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PubMed1985

Nutritional status in children receiving home parenteral nutrition.

Nutrition status was evaluated in 19 children aged 4 to 65 months who received total parenteral nutrition as their only source of nutrition (nine patients, group 1) or who ingested 30% to 70% of their total energy requirements orally and received the remainder intravenously (10 patients, group 2). All patients had received parenteral nutrition for 31.8 +/- 9.8 SD and 33.1 +/- 17.1 months, respectively. All patients in group 1 and four in group 2 had short bowel syndrome; five in group 2 had pseudo-obstruction syndrome. The children in group 1 had normal height, weight, midarm circumference (MAC), midarm muscle circumference (MAMC), and triceps skinfold thickness (TSF). In group 2 patients, height, MAC, and TSF, were significantly below normal, and their weight, MAMC, and TSF, were lower than in group 1. Hemoglobin, total lymphocyte count, and serum albumin concentration were below normal in group 1; serum total protein concentration was low in both groups. Serum bilirubin concentration was higher in group 1; serum glutamic pyruvic transaminase activity was elevated in both groups. These data indicate that children receiving long-term total parenteral nutrition can obtain and maintain normal height, weight, and other anthropometric measurements of nutritional status. Group 1 patients had better nutritional status than those in group 2, perhaps because of differences in the underlying medical disorders between the two groups, or possibly because of a propensity to underestimate the amount of parenteral nutrition needed by patients who ingest some nutrients.

Body Weight↗
PubMed1988

The link between nutritional status and clinical outcome: can nutritional intervention modify it?

Most clinicians subjectively feel that malnutrition in surgical patients is associated with poor clinical outcome. This overview provides a chronologic review of studies relating poor nutritional status to increased surgical morbidity. Techniques for identifying surgical patients with clinically important nutritional deficits are discussed. Retrospective and/or non-randomized clinical studies evaluating the efficacy of perioperative forced feeding are reviewed. These data suggest a possible role for preoperative nutritional support of selected malnourished surgical candidates and provide the rationale for a large-scale nutrition-intervention clinical trial.

Clinical Trials as Topic↗
PubMed2003

Assessment tools for nutritional status in the elderly.

Nutritional assessment in the elderly consists of many different tests--clinical, biochemical and anthropometric. However, objective markers of nutritional assessment often do not reflect physiologic, physical, cognitive and emotional function. Moreover, nutritional assessment using objective markers is more complicated in the older subject because metabolic changes, among others, affect some of the routine biochemical test results, and the reference values of the anthropometric measures are not always age-adjusted. In addition, it is possible that functional impairment may occur at a subclinical level and precede a measurable alteration in body composition, i.e., there may be clearly defined alterations in muscle function at a time when significant changes in body composition could not be detected. Malnutrition or nutritional deficiency is a continuum that starts with an individual's inadequate intake (that, in fact, does not meet his or her needs) and progresses through a series of functional changes that precede any changes in body composition. At present there is no gold standard for evaluating nutritional status. The relationship between nutritional status and functional capacities apparently is the simplest, but also the most reliable index of malnutrition. The extent of dependency and disability has a considerable impact on nutritional status and vice versa.

Aged↗
PubMed1995

Clinical examination compared with anthropometry in evaluating nutritional status.

Clinical assessments of nutritional status in a group of 44 inpatients, made by a panel of experienced childcare specialists, were compared with anthropometric assessments. Assessors were uniformly poor at detecting severe malnutrition and at assessing the nutritional status of infants. Nutritional status cannot be accurately assessed clinically and anthropometry is crucial.

Anthropometry↗
PubMed1982

Field use of hair epilation force in nutrition status assessment.

The nutritional status of 69 Nigerians, age 1 month to 75 yr was assessed with the Krumdieck trichotillometer, which measures the force required to epilate a hair (epilation force, EF). EF of normal subjects (serum albumin greater than or equal to 3.5 g/dl) was 36.5 +/- 9.5 mg (mean +/- SD)). EF was significantly lower (25.7 +/- 10.6 g) in malnourished subjects (serum albumin less than or equal to 3.0 g/dl). EF correlated significantly with weight-for-height, mid-arm circumference, mid-arm muscle circumference, and serum albumin (r = 0.36, 0.32, 0.30, and 0.30, respectively, (p less than 0.05), but did not correlate significantly with triceps skinfold. These findings are in agreement with the clinical impression that hair pluckability is affected more by protein depletion than by energy depletion. The trichotillometer may be a useful tool in assessment of protein nutritional status in the field since it requires little training, and no laboratory.

Adolescent↗
PubMed1986

[Branched-chain amino acids: indicators of fetal nutritional status].

Both nutritive state for Rohrer's ratio (Rr) and serum aminoacids (aa) (Chromatospek J-180) of the umbilical cord have been analyzed and correlated in two groups of the newborns: G-I (n: 12) preterm infants with an adequated weight for their gestational age (Re greater than 10 percentile) and G-II (n: 8) small for-date term infants (Rr less than 10 p). Ratios of the serum aa (total aa, no essential aa, NE/E, Ala/Thr, Whitehead's ratio (Wr), Ala/Leu, Ala/BCA, Gly/Val, Ser + Gly + Ala/BCA) were more elevated in G-II than those one of the G-I. We have shown a single correlation between Wr and Rr (r. much greater than 0.48, p less than 0.025) in G-I and between BCA Rr (r. much greater than 0.88, p less than 0.0025) in G-II; furthermore, we have proved a good correlation between the week of gestation and sum of BCA (r. much greater than 0.53, p less than 0.05) in the former that have not been observed among the latter which had BCA more increased than G-I (p less than 0.050). Some speculations about the role that could play the BCA in the energetic metabolism of the small-for-date infants are made; on the other hand, the BCA can give help to distinguish between premature or pseudopremature among infants weighing 2.500 g or less a birth.

Amino Acids, Branched-Chain↗
PubMed1991

Health status of hostel dwellers. Part III. Nutritional status of children 0--5 years.

The standards laid down by the National Center for Health Statistics in the USA were used to assess the nutritional status of children (0--5 years) in the Zones, an urban migrant council-built hostel complex in Langa, outside Cape Town. Of the children, 5.7% were below the 3rd percentile of weight-for-age (acute undernutrition). There was a significant difference between age categories and an increase in age was associated with an increase in proportion of children below the 3rd percentile. Acute undernutrition was significantly higher for children born outside Cape Town. There was a significant difference between age groups and percentage of children below the 3rd percentile of height-for-age (chronic undernutrition). Chronic nutritional levels were also significantly higher for children not born in Cape Town. Yet there were no significant differences between proportions of children under the 3rd percentile of height-for-weight (current nutritional status) for age category or place of birth. These results suggested that while in town children were adequately nourished, this was not the case at their home-base. Chronic undernutrition findings indicated an incremental negative effect of the poverty of the home-base on the long-term health status of hostel migrant children.

Age Factors↗
PubMed1995

Nutritional status in head and neck cancer patients.

The nutritional status of patients with head and neck cancer has been suspected as being a significant risk factor for surgical complications and cancer recurrence. Clinical dietary assessment was performed on a mixed group of 42 previously untreated, head and neck cancer patients scheduled to receive surgery with curative intent. Cox regression analysis was performed to investigate the relationship between demographic and tumour factors and nutritional status. Nutritional status correlated only with the locoregional stage of disease. A further regression analysis was performed to determine if nutritional status is an independent risk factor for early postoperative complications or recurrence. Nutritional status was not shown to influence surgical outcomes independent of tumour stage. Further study of the relationship between nutritional status and surgical results is required before recommending preoperative hyperalimentation in head and neck cancer patients.

Aged↗
PubMed1994

Circulating proteins and iron status in blood as indicators of the nutritional status of 10- to 12-year-old Bolivian boys.

The purpose of the present study was to evaluate the nutritional status of children based on anthropometric measurements, biochemical indicators of protein energy malnutrition as well as hematological variables. The subjects were 93 10- to 12-year-old Bolivian boys: 12 HAHSES, 28 HALSES, 36 LALSES, and 17 LALSES (see Introduction to this Supplement). The overall nutritional status of the boys was evaluated by anthropometric indicators (weight for age [W/A], height for age [H bd, and weight for height [W/H]). The biochemical indicators included proteins total, albumin, prealbumin, orosomucoid and protein C-reactive (for MPE) as well as hematocrit (Ht), hemoglobin (Hb), serum iron, serum ferritin, and transferrin saturation (TS). The prevalence of growth retardation of LSES boys at HA as well as at LA was found to be high when the 3rd percentile was used as the cutoff point. The corresponding prealbumin levels were found to be lower in LSES than in HSES boys at both altitudes. The study shows that LSES boys at both altitudes have significantly lower prealbumin levels than HSES boys. The socioeconomic factor seems to be more critical for the nutritional status of prepubertal boys than altitude. The study also shows that all the boys had hematological parameters within normal range. The HA boys of both SES had higher hemoglobin concentration and hematocrits than the LA boys, a fact that is explained by high-altitude hypoxia. The hematological data do not provide evidence of malnutrition among the boys.

Altitude↗
PubMed1990

Nutrition and aging: nutritional status of "apparently healthy" elderly (Dutch nutrition surveillance system).

In a nationwide survey the nutritional status was assessed of 539 apparently healthy, independently living elderly aged 65-79 years. Anthropometric data showed no energy deficits. The prevalence of anemia was 4 and 1% among men and women, respectively. Many elderly showed a low level of 25-hydroxyvitamin D in plasma (less than 31 nmol/L: men 35%; women 43%), indicating a marginal status. Although the prevalence of low blood levels of folate, pyridoxal-5'-phosphate, and total carotenoids was higher among the elderly than among younger adults, clear (clinical) signs of nutritional deficiencies were not observed. Prevalence of obesity (13%), hypercholesterolemia (38%), and hypertension (63%) was found to be high, the percentages being higher for women than for men. Several indicators of the nutritional status appeared to differ among age groups. It is concluded that few differences can be considered as being due to physiological aging, which finding should be reflected in reference values for elderly people.

Age Factors↗
PubMed1990

Long-term effects of a vegetarian diet on the nutritional status of elderly people (Dutch Nutrition Surveillance System).

The health and nutritional status (anthropometry, and blood and urine biochemistry) of 44 Dutch apparently healthy vegetarians, aged 65-97 years, refraining from meat, fish, and poultry consumption, was assessed for insight into long-term consequences of ovo-lacto- or lacto-vegetarianism. The results indicate that in comparison to omnivorous elderly the vegetarian elderly (especially men) have aged successfully with respect to cardiovascular risk factors. In contrast, vegetarian elderly are at a higher risk for a marginal iron, zinc, and vitamin B12 status. Although several vegetarian elderly showed low levels of 25-hydroxyvitamin D in plasma and many had low values of 24-hr urine volume (per kg body weight), these values are not likely the result of a vegetarian diet per se. It is concluded that, although some nutrition-related risks are prevalent among vegetarian elderly, these risks can probably be prevented by lifestyle changes.

25-Hydroxyvitamin D 2↗
PubMedDate not supplied

[Nutritional status as a factor and a result of nutritional and food security and their representations in Brazil].

We approach the determining factors and results of food and nutritional security in Brazil. The following aspects are considered: i. The concept to be studied; ii, The form of measuring a particular factor; iii. A Brazilian characterization on the subject, and iv. conclusions. Nutritional status is primarily a result of the balance between the needs and the spending of food energy and other essential nutrients and, secondarily, of multiple determinants in a given space, represented by physical, genetic, biological, cultural, psychosocio-economic and environmental factors. According to this, there are 3 basic causes of nutritional disorders: food, health and care. Because the repercussions of the economic changes on the nutritional status are not immediate, food security is only one factor of nutritional status and because subjects adapt differently to low food intake, the most adequate nutritional indicators in studies of food and nutritional security are the childhood indicators and the indicators of historical trends. The interpretation of nutritional indicators poses 3 main problems: to determine if the problem is really one of food security; to establish the degree of importance of the problem, and to determine which could be the appropriate normative intervention. The studies of nutritional status in Brazil show considerable improvement in the anthropometric indicators, emphasizing that the worst conditions prevail in the North East region and in the rural areas. Regarding micronutrient deficiencies, the absence of nationwide studies and the great advances in the programs to tackle this deficiencies, mainly vitamin A and iodine deficiencies are highlighted.

Anthropometry↗
PubMed1999

Nutritional status and assessment of patients on home parenteral nutrition: anthropometry, bioelectrical impedance, or clinical judgment?

The optimal method of assessing protein energy nutritional status in patients receiving home parenteral nutrition (HPN) is unknown. We evaluated protein energy nutritional status in 47 outpatients (23 male; 24 female) on HPN by measuring anthropometry, plasma proteins, and lymphocyte counts and compared these with the results of subjective clinical assessment and bioelectrical impedance measurements. Sixteen of the 47 patients (34%) were underweight (body mass index < 5th percentile of the reference) and 21 (45%) were below the 5th percentile of the reference for both triceps skinfold thickness and midarm muscle circumference. Plasma proteins were subnormal in 1-5 patients (2-11%). Lymphocyte counts were subnormal in 19 patients (40%). Clinical assessment classified 23 patients (49%) as well nourished and 24 (51%) as moderately malnourished. Moderately malnourished patients had a significantly lower body mass index than well-nourished patients (P = 0.02). Clinical assessment did not correlate with bioelectrical impedance analysis. Fat-free mass determined by bioelectrical impedance analysis resulted in values up to 9.4 kg lower and 8 kg higher than fat-free mass obtained by anthropometry. Weighing combined with a subjective clinical assessment is sufficient for evaluation of protein calorie nutritional status in patients on HPN.

Adult↗
PubMed1999

[Prognostic value of the nutrition status and pro-inflammatory cytokines (IL-1, TNF-alpha and IL-6) in critically ill patients].

OBJECTIVE: Prognosis of hospitalized patients depends on the status of nutrition, the intensity of the biologic inflammatory response or acute phase response (APR), triggered by cytokine, and the illness severity. These factors have been shown closely related, as cytokine causes malnutrition and organ failure. AIM: to analyze which of these factors are related to mortality and, by multivariate analysis, which of them have an independent predictive value. METHOD: We include 119 patients admitted to a semi-intensive care unit. Nutritional assessment was performed by mid arm anthropometrics, serum albumin, transferrin, IGF-I, and subjective nutritional evaluation; we also determine acute phase proteins and cytokine IL-1, TNF alpha and IL-6. Severity of illness was assessed by organ failure. The only end point considered was death or survival until discharge of hospital. RESULTS: The following data were related to increased mortality: impaired alimentary habits and nutritional subjective assessment, raised serum levels of IL-6 and neutrophil differential count, decreased lymphocyte count, hemoglobin and serum transferrin levels, a negative PPD and the presence of sepsis, shock or organ failure. At multivariate analysis (stepwise logistic regression) only nutritional variables, sepsis and organ failure data showed an independent predictive value, whereas IL-6 was displaced by organ failure data. CONCLUSION: Regarding prognosis, severity of illness and nutritional status have independent predictive value, whereas IL-6 was displaced, probably because it is closely related to the inflammatory response and to organ failure.

Adult↗
PubMed1999

[Nutritional status of surgical patients without apparent nutritional compromise].

Nutritional status of 80 preoperative patients from programmed surgeries of hernias and lithiasis was studied by anthropometric and biochemical parameters. Nutritional deficiencies related to pathology were not expected in these patients. Results were as follows: 77% of the population showed overweight, being 15% obese. Prevalent protein intake, evaluated by the urea nitrogen/creatinine ratio, was adequate in 87.5% of the patients; however, patients presented 72% of albumin, 52% of prealbumin and 50% of RBP below reference values. Transferrin, ceruloplasmin, alpha 2-macroglobulin and haptoglobin were not decreased. Assessment of vitamin A, carotenes and vitamin C showed plasmatic levels below reference values in 16% of the patients for vitamin A, 5% for carotenes and 27% for vitamin C. Respect to calcium status, data of calcium/creatinine ratio show deficiency in 45% of the population. Respect to iron, the nutritional status was in general adequate, patients at risk being 5% by Htc, 11% by Hb, 5% by TS% and 12.5% by FEP, women showed over twice abnormal values than men. Although some isolated relations were observed, in this population sex, age and pathology were variable that did not affect in a relevant way the nutritional status. In spite of the individual analysis of each nutrient did not show important deficiencies, the analysis by patient showed that only a few of them (7%) presented an optimal biochemical profile with all the studied parameters within the reference values.

Adolescent↗
PubMed1984

Implications of nutritional status on human biochemistry, physiology, and health.

Optimum nutrition is the level of intake that should promote the highest level of health. Although excess caloric intake will lead to obesity, a deficit in nutrition may result in a tissue depletion of essential nutrients that can lead to biochemical changes and eventually to clinical signs and symptoms. Nutrition requirements may differ according to sex, age, activity, or physiological state and can be influenced by drugs, smoking, alcohol, and other factors. With ever-increasing sedentary life styles and less physically demanding jobs, the resulting reduced caloric requirements have made it more difficult to make nutritionally sound food choices. Nutrition is the single most important component of preventive health care. Diet has been associated with cancer, heart disease, diabetes, stroke and hypertension, arteriosclerosis, and cirrhosis of the liver. The ability of the human to respond to stresses, such as altitude, heat, trauma, surgery, and infection can be influenced by nutritional status. Nutritional status is reflected in a variety of metabolic processes that provide the basis for a number of methods for its assessment.

Alcoholism↗
PubMed1993

Dietary intakes and biochemical profiles of nutritional status of ultramarathoners.

Nutritional status was determined in 17 ultramarathoners registered to participate in the Old Dominion 100-Miler. They had a mean age of 40 +/- 2 yr and ran 67.7 +/- 9.0 miles.wk-1. Subjects maintained 4-d dietary records on two occasions: usual and prerace. Fasting blood samples and 24-h urine collections were also obtained, and concentrations of selected vitamins and minerals were analyzed. Usual and prerace energy, carbohydrate and fat intakes of the ultramarathoners were not significantly different, but usual protein and alcohol intakes were significantly (P < 0.05) higher than prerace intakes. The amount of energy supplied by carbohydrates rose from a usual intake of 54.2 +/- 2.3% to 60.1 +/- 2.4% in the prerace period. Twelve subjects reported taking vitamin/mineral supplements and mean usual and prerace intakes of vitamin and minerals from food and supplements combined met the current recommendations. Biochemical indices of vitamin and mineral status were normal. However, our findings suggest that vitamin B12 metabolism may be altered in ultraendurance runners. Further research is required to determine whether ultraendurance athletes have special nutrition needs.

Adult↗