scholarly journals Association between oral nutritional supplementation and clinical and nutritional outcomes in the management of hospital malnutrition

2021 ◽  
Vol 11 (4) ◽  
pp. 46-52
Author(s):  
Ayla Nauane Ferreira dos Santos ◽  
Kamila Luana do Nascimento Silva ◽  
Vinícius Eponina dos Santos ◽  
Ranna Adrielle Lima Santos ◽  
Vivianne de Sousa Rocha
Keyword(s):  
Nutritional Assessment ◽  
Nutritional Supplement ◽  
Nutritional Intervention ◽  
Nutritional Supplementation ◽  
University Hospital ◽  
Nutritional Risk ◽  
Hospital Malnutrition ◽  
Significant Difference ◽  
Oral Nutritional Supplements ◽  
Nutritional Outcomes

Objective: To evaluate the association between oral nutritional supplementation and clinical and nutritional outcomes in the management of hospital malnutrition. Methods: This is a longitudinal observational study conducted by collecting electronic medical records of patients admitted to a university hospital between 2019 and 2020. Malnourished adult and elderly patients, who have been eating exclusively orally and using a nutritional supplement, were included.Sociodemographic, clinical, biochemical, nutritional risk, nutritional assessment, acceptance of nutritional prescription and characteristics of the nutritional supplement used were analyzed. An α = 5% was considered. Results: Forty patients were evaluated, most of them elderly and male. Among the oral nutritional supplements, the high-calorie and high-protein types were more prevalent, with an offer twice a day, average use of 39 days, and total acceptance of the nutritional prescription by only 30% of the patients. This nutritional intervention resulted in a slight improvement in anthropometric data, with no significant difference. Conclusion: Using the oral nutritional supplement for a longer period and better adherence would possibly present greater nutritional benefits to patients.

scholarly journals Oral Nutritional Supplementation Improves Growth in Children at Malnutrition Risk and with Picky Eating Behaviors

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3590
Author(s):  
Deepti Khanna ◽  
Menaka Yalawar ◽  
Pinupa Venkata Saibaba ◽  
Shirish Bhatnagar ◽  
Apurba Ghosh ◽  
...  
Keyword(s):  
Eating Behaviors ◽  
Nutritional Intervention ◽  
Nutritional Risk ◽  
Indian Children ◽  
Dietary Counseling ◽  
Picky Eating ◽  
Significant Difference ◽  
Oral Nutritional Supplements ◽  
Height Gain ◽  
Study Interval

The problem of poor nutrition with impaired growth persists in young children worldwide, including in India, where wasting occurs in 20% of urban children (<5 years). Exacerbating this problem, some children are described by their parent as a picky eater with behaviors such as eating limited food and unwillingness to try new foods. Timely intervention can help prevent nutritional decline and promote growth recovery; oral nutritional supplements (ONS) and dietary counseling (DC) are commonly used. The present study aimed to determine the effects of ONS along with DC on growth in comparison with the effects of DC only. Enrolled children (N = 321) were >24 to ≤48 months old, at malnutrition risk (weight-for-height percentile 3rd to 15th), and described as a picky eater by their parent. Enrollees were randomized to one of the three groups (N = 107 per group): ONS1 + DC; ONS2 + DC; and DC only. From day 1 to day 90, study findings showed significant increases in weight-for-height percentile for ONS1 + DC and for ONS2 + DC interventions, as compared to DC only (p = 0.0086 for both). There was no significant difference between the two ONS groups. Anthropometric measurements (weight and body mass index) also increased significantly over time for the two ONS groups (versus DC only, p < 0.05), while ONS1 + DC significantly improved mid-upper-arm circumference (p < 0.05 versus DC only), as well. ONS groups showed a trend toward greater height gain when compared to DC only group, but the differences were not significant within the study interval. For young Indian children with nutritional risk and picky eating behaviors, our findings showed that a 90-day nutritional intervention with either ONS1 or ONS2, along with DC, promoted catch-up growth more effectively than did DC alone.

scholarly journals The Frequency of Malnutrition in Patients with Type 2 Diabetes

2021 ◽  
Author(s):  
Miraç Vural Keskinler ◽  
Güneş Feyizoğlu ◽  
Kübra Yıldız ◽  
Aytekin Oğuz
Keyword(s):  
Type 2 Diabetes ◽  
Outpatient Clinic ◽  
High Body Mass Index ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Nutritional Risk ◽  
Cross Sectional ◽  
Significant Difference ◽  
Nrs 2002

Objective: Obesity is one of the most common comorbidities of diabetes mellitus (DM) whose frequency is rapidly increasing nowadays. Although obesity caused by excessive and unbalanced nutrition often accompanies diabetes; malnutrition is another complication of diabetes. This study was conducted to investigate the frequency of malnutrition in individuals with diabetes. Method: This study is a cross-sectional study. The patients with type 2 diabetes followed up in the diabetes outpatient clinic of a university hospital between February and March 2018 were included in the study. Anthropometric measurements of the patients and “Nutritional Risk Screening-2002” (NRS-2002) scores were recorded. Results: A total of 222 (F: 132 59.4%) patients were included in the study. When two groups with higher NRS (≥3) and lower NRS (<3) scores less than 3 were compared, any significant difference was not detected between two groups in terms of age, waist circumference and HbA1c values. Only BMI was found to be lower in the group with malnutrition risk (p: 0.030). When the patients were evaluated in terms of diabetes treatments and risk of malnutrition, any significant intergroup difference was not found (p: 0.847). Conclusion: It was found that there is a risk of malnutrition in one of every seven diabetics with a high body mass index who were being followed up in the diabetes outpatient clinic.

scholarly journals NUTRITIONAL INDICATORS OF MALNUTRITION IN HOSPITALIZED PATIENTS

2019 ◽  
Vol 56 (4) ◽  
pp. 447-450 ◽  
Author(s):  
Vânia Aparecida LEANDRO-MERHI ◽  
Caroline Lobo COSTA ◽  
Laiz SARAGIOTTO ◽  
José Luiz Braga de AQUINO
Keyword(s):  
Lymphocyte Count ◽  
Cox Regression ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Hospitalized Patients ◽  
Nutritional Risk ◽  
Calf Circumference ◽  
Significance Level ◽  
Cox Regression Analysis ◽  
Significant Difference

ABSTRACT BACKGROUND: Malnutrition is associated with clinical factors, including longer hospital stay, increased morbidity and mortality and hospital costs. OBJECTIVE: To investigate the prevalence of malnutrition using different nutritional indicators and to identify factors that contribute to malnutrition in hospitalized patients. METHODS: We investigated anthropometric, laboratory standards, nutritional risk screening (NRS), subjective global assessment (SGA), mini nutritional assessment and habitual energy consumption (HEC). Chi-square, Fisher’s exact test, Mann-Whitney test and univariate and multiple Cox regression analysis were used, at 5% significance level. RESULTS: It was found 21.01% of malnourished individuals by ASG; a total of 34.78% with nutritional risk according to NRS and 11.59% with low weight (BMI). There was no statistically significant difference in the prevalence of malnutrition by ASG (P=0.3344) and nutritional risk by NRS (P=0.2286), among the types of disorders. Patients with nutritional risk were of higher median age (64.5 vs 58.0 years; P=0.0246) and had lower median values of HEC (1362.1 kcal vs 1525 kcal, P=0.0030), of calf circumference (32.0 cm vs 33.5 cm, P=0.0405) of lymphocyte count (1176.5 cell/mm3 vs 1760.5 cell/ mm3, P=0.0095); and higher percentage of low body weight according to the BMI (22.9% vs 5.6%; P=0.0096). Lymphocyte count was associated with nutritional risk (P=0.0414; HR= 1.000; IC95%= 0.999; 1.000). CONCLUSION: NRS was more sensitive than other indicators in the diagnosis of malnutrition. Patients at risk were older and had lower HEC values, calf circumference, BMI and lymphocyte count. Low lymphocyte count was considered a factor associated with nutritional risk by the NRS.

scholarly journals ORAL NUTRITIONAL SUPPLEMENTS AND TASTE ADHERENCE IN MALNOURISHED ELDERLY ADULT’S OUTPATIENTS

2017 ◽  
pp. 1-5
Author(s):  
D.A. de Luis ◽  
O. Izaola ◽  
A Castro ◽  
J.J. Lopez ◽  
B. Torres ◽  
...  
Keyword(s):  
Weight Loss ◽  
Daily Intake ◽  
Nutritional Supplements ◽  
Nutritional Supplement ◽  
Taste Preferences ◽  
Oral Nutrition ◽  
Oral Nutritional Supplement ◽  
Nutrition Supplement ◽  
Significant Difference ◽  
Oral Nutritional Supplements

Abstract: The aim of our study was to evaluate a hypercaloric sweet milkbased oral nutrition supplement in a prospective 3 day-study designed to assess the taste preferences of this oral nutritional supplement (ONS) in elderly malnourished out-patients and the influence on adherence in daily intake during two months.A total of 28 out-patients with recent weight loss were included in this study. One flavour (chocolate, vanilla or strawberry) was administered each day in a random way during three consecutive days. In the first three days, patients were asked to fulfill two questionnaires in order to reflect ONS tolerance and acceptance. Sweet and aftertaste were better for chocolate flavour than for vanilla or strawberry flavours. Patients who chose vainilla took a total of 96.3+7.4 average bricks during outpatient followup (1.60+0.3 per day), patients who chose chocolate took 76.8+15.0 bricks (1.28+0.8 per day) and patients who chose strawberry bricks taken 60.3+19.5 bricks (1.10+0.7 per day), with a significant difference with vainilla flavour (p <0.01). The improvement of weight (vanilla +1.0+0.8 kg vs chocolate +0.5+0.8 kg vs 0.6+1.0 kg:p=0.03), tricipital skinfols (vanilla +1.5+0.3 mm vs chocolate +1.1+0.4 mm vs 0.7+0.3 mm:p=0.03), prealbumin levels (vanilla +4.2+0.8 mg/dl vs chocolate +3.9+0.7 mg/dl vs +3.6+1.0 mg/dl:p=0.01) and transferrin levels (vanilla +100.0+21.8 mg/dl vs chocolate +75.5+18.8 mg/dl vs 63.8+14.1 mg/dl:p=0.03) was higher in patients treated with vanilla ONS than chocolate or strawberry ONS. The three flavoured ONS taste preferences are similar although the consumption is high in vanilla flavoured ONS.

scholarly journals ORAL/ENTERAL NUTRITIONAL SUPPLEMENTATION IN CHILDREN TREATED FOR CANCER IN LOW-MIDDLE-INCOME COUNTRIES IS FEASIBLE AND EFFECTIVE: THE EXPERIENCE OF THE CHILDREN'S HOSPITAL MANUEL DE JESUS RIVERA "LA MASCOTA" IN NICARAGUA.

2018 ◽  
Vol 10 (1) ◽  
pp. e2018038 ◽  
Author(s):  
Nicolò Peccatori ◽  
Roberta Ortiz ◽  
Emanuela Rossi ◽  
Patricia Calderon ◽  
Valentino Conter ◽  
...  
Keyword(s):  
Solid Tumor ◽  
Nutritional Assessment ◽  
Malignant Tumors ◽  
Nutritional Intervention ◽  
Nutritional Supplementation ◽  
Middle Income ◽  
Children's Hospital ◽  
Low Middle Income Countries ◽  
Pediatric Cancer Patients ◽  
Children’S Hospital

Background and objectives. The prevalence of malnutrition in children diagnosed with malignant tumors in Nicaragua has been reported to be 67%. Thus, a nutritional program for children with cancer has been developed at the Children’s Hospital Manuel de Jesus Rivera (Managua, Nicaragua).Methods. A qualified nutritionist evaluated all patients and prescribed oral/enteral supplementation. The nutritional assessment was based on weight, height or length, mid upper arm circumference (MUAC) and triceps skin fold thickness (TSFT). In this descriptive study, pre and post-nutritional intervention data were compared and analyzed in terms of event free survival.Results. 104 patients (median age 7.0 years, 52 with leukemia/lymphoma and 52 with solid tumor) underwent oral/enteral nutritional supplementation; 64 of these patients had pre and post supplementation nutritional assessment. Overall, 55% of patients in the leukemia/lymphoma group and the 35% in the solid tumor group improved their condition or remained in an adequately nourished status.Conclusion. This experience demonstrates that nutritional supplementation in pediatric cancer patients who are inadequately nourished is feasible also in countries with limited resources and is effective in improving the nutritional conditions.

Role of nutritional status as predictor of survival in oesophageal cancer treated with definitive chemoradiation (dCRT): outcome from SCOPE1, a phase II/III randomised trial of dCRT +/- cetuximab.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 103-103
Author(s):  
Samantha Cox ◽  
Ceri Powell ◽  
Ben Carter ◽  
Chris Hurt ◽  
Somnath Mukherjee ◽  
...  
Keyword(s):  
Oesophageal Cancer ◽  
Nutritional Assessment ◽  
Risk Index ◽  
Randomised Trial ◽  
Nutritional Intervention ◽  
Nutritional Risk ◽  
Tube Placement ◽  
Dietary Advice ◽  
Oral Supplementation ◽  
Nutritional Risk Index

103 Background: Malnutrition is common in oesophageal cancer and may be related to the disease or treatment. We aimed to identify nutritional prognostic factors and the outcome of nutritional intervention in patients recruited to the SCOPE1 trial. Methods: 258 patients were randomly allocated to dCRT with or without the addition of cetuximab. Data was collected prior to induction chemotherapy (iCT) and before commencing concurrent CRT. Nutritional Risk Index (NRI) was calculated and categorised; ≥ 100 (no risk of malnutrition), 97.5-100 (mild risk), and < 97.5 (moderate to severe risk). The maximal nutritional intervention (MNI) received was classified as: none, dietary advice, oral supplementation or major intervention (enteral feeding/tube placement). Univariate and multivariate analyses using Cox proportional hazard modelling were conducted to identify predictive factors and important interactions involving MNI. Results: An NRI score < 100 at baseline strongly predicted reduced median overall survival (OS) in multivariate analysis (HR = 12.45, 95% CI 5.24 – 29.57; p = < 0.001). Furthermore, OS was improved in this group if they received dietary advice (HR = 0.12, p = 0.004), oral supplementation (HR = 0.13, p = < 0.001) or major intervention (HR = 0.13, p = 0.003) prior to commencement of iCT, but there was no benefit if intervention occurred after commencement of iCT. Patients on cetuximab arm undergoing major intervention had worse outcomes compared to control (13 months vs 28 months, p = 0.003). Conclusions: Assessment and correction of poor nutritional state at baseline may improve survival outcomes in oesophageal cancer patients treated with dCRT. The benefit of intervention is no longer observed once treatment has commenced, highlighting the need for early nutritional assessment and intervention. Reason for poor OS in patients on cetuximab requiring major intervention is unclear. Clinical trial information: 47718479.

scholarly journals Nutrition in Cancer Patients

2019 ◽  
Vol 8 (8) ◽  
pp. 1211 ◽  
Author(s):  
Paula Ravasco
Keyword(s):  
Quality Of Life ◽  
Body Composition ◽  
Boolean Function ◽  
Nutritional Intervention ◽  
Nutritional Risk ◽  
Cochrane Library ◽  
Body Composition Assessment ◽  
First Choice ◽  
Oral Nutritional Supplements

Background: Despite being recognised that nutritional intervention is essential, nutritional support is not widely accessible to all patients. Given the incidence of nutritional risk and nutrition wasting, and because cachexia management remains a challenge in clinical practice, a multidisciplinary approach with targeted nutrition is vital to improve the quality of care in oncology. Methods: A literature search in PubMed and Cochrane Library was performed from inception until 26 March. The search consisted of terms on: cancer, nutrition, nutritional therapy, malnutrition, cachexia, sarcopenia, survival, nutrients and guidelines. Key words were linked using “OR” as a Boolean function and the results of the four components were combined by utilizing the “AND” Boolean function. Guidelines, clinical trials and observational studies written in English, were selected. Seminal papers were referenced in this article as appropriate. Relevant articles are discussed in this article. Results: Recent literature supports integration of nutrition screening/assessment in cancer care. Body composition assessment is suggested to be determinant for interventions, treatments and outcomes. Nutritional intervention is mandatory as adjuvant to any treatment, as it improves nutrition parameters, body composition, symptoms, quality of life and ultimately survival. Nutrition counselling is the first choice, with/without oral nutritional supplements (ONS). Criteria for escalating nutrition measures include: (1) 50% of intake vs. requirements for more than 1–2 weeks; (2) if it is anticipated that undernourished patients will not eat and/or absorb nutrients for a long period; (3) if the tumour itself impairs oral intake. N-3 fatty acids are promising nutrients, yet clinically they lack trials with homogeneous populations to clarify the identified clinical benefits. Insufficient protein intake is a key feature in cancer; recent guidelines suggest a higher range of protein because of the likely beneficial effects for treatment tolerance and efficacy. Amino acids for counteracting muscle wasting need further research. Vitamins/minerals are recommended in doses close to the recommended dietary allowances and avoid higher doses. Vitamin D deficiency might be relevant in cancer and has been suggested to be needed to optimise protein supplements effectiveness. Conclusions: A proactive assessment of the clinical alterations that occur in cancer is essential for selecting the adequate nutritional intervention with the best possible impact on nutritional status, body composition, treatment efficacy and ultimately reducing complications and improving survival and quality of life.

scholarly journals The Graz Malnutrition Screening (GMS): a new hospital screening tool for malnutrition

2015 ◽  
Vol 115 (4) ◽  
pp. 650-657 ◽  
Author(s):  
Regina E. Roller ◽  
Doris Eglseer ◽  
Anna Eisenberger ◽  
Gerhard H. Wirnsberger
Keyword(s):  
Predictive Value ◽  
Nutritional Assessment ◽  
Short Form ◽  
Hospital Setting ◽  
Mini Nutritional Assessment ◽  
University Hospital ◽  
Nutritional Risk ◽  
Risk Screening ◽  
Hospitalised Patients ◽  
Blinded Manner

AbstractDespite the significant impact of malnutrition in hospitalised patients, it is often not identified by clinical staff in daily practice. To improve nutritional support in hospitals, standardised routine nutritional screening is essential. The Graz Malnutrition Screening (GMS) tool was developed for the purpose of malnutrition risk screening in a large hospital setting involving different departments. It was the aim of the present study to validate the GMS against Nutritional Risk Screening (NRS) and Mini Nutritional Assessment-short form (MNA-sf) in a randomised blinded manner. A total of 404 randomly selected patients admitted to the internal, surgical and orthopaedic wards of the University Hospital Graz were screened in a blinded manner by different raters. Concurrent validity was determined by comparing the GMS with the NRS and in older patients (70+ years) with the MNA-sf additionally. According to GMS, 31·9 or 28·5 % of the admitted patients were categorised as at ‘risk of malnutrition’ (depending on the rater). According to the reference standard of NRS, 24·5 % of the patients suffered from malnutrition. Pearson’srvalues of 0·78 compared with the NRS and 0·84 compared with the MNA showed strong positive correlations. Results of accuracy (0·85), sensitivity (0·94), specificity (0·77), positive predictive value (0·76) and negative predictive value (0·95) of GMS were also very high. Cohen’sκfor internal consistency of the GMS was 0·82. GMS proves to be a valid and reliable instrument for the detection of malnutrition in adult patients in acute-care hospitals.

scholarly journals Associação entre ferramenta de triagem e avaliação nutricional entre pacientes hospitalizados no município de Porto Alegre

2020 ◽  
Vol 2 (35) ◽  
pp. 144-148
Author(s):  
Camila Weschenfelder ◽  
Luciane Vieira Figueira ◽  
Talita Sthephanie Scotta Cabral ◽  
Jacqueline Schaurich dos Santos
Keyword(s):  
Predictive Value ◽  
Screening Tool ◽  
Nutritional Assessment ◽  
Cross Sectional Study ◽  
The Body ◽  
Assessment Tools ◽  
Nutritional Risk ◽  
Porto Alegre ◽  
Cross Sectional ◽  
Hospital Malnutrition

Introduction: Hospital malnutrition is associated with the worsening of the patient’s general condition and its early diagnosis allows the reduction of related complications. The aim of this study was to verify the agreement of the Short Nutritional Assessment Questionnaire (SNAQ) screening tool and the Subjective Global Assessment (SGA). Methods: Cross-sectional study, carried out in a general hospital in the city of Porto Alegre (RS). The SNAQ was applied by previously trained nutritionists and nurses, and the patient was considered at nutritional risk when the score was ≥2. SGA was applied by nutritionists in all patients and considered the gold standard for comparison. The Kappa coefficient was used to assess the degree of agreement between the screening and nutritional assessment tools. Kappa values between 0.21-0.60 were considered as low agreement, 0.61-0.8 as moderate agreement and greater than 0.81, as strong agreement. Results: Between January and March 2017, 186 patients were evaluated, of them 115 (62%) were women. The mean age was 65.7 ± 16.6 years and the body mass index (BMI) mean was 26.5 ± 5.5 kg/ m². According to SGA classification, 73.7% of the sample was considered to be well nourished, 14% moderately malnourished and 12.4% severely malnourished. Low agreement was observed between the nutritional risk diagnosed by nursing vs. nutrition through SNAQ (Kappa=0.58) and good agreement of SNAQ applied by the nutrition team with the nutritional diagnosis of SGA (Kappa=0.73). The SNAQ presented sensitivity of 85.7% (95% CI 73.3 - 92.9) and specificity of 90.5% (95% CI 84.4 - 94.4); positive predictive value of 76.4% (95% CI 65.7 - 84.5) and negative predictive value of 94.7% (95% CI 90 - 97.2). Conclusion: We conclude that the screening tool SNAQ when conducted by nutritionists can be used for early detection of hospital malnutrition.

scholarly journals Effect of Oral Nutritional Supplementation on Growth in Children with Undernutrition: A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3036
Author(s):  
Zhiying Zhang ◽  
Fei Li ◽  
Bridget A. Hannon ◽  
Deborah S. Hustead ◽  
Marion M. Aw ◽  
...  
Keyword(s):  
Systematic Review ◽  
Repeated Measures ◽  
Meta Analysis ◽  
Intervention Group ◽  
Nutritional Intervention ◽  
Nutritional Risk ◽  
Anthropometric Measures ◽  
Oral Nutritional Supplements ◽  
Z Scores ◽  
Usual Diet

Oral nutritional supplements (ONS) are used to promote catch-up growth in children with undernutrition. We conducted a systematic review and meta-analysis to summarize the evidence of ONS intervention effects on growth for 9-month- to 12-year-old children who were undernourished or at nutritional risk. Eleven randomized controlled trials met the inclusion criteria; trials compared changes in anthropometric measures in children using ONS or ONS + DC (dietary counselling) to measures for those following usual diet or placebo or DC alone. The RCTs included 2287 children without chronic diseases (mean age 5.87 years [SD, 1.35]; 56% boys). At follow-up time points up to 6 months, results showed that children in the ONS intervention group had greater gains in weight (0.423 kg, [95% confidence interval 0.234, 0.613], p < 0.001) and height (0.417 cm [0.059, 0.776], p = 0.022) versus control; greater gains in weight (0.089 kg [0.049, 0.130], p < 0.001) were evident as early as 7–10 days. Longitudinal analyses with repeated measures at 30, 60, and 90 days showed greater gains in weight parameters from 30 days onwards (p < 0.001), a trend towards greater height gains at 90 days (p = 0.056), and significantly greater gains in height-for-age percentiles and z-scores at 30 and 90 days, respectively (p < 0.05). Similar results were found in subgroup analyses of studies comparing ONS + DC to DC alone. For children with undernutrition, particularly those who were mildly and moderately undernourished, usage of ONS in a nutritional intervention resulted in significantly better growth outcomes when compared to control treatments (usual diet, placebo or DC alone).

Sign in / Sign up

Export Citation Format

Share Document