| 1. |
- Cappellari, Gianluca Gortan, et al.
(författare)
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Sarcopenic obesity research perspectives outlined by the sarcopenic obesity global leadership initiative (SOGLI) : Proceedings from the SOGLI consortium meeting in rome November 2022
- 2023
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Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 42:5, s. 687-699
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Tidskriftsartikel (refereegranskat)abstract
- The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched the Sarcopenic Obesity Global Leadership Initiative (SOGLI) to reach expert consensus on a definition and diagnostic criteria for Sarcopenic Obesity (SO).The present paper describes the proceeding of the Sarcopenic Obesity Global Leadership Initiative (SOGLI) meeting that was held on November 25th and 26th, 2022 in Rome, Italy. This consortium involved the participation of 50 researchers from different geographic regions and countries.The document outlines an agenda advocated by the SOGLI expert panel regarding the pathophysiology, screening, diagnosis, staging and treatment of SO that needs to be prioritized for future research in the field.
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| 2. |
- Donini, Lorenzo M., et al.
(författare)
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Definition and diagnostic criteria for sarcopenic obesity : ESPEN and EASO consensus statement
- 2022
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Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 41:4, s. 990-1000
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Loss of skeletal muscle mass and function (sarcopenia) is common in individuals with obesity due to metabolic changes associated with a sedentary lifestyle, adipose tissue derangements, comorbidities (acute and chronic diseases), and during the ageing process. Co-existence of excess adiposity and low muscle mass/function is referred to as sarcopenic obesity (SO), a condition increasingly recognized for its clinical and functional features that negatively influence important patient-centred outcomes. Effective prevention and treatment strategies for SO are urgently needed, but efforts are hampered by the lack of an universally established SO Definition and diagnostic criteria. Resulting inconsistencies in the literature also negatively affect the ability to define prevalence as well as clinical relevance of SO for negative health outcomes.Aims and methods: The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched an initiative to reach expert consensus on a Definition and diagnostic criteria for SO. The jointly appointed international expert panel proposes that SO is defined as the co-existence of excess adiposity and low muscle mass/function. The diagnosis of SO should be considered in at-risk individuals who screen positive for a co-occurring elevated body mass index or waist circumference, and markers of low skeletal muscle mass and function (risk factors, clinical symptoms, or validated questionnaires). Diagnostic procedures should initially include assessment of skeletal muscle function, followed by assessment of body composition where presence of excess adiposity and low skeletal muscle mass or related body compartments confirm the diagnosis of SO. Individuals with SO should be further stratified into Stage I in the absence of clinical complications, or Stage II if cases are associated with complications linked to altered body composition or skeletal muscle dysfunction.Conclusions: ESPEN and EASO, as well as the expert international panel, advocate that the proposed SO Definition and diagnostic criteria be implemented into routine clinical practice. The panel also encourages prospective studies in addition to secondary analysis of existing datasets, to study the predictive value, treatment efficacy, and clinical impact of this SO definition. (c) 2022 The Author(s). Published by Elsevier Ltd. on behalf of European Society for Clinical Nutrition and Metabolism and Obesity Facts published by S. Karger AG. This article is published under the Creative Commons CC-BY license. All rights reserved.
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| 3. |
- Jager-Wittenaa, Harriët, et al.
(författare)
-
Malnutrition and dietary treatment in older adults : a conference report
- 2019
-
Konferensbidrag (refereegranskat)abstract
- Aims: With an ageing population worldwide,pressure on health and social care systems grows. Strategies to preventage-related conditions as malnutrition, sarcopenia, and frailtyare therefore of ultimate importance, to enable older adults remainingphysically and mentally active and independent as long aspossible. Good nutrition plays a significant role in maintainingand improving functioning. The aim of the conference session wasto 1) elucidate and discuss nutritional challenges faced and strategiesto improve nutritional intake and nutritional status amongolder adults, and 2) to share knowledge and best practices gainedfrom both national and international (research) projects on nutritionand ageing conducted in Europe.Methods: In this conference session, three presentations about different aspects of malnutrition in older persons were given. Firstly,an overview of current practices in different European Countriesto prevent malnutrition in older adults were presented anddiscussed. Data were collected via the European Specialist Dietetic Network for Older Adults who reported on the most recent statistics,guidelines and practice for screening, prevalence and interventions for identifying, preventing and treating malnutrition. Secondly, the relationship between dietary intake, physical performance(gait speed and hand grip strength) and body composition(dual energy x-ray absorptiometry) in two cohorts from the GothenburgH70 Birth Cohort Studies, i.e., one Swedish cohort at age70 (born in 1944) and one Swedish cohort at age 85 (born in 1930)[1] were discussed. Thirdly, a range of strategies to support adequate nutrition in older adults were discussed.Results: Information was provided by representatives fromSpain, The Netherlands, United Kingdom, Switzerland, Greece,Turkey, and Portugal, which identified commonalities in practiceas well as variations that were specific for each country. Mandatory nutritional risk screening is not in place for every country andfor some countries, even when malnutrition screening is mandatorythe rate of screening uptake remained low. Many countriesreported staffing/dietetic capacity as a limitation, and the need fordietitians to raise awareness of the importance of nutrition amongstother medical and allied health professionals was raised. There isconsensus that dietitians should be regarded as integral membersof the multidisciplinary team and whilst there were some examplesof good practice, there is still room for improvement in this area. A variety of screening tools are used and reported malnutritionprevalence varied between countries, however with the latest GLIM consensus on the diagnosis criteria for malnutrition, thismay encourage consistency in criteria in the future.Data from the Gothenburg H70 Birth Cohort Studies [1]showed good dietary intake in relation to recommendations [2 although intake for some nutrients were somewhat lower in the 85-year olds compared to the 70-year olds. In both cohorts vitaminD was the nutrient with highest proportion of low intakes. Amongthe 70-year olds, alcohol intake had increased significantly indicatingchanges in lifestyle over time. Significant differences werefound in prevalence of low muscle mass, slow self-selected walkingspeed, and hand grip strength, with a higher proportion havingsarcopenia among the 85-year olds compared to the 70-year old(3% vs. 55% respectively) [3]. Differences were also found in mealpatterns among 85 year-olds in risk of malnutrition compared tothose without with lower meal frequency and less snack meals/dayamong those in risk of malnutrition.Strategies to support adequate nutrition range from strategiesto identify those in need of nutritional support to strategies regardingthe provision of nutrition [4]. As an important prerequisite, allolder persons should be routinely screened for malnutrition in regularintervals in order to identify an existing risk early. Various validated screening tools specifically for older persons are availablefor different healthcare settings [5]. Potential risk factors or causesof malnutrition, e.g. chewing or swallowing problems, medicationside effects or depression, need to be identified and eliminated asfar as possible [4]. Direct dietary strategies to support adequateintake include the recommendation or provision of energy andnutrient dense food and enriched meals in an appealing and appetizingway. Particular attention should be paid to sensory characteristics,adequate texture and food variety, always consideringindividual likes and dislikes. Dietary restrictions should generallybe avoided since they may limit food choice and eating pleasureand thus bear the risk of limiting dietary intake [4].Besides regular main meals, snacks should be available as needed.Furthermore, older persons should be encouraged to sharetheir mealtimes with others and eat in a pleasant, relaxed atmosphere. In case of dementia, finger food may help to maintain independenteating and allow for eating while walking for personswho are constantly pacing. Depending on individual resources andneed of assistance for shopping, preparing meals and eating, adequatesupport should be arranged. If oral nutrition is insufficientor impossible despite all these efforts, e.g., in case of dysphagia,enteral and parenteral nutrition should be taken into consideration[4].As often several persons – relatives as well as different healthcare professionals – are involved in nutritional care, communicationand close cooperation of these persons is important to ensureconsistent approaches and avoid double effort.Conclusions: Older adults are at increased risk of malnutrition,which in turn is related to poor health outcomes. Nutritional interventionsaim to maintain autonomy through physical independence,preventing disability, and to ensure quality of life among older adults. Nutritional care and support of older adults at risk or affected by malnutrition is thus an important public health concern, but adequate structures and strategies to prevent and treat malnutrition are not implemented everywhere. Future efforts should aim to put adequate nutritional care into practice as an integral part of geriatric healthcare in all settings in all countries.
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| 4. |
- Jager-Wittenaa, Harriët, et al.
(författare)
-
Malnutrition and dietary treatment in older adults : a conference report
- 2019
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aims: With an ageing population worldwide,pressure on health and social care systems grows. Strategies to preventage-related conditions as malnutrition, sarcopenia, and frailtyare therefore of ultimate importance, to enable older adults remainingphysically and mentally active and independent as long aspossible. Good nutrition plays a significant role in maintainingand improving functioning. The aim of the conference session wasto 1) elucidate and discuss nutritional challenges faced and strategiesto improve nutritional intake and nutritional status amongolder adults, and 2) to share knowledge and best practices gainedfrom both national and international (research) projects on nutritionand ageing conducted in Europe. Methods: In this conference session, three presentations about different aspects of malnutrition in older persons were given. Firstly,an overview of current practices in different European Countriesto prevent malnutrition in older adults were presented anddiscussed. Data were collected via the European Specialist Dietetic Network for Older Adults who reported on the most recent statistics,guidelines and practice for screening, prevalence and interventions for identifying, preventing and treating malnutrition. Secondly, the relationship between dietary intake, physical performance(gait speed and hand grip strength) and body composition(dual energy x-ray absorptiometry) in two cohorts from the GothenburgH70 Birth Cohort Studies, i.e., one Swedish cohort at age70 (born in 1944) and one Swedish cohort at age 85 (born in 1930)[1] were discussed. Thirdly, a range of strategies to support adequate nutrition in older adults were discussed. Results: Information was provided by representatives fromSpain, The Netherlands, United Kingdom, Switzerland, Greece,Turkey, and Portugal, which identified commonalities in practiceas well as variations that were specific for each country. Mandatory nutritional risk screening is not in place for every country andfor some countries, even when malnutrition screening is mandatorythe rate of screening uptake remained low. Many countriesreported staffing/dietetic capacity as a limitation, and the need fordietitians to raise awareness of the importance of nutrition amongstother medical and allied health professionals was raised. There isconsensus that dietitians should be regarded as integral membersof the multidisciplinary team and whilst there were some examplesof good practice, there is still room for improvement in this area. A variety of screening tools are used and reported malnutritionprevalence varied between countries, however with the latest GLIM consensus on the diagnosis criteria for malnutrition, thismay encourage consistency in criteria in the future.Data from the Gothenburg H70 Birth Cohort Studies [1]showed good dietary intake in relation to recommendations [2 although intake for some nutrients were somewhat lower in the 85-year olds compared to the 70-year olds. In both cohorts vitaminD was the nutrient with highest proportion of low intakes. Amongthe 70-year olds,alcohol intake had increased significantly indicatingchanges in lifestyle over time. Significant differences werefound in prevalence of low muscle mass, slow self-selected walkingspeed, and hand grip strength, with a higher proportion havingsarcopenia among the 85-year olds compared to the 70-year old(3% vs. 55% respectively) [3]. Differences were also found in mealpatterns among 85 year-olds in risk of malnutrition compared tothose without with lower meal frequency and less snack meals/dayamong those in risk of malnutrition.Strategies to support adequate nutrition range from strategiesto identify those in need of nutritional support to strategies regardingthe provision of nutrition [4]. As an important prerequisite, allolder persons should be routinely screened for malnutrition in regularintervals in order to identify an existing risk early. Various validated screening tools specifically for older persons are availablefor different healthcare settings [5]. Potential risk factors or causesof malnutrition, e.g. chewing or swallowing problems, medicationside effects or depression, need to be identified and eliminated asfar as possible [4]. Direct dietary strategies to support adequateintake include the recommendation or provision of energy andnutrient dense food and enriched meals in an appealing and appetizingway. Particular attention should be paid to sensory characteristics,adequate texture and food variety, always consideringindividual likes and dislikes. Dietary restrictions should generallybe avoided since they may limit food choice and eating pleasureand thus bear the risk of limiting dietary intake [4].Besides regular main meals, snacks should be available as needed.Furthermore, older persons should be encouraged to sharetheir mealtimes with others and eat in a pleasant, relaxed atmosphere. In case of dementia, finger food may help to maintain independenteating and allow for eating while walking for personswho are constantly pacing. Depending on individual resources andneed of assistance for shopping, preparing meals and eating, adequatesupport should be arranged. If oral nutrition is insufficientor impossible despite all these efforts, e.g., in case of dysphagia,enteral and parenteral nutrition should be taken into consideration[4].As often several persons – relatives as well as different healthcare professionals – are involved in nutritional care, communicationand close cooperation of these persons is important to ensureconsistent approaches and avoid double effort. Conclusions: Older adults are at increased risk of malnutrition,which in turn is related to poor health outcomes. Nutritional interventionsaim to maintain autonomy through physical independence,preventing disability, and to ensure quality of life among older adults. Nutritional care and support of older adults at risk or affected by malnutrition is thus an important public health concern, but adequate structures and strategies to prevent and treat malnutrition are not implemented everywhere. Future efforts should aim to put adequate nutritional care into practice as an integral part of geriatric healthcare in all settings in all countries.
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| 5. |
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| 6. |
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| 7. |
- Pourhassan, Maryam, et al.
(författare)
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Inflammation as a diagnostic criterion in the GLIM definition of malnutrition-what CRP-threshold relates to reduced food intake in older patients with acute disease?
- 2022
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Ingår i: European Journal of Clinical Nutrition. - : Springer Nature. - 0954-3007 .- 1476-5640. ; 76:3, s. 397-400
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/OBJECTIVES: In the recently introduced GLIM diagnosis of malnutrition (Global Leadership Initiative on Malnutrition), details of how to classify inflammation as an etiologic criterion are lacking. This study aimed to determine at what level of serum C-reactive protein (CRP) the risk of low food intake increases in acutely ill older hospitalized patients.SUBJECTS/METHODS: A total of 377 patients, who were consecutively admitted to a geriatric acute care ward, were analyzed. Nutritional intake was determined using the food intake item of Nutritional Risk Screening and the plate diagram method and patients were grouped into three categories as >75%, 50-75% and ≤50% of requirements. CRP was analyzed according to standard procedures and patients were classified into different CRP groups as follows: 0.0-0.99 mg/dl, 1.0-1.99 mg/dl, 2.0-2.99 mg/dl, 3.0-4.99 mg/dl, 5.0-9.99 mg/dl and ≥10.0 mg/dl.RESULTS: Of the total population (mean age of 82.2 ± 6.6 years; 241 females), 82 (22%) had intake <50% of requirements and 126 (33%) demonstrated moderate to severe inflammation. Patients with food intake <50% of requirements had a significantly higher median CRP level compared to patients with food intake >75% of requirements (P < 0.001). The group with serum-CRP levels above 3.0 mg/dl had a markedly higher proportion of patients with low food intake; i.e., <50% and <75% of the requirements.CONCLUSION: A serum-CRP of 3.0 mg/dl appears to be a reasonable threshold of acute inflammation leading to reduced food intake to serve as an orientation with regard to the inflammation criterion of the GLIM diagnosis in acutely ill older patients.
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| 8. |
- Pourhassan, Maryam, et al.
(författare)
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Severity of Inflammation Is Associated with Food Intake in Hospitalized Geriatric Patients-A Merged Data Analysis
- 2023
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Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 15:14
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Tidskriftsartikel (refereegranskat)abstract
- The extent to which inflammation impacts food intake remains unclear, serving as a key risk factor for malnutrition as defined by the Global Leadership Initiative on Malnutrition (GLIM). To address this, we analyzed a large, merged dataset of geriatric hospitalized patients across Europe. The study included 1650 consecutive patients aged & GE;65 year from Germany, Italy, Finland, Denmark, and Poland. Nutritional intake was assessed using the first item of the Mini Nutritional Assessment Short Form; C-reactive protein (CRP) levels were measured using standard procedures. In total (age 79.6 & PLUSMN; 7.4 year, 1047 females), 23% exhibited moderate to severe inflammation, and 12% showed severe inflammation; 35% showed moderate reductions in food intake, and 28% were considered malnourished. Median CRP levels differed significantly between patients with severe, moderate, and no decrease in food intake. Among patients with a CRP level of 3.0-4.99 mg/dL, 19% experienced a severe decrease in food intake, while 66% experienced moderate to severe decreases. Regression analysis revealed that inflammation was the most prominent risk factor for low food intake and malnutrition, surpassing other factors such as age, gender, infection, and comorbidity. A CRP level of & GE;3.0 mg/dL is associated with reduced food intake during last 3 months in two thirds of hospitalized geriatric patients and therefore indicative for a high risk of malnutrition.
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| 9. |
- Schindler, Karin, et al.
(författare)
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nutritionDay : 10 years of growth
- 2017
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Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 36:5, s. 1207-1214
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND & AIMS: Despite high prevalence at hospital admission, disease related malnutrition (DRM) remains under recognized and undertreated. DRM is associated with increased morbidity, hospital readmission rate, and burden for the healthcare system. The compelling need to increase awareness and knowledge through an international survey has triggered the launch of the nutritionDay (ND) concept.METHODS: ND is a worldwide annual systematic collection and analysis of data in hospital wards, intensive care units and nursing homes. ND is based on questionnaires to systematically collect and analyze the patient's characteristics, food intake and nutrition support, as well as the determinants of their environment (facility, health care personal, etc …). Questionnaires, outcome documentation sheets and step-by-step guidance are available as download in 30 languages.RESULTS: ND has described the nutritional status and behavior of over 150,000 hospitalized patients and nursing home's patients in over 56 participating countries. These data allowed a local, regional, national and international benchmarking at different levels (i.e. type of medical pathologies, care facilities, etc.) and over time. Sixteen peer-reviewed publications have already been released and picture the international scene of DRM.CONCLUSION: This review presents the 10-year of the ND project development and shows how ND serves all health care professionals to optimize nutrition care and nutrition related structures. ND keeps progressing and is likely to become a standard tool for determining the nutritional status and behavior of hospitalized patients and nursing home's population.
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| 10. |
- Visser, Marjolein, et al.
(författare)
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A Core Outcome Set for nutritional intervention studies in older adults with malnutrition and those at risk : a study protocol
- 2023
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Ingår i: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Malnutrition (i.e., protein-energy malnutrition) in older adults has severe negative clinical consequences, emphasizing the need for effective treatments. Many, often small, randomized controlled trials (RCTs) testing the effectiveness of nutritional interventions for the treatment of malnutrition showed mixed results and a need for meta-analyses and data pooling has been expressed. However, evidence synthesis is hampered by the wide variety of outcomes and their method of assessment in previous RCTs. This paper describes the protocol for developing a Core Outcome Set (COS) for nutritional intervention studies in older adults with malnutrition and those at risk.Methods: The project consists of five phases. The first phase consists of a scoping review to identify frequently used outcomes in published RCTs and select additional patient-reported outcomes. The second phase includes a modified Delphi Survey involving experienced researchers and health care professionals working in the field of malnutrition in older adults, followed by the third phase consisting of a consensus meeting to discuss and agree what critical outcomes need to be included in the COS. The fourth phase will determine how each COS outcome should be measured based on a systematic literature review and a second consensus meeting. This will be followed by a dissemination and implementation phase. Patient and Public Involvement (PPI) representatives will contribute to study design, oversight, consensus, and dissemination.Conclusions: The result of this project is a COS that should be included in any RCT evaluating the effect of nutritional interventions in older adults with malnutrition and those at risk. This COS will facilitate comparison of RCT results, will increase efficient use of research resources and will reduce bias due to measurement of the outcome and publication bias. Ultimately, the COS will support clinical decision making by identifying the most effective approaches for treating and preventing malnutrition in older adults.
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