Morphofunctional Nutritional Assessment in Clinical Practice

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: 15 May 2024 | Viewed by 6246

Special Issue Editors

1. Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain
2. Instituto de Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain
Interests: obesity; nutrigenetics; enteral nutrition; malnutrition related to the disease
Special Issues, Collections and Topics in MDPI journals
Centro de Investigación Endocrinología y Nutrición, Universidad de Valladolid, 47002 Valladolid, Spain
Interests: obesity and bone metabolismo; hyperglycaemia; stroke; enteral nutrition; nasogastric tube; dysphagia

Special Issue Information

Dear Colleagues,

The diagnosis of malnutrition is difficult because it does not depend only on weight at a given time, but also on its evolution and the underlying pathological situations. Therefore, the clinical use of body composition measurements is essential for adequate assessment of this malnutrition, especially in the evaluation of muscle mass and function. In this context, nutritional assessment can no longer be based on the determination of classical anthropometric measurements. The concept of morphofunctional nutritional assessment postulates that the diagnosis and monitoring of nutritional status must be carried out using techniques and biomarkers that determine the evaluation of intake, anthropometry, body composition, muscle strength, and function that include techniques such as bioelectrical impedance analysis or nutritional ultrasound, and new biological parameters too.

This Special Issue aims to show the implementation of this new concept of nutritional evaluation in the management of patients and in clinical research in nutrition.

Dr. Daniel-Antonio de Luis Roman
Dr. Juan J. López-Gómez
Guest Editors

Manuscript Submission Information

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Published Papers (4 papers)

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Editorial

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3 pages, 214 KiB  
Editorial
Morphofunctional Nutritional Assessment in Clinical Practice: A New Approach to Assessing Nutritional Status
Nutrients 2023, 15(19), 4300; https://doi.org/10.3390/nu15194300 - 09 Oct 2023
Cited by 1 | Viewed by 914
Abstract
This Special Issue of Nutrients titled “Morphofunctional Nutritional Assessment in Clinical Practice” is oriented to the diagnosis of disease-related malnutrition (DRM) [...] Full article
(This article belongs to the Special Issue Morphofunctional Nutritional Assessment in Clinical Practice)

Research

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10 pages, 794 KiB  
Article
Influence of the Results of Control of Intakes, Proteins and Anthropometry Nutritional Screening, Sarcopenia and Body Composition on the Clinical Evolution of Hospitalized Patients
Nutrients 2024, 16(1), 14; https://doi.org/10.3390/nu16010014 - 20 Dec 2023
Viewed by 679
Abstract
(1) Background: Hospital malnutrition and sarcopenia are common in inpatients and are associated with worse prognosis. Our objective is to determine the association of the positivity of CIPA (Control of Intakes, Proteins and Anthropometry) nutrition screening tool and sarcopenia and evaluate its prognostic [...] Read more.
(1) Background: Hospital malnutrition and sarcopenia are common in inpatients and are associated with worse prognosis. Our objective is to determine the association of the positivity of CIPA (Control of Intakes, Proteins and Anthropometry) nutrition screening tool and sarcopenia and evaluate its prognostic implications (length of stay, readmissions and mortality) as well as different components of body composition. (2) Methodology: Cross-sectional single-center study and prospective six months follow-up for prognostic variables. On admission, CIPA and EWGSOP2 criteria were assessed. (3) Results: Four hundred inpatients, a median of 65.71 years old and 83.6% with high comorbidity, were evaluated. In total, 34.8% had positive CIPA and 19.3% sarcopenia. Positive CIPA and sarcopenia had worse results in body composition (fat mass (FM), fat-free mass (FFM) and appendicular skeletal muscle mass index (ASMI)) and dynamometry. Positive CIPA is significantly associated with worse prognosis (mortality (OR = 1.99), readmissions (OR = 1.86) and length of stay (B = 0.19)). Positive CIPA and sarcopenia combined are associated with a tendency to higher mortality (OR = 2.1, p = 0.088). Low hand grip strength (HGS) is significantly related to a higher length of stay (B = −0.12). (4) Conclusions: In hospitalized patients, malnutrition independently and combined with sarcopenia is associated with a worse prognosis but not body composition. Low HGS is related to a higher length of stay. Full article
(This article belongs to the Special Issue Morphofunctional Nutritional Assessment in Clinical Practice)
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15 pages, 2166 KiB  
Article
Nutritional Ultrasonography, a Method to Evaluate Muscle Mass and Quality in Morphofunctional Assessment of Disease Related Malnutrition
Nutrients 2023, 15(18), 3923; https://doi.org/10.3390/nu15183923 - 09 Sep 2023
Cited by 1 | Viewed by 1576
Abstract
Nutritional ultrasonography is an emerging technique for measuring muscle mass and quality. The study aimed to evaluate the relationship between the parameters of body mass and quality of ultrasonography with other parameters of morphofunctional assessment in patients with disease-related malnutrition (DRM). Methods: A [...] Read more.
Nutritional ultrasonography is an emerging technique for measuring muscle mass and quality. The study aimed to evaluate the relationship between the parameters of body mass and quality of ultrasonography with other parameters of morphofunctional assessment in patients with disease-related malnutrition (DRM). Methods: A cross-sectional study was developed on 144 patients diagnosed with DRM according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Morphofunctional evaluation was assessed with anthropometric variables, handgrip strength and bioelectrical impedanciometry (BIA). Nutritional ultrasonography of quadriceps rectus femoris (QRF) was made (muscle mass (Muscle Area of Rectus Femoris index (MARFI)), Y axis and muscle quality (X-Y index and echogenicity). Results: The mean age of patients was 61.4 (17.34) years. The prevalence of sarcopenia in the sample was 33.3%. Patients with sarcopenia (S) had lower values of MARFI [(S: 1.09 (0.39) cm2/m2; NoS: 1.27 (0.45); p = 0.02), Y axis (S: 0.88 (0.27); NoS: 1.19 (0.60); p < 0.01) and X-Y index (S: 1.52 (0.61); NoS: 1.30 (0.53); p < 0.01)]. There was a correlation between BIA parameters (phase angle) and muscle mass ultrasonographic variables (MARFI) (r = 0.35; p < 0.01); there was an inverse correlation between muscle quality ultrasonographic variables (echogenicity) and handgrip strength (r = −0.36; p < 0.01). In the multivariate analysis adjusted by age, the highest quartile of the X-Y index had more risk of death OR: 4.54 CI95% (1.11–18.47). Conclusions: In patients with DRM and sarcopenia, standardized muscle mass and muscle quality parameters determined by ultrasonography of QRF are worse than in patients without sarcopenia. Muscle quality parameters had an inverse correlation with electric parameters from BIA and muscle strength. The highest quartile of the X-Y index determined by ultrasonography was associated with increased mortality risk. Full article
(This article belongs to the Special Issue Morphofunctional Nutritional Assessment in Clinical Practice)
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12 pages, 704 KiB  
Article
Global Subjective Assessment and Mini Nutritional Assessment Short Form Better Predict Mortality Than GLIM Malnutrition Criteria in Elderly Patients with Hip Fracture
Nutrients 2023, 15(8), 1828; https://doi.org/10.3390/nu15081828 - 10 Apr 2023
Cited by 4 | Viewed by 2063
Abstract
The objective of our study is to determine the prevalence of malnutrition in elderly patients with fragility hip fractures through different diagnostic tools and to determine which nutritional assessment tool better predicts mortality. Methods: This is a prospective study in patients over 65 [...] Read more.
The objective of our study is to determine the prevalence of malnutrition in elderly patients with fragility hip fractures through different diagnostic tools and to determine which nutritional assessment tool better predicts mortality. Methods: This is a prospective study in patients over 65 years of age hospitalized with a diagnosis of hip fracture. A nutritional assessment was performed using several tools: the Mini Nutritional Assessment Short Form (MNA-SF), the Subjective Global Assessment (SGA), and the GLIM criteria. For the definition of low muscle mass, four different methods were used: hand grip strength (HGS), calf circumference (CC), anthropometry, and bioelectrical impedance (BIA). Mortality was registered at three, six and twelve months. Results: 300 patients were included, 79.3% female, mean age 82.9 ± 7.1 years. The MNA-SF found 42% at risk of malnutrition, and 37.3% malnourished. Using SGA, there were 44% with moderate malnutrition, and 21.7% with severe malnutrition. In application of the GLIM criteria, 84.3%, 47%, 46%, and 72.7% of patients were malnourished when HGS, anthropometry, BIA, and CC were used, respectively. Mortality was 10%, 16.3% and 22% at 3, 6 and 12 months, respectively. In malnourished patients according to MNA-SF, mortality was 5.7 times greater [95%CI 1.3–25.4; p = 0.022] at 6 months and 3.8 times greater [95%CI 1.3–11.6; p = 0.018] at 12 months. In malnourished patients according to SGA, mortality was 3.6 times greater [95%CI 1.02–13.04; p = 0.047] at 3 months, 3.4 times greater [95%CI 1.3–8.6; p = 0.012] at 6 months and 3 times greater [95%CI 1.35–6.7; p = 0.007] at 12 months. Conclusion: The prevalence of malnutrition in patients admitted for fragility hip fracture is high. The SGA and MNA-SF are postulated as adequate tools to diagnose malnutrition in these patients, with predictive value for mortality at three, six, and twelve months. Full article
(This article belongs to the Special Issue Morphofunctional Nutritional Assessment in Clinical Practice)
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