scholarly journals Nutritional assessment and therapy in COPD: a European Respiratory Society statement

2014 ◽  
Vol 44 (6) ◽  
pp. 1504-1520 ◽  
Author(s):  
Annemie M. Schols ◽  
Ivone M. Ferreira ◽  
Frits M. Franssen ◽  
Harry R. Gosker ◽  
Wim Janssens ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Dietary Habits ◽  
Nutritional Assessment ◽  
Task Force ◽  
Nutritional Intervention ◽  
Chronic Obstructive ◽  
European Respiratory Society ◽  
Patient Counselling ◽  
Clinical Awareness ◽  
The Impact

Nutrition and metabolism have been the topic of extensive scientific research in chronic obstructive pulmonary disease (COPD) but clinical awareness of the impact dietary habits, nutritional status and nutritional interventions may have on COPD incidence, progression and outcome is limited. A multidisciplinary Task Force was created by the European Respiratory Society to deliver a summary of the evidence and description of current practice in nutritional assessment and therapy in COPD, and to provide directions for future research. Task Force members conducted focused reviews of the literature on relevant topics, advised by a methodologist. It is well established that nutritional status, and in particular abnormal body composition, is an important independent determinant of COPD outcome. The Task Force identified different metabolic phenotypes of COPD as a basis for nutritional risk profile assessment that is useful in clinical trial design and patient counselling. Nutritional intervention is probably effective in undernourished patients and probably most when combined with an exercise programme. Providing evidence of cost-effectiveness of nutritional intervention is required to support reimbursement and thus increase access to nutritional intervention. Overall, the evidence indicates that a well-balanced diet is beneficial to all COPD patients, not only for its potential pulmonary benefits, but also for its proven benefits in metabolic and cardiovascular risk.

Enteral Nutrition in the Chronic Obstructive Pulmonary Disease (COPD) Patient

2012 ◽  
Vol 25 (6) ◽  
pp. 583-585 ◽  
Author(s):  
Heather F. DeBellis ◽  
James W. Fetterman
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Enteral Nutrition ◽  
Nutritional Status ◽  
Pulmonary Disease ◽  
Dietary Habits ◽  
Physiological Stress ◽  
Nutritional Intervention ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Chronic obstructive pulmonary disease (COPD) is a progressive, chronic disease, in which malnutrition can have an undesirable effect. Therefore, the patient’s nutritional status is critical for optimizing outcomes in COPD. The initial nutrition assessment is focused on identifying calorically compromised COPD patients in order to provide them with appropriate nutrition. Nutritional intervention consists of oral supplementation and enteral nutrition to prevent weight loss and muscle mass depletion. Evaluation of nutritional status should include past medical history (medications, lung function, and exercise tolerance) and dietary history (patient’s dietary habits, food choices, meal patterns, food allergy information, and malabsorption issues), in addition to physiological stress, visceral proteins, weight, fat-free mass, and body mass index. The current medical literature conflicts regarding the appropriate type of formulation to select for nutritional intervention, especially regarding the amount of calories from fat to provide COPD patients. This review article focuses on the enteral product formulations currently available, and how they are most appropriately utilized in patients with COPD.

Nutrition as a Health Determinant in Elderly Patients

2019 ◽  
Vol 26 (19) ◽  
pp. 3652-3661 ◽  
Author(s):  
Tecla Mastronuzzi ◽  
Ignazio Grattagliano
Keyword(s):  
Nutritional Status ◽  
Elderly Population ◽  
Nutritional Assessment ◽  
Caloric Intake ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Nutritional Intervention ◽  
Social Risk ◽  
Social Risk Factors ◽  
The Impact

Background: An adequate caloric intake is a major determinant for the health status especially when degenerative conditions become a predominant risk for difficult-to-treat diseases as in aging. Methods: A structured search of literature on the major databases was performed using terms as nutrition, elderly and malnutrition. Results: According to most referenced articles, it appears to be unquestionable that both organic and social risk factors [economic hardship, loneliness, institutionalization] are important as determining causes of protein-caloric malnutrition. Some anthropometric, clinical and laboratory parameters can help to make diagnosis and quantify malnutrition. However, most of them are not cheap or are not simple to perform especially in the setting of General Practice. The application of a simple questionnaire [Mini Nutritional Assessment, MNA] allows to obtain in a fast, easy and non-invasive way a valid assessment of the nutritional status in geriatric patients. The maintenance of the nutritional status is the best measure to counteract the risk of proteincaloric malnutrition and its complications which often sneakily affects elderly population and in particular frail patients. Conclusion: This review, based on updated concepts, examines all the above mentioned points together with some aspects associated with malnutrition as an indicator of disease severity and health costs in the elderly population. Finally, the impact of nutritional intervention and nutrients supplementation on general indices of malnutrition are discussed as a promising strategy.

scholarly journals “NUTRITIONAL ASSESSMENT OF CARDIOVASCULAR DISEASE IN THE AREAS OF VISAKHAPATNAM”

2021 ◽  
pp. 54-56
Author(s):  
Vadarevu Sony ◽  
Mamidi Alekhya
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Nutritional Status ◽  
Dietary Habits ◽  
Nutritional Assessment ◽  
Saturated Fatty Acids ◽  
Anthropometric Measurement ◽  
Major Route ◽  
The Impact ◽  
Rheumatic Heart

Cardiovascular disease (CVD) is one of the most leading causes for morbidity and mortality in the worldwide. Age and other genetic factors are not only primarily responsible other factors including diabetes, hypertension lifestyles are some of the major risk factors associated with CVD. The study was designed to understand the nutritional status of the cardiovascular disease. The present study was an observational study which was carried out in Pinnacle hospital Arilova in Vishakhapatnam Andhra Pradesh. The study was designed to investigate the impact of nutritional status of cardiovascular disease patients in the age group of 40 to 70 years. A total of 100 samples were taken and the data was gathered through qualitative methods like questionnaire and interview methods. Anthropometric measurement, Biochemical parameters, clinical parameters, dietary intake was assessed by 24hours recall method and diet counselling was given. Among 100 samples 76 were male and 24 were female, stated physical status of the sample's states that majority of the samples go for walking (25%) everyday, 27% twice a week. 12% once a week and 36% never go for any physical activity. Majority of the samples (52) suffer from hypertension, (42) with atherosclerosis, (25) samples with myocardia infraction and 18 with angina pectoris, 8 with rheumatic heart disease and 4 with stroke. The study concludes the prevalence of hypertension, kidney disorders and diabetes are increasing with increase in CVD, the sedentary lifestyle and lack of physical exercise was one of the major route causes for CVD. High consumption of saturated fatty acids leads to obesity. Consumption of good dietary habits along with medication with physical activity helps in prevention and treatment of CVD.

European Respiratory Society Statement on Sleep Apnoea, Sleepiness and Driving Risk

2020 ◽  
pp. 2001272
Author(s):  
Maria R Bonsignore ◽  
Winfried Randerath ◽  
Sofia Schiza ◽  
Johan Verbraecken ◽  
Mark W Elliott ◽  
...  
Keyword(s):  
At Risk ◽  
Motor Vehicle ◽  
Task Force ◽  
Present Report ◽  
Sleep Apnoea ◽  
Accident Risk ◽  
European Respiratory Society ◽  
Obstructive Sleep ◽  
Patients At Risk ◽  
The Impact

Obstructive sleep apnoea (OSA) is highly prevalent and is a recognised risk factor for motor vehicle accidents (MVA). Effective treatment with continuous positive airway pressure (CPAP) has been associated with a normalisation of this increased accident risk. Thus, many jurisdictions have introduced regulations restricting the ability of OSA patients from driving until effectively treated. However, uncertainty prevails regarding the relative importance of OSA severity determined by the apnoea-hypopnoea frequency per hour and the degree of sleepiness in determining accident risk. Furthermore, the identification of subjects at risk for OSA and/or accident risk remains elusive. The introduction of official European regulations regarding fitness to drive prompted the European Respiratory Society to establish a Task Force to address the topic of sleep apnoea, sleepiness and driving with a view to providing an overview to clinicians involved in treating patients with the disorder. The present report evaluates the epidemiology of MVA in patients with OSA, the mechanisms involved in this association, the role of screening questionnaires, driving simulators and other techniques to evaluate sleepiness and/or impaired vigilance, the impact of treatment on MVA risk in affected drivers, and highlights the evidence gaps regarding the identification of OSA patients at risk for MVA.

Health, Developmental, and Nutritional Status of Adolescent Alcohol and Marijuana Abusers

PEDIATRICS ◽  
1987 ◽  
Vol 79 (2) ◽  
pp. 218-223
Author(s):  
James A. Farrow ◽  
Jane M. Rees ◽  
Bonnie S. Worthington-Roberts
Keyword(s):  
Liver Function ◽  
Nutritional Status ◽  
General Health ◽  
Dietary Habits ◽  
Pediatric Population ◽  
Pubertal Development ◽  
Self Report ◽  
Dietary History ◽  
Chemical Abuse ◽  
The Impact

The impact of alcohol and marijuana abuse on the physical health and nutritional status of adolescents has not been well documented. The health consequences of alcoholism and chemical abuse in adults may not relate to the pediatric population. Forty-nine adolescent boys (mean age 15.8 years) with varying degrees of alcohol and marijuana use by self-report were evaluated as to their general health, pubertal development and nutritional status using health and dietary history, physical examination, anthropometrics, and biochemical assays of liver function and tissue nutrients. Thirteen (27%) were alcohol and marijuana abusers, 20 (41%) marijuana abusers, and 16 (32%) nonusers. There were significant differences between alcohol and marijuana abusers and marijuana abusers compared to nonusers with respect to endorsing symptoms of nutritional deficiency (muscle weakness, bleeding gums, tiredness, etc) (P < .001). There were no significant differences between subgroups in other nutritional measures except plasma zinc concentration which was low in marijuana abusers (mean 85µg/dL). All adolescents reported consuming adequate nutrients, although alcohol and marijuana abusers reported eating more snack foods and less fruit, vegetables, and milk than other groups. There were no significant differences in hemotologic status (complete blood cell count, transferrin, folate), liver function (γ-glutamyltranspeptidase), or anthropometric and sexual maturational indices of growth. There were no chronic signs of chemical abuse by physical examinations. It appears that health and nutritional disability from chemical abuse in adolescents relates more to poor dietary habits and symptomatic deterioration in general health than to specific effects on growth or nutritional status. Studies with larger numbers of subjects need to document these findings.

scholarly journals Management of COPD exacerbations: a European Respiratory Society/American Thoracic Society guideline

2017 ◽  
Vol 49 (3) ◽  
pp. 1600791 ◽  
Author(s):  
Jadwiga A. Wedzicha ◽  
Marc Miravitlles ◽  
John R. Hurst ◽  
Peter M.A. Calverley ◽  
Richard K. Albert ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Antibiotic Therapy ◽  
Pulmonary Rehabilitation ◽  
Task Force ◽  
Chronic Obstructive ◽  
Noninvasive Mechanical Ventilation ◽  
European Respiratory Society ◽  
Copd Exacerbations ◽  
Home Based ◽  
Hospitalised Patients

This document provides clinical recommendations for treatment of chronic obstructive pulmonary disease (COPD) exacerbations.Comprehensive evidence syntheses, including meta-analyses, were performed to summarise all available evidence relevant to the Task Force's questions. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach and the results were summarised in evidence profiles. The evidence syntheses were discussed and recommendations formulated by a multidisciplinary Task Force of COPD experts.After considering the balance of desirable and undesirable consequences, quality of evidence, feasibility, and acceptability of various interventions, the Task Force made: 1) a strong recommendation for noninvasive mechanical ventilation of patients with acute or acute-on-chronic respiratory failure; 2) conditional recommendations for oral corticosteroids in outpatients, oral rather than intravenous corticosteroids in hospitalised patients, antibiotic therapy, home-based management, and the initiation of pulmonary rehabilitation within 3 weeks after hospital discharge; and 3) a conditional recommendation against the initiation of pulmonary rehabilitation during hospitalisation.The Task Force provided recommendations related to corticosteroid therapy, antibiotic therapy, noninvasive mechanical ventilation, home-based management, and early pulmonary rehabilitation in patients having a COPD exacerbation. These recommendations should be reconsidered as new evidence becomes available.

scholarly journals Telemedicine in chronic obstructive pulmonary disease

Breathe ◽  
2016 ◽  
Vol 12 (4) ◽  
pp. 350-356 ◽  
Author(s):  
Nicolino Ambrosino ◽  
Guido Vagheggini ◽  
Stefano Mazzoleni ◽  
Michele Vitacca
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Task Force ◽  
Chronic Obstructive ◽  
List Type ◽  
European Respiratory Society ◽  
Obstructive Pulmonary Disease ◽  
Economic Issues ◽  
Legal Problems

Telemedicine is a medical application of advanced technology to disease management. This modality may provide benefits also to patients with chronic obstructive pulmonary disease (COPD). Different devices and systems are used. The legal problems associated with telemedicine are still controversial. Economic advantages for healthcare systems, though potentially high, are still poorly investigated. A European Respiratory Society Task Force has defined indications, follow-up, equipment, facilities, legal and economic issues of tele-monitoring of COPD patients including those undergoing home mechanical ventilation.Key pointsThe costs of care assistance in chronic disease patients are dramatically increasing.Telemedicine may be a very useful application of information and communication technologies in high-quality healthcare services.Many remote health monitoring systems are available, ensuring safety, feasibility, effectiveness, sustainability and flexibility to face different patients’ needs.The legal problems associated with telemedicine are still controversial.National and European Union governments should develop guidelines and ethical, legal, regulatory, technical, administrative standards for remote medicine.The economic advantages, if any, of this new approach must be compared to a “gold standard” of homecare that is very variable among different European countries and within each European country.The efficacy of respiratory disease telemedicine projects is promising (i.e.to tailor therapeutic intervention; to avoid useless hospital and emergency department admissions, and reduce general practitioner and specialist visits; and to involve the patients and their families).Different programmes based on specific and local situations, and on specific diseases and levels of severity with a high level of flexibility should be utilised.A European Respiratory Society Task Force produced a statement on commonly accepted clinical criteria for indications, follow-up, equipment, facilities, legal and economic issues also of telemonitoring of ventilator-dependent chronic obstructive pulmonary disease patients.Much more research is needed before considering telemonitoring a real improvement in the management of these patients.Educational aimsTo clarify definitions of aspects of telemedicineTo describe different tools of telemedicineTo provide information on the main clinical resultsTo define recommendations and limitations

scholarly journals Core outcome set for the management of acute exacerbations of chronic obstructive pulmonary disease: the COS-AECOPD ERS Task Force study protocol

2020 ◽  
Vol 6 (3) ◽  
pp. 00193-2020
Author(s):  
Alexander G. Mathioudakis ◽  
Fekri Abroug ◽  
Alvar Agusti ◽  
Per Bakke ◽  
Konstantinos Bartziokas ◽  
...  
Keyword(s):  
Study Protocol ◽  
Task Force ◽  
Core Outcome Set ◽  
Measurement Instrument ◽  
Chronic Obstructive ◽  
Core Outcome ◽  
European Respiratory Society ◽  
Copd Exacerbations ◽  
Outcome Set ◽  
Multi Stakeholder

Randomised controlled trials (RCTs) on the management of COPD exacerbations evaluate heterogeneous outcomes, often omitting those that are clinically important and patient relevant. This limits their usability and comparability. A core outcome set (COS) is a consensus-based minimum set of clinically important outcomes that should be evaluated in all RCTs in specific areas of health care. We present the study protocol of the COS-AECOPD ERS Task Force, aiming to develop a COS for COPD exacerbation management, that could remedy these limitations.For the development of this COS we follow standard methodology recommended by the COMET initiative. A comprehensive list of outcomes is assembled through a methodological systematic review of the outcomes reported in relevant RCTs. Qualitative research with patients with COPD will also be conducted, aiming to identify additional outcomes that may be important to patients, but are not currently addressed in clinical research studies. Prioritisation of the core outcomes will be facilitated through an extensive, multi-stakeholder Delphi survey with a global reach. Selection will be finalised in an international, multi-stakeholder meeting. For every core outcome, we will recommend a specific measurement instrument and standardised time points for evaluation. Selection of instruments will be based on evidence-informed consensus.Our work will improve the quality, usability and comparability of future RCTs on the management of COPD exacerbations and, ultimately, the care of patients with COPD. Multi-stakeholder engagement and societal support by the European Respiratory Society will raise awareness and promote implementation of the COS.

scholarly journals Assessment of Nutritional Status of Adolescent College Girls at Rawalpindi

2010 ◽  
Vol 15 (1) ◽  
Author(s):  
Afshan Shahid ◽  
Farah Rashid Siddiqui ◽  
Mohammad Ayaz Bhatti ◽  
Mahmood Ahmed ◽  
Mohammad Wasif Khan
Keyword(s):  
Vitamin A ◽  
Nutritional Status ◽  
Adolescent Girls ◽  
Dietary Habits ◽  
Nutritional Assessment ◽  
Vitamin A Deficiency ◽  
Clinical Signs ◽  
Cross Sectional ◽  
Education And Health ◽  
Nutrient Consumption

Objectives: To assess the nutritional status of adolescent college girls by assessing the dietary intake in terms of carbohydrates,proteins, Estimating the hemoglobin levels in the study group and studying the clinical signs of malnutrition withspecial emphasis to vitamin A, iron and iodine deficiency.Design of Study: A cross-sectional study.Settings: Two Post-Graduate women colleges of Rawalpindi.Study Duration: 9 Months (From Jan 2006 to September 2006).Materials and Methods: Nutritional status of 508 adolescent girls was assessed with a questionnaire, clinical examinationand biochemical estimation (hemoglobin). The data thus collected was analyzed in July 2006 on computer with the help ofStatistical Package for Social Sciences (SPSS) and Excel.Results: Results revealed that 20%of girls were having BMI <18.5, 77% above 18.5% and 3% were obese. 57.09% of thegirls had goiter out of which 52.96% had palpable goiter and 4.13% had visible goiter. Pallor conjunctiva was seen in 1%girls. No clinical signs of Vitamin A deficiency were seen. Biochemical results indicated that 32.87% of the girls was sufferingfrom Iron deficiency anemia.Conclusions: Large longitudinal and cross-sectional studies, regarding nutrient consumption, dietary habits and nutritionalintervention are required in the adolescent girls. These studies can be thought provoking for the policy maker at thegovernment level. Nutritional education and health promotion can be used as tool to improve the health status of the nation.Key Words: Adolescent Health, Nutrition, Nutritional Assessment.

scholarly journals Effects of Polypharmacy on Appetite and Malnutrition Risk Among Institutionalized Lebanese Older Adults - Preliminary Results

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 69-69
Author(s):  
Berna Rahi ◽  
Tracy Daou ◽  
Nour Gereige ◽  
Yara Issa ◽  
Yara Moawad ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Homes ◽  
Nutritional Status ◽  
Dietary Habits ◽  
Nutritional Assessment ◽  
Short Form ◽  
Significant Risk ◽  
Nursing Home Residents ◽  
Mini Nutritional Assessment ◽  
Significant Difference

Abstract Objectives We aimed to assess the polypharmacy effect on appetite and malnutrition risk among Lebanese nursing home residents. We hypothesized that polypharmacy will be associated to lower appetite and increased of malnutrition. Methods A cross-sectional pilot study was carried out in two nursing homes in the North-Lebanon region. Fifty-three older adults (OA) aged 60 and above were recruited and were interviewed face-to-face. A general questionnaire was administered to gather information about their socio-demographics, dietary habits and physical activity routine. Appetite was evaluated by the Simplified Nutritional Appetite Questionnaire (SNAQ) validated for use with nursing homes residents. The participants' nutritional status was assessed using the Short Form of the Mini-Nutritional Assessment (MNA-SF). Polypharmacy was determined if OA were taking 5 or more medications. Information about attitudes towards the use, the number and the cost of medications was also collected. Differences in SNAQ and MNA scores based on polypharmacy were tested using Independent t-tests. Logistic regression was performed to assess the association between polypharmacy and nutritional status after adjusting for several factors. Results Our sample constituted of 49.1% females with an average age of 67.6 ± 3.8 and BMI of 22.3 ± 1.7 kg/m2. The majority were widowed (79.2%) and had a low level of education (85% elementary education). Regarding the MNA scores, 33% had a normal nutritional status while 59% were at risk of malnutrition and 8% were malnourished, with an average MNA score of 10.1 ± 2.2. The average SNAQ score was 11.0 ± 3.3, with 85% scoring ≤14, indicating an significant risk of at least 5% weight loss withing 6 months. Regarding medication use, 50.9% of OA take at least 5 drugs/d with an average of 4.3 ± 2 drugs. Independent t-tests showed that MNA scores were significantly lower in those taking 5 drugs/d vs those taking less (9.4 ± 2.5 vs 10.8 ± 1.6, P = .024) while no significant difference was observed for SNAQ scores (10.3 ± 2.9 vs 11.6 ± 3.6, P = .13). Logistic regressions did not show any significant association between polypharmacy and MNA or SNAQ categories. Conclusions Lower MNA scores were observed in OA taking ≥5 drugs/d indicating a higher risk of malnutrition with polypharmacy. This is significant since malnutrition can further worsen the aging process. Funding Sources N/A.

Sign in / Sign up

Export Citation Format

Share Document