication at the multidisciplinary board. For the latter, endoscopic placement (68%) is the dominant technique, followed by the radiologic (16%) and laparoscopic (16%) methods. Seventy-five percent start the enteral nutrition when clinically indicated, 17% immediately and 8% from the start of radiotherapy. Majority of specialists (19/24) keep the gastrostomy tube until the patient assume an adequate oral feeding. Fifteen centres are considering PG decrease swallowing function. Regarding factors and their importance in the decision for the PG, foreseen irradiated volume reached highest importance, followed by 'anatomical site', 'patients' choice' and 'postoperative versus definitive' and 'local expertise', with decreasing importance respectively. Disagreement indexes showed moderate variation. CONCLUSIONS: The use of a PG tube for LAHNC patients treated by CCRT shows disparity at national level. Prospective studies are needed to ensure proper indication of this supportive measure.


Assuntos
Quimiorradioterapia/efeitos adversos , Gastrostomia/estatística & dados numéricos , Neoplasias de Cabeça e Pescoço/terapia , Transtornos Nutricionais/terapia , Procedimentos Cirúrgicos Profiláticos/estatística & dados numéricos , Lesões por Radiação/terapia , Nutrição Enteral/instrumentação , Nutrição Enteral/métodos , Nutrição Enteral/estatística & dados numéricos , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Estadiamento de Neoplasias , Transtornos Nutricionais/epidemiologia , Transtornos Nutricionais/etiologia , Estado Nutricional , Padrões de Prática Médica/estatística & dados numéricos , Estudos Prospectivos , Lesões por Radiação/epidemiologia , Lesões por Radiação/etiologia , Radio-Oncologistas/estatística & dados numéricos
2.
Nutrients ; 13(6)2021 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-34073813

RESUMO

A study of the literature shows the lack of data on a comprehensive analysis of eating disorders in children with neurodysfunction, which constitute a clinical subgroup with an increased risk of abnormalities in this area. Therefore, the aim of this study was to determine the relationship between the coexistence of nutritional disorders and diseases or syndromes associated with neurodysfunction based on data collected during hospitalization at a rehabilitation center for children and adolescents. A retrospective analysis was carried out in a group of 327 children and adolescents aged 4-18 years. The study group covered various types of diseases or syndromes involving damage to the central nervous system. A retrospective analysis of baseline data (age, sex, main and additional diagnosis and Body Mass Index-BMI) was performed. Two assessment criteria of nutritional status were taken into account (z-score BMI and other previously published normative values). In the study group, malnutrition was found more frequently (18.0% of the respondents) than obesity (11.3% of the subjects). Hypothyroidism coexisting with malnutrition was identified in the study group (N% = 43.8%, p = 0.011) and malnutrition with tetraplegia in the subgroup of spastic cerebral palsy (N% = 34.2 %, p = 0.029).


Assuntos
Doenças do Sistema Nervoso Central/epidemiologia , Transtornos Nutricionais/epidemiologia , Adolescente , Índice de Massa Corporal , Paralisia Cerebral/epidemiologia , Criança , Pré-Escolar , Disfunção Cognitiva/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Feminino , Humanos , Hipotireoidismo/epidemiologia , Masculino , Desnutrição/epidemiologia , Transtornos Motores/epidemiologia , Estado Nutricional , Obesidade/epidemiologia , Quadriplegia/epidemiologia , Centros de Reabilitação , Estudos Retrospectivos , Síndrome
3.
Nutr Hosp ; 38(3): 540-544, 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-33765834

RESUMO

Introduction: Background: nutritional risk has been associated with worse outcomes at the critical care unit. The aim of this study was to describe the association between nutritional risk and length of stay, days on mechanical ventilation, and in-hospital mortality in patients infected with SARS-CoV-2. Methods: a retrospective cohort of ventilated, critically ill patients. We assessed nutrition risk at baseline using NUTRIC-score. Logistic and linear regression models were used to analyze the association between NUTRIC-score and clinical outcomes (days on mechanical ventilation, hospital length of stay, and in-hospital mortality). A survival analysis was performed using Kaplan-Meier curves. Results: a total of 112 patients were included, 39.3 % were overweight and 47.3 % were obese. Based on NUTRIC-Score, 66 % and 34 % of patients were at high and low nutritional risk, respectively. High nutritional risk was associated with increased mortality risk (OR: 2.4, 95 % CI, 1.06-5.47, p = 0.036) and higher 28-day mortality (HR: 2.05, 95 % CI, 1.01-4.23, p = 0.04) in comparison with low risk. Conclusion: high nutritional risk is related to mortality in SARS-CoV-2 critically ill patients. Overweight and obesity are common in this sample. More studies are needed to elucidate the impact of nutritional therapy on infection course and outcomes.


Assuntos
COVID-19/mortalidade , Mortalidade Hospitalar , Transtornos Nutricionais/mortalidade , Estado Nutricional , Respiração Artificial/estatística & dados numéricos , Índice de Massa Corporal , Intervalos de Confiança , Estado Terminal/mortalidade , Feminino , Humanos , Unidades de Terapia Intensiva , Estimativa de Kaplan-Meier , Tempo de Internação , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Transtornos Nutricionais/epidemiologia , Obesidade/epidemiologia , Obesidade/mortalidade , Razão de Chances , Sobrepeso/epidemiologia , Sobrepeso/mortalidade , Estudos Retrospectivos , Fatores de Tempo
4.
Nutrients ; 12(12)2020 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-33255334

RESUMO

Chronic kidney disease (CKD) is increasing in sub-Saharan Africa. Undernutrition has been prevalent amongst end stage CKD patients, with limited data on the prevalence of obesity. The aim of this study was to assess the nutritional status of CKD patients using various methods sensitive to over and under-nutrition. Stage 3 to 5 CKD patients (glomerular filtration rate (GFR) < 60 mL/min/1.73 m2) attending a pre-dialysis clinic in Cape Town, were enrolled. Exclusion criteria included infectious and autoimmune conditions. Sociodemographic, clinical and biochemical data were collected, and anthropometric measurements were performed. Dietary intake was measured with a quantified food frequency questionnaire (FFQ). Statistical Package for the Social Sciences (SPSS) version 26 was used for statistical analysis. Seventy participants, with mean age of 41.8 ± 11.8 years, 52.9% females and 47.1% males were enrolled. Participants enrolled mainly had stage 5 kidney failure. Thirty percent were overweight (21) and 25 (36%) were obese, 22 (60%) of females were overweight and obese, while 13 (39.4%) of males were predominantly normal weight. Abdominal obesity was found in 42 (60%) of participants, mainly in females. Undernutrition prevalence was low at 3%. Dietary assessment showed a high sugar and protein intake. There was a high prevalence of overweight, obesity and abdominal obesity in CKD stage 35 patients, with unhealthy dietary intake and other nutritional abnormalities.


Assuntos
Estado Nutricional , Obesidade/epidemiologia , Obesidade/fisiopatologia , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/fisiopatologia , Adulto , África ao Sul do Saara/epidemiologia , Comorbidade , Estudos Transversais , Diálise , Feminino , Humanos , Masculino , Transtornos Nutricionais/epidemiologia , Transtornos Nutricionais/fisiopatologia
5.
Sultan Qaboos Univ Med J ; 20(3): e344-e351, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33110651

RESUMO

Objectives: This study aimed to investigate the effect of bariatric surgery on degree of weight loss, as well as the prevalence of nutritional deficiencies, postoperative complications and adherence to dietary and lifestyle recommendations in a cohort of patients from Bahrain. Methods: This retrospective cohort study took place between March and September 2018 at two hospitals in Bahrain. All adult patients who had undergone bariatric surgery between 2012-2017 were included. Sociodemographic and clinical information was collected from the patients' medical records and during phone interviews. Results: A total of 341 patients participated in the study. The mean age was 39.82 ± 9.95 years and 67.7% were female. There was a significant relationship between postoperative body mass index and both the type of surgery and time since surgery (P = 0.025 and 0.008, respectively). While type of surgery had no significant effect on percent of excess weight loss (EWL) or percent of total weight loss (TWL), time since surgery significantly affected both of these weight loss measures (P = 0.006 and 0.001, respectively). Biochemical tests revealed haemoglobin, mean corpuscular volume, 25-hydroxy vitamin D, ferritin and iron deficiencies. Commonly reported complications included hair loss (59.5%), flatulence/abdominal pain (39.3%), dry skin (34.3%) and gastroesophageal reflux disease (33.1%). The level of adherence to dietary and lifestyle recommendations was high to moderate. Conclusion: Bariatric surgery was effective in accelerating EWL and TWL; however, it also resulted in complications such as nutritional deficiencies and gastrointestinal side-effects.


Assuntos
Cirurgia Bariátrica/normas , Transtornos Nutricionais/prevenção & controle , Comportamento de Redução do Risco , Cooperação e Adesão ao Tratamento/psicologia , Perda de Peso , Adulto , Barein , Cirurgia Bariátrica/estatística & dados numéricos , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Nutricionais/epidemiologia , Obesidade/psicologia , Obesidade/cirurgia , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Cooperação e Adesão ao Tratamento/estatística & dados numéricos
7.
Rev. esp. nutr. comunitaria ; 26(3): 0-0, jul.-sept. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-200757

RESUMO

FUNDAMENTOS: Los adultos mayores requieren de evaluaciones periódicas para determinar su estado de salud. El objetivo fue evaluar el estado ponderal y riesgo nutricional de adultos mayores que se encontraban en centros gerontológicos de Guayaquil, Ecuador, en febrero de 2018. MÉTODOS: El análisis de riesgo nutricional se realizó a 479 personas a quienes se les aplicó la herramienta Nutrition Screening Initiative Checklist, mientras que el análisis de estado ponderal incluyó a 465 personas a través de la medición del índice de masa corporal (IMC). Las pruebas se realizaron en 3 centros gerontológicos. RESULTADOS: Un total de 77% hombres y 81% mujeres se encontraban en un estado de riesgo nutricional grave por sus hábitos alimenticios, y un 61% de hombres y 45% de mujeres presentaron un estado ponderal normal. CONCLUSIONES: Los adultos mayores de la ciudad de Guayaquil requieren más atención por parte de los distintos gestores encargados de su salud para reducir el estado de riesgo grave en el que se encuentran actualmente, esto también tendrá incidencia para mejorar el estado nutricional que, si bien se encuentra controlado, no deja de ser un posible problema en el futuro


BACKGROUND: Older adults require periodic evaluations to determine their health status. The objectives were to evaluate the weight status and nutritional risk of elderly people in gerontological centers located in Guayaquil, Ecuador, in February 2018. METHODS: For the nutritional risk analysis 479 people were used to whom the Nutrition Screening Initiative Checklist tool was applied, while for the weight status analysis 465 people were used through the measurement of body mass index (BMI), the tests They were carried out in 3 centers. RESULTS: A total of 77% men and 81% women are in serious risk from their eating habits, and 61% men and 45% women have a normal weight status. CONCLUSIONS: Elderly people in Guayaquil require more attention from different managers in charge of their health, to reduce the serious risk that they're currently facing, this will also have an incidence improving the weight status that, even though is controlled, it's a possible problem in the future


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Saúde do Idoso Institucionalizado , Pesos e Medidas Corporais/estatística & dados numéricos , Transtornos Nutricionais/epidemiologia , Avaliação Nutricional , Estado Nutricional , Obesidade/epidemiologia , Desnutrição/epidemiologia , Fatores de Risco , Equador/epidemiologia , Comportamento Alimentar/classificação , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Índice de Massa Corporal , Inquéritos Nutricionais/estatística & dados numéricos
9.
Arab J Gastroenterol ; 21(3): 179-182, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32798189

RESUMO

BACKGROUND AND STUDY AIM: The prevalence of nutritional disorders in Saudi children with inflammatory bowel diseases (IBDs) has been reported using the World Health Organization (WHO) reference. Our aim was to provide more accurate definition of the prevalence of nutritional impairment in Saudi children with IBDs based on the national growth reference and to demonstrate the effect of using a reference from other populations on the prevalence rates. PATIENTS AND METHODS: Weight, height, and body mass index data, from the multicenter study of IBDs in Saudi children and adolescents, were plotted on the new Saudi national growth reference. Statistical analyses included frequency calculations and z-test for proportions to investigate the significance of the difference in prevalence. A p-value of < 0.05 was considered significant. RESULTS: Among a total of 374 patients, 119 (32%) had ulcerative colitis (UC) and 255 (68%) had Crohn's disease (CD). Compared with the WHO reference, the Saudi national reference produced a significantly lower prevalence of thinness in patients with UC (24% vs. 8%, p = 0.001), CD (35% vs. 20%, p = 0.002), and of short stature in patients with CD (28% vs. 11%, p < 0.001). The difference in the prevalence of overweight was not significant. CONCLUSIONS: We provide more accurate prevalence estimate of nutritional disorders in Saudi children with IBDs based on national reference. The use of the WHO reference overestimated the prevalence of thinness and short stature in Saudi children. Prevalence estimates based on references from other populations should be interpreted with caution.


Assuntos
Doenças Inflamatórias Intestinais , Transtornos Nutricionais , Adolescente , Criança , Humanos , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/epidemiologia , Transtornos Nutricionais/complicações , Transtornos Nutricionais/epidemiologia , Prevalência , Arábia Saudita/epidemiologia , Magreza
10.
Am J Clin Nutr ; 112(3): 721-769, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32687145

RESUMO

BACKGROUND: The US faces remarkable food and nutrition challenges. A new federal effort to strengthen and coordinate nutrition research could rapidly generate the evidence base needed to address these multiple national challenges. However, the relevant characteristics of such an effort have been uncertain. OBJECTIVES: Our aim was to provide an objective, informative summary of 1) the mounting diet-related health burdens facing our nation and corresponding economic, health equity, national security, and sustainability implications; 2) the current federal nutrition research landscape and existing mechanisms for its coordination; 3) the opportunities for and potential impact of new fundamental, clinical, public health, food and agricultural, and translational scientific discoveries; and 4) the various options for further strengthening and coordinating federal nutrition research, including corresponding advantages, disadvantages, and potential executive and legislative considerations. METHODS: We reviewed government and other published documents on federal nutrition research; held various discussions with expert groups, advocacy organizations, and scientific societies; and held in-person or phone meetings with >50 federal staff in executive and legislative roles, as well as with a variety of other stakeholders in academic, industry, and nongovernment organizations. RESULTS: Stark national nutrition challenges were identified. More Americans are sick than are healthy, largely from rising diet-related illnesses. These conditions create tremendous strains on productivity, health care costs, health disparities, government budgets, US economic competitiveness, and military readiness. The coronavirus disease 2019 (COVID-19) outbreak has further laid bare these strains, including food insecurity, major diet-related comorbidities for poor outcomes from COVID-19 such as diabetes, hypertension, and obesity, and insufficient surveillance on and coordination of our food system. More than 10 federal departments and agencies currently invest in critical nutrition research, yet with relatively flat investments over several decades. Coordination also remains suboptimal, documented by multiple governmental reports over 50 years. Greater harmonization and expansion of federal investment in nutrition science, not a silo-ing or rearrangement of existing investments, has tremendous potential to generate new discoveries to improve and sustain the health of all Americans. Two identified key strategies to achieve this were as follows: 1) a new authority for robust cross-governmental coordination of nutrition research and other nutrition-related policy and 2) strengthened authority, investment, and coordination for nutrition research within the NIH. These strategies were found to be complementary, together catalyzing important new science, partnerships, coordination, and returns on investment. Additional complementary actions to accelerate federal nutrition research were identified at the USDA. CONCLUSIONS: The need and opportunities for strengthened federal nutrition research are clear, with specific identified options to help create the new leadership, strategic planning, coordination, and investment the nation requires to address the multiple nutrition-related challenges and grasp the opportunities before us.


Assuntos
Infecções por Coronavirus/complicações , Transtornos Nutricionais/complicações , Fenômenos Fisiológicos da Nutrição , Pneumonia Viral/complicações , Pesquisa/normas , COVID-19 , Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Disparidades em Assistência à Saúde/economia , Humanos , Militares , National Institutes of Health (U.S.)/economia , Transtornos Nutricionais/economia , Transtornos Nutricionais/epidemiologia , Pandemias , Estados Unidos/epidemiologia , United States Department of Agriculture/economia , United States Dept. of Health and Human Services/economia
11.
Curr Opin Clin Nutr Metab Care ; 23(4): 288-293, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32487876

RESUMO

PURPOSE OF REVIEW: The Covid-19 pandemic has daunted the world with its enormous impact on healthcare, economic recession, and psychological distress. Nutrition is an integral part of every person life care, and should also be mandatorily integrated to patient care under the Covid-19 pandemic. It is crucial to understand how the Covid-19 does develop and which risk factors are associated with negative outcomes and death. Therefore, it is of utmost importance to have studies that respect the basic tenets of the scientific method in order to be trusted. The goal of this review is to discuss the deluge of scientific data and how it might influence clinical reasoning and practice. RECENT FINDINGS: A large number of scientific manuscripts are daily published worldwide, and the Covid-19 makes no exception. Up to now, data on Covid-19 have come from countries initially affected by the disease and mostly pertain either epidemiological observations or opinion papers. Many of them do not fulfil the essential principles characterizing the adequate scientific method. SUMMARY: It is crucial to be able to critical appraise the scientific literature, in order to provide adequate nutrition therapy to patients, and in particular, to Covid-19 infected individuals.


Assuntos
Infecções por Coronavirus , Transtornos Nutricionais , Terapia Nutricional/normas , Fenômenos Fisiológicos da Nutrição , Pandemias , Pneumonia Viral , COVID-19 , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Humanos , Transtornos Nutricionais/epidemiologia , Transtornos Nutricionais/etiologia , Transtornos Nutricionais/terapia , Terapia Nutricional/métodos , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Fatores de Risco
12.
Arch Argent Pediatr ; 118(3): e271-e277, 2020 06.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32470264

RESUMO

Gastrointestinal, nutritional, metabolic, endocrine, and microbiota medical problems in pediatric patients diagnosed with autism spectrum disorder (ASD) are some of the coexisting medical conditions in ASD diagnosis. Their prevalence reaches more than 91 % for gastrointestinal problems, up to 89 % for nutritional and metabolic disorders, more than 50 % for thyroid dysfunction, and up to 100 % for microbiota-related conditions. There is an urgency for medical practice to be updated and to include the assessment, testing, diagnosis, and treatment of these coexisting medical conditions in ASD diagnosis in the pediatric, adolescent, and adult population. A strict management of such conditions results in positive changes in the quality of life and symptoms based on which ASD is diagnosed many times. It should be based on high-quality scientific evidence with an adequate medical care and control.


Assuntos
Transtorno do Espectro Autista/complicações , Doenças do Sistema Endócrino/etiologia , Gastroenteropatias/etiologia , Microbioma Gastrointestinal , Transtornos Nutricionais/etiologia , Transtorno do Espectro Autista/microbiologia , Doenças do Sistema Endócrino/diagnóstico , Doenças do Sistema Endócrino/epidemiologia , Doenças do Sistema Endócrino/terapia , Gastroenteropatias/diagnóstico , Gastroenteropatias/epidemiologia , Gastroenteropatias/terapia , Humanos , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/epidemiologia , Transtornos Nutricionais/terapia , Prevalência
13.
JNMA J Nepal Med Assoc ; 58(224): 230-233, 2020 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-32417859

RESUMO

INTRODUCTION: School health has been considered as a high priority intervention in developing countries but it has not been prioritized in Nepal. The objectives of the study are to find out the prevalence of morbidity and nutritional status in school children. METHODS: A descriptive cross-sectional study was conducted in a private school located at Panauti Municipality of Kavrepalanchowk district for one week of November 2019. A convenient sampling technique was used. From a selected school, a total number of 356 students studying from Grade I to X were included in the study using. Confidence Interval at 95% was calculated along with frequency and proportion for binary data using Statistical Package for Social Science (SPSS) software. RESULTS: Among 356 students, the most common three morbidities were dental caries 43 (18.1%), tonsillitis 26 (6.2 %), and headache 18 (7.1 %). Based on weight for age, 43 (23.9%) boys and 22 (12.5%)girls were underweight and 12 (6.7%) boys and 4 (2.7%) girls were overweight and 6 (2%) were obese. Thus school health programs should give more emphasis on oral health, nutrition, personal hygiene, etc. CONCLUSIONS: The health and nutritional status of school children in this study were found to be satisfactory compared to other studies. The present study emphasized oral health. The school health program is important in the school for the prevention of diseases like a parasitic infestation, improving personal hygiene, and nutritional status.


Assuntos
Saúde do Adolescente/estatística & dados numéricos , Saúde da Criança/estatística & dados numéricos , Transtornos Nutricionais/epidemiologia , Estado Nutricional , Saúde Bucal/estatística & dados numéricos , Adolescente , Criança , Transtornos da Nutrição Infantil/epidemiologia , Estudos Transversais , Cárie Dentária/epidemiologia , Inquéritos de Saúde Bucal , Feminino , Inquéritos Epidemiológicos , Humanos , Higiene , Masculino , Morbidade , Nepal/epidemiologia , Inquéritos Nutricionais , Prevalência , Instituições Acadêmicas/estatística & dados numéricos
14.
Asia Pac J Clin Nutr ; 29(1): 161-165, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32229455

RESUMO

BACKGROUND AND OBJECTIVES: A previous pilot study revealed stunted children and obese adults in urbanized settled Tibetan communities. A survey with a representative population in selected communities was conducted to test the preliminary findings. METHODS AND STUDY DESIGN: A cross-sectional study on the nutritional status involving 504 children (244 boys and 260 girls, 5-16 y) and 927 adults (422 men and 505 women, 18-90 y) was conducted in communities, with anthropometric parameters measured. The z-scores for height-for-age (HAZ) and BMI-for-age (BAZ) in children were calculated according to WHO 2007 reference. RESULTS: The children showed a double burden of both under- and over-nutrition. The prevalence of under-nutrition in children was high - stunting (HAZ <-2) 10.7%, underweight (BAZ <-2) 9.5%, combined prevalence of stunting and underweight 19.4%. The rate of over-nutrition was also alarming - obesity 12.7% (BAZ >2). The mean value of HAZ (- 0.45±1.41) was lower than, whereas that of BAZ (0.05±1.76) was comparable to, the WHO reference. No significant differences were found in under- or over-nutrition between genders. Specifically, 8.9% of children demonstrated both short stature (HAZ <-1) and overweight (BAZ >1). By contrast, community adults showed almost a one-way direction tilted towards over-nutrition - overweight 61.4% (BMI ≥24 kg/m2), obesity 30.1% (BMI ≥28 kg/m2), and central obesity 62.0% (waist circumference, men ≥85 cm, women ≥80 cm). Women were marginally more likely to be obese than men (p=0.061). CONCLUSIONS: The co-existence of under- and over-nutrition in the community may have reflected the suboptimal early life nutrition and the obesogenic environment afterwards. Potential determinants need to be explored for future interventions.


Assuntos
Transtornos Nutricionais/epidemiologia , Estado Nutricional/etnologia , Urbanização , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antropometria , Criança , Pré-Escolar , China/etnologia , Estudos Transversais , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Prevalência , Magreza/epidemiologia , Tibet/epidemiologia , Adulto Jovem
16.
Pan Afr Med J ; 35: 15, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32341736

RESUMO

Introduction: Malnutrition is a major risk factor of cardiovascular and metabolic diseases and therefore the importance of good dietary practices and balanced diet cannot be overemphasized. University students tend to have poor eating practices which is related to nutritional status. The objective of our study was to assess the dietary practices of medical students, determine the prevalence of malnutrition among medical students and factors associated with malnutrition. Methods: We carried out a cross-sectional study from December 2013 to March 2014 involving 203 consenting students in the Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I, Faculties of Health Sciences of the Universities of Bamenda and Buea. A three-part questionnaire (socio-demographic profile, eating practices, and anthropometric parameters). Data was analysed using SPSS 18.0. Frequencies and percentages were determined for categorical variables. Means and standard deviations (mean ± SD) were calculated for continuous variables. Fischer's exact test was used to compare the categorical variables. Statistical significance was set at p ≤ 0.05. Results: Males constituted 44.3% of respondents. The mean age was 20.8 ± 1.6yrs. Most students had a monthly allowance of less than 20 000frs (34 USD) and 59.1% lived alone. Most students (49.8%) reported taking two meals a day with breakfast being the most skipped meal while supper was the meal most consumed by students. Snacking was common among these students as 40.8% admitted consuming snacks daily. Daily intake of milk, fruits, vegetable and meat were low (6.2%, 4.3%, 20.0% and 21.3% respectively). The BMI status of students was associated with gender (p=0.026). Conclusion: Our findings showed a high prevalence of malnutrition of 29.4% based on BMI (underweight 4.9%, overweight 21.6% and obesity 3.0%) among second year medical students of these three state universities. Irregular meals, meal skipping, low fruit, vegetable and milk consumption, high candy, fried foods and alcohol intakes were found to be poor eating practices frequent among these students. Our findings therefore suggest the need for coordinated efforts to promote healthy eating habits among medical students in general and female medical students in particular (and by extension youths in general) as a means of curbing malnutrition among youths.


Assuntos
Comportamento Alimentar , Estado Nutricional , Estudantes de Medicina/estatística & dados numéricos , Adolescente , Adulto , Camarões/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Desnutrição/epidemiologia , Desnutrição/etiologia , Transtornos Nutricionais/epidemiologia , Transtornos Nutricionais/etiologia , Inquéritos Nutricionais , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Prevalência , Faculdades de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Magreza/epidemiologia , Universidades/estatística & dados numéricos , Adulto Jovem
17.
Artigo em Inglês | MEDLINE | ID: mdl-32168832

RESUMO

BACKGROUND: Multimorbidity not only affects the quality of patients' lives, but can also bring a heavy economic burden to individuals, families and society. The purpose of this study was to reveal the connections between diseases, especially the important role each disease played in the entire multimorbidity network. METHODS: A total of 1,155,734 inpatients were enrolled through multistage stratified random sampling in Jilin Province in 2017. Categorical variables were compared using the Rao-Scott-χ2 test. Weighted networks were adopted to present the complex relationships of multimorbidity. RESULTS: The distributions of the number of diseases differed significantly by gender, age and health insurance scheme (P < 0.001). Diseases of the respiratory system had the highest weight in multimorbidity in young people. Endocrine, nutritional and metabolic diseases and circulatory system diseases were often associated with other systemic diseases in middle aged and old people. CONCLUSIONS: Multimorbidity with respiratory system diseases in young people should not be overlooked. Additionally, effective prevention efforts that target endocrine, nutritional and metabolic diseases and circulatory system diseases are needed in middle aged and old people.


Assuntos
Multimorbidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Criança , Pré-Escolar , China/epidemiologia , Doença Crônica , Comorbidade , Estudos Transversais , Doenças do Sistema Endócrino/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Doenças Metabólicas/epidemiologia , Pessoa de Meia-Idade , Transtornos Nutricionais/epidemiologia , Gravidez , Prevalência , Adulto Jovem
19.
Minerva Anestesiol ; 86(5): 527-536, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32000472

RESUMO

BACKGROUND: Adequate nutrition support during intensive care has several benefits including lower amount of infectious complications, improved wound healing, shorter length of stay (LOS) and decreased morbidity. The aim of the present study was to survey the adequacy of nutrition throughout Intensive Care Unit (ICU) stay and to examine various factors associated to cumulative nutrition inadequacy during ICU stay. METHODS: The study was a retrospective single center cohort study. The study population consisted of 1771 ICU adult (≥18 years) patients with emergency admission to ICU who had LOS between three and 40 days. Nutrition adequacy and factors associated to inadequate nutrition support during ICU stay were analyzed. RESULTS: Factors related to impaired energy balance were prescribed energy less than 25kcal/kg (OR 11.794 (9.017-15.427), P<0.001) and higher median CRP (OR 1.003 (1.001-1.004), P<0.001). Factors related to improved energy balance were length of stay (OR 0.975 (0.953-0.997), P=0.024), more than 30% Bolus enteral nutrition days (OR 0.314 (0.187-0.526), P<0.001) and Enteral/Parenteral -Ratio (OR 0.970 (0.953-0.987), P=0.001). CONCLUSIONS: The majority of ICU patients did not reach 60% of nutrition adequacy. Nutrition inadequacy was a common finding throughout the study population. Nutrition inadequacy might be partially avoidable since adequacy less than 60% was related to underprescription and failure to administer the prescribed nutrition. Bolus enteral nutrition might be an efficient method to deliver energy in ICU setting.


Assuntos
Cuidados Críticos , Estado Terminal , Transtornos Nutricionais , Adulto , Causalidade , Estudos de Coortes , Humanos , Incidência , Unidades de Terapia Intensiva , Tempo de Internação , Transtornos Nutricionais/epidemiologia , Apoio Nutricional , Estudos Retrospectivos
20.
J. negat. no posit. results ; 5(2): 189-201, feb. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194008

RESUMO

FUNDAMENTO: El cribado de riesgo nutricional permite detectar el riesgo de desnutrición desde su inicio y antes de su manifestación clínica. OBJETIVO: Evidenciar la utilidad del CONUT en el cribado nutricional al ingreso en un hospital de media-larga estancia. MÉTODOS: Se realizaron dos estudios longitudinales (2014n=121-2018n=155), utilizando CONUT para detectar precozmente el riesgo de desnutrición y evaluar la eficacia de la intervención nutricional. Las variables respuesta fueron el tipo y grado de desnutrición al ingreso y al alta. RESULTADOS: La prevalencia de desnutrición/riesgo nutricional detectada con CONUT al ingreso fue de 85,9%. Con la Valoración Nutricional Completa (VNC), la prevalencia de desnutrición al ingreso fue del 81,0% (5% desnutrición calórica, 17,4% mixta y 58,7% proteica). Un 5% de los pacientes en riesgo detectados mediante CONUT, todavía no podían ser diagnosticados mediante la VNC. Los valores al alta fueron 5% desnutrición calórica, 7,7% mixta y 36,4% proteica. CONUT permitió identificar y seguir la evolución del paciente desnutrido con mayor sensibilidad que los parámetros antropométricos. La intervención nutricional redujo la prevalencia y severidad de la desnutrición, mejorando fundamentalmente a expensas de corregir la desnutrición proteica. Los pacientes desnutridos presentaron mayor número de categorías diagnósticas. Se observaron diferencias significativas entre los perfiles nutricionales de las patologías más prevalentes. CONCLUSIONES: CONUT permitió automatizar eficientemente el cribado nutricional. La aplicación de un protocolo estructurado para la detección, monitorización y tratamiento de la desnutrición permitió identificar pacientes subsidiarios de beneficiarse del soporte nutricional, lo que se reflejó en una mejora del estado nutricional al alta


BACKGROUND: Nutritional risk screening enables the risk of malnutrition to be detected from its beginning and before its clinical expression. OBJECTIVE: To demonstrate the usefulness of CONUT in nutritional screening at admission to a medium-to-long stay hospital. METHODS: Two longitudinal studies (2014n=121-2018n=155) were conducted using CONUT for the early detection of the risk of malnutrition and to evaluate the efficacy of the nutritional intervention. The response variables were the type and degree of malnutrition at admission and discharge. RESULTS: The prevalence of malnutrition/nutritional risk detected with CONUT at admission was 85.9%. With the Comprehensive Nutritional Assessment (CNA), the prevalence of malnutrition at admission was 81.0% (caloric malnutrition 5%, mixed malnutrition 17.4%, and protein malnutrition 58.7%). 5% of the patients at risk detected by CONUT still could not be diagnosed by the CNA. The values at discharge were caloric malnutrition 5%, mixed malnutrition 7.7%, and protein malnutrition 36.4%. CONUT enabled the evolution of the malnourished patient to be identified and followed up with greater sensitivity when compared to the anthropometric parameters. Nutritional intervention reduced the prevalence and severity of malnutrition, essentially improving it upon protein malnutrition correction. Malnourished patients showed a greater number of diagnostic categories. Significant differences were observed among the nutritional profiles of the most prevalent diseases. CONCLUSIONS: CONUT enabled nutritional screening to be efficiently automated. The application of a structured protocol for the detection, monitoring and treatment of malnutrition made it possible to identify subsidiary patients to benefit from nutritional support, which was reflected in an improvement in nutritional status at discharge


Assuntos
Humanos , Avaliação Nutricional , Estado Nutricional/fisiologia , Transtornos Nutricionais/diagnóstico , Desnutrição/diagnóstico , Testes Diagnósticos de Rotina/métodos , Transtornos Nutricionais/epidemiologia , Desnutrição/epidemiologia , Fatores de Risco , Hospitalização/estatística & dados numéricos , Serviço Hospitalar de Admissão de Pacientes/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos
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