scholarly journals A Prospective Study Identifying a Change in Energy and Protein Intake of Older Adults during Inpatient Rehabilitation

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 453 ◽  
Author(s):  
Jorja Collins ◽  
Judi Porter ◽  
Helen Truby ◽  
Catherine Huggins

Understanding older patients’ dietary intake patterns may improve the timing of strategies to address hospital malnutrition. The aims of this study were to explore longitudinally the change in daily energy (kJ/day) and protein (g/day) intake, and associated factors. Data were derived using a 5-point scale to visually estimate plate waste, and known nutrient composition data. Analyses determined the change in intake between admission and day 14, and admission, day 14 and day 28, respectively. Data were available for 39 participants between admission and day 14 (median (interquartile range) age 82 (78–87) years; 54% male) and 12 participants between admission, day 14 and day 28 (median (IQR) age 79 (69–84) years; 58% male). From admission to day 14 there was a significant increase in the mean (SD) daily intake of energy (6177 (1879) kJ/day vs. 7213 (1903), p < 0.001) and protein (63.7 (23) g/day vs. 76.4 (23.0) g/day, p = 0.003) but no change from admission to day 14 to day 28. There was a significant inverse relationship between amount consumed at admission and change in intake. Variability in elderly patients’ intake over time has implications for the timing of nutritional care and data collection in research studies.

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhewen Ren ◽  
Fei Zhao ◽  
Hui Chen ◽  
Dongmei Hu ◽  
Wentao Yu ◽  
...  

Abstract Background The objectives of this study were to examine nutrient intakes of tuberculosis (TB) patients and to identify their associated factors. Methods In this cross-sectional study, 300 adult TB patients were surveyed in two impoverished counties in China. Nutrient intakes were evaluated through two consecutive 24-h dietary recalls and compared with the Chinese Dietary Reference Intakes (DRIs) 2013. The potential socio-demographic and behavioral factors were analyzed using multivariate logistic model to identify strong influential factors. Results We found that mean daily energy intake was 1655.0 kcal (SD: 619.3 kcal) and 1360.3 kcal (SD: 552.1 kcal) for male and female patients, respectively. The mean daily energy intake was significantly lower than that has been recommended by DRI (i.e., 2250 and 1800 kcal for males and females, respectively), with 87.4% of the male patients and 59.9% of female patients failed to consume adequate energy. The protein intakes were 44.6 g (SD: 18.2 g) and 35.9 g (SD: 12.3 g) for male and female patients, respectively, which were lower than the recommended values by DRI (i.e., 65 and 55 g for males and females, respectively). Most male (90.8%) and female (58.4%) TB patients had insufficient daily protein intake. Further analyses suggested that mean daily intakes of many micronutrients, were insufficient, while for most of patients, intakes of vitamin E and sodium were sufficient. We identified that unemployment was a risk factor for low energy intake (p < 0.05) and out-home-eating was a protective factor for low protein intake (p < 0.01). Conclusions In impoverished areas in China, intakes of macronutrients and most micronutrients in TB patients were inadequate compared with DRIs, especially for unemployed patients and patients eating at home. These findings suggested that public health actions are needed to promote education on TB patients about significance of nutritional support, and, further interventions in TB patients’ nutritional intakes are also required.


Author(s):  
Bhasker Amatya ◽  
Alaeldin Elmalik ◽  
Su Yi Lee ◽  
Krystal Song ◽  
Mary Galea ◽  
...  

Objective: To assess the utility of the modified Post-Stroke Checklist (mPSC) to identify impairments and care needs of patients with stroke (PwS) in an inpatient rehabilitation setting. Methods: Prospective observational design with consecutive admission of PwS (n = 44) at a tertiary rehabilitation facility. The post-stroke checklist was administered at hospital discharge (T1) and 3 months post-discharge (T2). Furthermore, validated questionnaires assessed function and participation, including the Clinical Functioning Information Tool (ClinFIT) on admission (T0), T1 and T2. Results: Participants’ mean age was 67.7 years (standard deviation; SD) 14.6), 58% of participants were female, and the mean length of inpatient stay was 32.7 days (SD 22.4). At T1, 80% and at T2 only 60% of participants reported ≥1 stroke-related problem (mean 5.3 (SD 3.3) and 3.6 (SD 2.8), respectively). Half of participants were referred to physiotherapy/occupational therapy, and 36% to specialist clinics following discharge. The most prevalent problems included: life after stroke (62.2%), fatigue (55.6%), activities of daily living, and mobility (51.1% each). Compared with T1, at T2 there was an observed reduction in all mPSC items, except pain and incontinence. Participants showed improved function at T1 and T2 (Extension Index, ClinFIT set), from T0 to T1 and T0 to T2 (p<0.001, with large effect sizes). Conclusion: The mPSC is feasible to implement in an inpatient rehabilitation setting and community. It can identify relevant stroke-related problems, and hence facilitate targeted intervention.


2007 ◽  
Vol 98 (5) ◽  
pp. 1077-1083 ◽  
Author(s):  
John M. de Castro

Intake in the morning is particularly satiating and associated with lower total amounts ingested for the day while intake at night is associated with greater overall daily intake. But, the influence of carbohydrates, fats or proteins ingested at various times of the day is unknown. The intakes of 375 male and 492 female free-living individuals that were acquired with 7 d diet-diary reports were reanalysed. The intakes of carbohydrates, fats and proteins, and the density of intake occurring during three 6 h periods (06.00 to 11.59 hours (morning), 12.00 to 17.59 hours (afternoon) and 18.00 to 23.59 hours (evening)) were identified and related to overall daily and meal intakes. Energy density of intake during all periods was found to be positively related to overall intake. When the proportion of daily carbohydrate ingested in the morning was high, less total food energy and carbohydrate were ingested over the entire day. When the proportion of daily fat ingested in the morning was high, less total food energy and carbohydrate and fat were ingested over the entire day. When the proportion of daily protein ingested in the morning was high, less protein was ingested over the entire day. Conversely, when intake was relatively high in the evening of either total food energy, carbohydrate or fat, then overall daily energy intakes tended to be higher. The results suggest that the morning intake association with reduced total intake is macronutrient specific, with morning carbohydrate, fat and protein intake associated with reduced daily carbohydrate, fat and protein intake, respectively.


1977 ◽  
Vol 88 (2) ◽  
pp. 399-403 ◽  
Author(s):  
R. Valdez Espinosa ◽  
J. J. Robinson ◽  
D. Scott

SUMMARYNine individually penned Finnish Landrace x Dorset Horn ewes with a mean litter size of 2·33 were offered a diet containing 63% digestible organic matter (DOM) and 13% crude protein in the dry matter at a daily intake of 0·82 kg DOM (1·3 x maternal maintenance) from 95 to 110 days of gestation. On day 111 DOMI was abruptly reduced to either 0·67 kg (T1, 0·54 kg (T2) or 0·36 kg (T3)/day and kept at these levels until a few days pre-partum.Daily N balance before food restriction was 4·9 ± 0·51 g/day. During the periods 3·9 (S1), 11·17 (S2) and 19·25 (S3) days after food restriction daily N balance was 2·8, 2·8 and 3·6 g for θwes on T1, 1·0,1·0 and 0·8 g for those on T2 and –4·1, -4·0and -4·0 g for those on T3. Total lamb birth weight was 8·0, 7·2 and 6·5 kg for treatments T1, T2 and T3 respectively. Using regression analysis it was calculated that plasma glucose concentration in late pregnancy for ewes with a total lamb birth weight of 8 kg fell below the pre-restriction value of 52 mg/100 ml when daily DOMI was reduced to 747 g. At this intake the plasma FFA concentration was 585/i-equiv./I compared with 288 before food restriction. Corresponding values for daily N balance were 5·1 and 4·9 g. A reduction in daily energy intake below 0·75 kg DOM resulted in a rapid decrease in plasma glucose and N balance, the latter being proportional to the increase in the concentration of plasma FFA. The mean daily loss of N from the maternal body was estimated to be 0·4, 1·6 and 6·1 g for treatments T1 to T3 respectively during the period of food restriction.


1994 ◽  
Vol 07 (03) ◽  
pp. 129-135 ◽  
Author(s):  
C.W. Miller ◽  
P.W. Morgan

SummaryTwenty-four dogs (27 limbs) were evaluated after surgery for correction of forelimb angular limb deformities. Partial ulnar ostectomies or definitive corrective osteotomies were performed depending upon the age of the dog. According to owner assessment nine of fourteen limbs were considered functionally good, or excellent, after partial ulnar ostectomies. Younger dogs appeared to have better functional results after dynamic correction with the mean age at surgery of dogs with good to excellent results being 6.5 months contrasted to the mean age at surgery of dogs with fair to poor results being 9.75 months. Ten of fourteen limbs were considered functionally good or excellent after definitive corrective osteotomy. One dog had definitive osteotomy after partial ulnar ostectomy in order to further correct a residual angular deformity. However, 58% of the limbs with radiographic follow-up had signs of degenerative joint disease (DJD). There were not significant differences between neither degree of angulation remaining after surgery and the functional result nor the degree of angulation remaining after surgery and the development of DJD. A prospective study is warranted to more objectively assess the efficacy of surgical correction of angular limb deformities in dogs.Twenty-four dogs were evaluated after surgery for correction of forelimb angular limb deformities. The results are described.


1997 ◽  
Vol 75 (7) ◽  
pp. 1176-1183 ◽  
Author(s):  
Horacio de la Cueva ◽  
Robert W. Blake

Aerodynamic power equations predict optimal speeds at which birds ought to fly if they are to maximize time spent in the air on a given energy store (minimum power speed, Vmp), distance covered using a given amount of fuel (maximum range speed, Vmr), and rate of delivering food to the chicks in the nest (Vnest), or maximize the daily energy balance (VDBAL). With the aerodynamic model employed, these speeds are 5.3, 7.0, 7.9, and 8.9 m∙s−1, respectively, for the Barn Swallow, Hirundo rustica. A comparison of the predicted flight speed with both the mean and median flight speeds (8 m∙s−1 in both cases; n = 821) recorded with Doppler radar indicates that Barn Swallows fly at speeds not significantly different from Vnest. The true sample size was unknown, and realistic sample sizes are drawn with bootstrap procedures and compared with those given by the number of measurements (821); no significant differences were found. To test the model, energy requirements for growth, prey density, and time spent foraging were varied independently in a sensitivity analysis. Large but realistic changes in these three variables do not contradict the model and predict speeds within the range measured in the field.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Hassan Emamian ◽  
Hossein Ebrahimi ◽  
Hassan Hashemi ◽  
Akbar Fotouhi

Abstract Background Previous studies have reported a high prevalence of hypertension in Iranian students, especially in rural areas. The aim of this study was to investigate the daily intake of salt in students and its association with high blood pressure. Methods A random sub-sample was selected from the participants of the second phase of Shahroud schoolchildren eye cohort study and then a random urine sample was tested for sodium, potassium and creatinine. Urine electrolyte esexcretion and daily salt intake were calculated by Tanaka et al.’s formula. Results Among 1455 participants (including 230 participants from rural area and 472 girls), the mean age was 12.9 ± 1.7 year and the mean daily salt intake was 9.7 ± 2.6 g (95% CI 9.5–9.8). The mean salt consumption in rural areas [10.8 (95% CI 10.4–11.2)] was higher than urban areas [9.4 (95% CI 9.3–9.6)], in people with hypertension [10.8 (95% CI 10.3–11.3)] was more than people with normal blood pressure [9.4 (95% CI 9.3–9.6)], and in boys [9.8 (95% CI 9.7–10.0)] was more than girls [9.3 (95% CI 9.1–9.6)]. Higher age, BMI z-score, male sex and rural life, were associated with increased daily salt intake. Increased salt intake was associated with increased systolic and diastolic blood pressure. Conclusion Daily salt intake in Iranian adolescents was about 2 times the recommended amount of the World Health Organization, was higher in rural areas and was associated with blood pressure. Reducing salt intake should be considered as an important intervention, especially in rural areas.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 376
Author(s):  
Martin Röhling ◽  
Andrea Stensitzky ◽  
Camila L. P. Oliveira ◽  
Andrea Beck ◽  
Klaus Michael Braumann ◽  
...  

Although meal replacement can lead to weight reduction, there is uncertainty whether this dietary approach implemented into a lifestyle programme can improve long-term dietary intake. In this subanalysis of the Almased Concept against Overweight and Obesity and Related Health Risk (ACOORH) study (n = 463), participants with metabolic risk factors were randomly assigned to either a meal replacement-based lifestyle intervention group (INT) or a lifestyle intervention control group (CON). This subanalysis relies only on data of participants (n = 119) who returned correctly completed dietary records at baseline, and after 12 and 52 weeks. Both groups were not matched for nutrient composition at baseline. These data were further stratified by sex and also associated with weight change. INT showed a higher increase in protein intake related to the daily energy intake after 12 weeks (+6.37% [4.69; 8.04] vs. +2.48% [0.73; 4.23], p < 0.001) of intervention compared to CON. Fat and carbohydrate intake related to the daily energy intake were more strongly reduced in the INT compared to CON (both p < 0.01). After sex stratification, particularly INT-women increased their total protein intake after 12 (INT: +12.7 g vs. CON: −5.1 g, p = 0.021) and 52 weeks (INT: +5.7 g vs. CON: −16.4 g, p = 0.002) compared to CON. Protein intake was negatively associated with weight change (r = −0.421; p < 0.001) after 12 weeks. The results indicate that a protein-rich dietary strategy with a meal replacement can improve long-term nutritional intake, and was associated with weight loss.


2019 ◽  
pp. jramc-2018-001132
Author(s):  
Pierre Perrier ◽  
J Leyral ◽  
O Thabouillot ◽  
D Papeix ◽  
G Comat ◽  
...  

IntroductionTo evaluate the usefulness of point-of-care ultrasound (POCUS) performed by young military medicine residents after short training in the diagnosis of medical emergencies.MethodsA prospective study was performed in the emergency department of a French army teaching hospital. Two young military medicine residents received ultrasound training focused on gall bladder, kidneys and lower limb veins. After clinical examination, they assigned a ‘clinicaldiagnostic probability’ (CP) on a visual analogue scale from 0 (definitely not diagnosis) to 10 (definitive diagnosis). The same student performed ultrasound examination and assigned an ‘ultrasounddiagnostic probability’ (UP) in the same way. The absolute difference between CP and UP was calculated. This result corresponded to the Ultrasound Diagnostic Index (UDI), which was positive if UP was closer to the final diagnosis than CP (POCUS improved the diagnostic accuracy), and negative conversely (POCUS decreased the diagnostic accuracy).ResultsForty-eight patients were included and 48 ultrasound examinations were performed. The present pathologies were found in 14 patients (29%). The mean UDI value was +3 (0–5). UDI was positive in 35 exams (73%), zero in 12 exams (25%) and negative in only one exam (2%).ConclusionPOCUS performed after clinical examination increases the diagnostic accuracy of young military medicine residents.


2016 ◽  
Vol 124 (4) ◽  
pp. 971-976 ◽  
Author(s):  
Kristin Huntoon ◽  
Tianxia Wu ◽  
J. Bradley Elder ◽  
John A. Butman ◽  
Emily Y. Chew ◽  
...  

OBJECT Peritumoral cysts are frequently associated with CNS hemangioblastomas and often underlie neurological morbidity and mortality. To determine their natural history and clinical impact, the authors prospectively analyzed hemangioblastoma-associated peritumoral cysts in patients with von Hippel-Lindau (VHL) disease. METHODS Patients with VHL disease who had 2 or more years of follow-up and who were enrolled in a prospective study at the National Institutes of Health were included. Serial prospectively acquired laboratory, genetic, imaging, and clinical data were analyzed. RESULTS One hundred thirty-two patients (of 225 in the VHL study with at least 2 years of follow-up) had peritumoral cysts that were followed for more than 2 years (total of 292 CNS peritumoral cysts). The mean age at study entrance was 37.4 ± 13.1 years ([mean ± SD], median 37.9, range 12.3–65.1 years). The mean follow-up was 7.0 ± 1.7 years (median 7.3, range 2.1–9.0 years). Over the study period, 121 of the 292 peritumoral cysts (41.4%) became symptomatic. Development of new cysts was associated with a larger number cysts at study enrollment (p = 0.002) and younger age (p < 0.0001). Cyst growth rate was associated with anatomical location (cerebellum cysts grew faster than spine and brainstem cysts; p = 0.0002 and p = 0.0008), younger age (< 35 years of age; p = 0.0006), and development of new neurological symptoms (p < 0.0001). Cyst size at symptom production depended on anatomical location (p < 0.0001; largest to smallest were found, successively, in the cerebellum, spinal cord, and brainstem). The most common location for peritumoral cysts was the cerebellum (184 cysts [63%]; p < 0.0001). CONCLUSIONS Peritumoral cysts frequently underlie symptom formation that requires surgical intervention in patients with VHL disease. Development of new cysts was associated with a larger number of cysts at study enrollment and younger age. Total peritumoral cyst burden was associated with germline partial deletion of the VHL gene.


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