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Search Results (236)

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Keywords = moderate malnutrition

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15 pages, 408 KiB  
Article
A Cross-Sectional Study: Association Between Nutritional Quality and Cancer Cachexia, Anthropometric Measurements, and Psychological Symptoms
by Cahit Erkul, Taygun Dayi, Melin Aydan Ahmed, Pinar Saip and Adile Oniz
Nutrients 2025, 17(15), 2551; https://doi.org/10.3390/nu17152551 - 4 Aug 2025
Abstract
Background/Objectives: Cancer is a complex disease that affects patients’ nutritional and psychological status. This study aimed to assess the nutritional status of patients diagnosed with lung and gastrointestinal system cancers and evaluate its association with anthropometric measurements, nutrient intake, and psychological symptoms. [...] Read more.
Background/Objectives: Cancer is a complex disease that affects patients’ nutritional and psychological status. This study aimed to assess the nutritional status of patients diagnosed with lung and gastrointestinal system cancers and evaluate its association with anthropometric measurements, nutrient intake, and psychological symptoms. Methods: This cross-sectional study was conducted with 180 patients with lung and gastrointestinal system cancers. Data were collected face-to-face by a questionnaire that included the Subjective Global Assessment-(SGA), Cachexia Assessment Criteria, 24 h Food Consumption Record, and Symptom Checklist-90-Revised-(SCL-90-R). Some anthropometric measurements were collected. Results: Body Mass Index (BMI) was found to be significantly lower (p < 0.001) in SGA-B (moderately malnourished) and SGA-C (severely malnourished) compared to those in SGA-A (well-nourished). The calf circumference was significantly lower (p = 0.002) in SGA-C compared to those in SGA-A and SGA-B. The mean SGA scores were found to be higher in cachexia-diagnosed participants (p < 0.001). The energy intake of SGA-C was significantly lower than SGA-A and SGA-B (p < 0.001). In addition, the energy intake of SGA-B was lower than SGA-A (p < 0.001). The protein intake of SGA-C was lower than SGA-A and SGA-B (p < 0.001). The protein intake of SGA-B was lower than SGA-A (p < 0.001). Regarding the intake of vitamins A, C, E, B1, and B6 and carotene, folate, potassium, magnesium, phosphorus, iron, and zinc, SGA-B and SGA-C were significantly lower than SGA-A (p < 0.001). Additionally, only phobic anxiety was found to be significantly higher in SGA-B than in SGA-A (p: 0.024). Conclusions: As the level of malnutrition increased, a reduction in some nutrient intake and anthropometric measurements was observed. No significant difference was found in any psychological symptoms except phobic anxiety. With this in mind, it is important that every cancer patient, regardless of the stage of the disease, is referred to a dietitian from the time of diagnosis. Full article
(This article belongs to the Section Nutrition and Public Health)
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10 pages, 784 KiB  
Article
Effect of Malnutrition on Femoral Cartilage Thickness in Pediatric Patients
by Şükrü Güngör, Raikan Büyükavcı, Fatma İlknur Varol, Emre Gök and Semra Aktürk
Children 2025, 12(8), 1021; https://doi.org/10.3390/children12081021 - 2 Aug 2025
Viewed by 133
Abstract
Background/Objectives: Malnutrition is an imbalance of nutrients required for growth, development, and organ function. Its impact on bone development is known, but its effects on cartilage remain unclear. This study aimed to evaluate the femoral cartilage thickness in children with primary malnutrition. [...] Read more.
Background/Objectives: Malnutrition is an imbalance of nutrients required for growth, development, and organ function. Its impact on bone development is known, but its effects on cartilage remain unclear. This study aimed to evaluate the femoral cartilage thickness in children with primary malnutrition. Methods: In this cross-sectional observational study, 83 children with primary malnutrition and 62 age- and sex-matched healthy controls were included. Patients with primary malnutrition were classified as mild, moderate and severe. Femoral cartilage thickness measurements of all children were taken by ultrasound from the femoral lateral condyle, femoral medial condyle and intercondylar area for both knees with the patient in a supine position with the knees flexed 90 degrees. Results: The right lateral, right medial, left lateral, and left medial femoral cartilages were significantly thicker in patients with malnutrition compared to those without malnutrition (p = 0.002, 0.004, <0.001, and 0.001, respectively). A significant negative correlation was found between age, weight Z-score, and height Z-score and triceps skinfold thickness. Conclusions: Distal femoral cartilage thickness is significantly greater in children with primary malnutrition. This demonstrates the effect of nutritional factors on cartilage tissue and suggests that children with chronic malnutrition are at risk for both knee joint problems and short stature later in life. Full article
(This article belongs to the Section Pediatric Gastroenterology and Nutrition)
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11 pages, 286 KiB  
Article
Beyond the Malnutrition Screening Tool: Assessing Hand Grip Strength and Gastrointestinal Symptoms for Malnutrition Prediction in Outpatients with Chronic Kidney Disease Not on Kidney Replacement Therapy
by Maya Young, Jessica Dawson, Ivor J. Katz, Kylie Turner and Maria Chan
Nutrients 2025, 17(15), 2471; https://doi.org/10.3390/nu17152471 - 29 Jul 2025
Viewed by 193
Abstract
Background: The Malnutrition Screening Tool (MST) is commonly used to identify malnutrition risk; however it has demonstrated poor sensitivity to detect malnutrition in inpatients with chronic kidney disease (CKD) and kidney replacement therapy (KRT) populations. Gastrointestinal symptoms, such as poor appetite, may [...] Read more.
Background: The Malnutrition Screening Tool (MST) is commonly used to identify malnutrition risk; however it has demonstrated poor sensitivity to detect malnutrition in inpatients with chronic kidney disease (CKD) and kidney replacement therapy (KRT) populations. Gastrointestinal symptoms, such as poor appetite, may better detect malnutrition. The accuracy of MST or other nutrition-related parameters to detect malnutrition in ambulatory patients with CKD stages 4–5 without KRT has not been evaluated. Methods: A single site retrospective audit of outpatient records from May 2020 to March 2025 was conducted. Patients with eGFR < 25 mL/min/1.73 m2 without KRT who had both MST and a 7-point Subjective Global Assessment (SGA) within 7 days were included. Sensitivity, specificity, and ROC-AUC analyses compared nutritional parameters against SGA-defined malnutrition. Nutritional parameters tested included MST, hand grip strength, upper gastrointestinal symptom burden, poor appetite and a combination of some of these parameters. Results: Among 231 patients (68.8% male, median age 69 years, median eGFR 15), 29.9% were at risk of malnutrition (MST ≥ 2) and 33.8% malnourished (SGA ≤ 5). All potential screening tools had AUC ranging from 0.604 to 0.710, implying a poor-to-moderate discriminator ability to detect malnutrition. Combining HGS ≤ 29.5 kg or MST ≥2 demonstrated high sensitivity (95.5%) and negative predictive value (93.3%), but low specificity (33.3%) for detecting malnutrition, indicating this approach is effective for ruling out malnutrition but may over-identify at-risk individuals. Conclusions: MST and other tested tools showed limited overall accuracy to identify malnutrition. Using combined nutritional markers of HGS or MST score was the most sensitive tool for detecting malnutrition in this advanced CKD without KRT population. Full article
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15 pages, 933 KiB  
Article
A Prospective Interventional Study on the Beneficial Effect of Fish Oil-Enriched High-Protein Oral Nutritional Supplement (FOHP-ONS) on Malnourished Older Cancer Patients
by Hui-Fang Chiu, Shu Ru Zhuang, You-Cheng Shen, Subramanian Thangaleela and Chin-Kun Wang
Nutrients 2025, 17(15), 2433; https://doi.org/10.3390/nu17152433 - 25 Jul 2025
Viewed by 379
Abstract
Background: Malnutrition and cancer-related fatigue (CRF) are prevalent in cancer patients, significantly impacting prognosis and quality of life. Oral nutritional supplements (ONSs) enriched with protein and ω-3 fatty acids may improve nutritional status and mitigate CRF. This study evaluates the effects of a [...] Read more.
Background: Malnutrition and cancer-related fatigue (CRF) are prevalent in cancer patients, significantly impacting prognosis and quality of life. Oral nutritional supplements (ONSs) enriched with protein and ω-3 fatty acids may improve nutritional status and mitigate CRF. This study evaluates the effects of a high-protein, fish oil-enriched ONS (FOHP-ONS) on nutritional intake, body composition, fatigue, and quality of life in malnourished cancer patients. Methods: Cancer patients with malnutrition or inadequate food intake received 8 weeks of FOHP-ONS (2 cans/day, providing 4.2 g/day of ω-3 fatty acids). Dietary intake, body weight, handgrip strength, serum biochemical markers, nutritional status (PG-SGA), fatigue (BFI-T), and quality of life (EORTC QLQ-C30) were assessed at baseline, week 4, and week 8. Results: Of the 33 enrolled patients, 30 completed the study. Energy and protein intake significantly increased (p < 0.05), and body BMI and handgrip strength showed significant improvements (p < 0.05), while muscle mass did not change significantly. Nutritional status, assessed by PG-SGA, improved, with the proportion of severely malnourished patients (Stage C) decreasing from 46.7% to 13.3%, and moderately malnourished patients (Stage B) improving to well-nourished status (Stage A) from 10.0% to 30.0% (p < 0.001). Serum albumin levels increased significantly (p < 0.05), while fasting blood glucose significantly decreased (p < 0.05). Additionally, triglyceride levels significantly decreased (p < 0.05), while total cholesterol and LDL-C showed a downward trend. Cancer-related fatigue scores improved across all domains (p < 0.05), and quality of life significantly increased, particularly in physical and role functioning (p < 0.05). Conclusions: FOHP-ONS supplementation improved nutritional intake, body composition, and muscle strength while alleviating CRF and enhancing quality of life in malnourished cancer patients. These findings support its potential role in nutritional intervention for malnourished cancer patients. Full article
(This article belongs to the Section Nutrition and Public Health)
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19 pages, 508 KiB  
Article
Improved Survival in Malnourished COVID-19 Inpatients with Oral Nutrition Supplementation
by Tyrus Vong, Lisa R. Yanek, Laura E. Matarese, Berkeley N. Limketkai and Gerard E. Mullin
Nutrients 2025, 17(15), 2401; https://doi.org/10.3390/nu17152401 - 23 Jul 2025
Viewed by 279
Abstract
Background: Malnutrition is associated with adverse clinical and economic outcomes. We recently reported that the hospital mortality rate in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected inpatients was higher in malnourished patients than in those without malnutrition. The present study aimed to determine [...] Read more.
Background: Malnutrition is associated with adverse clinical and economic outcomes. We recently reported that the hospital mortality rate in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected inpatients was higher in malnourished patients than in those without malnutrition. The present study aimed to determine if SARS-CoV-2-infected inpatients who received oral nutrition supplementation (ONS) had improved survival. We performed a retrospective cohort study including 37,215 adults (aged 18 and older) admitted with COVID-19 to five Johns Hopkins–affiliated hospitals between 1 March 2020, and 31 March 2023. Malnutrition risk was initially screened using the Malnutrition Universal Screening Tool (MUST), with cases subsequently confirmed by registered dietitians via a standardized, validated assessment protocol. Logistic regression analysis predicting hospital mortality examined the association of ONS with hospital survival in SARS-CoV-2-infected inpatients, incorporating covariates and weights for ONS receipt. Results: Malnutrition was an independent predictor of higher hospital mortality from COVID-19 illness. The prevalence of malnutrition among adult inpatients with SARS-CoV-2 infection in our cohort was 15.22%. Inpatient adults with moderate or severe malnutrition in the context of acute illness or injury who were given ONS had lower odds of inpatient mortality (moderate OR = 0.72, 95% CI 0.62–0.85; severe OR = 0.76, 95% CI 0.67–0.87; both p < 0.001). Overweight and obese patients who received ONS had higher odds of inpatient mortality (overweight OR = 1.15, 95% CI 1.08–1.22, p < 0.0001; obese OR = 1.08, 95% CI 1.01–1.14, p = 0.02, respectively). For inpatients who were underweight, receiving ONS was protective against inpatient mortality (OR = 0.78, 95% CI 0.68–0.88, p = 0.0001). Thus, among adult inpatients with SARS-CoV-2 infection, malnourished and underweight individuals appeared to experience improved survival when provided with oral nutritional supplements (ONS), whereas overweight or obese patients remain at an elevated risk of mortality. The timing of ONS receipt in hospitalized patients with SARS-CoV-2 influenced mortality. Patients who had earlier time to ONS had 13% lower odds of inpatient mortality (OR = 0.87, 95% CI 0.79–0.97, p = 0.0105). Conclusions: In a cohort of SARS-CoV-2 adult inpatients, those with confirmed malnutrition receiving oral nutrition supplements had a higher likelihood of hospital survival. This is the first study demonstrating an association of oral nutrition intervention with reduced hospital mortality in malnourished SARS-CoV-2-infected adults. Full article
(This article belongs to the Section Clinical Nutrition)
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16 pages, 391 KiB  
Systematic Review
High-Protein Dietary Interventions in Heart Failure: A Systematic Review of Clinical and Functional Outcomes
by Lorraine S. Evangelista, Rebecca Meraz, Kelly L. Wierenga, Angelina P. Nguyen, Alona D. Angosta and Jennifer Kawi
Nutrients 2025, 17(14), 2361; https://doi.org/10.3390/nu17142361 - 18 Jul 2025
Viewed by 513
Abstract
Background: Heart failure (HF) is frequently associated with skeletal muscle wasting, reduced functional capacity, and malnutrition. High-protein diets offer a promising nutritional intervention to improve these outcomes in individuals with HF. Objective: This systematic review evaluated randomized controlled trials of high-protein dietary interventions [...] Read more.
Background: Heart failure (HF) is frequently associated with skeletal muscle wasting, reduced functional capacity, and malnutrition. High-protein diets offer a promising nutritional intervention to improve these outcomes in individuals with HF. Objective: This systematic review evaluated randomized controlled trials of high-protein dietary interventions in HF populations, with emphasis on intervention characteristics, quantitative benefits, and risk of bias. Methods: We conducted a comprehensive search in PubMed, MEDLINE, Embase, and Cochrane CENTRAL from inception to June 2025. Eligible studies enrolled adults (≥18 years) with HF, implemented high-protein regimens (≥1.1 g/kg/day or ~25–30% of energy), and reported on functional capacity, body composition, muscle strength, clinical outcomes, or biochemical markers. Two reviewers independently screened, extracted data, and assessed bias (Cochrane RoB 2). Heterogeneity in dosing, duration, and outcomes precluded meta-analysis; we therefore provide a narrative synthesis. Results: Ten trials (nine randomized controlled trials, one pilot) involving 1080 patients (median n = 38; range 21–652) were included. High-protein interventions yielded mean improvements in six-minute walk distance of +32 ± 14 m, lean body mass gain of +1.6 ± 0.9 kg, and 9 ± 4% enhancement in quality-of-life scores; muscle strength effects varied from −2% to +11%. Two studies reported an 18% reduction in HF readmissions (p < 0.05). The risk-of-bias assessment identified two low-risk, three moderate-risk, and one high-risk study. Key limitations include small sample sizes, varied protein dosing (1.1–1.5 g/kg/day), short follow-up (2–6 months), and outcome heterogeneity. Conclusions: High-protein dietary strategies appear to confer modest, clinically relevant gains in functional capacity, nutritional status, and HF readmission risk. Larger, well-powered trials with standardized dosing and longer follow-up are necessary to establish optimal protein targets, long-term efficacy, and safety. Full article
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20 pages, 784 KiB  
Article
Geriatric Assessment as an Important Tool for Post-Hip Surgery Prognosis in Seniors
by Anca Iuliana Pîslaru, Irina Sîrbu, Sabinne-Marie Albișteanu, Ramona Ștefăniu, Ana-Maria Turcu, Gabriela Grigoraș, Iulia-Daniela Lungu, Roxana Maria Pînzaru, Ioana Dana Alexa and Adina Carmen Ilie
Nurs. Rep. 2025, 15(7), 262; https://doi.org/10.3390/nursrep15070262 - 17 Jul 2025
Viewed by 263
Abstract
Hip fractures in elderly patients pose significant clinical challenges, confronting us with high morbidity and mortality rates. A comprehensive geriatric assessment plays an important role in determining prognosis as well as the indication for surgery. Aim: In this study, we aim to [...] Read more.
Hip fractures in elderly patients pose significant clinical challenges, confronting us with high morbidity and mortality rates. A comprehensive geriatric assessment plays an important role in determining prognosis as well as the indication for surgery. Aim: In this study, we aim to (1) assess frailty-based functional status in seniors with hip fractures, (2) evaluate geriatric assessment’s predictive value for postoperative recovery, and (3) analyze 1-year postoperative survival. Material and Methods: This prospective study included 60 senior patients admitted for hip fracture in the Orthopedics Department. Patients were examined using geriatric assessment instruments Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Mini Nutritional Assessment (MNA), and Frailty Groningen Indicator (GFI). We recorded the sex, marital status, number of comorbidities, and number of recommended drugs. Results: In total, 65% of patients were frail pre-surgery; the proportion increased post-surgery to 86.7%; (p = 0.005). Age greater than 80 years and unmarried marital status were associated with higher frailty risk (p = 0.04; p = 0.03). Preoperatively, important predictors of frailty were mild–moderate cognitive impairment (p = 0.017), mild–moderate depression (p = 0.01), and malnutrition (p = 0.04). Postoperatively, only mild–moderate cognitive impairment (p = 0.04) and mild–moderate depression (p = 0.01) proved to be important predictors of frailty. According to the ROC curve, good predictors of postoperative frailty were shown to be preoperative frailty and the degree of polypharmacy and comorbidity. Of all parameters predictive of postoperative frailty, only the number of medications reached statistical significance (p < 0.038). The study identified a 1-year all-cause mortality rate of 42.6% in elderly patients who underwent hip fracture surgery, with a significant association between mortality and preoperative MMSE, GDS, and MNA scores. Conclusions: Complex geriatric assessment of senior patients with hip fracture can stratify postoperative risk and predict 1-year mortality and postoperative functional recovery. Key predictors include cognitive status, depression, malnutrition, and comorbidities. Multidisciplinary care and standardized evaluation are essential for improving outcomes. Full article
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17 pages, 951 KiB  
Article
Food Tolerance and Quality of Eating After Bariatric Surgery—An Observational Study of a German Obesity Center
by Alexandra Jungert, Alida Finze, Alexander Betzler, Christoph Reißfelder, Susanne Blank, Mirko Otto, Georgi Vassilev and Johanna Betzler
J. Clin. Med. 2025, 14(14), 4961; https://doi.org/10.3390/jcm14144961 - 13 Jul 2025
Viewed by 397
Abstract
Background: Bariatric surgeries, specifically laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), are a common intervention for morbid obesity, significantly affecting food tolerance and quality of eating. Understanding these changes is crucial for improving postoperative care and long-term success. Methods: [...] Read more.
Background: Bariatric surgeries, specifically laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), are a common intervention for morbid obesity, significantly affecting food tolerance and quality of eating. Understanding these changes is crucial for improving postoperative care and long-term success. Methods: This observational study at University Hospital Mannheim involved 91 patients, aged between 18 and 65 year, who underwent SG or RYGB between 2009 and 2019. Food tolerance was assessed between 25 days and 117 months after surgery using the validated score by Suter et al. (Food Tolerance Score, FTS) and an additional score evaluating tolerance to specific food groups and quality of life. Data on body composition were collected through Bioelectrical Impedance Analysis (BIA) at follow-up visits. Statistical analyses included linear mixed models to analyze the association of food tolerance with body composition changes. Results: The FTS indicated moderate or poor food tolerance in 62.6% of patients, with no significant differences between SG and RYGB. Considering the results of the additional score, food groups such as red meat, wheat products, raw vegetables, carbon dioxide, fatty foods, convenience food, and sweets were the most poorly tolerated food groups. A total of 57 of the participants had a baseline and follow-up BIA measurement. Postoperatively, a significant reduction in body weight and BMI as well as in BIA parameters (fat mass, lean mass, body cell mass, and phase angle) was found. Quality of life improved after bariatric surgery and 76.9% rated their nutritional status as good or excellent, despite possible food intolerances. Conclusions: Bariatric surgery significantly reduces weight and alters food tolerance. Despite moderate or poor food tolerance, patients reported high satisfaction with their nutritional status and quality of life. Detailed food tolerance assessments and personalized dietary follow-ups are essential for the early detection and management of postoperative malnutrition, ensuring sustained weight loss and improved health outcomes. Full article
(This article belongs to the Section Endocrinology & Metabolism)
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16 pages, 1155 KiB  
Article
Measuring Viscosity and Consistency in Thickened Liquids for Dysphagia: Is There a Correlation Between Different Methods?
by Javier Marín-Sánchez, Sofía Gimeno-Ruiz, Alejandro Berzosa, Javier Raso and Cristina Sánchez-Gimeno
Foods 2025, 14(13), 2384; https://doi.org/10.3390/foods14132384 - 5 Jul 2025
Viewed by 415
Abstract
Dysphagia is a common clinical condition, especially among older adults, associated with an increased risk of malnutrition, aspiration, and respiratory complications. A key therapeutic approach involves modifying liquid consistency using thickening agents to achieve safer swallowing. Although rotational rheometry offers accurate viscosity characterization, [...] Read more.
Dysphagia is a common clinical condition, especially among older adults, associated with an increased risk of malnutrition, aspiration, and respiratory complications. A key therapeutic approach involves modifying liquid consistency using thickening agents to achieve safer swallowing. Although rotational rheometry offers accurate viscosity characterization, its complexity and cost limit routine application in clinical or domestic settings. This study evaluates and correlates different methods for measuring the viscosity of thickened liquids, comparing rheological data with empirical techniques such as the Ford cup, Bostwick consistometer, and Line-Spread Test (LST). Several thickeners were tested—guar gum, xanthan gum, a guar/xanthan blend, maltodextrin-based mixtures, and a commercial thickener—across a range of concentrations, temperatures, and preparation times. The results demonstrate that simple methods, particularly the Bostwick consistometer and LST, show strong correlations with rheometer measurements within the International Dysphagia Diet Standardisation Initiative (IDDSI) Level 2 (mildly thick) and Level 3 (moderately thick) ranges. However, limitations were observed at extreme viscosities, where certain methods lacked sensitivity or operational feasibility. These findings support the potential of empirical tools for practical viscosity screening in dysphagia management, especially where rheometry is unavailable. This work provides evidence-based guidance for clinicians, caregivers, and food service professionals seeking safe, reproducible, and standardized approaches to fluid consistency assessment. Full article
(This article belongs to the Section Food Analytical Methods)
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29 pages, 1729 KiB  
Article
Morphofunctional Assessment of Malnutrition and Sarcopenia Using Nutritional Ultrasonography in Patients Undergoing Maintenance Hemodialysis
by José C. De La Flor, Estefanya García-Menéndez, Gregorio Romero-González, Celia Rodríguez Tudero, Elena Jiménez Mayor, Enrique Florit Mengual, Esperanza Moral Berrio, Beatriz Soria Morales, Michael Cieza Terrones, Secundino Cigarrán Guldris and Jesús Hernández Vaquero
Medicina 2025, 61(6), 1044; https://doi.org/10.3390/medicina61061044 - 5 Jun 2025
Viewed by 829
Abstract
Background and Objectives: Malnutrition and sarcopenia are highly prevalent and clinically impactful conditions in patients undergoing maintenance hemodialysis (MHD), yet their early detection remains challenging. This study aimed to assess the diagnostic performance of nutritional ultrasonography (NUS) in the morphofunctional evaluation of malnutrition [...] Read more.
Background and Objectives: Malnutrition and sarcopenia are highly prevalent and clinically impactful conditions in patients undergoing maintenance hemodialysis (MHD), yet their early detection remains challenging. This study aimed to assess the diagnostic performance of nutritional ultrasonography (NUS) in the morphofunctional evaluation of malnutrition and sarcopenia, and to compare its utility with established tools such as bioimpedance analysis (BIA), biochemical markers, handgrip strength (HGS), and functional performance tests. Materials and Methods: A cross-sectional study was conducted in 74 stable MHD patients. Clinical, analytical, anthropometric, BIA, NUS, and functional parameters were collected, along with validated nutritional and frailty scales. NUS was used to assess the quadriceps rectus femoris (QRF) and preperitoneal visceral fat (PPVF), measuring Y-axis, Y-axis/height, cross-sectional muscle area rectus femoris (CS-MARF), muscle area rectus femoris index adjusted to height (MARFIh), and supramuscular fat (SMF). Sarcopenia was defined according to the 2019 European Working Group on Sarcopenia in Older People (EWGSOP) criteria. Results: The prevalence of risk, confirmed, and severe sarcopenia was 24.3%, 40.5%, and 20.3%, respectively. Severe-to-moderate protein-energy wasting (PEW) affected 44.6% of patients. Compared to non-sarcopenic individuals, sarcopenic patients had lower values of HGS, prealbumin, lean body mass, and phase angle. NUS-derived cut-off values for sarcopenia were Y-axis ≤ 8 mm, Y-axis/height ≤ 2.9 mm/m2, CS-MARF ≤ 2.4 cm2, and MARFIh ≤ 0.9 cm2/m2. The most discriminative NUS parameters were Y-axis and SMF (AUC 0.67), followed by Y-axis/height (AUC 0.65) and MARFIh (AUC 0.63). NUS measurements correlated significantly with ASMI, phase angle, HGS, and SPPB scores. Conclusions: Nutritional ultrasonography is a feasible, reproducible, and clinically valuable tool for assessing muscle mass and quality in MHD patients. Its incorporation into routine practice may enhance early detection of malnutrition and sarcopenia, thereby facilitating timely, individualized nutritional interventions. Full article
(This article belongs to the Section Urology & Nephrology)
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11 pages, 890 KiB  
Article
Association Between Nutritional Status and Early Postoperative Infection Risk in Kidney Transplant Patients
by Elena González García, Tamara Arroyo, Mercedes Galván, María José Becerra, Margarita Gallego, Israel Mauro, Yanieli Hernández, Almudena Pérez-Torres, María Ovidia López Oliva, María José Santana and Carlos Jiménez
Nutrients 2025, 17(11), 1935; https://doi.org/10.3390/nu17111935 - 5 Jun 2025
Viewed by 591
Abstract
Malnutrition is one of the stronger predictors of morbi-mortality in end-stage kidney disease patients. Moreover, malnutrition in hospitalized patients severely affects multiple clinical outcomes, increasing the risk of complications. The Nutritional Risk Index and Geriatric Nutritional Risk Index are indexes used to evaluate [...] Read more.
Malnutrition is one of the stronger predictors of morbi-mortality in end-stage kidney disease patients. Moreover, malnutrition in hospitalized patients severely affects multiple clinical outcomes, increasing the risk of complications. The Nutritional Risk Index and Geriatric Nutritional Risk Index are indexes used to evaluate the risk of malnutrition in hospitalized adults, which have been validated for dialysis patients and have been reported to be a validated prognostic index of nutrition-related morbidity and mortality. Objectives: The aim of this study is to evaluate the prevalence of early postoperative infections and their possible relationship with malnutrition in renal transplantation. Methods: We conducted a retrospective observational study, including all patients who received a kidney transplant, a total of 140, between January 2020 and December 2023, at a tertiary-level Spanish hospital. Results: The average GNRI was 110.1 ± 11.6, equivalent to adequate nutrition, and only 16.4% of patients were at risk of malnutrition. The mean NRI was 111.4 ± 11.8, equivalent to no risk of malnutrition, and only 17.2% of patients had a moderate-to-severe risk of malnutrition. A total of 30 patients (21.4%) required oral nutritional supplementation at discharge, especially modular protein supplements (86.7%), and 52 patients (37.1%) presented an infection during their stay. The most frequent infections were urinary tract infections (69.8% of the total). Malnutrition calculated by the GNRI or NRI correlated to a longer postoperative hospital stay and a higher rate of infectious complications (p < 0.05). Conclusions: Malnourished patients have a higher risk of early postoperative complications, including infection, and a longer hospitalization stay. The evaluation of nutritional status for the diagnosis and treatment of malnutrition is strongly recommended in ESKD patients on the waiting list for a kidney transplant. Full article
(This article belongs to the Special Issue Nutrition and Metabolism in Chronic Kidney Diseases)
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12 pages, 2936 KiB  
Article
Association Between Malnutrition, Low Muscle Mass, Elevated NT-ProBNP Levels, and Mortality in Hemodialysis Patients
by Sadamu Takahashi, Tatsuki Tanaka, Yusuke Suzuki, Norihito Yoshida, Mai Hitaka, Shingo Ishii, Keisuke Yamazaki, Motoyuki Masai, Yosuke Yamada and Yasushi Ohashi
Nutrients 2025, 17(11), 1896; https://doi.org/10.3390/nu17111896 - 31 May 2025
Viewed by 666
Abstract
Background/Objectives: Malnutrition, muscle wasting, and fluid overload are highly prevalent in patients undergoing maintenance hemodialysis (HD) and may contribute to increased mortality risk. However, the combined impact of these factors has not been fully elucidated. Methods: In this multicenter prospective cohort [...] Read more.
Background/Objectives: Malnutrition, muscle wasting, and fluid overload are highly prevalent in patients undergoing maintenance hemodialysis (HD) and may contribute to increased mortality risk. However, the combined impact of these factors has not been fully elucidated. Methods: In this multicenter prospective cohort study, we enrolled 368 patients in maintenance HD at four dialysis facilities in Japan. Malnutrition was defined as moderate or higher nutritional risk using the nutritional risk index for Japanese hemodialysis patients (NRI-JH). Low muscle mass was assessed using the skeletal muscle mass index (SMI) according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019), and elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) was defined as values in the top quartile (≥7650 pg/mL). Mortality risk was analyzed using Cox proportional hazards models. Associations with inflammation, assessed by C-reactive protein (CRP), were also explored. Results: Over a three-year follow-up period, 52 deaths occurred. Malnutrition, low muscle mass, and elevated NT-proBNP were each independently associated with increased all-cause mortality (HR: 4.98, 3.25, and 5.45, respectively). Patients with multiple concurrent risk factors had significantly worse survival. Although CRP was positively associated with these risk factors, it was not an independent predictor of mortality. Conclusions: Malnutrition, low muscle mass, and elevated NT-proBNP are independent and additive risk factors for mortality in HD patients. These findings highlight the need for integrated assessment and management strategies to improve prognoses in this high-risk population. Full article
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20 pages, 1085 KiB  
Article
Nutritional and Physical Rehabilitation in Post-Critical Coronavirus Disease 2019 (COVID-19) Ambulatory Patients: The NutriEcoMuscle Study
by Clara Joaquín, Irene Bretón, María Julia Ocón-Bretón, Alba Zabalegui, Diego Bellido, Pilar Matía Martín, Miguel Ángel Martínez-Olmos, Ana Zugasti, María Riestra, Francisco Botella and José Manuel García-Almeida
Nutrients 2025, 17(10), 1722; https://doi.org/10.3390/nu17101722 - 20 May 2025
Viewed by 809
Abstract
Background: The prevalence of malnutrition is high in post-intensive care unit (ICU) coronavirus disease 2019 (COVID-19) patients during hospitalization and after hospital discharge. This paper presents prospective results from the NutriEcoMuscle study, a multicenter observational study. The study aimed to evaluate changes [...] Read more.
Background: The prevalence of malnutrition is high in post-intensive care unit (ICU) coronavirus disease 2019 (COVID-19) patients during hospitalization and after hospital discharge. This paper presents prospective results from the NutriEcoMuscle study, a multicenter observational study. The study aimed to evaluate changes in nutritional and functional status in post-ICU COVID-19 patients following nutritional and physical rehabilitation interventions. Secondary aims included assessing adherence to and tolerance of the oral nutritional supplement (ONS) used in the nutritional intervention. Methods: The study enrolled adults who had been admitted to the ICU due to severe COVID-19. At hospital discharge, the patients underwent a nutritional intervention based on oral nutritional supplements (ONSs) with 100% serum lactoprotein enriched with leucine and vitamin D and a physical rehabilitation program. They were followed up during three months. Performed assessments included Subjective Global Assessment (SGA), Global Leadership Initiative on Malnutrition (GLIM) criteria, Barthel index (BI), handgrip strength and Timed Up and Go test, bioelectrical impedance analysis (BIA), nutritional ultrasound (US), and tolerance and adherence to ONS. Sample size was calculated based on handgrip strength, and parametric and non-parametric tests were used to assess differences between the baseline and three-month outcomes. Results: The study included 96 patients (71.9% male, mean age 58.8 years, mean body mass index (BMI) of 28.8 kg/m2, 36.5% obese). A total of 85 patients (62 men and 23 women) completed the 90-day follow-up. The mean weight gain after the intervention was 6.8 (SD 5.2) kg (similar in men and women; p = 0.263). The proportion of patients with malnutrition according to the SGA or GLIM criteria decreased from 100% to 11.8% and 36.4%, respectively (p < 0.00001 in both cases). The proportion of patients with functional limitations by BI decreased from 66.7% to 27.0% (p < 0.0001). Handgrip strength increased more than 40% in both men and women (p < 0.00001). The time to perform the Timed Up and Go (TUG) test decreased more than 40% in both men and women (p < 0.00001). According to BIA, the mean fat mass did not increase significantly in either men or women. The mean fat-free mass index (FFMI) increased significantly in both men and women. There were also significant increases in body cell mass, skeletal muscle mass index, and appendicular skeletal muscle mass index. The phase angle (PhA) increased significantly in both men (26.5%) and women (17.4%). In a multivariate analysis, age and baseline PhA were related to the PhA increase (adjusted R2 = 0.5573). The US study showed a significant increase in the mean measurements of muscle area, muscle circumference, X-axis, and Y-axis in the rectus femoris. Regarding abdominal fat, there were no significant increases in total, superficial, or preperitoneal adipose tissue by US. Participants engaged in a median interquartile range (IQR) of 70 (0–120) min/week of strength exercise and 60 (0–120) min/week of moderate physical exercise. The supplement was well tolerated, and poor adherence (less than 50%) was low (4% of the participants). Conclusions: A three-month intervention, including ONS and physical rehabilitation, is associated with a significant improvement in nutritional and functional status. Patients gained weight primarily by increasing their muscle mass. There was no significant increase in fat mass, as measured by BIA or US. The intervention was well tolerated and had good adherence. Full article
(This article belongs to the Section Nutritional Epidemiology)
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20 pages, 267 KiB  
Article
Crohn’s Disease Patients Referred for Home Parenteral Nutrition—A Comprehensive Analysis of 18 Years’ Experience at a National Reference Centre
by Sandra Banasiak, Mariusz Panczyk, Jacek Sobocki and Zuzanna Zaczek
Nutrients 2025, 17(10), 1697; https://doi.org/10.3390/nu17101697 - 16 May 2025
Viewed by 555
Abstract
Background: Within 10 years of diagnosis, about 50% of patients with Crohn’s disease (CD) require surgery. Repeated small bowel resections can lead to the development of short bowel syndrome (SBS). It is estimated that 65–75% of CD patients are malnourished. This retrospective [...] Read more.
Background: Within 10 years of diagnosis, about 50% of patients with Crohn’s disease (CD) require surgery. Repeated small bowel resections can lead to the development of short bowel syndrome (SBS). It is estimated that 65–75% of CD patients are malnourished. This retrospective observational study was conducted in a Polish reference centre for home parenteral nutrition (HPN). The aim of the study was to investigate the nutritional status and characteristics of patients with CD referred to HPN and to analyse the course of their HPN treatment. Methods: The study group consisted of all adult patients (N = 46) with CD who qualified for HPN between November 2004 and April 2022. Results: The most common indication for HPN was SBS (n = 27; 58.70%), followed by ineffective gastrointestinal nutrition causing progressive malnutrition (N = 9; 19.57%), fistulas (N = 6; 13.04%), and short bowel syndrome and fistulas (N = 4; 8.70%). According to the results of Subjective Global Assessment (SGA), 47.83% (N = 22) of patients were diagnosed with severe malnutrition, followed by 15 patients (32.61%) with moderate malnutrition. Global Leadership Initiative on Malnutrition (GLIM) criteria showed that 71.73% (n = 33) of patients were malnourished on admission to the HPN centre. All patients received parenteral formulas based on individually tailored prescriptions. The results showed that patients with a stoma received statistically significantly higher PN volumes (p = 0.027) and higher amounts of amino acids (p = 0.046) and fat emulsion (p = 0.046). Septic complications were twice as common as mechanical or metabolic complications, although 43.47% of patients had no complications. At the time of data analysis, 19 patients (41.30%) had been successfully weaned from HPN, of whom 12 (26%) achieved nutritional autonomy after 136–1419 days (mean: 560 ± 380.9). Conclusions: Malnutrition is a major problem in CD patients, especially those with SBS. Early nutritional intervention and consideration of artificial nutrition in this study group (HPN) are necessary to prevent the long-term consequences of severe malnutrition. To our knowledge, this was the first study to report on Crohn’s patients referred to long-term HPN. Further studies are needed to assess the impact of HPN on functional, laboratory, and anthropometric outcomes with a view to optimising treatment outcomes. Full article
(This article belongs to the Special Issue Nutritional Strategies in Inflammatory Bowel Disease)
17 pages, 246 KiB  
Article
Does Food Habits and Malnutrition Affect Health Perception Among Diabetic Patients? A Mediation and Moderation Analysis
by Sufyan Habib, Nawaf N. Hamadneh, Asif Hasan, Ahmed S. M. Almamy and Bandar N. Hamadneh
Healthcare 2025, 13(10), 1093; https://doi.org/10.3390/healthcare13101093 - 8 May 2025
Viewed by 607
Abstract
Background: The prevalence of diabetes among young individuals has reached concerning levels, posing significant public health risks and exacerbating the economic burden on healthcare systems. The health outcomes of individuals with diabetes are heavily influenced by malnutrition and unhealthy dietary habits, which not [...] Read more.
Background: The prevalence of diabetes among young individuals has reached concerning levels, posing significant public health risks and exacerbating the economic burden on healthcare systems. The health outcomes of individuals with diabetes are heavily influenced by malnutrition and unhealthy dietary habits, which not only hamper effective blood glucose management but also negatively affect overall health perceptions. Introduction: This study analyzes the factors influencing malnutrition, food habits, and health perceptions among diabetic patients. Methods: A well-structured questionnaire was designed to collect data. A cross-sectional survey of 503 diabetic patients across various regions in India was conducted. Additionally, structural equation modeling, as well as mediation and moderation analyses, were performed. Results: The study findings revealed that dietary knowledge, dietitian-led interventions, and economic factors significantly influenced malnutrition and health outcomes. Conversely, nutritional quality did not emerge as a significant predictor. Discussions: The study will help pharmaceutical companies, governments, and healthcare practitioners in marketing dietary supplements, design focused dietary programs, and develop health education campaigns to improve diabetes patients’ quality of life. The findings illuminated the critical roles of dietary knowledge, dietitian-led interventions, economic factors, and lifestyle modifications in managing malnutrition and enhancing health outcomes. Conclusions: The study demonstrated significant mediation and moderation effects, emphasizing the complex interplay between food habits and malnutrition on health perceptions. However, nutritional quality was not a significant predictor, and the research underscored the necessity of holistic, personalized interventions. This will also help medical marketers in devising their marketing strategies. Full article
(This article belongs to the Special Issue Nutrition in Patient Care)
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