Is nutritional status a new indicator to use in clinical practice for colorectal cancer patients?

In this editorial we comment on the interesting article by Liu et al.The topic of discussion is the need for a cost-effective and easy-to-use scoring system for predicting the prognosis of colorectal cancer patients.In this context,nutritional assessment plays a crucial role in the multimodal evaluation of patients.In particular,the controlling nutritional status score was found to be an effective tool in the clinical decision-making process,in order to customize treatment strategies and to improve patient outcomes.

Preoperative controlling nutritional status as an optimal prognostic nutritional index to predict the outcome for colorectal cancer

BACKGROUND The controlling nutritional status(CONUT)score effectively reflects a patient’s nutritional status,which is closely related to cancer prognosis.This study invest-igated the relationship between the CONUT score and prognosis after radical surgery for colorectal cancer,and compared the predictive ability of the CONUT score with other indexes.AIM To analyze the predictive performance of the CONUT score for the survival rate of colorectal cancer patients who underwent potentially curative resection.METHODS This retrospective analysis included 217 patients with newly diagnosed colorectal.The CONUT score was calculated based on the serum albumin level,total lymphocyte count,and total cholesterol level.The cutoff value of the CONUT score for predicting prognosis was 4 according to the Youden Index by the receiver operating characteristic curve.The associations between the CONUT score and the prognosis were performed using Kaplan-Meier curves and Cox regression analysis.RESULTS Using the cutoff value of the CONUT score,patients were stratified into CONUT low(n=189)and CONUT high groups(n=28).The CONUT high group had worse overall survival(OS)(P=0.013)and relapse-free survival(RFS)(P=0.015).The predictive performance of CONUT was superior to the modified Glasgow prognostic score,the prognostic nutritional index,and the neutrophil-to-lymphocyte ratio.Meanwhile,the predictive performances of CONUT+tumor node metastasis(TNM)stage for 3-year OS[area under the receiver operating characteristics curve(AUC)=0.803]and 3-year RFS(AUC=0.752)were no less than skeletal muscle mass index(SMI)+TNM stage.The CONUT score was negatively correlated with SMI(P<0.01).CONCLUSION As a nutritional indicator,the CONUT score could predict long-term outcomes after radical surgery for colorectal cancer,and its predictive ability was superior to other indexes.The correlation between the CONUT score and skeletal muscle may be one of the factors that play a predictive role.

Clinical significance of preoperative nutritional status in elderly gastric cancer patients undergoing radical gastrectomy:A singlecenter retrospective study

BACKGROUND The population of elderly patients with gastric cancer is increasing,which is a major public health issue in China.Malnutrition is one of the greatest risk factors for adverse clinical outcomes in elderly patients with gastric cancer.AIM To investigate the preoperative nutritional status and its association with delayed discharge of elderly gastric cancer patients following radical gastrectomy.METHODS A total of 783 patients aged 65 years and older harboring gastric adenocarcinoma and following radical gastrectomy were retrospectively analyzed from the prospectively collected database of Zhongshan Hospital of Fudan University between January 2018 and May 2020.RESULTS The overall rate of malnutrition was 31.8%.The incidence of postoperative complications was significantly higher in the malnourished group compared to the well-nourished group(P<0.001).Nutritional characteristics in the malnourished group,including body mass index,prognostic nutritional index(PNI),albumin,prealbumin,and hemoglobin,were all significantly lower than those in the well-nourished group.The percentage of patients who received postoperative total nutrient admixture was lower in the malnourished group compared to the wellnourished group(22.1%vs 33.5%,P=0.001).Age≥70 years(HR=1.216,95%CI:1.048-1.411),PNI<44.5(HR=1.792,95%CI:1.058-3.032),operation time≥160 minutes(HR=1.431,95%CI:1.237-1.656),and postoperative complications grade III or higher(HR=2.191,95%CI:1.604-2.991)were all recognized as independent risk factors associated with delayed discharge.CONCLUSION Malnutrition is relatively common in elderly patients undergoing gastrectomy.Low PNI is an independent risk factor associated with delay discharge.More strategies are needed to improve the clinical outcome of these patients.

Predictive value of nutritional status and serological indicators in elderly patients with mild cognitive impairment

BACKGROUND Mild cognitive impairment(MCI)in elderly individuals is a transitional stage between normal cognition and dementia.Understanding the risk factors for MCI and identifying those at high risk are extremely important for the elderly population.AIM To analyze the risk factors for MCI in the elderly population and construct a clinical prediction model.METHODS Total 295 elderly individuals presenting with memory loss diagnosed at Wuxi People's Hospital between March 2021 and March 2024 were included.Comprehensive demographic,clinical,and serological data were collected for analysis.Participants were categorized into either an MCI group or a normal group based on their performance on the Montreal Cognitive Assessment Scale.An elaborate clinical predictive model was developed to predict the likelihood of MCI in stroke patients;its accuracy was evaluated using area under curve values and calibration curves.RESULTS The results of the study showed that old age,hypertension,diabetes,hyperlipidemia,smoking,high-salt diet,high-cholesterol diet,decreased red blood count,increased neutrophil lymphocyte ratio and increased low-density lipoprotein cholesterol were risk factors for the onset of MCI,with A high vitamin diet and elevated high-density lipoprotein cholesterol being protective factors.In addition,the prediction model constructed in this study exhibits good degrees of differentiation and calibration.CONCLUSION The risk factors for MCI are diverse.Early identification of individuals at high risk of MCI can better intervene and improve their quality of life of MCI patients.

Assessement of Nutritional Status of Households Using Weighed Food Intake in North West Region of Cameroon

This study determined the nutritional status of households in North western region of Cameroon using weighed food intake. Twenty–two rural and 106 urban households were randomly selected for weighed food intake Descriptive and inferential statistics were used to analyze collected data and significance at p < 0.05 accepted. Corn fufu with huckleberry was the most frequently consumed meal with little or no animal-source protein. Protein and B group vitamins intake of respondents in both communities were below the FAO/WHO recommended values while energy, iron, and vitamins A and C were in excess for most age groups. Adolescents 10 - 19 years and adults 20 years and above failed to meet at least 85% of RNI for calcium.

The Effects of Different Feeding Practices on the Nutritional Status of Infants below 12 Months Old in the Kumba 1 Sub-Division

Appropriate feeding practices are important during infancy for good health, growth and development of infants and children. WHO revised its earlier recommendation of Exclusive Breastfeeding (EBF) of infants from 4 to 6 months of age to EBF until about 6 months of age, with the addition of complementary foods thereafter. This recommendation confirms that breast milk alone is sufficient to meet infants’ nutritional requirements for the first 6 months of life. The main objective of this study was to investigate the effect of various feeding practices on the Nutritional status of infants 0 - 12-month-old in the Kumba 1 Sub-Division. A descriptive cross-sectional study was conducted from December 2019 to August 2020. A total of 341 nursing mothers and their infants 0 - 12 months of age were recruited. Socio-demographic factors and the different feeding habits of the children were assessed using a semi-structured questionnaire. Nutritional status was assessed using anthropometric measurements. The overall proportion of infants who exclusively breastfed for 6 months was 69.2% and those who were mix-fed were 30.8% in the study area. The overall prevalence of malnutrition in the population was 61.0%. Among the malnourished children, 53.1% were underweight, 19.6% were wasted and 10.0% were stunted. Though not significant, the prevalence of wasting (21.0%) and underweight (58.3%) was higher among Mix-Fed (MF) children when compared to their EBF counterparts. Feeding practices affected the nutritional status of the infants. Underweight and wasting were observed among infants on Complementary Feeding (CF), although some exclusively breast-fed infants were stunted. Hence, nursing mothers should try as much as possible to practice EBF as recommended by WHO and can practice CF when the child is above six months.

Effect of Early Enteral Nutrition Combined with Probiotics on the Nutritional Status of Patients with Severe Craniocerebral Injury

Objective:To observe the effect of early enteral nutrition combined with probiotics on the nutritional status of patients with severe craniocerebral injury.Methods:Thirty-five patients with severe craniocerebral injury were divided into the study group(17 patients)and the control group(18 patients)according to the method of a randomized numerical table;both groups of patients started enteral nutrition via nasogastric tube within 24–48 hours after admission to the hospital,and probiotics were given in addition to the study group.Hemoglobin,total plasma protein,albumin,prealbumin,cholinesterase,fasting blood glucose,and other indexes were monitored before and early morning after enteral nutrition support,and upper arm circumference(AC),triceps skinfold thickness(TSF),and upper arm muscle circumference(AMC)were measured,and gastrointestinal response and time to first defecation of the patients were observed and compared with GCS score.Results:The hemoglobin,serum albumin,prealbumin,cholinesterase,and total plasma protein levels in the study group were significantly higher and fasting blood glucose levels were significantly lower than those in the control group after treatment(P<0.05).The incidence of reflux and constipation in the study group was lower than that in the control group,and the time to first defecation was shorter than that in the control group(P<0.05).After treatment,AC,TSF,and AMC were higher in the study group than in the control group(P<0.05).GCS scores were significantly higher in both groups after treatment,but the trend was more pronounced in the study group(P<0.05).Conclusion:Compared with simple enteral nutrition,enteral nutrition combined with probiotics can better correct metabolic disorders after heavy craniocerebral injury and improve the nutritional status of patients.

Effect of early enteral nutrition on postoperative nutritional status and immune function in elderly patients with esophageal cancer or cardiac cancer

To explore the effect of early enteral nutrition （EN） on postoperative nutritional status, intestinal permeability, and immune 6anction in elderly patients with esophageal cancer or cardiac cancer. Methods： A total of 96 patients with esophageal cancer or cardiac cancer who underwent surgical treatment in our hospital from June 2007 to December 2010 were enrolled in this study. They were divided into EN group （n=50） and parenteral nutrition （PN） group （n=46） based on the nutrition support modes. The body weight, time to first flatus/defecation, average hospital stay, complications and mortality after the surgery as well as the liver function indicators were recorded and analyzed. Peripheral blood samples were collected on the days 1, 4 and 7 after surgery. The plasma diamine oxidase （DAO） activity and D-lactate level were determined to assess the intestinal permeability. The plasma endotoxin levels were determined using dynamic turbidimetric assay to assess the protective effect of EN on intestinal mucosal barrier. The postoperative blood levels of inflammatory cytokines and immunoglobulins were determined using enzyme- linked immunosorbent assay （ELISA）. Results： After the surgery, the time to first flatus/defecation, average hospital stay, and complications were significantly less in the EN group than those in the PN group （P〈0.05）, whereas the EN group had significantly higher albumin levels than the PN group （P〈0.05）. On the 7th postoperative day, the DAO activity, D-lactate level and endotoxin contents were significantly lower in the EN group than those in the PN group （all P〈0.05）. In addition, the EN group had significantly higher IgA, IgG, IgM, and CD4 levels than the PN group （P〈0.05） but significantly lower IL-2, IL-6, and TNF-a levels （P〈0.05）. Conclusions： In elderly patients with esophageal cancer or cardiac cancer, early EN after surgery can effectively improve the nutritional status, protect intestinal mucosal barrier （by reducing plasma endoxins）, and enhance the immune function

Impact of postoperative glycemic control and nutritional status on clinical outcomes after total pancreatectomy

AIM To evaluate the impact of glycemic control and nutritional status after total pancreatectomy(TP) on complications, tumor recurrence and overall survival.METHODS Retrospective records of 52 patients with pancreatic tumors who underwent TP were collected from 2007 to 2015. A series of clinical parameters collected before and after surgery, and during the follow-up were evaluated. The associations of glycemic control and nutritional status with complications, tumor recurrence and long-term survival were determined. Risk factors for postoperative glycemic control and nutritional status were identified.RESULTS High early postoperative fasting blood glucose(FBG) levels(OR = 4.074, 95%CI: 1.188-13.965, P = 0.025) and low early postoperative prealbumin levels(OR = 3.816, 95%CI: 1.110-13.122, P = 0.034) were significantly associated with complications after TP. Postoperative Hb A1 c levels over 7%(HR = 2.655, 95%CI: 1.299-5.425, P = 0.007) were identified as one of the independent risk factors for tumor recurrence. Patients with postoperative Hb A1 c levels over 7% had much poorer overall survival than those with Hb A1 c levels less than 7%(9.3 mo vs 27.6 mo, HR = 3.212, 95%CI: 1.147-8.999, P = 0.026). Patients with long-term diabetes mellitus(HR = 15.019, 95%CI: 1.278-176.211, P= 0.031) and alcohol history(B = 1.985, SE = 0.860, P = 0.025) tended to have poor glycemic control and lower body mass index levels after TP, respectively.CONCLUSION At least 3 mo are required after TP to adapt to diabetes and recover nutritional status. Glycemic control appears to have more influence over nutritional status on longterm outcomes after TP. Improvement in glycemic control and nutritional status after TP is important to prevent early complications and tumor recurrence, and improve survival.

Changes in the nutritional status of nine vitamins in patients with esophageal cancer during chemotherapy

BACKGROUND Many studies have investigated the relationships between vitamins and esophageal cancer(EC).Most of these studies focused on the roles of vitamins in the prevention and treatment of EC,and few studies have examined the changes in vitamin nutritional status and their influencing factors before and after chemotherapy for EC.Chemotherapy may have a considerable effect on EC patients’vitamin levels and hematological indicators.AIM To research the nutritional status of multiple vitamins in EC patients during chemotherapy and to assess its clinical significance.METHODS EC patients admitted to our center from July 2017 to September 2020 were enrolled in this study.Serum concentrations of nine vitamins(A,D,E,B9,B12,B1,C,B2 and B6),hemoglobin,total protein,albumin,blood calcium,blood phosphorus concentrations and body mass index(BMI)were measured in all EC patients.The changes in nine vitamins,hematological indicators and BMI were compared before and after two cycles of chemotherapy.The possible influential factors were analyzed.RESULTS In total,203 EC patients receiving chemotherapy were enrolled in this study.Varying degrees of vitamin A,D,C and B2 deficiency and weight loss were found in these patients,and the proportions of vitamin B2 and vitamin C deficiencies increased significantly after chemotherapy(both P<0.05).Serum concentrations of vitamins A,C,B2 and B6 and BMI before and after chemotherapy were statistically significant(all P<0.05).Multivariate analysis showed that vitamin A levels significantly differed between male and female EC patients,whereas vitamin D concentration significantly differed in EC patients in different stages(all P<0.05).Correlations were observed between the changes in serum concentrations of vitamin A and C before and after two cycles chemotherapy and the change in BMI(P<0.05).Hemoglobin,total protein,serum albumin and blood calcium concentrations significantly decreased in EC patients after chemotherapy(all P<0.05),while the blood phosphorus level significantly increased after chemotherapy(P<0.05).Using the difference in vitamin concentrations as the independent variables and the difference in BMI as the dependent variable,logistic regression analysis revealed statistically significant differences for vitamin A,vitamin D and vitamin C(F=5.082,P=0.002).CONCLUSION Vitamin A,D,C and B2 were mainly deficient in patients with EC during chemotherapy.Multivitamin supplementation may help to improve the nutritional status,chemotherapy tolerance and efficacy.

Effectiveness of a multifaceted intervention for the improvement of nutritional status and nutrition knowledge of children in poverty-stricken areas in Shaanxi Province, China

Objectives:Compare the differences between the intervention and control groups in changes of primary outcomes(body mass index[BMI]and waist-to-height ratio[WHtR])and secondary outcomes(nutrition knowledge of children and parents),from baseline to the 6-and 12-month follow-ups;examine the associations of changes in nutrition knowledge of children and their parents with children’s changes in BMI and WHtR.Data sources:Data collected from four schools in two poverty-stricken counties in northern Shaanxi Province in 2020‒2021.Methods:A multifaced intervention program targeted children(promoting healthy diet and nutrition education)and their parents(promoting nutrition knowledge)was conducted in the interventional group.Four schools,with two in each group,were randomly allocated to the intervention or control group,with 814 eligible children aged 7.1 to 12.8 years.The control group conducted myopia promotion.Differences in changes of BMI and WHtR between groups were compared with t-test.Mixed-effects model was used to examine the associations between changes in nutrition knowledge of children and parents with changes in children’s BMI and WHtR.Results:At the 6-month follow-up,the difference in changes in BMI between the intervention and control groups was 0.4 kg/m 2(P<0.001).At the 12-month follow-up,the difference in changes in BMI and WHtR between intervention and control groups was 0.1 kg/m^(2)(P<0.001)and 0.01 kg/m^(2)(P<0.001).In the intervention group,the nutrition knowledge awareness rate of children increased from 16.9%(69/409)at baseline to 21.3%(87/409)at 6-month,and 22.7%(93/409)at 12-month.The awareness rate of nutrition knowledge of parents also fluctuated,from 5.6%(23/409)to 6.6%(27/409)and 5.4%(22/409).However,the difference in changes in nutrition knowledge between intervention and control groups was non-significant.The 6-month follow-up changes in children’s nutrition knowledge scores were negatively associated with changes in BMI in girls(β=−0.26,95%confidence interval[CI]:−0.38 to−0.14,P<0.001),while positively associated with changes in WHtR in boys(β=0.003,95%CI:−0.0002 to 0.005,P=0.035).The 12-month follow-up changes in children’s nutrition knowledge scores were positively associated with changes in children’s WHtR(β=0.003,95%CI:0.0004 to 0.01,P=0.018).Conclusions:The intervention strategies did not reduce the BMI and WHtR of children,and the nutrition knowledge of children and parents increased after the intervention in intervention group.Changes in nutrition knowledge of children and their parents are associated with changes in children’s BMI or WHtR.Interventions with a new focus on obesity are needed to help improve children’s nutritional status in poverty-stricken areas in Shaanxi Province of China.

The effect of Levocarnitine on nutritional status and lipid metabolism during long-term maintenance hemodialysis

Objective To investigate the effect of Levocarnitine on lipid metabolism and nutritional status of maintenance hemodialysis(MHD)patients and possible mechanism.Methods A total of 40 MHD patients [mean age(53.5±7.1)years] who underwent normal hemodialysis more than 6 months were randomly classified into two groups,Levocarnitine supplemented group(LS-G)(n=20;Levocarnitine supplementation after each normal hemodialysis session,at a dose of 1.0 g/day by intravenous administration)and control group(C-G)(n=20;normal hemodialysis).Before treatment,one month and three months after treatment we respectively measured or observed the following items,the tolerance to hemodialysis,carnitine level in plasma,C-reactive protein,IL-6,TNF-α,percentage of neutrophil,and some relevant nutritional parameters,such as lipid profile,transferrin,total protein,albumin and prealbumin levels.Comparative analysis was conducted between the two groups.Results In LS-G three months after treatment,the levels of carnitine,hemoglobin,and prealbumin in plasma were significantly increased(P<0.05),but C-reactive protein,neutrophil percentage,low-density lipoprotein and triglyceride were significantly decreased(P<0.05)in contrast to those in C-G and before treatment.Transferrin,total protein,and albumin were elevated in LS-G,with no statistical significance.Conclusion There was a significant improvement of lipid metabolism and nutritional status for the long-term maintenance hemodialysis patients with Levocarnitine supplementation.And this improvement is related to the decrease of inflammatory factors.

Prognostic significance of a combined and controlled nutritional status score and EBV-DNA in patients with advanced nasopharyngeal carcinoma:a long-term follow-up study

Objective:Several studies have reported that the controlling nutritional status(CONUT)score is a prognostic predictor for survival among patients with different types of cancer.We assessed the prognostic value of changes in the CONUT score during treatment and theΔCONUT-EBV DNA score in patients with advanced nasopharyngeal carcinoma(NPC).Methods:We retrospectively analyzed 433 patients with advanced NPC having no evidence of metastasis from January 2007 to June 2011;the patients underwent radical concurrent chemoradiotherapy(CCRT)at Sun Yat-sen University Cancer Center and were grouped based on theirΔCONUT andΔCONUT-EBV DNA scores.Kaplan-Meier curves were used to compare the patient outcomes according to the cut-offΔCONUT score and theΔCONUT-EBV DNA scoring system.Results:Among all patients,overall survival(OS)was independently predicted by a highΔCONUT score(P=0.031)and high EBV DNA(P<0.001).TheΔCONUT-EBV DNA score[OS area under the curve(AUC)=0.621;progression free survival(PFS)-AUC=0.612;distant metastasis-free survival(DMFS)-AUC=0.622]was more predictive of OS,PFS,and DMFS in patients with advanced NPC than theΔCONUT score(OS-AUC=0.547;PFS-AUC=0.533;DMFS-AUC=0.522)and pretreatment plasma EBV DNA levels alone(OS-AUC=0.600;PFS-AUC=0.591,DMFS-AUC=0.610).TheΔCONUT-EBV DNA score was significantly correlated with OS,PFS,and DMFS in patients with advanced NPC treated with CCRT.Conclusions:TheΔCONUT-EBV DNA score may be useful in clinical practice as a convenient biomarker for predicting the outcomes in patients with advanced NPC treated with CCRT.

Value of the controlling nutritional status score and psoas muscle thickness per height in predicting prognosis in liver transplantation

BACKGROUND Patients with end-stage liver disease usually have varying degrees of malnutrition,and severe malnutrition may affect the prognosis of patients after liver transplantation(LT).However,there is no recommended standard for the nutrition assessment of patients waiting for LT,and it is unknown whether malnutrition has an impact on the occurrence of postoperative complications.AIM The study aim was to investigate the value of the controlling nutritional status(CONUT)score and psoas muscle thickness per height(PMTH)in predicting prognosis in LT.METHODS We retrospectively analyzed the clinical data of 313 patients who underwent classic orthotopic LT from January 2016 to December 2018 in Tianjin First Central Hospital affiliated with Tianjin Medical University.The CONUT score is derived from the preoperative serum albumin and total cholesterol levels,and total lymphocyte count.Patients were divided into low(≤4),medium(5–8),and high(9–12)CONUT score groups perioperative characteristics,Clavien-Dindo grade III/IV/V postoperative complications,graft loss and infection,and cumulative postoperative survival in the three groups were compared 3 mo after LT.PMTH was calculated as the ratio of the transverse thickness of the psoas muscle in the umbilical plane to the height of the patient.The cutoff values of receiver operating characteristic curves were determined separately for men and women.The values were 14.1 cm/m2 for women and 17.9 cm/m2 for men.The patients were then divided into low and high PMTH groups by the cutoff values.The comparison of data between the two groups was the same as above.RESULTS Patients with medium and high CONUT scores had lower preoperative serum hemoglobin,more intraoperative red blood cell(RBC)transfusions,longer postoperative intensive care unit stay and hospital stays,higher 7 and 14 preoperative-day serum bilirubin levels,and a higher incidence of postoperative grade III/IV complications and infections than patients with low CONUT scores.Differences in the 3-mo cumulative survival among the three groups were not significant.Patients with a low PMTH had higher preoperative serum urea nitrogen,more intraoperative packed RBC and frozen plasma transfusions,longer times to postoperative ventilator extubation,higher incidence of total postoperative complications,and a lower 3-mo cumulative survival than those with a high PMTH.CONCLUSION A CONUT score≥5 and a low PMTH were both associated with poor prognosis in LT.The CONUT score had no predictive value for short-term patient survival after LT,but the PMTH was predictive of short-term patient survival after LT.

Nutritional Status in Chronic Hemodialysis Patients

Hitherto, there has been no systematic evaluation of the nutritional status of HD patients in Thailand. 27 patients awaiting renal transplantation, 19 M 8 F, age 47.2 ± 8.6y (mean±SD), underwent HD at Ramathibodi Hospital. Dietary assessment revealed the average daily intake of men and women to be respectively 1571 ±314 and 1379 ± 403 kcal, 47 ± 11 and 42 ± 14 g protein. Anthropometric data showed that mean of BMI,percent ideal body weight (%IBW), percent standard triceps skinfold thickness (%TSF) and percent arm muscle circumference (%std MUAMC) to be 20.5 ± 2.6 kg/m2, 90±12, 75 ±30 and 100±13, respectively. However, 37%, 56% and 70% of these patients had BMI, BW and MUAC less than the minimal cut-off levels. These data reflect the importance of energy depletion in these patients. The average serum albumin was 39 ± 6 g/L while 52% suffered from low albumin levels. TC, LDL-C, HDL-C and TG were 4.34 ± 1.34, 2.9 ±1.06, 0.89 ± 0.33 and 1.10 ± 0.67 mmol/L while 15% had high TC, LDL-C and 58% had low HDL-C levels. Only one patient was suffered from hypertriglyceridemia. Whereas inadequate thiamine, riboflavin, ascorbic acid and α-tocopherol status were present in 4-30%, toxic levels of serum retinol were seen in almost all patients. Low serum zinc and copper levels were also present. This study disclosed a wide spectrum of nutritional problems usually overlooked in CRF patients undergoing chronic hemodialysis. Whereas zinc supplementation may be needed, vitamin A suppIementation in these patients should be discouraged

Influence of nutritional status in the postoperative period of patients with inflammatory bowel disease

Inflammatory bowel diseases(IBDs)are a group of chronic inflammatory diseases that affect the gastrointestinal tract,including Crohn's disease(CD)and ulcerative colitis.Surgery is a treatment option,and more than half of the patients with CD will undergo surgical interventions over the course of the disease.Postoperative complications are common in IBD patients,the most frequent being intraabdominal sepsis,infection of the surgical site,and adynamic ileum,and nutritional status is a factor that can influence postoperative outcome.Recent studies have shown that malnutrition,obesity,sarcopenia,and myosteatosis are predictors of surgical complications.However,most were retrospective studies with small patient samples and heterogeneity of clinical and nutritional assessment methods,which limit the extrapolation of data.Therefore,knowing the pathophysiological mechanisms of IBD and identifying the best parameters for assessing nutritional status are essential for prompt implementation of adequate nutritional interventions.

Study on Iron Nutritional Status in Adolescence

A study on iron-deficiency anemia (IDA) in adolescence was conducted among 478 teen-age students in Shanghai. The study indicated that the intake of nutrients among the students was generally insufficient. The lack of protein, calcium, Vitamin A, Vitamin B_1, and Vitamin B_2 was more serious. The morbidities of IDA among male and female students were 15.8 and 32.6%, respectively, higher in the female group (P<0.01). The iron-deficiency sufferers among male and female students were 46.8 and 61.8%, respectively, also higher in the female group (P<0.01). The causes of IDA were analyzed by the method of stepwise regression. In a study of the effect of IDA on intelligence and physical development in adolescents, we found that there was no significant effect of IDA on intelligence quotient (IQ) and school performance. However, the speed and endurance capabilities of students of both sexes were correlated directly with hemoglobin level. In female students, the speed capability was correlated directly with the serum ferritin content. On the basis of these findings, a special 3-month school lunch program was initiated. The results indicate that a comprehensive, rational, and balanced diet is beneficial to hemoglobin, free erythrocyte porphyrin, and serum ferritin contents and improves adolescent development. 1990 Academic Press. Inc.

Nutritional status in chronically hospitalized stroke patients complicated with pulmonary infection

Complicated pulmonary infection following stroke has traditionally been considered an aspirated infection by many physicians, and little attention has been paid to concomitant protein-energy malnutrition. In the present study, we hypothesized that protein-energy malnutrition may be present in hospitalized chronic stroke patients complicated with pulmonary infection. The results revealed that body protein and fat stores were significantly depleted in stroke patients with pulmonary infection. Protein-energy malnutrition was present in 12 of 27 patients with pulmonary infection. In comparison, only eight of 42 stroke patients without pulmonary infection exhibited protein-energy malnutrition. A significantly higher prevalence of protein-energy malnutrition was found in the pulmonary infection group, suggesting that protein-energy malnutrition is more likely to be present in hospitalized chronic stroke patients with pulmonary infection.

Evaluation of the nutritional status of patients with liver cirrhosis

BACKGROUND Progressive malnutrition coexists with liver diseases,particularly in patients with cirrhosis.Early diagnosis of malnutrition in patients with advanced stages of chronic liver disease and the implementation of appropriate nutritional treatment for malnourished patients should be an integral part of the therapeutic process.AIM To evaluate the nutritional status of patients with various severities of advanced liver fibrosis,using various nutritional status parameters.METHODS This study involved 118 patients with liver cirrhosis who were classified into three groups according to their Child-Pugh score.The nutritional status of the patients in each group was assessed using different methods.The average values obtained from the measurements were calculated for each research group.The influence of disease stage on the examined parameters of nutritional status was determined using one-way analysis of variance.To investigate the relationship between the parameters determining nutritional status and the stage of disease advancement,a correlation analysis was performed.RESULTS The Child-Pugh A group had the highest mean body weight(76.42 kg),highest mean body mass index(BMI)(26.72 kg/m²),and largest mean arm circumference(27.64 cm).In the Child-Pugh B group,the mean scores of all examined variables were lower than those of the Child-Pugh A group,whereas the mean body weight and BMI of the Child-Pugh C group were higher than those of the Child-Pugh B group.There was a very strong correlation between the Child-Pugh classification and subjective global assessment score;a very strong correlation between the Child-Pugh classification and arm circumference;a strong correlation between the Child-Pugh classification and body weight,albumin concentration,fat-free mass index,muscle mass index,phase angle,and BMI;and an average correlation between Child-Pugh classification and fat mass index.Notably,these indicators deteriorated with disease progression.CONCLUSION Advanced liver fibrosis leads to the deterioration of many nutritional status parameters.The extent of malnutrition increases with the progression of liver fibrosis.The Child-Pugh score reflects the nutritional status.

Nutritional Status and Associated Factors among Pregnant Women in Wondo Genet District, Southern Ethiopia

Inadequate quality and quantity diet is one of the major reasons for high levels of malnutrition in pregnant women. A cross-sectional survey was conducted in Wondo Genet District, Southern Ethiopia. A two-stage cluster sampling technique was used to select a representative sample of 153 pregnant women aged 19-49 years from three rural villages （＂Kebeles＂）. Energy and nutrient intakes from foods were calculated from one-day weighed food records on a sub-sample （n = 77）. The result of the study showed that the intakes of most nutrients were lower than the recommended intake. The energy intake of the study participants both in 2nd and 3rd trimesters of pregnancy were 2,308 kcal and 1,420.5 kcal compared to the recommended 2,340 kcal and 2,452 kcal, respectively. Except iron, almost all micronutrient intakes were lower than the recommended intake. Vitamin A intake was 3/ag compared with the recommended 800μg, while protein intake of the study respondents in 2nd and 3rd trimester of pregnancy was 45.9 g and 31.5 g, respectively, compared with the recommended 71 g. Risk factors for undernutrition were multiple pregnancy and no consumption of cereal-based foods. This study revealed that the energy and nutrient intake of the pregnant women in study area was below the recommended intakes. Furthermore, the situation might be aggravated by high phytate content food consumption reported. Nutritional status of pregnant women in study area was not adequate to support the increased energy and nutrient requirement of the participants.