RESUMEN
BACKGROUND: Depressive disorders are a critical public health concern in Chile. Nonetheless, there is a lack of evidence regarding the identification of depressive symptom clusters. The objective was to identify depressive symptom clusters among Chilean young adults and examine how demographic, and lifestyle factors as well as social support can influence and predict them. METHODS: Cross-sectional study conducted among 1,000 participants from the Limache cohort 2. A latent class analysis (LCA) was performed to identify depressive symptom clusters, using the Patient Health Questionnaire (PHQ-9). Multinomial logistic regression was then applied to explore the associations between identified classes and potential predictors. The models were adjusted by age and sex. RESULTS: Three latent classes of depressive symptoms were identified: minimal (25.7%); somatic (50.7%) and severe (23.6%). In the severe class for eight out nine depressive symptoms the probabilities were above 50%, and the probability of suicidal ideation was almost a third in this class. Being female (Adjusted Odds ratio [AOR], 2.49; 95% confidence interval [CI] [1.63-3.81]), current smoker (AOR, 1.74; 95% CI [1.15-2.65]), having basic education (AOR, 3.12; 95% CI [1.30-7.53]) and obesity (AOR, 2.72; 95% CI [1.61-4.59]) significantly increased the likelihood of belonging to severe class. Higher social support decreased the odds of being in the somatic (OR, 0.96; 95% CI [0.93-0.98]) and severe (OR, 0.92; 95% CI [0.90-0.94]) classes. CONCLUSIONS: These findings highlight the importance of individualized intervention strategies for depression management. Also, the study suggests that nutritional status and social support should be considered when addressing depression in this population.
Asunto(s)
Depresión , Análisis de Clases Latentes , Estado Nutricional , Apoyo Social , Humanos , Chile/epidemiología , Femenino , Masculino , Estudios Transversales , Depresión/epidemiología , Adulto Joven , Adulto , Adolescente , Factores de RiesgoRESUMEN
OBJECTIVES: This study aimed to evaluate the change in the Dietary Diversity (DD) Index of Maya women of reproductive age living in rural areas of the Western Highlands of Guatemala after nutrition, health, and agroecology interventions. METHODS: This is a secondary analysis study on DD from two matched groups from three villages in the Lake Atitlan area in the department of Sololá. The first cohort was recruited in 2017 (sample of n = 77). The second cohort was recruited in 2020 (sample of n = 61). Both were followed until 2021. The program provided various resources for assistance for food production and home improvements (sessions from 2018 to 2022). Agroecology sessions were conducted in the test farm. Due to the COVID-19, adjustments were made to continue the education and training sessions. RESULTS: Both cohort samples had a statistically significant increase in participants who consumed at least 15 g from five groups of foods (2017: p = .00002; 2020: p = .045). There was a statistically significant increase in mean food groups consumed daily (2017: p < .00001; 2020: p = .005). CONCLUSIONS FOR PRACTICE: Implementing interventions that include nutrition, health, and agroecology practices in the long term has demonstrated a statistically significant increase in the Dietary Diversity Index of Maya women in their reproductive years living in rural villages in the Western Highlands.
Asunto(s)
Dieta , Población Rural , Humanos , Femenino , Guatemala , Adulto , Población Rural/estadística & datos numéricos , Dieta/métodos , Dieta/estadística & datos numéricos , Estado Nutricional , COVID-19/prevención & control , COVID-19/epidemiología , Estudios de Cohortes , SARS-CoV-2 , Adulto JovenRESUMEN
INTRODUCTION: DNA hypomethylation in patients with systemic lupus erythematosus (SLE) has been recently documented in the literature. Low levels of DNA methylation have been observed globally and in genes associated with immune and inflammatory pathways in SLE's CD4+T lymphocytes. Given that certain micronutrients can either donate methyl groups within one-carbon metabolism pathways or serve as cofactors for enzymes involved in the DNA methylation process, this randomised, double-blind, placebo-controlled trial aims to investigate whether a 3-month supplementation of folic acid and vitamin B12 will modulate the DNA methylation profile in subcutaneous adipose tissue (primary outcome) of women with SLE and normal weight or excess body weight. As secondary objectives, we will assess gene expression, telomere length and phenotypic characteristics (ie, clinical parameters, body weight and composition, abdominal circumference, food intake and disordered eating attitude, physical activity, lipid profile, serum concentrations of leptin, adiponectin, and cytokines). METHODS AND ANALYSIS: Patients will be classified according to their nutritional status by body mass index in normal weight or excess body weight. Subsequently, patients in each group will be randomly assigned to either a placebo or an intervention group (folic acid (400 mcg) and vitamin B12 (2000 mcg) supplementation). Endpoint evaluations will be conducted using both intention-to-treat and per-protocol analyses. This study has the potential to design new personalised nutritional approaches as adjunctive therapy for patients with SLE. ETHICS AND DISSEMINATION: This study has been reviewed and approved by the Ethical Committee from Clinical Hospital of the School of Medicine of the University of Sao Paulo, Brazil (CAAE.: 47317521.8.0000.0068). TRIAL REGISTRATION NUMBER: NCT05097365 (first version).
Asunto(s)
Metilación de ADN , Suplementos Dietéticos , Ácido Fólico , Lupus Eritematoso Sistémico , Estado Nutricional , Vitamina B 12 , Humanos , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/tratamiento farmacológico , Femenino , Método Doble Ciego , Vitamina B 12/uso terapéutico , Ácido Fólico/uso terapéutico , Ácido Fólico/sangre , Adulto , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Adulto Joven , Índice de Masa CorporalRESUMEN
BACKGROUND: Some cancer survivors experience difficulties with concentration, attention, and memory; however, there are no studies on neurodevelopment in patients under 5 years of age who are undergoing cancer treatment. Our aim was to evaluate neurodevelopment in cancer patients under 5 years of age using the Early Development Instrument (EDI) test, considering factors such as nutritional status, type of cancer, and treatment effect. METHODS: A cross-sectional study was conducted from February 2018 to March 2019. Patients with cancer diagnoses outside the central nervous system in any phase of cancer treatment were included. RESULTS: A total of 45 patients were included. Regarding fine motor skills, 28% of patients with retinoblastoma and 23% of patients with leukemia or lymphoma had a risk of developmental delay compared to 0% of patients with solid tumors (p = 0.025). The final results showed that 19 (42.2%) patients had normal neurodevelopment (gray), 7 (15.5%) had a delay in neurodevelopment (light gray), and 19 (42.2%) had a risk of developmental delay (black). Regarding developmental delay, 52% of patients in the leukemia and lymphoma group, 71% in the retinoblastoma group, and 23% in the solid tumor group presented developmental delay (p = 0.06). CONCLUSIONS: The risk of delay and lag in neurodevelopment is common in cancer patients under 5 years of age undergoing treatment. However, more studies are required to evaluate the effect of treatment on this group of patients as it may be affected by various factors.
INTRODUCCIÓN: En algunos pacientes supervivientes de cáncer se presentan dificultades de concentración, atención y memoria, sin embargo no hay estudios en relación al neurodesarrollo en pacientes menores de 5 años que se encuentran en tratamiento oncológico. Por lo que el objetivo fue valorar el neurodesarrollo en pacientes con cáncer durante el tratamiento oncológico mediante la prueba EDI tomando en cuenta diversos factores como su estado nutricional, tipo de cancer, y el efecto del tratamiento. MÉTODOS: Se realizó un estudio transversal, de febrero de 2018 a marzo de 2019. Se incluyeron pacientes mayores de 1 año y menores de 5 años con diagnóstico de cáncer fuera del sistema nervioso central, en tratamiento oncológico. RESULTADOS: Se incluyeron 45 pacientes. En el área motor fina el 28% de los pacientes con retinoblastoma y 23% con leucemias y linfomas se encontraron en rojo (retraso) en comparación con 0% de los pacientes con tumores sólidos (p = 0.025). En el resultado global se encontró que 19 (42.2%) pacientes tuvieron neurodesarrollo normal (gris), 7 (15.5%) rezago en el neurodesarrollo (gris claro) y 19 (42.2%) con riesgo de retraso en el desarrollo (negro). De los pacientes que presentaron riesgo de retraso el 52% fueron del grupo de leucemias y linfomas, el 71% en el grupo de retinoblastoma y el 23% del grupo de tumores sólidos (p = 0.06). CONCLUSIONES: La presencia de riesgo de retraso y rezago en el neurodesarrollo es frecuente en menores de 5 años con diagnóstico de cáncer. Se requieren más estudios, para evaluar el efecto del tratamiento en este grupo de pacientes, ya que pueden influir diversos factores.
Asunto(s)
Discapacidades del Desarrollo , Neoplasias , Humanos , Estudios Transversales , Preescolar , Masculino , Femenino , Lactante , Discapacidades del Desarrollo/etiología , Discapacidades del Desarrollo/epidemiología , Trastornos del Neurodesarrollo/epidemiología , Trastornos del Neurodesarrollo/etiología , Retinoblastoma , Estado Nutricional , Desarrollo Infantil/fisiología , Supervivientes de Cáncer/estadística & datos numéricos , Factores de RiesgoRESUMEN
OBJECTIVE: The aim of this study was to evaluate the role of the prognostic nutritional index in predicting in-hospital mortality among patients with acute ischemic stroke. METHODS: This retrospective, observational study included patients diagnosed with acute ischemic stroke at the emergency department of the hospital between January 1, 2022, and January 1, 2023. Demographic data, vital parameters, comorbidities, stroke interventions, and laboratory data were collected from electronic medical records. Prognostic nutritional index was calculated using serum albumin levels and a total lymphocyte count. The primary outcome was in-hospital mortality. RESULTS: The study included 176 patients, divided into survivor (93.2%, n=164) and deceased (6.8%, n=12) groups. No significant differences were observed in age, gender, blood pressure, heart rate, or body temperature between the groups. Atrial fibrillation was significantly more common in the deceased group (50%) compared to the survivor group (18.9%) (p=0.011). The median lymphocyte count was significantly higher in the survivor group (1,353 [interquartile range, IQR 984-1,968]/mm³) compared to the deceased group (660 [IQR 462-1,188]/mm³) (p=0.009). The median albumin level was significantly lower in the deceased group (3.31 [IQR 2.67-3.4] g/dL) compared to the survivor group (3.74 [IQR 3.39-4.21] g/dL) (p<0.001). The median prognostic nutritional index was significantly higher in the survivor group (46.05 [IQR 39.1-51.3]) compared to the deceased group (36.7 [IQR 28.7-40.5]) (p<0.001). The area under the receiver operating characteristic for prognostic nutritional index predicting mortality was 0.791 (95%CI 0.723-0.848) (p=0.0002), with a cut-off value of ≤41.92 providing the highest diagnostic accuracy. CONCLUSIONS: Prognostic nutritional index is a valuable prognostic indicator for in-hospital mortality in acute ischemic stroke patients. Low prognostic nutritional index values are associated with increased mortality risk. Incorporating prognostic nutritional index into clinical practice may aid in the early identification of high-risk patients and the optimization of treatment strategies. Further research is needed to validate these findings and explore the broader clinical applications of prognostic nutritional index.
Asunto(s)
Mortalidad Hospitalaria , Evaluación Nutricional , Humanos , Femenino , Masculino , Estudios Retrospectivos , Pronóstico , Anciano , Persona de Mediana Edad , Recuento de Linfocitos , Albúmina Sérica/análisis , Factores de Riesgo , Anciano de 80 o más Años , Accidente Cerebrovascular Isquémico/mortalidad , Accidente Cerebrovascular Isquémico/sangre , Accidente Cerebrovascular/mortalidad , Valor Predictivo de las Pruebas , Estado Nutricional/fisiología , Curva ROCRESUMEN
Food and nutrition surveillance is fundamental to the formulation, implementation, monitoring, and evaluation of public policies on food and nutrition. The comparative analysis of the evolution of food and nutrition surveillance actions between countries makes it possible to learn about advances, challenges and innovations for the planning of interventions. This study aimed to describe and compare food and nutrition surveillance actions in Brazil and Portugal, countries with different geographical dimensions and socio-economic profiles, but with the common characteristic of having a universal healthcare system. We manually searched for documents describing food and nutrition surveillance actions and for potential data sources on the institutional websites of the Brazilian and Portuguese governments. The recommendations of the READ approach were used (59 documents were identified for Brazil and 29 for Portugal). In Brazil, food and nutrition surveillance actions are included in health policies and in the constraints of conditional cash transfer programs. The Brazilian Households Budget Surveys and health surveys are used simultaneously with the Brazilian National Food and Nutrition Surveillance System (SISVAN). In Portugal, food and nutrition surveillance actions are part of health policies, via the National Program and the Integrated Strategy for the Promotion of Healthy Eating. Among the data sources identified are the Portuguese Food Balance Sheet and household budget, health and food surveys, as well as initiatives to monitor the nutritional status of children and adolescents. In both countries, strategies need to be improved in terms of the regularity of data recording, the harmonization of food consumption indicators and the dissemination of information.
A vigilância alimentar e nutricional é fundamental para a formulação, a implementação, o monitoramento e a avaliação de políticas públicas de alimentação e nutrição. A análise comparativa da evolução das ações de vigilância alimentar e nutricional entre países permite o conhecimento de avanços, desafios e inovações para o planejamento de intervenções. O objetivo foi descrever e comparar as ações de vigilância alimentar e nutricional no Brasil e em Portugal, países com dimensões geográficas e perfis socioeconômicos distintos, mas com sistema de saúde universal em comum. Nós buscamos por documentos que descrevessem as ações de vigilância alimentar e nutricional e por potenciais fontes de dados de maneira manual em websites institucionais dos governos brasileiro e português. O estudo utilizou as recomendações da abordagem READ (59 documentos foram identificados para o Brasil e 29 para Portugal). No Brasil, as ações de vigilância alimentar e nutricional estão inseridas em políticas de saúde e nas condicionalidades dos programas de transferência condicionada de renda. As Pesquisas de Orçamentos Familiares e os inquéritos de saúde são utilizados simultaneamente no Sistema de Vigilância Alimentar e Nutricional (SISVAN). Em Portugal, as ações de vigilância alimentar e nutricional estão inseridas nas políticas de saúde, por meio do Programa Nacional e da Estratégia Integrada para a Promoção da Alimentação Saudável. Entre as fontes de dados identificadas estão a Balança Alimentar Portuguesa, os inquéritos de orçamentos familiares, de saúde e alimentares, além de iniciativas para o monitoramento do estado nutricional de crianças e adolescentes. Em ambos os países, as estratégias precisam ser aprimoradas em relação à regularidade do registro de dados, à harmonização dos indicadores do consumo alimentar e à disseminação das informações.
La vigilancia alimentaria y nutricional es fundamental para la formulación, implementación, monitoreo y evaluación de las políticas públicas de alimentación y nutrición. El análisis comparativo de la evolución de las acciones de vigilancia alimentaria y nutricional entre países permite el conocimiento de los avances, desafíos e innovaciones para la planificación de intervenciones. El objetivo fue describir y comparar las acciones de vigilancia alimentaria y nutricional en Brasil y en Portugal, países con diferentes dimensiones geográficas y perfiles socioeconómicos, pero con un sistema de salud universal en común. Buscamos documentos que describieran las acciones de vigilancia alimentaria y nutricional y posibles fuentes de datos manualmente en sitios web institucionales de los gobiernos de Brasil y Portugal. El estudio utilizó las recomendaciones del enfoque READ (se identificaron 59 documentos para Brasil y 29 para Portugal). En Brasil, las acciones de vigilancia alimentaria y nutricional están incluidas en políticas de salud y en las condicionalidades de los programas de transferencia condicionada de ingresos. Las Encuestas de Presupuestos Familiares y los estudios de salud se utilizan simultáneamente con el Sistema de Vigilancia Alimentaria y Nutricional (SISVAN). En Portugal, las acciones de vigilancia alimentaria y nutricional están incluidas en las políticas de salud, por medio del Programa Nacional y de la Estrategia Integrada para la Promoción de una Alimentación Saludable. Entre las fuentes de datos identificadas, se encuentran la Balanza Alimentaria Portuguesa, las encuestas de presupuestos familiares, de salud y alimentarias. Además de iniciativas para el monitoreo del estado nutricional de niños y adolescentes. En ambos países, es necesario mejorar las estrategias con relación a la regularidad del registro de datos, a la armonización de los indicadores de consumo de alimentos y a la difusión de la información.
Asunto(s)
Política Nutricional , Estado Nutricional , Brasil , Portugal , Humanos , Política de Salud , Encuestas Nutricionales , Factores SocioeconómicosRESUMEN
BACKGROUND: The association between dietary nutritional patterns, psychological factors, and metabolic health status has not been investigated in university students. There are studies that include numerous variables to test hypotheses from various theoretical bases, but due to their complexity, they have not been studied in combination. The scientific community recognizes the use of Gaussian graphical models (GGM) as a set of novel methods capable of addressing this. OBJECTIVE: To apply GGMs to derive specific networks for groups of healthy and unhealthy obese individuals that represent nutritional, psychological, and metabolic patterns in an Ecuadorian population. METHODOLOGY: This was a quantitative, non-experimental, cross-sectional, correlational study conducted on a sample of 230 obese/overweight university students, selected through a multi-stage random sampling method. To assess usual dietary intake, a Food Frequency Questionnaire (FFQ) was used; to evaluate psychological profiles (anxiety, depression, and stress), the DASS-21 scale was employed; blood pressure and anthropometric data were collected; and insulin levels, lipid profiles, and glucose levels were determined using fasting blood samples. The International Diabetes Federation (IDF) criteria were applied to identify metabolically healthy and unhealthy individuals. Statistical analysis relied on univariate methods (frequencies, measures of central tendency, and dispersion), and the relationships were analyzed through networks. The Mann-Whitney U test was used to analyze differences between groups. RESULTS: In metabolically unhealthy obese individuals, GGMs identified a primary network consisting of the influence of waist circumference on blood pressure and insulin levels. In the healthy obese group, a different network was identified, incorporating stress and anxiety variables that influenced blood pressure, anthropometry, and insulin levels. Other identified networks show the dynamics of obesity and the effect of waist circumference on triglycerides, anxiety, and riboflavin intake. CONCLUSIONS: GGMs are an exploratory method that can be used to construct networks that illustrate the behavior of obesity in the studied population. In the future, the identified networks could form the basis for updating obesity management protocols in Primary Care Units and supporting clinical interventions in Ecuador.
Asunto(s)
Dieta , Obesidad , Sobrepeso , Estudiantes , Humanos , Ecuador/epidemiología , Masculino , Femenino , Estudios Transversales , Estudiantes/psicología , Universidades , Adulto Joven , Obesidad/psicología , Sobrepeso/psicología , Adulto , Conducta Alimentaria/psicología , Estado Nutricional , Estado de Salud , AdolescenteRESUMEN
PURPOSE OF REVIEW: Cancer, a complex disease affecting millions globally, presents considerable challenges for both patients and health care providers. Within the broad spectrum of cancer care, nutrition plays a key role in supporting patients throughout their journey. This narrative review examines the role of nutrition in cancer care, exploring its impact on treatment outcomes, nutritional status, current dietary recommendations, physical activity, palliative care, and finally, as a nutritional encouragement for cancer survivors. RECENT FINDINGS: Evidence indicates that cancer and anticancer treatments frequently cause malnutrition and loss of muscle mass, which can exacerbate symptoms, impair immune function, and hamper recovery. Therefore, adequate nutritional support is crucial for maintaining strength, controlling symptoms, and optimizing treatment tolerance in patients with cancer. Several factors influence nutritional needs and dietary recommendations, including cancer type, treatment, and individual patient characteristics. Nutritional care aims not only to ensure sufficient energy and protein intake, but also to manage specific symptoms such as dysgeusia, nausea, and dysphagia. Registered dietitians play a crucial role in providing personalized nutritional guidance, monitoring nutritional status, and implementing interventions to address emerging challenges in cancer care. Furthermore, recent research has underscored the benefits of dietary interventions in cancer treatment. From targeted nutritional supplements to more invasive nutritional support, interest in how nutrition can affect cancer risk and treatment outcomes is increasing. Overall, this review highlights the critical role of nutritional care in comprehensive cancer treatment. By recognizing and meeting dietary demands throughout the entire cancer journey, health care professionals can improve patients' well-being, response to treatment, and long-term prognosis.
Asunto(s)
Desnutrición , Neoplasias , Estado Nutricional , Apoyo Nutricional , Humanos , Neoplasias/terapia , Cuidados Paliativos , Ejercicio Físico , Suplementos Dietéticos , Evaluación Nutricional , Supervivientes de Cáncer , DietaRESUMEN
BACKGROUND: To reduce health inequities in paediatric patients with complex diseases, our hospital developed a food security programme in 2022. The programme aims to mitigate food insecurity (FI) in paediatric patients with oncological, transplantation and congenital cardiovascular diagnoses, by providing a monthly nutritious food supply that covers up to 50% of the patient's family food intake, accompanied by social and nutritional follow-up. In this study, we aimed to assess the effect of the programme on FI and nutritional status and describe its implementation. METHOD: We conducted a before-and-after study of patients who entered the programme in a 14-month period. We used the Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA) scale score, FI level and nutritional status measures to assess the effect of the programme. We used the Wilcoxon and McNemar tests to assess changes in scores and proportions of patients with moderate and severe FI, respectively, 31.5%-14.4% (p=0.0008) and of moderate FI from 68.5% to 36.9%. RESULTS: 111 patients were included. They had a baseline median (IQR) ELCSA score=8 (7-11) that changed to 6 (4-9) (p<0.0001). Severe FI according to ELCSA changed from 31.5% to 14.4% (p<0.001) and moderate from 68.5% to 36.9% (p<0.001). We found no differences in nutritional status regarding height for age (49.5% vs 51.3%, p=0.76), weight for height (42.5% vs 59.1%, p=0.75) or body mass index for age (38% vs 46%, p=0.42) CONCLUSION: The programme reduced FI in families by improving its level to mild or moderate. Children who entered the programme maintained an appropriate nutritional status despite the considerable risk of malnutrition described for oncological paediatric patients and paediatric solid organ transplantation receptors.
Asunto(s)
Seguridad Alimentaria , Estado Nutricional , Humanos , Masculino , Femenino , Niño , Preescolar , Inseguridad Alimentaria , Lactante , Evaluación de Programas y Proyectos de Salud , Adolescente , Abastecimiento de Alimentos/estadística & datos numéricosRESUMEN
OBJECTIVE: The aim of this study was to analyze the association between participation in fitness-related exercises (FRE) and body image dissatisfaction (BID) in adolescents and evaluate the interaction between physical exercise and nutritional status in this association. METHODS: A cross-sectional study was conducted in 2015 involving 799 adolescents (10-16 years old) from 14 public schools in Curitiba (PR), Brazil. BID was assessed using the Body Shape Questionnaire and the Silhouette Scale. The FRE was classified as "does not practice," "practices ≤300 min/week," and "practices >300 min/week" by the Physical Activity Questionnaire for Adolescents. Poisson and multinomial logistic regressions, adjusted for sex, sexual maturation, and nutritional status analyzed the association of FRE and BID. RESULTS: The BID prevalence was 28.3%; 52.4% of the adolescents wanted to reduce their silhouettes; and 48.7% did not practice FRE. Adolescents who practiced FRE >300 min/week had a 28% higher prevalence for some level of BID (PR 1.28; 95%CI 1.08-1.52) and a 46% lower chance of wanting to reduce silhouettes (OR 0.54; 95%CI 0.35-0.82), compared to nonpractitioners. There was no interaction between FRE and nutritional status in association with BID. CONCLUSIONS: The adolescents who practice FRE >300 min/week are likely to have some level of BID and are less likely to report the desire to increase their silhouettes, regardless of their nutritional status.
Asunto(s)
Insatisfacción Corporal , Ejercicio Físico , Aptitud Física , Humanos , Adolescente , Estudios Transversales , Brasil , Femenino , Masculino , Ejercicio Físico/psicología , Insatisfacción Corporal/psicología , Niño , Aptitud Física/psicología , Estado Nutricional , Imagen Corporal/psicología , Encuestas y CuestionariosRESUMEN
INTRODUCTION: The malnutrition-inflammation process is one of the main causes of morbidity and mortality in patients with chronic kidney disease (CKD), influencing quality of life. The aim of this study was to identify the inflammatory and nutritional status of elderly hemodialysis (HD) and its association with quality of life. METHODS: This study was carried out in health services in three different cities. The Malnutrition-Inflammation Score (MIS) was used to assess the inflammatory and nutritional status, with anthropometric measurements, protein status, lean mass and function. The quality of life was assessed using KDQOL-SFTM. Data were analyzed using multivariate analysis and the Poisson model to evaluate the factors that increased the risk of developing malnutrition and inflammation. RESULTS: The MIS identified a 52.2% prevalence of malnutrition and inflammation in the population. In univariate analysis, most KDQOL-SFTM domains presented higher scores for nourished elderly. Anthropometric measures associated with muscle mass and functionality were lower in the malnourished elderly. Multivariate modeling revealed a higher nutritional risk of 50.6% for women and older age, since with each additional year of life the risk of malnutrition increased by 2.4% and by 0.4% with each additional month on HD. Greater arm muscle circumference (AMC) and higher serum albumin were factors for reducing malnutrition by 4.6% and 34.7%, respectively. CONCLUSION: Higher serum albumin and preserved AMC have been shown to be good indicators of better nutritional status. Higher MIS was associated with poorer quality of life, older age, lower income and education, longer time on dialysis, and presence of comorbidities.
Asunto(s)
Inflamación , Desnutrición , Estado Nutricional , Calidad de Vida , Diálisis Renal , Humanos , Femenino , Masculino , Anciano , Desnutrición/epidemiología , Desnutrición/etiología , Estudios Transversales , Anciano de 80 o más Años , Persona de Mediana Edad , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/terapiaRESUMEN
OBJECTIVES: To develop an allometric body mass index (ABMI) reference that adjusts the weight in relation to height, taking into account the changes during development (MULT ABMI reference), and to compare it with international BMI references. METHODS: The MULT ABMI reference was constructed through the LMS method, calculated with 65 644 ABMI observations of 17 447 subjects aged 5-22 years, from the United Kingdom, Ethiopia, India, Peru, Vietnam, Portugal, and Brazil. The M, S, and L curves of the MULT ABMI reference were compared with the curves of the MULT, World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), International Obesity Task Force (IOTF), and Dutch Growth Study (DUTCH). RESULTS: The greater differences in the M curve between MULT ABMI and WHO, CDC, IOTF, DUTCH, and MULT BMI references were around puberty (138 to 150 months for boys; 114 to 132 for girls). MULT ABMI presented S values similar to IOTF and DUTCH BMI references for boys 60 to 114 months and then became higher, approaching the MULT BMI S values from 198 to 240 months. For girls the MULT ABMI S values were close to the IOTF, CDC, and DUTCH from 60 to 110 months, and then became higher, approaching the MULT BMI S values until 240 months. CONCLUSION: MULT ABMI presented an advantage in comparison to the existing BMI references because it takes into account the growth changes during puberty and is a new option to assess the nutritional status of multiethnic populations.
Asunto(s)
Índice de Masa Corporal , Estado Nutricional , Humanos , Niño , Adolescente , Masculino , Femenino , Preescolar , Brasil , Adulto Joven , Valores de Referencia , Estatura , Vietnam , Peso Corporal , India , Perú , Etiopía , Reino Unido , Portugal , EtnicidadRESUMEN
This study aimed to estimate the prevalence of malnutrition using clustered anthropometric indicators and to describe the sociodemographic and dietary factors and health conditions that determine malnutrition in elderly Colombians. This was a secondary analysis of the study Health, Well-being and Ageing (SABE) Colombia, 2015. The survey included 23,694 people aged ≥ 60 years. Malnutrition excess was defined by clustering two indicators: body mass index (BMI) and waist circumference; weight deficit was defined by clustering BMI and arm and calf circumferences. The chi-square test was used to associate malnutrition with sociodemographic variables, dietary and health conditions, and to determine the heterogeneity of malnutrition, a latent class analysis was performed. Overweight was 31.9%, whereas underweight, according to BMI and calf circumference, was 7.9%, and increased to 18.8% when arm circumference was also taken into account. Five latent classes of malnutrition were generated - class 1: no overweight and deteriorated health conditions; class 2: no weight deficit and deteriorated health conditions; class 3: no malnutrition and deteriorated health conditions; class 4: overweight and multimorbidity; and class 5: low protein food intake without being underweight or overweight. It is concluded that a high prevalence of malnutrition in older adults exists, with excess rather than deficit. Sociodemographic and dietary factors and health conditions are associated differently with overweight and underweight.
El objetivo del estudio fue estimar la prevalencia de malnutrición por indicadores antropométricos agrupados y describir los factores sociodemográficos, alimentarios y condiciones de salud determinantes de malnutrición en personas mayores colombianas. Se realizó un análisis secundario del estudio Salud, Bienestar y Envejecimiento (SABE) Colombia, 2015. Incluyó 23.694 personas ≥ 60 años. La malnutrición por exceso se definió agrupando dos indicadores: índice de masa corporal (IMC) y circunferencia de cintura; el déficit de peso se definió agrupando el IMC y las circunferencias de brazo y pantorrilla. Para asociar la malnutrición con variables sociodemográficas, alimentarias y condiciones de salud se usó la prueba chi-cuadrado y para determinar la heterogeneidad de la malnutrición se realizó un análisis de clases latentes. El exceso de peso fue 31,9%; mientras que el déficit de peso según IMC y circunferencia de pantorrilla fue 7,9%, e incrementó a 18,8%, al tener en cuenta además la circunferencia del brazo. Se generaron cinco clases latentes para malnutrición, clase 1: sin exceso de peso y con deterioro en condiciones de salud; clase 2: sin déficit de peso y con deterioro en condiciones de salud; clase 3: sin malnutrición ni deterioro en condiciones de salud; clase 4: exceso de peso y multimorbilidad, y clase 5: bajo consumo de alimentos proteicos sin déficit ni exceso de peso. Se concluye que existe una prevalencia de malnutrición elevada en las personas mayores, representando más el exceso que el déficit. Tanto los factores sociodemográficos, alimentarios y condiciones de salud, se asocian de forma diferente al exceso que al déficit de peso.
O objetivo do estudo foi estimar a prevalência da desnutrição por meio de indicadores antropométricos agrupados e descrever os fatores sociodemográficos, alimentares e condições de saúde determinantes da desnutrição em idosos colombianos. Foi realizada uma análise secundária do estudo Saúde, Bem-estar e Envelhecimento (SABE) Colômbia, 2015. A pesquisa incluiu 23.694 pessoas com idade ≥ 60 anos. O excesso de desnutrição foi definido pelo agrupamento de dois indicadores: índice de massa corporal (IMC) e circunferência da cintura; o déficit de peso foi definido pelo agrupamento do IMC e das circunferências do braço e da panturrilha. Para associar a desnutrição a variáveis sociodemográficas, condições alimentares e de saúde, foi usado o teste do qui-quadrado e, para determinar a heterogeneidade da desnutrição, foi realizada uma análise de classe latente. O excesso de peso foi de 31,9%, enquanto o baixo peso, de acordo com o IMC e a circunferência da panturrilha, foi de 7,9%, e aumentou para 18,8% quando a circunferência do braço também foi levada em conta. Foram geradas cinco classes latentes para a desnutrição - classe 1: sem excesso de peso e condições de saúde deterioradas; classe 2: sem déficit de peso e condições de saúde deterioradas; classe 3: sem desnutrição e condições de saúde deterioradas; classe 4: excesso de peso e multimorbidade; e classe 5: baixa ingestão de alimentos proteicos sem déficit de peso ou excesso de peso. Conclui-se que há uma alta prevalência de desnutrição em idosos, com excesso em vez de déficit. Fatores sociodemográficos, alimentares e condições de saúde estão associados de forma diferente ao sobrepeso e ao baixo peso.
Asunto(s)
Índice de Masa Corporal , Desnutrición , Factores Socioeconómicos , Humanos , Colombia/epidemiología , Masculino , Anciano , Femenino , Desnutrición/epidemiología , Persona de Mediana Edad , Prevalencia , Anciano de 80 o más Años , Sobrepeso/epidemiología , Factores Sociodemográficos , Dieta/estadística & datos numéricos , Delgadez/epidemiología , Factores de Riesgo , Estado Nutricional , Estudios Transversales , Estado de SaludRESUMEN
BACKGROUND: COVID-19 is a systemic infection with a significant impact on nutrition risk and the hematopoietic system. The neutrophil-lymphocyte ratio (NLR) may have prognostic value in determining severe cases of COVID-19 and the urea-creatinine ratio (UCR) is currently being studied as a potential biomarker of catabolism associated with critical illness. The aim was to assess the association between the NLR, UCR and C-reactive protein (CRP) with nutritional risk in hospitalized patients with COVID-19. METHODS: This is a retrospective cross-sectional study that assessed 589 hospitalized patients with COVID-19, 18 years of age or older, of both sexes. Nutritional risk was assessed by Nutritional Risk Screening (NRS, 2002) and NLR by neutrophils divided by lymphocyte count. The UCR was calculated by the ratio between urea and creatinine and quantified by the calorimetric biochemical method and CRP by the immunoturbidimetric method. Differences between groups were applied by the Mann-Whitney U test and the automated binary regression test. RESULTS: Of the 589 patients, 87.4% were at nutritional risk. When evaluating patients admitted to the ICU, 91.9% were at nutritional risk. Patients with NRS ≥3 are older, with lower body mass and BMI, higher NLR and UCR and lower CRP values. However, 73% of patients admitted to the ward were at nutritional risk, and only age differed between groups, being higher in patients with NRS ≥3. Logistic regression showed a weak association between nutritional risk in NRS and UCR (Model 1) (OR = 0.96, 95%CI: 0.94-0.99, p = 0.003) and NRS with CRP (Model 1) (OR = 1.01, 95%CI: 1.00-1.02, p < 0.001) in patients in the ICU. On the other hand, the logistic regression in ward patients found association only for CRP in both models (Model 1, OR = 1.01, 95%CI: 1.00-1.01, p = 0.041) and (Model 2, OR = 1.01, 95%CI: 1.00-1.01, p = 0.031). CONCLUSION: We found a weak association between nutritional risk and UCR and CRP levels in patients admitted to the ICU, while in the ward patients the nutritional risk also had weak association with CRP.
Asunto(s)
Biomarcadores , Proteína C-Reactiva , COVID-19 , Creatinina , Hospitalización , Estado Nutricional , SARS-CoV-2 , Urea , Humanos , COVID-19/sangre , Masculino , Femenino , Estudios Transversales , Proteína C-Reactiva/metabolismo , Proteína C-Reactiva/análisis , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Creatinina/sangre , Urea/sangre , Biomarcadores/sangre , Evaluación Nutricional , Neutrófilos , Anciano de 80 o más Años , Factores de Riesgo , Adulto , Desnutrición/sangreRESUMEN
BACKGROUND & AIMS: The association of Prognostic Nutritional Index (PNI) with prognosis has been established for various cancer types, including rectal cancer. However, the precise relationship between PNI and body composition characteristics in patients with non-metastatic rectal cancer remain unclear. This study aimed to investigate the impact of PNI on overall survival and disease-free survival in non-metastatic rectal cancer patients undergoing total surgical resection. Additionally, it sought to assess the inflammatory status and body composition in patients across different PNI levels. METHODS: Patients with non-metastatic rectal cancer who underwent total surgical resection, were consecutively enrolled. PNI was calculated using the formula: PNI = (10 × serum albumin [g/dl]) + (0.005 × lymphocytes/µL). Body composition was assessed using CT-derived measurements and laboratory tests performed at diagnosis were used to calculate inflammatory indices. Univariate and multivariate logistic regression analyses as well as Kaplan-Meier curves were used to determine prognostic values. RESULTS: A total of 298 patients were included. Patients with low PNI demonstrated significantly reduced overall survival and disease-free survival compared to those with high PNI (Hazard ratio [HR] 1.85; Confidence interval [CI] 1.30-2 0.62; p = 0.001). Moreover, patients with low PNI exhibited heightened systemic inflammatory status and reduced skeletal muscle index, increased muscle radiodensity, as well as a decrease in subcutaneous adipose tissue area, subcutaneous fat index, and low attenuation of both subcutaneous and visceral adipose tissue. CONCLUSION: The PNI, assessed prior to treatment initiation, serves as a prognostic biomarker for non-metastatic rectal cancer patients undergoing total surgical resection and is linked with both inflammation and alterations in body composition.
Asunto(s)
Composición Corporal , Evaluación Nutricional , Estado Nutricional , Neoplasias del Recto , Humanos , Neoplasias del Recto/cirugía , Masculino , Femenino , Persona de Mediana Edad , Pronóstico , Anciano , Supervivencia sin Enfermedad , Albúmina Sérica/metabolismo , Estimación de Kaplan-Meier , Inflamación , Resultado del TratamientoRESUMEN
AIM: Liver-expressed antimicrobial peptide 2 (LEAP2) dynamics in human plasma and its association with feeding behaviour remain poorly understood. Therefore, this study aims: (a) to investigate fasting LEAP2 in participants with normal weight or with overweight or mild obesity (OW/OB); (b) to study the association between fasting LEAP2 and anthropometric and metabolic traits, feeding behaviour, LEAP2 genetic variants and blood cell DNA methylation status; and (c) to ascertain postprandial changes in LEAP2 after high protein intake and the association with feeding behaviour and food intake. METHODS: Anthropometric and behavioural measures, genotyping, methylation profiling, plasma glucose and LEAP2 concentrations were assessed in 327 females and males. A subgroup of 123 participants received an ad libitum high-protein meal, and postprandial LEAP2 concentration and behavioural measures were assessed. RESULTS: LEAP2 concentration was higher in participants with OW/OB (p < 0.001) and in females (p < 0.001), and was associated with LEAP2 single nucleotide polymorphisms rs765760 (p = 0.012) and rs803223 (p = 0.019), but not with LEAP2 methylation status. LEAP2 concentration was directly related to glycaemia (p = 0.001) and fullness (p = 0.003) in participants with normal weight, whereas it was associated with body mass index (p = 0.018), waist circumference (p = 0.014) and motor impulsivity in participants with OW/OB (p = 0.005). A negative association with reward responsiveness was observed in participants with OW/OB (p = 0.023). LEAP2 concentration was inversely associated with food intake (p = 0.034) and decreased after a high-protein meal (p < 0.001), particularly in women (p = 0.002). CONCLUSION: Increased LEAP2 in participants with OW/OB is associated with behavioural characteristics of obesity. Our results show sexual dimorphism in LEAP2 concentration before and after food intake and highlight the role of LEAP2 in feeding regulation.
Asunto(s)
Proteínas en la Dieta , Conducta Alimentaria , Conducta Impulsiva , Estado Nutricional , Obesidad , Recompensa , Humanos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Obesidad/genética , Obesidad/metabolismo , Obesidad/psicología , Obesidad/sangre , Proteínas en la Dieta/administración & dosificación , Conducta Alimentaria/fisiología , Periodo Posprandial , Polimorfismo de Nucleótido Simple , Sobrepeso/genética , Sobrepeso/metabolismo , Sobrepeso/sangre , Metilación de ADN , Ayuno , Proteínas Sanguíneas , Péptidos Catiónicos AntimicrobianosRESUMEN
BACKGROUND: Achieving nutritional goals established by scientific societies is a constant challenge and not always achieved. OBJECTIVE: To investigate the dietary adequacy of individuals with cardiovascular disease (CVD), participants in the Cardioprotective Brazilian Food Program residing in the Northeast region of Brazil, according to the recommendations of the Brazilian Society of Cardiology (SBC). METHODS: Cross-sectional analysis with data from the study implementing the Brazilian Cardioprotective Diet (DICA BR), which evaluated individuals with CVD treated in specialized cardiovascular health centers in eight states in the Northeast region. Food consumption was obtained by 24-hour dietary records and dietary adequacy followed SBC recommendations. Values of p < 0.05 were considered significant. RESULTS: 647 patients were studied, with a mean (standard deviation) age of 63.1 (9.4) years, 50.2% of whom were female. When evaluating food intake, a low adequacy of carbohydrates (52.3%), proteins (70.9%), lipids (38.8%), and fiber (22.4%) was observed. It was observed that the majority of women consumed a low-protein diet (59.2%) and the elderly had a greater inadequacy in carbohydrate consumption (52.6%). Regarding sodium intake, men had a higher intake (72.9%), while the elderly showed a 13% reduction. Furthermore, it was shown that men ate more fiber (28.1%) and individuals with higher education had a high consumption of saturated fatty acids (70.5%). CONCLUSIONS: Most individuals did not achieve the recommended dietary therapy goals for secondary cardiovascular prevention. The findings of the present study reinforce the need to implement structured strategies to encourage healthy eating habits in these individuals.
FUNDAMENTO: Alcançar as metas nutricionais estabelecidas pelas sociedades científicas é um desafio constante e nem sempre alcançado. OBJETIVO: Investigar a adequação alimentar de indivíduos com doença cardiovascular (DCV), participantes do Programa Alimentar Brasileiro Cardioprotetor residentes da região Nordeste do Brasil, segundo as recomendações da Sociedade Brasileira de Cardiologia (SBC). MÉTODOS: Análise transversal com dados do estudo de implementação da Dieta Cardioprotetora Brasileira (DICA BR) que avaliou indivíduos com DCV, atendidos em centros especializados em saúde cardiovascular em oito estados do Nordeste. O consumo alimentar foi obtido por recordatório alimentar de 24 horas e a adequação da dieta seguiu as recomendações da SBC. Foram considerados significantes valores de p < 0,05. RESULTADOS: Foram estudados 647 pacientes, com média (desvio padrão) de idade de 63,1 (9,4) anos, sendo 50,2% do sexo feminino. Na avaliação da ingestão alimentar, observou-se baixa adequação de carboidratos (52,3%), proteínas (70,9%), lipídios (38,8%) e fibras (22,4%). Observou-se que a maioria das mulheres consumia dieta hipoproteica (59,2%) e idosos tinham maior inadequação no consumo de carboidratos (52,6%). Em relação a ingestão de sódio, os homens apresentaram maior ingestão (72,9%), enquanto os idosos apresentaram redução de 13%. Além disso, foi demonstrado que os homens ingeriam mais fibras (28,1%) e indivíduos com maior escolaridade tinham um consumo elevado de ácidos graxos saturados (70,5%). CONCLUSÕES: A maioria dos indivíduos não alcançou as metas dietoterápicas preconizadas para prevenção cardiovascular secundária. Os achados do presente estudo reforçam a necessidade de implementação de estratégias estruturadas, a fim de estimular hábitos alimentares saudáveis nesses indivíduos.
Asunto(s)
Enfermedades Cardiovasculares , Humanos , Masculino , Femenino , Enfermedades Cardiovasculares/prevención & control , Brasil , Estudios Transversales , Persona de Mediana Edad , Anciano , Política Nutricional , Estado Nutricional , Dieta/normas , Factores Socioeconómicos , Factores Sexuales , Registros de DietaRESUMEN
The interaction between lifestyle--defined more specifically in health care as the personal exposome--and its implications on obesity and breast cancer development highlights the critical role of body composition and inflammation in these patients. There is clear evidence that the personal and internal exposome triggers biochemical, inflammatory, and metabolic reprogramming, which might favor ectopic lipid accumulation within the body, such as muscles. Additionally, the presence of excessive adipose tissue exacerbates these alterations in the internal exposome, resulting in cell damage and modifying body composition. Understanding the nexus between these lifestyle-induced exposome modifications, such as inflammation, and the resultant changes in body composition is crucial to assess the association with breast cancer progression and treatment responses. Various techniques can be used to evaluate body composition; one of those most used currently is bioelectrical impedance analysis. This analysis provides parameters, including phase angle (PhA), by which cellular health and metabolic activity can be assessed. In addition, PhA is a potential indicator of nutritional status and disease prognosis, as it has been linked to survival and quality of life in patients with cancer. Therefore, PhA might be used in daily oncology practice to implement an accurate nutritional intervention, reducing side effects and complications of oncology management, and improving quality of life during treatment and survival, even in patients with breast cancer with obesity or overweight. The aim of this review is to analyze the existing information on the current application of PhA in patients with breast cancer and its potential use as a tool to assess inflammatory response, identify malnutrition, and predict the deterioration of quality of life so that it could be proposed as an early indicator for nutritional interventions in this group of patients.
Asunto(s)
Composición Corporal , Neoplasias de la Mama , Inflamación , Estado Nutricional , Obesidad , Calidad de Vida , Humanos , Neoplasias de la Mama/complicaciones , Obesidad/complicaciones , Femenino , Impedancia Eléctrica , Estilo de Vida , Pronóstico , Tejido Adiposo/metabolismoRESUMEN
PURPOSE: To compare oral status, swallowing function (through instrumental and SLH assessment), and nutritional risk between dysphagic individuals with and without Parkinson's disease. METHOD: This is a cross-sectional retrospective study based on data collected from medical records. It included 54 dysphagic older adults, divided into two groups according to the diagnosis of Parkinson's disease. The study collected data on the speech-language-hearing assessment of postural control, tongue mobility and strength, maximum phonation time (MPT), and cough efficiency. Oral status was assessed using the number of teeth and the Eichner Index. The level of oral intake and pharyngeal signs of dysphagia were analyzed with four food consistencies, according to the International Dysphagia Diet Standardization Initiative classification, using fiberoptic endoscopic evaluation of swallowing, for comparison between groups. The severity of pharyngeal residues was analyzed and classified with the Yale Pharyngeal Residue Severity Rating Scale, and the nutritional risk was screened with the Malnutrition Screening Tool. RESULTS: The group of older adults with Parkinson's disease was significantly different from the other group in that they had fewer teeth, unstable postural control, reduced tongue strength, reduced MPT, weak spontaneous coughing, pharyngeal signs, less oral intake, and nutritional risk. CONCLUSION: Dysphagic older people with Parkinson's disease had different oral status, swallowing function, and nutritional risk from those without the diagnosis.
OBJETIVO: Comparar o estado oral, a função de deglutição por meio da avaliação instrumental, fonoaudiológica e do risco nutricional entre indivíduos disfágicos com e sem doença de Parkinson. MÉTODO: Trata-se de um estudo transversal e retrospectivo com base na coleta de dados dos prontuários. Foram incluídos 54 idosos disfágicos divididos em dois grupos, de acordo com a presença do diagnóstico de doença de Parkinson. Foram coletados dados com relação à avaliação fonoaudiológica de controle postural, mobilidade e força de língua, Tempo Máximo de Fonação (TMF) e eficiência da tosse. O estado oral foi avaliado por meio do número de dentes e o Índice de Eichner. Foram analisados o nível de ingestão oral e os sinais faríngeos de disfagia em quatro consistências alimentares, de acordo com a classificação International Dysphagia Diet Standardisation Initiative (IDDSI), por meio da videoendoscopia da deglutição, para comparação entre os grupos. Para análise e classificação da gravidade dos resíduos faríngeos, foi utilizado o Yale Pharyngeal Residue Severity Rating Scale (YPRSRS), enquanto que, para rastrear o risco nutricional foi utilizado o Malnutrition Screening Tool (MST). RESULTADOS: O grupo de idosos com doença de Parkinson apresentou diferença significativa em menor número de dentes, controle postural instável, força de língua reduzida, TMF reduzido, tosse espontânea fraca, sinais faríngeos, nível de ingestão oral menor e em risco nutricional, em comparação ao outro grupo. CONCLUSÃO: Os idosos disfágicos com doença de Parkinson apresentaram diferenças no estado oral, na função de deglutição e no risco nutricional em comparação àqueles sem o diagnóstico.