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Sample records for nutritional risk index

  1. Nutritional risk index is predictor of postoperative complications in operations of digestive system or abdominal wall?

    PubMed

    Thieme, Rubia Daniela; Cutchma, Gislaine; Chieferdecker, Maria Eliana Madalozzo; Campos, Antônio Carlos Ligocki

    2013-01-01

    Malnutrition can be considered the most common disease in hospitals due to its high prevalence. To investigate the methods of evaluation of the nutritional status that better correlate with postoperative complications and the length of hospital stay in patients submitted to gastrointestinal or abdominal wall surgeries. This is a retrospective evaluation of 215 nutritional assessment records. All were submitted to traditional anthropometry (weight, height, BMI, arm circumference, triceps skinfold thickness and mid-arm muscle circumference), subjective global assessment, serum albumin and lymphocyte count. Nutritional risk index was also calculated. A total of 125 patients were included. Malnutrition was diagnosed by mid-arm muscle circumference, nutritional risk index and subjective global assessment in 46%, 88% and 66%, respectively. Severe malnutrition was found in 17,6% if considered subjective global assessment and in 42% by the nutritional risk index. Oncologic patients had a worst nutritional status according to this index (5,42 less units). There was a negative correlation between occurrence the noninfectious postoperative complications with the nutritional risk index (p=0,0016). Similarly, lower serum albumin levels were associated with higher non infectious complications (p=0,0015). The length of hospital stay was, in average, 14,24 days less in patients without complications as compared with non infectious postoperative complications (p<0,05). Nutritional risk index and serum albumin are the parameters with the best capacity to predict the occurrence of non infectious postoperative complications and the length of hospital stay was higher to this patients.

  2. The Geriatric Nutritional Risk Index Predicts Survival in Elderly Esophageal Squamous Cell Carcinoma Patients with Radiotherapy

    PubMed Central

    Wang, Kunlun; Liu, Yang; You, Jie; Cui, Han; Zhu, Yiwei; Yuan, Ling

    2016-01-01

    The impact of nutritional status on survival among elderly esophageal squamous cell carcinoma (ESCC) patients undergoing radiotherapy is unclear. In this study, we aimed at validating the performance of the geriatric nutritional risk index (GNRI) in predicting overall survival time in elderly ESCC patients with radiotherapy. A retrospective cohort study was conducted on 239 ESCC patients aged 60 and over admitted consecutively from January 2008 to November 2014 in the Department of Radiotherapy, Henan Tumor Hospital (Affiliated Tumor Hospital of Zhengzhou University), Zhengzhou, Henan, China. All patients were subjected to nutritional screening using GNRI, and were followed for the occurrence of lymphatic node metastasis, radiation complication and mortality. The Kaplan–Meier method with Log-rank test was used to estimate survival curves. Univariable Cox regression analysis was used to identify variables associated with overall survival time. Among the 239 patients, 184 patients (76.9%) took no nutritional risk, 32 patients (13.4%) took moderate risk of malnutrition, and 23 patients (9.7%) took a high risk of malnutrition. Univariable Cox regression showed that both high nutritional risk group and moderate nutritional risk group were significantly less likely to survive than no nutritional risk patients (hazard ratio (HR) = 1.688, 95% confidence interval (CI) = 1.019–2.798 for moderate risk group, and HR = 2.699, 95% CI = 1.512–4.819 for high risk group, respectively). The GNRI is an independent prognostic factor for overall survival time in elderly ESCC patients with radiotherapy. A GNRI ≤98 can be suggested as an indicator of surviving less. PMID:27196126

  3. Prognostic Value of the Nutritional Risk Index in Heart Transplant Recipients.

    PubMed

    Barge-Caballero, Eduardo; García-López, Fernando; Marzoa-Rivas, Raquel; Barge-Caballero, Gonzalo; Couto-Mallón, David; Paniagua-Martín, María J; Solla-Buceta, Miguel; Velasco-Sierra, Carlos; Pita-Gutiérrez, Francisco; Herrera-Noreña, José M; Cuenca-Castillo, José J; Vázquez-Rodríguez, José Manuel; Crespo-Leiro, María G

    2017-08-01

    To study the prognostic impact of preoperative nutritional status, as assessed through the nutritional risk index (NRI), on postoperative outcomes after heart transplantation (HT). We conducted a retrospective, single-center study of 574 patients who underwent HT from 1991 to 2014. Preoperative NRI was calculated as 1.519 × serum albumin (g/L) + 41.7 × (body weight [kg] / ideal body weight [kg]). The association between preoperative NRI and postoperative outcomes was analyzed by means of multivariable logistic regression and multivariable Cox regression. Mean NRI before HT was 100.9 ± 9.9. According to this parameter, the prevalence of severe nutritional risk (NRI < 83.5), moderate nutritional risk (83.5 ≤ NRI < 97.5), and mild nutritional risk (97.5 ≤ NRI < 100) was 5%, 22%, and 10%, respectively. One year post-transplant mortality rates in these 4 categories were 18.2%, 25.3%, 7.9% and 10.2% (P < .001), respectively. The NRI was independently associated with a lower risk of postoperative infection (adjusted OR, 0.97; 95%CI, 0.95-1.00; P = .027) and prolonged postoperative ventilator support (adjusted OR, 0.96; 95%CI, 0.94-0.98; P = .001). Patients at moderate or severe nutritional risk had significantly higher 1-year post-HT mortality (adjusted HR, 1.55; 95%CI, 1.22-1.97; P < .001). Malnourished patients have a higher risk of postoperative complications and mortality after HT. Preoperative NRI determination may help to identify HT candidates who might benefit from nutritional intervention. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  4. Onodera's Prognostic Nutritional Index as a Risk Factor for Mortality in Peritoneal Dialysis Patients

    PubMed Central

    Kang, Seok Hui; Cho, Kyu Hyang; Park, Jong Won; Yoon, Kyung Woo

    2012-01-01

    The aim of this study was to evaluate the clinical relevance and usefulness of the Onodera's prognostic nutritional index (OPNI) as a prognostic and nutritional indicator in peritoneal dialysis (PD) patients. Patients were divided into 3 groups based on the initial OPNI score: group A (n = 186, < 40), group B (n = 150, 40-45), and group C (n = 186, > 45). Group A was associated with a higher grade according to the Davies risk index than the other groups. Serum creatinine and albumin levels, total lymphocyte count, and fat mass increased with an increase in OPNI. According to the edema index, the correlation coefficient for OPNI was -0.284 and for serum albumin was -0.322. Similarly, according to the C-reactive protein (CRP), the correlation coefficient for OPNI was -0.117 and for serum albumin was -0.169. Multivariate analysis adjusted for age, Davies risk index, CRP, and edema index revealed that the hazard ratios for low OPNI, serum albumin, and CRP were 1.672 (P = 0.003), 1.308 (P = 0.130), and 1.349 (P = 0.083), respectively. Our results demonstrate that the OPNI is a simple method that can be used for predicting the nutritional status and clinical outcome in PD patients. PMID:23166417

  5. Geriatric Nutritional Risk Index (GNRI) Independently Predicts Amputation Inchronic Criticallimb Ischemia (CLI).

    PubMed

    Luo, Han; Yang, Hongliu; Huang, Bin; Yuan, Ding; Zhu, Jingqiang; Zhao, Jichun

    2016-01-01

    General malnutrition usually occurs in critical limb ischemia (CLI) patients because of shortness of appetite and sleeplessness leaded by chronic pain. And amputation frequently is end-point of CLI patients. So the aim of this study was to assess the predictive ability of Geriatric nutritional risk index (GNRI) for predicting amputation in patients with CLI. A retrospective study was designed. Demographics, history, comorbidity, and risk factors for peripheral vascular disease of admitted patients, and laboratory study were documented. Patients' height, weight and BMI were recorded. Amputation was identified as end-point during follow-up. Patients' amputation-free survival (AFS) was recorded. 172 patients were identified, with mean age 71.98±3.12. Geriatric nutritional risk index (GNRI) = 90 was taken as cutoff value of high risk of amputation for CLI patients via using receiver operating characteristic (ROC) curve. Span of follow-up was 12-48 months. During follow-up, 60 patients (36.04%) received amputation surgery. And analyzed by Cox proportional hazards model, it is found that GNRI was the independent predictive factor for amputation in long term. This study revealed that GNRI was a reliable and effective predictive marker for AFS. GNRI could identify patients with high risk for amputation in early time.

  6. Geriatric nutritional risk index correlates with length of hospital stay and inflammatory markers in older inpatients.

    PubMed

    Gärtner, Simone; Kraft, Matthias; Krüger, Janine; Vogt, Lena J; Fiene, Michael; Mayerle, Julia; Aghdassi, Ali A; Steveling, Antje; Völzke, Henry; Baumeister, Sebastian E; Lerch, Markus M; Simon, Peter

    2017-08-01

    Malnutrition is a prevalent condition in older inpatients and has been shown to increase morbidity and direct medical costs. A number of established tools to assess malnutrition are available but malnourished patients rarely receive adequate nutritional assessment and treatment. The medical and economic consequences of malnutrition in hospitalized patients are therefore often underestimated. This study investigates whether the Geriatric Nutritional Risk Index (GNRI) predicts hospital mortality, correlates with length of hospital stay (LOS) and inflammatory markers in older inpatients. We conducted a prospective monocentric study in 500 hospital patients over 65 years of age (female: 248; male: 252; age: 76.3 ± 0.31 years). GNRI was correlated to C-reactive protein (CRP), lymphocyte count, LOS and all-cause mortality, adjusted for potential confounders. The median body mass index was 24.1 (25th percentile: 21.1; 75th percentile: 27.8) kg/m(2) and the mean GNRI 82.2 ± 0.56. A higher risk GNRI was associated with increased CRP levels (p < 0.05) and low lymphocyte counts (p < 0.05) after multivariable adjustment. Moreover, we found positive correlation between a higher risk GNRI and length of hospital stay, whereas, the association with in-hospital mortality was not significant. The GNRI correlates well with indicators of inflammation and the length of hospital stay. The routine implementation of the GNRI for the nutritional assessment of older patients could have a significant medical and socio-economic impact. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  7. Nutritional Risk Index predicts mortality in hospitalized advanced heart failure patients.

    PubMed

    Adejumo, Oluwayemisi L; Koelling, Todd M; Hummel, Scott L

    2015-11-01

    Hospitalized advanced heart failure (HF) patients are at high risk for malnutrition and death. The Nutritional Risk Index (NRI) is a simple, well-validated tool for identifying patients at risk for nutrition-related complications. We hypothesized that, in advanced HF patients from the ESCAPE (Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness) trial, the NRI would improve risk discrimination for 6-month all-cause mortality. We analyzed the 160 ESCAPE index admission survivors with complete follow-up and NRI data, calculated as follows: NRI = (1.519 × discharge serum albumin [in g/dl]) + (41.7 × discharge weight [in kg] / ideal body weight [in kg]); as in previous studies, if discharge weight is greater than ideal body weight (IBW), this ratio was set to 1. The previously developed ESCAPE mortality model includes: age; 6-minute walk distance; cardiopulmonary resuscitation/mechanical ventilation; discharge β-blocker prescription and diuretic dose; and discharge serum sodium, blood urea nitrogen and brain natriuretic peptide levels. We used Cox proportional hazards modeling for the outcome of 6-month all-cause mortality. Thirty of 160 patients died within 6 months of hospital discharge. The median NRI was 96 (IQR 91 to 102), reflecting mild-to-moderate nutritional risk. The NRI independently predicted 6-month mortality, with adjusted HR 0.60 (95% CI 0.39 to 0.93, p = 0.02) per 10 units, and increased Harrell's c-index from 0.74 to 0.76 when added to the ESCAPE model. Body mass index and NRI at hospital admission did not predict 6-month mortality. The discharge NRI was most helpful in patients with high (≥ 20%) predicted mortality by the ESCAPE model, where observed 6-month mortality was 38% in patients with NRI < 100 and 14% in those with NRI > 100 (p = 0.04). The NRI is a simple tool that can improve mortality risk stratification at hospital discharge in hospitalized patients with advanced HF. Published by Elsevier

  8. Nutrition-related risk indexes and long-term mortality in noncritically ill inpatients who receive total parenteral nutrition (prospective multicenter study).

    PubMed

    Tapia, María José; Ocón, Julia; Cabrejas-Gómez, Carmen; Ballesteros-Pomar, María D; Vidal-Casariego, Alfonso; Arraiza-Irigoyen, Carmen; Olivares, Josefina; Conde-García, Ma Carmen; García-Manzanares, Álvaro; Botella-Romero, Francisco; Quílez-Toboso, Rosa P; Cabrerizo, Lucio; Rubio, Miguel A; Chicharro, Luisa; Burgos, Rosa; Pujante, Pedro; Ferrer, Mercedes; Zugasti, Ana; Petrina, Estrella; Manjón, Laura; Diéguez, Marta; Carrera, Ma José; Vila-Bundo, Anna; Urgelés, Juan Ramón; Aragón-Valera, Carmen; Sánchez-Vilar, Olga; Bretón, Irene; García-Peris, Pilar; Muñoz-Garach, Araceli; Márquez, Efren; del Olmo, Dolores; Pereira, José Luis; Tous, María C; Olveira, Gabriel

    2015-10-01

    Malnutrition in hospitalized patients is associated with an increased risk of death, in both the short and the long term. The purpose of this study was to determine which nutrition-related risk index predicts long-term mortality better (three years) in patients who receive total parenteral nutrition (TPN). This prospective, multicenter study involved noncritically ill patients who were prescribed TPN during hospitalization. Data were collected on Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Geriatric Nutritional Risk Index (GNRI), body mass index, albumin and prealbumin, as well as long-term mortality. Over the 1- and 3-year follow-up periods, 174 and 244 study subjects (28.8% and 40.3%) respectively, died. Based on the Cox proportional hazards survival model, the nutrition-related risk indexes most strongly associated with mortality were SGA and albumin (<2.5 g/dL) (after adjustment for age, gender, C-reactive protein levels, prior comorbidity, mean capillary blood glucose during TPN infusion, diabetes status prior to TPN, diagnosis, and infectious complications during hospitalization). The SGA and very low albumin levels are simple tools that predict the risk of long-term mortality better than other tools in noncritically ill patients who receive TPN during hospitalization. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  9. The Geriatric Nutritional Risk Index Independently Predicts Mortality in Diabetic Foot Ulcers Patients Undergoing Amputations

    PubMed Central

    Xie, Yuanyuan; Zhang, Hailing; Ye, Tingting; Ge, Shengjie; Zhuo, Ruyi

    2017-01-01

    Objective. Patients with diabetic foot ulcers undergoing amputations have poor prognosis. Malnutrition usually occurs in this population and is associated with increased risk of mortality. The geriatric nutritional risk index (GNRI) is a widely used, simple, and well-established tool to assess nutritional risk. The purpose of this study was to assess the association between GNRI and all-cause mortality in diabetic foot ulcers patients undergoing minor or major amputations. Methods. This was a retrospective cohort study including 271 adult patients. Patients were divided into two groups according to a GNRI cutoff value of 92, and characteristics and mortality were compared between the two groups. Cox proportional hazard analysis was performed to explore the association between GNRI and mortality. Result. GNRI (p < 0.001), age (p < 0.001), and eGFR (p = 0.002) were independent predictors of mortality. Among a subgroup of 230 patients with minor amputation, increased age (p < 0.001), coronary artery disease (p = 0.030), and increased GNRI (p < 0.001) were major risk factors. Conclusion. GNRI on admission might be a novel clinical predictor for the incidence of death in patients with diabetic foot ulcers who were undergoing amputations. PMID:28164133

  10. The subjective global assessment predicts in-hospital mortality better than other nutrition-related risk indexes in noncritically ill inpatients who receive total parenteral nutrition in Spain (prospective multicenter study).

    PubMed

    2013-09-01

    Malnutrition in hospitalized patients is associated with an increased risk of death and complications. The purpose of this study was to determine which nutrition-related risk index predicts mortality better in patients receiving total parenteral nutrition. This prospective, multicenter study involved noncritically ill patients who were prescribed total parenteral nutrition. Data were collected on Subjective Global Assessment (SGA), Nutritional Risk Index, Geriatric Nutritional Risk Index, body mass index, albumin and prealbumin, as well as in-hospital mortality, length of stay, and infectious complications. Of the 605 patients included in the study, 18.8% developed infectious complications and 9.6% died in the hospital. SGA, albumin, Nutritional Risk Index and Geriatric Nutritional Risk Index were associated with longer hospital stay. Prealbumin levels were associated with infectious complications. Multiple logistic regression analysis showed (after adjustment for age, sex, C-reactive protein levels, mean blood glucose levels, use of corticoids, prior comorbidity, carbohydrates infused, diagnosis, and infectious complications) that the SGA, Geriatric Nutritional Risk Index, body mass index, albumin, and prealbumin were associated with an increased risk for in-hospital mortality. SGA was the tool that best predicted mortality and adequately discriminated the values of the other nutrition-related risk indexes studied. The SGA is a clinically effective and simple tool for nutrition assessment in noncritically ill patients receiving total parenteral nutrition and detects the risk of inpatient mortality better than others. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  11. Predicting outcome in patients with left ventricular systolic chronic heart failure using a nutritional risk index.

    PubMed

    Al-Najjar, Yahya; Clark, Andrew L

    2012-05-01

    Mortality in patients with chronic heart failure (CHF) is high and associated with body mass. However, the best method of assessing nutritional status in patients with CHF is not clear. We sought to demonstrate the prognostic use of a nutritional risk index (NRI) in ambulatory patients with CHF. Consecutive patients attending their first quarterly review appointment in the HF clinic were recruited. All patients had systolic left ventricular (LV) dysfunction. An NRI was calculated as: (1.5 × serum albumin [grams per liter]) + (current body weight/ideal weight). Patients were followed up every 4 months. Of the 538 patients enrolled in the study 75% were men. The patients' age was 71 ± 10 years (mean ± SD) and total median follow-up in survivors was 68 months (interquartile range 54 to 74). New York Heart Association classes II and III accounted for 60% and 27%, respectively, with 80% having moderate LV impairment or worse. Based on the NRI 23% of patients were at risk of malnutrition. Severely malnourished patients were older. There was no relation between NRI and LV function. The NRI was a univariable predictor of mortality (chi-square 25, p <0.001) and was an independent predictor of outcome in multivariable analysis (chi-square 12, p <0.001). In conclusion, the NRI is useful as a prognostic marker in patients with CHF in an outpatient setting. NRI might be of use as a surrogate marker for nutritional status in trials of dietary supplementation in CHF. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. [Nutritional risk in surgery evaluated by body mass index adjusted or not to elderly patients].

    PubMed

    Bicudo-Salomão, Alberto; Aguilar-Nascimento, José Eduardo de; Caporossi, Cervantes

    2006-01-01

    Standard body mass index cut-off points for malnutrition are routinely used for adults independently of their age. The hypothesis of this study was that a cut-off point higher than the usual for the diagnosis of malnutrition might be more precise to access the nutritional risk of aged surgical patients. To evaluate the morbimortality in aged surgical patients and its association with nutritional status assessed by body mass index using either the standard and a higher cut-off point for malnutrition. All patients admitted for operative procedures (n = 1,912) were allocated to either two groups: <65 years (n = 1,627) or >65 years old (n = 285). The body mass index was used to access the nutritional status. Two different cut-off points for malnutrition (18.5 or 24 kg/m(2)) were used in the group of older patients. Endpoints of the study were length of stay, morbidity and mortality. Length of stay was higher in patients over 65 years (6 [1-75] days vs. 4 [1-137] days). Both postoperative complications (37/285; 13.0% vs. 109/1627; 6.7%; OR 2.1; IC95% 1.40-3.09) and deaths (15/285; 5.3% vs. 34/1627; 2.1%; OR 2.6; IC95% 1.40-4.84) were most common in the older group. Using a higher cut-off (24 kg/m(2)), the length of stay (8 [1-75] days vs. 4 [1-43] days), postoperative complications (28/152; 18.4% versus 9/133; 6.8%; OR 3,1; IC95% 1.41-6.86) and re-operations (16/152; 10.5% versus 3/133; 2.2%; OR 5.1; IC95% 1.45-17.91) were greater in malnourished patients. However these correlations were not statistically significant with the cut-off point for malnutrition in 18.5 kg/m(2). Morbimortality is higher in surgical patients over 65 years old. In these, the cut-off point set in 24 kg/m(2) was most associated with the occurrence of postoperative complications, re-operations and length of stay.

  13. Relationship of nutritional risk, Body Mass Index (BMI), and cognitive functioning in preschoolers

    USDA-ARS?s Scientific Manuscript database

    Objective: To determine the relationships, if any, between nutritional risk, BMI z-score, and cognitive function in preschoolers. Background: Excessive adipose tissue found in obesity places children at increased health risk. Considerable research has documented that obesity leads to increased ri...

  14. Adherence to the Overall Nutritional Quality Index and Risk of Total Chronic Disease

    PubMed Central

    Chiuve, Stephanie E.; Sampson, Laura; Willett, Walter C.

    2011-01-01

    Background: The Overall Nutritional Quality Index (ONQI) algorithm is a nutrient profiling scheme that incorporates over 30 dietary components, and aims to rank foods by relative healthfulness. Purpose: To assess whether diets with a higher ONQI score predict lower risk of major chronic disease risk. Methods: A total of 62,284 healthy women from the Nurses’ Health Study and 42,382 healthy men from Health Professionals Follow-Up Study were followed from 1986 to 2006. Dietary data were collected from questionnaires at baseline. Each food was scored by the ONQI algorithm and the average ONQI score for the diet consumed by each participant was computed. Total chronic disease was defined as cardiovascular disease (CVD), cancer, diabetes and nontrauma death. Data analysis was conducted in 2010. Results: A total of 20,004 and 13,520 chronic disease events were documented in women and men, respectively. The ONQI score was inversely associated with risk of total chronic disease, CVD, diabetes and all-cause mortality (p-trend≤0.01), but not cancer, in both cohorts. Women in the highest compared to lowest quintile of the ONQI score had a relative risk (95% CI) of 0.91 (0.87, 0.95) for chronic disease, 0.79 (0.71, 0.88) for CVD, 0.86 (0.78, 0.96) for diabetes and 0.90 (0.84, 0.97) for all-cause mortality. Men in the highest compared to lowest quintile of the ONQI score had a relative risk of 0.88 (0.83, 0.93) for chronic disease, 0.77 (0.70, 0.85) for CVD, 0.84 (0.73, 0.96) for diabetes and 0.89 (0.83, 0.97) for all-cause mortality. Conclusions: The ONQI scoring system was associated with modestly lower risk of chronic disease and all-cause mortality. PMID:21496749

  15. Physical Activity, Sedentary Behaviors, and Nutritional Risk Profiles and Relations to Body Mass Index, Obesity, and Overweight in Eighth Grade.

    PubMed

    Berlin, Kristoffer S; Kamody, Rebecca C; Thurston, Idia B; Banks, Gabrielle G; Rybak, Tiffany M; Ferry, Robert J

    2017-01-01

    The objective of this article was to determine (1) the existence of individually varying patterns of physical activity, sedentary behavior, and nutrition intake risk; and (2) how these risk-patterns relate to youth's demographics, Body mass index (BMI) and psychosocial functioning. Participants (N = 9,304) from the 2007 8th Grade Early Childhood Longitudinal Study Cohort completed the revised Self-Description Questionnaire II. Age, sex, height, and weight were used to calculate body mass index (BMI) z scores and percentiles. Three risk profiles emerged via Latent Profile Analyses: "Active + Healthy Diet" (AHD; 16.3% Obese); "Sedentary + Unbalanced Diet" (SUD; 21.3% Obese); and "Screen-Time + Recreational Food" (STRF; 25.0% Obese). Significant differences in BMIs, psychosocial factors, and demographic characteristics were found across the profiles. Differential patterns of physical activity, sedentary behavior, and nutritional choices were found to predict BMI and psychosocial functioning. These findings may be helpful to refine and develop modular-based prevention and weight control intervention programs.

  16. Prognostic Impact of the Geriatric Nutritional Risk Index on Long-Term Outcomes in Patients Who Underwent Percutaneous Coronary Intervention.

    PubMed

    Wada, Hideki; Dohi, Tomotaka; Miyauchi, Katsumi; Doi, Shinichiro; Naito, Ryo; Konishi, Hirokazu; Tsuboi, Shuta; Ogita, Manabu; Kasai, Takatoshi; Hassan, Ahmed; Okazaki, Shinya; Isoda, Kikuo; Suwa, Satoru; Daida, Hiroyuki

    2017-03-16

    Malnutrition has been identified as an important predictor of poor clinical outcomes in patients with heart failure. The aim of this study is to examine the prognostic impact of nutritional status in patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). The impact of nutrition, assessed using the geriatric nutritional risk index (GNRI) calculated by serum albumin and body mass index, was evaluated in 2,853 patients with CAD who underwent their first PCI between 2000 and 2011. Patients were assigned to tertiles based on their GNRI levels. The incidences of all-cause death and cardiac death were assessed. The median GNRI values were 101 (interquartile range 95 to 106). Lower GNRI levels were associated with older age and higher prevalence of acute coronary syndrome and chronic kidney disease. During the median follow-up period of 7.4 years, Kaplan-Meier curves showed ongoing divergence in rates of mortality among tertiles (GNRI <98: 35.1%; 98 to 104: 20.6%; ≥104: 12.1%; log-rank p <0.0001). Stratification analysis by age also showed that the lowest GNRI tertile was associated with mortality in both patients <65 years and those ≥65 years. After adjusting for established cardiovascular risk factors, lower GNRI was an independent predictor of all-cause death (hazard ratio 1.55 per 10 decrease, 95% confidence interval 1.30 to 1.84, p <0.0001) and cardiac death (hazard ratio 1.44, 95% confidence interval 1.08 to 1.90, p = 0.01). In conclusion, nutritional status was associated with long-term clinical outcomes in CAD patients after PCI. Evaluation of GNRI carries important prognostic information and may guide the therapeutic approach to such patients.

  17. Validation of nutritional risk index method against patient-generated subjective global assessment in screening malnutrition in colorectal cancer patients

    PubMed Central

    Faramarzi, Elnaz; Mohammad-Zadeh, Mohammad; Nasirimotlagh, Behnam

    2013-01-01

    Objective To validate malnutrition screening tool of nutrition risk index (NRI) against patient-generated subjective global assessment (PG-SGA) as a gold standard tool in colorectal cancer patients before radiotherapy. Methods Nutritional status of 52 volunteer colorectal cancer patients with a mean age of 54.1±16.8 years who referred to radiotherapy center were assessed by PG-SGA (gold standard method) and NRI. Serum albumin levels of patients were determined by colorimetric method. A contingency table was used to determine the sensitivity, specificity, and predictive value of the NRI in screening patients at risk of malnutrition, in comparison with the PG-SGA in patients before radiotherapy. Results The findings of PG-SGA and NRI showed that 52% and 45% of patients in our study were moderately or severely malnourished respectively. The NRI had a sensitivity of 66% and a specificity of 60% against PG-SGA. The positive predictive value was 64% and the negative predicative value was 62%. The agreement between NRI and PG-SGA was statistically insignificant (kappa =0.267; P>0.05). Conclusions The findings of present study showed that the prevalence of malnutrition was high in patients with colorectal cancer. Moreover, NRI method had low sensitivity and specificity in assessing nutritional status of patients with cancer. It seems that the combination of anthropometric, laboratory parameters and a subjective scoring system may be helpful tools in screening of malnutrition in cancer patients. PMID:24255578

  18. The ability of the Geriatric Nutritional Risk Index to assess the nutritional status and predict the outcome of home-care resident elderly: a comparison with the Mini Nutritional Assessment.

    PubMed

    Cereda, Emanuele; Pusani, Chiara; Limonta, Daniela; Vanotti, Alfredo

    2009-08-01

    The Mini Nutritional Assessment (MNA) is recommended for grading nutritional status in the elderly. A new index for predicting the risk of nutrition-related complications, the Geriatric Nutritional Risk Index (GNRI), was recently proposed but little is known about its possible use in the assessment of nutritional status. Thus, we aimed to investigate its ability to assess the nutritional status and predict the outcome when compared with the MNA. Anthropometry and biochemical parameters were determined in 241 institutionalised elderly (ninety-four males and 147 females; aged 80.1 (SD 8.3) years). Nutritional risk and nutritional state were graded by the GNRI and MNA, respectively. At 6 months outcomes were: death; infections; bedsores. According to the GNRI and MNA, the prevalence of high risk (GNRI < 92)/malnutrition (MNA < 17), moderate risk (GNRI 92-98)/malnutrition at-risk (MNA 17-23.5) and no risk (GNRI > 98)/good status (MNA > 24) were 20.7/12.8%, 36.1/39% and 43.2/48.2%, respectively, with poor agreement in scoring the patient (Cohen's kappa test: kappa = 0.29; 95% CI 0.19, 0.39). GNRI categories showed a stronger association (OR) with overall outcomes than MNA classes, although no difference (P>0.05) was found between malnutrition (v. 'good status', OR 6.4; 95% CI 2.1, 71.9) and high nutritional risk (v. 'no risk', OR 9.7; 95% CI 3.0, 130). Multivariate logistic regression revealed the GNRI as an independent predictor of complications. In overall-outcome prediction, a good sensitivity was found only for GNRI < 98 (0.86 (95% CI 0.67, 0.96)). The combination of a GNRI > 98 with an MNA > 24 seemed to exclude adverse outcomes. The GNRI showed poor agreement with the MNA in nutritional assessment, but appeared to better predict outcome. In home-care resident elderly, outcome prediction should be performed by combining the suggestions from both these tools.

  19. The energy intake through regular nontherapeutic meals provision in long-term care: impact on nutritional status and related Geriatric Nutritional Risk Index.

    PubMed

    Sturtzel, Baerbel; Elmadfa, Ibrahim; Ohrenberger, Gerald

    2016-01-01

    To investigate how the energy intake of institutionalized long-term-care patients through the regular nontherapeutic meals provision is associated with the nutritional status and the Geriatric Nutritional Risk Index (GNRI). A 9 month longitudinal, observational study. Long-term-care Hospital. 66 long-term-care patients with multiple medical conditions and solely oral food-intake. 47 (71 %) patients, predominantly women (n = 39/47), with a mean age of 83.04 (±9.58) years completed study time and 19 (29 %) deceased. At week 1 and week 36 of observation time energy intake was measured by means of three-days-weighing-records. Body composition was assessed with bioelectrical impedance analysis. Serum albumin, body weight and body height were taken from the medical report. Albumin content, body weight and height were used to calculate the Geriatric Nutritional Risk Index: GNRI = [1.489 × albumin (g/L)] + [41.7 × (weight/ideal body weight)]. Energy intake was significantly below 24 kcal/kg body weight per day. The GNRI of the deceased patients was significantly (p = 0.002) lower than the GNRI of the completers. During observation time energy-intake p < 0.001, body fat (p = 0.001) and phase angle (PA) of bio impedance measurement (p = 0.018) and likewise the GNRI (p = 0.021) of the completers decreased significantly. At the beginning and at the end of observation time energy intake correlated significantly with PA (p = 0.028/p < 0.001) and GNRI (p = 0.436/p = 0.004). Also GNRI and PA correlated significantly at the beginning (p = 0.001) and at the end (p < 0.001) of observation time. The energy intake through non therapeutic meals provision was too low for sustaining the nutritional status and likewise the GNRI. The malnourishment and the nutrition related clinical risk of the geriatric patients aggrevated during observation time.

  20. Comparison of Geriatric Nutritional Risk Index scores on physical performance among elderly patients with chronic obstructive pulmonary disease.

    PubMed

    Matsumura, Takuro; Mitani, Yuji; Oki, Yutaro; Fujimoto, Yukari; Ohira, Mineko; Kaneko, Hiromi; Kawashima, Tsunehiro; Nishio, Masato; Ishikawa, Akira

    2015-01-01

    The Geriatric Nutritional Risk Index (GNRI) is a new prognostic indicator for nutritional status-related complications and mortality among the elderly. Here we aimed to compare 6-min walk distance (6MWD) between high and low GNRI groups for patients with COPD. We enrolled 63 elderly men with COPD. These subjects were divided into two groups based on their GNRI scores: high GNRI group (≥92 points; n = 44) and low GNRI group (n = 19); we compared 6MWD between these groups. The subjects' characteristics between the high and the low GNRI groups were similar, except for BMI and serum albumin levels. 6MWD were significantly lower in the low GNRI group (279.5 ± 112.3 m versus 211.1 ± 125.3 m; p = 0.03). The GNRI has a more close relation with exercise tolerance and may be a useful nutritional assessment scale for elderly patients with COPD. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Pros and cons of body mass index as a nutritional and risk assessment tool in dialysis patients.

    PubMed

    Carrero, Juan Jesús; Avesani, Carla Maria

    2015-01-01

    Obesity is a problem of serious concern among chronic kidney disease (CKD) patients; it is a risk factor for progression to end-stage renal disease and its incidence and prevalence in dialysis patients exceeds those of the general population. Obesity, typically assessed with the simple metric of body mass index (BMI), is considered a mainstay for nutritional assessment in guidelines on nutrition in CKD. While regular BMI assessment in connection with the dialysis session is a simple and easy-to-use monitoring tool, such ease of access can lead to excess-of-use, as the value of this metric to health care professionals is overestimated. This review examines BMI as a clinical monitoring tool in CKD practice and offers a critical appraisal as to what a high or a low BMI may signify in this patient population. Topics discussed include the utility of BMI as a reflection of body size, body composition and body fat distribution, diagnostic versus prognostic performance, and consideration of temporal trends over single assessments.

  2. Relationship between geriatric nutritional risk index and subpopulation lymphocyte counts in patients undergoing hemodialysis and peritoneal dialysis.

    PubMed

    Kang, Gyong Hoon; Kim, Ye Na; Shin, Ho Sik

    2016-11-01

    We investigated the relationship between geriatric nutritional risk index (GNRI) and subpopulation lymphocyte counts (SLCs) in hemodialysis (HD) and peritoneal dialysis (PD) patients and evaluated whether they can be helpful in the diagnosis of malnutrition in these patients. We examined the GNRI and SLCs of 50 HD patients (mean: 55.8 ± 12.7 years; 28 men and 22 women) and 16 Continuous Ambulatory Peritoneal Dialysis (CAPD) patients (mean: 49.8 ± 14.5 years; 10 men and six women). The GNRI is calculated based on the serum albumin level, dry weight, and ideal body weight and uses the following equation: GNRI = [14.89 × albumin (g/dL)] + [41.7 × (weight/ideal body weight)]. SLCs were evaluated using flow cytometry. T-tests and χ(2) tests were performed to compare the two groups. Logistic regression analysis was performed for predicting malnutrition in dialysis patients. The average GNRI value was 100.1 ± 8.4 in HD patients and 99.2 ± 8.1 in PD patients, and no significant differences in GNRI or SLC were observed between the two groups. SLCs were higher in patients with higher GNRI (GNRI ≥ 100) although there was no statistical difference. Logistic regression for predicting malnutrition according to GNRI revealed that age, female sex, and CD19 counts predicted malnutrition in HD and PD patients. These results suggest that GNRI and SLCs (especially CD19 count) may be significant nutritional markers in these patients.

  3. Effects of nutrition and exercise health behaviors on predicted risk of cardiovascular disease among workers with different body mass index levels.

    PubMed

    Huang, Jui-Hua; Huang, Shu-Ling; Li, Ren-Hau; Wang, Ling-Hui; Chen, Yu-Ling; Tang, Feng-Cheng

    2014-04-29

    Workplace health promotion programs should be tailored according to individual needs and efficient intervention. This study aimed to determine the effects of nutrition and exercise health behaviors on predicted risk for cardiovascular disease (CVD) when body mass index (BMI) is considered. In total, 3350 Taiwanese workers were included in this cross-sectional study. A self-reported questionnaire was used to measure their nutrition and exercise behaviors. Data on anthropometric values, biochemical blood determinations, and predicted CVD risk (using the Framingham risk score) were collected. In multiple regression analyses, the nutrition behavior score was independently and negatively associated with CVD risk. Exercise was not significantly associated with the risk. However, the interactive effect of exercise and BMI on CVD risk was evident. When stratified by BMI levels, associations between exercise and CVD risk were statistically significant for ideal weight and overweight subgroups. In conclusion, nutrition behavior plays an important role in predicting the CVD risk. Exercise behavior is also a significant predictor for ideal weight and overweight workers. Notably, for underweight or obese workers, maintaining health-promoting exercise seems insufficient to prevent the CVD. In order to improve workers' cardiovascular health, more specific health-promoting strategies should be developed to suit the different BMI levels.

  4. Dietary glycemic index and glycemic load and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC).

    PubMed

    Romieu, Isabelle; Ferrari, Pietro; Rinaldi, Sabina; Slimani, Nadia; Jenab, Mazda; Olsen, Anja; Tjonneland, Anne; Overvad, Kim; Boutron-Ruault, Marie-Christine; Lajous, Martin; Kaaks, Rudolf; Teucher, Birgit; Boeing, Heiner; Trichopoulou, Antonia; Naska, Androniki; Vasilopoulo, Effie; Sacerdote, Carlotta; Tumino, Rosario; Masala, Giovanna; Sieri, Sabina; Panico, Salvatore; Bueno-de-Mesquita, H Bas; Van-der-A, Daphne; van Gils, Carla H; Peeters, Petra H M; Lund, Eiliv; Skeie, Guri; Asli, Lene Angell; Rodriguez, Laudina; Navarro, Carmen; Amiano, Pilar; Sanchez, Maria-José; Barricarte, Aurelio; Buckland, Genevieve; Sonestedt, Emily; Wirfält, Elisabet; Hallmans, Göran; Johansson, Ingegerd; Key, Timothy J; Allen, Naomi E; Khaw, Kay-Tee; Wareham, Nicholas J; Norat, Teresa; Riboli, Elio; Clavel-Chapelon, Françoise

    2012-08-01

    The glycemic potential of a diet is associated with chronically elevated insulin concentrations, which may augment breast cancer (BC) risk by stimulating insulin receptor or by affecting insulin-like growth factor I (IGF-I)-mediated mitogenesis. It is unclear whether this effect differs by BC phenotype. The objective was to investigate the relation between glycemic index (GI), glycemic load (GL), and total carbohydrate intake with BC by using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). We identified 11,576 women with invasive BC among 334,849 EPIC women aged 34-66 y (5th to 95th percentiles) at baseline over a median follow-up of 11.5 y. Dietary GI and GL were calculated from country-specific dietary questionnaires. We used multivariable Cox proportional hazards models to quantify the association between GI, GL, and carbohydrate intake and BC risk. BC tumors were classified by receptor status. Overall GI, GL, and carbohydrates were not related to BC. Among postmenopausal women, GL and carbohydate intake were significantly associated with an increased risk of estrogen receptor-negative (ER(-)) BC when extreme quintiles (Q) were compared [multivariable HR(Q5-Q1) (95% CI) = 1.36 (1.02, 1.82; P-trend = 0.010) and HR(Q5-Q1) = 1.41 (1.05, 1.89; P-trend = 0.009), respectively]. Further stratification by progesterone receptor (PR) status showed slightly stronger associations with ER(-)/PR(-) BC [HR(Q5-Q1) (95% CI) = 1.48 (1.07, 2.05; P-trend = 0.010) for GL and HR(Q5-Q1) = 1.62 (1.15, 2.30; P-trend = 0.005) for carbohydrates]. No significant association with ER-positive BC was observed. Our results indicate that a diet with a high GL and carbohydrate intake is positively associated with an increased risk of developing ER(-) and ER(-)/PR(-) BC among postmenopausal women.

  5. Association between Low Dietary Protein Intake and Geriatric Nutrition Risk Index in Patients with Chronic Kidney Disease: A Retrospective Single-Center Cohort Study

    PubMed Central

    Kiuchi, Aki; Ohashi, Yasushi; Tai, Reibin; Aoki, Toshiyuki; Mizuiri, Sonoo; Ogura, Toyoko; Aikawa, Atsushi; Sakai, Ken

    2016-01-01

    Reduced dietary protein intake in malnourished patients with chronic kidney disease (CKD) may be associated with adverse clinical outcomes, which may mask any efficacy of a low-protein diet. The study included 126 patients with CKD who attended a dedicated dietary counseling clinic in 2005–2009 and were systematically followed until January 2015. Of these patients, 20 (15.9%) had moderate or severe nutrition-related risk of geriatric nutritional risk index (GNRI) < 92; these patients were more likely to be older, have a greater proteinuria, and have lower body mass index and serum albumin concentration. Dietary protein intake was significantly lower in older patients (r = −0.33, p < 0.001) and those with lower glomerular filtration rate (r = 0.47, p < 0.001). The non-protein to nitrogen calorie ratio was independently associated with GNRI. Reduced GNRI was significantly associated with mortality (hazard ratio (HR) = 4.94; 95% confidence interval (CI) = 1.61–15.42, p = 0.012) and cardiovascular events (HR = 9.37; 95% CI = 2.49–37.34, p = 0.006), but not with adverse renal outcomes. Restricting protein intake may be harmful to patients with any nutrition-related risk, suggesting that improvement of nutritional status should be a high priority. PMID:27782097

  6. Measuring nutritional risk in hospitals

    PubMed Central

    Rasmussen, Henrik H; Holst, Mette; Kondrup, Jens

    2010-01-01

    About 20%–50% of patients in hospitals are undernourished. The number varies depending on the screening tool amended and clinical setting. A large number of these patients are undernourished when admitted to the hospital, and in most of these patients, undernutrition develops further during hospital stay. The nutrition course of the patient starts by nutritional screening and is linked to the prescription of a nutrition plan and monitoring. The purpose of nutritional screening is to predict the probability of a better or worse outcome due to nutritional factors and whether nutritional treatment is likely to influence this. Most screening tools address four basic questions: recent weight loss, recent food intake, current body mass index, and disease severity. Some screening tools, moreover, include other measurements for predicting the risk of malnutrition. The usefulness of screening methods recommended is based on the aspects of predictive validity, content validity, reliability, and practicability. Various tools are recommended depending on the setting, ie, in the community, in the hospital, and among elderly in institutions. The Nutrition Risk Screening (NRS) 2002 seems to be the best validated screening tool, in terms of predictive validity ie, the clinical outcome improves when patients identified to be at risk are treated. For adult patients in hospital, thus, the NRS 2002 is recommended. PMID:21042553

  7. Nutritional risk of European elderly.

    PubMed

    de Morais, C; Oliveira, B; Afonso, C; Lumbers, M; Raats, M; de Almeida, M D V

    2013-11-01

    The elderly constitute a population group with a high prevalence of non-communicable chronic diseases and high risk of malnutrition. The aim of this study was to identify factors associated to nutritional risk in free-living European elderly. The sample included 644 European citizens, free living in the community, aged 65 years or more. The sample was quota controlled for age groups (65-74, ≥75 years), gender (male/female) and living circumstances (living alone/with others). Logistic regression was performed to identify factors associated with nutritional risk. Several variables regarding socio-demographic characteristics, food choice, health status and the satisfaction with food-related life were included in the analysis. According to the recoded score of the 'Determine your nutritional health' (NSI checklist), 53% of the elderly were at nutritional risk. Nutritional risk was more likely to occur in elderly who considered that it was more important to choose foods 'easy to chew'; with lower average number of fruit and vegetables (F&V) intake episodes and lower score for general health. It was also found in non-married participants; those that did not identify changes in their appetite; and those that felt changes in health status. In this sample, the lowest nutritional risk was found for body mass index (BMI) around 18.5 kg/m(2). Country of residence, gender and age were not found to have a significant effect on nutritional risk. Attention should be drawn to the living circumstances, changes in appetite or health, the general heath perception, F&V intake, choice of foods easy to chew and having a low or high BMI.

  8. Validity of nutrition risk index as a malnutrition screening tool compared with subjective global assessment in end-stage renal disease patients on peritoneal dialysis

    PubMed Central

    Prasad, N.; Sinha, A.; Gupta, A.; Bhadauria, D.; Manjunath, R.; Kaul, A.; Sharma, R. K.

    2016-01-01

    We undertook this study to compare subjective global assessment (SGA) and nutrition risk index (NRI) as malnutrition screening tools in peritoneal dialysis (PD) patients. Nutrition status of the patients was categorized into low, moderate and high risk of malnutrition based on both NRI and SGA. The sensitivity, specificity and predictive values of NRI were compared with SGA, an already validated tool of nutrition status assessment in PD patients. Two hundred and eighty-three end-stage renal disease patients (age 50.02 ± 13.76 years; 204 males, 150 diabetic) were included. Based on SGA, 71/283 (25.08%) had normal nutrition, 192/283 (67.84%) mild–moderate and 20/283 (7.07%) severe malnutrition. Based on NRI, 38/283 (13.43%) patients had normal nutritional status, 193/283 (68.20%) mild-moderate and 52/283 (18.37%) severe malnutrition. Twenty-three of 283 (8.1%) were correctly classified as normal by NRI (true negative) and 197/283 (69.6%) as malnourished (true positive), 15/283 (5.3%) as false negative, 48/283 (16.96%) were misclassified as malnourished (false positive). NRI has sensitivity of 92.9% and specificity of 32.39%. Positive predictive value and Negative predictive values (NPVs) of NRI are 80.41% and 60.53%, respectively. Accuracy of the test is 78%. The receiver operating characteristic curve of NRI is 0.63. To conclude, NRI carries high sensitivity but low specificity as compared to SGA. It can be used as screening tool but not as a diagnostic tool for assessment of nutritional status in PD patients because of its low specificity and NPV. PMID:26937075

  9. Validity of nutrition risk index as a malnutrition screening tool compared with subjective global assessment in end-stage renal disease patients on peritoneal dialysis.

    PubMed

    Prasad, N; Sinha, A; Gupta, A; Bhadauria, D; Manjunath, R; Kaul, A; Sharma, R K

    2016-01-01

    We undertook this study to compare subjective global assessment (SGA) and nutrition risk index (NRI) as malnutrition screening tools in peritoneal dialysis (PD) patients. Nutrition status of the patients was categorized into low, moderate and high risk of malnutrition based on both NRI and SGA. The sensitivity, specificity and predictive values of NRI were compared with SGA, an already validated tool of nutrition status assessment in PD patients. Two hundred and eighty-three end-stage renal disease patients (age 50.02 ± 13.76 years; 204 males, 150 diabetic) were included. Based on SGA, 71/283 (25.08%) had normal nutrition, 192/283 (67.84%) mild-moderate and 20/283 (7.07%) severe malnutrition. Based on NRI, 38/283 (13.43%) patients had normal nutritional status, 193/283 (68.20%) mild-moderate and 52/283 (18.37%) severe malnutrition. Twenty-three of 283 (8.1%) were correctly classified as normal by NRI (true negative) and 197/283 (69.6%) as malnourished (true positive), 15/283 (5.3%) as false negative, 48/283 (16.96%) were misclassified as malnourished (false positive). NRI has sensitivity of 92.9% and specificity of 32.39%. Positive predictive value and Negative predictive values (NPVs) of NRI are 80.41% and 60.53%, respectively. Accuracy of the test is 78%. The receiver operating characteristic curve of NRI is 0.63. To conclude, NRI carries high sensitivity but low specificity as compared to SGA. It can be used as screening tool but not as a diagnostic tool for assessment of nutritional status in PD patients because of its low specificity and NPV.

  10. A Sociodemographic Risk Index

    ERIC Educational Resources Information Center

    Moore, Kristin Anderson; Vandivere, Sharon; Redd, Zakia

    2006-01-01

    In this paper, we conceptualize and develop an index of sociodemographic risk that we hypothesize will be an improvement over the standard poverty measure as a measure of risk for children's development. The poverty line is widely used in government statistics and in research but is also widely acknowledged to have multiple shortcomings. Using…

  11. A Sociodemographic Risk Index

    ERIC Educational Resources Information Center

    Moore, Kristin Anderson; Vandivere, Sharon; Redd, Zakia

    2006-01-01

    In this paper, we conceptualize and develop an index of sociodemographic risk that we hypothesize will be an improvement over the standard poverty measure as a measure of risk for children's development. The poverty line is widely used in government statistics and in research but is also widely acknowledged to have multiple shortcomings. Using…

  12. Metabolic risk factors are associated with stiffness index, reflection index and finger skin temperature in children--Physical Activity and Nutrition in Children (PANIC) study.

    PubMed

    Veijalainen, Aapo; Tompuri, Tuomo; Laitinen, Tomi; Lintu, Niina; Viitasalo, Anna; Laaksonen, David E; Jääskeläinen, Jarmo; Lakka, Timo A

    2013-01-01

    Childhood metabolic syndrome (MetS) has been found to predict adulthood MetS, type 2 diabetes and cardiovascular disease, emphasizing the early identification of children at increased risk of these diseases. Children with clustering of metabolic risk factors have been reported to have a mild arterial stiffness and endothelial dysfunction, but limited evidence is available from population-based samples of children. The associations of metabolic risk factors with arterial stiffness, tone and endothelial function were studied in 173 prepubertal children (90 girls) 6-8 years of age. MetS was assessed both by continuous MetScore and dichotomously. Stiffness index (SI), reflection index (RI) and finger skin temperature (FST) were measured before and after maximum exercise test, and percent change was calculated for RI (RI%Δ) and FST (FST%Δ). MetScore (r=0.26, P=0.001), fasting insulin (r=0.24, P=0.002), fasting triglycerides (r=0.20, P=0.009), systolic (SBP; r=0.24, P=0.002) and diastolic blood pressure (DBP; r=0.19, P=0.013) correlated with SI. MetScore (r=-0.17, P=0.024, r=0.21, P=0.006), waist circumference (r=-0.19, P=0.012, r=0.23, P=0.003) and SBP (r=-0.16, P=0.035, r=0.21, P=0.005) correlated with RI and FST. High-density lipoprotein cholesterol correlated with FST (r=-0.22, P=0.004) and FST%Δ (r=-0.24, P=0.002). RI decreased and FST increased with exercise (P<0.001). Waist circumference correlated inversely with RI%Δ in boys (r=-0.22, P=0.046) and directly with RI%Δ in girls (r=0.27, P=0.011). Metabolic risk factors are associated with arterial stiffness, tone and endothelial function in prepubertal children. 

  13. [Nutritional risk screening and nutrition assessment for gastrointestinal cancer patients].

    PubMed

    Du, Yan-ping; Li, Ling-ling; He, Qing; Li, Yun; Song, Hu; Lin, Yi-jia; Peng, Jun-sheng

    2012-05-01

    To investigate the nutritional status, and provide evidence for nutritional treatment option. A total of 452 patients with gastrointestinal cancer were selected, including 156 gastric cancer,117 colon cancer, and 180 rectal cancer. The nutritional risk screening 2002(NRS2002) was applied to grade the nutritional risk. A multi-frequency bioelectrical impedance analysis was used to measure the patients' body composition. Albumin (Alb), prealbumin(PA), transferring(Tf), retinol binding protein(RBP), red blood cell(RBC), hemoglobin (Hb), haematocrit(Hct) were measured after fasting. The rate of patients with NRS2002 score more than 3 was 70.5%(110/156) for gastric cancer, 53.8%(63/117) for colon cancer, and 46.7%(86/180) for rectal cancer. The score for impaired nutritional status more than 1 for gastric cancer was higher than that for colorectal cancer(P<0.05), while patients with disease score more than 2 was less for gastric cancer(P<0.05). Body mass index(BMI), obesity degree, fat content, fat percentage, and arm circumference were lower in gastric cancer patients as compared to colorectal cancer patients(P<0.05); but protein percentage, muscle percentage, ratio of muscles of arm, and cell mass percentage were higher in gastric cancer patients(P<0.05). The proportions of patients with low Alb, PA, Tf, BC, Hb, Hct were higher for gastric cancer and colon cancer(P<0.05). Patients with gastric cancer are prone to fat loss and therefore have a higher nutritional risk and malnutrition than those with colorectal cancer. Combination of body composition analysis and laboratory examination may achieve comprehensive evaluation of the nutritional status of patients, and provide the evidence of nutritional therapy by being combined with NRS2002 score.

  14. Nutrition support in hospitalised adults at nutritional risk.

    PubMed

    Feinberg, Joshua; Nielsen, Emil Eik; Korang, Steven Kwasi; Halberg Engell, Kirstine; Nielsen, Marie Skøtt; Zhang, Kang; Didriksen, Maria; Lund, Lisbeth; Lindahl, Niklas; Hallum, Sara; Liang, Ning; Xiong, Wenjing; Yang, Xuemei; Brunsgaard, Pernille; Garioud, Alexandre; Safi, Sanam; Lindschou, Jane; Kondrup, Jens; Gluud, Christian; Jakobsen, Janus C

    2017-05-19

    The prevalence of disease-related malnutrition in Western European hospitals is estimated to be about 30%. There is no consensus whether poor nutritional status causes poorer clinical outcome or if it is merely associated with it. The intention with all forms of nutrition support is to increase uptake of essential nutrients and improve clinical outcome. Previous reviews have shown conflicting results with regard to the effects of nutrition support. To assess the benefits and harms of nutrition support versus no intervention, treatment as usual, or placebo in hospitalised adults at nutritional risk. We searched Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE (Ovid SP), Embase (Ovid SP), LILACS (BIREME), and Science Citation Index Expanded (Web of Science). We also searched the World Health Organization International Clinical Trials Registry Platform (www.who.int/ictrp); ClinicalTrials.gov; Turning Research Into Practice (TRIP); Google Scholar; and BIOSIS, as well as relevant bibliographies of review articles and personal files. All searches are current to February 2016. We include randomised clinical trials, irrespective of publication type, publication date, and language, comparing nutrition support versus control in hospitalised adults at nutritional risk. We exclude trials assessing non-standard nutrition support. We used standard methodological procedures expected by Cochrane and the Cochrane Hepato-Biliary Group. We used trial domains to assess the risks of systematic error (bias). We conducted Trial Sequential Analyses to control for the risks of random errors. We considered a P value of 0.025 or less as statistically significant. We used GRADE methodology. Our primary outcomes were all-cause mortality, serious adverse events, and health-related quality of life. We included 244 randomised clinical trials with 28,619 participants that met our inclusion criteria. We considered all trials to be at high risk of bias. Two

  15. Coffee, nutritional status, and renal artery resistive index.

    PubMed

    Trovato, Guglielmo M; Pirri, Clara; Martines, Giuseppe Fabio; Trovato, Francesca; Catalano, Daniela

    2010-01-01

    The relationship between nutrition and atherosclerosis is known, even dissociated from protein malnutrition. Cardiovascular impact of several nutrients is known; among them the action of coffee is still debated and cardiovascular effect of caffeine has been investigated without definite results. The aim of this study is to investigate whether coffee habits, and/or quantity of coffee consumption, have any relationship with renal resistive index (RRI), a hallmark of arterial stiffness (AS). The relationship of AS with nutritional status assessed by body composition and serum albumin, insulin resistance (assessed by HOMA), and renal function assessed by glomerular filtration rate (GFR) is concurrently investigated. This study was done with 221 consecutive patients, without diabetes, cancer, liver, renal, and heart disease, referred for clinical noninvasive assessment and nutritional counseling: 124 essential hypertensive and 97 nonhypertensive patients were eligible. Personalized Mediterranean diet, physical activity increase, and smoking withdrawal counseling were provided. By multiple linear regression, fat-free mass (FFM), HOMA (positive relationship), and number of cups of coffee/day (negative relationship) account for 17.2% of the variance to RRI. By odds ratios lower risk to increased RRI is associated with higher serum albumin, higher hemoglobin, and FFM; greater risk is associated with hypertension, insulin resistance (HOMA ≥ 3.0), and renal insufficiency (GFR ≤ 90); coffee, assessed by number of cups/day, reduces risk. Coffee use is inversely associated with RRI. Habitual coffee users have risk protection to higher RRI; lower serum albumin, insulin resistance, and renal insufficiency are associated with greater RRI.

  16. Preconception care: nutritional risks and interventions

    PubMed Central

    2014-01-01

    Introduction There is increasingly a double burden of under-nutrition and obesity in women of reproductive age. Preconception underweight or overweight, short stature and micronutrient deficiencies all contribute to excess maternal and fetal complications during pregnancy. Methods A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for adolescents, women and couples of reproductive age on maternal, newborn and child health (MNCH) outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture. Results Maternal pre-pregnancy weight is a significant factor in the preconception period with underweight contributing to a 32% higher risk of preterm birth, and obesity more than doubling the risk for preeclampsia, gestational diabetes. Overweight women are more likely to undergo a Cesarean delivery, and their newborns have higher chances of being born with a neural tube or congenital heart defect. Among nutrition-specific interventions, preconception folic acid supplementation has the strongest evidence of effect, preventing 69% of recurrent neural tube defects. Multiple micronutrient supplementation shows promise to reduce the rates of congenital anomalies and risk of preeclampsia. Although over 40% of women worldwide are anemic in the preconception period, only one study has shown a risk for low birth weight. Conclusion All women, but especially those who become pregnant in adolescence or have closely-spaced pregnancies (inter-pregnancy interval less than six months), require nutritional assessment and appropriate intervention in the preconception period with an emphasis on optimizing maternal body mass index and micronutrient reserves. Increasing coverage of nutrition-specific and nutrition

  17. Proposal of a Nutritional Quality Index (NQI) to Evaluate the Nutritional Supplementation of Sportspeople.

    PubMed

    Palacin-Arce, Alba; Monteagudo, Celia; Beas-Jimenez, Juan de Dios; Olea-Serrano, Fatima; Mariscal-Arcas, Miguel

    2015-01-01

    Numerous supplements are used by sportspeople. They are not always appropriate for the individual or the sports activity and may do more harm than good. Vitamin and mineral supplements are unnecessary if the energy intake is sufficient to maintain body weight and derives from a diet with an adequate variety of foods. The study objectives were to evaluate the main nutrients used as supplements in sports and to propose a nutritional quality index (NQI) that enables sportspeople to optimize their use of supplements and detect and remedy possible nutritional deficits. A nutritional study was performed in 485 sportspeople recruited from Centros Andaluces de Medicina del Deporte, (CAMD). All completed socio-demographic, food frequency, and lifestyle questionnaires. The nutritional quality of their diet and need for supplementation were evaluated by scoring their dietary intake with and without supplementation, yielding two NQI scores (scales of 0-21 points) for each participant. A superior mean NQI score was obtained when the supplements taken by participants were not included (16. 28 (SD of 3.52)) than when they were included (15.47 (SD: 3.08)), attributable to an excessive intake of some nutrients through supplementation. These results indicate that sportspeople with a varied and balanced diet do not need supplements, which appear to offer no performance benefits and may pose a health risk.

  18. Proposal of a Nutritional Quality Index (NQI) to Evaluate the Nutritional Supplementation of Sportspeople

    PubMed Central

    Palacin-Arce, Alba; Monteagudo, Celia; Beas-Jimenez, Juan de Dios; Olea-Serrano, Fatima; Mariscal-Arcas, Miguel

    2015-01-01

    Background Numerous supplements are used by sportspeople. They are not always appropriate for the individual or the sports activity and may do more harm than good. Vitamin and mineral supplements are unnecessary if the energy intake is sufficient to maintain body weight and derives from a diet with an adequate variety of foods. The study objectives were to evaluate the main nutrients used as supplements in sports and to propose a nutritional quality index (NQI) that enables sportspeople to optimize their use of supplements and detect and remedy possible nutritional deficits. Material and Methods A nutritional study was performed in 485 sportspeople recruited from Centros Andaluces de Medicina del Deporte, (CAMD). All completed socio-demographic, food frequency, and lifestyle questionnaires. The nutritional quality of their diet and need for supplementation were evaluated by scoring their dietary intake with and without supplementation, yielding two NQI scores (scales of 0-21 points) for each participant. Results A superior mean NQI score was obtained when the supplements taken by participants were not included (16. 28 (SD of 3.52)) than when they were included (15.47 (SD: 3.08)), attributable to an excessive intake of some nutrients through supplementation. Conclusions These results indicate that sportspeople with a varied and balanced diet do not need supplements, which appear to offer no performance benefits and may pose a health risk. PMID:25938239

  19. Evaluation of the Predictive Index for Osteoporosis as a Clinical Tool to Identify the Risk of Osteoporosis in Korean Men by Using the Korea National Health and Nutrition Examination Survey Data

    PubMed Central

    Moon, Ji Hyun; Kim, Lee Oh; Kim, Hyeon Ju

    2016-01-01

    Background We previously proposed the Predictive Index for Osteoporosis as a new index to identify men who require bone mineral density measurement. However, the previous study had limitations such as a single-center design and small sample size. Here, we evaluated the usefulness of the Predictive Index for Osteoporosis using the nationally representative data of the Korea National Health and Nutrition Examination Survey. Methods Participants underwent bone mineral density measurements via dual energy X-ray absorptiometry, and the Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians were assessed. Receiver operating characteristic analysis was used to obtain optimal cut-off points for the Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians, and the predictability of osteoporosis for the 2 indices was compared. Results Both indices were useful clinical tools for identifying osteoporosis risk in Korean men. The optimal cut-off value for the Predictive Index for Osteoporosis was 1.07 (sensitivity, 67.6%; specificity, 72.7%; area under the curve, 0.743). When using a cut-off point of 0.5 for the Osteoporosis Self-Assessment Tool for Asians, the sensitivity and specificity were 71.9% and 64.0%, respectively, and the area under the curve was 0.737. Conclusion The Predictive Index for Osteoporosis was as useful as the Osteoporosis Self-Assessment Tool for Asians as a screening index to identify candidates for dual energy X-ray absorptiometry among men aged 50–69 years. PMID:27900073

  20. Dietary screening tool identifies nutritional risk in older adults123

    PubMed Central

    Miller, Paige E; Mitchell, Diane C; Hartman, Terryl J; Lawrence, Frank R; Sempos, Christopher T; Smiciklas-Wright, Helen

    2009-01-01

    Background: No rapid methods exist for screening overall dietary intakes in older adults. Objective: The purpose of this study was to develop and evaluate a scoring system for a diet screening tool to identify nutritional risk in community-dwelling older adults. Design: This cross-sectional study in older adults (n = 204) who reside in rural areas examined nutrition status by using an in-person interview, biochemical measures, and four 24-h recalls that included the use of dietary supplements. Results: The dietary screening tool was able to characterize 3 levels of nutritional risk: at risk, possible risk, and not at risk. Individuals classified as at nutritional risk had significantly lower indicators of diet quality (Healthy Eating Index and Mean Adequacy Ratio) and intakes of protein, most micronutrients, dietary fiber, fruit, and vegetables. The at-risk group had higher intakes of fats and oils and refined grains. The at-risk group also had the lowest serum vitamin B-12, folate, β-cryptoxanthin, lutein, and zeaxanthin concentrations. The not-at-nutritional-risk group had significantly higher lycopene and β-carotene and lower homocysteine and methylmalonic acid concentrations. Conclusion: The dietary screening tool is a simple and practical tool that can help to detect nutritional risk in older adults. PMID:19458013

  1. Nutritional Risk among Oklahoma Congregate Meal Participants

    ERIC Educational Resources Information Center

    Quigley, Kimberly K.; Hermann, Janice R.; Warde, William D.

    2008-01-01

    Objective: To determine if there were differences by demographic variables in response rates to Nutrition Screening Initiative (NSI) Checklist statements reported by over 50% of Oklahoma Older Americans Act Nutrition Program (OAANP) congregate meal participants categorized at high nutritional risk based on cumulative NSI Checklist scores. Design:…

  2. Nutritional Risk among Oklahoma Congregate Meal Participants

    ERIC Educational Resources Information Center

    Quigley, Kimberly K.; Hermann, Janice R.; Warde, William D.

    2008-01-01

    Objective: To determine if there were differences by demographic variables in response rates to Nutrition Screening Initiative (NSI) Checklist statements reported by over 50% of Oklahoma Older Americans Act Nutrition Program (OAANP) congregate meal participants categorized at high nutritional risk based on cumulative NSI Checklist scores. Design:…

  3. Nutritional risk, nutritional status and incident disability in older adults. The FRADEA study.

    PubMed

    Martínez-Reig, M; Gómez-Arnedo, L; Alfonso-Silguero, S A; Juncos-Martínez, G; Romero, L; Abizanda, P

    2014-03-01

    To analyze if body mass index (BMI) and waist circumference (WC) as measures of nutritional status, and the Mini Nutritional Assessment Short Form (MNA-SF) as a nutritional risk measure are associated with increased risk of incident disability in basic activities of daily living (BADL) in a population based cohort of Spanish older adults. Concurrent cohort study. Albacete City, Spain. 678 subjects over age 70 from the FRADEA Study (Frailty and Dependence in Albacete). BMI, WC and MNA-SF were recorded at the basal visit of the FRADEA Study. Incident disability in BADL was defined as loss of the ability to perform bathing, grooming, dressing, toilet use, or feeding from basal to follow-up visit, using the Barthel index. The association between nutritional status and nutritional risk with incident BADL disability was determined by Kaplan-Meier analysis and logistic regression adjusted for age, sex, basal function, comorbidity, cognitive decline, depression risk and frailty status. Each point less of MNA-SF (OR 1.17, 95%CI 1.04-1.31) and MNA-SF<14 (OR 2.33, 95%CI 1.39-3.89), but not MNA-SF<12 (OR 1.47, 95%CI 0.89-2.42) had a greater adjusted risk of incident disability in BADL. Neither BMI (OR 1.02, 95%CI 0.97-1.06) nor WC (OR 1.01, 95%CI 0.99-1.03) were associated. Weight loss (OR 1.75, 95%CI 1.08-2.83) and mobility impairment (OR 3.35, 95%CI 1.67-6.73) remained as adjusted predictors of incident BADL disability, while anorexia almost reached the significance (OR 1.65, 95%CI 0.94-2.87). Nutritional risk measured with the MNA-SF is associated with incident disability in BADL in older adults, while nutritional status measured with BMI or WC is not.

  4. Nutritional risk and cognitive impairment in the elderly.

    PubMed

    Lee, Kang Soo; Cheong, Hae-Kwan; Kim, Eun A; Kim, Kyung Ran; Oh, Byoung Hoon; Hong, Chang Hyung

    2009-01-01

    The purpose of this study was to determine the relationship between nutritional risk and cognitive impairment in the elderly living in the community. Data obtained from 2934 subjects (912 men and 2022 women) aged above 60 years was analyzed from the Gwangju Dementia and Mild Cognitive Impairment Study (GDEMCIS). The study questionnaire comprised demographic characteristics, history of current and past illnesses, drug history, Korean version-Mini Mental State Examination (K-MMSE), and Nutritional Screening Initiative (NSI) checklist. Additionally, we examined the blood pressure, fasting serum glucose level, lipid profile, body mass index, and ApoE genotype. Of the total, 1942 (66.2%) demonstrated good nutritional state (NSI checklist score< or =2) and 992 (33.8%) were at moderate or high nutritional risk (NSI checklist score>2). Multiple logistic regression analysis revealed that moderate or high nutritional risk subjects were associated with an increased risk of cognitive impairment (K-MMSE score< or =17) after adjustment for age, sex, educational level, and Korean version of Short form Geriatric Depression Scale (K-SGDS) score (Odds ratio=OR=1.71, 95%; confidence interval=CI=1.17-2.50). These results suggest that nutritional risk may be associated with cognitive impairment in the elderly.

  5. Index of Free and Inexpensive Food and Nutrition Information Materials.

    ERIC Educational Resources Information Center

    Gordon, Kathleen, Comp.; And Others

    This annotated index contains approximately 2,000 free or inexpensive pamphlets or brochures about food and nutrition. The prime criterion for inclusion of materials was that they be easily available and inexpensive; the cut-off cost was set at $3.00. The majority of materials listed were produced in either Canada or the United States. These…

  6. Index of Free and Inexpensive Food and Nutrition Information Materials.

    ERIC Educational Resources Information Center

    Gordon, Kathleen, Comp.; And Others

    This annotated index contains approximately 2,000 free or inexpensive pamphlets or brochures about food and nutrition. The prime criterion for inclusion of materials was that they be easily available and inexpensive; the cut-off cost was set at $3.00. The majority of materials listed were produced in either Canada or the United States. These…

  7. Risk Factors for Delayed Enteral Nutrition in Critically Ill Children.

    PubMed

    Canarie, Michael F; Barry, Suzanne; Carroll, Christopher L; Hassinger, Amanda; Kandil, Sarah; Li, Simon; Pinto, Matthew; Valentine, Stacey L; Faustino, E Vincent S

    2015-10-01

    Delayed enteral nutrition, defined as enteral nutrition started 48 hours or more after admission to the PICU, is associated with an inability to achieve full enteral nutrition and worse outcomes in critically ill children. We reviewed nutritional practices in six medical-surgical PICUs and determined risk factors associated with delayed enteral nutrition in critically ill children. Retrospective cross-sectional study using medical records as source of data. Six medical-surgical PICUs in northeastern United States. Children less than 21 years old admitted to the PICU for 72 hours or more excluding those awaiting or recovering from abdominal surgery. A total of 444 children with a median age of 4.0 years were included in the study. Enteral nutrition was started at a median time of 20 hours after admission to the PICU. There was no significant difference in time to start enteral nutrition among the PICUs. Of those included, 88 children (19.8%) had delayed enteral nutrition. Risk factors associated with delayed enteral nutrition were noninvasive (odds ratio, 3.37; 95% CI, 1.69-6.72) and invasive positive-pressure ventilation (odds ratio, 2.06; 95% CI, 1.15-3.69), severity of illness (odds ratio for every 0.1 increase in pediatric index of mortality 2 score, 1.39; 95% CI, 1.14-1.71), procedures (odds ratio, 3.33; 95% CI, 1.67-6.64), and gastrointestinal disturbances (odds ratio, 2.05; 95% CI, 1.14-3.68) within 48 hours after admission to the PICU. Delayed enteral nutrition was associated with failure to reach full enteral nutrition while in the PICU (odds ratio, 4.09; 95% CI, 1.97-8.53). Nutrition consults were obtained in less than half of the cases, and none of the PICUs used tools to assure the adequacy of energy and protein nutrition. Institutions in this study initiated enteral nutrition for a high percentage of patients by 48 hours of admission. Noninvasive positive-pressure ventilation was most strongly associated with delay enteral nutrition. A better

  8. Nutritional risk and status of surgical patients; the relevance of nutrition training of medical students.

    PubMed

    Ferreira, C; Lavinhas, C; Fernandes, L; Camilo, Ma; Ravasco, P

    2012-01-01

    The prevalence of undernutrition among surgical patients is thought to be high, and negatively influencing outcomes. However, recent evidence shows the increase of overweight/obesity in hospitalised patients. A pilot cross-sectional study was conducted in 50 patients of a Surgical Department of the University Hospital of Santa Maria (CHLN) that aimed: 1) to assess nutritional risk and status through validated methods; 2) to explore the presence of overweight/obesity; 3) to evaluate the prevalence of metabolic risk associated with obesity. Nutritional risk was assessed by Malnutrition Universal Screening Tool (MUST), nutritional status by Body Mass Index (BMI), waist circumference (WC), & Subjective Global Assessment (SGA). Statistical significance was set for p < 0.05. 58% of patients were overweight/obese and 54% had high cardio-metabolic risk, according to waist circumference; 30% of patients had significantly lost weight (≥ 5%), whereas 28% gained weight. By MUST, 46% of patients were at low risk and 34% at high risk. By SGA, 58% patients were well nourished and 40% had moderate/severe undernutrition. A longer length of stay was associated with moderate/high risk by MUST, and undernutrition by SGA (p = 0.01). Undernutrition or obesity pose surgical risks. The lack of nutrition discipline in the medical curricula, limits the multiprofessional management and a better understanding of the more adequate approaches to these patients. Further, the change in the clinical scenario argues for more studies to clarify the prevalence and consequences of sarcopenic obesity in surgical patients.

  9. Parenteral nutrition: indications, risks and nursing care.

    PubMed

    Fletcher, Jane

    Parenteral nutrition is a recognised method of feeding patients with specific clinical conditions, most notably those with various forms of intestinal failure who cannot be fed enterally. However, it has several associated risks including sepsis, and metabolic and electrolyte imbalances. The aim of this article is to enhance nurses' understanding of parenteral nutrition and how this differs from oral or enteral nutrition, indications for use and the potential risks involved. Appropriate vascular access is discussed as well as the clinical monitoring that is required to ensure complications of therapy are detected quickly. A greater understanding of the issues associated with parenteral nutrition allows nurses caring for patients receiving parenteral nutrition to ensure safe and effective care.

  10. Foetal nutritional status and cardiovascular risk profile among children.

    PubMed

    Liu, Jian; Sempos, Christopher

    2007-10-01

    To estimate the impact of foetal nutritional status on cardiovascular risk among children with the Foetal Nutritional Status Index (FNSI), calculated by dividing the child's birth weight (BW, kg) by the mother's height (m2). Cross-sectional survey analysis. A sample of children from the US Third National Health and Nutrition Examination Survey. A total of 3109 children who were 5-11 years of age and had data on BW and mother's height. Non-fasting blood samples were included. Overall, the FNSI was positively associated with BW and negatively associated with mother's height (P<0.0001). Within sex-specific quintiles of FNSI (third quintile as reference) adjusted for potential confounding variables, cardiovascular risk factors tended to be 'higher' in the lower quintiles for males while the opposite was true for females. Multivariate logistic regression analyses indicated that the odds for males in quintile 1 was 2.4 for having a low level of high-density lipoprotein cholesterol (P<0.01) and 2.1 for having a cluster of cardiovascular risk factors (P=0.01); for females, the odds of having a cluster of cardiovascular risk factors was approximately two times higher for those in the first and fifth quintiles, who also had a significantly higher prevalence of central obesity. The FNSI may be a potential proxy indicator of foetal nutritional status and it may be used to test specific hypotheses of whether foetal nutrition restriction or overnutrition programmes future cardiovascular risk.

  11. Nutritional risk assessment in critically ill cancer patients: systematic review

    PubMed Central

    Fruchtenicht, Ana Valéria Gonçalves; Poziomyck, Aline Kirjner; Kabke, Geórgia Brum; Loss, Sérgio Henrique; Antoniazzi, Jorge Luiz; Steemburgo, Thais; Moreira, Luis Fernando

    2015-01-01

    Objective To systematically review the main methods for nutritional risk assessment used in critically ill cancer patients and present the methods that better assess risks and predict relevant clinical outcomes in this group of patients, as well as to discuss the pros and cons of these methods according to the current literature. Methods The study consisted of a systematic review based on analysis of manuscripts retrieved from the PubMed, LILACS and SciELO databases by searching for the key words “nutritional risk assessment”, “critically ill” and “cancer”. Results Only 6 (17.7%) of 34 initially retrieved papers met the inclusion criteria and were selected for the review. The main outcomes of these studies were that resting energy expenditure was associated with undernourishment and overfeeding. The high Patient-Generated Subjective Global Assessment score was significantly associated with low food intake, weight loss and malnutrition. In terms of biochemical markers, higher levels of creatinine, albumin and urea were significantly associated with lower mortality. The worst survival was found for patients with worse Eastern Cooperative Oncologic Group - performance status, high Glasgow Prognostic Score, low albumin, high Patient-Generated Subjective Global Assessment score and high alkaline phosphatase levels. Geriatric Nutritional Risk Index values < 87 were significantly associated with mortality. A high Prognostic Inflammatory and Nutritional Index score was associated with abnormal nutritional status in critically ill cancer patients. Among the reviewed studies that examined weight and body mass index alone, no significant clinical outcome was found. Conclusion None of the methods reviewed helped to define risk among these patients. Therefore, assessment by a combination of weight loss and serum measurements, preferably in combination with other methods using scores such as Eastern Cooperative Oncologic Group - performance status, Glasgow Prognostic

  12. Handgrip Strength Index Predicts Nutritional Status as a Complement to Body Mass Index in Crohn's Disease.

    PubMed

    Lu, Ze Lan; Wang, Tian Rong; Qiao, Yu Qi; Zheng, Qing; Sun, Ying; Lu, Jun Tao; Han, Xiao Xiao; Fan, Zhu Ping; Ran, Zhi Hua

    2016-12-01

    Body mass index [BMI] is widely used to measure nutritional status in Crohn's disease [CD] patients, but limitations remain. Measuring handgrip strength index, in addition to BMI, may aid in overcoming limitations. A total of 150 patients with CD and 254 controls were included in this study. All patients and controls underwent BMI, handgrip strength and bioelectrical impedance analysis. Bioelectrical impedance analysis included body cell mass, bone mineral content, skeletal muscle mass and body fat mass. A total of 88 CD patients were age-, sex- and BMI-matched with healthy controls for further analysis. BMI, body cell mass, body cell mass index, handgrip strength and handgrip strength index were all significantly decreased in the group of CD patients compared with controls [p < 0.0001]. When paired by BMI, healthy controls had significantly increased body cell mass index[p = 0.0344] and handgrip strength index [p = 0.0010] compared to patients. In addition, handgrip strength was well correlated with body cell mass [r = 0.8365, p < 0.0001]. BMI is widely used for detecting malnutrition, but it is less sensitive in predicting loss of body cell mass and skeletal muscle mass. Our study shows that handgrip strength index is an effective and convenient parameter to predict the functional nutritional status and muscular health in CD patients. Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  13. 2013 Nutrition Risk Evidence Review Panel. Evidence Review for: The Risk Factor of Inadequate Nutrition

    NASA Technical Reports Server (NTRS)

    2014-01-01

    The 2013 Nutrition Risk Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on November 20 - 21, 2013. The SRP reviewed the new Evidence Report for the Risk Factor of Inadequate Nutrition (from here on referred to as the 2013 Nutrition Evidence Report), as well as the Research Plan for this Risk. Overall, the SRP thinks the well-qualified research team has compiled an excellent summary of background information in the 2013 Nutrition Evidence Report. The SRP would like to commend the authors in general and particularly note that while the 2013 Nutrition Evidence Report has been written using a single nutrient approach, the research plan takes a much more integrated and physiologically based approach.

  14. Nutrition-related cardiovascular risk factors in older people: results from the Third National Health and Nutrition Examination Survey.

    PubMed

    Erlinger, T P; Pollack, H; Appel, L J

    2000-11-01

    In view of the recognized potential benefits of nutritional therapy in older persons, Congress is evaluating the coverage of nutritional services for Medicare beneficiaries. To estimate the number of older persons in the US who have one or more cardiovascular risk factors (hypertension, increased low density lipoprotein (LDL) cholesterol, and diabetes mellitus), for which nutritional therapy is recommended. Cross-sectional analysis of adults, aged > or = 65, participating in the Third National Health and Nutrition Examination Survey (NHANES III). The authors estimated the proportion of adults, aged > or = 65, with diabetes mellitus, increased LDL cholesterol, and/or hypertension. Efforts were made to assess whether obesity status, gender, race, and/or socioeconomic factors were associated with the prevalence of any or all three conditions. Approximately 86% (20 million persons) in the US, aged > or = 65, have at least one of the index conditions. Whereas a higher body mass index (BMI) increased the likelihood of having any or all three conditions, 81% of persons of average body weight (BMI <25 kg/m2) had at least one condition. After adjusting for age, gender, BMI, marital status, and poverty index, blacks were more likely than whites to have any one condition (odds ratio (OR) = 3.0, P < .01) or all three conditions (OR = 2.3, P = .05). Almost 90% of Americans aged > or = 65 have one or more nutrition-related cardiovascular risk factors. Improved nutritional interventions may be valuable especially for blacks, who have a higher prevalence of conditions requiring nutritional therapy.

  15. Impact of prognostic nutritional index on long-term outcomes in patients with breast cancer.

    PubMed

    Mohri, Tomomi; Mohri, Yasuhiko; Shigemori, Tsunehiko; Takeuchi, Kenji; Itoh, Yoshiyuki; Kato, Toshio

    2016-06-27

    Prognostic nutritional index has been shown to be a prognostic marker for various solid tumors. However, few studies have investigated the impact of the prognostic nutritional index on survival of patients with breast cancer. The aim of this study was to investigate the impact of the prognostic nutritional index on the long-term outcomes in patients with breast cancer. This study reviewed the medical records of 212 patients with breast cancer who underwent mastectomy. The prognostic nutritional index was calculated as 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count (per mm(3)). Receiver operating characteristic curve analysis was performed to determine the cutoff value of the prognostic nutritional index. The survival curves were calculated by the Kaplan-Meier method. Differences between the curves were analyzed by the log-rank test. Multivariate Cox proportional hazard model was used to evaluate the prognostic significance of prognostic nutritional index in patients with breast cancer. The mean prognostic nutritional index just before the operation was 51.9, and the median follow-up after surgery was 47.7 months. The optimal cutoff value of the prognostic nutritional index for predicting the overall survival was 52.8 from the receiver operating characteristic curve analysis. The 5-year overall survival rate was 98.3 % in the prognostic nutritional index >52.8 and 92.0 % in the prognostic nutritional index <52.8 (P = 0.013). In the multivariate analysis, a low prognostic nutritional index was an independent predictor for poor overall survival (HR, 5.88; 95 % CI, 1.13-108.01; P = 0.033). The prognostic nutritional index is a simple and useful marker for predicting the long-term outcomes of breast cancer patients, independent of the tumor stage.

  16. Prognostic impact of nutritional risk assessment in patients with chronic schizophrenia.

    PubMed

    Tsai, Ming-Tsun; Chang, Tien-Hao; Wu, Bo-Jian

    2017-04-22

    Protein-energy wasting is associated with poor outcome in various clinical settings. However, the prevalence of malnutrition and the prognostic impact of nutritional status are poorly understood in institutionalized patients with chronic schizophrenia. This study aimed to assess the predictive ability of the Geriatric Nutritional Risk Index and Onodera's Prognostic Nutritional Index for long-term outcomes in patients with chronic schizophrenia. All measurements, including nutritional scores, were performed at baseline after the enrollment of 542 (64.6% men, mean age 53.8±9.7years) patients with chronic schizophrenia. The median follow-up period was 408days. The endpoints were falls and infection-related hospitalizations. At study completion, 34 patients suffered falls and 40 patients were admitted to hospitals due to infection. Both indices showed significant association with infectious complications, whereas only the Onodera's Prognostic Nutritional Index was significantly associated with falls. The adjusted hazard ratios (95% confidence intervals) of low Onodera's Prognostic Nutritional Index were 2.38 (1.16-4.86) for falls and 1.99 (1.05-3.76) for infectious complications. The Onodera's Prognostic Nutritional Index is more appropriate than the Geriatric Nutritional Risk Index in identifying patients with chronic schizophrenia who are at risk for malnutrition and nutrition-related morbidity. Further studies are needed to explore whether early detection of patients with schizophrenia who are at risk for malnutrition could lead to the reduction of morbidity and mortality with the aid of appropriate interventions. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. [Evaluation of occupational risk factors, nutritional habits and nutritional status in industrial workers].

    PubMed

    Domagała-Dobrzycka, M

    2000-01-01

    The objective of this study was to examine the relationship between selected risk factors at the workplace and health indices in relation to nutritional habits and nutritional status in industrial workers. Exposure to physical and chemical risk factors and their impact on health in the province of Szczecin and in Poland was evaluated basing on data published in the Yearbooks of the Province of Szczecin, the Central Statistics Bureau (GUS) and Regional Inspectorate of Labor (OIP) in Szczecin. A random selection of plants in Szczecin was done and workplaces with chemical and physical risk levels exceeding the highest acceptable values were identified. Measurements of concentrations of chemicals and intensity of physical factors were performed by Work Environment Research Laboratories of the plants and by the laboratory of the Sanitary and Epidemiological Center in Szczecin. Eighty-eight men exposed to occupational risk factors were randomly selected. The mean period of exposure in that group was approximately ten years. The control group was composed of male workers (n = 83) not exposed to any of the risk factors in question (Tab. 3). Nutritional habits and nutritional status were studied during summer/autumn and winter/spring periods. Dietary survey consisted of the last 24-hour nutrient intake questionnaire. Nutritional status evaluation was based on body mass index (BMI) values and results of the following laboratory tests: blood cell count, levels of total protein, prealbumin, retinol binding protein (RBP), magnesium, inorganic phosphorus, and ascorbic acid. The following results were obtained: 1. Physical factors constituted the most frequent source of occupational risk in the province of Szczecin and in Poland in 1990-1994 (Tab. 1); 2. The incidence of occupational risk and occupational disease morbidity rates in 1990-1994 were lower for the province of Szczecin than the average for Poland; 3. The rate of fatal accidents at work in 1982-1994 was higher for the

  18. Flavonoids at the pharma-nutrition interface: Is a therapeutic index in demand?

    PubMed

    Peluso, Ilaria; Palmery, Maura

    2015-04-01

    The consumption of flavonoid-rich foods could have beneficial effects on health. However, different classes of flavonoids have different effect on disease risk and the relationship between flavonoid intake and risk of disease appeared to be non-linear. Furthermore, contrarily to vitamins, there are no symptoms of deficiency for flavonoids; therefore, our body treats them like other xenobiotics. Therefore, a therapeutic index should be determined. Despite flavonoids are at the pharma-nutrition interface, drugs and foods are subject to different regulatory frameworks and there is no recommended daily allowance (RDA) for flavonoids. Relatively little is known about the efficacy, safety and underlying mechanisms of these bioactive compounds, especially when taken in concert with drugs. Flavonoids could act both as drugs and pro-drugs with pharmacological and toxicological promiscuity. Due to the low bioavailability, the gastrointestinal tract could be the primary target of flavonoids and metabolites. Different effects have been observed after acute and chronic consumption and bioavailability and bioactivity have high inter-individual variability. Furthermore, the difficulties in the design and in the interpretation of human intervention studies make difficult the establishment of a therapeutic index for flavonoids. Probably the concept of 'personalized nutrition' previously proposed could be the better approach. However, despite more studies are needed in order to establish a therapeutic index for each flavonoid subclasses, at the moment RDA of total flavonoids could be between 250-400 mg/d, respecting the seasonality of food sources.

  19. [Application of Mini Nutritional Assessment in patients with chronic obstructive pulmonary disease and its correlation with BODE indexes].

    PubMed

    Sun, Jia; Zheng, Jingjing; Guo, Songwen; Zhu, Zhe; Chen, Xin

    2013-08-01

    To evaluate the value of Mini Nutritional Assessment (MNA) in geratic patients with chronic obstructive pulmonary disease (COPD) and analyze the correlation of MNA scores with BODE indexes. A total of 139 geratic outpatients with stable COPD admitted from April 2012 to October 2012 were enrolled. The nutritional statuses of the patients were assessed using MNA and the patients were subsequently classified into well-nourished group, risk of malnutrition group and malnutrition group. For all the patients, the anthropometric parameters, pulmonary function and 6-minute-walk distance (6MWD) were examined, and functional dyspnea was evaluated using Modified Medical Research Council Scale (MMRC). The BODE indexes were calculated and analyzed for their correlation with the MNA scores. The 3 groups showed no significant differences in gender distribution (P>0.05), but their age, anthropometric parameters and BODE indexes (BMI, MMRC, 6MWD, FEV1%pred) differed significantly (P<0.001). In all the patients, MNA scores showed a significant inverse correlation with BODE index (r=-0.602; P<0.001). MNA scores are strongly correlated with the anthropometrical parameters and BODE indexes to allow screening of the nutritional status in patients with COPD. Nutrition is an important factor affecting the disease symptoms, and nutritional improvement is one of the effective measures to relieve the symptoms of COPD.

  20. Screening of Nutritional Risk and Nutritional Support in General Surgery Patients: A Survey from Shanghai, China

    PubMed Central

    Jia, Zhen-Yi; Yang, Jun; Tong, Da-Nian; Peng, Jia-Yuan; Zhang, Zhong-Wei; Liu, Wei-Jie; Xia, Yang; Qin, Huan-long

    2015-01-01

    To determine the prevalence of nutritional risk in surgical departments and to evaluate the impact of nutritional support on clinical outcomes. The nutritional risk in different surgical diseases and the different way of nutritional support on clinical outcomes in patients at nutritional risk remain unclear. Hospitalized patients from general surgical departments were screened using the Nutritional Risk Screening (NRS) 2002 questionnaire on admission. Data were collected on nutritional risk, complications, and length of stay (LOS). Overall, 5034 patients were recruited; the overall prevalence of nutritional risk on admission were 19.2%. The highest prevalence was found among patients with gastric cancer. At-risk patients had more complications and longer LOS than nonrisk patients. Of the at-risk patients, the complication rate was significantly lower and LOS was significantly shorter in the nutritional-support group than in the no-support group (20.9 versus 30.0%, P < 0.05). Subgroup analysis showed reduced complication rates and LOS only in patients with gastric cancer, colorectal cancer, and hepato-pancreato-biliary (HPB) cancer. Significantly lower complication rates relative to nonsupported patients were found among patients who received enteral nutrition or who received support for 5 to 7 days, or daily support entailing 16 to 25 kcal/kg of nonprotein energy. Different surgical diseases have different levels of nutritional risk. The provision of nutritional support was associated with a lower complication rate and a shorter LOS for gastric, colorectal, and HPB cancer patients at nutritional risk. The improper use of nutritional support may not improve outcomes for at-risk patients. PMID:26011204

  1. Nutrition care-related practices and factors affecting nutritional intakes in hospital patients at risk of pressure ulcers.

    PubMed

    Roberts, S; Chaboyer, W; Desbrow, B

    2015-08-01

    Malnutrition is common in hospitals and is a risk factor for pressure ulcers. Nutrition care practices relating to the identification and treatment of malnutrition have not been assessed in patients at risk of pressure ulcers. The present study describes nutrition care practices and factors affecting nutritional intakes in this patient group. The study was conducted in four wards at two hospitals in Queensland, Australia. Adult patients at risk of pressure ulcers as a result of restricted mobility were observed for 24 h to determine their daily oral intake and practices such as nutrition screening, documentation and intervention. Independent samples t-tests and chi-squared tests were used to analyse dietary intake and nutrition care-related data. Predictors of receiving a dietitian referral were identified using logistic regression analyses. Two hundred and forty-one patients participated in the present study. The observed nutritional screening rate was 59% (142 patients). Weight and height were documented in 71% and 34% of cases. Sixty-nine patients (29%) received a dietitian referral. Predictors of receiving a dietitian referral included lower body mass index and longer length of stay. On average, patients consumed 73% and 72% of the energy and protein provided, respectively. Between 22% and 38% of patients consumed <50% of food provided at main meals. Nutrition care practices including malnutrition risk screening and documentation of nutritional parameters appear to be inadequate in patients at risk of pressure ulcers. A significant proportion of these patients eat inadequately at main meals, further increasing their risk of malnutrition and pressure ulcers. © 2014 The British Dietetic Association Ltd.

  2. Differences in nutrition status by body mass index in patients with peripheral artery disease.

    PubMed

    Oka, Roberta K; Alley, Hugh F

    2012-09-01

    Peripheral Arterial Disease (PAD) is most prevalent in the elderly and associated with increased cardio vascular disease (CVD) morbidity and mortality. Treatment focuses on improving functional capacity and reducing CVD risk factors. To date, little is understood about dietary habits and weight in this patient population. Nutritional and weight recommendations are based on heart health, and little is known about the unique needs of elderly PAD patients with multiple comorbidities. This prospective study compared 1) the dietary intake of nonobese PAD patients in comparison with those who were obese and; 2) dietary intake of those patients with the Estimated Average Requirement (EAR) based on age, gender and BMI. Nutritional intake was assessed with the Block 98 Food Frequency Questionnaire. Body mass index (BMI) was calculated in accordance with the National Heart, Lung, and Blood Institute (NHLBI) guidelines.The study population was divided into obese (BMI ≥ 30) and nonobese (NO) groups. Comparisons between groups were performed using the Mann-Whitney U test for continuous variables and the Chi-square test for ordinal variables. All tests were two-tailed and P < 0.05 was considered significant. The Estimated Average Requirement (EAR) cut-point method was used to compare nutritional variables with Dietary Reference Intakes (DRI). The study population included 189 NO (BMI < 30) and 111 obese (BMI > 30) individuals. Obese participants reported greater intake of foods containing cholesterol and trans-fatty acids and more frequent intake of B vitamins in comparison with the NO BMI group. Additionally, the nutrient intake of all participants by age, gender and BMI was lower than the EAR for magnesium, folate, and Vitamin E. These results suggest that the nutritional intake of PAD patients differs based on gender and BMI. Additionally, EAR was lower for specific nutrients than recommended. Further investigation is needed to examine the association between nutritional

  3. Nutrition and the Risk of Alzheimer's Disease

    PubMed Central

    Tan, Lin; Wang, Ying-Li; Sun, Lei

    2013-01-01

    Alzheimer's disease (AD) is a progressive neurodegenerative disorder that accounts for the major cause of dementia, and the increasing worldwide prevalence of AD is a major public health concern. Increasing epidemiological studies suggest that diet and nutrition might be important modifiable risk factors for AD. Dietary supplementation of antioxidants, B vitamins, polyphenols, and polyunsaturated fatty acids are beneficial to AD, and consumptions of fish, fruits, vegetables, coffee, and light-to-moderate alcohol reduce the risk of AD. However, many of the results from randomized controlled trials are contradictory to that of epidemiological studies. Dietary patterns summarizing an overall diet are gaining momentum in recent years. Adherence to a healthy diet, the Japanese diet, and the Mediterranean diet is associated with a lower risk of AD. This paper will focus on the evidence linking many nutrients, foods, and dietary patterns to AD. PMID:23865055

  4. Population-specific short-form mini nutritional assessment with body mass index or calf circumference can predict risk of malnutrition in community-living or institutionalized elderly people in taiwan.

    PubMed

    Tsai, Alan C; Chang, Tsui-Lan; Wang, Yi-Chen; Liao, Chiu-Ying

    2010-09-01

    A simple, reliable, noninvasive, and easy-to-use instrument is important for successful monitoring of emerging nutrition problems in elderly people. The objectives of this study were to determine whether adoption of population-specific body mass index (BMI) cutpoints would improve the predictive ability of the short-form Mini Nutritional Assessment (MNA) and whether calf circumference could be an acceptable alternative to BMI in the short-form MNA without compromising its predictive ability. Using convenience sampling, the study recruited 301 community-living, 109 care center-living, and 68 nursing home-living elderly people, 65 years or older, as subjects. Subjects were evaluated with the short-form MNA in three versions: (a) the original, (b) Taiwan version 1 (T1), that adopted population-specific BMI cutpoints, and (c) Taiwan version 2 (T2), which substituted calf circumference for BMI, and with the long-form MNA-T2 as a reference. The ability of the short forms to predict the long-form MNA-T2 was evaluated with binary classification and analysis of receiver operating characteristic curves. Results were analyzed with an SPSS for Windows 12.0 software package (version 12.0.1C, 2000, SPSS Inc, Chicago, IL). Results showed that adoption of population-specific anthropometric BMI cutpoints improved the predictive ability of the short-form MNA, whereas replacement of BMI with calf circumference further improved the predictive ability of the scale (kappa values of the binary classification tests were 0.596, 0.742, and 0.843 for community-living; 0.560, 0.683, and 0.839 for care center-living; and 0.346, 0.454, and 0.522 for nursing home-living elderly for the original, T1, and T2 MNA short-form versions, respectively). These results suggest that modification of a measurement tool according to cultural or anthropometric features of the target population is necessary. The study also shows that calf circumference can be an acceptable alternative to BMI in the short

  5. HEALTHY EATING INDEX AND OVARIAN CANCER RISK

    PubMed Central

    Chandran, Urmila; Bandera, Elisa V.; Williams-King, Melony G.; Paddock, Lisa E.; Rodriguez-Rodriguez, Lorna; Lu, Shou-En; Faulkner, Shameka; Pulick, Katherine; Olson, Sara H.

    2011-01-01

    The evidence for a role of diet on ovarian cancer prevention remains inconclusive. While many studies have evaluated individual foods and food groups, the evaluation of a comprehensive dietary quality index for predicting cancer risk has received little attention. This study investigates the association between the Healthy Eating Index (HEI), which reflects adherence to the current USDA Dietary Guidelines for Americans, and ovarian cancer risk in a population-based case-control study in New Jersey. A total of 205 cases and 390 controls completed the Block 98.2 Food Frequency Questionnaire (FFQ) in addition to reporting on potential risk factors for ovarian cancer. FFQ data were then utilized to calculate the HEI score, and cup, ounce, gram, or caloric equivalents for the 12 different food groups comprising the index. In multivariate models the OR for the highest tertile of the HEI score compared to the lowest (reflecting a better diet compared to a worse diet) was 0.90 (95% CI: 0.55–1.47). There was limited evidence for a statistically significant association between any of the 12 individual food components and ovarian cancer risk. Based on this study’s results, neither individual food groups nor dietary quality showed potential for preventing ovarian cancer. PMID:21286802

  6. On the risk criterion and the index of risk

    SciTech Connect

    Wang, J.C.; Johnson, R.O.; Lee, D.W.

    1996-06-10

    The development of a means to quantify risk, the determination of a risk criterion, and the establishment of a method to compare risks are three essential components in a probabilistic safety assessment. In this paper, the quantitative definition of risk given by Kaplan and Garrick is converted from a table to a graph to accommodate Farmer`s method of constructing a risk criterion. Farmer`s criterion is limited to a straight line, but its slope is made a free parameter. The high-frequency small-consequence problem noted by Farmer is solved by using an auxiliary vertical line to exclude scenarios with insignificant consequences. To compare risks associated with various accident scenarios, an index of risk relative to the straight-line risk criterion is proposed and developed. The results allow various accident scenarios to be ranked according to their weighted risks and, in turn, provide a measure of the effectiveness of mitigation.

  7. Early nutrition and later diabetes risk.

    PubMed

    Knip, Mikael; Akerblom, Hans K

    2005-01-01

    Early feeding may modify the risk of both type 1 (T1D) and type 2 diabetes (T2D) later in life. The information generated so far is, however, controversial. When evaluating studies on the impact of early feeding on risk of later diabetes, the data have to be assessed critically and possible confounding factors have to be considered. The study design may induce biases and there are considerable differences in early feeding practices across various countries and cultures. Accordingly it may not be possible to generalise observations based on one population. Long breastfeeding, exclusive breastfeeding in particular, and supplementation with vitamin D in infancy have been reported to confer partial protection against beta-cell autoimmunity and TID. In contrast, early exposure to cow's milk proteins and cereals and heavy weight in infancy have been implicated as risk factors for T1D. Long breastfeeding has also been observed to protect against T2D in aboriginal populations. Poor fetal nutrition resulting in low birth weight has been identified as a factor contributing to later insulin resistance and T2D. Recent data indicate that current overweight and obesity are stronger determinants of insulin resistance than birth weight among preschool children. High-nutrient diet and rapid growth in early infancy have been reported to adversely programme the principal components of the metabolic syndrome including insulin resistance and T2D. It is an important scientific and public-health objective to define protective and predisposing effects of early nutrition on the development of diabetes, since early feeding can potentially be modified to minimise the risk of later chronic diseases.

  8. HIV-Risk Index: Development and Validation of a Brief Risk Index for Hispanic Young People.

    PubMed

    Ballester-Arnal, Rafael; Gil-Llario, María Dolores; Castro-Calvo, Jesús; Giménez-García, Cristina

    2016-08-01

    The prevalence of HIV risk behaviors among young people facilitates the spread of HIV, in particular regarding unsafe sex behavior, although this trend is different within this population. For this reason, identifying the riskier young population is required to prevent HIV infection. The main purpose of this study was to develop and validate a risk index to assess the different sexual HIV risk exposure among Hispanic Young people. For this purpose, 9861 Spanish young people were randomly distributed into two groups (derivation and validation group). According to the results, the factor analyses grouped the nine items of the HIV- risk index into two factors (factor 1, direct sexual risk indicators and factor 2, indirect sexual risk indicators) with an equal structure for men and women by a multi-group confirmatory factor analysis. The variance explained was 54.26 %. Moreover, the Cronbach's alpha coefficient revealed high internal reliability (α = .79) and the convergent validity supported its evidence based on different HIV risk indexes. Therefore, the HIV-risk index seem to be a rigorous and valid measure to estimate HIV risk exposure among young people.

  9. Nutritional Risk and Nutritional Status at Admission and Discharge among Chinese Hospitalized Patients: A Prospective, Nationwide, Multicenter Study.

    PubMed

    Zhu, Mingwei; Wei, Junmin; Chen, Wei; Yang, Xin; Cui, Hongyuan; Zhu, Sainan

    2017-07-01

    The objective of this study was to assess nutritional risk and status of Chinese hospitalized patients at admission and discharge and relations with clinical outcomes. A prospective, nationwide, multicenter study was conducted from June to September 2014 in 34 large hospitals in 18 cities in China. Patients ≥ 18 years with a hospital stay of 7-30 days were recruited. Anthropometric and laboratory indicators, nutritional risk screening, and assessment by Nutritional Risk Screening 2002 (NRS 2002) and subjective global assessment (SGA) were performed within 24 hours of admission and discharge. Clinical data during hospitalization were collected. A total of 6,638 patients met the criteria with a male: female ratio of 1.39:1 and an average age of 59.72 ± 15.40 years. At admission, the proportion of patients with nutritional risk, body mass index (BMI) < 18.5 kg/m(2), and moderate to severe malnutrition was 40.12%, 8.92%, and 26.45%, respectively, whereas at discharge, these percentages were 42.28%, 8.91%, and 30.57%, respectively. The values of all of these indicators were higher in patients 65 years of age and older. Patients with nutritional risk at admission had a longer average hospital stay (14.02 ± 6.42 vs 13.09 ± 5.703 days), higher incidence of total complications (6.90% vs 1.52%), and greater total medical expenses (3.39 ± 7.50 vs 3.00 ± 3.38 million RMB; all p < 0.01) than patients without nutritional risk. Similar results were obtained for the patients with nutritional risk at discharge. The prevalence of nutritional risk and malnutrition, including moderate to severe malnutrition, at discharge is higher than that observed at admission; the clinical outcome of patients with nutritional risk is poor.

  10. Nutrition and the risk of stroke.

    PubMed

    Hankey, Graeme J

    2012-01-01

    Poor nutrition in the first year of a mother's life and undernutrition in utero, infancy, childhood, and adulthood predispose individuals to stroke in later life, but the mechanism of increased stroke risk is unclear. Overnutrition also increases the risk of stroke, probably by accelerating the development of obesity, hypertension, hyperlipidaemia, and diabetes. Reliable evidence suggests that dietary supplementation with antioxidant vitamins, B vitamins, and calcium does not reduce the risk of stroke. Less reliable evidence suggests that stroke can be prevented by diets that are prudent, aligned to the Mediterranean or DASH (Dietary Approaches to Stop Hypertension) diets, low in salt and added sugars, high in potassium, and meet, but do not exceed, energy requirements. Trials in progress are examining the effects of vitamin D and marine omega-3 fatty acid supplementation on incidence of stroke. Future challenges include the need to improve the quality of evidence linking many nutrients, foods, and dietary patterns to the risk of stroke. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Compliance with Mediterranean Diet Quality Index (KIDMED) and nutrition knowledge levels in adolescents. A case study from Turkey.

    PubMed

    Sahingoz, Semra Akar; Sanlier, Nevin

    2011-08-01

    Adopting an eating pattern complying with the Mediterranean diet not only decreases body fat mass and obesity risk, but also reduces development of various health problems. This study investigated the nutritional awareness and diet quality Mediterranean Diet Quality Index (KIDMED) of Turkish adolescents. The study was conducted with 890 voluntary participants (464 boys and 426 girls) aged 10-14 years. A questionnaire form was used to learn demographic characteristics of the participants. Participants' nutritional awareness was determined through a 20-item knowledge form and their nutritional habits through a 16-item Mediterranean Diet Quality Index (KIDMED). The average nutritional knowledge score was X=82.22 ± 0.42. Results indicated that 17.9% of the participants had a low quality diet (≤ 3 points), 59.2% had a mid-quality/needs-improvement diet (4-7 points) and 22.9% had an optimal quality diet (≥ 8 points). The study results showed that the subjects' diet quality was low and that their nutrition knowledge levels were related to their nutritional habits. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Use of 3 tools to assess nutrition risk in the intensive care unit.

    PubMed

    Coltman, Anne; Peterson, Sarah; Roehl, Kelly; Roosevelt, Hannah; Sowa, Diane

    2015-01-01

    Identifying patients at nutrition risk proves difficult in the intensive care unit (ICU) due to the nature of critical illness. No consensus exists on the most appropriate method to identify these patients. Traditional screens and assessments are often limited due to their subjective nature. The purpose of the quality improvement project was to compare proportions of ICU patients deemed at nutrition risk using 3 different tools. A convenience sample of 294 patients admitted to the ICU was used. Patients were assessed using the institution's routine nutrition screening method, the Subjective Global Assessment (SGA), and the NUTrition Risk in Critically ill (NUTRIC) score. Information was collected on demographics, severity of illness, hospital and ICU length of stay (LOS), and disposition. Descriptive statistics were used to examine counts/proportions of risk categories; means ± SD were used to summarize demographic and clinical variables. A total of 139 patients (47%) were deemed at nutrition risk or malnourished by at least 1 tool. Patients identified were older and had a lower body mass index, more weight loss, more fat and muscle wasting, more fluid accumulation, and lower average handgrips than those not at nutrition risk; they also had longer hospital and ICU LOS, higher rates of requiring further rehabilitation upon discharge, and higher mortality during hospitalization. Traditional screening and assessment tools did not uniformly identify patients as malnourished or at nutrition risk in the ICU and therefore may be inappropriate for use in this population. Inclusion of physical assessment, functional status, and severity of illness may be useful in predicting nutrition risk in the ICU. © 2014 American Society for Parenteral and Enteral Nutrition.

  13. Trajectories of Nutritional Risk: The Manitoba Follow-Up Study.

    PubMed

    Lengyel, C O; Jiang, D; Tate, R B

    2017-01-01

    To identify patterns of nutritional risk among older men over a four-year period and to project their survival rates over the next two and a half years. A prospective longitudinal study. Canada. Three hundred and thirty-six male survivors of the Manitoba Follow-up Study (MFUS) cohort with an average age of 90 years in 2011. Four years of nutritional risk SCREEN II scores (five waves) from the male survivors of the MFUS cohort. The semi-parametric group-based trajectory approach and survival analysis were used to investigate the trajectories of nutritional risk. Of the participants, 30% lived alone. Five distinct developmental trajectory groups for nutritional risk score were identified. Significant statistical differences were found among the five trajectory groups for SF-36 mental health (p=.02), SF-36 physical health (p=<.001), perception of aging successfully (p=.04) and living alone (p=<.001). Among the five groups, the most pairwise differences were found in appetite, intake of meat and alternatives, and vegetables and fruit, weight change, skipping meals and eating with others. Men in the poorest nutritional risk trajectory group were two times more likely to die within a 2 1/2 year period compared to men in the best nutritional risk trajectory group (hazard rate = 2.33, p=.07). Distinct nutritional risk trajectories were found for older men over a four year period. Poor nutritional risk trajectories are associated with higher risk of mortality for very old men over a short period of time. Timely nutritional assessments by health professionals are needed to identify older men at nutritional risk. Subsequent nutrition education and follow-up may be important in preventing further decline.

  14. Objective Understanding of Front-of-Package Nutrition Labels among Nutritionally At-Risk Individuals

    PubMed Central

    Ducrot, Pauline; Méjean, Caroline; Julia, Chantal; Kesse-Guyot, Emmanuelle; Touvier, Mathilde; Fezeu, Léopold K.; Hercberg, Serge; Péneau, Sandrine

    2015-01-01

    In the ongoing debate about front-of-package (FOP) nutrition labels, little data exist regarding nutritionally at-risk populations, although they are critical targets of prevention programs. This study aimed to compare the impact of FOP labels on the ability to rank products according to their nutritional quality among French adults potentially at risk of poor dietary quality (N = 14,230). Four labels were evaluated: Guideline Daily Amounts (GDA), Multiple Traffic Lights (MTL), 5-Color Nutrition Label (5-CNL), Green Tick (Tick), along with a reference without label. Mixed models were used to assess how individual characteristics and FOP labels were associated with the ability to rank products. Older participants and those with a lower educational level, income, nutritional knowledge, and likelihood of reading nutrition facts were less skilled at ranking food products according to nutritional quality. Compared with individual characteristics, nutrition labels had an increased impact on food product ranking ability. Overall, 5-CNL corresponded to the highest rate of correct responses, followed by MTL, GDA, and Tick (p < 0.0001). The strongest impact of 5-CNL was observed among individuals with no nutritional knowledge (odds ratio (OR): 20.24; 95% confidence interval (CI): 13.19–31.06). Therefore, 5-CNL appeared to be effective at informing consumers, including those who are nutritionally at-risk, about the nutritional quality of food products. PMID:26305255

  15. Objective Understanding of Front-of-Package Nutrition Labels among Nutritionally At-Risk Individuals.

    PubMed

    Ducrot, Pauline; Méjean, Caroline; Julia, Chantal; Kesse-Guyot, Emmanuelle; Touvier, Mathilde; Fezeu, Léopold K; Hercberg, Serge; Péneau, Sandrine

    2015-08-24

    In the ongoing debate about front-of-package (FOP) nutrition labels, little data exist regarding nutritionally at-risk populations, although they are critical targets of prevention programs. This study aimed to compare the impact of FOP labels on the ability to rank products according to their nutritional quality among French adults potentially at risk of poor dietary quality (N = 14,230). Four labels were evaluated: Guideline Daily Amounts (GDA), Multiple Traffic Lights (MTL), 5-Color Nutrition Label (5-CNL), Green Tick (Tick), along with a reference without label. Mixed models were used to assess how individual characteristics and FOP labels were associated with the ability to rank products. Older participants and those with a lower educational level, income, nutritional knowledge, and likelihood of reading nutrition facts were less skilled at ranking food products according to nutritional quality. Compared with individual characteristics, nutrition labels had an increased impact on food product ranking ability. Overall, 5-CNL corresponded to the highest rate of correct responses, followed by MTL, GDA, and Tick (p < 0.0001). The strongest impact of 5-CNL was observed among individuals with no nutritional knowledge (odds ratio (OR): 20.24; 95% confidence interval (CI): 13.19-31.06). Therefore, 5-CNL appeared to be effective at informing consumers, including those who are nutritionally at-risk, about the nutritional quality of food products.

  16. Prognostic significance of the prognostic nutritional index in esophageal cancer patients undergoing neoadjuvant chemotherapy.

    PubMed

    Nakatani, M; Migita, K; Matsumoto, S; Wakatsuki, K; Ito, M; Nakade, H; Kunishige, T; Kitano, M; Kanehiro, H

    2017-08-01

    Nutritional status is one of the most important issues faced by cancer patients. Several studies have shown that a low preoperative nutritional status is associated with a worse prognosis in patients with various types of cancer, including esophageal cancer (EC). Recently, neoadjuvant chemotherapy (NAC) and/or radiotherapy have been accepted as the standard treatment for resectable advanced EC. However, NAC has the potential to deteriorate the nutritional status of a patient. This study aimed to evaluate the prognostic significance of the nutritional status for EC patients who underwent NAC. We retrospectively reviewed 66 squamous cell EC patients who underwent NAC consisting of docetaxel, cisplatin, and 5-fluorouracil followed by subtotal esophagectomy at Nara Medical University Hospital between January 2009 and August 2015. To assess the patients' nutritional status, the prognostic nutritional index (PNI) before commencing NAC and prior to the operation was calculated as 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count in the peripheral blood (per mm3). The cutoff value of the PNI was set at 45. A multivariable analysis was performed to identify prognostic factors for overall survival (OS) and relapse-free survival (RFS). The mean pre-NAC and preoperative PNI were 50.2 ± 5.7 and 48.1 ± 4.7, respectively (P = 0.005). The PNI decreased following NAC in 44 (66.7%) patients. Before initiating NAC, 9 (13.6%) patients had a low PNI, and 12 (18.2%) patients had a low PNI prior to the operation. The pre-NAC PNI and preoperative PNI were significantly associated with the OS (P = 0.013 and P = 0.004, respectively) and RFS (P = 0.036 and P = 0.005, respectively) rates. The multivariable analysis identified the preoperative PNI as an independent prognostic factor for poor OS and RFS, although the pre-NAC PNI was not an independent predictor. Our results suggest that the preoperative PNI is a useful marker for predicting the long-term outcomes of EC patients

  17. Food parenting practices and their association with child nutrition risk status: comparing mothers and fathers.

    PubMed

    Watterworth, Jessica C; Hutchinson, Joy M; Buchholz, Andrea C; Darlington, Gerarda; Randall Simpson, Janis A; Ma, David W L; Haines, Jess

    2017-06-01

    In Canada, little is known about how food parenting practices are associated with young children's dietary intakes and no studies have examined food parenting practices of Canadian fathers. This study aimed to examine associations between food parenting practices and preschool-age children's nutrition risk. We conducted a cross-sectional analysis of thirty-one 2-parent families; 31 mothers, 31 fathers, and 40 preschool-age children. Parents completed an adapted version of the Comprehensive Feeding Practices Questionnaire. We calculated children's nutrition risk using their NutriSTEP score. To account for sibling association, we used generalized estimating equations, adjusting for child age, sex, household income, and parental body mass index. Both mothers' and fathers' involvement of children in meal preparation were associated with lower child nutrition risk (mother [Formula: see text] = -3.45, p = 0.02; father [Formula: see text] = -1.74, p = 0.01), as were their healthy home environment scores (mother [Formula: see text] = -8.36, p < 0.001; father [Formula: see text] = -2.69, p = 0.04). Mothers' encouragement of balance and variety was associated with lower nutrition risk ([Formula: see text] = -8.88, p = 0.01), whereas mothers' use of food as a reward was associated with higher nutrition risk ([Formula: see text] = 4.67, p < 0.001). Fathers' modelling of healthy behaviours was associated with lower nutrition risk ([Formula: see text] = -2.21, p = 0.01), whereas fathers' restriction for health ([Formula: see text] = 2.21, p = 0.03) and pressure-to-eat scores ([Formula: see text] = 3.26, p = <0.001) were associated with higher nutrition risk. No associations were found between child nutrition status and parental emotion regulation, control, monitoring, or restriction for weight. In conclusion, both mothers' and fathers' food parenting practices are associated with their children's nutrition status. Fathers should be included in food parenting practices

  18. Waist-to-Height Ratio and Body Mass Index as Indicators of Cardiovascular Risk in Youth

    ERIC Educational Resources Information Center

    Keefer, Daniel J.; Caputo, Jennifer L.; Tseh, Wayland

    2013-01-01

    Background: The purpose of this investigation was to determine if waist-to-height ratio (WHTR) or body mass index (BMI) is the better indicator of cardiovascular disease risk in children and adolescents of varying ages. Methods: Data from children and adolescents (N?=?2300) who were part of the 2003-2004 National Health and Nutrition Examination…

  19. Waist-to-Height Ratio and Body Mass Index as Indicators of Cardiovascular Risk in Youth

    ERIC Educational Resources Information Center

    Keefer, Daniel J.; Caputo, Jennifer L.; Tseh, Wayland

    2013-01-01

    Background: The purpose of this investigation was to determine if waist-to-height ratio (WHTR) or body mass index (BMI) is the better indicator of cardiovascular disease risk in children and adolescents of varying ages. Methods: Data from children and adolescents (N?=?2300) who were part of the 2003-2004 National Health and Nutrition Examination…

  20. Impact of preoperative nutritional support on clinical outcome in abdominal surgical patients at nutritional risk.

    PubMed

    Jie, Bin; Jiang, Zhu-Ming; Nolan, Marie T; Zhu, Shai-Nan; Yu, Kang; Kondrup, Jens

    2012-10-01

    This multicenter, prospective cohort study evaluated the effect of preoperative nutritional support in abdominal surgical patients at nutritional risk as defined by the Nutritional Risk Screening Tool 2002 (NRS-2002). A consecutive series of patients admitted for selective abdominal surgery in the Peking Union Medical College Hospital and the Beijing University Third Hospital in Beijing, China were recruited from March 2007 to July 2008. Data were collected on the nutritional risk screening (NRS-2002), the application of perioperative nutritional support, surgery, complications, and length of stay. A minimum of 7 d of parenteral nutrition or enteral nutrition before surgery was considered adequate preoperative nutritional support. In total 1085 patients were recruited, and 512 of them were at nutritional risk. Of the 120 patients with an NRS score at least 5, the complication rate was significantly lower in the preoperative nutrition group compared with the control group (25.6% versus 50.6%, P = 0.008). The postoperative hospital stay was significantly shorter in the preoperative nutrition group than in the control group (13.7 ± 7.9 versus 17.9 ± 11.3 d, P = 0.018). Of the 392 patients with an NRS score from 3 to 4, the complication rate and the postoperative hospital stay were similar between patients with and those without preoperative nutritional support (P = 1.0 and 0.770, respectively). This finding suggests that preoperative nutritional support is beneficial to patients with an NRS score at least 5 by lowering the complication rate. Copyright © 2012. Published by Elsevier Inc.

  1. Assessment of nutritional status and nutritional risk in hospitalized Iranian children.

    PubMed

    Moeeni, Vesal; Walls, Tony; Day, Andrew S

    2012-10-01

      This study aimed to define the nutritional state of children admitted to a tertiary Iranian hospital and to evaluate nutritional risk score tools in these children.   The anthropometry of hospitalized and healthy children from the same community was determined. Three nutritional risk score tools were applied to all inpatients.   One hundred and nineteen inpatients were recruited along with a comparison group of 100 children. The prevalence of under-nutrition in the inpatient group was 25.2% and 3% in the community group (p < 0.0001). Obesity/overweight was more prevalent in the community group than the inpatients (22% versus 2.5%: p = 0.04). Severely malnourished children had a longer hospital stay than those with normal nutrition (p < 0.0001). The nutritional risk score tools identified between 83% and 90% of the malnourished patients in the moderate and high-risk groups. The STRONG(kids) tool correlated more strongly with anthropometric measurements than the other tools. The length of hospital stay was associated with risk status (p = 0.004).   Hospitalized Iranian children have higher rates of under-nutrition than healthy children from the same community. NRS tools were able to identify children at nutritional risk; however, variable utility was observed. Further assessment of NRS tools in the developing setting is required. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.

  2. Seafood: nutritional benefits and risk aspects.

    PubMed

    Oehlenschläger, Jörg

    2012-06-01

    Seafood, such as fish, crustacean and molluscan shellfish, and echinoderms, provides in the edible part (e. g., filet, abdominal muscle) many nutritional components beneficial for the human diet like n-3 polyunsaturated long chain fatty acids (PUFAs), namely eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), essential elements such as selenium and iodine, high potassium and low sodium concentrations, and the vitamins D, A, E, and B(12), as well as taurine (2-aminoethanesulfonic acid) among others. Its protein is highly digestible due to low connective tissue content, and cholesterol content is also low in fish. Lean fish species are extremely low in fat content (<1 %), while fatty species are extremely rich in PUFAs. However, being subject to environmental influences from its habitat, seafood also entails water-borne health risks such as organic pollutants, toxins, parasites, and heavy metals. Nevertheless, the vast majority of experimental and epidemiological studies have proven that the benefits of fish intake exceed the potential risks even for vulnerable consumer groups.

  3. Nutritional status of allogeneic hematopoietic stem cell transplantation recipients: influencing risk factors and impact on survival.

    PubMed

    El-Ghammaz, Amro Mohamed Sedky; Ben Matoug, Rima; Elzimaity, Maha; Mostafa, Nevine

    2017-04-24

    Patients subjected to allogeneic hematopoietic stem cell transplantation (HSCT) are at increased nutritional risk which in turn may alter their outcome. For providing good nutritional care for patients, it is important to analyze risk factors influencing nutritional status during and after HSCT. Fifty patients undergoing allogeneic HSCT were subjected to nutritional status assessment by using the patient-generated subjective global assessment (PG-SGA) at initial admission, day 30 and day 180. Two patients (4%) had malnutrition at admission, 36 (72%) at day 30, and 24 (48%) at day 180. At day 30, comorbidity index higher than 0 and fever lasting for more than 1 week had a significant impact on nutritional status (P = .004 and P = .006, respectively). Regarding day 180, comorbidity index higher than 0 and presence of ≥grade II acute gastrointestinal graft versus host disease (GI GVHD) significantly influenced nutritional status (P = .017 and P = .026, respectively). Well-nourished patients at admission and day 180 had a significantly higher overall survival (OS) in comparison to malnourished patients (P < .001 and P = .012, respectively). Nutritional status at admission and day 180 had a significant influence on OS in multivariate analysis (P = .039 and P = .032, respectively). Allogeneic HSCT patients having high comorbidity index, developing prolonged fever, and experiencing ≥grade II acute GI GVHD suffer from worsening in their nutritional status during hospitalization and after discharge. Also, nutritional status at admission and day 180 significantly influences their survival.

  4. Novel immunological and nutritional-based prognostic index for gastric cancer

    PubMed Central

    Sun, Kai-Yu; Xu, Jian-Bo; Chen, Shu-Ling; Yuan, Yu-Jie; Wu, Hui; Peng, Jian-Jun; Chen, Chuang-Qi; Guo, Pi; Hao, Yuan-Tao; He, Yu-Long

    2015-01-01

    AIM: To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio in gastric cancer. METHODS: We retrospectively reviewed 632 gastric cancer patients who underwent gastrectomy between 1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate. Univariate and multivariate analyses were performed to identify risk factors for overall survival (OS). Propensity score analysis was performed to adjust variables to control for selection bias. RESULTS: Each index could predict OS in gastric cancer patients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring (hazard ratio, 1.668; 95% confidence interval: 1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage II-III disease (P = 0.019, P < 0.001), T3-T4 tumors (P < 0.001), or lymph node metastasis (P < 0.001). Canton score, a combination of PNI, NLR, and platelet, was a better indicator for OS than PNI, with the largest area under the curve for 12-, 36-, 60-mo OS and overall OS (P = 0.022, P = 0.030, P < 0.001, and P = 0.024, respectively). The maximum sensitivity, specificity, and agreement rate of Canton score for predicting prognosis were 84.6%, 34.9%, and 70.1%, respectively. CONCLUSION: PNI is an independent prognostic factor for OS in gastric cancer. Canton score can be a novel preoperative prognostic index in gastric cancer. PMID:26019461

  5. High nutrition risk is associated with higher risk of dysphagia in advanced age adults newly admitted to hospital.

    PubMed

    Popman, Amy; Richter, Marilize; Allen, Jacqueline; Wham, Carol

    2017-09-15

    To establish the prevalence of nutrition risk and associated risk factors among adults of advanced age newly admitted to hospital. A cross-sectional study was undertaken in adults aged over 85 years admitted to one of two hospital wards in Auckland within the previous 5 days. An interviewer-administered questionnaire was used to establish participant's socio-demographic and health characteristics. Markers of body composition and muscle strength were collected. Nutrition risk was assessed using the Mini Nutritional Assessment-Short Form (MNA-SF), dysphagia risk using the 10-Item Eating Assessment Tool (EAT-10) and level of cognition using the Montreal Cognitive Assessment. A total of 88 participants with a mean age of 90.0 ± 3.7 years completed the assessments. A third (28.4%) of the participants were categorised by the MNA-SF as malnourished and 43.2% were classified at risk of malnutrition. A third (29.5%) were at risk of dysphagia as assessed by EAT-10. Malnourished participants were more likely to be at risk of dysphagia (P = 0.015). The MNA-SF score was positively correlated with body mass index (r = 0.484, P < 0.001) and grip strength (r = 0.250, P = 0.026) and negatively correlated with risk of dysphagia (r = -0.383, P < 0.001). Among newly hospitalised adults of advanced age, over two thirds were malnourished or at risk of malnutrition, and a third were at risk of dysphagia. Nutrition risk was positively correlated with low BMI and grip strength and negatively correlated with dysphagia risk. Findings highlight the importance of screening for dysphagia risk, especially in those identified to be malnourished or at nutrition risk. © 2017 Dietitians Association of Australia.

  6. Body Mass Index Genetic Risk Score and Endometrial Cancer Risk

    PubMed Central

    Prescott, Jennifer; Setiawan, Veronica W.; Wentzensen, Nicolas; Schumacher, Fredrick; Yu, Herbert; Delahanty, Ryan; Bernstein, Leslie; Chanock, Stephen J.; Chen, Chu; Cook, Linda S.; Friedenreich, Christine; Garcia-Closas, Monserrat; Haiman, Christopher A.; Le Marchand, Loic; Liang, Xiaolin; Lissowska, Jolanta; Lu, Lingeng; Magliocco, Anthony M.; Olson, Sara H.; Risch, Harvey A.; Shu, Xiao-Ou; Ursin, Giske; Yang, Hannah P.; Kraft, Peter; De Vivo, Immaculata

    2015-01-01

    Genome-wide association studies (GWAS) have identified common variants that predispose individuals to a higher body mass index (BMI), an independent risk factor for endometrial cancer. Composite genotype risk scores (GRS) based on the joint effect of published BMI risk loci were used to explore whether endometrial cancer shares a genetic background with obesity. Genotype and risk factor data were available on 3,376 endometrial cancer case and 3,867 control participants of European ancestry from the Epidemiology of Endometrial Cancer Consortium GWAS. A BMI GRS was calculated by summing the number of BMI risk alleles at 97 independent loci. For exploratory analyses, additional GRSs were based on subsets of risk loci within putative etiologic BMI pathways. The BMI GRS was statistically significantly associated with endometrial cancer risk (P = 0.002). For every 10 BMI risk alleles a woman had a 13% increased endometrial cancer risk (95% CI: 4%, 22%). However, after adjusting for BMI, the BMI GRS was no longer associated with risk (per 10 BMI risk alleles OR = 0.99, 95% CI: 0.91, 1.07; P = 0.78). Heterogeneity by BMI did not reach statistical significance (P = 0.06), and no effect modification was noted by age, GWAS Stage, study design or between studies (P≥0.58). In exploratory analyses, the GRS defined by variants at loci containing monogenic obesity syndrome genes was associated with reduced endometrial cancer risk independent of BMI (per BMI risk allele OR = 0.92, 95% CI: 0.88, 0.96; P = 2.1 x 10−5). Possessing a large number of BMI risk alleles does not increase endometrial cancer risk above that conferred by excess body weight among women of European descent. Thus, the GRS based on all current established BMI loci does not provide added value independent of BMI. Future studies are required to validate the unexpected observed relation between monogenic obesity syndrome genetic variants and endometrial cancer risk. PMID:26606540

  7. Development and implementation of a business continuity management risk index.

    PubMed

    Kadar, Michael

    This paper will present the building blocks for developing and implementing the BCM risk index; whether it is used as a comprehensive metric for risk or preparedness. This paper introduces the concept of a business continuity management (BCM) risk index--a comprehensive metric that measures and reports the status of the primary 'intended outcome' of the BCM programme to top management. In addition to measuring the primary programme output,;the BCM risk index can be used to demonstrate the overall value of the BCM programme to executive management. This is accomplished because the BCM risk index allows quantitative measurement of current risk levels and their comparison with established risk tolerances. The BCM Risk Index can provide executive management with reports on the risk level of individual business units, departments, subsidiaries or the enterprise in a way that drives both risk management and BCM initiatives. The name 'risk index' can be misleading, however. The BCM risk index concept can also be used to measure preparedness levels. In fact, implementation at DTE Energy has resulted in calling it the 'preparedness index', which is used to measure and report preparedness levels rather than risk levels.

  8. Nutritional status and nutrition risk screening in hospitalized children in New Zealand.

    PubMed

    Moeeni, Vesal; Walls, Tony; Day, Andrew S

    2013-09-01

    Children requiring hospitalization are at risk of malnutrition. This study aimed to define the nutritional status of paediatric inpatients in comparison with healthy children and to compare and contrast the feasibility and validity of three nutritional risk screening (NRS) tools in the hospitalized children. A total of 162 children admitted to Christchurch Hospital were assessed along with a similar group of healthy children. Their nutritional state was assessed and classified using standard criteria. The NRS tools were applied, and patients were classified into low-, medium- and high-risk groups. The feasibility and validity of the tools were assessed. Under-nutrition was more frequent in the inpatient group (9.9% vs. 3.7%; p = 0.04), whereas both groups had similar rates of overweight/obesity. NRS tools were able to identify between 81% and 100% of the malnourished patients in the medium- to high-risk groups. Undernourished patients had longer hospital stay than well-nourished patients. Hospitalized children have higher rates of under-nutrition than healthy children in NZ. The three NRS tools were able to identify children at nutritional risk with differing utility. In this setting, STRONGkids was the most reliable tool. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  9. Development of the Nutrition and Swallowing Checklist, a Screening Tool for Nutrition Risk and Swallowing Risk in People with Intellectual Disability.

    ERIC Educational Resources Information Center

    Stewart, Lyn

    2003-01-01

    This article discusses nutrition problems in people with intellectual disabilities, the need for nutrition risk screening, and the development of the Nutrition and Swallowing Checklist in New South Wales. The checklist ensures carer involvement in identifying risks and an interdisciplinary approach to the assessment and management of nutrition and…

  10. Development of the Nutrition and Swallowing Checklist, a Screening Tool for Nutrition Risk and Swallowing Risk in People with Intellectual Disability.

    ERIC Educational Resources Information Center

    Stewart, Lyn

    2003-01-01

    This article discusses nutrition problems in people with intellectual disabilities, the need for nutrition risk screening, and the development of the Nutrition and Swallowing Checklist in New South Wales. The checklist ensures carer involvement in identifying risks and an interdisciplinary approach to the assessment and management of nutrition and…

  11. Nutritional Risk Screening 2002, Short Nutritional Assessment Questionnaire, Malnutrition Screening Tool, and Malnutrition Universal Screening Tool Are Good Predictors of Nutrition Risk in an Emergency Service.

    PubMed

    Rabito, Estela Iraci; Marcadenti, Aline; da Silva Fink, Jaqueline; Figueira, Luciane; Silva, Flávia Moraes

    2017-08-01

    There is an international consensus that nutrition screening be performed at the hospital; however, there is no "best tool" for screening of malnutrition risk in hospitalized patients. To evaluate (1) the accuracy of the MUST (Malnutrition Universal Screening Tool), MST (Malnutrition Screening Tool), and SNAQ (Short Nutritional Assessment Questionnaire) in comparison with the NRS-2002 (Nutritional Risk Screening 2002) to identify patients at risk of malnutrition and (2) the ability of these nutrition screening tools to predict morbidity and mortality. A specific questionnaire was administered to complete the 4 screening tools. Outcomes measures included length of hospital stay, transfer to the intensive care unit, presence of infection, and incidence of death. A total of 752 patients were included. The nutrition risk was 29.3%, 37.1%, 33.6%, and 31.3% according to the NRS-2002, MUST, MST, and SNAQ, respectively. All screening tools showed satisfactory performance to identify patients at nutrition risk (area under the receiver operating characteristic curve between 0.765-0.808). Patients at nutrition risk showed higher risk of very long length of hospital stay as compared with those not at nutrition risk, independent of the tool applied (relative risk, 1.35-1.78). Increased risk of mortality (2.34 times) was detected by the MUST. The MUST, MST, and SNAQ share similar accuracy to the NRS-2002 in identifying risk of malnutrition, and all instruments were positively associated with very long hospital stay. In clinical practice, the 4 tools could be applied, and the choice for one of them should be made per the particularities of the service.

  12. Association of nutritional risk and depressive symptoms with physical performance in the elderly: the Quebec longitudinal study of nutrition as a determinant of successful aging (NuAge).

    PubMed

    Avila-Funes, José Alberto; Gray-Donald, Katherine; Payette, Hélène

    2008-08-01

    Depressive symptoms and poor nutritional status have been associated with declines in physical capacity. However, it is not clear whether they exert independent effects and potential for interaction among these two variables has not been studied. The purpose of this report is to clarify the relationships between depressive symptoms and nutritional risk and physical capacity. Baseline data from community-living and well functioning men and women (n = 1,755) participating in the longitudinal study NuAge (Quebec, Canada), aged 67-84 years were used for this study. Physical performance (PP) was defined as the summary score of 4 tests of physical capacity [Standing Balance, Walking Speed, Chair Stands, and Timed "Up &Go"]. Depressive symptoms were measured with the Geriatric Depression Scale (GDS), and nutritional risk by the Elderly Nutrition Screening (ENS(c)) tool. Prevalence of mild depression (GDS score >or=11 and nutritional risk or mild depression (mean score: 10.45 +/- 3.45) as compared to those with both risk factors (8.66 +/- 3.59; p < 0.001). In multiple linear regression analysis, both depressive symptoms and nutritional risk scores were independently associated with PP score after adjustment for age, sex, educational level, income, burden of disease, body mass index and physical activity. There was no interaction of nutritional risk and depressive symptoms in relation to PP. The overall adjusted multiple regression model explained 34% of the observed variance in physical performance score. Nutritional risk and depressive symptoms are both potentially modifiable independent correlates of PP but there is no synergistic effect of the two risk factors.

  13. Nutritional Risk Needs Assessment of Community-Living Seniors: Prevalence of Nutrition Problems and Priorities for Action.

    ERIC Educational Resources Information Center

    Keller, Heather H.; Hedley, Margaret R.

    2002-01-01

    Surveyed community-dwelling older adults to examine the prevalence of nutritional risk, specific nutrition problems, and educational format preferences. Results revealed that nutrition problems and risk were prevalent among community-dwelling older adults. Common problems included significant weight change in 6 months and low intake of fruits,…

  14. Association between fat mass index and fat-free mass index values and cardiovascular risk in adolescents

    PubMed Central

    de Oliveira, Patrícia Morais; da Silva, Fabiana Almeida; Oliveira, Renata Maria Souza; Mendes, Larissa Loures; Pereira, Michele; Cândido, Ana Paula Carlos

    2016-01-01

    Abstract Objective: To describe the association between fat mass index and fat-free mass index values and factors associated with cardiovascular risk in adolescents in the city of Juiz de Fora, Minas Gerais. Methods: Cross-sectional study was with 403 adolescents aged 10–14 years, from public and private schools. Anthropometric, clinical, and biochemical measurements were obtained, as well as self-reported time spent performing physical exercises, sedentary activities and sexual maturation stage. Results: Regarding the nutritional status, 66.5% of the adolescents had normal weight, 19.9% were overweight and 10.2% were obese. For both genders, the fat mass index was higher in adolescents who had high serum triglycerides, body mass index and waist circumference. Conclusions: Adolescents who had anthropometric, clinical and biochemical characteristics considered to be at risk for the development of cardiovascular disease had higher values of fat mass index. Different methodologies for the assessment of body composition make health promotion and disease prevention more effective. PMID:26542380

  15. [Association between fat mass index and fat-free mass index values and cardiovascular risk in adolescents].

    PubMed

    de Oliveira, Patrícia Morais; da Silva, Fabiana Almeida; Souza Oliveira, Renata Maria; Mendes, Larissa Loures; Netto, Michele Pereira; Cândido, Ana Paula Carlos

    2016-01-01

    To describe the association between fat mass index and fat-free mass index values and factors associated with cardiovascular risk in adolescents in the city of Juiz de Fora, Minas Gerais. Cross-sectional study with 403 adolescents aged 10-14 years, from public and private schools. Anthropometric, clinical, biochemical measurements were obtained, as well as self-reported time spent performing physical exercises, sedentary activities and sexual maturation stage. Regarding the nutritional status; 66.5% of the adolescents had normal weight; 19.9% were overweight and 10.2% were obese. For both genders, the fat mass index was higher in adolescents that had high serum triglycerides, body mass index and waist circumference. Adolescents that had anthropometric, clinical and biochemical characteristics considered to be of risk for the development of cardiovascular disease had higher values of fat mass index. Different methodologies for the assessment of body composition make health promotion and disease prevention more effective. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  16. Association of nutritional risk and adverse medical outcomes across different medical inpatient populations.

    PubMed

    Felder, Susan; Lechtenboehmer, Christian; Bally, Martina; Fehr, Rebecca; Deiss, Manuela; Faessler, Lukas; Kutz, Alexander; Steiner, Deborah; Rast, Anna C; Laukemann, Svenja; Kulkarni, Prasad; Stanga, Zeno; Haubitz, Sebastian; Huber, Andreas; Mueller, Beat; Schuetz, Philipp

    2015-01-01

    The aim of this study was to examine the prevalence of nutritional risk and its association with multiple adverse clinical outcomes in a large cohort of acutely ill medical inpatients from a Swiss tertiary care hospital. We prospectively followed consecutive adult medical inpatients for 30 d. Multivariate regression models were used to investigate the association of the initial Nutritional Risk Score (NRS 2002) with mortality, impairment in activities of daily living (Barthel Index <95 points), hospital length of stay, hospital readmission rates, and quality of life (QoL; adapted from EQ5 D); all parameters were measured at 30 d. Of 3186 patients (mean age 71 y, 44.7% women), 887 (27.8%) were at risk for malnutrition with an NRS ≥3 points. We found strong associations (odds ratio/hazard ratio [OR/HR], 95% confidence interval [CI]) between nutritional risk and mortality (OR/HR, 7.82; 95% CI, 6.04-10.12), impaired Barthel Index (OR/HR, 2.56; 95% CI, 2.12-3.09), time to hospital discharge (OR/HR, 0.48; 95% CI, 0.43-0.52), hospital readmission (OR/HR, 1.46; 95% CI, 1.08-1.97), and all five dimensions of QoL measures. Associations remained significant after adjustment for sociodemographic characteristics, comorbidities, and medical diagnoses. Results were robust in subgroup analysis with evidence of effect modification (P for interaction < 0.05) based on age and main diagnosis groups. Nutritional risk is significant in acutely ill medical inpatients and is associated with increased medical resource use, adverse clinical outcomes, and impairments in functional ability and QoL. Randomized trials are needed to evaluate evidence-based preventive and treatment strategies focusing on nutritional factors to improve outcomes in these high-risk patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Nutritional Status of Maintenance Dialysis Patients: Low Lean Body Mass Index and Obesity Are Common, Protein-Energy Wasting Is Uncommon.

    PubMed

    Koefoed, Mette; Kromann, Charles Boy; Juliussen, Sophie Ryberg; Hvidtfeldt, Danni; Ekelund, Bo; Frandsen, Niels Erik; Marckmann, Peter

    2016-01-01

    Maintenance dialysis patients are at increased risk of abnormal nutritional status due to numerous causative factors, both nutritional and non-nutritional. The present study assessed the current prevalence of protein-energy wasting, low lean body mass index and obesity in maintenance dialysis patients, and compared different methods of nutritional assessment. In a cross-sectional study conducted in 2014 at Roskilde Hospital, Denmark, we performed anthropometry (body weight, skinfolds, mid-arm, waist, and hip circumferences), and determined plasma albumin and normalized protein catabolic rate in order to assess the prevalence of protein-energy wasting, low lean body mass index and obesity in these patients. Seventy-nine eligible maintenance dialysis patients participated. The prevalence of protein-energy wasted patients was 4% (95% CI: 2-12) as assessed by the coexistence of low lean body mass index and low fat mass index. Low lean body mass index was seen in 32% (95% CI: 22-44). Obesity prevalence as assessed from fat mass index was 43% (95% CI: 32-55). Coexistence of low lean body mass index and obesity was seen in 10% (95% CI: 5-19). The prevalence of protein-energy wasting and obesity varied considerably, depending on nutritional assessment methodology. Our data indicate that protein-energy wasting is uncommon, whereas low lean body mass index and obesity are frequent conditions among patients in maintenance dialysis. A focus on how to increase and preserve lean body mass in dialysis patients is suggested in the future. In order to clearly distinguish between shortage, sufficiency and abundance of protein and/or fat deposits in maintenance dialysis patients, we suggest the simple measurements of lean body mass index and fat mass index.

  18. Nutritional Status of Maintenance Dialysis Patients: Low Lean Body Mass Index and Obesity Are Common, Protein-Energy Wasting Is Uncommon

    PubMed Central

    Koefoed, Mette; Kromann, Charles Boy; Juliussen, Sophie Ryberg; Hvidtfeldt, Danni; Ekelund, Bo; Frandsen, Niels Erik; Marckmann, Peter

    2016-01-01

    Background and Aims Maintenance dialysis patients are at increased risk of abnormal nutritional status due to numerous causative factors, both nutritional and non-nutritional. The present study assessed the current prevalence of protein-energy wasting, low lean body mass index and obesity in maintenance dialysis patients, and compared different methods of nutritional assessment. Methods In a cross-sectional study conducted in 2014 at Roskilde Hospital, Denmark, we performed anthropometry (body weight, skinfolds, mid-arm, waist, and hip circumferences), and determined plasma albumin and normalized protein catabolic rate in order to assess the prevalence of protein-energy wasting, low lean body mass index and obesity in these patients. Results Seventy-nine eligible maintenance dialysis patients participated. The prevalence of protein-energy wasted patients was 4% (95% CI: 2–12) as assessed by the coexistence of low lean body mass index and low fat mass index. Low lean body mass index was seen in 32% (95% CI: 22–44). Obesity prevalence as assessed from fat mass index was 43% (95% CI: 32–55). Coexistence of low lean body mass index and obesity was seen in 10% (95% CI: 5–19). The prevalence of protein-energy wasting and obesity varied considerably, depending on nutritional assessment methodology. Conclusions Our data indicate that protein-energy wasting is uncommon, whereas low lean body mass index and obesity are frequent conditions among patients in maintenance dialysis. A focus on how to increase and preserve lean body mass in dialysis patients is suggested in the future. In order to clearly distinguish between shortage, sufficiency and abundance of protein and/or fat deposits in maintenance dialysis patients, we suggest the simple measurements of lean body mass index and fat mass index. PMID:26919440

  19. [Assessment of the nutritional status of Brazilian adolescents by body mass index].

    PubMed

    Sichieri, R; Allam, V L

    1996-01-01

    The assessment of nutritional status of adolescents is not an easy task because it should take into account sex, age, weight, stature and sexual maturation of the adolescents. In addition, an adequate classification should also be related to subsequent health-related outcomes during adult life. On the other side, screening for overweight and underweight among adolescents is highly desirable since nutritional status during adolescence correlates with adult body habitus. The objective of this study was to propose a classification for screening the nutritional status of Brazilian adolescents based on the body mass index (kg/m(2)) provided by the Pesquisa Nacional sobre Saúde e Nutrição-PNSN, a national survey of the Brazilian population carried out on 1989. We defined as cutoff the 10th and 90th percentile of the body mass index distribution and the 10th percentile for stature.

  20. Body Mass Index, Nutrient Intakes, Health Behaviours and Nutrition Knowledge: A Quantile Regression Application in Taiwan

    ERIC Educational Resources Information Center

    Chen, Shih-Neng; Tseng, Jauling

    2010-01-01

    Objective: To assess various marginal effects of nutrient intakes, health behaviours and nutrition knowledge on the entire distribution of body mass index (BMI) across individuals. Design: Quantitative and distributional study. Setting: Taiwan. Methods: This study applies Becker's (1965) model of health production to construct an individual's BMI…

  1. Body Mass Index, Nutrient Intakes, Health Behaviours and Nutrition Knowledge: A Quantile Regression Application in Taiwan

    ERIC Educational Resources Information Center

    Chen, Shih-Neng; Tseng, Jauling

    2010-01-01

    Objective: To assess various marginal effects of nutrient intakes, health behaviours and nutrition knowledge on the entire distribution of body mass index (BMI) across individuals. Design: Quantitative and distributional study. Setting: Taiwan. Methods: This study applies Becker's (1965) model of health production to construct an individual's BMI…

  2. Evidence Report: Risk Factor of Inadequate Nutrition

    NASA Technical Reports Server (NTRS)

    Smith, Scott M.; Zwart, Sara R.; Heer, Martina

    2015-01-01

    The importance of nutrition in exploration has been documented repeatedly throughout history, where, for example, in the period between Columbus' voyage in 1492 and the invention of the steam engine, scurvy resulted in more sailor deaths than all other causes of death combined. Because nutrients are required for the structure and function of every cell and every system in the body, defining the nutrient requirements for spaceflight and ensuring provision and intake of those nutrients are primary issues for crew health and mission success. Unique aspects of nutrition during space travel include the overarching physiological adaptation to weightlessness, psychological adaptation to extreme and remote environments, and the ability of nutrition and nutrients to serve as countermeasures to ameliorate the negative effects of spaceflight on the human body. Key areas of clinical concern for long-duration spaceflight include loss of body mass (general inadequate food intake), bone and muscle loss, cardiovascular and immune system decrements, increased radiation exposure and oxidative stress, vision and ophthalmic changes, behavior and performance, nutrient supply during extravehicular activity, and general depletion of body nutrient stores because of inadequate food supply, inadequate food intake, increased metabolism, and/or irreversible loss of nutrients. These topics are reviewed herein, based on the current gap structure.

  3. Nutritional risk and anthropometric evaluation in pediatric liver transplantation

    PubMed Central

    Zamberlan, Patrícia; Leone, Cláudio; Tannuri, Uenis; de Carvalho, Werther Brunow; Delgado, Artur Figueiredo

    2012-01-01

    OBJECTIVE: To analyze the nutritional status of pediatric patients after orthotopic liver transplantation and the relationship with short-term clinical outcome. METHOD: Anthropometric evaluations of 60 children and adolescents after orthotopic liver transplantation, during the first 24 hours in a tertiary pediatric intensive care unit. Nutritional status was determined from the Z score for the following indices: weight/age, height/age or length/age, weight/height or weight/length, body mass index/age, arm circumference/age and triceps skinfold/age. The severity of liver disease was evaluated using one of the two models which was adequated to the patients' age: 1. Pediatric End-stage Liver Disease, 2. Model for End-Stage Liver Disease. RESULTS: We found 50.0% undernutrition by height/age; 27.3% by weight/age; 11.1% by weight/height or weight/length; 10.0% by body mass index/age; 61.6% by arm circumference/age and 51.0% by triceps skinfold/age. There was no correlation between nutritional status and Pediatric End-stage Liver Disease or mortality. We found a negative correlation between arm circumference/age and length of hospitalization. CONCLUSION: Children with chronic liver diseases experience a significant degree of undernutrition, which makes nutritional support an important aspect of therapy. Despite the difficulties in assessment, anthropometric evaluation of the upper limbs is useful to evaluate nutritional status of children before or after liver transplantation. PMID:23295591

  4. Mother's body mass index as a predictor of infant's nutritional status in the post-emergency phase of a flood.

    PubMed

    Goudet, Sophie; Griffths, Paula; Bogin, Barry A

    2011-10-01

    Maternal nutritional status is a determinant of child health. This paper studies the association between a mother's body mass index (BMI) and her infant's nutritional status over a one year time frame after the 1998 flood crisis in Bangladesh. The paper uses secondary analysis of data collected from 757 households in seven rural areas of Bangladesh affected by the 1998 flood using multiple-stage probability sampling techniques (n = 143). Logistic regression models were employed to investigate the predictive impact of maternal BMI on infant's nutritional status after controlling for a range of child and maternal factors. An underweight mother was a significant factor with regard to the risk of infants suffering stunting (odds ratio (OR) = 4.45, 95 per cent confidence interval (CI) = 1.04-18.94) and being underweight (OR = 3.51, 95 per cent CI = 1.02-12.05) a year later, but not wasting (OR = 2.09, 95 per cent CI = 0.51-8.67). The findings suggest that there is a post-emergency link between maternal and infant nutritional health. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

  5. Nutritional risk in allogeneic stem cell transplantation: rationale for a tailored nutritional pathway.

    PubMed

    Aoyama, Takashi; Imataki, Osamu; Mori, Keita; Yoshitsugu, Kanako; Fukaya, Masafumi; Okamura, Ikue; Enami, Terukazu; Tatara, Raine; Ikeda, Takashi

    2017-04-01

    Hematopoietic stem cell transplantation carries nutrition-related risks. Therefore, nutritional therapy needs to be initiated before transplantation even takes place. We assessed nutritional risk among patients who underwent allogeneic stem cell transplantation. We assessed nutrient supply (calorie supply and protein supply) by chart review. Assessments were made from the pretreatment phase of transplantation to after the end of parenteral nutrition in 51 patients who underwent allogeneic stem cell transplantation at Shizuoka Cancer Center between 2007 and 2012. We compared nutrition-related adverse events and parameters between two groups: those in whom % loss of body weight was ≥7.5 and those in whom % loss of body weight was <7.5. A correlation was observed between changes in weight and skeletal muscle mass (r = 0.89; P < 0.0001). A weak correlation was observed between % loss of body weight and nutrient supply of calories (r = 0.517; P = 0.0001). There were significant differences between the % loss of body weight ≥7.5 group and the % loss of body weight <7.5 group in the following variables: % loss of body weight, nutrient supply from calories and protein; orally ingested nutrient supply from calories and protein; start day of oral intake; and acute graft-versus-host disease. Orally ingested calories were negatively correlated with nutrition-related adverse events in both groups. Early and customized nutritional intervention may be optimal for all patients who undergo allogeneic stem cell transplantation to ameliorate body weight loss associated with nutrition-related adverse events.

  6. [Nutritional risk evaluation and establishment of nutritional support in oncology patients according to the protocol of the Spanish Nutrition and Cancer Group].

    PubMed

    Marín Caro, M M; Gómez Candela, C; Castillo Rabaneda, R; Lourenço Nogueira, T; García Huerta, M; Loria Kohen, V; Villarino Sanz, M; Zamora Auñón, P; Luengo Pérez, L; Robledo Sáenz, P; López-Portabella, C; Zarazaga Monzón, A; Espinosa Rojas, J; Nogués Boqueras, Raquel; Rodríguez Suárez, L; Celaya Pérez, S; Pardo Masferrer, J

    2008-01-01

    Cancer and its oncological treatment cause symptoms which increase the patients risk to suffer from malnutrition. This affects the patients health status negatively by increasing the number of complications, reducing the tolerance to the oncology treatment and a decrease of the patients quality of life. Motivated by this, a group of health professionals from several spanish regions met with the backing of the Sociedad Española de Nutrición Básica y Aplicada (SENBA) to address strategies to improve the quality of nutritional intervention in cancer patients. This multidisciplinary group developed a protocol describing nutritional assessment and intervention in form of algorithms based on literature and personal experience. The patients are classified in a three step process: 1. type of their oncology treatment (curative or palliative); 2. nutritional risk of the antineoplastic therapy (low, medium or high risk) and 3. depending on the Subjective Global Assessment patient-generated (SGA-pg). The patients are classified as: A. patients with adequate nutritional state, B. patients with malnutrition or risk of malnutrition and C. patients suffering from severe malnutrition. During one year, the protocol has been used for 226 randomly chosen female and male patients older than 18 years. They were treated by the Medical and Radiotherapy Oncology outpatient clinic. More than a half of the patients were suffering from malnutrition (64%) increasing up to 81% for patients undergoing palliative treatment. Most of them were treated curatively (83%) and received oncology treatment with moderate or high nutritional risk (69%). 68% of patients were affected by some feeding difficulty. The mean percentage of weight loss has been 6.64% +/- 0.87 (min 0%, max 33%). Albumin values of 32% of the patients were between 3 and 3.5 g/dl and negatively correlated with feeding difficulties (p = 0.001). The body mass index (BMI) has not found to be a significant parameter for detecting

  7. [Prevalence and prevention of common nutritional risks in children after earthquake].

    PubMed

    Fan, Chao-Nan

    2013-06-01

    Children have been identified as the most nutritionally vulnerable group when disaster happens. The most common nutritional risks include protein-energy malnutrition, iron-deficiency anemia, and trace element deficiency in children after earthquake. During the disaster relief, effective nutritional interventions should be performed according to the nutritional conditions of children in the affected area, so as to prevent the common nutritional risks. Timely diagnosis and treatment should be provided for children at a high risk of malnutrition.

  8. Sarcopenia as a prognostic index of nutritional status in concurrent cirrhosis and hepatocellular carcinoma.

    PubMed

    Meza-Junco, Judith; Montano-Loza, Aldo J; Baracos, Vickie E; Prado, Carla M M; Bain, Vincent G; Beaumont, Crystal; Esfandiari, Nina; Lieffers, Jessica R; Sawyer, Michael B

    2013-01-01

    Abnormal body composition such as severe skeletal muscle depletion or sarcopenia has emerged as an independent predictor of clinical outcomes in a variety of clinical conditions. This study is the first study to report the frequency and prognostic significance of sarcopenia as a marker of nutritional status in patients with hepatocellular carcinoma (HCC). We analyzed 116 patients with HCC who were consecutively evaluated for liver transplant. Skeletal muscle cross-sectional area was measured by CT. Sarcopenia was defined using previously established cutpoints. Ninety-eight patients were males (85%), and the mean age was 58±6 years. Sarcopenia was present in 35 patients (30%). By univariate Cox analysis, male sex (HR, 3.84; P=0.02), lumbar skeletal muscle index (HR, 0.97; P=0.04), INR (HR, 8.18; P<0.001), MELD score (HR, 1.19; P<0.001), Child-Pugh (HR, 3.95; P<0.001), serum sodium (HR, 0.84; P<0.001), TNM stage (HR, 2.59; P<0.001), treatment type (HR, 0.53; P<0.001), and sarcopenia (HR, 2.27; P=0.004) were associated with increased risks of mortality. By multivariate Cox regression analysis, only MELD score (HR, 1.08; P=0.04), Child-Pugh (HR, 2.14; P=0.005), sodium (HR, 0.89; P=0.01), TNM stage (HR, 1.92; P<0.001), and sarcopenia (HR, 2.04; P=0.02) were independently associated with mortality. Median survival for sarcopenic patients was 16±6 versus 28±3 months in nonsarcopenic (P=0.003). Sarcopenia is present in almost one third of patients with HCC, and constitutes a strong and independent risk factor for mortality. Our results highlight the importance of body composition assessment in clinical practice.

  9. Validation of the nutrition screening tool 'Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II' among octogenarians.

    PubMed

    Wham, C A; Redwood, K M; Kerse, N

    2014-01-01

    To determine the validity of the nutrition screening tool 'Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II' (SCREEN II) among a purposive sample of octogenarians. Cross-sectional validation study. Bay of Plenty, New Zealand. Forty-five community-living residents aged 85-86 years. Equal proportions of participants were recruited at low, medium and high nutrition risk based on their SCREEN II score 12 months prior. Nutrition risk was assessed using SCREEN II. Demographic and health data were established. Using established criterion a dietitian's nutrition risk rating assessment ranked participants from low risk (score of 1) to high risk (score of 10). The assessment included a medical history, anthropometric measures and dietary intake. Dietary intake was established from three 24 hour multiple pass recalls (MPR). A Spearman's correlation determined the association between the SCREEN II score and the dietitian's risk score. Receiver operating characteristic (ROC) curves were completed to determine the sensitivity and specificity of the cut-off point for high nutrition risk. The SCREEN II score was significantly correlated with the dietitian's risk rating (rs = -0.76 (p<0.01). A newly defined cut-off point <49 was established for high nutrition risk derived from ROC curves and AUC (0.87, p < 0.01); sensitivity 90% and specificity 86%. SCREEN II is a simple, easy to use, 14 item questionnaire and appears to be a valid tool for detection of nutrition risk people aged 85-86 years.

  10. Analysis on nutritional risk screening and influencing factors of hospitalized patients in central urban area.

    PubMed

    Li, Su-Yun; Yu, Jiao-Hua; Diao, Zhao-Feng; Zeng, Li; Zeng, Min-Jie; Shen, Xiao-Fang; Zhang, Lin; Shi, Wen-Jia; Ke, Hui; Wang, Huan; Zhang, Xian-Na

    2017-08-01

    Rational nutritional support shall be based on nutritional screening and nutritional assessment. This study is aimed to explore nutritional risk screening and its influencing factors of hospitalized patients in central urban area. It is helpful for the early detection of problems in nutritional supports, nutrition management and the implementation of intervention measures, which will contribute a lot to improving the patient's poor clinical outcome. A total of three tertiary medical institutions were enrolled in this study. From October 2015 to June 2016, 1202 hospitalized patients aged ≥18 years were enrolled in Nutrition Risk Screening 2002 (NRS2002) for nutritional risk screening, including 8 cases who refused to participate, 5 cases of same-day surgery and 5 cases of coma. A single-factor chi-square test was performed on 312 patients with nutritional risk and 872 hospitalized patients without nutritional risk. Logistic regression analysis was performed with univariate analysis (P<0.05), to investigate the incidence of nutritional risk and influencing factors. The incidence of nutritional risk was 26.35% in the inpatients, 25.90% in male and 26.84% in female, respectively. The single-factor analysis showed that the age ≥60, sleeping disorder, fasting, intraoperative bleeding, the surgery in recent month, digestive diseases, metabolic diseases and endocrine system diseases had significant effects on nutritional risk (P<0.05). Having considered the above-mentioned factors as independent variables and nutritional risk (Y=1, N=0) as dependent variable, logistic regression analysis revealed that the age ≥60, fasting, sleeping disorders, the surgery in recent month and digestive diseases are hazardous factors for nutritional risk. Nutritional risk exists in hospitalized patients in central urban areas. Nutritional risk screening should be conducted for inpatients. Nutritional intervention programs should be formulated in consideration of those influencing

  11. The Significance of the Prognostic Nutritional Index in Patients with Completely Resected Non-Small Cell Lung Cancer

    PubMed Central

    Mori, Shunsuke; Usami, Noriyasu; Fukumoto, Koichi; Mizuno, Tetsuya; Kuroda, Hiroaki; Sakakura, Noriaki; Yokoi, Kohei; Sakao, Yukinori

    2015-01-01

    Objectives Immunological parameters and nutritional status influence the outcome of patients with malignant tumors. A prognostic nutritional index, calculated using serum albumin levels and peripheral lymphocyte count, has been used to assess prognosis for various cancers. This study aimed to investigate whether this prognostic nutritional index affects overall survival and the incidence of postoperative complications in patients with completely resected non-small cell lung cancer. Methods We retrospectively reviewed the medical records of 409 patients with non-small cell lung cancer who underwent complete resection between 2005 and 2007 at the Aichi Cancer Center. Results The 5-year survival rates of patients with high (≥50) and low (<50) prognostic nutritional indices were 84.4% and 70.7%, respectively (p = 0.0011). Univariate analysis showed that gender, histology, pathological stage, smoking history, serum carcinoembryonic antigen levels, and prognostic nutritional index were significant prognostic factors. Multivariate analysis identified pathological stage and the prognostic nutritional index as independent prognostic factors. The frequency of postoperative complications tended to be higher in patients with a low prognostic nutritional index. Conclusions The prognostic nutritional index is an independent prognostic factor for survival of patients with completely resected non-small cell lung cancer. PMID:26356222

  12. Nutritional metabolomics and breast cancer risk in a prospective study.

    PubMed

    Playdon, Mary C; Ziegler, Regina G; Sampson, Joshua N; Stolzenberg-Solomon, Rachael; Thompson, Henry J; Irwin, Melinda L; Mayne, Susan T; Hoover, Robert N; Moore, Steven C

    2017-08-01

    Background: The epidemiologic evidence for associations between dietary factors and breast cancer is weak and etiologic mechanisms are often unclear. Exploring the role of dietary biomarkers with metabolomics can potentially facilitate objective dietary characterization, mitigate errors related to self-reported diet, agnostically test metabolic pathways, and identify mechanistic mediators.Objective: The aim of this study was to evaluate associations of diet-related metabolites with the risk of breast cancer in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial.Design: We examined prediagnostic serum concentrations of diet-related metabolites in a nested case-control study in 621 postmenopausal invasive breast cancer cases and 621 matched controls in the multicenter PLCO cohort. We calculated partial Pearson correlations between 617 metabolites and 55 foods, food groups, and vitamin supplements on the basis of the 2015 Dietary Guidelines for Americans and derived from a 137-item self-administered food-frequency questionnaire. Diet-related metabolites (P-correlation < 1.47 × 10(-6)) were evaluated in breast cancer analyses. ORs for the 90th compared with the 10th percentile were calculated by using conditional logistic regression, with body mass index, physical inactivity, other breast cancer risk factors, and caloric intake controlled for (false discovery rate <0.2).Results: Of 113 diet-related metabolites, 3 were associated with overall breast cancer risk (621 cases): caprate (10:0), a saturated fatty acid (OR: 1.77; 95% CI = 1.28, 2.43); γ-carboxyethyl hydrochroman (γ-CEHC), a vitamin E (γ-tocopherol) derivative (OR: 1.64; 95% CI: 1.18, 2.28); and 4-androsten-3β,17β-diol-monosulfate (1), an androgen (OR: 1.61; 95% CI: 1.20, 2.16). Nineteen metabolites were significantly associated with estrogen receptor (ER)-positive (ER(+)) breast cancer (418 cases): 12 alcohol-associated metabolites, including 7 androgens and α-hydroxyisovalerate (OR

  13. WHO European Childhood Obesity Surveillance Initiative: School nutrition environment and body mass index in primary schools.

    PubMed

    Wijnhoven, Trudy M A; van Raaij, Joop M A; Sjöberg, Agneta; Eldin, Nazih; Yngve, Agneta; Kunešová, Marie; Starc, Gregor; Rito, Ana I; Duleva, Vesselka; Hassapidou, Maria; Martos, Eva; Pudule, Iveta; Petrauskiene, Ausra; Sant'Angelo, Victoria Farrugia; Hovengen, Ragnhild; Breda, João

    2014-10-30

    Schools are important settings for the promotion of a healthy diet and sufficient physical activity and thus overweight prevention. To assess differences in school nutrition environment and body mass index (BMI) in primary schools between and within 12 European countries. Data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) were used (1831 and 2045 schools in 2007/2008 and 2009/2010, respectively). School personnel provided information on 18 school environmental characteristics on nutrition and physical activity. A school nutrition environment score was calculated using five nutrition-related characteristics whereby higher scores correspond to higher support for a healthy school nutrition environment. Trained field workers measured children's weight and height; BMI-for-age (BMI/A) Z-scores were computed using the 2007 WHO growth reference and, for each school, the mean of the children's BMI/A Z-scores was calculated. Large between-country differences were found in the availability of food items on the premises (e.g., fresh fruit could be obtained in 12%-95% of schools) and school nutrition environment scores (range: 0.30-0.93). Low-score countries (Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania) graded less than three characteristics as supportive. High-score (≥0.70) countries were Ireland, Malta, Norway, Portugal, Slovenia and Sweden. The combined absence of cold drinks containing sugar, sweet snacks and salted snacks were more observed in high-score countries than in low-score countries. Largest within-country school nutrition environment scores were found in Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania. All country-level BMI/A Z-scores were positive (range: 0.20-1.02), indicating higher BMI values than the 2007 WHO growth reference. With the exception of Norway and Sweden, a country-specific association between the school nutrition environment score and the school BMI/A Z

  14. WHO European Childhood Obesity Surveillance Initiative: School Nutrition Environment and Body Mass Index in Primary Schools

    PubMed Central

    Wijnhoven, Trudy M.A.; van Raaij, Joop M.A.; Sjöberg, Agneta; Eldin, Nazih; Yngve, Agneta; Kunešová, Marie; Starc, Gregor; Rito, Ana I.; Duleva, Vesselka; Hassapidou, Maria; Martos, Éva; Pudule, Iveta; Petrauskiene, Ausra; Farrugia Sant’Angelo, Victoria; Hovengen, Ragnhild; Breda, João

    2014-01-01

    Background: Schools are important settings for the promotion of a healthy diet and sufficient physical activity and thus overweight prevention. Objective: To assess differences in school nutrition environment and body mass index (BMI) in primary schools between and within 12 European countries. Methods: Data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) were used (1831 and 2045 schools in 2007/2008 and 2009/2010, respectively). School personnel provided information on 18 school environmental characteristics on nutrition and physical activity. A school nutrition environment score was calculated using five nutrition-related characteristics whereby higher scores correspond to higher support for a healthy school nutrition environment. Trained field workers measured children’s weight and height; BMI-for-age (BMI/A) Z-scores were computed using the 2007 WHO growth reference and, for each school, the mean of the children’s BMI/A Z-scores was calculated. Results: Large between-country differences were found in the availability of food items on the premises (e.g., fresh fruit could be obtained in 12%−95% of schools) and school nutrition environment scores (range: 0.30−0.93). Low-score countries (Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania) graded less than three characteristics as supportive. High-score (≥0.70) countries were Ireland, Malta, Norway, Portugal, Slovenia and Sweden. The combined absence of cold drinks containing sugar, sweet snacks and salted snacks were more observed in high-score countries than in low-score countries. Largest within-country school nutrition environment scores were found in Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania. All country-level BMI/A Z-scores were positive (range: 0.20−1.02), indicating higher BMI values than the 2007 WHO growth reference. With the exception of Norway and Sweden, a country-specific association between the school

  15. [Effects of neonatal nutritional status on the risk for metabolic syndrome in Chilean obese children].

    PubMed

    Sapunar, Jorge; Bustos, Paulina; Sáez, Katia; Muñoz, Sergio; Asenjo, Sylvia

    2014-12-01

    Neonatal malnutrition defined by birth weight (BW) is a risk factor for obesity and cardio-metabolic diseases in adults. Neonatal ponderal index (NPI) may have better diagnostic value than BW to establish nutritional status. To determine the effect of neonatal nutritional status, established by the three NPI curves available in Chile, on the risk of Metabolic Syndrome (MS) in obese school children. A nested case/control study in a sample of 410 obese school children aged 10 to 16 years (57% males) was performed. The dichotomous response variable was the presence of MS defined as International Diabetes Federation (IDF) or Cook's criteria. The exposure variable was having NPI < percentile (p) 10. The frequency of MS was 36 and 39% according to the IDF and Cook criteria, respectively. The proportion of children with neonatal malnutrition exceeded 20%. A significantly increased risk for MS was only found when PNI was defined according to Lagos's Table and MS was defined using IDF criteria. Having a PNI > p90, however, showed a trend towards a reduced risk of MS, which only reached significance using Lagos's Table and Cook's Criteria. Neonatal malnutrition defined by NPI is common in obese school children. The condition of neonatal under nutrition defined as PNI < p10 may be a risk factor for developing MS. Instead, having a NPI > p90 could be protective.

  16. Nutrition and Gastric Cancer Risk: An Update

    USDA-ARS?s Scientific Manuscript database

    Data from epidemiologic, experimental, and animal studies indicate that diet plays an important role in the etiology of gastric cancer. High intake of fresh fruit and vegetable, lycopene and lycopene-containing food products, and potentially vitamin C and selenium may reduce the risk for gastric can...

  17. Prenatal Nutritional Deficiency and Risk of Adult Schizophrenia

    PubMed Central

    Brown, Alan S.; Susser, Ezra S.

    2008-01-01

    Converging evidence suggests that a neurodevelopmental disruption plays a role in the vulnerability to schizophrenia. The authors review evidence supporting in utero exposure to nutritional deficiency as a determinant of schizophrenia. We first describe studies demonstrating that early gestational exposure to the Dutch Hunger Winter of 1944–1945 and to a severe famine in China are each associated with an increased risk of schizophrenia in offspring. The plausibility of several candidate micronutrients as potential risk factors for schizophrenia and the biological mechanisms that may underlie these associations are then reviewed. These nutrients include folate, essential fatty acids, retinoids, vitamin D, and iron. Following this discussion, we describe the methodology and results of an epidemiologic study based on a large birth cohort that has tested the association between prenatal homocysteine, an indicator of serum folate, and schizophrenia risk. The study capitalized on the use of archived prenatal serum specimens that make it possible to obtain direct, prospective biomarkers of prenatal insults, including levels of various nutrients during pregnancy. Finally, we discuss several strategies for subjecting the prenatal nutritional hypothesis of schizophrenia to further testing. These approaches include direct assessment of additional prenatal nutritional biomarkers in relation to schizophrenia in large birth cohorts, studies of epigenetic effects of prenatal starvation, association studies of genes relevant to folate and other micronutrient deficiencies, and animal models. Given the relatively high prevalence of nutritional deficiencies during pregnancy, this work has the potential to offer substantial benefits for the prevention of schizophrenia in the population. PMID:18682377

  18. A nutritionally mediated risk effect of wolves on elk.

    PubMed

    Christianson, David; Creel, Scott

    2010-04-01

    Though it is widely argued that antipredator responses carry nutritional costs, or risk effects, these costs are rarely measured in wild populations. To quantify risk effects in elk, a species that strongly responds to the presence of wolves, we noninvasively monitored diet selection and nutrient balance in wintering elk in the Upper Gallatin, Montana, USA, over three winters while quantifying the local presence of wolves at a fine spatiotemporal scale. Standard nutritional indices based on the botanical and chemical composition of 786 fecal samples, 606 snow urine samples, and 224 forage samples showed that elk were generally malnourished throughout winter. Increased selection for dietary nitrogen within forage types (e.g., grasses) led to approximately 8% higher fecal nitrogen in the presence of wolves. However, urinary allantoin : creatinine and potassium : creatinine ratios decreased in the presence of wolves, suggesting large declines in energy intake, equal to 27% of maintenance requirements. Urinary nitrogen : creatinine ratios confirmed that deficiencies in nitrogen and/or energy were exacerbated in the presence of wolves, leading to increased endogenous protein catabolism. Overall, the nutritional effects of wolf presence may be of sufficient magnitude to reduce survival and reproduction in wintering elk. Nutritionally mediated risk effects may be important for understanding predator-prey dynamics in wild populations, but such effects could be masked as bottom-up forces if antipredator responses are not considered.

  19. Stability of the Framingham Nutritional Risk Score and its component nutrients over 8 years: the Framingham Nutrition Studies.

    PubMed

    Kimokoti, R W; Newby, P K; Gona, P; Zhu, L; Campbell, W R; D'Agostino, R B; Millen, B E

    2012-03-01

    Diet quality indices are increasingly used in nutrition epidemiology as dietary exposures in relation to health outcomes. However, literature on the long-term stability of these indices is limited. We aimed to assess the stability of the validated Framingham Nutritional Risk Score (FNRS) and its component nutrients over 8 years, as well as the validity of the follow-up FNRS. Framingham Offspring/Spouse Study women and men (n=1734) aged 22-76 years were evaluated over 8 years. Individuals' nutrient intake and nutritional risk scores were assessed using 3-day dietary records administered at baseline (1984-1988) and at follow-up (1992-1996). Agreement between baseline and follow-up FNRS and nutrient intakes was evaluated by Bland-Altman method; stability was assessed using intra-class correlation (ICC) and weighted Kappa statistics. The effect of diet quality (as assessed by the FNRS) on cardiometabolic risk factors was evaluated using analysis of covariance. Modest changes from baseline (15%) were observed in nutrient intake. The stability coefficients for the FNRS (ICC: women, 0.49; men, 0.46; P<0.0001) and many nutrients (ICC 0.3) were moderate. Over half of the women and men (58%) remained in the same or contiguous baseline and follow-up quartile of the FNRS and few (3-4%) shifted >1 quartile. The FNRS was directly associated with body mass index in women (P<0.01) and high-density lipoprotein cholesterol among both women (P<0.001) and men (P<0.01). The FNRS and its constituent nutrients remained relatively stable over 8 years of follow-up. The stability of diet quality has implications for prospective epidemiological investigations.

  20. Added sugar, glycemic index and load in colon cancer risk.

    PubMed

    Galeone, Carlotta; Pelucchi, Claudio; La Vecchia, Carlo

    2012-07-01

    There is a growing body of in-vivo evidences that sucrose-rich diets cause mutations in the rat colon epithelium, with several biological mechanism hypothesized, but epidemiological studies have yielded conflicting results. In order to provide a quantification of the magnitude of the risk of colon cancer for high intake of added sugar, high dietary glycemic index and glycemic load, we performed a meta-analysis based on a systematic review of the literature to date. Recent epidemiological data indicate a lack of association between high intake of added sugar, high-glycemic index and glycemic load diets and risk of colon cancer. There is no consistent evidence from epidemiological studies, although a modest excess risk emerged in case-control studies, that added sugars, dietary glycemic index and glycemic load are associated with increased risk of colon cancer, independently from their effect on energy intake, overweight, obesity and diabetes, which are related to excess colon cancer risk.

  1. Nutritional Status and Tuberculosis Risk in Adult and Pediatric Household Contacts

    PubMed Central

    Acharya, Xeno; Huang, Chuan-Chin; Becerra, Mercedes C.; Galea, Jerome T.; Chiang, Silvia S.; Contreras, Carmen; Calderon, Roger; Yataco, Rosa; Velásquez, Gustavo E.; Tintaya, Karen; Jimenez, Judith; Lecca, Leonid; Murray, Megan B.

    2016-01-01

    Background Studies show obesity decreases risk of tuberculosis (TB) disease. There is limited evidence on whether high body mass index also protects against TB infection; how very high body mass indices influence TB risk; or whether nutritional status predicts this risk in children. We assessed the impact of body mass index on incident TB infection and disease among adults and children. Methods and Findings We conducted a prospective cohort study among household contacts of pulmonary TB cases in Lima, Peru. We determined body mass index at baseline and followed participants for one year for TB infection and disease. We used Cox proportional regression analyses to estimate hazard ratios for incident TB infection and disease. We enrolled 14,044 household contacts, and among 6853 negative for TB infection and disease at baseline, 1787 (26.1%) became infected. A total of 406 contacts developed secondary TB disease during follow-up. Body mass index did not predict risk of TB infection but overweight household contacts had significantly decreased risk of TB disease (HR 0.48; 95% CI 0.37–0.64; p <0.001) compared to those with normal weight. Among adults, body mass index ≥ 35 kg/m2 continued to predict a lower risk of TB disease (HR 0.30; 95% CI 0.12–0.74; p 0.009). We found no association between high body mass index and TB infection or disease among children under 12 years of age. Conclusions High body mass index protects adults against TB disease even at levels ≥ 35 kg/m2. This protective effect does not extend to TB infection and is not seen in children. PMID:27835678

  2. [Effectiveness of the Body Mass Index in the nutritional diagnosis of pregnant adolescents].

    PubMed

    Rached-Paoli, Ingrid; Henriquez-Pérez, Gladys

    2010-06-01

    The purpose of this study was to analyze the diagnostic capacity of different classification criteria based on Body Mass Index in the assessment of nutritional status and to evaluate their effectiveness. The sample comprised 367 healthy pregnant adolescents in their first trimester of gestation, from a socioeconomic level IV, between Oct. 1999 and Dec. 2008. Two methodologies were applied for the nutritional classification: (1) Integral nutritional diagnosis (gold standard), and (2) Body Mass Index (BMI), using local reference values: Proyecto Venezuela and the Transversal Study of Caracas, and international reference values: Frisancho and WHO 2006. Concordances, kappa, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and the Youden index were calculated. According to the gold standard and BMI, the percentage of well-nourished pregnant women ranged between 62.4% and 80.6%. Within the deficit range, Frisancho was the most effective with kappa: 0.80; sensitivity: 87.3%; specificity: 94.8%; positive likelihood ratio: 16.9, and negative likelihood ratio: 0.13; Youden index: 0.82. Within the excess range, Frisancho and the Transversal Study of Caracas were the most effective with Youden index: 0.86 and 0.83, respectively. These results revealed that Frisancho was the best criterion to diagnose malnutrition in deficit in pregnant women. All references have an adequate diagnostic capacity for the excess range, of which Frisancho and the Transversal Study of Caracas are the best. We recommend using such reference values to optimize the efficiency of the BMI indicator in diagnosing malnutrition in deficit and in excess in the first trimester of gestation in pregnant adolescents within populations with similar characteristics.

  3. Creating a school nutrition environment index and pilot testing it in elementary and middle schools in urban South Korea

    PubMed Central

    Kwon, Kwang-il; Kweon, Soon Ju; Wang, Youfa; Gittelsohn, Joel

    2017-01-01

    BACKGROUND/OBJECTIVES The role of a school's nutrition environment in explaining students' eating behaviors and weight status has not been examined in an Asian setting. The purpose of this study was to create a school nutrition environment index and to pilot test the index in elementary and middle schools in urban South Korea. SUBJECTS/METHODS This study used a mixed-methods approach. Environment assessment tools were developed based on formative research, which comprised literature reviews, in-depth interviews, and focus group discussions. Key elements from the formative research were included in the assessment tool, which consisted of a structured survey questionnaire for school dietitians. Fifteen school dietitians from 7 elementary and 8 middle schools in Seoul completed the questionnaire. RESULTS The formative research revealed four main sections that guided a summary index to assess a school's nutrition environment: resource availability, education and programs, dietitians' perceptions and characteristics, and school lunch menu. Based on the literature reviews and interviews, an index scoring system was developed. The total possible score from the combined four index sections was 40 points. From the 15 schools participating in the pilot survey, the mean school nutrition-environment index was 22.5 (standard deviation ± 3.2; range 17-28). The majority of the schools did not offer classroom-based nutrition education or nutrition counseling for students and parents. The popular modes of nutrition education were school websites, posters, and newsletters. CONCLUSIONS This paper illustrates the process used to develop an instrument to assess a school's nutrition environment. Moreover, it presents the steps used to develop a scoring system for creation of a school nutrition environment index. As pilot testing indicated the total index score has some variation across schools, we suggest applying this instrument in future studies involving a larger number of schools

  4. Creating a school nutrition environment index and pilot testing it in elementary and middle schools in urban South Korea.

    PubMed

    Park, Sohyun; Kwon, Kwang-Il; Kweon, Soon Ju; Wang, Youfa; Gittelsohn, Joel

    2017-10-01

    The role of a school's nutrition environment in explaining students' eating behaviors and weight status has not been examined in an Asian setting. The purpose of this study was to create a school nutrition environment index and to pilot test the index in elementary and middle schools in urban South Korea. This study used a mixed-methods approach. Environment assessment tools were developed based on formative research, which comprised literature reviews, in-depth interviews, and focus group discussions. Key elements from the formative research were included in the assessment tool, which consisted of a structured survey questionnaire for school dietitians. Fifteen school dietitians from 7 elementary and 8 middle schools in Seoul completed the questionnaire. The formative research revealed four main sections that guided a summary index to assess a school's nutrition environment: resource availability, education and programs, dietitians' perceptions and characteristics, and school lunch menu. Based on the literature reviews and interviews, an index scoring system was developed. The total possible score from the combined four index sections was 40 points. From the 15 schools participating in the pilot survey, the mean school nutrition-environment index was 22.5 (standard deviation ± 3.2; range 17-28). The majority of the schools did not offer classroom-based nutrition education or nutrition counseling for students and parents. The popular modes of nutrition education were school websites, posters, and newsletters. This paper illustrates the process used to develop an instrument to assess a school's nutrition environment. Moreover, it presents the steps used to develop a scoring system for creation of a school nutrition environment index. As pilot testing indicated the total index score has some variation across schools, we suggest applying this instrument in future studies involving a larger number of schools. Future studies with larger samples will allow investigation

  5. Growth and nutritional risk in children with developmental delay.

    PubMed

    Malone, C; Sharif, F; Glennon-Slattery, C

    2016-11-01

    Nutritional risk impacts outcome in developmental delay. The main objectives were to identify the incidence and factors contributing to growth faltering. Clinical data review was completed for 500 patients with developmental delay accepted to an Early Intervention service. Data was collected using the standardised parent nutrition screening checklist prior to and at time of initial dietary assessment. Data was compared to nutritional assessment data, GOSH and FSAI dietary guidelines. Weight category was determined using RCPCH growth and BMI charts. Statistical analysis was conducted using Statistical Package for the Social Sciences version 20 (IBM Statistics 20.0). Nutritional risk was identified in 48.6 %. Weight categories were growth faltering (13.5 %), underweight (7.7 %), overweight (8.4 %) and obesity (4.3 %) at initial assessment. Growth faltering was correlated with age <1 year (p = 0.000) and with gestational age (p = 0.017) with highest rates identified in those born 32-36 weeks (3.6 %). Weight category was associated with introduction of solids pre 17 weeks recommendation (10.1 %), ANOVA demonstrating significance (P = 0.013). There was poor parental recognition of nutritional risk in 22.7 % of those assessed. Nutritional difficulties were common: 4.2 % were enterally fed, 7.7 % were on prescribed nutritional supplements, 29.1 % (n = 121) had feeding difficulties and 13.9 % (n = 58) had behavioural feeding difficulties. Iron intake did not meet the recommended intake in 20.9 % (n = 87), calcium in 4.5 % (n = 19). The prevalence of constipation was 21.6, 11.8 % of whom required medical management. Developmental delay predisposes to nutritional deficits which influence outcome. Screening, assessment and timely interventions are warranted to prevent poorer developmental outcomes.

  6. Preoperative prognostic nutritional index predicts postoperative surgical site infections in gastrointestinal fistula patients undergoing bowel resections

    PubMed Central

    Hu, Qiongyuan; Wang, Gefei; Ren, Jianan; Ren, Huajian; Li, Guanwei; Wu, Xiuwen; Gu, Guosheng; Li, Ranran; Guo, Kun; Deng, Youming; Li, Yuan; Hong, Zhiwu; Wu, Lei; Li, Jieshou

    2016-01-01

    Abstract Recent studies have implied a prognostic value of the prognostic nutritional index (PNI) in postoperative septic complications of elective colorectal surgeries. However, the evaluation of PNI in contaminated surgeries for gastrointestinal (GI) fistula patients is lack of investigation. The purpose of this study was to explore the predictive value of PNI in surgical site infections (SSIs) for GI fistula patients undergoing bowel resections. A retrospective review of 290 GI patients who underwent intestinal resections between November 2012 and October 2015 was performed. Univariate and multivariate analyses were conducted to identify risk factors for SSIs, and receiver operating characteristic cure was used to quantify the effectiveness of PNI. SSIs were diagnosed in 99 (34.1%) patients, with incisional infection identified in 54 patients (18.6%), deep incisional infection in 13 (4.5%), and organ/space infection in 32 (11.0%). receiver operating characteristic curve analysis defined a PNI cut-off level of 45 corresponding to postoperative SSIs (area under the curve [AUC] = 0.72, 76% sensitivity, 55% specificity). Furthermore, a multivariate analysis indicated that the PNI < 45 [odd ratio (OR): 2.24, 95% confidence interval (CI): 1.09–4.61, P = 0.029] and leukocytosis (OR: 3.70, 95% CI: 1.02–13.42, P = 0.046) were independently associated with postoperative SSIs. Preoperative PNI is a simple and useful marker to predict SSIs in GI fistula patients after enterectomies. Measurement of PNI is therefore recommended in the routine assessment of patients with GI fistula receiving surgical treatment. PMID:27399098

  7. Fat-Free Mass Index for Evaluating the Nutritional Status and Disease Severity in COPD.

    PubMed

    Luo, Yuwen; Zhou, Luqian; Li, Yun; Guo, Songwen; Li, Xiuxia; Zheng, Jingjing; Zhu, Zhe; Chen, Yitai; Huang, Yuxia; Chen, Rui; Chen, Xin

    2016-05-01

    Despite the high prevalence of weight loss in subjects with COPD, the 2011 COPD management guidelines do not include an index measuring nutritional status. Fat-free mass index (FFMI) can accurately determine the nutritional status of subjects and may be closely correlated with COPD severity. We aimed to determine the nutritional status evaluated by FFMI according to the 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) levels in stable subjects with COPD and the association between nutritional status and respiratory symptoms, exercise capacity, and respiratory muscle function. We included 235 stable subjects with COPD in this cross-sectional study. All of the subjects were divided into the 2011 GOLD Groups A, B, C, and D. FFMI (measured by bioelectrical impedance), spirometry (FEV1, percent-of-predicted FEV1, and FEV1/FVC), respiratory muscle function (peak inspiratory and peak expiratory pressures), exercise capacity (6-min walk distance), and dyspnea severity (Modified Medical Research Council dyspnea scale) were measured and compared between the GOLD groups. Malnutrition was identified in 48.5% of subjects and most prevalent in Group D (Group A: 41%, Group B: 41%, Group C: 31%, and Group D: 62%). FFMI was significantly lower in Group D (P < .001), with both sexes considered malnourished. Low FFMI significantly correlated with frequent exacerbation, older age, decreased pulmonary function, 6-min walk distance, peak inspiratory pressure, and worsened dyspnea. FFMI was significantly lower in the emphysema-dominant phenotype and mixed phenotype compared with the normal phenotype and airway-dominant phenotype. A stepwise multiple linear regression analysis identified peak inspiratory pressures and older age as independent predictors of FFMI. Malnutrition is highly prevalent in all COPD groups, particularly in Group D subjects, who warrant special attention for nutritional intervention and pulmonary rehabilitation. FFMI significantly correlated with

  8. Relationship between nutritional risk and exercise capacity in severe chronic obstructive pulmonary disease in male patients

    PubMed Central

    Shan, Xizheng; Liu, Jinming; Luo, Yanrong; Xu, Xiaowen; Han, Zhiqing; Li, Hailing

    2015-01-01

    Objective The nutritional status of chronic obstructive pulmonary disease (COPD) patients is associated with their exercise capacity. In the present study, we have explored the relationship between nutritional risk and exercise capacity in severe male COPD patients. Methods A total of 58 severe COPD male patients were enrolled in this study. The patients were assigned to no nutritional risk group (n=33) and nutritional risk group (n=25) according to the Nutritional Risk Screening (NRS, 2002) criteria. Blood gas analysis, conventional pulmonary function testing, and cardiopulmonary exercise testing were performed on all the patients. Results Results showed that the weight and BMI of the patients in the nutritional risk group were significantly lower than in the no nutritional risk group (P<0.05). The pulmonary diffusing capacity for carbon monoxide of the no nutritional risk group was significantly higher than that of the nutritional risk group (P<0.05). Besides, the peak VO2 (peak oxygen uptake), peak O2 pulse (peak oxygen pulse), and peak load of the nutritional risk group were significantly lower than those of the no nutritional risk group (P<0.05) and there were significantly negative correlations between the NRS score and peak VO2, peak O2 pulse, or peak load (r<0, P<0.05). Conclusion The association between exercise capacity and nutritional risk based on NRS 2002 in severe COPD male patients is supported by these results of this study. PMID:26150712

  9. Relationship between nutritional risk and exercise capacity in severe chronic obstructive pulmonary disease in male patients.

    PubMed

    Shan, Xizheng; Liu, Jinming; Luo, Yanrong; Xu, Xiaowen; Han, Zhiqing; Li, Hailing

    2015-01-01

    The nutritional status of chronic obstructive pulmonary disease (COPD) patients is associated with their exercise capacity. In the present study, we have explored the relationship between nutritional risk and exercise capacity in severe male COPD patients. A total of 58 severe COPD male patients were enrolled in this study. The patients were assigned to no nutritional risk group (n=33) and nutritional risk group (n=25) according to the Nutritional Risk Screening (NRS, 2002) criteria. Blood gas analysis, conventional pulmonary function testing, and cardiopulmonary exercise testing were performed on all the patients. Results showed that the weight and BMI of the patients in the nutritional risk group were significantly lower than in the no nutritional risk group (P<0.05). The pulmonary diffusing capacity for carbon monoxide of the no nutritional risk group was significantly higher than that of the nutritional risk group (P<0.05). Besides, the peak VO2 (peak oxygen uptake), peak O2 pulse (peak oxygen pulse), and peak load of the nutritional risk group were significantly lower than those of the no nutritional risk group (P<0.05) and there were significantly negative correlations between the NRS score and peak VO2, peak O2 pulse, or peak load (r<0, P<0.05). The association between exercise capacity and nutritional risk based on NRS 2002 in severe COPD male patients is supported by these results of this study.

  10. Syncrude`s fire hazard index priorities risks

    SciTech Connect

    Kelly, B.

    1997-05-01

    To quantify fire hazard risks within large production facilities and help establish priorities for additional fire controls, Syncrude Canada Ltd. created a fire hazard index, to identify high-priority risks. The fire hazard index scoring system assigns a number score to each facility or work area. The numerical score represents the composite fire risk associated with the area of concern. The resulting scores are used as a comparative tool to determine which fire risks receive top priority for additional controls and fire inspections/surveys. Unlike other fire hazard indices, the Syncrude index can be used for all facilities regardless of whether they handle flammable material. As a result, the potential fire hazard associated with vehicles, shops, offices, computer rooms, and mechanical equipment can be assessed. 1 ref., 2 figs., 1 tab.

  11. Socio-Cognitive and Nutritional Factors Associated with Body Mass Index in Children and Adolescents: Possibilities for Childhood Obesity Prevention

    ERIC Educational Resources Information Center

    O'Dea, Jennifer A.; Wilson, Rachel

    2006-01-01

    A large national study of schoolchildren aged 6-18 years was conducted to assess nutritional and socio-cognitive factors associated with body mass index (BMI). A questionnaire was used to assess nutritional quality of breakfast, importance of physical activity and food variety score, among 4441 students from randomly selected schools in all states…

  12. Socio-Cognitive and Nutritional Factors Associated with Body Mass Index in Children and Adolescents: Possibilities for Childhood Obesity Prevention

    ERIC Educational Resources Information Center

    O'Dea, Jennifer A.; Wilson, Rachel

    2006-01-01

    A large national study of schoolchildren aged 6-18 years was conducted to assess nutritional and socio-cognitive factors associated with body mass index (BMI). A questionnaire was used to assess nutritional quality of breakfast, importance of physical activity and food variety score, among 4441 students from randomly selected schools in all states…

  13. Risk assessment of genetically modified crops for nutrition and health.

    PubMed

    Magaña-Gómez, Javier A; de la Barca, Ana M Calderón

    2009-01-01

    The risk assessment of genetically modified (GM) crops for human nutrition and health has not been systematic. Evaluations for each GM crop or trait have been conducted using different feeding periods, animal models, and parameters. The most common result is that GM and conventional sources induce similar nutritional performance and growth in animals. However, adverse microscopic and molecular effects of some GM foods in different organs or tissues have been reported. Diversity among the methods and results of the risk assessments reflects the complexity of the subject. While there are currently no standardized methods to evaluate the safety of GM foods, attempts towards harmonization are on the way. More scientific effort is necessary in order to build confidence in the evaluation and acceptance of GM foods.

  14. Nutritional yield: a proposed index for fresh food improvement illustrated with leafy vegetable data.

    PubMed

    Bumgarner, Natalie R; Scheerens, Joseph C; Kleinhenz, Matthew D

    2012-09-01

    Consumer interest in food products, including fresh vegetables, with health promoting properties is rising. In fresh vegetables, these properties include vitamins, minerals, dietary fiber, and secondary compounds, which collectively impart a large portion of the dietary, nutritional or health value associated with vegetable intake. Many, including farmers, aim to increase the health-promoting properties of fresh vegetables on the whole but they face at least three obstacles. First, describing crop composition in terms of its nutrition-based impact on human health is complex and there are few, if any, accepted processes and associated metrics for assessing and managing vegetable composition on-farm, at the origin of supply. Second, data suggest that primary and secondary metabolism can be 'in conflict' when establishing the abundance versus composition of a crop. Third, fresh vegetable farmers are rarely compensated for the phytochemical composition of their product. The development and implementation of a fresh vegetable 'nutritional yield' index could be instrumental in overcoming these obstacles. Nutritional yield is a function of crop biomass and tissue levels of health-related metabolites, including bioavailable antioxidant potential. Data from a multi-factor study of leaf lettuce primary and secondary metabolism and the literature suggest that antioxidant yield is sensitive to genetic and environmental production factors, and that changes in crop production and valuation will be required for fresh vegetable production systems to become more focused and purposeful instruments of public health.

  15. An Anthropometric Risk Index Based on Combining Height, Weight, Waist, and Hip Measurements

    PubMed Central

    2016-01-01

    Body mass index (BMI) can be considered an application of a power law model to express body weight independently of height. Based on the same power law principle, we previously introduced a body shape index (ABSI) to be independent of BMI and height. Here, we develop a new hip index (HI) whose normalized value is independent of height, BMI, and ABSI. Similar to BMI, HI demonstrates a U-shaped relationship to mortality in the Third National Health and Nutrition Examination Survey (NHANES III) population. We further develop a new anthropometric risk index (ARI) by adding log hazard ratios from separate nonlinear regressions of the four indicators, height, BMI, ABSI, and HI, against NHANES III mortality hazard. ARI far outperforms any of the individual indicators as a linear mortality predictor in NHANES III. The superior performance of ARI also holds for predicting mortality hazard in the independent Atherosclerosis Risk in Communities (ARIC) cohort. Thus, HI, along with BMI and ABSI, can capture the risk profile associated with body size and shape. These can be combined in a risk indicator that utilizes complementary information from height, weight, and waist and hip circumference. The combined ARI is promising for further research and clinical applications. PMID:27830087

  16. [Food and nutritional security in a risk area for malaria].

    PubMed

    Guzmán, Valentina; Correa, Adriana María; Carmona-Fonseca, Jaime; Blair, Silvia

    2003-09-01

    To explore some relationships between alimentary and nutritional security (SAN) and nutritional status in an endemic malaria community, applying qualitative and quantitative methods simultaneously. The study was descriptive and prospective. The population were all farming Afro-American families who live in the basin of the river Valle (Bahía Solano. Chocó, Colombia) that derived the base of their feeding of the agriculture. The SAN was measured from the monthly availability of foods and was classified in adequate and inadequate according to the available monthly caloric balance percentage. We determined the risk of acute malnutrition (indicative P/T), chronic (T/E), global (P/E) and risk of thinness (BMI). We sought for malarian cases. The official data of illness were revised. We applied surveys to know the morbidity and knowledge, attitudes and practices in malaria infections, 29% of homes had alimentary insecurity. There was protein deficit and iron of high availability, calcium and vitamin A in 100% of families. In children under 6 years old, we found 31% and 69%, in same order, with low P/T and T/E, while in the 6-10 year old children had 14% and 41%, respectively. In adolescents (11 to 17 years old) the risk of thinness was 15% and in adults 3%. There was not association between alimentary available and family nutritional status. These results suggest subclinics deficiencies of micronutrients.

  17. Screening for Malnutrition in Community Dwelling Older Japanese: Preliminary Development and Evaluation of the Japanese Nutritional Risk Screening Tool (NRST).

    PubMed

    Htun, N C; Ishikawa-Takata, K; Kuroda, A; Tanaka, T; Kikutani, T; Obuchi, S P; Hirano, H; Iijima, K

    2016-02-01

    Early and effective screening for age-related malnutrition is an essential part of providing optimal nutritional care to older populations. This study was performed to evaluate the adaptation of the original SCREEN II questionnaire (Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II) for use in Japan by examining its measurement properties and ability to predict nutritional risk and sarcopenia in community-dwelling older Japanese people. The ultimate objective of this preliminary validation study is to develop a license granted full Japanese version of the SCREEN II. The measurement properties and predictive validity of the NRST were examined in this cross-sectional study of 1921 community-dwelling older Japanese people. Assessments included medical history, and anthropometric and serum albumin measurements. Questions on dietary habits that corresponded to the original SCREEN II were applied to Nutritional Risk Screening Tool (NRST) scoring system. Nutritional risk was assessed by the Geriatric Nutrition Risk Index (GNRI) and the short form of the Mini-Nutritional Assessment (MNA-SF). Sarcopenia was diagnosed according to the criteria of the European Working Group on Sarcopenia in Older People. The nutritional risk prevalences determined by the GNRI and MNA-SF were 5.6% and 34.7%, respectively. The prevalence of sarcopenia was 13.3%. Mean NRST scores were significantly lower in the nutritionally at-risk than in the well-nourished groups. Concurrent validity analysis showed significant correlations between NRST scores and both nutritional risk parameters (GNRI or MNA-SF) and sarcopenia. The areas under the receiver operating characteristic curves (AUC) of NRST for the prediction of nutritional risk were 0.635 and 0.584 as assessed by GNRI and MNA-SF, respectively. AUCs for the prediction of sarcopenia were 0.602 (NRST), 0.655 (age-integrated NRST), and 0.676 (age and BMI-integrated NRST). These results indicate that the NRST is a

  18. Low Omega-3 Index in Pregnancy Is a Possible Biological Risk Factor for Postpartum Depression

    PubMed Central

    Markhus, Maria Wik; Skotheim, Siv; Graff, Ingvild Eide; Frøyland, Livar; Braarud, Hanne Cecilie; Stormark, Kjell Morten; Malde, Marian Kjellevold

    2013-01-01

    Background Depression is a common disorder affecting 10–15% women in the postpartum period. Postpartum depression can disrupt early mother-infant interaction, and constitutes a risk factor for early child development. Recently, attention has been drawn to the hypothesis that a low intake of seafood in pregnancy can be a risk factor for postpartum depression. Seafood is a unique dietary source of the marine omega-3 fatty acids and is a natural part of a healthy balanced diet that is especially important during pregnancy. Methods In a community based prospective cohort in a municipality in Western Norway, we investigated both nutritional and psychological risk factors for postpartum depression. The source population was all women who were pregnant within the period November 2009 - June 2011. The fatty acid status in red blood cells was assessed in the 28th gestation week and participants were screened for postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS) three months after delivery. The aim of the present study was to investigate if a low omega-3 index in pregnancy is a possible risk factor for postpartum depression. Results In a simple regression model, the omega-3 index was associated with the EPDS score in a nonlinear inverse manner with an R square of 19. Thus, the low omega-3 index explained 19% of the variance in the EPDS score. The DPA content, DHA content, omega-3 index, omega-3/omega-6 ratio, total HUFA score, and the omega-3 HUFA score were all inversely correlated with the EPDS score. The EPDS scores of participants in the lowest omega-3 index quartile were significantly different to the three other omega-3 index quartiles. Conclusion In this study population, a low omega-3 index in late pregnancy was associated with higher depression score three months postpartum. PMID:23844041

  19. Platelet activation risk index as a prognostic thrombosis indicator

    PubMed Central

    Zlobina, K. E.; Guria, G. Th.

    2016-01-01

    Platelet activation in blood flow under high, overcritical shear rates is initiated by Von Willebrand factor. Despite the large amount of experimental data that have been obtained, the value of the critical shear rate, above which von Willebrand factor starts to activate platelets, is still controversial. Here, we recommend a theoretical approach to elucidate how the critical blood shear rate is dependent on von Willebrand factor size. We derived a diagram of platelet activation according to the shear rate and von Willebrand factor multimer size. We succeeded in deriving an explicit formula for the dependence of the critical shear rate on von Willebrand factor molecule size. The platelet activation risk index was introduced. This index is dependent on the flow conditions, number of monomers in von Willebrand factor, and platelet sensitivity. Probable medical applications of the platelet activation risk index as a universal prognostic index are discussed. PMID:27461235

  20. Use of body mass index of adults in assessing individual and community nutritional status.

    PubMed Central

    Bailey, K. V.; Ferro-Luzzi, A.

    1995-01-01

    Adult malnutrition is much more widespread than is commonly recognized. Described in this article is the use of body mass index (BMI = weight in kg/(height in metres)2) as a measure of adult nutritional status, both of individuals and of communities. Concurrent assessment of the nutritional status of children and adults permits conclusions to be drawn about whether there is generalized undernutrition in a community or whether other factors (e.g., childhood infections or feeding practices) are more important in childhood malnutrition. Included is a tabular presentation that permits rapid assessment of both thinness or underweight (BMI values < 16, 17 and 18.5) and overweight (BMI > 25, 30 and 40). Examples of the use of BMI in both clinical and public health practice are also given. PMID:8846494

  1. Developing a risk-based air quality health index

    NASA Astrophysics Data System (ADS)

    Wong, Tze Wai; Tam, Wilson Wai San; Yu, Ignatius Tak Sun; Lau, Alexis Kai Hon; Pang, Sik Wing; Wong, Andromeda H. S.

    2013-09-01

    We developed a risk-based, multi-pollutant air quality health index (AQHI) reporting system in Hong Kong, based on the Canadian approach. We performed time series studies to obtain the relative risks of hospital admissions for respiratory and cardiovascular diseases associated with four air pollutants: sulphur dioxide, nitrogen dioxide, ozone, and particulate matter with an aerodynamic diameter less than 10 μm (PM10). We then calculated the sum of excess risks of the hospital admissions associated with these air pollutants. The cut-off points of the summed excess risk, for the issuance of different health warnings, were based on the concentrations of these pollutants recommended as short-term Air Quality Guidelines by the World Health Organization. The excess risks were adjusted downwards for young children and the elderly. Health risk was grouped into five categories and sub-divided into eleven bands, with equal increments in excess risk from band 1 up to band 10 (the 11th band is 'band 10+'). We developed health warning messages for the general public, including at-risk groups: young children, the elderly, and people with pre-existing cardiac or respiratory diseases. The new system addressed two major shortcomings of the current standard-based system; namely, the time lag between a sudden rise in air pollutant concentrations and the issue of a health warning, and the reliance on one dominant pollutant to calculate the index. Hence, the AQHI represents an improvement over Hong Kong's existing air pollution index.

  2. Risk index proposal to predict atrial fibrillation after cardiac surgery.

    PubMed

    Silva, Rogério Gomes da; Lima, Gustavo Glotz de; Guerra, Nelma; Bigolin, André Vicente; Petersen, Lucas Celia

    2010-01-01

    Atrial fibrillation (AF) is a common complication following cardiac surgery and is associated with an increased patient morbidity and mortality. The objective of this study was to develop a risk index proposal to predict AF after cardiac surgery. A prospective observational study in that 452 patients were selected to assess the incidence and risk factors associated with postoperative AF. Only patients following cardiac surgery were selected. Continuous cardiac monitor and daily electrocardiogram were assessed. The most associated in a multivariable logistic model were selected for the risk index. The average incidence of AF was 22.1%. The most associated factors with AF were: patients older than 75 years of age, mitral valve disease, no use of a beta blocker, withdrawal of a beta-blocker and a positive fluid balance. The absence risk factor determined 4.6% chance to postoperative AF, and for one, two and three or more risk factors, the chance was 16.6%, 25.9% and 46.3%, respectively. In a multivariable logistic model was possible to develop a risk index proposal to predict postoperative AF with a major risk of 46.3% in the presence of three or more risk factors.

  3. [The iberoamerican scientific production in nutritional sciences: the indexation in PubMed and Google Scholar].

    PubMed

    Franco-Pérez, Alvaro Moisés; Sanz-Valero, Javier; Wanden-Berghe, Carmina; Melian-Fleitas, Liliana

    2014-11-01

    Analyze by bibliometric technique, the Iberoamerican scientific literature related to the nutritional sciences and retrieved on main search engines with free access through Internet (PubMed and Google Scholar). Bibliometric analysis of scientific production recovered in the different selected search tools. The data were obtained by applying to each of them, a composed search equation according to the scheme: Population (neoplasms), Intervention (nutritional status), Outcome (quality of life). 789 references were reviewed, 604 of those were papers published in 277 journals, presenting 20 or more references: Supportive Care in Cancer 27 (4.47%; CI 95% 2.82-6.12) and Clinical Nutrition 20 (3.31%; CI 95% 1.88-4.74). Mean age of documents: 8.08 ± 6.40 (CI 95% 7.63-8.53), median 6 years (Burton Kleber Index), maximum 34 years and Price Index of 43.90%. The predominant geographical distribution among the authors was American, while the articles were written primarily in English. Dispersion of literature (Bradford Law): core (1st tertile), 22 journals (7.94%; CI 95% 4.76-11.13) with 202 articles published (33.44%; CI 95% 29.68-37.21). Statistics related to the impact factor of the core: mean 4.033 ± 4.022 and maximum 18,038 (Journal of Clinical Oncology). The studied thematic continues in force according to the current indicators, with a dominance of English as language of publication and United States filiation. The most referenced journals matching with high Impact publications on nutritional sciences and oncology. Highlighting the presence of an Iberoamerican journal (Nutrición Hospitalaria) with a clear international vocation. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  4. Assessment of cardiovascular risk in patients with rheumatoid arthritis using the SCORE risk index.

    PubMed

    de Campos, Otávio Augusto Martins; Nazário, Nazaré Otília; de Magalhães Souza Fialho, Sônia Cristina; Fialho, Guilherme Loureiro; de Oliveira, Fernando José Savóia; de Castro, Gláucio Ricardo Werner; Pereira, Ivânio Alves

    2016-01-01

    Rheumatoid arthritis is an autoimmune disease that causes systemic involvement and is associated with increased risk of cardiovascular disease. To analyze the prediction index of 10-year risk of a fatal cardiovascular disease event in female RA patients versus controls. Case-control study with analysis of 100 female patients matched for age and gender versus 100 patients in the control group. For the prediction of 10-year risk of a fatal cardiovascular disease event, the SCORE and modified SCORE (mSCORE) risk indexes were used, as suggested by EULAR, in the subgroup with two or more of the following: duration of disease ≥10 years, RF and/or anti-CCP positivity, and extra-articular manifestations. The prevalence of analyzed comorbidities was similar in RA patients compared with the control group (p>0.05). The means of the SCORE risk index in RA patients and in the control group were 1.99 (SD: 1.89) and 1.56 (SD: 1.87) (p=0.06), respectively. The means of mSCORE index in RA patients and in the control group were 2.84 (SD=2.86) and 1.56 (SD=1.87) (p=0.001), respectively. By using the SCORE risk index, 11% of RA patients were classified as of high risk, and with the use of mSCORE risk index, 36% were at high risk (p<0.001). The SCORE risk index is similar in both groups, but with the application of the mSCORE index, we recognized that RA patients have a higher 10-year risk of a fatal cardiovascular disease event, and this reinforces the importance of factors inherent to the disease not measured in the SCORE risk index, but considered in mSCORE risk index. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  5. Nutritional screening in surgical patients of a teaching hospital from Southern Brazil: the impact of nutritional risk in clinical outcomes

    PubMed Central

    Garcia, Rosane Scussel; Tavares, Léa Regina da Cunha; Pastore, Carla Alberici

    2013-01-01

    ABSTRACT Objective: To assess the prevalence of nutritional risk in surgical patients of a teaching hospital and its associated factors. Methods: A cross-sectional study with secondary data of surgical ward patients of the Hospital Escola da Universidade Federal de Pelotas, from April to October, 2010. Patients were evaluated up to 36 hours after admission using the Malnutrition Screening Tool. Results: The study included 565 patients, with a mean age of 52.8±15.6 years, and the majority (51%) was female. More than 30% of the patients presented with an average or high nutritional risk, and 7% of them were at high risk. Associated with the greater risk were aging, cancer surgery, and mortality. The length of hospital stay showed a linear increase according to nutritional risk. Conclusion: The Malnutrition Screening Tool is a simple and effective tool for nutritional screening that does not require anthropometric measurements. In this study, average or high nutritional risk was prevalent in one third of the sample, and was related to increased mortality, hospital stay, cancer, and aging. Nutritional care outpatients’ protocols could be used prior to elective surgery to reduce the nutritional risk of these patients, improving clinical outcomes and reducing length and costs of hospital stay. PMID:23843052

  6. Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study.

    PubMed

    Buckland, G; Travier, N; Huerta, J M; Bueno-de-Mesquita, H B As; Siersema, P D; Skeie, G; Weiderpass, E; Engeset, D; Ericson, U; Ohlsson, B; Agudo, A; Romieu, I; Ferrari, P; Freisling, H; Colorado-Yohar, S; Li, K; Kaaks, R; Pala, V; Cross, A J; Riboli, E; Trichopoulou, A; Lagiou, P; Bamia, C; Boutron-Ruault, M C; Fagherazzi, G; Dartois, L; May, A M; Peeters, P H; Panico, S; Johansson, M; Wallner, B; Palli, D; Key, T J; Khaw, K T; Ardanaz, E; Overvad, K; Tjønneland, A; Dorronsoro, M; Sánchez, M J; Quirós, J R; Naccarati, A; Tumino, R; Boeing, H; Gonzalez, C A

    2015-08-01

    Several modifiable lifestyle factors, including smoking, alcohol, certain dietary factors and weight are independently associated with gastric cancer (GC); however, their combined impact on GC risk is unknown. We constructed a healthy lifestyle index to investigate the joint influence of these behaviors on GC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The analysis included 461,550 participants (662 first incident GC cases) with a mean follow-up of 11.4 years. A healthy lifestyle index was constructed, assigning 1 point for each healthy behavior related to smoking status, alcohol consumption and diet quality (represented by the Mediterranean diet) for assessing overall GC and also body mass index for cardia GC and 0 points otherwise. Risk of GC was calculated using Cox proportional hazards regression models while adjusting for relevant confounders. The highest versus lowest score in the healthy lifestyle index was associated with a significant lower risk of GC, by 51% overall (HR 0.49 95% CI 0.35, 0.70), by 77% for cardia GC (HR 0.23 95% CI 0.08, 0.68) and by 47% for noncardia GC (HR 0.53 (95% CI 0.32, 0.87), p-trends<0.001. Population attributable risk calculations showed that 18.8% of all GC and 62.4% of cardia GC cases could have been prevented if participants in this population had followed the healthy lifestyle behaviors of this index. Adopting several healthy lifestyle behaviors including not smoking, limiting alcohol consumption, eating a healthy diet and maintaining a normal weight is associated with a large decreased risk of GC. © 2014 UICC.

  7. Clinical Significance of the Prognostic Nutritional Index for Predicting Short- and Long-Term Surgical Outcomes After Gastrectomy

    PubMed Central

    Lee, Jee Youn; Kim, Hyoung-Il; Kim, You-Na; Hong, Jung Hwa; Alshomimi, Saeed; An, Ji Yeong; Cheong, Jae-Ho; Hyung, Woo Jin; Noh, Sung Hoon; Kim, Choong-Bai

    2016-01-01

    Abstract To evaluate the predictive and prognostic significance of the prognostic nutritional index (PNI) in a large cohort of gastric cancer patients who underwent gastrectomy. Assessing a patient's immune and nutritional status, PNI has been reported as a predictive marker for surgical outcomes in various types of cancer. We retrospectively reviewed data from a prospectively maintained database of 7781 gastric cancer patients who underwent gastrectomy from January 2001 to December 2010 at a single center. From this data, we analyzed clinicopathologic characteristics, PNI, and short- and long-term surgical outcomes for each patient. We used the PNI value for the 10th percentile (46.70) of the study cohort as a cut-off for dividing patients into low and high PNI groups. Regarding short-term outcomes, multivariate analysis showed a low PNI (odds ratio [OR] = 1.505, 95% CI = 1.212–1.869, P <0.001), old age, male sex, high body mass index, medical comorbidity, total gastrectomy, and combined resection to be independent predictors of postoperative complications. Among these, only low PNI (OR = 4.279, 95% CI = 1.760–10.404, P = 0.001) and medical comorbidity were independent predictors of postoperative mortality. For long-term outcomes, low PNI was a poor prognostic factor for overall survival, but not recurrence (overall survival: hazard ratio [HR] = 1.383, 95% CI = 1.221–1.568, P < 0.001; recurrence-free survival: HR = 1.142, 95% CI = 0.985–1.325, P = 0.078). PNI can be used to predict patients at increased risk of postoperative morbidity and mortality. Although PNI was an independent prognostic factor for overall survival, the index was not associated with cancer recurrence. PMID:27149460

  8. Methods to evaluate the nutrition risk in hospitalized patients

    PubMed Central

    Erkan, Tülay

    2014-01-01

    The rate of malnutrition is substantially high both in the population and in chronic patients hospitalized because of different reasons. The rate of patients with no marked malnutrition at the time of hospitalization who develop malnutrition during hospitalization is also substantially high. Therefore, there are currently different screening methods with different targets to prevent malnutrition and its overlook. These methods should be simple and reliable and should not be time-consuming in order to be used in daily practice. Seven nutrition risk screening methods used in children have been established until the present time. However, no consensus has been made on any method as in adults. It should be accepted that interrogation of nutrition is a part of normal examination to increase awareness on this issue and to draw attention to this issue. PMID:26078678

  9. 2013 Nutrition Risk Research Plan Review Final Report. Research Plan Review for: The Risk Factor of Inadequate Nutrition

    NASA Technical Reports Server (NTRS)

    2014-01-01

    The 2013 Nutrition Risk Standing Review Panel (from here on referred to as the SRP) was impressed by the degree of progress the nutrition discipline has made with the research plan presented since the 2012 Nutrition Risk SRP WebEx/teleconference. The scientists and staff associated with the nutrition discipline have, in addition, continued their impressive publication track record. Specifically the SRP found that the novel and important progress in the ocular health research area (Gap N7.3) represents an important advance in understanding the etiology and potential countermeasures for this condition and thinks that the work will not only be valuable for vision, but may have implications for cardiovascular health, as well. The SRP also considered the bone countermeasure data presented a potentially valuable tool for investigating bone metabolism under the unique conditions of space travel, specifically the innovation of variable use of stable Ca isotopes for bone synthesis and equal contribution for bone to investigate bone metabolism, as well as, the impact of the advanced resistive exercise device (ARED) on body composition during spaceflight. Finally, the SRP considers the planned Integrated Nutrition task to be an important and necessary strategic part of the research plan. The SRP is concerned that the risks observed in previous research on Low Earth Orbit (LEO) may not capture all the risks of longer duration flight beyond LEO. In particular, the SRP believes that there may be a much greater likelihood of an intensified chronic inflammatory response compared to the very minimal evidence seen to date and that modest effects seen in LEO, such as the reduction in appetite, may not predict an absence in longer duration flight out of LEO. The added complications of longer duration flight, greater bio-behavioral stress, radiation exposure, poorer communication, and inability to respond to unforeseen exigencies may create different risks. Thus, preparation for

  10. Nutritional risk factors for tuberculosis among adults in the United States, 1971-1992.

    PubMed

    Cegielski, J Peter; Arab, Lenore; Cornoni-Huntley, Joan

    2012-09-01

    The risk of developing tuberculosis (TB) may be related to nutritional status. To determine the impact of nutritional status on TB incidence, the authors analyzed data from the First National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study (NHEFS). NHANES I collected information on a probability sample of the US population in 1971-1975. Adults were followed up in 1982-1992. Incident TB cases were ascertained through interviews, medical records, and death certificates. TB incidences were compared across different levels of nutritional status after controlling for potential confounding using proportional hazards regression appropriate to the complex sample design. TB incidence among adults with normal body mass index was 24.7 per 100,000 person-years (95% confidence interval (CI): 13.0, 36.3). In contrast, among persons who were underweight, overweight, and obese, estimated TB incidence rates were 260.2 (95% CI: 98.6, 421.8), 8.9 (95% CI: 2.2, 15.6), and 5.1 (95% CI: 0.0, 10.5) per 100,000 person-years, respectively. Adjusted hazard ratios were 12.43 (95% CI: 5.75, 26.95), 0.28 (95% CI: 0.13, 0.63), and 0.20 (95% CI: 0.07, 0.62), respectively, after controlling for demographic, socioeconomic, and medical characteristics. A low serum albumin level also increased the risk of TB, but low vitamin A, thiamine, riboflavin, and iron status did not. A population's nutritional profile is an important determinant of its TB incidence.

  11. The Prognostic Nutritional Index Predicts Survival and Identifies Aggressiveness of Gastric Cancer.

    PubMed

    Eo, Wan Kyu; Chang, Hye Jung; Suh, Jungho; Ahn, Jin; Shin, Jeong; Hur, Joon-Young; Kim, Gou Young; Lee, Sookyung; Park, Sora; Lee, Sanghun

    2015-01-01

    Nutritional status has been associated with long-term outcomes in cancer patients. The prognostic nutritional index (PNI) is calculated by serum albumin concentration and absolute lymphocyte count, and it may be a surrogate biomarker for nutritional status and possibly predicts overall survival (OS) of gastric cancer. We evaluated the value of the PNI as a predictor for disease-free survival (DFS) in addition to OS in a cohort of 314 gastric cancer patients who underwent curative surgical resection. There were 77 patients in PNI-low group (PNI ≤ 47.3) and 237 patients in PNI-high group (PNI > 47.3). With a median follow-up of 36.5 mo, 5-yr DFS rates in PNI-low group and PNI-high group were 63.5% and 83.6% and 5-yr OS rates in PNI-low group and PNI-high group were 63.5% and 88.4%, respectively (DFS, P < 0.0001; OS, P < 0.0001). In the multivariate analysis, the only predictors for DFS were PNI, tumor-node-metastasis (TNM) stage, and perineural invasion, whereas the only predictors for OS were PNI, age, TNM stage, and perineural invasion. In addition, the PNI was independent of various inflammatory markers. In conclusion, the PNI is an independent prognostic factor for both DFS and OS, and provides additional prognostic information beyond pathologic parameters.

  12. Prognosis Prediction for Postoperative Esophageal Cancer Patients Using Onodera's Prognostic Nutritional Index.

    PubMed

    Matsumoto, Hideo; Okamoto, Yuko; Kawai, Akimasa; Ueno, Daisuke; Kubota, Hisako; Murakami, Haruaki; Higashida, Masaharu; Hirai, Toshihiro

    2017-07-20

    Preoperative nutritional status may impact surgical outcome and prognosis. We evaluated the predictive value of Onodera's prognostic nutritional index (O's-PNI) of surgical outcome following esophagectomy in esophageal cancer patients. In total, 144 patients undergoing esophagectomy for esophageal cancer from April 2010 to May 2015 were evaluated, retrospectively. Eighty-four patients were enrolled in this study. O's-PNIs were calculated before surgery, discharge, and 1, 2, and 6 mo after discharge. The relationship between O's-PNI and occurrence of complications as classified by the Clavien-Dindo (C-D) classification, length of hospital stay, and survival time was investigated. The mean O's-PNI for patients with complications of more than Grade 2 by the C-D classification was 37.4, which was significantly lower than that for Grades 0 or 1 (40.5, P = 0.0094). A negative correlation was obtained between O's-PNI and hospital stay length (P = 0.0006), whereas a positive correlation was obtained for O's-PNI at 6 mo postsurgery and overall survival (P = 0.0171, P = 0.0201). O's-PNI may represent a useful indicator of the occurrence of complications and length of hospital stay, and may influence overall survival at 6 mo postsurgery. Nutritional management during the perioperative period could therefore contribute to satisfactory outcomes following esophagectomy in esophageal cancer patients.

  13. Comparison of Nutritional Risk Scores for Predicting Mortality in Japanese Chronic Hemodialysis Patients.

    PubMed

    Takahashi, Hiroshi; Inoue, Keiko; Shimizu, Kazue; Hiraga, Keiko; Takahashi, Erika; Otaki, Kaori; Yoshikawa, Taeko; Furuta, Kumiko; Tokunaga, Chika; Sakakibara, Tomoyo; Ito, Yasuhiko

    2017-05-01

    Protein energy wasting (PEW) is consistently associated with poor prognosis in hemodialysis (HD) patients. We compared the predictability of PEW as diagnosed by The International Society of Renal Nutrition and Metabolism criteria (PEWISRNM) and geriatric nutritional risk index (GNRI) for all-cause mortality in Japanese HD patients. As cut-off values for body mass index (BMI) for PEW have not been established in PEWISRNM for Asian populations, these were also investigated. The nutritional status from 409 HD patients was evaluated according to ISRNM and GNRI criteria. To compare the predictability of mortality, C-index, net reclassification improvement (NRI) and integrated discrimination improvement were evaluated. During follow-up (median, 52 months; range, 7 months), 70 patients (17.1%) presented PEW according to ISRNM and 131 patients (32.1%) according to GNRI; in addition, 101 patients (24.7%) died. PEWISRNM and GNRI were identified as independent predictors of death. Addition of PEWISRNM and GNRI to a predictive model based on established risk factors improved NRI and integrated discrimination improvement. However, no differences were found between models including PEWISRNM and GNRI. When lowering the criterion level of BMI per 1 kg/m(2) sequentially, PEWISRNM at BMI <20 kg/m(2) maximized the hazard ratio for mortality. The model including PEWISRNM at BMI <20 kg/m(2) improved NRI compared with the model including GNRI. PEWISRNM and GNRI represent independent predictors of mortality, with comparable predictability. The diagnostic criterion of BMI in the ISRNM for Japanese population might be better at <20 kg/m(2) than at <23 kg/m(2). Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  14. Solemnity: A Clinical Risk Index for Iron Deficient Infants.

    ERIC Educational Resources Information Center

    Honig, Alice Sterling; Oski, Frank A.

    1984-01-01

    Studies four groups of infants with iron deficiency but without anemia in an attempt to discover behavioral signs that can be used to index high-risk probability for iron deficiency. Solemnity in well-attached infants is suggested as a clinical sign to indicate the need for biochemical screening for iron deficiency. (AS)

  15. Increasing Risk Awareness: The Coastal Community Resilience Index

    ERIC Educational Resources Information Center

    Thompson, Jody A.; Sempier, Tracie; Swann, LaDon

    2012-01-01

    As the number of people moving to the Gulf Coast increases, so does the risk of exposure to floods, hurricanes, and other storm-related events. In an effort to assist communities in preparing for future storm events, the Coastal Community Resilience Index was created. The end result is for communities to take actions to address the weaknesses they…

  16. Solemnity: A Clinical Risk Index for Iron Deficient Infants.

    ERIC Educational Resources Information Center

    Honig, Alice Sterling; Oski, Frank A.

    1984-01-01

    Studies four groups of infants with iron deficiency but without anemia in an attempt to discover behavioral signs that can be used to index high-risk probability for iron deficiency. Solemnity in well-attached infants is suggested as a clinical sign to indicate the need for biochemical screening for iron deficiency. (AS)

  17. Increasing Risk Awareness: The Coastal Community Resilience Index

    ERIC Educational Resources Information Center

    Thompson, Jody A.; Sempier, Tracie; Swann, LaDon

    2012-01-01

    As the number of people moving to the Gulf Coast increases, so does the risk of exposure to floods, hurricanes, and other storm-related events. In an effort to assist communities in preparing for future storm events, the Coastal Community Resilience Index was created. The end result is for communities to take actions to address the weaknesses they…

  18. Nutrition Education and Body Mass Index in Grades K-12: A Systematic Review.

    PubMed

    Price, Cayla; Cohen, Deborah; Pribis, Peter; Cerami, Jean

    2017-09-01

    Overweight and obese body mass index (BMI) status affects an increasing number of children in the United States. The school setting has been identified as a focus area to implement obesity prevention programs. A database search of PubMed, Education Search Complete, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was conducted for peer-reviewed articles published between January 2005 and December 2015 pertaining to programs offered in the school setting to grades K-12 in the United States with a nutrition education component and measured BMI percentile or BMI z-score as an outcome. Seven studies focused on elementary (K-5) populations and 2 studies focused on grades 6-8. Among the 9 identified studies, those with long-term (greater than 1 year) implementation showed more pronounced results with positive impact on reducing overweight/obese BMI measures. This set of studies suggests that long-term nutrition education delivered in the school setting can provide children with tools to attain a healthy weight status. Additional studies examining participants' BMI status years after the initial study, and studies examining programs in grades 9-12 are needed to determine the most effective delivery time and methods. © 2017, American School Health Association.

  19. Infant and child feeding index reflects feeding practices, nutritional status of urban slum children.

    PubMed

    Lohia, Neha; Udipi, Shobha A

    2014-11-30

    Infant and child feeding index (ICFI) an age-specific index, can be used to assess child feeding practices. We used the ICFI to assess feeding practices for urban slum children and the association between ICFI and child nutritional status. 446 children aged 6 to 24 months from urban slums of Mumbai, India were studied. We used the 24-hour diet recall to study dietary diversity and a food frequency questionnaire for consumption of food groups during the preceding week. ICFI was computed using five components, namely, breastfeeding, use of bottle, dietary diversity score (DDS), food group frequency score (FGFS) and feeding frequency scores (FFS). Weight, height and Mid-Upper Arm Circumference (MUAC) were measured, and z scores were calculated. Association between ICFI scores and nutritional status was examined. The mean total ICFI score for all was 5.9 ± 1.9. Among the five components, FGFS and FFS differed between children <12 months of age and >12 months and by breast feeding status. In contrast, there were no differences vis-à-vis dietary diversity scores (DDS), breast feeding, and use of bottle. Non-breastfed children had significantly higher DDS scores than did breastfed children. The mean feeding frequency score (FFS) for children <12 months of age was slightly but not significantly lower than scores for children >12 months of age. Mother's age and child's age were significant determinants of ICFI. Multivariate analysis indicated that ICFI was significantly associated with Length-for-Age z scores (LAZ) and BMI-for-Age z scores (BAZ). Sensitivity of ICFI was lower than its specificity. The results of the present study confirmed that the ICFI can be used to collect information on key components of young child feeding practices and be incorporated into public-health programmes. Further, it could be used to determine the influence of complementary feeding practices on nutritional status of children.

  20. [Impact of pre-pregnancy body mass index on baby's physical growth and nutritional status].

    PubMed

    Li, Hongyan; Tan, Shan; Gao, Xiao; Xiang, Shiting; Zhang, Li; Huang, Li; Xiong, Changhui; Yan, Qiang; Lin, Ling; Li, Dimin; Yi, Juan; Yan, Yan

    2015-04-01

    To explore the impact of pre-pregnancy body mass index on baby's physical growth and nutritional status. A total of 491 pairs of mother-infant were divided into 3 groups according to mother's pre-pregnancy body mass index (BMI): a pre-pregnancy low BMI group (BMI<18.5 kg/m², n=93), a pre-pregnancy normal BMI group (18.5 kg/m² ≤ BMI<24.0 kg/m², n=326), and a pre-pregnancy high BMI group (BMI ≥ 24.0 kg/m², n=72). Analysis of variance of repeated measurement data and the median percentage methods were used to compare the physical growth and nutritional status of babies in different groups. Baby's weight in the high BMI group were higher than that in the normal BMI and the low BMI group (F=3.958, P=0.020). The incidence of malnutrition in the low BMI group showed a tendency to decline along with the months (χ²=5.611, P=0.018), the incidence of overweight and obesity in the high and the normal BMI groups displayed a tendency to decline along with the months (χ²=18.773, 53.248, all P<0.001). Baby in the low BMI group had higher incidence of malnutrition while baby in the high BMI group had higher incidence of overweight and obesity. Pregnancy BMI was correlated with the growth of baby. Too high or too low prepregnancy BMI exerts harmful effect on baby's weight and nutritional status. Medical workers should strengthen the education on women's pre-pregnancy to remind them keeping BMI at normal level.

  1. Profiles of body mass index and the nutritional status among children and adolescents categorized by waist-to-height ratio cut-offs.

    PubMed

    Zhang, Ying-Xiu; Wang, Zhao-Xia; Chu, Zun-Hua; Zhao, Jin-Shan

    2016-11-15

    Waist-to-height ratio (WHtR) is proposed as a simple, valid and convenient measure of abdominal obesity and health risks in practice. The present study examined the distribution of nutritional status among children and adolescents categorized by WHtR cut-offs. A total of 30,459 students (15,249 boys and 15,210 girls) aged 7-18years participated in the study. Height, weight and waist circumference (WC) of all subjects were measured, body mass index (BMI) and WHtR were calculated. The grades of nutritional status (thinness, normal weight, overweight and obesity) was defined by the international BMI cut-offs. All subjects were divided into three groups (low, moderate and high) according to their WHtR, BMI level and the distribution of nutritional status among the three groups were compared. In both boys and girls, significant differences in BMI level and the nutritional status were observed among the three groups. Children and adolescents aged 7-18years in the 'high WHtR group' (≥0.5) had higher BMI than those in the 'low WHtR group' (<0.4) by 6.00-10.15kg/m(2) for boys and 5.24-9.51kg/m(2) for girls. 'low WHtR group' had higher prevalence of thinness, and 'high WHtR group' had higher prevalence of overweight and obesity. The optimal distribution of nutritional status is found in the 'moderate WHtR group' (between 0.4 and 0.5) with the highest proportion of normal weight and low prevalence of thinness and obesity. WHtR is associated with nutritional status, which could be an indicator of nutritional status and early health risk. It is necessary to develop optimal boundary values in the future. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Waist circumference, body mass index, and postmenopausal breast cancer incidence in the Cancer Prevention Study-II Nutrition Cohort.

    PubMed

    Gaudet, Mia M; Carter, Brian D; Patel, Alpa V; Teras, Lauren R; Jacobs, Eric J; Gapstur, Susan M

    2014-06-01

    High body mass index (BMI) is an established risk factor for postmenopausal breast cancer. However, less is known about associations with waist circumference. In particular, it is unclear whether a larger waist circumference is associated with risk more than would be expected based solely on its contribution to BMI. We examined the associations of BMI and waist circumference with risk of postmenopausal breast cancer, with and without mutual adjustment, in the Cancer Prevention Study-II Nutrition Cohort. Analyses included 28,965 postmenopausal women who reported weight and waist circumference on a questionnaire in 1997 and were not taking menopausal hormones. During a median follow-up of 11.58 years, 1,088 invasive breast cancer cases were identified. Hazard ratios (HR) and 95 % confidence intervals (CI) were estimated from multivariable-adjusted Cox proportional hazard regression models. Without adjustment for BMI, a larger waist circumference was associated with higher risk of breast cancer (per 10 cm increase in waist circumference, HR = 1.13, 95 % CI 1.08-1.19). However, adjustment for BMI eliminated the association with waist circumference (per 10 cm HR = 1.00, 95 % CI 0.92-1.08). BMI was associated with risk unadjusted for waist circumference (per 1 kg/m(2) HR = 1.04, 95 % CI 1.03-1.05) and adjusted for waist circumference (per 1 kg/m(2) HR = 1.04, 95 % CI 1.02-1.06). Our study of predominantly white women provides evidence that a larger waist circumference is associated with higher risk of postmenopausal breast cancer, but not beyond its contribution to BMI.

  3. The Social Environment of Schools and Adolescent Nutrition: Associations between the School Nutrition Climate and Adolescents' Eating Behaviors and Body Mass Index

    ERIC Educational Resources Information Center

    Cvjetan, Branko; Utter, Jennifer; Robinson, Elizabeth; Denny, Simon

    2014-01-01

    Background: The aim of this study was to determine the association between the school nutrition climate and students' eating behaviors and body mass index (BMI). Methods: Data were collected as part of Youth'07, a nationally representative health survey of high school students in New Zealand. Overall, 9107 randomly selected students from 96…

  4. The Social Environment of Schools and Adolescent Nutrition: Associations between the School Nutrition Climate and Adolescents' Eating Behaviors and Body Mass Index

    ERIC Educational Resources Information Center

    Cvjetan, Branko; Utter, Jennifer; Robinson, Elizabeth; Denny, Simon

    2014-01-01

    Background: The aim of this study was to determine the association between the school nutrition climate and students' eating behaviors and body mass index (BMI). Methods: Data were collected as part of Youth'07, a nationally representative health survey of high school students in New Zealand. Overall, 9107 randomly selected students from 96…

  5. Mini-Nutritional-Assessment (MNA) without body mass index (BMI) predicts functional disability in elderly Taiwanese.

    PubMed

    Lee, Li-Chin; Tsai, Alan Chung-hong

    2012-01-01

    Nutritional status and functional ability are mutually dependent especially in the elderly. This study examined the functional status-predictive ability of the MNA in a cross-sectional study. We analyzed the dataset of the "Survey of Health and Living Status of the Elderly in Taiwan" (SHLSET). Subjects were 2948≥65 year-old persons who were rated with the long-form (LF) and short-form (SF) MNA with or without BMI for the risk of malnutrition, and with the Activities of Daily Living (ADL) and the Instrument Activities of Daily Living (IADL) for functional status. The ADL and IADL scores were calculated according to rated nutritional status. Receiver Operating Characteristic (ROC) curves were generated for ADL and IADL status predicted by the MNA. Logistic regression was performed to evaluate the association of rated MNA scores with ADL or IADL status. Results showed that both SF and LF of MNA-T1 and T2 were able to predict ADL and IADL disabilities. Those who were rated malnourished or at risk of malnutrition had drastically higher risk of ADL or IADL dependency compared to those who were rated normal. The SF versions performed well in rating nutritional status and predicting ADL and IADL status. Overall, MNA-T2-SF performed at least equally well as MNA-T1-SF in rating functional decline. These results suggest the MNA is able to predict functional decline of the elderly. MNA-T2, especially the SF, a version without BMI should be particularly useful in clinical, long-term care and community settings.

  6. Redox homeostasis in stomach medium by foods: The Postprandial Oxidative Stress Index (POSI) for balancing nutrition and human health.

    PubMed

    Kanner, Joseph; Selhub, Jacob; Shpaizer, Adi; Rabkin, Boris; Shacham, Inbal; Tirosh, Oren

    2017-08-01

    Red-meat lipid peroxidation in the stomach results in postprandial oxidative stress (POS) which is characterized by the generation of a variety of reactive cytotoxic aldehydes including malondialdehyde (MDA). MDA is absorbed in the blood system reacts with cell proteins to form adducts resulting in advanced lipid peroxidation end products (ALEs), producing dysfunctional proteins and cellular responses. The pathological consequences of ALEs tissue damage include inflammation and increased risk for many chronic diseases that are associated with a Western-type diet. In earlier studies we used the simulated gastric fluid (SGF) condition to show that the in vitro generation of MDA from red meat closely resembles that in human blood after consumption the same amount of meat. In vivo and in vitro MDA generations were similarly suppressed by polyphenol-rich beverages (red wine and coffee) consumed with the meal. The present study uses the in vitro SGF to assess the capacity of more than 50 foods of plant origin to suppress red meat peroxidation and formation of MDA. The results were calculated as reducing POS index (rPOSI) which represents the capacity in percent of 100g of the food used to inhibit lipid peroxidation of 200g red-meat a POSI enhancer (ePOSI). The index permitted to extrapolate the need of rPOSI from a food alone or in ensemble such Greek salad, to neutralize an ePOSI in stomach medium, (ePOS-rPOSI=0). The correlation between the rPOSI and polyphenols in the tested foods was R(2)=0.75. The Index was validated by comparison of the predicted rPOSI for a portion of Greek salad or red-wine to real inhibition of POS enhancers. The POS Index permit to better balancing nutrition for human health. Copyright © 2017. Published by Elsevier B.V.

  7. Novel Threat-risk Index Using Probabilistic Risk Assessment and Human Reliability Analysis - Final Report

    SciTech Connect

    George A. Beitel

    2004-02-01

    In support of a national need to improve the current state-of-the-art in alerting decision makers to the risk of terrorist attack, a quantitative approach employing scientific and engineering concepts to develop a threat-risk index was undertaken at the Idaho National Engineering and Environmental Laboratory (INEEL). As a result of this effort, a set of models has been successfully integrated into a single comprehensive model known as Quantitative Threat-Risk Index Model (QTRIM), with the capability of computing a quantitative threat-risk index on a system level, as well as for the major components of the system. Such a threat-risk index could provide a quantitative variant or basis for either prioritizing security upgrades or updating the current qualitative national color-coded terrorist threat alert.

  8. Functional approximation and optimal specification of the mechanical risk index.

    PubMed

    Kaiser, Mark J; Pulsipher, Allan G

    2005-10-01

    The mechanical risk index (MRI) is a numerical measure that quantifies the complexity of drilling a well. The purpose of this article is to examine the role of the component factors of the MRI and its structural and parametric assumptions. A meta-modeling methodology is applied to derive functional expressions of the MRI, and it is shown that the MRI can be approximated in terms of a linear functional. The variation between the MRI measure and its functional specification is determined empirically, and for a reasonable design space, the functional specification is shown to a good approximating representation. A drilling risk index is introduced to quantify the uncertainty in the time and cost associated with drilling a well. A general methodology is outlined to create an optimal MRI specification.

  9. Social isolation, support, and capital and nutritional risk in an older sample: ethnic and gender differences

    PubMed Central

    Locher, Julie L.; Ritchie, Christine S.; Roth, David L.; Baker, Patricia Sawyer; Bodner, Eric V.; Allman, Richard M.

    2009-01-01

    This study examines the relationships that exist between social isolation, support, and capital and nutritional risk in older black and white women and men. The paper reports on 1000 community-dwelling older adults aged 65 and older enrolled in the University of Alabama at Birmingham (UAB) Study of Aging, a longitudinal observational study of mobility among older black and white participants in the USA. Black women were at greatest nutritional risk; and black women and men were the groups most likely to be socially isolated and to possess the least amounts of social support and social capital. For all ethnic–gender groups, greater restriction in independent life–space (an indicator of social isolation) was associated with increased nutritional risk. For black women and white men, not having adequate transportation (also an indicator of social isolation) was associated with increased nutritional risk. Additionally, for black and white women and white men, lower income was associated with increased nutritional risk. For white women only, the perception of a low level of social support was associated with increased nutritional risk. For black men, not being married (an indicator of social support) and not attending religious services regularly, restricting activities for fear of being attacked, and perceived discrimination (indicators of social capital) were associated with increased nutritional risk. Black females had the greatest risk of poor nutritional health, however more indicators of social isolation, support, and capital were associated with nutritional risk for black men. Additionally, the indicators of social support and capital adversely affecting nutritional risk for black men differed from those associated with nutritional risk in other ethnic–gender groups. This research has implications for nutritional policies directed towards older adults. PMID:15571893

  10. A disconnection between nutritional status (in terms of body mass index and phase angle) and psychopathology in anorexia nervosa.

    PubMed

    Federico, Fortunato; Benedetta, Demartini; Claudia, Maffoni; Emanuela, Apicella; Valentina, Leonardi; Leonardo, Mendolicchio

    2017-06-01

    The aim of our study was to investigate the relationship between nutritional status (body mass index and phase angle) and psychological symptoms at admission and discharge in a residential population of anorexic patients. We also aimed to determine the evolution of the above psychological symptoms and nutrition rehabilitation from admission to discharge. Thirty-six consecutive patients were included. The evaluation was performed using the following measures at admission and discharge: body mass index, phase angle, Eating Disorders Inventory-3, Multiphasic Personality Inventory-2 and Body Uneasiness. Admission and discharge nutritional status were not correlated with psychometric scores respectively at admission and at discharge. In addition, neither the improvement in the scores on the psychometric scales between admission and discharge was correlated to body mass index, phase angle improvement. For the group as a whole there were significant improvements from admission to discharge in nutritional status, Multiphasic Personality Inventory-2-Depression, Body Uneasiness-Global Score Index and in all the composites of Eating Disorders Inventory-3. Our data showed a disconnection between nutritional status and eating disorders psychopathology and/or psychiatric comorbidities. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  11. Childhood body mass index trajectories predicting cardiovascular risk in adolescence.

    PubMed

    Boyer, Brittany P; Nelson, Jackie A; Holub, Shayla C

    2015-06-01

    The present study compared growth parameters of girls' and boys' body mass index (BMI) trajectories from infancy to middle childhood and evaluated these parameters as predictors of cardiovascular disease (CVD) risk in adolescence. Using 657 children from the NICHD Study of Early Child Care and Youth Development, quadratic growth curve analyses were conducted to establish growth parameters (intercept, slope, and quadratic term) for girls and boys from age 15 months to 10.5 years. Parameters were compared across gender and evaluated as predictors of a CVD risk index at the age of 15 years, controlling for characteristics of the adiposity rebound (AR) including age at which it occurred and children's BMI at the rebound. Boys had more extreme trajectories of growth than girls with higher initial BMI at age 15 months (intercept), more rapid declines in BMI before the AR (slope), and sharper rebound growth in BMI after the rebound (quadratic term). For boys and girls, higher intercept, slope, and quadratic term values predicted higher CVD risk at the age of 15 years, controlling for characteristics of the AR. Findings suggest that individuals at risk for developing CVD later in life may be identified before the AR by elevated BMI at 15 months and slow BMI declines. Because of the importance of early intervention in altering lifelong health trajectories, consistent BMI monitoring is essential in identifying high-risk children. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  12. Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk.

    PubMed

    Cappello, Silvia; Cereda, Emanuele; Rondanelli, Mariangela; Klersy, Catherine; Cameletti, Barbara; Albertini, Riccardo; Magno, Daniela; Caraccia, Marilisa; Turri, Annalisa; Caccialanza, Riccardo

    2016-12-23

    Background: Elevated plasma vitamin B12 concentrations were identified as predictors of mortality in patients with oncologic, hepatic and renal diseases, and in elderly and critically ill medical patients. The association between vitamin B12 concentrations and in-hospital mortality in adult patients at nutritional risk has not been assessed. Methods: In this five-year prospective study, we investigated whether high vitamin B12 concentrations (>1000 pg/mL) are associated with in-hospital mortality in 1373 not-bed-ridden adult patients at nutritional risk (Nutrition Risk Index <97.5), admitted to medical and surgical departments. Results: Three hundred and ninety-six (28.8%) patients presented vitamin B12 > 1000 pg/mL. Two hundred and four patients died in the hospital (14.9%). The adjusted odds ratio of in-hospital mortality in patients with high vitamin B12 was 2.20 (95% CI, 1.56-3.08; p < 0.001); it was independent of age, gender, body mass index, six-month previous unintentional weight loss, admission ward, presence of malignancy, renal function, C-reactive protein and prealbumin. Patients with high vitamin B12 also had a longer length of stay (LOS) than those with normal concentrations (median 25 days, (IQR 15-41) versus 23 days (IQR 14-36); p = 0.014), and elevated vitamin B12 was an independent predictor of LOS (p = 0.027). Conclusions: An independent association between elevated vitamin B12 concentrations, mortality and LOS was found in our sample of hospitalized adult patients at nutritional risk. Although the underlying mechanisms are still unknown and any cause-effect relation cannot be inferred, clinicians should be aware of the potential negative impact of high vitamin B12 concentrations in hospitalized patients at nutritional risk and avoid inappropriate vitamin supplementation.

  13. Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk

    PubMed Central

    Cappello, Silvia; Cereda, Emanuele; Rondanelli, Mariangela; Klersy, Catherine; Cameletti, Barbara; Albertini, Riccardo; Magno, Daniela; Caraccia, Marilisa; Turri, Annalisa; Caccialanza, Riccardo

    2016-01-01

    Background: Elevated plasma vitamin B12 concentrations were identified as predictors of mortality in patients with oncologic, hepatic and renal diseases, and in elderly and critically ill medical patients. The association between vitamin B12 concentrations and in-hospital mortality in adult patients at nutritional risk has not been assessed. Methods: In this five-year prospective study, we investigated whether high vitamin B12 concentrations (>1000 pg/mL) are associated with in-hospital mortality in 1373 not-bed-ridden adult patients at nutritional risk (Nutrition Risk Index <97.5), admitted to medical and surgical departments. Results: Three hundred and ninety-six (28.8%) patients presented vitamin B12 > 1000 pg/mL. Two hundred and four patients died in the hospital (14.9%). The adjusted odds ratio of in-hospital mortality in patients with high vitamin B12 was 2.20 (95% CI, 1.56–3.08; p < 0.001); it was independent of age, gender, body mass index, six-month previous unintentional weight loss, admission ward, presence of malignancy, renal function, C-reactive protein and prealbumin. Patients with high vitamin B12 also had a longer length of stay (LOS) than those with normal concentrations (median 25 days, (IQR 15–41) versus 23 days (IQR 14–36); p = 0.014), and elevated vitamin B12 was an independent predictor of LOS (p = 0.027). Conclusions: An independent association between elevated vitamin B12 concentrations, mortality and LOS was found in our sample of hospitalized adult patients at nutritional risk. Although the underlying mechanisms are still unknown and any cause-effect relation cannot be inferred, clinicians should be aware of the potential negative impact of high vitamin B12 concentrations in hospitalized patients at nutritional risk and avoid inappropriate vitamin supplementation. PMID:28025528

  14. Body mass index, body fat, and nutritional status of patients with heart failure: The PLICA study.

    PubMed

    Gastelurrutia, Paloma; Lupón, Josep; de Antonio, Marta; Zamora, Elisabet; Domingo, Mar; Urrutia, Agustín; Altimir, Salvador; Coll, Ramon; Díez, Crisanto; Bayes-Genis, Antoni

    2015-12-01

    Nutritional assessment may help to explain the incompletely understood obesity paradox in patients with heart failure (HF). Currently, obesity is usually identified by body mass index (BMI). Our objective was to assess the prognostic influence of undernourishment in HF outpatients. Two published definitions of undernourishment were used to assess 214 ambulatory HF patients. Definition 1 included albumin, total lymphocyte count, tricipital skinfold (TS), subscapular skinfold, and arm muscle circumference (AMC) measurements (≥2 below normal considered undernourishment). Definition 2 included TS, AMC, and albumin (≥1 below normal considered undernourishment). Patients were also stratified by BMI and body fat percentage and followed for 2 years. All-cause death or HF hospitalization was the primary endpoint. Based on BMI strata, among underweight patients, 60% and 100% were undernourished by Definitions 1 and 2, respectively (31% and 44% among normal-weight, 4% and 11% among overweight, and 0% and 3% among obese patients, respectively, according to the two definitions). The most prevalent undernourishment type was marasmus-like (18% of the total cohort). Undernourishment by both definitions was significantly associated with lower event-free survival. Following multivariable analysis, age, NYHA functional class, NTproBNP, and undernourishment (hazard ratio [HR] 2.25 [1.11-4.56] and 2.24 [1.19-4.21] for Definitions 1 and 2, respectively) remained in the model. In this cohort, BMI and percentage of body fat did not independently predict 2-year event-free survival. Nutritional status is a key prognostic factor in HF above and beyond BMI and percentage of body fat. Patients in normal BMI range and even in overweight and obese groups showed undernourishment. The high mortality observed in undernourishment, infrequent in high BMI patients, may help to partly explain the obesity paradox. Proper undernourishment assessment should become routine in patients with HF

  15. Body mass index, nutritional knowledge, and eating behaviors in elite student and professional ballet dancers.

    PubMed

    Wyon, Matthew A; Hutchings, Kate M; Wells, Abigail; Nevill, Alan M

    2014-09-01

    It is recognized that there is a high esthetic demand in ballet, and this has implications on dancers' body mass index (BMI) and eating behaviors. The objective of this study was to examine the association between BMI, eating attitudes, and nutritional knowledge of elite student and professional ballet dancers. Observational design. Institutional. One hundred eighty-nine participants from an elite full-time dance school (M = 53, F = 86) and from an elite ballet company (M = 16, F = 25) volunteered for the study. There were no exclusion criteria. Anthropometric data (height and mass), General Nutrition Knowledge Questionnaire (GNKQ), and the Eating Attitude Test-26 (EAT-26) were collected from each participant. Univariate analysis of variance was used to examine differences in gender and group for BMI, GNKQ, and EAT-26. Regression analyses were applied to examine interactions between BMI, GNKQ, and EAT-26. Professional dancers had significantly greater BMI than student dancers (P < 0.001), and males had significantly higher BMI scores than females (P < 0.05). Food knowledge increased with age (P < 0.001) with no gender difference. Student dancers had a significant interaction between year group and gender because of significantly higher EAT-26 scores for females in years 10 and 12. Regression analysis of the subcategories (gender and group) reported a number of significant relationships between BMI, GNKQ, and EAT-26. The findings suggest that dancers with disordered eating also display lower levels of nutritional knowledge, and this may have an impact on BMI. Female students' eating attitudes and BMI should especially be monitored during periods of adolescent development.

  16. [Nutritional risk factors of a vegetarian diet in adult lacto-ovo vegetarians].

    PubMed

    Krajcovicova-Kudlackova, M; Simoncic, R; Bederova, A; Klvanova, J; Magalova, T; Grancicova, E; Brtkova, A

    2000-01-01

    Risk nutritional factors of alternative alimentation detected in childhood were evaluated in a group of adult lactoovovegetarians (n = 47). The levels of iron, calcium, zinc, total proteins, gluthatione, plasmatic profile of fatty acids and the lipoperoxidation product in correlation with the values of antioxidative vitamins were studied. The results are compared with mean sample upon mixed nutrition (omnivores n = 42). In both groups were the mean values of iron, calcium and zinc in physiological range, but significantly lower in vegetarians. In the alternative nutrition group was in 21 percent of probands hyposiderinemia detected (vs 5 percent in the omnivores group), in 19 percent of probands hypocalcemia (vs 9 percent) and in 6 percent hypozincemia (vs 0 percent). Full-bodied mixture of milk proteins, egg proteins and vegetable sources in lactoovovegetarians ensured sufficient protein saturation and caused significantly higher level of blood gluthatione (intake also in food). Increased value of fatty acid peroxidation index was not due to increased lipoperoxidation in lactoovovegetarians--significantly lower levels of conjugated fatty acid dienes were determined. This was ensured by sufficient protection by means of essential antioxidants--the levels of vitamins E, C, beta-carotene are in vegetarians significantly higher. These are overtreshold values representing reduced risk of free-radical diseases. Lactoovovegetarians had significantly higher content of linoleic and alpha-linoleic acids in plasma. Values of polyunsaturated fatty acids with C20 and C22 and 3-6 double bonds were similar to values in omnivores. In probands on alternative nutrition with iron deficit was significantly lower activity of delta 6 desaturase determined. (Tab. 3, Ref. 45.)

  17. Effect of Parental Migration Background on Childhood Nutrition, Physical Activity, and Body Mass Index

    PubMed Central

    Bottai, Matteo; Kull, Inger; Wickman, Magnus; Wolk, Alicja; Moradi, Tahereh

    2014-01-01

    Background. Poor nutrition, lack of physical activity, and obesity in children have important public health implications but, to date, their effects have not been studied in the growing population of children in Sweden with immigrant parents. Methods. We estimated the association between parental migration background and nutrition, physical activity, and weight in 8-year-old children born in Stockholm between 1994 and 1996 of immigrants and Swedish parents (n = 2589). Data were collected through clinical examination and questionnaires filled out by parents. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using multivariable logistic regression. Results. Children of immigrants complied more closely with Nordic Nutrition Recommendations compared with those of Swedes (OR = 1.35, 95% CI 1.11–1.64). They had higher intake of dietary fibre, vitamins C, B6, and E, folic acid, and polyunsaturated fatty acids (omega-3 and omega-6) reflecting higher consumption of foods of plant origin, but lower intake of vitamins A and D, calcium, and iron reflecting lower consumption of dairy products. Children of immigrants had higher intake of sucrose reflecting higher consumption of sugar and sweets. Furthermore, these children had a higher risk of having low physical activity (OR = 1.31, 95% CI 1.06–1.62) and being overweight (OR = 1.33, 95% CI 1.06–1.65) compared with children of Swedish parents. The odds of having low physical activity and being overweight were even higher in children whose parents were both immigrants. A low level of parental education was associated with increased risk of low physical activity regardless of immigration background. Conclusions. Culturally appropriate tools to capture the diverse range of ethnic foods and other lifestyle habits are needed. Healthcare professionals should be aware of the low levels of physical activity, increased weight, and lack of consumption of some important vitamins among children of immigrants

  18. Prognostic nutritional index as a prognostic biomarker for survival in digestive system carcinomas.

    PubMed

    Zhao, Yang; Xu, Peng; Kang, Huafeng; Lin, Shuai; Wang, Meng; Yang, Pengtao; Dai, Cong; Liu, Xinghan; Liu, Kang; Zheng, Yi; Dai, Zhijun

    2016-12-27

    The prognostic nutritional index (PNI) has been reported to correlate with the prognosis in patients with various malignancies. We performed a meta-analysis to determine the predictive potential of PNI in digestive system cancers. Twenty-three studies with a total of 7,384 patients suffering from digestive system carcinomas were involved in this meta-analysis. A lower PNI was significantly associated with the shorter overall survival (OS) [Hazard Ratio (HR) 1.83, 95% Confidence Interval (CI) 1.62-2.07], the poorer disease-free survival (DFS) (HR 1.85, 95% CI 1.19-2.89), and the higher rate of post-operative complications (HR 2.31, 95% CI 1.63-3.28). In conclusion, PNI was allowed to function as an efficient indicator for the prognosis of patients with digestive system carcinomas.

  19. Prognostic nutritional index as a prognostic biomarker for survival in digestive system carcinomas

    PubMed Central

    Zhao, Yang; Xu, Peng; Kang, Huafeng; Lin, Shuai; Wang, Meng; Yang, Pengtao; Dai, Cong; Liu, Xinghan; Liu, Kang; Zheng, Yi; Dai, Zhijun

    2016-01-01

    The prognostic nutritional index (PNI) has been reported to correlate with the prognosis in patients with various malignancies. We performed a meta-analysis to determine the predictive potential of PNI in digestive system cancers. Twenty-three studies with a total of 7,384 patients suffering from digestive system carcinomas were involved in this meta-analysis. A lower PNI was significantly associated with the shorter overall survival (OS) [Hazard Ratio (HR) 1.83, 95% Confidence Interval (CI) 1.62–2.07], the poorer disease-free survival (DFS) (HR 1.85, 95% CI 1.19–2.89), and the higher rate of post-operative complications (HR 2.31, 95% CI 1.63–3.28). In conclusion, PNI was allowed to function as an efficient indicator for the prognosis of patients with digestive system carcinomas. PMID:27888808

  20. The Significance of the Prognostic Nutritional Index for All Stages of Pancreatic Cancer.

    PubMed

    Lee, Sang Hoon; Chung, Moon Jae; Kim, Bun; Lee, Hee Seung; Lee, Hyun Jik; Heo, Ja Yoon; Kim, Yeong Jin; Park, Jeong Youp; Bang, Seungmin; Park, Seung Woo; Song, Si Young; Chung, Jae Bock

    2017-04-01

    Nutritional status affects the prognosis of various tumors. The prognostic nutritional index (PNI) is the known predictor of postoperative outcome in resectable pancreatic cancer patients. This study aimed to validate the prognostic value of PNI in all stages of pancreatic cancer. We retrospectively reviewed 499 patients with pancreatic cancer who were diagnosed at Severance Hospital between January 2006 and December 2011. The PNI value was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (/mm(3)) at initial diagnosis. The median patient age was 62 yr, and 289 were men. The study group comprised resectable disease (n = 121), locally advanced disease (n = 118), and metastatic disease (n = 260). Univariate and multivariate analysis revealed that PNI ≤ 49.5 at initial diagnosis, together with performance status, platelet count, and clinical stage, was significantly associated with overall survival (hazard ratio, 1.562; all P < 0.05). Patients with PNI ≤ 49.5 (n = 208) had shorter median overall survival compared to patients with high PNI (9.8 vs. 14.2 mo; log rank, P < 0.001). In clinical stage subgroup analysis, initial PNI ≤49.5 independently predicted shorter overall survival, especially in resectable and metastatic disease (P = 0.041, P = 0.002, respectively).

  1. The usefulness of densitometry as a method of assessing the nutritional status of athletes. Comparison with body mass index.

    PubMed

    Infante, J R; Reyes, C; Ramos, M; Rayo, J I; Lorente, R; Serrano, J; Domínguez, M L; García, L; Durán, C; Sánchez, R

    2013-01-01

    The body mass index (BMI) is used to assess nutritional status. The result in athletes may be overestimated due to increase in muscle mass. To assess the usefulness of fat mass index (FMI) and lean mass index (LMI) determination as indicators of nutritional status and to compare the results with BMI. We studied 28 amateur rugby players, male. After being subjected to whole body densitometry by dual X-ray absorptiometry, we determined fat and lean body mass together with other parameters. FMI (fat in kg/height in meters(2)), LMI (lean in kg/height in meters(2)) and appendicular muscle mass index (AMMI, arms and legs musculature in kg/height in meters(2)) were calculated. Using BMI, 18 players were overweight and 4 obese type I. Considering FMI, 7 of them had normal values and high LMI and AMMI, one of them changed from overweight to obese and another one from obese to overweight. Of the 6 players with normal BMI, one of them showed fat excess and another one fat defect. The results changed the assessment of nutritional status in 39% of players. Although BMI is an appropriate parameter in general population for the assessment of nutritional status, in athletes should be taken into account fat and muscle body percentage and their corresponding indexes. The whole body densitometry appears to be a simple and reliable technique for this purpose. Copyright © 2012 Elsevier España, S.L. and SEMNIM. All rights reserved.

  2. Dietary intake, physical activity, body mass index, and childhood asthma in the Third National Health And Nutrition Survey (NHANES III).

    PubMed

    Romieu, Isabelle; Mannino, David M; Redd, Stephen C; McGeehin, Michael A

    2004-07-01

    Childhood asthma may be affected by dietary changes and increased body mass related to a sedentary lifestyle, although the mechanisms are poorly understood. To test this hypothesis, we used data from the National Health and Nutrition Survey (NHANES III) from 1988-1994, including 7,904 children. We analyzed cross-sectional information on body mass index (BMI = weight/height2), physical activity (hr/day viewing television), dietary intake (24-hr recall), and vitamin C intake (60 mg/day). The probability of self-reported asthma or wheezing relating to risk factors was calculated by logistic regression. After controlling for dietary intake, physical activity, and sociodemographic variables, asthma risk was three times higher for children aged 6-16 years in the highest percentiles of BMI (>95th percentile) when compared to children in percentiles 25-49 (OR = 3.44; 95% CI, 1.49-7.96). No increase was observed in children aged 2-5 years. Low vitamin C intake was marginally related to self-reported current wheezing in children aged 6-16 years. Our results show that increased BMI may influence asthma prevalence in children, but further investigation is needed.

  3. Adapting the Healthy Eating Index 2010 for the Canadian Population: Evidence from the Canadian National Nutrition Survey.

    PubMed

    Jessri, Mahsa; Ng, Alena Praneet; L'Abbé, Mary R

    2017-08-21

    The Healthy Eating Index (HEI) is a diet quality index shown to be associated with reduced chronic disease risk. Older versions of the HEI have been adapted for Canadian populations; however, no Canadian modification of the Healthy Eating Index-2010 (HEI-2010) has been made. The aims of this study were: (a) to develop a Canadian adaptation of the HEI-2010 (i.e., Healthy Eating Index-Canada 2010 (HEI-C 2010)) by adapting the recommendations of the HEI-2010 to Canada's Food Guide (CFG) 2007; (b) to evaluate the validity and reliability of the HEI-C 2010; and (c) to examine relationships between HEI-C 2010 scores with diet quality and the likelihood of being obese. Data from 12,805 participants (≥18 years) were obtained from the Canadian Community Health Survey Cycle 2.2. Weighted multivariate logistic regression was used to test the association between compliance to the HEI-C 2010 recommendations and the likelihood of being obese, adjusting for errors in self-reported dietary data. The total mean error-corrected HEI-C 2010 score was 50.85 ± 0.35 out of 100. Principal component analysis confirmed multidimensionality of the HEI-C 2010, while Cronbach's α = 0.78 demonstrated internal reliability. Participants in the fourth quartile of the HEI-C 2010 with the healthiest diets were less likely to consume refined grains and empty calories and more likely to consume beneficial nutrients and foods (p-trend < 0.0001). Lower adherence to the index recommendations was inversely associated with the likelihood of being obese; this association strengthened after correction for measurement error (Odds Ratio: 1.41; 95% Confidence Interval: 1.17-1.71). Closer adherence to Canada's Food Guide 2007 assessed through the HEI-C 2010 was associated with improved diet quality and reductions in the likelihood of obesity when energy intake and measurement errors were taken into account. Consideration of energy requirements and energy density in future updates of Canada's Food Guide are

  4. Permissive Underfeeding or Standard Enteral Feeding in High- and Low-Nutritional-Risk Critically Ill Adults. Post Hoc Analysis of the PermiT Trial.

    PubMed

    Arabi, Yaseen M; Aldawood, Abdulaziz S; Al-Dorzi, Hasan M; Tamim, Hani M; Haddad, Samir H; Jones, Gwynne; McIntyre, Lauralyn; Solaiman, Othman; Sakkijha, Maram H; Sadat, Musharaf; Mundekkadan, Shihab; Kumar, Anand; Bagshaw, Sean M; Mehta, Sangeeta

    2017-03-01

    The optimal nutritional strategy for critically ill adults at high nutritional risk is unclear. To examine the effect of permissive underfeeding with full protein intake compared with standard feeding on 90-day mortality in patients with different baseline nutritional risk. This is a post hoc analysis of the PermiT (Permissive Underfeeding versus Target Enteral Feeding in Adult Critically Ill Patients) trial. Nutritional risk was categorized by the modified Nutrition Risk in Critically Ill score, with high nutritional risk defined as a score of 5-9 and low nutritional risk as a score of 0-4. Additional analyses were performed by categorizing patients by body mass index, prealbumin, transferrin, phosphate, urinary urea nitrogen, and nitrogen balance. Based on the Nutrition Risk in Critically Ill score, 378 of 894 (42.3%) patients were categorized as high nutritional risk and 516 of 894 (57.7%) as low nutritional risk. There was no association between feeding strategy and mortality in the two categories; adjusted odds ratio (aOR) of 0.84 (95% confidence interval [CI], 0.56-1.27) for high nutritional risk and 1.01 (95% CI, 0.64-1.61) for low nutritional risk (interaction P = 0.53). Findings were similar in analyses using other definitions, with the exception of prealbumin. The association of permissive underfeeding versus standard feeding and 90-day mortality differed when patients were categorized by baseline prealbumin level (≤0.10 g/L: aOR, 0.57 [95% CI, 0.31-1.05]; >0.10 and ≤0.15 g/L: aOR, 0.79 [95% CI, 0.42-1.48]; >0.15 g/L: aOR, 1.55 [95% CI, 0.80, 3.01]; interaction P = 0.009). Among patients with high and low nutritional risk, permissive underfeeding with full protein intake was associated with similar outcomes as standard feeding.

  5. Carbohydrate intake, glycemic index and prostate cancer risk

    PubMed Central

    Vidal, Adriana C.; Williams, Christina D.; Allott, Emma H.; Howard, Lauren E.; Grant, Delores J.; McPhail, Megan; Sourbeer, Katharine N.; Pao-Hwa, Lin; Boffetta, Paolo; Hoyo, Cathrine; Freedland, Stephen J.

    2014-01-01

    BACKGROUND Reported associations between dietary carbohydrate and prostate cancer (PC) risk are poorly characterized by race. METHODS We analyzed the association between carbohydrate intake, glycemic index (GI), and PC risk in a study of white (N=262) and black (N=168) veterans at the Durham VA Hospital. Cases were 156 men with biopsy-confirmed PC and controls (N=274) had a PSA test but were not recommended for biopsy. Diet was assessed before biopsy with a self-administered food frequency questionnaire. Logistic regression models were used to estimate PC risk. RESULTS In multivariable analyses, higher carbohydrate intake, measured as percent of energy from carbohydrates, was associated with reduced PC risk (3rd vs. 1st tertile, OR=0.41, 95%CI 0.21–0.81, p=0.010), though this only reached significance in white men (p-trend=0.029). GI was unrelated to PC risk among all men, but suggestively linked with reduced PC risk in white men (p-trend=0.066) and increased PC risk in black men (p-trend=0.172), however the associations were not significant. Fiber intake was not associated with PC risk (all p-trends >0.55). Higher carbohydrate intake was associated with reduced risk of high-grade (p-trend=0.016), but not low-grade PC (p-trend=0.593). CONCLUSIONS Higher carbohydrate intake may be associated with reduced risk of overall and high-grade PC. Future larger studies are needed to confirm these findings. PMID:25417840

  6. Carbohydrate intake, glycemic index and prostate cancer risk.

    PubMed

    Vidal, Adriana C; Williams, Christina D; Allott, Emma H; Howard, Lauren E; Grant, Delores J; McPhail, Megan; Sourbeer, Katharine N; Hwa, Lin Pao; Boffetta, Paolo; Hoyo, Cathrine; Freedland, Stephen J

    2015-03-01

    Reported associations between dietary carbohydrate and prostate cancer (PC) risk are poorly characterized by race. We analyzed the association between carbohydrate intake, glycemic index (GI), and PC risk in a study of white (N = 262) and black (N = 168) veterans at the Durham VA Hospital. Cases were 156 men with biopsy-confirmed PC and controls (N = 274) had a PSA test but were not recommended for biopsy. Diet was assessed before biopsy with a self-administered food frequency questionnaire. Logistic regression models were used to estimate PC risk. In multivariable analyzes, higher carbohydrate intake, measured as percent of energy from carbohydrates, was associated with reduced PC risk (3rd vs. 1st tertile, OR = 0.41, 95% CI 0.21-0.81, P = 0.010), though this only reached significance in white men (p-trend = 0.029). GI was unrelated to PC risk among all men, but suggestively linked with reduced PC risk in white men (p-trend = 0.066) and increased PC risk in black men (p-trend = 0.172), however, the associations were not significant. Fiber intake was not associated with PC risk (all p-trends > 0.55). Higher carbohydrate intake was associated with reduced risk of high-grade (p-trend = 0.016), but not low-grade PC (p-trend = 0.593). Higher carbohydrate intake may be associated with reduced risk of overall and high-grade PC. Future larger studies are needed to confirm these findings. © 2014 Wiley Periodicals, Inc.

  7. Nutritional risk is associated with long term mortality in hospitalized patients with chronic heart failure.

    PubMed

    Tevik, Kjerstin; Thürmer, Hanne; Husby, Marit Inderhaug; de Soysa, Ann Kristin; Helvik, Anne-Sofie

    2016-04-01

    Mortality among patients with chronic heart failure (CHF) is still high despite progress in medical and surgical treatment. The patients' nutritional condition may play an important role, and needs further investigation. The aim of this study was to evaluate whether nutritional risk in hospitalized patients with CHF was associated with three-year mortality. A prospective study was conducted in 131 hospitalized Norwegian patients with CHF. Nutritional screening was performed using Nutritional Risk Screening (NRS-2002). The primary clinical outcome was death from any cause. The prevalence of nutritional risk was 57% (NRS-2002 score ≥ 3). The overall mortality rate was 52.6% within three-year follow up. More patients at nutritional risk (N = 51) died compared to patients not at nutritional risk (N = 18) (P < 0.001). In adjusted analyses patients at nutritional risk had more than five-time higher odds (OR 5.85; 95% CI 2.10-16.24) to die before three-year follow-up than those not at nutritional risk. In adjusted Cox multivariate analysis, the nutritional risk was associated with increased mortality (HR 2.78; 95% CI 1.53-5.03). Furthermore, in adjusted analysis components in NRS-2002 were associated with mortality, i.e. nutritional status (HR 1.82; 95% CI 1.03-3.22), severity of disease (NYHA-class IV) (HR 1.78; 95% CI 1.00-3.16) and age (≥ 70 year) (HR 3.24; 95% CI 1.48-7.10). Nutritional risk as defined by NRS-2002 in hospitalized patients with CHF was significantly associated with long term mortality. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Low-, medium- and high-glycaemic index carbohydrates and risk of type 2 diabetes in men.

    PubMed

    Similä, Minna E; Valsta, Liisa M; Kontto, Jukka P; Albanes, Demetrius; Virtamo, Jarmo

    2011-04-01

    Findings on dietary glycaemic index (GI) and glycaemic load (GL) as risk factors for type 2 diabetes have been controversial. We examined the associations of dietary GI and GL and the associations of substitution of lower-GI carbohydrates for higher-GI carbohydrates with diabetes risk in a cohort of Finnish men. The cohort consisted of 25 943 male smokers aged 50-69 years. Diet was assessed, at baseline, using a validated diet history questionnaire. During a 12-year follow-up, 1098 incident diabetes cases were identified from a national register. Cox proportional hazard modelling was used to estimate the risk of diabetes, and multivariate nutrient density models were used to examine the effects of substitution of different carbohydrates. Dietary GI and GL were not associated with diabetes risk; multivariate relative risk (RR) for highest v. lowest quintile for GI was 0·87 (95 % CI 0·71, 1·07) and for GL 0·88 (95 % CI 0·65, 1·17). Substitution of medium-GI carbohydrates for high-GI carbohydrates was inversely associated with diabetes risk (multivariate RR for highest v. lowest quintile 0·75, 95 % CI 0·59, 0·96), but substitution of low-GI carbohydrates for medium- or high-GI carbohydrates was not associated with the risk. In conclusion, dietary GI and GL were not associated with diabetes risk, and substitutions of lower-GI carbohydrates for higher-GI carbohydrates were not consistently associated with a lower diabetes risk. The associations of dietary GI and GL with diabetes risk should be interpreted by considering nutritional correlates, as foods may have different properties that affect risk.

  9. Low, medium, and high glycaemic index carbohydrates and risk of type 2 diabetes in men

    PubMed Central

    Similä, Minna E.; Valsta, Liisa M.; Kontto, Jukka P.; Albanes, Demetrius; Virtamo, Jarmo

    2012-01-01

    Findings on dietary glycaemic index (GI) and glycaemic load (GL) as risk factors for type 2 diabetes have been controversial. We examined the associations of dietary GI and GL and the associations of substitution of lower GI carbohydrates for higher GI carbohydrates with diabetes risk in a cohort of Finnish men. The cohort consisted of 25 943 male smokers aged 50–69 years. Diet was assessed, at baseline, using a validated diet history questionnaire. During a 12-year follow-up, 1 098 incident diabetes cases were identified from a national register. Cox proportional hazard modelling was used to estimate the risk for diabetes and multivariate nutrient density models to examine the effects of substitution of different carbohydrates. Dietary GI and GL were not associated with diabetes risk; multivariate relative risk (RR) for highest versus lowest quintile for GI was 0.87 (95% CI: 0.71, 1.07) and for GL 0.88 (95% CI: 0.65, 1.17). Substitution of medium GI carbohydrates for high GI carbohydrates was inversely associated with diabetes risk (multivariate RR for highest versus lowest quintile 0.75, 95% CI: 0.59, 0.96), but substitution of low GI carbohydrates for medium or high GI carbohydrates was not associated with the risk. In conclusion, dietary GI and GL were not associated with diabetes risk and substitutions of lower GI carbohydrates for higher GI carbohydrates were not consistently associated with lower diabetes risk. The associations of dietary GI and GL with diabetes risk should be interpreted by considering nutritional correlates, as foods may have different properties that affect risk. PMID:21114892

  10. [Prevalence of nutritional risk evaluated with NRS-2002 in Mexican oncology population].

    PubMed

    Alvarez-Altamirano, Karolina; Delgadillo, Tania; García-García, Antonio; Alatriste-Ortiz, Gabriela; Fuchs-Tarlovsky, Vanessa

    2014-07-01

    Hospitalized patients have high risk of malnutrition, specially those with cancer. There are some screening tools that lead to the detection of malnutrition in hospitalized patients, as Nutritional Risk Screening 2002 (NRS-2002), which we used in Mexican population with cancer at the moment of hospital admission to determine the prevalence of malnutrition risk, and to determine as well as the best predictive item to measuring nutritional risk in our population. Nutritional status in cancer patients with NRS 2002 during hospital admission was assessed. To the analysis of variable non statistical parametric tests, student-t test, Pearson and Spearman test, as well as ANOVA test were used. To determine the best item for predicting nutritional risk in Mexican population with cancer, a logistic regression test was applied. Of our population, 50.2% of were classified as patients in nutritional risk at hospital admission. Gender, age, normal levels of IMC lower than 20.5, food intake, weight loss and hematological cancer were associated with nutritional risk (p < 0.05). The best model of logistic regression for predicting nutritional risk were the same used by NRS-2002 questionnaire (p < 0.05). Malnutrition prevalence is high in cancer patients and NRS-2002 is a reliable tool for predicting nutritional risk in Mexican population with cancer. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  11. Nutrition risk factors among home delivered and congregate meal participants: need for enhancement of nutrition education and counseling among home delivered meal participants.

    PubMed

    Wunderlich, S; Bai, Y; Piemonte, J

    2011-11-01

    The short-term impact of nutrition education and counseling intervention on nutrition risk factors among home delivered (HDM) and congregate (CGM) meal participants using Nutrition Survey Risk Screening was studied. A two-year intervention was conducted with 355 participants (n=259 CGM, n=96 HDM). Various nutrition behaviors that affect the nutrition risk score were compared. Congregate and home delivered meal locations in a northern county of New Jersey. CGM and HDM participants in a northern county of New Jersey age 60 and older. CGM participants received regular topical nutrition education and counseling in a classroom format with cooking demo, discussion, and handouts. The HDM participants only received the printed material (same handouts) and counseling by telephone. Demographics, medical condition, risk factors data were collected. All participants completed the 12 items checklist Nutrition Survey Risk Screening. Nutritional behaviors assessed include number of meals eaten per day, servings of fruits and vegetables and nutrition risk score. A score of 6 or more points was defined as persons at high risk nutritionally. The impact of the intervention was evaluated using ANOVA/chi-square on Nutrition Survey Risk Screening. Nutrition education and counseling intervention improved nutrition risk scores; 5.76 to 5.32 (p=0.14) in CGM, 8.1 to 6.1 (p<0.01) in HDM. A slight improvement in nutrition behaviors was noted: eating ≥ 2 meals in HDM (76 to 81.6 %, p= .310), eating ≥ 5 servings of fruits and vegetables in CGM (38 to 41.4 %, p=. 398). Appropriate nutrition intervention for both HDM and CGM participants can improve health condition and delay chronic diseases. HDM participants need to be a primary focus for more effective nutrition education and counseling.

  12. Pressure ulcer is associated with malnutrition as assessed by Nutritional Risk Screening (NRS 2002) in a mixed hospital population.

    PubMed

    Alhaug, Johanne; Gay, Caryl L; Henriksen, Christine; Lerdal, Anners

    2017-01-01

    Background and aim: Pressure ulcers (PUs) and malnutrition represent a significant health problem for hospital inpatients. Satisfactory nutritional status is crucial for proper wound healing. Risk of malnutrition can be identified using standardized screening tools, such as the Nutritional Risk Screening (NRS) 2002. Objective: The objective of this study was to examine whether nutritional status based on the NRS 2002 is associated with PU in hospital inpatients. Design: The data for this cross-sectional analysis were based on 10 screening days between September 2012 and May 2014. All adult inpatients admitted to a medical or surgical ward on the screening days were evaluated for eligibility. Nursing students and ward nurses conducted the NRS 2002 initial screening and skin examinations for PU classification (Stages I-IV). A registered clinical dietician conducted all NRS 2002 final screenings. Results: The sample consisted of 651 patients, with mean age 62.9 years. Skin examinations indicated an 8% PU prevalence. Factors associated with PUs included age ≥ 70 years, low body mass index (BMI) and hospitalization in the medical department. Based on the initial screening, 48% were at 'Low risk' for malnutrition and 52% were at 'Possible risk'. After final screening, 34% of the sample was identified as 'At risk' for malnutrition. Patients identified at 'Possible risk' by the initial screening or 'At risk' by the final screening were more likely than patients at 'Low risk' to have a PU (OR = 2.58 and 2.55, respectively). Each of the three initial screening items was significantly associated PU, with 'Is BMI<20?' and 'Ate less past week?' having the strongest associations. Conclusion: Nutritional risk using the NRS 2002 is associated with the presence of PU in a mixed hospital population. The final screening had a slightly stronger association with PU compared to the initial screening.

  13. A Computerized Risk Index Screening Program for At-Risk Students.

    ERIC Educational Resources Information Center

    Stowitschek, Joseph J.; And Others

    This paper describes a data-based screening tool for identifying at-risk students. It is intended to complement referral and other qualitative means of identification. The Computerized Risk Index Screening Program (CRISP) is an application of a commonly available data management program that: (1) provides a school-based screening system; (2) can…

  14. Parent, but not teacher, weight bias correlates with nutritional risk in preschool children

    USDA-ARS?s Scientific Manuscript database

    Background: Maladaptive eating behaviors have been reported among youth who report experiencing weight bias, so it is important to study whether nutritional risk and zBMI of young children correlate with weight biases held by caregivers. A previous analysis of these data showed that nutritional risk...

  15. Rural Middle School Nutrition and Physical Activity Environments and the Change in Body Mass Index during Adolescence

    ERIC Educational Resources Information Center

    Demment, Margaret; Wells, Nancy; Olson, Christine

    2015-01-01

    Background: For rural adolescents, schools are among the few places where environmental interventions can promote health outside of the home. The goal of this study was to assess the nutrition and physical activity (N&PA) environments of schools attended by a birth cohort and examine the association with change in body mass index (BMI) from…

  16. Rural Middle School Nutrition and Physical Activity Environments and the Change in Body Mass Index during Adolescence

    ERIC Educational Resources Information Center

    Demment, Margaret; Wells, Nancy; Olson, Christine

    2015-01-01

    Background: For rural adolescents, schools are among the few places where environmental interventions can promote health outside of the home. The goal of this study was to assess the nutrition and physical activity (N&PA) environments of schools attended by a birth cohort and examine the association with change in body mass index (BMI) from…

  17. Development and evaluation of a method for calculating the Healthy Eating Index-2005 using the Nutrition Data System for Research

    USDA-ARS?s Scientific Manuscript database

    Objective: To develop and evaluate a method for calculating the Healthy Eating Index-2005 (HEI-2005) with the widely used Nutrition Data System for Research (NDSR) based on the method developed for use with the US Department of Agriculture’s (USDA) Food and Nutrient Dietary Data System (FNDDS) and M...

  18. Development of a preliminary risk index to identify trauma patients at risk for an unplanned intubation.

    PubMed

    Kim, Dennis; Kobayashi, Leslie; Chang, David; Fortlage, Dale; Coimbra, Raul

    2014-01-01

    The development of respiratory failure requiring an emergent unplanned intubation (UI) is a potentially preventable complication associated with increased morbidity and mortality. The objective of this study was to develop a clinical risk index for UI based on readily available clinical data to assist in the identification of trauma patients at risk for this complication. We also sought to determine the impact of UI on patient outcomes. This is a 3-year retrospective analysis of our Level 1 trauma center registry to identify all patients requiring a UI. Patients who required a UI were compared with patients who were never intubated. An additive risk index consisting of 10 clinical variables was created using the final significant variables from a stepwise logistic regression model. The sensitivity and specificity of every possible index score were calculated and added together to calculate the "gain in certainty" values. During the 3-year period, 7,552 patients were admitted, of whom 967 (12.8%) required intubation. Of these, 55 (5.7%) underwent a UI. The final risk index consisted of 10 variables as follows: age 55 years to 64 years, age 65 years or older, male sex, Glasgow Coma Scale (GCS) score of 9 to 13, seizures, chronic obstructive pulmonary disease, traumatic brain injury, four or more rib fractures, spine fractures, and long-bone fractures. Gain in certainty was maximized at an index score of 4, with the highest combined sensitivity and specificity of 86.0% and 74.9%, respectively. The probability of UI increased from 0.9% at a score of 1 to 2.9% at 4 and 43% at 9. UI was associated with increased overall complications, length of stay, and mortality (p < 0.001). UI is a potentially preventable adverse event associated with poor outcomes. Identification of patients at risk for this complication may be possible through the development of an additive risk index. Prospective validation of the risk index is potentially warranted. Diagnostic study, level III.

  19. Relationship Between Triglyceride Tolerance, Body Mass Index, and Fat Depots in Hospitalized Patients Receiving Parenteral Nutrition.

    PubMed

    Frazee, Erin N; Nystrom, Erin M; McMahon, M Molly; Williamson, Eric E; Miles, John M

    2015-11-01

    Hypertriglyceridemia has been associated with adverse outcomes in patients receiving intravenous fat emulsions (IVFEs), but little is known about its prevalence and causes. The study investigated whether a relationship exists between body mass index (BMI) and triglyceride tolerance in parenterally fed patients. We conducted a retrospective analysis of 287 adults receiving parenteral nutrition to determine whether patients with very low BMI (VLBMI, <16 kg/m(2)) tolerate IVFEs better than do patients with low BMI (LBMI, 16-18.4 kg/m(2)), normal-weight patients (NBMI, 18.5-24.9 kg/m(2)), and overweight/obese patients (HBMI, ≥25 kg/m(2)). The median triglyceride concentration during IVFE was significantly lower in VLBMI patients at 107 mg/dL compared with 124 mg/dL in non-VLBMI patients (P = .016), despite higher lipid infusion rates in the VLBMI group. There was a significant association between triglycerides and BMI in the aggregate cohort (R = 0.2375, P < .0001), with the highest frequency of hypertriglyceridemia occurring in HBMI patients despite relatively lower lipid and energy supply. In a subset of VLBMI patients (n = 36) who had an abdominal computed tomography scan, there was 25- to 100-fold variability in the size of the abdominal adipose tissue depots. In this subgroup, triglyceride concentrations correlated with visceral fat but not subcutaneous abdominal fat. In summary, patients with VLBMI have lower triglyceride concentrations during IVFEs than do other individuals, but there is considerable variability in triglycerides and body fat in this group. Caution should be employed with the use of IVFEs, especially in HBMI patients. © 2014 American Society for Parenteral and Enteral Nutrition.

  20. Prognostic nutritional index is an independent prognostic factor for gastric cancer patients with peritoneal dissemination

    PubMed Central

    Nie, Runcong; Yuan, Shuqiang; Chen, Shi; Chen, Xiaojiang; Chen, Yongming; Zhu, Baoyan; Qiu, Haibo; Zhou, Zhiwei; Peng, Junsheng; Chen, Yingbo

    2016-01-01

    Objective The predictive and prognostic role of prognostic nutritional index (PNI) in gastric cancer patients with peritoneal dissemination remains unclear. This study aims to explore the role of the PNI in predicting outcomes of gastric cancer patients with peritoneal dissemination. Methods A total of 660 patients diagnosed with gastric adenocarcinoma with peritoneal metastasis between January 2000 and April 2014 at Sun Yat-sen University Cancer Center and the Sixth Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The clinicopathologic characteristics and clinical outcomes of patients with peritoneal dissemination were analyzed. Results Compared with PNI-high group, PNI-low group was correlated with advanced age (P=0.036), worse performance status (P<0.001), higher frequency of ascites (P<0.001) and higher frequency of multisite distant metastasis (P<0.001). Kaplan-Meier survival curves showed that PNI-high group had a significantly longer median overall survival than PNI-low group (13.13 vs. 9.03 months, P<0.001). Multivariate survival analysis revealed that Borrmann type IV (P=0.014), presence of ascites (P=0.017) and lower PNI (P=0.041) were independent poor prognostic factors, and palliative surgery (P<0.001) and first-line chemotherapy (P<0.001) were good prognostic factors. For patients receiving palliative surgery, the postoperative morbidity rates in the PNI-low group and PNI-high group were 9.1% and 9.9%, respectively (P=0.797). The postoperative mortality rate was not significantly different between PNI-low and PNI-high groups (2.3% vs. 0.9%, P=0.362). Conclusions PNI is a useful and practical tool for evaluating the nutritional status of gastric cancer patients with peritoneal dissemination, and is an independent prognostic factor for these patients. PMID:28174485

  1. High nutritional risk is associated with worse health-related quality of life in patients with heart failure beyond sodium intake.

    PubMed

    Son, Youn-Jung; Song, Eun Kyeung

    2013-04-01

    The most desirable outcome in heart failure (HF) management is to improve health-related quality of life (HRQoL) as a patient-centred health outcome. Nutrition is assumed to be important in HF management, whereas there is little evidence that nutritional risk affects HRQoL, except for sodium. We aimed to determine whether nutritional risk is associated with worse HRQoL after controlling for daily sodium intake. A total of 134 consecutive patients with HF [age 63 ± 11 years, 35% female, 45% New York Heart Association (NYHA) class III/IV, ejection fraction (EF) 33 ± 13%] completed the Nutrition Screening Initiative (NSI) to assess nutritional risk and a 24-h urine sodium excretion assessment to estimate daily sodium intake at baseline. The Minnesota Living with HF Questionnaire was used to evaluate HRQoL at baseline and 6 months later. Hierarchical linear regressions were used to determine whether nutritional risk predicted HRQoL at baseline and 6 months later. Seventy-eight (58.2%) patients had high nutritional risk as indicated by a total NSI score ≥ 6. Increased nutritional risk was independently associated with worse HRQoL at baseline and 6 months later (β = 0.33, p < 0.001; β = 0.35, p < 0.001, respectively), after controlling for age, gender, aetiology, body mass index, NYHA class, EF, total comorbidity score, prescribed medications, and daily sodium intake. These findings show that higher nutritional risk beyond sodium intake affects worse HRQoL in patients with HF. Further work is required to provide specific dietary guidelines to improve health outcomes for patients with HF.

  2. Patterns of Risk: The Nutritional Status of the Rural Poor.

    ERIC Educational Resources Information Center

    Shotland, Jeffrey; Loonin, Deanne

    Nutrition and health are underlying influences to education performance. This report is a collection and analysis of data on nutrition and the rural poor in the United States. It presents an empirical assessment of critical nutritional and social-service problems experienced by the rural poor population. The first section of the report uses data…

  3. Nutrition risk screening: the interrelationship of food insecurity, food intake, and unintentional weight change among homebound elders.

    PubMed

    Sharkey, Joseph R

    2004-01-01

    Nutrition risk screening is a key component of the homedelivered meals program. To examine direct and indirect relationships among individual components of nutrition risk, path analysis was conducted on routinely collected data from 908 homebound elders who received home-delivered meals. The good fit of the model revealed that specific nutrition risk factors and indicators of nutritional risk were directly and indirectly associated with meal frequency and unintended weight change. With the heightened vulnerability for poor nutritional health among homebound elders who report food insecurity, policymakers and service providers should strengthen efforts to target individual components of nutrition risk rather than aggregate scores or categorical measures.

  4. NRS-2002 for pre-treatment nutritional risk screening and nutritional status assessment in head and neck cancer patients.

    PubMed

    Orell-Kotikangas, Helena; Österlund, Pia; Saarilahti, Kauko; Ravasco, Paula; Schwab, Ursula; Mäkitie, Antti A

    2015-06-01

    The aim of this study was to assess the value of nutritional risk screening-2002 (NRS-2002) as a nutritional risk screening and status assessment method and to compare it with nutritional status assessed by subjective and objective methods in the screening of head and neck cancer patients. Sixty-five consecutive patients (50 male), with a median age of 61 years (range, 33-77), with head and neck squamous cell carcinoma (HNSCC) were enrolled prior to cancer therapy. Nutritional status was assessed by NRS-2002, patient-generated subjective global assessment (PG-SGA), handgrip strength (HGS) and mid-arm muscle area (MAMA). Twenty-eight percent of patients were at nutritional risk based on NRS-2002, and 34 % were malnourished according to PG-SGA, while 43 % had low HGS. NRS-2002 cut-off score of ≥3 compared with the nutritional status according to PG-SGA showed 77 % specificity and 98 % sensitivity (K = 0.78). NRS-2002 was able to predict malnutrition (PG-SGA BC) both in men (p < 0.001) and in women (p < 0.05). NRS-2002 identified correctly patients with malnutrition with a score of ≥3 (p < 0.001) and risk patients with a score of ≥2 (p < 0.001). These results suggest that NRS-2002 seems to be a reliable indicator of malnutrition, while NRS-2002 with the cut-off score of ≥2 seems to be more reliable for nutrition screening in head and neck cancer patients prior to oncological treatment.

  5. Prevalence and risk factors associated with nutrition-related noncommunicable diseases in the Eastern Mediterranean region

    PubMed Central

    Musaiger, Abdulrahman O; Al-Hazzaa, Hazzaa M

    2012-01-01

    This paper reviews the current situation concerning nutrition-related noncommunicable diseases (N-NCDs) and the risk factors associated with these diseases in the Eastern Mediterranean region (EMR). A systematic literature review of studies and reports published between January 1, 1990 and September 15, 2011 was conducted using the PubMed and Google Scholar databases. Cardiovascular disease, type 2 diabetes, metabolic syndrome, obesity, cancer, and osteoporosis have become the main causes of morbidity and mortality, especially with progressive aging of the population. The estimated mortality rate due to cardiovascular disease and diabetes ranged from 179.8 to 765.2 per 100,000 population, with the highest rates in poor countries. The prevalence of metabolic syndrome was very high, ranging from 19% to 45%. The prevalence of overweight and obesity (body mass index ≥25 kg/m2) has reached an alarming level in most countries of the region, ranging from 25% to 82%, with a higher prevalence among women. The estimated mortality rate for cancer ranged from 61.9 to 151 per 100,000 population. Osteoporosis has become a critical problem, particularly among women. Several risk factors may be contributing to the high prevalence of N-NCDs in EMR, including nutrition transition, low intake of fruit and vegetables, demographic transition, urbanization, physical inactivity, hypertension, tobacco smoking, stunting of growth of preschool children, and lack of nutrition and health awareness. Intervention programs to prevent and control N-NCDs are urgently needed, with special focus on promotion of healthy eating and physical activity. PMID:22399864

  6. Multiple nutritional factors and the risk of Hashimoto's Thyroiditis.

    PubMed

    Hu, Shiqian; Rayman, Margaret P

    2017-03-14

    Background Hashimoto's Thyroiditis (HT) is considered to be the most common autoimmune disease. It is currently accepted that genetic susceptibility, environmental factors and immune disorders contribute to its development. Regarding nutritional factors, evidence implicates high iodine intake, deficiencies of selenium and iron with a potential relevance of vitamin D status. To elucidate the role of nutritional factors in the risk, pathogenesis and treatment of Hashimoto's Thyroiditis (HT), PubMed and the Cochrane Library were searched for publications on iodine, iron, selenium and vitamin D and risk/treatment of HT. Summary Iodine: Chronic exposure to excess iodine intake induces autoimmune thyroiditis, partly because highly-iodinated thyroglobulin is more immunogenic. Recent introduction of universal salt iodization can have a similar, though transient, effect. Iron: Iron deficiency impairs thyroid metabolism. Thyroid peroxidase (TPO), the enzyme responsible for the production of thyroid hormones is a heme (iron-containing) enzyme; it becomes active at the apical surface of thyrocytes only after binding heme. HT patients are frequently iron-deficient as autoimmune gastritis, which impairs iron absorption, is a common co-morbidity. Treatment of anemic women with impaired thyroid function with iron improved thyroid-hormone concentrations while thyroxine and iron together were more effective in improving iron status. Selenium: Selenoproteins are essential to thyroid action. In particular, the glutathione peroxidases protect the thyroid by removing excessive hydrogen peroxide produced there for thyroglobulin iodination. Genetic data implicate the anti-inflammatory selenoprotein S in HT risk. There is evidence from observational studies and randomized controlled trials that selenium/selenoproteins can reduce TPO-antibody titer, hypothyroidism and post-partum thyroiditis. Vitamin D: Lower vitamin D status has been found in HT patients than in controls and inverse

  7. Nutrition

    MedlinePlus

    Nutrition Health Education During the 2 years preceding the study: • The percentage of states that provided funding for staff development or offered staff development on nutrition and dietary behavior to those who teach health ...

  8. Nutrition

    MedlinePlus

    ... into your diet. These include brightly colored and dark fruits and vegetables. Balance the food you eat ... can also order your free copy of Nutrition Matters and visit our Ask about Nutrition forum. << Back ...

  9. Cardiopulmonary risk index does not predict complications after thoracic surgery.

    PubMed

    Melendez, J A; Carlon, V A

    1998-07-01

    The preoperative cardiopulmonary risk index (CPRI) is a multifactorial index intended to predict postoperative outcome after thoracic surgery. It combines cardiac and pulmonary information into one parameter that ranges from 1 to 10, with 10 being the worst. A CPRI > or = 4 has been advocated as an effective predictor of postoperative pulmonary and cardiac complications. This study prospectively evaluates the predictive value of CPRI in a large population of patients undergoing thoracic surgery. We performed prospective calculation of CPRI in patients about to undergo thoracic surgery. Postthoracic surgery occurrence of pneumonia, atelectasis, arrhythmias, congestive heart failure, respiratory failure requiring therapy, or death occurring within 30 days of surgery was compared with preoperative CPRI and its components. One hundred eighty consecutive patients, aged 15 to 87 years, were studied. Operations performed included 114 lobectomies, 35 wedge resections, 19 pneumonectomies, 5 pleurectomies, 5 lymph node dissections, 1 thoracic wall resection, and 1 paravertebral tumor resection. Twenty-seven percent of patients experienced complications. CPRI and its components did not predict complications, deaths, or the number of in-hospital days. We found a CPRI > or = 4 to be a moderate predictor of outcome for patients undergoing pneumonectomy (n = 19). It correctly identified four of nine postpneumonectomy complications. The preoperative CPRI and its components are inadequate predictors of medical complications after thoracic surgery in a general population. In the subgroup of patients undergoing pneumonectomy, the index may be of some value in forecasting outcome.

  10. Associations between depressive symptomatology, diet, and body mass index among participants in the supplemental nutrition assistance program.

    PubMed

    Flórez, Karen R; Dubowitz, Tamara; Ghosh-Dastidar, Madhumita Bonnie; Beckman, Robin; Collins, Rebecca L

    2015-07-01

    Participation in the Supplemental Nutrition Assistance Program (SNAP) has been shown to increase food security, or access to adequate food; however, SNAP participation has also been associated with obesity among certain demographic groups (eg, women, but not men and children), possibly due to poorer dietary quality. Depressive symptomatology is an understudied factor, which is associated with obesity across the lifespan. This study examined the relationship between depressive symptomatology, dietary quality, and body weight among a sample of SNAP participants (n=639). The analysis was cross-sectional; survey data were collected in May to December 2011 by trained data collectors. Adults who self-identified as the primary food shopper of the household in two predominantly low-income African-American neighborhoods characterized as "food deserts" in Pittsburgh, PA, were recruited to participate in this study. Dietary quality was calculated using the US Department of Agriculture's Healthy Eating Index-2005. Body mass index (BMI; calculated as kg/m(2)) was based on objective measurements taken by the interviewer. Current depressive symptomatology was assessed by a trained interviewer using the Patient Health Questionnaire-2. Descriptive statistics (means and percentages); two multivariate ordinary least-square regression analyses predicting BMI and dietary quality from depressive symptomatology while controlling for sociodemographic factors and food insecurity were performed. Depression was a strong and statistically significant predictor of both dietary quality and BMI; higher score in depressive symptomatology was associated with lower scores in dietary quality (β=-1.26; P<0.0001). A higher score in depressive symptomatology was associated with higher BMI (β=.63; P=0.0031). These findings show that depressive symptomatology is significantly associated with weight-related outcomes and suggests that understanding the risk of depression among SNAP participants could be

  11. Glycemic index, glycemic load and thyroid cancer risk.

    PubMed

    Randi, G; Ferraroni, M; Talamini, R; Garavello, W; Deandrea, S; Decarli, A; Franceschi, S; La Vecchia, C

    2008-02-01

    Risk of thyroid cancer has already been related to refined cereals and starch food, but the association has not been studied in terms of glycemic index (GI) and glycemic load (GL). We analyzed data from a case-control study conducted in Italy from 1986 to 1992 and including 399 histologically confirmed and incident cases of thyroid cancer and 616 control subjects. Information on dietary habits was derived through a food-frequency questionnaire and multivariate odds ratios (ORs) for GI and GL levels were estimated with adjustment for age, education, sex, area of residence, history of diabetes, body mass index, smoking, alcohol consumption, intake of fruit and vegetables, and noncarbohydrate energy intake. Compared with the lowest tertile, the ORs in subsequent tertiles were 1.68 and 1.73 for GI, and 1.76 and 2.17 for GL. The OR for highest tertile of GI compared with lowest one was 1.70 for papillary and 1.57 for follicular thyroid cancer. The ORs for GL were 2.17 for papillary and 3.33 for follicular thyroid cancer. Our study shows that high dietary levels of GI and GL are associated with thyroid cancer risk.

  12. Association Between Nutritional Status, Inflammatory Condition, and Prognostic Indexes with Postoperative Complications and Clinical Outcome of Patients with Gastrointestinal Neoplasia.

    PubMed

    Costa, Milena Damasceno de Souza; Vieira de Melo, Camila Yandara Sousa; Amorim, Ana Carolina Ribeiro de; Cipriano Torres, Dilênia de Oliveira; Dos Santos, Ana Célia Oliveira

    2016-10-01

    The aim of this study is to describe and relate nutritional and inflammatory status and prognostic indexes with postoperative complications and clinical outcome of patients with gastrointestinal malignancies. Twenty-nine patients were evaluated; nutritional assessment was carried out by subjective and objective parameters; albumin, pre-albumin, C-reactive protein (CRP), and alpha-1-acid glycoprotein (AGP) were determined. To assess prognosis, the Glasgow scale, the Prognostic Inflammatory Nutritional Index (PINI), and CRP/albumin ratio were used; the clinical outcomes considered were hospital discharge and death. A high Subjective Global Assessment (SGA) score was associated with the occurrence of postoperative complications: 73% of the patients with postoperative complications had the highest SGA score, but only 6% of those without postoperative complications had the highest SGA score (P < 0.001). Greater occurrence of death was observed in patients with a high SGA score, low serum albumin, increased CRP, PINI > 1, and Glasgow score 2. There was a positive correlation between weight loss percentage with serum CRP levels (P = 0.002), CRP/albumin (P = 0.002), PINI (P = 0.002), and Glasgow score (P = 0.000). This study provides evidence that the assessment of the nutritional status and the use of prognostic indexes are good tools for predicting postoperative complications and clinical outcome in patients with gastrointestinal neoplasia.

  13. Body mass index and risk of diabetic retinopathy

    PubMed Central

    Zhou, Yue; Zhang, Yuezhi; Shi, Ke; Wang, Changyun

    2017-01-01

    Abstract Diabetic retinopathy (DR) is a frequent cause of acquired blindness worldwide. Various studies have reported the effects of body mass index (BMI) on the risk of DR, but the results remain controversial. Therefore, a meta-analysis was performed to evaluate the relationship between BMI and the risk of DR. A systematic search was performed using the Cochrane Library, PubMed, and Embase databases to obtain articles published through December 2016. Articles regarding the association between BMI and the risk of DR were retrieved. The adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) were included and then pooled with a random effects model. A total of 27 articles were included in this meta-analysis. When BMI was analyzed as a categorical variable, neither being overweight (OR = 0.89, 95% CI 0.75–1.07; P = .21; I2 = 65%) nor obesity (OR = 0.97, 95% CI 0.73–1.30; P = .86) were associated with an increased risk of DR when compared with normal weight. When BMI was analyzed as a continuous variable, a higher BMI was not associated with an increased risk of DR (OR = 0.99, 95% CI 0.97–1.01; P = .25; I2 = 79%). The pooled results did not significantly change after the sensitivity analysis. Based on the current publications, neither being overweight nor obesity is associated with an increased risk of DR. Further studies should confirm these findings. PMID:28562529

  14. Early detection of coagulation abnormalities in patients at nutritional risk: the novel role of thromboelastography.

    PubMed

    Xu, Ziwei; Li, Yousheng; Yang, Xiufang; Wang, Jian; Li, Jieshou

    2014-01-01

    It is believed that malnutrition is common among hospitalized patients and associated with increased risk of morbidity and mortality. It is unclear if it is more likely to cause coagulation disorders in patients with malnutrition. We, therefore, investigate the feasibility of using thromboelastography (TEG) in early detection of coagulation abnormalities in patients at nutritional risk. Fifty successive adult patients with gastrointestinal disease were prospectively divided into one of two groups according to nutritional risk score (less than 3 and 3 or greater). Blood samples were collected at admission for analysis of standard biochemical parameters, routine coagulation tests, and TEG parameters. A total of 62 per cent of patients (n = 31) were at nutritional risk. Serum concentrations of prealbumin, transferrin, total protein, low-density lipoprotein, high-density lipoprotein, and cholesterol were much lower in the nutritional risk group than in the no-risk group (P ≤ 0.05). There was no significant difference in routine coagulation tests, whereas most of the TEG parameters showed significant differences between the two groups. The overall coagulation function was worse in patients at nutritional risk than in patients with good nutritional status (P ≤ 0.01). TEG appears to be more sensitive for the detection of coagulation abnormalities compared with routine coagulation tests in patients at nutritional risk. The phenomenon described in this article should be useful in further studies of patients with malnutrition.

  15. Evaluation of Prognostic Nutritional Index in Patients Undergoing Radical Surgery with Nonsmall Cell Lung Cancer.

    PubMed

    Qiu, Chen; Qu, Xiao; Shen, Hongchang; Zheng, Chunlong; Zhu, Linhai; Meng, Long; Du, Jiajun

    2015-01-01

    The prognostic nutritional index (PNI) has been reported to be a prognostic indicator in some malignant tumors. However, its prognostic value in nonsmall cell lung cancer (NSCLC) has not been fully investigated. A retrospective review of 1416 patients with NSCLC who underwent radical surgery between January 2006 and December 2011 was conducted. To obtain optimal cutoff levels of PNI, running log-rank statistics was applied. Survival was calculated by the Kaplan-Meier method. The prognostic significance of PNI, together with various clinicopathological factors, was evaluated by multivariate analysis. The optimal cutoff point for PNI was 52. The 1-, 3-, and 5-yr survival rates in patients with PNI of less than 52 were 80.0%, 61.3%, and 50.4%, respectively, and were significantly more unfavorable than those in patients with PNI 52 or higher (84.7%, 71.5%, and 60.3%, respectively, P < 0.001). Multivariate analysis suggested that gender (P = 0.026), age (P < 0.001), PNI (P = 0.005), differentiation (P = 0.024), pathology T category (P = 0.003), and pathology N category (P < 0.001) were revealed to be independent prognostic factors. Our results indicate that PNI is an independent predictor of survival for patients undergoing radical surgery with NSCLC.

  16. Effect of nutrition and atherogenic index on the occurrence and intensity of insulin resistance.

    PubMed

    Ostrowska, Lucyna; Witczak, Katarzyna; Adamska, Edyta

    2013-01-01

    Diet is one of the factors that can stimulate genetic predisposition and, in consequence, lead to insulin resistance. An adequate supply of nutrients and energy-rich diet as well as increased physical activity are the most effective methods to prevent metabolic disorders. The objective of this study was to determine whether there are any associations between nutrition and the occurrence of insulin resistance. The study included 143 individuals. Fasting glucose and insulin levels were measured and the HOMA-IR index was calculated for each patient. Nondiabetic patients were divided into the study and control groups. We conducted anthropometric measurements (body mass, height, and waist circumference), biochemical analysis (fasting glucose and insulin), and dietary interview. We observed a negative correlation between the percentage of sucrose in the diet and the HOMA-IR value, and a positive correlation between the percentage of protein intake and the HOMA-IR value. Moreover, there was a significantly higher intake of lactose in men without insulin resistance compared with those with insulin resistance. The results encourage to conduct further, more detailed research involving a larger group of patients to better understand associations between dietary content and insulin resistance.

  17. Body mass index and waist circumference are good indicators for classifying children's nutritional status.

    PubMed

    Jensen, Natália Sanchez Oliveira; Camargo, Taís de Fátima Borges; Bergamaschi, Denise Pimentel

    2016-04-01

    This study aimed to investigate the relationship between anthropometric indicators - body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) - and the sum of skinfold thicknesses in 7-10-year-old children attending a public school in São Paulo (SP). Height, weight, WC and triceps, biceps, subscapular and suprailiac skinfolds were measured, and the sum of skinfold thicknesses, BMI and WHtR were calculated. A Bland-Altman analysis was used in order to compare methods, with values transformed into z-scores. The analysis of limits of agreement and confidence intervals showed evidence of good agreement, above all between BMI and WC, and the sum of skinfold thicknesses, complying with strict agreement limits and differences smaller than 1 standard deviation (SD). WHtR showed moderate limits of agreement, from -1.02 to + 0.64 SD (boys) and -0.74 to + 1.12 SD (girls); its performance was not better than that of WC alone, the lower and upper limits of agreement for which were -0.91 to + 0.58 SD (boys) and -0.56 to + 0.89 SD (girls). The results support the use of anthropometric indicators to classify nutritional status, above all BMI and WC, in that both are similar when classifying children according to body fatness, and confer the advantages of being easy to obtain and affordable.

  18. Dietary glycemic index and glycemic load and their relationship to cardiovascular risk factors in Chinese children.

    PubMed

    Zhang, Xinyu; Zhu, Yanna; Cai, Li; Ma, Lu; Jing, Jin; Guo, Li; Jin, Yu; Ma, Yinghua; Chen, Yajun

    2016-04-01

    The purpose of this study was to examine the cross-sectional associations between dietary glycemic index (GI) and glycemic load (GL) and cardiovascular disease (CVD) risk factors in Chinese children. A total of 234 Chinese schoolchildren aged 8-11 years in Guangdong participated in the study. Dietary intake was assessed via a 3-day dietary record. Seven established cardiovascular indicators were analyzed in this study: fasting plasma glucose (FPG), fasting triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), systolic blood pressure, and diastolic blood pressure. Higher dietary GI was significantly associated with higher TG levels (P = 0.037) and lower HDL-C levels (P = 0.005) after adjusting for age, sex, nutritional intake, physical activity, and body mass index z score. LDL-C was found to differ across tertiles of dietary GL. The middle tertile tended to show the highest level of LDL-C. TC, FPG, and blood pressure were independent of both dietary GI and GL. Our findings suggest that higher dietary GI is differentially associated with some CVD risk factors, including lower HDL-C and higher TG, in school-aged children from south China.

  19. Dietary glycemic index and glycemic load and the risk of type 2 diabetes in older adults.

    PubMed

    Sahyoun, Nadine R; Anderson, Amy L; Tylavsky, Frances A; Lee, Jung Sun; Sellmeyer, Deborah E; Harris, Tamara B

    2008-01-01

    It is unclear whether immediate dietary effects on blood glucose influence the risk of developing type 2 diabetes. The objective of this study was to examine whether the dietary glycemic index (GI) and glycemic load (GL) were associated with the risk of type 2 diabetes in older adults. The Health, Aging, and Body Composition Study is a prospective cohort study of 3075 adults who were 70-79 y old at baseline (n=1898 for this analysis). The intakes of specific nutrients and food groups and the risk of type 2 diabetes over a 4-y period were examined according to dietary GI and GL. Dietary GI was positively associated with dietary carbohydrate and negatively associated with the intakes of protein, total fat, saturated fat, alcohol, vegetables, and fruit. Dietary GL was positively associated with dietary carbohydrate, fruit, and fiber and negatively associated with the intakes of protein, total fat, saturated fat, and alcohol. Persons in the higher quintiles of dietary GI or GL did not have a significantly greater incidence of type 2 diabetes. These findings do not support a relation between dietary GI or GL and the risk of type 2 diabetes in older adults. Because dietary GI and GL show strong nutritional correlates, the overall dietary pattern should be considered.

  20. Nutrition in primary and secondary prevention of cardiovascular risk in the continental and Mediterranean regions of Croatia.

    PubMed

    Sikic, Jozica; Stipcevic, Mira; Vrazic, Hrvoje; Cerkez Habek, Jasna; Margetic, Eduard; Gulin, Dario

    2017-09-16

    The aim of this observational study was to evaluate the effect of Mediterranean and continental nutrition on cardiovascular risk in patients with acute and chronic coronary heart disease in Croatia. The study included 1284 patients who were hospitalized in a 28-month period due to acute or chronic ischaemic heart disease in hospitals across Croatia. An individual questionnaire was prepared which enabled recording of various cardiovascular risk factors. Patients with chronic coronary artery disease have a better index of healthy diet than patients with acute coronary disease. Women have a better index of diet than men in both Croatian regions. When the prevalence of risk factors (impaired glucose tolerance, diabetes mellitus types I and II, hypercholesterolaemia, hypertriglyceridaemia and hypertension) in patients with Mediterranean and continental nutrition is compared, a trend is seen for patients who have risk factors to consume healthier food. The Mediterranean diet is associated with reduced risk of developing cardiovascular disease. This effect is more evident in patients with known cardiovascular disease.

  1. Body mass index, lifetime smoking intensity and lung cancer risk.

    PubMed

    El-Zein, Mariam; Parent, Marie-Elise; Nicolau, Belinda; Koushik, Anita; Siemiatycki, Jack; Rousseau, Marie-Claude

    2013-10-01

    There is as yet no generally accepted explanation for the common finding that low body mass index (BMI) is associated with an increased risk of lung cancer. We investigated this association in a Canadian population-based case-control study (1996-2002) with a particular view to assessing the hypothesis that the observed association was due to residual confounding by smoking. Analyses were based on 1,076 cases and 1,439 controls who provided their height at enrollment and their weight at two points in time, at age 20 and 2 years before enrollment. BMI, in kg/m(2) , was classified into underweight (<18.5), normal (18.5-24.9), overweight (25.0-29.9), and obese (≥30). Smoking history was synthesized into a comprehensive smoking index (CSI) that integrated duration, intensity and time since quitting. Odds ratios (ORs) and 95% confidence intervals (CIs) for BMI-lung cancer associations were estimated, adjusting for CSI as well as several sociodemographic, lifestyle and occupational factors. The normal BMI category was used as the reference. Among those who were underweight at age 20, there was a lower risk of lung cancer (OR = 0.69, 95% CI: 0.50-0.95). Conversely, lung cancer risk was increased among those who were underweight 2 years before enrollment (OR = 2.30, 95% CI: 1.30-4.10). The results were almost identical when stratifying analyses based on smoking history into never/lighter and heavier smokers. The inverse association between recent BMI and lung cancer is unlikely to be largely attributable to residual confounding by smoking. Reverse causality or a true relationship between BMI and lung cancer remain plausible.

  2. Nutritional status and dietary intake among pregnant women in relation to pre-pregnancy body mass index in Japan.

    PubMed

    Uno, Kaoru; Takemi, Yukari; Hayashi, Fumi; Hosokawa, Momo

    2016-01-01

    Objective The present study examined nutritional status and dietary intake of pregnant women in Japan in relation to pre-pregnancy body mass index (BMI).Methods Participants included 141 Japanese women with singleton pregnancies, from the outpatient department of the S hospital, Gunma prefecture, Japan. Two-day food records, dietary assessment questionnaires, and clinical records were obtained at 20 weeks gestation. Nine patients were excluded from the study due to morning sickness. The remaining 132 participants were divided into 3 groups according to pre-pregnancy BMI: underweight, normal weight, and overweight. Nutritional status and dietary intake were analyzed in relation to BMI using the chi-square test, Fisher's exact test, Kruskal-Wallis test, one-way analysis of variance, and analysis of covariance with adjustment for age, employment status, and total energy intake.Results Women who were underweight before pregnancy were more frequently working full-time than normal weight and overweight women. Underweight women were also more frequently anemic (P=0.038, underweight 39.3%, normal weight 24.7%, overweight 0%) and had lower mean hemoglobin (Hb) (P=0.021, underweight 11.3 g/dL, normal weight 11.6 g/dL, overweight 12.1 g/dL) and hematocrit (Hct) levels (P=0.025, underweight 33.7%, normal weight 34.3%, overweight 36.0%). Their dietary intake of protein, iron, magnesium, and folic acid was lower than that of normal weight and overweight women. Their meals tended to include fewer meat, fish, egg, and soybean dishes (underweight, mean of 4.7 servings per day; normal weight, 6.1 servings; overweight, 6.1 servings).Conclusion Pregnant women who were underweight before pregnancy had increased risk of anemia as well as reduced Hb and Hct levels. They had lower dietary intake of protein, iron and folic acid compared to women in the other BMI categories. Anemia and these nutrient deficiencies are known risk factors for low birth weight. Our findings suggest

  3. Use of Nutrition Risk in Critically ill (NUTRIC) Score to Assess Nutritional Risk in Mechanically Ventilated Patients: A Prospective Observational Study.

    PubMed

    Kalaiselvan, M S; Renuka, M K; Arunkumar, A S

    2017-05-01

    Nutritional risk assessment must be done on all critically ill patients. Malnutrition in intensive care unit (ICU) patients is associated with adverse clinical outcomes. Traditional scoring systems cannot be used for screening in mechanically ventilated (MV) patients because these patients are unable to provide information on their history of food intake and weight loss. The Nutrition Risk in Critically ill (NUTRIC) score is the appropriate nutritional assessment tool in MV patients. This prospective observational study was conducted to identify the nutritional risk in MV patients using modified NUTRIC (mNUTRIC) score (with the exception of interleukin-6). All adult patients admitted to the ICU and required MV for more than 48 h were included in the study. Data were collected on variables required to calculate mNUTRIC score. Patients with mNUTRIC score ≥5 are considered at nutritional risk. Outcome data were collected on ICU length of stay, ventilator-free days, and mortality. A total of 678 MV patients fit into the inclusion criteria. Majority of the patients were male (67%). Mean age of the patients was 55 years. About 288 (42.5%) patients were at high nutritional risk (mNUTRIC score ≥5). Patients with high mNUTRIC score ≥5 had longer mean ICU average length of stay of 9.0 (±4.2) versus 7.8 (±5.8) mean (± standard deviation) days (P < 0.01) and higher mortality 41.4% versus 26.1% (P < 0.0) compared to patients with low NUTRIC score (≤4). High mNUTRIC score (≥5) predicted mortality with area under the curve of 0.582 (95% confidence interval 0.535-0.628). Nearly 42.5% of MV patients admitted to ICU were at nutritional risk, and high mNUTRIC score was associated with increased ICU length of stay and higher mortality.

  4. Relation of Serum Phosphorus Levels to Ankle Brachial Pressure Index (From the Third National Health and Nutrition Examination Survey)

    PubMed Central

    Kendrick, Jessica; Ix, Joachim H.; Targher, Giovanni; Smits, Gerard; Chonchol, Michel

    2010-01-01

    Higher levels of serum phosphorus that remain within the reference range are associated with increased risk of cardiovascular disease (CVD). However, the mechanisms by which higher serum phosphorus concentrations may contribute to the development of CVD remain unclear. Cross-sectional association between serum phosphorus levels and arterial stiffness as estimated by an ankle brachial pressure index (ABPI) >1.3, was examined in 581 participants in the Third National Health and Nutrition Examination Survey. Logistic regression analysis was performed to evaluate whether higher serum phosphorus levels were associated with high ABPI, independently of several potential confounders. Among the 581 participants, 38% and 10% had a serum phosphorus levels >3.5 and >4.0 mg/dL, respectively. An ABPI >1.3 was present in 7.3% of participants. Higher quartiles of serum phosphorus levels were associated with a greater prevalence of high ABPI: 5.4%, 3.7%, 7.8%, and 12.9% for quartiles 1 (<3.1 mg/dL), 2 (3.1 to 3.4 mg/dL), 3 (3.4 to 3.7 mg/dL) and 4 (3.7 to 5.0 mg/dL), respectively. There was a strong, positive association between the highest quartile of serum phosphorus (3.7 to 5.0 mg/dL) and high ABPI when compared to the reference group (3.1 to 3.4 mg/dL) after adjustment for demographics, traditional CVD risk factors, kidney function, C-reactive protein, serum calcium, and 25-hydroxyvitamin D levels (adjusted odds ratio 4.78, 95% CI 1.73 to 13.2; p=0.003). In conclusion, serum phosphorus levels, even within the reference range, are independently associated with high ABPI, a marker of arterial stiffness, in the US adult population. PMID:20691317

  5. The social environment of schools and adolescent nutrition: associations between the school nutrition climate and adolescents' eating behaviors and body mass index.

    PubMed

    Cvjetan, Branko; Utter, Jennifer; Robinson, Elizabeth; Denny, Simon

    2014-10-01

    The aim of this study was to determine the association between the school nutrition climate and students' eating behaviors and body mass index (BMI). Data were collected as part of Youth'07, a nationally representative health survey of high school students in New Zealand. Overall, 9107 randomly selected students from 96 randomly selected schools participated. School-level measures were created by aggregating students' reports within schools. Analyses were conducted using multilevel modeling, accounting for student-level characteristics. There was a positive association between the school nutrition climate and students' consumption of fruits and vegetables. This relationship was statistically significant after controlling for the background characteristics of students. There were no associations between the school nutrition climate and students' junk food consumption or BMI. The school nutrition climate appears to have a positive influence on adolescents' healthy eating behaviors (fruit and vegetable intake), but a limited effect on unhealthy eating behaviors and ultimately body weight. This may reflect the pervasiveness of junk food in the environments of adolescents outside of school and the difficulty in limiting its consumption. © 2014, American School Health Association.

  6. Children-at-risk for poor nutrition: expanding the approach of future professionals in educational institutions.

    PubMed

    Shor, Ron

    2011-08-01

    To examine how the subject of nutrition is being addressed in the work with children at risk of poor nutrition in educational institutions and what the barriers are which may hinder inclusion of this subject. A structured questionnaire was constructed for the purpose of this study and was implemented with 111 students in Israel who are working in their internships in educational institutions with children who are exposed to risk factors of poor nutrition (e.g., parental neglect, lack of knowledge, poverty). Participants attributed a high level of importance to integrating nutrition-related components in their work. However, the findings indicate less emphasis on nutrition-related components than on psycho-social-educational components, as well as a low level of collaboration with specialists in the area of nutrition. In addition, it was found that knowledge-based barriers and institutional-related systemic barriers may hinder future teachers' capabilities to incorporate those components despite their favorable approach towards this subject. The findings illuminate the need to reduce barriers hampering the individual work with children at risk of poor nutrition in educational institutions. In the training of future teachers, there is a need to advance a bio-psycho-social educational approach incorporating a knowledge base about assessing situations of poor nutrition, including how to advance an interdisciplinary collaboration with specialists in the area of nutrition. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk.

    PubMed

    Castro-Quezada, Itandehui; Sánchez-Villegas, Almudena; Estruch, Ramón; Salas-Salvadó, Jordi; Corella, Dolores; Schröder, Helmut; Alvarez-Pérez, Jacqueline; Ruiz-López, María Dolores; Artacho, Reyes; Ros, Emilio; Bulló, Mónica; Covas, María-Isabel; Ruiz-Gutiérrez, Valentina; Ruiz-Canela, Miguel; Buil-Cosiales, Pilar; Gómez-Gracia, Enrique; Lapetra, José; Pintó, Xavier; Arós, Fernando; Fiol, Miquel; Lamuela-Raventós, Rosa María; Martínez-González, Miguel Ángel; Serra-Majem, Lluís

    2014-01-01

    Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI) and glycemic load (GL) are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ). We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths). As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04); P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.

  8. Biomechanical rupture risk assessment of abdominal aortic aneurysms based on a novel probabilistic rupture risk index.

    PubMed

    Polzer, Stanislav; Gasser, T Christian

    2015-12-06

    A rupture risk assessment is critical to the clinical treatment of abdominal aortic aneurysm (AAA) patients. The biomechanical AAA rupture risk assessment quantitatively integrates many known AAA rupture risk factors but the variability of risk predictions due to model input uncertainties remains a challenging limitation. This study derives a probabilistic rupture risk index (PRRI). Specifically, the uncertainties in AAA wall thickness and wall strength were considered, and wall stress was predicted with a state-of-the-art deterministic biomechanical model. The discriminative power of PRRI was tested in a diameter-matched cohort of ruptured (n = 7) and intact (n = 7) AAAs and compared to alternative risk assessment methods. Computed PRRI at 1.5 mean arterial pressure was significantly (p = 0.041) higher in ruptured AAAs (20.21(s.d. 14.15%)) than in intact AAAs (3.71(s.d. 5.77)%). PRRI showed a high sensitivity and specificity (discriminative power of 0.837) to discriminate between ruptured and intact AAA cases. The underlying statistical representation of stochastic data of wall thickness, wall strength and peak wall stress had only negligible effects on PRRI computations. Uncertainties in AAA wall stress predictions, the wide range of reported wall strength and the stochastic nature of failure motivate a probabilistic rupture risk assessment. Advanced AAA biomechanical modelling paired with a probabilistic rupture index definition as known from engineering risk assessment seems to be superior to a purely deterministic approach.

  9. Biomechanical rupture risk assessment of abdominal aortic aneurysms based on a novel probabilistic rupture risk index

    PubMed Central

    Polzer, Stanislav; Gasser, T. Christian

    2015-01-01

    A rupture risk assessment is critical to the clinical treatment of abdominal aortic aneurysm (AAA) patients. The biomechanical AAA rupture risk assessment quantitatively integrates many known AAA rupture risk factors but the variability of risk predictions due to model input uncertainties remains a challenging limitation. This study derives a probabilistic rupture risk index (PRRI). Specifically, the uncertainties in AAA wall thickness and wall strength were considered, and wall stress was predicted with a state-of-the-art deterministic biomechanical model. The discriminative power of PRRI was tested in a diameter-matched cohort of ruptured (n = 7) and intact (n = 7) AAAs and compared to alternative risk assessment methods. Computed PRRI at 1.5 mean arterial pressure was significantly (p = 0.041) higher in ruptured AAAs (20.21(s.d. 14.15%)) than in intact AAAs (3.71(s.d. 5.77)%). PRRI showed a high sensitivity and specificity (discriminative power of 0.837) to discriminate between ruptured and intact AAA cases. The underlying statistical representation of stochastic data of wall thickness, wall strength and peak wall stress had only negligible effects on PRRI computations. Uncertainties in AAA wall stress predictions, the wide range of reported wall strength and the stochastic nature of failure motivate a probabilistic rupture risk assessment. Advanced AAA biomechanical modelling paired with a probabilistic rupture index definition as known from engineering risk assessment seems to be superior to a purely deterministic approach. PMID:26631334

  10. Effects of Playing a Serious Computer Game on Body Mass Index and Nutrition Knowledge in Women

    PubMed Central

    Hallinan, Sean; Seif El-Nasr, Magy; Subramanian, Shree; Castaneda-Sceppa, Carmen

    2016-01-01

    Background Obesity and weight gain is a critical public health concern. Serious digital games are gaining popularity in the context of health interventions. They use persuasive and fun design features to engage users in health-related behaviors in a non-game context. As a young field, research about effectiveness and acceptability of such games for weight loss is sparse. Objective The goal of this study was to evaluate real-world play patterns of SpaPlay and its impact on body mass index (BMI) and nutritional knowledge. SpaPlay is a computer game designed to help women adopt healthier dietary and exercise behaviors, developed based on Self-Determination theory and the Player Experience of Need Satisfaction (PENS) model. Progress in the game is tied to real-life activities (e.g., eating a healthy snack, taking a flight of stairs). Methods We recruited 47 women to partake in a within-subject 90-day longitudinal study, with assessments taken at baseline, 1-, 2-, and 3- months. Women were on average, 29.8 years old (±7.3), highly educated (80.9% had BA or higher), 39% non-White, baseline BMI 26.98 (±5.6), who reported at least contemplating making changes in their diet and exercise routine based on the Stages of Change Model. We computed 9 indices from game utilization data to evaluate game play. We used general linear models to examine inter-individual differences between levels of play, and multilevel models to assess temporal changes in BMI and nutritional knowledge. Results Patterns of game play were mixed. Participants who reported being in the preparation or action stages of behavior change exhibited more days of play and more play regularity compared to those who were in the contemplation stage. Additionally, women who reported playing video games 1-2 hours per session demonstrated more sparse game play. Brief activities, such as one-time actions related to physical activity or healthy food, were preferred over activities that require a longer commitment (e

  11. Effects of Playing a Serious Computer Game on Body Mass Index and Nutrition Knowledge in Women.

    PubMed

    Shiyko, Mariya; Hallinan, Sean; Seif El-Nasr, Magy; Subramanian, Shree; Castaneda-Sceppa, Carmen

    2016-06-02

    Obesity and weight gain is a critical public health concern. Serious digital games are gaining popularity in the context of health interventions. They use persuasive and fun design features to engage users in health-related behaviors in a non-game context. As a young field, research about effectiveness and acceptability of such games for weight loss is sparse. The goal of this study was to evaluate real-world play patterns of SpaPlay and its impact on body mass index (BMI) and nutritional knowledge. SpaPlay is a computer game designed to help women adopt healthier dietary and exercise behaviors, developed based on Self-Determination theory and the Player Experience of Need Satisfaction (PENS) model. Progress in the game is tied to real-life activities (e.g., eating a healthy snack, taking a flight of stairs). We recruited 47 women to partake in a within-subject 90-day longitudinal study, with assessments taken at baseline, 1-, 2-, and 3- months. Women were on average, 29.8 years old (±7.3), highly educated (80.9% had BA or higher), 39% non-White, baseline BMI 26.98 (±5.6), who reported at least contemplating making changes in their diet and exercise routine based on the Stages of Change Model. We computed 9 indices from game utilization data to evaluate game play. We used general linear models to examine inter-individual differences between levels of play, and multilevel models to assess temporal changes in BMI and nutritional knowledge. Patterns of game play were mixed. Participants who reported being in the preparation or action stages of behavior change exhibited more days of play and more play regularity compared to those who were in the contemplation stage. Additionally, women who reported playing video games 1-2 hours per session demonstrated more sparse game play. Brief activities, such as one-time actions related to physical activity or healthy food, were preferred over activities that require a longer commitment (e.g., taking stairs every day for a week

  12. Dietary fiber and the glycemic index: a background paper for the Nordic Nutrition Recommendations 2012

    PubMed Central

    Øverby, Nina Cecilie; Sonestedt, Emily; Laaksonen, David E.; Birgisdottir, Bryndis Eva

    2013-01-01

    The aim of this study is to review recent data on dietary fiber (DF) and the glycemic index (GI), with special focus on studies from the Nordic countries regarding cardiometabolic risk factors, type 2 diabetes, cardiovascular disease, cancer, and total mortality. In this study, recent guidelines and scientific background papers or updates on older reports on DF and GI published between 2000 and 2011 from the US, EU, WHO, and the World Cancer Research Fund were reviewed, as well as prospective cohort and intervention studies carried out in the Nordic countries. All of the reports support the role for fiber-rich foods and DF as an important part of a healthy diet. All of the five identified Nordic papers found protective associations between high intake of DF and health outcomes; lower risk of cardiovascular disease, type 2 diabetes, colorectal and breast cancer. None of the reports and few of the Nordic papers found clear evidence for the GI in prevention of risk factors or diseases in healthy populations, although association was found in sub-groups, e.g. overweight and obese individuals and suggestive for prevention of type 2 diabetes. It was concluded that DF is associated with decreased risk of different chronic diseases and metabolic conditions. There is not enough evidence that choosing foods with low GI will decrease the risk of chronic diseases in the population overall. However, there is suggestive evidence that ranking food based on their GI might be of use for overweight and obese individuals. Issues regarding methodology, validity and practicality of the GI remain to be clarified. PMID:23538683

  13. Impact of nutritional support that does and does not meet guideline standards on clinical outcome in surgical patients at nutritional risk: a prospective cohort study.

    PubMed

    Sun, Da-Li; Li, Wei-Ming; Li, Shu-Min; Cen, Yun-Yun; Lin, Yue-Ying; Xu, Qing-Wen; Li, Yi-Jun; Sun, Yan-Bo; Qi, Yu-Xing; Yang, Ting; Lu, Qi-Ping; Xu, Peng-Yuan

    2016-08-19

    To investigate the impact of nutritional support on clinical outcomes in patients at nutritional risk who receive nutritional support that meets guideline standards and those who do not. This prospective cohort study enrolled hospitalized patients from the Second Affiliated Hospital of Kunming Medical University from February 2010 to June 2012. The research protocols were approved by the university's ethics committee, and the patients signed informed consent forms. The clinical data were collected based on nutritional risk screening, administration of enteral and parenteral nutrition, surgical information, complications, and length of hospital stay. During the study period, 525 patients at nutritional risk were enrolled in the cohorts. Among patients who received nutritional support that met the guideline standards (Cohort 1), the incidence of infectious complications was lower than that in patients who did not meet guideline standards (Cohort 2) (17.1 % vs. 26.9 %, P = 0.01). Subgroup analysis showed that individuals who received a combination of parenteral nutrition (PN) and enteral nutrition (EN) for 7 or more days had a significantly lower incidence of infectious complications (P = 0.001) than those who received only PN for 7 or more days or those who received nutritional support for less than 7 days or at less than 10 kcal/kg/d. Binary logistic regression analysis showed that, after adjusting for confounding factors, nutritional support that met guideline standards for patients with nutritional risk was a protective factor for complications (OR: 0.870, P < 0.002). In patients at nutritional risk after abdominal surgery, nutritional support that meets recommended nutrient guidelines (especially regimens involving PN + EN ≥ 7 days) might decrease the incidence of infectious complications and is worth recommending; however, well-designed trials are needed to confirm our findings. Nutritional support that does not meet the guideline standards is considered

  14. Children-at-Risk for Poor Nutrition: Expanding the Approach of Future Professionals in Educational Institutions

    ERIC Educational Resources Information Center

    Shor, Ron

    2011-01-01

    Objectives: To examine how the subject of nutrition is being addressed in the work with children at risk of poor nutrition in educational institutions and what the barriers are which may hinder inclusion of this subject. Methods: A structured questionnaire was constructed for the purpose of this study and was implemented with 111 students in…

  15. Children-at-Risk for Poor Nutrition: Expanding the Approach of Future Professionals in Educational Institutions

    ERIC Educational Resources Information Center

    Shor, Ron

    2011-01-01

    Objectives: To examine how the subject of nutrition is being addressed in the work with children at risk of poor nutrition in educational institutions and what the barriers are which may hinder inclusion of this subject. Methods: A structured questionnaire was constructed for the purpose of this study and was implemented with 111 students in…

  16. Nutrition label use is associated with lower longer-term diabetes risk in US adults.

    PubMed

    Kollannoor-Samuel, Grace; Shebl, Fatma M; Hawley, Nicola L; Pérez-Escamilla, Rafael

    2017-03-29

    Background: Regular nutrition label use may have important long-term health implications. To our knowledge, the role of nutrition label use in protecting against the development of chronic diseases was unexplored prospectively before this study.Objective: We tested the association between nutrition label use and risk of a future diabetes diagnosis in a multiethnic US cohort.Design: Data from the ongoing National Longitudinal Survey of Youth-1979 (NLSY79) were analyzed. From 2002 (baseline) to 5 follow-up time points (2004-2012), 7150 diabetes-free, multiethnic young adults were prospectively followed for a diagnosis of incident diabetes. Nutrition label use, diabetes diagnosis, time to diabetes diagnosis, and all covariates were self-reported.Results: Between January 2002 and September 2013, 430 participants (6.0%) were diagnosed with diabetes. A weighted, multivariable, extended Cox regression was conducted, which suggested that in nutrition label users, the HR of diabetes diagnosis risk decreased significantly with time (P-nutrition label use × time interaction < 0.05) compared with risk in nutrition label nonusers.Conclusions: There is an association between nutrition label use and diabetes risk in the longer term. However, additional longitudinal research with a robust dietary intake assessment is needed to test this hypothesis.

  17. Short-term nutritional counseling reduces body mass index, waist circumference, triceps skinfold and triglycerides in women with metabolic syndrome

    PubMed Central

    2010-01-01

    Background It is recognized that the growing epidemic of metabolic syndrome is related to dietary and lifestyle changes. Objective The purpose of this study was to evaluate short-term application of nutritional counseling in women with metabolic syndrome. Methods This follow-up study was conducted from September to November 2008 with thirty three women ≥35 years old screened clinically for nutritional counseling. Dietary intake was reported, and biochemical and body composition measures were taken at baseline and after three months of follow-up. Results Of the 33 women evaluated, 29 patients completed the study. The prevalence of type 2 diabetes mellitus, hypertension, dyslipidemia, and obesity was high at 38%, 72.4%, 55.2%, and 75.8%, respectively. At the end of three-months of follow-up, a significant decline in body mass index, waist circumference, triceps skinfold, and triglycerides was observed, as was an increase in calcium and vitamin D intake. The multiple regression analysis showed that changes in body mass index, triceps skinfold, waist circumference and triglyceride levels after nutritional intervention were positively associated with changes in anthropometric (loss of body weight) and biochemical (decrease of TG/HDL-c ratio) parameters. Moreover, waist circumference changes were negatively associated with changes in calcium and vitamin D intake. Conclusion Short-term nutritional counseling improved some factors of metabolic syndrome. Moreover, the increases in calcium and vitamin D consumption can be associated with the improvement in markers of metabolic syndrome. PMID:20181143

  18. Assessment of nutritional quality, glycaemic index, antidiabetic and sensory properties of plantain (Musa paradisiaca)-based functional dough meals.

    PubMed

    Famakin, Opeyemi; Fatoyinbo, Akindele; Ijarotimi, Oluwole Steve; Badejo, Adebanjo Ayobamidele; Fagbemi, Tayo Nathaniel

    2016-11-01

    Nutrition transition to high energy-dense foods has been implicated as the major causes of diet related diseases. Plantain-based dough meals supplemented with soybean cake and cassava fibre were developed by combining them in different proportions using response surface methodology. The flour blends were analyzed for the nutritional composition while the glycaemic index, antidiabetic potentials and protein digestibility of the dough meals were determined in wistar rats. The nutritional and essential amino acid contents of the flour blends were comparable to that of cerolina (a commercially available food product commonly recommended for diabetic patients). The rats fed with the formulated dough meals had lower glycaemic index and glycaemic load, and the blood glucose was significantly reduced compared to cerolina and metformin (a synthetic antidiabetic drug). All the plantain-based dough meals were comparable to cerolina and metformin in terms of nutritional quality and blood glycaemic control activities, respectively. Hence, the formulated plantain-based dough meals have potential to be used for the prevention and management of diabetes mellitus.

  19. Preoperative albumin-to-globulin ratio and prognostic nutrition index predict prognosis for glioblastoma

    PubMed Central

    Xu, Wen-Zhe; Li, Feng; Xu, Zhen-Kuan; Chen, Xuan; Sun, Bin; Cao, Jing-Wei; Liu, Yu-Guang

    2017-01-01

    Objective Impaired immunonutritional status has disadvantageous effects on outcomes for cancer patients. Preoperative albumin-to-globulin ratio (AGR) and the prognostic nutrition index (PNI) have been used as prognostic factors in various cancers. We aimed to evaluate the clinical significance of the AGR and PNI in glioblastoma. Materials and methods This retrospective analysis involved 166 patients. Demographic, clinical, and laboratory data were collected. AGR and the PNI were calculated as AGR = albumin/(total serum protein − albumin) and PNI = albumin (g/L) + 5 × total lymphocyte count (109/L). Overall survival (OS) was estimated by Kaplan–Meier analysis. Receiver-operating characteristic analysis was used to assess the predictive ability of AGR and the PNI. Cox proportional-hazard models estimating hazard ratios (HRs) and 95% confidence intervals (CIs) were used for univariable and multivariable survival analyses. Results The cutoff values of AGR and PNI were 1.75 and 48. OS was enhanced, with high AGR (>1.75) and the PNI (>48) (P<0.001 for both). Areas under the receiver-operating characteristic curve for AGR and the PNI were 0.68 and 0.631 for 1-year survival and 0.651 and 0.656 for 2-year survival (P<0.05 for all), respectively. On multivariable analyses, both AGR and the PNI were independent predictors of OS (AGR, HR 0.785, 95% CI 0.357–0.979 [P=0.04]; PNI, HR 0.757, 95% CI 0.378–0.985 [P=0.039]). On subgroup analysis, AGR and the PNI were significant prognostic factors for OS in patients with adjuvant therapy (AGR P<0.001; PNI P=0.001). Conclusion Preoperative AGR and the PNI may be easy-to-perform and inexpensive indices for predicting OS with glioblastoma. AGR and the PNI could also help in developing good adjuvant-therapy schedules. PMID:28223828

  20. Obesity-risk behaviors and their associations with body mass index (BMI) in Korean American children.

    PubMed

    Jang, Myoungock; Grey, Margaret; Sadler, Lois; Jeon, Sangchoon; Nam, Soohyun; Song, Hee-Jung; Whittemore, Robin

    2017-08-03

    The purpose of the paper was to describe obesity-risk behaviors (diet, physical activity, and sedentary behavior) and examine the relationships of the obesity-risk behaviors with body mass index (BMI) in school-aged Korean American children. Korean American children have a risk of becoming overweight or obese and developing obesity-related complications; however, there is limited research about obesity-risk behaviors in Korean American children. A cross-sectional study. Obesity-risk behaviors of children were assessed with well-validated self-report questionnaires (i.e., Elementary-level School-based Nutrition Monitoring Questionnaire) from children and their mothers. Height and weight of children were measured. Data were analyzed with bivariate and multivariate analyses using mixed effects models to incorporate the correlation within siblings. A total of 170 Korean American children [mean age 10.9 (2.0) years; 52.4% girls; mean BMI 19.3(3.2); 28.7% ≥85 percentiles] participated in the study. Only 38.3% of Korean American children met established recommendations of 5 fruits/vegetables per day; 56.5% met recommendations for more than 3 days per week of vigorous physical activity, and 40.8% met recommendations for less than 2 hours of recreational screen time per day. Sixty percent and 88.8% of children met the recommendation of sleep on a weekday and weekend, respectively. Only screen time was positively associated with child BMI Z-score (β=0.08; p<.03). Health care providers need to be aware of the increased rate of overweight and obesity in Korean American children and initiate clinical interventions to improve obesity-risk behaviors, especially sedentary behavior, in Korean American children. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  1. Subjectively healthy elderly consuming a liquid nutrition supplement maintained body mass index and improved some nutritional parameters and perceived well-being.

    PubMed

    Krondl, M; Coleman, P H; Bradley, C L; Lau, D; Ryan, N

    1999-12-01

    To evaluate regular use of a liquid nutrition supplement by subjectively healthy elderly persons in terms of body mass index, nutrient intake, selected biochemical parameters, and perceived quality-of-life changes, and to identify advantages and limitations of use. A 16-week intervention study in which subjects were assigned randomly to either a supplemented group or a control group and compared in terms of intergroup and intragroup differences in weight, food intake, blood values, and quality-of-life indexes. Adherence to protocol was monitored by monthly visits with an interviewer and food intake records. Seventy-one independent living, older Canadian adults (mean age = 70 +/- 7 years) consuming on average less than 4 servings of fruit and vegetables daily and a supplement-free diet before the study. Subjects were without functional limitations and did not require therapeutic diets or medical treatments that affect nutritional status. Data were collected in home interviews. Blood for analysis was obtained from a subsample of 36 subjects. Inclusion of six 235-mL cans of liquid nutrition supplement weekly into the self-selected dietary patterns of the supplemented group. Results were analyzed by Student t tests or Wilcoxon rank sum test, analysis of variance, and multiple stepwise regression. Body mass index, energy intake, and consumption of fruit and vegetables did not change throughout the study. In the supplemented group, statistically significant increases occurred from baseline to termination of the study in these nutrients: protein, calcium, iron, magnesium, and folate. Serum albumin, folate, ferritin, hemoglobin, and zinc values were within the normal range for the supplemented and control groups. Scores for the Medical Outcomes Study 36-Item Short-Form Health Status scales increased for the supplemented group from baseline to termination for vitality and general health perception. Values for the General Well-Being Questionnaire improved for anxiety and

  2. Nutrition Can Modulate the Toxicity of Environmental Pollutants: Implications in Risk Assessment and Human Health

    PubMed Central

    Ormsbee, Lindell; McClain, Craig J.; Watkins, Bruce A.; Blumberg, Bruce; Bachas, Leonidas G.; Sanderson, Wayne; Thompson, Claudia; Suk, William A.

    2012-01-01

    Background: The paradigm of human risk assessment includes many variables that must be viewed collectively in order to improve human health and prevent chronic disease. The pathology of chronic diseases is complex, however, and may be influenced by exposure to environmental pollu-tants, a sedentary lifestyle, and poor dietary habits. Much of the emerging evidence suggests that nutrition can modulate the toxicity of environmental pollutants, which may alter human risks associated with toxicant exposures. Objectives: In this commentary, we discuss the basis for recommending that nutrition be considered a critical variable in disease outcomes associated with exposure to environmental pollutants, thus establishing the importance of incorporating nutrition within the context of cumulative risk assessment. Discussion: A convincing body of research indicates that nutrition is a modulator of vulnerability to environmental insults; thus, it is timely to consider nutrition as a vital component of human risk assessment. Nutrition may serve as either an agonist or an antagonist (e.g., high-fat foods or foods rich in antioxidants, respectively) of the health impacts associated with exposure to environmental pollutants. Dietary practices and food choices may help explain the large variability observed in human risk assessment. Conclusion: We recommend that nutrition and dietary practices be incorporated into future environmental research and the development of risk assessment paradigms. Healthful nutrition interventions might be a powerful approach to reduce disease risks associated with many environmental toxic insults and should be considered a variable within the context of cumulative risk assessment and, where appropriate, a potential tool for subsequent risk reduction. PMID:22357258

  3. Postmenopausal survivors of breast cancer at risk for osteoporosis: nutritional intake and body size.

    PubMed

    Lindsey, Ada M; Gross, Gloria; Twiss, Jan; Waltman, Nancy; Ott, Carol; Moore, Timothy E

    2002-02-01

    Postmenopausal survivors of breast cancer for whom hormone replacement therapy is contraindicated are at risk for development of osteoporosis. The primary purpose of this article is to describe, in a sample of 30 postmenopausal survivors of breast cancer, their calcium and vitamin D intake compared with recommended dietary guidelines for those nutrients for postmenopausal women not taking hormone replacement therapy and the body mass index of these women as nutritional status risk factors for development of osteoporosis. Bone health and presence of osteoporosis were determined by bone mineral density testing of the spine, hip, and forearm. To obtain calcium and vitamin D intake, including supplements, 3-day diet records were completed; height and weight measures were used to calculate body mass index. The sample participants ranged in age from 42 to 65 years; the majority (56%) had been menopausal or off hormone replacement therapy for 5 years or less, and 70% had completed breast cancer treatment for 5 years or less (except tamoxifen). The majority (63%) were of medium body frame size; 30% were of small frame size. The mean body mass index (27.3) and mean weight (160 lbs) indicate that these women, as a group, were over-weight. Although a large percent (63%) were taking calcium supplements, the mean daily intake (diet and supplements) of calcium (1,353 mg) and vitamin D (403 IU) was less than the recommended dietary guidelines for these nutrients in this population. At study entry, 80% of the women were osteopenic (60%) or osteoporotic (20%) and none was receiving treatment/prevention for osteoporosis; only 1 had a previous known osteoporosis diagnosis. This is a special group of women for whom screening and preventive strategies for osteoporosis are imperative.

  4. A multicenter risk index for atrial fibrillation after cardiac surgery.

    PubMed

    Mathew, Joseph P; Fontes, Manuel L; Tudor, Iulia C; Ramsay, James; Duke, Peter; Mazer, C David; Barash, Paul G; Hsu, Ping H; Mangano, Dennis T

    2004-04-14

    Atrial fibrillation is a common, but potentially preventable, complication following coronary artery bypass graft (CABG) surgery. To assess the nature and consequences of atrial fibrillation after CABG surgery and to develop a comprehensive risk index that can better identify patients at risk for atrial fibrillation. Prospective observational study of 4657 patients undergoing CABG surgery between November 1996 and June 2000 at 70 centers located within 17 countries, selected using a systematic sampling technique. From a derivation cohort of 3093 patients, associations between predictor variables and postoperative atrial fibrillation were identified to develop a risk model, which was assessed in a validation cohort of 1564 patients. New-onset atrial fibrillation after CABG surgery. A total of 1503 patients (32.3%) developed atrial fibrillation after CABG surgery. Postoperative atrial fibrillation was associated with subsequent greater resource use as well as with cognitive changes, renal dysfunction, and infection. Among patients in the derivation cohort, risk factors associated with atrial fibrillation were advanced age (odds ratio [OR] for 10-year increase, 1.75; 95% confidence interval [CI], 1.59-1.93); history of atrial fibrillation (OR, 2.11; 95% CI, 1.57-2.85) or chronic obstructive pulmonary disease (OR, 1.43; 95% CI, 1.09-1.87); valve surgery (OR, 1.74; 95% CI, 1.31-2.32); and postoperative withdrawal of a beta-blocker (OR, 1.91; 95% CI, 1.52-2.40) or an angiotensin-converting enzyme (ACE) inhibitor (OR 1.69; 95% CI, 1.38-2.08). Conversely, reduced risk was associated with postoperative administration of beta-blockers (OR, 0.32; 95% CI, 0.22-0.46), ACE inhibitors (OR, 0.62; 95% CI, 0.48-0.79), potassium supplementation (OR, 0.53; 95% CI, 0.42-0.68), and nonsteroidal anti-inflammatory drugs (OR, 0.49; 95% CI, 0.40-0.60). The resulting multivariable risk index had adequate discriminative power with an area under the receiver operating characteristic (ROC

  5. Plasma carotenoids and breast cancer risk in the Cancer Prevention Study II Nutrition Cohort.

    PubMed

    Wang, Ying; Gapstur, Susan M; Gaudet, Mia M; Furtado, Jeremy D; Campos, Hannia; McCullough, Marjorie L

    2015-09-01

    Several circulating carotenoids have been inversely associated with postmenopausal breast cancer risk in large cohort studies and a pooled analysis. Whether associations differ by tumor or participant characteristics remains unclear. We investigated the associations of plasma carotenoids with postmenopausal breast cancer risk overall and by estrogen receptor (ER) status, tumor stage, smoking status, and body mass index, in a case-control study nested in the Cancer Prevention Study II Nutrition Cohort. A total of 496 invasive breast cancer cases diagnosed between blood draw in 1998-2001 and June 30, 2007 and matched 1:1 with controls on race, birth date, and blood draw date were included. Multivariable-adjusted conditional and unconditional logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Plasma α-carotene above the lowest quartile was associated with significant 40-43% lower risk of invasive breast cancer risk (fourth vs. first quartile OR 0.60, 95% CI 0.41-0.87, P-trend = 0.037) after adjustment for multiple covariates. This inverse association was strengthened after further adjustment for other plasma carotenoids and total fruit and vegetable intake (fourth vs. first quartile OR 0.50, 95% CI 0.29-0.85, P-trend = 0.041). Other plasma carotenoids or total carotenoids were not associated with breast cancer risk. The inverse association of α-carotene with breast cancer remained for ER+, but not for ER- tumors, although test for heterogeneity was not statistically significant (P-heterogeneity = 0.49). These results suggest that higher plasma α-carotene is associated with lower risk of invasive breast cancer.

  6. Anthropometric measures and epithelial ovarian cancer risk in the European Prospective Investigation into Cancer and Nutrition.

    PubMed

    Lahmann, Petra H; Cust, Anne E; Friedenreich, Christine M; Schulz, Mandy; Lukanova, Annekatrin; Kaaks, Rudolf; Lundin, Eva; Tjønneland, Anne; Halkjaer, Jytte; Severinsen, Marianne Tang; Overvad, Kim; Fournier, Agnès; Chabbert-Buffet, Nathalie; Clavel-Chapelon, Françoise; Dossus, Laure; Pischon, Tobias; Boeing, Heiner; Trichopoulou, Antonia; Lagiou, Pagona; Naska, Androniki; Palli, Domenico; Grioni, Sara; Mattiello, Amalia; Tumino, Rosario; Sacerdote, Carlotta; Redondo, María-Luisa; Jakszyn, Paula; Sánchez, María-José; Tormo, María-José; Ardanaz, Eva; Arriola, Larraitz; Manjer, Jonas; Jirström, Karin; Bueno-de-Mesquita, H Bas; May, Anne M; Peeters, Petra H M; Onland-Moret, N Charlotte; Bingham, Sheila; Khaw, Kay-Tee; Allen, Naomi E; Spencer, Elizabeth; Rinaldi, Sabina; Slimani, Nadia; Chajes, Véronique; Michaud, Dominique; Norat, Teresa; Riboli, Elio

    2010-05-15

    We examined the associations of measured anthropometric factors, including general and central adiposity and height, with ovarian cancer risk. We also investigated these associations by menopausal status and for specific histological subtypes. Among 226,798 women in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, there were 611 incident cases of primary, malignant, epithelial ovarian cancer diagnosed during a mean 8.9 years of follow-up. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for potential confounders. Compared to women with body mass index (BMI) < 25 kg/m2, obesity (BMI > or = 30 kg/m2) was associated with excess ovarian cancer risk for all women combined (HR = 1.33, 95% CI = 1.05-1.68; p(trend) = 0.02) and postmenopausal women (HR = 1.59, 95% CI = 1.20-2.10; p(trend) = 0.001), but the association was weaker for premenopausal women (HR = 1.16, 95% CI = 0.65-2.06; p(trend) = 0.65). Neither height or weight gain, nor BMI-adjusted measures of fat distribution assessed by waist circumference, waist-hip ratio (WHR) or hip circumference were associated with overall risk. WHR was related to increased risk of mucinous tumors (BMI-adjusted HR per 0.05 unit increment = 1.17, 95% CI = 1.00-1.38). For all women combined, no other significant associations with risk were observed for specific histological subtypes. This large, prospective study provides evidence that obesity is an important modifiable risk factor for epithelial ovarian cancer, particularly among postmenopausal women.

  7. Variation in nutritional risk among Mexican American and non-Mexican American homebound elders who receive home-delivered meals.

    PubMed

    Sharkey, Joseph R

    2004-01-01

    Good nutritional health is essential to prevent functional decline and improve quality of life. Little is known of disparities in the extent of risk for poor nutritional health among homebound Mexican American (MA) elders who receive Older American Act Nutrition Program (OAANP) home-delivered meals. In order to assist OAANP service providers in understanding racial/ethnic differences in nutritional risk, this study examined routinely collected data on 908 homebound MA and non-MA in the Texas Lower Rio Grande Valley. Homebound MA were more likely to report poverty, risk factors for and indicators of poor nutritional health. Independent of poverty and covariates,MA were more likely to report very high nutritional risk. This underscores the importance of understanding racial/ethnic disparities in the extent of risk for poor nutritional health for the development, implementation, and evaluation of effective strategies to alleviate nutritional health disparities.

  8. Nutrition

    NASA Technical Reports Server (NTRS)

    Lane, Helen W.

    1990-01-01

    This is a collection of viewgraphs on the Johnson Space Center's work on nutrition for long duration space missions. Nutritional requirements are affected by isolation, workloads, and cold as well as the psychological needs, metabolism, and fluid balance of an individual.

  9. Nutrition and physical activity randomized control trial in child care centers improves knowledge, policies, and children's body mass index.

    PubMed

    Alkon, Abbey; Crowley, Angela A; Neelon, Sara E Benjamin; Hill, Sherika; Pan, Yi; Nguyen, Viet; Rose, Roberta; Savage, Eric; Forestieri, Nina; Shipman, Linda; Kotch, Jonathan B

    2014-03-01

    To address the public health crisis of overweight and obese preschool-age children, the Nutrition And Physical Activity Self Assessment for Child Care (NAP SACC) intervention was delivered by nurse child care health consultants with the objective of improving child care provider and parent nutrition and physical activity knowledge, center-level nutrition and physical activity policies and practices, and children's body mass index (BMI). A seven-month randomized control trial was conducted in 17 licensed child care centers serving predominantly low income families in California, Connecticut, and North Carolina, including 137 child care providers and 552 families with racially and ethnically diverse children three to five years old. The NAP SACC intervention included educational workshops for child care providers and parents on nutrition and physical activity and consultation visits provided by trained nurse child care health consultants. Demographic characteristics and pre - and post-workshop knowledge surveys were completed by providers and parents. Blinded research assistants reviewed each center's written health and safety policies, observed nutrition and physical activity practices, and measured randomly selected children's nutritional intake, physical activity, and height and weight pre- and post-intervention. Hierarchical linear models and multiple regression models assessed individual- and center-level changes in knowledge, policies, practices and age- and sex-specific standardized body mass index (zBMI), controlling for state, parent education, and poverty level. Results showed significant increases in providers' and parents' knowledge of nutrition and physical activity, center-level improvements in policies, and child-level changes in children's zBMI based on 209 children in the intervention and control centers at both pre- and post-intervention time points. The NAP SACC intervention, as delivered by trained child health professionals such as child care

  10. Association between the hemodialysis eating index and risk factors of cardiovascular disease in hemodialysis patients.

    PubMed

    Chiu, Yi-Fang; Chen, Yi-Chun; Wu, Pei-Yu; Shih, Chun-Kuang; Chen, Hsin-Hung; Chen, Hsi-Hsien; Chen, Tso-Hsiao; Yang, Shwu-Huey

    2014-05-01

    In this study, a Hemodialysis Eating Index (HDEI) suitable for hemodialysis (HD) patients in Taiwan was developed based on the dietary recommendations of the U.S. National Kidney Foundation for HD patients and the Taiwanese 2011 Daily Food Guide. The HDEI was used to explore HD-associated cardiovascular disease (CVD) risk factors. In this prospective study, 108 HD patients from 2 HD centers in Taiwan were recruited as participants in 2010. All participants were older than 20 years. Patient CVD risk factor and 3-day dietary data were collected, and their HDEI scores were calculated. The HDEI scores comprise 12 food-related factors: the consumption of vegetables, fruits, total grains, whole grains, high-protein foods, high biological values, red and white meat, fish, oils, saturated fatty acids or trans fatty acids, nuts, and the duration of multivitamin use. The scores ranged from 5 to 100, and SAS software version 9.3 was used to perform statistical analyses. A P value less than .05 was considered statistically significant. The HDEI scores and serum albumin (Alb) levels were significantly and positively correlated. The participants were divided into 2 groups on the basis of the median HDEI score of 72.2. Two months after HDEI evaluation, the high-HDEI scoring group exhibited significantly decreased levels of serum total cholesterol and increased hemoglobin (Hb) levels. The HDEI can be used to reflect selected nutritional status markers, such as Alb and Hb levels and CVD risk factors, for HD patients. The HDEI can also serve as an eating index for HD patients in Taiwan to facilitate CVD prevention. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  11. Nutrition.

    PubMed

    Durnin, J V

    1976-07-01

    Nutrition appeared somewhat late on the scene in the I.B.P. projects in the U.K., but eventually it occupied an integral part of many of the H.A. (human adaptability) investigations. The nutritional data obtained in the studies of isolated and nearisolated communities in Tristan da Cunha and in New Guinea provided information of wide nutritional significance. There were also detailed and extensive studies in Israel which, similarly to those in New Guinea, attempted to relate nutritional factors to enviroment, working conditions, and physical fitness. Some extraordinarily low energy intakes found in Ethiopians have induced much speculation on the extent which man can adequately adapt to restricted food supplies. Interesting nutritional observations, of general importance, have also arisen from results obtained on such disparate groups as Glasgow adolescents, Tanzanian and Sudanese students, children in Malawi and vegans in the U.K.

  12. Prognostic nutritional index before adjuvant chemotherapy predicts chemotherapy compliance and survival among patients with non-small-cell lung cancer

    PubMed Central

    Shimizu, Katsuhiko; Okita, Riki; Saisho, Shinsuke; Yukawa, Takuro; Maeda, Ai; Nojima, Yuji; Nakata, Masao

    2015-01-01

    Background Adjuvant chemotherapy after the complete resection of non-small-cell lung cancer (NSCLC) is now the standard of care. To improve survival, it is important to identify risk factors for the continuation of adjuvant chemotherapy. In this study, we analyzed chemotherapy compliance and magnitude of the prognostic impact of the prognostic nutritional index (PNI) before adjuvant chemotherapy. Methods We conducted a retrospective review of data from 106 patients who had received adjuvant chemotherapy. The adjuvant chemotherapy consisted of an oral tegafur agent (OT) or platinum-based chemotherapy (PB). The correlations between the PNI values and recurrence-free survival (RFS) were then evaluated. Results In the PB group, the percentage of patients who completed the four planned cycles of chemotherapy was not correlated with the PNI. In the OT group, however, a significant difference was observed in the percentage of patients who completed the planned chemotherapy according to the PNI before adjuvant chemotherapy. The RFS of patients with a PNI <50 before adjuvant chemotherapy was significantly poorer than that of the patients with a PNI ≥50. A multivariate analysis showed that nodal metastasis and PNI before chemotherapy were independent predictors of the RFS. However, PNI before surgery was not a predictor of the RFS. In the subgroup analysis, PNI before chemotherapy was independent predictor of the RFS in the OT group (P=0.019), but not in the PB group (P=0.095). Conclusion The PNI before adjuvant chemotherapy influenced the treatment compliance with the planned chemotherapy in the OT group, but not the PB group. In addition, a low PNI before adjuvant chemotherapy was associated with a poor RFS in a multivariate analysis, especially in the OT group. PMID:26504397

  13. Evaluation of dysphagia risk, nutritional status and caloric intake in elderly patients with Alzheimer's.

    PubMed

    Goes, Vanessa Fernanda; Mello-Carpes, Pâmela Billig; de Oliveira, Lilian Oliveira; Hack, Jaqueline; Magro, Marcela; Bonini, Juliana Sartori

    2014-01-01

    to evaluate the risk of dysphagia and its relationship with the stage of Alzheimer's Disease, as well as the relationship between the risk of dysphagia and nutritional status and caloric intake in elderly people with Alzheimer's disease. the sample consisted of 30 subjects of both genders with probable Alzheimer's disease. The stage of the disease, nutritional status, energy intake, and risk of dysphagia were assessed. it was found that increased risk of dysphagia is associated with the advance in the stages of Alzheimer's disease and that even patients in the early stages of disease have a slight risk of developing dysphagia. No association was found between nutritional status and the risk of dysphagia. High levels of inadequate intake of micronutrients were also verified in the patients. an association between dysphagia and the development of Alzheimer's disease was found. The results indicate the need to monitor the presence of dysphagia and the micronutrient intake in patients with Alzheimer's disease.

  14. Metabolic risk in schoolchildren is associated with low levels of cardiorespiratory fitness, obesity, and parents' nutritional profile.

    PubMed

    Todendi, Pâmela Ferreira; Valim, Andréia Rosane de Moura; Reuter, Cézane Priscila; Mello, Elza Daniel de; Gaya, Anelise Reis; Burgos, Miria Suzana

    2016-01-01

    Verify the association between metabolic risk profile in students with different levels of cardiorespiratory fitness and body mass index, as well as the nutritional status of their parents. A cross-sectional study comprising 1.254 schoolchildren aged between seven and 17 years. The metabolic risk profile was calculated by summing the standardized values of high density lipoproteins and low density lipoproteins, triglycerides, glucose and systolic blood pressure. The parents' nutritional status was evaluated by self-reported weight and height data, for body mass index calculating. The body mass index of schoolchildren was classified as underweight/normal weight and overweight/obesity. The cardiorespiratory fitness was assessed by 9-minute running/walk test, being categorized as fit (good levels) and unfit (low levels). Data were analyzed using prevalence ratio values (PR). The data indicates a higher occurrence of developing metabolic risk in schoolchildren whose mother is obese (PR: 1.50; 95% CI: 1.01, 2.23), and even higher for those whose father and mother are obese (PR: 2, 79, 95% CI: 1.41; 5.51). Students who have low levels of cardiorespiratory fitness and overweight/obesity have higher occurrence of presenting metabolic risk profile (PR: 5.25; 95% CI: 3.31; 8.16). the occurrence of developing metabolic risk in schoolchildren increase when they have low levels of cardiorespiratory fitness and overweight/obesity, and the presence of parental obesity. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  15. [Index of Nutritional Purchasing Power Parity: comparison of caloric costs of a healthy versus an unhealthy diet].

    PubMed

    Mendoza Velázquez, Alfonso

    2012-01-01

    Develop the Index of Nutritional Purchasing Power Parity (Nut3-CiO) as an instrument to compare the caloric costs of a healthy versus an unhealthy diet between regions or cities in a country over time. Indices of caloric prices were constructed and the "law of one price" was used to derive the Nut3-CiO index. Caloric inflation rates were obtained using basic descriptive statistics. The Nut3-CiO was applied in the major cities of Mexico during the period from January 1996 to December 2010. The statistical behavior of the Nut3-CiO revealed that, in Mexican cities, products for a typical diet are less expensive than products for a healthy diet. The findings showed a cyclical behavior to the index, a high correlation between inflation for the typical diet and inflation for the market basket, and a high persistence of prices. The Nut3-CiO index makes it possible to periodically compare the price differential of two types of diets-typical and healthy-between cities in a single country. This instrument could help health authorities identify the cities where it is easier or more difficult for consumers to access a typical or healthy diet in terms of cost. Furthermore, it makes it possible to estimate the percentage adjustment necessary in each city to attain levels of nutritional purchasing power parity.

  16. Body Mass Index and Risk of Death in Asian Americans

    PubMed Central

    Wang, Sophia; Kitahara, Cari M.; Moore, Steven C.; Berrington de Gonzalez, Amy; Bernstein, Leslie; Chang, Ellen T.; Flint, Alan J.; Freedman, D. Michal; Gaziano, J. Michael; Hoover, Robert N.; Linet, Martha S.; Purdue, Mark; Robien, Kim; Schairer, Catherine; Sesso, Howard D.; White, Emily; Willcox, Bradley J.; Thun, Michael J.; Hartge, Patricia; Willett, Walter C.

    2014-01-01

    Objectives. We investigated the association between body mass index (BMI) and mortality among Asian Americans. Methods. We pooled data from prospective cohort studies with 20 672 Asian American adults with no baseline cancer or heart disease history. We estimated hazard ratios and 95% confidence intervals (CIs) with Cox proportional hazards models. Results. A high, but not low, BMI was associated with increased risk of total mortality among individuals aged 35 to 69 years. The BMI was not related to total mortality among individuals aged 70 years and older. With a BMI 22.5 to < 25 as the reference category among never-smokers aged 35 to 69 years, the hazard ratios for total mortality were 0.83 (95% CI = 0.47, 1.47) for BMI 15 to < 18.5; 0.91 (95% CI = 0.62, 1.32) for BMI 18.5 to < 20; 1.08 (95% CI = 0.86, 1.36) for BMI 20 to < 22.5; 1.14 (95% CI = 0.90, 1.44) for BMI 25 to < 27.5; 1.13 (95% CI = 0.79, 1.62) for BMI 27.5 to < 30; 1.82 (95% CI = 1.25, 2.64) for BMI 30 to < 35; and 2.09 (95% CI = 1.06, 4.11) for BMI 35 to 50. Higher BMI was also related to increased cardiovascular disease and cancer mortality. Conclusions. High BMI is associated with increased mortality risk among Asian Americans. PMID:24432919

  17. Risk of aspiration in patients on enteral nutrition: frequency, relevance, relation to pneumonia, risk factors, and strategies for risk reduction.

    PubMed

    Mizock, Barry A

    2007-08-01

    Upper digestive feeding intolerance, as evidenced by high gastric residual volume and vomiting, is the most common complication among hospitalized patients receiving enteral nutrition. These patients are at high risk of developing aspiration pneumonia, which in turn is associated with prolonged hospital stay and increased mortality. Most episodes of aspiration are small in volume and do not lead to pneumonia. The likelihood of pneumonia increases with multiple aspirations. Pneumonia is also more common in critically ill patients who have bacterial colonization of the oropharynx. Gastric residual volume is commonly used as a means to assess aspiration risk during tube feeding. However, recent studies have demonstrated that this measurement has limited sensitivity. The approach to minimizing the frequency of aspiration during tube feeding involves assessment of the patient's degree of risk and initiation of appropriate measures directed at risk reduction.

  18. Body mass index, height and risk of lymphoid neoplasms in a large United States cohort.

    PubMed

    Patel, Alpa V; Diver, W Ryan; Teras, Lauren R; Birmann, Brenda M; Gapstur, Susan M

    2013-06-01

    Results from epidemiologic studies examining associations between body size and risk of non-Hodgkin lymphoma (NHL) are inconsistent, and etiology may vary by histologic subtype of disease. Using Cox proportional hazards regression, multivariable relative risks (RRs) and 95% confidence intervals (CIs) were computed for associations of body mass index (BMI) and height with NHL in the prospective American Cancer Society Cancer Prevention Study-II Nutrition Cohort. From 1992 to 2007, 2074 incident cases of NHL were identified among 152 423 men and women. Obese individuals (BMI ≥ 30 kg/m(2)) had 23% higher incidence of NHL (95% CI 1.08-1.40) compared to those with normal weight (BMI 18.5-< 25 kg/m(2)). Height was positively associated with NHL (RR = 1.25, 95% CI 1.10-1.43, sex-specific quintile 5 vs. 1). BMI associations were strongest for diffuse large B-cell lymphoma. Height was most strongly associated with chronic lymphocytic leukemia/small lymphocytic lymphoma and to a lesser extent with multiple myeloma. These findings provide further evidence that body size may play a role in the etiology of NHL, which is of public health importance given the rapid rise in obesity worldwide.

  19. Glaucoma risk index: automated glaucoma detection from color fundus images.

    PubMed

    Bock, Rüdiger; Meier, Jörg; Nyúl, László G; Hornegger, Joachim; Michelson, Georg

    2010-06-01

    Glaucoma as a neurodegeneration of the optic nerve is one of the most common causes of blindness. Because revitalization of the degenerated nerve fibers of the optic nerve is impossible early detection of the disease is essential. This can be supported by a robust and automated mass-screening. We propose a novel automated glaucoma detection system that operates on inexpensive to acquire and widely used digital color fundus images. After a glaucoma specific preprocessing, different generic feature types are compressed by an appearance-based dimension reduction technique. Subsequently, a probabilistic two-stage classification scheme combines these features types to extract the novel Glaucoma Risk Index (GRI) that shows a reasonable glaucoma detection performance. On a sample set of 575 fundus images a classification accuracy of 80% has been achieved in a 5-fold cross-validation setup. The GRI gains a competitive area under ROC (AUC) of 88% compared to the established topography-based glaucoma probability score of scanning laser tomography with AUC of 87%. The proposed color fundus image-based GRI achieves a competitive and reliable detection performance on a low-priced modality by the statistical analysis of entire images of the optic nerve head. Copyright (c) 2010 Elsevier B.V. All rights reserved.

  20. External validation of the paediatric risk of malignancy index.

    PubMed

    Hermans, A J; Kluivers, K B; Massuger, L F; Coppus, S F

    2016-02-01

    This study aimed to validate the paediatric risk of malignancy index (PRMI), as previously published. External validation study. Academic hospital: Radboud University Medical Center. Female paediatric patients under the age of 18 years diagnosed with, or treated for, an adnexal mass between January 1999 and October 2013. Information was collected on diagnosis, presenting symptoms, and signs and imaging characteristics. The PRMI was calculated for each patient. Sensitivity, specificity, and positive and negative predictive values were calculated, and the results were visualised using a receiver operating characteristic curve (ROC curve). Histological diagnosis, discriminative performance using the area under the curve (AUC) of the ROC curve and sensitivity and specificity. Seventy-eight patients were included, with a median age of 12 years. A malignant mass was found in 17 patients (21.8%). The PRMI with a cut-off value of 7 resulted in a sensitivity of 70.1% (95% CI 44.1-89.6%) and a specificity of 85.3% (95% CI 73.8-93.0%). The area under the ROC curve was 0.868 (95% CI 0.756-0.980). The PRMI showed less discriminative capacity than originally published, but its performance was still good; however, further prospective validation studies are needed to define whether the model is useful in daily clinical practice. © 2015 Royal College of Obstetricians and Gynaecologists.

  1. [Effect of early nutritional intervention in the a outcome of patients at risk clinical nutrition].

    PubMed

    Montoya Montoya, Susana; Múnera García, Nora Elena

    2014-02-01

    Introducción: La desnutrición hospitalaria es un proceso multicausal y de alta prevalencia. La intervención nutricional en una etapa temprana mejora el pronóstico de los pacientes afectados. Objetivo: Comparar el efecto de una intervención nutricional temprana con el de una atención de rutina, sobre el resultado clínico, en pacientes con riesgo nutricional, detectados con la herramienta de cribado Nutritional Risk Screening NRS 2002, que ingresan a una institución de salud de alta complejidad. Materiales y métodos: Estudio cuasi experimental. Se evaluó en las primeras 48 horas de admisión a 891 pacientes, de los cuales 247 estaban en riesgo nutricional, 116 constituyeron el grupo con atención de rutina y 54 el grupo intervenido. Se evaluaron las complicaciones, días de estancia hospitalaria, pérdida de peso, cambio de índice de masa corporal y adecuación proteico-calórica. Resultados: Los pacientes intervenidos presentaron mayor consumo calórico (1617 ± 444,5 vs 1366 ± 467,1 kilocalorías, p = 0,002) y proteico (1,2 ± 0,2 vs 0,9 ± 0,3 g, p = 0,000), una ganancia de peso promedio de 0,7% vs una pérdida de 2.3% (p = 0,000), una proporción de complicaciones moderadas del 8,2% vs 25,2% (p = 0,012) y una reducción del tiempo de estancia hospitalaria de 2,2 días (p = 0,138), en comparación con el grupo con atención de rutina. Conclusión: La intervención nutricional temprana en los pacientes en riesgo nutricional, disminuyó la proporción de complicaciones moderadas, mejoró la adecuación de energía, proteína y la evolución nutricional en términos de ganancia de peso y cambio de IMC. Los días de estancia no mostraron diferencias significativas.

  2. Nutritional risk and gastrointestinal dysautonomia symptoms in Parkinson's disease outpatients hospitalised on a scheduled basis.

    PubMed

    Barichella, Michela; Cereda, Emanuele; Madio, Carmen; Iorio, Laura; Pusani, Chiara; Cancello, Raffaella; Caccialanza, Riccardo; Pezzoli, Gianni; Cassani, Erica

    2013-07-28

    Dysautonomia symptoms of nutritional interest may often occur in Parkinson's disease (PD), but the role played in affecting the risk of malnutrition still needs to be clarified. A total of 208 consecutive PD outpatients hospitalised on a scheduled basis were assessed for nutritional risk by the Malnutrition Universal Screening Tool. Presence of dysautonomia symptoms (dysphagia, sialorrhoea and constipation) was investigated using clinical rating scales. In our population, prevalence of nutritional risk was 17·2 (95 % CI 12·1, 24·0) % and relied mainly on unintentional weight loss. Sialorrhoea, dysphagia, dysphagia to liquids and constipation were observed in 10·6, 11·0, 14·4 and 59·6 % of the patients, respectively. Nutritional risk was independently associated with the number of dysautonomia symptoms (OR 1·39 (95 % CI 1·00, 1·96); P= 0·048) but not with single symptoms. An independent association was also found with the severity of motor symptoms (Hoehn-Yahr stage, OR 1·48 (95 % CI 1·00, 2·55); P= 0·049) and levodopa dose (OR 1·16 (95 % CI 1·04, 1·31) mg/kg per d; P= 0·009). Nutritional risk in PD outpatients appears to depend mainly on dysautonomic syndrome, disease severity and levodopa dosage. Implications for outcome deserve further investigation. The assessment of nutritional status and of gastrointestinal dysautonomia symptoms should be part of the routine work-up of a PD patient.

  3. Beyond Body Mass Index. Is the Body Cell Mass Index (BCMI) a useful prognostic factor to describe nutritional, inflammation and muscle mass status in hospitalized elderly?: Body Cell Mass Index links in elderly.

    PubMed

    Rondanelli, Mariangela; Talluri, Jacopo; Peroni, Gabriella; Donelli, Chiara; Guerriero, Fabio; Ferrini, Krizia; Riggi, Emilia; Sauta, Elisabetta; Perna, Simone; Guido, Davide

    2017-03-24

    The aim of this study was to establish the effectiveness of Body Cell Mass Index (BCMI) as a prognostic index of (mal)nutrition, inflammation and muscle mass status in the elderly. A cross-sectional observational study has been conducted on 114 elderly patients (80 women and 34 men), with mean age equal to 81.07 ± 6.18 years. We performed a multivariate regression model by Structural Equation Modelling (SEM) framework. We detected the effects over a Mini Nutritional Assessment (MNA) stratification, by performing a multi-group multivariate regression model (via SEM) in two MNA nutritional strata, less and bigger (or equal) than 17. BCMI had a significant effect on albumin (β = +0.062, P = 0.001), adjusting for the other predictors of the model as Body Mass Index (BMI), age, sex, fat mass and cognitive condition. An analogous result is maintained in MNA<17 stratum. BMI has confirmed to be a solid prognostic factor for both free fat mass (FFM) (β = +0.480, P < 0.001) and Skeletal Muscle Index (SMI) (β = +0.265, P < 0.001), assessed by DXA. BCMI also returned suggestive evidences (0.05 < P < 0.10) for both the effect on FFM and on SMI in overall sample. The main result of this study is that the BCMI, compared to BMI, proved to be significantly related to an important marker as albumin in geriatric population. Then, assessing the BCMI could be a valuable, inexpensive, easy to perform tool to investigate the inflammation status of elderly patients. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  4. Supportive interventions for enhancing dietary intake in malnourished or nutritionally at-risk adults.

    PubMed

    Baldwin, Christine; Kimber, Katherine L; Gibbs, Michelle; Weekes, Christine Elizabeth

    2016-12-20

    Supportive interventions such as serving meals in a dining room environment or the use of assistants to feed patients are frequently recommended for the management of nutritionally vulnerable groups. Such interventions are included in many policy and guideline documents and have implications for staff time but may incur additional costs, yet there appears to be a lack of evidence for their efficacy. To assess the effects of supportive interventions for enhancing dietary intake in malnourished or nutritionally at-risk adults. We identified publications from comprehensive searches of the Cochrane Library, MEDLINE, Embase, AMED, British Nursing Index, CINAHL, SCOPUS, ISI Web of Science databases, scrutiny of the reference lists of included trials and related systematic reviews and handsearching the abstracts of relevant meetings. The date of the last search for all databases was 31 March 2013. Additional searches of CENTRAL, MEDLINE, ClinicalTrials.gov and WHO ICTRP were undertaken to September 2016. The date of the last search for these databases was 14 September 2016. Randomised controlled trials of supportive interventions given with the aim of enhancing dietary intake in nutritionally vulnerable adults compared with usual care. Three review authors and for the final search, the editor, selected trials from titles and abstracts and independently assessed eligibility of selected trials. Two review authors independently extracted data and assessed risk of bias, as well as evaluating overall quality of the evidence utilising the GRADE instrument, and then agreed as they entered data into the review. The likelihood of clinical heterogeneity amongst trials was judged to be high as trials were in populations with widely different clinical backgrounds, conducted in different healthcare settings and despite some grouping of similar interventions, involved interventions that varied considerably. We were only able, therefore, to conduct meta-analyses for the outcome measures

  5. Use of Fitness and Nutrition Apps: Associations With Body Mass Index, Snacking, and Drinking Habits in Adolescents.

    PubMed

    De Cock, Nathalie; Vangeel, Jolien; Lachat, Carl; Beullens, Kathleen; Vervoort, Leentje; Goossens, Lien; Maes, Lea; Deforche, Benedicte; De Henauw, Stefaan; Braet, Caroline; Eggermont, Steven; Kolsteren, Patrick; Van Camp, John; Van Lippevelde, Wendy

    2017-04-25

    Efforts to improve snacking and drinking habits are needed to promote a healthy body mass index (BMI) in adolescents. Although commercial fitness and nutrition mobile phone apps are widely used, little is known regarding their potential to improve health behaviors, especially in adolescents. In addition, evidence on the mechanisms through which such fitness and nutrition apps influence behavior is lacking. This study assessed whether the use of commercial fitness or nutrition apps was associated with a lower BMI and healthier snacking and drinking habits in adolescents. Additionally, it explored if perceived behavioral control to eat healthy; attitudes to eat healthy for the good taste of healthy foods, for overall health or for appearance; social norm on healthy eating and social support to eat healthy mediated the associations between the frequency of use of fitness or nutrition apps and BMI, the healthy snack, and beverage ratio. Cross-sectional self-reported data on snack and beverage consumption, healthy eating determinants, and fitness and nutrition app use of adolescents (N=889; mean age 14.7 years, SD 0.8; 54.8% [481/878] boys; 18.1% [145/803] overweight) were collected in a representative sample of 20 schools in Flanders, Belgium. Height and weight were measured by the researchers. The healthy snack ratio and the healthy beverage ratio were calculated as follows: gram healthy snacks or beverages/(gram healthy snacks or beverages+gram unhealthy snacks or beverages)×100. Multilevel regression and structural equation modeling were used to analyze the proposed associations and to explore multiple mediation. A total of 27.6% (245/889) of the adolescents used fitness, nutrition apps or both. Frequency of using nutrition apps was positively associated with a higher healthy beverage ratio (b=2.96 [1.11], P=.008) and a higher body mass index z-scores (zBMI; b=0.13 [0.05], P=.008. A significant interaction was found between the frequency of using nutrition and for

  6. Use of Fitness and Nutrition Apps: Associations With Body Mass Index, Snacking, and Drinking Habits in Adolescents

    PubMed Central

    Vangeel, Jolien; Lachat, Carl; Beullens, Kathleen; Vervoort, Leentje; Goossens, Lien; Maes, Lea; Deforche, Benedicte; De Henauw, Stefaan; Braet, Caroline; Eggermont, Steven; Kolsteren, Patrick; Van Camp, John; Van Lippevelde, Wendy

    2017-01-01

    Background Efforts to improve snacking and drinking habits are needed to promote a healthy body mass index (BMI) in adolescents. Although commercial fitness and nutrition mobile phone apps are widely used, little is known regarding their potential to improve health behaviors, especially in adolescents. In addition, evidence on the mechanisms through which such fitness and nutrition apps influence behavior is lacking. Objectives This study assessed whether the use of commercial fitness or nutrition apps was associated with a lower BMI and healthier snacking and drinking habits in adolescents. Additionally, it explored if perceived behavioral control to eat healthy; attitudes to eat healthy for the good taste of healthy foods, for overall health or for appearance; social norm on healthy eating and social support to eat healthy mediated the associations between the frequency of use of fitness or nutrition apps and BMI, the healthy snack, and beverage ratio. Methods Cross-sectional self-reported data on snack and beverage consumption, healthy eating determinants, and fitness and nutrition app use of adolescents (N=889; mean age 14.7 years, SD 0.8; 54.8% [481/878] boys; 18.1% [145/803] overweight) were collected in a representative sample of 20 schools in Flanders, Belgium. Height and weight were measured by the researchers. The healthy snack ratio and the healthy beverage ratio were calculated as follows: gram healthy snacks or beverages/(gram healthy snacks or beverages+gram unhealthy snacks or beverages)×100. Multilevel regression and structural equation modeling were used to analyze the proposed associations and to explore multiple mediation. Results A total of 27.6% (245/889) of the adolescents used fitness, nutrition apps or both. Frequency of using nutrition apps was positively associated with a higher healthy beverage ratio (b=2.96 [1.11], P=.008) and a higher body mass index z-scores (zBMI; b=0.13 [0.05], P=.008. A significant interaction was found between the

  7. The impact of nutritional status, nutritional risk, and nutritional treatment on clinical outcome of 2248 hospitalized cancer patients: a multi-center, prospective cohort study in Chinese teaching hospitals.

    PubMed

    Pan, Hongming; Cai, Sanjun; Ji, Jiafu; Jiang, Zhiwei; Liang, Houjie; Lin, Feng; Liu, Xiyong

    2013-01-01

    To better understand the impact of undernutrition, nutritional risk, and nutritional treatment on the clinical outcomes of hospitalized cancer patients in China, the authors conducted a multicenter, cross-sectional study with 2248 cancer patients from 20 hospitals from January to June 2010. The authors defined 19.7% and 26.8% patients as undernourished at baseline and reassessment, respectively. Patients with gastrointestinal malignancies had a higher rate of undernutrition than other patients. The nutritional risk rate was 24.6% and 40.2% at baseline and reassessment, respectively. For patients with nutritional risk, the relative risk (RR) of adverse events (AEs) significantly increased with and without nutritional treatment. In comparison with the nonnutritional treatment subgroup, patients who received enteral nutrition (EN) or total parenteral nutrition (TPN) significantly reduced the RR of AE development. The RR of AEs for EN and TPN were 0.08 (95% CI: 0.01-0.62) and 0.56 (95% CI: 0.33-0.96), respectively. Separated nutrient infusion increased the risk of AEs. The authors concluded that undernutrition and nutritional risk are general problems that impact the outcomes of hospitalized cancer patients in China. Higher NRS2002 scores are related to AE risk but not weight loss. In nutritional treatment, EN and TPN can significantly reduce the risk of AEs.

  8. [Influence of nutrition on selected metabolic cardiovascular risk factors among female residents of Krakow].

    PubMed

    Piórecka, Beata; Jagielski, Paweł; Zwirska, Jaśmina; Piskorz, Anna; Brzostek, Tomasz; Schlegel-Zawadzka, Małgorzata

    2007-01-01

    The study involved influence of nutritional factors on select anthropometrical and lipid indices (total cholesterol, LDL, HDL) in female residents of Krakow who were voluntarily participating in the investigation. Only women free of diagnosed cardiovascular diseases were included. The study group consisting of 100 women aged 30-65 years, was divided into two groups: pre-menopause (PM, n=47) and after menopause (AM, n=53). The anthropometrical measurements, % of fat tissue - Tanita scale and Body Mass Index (BMI) was calculated. The energy value and the consumption of basic nutrients intake were calculated using 24-hour recalls from the day before the examination. The AM group presented higher anthropometrical and metabolic risk profile: overweight and obesity (BMI-PM = 25.51 +/- 4.16 kg/m2; AM = 28.28 +/- 4.89 kg/m2) and central adiposity type (WC-PM = 81.04 +/- 10.00 cm; AM = 86.46 +/- 11.73 cm); lipids (Total cholesterol-PM = 5.14 +/- 0.87 mmol/l, AM = 5.67 +/- 1.10 mmol/l; LDL-chol-PM = 2.98 +/- 0.90 mmol/l, AM = 3.40 +/- 0.93 mmol/l; HDL-chol-PM = 1.65 +/- 0.39 mmol/l; AM = 1.63 + 0.46 mmol/l). The irregular participation of fatty acids, proteins from plant sources and dietary fibers in daily diet were found (%Energy PM: SFA = 11.66 +/- 4.34, MUFA = 10.91 +/- 4.04, PUFA = 4.76 +/- 2.75, Keys index = 41.89 +/- 14.91; %EnergyAM: SFA = 11.48 +/- 3.86, MUFA = 11.02 +/- 4.12, PUFA = 4.89 +/- 2.92, Keys index = 40.87 +/- 14.4). Women in the AM group represented healthier nutritional behaviors. Results presented indicate that in further study concerning evaluation of nutrients consumption among women the fact of natural menopause should be considered.

  9. Diabetes mellitus and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition.

    PubMed

    Tsilidis, Konstantinos K; Allen, Naomi E; Appleby, Paul N; Rohrmann, Sabine; Nöthlings, Ute; Arriola, Larraitz; Gunter, Marc J; Chajes, Veronique; Rinaldi, Sabina; Romieu, Isabelle; Murphy, Neil; Riboli, Elio; Tzoulaki, Ioanna; Kaaks, Rudolf; Lukanova, Annekatrin; Boeing, Heiner; Pischon, Tobias; Dahm, Christina C; Overvad, Kim; Quirós, J Ramón; Fonseca-Nunes, Ana; Molina-Montes, Esther; Gavrila Chervase, Diana; Ardanaz, Eva; Khaw, Kay T; Wareham, Nick J; Roswall, Nina; Tjønneland, Anne; Lagiou, Pagona; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Palli, Domenico; Pala, Valeria; Tumino, Rosario; Vineis, Paolo; Bueno-de-Mesquita, H Bas; Malm, Johan; Orho-Melander, Marju; Johansson, Mattias; Stattin, Pär; Travis, Ruth C; Key, Timothy J

    2015-01-15

    The current epidemiologic evidence suggests that men with type 2 diabetes mellitus may be at lower risk of developing prostate cancer, but little is known about its association with stage and grade of the disease. The association between self-reported diabetes mellitus at recruitment and risk of prostate cancer was examined in the European Prospective Investigation into Cancer and Nutrition (EPIC). Among 139,131 eligible men, 4,531 were diagnosed with prostate cancer over an average follow-up of 12 years. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models stratified by EPIC-participating center and age at recruitment, and adjusted for education, smoking status, body mass index, waist circumference, and physical activity. In a subset of men without prostate cancer, the cross-sectional association between circulating concentrations of androgens and insulin-like growth factor proteins with diabetes status was also investigated using linear regression models. Compared to men with no diabetes, men with diabetes had a 26% lower risk of prostate cancer (HR, 0.74; 95% CI, 0.63-0.86). There was no evidence that the association differed by stage (p-heterogeneity, 0.19) or grade (p-heterogeneity, 0.48) of the disease, although the numbers were small in some disease subgroups. In a subset of 626 men with hormone measurements, circulating concentrations of androstenedione, total testosterone and insulin-like growth factor binding protein-three were lower in men with diabetes compared to men without diabetes. This large European study has confirmed an inverse association between self-reported diabetes mellitus and subsequent risk of prostate cancer.

  10. [Influence of maternal nutritional status, weight gain and energy intake on fetal growth in high-risk pregnancies].

    PubMed

    Nomura, Roseli Mieko Yamamoto; Paiva, Letícia Vieira; Costa, Verbênia Nunes; Liao, Adolfo Wenjaw; Zugaib, Marcelo

    2012-03-01

    To analyze the influence of maternal nutritional status, weight gain and energy consumption on fetal growth in high-risk pregnancies. A prospective study from August 2009 to August 2010 with the following inclusion criteria: puerperae up to the 5th postpartum day; high-risk singleton pregnancies (characterized by medical or obstetrical complications during pregnancy); live fetus at labor onset; delivery at the institution; maternal weight measured on the day of delivery, and presence of medical and/or obstetrical complications characterizing pregnancy as high-risk. Nutritional status was assessed by pregestational body mass index and body mass index in late pregnancy, and the patients were classified as: underweight, adequate, overweight and obese. A food frequency questionnaire was applied to evaluate energy consumption. We investigated maternal weight gain, delivery data and perinatal outcomes, as well as fetal growth based on the occurrence of small for gestational age and large for gestational age neonates. We included 374 women who were divided into three study groups according to newborn birth weight: adequate for gestational age (270 cases, 72.2%), small for gestational age (91 cases, 24.3%), and large for gestational age (13 cases, 3.5%). Univaried analysis showed that women with small for gestational age neonates had a significantly lower mean pregestational body mass index (23.5 kg/m², p<0.001), mean index during late pregnancy (27.7 kg/m², p<0.001), and a higher proportion of maternal underweight at the end of pregnancy (25.3%, p<0.001). Women with large for gestational age neonates had a significantly higher mean pregestational body mass index (29.1 kg/m², p<0.001), mean index during late pregnancy (34.3 kg/m², p<0.001), and a higher proportion of overweight (30.8%, p=0.02) and obesity (38.5%, p=0.02) according to pregestational body mass index, and obesity at the end of pregnancy (53.8%, p<0.001). Multivariate analysis revealed the index value

  11. TOTAL LYMPHOCYTE COUNT AND SERUM ALBUMIN AS PREDICTORS OF NUTRITIONAL RISK IN SURGICAL PATIENTS

    PubMed Central

    ROCHA, Naruna Pereira; FORTES, Renata Costa

    2015-01-01

    Background: Early detection of changes in nutritional status is important for a better approach to the surgical patient. There are several nutritional measures in clinical practice, but there is not a complete method for determining the nutritional status, so, health professionals should only choose the best method to use. Aim: To evaluate the total lymphocyte count and albumin as predictors of identification of nutritional risk in surgical patients. Methods: Prospective longitudinal study was conducted with 69 patients undergoing surgery of the gastrointestinal tract. The assessment of nutritional status was evaluated by objective methods (anthropometry and biochemical tests) and subjective methods (subjective global assessment). Results: All parameters used in the nutritional assessment detected a high prevalence of malnutrition, with the exception of BMI which detected only 7.2% (n=5). The albumin (p=0.01), the total lymphocytes count (p=0.02), the percentage of adequacy of skinfolds (p<0.002) and the subjective global assessment (p<0.001) proved to be useful as predictors of risk of postoperative complications, since the smaller the values of albumin and lymphocyte count and higher the score the subjective global assessment were higher risks of surgical complications. Conclusions: A high prevalence of malnutrition was found, except for BMI. The use of albumin and total lymphocyte count were good predictor for the risk of postoperative complications and when used with other methods of assessing the nutritional status, such as the subjective global assessment and the percentage of adequacy of skinfolds, can be useful for identification of nutritional risk and postoperative complications. PMID:26537145

  12. Pressure ulcer is associated with malnutrition as assessed by Nutritional Risk Screening (NRS 2002) in a mixed hospital population

    PubMed Central

    Alhaug, Johanne; Gay, Caryl L; Henriksen, Christine; Lerdal, Anners

    2017-01-01

    ABSTRACT Background and aim: Pressure ulcers (PUs) and malnutrition represent a significant health problem for hospital inpatients. Satisfactory nutritional status is crucial for proper wound healing. Risk of malnutrition can be identified using standardized screening tools, such as the Nutritional Risk Screening (NRS) 2002. Objective: The objective of this study was to examine whether nutritional status based on the NRS 2002 is associated with PU in hospital inpatients. Design: The data for this cross-sectional analysis were based on 10 screening days between September 2012 and May 2014. All adult inpatients admitted to a medical or surgical ward on the screening days were evaluated for eligibility. Nursing students and ward nurses conducted the NRS 2002 initial screening and skin examinations for PU classification (Stages I–IV). A registered clinical dietician conducted all NRS 2002 final screenings. Results: The sample consisted of 651 patients, with mean age 62.9 years. Skin examinations indicated an 8% PU prevalence. Factors associated with PUs included age ≥ 70 years, low body mass index (BMI) and hospitalization in the medical department. Based on the initial screening, 48% were at ‘Low risk’ for malnutrition and 52% were at ‘Possible risk’. After final screening, 34% of the sample was identified as ‘At risk’ for malnutrition. Patients identified at ‘Possible risk’ by the initial screening or ‘At risk’ by the final screening were more likely than patients at ‘Low risk’ to have a PU (OR = 2.58 and 2.55, respectively). Each of the three initial screening items was significantly associated PU, with ‘Is BMI<20?’ and ‘Ate less past week?’ having the strongest associations. Conclusion: Nutritional risk using the NRS 2002 is associated with the presence of PU in a mixed hospital population. The final screening had a slightly stronger association with PU compared to the initial screening. PMID:28659732

  13. [Effectiveness of body mass index in the nutritional diagnosis of pregnant women].

    PubMed

    Rached-Paoli, Ingrid; Henriquez-Pérez, Gladys; Azuaje-Sánchez, Arelis

    2005-03-01

    Our goal was to analyze the concordances and non-concordances of the nutritional classification in pregnant women and to evaluate their effectiveness when different BMI classification methodologies were applied. The study consisted of 314 adult healthy pregnant women in their first trimester, of socioeconomic status IV. In all of them, two nutritional classification criteria were applied: the integral nutritional diagnosis (IND) and different BMI reference values (Institute of Medicine, FAO/OMS, Frisancho, Bray, and Atalah). Kappa, concordance and nonconcordance, sensitivity, specificity, positive and negative predictive values were calculated. The highest frequency of concordance between IND and the analyzed classification criteria in comparing four and three nutritional categories was Frisancho's with the following results 89.2%, Kappa = 0.81 in the first case, and 91.4, Kappa = 0.84 in the second case. In deficit, the Bray and Atalah classification criteria were the highest sensitivities. In excess, FAO/ OMS, Frisancho, and Bray had a high sensitivity (1 - 0.99). Frisancho, in addition, had a high specificity with respect to FAO/OMS and Bray. Frisancho's classification criteria are the best choice for diagnosing adult pregnant women's nutritional status during the first trimester within population groups with these characteristics.

  14. Nutrition in the adolescent.

    PubMed

    Wahl, R

    1999-02-01

    This article reviews the nutritional requirements of puberty and the clinical assessment of nutritional status, and discusses the nutritional risks imposed by vegetarian diets, pregnancy, and athletic involvement. Energy (calories) and protein are essential in pubertal development. Adolescent females require approximately 2200 calories/day, whereas male adolescents require 2500-3000 calories/day. Additional intake requirements include fat, calcium, iron, zinc, vitamins, and fiber. The clinical assessment of nutritional status begins with obtaining a good diet history of the patient and this could be offered by the body mass index. Nutritional deficiencies and poor eating habits established during adolescence can have long-term consequences, including delayed sexual maturation, loss of final adult height, osteoporosis, hyperlipidemia, and obesity. As for vegetarian adolescents, nutritional risks include lack of iodine, vitamin B12, vitamin D, and some essential fatty acids. In addition, substances in some grains reduce gut absorption, thus increasing mineral deficiencies. Pregnancy may also be a risk factor for poor nutrition during adolescence. A pregnant adolescent has different nutritional needs because she is still growing. Among adolescent athletes many are turning to nutritional supplements in an attempt to improve athletic performance. A balanced, varied diet provides adequate calories and nutrition to meet the needs of most adolescents. They also have greater water needs than do adult athletes. Details on adolescent health concerns are further discussed in this article.

  15. Childhood body mass index growth trajectories and endometrial cancer risk.

    PubMed

    Aarestrup, Julie; Gamborg, Michael; Tilling, Kate; Ulrich, Lian G; Sørensen, Thorkild I A; Baker, Jennifer L

    2017-01-15

    Previously, we found that excess weight already in childhood has positive associations with endometrial cancer; however, associations with changes in body mass index (BMI) during childhood are not well understood. Therefore, we examined whether growth in childhood BMI is associated with endometrial cancer and its sub-types. A cohort of 155,505 girls from the Copenhagen School Health Records Register with measured weights and heights at the ages of 6-14 years and born 1930-1989 formed the analytical population. BMI was transformed to age-specific z scores. Using linear spline multilevel models, each girl's BMI growth trajectory was estimated as the deviance from the average trajectory for three different growth periods (6.25-7.99, 8.0-10.99, 11.0-14.0 years). Via a link to health registers, 1,020 endometrial cancer cases were identified, and Cox regressions were performed. A greater gain in BMI during childhood was positively associated with endometrial cancer but no differences between the different growth periods were detected in models adjusted for baseline BMI. The hazard ratios for the associations with overall growth during childhood per 0.1 z score increase were 1.15 (95% confidence interval [CI]: 1.07-1.24) for all endometrial cancers, 1.12 (95% CI: 1.04-1.21) for estrogen-dependent cancers, 1.16 (95% CI: 1.06-1.26) for endometrioid adenocarcinomas and 1.46 (95% CI: 1.16-1.84) for non-estrogen-dependent cancers. Growth in BMI in early life is positively linked to later endometrial cancer risk. We did not identify any sensitive childhood growth period, which suggests that excess gain in BMI during the entire childhood period should be avoided. © 2016 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

  16. Childhood body mass index growth trajectories and endometrial cancer risk

    PubMed Central

    Aarestrup, Julie; Gamborg, Michael; Tilling, Kate; Ulrich, Lian G.; Sørensen, Thorkild I.A.

    2016-01-01

    Previously, we found that excess weight already in childhood has positive associations with endometrial cancer; however, associations with changes in body mass index (BMI) during childhood are not well understood. Therefore, we examined whether growth in childhood BMI is associated with endometrial cancer and its sub‐types. A cohort of 155,505 girls from the Copenhagen School Health Records Register with measured weights and heights at the ages of 6–14 years and born 1930–1989 formed the analytical population. BMI was transformed to age‐specific z scores. Using linear spline multilevel models, each girl's BMI growth trajectory was estimated as the deviance from the average trajectory for three different growth periods (6.25–7.99, 8.0–10.99, 11.0–14.0 years). Via a link to health registers, 1,020 endometrial cancer cases were identified, and Cox regressions were performed. A greater gain in BMI during childhood was positively associated with endometrial cancer but no differences between the different growth periods were detected in models adjusted for baseline BMI. The hazard ratios for the associations with overall growth during childhood per 0.1 z score increase were 1.15 (95% confidence interval [CI]: 1.07–1.24) for all endometrial cancers, 1.12 (95% CI: 1.04–1.21) for estrogen‐dependent cancers, 1.16 (95% CI: 1.06–1.26) for endometrioid adenocarcinomas and 1.46 (95% CI: 1.16–1.84) for non‐estrogen‐dependent cancers. Growth in BMI in early life is positively linked to later endometrial cancer risk. We did not identify any sensitive childhood growth period, which suggests that excess gain in BMI during the entire childhood period should be avoided. PMID:27718528

  17. Upper-arm anthropometry: an alternative indicator of nutritional health to body mass index in unilateral lower-extremity amputees?

    PubMed

    Miller, Michelle; Wong, Wing Ki; Wu, Jing; Cavenett, Sally; Daniels, Lynne; Crotty, Maria

    2008-10-01

    To evaluate the utility of body mass index (BMI) and corrected-arm-muscle area (CAMA) as measures of nutritional health for lower-limb amputees attending prosthetics clinics. Cross-sectional study. Prosthetics clinic in Australia. Unilateral lower-extremity amputees (N=58; age range, 21-91y; 37 transtibial, 21 transfemoral) attending a regional prosthetics clinic between May and November 2003. Not applicable. Weight (without prosthesis), corrected and uncorrected for the amputated limb was used with height estimated from knee height to calculate corrected BMI (cBMI) and uncorrected BMI (uBMI). CAMA was calculated using the mean of triplicate mid-upper-arm circumference (MUAC) and triceps skinfold thickness (TST) measurements. The Mini Nutritional Assessment (MNA) and Assessment of Quality of Life were administered according to recommended protocols. The Pearson correlation was used to determine the strength and significance of associations between variables, and bivariate regression analyses were performed to determine whether an association existed between the nutritional variables (BMI, CAMA, MNA) and quality of life (QOL). There were no statistically significant differences in the measures of nutritional health according to site (transtibial, transfemoral) of amputation. MUAC, TST, and CAMA all showed moderate to high positive correlations (r range, .541-.782) with both cBMI and uBMI. The strength of the relationship between the MNA and cBMI/uBMI was weaker (r=.383, r=.380, respectively) but remained positive and statistically significant (P=.003). QOL was not associated with cBMI or uBMI but was related to CAMA (beta=-.132; P=.030) and MNA (beta=-.561; P=.017). For persons with unilateral lower-extremity amputation, measurement of upper-arm anthropometry may be a more useful indicator of nutritional health and its consequences than BMI.

  18. Sarcopenia is a risk factor for elevated aminotransferase in men independently of body mass index, dietary habits, and physical activity.

    PubMed

    Yoo, Ki Deok; Jun, Dae Won; Lee, Kang Nyeong; Lee, Hang Lak; Lee, Oh Young; Yoon, Byung Chul; Choi, Ho Soon

    2015-04-01

    Aminotransferase activity is a surrogate marker of liver injury showing strong correlations with obesity and metabolic syndrome. However, elevated aminotransferase activity is not uncommon in non-obese and non-alcoholic patients in clinical practice. To examine the relationship between sarcopenia and aminotransferase activity in a large population-based cohort. Data from the Korean National Health and Nutrition Examinations were used. A total of 13,431 subjects were included. A whole-body dual X-ray absorptiometry scan was performed on each patient to measure total and regional muscle mass. Appendicular skeletal muscle mass indices were also obtained. The prevalence of sarcopenia was significantly higher in the group with elevated aminotransferase levels than in the normal liver enzyme group (males: 26.5% vs. 16.9%; females: 38.3% vs. 22.1%, p<0.05). The skeletal muscle index was negatively correlated with most cardiometabolic risk factors, including fasting glucose and cholesterol levels. The frequency of elevated aminotransferase increased in male patients with sarcopenia after adjusting for potential confounding factors including age, body mass index, fasting glucose level, dietary, and exercise habits. However, the correlation was no longer observed in women after adjusting for body mass index. Sarcopenia is a risk factor for elevated aminotransferase in men, independently of body mass index, dietary habits, and physical activity. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  19. Clinical Significance of the Prognostic Nutritional Index for Predicting Short- and Long-Term Surgical Outcomes After Gastrectomy: A Retrospective Analysis of 7781 Gastric Cancer Patients.

    PubMed

    Lee, Jee Youn; Kim, Hyoung-Il; Kim, You-Na; Hong, Jung Hwa; Alshomimi, Saeed; An, Ji Yeong; Cheong, Jae-Ho; Hyung, Woo Jin; Noh, Sung Hoon; Kim, Choong-Bai

    2016-05-01

    To evaluate the predictive and prognostic significance of the prognostic nutritional index (PNI) in a large cohort of gastric cancer patients who underwent gastrectomy.Assessing a patient's immune and nutritional status, PNI has been reported as a predictive marker for surgical outcomes in various types of cancer.We retrospectively reviewed data from a prospectively maintained database of 7781 gastric cancer patients who underwent gastrectomy from January 2001 to December 2010 at a single center. From this data, we analyzed clinicopathologic characteristics, PNI, and short- and long-term surgical outcomes for each patient. We used the PNI value for the 10th percentile (46.70) of the study cohort as a cut-off for dividing patients into low and high PNI groups.Regarding short-term outcomes, multivariate analysis showed a low PNI (odds ratio [OR] = 1.505, 95% CI = 1.212-1.869, P <0.001), old age, male sex, high body mass index, medical comorbidity, total gastrectomy, and combined resection to be independent predictors of postoperative complications. Among these, only low PNI (OR = 4.279, 95% CI = 1.760-10.404, P = 0.001) and medical comorbidity were independent predictors of postoperative mortality. For long-term outcomes, low PNI was a poor prognostic factor for overall survival, but not recurrence (overall survival: hazard ratio [HR] = 1.383, 95% CI = 1.221-1.568, P < 0.001; recurrence-free survival: HR = 1.142, 95% CI = 0.985-1.325, P = 0.078).PNI can be used to predict patients at increased risk of postoperative morbidity and mortality. Although PNI was an independent prognostic factor for overall survival, the index was not associated with cancer recurrence.

  20. Prenatal nutrition, epigenetics and schizophrenia risk: can we test causal effects?

    PubMed Central

    Kirkbride, James B; Susser, Ezra; Kundakovic, Marija; Kresovich, Jacob K; Smith, George Davey; Relton, Caroline L

    2014-01-01

    We posit that maternal prenatal nutrition can influence offspring schizophrenia risk via epigenetic effects. In this article, we consider evidence that prenatal nutrition is linked to epigenetic outcomes in offspring and schizophrenia in offspring, and that schizophrenia is associated with epigenetic changes. We focus upon one-carbon metabolism as a mediator of the pathway between perturbed prenatal nutrition and the subsequent risk of schizophrenia. Although post-mortem human studies demonstrate DNA methylation changes in brains of people with schizophrenia, such studies cannot establish causality. We suggest a testable hypothesis that utilizes a novel two-step Mendelian randomization approach, to test the component parts of the proposed causal pathway leading from prenatal nutritional exposure to schizophrenia. Applied here to a specific example, such an approach is applicable for wider use to strengthen causal inference of the mediating role of epigenetic factors linking exposures to health outcomes in population-based studies. PMID:22690666

  1. Prenatal nutrition, epigenetics and schizophrenia risk: can we test causal effects?

    PubMed

    Kirkbride, James B; Susser, Ezra; Kundakovic, Marija; Kresovich, Jacob K; Davey Smith, George; Relton, Caroline L

    2012-06-01

    We posit that maternal prenatal nutrition can influence offspring schizophrenia risk via epigenetic effects. In this article, we consider evidence that prenatal nutrition is linked to epigenetic outcomes in offspring and schizophrenia in offspring, and that schizophrenia is associated with epigenetic changes. We focus upon one-carbon metabolism as a mediator of the pathway between perturbed prenatal nutrition and the subsequent risk of schizophrenia. Although post-mortem human studies demonstrate DNA methylation changes in brains of people with schizophrenia, such studies cannot establish causality. We suggest a testable hypothesis that utilizes a novel two-step Mendelian randomization approach, to test the component parts of the proposed causal pathway leading from prenatal nutritional exposure to schizophrenia. Applied here to a specific example, such an approach is applicable for wider use to strengthen causal inference of the mediating role of epigenetic factors linking exposures to health outcomes in population-based studies.

  2. A theory-based newsletter nutrition education program reduces nutritional risk and improves dietary intake for congregate meal participants.

    PubMed

    Francis, Sarah L; MacNab, Lindsay; Shelley, Mack

    2014-01-01

    At-risk older adults need community-based nutrition programs that improve nutritional status and practices. This 6-month study assessed the impact of the traditional Chef Charles (CC) program (Control) compared to a theory-based CC program (Treatment) on nutritional risk (NR), dietary intakes, self-efficacy (SE), food security (FS), and program satisfaction for congregate meal participants. Participants were mostly educated, single, "food secure" White females. NR change for the treatment group was significantly higher (P = 0.042) than the control group. No differences were noted for SE or FS change and program satisfaction between groups. The overall distribution classification levels of FS changed significantly (P < .001) from pre to post. Over half (n = 46, 76.7%) reported making dietary changes and the majority (n = 52, 86.7%) rated CC as good to excellent. Results suggest the theory-based CC program (treatment) is more effective in reducing NR and dietary practices than the traditional CC program (control).

  3. Risk factors and risk index of cardiac events in pregnant women with heart disease.

    PubMed

    Liu, Hua; Huang, Tao-Tao; Lin, Jian-Hua

    2012-10-01

    Pregnant women with heart disease are at high risk. Studies of risk factors of these patients are of great significance to improve maternal and fetal outcomes. In this paper, we try to discuss the main risk factors of cardiac events in pregnant women with heart disease and to establish a risk assessment system. A retrospective analysis was carried out for pregnancies in 1741 women with heart disease who delivered in Shanghai Obstetrical Cardiology Intensive Care Center between January 1993 and September 2010. A Logistic regression model was used to identify independent risk factors of cardiac events and calculate the risk index in pregnant women with heart disease. The composition of heart disease in pregnant women was arrhythmia (n = 662, 38.00%), congenital heart disease (CHD; n = 529, 30.40%), cardiomyopathy (n = 327, 18.80%), rheumatic heart disease (RHD; n = 151, 8.70%), and cardiopathy induced by pre-eclampsia (n = 53, 3.00%). Main cardiac events were heart failure (n = 110, 6.32%), symptomatic arrhythmia needing medication (n = 43, 2.47%), cardiac arrest (n = 2, 0.11%), syncope (n = 3, 0.17%), and maternal death (n = 10, 0.57%). Six independent risk factors to predict cardiac events in pregnant women with heart disease were cardiac events before pregnancy (heart failure, severe arrhythmia, cardiac shock, etc., P = 0.000), New York Heart Association (NYHA) class > II (P = 0.000), oxygen saturation < 90% (P = 0.018), pulmonary artery hypertention (PAH) > 50 mmHg (P = 0.025), cyanotic heart disease without surgical correction (P = 0.015), and reduced left ventricular systolic function (ejection fraction < 40%, P = 0.003). Every risk factor was calculated as 1 score. The incidence of cardiac events in patients with scores 0, 1, 2, 3, and ≥ 4 was 2.10%, 31.61%, 61.25%, 68.97%, and 100.00% respectively. Pregnancy with heart disease could lead to undesirable pregnancy outcomes. The risk of cardiac events in pregnant women with heart disease could be assessed by

  4. Nutrition-Related Cancer Prevention Cognitions and Behavioral Intentions: Testing the Risk Perception Attitude Framework

    ERIC Educational Resources Information Center

    Sullivan, Helen W.; Beckjord, Ellen Burke; Finney Rutten, Lila J.; Hesse, Bradford W.

    2008-01-01

    This study tested whether the risk perception attitude framework predicted nutrition-related cancer prevention cognitions and behavioral intentions. Data from the 2003 Health Information National Trends Survey were analyzed to assess respondents' reported likelihood of developing cancer (risk) and perceptions of whether they could lower their…

  5. Nutrition-Related Cancer Prevention Cognitions and Behavioral Intentions: Testing the Risk Perception Attitude Framework

    ERIC Educational Resources Information Center

    Sullivan, Helen W.; Beckjord, Ellen Burke; Finney Rutten, Lila J.; Hesse, Bradford W.

    2008-01-01

    This study tested whether the risk perception attitude framework predicted nutrition-related cancer prevention cognitions and behavioral intentions. Data from the 2003 Health Information National Trends Survey were analyzed to assess respondents' reported likelihood of developing cancer (risk) and perceptions of whether they could lower their…

  6. Low Prognostic Nutritional Index (PNI) Predicts Unfavorable Distant Metastasis-Free Survival in Nasopharyngeal Carcinoma: A Propensity Score-Matched Analysis

    PubMed Central

    Hong, Shaodong; Chen, Haiyang; Liang, Shaobo; Peng, Peijian; Chen, Yong

    2016-01-01

    Background Poor nutritional status is associated with progression and advanced disease in patients with cancer. The prognostic nutritional index (PNI) may represent a simple method of assessing host immunonutritional status. This study was designed to investigate the prognostic value of the PNI for distant metastasis-free survival (DMFS) in patients with nasopharyngeal carcinoma (NPC). Methods A training cohort of 1,168 patients with non-metastatic NPC from two institutions was retrospectively analyzed. The optimal PNI cutoff value for DMFS was identified using the online tool “Cutoff Finder”. DMFS was analyzed using stratified and adjusted analysis. Propensity score-matched analysis was performed to balance baseline characteristics between the high and low PNI groups. Subsequently, the prognostic value of the PNI for DMFS was validated in an external validation cohort of 756 patients with NPC. The area under the receiver operating characteristics curve (AUC) was calculated to compare the discriminatory ability of different prognostic scores. Results The optimal PNI cutoff value was determined to be 51. Low PNI was significantly associated with poorer DMFS than high PNI in univariate analysis (P<0.001) as well as multivariate analysis (P<0.001) before propensity score matching. In subgroup analyses, PNI could also stratify different risks of distant metastases. Propensity score-matched analyses confirmed the prognostic value of PNI, excluding other interpretations and selection bias. In the external validation cohort, patients with high PNI also had significantly lower risk of distant metastases than those with low PNI (Hazards Ratios, 0.487; P<0.001). The PNI consistently showed a higher AUC value at 1-year (0.780), 3-year (0.793) and 5-year (0.812) in comparison with other prognostic scores. Conclusion PNI, an inexpensive and easily assessable inflammatory index, could aid clinicians in developing individualized treatment and follow-up strategies for patients

  7. Iodine nutrition in elementary state schools of Queretaro, Mexico: correlations between urinary iodine concentration with global nutrition status and social gap index.

    PubMed

    García-Solís, Pablo; Solís-S, Juan Carlos; García-Gaytán, Ana Cristina; Reyes-Mendoza, Vanessa A; Robles-Osorio, Ludivina; Villarreal-Ríos, Enrique; Leal-García, Luisa; Hernández-Montiel, Hebert Luis

    2013-08-01

    To estimate median urinary iodine concentration (UIC), and to correlate it with global nutrition indicators and social gap index (SGI) in 50 elementary state schools from 10 municipalities in the State of Queretaro, Mexico. 1,544 students were enrolled and an above of requirements of iodine intake was found (median UIC of 297 µg/L). Iodine status was found as deficient, adequate, more than adequate and excessive in 2, 4, 19 and 25 schools, respectively. Seventy seven percent of table salt samples showed adequate iodine content (20-40 ppm), while 9.6% of the samples had low iodine content (< 15 ppm). Medians of UIC per school were positively correlated with medians of body mass index (BMI) by using the standard deviation score (SDS) (r = 0.47; p < 0.005), height SDS (r = 0.41; p < 0.05), and overweight and obesity prevalence (r = 0.41; p < 0.05). Medians of UIC per school were negatively correlated with stunting prevalence (r = -0.39; p = 005) and social gap index (r = -0.36; p < 0.05). Best multiple regression models showed that BMI SDS and height were significantly related with UIC (p < 0.05). There is coexistence between the two extremes of iodine intake (insufficient and excessive). To our knowledge, the observed positive correlation between UIC and overweight and obesity has not been described before, and could be explained by the availability and consumption of snack food rich in energy and iodized salt.

  8. Association between the Family Nutrition and Physical Activity screening tool and cardiovascular disease risk factors in 10-year old children

    NASA Astrophysics Data System (ADS)

    Yee, Kimbo Edward

    Purpose. To examine the association of the Family Nutrition and Physical Activity (FNPA) screening tool, a behaviorally based screening tool designed to assess the obesogenic family environment and behaviors, with cardiovascular disease (CVD) risk factors in 10-year old children. Methods. One hundred nineteen children were assessed for body mass index (BMI), percent body fat (%BF), waist circumference (WC), total cholesterol, HDL-cholesterol, and resting blood pressure. A continuous CVD risk score was created using total cholesterol to HDL-cholesterol ratio (TC:HDL), mean arterial pressure (MAP), and WC. The FNPA survey was completed by parents. The associations between the FNPA score and individual CVD risk factors and the continuous CVD risk score were examined using correlation analyses. Results. Approximately 35% of the sample were overweight (19%) or obese (16%). The mean FNPA score was 24.6 +/- 2.5 (range 18 to 29). Significant correlations were found between the FNPA score and WC (r = -.35, p<.01), BMI percentile (r = -.38, p<.01), %BF (r = -.43, p<.01), and the continuous CVD risk score (r = -.22, p = .02). No significant association was found between the FNPA score and TC:HDL (r=0.10, p=0.88) or MAP (r=-0.12, p=0.20). Conclusion. Children from a high-risk, obesogenic family environment as indicated with a lower FNPA score have a higher CVD risk factor profile than children from a low-risk family environment.

  9. Evaluation of the nutritional status of older hospitalised geriatric patients: a comparative analysis of a Mini Nutritional Assessment (MNA) version and the Nutritional Risk Screening (NRS 2002).

    PubMed

    Christner, S; Ritt, M; Volkert, D; Wirth, R; Sieber, C C; Gaßmann, K-G

    2016-12-01

    The present study aimed to evaluate a short-form (MNA-SF) version of the Mini Nutritional Assessment (MNA), in which some of the items were operationalised, based on scores from tools used for a comprehensive geriatric assessment, as a method for analysing the nutritional status of hospitalised geriatric patients. We compared this MNA-SF version with the corresponding MNA long-form (MNA-LF) and Nutritional Risk Screening 2002 (NRS 2002) in terms of completion rate, prevalence and agreement regarding malnutrition and/or the risk of this. In total, 201 patients aged ≥65 years who were hospitalised in geriatric wards were included in this analysis. The MNA-SF, MNA-LF and NRS 2002 were completed in 98.0%, 95.5% and 99.5% of patients (P = 0.06), respectively. The MNA-SF, MNA-LF and NRS 2002 categorised 93.4%, 91.1% and 66.0% of patients as being malnourished or at risk of being malnourished (P < 0.001). Agreement between the MNA-SF and MNA-LF was substantial (κ = 0.70, P < 0.001). No agreement between the MNA-SF and NRS 2002 was found (κ = -0.12, P < 0.001). Interestingly, NRS 2002 part 1 (prescreening) revealed a false negative rate of 21.0% (only in patients aged ≥70 years who showed moderate disease severity) in relation to the NRS 2002 part 2. The MNA-SF version emerged as a useful tool for evaluating the nutritional status of hospitalised geriatric patients. The NRS 2002 part 1 showed limited value as a prescreening aid in relation to the NRS 2002 part 2 in the same group of patients. © 2016 The British Dietetic Association Ltd.

  10. Carbohydrate nutrition and risk of adiposity-related cancers: results from the Framingham Offspring cohort (1991-2013).

    PubMed

    Makarem, Nour; Bandera, Elisa V; Lin, Yong; Jacques, Paul F; Hayes, Richard B; Parekh, Niyati

    2017-06-01

    Higher carbohydrate intake, glycaemic index (GI), and glycaemic load (GL) are hypothesised to increase cancer risk through metabolic dysregulation of the glucose-insulin axis and adiposity-related mechanisms, but epidemiological evidence is inconsistent. This prospective cohort study investigates carbohydrate quantity and quality in relation to risk of adiposity-related cancers, which represent the most commonly diagnosed preventable cancers in the USA. In exploratory analyses, associations with three site-specific cancers: breast, prostate and colorectal cancers were also examined. The study sample consisted of 3184 adults from the Framingham Offspring cohort. Dietary data were collected in 1991-1995 using a FFQ along with lifestyle and medical information. From 1991 to 2013, 565 incident adiposity-related cancers, including 124 breast, 157 prostate and sixty-eight colorectal cancers, were identified. Cox proportional hazards models were used to evaluate the role of carbohydrate nutrition in cancer risk. GI and GL were not associated with risk of adiposity-related cancers or any of the site-specific cancers. Total carbohydrate intake was not associated with risk of adiposity-related cancers combined or prostate and colorectal cancers. However, carbohydrate consumption in the highest v. lowest quintile was associated with 41 % lower breast cancer risk (hazard ratio (HR) 0·59; 95 % CI 0·36, 0·97). High-, medium- and low-GI foods were not associated with risk of adiposity-related cancers or prostate and colorectal cancers. In exploratory analyses, low-GI foods, were associated with 49 % lower breast cancer risk (HR 0·51; 95 % CI 0·32, 0·83). In this cohort of Caucasian American adults, associations between carbohydrate nutrition and cancer varied by cancer site. Healthier low-GI carbohydrate foods may prevent adiposity-related cancers among women, but these findings require confirmation in a larger sample.

  11. [Nutritional risk factors in patients with head and neck cancer in oncology care center Michoacan state].

    PubMed

    García Rojas Vázquez, L E; Trujano-Ramos, L A; Pérez-Rivera, E

    2013-01-01

    The head and neck cancer in Michoacán, Mexico, ranks as the third most common cancer and accounts for 12% of deaths. The increase in malnutrition in a patient with this disease has been associated with increased mortality. We studied prospectively 30 patients of both sexes, aged 18 years with head and neck cancer in the Cancer Care Center of Michoacan. In the evaluation period since August 2010 to August 2011. Formats were used VGS-Oncology (Subjective Global Assessment), NRS 2002 (Nutritional risk screen) and Guss (Gugging Swallowing Screen), through which nutritional risk was determined, and established the swallowing capacity of the study population. In our study, 53.3% of the population had moderate malnutrition according to the VGS Oncology, 33% weight loss record. The NRS 2002 show that 43.3% is at risk of malnutrition. The degree of dysphagia is shown more often in older patients, cancer type and stage of illness. Nutritional risk scales relate directly proportional to tumor location and stage, as well, there are other different oncological factors involved in the patient's nutritional deterioration. Therefore it is of vital importance to have a nutritionist as part of the multidisciplinary team, to detect the nutritional risk and to be able to handle it in an opportune way. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  12. [Value of the palliative prognostic index, controlling nutritional status, and prognostic nutritional index for objective evaluation during transition from chemotherapy to palliative care in cases of advanced or recurrent gastrointestinal cancer].

    PubMed

    Fukushima, Tsuyoshi; Annen, Kazuya; Kawamukai, Yuji; Onuma, Noritomo; Kawashima, Mayu

    2014-07-01

    We investigated whether objective evaluation by using the palliative prognostic index(PPI), controlling nutritional status(COUNT), and prognostic nutritional index(PNI)can provide prognostic information during the transition from chemotherapy to palliative care in patients with advanced or recurrent gastrointestinal cancer. The subjects were 28 patients with gastrointestinal cancer who died of their disease between January 2009 and June 2012. We compared the PPI, COUNT, and PNI scores between patients who died within 90 days of completing chemotherapy(Group A, n=14)and patients who survived for 90 or more days(Group B, n=14). The PPI score for Group A(4.0)was significantly higher than that for Group B(0.8)(p<0.001). The COUNT score was also significantly higher for Group A(6.3)than for Group B (3.9)(p=0.033). A significant difference in survival was evident when the cutoff value for PNI was set at 40 in the critical region(68/118, p=0.04). Our study suggests that the PPI, COUNT, and PNI may be useful for objective evaluation during the transition from chemotherapy to palliative care.

  13. The Index of Harm: A Measure for Comparing Occupational Risk Across Industries

    DTIC Science & Technology

    1988-03-01

    estimate of BEIR II (absolute Risk-Plateau Model) (Ref. 12). Under two of the five assumptions tested, the mining industry is found to have the...highest index of harm; under a third assumption, it comes very close to registering the highest index. The true index of harm for the mining industry -and

  14. A High Dietary Glycemic Index Increases Total Mortality in a Mediterranean Population at High Cardiovascular Risk

    PubMed Central

    Castro-Quezada, Itandehui; Sánchez-Villegas, Almudena; Estruch, Ramón; Salas-Salvadó, Jordi; Corella, Dolores; Schröder, Helmut; Álvarez-Pérez, Jacqueline; Ruiz-López, María Dolores; Artacho, Reyes; Ros, Emilio; Bulló, Mónica; Covas, María-Isabel; Ruiz-Gutiérrez, Valentina; Ruiz-Canela, Miguel; Buil-Cosiales, Pilar; Gómez-Gracia, Enrique; Lapetra, José; Pintó, Xavier; Arós, Fernando; Fiol, Miquel; Lamuela-Raventós, Rosa María; Martínez-González, Miguel Ángel; Serra-Majem, Lluís

    2014-01-01

    Objective Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI) and glycemic load (GL) are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. Material and Methods The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ). We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. Results We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths). As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15–4.04); P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. Conclusions High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk. PMID:25250626

  15. [Nutritional status and risk factors for malnutrition in low-income urban elders].

    PubMed

    Hyun, Hye Sun; Lee, Insook

    2014-12-01

    The purpose of this study was to evaluate the nutritional status of low-income urban elders by diversified ways, and to analyze the risk factors for malnutrition. The participants in this study were 183 low-income elders registered at a visiting healthcare facility in a public health center. Data were collected using anthropometric measurements, and a questionnaire survey. For data analysis, descriptive statistics, χ²-test, t-test, Fisher's exact test, multiple logistic regression analysis were performed using SPSS 20.0. Regarding the nutritional status of low-income elders as measured by the Mini Nutritional Assessment (MNA), 10.4% of the elders were classified as malnourished; 57.4% as at high risk for malnutrition; and 32.2% as having normal nutrition levels. The main factors affecting malnutrition for low-income elders were loss of appetite (OR=3.34, 95% CI: 1.16~9.56) and difficulties in meal preparation (OR=2.35, 95% CI: 1.13~4.88). In order to effectively improve nutrition in low-income urban elders, it is necessary to develop individual intervention strategies to manage factors that increase the risk of malnutrition and to use systematic approach strategies in local communities in terms of a nutrition support system.

  16. Developing a new Bayesian Risk Index for risk evaluation of soil contamination.

    PubMed

    Albuquerque, M T D; Gerassis, S; Sierra, C; Taboada, J; Martín, J E; Antunes, I M H R; Gallego, J R

    2017-12-15

    Industrial and agricultural activities heavily constrain soil quality. Potentially Toxic Elements (PTEs) are a threat to public health and the environment alike. In this regard, the identification of areas that require remediation is crucial. In the herein research a geochemical dataset (230 samples) comprising 14 elements (Cu, Pb, Zn, Ag, Ni, Mn, Fe, As, Cd, V, Cr, Ti, Al and S) was gathered throughout eight different zones distinguished by their main activity, namely, recreational, agriculture/livestock and heavy industry in the Avilés Estuary (North of Spain). Then a stratified systematic sampling method was used at short, medium, and long distances from each zone to obtain a representative picture of the total variability of the selected attributes. The information was then combined in four risk classes (Low, Moderate, High, Remediation) following reference values from several sediment quality guidelines (SQGs). A Bayesian analysis, inferred for each zone, allowed the characterization of PTEs correlations, the unsupervised learning network technique proving to be the best fit. Based on the Bayesian network structure obtained, Pb, As and Mn were selected as key contamination parameters. For these 3 elements, the conditional probability obtained was allocated to each observed point, and a simple, direct index (Bayesian Risk Index-BRI) was constructed as a linear rating of the pre-defined risk classes weighted by the previously obtained probability. Finally, the BRI underwent geostatistical modeling. One hundred Sequential Gaussian Simulations (SGS) were computed. The Mean Image and the Standard Deviation maps were obtained, allowing the definition of High/Low risk clusters (Local G clustering) and the computation of spatial uncertainty. High-risk clusters are mainly distributed within the area with the highest altitude (agriculture/livestock) showing an associated low spatial uncertainty, clearly indicating the need for remediation. Atmospheric emissions, mainly

  17. Characteristics of NRS-2002 Nutritional Risk Screening in patients hospitalized for secondary cardiovascular prevention and rehabilitation.

    PubMed

    Boban, Marko; Laviano, Alessandro; Persic, Viktor; Rotim, Ante; Jovanovic, Zeljko; Vcev, Aleksandar

    2014-01-01

    The aim of our study was to assess the prevalence and characteristics of nutritional risk in patients scheduled for cardiovascular rehabilitation. Knowledge concerning nutritional aspects of cardiovascular diseases is contemporary limited. Nutritional risk screening using a standardized Nutritional Risk Screening-2002 (NRS-2002) questionnaire was performed on a cohort of consecutive patients scheduled for rehabilitation 1-6 months after treatment for ischemic, valvular, or combined causes of heart diseases. Baseline weight was available for more than 80% of patients. The study population consisted of 317 patients, aged 23-85 years, with a mean age of 62.5 ± 11.3 years. Male to female share was 253 (79.8%) and 64 (20.2%), respectively. Twenty-eight (8.8%) were treated for myocardial infarction conservatively, 151 (47.6%) by percutaneous coronary interventions, and 145 (45.7%) by surgery. NRS-2002 was 3.56 ± 1.54 in range 0-6. A high correlation was found between the NRS-2002 and percentage weight loss history (rho = 0.813; p <0.001). Significant differences according to increased nutritional risk (NRS-2002 ≥ 3) were found within age groups (p < 0.001), disease etiology (p = 0.002), cardiovascular treatments (p < 0.001), and grades of renal function (p < 0.001). Odds for developing increased nutritional risk (NRS-2002 ≥ 3) were significant for cardiovascular treatments (odds ratio [OR] = 4.35, 95% confidence interval [CI], 2.28-8.30, p < 0.001), age (OR = 3.19, 95% CI, 2.00-5.09, p < 0.001), grade of renal function (OR = 1.91, 95% CI, 1.17-3.09, p = 0.009), diabetes mellitus (OR = 2.37, 95% CI, 1.09-5.16, p = 0.029), and any psychological disturbance (OR = 2.04, 95% CI, 1.06-3.90, p = 0.032). Pronounced nutritional risk frequently existed among patients at stationary cardiovascular rehabilitation. Nutritional risk was connected with preceding cardiovascular treatments, patient age, and renal function. Further studies concerning nutritional risk and its

  18. Nutrition.

    ERIC Educational Resources Information Center

    Saur, Susan

    An elementary level nutrition unit provides teachers with student background information, suggested activities, and student worksheets. Part 1 focuses on the relationship of food to growth, health, and energy. In part 2, students learn about the four main food groups. Part 3 deals with nutrients and provides information about carbohydrates, fats,…

  19. [Influence of the nutritional status in the risk of eating disorders among female university students of nutrition: eating patterns and nutritional status].

    PubMed

    Silva, Janiara David; Silva, Amanda Bertolini de Jesus; de Oliveira, Aihancreson Vaz Kirchoff; Nemer, Aline Silva de Aguiar

    2012-12-01

    The scope of this paper was to evaluate the relationship between changes in eating behavior associated with dissatisfaction with body image, and the nutritional status of female university students of nutrition. A cross-sectional study was conducted among 175 female students of nutrition (ENUT/UFOP). The Eating Attitudes Test-26 (EAT-26) and Body Shape Questionnaire (BSQ) were applied and anthropometric measurements were taken. 21.7% of the students were found to be high risk in terms of eating disorders, and 13.7% declared dissatisfaction with their body image. The majority of students with positive results in the BSQ and EAT-26 tests were eutrophic. The students who were overweight, with elevated body fat percentage (% BF) and waist circumference (WC) had a 5-9 times greater risk of change in eating habits. There was a positive association between the anthropometric parameters with high scores in the EAT-26 and BSQ questionnaires. The future dietitians who are overweight, with increased body fat and waist circumference were more likely to be dissatisfied with their body image and develop eating disorders. The use of other anthropometric parameters, in addition to BMI, may prove useful in screening individuals susceptible to the emergence of excessive concerns with weight and diet.

  20. [Modified texture diet and useful in patients with nutritional risk].

    PubMed

    de Luis, Daniel A; Aller, Rocío; Izaola, Olatz

    2014-01-20

    In the nutritional management of patients with dysphagia and/or elderly must make a multidisciplinary approach and a main tool is changing the texture of food. Patients with dysphagia, who need a texture modified diet, generally do not have a calorie and nutrient requirements different from those exhibited by people of the same age and sex, unless a condition or disease coexist. In these patients, Texture of foods should be individualized according to the patient and the time course of their disease. The use of texture modified diets without specifying produces a clear decrease in caloric and protein intakes and nutritional disorders. These patients may have other characteristics associated diseases, which would require special modification, as in the case of diabetes mellitus, hypertension, osteoporosis and constipation. Sometimes it is necessary to use artificial products to achieve different desired textures and precooked dishes, too.

  1. Anthropometry of Arm: Nutritional Risk Indicator in Amyotrophic Lateral Sclerosis

    PubMed Central

    Stanich, Patricia; Oliveira, Acary Souza Bulle; Orsini, Marco

    2015-01-01

    The aim of the paper is to examine the correlation between clinical data, nutritional, respiratory and functional parameters in amyotrophic lateral sclerosis (ALS). This is a descriptive study of 111 ALS patients [91 spinal onset (GS) and 20 bulbar onset (GB)] carried on using nutritional and respiratory parameters and amyotrophic lateral sclerosis functional rating scale (ALSFRS). ALSFRS was analyzed in the main domains (D1, D2 and D3). Forced vital capacity and anthropometric measurements, there was significant association for GS and GB, and in GS there was positive correlation with midarm circumference (MAC) (r=0.30; P=0.020), midarm muscle circumference (r=0.29; P=0.026), arm muscle area (r=0.28; P=0.033) and protein-caloric malnutrition score (r=0.27; P=0.039), while for GB only with body weight (r=0.64; P=0.024). On correlation of nutritional parameters and ALSFRS for GS patients we observed that MAC and %MAC presented positive association with both issues of D1 and D2. For GB, the total score in addition to correlate positively with anthropometric parameters related to lean body mass also presented negative association with a parameter associated with body fat. In summary, it is suggested that the application of anthropometry of arm could be useful in routine monitoring of ALS patients. PMID:26788263

  2. Anthropometry of Arm: Nutritional Risk Indicator in Amyotrophic Lateral Sclerosis.

    PubMed

    Salvioni, Cristina Cleide Dos Santos; Stanich, Patricia; Oliveira, Acary Souza Bulle; Orsini, Marco

    2015-12-29

    The aim of the paper is to examine the correlation between clinical data, nutritional, respiratory and functional parameters in amyotrophic lateral sclerosis (ALS). This is a descriptive study of 111 ALS patients [91 spinal onset (GS) and 20 bulbar onset (GB)] carried on using nutritional and respiratory parameters and amyotrophic lateral sclerosis functional rating scale (ALSFRS). ALSFRS was analyzed in the main domains (D1, D2 and D3). Forced vital capacity and anthropometric measurements, there was significant association for GS and GB, and in GS there was positive correlation with midarm circumference (MAC) (r=0.30; P=0.020), midarm muscle circumference (r=0.29; P=0.026), arm muscle area (r=0.28; P=0.033) and protein-caloric malnutrition score (r=0.27; P=0.039), while for GB only with body weight (r=0.64; P=0.024). On correlation of nutritional parameters and ALSFRS for GS patients we observed that MAC and %MAC presented positive association with both issues of D1 and D2. For GB, the total score in addition to correlate positively with anthropometric parameters related to lean body mass also presented negative association with a parameter associated with body fat. In summary, it is suggested that the application of anthropometry of arm could be useful in routine monitoring of ALS patients.

  3. Nutrition Education and Body Mass Index in Grades K-12: A Systematic Review

    ERIC Educational Resources Information Center

    Price, Cayla; Cohen, Deborah; Pribis, Peter; Cerami, Jean

    2017-01-01

    Background: Overweight and obese body mass index (BMI) status affects an increasing number of children in the United States. The school setting has been identified as a focus area to implement obesity prevention programs. Methods: A database search of PubMed, Education Search Complete, and Cumulative Index to Nursing and Allied Health Literature…

  4. Impact of nutrition support on clinical outcome and cost-effectiveness analysis in patients at nutritional risk: A prospective cohort study with propensity score matching.

    PubMed

    Zhang, Hui; Wang, Yang; Jiang, Zhu-Ming; Kondrup, Jens; Fang, Hai; Andrews, Martha; Nolan, Marie T; Mu, Shao-Yu; Zhang, Jun; Yu, Kang; Lu, Qian; Kang, Wei-Ming

    2017-05-01

    There is a lack of evidence regarding the economic effects of nutrition support in patients at nutritional risk. The aim of this study was to perform a cost-effectiveness analysis by comparing an adequate nutrition support cohort with a no-support cohort. A prospective observational study was performed in the surgical and medical gastroenterology wards. We identified patients at nutritional risk and the provision of nutrition support by the staff, unaware of the risk status, was recorded. Cost data were obtained from each patient's statement of accounts, and effectiveness was measured by the rate of infectious complication. To control for potential confounding variables, the propensity score method with matching was carried out. The incremental cost-effectiveness ratio was calculated based on the matched population. We screened 3791 patients, and 440 were recruited for the analysis. Patients in the nutrition support cohort had a lower incidence of infectious complications than those in the no-support cohort (9.1 versus 18.1%; P = 0.007). This result was similar in the 149 propensity matched pairs (9.4 versus 24.2%; P < 0.001). The median hospital length of stay was significantly reduced among the matched nutrition support patients (13 versus 15 d; P < 0.001). The total costs were similar among the matched pairs (US $6219 versus $6161). The incremental cost-effectiveness analysis suggested that nutrition support cost US $392 per patient prevented from having infectious complications. Nutrition support was associated with fewer infectious complications and shorter length of stay in patients at nutritional risk. The incremental cost-effectiveness ratio indicated that nutrition support had not increased costs significantly. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Obesity Risk in Urban Adolescent Girls: Nutritional Intentions and Health Behavior Correlates

    PubMed Central

    Groth, Susan W.; Morrison-Beedy, Dianne

    2013-01-01

    Obesity is an expanding epidemic and minority adolescent girls are at high risk. One way to tailor interventions for obesity prevention is to target intention to engage in particular behaviors. Data collected from adolescent girls’ intentions and behaviors regarding nutrition, physical activity, and sleep patterns were used to examine nutritional intentions in relation to healthy behaviors. Adolescent girls reported behaviors that increased their risks for obesity. Nutritional intentions were significantly associated with physical activity and sleep. These results suggest that healthy behaviors tend to occur in clusters, possibly extending the theory of planned behavior beyond individual behaviors to groups of related behaviors. Nurses can intervene with high-risk adolescent girls by promoting healthy diets, recommended levels of physical activity, and adequate sleep. PMID:22187861

  6. Comparison among direct, indirect and index selections on agronomic traits and nutritional quality traits in common bean.

    PubMed

    Jost, Evandro; Ribeiro, Nerinéia Dalfollo; Maziero, Sandra Maria; Possobom, Micheli Thaise Della Flora; Rosa, Daniele Piano; da Silva Domingues, Lucas

    2013-03-30

    Selection indices are linear combinations that allow the selection of several characters simultaneously. The objective of this study was to verify the efficiency of direct selection, indirect selection and selection indices in the identification of higher inbred common bean lines for grain yield, morphological, phenological and nutritional traits. There is genetic variability for grain yield, lodging, general adaptation note, cycle, insertion of the first pod, calcium and iron concentrations in the seeds. Moderate phenotypic correlation coefficients were observed between grain yield and general adaptation note (r = -0.57) and cycle (r = -0.57). When direct selection was performed for grain yield, the insertion of the first pod, calcium and iron concentrations showed negative indirect selection gains. The classic index showed that the distribution of gains has become more balanced: grain yield (39.05%), calcium (8.29%) and iron concentration (1.64%). Direct selection and indirect selection are not efficient in the simultaneous selection of agronomic traits and nutritional quality in common bean. The classical, base and multiplicative indexes provide responses of gain balanced among traits and superior genetic progress in the selection of inbred common bean lines, and have a high coincidence between the lines selected. © 2012 Society of Chemical Industry.

  7. Analysis of risk factors for pharyngocutaneous fistula after total laryngectomy with particular focus on nutritional status.

    PubMed

    Mattioli, F; Bettini, M; Molteni, G; Piccinini, A; Valoriani, F; Gabriele, S; Presutti, L

    2015-10-01

    Pharyngocutaneous fistula (PCF) is the most common complication following total laryngectomy and the most difficult to manage. It often causes increased morbidity, delays starting adjuvant therapy, prolongs hospitalisation, increases treatment costs and reduces the quality of life (QoL). The objective of this study is to analyse the predisposing factors and the most important nutritional parameters related to the development of PCF in patients undergoing total laryngectomy and to suggest medical alternatives that might improve results. We performed a retrospective study of 69 patients who underwent either primary or salvage total laryngectomy in our department between January 2008 and January 2012. Risk factors for fistula formation were analysed including tumour characteristics (histology, grading, AJCC stage), treatment (primary or salvage surgery, extent of resection, flap reconstruction, preoperative radiotherapy), comorbidity and nutritional status (preoperative haemoglobin, albumin and prealbumin levels and their changes during hospitalisation). Twenty-four patients developed a PCF (overall incidence 34.8%). Fistula formation was significantly higher in patients with diabetes, preoperative malnutrition (identified from low preoperative albumin and prealbumin levels). After specific nutritional evaluation and support, no patient developed a PCF. Risk factors for PCF formation are extensively treated in the literature but identification of high-risk patients is still controversial. Our study demonstrates that nutritional status of the patient, assessed by preoperative albumin, is also an important risk factor for PCF formation in addition to classical factors. Maintenance of a normal perioperative nutritional status can be helpful to avoid this complication.

  8. Long-term nutrition education reduces several risk factors for type 2 diabetes mellitus in Brazilians with impaired glucose tolerance.

    PubMed

    Pimentel, Gustavo D; Portero-McLellan, Kátia C; Oliveira, Erick P; Spada, Ana P M; Oshiiwa, Marie; Zemdegs, Juliane C S; Barbalho, Sandra M

    2010-03-01

    The aim of this study was to evaluate the effects of a nutrition education program (NEP) on anthropometric, dietetic, and metabolic parameters in high-risk subjects for type 2 diabetes mellitus. Fifty-one participants, both sexes, were randomly assigned to either the control (58.8%) or the intervention (NEP) group. The intervention group received frequent individual and group nutritional counseling from a team of nutritionists. Participants were assessed at baseline (M0) and after 12 months (M1) for anthropometric, dietetic, and metabolic parameters. The hypothesis was that high-risk subjects for type 2 diabetes mellitus participating in NEP would show an improvement in these parameters. At M1, the intervention group showed a significant decline in body weight (-3.4%), body mass index (-5.7%), cholesterol intake (-49.5%), fasting glycemia (-14.0%), fasting insulin (-9.0%), postprandial glycemia (-21.0%), postprandial insulin (-71.0%), total serum cholesterol (-23.0%), and glycated hemoglobin (-24.0%). A decrease in energy intake (5%, P = .06) and low-density lipoprotein cholesterol (25%, P = .07) was observed in the interventional group, although it did not reach statistical significance. In contrast, the control group presented a significantly higher energy intake (19%, P = .04) and a nonsignificant increase in consumption of all macronutrients. The long-term NEP was found to improve anthropometric, dietary, and metabolic parameters in high-risk subjects for type 2 diabetes mellitus.

  9. Rationale and Development of a Security Assurance Index with Application toward the Development of a World Risk Index

    SciTech Connect

    M. M. Plum; G. A. Beitel, PhD

    2006-06-01

    Assurance categories were previously developed to support the Department of Homeland Security’s efforts in the mitigation of Cyber Control System events. Defined according to the risk of life and economic loss, the minimum range is designated by policy, whereas the maximum limit seems to be constrained only by limits and interdependencies of the event. Use of this life / assets scale has proven to be helpful in managing risk due to the scale's ease of use, communication, and understanding. Suggestions have been made that this scale could be applied to all events of terror, disaster, and calamity of an international scale, with equally good results. This paper presents the history of some existing scales of disaster and assurance, the rationale behind the development of the original Security Assurance Index, and our proposed scale of disaster and calamity as a World Risk Index.

  10. Stability of the Framingham Nutritional Risk Score and its component nutrients over 8 years: The Framingham Nutrition Studies

    PubMed Central

    Kimokoti, Ruth W.; Newby, P.K.; Gona, Philimon; Zhu, Lei; Campbell, Wei R.; D'Agostino, Ralph B.; Millen, Barbara E.

    2011-01-01

    Background / Objectives Diet quality indices are increasingly used in nutrition epidemiology as dietary exposures in relation to health outcomes. However, literature on long-term stability of these indices is limited. We aimed to assess the stability of the validated Framingham Nutritional Risk Score (FNRS) and its component nutrients over 8 years as well as the validity of the follow-up FNRS. Subjects / Methods Framingham Offspring/Spouse Study women and men (n=1 734) aged 22-76 years wwver 8 years. Individuals' nutrient intake and nutritional risk scores were assessed using 3-day dietary records administered at baseline (1984-1988) and at follow-up (1992-1996). Agreement between baseline and follow-up FNRS and nutrient intakes was evaluated using Bland-Altman method; stability was assessed using intra-class correlation (ICC) and weighted Kappa statistics. The effect of diet quality (as assessed by the FNRS) on cardiometabolic risk factors was evaluated using ANCOVA. Results Modest changes from baseline (≤15%) were observed in nutrient intake. Stability coefficients for the FNRS (ICC: women=0.49; men=0.46; P<0.0001) and many nutrients (ICC ≥0.3) were moderate. Over half of women and men (58%) remained in the same or contiguous baseline and follow-up quartile of the FNRS and few (3-4%) shifted >1 quartile. The FNRS was directly associated with BMI in women (P<0.01) and HDL-cholesterol among both women (P<0.001) and men (P<0.01). Conclusion The FNRS and its constituent nutrients remained relatively stable over 8 years of follow-up. The stability of diet quality has implications for prospective epidemiological investigations. PMID:21970940

  11. Heated apple juice supplemented with onion has greatly improved nutritional quality and browning index.

    PubMed

    Lee, Bonggi; Seo, Jeong Dae; Rhee, Jin-Kyu; Kim, Choon Young

    2016-06-15

    Although fruit juices are very popular, enzymatic browning occurs easily. Browning of fruit juice deteriorates nutrition value and product quality due to oxidation of polyphenol compounds. Therefore, development of natural food additives that reduce browning will be beneficial for improving quality of fruit juices. Onion has been reported to be a potent natural anti-browning agent. Here, we compared unheated and heated apple juices pre-supplemented with onion with respect to browning and nutritional quality. The unheated apple juice supplemented with onion showed reduced browning as well as increased total soluble solid, total phenol concentration, radical scavenging activities, and ferric reducing and copper chelating activities without any change in flavonoid concentration. On the other hand, heated juice supplemented with onion not only showed improved values for these parameters but also markedly increased flavonoid concentration. Thus, we conclude that application of heating and onion addition together may greatly improve quality of apple juice.

  12. Weight-for-age as an index of risk of death in children.

    PubMed

    Kielmann, A A; McCord, C

    1978-06-10

    Between April, 1968, and May, 1973, the Department of International Health of Johns Hopkins University studied the effects of the interaction of nutrition and infection in fourteen villages of Punjab, North India. Serial anthropometric measurements (used as index of nutritional status) and vital statistics of almost 3000 children aged 1-36 months showed that, on average, child mortality doubled with each 10% decline below 80% of the Harvard weight median. The relation between season and mortality showed that mortality-rates were highest just before and during the main (wheat) harvest, reflecting the effects of food scarcity, relative child neglect, and climate on child deaths among those already underweight.

  13. Evaluation of a risk index for advanced proximal neoplasia of the colon.

    PubMed

    Ruco, Arlinda; Stock, David; Hilsden, Robert J; McGregor, S Elizabeth; Paszat, Lawrence F; Saskin, Refik; Rabeneck, Linda

    2015-01-01

    A clinical risk index that uses distal colorectal findings at flexible sigmoidoscopy (FS) in conjunction with easily determined risk factors for advanced proximal neoplasia (APN) may be useful for tailoring or prioritizing screening with colonoscopy. To conduct an external evaluation of a previously published risk index in a large, well-characterized cohort. Cross-sectional. Teaching hospital and colorectal cancer screening center. A total of 5139 asymptomatic persons aged 50 to 74 (54.9% women) with a mean age (±SD) of 58.3 (±6.2) years. Between 2003 and 2011, all participants underwent a complete screening colonoscopy and removal of all polyps. Participants were classified as low, intermediate, or high risk for APN, based on their composite risk index scores. The concordance or c-statistic was used to measure discriminating ability of the risk index. A total of 167 persons (3.2%) had APN. The prevalence of those with APN among low-, intermediate-, and high-risk categories was 2.1%, 2.9%, and 6.5%, respectively. High-risk individuals were 3.2 times more likely to have APN compared with those in the low-risk category. The index did not discriminate well between those in the low- and intermediate-risk categories. The c-statistic for the overall index was 0.62 (95% confidence interval, 0.58-0.66). Distal colorectal findings were derived from colonoscopies and not FS itself. The risk index discriminated between those at low risk and those at high risk, but it had limited ability to discriminate between low- and intermediate-risk categories for prevalent APN. Information on other risk factors may be needed to tailor, or prioritize, access to screening colonoscopy. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  14. HIGH BODY MASS INDEX AMONG PATIENTS UNDERGOING HEMATOPOIETIC STEM CELL TRANSPLANTATION: RESULTS OF A CROSS-SECTIONAL EVALUATION OF NUTRITIONAL STATUS IN A PRIVATE HOSPITAL.

    PubMed

    Pereira, Andrea Z; Victor, Elivane S; Vidal Campregher, Paulo; Piovacari, Silvia M F; Bernardo Barban, Juliana S; Pedreira, Wilson L; Hamerschlak, Nelson

    2015-12-01

    nutritional status before hematopoietic stem cell transplantation (HSCT) affects prognosis: better nourished patients have shorter time to engraftment, while malnutrition is associated with increase of mortality rates, complications, medical costs, poor quality of life and hospitalization stay. Furthermore, underweight patients have increased risk of death in the early post- HSCT period, and non-relapse mortality is greater for those who are extremely underweight, overweight and obese. Obesity is associated with treatment-related toxicity, higher incidence of grade II-IV acute graft-versus- host disease (GVHD), infections and mortality. The objective of this study was to investigate the nutritional status of patients undergoing HSCT between 2007-2013 in a private hospital, by calculating the body mass index (BMI), to verify the prevalence of any nutritional imbalances, especially obesity. in this retrospective study, based on medical records, we analyzed data from all patients with malignant and nonmalignant diseases who underwent HSCT from January 2007 to February 2014 in the Hematology- Oncology and Bone Marrow Transplantation Center at a large, tertiary referral center in Brazil. a total of 257 cases were treated in the period and analyzed, of which 79% were aged up to 65 years old. Among these, 56% were overweight or obese. We observed a higher prevalence of obesity in elderly patients (P < 0.001). The mean BMI of the total sample was 26.4 kg/m2. BMI was significantly different between genders, with higher prevalence of overweight among men (P < 0.001). differently from other studies, our investigation has shown low rates of underweight and more overweight and obesity rates in men and elderly patients undergoing HSCT. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  15. Evaluation of Malnutrition Risk after Liver Transplantation Using the Nutritional Screening Tools.

    PubMed

    Lim, Hee-Sook; Kim, Hyung-Chul; Park, Yoon-Hyung; Kim, Soon-Kyung

    2015-10-01

    Malnutrition is a common problem in patients with end-stage liver disease requiring liver transplantation. The aim of this study was to evaluate nutritional status by using nutritional screening tools [Nutritional Risk Screening (NRS) 2002, Malnutrition Universal Screening Tool (MUST) and Subjective Global Assessment (SGA)] in patients before and after liver transplantation. We analyzed medical record, blood test, nutrient intake and malnutrition rate just before transplantation and at discharge, and at 3, 6, 12 months after transplantation respectively. Initially 33 patients enrolled as study subjects and finally 28 patients completed the study. Nutrients intake such as energy, fiber, calcium, potassium, vitamin C, and folate were insufficient at 12 months after transplantation. The rates of malnutrition before transplantation were very high, reported at 81.8% for the NRS 2002, 87.9% for the MUST, and 84.8% for the SGA. By 12 months after operation, malnutrition rates reported at NRS, MUST and SGA had decreased to 6.1%, 10.7%, and 10.7%, respectively. Sensitivity was 87.1% for the NRS 2002, 82.0% for the MUST, and 92.0% for the SGA. Of these screening tools the SGA was the highest sensitive tool that predict the risk of mortality in malnutrition patients who received transplantation. Further studies on nutritional status of patients and proper tools for nutrition intervention are needed to provide adequate nutritional care for patients.

  16. Evaluation of Malnutrition Risk after Liver Transplantation Using the Nutritional Screening Tools

    PubMed Central

    Lim, Hee-Sook; Kim, Hyung-Chul; Park, Yoon-Hyung

    2015-01-01

    Malnutrition is a common problem in patients with end-stage liver disease requiring liver transplantation. The aim of this study was to evaluate nutritional status by using nutritional screening tools [Nutritional Risk Screening (NRS) 2002, Malnutrition Universal Screening Tool (MUST) and Subjective Global Assessment (SGA)] in patients before and after liver transplantation. We analyzed medical record, blood test, nutrient intake and malnutrition rate just before transplantation and at discharge, and at 3, 6, 12 months after transplantation respectively. Initially 33 patients enrolled as study subjects and finally 28 patients completed the study. Nutrients intake such as energy, fiber, calcium, potassium, vitamin C, and folate were insufficient at 12 months after transplantation. The rates of malnutrition before transplantation were very high, reported at 81.8% for the NRS 2002, 87.9% for the MUST, and 84.8% for the SGA. By 12 months after operation, malnutrition rates reported at NRS, MUST and SGA had decreased to 6.1%, 10.7%, and 10.7%, respectively. Sensitivity was 87.1% for the NRS 2002, 82.0% for the MUST, and 92.0% for the SGA. Of these screening tools the SGA was the highest sensitive tool that predict the risk of mortality in malnutrition patients who received transplantation. Further studies on nutritional status of patients and proper tools for nutrition intervention are needed to provide adequate nutritional care for patients. PMID:26566519

  17. Nutritional Alert in hospitalized patients.

    PubMed

    Brieux, Humberto Fernán Mandirola; Kaminker, Diego; Campos, Fernando; Guillen, Sebastian; Alejandris, Javier; Luna, Daniel; Baum, Analia; de Quirós, Fernán Gonzalez Bernaldo

    2014-01-01

    The objective of the study is to assess a nutritional risk alert using an Informatics System in hospitalized patients versus the conventional methodology. We studied 400 medical patients at the Belgrano Hospital Critical Care Unit. We considered two groups of 200 patients. In the first the group (Control Group), nutritional risk was diagnosed in a traditional way. In the second group (Alarm Group), nutritional risk was diagnosed with an alert system. The alert was triggered when a patient showed low levels of, at least, two of the following variables: albumin, cholesterol, triglyceride, lymphocyte or low body mass index (BMI). Nutritional risk was detected in 20.3% of the Control Group patients while, in the Alert Group, nutritional risk was detected in 34.3% of the patients; the difference between the two groups was significant (p<0.001), with a sensitivity rate of 99% and a specificity rate of 98%. Malnutrition is more easily detected when using an alert system.

  18. Body mass index and risk of Parkinson's disease: a prospective cohort study.

    PubMed

    Logroscino, Giancarlo; Sesso, Howard D; Paffenbarger, Ralph S; Lee, I-Min

    2007-11-15

    High body mass index has been associated with increased risk of several chronic diseases, including cardiovascular disease, and, recently, Alzheimer's disease. There are few data on the association of body mass index with Parkinson's disease, and results have been inconsistent. The authors conducted a prospective study among 10,812 men in the Harvard Alumni Health Study, followed from 1988 to 1998 (mean age at baseline: 67.7 years), to test the hypothesis that body mass index is associated with Parkinson's disease risk. Among 106 incident cases of Parkinson's disease, body mass index at baseline was not associated with Parkinson's disease risk (for body mass index <22.5, 22.5-<24.9, and > or =25.0 kg/m2: multivariate relative risks = 1.51 (95% confidence interval: 0.95, 2.40), 1.00 (referent), and 0.86 (95% confidence interval: 0.53, 1.41)). The authors had information on body mass index during late adolescence, when men entered college; this was unrelated to Parkinson's disease risk as well. Subjects who lost at least 0.5 units of body mass index per decade between college entry and 1988 had a significantly increased Parkinson's disease risk, compared with men having stable body mass index (multivariate relative risk = 2.60, 95% confidence interval: 1.10, 6.10). The authors conclude that body mass index is unrelated to Parkinson's disease risk and speculate that the observation of increased risk with body mass index loss since late adolescence may reflect weight loss due to Parkinson's disease that preceded clinical diagnosis.

  19. A Land-Use Perspective for Birdstrike Risk Assessment: The Attraction Risk Index

    PubMed Central

    Coccon, Francesca; Zucchetta, Matteo; Bossi, Giulia; Borrotti, Matteo; Torricelli, Patrizia; Franzoi, Piero

    2015-01-01

    Collisions between aircraft and birds, birdstrikes, pose a serious threat to aviation safety. The occurrence of these events is influenced by land-uses in the surroundings of airports. Airports located in the same region might have different trends for birdstrike risk, due to differences in the surrounding habitats. Here we developed a quantitative tool that assesses the risk of birdstrike based on the habitats within a 13-km buffer from the airport. For this purpose, we developed Generalized Linear Models (GLMs) with binomial distribution to estimate the contribution of habitats to wildlife use of the study area, depending on season. These GLMs predictions were combined to the flight altitude of birds within the 13-km buffer, the airport traffic pattern and the severity indices associated with impacts. Our approach was developed at Venice Marco Polo International airport (VCE), located in northeast Italy and then tested at Treviso Antonio Canova International airport (TSF), which is 20 km inland. Results from the two airports revealed that both the surrounding habitats and the season had a significant influence to the pattern of risk. With regard to VCE, agricultural fields, wetlands and urban areas contributed most to the presence of birds in the study area. Furthermore, the key role of distance of land-uses from the airport on the probability of presence of birds was highlighted. The reliability of developed risk index was demonstrated since at VCE it was significantly correlated with bird strike rate. This study emphasizes the importance of the territory near airports and the wildlife use of its habitats, as factors in need of consideration for birdstrike risk assessment procedures. Information on the contribution of habitats in attracting birds, depending on season, can be used by airport managers and local authorities to plan specific interventions in the study area in order to lower the risk. PMID:26114958

  20. Dietary Inflammatory Index and Cardiometabolic Risk Parameters in Overweight and Sedentary Subjects.

    PubMed

    Camargo-Ramos, Claudia Marcela; Correa-Bautista, Jorge Enrique; Correa-Rodríguez, María; Ramírez-Vélez, Robinson

    2017-10-06

    Nutrition has been established as a relevant factor in the development of cardiovascular disease (CVD). We aimed to investigate the relationship between the dietary inflammatory index (DII) and cardiometabolic risk parameters in a cohort of 90 overweight and sedentary adults from Bogotá, Colombia. A 24-h dietary record was used to calculate the DII. Body composition variables, flow-mediated dilation (FMD), pulse wave velocity (PWV), lipid profile, glucose, glycosylated hemoglobin (Hb1Ac), and blood pressure were measured and a cardiometabolic risk score (MetScore) was calculated. A lower DII score (anti-inflammatory diet) was significantly associated with higher high-density lipoprotein-cholesterol (HDL-C) and FMD, and lower Hb1Ac and MetScore (p < 0.05). A lower DII score was inversely correlated with plasma triglyceride levels (r = -0.354, p < 0.05), glucose (r = -0.422, p < 0.05), MetScore (r = -0.228, p < 0.05), and PWV (r = -0.437, p < 0.05), and positively with FMD (r = 0.261, p < 0.05). In contrast, a higher DII score (pro-inflammatory diet) showed a positive relationship with MetScore (r = 0.410, p < 0.05) and a negative relationship with FMD (r = -0.233, p < 0.05). An increased inflammatory potential of diet was inversely associated with an improved cardiometabolic profile, suggesting the importance of promoting anti-inflammatory diets as an effective strategy for preventing CVD.

  1. High glycemic index diet as a risk factor for depression: analyses from the Women's Health Initiative.

    PubMed

    Gangwisch, James E; Hale, Lauren; Garcia, Lorena; Malaspina, Dolores; Opler, Mark G; Payne, Martha E; Rossom, Rebecca C; Lane, Dorothy

    2015-08-01

    The consumption of sweetened beverages, refined foods, and pastries has been shown to be associated with an increased risk of depression in longitudinal studies. However, any influence that refined carbohydrates has on mood could be commensurate with their proportion in the overall diet; studies are therefore needed that measure overall intakes of carbohydrate and sugar, glycemic index (GI), and glycemic load. We hypothesized that higher dietary GI and glycemic load would be associated with greater odds of the prevalence and incidence of depression. This was a prospective cohort study to investigate the relations between dietary GI, glycemic load, and other carbohydrate measures (added sugars, total sugars, glucose, sucrose, lactose, fructose, starch, carbohydrate) and depression in postmenopausal women who participated in the Women's Health Initiative Observational Study at baseline between 1994 and 1998 (n = 87,618) and at the 3-y follow-up (n = 69,954). We found a progressively higher dietary GI to be associated with increasing odds of incident depression in fully adjusted models (OR for the fifth compared with first quintile: 1.22; 95% CI: 1.09, 1.37), with the trend being statistically significant (P = 0.0032). Progressively higher consumption of dietary added sugars was also associated with increasing odds of incident depression (OR for the fifth compared with first quintile: 1.23; 95% CI: 1.07, 1.41; P-trend = 0.0029). Higher consumption of lactose, fiber, nonjuice fruit, and vegetables was significantly associated with lower odds of incident depression, and nonwhole/refined grain consumption was associated with increased odds of depression. The results from this study suggest that high-GI diets could be a risk factor for depression in postmenopausal women. Randomized trials should be undertaken to examine the question of whether diets rich in low-GI foods could serve as treatments and primary preventive measures for depression in postmenopausal women.

  2. Risk factors of nutritional blindness and determinants of a successful vitamin A prophylaxis programme.

    PubMed

    Gujral, S; Gopaldas, T

    1995-02-01

    Data on 7668 children (0-72 months) and their 4621 mothers and 81 Anganwadi Workers (AWWs) collected for the USAID Assisted ICDS Evaluation Surveys were analysed. The results indicated that the major risk factors of nutritional blindness were lack of nutrition and health knowledge among mothers; presence of iron deficiency anemia in the children; and history of the child having had measles in the past one year. Mother's health and nutrition, knowledge and maternal literacy status were the determinants of the success of a vitamin A prophylaxis programme. Factors that determined AWW's performance in vitamin A supplementation were her nutrition and health knowledge, her literacy status and the amount of supervisory assistance she received from Auxillary Nurse Midwife (ANM).

  3. Idiosyncratic risk in the Dow Jones Eurostoxx50 Index

    NASA Astrophysics Data System (ADS)

    Daly, Kevin; Vo, Vinh

    2008-07-01

    Recent evidence by Campbell et al. [J.Y. Campbell, M. Lettau B.G. Malkiel, Y. Xu, Have individual stocks become more volatile? An empirical exploration of idiosyncratic risk, The Journal of Finance (February) (2001)] shows an increase in firm-level volatility and a decline of the correlation among stock returns in the US. In relation to the Euro-Area stock markets, we find that both aggregate firm-level volatility and average stock market correlation have trended upwards. We estimate a linear model of the market risk-return relationship nested in an EGARCH(1, 1)-M model for conditional second moments. We then show that traditional estimates of the conditional risk-return relationship, that use ex-post excess-returns as the conditioning information set, lead to joint tests of the theoretical model (usually the ICAPM) and of the Efficient Market Hypothesis in its strong form. To overcome this problem we propose alternative measures of expected market risk based on implied volatility extracted from traded option prices and we discuss the conditions under which implied volatility depends solely on expected risk. We then regress market excess-returns on lagged market implied variance computed from implied market volatility to estimate the relationship between expected market excess-returns and expected market risk.We investigate whether, as predicted by the ICAPM, the expected market risk is the main factor in explaining the market risk premium and the latter is independent of aggregate idiosyncratic risk.

  4. Development of a brief parent-report risk index for children following parental divorce.

    PubMed

    Tein, Jenn-Yun; Sandler, Irwin N; Braver, Sanford L; Wolchik, Sharlene A

    2013-12-01

    This article reports on the development of a brief 15-item parent-report risk index (Child Risk Index for Divorced or Separated Families; CRI-DS) to predict problem outcomes of children who have experienced parental divorce. A series of analyses using 3 data sets were conducted that identified and cross-validated a parsimonious set of items representing parent report of child behavior problems and family level risk and protective factors, each of which contributed to the predictive accuracy of the index. The index predicted child behavior outcomes and substance abuse problems up to 6 years later. The index has acceptable levels of sensitivity and specificity as a screening measure to predict problem outcomes up to 1 year later. The use of the index to identify the need for preventive services is discussed, along with limitations of the study.

  5. Wealth index and risk of childhood overweight and obesity: evidence from four prospective cohorts in Peru and Vietnam.

    PubMed

    Carrillo-Larco, Rodrigo M; Miranda, J Jaime; Bernabé-Ortiz, Antonio

    2016-05-01

    To estimate the incidence and risk of childhood overweight and obesity according to socioeconomic status in Peruvian and Vietnamese school-aged children. Longitudinal data from the Young Lives study were analyzed. Exposure was wealth index in tertiles. Outcome was overweight and obesity. Cumulative incidence per 100 children-years, relative risks (RR), and 95 % confidence intervals (95 % CI) were calculated. A hierarchical approach, including child- and family-related variables, was followed to construct multivariable models. The cumulative incidence of overweight and obesity was 4.8 (95 % CI 4.1-5.5) and 1.7 (95 % CI 1.3-2.2) in the younger and older Peruvian cohort, respectively; and in Vietnam 1.5 (95 % CI 1.2-1.8) and 0.3 (95 % CI 0.2-0.5), respectively. The incidence of overweight and obesity was higher at the top wealth index tertile in all samples. In the older cohorts, comparing highest versus bottom wealth index tertile, RR of overweight and obesity was four to nine times higher: 4.25 in Peru (95 % CI 2.21-8.18) and 9.11 in Vietnam (95 % CI 1.07-77.42). The results provide important information for childhood obesity prevention in countries moving ahead with economic, epidemiological and nutritional transitions.

  6. Low Prognostic Nutritional Index Correlates with Worse Survival in Patients with Advanced NSCLC following EGFR-TKIs

    PubMed Central

    Qin, Tao; Hu, Zhi-Huang; Hong, Shao-Dong; Zhou, Ting; Huang, Yan; Zhao, Hong-Yun; Zhang, Li

    2016-01-01

    Objective This study was designed to demonstrate the prognostic value of prognostic nutritional index (PNI), a reflection systemic immunonutritional status, on the long-term survival of patients taking epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs). Methods In this retrospective study, eligible advanced NSCLC patients with sensitive EGFR mutations (exon 19 deletion or L858R in exon 21) were included to investigate the correlation between the PNI and overall survival (OS). The PNI was calculated as 10 x serum albumin value (g/dl) + 0.005 x peripheral lymphocyte count (per mm3). The prognostic significance of PNI and other clinicopathologic factors was identified by univariate and multivariate analysis. Results Finally, 144 patients met the inclusion criteria. The optimal cut-off value of PNI for survival stratification was 48.78. Compared with high PNI group (n = 81), low PNI (n = 63) was significantly associated with elevated C-reactive protein (CRP) level and non-response to TKIs. Overall survival was superior in the high PNI group (HR, 0.44, p = 0.004), especially for patient with L858R (HR, 0.37, p = 0.009) rather than 19 deletion (HR, 0.69, p = 0.401). The independent prognostic value of PNI was validated by multivariate analysis. Conclusion This pilot investigation demonstrated that low prognostic nutritional index correlates with worse survival for patients with advanced NSCLC and taking EGFR-TKIs. The assessment of a convenient index, known as PNI, worth attention in routine clinical practice for patients following EGFR-TKIs treatment. PMID:26784943

  7. Nutrition and risk of dementia: overview and methodological issues

    PubMed Central

    Morris, Martha Clare

    2016-01-01

    After little more than two decades of research on nutrition and dementia, there is strong evidence for preventive effects of vitamin E, B vitamins, and n-3 fatty acids, and deleterious effects of saturated fat, on dementia. Among specific foods with evidence of neuroprotection are green leafy vegetables and other vegetables, berries, and seafood. A number of studies have examined dietary patterns, particularly the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets; neither of these diets is tailored to the specific foods and nutrients that have been identified as neuroprotective. A new diet, called MIND (Mediterranean–DASH Intervention for Neurodegenerative Delay), incorporates many elements of the Mediterranean and DASH diets but with modifications that reflect the best evidence for brain neuroprotection. The evidence in support of the relation of various nutrients and the Mediterranean diet to dementia has been inconsistent. The seeming inconsistencies may be explained by inattention to nutrient/food intake levels in the interpretation of study findings and trial design. This includes a shifting metric among studies for scoring adherence to the Mediterranean diet. Future studies should pay particular attention to levels of intake in the design and analyses of nutritional studies. PMID:27116239

  8. Nutrition and risk of dementia: overview and methodological issues.

    PubMed

    Morris, Martha Clare

    2016-03-01

    After two decades of research on nutrition and dementia there is strong evidence for preventive effects of vitamin E, B vitamins, and n-3 fatty acids and deleterious effects of saturated fat on dementia. Among specific foods with evidence of neuroprotection are green leafy vegetables, other vegetables, berries, and seafood. A number of studies have examined dietary patterns, particularly the Mediterranean diet and DASH (Dietary Approaches to Stop Hypertension), neither of which is tailored to the specific foods and nutrients that have been identified as neuroprotective. A new diet called MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) incorporates many elements of the Mediterranean diet and DASH but with modifications that reflect current evidence for brain neuroprotection. The evidence in support of the relation of various nutrients and the Mediterranean diet to dementia has been inconsistent. The inconsistencies may be explained by inattention to nutrient/food intake levels in the interpretation of study findings and trial design, including a shifting metric among studies for scoring adherence to the Mediterranean diet. Future studies should pay particular attention to levels of intake in the design and analyses of nutritional studies.

  9. Sensitivity analysis of the Ohio phosphorus risk index

    USDA-ARS?s Scientific Manuscript database

    The Phosphorus (P) Index is a widely used tool for assessing the vulnerability of agricultural fields to P loss; yet, few of the P Indices developed in the U.S. have been evaluated for their accuracy. Sensitivity analysis is one approach that can be used prior to calibration and field-scale testing ...

  10. [Association between non-nutritive sweeteners and obesity risk among university students in Latin America].

    PubMed

    Durán Agúero, Samuel; Blanco Batten, Estela; Rodríguez Noel, María del Pilar; Cordón Arrivillaga, Karla; Salazar de Ariza, Julieta; Record Cornwall, Jiniva; Cereceda Bujaico, María Del Pilar; Antezana Almorza, Sonia; Espinoza Bernardo, Sissy; Encina Vega, Claudia

    2015-03-01

    The association between non-nutritive sweeteners and obesity is controversial. To determine whether the consumption of non-nutritive sweeteners is related to higher risk for overweight or obesity among university students in Chile, Panama, Guatemala and Peru. A total of 1,224 (472 from Chile, 300 from Panama, 248 from Guatemala and 204 from Peru) male and female university students aged between 18 and 26 years participated in the study. Each student reported their food intake (frequency of weekly consumption) in a survey that contained photos of foods containing non-nutritive sweeteners adapted for each country. Anthropometry was also measured. More than 80% of students consumed at least one product containing non-nutritive sweeteners. Females who ate acesulfame potassium and sucralose had a lower risk of overweight or obesity with an odds ratio (OR) of 0.5 (confidence intervals (CI) = 0.3-0.9; p = 0.003) and OR = 0.4 (IC = 0.2-0.8; p = 0.01), respectively. In this sample of Latinamerican university students, consumption of non-nutritive sweeteners was associated with lower risk of overweight only in females.

  11. Nutritional status and well being. Is there a relationship between body mass index and the well-being of older people?

    PubMed

    Balcombe, N R; Ferry, P G; Saweirs, W M

    2001-01-01

    Poor nutritional status may impair well being indirectly as a consequence of increased morbidity and decline in functional status. The aim of this study was to examine the independent effect of body mass index on the well being of older people. Thirty one hospital-based patients over 65 years of age were studied. Well being was assessed using the Philadelphia Geriatric Center Morale Scale (PGCMS)--anglicised version. Body mass index and well being were assessed on admission to hospital and at three months. At follow-up, a significant correlation was observed between body mass index and PGCMS values. Further analysis showed that this relationship was linear, with poor nutritional status being associated with low levels of well being and good nutritional status being associated with the highest levels of well being. High or low body mass index was able to predict the PGCMS score with a poor sensitivity of 44% and specificity of 96%. When the contribution of potential confounding variables was analysed, body mass was found to have no significant independent effect on well being. Instead, the presence of depression was the most powerful predictor of levels of well being. In conclusion, this study has demonstrated that nutritional status, as indicated by body mass index, has no detectable independent effect on well being. However, measurement of nutritional status may still have a role in the assessment of well being, in that, while the finding of a low body mass index cannot be taken as indicative of low levels of well being, the finding of a high body mass index is likely to indicate adequate well being. Further studies, however, are required in this area that would involve larger numbers of subjects and alternative measures of nutritional status and well being.

  12. State of the art in benefit-risk analysis: food and nutrition.

    PubMed

    Tijhuis, M J; de Jong, N; Pohjola, M V; Gunnlaugsdóttir, H; Hendriksen, M; Hoekstra, J; Holm, F; Kalogeras, N; Leino, O; van Leeuwen, F X R; Luteijn, J M; Magnússon, S H; Odekerken, G; Rompelberg, C; Tuomisto, J T; Ueland, Ø; White, B C; Verhagen, H

    2012-01-01

    Benefit-risk assessment in food and nutrition is relatively new. It weighs the beneficial and adverse effects that a food (component) may have, in order to facilitate more informed management decisions regarding public health issues. It is rooted in the recognition that good food and nutrition can improve health and that some risk may be acceptable if benefit is expected to outweigh it. This paper presents an overview of current concepts and practices in benefit-risk analysis for food and nutrition. It aims to facilitate scientists and policy makers in performing, interpreting and evaluating benefit-risk assessments. Historically, the assessments of risks and benefits have been separate processes. Risk assessment is mainly addressed by toxicology, as demanded by regulation. It traditionally assumes that a maximum safe dose can be determined from experimental studies (usually in animals) and that applying appropriate uncertainty factors then defines the 'safe' intake for human populations. There is a minor role for other research traditions in risk assessment, such as epidemiology, which quantifies associations between determinants and health effects in humans. These effects can be both adverse and beneficial. Benefit assessment is newly developing in regulatory terms, but has been the subject of research for a long time within nutrition and epidemiology. The exact scope is yet to be defined. Reductions in risk can be termed benefits, but also states rising above 'the average health' are explored as benefits. In nutrition, current interest is in 'optimal' intake; from a population perspective, but also from a more individualised perspective. In current approaches to combine benefit and risk assessment, benefit assessment mirrors the traditional risk assessment paradigm of hazard identification, hazard characterization, exposure assessment and risk characterization. Benefit-risk comparison can be qualitative and quantitative. In a quantitative comparison, benefits

  13. Prospective association between cancer risk and an individual dietary index based on the British Food Standards Agency Nutrient Profiling System.

    PubMed

    Donnenfeld, Mathilde; Julia, Chantal; Kesse-Guyot, Emmanuelle; Méjean, Caroline; Ducrot, Pauline; Péneau, Sandrine; Deschasaux, Mélanie; Latino-Martel, Paule; Fezeu, Léopold; Hercberg, Serge; Touvier, Mathilde

    2015-11-28

    The Food Standards Agency Nutrient Profiling System (FSA-NPS) constitutes the basis for the Five-Colour Nutrition Label suggested in France to be put on the front-of-pack of food products. At the individual level, a dietary index (FSA-NPS DI) has been derived and validated and corresponds to a weighted mean of all FSA-NPS scores of foods usually consumed by the individual, reflecting the nutritional quality of his/her diet. Our aim was to investigate the association between the FSA-NPS DI and cancer risk in a large cohort. This prospective study included 6435 participants to the SUpplémentation en VItamines et Minéraux AntioXydants cohort (1994-2007) who completed at least six 24 h dietary records during the first 2 years of follow-up. FSA-NPS DI was computed for each subject (higher values representing lower nutritional quality of the diet). After a median follow-up of 12·6 years, 453 incident cancers were diagnosed. Associations were characterised by multivariate Cox proportional hazards models. The FSA-NPS DI was directly associated with overall cancer risk (hazard ratio (HR)for a 1-point increment=1·08 (95 % CI 1·01, 1·15), P trend=0·02; HRQ5 v. Q1=1·34 (95 % CI 1·00, 1·81), P trend=0·03). This association tended to be more specifically observed in subjects with moderate energy intake (≤median, HRfor a 1-point increment=1·10 (95 % CI 1·01-1·20), P trend=0·03). No association was observed in subjects with higher energy intake (P trend=0·3). Results were not statistically significant for breast and prostate cancer risks. For the first time, this study investigated the prospective association between the FSA-NPS individual score and cancer risk. The results suggest that unhealthy food choices may be associated with a 34 % increase in overall cancer risk, supporting the public health relevance of developing front-of-pack nutrition labels based on this score.

  14. The correlation between the comprehensive nutrition index and quality of life of patients with nasopharyngeal carcinoma treated by intensity-modulated radiotherapy.

    PubMed

    Ma, Liqin; Wu, Tingting; Pan, Jianji; Kong, Xiangquan; Guo, Qiaojuan; Yang, Ling; Zhang, Yu; Lin, Shaojun; Chen, Chuanben; Huang, Chaobin

    2014-01-01

    The purpose of this study was to compare the changing tendency of nutrition with 54 nasopharyngeal carcinoma patients during intensity-modulated radiation therapy (IMRT), and to investigate the correlation between comprehensive nutritional status and quality of life (QoL), which was assessed by the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire. The nutritional index, including body mass index, ideal body weight percentage, usual body weight percentage, albumin, hemoglobin, and total lymphocyte count (TLC), was evaluated at 2 time points: within 48 h after admission (T1) and at the end of treatment with IMRT (T2). A statistically significant downgrade of every index was observed during IMRT. A comprehensive nutritional model was established by principal components analysis at T2. QoL scores of functional (P = 0.002) and the global QoL scales (P = 0.001) existed a positive correlation with comprehensive nutritional status. QoL scores of symptom scales (P = 0.002) and 6 single items (P = 0.005) had a negative correlation with it. The scores of global QoL scales in comprehensive nutrition of normal (20.4%), moderate (55.6%), and severe malnutrition (24.1%) were 69.70 ± 17.98, 48.33 ± 19.25, and 37.18 ± 24.67, respectively. Patients with different nutritional status had different QoL (B = 10.405, SE = 2.828, t = 3.680, P = 0.001). Multiaspect nutritional supports should be enhanced to improve patients' comprehensive nutritional status during treatment.

  15. Performance assessment of the risk index category for surgical site infection after colorectal surgery.

    PubMed

    Watanabe, Masanori; Suzuki, Hideyuki; Nomura, Satoshi; Hanawa, Hidetsugu; Chihara, Naoto; Mizutani, Satoshi; Yoshino, Masanori; Uchida, Eiji

    2015-02-01

    The traditional National Healthcare Safety Network (previously National Nosocomial Infections Surveillance) risk index is used to predict the risk of surgical site infection across many operative procedures. However, this index may be too simple to predict risk in the various procedures performed in colorectal surgery. The aim of this study was to evaluate the usefulness of the risk index by analyzing the impact of the risk index factors on surgical site infection after abdominal colorectal surgery. Using our surgical site infection surveillance database, we analyzed retrospectively 538 consecutive patients who underwent abdominal colorectal surgery between 2005 and 2010. Correlations between surgical site infection and the following risk index factors were analyzed: length of operation, American Society of Anesthesiologists score, wound classification, and use of laparoscopy. The 75th percentile for length of operation was determined separately for open and laparoscopic surgery in the study model. Univariate analyses showed that surgical site infection was more strongly associated with a >75th percentile length of operation in the study model (odds ratio [OR], 2.07) than in the traditional risk index model (OR, 1.64). Multivariable analysis found that surgical site infection was independently associated with a >75th percentile length of operation in the study model (OR, 2.75; 95% confidence interval [CI], 1.66-4.55), American Society of Anesthesiologists score ≥3 (OR, 2.22; 95% CI, 1.10-4.34), wound classification ≥III (OR, 5.29; 95% CI, 2.62-10.69), and open surgery (OR, 2.21; 95% CI, 1.07-5.17). Performance of the risk index category was improved in the study model compared with the traditional model. The risk index category is sufficiently useful for predicting the risk of surgical site infection after abdominal colorectal surgery. However, the 75th percentile length of operation should be set separately for open and laparoscopic surgery.

  16. A Late Life Risk Index for Severe Cognitive Impairment in Mexico

    PubMed Central

    Downer, Brian; Veeranki, Sreenivas P.; Wong, Rebeca

    2016-01-01

    Background Several dementia risk indices have been developed for older adults in high-income countries. However, no index has been developed for populations in low- or middle-income countries. Objective To create a risk index for predicting severe cognitive impairment among adults aged ≥60 in Mexico and to compare the accuracy of this index to the Dementia Screening Indicator (DSI). Methods This study included 3,002 participants from the Mexican Health and Aging Study (MHAS) interviewed in 2001 and 2012. The MHAS risk index included sociodemographic, health, and functional characteristics collected in 2001. A point value based on the beta coefficients from a multivariable logistic regression model was assigned to each risk factor and the total score was calculated. Results The MHAS risk index (AUC = 0.74 95% CI = 0.70–0.77) and DSI (AUC = 0.72 95% CI = 0.69–0.77) had similar accuracy for discriminating between participants who developed severe cognitive impairment from those who did not. A score of ≥16 on the MHAS risk index had a sensitivity of 0.69 (95% CI = 0.64–0.70) and specificity of 0.67 (95% CI = 0.66–0.69). A score of ≥23 on the DSI had a sensitivity of 0.56 (95% CI = 0.50–0.63) and specificity of 0.78 (95% CI = 0.76–0.79). Discussion The MHAS risk index and DSI have moderate accuracy for predicting severe cognitive impairment among older adults in Mexico. This provides evidence that existing dementia risk indices may be applicable in low- and middle-income countries such as Mexico. Future research should seek to identify additional risk factors that can improve the accuracy of the MHAS risk index. PMID:27060940

  17. Measuring Appetite with the Simplified Nutritional Appetite Questionnaire Identifies Hospitalised Older People at Risk of Worse Health Outcomes

    PubMed Central

    PILGRIM, A.L.; BAYLIS, D.; JAMESON, K.A.; COOPER, C.; SAYER, A.A.; ROBINSON, S.M.; ROBERTS, H.C.

    2016-01-01

    Objectives Poor appetite is commonly reported by older people but is rarely measured. The Simplified Nutritional Appetite Questionnaire (SNAQ) was validated to predict weight loss in community dwelling older adults but has been little used in hospitals. We evaluated it in older women on admission to hospital and examined associations with healthcare outcomes. Design Longitudinal observational with follow-up at six months. Setting Female acute Medicine for Older People wards at a University hospital in England. Participants 179 female inpatients. Measurements Age, weight, Body Mass Index (BMI), grip strength, SNAQ, Barthel Index Score, Mini Mental State Examination (MMSE), Geriatric Depression Scale: Short Form (GDS-SF), Malnutrition Universal Screening Tool (MUST), category of domicile and receipt of care were measured soon after admission and repeated at six month follow-up. The length of hospital stay (LOS), hospital acquired infection, readmissions and deaths by follow-up were recorded. Results 179 female participants mean age 87 (SD 4.7) years were recruited. 42% of participants had a low SNAQ score (<14, indicating poor appetite). A low SNAQ score was associated with an increased risk of hospital acquired infection (OR 3.53; 95% CI: 1.48, 8.41; p=0.004) and with risk of death (HR 2.29; 95% CI: 1.12, 4.68; p = 0.023) by follow-up. Conclusion Poor appetite was common among the older hospitalised women studied, and was associated with higher risk of poor healthcare outcomes. PMID:26728926

  18. Nutritional approaches in the risk reduction and management of Alzheimer's disease.

    PubMed

    Mi, Weiqian; van Wijk, Nick; Cansev, Mehmet; Sijben, John W C; Kamphuis, Patrick J G H

    2013-09-01

    Alzheimer's disease (AD) is a heterogeneous and devastating neurodegenerative disease with increasing socioeconomic burden for society. In the past 30 y, notwithstanding advances in the understanding of the pathogenesis of the disease and consequent development of therapeutic approaches to novel pathogenic targets, no cure has so far emerged. This contribution focuses on recent nutritional approaches in the risk reduction and management of AD with emphasis on factors providing a rationale for nutritional approaches in AD, including compromised nutritional status, altered nutrient uptake and metabolism, and nutrient requirements for synapse formation. Collectively these factors are believed to result in specific nutritional requirement in AD. The chapter also emphasizes investigated nutritional interventions in patients with AD, including studies with single nutrients and with the specific nutrient combination Fortasyn Connect and discusses the current shift of paradigm to intervene in earlier stages of AD, which offers opportunities for investigating nutritional strategies to reduce the risk for disease progression. Fortasyn Connect was designed to enhance synapse formation and function in AD by addressing the putative specific nutritional requirements and contains docosahexaenoic acid, eicosapentaenoic acid, uridine-5'-mono-phosphate, choline, phospholipids, antioxidants, and B vitamins. Two randomized controlled trials (RCTs) with the medical food Souvenaid, containing Fortasyn Connect, showed that this intervention improved memory performance in mild, drug-naïve patients with AD. Electroencephalography outcome in one of these clinical studies suggests that Souvenaid has an effect on brain functional connectivity, which is a derivative of changed synaptic activity. Thus, these studies suggest that nutritional requirements in AD can be successfully addressed and result in improvements in behavioral and neuro-physiological alterations that are characteristic to AD

  19. Bioelectrical impedance vectorial analysis and nutritional status of older women according to body mass index

    USDA-ARS?s Scientific Manuscript database

    Longitudinal studies, both epidemiological and clinical, have shown that elderly with high body mass index (BMI) are able to better face stressing factors, and have better survival rate as consequence. The aim of the present study was to evaluate if higher BMI values were associated with improved nu...

  20. Nutritional status and diarrheal illness as independent risk factors for alveolar pneumonia.

    PubMed

    Coles, Christian L; Fraser, Drora; Givon-Lavi, Noga; Greenberg, David; Gorodischer, Raphael; Bar-Ziv, Jacob; Dagan, Ron

    2005-11-15

    Community-acquired alveolar pneumonia (CAAP) is typically associated with bacterial infections and is especially prevalent in vulnerable populations worldwide. The authors studied nutritional status and diarrheal history as risk factors for CAAP in Bedouin children <5 years of age living in Israel. In this prospective case-control study (2001-2002), 334 children with radiographically confirmed CAAP were compared with 529 controls without pneumonia with regard to nutritional status and diarrhea history. Controls were frequency matched to cases on age and enrollment month. Logistic regression models were used to evaluate associations of CAAP with nutritional status and recent diarrhea experience. Anemia (adjusted odds ratio (AOR) = 3.32, 95% confidence interval (CI): 2.24, 4.94; p < 0.001), low birth weight (AOR = 2.16, 95% CI: 1.32, 3.54; p = 0.002), stunting (AOR = 2.22, 95% CI: 1.31, 3.78; p = 0.004), serum retinol concentration (AOR = 1.03 per microg/dl, 95% CI: 1.02, 1.05; p < 0.001), and having > or =1 diarrhea episodes within 31 days prior to enrollment (AOR = 2.30, 95% CI: 1.26, 4.19; p = 0.007) were identified as risk factors for CAAP. Results suggest that improving antenatal care and the nutritional status of infants may reduce the risk of CAAP in Bedouin children. Furthermore, they suggest that vaccines developed to prevent diarrhea may also lower the risk of CAAP.

  1. Nutritional Status and Risk Factors for Chronic Disease in Urban-Dwelling Adults with Down Syndrome

    ERIC Educational Resources Information Center

    Braunschweig, Carol L.; Gomez, Sandra; Sheean, Patricia; Tomey, Kristin M.; Rimmer, James; Heller, Tamar

    2004-01-01

    Nutritional status and biochemical risk factors for chronic disease were assessed in 48 community-dwelling adults with Down syndrome in the Chicago area. Dietary intake was measured using a food frequency questionnaire completed by the participant's primary caregiver; anthropometric measures included height and weight and waist circumference.…

  2. Nutritional Status and Risk Factors for Chronic Disease in Urban-Dwelling Adults with Down Syndrome

    ERIC Educational Resources Information Center

    Braunschweig, Carol L.; Gomez, Sandra; Sheean, Patricia; Tomey, Kristin M.; Rimmer, James; Heller, Tamar

    2004-01-01

    Nutritional status and biochemical risk factors for chronic disease were assessed in 48 community-dwelling adults with Down syndrome in the Chicago area. Dietary intake was measured using a food frequency questionnaire completed by the participant's primary caregiver; anthropometric measures included height and weight and waist circumference.…

  3. Relationship Between the Comprehensive Nutritional Index and the EORTC QLQ-H&N35 in Nasopharyngeal Carcinoma Patients Treated with Intensity-Modulated Radiation Therapy.

    PubMed

    He, Yan; Chen, Liping; Chen, Linmin; Hu, Wen; Wang, Cong; Tang, Linquan; Mai, Haiqiang; Li, Jianmei; Wu, Liping; Fan, Yuying

    2017-04-01

    This study aimed to explore the relationship between the comprehensive nutritional index (CNI) and quality of life in nasopharyngeal carcinoma (NPC) patients receiving intensity-modulated radiation therapy (IMRT). The nutritional index, which includes total lymphocyte count, hemoglobin and albumin levels, body mass index, and usual body weight percentage, was evaluated pre-treatment and post-treatment in patients who underwent IMRT. The quality of life of NPC patients was measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Cancer Module (EORTC QLQ-H&N35) at four time points: pre-treatment, post-treatment, and 3 and 6 mo after IMRT. A comprehensive nutritional model was used to assess the correlation with QLQ-H&N35. The nutritional index decreased significantly post-treatment. The CNI was associated with immunotherapy; the International Union Against Cancer (UICC) stage; concurrent chemotherapy; speech problems, trouble with social contact, feeling ill and having dental problems at pre-treatment; sexuality at 3 mos post-treatment; and sensory problems and xerostomia at 6 mo post-treatment (P < 0.05). The nutritional status and QLQ-H&N35 scores in NPC patients decreased during IMRT. Our study provides an alternative measure of the CNI to improve the QLQ-H&N35 evaluation system for patients with NPC.

  4. Relationship between body mass index, nutrition, strength, and function in elderly individuals with chronic obstructive pulmonary disease.

    PubMed

    Benton, Melissa J; Wagner, Carolyn L; Alexander, Jeffrey L

    2010-01-01

    Individuals with severe chronic obstructive pulmonary disease are frequently characterized as cachectic and suffering from generalized weight loss and muscle wasting. Loss of body mass is associated with disability and premature mortality, and body mass index (BMI) has been used as a marker for nutritional status and to predict survival. This cross-sectional study evaluated the association between BMI (kg/m(2)), nutritional intake, strength, and function in 19 elderly (70 +/- 1 years) men and women (BMI = 27.8 +/- 1.1 kg/m(2)) enrolled in a pulmonary rehabilitation program. Three-day prospective diet records were collected and analyzed using Food Processor software. Upper and lower body strength was measured using 1 repetition maximum testing for chest and leg press. Function (endurance, strength, and power) was assessed using the Senior Fitness Test battery (6-minute walk, up-and-go, chair stand, arm curl). BMI was positively associated with upper (P < .05) and lower (P < .01) body strength but was not related to nutrition or function. Total daily caloric (kcal/d), protein (g/d), and carbohydrate (g/d) intakes were positively related to upper body strength (P < .01, P < .01, and P < .05, respectively) and lower body strength (P < .05, P < .05, and P < .05, respectively) and 6-minute walk (P < .05). Fat intake (g/d) was positively related to upper body strength (P < 0.05) alone. Despite health concerns regarding obesity and overweight, clinicians should consider the impact of BMI and dietary intake before initiating weight loss interventions in patients with chronic obstructive pulmonary disease.

  5. Let Food Be Thy Medicine: Diet, Nutrition, and Biomarkers' Risk of Alzheimer's Disease.

    PubMed

    Mosconi, Lisa; McHugh, Pauline F

    2015-06-01

    Epidemiological evidence linking diet-one of the most important modifiable lifestyle factors-and risk of Alzheimer's disease (AD)-the most common cause of dementia-is rapidly increasing. However, the biological mechanisms underlying the relationship between dietary nutrients, brain aging, and risk of AD are largely unexplored. Recent studies using brain imaging and biological markers of AD have begun to clarify how diet and nutrition modulate risk of AD in cognitively normal individuals, especially those at increased genetic risk. Such knowledge is critical prior to implementing dietary recommendations for prevention and treatment of disease.

  6. Let Food Be Thy Medicine: Diet, Nutrition, and Biomarkers’ Risk of Alzheimer’s Disease

    PubMed Central

    Mosconi, Lisa; McHugh, Pauline F.

    2015-01-01

    Epidemiological evidence linking diet—one of the most important modifiable lifestyle factors—and risk of Alzheimer’s disease (AD)—the most common cause of dementia—is rapidly increasing. However, the biological mechanisms underlying the relationship between dietary nutrients, brain aging, and risk of AD are largely unexplored. Recent studies using brain imaging and biological markers of AD have begun to clarify how diet and nutrition modulate risk of AD in cognitively normal individuals, especially those at increased genetic risk. Such knowledge is critical prior to implementing dietary recommendations for prevention and treatment of disease. PMID:26167396

  7. Nutrition intervention for high-risk auto workers: results of the Next Step Trial.

    PubMed

    Tilley, B C; Glanz, K; Kristal, A R; Hirst, K; Li, S; Vernon, S W; Myers, R

    1999-03-01

    The Next Step Trial tested interventions encouraging prevention and early detection practices in automotive-industry employees at increased colorectal cancer risk. This article describes results of the nutrition intervention promoting low-fat, high-fiber eating patterns. Twenty-eight worksites (5,042 employees at baseline) were randomized to a 2-year nutrition intervention including classes, mailed self-help materials, and personalized dietary feedback. Control worksites received no intervention. Nutrition outcomes were assessed by mailed food frequency questionnaires (FFQs) Primary nutrition outcomes included percentage energy from fat and fiber density (g/1,000 kcal) at 1 year postrandomization. Secondary outcomes included servings of fruits/vegetables and dietary measures at 2 years postrandomization. Analyses were adjusted for within worksite correlations and baseline covariates. Fifty-eight percent of employees returned FFQs. At 1 year, there were modest but statistically significant intervention effects for fat (-0.9 %en), fiber (+0.5 g/1,000 kcal), and fruits/vegetables (+0.2 servings/day) (all P < 0.007). At 2 years, due to significant positive changes in control worksites, intervention effects were smaller, significant for fiber only. Intervention effects were larger in younger (<50 years), active employees and class attendees. The nutrition intervention produced significant but modest effects on dietary fat and fiber and fruits/vegetables in these high-risk employees. Age and dose effects suggest younger employees may be more responsive to this intervention. Copyright 1999 American Health Foundation and Academic Press.

  8. Nutrition and Other Protective Behaviors Motivated by Environmental Health Risk Awareness.

    PubMed

    Jones, Elizabeth W; Feng, Limin; Dixon, Jane K; Dixon, John P; Hofe, Carolyn R; Gaetke, Lisa M

    2016-01-01

    Research findings have suggested that exposure to environmental pollutants contributes to increased health risks, which may be modulated by certain nutrition and other protective health behaviors. Nutrition professionals play an important role in effectively disseminating this information and in devising specific community-based nutrition education programs for audiences located in areas with environmental health issues. To assess awareness of environmental health problems and motivation to adopt protective health behaviors for use in planning nutrition education programs for communities exposed to environmental pollutants. Data were collected from a modified, validated Environmental Health Engagement Profile (EHEP) survey instrument administered to adults (n=774) participating in community events in Kentucky based on location relative to hazardous waste sites. The modified EHEP survey instrument showed good internal consistency reliability, and demographic characteristics were evaluated. Correlation analyses revealed significant positive correlations in all groups, separately and combined, between awareness of environmental pollution in an individual's surroundings and the extent of concern that pollutants cause adverse health effects (P < 0.01) and between concern that pollutants cause adverse health effects and taking personal actions to protect against such environmental insults (P < 0.01). The groups having the highest level of awareness posed by pollution are those residing near federally designated hazardous waste sites. These results suggest that determining and expanding an audience's knowledge and perceptions of environmental health risks will enhance effective nutrition education program planning.

  9. Nutrition and Other Protective Behaviors Motivated by Environmental Health Risk Awareness

    PubMed Central

    Jones, Elizabeth W.; Feng, Limin; Dixon, Jane K.; Dixon, John P.; Hofe, Carolyn R.; Gaetke, Lisa M.

    2016-01-01

    Background Research findings have suggested that exposure to environmental pollutants contributes to increased health risks, which may be modulated by certain nutrition and other protective health behaviors. Nutrition professionals play an important role in effectively disseminating this information and in devising specific community-based nutrition education programs for audiences located in areas with environmental health issues. Objective To assess awareness of environmental health problems and motivation to adopt protective health behaviors for use in planning nutrition education programs for communities exposed to environmental pollutants. Method Data were collected from a modified, validated Environmental Health Engagement Profile (EHEP) survey instrument administered to adults (n=774) participating in community events in Kentucky based on location relative to hazardous waste sites. Results The modified EHEP survey instrument showed good internal consistency reliability, and demographic characteristics were evaluated. Correlation analyses revealed significant positive correlations in all groups, separately and combined, between awareness of environmental pollution in an individual’s surroundings and the extent of concern that pollutants cause adverse health effects (P < 0.01) and between concern that pollutants cause adverse health effects and taking personal actions to protect against such environmental insults (P < 0.01). The groups having the highest level of awareness posed by pollution are those residing near federally designated hazardous waste sites. Conclusion These results suggest that determining and expanding an audience’s knowledge and perceptions of environmental health risks will enhance effective nutrition education program planning. PMID:28090221

  10. Preoperative Nutritional Therapy Reduces the Risk of Anastomotic Leakage in Patients with Crohn's Disease Requiring Resections

    PubMed Central

    Guo, Zhen; Guo, Dong; Gong, Jianfeng; Zhu, Weiming; Zuo, Lugen; Sun, Jing; Li, Ning; Li, Jieshou

    2016-01-01

    Background. The rate of anastomotic leakage is high in surgeries for Crohn's disease, and therefore a temporary diverting stoma is often needed. We conducted this study to investigate whether preoperative nutritional therapy could reduce the risk of anastomotic leakage while decreasing the frequency of temporary stoma formation. Methods. This was a retrospective study. Patients requiring bowel resections due to Crohn's disease were reviewed. The rate of anastomotic leakage and temporary diverting stoma was compared between patients who received preoperative nutritional therapy and those on a normal diet before surgery. Possible predictive factors for anastomotic leakage were also analyzed. Results. One hundred and fourteen patients undergoing 123 surgeries were included. Patients in nutritional therapy (NT) group had a significantly lower level of C-reactive protein on the day before surgery. Patients in NT group suffered less anastomotic leakage (2.3% versus 17.9%, P = 0.023) and less temporary diverting stoma (22.8% versus 40.9%, P = 0.036). Serum albumin of the day before surgery ≤35 g/L and preoperative nutritional therapy were identified as factors which independently affected the rate of anastomotic leakage. Conclusion. Preoperative nutritional therapy reduced the risk of anastomotic leakage and the frequency of temporary diverting stoma formation in patients with Crohn's disease requiring resections. PMID:26858749

  11. Are copper, zinc and selenium in erythrocytes valuable biological indexes of nutrition and pathology?

    PubMed

    Vitoux, D; Arnaud, J; Chappuis, P

    1999-11-01

    The real significance of the level of trace elements copper, zinc and selenium in erythrocytes is still a matter of debate. This review is an evaluation of the potential value of copper, zinc and selenium in red blood cells in physiology, nutrition and pathology, taking into account the other commonly used indices and the analytical difficulty encountered for erythrocyte determinations. The main analytical methods and reference values in erythrocytes are also presented. The literature of the last 3 decades was analyzed. On the basis of these papers, the role of erythrocyte copper in various pathologies should be re-investigated, especially when they include inflammatory processes or hormonal changes. The main interest of zinc determination in red blood cells concerns thyroid pathology. In general, the value of selenium in erythrocytes agrees with selenium in serum and its determination is often unnecessary.

  12. Oral contraceptives, reproductive history and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition

    PubMed Central

    Tsilidis, K K; Allen, N E; Key, T J; Bakken, K; Lund, E; Berrino, F; Fournier, A; Olsen, A; Tjønneland, A; Overvad, K; Boutron-Ruault, M-C; Clavel-Chapelon, F; Byrnes, G; Chajes, V; Rinaldi, S; Chang-Claude, J; Kaaks, R; Bergmann, M; Boeing, H; Koumantaki, Y; Stasinopoulou, G; Trichopoulou, A; Palli, D; Tagliabue, G; Panico, S; Tumino, R; Vineis, P; Bueno-de-Mesquita, H B; van Duijnhoven, F J B; van Gils, C H; Peeters, P H M; Rodríguez, L; González, C A; Sánchez, M-J; Chirlaque, M-D; Barricarte, A; Dorronsoro, M; Borgquist, S; Manjer, J; van Guelpen, B; Hallmans, G; Rodwell, S A; Khaw, K-T; Norat, T; Romaguera, D; Riboli, E

    2010-01-01

    Background: Oral contraceptive use and reproductive factors may initiate long-term changes to the hormonal milieu and thereby, possibly influence colorectal cancer risk. Methods: We examined the association of hormonal and reproductive factors with risk of colorectal cancer among 337 802 women in the European Prospective Investigation into Cancer and Nutrition, of whom 1878 developed colorectal cancer. Results: After stratification for center and age, and adjustment for body mass index, smoking, diabetes mellitus, physical activity and alcohol consumption, ever use of oral contraceptives was marginally inversely associated with colorectal cancer risk (hazard ratio (HR), 0.92; 95% confidence interval (CI), 0.83–1.02), although this association was stronger among post-menopausal women (HR, 0.84; 95% CI: 0.74–0.95). Duration of oral contraceptive use and reproductive factors, including age at menarche, age at menopause, type of menopause, ever having an abortion, parity, age at first full-term pregnancy and breastfeeding, were not associated with colorectal cancer risk. Conclusion: Our findings provide limited support for a potential inverse association between oral contraceptives and colorectal cancer risk. PMID:21045829

  13. Evaluation of dysphagia risk, nutritional status and caloric intake in elderly patients with Alzheimer's

    PubMed Central

    Goes, Vanessa Fernanda; Mello-Carpes, Pâmela Billig; de Oliveira, Lilian Oliveira; Hack, Jaqueline; Magro, Marcela; Bonini, Juliana Sartori

    2014-01-01

    Objective to evaluate the risk of dysphagia and its relationship with the stage of Alzheimer's Disease, as well as the relationship between the risk of dysphagia and nutritional status and caloric intake in elderly people with Alzheimer's disease. Methods the sample consisted of 30 subjects of both genders with probable Alzheimer's disease. The stage of the disease, nutritional status, energy intake, and risk of dysphagia were assessed. Results it was found that increased risk of dysphagia is associated with the advance in the stages of Alzheimer's disease and that even patients in the early stages of disease have a slight risk of developing dysphagia. No association was found between nutritional status and the risk of dysphagia. High levels of inadequate intake of micronutrients were also verified in the patients. Conclusion an association between dysphagia and the development of Alzheimer's disease was found. The results indicate the need to monitor the presence of dysphagia and the micronutrient intake in patients with Alzheimer's disease. PMID:26107841

  14. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    MedlinePlus

    Understanding Task Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults The U.S. Preventive Services Task Force (Task Force) has issued a ...

  15. Potential Risk Estimation Drowning Index for Children (PREDIC): a pilot study from Matlab, Bangladesh.

    PubMed

    Borse, N N; Hyder, A A; Bishai, D; Baker, T; Arifeen, S E

    2011-11-01

    Childhood drowning is a major public health problem that has been neglected in many low- and middle-income countries. In Matlab, rural Bangladesh, more than 40% of child deaths aged 1-4 years are due to drowning. The main objective of this paper was to develop and evaluate a childhood drowning risk prediction index. A literature review was carried out to document risk factors identified for childhood drowning in Bangladesh. The Newacheck model for special health care needs for children was adapted and applied to construct a childhood drowning risk index called "Potential Risk Estimation Drowning Index for Children" (PREDIC). Finally, the proposed PREDIC Index was applied to childhood drowning deaths and compared with the comparison group from children living in Matlab, Bangladesh. This pilot study used t-tests and Receiver Operating Characteristic (ROC) curve to analyze the results. The PREDIC index was applied to 302 drowning deaths and 624 children 0-4 years old living in Matlab. The results of t-test indicate that the drowned children had a statistically (t=-8.58, p=0.0001) significant higher mean PREDIC score (6.01) than those in comparison group (5.26). Drowning cases had a PREDIC score of 6 or more for 68% of the children however, the comparison group had 43% of the children with score of 6 or more which was statistically significant (t=-7.36, p<0.001). The area under the curve for the Receiver Operating Characteristic curve was 0.662. Index score construction was scientifically plausible; and the index is relatively complete, fairly accurate, and practical. The risk index can help identify and target high risk children with drowning prevention programs. PREDIC index needs to be further tested for its accuracy, feasibility and effectiveness in drowning risk reduction in Bangladesh and other countries. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Body size and risk of renal cell carcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC).

    PubMed

    Pischon, Tobias; Lahmann, Petra H; Boeing, Heiner; Tjønneland, Anne; Halkjaer, Jytte; Overvad, Kim; Klipstein-Grobusch, Kerstin; Linseisen, Jakob; Becker, Nikolaus; Trichopoulou, Antonia; Benetou, Vassiliki; Trichopoulos, Dimitrios; Sieri, Sabina; Palli, Domenico; Tumino, Rosario; Vineis, Paolo; Panico, Salvatore; Monninkhof, Evelyn; Peeters, Petra H M; Bueno-de-Mesquita, H Bas; Büchner, Frederike L; Ljungberg, Börje; Hallmans, Göran; Berglund, Göran; Gonzalez, Carlos Alberto; Dorronsoro, Miren; Gurrea, Aurelio Barricarte; Navarro, Carmen; Martinez, Carmen; Quirós, J Ramón; Roddam, Andrew; Allen, Naomi; Bingham, Sheila; Khaw, Kay-Tee; Kaaks, Rudolf; Norat, Teresa; Slimani, Nadia; Riboli, Elio

    2006-02-01

    Previous studies suggest that obesity is related to increased risk of renal cell carcinoma (RCC); however, only a few studies report on measures of central vs. peripheral adiposity. We examined the association between anthropometric measures, including waist and hip circumference and RCC risk among 348,550 men and women free of cancer at baseline from 8 countries of the European Prospective Investigation into Cancer and Nutrition (EPIC). During 6.0 years of follow-up we identified 287 incident cases of RCC. Relative risks were calculated using Cox regression, stratified by age and study center and adjusted for smoking status, education, alcohol consumption, physical activity, menopausal status, and hormone replacement therapy use. Among women, an increased risk of RCC was conferred by body weight (relative risk [RR] in highest vs. lowest quintile = 2.13; 95% confidence interval [CI] = 1.16-3.90; p-trend = 0.003), body mass index (BMI) (RR = 2.25; 95% CI = 1.14-4.44; p-trend = 0.009), and waist (RR = 1.67; 95% CI = 0.94-2.98; p-trend = 0.003) and hip circumference (RR = 2.30; 95% CI = 1.22-4.34; p-trend = 0.01); however, waist and hip circumference were no longer significant after controlling for body weight. Among men, hip circumference (RR = 0.44; 95% CI = 0.20-0.98; p-trend = 0.03) was related significantly to decreased RCC risk only after accounting for body weight. Height was not related significantly to RCC risk. Our findings suggest that obesity is related to increased risk of RCC irrespective of fat distribution among women, whereas low hip circumference is related to increased RCC risk among men. Our data give further credence to public health efforts aiming to reduce the prevalence of obesity to prevent RCC, in addition to other chronic diseases. Copyright 2005 Wiley-Liss, Inc.

  17. Oral contraceptive use and reproductive factors and risk of ovarian cancer in the European Prospective Investigation into Cancer and Nutrition

    PubMed Central

    Tsilidis, K K; Allen, N E; Key, T J; Dossus, L; Lukanova, A; Bakken, K; Lund, E; Fournier, A; Overvad, K; Hansen, L; Tjønneland, A; Fedirko, V; Rinaldi, S; Romieu, I; Clavel-Chapelon, F; Engel, P; Kaaks, R; Schütze, M; Steffen, A; Bamia, C; Trichopoulou, A; Zylis, D; Masala, G; Pala, V; Galasso, R; Tumino, R; Sacerdote, C; Bueno-de-Mesquita, H B; van Duijnhoven, F J B; Braem, M G M; Onland-Moret, N C; Gram, I T; Rodríguez, L; Travier, N; Sánchez, M-J; Huerta, J M; Ardanaz, E; Larrañaga, N; Jirström, K; Manjer, J; Idahl, A; Ohlson, N; Khaw, K-T; Wareham, N; Mouw, T; Norat, T; Riboli, E

    2011-01-01

    Background: It is well established that parity and use of oral contraceptives reduce the risk of ovarian cancer, but the associations with other reproductive variables are less clear. Methods: We examined the associations of oral contraceptive use and reproductive factors with ovarian cancer risk in the European Prospective Investigation into Cancer and Nutrition. Among 327 396 eligible women, 878 developed ovarian cancer over an average of 9 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models stratified by centre and age, and adjusted for smoking status, body mass index, unilateral ovariectomy, simple hysterectomy, menopausal hormone therapy, and mutually adjusted for age at menarche, age at menopause, number of full-term pregnancies and duration of oral contraceptive use. Results: Women who used oral contraceptives for 10 or more years had a significant 45% (HR, 0.55; 95% CI, 0.41–0.75) lower risk compared with users of 1 year or less (P-trend, <0.01). Compared with nulliparous women, parous women had a 29% (HR, 0.71; 95% CI, 0.59–0.87) lower risk, with an 8% reduction in risk for each additional pregnancy. A high age at menopause was associated with a higher risk of ovarian cancer (>52 vs ⩽45 years: HR, 1.46; 95% CI, 1.06–1.99; P-trend, 0.02). Age at menarche, age at first full-term pregnancy, incomplete pregnancies and breastfeeding were not associated with risk. Conclusion: This study shows a strong protective association of oral contraceptives and parity with ovarian cancer risk, a higher risk with a late age at menopause, and no association with other reproductive factors. PMID:21915124

  18. Association between nutritional risk and routine clinical laboratory measurements and adverse outcomes: a prospective study in hospitalized patients of wuhan tongji hospital

    PubMed Central

    Chen, Z Y; Gao, C; Ye, T; Zuo, X Z; Wang, G H; Xu, X S; Yao, Y

    2015-01-01

    Background/Objectives: Nutritional risk screening (NRS-2002) and routine clinical laboratory measurements (RCLMs) had been shown to have a predictive value in adverse outcomes in some studies, respectively. This study analyzed the association between NRS-2002 and RCLMs and estimated their prospective value in predicting adverse outcomes. Subjects/Methods: A total of 916 hospitalized patients were screened on admission with NRS-2002 and Subjective Global Assessment; RCLMs, which include blood test, kidney and liver function and electrolytes, were recorded. Diagnosis, nutritional support, surgery, radiotherapy, chemotherapy, complications, mortality and hospital stay during hospitalization were collected. The X2-test, odds ratios with 95% confidence intervals, kappa (k) statistic and regression analyses were conducted. Results: An overall 48.1% of the 916 patients were at nutritional risk on admission. Comparing ‘at risk' with ‘no risk', a significantly higher incidence of abnormality was found not only in nutritional markers but also in other parameters of RCLMs (OR ranged from 1.5 to 3.5). Regression analyses showed that ‘at risk' determined at admission was not a significant predictor of adverse outcomes after adjusting for other confounding factors, although it was a strong predictor in univariate analysis, whereas hypoalbuminemia, low total lymphocyte count, abnormality of hepatic and renal function were predictors after adjusting for confounders. Conclusions: The findings suggest that NRS-2002 might be a global index of ‘sickness' rather than be only a nutritional screening tool. It being rated once at admission is insufficient and should be repeated for using it as a predictor, whereas RCLMs routinely measured at admission may be able to be used to predict adverse outcomes. PMID:25369828

  19. Leptin as a marker of nutrition and cardiovascular risk in peritoneal dialysis patients.

    PubMed

    Aguilera, Abelardo; Bajo, M Auxiliadora; Rebollo, Francisco; Díez, Juan J; Díaz, Candido; Paiva, Ana; Codoceo, Rosa; Selgas, Rafael

    2002-01-01

    Anorexia and protein malnutrition, occasionally associated with obesity, are frequently observed in peritoneal dialysis (PD) patients. Both are recognized risk factors for cardiovascular (CV) morbidity and mortality. Leptin is produced by adipocytes and regulates body-fat mass through a satiety central effect. Leptin accumulates in the uremic state. We analyzed the relationship between plasma leptin levels, nutritional status, obesity, CV risk factors, and atherosclerosis in PD patients. Leptin was determined using a polyclonal antibody [radioimmunoassay: Linco Research, St. Louis, MO, U.S.A.]. The normal range was 1-7.8 ng/mL. We studied 38 PD patients. Mean leptin levels were 59.1 +/- 57.5 ng/mL (elevated in 32 patients). Women (n = 21) showed higher leptin levels than did men (80.4 +/- 60 ng/mL vs. 32.3 +/- 43.3 ng/mL, p < 0.01), in spite of both groups having a similar body mass index (BMI). A statistically significant direct correlation was found between leptin and BMI (r = 0.7, p < 0.01) and triceps skin-fold measurement (r = 0.77, p < 0.01). Leptin levels and renal creatinine clearance (CCr) showed no significant correlation. Independent of BMI, higher leptin levels were associated with parameters considered to be CV risk factors (Framingham study), such as serum triglycerides < 150 mg/dL (n = 29) as compared with > 150 mg/dL (44.2 +/- 53.2 ng/mL vs. 80 +/- 58.4 ng/mL, p < 0.05), cholesterol < 250 mg/dL (n = 28) as compared with > 250 mg/dL, (50 +/- 55.6 mg/dL vs. 84.7 +/- 57.7 mg/dL, p < 0.05), uric acid < 7 mg/dL (n = 28) as compared with > 7 mg/dL (47 +/- 53.7 mg/dL vs. 93.1 +/- 56.6 mg/dL, p < 0.05), and the presence or lack of presence of left ventricular hypertrophy [68.8 +/- 60 (n = 30) vs. 29.5 +/- 23.7 (n = 5), p < 0.05]. The patients were classified into two groups according to a clinical atherosclerosis score (CAS). Nineteen patients had low CAS scores, and they showed higher plasma leptin values than did the other patients (82.4 +/- 65.7 ng/mL vs

  20. Gallbladder cancer and nutritional risk factors in Chile

    PubMed

    Navarro Rosenblatt, Deborah; Durán Agüero, Samuel

    2016-02-16

    Gallbladder cancer is the most malign neoplasm of the biliary tract. Chile presents the third highest prevalence of gallbladder cancer in the Americas, being Chilean women from the city of Valdivia the ones with the highest prevalence. The main risk factors associated with gallbladder cancer are: sex, cholelithiasis, obesity, ethnicity, chronic inflammation, history of infection diseases such as Helicobacter pyloriand Salmonellaand family history of gallbladder cancer. In Chile gallbladder cancer mortality is close to prevalence level. This is related to the silent symptomatology of this cancer, as well as the lack of specific symptoms. The high prevalence of obesity and infectious diseases present in Chile are two of the main risk factors of gallbladder cancer and Chile has prevalence of obesity close to 30%. The aim of this literary review is to inform and summarize the main risk factors of gallbladder cancer that are prevalent in Chile, in order to be able to focus preventive and management interventions of this risk factor for the reduction in prevalence and mortality of gallbladder cancer in Chile.

  1. Low skeletal muscle mass index is associated with function and nutritional status in residents in a Turkish nursing home.

    PubMed

    Tufan, Asli; Bahat, Gulistan; Ozkaya, Hilal; Taşcıoğlu, Didem; Tufan, Fatih; Saka, Bülent; Akin, Sibel; Karan, Mehmet Akif

    2016-09-01

    To determine the prevalence of low muscle mass (LMM) and the relationship between LMM with functional and nutritional status as defined using the LMM evaluation method of European Working Group on Sarcopenia in Older People (EWGSOP) criteria among male residents in a nursing home. Male residents aged >60 years of a nursing home located in Turkey were included in our study. Their body mass index (BMI) kg/m(2), skeletal muscle mass (SMM-kg) and skeletal muscle mass index (SMMI-kg/m(2)) were calculated. The participants were regarded as having low SMMI if they had SMMI <9.2 kg/m(2) according to our population specific cut-off point. Functional status was evaluated with Katz activities of daily living (ADL) and Lawton Instrumental Activities of Daily Living (IADL). Nutritional assessment was performed using the Mini Nutritional Assessment (MNA). The number of drugs taken and chronic diseases were recorded. One hundred fifty-seven male residents were enrolled into the study. Their mean age was 73.1 ± 6.7 years with mean ADL score of 8.9 ± 2.0 and IADL score of 8.7 ± 4.6. One hundred twelve (71%) residents were aged >70 years. Thirty-five men (23%) had low SMMI in group aged >60 years, and twenty-eight subjects (25%) in the group aged >70 years. MNA scores were significantly lower in residents with low SMMI compared with having normal SMMI (17.1 ± 3.4 versus 19.6 ± 2.5, p = 0.005). BMI was significantly lower in the residents with low SMMI compared with normal SMMI (19.6 ± 2.7 versus 27.1 ± 4.1, p< 0.001). ADL scores were significantly different between residents with low SMMI and normal SMMI in those aged >70 years (8.1 ± 2.6 versus 9.1 ± 1.6, p = 0.014). In regression analyses, the only factor associated with better functional status was the lower age (p = 0.04) while the only factor associated with better nutrition was higher SMMI (p = 0.01). Low SMMI detected by LMM evaluation method of EWGSOP

  2. Development of a Composite Trauma Exposure Risk Index

    PubMed Central

    Liu, Honghu; Prause, Nicole; Wyatt, Gail E.; Williams, John K.; Chin, Dorothy; Davis, Teri; Loeb, Tamra; Marchand, Erica; Zhang, Muyu; Myers, Hector F.

    2015-01-01

    The high burden of exposure to chronic life adversities and trauma is quite prevalent, but assessment of this risk burden is uncommon in primary care settings. This calls for a brief, multiple dimensional mental health risk screening tool in primary care settings. We aimed to develop such a screening tool named the UCLA Life Adversities Screener (LADS). Using pooled data across four studies from the UCLA Center for Culture, Trauma and Mental Health Disparities, five domains of mental health risk including perceived discrimination, sexual abuse histories, family adversity, interpersonal violence, and trauma histories, were identified. Regression models for depression (Centers for Epidemiology Studies-Depression scale (CES-D)) and PTSD (Posttraumatic Diagnostic Scale (PDS)), controlling for demographic factors, were fitted to to develop a weighted continuous scale score for the UCLA LADS. Confirmatory factor analysis supported the five-domain structure, while Item Response Theory (IRT) endorsed the inclusion of each item. Receiver Operating Characteristic (ROC) analysis indicated that the score was predictive for classifying subjects as reaching clinical threshold criteria for either depression (Beck Depression Inventory-II (BDI-II) ≥14 or Patient Health Questionnaire-9 (PHQ-9) ≥ 10) or anxiety (Patient Health Questionnaire-13 (PHQ-13) ≥10). An optimal cut of 0.33 is suggested based on maximizing sensitivity and specificity of the LADS score, identifying patients at high risk for mental health problems. Given its predictive utility and ease of administration, the UCLA LADS could be useful as a screener to identify racial minority individuals in primary care settings who have a high trauma burden, needing more extensive evaluation. PMID:25984638

  3. Development of a composite trauma exposure risk index.

    PubMed

    Liu, Honghu; Prause, Nicole; Wyatt, Gail E; Williams, John K; Chin, Dorothy; Davis, Teri; Loeb, Tamra; Marchand, Erica; Zhang, Muyu; Myers, Hector F

    2015-09-01

    The high burden of exposure to chronic life adversities and trauma is quite prevalent, but assessment of this risk burden is uncommon in primary care settings. This calls for a brief, multiple dimensional mental health risk screening tool in primary care settings. We aimed to develop such a screening tool named the University of California, Los Angeles (UCLA) Life Adversities Screener (LADS). Using pooled data across 4 studies from the UCLA Center for Culture, Trauma, and Mental Health Disparities, 5 domains of mental health risk including perceived discrimination, sexual abuse histories, family adversity, intimate partner violence, and trauma histories, were identified. Regression models for depression (Centers for Epidemiology Studies Depression Scale) and posttraumatic stress disorder (Posttraumatic Diagnostic Scale), controlling for demographic factors, were fitted to develop a weighted continuous scale score for the UCLA LADS. Confirmatory factor analysis supported the 5-domain structure, while item response theory endorsed the inclusion of each item. Receiver operating characteristic analysis indicated that the score was predictive for classifying subjects as reaching clinical threshold criteria for either depression (Beck Depression Inventory-II ≥ 14 or Patient Health Questionnaire-9 ≥ 10) or anxiety (Patient Health Questionnaire-13 ≥10). An optimal cut of 0.33 is suggested based on maximizing sensitivity and specificity of the LADS score, identifying patients at high risk for mental health problems. Given its predictive utility and ease of administration, the UCLA LADS could be useful as a screener to identify racial minority individuals in primary care settings who have a high trauma burden, needing more extensive evaluation.

  4. The STRONGkids nutritional risk screening tool can be used by paediatric nurses to identify hospitalised children at risk.

    PubMed

    Moeeni, Vesal; Walls, Tony; Day, Andrew S

    2014-12-01

    Hospitalised children have higher rates of undernutrition. Early detection of at-risk patients could lead to prompt preventative or corrective interventions. Several nutritional risk screening tools are available for screening hospitalised children including the STRONGkids tool. This study was designed to assess the usefulness of STRONGkids when applied by nurses rather than a paediatrician. The STRONGkids questionnaire was simplified to enhance clarity with nursing staff. Trained nursing staff were asked to apply the tool to children, aged 1 month to 17 years, admitted to the Christchurch Hospital, New Zealand. Each patient was also assessed by a paediatrician. In addition, the current nutritional state of each patient was defined by measuring their weight and height. Of the 162 children enrolled, 11.7% were undernourished and 13% overnourished. STRONGkids recognised 84% of undernourished children when the tool was applied by nurses and 90% when the tool was applied by a paediatrician, indicating substantial agreement (kappa = 0.65). A minor simplification to the questionnaire improved its utility. STRONGkids successfully recognised at-risk children, when applied by either nurses or a paediatrician. It was suitable and feasible for nursing staff to use it to screen for children at risk of nutritional deterioration. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  5. LA sprouts randomized controlled nutrition, cooking and gardening programme reduces obesity and metabolic risk in Hispanic/Latino youth.

    PubMed

    Gatto, N M; Martinez, L C; Spruijt-Metz, D; Davis, J N

    2017-02-01

    Many programmes for children that involve gardening and nutrition components exist; however, none include experimental designs allowing more rigorous evaluation of their impact on obesity. The objective of this study is to explore the effects of a novel 12-week gardening, nutrition and cooking intervention {'LA Sprouts'} on dietary intake, obesity parameters and metabolic disease risk among low-income, primarily Hispanic/Latino youth in Los Angeles.. This study used a randomized control trial involving four elementary schools [two randomized to intervention {172, 3rd-5th grade students}; two randomized to control {147, 3rd-5th grade students}]. Classes were taught in 90-min sessions once per week for 12 weeks. Data collected at pre-intervention and post-intervention included dietary intake via food frequency questionnaire, anthropometric measures {body mass index, waist circumference}, body fat, and fasting blood samples. LA Sprouts participants compared with controls had significantly greater reductions in body mass index z-scores {-0.1 vs. -0.04, respectively; p = 0.01} and waist circumference {-1.2 vs. 0.1 cm; p < 0.001}. Fewer LA Sprouts participants had the metabolic syndrome after the intervention than before, while controls with metabolic syndrome increased. LA Sprouts participants compared with controls increased dietary fiber intake {+3.4% vs. -16.5%; p = 0.04}. All participants decreased vegetable intake, but decreases were less in LA Sprouts than controls {-3.7% vs. -26.1%; p = 0.04}. Change in fruit intake did not differ between LA Sprouts and controls. LA Sprouts was effective in reducing obesity and metabolic risk; however, additional larger and longer-term studies are warranted. © 2016 World Obesity Federation.

  6. Increased risk of iodine deficiency with vegetarian nutrition.

    PubMed

    Remer, T; Neubert, A; Manz, F

    1999-01-01

    Observational studies primarily based on diet questionnaires or food records have reported that vegetarians can have a very low I intake. However, analytically ascertained data on the possible degree of I deficiency with this form of diet is lacking. Six healthy adult volunteers participated in the present controlled experimental diet study carried out in four separate 5 d diet periods. The study diets, normal, protein-rich, lactovegetarian, and repeat of the initial normal diet, were almost isoenergetic and contained no fish, sea food, iodized salt or processed foods fortified with I. During the last 48 h of each diet period two 24 h urine samples were obtained from each subject. I analyses were performed in the urine samples and in representative samples taken from all ingested diets. Urinary I excretion was significantly lower with the lactovegetarian diet (36.6 (SD 8.8) micrograms/d) than with the normal and the protein-rich diets (50.2 (SD 14.0) and 61.0 (SD 8.0) micrograms/d respectively). Accordingly, a markedly reduced I intake was confirmed analytically for the lactovegetarian diet (15.6 micrograms/d v. 35.2 and 44.5 micrograms/d respectively). Our results provide experimental confirmation of literature findings indicating that I supply is higher with non-vegetarian than with vegetarian diets. Specifically, the extremely low intake and urinary output of I as analytically determined for one exemplary vegetarian diet, demonstrate that dietary I may be limiting when strict forms of vegetarian dietary practices (no iodized salt, no I supplements) are followed. The present study is, therefore, the first diet-experiment-based pointer to the potential danger of I deficiency disorders due to strict forms of vegetarian nutrition, especially when fruits and vegetables grown in soils with low I levels are ingested.

  7. Nutritional Status Based on Body Mass Index Is Associated With Morbidity and Mortality in Mechanically Ventilated Critically Ill Children in the PICU.

    PubMed

    Bechard, Lori J; Duggan, Christopher; Touger-Decker, Riva; Parrott, J Scott; Rothpletz-Puglia, Pamela; Byham-Gray, Laura; Heyland, Daren; Mehta, Nilesh M

    2016-08-01

    To determine the influence of admission anthropometry on clinical outcomes in mechanically ventilated children in the PICU. Data from two multicenter cohort studies were compiled to examine the unique contribution of nutritional status, defined by body mass index z score, to 60-day mortality, hospital-acquired infections, length of hospital stay, and ventilator-free days, using multivariate analysis. Ninety PICUs from 16 countries with eight or more beds. Children aged 1 month to 18 years, admitted to each participating PICU and requiring mechanical ventilation for more than 48 hours. Data from 1,622 eligible patients, 54.8% men and mean (SD) age 4.5 years (5.1), were analyzed. Subjects were classified as underweight (17.9%), normal weight (54.2%), overweight (14.5%), and obese (13.4%) based on body mass index z score at admission. After adjusting for severity of illness and site, the odds of 60-day mortality were higher in underweight (odds ratio, 1.53; p < 0.001) children. The odds of hospital-acquired infections were higher in underweight (odds ratio, 1.88; p = 0.008) and obese (odds ratio, 1.64; p < 0.001) children. Hazard ratios for hospital discharge were lower among underweight (hazard ratio, 0.71; p < 0.001) and obese (hazard ratio, 0.82; p = 0.04) children. Underweight was associated with 1.3 (p = 0.001) and 1.6 (p < 0.001) fewer ventilator-free days than normal weight and overweight, respectively. Malnutrition is prevalent in mechanically ventilated children on admission to PICUs worldwide. Classification as underweight or obese was associated with higher risk of hospital-acquired infections and lower likelihood of hospital discharge. Underweight children had a higher risk of mortality and fewer ventilator-free days.

  8. Significance of preoperative prognostic nutrition index as prognostic predictors in patients with metastatic renal cell carcinoma with tyrosine kinase inhibitors as first-line target therapy.

    PubMed

    Cai, Wen; Zhong, Hai; Kong, Wen; Dong, Baijun; Chen, Yonghui; Zhou, Lixin; Xue, Wei; Huang, Yiran; Zhang, Jin; Huang, Jiwei

    2017-09-09

    Prognostic nutritional index (PNI) is a recognized indicator of both immune and nutritional status. It was firstly used as a preoperative prognostic indicator, and its role in the prognosis of patients with metastatic renal cell carcinoma (mRCC) has not yet been investigated in large-scale study. The purpose of this work was to investigate the prognostic role of pretreatment PNI in patients with mRCC with sorafenib or sunitinib as first-line targeted therapy. In this retrospective single-center research, the Kaplan-Meier method was used to estimate the progression-free survival (PFS) and overall survival (OS) of 178 mRCC patients who received first-line therapy of sorafenib or sunitinib. Log-rank test was used to compare the survival outcomes of patients with low pretreatment PNI (PNI < 51.62) and high pretreatment PNI (PNI ≥ 51.62), and Cox proportional hazard regression model was used to compare PFS and OS between these two groups. Prognostic accuracy was determined using Harrell concordance index. The overall median PFS and OS time for all 178 patients were 11 months (95% CI 9-12 months) and 24 months (95% CI 19-33 months), respectively. Patients with low pretreatment PNI both had significantly shorter median PFS (7 vs 19 months, P < 0.001) and OS (14 vs 50 months, P < 0.001) than those with high PNI. Multivariate analysis showed that pretreatment PNI was an independent predictor of OS (HR 1.658, 95% CI 1.040-2.614, P = 0.033) and an independent predictor of PFS as well (HR 1.842, 95% CI 1.226-2.766, P = 0.003). The model built by the addition of pretreatment PNI improved predictive accuracy of PFS and OS compared with the International Metastatic Renal Cell Carcinoma Database Consortium Model (Heng model) (c-index: 0.68 and 0.70). Comparing to NLR (neutrophil-to-lymphocyte ratio) (0.69 and 0.72), PNI might be a preciser factor to predict PFS and OS (0.71 and 0.73). Low pretreatment PNI could be a significant risk factor for mRCC patients who

  9. Individual, nutritional support prevents undernutrition, increases muscle strength and improves QoL among elderly at nutritional risk hospitalized for acute stroke: a randomized, controlled trial.

    PubMed

    Ha, Lisa; Hauge, Truls; Spenning, Anne Bente; Iversen, Per Ole

    2010-10-01

    Undernutrition after an acute stroke increases the risk of poor outcome. We wanted to examine the effect of individualized, nutritional support on weight loss and functional outcomes in stroke patients. Acute stroke patients at nutritional risk were randomized to either individualized, nutritional care or routine care while in hospital. Patients in the intervention group received an individualized treatment plan aiming to prevent weight loss. In accordance with routine care, the controls did not have such a treatment plan. Patients were reviewed at follow-up after three months. Primary outcome measure was the percentage of patients with weight loss ≥5%. Secondary outcomes measures were quality of life (QoL), handgrip strength and length of hospital stay. This trial is registered with ClinicalTrials.gov, number NCT00163007. At follow-up, 20.7% of the intervention group (n = 58) lost ≥5% weight compared with 36.4% in the control group (n = 66) (P = 0.055). The intervention group had a significantly higher increase in QoL score (P = 0.009) and in handgrip strength (P = 0.002). There was no difference in length of hospital stay. Individualized, nutritional treatment strategy can prevent clinically significant weight loss and improve QoL in elderly acute stroke patients at nutritional risk. Copyright © 2010 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  10. Dietary glycemic index and glycemic load, and breast cancer risk: a case-control study.

    PubMed

    Augustin, L S; Dal Maso, L; La Vecchia, C; Parpinel, M; Negri, E; Vaccarella, S; Kendall, C W; Jenkins, D J; Francesch, S

    2001-11-01

    Certain types of carbohydrates increase glucose and insulin levels to a greater extent than others. In turn, insulin may raise levels of insulin-like growth factors, which may influence breast cancer risk. We analyzed the effect of type and amount of carbohydrates on breast cancer risk, using the glycemic index and the glycemic load measures in a large case-control study conducted in Italy. Cases were 2,569 women with incident, histologically-confirmed breast cancer interviewed between 1991 and 1994. Controls were 2588 women admitted to the same hospital network for a variety of acute, non-neoplastic conditions. Average daily glycemic index and glycemic load were calculated from a validated 78-item food frequency questionnaire. Direct associations with breast cancer risk emerged for glycemic index (odds ratio, OR for highest vs. lowest quintile = 1.4; P for trend <0.01) and glycemic load (OR = 1.3; P < 0.01). High glycemic index foods, such as white bread, increased the risk of breast cancer (OR = 1.3) while the intake of pasta, a medium glycemic index food, seemed to have no influence (OR = 1.0). Findings were consistent across different strata of menopausal status, alcohol intake, and physical activity level. This study supports the hypothesis of moderate, direct associations between glycemic index or glycemic load and breast cancer risk and, consequently, a possible role of hyperinsulinemia/insulin resistance in breast cancer development.

  11. Determinants of the omega-3 index in a Mediterranean population at increased risk for CHD.

    PubMed

    Sala-Vila, Aleix; Harris, William S; Cofán, Montserrat; Pérez-Heras, Ana M; Pintó, Xavier; Lamuela-Raventós, Rosa M; Covas, Maria-Isabel; Estruch, Ramon; Ros, Emilio

    2011-08-01

    The omega-3 index, defined as the sum of EPA and DHA in erythrocyte membranes expressed as a percentage of total fatty acids, has been proposed as both a risk marker and risk factor for CHD death. A major determinant of the omega-3 index is EPA+DHA intake, but the impact of other dietary fatty acids has not been investigated. In a cross-sectional study on 198 subjects (102 men and 96 women, mean age 66 years) at high cardiovascular risk living in Spain, the country with low rates of cardiac death despite a high prevalence of cardiovascular risk factors, dietary data were acquired from FFQ and blood cell membrane fatty acid composition was measured by GC. The average consumption of EPA+DHA was 0·9 g/d and the mean omega-3 index was 7·1 %. In multivariate models, EPA+DHA intake was the main predictor of the omega-3 index but explained only 12 % of its variability (P < 0·001). No associations with other dietary fatty acids were observed. Although the single most influential determinant of the omega-3 index measured here was the intake of EPA+DHA, it explained little of the former's variability; hence, the effects of other factors (genetic, dietary and lifestyle) remain to be determined. Nevertheless, the high omega-3 index could at least partially explain the paradox of low rates of fatal CHD in Spain despite a high background prevalence of cardiovascular risk factors.

  12. Nutritional Risk in Major Abdominal Surgery: Protocol of a Prospective Observational Trial to Evaluate the Prognostic Value of Different Nutritional Scores in Pancreatic Surgery

    PubMed Central

    Probst, Pascal; Haller, Sebastian; Dörr-Harim, Colette; Bruckner, Thomas; Ulrich, Alexis; Hackert, Thilo; Diener, Markus K

    2015-01-01

    Background The influence of patients’ preoperative nutritional status on their clinical outcome has already been proven. Therefore, patients with malnutrition are in need of additional therapeutic efforts. However, for pancreatic surgery, evidence suggesting the adequacy of existing nutritional assessment scores to estimate malnutrition associated with postoperative outcome is limited. Objective The aim of the observational trial “Nutritional Risk in Major Abdominal Surgery (NURIMAS) Pancreas” is to prospectively assess and analyze different nutritional assessment scores for their prognostic value on postoperative complications in patients undergoing pancreatic surgery. Methods All patients scheduled to receive elective pancreatic surgery at the University Hospital of Heidelberg will be screened for eligibility. Preoperatively, 12 nutritional assessment scores will be collected and patients will be assigned either at risk or not at risk for malnutrition. The postoperative course will be followed prospectively and complications according to the Clavien-Dindo classification will be recorded. The prognostic value for complications will be evaluated for every score in a univariable and multivariable analysis corrected for known risk factors in pancreatic surgery. Results Final data analysis is expected to be available during Spring 2016. Conclusions The NURIMAS Pancreas trial is a monocentric, prospective, observational trial aiming to find the most predictive clinical nutritional assessment score for postoperative complications. Using the results of this protocol as a knowledge base, it is possible to conduct nutritional risk-guided intervention trials to prevent postoperative complications in the pancreatic surgical population. Trial Registration germanctr.de: DRKS00006340; https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00006340 (Archived by WebCite at http://www.webcitation.org/6bzXWSRYZ) PMID:26573991

  13. Enviromentally sensitive patch index of desertification risk applied to the main habitats of Sicily

    NASA Astrophysics Data System (ADS)

    Duro, A.; Piccione, V.; Ragusa, M. A.; Rapicavoli, V.; Veneziano, V.

    2017-07-01

    The authors applied the MEDALUS - Mediterranean Desertification and Land Use - procedure to the most representative sicilian habitat by extension, socio-economic and environmental importance, in order to assess the risk of desertification. Thanks to the ESPI, Environmentally Sensitive Patch Index, in this paper the authors estimate the current and future regional levels of desertification risk.

  14. [Screening of malnutrition risk versus indicators of nutritional status and systemic inflammatory response in newly diagnosed lung cancer patients].

    PubMed

    Illa, P; Tomíšková, M; Skřičková, J

    2014-01-01

    Most lung cancers are already advanced at the time of dia-gnosis. In these patients, a frequent symptom is protein energy malnutrition, often diagnosed prior to oncological treatment. Malnutrition results in poor tolerance of treatment and increased morbidity and mortality. Nutritional Risk Screening (NRS) 2002 adapted for oncological patients was used to assess the risk of undernutrition in a group of 188 lung cancer patients. The risk was evaluated on a 6- point scale according to common signs of nutritional status and tumor and its treatment risk factors. A score of 3 and more (called "nutritional risk") means a significant risk of malnutrition. Furthermore, pretreatment nutritional characteristics were evaluated in patients (including the value of BMI) and laboratory values indicating malnutrition/ acute phase response (albumin/ C reactive protein - CRP). Acceptable NRS score was found in 50.6%, while in 45.3% was suggested into risk of malnutrition ("nutritional risk"). Only 6.6% of our patients had a BMI less than 20 kg/ m2. Significant differences in albumin and CRP values in various categories of NRS were confirmed. Initial signs of cancer malnutrition may be overlooked in patients who fall within or above the range of BMI for adequate weight, although these patients may be at significant risk of malnutrition. The indicators of nutritional status and systemic inflammatory responses were significantly associated with resulting values NRS score.

  15. Dietary patterns based on carbohydrate nutrition are associated with the risk for diabetes and dyslipidemia.

    PubMed

    Song, Su Jin; Lee, Jung Eun; Paik, Hee-Young; Park, Min Sun; Song, Yoon Ju

    2012-08-01

    Several studies have been conducted on dietary patterns based on carbohydrate nutrition in Asian populations. We examined the cross-sectional associations in dietary patterns based on carbohydrate nutrition, including the glycemic index (GI) with dyslipidemia and diabetes among the Korean adult population. We analyzed 9,725 subjects (3,795 men and 5,930 women, ≥ 20 years) from the Fourth Korea National Health and Nutrition Examination Survey. Dietary information was collected using single 24-hour recall. Reduced rank regression was used to derive dietary patterns from 22 food groups as predictor variables and four dietary factors related to the quantity and quality of carbohydrates as response variables. Two dietary patterns were identified: 1) the balanced pattern was characterized by high intake of various kinds of foods including white rice, and 2) the rice-oriented pattern was characterized by a high intake of white rice but low intake of vegetables, fruits, meat, and dairy products. Both patterns had considerable amounts of total carbohydrate, but GI values differed. The rice-oriented pattern was positively associated with hypertriglyceridemia in men and low high density lipoprotein-cholesterol in both men and women. The balanced pattern had no overall significant association with the prevalence of dyslipidemia or diabetes, however, men with energy intake above the median showed a reduced prevalence of diabetes across quintiles of balanced pattern scores. The results show that dietary patterns based on carbohydrate nutrition are associated with prevalence of dyslipidemia and diabetes in the Korean adult population.

  16. Nutrition Risk in Home-Bound Older Adults: Using Dietician-Trained and Supervised Nutrition Volunteers for Screening and Intervention

    ERIC Educational Resources Information Center

    Laforest, Sophie; Goldin, Benita; Nour, Kareen; Roy, Marie-Andree; Payette, Helene

    2007-01-01

    Nutrition screening and early intervention in home-bound older adults are key to preventing unfavourable health outcomes and functional decline. This pilot study's objectives were (a) to test the reliability of the Elderly Nutrition Screening Tool (ENS [C]) when administered by dietician-trained and supervised nutrition volunteers, and (b) to…

  17. Nutrition Risk in Home-Bound Older Adults: Using Dietician-Trained and Supervised Nutrition Volunteers for Screening and Intervention

    ERIC Educational Resources Information Center

    Laforest, Sophie; Goldin, Benita; Nour, Kareen; Roy, Marie-Andree; Payette, Helene

    2007-01-01

    Nutrition screening and early intervention in home-bound older adults are key to preventing unfavourable health outcomes and functional decline. This pilot study's objectives were (a) to test the reliability of the Elderly Nutrition Screening Tool (ENS [C]) when administered by dietician-trained and supervised nutrition volunteers, and (b) to…

  18. [Vegetarian nutrition: Preventive potential and possible risks. Part 1: Plant foods].

    PubMed

    Ströhle, Alexander; Waldmann, Annika; Wolters, Maike; Hahn, Andreas

    2006-10-01

    Today vegetarian nutrition is more accepted and widespread in Europe than in former years. For a long time scientific research on vegetarian diets has focused mostly on malnutrition, whereas nowadays research centers increasingly on the preventive potential of plant-based diets. We followed a nutritive and a metabolic-epidemiological approach to obtain dietary recommendations. A MEDLINE research was performed for all plant food groups relevant for a vegetarian diet (key words: all relevant food groups, "vegetarian diet", "chronic disease", "cancer", "cardiovascular disease", "diabetes mellitus", "osteoporosis"). All relevant food groups were characterized regarding their nutrient content and rated with respect to the available metabolic-epidemiological evidence. Based on the evidence criteria of the WHO/FAO, cancer risk reduction by a high intake of vegetables and fruits is assessed as probable or possible, while a lowered risk of cardiovascular disease is convincing and a lowered risk of osteoporosis is probable. The evidence of a risk reducing effect of whole grain relating to colorectal cancer is assessed as possible, whereas it is probable relating to cardiovascular disease and diabetes mellitus type 2. There is an insufficient risk-reducing effect of legumes like soja relating to epithelial tumours and cardiovascular disease. The evidence of a risk-reducing effect of nuts to cardiovascular disease is assessed as probable, and in relation to cholelithiasis and diabetes mellitus type 2 as possible and insufficient, respectively. In conclusion, high consumption of fruits, vegetables, whole grains and nuts can lower the risk for several chronic diseases.

  19. Nutritional status, dietary energy intake and the risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD).

    PubMed

    Hallin, Runa; Koivisto-Hursti, Ulla-Kaisa; Lindberg, Eva; Janson, Christer

    2006-03-01

    Loss of body weight, as a result of imbalance between increased energy demand and/or reduced dietary intake, is a common problem in patients with COPD. The aim of this investigation was to examine the relationship between nutritional intake, change in body weight and the risk of exacerbation in patients with COPD. The study comprised 41 patients who were hospitalised because of an exacerbation of COPD. The follow-up period was 12 months. Weight, height and lung function were measured at baseline. At the 12-month follow-up, weight change and current weight were assessed by an interview and nutritional intake was recorded in a food diary for 7 days. An acute exacerbation was defined as having been admitted to hospital and/or making an emergency visit to hospital, due to COPD during the follow-up period. At baseline, 24% of the patients were underweight (body mass index (BMI)<20 kg/m2), 46% were of normal weight (BMI 20-25 kg/m2) and 29% were overweight (BMI>25 kg/m2). Energy intake was lower than the calculated energy demand for all groups. During the follow-up period, 24 of the 41 patients had an exacerbation. A low BMI at inclusion and weight loss during the follow-up period were independent risk factors for having an exacerbation (P=0.003 and 0.006, respectively). We conclude that, in patients who are hospitalised because of COPD, underweight and weight loss during the follow-up period are related to a higher risk of having new exacerbations.

  20. Model risk for European-style stock index options.

    PubMed

    Gençay, Ramazan; Gibson, Rajna

    2007-01-01

    In empirical modeling, there have been two strands for pricing in the options literature, namely the parametric and nonparametric models. Often, the support for the nonparametric methods is based on a benchmark such as the Black-Scholes (BS) model with constant volatility. In this paper, we study the stochastic volatility (SV) and stochastic volatility random jump (SVJ) models as parametric benchmarks against feedforward neural network (FNN) models, a class of neural network models. Our choice for FNN models is due to their well-studied universal approximation properties of an unknown function and its partial derivatives. Since the partial derivatives of an option pricing formula are risk pricing tools, an accurate estimation of the unknown option pricing function is essential for pricing and hedging. Our findings indicate that FNN models offer themselves as robust option pricing tools, over their sophisticated parametric counterparts in predictive settings. There are two routes to explain the superiority of FNN models over the parametric models in forecast settings. These are nonnormality of return distributions and adaptive learning.

  1. MATERNAL NUTRITIONAL STATUS AS A CONTRIBUTING FACTOR FOR THE RISK OF FETAL ALCOHOL SPECTRUM DISORDERS

    PubMed Central

    May, Philip A.; Hamrick, Kari J.; Corbin, Karen D.; Hasken, Julie M.; Marais, Anna-Susan; Blankenship, Jason; Hoyme, H. Eugene; Gossage, J. Phillip

    2016-01-01

    Objective Compare nutritional status of 57 South African mothers of children with fetal alcohol spectrum disorders (FASD) with 148 mothers of controls. Methods Dietary data were analyzed for macronutrients, micronutrients, and fats via Estimated Average Requirements (EAR) and Adequate Intakes (AI) for pregnant women. Results Virtually all mothers were likely deficient on most micronutrients by either EAR (<50%) or AI values. Mothers of FASD children consumed more of 13 of 25 micronutrients. For percentage below EAR, only vitamin D was significantly higher for FASD mothers. Despite no difference in total food intake, control mothers had a higher mean body mass index (BMI) than FASD mothers. Maternal BMI is more significant for positive child outcomes than any individual nutrient. Conclusions Most mothers have inadequate dietary intake. Minor advantages in nutrient intake are overpowered by teratogenic effects of alcohol. Further study is needed of the interaction of alcohol, maternal nutrition, and metabolism. PMID:26656914

  2. Maternal nutritional status as a contributing factor for the risk of fetal alcohol spectrum disorders.

    PubMed

    May, Philip A; Hamrick, Kari J; Corbin, Karen D; Hasken, Julie M; Marais, Anna-Susan; Blankenship, Jason; Hoyme, H Eugene; Gossage, J Phillip

    2016-01-01

    Compare nutritional status of 57 South African mothers of children with fetal alcohol spectrum disorders (FASD) with 148 mothers of controls. Dietary data were analyzed for macronutrients, micronutrients, and fats via estimated average requirements (EAR) and adequate intakes (AI) for pregnant women. Virtually all mothers were likely deficient on most micronutrients by either EAR (<50%) or AI values. Mothers of FASD children consumed more of 13 of 25 micronutrients. For percentage below EAR, only vitamin D was significantly higher for FASD mothers. Despite no difference in total food intake, control mothers had a higher mean body mass index (BMI) than FASD mothers. Maternal BMI is more significant for positive child outcomes than any individual nutrient. Most mothers have inadequate dietary intake. Minor advantages in nutrient intake are overpowered by teratogenic effects of alcohol. Further study is needed of the interaction of alcohol, maternal nutrition, and metabolism. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Body mass index predicts risk for complications from transtemporal cerebellopontine angle surgery.

    PubMed

    Mantravadi, Avinash V; Leonetti, John P; Burgette, Ryan; Pontikis, George; Marzo, Sam J; Anderson, Douglas

    2013-03-01

    To determine the relationship between body mass index (BMI) and risk for specific complications from transtemporal cerebellopontine angle (CPA) surgery for nonmalignant disease. Case series with chart review. Tertiary-care academic hospital. Retrospective review of 134 consecutive patients undergoing transtemporal cerebellopontine angle surgery for nonmalignant disease from 2009 to 2011. Data were collected regarding demographics, body mass index, intraoperative details, hospital stay, and complications including cerebrospinal fluid leak, wound complications, and brachial plexopathy. One hundred thirty-four patients were analyzed with a mean preoperative body mass index of 28.58. Statistical analysis demonstrated a significant difference in body mass index between patients with a postoperative cerebrospinal fluid leak and those without (P = .04), as well as a similar significant difference between those experiencing postoperative brachial plexopathy and those with no such complication (P = .03). Logistical regression analysis confirmed that body mass index is significant in predicting both postoperative cerebrospinal fluid leak (P = .004; odds ratio, 1.10) and brachial plexopathy (P = .04; odds ratio, 1.07). Elevated body mass index was not significant in predicting wound complications or increased hospital stay beyond postoperative day 3. Risk of cerebrospinal fluid leak and brachial plexopathy is increased in patients with elevated body mass index undergoing surgery of the cerebellopontine angle. Consideration should be given to preoperative optimization via dietary and lifestyle modifications as well as intraoperative somatosensory evoked potential monitoring of the brachial plexus to decrease these risks.

  4. Red cell distribution width and risk of cardiovascular mortality: Insights from National Health and Nutrition Examination Survey (NHANES)-III.

    PubMed

    Shah, Neeraj; Pahuja, Mohit; Pant, Sadip; Handa, Aman; Agarwal, Vratika; Patel, Nileshkumar; Dusaj, Raman

    2017-04-01

    Red cell distribution width (RDW) has been linked to cardiovascular disease. We sought to determine whether addition of RDW improved the Framingham risk score (FRS) model to predict cardiovascular mortality in a healthy US cohort. We performed a post-hoc analysis of the National Health and Nutritional Examination Survey-III (1988-94) cohort, including non-anemic subjects aged 30-79years. Primary endpoint was death from coronary heart disease (CHD). We divided the cohort into three risk categories: <6%, 6-20% and >20%. RDW>14.5 was considered high. Kaplan-Meier survival curves and Cox proportional hazards models were created. Discrimination, calibration and reclassification were used to assess the value of addition of RDW to the FRS model. We included 7005 subjects with a mean follow up of 14.1years. Overall, there were 233 (3.3%) CHD deaths; 27 (8.2%) in subjects with RDW>14.5 compared to 206 (3.1%) in subjects with RDW≤14.5 (p<0.001). Adjusted hazard ratio of RDW in predicting CHD mortality was 2.02 (1.04-3.94, p=0.039). Addition of RDW to FRS model showed significant improvement in C-statistic (0.8784 vs. 0.8751, p=0.032) and area under curve (0.8565 vs. 0.8544, p=0.05). There was significant reclassification of FRS with a net reclassification index (NRI) of 5.6% (p=0.017), and an intermediate-risk NRI of 9.6% (p=0.011). Absolute integrated discrimination index (IDI) was 0.004 (p=0.02), with relative IDI of 10.4%. Our study demonstrates that RDW is a promising biomarker which improves prediction of cardiovascular mortality over and above traditional cardiovascular risk factors. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Healthy Lifestyle and Risk of Cancer in the European Prospective Investigation Into Cancer and Nutrition Cohort Study

    PubMed Central

    McKenzie, Fiona; Biessy, Carine; Ferrari, Pietro; Freisling, Heinz; Rinaldi, Sabina; Chajès, Veronique; Dahm, Christina C.; Overvad, Kim; Dossus, Laure; Lagiou, Pagona; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Bueno-de-Mesquita, H. Bas; May, Anne; Peeters, Petra H.; Weiderpass, Elisabete; Sanchez, Maria-Jose; Navarro, Carmen; Ardanaz, Eva; Ericson, Ulrika; Wirfält, Elisabet; Travis, Ruth C.; Romieu, Isabelle

    2016-01-01

    Abstract It has been estimated that at least a third of the most common cancers are related to lifestyle and as such are preventable. Key modifiable lifestyle factors have been individually associated with cancer risk; however, less is known about the combined effects of these factors. This study generated a healthy lifestyle index score (HLIS) to investigate the joint effect of modifiable factors on the risk of overall cancers, alcohol-related cancers, tobacco-related cancers, obesity-related cancers, and reproductive-related cancers. The study included 391,608 men and women from the multinational European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The HLIS was constructed from 5 factors assessed at baseline (diet, physical activity, smoking, alcohol consumption, and anthropometry) by assigning scores of 0 to 4 to categories of each factor, for which higher values indicate healthier behaviors. Hazard ratios (HR) were estimated by Cox proportional regression and population attributable fractions (PAFs) estimated from the adjusted models. There was a 5% lower risk (adjusted HR 0.952, 95% confidence interval (CI): 0.946, 0.958) of all cancers per point score of the index for men and 4% (adjusted HR 0.961, 95% CI: 0.956, 0.966) for women. The fourth versus the second category of the HLIS was associated with a 28% and 24% lower risk for men and women respectively across all cancers, 41% and 33% for alcohol-related, 49% and 46% for tobacco-related, 41% and 26% for obesity-related, and 21% for female reproductive cancers. Findings suggest simple behavior modifications could have a sizeable impact on cancer prevention, especially for men. PMID:27100409

  6. Healthy Lifestyle and Risk of Cancer in the European Prospective Investigation Into Cancer and Nutrition Cohort Study.

    PubMed

    McKenzie, Fiona; Biessy, Carine; Ferrari, Pietro; Freisling, Heinz; Rinaldi, Sabina; Chajès, Veronique; Dahm, Christina C; Overvad, Kim; Dossus, Laure; Lagiou, Pagona; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Bueno-de-Mesquita, H Bas; May, Anne; Peeters, Petra H; Weiderpass, Elisabete; Sanchez, Maria-Jose; Navarro, Carmen; Ardanaz, Eva; Ericson, Ulrika; Wirfält, Elisabet; Travis, Ruth C; Romieu, Isabelle

    2016-04-01

    It has been estimated that at least a third of the most common cancers are related to lifestyle and as such are preventable. Key modifiable lifestyle factors have been individually associated with cancer risk; however, less is known about the combined effects of these factors. This study generated a healthy lifestyle index score (HLIS) to investigate the joint effect of modifiable factors on the risk of overall cancers, alcohol-related cancers, tobacco-related cancers, obesity-related cancers, and reproductive-related cancers. The study included 391,608 men and women from the multinational European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The HLIS was constructed from 5 factors assessed at baseline (diet, physical activity, smoking, alcohol consumption, and anthropometry) by assigning scores of 0 to 4 to categories of each factor, for which higher values indicate healthier behaviors. Hazard ratios (HR) were estimated by Cox proportional regression and population attributable fractions (PAFs) estimated from the adjusted models. There was a 5% lower risk (adjusted HR 0.952, 95% confidence interval (CI): 0.946, 0.958) of all cancers per point score of the index for men and 4% (adjusted HR 0.961, 95% CI: 0.956, 0.966) for women. The fourth versus the second category of the HLIS was associated with a 28% and 24% lower risk for men and women respectively across all cancers, 41% and 33% for alcohol-related, 49% and 46% for tobacco-related, 41% and 26% for obesity-related, and 21% for female reproductive cancers. Findings suggest simple behavior modifications could have a sizeable impact on cancer prevention, especially for men.

  7. [Association of body mass index and aerobic physical fitness with cardiovascular risk factors in children].

    PubMed

    Gonçalves, Reginaldo; Szmuchrowski, Leszek Antony; Damasceno, Vinícius Oliveira; de Medeiros, Marcelo Lemos; Couto, Bruno Pena; Lamounier, Joel Alves

    2014-09-01

    To identify the association between both, body mass index and aerobic fitness, with cardiovascular disease risk factors in children. Cross-sectional study, carried out in Itaúna-MG, in 2010, with 290 school children ranging from 6 to 10 years-old of both sexes, randomly selected. Children from schools located in the countryside and those with medical restrctions for physical activity were not included. Blood sample was collected after a 12-hour fasting period. Blood pressure, stature and weight were evaluated in accordance with international standards. The following were considered as cardiovascular risk factors: high blood pressure, high total cholesterol, LDL, triglycerides and insulin levels, and low HDL. The statistical analysis included the Spearman's coefficient and the logistic regression, with cardiovascular risk factors as dependent variables. Significant correlations were found, in both sexes, among body mass index and aerobic fitness with most of the cardiovascular risk factors. Children of both sexes with body mass index in the fourth quartile demonstrated increased chances of having high blood insulin and clustering cardiovascular risk factors. Moreover, girls with aerobic fitness in the first quartile also demonstrated increased chances of having high blood insulin and clustering cardiovascular risk factors. The significant associations and the increased chances of having cardiovascular risk factors in children with less aerobic fitness and higher levels of body mass index justify the use of these variables for health monitoring in Pediatrics. Copyright © 2014 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  8. Association of body mass index and aerobic physical fitness with cardiovascular risk factors in children☆

    PubMed Central

    Gonçalves, Reginaldo; Szmuchrowski, Leszek Antony; Damasceno, Vinícius Oliveira; de Medeiros, Marcelo Lemos; Couto, Bruno Pena; Lamounier, Joel Alves

    2014-01-01

    Objective: To identify the association between both, body mass index and aerobic fitness, with cardiovascular disease risk factors in children. Methods: Cross-sectional study, carried out in Itaúna-MG, in 2010, with 290 school children ranging from 6 to 10 years-old of both sexes, randomly selected. Children from schools located in the countryside and those with medical restrctions for physical activity were not included. Blood sample was collected after a 12-hour fasting period. Blood pressure, stature and weight were evaluated in accordance with international standards. The following were considered as cardiovascular risk factors: high blood pressure, high total cholesterol, LDL, triglycerides and insulin levels, and low HDL. The statistical analysis included the Spearman's coefficient and the logistic regression, with cardiovascular risk factors as dependent variables. Results: Significant correlations were found, in both sexes, among body mass index and aerobic fitness with most of the cardiovascular risk factors. Children of both sexes with body mass index in the fourth quartile demonstrated increased chances of having high blood insulin and clustering cardiovascular risk factors. Moreover, girls with aerobic fitness in the first quartile also demonstrated increased chances of having high blood insulin and clustering cardiovascular risk factors. Conclusion: The significant associations and the increased chances of having cardiovascular risk factors in children with less aerobic fitness and higher levels of body mass index justify the use of these variables for health monitoring in Pediatrics. PMID:25479851

  9. Risk Assessment to Underpin Food Regulatory Decisions: An Example of Public Health Nutritional Epidemiology

    PubMed Central

    Baines, Janis; Cunningham, Judy; Leemhuis, Christel; Hambridge, Tracy; Mackerras, Dorothy

    2011-01-01

    The approach used by food regulation agencies to examine the literature and forecast the impact of possible food regulations has many similar features to the approach used in nutritional epidemiological research. We outline the Risk Analysis Framework described by FAO/WHO, in which there is formal progression from identification of the nutrient or food chemical of interest, through to describing its effect on health and then assessing whether there is a risk to the population based on dietary exposure estimates. We then discuss some important considerations for the dietary modeling component of the Framework, including several methodological issues that also exist in research nutritional epidemiology. Finally, we give several case studies that illustrate how the different methodological components are used together to inform decisions about how to manage the regulatory problem. PMID:22254081

  10. [Nutritional therapy in the obese patient with insulin resistance and cardiovascular risk].

    PubMed

    Nubiola, A; Remolins, I; Nubiola, M

    2016-01-01

    Currently, each of the different scientific societies advocate one kind or another nutritional recommendations for patients with vascular risk. This variety of diets on the one hand enrich the nutritional therapeutic possibilities, but on the other can lead to some confusion, both for the patient and for the professional that advises. Furthermore, most studies assessing vascular risk mention a "diet" without defining or specifying to which kind of diet they refer, thereby introducing an important bias in the results of those studies. In fact, some of them bear a degree of contradiction. This review aims to shed some light on such a controversial topic. Copyright © 2015 SEHLELHA. Published by Elsevier España, S.L.U. All rights reserved.

  11. Risk assessment to underpin food regulatory decisions: an example of public health nutritional epidemiology.

    PubMed

    Baines, Janis; Cunningham, Judy; Leemhuis, Christel; Hambridge, Tracy; Mackerras, Dorothy

    2011-01-01

    The approach used by food regulation agencies to examine the literature and forecast the impact of possible food regulations has many similar features to the approach used in nutritional epidemiological research. We outline the Risk Analysis Framework described by FAO/WHO, in which there is formal progression from identification of the nutrient or food chemical of interest, through to describing its effect on health and then assessing whether there is a risk to the population based on dietary exposure estimates. We then discuss some important considerations for the dietary modeling component of the Framework, including several methodological issues that also exist in research nutritional epidemiology. Finally, we give several case studies that illustrate how the different methodological components are used together to inform decisions about how to manage the regulatory problem.

  12. Nutritional status and physical activity level as risk factor for traumatic dental injuries occurrence: a systematic review

    PubMed Central

    Goettems, Marília Leão; Schuch, Helena Silveira; Hallal, Pedro Curi; Torriani, Dione Dias; Demarco, Flávio Fernando

    2014-01-01

    Aim To systematically review epidemiological articles assessing traumatic dental injuries (TDI) rates according to the physical activity habits and nutritional status. Methods A search was conducted using PubMed, ISI, Scopus, SciELO, LILACS, and gray literature in Brazilian Theses Databank. We searched for dental trauma, traumatic dental injuries, tooth injuries, tooth fractures, physical activity, motor activity, exercise, sedentary lifestyle, sports, obesity, body mass index (BMI), overweight, and fatness. Databases were searched in duplicate from their earliest records until 2012. Additional studies were identified by searching bibliographies of the articles. Two reviewers performed data extraction and analyzed study procedural quality using the Newcastle–Ottawa scale. PRISMA guidelines for reporting systematic reviews were followed. Results We found 1159 articles, of whom 14 reports involving 13 studies were selected. One article was a birth cohort, one had a case–control design, and the others were cross-sectional. The quality of evidence varied across the studies and was high (9) in 3. Eleven of the studies included assessed influence of nutritional status: five show a positive association between dental trauma and overweight and six do not show any association. Regarding physical activity level, five studies assessed its effect on trauma occurrence: two detected that physical activity acts as a protective factor and two that physical active increases the risk of dental injuries, and one showed no differences in TDI occurrence. Physical activity estimated from questionnaires and BMI were the most frequently used measures, but methodological differences prevent the comparison of results. Conclusion The results suggest that no truly causal relationship exists between dental trauma and physical activity and nutritional status. Due to the relatively low level of evidence currently present, studies with more robust design, for example, prospective cohort

  13. Nutritional status and physical activity level as risk factor for traumatic dental injuries occurrence: a systematic review.

    PubMed

    Goettems, Marília Leão; Schuch, Helena Silveira; Hallal, Pedro Curi; Torriani, Dione Dias; Demarco, Flávio Fernando

    2014-08-01

    To systematically review epidemiological articles assessing traumatic dental injuries (TDI) rates according to the physical activity habits and nutritional status. A search was conducted using PubMed, ISI, Scopus, SciELO, LILACS, and gray literature in Brazilian Theses Databank. We searched for dental trauma, traumatic dental injuries, tooth injuries, tooth fractures, physical activity, motor activity, exercise, sedentary lifestyle, sports, obesity, body mass index (BMI), overweight, and fatness. Databases were searched in duplicate from their earliest records until 2012. Additional studies were identified by searching bibliographies of the articles. Two reviewers performed data extraction and analyzed study procedural quality using the Newcastle-Ottawa scale. PRISMA guidelines for reporting systematic reviews were followed. We found 1159 articles, of whom 14 reports involving 13 studies were selected. One article was a birth cohort, one had a case-control design, and the others were cross-sectional. The quality of evidence varied across the studies and was high (9) in 3. Eleven of the studies included assessed influence of nutritional status: five show a positive association between dental trauma and overweight and six do not show any association. Regarding physical activity level, five studies assessed its effect on trauma occurrence: two detected that physical activity acts as a protective factor and two that physical active increases the risk of dental injuries, and one showed no differences in TDI occurrence. Physical activity estimated from questionnaires and BMI were the most frequently used measures, but methodological differences prevent the comparison of results. The results suggest that no truly causal relationship exists between dental trauma and physical activity and nutritional status. Due to the relatively low level of evidence currently present, studies with more robust design, for example, prospective cohort should address this question, especially

  14. [An epidemiological index to assess the nutritional status of children based in a polynomial model of values from Z punctuation for the age in Mexico].

    PubMed

    Avila-Curiel, A; Shamah, T; Barragán, L; Chávez, A; Avila, Maria; Juárez, L

    2004-03-01

    A nutritional status index was built by modeling the mathematical function of the mean Z scores of weight for age, from 60,079 children under five years of age, selected in a probabilistic fashion from the Mexican population. The most precise mathematical model was a fifth degree polynomial. The correlation coefficient was between .937index is the integral of the polynomial function, which represents the nutritional gap between the observed and the reference population. This model is used to analyze the characteristics of the different study populations. The index shows an improvement of -39.6 to -16.8 at the national level, between the years 1988 and 1999. This improvement is greater in urban (-36-4 to -8.4) than in rural areas (-48.8 in 1989, to -37.7 in 1999). The indigenous rural population of the country showed the highest levels of malnutrition (-54.4), as compared to the non-indigenous rural population (-37.1). In Mexico, City, the index was -5.9 in 1995, which represents an average of extreme nutritional values: -17.3 in the lower socioeconomic strata and 18.0 in the higher strata, the latter suggesting the presence of childhood obesity. This index is useful to estimate the epidemiological burden and the characteristics of malnutrition at early ages, as well as to assess the impact of interventions, without being altered by common biases related to the utilization of malnutrition prevalence values.

  15. A frailty index to predict the mortality risk in a population of senior mexican adults

    PubMed Central

    García-González, José Juan; García-Peña, Carmen; Franco-Marina, Francisco; Gutiérrez-Robledo, Luis Miguel

    2009-01-01

    Background Frailty in the elderly can be regarded as nonspecific vulnerability to adverse health outcomes, caused by multiple factors. The aim was to analyze the relationships between the frailty index, age and mortality in a two year follow up study of Mexican elderly. Methods A frailty index was developed using 34 variables. To obtain the index, the mean of the total score for each individual was obtained. Survival analyses techniques were used to examine the risk ratios for the different levels of the frailty index. Kaplan-Meier estimates were obtained, adjusted for age and gender. Cox proportional hazards models were also built to obtain hazard ratio estimates. Results A total of 4082 participants was analyzed. Participants had an average age of 73 years and 52.5% were women. On average, participants were followed-up for 710 days (standard deviation = 111 days) and 279 of them died. Mortality increased with the frailty index level, especially in those with levels between .21 to .65, reaching approximately 17% and 21%, respectively. Cox proportional hazards models showed that participants with frailty index levels associated to increased mortality (.21 and higher) represent 24.0% of those aged 65-69 years and 47.6% of those 85 and older. Conclusion The frailty index shows the properties found in the other studies, it allows stratifying older Mexican into several groups different by the degree of the risk of mortality, and therefore the frailty index can be used in assessing health of elderly. PMID:19887005

  16. Dietary glycemic index, glycemic load, insulin index, fiber and whole-grain intake in relation to risk of prostate cancer.

    PubMed

    Nimptsch, K; Kenfield, S; Jensen, M K; Stampfer, M J; Franz, M; Sampson, L; Brand-Miller, J C; Willett, W C; Giovannucci, E

    2011-01-01

    Insulin may play a role in prostate cancer tumorigenesis. Postprandial blood glucose and insulin responses of foods depend importantly on the carbohydrate quality and quantity, represented by glycemic index (GI), glycemic load (GL), fiber and whole-grain content, but are also influenced by intake of protein and other characteristics. The recently developed insulin index (II) quantifies the postprandial insulin secretion, also taking into account these additional characteristics. We investigated the association between dietary GI, GL, II, fiber, and whole grains and risk of total prostate cancer (n = 5,112) and subgroups of prostate cancer as defined by stage or grade in 49,934 male participants of the Health Professionals Follow-up Study. Multivariate adjusted hazard ratios (HR) and 95% confidence intervals (95% CI) were estimated using Cox proportional hazards regression. Dietary GI, GL, II, or fiber was not associated with risk of total or subgroups of prostate cancer. We observed a positive association between dietary intake of whole grains and total prostate cancer (HR highest versus lowest quintile 1.13, 95% CI 1.03-1.24), which was attenuated after restriction to PSA-screened participants (HR 1.03, 95% CI 0.91-1.17). These results suggest that long-term exposure to a diet with a high insulin response does not affect prostate cancer incidence.

  17. American Society of Anesthesiologists Classification Versus ARISCAT Risk Index: Predicting Pulmonary Complications Following Renal Transplant.

    PubMed

    Kupeli, Elif; Er Dedekarginoglu, Balam; Ulubay, Gaye; Oner Eyuboglu, Fusun; Haberal, Mehmet

    2017-02-01

    Patients with chronic renal failure are prone to pulmonary complications. Renal transplant recipients should undergo complete preoperative evaluation to determine risk of postoperative pulmonary complications. The American Society of Anesthesiologists classification and the Assess Respiratory Risk in Surgical Patients in Catalonia risk index correlate well with incidence of postoperative pulmonary complications. Here, we compared their accuracy in predicting pulmonary complications following renal transplant. We retrospectively reviewed medical records of renal transplant recipients between years 2004 and 2015. We collected patient data on Assess Respiratory Risk in Surgical Patients in Catalonia risk index, including demographics, smoking history, comorbidities, preoperative pulmonary risk score, laboratory results, surgery information, history of lower respiratory tract infection 1 month pretransplant, urgency of surgery, American Society of Anesthesiologists classification, and pulmonary complications within 1 month posttransplant. Of 172 patients (123 males; mean age 38.82 y), 22 (12.8%) developed pulmonary complication during the first month posttransplant, including effusion (9 patients), pneumonia (10 patients), respiratory inefficiency (2 patients), and pulmonary embolism (1 patient). Atelectasis was observed in 95.4% of patients with complications. A positive correlation was observed between age and development of complications (r = 0.171; P = .025). Regarding risk score, 75% of patients at high risk and 19.5% at intermediate risk developed pulmonary complications. Patients with low-risk scores had significantly lower complications than intermediate- and high-risk groups (P < .001). A positive correlation was observed between preoperative risk score and complications (r = 0.34; P < .001). There was no association between the American Society of Anesthesiologists scores and postoperative complications (P = .7). The American Society of Anesthesiologists

  18. [Intervention with rumba and nutrition education to modify cardiovascular risk factors in adults with metabolic syndrome].

    PubMed

    Pérez-Idárraga, Alexandra; Valencia Gómez, Katerine; Gallo Villegas, Jaime; Arenas Sosa, Mónica; Quintero Velásquez, Mario A

    2015-01-01

    Evaluate the effect of an intervention with rumba dance and nutrition education on the cardiovascular risk factors in a group of people with metabolic syndrome in a rural area of Colombia. Controlled, randomized clinical trial that included 59 people between 30 and 60 years of age with metabolic syndrome. The intervention group (n = 30) participated in a 12-week exercise program of aerobic rumba (60 minutes, 3 days per week) and muscle-strengthening work (30 minutes, twice a week). Each week the group also received two hours of nutrition education. The control group (n = 29) continued with conventional care. An assessment was made of the effect on the cardiovascular risk factors (physiological, metabolic, anthropometric, and nutritional) in the intervention group. The intervention group showed a reduction in systolic blood pressure (-10.0 mmHg; CI95%: -14.3 to -5.6, P < 0.001), diastolic blood pressure (-4.8 mmHg; CI95%: -8.4 to -1.1, P < 0.05) and overall cardiovascular risk at 10 years (-1.5%; CI95%: -2.7 to -0.3, P < 0.05). Furthermore, there was an increase in peak oxygen con-sumption (1.7 ml O2∙kg-1∙min-1; CI95%: 0.1 to 3.3, P < 0.05) and muscular strength (P < 0.001). Positive changes were also observed in body composition, caloric intake, and consumption of macro and micronutrients (P < 0.05). No differences were detected between metabolic variables in the two groups or in inflammatory markers (P < 0.05). An exercise program with rumba and muscular strengthening, combined with nutrition education, favorably modifies cardiovascular risk factors in people with metabolic syndrome.

  19. Childhood Obesity Risk Evaluation based on perinatal factors and family sociodemographic characteristics: CORE index.

    PubMed

    Manios, Yannis; Birbilis, Manolis; Moschonis, George; Birbilis, George; Mougios, Vassilis; Lionis, Christos; Chrousos, George P

    2013-04-01

    The aim of this study was to develop an index that estimates late childhood obesity risk based on certain perinatal and family sociodemographic characteristics. The study was cross-sectional with retrospectively collected data from a representative sample of 2,294 primary schoolchildren, aged 9-13 years, in four counties from north, west, central, and south Greece. Mother's prepregnancy weight status, maternal smoking during pregnancy, maternal educational level, and infant weight gain in the first 6 months of life were combined with children's gender for the development of the Childhood Obesity Risk Evaluation (CORE) index. The score of the CORE index ranged from 0 to 11 units and each unit was associated with an obesity risk probability (range, 4-40 %). Cutoff point analysis revealed that a score ≤ 5 units best discriminated obese from non-obese children. On the basis of this cutoff point, the sensitivity of the CORE index was 54 % and the corresponding specificity 65 %. The proposed CORE index and the relevant percent risk probability chart could be used by pediatricians and other health professionals to identify children at high risk for obesity from early life. This simple and inexpensive tool could be useful in assisting early childhood obesity preventing initiatives.

  20. Diet Quality Index as a predictor of short-term mortality in the American Cancer Society Cancer Prevention Study II Nutrition Cohort.

    PubMed

    Seymour, Jennifer D; Calle, Eugenia E; Flagg, Elaine W; Coates, Ralph J; Ford, Earl S; Thun, Michael J

    2003-06-01

    The Diet Quality Index (DQI) was developed to measure overall dietary patterns and to predict chronic disease risk. This study examined associations between DQI and short-term all-cause, all-circulatory-disease, and all-cancer mortality in the American Cancer Society Cancer Prevention Study II Nutrition Cohort, a cohort of US adults aged 50-79 years enrolled in a prospective study. After 4 years of follow-up (1992-1996), there were 869 deaths among 63,109 women and 1,736 deaths among 52,724 men. All study participants reported being disease free at baseline in 1992-1993. In age-adjusted Cox models, a higher DQI, which was indicative of a poorer quality diet, was positively related to all-cause and all-circulatory-disease mortality rates in both women and men and to cancer mortality in men only. However, in fully adjusted Cox models, only circulatory disease mortality was clearly positively related to DQI and only in women (medium-low-quality diet vs. highest-quality diet: rate ratio = 1.86, 95% confidence interval: 1.19, 2.89). Although trend tests indicated significant positive relations between DQI and all-cause mortality, effects were small (rate ratios

  1. Nutritional Status among Rural Community Elderly in the Risk Area of Liver Fluke, Surin Province, Thailand.

    PubMed

    Kaewpitoon, Soraya J; Namwichaisirikul, Niwatchai; Loyd, Ryan A; Churproong, Seekaow; Ueng-Arporn, Naporn; Matrakool, Likit; Tongtawee, Taweesak; Rujirakul, Ratana; Nimkhuntod, Porntip; Wakhuwathapong, Parichart; Kaewpitoon, Natthawut

    2015-01-01

    Thailand is becoming an aging society, this presenting as a serious problem situation especially regarding health. Chronic diseases found frequently in the elderly may be related to dietary intake and life style. Surin province has been reported as a risk area for liver fluke with a high incidence of cholangiocarcinma especially in the elderly. Therefore, this study aimed to determine the nutritional status and associated factors among elderly in Surin province, northeast of Thailand. A community-based cross-sectional study was conducted among 405 people aged 60 years and above, between September 2012 and July 2014. The participants were selected through a randomized systematic sampling method and completed a pre-designed questionnaire with general information, food recorded, weight, height, waist circumference, and behavior regarding to food consume related to liver fluke infection. The data were analyzed using descriptive statistics and Spearman's rank correlation coefficients. The majority of participants was female (63.5%), age between 60-70 years old (75.6%), with elementary school education (96.6%), living with their (78.9%), and having underlying diseases (38.3%). Carbohydrate (95.3%) was need to improve the consumption. The participants demonstrated under-nutrition (24.4%), over-nutrition (16.4%), and obesity (15.4%). Elderly had a waist circumference as the higher than normal level (34.0%). Gender, female, age 71-80 years old, elementary school and underlying diseases were significantly associated with poor nutritional status. The majority of them had a high knowledge (43.0%), moderate attitude (44.4%), and moderate practice (46.2%) regarding food consumption related to liver fluke infection. In conclusion, these findings data indicated that elderly age group often have an under- or over-nutritional status. Carbohydrate consumption needs to be improved. Some elderly show behavior regarding food consumption that is related to liver fluke infection hat needs

  2. Nutritional knowledge, diet quality and breast or lung cancer risk: a case-control study of adults from Warmia and Mazury region in Poland.

    PubMed

    Hawrysz, Iwona; Krusińska, Beata; Słowińska, Małgorzata Anna; Wądołowska, Lidia; Czerwińska, Anna; Biernacki, Maciej

    2016-01-01

    Knowledge on proper nutrition favours the creation of pro-healthy nutritional behaviours of people. Studies related to the nutritional knowledge of adults, diet quality and incidence of breast or lung cancers are limited. Analysis of the relationship between the level of nutritional knowledge, diet quality and risk of breast cancer in women or lung cancer in men from the Warmia and Mazury region in Poland. The study was carried out in 202 subjects aged 23-80 years, including 107 women (17 cases of breast cancer) and 95 men (54 cases of lung cancer) from the Warmia and Mazury region in Poland. Nutritional knowledge was evaluated with the Questionnaire of Eating Behaviours (QEB), including 25 statements. Based on the frequency of the consumption of 16 food items, two diet quality indices were created: the pro-Healthy-Diet-Index-8 (pHDI-8) and the non-Healthy-Diet-Index-8 (nHDI-8). The values of pHDI-8 and nHDI-8 were calculated on the basis of the sum of the daily frequency of consumption of the selected food items and expressed as times/day. The Odds Ratio (OR) of both breast cancer or lung cancer in relation to the level of nutritional knowledge was calculated based on a logistic regression analysis. The incidence of breast or lung cancer in the bottom, middle and upper tertile of nutritional knowledge was 57.6%, 32.6% and 15.8%, respectively. As nutritional knowledge grew in the subsequent tertiles, pHDI-8 was on the increase (2.63 vs. 3.78 vs. 4.22 times/day) and n-HDI-8 was on the decrease (1.32 vs. 1.21 vs. 0.94 times/day). In the upper tertile of nutritional knowledge, the Odds Ratio for the incidence of breast or lung cancers varied from 0.06 (95% CI: 0.02; 0.17; p<0.05, with adjustment for cancer type and age) to 0.17 (95% CI: 0.04; 0.69; p<0.05, with adjustment for age and sex) when compared to the bottom tertile (OR=1.00). In the middle tertile of nutritional knowledge, the Odds Ratio of both cancers varied from 0.27 (95% CI: 0.12; 0.62, p<0.05, with

  3. ENSO-Based Index Insurance: Approach and Peru Flood Risk Management Application

    NASA Astrophysics Data System (ADS)

    Khalil, A. F.; Kwon, H.; Lall, U.; Miranda, M. J.; Skees, J. R.

    2006-12-01

    Index insurance has recently been advocated as a useful risk transfer tool for disaster management situations where rapid fiscal relief is desirable, and where estimating insured losses may be difficult, time consuming, or subject to manipulation and falsification. For climate related hazards, a rainfall or temperature index may be proposed. However, rainfall may be highly spatially variable relative to the gauge network, and in many locations data are inadequate to develop an index due to short time-series and the spatial dispersion of stations. In such cases, it may be helpful to consider a climate proxy index as a regional rainfall index. This is particularly useful if a long record is available for the climate index through an independent source and it is well correlated with the regional rainfall hazard. Here, ENSO related climate indices are explored for use as a proxy to extreme rainfall in one of the departments of Peru -- Piura. The ENSO index insurance product may be purchased by banks or microfinance institutions (MFIs) to aid agricultural damage relief in Peru. Crop losses in the region are highly correlated with floods, but are difficult to assess directly. Beyond agriculture, many other sectors suffer as well. Basic infrastructure is destroyed during the most severe events. This disrupts trade for many micro-enterprises. The reliability and quality of the local rainfall data is variable. Averaging the financial risk across the region is desirable. Some issues with the implementation of the proxy ENSO index are identified and discussed. Specifically, we explore (a) the reliability of the index at different levels of probability of exceedance of maximum seasonal rainfall; (b) the potential for clustering of payoffs; (c) the potential that the index could be predicted with some lead time prior to the flood season; and (d) evidence for climate change or non-stationarity in the flood exceedance probability from the long ENSO record. Finally, prospects for

  4. Association between selenium nutritional status and metabolic risk factors in men with visceral obesity.

    PubMed

    Mutakin; Meiliana, Anna; Wijaya, Andi; Kobayashi, Kenji; Yamazaki, Chiho; Kameo, Satomi; Nakazawa, Minato; Koyama, Hiroshi

    2013-04-01

    Previous evidence has suggested an association between selenium and cardiovascular disease, which is main outcome of metabolic syndrome. The aim of this study was to examine possible correlation between selenium nutritional status and metabolic risk factors in men with visceral obesity. Plasma samples were collected from 123 Indonesian men with visceral obesity. Their metabolic risk factors and selenium nutritional status were analyzed. The eligible subjects (n=78) were stratified according to the International Diabetes Federation: obese, obese plus one component, and obese plus two components or more. Obese plus two components or more were diagnostic criteria of metabolic syndrome. Pearson's correlation was performed to examine the correlation in each group. In the obese group, selenium positively correlated with high-density lipoprotein (HDL) cholesterol (r=0.390, P<0.05) and with fatty acid binding protein-4 (FABP4) (r=0.474, P<0.05); glutathione peroxidase-3 (GPx3) activity was inversely correlated with FABP4 (r=-467, P<0.05). In the obese plus one component group, GPx3 activity positively correlated with HDL cholesterol (r=0.413, P<0.05). In the metabolic syndrome group, selenium negatively correlated with monocytes chemoattractant protein (MCP)-1 (r=-0.429, P<0.05). These results show that the association between selenium nutritional status and metabolic risk factors is limited to particular group of obese men with or without metabolic syndrome. Copyright © 2012. Published by Elsevier GmbH.

  5. Adult height and risk of breast cancer: a possible effect of early nutrition

    PubMed Central

    Nilsen, T I Lund; Vatten, L J

    2001-01-01

    The relationship of breast cancer to early reproductive development and height suggests that fetal and childhood nutrition may be important in its aetiology. Caloric restriction sufficient to reduce adult height may reduce breast cancer risk. During World War II (WWII) there was a marked reduction in average caloric intake in Norway that resulted in greater nutritional diversity. We hypothesized that a positive association between height and risk of breast cancer would be stronger among women who were born during this period than among women born before or after the war. A total of 25 204 Norwegian women were followed up for approximately 11 years, and 215 incident cases of breast cancer were registered. We found the strongest positive association between height and breast cancer among women born during WWII: women in the tallest tertile (>167 cm) had a relative risk of 2.5 (95% confidence interval = 1.2–5.5) compared with the shortest (≤ 162 cm). Among women born before or after the war we found no clear association with height. The association with height in the WWII cohort may imply a role for early nutrition in breast cancer aetiology. © 2001 Cancer Research Campaignhttp://www.bjcancer.com PMID:11592765

  6. Impact of genetic risk assessment on nutrition-related lifestyle behaviours

    PubMed Central

    Vernarelli, Jacqueline A.

    2013-01-01

    Genetic susceptibility testing for common complex disease is a practice that is currently in clinical use. There are two types of gene mutations, and therefore, two varieties of genotype testing: deterministic and susceptibility. As the term suggests, deterministic genes determine whether or not a person will develop a given trait in Mendelian fashion, such as Huntington’s disease. Genotype screening for such deterministic mutations has existed for decades, and is commonly used in routine medical practice. In recent years, the sequencing of the human genome has identified several ‘susceptibility genes’ or genes with incomplete penetrance. Mutations in these genes may increase disease susceptibility, but are not causative for disease. Genetic susceptibility testing allows unaffected individuals to obtain risk information for a variety of common complex diseases and health conditions including Alzheimer’s disease (AD), CVD, cancer and diabetes. The availability of genetic susceptibility testing has increased over the past decade, and several studies are now focusing on the impact that genetic testing has on health and other lifestyle behaviours related to nutrition. The aim of this paper is to review the literature and evaluate what, if any, impact genetic risk assessment has on behaviours related to nutrition and physical activity. This paper summarises seven clinical studies that evaluated the impact of disclosing genetic risk information for disease on nutrition-related health behaviour changes. Of these seven studies, only three studies reported that health behaviour change was influenced by genotype disclosure. PMID:23095764

  7. Type 2 diabetes mellitus unawareness, prevalence, trends and risk factors: National Health and Nutrition Examination Survey (NHANES) 1999–2010

    PubMed Central

    Zhang, Nana; Yang, Xin; Zhu, Xiaolin; Zhao, Bin; Huang, Tianyi

    2017-01-01

    Objectives To determine whether the associations with key risk factors in patients with diagnosed and undiagnosed type 2 diabetes mellitus (T2DM) are different using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010. Methods The study analysed the prevalence and association with risk factors of undiagnosed and diagnosed T2DM using a regression model and a multinomial logistic regression model. Data from the NHANES 1999–2010 were used for the analyses. Results The study analysed data from 10 570 individuals. The overall prevalence of diagnosed and undiagnosed T2DM increased significantly from 1999 to 2010. The prevalence of undiagnosed T2DM was significantly higher in non-Hispanic whites, in individuals <30 years old and in those with near optimal (130–159 mg/dl) or very high (≥220 mg/dl) non-high-density lipoprotein cholesterol levels compared with diagnosed T2DM. Body mass index, low economic status or low educational level had no effect on T2DM diagnosis rates. Though diagnosed T2DM was associated with favourable diet/carbohydrate intake behavioural changes, it had no effect on physical activity levels. Conclusion The overall T2DM prevalence increased between 1999 and 2010, particularly for undiagnosed T2DM in patients that were formerly classified as low risk. PMID:28415936

  8. Type 2 diabetes mellitus unawareness, prevalence, trends and risk factors: National Health and Nutrition Examination Survey (NHANES) 1999-2010.

    PubMed

    Zhang, Nana; Yang, Xin; Zhu, Xiaolin; Zhao, Bin; Huang, Tianyi; Ji, Qiuhe

    2017-04-01

    Objectives To determine whether the associations with key risk factors in patients with diagnosed and undiagnosed type 2 diabetes mellitus (T2DM) are different using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010. Methods The study analysed the prevalence and association with risk factors of undiagnosed and diagnosed T2DM using a regression model and a multinomial logistic regression model. Data from the NHANES 1999-2010 were used for the analyses. Results The study analysed data from 10 570 individuals. The overall prevalence of diagnosed and undiagnosed T2DM increased significantly from 1999 to 2010. The prevalence of undiagnosed T2DM was significantly higher in non-Hispanic whites, in individuals <30 years old and in those with near optimal (130-159 mg/dl) or very high (≥220 mg/dl) non-high-density lipoprotein cholesterol levels compared with diagnosed T2DM. Body mass index, low economic status or low educational level had no effect on T2DM diagnosis rates. Though diagnosed T2DM was associated with favourable diet/carbohydrate intake behavioural changes, it had no effect on physical activity levels. Conclusion The overall T2DM prevalence increased between 1999 and 2010, particularly for undiagnosed T2DM in patients that were formerly classified as low risk.

  9. Stability of infant and child feeding index over time and its association with nutritional status of HIV exposed infants in Sidama Zone, Southern Ethiopia: a longitudinal study.

    PubMed

    Haile, Demewoz; Belachew, Tefera; Berhanu, Getenesh; Setegn, Tesfaye; Biadgilign, Sibhatu

    2014-12-01

    Even though many studies showed that infant and child feeding index has a statistically significant association with nutritional status, there is paucity of studies on stability of infant and child feeding index over time and its association with nutritional status of HIV exposed infants. This study aimed to investigate the stability of infant and child feeding index over time that is developed based on the current recommendations and its association with nutritional status of HIV exposed infants in Sidama Zone, Southern Ethiopia. A panel study design was conducted in health institutions in Sidama Zone from February to July, 2012. Three repeated measurements of data were collected from each HIV exposed infant aged 6-17 months over the 6 month follow-up period approximately per 2 month interval. The cross-sectional index was found stable overtime with the repeatability coefficient of 0.802 which differed significantly from zero (95% CI: 0.75-0.85). A longitudinal infant and child feeding index (L-ICFI) has a statistically significant association with length for age Z scores (LAZ) and weight for age Z scores (WAZ) at visit three (β=0.262, p=0.007; β=0.226, p=0.017), respectively. But the longitudinal index has no statistically significant association with WLZ score (p=0.552). There was no significant difference in change of LAZ and WAZ over time between L-ICFI tertiles for both female and male HIV exposed infants. The index is stable overtime at individual level even though one third of the index components were not stable. The L-CFI was associated with LAZ and WAZ but not with WLZ. However there was no significant difference in change of HAZ and WAZ over time between L-ICFI tertiles for both female and male HIV exposed infants. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. A Preoperative Nutritional Index for Predicting Cancer-Specific and Overall Survival in Chinese Patients With Laryngeal Cancer

    PubMed Central

    Fu, Yan; Chen, Shu-Wei; Chen, Shi-Qi; Ou-Yang, Dian; Liu, Wei-Wei; Song, Ming; Yang, An-Kui; Zhang, Quan

    2016-01-01

    Abstract Pinato prognostic nutritional index (PNI) adequately predicts long-term outcomes of various malignancies. However, its value in predicting outcomes in laryngeal squamous cell carcinoma (LSCC) is unknown. All patients newly diagnosed with LSCC presenting to the Department of Head and Neck Oncology at Sun Yat-sen University Cancer Center between January 1, 1990 and July 31, 2010 were eligible. The PNI was calculated as serum albumin (g/L) + 5 × total lymphocyte count/L. The Cutoff Finder software program was used to classify the patients into 3 groups for which the PNI score was at least 70% sensitive, at least 70% specific, or equivocal. Cancer-specific survival was estimated using the Kaplan–Meier method, and predictors were assessed with Cox regression analysis. Median time between surgery and PNI administration for the 975 eligible patients was 83 months. Index score groups were significantly associated with age, T stage, TNM stage, and type of surgery. Five-year CSS and OS were 57.3% and 56.6% in patients with PNI scores below 48.65 (low-probability of survival), 72.8% and 71.3% with scores between 48.65 and 56.93 (moderate-probability of survival), and 77.6% and 75.3% with scores above 56.93 (high-probability of survival); 10-year CSS and OS were 44.2% and 42.7%, 61.6% and 55.6%, 68.3% and 63.5%, respectively. The PNI score groups significantly predicted CSS and OS (P < 0.001). The PNI is an inexpensive and readily available score that predicted survival in patients with LSCC after curative laryngectomy. PMID:26986105

  11. Nutritional status of children and adolescents based on body mass index: agreement between World Health Organization and International Obesity Task Force.

    PubMed

    Cavazzotto, Timothy Gustavo; Brasil, Marcos Roberto; Oliveira, Vinicius Machado; da Silva, Schelyne Ribas; Ronque, Enio Ricardo V; Queiroga, Marcos Roberto; Serassuelo Junior, Helio

    2014-03-01

    To investigate the agreement between two international criteria for classification of children and adolescents nutritional status. The study included 778 girls and 863 boys aged from six to 13 years old. Body mass and height were measured and used to calculate the body mass index. Nutritional status was classified according to the cut-off points defined by the World Health Organization and the International Obesity Task Force. The agreement was evaluated using Kappa statistic and weighted Kappa. In order to classify the nutritional status, the agreement between the criteria was higher for the boys (Kappa 0.77) compared to girls (Kappa 0.61). The weighted Kappa was also higher for boys (0.85) in comparison to girls (0.77). Kappa index varied according to age. When the nutritional status was classified in only two categories--appropriate (thinness + accentuated thinness + eutrophy) and overweight (overweight + obesity + severe obesity)--, the Kappa index presented higher values than those related to the classification in six categories. A substantial agreement was observed between the criteria, being higher in males and varying according to the age.

  12. Nutritional status of children and adolescents based on body mass index: agreement between World Health Organization and International Obesity Task Force

    PubMed Central

    Cavazzotto, Timothy Gustavo; Brasil, Marcos Roberto; Oliveira, Vinicius Machado; da Silva, Schelyne Ribas; Ronque, Enio Ricardo V.; Queiroga, Marcos Roberto; Serassuelo, Helio

    2014-01-01

    Objective: To investigate the agreement between two international criteria for classification of children and adolescents nutritional status. Methods: The study included 778 girls and 863 boys aged from six to 13 years old. Body mass and height were measured and used to calculate the body mass index. Nutritional status was classified according to the cut-off points defined by the World Health Organization and the International Obesity Task Force. The agreement was evaluated using Kappa statistic and weighted Kappa. Results: In order to classify the nutritional status, the agreement between the criteria was higher for the boys (Kappa 0.77) compared to girls (Kappa 0.61). The weighted Kappa was also higher for boys (0.85) in comparison to girls (0.77). Kappa index varied according to age. When the nutritional status was classified in only two categories - appropriate (thinness + accentuated thinness + eutrophy) and overweight (overweight + obesity + severe obesity) -, the Kappa index presented higher values than those related to the classification in six categories. Conclusions: A substantial agreement was observed between the criteria, being higher in males and varying according to the age. PMID:24676189

  13. A comparison of the environmental impact of different AOPs: risk indexes.

    PubMed

    Giménez, Jaime; Bayarri, Bernardí; González, Óscar; Malato, Sixto; Peral, José; Esplugas, Santiago

    2014-12-31

    Today, environmental impact associated with pollution treatment is a matter of great concern. A method is proposed for evaluating environmental risk associated with Advanced Oxidation Processes (AOPs) applied to wastewater treatment. The method is based on the type of pollution (wastewater, solids, air or soil) and on materials and energy consumption. An Environmental Risk Index (E), constructed from numerical criteria provided, is presented for environmental comparison of processes and/or operations. The Operation Environmental Risk Index (EOi) for each of the unit operations involved in the process and the Aspects Environmental Risk Index (EAj) for process conditions were also estimated. Relative indexes were calculated to evaluate the risk of each operation (E/NOP) or aspect (E/NAS) involved in the process, and the percentage of the maximum achievable for each operation and aspect was found. A practical application of the method is presented for two AOPs: photo-Fenton and heterogeneous photocatalysis with suspended TiO2 in Solarbox. The results report the environmental risks associated with each process, so that AOPs tested and the operations involved with them can be compared.

  14. ERICA: A multiparametric toxicological risk index for the assessment of environmental healthiness.

    PubMed

    Boriani, Elena; Mariani, Alessandro; Baderna, Diego; Moretti, Cinzia; Lodi, Marco; Benfenati, Emilio

    2010-10-01

    A risk assessment strategy considering the impact of chemicals on the whole ecosystem has been developed in order to create a sound and useful method for quantifying and comparing the global risk posed by the main different hazardous chemicals found in the environment. This index, called Environmental Risk Index for Chemical Assessment (ERICA), merges in a single number the environmental assessment, the human health risk assessment and the uncertainty due to missing or uncertain data. ERICA uses a dedicated scoring system with parameters for the main characteristics of the pollutants. The main advantage is that it preserves a simple approach by condensing in this single value an analysis of the risk for the area under observation. ERICA quantifies and compares the global risk posed by hazardous chemicals found in the environment and can be considered a diagnostic and prognostic method for environmental contaminants in critical and potentially dangerous sites, such as incinerators, landfills and industrial areas or in broader geographical areas. The application of the proposed integrated index provides a preliminary quantitative analysis of possible environmental alert due to the presence of one or some pollutants in the investigated site. This paper presents the method and the equations behind the index and a first case study based on the Italian legislation and a pilot study located on the Italian seacoast. Copyright 2010 Elsevier Ltd. All rights reserved.

  15. Index models to evaluate the risk of phosphorus and nitrogen loss at catchment scales.

    PubMed

    Drewry, J J; Newham, L T H; Greene, R S B

    2011-03-01

    This paper investigates index models as a tool to estimate the risk of N and P source strengths and loss at the catchment scale. The index models assist managers in improving the focus of remediation actions that reduce nutrient delivery to waterbodies. N and P source risk factors (e.g. soil nutrient concentrations) and transport risk factors (e.g. distance-to-streams) are used to determine the overall risk of nutrient loss for a case study in the Tuross River catchment of coastal southeast Australia. In the development of the N index model for Tuross, particulate N was considered important based on the observed event water quality data. In contrast to previous N index models, erosion and contributing distance were therefore included in the Tuross River catchment N index. Event-based water quality monitoring, and soil information, or in data-poor catchments conceptual understanding, are essential to represent catchment-scale processes. The techniques have high applicability in other catchments, and are complementary to other modelling techniques such as process-based semi-distributed modelling. Index models generally provide much more detailed spatial resolution than fully- or semi-distributed conceptual modelling approaches. Semi-distributed models can be used to quantify nutrient loads and provide overall direction to set the broad focus of management. Index models can then be used to refine on-the-ground investigations and investment priorities. In this way semi-distributed models can be combined with index models to provide a set of powerful tools to influence management decisions and outcomes. Copyright © 2010 Elsevier Ltd. All rights reserved.

  16. Informing Early Childhood Policy: An Analysis of the Sensitivity of a School Readiness Risk Index to Changes in Indicator Selection

    ERIC Educational Resources Information Center

    Schumacher, Krista S.

    2015-01-01

    The importance of school readiness to both the future of an individual child and society as a whole has given rise to several state-specific indexes designed to measure county-level risk for starting school unprepared to learn. One such index is the Oklahoma School Readiness Risk Index (OK SRRI), comprised of indicators known to be associated with…

  17. Informing Early Childhood Policy: An Analysis of the Sensitivity of a School Readiness Risk Index to Changes in Indicator Selection

    ERIC Educational Resources Information Center

    Schumacher, Krista S.

    2015-01-01

    The importance of school readiness to both the future of an individual child and society as a whole has given rise to several state-specific indexes designed to measure county-level risk for starting school unprepared to learn. One such index is the Oklahoma School Readiness Risk Index (OK SRRI), comprised of indicators known to be associated with…

  18. Rural middle school nutrition and physical activity environments and the change in body mass index during adolescence.

    PubMed

    Demment, Margaret; Wells, Nancy; Olson, Christine

    2015-02-01

    For rural adolescents, schools are among the few places where environmental interventions can promote health outside of the home. The goal of this study was to assess the nutrition and physical activity (N&PA) environments of schools attended by a birth cohort and examine the association with change in body mass index (BMI) from sixth to eighth grade. Using data from adolescents of a rural New York State birth cohort (N = 281), we used linear mixed models to identify N&PA environments associated with change in BMI. We also examined family income trajectory as a potential modifier to consider how the association between school environment and change in BMI might differ depending on income. We found considerable heterogeneity in environments within and between schools. Among students with low-income trajectories, reductions in BMI z-scores were associated with school environments that promote better physical education (PE) and general (non-PE, non-sport) physical activity. Schools with better sports environments were associated with reductions in BMI for some students, but not lower-income students. School environments may have differing effects on students depending on their socioeconomic status. Strategies are needed to identify and address barriers that impair low-income students' access to health-promoting school resources. © 2015, American School Health Association.

  19. Prognostic nutritional index predicts short-term outcomes after liver resection for hepatocellular carcinoma within the Milan criteria

    PubMed Central

    Li, Na; Ren, Yifan; Shi, Aihua; Lv, Yi; He, Haiqi

    2016-01-01

    Background The prognostic nutritional index (PNI) is calculated based on the serum albumin concentration and the total lymphocyte count. The aim of this study was to investigate the prognostic ability of the PNI for postoperative complications after liver resection to treat hepatocellular carcinoma (HCC) within the Milan criteria. Results Postoperative complications were observed in 166 (44.6%) patients. The optimal cutoff value of the PNI was set at 45.6 for postoperative complications. Patients in the PNI-low (PNI < 45.6) group were more likely to have postoperative complications, more blood loss, a longer surgery time and a longer hospital stay than patients in the PNI-high group (PNI > 45.6). Our regression analysis demonstrated that the preoperative PNI and albumin-bilirubin (ALBI) score were significantly associated with postoperative complications (Pearson correlation coefficient, -0.865, p < 0.001). The multivariate analysis revealed that the PNI was an independent predictor of postoperative complications. Materials and Methods Three-hundred and seventy-two patients who underwent partial hepatectomy for HCC from 2003 to 2014 were identified. The cutoff value of the PNI was determined by a receiver operating characteristic (ROC) curve analysis. Univariate and multivariate analyses were performed to identify clinicopathological features associated with postoperative complications. Conclusion The PNI may be a significant prognostic factor for evaluating short-term outcomes of patients with HCC after partial hepatectomy. PMID:27835570

  20. Ecological risks of trace metals in Guanabara Bay, Rio de Janeiro, Brazil: An index analysis approach.

    PubMed

    de Carvalho Aguiar, Valquiria Maria; de Lima, Michelle Nunes; Abuchacra, Rodrigo Coutinho; Abuchacra, Paula Ferreira Falheiro; Neto, José Antônio Baptista; Borges, Heloísa Vargas; de Oliveira, Vitor Calôr

    2016-11-01

    Total concentrations of Ni, Cr, Cu, Pb and Zn were determined in surface sediments from 30 stations in Guanabara Bay in 1999 and 2008. An approach using various environmental indices was used to assess contamination status of metals. This approach allowed the comparison with different coastal areas. Background Enrichment Index, Contamination index and Ecological Risk index (Pollution Load Index; Sediment Quality Guideline Quotient and Ecological Risk Index) were calculated for the metals. Results revealed a great load of organic matter and significant increases in Cu and Pb levels between 1999 and 2008. The concentrations of Cr and Zn were of great concern, surpassing the values of Probable Effect Level reference values. In spite of the differences of each index, results effectively revealed the striking contamination in Guanabara Bay concerning trace metals, and also suggested potential risk to local biota. The contamination of the northwest area was notably higher than the rest of the bay. In comparison with some other coastal bays around the world, Guanabara Bay stood out as a remarkably contaminated environment.

  1. Human Research Program Human Health Countermeasures Element Nutrition Risk Standing Review Panel

    NASA Technical Reports Server (NTRS)

    Bistrian, Bruce

    2009-01-01

    The Nutrition Risk Standing Review Panel (SRP) reviewed and discussed the specific gaps and tasks for the Human Health Countermeasures (HHC) Element related to nutrition identified in the Human Research Program (HRP) Integrated Research Plan. There was general consensus that the described gaps and proposed tasks were critical to future NASA mission success. The SRP acknowledged the high scientific quality of the work currently being undertaken by the Nutritional Biochemistry group under the direction of Dr. Scott Smith. In review of the entire HRP, four new gaps were identified that complement the Element's existing research activities. Given the limitations of ground-based analogs for many of the unique physiological and metabolic alterations in space, future studies are needed to quantify nutritional factors that change during actual space flight. In addition, future tasks should seek to better evaluate the time course of physiological and metabolic alterations during flight to better predict alterations during longer duration missions. Finally, given the recent data suggesting a potential role for increased inflammatory responses during space flight, the role of inflammation needs to be explored in detail, including the development of potential countermeasures and new ground based analogs, if this possibility is confirmed.

  2. Synthetic and natural nutritional supplements: health "allies" or risk to public health?

    PubMed

    Kioukia-Fougia, Nassia; Georgiadis, Nikolaos; Tsarouhas, Konstantinos; Vasilaki, Fotini; Fragkiadaki, Persefoni; Meimeti, Evangelia; Tsitsimpikou, Christina

    2016-09-23

    The modern way of life involves high stress levels, poor eating habits, lack of exercise, obesity and other detrimental health factors. Nutritional supplements (NS) are complexes of nutrients with variant activity that may infer reversal to nutrient depletion. They tend to be popular amongst social categories associated with the healthy life style, such as the elite and amateur athletes, military people and the general population. An overview of the state of play with regards to nutritional supplements -natural and synthetic-, is important both from toxicological and commercial point of view. From a thorough literature review on nutritional supplements, several patents of application have been identified and herewith reviewed, that recommend natural vegetable extracts as food supplements for prophylaxis, therapy, protection of immune system, diabetes, oxidative stress, cancer, chronic inflammations and other health conditions. Besides,