Assessing nutritional status in the ICU

Nutrient Utilization ◽

Protein Energy ◽

Catabolic Rate ◽

Patients At Risk ◽

Patient’S History

Decreased nutrient intake, increased body requirements, and/or altered nutrient utilization are frequently combined in critically-ill patients. The initial nutritional status and the extent of the disease-related catabolism are the main risk factors for nutrition- related complications. Many complications are related to protein energy malnutrition, which is frequent in the ICU setting. Assessing nutritional status pursues several different goals. Nutritional assessment is required for patients presenting with clinical evidence of malnutrition, with chronic diseases, with acute conditions accompanied by a high catabolic rate, and elderly patients. Recording the patient’s history, nutrient intake, and physical examination, and subjective global assessment allows classification of nutritional status. All the traditional markers of malnutrition, anthropometric measurements and plasma proteins, lose their specificity in the sick adult as each may be affected by a number of non-nutritional factors. Muscle function evaluated by hand-grip strength in cooperative patients and serum albumin provide an objective risk assessment. Several nutritional indices have been validated in specific groups of patients to identify patients at risk of nutritionally-mediated complications and, therefore, the need for nutritional support. A strong suspicion remains the best way of uncovering potentially harmful nutritional deficiencies.

Nutritional assessment

10.1093/med/9780198759928.003.0003 ◽

2018 ◽

Author(s):

John Puntis

Keyword(s):

Nutritional Assessment ◽

Growth Failure ◽

Developed Countries ◽

Negative Effects ◽

Healthy Life ◽

Protein Energy ◽

Nutritional Needs ◽

Routine Assessment

Routine assessment of nutritional status should be part of normal practice when seeing any patient. The purpose is to document objective nutritional parameters (e.g. anthropometry), identify nutritional deficiencies, and establish nutritional needs. Protein–energy malnutrition has many adverse consequences including growth failure (identified by reference to standard growth charts). Worldwide, malnutrition contributes to a third of deaths in children under 5 years of age, and one in nine people don’t have enough food to lead an active and healthy life. In developed countries, malnutrition complicates both acute and chronic illness with negative effects on outcomes. In clinical practice, a useful approach to nutritional assessment is to consider three elements: ‘what you are’ (i.e. body habitus—underweight for height; short for age; etc.), ‘what you can do’ (functional activity), and ‘what you eat’ (current nutritional intake).

Nutrition in Children with Kidney Disease: Pitfalls of Popular Assessment Methods

Peritoneal Dialysis International ◽

10.1177/089686080502503s38 ◽

2005 ◽

Vol 25 (3_suppl) ◽

pp. 143-146 ◽

Cited By ~ 13

Author(s):

Bethany J. Foster ◽

Mary B. Leonard

Keyword(s):

Body Composition ◽

High Risk ◽

Kidney Disease ◽

Nutritional Status ◽

Nutritional Assessment ◽

Fluid Overload ◽

Protein Energy ◽

Accurate Picture ◽

Pubertal Delay

Children with chronic kidney disease (CKD) are considered at high risk for protein-energy malnutrition. Clinical practice guidelines generally recommend an evaluation of numerous nutritional parameters to give a complete and accurate picture of nutritional status. This review summarizes the potential limitations of commonly used methods of nutritional assessment in the setting of CKD. Unrecognized fluid overload and inappropriate normalization of body composition measures are the most important factors leading to misinterpretation of the nutritional assessment in CKD. The importance of expressing body composition measures relative to height or height-age in a population in whom short stature and pubertal delay are highly prevalent is emphasized. The limitations of growth as a marker for nutritional status are also addressed. In addition, the prevailing belief that children with CKD are at high risk for malnutrition is challenged.

Angular Cheilitis pada Anak yang Mengalami Defisiensi Nutrisi

e-GIGI ◽

10.35790/eg.v9i2.34871 ◽

2021 ◽

Vol 9 (2) ◽

pp. 196

Author(s):

Verena M. Ekarisma ◽

Christy N. Mintjelungan ◽

Aurelia S. R. Supit ◽

Johanna A. Khoman

Keyword(s):

Literature Review ◽

Nutritional Status ◽

Vitamin B ◽

Cross Sectional ◽

Oral Infections ◽

Protein Energy ◽

Complex Deficiency

Abstract: Nutritional problems in Indonesia and developing countries in general are still dominated by the protein energy malnutrition (PEM) and other micronutrient problems such as iron deficiency and vitamin B complex deficiency. Nutritional deficiency is always accompanied by malnutrition in childhood. Children face the greatest risk of developing malnutrition. This can lead the children to become susceptible to infectious diseases. One of the most common oral infections in children with nutritional deficiencies is angular cheilitis. This study was aimed to review nutritional deficiencies in children with angular cheilitis. This was a literature review study. This study reviewed topics related to nutritional deficiencies in children from previous studies. There were 12 literature reviewed in this study consisting of 11 cross-sectional studies and one simple experimental study. The results showed that angular cheilitis was more common in children with malnutrition based on BMI for age measurement and moderate nutritional status based on MUAC measurements. Angular cheilitis type 1 were most commonly found in children with mild nutritional status, while types 2, 3 and 4 were most commonly found in children with moderate nutritional status. None of types 2, 3, and 4 were seen in children with good nutritional status. In conclusion, children with angular cheilitis are mostly deficient in vitamin B complex.Keywords: angular cheilitis, children, nutritional deficiencies Abstrak: Masalah nutrisi di Indonesia dan di negara berkembang pada umumnya masih didominasi oleh masalah kurang energi dan protein (KEP) serta masalah nutrisi mikro lainnya seperti defisiensi zat besi dan defisiensi vitamin B kompleks. Defisiensi nutrisi selalu dihubungkan dengan kekurangan gizi pada masa anak-anak. Anak-anak menghadapi risiko paling besar untuk mengalami kurang gizi. Defisiensi nutrisi dapat menyebabkan anak rentan terhadap penyakit infeksi. Salah satu penyakit infeksi rongga mulut yang sering terjadi pada anak dengan defisiensi nutrisi ialah angular cheilitis. Penelitian ini bertujuan untuk mengetahui gambaran defisiensi nutrisi pada anak dengan angular cheilitis. Jenis penelitian ialah suatu literature review. Penelitian ini mempelajari topik terkait defisiensi nutrisi pada anak dengan angular cheilitis dari penelitian-penelitian sebelumnya. Pustaka yang diulas dan dipelajari dalam penelitian ini sebanyak 12 pustaka yang terdiri dari 11 studi potong lintang dan satu eksperimental sederhana. Hasil penelitian menunjukkan bahwa lesi angular cheilitis lebih sering ditemukan pada anak dengan status gizi kurang berdasarkan pengukuran IMT/U dan status kurang nutrisi sedang berdasarkan pengukuran LLA. Lesi angular cheilitis tipe 1 paling banyak ditemukan pada anak dengan status kurang nutrisi ringan, sedangkan tipe 2, 3 dan 4 paling banyak ditemukan pada anak dengan status kurang nutrisi sedang dan tidak satu pun lesi tipe 2, 3, 4 terlihat pada anak dengan status nutrisi baik. Simpulan penelitian ini ialah anak dengan angular cheilitis paling banyak mengalami defisiensi nutrisi mikro vitamin B kompleks.Kata kunci: angular cheilitis, anak, defisiensi nutrisi

Interaction of two public health problems in Turkish schoolchildren: nutritional deficiencies and goitre

Public Health Nutrition ◽

10.1017/phn2006983 ◽

2006 ◽

Vol 9 (8) ◽

pp. 1001-1006 ◽

Cited By ~ 2

Author(s):

Betul Ersoy ◽

Hafize Sunalcan Günes ◽

Turkan Gunay ◽

Ozge Yilmaz ◽

Erhun Kasirga ◽

...

Keyword(s):

Nutritional Status ◽

Primary Schools ◽

Economic Status ◽

World Health ◽

Anthropometric Indices ◽

School Aged Children ◽

Socio Economic Status ◽

Protein Energy

AbstractObjectiveThe aim of the present study was to determine the interaction of and association between frequency of goitre detected by palpation, nutritional status evaluated by anthropometric indices and socio-economic status in school-aged children.SubjectsOne thousand and eighteen prepubertal and pubertal children (aged 6–14 years) attending primary schools in an urban area were included in this study.Design and settingAll subjects were evaluated for the presence of goitre and nutritional status. Thyroid size was assessed using the World Health Organization's (WHO) palpation system (1960). Severity of protein–energy malnutrition (PEM) was based on WHO criteria. Children were grouped into four categories of socio-economic status.ResultsEight per cent of children were detected to have goitre by palpation. Body mass index and weight-for-height were significantly lower in children who had palpable goitre than in children who did not have goitre (P < 0.05). Frequencies of having palpable goitre and being stunted and underweight were especially higher in children with very low socio-economic status (P = 0.016, 0.01 and 0.01, respectively). Frequency of being stunted, underweight and wasted in children with palpable goitre did not change significantly according to socio-economic status (P>0.05). In logistic regression analyses, the most important factor in detection of palpable goitre was socio-economic status (B = 0.517, P = 0.004). Fathers' education and occupation were found to be most significant (P = 0.031 and 0.020, respectively).ConclusionChildren detected to have palpable goitre were thinner. However, nutritional disorders were not more frequent among children with palpable goitre compared with children without goitre. Goitre and nutritional deficiencies were more common in children with lower socio-economic status but the frequency of nutritional disorders in children with palpable goitre did not change according to socio-economic status.

Dynamic Oral Texture Properties of Selected Indigenous Complementary Porridges Used in African Communities

Foods ◽

10.3390/foods8060221 ◽

2019 ◽

Vol 8 (6) ◽

pp. 221 ◽

Cited By ~ 3

Author(s):

James Makame ◽

Tanita Cronje ◽

Naushad M. Emmambux ◽

Henriette De Kock

Keyword(s):

Young Children ◽

Low Income ◽

Nutrient Intake ◽

Control Method ◽

Public Health Problem ◽

Major Public Health Problem ◽

Texture Properties ◽

Protein Energy ◽

Infants And Young Children

Child malnutrition remains a major public health problem in low-income African communities, caused by factors including the low nutritional value of indigenous/local complementary porridges (CP) fed to infants and young children. Most African children subsist on locally available starchy foods, whose oral texture is not well-characterized in relation to their sensorimotor readiness. The sensory quality of CP affects oral processing (OP) abilities in infants and young children. Unsuitable oral texture limits nutrient intake, leading to protein-energy malnutrition. The perception of the oral texture of selected African CPs (n = 13, Maize, Sorghum, Cassava, Orange-fleshed sweet potato (OFSP), Cowpea, and Bambara) was investigated by a trained temporal-check-all-that-apply (TCATA) panel (n = 10), alongside selected commercial porridges (n = 19). A simulated OP method (Up-Down mouth movements- munching) and a control method (lateral mouth movements- normal adult-like chewing) were used. TCATA results showed that Maize, Cassava, and Sorghum porridges were initially too thick, sticky, slimy, and pasty, and also at the end not easy to swallow even at low solids content—especially by the Up-Down method. These attributes make CPs difficult to ingest for infants given their limited OP abilities, thus, leading to limited nutrient intake, and this can contribute to malnutrition. Methods to improve the texture properties of indigenous CPs are needed to optimize infant nutrient intake.

Nutritional Status of Participating and Non-participating Pupils in the Ghana School Feeding Programme

Journal of Food Research ◽

10.5539/jfr.v1n3p263 ◽

2012 ◽

Vol 1 (3) ◽

pp. 263 ◽

Cited By ~ 10

Author(s):

A. O. Danquah ◽

A. N. Amoah ◽

M. Steiner-Asiedu ◽

C. Opare-Obisaw

Keyword(s):

Nutritional Status ◽

School Children ◽

School Lunch ◽

Nutrient Deficiencies ◽

Demographic Health Survey ◽

School Feeding ◽

Protein Energy ◽

Significant Difference ◽

Better Than

The Ghana Demographic Health Survey indicates that the major nutritional challenges in Ghana among school children are protein-energy malnutrition and micro-nutrient deficiencies. School Feeding Programmes are one of the main interventions addressing malnutrition and its related effects on children’s health and education. The purpose of this study was to assess the influence of Ghana School Feeding Programme on nutritional status of school children in Atwima-Nwabiagya District of Ashanti Region, Ghana. A total of 234 pupils between 9 and 17 years of age, comprising 114 participants and 120 non-participants from three participating and three non-participating schools, respectively, with similar characteristics, took part in the study. It was hypothesized that the nutritional status of participants was better than that of non-participants. Results did not indicate any association between the school lunch and nutritional status. There was no statistically significant difference in the nutritional status of participants and non-participants. The programme did not impact the nutritional status of participants.

MALNUTRITION IN CIRRHOSIS: ASSOCIATION WITH ETIOLOGY AND HEPATOCELLULAR DYSFUNCTION

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.202000000-71 ◽

2020 ◽

Vol 57 (4) ◽

pp. 375-380

Author(s):

Kalinca S OLIVEIRA ◽

Luana Reis OLIVEIRA ◽

Sabrina A FERNANDES ◽

Gabriela P CORAL

Keyword(s):

Liver Disease ◽

Nutritional Status ◽

Muscle Thickness ◽

Bioelectrical Impedance ◽

Disease Etiology ◽

Adductor Pollicis Muscle ◽

Protein Energy ◽

End Stage ◽

A Prospective Study

ABSTRACT BACKGROUND: The protein-energy malnutrition alters the prognosis of patients with cirrhosis. Its prevalence may vary according to the etiology of liver disease, it´s severity and the evaluation of the method applied. The infection by the hepatitis C virus (HCV) and alcoholism are the main etiologies of cirrhosis and result in a significant morbidity and mortality. OBJECTIVE: To evaluate the nutritional status of patients with cirrhosis according the liver disease etiology and severity. METHODS: It is a prospective study, in which the sample was for convenience and consisted of patients with cirrhosis, infected by HCV or alcoholic etiology. The nutritional status evaluation was carried out through anthropometry, food consumption, bioelectrical impedance (BIA) and subjective global assessment (SGA). The anthropometric data evaluated were weight, height, body mass index (BMI), triceps skinfold (TSF), circumference of the arm (CA), non-dominant handshake strength (FAM) and the adductor pollicis muscle thickness (APM). Patients were classified according to the severity of liver disease, using the Child-Pugh and Model for End-stage Liver Diseases (MELD) scores. RESULTS: Ninety patients with cirrhosis were evaluated, 47 with HCV and 43 with alcoholic etiology. The prevalence of protein-calorie malnutrition ranged from 10.9% to 54.3% in the HCV group and from 4.7% to 20.9% in the alcoholic group, depending on the method used for evaluation. The group with HCV infection presented a higher malnutrition prevalence in comparison to the alcoholic in the following evaluations: TSF (P<0.001), phase angle (PA) (P=0.016) and SGA (P=0.010). PA values were lower in patients with viral cirrhosis (5.68±1.05) when compared to those with alcoholic etiology (6.61±2.31) (P=0.016). When all patients were analyzed, regardless of etiology, an inversely correlation was observed among Child-Pugh score and PA values (P=0.018). CONCLUSION: HCV cirrhosis showed worse nutritional parameters in comparison to alcoholic etiology; however, the PA was associated with worse liver function in both etiologies.

Low serum albumin and total lymphocyte count as predictors of 30 day hospital readmission in patients 65 years of age or older

10.7287/peerj.preprints.1186v1 ◽

2015 ◽

Author(s):

Robert Robinson

Keyword(s):

Risk Factor ◽

Serum Albumin ◽

Hospital Readmission ◽

Lymphocyte Count ◽

Total Lymphocyte Count ◽

Total Lymphocyte ◽

Protein Energy ◽

Patients At Risk ◽

Low Serum

Introduction: Hospital readmission within 30 days of discharge is a target for health care cost savings through the medicare Value Based Purchasing initiative. Because of this focus, hospitals and health systems are investing considerable resources into the identification of patients at risk of hospital readmission and designing interventions to reduce the rate of hospital readmission. Malnutrition is a known risk factor for hospital readmission. Materials and Methods: All medical patients 65 years of age or older discharged from Memorial Medical Center from January 1, 2012 to March 31, 2012 who had a determination of serum albumin level and total lymphocyte count on hospital admission were studied retrospectively. Admission serum albumin levels and total lymphocyte counts were used to classify the nutritional status of all patients in the study. Patients with a serum albumin less than 3.5 grams/dL and/or a TLC less than 1,500 cells per mm3 were classified as having protein energy malnutrition. The primary outcome investigated in this study was hospital readmission for any reason within 30 days of discharge. Results: The study population included 1,683 hospital discharges with an average age of 79 years. The majority of the patients were female (55.9%) and had a DRG weight of 1.22 (0.68). 219 patients (13%) were readmitted within 30 days of hospital discharge. Protein energy malnutrition was common in this population. Low albumin was found in 973 (58%) patients and a low TLC was found in 1,152 (68%) patients. Low albumin and low TLC was found in 709 (42%) of patients. Kaplan-Meier analysis shows any laboratory evidence of PEM is a significant (p < 0.001) predictor of hospital readmission. Low serum albumin (p < 0.001) and TLC (p = 0.018) show similar trends. Cox proportional-hazards regression analysis showed low serum albumin (Hazard Ratio 3.27, 95% CI: 2.30-4.63) and higher DRG weight (Hazard Ratio 1.19, 95% CI: 1.03-1.38) to be significant independent predictors of hospital readmission within 30 days. Discussion: This study investigated the relationship of PEM to the rate of hospital readmission within 30 days of discharge in patients 65 years of age or older. These results indicate that laboratory markers of PEM can identify patients at risk of hospital readmission within 30 days of discharge. This risk determination is simple and identifies a potentially modifiable risk factor for readmission: protein energy malnutrition.

Prevalence of nutritional deficiencies among school going adolescents of Vadodara, Gujarat, India: a cross sectional study

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20195157 ◽

2019 ◽

Vol 6 (6) ◽

pp. 1767

Author(s):

Ashish Shamjibhai Bhalsod ◽

Nisarg N. Dave ◽

Nilesh Thakor

Keyword(s):

Vitamin A Deficiency ◽

Cross Sectional Study ◽

Growth Spurt ◽

Cross Sectional ◽

Male Adolescents ◽

Protein Energy ◽

Complex Deficiency ◽

Fatty Acid Deficiency

Background: Adolescent constitutes over 23% of the population in India. Critical development occurs during adolescence period. Growth spurt and increase in physical activity during adolescent period increases the nutrition and health needs of the adolescent. Objective was to study prevalence of nutritional deficiencies among school going adolescents of Vadodara city, Gujarat.Methods: The study was carried during period from September 2018 to August 2019. After taking the permission of principals of 3 schools and consent of the parents of adolescents, 511 adolescents from 3 schools of Vadodara city were examined for signs of various nutritional deficiencies. The data was collected by predesign, pretested proforma and analyzed using SPSS 17.0 (Trial Version).Results: Out of total 511 adolescents 253(49.5%) were female. Mean age of the study adolescents was 15.6±1.81 years. Maximum numbers of the adolescents were in the age group of 10-14 years (60.3%). Mean age of female and male adolescents was 15.2±1.71 years and 15.6±2.01 years respectively. The study revealed that vitamin A deficiency was present in 38(7.4%) adolescents. Vitamin B complex deficiency signs were seen in 112(21.9%) adolescents. Vitamin C deficiency signs were seen in 43(8.4%) adolescents. Protein Energy Malnutrition was observed in 52(10.1%) adolescents. Essential fatty acid deficiency was observed in 56(10.9%) adolescents.Conclusions: High prevalence of nutritional deficiencies among these adolescents needs great attention and health education.

Nutritional deficiencies and later behavioural development

Proceedings of The Nutrition Society ◽

10.1017/s0029665100000069 ◽

2000 ◽

Vol 59 (1) ◽

pp. 47-54 ◽

Cited By ~ 54

Author(s):

S. M. Grantham-McGregor ◽

S. P. Walker ◽

S. Chang

Keyword(s):

Cultural Context ◽

School Achievement ◽

Term Effect ◽

Long Term Effects ◽

Protein Energy ◽

Long Term Effect ◽

Long Term Follow Up

The literature on the long-term effects of nutritional deficiencies in early life is reviewed. The severity and duration of the deficiency, the stage of the children’s development, the biological condition of the children and the socio-cultural context may all modify the effect. There is substantial evidence that reduced breast-feeding, small-for-gestational-age birth weight, Fe and I deficiency, and protein-energy malnutrition (PEM) are associated with long-term deficits in cognition and school achievement. However, all these conditions are associated with poverty and poor health, which may account for the association. It is difficult to establish that the long-term relationship is causal, as it requires a randomized treatment trial with long-term follow-up. Such studies are only available for I deficiency in utero and early childhood PEM. Results from these studies indicate that I deficiency has a long-term effect and PEM probably has a long-term effect.