Assessment of the nutritional status

A desnutrição é reconhecida como um dos principais problemas médicos, especialmente em países em desenvolvimento. Os métodos para avaliar o estado nutricional de indivíduos em grupos populacionais foram extensivamente tratados na literatura médica. O objetivo principal desta revisão foi proporcionar uma análise crítica da avaliação nutricional bioquímica e antropométrica.Malnutrition is recognized as one of the major medical clinical problem, especially in developing countries. The means to assess the nutricional status of individuals or population groups have been extensively discussed in medical literature. The main objective of this review is providing a critical analysis of anthropometric and biochemical nutritional evaluation

Clinical and Nutritional characterization of patients with massive intestinal resection in Ribeirão Preto, SP, Brazil

Background: Short bowel syndrome (SBS) is a clinical situation due to extensive intestinal resection or dysfunction of the absorptive system of the small intestine. When these patints are not submitted to nutritional therapy their maximum survival is six months. In Brazil there are few reference centers for the treatment and follow-up of these patients and information about their characterization is scarce. Objective: To describe enterectomized patients attended during the period from 1996 to 2007. Methods: All medical records of the patients attended at the Nutrology service of HCFMRP-USP were analyzed retrospectively. Data were collected and analyzed descriptively using the contingency test and the Wilcoxon- Mann-Whitney test for independent samples. Results: Thirty-eight patients with a mean age of 52 years at the time of enterectomy were analyzed, 47% of them males and 53% females. The main etiology of SBS was mesenteric ischemia (73%). Of these patients, 67% had some risk factor associated with atherosclerosis. No significant differences in eating habits were detected between the period before and after surgery. After surgery, 39% of the patients developed a significant weight loss and 79% developed some type of complication, surgical in 34%, infectious in 66% and of both types in 21%. Survival was 9.5 years. Conclusion: Extensive resections of the small bowel may be associated with atherosclerosis and represent an important nutritional risk, with a significant weight loss during the first year, which seems to be related to increased morbidity. Adequate nutritional therapy is associated with increased survival

Iron peptide complex does not increase blood iron concentration at the same extent as ferrous sulfate after oral ingestion in healthy adult males

Iron-deficient anemia continues to be one of the major nutritional and public health problems all over the world. Although ferrous sulfate is largely used for the prevention and treatment of this deficiency, the gastrointestinal side effects preclude its use in some cases. This study aimed to compare the effect of iron peptide complex and ferrous sulfate on serum iron and to examine serial serum iron levels. Ten volunteers were submitted to 5 different treatments: Control (C), Ferrous sulfate 60 mg (FS), Iron peptide 60 mg (IP1), Iron peptide 80 mg (IP2) and Iron peptide 60 mg plus diet (IPD). In the first treatment (C), empty capsules were given, whereas in the second (FS), third (IP1), fourth (IP2) and fifth (IPD) treatments, ferrous sulfate 60 mg, iron peptide complex 60 mg, iron peptide complex 80 mg and iron peptide complex 60 mg plus diet were given in a randomized crossover design, with a washout period of 1 week. The products were offered as capsules and blood samples were drawn at the following time points: 0, 30, 60, 120, 240, 480 and 720 minutes after oral intake. FS produced higher serum iron levels than Control, IP1, IP2 and IPD (P< 0.05). The areas under the curves for serum iron for the different compounds gave AUCFS > AUCC = AUCIP1 = AUCIP2 = AUCIPD. Conclusions: The iron peptide complex did not increase blood iron FS C IP1 IP2 IPD concentration as compared to control and ferrous sulfate at the respective time points

Anthropometric evolution and gastrointestinal complaints in oral nutritional supplementation and enteral nutritional therapy

OBJETIVO: Em pacientes hospitalizados, comparar a evolução de variáveis antropométricas e a ocorrência de efeitos adversos relacionados ao consumo de suplementos nutricionais e infusão de nutrição enteral. MÉTODOS: 10 pacientes que recebiam suplementos nutricionais (Grupo SN) e 20 em nutrição enteral (Grupo NE), pareados para o gênero, idade (50 ± 21 vs 49 ± 23 anos) e afecções de base foram submetidos à avaliação antropométrica ao início e término da terapêutica. Diariamente, foi aplicado um questionário semi-estruturado referente às queixas gastrointestinais. Determinaram-se as diferenças estatísticas obtidas entre o início e o final da terapêutica (teste t para amostras dependentes) e entre os grupos de estudo (teste t para amostras independentes). RESULTADOS: A circunferência muscular do braço aumentou nos pacientes do Grupo NE (80 ± 15 vs 85 ± 15% de adequação, p = 0,009) e diminuiu no Grupo SN (96 ± 14 vs 92 ± 14% de adequação, p = 0,04). Náuseas e vômitos foram mais frequentes no Grupo SN (60 vs 10%, p = 0,01) e as queixas relacionadas ao sabor dos produtos ocorreram em 30% dos casos. CONCLUSÃO: Os pacientes que receberam suplementos nutricionais apresentaram maior ocorrência de queixas gastrointestinais e evolução desfavorável dos parâmetros antropométricos. Os dados obtidos no estudo não evidenciam o benefício da suplementação nutricional de rotina em pacientes hospitalizados.OBJECTIVE: To compare the evolution of anthropometric variables and the occurrence of adverse effects related to the ingestion of nutritional food supplements and enteral diet administration in hospitalized patients. METHODS: The study was performed in the Clinical Medicine wards of the Hospital of the School of Medicine of Ribeirão Preto, USP, with 10 patients receiving nutrition supplements, and 20 patients under enteral nutrition therapy, paired by gender, age (50 ± 21 vs 49 ± 23 years) and basic afflictions. All were volunteers submitted to anthropometric evaluation at the beginning and end of nutritional therapy, utilizing standard techniques. A semi-structured questionnaire was applied daily referring to gastrointestinal complaints. Statistical differences between onset and final results (t-test for dependent samples) and between-group differences (t-test for independent samples) were estimated. RESULTS: Arm muscle circumference increased in patients receiving enteral nutrition therapy (80 ± 15 vs 85 ± 15% adequacy, p = 0.009) and decreased in those receiving nutritional supplements (96 ± 14 vs 92 ± 14% adequacy, p = 0.04). Nausea and vomiting were more frequent in the latter (60 vs 10%, p = 0.01); complaints about taste of the products were reported by 30% of the cases. CONCLUSION: Patients who received oral nutrition supplements reported gastrointestinal complaints and had a less favorable anthropometric evolution. Study data did not disclose the benefit of routine nutrition supplements for hospitalized patients