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- Nordén, J., et al.
(författare)
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Nutrition impact symptoms and body composition in patients with COPD
- 2015
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Ingår i: European Journal of Clinical Nutrition. - : Nature Publishing Group. - 0954-3007 .- 1476-5640. ; 69:2, s. 256-261
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Tidskriftsartikel (refereegranskat)abstract
- Background/Objectives:Anorexia or lack of appetite is common in chronic obstructive pulmonary disease (COPD) and may be caused or augmented by several symptoms affecting appetite and eating. We aimed to investigate and quantify the extent of nutrition impact symptoms (NIS) in patients with COPD and to explore relationships between NIS and fat-free mass depletion.Subjects/Methods:The results in this cross-sectional study are based on 169 COPD patients (62% female subjects). Body composition was assessed using bioelectrical impedance spectroscopy and the patients reported NIS by two newly developed questionnaires: the Eating Symptoms Questionnaire (ESQ) and the Disease-Related Appetite Questionnaire (DRAQ).Results:Symptoms with the highest prevalence were dry mouth (71%), stomach ache (39%), pain or aches affecting appetite (36%) and constipation (35%). Problems with diarrhoea and feeling affected by smells were more severe among women compared with men (P<0.05). Thirty-six percent of the patients were depleted (fat-free mass index (FFMI) <15 kg/m(2) for women and FFMI<16 kg/m(2) for men). Depleted patients had more NIS (P<0.05) and also rated appetite and taste of food as worse compared with non-depleted patients (P<0.05).Conclusions:NIS are common in patients with COPD, and depleted patients have more severe symptoms. To investigate how these symptoms are best prevented and/or managed and whether NIS prevention/treatment can affect development of malnutrition in patients with COPD is a challenge for the future.
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- Cederholm, Tommy, et al.
(författare)
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Diagnostic criteria for malnutrition - An ESPEN Consensus Statement
- 2015
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Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 34:3, s. 335-340
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To provide a consensus-based minimum set of criteria for the diagnosis of malnutrition to be applied independent of clinical setting and aetiology, and to unify international terminology. Method: The European Society of Clinical Nutrition and Metabolism (ESPEN) appointed a group of clinical scientists to perform a modified Delphi process, encompassing e-mail communications, face-to-face meetings, in group questionnaires and ballots, as well as a ballot for the ESPEN membership. Result: First, ESPEN recommends that subjects at risk of malnutrition are identified by validated screening tools, and should be assessed and treated accordingly. Risk of malnutrition should have its own ICD Code. Second, a unanimous consensus was reached to advocate two options for the diagnosis of malnutrition. Option one requires body mass index (BMI, kg/m(2)) <18.5 to define malnutrition. Option two requires the combined finding of unintentional weight loss (mandatory) and at least one of either reduced BMI or a low fat free mass index (FFMI). Weight loss could be either >10% of habitual weight indefinite of time, or >5% over 3 months. Reduced BMI is <20 or <22 kg/m(2) in subjects younger and older than 70 years, respectively. Low FFMI is <15 and <17 kg/m(2) in females and males, respectively. About 12% of ESPEN members participated in a ballot; >75% agreed; i.e. indicated >= 7 on a 10-graded scale of acceptance, to this definition. Conclusion: In individuals identified by screening as at risk of malnutrition, the diagnosis of malnutrition should be based on either a low BMI (<18.5 kg/m(2)), or on the combined finding of weight loss together with either reduced BMI (age-specific) or a low FFMI using sex-specific cut-offs. (C) 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
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- Dey, D K, et al.
(författare)
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Body mass index, weight change and mortality in the elderly. A 15 y longitudinal population study of 70 y olds
- 2024
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Ingår i: European Journal of Clinical Nutrition. - : Nature Publishing Group. - 0954-3007 .- 1476-5640. ; 55:6, s. 482-492
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine the relationship between body mass index (BMI) at age 70, weight change between age 70 and 75, and 15 y mortality. DESIGN: Cohort study of 70-y-olds. SETTING: Geriatric Medicine Department, Göteborg University, Sweden. SUBJECTS: A total of 2628 (1225 males and 1403 females) 70-y-olds examined in 1971--1981 in Gothenburg, Sweden. RESULTS: The relative risks (RRs) for 15 y mortality were highest in the lowest BMI quintiles of males 1.20 (95% CI 0.96--1.51) and females 1.49 (95% CI 1.14--1.96). In non-smoking males, no significant differences were observed across the quintiles for 5, 10 and 15 y mortality. In non-smoking females, the highest RR (1.58, 95% CI 1.15--2.16) for 15 y mortality was in the lowest quintile. After exclusion of first 5 y death, no excess risks were found in males for following 5 and 10 y mortality across the quintiles. In females, a U-shaped relation was observed after such exclusions. BMI ranges with lowest 15 y mortality were 27--29 and 25--27 kg/m(2) in non-smoking males and females, respectively. A weight loss of > or = 10% between age 70 and 75 meant a significantly higher risk for subsequent 5 and 10 y mortality in both sexes relative to individuals with 'stable' weights. CONCLUSION: Low BMI and weight loss are risk factors for mortality in the elderly and smoking habits did not significantly modify that relationship. The BMI ranges with lowest risks for 15 y mortality are relatively higher in elderly. Exclusion of early deaths from the analysis modified the weight-mortality relationship in elderly males but not in females.
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- Dey, D K, et al.
(författare)
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Height and body weight in the elderly. I. A 25-year longitudinal study of a population aged 70 to 95 years
- 2024
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Ingår i: European Journal of Clinical Nutrition. - : Nature Publishing Group. - 0954-3007 .- 1476-5640. ; 53:12, s. 905-914
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe longitudinal changes in height and body weight between the ages of 70 and 95 y. DESIGN : Longitudinal cohort study with representative sample of 70-y-olds. SETTING: Department of Geriatric Medicine, Göteborg University, Sweden. SUBJECTS: 449 males and 524 females, aged 70 y, living in Göteborg were examined in 1971-72 and this study population participated on 11 occasions during a 25-year follow-up. RESULTS: Mean height decreased 4 and 4.9 cm in males and females respectively and the trend was significant between the ages of 70 and 95 y in both sexes. Between 70 and 75 y of age, a significant difference was found between quintiles of body height where in the highest quintile height was lowered by 0.4 and 0. 3 cm/y, in males and females respectively, and in the lowest quintile by 0.1 cm/y in both sexes. Mean body weight decreased 3.2 and 5.1 kg in males and females respectively, from age 70 to 95 y. The trend was significant over 22 and 20 y for males and females, respectively.Between the ages of 70 and 80 y, individuals in highest quintile of body weight decreased at a rate of 0.8 and 0.6 kg/y, three times higher than those in lowest quintile. Due to the decrease in both height and weight over time, body mass index (BMI) was less affected. CONCLUSION: Height, body weight and BMI decreased significantly in both sexes after age 70 y, and there was a gender difference in the trend. The results can be used as reference data for Swedish elderly and might be of importance to the understanding of anthropometry with the ageing process.
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- Eyre, S., et al.
(författare)
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Using Bioimpedance Spectroscopy for Diagnosis of Malnutrition in Chronic Kidney Disease Stage 5—Is It Useful?
- 2022
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Ingår i: Journal of Renal Nutrition. - : Elsevier BV. - 1051-2276. ; 32:2, s. 170-177
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Malnutrition is common in chronic kidney disease stage 5 (CKD5) and has negative clinical impacts. The aim of the present study is to evaluate bioimpedance spectroscopy (BIS) in diagnosing malnutrition in CKD5 including hemodialysis and peritoneal dialysis patients (CKD5D) using cutoff values for fat-free mass index (FFMI) according to the Global Leadership Initiative on Malnutrition criteria. Dual-energy X-ray absorptiometry (DXA) was used as a reference method. Design and Methods: We performed a single-center cross-sectional diagnostic study of 90 patients with CKD5 or CKD5D. Results: BIS-derived FFMI estimates were significantly higher compared with those obtained by DXA (18.5 ± 2.6 vs.17.8 ± 2.0, P <.05). The mean difference in FFMI estimates between the methods (DXA–BIS) and Bland-Altman 95% limits of agreements is –0.38 (2.76, –3.52) kg/m2. Overhydration (B = 0.67, P <.001), age (B = 0.02, P =.037), and interactions between overhydration and CKD5 subgroups (P =.034) independently predicted bias in BIS-derived FFMI. BIS-derived FFMI showed poor sensitivity (64%) and positive predictive value (48%) in diagnosing malnutrition in the present study population. Conclusion: The present study showed a limited agreement between estimates of FFMI derived by BIS and DXA due to a large interindividual variation. Using BIS as a clinical tool for assessing FFMI has limited accuracy and poor sensitivity in diagnosing malnutrition in patients with CKD5 and CKD5D. © 2021
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- Hyltander, Anders, 1954, et al.
(författare)
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Supportive nutrition on recovery of metabolism, nutritional state, health-related quality of life, and exercise capacity after major surgery: a randomized study
- 2005
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Ingår i: Clinical gastroenterology and hepatology. - 1542-3565. ; 3:5, s. 466-74
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: The aim of this study was to investigate whether specialized supportive enteral and parenteral feeding have superior effects compared to oral nutrition on recovery during long-term postoperative treatment of cancer patients with preoperative weight loss and reduced maximum exercise capacity. METHODS: One hundred twenty-six patients referred for resection of the esophagus (n = 48), stomach (n = 28), or pancreas (n = 50) were considered to be included before operation. Included patients (n = 80) received supportive enteral or parenteral nutrition postoperatively at home corresponding to 1000 kcal/d until the patients did not wish to continue with artificial nutrition for any reason. Patients randomized to oral nutrition only served as control subjects. Caloric intake, body composition (dual-energy x-ray absorptiometry), and respiratory gas exchanges at rest and during exercise were measured including health-related quality of life. RESULTS: Survival and hospital stay did not differ among the groups, whereas overall complications were higher on artificial nutrition (P < .05). Changes in resting energy expenditure and biochemical tests did not differ during follow-up among the groups. Body weight and whole body fat declined similarly over time in all groups (P < .005), whereas lean body mass was unchanged during follow-up compared to preoperative values. Maximum exercise capacity and maximum oxygen consumption were normalized within 6 months postoperatively in all groups. There was no difference in recovery of food intake among the groups. Parenteral feeding was associated with the highest rate of nutrition-related complications, whereas enteral feeding reduced quality of life most extensively. CONCLUSION: After major surgery, specialized supportive enteral and parenteral nutrition are not superior to oral nutrition only when guided by a dietitian.
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