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Validation of the Subjective Global Nutrition Assessment (SGNA) and Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) to Identify Malnutrition in Hospitalized Malaysian Children

Ong SH, Chee WSS, Lapchmanan LM, Ong SN, Lua ZC, Yeo JX

J Trop Pediatr, 2019 02 01;65(1):39-45.
PMID: 29514329 DOI: 10.1093/tropej/fmy009

Background: Early detection of malnutrition in hospitalized children helps reduce length of hospital stay and morbidity. A validated nutrition tool is essential to correctly identify children at risk of malnutrition or who are already malnourished. This study compared the use of the Subjective Global Nutrition Assessment (SGNA, nutrition assessment tool) and Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP, nutrition screening tool) with objective nutritional parameters to identify malnutrition in hospitalized children.
Methods: A cross-sectional study was carried out in two general paediatric wards in a public hospital. SGNA and STAMP were performed on 82 children (52 boys and 30 girls) of age 1-7 years. The scores from both methods were compared against Academy of Nutrition and Dietetics/American Society of Parental and Enteral Nutrition Consensus Statement for identification of paediatric malnutrition. The objective measurements include anthropometry (weight, height and mid-arm circumference), dietary intake and biochemical markers (C-reactive protein, total lymphocytes and serum albumin). Kappa agreement between methods, sensitivity, specificity and cross-classification were computed.
Results: SGNA and STAMP identified 45% and 79% of the children to be at risk of malnutrition, respectively. Using a compendium of objective parameters, 46% of the children were confirmed to be malnourished. The agreement between SGNA and objective measurements (k = 0.337) was stronger than between STAMP and objective measurements (k = 0.052) in evaluating the nutritional status of hospitalized children. SGNA also has a 4-fold higher specificity (70.45%) than STAMP (18.18%) in detecting children who are malnourished.
Conclusion: SGNA is a valid nutrition assessment tool in diagnosing malnutrition status among hospitalized children in Malaysia. The discrepancy in specificity values between the two methods explains the distinguished roles between SGNA and STAMP. The use of STAMP will have to be followed up with a more valid tool such as SGNA to verify the actual nutrition status of the paediatric population.

Matched MeSH terms: Nutrition Assessment
Fulltext Nutritional and physical activity status among adults living in low-cost housing area in Selangor

Lim, Siew Wen, Roslee Rajikan, Razinah Sharif

Jurnal Sains Kesihatan Malaysia, 2016;14(2):79-88.
MyJurnal

This study aimed to assess the nutritional and physical activity status among adults living in low-cost housing area. This cross-sectional study involved 115 adults aged from 18 to 59 years old (46 male and 69 female). Anthropometric and body composition measurements of height, weight, body fat percentage, waist and hip circumference were taken. Biochemical measurements included blood glucose, blood cholesterol and blood pressure. Dietary intake was evaluated by interviewing subjects using Food Frequency Questionnaires (FFQ). Physical activity status was determined by interviewing subjects using International Physical Activity Questionnaire (IPAQ). Most of the subjects were found to be mainly on low socioeconomic status and working as blue collar workers. The mean body mass index (BMI) for men and women were 27.3 ± 6.3 kg/m2 and 28.5 ± 5.3 kg/m2, respectively. The waist-hip ratio of men and women were 0.92 ± 0.07 and 0.86 ± 0.06, respectively. Mean blood pressure observed was 128.8 ± 18.8 mmHg (systolic) and 78.2 ± 12.1 mmHg (diastolic). Mean blood glucose was reported to be 6.6 ± 3.2 mmol/L while the mean blood cholesterol was 5.2 ± 1.0 mmol/L. Overall energy intake was 2705 ± 603 kcal with the contribution of 53.4% carbohydrate, 13.5% protein and 32.5% fat to overall energy intake. The nutrients that did not achieve Malaysia’s Recommended Nutrient Intake (RNI) were calcium (73.1%), thiamine (70.5%), folate (25.0%) and vitamin A (19.6%). The mean physical activity of subjects was 6739.8 ± 8135.6 MET-min/week (high physical activity). In conclusion, the adults living in low-cost housing have unsatisfactory nutritional status yet they have good physical activity level which might be contributed by their occupation.

Matched MeSH terms: Nutrition Assessment
Fulltext Ultra-processed food consumption in relation to BMI and body fat percentage of adults in Terengganu

Asma’ Ali, Nurul Atiqah Khasbullah, Fauziah Tufail Ahmad, Hayati Mohd Yusof

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):37-43.
MyJurnal

Introduction: There is an emergent increase of ultra-processed food consumption in developing countries including Malaysia which carries a likelihood towards the increase of obesity. However, few studies have been done in relating between ultra-processed consumption and obesity, especially in Malaysia. Therefore, this study aims to determine the consumption of ultra-processed foods and its relationship with BMI and body fat percentage among university committee in Kuala Nerus, Terengganu. Methods: A cross-sectional study was performed among 167 individuals aged 18 to 59 years old in Kuala Nerus. Data were collected using a researcher-administered questionnaire which consisted of three different sections: socio-demographic profile, two days 24-hour dietary recall, and nutritional status assessment on BMI and body fat percentage. Consumption of ultra-processed foods were determined by classifying two days 24-hour dietary recall based on ultra-processed food classification. Data were analyzed using SPSS version 21.0 with p

Matched MeSH terms: Nutrition Assessment
Fulltext Validity and acceptability of image-based food record in assessing nutrient intake among selected Malaysian undergraduates

Kai Sze Chan, Yit Siew Chin

Malaysian Journal of Medicine and Health Sciences, 2020;16(106):69-76.
MyJurnal

Introduction: Recognising the limitations of present dietary assessments method, recent attention had been drawn to image-based food record (IBFR) to assess dietary intake of the population. Thus, the present study aimed to compare nutrient intake assessed using IBFR with 24-hour diet recall (24DR) among nutrition and dietetics student. Method: There were 46 nutrition and dietetic undergraduates participated in the study, and information on the socio-demo- graphic background and acceptability toward IBFR were obtained. Respondents were trained to complete one-day IBFR, and they were interviewed by researchers on the following day for their 24DR. Result: The mean age of respon- dents was 21.4±1.7 years old. The present study revealed that there were significantly higher protein and beta-caro- tene, but lower vitamin C reported by IBFR compared to 24DR. Medium to strong correlations were found between IBFR and 24DR for energy and nutrients intakes. The Bland-Altman analysis demonstrated a good level of agreement between IBFR and 24DR for energy and macronutrients (carbohydrates, protein and fat), respectively. The mean differences between IBFR and 24DR were -36 kcal for total daily energy intake, while mean differences of -12.24g, 0.79g, and 1.52g were reported for carbohydrates protein, and fat, respectively. Moderate level of agreement toward acceptability was demonstrated, and most of them (67.4%) preferred IBFR method. Conclusion: The present study re- vealed that IBFR showed a good level of agreement with 24DR in assessing nutrient intake. However, more extensive works should be considered to improve IBFR in assessing the energy and nutrients intake for the general population.

Matched MeSH terms: Nutrition Assessment
Fulltext Impact of dietitian delivered intensive nutrition intervention on dietary intake and weight outcome among gynecology cancer outpatient prior to surgery

Aini Masitah Mohammad, Zalina Abu Zaid, Ho Chiou Yi, Zuriati Ibrahim, Zulfitri ‘Azuan Mat Daud, Nor Baizura Md. Yusop, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(106):122-130.
MyJurnal

Introduction: This is open label randomised control trial, aimed to identify whether an early (commenced at the time of diagnosis) and intensive nutrition intervention (INI) (individualised dietary counselling, oral nutritional sup- plements [ONS], telephone, and home visit) can improve weight and dietary intake of gynaecological cancer (GC) patients preoperatively. Methods: Selected GC patients planned for surgery were randomly grouped into control group (CG) (n = 35) and intervention group (IG) (n = 34). Malnutrition screening tool (MST) was used as a screening tool, while Patient-Generated Subjective Global Assessment (PG-SGA) was used as a nutrition assessment tool. IG received an intensive individualised dietary counselling with the supply of ONS at baseline (Day 1). This continued with telephone and home visit follow-up by research dietitian (Day 3 and Day 6). Meanwhile, CG only received general nutritional counselling without supply of ONS. Final assessment was conducted on Day 14. The primary outcomes included weight changes measured using TANITA and dietary intake assessment using 24-hour diet recall. Results: Mean duration of INI was 14 days. At the end of the treatment period, there was a significant weight change between groups (p < 0.001), with 0.14% weight gain in IG and 1.3% weight reduction in CG. Mean energy and protein intake of IG were higher compared to CG by +329 kcal/day and +12.2 g/day, respectively. Conclusion: This study showed that INI that incorporated individualised dietary counselling, ONS, telephone counselling, and home visit can increase energy and protein intake of GC patients, resulting in weight gain.

Matched MeSH terms: Nutrition Assessment
Fulltext Association between drinking water sources and diarrhea with malnutrition among kindergarten's children in Baghdad city, Iraq

Hasanain, F.G., Jamsiah, M., Zaleha, M.I., Azmi M. Tamil, Mohammed, A.A.

Malaysian Journal of Public Health Medicine, 2012;12(1):45-48.
MyJurnal

Malnutrition is associated with childhood diseases such as diarrhea or other severe illness. Children who suffer from
repeated episodes of diarrhea are more likely to suffer from malnutrition. In addition, the source of drinking water is
a very important factor affecting the nutritional status. The objective of this study was to find out the prevalence of
malnutrition condition among children aged 3 to 5 years old and the factors associated with it. A cross sectional study
using simple random sampling was conducted among 220 children aged 3 to 5 years old from four kindergartens in
Baghdad city, Iraq. Nutritional assessment was carried out using the indicator weight-for-age z-score based on World
Health Organization cut off points. Acute malnutrition was found in 18.2 % of the respondents. In this study 65 % of
the respondents used tap water to drink as compared to 35 % who used sterilized bottles as source of drinking water.
The environmental factors mainly the source of drinking water was significantly associated with child nutritional
status (p=0.034). The prevalence of diarrhea and admissions to the hospital due to diarrhea were also significantly
associated with malnutrition (p < 0.01, p

Matched MeSH terms: Nutrition Assessment
Fulltext Nutrition and breast cancer risk: review of recent studies

Hasanain Faisal Ghaz, Al-abed Ali Ahmed Al-abed, TibaNezar Hasan, Zaleha Md. Is, Mohammed A. AbdalQader, Saif Abdul-Majeed

Malaysian Journal of Public Health Medicine, 2016;16(1):75-80.
MyJurnal

The association between nutrition and cancer in general had been a controversial issue between scientists in the last
three decades, because some argued that there is a relationship and some nutrients can help in preventing cancer
occurrence, although this has not been a consistent finding by other studies. Studies were identified through a
systematic review of literature available on PubMed in between 1st January 2010 to 31st December 2013. We
included all studies that assessed nutrition or diet with occurrence or mortality of breast cancer. Out of 42 articles,
we included 8 articles in our screening and discussion. Among these 8 studies, there were 2 case-controls, 3 cohort
and 3 randomized control trials (RCT) studies. Although most studies reported that nutrition isassociated with
decreased risk, some reported the contrary,whereas others reported no relation. It was demonstrated a conflict
between the included papers in regards of the association between nutrition and breast cancer. These finding needs
to be re-evaluated in future studies.

Matched MeSH terms: Nutrition Assessment
Fulltext Development of a local malnutrition risk screening tool-hospital (MRST-H) for hospitalised elderly patients

Sakinah H, Suzana S, Noor Aini MY, Philip Poi JH, Shahrul Bahyah K

Malays J Nutr, 2012 Aug;18(2):137-47.
PMID: 24575662

INTRODUCTION: Hospitalised elderly patients are at high risk of malnutrition due to the presence of chronic diseases and inadequate food intake. It was on this premise that a Malnutrition Risk Screening Tool-Hospital (MRST-H) was developed for identifying the risk of malnutrition among Malaysian elderly patients.
METHODS: A total of 181 respondents aged 65 years and above who had been admitted to the Geriatric Ward of the University Malaya Medical Centre were recruited. The respondents' nutritional assessment was assessed using the Global Indicator of Malnutrition (GIM), a reference gold standard of malnutrition consisting of anthropometric measurements, biochemical indicators and the Subjective Global Assessment (SGA). Important predictive factors of malnutrition were determined by logistic regression analysis.
RESULTS: Five out of 18 predictive factors were significantly associated with malnutrition (p<0.05) in the final multivariate logistic regression model. These five factors were used to develop the MRST-H. Its validity was tested among 100 elderly inpatients in the Kuala Lumpur Hospital. The MRST-H was found to have 66.7% sensitivity, 96.2% specificity and 82.4% positive predictive value to GIM. The MRST-H was tested for reliability among 40 patients involving three raters (a dietitian and two nurses). The Kappa index of agreement was excellent between the dietitian with nurse A (81.3%, Kappa=0.84) and nurse B (87.5%, Kappa=0.89) respectively.
CONCLUSION: The MRST-H developed showed high validity and reliability as a screening tool for identifying hospitalised elderly patients with high risk of malnutrition.

Matched MeSH terms: Nutrition Assessment
Fulltext Abdominal Obesity in Malaysian Adults: National Health and Morbidity Survey III (NHMS III, 2006)

Kee CC, Jamaiyah H, Noor Safiza MN, Khor GL, Suzana S, Jamalludin AR, et al.

Malays J Nutr, 2008 Sep;14(2):125-35.
PMID: 22691770 MyJurnal

Abdominal obesity (AO) is an independent risk factor for cardiovascular disease, hypertension and diabetes mellitus in adults. There is a lack of data on the magnitude and socio-demographic profile of AO among Malaysian adults at the national level. In the Third National Health and Morbidity Survey (NHMS III) conducted in 2006, AO of adults aged 18 years and above was determined based on the waist circumference as part of the nutritional status assessment. This article reports the prevalence of AO in relation to socio-economic factors and demographic characteristics of adult subjects. Out of a total of 33,465 eligible individuals 18 years and above, waist circumference was measured in 32,900 (98.3%) individuals. The prevalence of AO was assessed using the cut-off points recommended by World Health Organization. The mean waist circumference in men and women was 84.0cm [95% confidence interval (95% CI): 83.8, 84.3] and 80.3cm (95% CI: 80.1, 80.6) respectively. The national prevalence of AO was 17.4% (95% CI: 16.9, 17.9). The identified risks of AO were women (OR: 4.2, 95% CI: 3.8, 4.6), aged 50-59 years (OR: 5.6, 95% CI: 4.0, 7.7), Indians (OR: 3.0, 95% CI: 2.4, 3.8), housewives (OR: 1.4, 95% CI: 1.1, 1.7), subjects with primary education (OR: 1.3, 95% CI: 1.1, 1.5) and ever married (OR: 1.4, 95% CI: 1.2, 1.6). Being the largest population-based study on AO among Malaysians, these findings have important public health implications. There is an urgent need to revise public health policies and programmes aimed at prevention of abdominal obesity especially in the groups at risk.
Study name: National Health and Morbidity Survey (NHMS-2006)

Matched MeSH terms: Nutrition Assessment
Fulltext Malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement

Suzana S, Boon PC, Chan PP, Normah CD

Malays J Nutr, 2013 Apr;19(1):65-75.
PMID: 24800385 MyJurnal

INTRODUCTION: Malnutrition is a common phenomenon among the elderly and quite often related to psychosocial problems. The objective of this study was to determine malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement, i.e. FELDA Sungai Tengi, Selangor.
METHODS: A cross-sectional study was conducted among 160 subjects (men = 36.2%), with a mean age of 65.0 +/- 3.9 years, who were interviewed to obtain information on malnutrition risk and appetite using Mini Nutritional Assessment Short Form and Simplified Nutritional Appetite Questionnaire, respectively. Functional status was determined using Instrumental Activities of Daily Living (IADL), Elderly Mobility Scale (EMS) and handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale and De Jong Gierveld Loneliness Scale were used to identify cognitive impairment, depressive symptoms and loneliness status of subjects respectively. A total of 42.5% of subjects were at risk of malnutrition and 61.2% had poor appetite. The mean scores of IADL and EMS were lower in subjects at risk of malnutrition, compared to those who were not at high risk (p < 0.05 for both parameters). Multiple linear regression showed that 19.8% of malnutrition risk was predicted by poor appetite, decreased functional status (IADL) and depression.
CONCLUSION: Malnutrition risk was prevalent and associated with poor appetite, functional status and psychosocial problems among the elderly subjects. The psychosocial aspect should also be incorporated in nutrition intervention programmes in order to improve mental well-being and functional independancy.
Study site; FELDA Sungai Tengi, Selangor, Malaysia
Device, Questionnaire & Scale: Mini Nutritional Assessment Short Form; Simplified Nutritional Appetite Questionnaire, Instrumental Activities of Daily Living (IADL); Elderly Mobility Scale (EMS); handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale (GDS-15); De Jong Gierveld Loneliness Scale

Matched MeSH terms: Nutrition Assessment*
Fulltext Validation of nutritional screening tools against anthropometric and functional assessments among elderly people in Selangor

Suzana S, Siti Saifa H

Malays J Nutr, 2007 Mar;13(1):29-44.
PMID: 22692187 MyJurnal

This cross sectional study was conducted to determine the validity of three screening tools, Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Risk Screening Tool for Community (MRST-C) and Malnutrition Risk Screening Tool for Hospital (MRST-H) among elderly people at health clinics. The screening tools were validated against anthropometric and functional assessments. The anthropometric assessments that were carried out included body weight, height, arm span, body mass index (BMI), calf circumference (CC) and mid upper arm circumference (MUAC). A set of questionnaire on manual dexterity, muscular strength, instrumental activities daily living (IADL) and cognitive status was used to assess functional abilities. A total of 156 subjects were recruited from rural (38 subjects) and urban (118 subjects) health clinics at Sabak Bernam and Cheras respectively. Subjects' age ranged from 60 to 83 years old, with 44.2% were men and 55.8% women. The prevalence of muscle wasting among the subjects assessed from MUAC and CC were both 7.0%. MNA-SF had the highest correlation with BMI (r = 0.497, p<0.001), followed by MUAC (r = 0.398, p<0.001), CC (r = 0.473, p<0.001), cognitive assessment (r = 0.229, p<0.001) and handgrip strength (r = 0.209, p<0.001). Whilst MRST-C had the highest correlation with IADL score (r =-0.320, p<0.001) and MRST-H had the highest correlation with the lock and key test (r = -0.325, p<0.01). Sensitivity was the highest for MNA-SF (93.2%), followed by MRST-H (52.5%) and MRST-C (25.8%). Specificity was the highest for MRST-H (97.3%), followed by MRST-C (90.8%) and MNA-SF (79.4%). Positive predictive value (PPV) for MRST-H, MNA-SF and MRST-C was 55.5%, 18.2% and 14.1%, respectively. In conclusion, among the screening tools being validated, MNA-SF is considered the most appropriate tool to be used in health clinics for identification of elderly individuals who are at high risk of malnutrition.

Matched MeSH terms: Nutrition Assessment*
Fulltext Dietetic practices in the management of childhood obesity in Malaysia

Nor Baizura, M.Y., Ting, T.H., Zalilah, M.S., Ruzita, A.T., Spurrier, N.

Malays J Nutr, 2014;20(2):255-269.
MyJurnal

Introduction: Dietitians play an essential role in the management of childhood obesity and consistency in dietetic practices is required to ensure the effectiveness of treatment. This study assessed dietitians’ current practices in the management of childhood obesity, compared the practices with nutrition practice guidelines used by dietitians in other countries and identified practice components for the development of nutrition practice guidelines for the management of childhood obesity in Malaysia.
Methods: A cross-sectional study was conducted among 40 dietitians in 16 Ministry of Health hospitals and three teaching hospitals. Information on current dietetic practices in the management of childhood obesity was obtained through a mailed survey questionnaire. The practices included nutritional assessment, determination of energy requirement, dietary prescription and physical activity modification. Emails were sent to 31 dietetic associations in other countries to obtain information on practice guidelines used by dietitians.
Results: Frequently used dietary intervention and physical activity modification approaches were high fibre diet (65%), low fat diet (40%), reduction of sedentary pursuits and screen times (67.5%) and an increase in duration of current physical activities (60%). In comparison to other dietetic practice guidelines, the current dietetic practices in Malaysia do not usually include waist circumference, biochemical and blood pressure data. However, similar to other guidelines, the current dietetic practices included low dietary fat, high fibre diet, decreased sedentary activity and increased physical activity level.
Conclusions: The dietetic practices in the management of childhood obesity in Malaysia are diverse. A comprehensive nutrition practice guideline for management of childhood obesity is urgently needed for standardisation of dietetic practices in Malaysia.

Matched MeSH terms: Nutrition Assessment
Fulltext Prevalence of geriatric malnutrition and its associated factors at the Hospital Universiti Sains Malaysia, Kelantan

Nur Fazimah Sahran, Sakinah Harith, Rosminah Mohamed

Malays J Nutr, 2016;22(1):41-54.
MyJurnal

Introduction: Identified parameters associated with geriatric malnutrition add greatly to the knowledge of clinical nutrition and facilitate patient-centred nutritional care management.
Methods: A six-month cross-sectional study with the aims of deterrninine the prevalence of malnutrition and its associated parameters was conducted among hospitalised geriatrics admitted to Hospital USM. A total of 130 (49 men, 81 women) eligible participants with a mean age of 69.7 (6.99) were recruited for this study. Anthropometric tests, biochemical tests, and subjective global assessments (SGA) were applied in this study to assess the nutritional status of the participants. Meanwhile, socio-demographics, nutritional risk factors, and clinical elements were examined to identify the associated factors of malnutrition.
Results: The findings of this study revealed that 35.4% of the participants were malnourished based on SGA ratings of B (26.2%) and C (9.2%), with women having a significantly higher proportion (43.5%) compared to men (22 4%) with p

Matched MeSH terms: Nutrition Assessment
Fulltext Effects of sports nutrition education intervention on sports nutrition knowledge, attitude and practice, and dietary intake of Malaysian team sports athletes

Siti Soraya Mohd Elias, Hazizi Abu Saad, Mohd Nasir Mohd Taib, Zubaidah Jamil

Malays J Nutr, 2018;24(1):103-116.
MyJurnal

Introduction: The purpose of this study was to determine the effects of sports nutrition education intervention on improvements in sports nutrition knowledge, attitude and practice (KAP), and dietary intake among Malaysian team sports athletes. Methods: A total of 105 male participants representing four team sports under the elite sports programme were recruited based on a name list provided by National Sports Council of Malaysia. Teams were assigned by stratified random sampling to either the experimental group (EG) (n=52) or the comparison group (CG) (n=53). The EG received seven weeks of education intervention programme based on a validated booklet covering basic sports nutrition for team sports. A self-administered sports nutrition KAP questionnaire and dietary intake assessment of total energy, carbohydrates, proteins and fats based on three-day food records was conducted before and after the intervention. Results: There were significant increments (p

Matched MeSH terms: Nutrition Assessment
Zinc supplementation influences genomic stability biomarkers, antioxidant activity, and zinc transporter genes in an elderly Australian population with low zinc status

Sharif R, Thomas P, Zalewski P, Fenech M

Mol Nutr Food Res, 2015 Jun;59(6):1200-12.
PMID: 25755079 DOI: 10.1002/mnfr.201400784

An increased intake of Zinc (Zn) may reduce the risk of degenerative diseases but may prove to be toxic if taken in excess. This study aimed to investigate whether zinc carnosine supplement can improve Zn status, genome stability events, and Zn transporter gene expression in an elderly (65-85 years) South Australian cohort with low plasma Zn levels.

Matched MeSH terms: Nutrition Assessment
Fulltext Vitamin Status among Breastfed Infants in Bhaktapur, Nepal

Ulak M, Chandyo RK, Thorne-Lyman AL, Henjum S, Ueland PM, Midttun Ø, et al.

Nutrients, 2016 Mar 08;8(3):149.
PMID: 27005657 DOI: 10.3390/nu8030149

Vitamin deficiencies are known to be common among infants residing in low- and middle-income countries but relatively few studies have assessed several biochemical parameters simultaneously. The objective of the study was to describe the status of vitamins (A, D, E, B₆, B12 and folate) in breastfed infants. We measured the plasma concentrations of trans retinol, 25 hydroxy vitamin D, α-tocopherol, pyridoxal 5'-phosphate, cobalamin, folate, methylmalonic acid, homocysteine, hemoglobin and C-reactive protein from 467 randomly selected infants. One in five (22%) was deficient in at least one vitamin. Mean (SD) plasma folate concentration was 73 (35) nmol/L, and no infant in the sample was folate deficient. Vitamin B₆ deficiency and vitamin B12 deficiency was found in 22% and 17% of the infants, respectively. Elevated plasma methylmalonic acid or total homocysteine concentration was found in 82% and 62% of infants, respectively. Fifteen percent of infants were vitamin A deficient and 65% were marginally deficient in vitamin A. Fewer than 5% of infants had low plasma vitamin D concentration or vitamin E concentration (α-tocopherol <9.3 µmol/L). Our results illustrate the importance of continued supplementation campaigns and support the expansion of food fortification and dietary diversification programs that target children and women in Nepal.

Matched MeSH terms: Nutrition Assessment
Fulltext Malnutrition as Key Predictor of Physical Frailty among Malaysian Older Adults

Norazman CW, Adznam SN, Jamaluddin R

Nutrients, 2020 Jun 08;12(6).
PMID: 32521618 DOI: 10.3390/nu12061713

Studies have been carried out on the association between frailty and malnutrition, but the similarities and divergence of the relationship remain debatable. This study aimed to explore the prevalence of malnutrition risk and frailty as well as the overlapping constructs. The associations that emerged were assessed independently of other risk factors. A total of 301 community-dwelling older adults with a mean age of 66.91 ± 5.59 years old were randomly recruited. Fried Criteria and Mini Nutritional Assessment-Short Form (MNA-SF) were used to assess frailty status and malnutrition, respectively. Other related nutritional assessments were assessed (body mass index (BMI), circumference measures, body fat % and skeletal muscle mass). The prevalence of frailty was 14.6% and prefrail was 59.7%; 29.6% were at risk of malnutrition, and 3.3% were malnourished. Malnutrition risk was significantly associated with a higher number of chronic diseases, BMI, circumference of mid-upper arm (MUAC), and calf, (CC)and skeletal muscle mass (SMM) and frailty, whereas frailty was significantly associated with higher number of chronic diseases, SMM and malnutrition. Frailty syndrome can be predicted with increasing age, body fat, lower skeletal muscle and malnutrition. Those who were frail were found to be five times more likely to be at risk of malnutrition. Results suggested that frailty and malnutrition shared considerable overlap, which emphasised the interrelated but discrete concepts. Therefore, the assessment of malnutrition is imperative and could be used as a practical implication in assessing frailty syndrome.

Matched MeSH terms: Nutrition Assessment
Fulltext Protein-Energy Wasting Assessment and Clinical Outcomes in Patients with Acute Kidney Injury: A Systematic Review with Meta-Analysis

Khor BH, Tiong HC, Tan SC, Abdul Rahman R, Abdul Gafor AH

Nutrients, 2020 Sep 13;12(9).
PMID: 32933198 DOI: 10.3390/nu12092809

Nutritional assessment is essential to identify patients with acute kidney injury (AKI) who are protein-energy wasting (PEW) and at risk of poor clinical outcomes. This systematic review aimed to investigate the relationship of nutritional assessments for PEW with clinical outcomes in patients with AKI. A systematic search was performed in PubMed, Scopus, and Cochrane Library databases using search terms related to PEW, nutrition assessment, and AKI to identify prospective cohort studies that involved AKI adult patients with at least one nutritional assessment performed and reported relevant clinical outcomes, such as mortality, length of stay, and renal outcomes associated with the nutritional parameters. Seventeen studies reporting eight nutritional parameters for PEW assessment were identified and mortality was the main clinical outcome reported. A meta-analysis showed that PEW assessed using subjective global assessment (SGA) was associated with greater mortality risk (RR: 1.99, 95% CI: 1.36-2.91). Individual nutrition parameters, such as serum chemistry, body mass, muscle mass, and dietary intakes, were not consistently associated with mortality. In conclusion, SGA is a valid tool for PEW assessment in patients with AKI, while other nutrition parameters in isolation had limited validity for PEW assessment.

Matched MeSH terms: Nutrition Assessment
Fulltext Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review

Sahathevan S, Khor BH, Ng HM, Gafor AHA, Mat Daud ZA, Mafra D, et al.

Nutrients, 2020 Oct 15;12(10).
PMID: 33076282 DOI: 10.3390/nu12103147

Hemodialysis (HD) majorly represents the global treatment option for patients with chronic kidney disease stage 5, and, despite advances in dialysis technology, these patients face a high risk of morbidity and mortality from malnutrition. We aimed to provide a novel view that malnutrition susceptibility in the global HD community is either or both of iatrogenic and of non-iatrogenic origins. This categorization of malnutrition origin clearly describes the role of each factor in contributing to malnutrition. Low dialysis adequacy resulting in uremia and metabolic acidosis and dialysis membranes and techniques, which incur greater amino-acid losses, are identified modifiable iatrogenic factors of malnutrition. Dietary inadequacy as per suboptimal energy and protein intakes due to poor appetite status, low diet quality, high diet monotony index, and/or psychosocial and financial barriers are modifiable non-iatrogenic factors implicated in malnutrition in these patients. These factors should be included in a comprehensive nutritional assessment for malnutrition risk. Leveraging the point of origin of malnutrition in dialysis patients is crucial for healthcare practitioners to enable personalized patient care, as well as determine country-specific malnutrition treatment strategies.

Matched MeSH terms: Nutrition Assessment
Fulltext Can Malaysian Young Adults Report Dietary Intake Using a Food Diary Mobile Application? A Pilot Study on Acceptability and Compliance

Chen YS, Wong JE, Ayob AF, Othman NE, Poh BK

Nutrients, 2017 Jan 13;9(1).
PMID: 28098770 DOI: 10.3390/nu9010062

Mobile applications may improve dietary reporting among young adults due to their high accessibility and embedded camera function. This pilot study aimed to (i) evaluate users' acceptability and compliance in reporting dietary intake using a newly developed food diary mobile application (food app); and (ii) identify issues and recommendations for improving dietary assessment using this food app via quantitative and qualitative protocols. Twenty-eight university students each used a food app for seven consecutive days and attended one of five focus group interviews. A 42% decrement in reporting compliance was observed throughout the seven-day recording period. An average of 5.9 recording days were reported and 4.8 occasions of meal data were uploaded each day. Based on questionnaires, high levels of agreement were reported in terms of perceived usefulness (69.3%), perceived ease of use (77.1%), attitude (73.6%), perceived enjoyment (62.6%), and smartphone experience (91.1%), but such agreement was not reported for intention to use (38.1%) and social influence (33.4%). Four major themes emerged from the focus group interviews, namely, (i) features; (ii) potential use; (iii) utility issues of the food app; and (iv) suggestions for improvements. While the food app was well-accepted by most of the young adults, the current prototype would benefit from incorporation of a barcode scanning function, customizable reminders, in-app tutorial, an entertainment component, and enhancement in overall appearance.

Matched MeSH terms: Nutrition Assessment

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