9 research outputs found
Methods for assessing protein-energy malnutrition for patients on hemodialysis
Prema literaturi, proteinsko - energetska malnutricija jedna je od najÄeÅ”Äih komplikacija kod pacijenata na hemodijalizi. Cilj ovog rada bio je procijeniti nutritivni status pacijenata na hemodijalizi te odrediti optimalni naÄin procjene. U istraživanju je sudjelovao 71 ispitanik, 40 muÅ”karaca i 31 žena, Äiji medijan trajanja hemodijalize iznosi 31 mjesec. Nutritivna procjena provedena je pomoÄu antropometrijskih i biokemijskih metoda, upitnika za procjenu nutritivnog statusa i kliniÄkog pregleda. Rezultati pokazuju da najveÄi broj ispitanika ima normalnu (47,9 %), a 38 % prekomjernu tjelesnu masu. SGA metodom (eng. Subjective Global Assessment) utvrÄena je izrazita malnutricija kod 38 % ispitanika Äime se ova metoda pokazala kao najrigoroznija, dok je MST (eng. Malnutrition Screening Tool) najmanje stroga i ujedno, uz MUST (eng. Malnutrition Universal Screening Tool), najjednostavnija i najbrža metoda za provedbu pri procjeni nutritivnog statusa pacijenata na hemodijalizi. Äak 96 % pacijenata ima hipoalbuminemiju koja se javlja kao rezultat loÅ”eg prehrambenog unosa i smatra se jakim prediktorom mortaliteta kod pacijenata na hemodijalizi.According to literature, protein - energy malnutrition is one of the most common complications for patients on hemodialysis. The aim of this study was to assess nutritional status of patients on hemodialysis and determine the optimal way of assessment. The study included 71 patients, 40 males and 31 females, whose median of hemodialysis duration is 31 months. Nutritional assessment was carried out with anthropometric and biochemical methods, questionnaires for assessing nutritional status and clinical examination. The results have shown that most of the respondents have normal body mass (47,9 %) while 38 % are overweight. SGA method (Subjective Global Assessment) determined severe malnutrition for 38 % of respondents which makes it the most rigorous method, while MST (Malnutrition Screening Tool) is the least strict and also, with MUST (Malnutrition Universal Screening Tool), the easiest and fastest method for assessing nutritional status of patients on hemodialysis. Even 96 % of patients have hypoalbuminemia which is the result of bad nutritional intake and is considered to be a strong mortality predictor for patients on hemodialysis
Percepcija tijela i uÄestalost ortoreksije nervoze u mladih osoba u Hrvatskoj
The prevalence of eating disorders in young people is steadily increasing, which brings orthorexia nervosa into focus, especially in pandemic and stress-related periods. Therefore, the aim of this study was to determine the prevalence of orthorexia nervosa in young people and relate it to anthropometric parameters, eating habits and perception of body appearance. This study included 191 participants aged 18-24 years, of which 85,9 % females. Data on body mass and height were collected, from which body mass index was calculated, while their eating attitudes were evaluated by using 5-point scale. The prevalence of orthorexia nervosa was assessed using the ORTO-15 questionnaire, while the Physical Appearance Comparison Scale - Revised (PACS-R) was used to assess participantās appearance comparison tendencies with other people. It was found that 38.2% of the respondents had orthorexia nervosa. There were no statistically significant differences in the body mass index between the participants with or without the diagnosis of orthorexia (p=0.276). Nevertheless, in the group of participants not diagnosed with orthorexia, those with adequate body weight predominated (89.9%), while among subjects diagnosed with orthorexia the proportions of undernourished (8.2%) and overweight participants (15.1%) were higher. Participants with orthorexia found a healthy diet more important than subjects without orthorexia (p=0.001), while there were no statistically significant differences in self-rated diet quality between the two groups (p=0.815). Furthermore, there was a statistically significant negative correlation between the results of PACS-R and ORTO-15 (p<0.01). Ultimately, there was a statistically significant difference in the results of PACS-R between participants with or without the diagnosis of orthorexia (p=0.032). High share of participants was diagnosed with orthorexia nervosa. Even though young people who developed orthorexia nervosa mostly had normal body weight, they had a greater tendency to compare their physical appearance to the appearance of others, what indicated distorted perception of their own body image. This brings to attention the importance of educating young people, especially female, about healthy diet, and confirms the necessity of an interdisciplinary approach in treating orthorexia nervosa, including psychological support.Prevalencija poremeÄaja hranjenja u mladih ljudi u stalnom je porastu, Å”to dovodi u fokus ortoreksiju nervozu, osobito u razdobljima pandemije i stresa. Stoga je cilj ovog istraživanja bio utvrditi prevalenciju ortoreksije nervoze u mladih ljudi i povezati je s antropometrijskim parametrima, prehrambenim navikama i percepcijom tjelesnog izgleda. Ovo istraživanje ukljuÄivalo je 191 ispitanika u dobi od 18-24 godine, od Äega je 85,9 % ženskog spola. Prikupljeni su podaci o tjelesnoj masi i visini ispitanika iz kojih je izraÄunat indeks tjelesne mase. Prevalencija ortoreksije nervoze procijenjena je pomoÄu upitnika ORTO-15, dok je upitnik PACS-R (eng. Physical Appearance Comparison Scale ā Revised) koriÅ”ten za procjenu tendencije usporedbe tjelesnog izgleda ispitanika s drugim osobama. UtvrÄeno je da 38,2 % ispitanika ima ortoreksiju nervozu. Nije bilo statistiÄki znaÄajnih razlika u indeksu tjelesne mase izmeÄu ispitanika s obzirom na ortoreksiju nervozu (p=0,276). Ipak, u skupini ispitanika bez utvrÄene ortoreksije prevladavali su oni s adekvatnom tjelesnom masom (89,9 %), dok je meÄu ispitanicima s utvrÄenom ortoreksijom bio veÄi udio pothranjenih ispitanika (8,2 %) i onih s prekomjernom tjelesnom masom (15,1 %). Ispitanicima s ortoreksijom pravilna prehrana je važnija nego ispitanicima bez ortoreksije (p=0,001), dok statistiÄki znaÄajne razlike u samoprocjeni kvalitete prehrane nije bilo (p=0,815). Nadalje, utvrÄena je statistiÄki znaÄajna negativna korelacija izmeÄu rezultata PACS-R i ORTO-15 (p<0,01). U konaÄnici, postojala je statistiÄki znaÄajna razlika u rezultatima PACS-R izmeÄu ispitanika obzirom na utvrÄenu ortoreksiju (p=0,032). Ortoreksija nervoza utvrÄena je kod velikog broja ispitanika. Iako su mlade osobe koje su razvile ortoreksiju nervozu uglavnom adekvatne tjelesne mase, imaju veÄu sklonost usporeÄivati svoj fiziÄki izgled s izgledom drugih, Å”to upuÄuje na iskrivljenu percepciju vlastitog tijela. Ovime se skreÄe pozornost na važnost educiranja mladih osoba o pravilnoj prehrani, posebice žena, te se potvrÄuje važnost interdisciplinarnog pristupa u lijeÄenju ortoreksije nervoze, koja bi trebala ukljuÄivati i psiholoÅ”ku
podrŔku
Breastfeeding: Health benefits and dietary recommendations
Dojenje je prirodan naÄin hranjenja novoroÄenÄeta jer mu pruža sve neophodne hranjive tvari potrebne za odgovarajuÄi rast i razvoj. TakoÄer,
dojenje je osjetljivo razdoblje kada se stvara emocionalna i tjelesna veza izmeÄu majke i djeteta, pružajuÄi djetetu osjeÄaj sigurnosti, opuÅ”tenosti
i nježnosti. U skladu s navedenim, posveÄenost institucija i raznih udruga za podizanje druÅ”tvene i zdravstvene svijesti te promicanje važnosti
dojenja neprestano rastu. Svjetska zdravstvena organizacija (SZO) preporuÄuje iskljuÄivo dojenje tijekom prvih Å”est mjeseci djetetovog života,
Å”to djetetu pruža brojne kratkoroÄne i dugoroÄne koristi. Kada se govori o koristima dojenja, naglasak se stavlja prvenstveno na dobrobit djeteta,
dok bi potrebe dojilja trebale biti od jednake važnosti. Razdoblje laktacije i dojenja zahtijeva veÄi majÄin energijski unos u usporedbi s razdobljem
posljednjeg tromjeseÄja trudnoÄe kako bi se zadovoljile sve potrebe majke i djeteta za mikro- i makronutrijentima. KoliÄina i sastav mlijeka, odnosno
kvaliteta prehrane dojenÄeta, dijelom ovisi o kvaliteti majÄine prehrane, a dijelom o majÄinim tjelesnim zalihama iz kojih se nadoknaÄuju hranjive
tvari u sluÄaju nedovoljnog prehrambenog unosa. Kako bi se izbjegli negativni uÄinci laktacije i dojenja na prehrambeni i zdravstveni status majke u
nadolazeÄim životnim razdobljima, presudno je posvetiti posebnu pozornost raznovrsnoj, uravnoteženoj i energijski zadovoljavajuÄoj prehrani. Iako
je primarni cilj postiÄi preporuÄeni unos svih esencijalnih hranjivih sastojaka prehranom, u sluÄajevima neuravnotežene prehrane, zdravstvenih
problema ili prakticiranja restriktivne dijete, potrebna je primjena dodataka prehrani. Zbog poveÄanih bioloÅ”kih potreba i utvrÄenih deficita, u
dodacima prehrani za trudnice Äesto se mogu naÄi željezo, kalcij, cink, jod, folat te vitamini B12, C i D
Combining hand grip strength with nutritional screening tools in elderly patients with chronic kidney disease
Malnutrition in vulnerable patient populations must be rapidly detected using techniques that are easy to incorporate into everyday clinical practice.
The new recommendations defined the 7-point Subjective Global Assessment (SGA) as optimal for nutritional assessment in chronic kidney disease
(CKD), while Geriatric Nutrition Risk Index (GNRI) demands additional examination in elderly. This study aimed to determine the accuracy of
several concise tools used in the clinical practice and the correlation of this tools with functional method hand grip strength (HGS) in elderly patients
with CKD. In this cross-sectional study, anthropometric and functional data for 50 elderly hemodialysis patients were analyzed using numerous
survey-based tools for screening nutritional status (Malnutrition Screening Tool ā MST, Nutritional Risk Screening 2002 - NRS2002, Malnutrition
Universal Screening Tool - MUST, Mini Nutritional Assessment - MNA, GNRI), which we compared to the standard 7-point SGA nutritional
assessment tool. The sensitivity, specificity, and accuracy of these tools for detecting malnutrition were compared with the standard by using receiver
operating characteristic (ROC) curve analysis. 7-point SGA classified 36.6% of participants as well nourished, and 63.4% as mildly to moderately
malnourished, while the simplest alternative methods showed lower accuracy, classifying much higher proportions of participants as well nourished
(MST, 92.0%; NRS2002, 80.4%). MNA had the highest accuracy based on receiver operating characteristic curves. HGS correlated moderately with
7-point SGA (r = 0.331), MNA (r = 0.410), and GNRI (r = 0.320). Our small study suggests that MNA is the best tool for malnutrition risk screening
in elderly with CKD. Combining HGS with concise tools, such as GNRI, may provide better results and unburden healthcare professionals
Nutritional status of hemodialysis patients
Hemodialysis patients are vulnerable population group and they, among other, should take special care on food and fluid intake with emphasis on energy, potassium, phosphorus, sodium and protein intake. The nutritional status of patients (n=14) was assessed through measurement of body weight, body height, upper arm circumference, lower leg circumference and handgrip dynamometry; as well as selected biochemical parameters: urate concentration, calcium and phosphate levels, total protein, creatinine, albumin and globulin ratio and C-reactive protein; and dietary assessment method: 3-day food record (3DD). Using range between 18.5 and 24.9 kg/m2 as cut-off, 35.7 and 57% of patients were classified as adequately nourished and overweight, respectively. According to results of 3DD, most of the subjects are supposed to align their micro- and macro- nutrients intake with the recommendations, with emphasis on the increasing intake of protein and energy as well as on decreasing intake of potassium, phosphorus, sodium and energy
THE IMPACT OF EDUCATION ABOUT SPECIFIC COOKING METHODS ON SERUM POTASSIUM LEVELS IN PATIENTS ON HEMODIALYSIS
Progression of chronic kidney disease often results with developing hyperkalemia; the increased serum level of potassium, which causes cardiac, neuromuscular and gastrointestinal complications. Hyperkalemia is generally associated with cardiac arhythmias and higher risk of mortality in patients on hemodialysis. The aim was to determine the impact of education on potassium control among patients on hemodialysis, while basing additional education on potassium-reducing techniques during food preparation and applying diet prepared accordingly to learned techniques. Participants were 47 patients on hemodialysis divided in control (n=22) and intervention (n=25) groups. All participants were educated by trained dietitian and received materials about proper nutrition at the beginning of the 1-year longitudinal study. The intervention group was educated additionally on potassium-reducing food preparation techniques. While both groups received two hospital meals per day during hemodialysis, meals for the intervention group were prepared accordingly to suggested food preparation techniques. Biochemical parameters were monitored during the study according to standard methods. The results showed that there was significant change in reduction of serum levels of potassium in intervention group compared to control group after one year of the study (p=0.037). Also, monthly serum levels of potassium were significantly reduced (p<0.05), compared to baseline of the study, during first 8 months in the control group and during all 12 months in the intervention group. Education about food preparation, proper diet alterations and its implementation can be useful in decreasing serum potassium levels and preventing hyperkalemia in patients on hemodialysis
Methods for assessing protein-energy malnutrition for patients on hemodialysis
Prema literaturi, proteinsko - energetska malnutricija jedna je od najÄeÅ”Äih komplikacija kod pacijenata na hemodijalizi. Cilj ovog rada bio je procijeniti nutritivni status pacijenata na hemodijalizi te odrediti optimalni naÄin procjene. U istraživanju je sudjelovao 71 ispitanik, 40 muÅ”karaca i 31 žena, Äiji medijan trajanja hemodijalize iznosi 31 mjesec. Nutritivna procjena provedena je pomoÄu antropometrijskih i biokemijskih metoda, upitnika za procjenu nutritivnog statusa i kliniÄkog pregleda. Rezultati pokazuju da najveÄi broj ispitanika ima normalnu (47,9 %), a 38 % prekomjernu tjelesnu masu. SGA metodom (eng. Subjective Global Assessment) utvrÄena je izrazita malnutricija kod 38 % ispitanika Äime se ova metoda pokazala kao najrigoroznija, dok je MST (eng. Malnutrition Screening Tool) najmanje stroga i ujedno, uz MUST (eng. Malnutrition Universal Screening Tool), najjednostavnija i najbrža metoda za provedbu pri procjeni nutritivnog statusa pacijenata na hemodijalizi. Äak 96 % pacijenata ima hipoalbuminemiju koja se javlja kao rezultat loÅ”eg prehrambenog unosa i smatra se jakim prediktorom mortaliteta kod pacijenata na hemodijalizi.According to literature, protein - energy malnutrition is one of the most common complications for patients on hemodialysis. The aim of this study was to assess nutritional status of patients on hemodialysis and determine the optimal way of assessment. The study included 71 patients, 40 males and 31 females, whose median of hemodialysis duration is 31 months. Nutritional assessment was carried out with anthropometric and biochemical methods, questionnaires for assessing nutritional status and clinical examination. The results have shown that most of the respondents have normal body mass (47,9 %) while 38 % are overweight. SGA method (Subjective Global Assessment) determined severe malnutrition for 38 % of respondents which makes it the most rigorous method, while MST (Malnutrition Screening Tool) is the least strict and also, with MUST (Malnutrition Universal Screening Tool), the easiest and fastest method for assessing nutritional status of patients on hemodialysis. Even 96 % of patients have hypoalbuminemia which is the result of bad nutritional intake and is considered to be a strong mortality predictor for patients on hemodialysis
Važnost interdisciplinarnog pristupa lijeÄnika i nutricionista u zbrinjavanju pacijenata
Interdisciplinaran pristup koji ukljuÄuje suradnju izmeÄu lijeÄnika i nutricionista kljuÄan je u lijeÄenju bolesti i stanja povezanih s prehranom. Taj holistiÄki pristup omoguÄuje cjelovitu brigu o pacijentima, uzimajuÄi u obzir njihove prehrambene potrebe i ciljeve. Cilj ovog rada bio je procijeniti opÄe znanje o prehrani meÄu lijeÄnicima, specijalistima gastroenterologije, endokrinologije, medicine rada, opÄe prakse te nutricionistima. Podaci o znanju prikupljeni su pomoÄu validiranog upitnika modificiranog za potrebe istraživanja kako bi se procijenili razliÄiti aspekti znanja o prehrani. Rezultati su pokazali znaÄajne razlike u odgovorima s obzirom na lijeÄniÄku specijalizaciju, pri Äemu su endokrinolozi postigli najbolje rezultate (71,5 Ā± 3,54). Nutricionisti su postigli opÄenito bolje rezultate (71,31 Ā± 3,59) u usporedbi s lijeÄnicima (63,23 Ā± 6,23), Å”to ukazuje na važnost njihove ukljuÄenosti u podruÄje prehrambene skrbi. Dobiveni rezultati naglaÅ”avaju važnost multidisciplinarnog pristupa i uspostavljanja suradnje izmeÄu lijeÄnika i nutricionista kako bi se osigurala optimalna prehrambena skrb za pacijente