Clinical nutrition ESPEN最新文献

{"title":"Impact of Low Muscle Mass and Bone Mineral Density on Long-Term Outcomes of Acute Ischemic Stroke: A prospective study.","authors":"Dogan Dinc Oge, Ethem Murat Arsava, Mehmet Akif Topcuoglu","doi":"10.1016/j.clnesp.2024.12.021","DOIUrl":"https://doi.org/10.1016/j.clnesp.2024.12.021","url":null,"abstract":"<p><strong>Background: </strong>Premorbid sarcopenia, osteoporosis, and obesity are epiphenomena that affect survival and functional outcomes in patients with acute ischemic stroke. The effects of preexisting sarcopenia and/or osteopenia on long-term outcome after ischemic stroke were herein prospectively studied.</p><p><strong>Methods: </strong>Dual-energy x-ray absorptiometry (DeXA), bio-impedance analysis (BIA) and muscle ultrasonography (US) data were prospectively collected within the first 72 hours in 297 consecutive acute ischemic stroke patients (45.5% women, mean age: 67.8 years). Bone mineral density (BMD) and bone mineral content (BMC) were measured by DeXA for the lumbar spine, and hip (femoral neck and total). BIA was used to measure skeletal muscle mass indices (SMMI, normalized to height-squared, weight and body mass index - SMMI-height, SMMI-weight and SMMI-BMI, respectively) and phase angle. Vertical muscle thickness (MT, mm) for biceps brachii (BB), rectus femoris (RF), vastus lateralis (VL) and gastrocnemius medialis (GCM), cross-sectional area (CSA, cm²) for BB and RF, fascicle length (fL) and pennation angle (PeA) for VL and GCM were measured using muscle US. Multiple exploratory logistic regression models were constructed for detect predictors of mortality and unfavorable functional outcome (Modified Rankin score-mRS>1) at the end of the first year. The cut-off value determined by the Younden-J index, and the lower limit of the 95% confidence interval of the area under the receiver operating characteristic (ROC) curve (AUC) were reported.</p><p><strong>Results: </strong>Independent predictors for one-year unfavorable prognosis were phase angle (cut-off ≤5^o; lower limit of 95%CI of ROC-AUC: 0.704); muscle thickness (AUCs were 0.677 for RF (≤9.29), 0.660 for GCM (≤13.38), 0.655 for R+VIM (vastus intermedius) (≤15.31), 0.605 for BB+brachialis (≤23.98) and 0.592 for VL (≤10.64), 0.619 for VL transverse MT (≤19.95 mm), and cross sectional areas (0.656 for RF (≤4.27 cm²) and 0.609 for BB (≤8.88 cm²). Independent predictors for 1-year mortality were phase angle (95% lower limit of AUC 0.746 for ≤3.7^o), BB+brachialis MT (0.625 for ≤23.98 mm), and BB MT (0.613 for ≤19.27).</p><p><strong>Conclusions: </strong>Phase angle and ultrasonographic muscle-size parameters (thickness and cross-sectional area) obtained at admission are significant and independent predictors of long-term functional prognosis and mortality in acute ischemic stroke. Ultrasound parameters of muscle architecture (pennation angle, fiber length), DeXA (BMC and BMD), and BIA-derived SMMI have low independent prediction capability of long-term prognosis.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the associations between a dual diagnosis of malnutrition and obesity and length of stay, readmissions, and 12-month mortality in patients aged >65yrs admitted to hospital - a retrospective observational single-centre study.","authors":"Emma Sganzerla, Ranjeev Chrysanth Pulle, Donna Hickling, Jack Bell","doi":"10.1016/j.clnesp.2024.12.026","DOIUrl":"https://doi.org/10.1016/j.clnesp.2024.12.026","url":null,"abstract":"<p><strong>Objective: </strong>Despite the protective effect of obesity on mortality in older patients, the dual diagnosis of obesity and malnutrition may worsen outcomes. This study aimed to investigate whether obese patients aged 65 years and over with a diagnosis of malnutrition have different outcomes to obese, non-malnourished peers.</p><p><strong>Methods: </strong>This retrospective study of inpatients included 9 years of data from annual Malnutrition Audits (2011- 2019). Obesity was defined as Body Mass Index (BMI) >30kg/m²; malnutrition was defined by Subjective Global Assessment (SGA) category B or C. Logistic regression analyses were used to consider the association between a concurrent diagnosis of malnutrition and obesity and outcomes including: 12-month mortality, prolonged length of stay (defined as >50^th centile, very prolonged as >75^th centile) and hospital readmission within 12 months.</p><p><strong>Results: </strong>326 obese patients aged 65yrs and over were included. Median patient age was 76.1yrs, with 51.8% female. 37 patients (11%) were malnourished and obese, with a median BMI of 32.9kg/m². Malnutrition increased the odds of prolonged length of stay (OR:3.30, 95% CI 1.58 - 6.91, p = 0.002) and very prolonged length of stay (OR: 4.17, 95% CI 1.89 - 9.21, p = <0.001), as well as increased 12-month mortality (OR: 2.89, 95% CI 1.40 - 5.96, p = 0.004). Malnutrition was not associated with increased hospital presentations within 12 months (p = 0.531).</p><p><strong>Conclusion: </strong>Older patients with a dual diagnosis of obesity and malnutrition have worse outcomes than their obese but non-malnourished peers. The presence of obesity should not preclude the assessment of nutritional status in older patients.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Omega-3 Fatty Acids Are Not Associated with Muscle Strength, Regardless of Age or Protein Intake: National Health and Nutrition Examination Survey 2011-12.","authors":"Rafaela Nehme, Isabela M Sponchiado, Larissa S Limirio, Jaqueline L Pereira, Hamilton Roschel, Flávia M S de Branco, Erick P de Oliveira","doi":"10.1016/j.clnesp.2024.12.025","DOIUrl":"https://doi.org/10.1016/j.clnesp.2024.12.025","url":null,"abstract":"<p><strong>Background & aims: </strong>Muscle strength is a key predictor of both quality of life and mortality. Although numerous studies have investigated the relationship between omega-3 (ω-3) intake and muscle strength, the evidence remains inconclusive. Furthermore, it is unclear whether this association is influenced by protein intake. Therefore, the aim of this study was to evaluate the potential associations between plasma ω-3 levels (as a biomarker of ω-3 intake) and muscle strength across different age ranges and levels of protein intake.</p><p><strong>Method: </strong>A cross-sectional study was conducted involving 1,708 individuals aged 20 to 80 years from the 2011-2012 National Health and Nutrition Examination Survey (NHANES). Plasma levels of total ω-3 fatty acids and their subtypes-alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA)-were measured using chromatography-mass spectrometry. Muscle strength was assessed using handgrip strength, with the combined grip strength of both hands being analyzed. Dietary intake was evaluated using two 24-hour recalls, and usual intake was estimated using the National Cancer Institute method. Linear regression analyses were conducted to examine the associations between plasma ω-3 fatty acids and muscle strength, stratified by age groups (< 60 years and ≥ 60 years) and protein intake categories (< 0.8 g/kg, ≥ 0.8 - < 1.2 g/kg, and ≥ 1.2 g/kg), while adjusting for potential confounders.</p><p><strong>Results: </strong>Total plasma ω-3, ALA, EPA, and DHA were not significantly associated with muscle strength in the total sample, regardless of protein intake levels. This lack of association remained consistent across all age groups and protein intake strata.</p><p><strong>Conclusion: </strong>Plasma ω-3 fatty acids were not associated with muscle strength, regardless of age or protein intake. Overall, these findings suggest that plasma ω-3 fatty acids may not play a significant role in muscle strength.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consumption of ultra-processed foods is associated with dietary iron availability, anemia, and excess weight in socially vulnerable children.","authors":"Jonatan Christian de Lima Santos Queiroz, Luis Carlos Rey, Terezinha da Rocha Ataide, Telma Maria de Menezes Toledo Florêncio, Luiz Gonzaga Ribeiro Silva-Neto","doi":"10.1016/j.clnesp.2024.12.023","DOIUrl":"https://doi.org/10.1016/j.clnesp.2024.12.023","url":null,"abstract":"<p><strong>Background & aims: </strong>Eating habits during childhood have undergone significant changes, with a notable increase in the consumption of ultra-processed foods (UPF). This situation deserves attention, given the close relationship between UPF and adverse health outcomes. This is due to the nutritional composition of UPF, which has high levels of health-critical nutrients such as sugar, fat, and sodium, thus compromising the overall quality of the diet. An excess of these nutrients can increase the risk of developing excess weight, nutritional deficiencies, and chronic diseases during childhood. Among the nutritional deficiencies is iron. This is due to the fact that UPF are not good sources of iron. This, combined with the fact that UPF is low in nutrients that help make iron more available, such as vitamin C, increases the risk of developing anemia. Therefore, this study aimed to assess the availability of iron, as well as the presence of anemia and excess weight in children living in situations of social vulnerability, and to determine their association with the consumption of UPF.</p><p><strong>Methods: </strong>This is a population-based cross-sectional study. Children aged between 6 and 59 months living in slums were included. The presence of excess weight was assessed by measuring weight and height, and the presence of anemia was determined by hemoglobin concentration, assessed using the HemoCue portable hemoglobinometer. A 24-hour food recall was also used to assess the relative calorie intake of UFP and the dietary availability of iron using an algorithm. All statistical analyses were carried out using the statistical software Jamovi.</p><p><strong>Results: </strong>In this study, 443 children were included; 19.2% were classified as with excess weight, and 55.6% were anemic; the average absorbable iron content was 0.54 (SD +/- 0.42) mg, and 39.2% of the calories consumed came from UPF. The association analysis showed that children with calorie share relative to UPF had a decrease of -0.12 mg of bioavailable iron (β: -0.12; 95% CI: -0.23; -0.01). It was also possible to identify that the higher calorie share of UPF increased their chances of being classified as with excess weight and anemic by up to 116% (OR: 2.16; 95% CI 1.05; 4.46) and 145% (OR: 2.45; 95% CI: 1.26; 4.78), respectively.</p><p><strong>Conclusions: </strong>The relationship found between UPF consumption and the availability of iron in the diet, excess weight, and anemia calls for attention, especially in contexts of social vulnerability. These findings demonstrate the need for greater attention to nutrition in childhood to promote an adequate and healthy diet. This can help to change the nutritional and epidemiological panorama of the population, contributing to a better general state of health for future generations of adults.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathway analysis of the impact of dysphagia on the prognosis of patients with stroke: based on structural equation modeling.","authors":"Liu Huan, Hou Yutong, Shi Jiajia, Liu Wenbo, Zhang Pingping","doi":"10.1016/j.clnesp.2024.12.017","DOIUrl":"https://doi.org/10.1016/j.clnesp.2024.12.017","url":null,"abstract":"<p><strong>Background and aims: </strong>Dysphagia is significantly correlated with prognostic outcomes in patients with stroke; however, the intrinsic mechanism of action between the two remains unclear. This study aimed to model the intrinsic mechanism of action between dysphagia and prognostic outcomes in patients with stroke based on structural equation modeling.</p><p><strong>Methods: </strong>A retrospective analysis of 900 inpatients with stroke from three large hospitals was performed. AMOS software (version 23.0) was used to construct the structural equation modeling.</p><p><strong>Results: </strong>The overall model showed a good fit (chi-square = 27.3, root mean square error of approximation = 0.01, standardized root mean square residual = 0.032, comparative fit index = 0.98, and adjusted goodness of fit = 0.94). Structural equation modeling showed that the total effect of dysphagia on the prognosis of patients with stroke was 0.694, with a direct effect of 0.599, accounting for 86.31% of the total effect. The total indirect effect was 0.095, with the mediating effects of serum albumin level and pneumonia accounting for 6.48% and 7.35% of the total effect, respectively. The moderating effects of sex on dysphagia and the relationship between activities of daily living, modified Rankin scale score, and length of hospital stay were insignificant (ΔR2 = 0.063, P = 0.145; ΔR2 = 0.002, P = 0.620; ΔR2 = 0.001, P = 0.307).</p><p><strong>Conclusions: </strong>Dysphagia can directly affect the prognostic outcomes of patients with stroke and indirectly affect prognosis by triggering pneumonia and lowering albumin levels. Sex was not found to play a moderating role in the relationship between dysphagia and prognosis.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in nutritional status and effectiveness of the dietary intervention of multimodal prehabilitation for patients with colorectal cancer: a secondary analysis of the PREHAB randomized clinical trial.","authors":"C van Erven, D Ten Cate, R van Lieshout, S Beijer, J Dieleman, S Geertsema, M Jalink, J van der Meulen-Franken, N Rademakers, C Gillis, G Slooter","doi":"10.1016/j.clnesp.2024.12.024","DOIUrl":"https://doi.org/10.1016/j.clnesp.2024.12.024","url":null,"abstract":"<p><strong>Background & aims: </strong>Prehabilitation is a preoperative multimodal program including exercise, nutritional, and psychological support. Little is known about changes in nutritional status during prehabilitation.</p><p><strong>Methods: </strong>This secondary analysis of the PREHAB trial aims to assess changes in nutritional status and explore the effectiveness of a four-week nutritional intervention. Data were collected at baseline and preoperatively (end of the program), including body composition with bioelectrical impedance analysis (single frequency, 50kHz), muscle strength (indirect 1RM leg press), three-day food diaries and the scored PG-SGA. Protein requirements were set at 1.5 g/kg body weight.</p><p><strong>Results: </strong>Sixty-seven participants were enrolled, 34 to standard care and 33 to four-week prehabilitation. Nutritional status improved in both groups: -1 point change in the standard care group (p =, 0.027), and -1.5 point in the prehabilitation group (p = 0.015). Those who received prehabilitation statistically increased fat free mass (0.9kg, p = 0.017) and appendicular skeletal muscle mass (0.5kg, p = 0.007. In contrast, an increase in fat mass (0.6kg, p = 0.016) was observed within the standard care group only. Participants in the prehabilitation group had a substantial increase of 27% muscle strength (p = <0.001). Optimal protein intake was more often achieved within the prehabilitation group (47%, p = <0.001).</p><p><strong>Conclusion: </strong>Our study provides evidence for the positive impact of multimodal prehabilitation on preoperative nutritional status in adult patients with CRC, especially in body composition and muscle strength. Achieving optimal protein intake was challenging, both dietary counseling and supplements are recommended to improve intake.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The associations between dietary omega-6, omega-3, and omega 6 to omega 3 ratio fatty acids and hypertension risk among adults: A prospective cohort study.","authors":"Ebrahim Shakiba, Yahya Pasdar, Sara Ebrahimi-Mousavi, Farid Najafi, Amir Saber, Mohammad Hossein Shakiba, Amir Bagheri","doi":"10.1016/j.clnesp.2024.12.022","DOIUrl":"10.1016/j.clnesp.2024.12.022","url":null,"abstract":"<p><strong>Background and aims: </strong>Previous studies have yielded mixed results on the connection between dietary omega-3 and omega-6 intakes and the risk of hypertension (HTN) incidents. Therefore, we conducted a study to survey the connection between baseline dietary intake of omega-3, omega-6, and omega-6 to omega 3 (omega-6/3) fatty acids (FA) and the risk of hypertension.</p><p><strong>Methods: </strong>We conducted a prospective cohort study and assessed dietary intake through a 118-item food frequency questionnaire (FFQ). To determine the relationship between dietary omega-3, omega-6, and omega-6/3 ratio intake and the risk of developing hypertension, we applied Cox proportional hazards analysis to determine hazard ratios (HR) and 95 % confidence intervals (CIs).</p><p><strong>Results: </strong>After following 7359 participants who did not have hypertension at the beginning of the study for 6.4 ± 1.33 years, we identified 597 new cases of hypertension (8.11 %). Our analysis, which controlled for all confounders, did not identify any significant link among the highest versus lowest quartile of dietary omega-3 intake (HR: 0.87, 95 % CI: 0.63, 1.18; P trend: 0.34), omega-6 intake (HR: 1.04; 95 % CI: 0.81, 1.34; P trend: 0.82), and omega-6/3 ratio intakes (HR: 1.06, 95 % CI: 0.82, 1.36; P trend: 0.66) and HTN risk.</p><p><strong>Conclusions: </strong>To sum up, our study revealed that dietary omega-3, omega-6, and omega-6/3 ratio were not associated with the hypertension risk.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"418-423"},"PeriodicalIF":2.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calf circumference may complement the nutritional assessment of children under 10 in the paediatric intensive care unit.","authors":"Rafaela Rodrigues Vieira, Patrícia Zamberlan","doi":"10.1016/j.clnesp.2024.12.020","DOIUrl":"10.1016/j.clnesp.2024.12.020","url":null,"abstract":"<p><strong>Background: </strong>Nutritional intervention during hospitalisation is vital in managing of children and adolescents in intensive care. In this context, body composition measurements, such as mid-upper arm circumference (MUAC), can help improve the accuracy of nutritional assessments. However, using MUAC has some limitations. Calf circumference (CC) is a straightforward, inexpensive, and easily obtainable measurement. However, no reference values currently exist for CC in paediatric patients.</p><p><strong>Aims: </strong>To describe the nutritional monitoring of critically ill children and adolescents in the Paediatric Intensive Care Unit (PICU) using CC.</p><p><strong>Methods: </strong>Patients aged 6 months to 18 years old who were admitted to the PICUs participated in the study. Two MUAC and CC measurements were performed: one in the first 48 h of admission to the PICU and another after 7 days. The percentage change between the two measurements was compared. Information was also evaluated about demographic and outcome data. Analyses were conducted with all patients included in the sample collectively and subdivided by age (<10 years and ≥10 years).</p><p><strong>Results: </strong>Two hundred and eleven patients underwent anthropometric assessment on admission, and the sample for comparative analyses consisted of 103 patients (after discharges and deaths). MUAC and CC significantly decreased in the first week of hospitalisation. A positive weak correlation was found between the percentage change in the MUAC and CC only for individuals under 10 years old and for the total sample, but not for adolescents. The all age group and children under 10 years old showed a greater reduction in CC than in MUAC. The same did not occur for adolescents.</p><p><strong>Conclusions: </strong>Calf circumference may be a promising method for nutritional monitoring of critically ill children in Paediatric Intensive Care Units because it can indicate signs of depletion earlier than mid-upper arm circumference. These results are more meaningful for children than for adolescents.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"445-452"},"PeriodicalIF":2.9,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of radiotherapy on body weight in head and neck cancer patients: A prospective study.","authors":"Ingrid M Fange Gjelstad, Christian Lyckander, Anne Høidalen, Åse Bratland, Rune Blomhoff, Ingvild Paur, Christine Henriksen","doi":"10.1016/j.clnesp.2024.12.019","DOIUrl":"10.1016/j.clnesp.2024.12.019","url":null,"abstract":"<p><strong>Background: </strong>Patients with head and neck cancer (HNC) undergoing radiotherapy or chemoradiotherapy often experience symptoms that affect their ability to eat. This study aimed to explore the impact of radiotherapy on body weight in HNC patients and compare the characteristics of patients receiving enteral tube feeding with those maintaining an oral diet.</p><p><strong>Methods: </strong>In this prospective study, 52 patients with HNC were examined at diagnosis, at the start and end of radiotherapy, and six weeks after end of treatment. The nutritional assessment included measurements of body weight, food intake, and malnutrition using Patient-Generated Subjective Global Assessment (PG-SGA). Other variables were retrieved from the electronic patient record.</p><p><strong>Results: </strong>Critical weight loss (defined as >5 % from start of radiotherapy) was present in 60 % of the patients at the end of radiotherapy, and only half of these patients received any enteral nutrition therapy. The mean weight loss was 5.8 % during radiotherapy, and an additional 2.1 % at follow-up (n = 48). A nasogastric feeding tube was used by 42 % at the end of radiotherapy, and 29 % at follow-up. The tube feeding users had a lower energy intake and higher weight loss than non-tube feeding users (22 vs 27 kcal/kg body weight, 7.8 vs 4.4 % weight loss) at the end of radiotherapy treatment. According to PG-SGA, 92 % of the patients were malnourished at the end of treatment and 71 % at follow-up (p < 0.001).</p><p><strong>Conclusion: </strong>Critical weight loss and malnutrition were common in HNC patients after radiotherapy, and enteral tube feeding was initiated in only half of the cases with critical weight loss. Patients receiving enteral tube feeding may need closer monitoring to ensure adequate energy intake, and other treatment options may be necessary. These results emphasize the need for improved nutritional intervention during and after radiotherapy.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"390-399"},"PeriodicalIF":2.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional risk screening and nutritional assessment for children with cerebral palsy: A review of the current research status and future directions.","authors":"Jixun Zhao, Yuyang Qiu, Huiqun Wang","doi":"10.1016/j.clnesp.2024.12.018","DOIUrl":"10.1016/j.clnesp.2024.12.018","url":null,"abstract":"<p><strong>Background: </strong>Although the primary impairment involved in Cerebral palsy (CP) is motor function, malnutrition is also common. However, there is a lack of tool recommendations for early malnutrition risk screening in children with CP, and the means of nutritional intervention for children with CP are also limited.</p><p><strong>Methods: </strong>This study systematically searched the literature about clinical nutrition related content of cerebral palsy in Pubmed, MEDLINE, Embase, and the Cochrane Library in Jan 2024 and by hand searching, and we checked reference lists and citations to identify additional studies. Search terms include cerebral palsy, children, diagnosis, prediction, malnutrition, nutritional risk screening, nutritional assessment, nutritional support. Additions are marked in red in the modified version.</p><p><strong>Results: </strong>The timing of diagnosis of CP has been moving forward, and some new diagnostic tools have been developed. Nutritional status is correlated with regional economic level, but there is still a malnutrition rate of nearly 30 % in developed countries. Severe restrictions in terms of gross motor function, swallowing dysfunction, feeding difficulties, cognitive impairment, and insufficient energy intake are common risk factors for malnutrition in children with CP. Z-score should be calculated in combination with measurement indicators in the assessment of physical development of children with CP. The nutritional outcomes of children with CP can be improved by various means, including diversified a Nutrition Support Team (NST) interventions.</p><p><strong>Conclusions: </strong>The incidence of malnutrition in children with CP is high, which needs to be paid more attention. More effective malnutrition risk screening tools need to be developed for children with CP to guide the implementation of comprehensive and personalized nutritional interventions and improve malnutrient-related outcomes.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"382-389"},"PeriodicalIF":2.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}