| 1. |
- 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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| 2. |
- Axelsson, Lars, et al.
(författare)
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Bioelectrical phase angle at diagnosis as a prognostic factor for survival in advanced head and neck cancer.
- 2018
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Ingår i: European Archives of Oto-Rhino-Laryngology. - : Springer Science and Business Media LLC. - 0937-4477 .- 1434-4726. ; 275:9, s. 2379-2386
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Tidskriftsartikel (refereegranskat)abstract
- Bioelectrical impedance analysis (BIA) is used to measure the patient's body composition, fat-free mass, phase angle (PA), and standardized phase angle (SPA), which are affected by malnutrition. Low values of PA and SPA have been found to be negative prognostic factors for survival in different types of cancer and other severe diseases. The aim of the current study was to investigate whether PA and SPA can be used to predict survival in head and neck (HN) cancer.One hundred twenty-eight patients with advanced HN cancer treated in Western Sweden 2002-2006 were examined with BIA at diagnosis, and PA and SPA were calculated. Patients' age, gender, tumor site, TNM stage, and performance status were obtained, and weight, height, and BIA were measured. Survival up to 12years was ascertained.The mean PA was 5.85° and the median was 5.91°. Lower PA and SPA values were significantly associated with shorter overall survival in univariate analyses, together with higher age, oral cancer, higher T class, worse performance status, more weight loss before diagnosis, lower: weight, height, BMI, and reactance. Age, performance status, T class, and PA were significant factors for the overall survival in the multivariable analysis. A PA cutoff value at 5.95° provided the best prediction of 5-year survival.PA and SPA at diagnosis are significant factors for survival in patients with advanced HN cancer. They are promising prognostic tools to use in treatment planning; further studies are needed.
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| 3. |
- Bosaeus, Ingvar, et al.
(författare)
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Nutrition and physical activity for the prevention and treatment of age-related sarcopenia
- 2016
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Ingår i: Proceedings of the Nutrition Society. - 0029-6651 .- 1475-2719. ; 75:2, s. 174-180
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Tidskriftsartikel (refereegranskat)abstract
- Sarcopenia, defined as loss of skeletal muscle mass and function, is associated with adverse outcomes such as physical disability, impaired quality of life and increased mortality. Several mechanisms are involved in the development of sarcopenia. Potentially modifiable factors include nutrition and physical activity. Protein metabolism is central to the nutritional issues, along with other potentially modifying nutritional factors as energy balance and vitamin D status. An increasing but still incomplete knowledge base has generated recent recommendations on an increased protein intake in the elderly. Several factors beyond the total amount of protein consumed emerge as potentially important in this context. A recent summit examined three hypotheses: (1) A meal threshold; habitually consuming 25-30 g protein at breakfast, lunch and dinner provides sufficient protein to effectively stimulate muscle protein anabolism; (2) Protein quality; including high-quality protein at each meal improves postprandial muscle protein synthesis; and (3) performing physical activity in close temporal proximity to a high-quality protein meal enhances muscle anabolism. Optimising the potential for muscle protein anabolism by consuming an adequate amount of high-quality protein at each meal, in combination with physical activity, appears as a promising strategy to prevent or delay the onset of sarcopenia. However, results of interventions are inconsistent, and well-designed, standardised studies evaluating exercise or nutrition interventions are needed before guidelines can be developed for the prevention and treatment of age-related sarcopenia.
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| 4. |
- Bosaeus, Ingvar, 1950, et al.
(författare)
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Nutrition and physical activity for the prevention and treatment of age-related sarcopenia
- 2016
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Ingår i: Proceedings of the Nutrition Society. - : Cambridge University Press. - 0029-6651 .- 1475-2719. ; 75:2, s. 174-180
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Tidskriftsartikel (refereegranskat)abstract
- Sarcopenia, defined as loss of skeletal muscle mass and function, is associated with adverse outcomes such as physical disability, impaired quality of life and increased mortality. Several mechanisms are involved in the development of sarcopenia. Potentially modifiable factors include nutrition and physical activity. Protein metabolism is central to the nutritional issues, along with other potentially modifying nutritional factors as energy balance and vitamin D status. An increasing but still incomplete knowledge base has generated recent recommendations on an increased protein intake in the elderly. Several factors beyond the total amount of protein consumed emerge as potentially important in this context. A recent summit examined three hypotheses: (1) A meal threshold; habitually consuming 25-30 g protein at breakfast, lunch and dinner provides sufficient protein to effectively stimulate muscle protein anabolism; (2) Protein quality; including high-quality protein at each meal improves postprandial muscle protein synthesis; and (3) performing physical activity in close temporal proximity to a high-quality protein meal enhances muscle anabolism. Optimising the potential for muscle protein anabolism by consuming an adequate amount of high-quality protein at each meal, in combination with physical activity, appears as a promising strategy to prevent or delay the onset of sarcopenia. However, results of interventions are inconsistent, and well-designed, standardised studies evaluating exercise or nutrition interventions are needed before guidelines can be developed for the prevention and treatment of age-related sarcopenia.
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| 5. |
- Buendia, Ruben, 1982, et al.
(författare)
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Estimation of body fluids with bioimpedance spectroscopy: state of the art methods and proposal of novel methods
- 2015
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Ingår i: Physiological Measurement. - : IOP Publishing. - 0967-3334 .- 1361-6579. ; 36:10
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Tidskriftsartikel (refereegranskat)abstract
- Determination of body fluids is a useful common practice in determination of disease mechanisms and treatments. Bioimpedance spectroscopy (BIS) methods are non-invasive, inexpensive and rapid alternatives to reference methods such as tracer dilution. However, they are indirect and their robustness and validity are unclear. In this article, state of the art methods are reviewed, their drawbacks identified and new methods are proposed. All methods were tested on a clinical database of patients receiving growth hormone replacement therapy. Results indicated that most BIS methods are similarly accurate (e.g. < 0.5 +/- 3.0% mean percentage difference for total body water) for estimation of body fluids. A new model for calculation is proposed that performs equally well for all fluid compartments (total body water, extra-and intracellular water). It is suggested that the main source of error in extracellular water estimation is due to anisotropy, in total body water estimation to the uncertainty associated with intracellular resistivity and in determination of intracellular water a combination of both.
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| 6. |
- 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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| 7. |
- Ellegård, Lars, 1958, et al.
(författare)
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Body composition in overweight and obese women postpartum: bioimpedance methods validated by dual energy X-ray absorptiometry and doubly labeled water
- 2016
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Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 70, s. 1181-1188
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Tidskriftsartikel (refereegranskat)abstract
- © 2016 Macmillan Publishers LimitedBackground/Objectives:Obesity, pregnancy and lactation all affect body composition. Simple methods to estimate body composition are useful in clinical practice and to evaluate interventions. In overweight and obese lactating women, such methods are not fully validated. The objective of this study was to validate the accuracy and precision of bioimpedance spectroscopy (BIS) by Xitron 4200 and 8-electrode multifrequency impedance (multifrequency bioimpedance analysis, MFBIA) by Tanita MC180MA with the reference methods dual energy X-ray absorptiometry (DXA) and doubly labeled water (DLW) for the assessment of body composition in 70 overweight and obese women postpartum.Subjects/Methods:The LEVA-study (Lifestyle for Effective Weight loss during lactation) consisted of an intervention and follow-up with three assessments at 3, 6 and 15 months postpartum, which made possible the validation of both accuracy and precision. Mean differences between methods were tested by a paired t-test and Bland–Altman plots for systematic bias.Results:At baseline, BIS and MFBIA underestimated fat mass (FM) by 2.6±2.8 and 8.0±4.2kg compared with DXA (P<0.001) but without systematic bias. BIS and MFBIA overestimated total body water (TBW) by 2.4±2.2 and 4.4±3.2kg (P<0.001) compared with DLW, with slight systematic bias by BIS. BIS correctly estimated muscle mass without systematic bias (P>0.05). BIS overestimated changes in TBW (P=0.01) without systematic bias, whereas MFBIA varied greatly and with systematic bias.Conclusions:BIS underestimates mean FM compared with DXA but can detect mean changes in body composition, although with large limits of agreement. BIS both accurately and precisely estimates muscle mass in overweight and obese women postpartum. MFBIA underestimates FM and overestimates TBW by proprietary equations compared with DXA and DLW.European Journal of Clinical Nutrition advance online publication, 30 March 2016; doi:10.1038/ejcn.2016.50.
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| 8. |
- Ellegård, L. H., et al.
(författare)
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Longitudinal changes in phase angle by bioimpedance in intensive care patients differ between survivors and non-survivors
- 2018
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier BV. - 2405-4577. ; 24, s. 170-172
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: Intensive care (ICU) patients suffer from metabolic stress, creating a catabolic state which might disturb nutritional status and body composition. Alterations in body fluid compartments by disease or massive volume resuscitation could invalidate bioimpedance hydrometry. Still bioimpedance might give other information. Methods: 52 ICU patients (35 male, 17 female, mean age 66 years), BMI 29,2 were assessed by bioimpedance spectroscopy. Phase angle (PhA) at 50 kHz was assessed. Results: On first assessment PhA was 3.7 ± 1.0°. In 26 patients reassessed after median 5 days PhA was not significantly changed, although R 50 kHz and Xc 50 kHz both increased (p = 0.047), indicating diminishing overhydration. Body weight and body cell mass decreased by 1.8 ± 5.7 and 2.8 ± 7.5 kg (p = 0.13). Fat free mass and extracellular water decreased 4.5 ± 8.9 kg (p = 0.032) and 1.5 ± 3.5 kg (p = 0.031), while CRP decreased 63 mg/l (p = 0.002). In 17 survivors PhA increased 0.62 ± 1.24° (NS), while in 9 non-survivors PhA decreased 0.24 ± 0.82° (p = 0.06), with 0.86° difference (p = 0.049) between groups. Conclusion: Phase angle by bioimpedance is very low in ICU patients and positive changes in PhA seems to reflect more favorable outcome. Bioimpedance by Body Scout appears unsuitable for the assessment of fat free mass or overhydration in ICU patients.
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