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PubMed1983

[Nutritional rehabilitation and evaluation of the nutritional state. Validity of anthropometric measures for following, in hospitalized patients, the course of nutritional status and of body compartments during nutritional recovery].

A population suffering from a serious form of malnutrition was examined. The effectiveness of nutritional rehabilitation is demonstrated by the statistically significant changes observed in clinical and laboratory indicators. Several anthropometric measurements related to nutritional status are also compared with total body potassium (TBK) in patients with a positive nitrogen balance during the process of nutritional rehabilitation. It is concluded that weight (W), arm circumference (AC), middle arm muscle circumference (MAMC) and skinfold thickness (ST) measures are useful, and sufficiently accurate and precise to follow the evolution of nutritional status and body compartments.

Adult↗

PubMed2005

Fecal elastase: pancreatic status verification and influence on nutritional status in children with cystic fibrosis.

OBJECTIVES: To evaluate fecal elastase 1 (FE) levels in young children with cystic fibrosis and pancreatic insufficiency and to explore the relationship between FE and growth, nutrition, pulmonary status and fat absorption over a 24-month period. METHODS: FE, indicating pancreatic lipase activity, was assessed in children (6.0 to 8.9 years of age) with cystic fibrosis and pancreatic insufficiency. FE >15 microg/g stool was defined as residual pancreatic activity, suggesting some pancreatic function, and FE </=15 microg/g stool was defined as no pancreatic activity, suggesting pancreatic insufficiency. Seven-day weighed food records were collected and coefficient of fat absorption was calculated using dietary records and 72-hour stool collection. Height adjusted for mid-parental height, weight, body mass index, upper arm muscle area and upper arm fat area were measured and Z scores were calculated. Forced expiratory volume in 1 second was the measure of pulmonary function. RESULTS: Ten children (12%) had residual pancreatic activity (range, 17 to 667 microg/g stool) and 75 had no pancreatic activity. Children with no pancreatic activity had significantly lower coefficients of fat absorption than did those with residual pancreatic activity (81% +/- 14% versus 94% +/- 3%; P = 0.009) and significantly lower adjusted height Z score (-0.8 +/- 1.0 versus -0.1 +/- 1.3; P = 0.03). Children with residual pancreatic activity had significantly greater improvement in weight for age Z scores, upper arm muscle area Z scores, and upper arm fat area Z scores than children with no pancreatic activity (P </= 0.01). Children with no pancreatic activity were significantly (P = 0.007) more likely to have the DeltaF508/DeltaF508 genotype than were those with residual pancreatic activity (61% versus 11%). CONCLUSIONS: These data suggest that a substantial number (12% in this sample) of children with cystic fibrosis have a misclassified pancreatic status. Children with residual FE had greater fat absorption and improved growth and nutritional status over 24 months. FE assessment should be used to verify pancreatic status in patients with cystic fibrosis.

Anthropometry↗

PubMed2001

The relationship among dental status, nutrient intake, and nutritional status in older people.

Dental health status may influence nutrition. The objective of this part of the National Diet and Nutrition Survey was to assess if there is a relationship between dental status in people 65 years and older and intake of certain nutrients and any link between dental status and blood-derived values of key nutrients. Random national samples of independently living subjects and those living in institutions had dental examinations, interviews, four-day food diaries, and blood and urine analyzed. In the sample living independently, intakes of most nutrients were lower in edentate than dentate subjects. Intake of non-starch polysaccharides, protein, calcium, non-heme iron, niacin, and vitamin C was significantly lower in edentate subjects. People with 21 or more teeth consumed more of most nutrients, particularly of non-starch polysaccharide. This relationship in intake was not apparent in the hematological analysis. Plasma ascorbate and plasma retinol were the only analytes significantly associated with dental status.

Aged↗

PubMed2006

Nutritional status, as determined by the Mini-Nutritional Assessment, and osteoporosis: a cross-sectional study of an elderly female population.

OBJECTIVE: To investigate the relationship between osteoporosis and nutritional status as determined by the Mini-Nutritional Assessment (MNA). DESIGN: A cross-sectional study. SETTING: Stockholm, Sweden. SUBJECTS: A total of 351 elderly free-living women (mean age 73+/-2.3 years). METHODS: MNA (range 0-30 points; <17 indicates malnutrition, 17.5-23.5 risk of malnutrition and >or=24 well nourished), measurements of bone mineral density of the left hip and lumbar spine using Hologic QDR 4500, and of the heel using Calscan DEXA-T. RESULTS: The median MNA score was 27 (range 12.5-30). One woman was classified as malnourished and 7.4% were at risk of malnutrition. Osteoporosis of the femoral neck was observed in 22% and a fracture after the age of 50 was reported by 31% of the participants. The following items in the MNA questionnaire exhibited an increased risk of having osteoporosis in the femoral neck and/or total hip: an MNA score of <27 (odds ratio (OR)=2.09; CI=1.14-3.83); a mid-arm circumference of less than 28 cm (OR=2.97; CI=1.29-6.81); and regular use of more than 3 drugs each day (OR=2.12; CI=1.00-4.50). A body weight of more than 70 kg exhibited a decreased risk of having osteoporosis (OR=0.31; CI=0.14-0.70). CONCLUSIONS: In general, the nutritional status was good in this population of free-living elderly women. Nevertheless, half of the women who displayed an MNA score <27 points had a twofold increased risk of having osteoporosis. SPONSORSHIP: Karolinska Institutet, Stockholm County Council.

Absorptiometry, Photon↗

PubMed1976

Nutritional status measures as predictors of nutritional risk in preschool children.

Data from 19 dietary and biochemical indices of nutritional status for 419 participants in the Preschool Nutrition Survey were analyzed to determined the smallest number of variables that could be used to identify all children with any of measure below a criterion of adequacy. Serum transferrin iron and dietary iron intake identified 74% of those at nutritional risk. Additional information on dietary calories, calcium, ascorbic acid, thiamin, and vitamin A identified all subjects at risk.

Ascorbic Acid Deficiency↗

PubMed1989

[Assessing nutritional status].

Malnutrition is associated with a delayed recovery from illness and an increased rate of complications. Heart failure, respiratory diseases, impaired immune function and postoperative wound healing are influenced by the nutritional status. Nutritional assessment includes patients history, physical examination, anthropometric measurements, laboratory dates and changes of immunocompetence. Anthropometric assessment, like skinfold and muscle area measurements, is not an extremely accurate method predicting nutritional status of an individual patient. Multifactorial influence on the concentration of the serum proteins, albumine, transferrin and retinolbinding protein caused a wide range of normal values. Therefore the validity and sensitivity of these parameters to assess nutritional status are diminished for the individual patient. The concentration of serum albumin seems to be of some value as a marker for nutritional status. The influence of malnutrition on immunity is complex. There are no sensitive markers available to assess the influence of malnutrition on the immuno competence of an individual patient for the clinical routine. Malnutrition may be assessed and the resulting clinical complications may be predicted by calculating a prognostic nutritional index, which include several nutritional parameters.

Anthropometry↗

PubMed1984

Clinical significance of preoperative nutritional status in 215 noncancer patients.

Preoperative nutritional status was assessed by: the percentage weight loss (% WL), body weight in relation to reference weight (WI), arm muscle circumference (AMC), and S-albumin (S-Alb) in a prospective study of 215 noncancer patients classified into three groups according to type of surgery: major vascular, minor vascular, and abdominal. The clinical significance of the nutritional markers was assessed by correlations to postoperative outcome and the time spent in the hospital after surgery. The influence of age on nutritional markers and clinical variables was evident but was ruled out in all correlations. If malnutrition was classified as two or more abnormal values in the nutritional markers (% WL, WI, AMC, S-Alb), the overall frequency was 12%, highest in the major vascular surgery group (18%) and lowest in the minor vascular group (4%). Patients with low nutritional status stayed an average of 29 days in the hospital compared to 14 days if the nutritional status was normal (p less than 0.01). The overall complication frequency was higher in patients with low nutritional status compared to normal status (48% and 23%, respectively, p less than 0.01). The frequency of serious complications was 31% in undernourished and 9% in well-nourished patients (p less than 0.05). Various nonnutritional variables such as age, diagnosis, and duration of surgery were shown to increase the predictive ability of nutritional status. The results of this study confirm that nutritional state per se is predictive for postoperative outcome even when variables were stabilized for different backgrounds with covariation to nutritional status.

Abdomen↗

PubMed2001

[Food intake and nutritional status in a group of healthy elderly residing in a nursing home].

BACKGROUND: Aging is accompanied by a variety of economic, psychologic, and social changes that can compromise the nutritional status. Nutrition is an important aspect of healthful behaviour and a major component of general wellbeing of individuals throughout their life cycle. Nutritional intake appears to be an important factor contributing to aging. So, the purpose of this project was to evaluate diet and nutritional status. METHODS: Fifty-one healthy elderly subjects aged 70 years and older (31 F and 20 M), residing in a nursing home have been studied. Nutrient intake was assessed using 24-hour recalls; nutritional status was assessed using anthropometric measurements. The nutrient intakes for individuals were compared with the Italian Recommended Dietary Allowances (RDAs). RESULTS: Mean energy intake was 1,625 kcal; the average percentages of carbohydrate, protein, and fat were 54%, 16%, and 30%, respectively. The mean vitamin and mineral intake for participants met the RDAs except for calcium and selenium intakes. The mean fibre intake was low. The analysis of food products intake indicated that the above mentioned inadequacy in nutrient intake was the result of low consumption of milk and milk products containing calcium and a low consumption of integral foods or fruits containing fibre. CONCLUSIONS: The significance of sound nutrition education and the adverse impact of consumer misinformation about the benefits of these food choices becomes clear with the recognition that nutritional status influences the rate of physiologic and functional declines with age. This approach will require new efforts in consumer education sensitive to the needs and beliefs of older people.

English Abstract↗

PubMed1999

[Nutritional status and energy expenditure in elders of differing socioeconomic level].

BACKGROUND: Income and socioeconomic status can influence nutritional status of individuals. Since elders are a more vulnerable group to nutritional deficiencies, socioeconomic status could have a special relevance on nutrition of elderly people. AIM: To assess the influence of socioeconomic status on the nutritional status of elders. MATERIAL AND METHODS: Elders of both sexes of high socioeconomic level and age and sex matched elders of low socioeconomic status were studied. Anthropometry, body composition using double beam X ray absorptiometry, resting energy expenditure using an open circuit indirect calorimeter, routine biochemistry, blood levels of folic acid, vitamin B12 and homocysteine were measured in all subjects. RESULTS: Fourteen female elders of high socioeconomic level, 14 females of low level and 12 males of each level were studied. Mean age of females and males was 71.5 +/- 3.7 and 73.9 +/- 4.2 years old respectively. Males and females of high socioeconomic status were taller than their counterparts of low status. Females of high socioeconomic status had a lower body mass index than their pairs of low status (26.3 +/- 3.8 and 30.2 +/- 5.6 kg/m2 respectively p < 0.02). Men of high economic status had a higher fat mass than their pairs of low level (20.3 +/- 3.5 and 15.1 +/- 5.5 kg respectively, p < 0.005). No differences in resting energy expenditure in women of differing socioeconomic level were observed. Men of high level had a higher energy expenditure that their counterparts of low level (36.0 +/- 4.9 and 32.8 +/- 2.2 Kcal/kg lean body mass/day respectively, p < 0.02). Low level male elders had higher serum total cholesterol and triglycerides. Folic acid, vitamin B12 and homocysteine levels were within normal limits. Dietary intake showed deficiencies in calorie, protein and vitamin intake in all subjects. CONCLUSIONS: In this group of elders, low socioeconomic level did not produce a significant impact on nutritional status.

Absorptiometry, Photon↗

PubMed1981

A study of the nutritional status of pediatric cancer patients.

The records of 455 children were reviewed to investigate the relationship of nutritional status at time of first referral to various measurements of disease and survival. Initial symptoms of weight loss, anorexia, fatigue, and early satiety were all directly correlated. Serum albumin level and nutritional status were not directly correlated. Likewise, there was no direct relationship between performance status and nutritional status. However, higher values of serum albumin were associated with better performance status. Nutritional status was directly related to freedom from relapse among children with solid tumors whether they had localized or non-localized disease. In addition, improved survival was related to good nutritional status for children with localized disease, whereas those with advanced disease had a poorer survival regardless of their nutritional status. Nutritional status appears to have prognostic implications among children with cancer.

Body Height↗

PubMed1990

Effect of giardia infection on nutritional status of preschool children.

Nutritional status of 34 children aged 24-72 months and infected with giardia was compared with that of 92 children matched for age, sex and income and 34 children matched for age, sex, income as well as birth order. Children without giardiasis were found to have better nutritional status in both comparisons. The difference was more pronounced in the second instance. Of the seven anthropometric parameters used for comparison, four were significantly lower (weight, weight for age, midarm circumference and midarm circumference for age), while two (height for age and weight for height) showed nonsignificant childhood malnutrition and that matching for birth order enhances the utility of case-control studies in children.

Anthropometry↗

PubMed1985

Comparative study of nursing mothers in Africa (Zaire) and in Europe (Sweden): breastfeeding behaviour, nutritional status, lactational hyperprolactinaemia and status of the menstrual cycle.

A total of 1036 nursing mothers were investigated for their nursing behaviour, status of nutrition and menstrual cycle, serum prolactin and progesterone; 61 in Sweden, 457 in an urban area of Zaïre (Bukavu, Kivu) and 518 in a rural area of the same region (Kabare, Kivu). Lactational hyperprolactinaemia is influenced by the frequency but not by the duration of suckling. The return of luteinization of follicles, but not that of menstrual bleeding, was inversely related to the degree of lactational hyperprolactinaemia. Significant luteinization took place in only some 10% of the mothers during the first three months of lactation in Sweden and within the first year in Zaïre. In these mothers with luteinized follicles the average progesterone was only slightly above 1.0 ng/ml indicating poor luteinization. Lactational hyperprolactinaemia, the return of menstruation and luteinization during lactation were not related to the nutritional status as evaluated by the body weight indices and serum albumin. However, suckling and hyperprolactinaemia do not appear to be the only factors involved in the control of fertility during lactation. When serum prolactin levels were equally low, i.e. below 500 microU/ml, twice the number of lactating mothers with signs of luteinization were found in the urban than in the rural population of Zaïre.

Body Weight↗

PubMed1996

Maternal nutritional knowledge and the nutritional status of preschool children in a Nairobi slum.

Most nutrition education programmes in Kenya operate on the premise that nutritional knowledge can have an impact on children's nutritional status. It has, however, been argued that nutritional knowledge among low income groups is unlikely to have an impact, hence, the need to establish whether there is a relationship between nutritional status and maternal nutritional knowledge. In a cross-sectional survey carried out in a Nairobi slum (Kibera), nutritional status of 363 children aged six to 24 months was measured and nutritional knowledge of their mothers assessed. Makina village was randomly selected as the study site and all consenting households were involved in the study. The study established that most mothers (97.5%) have access to nutrition education. Prevalence of stunting (86.2%) and underweight (58.4%) was high but that of wasting (1.9%) was low. There was no significant relationship between the nutritional status of children and overall nutritional knowledge. Unexpectedly, a negative relationship was found between nutritional status and mothers' ability to recognise clinical signs of malnutrition, knowledge in the weaning process and dietary management during sickness. Knowledge on frequency of feeding was, however, positively related to nutritional states. In conclusion, nutritional knowledge alone is inadequate in ensuring young children's nutrition security and, hence, for nutrition education programmes to have a positive impact, facilitational strategies must be incorporated.

Adult↗

PubMed2001

Peritoneal transport status correlates with morbidity but not longitudinal change of nutritional status of continuous ambulatory peritoneal dialysis patients: a 2-year prospective study.

Cross-sectional studies show that peritoneal transport status is associated with nutritional status and clinical outcome of continuous ambulatory peritoneal dialysis (CAPD) patients. High transporters often are assumed to have progressive malnutrition as a result of fluid overload and nutrient loss in dialysis effluent. There are few prospective data to confirm this assumption, however. We studied 235 unselected CAPD patients to examine this possibility. There were 58 new cases and 177 prevalent cases. A standard peritoneal equilibration test was performed at enrollment. All patients were followed for 2 years. Dialysis adequacy and nutritional assessment, including serum albumin, protein nitrogen appearance, and lean body mass, were performed at 0, 12, and 24 months. Clinical outcome included hospitalization, actuarial patient survival, and technique survival. The mean age was 51.6 +/- 12.4 years. The mean 4-hour dialysate-to-plasma ratio of creatinine was 0.57 +/- 0.12 for all cases (0.60 +/- 0.12 for new cases). Patients were classified into three groups: high/high-average (H/HA) (63 cases), low-average (LA) (105 cases), and low (L) (67 cases) transporters. Baseline demographic data and total Kt/V were similar in all transport groups. There were weak correlations between 4-hour dialysate-to-plasma ratio of creatinine and baseline serum albumin (r = -0.249, P: < 0.001), protein nitrogen appearance (r = -0.190, P: < 0.01), and percentage of lean body mass (r = -0.194, P: < 0.01). The H/HA group was a specific but not a sensitive predictor of poor baseline nutritional status. There was no significant change in any nutritional indices after 2 years in new cases and prevalent cases, regardless of transport status. The differences in nutritional indices between groups remained unchanged during the study period. There was a significant difference in hospitalization rate among peritoneal transport groups (median 12 versus 7 versus 3 days per year for H/HA, LA, and L groups, Kruskal-Wallis test, P: < 0.05). The difference remained similar when new cases and prevalent cases were analyzed separately. The L group had slightly better 2-year patient survival than the H/HA group (90.2% versus 83.3%), but the result was not statistically significant. We conclude that peritoneal transport status is not associated with longitudinal change of nutritional parameters, although transport status is associated with short-term patient morbidity. Further study is needed to identify the mechanisms of poor clinical outcome in high peritoneal transporters.

Biological Transport↗

PubMed1995

[Guidelines for the dietetic treatment of patients with anorexia nervosa based on an assessment of their nutritional status].

The evaluation of the nutritional status of patients with anorexia nervosa is of great utility when establishing guidelines for specific and appropriate dietary programs to face nutritional deficiencies and thus favoring their recovery. The nutritional status of patients was evaluated by means of anthropometric, biochemical, and dietetic parameters in a group of 78 anorexics who followed a psychiatric and nutritional therapy, 57 in an ambulatory basis and 21 as in-patients. Anthropometric parameters (weight and body mass index) showed a severe depletion of the nutritional status, particularly in in-patients. Only 25% of patients had a body mass index higher than 18 and 5% had values within normal ranges. While biochemical indexes (hemoglobin, hematocrit, red blood cells, mean corpuscular volume, total proteins and vitamins: thiamine, riboflavin, B6, ascorbic acid, alpha-tocopherol, retinol and beta-carotene) were within normal ranges in most cases, there were variable percentages of patients with marginal values and clearly deficient for group B vitamins: thiamine (79 +/- 11 U/l; P25 = 70 U/l), riboflavin (884 +/- 160 U/l; P5 = 640 U/l) and B6 (309 +/- 131 U/l; P25 = 227 U/l). The study of the diet showed a marked lack of energy supply (only 25% of patients had their needs satisfied (P75 = 101%) and minerals (iron, magnesium, and zinc). Intake of proteins and vitamins was, in general, satisfactory. Critical points to be considered in refeeding are energy and mineral deficiencies.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2006

The nutritional status of frail elderly with care needs according to the mini-nutritional assessment.

BACKGROUND AND AIMS: Although malnutrition is common in the geriatric population, the relationship between frail elderly with various care needs and nutritional status remains unknown. The purpose of this study was to analyze the association between subjects with higher care needs and poorer nutritional status in the Japanese community-dwelling frail elderly. METHODS: A total of 281 community-dwelling elderly subjects from day-care centers (81.9+/-7.2yr of age mean+/-SD; 72 men and 209 women) who were eligible for Long-Term Care Insurance were enrolled in this study to evaluate their nutritional status using the mini-nutritional assessment. The levels of care needs of participants were classified into six levels according to the Long-Term Care Insurance program. RESULTS: According to the mini-nutritional assessment classification, 39.9%, 51.2%, and 8.9% of the participants were assessed as well-nourished, at-risk of malnutrition, and malnourished, respectively. There were significant differences among the six groups with regard to the nutritional status; subjects with higher care needs were associated with poorer nutritional status. In the higher care needs group, more than half of the subjects did not know their weight change during 3-month intervals. CONCLUSIONS: The population of elderly with higher care needs in the community is associated with a higher prevalence of malnutrition.

Aged, 80 and over↗

PubMed1978

Nutritional status of main food preparers and of nutrition education assistants.

The dietary habits and nutritional status of nutrition education assistants (NEAS) in the Expanded Food and Nutrition Education Program in Missouri were compared with a representative population of Missouri main food preparers (MFPs) from the same regions of the state. Dietary histories indicated that the NEAs tended to have better habits than the MFPs. Using biochemical parameters for determining status for iron, vitamin A, ascorbic acid, and riboflavin, the differences between the two groups were not as great as for the dietary intakes. However, almost half of the MFPs were taking at least one vitamin or mineral supplement compared with 17 per cent of the NEAs. A low dietary intake, coupled with some anemia, probably relating to a low iron intake, was a major nutritional problem for both groups of subjects. Low plasma vitamin A values were also observed among a large proportion of both groups, and obesity was a widespread problem for both groups.

Adult↗

PubMed1997

Sensation of smell does not determine nutritional status in patients with cystic fibrosis.

Poor nutritional status in patients with cystic fibrosis (CF) is associated with increased mortality. Patients with CF often have a decreased sensation of smell secondary to recurrent sinus infections or sinus surgery; in other CF populations, a decreased sensation of smell has been associated with poor nutritional status. We hypothesized that a decreased sensation of smell would be associated with worse nutritional status in patients with CF. We studied 50 (26 F and 24 M) of 58 consecutive patients with CF (86%) aged 14-53 years (28 +/- 8; mean +/- SD) who attended the University of Washington Medical Center from June 1994 to March 1995 and who agreed to participate. Demographic information was obtained, and nutritional status was assessed by ideal body weight, arm muscle area, arm fat area, pancreatic sufficiency, insulin-requiring diabetes, vitamins A and E levels, albumin, iron, iron binding capacity, ferritin, cholesterol, and zinc levels. Objective sensation of small was examined (Sensonics, Philadelphia, PA), a sinus compacted tomogram (CT) was performed, and a questionnaire for prior sinus symptoms, sinus surgery, medications, and subjective sensation of smell was administered. Twenty-seven of 49 subjects (55%) had an objective decrease in sensation of smell, 23/50 (46%) had had prior sinus surgery. 46/50 (92%) were pancreatic insufficient, and 8/50 (16%) were insulin-requiring diabetics. Weight for height ranged from the 38th to 157th percentile (100 +/- 18; mean +/- SD). Arm muscle area ranged from the < 5th to the 75th percentile (25 +/- 23; mean +/- SD). Arm fat area ranged from the < 5th to the 95th percentile (45 +/- 39; mean +/- SD). Sinus CT scans were abnormal in all patients (100%). Patients with anosmia were more likely to have had sinus surgery, but their nutritional status was no different from that of patients with a normal sensation of smell. We conclude that decreased sensation of smell is common in patients with CF, especially those with prior sinus surgery. Subjective sensation of smell and sinus CT scans were unreliable indicators of a decreased objective sensation of smell. In this pilot study, no association was found between sensation of smell and nutritional status.

Adolescent↗