Effect of Nutritional Intervention Programs on Nutritional Status and Readmission Rate in Malnourished Older Adults with Pneumonia: A Randomized Control Trial

Pneumonia leads to changes in body composition and weakness due to the malnourished condition. In addition, patient family caregivers always have a lack of nutritional information, and they do not know how to manage patients’ nutritional intake during hospitalization and after discharge. Most intervention studies aim to provide nutritional support for older patients. However, whether long-term nutritional intervention by dietitians and caregivers from patients’ families exert clinical effects—particularly in malnourished pneumonia—on nutritional status and readmission rate at each interventional phase, from hospitalization to postdischarge, remains unclear. To investigate the effects of an individualized nutritional intervention program (iNIP) on nutritional status and readmission rate in older adults with pneumonia during hospitalization and three and six months after discharge. Eighty-two malnourished older adults with a primary diagnosis of pneumonia participated. Patients were randomly allocated to either a nutrition intervention (NI) group or a standard care (SC) group. Participants in the NI group received an iNIP according to energy and protein intake requirements in addition to dietary advice based on face-to-face interviews with their family caregivers during hospitalization. After discharge, phone calls were adopted for prescribing iNIPs. Anthropometry (i.e., body mass index, limb circumference, and subcutaneous fat thickness), blood parameters (i.e., albumin and total lymphocyte count), hospital stay, Mini-Nutritional Assessment-Short Form (MNA-SF) score, target daily calorie intake, total calorie intake adherence rate, and three-major-nutrient intakes were assessed during hospitalization and three and six months after discharge. Both groups received regular follow-up through phone calls. Furthermore, the rate of readmission resulting from pneumonia was recorded after discharge. During hospital stay, the NI group showed significant increases in daily calorie intake, total calorie intake adherence rate, and protein intake compared with the SC group (p < 0.05); however, no significant difference was found in anthropometry, blood biochemical values, MNA-SF scores, and hospital stay. At three and six months after discharge, the NI group showed significantly higher daily calorie intake and MNA-SF scores (8.2 vs. 6.5 scores at three months; 9.3 vs. 7.6 scores at six months) than did the SC group (p < 0.05). After adjusting for sex, the readmission rate for pneumonia significantly decreased by 77% in the NI group compared with that in the SC group (p = 0.03, OR: 0.228, 95% CI: 0.06–0.87). A six-month iNIP under dietitian and patient family nutritional support for malnourished older adults with pneumonia can significantly improve their nutritional status and reduce the readmission rate.

Download Full-text

Nutritional Intervention May Improve Body Mass Index of Malnourished Hospitalized Psychiatric Patients – A Preliminary Observation

Current Topics in Nutraceutical Research ◽

10.37290/ctnr2641-452x.18:256-259 ◽

2019 ◽

Vol 18 (3) ◽

pp. 256-259

Author(s):

Hou Y.C. ◽

Hsieh Y.L. ◽

Tzeng I.S. ◽

Kuo C.Y.

Keyword(s):

Body Weight ◽

Psychiatric Patients ◽

Psychiatric Hospitals ◽

Nutritional Intervention ◽

Nutrition Intervention ◽

Calorie Intake ◽

Psychiatric Ward ◽

Increased Risk ◽

Total Calorie ◽

Total Calorie Intake

Malnutrition is an important issue in hospitalized patients. Poor nutrition may lead to increased risk of morbidity and death, impaired mental and physical conditions, apathy, depression, self-neglect, increased risk of medical complications, increased risk of pressure ulcers, reduced immune response, delayed wound healing, longer hospital stays, and reduced quality of life. However, few studies have investigated malnutrition in psychiatric patients. Psychiatric patients are known to have an increased risk of malnutrition, but psychiatric hospitals rarely conduct physical examinations and nutritional assessments. In this preliminary study, patients from a psychiatric ward of the Taipei Tzu Chi Hospital were chosen using the Malnutrition Universal Screening Tool. We used the before-and-after analysis to test the effect of a nutrition intervention on the selected parameters. We found that patients who had an impaired nutritional status showed significant increases in body weight (mean: 43.6 ± 7.5 vs. 46.5 ± 8.2 kg; P < 0.001), BMI (mean: 16.8 ± 2.0 vs. 17.9 ± 2.1 kg/m2; P < 0.001), and total calorie intake (mean: 1128 ± 230 vs. 1378 ± 320 Kcal; P < 0.001). Nutritional intervention significantly improved body weight, BMI, and total calorie intake. Nutritional intervention may help prevent malnutrition and improve the management of psychiatric patients.

Download Full-text

Using Dietary Macronutrient Patterns to Predict Sarcopenic Obesity in Older Adults: A Representative Korean Nationwide Population-Based Study

Nutrients ◽

10.3390/nu13114031 ◽

2021 ◽

Vol 13 (11) ◽

pp. 4031

Author(s):

Jun-Hyuk Lee ◽

Hye-Min Park ◽

Yong-Jae Lee

Keyword(s):

Older Adults ◽

Population Based ◽

Sarcopenic Obesity ◽

Calorie Intake ◽

Macronutrient Intake ◽

Dietary Recall ◽

Adverse Health Outcomes ◽

Increased Risk ◽

Total Calorie ◽

Total Calorie Intake

Older adults with sarcopenic obesity (SO) are at increased risk of adverse health outcomes. It has not been identified which pattern of macronutrient intake is appropriate in relation to SO. We aimed to compare the patterns of macronutrient intake for predicting SO in older adults. Data from a total of 3828 older adults who participated in the 2008–2011 Korea National Health and Nutrition Examination Survey were analyzed. The one-day 24 h dietary recall method was used to assess macronutrient intake. SO was defined by a combination of body mass index (BMI) ≥ 25 kg/m2 and BMI adjusted-appendicular skeletal muscle mass <0.789 for men and <0.512 for women. Weighted logistic regression analysis revealed the odds ratio (95% confidence interval) for SO of total calorie intake per 100 increments and carbohydrate (CHO) intake (g/kg/day) per 1 increment to be 0.95 (0.91–0.99) and 0.83 (0.74–0.94), respectively, after adjusting for confounding variables in women. The predictive power for SO of CHO intake (g/kg/day) was higher compared with the other patterns of macronutrient intake both in men and women. In conclusion, total calorie intake and CHO intake (g/kg/day) are inversely related to SO in women. CHO intake (g/kg/day) could be the best index for determining SO.

Download Full-text

Diet Intervention Study through Telemedicine Assistance for Systemic Nickel Allergy Syndrome Patients during the COVID-19 Pandemic

Nutrients ◽

10.3390/nu13082897 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2897

Author(s):

Eleonora Nucera ◽

Angela Rizzi ◽

Raffaella Chini ◽

Sara Giangrossi ◽

Franziska Michaela Lohmeyer ◽

...

Keyword(s):

Nutritional Status ◽

Diet Therapy ◽

Dietary Therapy ◽

Calorie Intake ◽

Adherence Rate ◽

Nickel Allergy ◽

Adherence To Diet ◽

Study Results ◽

Before And After ◽

Evaluation And Assessment

Background: Restrictions due to the COVID-19 pandemic limited patients’ access to hospital care. The aims of this study were to assess dietary nutritional status, quality of life (QoL), and adherence to dietary therapy before and after 30-day personalized diet therapy through telenutrition tools in patients with systemic nickel allergic syndrome (SNAS). Methods: Each SNAS patient underwent the following allergological procedures: (a) face-to-face visit (nutritional visit and QoL evaluation) with prescription of one out of five personalized and balanced dietary plans different for calorie intake, (b) video call visit for dietary evaluation and assessment of adherence to diet after 15 days, and (c) video call visit for dietary and QoL evaluation and assessment of adherence to diet therapy after 30 days (end of study). Results: We enrolled 20 SNAS patients. After 15 and 30 days, we found a statistically significant improvement in anthropometric findings after diet therapy, a significant adherence rate to low-nickel diet (60% and 80%, respectively), and an improvement in QoL with an increase in almost all psychometric indices. Conclusions: Our study demonstrates that telenutrition can be a valid tool to monitor nutritional status and adherence to balanced low-Ni diet positively affecting QoL in SNAS patients during the COVID-19 pandemic.

Download Full-text

Relationship between pregestational nutritional status and type of processing of foods consumed by high-risk pregnant women

Revista Brasileira de Saúde Materno Infantil ◽

10.1590/1806-93042019000200006 ◽

2019 ◽

Vol 19 (2) ◽

pp. 351-361

Author(s):

Débora Cardoso Fernandes ◽

Ioná Carreno ◽

André Anjos da Silva ◽

Tais Battisti Guerra ◽

Fernanda Scherer Adami

Keyword(s):

Fatty Acids ◽

High Risk ◽

Nutritional Status ◽

Pregnant Women ◽

Maternal Age ◽

Sodium Intake ◽

Monounsaturated Fatty Acids ◽

Calorie Intake ◽

Processed Foods ◽

Total Calorie

Abstract Objectives: to relate pregestational nutritional status, maternal age and number of pregnancies to the distribution of macronutrients and micronutrients according to the type of processing offoods consumed by high-risk pregnant women. Methods: a retrospective cross-sectional study was carried out with data from medical records of 200 pregnant women served by a public outpatient clinic in Rio Grande do Sul from 2014 to 2016. Results: the mean percentages of lipids, monounsaturated fatty acids, polyunsaturated fatty acids and sodium intake were higher among ultra-processed foods. There was a significant inverse correlation between maternal age and total calorie intake (p=0.003) and percentage of carbohydrates (p=0.005) and proteins (p=0.037) from ultra-processed foods. There was also a significant association between pregestational nutritional status and total calorie intake (p=0.018) and percentage of carbohydrates (p=0.048) from ultra-processed foods. Conclusions: the mean percentages of lipids, monounsaturated fatty acids, polyunsaturated fatty acids and sodium intake were higher among ultra-processed foods. It was observed that the older the maternal age of high-risk pregnant women, the lower the intake of total calories and percentages of carbohydrates and proteins from ultra-processed foods. It was also observed that pregestational nutritional status was significantly associated with the intake of total calories and percentage of carbohydrates from ultra-processed foods.

Download Full-text

Comprehensive nutritional assessment of frail older adults and a tailored protein-enhanced diet as a way to improve the nutritional status

Nutrition & Food Science ◽

10.1108/nfs-02-2021-0047 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Alina Jaroch ◽

Mariusz Kozakiewicz ◽

Alicja Kowalkowska ◽

Emilia Główczewska-Siedlecka ◽

Kornelia Kędziora-Kornatowska

Keyword(s):

Older Adults ◽

Nutritional Status ◽

Lean Body Mass ◽

Muscle Mass ◽

Physical Performance ◽

Body Mass ◽

Nutritional Intervention ◽

Content Type ◽

Protein Consumption ◽

Frail Older Adults

Purpose Frailty is a geriatric syndrome which can be reversible or less severe through appropriate nutritional interventions. In the present study, to test the efficiency of individualized nutritional intervention was conducted a comprehensive assessment of the nutritional status of frail older adults and evaluation of the effect of nutritional intervention on the nutritional status of pre-frail older patients. Design/methodology/approach Frail older adults (n = 43; mean age 84.6 ± 6.4 years old; 81.4% women) had nutritional status assessed using nutritional anthropometry, body composition, and food frequency questionnaire. Pre-frail patients (n = 16; mean age 68.4 ± 5.5 years old; 81.3% women) for eight weeks were consuming 1.0 g protein/kg BW/day. Robust older adults formed a control group (n = 29; mean age 69.3 ± 5.3 years old; 82.8% women). Findings Frail older adults had weight and muscle mass loss, and their diet variety was sufficient. After the intervention, pre-frail patients increased their protein consumption by 25.8% (P = 0.002). An increase in lean body mass (+1.0 kg), skeletal muscle mass (+0.3 kg) and improvement in physical performance was also observed. Originality/value An individual diet for pre-frail older adults can reverse weight loss and increase lean body mass, furthermore preventing or delaying the development of frailty syndrome. Moreover, increased protein consumption improves physical performance of pre-frail older adults.

Download Full-text

Nutritional status of the adolescent mothers in a rural area of Bangladesh

Journal of Dhaka Medical College ◽

10.3329/jdmc.v22i1.15539 ◽

2013 ◽

Vol 22 (1) ◽

pp. 7-10

Author(s):

Masuma Begum ◽

Md Tarique Mehedi ◽

Arif Mahmud ◽

Sayeda Riya ◽

Kazi Monisur Rahman

Keyword(s):

Nutritional Status ◽

Family Size ◽

Adolescent Mothers ◽

Leafy Vegetables ◽

Adolescent Mother ◽

Nutritional Deficiencies ◽

Calorie Intake ◽

Carbohydrate Source ◽

Total Calorie ◽

Total Calorie Intake

Background: Adolescence is a significant period of human growth and maturation. In Bangladesh adolescent population is about 24% and highest prevalence of nutritional deficiencies occur during adolescence. The young mothers nutritional status is very important. This cross-sectional study was carried out to investigate the nutritional status and dietary pattern of adolescent mothers. Methods: Total 103 adolescent mothers nutritional status was assessed by anthropometric measurements-height, weight, MAC and BMI. Food intake pattern was assessed by food frequency questionnaire and nutrient intake was assessed by 24 hours recall method. Results: Underweight was 39.8%, normal weight 51.5% and overweight 7.8%. Mean calorie intake was 1838.38 Kcal (81.34% of RDA), daily protein intake was 58.74 gm (124.98% of RDA) and daily fat intake was 58.75 gm (117.75% of RDA). about 57.31% of the total calorie intake (1789.19 Kcal) came from carbohydrate source, 13.13% from protein and 29.55% from fat. A significant percentage of mothers did not take milk (25.5%) or egg (22.5%) once in a week. Pulse was consumed regularly above 6 times a week by 54.9% of the mothers. Fish was consumed 4-6 times by 39.2%, green leafy vegetables above 6 times by 35.3%. There were positive association found between nutritional status and family size, monthly family income and total calorie intake. Conclusion: nutritional status of the adolescent mothers were not so satisfactory. nutritional status is largely associated with their socio-economic status and family size. DOI: http://dx.doi.org/10.3329/jdmc.v22i1.15539 J Dhaka Medical College, Vol. 22, No. 1, April, 2013, Page 7-10

Download Full-text

Nutritional status of older adults in a community in Pathanamthitta district of Kerala

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20175721 ◽

2017 ◽

Vol 6 (1) ◽

pp. 210 ◽

Cited By ~ 3

Author(s):

Jacob Abraham ◽

Navaneetha N. ◽

Felix Johns ◽

Rajalakshmy Aiyappan ◽

Mili M. ◽

...

Keyword(s):

Older Adults ◽

At Risk ◽

Nutritional Status ◽

Family Income ◽

Assessment Tool ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Health Economy ◽

Calorie Intake ◽

Dietary Recall

Background: India is said to be shifting from an undernourished to over nourished population with advances in health, economy and medical care. But there is paucity of information regarding nutritional status of older adults in the country, who are socially and economically insecure. Hence the present study attempts to assess the nutritional status of people above 60 years of age, and to find the factors associated with it.Methods: A cross sectional study was conducted among 129 people aged above 60 years, residing in Pathanamthitta district, Kerala. Mini Nutritional Assessment tool (MNA) was used to classify the respondents as having ‘normal nutrition’ (score 23.5 and above), ‘at risk of malnutrition’ (17-23.5), ‘malnourished’ (<17). A 24-hour dietary recall was done to calculate per day calorie intake and compare with Recommended Daily Allowance (RDA). The results were interpreted as adequate or deficient. Descriptive statistics, chi-square and spearman’s correlation were done to find relationship between various sociodemographic variables, MNA status, BMI and calorie intake.Results: Females constituted 75.2%; 81.4% were unemployed; 62% belonged to rural area. Nutritional assessment showed 41.9% to be having normal nutrition, 46.5% at risk of malnutrition, and 11.6% malnourished. Caloric intake was less than the RDA in 89.1%. There was no association between calorie intake per day and MNA status. Education (p=0.025), place of residence (p=0.021), marital status (p=0.003), and family income (p=0.031) were factors significantly influencing nutritional status in elderly. There was significant correlation between MNA status and BMI (p<0.001, r=0.329).Conclusions: Malnutrition was seen in 11.6% of older adults in this study and another major proportion was at risk of malnutrition. Better nutritional status was significantly associated with good education, urban residence, married state, and higher family income. Dietary intake was inadequate among older adults. 24-hour dietary recall reflected nutritional status of only the malnourished.

Download Full-text

Self-reported morbidities, nutritional characteristics, and associated factors in institutionalized and non-institutionalized older adults

BMC Geriatrics ◽

10.1186/s12877-021-02067-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Abdelhafid Benksim ◽

Rachid Ait Addi ◽

Elhassania Khalloufi ◽

Aziz Habibi ◽

Mohamed Cherkaoui

Keyword(s):

Older Adults ◽

Health Insurance ◽

Nutritional Status ◽

Statistical Significance ◽

Well Being ◽

Public Institution ◽

Subjective Well Being ◽

Number Of Children ◽

Significant Difference ◽

Nutritional Characteristics

Abstract Background As the world’s population ages and people live longer, it seems important to ensure that older people have a good quality of life and positive subjective well-being. The objective of this study is to determine socio-economic, health and nutritional characteristics of institutionalized and non-institutionalized elders in the province of Marrakech. Methods This study was conducted among 368 older adults in the province of Marrakech between March 2017 and June 2019. Of all participants, 180 older adults reside in a public institution and 188 of them live in their own homes. Data on health conditions, nutritional status, functional and socio-economic characteristics were collected. Data was analyzed using SPSS Statistics for Windows, Version 16.0. Statistical significance was set at p < 0.05. Results Institutionalized elders were illiterate (80.0%), had low incomes (95.5%), and unmarried (73.3%), they reported also no children (56.1%) and no health insurance (98.9%). Institutional residents suffered from malnutrition (22.2%), hearing impairments (35.6%) and severe edentulism (43.3%). There was no significant difference between both groups on daily activities and depression. A multivariate analysis identified a model with three significant variables associated with non-institutionalized elders: health insurance (P = 0.001; OR = 107.49), number of children (P = 0.001; OR = 1.74) and nutritional status (p = 0.001; OR = 3.853). Conclusions This study shows that the institutionalization of older adults is considerably induced by various factors such as nutritional problems, lack of health insurance and family structure. To mitigate the effects of this phenomenon, home care strategies and preventive actions should be implemented to delay the institutionalization of older adults and therefore keep them socially active in their own homes.

Download Full-text

Music Is Healing: Developing a Music Module for a Pain Management Intervention for African American Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.2967 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 815-815

Author(s):

Mary Janevic ◽

Sheria Robinson-Lane ◽

Afton Hassett ◽

Rebecca Courser

Keyword(s):

Older Adults ◽

African American ◽

Pain Management ◽

Health Workers ◽

New Music ◽

Participant Engagement ◽

Management Intervention ◽

Phone Calls ◽

Positive Memories ◽

African American Older Adults

Abstract Music has a known analgesic effect. Our multidisciplinary team is developing a music-focused module for Positive STEPS, a pain self-management intervention based on principles of positive psychology. The priority population is African American older adults with disabling chronic pain. Positive STEPS is delivered via website and phone calls from community health workers. To inform program design, we conducted two focus groups with older adults in Detroit (n=16; 100% female and African American; 75% age 70+). All participants said they would enjoy using music to cope with pain. Content analysis revealed the following themes regarding music for pain management: it elicits positive memories, reduces stress, motivates exercise and daily activities, and promotes relaxation. Participants offered ideas for music-focused activities, including learning about unfamiliar genres and using music for meditation/relaxation. Findings will inform the design of a new music module, to be pilot-tested for its effect on participant engagement and pain-related outcomes.

Download Full-text