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PubMed1996

Nutritional status and mortality of highland children in Nepal: impact of sociocultural factors.

This study investigates the nutritional status of native children in the highlands of Nepal (1,700-3,000 m) and explores the relationship between child mortality and surviving children's nutritional status. A random sample of 145 households from 11 villages in the Koshi Hill Zone in east Nepal was surveyed, and the nutritional status of the 438 children < 14 years of age living in these households was assessed by means of anthropometry. We found a severe growth retardation in the Nepalese children compared to lowland reference groups as well as to highland children from the Andes. Child mortality and altitude are not significantly different between higher (Brahman and Chetri) and lower (Baisya and Sudra) caste households. A lower caste status and higher altitude of the household is associated with a significantly better nutritional status in offspring. In multiple regression analyses, improved nutritional status in children is significantly associated with lower caste (P = 0.001), higher altitude (P = 0.009), and less crowding (P = 0.001) but not with sibling mortality (P = 0.11). We thus conclude that nutritional status of children in households in the highlands of Nepal is associated with the household's socioeconomic status and altitude but not with mortality among siblings.

Adolescent↗
PubMed1990

Changes in the protein nutritional status of adolescent wrestlers.

The protein nutritional status of adolescent wrestlers was studied to determine whether changes occur during a season of competition and weight loss. Subjects (N = 18) were measured prior to the start of the season (PRE), twice in the midseason, and once during late season (LATE) for weight, percent body fat, and height. At each of these times, a venous blood sample was obtained from the subjects, who were fasted, and analyzed for concentrations of albumin, prealbumin, retinol binding protein (RBP), blood urea nitrogen (BUN), hemoglobin, hematocrit, and 23 amino acids. Diet records were kept by subjects to assess daily energy, protein, fat, and carbohydrate intake. Data were analyzed by repeated measures ANOVA. Results showed that wrestlers decreased weight by an average of 6.6 +/- 0.9% and that percent body fat, fat-free weight, plasma levels of prealbumin and RBP, the ratio of total essential amino acids to total amino acids, and dietary energy nutrient intakes were significantly lower at LATE compared to PRE. RBP decreased during midseason and averaged (+/- SE) 3.21 +/- 0.15 mg.100 ml-1 at LATE; prealbumin was significantly lower at LATE with a mean value of 19.8 +/- 1.0 mg.100 ml-1. Total energy intake decreased from PRE values by 35%, to approximately 27 kcal.kg-1.d-1 during the season. In conclusion, in these high school wrestlers who lost approximately 6.6% of weight, there were adverse effects on some of the indices of protein nutritional status.

Adolescent↗
PubMedDate not supplied

[The assessment of nutritional status in patients over 60 with arteriopathy].

The nutritional status of patients older than 60 years affected by arteriopathy, who were admitted in a scheduled manner to a Vascular Surgery Department, have been studied. The nutritional status was evaluated upon admittance to the hospital and again upon release from the same, to determine whether this changes during the hospital stay. A total of 93 patients (80 men males and 13 females), with a mean age of 71 years, who were admitted to the hospital during a one year period, were studied prospectively. Among the present risk factors, active smokers or ex-smokers (83.87%), diabetics (32.25%), and the consumption of more than 40 g of alcohol/day (21.5%), should be noted. Upon admittance to the hospital, 43.5% of the studied cases presented mild malnutrition. During the hospital stay, which lasted 26.4 +/- 13.8 days, the nutritional status of these patients was ot modified. It should be noted that the delayed type sensitivity skin tests showed anergy in all cases, which suggests that this parameter is not a good nutritional marker for individuals over 60. Finally, we observe that the lean body mass index did not correlate with the rest of the anthropometric parameters used, which could indicate that age affects the lean body mass more than it does the other body components.

Aged↗
PubMed1992

Indicators of poor nutritional status in older Americans.

Physicians need to be alert to indicators of poor nutritional status in older patients. These indicators include physical signs, specific symptoms or sets of symptoms, and measurable parameters that indicate poor nutritional status is already present and is causing some effect (although the effect may not be symptomatic and may not be quantifiable). Indicators of poor nutritional status may be detected by interviewing an elderly patient or his or her caregivers, by observing the patient in his or her environment, or by physically examining the patient and/or making specific measurements, including laboratory tests. Since some of these indicators are sensitive to change in the nutritional status over time, they may be potentially useful in confirming the improvement or deterioration in nutritional status.

Activities of Daily Living↗
PubMed2001

[Nutritional status in HIV infected patients].

OBJECTIVES: Nutritional assessment in HIV infected patients must be a main objective in the treatment of this disease. The main objective of our work was to study the nutritional status with biochemical and anthropometrical parameters in a group of HIV infected patients. MATERIAL AND METHODS: A total of 119 patients were evaluated. In all patients the next parameters were assessed: age, sex, treatment with anti-retroviral drugs, performed an anthropometric evaluation (weight, height, tricipital skinfold, arm circumference, arm muscular circumference and body mass index) and biochemical evaluation (albumin, prealbumin, transferrin, total proteins, triglycerides, cholesterol, lymphocytes and count of CD4). RESULTS: Patients had an average age 37.9 +/- 9.9 years, weight 64.5 +/- 13.2 kg and body mass index 22.5 +/- 3.5. The values of total proteins, albumin, prealbumin y transferrin were all normal, only patients with AIDS had low levels of transferrin (262.5 +/- 49.2 mg/dl vs 277.8 +/- 87.5; p < 0.05). Percentil distribution of anthropometric parameters showed a deep depletion in muscular protein compartment, 53.1% of patients had skinfold under P 50, 91.8% had arm circumference under P 50, and 91.8% arm muscular circumference under P 50. High levels of triglycerides were detected in 30.5%, these levels are related with the HIV phase and the number of antiretroviral drugs. CONCLUSION: Nutritional status in HIV infected patients is good in our population, only a deep depletion in muscular proteic compartment was detected. Transferrin was decreased in AIDS patients. High levels of triglycerides were secondary to the number of antiretroviral drug taking by patients.

Adult↗
PubMed1987

Nutritional status of the elderly in Naples.

Nutritional status (anthropometry, food habits, thiamin and riboflavin status) has been evaluated in 136 (70 males and 66 females) free living healthy elderly individuals (age range 65-69 yrs) from the district of San Carlo Arena that can be considered representative of the sociocultural and economic level of the city of Naples. By assuming as reference values those of middle aged individuals, 50 percent of elderly men and 85 percent of elderly women showed different degree of excess body fat. As far as food habits are concerned legumes, vegetables and fruit daily intake was quite high whilst alcohol consumption was low. Furthermore milk and eggs intake was low and infrequent. Although prevalence of excess body weight was high, total daily energy intake was found to be equal or slightly above dietary recommendations for the elderly. Diet composition showed a high protein intake whilst CHO and fat intake was slightly below recommendations. Micronutrients' intake was insufficient for calcium in 10 percent of both males and females and for iron in 20 percent of men and 40 percent of women. Niacin intake was low in about 50 percent of both men and women. Thiamin nutritional status was found low in 20 percent of men and women and riboflavin status in 40 percent of men and 20 percent of women. In conclusion obesity and overweight are very frequent in an urbanized sample of free living healthy elderly individuals of Naples. On the other hand serum calcium and iron and some vitamin deficiency is not uncommon. The composition of the diet seems to be also poor in some micronutrients.

Aged↗
PubMedDate not supplied

Influence of maternal literacy on the nutritional status of preschool children.

The impact of maternal literacy status on the nutritional status of pre-school children in Parbhani was studied. Results revealed that the children of literate mothers had better anthropometric measurements than children of illiterate mothers. Nutrient deficiency signs especially of protein energy malnutrition were more predominant among the children of illiterate mothers. Food consumption pattern was better in children with literate mothers as compared to children of illiterate mothers. The consumption of milk and milk products, fruits, sugar and jaggery was significantly greater in children with literate mothers.

Anthropometry↗
PubMed2005

Nutritional status of endurance athletes: what is the available information?

Nutritional status is a critical determinant of athletic performance. We question whether currently available studies can give adequate information on nutritional status of endurance athletes. This paper is a critical review of articles published from 1989 to 2003 that investigate nutritional status of endurance athletes. The terms, "nutrition", "diet", or "nutrient", were combined with "endurance athletes" to perform Medline and Pubmed electronic database searches. Two inclusion criteria were considered: (a) study subjects should be adults and (b) articles should report gender-specific values for total energy expenditure and intake of energy, macro and micronutrient from food. Only seven studies fulfilled inclusion criteria. In general, the conclusions of these studies are that endurance athletes have negative energy balance, low intake of carbohydrate, adequate to high intake of protein, and high intake of fat. A critical discussion of the articles' data on vitamins, minerals and trace elements adequacy is conducted using insights and methodology proposed by the newly published assessment and interpretation of Dietary Reference Intakes (DRIs). The studies evaluated give an inappropriate evaluation of the prevalence of adequacy/inadequacy of micronutrient intake among endurance athletes. In this work we indicate potential limitations of existing nutritional data, which reflects the misconceptions found in published literature on nutritional group evaluation. This review stresses the need for a comprehensive and well-conducted nutrition assessment planning to fulfill the existing gap in reliable information about micronutrient adequacy of endurance athletes.

Adult↗
PubMed2002

Nutritional status in dialysis patients: a European consensus.

BACKGROUND: Malnutrition is common in dialysis patients and closely related to morbidity and mortality. Therefore, assessment of nutritional status and nutritional management of dialysis patients play a central role in everyday nephrological practice. METHODS: Achieving a consensus on key points relating to pathogenesis, clinical assessment, and nutritional management of dialysis patients. RESULTS: The assessment of nutritional status should be based on clinical assessment and biochemical parameters, including history of weight loss, per cent standard weight, body mass index, muscle mass, subcutaneous fat mass, and plasma albumin, creatinine, bicarbonate and cholesterol. Co-morbid conditions should be assessed and C-reactive protein (CRP) measured--as a marker of inflammation--as there is a close relation between malnutrition, on one side, and co-morbid conditions and inflammation on the other. For a more detailed assessment, subjective global assessment of nutritional status is a well-validated tool, and dual-energy X-ray absorptiometry (DEXA) is a useful method for routine assessment of lean body mass. Anthropometric methods are also useful. They are cheap and easy to apply, although less precise than DEXA. The recommended daily protein intake is at least 1.2 g/kg standard body weight and the energy intake 35 kcal/kg standard body weight (BW), in patients <60 years, and 30 kcal/kg standard BW in patients >60 years. The standard bicarbonate level should be at least 22 mmol/l. If CRP is >10 mg/l, it is important to seek and treat the underlying cause. Adequate dialysis (for haemodialysis: Kt/V >1.2) should be ensured and, although no definite evidence of the importance of dialysis water quality is available, the opinion of the authors is that the water quality should be high. The role of the biocompatibility of the dialysis membrane is still not clear. The dietitian plays a pivotal role in the nutritional care of dialysis patients, and patients should be provided with dietary counselling from the start of substitutive treatment in order to meet the recommended nutritional intakes. Dietary counselling can also play an important role in an integrated treatment of hyperphosphataemia, although most patients will also need phosphate binders if they have an adequate protein intake. CONCLUSION: Malnutrition assessment and treatment is a great challenge for nephrological care. Achieving evidence-based consensus can help in implementing the progress of knowledge in clinical practice.

Body Mass Index↗
PubMed2001

Nutritional status in patients with rheumatoid arthritis.

BACKGROUND: Some chronic diseases have been associated to an impairment of nutritional status. OBJECTIVE: To analyze nutritional status and its relation to dietary intake, disease activity and treatment in rheumatoid arthritis. PATIENTS AND METHODS: We have included 93 patients (43 men and 50 women) and 93 age- and sex-matched healthy controls. The assessment of nutritional status included anthropometric (body mass index, tricipital skin fold and midarm muscular circumference) and biochemical (serum albumin, prealbumin and retinol binding protein) parameters. Dietary intake was calculated from a food frequency questionnaire. As a measure of disease activity, we used the Health Assessment Questionnaire, Ritchie index, tender and swollen joint count and C-reactive protein. Statistical analysis was performed in the whole series and in every functional class. RESULTS: In the whole series, midarm muscular circumference and serum albumin were significantly lower in patients than in controls. All anthropometric parameters and serum albumin were significantly lower in patients in functional class IV than in their respective controls. The dietary intake of energy, carbohydrates, vegetal proteins and lipids was higher in patients than in controls. Midarm muscular circumference and serum albumin had a significant inverse relation with disease activity parameters; body mass index, midarm muscular circumference and serum albumin correlated inversely with the cumulative dose of glucocorticoids. CONCLUSIONS: Patients with rheumatoid arthritis in functional class IV have an impairment of nutritional status without a deficient dietary intake. The differences found in other functional classes are explained by rheumatoid arthritis itself. Nutritional parameters are related to disease activity and glucocorticoid treatment.

Age Distribution↗
PubMed2006

Nutritional status as a risk factor in esophageal surgery.

BACKGROUND: Nutritional condition is one of the factors determining postoperative outcome in esophageal surgery. This study explored the relation between preoperative nutritional status and postoperative infectious complications. METHODS: From a prospective database, 400 patients who underwent esophageal resection for malignancy were selected. Preoperative nutritional status was assessed by body mass index, prognostic nutritional index (PNI), nutritional risk index (NRI) and weight loss. The association between nutritional parameters and postoperative complications and mortality, gender, age and hospitalization was assessed. RESULTS: PNI and NRI differed between the patients with and without postoperative infectious complications (p = 0.031 and p = 0.009, respectively). However, receiver operating characteristic curves showed that PNI and NRI have a low predictive value for such complications. Also, no associations were found between nutritional parameters and in-hospital mortality. Although mean nutritional parameters were significantly lower, i.e. worse, in patients with neoadjuvant treatment as compared to no such treatment, the incidence of complications did not significantly differ between these treatment groups. Although PNI and NRI correlated negatively with age, no association was found between age and infectious complications. Multivariate analysis of various factors showed the male gender to be the only significant risk factor for development of infectious complications. DISCUSSION: Preoperative nutritional status established by PNI, NRI, body mass index and weight loss has limited value in predicting complications following esophageal resection.

Adult↗
PubMed2004

Comparison of different scoring methods for assessing the nutritional status of hospitalised patients.

OBJECTIVE: Despite intense clinical research, no commonly accepted diagnostic tool for assessment of nutritional status is yet available. In this study a comparison of four different methods for diagnosis of the nutritional status of patients admitted to a university hospital in Austria is presented. PATIENTS AND METHODS: Clinical data of 640 hospitalised patients were analysed in a prospective-descriptive study design. Four recommended methods, the Innsbruck nutrition score (INS), the Prideaux nutritional risk assessment (PNRA), the well established nutrition risk index (NRI), and the body mass index (BMI) were used to analyse nutritional status. RESULTS: The BMI showed 90.2% of the patients evaluated to have normal nutritional status, whereas the PNRA identified 48.9%, the NRI 40% and the INS 58.6% as well nourished. Patients were variously diagnosed with moderate malnutrition: 9% (BMI), 42% (PNRA), 54.8% (NRI) and 30% (INS). Severe malnutrition was detected in 0.5% (BMI), 9.1% (PNRA), 5.2% (NRI) and 11.4% (INS) of the patients evaluated. Cancer patients had the worst nutritional status. CONCLUSION: Malnutrition seems to be a common diagnosis among hospitalised patients in Austria. Screening and assessment of nutritional status should be integrated into clinical routine. The methods tested scored malnutrition at different frequencies. BMI seemed to underestimate the prevalence of malnutrition. The PNRA provided some information on clinical outcome, whereas the NRI had the best relationship between the degree of malnutrition and length of stay. Calculation of the INS may give correct diagnosis of severe malnutrition. Further prospective clinical studies are needed to validate the scoring systems used in this study and to provide accurate clinical diagnosis of malnutrition.

Adolescent↗
PubMed1994

Nutritional status in cirrhosis. Italian Multicentre Cooperative Project on Nutrition in Liver Cirrhosis.

Malnutrition frequently occurs in patients with chronic liver disease and may represent a risk factor influencing both short- and long-term survival in these patients. Previously published studies have tended to be confined to alcoholic patients and there are few data on the prevalence of nutritional abnormalities in patients with cirrhosis not of alcoholic origin. Anthropometric measurements and a clinical evaluation of the nutritional status of 1402 patients with cirrhosis (883 males and 519 females) were recorded between January 1988 and 1989 by the Italian Multicentre Cooperative project on Nutrition in Liver Cirrhosis. The origin of liver disease was alcohol-related in 37% of patients. Child-Pugh criteria were used to establish the severity of the liver disease. Patients with cirrhosis exhibited a wide range of nutritional abnormalities. While 29% of females and 18% of males appeared to be overnourished, a significant reduction in fat stores, as estimated by the mid-arm fat area, and/or muscle mass, as estimated by mid-arm muscle area, was observed in 30% of patients with cirrhosis. The prevalence of signs of nutritional depletion increased in both sexes as liver function deteriorated. Mean values for mid-arm fat area decreased by 30% in males and by 40% in females with moderate to severe liver failure (Child-Pugh Classes B and C). The reduction in mid-arm muscle area was more evident in males (17% decrease) than in females (9% decrease). Patients with alcohol-related cirrhosis showed a higher prevalence of malnutrition and had more frequent severe liver impairment (Child-Pugh Classes B and C).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1997

Dietary, anthropometric, hematological and biochemical assessment of the nutritional status of centenarians and elderly people in Okinawa, Japan.

OBJECTIVE: The population of old people has increased and nutritional disorders are common among them. The assessment of nutritional status and dietary intakes of this population is necessary in order to improve their nutritional status and reduce risk to infection and mortality. In the present study, data on the nutritional status of healthy elderly and centenarians is provided. SUBJECTS: Participants were free-living healthy volunteers (39 centenarians; 11 male and 28 female and 44 elderly in their 70s; 13 male and 31 female). METHODS: Their nutritional status was assessed by anthropometric measurements, hematological and biochemical variables. Activities of daily living (ADL) of 11 items were scored depending upon their activities with a maximum score of 5.0. Dietary survey by food recording was done for 2 days and food models were used to obtain the best estimate of food intake. Energy and nutrient intakes were compared with Japanese recommended dietary allowances (RDAs). RESULTS: The elderly had complete independence of physical activities, good sensory function and cognitive abilities. The physical activities of male centenarians were between the category of completely independent and independent but slow. In female centenarian participants, their physical activities were independent but slow or independent with difficulty. The functions of auditory acuity and eyesight of the centenarians were poor but their cognitive abilities were still good. The elderly subjects had short stature whereas their body weight and body mass index (BMI) were not low, especially among the women, compelling female elderly to reduce their food intake to control the weight. Energy intake of female centenarians was low. The ADL in the female centenarians was positively related to energy, suggesting that the low energy intake of the female centenarians was mainly due to their low ADL. Anthropometric, hematological and biochemical variables of the centenarians were lower or near the lower reference limit except serum lipids. All the hematological and biochemical variables were statistically lower (p < 0.05) in the centenarians than in the elderly particularly for females with some minor exceptions. CONCLUSION: The results of the present study showed that the nutritional status assessed by ADL and anthropometric, hematological and biochemical parameters was poor in the centenarian subjects but was maintained in the elderly subjects except height and that the diet was not the major factor of their problems in the nutritional status.

Activities of Daily Living↗
PubMed1994

Poverty and children's nutritional status in the United States.

This study describes deficits in nutritional status among poor children in the United States using data from the National Longitudinal Survey of Youth for children born between 1979 and 1988. The prevalence of low height-for-age (stunting) and low weight-for-height (wasting) is higher among children in persistently poor families. Differentials appear greater according to long-term rather than short-term income; hence, single-year income measures do not adequately capture the effects of persistent poverty on children's nutritional status. Differences in nutritional status between poor and nonpoor children remain large even when controls for other characteristics associated with poverty, such as low maternal educational attainment, single-parent family structure, young maternal age, low maternal academic ability, and minority racial identification, are included. The excess risks of stunting and wasting among poor children are not reduced appreciably when size of the infant at birth or mother's height and weight are controlled.

Body Height↗
PubMed1996

Effect of participation in congregate-site meal programs on nutritional status of the healthy elderly.

OBJECTIVE: This study was designed to evaluate whether participation in a congregate-site meal program influenced the nutritional status of a group of healthy elderly. DESIGN: Nutritional status, as defined by dietary intake and biochemical indexes, was assessed in free-living persons (aged 60 to 89 years) who either did (n = 70) or did not (n = 65) participate in the meal program. Three-day mean intakes of 17 nutrients and serum levels of 13 indexes of nutritional status were measured. STATISTICAL ANALYSES: Multifactorial analysis of variance was used to determine differences in nutrient intake data and biochemical indexes between the groups. By means of correlation analysis, relationships between income and main outcome measures were examined. chi 2 Analysis was used to determine differences in response to categorical variables of the questionnaire. RESULTS: In general, dietary intakes of participants did not differ significantly from those of nonparticipants, nor did the meal provided at the site significantly affect the overall dietary intake of participants. Mean biochemical indexes of nutritional status were within normal ranges for participants and nonparticipants, except for iron. However, 26% of the population consumed diets that may place them at risk for nutritional inadequacy. CONCLUSIONS: Mean dietary intake data and biochemical indexes of nutritional status suggest that the congregate-site meal program did not significantly affect the nutritional status of the population surveyed. Additional studies focusing on the nutritional intake and status of low-income, ethnic minority, and socially isolated participants in the congregate-site meal program are needed to assess which populations are at risk for nutritional deficiencies.

Aged↗
PubMed2000

Impact of nutritional status on outcomes after liver transplantation.

BACKGROUND: Poor preoperative nutritional status has been reported to be associated with adverse outcomes after liver transplantation. Published data are, however, conflicting, with methods of preoperative nutritional assessment and postoperative outcomes varying between studies. METHODS: We prospectively studied the predictive value of preoperative nutritional status for adverse outcomes after liver transplantation. Assessment of preoperative nutritional status included: body cell mass determination, subjective global assessment, anthropometry, handgrip dynamometry, biochemical and amino acid profile, Child's score, and dual-energy x-ray absorptiometry. Death, intensive care unit (ICU) length of stay > or =4 days, hospital length of stay > or =15 days, blood usage > or =36 U of blood products, infection, rejection, and global resource utilization (an index of cost) greater than the median were considered poor outcomes. RESULTS: Fifty-three patients were studied. Longer ICU stay was associated with lower handgrip strength (P<0.01) and lower aromatic amino acid levels (P<0.01). Longer total hospital stay and the development of infections were associated with lower branched chain amino acid levels (P<0.01 and <0.001, respectively). Acute cellular rejection was associated with lower total body fat (P<0.001) and higher triglyceride levels (P<0.02). Neither death nor higher global resource utilization was associated with any preoperative nutritional parameter. CONCLUSIONS: Lower preoperative handgrip strength and branched chain amino acid levels are associated with longer ICU stays and increased likelihood of posttransplant infections. In our program, in which nutritional support was provided to potential recipients exhibiting malnourishment, none of the measured nutritional parameters were associated with mortality or greater global resource utilization.

Adult↗