Disease related malnutrition (DRM) is prevalent in hospitals and is associated with increased care needs, prolonged hospital stay, delayed rehabilitation and death. Nutrition care process related activities such as screening, assessment and treatment has been advocated by scientific societies and patient organizations but implementation is variable. We analyzed the cross-sectional nutritionDay database for prevalence of nutrition risk factors, care processes and outcome for medical patients. In 59126 medical patients included between 2006-2015 the prevalence of recent weight loss (45%), history of decreased eating (48%) and low actual eating (53%) was more prevalent than low BMI (8%). Each of these risk factors was associated with a large increase in 30 days hospital mortality. Nutrition care processes increases slightly with presence of risk factors but never done in more than 50% of patients. Only a third of patients not eating in hospital receive oral nutritional supplements or artificial nutrition. We suggest that political action should be taken to raise awareness and formal education on all aspects related to DRM for all stakeholders, to create and support responsibilities within hospitals, and to create adequate reimbursement schemes. Collection of routine and benchmarking data is crucial to tackle DRM.

Background: Evaluation of nutrition programs is essential to guarantee the effectiveness of community-based management of acute malnutrition (CMAM). Methods: The Rainbow Project Supplementary Feeding Programs (SFPs) in Zambia were evaluated between years 2015-17, following implementation of new recommendations based on previous evaluations (years 2012-14). Outcomes of the program were compared with International Standards and with those of 2012-14. Cox proportional risk regression analysis was performed to identify predictors of mortality and defaulting. Results: Data for 900 under age 5 years malnourished children (48.8% male; mean age 19.7months ±9.9) were analyzed. Rainbow 2015-17 program outcomes met International Standards, for general malnutrition or stratified moderate acute malnutrition (MAM) and severe acute malnutrition (SAM). When comparing with 2012-14 outcomes, better performance was noted: mortality rates were reduced by half (5.6% vs 3.1%, p = 0.01; for SAM: 12.4% vs 6.7%, p = 0.006), with significant improvement in average weight gain and mean length of stay (p<0.001), and increased awareness of HIV status (+30%; p < 0.001). HIV infection (5.5; 1.9–15.9), WAZ < −3 at baseline (4.6; 1.3–16.1) and kwashiorkor (3.5; 1.2–9.5) remained the major predictors of mortality. Conclusion: The effectiveness of the Rainbow SFPs for child malnutrition treatment and prevention in Zambia has significantly improved after evaluation and implementation activities, with impressive outcomes which resulted in a 50% reduction in mortality.

Childhood obesity is a preventable multi-systemic disease that has become an epidemic. In this narrative review, we showed evidence, in the literature, of the affectation of body systems by obesity. Co-morbid conditions of obesity in the cardiovascular, nervous, dermatological, respiratory, endocrine, reproductive, musculoskeletal, gastrointestinal, and renal systems, and its effects on mental health are discussed. Obesity ultimately reduces the quality of life of children and is a leading cause of preventable deaths. Effective measures aimed at the prevention of obesity and the treatment of its co-morbid conditions should be taken.

The simplified, combined protocol admits children with a mid-upper-arm circumference (MUAC) of <125 mm or edema to malnutrition treatment with ready-to-use therapeutic food (RUTF) prescribing 2 daily RUTF sachets to children with MUAC <115 mm or edema and 1 daily sachet to those with MUAC ≥115 mm but <125 mm. This treatment has previously been shown to result in non-inferior programmatic outcomes compared to standard treatment. We aimed at observing its effectiveness in a routine setting at scale, including via delivery by community health workers (CHW). A total of 27 601 children were admitted to the simplified, combined treatment. Treatment resulted in 96% overall recovery with a mean LOS of 40 days and a mean RUTF consumption of 63 sachets per child treated. Among children admitted with MUAC <115 mm or edema 94% recovered with a mean LOS of 55 days and consuming an average of 97 RUTF sachets. Recovery in all sub-groups studied exceeded 90%.Treatment by CHWs resulted in similar (96%) recovery as treatment by formal health care workers (96%). The simplified, combined protocol results in high recovery and low RUTF consumption per child treated, and can safely be adopted by CHWs to provide treatment in the community-level.

Breastmilk is the only recommended source of nutrition for infants below six-months of age. However, a significant proportion of children are either on supplemental breastfeeding(SBF) or weaned due to the early introduction of solid/semi-solid/soft food and liquids(SSF) before 6 months of age. There is good evidence that Exclusive Breastfeeding(EBF) in infants below six-months of age protects them from preventable illnesses, including malnutrition. The relationship between infant feeding practices and coexisting forms of malnutrition(CFM) has not yet been explored. This study examined the association of different feeding indicators(continuation of breastfeeding, predominant feeding, and SSF) and feeding practices(EBF, SBF, and complete weaning) with CFM in infants aged below six-months of age in Pakistan. National and regional datasets of Pakistan from the last ten years were retrieved from the Demographic Health Surveys(DHS) and UNICEF data repositories. In Pakistan, 34.5%(n=6131) of infants have some form of malnutrition. Among malnourished infants, 44.7%(~15.4% of the total sample) had a CFM. Continuation of breastfeeding was observed in more than 85% of infants, but less than a quarter were on EBF, and the rest were either SBF(65.4%) or weaned infants(13.7%). Compared to EBF, complete weaning increased the odds of coexistence of underweight with wasting and underweight with both wasting and stunting by 1.96(1.12-3.47) and 2.25(1.16-4.36), respectively. Overall, breastfed children had lower odds of various forms of CFM (compared to non-breastfed), except for the coexistence of stunting with overweight/obesity. Continuation of any breastfeeding protects infants in Pakistan from various types of CFM during the first six months of life.

Malnutrition is a serious problem with negative impact on the quality of life and the evolution of our patients, contributing to an increase in morbidity, hospital stay, mortality and health spending. Early identification is fundamental to implement the necessary therapeutic actions involving adequate nutritional support to prevent or reverse malnutrition. This review presents two complementary methods of fighting malnutrition: nutritional screening and nutritional assessment. Nutritional risk screening is conducted using simple, quick-to-perform tools and is the first line of action in detecting at-risk patients. It should be implemented systematically and periodically on admission to hospital or residential care, as well as on an outpatient basis for patients with chronic conditions. Once patients with a nutritional risk have been detected they should undergo a more detailed nutritional assessment to identify and quantify the type and degree of malnutrition. This should include health history and clinical examination, dietary history, anthropometric measurements, evaluation of the degree of aggression determined by the disease, functional assessment and, whenever possible, some method of measuring body composition.

Widely consumed forest fruits in Gabon, were analyzed for nutrient and bioactive compositions and their potential contributions to meeting the nutrient requirements of consumers. Edible pulps of Panda oleosa, Gambeya lacourtiana and Poga oleosa contained substantial amounts of bioactive compounds; flavonoids (13.5–22.8 mg/100g), proanthocyanins (2.4–7.6 mg/100g), polyphenols (49.6-77.3 mg/100g) and vitamin C (6.7–97.7 mg/100g). The highest content of β-carotene (76.6 µg/100g) was registered in fruits of Pseudospondias longifolia. The fruits of P. oleosa had the highest essential minerals Fe, Zn and Se. If a child aged 1 to 3 years consumed about 200g or if a non-lactating and non-pregnant woman consumed 300g of P. oleosa, A. lepidophyllus, G. lacourtiana, P. longifolia and P. oleosa, they could obtain substantial RDI ranging between 20-100% for energy, vitamins C and E, iron, magnesium, iron and zinc. Forest fruits can considerably contribute towards the human nutrient requirements. Based on the results of this study, forest foods should be considered in formulating policies governing food and nutrition security in Gabon.

Malnutrition in children is a global health problem, particularly in developing countries. The effects of an insufficient supply of nutrients on body composition and physiological functions may have implications for drug disposition and ultimately affect the clinical outcome in this vulnerable population. Physiologically based pharmacokinetic (PBPK) modeling can be used to predict the effect of malnutrition as it links physiological changes to pharmacokinetic (PK) consequences. However, the absence of detailed information on body composition and the limited availability of controlled clinical trials in malnourished children complicates the establishment and evaluation of a generic PBPK model in this population. In this manuscript we describe the creation of physiologically-based bridge to a malnourished pediatric population, by combining information on a) the differences in body composition between healthy and malnourished adults and b) the differences in physiology between healthy adults and children. Model performance was confirmed using clinical reference data. This study presents a physiologically-based translational framework for prediction of drug disposition in malnourished children. The model is readily applicable for dose recommendation strategies to address the urgent medicinal needs of this vulnerable population.

Pearl millet is an important food crop in the arid and semi-arid tropical regions of Africa and Asia. These regions are home to millions of poor smallholder’s households living in harsh agro ecology and reported higher prevalence of malnutrition. Such poor households have few options in terms of food crops, besides the limited markets. Indeed, pearl millet is one of the food crops they continue to grow for their food and nutritional security. Pearl millet is important sources of dietary carbohydrates, energy, protein, and important minerals such as calcium, iron and zinc. Considering inherent high nutritional values and climate resilient nature (drought and heat), demand for pearl millet as food, beside valued for its Stover as a source of livestock fodder, is projected to grow strongly in Asia (India) and Africa (West and Central Africa). Iron (cause anemia) and zinc (cause stunting) deficiencies are widespread and serious public health problems worldwide, including India and Africa. Biofortification is a cost-effective and sustainable agricultural strategy to address this problem. Research on pearl millet has shown that large genetic variability (30-140 mg/kg Fe and 20-90 mg/kg Zn) available in this crop can be effectively utilized to develop high-yielding cultivars with high iron and zinc densities. Both Open –pollinated varieties (Dhanshakti and Chakti) and hybrids (ICMH 1202, ICMH 1203 and ICMH 1301) of pearl millet with high grain yield (>3.5 tons/ha in hybrids) and high levels of iron (70-75 mg/kg) and zinc (35-40 mg/kg) densities have been developed and released. Currently, India growing >70,000 ha of biofortified pearl millet, besides more pipeline hybrids and varieties are under various stage of testing at the national (India) and international (west Africa) trials for possible release. Genomic tools will be an integral part of breeding program particularly for nutritional traits to use diagnostic markers and genomic selection. Clinical studies showed that 200g grains from biofortified cultivar would provide bioavailable Fe to meet full recommended daily allowance (RDA) in children, adult men and 80% of the RDA in women. Till today, no markets to promote biofortified cultivars/grains/products as no incentive price and such products aims to address food and nutritional security challenges simultaneously. The demand is likely to increase only after investment and integration into modern public distribution system, nutritional intervention schemes, private seed and food companies with strong mainstreaming nutritional policies. In the non-traditional regions, this will contribute to livestock and poultry feed industry as spill-over benefits to improve nutrition.

The purpose of this study was to (a) compare macro- and micronutrient intakes between male and female CD patients (b) compare micronutrient intakes of CD patients to a representative population of healthy individuals, and; (c) describe Mediterranean diet scores (P-MDS) of male and female CD patients in remission recruited from an IBD clinic in Calgary, AB. Consecutive patients with ileal and/or colonic CD in endoscopic remission were recruited for participation in this cross-sectional study. Sixty-seven patients were enrolled, with a mean age of 45, and a BMI ≥ 25. Compared with the healthy population, patients with CD had similar energy, protein, carbohydrate and total fat intake. However, PUFA, omega-6 and 3 and MUFA were lower in CD patients and dietary fibre intake was higher. Vitamins C, D, thiamin, niacin, magnesium, phosphorus, zinc and potassium were all significantly lower in all CD patients compared to a healthy population. Few patients with CD met P-MDS criteria for olive oil, vegetable, legumes, and fish intake or consuming Sofrito sauce (mean 4.5, SD=1.1 in males and 4.7, SD=1.8 in females). Patients with CD in remission have suboptimal dietary intakes and patterns and targeted dietary interventions may be beneficial in this population to improve intake.

Being overweight or obese is a public health problem. This work evaluated a food and nutrition education (EAN) intervention against overweight schoolchildren in four schools in the West Panama Province. A quasi-experimental before-and-after study that implemented a 34-week EAN intervention through workshops with didactic material to 403 children between 8 and 13 years old. The knowledge and attitude survey was used as an evaluation tool before and after the educational intervention. The prevalence of excess weight (40%) did not report differences after the intervention. No differences were reported in the median level of attitude, although higher levels of knowledge were reported in students of both sexes. EAN in schoolchildren can be effective in acquiring knowledge and maintaining a positive attitude towards food.

Background: Malnutrition has negative consequences in hospitals, like poor disease recovery, increased mortality, length of hospitalization, readmission, and health care costs.Aims: This review was designed to determine malnutrition prevalence in hospitals located in eastern Mediterranean region (EMR).Study design: To conduct this systematic review, papers, including original articles, related references and conference proceedings on the prevalence of malnutrition in adult hospitalized patients published in international journals and scientific databases from 1 Jan 2017 to 31 Jan 2022 will be included. The following keywords and their alternatives will be used in the literature search: malnutrition, patient, and EMR. The protocol has been registered at PROSPERO (code: CRD42022339426).Methods: After initial screening based on inclusion and exclusion criteria, the full text articles will be read carefully and eligible documents will be selected according to the defined objectives. Afterward, the selected papers will be reviewed for methodological quality and the required information will be extracted. Finally, in case of sufficient data, a meta-analysis will be performed. Screening, selection, quality assessment, and data extraction will be done by at least two independent reviewers.Results: This review is ongoing and will be completed until the end of year 2023.Conclusion: This review aims to provide comprehensive evidence about the prevalence of malnutrition among adult inpatients in EMR hospitals. This can provide regional authorities, health managers and policy makers good information regarding current status to make appropriate decisions for promoting the health status in hospitals.

Background: Treatment at stabilization center is an important intervention to avert the huge burden of mortality for children with complicated severe acute malnutrition (SAM). Recent reviews indicated a wide range in recovery rate (34-88%) due to several context-specific factors. This study aimed to estimate time to recovery and to determine predictors of time to recovery among children aged 6-59 month with severe acute malnutrition. Method: Retrospective cohort study was used among 375 children aged 6-59 months admitted in Jimma university medical center, from September 2015 to September 2017. Kaplan Meir estimate and survival curve was used to compare the time to recovery using log-rank test among different characteristics. Cox Proportional Hazard Model was used to identify significant predictors of time to recovery. Results: Median time of recovery for cohort of SAM children’s was 19 days (95%CI: 17.95-20.05). Independent predictors of time to recovery were: Play stimulation, vaccination status, Tuberculosis, malaria, use of amoxicillin, deworming and shock. Conclusion: The findings of this study showed that the average length of stay on treatment and median time for recovery are within the sphere standard. Psychosocial stimulation, appropriate provision of routine medication and management of medical co-morbidity are needed to promote fast recovery.

Rice (Oryza sativa L.) supplies nourishment to about half of the population of the world's inhabitants. Of them, more than 2 billion people suffer from "hidden hunger" in which they are unable to meet the recommended nutrients or micronutrients from their daily dietary intake. Bio-fortification refers to developing micronutrient-rich diet foods using traditional breeding methods and modern biotechnology, a promising approach to nutrition enrichment as part of an integrated strategy for food systems. To improve the profile of rice grain for the biofortification related traits, understanding the genetics of important biofortification traits is required. Moreover, these attributes are quantitative in nature and are influenced by several genes and environmental variables. In the course of past decades, several endeavours such, as finding the important quantitative trait loci (QTLs) for improving the nutrient profile of rice seeds were successfully undertaken. In this review, we have presented the information regarding the QTLs identified for the biofortification traits in the rice.

Double burden of malnutrition (DBM) and anaemia is a growing concern in developing countries. 5,763 mother-child pairs were selected from a cross-sectional study (Bangladesh Demographic Health Survey, 2011) to examine DBM and anaemia in households. Overweight mothers had stunted (24.5%), underweight (19.8%), wasted (9.3%) and anaemic (51.7%) children. Region and drinking water were positively associated with both DBM and anaemia (p < 0.001). Father’s occupation and wealth index were positively associated with DBM (p <0.001) only. More policies and awareness programmes are needed to address the coexistence of child undernutrition and maternal overweight/obesity and anaemia in the same household.

Climate variability and change has been found to be one of the factors that affect economies leading to food insecurity in various parts of the world. Kenya is no exception. This study looks at how climate variability has contributed to food insecurity in Kisii County, Kenya. The objectives of this study is therefore to, (i) to examine the rainfall and temperature trends in Kisii County for a period of approximately 30 years, (ii) to examine the effect of climate variability on food production and (iii) to assess the perception of local farmers on weather and climate information, (iv) to evaluate the coping strategies adopted at to bridge the gap on food deficit at different household level and (v) to assess the nutritional status of children and the elderly. The study was conducted in two sub-counties of Kisii County; Marani and Bomachoge Chache. The data used was mainly rainfall and temperature data from meteorological stations and sample data gathered from selected groups. The study population comprised of children between 6 months and 59 months, household heads, elderly people and agricultural officers. Purposive sampling was used to select agricultural officers while multistage sampling was used to select respondents at household level. Data was collected by use of a pre-tested questionnaire. The MUAC tape was used to collect nutritional status of children while BMI data was obtained from elderly people. Mann Kendall statistic was used to determine whether the trend of rainfall and temperature observed is significant while Chi-square test was used to determine whether the coping strategies observed varied significantly at household level. From the analysis, rainfall has not shown any significant change in Kisii County while temperature trend has been significantly increasing over the years at 95% confidence level. This could explain the observed reduction in river levels. Analysis of crop production and price trends of major food crops in Kisii County showed a decreasing trend of food production leading to increase in price over the years. This meant that farmers could not produce enough to take them to the next harvesting season making farmers to adopt different coping strategies at household level which differed significantly according to Chi-Square test. Malnutrition status of both elderly people above 59 years and children between 6-59 months were similar with 23% of both children/elderly being severely malnourished/malnourished. This study has only looked at climatic factors such as rainfall and temperature. Other aspects such as depth of underground water, ph level of soil and the effects of land fragmentation also need to be looked at. This study is important to both farmers in choosing the right crop to plant, and policy makers and planners in formulating the best mitigation and intervention strategies for Kisii County food insecurity problem. This will further contribute to national efforts towards achievement of vision 2030.

Preventing malnutrition and dehydration in older care home residents is complex, with both conditions remaining prevalent, despite numerous guidelines spanning several decades. This policy-mapping scoping review used snowballing search methods to locate publicly-available policies, reports and best practice guidelines relating to hydration and nutrition in UK residential care homes, to describe the existing knowledge base and pinpoint gaps in practice, interpretation and further investigation. Findings were synthesised narratively to identify solutions. Strategies for improvements to nutritional and hydration care include: development of age and population-specific nutrient and fluid intake guidelines; statutory regulation, contractual obligations for commissioners, appropriate menu-planning, implementation and auditing of care, acknowledgment of residents’ eating and drinking experiences, effective screening, monitoring and treatment and staff training. The considerable body of existing knowledge is failing to influence practice, relating to translational issues of implementing knowledge into care at the point of delivery, and this is where future research and actions should focus.

The proportion of adults aged over 60 years in the world is expected to reach 20% by the year 2050. Ageing is associated with several physiological changes that increase the risk of malnutrition among this population. Malnutrition is characterized by deficiencies or insufficiencies of macro- and micronutrients. Malnutrition has detrimental effects on the health, wellbeing and quality of life of older adults. Nuts are rich in energy, unsaturated fats, protein, as well as other nutrients that provide a range of health benefits. While the effects of nuts on overnutrition have been studied extensively, very few studies have been specifically designed to understand the role of nuts in mitigating undernutrition in the elderly. Therefore, this review explores the potential role of nuts in improving the nutritional status of older adults who are at risk of undernutrition. Several properties of whole nuts, some of which appear important for addressing overnutrition, (e.g. hardness, lower-than-expected nutrient availability, satiety-enhancing effects) may limit their effectiveness as a food to combat undernutrition. However, we propose that modifications such as transforming the physical form of nuts, addressing the timing of nut ingestion, and introducing variety may overcome these barriers. This review also discusses the feasibility of using nuts to prevent and reverse undernutrition among older adults. We conclude with a recommendation to conduct clinical studies in the future to test this conceptual framework.

Since the origin of COVID-19, everyone is getting accustomed to the new rules and regulations, travel restrictions and new lifestyle. Constant changes in the government advisories and the COVID-19 guidelines poses a real challenge for children to adapt to causing stress, anxiety and other mental health issues. Therefore, it is imperative to raise awareness about the challenges that Indian children are dealing with to help them better cope with this stressful and frantic time. The focus of this review is on various child-related problems that the Indian government is trying to tackle such as stress, depression, malnutrition, school closures, digital divide, child labor, child trafficking in context of mental health issues caused by them during COVID-19. Highlights:The reader will come to appreciate that: Digital-divide caused by shifting offline learning to online mode. Strategies implemented by Indian government to combat malnutrition Effect of COVID-19 lockdown on children suffering from mental disorders Child labor and trafficking and the strategies that aim to decrease child labor during the pandemic Educating the children appropriately regarding COVID protocols

Seven human coronaviruses are known to infect humans. The most recent one, SARS-CoV-2, was isolated and identified in January 2020 from a patient presenting with severe respiratory illness in Wuhan, China. Even though viral coinfections have the potential to influence the resultant disease pattern in the host, very few studies have looked at the disease outcomes in patients infected with both HIV and hCoVs. Groups are now reporting that even though HIV-positive patients can be infected with hCoVs, the likelihood of developing severe CoV-related diseases in these patients is often similar to what is seen in the general population. This review aimed to summarize the current knowledge of coinfections reported for the HIV and hCoVs. Also, based on the available data, this review aimed to theorize why HIV-positive patients do not frequently develop severe CoV-related diseases.

There is limited evidence for the association between malnutrition and hospital mortality as well as Intensive Care Unit length-of-stay (ICU-LOS) in critically ill patients. We aimed to examine the aforementioned associations by conducting a prospective cohort study in an ICU of a Singapore tertiary hospital. Between August 2015 and October 2016, all adult patients with ≥24 h of ICU-LOS were included. The 7-point Subjective Global Assessment (7-point SGA) was used to determine patients’ nutritional status within 48 hours of ICU admission. Multivariate analyses were conducted in two ways: 1) presence versus absence of malnutrition, and 2) dose-dependent association for each 1-point decrease in the 7-point SGA. There were 439 patients of which 28.0% were malnourished, and 29.6% died before hospital discharge. Malnutrition was associated with an increased risk of hospital mortality [adjusted-RR 1.39 (95%CI: 1.10–1.76)], and this risk increased with a greater degree of malnutrition [adjusted-RR 1.09 (95%CI: 1.01–1.18) for each 1-point decrease in the 7-point SGA]. No significant association was found between malnutrition and ICU-LOS. Conclusion: There was a clear association between malnutrition and higher hospital mortality in critically ill patients. The association between malnutrition and ICU-LOS could not be replicated and hence requires further evaluation.

Malnutrition and dental caries in early childhood remain persistent and intertwined global health challenges, particularly for indigenous and geographically-remote populations. To examine the prevalence and associations between early childhood dental caries, parent-reported mouth pain and malnutrition in the Amazonian region of Ecuador, we conducted a cross-sectional study of the oral health and nutrition status of 1,407 children from birth through age 6 in the “Alli Kiru” program (2011-2013). We used multivariate regression analysis to examine relationships between severe caries, parent-reported mouth pain measures, and nutritional status. The prevalence of dental caries was 65.4%, with 44.7% of children having deep or severe caries, and 33.8% reporting mouth pain. The number of decayed, missing and filled teeth dmft) increased dramatically with age. Malnutrition was prevalent, with 35.9% of children stunted, 1.1% wasted, 7.4% underweight, and 6.8% overweight. As mouth pain increased in frequency, odds for severe caries increased. For each unit increase in mouth pain frequency interfering with sleeping, children had increased odds for underweight (AOR: 1.27; 95% CI: 1.02 – 1.54) and decreased odds for overweight (AOR: 0.76; 95% CI: 0.58 – 0.97). This relationship was most pronounced among 3-6 year-olds. Early childhood caries, mouth pain and malnutrition were prevalent in this sample of young children. Parent-reported mouth pain was associated with severe caries, and mouth pain interfering with sleeping was predictive of poor nutritional status. We demonstrate the utility of a parsimonious parent-reported measure of mouth pain to predict young children’s risk for severe early childhood caries and malnutrition, which has implications for community health interventions.

Coronavirus disease 2019 (COVID-19) is associated with high risk of malnutrition, primarily in elderly people; assessing nutritional risk using appropriate screening tools is critical. This systematic review identified applicable tools and assessed their measurement properties. Literature was searched in the MEDLINE, Embase, and LILACS databases. Four studies conducted in China met the eligibility criteria. Sample sizes ranged from six to 182, and participants’ ages from 65 to 87 years. Seven nutritional screening and assessment tools were used: the Nutritional Risk Screening 2002 (NRS-2002), Mini Nutritional Assessment (MNA), MNA-short form (MNA-sf), Malnutrition Universal Screening Tool (MUST), Nutritional Risk Index (NRI), Geriatric NRI (GNRI), and modified Nutrition Risk in the Critically ill (mNUTRIC) score. Nutritional risk was identified in 27.5% to 100% of participants. The NRS-2002, MNA, MNA-sf, NRI, and MUST demonstrated high sensitivity; the MUST had better specificity. The MNA and MUST demonstrated better criterion validity. The MNA-sf demonstrated better predictive validity for poor appetite and weight loss; the NRS-2002 demonstrated better predictive validity for prolonged hospitalization. mNUTRIC score demonstrated good predictive validity for hospital mortality. Most instruments demonstrate high sensitivity for identifying nutritional risk, but none are acknowledged as the best for nutritional screening in elderly COVID-19 patients.

Infant malnutrition remains as an important cause of death and disability, Haiti has the highest prevalence in America, so preventive strategies are needed. Our objective was to assess infant and young children malnutrition in Haiti and to study an association to World Health Organization (WHO) recommended feeding practices adherence. Cross-sectional study of children younger than 2 years old, recruited at Saint Espri Health Center, Port Au Prince (August to September 2014). We registered feeding practices, social and demographic data, and performed anthropometry (WHO-2006 standard). We evaluated 278 infants and young children, 8.08 ± 6.5 months old, 53.2% female. 18.35% had underweight; 13.31% were stunted and 13.67% had moderate or severe wasting. Malnutrition was associated to male gender, older age, lower education of mothers and higher number of siblings. The adherence to WHO recommended practices for breastfeeding was from 11.8 to 97.9% and was related to a lower prevalence of malnutrition. For complementary food, adherence was 9.7 to 90.3%, also associated to lower malnutrition. Conclusion: Prevalence of infant and young children malnutrition in this Haitian Health Center population was high, related to some risk factors. The adherence to WHO recommended feeding practices was associated to a better nutritional status.

Childhood malnutrition is one of the most persistent public health problems throughout developing countries including Nigeria. This study focused on the evaluation of complementary food produced by solid-state fermentation of Fonio and Soybean using Rhizopus oligosporus (2710) and Orange-fleshed sweet potatoes (OFSP) using Lactobacillus planterum, (B-41621). Solid state fermentation (SSF) was carried out by inoculating Fonio and Soybean with spore suspension (1×10⁶spores/ml) of Rhizopus oligosporus (2710) and OFSP with spore suspension (1×10⁶spores/ml) of Lactobacillus planterum (B-41621). The samples were blended in the following ratios: Fonio and Soybean 100: 100 (AS), fonio/soybean and OFSP 50: 50(ASO), and compared with a commercial infant formula which served as the control (CTRL). Quality characteristics of the samples were evaluated. Results showed that moisture, crude protein, fibre, ash content, beta carotene and titratable acidity increased significantly (p<0.05) as fermentation progressed. The iron content ranged from 6.57–8.41mg/100g while the beta carotene content ranged from 15.80 –17.35mg/100g. Viscosity ranged from 8200 –15400cP, while that of swelling capacity ranged from 2.25-3.41(g/g). In sensory scores, there were no significant (p>0.05) difference between the average mean scores of the samples. SSF improved the nutritional content and flavour of the developed complementary food which is needed for infant growth and development.

Many of the wide-ranging symptoms of COVID-19 have not been associated previously with a respiratory illness. A similarity between these atypical symptoms and the symptoms of malnutrition was observed. To investigate, a comparison of COVID-19 symptomatology with recognised states of malnutrition showed a significant relationship that was further explored in a review of the literature. This hypothesis links the atypical symptoms to the effects of increasing protein malnutrition. The rapid appearance of malnutrition symptoms at the beginning of the COVID-19 infection is concurrent with the rapid cell proliferation of the immune system. Although previous work has, in general, assumed that the body is capable of providing for the needs of the immune system during infection, heightened immune activity from the commencement of COVID-19 could require an early increase in energy yielding sources. Should insufficient availability of protein resources occur, this could quickly lead to malnutrition. Any continuing insufficiency, during the active phase of the virus, might result in widespread depletions in the tissues and the consequential malfunctioning of many organs. A new appraisal of the immune system requirements needed to counteract the impact of the novel virus, COVID-19, could show the potential benefit for earlier protein intervention in the disease process. This hypothesis could also have relevance for other life situations where a rapid cell proliferation might occur.

Although the need to assess hydration is well recognized, laboratory tests and clinical impressions are impractical and lack sensitivity to be clinically meaningful. Different approaches use bioelectrical impedance measurements to overcome some of these limitations and aid in classification of hydration status. One indirect approach utilizes single or multiple frequency bioimpedance in regression equations and theoretical models, respectively, with anthropometric measurements to predict fluid volumes (bioelectrical impedance spectroscopy; BIS) and estimate fluid overload based on deviation of calculated to reference extracellular fluid volume. Alternatively, bioimpedance vector analysis (BIVA) uses direct phase-sensitive measurements of resistance and reactance, measured at 50 kHz, normalized for height, then plotted on a bivariate graph, resulting in a vector with length related to fluid content normalized by standing height, and direction with phase angle that indexes hydration status. Comparison with healthy population norms enables BIVA to classify (normal, under- and over-) and rank (change relative to pre-treatment) hydration independent of body weight. Each approach has wide-ranging uses in evaluation and management of clinical groups with overhydration with an evolving emphasis on prognosis. This review discusses the advantages and limitations of BIS and BIVA for hydration assessment with comments on future applications.

Background: Appendicular skeletal muscle (or lean) mass (ALM) estimated using dual-energy X-ray absorptiometry (DXA) is considered to be a preferred method for sarcopenia studies. However, DXA is expensive, has limited portability, and requires radiation exposure. Bioelectrical impedance analysis (BIA) is inexpensive, easy to use, and portable; thus BIA might be useful in sarcopenia investigations. However, a large variety of models have been commercially supplied by different companies, and for most consumer products, the equations estimating ALM are not disclosed. It is therefore difficult to use these equations for research purposes. In particular, the BIA equation is often age-dependent, which leads to fundamental difficulty in examining age-related ALM loss. The aims of the current study were as follows: (1) to develop and validate an equation to estimate ALM using multi-frequency BIA (MF-BIA) based on theoretical models, and (2) to establish sarcopenia cutoff values using the equation for the Japanese population. Methods: We measured height (Ht), weight, and ALM obtained using DXA and a standing-posture 8-electrode MF-BIA (5, 50, 250 kHz) in 756 Japanese individuals aged 18 to 86-years-old (222 men and 301 women as developing equation group and 97 men and 136 women as a cross validation group). The traditional impedance index (Ht²/Z₅₀) and impedance ratio of high and low frequency (Z₂₅₀/Z₅) of hand to foot values were calculated. Multiple regression analyses were conducted with ALM as dependent variable in men and women separately. Results: We created the following equations: ALM = (0.6947 × (Ht²/Z₅₀)) + (−55.24 × (Z₂₅₀/Z₅)) + (−10,940 × (1/Z₅₀)) + 51.33 for men, and ALM = (0.6144 × (Ht²/Z₅₀)) + (−36.61 × (Z₂₅₀/Z₅)) + (−9332 × (1/Z₅₀)) + 37.91 for women. Additionally, we conducted measurements in 1624 men and 1368 women aged 18 to 40 years to establish sarcopenia cutoff values in the Japanese population. The mean values minus 2 standard deviations of the skeletal muscle mass index (ALM/Ht²) in these participants were 6.8 and 5.7 kg/m² in men and women, respectively. Conclusion: The current study established and validated a theoretical and age-independent equation using MF-BIA to estimate ALM and provided reasonable sarcopenia cutoff values.

People with severe mental illness (SMI) are often in poor physical health, resulting in higher mortality and reduced life expectancy compared to the general population. Although eating habits are one of the main predictors of physical health, few studies assess the nutritional status and eating behaviour of people with SMI. The aim of this study was to examine the nutritional status and risk of malnutrition in people with SMI and in need of intensive psychiatric treatment. The cross-sectional study included 65 inpatients and 67 outpatients with psychotic or depressive disorders from the Psychiatric Hospital of the University of Zurich. Patients’ assessments at admission included anthropometric measurements, such as weight and height, and interview data including severity of symptoms and functioning (SCL-K-9, PHQ-D, CGI, m-GAF), personal and medical data, nutrition risk screening tools (adapted NRS, MNA-SF) and laboratory values. The results showed that 32% of the inpatients (body mass index [BMI] = 25.3) and 34% of the outpatients (BMI = 27.9) were at risk of malnutrition, which was associated with higher levels of psychiatric symptoms and lower levels of functioning. These results indicate that a substantial proportion of psychiatric patients seem to be at risk of malnutrition, despite most being overweight, and hence they might benefit from nutritional support during their psychiatric treatment. Moreover, nutritional risk screening tools specifically developed for the mental healthcare setting are needed.

Poor understanding of malnutrition burden is a common reason for not prioritizing the care of small and nutritionally at-risk infants aged under-six months (infants u6m). We aimed to estimate the anthropometric deficit prevalence in infants u6m attending health centres, using the Composite Index of Anthropometric Failure (CIAF); and to assess the overlap of different individual indicators. We undertook a two-week survey of all infants u6m visiting each of 18 health centres in two zones of the Oromia region, Ethiopia. We measured weight, length, and MUAC (Mid upper arm circumference); and calculated weight-for-length (WLZ), length-for-age (LAZ), and weight-for-age z-scores (WAZ). Overall, 21.7% (95% CI: 19.2; 24.3) of infants u6m presented CIAF and of these, 10.7% (95% CI: 8.93; 12.7) had multiple anthropometric deficits. Low MUAC overlapped with 47.5% (95% CI: 38.0; 57.3), 43.8% (95% CI: 34.9; 53.1), and 42.6% (95% CI: 36.3; 49.2) of the stunted, wasted and CIAF prevalence, respectively. Underweight overlapped with 63.4% (95% CI: 53.6; 72.2), 52.7% (95% CI: 43.4; 61.7), and 59.6% (95% CI: 53.1; 65.9) of the stunted, wasted and CIAF prevalence, respectively. Anthropometric deficits, single and multiple, are prevalent in infants attending health centres. WAZ overlaps more with other forms of anthropometric deficits than MUAC.