DESIGN: Scoping review.
SETTING: Systematic search using PubMed and Web of Science.
RESULTS: We identified twelve tools from seventy-four eligible publications. They were developed for Koreans (n 4), Bangladeshis (n 2), Iranians (n 1), Indians/Malays/Chinese (n 1), Japanese (n 3) and Chinese Americans (n 1). Most tools (10/12) were composed of a dish-based FFQ. Although the development process of a dish list varied among the tools, six studies classified mixed dishes based on the similarity of their characteristics such as food ingredients and cooking methods. Tools were validated against self-reported dietary information (n 9) and concentration biomarkers (n 1). In the eight studies assessing the differences between the tool and a reference, the mean (or median) intake of energy significantly differed in five studies, and 26-83 % of nutrients significantly differed in eight studies. Correlation coefficients for energy ranged from 0·15 to 0·87 across the thirteen studies, and the median correlation coefficients for nutrients ranged from 0·12 to 0·77. Dish-based dietary assessment tools were used in fifty-nine studies mainly to assess diet-disease relationships in target populations.
CONCLUSIONS: Dish-based dietary assessment tools have exclusively been developed and used for Asian-origin populations. Further validation studies, particularly biomarker-based studies, are needed to assess the applicability of tools.
METHODS: We conducted a prospective observational study in 13 international ICUs involving mechanically ventilated cardiac surgery patients with an ICU stay of at least 72 h. Collected data included the energy and protein prescription, type of and time to the initiation of nutrition, and actual quantity of energy and protein delivered (maximum: 12 days).
RESULTS: Among 237 enrolled patients, enteral nutrition (EN) was started, on average, 45 h after ICU admission (range, 0-277 h; site average, 53 [range, 10-79 h]). EN was prescribed for 187 (79%) patients and combined EN and parenteral nutrition in 33 (14%). Overall, patients received 44.2% (0.0%-117.2%) of the prescribed energy and 39.7% (0.0%-122.8%) of the prescribed protein. At a site level, the average nutrition adequacy was 47.5% (30.5%-78.6%) for energy and 43.6% (21.7%-76.6%) for protein received from all nutrition sources.
CONCLUSION: Critically ill cardiac surgery patients with prolonged ICU stay experience significant delays in starting EN and receive low levels of energy and protein. There exists tremendous variability in site performance, whereas achieving optimal nutrition performance is doable.
DESIGN: Cross-sectional analysis.
SETTING: The Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study.
PARTICIPANTS: Fifteen-year-old secondary school children who have given consent and who participated in the MyHeART study in 2014.
PRIMARY OUTCOME MEASURE: Muscle strength was measured in relation to dietary intake (energy and macronutrients) and physical activity by using a hand grip dynamometer.
RESULTS: Among the 1012 participants (395 male; 617 female), the hand grip strength of the males was higher than that of the females (27.08 kg vs 18.63 kg; p<0.001). Also, males were more active (2.43vs2.12; p<0.001) and consumed a higher amount of energy (2047 kcal vs 1738 kcal; p<0.001), carbohydrate (280.71 g vs 229.31 g; p<0.001) and protein (1.46 g/kg body weight (BW) vs 1.35 g/kg BW; p<0.168). After controlling for ethnicity, place of residency and body mass index, there was a positive relationship between hand grip strength and the intake of energy (r=0.14; p=0.006), carbohydrate (r=0.153; p=0.002) and fat (r=0.124; p=0.014) and the physical activity score (r=0.170; p=0.001) and a negative relationship between hand grip strength and the intake of protein (r=-0.134; p=0.008), for males. However, this was not observed among females.
CONCLUSIONS: Energy, carbohydrate and fat intakes and physical activity score were positively correlated with hand grip strength while protein intake was negatively correlated with hand grip strength in males but not in females.
BACKGROUND: Continuous effort has been made to identify patients at high risk of malnutrition, but monitoring and documentation of nutritional intake are relative less emphasized upon.
METHODS: A needs assessment through a cross-sectional study design was carried out at six hospitals in Yogyakarta, Indonesia. A self-administered semi-structured questionnaire was filled out by 111 respondents recruited from three different professions (nurses, dietitians and serving assistants) in the wards.
RESULTS: Seventy per cent of the respondents perceived that the current dietary assessment tool used to record patients' food intake was simple; however, the disadvantage of this tool was its tedious process of computing nutritional values of food consumed. Furthermore, more than half respondents encountered problems in conducting food intake record of patients, primarily due to limited number of human resources, followed by time constraints and perception that such dietary assessment as not part of their job scope.
DISCUSSION: This study has revealed important information in developing a simple, valid and reliable dietary assessment tool for monitoring food intake of hospitalized patients to be applied by interdisciplinary hospital professionals.
CONCLUSIONS: Awareness of the important on monitoring nutrient intake of patients should be emphasized among healthcare professionals. The current dietary assessment tool requires modification due to lengthy time taken to complete the task and poor accuracy in intake estimation.
IMPLICATION FOR NURSING AND HEALTH POLICY: Hospitals should provide protocols and guidelines of cooperation among interdisciplinary professionals, including nurses, which includes a simple dietary assessment tool to assist nutritional management of hospitalized patients.
METHODS AND STUDY DESIGN: The data used for this analysis were from 1143 children, 6-12 years old, that participated in the South East Asian Nutrition Survey (SEANUTS). Physical activity (PA) was measured using pedometers for 2 consecutive days and was categorized low, moderate and high. Child nutritional status was categorized based on body mass index for age z-scores (BAZ) into normal weight (-2 SD ≤BAZ≤1 SD) or overweight (BAZ >1 SD). Energy intake was calculated from a one day 24 hour recall and compared to the Indonesian recommended dietary allowance (RDA) for energy.
RESULTS: Children with low PA had higher risk (ODDs 3.4, 95% CI: 2.0, 6.0) of being overweight compared to children who had high PA. Children with moderate PA and energy take >100% RDA had higher risk (ODDs 4.2, 95% CI 1.9, 9.3) of being overweight than children with high PA and energy intakes ≤100% RDA.
CONCLUSIONS: Low physical activity independently or moderate physical activity and high energy intake are risk factors for Indonesian children to get overweight. Program intervention such as increasing physical activity at school and home is needed to reduce overweight among children.
METHODS: This is a prospective observational study conducted among critically ill patients aged ≥18 years, intubated and mechanically ventilated within 48 h of ICU admission and stayed in the ICU for at least 72 h. Information on baseline characteristics and nutritional risk status (the modified Nutrition Risk in Critically ill [NUTRIC] score) was collected on day 1. Nutritional intake was recorded daily until death, discharge, or until the twelfth evaluable days. Mortality status was assessed on day 60 based on the patient's hospital record. Patients were divided into 3 groups a) received <2/3 of prescribed energy and protein (both <2/3), b) received ≥2/3 of prescribed energy and protein (both ≥2/3) and c) either energy or protein received were ≥2/3 of prescribed (either ≥2/3). The relationship between the three groups with 60-day mortality was examined by using logistic regression with adjustment for potential confounders. Sensitivity analysis was performed to examine the influence of ICU length of stay (≥7 days) and nutritional risk status.
RESULTS: Data were collected from 154 mechanically ventilated patients (age, 51.3 ± 15.7 years; body mass index, 26.5 ± 6.7 kg/m2; 54% male). The mean modified NUTRIC score was 5.7 ± 1.9, with 56% of the patients at high nutritional risk. The patients received 64.5 ± 21.6% of the amount of energy and 56.4 ± 20.6% of the amount of protein prescribed. Provision of energy and protein at ≥2/3 compared with <2/3 of the prescribed amounts was associated with a trend towards increased 60-day mortality (Adjusted odds ratio [Adj OR] 2.23; 95% confidence interval [CI], 0.92-5.38; p = 0.074). No difference in mortality status was found between energy and protein provision at either ≥2/3 compared with <2/3 of the prescribed amounts (Adj OR 1.61, 95% CI, 0.58-4.45; p = 0.357). Nutritional risk status, not ICU length of stay, influenced the relationship between nutritional adequacy and 60-day mortality.
CONCLUSIONS: Energy and protein adequacy of ≥2/3 of the prescribed amounts were associated with a trend towards increased 60-day mortality among mechanically ventilated critically ill patients. However, neither energy nor protein adequacy alone at ≥ or <2/3 adequacy affect 60-day mortality. Increased mortality was associated with provision of energy and protein at ≥2/3 of the prescribed amounts, which only affected patients with low nutritional risk.