Ehkäise, tunnista ja hoida vanhuksen vajaaravitsemus

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Ehkäise, tunnista ja hoida vanhuksen vajaaravitsemus

Vertaisarvioitu.• Vanhusten vajaaravitsemus on yleistä myös Suomessa. Se hankaloittaa merkittävästi lääketieteellistä hoitoa. • Vajaaravitsemusriskin tunnistaminen ja varhainen hoito säästävät terveyden- huollon kustannuksia. Vajaaravitun potilaan hoitaminen voi maksaa jopa kolme kertaa niin paljon kuin normaalissa ravitsemustilassa olevan. • Hyvä ravitsemustila tukee vanhusten toimintakykyä ja itsenäistä elämää. • Säännöllinen punnitseminen, vajaaravitsemuksen seulonta ja aktiivinen ravitsemushoito kuuluvat jokaisen ikäihmisen hoitopolkuun

Ehkäise, tunnista ja hoida vanhuksen vajaaravitsemus

Vanhusten vajaaravitsemus on yleistä myös Suomessa. Se hankaloittaa merkittävästi lääketieteellistä hoitoa.Vajaaravitsemusriskin tunnistaminen ja varhainen hoito säästävät terveydenhuollon kustannuksia. Vajaaravitun potilaan hoitaminen voi maksaa jopa kolme kertaa niin paljon kuin normaalissa ravitsemustilassa olevan.Hyvä ravitsemustila tukee vanhusten toimintakykyä ja itsenäistä elämää.Säännöllinen punnitseminen, vajaaravitsemuksen seulonta ja aktiivinen ravitsemushoito kuuluvat jokaisen ikäihmisen hoitopolkuun.</p

Economy matters to fight against malnutrition: results from a multicenter survey

Background and Aim: Malnutrition represents a serious health care threat, as it increases morbidity, mortality and health care cost. The effective screening and treatment with enteral (EN) or parenteral (PN) nutrition are the key elements of the policy called Optimal Nutrition Care for All (ONCA). The study tried to analyze the impact of the state’s economy on the implementation of EN and PN to define its role in ONCA. Material and Methods: an international survey in twenty two European countries was performed between January and December 2014. An electronic questionnaire was distributed to 22 representatives of clinical nutrition (PEN) societies. The questionnaire comprised questions regarding country economy, reimbursement, education and the use EN and PN. Return rate was 90.1% (n=20) Results: EN and PN were used in all countries surveyed (100%), but to different extent. The country’s income significantly influenced the reimbursement for EN and PN (p0.05). Education was actively carried out in all countries, however the teaching at the pre-graduate level was the least widespread, and also correlated with the country income (p=0.042). Conclusions: Results indicated that economic situation influences all aspects of ONCA, including education and treatment. The reimbursement for EN and PN seemed to be the key factor of effective campaign against malnutrition

Vajaaravitsemuksen kustannukset

Tiivistelmä Vajaaravitsemus maksaa Suomen terveydenhuollolle vuodessa yli 600 miljoonaa euroa. Kustannuksia kerryttävät erityisesti pitkittynyt ja komplisoitunut sairaala- tai laitoshoito sekä toipumisen pitkittyminen. Aikuispotilaalla sairaalaan tullessa todettu tai hoitojakson aikana kehittynyt vajaaravitsemustila aiheuttaa 2 900−6 564 euron kustannuksen hoitojaksoa kohti. Kustannuksia on mahdollista vähentää varhaisella riskin tunnistamisella ja tehostetulla ravitsemuksella.Abstract The cost of malnutrition is rising, especially because of prolonged hospital stays due to infections and other complications resulting from malnutrition. Substantial increases in costs are caused by prolonged diseases or prolonged recovery from injuries or operations, partly caused by malnutrition. Malnutrition present at admission or developing during the hospital stay causes additional costs of 2 900−6 564 euros per patient. Malnutrition in Finland costs over 600 million euros annually. This sum could be reduced by early malnutrition detection and intensified nutritional treatment

ESPEN guideline on hospital nutrition

Funding Information: This guideline was solely financed by ESPEN , the European Society for Clinical Nutrition and Metabolism. Publisher Copyright: © 2021 Elsevier Ltd and European Society for Clinical Nutrition and MetabolismIn hospitals through Europe and worldwide, the practices regarding hospital diets are very heterogeneous. Hospital diets are rarely prescribed by physicians, and sometimes the choices of diets are based on arbitrary reasons. Often prescriptions are made independently from the evaluation of nutritional status, and without taking into account the nutritional status. Therapeutic diets (low salt, gluten-free, texture and consistency modified, …) are associated with decreased energy delivery (i.e. underfeeding) and increased risk of malnutrition. The European Society for Clinical Nutrition and Metabolism (ESPEN) proposes here evidence-based recommendations regarding the organization of food catering, the prescriptions and indications of diets, as well as monitoring of food intake at hospital, rehabilitation center, and nursing home, all of these by taking into account the patient perspectives. We propose a systematic approach to adapt the hospital food to the nutritional status and potential food allergy or intolerances. Particular conditions such as patients with dysphagia, older patients, gastrointestinal diseases, abdominal surgery, diabetes, and obesity, are discussed to guide the practitioner toward the best evidence based therapy. The terminology of the different useful diets is defined. The general objectives are to increase the awareness of physicians, dietitians, nurses, kitchen managers, and stakeholders towards the pivotal role of hospital food in hospital care, to contribute to patient safety within nutritional care, to improve coverage of nutritional needs by hospital food, and reduce the risk of malnutrition and its related complications.Peer reviewe

Formation and validation of the healthy diet index (Hdi) for evaluation of diet quality in healthcare

Lack of tools to evaluate the quality of diet impedes dietary counselling in healthcare. We constructed a scoring for a validated food intake questionnaire, to measure the adherence to a healthy diet that prevents type 2 diabetes (T2D). The Healthy Diet Index (HDI) consists of seven weighted domains (meal pattern, grains, fruit and vegetables, fats, fish and meat, dairy, snacks and treats). We studied the correlations of the HDI with nutrient intakes calculated from 7-day food records among 52 men and 25 women, and associations of HDI with biomarkers and anthropometrics among 645 men and 2455 women. The HDI correlated inversely with total fat (Pearson’s r = −0.37), saturated fat (r = −0.37), monounsaturated fat (r = −0.37), and the glycaemic index of diet (r = −0.32) and positively with carbohydrates (r = 0.23), protein (r = 0.25), fibre (r = 0.66), magnesium (r = 0.26), iron (r = 0.25), and vitamin D (r = 0.27), (p < 0.05 for all). In the linear regression model adjusted for BMI and age, HDI is associated inversely with waist circumference, concentrations of fasting and 2-h glucose and triglycerides in men and women, total and LDL cholesterol in women, and fasting insulin in men (p < 0.05 for all). The HDI proved to be a valid tool to measure adherence to a health-promoting diet and to support individualised dietary counselling.publishedVersionPeer reviewe