Protein Energy Malnutrition and the Nervous System: the Impact of Socioeconomic Condition, Weaning Practice, Infection and Food Intake, an Experience in Nigeria

2005 ◽  
Vol 4 (5) ◽  
pp. 304-309 ◽  
Author(s):  
T.O. Odebode . ◽  
S.O. Odebode .
Keyword(s):  
Nervous System ◽  
Food Intake ◽  
Protein Energy Malnutrition ◽  
Socioeconomic Condition ◽  
Protein Energy ◽  
The Impact

scholarly journals 3423 Poorer Outcomes Among Septic Patients with Protein Energy Malnutrition

2019 ◽  
Vol 3 (s1) ◽  
pp. 124-124
Author(s):  
Adeyinka Charles Adejumo ◽  
Olalekan Akanbi ◽  
Lydie Pani
Keyword(s):  
Clinical Outcomes ◽  
Primary Care Physicians ◽  
Protein Energy Malnutrition ◽  
Community Dwelling ◽  
P Value ◽  
Protein Energy ◽  
Propensity Matching ◽  
Study Population ◽  
Clinical Conditions ◽  
The Impact

OBJECTIVES/SPECIFIC AIMS: Protein Energy Malnutrition (PEM) could compromise the body’s defense systems resulting in sepsis, which further depletes calorie stores. Among hospitalized patients, we investigate 1) the relationship between PEM and sepsis, 2) the impact of PEM on trends in mortality from sepsis, and 3) the influence of PEM on clinical outcomes of sepsis. METHODS/STUDY POPULATION: Using the 2014 Healthcare Cost and Utilization Project - Nationwide Inpatient Sample (NIS) patient’s discharge records, we identified patients with sepsis, PEM, and other clinical conditions with ICD-9-CM codes. After stratifying sepsis into two: uncomplicated (without shock) and complicated (with shock), we estimated the adjusted odds (aOR) of developing sepsis (total, uncomplicated and complicated) with PEM. Then, we selected hospitalizations with sepsis from 2007-2014 years of the HCUP-NIS, and calculated the trend in mortality from sepsis, stratified by PEM status, as an effect modifier. Finally, we matched PEM to no PEM (1:1) using a greedy algorithm-based propensity methodology and estimated the effect of having mortality, complicated sepsis and 10 other clinical outcomes and healthcare utilization (SAS 9.4). RESULTS/ANTICIPATED RESULTS: PEM was associated with higher odds for sepsis (aOR:3.97[3.89-4.05]), and complicated vs. uncomplicated sepsis (1.74[1.67-1.81]). Although mortality in sepsis has been trending down from 2007-2014 (−1.19%/year, p-trend<0.0001), the decrease was less pronounced among those with PEM vs. no-PEM (−0.86%/year vs. −1.29%/year, p-value < 0.0001). After propensity matching, PEM was associated with higher mortality (1.35[1.32-1.37]), cost ($160,724[159,517-161,940] vs. $86,650[85,931-87,375]), length of stay (14.76[14.68-14.84] vs. 8.49[8.45-8.56] days), and worse outcomes in general. DISCUSSION/SIGNIFICANCE OF IMPACT: PEM is a risk factor of sepsis and associated with poorer outcomes among septic patients. A concerted effort involving primary care physicians, nutritionists, nurses in identifying, preventing, and treatment of PEM in the community-dwelling individuals before hospitalization might mitigate against these devastating outcomes.

Increased Food Intake after the Addition of Amylase-Rich Flour to Supplementary Food for Malnourished Children in Rural Communities of Bangladesh

2005 ◽  
Vol 26 (4) ◽  
pp. 323-329 ◽  
Author(s):  
M. Iqbal Hossain ◽  
M. A. Wahed ◽  
Shaheen Ahmed
Keyword(s):  
Rural Communities ◽  
Food Intake ◽  
Protein Energy Malnutrition ◽  
Effective Means ◽  
The Other ◽  
Community Nutrition ◽  
Supplementary Food ◽  
Malnourished Children ◽  
Protein Energy ◽  
Added Water

Background In Bangladesh, as in other developing countries, protein–energy malnutrition is most prevalent among children during weaning. After weaning, children are often fed cereal-based diluted low-calorie porridge, resulting in growth-faltering. Objective To assess the effect on food intake of adding amylase-rich flour (ARF) from germinated wheat to supplementary food among children in nine rural Community Nutrition Centers under the Bangladesh Integrated Nutrition Project (BINP). Methods A total of 166 malnourished children of either sex, aged 6 to 24 months, received one of three diets randomly allocated to the Community Nutrition Centers. The composition of the diets was the same; however, the consistency and calorie density were altered by adding either ARF or water. Thirty-five children received the standard supplementary food of the BINP (S-SF), 65 received supplementary food with added ARF (ARF-SF), and 66 received supplementary food with added water (W-SF). The children were studied for six weeks. Results The mean ± SD intake of supplementary food from a single meal by children completing six weeks on the diets was higher for children receiving ARF-SF (33.91 ± 8.25 g) than for those receiving S-SF (25.66 ± 6.73 g) or W-SF (30.26 ± 8.39 g) (p < .05 for both comparisons). The weight of vomited food was significantly higher for children receiving W-SF than for children in the other two groups. Weight gain and increments in length and weight-for-height were higher for children who received ARF-SF than for children in the other two groups, but the differences were not statistically significant. The acceptability of ARF-SF was higher than that of the two other diets. The additional cost of adding 2 g of ARF to the diet was about Taka 0.25 (US$1 = Taka 48). Conclusions Addition of ARF to existing standard supplementary food, as used under the BINP program, is a simple and effective means to increase the intake of food by changing its consistency, thus making it easier for malnourished children to ingest.

scholarly journals Study on impact of protein energy malnutrition on development in children

2019 ◽  
Vol 6 (6) ◽  
pp. 2566
Author(s):  
Dhara Patel ◽  
Greeshma Issac
Keyword(s):  
Protein Energy Malnutrition ◽  
Fine Motor ◽  
Maximum Effect ◽  
P Value ◽  
Normal Children ◽  
Social Domain ◽  
Gross Motor ◽  
Protein Energy ◽  
Grade 3 ◽  
The Impact

Background: Majority of the children in India who live below the poverty line in an environment of deprivation and starvation have physical and developmental retardation. The Objective of this study to study the impact and comparison of protein energy malnutrition on the development with normal children.Methods: This was a hospital based cross sectional study in which total 128 cases of protein energy malnutrition and 30 normal children were enrolled from nutritional rehabilitation center and in patients wards. The study population comprised of children less than 5 years of age, having weight for height/length ≤3 SD, with visible wasting, or bipedal oedema, with mid arm circumference <11.5 cm were assessed for their development in all four domains using Denver II developmental Screening Test (DDST-II).Results: The gross motor milestones are affected in 62.5% with grade4 PEM & 42.85% with grade 3, the fine motor component is affected more in grade 4 with other domains less affected, no significant relation of language delay with PEM was observed in this study, 40% of children with grade 4 PEM shows delay in social domain while 18.18% of the patients with grade 3 PEM show delay in social domain. No patients with grade 1 or grade 2 PEM showed delay in social domain. All four domains are affected in PEM with a maximum effect in gross motor, but the difference does not seem to be significant as the p value is 0.3 i.e.  >0.05 which is insignificant.Conclusions: My study on the effect of protein energy malnutrition on development proves that there in increasing delay in all the domains of development with increasing grade of malnutrition. Early detection of malnutrition in community can cause early intervention and increase the productivity of nation.

scholarly journals Impact of protein energy malnutrition on thyroid size in an iodine deficient population of Gujarat (India): Is it an aetiological factor for goiter?

2001 ◽  
pp. 11-17 ◽  
Author(s):  
SR Brahmbhatt ◽  
RM Brahmbhatt ◽  
SC Boyages
Keyword(s):  
Negative Correlation ◽  
Protein Energy Malnutrition ◽  
Linear Regression Analysis ◽  
Thyroid Volume ◽  
World Health ◽  
Aetiological Factor ◽  
Anthropometric Parameters ◽  
Thigh Circumference ◽  
Protein Energy ◽  
The Impact

OBJECTIVE: To assess the severity of protein energy malnutrition (PEM) in iodine deficient subjects and to assess the impact of PEM on thyroid size. METHODS: 1002 subjects (530 school-aged children and 472 adults) were assessed for PEM by direct anthropometric measurements of height, weight, triceps skinfold (TSF) thickness, mid upper arm circumference (MUAC) and thigh circumference (TC), and derived indices of body surface area (BSA), body mass index (BMI), and Z-scores for weight-for-age (WAZ), height-for-age (HAZ), and weight-for-height (WHZ). Severity of PEM was based on the World Health Organization (WHO) criteria and the threshold on the Waterlow classification. Thyroid size was measured by ultrasonography to determine the thyroid volume (TV). Linear regression analysis was performed between TV and anthropometric parameters. RESULTS: Children had severe PEM as evident from the WHO percentage prevalence of stunting (HAZ<-2SD)=64% (where <-2SD is the Z-score deficit), wasting (WHZ<-2SD)=43%, underweight (WAZ<-2SD)=82% and BMI<16 kg/m=90%. Waterlow classification showed that children were either stunted or wasted, or stunted and wasted, or stunted and obese. Nearly 100% (529/530) of the children had goiter as evidenced from enlarged TV-for-BSA when compared with the WHO reference. There was a weak but statistically significant (P<0.05) positive correlation between TV and BSA, weight, height, MUAC, TC and HAZ but a negative correlation between TV and WHZ, BMI and TSF (r=-0.1-0.2). Adults had PEM as evident from BMI<18.5 kg/m in 54% subjects. Median MUAC=22.7 cm reveals prolonged severe PEM. Eighty-two percent had enlarged TV (>20 ml). There was a significant (P=0.01) negative correlation between TV and MUAC. CONCLUSIONS: (i) The severity of acute (wasting) and chronic (stunting) PEM is very high in Gujarati children. They are stunted or wasted, or stunted and wasted, or stunted and obese. Gujarati adults are thin with low protein and fat reserves. (ii) Anthropometric parameters showed a significant (P<0.001) correlation (r=0.1-0.2) with thyroid size. (iii) Higher prevalence of goiter may be due to macro-nutrient malnutrition (PEM) in the face of micro-nutrient malnutrition (iodine deficiency disorders, IDD).

scholarly journals 3417 Impact of Protein-Energy Malnutrition on Outcomes of Heart Failure Hospitalizations

2019 ◽  
Vol 3 (s1) ◽  
pp. 123-123
Author(s):  
Adeyinka Charles Adejumo ◽  
Olumuyiwa Ogundipe
Keyword(s):  
Heart Failure ◽  
Clinical Outcomes ◽  
Protein Energy Malnutrition ◽  
Low Grade ◽  
Protein Energy ◽  
The Us ◽  
Study Population ◽  
Comorbidity Index ◽  
The Impact ◽  
Low Grade Inflammation

OBJECTIVES/SPECIFIC AIMS: Chronically elevated cytokines from un-abating low-grade inflammation in heart failure (HF) results in Protein-Energy Malnutrition (PEM). However, the impact of PEM on clinical outcomes of admissions for HF exacerbations has not been evaluated in a national data. METHODS/STUDY POPULATION: From the 2012-2014 Nationwide Inpatient Sample (NIS) patient’s discharge records for primary HF admissions, we identified patients with concomitant PEM, and their demographic and comorbid factors. We propensity-matched PEM cohorts (32,771) to no-PEM controls (1:1) using a greedy algorithm-based methodology and estimated the effect of different clinical outcomes (SAS 9.4). RESULTS/ANTICIPATED RESULTS: There were 32,771 (~163,885) cases of PEM among the 541,679 (~2,708,395) primary admissions for HF between 2012 and 2014 in the US. PEM cases were older (PEM:76 vs. no-PEM:72 years), Whites (70.75% vs. 67.30%), and had higher comorbid burden, with Deyo-comorbidity index >3 (31.61% vs. 26.30%). However, PEM cases had lower rates of obesity, hyperlipidemia and diabetes. After propensity-matching, PEM was associated with higher mortality (AOR:2.48[2.31-2.66]), cardiogenic shock (3.11[2.79-3.46]), cardiac arrest (2.30[1.96-2.70]), acute kidney failure (1.49[1.44-1.54]), acute respiratory failure (1.57[1.51-1.64]), mechanical ventilation (2.72[2.50-2.97]). PEM also resulted in higher non-routine discharges (2.24[2.17-2.31]), hospital cost ($80,534[78,496-82,625] vs. $43,226[42,376-44,093]) and longer duration of admission (8.61[8.49-8.74] vs. 5.28[5.23-5.34] days). DISCUSSION/SIGNIFICANCE OF IMPACT: In the US, PEM is a common comorbidity among hospitalized HF subjects, and results in devastating health outcomes. Early identification and prevention of PEM in heart failure subjects during clinic visits and prompt treatment of PEM both in the clinic and during hospitalization are essential to decrease the excess burden of PEM.

scholarly journals UNBALANCED DISTRIBUTION OF FOOD

2017 ◽  
Vol 1 (1) ◽  
pp. 199-208
Author(s):  
Buse Sarikaya
Keyword(s):  
Food Intake ◽  
Food Production ◽  
Heart Diseases ◽  
Protein Energy Malnutrition ◽  
Health Problems ◽  
Nutrition And Health ◽  
Protein Energy ◽  
Nutritional Health ◽  
Production And Distribution ◽  
Weight Protein

While people starve every day, food is being wasted. Simultaneously a food shortage does not exist on our planet. There is no lack of food. Production and distribution are the two primary causes of this problem. Unbalanced nutrition is the cause of obesity, overweight and hunger. Insufficient food intake causes nutritional problems such as vitamin and Iodine deficiency, Anaemia, Underweight and Stunting, Low birth weight, Protein-Energy Malnutrition, excess intake of food causes. However, nutritional health problems are not only caused by the absense of food but also from excessive food intake causing diabetes, hypertension, heart diseases etc. These all health problems effect societies worldwide. Bringing the global burden of diet-related noncomunicable diseases under control and enhancing public nutrition and health requires a muti-diciplinary approach.

scholarly journals Effect of Exogenous Cholecystokinin (CCK)-8 on Food Intake and Plasma CCK, Leptin, and Insulin Concentrations in Older and Young Adults: Evidence for Increased CCK Activity as a Cause of the Anorexia of Aging

2001 ◽  
Vol 86 (12) ◽  
pp. 5830-5837 ◽  
Author(s):  
Caroline G. MacIntosh ◽  
John E. Morley ◽  
Judith Wishart ◽  
Howard Morris ◽  
Jan B. M. J. Jansen ◽  
...  
Keyword(s):  
Food Intake ◽  
Older People ◽  
Healthy Aging ◽  
Protein Energy Malnutrition ◽  
Age Groups ◽  
Postprandial Glucose ◽  
Saline Control ◽  
Older Subjects ◽  
Young Subjects ◽  
The Impact

Healthy aging is associated with reductions in appetite and food intake—the so-called anorexia of aging, which may predispose to protein-energy malnutrition. One possible cause of the anorexia of aging is an increased satiating effect of cholecystokinin (CCK). To investigate the impact of aging on the satiating effects of CCK, 12 young and 12 older healthy subjects received 25-min iv infusions of saline (control) and CCK-8, 1 ng/kg per min or 3 ng/k per min, on 3 separate days before a test meal. Older subjects ate less than young subjects, and food intake was suppressed 21.6% by CCK-8, compared with the control day (P &lt; 0.05). The suppression of energy intake by CCK-8 in older subjects was twice that in young subjects (32 ± 6% vs. 16 ± 6% sem, P &lt; 0.05) and was related to plasma CCK-8 concentrations, which were higher at baseline (P &lt; 0.05) and increased more during CCK-8 infusions in older than young subjects (P &lt; 0.01). The extent of suppression of food intake per given rise in plasma CCK-8 concentrations did not differ between the two age groups (P = 0.35). Endogenous CCK concentrations were higher at baseline in older subjects (P &lt; 0.001) and decreased during the CCK-8 but not control infusions (P &lt; 0.01), suggesting that CCK suppresses its own release. Plasma leptin concentrations were not affected by CCK infusion, whereas postprandial insulin concentrations were lowered and the peak postprandial glucose concentration was delayed but not affected by CCK-8 infusion. Because older people retain their sensitivity to the satiating effects of exogenous CCK and plasma endogenous CCK concentrations are higher in older people, increased CCK activity may contribute to the anorexia of aging.

scholarly journals Nutritional Management of Diarrhoea

1995 ◽  
Vol 16 (4) ◽  
pp. 1-7 ◽  
Author(s):  
Homero Martínez ◽  
Andrew M. Tomkins
Keyword(s):  
Food Intake ◽  
Structural Damage ◽  
Driving Forces ◽  
Muscle Protein ◽  
Protein Energy Malnutrition ◽  
The Body ◽  
Nutrient Loss ◽  
Support Network ◽  
Health Providers ◽  
Protein Energy

Diarrhoeal disease may cause, precipitate, or exacerbate protein-energy and micronutrient malnutrition through five possible mechanisms: 1) reduced food intake-reduction of food intake during diarrhoea may be due to the child's anorexia, maternal food-withholding behaviour, or both; 2) decreased absorption of nutrients-structural damage to the intestine, as well as the physical action of increased intestinal movement and reduced fluid transit time, interact to produce decreased absorption of nutrients; 3) increased catabolic losses-under the influence of the inflammatory process, diarrhoea of infectious origin induces an average daily negative nitrogen balance of 0.9 g/kg/day, as muscle protein is converted to glucose through gluconeogenesis by the liver; this glucose is used as a fuel by tissues to sustain the hypermetabolism associated with fever; 4) nutrient loss from the intestine-in diarrhoea nutrients are lost directly from the intestinal tract; 5) metabolic inefficiency due to micronutrient deficiency-the increased rate of tissue synthesis displayed by children recovering from protein-energy malnutrition may be hampered by a limited supply of nutrients from the body pool, which in turn may not be replenished fast enough by dietary intake. The two main driving forces that determine nutritional care of the sick child in the home are advice from healthcare providers (mainly physicians) and the mothers’ own beliefs; a third determinant of care is the social support network available to mothers or social pressure to act in a determined way. Therefore, health providers should be knowledgeable about appropriate feeding management of illness, and should provide sound advice to mothers. The likelihood that mothers will follow the recommendations given by the health-care system (whether formal or informal) will be greater if these conform to mothers’ cultural norms and their explanatory model of disease. Feeding practices followed in health facilities should be consistent with those advised for the mothers at home. In order to make a successful change in a given practice, culture-sensitive interventions should be used.

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