Association of Body Composition, Physical Functioning, and Protein Intake in Adult Patients With Mitochondrial Diseases
Zweers, Heidi E.E. ; Bordier, Valentine ; ‘t Hulst, Jeanne in; Janssen, Mirian C.H. ; Wanten, Geert J.A. ; Leij-Halfwerk, Susanne - \ 2020
Journal of Parenteral and Enteral Nutrition (2020). - ISSN 0148-6071
BIA - body composition - DXA - handgrip strength - malnutrition - mitochondrial disease - nutrition assessment - physical functioning - sarcopenia
Background: Whether decreased physical functioning of patients with mitochondrial disease (MD) is related to altered body composition or low protein intake needs clarification at the background of the nutrition state. Methods: In this 2-site cross-sectional study, MD patients were age-, body mass index (BMI)–, and gender-matched to controls. Body composition was assessed by dual-energy x-ray absorptiometry. Physical functioning was measured by handgrip strength, 6-minute walking test, 30-second sit-to-stand test (30SCT), and 6-minute mastication test. Total daily protein intake was calculated by 3-day food records. Malnutrition was assessed by Patient-Generated Subjective Global Assessment and the Global Leadership Initiative on Malnutrition (GLIM) criteria and sarcopenia by the 2018 consensus. Data were analyzed using independent samples t-tests, Fisher exact test, and Spearman and Pearson correlation coefficients. Results: Thirty-seven MD patients (42 ± 12 years, BMI: 23 ± 4 kg/m2, 59% females) and 37 matched controls were included. Handgrip strength was moderate, inversely related to fat mass index in both MD patients and controls, whereas it correlated with fat-free mass index in controls solely. Protein intake was associated with muscle strength (handgrip strength and 30SCT) in MD patients but not in controls. Twenty-seven MD patients (73%) were malnourished, and 5 (14%) were classified as sarcopenic. Conclusions: Muscle strength is related to body composition and protein intake in MD patients. This, in combination with the high incidence of both malnutrition and sarcopenia, warrants individual nutrition assessment in MD patients.
Nutritional care: The 'poor child' of clinical care in children with cerebral palsy
Snik, D.A.C. ; Jongerius, P.H. ; Roos, N.M. de; Verschuren, O. - \ 2019
Journal of Pediatric Rehabilitation Medicine 12 (2019)2. - ISSN 1874-5393 - p. 133 - 138.
body composition - cerebral palsy - malnutrition - Nutrition - nutritional management
There is a considerable risk of malnutrition for children with Cerebral Palsy (CP) due to insufficient nutritional intake. The most important causes of insufficient intake are feeding problems which are highly prevalent in children with CP (depending on definition, age and heterogeneity of the researched population). Considering these facts, nutritional status should have the full attention of healthcare professionals but this is not yet the case. Evidence from research in clinical practice suggests that: 1) there is no consensus regarding who should perform the measurement and how often, 2) no standardised nutritional assessment is implemented, and 3) there is suboptimal communication and management about feeding and nutritional status in most healthcare networks. To overcome these problems, validated and practical tools for the screening and assessment of nutritional status should be a topic of research and subsequently made available and implemented in clinical practice. Because body composition is an objective indicator of available energy stores, research should focus on optimising measurement methods to determine body composition using anthropometric measures or bioelectrical impedance analysis (BIA). Furthermore, there is a definite need among health care providers for explicit and clear agreements on organisation and communication about nutritional care for children with CP.
Conventional and food-to-food fortification: An appraisal of past practices and lessons learned
Chadare, Flora Josiane ; Idohou, Rodrigue ; Nago, Eunice ; Affonfere, Marius ; Agossadou, Julienne ; Fassinou, Toyi Kévin ; Kénou, Christel ; Honfo, Sewanou ; Azokpota, Paulin ; Linnemann, Anita R. ; Hounhouigan, Djidjoho J. - \ 2019
Food Science and Nutrition 7 (2019)9. - ISSN 2048-7177 - p. 2781 - 2795.
food fortification - malnutrition - micronutrient deficiencies - outcomes
Food fortification is an important nutrition intervention to fight micronutrient deficiencies and to reduce their incidence in many low- and middle-income countries. Food fortification approaches experienced a significant rise in the recent years and have generated a lot of criticism. The present review aimed to shed light on the actual effect of food fortification approaches on the reduction of malnutrition. A set of 100 articles and reports, which have dealt with the impact of food fortification on malnutrition, were included in this review. This review identified a broad selection of local raw materials suitable for a food-to-food fortification approach.
Energy and Protein Intake of Alzheimer's Disease Patients Compared to Cognitively Normal Controls : Systematic Review
Doorduijn, Astrid S. ; Rest, Ondine van de; Flier, Wiesje M. van der; Visser, Marjolein ; Schueren, Marian A.E. de van der - \ 2019
Journal of the American Medical Directors Association 20 (2019)1. - ISSN 1525-8610 - p. 14 - 21.
malnutrition - mild cognitive impairment - Older adults
Objectives: Protein and energy malnutrition and unintended weight loss are frequently reported in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Possible underlying mechanisms include increased energy expenditure, altered uptake of nutrients, a reduced nutritional intake, or a combination of these 3. We aimed at systematically reviewing the literature to examine potential differences in energy and protein intake in patients with MCI and AD compared to controls as a possible mechanism for unintended weight loss. Design: Systematic review and meta-analysis. Setting: PubMed and Cochrane Electronic databases were searched from inception to September 2017 for case control studies. Participants: Patients with MCI or AD compared to cognitive healthy controls, all adhering to a Western dietary pattern. Measurements: Energy and protein intake. Results: The search resulted in 7 articles on patients with AD versus controls, and none on patients with MCI. Four articles found no differences in energy and protein intakes, 1 found higher intakes in patients with AD, and 1 article found lower intakes in patients with AD compared to controls. One article reported on intakes, but did not test differences. A meta-analysis of the results indicated no difference between patients with AD and controls in energy [−8 kcal/d, 95% confidence interval (CI): −97, 81; P = .85], or protein intake (2 g/d, 95% CI: −4, 9; P = .47). However, heterogeneity was high (I2 > 70%), and study methodology was generally poor or moderate. Conclusion: Contrary to frequently reported unintended weight loss, our systematic review does not provide evidence for a lower energy or protein intake in patients with AD compared to controls. High heterogeneity of the results as well as of participant characteristics, setting, and study methods was observed. High-quality studies are needed to study energy and protein intake as a possible mechanism for unintended weight loss and malnutrition in both patients with MCI and AD.
Human nutrition : a crunchy bite
Kok, F.J. - \ 2015
Wageningen : Wageningen University - ISBN 9789462573703 - 28
obesity - malnutrition - infant nutrition - nutrition and health - nutrition research - human nutrition research - vitamins - aging - pregnancy - abdominal fat - body fat - obesitas - slechte voeding - zuigelingenvoeding - voeding en gezondheid - voedingsonderzoek - voedingsonderzoek bij de mens - vitaminen - verouderen - zwangerschap - buikvet - lichaamsvet
Farewell address upon retiring as Professor of Nutrition and Health
at Wageningen University on 15 October 2015
Inequalities in Food Security and Nutrition. A Life Course Perspective
Bras, H. - \ 2015
Wageningen : Wageningen University - ISBN 9789462571891 - 36
voedselzekerheid - voeding - slechte voeding - gezondheidsongelijkheden - honger - levensloop - wereld - food security - nutrition - malnutrition - health inequalities - hunger - life course - world
The double burden of malnutrition: obesity and iron deficiency
Cepeda López, A.C. - \ 2015
Wageningen University. Promotor(en): Michael Zimmermann, co-promotor(en): Alida Melse-Boonstra; I. Herter Aeberli; S. Osendarp. - Wageningen : Wageningen University - ISBN 9789462574465 - 158
obesitas - overgewicht - ijzergebrekanemie - gebreksziekten - slechte voeding - ontsteking - ijzerabsorptie - ascorbinezuren - ascorbinezuur - vrouwen - kinderen - kindervoeding - bloedvolume - mens - obesity - overweight - iron deficiency anaemia - deficiency diseases - malnutrition - inflammation - iron absorption - ascorbic acids - ascorbic acid - women - children - child nutrition - blood volume - man
Background: The world faces a “double burden” of malnutrition; this is true especially in transition countries like Mexico. The co-existence of obesity and iron deficiency (ID) within a person has been clearly demonstrated in several studies but the mechanisms linking them remain largely unknown.
Objectives: To investigate possible mechanisms that link obesity and iron status through the following specific objectives: a) reviewing the existing literature; b) investigating the coexistence of obesity and iron deficiency at the national level in Mexico; c) assessing and comparing iron absorption and blood volume (BV) in healthy, non-anemic women from different body mass index (BMI) categories, and evaluating if ascorbic acid improves iron absorption in overweight (OW) and obese (OB) women; d) evaluating if differences in BV explains reduced iron status in OW/OB women; and e) evaluating whether fat loss in obese subjects decreases inflammation and serum hepcidin and thereby improves iron absorption.
Methods: a) A literature review was conducted using Google Scholar and PubMed search engines; b) data from the 1999 Mexican Nutrition Survey, which included 1174 children (aged 5–12 y) and 621 nonpregnant women (aged 18–50 y), was used to assess the relationship between BMI, dietary iron, and dietary factors affecting iron bioavailability, iron status, and inflammation; c & d) healthy, non-anemic Swiss women (n=62) (BMI 18.5-39.9 kg/m2) consumed a stable-isotope labelled wheat-based test meal, without (-AA) and with (+AA) 31.4 mg ascorbic acid. We measured iron absorption, body composition by dual energy X-ray absorptiometry (DXA), blood volume by carbon monoxide (CO)-rebreathing method, iron status, inflammation and serum hepcidin; e) We performed a 6-month, prospective study in OB (BMI, ≥35<45 kg/m2) adults from Mexico (n=..), who had recently undergone laparoscopic sleeve-gastrectomy (LSG). At 2 months and 8 months post-LSG, subjects consumed a test drink with 6mg 57Fe as ferrous sulfate and were intravenously infused with 100 μg 58Fe as iron citrate and we measured body composition by DXA, iron status, hepcidin and inflammation.
Results: a) Obesity-related subclinical inflammation and its effects on hepcidin levels seem to be the most plausible explanation for the link between ID and obesity; b) the risk of iron deficiency in OB women and children was 2-4 times that of normal-weight individuals at similar dietary iron intakes. In addition, we found that C-reactive protein but not iron intake was a strong negative predictor of iron status, independently of BMI (P < 0.05); c) dietary iron absorption was lower in OW/OB versus normal weight subjects (Geometric mean (95%CI): 12.9 (9.7, 16.9)%) vs 19.0 (15.2, 23.5)%, P=0.049). Moreover, the enhancing effect of ascorbic acid on iron absorption in overweight/obese (28%) was only half that in normal weight women (56%); d) OW/OB women presented higher absolute blood volume and lower serum iron compared to the normal weight group. BV (r2=0.22, β=-0.29, P=0.02) was a negative predictor for serum iron when adjusted for body iron stores. We developed an equation to calculate BV in OW and OB women considering weight, height and lean body mass; e) Fat loss lead to a reduction of inflammation (Interleukin-6) and hepcidin concentrations. In iron-deficient subjects (n=17), iron absorption significantly increased after fat loss (Geometric mean (95%CI): 9.7% (6.5-14.6) to 12.4% (7.7-20.1) (P=0.03), while in iron sufficient subjects (n=21), it did not change (Geometric mean (95%CI): 5.9% (4.0-8.6) and 5.6% (3.9-8.2)) (P=0.81)).
Conclusion: Increased hepcidin concentrations, along with subclinical inflammation, limits dietary iron absorption in subjects with excessive body fat, especially in iron deficient individuals. Due to a dilutional effect of blood volume, ‘true’ hypoferremia might be overestimated in populations with a high prevalence of obesity when using serum iron as an indicator. OW/OB individuals may require: higher dietary iron intake combined with iron absorption enhancers to keep their iron status in balance; and a reduction of the obesity-related inflammatory process in order to ensure adequate iron absorption.
That’s why I take my ONS. Means-end chain as a novel approach to elucidate the personally relevant factors driving ONS consumption in nutritionally frail elderly users
Uijl, L.C. den; Kremer, S. ; Jager, G. ; Stelt, Annelies van der; Graaf, C. de; Gibson, P. ; Godfrey, J. ; Lawlor, J.B. - \ 2015
Appetite 89 (2015). - ISSN 0195-6663 - p. 33 - 40.
sensory attributes - supplements - care - malnutrition - perceptions - prevalence - interview - consumers - motives - drinks
Oral nutritional supplements (ONS) are a recommended form of nutritional intervention for older malnourished persons when a ‘food first’ approach and/or food fortification prove ineffective. The efficacy of ONS will depend on, amongst other factors, whether persons do, or do not, consume their prescribed amount. Factors influencing ONS consumption can be product, context, or person related. Whereas product and context have received some attention, little is known about the person factors driving ONS consumption. In addition, the relative importance of the product, context, and person factors to ONS consumption is not known. Using the means-end chain (MEC) method, the current study elucidated personally relevant factors (product, context, and person factors) related to ONS consumption in two groups of older nutritionally frail ONS users: community-dwelling persons and care home residents with mainly somatic disorders. To our knowledge, the current work is the first to apply the MEC method to study older nutritionally frail ONS users. Forty ONS users (n¿=¿20 per group) were recruited via healthcare professionals. The level of frailty was assessed using the FRAIL scale. Both groups were interviewed for 30 to 45 minutes using the soft laddering technique. The laddering data were analysed using LadderUX software™. The MEC method appeared to work well in both groups. The majority of the participants took ONS on their doctor's or dietician's prescription as they trusted their advice. The community-dwelling group took ONS to prolong their independence, whereas the care home group reported values that related more to small improvements in quality of life. In addition, care home residents perceived themselves as dependent on their caregiver for their ONS arrangements, whereas this dependence was not reported by community-dwelling persons. Key insights from this work will enable doctors and dieticians to customize their nutritional interventions to ONS users' personal needs and thus positively impact health outcomes
Loss of Olfactory Function and Nutritional Status in Vital Older Adults and Geriatric Patients
Toussaint, N. ; Roon, M. de; Campen, J.P.C.M. van; Kremer, S. ; Boesveldt, S. - \ 2015
Chemical Senses 40 (2015)3. - ISSN 0379-864X - p. 197 - 203.
mild cognitive impairment - odor identification - normative data - taste - malnutrition - smell - discrimination - dysfunction - prevalence - validation
The aim of this cross-sectional study was to assess the association of olfactory function and nutritional status in vital older adults and geriatric patients. Three hundred forty-five vital (mean age 67.1 years) and 138 geriatric older adults (mean age 80.9 years) were included. Nutritional status was assessed using the mini nutritional assessment-short form. The Sniffin’ Sticks was used to measure olfactory function. Eleven percentage of the vital older adults were at risk of malnutrition, whereas 60% of the geriatric participants were malnourished or at risk. Only 2% of the vital older adults were anosmic, compared with 46% of the geriatric participants. Linear regression demonstrated a significant association (P = 0.015) between olfactory function and nutritional status in the geriatric subjects. However, this association became insignificant after adjustment for confounders. Both crude and adjusted analysis in the vital older adults did not show a significant association. The results indicate that, in both groups of elderly, there is no direct relation between olfactory function and nutritional status. We suggest that a decline in olfactory function may still be considered as one of the risk-factors for malnutrition in geriatric patients—once co-occurring with other mental and/or physical problems that are more likely to occur in those patients experience.
The influence of olfactory impairment in vital, independently living older persons on their eating behaviour and foodliking
Kremer, S. ; Holthuysen, N.T.E. ; Boesveldt, S. - \ 2014
Food Quality and Preference 38 (2014). - ISSN 0950-3293 - p. 30 - 39.
age-related-changes - flavor amplification - nutritional-status - functional foods - salt reduction - taste - smell - malnutrition - consumption - perception
These two studies investigated eating behaviour and food liking of independently living Dutch older people with and without olfactory impairment. In the first study, an internet survey was conducted in relation to their olfactory status (n = 512; age 55–91). Hyposmic older people reported eating the same meal more often within a week than their unimpaired peers, and they also differed in some of the types of foods they reported eating as snacks (i.e. fewer cookies and nuts, more candy). In the second study, various strategies to increase food liking among older consumers were investigated, as well as their liking of reformulated foods with an expected reduced palatability. The strategies included (1) combined visual enrichment and flavour enrichment of mashed potatoes, (2) enhancement of taste intensity and thickness of gravy, and (3) flavour enrichment of stews. The reformulation encompassed (1) salt reduction of meatballs and (2) protein enrichment of bread. Thirty-eight young consumers (age 32.3 ± 8.9 y), 41 normosmic older consumers (age 65.1 ± 5.2 y), and 43 hyposmic older consumers (age 68.5 ± 5.9 y) assessed food liking on a 100 mm visual analogue scale. Both older groups increased their food liking in response to the changes made in the mashed potatoes and gravies, decreased their food liking in response to the salt reduction in the meatball and increased their product liking once information was given on the reduction. In conclusion, older persons – regardless of their olfactory status – may respond positively to multi-sensory enrichment in warm meal components. At the same time, certain types of foods may still appeal more or less to hyposmic older persons which in turn may lead to the development of different dietary intake patterns.
Integrated Food and Nutrition Security Programming to Address Undernutrition : The Plan Approach
Boer, F.A. de; Verdonk, I. - \ 2012
Wageningen : Wageningen UR Centre for Development Innovation (Report / Wageningen UR Centre for Development Innovation CDI-12-014) - 34
voedselzekerheid - slechte voeding - honger - ondervoeding - food security - malnutrition - hunger - undernutrition
From a technical point of view, it is widely recognised that an integrated approach to food and nutrition security is an effective way to promote child nutritional well-being. In this desk review, based on project documents of the countries which took part in the PLAN NL supported Food and Nutrition Security Support Programme (FNSSP), what kind of interventions were undertaken and their strengths and weaknesses are compared with the lessons learned from the World Bank. Report number CDI-12-014.
Nationwide shifts in the double burden of overweight and underweight in Vietnamese adults in 2000 and 2005: two national nutrition surveys
Ha, Do T.P. ; Feskens, E.J.M. ; Deurenberg, P.R.M. ; Mai, L.B. ; Khan, N.C. ; Kok, F.J. - \ 2011
BMC Public Health 11 (2011). - ISSN 1471-2458 - 9 p.
body-mass index - chi-minh city - obesity - trends - malnutrition - prevalence - epidemic - patterns - women - poor
Background - In developing countries, overweight prevalence is increasing while underweight prevalence is still high. This situation is known as the double nutrition burden. Both underweight and overweight are related to increased risk of chronic non-communicable diseases, reduced well-being and quality of life. This study aims to compare the prevalence of overweight and underweight among Vietnamese adults in 2000 and 2005. Methods - The study was based on two nationally representative surveys, the National Nutrition Survey 2000 (14,452 subjects) and the National Adult Obesity Survey 2005 (17,213 subjects). Adults aged 25-64 years were sampled to be nationally representative. Multiple multinomial logistic regression analysis was used to investigate the association of underweight and overweight with socio-economic indicators. Results - The distribution of BMI across the population and population groups indicated a shift towards higher BMI levels in 2005 as compared to 2000. The nationwide prevalence of overweight (BMI = 25 kg/m2) and obesity (BMI = 30 kg/m2) was 6.6% and 0.4% respectively in 2005, almost twice the rates of 2000 (3.5% and 0.2%). Using the Asian BMI cut-off of 23 kg/m2 the overweight prevalence was 16.3% in 2005 and 11.7% in 2000. In contrast, the underweight prevalence (BMI <18.5 kg/m2) of 20.9% in 2005 was lower than the rate of 25.0% in 2000. Women were more likely to be both underweight and overweight as compared to men in both 2000 and 2005. Urban residents were more likely to be overweight and less likely to be underweight as compared to rural residents in both years. The shifts from underweight to overweight were clearer among the higher food expenditure levels. Conclusions - The double nutrition burden was clearly present in Vietnam. The distribution of BMI across the population groups generally indicated a shift towards higher BMI levels in 2005 as compared to 2000. The prevalence of overweight was increased while the declined level of undernutrition was still high in 2005. The shifts of underweight to overweight were most obvious among population groups with higher food expenditure levels
Comparison of the effect of individual dietary counselling and of standard nutritional care on weight loss in patients with head and neck cancer undergoing radiotherapy
Berg, M.G.A. van den; Rasmussen-Conrad, E.L. ; Wei, K.H. ; Lintz-Luidens, H. ; Kaanders, J.H.A.M. ; Merkx, M.A.W. - \ 2010
The British journal of nutrition 104 (2010)6. - ISSN 0007-1145 - p. 872 - 877.
quality-of-life - oral-cancer - impact - malnutrition - therapy - support
Clinical research shows that nutritional intervention is necessary to prevent malnutrition in head and neck cancer patients undergoing radiotherapy. The objective of the present study was to assess the value of individually adjusted counselling by a dietitian compared to standard nutritional care (SC). A prospective study, conducted between 2005 and 2007, compared individual dietary counselling (IDC, optimal energy and protein requirement) to SC by an oncology nurse (standard nutritional counselling). Endpoints were weight loss, BMI and malnutrition (5% weight loss/month) before, during and after the treatment. Thirty-eight patients were included evenly distributed over two groups. A significant decrease in weight loss was found 2 months after the treatment (P=0.03) for IDC compared with SC. Malnutrition in patients with IDC decreased over time, while malnutrition increased in patients with SC (P=0.02). Therefore, early and intensive individualised dietary counselling by a dietitian produces clinically relevant effects in terms of decreasing weight loss and malnutrition compared with SC in patients with head and neck cancer undergoing radiotherapy.
Exposure to the Chinese famine in early life and the risk of hyperglycemia and type 2 diabetes in adulthood.
Li, Y. ; He, Y. ; Qi, L. ; Jaddoe, V.W. ; Feskens, E.J.M. ; Yang, X. ; Ma, G. ; Hu, F.B. - \ 2010
Diabetes 59 (2010)10. - ISSN 0012-1797 - p. 2400 - 2406.
beta-cell mass - in-utero - disease - health - malnutrition - hypothesis - overweight - fetal
OBJECTIVE Early developmental adaptations in response to undernutrition may play an essential role in susceptibility to type 2 diabetes, particularly for those experiencing a "mismatched rich nutritional environment" in later life. We examined the associations of exposure to the Chinese famine (1959-1961) during fetal life and childhood with the risk of hyperglycemia and type 2 diabetes in adulthood. RESEARCH DESIGN AND METHODS We used the data for 7,874 rural adults born between 1954 and 1964 in selected communities from the cross-sectional 2002 China National Nutrition and Health Survey. Hyperglycemia was defined as fasting plasma glucose >= 6.1 mmol/1 and/or 2-h plasma glucose >= mmol/1 and/or a previous clinical diagnosis of type 2 diabetes. RESULTS Prevalences of hyperglycemia among adults in nonexposed, fetal exposed, early-childhood, mid-childhood, and late-childhood exposed cohorts were 2.4%, 5.7%, 3.9%, 3.4%, and 5.9%, respectively. In severely affected famine areas, fetal-exposed subjects had an increased risk of hyperglycemia compared with nonexposed subjects (odds ratio = 3.92; 95% CI: 1.64-9.39; P = 0.002); this difference was not observed in less severely affected famine areas (odds ratio = 0.57; 95% CI: 0.25-1.31; P = 0.185). The odds ratios were significantly different between groups from the severe and less severe famine areas (P for interaction = 0.001). In severely affected famine areas, fetal-exposed subjects who followed an affluent/Western dietary pattern (odds ratios = 7.63; 95% CI: 2.41-24.1; P = 0.0005) or who had a higher economic status in later life experienced a substantially elevated risk of hyperglycemia (odds ratios = 6.20; 95% Cl: 2.08-18.5; P = 0.001). CONCLUSIONS Fetal exposure to the severe Chinese famine increases the risk of hyperglycemia in adulthood. This association appears to be exacerbated by a nutritionally rich environment in later life. Diabetes 59:2400-2406, 2010
Global control of micronutrient deficiencies: divided they stand, united they fall
Zimmermann, M.B. - \ 2007
Wageningen : Wageningen University - 27
slechte voeding - gebreksziekten - sporenelementtekorten - vitaminetekorten - voedselzekerheid - ontwikkelingslanden - malnutrition - deficiency diseases - trace element deficiencies - vitamin deficiencies - food security - developing countries
Dr. Zimmermann is appointed as honorary professor Micronutrients and International Health at Wageningen University.
Cytokines related to nutritional status in patients with untreated pulmonary tuberculosis in Indonesia
Karyadi, E. ; Dolmans, W.M.V. ; West, C.E. ; Crevel, R. ; Nelwan, R.H.H. ; Amin, Z. ; Gross, R. ; Ven-Jongekrijg, J. Van der; Meer, J.W.M. van der - \ 2007
Asia Pacific Journal of Clinical Nutrition 16 (2007)2. - ISSN 0964-7058 - p. 218 - 226.
necrosis-factor-alpha - vitamin-a - zinc-deficiency - mycobacterium-tuberculosis - interleukin-6 - supplementation - malnutrition - secretion - infection - children
Although several studies have dealt with the patterns of cytokine production in tuberculosis, little is known about the association between nutrient deficiencies and cytokines in tuberculosis. The objective of this study was to assess the concentration of cytokines related to nutritional status during tuberculosis. In 41 untreated tuberculosis patients and matched healthy controls in an urban hospital in Indonesia, we measured: height and weight, parameters of iron, vitamin A and zinc; and cytokines concentrations in the circulation and production in whole blood cultures. Plasma interleukin-6 (IL-6) and interleukin-1 receptor antagonist (IL-1ra) were significantly higher in patients than in controls. Patients with cavities (n=26) had higher concentrations of IL-6 than patients without cavities (n=15). Body mass index
24-Hour Indirect Calorimetry in Mechanically Ventilated Critically III Patients
Zijlstra, N. ; Dam, S.M. ten; Hulshof, P.J.M. ; Ram, C. ; Hiemstra, G. ; Roos, N.M. de - \ 2007
Nutrition in Clinical Practice 22 (2007)2. - ISSN 0884-5336 - p. 250 - 255.
resting energy-expenditure - nutritional support - requirements - malnutrition - metabolism - basal
Background: Energy imbalance in critically ill, mechanically ventilated patients may lead to medical complications. The nutrition care team needs accurate, noninvasive, rapid methods to estimate energy requirements. We investigated whether brief measurements of indirect calorimetry at any time of the day would give valid estimates of 24-hour energy expenditure (EE). Methods: EE of 12 mechanically ventilated critically ill patients (6 men, 6 women, mean +/- SD age 67 +/- 18 years, weight 70.2 +/- 8.8 kg) was recorded every minute during 24 hours by indirect calorimetry. All patients were continuously fed enteral nutrition. Results: Mean - SD EE was 1658 279 kcal/d (6941 +/- 1167 kJ/d). Within patients, EE during the day fluctuated by 234 kcal in the most constant patient to 1190 kcal in the least constant patient, with a mean fluctuation of 521 kcal (12 patients). No statistically significant difference (p = .53) in mean EE between morning (6-12 hours, 1676 kcal), afternoon (12-18 hours, 1642 kcal), evening (18-24 hours, 1658 kcal), and night (0-6 hours, 1655 kcal) was found. A 2-hour instead of a 24-hour measurement resulted in a maximal error of 128 kcal (536 kJ), which was <10% of the average EE. The maximal error decreased with longer time intervals. Conclusions: In mechanically ventilated critically ill patients, 24-hour indirect calorimetry measurements can be replaced by shorter ( 2 hours) measurements. Time of day did not affect EE.
Intake of micronutrients high in animal-source foods is associated with better growth in rural Kenyan school children
Grillenberger, M. ; Neumann, C.G. ; Murphy, S.P. ; Bwibo, N.O. ; Weiss, R.E. ; Jiang, L.H. ; Hautvast, J.G.A.J. ; West, C.E. - \ 2006
The British journal of nutrition 95 (2006)2. - ISSN 0007-1145 - p. 379 - 390.
improve dietary quality - catch-up growth - bone - xerophthalmia - malnutrition - iron - fat - schoolchildren - childhood - toddlers
Observational studies have shown that children in developing countries consuming diets containing high amounts of bioavailable nutrients, such as those found in animal-source foods, grow better. The present study investigated which specific nutrients from the diet of Kenyan school children predicted their growth. The children (n 544, median age 7 years) participated in a 2-year long food supplementation study with animal-source foods. Height gain during the intervention period was positively predicted by average daily intakes of energy from animal-source foods, haem Fe, preformed vitamin A, Ca and vitamin B-12. Weight gain was positively predicted by average daily intakes of energy from animal-source foods, haem Fe, preformed vitamin A, Ca and vitamin B-12. Gain in mid-upper-arm muscle area was positively predicted by average daily intakes of energy from animal-source foods and vitamin B-12. Gain in mid-upper-arm fat area was positively predicted by average daily intakes of energy from animal-source foods. Gain in subscapular skinfold thickness was not predicted by any of the nutrient intakes. Negative predictors of growth were total energy and nutrients that are contained in high amounts in plant foods. The study shows that growth was positively predicted by energy and nutrients that are provided in high amounts and in a bioavailable form in meat and milk, and their inclusion into the diets of children in developing countries should be part of all food-based programmes in order to improve micronutrient status and growth.
Optimizing the ambiance during mealtimes in Dutch nursing homes
Nijs, K.A.N.D. - \ 2006
Wageningen University. Promotor(en): Wija van Staveren; Frans Kok, co-promotor(en): Kees de Graaf. - [S.l. ] : S.n. - ISBN 9789085043942 - 150
maaltijden - verpleeghuizen - slechte voeding - ouderenvoeding - oudere patiënten - voedingstoestand - kwaliteit van het leven - eten - meals - nursing homes - malnutrition - elderly nutrition - elderly patients - nutritional state - quality of life - eating
Als bewoners van verpleeghuizen gezellig samen aan tafel de maaltijd gebruiken, voelen ze zich aantoonbaar gezonder. Bovendien blijft hun lichaamsgewicht beter op peil en verslechtert hun mogelijkheid om nog redelijk te bewegen minder snel.
Nutritional care in old age: the effect of supplementation on nutritional status and performance
Manders, M. - \ 2006
Wageningen University. Promotor(en): Wija van Staveren; W.H.L. Hoefnagels, co-promotor(en): Lisette de Groot. - [S.l. ] : S.n. - ISBN 9789085043959 - 134
ouderenvoeding - voedselsupplementen - bijvoeding - voedingstoestand - slechte voeding - ouderen - ouderdom - elderly nutrition - food supplements - supplementary feeding - nutritional state - malnutrition - elderly - old age
Malnutrition is frequently observed in elderly people living in nursing homes and homes for the elderly. Anorexia resulting in inadequate dietary intake is often a cause of malnutrition. Malnutrition in old age affects several aspects of functioning. Earlier research has shown that a complete supplement improves nutritional status. These studies were however not sufficiently powerful to investigate an effect of such a supplement on functioning. Yet, positive results of a pilot study pointed in that direction. In this thesis we assumed that improving nutritional status by nutritional supplementation could lead to improvement in functioning, following improved total dietary intake, without affecting habitual intakes.In the current study residents of nursing homes and homes for the elderly were participating in a 24-week, randomised, double-blind, placebo-controlled intervention trial (n=176). They randomly received either a nutrient dense drink or a placebo drink twice a day in addition to their usual diet. Two packages of the nutrient dense drink contained 250 kcal and vitamins, minerals and trace elements at the level of 25 to 175% of the Dutch RDA. The placebo drink contained no energy and no vitamins and minerals.Using the complete supplement appeared to have a beneficial effect on dietary intake. The change in total energy intake was some 0.8 MJ/day higher in the supplement group than that in the control group (p=0.166). Moreover, a significantly favourable effect (p<0.001) was observed for the intake of vitamins and minerals. Hereby the supplement group did not appear to compensate their regular intakes for the energy content of the provided supplements. The positive effect on dietary intake was supported by changes in nutritional status, because markers of nutritional status of the intervention group compared favourably with those of the placebo group. These changes showed amongst others a positive effect of the intervention drink on body weight (1.6 kg difference in change; p=0.035), calf circumference (0.9 cm difference in change; p=0.048), and blood values (e.g. Hcy decreased from 16.8 to 11.2 μmol/L in the supplement group). In the study population no significant effect was found on functionality outcomes, including cognitive function, mood, physical performance and the ability to perform activities of daily living. However, a subgroup of participants with BMI at baseline below 24.4 kg/m 2 performed better on the cognitive subscale of the Alzheimer's Disease Assessment Scale (p=0.09), and its language sub score (p=0.01) after 24 weeks of intervention.To prevent serious malnutrition it is advocated to regularly weigh institutionalised elderly and use a short questionnaire for decreased appetite. With these instruments the development of malnutrition can be detected early and if indicated preventive action can be taken. Future research should be focused on efficient implementation of the used food supplement in every day practice. Nutrition policy should be focused on improvement of usual diet as well as temporarily providing nutritional supplements if indicated. From the findings of our intervention trial we conclude that the applied supplement is effective for counteracting the development of malnutrition in this population. Furthermore, the results of this trial suggest that it is effective as treatment for decreasing function in a subgroup of institutionalized elderly people with low BMI.