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.

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 Jianpi Wenshen Granules on the Nutritional Control Status Score in Elderly Patients Undergoing Maintenance Hemodialysis

Objective:To explore the effect of Jianpi Wenshen Granules on the Controlling Nutritional Status(CONUT)score in elderly patients undergoing maintenance hemodialysis.Methods:Seventy elderly outpatients undergoing maintenance hemodialysis from January 2023 to January 2024 at the Blood Purification Centers of Taizhou Traditional Chinese Medicine Hospital and Taizhou Second People’s Hospital were selected as the study subjects.The patients were randomly divided into two groups:the study group and the control group,with 35 patients in each group.Both groups received maintenance hemodialysis,while the control group received only conventional Western medicine treatment,and the study group was additionally treated with Jianpi Wenshen Granules.The changes in biochemical and inflammatory markers before and after treatment were compared between the two groups.The nutritional status of the patients was assessed using the Controlling Nutritional Status(CONUT)score,and detailed statistics were gathered on anemia and albumin levels in both groups.Results:After treatment,the CONUT score in the study group significantly decreased compared to the control group,showing a significant correlation(P<0.05).Albumin and hemoglobin levels significantly increased,with a notable difference(P<0.05).There were no significant differences in alanine aminotransferase and aspartate aminotransferase levels between the two groups before and after treatment(P>0.05).Conclusion:In elderly patients undergoing maintenance hemodialysis,Jianpi Wenshen Granules improve the CONUT score and enhance nutritional status,demonstrating potential for clinical application and promotion.

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

Consequence alimentary reconstruction in nutritional status after total gastrectomy for gastric cancer

AIM To investigate the effect of gastroenteric reconstruction on the nutritional status of patients with gastric cancer after total gastrectomy. METHODS From 1989 1994, nutritional status was studied in 24 patients, including 12 patients with the gastric reservoir and pyloric sphincter reconstruction (GRPS), 7 with Braun′s esophago jejunostomy (EJ) and 5 with Lawrance′s Roux en Y reconstruction (RY). The ability of these patients to ingest and absorb the amount of nutrients was examined and compared, and metabolic balance test was performed to compare the efficiency of those patients to accumulate and use the absorbed nutrients. RESULTS In the controlled hospital situation, the amount of food ingested by all the patients was greater than that required for maintenance of ideal body weight. In direct contrast, food intake in most patients with EJ or RY reconstruction significantly decreased when the patients returned home and that in EJ patients it was the lowest. The overgrowth of anaerobic bacteria was found in the jejunum in the patients with EJ and RY, due mainly to food stasis in the duodenum or in the Roux limb, caused by the operative procedure itself. In patients with GRPS, because of restoring of the alimentary continuity according to the normal digestive physiologic characters, all the nutritional parameters could fall in the normal range. CONCLUSION The most common mechanism responsible for postoperative malnutrition was inadequate food intake. Having solved the problem of alkaline reflux esophagitis, it is imperative to preserve the duodenal food passage to reduce malabsorption and other complications after total gastrectomy.

Dairy Consumption and Associations with Nutritional Status of Chinese Children and Adolescents

Objective This study aimed to describe frequency and quantity of total dairy consumption of Chinese children and adolescents and explore the associations between dairy consumption and nutrition status, including stunting, wasting, overweight, and obesity. Methods Participants included 28,250 children and adolescents aged 6-17 years old. A food frequency questionnaire(FFQ) including 100 kinds of food was used to collect information about frequency and quantity of dairy consumption. Determination of stunting was with a height cutoff value for age and gender, and determination for wasting, overweight, and obesity was with BMI for age and gender. Results Of the total sample, 36.1% of children aged 6-17 reported consuming dairy food more than once per day(≥ 1/day). The average total dairy intake of all the participants was 126.7 g/day. For boys, dairy consumption had an inverse correlation with stunting and wasting after controlling for confounders. For girls, dairy consumption was negatively associated with stunting and obesity after controlling for confounders as above. Conclusion Dairy consumption in Chinese children and adolescents was relatively lower than that in developed countries, and was negatively associated with stunting and wasting for boys and with stunting and obesity for girls.

Handgrip Strength as a Predictor of Nutritional Status in Chinese Elderly Inpatients at Hospital Admission

Objective To assess nutritional status and define gender-and age-specific handgrip strength（HGS） cut-point values for malnutrition or nutritional risk in elderly inpatients. Methods A cross-sectional study of 1,343 elderly inpatients was conducted in the Chinese PLA General Hospital. Nutrition Risk Screening（NRS 2002） and Subjective Global Assessment（SGA） were administered. Anthropometric measurements and blood biochemical indicators were obtained using standard techniques. The gender-and age-specific receiver operating characteristic（ROC） curves were constructed to evaluate the HGS for nutritional status by SGA and NRS 2002. Sensitivity, specificity, and areas under the curves（AUCs） were calculated. Results According to NRS 2002 and SGA, 63.81% of elderly inpatients were at nutritional risk and 28.22% were malnourished. Patients with higher HGS had an independently decreased risk of malnutrition and nutritional risk. The AUCs varied between 0.670 and 0.761. According to NRS 2002, the optimal HGS cut-points were 27.5 kg（65-74 years） and 21.0 kg（75-90 years） for men and 17.0 kg（65-74 years） and 14.6 kg（75-90 years） for women. According to SGA, the optimal HGS cut-points were 24.9 kg（65-74 years） and 20.8 kg（75-90 years） for men and 15.2 kg（65-74 years） and 13.5 kg（75-90 years） for women. Conclusion Elderly inpatients had increased incidence of malnutrition or nutritional risk. HGS cut-points can be used for assessing nutritional status in elderly inpatients at hospital admission in China.

Effects of nutritional and psychological status in gastrointestinal cancer patients on tolerance of treatment

AIM: To assess the effects of poor nutritional and psychological status on tolerance of cancer treatment and the recovery of physical performance status in patients with gastrointestinal cancer. METHODS: An epidemiological survey with respect to nutritional and psychological status in patients with gastrointestinal cancer was conducted among 182 operated patients in four provincial-level hospitals from December 2005 to June 2006. The food frequency survey method, state-trait anxiety inventory (STAI) and depression status inventory (DSI) were used to obtain information about the diet and psychological status in the patients. Nutritional status in the participants was reflected by serum albumin (Alb), hemoglobin (HB) and body mass index (BMI). RESULTS: Alb, protein intake and anxiety were associated with the severity of side effects of treatment. The adjusted relative risk (RR) for Alb, protein intake and anxiety was 3.30 (95% CI: 1.08, 10.10, P = 0.03), 3.25 (95% CI: 1.06, 9.90, P = 0.04) and 1.48 (95% CI: 1.29, 1.70, P < 0.0001), respectively. Moreover, calorie intake, HB and depression were associated with the recovery of physical performance status in the patients. Adjusted relative risk was 2.12 (95% CI: 1.09, 4.03, P = 0.028), 2.05 (95% CI: 1.08, 3.88, P =0.026) and 1.07 (95% CI: 1.02, 1.12, P = 0.007), respectively. CONCLUSION: Both poor nutrition status and psychological status are independent risk factors for severe side effects of cancer treatment, and have impact on the recovery of physical performance status in patients after treatment.

Effects of radical cholecystectomy on nutritional and immune status in patients with gallbladder carcinoma

INTRODUCTION Carcinoma of the gallbladder is the most commonneoplasm in biliary tract,and its incidence has beenrising in recent years.The rate of correct diagnosisin early gallbladder carcinoma has been raised afterthe wide use of CT,ultrasound scans and frozensection examination.Now radical cholecystectomyis advocated as the best management for patientswith early gallbladder carcinoma.In the

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.

A comparison of short-term postoperative outcomes including nutritional status between gastrectomy with simultaneous cholecystectomy and gastrectomy only in patients with gastric cancer

Objective: We aimed to evaluate the effect of simultaneous cholecystectomy on the short-term postoperative outcomes and nutritional status in patients with gastric cancer.Methods: We retrospectively reviewed data from 4,820 patients with gastric cancer who underwent gastrectomy from January 2011 to December 2016. Patients who underwent only gastrectomy(N=4,578) were matched to those who underwent simultaneous cholecystectomy during gastrectomy(N=242) at a 1:1 ratio using propensity score matching analysis. The nutritional status and inflammatory responses preoperatively and postoperatively and postoperative outcomes were compared between the groups.Results: The simultaneous cholecystectomy group showed more intraoperative blood loss and a longer operative time than the gastrectomy only group [150.0(100.0, 200.0) m L vs. 100.0(100.0, 200.0) m L, P=0.006;176.0(150.0,210.0) min vs. 155.0(128.0, 188.0) min, P<0.001, respectively]. Intraoperative event rate, postoperative complication rate, and postoperative recovery did not differ between the groups. All parameters including body weight, the hemoglobin level, absolute lymphocyte count, total protein level, albumin level, fasting glucose level,and prognostic nutritional index excluding the cholesterol level were not significantly different between the groups,and their changing patterns were similar. Although the cholesterol level was significantly lower in the simultaneous cholecystectomy group than in the gastrectomy only group at all follow-up points, the mean value of the decreased cholesterol level was within normal range.Conclusions: In gastric cancer patients with gallbladder disease, simultaneous cholecystectomy is safe and not associated with additional nutritional loss.

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.

Hypo-Calories with Micronutrients and Fat Emulsion of Pre-Operative Peripheral Parenteral Nutrition in Malnutrition Risk Rectal Cancer Patients: A Retrospective Cross-Sectional Study

Malnutrition has been recognized as a significant risk factor for the post operated patients, especially for those patients undergoing abdominal operations. This study evaluated the effect of hypo-calories with micronutrients of pre-operative peripheral parenteral nutrition support (PPPN) for rectal cancer patients. Retrospective cross sectional study method was used to investigate. We screened rectal cancer patients past year pre-operative with malnutrition risk from our cancer database and divided into 2 groups, received or not received PPPN and compared the post-operative outcomes. The results showed that the post-operative serum albumin of the 25 patients received PPPN averaged 2.5 ± 0.32 g/dl;significantly better than those of the 15 patients not received PPPN (non-PPPN), which averaged 1.92 ± 0.42 g/dl. The first ambulatory time required 3.0 ± 0.8 days for the PPPN, significantly shorter than those for the non-PPPN, which averaged 4.9 ± 2.4 days. Post-operative hospital days for the patients received PPPN were 18.2 ± 10.5 day, also significantly fewer than the non-PPPN, which averaged 33.7 ± 20.0 day. More than 25% of the non-PPPN was infected with sepsis, while none was infected in the PPPN patients. In conclusion, this study verified the benefits of micronutrients of pre-operative peripheral parenteral nutrition support for rectal cancer patients.

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.

Nutritional status as a predictor of hospitalization in inflammatory bowel disease:A review

BACKGROUND Inflammatory bowel disease(IBD) presents an inflammatory picture that in the long run can lead to complications and consequently more hospitalizations compared to other diseases.AIM To evaluate the influence of nutritional status on the occurrence of IBD-related hospitalization.METHODS This integrative review was conducted in the online databases PubMed and MEDLINE, using the terms "obesity" and "malnutrition" accompanied by"hospitalization", each combined with "Crohn's disease" or "ulcerative colitis".Only studies conducted with humans, adults, and published in English or Spanish were selected, and those that were not directly associated with nutritional status and hospitalization were excluded from this review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guide was used as the basis for selection of studies.RESULTS Of the 80 studies identified, only five met the proposal of this review. None evaluated the association of good nutritional status with the risk of hospitalization. Malnutrition had a strong correlation with the risk of hospitalization related to IBD, and there was disagreement among three studies regarding the association of obesity and hospitalization rates.CONCLUSION Few studies have evaluated nutritional status as a predictor of IBD-related hospitalization. The presence of malnutrition appears to be associated with hospitalization in these patients, but further studies are needed to elucidate the issue.

Nutritional status in non-alcoholic subclinical porto-systemic encephalopathy

AIM To understand the role of nutritional status in cirrhotic patients without clinical porto-systemic encephalopathy (PSE).METHODS Fifty-one non-alcoholic patients with cirrhosis without PSE were studied prospectively and compared with 20 healthy volunteers. The nutritional evaluation included serum prealbumin, albumin, transferrin, body mass index (BMI), mid-arm muscle circumference (MAMC), and grip power. The occurrence of subclinical PSE (SPSE) was defined when N20-N65 inter-peak latencies of median nerve-stimulated somatosensory evoked potentials were ＞2.5 standard deviations of control means. Blood chemistries were tested within 12h of somatosensory evoked potentials test and nutritional evaluation.RESULTS Twenty-five, 17 and 9 cirrhotic patients were graded as Child-Pugh class A, B, and C, respectively. Twenty-four (47.1%) patients developed SPSE. Cirrhotic patients with SPSE had lower serum albumin (2.8g/dL±0.5g/dL vs 3.1g/dL±0.7g/dL, P＜0.001) levels than those without SPSE. Prealbumin (10.6mg/dL±5.7mg/dL vs 12.5mg/dL±5.8mg/dL), transferrin (164mg/dL±46mg/dL vs 178mg/dL±58mg/dL), BMI (23.7kg/m2±2.7kg/m2 vs 25.3kg/m2±3.6kg/m2), MAMC (22.2cm±2.6cm vs 22.7cm±3.5cm), and grip power (26.3kg±6.4kg vs 26.9kg±6.8kg) were not different between cirrhotic patients with and without SPSE. N20-N65 inter-peak latencies were correlated with serum albumin levels (P=0.01) but not with prealbumin, transferrin, BMI, MAMC, or grip power. Serum albumin, prealbumin and transferrin levels were different among cirrhotic patients with Child-Pugh classes A, B, and C (P＜0.05). BMI, MAMC, and grip power were not different among Child-Pugh classes A, B and C.CONCLUSION Our data suggest that serum albumin level is a simple test in the evaluation of nutritional status in patients with cirrhosis.

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.