Prevention, identification and management of malnutrition in older people in the community.

Malnutrition, specifically undernutrition, is a significant health concern among older people, yet it is under-detected and under-treated in the community. The causes of malnutrition are complex and multifactorial, and the risk has been exacerbated by the coronavirus disease 2019 (COVID-19) pandemic due to social isolation and loneliness, which can affect older people's appetite and thus reduce their nutritional intake. This article discusses the causes and consequences of malnutrition in older people and describes what is involved in malnutrition screening, person-centred care planning and treatment. The author considers various approaches to overcoming the barriers associated with identifying malnutrition in older people in the community and outlines the role of the nurse in the effective management of malnutrition in this population.

Impacts of COVID-19 on Nutritional Intake in Rural China: Panel Data Evidence.

The COVID-19 pandemic introduced risks and challenges to global food and nutrition security. In this paper, we examine the impact of the COVID-19 pandemic on the nutritional intake of China's rural residents using panel data and a fixed effects model. The data were collected in 2019 and 2020 and covered nine provinces and 2631 households in rural China. The results reveal that an increase of 100 confirmed cases in a county resulted in a 1.30% (p < 0.01), 1.42% (p < 0.01), 1.65% (p < 0.01), and 1.15% (p < 0.01) decrease in per capita intake of dietary energy, carbohydrates, fats, and proteins, respectively. Moreover, the COVID-19 pandemic had a significant and negative effect on dietary macronutrient intake in the low-income group at the 5% level of significance. Our study indicates that the potential insufficient nutrition situation, nutritional imbalance, and dietary imbalance of low-income rural residents should be addressed appropriately.

Malnutrition during pandemic among home-nursed and community-dwelling elderly

Background: The current COVID-19 pandemic has led to serious changes in the daily routine of people including the elderly. One of the most feared impacts is the increasing malnutrition among the elderly, which contributes to exacerbating public health problems. Objective: To evaluate the differences in nutritional status, the risk of malnutrition, and nutritional intake between the elderly receiving home nursing and community-dwelling elderly during the COVID 19 pandemic. Method: Cross-sectional study with 60 home-nursed elderly residents and 52 community-dwelling elderly in South Jakarta. Nutritional status was determined through BMI, the risk for malnutrition was assessed by MNA, and nutritional intake was calculated using the interview method with a 24-hour food recall. Results: The study found, based on MNA, that there is a high risk of malnutrition (63.5%) among community-dwelling elderly compared to the elderly receiving home nursing (71.7%). A good prevalence of nutrition status was found in community-dwelling elderly (36.5%) better than home-nursed elderly (28.3%). Based on MNA, the elderly at risk of malnutrition who live with a home nursing are mostly male (76.5%), at 60 - 65 years (44.1%), last education is high school (38.2%), do not have disease comorbidities (70.6%), and had inadequate intake (55.9% energy, 41.2% protein, 61.8% fat, and 76.5% carbohydrate) while the elderly who live in the community are mostly female (69.4%), at 60 - 65 years (50%), the last education in elementary school (33.3%), have comorbidities (52.8%) and have inadequate intake (72.2% energy, 100% protein, 50% fat, 80.6% carbohydrate). There were significant differences in protein and fiber intake (p<0.05) between both groups. Implication: In this COVID-19 pandemic, health care workers need to be more active in conducting malnutrition risk screening particularly for community-dwelling elderly. More effort is required to advocate and ensure improved nutritional intake in this vulnerable group.

Protein and Energy Intake Assessment and Their Association With In-Hospital Mortality in Critically Ill COVID-19 Patients: A Prospective Cohort Study.

Background and Aim: It is partially known that nutritional intake could alleviate proteolysis and course of disease severity in patients with COVID-19; however, not enough data are available in this regard. The present study aimed to assess protein and energy intake and their association with in-hospital mortality in critically ill COVID-19 patients. Methods: A total of 126 patients with COVID-19, who were critically ill, ≥5 days and a subset of 111 patients in ICU ≥10 days completed the present prospective observational cohort study. Results: Protein and energy intakes on Day 5 of ICU admission in survivors were 46 and 58% of target values, respectively. These values in non-survivors were 42 and 50% of target values, respectively (p < 0.05). In the sample ≥10 days, protein and energy intakes in survivors reached 64 and 87% of target values, respectively, without statistically significant differences with non-survivors. In the sample ≥5 days, Cox proportional hazard regression was adjusted for GLIM, APACHE II, comorbidity, and age; the results indicated that the patients with protein and energy intake lower than 0.59 g/kg/day and 14 kcal/kg/day, had ~2-fold mortality hazard (protein: HR, 2.38; 95% CI, 1.40-4.03; P = 0.001 and energy: HR, 2.23; 95% CI, 1.27-3.92; P = 0.005). Conclusion: Actual protein and energy intakes in critically ill patients with COVID-19 are in suboptimal levels compared with goal recommendations in these patients. Moreover, higher amounts of protein and energy intakes in the early acute phase were significantly associated with better survival and lower risk of in-hospital mortality.