RESUMEN
MATERIAL AND METHODS: Trends in the prevalence of overweight and obesity in Denmark were compared to changes in diet and physical activity by using data from the nationwide dietary surveys of 1985 and 1995 comprising 2,000 adults, aged 15-80 years. RESULTS: The prevalence of overweight and obesity has increased by more than 20% in men (1985: 35.7% vs 1995: 44.1%) and women (1985: 22.3% vs 1995: 29.4%). The prevalence of obesity rose especially in men from 1985 (5.0%) to 1995 (8.8%), less dramatically in women (1985: 5.3% vs 1995: 6.6%). A decrease of 20% and 5% in energy intake has been registered, respectively in men and women. At the same time, sedentary work increased considerably from 1995 (19.5%) to 1985 (38.2%), whereas leisure time physical activity was higher than before. DISCUSSION: The increasing prevalence of overweight and obesity is probably explained by a decrease in the total energy expenditure, owing to the fact that sedentary work has doubled. Hence, a rise in the level of leisure time physical activity did not compensate for the lower expenditure of energy during working hours.
Asunto(s)
Ejercicio Físico , Conducta Alimentaria , Obesidad/etiología , Adolescente , Adulto , Anciano , Dinamarca/epidemiología , Ingestión de Energía , Metabolismo Energético , Femenino , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , PrevalenciaAsunto(s)
Anticolesterolemiantes , Enfermedades Cardiovasculares/prevención & control , Grasas de la Dieta , Margarina , Fitosteroles , Fitosteroles/administración & dosificación , Anticolesterolemiantes/administración & dosificación , Anticolesterolemiantes/metabolismo , LDL-Colesterol/sangre , Grasas de la Dieta/administración & dosificación , Grasas de la Dieta/metabolismo , Alimentos Fortificados , Humanos , Margarina/análisis , Fitosteroles/química , Fitosteroles/metabolismoRESUMEN
The purpose of the study was to compare the nutritional state in a group of hospitalised patients aged over 65 years and a group of younger patients. Information about body height, body weight, body mass index (BMI), weight index (WI), percent weight loss and energy intake was obtained from 89 elderly and 55 younger patients. We found no significant difference in the prevalence of malnutrition (BMI < or = 18.5 kg/m2 and/or WI < or = 80%) or underweight (BMI < 20 kg/m2) among the elderly patients compared to younger. However, significantly more elderly patients had lost more than 5% of their body weight (52.1% vs. 10.0%, p < 0.001). Also, the elderly patients had had a significantly longer hospital stay before the survey started (14 days vs. 4 days, p < 0.001). The prevalence of weight loss was higher (74% vs. 30%, chi 2 = 8.1, p < 0.01) among the elderly with the longest stay (18 days vs. 4 days). Therefore, special attention must be directed towards the nutritional status of the elderly patient in order to initiate nutritional support in time.
Asunto(s)
Hospitalización , Estado Nutricional , Adulto , Anciano , Índice de Masa Corporal , Peso Corporal , Ingestión de Energía , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Trastornos Nutricionales/etiología , Factores de Riesgo , Pérdida de PesoRESUMEN
The "Subjective Global Assessment", the "Nutrition Risk Score" and a Danish counterpart are simple screening methods to detect patients at risk of nutrition-related complications. The cut-off points used in the screening are a body mass index (BMI) less than 20 kg/m2 (or 18.5 kg/m2 in the Danish version) and weight loss of more than 5% during the last month--regardless of age. This review of the literature indicates that the optimal range of BMI for elderly people is increasing from 18.7-25 kg/m2 to 24-29 kg/m2. It also suggests that a clinically significant weight loss for the elderly is around 5% annually, less than in younger age groups. Finally, there seems to be a high percentage of the old, especially those initially malnourished, who will not benefit from nutritional support. In conclusion, other cut-off points should be used for elderly (65+ years) patients, i.e. BMI less than 24 kg/m2 or any degree of weight loss.
Asunto(s)
Índice de Masa Corporal , Hospitalización , Evaluación Nutricional , Trastornos Nutricionales/diagnóstico , Pérdida de Peso , Anciano , Dinamarca , Humanos , Tamizaje Masivo , Trastornos Nutricionales/etiología , Trastornos Nutricionales/prevención & control , Factores de RiesgoRESUMEN
The purpose of the study was to evaluate the predictive capacity of the Mini Nutritional Assessment method (MNA), by means of data from the Danish part of the SENECA survey (1988), and the follow-up study from 1993. Using the MNA, 171 persons between 70-75 years of age were classified according to their nutritional risk as either being "well-nourished", comprising 78.4% or "at risk of malnutrition" comprising 21.6%. A total of 115 persons participated in the follow-up study. The participation rate in the follow-up study was significantly lower in the risk group (p < 0.01). The 13 Danes judged "at risk of malnutrition" had had a significantly higher occurrence of acute diseases (p < 0.05), need of help (p < 0.05) and weight loss (p < 0.001) in the preceding years. However, no significant differences were found in hospitalization rates and physician visits between the two groups. In conclusion, the results indicate that the MNA is capable of identifying a group of 70-75 year-old Danes who are at risk of certain nutrition-related health problems.
Asunto(s)
Evaluación Geriátrica , Evaluación Nutricional , Estado Nutricional , Anciano , Dinamarca , Ingestión de Energía , Europa (Continente) , Estudios de Seguimiento , Humanos , Trastornos Nutricionales/prevención & control , Encuestas Nutricionales , Valor Predictivo de las Pruebas , Pronóstico , Factores de RiesgoRESUMEN
The average salt intake (sodium chloride) in Denmark is about 10 g/person/day, which is approximately 8 times higher than the estimated need. Salt added during industrial processing of foods constitutes more than 50% of the daily salt intake. Observational and experimental epidemiological studies indicate no decisive effects on blood pressure in humans caused by considerable variations in the daily salt intake. However, a small group of patients with hypertension may lower their blood pressure by reducing the daily intake of salt to 5 g. It has not been convincingly documented that high salt intake is an independent risk factor in the pathogenesis of asthma, osteoporosis, toxaemia of pregnancy or apoplectic stroke. On the other hand, several epidemiological studies point to the fact that the intake of salted foods may increase the risk of gastric cancer. It is recommended 1) that the food industry as far as possible limits the addition of salt, 2) that foods are supplied with a declaration of the salt content, and 3) that the research in this field is strengthened to facilitate the identification of persons at increased risk of developing disorders associated with high salt intake.
Asunto(s)
Estado de Salud , Cloruro de Sodio Dietético/administración & dosificación , Dinamarca , Aditivos Alimentarios/efectos adversos , Aditivos Alimentarios/análisis , Humanos , Factores de Riesgo , Cloruro de Sodio Dietético/efectos adversos , Cloruro de Sodio Dietético/análisisRESUMEN
Symptoms of depression and anxiety were measured in a prospective follow-up study of 36 cancer patients before and during chemotherapy by means of the Hamilton rating scales and the Melancholia Scale. These scales proved useful in the examined population. Moderate or severe depression was seen in almost half of the patients before chemotherapy, but this figure decreased during follow-up. The symptomatology resembled that of primary depression, and the brief rating scales for depression seemed suitable for screening purpose. Problems in identifying morbid states of anxiety and depression are discussed.
Asunto(s)
Antineoplásicos/uso terapéutico , Trastornos de Ansiedad/diagnóstico , Neoplasias de la Mama Masculina/tratamiento farmacológico , Neoplasias de la Mama/tratamiento farmacológico , Carcinoma de Células Pequeñas/tratamiento farmacológico , Trastorno Depresivo/diagnóstico , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Ováricas/tratamiento farmacológico , Adulto , Anciano , Trastornos de Ansiedad/etiología , Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/psicología , Neoplasias de la Mama Masculina/complicaciones , Neoplasias de la Mama Masculina/psicología , Carcinoma de Células Pequeñas/complicaciones , Carcinoma de Células Pequeñas/psicología , Trastorno Depresivo/etiología , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/psicología , Masculino , Persona de Mediana Edad , Neoplasias Ováricas/complicaciones , Neoplasias Ováricas/psicología , Estudios Prospectivos , Encuestas y CuestionariosAsunto(s)
Caquexia/tratamiento farmacológico , Neoplasias/tratamiento farmacológico , Antineoplásicos/efectos adversos , Antineoplásicos/uso terapéutico , Caquexia/etiología , Glucocorticoides/efectos adversos , Glucocorticoides/uso terapéutico , Antagonistas de los Receptores Histamínicos/efectos adversos , Antagonistas de los Receptores Histamínicos/uso terapéutico , Humanos , Hidrazinas/efectos adversos , Hidrazinas/uso terapéutico , Neoplasias/complicaciones , Progestinas/efectos adversos , Progestinas/uso terapéuticoRESUMEN
Energy and protein intake and eating-related complaints were studied in 52 patients with cancer of the breast, ovary or lung prior to and after 1 and 3 cycles of chemotherapy. Pretreatment intakes were somewhat lower than recommended, but did not change after therapy. Many patients had eating-related complaints, but these complaints did not increase after therapy. Eating-related complaints (except poor appetite) had no impact on intake. Electrical taste detection thresholds and chemical smell detection thresholds were measured before and after three cycles of chemotherapy. Changes in food intake had no relation to changes in chemosensory thresholds. Perceived taste and smell changes were not reflected in chemosensory thresholds.
Asunto(s)
Antineoplásicos/efectos adversos , Neoplasias de la Mama/tratamiento farmacológico , Ingestión de Energía , Trastornos de Alimentación y de la Ingestión de Alimentos/etiología , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Ováricas/tratamiento farmacológico , Umbral Sensorial , Umbral Gustativo , Adulto , Anciano , Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/psicología , Ingestión de Energía/efectos de los fármacos , Femenino , Humanos , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/psicología , Masculino , Persona de Mediana Edad , Neoplasias Ováricas/complicaciones , Neoplasias Ováricas/psicología , Estudios Prospectivos , Umbral Sensorial/efectos de los fármacos , Umbral Gustativo/efectos de los fármacosRESUMEN
For monitoring of warfarin treatment only analyses with documented International Sensitivity Index should be used. Until further studies clarify the matter, we recommend the therapeutic intervals proposed by the American College of Chest Physicians and the National Heart, Lung, and Blood Institute. For induction of treatment, a daily warfarin dose of 10 mg is useful. Overlapping heparin therapy is recommended for at least five days. Day-to-day variation of dietary vitamin K intake of less than 250-500 micrograms and an alcohol consumption below 47 g/day will not disturb anticoagulation. Bleeding is more common during long-term treatment, among elderly patients and in patients with cerebral arteriosclerotic disease, especially in combination with uncontrolled hypertension. Bleeding patients often have underlying pathology which should be looked for.