Nutricion hospitalaria最新文献

Introduction: Introduction: this study evaluated the predictive value of inflammatory indices including neutrophil-percentage-to-albumin ratio (NPAR), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to-lymphocyte ratio (ELR) for mortality in adults with chronic kidney disease (CKD). Methods: this study analyzed adults aged 40-79 years with CKD from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. Cox regression models assessed associations between inflammatory indices and all-cause/cardiovascular disease (CVD) mortality. Receiver operating characteristic curves evaluated their predictive accuracy. Restricted cubic splines and recursive algorithm analyzed threshold effects. Subgroup analyses were performed by demographic and clinical characteristics. Results: among 2496 subjects, elevated NPAR (HR: 2.05, 95 % CI: 1.62-2.59), NLR (HR: 2.28, 95 % CI: 1.78-2.93), ELR (HR: 1.61, 95 % CI: 1.27-2.03) and SII (HR: 1.61, 95 % CI: 1.26-2.06) were independently associated with increased all-cause mortality risk after adjustment. Similar patterns were observed for CVD mortality. NPAR showed the highest predictive value for both all-cause mortality (AUC: 0.610) and CVD mortality (AUC: 0.599). Non-linear relationships and threshold effects were identified between NPAR and mortality. The associations remained consistent across subgroups, with NPAR showing enhanced prediction in diabetic patients (p for interaction = 0.029). Conclusion: NPAR, SII, and NLR independently predicted mortality in CKD patients. NPAR demonstrated the strongest predictive capability, particularly in patients with diabetes, suggesting its potential as a practical tool for mortality risk stratification in CKD.

Introduction: Background: exercise impacts hand-grip strength (HGS) performance in adults. There is controversy regarding anthropometric and body composition indicators associated with HGS. We analyzed the association between HGS, anthropometry, and body composition parameters according to exercise level. Methods: we evaluated 209 participants, 104 men and 105 women between 18 and 59 y/o. Subjects were categorized according to the Global Physical Activity Questionnaire and the American Physical Activity Guidelines into two groups: Non-Adequate Level of Exercise (NALE) and Adequate Level of Exercise (ALE). Physical activity level was determined using the FAO/WHO factorial method. Body composition was performed using electrical bioimpedance. HGS was measured with a digital dynamometer (BTE™). Results: age did not correlate with HGS. Men and women in the ALE group had a lower level of fat mass index (p < 0.05) and higher levels of skeletal muscle index (SMI) (p < 0.05) and HGS (p = 0.008). Men in the normal SMI and overweight body mass index groups exhibited higher handgrip strength (HGS). In both sexes, the taller group had higher HGS values (p = 0.03). Significant correlations were observed in men between HGS and height, exercise, fat-free mass, and SMI. In women, there were significant correlations between fat mass and height. In no case was the effect size strong. HGS estimation models by sex are presented. Conclusion: height, exercise, and muscle mass influenced hand-grip strength in men, while height and adiposity did so in women.

Introduction: Objective: to evaluate the factors associated with non-compliance with the Quality Indicators in Nutritional Therapy (QINT) related to the prescribed and infused volume of Enteral Nutritional Therapy (ENT). Method: cross-sectional study, aligned with a prospective cohort, carried out in two clinical wards and two surgical wards of a Brazilian public hospital of high complexity and reference in ENT. Patients aged > 18 years, of both sexes, who required ENT exclusively by tube were included. The QINT "enteral volume infused index" and "frequency of days of adequate administration of the prescribed volume X volume infused in patients on ENT" were analyzed. Multivariate Poisson regression was adopted to identify factors associated with the outcome. Results: the 159 patients included totaled 565 days using ENT. The independent risk factors for non-compliance with the "enteral volume infused index" indicator were: being a surgical patient (HR: 2.12; 95 % CI: 1.31-3.41; p = 0.002), the presence of chronic obstructive pulmonary disease (COPD) (HR: 2.34; 95 % CI: 1.54-3.57; p = 0.002) and use of antidiarrheals (HR: 2.35; 95 % CI: 1.45-3.80; p = 0.001). The use of antidiarrheals (HR 19.75; 95 % CI: 10.05-38.79; p = 0.000) was the only risk factor identified for non-compliance with the indicator "frequency of days of adequate administration of the prescribed volume X volume infused in patients on ENT." Conclusions: surgical patients, those with COPD, and those using antidiarrheals are at greater risk of not reaching the prescribed ENT volume over the prescribed days.

Introduction: Introduction: in the context of the climate crisis and growing concern for sustainable food systems, understanding public perceptions is key to informing public policies and intervention strategies. Objective: to explore the knowledge and perceptions of Chilean adults regarding the environmental, cultural, and nutritional factors that influence the adoption of sustainable dietary practices. Methods: a cross-sectional study that analyzed the perceptions of 470 Chilean adults on environmental, cultural, and nutritional factors related to sustainable eating. A survey was carried out between January and August 2024, assessing 12 dimensions associated with food sustainability. Results: younger participants (18-30 years), women, and individuals with higher educational levels placed greater importance on aspects such as low environmental impact, respect for biodiversity, and the consumption of organic products. Statistically significant differences were observed by age group, educational level, and sex, revealing sociocultural patterns associated with interest in and knowledge of sustainable food practices. Conclusion: these findings highlight the need for targeted public policies, inclusive educational strategies, and actions that promote sustainable dietary habits across diverse population sectors.

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Introduction: Background and aims: there is a need for a kidney-specific nutritional screening tool for patients with renal failure. It was planned to perform the validity and reliability of the Renal Inpatient Nutrition Screening Tool screening tool developed for renal patients in Turkey. Methods: the validity and reliability of the Renal Inpatient Nutrition Screening Tool were investigated by comparing it with the Malnutrition Universal Screening Tool and the Subjective Global Assessment for assessing malnutrition in 153 adult patients newly admitted to the nephrology unit. Nutritional status was assessed using anthropometric measurements and nurse opinion was assessed using a questionnaire. Results: the Renal Inpatient Nutrition Screening Tool was found to be more sensitive than the Malnutrition Universal Screening Tool in identifying increased malnutrition risks and providing dietary guidance. Cramer V coefficient was 0.238 between the Malnutrition Universal Screening Tool and the Renal Inpatient Nutrition Screening Tool, and 0.137 between the Subjective Global Assessment and the Renal Inpatient Nutrition Screening Tool, indicating the compatibility of the Renal Inpatient Nutrition Screening Tool with the variables in the Malnutrition Universal Screening Tool screening tool. A significant positive moderate correlation was observed between the total number of red boxes in the Renal Inpatient Nutrition Screening Tool and the total score of Malnutrition Universal Screening Tool (p < 0.05; r = 0.404). Conclusions: the Renal Inpatient Nutrition Screening Tool is a valid and reliable tool for assessing malnutrition risks in renal patients in Turkey, particularly when used by experienced specialist nurses in nephrology units.

Introduction: Introduction: advanced glycation end-products contribute to oxidative stress and inflammation, which are linked to chronic diseases like cardiovascular disease and type-2 diabetes. Objectives: the aim of this study is to explore the relationship between adherence to the Mediterranean diet and cardiovascular risk, focusing on the influence of advanced glycation end-products assessed through skin autofluorescence analysis. Methods: anthropometric measurements including waist circumference, hip circumference, height, and body weight were recorded for 200 healthy individuals. Body mass index, waist-to-hip ratio, and waist-to-height ratio were calculated based on these measurements. Levels of advanced glycation end-products were assessed using the AGE Reader, while adherence to the Mediterranean diet was evaluated using the Mediterranean Diet Adherence Scale. Results: a significant negative correlation was found between high adherence to the Mediterranean diet and levels of advanced glycation end-products (p < 0.05). Conversely, advanced glycation end-product levels showed significant positive correlations with age, body weight, body mass index, waist circumference, hip circumference, and waist-to-height ratio (p < 0.05). Conclusion: this study demonstrates that individuals who adhere closely to the Mediterranean diet exhibit lower levels of advanced glycation end-products, which are established risk factors for cardiovascular disease.

Introduction: Objective: this study aimed to explore the association between the Alternative Healthy Eating Index (AHEI) and both osteoporosis and muscle mass among U.S. adults aged 50 years and older, using data from the National Health and Nutrition Examination Survey (NHANES). Methods: data from 9,466 participants were analyzed to examine the association between AHEI and osteoporosis, defined as a bone mineral density (BMD) T-score ≤ -2.5. Another 2,233 participants were included to evaluate the association between AHEI and muscle mass, measured by appendicular lean mass index (ALMI). Weighted multivariable logistic and linear regression analyses, restricted cubic spline (RCS) models, and subgroup analyses were conducted to investigate the relationships of AHEI with both outcomes. Results: compared with the lowest AHEI tertile (Q1), the highest tertile (Q3) was significantly associated with both a lower prevalence of osteoporosis (OR  =  0.55, 95 % CI: 0.38-0.80; p  =  0.002) and a reduced ALMI (β = -0.18, 95 % CI: -0.34 to -0.01; p = 0.039). The RCS analysis observed no significant nonlinear association, and subgroup analyses showed consistency across different population groups. Conclusion: a higher AHEI is significantly associated with a lower prevalence of osteoporosis and a lower ALMI among middle-aged and older U.S. adults, underscoring the necessity of developing more precise and personalized dietary interventions aimed at delaying age-related decline in both skeletal and muscular systems.

Introduction: Introduction: type 1 diabetes (T1D) is a chronic disease whose proper nutritional and physical management can help prevent and manage complications. Objective: to assess the knowledge, influence, and behavior regarding eating habits and physical activity in children and adolescents with T1D, in relation to international guidelines, in order to identify areas for improvement. Methods: an electronic questionnaire was administered to 177 individuals aged 3 to 20 years during September and October 2023. The survey collected information on knowledge, influences, and behaviors related to diet and physical activity. Results: a total of 43.0 % consume vegetables daily, while 6.0 % never do. About 48.3 % eat fruits two or more times per day. A 6.0 % do not know how to count carbohydrates, and 15.0 % do not do so for every meal. To treat hypoglycemia, 62.0 % use juice or soft drinks, and 10.0 % rely on whatever food is available. Over 75.0 % reported modifying their dietary habits after diagnosis. Regarding physical activity, 51.0 % maintained their previous activity levels, and 22.0 % increased them. Identified barriers included a lack of knowledge about T1D and how to exercise properly. Conclusion: the results highlight the need for educational interventions targeting patients, families, and healthcare professionals to promote adherence to nutritional and physical activity recommendations, thereby improving disease control and preventing complications.

Introduction: Background and objective: polypharmacy is prevalent among patients undergoing hemodialysis (HD). This study aimed to determine the prevalence of polypharmacy and to define drug consumption according to pharmacotherapeutic classification, as well as to assess its association with clinical and nutritional outcomes in HD patients. Patients and methods: a cross-sectional, retrospective study in 96 prevalent patients on HD over a two-year period. Sociodemographic, clinical, nutritional, and laboratory data, as well as drug consumption, were collected. Polypharmacy was defined as the use of ≥ 4 drugs/day. Protein-energy wasting syndrome (PEW) was assessed using the malnutrition-inflammation score (MIS ≥ 5), and comorbidity was evaluated with the Charlson Comorbidity Index (CCI). Results: the prevalence of polypharmacy was 60.4 % (n = 58). Patients with polypharmacy had a higher body mass index and transferrin saturation but lower serum creatinine and HDL-cholesterol levels compared to those with low drug consumption (p < 0.05). Additionally, patients with polypharmacy had higher PEW and CCI score (> 3 points). Overall, the most used medications were intravenous iron-sucrose (90.6 %), erythropoiesis-stimulating agents (65.6 %), antihypertensives (58.0 %), and vitamin D (43.7 %). PEW was present in 34.8 % of patients, with a higher prevalence in the polypharmacy group (21.7 %). Conclusions: polypharmacy is highly prevalent among older adults on HD and is associated with higher comorbidity and nutritional risk. These findings highlight the need for a comprehensive and interdisciplinary approach to optimize the rational use of medications and improve the management of pluripathological patients undergoing HD.