A comparison of the different anthropometric indices for assessing malnutrition among older people in Turkey: a large population-based screening.

OBJECTIVE: Due to an increase in aging worldwide, assessment of the nutritional status of older people becomes an important matter. Malnutrition in older people increases the risk of infections, disease period and hospitalization rates. This study aimed to compare the different anthropometric indices for detecting malnutrition among older people and comparing these indices among males and females to explain the possible differences. METHODS: In this cross-sectional study, 2721 aged 65 years and older in Turkey were enrolled. Anthropometric measurements weight, height, hip circumference (HC), and waist circumference (WC), abdominal circumference (AC), mid-upper arm circumference (MUAC), triceps skinfold thickness (TST), calf circumference (CC)) were measured. Body mass index (BMI), abdominal volume index (AVI), body roundness index (BRI) and body adiposity index (BAI), and waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) indices were calculated using standardized formulas. The receiver operator characteristic curves (ROCs) were conducted in detecting the best anthropometric parameters. Adjusted odds ratios (OR) (stratified by sex) calculated for each anthropometric index. RESULTS: Participants with both BMI < 18.5 (1.1%) and BMI > 25 (80%) defined as the malnourished group and BMI of 18.5-24.99 (18.9%) defined as the normal group. In both sexes, the area under the curve (AUC) was > 0.7 for all anthropometric indices except WHR in females (AUC 0.66). BRI, WHR, WHtR, and AVI indices strongly predict the risk of malnutrition among both sexes. In males, the ORs were for BRI (6.83, 95% CI 5.39-8.66), WHR (6.43, 95% CI 5.9-6.9), AVI (2.02, 95% CI 1.86-2.12). In females, the ORs were for BRI (3.72, 95% CI 3.09-4.48), WtHR (2.63, 95% CI 1.3-3.5), and WHR (2.45, 95% CI 1.9-3.06). DISCUSSION: The presence of a large AUC in almost all anthropometric indices suggests that they can be used to assess the risk of malnutrition among older persons in both sexes.

Food intake, plate waste and its association with malnutrition in hospitalized patients.

BACKGROUND: Hospital malnutrition is a worldwide dilemma and challenge. High levels of plate waste contribute to malnutrition-related complications in hospital. We investigated the association between the levels of plate waste, food intake and patient satisfaction with nutritional risk and malnutrition prevalence in three hospital settings. METHODS: The sample population of 120 patients, aged 18-65 year, admitted consecutively over a 12 month period to 3 different educational university hospitals was included. For all the patients, diet history, anthropometric measurements, body mass index and patient satisfaction with the hospital food service was evaluated. Weight plate waste for all daily meals was done and actual intakes computed individually for each day. Nutrition risk screening (NRS)-2002 (≥ 3) tool was used for estimating the nutritionally at-risk population. Results: From one hundred twenty non-critically ill patients with a mean 8.9 ± 3.5 day length of hospital stay, 40.8% (49) were men and 59.2% (71) were female. Mean energy and protein requirements were 2,030.3 ± 409.03 kcal/day and 76.13 ± 15.33 g/day respectively. Mean intakes were 1,326 ± 681.44 kcal/day and 66.81 ± 31.66 g/day respectively. The mean percent of plate waste for lunch and dinner were 37.7 ± 29.88 and 30.4 ± 23.61 respectively. In the total population, 25% of patients were satisfied and 75% patients were unsatisfied with hospital foods. Based on BMI (< 20), unintentional weight loss (> 10%), malnutrition prevalence was 12.5% and 14.2% respectively during hospitalization. The prevalence of nutritionally at-risk population was 30% at admission time and reached 33.3% at discharge. CONCLUSION: Plate waste and hospital malnutrition were highly prevalent in accompanying with increasing nutritionally risk progression. So it should be addressed as an important health issue and appropriate strategies for stimulating governmental policies should be adopted.

Food intake, plate waste and its association with malnutrition in hospitalized patients / Ingesta y desperdicio de alimentos y su asociación con la desnutrición hospitalaria

Background: Hospital malnutrition is a worldwide dilemma and challenge. High levels of plate waste contribute to malnutrition-related complications in hospital. We investigated the association between the levels of plate waste, food intake and patient satisfaction with nutritional risk and malnutrition prevalence in three hospital settings. Methods: The sample population of 120 patients, aged 18-65 year, admitted consecutively over a 12 month period to 3 different educational university hospitals was included. For all the patients, diet history, anthropometric measurements, body mass index and patient satisfaction with the hospital food service was evaluated. Weight plate waste for all daily meals was done and actual intakes computed individually for each day. Nutrition risk screening (NRS)-2002 (≥ 3) tool was used for estimating the nutritionally at-risk population. Results: From one hundred twenty non-critically ill patients with a mean 8.9 ± 3.5 day length of hospital stay, 40.8% (49) were men and 59.2% (71) were female. Mean energy and protein requirements were 2,030.3 ± 409.03 kcal/day and 76.13 ± 15.33 g/day respectively. Mean intakes were 1,326 ± 681.44 kcal/day and 66.81 ± 31.66 g/day respectively. The mean percent of plate waste for lunch and dinner were 37.7 ± 29.88 and 30.4 ± 23.61 respectively. In the total population, 25% of patients were satisfied and 75% patients were unsatisfied with hospital foods. Based on BMI (< 20), unintentional weight loss (> 10%), malnutrition prevalence was 12.5% and 14.2% respectively during hospitalization. The prevalence of nutritionally at-risk population was 30% at admission time and reached 33.3% at discharge. Conclusion: Plate waste and hospital malnutrition were highly prevalent in accompanying with increasing nutritionally risk progression. So it should be addressed as an important health issue and appropriate strategies for stimulating governmental policies should be adopted (AU)

Introducción: la desnutrición hospitalaria constituye a la vez un problema y un reto. Una cantidad grande de desperdicio en el menú hospitalario se correlaciona con mayor incidencia de complicaciones asociadas a la desnutrición. Se evalúa en este trabajo la asociación entre la cantidad de comida desechada, el consumo real y la satisfacción de los pacientes con la prevalencia de desnutrición y de riesgo nutricional en tres hospitales iraníes. Métodos: se evaluó una muestra de 120 pacientes, de 18 a 65 años, ingresados a lo largo de 12 meses en tres hospitales universitarios de distinto nivel. Se recogieron datos de la historia dietética, las medidas antropométricas, el índice de masa corporal y el grado de satisfacción de los pacientes con el menú servido. Se pesó el desperdicio de las bandejas de alimentación y la ingesta diaria de cada paciente. El riesgo nutricional se evaluó mediante la herramienta NRS-2000, estimando el riesgo cuando la puntuación era ≥ 3. Resultados: se incluyeron 120 pacientes no críticos, con una duración media de hospitalización de 8,9 ± 3,5 días. El 40,8% (49) eran varones. Los requerimientos energéticos medios eran 2.030,3 ± 409,03 kcal/día y los proteicos de 76,13 ± 15,33 g/día. La ingesta media fue de 1.326 ± 681,44 kcal/día y la proteica de 66,81 ± 31,66 g/día. Se desperdició en la comida y en la cena una media del 37,7 ± 29,88 y 30,4 ± 23,61 respectivamente. Solo un 25% de los pacientes estaban satisfechos con la dieta. Un 12,5% de los pacientes tenían un IMC < 20 y un 14,2% una pérdida no intencionada de peso > 10%. La prevalencia de riesgo nutricional era del 30% al ingreso y del 33,3% al alta. Conclusión: el desperdicio de la comida en el hospital y la desnutrición hospitalaria tienen una alta prevalencia en la muestra estudiada, que se acompañaban de un mayor riesgo nutricional. Las administraciones públicas deberían abordar este problema y desarrollar estrategias de prevención adecuadas (AU)

Prevalence of overweight and obesity in Turkish adults.

The aims of this study were to assess the prevalence and patterns of adult overweight and obesity in Turkey and discuss the impact of socio-environmental factors. A cross-sectional nationwide survey was carried out on 2100 adults (1050 males and 1050 females) aged 18 to 65 years from 7 geographic regions of Turkey. Data on height and weight were measured according to the Anthropometric Standardization Reference Manual and a questionnaire was applied to access the socio-economic status. The body mass index (BMI) (kg/m2), overweight and obesity were calculated, and percentiles were developed by LMS method. Mean BMI was 26.24 for males and 28.02 for females. Results showed that obesity was more pronounced among females (34.19%) than among males (20%). Logistic regression analysis revealed that older age and education level among females, and older age and occupational status among males have impact on obesity. Comparison of the present results with former nationwide studies conducted in Turkey showed that height and weight for both sexes have increased with the improved socio-economic conditions. In addition, increased weight and BMI needed to be monitored particularly for females in terms of acute health problems.