Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 108
Filter
1.
BMC Public Health ; 22(1): 2092, 2022 11 16.
Article in English | MEDLINE | ID: covidwho-2113794

ABSTRACT

BACKGROUND: Child hunger has long-term and short-term consequences, as starving children are at risk of many forms of malnutrition, including wasting, stunting, obesity and micronutrient deficiencies. The purpose of this paper is to show that the child hunger and socio-economic inequality in South Africa increased during her COVID-19 pandemic due to various lockdown regulations that have affected the economic status of the population. METHODS: This paper uses the National Income Dynamics Study-Coronavirus Rapid Mobile Survey (NIDS-CRAM WAVES 1-5) collected in South Africa during the intense COVID-19 pandemic of 2020 to assess the socioeconomic impacts of child hunger rated inequalities. First, child hunger was determined by a composite index calculated by the authors. Descriptive statistics were then shown for the investigated variables in a multiple logistic regression model to identify significant risk factors of child hunger. Additionally, the decomposable Erreygers' concentration index was used to measure socioeconomic inequalities on child hunger in South Africa during the Covid-19 pandemic. RESULTS: The overall burden of child hunger rates varied among the five waves (1-5). With proportions of adult respondents indicated that a child had gone hungry in the past 7 days: wave 1 (19.00%), wave 2 (13.76%), wave 3 (18.60%), wave 4 (15, 68%), wave 5 (15.30%). Child hunger burden was highest in the first wave and lowest in the second wave. The hunger burden was highest among children living in urban areas than among children living in rural areas. Access to electricity, access to water, respondent education, respondent gender, household size, and respondent age were significant determinants of adult reported child hunger. All the concentrated indices of the adult reported child hunger across households were negative in waves 1-5, suggesting that children from poor households were hungry. The intensity of the pro-poor inequalities also increased during the study period. To better understand what drove socioeconomic inequalites, in this study we analyzed the decomposed Erreygers Normalized Concentration Indices (ENCI). Across all five waves, results showed that race, socioeconomic status and type of housing were important factors in determining the burden of hunger among children in South Africa. CONCLUSION: This study described the burden of adult reported child hunger and associated socioeconomic inequalities during the Covid-19 pandemic. The increasing prevalence of adult reported child hunger, especially among urban children, and the observed poverty inequality necessitate multisectoral pandemic shock interventions now and in the future, especially for urban households.


Subject(s)
COVID-19 , Malnutrition , Adult , Child , Female , Humans , Hunger , COVID-19/epidemiology , Pandemics , South Africa/epidemiology , Communicable Disease Control , Socioeconomic Factors , Malnutrition/epidemiology
2.
BMC Public Health ; 22(1): 2035, 2022 11 07.
Article in English | MEDLINE | ID: covidwho-2108756

ABSTRACT

BACKGROUND: The COVID-19 pandemic drew hygiene to the center of disease prevention. The provision of adequate water, sanitation, and hygiene (WASH) services is crucial to protect public health during a pandemic. Yet, access to levels of water supply that support adequate hygiene measures are deficient in many areas in Nepal. We examined WASH practices and their impact on child health and nutritional status in two districts before and during the COVID-19 pandemic. METHODS: A longitudinal and mixed method study was conducted in March-May 2018 and November-December 2021. In total, 715 children aged 0-10 years were surveyed at baseline. Of these, 490 children were assessed at endline. Data collection methods included observations, a questionnaire, stool analysis, anthropometric measurements, water quality analysis, and an assessment of clinical signs of nutritional deficiencies. We conducted 10 in-depth interviews to understand major problems related to COVID-19. RESULTS: Most respondents (94.2%) had heard about COVID-19; however, they did not wear face masks or comply with any social distancing protocols. Almost 94.2% of the households self-reported handwashing with soap 5-10 times per day at endline, especially after defecation, compared to 19.6% at baseline. Water quality was better at endline than at baseline with median 12 to 29 CFU Escherichia coli/100 mL (interquartile range at baseline [IQR] = 4-101) at the point of collection and 34 to 51.5 CFU Escherichia coli/100 mL (IQR = 8-194) at the point of consumption. Fever (41.1-16.8%; p = 0.01), respiratory illness (14.3-4.3%; p = 0.002), diarrhea (19.6-9.5%; p = 0.01), and Giardia lamblia infections (34.2-6.5%, p = 0.01) decreased at endline. In contrast, nutritional deficiencies such as bitot's spots (26.7-40.2%; p = 0.01), pale conjunctiva (47.0-63.3%; p = 0.01), and dermatitis (64.8-81.4%; p = 0.01) increased at endline. The inadequacy of the harvest and the lack of household income to meet households' nutritional needs increased drastically (35.0-94.2%; p = 0.01). CONCLUSION: We found that improved water quality and handwashing practices were associated with a decrease in infectious diseases. However, food security also decreased resulting in a high prevalence of nutritional deficiencies. Our findings underline that disaster preparedness should consider access to adequate WASH, nutrition, and health supplies.


Subject(s)
COVID-19 , Malnutrition , Child , Humans , Sanitation , Nutritional Status , COVID-19/epidemiology , COVID-19/prevention & control , Pandemics/prevention & control , Nepal/epidemiology , Hygiene , Water Supply , Malnutrition/epidemiology , Escherichia coli
3.
Asia Pac J Clin Nutr ; 31(3): 496-503, 2022.
Article in English | MEDLINE | ID: covidwho-2080828

ABSTRACT

BACKGROUND AND OBJECTIVES: Home enteral nutrition was reported to be a treatment reducing malnutrition rates and improving the rational allocation of medical resources. We aim to investigate the epidemiological characteristics and improved the management of home enteral nutrition. METHODS AND STUDY DESIGN: 3953 patients with home enteral nutrition were enrolled in West China Hospital, located in Sichuan province, between January 1, 2021, and December 31, 2021. RESULTS: 7238 visit records (3429 females and 3809 males) were included. The median age was 59.0, with the age from 1 to 115. The top two diseases were oncologic disorders (40.3%) and digestive disorders (15.9%). Oral nutritional supplements (86.2%) was the major treatment of home enteral nutrition. The median daily energy intake and daily protein intake were 575.1 kcal and 31.2 g. 25.8%, 39.3%, 34.9% patients choose online clinic (1867), offline clinic (2843) and hospital to home (2528) respectively. Interestingly, 63.6% patients were revisited, and the rate of online clinic, offline clinic and hospital to home was increasingly lower (91.9%, 71.5%, 33.8%) among them, revealing online clinic improving the revisit rate. Most patients lived in Chengdu (60.5%), and 67.4% patients from Chengdu were revisited. The median monthly cost of hospital to home patients (¥ 1863.8) was higher than the total median monthly cost (¥ 1714.5), illustrating the cost may reduce the revisit rate. CONCLUSIONS: Distance, cost and convenience may be the key factors to determine the method of visit and revisit in patients of home enteral nutrition. Online clinic may enhance the patients' follow-up.


Subject(s)
Enteral Nutrition , Malnutrition , Cross-Sectional Studies , Dietary Proteins , Enteral Nutrition/methods , Female , Humans , Male , Malnutrition/epidemiology , Malnutrition/prevention & control , Middle Aged , Tertiary Care Centers
4.
Nutrients ; 14(19)2022 Oct 08.
Article in English | MEDLINE | ID: covidwho-2066302

ABSTRACT

SARS-CoV-2 infection (COVID-19) is associated with malnutrition risk in hospitalised individuals. COVID-19 and malnutrition studies in large European cohorts are limited, and post-discharge dietary characteristics are understudied. This study aimed to assess the rates of and risk factors for ≥10% weight loss in inpatients with COVID-19, and the need for post-discharge dietetic support and the General Practitioner (GP) prescription of oral nutritional supplements, during the first COVID-19 wave in a large teaching hospital in the UK. Hospitalised adult patients admitted between March and June 2020 with a confirmed COVID-19 diagnosis were included in this retrospective cohort study. Demographic, anthropometric, clinical, biochemical, and nutritional parameters associated with ≥10% weight loss and post-discharge characteristics were described. Logistic regression models were used to identify risk factors for ≥10% weight loss and post-discharge requirements for ongoing dietetic input and oral nutritional supplement prescription. From the total 288 patients analysed (40% females, 72 years median age), 19% lost ≥ 10% of their admission weight. The length of hospital stay was a significant risk factor for ≥10% weight loss in multivariable analysis (OR 1.22; 95% CI 1.08-1.38; p = 0.001). In addition, ≥10% weight loss was positively associated with higher admission weight and malnutrition screening scores, dysphagia, ICU admission, and artificial nutrition needs. The need for more than one dietetic input after discharge was associated with older age and ≥10% weight loss during admission. A large proportion of patients admitted to the hospital with COVID-19 experienced significant weight loss during admission. Longer hospital stay is a risk factor for ≥10% weight loss, independent of disease severity, reinforcing the importance of repeated malnutrition screening and timely referral to dietetics.


Subject(s)
COVID-19 , Malnutrition , Adult , Aftercare , COVID-19/epidemiology , COVID-19 Testing , Female , Hospitalization , Hospitals, Teaching , Humans , Male , Malnutrition/diagnosis , Malnutrition/epidemiology , Malnutrition/etiology , Nutritional Status , Patient Discharge , Retrospective Studies , SARS-CoV-2 , Weight Loss
5.
PLoS One ; 17(10): e0275345, 2022.
Article in English | MEDLINE | ID: covidwho-2065132

ABSTRACT

Issues related to malnutrition, broadly defined, have received a growing attention in recent years, not only in connection with the Sustainable Development Goals but also recently with the unprecedented Covid-19 pandemic. At the same time, there exists a complex interaction between institutions, capital flows, and food and nutrition security that has received less attention in the relevant literature. In this paper we estimate a series of dynamic panel data models to examine the impact of institutional quality and capital flows on food security, nutrition security and undernourishment by using panel data for 25 SSA countries over the period 1996 to 2018. One of the key contributions of the paper is the use of both aggregate and disaggregated capital flows to examine the impact on both food and nutrition security, a dimension that has been surprisingly neglected in most of the relevant literature. We combine this with the interaction of various types of capital flows with an institutional quality index we constructed from various governance indicators to examine the impact of institutions on the overall nexus. Finally, we examine the impact not only on food and nutrition security but also on undernourishment. Our findings clearly demonstrate the importance of a heterogeneity approach and reflect on earlier work regarding the role of institutional quality in the overall nexus between external capital flows and various measures of food and nutrition security which leads, and as expected, to an interesting variation in the results obtained, depending on the type of capital flows and the interaction with the governance indicators.


Subject(s)
COVID-19 , Malnutrition , COVID-19/epidemiology , Food Supply/methods , Humans , Malnutrition/epidemiology , Nutritional Status , Pandemics
6.
Asia Pac J Clin Nutr ; 31(3): 355-361, 2022.
Article in English | MEDLINE | ID: covidwho-2056208

ABSTRACT

BACKGROUND AND OBJECTIVES: Malnutrition is common in elderly patients and is an important geriatric syndrome that increases mortality. We aim to examine the frequency of malnutrition and independent risk factors associated with mortality in hospitalized elderly patients with COVID-19. METHODS AND STUDY DESIGN: Patients aged 65 years and older with COVID-19, who were hospitalized between 15th March and 30th April 2020, were included. Demographic characteristics of the patients, their comorbid diseases, medications, malnutrition, and mortality status were recorded. Nutritional Risk Screening-2002 was used as a malnutrition risk screening tool. The factors affecting mortality were analyzed using multivariate Binary Logistic regression analysis. RESULTS: Of the 451 patients included in the study, the mean age was 74.8±7.46 and 51.2% of them were female. The mean number of comorbid diseases was 1.9±1.28. Malnutrition risk was 64.7%, polymorbidity rate was 57.6% and polypharmacy was 19.3%. Mortality rate was found 18.4%. The risk factors affecting mortality were presented as malnutrition risk (OR: 3.26, p=0.013), high number of comorbid diseases (OR: 1.48, p=0.006), and high neutrophil/lymphocyte ratio (OR: 1.18, p<0.001), C-reactive protein (OR: 1.01, p<0.001), and ferritin (OR: 1.01, p=0.041) in elderly patients with COVID-19. Malnutrition risk (3.3 times), multiple comorbid diseases (1.5 times), and high neutrophil/lymphocyte ratio (1.2 times) were independent risk factors that increased the mortality. CONCLUSIONS: The frequency of malnutrition risk and mortality in elderly patients with COVID-19 is high. The independent risk factors affecting mortality in these patients are the risk of malnutrition, multiple comorbid diseases, and a high neutrophil/lymphocyte ratio.


Subject(s)
COVID-19 , Malnutrition , Aged , Aged, 80 and over , C-Reactive Protein , Female , Ferritins , Geriatric Assessment/methods , Humans , Male , Malnutrition/complications , Malnutrition/diagnosis , Malnutrition/epidemiology , Nutrition Assessment , Nutritional Status , Risk Factors , Turkey/epidemiology
7.
Indian J Public Health ; 66(3): 313-320, 2022.
Article in English | MEDLINE | ID: covidwho-2055731

ABSTRACT

The slow improvement in micronutrient malnutrition globally and in India warrants a need for scaling-up scientifically proven, cost-effective public health interventions. The present review discusses the potential of staple food fortification as a complementary strategy to tackle micronutrient deficiencies, while addressing the current concerns raised regarding its implementation. The review indicates the below par status of current strategies like dietary diversity and supplementation to address multiple micronutrients deficiencies in India and the need for complementary strategies to tackle this problem. Based on systematic reviews and meta-analysis, global and national evidence has identified staple food fortification as a proven and recognized cost-effective solution to address micronutrient deficiencies. The Government of India has shown a strong leadership to promote this proven intervention. Further, the paper addresses the concern that large-scale staple food fortification (LSFF) may lead to excessive nutrient intakes when delivered together with other interventions, e.g., supplementation, dietary diversity, among the same populations. A key message that emerges from this review is that LSFF is safe with current dietary intake and deficiencies and low coverage of other interventions. Given the current situation of food and nutrition insecurity which the COVID-19 pandemic has further exacerbated, and the critical role that nutrition plays in building immunity, it is even more important that health and nutrition of the population, especially vulnerable age groups, is not only safeguarded but also strengthened. LSFF should be implemented without any further delay to reach the most vulnerable segments of the population to reduce the dietary nutrient gap and prevent micronutrient deficiencies. Effective monitoring and regular dietary surveys will help ensure these interventions are being deployed correctly.


Subject(s)
COVID-19 , Malnutrition , Food, Fortified , Humans , India/epidemiology , Malnutrition/epidemiology , Malnutrition/prevention & control , Micronutrients , Minerals , Pandemics , Vitamins
8.
PLoS Pathog ; 18(10): e1010810, 2022 10.
Article in English | MEDLINE | ID: covidwho-2054393

ABSTRACT

Despite the fact that we produce enough food to feed everyone on Earth, world hunger is on the rise. On the other side of the table, the obesity crisis also weighs heavily. Malnutrition is less about food than about socioeconomic factors such as conflict, poverty, and global disasters such as climate change and the novel Coronavirus Disease 2019 (COVID-19) pandemic. Nutrition and infectious disease exist in an intricate dance. Adequate and balanced nutrition is critical for appropriate response to infection and any changes in the balance can serve as a tipping point for the next pandemic. On the other hand, pandemics, such as COVID-19, lead to greater malnutrition. Both over- and undernutrition increase severity of disease, alter vaccine effectiveness, and potentially create conditions for viral mutation and adaptation-further driving the disease and famine vicious cycle. These long-term health and socioeconomic repercussions have direct effects at individual and global levels and lead to long-term consequences. Therefore, investing in and strengthening public health, pandemic prevention, and nutrition programs become vital at a much more complex systems level.


Subject(s)
COVID-19 , Malnutrition , Famine , Humans , Hunger , Malnutrition/epidemiology , Pandemics/prevention & control
9.
Nutrients ; 14(18)2022 Sep 16.
Article in English | MEDLINE | ID: covidwho-2043874

ABSTRACT

BACKGROUND: The phenotype of patients affected by COVID-19 disease changed between the waves of the pandemic. We assessed the prevalence of oropharyngeal dysphagia (OD), malnutrition (MN), and mortality between the first three waves of COVID-19 patients in a general hospital. METHODS: a prospective observational study between April 2020-May 2021. Clinical assessment for OD was made with the volume-viscosity swallowing test; nutritional assessment was performed consistent with GLIM criteria. A multimodal intervention was implemented in the second and third wave, including (a) texturized diets-fork mashable (1900 kcal + 90 g protein) or pureed (1700 kcal + 75 g protein), (b) oral nutritional supplements (500-600 kcal + 25-30 g protein), and (c) fluid thickening (250 mPa·s or 800 mPa·s). RESULTS: We included 205 patients (69.3 ± 17.6 years) in the 1st, 200 (66.4 ± 17.5 years) in the 2nd, and 200 (72.0 ± 16.3 years;) in the 3rd wave (p = 0.004). On admission, prevalence of OD was 51.7%, 31.3% and 35.1%, and MN, 45.9%, 36.8% and 34.7%, respectively; mortality was 10.7%, 13.6% and 19.1%. OD was independently associated with age, delirium, and MN; MN, with age, OD, diarrhea and ICU admission; mortality, with age, OD and MN. (4) Conclusions: Prevalence of OD, MN and mortality was very high among COVID-19 patients. OD was independently associated with MN and mortality. An early and proactive multimodal nutritional intervention improved patients' nutritional status.


Subject(s)
COVID-19 , Deglutition Disorders , Malnutrition , COVID-19/epidemiology , Deglutition Disorders/complications , Deglutition Disorders/epidemiology , Deglutition Disorders/therapy , Humans , Malnutrition/complications , Malnutrition/epidemiology , Nutritional Status , Pandemics , Prevalence
10.
Trends Pharmacol Sci ; 43(12): 994-997, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2028545

ABSTRACT

Together with climate change, both the geopolitical events in Ukraine and social disruptions in supply chains from the COVID-19 pandemic could produce global food shortages or even mass starvation events. Promising new interventions include vaccines to prevent infectious causes of malnutrition or infections disproportionately causing death among the malnourished.


Subject(s)
COVID-19 , Malnutrition , Vaccines , Humans , Pandemics/prevention & control , COVID-19/prevention & control , Malnutrition/prevention & control , Malnutrition/epidemiology , Malnutrition/etiology
11.
Nutrients ; 14(16)2022 Aug 22.
Article in English | MEDLINE | ID: covidwho-1997733

ABSTRACT

Background: Malnutrition is highly prevalent in medical inpatients and may also negatively influence clinical outcomes of patients hospitalized with COVID-19. We analyzed the prognostic implication of different malnutrition parameters with respect to adverse clinical outcomes in patients hospitalized with COVID-19. Methods: In this observational study, consecutively hospitalized adult patients with confirmed COVID-19 at the Cantonal Hospital Aarau (Switzerland) were included between February and December 2020. The association between Nutritional Risk Screening 2002 (NRS 2002) on admission, body mass index, and admission albumin levels with in-hospital mortality and secondary endpoints was studied by using multivariable regression analyses. Results: Our analysis included 305 patients (median age of 66 years, 66.6% male) with a median NRS 2002-score of 2.0 (IQR 1.0, 3.0) points. Overall, 44 patients (14.4%) died during hospitalization. A step-wise increase in mortality risk with a higher nutritional risk was observed. When compared to patients with no risk for malnutrition (NRS 2002 < 3 points), patients with a moderate (NRS 2002 3-4 points) or high risk for malnutrition (NRS 2002 ≥ 5 points) had a two-fold and five-fold increase in risk, respectively (10.5% vs. 22.7% vs. 50.0%, p < 0.001). The increased risk for mortality was also confirmed in a regression analysis adjusted for gender, age, and comorbidities (odds ratio for high risk for malnutrition 4.68, 95% CI 1.18 to 18.64, p = 0.029 compared to patients with no risk for malnutrition). Conclusions: In patients with COVID-19, the risk for malnutrition was a risk factor for in-hospital mortality. Future studies should investigate the role of nutritional treatment in this patient population.


Subject(s)
COVID-19 , Malnutrition , Adult , Aged , Female , Hospitalization , Humans , Male , Malnutrition/epidemiology , Nutrition Assessment , Nutritional Status
12.
J Nutr Sci ; 11: e63, 2022.
Article in English | MEDLINE | ID: covidwho-1972474

ABSTRACT

Child malnutrition is the leading public health problem in Sub-Saharan Africa, resulting in poor health and economic losses. Ethiopia has one of the highest child undernutrition rates in the world that occurs to multifaceted factors, including food insecurity. Thus, we performed a cross-sectional study to assess the prevalence and risk factors for child undernutrition in largely food insecure areas of Ethiopia. Data were collected from 354 mother-child pairs from the Siraro district. Both bivariate and multivariate logistic regression was used for statistical analysis. Variables with a P-value of <0⋅05 in multivariate analysis were used to detect statistical significance at a 95 % confidence level. About 67 % of households are food insecure. The prevalence of stunting wasting and underweight were 42⋅7, 9⋅9 and 27⋅7 %, respectively. Female gender, higher age of the child (12-23 months v. 6-11 months), living in a household with five or more siblings, not getting therapeutic zinc supplement at least once, inadequate diet diversity, lack of growth monitoring service, and maternal own income increases the likelihood of child undernutrition. It can be concluded that child undernutrition is a severe public health problem in the study area. Improving primary healthcare services related to zinc supplementation, growth monitoring and promotion, and improving infant and child feeding practices can be considered as a strategy to address the problem.


Subject(s)
Child Nutrition Disorders , Malnutrition , Child Nutrition Disorders/complications , Child Nutrition Disorders/epidemiology , Child, Preschool , Cross-Sectional Studies , Ethiopia/epidemiology , Female , Food Insecurity , Humans , Infant , Malnutrition/epidemiology , Zinc
13.
Nutr Cancer ; 74(10): 3601-3610, 2022.
Article in English | MEDLINE | ID: covidwho-1915351

ABSTRACT

Cancer patients often face malnutrition, which negatively affects their response to cancer treatment. This study aims to analyze the effects of the COVID-19 pandemic on nutritional status and anxiety in cancer patients with different types and stages of cancer. This is a cross-sectional cohort study that includes 1,252 patients with varying cancer types from 17 radiation oncology centers. The nutritional risk scores (NRS-2002) and coronavirus anxiety scale (CAS) scores of all patients were measured. NRS-2002 ≥ 3 and CAS ≥ 5 were accepted as values at risk. Of all patients, 15.3% had NRS-2002 ≥ 3. Breast cancer was the most prevalent cancer type (24.5%) with the lowest risk of nutrition (4.9%, p < 0.001). Nutritional risk was significantly higher in patients with gastrointestinal cancer, head and neck cancer, and lung cancer (p < 0.005) and in patients with stage IV disease (p < 0.001). High anxiety levels (CAS ≥ 5) were significantly related to voluntary avoidance and clinical postponement of hospital visits due to the pandemic (p < 0.001), while clinical postponement was particularly frequent among patients with NRS-2002 < 3 (p = 0.0021). Fear and anxiety in cancer patients with COVID-19 cause hesitations in visiting hospitals, leading to disrupted primary and nutritional treatments. Thus, nutritional monitoring and treatment monitoring of cancer patients are crucial during and after radiotherapy.


Subject(s)
COVID-19 , Head and Neck Neoplasms , Malnutrition , Ambulatory Care Facilities , Anxiety/epidemiology , Anxiety/etiology , COVID-19/epidemiology , Cross-Sectional Studies , Head and Neck Neoplasms/complications , Humans , Malnutrition/epidemiology , Malnutrition/etiology , Malnutrition/therapy , Nutrition Assessment , Nutritional Status , Pandemics
14.
Med J Malaysia ; 77(3): 313-319, 2022 05.
Article in English | MEDLINE | ID: covidwho-1871853

ABSTRACT

BACKGROUND: Acute illness and hospitalisation detriment the nutritional status of older patients. This study aimed to describe the prevalence of malnutrition, characteristics and in-hospital outcomes associated with malnutrition, and nutritional management among patients who were admitted to the Subacute Geriatric Ward. METHODS: This is a retrospective study of older patients (age ≥ 60) who were admitted to the Subacute Geriatric Ward of Kuala Lumpur Hospital from 1 March 2021 to 31 May 2021. Malnutrition was identified using the Mini Nutritional Assessment-Short Form (MNA-SF). The in-hospital outcomes evaluated were hospital-associated complications, namely delirium, functional decline, incontinence, inpatient falls, inpatient pressure injuries, hospital-acquired infection, institutionalisation, and inpatient mortality. RESULTS: Seventy-three patients were included (mean age 74.7, female 58.9%), of which 28 (38.4%) and 27 (37.0%) were malnourished and at risk of malnutrition, respectively. Poorer nutritional status was associated with increased age, comorbidity burden, frailty, immobility, impaired basic activities of daily living, history of falls, cognitive impairment, incontinence, and arthritis. About 71.2% and 60.3% of patients were offered dietitian review and oral nutritional supplements, respectively. The in-hospital outcome rates were higher among malnourished patients, but the differences were not statistically significant. However, multiple hospital-associated complications were more common with poorer nutritional status (p = 0.018). CONCLUSION: Hospital malnutrition is prevalent among older patients, and unidentified malnutrition is not justified due to its association with multiple adverse outcomes.


Subject(s)
COVID-19 , Malnutrition , Activities of Daily Living , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Female , Geriatric Assessment , Hospitalization , Humans , Malaysia/epidemiology , Malnutrition/complications , Malnutrition/epidemiology , Pandemics , Retrospective Studies , Tertiary Care Centers
15.
Ann Nutr Metab ; 78 Suppl 2: 40-50, 2022.
Article in English | MEDLINE | ID: covidwho-1861722

ABSTRACT

BACKGROUND: Over the last 30-40 years, we have seen an improvement in global child undernutrition, with major reductions in wasting and stunting. Meanwhile, childhood obesity has dramatically increased, initially in high-income populations and subsequently in the more economically vulnerable. These trends are related to significant changes in diet and external factors, including new environmental threats. SUMMARY: Obesity rates first increased in older children, then gradually in infants. And in the next couple of years, there will be more overweight and obese than moderately or severely underweight children in the world. The changes in childhood nutritional landscape are a result of poor diets. Today, almost 50% of the world's population consumes either too many or too few calories. Dietary disparities between countries result in disparities of under- and overnutrition and impact the global health landscape. Most children with obesity, wasting, and micronutrient deficiencies live in lower income countries and in lower income families within any country. High energy-low nutrient diets are contributing to the increase in non-communicable diseases, which will manifest later in this generation of children. In 1990, child wasting was the #1 leading risk factor for mortality for all ages, and high BMI was #16; today, they are #11 and #5, respectively. COVID-19 and climate change are new major threats to global nutrition. Current and future efforts to improve the state of child nutrition require multisectoral approaches to reprioritize actions which address current trends and emerging threats.


Subject(s)
COVID-19 , Malnutrition , Pediatric Obesity , COVID-19/epidemiology , COVID-19/prevention & control , Child , Diet , Humans , Infant , Malnutrition/epidemiology , Malnutrition/prevention & control , Nutritional Status , Pediatric Obesity/epidemiology , Pediatric Obesity/prevention & control
16.
Nutrients ; 14(7)2022 Apr 02.
Article in English | MEDLINE | ID: covidwho-1834856

ABSTRACT

INTRODUCTION: Poor physical performance has been shown to be a good predictor of complications in some pathologies. The objective of our study was to evaluate, in patients with colorectal neoplasia prior to surgery, physical performance and its relationship with postoperative complications and in-hospital mortality, at 1 month and at 6 months. METHODS: We conducted a prospective study on patients with preoperative colorectal neoplasia, between October 2018 and July 2021. Physical performance was evaluated using the Short Physical Performance Battery (SPPB) test and hand grip strength (HGS). For a decrease in physical performance, SPPB < 10 points or HGS below the EWGSOP2 cut-off points was considered. Nutritional status was evaluated using subjective global assessment (SGA). The prevalence of postoperative complications and mortality during admission, at 1 month, and at 6 months was evaluated. RESULTS: A total of 296 patients, mean age 60.4 ± 12.8 years, 59.3% male, were evaluated. The mean BMI was 27.6 ± 5.1 kg/m2. The mean total SPPB score was 10.57 ± 2.07 points. A total of 69 patients presented a low SPPB score (23.3%). Hand grip strength showed a mean value of 33.1 ± 8.5 kg/m2 for men and 20.7 ± 4.3 kg/m2 for women. A total of 58 patients presented low HGS (19.6%). SGA found 40.2% (119) of patients with normal nourishment, 32.4% (96) with moderate malnutrition, and 27.4% (81) with severe malnutrition. Postoperative complications were more frequent in patients with a low SPPB score (60.3% vs. 38.6%; p = 0.002) and low HGS (64.9% vs. 39.3%, p = 0.001). A low SPPB test score (OR 2.57, 95% CI 1.37-4.79, p = 0.003) and low HGS (OR 2.69, 95% CI 1.37-5.29, p = 0.004) were associated with a higher risk of postoperative complications after adjusting for tumor stage and age. Patients with a low SPPB score presented an increase in in-hospital mortality (8.7% vs. 0.9%; p = 0.021), at 1 month (8.7% vs. 1.3%; p = 0.002) and at 6 months (13.1% vs. 2.2%, p < 0.001). Patients with low HGS presented an increase in mortality at 6 months (10.5% vs. 3.3%; p = 0.022). CONCLUSIONS: The decrease in physical performance, evaluated by the SPPB test or hand grip strength, was elevated in patients with colorectal cancer prior to surgery and was related to an increase in postoperative complications and mortality.


Subject(s)
Colorectal Neoplasms , Malnutrition , Aged , Colorectal Neoplasms/complications , Colorectal Neoplasms/surgery , Female , Hand Strength , Humans , Male , Malnutrition/complications , Malnutrition/diagnosis , Malnutrition/epidemiology , Middle Aged , Physical Functional Performance , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Prospective Studies
18.
Nutrients ; 14(9)2022 Apr 29.
Article in English | MEDLINE | ID: covidwho-1820347

ABSTRACT

BACKGROUND: A higher risk for severe clinical courses of coronavirus disease 2019 (COVID-19) has been linked to deficiencies of several micronutrients. We therefore studied the prevalence of deficiencies of eight different micronutrients in a cohort of hospitalized COVID-19-patients. METHODS: We measured admission serum/plasma levels of vitamins A, B12, D, and E, as well as folic acid, zinc, selenium, and copper in 57 consecutively admitted adult patients with confirmed COVID-19 and analyzed prevalence of micronutrient deficiencies and correlations among micronutrient levels. Further, we studied associations of micronutrient levels with severe disease progression, a composite endpoint consisting of in-hospital mortality and/or need for intensive care unit (ICU) treatment with logistic regression. RESULTS: Median age was 67.0 years (IQR 60.0, 74.2) and 60% (n = 34) were male. Overall, 79% (n = 45) of patients had at least one deficient micronutrient level and 33% (n = 19) had ≥3 deficiencies. Most prevalent deficiencies were found for selenium, vitamin D, vitamin A, and zinc (51%, 40%, 39%, and 39%, respectively). We found several correlations among micronutrients with correlation coefficients ranging from r = 0.27 to r = 0.42. The strongest associations with lower risk for severe COVID-19 disease progression (adjusted odds ratios) were found for higher levels of vitamin A (0.18, 95% CI 0.05-0.69, p = 0.01), zinc (0.73, 95% CI 0.55-0.98, p = 0.03), and folic acid (0.88, 95% CI 0.78-0.98, p = 0.02). CONCLUSIONS: We found a high prevalence of micronutrient deficiencies in mostly older patients hospitalized for COVID-19, particularly regarding selenium, vitamin D, vitamin A, and zinc. Several deficiencies were associated with a higher risk for more severe COVID-19 courses. Whether supplementation of micronutrients is useful for prevention of severe clinical courses or treatment of COVID-19 warrants further research.


Subject(s)
COVID-19 , Malnutrition , Selenium , Adult , Aged , COVID-19/epidemiology , Cohort Studies , Disease Progression , Female , Folic Acid , Humans , Male , Malnutrition/epidemiology , Micronutrients , Prevalence , Vitamin A , Vitamin D , Vitamins , Zinc/therapeutic use
19.
Int J Environ Res Public Health ; 19(8)2022 04 13.
Article in English | MEDLINE | ID: covidwho-1809870

ABSTRACT

The objective of this study was to explore the socioeconomic inequalities in undernutrition among ever-married women of reproductive age. We used nationally representative cross-sectional data from the Bangladesh Demographic and Health Survey, 2017-2018. Undernutrition was defined as a body mass index (BMI) of <18.5 kg/m2. The concentration index (C) was used to measure the socioeconomic inequality in the prevalence of women's undernutrition. A multiple binary logistic regression model was carried out to find out the factors associated with women's undernutrition. The prevalence of undernutrition among women of 15-49 years was 12%. Among them, 8.5% of women were from urban and 12.7% of women were from rural areas. The prevalence of undernutrition was highest (21.9%) among women who belonged to the adolescent age group (15-19 years). The C showed that undernutrition was more prevalent among the socioeconomically worst-off (poorest) group in Bangladesh (C = -0.26). An adjusted multiple logistic regression model indicated that women less than 19 years of age had higher odds (adjusted odds ratio, AOR: 2.81; 95% confidence interval, CI: 2.23, 3.55) of being undernourished. Women from the poorest wealth quintile (AOR: 3.93, 95% CI: 3.21, 4.81) had higher odds of being undernourished. On the other hand, women who had completed secondary or higher education (AOR: 0.55; 95% CI: 0.49, 0.61), married women who were living with their husbands (AOR: 0.72, 95% CI: 0.61, 0.86), and women exposed to mass media (AOR: 0.87, 95% CI: 0.79, 0.97) were less likely to be undernourished. Intervention strategies should be developed targeting the poorest to combat undernutrition in women of reproductive age in Bangladesh.


Subject(s)
Malnutrition , Adolescent , Adult , Bangladesh/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Malnutrition/epidemiology , Marriage , Prevalence , Socioeconomic Factors , Young Adult
20.
BMJ Glob Health ; 7(4)2022 04.
Article in English | MEDLINE | ID: covidwho-1807374

ABSTRACT

Over the last two decades, severe acute malnutrition (SAM) has been increasing in India despite favourable national-level economic growth. The latest round of the National Family Health Survey 5 (NFHS-5) results was released, allowing us to assess changes in the malnutrition trends. Analysis of the previous rounds of the NFHS (NFHS-4) has already shown disturbing levels of wasting, often co-occurring with other forms of anthropometric failures. These have been shown to occur in clusters of districts across India that already needed urgent policy and programmatic action. A rapid assessment of data from NFHS-5 for some of these districts for which data are now available shows an alarming increase in SAM in several malnutrition hotspot districts. Surprisingly, some districts outside hotspots and in states and regions that have previously not been known for high malnutrition too have shown increasing SAM prevalence in the latest round. The data from NFHS-5 was collected just before the COVID-19 pandemic and hence does not yet reflect the likely impact of the pandemic on food security, livelihoods and other social stressors among the most marginalised Indian households. Based on this emerging pattern of increasing SAM, we call for an urgent policy and programmatic action to strengthen the Anganwadi system, which caters to preschool children in India and community-based management of acute malnutrition based on recent evidence on their effectiveness.


Subject(s)
COVID-19 , Child Nutrition Disorders , Malnutrition , Severe Acute Malnutrition , COVID-19/epidemiology , Child Nutrition Disorders/epidemiology , Child, Preschool , Humans , Malnutrition/epidemiology , Pandemics , Severe Acute Malnutrition/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL