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Impact of Malnutrition upon Healthcare and Clinical Outcomes

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (26 February 2021) | Viewed by 32028

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Special Issue Editor

Dr. Keisuke Maeda

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Guest Editor

Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Aichi, Japan
Interests: geriatric nutrition; sarcopenia; frailty; dysphagia; aspiration pneumonia
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

There has been growing interest in malnutrition, including undernutrition and obesity, as a potential target for disease treatment and prevention. Numerous studies have shown associations between malnutrition and health outcomes. Malnutrition is caused by various factors such as loss of appetite and nutritional intake, swallowing difficulties, aging, inactivity, acute inflammatory diseases, chronic inflammatory diseases, endocrine diseases, and even hospitalization. Given that global criteria to diagnose malnutrition and malnutrition-related conditions such as frailty, sarcopenia, and cachexia have been proposed lately, research on malnutrition in every setting would be accelerated.

The aim of this Special Issue is to update knowledge on malnutrition related to healthcare and clinical outcomes. Original research conducted in communities, care facilities, clinics, and hospitals and systematic/narrative review articles are invited. The Special Issue will focus on adult and geriatric nutrition. Investigations on the importance of nutrition support teams, nutritional screening/assessment, food fortification, artificial nutrition, hand feeding, and texture-modified diets are welcome.

Dr. Keisuke Maeda
Guest Editor

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Keywords

Undernutrition
Obesity
Sarcopenia
Frailty
Cachexia
Dysphagia
Artificial nutrition

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Published Papers (5 papers)

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Research

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14 pages, 367 KiB

Open AccessArticle

Mapping Health-Related Quality of Life, Anxiety, and Depression in Patients with Head and Neck Cancer Diagnosed with Malnutrition Defined by GLIM

by Ylva Tiblom Ehrsson, Per Fransson and Sandra Einarsson

Nutrients 2021, 13(4), 1167; https://doi.org/10.3390/nu13041167 - 1 Apr 2021

Cited by 19 | Viewed by 3162

Abstract

Patients with cancer deal with problems related to physical, psychological, social, and emotional functions. The aim was to investigate malnutrition defined by the Global Leadership Initiative on Malnutrition (GLIM) criteria in relation to health-related quality of life, anxiety, and depression in patients with head and neck cancer. This was a prospective observational research study with 273 patients followed at the start of treatment, seven weeks, and one year. Data collection included nutritional status and support, and the questionnaires: European Organization for Research and Treatment of Cancer Head and neck cancer module (EORTC QLQ-H&N35) and the Hospital Anxiety and Depression Scale (HADS). Malnutrition was defined using the GLIM criteria. The study showed that patients with malnutrition had significantly greater deterioration in their health-related quality of life at seven weeks. On a group level, health-related quality of life was most severe at this time point and some scores still implied problems at one year. Significantly, more patients reported anxiety at the start of treatment whereas significantly more patients reported depression at seven weeks. Over the trajectory of care, the need for support often varies. Psychosocial support is imperative and at the end of treatment extra focus should be put on nutritional interventions and managing treatment-related symptoms to improve nutritional status and health-related quality of life. In the long-term, head and neck cancer survivors need help to find strategies to cope with the remaining sequel. Full article

(This article belongs to the Special Issue Impact of Malnutrition upon Healthcare and Clinical Outcomes)

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8 pages, 249 KiB

Open AccessArticle

COVID-19 Infection-Related Weight Loss Decreases Eating/Swallowing Function in Schizophrenic Patients

by Takeshi Kikutani, Yoko Ichikawa, Eri Kitazume, Arato Mizukoshi, Takashi Tohara, Noriaki Takahashi, Fumiyo Tamura, Manami Matsutani, Junko Onishi and Eiichiro Makino

Nutrients 2021, 13(4), 1113; https://doi.org/10.3390/nu13041113 - 29 Mar 2021

Cited by 3 | Viewed by 3009

Abstract

Background: In older people with psychoneurological diseases, COVID-19 infection may be associated with a risk of developing or exacerbating dysphagia. The aim of the present study was to examine the relationship between eating/swallowing function and COVID-19 infection. Methods: Subjects were 44 inpatients with confirmed COVID-19 infection being treated for schizophrenia in a psychiatric ward. Eating function was assessed using the Food Intake Level Scale (FILS) before and after infection. We also evaluated age, comorbidities, COVID-19 hospital stay, obesity index, weight loss rate, and chlorpromazine equivalent. Results: Subjects had a mean age of 68.86 years. Pre-infection, 20 subjects had a FILS score of 7–9 (presence of eating/swallowing disorder) and 24 subjects had a score of 10 (normal). Eating function after infection resolution showed decreasing FILS score compared to that before infection in 14 subjects (74.14 years). Six subjects (79.3 years) transitioned from oral feeding to parenteral feeding. A ≥ 10% weight loss during infection treatment was significantly associated with decreased eating function and a transition to parenteral feeding. Chlorpromazine equivalents, comorbidities, and number of days of hospitalization showed no associations with decreased eating function. Conclusions: Preventing malnutrition during treatment for COVID-19 infection is important for improving post-infection life prognosis and maintaining quality of life (QOL). Full article

(This article belongs to the Special Issue Impact of Malnutrition upon Healthcare and Clinical Outcomes)

11 pages, 719 KiB

Open AccessFeature PaperArticle

Nutritional Management Enhances the Recovery of Swallowing Ability in Older Patients with Sarcopenic Dysphagia

by Akio Shimizu, Ichiro Fujishima, Keisuke Maeda, Hidetaka Wakabayashi, Shinta Nishioka, Tomohisa Ohno, Akiko Nomoto, Jun Kayashita, Naoharu Mori and The Japanese Working Group on Sarcopenic Dysphagia

Nutrients 2021, 13(2), 596; https://doi.org/10.3390/nu13020596 - 11 Feb 2021

Cited by 48 | Viewed by 6482

Abstract

This study assessed whether a high provided energy of ≥30 kcal/ideal body weight (IBW)/day (kg) for patients with sarcopenic dysphagia effectively improved swallowing ability and the activities of daily living (ADLs). Among 110 patients with sarcopenic dysphagia (mean age, 84.9 ± 7.4 years) who were admitted to a post-acute hospital, swallowing ability and the ADLs were assessed using the Food Intake LEVEL Scale (FILS) and the Functional Independence Measure (FIM), respectively. The primary outcome was the FILS at discharge, while the secondary outcome was the achievement of the FIM with a minimal clinically important difference (MCID) at discharge. We created a homogeneous probability model without statistically significant differences using the inverse probability of treatment weighting (IPTW) method with and without a mean provided energy of ≥30 kcal/IBW/day (kg) for a period of 1 week of hospitalization and compared the outcomes between groups. A mean provided energy of ≥30 kcal/IBW/day (kg) was achieved in 62.7% of patients. In the IPTW model, the FILS and the rates of achieved MCID of the FIM at discharge were significantly higher in the mean provided energy of ≥30 kcal/IBW/day (kg) group (p = 0.004 and p < 0.001, respectively). A high provided energy for patients with sarcopenic dysphagia may improve swallowing ability and produce clinically meaningful functional outcomes. Full article

(This article belongs to the Special Issue Impact of Malnutrition upon Healthcare and Clinical Outcomes)

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Review

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14 pages, 799 KiB

Open AccessReview

Related Factors and Clinical Outcomes of Osteosarcopenia: A Narrative Review

by Tatsuro Inoue, Keisuke Maeda, Ayano Nagano, Akio Shimizu, Junko Ueshima, Kenta Murotani, Keisuke Sato, Kazuki Hotta, Shinichiro Morishita and Atsuhiro Tsubaki

Nutrients 2021, 13(2), 291; https://doi.org/10.3390/nu13020291 - 20 Jan 2021

Cited by 48 | Viewed by 8174

Abstract

Osteopenia/osteoporosis and sarcopenia are common geriatric diseases among older adults and harm activities of daily living (ADL) and quality of life (QOL). Osteosarcopenia is a unique syndrome that is a concomitant of both osteopenia/osteoporosis and sarcopenia. This review aimed to summarize the related factors and clinical outcomes of osteosarcopenia to facilitate understanding, evaluation, prevention, treatment, and further research on osteosarcopenia. We searched the literature to include meta-analyses, reviews, and clinical trials. The prevalence of osteosarcopenia among community-dwelling older adults is significantly higher in female (up to 64.3%) compared to male (8–11%). Osteosarcopenia is a risk factor for death, fractures, and falls based on longitudinal studies. However, the associations between osteosarcopenia and many other factors have been derived based on cross-sectional studies, so the causal relationship is not clear. Few studies of osteosarcopenia in hospitals have been conducted. Osteosarcopenia is a new concept and has not yet been fully researched its relationship to clinical outcomes. Longitudinal studies and high-quality interventional studies are warranted in the future. Full article

(This article belongs to the Special Issue Impact of Malnutrition upon Healthcare and Clinical Outcomes)

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26 pages, 1150 KiB

Open AccessReview

Undernutrition, Sarcopenia, and Frailty in Fragility Hip Fracture: Advanced Strategies for Improving Clinical Outcomes

by Tatsuro Inoue, Keisuke Maeda, Ayano Nagano, Akio Shimizu, Junko Ueshima, Kenta Murotani, Keisuke Sato and Atsuhiro Tsubaki

Nutrients 2020, 12(12), 3743; https://doi.org/10.3390/nu12123743 - 4 Dec 2020

Cited by 79 | Viewed by 10044

Abstract

Geriatric patients with hip fractures often experience overlap in problems related to nutrition, including undernutrition, sarcopenia, and frailty. Such problems are powerful predictors of adverse responses, although few healthcare professionals are aware of them and therefore do not implement effective interventions. This review aimed to summarize the impact of undernutrition, sarcopenia, and frailty on clinical outcomes in elderly individuals with hip fractures and identify successful strategies that integrate nutrition and rehabilitation. We searched PubMed (MEDLINE) and Cochrane Central Register of Controlled Trials (CENTRAL) for relevant literature published over the last 10 years and found that advanced interventions targeting the aforementioned conditions helped to significantly improve postoperative outcomes among these patients. Going forward, protocols from advanced interventions for detecting, diagnosing, and treating nutrition problems in geriatric patients with hip fractures should become standard practice in healthcare settings. Full article

(This article belongs to the Special Issue Impact of Malnutrition upon Healthcare and Clinical Outcomes)

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