Search Results (108)

Background/Objectives: Malnutrition affects 20–71% of patients with head and neck cancer (HNC), owing to tumor location, treatment-induced toxicities, and systemic inflammation. Enteral nutrition is preferred when oral intake is inadequate, yet standard powdered formulas require labor-intensive reconstitution and carry a contamination risk. PSU Blen, a ready-to-drink chicken-protein-based polymeric formula, was developed to address these limitations. Methods: In this single-center study, thirty clinically stable patients with HNC on tube feeding were randomized 1:1 to PSU Blen or a commercial powdered polymeric formula (Blendera) for 4 weeks. The primary outcome was change in Patient-Generated Subjective Global Assessment (PG-SGA) score from baseline to week 4, analyzed under a prespecified non-inferiority framework (margin δ = 2 points, selected as a clinically acceptable upper bound based on published PG-SGA data). Secondary outcomes were handgrip strength, body weight, body mass index, serum albumin, hemoglobin, and platelet count. Results: The mean change in PG-SGA score was −1.13 (SD 0.92) and −0.87 (SD 1.36) in the PSU Blen and Blendera groups; the between-group difference was −0.27 points (two-sided 90% CI: −0.99 to +0.45), with the upper bound below the non-inferiority margin. Sensitivity analyses yielded consistent results. No significant between-group differences were observed for secondary outcomes, and both formulas were well tolerated, with no gastrointestinal intolerance or serious adverse events. Conclusions: PSU Blen demonstrated non-inferior nutritional outcomes based on the PG-SGA endpoint over 4 weeks, with comparable tolerability. Longer-term and multicenter studies are warranted to further evaluate its clinical utility and practical advantages in routine enteral nutrition practice. Full article

Background/Objectives: Human papillomavirus (HPV) is a well-established prognostic marker in oropharyngeal squamous cell carcinoma (OPSCC); however, the short-term treatment response remains heterogeneous, particularly among HPV-positive patients. Given the high prevalence of malnutrition in head and neck cancer, this study examined whether baseline nutritional status, body composition and functional status were associated with early treatment response in OPSCC according to HPV status. Methods: A prospective observational multicenter cohort study of newly diagnosed OPSCC patients eligible for curative-intent treatment was conducted at three tertiary hospitals in Barcelona, Spain. Baseline assessments comprised anthropometry, computed tomography (CT)-based body composition at L3, functional performance tests, systemic inflammatory biomarkers and nutritional diagnosis by the Patient-Generated Subjective Global Assessment (PG-SGA). Early treatment response, assessed around 12 weeks post-therapy, was classified as complete remission (CR) or non-complete remission (NCR). Classification tree analyses were performed separately by HPV status. Results: Of 101 enrolled patients, 97 completed post-treatment assessment, of whom 51% were HPV-positive. Among HPV-positive patients, PG-SGA score was the main discriminating variable for early response within the classification tree model, with CR achieved in 74% of patients scoring <6 versus 33% of those scoring ≥6 (AUC 0.68, 95% CI 0.55–0.82). Conversely, Eastern Cooperative Oncology Group Performance Status (ECOG PS) and age were the primary discriminating variables in HPV-negative patients (AUC 0.81, 95% CI 0.70–0.93). In both HPV subgroups, body composition and inflammatory markers were not retained in the analysis once nutritional and functional status were considered. Conclusions: PG-SGA-defined nutritional status was associated with early treatment response in HPV-positive patients, while functional status was the main variable retained in HPV-negative patients. These findings support the potential clinical value of standardized nutritional assessment in OPSCC and suggest that early identification of poor nutritional status or functional impairment may help refine supportive care planning at treatment initiation. Full article

Background: Malnutrition is a major global geriatric health problem, reported in approximately one-fifth of older adults worldwide and occurring even more frequently in acute care and hospital settings. Among older adults presenting to the emergency department (ED), nutritional vulnerability is often underrecognized because early ED decision-making is primarily dominated by acute physiological instability and the need for rapid disposition. Clarifying whether commonly used malnutrition screening tools provide clinically useful information beyond frailty, comorbidity burden and acute illness severity may help determine their role in early geriatric ED risk stratification, in-hospital care planning, and resource utilization. Objectives: To evaluate the prevalence, agreement, and clinical utility of three validated malnutrition screening tools the Malnutrition Universal Screening Tool (MUST), Nutritional Risk Screening 2002 (NRS-2002), and the clinician-administered Subjective Global Assessment (SGA) in older ED patients, and to examine their associations with hospital admission and length of stay (LOS). Methods: This prospective single-center study included 325 patients aged ≥65 years presenting to the ED. Nutritional status was assessed using the MUST, the NRS-2002, and the SGA. Agreement between tools was evaluated using Cohen’s kappa, positive percent agreement, and negative percent agreement. Associations with hospital admission were analyzed using multivariable logistic regression adjusted for age, sex, Clinical Frailty Scale, National Early Warning Score 2, and Charlson Comorbidity Index. Multivariable linear regression was used to identify predictors of LOS. Results: Overall, 32.6% of patients required hospital admission. Among admitted patients, the median hospital length of stay was 5 days (IQR 2–9). The prevalence of high nutritional risk varied substantially across tools, from 16.6% with the MUST to 41.5% with the NRS-2002 and 23.4% with the SGA. Agreement between tools was moderate overall (κ = 0.41–0.60), with moderate concordance in identifying low-risk and high-risk patients. After adjustment for clinically relevant covariates, none of the screening tools was independently associated with hospital admission. However, high-risk classification by the NRS-2002 was independently associated with prolonged LOS (β = 0.47, 95% CI 0.10–0.85; p = 0.01), whereas the MUST and the SGA were not. Conclusions: In older ED patients, malnutrition screening tools did not add independent value for predicting immediate hospital admission beyond frailty, comorbidity burden, and acute illness severity. However, the NRS-2002 was associated with longer hospital stay, suggesting potential value for early identification of patients who may require more complex in-hospital care and resource planning. Full article

Background/Objectives: Malnutrition is highly prevalent in patients with advanced colorectal cancer (CRC) and is associated with poorer treatment tolerance, reduced quality of life, and worse clinical outcomes. Chemotherapy regimens incorporating irinotecan are commonly used in later treatment lines but present a distinct toxicity profile characterized mainly by gastrointestinal symptoms and functional decline, which may negatively affect nutritional status. This study aimed to evaluate the impact of irinotecan-containing chemotherapy regimens on nutritional status and functional capacity in patients with advanced CRC using the Patient-Generated Subjective Global Assessment (PG-SGA). Methods: A cross-sectional observational study was conducted in 91 adult patients with histologically confirmed stage III–IV colorectal adenocarcinoma undergoing active systemic chemotherapy between November 2023 and June 2024. Demographic and clinical variables, treatment regimens, and exposure to irinotecan were recorded. Nutritional status was assessed using the PG-SGA, and body composition was evaluated by multifrequency bioelectrical impedance analysis. Associations between irinotecan exposure and nutritional, functional, and symptom-related variables were analyzed using χ² or Fisher’s exact tests. Results: Thirteen patients (14.3%) received irinotecan-containing regimens, most frequently combined with FOLFOX. Patients exposed to irinotecan presented higher PG-SGA scores, indicating a greater nutritional burden. Although most gastrointestinal symptoms did not reach statistical significance, early satiety (p = 0.041) and functional deterioration (p = 0.039) were significantly associated with irinotecan administration, while nausea (p = 0.089) and vomiting (p = 0.087) showed trends toward significance. The subgroup treated with FOLFOX–irinotecan also demonstrated a higher frequency of functional impairment compared with those receiving FOLFOX alone. Conclusions: Irinotecan-containing chemotherapy regimens in advanced CRC may be associated with a distinct pattern of nutritional deterioration primarily driven by functional decline and gastrointestinal symptoms affecting food intake. Systematic nutritional assessment using validated tools such as the PG-SGA may allow early identification of vulnerable patients and support the implementation of timely multimodal interventions aimed at improving treatment tolerance and clinical outcomes. Full article

Background/Objectives: Appropriate nutritional management constitutes one of the key elements of conservative treatment and renal replacement therapy in patients with chronic kidney disease (CKD). The level of patients’ nutritional knowledge may significantly influence adherence to dietary recommendations, the rate of disease progression, and the frequency of complications. The aim of this study was to assess the level of nutritional knowledge, dietary habits, adherence to dietary recommendations, and nutritional status of patients with CKD according to disease stage. Methods: This cross-sectional study was conducted among 98 adult patients diagnosed with CKD. A questionnaire assessing nutritional knowledge and dietary behaviors was administered. An overall nutritional knowledge score was calculated based on eight questionnaire items assessing nutritional knowledge. Nutritional status was evaluated using the Subjective Global Assessment (SGA) and the Simplified Nutritional Appetite Questionnaire (SNAQ). Anthropometric, clinical, and biochemical data were collected. Statistical analysis was performed using tests appropriate to the data distribution. Results: The level of nutritional knowledge varied and was dependent on CKD stage. Patients in more advanced stages of the disease demonstrated significantly higher awareness of dietary recommendations compared with those in earlier stages. The median nutritional knowledge score was 6 points, with 46.9% of participants demonstrating insufficient knowledge (<6 points) and 53.1% achieving adequate knowledge (≥6 points). The greatest knowledge deficits concerned the control of phosphorus, potassium, sodium, and fluid intake. Discrepancies were also observed between declared knowledge and actual dietary behaviors. Good nutritional status (SGA A) was identified in 73 patients, risk of malnutrition or moderate malnutrition (SGA B) in 22 individuals, and severe malnutrition (SGA C) in 3 patients. SNAQ indicated good appetite in the study population, with an average consumption of three meals per day, and identified a risk of weight loss in 6% of patients. Overweight and obesity were present in more than half of the study population, while underweight was observed in 4%. Conclusions: Nutritional knowledge among patients with CKD remains insufficient, particularly in the early stages of the disease. The findings highlight the necessity of early and systematic implementation of individualized nutritional education as an integral component of slowing disease progression. Full article

Background: Hematologic malignancies pose a critical threat to global health, with their pathological progression intrinsically linked to metabolic dysregulation and nutrient imbalance. Malnutrition accelerates the trajectory of adverse outcomes while substantially diminishing the quality of survival. Although several nutritional assessment tools are currently used in clinical practice, a significant evidence gap persists regarding their validation in populations with hematologic neoplasms. This study systematically evaluates the prognostic performance of existing nutritional assessment instruments in this cohort. Based on these findings, we further explored the feasibility of a preliminary framework that reflects metabolic characteristics specific to this population. Methods: This prospective cohort study analyzed nutritional assessment data from 1067 patients with hematologic malignancies enrolled in the INSCOC registry. Eight assessment systems were examined: Patient-Generated Subjective Global Assessment (PG-SGA), Modified PGSGA (mPG-SGA), PGSGA Short Form (PG-SGA SF), Abbreviated PGSGA (abPG-SGA), Nutritional Risk Screening-2002 (NRS-2002), Global Leadership Initiative on Malnutrition criteria (GLIM), Scored-GLIM, and Karnofsky Performance Status Scale (KPS). Kaplan–Meier survival curves and multivariate Cox regression analyses were conducted to investigate the association between nutritional status and overall survival (OS) and to determine the prognostic weight of individual components within the nutritional assessment tools. Linear regression models were applied to examine the relationships between nutritional assessment tools, length of hospital stay (LOS), and EORTC QLQ-C30 scores. The predictive performance of the tools was evaluated using the area under the receiver operating characteristic curve (AUC) and the concordance index (C-index). Least absolute shrinkage and selection operator (LASSO) regression was applied to optimize the selection of inflammation-related biomarkers. Results: A total of 1067 participants were analyzed (mean [SD] age, 55.54 [17.4] years; 625 were male [58.6%]). Cox proportional hazards regression demonstrated statistically significant associations for all eight nutritional assessment tools (p ≤ 0.05). However, their prognostic discrimination was limited, as indicated by the AUC analysis. Specifically, the area under the curve (AUC) values for each tool were as follows: mPG-SGA, 0.561; NRS-2002, 0.557; PG-SGA, 0.550; KPS, 0.544; PG-SGA SF, 0.542; abPG-SGA, 0.528; Scored-GLIM, 0.489; and GLIM, 0.473. The concordance index validation further corroborated these findings. Prognostically significant components and inflammation-related biomarkers identified by Cox and LASSO regression were combined to explore a composite assessment approach, termed the Hematologic Marker–Patient Generated Subjective Global Assessment (HMPG-SGA), incorporating the albumin–globulin ratio (AGR). The HMPG-SGA was significantly associated with overall survival (p < 0.001), with an AUC of 0.616 and a C-index of 0.605. Conclusions: Multidimensional validation demonstrated limited prognostic discrimination of eight conventional nutritional assessment tools for overall survival in patients with hematologic malignancies. Based on existing assessment tools and integrated hematologic indicators, the HMPG-SGA was preliminarily explored as a prognostic assessment tool in hematologic malignancies. Full article

Background/Objectives: Studies evaluating the impact of diet quality on nutrition- and muscle-related outcomes in cancer are limited. This study aimed to understand the diet quality of people with lung cancer and its cross-sectional associations with malnutrition, low muscle mass and (probable)-sarcopenia. Methods: Three-day food records were collected from 47 adults (mean ± SD age 70.6 ± 8.6 years; 58% male) with lung cancer prior to, or within one week, of curative-intent (chemo)radiotherapy. Dietary Guidelines Index (DGI-2013) and Mediterranean Diet Score (MDS) estimated diet quality, reflecting established healthy eating patterns. Malnutrition was determined using Patient Generated Subjective Global Assessment (PG-SGA). Low muscle mass was estimated using diagnostic third lumbar vertebra computed tomography (CT) images. (Probable)-sarcopenia was determined using the revised European Working Group for Sarcopenia in Older People definition, including low muscle (grip) strength, muscle mass and impaired function. Multivariate adjusted logistic regression analyses estimated odds ratios (OR) and 95% confidence intervals (CI) for associations between diet quality and outcomes. Results: Prevalence of malnutrition, low muscle mass and (probable)-sarcopenia were 36.2%, 50.0% and 13.6%, respectively. Mean ± SD DGI-2013 score was 53.0 ± 13.0. Adherence to the DGI-2013 was not significantly associated with malnutrition (OR, 0.67 [95%CI 0.35, 1.28]), low muscle mass (0.90 [95%CI 0.47, 1.70]) or (probable)-sarcopenia (0.73 [95%CI 0.29, 1.80]). Mean ± SD MDS was 3.6 ± 1.5. Adherence to the MDS was not significantly associated with malnutrition (0.75 [95%CI 0.37, 1.49]), low muscle mass (0.98 [95%CI 0.51, 1.88]) or (probable)-sarcopenia (1.82 [95%CI 0.72, 4.85]). Conclusions: Diet quality was not associated with malnutrition, low muscle mass or (probable)-sarcopenia. Given that overall diet quality was poor, it remains unclear whether high diet quality may be associated with nutritional status or muscle-related outcomes. Further research is needed to determine whether diet quality should be considered in nutritional interventions during lung cancer treatment. Full article

Autosomal dominant polycystic kidney disease (ADPKD) is the most frequent monogenic kidney disease (≈4 cases per 10.000 inhabitants) and a major cause of end-stage kidney disease (ESKD). Beyond progressive cystic enlargement of the kidneys and frequent extrarenal involvement, adults with ADPKD often exhibit a distinctive “body phenotype” with central adiposity and marked abdominal distension due to renal and hepatic organomegaly. In this setting, conventional anthropometric indices such as body mass index (BMI) and crude body weight are of limited value, as they cannot distinguish nutritional tissues (muscle, subcutaneous fat) from non-nutritional mass (cyst fluid, fibrotic tissue, or expanded extracellular water). This review summarizes the current evidence on malnutrition and sarcopenia in adult ADPKD, with a focus on the impact of organomegaly and adiposity. Cross-sectional work using the modified Subjective Global Assessment (SGA) has shown that approximately one-third of ambulatory ADPKD patients are at risk of becoming, or have become, malnourished, and that height-adjusted total kidney and liver volume (htTKLV) is the strongest clinical predictor of malnutrition, whereas eGFR plays a secondary role. Bioelectrical impedance analysis (BIA) further demonstrates a disease-specific body composition phenotype, with increased total and extracellular body water, particularly in the trunk, a reduced phase angle and reduced lean mass, consistent with early malnutrition and sarcopenia. These alterations are present even at relatively preserved kidney function and, in matched analyses, distinguish ADPKD from non-ADPKD CKD. Prospective data from a multicenter cohort indicate that the baseline SGA-defined nutritional status independently predicts short-term eGFR decline in typical ADPKD, supporting malnutrition as a potential modifier of renal trajectory rather than a mere correlate of advanced disease. In parallel, narrative syntheses on adiposity highlight that a higher BMI, waist circumference and visceral fat are associated with larger total kidney volume, faster eGFR loss and greater symptom burden, and raise concern for a sarcopenic obesity phenotype in which excess fat and cystic mass coexist with low muscle mass. Collectively, these findings support a pathophysiological model in which organomegaly-driven mechanical effects (early satiety, gastrointestinal discomfort), systemic inflammation, insulin resistance and cyst-related metabolic reprogramming converge to produce “hidden malnutrition” in ADPKD, masked by apparent overweight. From a clinical perspective, malnutrition and sarcopenia should be regarded as central, disease-modifying components of the ADPKD phenotype. Routine nutritional screening (e.g., SGA/PG-SGA) and BIA-based body composition assessment, particularly in patients with severe organomegaly or symptomatic polycystic liver disease, should be integrated into ADPKD care pathways, and individualized, muscle-preserving nutritional strategies should be tested in future prospective studies. Full article

Background/Objectives: The Global Leadership Initiative on Malnutrition (GLIM) recently updated its inflammation criterion through a Delphi consensus to standardize its assessment. This study aimed to assess the impact of these new recommendations on the concurrent and predictive validity of the GLIM criteria in hospitalized medical patients. Methods: This post hoc analysis re-evaluated a previously published cohort of 119 hospitalized patients with acute medical conditions, originally assessed using the GLIM criteria and the Subjective Global Assessment (SGA) as the reference standard. Inflammation was redefined according to the 2024 GLIM Delphi consensus, and the concurrent and predictive validity of the modified GLIM criteria (GLIM-I) were examined. Receiver operating characteristic (ROC) curves were used to compare the discriminative ability of SGA, original GLIM, and GLIM-I to predict prolonged hospital stay. Results: With the updated inflammation definition, all patients met the etiologic criterion, increasing malnutrition prevalence from 41.7% to 52.2%. GLIM-I showed a sensitivity of 78.0% and specificity of 67.7% versus SGA, not reaching the predefined ≥80% threshold for concurrent validity. Predictive validity was maintained (adjusted odds ratio (OR) = 3.40; 95% CI: 1.31–8.83). SGA achieved the highest discriminative ability (area under the curve (AUC) = 0.783; 95% CI: 0.693–0.874), significantly outperforming the original GLIM (AUC = 0.723; 95% CI: 0.616–0.830; p = 0.049). GLIM-I showed similar performance (AUC = 0.731; 95% CI: 0.620–0.843; p = 0.727). Conclusions: SGA should continue to be considered the method of choice for nutritional diagnosis in hospitalized medical patients. Further research is needed to determine how the new inflammation criteria influence the validity of the GLIM framework in other clinical contexts before their widespread implementation. Full article

Background/Objectives: Colorectal cancer (CRC) is associated with anorexia–cachexia syndrome, which negatively affects health-related quality of life (HRQoL). This study aimed to evaluate HRQoL and functional status in CRC patients undergoing chemotherapy who were eligible for oral nutritional supplementation (ONS). Methods: In this prospective, randomized study, 72 patients with stage II–IV CRC were enrolled (40 intervention group [IG], 32 control group [CG]). IG received ONS (2 × 125 mL/day, 600 kcal, 36 g protein) for 12 weeks, while CG received dietary counseling only. HRQoL was assessed every 4 weeks with the Functional Assessment of Anorexia/Cachexia Therapy (FAACT, version 4.0). Functional status was evaluated with the Karnofsky scale. Nutritional status was assessed using the Subjective Global Assessment (SGA), Nutritional Risk Screening (NRS-2002), and body mass index (BMI), and appetite was assessed on a visual analogue scale (VAS). Clinical Trial Registration: ClinicalTrials.gov, NCT02848807. Results: Mean FAACT score did not differ significantly between groups over 12 weeks (101.0 ± 22.8, 95% CI: 94.6–107.4 vs. 105.1 ± 21.4, 95% CI: 99.1–111.1; p = 0.06). However, the observed difference corresponded to an effect size at the lower bound of the moderate range. However, minimally important difference (MID) analysis demonstrated that clinically meaningful improvement was significantly more frequent in IG than in CG for global FAACT (32% vs. 8%; p = 0.03, OR = 5.50, 95% CI: 1.10–27.62, φ = 0.29), physical well-being (32% vs. 8%; p = 0.03, OR = 5.50, 95% CI: 1.10–27.62, φ = 0.29), and emotional well-being (38% vs. 4%; p = 0.002, OR = 14.86, 95% CI: 1.79–123.36, φ = 0.40). Functional well-being and anorexia/cachexia concerns showed favorable, but nonsignificant, trends (FWB improvement: 29% vs. 8%, p = 0.05, OR = 4.79, 95% CI: 0.95–24.27, φ = 0.26; ACS deterioration: 3% vs. 20%, p = 0.07, OR = 0.12, 95% CI: 0.01–1.11, φ = 0.28). HRQoL correlated positively with nutritional status, appetite, and functional performance, while Karnofsky scores remained stable in both groups. Conclusions: ONS did not significantly change the mean QoL scores at the group level but increased the proportion of patients achieving clinically meaningful improvement, particularly in the physical and emotional domains. These findings suggest that ONS may benefit selected patients who respond to nutritional interventions, underscoring the clinical relevance of individualized nutrition strategies in oncology. Full article

Background: Malnutrition is a prevalent and under-recognized condition in patients with type 2 diabetes mellitus (T2DM), contributing to various complications, including liver fibrosis. In this study, we aimed to evaluate the association between malnutrition and liver fibrosis in patients with T2DM, and to assess whether inflammation mediates this relationship. Methods: In this prospective single-centre study, 87 adult outpatients with T2DM underwent nutritional assessment using the Subjective Global Assessment (SGA) and liver stiffness measurement by transient elastography. Metabolic dysfunction-associated steatotic liver disease (MASLD) was diagnosed according to EASL guidelines. C-reactive protein (CRP) was measured as a marker of systemic inflammation. Multivariable linear regression and mediation analysis were performed, adjusting for age and sex. Results: Malnutrition was present in 50.6% of patients, MASLD in 66.7%, and both conditions coexisted in 36.8%. Malnutrition (B = 2.29, p < 0.001), MASLD (B = 1.54, p = 0.001), smoking (B = 1.06, p = 0.014), and CRP (B = 0.32, p < 0.001) were independently associated with increased liver stiffness. CRP partially mediated the effect of malnutrition on liver stiffness (indirect effect = 0.54; 95% CI 0.20–0.95), accounting for 18% of the total effect. Conclusions: In T2DM, malnutrition is a strong independent predictor of liver fibrosis, with its effect partially mediated by systemic inflammation. Addressing nutritional status and inflammatory burden may help slow fibrotic progression in this high-risk population. Full article

Background: Malnutrition is a significant national health problem in countries with low and intermediate incomes and was announced in the United Nations’ 2030 Agenda for Sustainable Development Goals. Chemotherapy may have adverse effects on nutritional health issues and quality of life experience, particularly in patients with gastrointestinal (GIT) cancer. Our research’s objective was to determine the beneficial effects of oral nutrition supplements on nutritional status assessed by maintenance of whole-body composition and patient-generated subjective global assessment (PG-SGA) in all GIT cancer patients treated with chemotherapy medications. Methods: Among the patients, the nutrition support (NS) group (n = 75) received 500 kcal daily of a balanced oral nutrition supplement formula for 12 weeks, while the control (C) group (n = 75) did not. Anthropometric measures, whole-body composition, nutritional status biomarkers, and the PG-SGA questionnaire were assessed. Additionally, this study analyzed whole-body composition, skeletal mass, fat mass, laboratory data, the complete lipid profile, albumin, total protein, adverse effects, and therapy delays. Results: After 12 weeks, the NS group showed a significant increase in body weight, with a mean difference of 1.27 ± 3.39, while the C group showed a mean difference of only 0.15 ± 0.42. Moreover, fat mass increased in the NS group, showing a mean difference of 0.55 ± 3.69, while the C group showed a fat mass loss with a mean difference of −0.21 ± 2.93. The fat mass index (FMI) indicated statistical significance between the two groups. There was a statistically significant difference in the lean mass index between the two groups, favoring a steady increase in the NS group. The NS group showed improvements in the PG-SGA and nutritional biochemical markers, such as albumin. The initial findings from our study include data from a total of 150 patients, including 75 patients in the NS group and 75 patients in the C group. These results are consistent with earlier research. Conclusions: Early oral nutrition supplements for GIT cancer may enhance nutritional outcomes and reduce the delay of disease-related therapy. Additionally, they may help maintain body composition. Full article

Background: Malnutrition is common in chronic hemodialysis (HD) patients and often remains underdiagnosed. While body composition, functional status, and anthropometric measures can support nutritional assessment, their associations with nutritional status are not fully established in this population. This study aimed to evaluate the diagnostic performance of various measures for assessing malnutrition in chronic HD patients, using the Subjective Global Assessment (SGA) as the reference standard. Methods: This cross-sectional study involved chronic HD patients, stratified by nutritional status using the SGA. Data collection consisted of clinical interviews, anthropometric and functional measurements, bioelectrical impedance analysis (BIA), and biochemical analyses. Statistical analysis included Spearman’s correlation, logistic regression, receiver operating characteristic (ROC) curve analysis with area under the curve (AUC) to assess predictive accuracy, standardized effect sizes to show the magnitude of differences, and kappa statistics to evaluate concordance between variables. Results: This study included 103 chronic HD patients. Malnutrition was diagnosed in 50.5% of patients based on the SGA. Phase angle (PA) was the strongest single predictor of malnutrition (AUC = 0.79; specificity 0.88; sensitivity 0.58). PA ≤ 5.1° was significantly associated with higher malnutrition risk (OR: 10.23; 95% CI: 3.93–30.61; p < 0.001). Handgrip strength (HGS) also demonstrated good diagnostic value (AUC = 0.71; specificity 0.84; sensitivity 0.59). A multivariable model incorporating eight parameters—gender, post-dialysis ECW/ICW ratio, post-dialysis lean and fat mass, serum albumin, normalized protein catabolic rate (nPCR), arm circumference (AC), and HGS—achieved an AUC of 0.88 (95% CI: 0.81–0.95) and pseudo-R² of 0.46, demonstrating improved predictive performance. Conclusions: An integrated panel of anthropometric, bioimpedance, functional, and biochemical markers provides superior diagnostic accuracy compared to individual predictors, supporting a holistic diagnostic approach in HD patients. Full article

Background/Objectives: Colorectal cancer (CRC) has high prevalence and mortality, with a high frequency of malnutrition during chemotherapy (60–70%). Malnutrition reduces treatment tolerance, quality of life, and survival. The Patient-Generated Subjective Global Assessment (PG-SGA) is effective in detecting it, but its use is not systematic. This study aims to analyze the prevalence and degrees of malnutrition in CRC patients undergoing active chemotherapy, using the PG-SGA, and to propose its systematic implementation in oncology care protocols. Methods: Observational, cross-sectional, and descriptive study in patients with stage III–IV CRC receiving FOLFOX, XELOX, or irinotecan regimens. Nutritional status was assessed with PG-SGA and body composition by bioimpedance. Results: The study includes 91 patients. A total of 45.05% of patients required intensive nutritional intervention, 39.56% needed dietary and pharmacological measures, 10.99% required health education, and only 4.4% did not require intervention. FOLFOX was significantly associated with taste alterations (p < 0.001), nausea (p = 0.020), unpleasant odors, and eating problems; XELOX with diarrhea (p = 0.009) and xerostomia (p = 0.038). Irinotecan was related to poorer functional capacity (p = 0.042). Oxaliplatin was linked to loss of appetite (p = 0.034) and unpleasant odors (p = 0.035). Older age correlated with a greater need for intensive interventions. Conclusions: The study shows a high nutritional risk in oncology patients, particularly in those with colorectal cancer undergoing FOLFOX treatment, associated with symptoms that impair intake and functional capacity. The systematic implementation of nutritional screening from the onset of treatment, using tools such as the PG-SGA and GLIM criteria, is essential for early detection and individualized management, improving therapy tolerance, clinical outcomes, and quality of life. Full article

Background: Malnutrition is a prevalent but underrecognized condition in cardiovascular disease (CVD) patients, associated with adverse outcomes including longer hospitalizations, higher readmission rates, and increased mortality. Traditional measures such as body mass index (BMI) often fail to detect malnutrition, especially in patients with fluid retention, sarcopenia, or obesity. Methods: This review critically examines current tools used to assess nutritional status in CVD populations. Screening instruments such as Nutritional Risk Screening 2002 (NRS 2002), Mini Nutritional Assessment (MNA, MNA-SF), Malnutrition Universal Screening Tool (MUST), Subjective Global Assessment (SGA), and the Controlling Nutritional Status (CONUT) score are discussed, alongside diagnostic frameworks including the Global Leadership Initiative on Malnutrition (GLIM) criteria. The role of body composition assessment, particularly bioelectrical impedance analysis (BIA) and phase angle (PA), is also highlighted. Results: These tools differ in diagnostic performance and applicability, with many influenced by the pathophysiological features of CVD, such as inflammation, altered fluid balance, and pharmacotherapy. GLIM criteria provide a standardized two-step approach, combining phenotypic and etiologic factors, but require further validation in cardiology settings. Conclusions: A tailored, multimodal approach could be recommended: initial screening followed by confirmatory assessment using GLIM criteria and objective measures of muscle mass or cellular integrity. Clinicians should be aware of tool-specific limitations and interpret findings in the context of CVD-specific challenges. Full article