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PubMed2005

Non-nutritive sucking for promoting physiologic stability and nutrition in preterm infants.

BACKGROUND: Non-nutritive sucking is used during gavage feeding and in the transition from gavage to breast/bottle feeding in preterm infants. The rationale for this intervention is that non-nutritive sucking facilitates the development of sucking behaviour and improves digestion of enteral feedings. Non-nutritive sucking has been considered to be a benign intervention, although it has the potential to have a negative effect on breastfeeding or on the incidence of later oral aversion. OBJECTIVES: To determine whether non-nutritive sucking (NNS) in preterm infants influences: a) weight gain, b) energy intake, c) heart rate, d) oxygen saturation, e) length of hospital stay, f) intestinal transit time, g) age at full oral feeds, or h) any other clinically relevant outcomes. SEARCH STRATEGY: MEDLINE and CINAHL databases back to 1976 and The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2005) were searched. The EMBASE database was added to the search strategy for 2005. Reference lists/bibliographies of relevant articles and reviews were also searched. A comprehensive list of relevant articles was sent to two major authors in this area. They were asked if they knew of any other published or unpublished studies relevant to the area that had not been included in the original list. SELECTION CRITERIA: All trials utilizing experimental or quasi-experimental designs in which non-nutritive sucking in preterm infants was compared to no provision of non-nutritive sucking. Measured clinically relevant outcomes. Reports were in English or a language for which a translator was available.Computerized searches were conducted by both reviewers. All potentially relevant titles and abstracts identified by either reviewer were extracted. All retrieved articles were assessed for relevance independently by each reviewer, based on a pre-determined set of criteria. The reference lists/bibliographies of each article were reviewed independently for additional relevant titles and were also retrieved and assessed for relevance. Articles that met all relevance criteria were then assessed for methodologic quality based on a predetermined set of criteria. Those articles judged to have the appropriate quality by both reviewers were included in the analysis. DATA COLLECTION AND ANALYSIS: Data were extracted independently by the two authors. No subgroup analyses were performed because of the small number of studies related to the relevant outcomes. MAIN RESULTS: This review consisted of 21 studies, 15 of which were randomized controlled trials. NNS was found to decrease significantly the length of hospital stay in preterm infants. The review did not reveal a consistent benefit of NNS with respect to other major clinical variables (weight gain, energy intake, heart rate, oxygen saturation, intestinal transit time, age at full oral feeds and behavioral state). The review identified other positive clinical outcomes of NNS: transition from tube to bottle feeds and better bottle feeding performance. No negative outcomes were reported in any of the studies. AUTHORS' CONCLUSIONS: This review found a significant decrease in length of stay in preterm infants receiving a NNS intervention. The review did not reveal a consistent benefit of NNS with respect to other major clinical variables (weight gain, energy intake, heart rate, oxygen saturation, intestinal transit time, age at full oral feeds and behavioral state). The review identified other positive clinical outcomes of NNS: transition from tube to bottle feeds and better bottle feeding performance. No negative outcomes were reported in any of the studies. There were also a number of limitations of the presently available evidence related to the design of the studies, outcome variability, and lack of long-term data. Based on the available evidence, NNS in preterm infants would appear to have some clinical benefit. It does not appear to have any short-term negative effects. In view of the fact that there are no long-term data, further investigations are recommended. In order to facilitate meta-analysis of these data, future research in this area should involve outcome measures consistent with those used in previous studies. In addition, published reports should include all relevant data.

Humans↗
PubMed1985

Nutrition and somatomedin. XIII. Usefulness of somatomedin-C in nutritional assessment.

Malnutrition is common in hospitalized patients, but current measures of nutritional status are limited. Because levels of somatomedins are regulated by nutrition, the utility of somatomedin-C measurement in nutritional assessment was studied. Thirty-seven malnourished patients had measurement of somatomedin-C and conventional nutritional indexes. In 28 patients seen before therapy, the somatomedin-C level was reduced (38 percent of normal) and was lower than the albumin level (66 percent, p less than 0.01), transferrin level (59 percent, p less than 0.05), and lymphocyte count (43 percent, p = NS). Somatomedin-C level was lowest with combined "kwashiorkor-marasmus" (25 percent of normal) and also reduced with "kwashiorkor" (51 percent) or "marasmus" (57 percent) alone. Somatomedin-C was correlated with albumin, transferrin, and lymphocyte count (p less than 0.02 for each). In six patients given nutritional therapy, somatomedin-C levels rose by more than 70 percent in each (mean increase 181 percent), whereas lymphocyte counts rose in four (increase 78 percent for all patients), transferrin levels rose in four (increase 33 percent), and albumin levels rose in one (-6 percent). In 20 patients with detailed dietary analysis, only somatomedin-C was correlated with intake of protein and calories (p less than 0.005 for each). Somatomedin-C may be a sensitive marker of malnutrition and the response to nutritional therapy.

Adult↗
PubMed2005

Does nutritional risk, as assessed by Nutritional Risk Index, increase during hospital stay? A multinational population-based study.

BACKGROUND: Progressive nutritional depletion has been reported during hospital stay. This prospective study compared the proportion of nutritional risk at hospital admission in three European countries and further evaluated nutritional risk at late versus early phase of hospitalization in one hospital. METHODS: Nutritional risk was determined in Geneva, Switzerland (n = 652), Berlin, Germany (n = 621) and Nice, France (n = 107) at hospital admission, and during hospital stay (0-100 d) in Nice (n = 527) by the Nutritional Risk Index (NRI) = (1.519 x serum albumin, g/l)+41.7 x (present weight/usual weight). NRI score of >100: no risk (NR); 97.5-100: mild risk; 83.5-97.5: moderate risk (MR); 83.5: severe risk (SR). Logistic regressions were used to determine the odds ratios (OR) between MR or SR and length of hospital stay (LOS) 16d compared to 1-15 d or nutritional assessment at 16-100 d compared to 1-15 d of hospitalization. RESULTS: Patients, assessed at hospital admission, who were hospitalized >16d were more likely (P < 0.001) to be at MR (OR 2.0, CI 1.4-3.0) or SR (OR 3.3, CI 1.7-6.2) than patients hospitalized 1-15 d. Nice patients assessed at 16-100 d were more likely (P < 0.001) to be at MR (OR 5.4, CI 2.1-14.3) and SR (OR 14.7, CI 5.4-40.0) than patients assessed at 1-15 d of hospitalization. CONCLUSIONS: The risk of MR or SR by NRI was greater in patients assessed during hospitalization than in patients assessed at hospital admission, which suggests that patients evaluated later during hospitalization are at greater risk than patients evaluated in the early phase of hospitalization. Ongoing assessment during hospitalization seems important to identify patients who are at increased risk for complications.

Analysis of Variance↗
PubMed2004

Intercollegiate student athlete use of nutritional supplements and the role of athletic trainers and dietitians in nutrition counseling.

A survey of university student athletes was conducted to determine supplement use, perceived efficacy of supplements, availability and use of nutrition services, and perceived nutrition knowledge of athletic trainers. Results from 236 athletes showed that 88% used one or more nutritional supplements, yet perceived efficacy was moderate (2.9 or less; 5-point scale). Classes (69.4%), brochures (75%), and individual counseling (47%) were available and were used by 29.9%, 33.2%, and 17.9% of athletes, respectively. Primary sources of nutrition information were athletic trainers (39.8%), strength and conditioning coaches (23.7%), and dietitians (14.4%). Athletes perceived athletic trainers to have strong nutrition knowledge (mean=3.8+/-0.9; 5-point scale). Many (23.5%) did not know whether a dietitian was available. Dietitians must accelerate their marketing efforts to student athletes, work closely with athletic trainers to provide sound nutrition information, and provide services that meet the needs of a diverse population of student athletes.

Adolescent↗
PubMedDate not supplied

Diabetes Nutrition and Complications Trial: adherence to the ADA nutritional recommendations, targets of metabolic control, and onset of diabetes complications. A 7-year, prospective, population-based, observational multicenter study.

OBJECTIVE: To know the adherence to the ADA nutritional recommendations and its relation to targets of metabolic control and onset of diabetic complications in a sample of diabetic people in Spain. RESEARCH DESIGN AND METHODS: The Diabetes Nutrition and Complications Trial (DNCT) is a prospective, population-based, observational multicenter study designed to know the nutritional pattern, based on the 7-day food diaries, of a population with long-standing diabetes mellitus (93/99 type 1/type 2 diabetic patients, 20/18 years of duration of diabetes, and 6.9%/6.4% HbA(1c) values) and its relation with the onset of microvascular and macrovascular diabetes complications between 1993 and 2000. RESULTS: After a median follow-up period of 6.5 years, more than 55% of diabetic people complied with the recommendation of protein intake between 15% and 20%, but only 27% consumed less than 10% of saturated fatty acids (SFAs), the 13% achieved up 10% of polyunsaturated fatty acids (PUFAs) intake, the 39% consumed more than 60% from carbohydrate and monounsaturated fatty acids (MUFAs), and the 30% consumed <300 mg/day of cholesterol. In spite of these, more than 90% had an optimal HDL cholesterol and non-HDL cholesterol level, and triglycerides level, while less than 41% of diabetic people had an HbA(1c) value >7.5%. Moreover, more than 69% consumed a MUFAs-to-SFAs ratio >1.5 and the 46% a PUFAs-to-SFAs ratio >0.4. Nonadherence to nutritional recommendation, but MUFAs/SFAs ratio >1.5 and PUFAs/SFAs ratio >0.4, was associated with a reduction between 3.4- and 8.2-fold in the risk of onset of diabetic complications. CONCLUSIONS: The adherence to ADA nutritional recommendations for people with diabetes in Spain is rather poor except for the protein consumption. Only PUFAs/SFAs >0.4 and MUFAs/SFAs>1.5 were associated to near-optimal targets of metabolic control and a reduction in the risk of the onset of diabetic complications. These data suggest that other nutritional recommendations should be taken in mind.

Adult↗
PubMed2003

The effect of unselected post-operative nutritional supplementation on nutritional status and clinical outcome of orthopaedic patients.

BACKGROUND AND AIMS: Nutritional supplements are widely administered in hospitals and can benefit clinical outcome. The aim here was to determine the effect of routine post-operative nutritional supplementation on the nutritional status and clinical outcome of adult orthopaedic patients. METHODS: A prospective controlled study was conducted on two adult orthopaedic wards. Patients in the study group were prescribed two nutritional supplements/day post-operatively. Nutritional and biochemical indices and incidence of clinical complications were observed. RESULTS: Of 181 patients studied, 14 in the supplemented group and 34 in the control (P=0.005) developed major complications. There were 22 occurrences of major complications in the supplemented group and 55 in the control (P=0.0002). There was no significant difference in the number of minor complications between the two groups (P=0.2). There was no statistical difference in changes in nutritional parameters or in albumin or CRP between the two groups. There were significantly greater reductions in transferrin (P=0.002) and in haemoglobin (P=0.002) in the control group at week 1. The median costs of hospital stay were 2068 UK pounds in the supplemented group and 2199 UK pounds in the control. The median cost of additional treatments was 30.16 UK pounds in the supplemented group and 46.23 UK pounds in the control. CONCLUSION: A significant reduction in major complications and in number and costs of additional treatments was seen in the supplemented group.

Adult↗
PubMed2000

The development of "Nutrition in Medicine" interactive CD-ROM programs for medical nutrition education.

In 1995 and in 1998 the University of North Carolina at Chapel Hill received R25 grant support to create interactive CD-ROMs for teaching nutrition and nutritional biochemistry to medical students, the Nutrition In Medicine (NIM) series. Seven of the proposed ten titles have been created. Three series (Disease, Lifecycle, and Special Topics in Nutrition) teach nutrition concepts using computer-aided instruction (CAI) with emphasis on interactive learning. Patient cases with television-quality interactive videos allow students to apply nutrition knowledge to clinical problems. Pop quizzes, text-based interactions, and multiple-choice examinations help the student self-evaluate progress via immediate feedback. Educators using the programs get instructional support and updates through a dedicated Web site, printed material, telephone support, e-mail, and CD-ROM-based computer programs. Implementation at medical and osteopathic schools is continuously surveyed through questionnaires and follow-up telephone interviews. By 1999, 120 of 137 eligible U.S. medical schools owned copies of NIM CAI programs, of which 76 indicated that they were currently implementing the programs.

CD-ROM↗
PubMed1983

An innovation in nutrition education: development of a national nutrition test-item bank.

A NNTIB prototype has been developed and implemented at the University of Alabama in Birmingham School of Medicine. The further development of the Bank as a shared national resource was considered at a workshop carried out in conjunction with the 1983 ASCN meeting. Through this forum it was confirmed that the concept of a NNTIB is both valid and viable, receiving the support of a variety of nutrition educators and the endorsement of the ASCN Committee on Nutrition Education. The general recommendations of the workshop participants were that a modification of the test-item bank prototype be used as the model for the development of a national bank. A key recommendation was the development of a committee to oversee the acceptance and review of test items included in the NNTIB. Recognizing that the major constraints in the development of a national bank are likely to be logistical, mechanical, and fiscal, it is our belief that each of the limitations could be overcome if the Bank were adopted by a parent society with a long-term commitment to its continued support and development. After such support has been identified and pilot trials have been carried out, the implications of the NNTIB for advances in the field of nutrition go well beyond improved quality of testing materials and extend into the critical area of the establishment of standards of nutrition education and certification of competency. The development of the NNTIB offers a challenge to nutrition educators, national nutrition organizations, and interested governmental agencies for their involvement and support.

Congresses as Topic↗
PubMed2003

Understanding nutrition communication between health professionals and consumers: development of a model for nutrition awareness based on qualitative consumer research.

BACKGROUND: Consumers have been exposed to nutrition information from a variety of sources, including the family doctor. They are often not aware of their own risk behavior regarding nutrition. OBJECTIVE: This study sought to assess food associations, conversation topics, interest in food topics, and use of information sources by means of qualitative consumer research. Another aim was to provide a hypothetical model for nutrition awareness that could be tested in a quantitative survey. DESIGN: Three focus groups with 30 Dutch consumers altogether were carried out. Qualitative data were analyzed with the computer software program NUD*IST (QSR, Melbourne) by sorting text blocks into categories, and new themes emerged. In addition, a hypothetical model for nutrition awareness was developed. RESULTS: Consumers associated food most often with safe food, and food safety was the topic most often discussed. Tasty food was the most important food conversation topic. The family doctor was the information source most talked about. Furthermore, consumers possibly lacked some nutrition awareness. CONCLUSIONS: Careful analysis revealed new themes (new in the past 10 y), such as concerns about food safety and reconsideration of the roles of family doctors and dietitians. Based on these themes, recommendations for nutrition communication were composed.

Adolescent↗
PubMed1991

Improvement of nutritional status in cholestatic children with supplemental nocturnal enteral nutrition.

Protein energy malnutrition is a common complication in cholestatic children in a hepatic transplant program, and may be detrimental to the postoperative outcome. Improvement of the nutritional status may be of obvious importance to improve the prognosis. This study compared oral nutrition with oral nutrition supplemented with nocturnal enteral feeding in children with prolonged cholestasis. In six children with prolonged cholestasis (conjugated bilirubin over 25 mg/L and/or GGT over 110 IU/L in infants aged less than 3 months or over 50 IU/L in older infants and/or alkaline phosphatase over 500 IU/L, for more than 3 months), we compared a 4 to 6 month period with oral nutrition and similar periods with 10 to 12 h nocturnal enteral feeding given at home as an energetic supplement. Energy intake during the second period was 180-200% of recommended dietary allowances. No ascites was found in the six patients during the study period. The Z scores of body weight, weight expressed as percent of ideal body weight (IBW), weight/height2, and arm circumference/head circumference were calculated at the beginning and at the end of each period. With only oral nutrition, a diminution in percentage of ideal W/H and a diminution in Z score for the body weight were observed in five of six patients. At the end of the second period, the average of all of the nutritional indexes was increased and the Z score for the body weight was also increased in four of six patients. Significant statistical differences (p less than 0.05) were found in W as percentage of IBW and the Z score for log W/H2.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1993

Alternative ways of facilitating nutritional support without a nutrition support team.

In the absence of a formal nutritional support team, a group of physicians, pharmacists, dietitians, and nurses at the authors' institution organized to devise alternative ways to facilitate nutritional support. The efforts of this group led to the redesign of the Pharmacy Department's parenteral nutrition order form into a clinical tool for the prescribing physician, and the development of a system for daily patient monitoring by dietitians and pharmacists for patients receiving specialized nutritional products. The delivery of parenteral nutrition was also streamlined to coordinate with the daily patient monitoring. A future goal is to increase three-way communication and teamwork among the physicians, dietitians, and pharmacists. These methods may be practical alternatives to facilitating nutritional support without the benefit of a support team.

Clinical Pharmacy Information Systems↗
PubMedDate not supplied

Nutrition services in State and local public health agencies. Special supplement: revision of the 1955 guide by the Nutrition Services Project Committee.

The contribution of nutrition in preventing disease, prolonging life, and promoting health through organized community effort is well recognized. While many gains have been made in public health nutrition, it is clear that the American population continues to exhibit nutrition problems. Rene Dubos has said that no community will find it possible to deal simultaneously with all of the health problems inherited from the past and with those brought about by modernization and change. The challenge lies in determining priorities and making difficult choices in the face of shifting responsibilities among levels of government, reduced resources, and increased competition. The purpose of this guide is to help public health officials appreciate the important role nutrition services play in meeting the health needs of their communities. The recommendations for nutrition programs are sensitive to the social, economic, and political forces that are shaping the future of public health. How well public health officials meet the challenge of providing nutrition services in their communities will be a significant factor influencing the health status of the American population in the 1980s and beyond.

Cost-Benefit Analysis↗
PubMedDate not supplied

[Home and ambulatory artificial nutrition. Enteral nutrition. The NADYA Group].

Home enteral nutrition is, at present, a therapeutic alternative which can be applied to a great number of patients who only require hospitalization for the nutritional treatment, thus improving their quality of life and reducing costs. The experience in this field is great in other countries, and we believe its use is growing in Spain. To better understand this situation, the data of 589 patients from 25 hospitals of the entire national territory, have been evaluated. When analyzing the diseases which led to the instigation of enteral nutrition, the most frequent causes were found to be neurological afflictions and tumoral processes. At the time of establishing the indication, only 50% of the patients were undergoing curative therapy. The nasogastric tube was used in the majority of cases (69%), even during prolonged periods of time. The formula of enteral nutrition which was most used was the standard, possibly due to the difficulty of acquiring other types of formulas when this is not specifically indicated. The formula is frequently administered by syringe (44%) and by bolus (41%). The cost of the formula and the necessary infusion material, was mainly carried by the referring hospital. The complications registered were rare (0.18 episodes/patient) and of a slight character, of gastrointestinal of mechanical origin, which could be resolved in the home. The follow up of the patient was done in similar percentages by the Departments of Nutrition, by the at home hospitalization teams, and, in a coordinated way, between Nutrition and Primary Attention. 23 % of the patients finished the treatment due to improvement, 20 % died, and 15 % continued treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Home and ambulatory artificial nutrition. Parenteral nutrition. The NADYA Group].

In recent years and increase in the use of parenteral nutrition in the home, as an alternative to covering the nutritional needs of patients incapable of covering them orally or enterally and who do not require hospitalization, is being seen. The number of patients undergoing treatment with, or as candidates for, this specialized nutritional support in Spain, is unknown. The data of 39 patients from 10 therapeutic teams at the national level, have been collected and evaluated. With an average age of 42 years, 54% were male. The pathology which most frequently indicated a need for at home parenteral nutrition was mesenteric thrombosis, followed by intestinal inflammatory disease (24 and 18%). The indication was definite in 54% of the cases. The blood vessel most frequently accessed was the subclavian (73%), preferently using tunneled catheters of the Hickman type (53%), and scarcely using the implanted type (6%). Practically all patients receive individualized formulas, adapted to their nutritional needs. The infusion is nocturnal in 65% of the cases, and only 58% of the cases use an infusion pump. IN the majority of cases, the supply of the formulas as well as the infusion material, is taken on entirely by the reference hospital which also takes care of the follow up of the patient. An adequate network of distribution which enables the patient to access this material in his usual environment, is not available. An improvement in quality of life and nutritional state is seen in the evaluated patients, of which 41% finished treatment (transitory indications), 23% had died, and the rest continued treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Nutritional status and food security: winter nutrition monitoring in Sarajevo 1993-1994.

OBJECTIVE: To monitor nutritional status and food security throughout the winter of 1993-1994 in order to provide early warning of any deterioration, identify the nutritionally vulnerable and so enable humanitarian agencies to respond appropriately. DESIGN: Four different household groups were prospectively followed: residents, refugees in collective centres, refugees in private accommodation and elderly living alone (either residents or refugees). Four local communities were purposively selected and two collective centres were randomly selected. Households were randomly selected within each community and collective centre. An additional sample of all elderly inhabitants of the old people's home were nutritionally assessed only. SETTING: Monitoring was implemented in the besieged city of Sarajevo. SUBJECTS: 143 households with 90 children (< 18 years), 230 adults (18-59 years), and 94 elderly (60 + years) members, and 40 elderly inhabitants of the old people's home were monitored. INTERVENTIONS: Every month from December 1993 to March 1994, information on household food security was collected through structured questionnaires. All subjects were weighed and their heights measured. Weight for age Z scores in children (six months to 12 years) and body mass index (BMI) in adults and the elderly were calculated. RESULTS: While the nutritional status of adults and children consistently remained normal, high levels of undernutrition were detected among the elderly ranging from 16% to 21% (BMI < 18.5). Between December 1993 and February 1994, adults lost an average of 260 grams in weight (paired t test p = 0.005). Indicators of household food security (food stocks per person, market food prices and access to food aid) showed negative trends during the same time period. CONCLUSIONS: Whilst there was no nutritional disaster in Sarajevo over the winter 1993-1994, there were signs that capacity to cope was weakening in some groups. The elderly were identified as the most nutritionally vulnerable due to sickness, cold, stress and problems related to food preparation. The most food insecure group were refugees in collective centres who were highly dependent on food aid, were less likely to have relatives outside Sarajevo to support them, had fewer possessions to sell and were least likely to have gardens.

Adolescent↗
PubMed1987

Postoperative complications in colorectal surgery in relation to preoperative clinical and nutritional state and postoperative nutritional treatment.

The impact of the pre-operative nutritional and clinical state on post-operative morbidity and mortality is not fully known and the effect of total parenteral nutrition (TPN) on the postoperative complication rate has not been established. We have investigated the effects of postoperative TPN on the complication rate in 92 patients after major colorectal surgery for carcinoma of the large bowel or inflammatory bowel disease in a controlled, randomised study. The complication rate was analysed against seven commonly used nutritional (biochemical and anthropometric) variables and against the diagnosis, clinical inflammatory activity and presence of pre-operative septic complication. Patients were randomly allocated to postoperative TPN or conventional fluid and electrolyte support. The results show no correlation between the complication rate and the nutritional and clinical state of the patients as assessed pre-operatively. The complication rate was not significantly reduced by postoperative TPN. This study indicates that biochemical and anthropometric nutritional variables do not identify patients at risk to develop postoperative complications. The presence of pre-operative complications showed a marginal correlation with postoperative morbidity, in agreement with previous experience. The result of this study obviates the use of TPN in routine postoperative care.

Adult↗
PubMed2003

Nutritional risk in institutionalized older women determined by the Mini Nutritional Assessment test: what are the main factors?

OBJECTIVES: We assessed which factors contribute to the high level of nutritional risk detected by the Mini Nutritional Assessment (MNA) test in institutionalized older women. To this end, we undertook a complete nutritional assessment. METHODS: A cross-sectional study in 89 older women (age range, 72-98 y) living in two private nursing homes in Granada (Spain) was carried out. The MNA test was used as an assessment tool to detect nutritional risk. The nutritional assessment included anthropometric measurements (body mass index, triceps and subscapular skinfold thicknesses, and mid-arm and calf circumferences), quantification of dietary intake (7-d weighed-food records), clinical and functional evaluations (number of drugs, Katz index, and Red Cross cognitive scale), and biological markers (albumin, prealbumin, transferrin, and lymphocyte counts). RESULTS: We found that 7.9% (n = 5) of the older women were malnourished (MNA score, 14.5 +/- 1.4), 61.8% (n = 56) were at risk of malnutrition (MNA score, 20.6 +/- 2.1), and 30.3% (n = 28) were well nourished (MNA score, 25.0 +/- 1.1) according to the MNA test. CONCLUSIONS: This high prevalence of risk of malnutrition detected by the MNA test in healthy institutionalized older women was due mainly to risk situations and self-perception of health and did not depend on age. Inadequate micronutrients intake may contribute to the development of malnutrition in this population.

Aged↗
PubMed1985

Nutritional requirement for taurine in patients receiving long-term parenteral nutrition.

Animals fed diets lacking the amino acid taurine have low plasma and tissue levels of taurine and ultimately have retinal dysfunction. Since parenteral nutrition does not ordinarily provide taurine, we looked for evidence of taurine deficiency in 21 children and 23 adults undergoing long-term parenteral nutrition at home for an average of 27 +/- 23 (S.D.) months. The fasting plasma taurine level was reduced in children as compared with controls (26 +/- 13 vs. 57 +/- 16 mumol per liter, P less than 0.001). In adults with less than 25 per cent intestinal absorption of the recommended caloric intake, the plasma taurine level was also significantly reduced and correlated inversely with the duration of parenteral nutrition. Electroretinograms were abnormal in each of eight children who were examined. Addition of taurine to the intravenous solutions restored plasma levels to normal in four children; the electroretinograms of three of these children also became normal. The plasma taurine level became abnormally low again in two of three children one year after the intravenous taurine was discontinued. We conclude that children and possibly adults receiving long-term parenteral nutrition have a nutritional requirement for taurine.

Adolescent↗