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@#A Technical Working Group composed of health professionals and multispecialty healthcare experts, have come together to emphasize the crucial role of nutrition in promoting overall health and wellbeing. Nutrition serves as the cornerstone of optimal physical and mental functioning, and they firmly believe that a well-balanced diet should be the primary source of essential nutrients for individuals of all ages. However, they acknowledge the existence of prevalent gaps in nutrition and the potential benefits of oral micronutrient supplementation particularly those that contain iron and appetite stimulants in addressing these gaps across the entire disease spectrum. Despite the importance of nutrition, various factors like appetite loss due to medications and illnesses contribute to gaps in dietary intake. Modern dietary patterns, often characterized by highly processed foods, excessive added sugars, unhealthy fats, and insufficient intake of fruits, vegetables, whole grains, and lean proteins, can result in nutrient deficiencies. Additionally, socio-economic factors, cultural practices, limited access to nutritious food options, and individual dietary restrictions may further contribute to these gaps. Moreover, individuals who have poor appetite and nutrient intakes with certain conditions, or those who avoid certain foods (such as strict vegetarians and vegans) might benefit from taking supplementation. Multivitamin supplementation can play a supportive role in addressing nutritional gaps. These supplements, when used appropriately and as part of a balanced diet, can provide a convenient and reliable source of essential vitamins and minerals. Multivitamins are particularly useful in situations where dietary intake alone may not meet individual nutrient requirements due to limitations or specific health conditions. They offer an accessible option to help bridge the nutritional gaps and ensure adequate nutrient intake.
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Objectives@#The study aimed to compare the performance of weight circumference (WC) measurement using the World Health Organization (WHO) versus National Institutes of Health (NIH) protocol in identifying visceral adiposity, and to determine the association of WC with cardiometabolic risk factors among overweight and obese adult Filipinos.@*Methodology@#A retrospective study involving 221 subjects (99 males, 122 females) evaluated at an outpatient weight intervention center of a tertiary hospital. The WC was measured at the superior border of the iliac crest (WC-NIH) and midway between the lowest rib and the iliac crest (WC-WHO) for each patient. Using visceral fat rating (VF) derived via bioelectrical impedance analysis (BIA) as reference standard, diagnostic accuracy tests for both protocols (using cut-offs of ≥90 cm in males and ≥80 cm in females) were done. Cardiometabolic parameters were also obtained, and binary logistic regression was performed to determine associations with WC@*Results@#Among males, WC-WHO had 96% sensitivity (95% CI 88.8%-99.2%) and 25% specificity (95% CI 9.77%-46.7%) while WC-NIH had 94.7% sensitivity (95% CI 86.9%-98.5%) and 29.2% specificity (95% CI 12.6%-51.1%) to predict high VF >12. Among females, WC-WHO had 100% sensitivity (95% CI 90%-100%) and 24.1% specificity (95% CI 15.6%-34.5%) while WC-NIH had 100% sensitivity (95% CI 90%-100%) and 4.6% specificity (95% CI 1.3%-11.4%). Prevalence of high VF was significantly greater among males – 75.8% (95% CI 66.1%-83.8%) vs. 28.7% (95% CI 20.9%-37.6%) in females (p<0.001). Among females, WC-NIH tended to have higher measurements than WC-WHO by an average of 4.67 cm. Females with WC-WHO measurements of at least 80 cm were approximately four times more likely to have low (<50 mg/dL) HDL levels (cOR 3.82, p=<0.05), even after adjusting for age (aOR 3.83, p=<0.05).@*Conclusion@#WC measurement using the WHO and NIH protocols were both highly sensitive but had low specificity in predicting high VF estimated via BIA among overweight and obese adult Filipinos in this study. WC-NIH measurements tended to be higher among the females, which may affect classification of central obesity when using this protocol. WC ≥80 cm measured using the WHO protocol was associated with low HDL levels among female subjects. Prospective studies conducted among the general Filipino population are recommended to verify these findings.
Sujets)
Tour de taille , Obésité abdominaleRésumé
Introduction@#Malnutrition among hospitalized patients is highly prevalent. This adversely affects outcomes with longer length of stay (LOS), higher treatment costs and increased mortality. People with diabetes mellitus (DM) are particularly vulnerable to malnutrition and its consequences.@*Objective@#To determine the association of nutritional status with LOS and mortality among adults with Type 2 DM.@*Methodology@#This was a retrospective study of 439 adult patients with type 2 diabetes admitted in the medical ward of a tertiary hospital from January 1, 2018 to December 31, 2018. Demographics, anthropometrics, feeding route, LOS and outcomes were taken from the Clinical Nutrition Service database; biochemical data were taken from the Healthcare System, and were analyzed.@*Results@#In our analysis, 83.8% were found to be malnourished with 50.3% moderately-malnourished (MM) (Nutrition risk level 1-2) and 33.5% severely-malnourished (SM) (Nutrition risk level ≥3). BMI category and malnutrition were the significant confounders for LOS. After controlling for BMI, LOS was longer by a mean of 2.2 days in SM compared to well-nourished (WN) patients (95% CI=0.49-3.95, p=0.012). Of the malnourished patients, 6.1% of SM and 0.5% of MM patients died. None of the WN patients died. Feeding route, admitted for neoplasm, low albumin levels and malnutrition were the confounding factors associated with mortality. After controlling for these factors, SM had higher odds of dying compared to MM patients [adjusted OR=8.91 (95% CI=1.04-76.18, p=0.046)].@*Conclusion@#Among hospitalized non-critically ill adult patients with type 2 diabetes, SM patients but not MM patients had significantly longer LOS compared to WN patients, and greater degrees of malnutrition were associated with higher mortality.